Tuberculosis or TB is a major issue in Malaysia as the dramatic emerge of infection. In Mac 2016 (Until 15 April 2016)
3049 cases were reported and total cases were reported 7717 cases which increasing 902 (13.0%) cases at same month
2015 (6815 cases). Meanwhile, prevention and diagnosis should be started from children. Educational planning with
the collaboration from Ministry of Education (MOE) and Ministry of Health (MOH) should be intensive to ensure the
prevention and mechanism control of this disease can be cure at the beginning. The focus of the study was given on the
(1) transmission of tuberculosis (TB) in Malaysia (2) practice of prevention of TB (3) mechanism control in educational
institutions and (4) promotion health programmes in schools. The conclusion of this study is drawn on the premise of
providing plausible suggestion that will promote good governance for the Ministry of Education (MOE) and Ministry of
Health (MOH) to strengthening the current policy for a better future implementation.
Calcium carbonate (CaCO3
) plays a crucial role in influencing the growth of osteoblast. This study was conducted
to compare the performance of alginate/cockle shell powder nanobiocomposite (nCP) bone scaffold developed from
naturally occurring CaCO3 with alginate/calcium carbonate (CC) bone scaffold developed using synthetic CaCO3. The
study compares the performance of the scaffold in supporting the growth of osteoblast through in vitro evaluations as
well as initial biocompatibility observations through in vivo methods. Both scaffolds were developed using the mixture
of 40% alginate solution with either 60% of nano cockle shell powder or synthetic CaCO3 to obtain a three dimensional
scaffold structure. In vitro evaluation on calcium release and ALP enzyme activity was conducted on both scaffolds seeded
with osteoblast on day’s three, five and seven using commercial kits. In vivo observations using histological methods
were further conducted by implanting osteoblast seeded scaffold subcutaneously at the dorsum of 8 albino mice for 21
days. Findings from in vitro studies showed a significant increase (p < 0.05) in the release of calcium and ALP enzyme
activity in nCP scaffolds on day seven compared to days three and five of CC scaffold. Histological observations using
H&E and von Kossa staining showed infiltration and proliferation of osteoblast on both scaffolds as well as early stage
bone tissue formation. Formation of new blood vessels within the scaffolds was also observed in nCP scaffold. Both the
developed scaffolds were noted to support osteoblast growth and new tissue formation with better potentials displayed by
nCP scaffolds comparatively. This study shows that naturally occurring CaCO3 obtained from cockle shells in the form
of nano powder has good potentials to be used as a biomaterial for bone tissue engineering applications.
The objective of this study was to evaluate the antimicrobial potential of methanol, acetone and distilled water stem
bark extracts from Canarium odontophyllum against Staphylococcus aureus ATCC 25923, Bacillus cereus ATCC 6633,
Escherichia coli ATCC 25932, Pseudomonas aeruginosa ATCC 27853, Acinetobacter baumannii strain sensitive, Candida
albicans ATCC 64677, Candida glabrata ATCC 90028, Aspergillus niger and Fusarium solani M2781. The extracts from
C. odontophyllum stem bark from 3.125 mg/ml to 25 mg/ml were screened against the tested microorganisms using disc
diffusion method. The Minimum inhibitory concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the
extracts against susceptible organisms were determined using microbroth dilution method and streak-plate technique,
respectively. From the antibacterial screening assay, the growth of S. aureus, B. cereus and A. baumannii were inhibited
by methanol extract whereas the acetone extract was capable of inhibiting all the tested microorganisms except E.coli,
F. solani and A. niger. The lowest MIC value for methanol extract was against A. baumannii (0.195 mg/ml) whereas
its MBC value was twice its MIC value (0.391 mg/ml), indicating that methanol extract was bacteriostatic against A.
baumannii. While for acetone extract, S. aureus showed bactericidal effect with equal MIC and MBC values at 0.195 mg/
ml. In conclusion, stem bark of C. odontophyllum has the potential to be the source of antibacterial agent and can be
exploited as an alternative phytoantimicrobial.
