Drug addictions in Malaysia: a mini-review on drug types, rehabilitation centers and therapeutic programs.

Drug addiction remains one of the most complex social problems worldwide that has yet to be resolved. In Malaysia, abuse of various types of drugs has been reported which warrants the government to take immediate strategies in managing drug addicts. Despite implementing various strategies to treat drug addiction, statistics show the number of relapses continues to skyrocket over the years. This calls for urgent attention to improve the effectiveness of substance abuse treatment services in Malaysia. Moreover, emerging evidence shows a change in trend in the type of drug being abused. This factor could potentially contribute to the ineffectiveness of the strategies employed in the treatment of substance abuse. Therefore, this review provides an overview of the major types of drugs commonly abused in Malaysia. Additionally, in an effort to search for ways to improve the effectiveness of substance abuse treatment services, we identified the public institutions responsible for managing drug addicts in Malaysia and discussed the therapeutic programs offered at the institutions. Review findings support the need for future research on the effectiveness of these therapeutic programs and recommend the implementation of evidence-based programs to improve the effectiveness of substance abuse treatments in Malaysia.

DIAGNOSTIC REFERENCE LEVELS FOR COMMON CT EXAMINATIONS: RESULTS FROM A STATEWIDE DOSE SURVEY.

The aim of this study was to investigate the current radiation doses for CT examinations throughout a state in Malaysia and, based on this data, to propose local diagnostic reference levels (DRLs) for the most common CT examinations. A study was conducted in three of the four hospitals that have provided CT services throughout the state. A survey booklet was designed to facilitate collection of pertinent CT scan data. The following information were extracted and recorded for each study: tube voltage, tube current, number of scans phases, CT dose index volume (CTDIvol) and dose length product (DLP). Proposed local DRLs of CT brain and thorax were up to 12% lower than the current national DRLs. However, an increase of DLP (median value) for CT abdomen was also found as compared to the 75th percentile of national DRLs. Therefore, considerable optimisation should be made to achieve a better dose reduction.

Digital Mammograms with Image Enhancement Techniques for Breast Cancer Detection: A Systematic Review.

BACKGROUND: Digital mammograms with appropriate image enhancement techniques will improve breast cancer detection, and thus increase the survival rates. The objectives of this study were to systematically review and compare various image enhancement techniques in digital mammograms for breast cancer detection. METHODS: A literature search was conducted with the use of three online databases namely, Web of Science, Scopus, and ScienceDirect. Developed keywords strategy was used to include only the relevant articles. A Population Intervention Comparison Outcomes (PICO) strategy was used to develop the inclusion and exclusion criteria. Image quality was analyzed quantitatively based on peak signal-noise-ratio (PSNR), Mean Squared Error (MSE), Absolute Mean Brightness Error (AMBE), Entropy, and Contrast Improvement Index (CII) values. RESULTS: Nine studies with four types of image enhancement techniques were included in this study. Two studies used histogram-based, three studies used frequency-based, one study used fuzzy-based and three studies used filter-based techniques. All studies reported PSNR values whilst only four studies reported MSE, AMBE, Entropy, and CII values. Filter-based was the highest PSNR values of 78.93, among other types. For MSE, AMBE, Entropy, and CII values, the highest were frequency-based (7.79), fuzzy-based (93.76), filter-based (7.92), and frequency-based (6.54) respectively. CONCLUSION: In summary, image quality for each image enhancement technique is varied, especially for breast cancer detection. In this study, the frequency-based of Fast Discrete Curvelet Transform (FDCT) via the UnequiSpaced Fast Fourier Transform (USFFT) shows the most superior among other image enhancement techniques.

Radiation dose and diagnostic image quality associated with iterative reconstruction in coronary CT angiography: A systematic review.

The aim of this systematic review is to evaluate the radiation dose reduction achieved using iterative reconstruction (IR) compared to filtered back projection (FBP) in coronary CT angiography (CCTA) and assess the impact on diagnostic image quality. A systematic search of seven electronic databases was performed to identify all studies using a developed keywords strategy. A total of 14 studies met the criteria and were included in a review analysis. The results showed that there was a significant reduction in radiation dose when using IR compared to FBP (P < 0.05). The mean and standard deviation (SD) difference of CTDIvol and dose-length-product (DLP) were 14.70 ± 6.87 mGy and 186 ± 120 mGy.cm respectively. The mean ± SD difference of effective dose (ED ) was 2.9 ± 1.7 mSv with the range from 1.0 to 5.0 mSv. The assessment of diagnostic image quality showed no significant difference (P > 0.05). The mean ± SD difference of image noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were 1.05 ± 1.29 HU, 0.88 ± 0.56 and 0.63 ± 1.83 respectively. The mean ± SD percentages of overall image quality scores were 71.79 ± 12.29% (FBP) and 67.31 ± 22.96% (IR). The mean ± SD percentages of coronary segment analysis were 95.43 ± 2.57% (FBP) and 97.19 ± 2.62% (IR). In conclusion, this review analysis shows that CCTA with the use of IR leads to a significant reduction in radiation dose as compared to the use of FBP. Diagnostic image quality of IR at reduced dose (30-41%) is comparable to FBP at standard dose in the diagnosis of CAD.