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(1) Objective: To evaluate the diagnostic performance of prototype handheld ultrasound compared to automated breast ultrasound, according to the fifth edition of BI-RADS categorization, among females with positive lumps. (2) Methods: A total of 1004 lesions in 162 participants who underwent both prototype handheld ultrasound and automated breast ultrasound were included. Two radiologists and a sonographer independently evaluated the sonographic features of each lesion according to the fifth BI-RADS edition. The kappa coefficient (κ) was calculated for each BI-RADS descriptor and final assessment category. The cross-tabulation was performed to see whether there were differences between the ABUS and prototype HHUS results. Specificity and sensitivity were evaluated and compared using the McNamar test. (3) Results: ABUS and prototype HHUS observers found the same number of breast lesions in the 324 breasts of the 162 respondents. There was no significant difference in the mean lesion size, with a maximum mean length dimension of 0.48 ± 0.33 cm. The assessment of the lesion’s shape, orientation, margin, echo pattern, posterior acoustic features, and calcification was obtained with good to excellent agreements between ABUS and prototype HHUS observers (κ = 0.70–1.0). There was absolutely no significant difference between ABUS and prototype HHUS in assessment of lesion except for lesion orientation p = 0.00. Diagnostic accuracy (99.8% and 97.7–98.9%), sensitivity (99.5% and 98.0–99.0%), specificity (99.8% and 99.6–99.8%), positive predictive value (98.1% and 90.3–96.2%), negative predictive value (90.0% and 84.4–88.7%), and areas under the curve (0.98 and 0.83–0.92; p < 0.05) were not significantly different between ABUS and prototype HHUS observers. (4) Conclusion: According to the fifth BI-RADS edition, automated breast ultrasound is not statistically significantly different from prototype handheld ultrasound with regard to interobserver variability and diagnostic performance.

This study investigated the influence of multiliteracy in opaque orthographies on phonological awareness. Using a visual rhyme judgement task in English, we assessed phonological processing in three multilingual and multiliterate populations who were distinguished by the transparency of the orthographies they can read in (N = 135; ages 18–40). The first group consisted of 45 multilinguals literate in English and a transparent Latin orthography like Malay; the second group consisted of 45 multilinguals literate in English and transparent orthographies like Malay and Arabic; and the third group consisted of 45 multilinguals literate in English, transparent orthographies, and Mandarin Chinese, an opaque orthography. Results showed that all groups had poorer performance in the two opaque conditions: rhyming pairs with different orthographic endings and non-rhyming pairs with similar orthographic endings, with the latter posing the greatest difficulty. Subjects whose languages consisted of half or more opaque orthographies performed significantly better than subjects who knew more transparent orthographies than opaque orthographies. The findings are consistent with past studies that used the visual rhyme judgement paradigm and suggest that literacy experience acquired over time relating to orthographic transparency may influence performance on phonological awareness tasks.

A mammography provides a grayscale image of the breast. The main challenge of analyzing mammography images is to extract the region boundary of the breast abnormality for further analysis. In computer vision, this method is also known as image segmentation. The variational level set mathematical model has been proven to be effective for image segmentation. Several selective types of variational level set models have recently been formulated to accurately segment a specific object on images. However, these models are incapable of handling complex intensity inhomogeneity images, and the segmentation process tends to be slow. Therefore, this study formulated a new selective type of the variational level set model to segment mammography images that incorporate a machine learning algorithm known as Self-Organizing Map (SOM). In addition to that, the Gaussian function was applied in the model as a regularizer to speed up the processing time. Then, the accuracy of the segmentation’s output was evaluated using the Jaccard, Dice, Accuracy and Error metrics, while the efficiency was assessed by recording the computational time. Experimental results indicated that the new proposed model is able to segment mammography images with the highest segmentation accuracy and fastest computational speed compared to other iterative models.

This review article presents fractional derivative cancer treatment models to show the importance of fractional derivatives in modeling cancer treatments. Cancer treatment is a significant research area with many mathematical models developed by mathematicians to represent the cancer treatment processes like hyperthermia, immunotherapy, chemotherapy, and radiotherapy. However, many of these models were based on ordinary derivatives and the use of fractional derivatives is still new to many mathematicians. Therefore, it is imperative to review fractional cancer treatment models. The review was done by first presenting 22 various definitions of fractional derivative. Thereafter, 11 articles were selected from different online databases which included Scopus, EBSCOHost, ScienceDirect Journal, SpringerLink Journal, Wiley Online Library, and Google Scholar. These articles were summarized, and the used fractional derivative models were analyzed. Based on this analysis, the merit of modeling with fractional derivative, the most used fractional derivative definition, and the future direction for cancer treatment modeling were presented. From the results of the analysis, it was shown that fractional derivatives incorporated memory effects which gave it an advantage over ordinary derivative for cancer treatment modeling. Moreover, the fractional derivative is a general definition of all derivatives. Also, the fractional models can be applied to different cancer treatment procedures and the most used fractional derivative is the Caputo as well as its non-singular kernel versions. Finally, it was concluded that the future direction for cancer treatment modeling is the adoption of fractional derivative models corroborated with experimental or clinical data.

Breast cancer-related lymphedema (BCRL) is a form of secondary lymphedema that is characterized by abnormal swelling of one or both arms due to the accumulation of lymph fluid in the interstitial tissue spaces, resulting from obstruction of the lymphatic vessels due to surgery insults, radiotherapy, or chemotherapy. Due to the multifactorial nature of this condition, the pathogenesis of secondary lymphedema remains unclear and the search for molecular factors associated with the condition is ongoing. This study aimed to identify serum microRNAs and adipokines associated with BCRL. Blood was collected from 113 breast cancer survivors and processed to obtain serum for small RNA-sequencing (BCRL vs. non-BCRL, n = 7 per group). MicroRNAs that were differentially expressed (fold change >1.5, p < 0.05) between lymphedema cases and those without lymphedema were further quantified in a validation cohort through quantitative reverse transcription PCR (BCRL n = 16, non-BCRL, n = 83). Leptin and adiponectin levels were measured in a combined cohort (BCRL n = 23, non-BCRL n = 90) using enzyme-linked immunosorbent assays. Two of the most significantly upregulated microRNAs, miR-199a-3p and miR-151a-3p, were strongly correlated with the onset of lymphedema and diabetes mellitus in the BCRL group. Leptin levels were higher in the BCRL cohort compared to the non-BCRL cohort (p < 0.05). A metabolic syndrome biomarker, the adiponectin/leptin ratio, was found to be lower in the BCRL group than in the non-BCRL group (median: 0.28 vs. 0.41, p < 0.05). Extensive studies on the mechanisms of the identified microRNAs and association of leptin with arm lymphedema may provide new insights on the potential biomarkers for lymphedema that should be followed up in a prospective cohort study.

