BiofilmQuant: A Computer-Assisted Tool for Dental Biofilm Quantification

Dental biofilm is the deposition of microbial material over a tooth substratum. Several methods have recently been reported in the literature for biofilm quantification; however, at best they provide a barely automated solution requiring significant input needed from the human expert. On the contrary, state-of-the-art automatic biofilm methods fail to make their way into clinical practice because of the lack of effective mechanism to incorporate human input to handle praxis or misclassified regions. Manual delineation, the current gold standard, is time consuming and subject to expert bias. In this paper, we introduce a new semi-automated software tool, BiofilmQuant, for dental biofilm quantification in quantitative light-induced fluorescence (QLF) images. The software uses a robust statistical modeling approach to automatically segment the QLF image into three classes (background, biofilm, and tooth substratum) based on the training data. This initial segmentation has shown a high degree of consistency and precision on more than 200 test QLF dental scans. Further, the proposed software provides the clinicians full control to fix any misclassified areas using a single click. In addition, BiofilmQuant also provides a complete solution for the longitudinal quantitative analysis of biofilm of the full set of teeth, providing greater ease of usability.Comment: 4 pages, 4 figures, 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2014

A Statistical Modeling Approach to Computer-Aided Quantification of Dental Biofilm

Biofilm is a formation of microbial material on tooth substrata. Several methods to quantify dental biofilm coverage have recently been reported in the literature, but at best they provide a semi-automated approach to quantification with significant input from a human grader that comes with the graders bias of what are foreground, background, biofilm, and tooth. Additionally, human assessment indices limit the resolution of the quantification scale; most commercial scales use five levels of quantification for biofilm coverage (0%, 25%, 50%, 75%, and 100%). On the other hand, current state-of-the-art techniques in automatic plaque quantification fail to make their way into practical applications owing to their inability to incorporate human input to handle misclassifications. This paper proposes a new interactive method for biofilm quantification in Quantitative light-induced fluorescence (QLF) images of canine teeth that is independent of the perceptual bias of the grader. The method partitions a QLF image into segments of uniform texture and intensity called superpixels; every superpixel is statistically modeled as a realization of a single 2D Gaussian Markov random field (GMRF) whose parameters are estimated; the superpixel is then assigned to one of three classes (background, biofilm, tooth substratum) based on the training set of data. The quantification results show a high degree of consistency and precision. At the same time, the proposed method gives pathologists full control to post-process the automatic quantification by flipping misclassified superpixels to a different state (background, tooth, biofilm) with a single click, providing greater usability than simply marking the boundaries of biofilm and tooth as done by current state-of-the-art methods.Comment: 10 pages, 7 figures, Journal of Biomedical and Health Informatics 2014. keywords: {Biomedical imaging;Calibration;Dentistry;Estimation;Image segmentation;Manuals;Teeth}, http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=6758338&isnumber=636350

Dual chamber pacemaker implants--a new opportunity in Pakistan for children with congenital and acquired complete heart block

Implantation of cardiac pacemakers has been practiced for at least five decades with continuous developments of the hardware. The invention of dual chamber pacemakers has initiated a debate concerning its superiority over single chamber ventricular pacemakers. Throughout the world, surgeons have been using dual chambered permanent pacemakers with successful follow ups. However, Pakistan has not yet taken the advantage of such pacemaker devices till now. We report three cases that underwent a dual chamber permanent pacemaker implantation for the first time in children less than 8 kg with successful follow ups

CIDI-Lung-Seg: A Single-Click Annotation Tool for Automatic Delineation of Lungs from CT Scans

Accurate and fast extraction of lung volumes from computed tomography (CT) scans remains in a great demand in the clinical environment because the available methods fail to provide a generic solution due to wide anatomical variations of lungs and existence of pathologies. Manual annotation, current gold standard, is time consuming and often subject to human bias. On the other hand, current state-of-the-art fully automated lung segmentation methods fail to make their way into the clinical practice due to their inability to efficiently incorporate human input for handling misclassifications and praxis. This paper presents a lung annotation tool for CT images that is interactive, efficient, and robust. The proposed annotation tool produces an "as accurate as possible" initial annotation based on the fuzzy-connectedness image segmentation, followed by efficient manual fixation of the initial extraction if deemed necessary by the practitioner. To provide maximum flexibility to the users, our annotation tool is supported in three major operating systems (Windows, Linux, and the Mac OS X). The quantitative results comparing our free software with commercially available lung segmentation tools show higher degree of consistency and precision of our software with a considerable potential to enhance the performance of routine clinical tasks.Comment: 4 pages, 6 figures; to appear in the proceedings of 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2014

Comparison of Erythropoietin alone with Erythropoietin plus oral Ascorbic Acid in the Treatment of Anemia in Chronic Kidney Disease Patients

Objective Of the Study:   To compare efficacy of “Oral ascorbic acid in combination with Erythropoietin”  with “standard dose of erythropoietin alone” in renal anemia in terms of mean hemoglobin rise. Introduction: Recombinant human erythropoietin (rhEPO) has a vital role in management of anemia in CKD (chronic kidney disease) patients. In the last decade, Ascorbic acid (AA) has emerged as a potential therapy to improve anemia probably by enhancing iron mobilization. We have conducted this study to compare the mean hemoglobin rise after treatment with standard dose erythropoietin alone with standard dose erythropoietin plus Oral ascorbic acid in CKD patients who were suffering from anemia. Materials & Methods: A total of 70 patients of CKD with anemia, 18 to 70 years of age of both genders were included. Patients with laboratory proven iron deficiency anemia, obvious blood loss, pernicious anemia, hyperparathyroidism and contraindications for erythropoietin or ascorbic acid treatment were excluded. The patients which were selected randomly placed in two groups. Group A (erythropoietin alone) & Group B (erythropoietin plus oral ascorbic acid), by using lottery method. Outcome variable like hemoglobin was measured at 2, 4 and 6 months. Results: Mean age was 48.90 ± 13.53 years. Male to female ratio was 1.6:1 with 43 (61.43%) males and 27 (38.57%) females. Mean pre-therapy hemoglobin  was 9.40 ± 1.03 g/dl in the Group A while it was 9.42 ± 0.98 g/dl (p-value = 0.901) in Group B and  mean post-therapy hemoglobin in the Group A was 9.34 ± 1.06 g/dl while in the Group B was 10.37 ± 1.16 g/dl with p value of 0.0002 which is statistically significant. Conclusion: The study concluded that standard dose erythropoietin plus Oral ascorbic acid in CKD anemia is more effective  as compared to erythropoietin alone. Keywords: Chronic kidney disease, Erythropoietin, Ascorbic acid, Anemia