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Fulltext Functional Properties and Molecular Degradation of Schizostachyum Brachycladum Bamboo Cellulose Nanofibre in PLA-Chitosan Bionanocomposites

Rizal S, Saharudin NI, Olaiya NG, Khalil HPSA, Haafiz MKM, Ikramullah I, et al.

Molecules, 2021 Apr 01;26(7).
PMID: 33916094 DOI: 10.3390/molecules26072008

The degradation and mechanical properties of potential polymeric materials used for green manufacturing are significant determinants. In this study, cellulose nanofibre was prepared from Schizostachyum brachycladum bamboo and used as reinforcement in the PLA/chitosan matrix using melt extrusion and compression moulding method. The cellulose nanofibre(CNF) was isolated using supercritical carbon dioxide and high-pressure homogenisation. The isolated CNF was characterised with transmission electron microscopy (TEM), FT-IR, zeta potential and particle size analysis. The mechanical, physical, and degradation properties of the resulting biocomposite were studied with moisture content, density, thickness swelling, tensile, flexural, scanning electron microscopy, thermogravimetry, and biodegradability analysis. The TEM, FT-IR, and particle size results showed successful isolation of cellulose nanofibre using this method. The result showed that the physical, mechanical, and degradation properties of PLA/chitosan/CNF biocomposite were significantly enhanced with cellulose nanofibre. The density, thickness swelling, and moisture content increased with the addition of CNF. Also, tensile strength and modulus; flexural strength and modulus increased; while the elongation reduced. The carbon residue from the thermal degradation and the glass transition temperature of the PLA/chitosan/CNF biocomposite was observed to increase with the addition of CNF. The result showed that the biocomposite has potential for green and sustainable industrial application.
Fulltext Extraction of Cellulose Nanofibers via Eco-friendly Supercritical Carbon Dioxide Treatment Followed by Mild Acid Hydrolysis and the Fabrication of Cellulose Nanopapers

Atiqah MSN, Gopakumar DA, F A T O, Pottathara YB, Rizal S, Aprilia NAS, et al.

Polymers (Basel), 2019 Nov 05;11(11).
PMID: 31694184 DOI: 10.3390/polym11111813

The conventional isolation of cellulose nanofibers (CNFs) process involves high energy input which leads to compromising the pulp fiber's physical and chemical properties, in addition to the issue of elemental chlorine-based bleaching, which is associated with serious environmental issues. This study investigates the characteristic functional properties of CNFs extracted via total chlorine-free (TCF) bleached kenaf fiber followed by an eco-friendly supercritical carbon dioxide (SC-CO2) treatment process. The Fourier transmission infra-red FTIR spectra result gave remarkable effective delignification of the kenaf fiber as the treatment progressed. TEM images showed that the extracted CNFs have a diameter in the range of 10-15 nm and length of up to several micrometers, and thereby proved that the supercritical carbon dioxide pretreatment followed by mild acid hydrolysis is an efficient technique to extract CNFs from the plant biomass. XRD analysis revealed that crystallinity of the fiber was enhanced after each treatment and the obtained crystallinity index of the raw fiber, alkali treated fiber, bleached fiber, and cellulose nanofiber were 33.2%, 54.6%, 88.4%, and 92.8% respectively. SEM images showed that amorphous portions like hemicellulose and lignin were removed completely after the alkali and bleaching treatment, respectively. Moreover, we fabricated a series of cellulose nanopapers using the extracted CNFs suspension via a simple vacuum filtration technique. The fabricated cellulose nanopaper exhibited a good tensile strength of 75.7 MPa at 2.45% strain.
Fulltext The Role of Two-Step Blending in the Properties of Starch/Chitin/Polylactic Acid Biodegradable Composites for Biomedical Applications

Olaiya NG, Nuryawan A, Oke PK, Khalil HPSA, Rizal S, Mogaji PB, et al.

