A secure routing approach based on league championship algorithm for wireless body sensor networks in healthcare.

Patients must always communicate with their doctor for checking their health status. In recent years, wireless body sensor networks (WBSNs) has an important contribution in Healthcare. In these applications, energy-efficient and secure routing is really critical because health data of individuals must be forwarded to the destination securely to avoid unauthorized access by malicious nodes. However, biosensors have limited resources, especially energy. Recently, energy-efficient solutions have been proposed. Nevertheless, designing lightweight security mechanisms has not been stated in many schemes. In this paper, we propose a secure routing approach based on the league championship algorithm (LCA) for wireless body sensor networks in healthcare. The purpose of this scheme is to create a tradeoff between energy consumption and security. Our approach involves two important algorithms: routing process and communication security. In the first algorithm, each cluster head node (CH) applies the league championship algorithm to choose the most suitable next-hop CH. The proposed fitness function includes parameters like distance from CHs to the sink node, remaining energy, and link quality. In the second algorithm, we employs a symmetric encryption strategy to build secure connection links within a cluster. Also, we utilize an asymmetric cryptography scheme for forming secure inter-cluster connections. Network simulator version 2 (NS2) is used to implement the proposed approach. The simulation results show that our method is efficient in terms of consumed energy and delay. In addition, our scheme has good throughput, high packet delivery rate, and low packet loss rate.

Evaluation of Prevalence and Associated Factors of Dry Eye Syndrome among Medical Students Exposed to Visual Display Terminal in Health Campus, Universiti Sains Malaysia

@#Introduction: Dry eye syndrome (DES) has become a public health concern, especially during the COVID-19 pandemic. Medical students are at risk due to an increase in visual display terminal (VDT) exposure given the transition to full-time online lectures. The presence of reduced blink rate and tear film instability in VDT users causes an increase in tear evaporation leading to symptoms of DES. This study helps us to learn about the associated factors of VDT use and DES among the young generation. This study aims to determine the prevalence and associated factors of DES among medical students exposed to VDT at the health campus, Universiti Sains Malaysia (USM). Methods: A cross-sectional study involving 140 undergraduate medical students aged 22 to 29 years old who were VDT users. Factors analysed are age, gender, race and duration of VDT usage. Data collection included both subjective assessment (OSDI questionnaire) and objective assessment (TBUT and Schirmer’s test). Statistical analysis was conducted using Statistical Package for the Social Science (SPSS Inc Version 24). Results were analysed using descriptive analysis and multivariate logistic regression. Results: Most of the medical student cohort was female and Malay. Most of the students use VDT for less than 8 hours. A high incidence of DES was noted among medical students (92.1%). None of the factors showed significant association with positive findings DES by subjective and objective assessment and duration of VDT usage. Conclusion: DES is common among VDT users. This study showed a high prevalence of DES among medical students in USM. The factors analysed did not show a significant association between DES and duration of VDT usage. This study may help to recognize the problem and will raise awareness of their daily practice and implement preventive measures to avoid VDT-related DES.

Correction to: Automatic COVID-19 detection mechanisms and approaches from medical images: a systematic review.

[This corrects the article DOI: 10.1007/s11042-022-12952-7.].

An Analysis of New Feature Extraction Methods Based on Machine Learning Methods for Classification Radiological Images.

The lungs are COVID-19's most important focus, as it induces inflammatory changes in the lungs that can lead to respiratory insufficiency. Reducing the supply of oxygen to human cells negatively impacts humans, and multiorgan failure with a high mortality rate may, in certain circumstances, occur. Radiological pulmonary evaluation is a vital part of patient therapy for the critically ill patient with COVID-19. The evaluation of radiological imagery is a specialized activity that requires a radiologist. Artificial intelligence to display radiological images is one of the essential topics. Using a deep machine learning technique to identify morphological differences in the lungs of COVID-19-infected patients could yield promising results on digital images of chest X-rays. Minor differences in digital images that are not detectable or apparent to the human eye may be detected using computer vision algorithms. This paper uses machine learning methods to diagnose COVID-19 on chest X-rays, and the findings have been very promising. The dataset includes COVID-19-enhanced X-ray images for disease detection using chest X-ray images. The data were gathered from two publicly accessible datasets. The feature extractions are done using the gray level co-occurrence matrix methods. K-nearest neighbor, support vector machine, linear discrimination analysis, naïve Bayes, and convolutional neural network methods are used for the classification of patients. According to the findings, convolutional neural networks' efficiency linked to imaging modalities with fewer human involvements outperforms other traditional machine learning approaches.

