Displaying publications 1 - 20 of 31 in total

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  1. Khandelwal A, Gupta A, Virmani V, Khandelwal K
    Med J Malaysia, 2012 Oct;67(5):534-5.
    PMID: 23770877
    Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been used as effective treatment for early-stage transitional carcinoma of the urinary bladder. We present a case of a 68 year old man who had an abdominal aortic aneurysm following BCG therapy for bladder cancer. Contrast enhanced computerized tomogram (CECT) of abdomen and pelvis revealed bilateral hypodense lesions suggestive of psoas abscesses. In addition, a saccular abdominal aortic aneurysm measuring 4x3.6 cm involving infrarenal aorta with surrounding hematoma was seen. At surgery, he was found to have a psoas abscess and hemorrhage. He underwent ligation of the aorta and an axillary-bifemoral bypass. He was given one year of anti-tubercular therapy to which he responded clinically.
  2. Lal C, Gupta A, Khaira A, Tiwari SC
    Med J Malaysia, 2009 Jun;64(2):184.
    PMID: 20058588
    Sir, We here are highlighting the scenario of presentation of renal dysfunction in developing countries like India where a large number of patients present clinically as acute renal failure (ARF) but on thorough evaluation found to have advanced stages of chronic kidney disease (CKD stages 4 and 5)1 . Historically these patients are symptomatic for few days prior to presenting. Preceding slight unwell-ness is ignored either by patient or his family physician. They are often being treated with non-specific medications like analgesics and multivitamins which act as placebo. Iron deficiency anemia is unevaluated for a renal cause. Non-standardized laboratories under diagnose early CKD. Ultrasound imaging too is of poor quality. All the more there are no nationalized health screening programmes. To add to the dismal scenario, at the tertiary care centres they are initially admitted as ARF, with a hope of significant recovery. But later on they turn out to be CKD 5.
  3. Gupta A, Thida W, Nazir B, Yeo CS, Low Y, Ong CL
    Med J Malaysia, 2015 Aug;70(4):259-62.
    PMID: 26358026
    Isolated fallopian tube torsion is an uncommon diagnosis. It is particularly rare in the paediatric and post-menopausal age groups. It lacks pathognomonic symptoms, signs and imaging findings, yet each of these diagnostic steps plays a crucial role in early diagnosis. We describe two cases of isolated fallopian tube torsion in prepubertal females.
  4. Misra S, Gupta A, Saran RK
    Malays J Pathol, 2020 Dec;42(3):487-490.
    PMID: 33361734
    Report of a 3-month old girl child who died due to multi-systemic infection of cytomegalovirus (CMV) involving the lungs, liver and kidneys along with pneumocystis jiroveci pneumonia (PJP). The mother of the child tested positive for CMV IgG and HIV with a very low CD4 count (160/ μl). Co-infection of cytomegalovirus and pneumocystis jiroveci always occurs in the setting of immunocompromise. Congenital CMV infection is transmitted through the placenta, especially during the first trimester and causes severe multi-systemic disease whereas perinatal infection is acquired during childbirth/ breastfeeding where the babies have maternal protective antibodies leading to much milder or asymptomatic infection. PJP is more common in infancy and presents as hypoxic pneumonia. CMV causes cyto-nucleomegaly and classic "owl's eye" inclusions on histology while PJP presents with characteristic fluffy "cotton ball" alveolar exudates.
  5. Jain P, Chhabra H, Chauhan U, Prakash K, Gupta A, Soliman MS, et al.
    Sci Rep, 2023 Jan 31;13(1):1792.
    PMID: 36720922 DOI: 10.1038/s41598-023-29024-x