The purpose of this study was to characterize, differentiate and correlate visual field and brain activation in visual cortex
for normal, glaucoma suspect (GS) and primary open angle glaucoma (POAG) participants using Standard Automated
Perimetry (SAP) and functional Magnetic Resonance Imaging (fMRI) respectively. The fMRI scans and SAP test were both
carried out in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Two types of black-and-white checkerboard
pattern were displayed to the participants during the fMRI scans. The fMRI data were analyzed using WFU pickatlas
toolbox targeting visual cortex area. The results showed that there was no significant difference in number of activated
voxel between the three groups in visual cortex (BA 17, 18 and 19) while viewing all the given stimuli (p > 0.05). The
pattern standard deviation (PSD) of SAP for visual field also revealed no significant differences (p > 0.05) in all groups of
participants. However, negative correlation between PSD and fMRI activation was observed. The PSD values increased with
a decrease in fMRI activation. With reference to visual field analysis, the results suggest that glaucomatous neuropathy of
POAG patients has led to a gradual decrease in visual cortex activation and a gradual increase in PSD.
Quassia borneensis has been traditionally used as antihypertensive agent without any scientific literature on its mechanism
of action. The objective of this study was to evaluate the antiinflammatory, antioxidant and antiproliferation properties of
Q. borneensis extracts. The hexane, chloroform and aqueous extracts of root and bark of Q. borneensis were subjected to
nitric oxide (NO) inhibition assay in LPS-stimulated RAW 264.7 cells. Expression of inducible NO synthase (iNOS) protein
level was analyzed by Western blot. The antioxidant and antiproliferative activities of the extracts on HL-60 cells were
determined using Ferric Reducing Antioxidant Power (FRAP) and MTT assays, respectively. The chloroform extract of
Q. borneensis root obtained by soxhlet method (CSR) significantly inhibited 97.64 ± 0.96% of NO production (p < 0.001)
and suppressed iNOS expression (p < 0.05) at the highest concentration of 1.0 µg/ml. The chloroform extract of bark
obtained by maceration (CMB) exhibited the highest antioxidant capacity in the absence and presence of HL-60 cells,
where the FRAP value were 125.45 ± 9.10 µM FeSO4
.7H2
O and 181.55 ± 3.45 µM FeSO4
.7H2
O, respectively. The greatest
inhibition of HL-60 cell proliferation was exhibited by the chloroform extract of bark obtained by soxhlet method (CSB)
with the IC50 of 5.0 µg/ml. The findings suggested that the chloroform extracts of Q. borneensis possess antiinflammatory,
antioxidant and antiproliferative activities.
The aim of this study was to determine whether pattern-reversal Visual Evoked Potential (PRVEP) is affected in mild
cognitive impairment (MCI). Participants aged ≥ 60 years diagnosed as MCI were invited to participate in a study together
with a group of controls. PRVEP was measured using A RETI-port/Scan 21 and stimuli of large and small checks sizes,
1° (60 min of arc) and 0.25° (15 min) respectively were used to obtain responses. The amplitude and implicit times of
the MCI and control groups were then compared. A total of 18 MCI participants (age 65.7 ± 3.1 years) and 18 controls
(65.1 ± 3.8 years) consented to participate in the study. The amplitude and implicit times for the MCI group using the
target sizes of 60 min of arc were 9.80 ± 4.06 µV and 108.83 ± 7.63 ms and for 30 min of arc were 11.00 ± 7.44 µV
and 123.96 ± 6.18 ms respectively. Consecutively for the control groups the amplitudes and implicit times were 8.96 ±
3.52µV, 105.85 ± 3.60 ms and 11.97± 6.11 µV, 122.57 ± 8.28 ms. PRVEP results did not reveal significant differences in
P100-wave amplitude nor implicit time between the two groups under investigation. This study concluded that the visual
pathway of MCI participants may be unaffected in the early part of the disease process.
Biocompatibility and growth of osteoblast on bone scaffolds play an important role towards their therapeutic application.
The presence of oxidative stress generated by bone scaffolds highly influences osteoblast growth and its functional
performance. In this study in-vitro interaction of developed Alginate/Cockle Shell powder nanobiocomposite bone scaffold
on osteoblast with regards to cytotoxicity and oxidative stress are evaluated. Cytotoxicity studies using MTT assays
revealed a significant increase in viability of cultured osteoblast in the presences of the scaffold extracts. The growth of
osteoblast on the scaffold were not deterred with the presence of any major oxidative stress factors as determined through
oxidative stress profile studies using SOD, GSH and ROS assays. The nanobiocomposite scaffold evaluated in this study
shows promising use in regards to facilitating osteoblast proliferation, growth and viability.
