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Fulltext Effects of prolonged confined isolation on status of inflammation, endothelial activation and function: in preparation for possible future manned space expedition to mars

Thuhairah Rahman, Radzi Ahmad, Suhaila Muid, Tengku Saifudin Tengku Ismail, Buravkova, Ludmila B., Hapizah Nawawi

Pertanika Journal of Science & Technology, 2020;28(2):659-672.
MyJurnal

Inflammation and endothelial dysfunction are key components in atherogenesis. Should the status of these pro-atherogenesis factors be enhanced during prolonged confined space travel, specific countermeasures need to be instituted to prevent these processes to ensure safe outcome for astronauts during space expeditions. Six crew members were exposed to prolonged, confined isolation for 520 days. Standard exercise and diet regime were instituted throughout isolation phase. Age and gender-matched healthy, free living controls were recruited in parallel. Serial serum and whole blood were analysed for biomarkers of inflammation (hsCRP and IL-6) and endothelial activation (sICAM-1, sVCAM-1 and E-selectin). Flow-mediated dilatation (FMD) of the artery was performed following the standard protocols set by the International Brachial Artery Reactivity Task Force by trained personnel. There was decreased sVCAM-1 concentration in crew members compared to baseline. However, there was significant decrease in percentage dilatation from baseline in FMD of the brachial artery in the crew members. Percent change increment was observed in hsCRP while percent change reduction was seen in sVCAM-1. The enhanced inflammation and reduced endothelial function could possibly be attributed to the rigorous exercise instituted throughout the confinement period. Furthermore, possible haemoconcentration as a result of psychosocial stress and/ or exercise-induced physiological response could further explain elevations in hsCRP, and unlikely pathological. Furthermore, endothelial activation was attenuated during isolation, suggesting that the diet and exercise program instated throughout the period improved endothelial function.
Fulltext Draft Genome Sequence of Plant Growth-Promoting Rhizobacterium Burkholderia sp. Strain USMB20, Isolated from Nodules of Mucuna bracteata

Aziz NA, Shaffie S, Rahman AYA, Hokchai Y, Najimudin N, Ghazali AHA

Microbiol Resour Announc, 2021 Mar 18;10(11).
PMID: 33737365 DOI: 10.1128/MRA.01051-20

Burkholderia sp. strain USMB20 is a plant growth-promoting rhizobacterium that was isolated from nodules of the leguminous cover crop Mucuna bracteata. The draft genome sequence of Burkholderia sp. strain USMB20 has an assembly size of 7.7 Mbp in 26 contigs with a GC content of 66.88%.
Fulltext Hamman’s syndrome: a rare benign syndrome

Aida Abdul Rahim, Mohd Taufiq Yahaya1, Siti Nor Farhana Mohd Shafie, Laila Mastura Ahmad Apandi

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):357-359.
MyJurnal

Hamman’s syndrome by definition is spontaneous pneumomediastinum with the exclusion of thoracic trauma or iatrogenic cause. It is rare and is more common in adolescence male. Amongst the risk factors are underlying lung condition such as asthma and interstitial lung disease, drug inhalation and parturient woman. Patient usually pres- ents with sudden onset of shortness of breath and chest pain with subcutaneous emphysema on examination. The diagnosis is confirmed with chest radiograph. The prognosis of Hamman’s syndrome is excellent. Most cases are self-limiting and resolve spontaneously. However, Hamman’s syndrome is a poorly recognised disease due to its rarity. Therefore, the patient may be subjected to misdiagnosis and treatment. This is a case report of Hamman’s syn- drome misdiagnosed and treated as pneumothorax. The objective of this case report is to highlight the importance of differentiating this benign syndrome with life threatening differentials which may have similar clinical presentation. Thus, avoiding unnecessary costly investigation, treatment and invasive procedures.
Fulltext A study of the parameters that effect the quality of the estimated modal parameters in automated enhanced frequency domain decomposition algorithm