Background: Ultrasonographic (USG) measurements of the liver length, gallbladder wall thickness (GBWT), diameters of the inferior vena cava (IVC), portal vein (PV), and pancreas are valuable and reliable in diagnosis hepatobiliary and pancreas conditions. This study is aimed to determine the normal values of liver length, GBWT, AP diameters of the IVC and PV, AP diameter of the head and body of the pancreas. Methods: A prospective cross–sectional study was carried out in this study. A total of the 408 participants were randomly recruited using a systematic method. According to the USG reports, the subjects who had normal USG report for liver, biliary system, and pancreas were described as normals, whereas the subjects who had hepatobiliary diseases such as fatty liver, liver cysts, hemangioma, cirrhosis, gallbladder wall thickening, acute cholecystitis, gallstones, and polyps were recorded as abnormal subjects. Results: Of the 408 participants with a mean of 52.6 ± 8.4 years old. Of those, 294 (72.1%) participants were normal and 114 (27.9%) subjects were reported as abnormal. More than half of the study population was males, 52.9% versus 47.1% of females. There was a significant difference of liver length, head, and body of the pancreas between genders (P = 0.004, 0.002, and P < 0.001, respectively). Moreover, the pancreatic body only was significantly correlated with age (P = 0.026). There also was a significant difference of the liver length, head, and body of the pancreas between normal and abnormal subjects (P < 0.001, P = 0.007, and P < 0.001). Conclusion: Liver length, diameter of the head, and body of the pancreas were significantly associated with gender and hepatobiliary diseases. In addition, only the diameter of the body of the pancreas was significantly correlated with age.

The aim of our study is to evaluate the diagnostic accuracy of double inversion recovery (DIR) in detection of multiple sclerosis (MS) lesions as well as the correlation between the expanded disability status scale (EDSS) and lesion load measurement detected by DIR, fluid attenuated inversion recovery (FLAIR) and T2 weighted imaging (T2WI) in order to reveal the essential role of DIR sequence in assessing clinical inability as a practicable experiment. A total of 97 patients were assessed on a 3T Siemens Skyra MRI scanner using DIR, FLAIR, and T2W_TSE sequences. EDSS was used to assess the physical disability in patients with MS. The diagnostic accuracy of DIR, FLAIR and T2WI sequences was also determined in different anatomical regions. Sensitivity and specificity were assessed by relative operating characteristics/ receiver operating characteristics (ROC) curve at different cut off points. Spearman correlation was applied to identify the significant relationships between the number of lesions displayed by DIR, FLAIR and T2WI at different regions and EDSS score. Our results pointed out the highest sensitivity (92.9%) and specificity (73.5%) for the number of lesions in infratentorial region at the cut-off point of 4.5 and the highest correlation between the number of lesions and EDSS was observed in infratentorial region (r= 0.584, p

BackgroundMagnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS). Advances in MRI techniques such as double inversion recovery (DIR) made it more sensitive to distinguish lesions in the brain. To investigate the lesion load on different anatomical regions of the brain with MS using DIR, fluid attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI) sequences. A total of 97 MS patients were included in our retrospective study, confirmed by neurologist. The patients were randomly selected from the major hospital in Saudi Arabia. All images were obtained using 3T Scanner (Siemens Skyra). The images from the DIR, FLAIR, and T2WI sequence were compared on axial planes with identical anatomic position and the number of lesions was assigned to their anatomical region.ResultsComparing the lesion load measurement at various brain anatomical regions showed a significant difference among those three methods (p< 0.05).ConclusionDIR is a valuable MRI sequence for better delineation, greater contrast measurements and the increasing total number of MS lesions in MRI, compared with FLAIR, and T2WI and DIR revealed more intracortical lesions as well; therefore, in MS patients, it is recommended to add DIR sequence in daily routine imaging sequences.

Pressure Ulcers (PUs) are localized tissue damage that usually occur over the soft tissue of body prominence when a subject is exposed to prolonged external mechanical loading. Several studies have proposed that skin blood flow response (SBFR) can be used in PU evaluation to determine tissue ischemic accumulation due to insufficient time of tissue recovery. In previous study, twenty one Sprague Dawley rats weigh 388-481g that were divided into three different group have been used to investigate the trends of SBFR signal using time domain features like peak reactive hyperaemia (RH), time to peak RH and area under the RH curve as well as frequency domain features like peak power spectral density (PSD) and total PSD. However, the results indicate that both frequency domain features are not effective at determining individual insufficient recovery time. In this study, Continuous Wavelet Transform (CWT) based features such as average amplitude and relative amplitude based on Morlet wavelet function scale 200 are investigated. The results show that the samples representing inconsistent trend of average amplitude for metabolic frequency range are dominant in all short (3 samples) , moderate (4 samples) and prolonged groups (4 samples), while no clear pattern can be established for relative amplitude. Hence both features may not suitable at distinguishing between sufficient and insufficient recovery time due to the low percentage in number of samples.

Plantar fasciitis (PFS) is described by an intense pain over medial tubercle of calcaneus, increased with the first step after waking up, after rest and during weightbearing activity. It is the most common cause of plantar heel pain in adults with the prevalence estimated 10% of the general population. Ultrasound imaging is commonly being used to measure the PF thickness, evaluate the efficacy of different treatments and a guide therapeutic technique in patients with PFS. The objective of this study was to systematically review the studies that were previously published to evaluate the role of ultrasound in the assessment of PF in patients with PFS.A systematic search was carried out over the last 5 years from 2017 to 2022 on basis the following electronic databases: Science Direct, Scopus, Web of Science, Springer and PubMed. The keywords that used in the searching were: ultrasound, sonography, ultrasonography, plantar fasciitis, imaging of plantar fascia, physiotherapy of plantar fasciitis, interventional treatment of plantar fasciitis, randomized controlled trial of plantar fasciitis and interventional ultrasound. The review focused on the assessment of PF in patients with PFS underwent different interventions using B-mode, shear wave elastography (SWE) and color Doppler ultrasound.During the search process, 1661 were recorded using the proper keywords from 2017 to 2022 in which 666 original articles were found after removing the review and duplicated articles. Of these, thirty articles met the inclusion criteria and included in this review. The articles have assessed the PF in patients with PFS under different conditions using different ultrasound modes. Twenty-six articles evaluated the effectiveness of different treatment on PF in patients with PFS using different ultrasound modes. In 8 of 26 articles, the ultrasound was used as both an assessment tool of PF and guide therapeutic technique in patients with PFS. In 18 articles, the ultrasound was used as only assessment tool to identify the PF thickness and its observation changes in patients with PFS. Four articles compared the PF thickness and its intrafascial changes between patients with PFS and healthy subjects.The ultrasound can be a reliable tool in assessment the effect of different interventions on PF by evaluating its thickness, echogenicity and stiffness changes in patients with PFS. There were different methods and treatments were used among the studies.