Herbal-based slimming products which are consumed orally may be contaminated with heavy metals as well as
microorganisms. This study aimed to evaluate the safety level of these slimming products by determining heavy metals
and microbial contamination in different batch production. Six different brands of herbal-based slimming products (A, B,
C, G, H and I) with three different batch productions (1, 2 and 3) were investigated (n =18). Five heavy metals Arsenic,
Cadmium, Chromium, Copper and Zinc were determined using an Inductively Coupled Plasma-Mass Spectrometry
(ICP-MS). The presence of microorganisms was determined by total aerobic count and the bacteria were identified. The
samples’ moisture content was determined by calculating the percentage of water loss after drying process. All batches
of samples A and B had high content of zinc, over the permissible level of 5ppm while, 6 samples contained Chromium
above the permissible level (1.5 ppm). All 3 batches of sample A presented with the highest total daily intake of heavy
metals. Bacteria were present in all the samples tested with the highest numbers in samples G, H and A followed by
B, I and C. The highest number of fungi was found in product A while product I was free from fungal contamination.
Aspergillus spp. was the predominant fungus present in the samples. There was a weak correlation between moisture
content and bacteria (r = 0.087) and fungal (r = 0.253) presence in the samples. As some herbal slimming products
contain heavy metals as well as microorganisms, consumers need to be more vigilant and discerning when selecting
products to be consumed.
Visual conditions such as anisometropia, monovision and monocular undercorrection affect the combination of visual
input from both eyes. This study investigated the effects of monocular blur, in binocularly normal participants, on
stereoacuity and binocular contrast sensitivity. Fifteen young adults (age range between 19 and 23 years old) with normal
visual acuity and binocular vision participated in this study. Stereopsis was measured using the TNO test with a series
of positive spherical lenses placed before the dominant eye. The procedure was repeated using the Titmus Stereotest on
five participants as a control experiment. Monocular and binocular contrast sensitivities were also measured using the
Pelli-Robson Contrast Sensitivity Chart. Blur was induced monocularly with a series of positive spherical lenses placed
before the dominant eye and binocular contrast sensitivity was re-measured. Stereopsis scores decreased significantly
when monocular blur was imposed. Across blur levels, absolute stereopsis scores measured with TNO test were worse
than those measured with Titmus stereotest (all p < 0.05). However, the ratio of scores obtained without blur and under
monocular blur appeared to be similar for both tests. Stereopsis without blur was between 6.82× to 8× better than that
obtained with the highest level of imposed monocular blur. Binocular contrast sensitivity score decreased significantly
with increasing level of monocular blur (p < 0.01). Binocular contrast sensitivity score without blur was 1.62× better
than that obtained under binocular viewing with highest level of imposed blur. Stereopsis tests are more sensitive than
measurements of binocular contrast sensitivity as an indicator of interocular acuity discrepancies which could occur
in anisometropic or monovision patients. However, the choice of stereopsis test is crucial, as the TNO test appears to be
more sensitive to monocular blur than the Titmus stereostest.
Plantar pressure, force and contact area information may provideinsights regarding stresses imparted to the foot when performing functional tasks. There is limited information regarding plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). The aim of our study was to investigate the changes in the plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). A total of 20 adults with non-specific LBP and 20 matched individuals without LBP were recruited according to the predefined recruitment criteria. Plantar pressure (PP), maximum force (MF) and contact area (CA were measured in standing position and during walking while carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using their right hand on a Matscan pressure assessment system. A two-way mixed analysis of variance (group× load) was conducted to analyse the data. No significant main effectof group was demonstrated on both the right and left foot during standing (PP: p = 0.74, p = 0.32; MF: p = 0.17, p = 0.67; CA: p = 0.25, p = 0.24) and walking (PP: p = 0.61, p = 0.48; MF: p = 0.19, p = 0.06; CA: p = 0.16, p = 0.26. Similarly, there was no interaction effect between the loads and groups on the PP (p = 0.89, p = 0.47), MF (p = 0.76, p = 0.83) and CA (p = 0.88, p = 0.20) on theright and left foot, respectively during standing. However, a significant interaction effect (p < 0.05), between the loads and groups was demonstrated on the PP, MF and CA on the left foot during walking. The results of our study suggest that stresses imparted to the foot alters during dynamic postures and this may be a compensatory mechanism. Plantar pressure, force and contact area were similar in adults both with and without LBP when standing and walking. Further biomechanical information that includes both kinematic and kinetic data in lumbopelvic and lower limbs in relation to the foot may be required to justify for prevention and management strategies among adults with LBP.