Automatic COVID-19 detection mechanisms and approaches from medical images: a systematic review.

Since early 2020, Coronavirus Disease 2019 (COVID-19) has spread widely around the world. COVID-19 infects the lungs, leading to breathing difficulties. Early detection of COVID-19 is important for the prevention and treatment of pandemic. Numerous sources of medical images (e.g., Chest X-Rays (CXR), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI)) are regarded as a desirable technique for diagnosing COVID-19 cases. Medical images of coronavirus patients show that the lungs are filled with sticky mucus that prevents them from inhaling. Today, Artificial Intelligence (AI) based algorithms have made a significant shift in the computer aided diagnosis due to their effective feature extraction capabilities. In this survey, a complete and systematic review of the application of Machine Learning (ML) methods for the detection of COVID-19 is presented, focused on works that used medical images. We aimed to evaluate various ML-based techniques in detecting COVID-19 using medical imaging. A total of 26 papers were extracted from ACM, ScienceDirect, Springerlink, Tech Science Press, and IEEExplore. Five different ML categories to review these mechanisms are considered, which are supervised learning-based, deep learning-based, active learning-based, transfer learning-based, and evolutionary learning-based mechanisms. A number of articles are investigated in each group. Also, some directions for further research are discussed to improve the detection of COVID-19 using ML techniques in the future. In most articles, deep learning is used as the ML method. Also, most of the researchers used CXR images to diagnose COVID-19. Most articles reported accuracy of the models to evaluate model performance. The accuracy of the studied models ranged from 0.84 to 0.99. The studies demonstrated the current status of AI techniques in using AI potentials in the fight against COVID-19.

Changes of Ocular Biometry and Intraocular Pressure in Patients Treated With Intravitreal Injection of Antivascular Endothelial Growth Factors

@#Introduction: Anti-vascular endothelial growth factors (anti-VEGF) intravitreal injection is one of the popular procedures for medical retina diseases. However, the incidence of angle-closure post intravitreal injection was reported. Several similar studies were conducted previously, but the results were inconsistent and mostly focused on bevacizumab. Methods: A prospective cohort study was conducted. After informed consent, patients who were more than 17 years old and received the first intravitreal anti-VEGF injections (ranibizumab or aflibercept) were recruited. Exclusion criteria included patients with underlying glaucoma, ocular hypertension, intumescence cataract, high refractive error or those with history of intraocular operation or ocular trauma. Pre- and post-injection’s intraocular pressure (IOP) and ocular biometry included “central anterior chamber depth” (CACD), “angle opening distance” (AOD500), and “trabeculo-iris angle” (TIA500) at nasal and temporal 500 µm away the scleral spur were acquired and analyzed. Results: 72 eyes from 66 patients were studied. Mean (SD) increment of IOP following injection within 30 minutes and 1 hour were 6.16 (0.68) mmHg (p<0.001) and 1.26 (0.35) mmHg (p=0.002) respectively. Mean (SD) differences of temporal TIA500 between pre with within 30 minutes and 1-hour post-injection were 1.66 (0.66) degrees (p=0.04) and 1.45 (0.57) degrees (p=0.04) respectively. No significant relationship between the changes of IOP and ocular biometry was found. Conclusion: A single dose of anti-VEGF in a normal population is relatively safe. However, concern on the risk of glaucoma progression and acute angle-closure still needs to be addressed. Further studies on at-risk populations and repeated injections are useful.

