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Background: Farm workers and female cotton pickers are exposed to residual impacts of pesticide use in cotton production, in addition to dust, ultraviolet radiation, etc. Cotton picking causes various health hazards among cotton pickers with varied health cost. A soil bacterium known as Bacillus thuringiensis (Bt) is incorporated in cotton seed through genetic modification and it has resistance against certain bollworms of cotton. So it is considered that Bt cotton fields have less pesticide exposure compared to non-Bt cotton fields. This study was designed to examine and compare the impacts and health cost of cotton picking among female cotton pickers working in Bt and non-Bt cotton fields., Methods: The study used the data collected from Vehari district of Pakistani Punjab. Health hazards and associated health cost of the respondents involved in Bt cotton picking were compared with those who harvested non-Bt cotton. Comparative use of the personal protective measures among those respondents was also examined. Health cost function and its determinants were analyzed using ordinary least square method., Results: Findings of the study showed that 61 % cotton pickers from Bt cotton households reported one or more health effects of pesticide during picking season whereas this percentage for non-Bt cotton households was 66 %. Health impacts included skin problems, headache, cough, flu/fever, eye irritation and sleeplessness, however, percentage of these health impacts was comparatively higher among non-Bt cotton households. Health cost from exposure to pesticide use in cotton was US$ 5.74 and 2.91 per season for non-Bt cotton and Bt cotton households, respectively. Education, picking in Bt cotton fields and preventive measures were significantly related with health cost., Conclusion: Cotton pickers working in Bt cotton fields are found to have less occupational health hazards compared to those working in non-Bt cotton fields. Thus generating awareness among cotton pickers for adopting precautionary measures during harvesting and the use of Bt cotton seed can result in a decline in the ill-effects of cotton picking.

Background: Pediatric Intensive Care Unit (PICU) patients are often prescribed antibiotics with a low threshold in comparison to patients elsewhere. Irrational antibiotics use can lead to rapid emergence of drug resistance, so surveillance of their use is important., Objectives: To evaluate the use of antibiotics in relation to bacteriological findings in PICU of a Tertiary Hospital., Methods: Retrospective review of medical records of all children (age 1 month-16 years) admitted in our closed multidisciplinary-cardiothoracic PICU from January to June 2013 was performed, after approval from Ethical Review Committee. For each antibiotic, indication (prophylactic, empiric, therapeutic) and duration of use were recorded. All diagnoses of infections were recorded according to diagnostic criteria of IPSCC 2005. Results are presented as frequency and percentages and median with inter quartile range using SPSS version 19., Results: All of the total 240 patients admitted in PICU during the study period received antibiotics: 43% (n = 104) prophylactically, 42% (n = 102) empirically, and 15% (n = 15) therapeutically. Median number of antibiotic use per patient in PICU was 3, with range of 1-7. 25% received 1 antibiotic, 23% received 2 antibiotics, 29% received 3 antibiotics, and rest received ≥4 antibiotics. Most commonly used antibiotics were cefazolin, meropenem, vancomycin and ceftriaxone, and most frequently used combination was meropenem and vancomycin. In majority of the cases, (70%) empiric antibiotic combinations were stopped in 72 h., Conclusion: This is the first report of antibiotics use in PICU from our country, which shows that antibiotics are prescribed universally in our PICU. Strategies to assess the need for antibiotic use are needed.

Intracerebral hemorrhage (ICH) in children is a rare but disabling disease that accounts for almost half cases of stroke. We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were <1 year. On presentation 44% had vomiting, 42% had seizures, and GCS < 8 while 40% had altered level of consciousness. Single bleed was present in 88%, 94% had supratentorial bleed, and 32% had intraventricular extension. 72% had bleed volume of <30 mL and 8% had >60 mL. CT scan was done in 98% patients and MRI in 34%, while 6% underwent conventional angiography. 60% patients were managed conservatively, 36% underwent neurosurgical intervention, and 6% underwent radiological vascular intervention. Hematologic causes were identified in 52% patients and vascular malformations in 14% and in 26% no cause could be identified. 26% of patients expired.