The efficacy of a 2.15% imidacloprid gel bait against laboratory strain Periplaneta americana and Blattella germanica
was evaluated under laboratory conditions. The susceptibility trend of both species towards imidacloprid was: adult male
< adult female < nymphs. All stages of both species were dead within 10 days in primary poisoning testing. Periplaneta
americana adult male (LT50 = 0.47 h; LT95 = 5.24 h) died fastest, while nymphs of B. germanica took the longest time to
reach 95% mortality (LT95 = 43.84 h). In indirect exposure via secondary poisoning, only adult males of P. americana (LT50
= 100.63 h) and B. germanica (LT50 = 54.66 h) obtained 50% mortality before the testing ended. No complete mortalities
were achieved in any stages of both species within 10 days of secondary poisoning testing. Therefore, imidacloprid gel
bait used in this study was able to cause complete mortalities within less than 2 days of 10-day primary poisoning testing
but less effective in the 10-day secondary poisoning testing.
The notion of fruit and vegetables (FV) in preventing chronic diseases has long been discerned. To meet the recommended
FV intake, FV juices have emerged as a convenient and healthy choice. Mixed fruit and vegetable juices (MFVJ) cater the
blend of desirable flavor and taste of consumers. This study was carried out to determine the total phenolic content (TPC),
antioxidant activities and sugar content of selected MFVJ. Folin-Ciocalteu assay was employed to quantify TPC, whereas
DPPH and FRAP assays were used to evaluate the antioxidant activities of MFVJ. The sugar content was determined using
phenol-sulfuric acid method. MFVJ extracted from bitter gourd, green apple and orange (BGO) had the highest TPC content
(76.4 ± 4.2 mg GAE/100 ml). Celery and green apple (CG) juice showed the highest DPPH value (522.3 ± 7.6 mg TE/100
ml) whereas carrot and starfruit (AS) juice have the highest FRAP value (419.6 ± 21.6 mg TE/100 ml). The sugar content
of MFVJ was within the range of 5.7-13.3 g/100 ml. MFVJ can be considered as healthy beverages with considerable
amounts of phenolic compounds and low sugar content. This study provides some useful reference for consumers who
consume juices with combinations of FV. Future studies need to discover more combinations of FV juices, providing more
data pertaining to MFVJ. Identification of individual phenolic compounds should also be part of future research using
various instrumental analyses.
MGMT (O6
-Methylguanine-DNA Methyltransferase) suppresses tumor development by removing alkyl adduct, while
SPOCK2 (SPARC/Osteonectin CWCV and Kazal-like domains proteoglycan) abolishes the inhibition of membrane-type
matrix metalloproteinases (MT-MMP) which leads to angiogenesis. Hence, MGMT methylation may initiate malignant cells
transformation. In contrast, SPOCK2 methylation is hypothesized not to be a common event in diffuse large B-cell lymphoma
(DLBCL). In this study, we examined the methylation status of MGMT and SPOCK2 in DLBCL as in Malaysia the information
is extremely lacking. A total of 88 formalin-fixed paraffin-embedded tissue of patients diagnosed with DLBCL from the
year 2006 to 2013 were retrieved from Hospital Universiti Sains Malaysia, Kelantan and Hospital Tengku Ampuan Afzan,
Pahang. Methylation-specific polymerase chain reaction (MSP) was used to examine the methylation status of both genes.
Interestingly, methylation of MGMT was detected in all the 88 DLBCL samples, whereas SPOCK2 was found to be methylated
in 83 of 88 (94.3%) DLBCL cases. Our study showed a remarkably high percentage of promoter methylation of both
MGMT and SPOCK2 genes. Our finding also negates initial expectation that SPOCK2 methylation would be an uncommon
event in the majority of DLBCL cases. This study has shown a very high percentage of promoter methylation of MGMT and
SPOCK2 in the DLBCL cases studied by MSP, using archival lymphoma tissues. Nonetheless, additional research is needed
to quantitatively evaluate MGMT and SPOCK2 methylation, and to analyse gene expression and/or protein expression in
order to further understand the role of MGMT and SPOCK2 methylation in the pathogenesis of DLBCL.