A Rare Ocular Manifestation of Idiopathic Hypertrophic Cranial Pachymeningitis.

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare form of thickening of the dura mater. There are limited reports on the ocular manifestation of IHCP and its treatment. Up to our knowledge, there is no report on bilateral superior ophthalmic veins (SOV) dilatation with IHCP and there are only a few reports on anterior scleritis with IHCP. We report a 62-year-old gentleman with underlying hypertension and chronic headache who presented with fever, headache, and unresolving both eyes redness as manifestations of bilateral anterior scleritis, anterior uveitis, secondary glaucoma, and multiple cranial nerve palsies. Magnetic resonance imaging of the brain showed global thickening and enhancement of the pachymeninges with bilateral SOV dilatations. The diagnosis of IHCP was made after ruling out infective and autoimmune causes. The patient was treated with oral prednisolone, oral azathioprine, topical timolol maleate, topical dexamethasone, and topical moxifloxacin. The patient was successfully treated and was stable throughout two years review. In conclusion, unresolved red eyes with headaches can be an early presentation of IHCP. Pathophysiology and treatment of the ocular manifestations and IHCP were discussed.

Lower eyelid fornix deepening: A new indication for the facial artery myomucosal flap

Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.

Case Series on Drug Reaction with Eosinophilia and Systemic Syndrome (DRESS) with Different Ocular Manifestation

@#“Drug reaction with eosinophilia and systemic syndrome” (DRESS) is a rare type of “severe cutaneous adverse reaction” (SCAR). We report 3 patients with DRESS who had different presentations. The first case developed DRESS following initiation of Allopurinol a month earlier. He presented with bilateral pseudomembranous conjunctivitis which resolved after 2 weeks. Two months later he presented with bilateral severe meibomian gland dysfunction (MGD), ocular surface disease (OSD) with severe dry eyes and left eye corneal perforation. The second case developed DRESS following initiation of allopurinol and had bilateral conjunctivitis. As for the third case, DRESS happened after taking Roxithromycin. She was diagnosed to have bilateral MGD, blepharitis and dry eyes. Case 2 and 3 did not develop ocular long-term complications. DRESS can cause acute and long-term ocular complications and therefore, following up patients with DRESS is essential to treat any complications with the aim to prevent corneal perforation.

Kimura Disease as a Rare Cause of Proptosis: A Case Report

ABSTRACT@#Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.

Traumatic Globe Displacement Into Anterior Cranial Fossa

@#A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haematoma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe repositioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.

Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls.

AIM: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness measured via optical coherence tomography (OCT) between different groups of myopia severity and controls. METHODS: This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia (LM) [spherical equivalent (SE) from greater than -0.5 D, up to -3.0 D], moderate myopia (MM; SE greater than -3.0 D, up to -6.0 D) and high myopia (HM; SE greater than -6.0 D). The control group consisted of emmetropic (EM) patients (SE from +0.5 D to -0.5 D). A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance. RESULTS: A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23y. There were 180 (44.7%) eyes with EM, 124 (30.8%) with LM, 73 (18.1%) with MM and 26 (6.5%) with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group (P=0.017). Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group (P=0.017). CONCLUSION: The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.

Neuroretinitis in ocular bartonellosis: a case series.

We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

Open globe injury in Hospital Universiti Sains Malaysia - A 10-year review.