This paper examines the impact of trade openness and foreign direct investment (FDI) on life expectancy using time series data over the period of 1972-2013. We have applied structural break unit root as well as cointegration tests to examine integrating properties of the variables and cointegration among the variables. The causal linkage between the variables has been tested by applying the VECM Granger causality. The empirical evidence confirms the presence of cointegration amid the variables. Moreover, trade openness and FDI increase population health measured by life expectancy in the long-run. Furthermore, the analysis suggests that trade openness and FDI cause life expectancy in the short-run. These findings have several policy implications to improve life expectancy for the people of Pakistan in particular and other developing countries in general., (© Springer Science+Business Media Dordrecht 2015.)

Chondrocytes are the exclusive cells residing in cartilage and maintain the functionality of cartilage tissue. Series of biocomponents such as different growth factors, cytokines, and transcriptional factors regulate the mesenchymal stem cells (MSCs) differentiation to chondrocytes. The number of chondrocytes and dedifferentiation are the key limitations in subsequent clinical application of the chondrocytes. Different culture methods are being developed to overcome such issues. Using tissue engineering and cell based approaches, chondrocytes offer prominent therapeutic option specifically in orthopedics for cartilage repair and to treat ailments such as tracheal defects, facial reconstruction, and urinary incontinence. Matrix-assisted autologous chondrocyte transplantation/implantation is an improved version of traditional autologous chondrocyte transplantation (ACT) method. An increasing number of studies show the clinical significance of this technique for the chondral lesions treatment. Literature survey was carried out to address clinical and functional findings by using various ACT procedures. The current study was conducted to study the pharmacological significance and biomedical application of chondrocytes. Furthermore, it is inferred from the present study that long term follow-up studies are required to evaluate the potential of these methods and specific positive outcomes.

Objective: To determine the efficacy of N-acetylcysteine (NAC) in children aged > 1 month to 16 years admitted with Fulminant Hepatic Failure (FHF) secondary to Acute Viral Hepatitis (AVH) in a tertiary care center of a developing country., Study Design: Analytical study., Place and Duration of Study: Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan, from January 2007 to December 2011., Methodology: Medical records of children (> 1 month - 16 years) with FHF admitted with AVH of known etiology who received NAC were reviewed retrospectively. Liver function tests (mean ± SD) at baseline, 24 hours after NAC and before or at the time of discharge/death were recorded and compared via using repeated measures ANOVA(r-ANOVA). Efficacy of NAC is defined in improvement in biochemical markers, liver function test and discharge disposition (survived or died). Mortality associated risk factors were identified by using logistic regression analysis. P-value and 95% confidence interval were recorded., Results: Forty children (mean age was 80 ± 40 months) with FHF secondary to AVH received NAC. Majority were males (n=25; 63%). Vomiting (75%) and jaundice (65%) were the main presenting symptoms, one-third had hypoglycemic, while 40% had altered sensorium at the time of admission. There was significant statistical difference in liver enzymes and prothrombin time on admission comparing at discharge in children received NAC (p < 0.001). Fifteen (38%) children died. Severe vomiting {Odds Ratio (OR) 0.22, 95% Confidence Interval (CI) 0.05 - 0.8}, jaundice (OR 9.3, CI 1.1 - 82.6), inotropic support (OR 20.6, CI 3.5 - 118.3) and mechanical ventilation (OR 4.3, CI 1.1 - 16.6) at the time of admission are associated with risk factors for mortality in children with FHF secondary to AVH., Conclusion: NAC used in children with FHF secondary to AVH is associated with markedly improved liver function tests and recovery. FHF with complications is high risk for mortality.

A series of aralkanoic acids was converted into aralkanoic acid hydrazides through their esters formation. The aralkanoic acid hydrazides upon treatment with carbon disulfide and methanolic potassium hydroxide yielded potassium dithiocarbazinate salts, which on refluxing with aqueous hydrazine hydrate yielded 5-aralkyl-4-amino-3-mercapto-1,2,4-triazoles. The target compounds, 3-aralkyl-6-(substitutedquinolinyl)[1,2,4]triazolo[3,4-b][1,3,4]thiadiazoles, were synthesized by condensing various quinolinyl substituted carboxylic acids with 5-aralkyl-4-amino-3-mercapto-1,2,4-triazoles in phosphorus oxychloride. The structures of the newly synthesized triazolothiadiazoles were characterized by IR, 1H NMR, 13C NMR, and elemental analysis studies. The structure of one of the 5-aralkyl-4-amino-3-mercapto-1,2,4-triazoles was unambiguously deduced by single crystal X-ray diffraction analysis. All the synthesized compounds were screened for their acetylcholinesterase inhibition activities. Four of the triazolothiadiazoles exhibited excellent acetylcholinesterase inhibition activities as compared to the reference inhibitor.

