Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Reviews
Year : 2009 | Month : February | Volume : 3 | Issue : 1 | Page : 1341 - 1347

Digital Camera – A Review Of Its Applications In Urology And Genitourinary Surgery

SINGH IQBAL

Dept of Surgery, Division of Urology University College of Medical Sciences(University of Delhi)GTB Hospital,Delhi-10095.(India)

Correspondence Address :
Dr Iqbal Singh,M.Ch (Urology,AIIMS),DNB (Uro),MS,DNB(Surg), MNAMS,Professor&Senior Consultant Urologist,Dept of Surgery, UCMS,F-14 South Extension Part-2,NDSE-2,New Delhi-110049.(India).Tel:(Resi)-91-11-26257693,(Fax)-91-11-22590495 Email:iqbalsinghp@yahoo.co.uk

Abstract

Aims: To choose the right digital imaging device and to report and review on the various applications of a digital camera in our urological setting. Advances and newer emerging tools in the field of digital imaging makes it mandatory for a urologist to acquaint oneself with the basics of digital imaging, so as to enable oneself to choose the appropriate system compatible with one’s requirement and work setting. Methods: We have reviewed the basic technical literature on digital photography and the factors to be considered while choosing the right digital camera. We have described the usage and testing of three such camera devices (Sony Mavica FD73™, Sony Cybershot™ (DSC-T10) and the Nokia™ 6270 mobile phone in built camera device) in our hospital urological setting over the last three years.
Results: The right digital camera must have at least 2-4 mega-pixel resolution with a macro mode; CCD sensor, adequate compression, high memory and at least 4x optical zoom with white balance.
Conclusion: The digital camera is like a hand held mobile scanner that allows instant digital data acquisition. It is a portable, extremely versatile, reliable and efficient device to capture, store and reproduce digital images throughout the urological setting in any compatible format. It should be considered as a standard accessory by all practicing urologists and surgeons, so as to maintain a reliable documentation of all their records and investigations in a readily reproducible format.

Keywords

Digital imaging, digital camera, urological imaging

Introduction
The increasing demand for a quick and reliable documentation of their professional and operative work has lead urologists to acquire several advanced imaging systems (1),(2). All urologists need to be familiar with the basics of digital imaging, since it is expected to completely supplant conventional medical imaging in the next decade (2). Already, most recording and documentation is being done via digital camcorders that have a convenient computer interface to edit, store and reproduce images and videos. We propose that a digital camera is an efficient and economical way of acquiring and storing data in a digitized format that allows reproducibility and excellent compatibility with software programmes, computer and multimedia devices for presentations, internet based correspondence, teaching and educational purposes (3).

Material and Methods

Methods
The right digital device is the most important decision. The best way out, is to first familiarize oneself with the technical jargon that is often listed by most manufacturers and sellers to promote their device. These terms include pixels, resolution (megapixels), memory (storage capacity), compression format, aperture, zoom (optical versus digital), macro function, CCD sensor (storage film) and white balance, aperture and shutter speed. We have briefly reviewed the definitions of the salient terms pertaining to digital imaging.

Digital Image
This is an image that is recorded in precise numbers (binary codes as 0 or 1) in a digitized code. It is usually saved as a 640x480 pixel resolution using the JPEG (Joint Photographic Expert Group) compression format by most digital devices.

Pixels
These are the small units or blocks that comprise a digital image, which may or may not be individually visible, depending on the size of the image. The pixels of a digital camera do not always correspond with its printed version.; In other words, in the printed photo, the number of pixels tend to exceed the pixel resolution of the camera. This in effect means that the quality of a printed photo will always be inferior to the one visible on the camera monitor. For most urologists, for publication or documentation purposes, the standard print size of 4x6" would suffice (i.e., the digital camera should be of at least 2 megapixels). A higher megapixel only increases the file storage size without any real benefit on the standard sized prints of 4"x6".