    A hepta-band terahertz metamaterial absorber (MMA) with modified dual T-shaped resonators deposited on polyimide is presented for sensing applications. The proposed polarization sensitive MMA is ultra-thin (0.061 λ) and compact (0.21 λ) at its lowest operational frequency, with multiple absorption peaks at 1.89, 4.15, 5.32, 5.84, 7.04, 8.02, and 8.13 THz. The impedance matching theory and electric field distribution are investigated to understand the physical mechanism of hepta-band absorption. The sensing functionality is evaluated using a surrounding medium with a refractive index between 1 and 1.1, resulting in good Quality factor (Q) value of 117. The proposed sensor has the highest sensitivity of 4.72 THz/RIU for glucose detection. Extreme randomized tree (ERT) model is utilized to predict absorptivities for intermediate frequencies with unit cell dimensions, substrate thickness, angle variation, and refractive index values to reduce simulation time. The effectiveness of the ERT model in predicting absorption values is evaluated using the Adjusted R2 score, which is close to 1.0 for nmin = 2, demonstrating the prediction efficiency in various test cases. The experimental results show that 60% of simulation time and resources can be saved by simulating absorber design using the ERT model. The proposed MMA sensor with an ERT model has potential applications in biomedical fields such as bacterial infections, malaria, and other diseases.
  6. Covés-Datson EM, King SR, Legendre M, Swanson MD, Gupta A, Claes S, et al.
    Sci Rep, 2021 01 12;11(1):656.
    PMID: 33436903 DOI: 10.1038/s41598-020-80577-7
    Lectins, carbohydrate-binding proteins, have been regarded as potential antiviral agents, as some can bind glycans on viral surface glycoproteins and inactivate their functions. However, clinical development of lectins has been stalled by the mitogenicity of many of these proteins, which is the ability to stimulate deleterious proliferation, especially of immune cells. We previously demonstrated that the mitogenic and antiviral activities of a lectin (banana lectin, BanLec) can be separated via a single amino acid mutation, histidine to threonine at position 84 (H84T), within the third Greek key. The resulting lectin, H84T BanLec, is virtually non-mitogenic but retains antiviral activity. Decreased mitogenicity was associated with disruption of pi-pi stacking between two aromatic amino acids. To examine whether we could provide further proof-of-principle of the ability to separate these two distinct lectin functions, we identified another lectin, Malaysian banana lectin (Malay BanLec), with similar structural features as BanLec, including pi-pi stacking, but with only 63% amino acid identity, and showed that it is both mitogenic and potently antiviral. We then engineered an F84T mutation expected to disrupt pi-pi stacking, analogous to H84T. As predicted, F84T Malay BanLec (F84T) was less mitogenic than wild type. However, F84T maintained strong antiviral activity and inhibited replication of HIV, Ebola, and other viruses. The F84T mutation disrupted pi-pi stacking without disrupting the overall lectin structure. These findings show that pi-pi stacking in the third Greek key is a conserved mitogenic motif in these two jacalin-related lectins BanLec and Malay BanLec, and further highlight the potential to rationally engineer antiviral lectins for therapeutic purposes.
  7. Ye Q, Gao Y, Patel RJ, Cao B, Li A, Powell J, et al.
    Science, 2024 Apr 05;384(6691):26-28.
    PMID: 38574143 DOI: 10.1126/science.adp2180
  8. Agrawal R, Testi I, Mahajan S, Yuen YS, Agarwal A, Rousselot A, et al.
    Ocul Immunol Inflamm, 2020 Apr 06.
    PMID: 32250731 DOI: 10.1080/09273948.2020.1716025
    An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence, and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis, and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.
  9. Agrawal R, Agarwal A, Jabs DA, Kee A, Testi I, Mahajan S, et al.
    Ocul Immunol Inflamm, 2019 Dec 10.
    PMID: 31821096 DOI: 10.1080/09273948.2019.1653933
    Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB).Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes.Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease "remission" and "cure", both of which are relevant for reporting treatment outcomes.Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.
  10. Sahay M, Jasuja S, Tang SCW, Alexander S, Jha V, Vachharajani T, et al.
    Nephrology (Carlton), 2021 Feb;26(2):142-152.
    PMID: 33169890 DOI: 10.1111/nep.13825
    AIM: There is paucity of data on the epidemiology of end-stage kidney disease (ESKD) from South Asia and South-East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies.

