Key Words

Microorganisms, Fungal elements, Microphotograph, Camera phone technology, Mobile

Introduction

Light microscopy is an basic essential tool in modern diagnosis and resarch. The advent of digital imaging has only enhanced this diagnostic role, as sample images are now frequently transferred among technologically-advanced hospitals for further consultation and evaluation. In many places the required equipment is either unavailable or insufficiently portable, and operators may not poses adequate training to make full use of the image obtained. So we used a simple technique to capture the digital images by camera-enabled mobile phone which can be transferred to computer. These images can be enhanced for brightness, contrast etc using computer software.

Materials and Methods

We used a sleeve made up of paper so that it fits outside an eyepiece of the microscope. The cylindrical tube (sleeve) can be made by simply encircling few layers of routinely used paper around one of the eyepiece of the microscope. It can also be made from chart paper or some other material so that it snuggly fits around the eyepiece. We made this cylindrical tube of size 35 mm diameter and 55 mm long (Figure 1).

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Figure 1. The paper tube which can be used to wrap the eyepiece

Length can be adjusted according to your cameraphone so that we get clear image on the screen. This also helps to keep the phone camera steady at the correct distance from, and parallel to, the microscope eyepiece lens. When the microscopic field to be captured is in focus, place the camera lens of the mobile phone over the paper tube so that the image of the microscopic field is viewed on the mobile screen (Figure 2).

Figure 2. Image showing the camera of mobile phone being kept over the eyepiece of microscope to capture the image

By viewing the phone display and carefully adjusting the camera position, the image is centered, refocused if necessary, and captured. The tube can be also used to focus the image like telescope. It can then be transmitted directly to another mobile phone or, ideally, to a computer, where it can be enlarged and enhanced, for expert opinion and permanent record. We use Nokia N70 mobile with built-in digital camera with 2 megapixel image resolution. It can be set to capture the images of resolution 1600×1200 pixels which are enough to be transmitted and stored in computer.

Result

We obtained images of both stained slides as well wet mount using mobile camera of resolution upto resolution 1600×1200 pixels. Figure 3 is a stained slide showing fungal hyphae in a biopsy sample focused under oil immersion. Figure 4 is an image of saline mount of stool showing larvae of Strongyloides stercoralis under high power.

Figure 3. Microphotography using mobile camera phone showing fungal hyphae in stained biopsy material under oil immersion field.

Figure 4. Microphotography using mobile camera phone showing larva of Strongyloides stercoralis in saline preparation of stool under high power

We can also shoot video of motile organisms like trophozoites of Giardia, Entamoeba as well as larvae of Strongyloides. We have posted some of these videos on website so that it can be viewed by many people.(1) The images transmitted to computer were enhanced by photo software Ulead Photo Express.

A novel application of mobile cameraphone is the capture and transmission of images directly from eyepiece of an ordinary laboratory microscope. We developed a simple technique to use cameraphone to capture the images of slides made from clinical material. Mobile cameraphones are becoming cheaper and more sophisticated, with high resolution, zoom lenses, autofocus and video capture commonplace. The ubiquity of mobile phone networks will allow application of this simple technique in many situations where the dedicated and expensive microscope, camera, software, and computer network required for conventional telemedicine do not exist; for example, in rural diagnostic laboratories in developing countries. The digitalized image can then be sent via internet to an expert for an accurate diagnosis. Frean J (2) used plastic bottle cap, 35mm in diameter and 13mm deep, with an aperture about the diameter of the eyepiece lens (20mm) cut out of it. Breslauer DN et al (3) developed a high-resolution microscope attachment for camera-enabled mobile phones that is capable of both brightfield and fluorescence imaging. They used this device to capture digital color images of malaria parasites in thin and thick blood film, sickled red blood cells in peripheral blood smear, and, using fluorescence, tubercle bacilli in Auramine O stained sputum smear. Remote expert viewing of medical images (telemedicine) is well established. An emerging variant is transmission of images captured by mobile (cellular) telephone cameras. This technique has been used to aid diagnosis and management of problems in, among others, urology, emergency sonography and neurosurgery. (4,5,6) In India Godse CS et al (7) also showed the use of mobile camera microphotography a technique for telediagnosis of Malaria.

Discussion

Images can also be taken without using any adapter or device, but requires some practice. Bellina L et al (8) took images by simply approaching the lens of the m-phone camera to the ocular of the microscope carefully centering the observed field, until the image would appear perfectly in focus on the screen of the mobile cell-phone, using hands to shield from external light interference. There is wide reference and promotion on the internet of optical adaptors and more complex techniques for the capture and transmission of microphotography images which seems to elicit the interest of the market. A microscope is normally already available in any medical laboratory, but the technology to take the images are not available. So to conclude, we suggest to adopt this simple method of microphotography which could significantly increase opportunities and quality diagnostics while lowering costs and considerably increasing connectivity between most isolated laboratories and distant reference center.