Polymers (Basel), 2020 Mar 05;12(3).
PMID: 32151004 DOI: 10.3390/polym12030592

The current research trend for excellent miscibility in polymer mixing is the use of plasticizers. The use of most plasticizers usually has some negative effects on the mechanical properties of the resulting composite and can sometimes make it toxic, which makes such polymers unsuitable for biomedical applications. This research focuses on the improvement of the miscibility of polymer composites using two-step mixing with a rheomixer and a mix extruder. Polylactic acid (PLA), chitin, and starch were produced after two-step mixing, using a compression molding method with decreasing composition variation (between 8% to 2%) of chitin and increasing starch content. A dynamic mechanical analysis (DMA) was used to study the mechanical behavior of the composite at various temperatures. The tensile strength, yield, elastic modulus, impact, morphology, and compatibility properties were also studied. The DMA results showed a glass transition temperature range of 50 °C to 100 °C for all samples, with a distinct peak value for the loss modulus and factor. The single distinct peak value meant the polymer blend was compatible. The storage and loss modulus increased with an increase in blending, while the loss factor decreased, indicating excellent compatibility and miscibility of the composite components. The mechanical properties of the samples improved compared to neat PLA. Small voids and immiscibility were noticed in the scanning electron microscopy images, and this was corroborated by X-ray diffraction graphs that showed an improvement in the crystalline nature of PLA with starch. Bioabsorption and toxicity tests showed compatibility with the rat system, which is similar to the human system.
Long-term evaluation of osteoarthritis sheep knee, treated with TGF-β3 and BMP-6 induced multipotent stem cells

Ude CC, Shamsul BS, Ng MH, Chen HC, Ohnmar H, Amaramalar SN, et al.

Exp Gerontol, 2018 04;104:43-51.
PMID: 29421350 DOI: 10.1016/j.exger.2018.01.020

BACKGROUND: Hyaline articular cartilage, which protects the bones of diarthrodial joints from forces associated with load bearing, frictions, and impacts has very limited capacities for self-repair. Over the years, the trend of treatments has shifted to regenerations and researchers have been on the quest for a lasting regeneration. We evaluated the treatment of osteoarthritis by chondrogenically induced ADSCs and BMSCs for a long time functional recovery.
METHODS: Osteoarthritis was induced at the right knee of sheep by complete resection of ACL and medial meniscus. Stem cells from sheep were induced to chondrogenic lineage. Test sheep received 5 mls single doses of 2 × 107 autologous PKH26-labelled ADSCs or BMSCs, while controls received basal medium. Functional recovery of the knees was evaluated via electromyography.
RESULTS: Induced ADSCs had 625, 255, 393, 908, 409, 157 and 1062 folds increases of collagen I, collagen II, aggrecan, SOX9, cartilage oligomeric protein, chondroadherin and fibromodullin compare to uninduced cells, while BMSCs had 702, 657, 321, 276, 337, 233 and 1163 respectively; p = .001. Immunocytochemistry was positive for these chondrogenic markers. 12 months post-treatment, controls scored 4 in most regions using ICRS, while the treated had 8; P = .001. Regenerated cartilages were positive to PKH26 and demonstrated the presence of condensing cartilages on haematoxylin and eosin; and Safranin O. OA degenerations caused significant amplitude shift from right to left hind limb. After treatments, controls persisted with significant decreases; while treated samples regained balance.
CONCLUSIONS: Both ADSCs and BMSCs had increased chondrogenic gene expressions using TGF-β3 and BMP-6. The treated knees had improved cartilage scores; PKH26 can provide elongated tracking, while EMG results revealed improved joint recoveries. These could be suitable therapies for osteoarthritis.
Fulltext TVET programme and health-related quality of life among low-income populations during the COVID-19 pandemic in Malaysia

Yasin RM, Tan MP, Said MA, Rasul MS, Thangiah N, Rizal H, et al.

