GUIDELINES FOR MIDTERM REPORT AND

PROJECT REPORT
FOR UNDERGRADUATE STUDENTS OF
ELECTRONICS AND COMMUNICATION

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 Guidelines for submission of mid term report

1. Name of the Student:

2. Registration Number:
3. Section and Roll Number:
4. Name, designation and address of external guide:
5. Name of internal guide
6. Report should include main block diagram of dissertation, problem description,
and work done so far, further work to be done with sufficient description.
7. Partial result for the work done so far must be included which has to be duly
attested by the external guide/supervisor.
8. In case of fully hardware project the photograph of the circuit module/board
developed should be included.
9. Report of 15- 20 pages
10. Title of Project
11. Abstract
12. Introduction
13. Methodology / Procedure / Experimental set up
14. Review by External guide and signature
15. Refer the format enclosed
16. If the project is in college and under any faculty other than internal guide, then
give name, designation and department. Mention him / her as Co-Guide.

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 Appendix - B

MID TERM REPORT OF

TECHNICAL ANALYSIS OF ELECTROCARDIOGRAMS AND

DEVELOPMENT OF GRAPHICAL USER INTERFACE FOR
ASSISTANCE IN CLINICAL DECISION MAKING

A thesis to be submitted

to

MANIPAL UNIVERSITY
(Formerly known as Manipal Academy of Higher Education)

For Partial Fulfillment of the Requirement for the

Award of the Degree

of

BACHELOR OF ENGINEERING

in

ELECTRONICS AND COMMUNICATION ENGINEERING

by
SRINIVAS K.S.
Reg. No. 4MI99LBE01
Final Year B.E.

Under the Guidance of

Mr. JAGADEESH PAI Mr. AMRITHRAJ

Reader, Department of E &C Engineering Lead Engineer, Freescale Semiconductors
Internal Guide External Guide / Co Guide
DEPARTMENT OF ELECTRONICS AND
COMMUNICATION ENGINEERING
MANIPAL INSTITUTE OF TECHNOLOGY
(A constituent college of Manipal University, Manipal)
MANIPAL - 576 104, KARNATAKA, INDIA

APRIL 2001

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Feature extraction of speech / voice signals and classification using ANN

Abstract — The method is used to register the laryngeal behavior indirectly by measuring change in the electrical
impedance across the throat during speak or voice. The RF carrier signal is amplitude modulated by the modulating
speech/ voice signal and the dc component from the demodulated signal is extracted. The variations in the dc
component correspond to the vocal fold abduction/laryngeal movement. For normal and pathology conditions the
results are recorded. These values form a feature vector which reveals information regarding pathology. Then a
classical multilayer feed forward neural network with back propagation algorithm is employed to serve as a classifier
of the feature vector, giving 100% successful results for the specific data set considered.

Keywords— Electroglottography (EGG), Artificial Neural Network (ANN), Back propagation algorithm

1. INTRODUCTION

Oral cancer is one of the ten most common cancers in the world with more than 500000 new cases
projected world wide annually [1]. The successful therapy of oral cancer has been significantly hindered by
the subsequent development of secondary tumors, the major determinant for treatment failure and death.
Most cancers do not produce symptoms until the tumors are either too large to be removed surgically or
until cancerous cells have spread to other tissues. Therapies other than surgery, such as use of chemical
toxins or irradiation, while often effective in destroying most tumor cells, are usually not curative. The
small fraction of residual viable tumor cells is able to proliferate, develop resistance to further therapy and
eventually kill the patient [2]. Therefore, there is a need to diagnose cancer when tumor is still small
enough to completely remove surgically. Cancer if, detected early can potentially be cured [1, 2].

1.1 Present techniques for diagnosis of malignancy

Cancers at present are usually detected only by clinical examination and are confirmed by biopsy. X-ray
technique like Computed- Topography and other technique such as Magnetic Resonance Imaging are
sometimes used to detect the location and extent of primary tumors. In biopsy, histopathology is considered
to be a gold standard and is used to confirm the presence of malignancy. But this method has several
disadvantages, some of which are, delay in the diagnosis because of time required for sample preparation,
inadequate biopsy specimen because of uncertain clinical observation, biopsy from non-representative
areas etc. , and above all, the method is usually applicable only towards later stages of the disease. It is
highly subjective.