Microcalcifications in mammogram images are primary indicators for detecting the early stages of breast cancer. However, dense tissues and noise in the images make it challenging to classify the microcalcifications. Currently, preprocessing procedures such as noise removal techniques are applied directly on the images, which may produce a blurry effect and loss of image details. Further, most of the features used in classification models focus on local information of the images and are often burdened with details, resulting in data complexity. This research proposed a filtering and feature extraction technique using persistent homology (PH), a powerful mathematical tool used to study the structure of complex datasets and patterns. The filtering process is not performed directly on the image matrix but through the diagrams arising from PH. These diagrams will enable us to distinguish prominent characteristics of the image from noise. The filtered diagrams are then vectorised using PH features. Supervised machine learning models are trained on the MIAS and DDSM datasets to evaluate the extracted features’ efficacy in discriminating between benign and malignant classes and to obtain the optimal filtering level. This study reveals that appropriate PH filtering levels and features can improve classification accuracy in early cancer detection.

Coded Aperture (CA) imaging has recently been used in nuclear medicine, but still, there is no commercial SPECT imaging camera based on CA for cancer detection. The literature is rich in examples of using the CA for planar and thin 3D imaging. However, thick 3D reconstruction is still challenging for small lesion detection. This paper presents the results of mosaic modified uniformly redundant array (MURA) mask/antimask CA combined with a maximum-likelihood expectation-maximization (MLEM) algorithm. The MLEM is an iterative algorithm applied to a mosaic MURA CA mask/antimask for 3D anthropomorphic breast phantom reconstruction, slice by slice. The difference between the mask and the antimask suppresses the background noise to enhance the quality of reconstructed images. Furthermore, all reconstructed slices are stacked to form a 3D breast phantom image from single-projection data. The results of phantom reconstruction with 8 mm, 6 mm, 4 mm, and 3 mm lesions are presented. Moreover, the proposed SPECT imaging camera can reconstruct a 3D breast phantom from single-projection data of the patient’s scanning. To assess the quality of lesions in the reconstructed images, the contrast-to-background ratio (CBR), the peak signal-to-noise ratio (PSNR) and mean square error (MSE) were measured.

Magnetic resonance imaging (MRI) provides a significant key to diagnose and monitor the progression of multiple sclerosis (MS) disease. Manual MS-lesion segmentation, expanded disability status scale (EDSS) and patient's meta information can provide a gold standard for research in terms of automated MS-lesion quantification, automated EDSS prediction and identification of the correlation between MS-lesion and patient disability. In this dataset, we provide a novel multi-sequence MRI dataset of 60 MS patients with consensus manual lesion segmentation, EDSS, general patient information and clinical information. On this dataset, three radiologists and neurologist experts segmented and validated the manual MS-lesion segmentation for three MRI sequences T1-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR). The dataset can be used to study the relationship between MS-lesion, EDSS and patient clinical information. Furthermore, it also can be used for the development of automated MS-lesion segmentation, patient disability prediction using MRI and correlation analysis between patient disability and MRI brain abnormalities include MS lesion location, size, number and type.

The edible bird nest (EBN) from Aerodramus fuciphagus has been consumed as a Chinese traditional food for health and medicinal purposes due to its elevated nutritional value. The present study focused on the influence of characterization and extraction methods on protein profiling, which could be a guideline for grading the EBN. The proposed extraction method is similar to the common food preparation methods of consumers and thus can accurately establish the bioactive protein available upon human consumption. The characterization includes physicochemical analysis (physical, morphology, elemental composition, and microbial content) and chemical analysis (crude protein and amino acid). The morphology of half-cup EBN was found to be uniformly shaped and rich in calcium as compared to rough surface of stripe-shaped EBN, and there was no significant microbial growth in both types of EBN. The crude protein and amino acid content in half-cup EBN were significantly higher than stripe-shaped EBN. The full stew (FS) and stew (SE) extraction methods produced a maximal yield of soluble protein. Sialic acid content in SE extract (8.47%, w/w) and FS extract (7.91%, w/w) were recorded. About seven parent proteins (39.15 to 181.68 kDa) were identified by LC-MS/MS Q-TOF, namely 78 kDa glucose-regulated protein, lysyl oxidase-3, Mucin-5AC-like, acidic mammalian chitinase-like, 45 kDa calcium-binding protein, nucleobindin-2, and ovoinhibitor-like. In conclusion, the characteristics and extraction methods influence the availability of bioactive protein and peptides, demonstrating the potential usage of EBN in improving its biological activities and nutritional properties.

Edible bird’s nest (EBN) produced by Aerodramus fuciphagus has a high demand for nutritional and medicinal application throughout the world. The present study was to evaluate the authentication of a man-made house EBN, which are half cup and stripe-shaped by FTIR. Next, both samples were compared according to their metabolite, nutritional, and mineral composition. The results indicated that the FTIR spectra of both EBN samples were identical and similar to the reference, suggesting the authenticity of the EBN used. The metabolites that contribute to the possible medicinal properties of EBN were found by using GC-MS. The results of the proximate analysis, followed by the standard AOAC method, inferred that both EBN shapes to be rich in crude protein and carbohydrate contents. However, the proximate composition between the half cup and stripe-shaped EBN showed significant differences. Major mineral elements detected were calcium and sodium, and magnesium contents were significantly different between both EBN. Additionally, the half cup and stripe-shaped EBN had a low level of heavy metal content than the maximum regulatory limit as set by the Malaysian Food Act 1983. This study concludes that the nutritional composition varied between the samples and thus suggests that nutrient content should be considered as criteria for the grading requirement of commercialized EBN.

Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p &lt, 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p &lt, 0.001), axillary lymph nodes excision (&gt, 10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p &lt, 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p &lt, 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients.

Background: We aimed to assess whether “Managing Patients on Chemotherapy” book is effective to improve quality of life (QOL) of cancer patient via counselling by pharmacist. Methods: A randomized control trial study was run among 2120 cancer patients in public hospitals in Peninsular Malaysia, from Apr 2016-Jan 2018. The treatment group received counselling regarding chemotherapy by using developed module. The data were collected at three time-points: baseline, 1st, 2nd and 3rd follow-ups after counseling by Validated Malay version of the WHOQOL-BREF of questionnaire. Data analyses were done using χ2 and two-way repeated measure ANOVA. Results: The treatment group improved significantly as compared to control group in physical health, psychological health, social relationship, environment and overall QOL (P