Muhammad Danial Abu Hasan, Zair Asrar Ahmad, Mohd Salman Leong, Lim, Meng Hee

Pertanika Journal of Science & Technology, 2020;28(3):797-828.
MyJurnal

This paper presents parameters analysis for the estimated modal damping ratio using a new version of the automated enhanced frequency domain decomposition (AEFDD). The purpose of this study is to provide a better choice of a maximum number of points of time segments and modal assurance criterion (MAC) index number regarding to the variable level of system damping (low and high damped structure) and degree of freedom of the system. According current literature, frequency domain (FD) methods seem to have the problem with providing a correct identification of the modal damping ratio, since the correct estimate of modal damping is still an open problem and often leads to biased estimates. This technique is capable of providing consistent modal parameters estimation, particularly for modal frequencies and mode shapes. As a necessary fundamental condition, the algorithm has been assessed first from computed numerical responses according to random white noise, acting on different shear-type frame structures and corrupted with noise. Results indicate that reducing the value of natural frequencies and modal damping ratios of the modes under analysis demands longer time segments and a high value of the maximum number of points for adequate information on the decaying correlation functions when computing a modal damping ratio. In addition, the results also prove that the MAC index does not significantly affect the results for the low damped system. However, the use of a high MAC index value for the high damped system significantly introduces large error bound and it becomes worse, particularly for the higher modes, as the standard deviation of percentage error increases gradually. Furthermore, the use of a MAC index for a high number of points of time segments significantly increases the standard deviation of the percentage error.
Fulltext Changes in the urinary metabolites in losartan-treated spontaneously hypertensive rats

Norasikin Ab Azis, Mohd Saleh Ahmad Kamal, Zurain Radjeni, Ahmed Mediani, Renu Agarwal

Journal of Clinical and Health Sciences, 2021;6(1):32-45.
MyJurnal

Introduction: This study examined the association of losartan induced changes in urinary
metabolomic profile with the changes in blood pressure (BP) and renin-angiotensinaldosterone system (RAAS) in spontaneously hypertensive rats (SHR). Methods: Male SHR
were administered with either 0.5 mL of distilled water (control group, n=6) or 10 mg.kg-1 of
losartan (group 2, n=6) daily by oral gavage for 4 weeks. Body weight, BP, food and water
intake were measured weekly. At week 4, urine was collected for urinary electrolyte analysis
and metabolite profiling, after which the animals were euthanised by decapitation and blood
was collected for analysis of components of RAAS and electrolyte concentrations. Urine
metabolite profile of SHR was determined using proton nuclear magnetic resonance (
1H-NMR)
spectrometry combined with multivariate data analysis. Results: At week 4, losartan-treated
SHR had significantly lower BP than non-treated SHR. There were no differences in water
and food intake, body weight, serum and urinary electrolyte concentrations or in their urinary
excretions between the two groups. No differences were evident in the components of RAAS
except that the angiotensinogen level was significantly higher in losartan-treated SHR
compared to non-treated SHR. Orthogonal partial least squares discriminant analysis (OPLSDA) showed clear separation of urinary metabolites between control and losartan-treated
SHR. Losartan-treated SHR group was separated from the control group by changes in the
intermediates involved in glycine, serine and threonine metabolism. Conclusion:
Antihypertensive effect of losartan in SHR seems to be associated with changes in urinary
metabolite profile, particularly involving the metabolism of glycine, serine and threonine.
Fulltext Innovations in flapless corticotomy to accelerate orthodontic tooth movement: a review focusing on the different techniques, limitations and future possibilities

Sharmin Sultana, Norma Ab Rahman, Siti Lailatul Akmar Zainuddin, Basaruddin Ahmad

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):308-315.
MyJurnal

The aim of this narrative review is to discuss on different approaches of the flapless corticotomy techniques to ac- celerate orthodontic tooth movement. There was limited understanding about the effect of the surgical procedures because of the great variations in the procedures between the flapless corticotomy techniques. Hence, no specific technique can be claimed to be superior to another. Eleven clinical trials have been reviewed from PubMed, Science Direct, and Google Scholar using the keywords such as accelerated, orthodontic tooth movement (OTM), minimally invasive corticotomy, RAP, corticision, piezocision, lasercision/laser assisted flapless corticotomy (LAFC), micro-os- teoperforations (MOPs), discision and their combinations in the last 10 years. Early reports showed that Piezocision, MOPs and LAFC procedures are comparatively less aggressive flapless corticotomy procedure to accelerate OTM and more comfortable to the patient.
Fulltext Analysis of Different Boundary Conditions on Homogeneous One-Dimensional Heat Equation

Muhammad Aniq Qayyum Mohamad Sukry, Norazlina Subani, Muhammad Arif Hannan, Faizzuddin Jamaluddin, Ahmad Danial Hidayatullah Badrolhisam