1.2 Our approach

Our approach for the diagnosis of malignancy is laser induced fluorescence based optical pathology
technique where classification of different pathological states of the tissue is done by using artificial neural
network (ANN). The objectives involved in this study are, to record fluorescence spectra of oral tissues
using standard instrumentation set up, to extract different features like mean, standard deviation total
energy, spectral residual etc. from the fluorescence spectra using Matlab signal processing tools, the
identification of the pathological states of human oral tissues by using artificial neural network.

4 of 32
 2. EXPERIMENTAL SETUP AND ANN ANALYSIS

2.1 Tissue Samples

Details of the sample preparation and spectral recording are mentioned elsewhere [3]. The sample details
are given in Table I.

Table I: Sample Details

Spectral No Sample Type Mean age Histopathology Spectroscopy

1- 20 61 ± 6.1 -
Standard Set Normal epithelial cell

21-40 Malignant 62 ± 6.1 -

Standard set Squamous cell carcinoma

41-80 Normal Test 62 ± 6.1 Normal

Set Normal epithelial cell

81-117 Malignant 64 ± 7.5 Malignant

Test Set Squamous cell carcinoma

2.2 Experimental setup and data Acquisition

The data was collected by using a fiber optic probe, designed and fabricated in our laboratory, which is
readily adaptable to in- vivo studies [3]. Details of the experimentation are shown elsewhere [3].

2.3 Model of ANN diagnostic system architecture

An ANN structure is employed for the classification of recorded fluorescence spectra. The spectra are
normalized, background corrected and filtered with 21-order median filter to eliminate undesirable spikes
due to noise and other disturbances. The spectra are then fed to the feature extraction module and different
features are extracted.

2.4 Design of ANN with Back Propagation Algorithm

Three layers are sufficient to design any nonlinear network [4-8], the input, the hidden and the output. Input
is a layer of nodes with four features. An optimum number of seven neurons are considered in hidden layer
and one neuron in output layer. Hidden and output layers have same activation function for all neurons.
Activation function is a tan sigmoid function. The performance goal is set at 0.001 accuracy and number of
epochs used is 15,000. Levenberg – Marquardt algorithm which is a high performance algorithm and
operates in batch mode is used for training the network.

2.5 Training of ANN

4 features of normal and 4 features of malignant from 20 tissue spectra of normal and 20 tissue spectra of
malignant are used to train the network. Feature vector (MATRIX) is constructed by overlapping both
normal and malignant features (40 x 4 vector) and training program is executed. While training of the
neural network, '1' is assigned as the target for normal and '0' is assigned as the target for malignant. The
training of ANN is stopped once the performance goal is met which is shown in Figure 2.2.The
convergence is achieved in 907 epochs.

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 Figure 2.2: Training of ANN and convergence

REFERENCES

[1] Krishnamurthy, Childers (1986) Two Channel Speech Analysis. IEEE Transactions on Acoustics, Speech and Signal
Processing. ASSP-34:730-743
[2] G.Subramanya Nayak, Sudha Kamath et al. (2006) Principal Component Analysis and Artificial Neural Network
Analysis of oral Tissue Fluorescence Spectra: Classification of Normal, Premelignant and Malignant Pathological
Condition Biopolymers 82:152-166

6 of 32
 Guidelines for submission of Final Project report

1. As per the format enclosed.

2. Maximum of 60-70 pages
3. 01 hard copy and 01 soft copy to be submitted to department office.
4. Hard copy – Spiral binding with Blue cover.
5. Final project report – duly signed by external guide ( for projects in a company )
6. Certificate from the External guide in a company letterhead is must and
copy of the same – to be kept in the report before department certificate)
7. If the project is in college and under any faculty other than internal guide, then
give name, designation and department. Mention him / her as Co-Guide.

7 of 32
 I. GUIDELINES
FOR THE PREPARATION OF B.E. PROJECT REPORT.