Introduction The survival rate of female breast cancer survivors has been reported to be higher than other types of cancer in Malaysia. Nonetheless, breast cancer survivors face new challenges from unwanted side effects of treatment or management such as fatigue, psychological disturbance, or arm swelling, which can lead to the decline of quality of life (QOL). This study aims to adapt the Malay version of the Functional Assessment of Cancer Therapy-Breast (FACT-B) to evaluate the QOL and to test its reliability and validity in Malaysian breast cancer survivors. Methods The Malay version of the FACT-B, with Disabilities of Arms, Shoulders and Hands (DASH), and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) were distributed to female breast cancer survivors which were recruited on a voluntary basis, from cancer support groups based in selected states in Malaysia. Reliability was assessed based on internal consistency (Cronbach's α), whereas concurrent validity was examined by comparing domains in FACT-B with DASH and PHQ-ADS. Finally, total scores of each domain were analysed between lymphedema and without lymphedema groups for known-group validity. Results A total of 113 breast cancer survivors agreed to participate (response rate = 100%) in the study. Our results showed that the Cronbach's α value for Malay FACT-B is 0.88, and each domain ranged from 0.62 to 0.88. A strong correlation was found between the physical well-being domain of FACT-B with DASH. Meanwhile, the breast cancer scale (BCS) displayed significant correlation with the instrument, Patient Health Questionnaire- Anxiety Depression Scale (PHQ-ADS), indicating that multiple factors including psychological distress were measured in the BCS domain. Furthermore, the instrument was able to detect differences in physical, functional and QOL between participants from lymphedema and without lymphedema groups. Conclusion The Malay version of the FACT-B demonstrated reliable properties and is effective in assessing QOL and can be applied in Malaysian breast cancer survivors.

Frequent repositioning is important to prevent pressure ulcer (PU) development, by relieving pressure and recovering damages on skin areas induced by repetitive loading. Although repositioning is the gold standard to prevent PU, there is currently no strategy for determining tissue condition under preventive approaches. In this study, the peak reactive hyperemia (RH) trends and ultrasonographic (US) features are compared with the tissue condition under histopathological examination to determine the potential use of these features in determining the tissue condition noninvasively. Twenty-one male Sprague-Dawley rats (seven per group), with body weight of 385-485 g, were categorized into three groups and subjected to different recovery times, each with three repetitive loading cycles at skin tissues above of right trochanter area. The first, second, and third groups were subjected to short (3 minutes), moderate (10 minutes), and prolonged (40 minutes) recovery, respectively, while applying fixed loading time and pressure (10 minutes and 50 mmHg, respectively), to provide different degree of recovery and tissue conditions (tissue damage and tissue recovery). Peak RH was measured in the three cycles to determine RH trend (increasing, decreasing, and inconsistent). All rat tissues were evaluated using ultrasound at pre- and post-experiment and rated by two raters to categorize the severity of tissue changes (no, mild, moderate, and severe). The tissue condition was also evaluated using histopathological examination to distinguish between normal and abnormal tissues. Most of the samples with increasing RH trend is related to abnormal tissue (71%); while inconsistent RH trends is more related to normal tissue (82%). There is no relationship between the tissue conditions evaluated under ultrasonographic and histopathological examination. Peak RH trend over repetitive loading may serve as a new feature for determining the tissue condition that leading to pressure ulcer.

The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P 0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p 0.05).Repetitive counselling by pharmacists based on the "Managing Patients on Chemotherapy" module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia.This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect.

Background: Non-alcoholic fatty liver disease (NAFLD) is a very common liver disease in the world, particularly in Western and developed countries. It is rapidly growing in the Asia- Pacific region.Objectives: This study was designed to determine the association between risk factors and non-alcoholic fatty liver disease grades among Malaysian adults.Patients and Methods: A cross-sectional observational study design was prospectively carried out in this study. Consecutive 628 respondents who attended for a medical checkup at urban health center had been recruited for the study. All respondents had the physical examination, blood tests, clinical assessments, and abdominal ultrasound. A structured self-administered questionnaire has been also used in this study in this survey.Results: From a total of 628 “health screened” subjects, 235 subjects (37.4%) were diagnosed to have non-alcoholic fatty liver disease. Female gender and Chinese race were predominant in our study population. Of those with NAFLD, more than half subjects (63.4) had a moderate grade of non-alcoholic fatty liver disease. The mean age of the study population was 54.54 ±6.69 years. Differences of the mean body mass index (BMI) and waist to hip ratio (WHR) were found to be significant among non-alcoholic fatty liver disease grades (P< 0.001). Similarly, mean triglycerides (TG) and high-densiy lipoprotein-cholesterol (HDL-C) levels had significant differences among non-alcoholic fatty liver disease grades (P< 0.001 and P= 0.016, respectively).Conclusion: the non-alcoholic fatty liver disease is common among urban Malaysian adult population. Anthropometric measurements were closely correlated with non-alcoholic fatty liver disease grades.Keywords: Non-alcoholic fatty liver disease, NAFLD grades, sonography, urban population. العوامل المؤثرة على تدرجات مرض تشمع الكبد الغير كحولي المغموض بواسطة جهاز السونار في مركز الفحص في مدينة كلانك فالي في ماليزيا م.م عبد الستار عارف م. د. صفوان سعيد محمد د. هتيما ابو حسن د. حياتي خضر شاهر د. رملة محمد ابراهيم د. نورال نادية محمد م.م .د. سارة قحطان محمد صالح أ.د. روزي محمود الخلاصة: الخلفية : يعتبر مرض الكبد الدهني غير الكحولي (NAFLD) مرضًا شائعًا في العالم ، خاصةً في الدول الغربية والمتقدمة. ينمو بسرعة في منطقة آسيا والمحيط الهادئ. الاهداف : هذه الدراسة قد صممت لتحديد العلاقة بين العوامل الخطرة ودرجات مرض الكبد الدهني الغير كحولي بين البالغين الماليزيين. المرضى وطرق العمل : دراسة المسح المقطعي المستقبلية قد نفذت في هذا البحث . تم تسجيل 628 بالتتابع شخص ممن حضروا في الفحوص الطبية في المركز الصحي الحضري. جميع المستجيبين خضعوا للفحص البدني ، اختبارات الدم ، والتقييمات السريرية والموجات فوق الصوتية للبطن. كما تم استخدام استبيان يملى من قبل المريض نفسه في هذه الدراسة. النتائج : من مجموع 628 "قد خضعوا للفحوصات الصحية" ، تم تشخيص 235 شخصًا (37.4٪) مصابون بمرض الكبد الدهني غير الكحولي. كانت جنس الإناث والعرق الصيني السائد في مجتمع الدراسة لدينا. من أولئك الذين لديهم مرض الكبد الدهني الغير كحولي ، أكثر من نصف الأشخاص (63.4) كان لديهم درجة متوسطة من مرض الكبد الدهني غير الكحولي. بلغ متوسط عمر مجتمع الدراسة 54.54 ± 6.69 سنة. تم العثور على اختلافات في مؤشر كتلة الجسم (BMI) ونسبة الخصر إلى الورك (WHR) لتكون كبيرة بين درجات مرض الكبد الدهني غير الكحولي (P

