Evaluation of web-based annotation of ophthalmic images for multicentric clinical trials.

An Internet browser-based annotation system can be used to identify and describe features in digitalized retinal images, in multicentric clinical trials, in real time. In this web-based annotation system, the user employs a mouse to draw and create annotations on a transparent layer, that encapsulates the observations and interpretations of a specific image. Multiple annotation layers may be overlaid on a single image. These layers may correspond to annotations by different users on the same image or annotations of a temporal sequence of images of a disease process, over a period of time. In addition, geometrical properties of annotated figures may be computed and measured. The annotations are stored in a central repository database on a server, which can be retrieved by multiple users in real time. This system facilitates objective evaluation of digital images and comparison of double-blind readings of digital photographs, with an identifiable audit trail. Annotation of ophthalmic images allowed clinically feasible and useful interpretation to track properties of an area of fundus pathology. This provided an objective method to monitor properties of pathologies over time, an essential component of multicentric clinical trials. The annotation system also allowed users to view stereoscopic images that are stereo pairs. This web-based annotation system is useful and valuable in monitoring patient care, in multicentric clinical trials, telemedicine, teaching and routine clinical settings.

Patterns of cardiac disorders and epidemiology of coronary artery disease in urban population of Ahmedabad.

A hospital based study of coronary artery disease (CAD) was carried out in Gujaratis, admitted to Dr Jivraj Mehta Smarak Health Foundation, Ahmedabad. Total 276 subjects were surveyed. CAD was diagnosed by ECG criteria. Prevalence of CAD in hospital admission was 29.6%. Highest incidence of CAD was seen in the age group of 51 to 60 years. Male/female ratio was 1.6:1. As a single risk factor hypertension was ranked first, next was obesity followed by hyperlipidaemia, diabetes, tobacco habits, and family history of CAD. Overall mortality of CAD was 3.99%, being 1.83% for angina pectoris (AP) and 5.39% for myocardial infarction (MI). Mortality rate was higher in subjects having 2 or more risk factors. Incidence of CAD in young (age < 40 years) was very low (1.09%).

Transfemoral extraction of knotted pulmonary artery catheter in right atrium.

Knotting of a pulmonary artery catheter (PAC) is a rare complication which is usually seen to occur in the right ventricle. We describe knotting of a PAC in the right atrium and its extraction by non surgical means through the femoral route.