Front Public Health, 2024;12:1164056.
PMID: 38504686 DOI: 10.3389/fpubh.2024.1164056

INTRODUCTION: Education improves the economy and quality of life. The availability of skilled education in Malaysia is not restricted to the younger generation but is available to people of all ages, including those with low incomes.
METHODS: This study used the EuroQol 5-Dimension 5-Level (EQ- 5D-5L) tool during the COVID-19 pandemic to examine relationships between socio-demographics, knowledge, and attitudes towards education and outcomes of health-related quality of life (HRQOL). Between September and October 2020 and January and February 2021, a cross-sectional study using a multi-stage sampling technique was carried out.
RESULTS: A total of 1,997 adults participated, with a mean age of 45.17 (SD 14.113). In total, 74.9% had good knowledge, while 59.8% had a positive attitude towards skill education. In univariate analyses, the EQ-5D-5L score was related to age, income, education level, marital status, employment status, financial strain level, and knowledge and attitude towards skilled education. Generalised linear model analyses demonstrated that lower EQ-5D-5L scores were associated with older age, financial constraints, and a negative attitude towards skills education. However, additional adjustments for knowledge and attitude towards skills education show only an increase in age and financial strain was significant.
CONCLUSION: The findings suggest that appropriate strategies be implemented to increase low-income populations' knowledge and attitude towards skill education. Improving education may improve the quality of life for this vulnerable group. Additionally, a qualitative study can be conducted to determine the barriers to low-income households participating in skilled education to fill in the knowledge gap.
Effects of a Multicomponent Exercise and Therapeutic Lifestyle (CERgAS) Intervention on Gait Function in Lower-Income Urban-Dwelling Older Adults: A Cluster Randomized Controlled Trial

Loh DA, Naqiah Hairi N, Mohd Hairi F, Peramalah D, Kandiben S, Abd Hamid MAI, et al.

J Aging Phys Act, 2023 Aug 01;31(4):531-540.
PMID: 36509091 DOI: 10.1123/japa.2022-0047

This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group (p = .650) and interaction (p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.
Fulltext Exploring the Relationships of Financial Literacy and Financial Behaviour with Health-Related Quality of Life (HRQOL) among the Low-Income Working Population in Malaysia during the COVID-19 Pandemic

Sabri MF, Said MA, Magli AS, Pin TM, Rizal H, Thangiah N, et al.

Int J Environ Res Public Health, 2022 Sep 30;19(19).
PMID: 36231818 DOI: 10.3390/ijerph191912520

This cross-sectional study examined the relationships of financial literacy (FL) and financial behaviour (FB) with health-related quality of life (HRQOL) during the COVID-19 pandemic among low-income working population (20-60 years old) in Malaysia. A self-administered questionnaire survey was used with HRQOL data were gathered using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) tool. A generalised linear model was employed to examine the hypothesised relationships between the constructs. From 1186 respondents, the majority were employed (73.9%), had a monthly household income of less than RM 2500 (74.5%), and did not have any chronic medical conditions (74.5%). The mean (SD) values of FL, FB, and EQ-5D-5L were 5.95 (1.48), 22.08 (4.79), and 0.96 (0.10), respectively. The results of the adjusted model revealed lower age group, Malay ethnicity, Indian ethnicity, and increased FB score as significant determinants of higher EQ-5D-5L scores. With the addition of the chronic medical condition factor into the saturated model, the lower age group, ethnicity, and no chronic medical condition were significant determinants of higher HRQOL. The effects of FB on QOL were confounded by chronic diseases, implying that interventions that focus on improving FB for those with chronic medical condition may help to improve the QOL among the low-income working population.
Impact of WhatsApp on improving denture care knowledge and the awareness of the relationship between edentulism and general health

Wan Abd Manan WNH, Abg Abd Mohd Rizal DNS, Borhan FW, Lestari W, Ismail A, Che Musa MF, et al.