Malaysian Journal of Science, Health & Technology, 2021;7(1):15-21.
MyJurnal

Partial differential equations involve results of unknown functions when there are multiple independent variables. There is a need for analytical solutions to ensure partial differential equations could be solved accurately. Thus, these partial differential equations could be solved using the right initial and boundaries conditions. In this light, boundary conditions depend on the general solution; the partial differential equations should present particular solutions when paired with varied boundary conditions. This study analysed the use of variable separation to provide an analytical solution of the homogeneous, one-dimensional heat equation. This study is applied to varied boundary conditions to examine the flow attributes of the heat equation. The solution is verified through different boundary conditions: Dirichlet, Neumann, and mixed-insulated boundary conditions. the initial value was kept constant despite the varied boundary conditions. There are two significant findings in this study. First, the temperature profile changes are influenced by the boundary conditions, and that the boundary conditions are dependent on the heat equation’s flow attributes.
Fulltext Occupational safety and health practice in school's classroom in Malaysia

Noor Adilah Hamzah, Ahmad Rasdan Ismail, Nor Kamilah Makhtar, Khairul Azhar Mat Daud, Norhidayah Mat Sout

Journal of Occupational Safety and Health, 2018;15(2):13-22.
MyJurnal

Today, more accidents reported in school, resulting not only minor injuries but also severe injuries such as fire in schools, mercury spills and falling from high places. The study was aimed at measuring the level of occupational safety and health practices in schools. The study was conducted at 205 schools in Kelantan, Malaysia. This study is a semi-quantitative study using observation method. Data collection is conducted based on Hazard Identification, Risk Assessment and Risk Control (HIRARC) Guidelines provided by the Department of Occupational Safety and Health, Malaysia. Hazard identification, risk assessment and risk control are determined using the HIRARC form. The findings were measured by determining the discrete data according to the number of low, medium and high-risk levels found. The study found that there were two dominant hazards namely physical hazard and ergonomic hazard. Therefore, the management should increase and improve classroom safety awareness to ensure safety and health of all occupants.
Fulltext A review on the factors influencing the attendance of postpartum diabetes screening for mothers with gestational diabetes mellitus

Puganeswary Thangarajah, Halimatus Sakdiah Minhat, Nor Afiah Mohd Zulkefli, Norliza Ahmad

Malaysian Journal of Medicine and Health Sciences, 2019;15(203):84-88.
MyJurnal

Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to iden- tify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpar- tum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy.
Fulltext Translation and adaptation of hearing handicap inventory for adult (HHIA) into malay language: a pilot study

Tengku Zulaila Hasma Tengku Zam Zam, Ahmad Aidil Arafat Dzulkarnain, Sarah Rahmat, Masnira Jusoh

International Journal of Allied Health Sciences, 2017;1(2):92-100.
MyJurnal

Patient’s self-perceived handicap inventory is an important tool for modern’s health care management including hearing loss. The HHIA is a selfreporting outcome measurement invented to identify hearing-impaired patients’ complaints for appropriate client-centred rehabilitation program. HHIA has been
reported among one of the valid self-perceived hearing handicap measures, and could even addressed issues for patient with mild and unilateral hearing loss. This study aims to translate HHIA into Malay language (HHIA-M) and to adapt the questionnaire culturally for clinical use among Malaysian population.
Fulltext Design and development of 3d face mask clips for hijab

Ahmad Sofian, Shminan, Rehman, Ullah Khan, Wan Norizan, Wan Hashim, Iswandy, Jamaludin

Journal of Cognitive Sciences & Human Development, 2020;6(2):52-62.
MyJurnal

The world has suffered from a critical shortage of Personal Protective Equipment (PPE) (Riva et al., 2007) during the pandemic of Covid-19 for medical staffs, the front liners. Like the whole world, Malaysia also imposed the stay-at-home and Movement Control Order (MCO) to break the chain of infections and flatten the curve of cases. The supply of PPE became a challenge during the lock down. There have been joined efforts from various parties stepping up, with different ways to help the production process of these key equipment but mostly focus on PPTs for male. Another challenge was face mask for Muslim lady health workers who wear hijab. This paper is about how to overcome these challenges and designed a novel face mask clip for hijab, using 3D printing. The face mask clip is for wearing a mask over hijab and is designed by generating a 3D digital file using computer-aided design (Hourcade, Bullock-Rest, & Hansen, 2012) software. Then the 3D design was converted to Standard Tessellation Language (STL) format, for the use of 3D printing systems. Then the design was split into layers for precise printing. The clips were tested by the staff in faculty of Cognitive Sciences and Human Development, Universiti Malaysia Sarawak. Feedbacks were collected by an online survey using the modified System Usability Scale. The participants reported that the clips are very comfortable and easy to use.
Fulltext The effect of listening to Qur’anic recitation on social skills among children with Autism Spectrum Disorder (ASD)