Resolution
This refers to the ability of the digital device to distinguish two very closely situated points (or pixels) as separate (measured in "megapixels", 1 mega-pixel =1,000,000 pixels). Thus, higher the resolution of a camera, larger will be the printouts. If a digitized image is enlarged, it generally results in a loss of picture quality, resulting in a poor quality print (pixels blocks become disturbingly visible). This can be avoided by following the simple rule that every one mega-pixel increase in resolution corresponds to an increase in print size by 4"x4" (Table/Fig 3). For editing, cropping, enhancement and storing these images in electronic format, such as in a power point slide or multimedia presentation, the resolution will again matter, since editing often results in a loss of picture quality. The megapixels resolution being quoted for a particular camera should be the true (effective) one and not an interpolated resolution (artificially added resolution by the camera), since this is not the true resolution. Thus, the camera resolution specified should be the (effective) megapixel rating and it must not contain the word "interpolated”. In our opinion and for most of our needs in our urological setting, we found that a 3 megapixels resolution camera offered us good value for money without compromising on picture quality.

Auto-Focus (Af) Illuminator
Digital cameras use "contrast detection" when they focus on a subject. When light levels are low, the camera may not be able to decide on a focus distance and some cameras won't even take a picture, while others may default to some preset focus distance (usually infinity). Here, the AF illuminators come into play, they cast a bright, focused beam of light onto the subject, and so the camera can see better and focus properly. An AF illuminator is desirable for the imaging required in the hospitals and operating suites.

Memory
This is the size of the storage media. Most digital cameras use a memory stick//card to store its images. The "Sony Mavica™" directly records onto a 3½" floppy disk, allowing direct computer connectivity, while others necessitate the use of a plug in device via a USB (universal serial bus) port. The Sony Cybershot™ records both images as well as videos directly onto a built in memory disk or onto removable miniature flash disks of varying storage capabilities (1-2 Gigabytes), which can be easily transferred to a computer interface both via a blue tooth™ wireless protocol, as well as directly via the USB interface. Many manufacturers of digital video recording digital devices have also started to transition to DVD-R and DVD-RW-based cameras (at present priced in the range >700-1000 USD$) which cost double the cost of a 3-megapixel still digital camera. The latest hand held digital camcorder devices like those of Cannon™ can store the recorded images and videos directly on to an inbuilt hard disk with recording durations of up to 24 hours, thereby doing away with both the digital tapes as well as the digital disks (DVD). This has the advantage of obviating the need to first separately capture the video on a computer prior to its editing.

Recording Format
This is the program used by the camera to record images. Most digital cameras record images in the standard "JPEG interchangeable file format"- a program that is readily recognized by most image displaying and editing programs such as the MS Power point™, Adobe Photo Deluxe™, Adobe Photoshop™, etc. Digital cameras tend to compress images to maximize their storage. A compressed image often looks slightly inferior, but most digital cameras have the option of switching off this compression mode. The compressed digital images come handy when these have to be e-mailed, since this needs 1/4th the usual space and mailing time as compared to an uncompressed digital image. For publication purposes, journals insist for distortion free high quality art images (high-resolution art images in an uncompressed mode) which are saved as “TIFF” or “EPS” files.

Macro Function
The macro mode the ability to capture high-resolution images from an extreme close up. This is needed to capture operative images in the operating suite or for close up shots of clinical specimens and subjects with interesting clinical findings, such as unusual genitourinary abnormalities. We prefer a macro mode camera to enable getting as close as 2-4 inches from the subject.

CCD Sensor
This is the camera film! CCD stands for ‘charge coupled device’ (sensor device) used by most digital cameras to sense the image before it is recorded and stored in the camera’s storage media. CMOS (complementary metal oxide semiconductor) is another such much cheaper image sensing device; however, the quality of this image is far inferior to the one sensed by a CCD sensor. Thus, it is always better to prefer a camera with a CCD digital device.

Zoom Function
The zoom function (optical or digital) generally refers to magnification of an image. The optical zoom uses the camera optical system to enlarge an image by bringing the object closer to the camera (true resolution zoom), since this does not result in any loss of picture clarity. The digital zoom (electronic brain) on the other hand, is an artificially blown up image gained by increasing the inter-pixel gap of an image, with the camera artificially filling in the empty pixels with a guessed colour pixel (interpolation), i.e., it makes a guess about how the picture should look while zoomed in, to enlarge an image. This often distorts the true image by causing it to become more “pixelated”. If the same digitally zoomed image is closely compared with one that is optically zoomed, the outlined pixels tend to show image distortion which is visible only if one views close up print images. Thus, one must prefer a digital camera with a high optical zoom in place of digital zoom. For our purposes in a urological setting, we found the 4x optical zoom to be sufficient, as this enabled the capturing of sharply focused images of x-ray films.