DEPARTMENT
OF
E & C ENGINEERING

8 of 32
 MANIPAL INSTITUTE OF TECHNOLOGY,
(A constituent college of Manipal University, Manipal)

MANIPAL - 576 104, Karnataka, India.

The arrangement in parts of B.E. project report is as follows:

1. COVER PAGE

2. INSIDE COVER PAGE

3. QUOTATIONS (if any)

4. DEDICATION PAGE (if any)

5. CERTIFICATE(S)

6. ACKNOWLEDGEMENTS

7. ABSTRACT

8. TABLE OF CONTENTS

9. LIST OF TABLES

10. LIST OF FIGURES

11. ABBREVIATIONS (if any)

12. NOTATIONS (if any)

13. CHAPTERS

14. REFERENCES

9 of 32
The formats for various headings are given below.

1. THE COVER PAGE The fonts and locations of various items on this
page should be exactly as shown in Annexure-1A
(for BE) and Annexure-1B (for M.Tech).

2. INSIDE COVER PAGE Same as the cover page

3. QUOTATIONS: This should not exceed one page

4. DEDICATION PAGE This should not exceed one page.

The fonts and locations of the various items on the
5. CERTIFICATE(S)
certificate should be exactly as shown in

Annexure-2A (for BE) and Annexure-2B (for

M.Tech).

M.Tech students doing their project in industry /

outside-organisation must also submit a certificate
from the concerned authority.

6. ACKNOWLEDGEMENTS This should not exceed two pages.

7. ABSTRACT This should not exceed two pages (about 600

words) and should contain not more than 6 key
words. See Annexure-3.

8. TABLE OF CONTENTS See Annexure-4.

9. LIST OF TABLES See Annexure-5.

10. LIST OF FIGURES Same format as in list of Tables.

10 of 32
11. ABBREVIATIONS See Annexure-6.

12. NOTATION See Annexure-7.

13. CHAPTERS See Annexure-8 (and 9)

14. REFERENCES References should be complete in all respects.

Indicative examples are provided in Annexure-10

1) STYLE NOTES FOR PROJECT REPORT PRODUCTION

1. PAPER
 Use A4 (210 mm X 297 mm) bond un-ruled paper (80 gsm) for all copies
submitted. Use one side of the page only for all printed / typed matter.
2. NUMBERING
a) Pages
 Every page in the Project Report except the Title page must be accounted
for.
 The page numbering, starting from acknowledgements and till the
beginning of the introductory Chapter should be printed in small Roman
numbers, i.e. i. ii. iii. iv ……..
 All printed page numbers should be located at the bottom center of the
page, 17 mm (2/3”) from the bottom edge, using normal print.
b) Chapters
 Use only Arabic numerals. Chapter numbering should be centered on the top of the page using large bold print.

 Example: CHAPTER 1
c) Sections
 Use only Arabic numerals with decimals. Section numbering should be left justified using bold print.
 Example: 1.1, 1.2, 1.3, etc.

d) Subsections
 Use only Arabic numerals with two decimals. Subsection numbering should be left justified using bold print.
 Example: 1.1.1, 1.1.2, 1.1.3, etc.

 NOTE: Sub- section levels beyond the third level (e.g. 1.2.1.1, 3.2.1.3,
etc.) are not recommended.

11 of 32
e) Equation(s) / Formula (e)
 Use only Arabic numerals with single decimal. Equation numbers should
be right justified using normal print. Mathematical symbols should be
printed in italics.
 Format: (<Chapter number> . <Equation serial number>)

 Examples: (Please note that the equation numbers are flush right in normal print).

F u , v =
1
M −1 N−1
∑ ∑ f x , y e
[  − j2π
ux vy

M N ] (5.1)
MN x =0 y=0

for, u = 0, 1, 2 . . . . . M – 1 and v = 0, 1, 2 . . . . . N – 1.