J Prosthet Dent, 2024 Nov 29.
PMID: 39616100 DOI: 10.1016/j.prosdent.2024.11.004

STATEMENT OF PROBLEM: Denture wearers are susceptible to diseases related to denture hygiene and are more prone to develop systemic disease because of poor understanding and awareness of the impact of edentulism on general health.
PURPOSE: The purpose of this clinical study was to evaluate the effectiveness of traditional chairside practice and WhatsApp in improving patient knowledge of denture care and their awareness of the impact of edentulism on general health.
MATERIAL AND METHODS: Sixty-two participants who attended the Polyclinic Kulliyyah of Dentistry, IIUM Kuantan in 2022 for removable prosthesis fabrication were recruited. The participants were randomized into 2 groups: control (traditional chairside) and intervention (WhatsApp) group. Video intervention was sent via WhatsApp to the participants. Pretreatment and posttreatment questionnaires were distributed from March to September 2022 to survey their sociodemographic data, knowledge of denture care, and awareness of the effect of edentulism on general health. Data were obtained and checked for normality using the Shapiro-Wilk test. Data were analyzed using the Mann-Whitney U and Wilcoxon-Paired Signed-Rank tests (α=.05).
RESULTS: Eighty-two percent of participants favored WhatsApp as a tool for receiving information and used it daily (66.1%). The level of overall knowledge and awareness increased in groups after denture insertion instruction. Participants' knowledge of denture care (P=.001) and awareness of the effect of edentulism on general health (P=.001) improved significantly in the WhatsApp intervention group compared with the control group.
CONCLUSIONS: WhatsApp can be used as an alternative tool for improving denture care knowledge among denture wearers; increased awareness was observed with WhatsApp compared with the traditional chairside approach.
Fulltext Health system reform from the people's point of view: development of reliable and valid questionnaire

Saad Ahmed Ali Jadoo, Syed Mohamed Aljunid, Seher Nur Sulku, Sami Abdo Radman Al-Dubai, Sharifa Ezat Wan Puteh, Zafar Ahmed, et al.

Malaysian Journal of Public Health Medicine, 2013;13(2):65-76.
MyJurnal

Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
Fulltext Peoples expectations from healthcare providers - a Turkish perspective

Saad Ahmed Ali Jadoo, Syed Mohamed Aljunid, Seher Nur Sulku, Sharifa Ezat Wan Puteh, Zafar Ahmed, Mohd Rizal Abdul Manaf, et al.

Malaysian Journal of Public Health Medicine, 2013;13(2):88-97.
MyJurnal

There is high expectation from the population on part of the healthcare providers. These include; skilful and timely medication administration; and knowledge, honesty, listening skills, availability and professional attitude. The aim of this paper is to evaluate the expectation of population with regards to the healthcare providers in Turkey. A cross- sectional study was conducted in Turkey, including both rural and urban population, carried out from October 2011 till January 2012. A total of 540 household heads were selected using multistage random sampling technique. Data was collected using modified self-administered 16-items QUOTE (Quality of Care Through the Patients’ Eyes) questionnaire. The questionnaire measures communication/ accessibility, organizational skills and professional skills. The response rate was (77.1%) and data was analyzed by using SPSS version 16.0. All the aspects measured using QUOTE questionnaire were found to be important by the majority of respondents, but with varying degrees of priority. The quality aspects related to the professional skills of physicians was ranked first followed by communication/ accessibility and last but not the least is the organizational skills of health care providers. This study explored the Turkish people priorities and expectations regarding healthcare providers. The public priorities and expectation were different across population. This may reflect the need to understand people's expectations before providing the services to avoid complaints that may occur after the services have been rendered.
Fulltext Spectrofluorometric and molecular docking studies on the binding of curcumenol and curcumenone to human serum albumin

Hamdi OA, Feroz SR, Shilpi JA, Anouar el H, Mukarram AK, Mohamad SB, et al.

Int J Mol Sci, 2015;16(3):5180-93.
PMID: 25756376 DOI: 10.3390/ijms16035180

Curcumenol and curcumenone are two major constituents of the plants of medicinally important genus of Curcuma, and often govern the pharmacological effect of these plant extracts. These two compounds, isolated from C. zedoaria rhizomes were studied for their binding to human serum albumin (HSA) using the fluorescence quench titration method. Molecular docking was also performed to get a more detailed insight into their interaction with HSA at the binding site. Additions of these sesquiterpenes to HSA produced significant fluorescence quenching and blue shifts in the emission spectra of HSA. Analysis of the fluorescence data pointed toward moderate binding affinity between the ligands and HSA, with curcumenone showing a relatively higher binding constant (2.46 × 105 M-1) in comparison to curcumenol (1.97 × 104 M-1). Cluster analyses revealed that site I is the preferred binding site for both molecules with a minimum binding energy of -6.77 kcal·mol-1. However, binding of these two molecules to site II cannot be ruled out as the binding energies were found to be -5.72 and -5.74 kcal·mol-1 for curcumenol and curcumenone, respectively. The interactions of both ligands with HSA involved hydrophobic interactions as well as hydrogen bonding.
Fulltext Seropositivity and serointensity of Toxoplasma gondii antibodies and DNA among patients with schizophrenia

Omar A, Bakar OC, Adam NF, Osman H, Osman A, Suleiman AH, et al.