Exposure
A good exposure necessitates a balanced combination of the aperture and the shutter speed. Most of the cheaper digital cameras carry three or four shutter speeds, and this generally results in a loss of the picture quality. It is desirable that any digital still camera must provide a full range of shutter speeds from 1/1000 sec to 1 sec.

White balance
A digital camera records images, depending on the amount of light its sensor device (CCD or CMOS) receives, it then generates an analog charge which is converted to digital pixels, and this allows a digital camera to generate the appropriate colour. For this reason, the images may not look true to colour. To prevent this, it is advisable to choose a digital camera with a white card that allows white balance calibration in a variety of different settings.

Power
All digital camera devices drain the batteries heavily and so it is a good decision to go for the high performance rechargeable cells. Most of the digital cameras come packed with rechargeable NiCd-(nickel cadmium), NiMH-(nickel metal hydride) or Info-Lithium™ batteries. Info-lithium™ and NiMH batteries should be preferred over NiCd batteries, as the former do not have any memory, i.e. they need not be fully drained every time before recharging and are also cheaper in the long run. Alkaline batteries turn out be much more expensive in the long run and so it is wise to avoid them.

Using The Digital Camera
We tested the portable digital Sony Mavica FD73™ camera in the hospital wards, operating suites and outpatient departments. The InfoLithium™ battery was pre charged for at least 2 hours prior to the first use. The camera resolution was set to the fine recording mode and a fresh preformatted 1.44MB Sony™ 3½" floppy disk was inserted into the camera. The camera was switched on and the full view was seen immediately via its 2.5" LCD screen. All images were recorded on to the floppy disk in the JPEG camera format. Operative and clinical images were colour recorded, while x-ray and scan films were recorded in the black and white mode to save disk space. The captured images were off-loaded onto an office desktop computer via its floppy disk drive onto its hard drive. These images were then viewed and edited using the Microsoft Photoeditor™ software for their polarity, size, contrast and brightness. They were then transferred to an ArcSoft™ photo album (bundled software provided along with the camera) to create a readily viewable digital photo library. Prints, when needed, were obtained using a HP DeskJet 5550™ printer. We also tested the Sony Cybershot™ (DSC-T10) which had a maximal 7.2 megapixel resolution with high sensitivity. All images recorded with this device were set to 2-3-megapixel resolutions. We also tested the Nokia™ 6270 mobile phone in- built 2-megapixel camera’s ability to record images of x-rays and operative sites.


Results

Choosing the right digital camera is one of the most important decisions to be made, keeping in mind the cost factor and the requirements of the urologist or the surgeon. Some of the good branded digital cameras that meet our requirements are those of Sony™, Cannon™, Olympus™, and Kodak™. In our urological and surgical setting, we found that a digital camera above 3-4 megapixels with 2x-4x optical zoom; with a macro mode CCD sensor, variable aperture speeds and at least 128 MB memory, was more than adequate for all our needs. This translates to a cost of about 300-500 USD$. We extensively used the Sony Digital Mavica™ (MVC-FD73) with a built in flash for all our purposes and later the Sony DSC-T-10 Cybershot™ device. The former device records all the images on a standard 3½" 1.45 megabytes floppy computer disk, which can be easily viewed, transferred and stored on to a hard drive, while the latter recorded these directly on to its flash miniature disk. These stored images were further sorted into an Arc soft™ photo album digital library, allowing easy indexing, viewing, e-mailing, reproducibility and printing of high resolution good quality images for our academic and teaching purposes. The software (Arcsoft™) comes bundled with the digital camera and so no additional costs are involved in setting up such a digital photo library.

Some sample digital images recorded with the Sony Digital Mavica™ (MVC-FD73) are shown in (Table/Fig 1),(Table/Fig 2) depicts the images recorded with the Nokia™ 6270 mobile phone in built camera device. We found that the resolution of the photographs obtained from an inkjet printer were of a good quality, suitable for publication and poster display. On a single 3½", 1.44 MB computer floppy disk, we were able to record upto 30 black and white images or 20 high fine resolution full colour images. A 1 Gb flash memory disk on the other hand, can store up to 1000 still images with a 2-3 megapixel resolution.