{ }
M N
2 2
TP= ∑ ∑ ∣ F u , v  ∣2 − ∣ F  0,0 ∣2 .
M N
u =− v =−
2 2

(5.2)

D0 =
M
if N ≥ M
4
(5.3)
N
if N  M ,
4
¿
¿ {¿ { ¿ ¿ ¿

D u , v  =  u2  v 2 . (5.4)

PR=  xHFP
TP
100 (5.5)

f) References

 Use only Arabic numerals. Serial numbering. Alphabetical order of

surname or last name of first author.
 Two or more references by same author(s) in the same year should be
indicated by small – case alphabets in italics.

(a) 3. TEXT
a) Colour: Black print

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b) Font:

Regular text Times Roman 12 pts. and normal print

CHAPTER HEADINGS Times Roman 15 pts. and bold print and

all capitals.

SECTION HEADINGS Times Roman 12 pts. and bold print and

capitals.

Subsection Headings Times Roman 12 pts., bold print and

leading capitals, i.e. only first letter in
each word to be in capital.

Special Text Italics / Superscript / Subscript / Special

symbols etc., as per necessity. Special
text may include footnotes, endnotes,
physical or chemical symbols,
mathematical notations, etc.

References Same font as regular text. Serial number

and all authors’ names to be in bold
print. Journal names and book titles in
italics. For format see Annexure 10

c) Spacing:

 Use double spacing between the lines.

 Use triple spacing between paragraphs.

 All paragraphs in the project report should be left justified completely,

from the first line to the last line.

 Use double spacing between the regular text and quotations.

 Provide three spaces between:

1) Chapter title and first sentence of a Chapter.

2) Last line of a section / sub-section and the title of the next section
/ sub-section.
3) Paragraphs.

13 of 32
  Use single spacing between:

1) In footnotes and endnotes for text.

2) In explanatory notes for tables and figures.
3) In text corresponding to bullets, listings, and quotations in the
main body of the project report.
 Use single space in references and double space between references.

d) Justification

 The text should be fully justified.

 Hyphenation should be avoided as far as possible.

 Text corresponding to bullets and listings should be intended.

 Quotations from other research work must be indented on the left and the
right, if they are longer than two lines. Shorter quotations can be included
as part of the regular text.

e) Widows and Orphans

 At the bottom of a page, a paragraph should have at least two lines.

Similarly at the top of a page, a paragraph should end with at least two
lines

4. MARGINS

 The margin for the regular text are as follows:

LEFT 31.7 mm (1.25”)

RIGHT 31.7 mm (1.25”)

TOP 25.4 mm (1.00”)

BOTTOM 17.0 mm (0.67”)

 Please note that the bottom of the page numbers should be 17.0 mm above
the bottom edge of the numbered pages.

5. TABLES

 A sample of Table is provided in Annexure-9.

14 of 32
  All Tables should have sharp lines, drawn in black ink, to separate
rows/columns as and when necessary.

 Tables should follow immediately after they are referred to for the first
time in the text. Splitting of paragraphs, including Tables on a page,
should be avoided. Provide three spaces on the top and the bottom of all
Tables to separate them from the regular text, whenever applicable.

 The last line of the title of any Table should be 10 mm to 15 mm above the
top-most horizontal line of the Table, and the title should be centered with
respect to the Table. The titles must be in the same font as the regular text
and should be single- spaced. The title format is given below:

 Whenever a Table exceeds one page, present the full title of the Table on
the first page and in the following pages provide the Table number and
state “(contd.)” after it. Example: Table 5.7 (contd.)

 Whenever explanatory notes are used for clarifying any information

presented inside the Tables, print them after leaving a single space
immediately below the Tables.

 All Tables in landscape format must be placed such that their top portions
are near the binding of the project report and their bottom portions near
the outer edge.

 Table<blank><chapter number>.<serial number><left indent><table title>

(i) 6. FIGURES
 Sample of a Figure is provided in Annexure-9.

 All Figures, drawings, and graphs should be drawn in black ink with sharp
lines and adequate contrast between different plots if more than one plot is
present in the same graph.

 Figures should follow immediately after they are referred to for the first
time in the text. Splitting of paragraphs, for including Figures on a page,
should be avoided. Provide three spaces on the top and bottom of all
figures to separate them from the regular text, wherever applicable.

