https://journals.iium.edu.my/kom/index.php/imjm <p>IIUM Medical Journal Malaysia (IMJM) formerly known as the International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies. IMJM is published quarterly, the dates of publication being the 1st day of the months of January, April, July and October.</p> IIUM Press en-US IIUM Medical Journal Malaysia 1823-4631 <p>All material submitted for publication is assumed to be submitted exclusively to the IIUM Medical Journal Malaysia (IMJM) unless the contrary is stated. Manuscript decisions are based on a double-blinded peer review process. The Editor retains the right to determine the style and if necessary, edit and shorten any material accepted for publication.</p> <p>IMJM retain copyright to all the articles published in the journal. All final ‘proof’ submissions must be accompanied by a completed&nbsp;Copyright Assignment Form, duly&nbsp;signed by all authors. The author(s) or copyright owner(s) irrevocably grant(s) to any third party, in advance and in perpetuity, the right to use, reproduce or disseminate the research article in its entirety or in part, in any format or medium, provided that no substantive errors are introduced in the process, proper attribution of authorship and correct citation details are given, and that the bibliographic details are not changed. If the article is reproduced or disseminated in part, this must be clearly and unequivocally indicated.</p> https://journals.iium.edu.my/kom/index.php/imjm/article/view/3367 <p><strong>INTRODUCTION</strong>: Despite frequent interactions between haemodialysis patients and healthcare providers, local evidence remains limited. This study assessed patient-doctor relationships and communication among haemodialysis patients in Peninsular Malaysia and examined factors associated with relationship scores. <strong>MATERIAL AND METHODS</strong>: A cross-sectional study involving 640 haemodialysis patients was conducted between September 1 and October 24, 2024, using multistage random sampling across Peninsular Malaysia. Data were collected using the Patient-Doctor Relationship Questionnaire-9 (PDRQ-9) and the Doctor-Patient Communication Questionnaire (DPCQ). Multiple linear regression analysis was performed to identify associated factors. <strong>RESULTS</strong>: Most respondents were female (54.5%), aged 48 years or older (57.1%), Malay (47.0%), and married (58.8%), with nearly 60% reporting a monthly income below RM 4,360. The mean patient-doctor relationship score was 35.40 (SD=7.74), and the mean communication score was 51.09 (SD=8.14). After adjustment, age, educational attainment, and doctor–patient communication were significantly associated with relationship scores. Younger patients aged 18-27 years reported lower scores (adjusted β=-0.044, p=0.027), while higher educational attainment was positively associated (adjusted β=0.034, p=0.023). Doctor-patient communication emerged as the strongest predictor (adjusted β=1.163, p&lt;0.001). Income, employment status, geographical location, and centre type were not significant. <strong>CONCLUSION</strong>: These findings underscore the pivotal role of effective communication in strengthening patient-doctor relationships. Targeted interventions addressing communication skills and age- and education-related disparities may enhance patient experience and satisfaction. Future research should assess the long-term clinical impact of communication improvements.</p> Ab Farid Fajilah Ab Aziz Mohd Ismail Ibrahim Najib Majdi Yaacob Afiq Izzudin Abdul Rahim Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3367 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3368 <p>INTRODUCTION: Traumatic brain injury (TBI) is frequently linked to psychological challenges, including post-traumatic stress symptoms (PTSS), depressive symptoms, and emotional regulation difficulties. Despite the high prevalence of these issues in individuals with TBI, research on their interrelationships remains limited. This study aims to investigate the prevalence of PTSS, depressive symptoms, and emotional regulation difficulties among individuals with TBI and to explore the relationships between these challenges. MATERIALS AND METHODS: A cross-sectional study was conducted with 150 individuals with a history of TBI. Participants completed self-report measures: the Post-Traumatic Stress Disorder Checklist (PCL), the Patient Health Questionnaire (PHQ-9), and the Emotion Regulation Questionnaire (ERQ). Descriptive statistics and correlation tests were employed to assess the prevalence and interrelationships between the variables. RESULTS: The results revealed that 80.7% of participants met the clinical threshold for PTSS, 83.3% exhibited moderate to severe depressive symptoms, and 32% demonstrated low cognitive reappraisal scores. Additionally, 74% of participants showed medium to high levels of expressive suppression. Strong positive correlations were found between expressive suppression and PTSS (Spearman’s ρ=0.532, p&lt;0.001) and between PTSS and depressive symptoms (Spearman’s ρ=0.728, p&lt;0.001). CONCLUSION: The study highlights significant psychological challenges in individuals with TBI, emphasizing the role of emotional regulation in the co-occurrence of PTSS and depressive symptoms. These findings suggest that emotional regulation strategies, particularly expressive suppression, play a crucial role in the psychological outcomes of TBI. Future research should focus on longitudinal studies to better understand these relationships and their long-term implications.