AIM: To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome. METHODS: Retrospective review of medical records of open globe injury cases that presented from January 2000 to December 2009. Classification of open globe injury was based on the Birmingham Eye Trauma Terminology (BETT). Records were obtained with hospital permission via the in-house electronic patient management system, and the case notes of all patients with a diagnosis of open globe injury were scrutinised. Patients with prior ocular trauma, pre-existing ocular conditions affecting the visual acuity, contrast sensitivity, central vision or corneal thickness, as well as those with a history of previous intraocular or refractive surgery were excluded. Analysis of data was with SPSS version 20.0. Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome. RESULTS: This study involved 220 patients (n=222 eyes). The most common place of injury was the home (51.8%), followed by the workplace (23.4%). Among children aged less than 16y of age, domestic-related injury was the predominant cause (54.6%), while in those aged 16y and above, occupational injuries were the most common cause (40.0%). Most eyes (76.5%) had an initial visual acuity worse than 3/60, and in half of these, the visual acuity improved. The visual outcome was found to be significantly associated with the initial visual acuity (P<0.005), posterior extent of wound (P<0.001), length of wound (P<0.001), presence of hyphaema (P<0.001) and presence of vitreous prolapse ((P<0.005). CONCLUSION: The most common causes of open globe injury are domestic accidents and occupational injuries. Significant prognostic factors for final visual outcome in patients with open globe injury are initial visual acuity, posterior extent and length of wound, presence of hyphaema and presence of vitreous prolapse. Awareness of the factors predicting a poor visual outcome may be helpful during counselling of patients with open globe injuries.

Successful treatment of syphilitic uveitis in HIV-positive patients.

We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV)-positive patients at Malaysia's Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3) and panuveitis (case 2). Each patient showed a high Venereal Disease Research Laboratory (VDRL) titer at presentation and they were also newly diagnosed as HIV positive with variable CD4 counts. All three patients responded well to a neurosyphilis regimen of intravenous penicillin G. At 3 months posttreatment, there was reduction in VDRL titer with improvement of vision in the affected eye. Diagnosis of syphilis needs to be ruled out in all cases of uveitis. All syphilitic uveitis cases should have HIV screening and vice versa, as syphilis is one of the most common infectious diseases associated with HIV-positive patients. Early detection and treatment are important for a good visual outcome.

Candida glabrata endophthalmitis following penetrating keratoplasty in a patient with negative donor rim culture.

BACKGROUND: Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture. CASE PRESENTATION: A 63-year-old patient, diagnosed Fuch's endothelial dystrophy in both eyes underwent a penetrating keratoplasty in his right eye. He had multiple underlying medical problems, which included diabetes mellitus, hypertension, hypoadrenalism on oral dexamethasone and fatty liver secondary to hypertrigliseridemia. He developed multiple suture abscesses, corneal haziness, retrocorneal white plaques and a level of hypopyon two weeks after an uneventful penetrating keratoplasty in his right eye. Cultures of the donor button and the transport media culture were negative. Candida glabrata was isolated successfully from the aqueous and vitreous taps. He was treated with a combination of topical, intracameral, intravitreal and intravenous Amphotericin B. His final visual acuity remained poor due to the haziness of the corneal button. CONCLUSION: Candida glabrata endophthalmitis following penetrating keratoplasty can occur in negative donor rim and transport media cultures. The growth of the organism is facilitated by the patient's immunocompromised status. Awareness by the ophthalmologists and appropriate choice of antibiotics are mandatory in this challenging condition.

A unilateral mild anterior uveitis due to intralenticular foreign body / 国际眼科杂志(Guoji Yanke Zazhi)

A 25-year man presented with symptom of photophobia and tearing in the right eye for 2 months duration. It was associated with painless gradual reduced vision. There was a history of hammering on a metal object prior to that. Ocular examination revealed signs of mild anterior uveitis due to a retained metallic intralenticular foreign body. Conjunctiva was white. Computed Tomography (CT) scan of the orbit confirmed presence of a single intraocular foreign body. The condition is misleading and can be easily overlooked. A detailed history and clinical examination are mandatory in this misleading situation.

Dental infection presenting with ipsilateral parapharyngeal abscess and contralateral orbital cellulitis – A case report

A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomography showed left orbital cellulitis and right parapharyngeal abscess. There was also evidence suggestive of a dental abscess over right upper alveolar region. Magnetic resonance imaging revealed left superior ophthalmic vein thrombosis. Emergency drainage of the right parapharyngeal abscess was performed. Right maxillary molar extraction revealed periapical abscess. Left eye proptosis markedly reduced after initiating heparin.