Two naphthalene derivatives, naphthalene-2,3-dicarboxylic acid (NDA) and 1,8-dimethoxynaphthalene (DMN) were screened for antioxidant and anti-diabetic activities. Biological antioxidant studies revealed NDA as more effective antioxidant as compared to DMN. Both compounds significantly increased the cholesterol level but showed varied biological activities as regards glucose and triglyceride concentrations. The cytotoxicity results evidenced DMN to significantly inhibit the cell proliferation in a dose dependent manner with IC₅₀ of 0.13 mM. Like the biological antioxidant studies, the electrochemical results also witnessed NDA as stronger antioxidant than DMN. The pH dependent spectrophotometric and electrochemical behavior was investigated in order to provide useful mechanistic insights about the biological role of the selected compounds., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To assess the burden and spectrum of neurological illness in a pediatric intensive care unit and review the associated mortality., Methods: Retrospective review of medical records of children (1 mo-16 years) with acute neurological diagnosis admitted in PICU in Aga Khan University hospital from January 2008 to December 2011 was done. Basic demographic, diagnosis, neuro diagnostic procedures performed, therapies and outcomes were done on a structured datasheet., Results: During study period, 231 (19.3%) patients were admitted with acute neurological illnesses in PICU. The mean age was 67 ±50 months, 54% (n=125) was under-five and 138 (59.7%) were males. Out of total, 144 (62.3%) had neurological illness and 87 (37.7%) had neurosurgical diagnosis. In acute neurological illness, 51.5% (n=119) had non-traumatic-coma (NTC) and 10.8% (n=25) had neuromuscular illness. CNS infection (26%, n=60) in structural cause and status epilepticus (10%, n=23) were the most common cause of structural and metabolic type of NTC respectively. Severe traumatic brain injury (21.2%, n=49) and postoperative neurosurgical illness (16.5%, n=38) were common neurosurgical cases in our cohort. The intensive care resources were utilized as mechanical ventilation in 78% (n=180), inotropic support in 29.4% (n=67) and therapeutic hypothermia in 33% (n=76). Fifty children (21.6%) required PICU care for observation only. More than 500 neurodiagnostic tests/procedures were performed in this cohort of children with acute neurological disorders in PICU. The mortality rate in neurological cases was 18% (42/231) as compared to the overall mortality rate was 12% in PICU., Conclusion: Acute neurological disorders were common in PICU, and were associated with higher mortality. CNS infections, status epilepticus and severe traumatic brain injuries were the most common acute neurological illnesses in our cohort.

Sodium molybdate (Na2MoO4) has been used as an additive to 1 mol L(-1) lithium sulfate electrolyte for electrochemical capacitors based on activated carbon (AC) electrodes, in order to reduce the corrosion of stainless steel current collectors. We demonstrate that the MoO4(2-) anions improve the overall capacitance owing to pseudofaradaic processes. In a two-electrode cell, capacitance values of 121 F g(-1) have been achieved up to 1.6 V using 1 mol L(-1) Li2SO4 + 0.1 mol L(-1) Na2MoO4, as compared to 103 F g(-1) when 1 mol L(-1) Li2SO4 is used. Further, by using a two-electrode setup equipped with a reference electrode, we could demonstrate that, at 1.6 V, the positive electrode potential reaches a value of 0.96 V vs. NHE in 1 mol L(-1) Li2SO4, crossing the thermodynamic potential limit of oxygen evolution (Eox = 0.846 V vs. NHE), and the pitting potential, Epit = 0.95 V vs. NHE. By contrast, in 1 mol L(-1) Li2SO4 + 0.1 mol L(-1) Na2MoO4, the pseudofaradaic contribution occurring at -0.05 V vs. NHE due to MoO4(2-) anions drives the positive electrode to reach only 0.798 V vs. NHE. Hence, the oxidation of the AC and corrosion of the stainless steel current collector at the positive electrode are unlikely in Li2SO4 + Na2MoO4 when the capacitor operates at 1.6 V. During potentiostatic floating of the capacitor at 1.6 V for 120 hours in Li2SO4 + Na2MoO4, the capacitance and resistance remain constant at 125 F g(-1) and ~1.0 Ω, respectively, while the resistance increases from 1.4 Ω to 3.1 Ω in Li2SO4. Overall, the addition of MoO4(2-) anions to Li2SO4 aqueous electrolyte allows the capacitance to be enhanced, corrosion of the positive stainless steel current collector to be inhibited and the AC/AC electrochemical capacitor to demonstrate stable performance up to 1.6 V.