Korean J Parasitol, 2015 Feb;53(1):29-34.
PMID: 25748706 DOI: 10.3347/kjp.2015.53.1.29

The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.
Fulltext Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial

Magosso E, Ansari MA, Gopalan Y, Shuaib IL, Wong JW, Khan NA, et al.

Nutr J, 2013;12(1):166.
PMID: 24373555 DOI: 10.1186/1475-2891-12-166

Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obesity, insulin resistance, lipid peroxidation and oxidative stress have been identified amongst the possible hits leading to the onset and progression of this disease. Nutritional evaluation of NAFLD patients showed a lower-than-recommended intake of vitamin E. Vitamin E is a family of 8 isoforms, 4 tocopherols and 4 tocotrienols. Alpha-tocopherol has been widely investigated in liver diseases, whereas no previous clinical trial has investigated tocotrienols for NAFLD. Aim of the study was to determine the effects of mixed tocotrienols, in normalising the hepatic echogenic response in hypercholesterolaemic patients with ultrasound-proven NAFLD.
Quality of life in Malaysian colorectal cancer patients

Wan Puteh SE, Saad NM, Aljunid SM, Abdul Manaf MR, Sulong S, Sagap I, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:110-7.
PMID: 23857846 DOI: 10.1111/appy.12055

The rapidly increasing of incidence colorectal cancer (CRC) in Malaysia and the introduction of new treatments that prolong survival advocating treatment outcome measures such as patients' quality of life (QOL) are evaluated in this study. The study aims to determine QOL in CRC patients according to cancer stage and age.
Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:7-13.
PMID: 23857831 DOI: 10.1111/appy.12036

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.
Orgasmic dysfunction among Malay diabetic women in Malaysia

Ismail AH, Baw R, Sidi H, Guan NC, Midin M, Nik Jaafar NR, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S29-33.
PMID: 23623640 DOI: 10.1016/j.comppsych.2013.03.009

The present study aimed to determine the prevalence and associated factors of orgasmic dysfunction among Malay women with type 2 diabetes mellitus in Malaysia.
Serum IL-6 and IL-1-ra with sequential organ failure assessment scores in septic patients receiving high-volume haemofiltration and continuous venovenous haemofiltration

Ghani RA, Zainudin S, Ctkong N, Rahman AF, Wafa SR, Mohamad M, et al.

Nephrology (Carlton), 2006 Oct;11(5):386-93.
PMID: 17014550

Sepsis is characterized by an uncontrolled release of pro-inflammatory and anti-inflammatory mediators leading to immunoparalysis, cellular and humoral dysfunction, multiorgan dysfunction and death. This study evaluated the efficacy of high-volume haemofiltration (HVHF) compared with continuous venovenous haemofiltration (CVVH) in removing these inflammatory mediators. Clinical responses were assessed with the sequential organ failure assessment (SOFA) score.
Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography

Tan SK, Ng KH, Yeong CH, Raja Aman RRA, Mohamed Sani F, Abdul Aziz YF, et al.

Quant Imaging Med Surg, 2019 Apr;9(4):552-564.
PMID: 31143647 DOI: 10.21037/qims.2019.03.13