Seaweed contains various nutrients that has the potential to be a source of nutritious food, but only a few studies done on
the red seaweeds in Malaysia. Therefore, this study was conducted to determine the macronutrients content, amino acid
profile and fatty acid component in Kappaphycus alvarezii and Kappaphycus striatum. The study found that the range
of moisture, fat, ash, protein, fiber and carbohydrates content for both red seaweeds were 6.9% - 7.3%, 0.5% - 2.6%,
29.4% - 30.9%, 2.5% - 5.7% , 5.3% - 5.5% and 50.1% - 53.3% respectively. A total of 16 amino acids were identified
in which the essential amino acid for K. alvarezii and K. striatum were 41.11% and 36.15% respectively. A total of 34
fatty acids were identified in which the content of saturated fatty acids (SFA) was the highest (42.7% - 72.8%), followed
by mono-unsaturated fatty acid (MUFA) (13.8% - 36.2%) and polyunsaturated fatty acids (PUFAs) was the lowest (13.5%
- 21.2%). In conclusion, this study suggest that K. alvarezii and K. striatum are potentially be used as raw materials or
food ingredients to improve the nutritional value of the human diet.
Cochlear implant (CI) is the main intervention option for people with severe and profound sensorineural hearing loss.
The purpose of this study was to investigate the auditory performance of a group of prelingually deafened paediatric
cochlear implant users using direct speech perception measures (objective) and a parental questionnaire (subjective)
and to identify significant demographic factors that might contribute to their performance. A total of 48 children from the
Cochlear Implant Program under the Malaysian Ministry of Health with hearing age of 12 to 89 months (mean = 42.60
± 19.46 months) participated in this study. The speech perception test was conducted using selected tests from the Malay
version of the Evaluation of Auditory Response to Speech (EARS) while parental views of the children’s performance were
collected using the Malay version of the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) questionnaire.
The recorded speech stimuli were presented to the children in a free field at approximately 65 dB SPL in a sound treated
room. The speech perception test results were then categorized using the Malay version of the Categories of Auditory
Performance Index (My-CAPI) with 10 categories ranging from ‘0’ to ‘9’. Results showed that most of the children (N = 20,
41.7%) were performing at category 2 of My-CAPI (limited closed set speech perception) with three children achieved the
maximum category 9 (advanced open-set sentences in noise). Communication mode was the only demographic factor that
significantly correlated with the My-CAPI and PEACH scores (p < 0.01). Pearson correlation coefficient showed a strong
relationship between the PEACH scores and My-CAPI levels (p < 0.01; r = 0.71) suggesting that the PEACH questionnaire
can be used as an indicator of the auditory performance if the speech perception tests cannot be performed. The findings
suggest that the majority of the CI children tested in this study had not achieved satisfactory auditory performance and that the use of oral communication mode was the main
factor associated with better auditory outcomes.
This study aims to investigate the viability and effectiveness of the Hanen More Than Words (HMTW) programme amongst
parents of children with Autism Spectrum Disorder (ASD). This quassi-experimental study involved 31 children (27 boys,
4 girls; M = 34.58 months, SD = 3.67) who met criteria for ASD and their parents. The measurement was conducted in
three phases; Time 1 (prior to intervention), Time 2 and Time 3 (at three and five months after the intervention begins).
The outcome measures were assessed based on: (1) changes in parental facilitative strategies; (2) the children’s growth
in vocabulary and (3) the progress of communication and social skills. The paired t-test were used to analyze the pre
and post findings within the intervention and control group with p-value
To compare the ability of methods based on skeletal muscle index (SMI) and another one by the European Working Group
on Sarcopenia in Older People (EWGSOP) based on both muscle mass and physical function in identifying older adults
with sarcopenia. Anthropometric measurements and physical performance (hand grip strength and gait speed) were
performed. In order to determine the value of SMI, body impedance analysis was also carried out. A total of 426 older
adults, mostly women (60.8%) with mean age of 68.4 ± 6.2 years participated in this study. Methods based on SMI and
EWGSOP identified 50.5% and 32.2% older adults as sarcopenic respectively. Method based on SMI showed a significantly
higher percentage of men (70.7%) were sarcopenic as compared to women (37.5%) (p < 0.05). No such difference was
noted for EWGSOP method, with 28.7% of men were sarcopenic as compared to women (34.4%). Binary logistic regression
indicated that aged 75 years and above (adjusted odds ratio: 3.3, 95% confidence interval: 1.9 – 5.6) and having arthritis
(adjusted odds ratio: 2.5, confidence interval: 1.3 – 4.7) to be associated with sarcopenia as assessed using method
recommended by EWGSOP. The lower prevalence of sarcopenia by EWGSOP as compared to SMI may be due to the more
comprehensive method by EWGSOP. Further research regarding validation of these two screening methods against a gold
standard of screening for sarcopenia is needed in order to identify the best method..