Background/purpose: Computer-aided design (CAD) methods are highly valuable for the analysis of skin lesions using digital dermoscopy due to low rate of diagnostic accuracy of expert dermatologist. In computerized diagnostic methods, automatic border detection is the first and crucial step., Method: In this study, a novel unified approach is proposed for automatic border detection (ABD). A preprocessing step is performed by normalized smoothing filter (NSF) to reduce background noise. Mixture models technique is then utilized to initially segment the lesion area roughly. Afterward, local entropy thresholding is performed to extract the lesion candidate pixels and the lesion border is smoothed using morphological reconstruction., Results: The overall ABD system is tested on a set of 100 dermoscopy images with ground truth. A comparative study was conducted with the other three state-of-the-art methods using statistical metrics. This ABD technique has the minimal average error probability rate of 5%, true detection of 92.10% and false positive rate of 6.41%., Conclusion: Results demonstrate that the proposed method segments the lesion area accurately. Sample dataset and execute software are available online and can be downloaded from: http://cs.ntu.edu.pk/research., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The present study investigated the role of kisspeptin-10 on reproductively significant trace elements in relation to testosterone release in male rabbits, Oryctolagus cuniculus. Groups of rabbits were exposed to single 1 μg kisspeptin dose (i.v., saphenous vein), while simultaneous groups were pretreated with a kisspeptin antagonist, peptide-234 (50 μg) 20 min before administering kisspeptin. Sequential blood sampling was done through marginal ear vein puncture at staggered time intervals: 0, 0.5, 1, 2, 4, and 24 h to determine serum testosterone. Testes and whole blood were collected at 4 and 24 h post dosage to determine trace element concentrations through atomic absorption spectrophotometry. In testes, zinc (Zn), manganese (Mn), and Fe concentrations showed significant increases at 24 h, while copper (Cu) concentration was found elevated at 4 and 24 h both (P < 0.001). In whole blood, Zn and Cu concentrations were significantly elevated at 4 and 24 h, while Mn and cobalt (Co) concentrations showed increases only at 24 h (P < 0.001). Blood iron concentration was not altered in the blood. In contrast, no change occurred in testicular Co, and chromium or nickel concentrations in either testes or blood. Compared to control and predose groups, serum testosterone levels increased gradually and peaked at 2 h (P < 0.001) post kisspeptin treatment but declined thereafter. Pretreatment with antagonist abolished all increases in trace elements and testosterone concentrations. The present study provides first evidence that reproduction- and fertility-related peptide "kisspeptin" modulates testicular and blood trace elements and that this action is likely GPR54-dependent.

Background/purpose: Accurate segmentation and repair of hair-occluded information from dermoscopy images are challenging tasks for computer-aided detection (CAD) of melanoma. Currently, many hair-restoration algorithms have been developed, but most of these fail to identify hairs accurately and their removal technique is slow and disturbs the lesion's pattern., Methods: In this article, a novel hair-restoration algorithm is presented, which has a capability to preserve the skin lesion features such as color and texture and able to segment both dark and light hairs. Our algorithm is based on three major steps: the rough hairs are segmented using a matched filtering with first derivative of gaussian (MF-FDOG) with thresholding that generate strong responses for both dark and light hairs, refinement of hairs by morphological edge-based techniques, which are repaired through a fast marching inpainting method. Diagnostic accuracy (DA) and texture-quality measure (TQM) metrics are utilized based on dermatologist-drawn manual hair masks that were used as a ground truth to evaluate the performance of the system., Results: The hair-restoration algorithm is tested on 100 dermoscopy images. The comparisons have been done among (i) linear interpolation, inpainting by (ii) non-linear partial differential equation (PDE), and (iii) exemplar-based repairing techniques. Among different hair detection and removal techniques, our proposed algorithm obtained the highest value of DA: 93.3% and TQM: 90%., Conclusion: The experimental results indicate that the proposed algorithm is highly accurate, robust and able to restore hair pixels without damaging the lesion texture. This method is fully automatic and can be easily integrated into a CAD system., (© 2011 John Wiley & Sons A/S.)