 The first line of the title for Figures, drawings, graphs and photos should
be between 10 mm and 15 mm below the bottom and they should be
centered with respect to the Figure. The titles must be in the same font as
the regular text and should be Single spaced. The title format is given
below:

15 of 32
  Fig.<blank><Chapter number>.<serial number><left indent><Figure
title>

 Example: Fig. 4.23

 Whenever a Figure exceeds one page (as in the case of large flow charts
for computer programs) present the full title of the figure on the first page
and in the following pages provide the figure number and state “(contd.)
after it.

 Example: Fig. 4.23 (contd.)

 When there are many plots in a single graph or Figure, the lettering,
labeling or numbering of each plot for its identification should be of a size
such that even after size reduction in the project report, the identification
should be clearly legible.

 All Figures in landscape format must be placed such that their top portions
are near the binding of the project report and their bottom portions near
the outer edge.

7. PHOTOS

 Use colour photos only if they are necessary. Remember that the project
report may have to be photocopied. In case colour photos are used, all
copies of the project report must contain only colour photos.

 Each photo should be numbered and referred to as a Figure. Photo titles

should be similar to those provided for Figures.

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 Annexure – 1A

CLASSIFICATION OF CARDIAC ABNORMALITIES

USING NEURAL NETWORKS AND FUZZY LOGIC
A project report submitted

to

MANIPAL UNIVERSITY
(Formerly known as Manipal Academy of Higher Education)

For Partial Fulfillment of the Requirement for the

Award of the Degree

of

BACHELOR OF ENGINEERING

in

ELECTRONICS AND COMMUNICATION ENGINEERING

by

MANJUNATH S. GURIKAR
RITHESH KINI
SANDEEP KAMATH
SOMANATH H. YADARANGI

Under the Guidance of

Mr. SURESH AMIN Mr. GIRISH SAXENA

Reader, Department of E & C Engineering Project Engineer, Tata Consultancy
Internal Guide External Guide / Co- Guide
DEPARTMENT OF ELECTRONICS AND
COMMUNICATION ENGINEERING
MANIPAL INSTITUTE OF TECHNOLOGY
(A constituent college of Manipal University, Manipal)
MANIPAL - 576 104, KARNATAKA, INDIA
APRIL 2001

17 of 32
 Annexure – 2A

MANIPAL INSTITUTE OF TECHNOLOGY

(A constituent college of Manipal University, Manipal)
MANIPAL - 576 104.

DEPARTMENT OF E & C ENGINEERING

CERTIFICATE
This is to certify that the project work titled “DIGITAL STEGANOGRAPHY

FOR MEDICAL INFORMATION EXCHANGE” is a bonafied work of

LLOYD LOBO 4MI98BM013

MOHANDASA NAYAK 4MI98BM031

VIJAY S.N. 4MI98BM021

carried out in partial fulfillment of the requirements for awarding the degree of
Bachelor of Engineering in Electronics and Communication discipline in
Manipal Institute of Technology under Manipal University, Manipal during the
academic year 2001-2002.

Internal Guide HOD

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 Annexure - 3

II. ABSTRACT

KEYWORDS: Diabetic neuropathy; optical pedobarograph; foot pressures; power

ratio; early plantar ulcer detection; ANN foot model.

In diabetic patients, neuropathy (loss of sensation) is the primary etiologic factor. Due to

the sensory neuropathy, patients are unable to sense pressure, pain or micro trauma on the

foot. An injury or infection in the neuropathic foot results in a serious medical condition

often leading to amputation. Therefore foot problems in patients with diabetes mellitus

are a major public health concern these days. The present study is aimed at using new

diagnostic pressure parameters and correlating them to quantified plantar sensation to

understand pressure distribution patterns under the soles of diabetic feet in different

levels of sensation loss, possibly responsible for ulcer formation. Sensations of plantar

surface of the diabetic foot (in ten standard foot sole areas) are quantified using Semmes–

Weinstein monofilaments and classified into four different categories. Standing and

walking foot pressure measurements are carried out using optical pedobarograph.