    METHODS: The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community-based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher-middle-income) and Group 2 (lower|lowermiddle income). Student t-test, Mann-Whitney U test and Fisher's exact test were used for comparison.

    RESULTS: Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2-59.45 vs 47.7 years).

    CONCLUSION: Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.

  11. Bhargava V, Jasuja S, Tang SC, Bhalla AK, Sagar G, Jha V, et al.
    Nephrology (Carlton), 2021 Nov;26(11):898-906.
    PMID: 34313370 DOI: 10.1111/nep.13949
    BACKGROUND: Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia and Southeast Asia (SA&SEA) region.

    METHODS: The National Nephrology Societies of the region responded to a questionnaire on KRT practices. The responses were based on the latest registry data, acceptable community-based studies and societal perceptions. The representative countries were divided into high income and higher-middle income (HI & HMI) and low income and lower-middle income (LI & LMI) groups.

    RESULTS: Data provided by 15 countries showed almost similar percentage of GDP as health expenditure (4%-7%). But there was a significant difference in per capita income (HI & HMI -US$ 28 129 vs. LI & LMI - US$ 1710.2) between the groups. Even after having no significant difference in monthly cost of haemodialysis (HD) and PD in LI & LMI countries, they have poorer PD utilization as compared to HI & HMI countries (3.4% vs. 10.1%); the reason being lack of formal training/incentives and time constraints for the nephrologist while lack of reimbursement and poor general awareness of modalities has been a snag for the patients. The region expects ≥10% PD growth in the near future. Hong Kong and Thailand with 'PD first' policy have the highest PD utilization.

    CONCLUSION: Important deterrents to PD underutilization were lack of PD centric policies, lackadaisical patient/physician's attitude, lack of structured patient awareness programs, formal training programs and affordability.

  12. Sharma SD, Gupta A, Bansal P, Alexander M, Vidya B, Gupta H
    Natl J Maxillofac Surg, 2022 Aug;13(Suppl 1):S91-S96.
    PMID: 36393928 DOI: 10.4103/njms.njms_309_21
    Aim: The goal of this study was to assess the effectiveness of piezotome as compared to periotome extractions of nonrestorable endodontic treatment of teeth in terms of operational time, pain control, and postoperative bone loss considering the prosthetic rehabilitation in future.

    Materials and Methods: A double-blind, randomized controlled trial was conducted with 100 patients who wanted single-rooted teeth to be extracted (which failed endodontically). The participants have been randomized into two equal groups named as - (i) a periotome group (ii) and a piezotome group. Duration of the surgery, postoperative pain within 7 days, complications (if any) associated with the extraction process were performed as a part of clinical assessment. Bone loss has been analyzed 6 months after the surgery radiographically. The data have been recorded and analyzed using the version 22.0 of the SPSS software package.

    Results: All parameters in the periotome category (P < 0.05) were statistically significant except for bone loss and gingival laceration in comparison to piezotome group. In the piezotome group, a longer time was observed for surgery and delayed pain control was achieved. In our study, we found statistically significant more marginal bone loss in piezotome group in comparison with periotome group.

    Conclusion: The findings of this study indicate that for intraoperative and postoperative comfort periotome could be used as a safer and cheaper option for atraumatic extractions but piezosurgery may prove as a better choice soon for surgeries in the maxillofacial region to maintain soft-tissue integrity.

  13. Elhence A, Gahlot N, Gupta A, Garg P
    Malays Orthop J, 2020 Nov;14(3):180-183.
    PMID: 33403083 DOI: 10.5704/MOJ.2011.030
    Arterial haemorrhage is a potentially life threatening complication in severe pelvic ring injuries such as "open book" fractures. These injuries mostly implicate the posterior branches of the internal iliac artery. However, we report an unusual case wherein the source of bleeding was identified to be the internal pudendal artery and its branches. Patient was a 27-year-old male who presented to the emergency following an alleged history of road traffic accident and was diagnosed as a case of pelvic fracture (Young and Burgess Antero-Posterior Compression II) with sacral fracture (Denis type 2) with suspected urethral injury. Computerised Tomography (CT) angiogram revealed contrast extravasation from the right internal pudendal artery. However, digital subtraction angiography (DSA) was normal indicating spontaneous closure of the arterial bleeder. Surgical stabilisation of the fracture was carried out and subsequently, patient was discharged. This report serves to highlight that although uncommon, internal pudendal artery can be injured in hemodynamically unstable "open book" pelvic fractures and hence, must be always ruled out.
  14. Ghoreishi A, Arsang-Jang S, Sabaa-Ayoun Z, Yassi N, Sylaja PN, Akbari Y, et al.
    J Stroke Cerebrovasc Dis, 2020 Dec;29(12):105321.
    PMID: 33069086 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105321
    BACKGROUND: The emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran.