A preliminary field study was undertaken to evaluate the efficacy of a mosquito trap; Mosquito Killing System (MKS) in
capturing mosquitoes and other insects. MKS has an automatic activation by the use of a photocell. It is also supplemented
with carbon dioxide and heat as attractants for mosquitoes and other insects. Three units of MKS were employed at three
different locations within two study sites for ten days. The mosquitoes and other insects that were trapped in MKS were
collected and morphologically identified daily in the laboratory. A total of 1,928 mosquitoes and other insects were
trapped in all units of MKS. High numbers of mosquitoes (93.05%), particularly Aedes sp. and Culex sp. were captured
from MKS. Among these, Culex quinquefasciatus (91.81%) was most abundant species collected. Only 0.84% of Aedes
aegypti and Aedes albopictus trapped in MKS. Female mosquitoes (83.44%) were found to be more attracted to MKS
compared to male mosquitoes of various species. These findings illustrated the potency of MKS utilization in surveillance
and control activities of Cx. quinquefasciatus; a nuisance mosquito and also potential vector of urban brancroftian
filariasis in Malaysia.
The aim of this study was to determine the effect of time of measurement on central corneal thickness in young myopes.
Seventy healthy myopic subjects (non contact lens wearers) were involved in this study with mean age of 22.43 ± 1.76
years. Subjective refraction was determined using cross-cylinder technique, corneal curvature was measured using
keratometer (Shin-Nippon) and central corneal thickness (CCT) was determined using specular microscope (Topcon
SP-3000P). The CCT was measured in the morning (between 8 to 11 am) and in the afternoon (between 2 to 5 pm). The
results showed that the mean of refraction for all subjects was -2.59 ± 1.85 DS and mean of cornea curvature was 7.74
± 0.25 mm. Mean CCT in the morning was 517 ± 37 μm and 516 ± 36 μm in the afternon. Statistical analysis showed no
significant difference between both measurements (T = 1.713 and P = 0.091). Correlation analysis showed insignificant
correlation between CCT and refractive error (r = -0.078, p > 0.05) and CCT with corneal curvature in the horizontal
meridian (r = 0.014, p > 0.05) and at vertical meridian (r = 0.029, p > 0.05). This study concluded that there is no
significant effect of time of measurement on CCT in young myopes
Excellent treatment setup accuracy with highly conformal radiation technique will improve oral mucosal sparing by
limiting uninvolved mucosal structures from receiving high dose radiation. Therefore, a study was conducted to identify
the ideal immobilization device for interfraction treatment setup accuracy improvement. A total of twelve oral cancer
patients underwent volumetric modulated arc therapy (VMAT) was categorized into three different group depending on
immobilization device they used for treatment. HFW: headFIX® mouthpiece molded with wax, SYR: 10 cc/ml syringe and
TDW: wooden tongue depressor molded by wax. Each patient underwent image-guided radiotherapy with a total of 292
cone beam computed tomography (CBCT) data sets for position treatment setup errors measurement. The variations in
translational (lateral, longitudinal, vertical) and rotational (pitch, yaw, roll) in each CBCT image were calculated. Patient
positioning errors were analyzed for time trends over the course of radiotherapy. CTV-PTV margins were calculated from
the systematic (Σ) and random (σ) errors. Mean ± SD for absolute treatment setup error was statistically significant
(p < 0.001) lower for all translational errors and yaw direction in HFW. The interfraction 3D vector errors were 1.93 ±
0.66, 3.84 ± 1.34 and 2.79 ± 1.17 mm for the HFW, SYR and TDW respectively. There are positive increments between 3D
vector errors over the treatment fraction for all devices. The calculated CTV-PTV margins were 3.08, 2.22 and 0.81 mm,
3.76, 6.24 and 5.06 mm and 3.06, 3.45 and 4.84 mm in R-L, S-I and A-P directions, respectively. HFW shows smaller errors
in almost all comparison indicating higher accuracy and reproducibility of the immobilization device in maintaining
patient’s position. All margins calculated did not exceed hospital protocol (5 mm) except S-I and A-P directions using
SYR. However, in some special situations, such as re-irradiation or the close proximity of organs at risk and high-dose
regions or lower (i.e., 3 mm) margins could benefit from daily image guidance.