In the space domain analysis of walking foot pressures, studies are performed on 20

normal and 40 diabetic feet in different levels of sensation loss, using new diagnostic

parameters, normalised peak pressure (NPP), pressure contact ratio (PCR) and their

gradients (relative difference). It is found that the values of these foot pressure parameters

of diabetic patients are much higher than those of normal subjects in general and these

values increase with degree of neuropathy, in all the areas of the foot. But these pressure

parameters in the space domain analysis could not distinguish clearly the diabetic feet in

different levels of loss of sensation.

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A detailed analysis is performed first on standing foot pressure images in frequency

domain. A new parameter, power ratio (PR, ratio of power in higher spatial frequency

components to the total power in an image) is used to distinguish between the foot

pressure image patterns of diabetic neuropathy subjects (in different levels of sensation

loss) and those of normal foot. The results could help to detect the early stages of

neuropathy responsible for plantar ulcers only in the heel of diabetic feet.

The study is carried out further to analyse walking foot pressure images of diabetic

subjects in different levels of neuropathy and use the same parameter power ratio, PR

(defined earlier) to distinguish normal from the diabetic feet. The parameter is able to

distinguish clearly the normal from the diabetic feet and also make clear distinctions

without overlap between diabetic feet in different levels of loss of sensation. The result

could help to detect the early stages of neuropathy responsible for plantar ulcers in both

the heel and fore-foot areas of diabetic feet.

Two comprehensive foot models are developed using artificial neural networks with

pressure parameters, namely, NPP, PCR and PR are used as input variables and sensation

levels as output variable. The nonlinear model helps in classifying the foot in the

category of normal and diabetic in different levels of sensation loss. The neural network

model can be trained with sufficient number of data sets of foot pressure parameters

corresponding to the ulcer at early stage neuropathy. This model then could help in

detecting the plantar surface of foot likely to have ulcer and the information can be

utilised by orthopaedic surgeons to devise early corrective methods to prevent the foot-

sole ulcers and enhance the quality of life by avoiding the lower limb complications of

diabetes.

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 Annexure - 4

TABLE OF CONTENTS

Page

i
ACKNOWLEDGEMENTS.........................................................................
ABSTRACT ........................................................................................................ iii

LIST OF TABLES .............................................................................................. ix

B..................................................................................................................LIST OF FIGURES xi
....................................................................................................................................................

C....................................................................................................................ABBREVIATIONS xv
....................................................................................................................................................

D..............................................................................................................................NOTATION xvii
....................................................................................................................................................

CHAPTER 1 III...........................................................INTRODUCTION

1.1 A..............................................................................................................General 1
...............................................................................................................................

1.2 Diabetes.............................................................................................. 1
1.2.1 Foot Problems in Diabetes................................................................. 3
1.2.2 Ulcer Formation................................................................................. 3
1.2.3 Sites of Neuropathic Ulcers................................................................ 5
1.2.4 Anaesthesia and Sensory Paralysis due to Diabetes........................... 6
1.2.5 Causes of Ulceration.......................................................................... 8
1.2.6 B.............................................................................................Foot Bone Damage 9
...............................................................................................................................

1.3 Anatomy of the Foot.......................................................................... 10

1.3.1 Foot Skeleton...................................................................................... 10
1.3.2 Arches of the Foot.............................................................................. 12
1.3.3 Muscles of the Foot............................................................................ 13
1.4 C.................................................................................Organisation of the Thesis 17
...............................................................................................................................

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 CHAPTER 2 OVERVIEW OF THE LITERATURE

2.1 Introduction............................................................................... 19
2.2 Significant Findings about Foot Pressures......................................... 20
2.3 Findings Regarding Diabetic Foot Pressures..................................... 21

LIST OF TABLES Annexure - 5

Table (3) Title (a)

3.1 Details of Semmes–Weinstein nylon monofilaments used for

classification of diabetic neuropathy.......................................................... 39

4.1 Comparison of mean of maximum NPP values [kPaN-1(ms-1)-1] in the

different foot areas for normal and diabetic subjects.................................. 45