Objective: To compare the diagnostic performance of the automatic breast volume scanner (ABVS) against the handheld ultrasound (HHUS) in the differential diagnosis of benign and malignant breast lesions. Methods: A systematic search and review of studies involving ABVS and HHUS for breast cancer screening were performed. The search involved the data taken from Scopus, PubMed, and science direct databases and was conducted between the year 2011 to 2020. The prospective method was used in determining the inclusion and exclusion criteria while the evidence level was determined using the BI-RADS categories for diagnostic studies. In addition, the parameters of specificity, mean age, sensitivity, tumor number, and diagnostic accuracy of the ABVS and HHUS were summarized. Results: No systematic review or randomized controlled trial were identified in the systematic search while one cross-sectional study, eight retrospective studies, and 10 prospective studies were found. Sufficient follow-up of the subjects with benign and malignant findings were made only in 10 studies, in which only two had used ABVS and HHUS after performing mammographic screening and MRI. Analysis was made of 21 studies, which included 5448 lesions (4074 benign and 1374 malignant) taken from 6009 patients. The range of sensitivity was (0.72–1.0) for ABVS and (0.62–1.0) for HHUS; the specificity range was (0.52–0.98)% for ABVS and (0.49–0.99)% for HHUS. The accuracy range among the 11 studies was (80–99)% and (59–98)% for the HHUS and ABVS, respectively. The identified tumors had a mean size of 2.1 cm, and the detected cancers had a mean percentage of 94% (81–100)% in comparison to the non-cancer in all studies. Conclusions: The evidence available in the literature points to the fact that the diagnostic performance of both ABVS and HHUS are similar with reference to the differentiation of malignant and benign breast lesions.

Background: Monte Carlo N-Particle code, version 5 (MCNP5) is a generalpurpose Monte Carlo code and it can be used for the design of imaging systems. In this paper, a realistic single photon emission computed tomography (SPECT) model was developed referred to the SIEMENS Symbia T imaging system. Methods: The most important components of the SPECT camera were modeled, especially a low-energy highresolution collimator with hexagonalhole was simulated as closely as possible to its shape and dimensions. The photoelectric effect, Compton and coherent scattering were included in the gamma transport process. In order to validate the SPECT model, specifications in terms of intrinsic spatial resolution, energy resolution, sensitivity, system spatial resolution, and tomography spatial resolution were calculated in comparison with experimental data. Results: Overall results showed good agreements between the simulations and experimental results provided by SIEMENS. The simulated intrinsic resolution and energy resolution matched well with experimental data. The sensitivity measurements from simulation data yielded higher values. For the system spatial resolution, it differed about 3% compared with the experimental result. The tomographic results showed differences of 5.9%, 5.6%, 0.3%, 10.7%, and 0.2% for the five average resolutions, respectively. Conclusion: In summary, the results demonstrated the flexibility and accuracy of MCNP5 to simulate the basic features of SIEMENS Symbia T SPECT Camera and exemplified its potential benefits in protocol optimization and in system design.

The aim of the study is to evaluate radiation dose and its relationship with the effective head diameter obtained during CT brain examination performed via a 640 multi-slice CT scanner. Data from a total of 146 patients, who underwent CT brain examinations in our institutions, was collected retrospectively from January 2019 to June 2019. Data, such as volume Computed Tomography Dose Index (CTDIvol) value, scanning range, dose-length product (DLP) value, and diameter of the patient's head based on Antero-posterior (AP) and Lateral (LAT) were recorded in a standardized form for analyzation. Effective dose (E) and Size-Specific Dose Estimate (SSDE) were determined and compared within plain brain CT and contrast-enhanced CT (CECT). The mean Es of the plain brain CT and CECT were 2.02 ± 0.41 mSv and 4.23 ± 0.75 mSv, respectively, and differed significantly with a p-value of less than 0.05. There are no significant differences of E and SSDE in contrast enhancement when compared among genders (p-value > 0.05) and within race for plain brain CT. The radiation doses differed significantly between male (2.08 ± 0.47 mSv) and female (1.94 ± 0.31 mSv) patients. It was found that skin organs received the highest risk overall, followed by thyroid and then esophagus. This study shows that radiation doses from CT brain mostly depend upon the type of examination. Thus, extra safety measures should be considered for type of examination to reduce the potential risk associated with CT scans.

Despite the progress made in cancer treatment, difficulties are encountered with tumour targeting due to cancer structural complexity. The synthesis of homogenous calcium carbonate (CaCO3) nanoparticles could be a carrier for doxorubicin in the management of bone cancer due to its osteoconductive and physicochemical properties with simple synthesis method to produce large scale. Among the nanocarriers, CaCO3 nanoparticles have exhibited promising potential as targeting drug nanocarrier. The aim of this study is to synthesised and characterised doxorubicin-conjugated CaCO3 nanoparticle (CS-CaCO3NP-DOX), using a simple precipitation and mechanical approach to synthesise homogeneous CaCO3NP from cockleshell. The oven-dried nanoparticles were further characterised for its physicochemical properties before and after conjugating with doxorubicin. A homogenous aragonite, spherical, porous nanocarrier was obtained with a mean diameter of 24.9 nm and zeta potential of –21 mV. The energy dispersion X-ray analysis revealed high proportion of calcium as a major element in the nanoparticle. The spectrum peak suggests little alteration upon incorporation of doxorubicin. Higher loading content and encapsulation efficiency were recorded with CS-CaCO3NP. These properties underscore the potential of CS-CaCO3NP in the delivery of doxorubicin, thus giving it a high potential for application in the delivery of the anticancer in the management of cancers.

Policosanol, a mixture of long-chain alcohols found in animal and plant waxes, has several biological effects. However, it has a bioavailability of less than 10%. One of the ways of improving bioavailability is by nanoemulsion formulation. We developed rice bran wax policosanol nanoemulsion (npol) using high-pressure homogenization. Even though earlier toxicological studies did not show policosanol-related toxicity, it is an essential part of the development of the therapeutic formulation to evaluate its toxicity status. In this study, in vitro, in vivo toxicity, and irritation and anti-irritation potential of the npol were evaluated. 3T3-L1 cells and Sprague Dawley rats were treated with npol in the in vitro and acute oral toxicity tests; while the Hen’s Egg Test Chorio-Allantoic membrane (HET-CAM) was used to test for its irritation and anti-irritation potential. npol at 2mg/mL showed lower toxicity to 3T3-L1 cells by MTT assay compared to the same concentration of policosanol after 24 (60 and 50% viabilities), 48 (62 and 58% viabilities), and 72 (110 and 89% viabilities) hours, respectively. npol was non-irritant and has slightly anti-irritant potential based on the HET-CAM test. There was also no significant toxicity to a limit test dose of 40 ml/Kg body weight of npol (containing 2000 mg/Kg body weight of policosanol) in acute oral toxicity test on Sprague-Dawly rats. The results suggest that policosanol nanoemulsion is a safe formulation devoid of toxicity and irritation potential.