Background: High delivery rate is an important factor in optimizing contrast medium administration in coronary computed tomography angiography (CCTA). A personalized contrast volume calculation algorithm incorporating high iodine delivery rate (IDR) can reduce total iodine dose (TID) and produce optimal vessel contrast enhancement (VCE) in low tube voltage CCTA. In this study, we developed and validated an algorithm for calculating the volume of contrast medium delivered at a high rate for patients undergoing retrospectively ECG-gated CCTA with low tube voltage protocol.
Methods: The algorithm for an IDR of 2.22 gI·s-1 was developed based on the relationship between VCE and contrast volume in 141 patients; test bolus parameters and characteristics in 75 patients; and, tube voltage in a phantom study. The algorithm was retrospectively tested in 45 patients who underwent retrospectively ECG-gated CCTA with a 100 kVp protocol. Image quality, TID and radiation dose exposure were compared with those produced using the 120 kVp and routine contrast protocols.
Results: Age, sex, body surface area (BSA) and peak contrast enhancement (PCE) were significant predictors for VCE (P<0.05). A strong linear correlation was observed between VCE and contrast volume (r=0.97, P<0.05). The 100-to-120 kVp contrast enhancement conversion factor (Ec) was calculated at 0.81. Optimal VCE (250 to 450 HU) and diagnostic image quality were obtained with significant reductions in TID (32.1%) and radiation dose (38.5%) when using 100 kVp and personalized contrast volume calculation algorithm compared with 120 kVp and routine contrast protocols (P<0.05).
Conclusions: The proposed algorithm could significantly reduce TID and radiation exposure while maintaining optimal VCE and image quality in CCTA with 100 kVp protocol.
Fulltext Health-related quality of life of female patients with congenital adrenal hyperplasia in Malaysia

Zainuddin AA, Grover SR, Abdul Ghani NA, Wu LL, Rasat R, Abdul Manaf MR, et al.

Health Qual Life Outcomes, 2020 Aug 01;18(1):258.
PMID: 32738912 DOI: 10.1186/s12955-020-01515-9

BACKGROUND: This study investigates the health-related quality of life (HRQOL) of female patients with congenital adrenal hyperplasia (CAH) in Malaysia. The objectives were to attain socio-demographic and medical data on these Malaysian females with CAH and establish their health-related quality of life (HRQOL) in comparison to age matched diabetic controls.
METHODS: A cross-sectional study was conducted over 6 months in the two main tertiary centres for CAH patients in Malaysia. Participants including 59 female-raised CAH patients (mean age ± SD = 16.3 ± 4.2 years, range 10-28 years) compared to 57 age-matched female diabetic patients (mean age ± SD = 16.5 ± 3.4 years, range 10-26 years). Socio-demographic and medical profiles was obtained through semi-structured interviews. HRQOL of participants were evaluated utilising validated, Malay translated questionnaires which were age appropriate: Pediatric Quality of Life Inventory (PedsQL v4.0) scales for Child (8-12) and Adolescent (13-18) and Medical Outcome Survey 36-item Short Form version. These were then compared to the diabetic controls.
RESULTS: The CAH participants consisted of children (ages 10-12 years, n = 12), adolescents (ages 13-17 years, n = 29) and adults (≥ 18 years, n = 18). The majority were Malays (64.4%) and had salt-wasting CAH (67.8%). There were no significant differences between the total mean score of the HRQOL of the combined children and adolescents CAH group (total mean score ± SD = 81.6 ± 17.9, 95% CI = 75.6-87.6) when compared to age-matched diabetic patients (total mean score ± SD = 80.8 ± 11.0, 95% CI = 77.0-84.5, P = 0.81, effect size = 0.05); no significant difference between the adult CAH and diabetic controls in the physical [median score (IQR) CAH vs diabetics; 49.3 (11.4) vs. 50.2 (6.1), P = 0.60, effect size = 0.09] and the mental composite scores [median score (IQR) CAH vs. diabetics; 47.8 (14.1) vs. 50.0 (10.8), P = 0.93, effect size = 0.01].
CONCLUSIONS: The HRQOL of the Malaysian CAH cohort were comparable to the diabetic controls.
Marrow Fat Content and Composition in β-Thalassemia: A Study using 1 H-MRS

Ismail UN, Azlan CA, Khairullah S, Azman RR, Omar NF, Md Shah MN, et al.

J Magn Reson Imaging, 2021 01;53(1):190-198.
PMID: 33237616 DOI: 10.1002/jmri.27294

BACKGROUND: β-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition.
PURPOSE: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using 1 H-MRS.
STUDY TYPE: Prospective.
SUBJECTS: Twenty-three subjects were included in this study, seven control and 16 β-thalassemia subjects.
FIELD STRENGTH/SEQUENCE: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence.
ASSESSMENT: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter).
STATISTICAL TESTS: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P

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