4.2 Coefficients of correlation (r) between NPP values and levels of

sensation (S) and the corresponding regression equations in different
areas of the foot in diabetic subjects........................................................... 47

4.3 Comparison of mean of maximum NPP gradient values [kPaN-1(ms-1)-1/

pixel ] in the different foot areas for normal and diabetic subjects............ 49

4.4 Coefficients of correlation (r) between NPP gradient values and levels of
sensation (S) and the corresponding regression equations in different
areas of the foot in diabetic subjects........................................................... 51

4.5 Comparison of mean of maximum PCR values [kPaN-1(ms-1)-1] in the

different foot areas for normal and diabetic subjects.................................. 54

4.6 Coefficients of correlation (r) between PCR values and levels of

sensation (S) and the corresponding regression equations in different
areas of the foot in diabetic subjects........................................................... 56

4.7 Comparison of mean of maximum PCR gradient values [kPaN-1(ms-1)-1 /

pixel ] in the different foot areas for normal and diabetic subjects............ 58

4.8 Coefficients of correlation (r) between PCR gradient values and levels of
sensation (S) and the corresponding regression equations in different

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 areas of the foot in diabetic subjects........................................................... 60

5.1 Comparison of mean values of PR (of left and right foot) in the different
foot areas for normal subjects with different age from standing foot
pressure image analysis.............................................................................. 74

Annexure - 6

(a) ABBREVIATIONS

AH Adductor Hallucis

ANN Artificial Neural Network

BMP Bit map

CCD Charge Coupled Device

EDL Extensor Digitorum Longus

EHL Extensor Hallucis Longus

FDL Flexor Digitorum Longus

FFT Fast Fourier Transform

FHL Flexor Hallucis Longus

HFP High Frequency Power

IER Inferior Extensor Retinaculum

LFP Low Frequency Power

LOPS Loss of Protective Sensation

MB Mega Byte

MOS D. Metal Oxide Semiconductor

MOSFET Metal Oxide Semiconductor Field Effect Transistor

23 of 32
MTH Metatarsal Head

NPP Normalised Peak Power

NPP Grad. Normalised Peak Power Gradient

Annexure - 7

(a) NOTATIONS

ai
Input variables for an artificial neural network
bk Output variables of an artificial neural network
(i) The size of foot area image (in pixels)

n The number of samples in a foot category

(ii) Peak pressure in the specified areas of the foot

p Probability value of Student’s t - test

r E. Correlation coefficient

S Foot-sole sensation level

si The output of input-layer of artificial neural network

sj h The output of hidden-layer of an artificial neural network

t Time during which a pressure of 50% or higher of peak pressure acts on the
specified foot area
(i) F. Total contact time of the foot

u, v Spatial frequency (in cycles per pixel) variables of a foot area image
(i) Walking velocity
(ii) Weight of the subject

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wjih Weights of the links between input and hidden layers of an artificial neural
network

wkjo Weights of the links between hidden and output layers of an artificial neural
network

x, y Space variables (in pixels) of foot area image

θ j
h Bias term of hidden layer of artificial neural network

θ k
o
Bias term of output layer of artificial neural network

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 Annexure - 8

CHAPTER 1

INTRODUCTION

1.1 GENERAL

Diabetes continues to be one of the most common underlying factors associated with

lower–extremity amputation in post–industrialised and developing countries (Armstrong

et al., 1998a). Amputations are perhaps the most feared and well–recognised

complication of diabetes by the general public. Ulceration is the most common single

precursor to amputation and has been identified as a component in 85% of lower-

extremity amputations (Pecoraro et al., 1990). Many studies have focused on

neuropathy, in conjunction with elevated ground reaction forces, as the principal cause of

these ulcerations. It is also hypothesised that at the cellular level, increased rate of tissue

deformation may result in elevated intracellular calcium concentration, which may lead to

cellular death subsequently causing ulcerations (Landsman et al., 1995). The present

study is an effort to understand the pressure distribution patterns under the foot-soles of

diabetic subjects at different levels of neuropathy (characterised by different grades of

sensation loss) with new foot pressure parameters, possibly indicating the different stages

in the progress of neuropathy and hence help to detect the early stages of neuropathy

responsible for plantar ulcers.