Background Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia. Method A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on ‘Managing Patients on Chemotherapy’ by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses. Results In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial Ƞ2 = 0.66), psychological (p = 0.001, partial Ƞ2 = 0.65), social relationships (p = 0.001, partial Ƞ2 = 0.30), and environment (p = 0.001, partial Ƞ2 = 0.67) and decrease in the anxiety (p = 0.000; partial Ƞ2 = 0.23), depression (p = 0.000; partial Ƞ2 = 0.40). Conclusion The module on ‘Managing Patients on Chemotherapy’ along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy. Trial registration number National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR-12-1057-12,363 on 21 December 2012.

The most common cause of the chronic liver disease is non-alcoholic fatty liver disease (NAFLD). This study was designed to compare a mean subcutaneous tissue thickness (SCTT) and hepatic echo-intensity attenuation rate (HEIAR) among NAFLD grades. Sonography was carried out on 628 consecutive subjects. The distance between the skin surface and the liver capsule was measured and was labelled the SCTT. Also, the ultrasound of HEIAR was retrospectively quantified on an image archiving. HEIAR was calculated as the difference between mean intensity of echo for two regions of interest (ROIs) in near- and far-fields divided by the distance between these two ROIs multiply by frequency of the probe. Of the 628, 235 subjects were diagnosed with NAFLD. The age range was 45 – 75 years with mean 54.5 ± 6.7 years. There was a significant difference of mean SCTT among NAFLD grades (p

Stimuli-responsive cockleshell derived nanocarrier (CSNP) have huge potential in drug targeted delivery. They can be employed for targeted site-specific drug delivery due to its responsive nature to stimuli such as change in pH which minimizing its systemic off-targeted effect to due to excessive releases of doxorubicin. We use a simple top-down method to synthesis CSNP carrier from biological waste of cockleshell, which were negatively charged with higher loading capacity when conjugated with DOX. This study is aimed at demonstrating the in vitro release mechanism of DOX from CSNP under the influence of change in pH and to develop a bioanalytical method for pharmacokinetics of the synthesized CSNP-DOX in dogs. Apart from drug release kinetic of CSNP evaluation, a high-performance liquid chromatography bioanalytical method was developed and validated for the pharmacokinetics of CSNP-DOX determination. Six dogs were divided into two groups to receive CSNP-DOX and free DOX 30 mg/m2 i.v respectively. At predetermined time interval, blood was sampled and processed for DOX concentration. The CSNP-DOX with high encapsulation efficiency and a mean diameter of 34.0 ± 3.4 nm was used. The in vitro release profiles demonstrated by DOX release from CSNP-DOX-loaded were pH dependent in nature which follows a Higuchi mathematical model equation. Pharmacokinetic parameters were determined with an excellent bioanalytical method having high extraction yield and linearity of 89.87% and 0.997. CSNP-DOX increases the t1/2 and AUC0-t of DOX as compared to dogs given free DOX. Our data further reveal a sustained release of DOX from CSNP under the influence of change in pH. However, we developed a rapid bioanalytical method for cumula al model. Based on these novel results, CSNP reveal to have promising ability to prolong release of DOX in circulation which tends to reduce cytotoxic DOX release quantification which was further expressed on kinetic mathematic

Pressure Ulcer (PU) is an area of the skin in which cutaneous tissue is compromised and there is progressive damage on the underlying tissue caused by blood flow obstruction due to prolonged external direct pressure. Research has shown that ischemic stress response can be evaluated using skin blood flow response (SBFR) signal features which are useful for pressure ulcer evaluation. Trends of peak reactive hyperemia (RH) were observed for three repetitive loading-unloading cycles in previous animal study to investigate tissue recovery. However, tissue recovery and tissue damage cannot be discriminated by the trends of peak RH for short recovery time. The trends of alternative time-domain SBFR features such i.e total hyperemic response as well as frequency-domain features using Fast Fourier Transform (FFT) and Short Time Fourier Transform (STFT) i.e total power spectrum are further investigated to indicate tissue recovery. The results show that total hyperaemic response outperforms peak RH at detecting insufficient tissue recovery with 72% of samples with increasing trend in the short recovery time group compared to 57% of samples for peak RH. Total hyperemic response is effective at discriminating insufficient recovery time while other investigated features are only effective at detecting sufficient recovery time.

One of the sources of death among women is breast cancer. It is well known that Mammogram is the best method for breast cancer detection. Subsequently, there are solid requirements for the improvement of computer aided diagnosis (CAD) systems to assist radiologists in making decision. In this paper, the curvelet changes is proposed to classify the breast cancer. Curvelet refers to multi-level change which have the characteristics of directionality and anisotropy. It splits several characteristic impediments of wavelet to edges of an image. Two component extraction techniques were created associated with curvelet and wavelet coefficients to separate among various classes of breast. Finally, the K-Nearest Neighbor (KNN) classifiers were utilized to decide if the district is unusual or ordinary. The adequacy of the suggested strategies has been implemented with Mammographic Image Analysis Society (MIAS) data images. All the dataset is utilized by the suggested strategies. Then calculations have been applied with both curvelet and wavelet for correlation test were performed. The general outcomes show that curvelet change shows superior compared to the wavelet and the thing that matters is measurably noteworthy.

Computed tomography (CT) imaging remains the most utilized modality for liver-related cancer screening and treatment monitoring purposes. Liver, liver tumor and liver vasculature segmentation from CT data is a prerequisite for treatment planning and computer assisted detection/diagnosis systems. In this paper, we present a survey on liver, liver tumor and liver vasculature segmentation methods that are using CT images, recent methods presented in the literature are viewed and discussed along with positives, negatives and statistical performance of these methods. Liver computer assisted detection/diagnosis systems will also be discussed along with their limitations and possible ways of improvement. In this paper, we concluded that although there is still room for improvement, automatic liver segmentation methods have become comparable to human segmentation. However, the performance of liver tumor segmentation methods can be considered lower than expected in both automatic and semi-automatic methods. Furthermore, it can be seen that most computer assisted detection/diagnosis systems require manual segmentation of liver and liver tumors, limiting clinical applicability of these systems. Liver, liver tumor and liver vasculature segmentation is still an open problem since various weaknesses and drawbacks of these methods can still be addressed and improved especially in tumor and vasculature segmentation along with computer assisted detection/diagnosis systems.

Background: The development of wire mesh collimator (WMC), has improved the performance of Single Photon Emission Computed tomography (SPECT) because of its higher sensitivity whilst maintaining the same resolution. Consequently, the WMC allows better detection of early–stage cancer. The purpose of this study was to find an optimal filter for image reconstruction for breast SPECT imaging. Methods: Half–ellipsoidal breast phantom in the prone position was simulated with dual–head SPECT camera by Monte Carlo N–Particle Transport Code, version 5 (MCNP5). Six different filters were compared with 17 different cutoff frequencies (Fc), ranging from 0.2 Nyquist frequency (Nq) to 1.0 Nq, with step 0.05. For Butterworth filter, order was from 3 to 12 with step 1. A total of 255 central slices with different parameters were reconstructed by filtered back projection (FBP) to compare the image performance in terms of contrast, noise level and tumour size. Results: The values of tumour size, contrast and noise level were greatly influenced by different filter types and the value of Fc. Ramp and Butterworth produced the best value of tumour size and contrast, whilst Parzen, Hann and Hamming filters gave smoother images. Overall, results showed that Butterworth filter with the highest mean score. Conclusion: Butterworth filter proved to be the provided the best image quality at a higher sensitivity and was found to be the optimum filter for quantitative analysis.