Background/purpose: Melanoma Recognition based on clinical ABCD rule is widely used for clinical diagnosis of pigmented skin lesions in dermoscopy images. However, the current computer-aided diagnostic (CAD) systems for classification between malignant and nevus lesions using the ABCD criteria are imperfect due to use of ineffective computerized techniques., Methods: In this study, a novel melanoma recognition system (MRS) is presented by focusing more on extracting features from the lesions using ABCD criteria. The complete MRS system consists of the following six major steps: transformation to the CIEL*a*b* color space, preprocessing to enhance the tumor region, black-frame and hair artifacts removal, tumor-area segmentation, quantification of feature using ABCD criteria and normalization, and finally feature selection and classification., Results: The MRS system for melanoma-nevus lesions is tested on a total of 120 dermoscopic images. To test the performance of the MRS diagnostic classifier, the area under the receiver operating characteristics curve (AUC) is utilized. The proposed classifier achieved a sensitivity of 88.2%, specificity of 91.3%, and AUC of 0.880., Conclusions: The experimental results show that the proposed MRS system can accurately distinguish between malignant and benign lesions. The MRS technique is fully automatic and can easily integrate to an existing CAD system. To increase the classification accuracy of MRS, the CASH pattern recognition technique, visual inspection of dermatologist, contextual information from the patients, and the histopathological tests can be included to investigate the impact with this system., (© 2012 John Wiley & Sons A/S.)

Background/purpose: Dermoscopy images often suffer from low contrast caused by different light conditions, which reduces the accuracy of lesion border detection. Accordingly for lesion recognition, automatic melanoma border detection (MBD) is an initial as well as crucial task., Method: In this article, a novel perceptually oriented approach for MBD is presented by combing region and edge-based segmentation techniques. The MBD system for color contrast and segmentation improvement consists of four main steps: first, the RGB dermoscopy image is transformed to CIE L*a*b* color space, lesion contrast is then enhanced by adjusting and mapping the intensity values of the lesion pixels in the specified range using the three channels of CIE L*a*b*, a hill-climbing algorithm is used later to detect region-of-interest (ROI) map in a perceptually oriented color space using color channels (L*,a*,b*) and finally, an adaptive thresholding is applied to determine the optimal lesion border. Manually drawn borders obtained from an experienced dermatologist are utilized as a ground truth for performance evaluation., Results: The proposed MBD method is tested on a total of 100 dermoscopy images. A comparative study with three state-of-the-art color and texture-based segmentation techniques (JSeg, dermatologists-like tumor area extraction: DTEA and region-based active contours: RAC), is also conducted to show the effectiveness of our MBD method using measures of true positive rate (TPR), false positive rate (FPR), and error probability (EP). Among different algorithms, our MBD algorithm achieved TPR of 94.25%, FPR of 3.56%, and EP of 4%., Conclusions: The proposed MBD approach is highly accurate to detect the lesion border area. The MBD software and sample of dermoscopy images can be downloaded at http://cs.ntu.edu.pk/research.php., (© 2012 John Wiley & Sons A/S.)