Wan Fara Adila Wan Ahmad Kaspi, Kartini Ilias, Amir Muhriz Abdul Latiff, Mohd Zaid Daud

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):101-101.
MyJurnal

Introduction: The number of children diagnosed with Autism Spectrum Disorder (ASD) keeps increasing every year. ASD is a neurodevelopmental disability that affects social communication and social interaction. They also demon-strate restricted, repetitive pattern of behaviour, interest or activities (RRB) that shows at an early developmental age. Due to this characteristic, ASD children are facing difficulties in social skills aspect such as eye contact, expression, and making friends. Studying and reciting the Quran are often used in Malaysia to ameliorate the symptoms, but there is no specific study in Malaysia that demonstrates the impact of these renditions on ASD’s children’s social skills. The objective of this study was to investigate the effect selected Qur’anic verses recitation on the social skills of the children with Autism Spectrum Disorder (ASD). Methods: This study will use the quasi-experimental research design. This study will be held at IDEAS Autism Centre, Rawang. The purposive sampling technique will be used and 14 ASD Muslim children aged 4-6 years old will be chosen. The ASD children will be divided into an experimental and control group. The experimental group will be listening to selected Qur’anic verses before the intervention. The Social Responsiveness Scale- Second Edition (SRS-2) will be used to assess the response. The scale consists of a 65-item questionnaire, with a 4-point Likert-scale. Results: The expected result for this study is the ASD children in the experimental group will have lower Total-scores of SRS-2 compared to control group. Conclusion: Listening to Qur’anic recitation provides a cost-effective complementary therapy to improve social skills among Muslim ASD children. Information from this study also can be used as a stepping stone in developing the teaching module to ASD children.
Fulltext Trends of prevalence of anaemia among adolescents in a middle-income country: a cohort study

Vanitha Krishnan, Hazreen Abdul Majid, Rafdzah Ahmad Zaki, Muhammad Yazid Jalaludin

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):105-105.
MyJurnal

Introduction: Anaemia is a significant public health problem among adolescents globally but there is limited data in many countries, including Malaysia. This study aims to investigate the 5-years incidence of anemia among Malaysian adolescents by gender, ethnicity, locality of schools, Body Mass Index, stature and diet intake. Methods: A secondary analysis of existing data from MyHeART study was conducted within a closed cohort of 528 adolescents (aged 13 years) attended 15 public secondary schools from Kuala Lumpur, Selangor and Perak. The adolescents who were followed up at 15 and 17 years old had completed haemoglobin assessment, anthropometric measurements and -days diet history. The data was cleaned and missingness was handled accordingly with multiple imputation. SPSS Software version 21 was used to analyse the data, with Generalised Estimating Equation (GEE) showing the effect of time on the trajectory of prevalence of anaemia over the 5 years. Results: The prevalence or incidence? of anaemia in 2012, 2014 and 2016 was 7.9% (95%CI: 5.0-12.3), 13.9% (95%CI: 10.0-19.0) and 15.8% (95%CI:11.3-21.7). In females, anaemia increased from 11.1% (95%CI:6.7-18.7) to 15.7% (11.4-21.3) and 23.1%(95%CI: 16.8-31.0); the change was significant from 13 to 15 years old. Similar trend was noticed in those who are stunted, overweight/obese, in both urban/rural schools and didn’t meet their daily recommended nutrient intake for total calorie, protein and iron. Conclusion: Anaemia is increasing in trend among the adolescents over the years and deems attention from the relevant stakeholders to create a robust anemia prevention program.
Fulltext A rare case of Tuberculous Prostatitis

Nurul Yaqeen Esa, Mohammad Hanafiah, Marymol Koshy, Hilmi Abdullah, Ahmad Izuanuddin Ismail, Mohamed Fauzi Abdul Rani

Journal of Clinical and Health Sciences, 2016;1:33-36.

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.
Fulltext Improper technique of eye drop instillation leading to corneal ulcer in a visually impaired glaucoma patient

Azhan, A., Zunaina, E., Fatimah, S.S., Ahmad Nurfahmi Akhtar Ali, Khairidzan, M.K.

