Background Many upper-middle-income countries (UMICs), including Malaysia, continue to face low breast cancer (BC) screening rates and patients with delayed presentation of BC. This study investigated the role of beliefs about BC and use of screening (e.g. beliefs about whether or not screening reduced the possibility of dying from BC). Methods A nationwide cross-sectional study was conducted in which a total of 813 women (aged ≥ 40 years old) were randomly selected and surveyed using the validated Awareness and Beliefs about Cancer (ABC) measure. The association between BC screening use, sociodemographic characteristics, and negative beliefs about BC screening were analysed using stepwise Poisson regressions. Results Seven out of ten Malaysian women believed that BC screening was necessary only when experiencing cancer symptoms. Women > 50 years and from households with more than one car or motorcycle were 1.6 times more likely to attend a mammogram or a clinical breast examination (mammogram: Prevalence Ratio (PR) = 1.60, 95% Confidence Interval (CI) = 1.19–2.14, Clinical Breast Examination (CBE): PR = 1.61, 95% CI = 1.29–1.99). About 23% of women expected to feel anxious about attending BC screening, leading them to avoid the procedure. Women who held negative beliefs about BC screening were 37% less likely to attend a mammogram (PR = 0.63, 95% CI = 0.42–0.94) and 24% less likely to seek a CBE (PR = 0.75, 95% CI = 0.60–0.95). Conclusions Public health strategies or behaviour interventions targeting negative beliefs about BC screening among Malaysian women may increase uptake and reduce late presentation and advanced-stage cancer. Insights from the study suggest that women under 50 years, in the lower income group without a car or motorcycle ownership, and of Malay or Indian ethnicity (compared to Chinese-Malay) are more likely to hold beliefs inhibiting BC screening.

Intervertebral disc (IVD) degeneration is one of the primary causes of low back pain, causing disability; hence, there is no regenerative nature of the current treatments. Hyaluronic acid (HA) was reported to facilitate tissue repair and alleviate pain. Herein, we determined the therapeutic effect of HA and type II collagen (COLII) hydrogel for tissue repair targeting pain in IVD degeneration. We implanted HA/COLII hydrogel following surgically induced disc injury at coccygeal levels in the rat tail model of pain. We assessed the efficacy of the HA/COLII hydrogel in reducing pain behaviour by using the von Frey assessment, protein expression of growth-associated protein (GAP) 43 for sensory nerve innervation, and disc hydration by magnetic resonance imaging (MRI). We observed the anti-nociceptive effect of the HA/COLII hydrogel in alleviating mechanical allodynia in rats. There was an inhibition of sensory hyperinnervation indicated by the GAP43 protein in the treatment group. We revealed an increase in T1ρ mapping of MRI, indicating that the hydrogel restored disc hydration in vivo. Our findings suggest the HA/COLII hydrogel alleviates pain behaviour, inhibits hyperinnervation and promotes disc hydration for tissue repair, implying that it is a potential candidate for the treatment of degenerative disc-associated low back pain.

Introduction Breast cancer (BC) screening uptake in Malaysia is low and a high number of cases present at a late stage. Community navigation and mobile health (mHealth) may increase screening attendance, particularly by women from rural communities. This randomized controlled study evaluated an intervention that used mHealth and community health workers to educate women about BC screening and navigate them to clinical breast examination (CBE) services in the context of the COVID-19 pandemic. Methods Women aged 40–74 years, from Segamat, Malaysia, with a mobile phone number, who participated in the South East Asian Community Observatory health survey, (2018) were randomized to an intervention (IG) or comparison group (CG). The IG received a multi-component mHealth intervention, i.e. information about BC was provided through a website, and telephone calls and text messages from community health workers (CHWs) were used to raise BC awareness and navigate women to CBE services. The CG received no intervention other than the usual option to access opportunistic screening. Regression analyses were conducted to investigate between-group differences over time in uptake of screening and variable influences on CBE screening participation. Results We recruited 483 women in total; 122/225 from the IG and 144/258 from the CG completed the baseline and follow-up survey. Uptake of CBE by the IG was 45.8% (103/225) whilst 3.5% (5/144) of women from the CG who completed the follow-up survey reported that they attended a CBE during the study period (adjusted OR 37.21, 95% CI 14.13; 98.00, p<0.001). All IG women with a positive CBE attended a follow-up mammogram (11/11). Attendance by IG women was lower among women with a household income ≥RM 4,850 (adjusted OR 0.48, 95% CI 0.20; 0.95, p = 0.038) compared to participants with a household income

The purpose of this paper is to review the new management policy in medical imaging of the Covid-19 post-pandemic transition. This paper discussed the Standard Operating Procedure (SOP) introduced by the Ministry of Health (MoH) Malaysia to prevent and control intrahospital transmissions of Covid-19. A conceptual framework is proposed to highlight the key areas in the national SOP for preventing Covid-19 intrahospital transmissions in the radiology department. The key areas were classified into four categories: planned requests (patient appointments), (ii) open-access management (walk-in patient workflow and the triage system), (iii) direct contact (during radiology procedures), and (iv) exit policy and disinfection (post imaging conduct). The paper ends with a summary of diagnostic imaging classifications based on chest radiographs (CXR) and Computed Tomography (CT) images of suspected and confirmed Covid-19 patients. The Covid-19 SOP for the radiology department by the MoH was found to retain most of the patient quarantine and isolation guidelines by the Centre for Disease Control and Prevention (CDC) and incorporated several international policies on patient triage and disinfection of radiological equipment. The majority of the SOP is also sustained, like the SOP during the pandemic, except for the SOP that has been proven to be insignificant by recent research. The Covid-19 SOP for the radiology department plays an important role in reducing the intrahospital spread of Covid-19, with some areas needing improvement. Health workers in the radiology department should continue implementing the Covid-19 SOP and increase their knowledge in identifying Covid-19 signs on radiographic images to help safeguard themselves and the patients from intrahospital transmissions.

Background This study presents a registration system that integrates preoperative cardiac Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) volume data with 2D Ultrasound (US) images of the aortic valve. The registration process aims to combine three different imaging modalities (US-CT-MRI) to improve the accuracy of diagnosing aortic valve disorders and provide surgical guidance during the implantation and replacement of the transcatheter aortic valve. Methods The registration framework involves two key components: temporal synchronization and spatial registration. Temporal synchronization allows the identification of frames in the CT and MRI volume that correspond to the same cardiac phase as the US time-series data. For spatial registration, an intensity-based normalized mutual information method combined with a pattern search optimization algorithm is used to produce interpolated cardiac CT and MRI images that align with the US image. Results The accuracy of the trimodality registration method is evaluated using the Dice similarity coefficient. The obtained coefficients are 0.92±0.05 and 0.92±0.04 for comparisons between US-CT and US-MRI, respectively, in short-axis "Mercedes Benz" sign views. The Hausdorff distance, which measures the dissimilarity between two sets of points, was found to be 1.49±0.20 and 1.49±0.19 for both US-CT and US-MRI pairings, respectively. Notably, these values are comparable to the precision achieved when an expert manually registers each image. Conclusions The proposed registration technique demonstrates excellent accuracy in enhancing image-guided systems for aortic valve surgical guidance. It shows promise in the context of Transcatheter Aortic Valve Implantation (TAVI) and Transcatheter Aortic Valve Replacement (TAVR) procedures. The successful integration of US-CT-MRI imaging modalities enables better diagnosis and surgical planning for aortic valve disorders, potentially leading to improved patient outcomes in these procedures.