Discussion

Various factors need to be taken into account by the urologist before choosing the appropriate digital camera (4). Besides the cost (5), other factors that need to be considered are; (i) the effective M-pixel rating-should be at least 4, (ii) the optical zoom-should not be less than 2x in any case though 4x would be excellent, (iii) macro mode should be available and (v) there should be at least 128 MB memory.

The applications of a digital camera are tremendous. We captured images of X-ray films, analog photos, thermal prints of contrast studies, cathode ray tube (TV monitor) images by adjusting and synchronizing the shutter speed of the digital camera to 16 frames/sec and extreme close up shots of many operative procedures. With a lens-adaptor, one can easily hook up the digital camera to a still or operating microscope to acquire high quality digital photomicrographs, for teaching purposes (3). Short duration digitized video clips can also be recorded for insertion into multimedia presentations.

For recording finer digital images in the operative urological suite, we used the uncompressed highest quality JPEG level camera setting. This may be needed for large print outs and poster display purposes (with a larger image there is more room to crop images, without affecting the quality).

Analog photographs have the drawback of being misplaced and getting faded over a period of time, reproducibility varies with each print and the negatives need to be carefully stored, since they also degenerate over a period of time (6),(7),(8),(9). In contrast, digital images were easily available at all times, with secure backup copies being readily available on a backup drive (CD R or RW disk by using a CD writer), and thus the risk of loosing them was minimized. These could easily be e-mailed to another network computer for Internet based correspondence. Digital images are thus immune to quality degradation and are superior to their analog photos by way of colour, contrast, sharpness and depth (8),(9). The chief advantage of digital images is that they can be further improved and favorably modified using image enhancing and filtering software (9). Enhancement is accomplished by using a cluster of pixels (kernels); with the central pixel as a control, the surrounding pixels are subject to a computerized variation to digitally enhance the final image (9).

We found the Mavica™ camera to be cost effective (430 US$), portable, highly versatile, user friendly and an efficient device for the recording and documentation of all interesting urological clinical cases, specimens, x-rays and operative procedures. Digital imaging is already a well-established low cost method for accurate documentation of clinical findings in other specialties of medicine (5). Digital camera should be added to the standard armamentarium of every urologist’s armor. The mobile phone camera allows the acquisition of good-quality digital images of operative surgical procedures and radiographical studies with instantaneous data transfer and storage for records (10). The newer technology of smart phones has considerably reduced costs, allowing instant capture and transmission of images via the multimedia messaging service (MMS) protocol, thereby facilitating teleconsultation and allowing the creation of an online Weblog for viewing medical images, thus increasing the efficiency of our surgical practice (11).

Conclusion

The Sony digital Mavica FD 73™ camera, Sony Cybershot™ DSC-T10 and the Nokia™ 6270 mobile phone in built camera device were extensively used in our uro-surgical setting to capture high-resolution good quality easily reproducible images. We found that the still digital images recorded by the Nokia™ 6270 mobile phone in built camera device were of an excellent quality too, affording easy reproduction and good quality print outs. The other real advantages of using a mobile phone camera recording device, is the ease of transferring images easily at the touch of a button using the in built blue tooth wireless technology or by using the multimedia MMS messaging service of the mobile phone service provider that can easily transmit images anywhere over the internet. Besides an excellent digital image library/archive being maintained by us, we found it very useful to review and refine our work, strategies and treating modalities. Easy tracking and storage of multiple images were also really simplified.

The overall convenience and low cost of the floppy disk media of our Mavica™ digital camera makes it a very versatile, efficient and cost effective portable camera. Above all, we found it to be an extremely cost effective and useful tool for teaching, academic and publishing purposes in a University teaching hospital setting such as ours. Though today, most recording is done with a camcorder and delivery to the computer is via a fine wire, and the floppy disc has been largely replaced by the CD (storage capacity of which is 400 fold greater than the floppy disc), DVD and hard disk, nevertheless, the Mavica™ type of digital still camera still retains it’s place, mainly due to its affordability, versatility, mobility and instant reproducibility with all compatible medias. However, this has now been increasingly replaced by a mobile phone in-built camera device, now available on several mobile phones, that is convenient to use and to transfer images over the internet, and that is readily available with many physicians even inside the OTs.

We recommend that digital imaging should be freely used by urologists who are desirous of maintaining a cost-effective, accurate and reliable documentation (digital archive) of their clinico-pathological and radiological findings.

References

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