Journal of Clinical and Health Sciences, 2018;3(2):43-47.
MyJurnal

We report a case of visually impaired glaucoma patient with long term use of topical glaucoma medications presented with a corneal ulcer due to the improper technique of eye drop instillation. A 70-year-old gentleman with advanced primary open angle glaucoma (POAG) on his right eye and absolute glaucoma on his left eye, presented with painful redness and purulent discharge of the right eye for two weeks. He was using four types of topical glaucoma medication on his right eye since failed trabeculectomy two years ago. His right eye vision was 6/24 and painless blindness of the left eye before the presentation. He was administering all the medications himself despite his current vision status. Right eye examination showed visual acuity of 3/60 with clinical features of corneal ulcer. During the observation of his eye drop instillation technique, he consistently touched the tip of the bottle to his right cornea. The corneal contact area corresponded to the corneal ulcer area and size. In addition to this, the culture result obtained from both corneal ulcer and the bottles’ tips yielded similar microorganism which was Staphylococcus aureus. After an intensive course of topical antibiotics treatment, the corneal ulcer healed with a scar and the vision improved to 6/24 from 3/60. Although this incident is rare, it is crucial for the treating physicians to address the issue properly and co-manage these patients with pharmacists and nursing staffs as well as to seek support from the caretakers to prevent this blinding complication.
Fulltext Antiretroviral treatment-associated labia majora lipohypertrophy: A rare case and plastic surgical treatment options

Akmal Hisham, Devananthan Ilenghoven, Wan Syazli Wan Ahmad Kamal, Salina Ibrahim, Shah Jumaat Mohd Yussof

Journal of Clinical and Health Sciences, 2017;2:43-47.

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).
Fulltext A fatal case of rhinocerebral mucormycosis

Nurul Suhaili Kamarudin, Rosni Ibrahim, Nur Hanani Ahmad, Siti Norbaya Masri

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):329-331.
MyJurnal

Rhinocerebral mucormycosis is a potentially fatal and progressive angioinvasive fungal infection. It is classically described in patients with uncontrolled diabetes mellitus and hematological malignancies. This report describes a case of progressive rhinocerebral mucormycosis in a patient with poorly controlled diabetes who was on prolonged prednisolone therapy for autoimmune kidney disease. The patient, who was a female, presented to hospital with headache, orbital pain and nasal bridge swelling. Black eschar on nasal mucosae was present on admission. Later, she was started on intravenous fluconazole for the diagnosis of fungal sinusitis. Subsequently, she developed intra- cerebral haemorrhage complicated with transtentorial herniation. Diagnosis of rhinocerebral mucormycosis was later observed by a laboratory finding and the treatment was changed to intravenous amphotericin B. However, the patient succumbed to her illness on the 6th day of hospitalisation. This report discusses the risk factors associated with rhinocerebral mucormycosis as well as the underlying pathogenesis. This report will also highlight the importance of early diagnosis and appropriate treatment for mucormycosis to improve prognosis in patients.
Fulltext Interaction between Metarhizium anisopliae and Its Host, the Subterranean Termite Coptotermes curvignathus during the Infection Process

Syazwan SA, Lee SY, Sajap AS, Lau WH, Omar D, Mohamed R

Biology (Basel), 2021 Mar 25;10(4).
PMID: 33806225 DOI: 10.3390/biology10040263

Metarhizium anisopliae (Metchnikoff) Sorokin, a pathogenic fungus to insects, infects the subterranean termite, Coptotermes curvignathus Holmgren, a devastating pest of plantation trees in the tropics. Electron microscopy and proteomics were used to investigate the infection and developmental process of M. anisopliae in C. curvignathus. Fungal infection was initiated by germ tube penetration through the host's cuticle as observed at 6 h post-inoculation (PI), after which it elongated into the host's integumental tissue. The colonization process continued as seen from dissemination of blastospores in the hemocoel at 96 h PI. At this time point, the emergent mycelia had mummified the host and forty-eight hours later, new conidia were dispersed on the termites' body surface. Meanwhile, hyphal bodies were observed in abundance in the intercellular space in the host's body. The proteomes of the pathogen and host were isolated separately using inoculated termite samples withdrawn at each PI-time point and analyzed in two-dimensional electrophoresis (2-DE) gels. Proteins expressed in termites showed evidence of being related to cell regulation and the immune response, while those expressed in M. anisopliae, to transportation and fungal virulence. This study provides new information on the interaction between termites and its entomopathogen, with potential utilization for developing future biopesticide to control the termite population.
Fulltext Estimation of kidneys and urinary bladder doses based on the region of interest in (18)fluorine-fluorodeoxyglucose positron emission tomography/computed tomography examination: a preliminary study