Ethnic origin plays an important role in bone morphometry. Studies examining the influence of coracoid process have focused primarily on adults and have not included people from diverse Asian ethnic backgrounds. Our goal was to explore ethnic differences in morphometry of coracoid among Asian population. We performed morphometric measurements of coracoid process on cadaveric shoulders and shoulder CT scans from 118 specimens. The cadaveric sample included Indian (46%), Chinese (27%), and Myanmarese (27%) subjects, while the CT scans sample included Chinese (67%) and Malay (33%) subjects. The morphometric measurements were performed using digital caliper and software developed at Golden Horses Health Sanctuary (GHHS). In the Indian cadaveric shoulders, the coracoid process is better developed than the other groups with the exception of the tip width of coracoid process. There are significant differences in almost all measurements (P<0.05) between the ethnic groups. On the other hand, the morphometry of coracoid process from CT scans data is bigger in Chinese than Malay subjects when stratified by sex (P<0.05). Moreover, in all morphometric measurements, the females had smaller measurements than males (P<0.05). Understanding such differences is important in anatomy, forensic and biological identity, and orthopaedic and shoulder surgeries.

Breast and areola boundary detection and segmentation present the biggest challenge in breast segmentation from thermography images, as breast boundaries, especially in the upper quadrants of the breast, are nonexistent. Many segmentation approaches have been proposed for breast segmentation, such as active contours and snakes, circular Hough transforms, and live wires, but these methods often fail to achieve satisfactory results. With recent advances in image processing techniques, new segmentation concepts are being developed, such as random walkers, which have received high interest from the medical imaging community. In this study, 91 images acquired utilizing a FLIR A320 thermal camera are used for developing an automatic breast segmentation from thermography images based on the random walker algorithm. A series of enhancement filters are applied to the image to make areola detection more accurate. Afterwards, the areola is detected using a series of circular Hough transforms. The detected areola region is then utilized for automatic seed placement for the random walker algorithm. Based on expert radiologist evaluation, the proposed segmentation algorithm was able to achieve 81.3% success rate in breast segmentation, while there was a 37.5% increase in the detection of breast cancer-related abnormalities by radiologists utilizing the segmented images, compared to utilizing original images.

We have reported that a bioactive-rich fraction, called EORY, from a combination of supercritical fluid-extracted rice bran oil and palm oil has abundant gamma-oryzanol, tocopherols and tocotrienol. Moreover, EORY has balanced composition of polyunsaturated:saturated fatty acids, with the potential for hypocholesterolaemic and antioxidant effects. However, the bioactive compounds in EORY are lipophilic and therefore pose bioavailability problems. This study evaluated the cardioprotective effects of orally-administered EORY emulsion and its nanoemulsion (NEORY) on diet-induced hypercholesterolaemic rats. NEORY reduced body weight gain, heart weight, lipid parameters and oxidised LDL, and improved HDL better than EORY and simvastatin. NEORY also significantly increased hepatic mRNA expression of HMGCoA reductase, apolipoprotein A1 and LDLR, and lowered apolipoprotein B and LPL. The effects of NEORY on lipid parameters, lipid peroxidation markers and hepatic cholesterol metabolism suggested that it could regulate the risk of cardiovascular disease, possibly due to increased absorption of gamma-oryzanol, tocopherols and tocotrienol.

Background Detection of small breast lesions is a challenging task for radiologists. Computer aided detection (CAD) systems are implemented to aid radiologists in detecting masses and microcalcifications. This has the potential to raise the level of sensitivity in breast cancer detection. Objectives To evaluate a new system to detect suggestions of suspicious small lesions. Methods Small samples were extracted from different tissue types. Texture features were calculated, and the best features were selected using Waikato Environment for Knowledge Analysis (WEKA) software. Subsequently, 7 selected features were used to form a decision tree. To reduce false negative cases, fuzzy logic was used. In the implementation phase, input images were divided into 8 pixel ´ 8 pixel tiles. For each tile, all selected features were computed as fuzzy inputs. Results To evaluate the technique, the suggested system was applied to 326 images obtained from the National Cancer Society of Malaysia. Based on this application, results showed that the suggested system has an acceptable sensitivity of 85.6% and specificity of 90.7%. Conclusions The fuzzy system is a promising technique for early detection of breast cancer.

Pressure Ulcer (PU) or pressure sore is localized injury to the skin or underlying tissue or both that occur over a bony prominence when a patient is subjected to direct pressure for a lengthy period. Research have shown that skin blood flow response (SBFR) is a useful signal in PU evaluation due to its ability to determine ischemic stress response. In previous animal study, peak reactive hyperaemia (RH), a feature of SBFR has been measured for three loading-unloading cycles to indicate tissue recovery. However, in that study, peak SBFR feature cannot discriminate between tissue injury and tissue recovery effectively for short recovery time. In this study, the potential use of other SBFR signal features including time domain features i.e time to peak and frequency domain features i.e peak of power spectrum and total of power spectrum are investigated. The results show that for the samples taken, peak RH and area under the curve are both effective at discriminating between short of insufficient recovery time while other investigated features are ineffective.

There are reports of improved redox outcomes due to consumption of Edible Bird’s Nest (EBN). Many of the functional effects of EBN can be linked to its high amounts of antioxidants. Interestingly, dietary components with high antioxidants have shown promise in the prevention of aging and its related diseases like Alzheimer’s disease. In this study, the antioxidative potentials of EBN and its constituents, lactoferrin (LF) and ovotransferrin (OVF), were determined and protective effects against hydrogen peroxide (H2O2)- induced toxicity on SH-SY5Y cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and acridine orange and propidium iodide (AO/PI) staining with microscopy were examined. Results showed that EBN and its constituents attenuated H2O2-induced cytotoxicity, and decreased radical oxygen species (ROS) through increased scavenging activity. Furthermore, LF, OVF, and EBN produced transcriptional changes in antioxidant related genes that tended towards neuroprotection as compared to H2O2-treated group. Overall, the results suggest that LF and OVF may produce synergistic or all-or-none antioxidative effects in EBN.