    METHODS: This study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model.

    RESULTS: During the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p 

  15. Gupta A, Low WL, Radecka I, Britland ST, Mohd Amin MC, Martin C
    J Microencapsul, 2016 Dec;33(8):725-734.
    PMID: 27781557 DOI: 10.1080/02652048.2016.1253796
    Wounds that remain in the inflammatory phase for a prolonged period of time are likely to be colonised and infected by a range of commensal and pathogenic microorganisms. Treatment associated with these types of wounds mainly focuses on controlling infection and providing an optimum environment capable of facilitating re-epithelialisation, thus promoting wound healing. Hydrogels have attracted vast interest as moist wound-responsive dressing materials. In the current study, biosynthetic bacterial cellulose hydrogels synthesised by Gluconacetobacter xylinus and subsequently loaded with silver were characterised and investigated for their antimicrobial activity against two representative wound infecting pathogens, namely S. aureus and P. aeruginosa. Silver nitrate and silver zeolite provided the source of silver and loading parameters were optimised based on experimental findings. The results indicate that both AgNO3 and AgZ loaded biosynthetic hydrogels possess antimicrobial activity (p 
  16. Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, et al.
    J Hypertens, 2024 Jan 01;42(1):23-49.
    PMID: 37712135 DOI: 10.1097/HJH.0000000000003563
    Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
  17. Chopra S, Gupta A, Aoyama H, Wu HG, Mahmood H, Tharavichitkul E, et al.
    JCO Glob Oncol, 2023 Jun;9:e2300002.
    PMID: 37384859 DOI: 10.1200/GO.23.00002
    PURPOSE: This survey was conducted to assess the current research practices among the 14 members of the Federation of Asian Organizations for Radiation Oncology (FARO) committee, to inform measures for research capacity building in these nations.

    MATERIALS AND METHODS: A 19-item electronic survey was sent to two research committee members from the 14 representative national radiation oncology organizations (N = 28) that are a part of FARO.

    RESULTS: Thirteen of the 14 member organizations (93%) and 20 of 28 members (71.5%) responded to the questionnaire. Only 50% of the members stated that an active research environment existed in their country. Retrospective audits (80%) and observational studies (75%) were the most common type of research conducted in these centers. Lack of time (80%), lack of funding (75%), and limited training in research methodology (40%) were cited as the most common hindrances in conducting research. To promote research initiatives in the collaborative setting, 95% of the members agreed to the creation of site-specific groups, with head and neck (45%) and gynecological cancers (25%) being the most preferred disease sites. Projects focused on advanced external beam radiotherapy implementation (40%), and cost-effectiveness studies (35%) were cited as some of the potential areas for future collaboration. On the basis of the survey results, after result discussion and the FARO officers meeting, an action plan for the research committee has been created.

    CONCLUSION: The results from the survey and the initial policy structure may allow facilitation of radiation oncology research in the collaborative setting. Centralization of research activities, funding support, and research-directed training are underway to help foster a successful research environment in the FARO region.