The desired 3-(arylsulfonyl)spiroimidazolidine-2,4-diones were synthesized by reacting spiroiminoimidazolidine-2,4-dione with arylsulfonyl chlorides. Spiroimidazolidine-2,4-dione was in turn synthesized from norcamphor. Structures of the synthesized molecules were established by modern spectroscopic techniques. The synthesized compounds were screened for in vivo antidiabetic activity and aldose reductase inhibition. Compounds 2a, 2b and 2g exhibited excellent dual activity, compound 2a being most prominent. These results reveal that the synthesized compounds may serve as the molecule of choice to treat diabetes and diabetic complications using a single medication., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Computer-aided pattern classification of melanoma and other pigmented skin lesions is one of the most important tasks for clinical diagnosis. To differentiate between benign and malignant lesions, the extraction of color, architectural order, symmetry of pattern and homogeneity (CASH) is a challenging task., Methods: In this article, a novel pattern classification system (PCS) based on the clinical CASH rule is presented to classify among six classes of patterns. The PCS system consists of the following five steps: transformation to the CIE L*a*b* color space, pre-processing to enhance the tumor region and removal of hairs, tumor-area segmentation, color and texture feature extraction, and finally, classification based on a multiclass support vector machine., Results: The PCS system is tested on a total of 180 dermoscopic images. To test the performance of the PCS diagnostic classifier, the area under the receiver operating characteristics curve (AUC) is utilized. The proposed classifier achieved a sensitivity of 91.64%, specificity of 94.14%, and AUC of 0.948., Conclusion: The experimental results demonstrate that the proposed pattern classifier is highly accurate and classify between benign and malignant lesions into some extend. The PCS method is fully automatic and can accurately detect different patterns from dermoscopy images using color and texture properties. Additional pattern features can be included to investigate the impact of pattern classification based on the CASH rule., (© 2011 John Wiley & Sons A/S.)

Objective: To provide size estimation and to determine risky behaviours and HIV prevalence among female sex workers in Pakistan, which has progressed from a low to concentrated level of HIV epidemic., Methods: A cross-sectional study (geographic mapping and integrated behavioural and biological survey-IBBS) was conducted between August 2005 to January 2006 in Karachi, Hyderabad and Sukkur. A detailed questionnaire and dry blood spot (DBS) specimen for HIV testing were collected by trained interviewers after informed consent. The study was ethically approved by review boards in Canada and Pakistan., Results: About 14,900 female sex workers were estimated to be functional in Sindh. A total of 1158 of them were interviewed for the study. Average age of sex workers was 27.4 +/- 6.7 years, and the majority 787 (67.9%) were married, and uneducated 764 (65.9%). Sindhi (26.4%) was the predominant ethnicity. Mean number of paid clients was 2.1 +/- 1.2. three workers were confirmed HIV positive (0.75%, 95 percent CI 0.2-2.2%) from Karachi. Condom use at last sexual act was highest (68%) among brothel-based workers from Karachi, and the lowest in Sukkur where only 1.3% street-based workers reported using a condom at last sexual act. Overall use of illicit drugs through injections was negligible., Conclusion: HIV prevalence among female sex workers in Sindh, Pakistan is low but risky behaviours are present. Well organised service delivery programmes can help promoting safer practices.

Background/purpose: Border (B) description of melanoma and other pigmented skin lesions is one of the most important tasks for the clinical diagnosis of dermoscopy images using the ABCD rule. For an accurate description of the border, there must be an effective skin tumor area extraction (STAE) method. However, this task is complicated due to uneven illumination, artifacts present in the lesions and smooth areas or fuzzy borders of the desired regions., Methods: In this paper, a novel STAE algorithm based on improved dynamic programming (IDP) is presented. The STAE technique consists of the following four steps: color space transform, pre-processing, rough tumor area detection and refinement of the segmented area. The procedure is performed in the CIE L(*) a(*) b(*) color space, which is approximately uniform and is therefore related to dermatologist's perception. After pre-processing the skin lesions to reduce artifacts, the DP algorithm is improved by introducing a local cost function, which is based on color and texture weights., Results: The STAE method is tested on a total of 100 dermoscopic images. In order to compare the performance of STAE with other state-of-the-art algorithms, various statistical measures based on dermatologist-drawn borders are utilized as a ground truth. The proposed method outperforms the others with a sensitivity of 96.64%, a specificity of 98.14% and an error probability of 5.23%., Conclusion: The results demonstrate that this STAE method by IDP is an effective solution when compared with other state-of-the-art segmentation techniques. The proposed method can accurately extract tumor borders in dermoscopy images., (© 2011 John Wiley & Sons A/S.)

