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The described technique has the potential to improve the success rate of axillary vein access and minimize complications during pacemaker implantation.

Macular edema (ME) and central serous retinopathy (CSR) are two macular diseases that affect the central vision of a person if they are left untreated. Optical coherence tomography (OCT) imaging is the latest eye examination technique that shows a cross-sectional region of the retinal layers and that can be used to detect many retinal disorders in an early stage. Many researchers have done clinical studies on ME and CSR and reported significant findings in macular OCT scans. However, this paper proposes an automated method for the classification of ME and CSR from OCT images using a support vector machine (SVM) classifier. Five distinct features (three based on the thickness profiles of the sub-retinal layers and two based on cyst fluids within the sub-retinal layers) are extracted from 30 labeled images (10 ME, 10 CSR, and 10 healthy), and SVM is trained on these. We applied our proposed algorithm on 90 time-domain OCT (TD-OCT) images (30 ME, 30 CSR, 30 healthy) of 73 patients. Our algorithm correctly classified 88 out of 90 subjects with accuracy, sensitivity, and specificity of 97.77%, 100%, and 93.33%, respectively.

Objective. To assess the knowledge and perception of primary school teachers regarding autism in private and public schools of Karachi, Pakistan. Methods. A cross-sectional survey was conducted on primary school teachers in different districts of Karachi. A sample size of 170 teachers was selected by purposive sampling. Primary data was collected using self-administered questionnaires. These questions assessed the teacher's knowledge and perception of Autism. Data was entered on SPSS version 20. Frequencies and percentages were taken out for categorical variables. Results. Of the total 170 teachers, 85 were from the Private and 85 from Public sector schools. 55% (n = 94) of the teachers knew about Autism through the media and only 9% (n = 15) had formal training through workshops on Autism. 62% (n = 105) of the teachers were of the opinion that Autism is treatable. Majority of the teachers (57%) said that proper training is required for teaching autistic children. Conclusion. The knowledge related to Autism in our existing sample has mostly come from the media. Although we cannot undermine the role of media, there is a need to give formal training to teachers regarding the differentiating features of Autism, which in turn will aid in early diagnosis of the disease.

This study aims to provide estimates, trends and projections of vision loss burden in Pakistan from 1990 to 2025. Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2017) was used to observe the vision loss burden in terms of prevalence and Years Lived with Disability (YLDs). As of 2017, out of 207.7 million people in Pakistan, an estimated 1.12 million (95% Uncertainty Interval [UI] 1.07–1.19) were blind (Visual Acuity [VA] <3/60), 1.09 million [0.93–1.24] people had severe vision loss (3/60≤VA<6/60) and 6.79 million [6.00–7.74] people had moderate vision loss (6/60≤VA<6/18). Presbyopia was found to be the most common ocular condition that affected an estimated 12.64 million [11.94–13.41] people (crude prevalence 6.08% [5.75–6.45]; 61% female). In terms of age-standardized YLDs rate, Pakistan is ranked fourth among other South Asian countries and twenty-first among other 42 low-middle income countries (classified by World Bank), with 552.98 YLDs [392.98–752.95] per 100,000. Compared with 1990, all-age YLDs count of blindness and vision impairment increased by 55% in 2017, which is the tenth highest increase among major health loss causes (such as dietary iron deficiency, headache disorders, low back pain etc.) in Pakistan. Moreover, our statistics show an increase in vision loss burden by 2025 for which Pakistan needs to make more efforts to encounter the growing burden of eye diseases.

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Macula is an oval shaped area near the center of human retina that covers the area of 5500 microns and at its center, there is a small pit known as fovea with the diameter of 1500 microns. Macular disorders involve group of diseases that damages macula resulting in blindness or vision loss. Macular Edema 'ME' is the most common disease related to macula. The symptoms for this disease usually appear in final stages to patient when it is very difficult to cure it and at that time it causes severe damage to central vision. However if it is detected in early stages then it can be easily cured. Different techniques that are used to detect ME are Fundus Photography (also known as Fundography), Fundus Fluorescein Angiography 'FFA' and Optical Coherence Tomography 'OCT'. Earlier, Fundography was the most widely used test to detect ME. But now a days OCT is being widely used for detecting ME due to its ability to detect small changes in sub-retinal layers. In this paper, we present a detailed comparison between Fundography and OCT imaging technology for the detection of Macular Edema using our own dataset provided to us by Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi. Total 64 patients were studied in this experiment by examining their fundus and OCT images where 15 patients had ME while 49 were healthy persons. OCT images provide an objective evaluation of early macular edema as compared to Fundography.

The newly driven concept of electronic health (eHealth) has made distance irrelevant in healthcare. eHealth, which is commonly known as an electronic form of healthcare, refers broadly to the use of advanced information and communication technology within healthcare environments. However, its practical implementation poses many sets of challenges. One of the major challenges is authentication and integrity verification of vital medical data. Proper verification of patients with associated medical images or data is crucial to conduct accurate medical diagnostics. This paper presents an imperceptible watermarkingbased security framework to address the issues of authentication and integrity verification of medical images for eHealth applications. The electronic patient record (EPR), as a watermark image, is embedded in optical coherence tomography (OCT)/fundus scan (consisting of healthy and diseased scans), using a hybrid watermarking technique based on fast curvelet transform (FCT) and singular value decomposition (SVD). The proposed work showed a high level of robustness, imperceptibility, and security for medical images when compared with the state-of-the-art existing watermarking techniques. In addition, we conducted a comparative analysis of the watermarked OCT/fundus scans with non-watermarked scans, and our results validate that the insertion of the watermark in the retinal images does not affect the automated medical image diagnosis of various retinal pathologies. Moreover, the correct recovery of the EPR from the watermarked scans makes the proposed framework applicable to the authentication of medical images for a computerbased automated diagnostic system in an eHealth arrangement.