  18. Sharma S, Gupta A, Chik SMST, Kee CG, Mistry BM, Kim DH, et al.
    Int J Biol Macromol, 2017 Nov;104(Pt A):189-196.
    PMID: 28596005 DOI: 10.1016/j.ijbiomac.2017.06.015
    In the present study chicken feathers were hydrolyzed by chemical treatment in alkaline conditions. The pH value of feather hydrolyzed solution was amended accordingly the iso-electric precipitation. Two types of keratin microparticles KM1, KM2 were synthesized under acidic conditions at 3.5 and 5.5pH respectively. The synthesized keratin microparticles possessed uniform and round surface by scanning electron microscopy (SEM). The thermal degradation of microparticles were examined by thermogravimetry (TGA). Fourier transform infrared spectroscopy (FTIR) revealed that the extracted keratin retained the most of protein backbone. The microparticles were screened for their in vitro anticancer activities by SRB bioassay towards HeLa, SK-OV-3 and A549 cancer cell lines. Futhermore, their cytotoxicity towards healthy cell lines was analyzed having Malin Darby canine kidney (MDCK) cell lines along with in vitro antioxidant activity using DPPH and ABTS methods KM1 and KM2 showed 200.31±1.01 and 139.73±0.94, 214.16±0.29 and 153.92±0.61, 328.92±3.46 and 200.33±2.48μg/mL of IC50 levels against HeLa, SK-OV-3, and A549 cell lines, respectively. Moreover, KM1 and KM2 demonstrated significant antioxidant potency with IC50 levels 13.15 and 9.02μg/mL as well as 8.96 and 5.60μg/mL in DPPH and ABTS radical scavenging bioassay, respectively.
  19. Ramakrishnan N, Sharma S, Gupta A, Alashwal BY
    Int J Biol Macromol, 2018 May;111:352-358.
    PMID: 29320725 DOI: 10.1016/j.ijbiomac.2018.01.037
    Plastics have been one of the highly valued materials and it plays an significant role in human's life such as in food packaging and biomedical applications. Bioplastic materials can gradually work as a substitute for various materials based on fossil oil. The issue like sustainability and environmental challenges which occur due to manufacturing and disposal of synthetic plastics can be conquering by bio-based plastics. Feathers are among the most inexpensive abundant, and renewable protein sources. Feathers disposal to the landfills leads to environmental pollutions and it results into wastage of 90% of protein raw material. Keratin is non-burning hydrophilic, and biodegradable due to which it can be applicable in various ways via chemical processing. Main objective of this research is to synthesis bioplastic using keratin from chicken feathers. Extracted keratin solution mixed with different concentration of glycerol (2 to 10%) to produce plastic films. The mixture was stirred under constant magnetic stirring at 60 °C for 5 h. The mixtures are then poured into aluminum weighing boat and dried in an oven at 60 °C for 24 h. The mechanical properties of the samples were tested and the physic-chemical properties of the bioplastic were studied. According to the results, Scanning Electron Microscopy test showed good compatible morphologies without holes, cavity and edge. The difference in chemical composition was analyzed using Fourier transform infrared spectroscopy (FTIR). The samples were also characterized by thermo gravimetric analysis (TGA), differential scanning calorimetry (DSC), X-Ray diffraction (XRD) to check the thermal and crystallinity properties. Other than that, bioplastic made up from keratin with 2% of glycerol has the best mechanical and thermal properties. According to biodegradability test, all bioplastic produced are proven biodegradable. Therefore, the results showed possible application of the film as an alternative to fossil oil based materials which are harmful to the environment.
  20. Baradaran H, Ng CR, Gupta A, Noor NM, Al-Dasuqi KW, Mtui EE, et al.
    Int Angiol, 2017 Oct;36(5):445-461.
    PMID: 28541017 DOI: 10.23736/S0392-9590.17.03811-1
    BACKGROUND: The extent of calcium volume in the carotid arteries of contrast-based computer tomography (CT) is a valuable indicator of stroke risk. This study presents an automated, simple and fast calcium volume computation system. Since the high contrast agent can sometimes obscure the presence of calcium in the CT slices, it is therefore necessary to identify these slices before the corrected volume can be estimated.

    METHODS: The system typically consists of segmenting the calcium region from the CT scan into slices based on Hounsfield Unit-based threshold, and subsequently computing the summation of the calcium areas in each slice. However, when the carotid volume has intermittently higher concentration of contrast agent, a dependable approach is adapted to correct the calcium region using the neighboring slices, thereby estimating the correct volume. Furthermore, mitigation is provided following the regulatory constraints by changing the system to semi-automated criteria as a fall back solution. We evaluate the automated and semi-automated techniques using completely manual calcium volumes computed based on the manual tracings by the neuroradiologist.

    RESULTS: A total of 64 patients with calcified plaque in the internal carotid artery were analyzed. Using the above algorithm, our automated and semi-automated system yields correlation coefficients (CC) of 0.89 and 0.96 against first manual readings and 0.90 and 0.96 against second manual readings, respectively. Using the t-test, there was no significant difference between the automated and semi-automated methods against manual. The intra-observer reliability was excellent with CC 0.98.

    CONCLUSIONS: Compared to automated method, the semi-automated method for calcium volume is acceptable and closer to manual strategy for calcium volume. Further work evaluating and confirming the performance of our semi-automated protocol is now warranted.

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