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Preliminary Studies in the Use of the Foldscope Paper Microscope for Diagnostic Analysis of Crystals in Urine: Issues in the Analysis of Liquid Samples and Potential Applications in Low Budget/Low Tech Regions of the World”.
EP28851
Preliminary Studies in the Use of the Foldscope Paper Microscope for Diagnostic Analysis of Crystals in Urine: Issues in the Analysis of Liquid Samples and Potential Applications in Low Budget/Low Tech Regions of the World”.
Submitted on 19 Jul 2018

Calder, R., Stevens, D. and Leifer, Z.
New York College of Podiatric Medicine
This poster was presented at Digital Pathology and Artificial Intelligence Congress US 2018
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Poster Abstract
The Foldscope was developed by Dr. Manu Prakash at Stanford as a cheap (under $1.00) microscope made of paper and usable for microscopy by students all over the world and in more serious research or diagnostic roles by professionals. It is especially advantageous to those in regions of the world where budget and availability of high-end instrumentation is severely limited. Here at NYCPM, we obtained a Foldscope from Dr. Prakash. We assembled it (“fold on the dotted lines”), inserted battery and lens and produced a microscope. Two of us (RC and DS) had prior certification and experience as laboratory technicians, including urinalysis. It was determined to evaluate if the Foldscope could be used in this role. Preliminary projects were designed to test this, by preparing samples of likely target crystals – uric acid and calcium oxalate. This was preliminary, as real urine samples from real patients required complex IRB approval, rules and regulations. In this study, it was determined that the crystals could in fact be visualized with this low budget instrument. Furthermore, several issues emerged, different from using a glass or digitized slide – e.g., holding the microscope up to a light source resulted in the liquid sample dripping on the observers face (!). Methods were developed to keep it flat, with attention to clamps to hold it and a light source appropriately placed. Successful imaging by iPad or cell phone allows the necessary component of Telepathology implicit in its application. Further development is needed as to methodology and as to validation with patient samples. Determination of the full range of identifiable crystals and cells of diagnostic significance would expand the usefulness of this application. Its use in low budget/low tech regions of the world would be greatly advantageous.

1. Foldscope: Good overview:
https://en.wikipedia.org/wiki/Foldscope
2. Crystals: Good overview :
https://laboratoryinfo.com/types-of-crystals-in-urine/
“Types of crystals found in human urine and their clinical significance”
3. Diagnostics in Developing Countries: A good review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665590/

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