The skin cancer was analyzed by dermoscopy helpful for dermatologists. The classification of melanoma and carcinoma such as basal cell, squamous cell, and merkel cell carcinomas tumors can be increased the sensitivity and specificity. The detection of an automated border is an important step for the correctness of subsequent phases in the computerized melanoma recognition systems. The artifacts such as, dermoscopy-gel, specular reflection and outline (skin lines, blood vessels, and hair or ruler markings) were also contained in the dermoscopic images. In this paper, we present an unsupervised approach for multiple lesion segmentation, modification of Region-based Active Contours (RACs) as well as artifact diminution steps. Iterative thresholding is applied to initialize level set automatically; the stability of curves is enforced by maximum smoothing constraints on Courant-Friedreichs-Lewy (CFL) function. The work has been tested on dermoscopic database of 320 images. The border detection error is quantified by five distinct statistical metrics and manually used to determine the borders from a dermatologist as the ground truth. The segmentation results were compared with other state-of-the-art methods along with the evaluation criteria. The unsupervised border detection system increased the true detection rate (TDR) is 4.31% and reduced the false positive rate (FPR) of 5.28%., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Background/purpose: Automated border detection is an important and challenging task in the computerized analysis of dermoscopy images. However, dermoscopic images often contain artifacts such as illumination, dermoscopic gel, and outline (hair, skin lines, ruler markings, and blood vessels). As a result, there is a need for robust methods to remove artifacts and detect lesion borders in dermoscopy images., Methods: This automated method consists of three main steps: (1) preprocessing, (2) edge candidate point detection, and (3) tumor outline delineation. First, algorithms to reduce artifacts were used. Second, a least-squares method (LSM) was performed to acquire edge points. Third, dynamic programming (DP) technique was used to find the optimal boundary of the lesion. Statistical measures based on dermatologist-drawn borders were utilized as ground-truth to evaluate the performance of the proposed method., Results: The method is tested on a total of 240 dermoscopic images: 30 benign melanocytic, 50 malignant melanomas, 50 basal cell carcinomas, 20 Merkel cell carcinomas, 60 seborrheic keratosis, and 30 atypical naevi. We obtained mean border detection error of 8.6%, 5.04%, 9.0%, 7.02%, 2.01%, and 3.24%, respectively., Conclusions: The results demonstrate that border detection combined with artifact removal increases sensitivity and specificity for segmentation of lesions in dermoscopy images., (© 2011 John Wiley & Sons A/S.)

Malignant melanoma and basal cell carcinoma are common skin tumours. For skin lesion classification it is necessary to determine and calculate different attributes such as exact location, size, shape and appearance. It has been noted that illumination, dermoscopic gel and features such as blood vessels, hair and skin lines can affect border detection. Thus, there is a need for approaches that minimise the effect of such features. This study aims to detect multiple borders from dermoscopy with increased sensitivity and specificity for the detection of early melanoma and other pigment lesions. An automated border detection method based on minimising geodesic active contour energy and incorporating homomorphic, median and anisotropic diffusion (AD) filtering, as well as top-hat watershed transformation is used. Extensive experiments on various skin lesions were conducted on real dermoscopic images and proved to enhance accurate border detection and improve the segmentation result by reducing the error rate from 12.42% to 7.23%. The results have validated the integrated enhancement of numerous lesion border detections with the noise removal algorithm which may contribute to skin cancer classification.

Background: The majority of patients remain concerned about radiation exposure and the health risk associated to it. A doctor is a person who can answer all pertinent questions regarding radiation and can satisfy their patients. Medical students, who are future doctors, can acquire this capability during their clinical rotation in the radiology department. The study is to assess knowledge, hazards, misconceptions and misunderstanding among medical students regarding equipments using ionizing and non-ionizing radiation., Methods: A questionnaire was self administered to medical students of a private medical college of Karachi. One hundred and twelve students who had completed their clinical rotation in the radiology department from fourth and final year MBBS class were included in the study. The obtained data was analyzed using statistical software., Results: Nearly 40% of the students accepted that objects in the X-ray room emit radiation after an X-ray procedure and nearly the same percentage agreed that protective measures should be taken while performing an ultrasound and that dangerous radiation is emitted from good quality microwave equipment. Slightly more than one-third students viewed that gamma rays are more hazardous than X-rays while the same percentage agreed that intravenous contrast material used in angiogram is radioactive. Sixty-seven percent students agreed that nuclear material used in medicine is potentially explosive while 18% of students were in the opinion that MRI emits ionizing radiation. Twenty-eight percent of the students believe that a radiologist have a shorter life span as compared to other medical specialist., Conclusion: The majority of medical students in both years have limited knowledge about various aspects of radiation sources, the risk involved and its protection. Better teaching methods and programmes are required for medical students in the subject of radiology.