The evolution of nanomaterial in science has brought about a growing increase in nanotechnology, biomedicine, and engineering fields. This study was aimed at fabrication and characterization of conjugated gold-cockle shell-derived calcium carbonate nanoparticles (Au-CSCaCO3NPs) for biomedical application. The synthetic technique employed used gold nanoparticle citrate reduction method and a simple precipitation method coupled with mechanical use of a Programmable roller-ball mill. The synthesized conjugated nanomaterial was characterized for its physicochemical properties using transmission electron microscope (TEM), field emission scanning electron microscope (FESEM) equipped with energy dispersive X-ray (EDX) and Fourier transform infrared spectroscopy (FTIR). However, the intricacy of cellular mechanisms can prove challenging for nanomaterial like Au-CSCaCO3NPs and thus, the need for cytotoxicity assessment. The obtained spherical-shaped nanoparticles (light-green purplish) have an average diameter size of 35 ± 16 nm, high carbon and oxygen composition. The conjugated nanomaterial, also possesses a unique spectra for aragonite polymorph and carboxylic bond significantly supporting interactions between conjugated nanoparticles. The negative surface charge and spectra absorbance highlighted their stability. The resultant spherical shaped conjugated Au-CSCaCO3NPs could be a great nanomaterial for biomedical applications.

Doxorubicin (DOX) is a potent anticancer agent with cytotoxic effects which limit its clinical usage. This effect is due to its nonselective nature causing injury to the cells as a result of reactive free oxygen radical’s release. Cockleshell-derived calcium carbonate nanoparticle (CS-CaCO3NP) is a pH-responsive carrier with targeted delivery potentials. This study aimed at evaluating the toxicity effects of repeated dose administration of DOX-loaded CS-CaCO3NP in healthy dogs. Fifteen dogs with an average body weight of 15 kg were randomized equally into 5 groups. Dogs were subjected to 5 doses at every 3-week interval with (i) normal saline, (ii) DOX, 30 mg/m2, and the experimental groups: CS-CaCO3NP-DOX at (iii) high dose, 50 mg/m2, (iv) clinical dose, 30 mg/m2, and (v) low dose, 20 mg/m2. Radiographs, electrocardiography, and blood samples were collected before every treatment for haematology, serum biochemistry, and cardiac injury assessment. Heart and kidney tissues were harvested after euthanasia for histological and ultrastructural evaluation. The cumulative dose of DOX 150 mg/m2 over 15 weeks revealed significant effects on body weight, blood cells, functional enzymes, and cardiac injury biomarkers with alterations in electrocardiogram, myocardium, and renal tissue morphology. However, the dogs given CS-CaCO3NP-DOX 150 mg/m2 and below did not show any significant change in toxicity biomarker as compared to those given normal saline. The study confirmed the safety of repeated dose administration of CS-CaCO3NP-DOX (30 mg/m2) for 5 cycles in dogs. This finding offers opportunity to dogs with cancer that might require long-term administration of DOX without adverse effects.

The aim of this research is to investigate whether edible bird's nest (EBN) attenuates cortical and hippocampal neurodegeneration in ovariectomized rats. Ovariectomized rats were randomly divided into seven experimental groups (n = 6): the ovariectomy (OVX) group had their ovaries surgically removed; the sham group underwent surgical procedure similar to OVX group, but ovaries were left intact; estrogen group had OVX and received estrogen therapy (0.2 mg kg(-1) per day); EBN treatment groups received 6%, 3%, and 1.5% EBN, respectively. Control group was not ovariectomized. After 12 weeks of intervention, biochemical assays were performed for markers of neurodegeneration, and messenger ribonucleic acid (mRNA) levels of oxidative stress-related genes in the hippocampus and frontal cortex of the brain were analysed. Caspase 3 (cysteine-aspartic proteases 3) protein levels in the hippocampus and frontal cortex were also determined using western blotting. The results show that EBNs significantly decreased estrogen deficiency-associated serum elevation of advanced glycation end-products (AGEs), and they changed redox status as evidenced by oxidative damage (malondialdehyde content) and enzymatic antioxidant defense (superoxide dismutase and catalase) markers. Furthermore, genes associated with neurodegeneration and apoptosis were downregulated in the hippocampus and frontal cortex by EBN supplementation. Taken together, the results suggest that EBN has potential for neuroprotection against estrogen deficiency-associated senescence, at least in part via modification of the redox system and attenuation of AGEs.

Breast cancer among women has reached an alarming stage compared to 20 years ago. It was found that single nucleotide polymorphisms (SNPs) play an important role in the development of breast cancer. SNPs may suppress or activate the functional genes, which then leads to an increased survival of cells due to the suppression of tumour suppressor genes or increased activity in detrimental proteins, resulting in cancers. Recently, breast cancer research is given significant attention due to the increasing number of breast cancer patients in Malaysia each year. However, breast cancer researches in Malaysia are mainly focused on well known breast cancer genes such as BRCA1 and BRCA2. There is less emphasis on the other breast cancer contributing genes. This paper was aimed to review the research findings on mutations associated with breast cancer in Malaysian Malay, Malaysian Chinese and Malaysian Indian as it has never been cumulatively reported and to ascertain the common mutations found in these three major Malaysia ethnicity.

Background Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia. Methods A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models. Result A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p

Calcium carbonate nanoparticles have shown promising potentials in the delivery of drugs and metabolites. There is however, a paucity of information on the safety of their intentional or accidental over exposures to biological systems and general health safety. To this end, this study aims at documenting information on the safety of subcutaneous doses of biogenic nanocrystals of aragonite polymorph of calcium carbonate derived from cockle shells (ANC) in Sprague-Dawley (SD) rats. ANC was synthesized using the top-down method, characterized using the transmission electron microscopy and field emission scanning electron microscope and its acute and repeated dose 28-day trial toxicities were evaluated in SD rats. The results showed that the homogenous 30 ± 5 nm-sized spherical pure aragonite nanocrystals were not associated with mortality in the rats. Severe clinical signs and gross and histopathological lesions, indicating organ toxicities, were recorded in the acute toxicity (29,500 mg/m2) group and the high dose (5900 mg/m2) group of the repeated dose 28-day trial. However, the medium- (590 mg/m2 body weight) and low (59 mg/m2)-dose groups showed moderate to mild lesions. The relatively mild lesions observed in the low toxicity dosage group marked the safety margin of ANC in SD rats. It was concluded from this study that the toxicity of CaCO3 was dependent on the particulate size (30 ± 5 nm) and concentration and the route of administration used.

Background and Aim: The risk of breast cancer increases directly in line with breast density. Therefore, it is important to pay more attention to denser breasts in order to detect abnormalities. The aim of this paper was to design and suggest a quantitative method to categorize breast density in digital mammogram images using fuzzy logic. Materials and Methods: This was a crosectional study which resulted in developing a new system. The research population was including patients who undergo mammography in National Cancer Society of Malaysia during 2010 to 2011. Sample included 220 mammogram images which was selected randomly. Data analysis was done using SPSS with Kappa statistics. Results: Accuracy level of 92.8% was obtained based on evaluation of the system and there was a strong correlation between the system output and radiologists’ estimation (K=0.87, p=0.0001). Conclusion : Results obtained from the suggested system had higher performance than similar systems. Therefore, it could be concluded that the fuzzy logic may be used in this area. In addition, such systems could be helpful for physicians.