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1.2 DIABETES

Diabetes is a disorder caused by decreased production of insulin, or by decreased ability

to use insulin. Insulin is a hormone produced by the pancreas that is necessary for the

cells to be able to use blood sugar. Annexure - 9

Power ratio, PR

60

Area 1
50 PR1 = 3.03(S1 ) + 15.43
r = 0.94

40

30

20

3.0 4.5 6.0 7.5 9.0 10 10.5

3.0 4.5 7.5 10.0
Sensation levels, S (gm)
Fig. 5.6 Variation of PR with the levels of sensation, S in the medial heel region (area 1)

of 50 feet of diabetic subjects from standing foot pressure image analysis.

Table 5.5 Coefficients of correlation (r) between PR values and levels of sensation (S)

and the corresponding regression equations in different areas of the foot in

diabetic subjects.

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Foot Correlation coefficients
areas (r)
1 0.94
2 0.96
4 0.74
5 0.79
6 0.77
7 0.83
8 0.78
9 0.74
10 0.75
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IV. REGRESSION EQUATIONS
PR1 = 3.03 x S1 + 15.43
PR2 = 3.45 x S2 + 12.94
PR4 = 2.80 x S4 + 14.73
PR5 = 2.93 x S5 + 14.03
PR6 = 3.28 x S6 + 13.21
PR7 = 3.07 x S7 + 13.51
PR8 = 4.02 x S8 + 08.82
PR9 = 4.19 x S9 + 08.02
PR10 = 4.66 x S10 + 4.66
 Annexure -10

REFERENCES

1. Alexander, I. J. (1990) The assessment of dynamic foot-to-ground contact forces

and plantar pressure distribution: A review of the evolution of current techniques
and clinical applications, Foot and Ankle, 11, 152–167.

2. Armstrong, D.G., Lavery, L.A. and Harkless, L.B. (1998a) Validation of diabetic
wound classification system, Diabetes Care, 21, 855–867.

3. Armstrong, D.G., Lavery, L.A. and Bushman, T.D. (1998b) Peak foot pressures
influence the healing time of diabetic foot ulcers treated with total contact casts, J.
Rehabilitation Research and Development, 35, 1–5.

4. Barrett, J. P. and Mooney, V. (1973) Neuropathy and diabetic pressure lesions,

Orthop. Clin. North Am., 4, 43–47.

5. Betts, R. P. and Franks, C.I. (1980) Static and dynamic foot-pressure

measurements in clinical orthopaedics, Med. Biol. Eng. Comput., 18, 674–684.

6. Boulton, A. J. M. The high-risk foot in diabetes mellitus, pp. 49–59. In R.G.

Frykberg (ed.) Diabetic Neuropathy, Churchill Livingstone, New York, 1991.

7. Brand, P. Insensitive Feet - A Practical Handbook on Foot Problems in Leprosy,

The Leprosy Mission International, Brendford, England, UK., 1989.

8. Gonzalez, R.C. and P. Wintz, Image Transforms, Digital image processing, second
edition, Addison-Wesley, USA, 1987.

9. Habershaw, G. and Donovan, J.C. The diabetic Charcot foot, pp. 32–44. In Kozak
G.P., Hoar, C.S. Rowbotham, J.I., Wheelock, F.C., Gibbons, G.W. and
Campbell, D. (eds.) Management of Diabetic Foot Problems. W.B. Saunders Co.,
Philadelphia, 1984.

10. Patil, K. M., Prabhu, G.K., Srinivasan, S., Narayanamurthy, V.B. and
Parivalavan, R. (2000) Artificial neural network model for analysis of walking
foot pressures at different levels of diabetic neuropathy, Proceedings of the 10th
International Conference on Biomedical Engineering, pp. 459–460, Dec. 6–9,
Singapore.

Note:
 For papers by single authors see example (1)
 For papers by two authors see examples (4,5)
 For papers with more than two authors see examples (2,3)
 For books see examples (6,7,8)
 For articles in edited books / volumes see example (9)
 For papers presented at conference see example (10)

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