“nailfold Capillaroscopy Using Usb Digital Microscope in the Assessment of Microcirculation in Diabetes Mellitus”

Introduction: Nailfold capillaroscopy is a simple, non-invasive technique used to assess microcirculation in various diseases such as Systemic Sclerosis, Dermatomyositis, Diabetes Mellitus, and Hypertension etc. Microcirculation is the part of the circulation where oxygen, nutrients, hormones, and waste products are exchanged between circulating blood and parenchyma cells through the blood vessels with a diameter less than 100 μm such as capillaries. In a healthy person, capillaries are hairpin shaped placed parallel to each other in a fairly uniform distribution. Capillaries exhibit various morphological as well as hemodynamic parameters which vary with the health condition of a person. Important morphological parameters are capillary density, distance between capillaries and capillary dimensions namely length, width and height while Red blood Cell velocity is an important Hemodynamic parameter. Diabetes Mellitus is characterized by the capillary architectures such as tortuosity, avasculature, enlargement and elongation as well as reduction in capillary density. Diabetes is a metabolic disease associated with multiple complications has been a 2 major contributor to morbidity and hence has been considered for the study. Most of the studies have employed a high resolution videocapillaroscope to capture the video of microcirculation in capillaries. Panoramic mosaic of video frames is employed for image stabilization. Skeleton extraction is employed to extract the edges of the capillary and later utilized for parameterization of capillary. In Indian context, NC is yet to gain popularity, the probable reasons being the high cost of Video capillaroscope, lack of operational knowledge etc. We have used a USB digital microscope for imaging as suggested by Vivek Vasdev et al which has a convenient image as well as video capture facility. But the image suffers from low-contrast which needs to be corrected. USB Digital microscope having electronic magnification of 200x, optical magnification of 4.5, and resolution of 1024x968, adjustable light intensity generated by eight LEDs embedded in the device and powered by the USB port is used. This study involves image enhancement, segmentation and classification of capillaries for Diabetes in Indian population. A capillary is a microvessel where the actual exchange of nutrients, gases and waste products happen in a circulatory system. Arteries and veins branch out into arterioles and venules which further branch into capillaries. Capillaries have three limbs namely arteriolar, venular and apical limb, each of them having different dimensions as shown in Fig 1(a). In a healthy person as in Fig 1(b), the capillaries are hairpin shaped appearing parallel to …