Mustapha FA, Bashah FAA, Yassin IM, Fathinul Fikri AS, Nordin AJ, Abdul Razak HR

Quant Imaging Med Surg, 2017 Jun;7(3):310-317.
PMID: 28811997 DOI: 10.21037/qims.2017.05.03

BACKGROUND: Kidneys and urinary bladder are common physiologic uptake sites of 18fluorine-fluorodeoxyglucose ((18)F-FDG) causing increased exposure of low energy ionizing radiation to these organs. Accurate measurement of organ dose is vital as (18)F-FDG is directly exposed to the organs. Organ dose from (18)F-FDG PET is calculated according to the injected (18)F-FDG activity with the application of dose coefficients established by International Commission on Radiological Protection (ICRP). But this dose calculation technique is not directly measured from these organs; rather it is calculated based on total injected activity of radiotracer prior to scanning. This study estimated the (18)F-FDG dose to the kidneys and urinary bladder in whole body positron emission tomography/computed tomography (PET/CT) examination by comparing dose from total injected activity of (18)F-FDG (calculated dose) and dose from organs activity based on the region of interest (ROI) (measured dose).
METHODS: Nine subjects were injected intravenously with the mean (18)F-FDG dose of 292.42 MBq prior to whole body PET/CT scanning. Kidneys and urinary bladder doses were estimated by using two approaches which are the total injected activity of (18)F-FDG and organs activity concentration of (18)F-FDG based on drawn ROI with the application of recommended dose coefficients for (18)F-FDG described in the ICRP 80 and ICRP 106.
RESULTS: The mean percentage difference between calculated dose and measured dose ranged from 98.95% to 99.29% for the kidneys based on ICRP 80 and 98.96% to 99.32% based on ICRP 106. Whilst, the mean percentage difference between calculated dose and measured dose was 97.08% and 97.27% for urinary bladder based on ICRP 80 while 96.99% and 97.28% based on ICRP 106. Whereas, the range of mean percentage difference between calculated and measured organ doses derived from ICRP 106 and ICRP 80 for kidney doses were from 17.00% to 40.00% and for urinary bladder dose was 18.46% to 18.75%.
CONCLUSIONS: There is a significant difference between calculated dose and measured dose. The use of organ activity estimation based on drawn ROI and the latest version of ICRP 106 dose coefficient should be explored deeper to obtain accurate radiation dose to patients.
Fulltext SPECT-CT in differentiating metastatic and degenerative lesions of the spine

Khadijah Abdul Hamid, Sazilah Ahmad Sarji, Mohammad Nazri Md Shah, Ibrahim Lutfi Shuaib

Malaysian Journal of Medicine and Health Sciences, 2020;16(102):31-37.
MyJurnal

Introduction: The purpose of this study was to determine the usefulness of SPECT-CT in differentiating metastatic and degenerative disease of the spine. Methods: Twenty-eight patients aged 50 years and above diagnosed with various cancers were referred for whole body (WB) planar bone scintigraphy. Those with a maximum three foci of tracer up- take in the spine were selected for the study. SPECT-CT of these areas of uptake was performed and the lesions were classified as degenerative, indeterminate or metastasis. A repeat study (WB planar bone scintigraphy and SPECT-CT) was performed between 3 to 12 months later. These areas of uptake were reassessed and compared with the first WB planar bone scintigraphy and SPECT-CT. The second SPECT-CT was used as the standard for the diagnosis. Results: Thirty-seven lesions in 28 patients were assessed. The sensitivity of the first WB planar bone scintigraphy, second WB planar bone scintigraphy and first SPECT-CT is 75%, 62.5% and 75% respectively. The specificity of the first WB planar bone scintigraphy, second WB planar bone scintigraphy and first SPECT-CT is 86%, 93%, 90% respectively. There was 2.7% of ‘indeterminate lesion’ in the first WB planar bone scintigraphy, 5.4% in the second WB planar bone scintigraphy, and 5.4% in the first SPECT-CT. The indeterminate lesions were resolved in the second SPECT-CT. Conclusion: SPECT- CT is useful in differentiating degenerative disease from metastatic lesions in the spine.

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