</p> Iszati Afiqah Iskandar Zulkarnain Mohd Faizal Mohd Zulkifly Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3368 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3369 <p>INTRODUCTION: Diabetes mellitus (DM) is a major public health concern, with a prevalence of over 11% worldwide and expected to rise to 13% by 2050. Cardiovascular disease (CVD) is the leading cause of death among people with diabetes, responsible for roughly one-third of all deaths. In preclinical research, γ-oryzanol (γ-ORZ), a bioactive substance derived from rice bran oil, has demonstrated promising antidiabetic effects. This study used a rat model of type 2 diabetes mellitus (T2DM) to evaluate the cardioprotective effects of γ-ORZ. MATERIALS AND METHODS: Fifty-four male Sprague-Dawley rats (200–250 g) were randomly allocated into six groups (n=9): non-diabetic control, non-diabetic + γ-ORZ (100 mg/kg), diabetic control, diabetic + metformin (300 mg/kg), diabetic + γ-ORZ (100 mg/kg), and diabetic + metformin + γ-ORZ (same doses as above). A single injection of streptozotocin (40 mg/kg) was administered after six weeks on a high-fat diet to develop type 2 diabetes. Treatments were given orally for a period of four weeks. RESULTS: γ-ORZ significantly lowered fasting blood glucose, glycated haemoglobin (HbA1c), insulin resistance (HOMA-IR), triglycerides (TG), and total cholesterol (TC), while increasing high-density lipoprotein (HDL) levels (p&lt;0.05). No significant differences were observed in body weight, food intake, or serum insulin levels (p&gt;0.05). Histopathological examination revealed improved cardiac tissue structure in γ-ORZ-treated diabetic rats compared to diabetic controls. CONCLUSION: γ-ORZ exhibited notable cardiometabolic benefits in diabetic rats through modulation of glucose and lipid metabolism. These findings</p> Mustapha Ismail Radda Siti Fairuz Mohd Yusof Rozaziana Ahmad Abdul Jalil Rohana Wan Rosli Wan Ishak Anani Aila Mat Zin Aminah Che Romli Norsuhana Omar Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3369 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3370 <p><strong>INTRODUCTION</strong>: Falls are a leading cause of injury and disability among older adults, posing a significant public health challenge. In Malaysia, the prevalence of falls among community-dwelling older adults varies widely. Despite the availability of fall prevention programmes, adoption remains limited. This study aimed to assess fall prevention behaviour and its associated factors among older persons attending Klinik Rawatan Keluarga, Hospital Pakar Universiti Sains Malaysia. <strong>MATERIALS AND METHODS</strong>: A cross-sectional design was employed involving 213 older adults selected via systematic sampling at a primary care clinic in Hospital Pakar Universiti Sains Malaysia. Data on socio-demographics, comorbidities, and fall history were collected. The validated Malay version of the Fall Prevention Knowledge and Behaviour (FPKB) questionnaire was used to evaluate participants’ knowledge and behaviour. Logistic regression analysis were performed to investigate the associations between sociodemographic, medical characteristics, fall history, Fall Risk Assessment (FRA), and Fall Prevention Knowledge with Fall Prevention Behaviours. <strong>RESULTS</strong>: Results showed that 43.7% had poor fall prevention knowledge, and 44.1% demonstrated inadequate preventive behaviour. Participants with good knowledge had significantly lower odds of poor behaviour (OR=0.425; 95% CI: 0.244–0.740; p=0.002). <strong>CONCLUSION</strong>: These findings underscore the crucial role of health literacy in fostering effective fall prevention practices. Strengthening educational interventions in clinical settings may enhance behavioural outcomes and reduce fall-related risks among older adults.</p> Nik Faizatullisa Nik Zulkefli Azidah Abdul Kadir Imran Ahmad Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3370 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3371 <p><strong>INTRODUCTION</strong>: Understanding mental health literacy among women is important in improving mental health outcomes and promoting help-seeking. Despite increasing attention to mental health, little is known about the mental health literacy of women in Kelantan. This study aimed to assess the level of mental health literacy (MHL) and identify the associated factors among women in Kelantan, Malaysia.<strong> MATERIALS AND METHODS</strong>: A cross-sectional survey was conducted from November 2023 to March 2024, involving 431 women aged 18 to 60 years selected through convenience sampling. Data were collected using the Malay versions of the Mental Health Literacy Scale (MHLS) and Mental Help Seeking Attitudes Scale (MHSAS). <strong>RESULTS</strong>: Participants had a mean age of 39.7(9.9) years, with the majority being Malay (98.6%), Muslim (99.1%), and married (77.5%). Most had completed secondary (43.4%) or tertiary education (55.9%), and 64% were from the B40 income group. The mean MHL score was 111.9 (13.5). Multiple linear regression analysis revealed that higher education (b=8.36, p&lt;0.001), higher monthly income (b=3.31, p=0.002), and higher scores of attitudes toward mental help-seeking (b = 2.70, p&lt;0.001) were significantly associated with better MHL scores. Married women had significantly lower MHL scores (b=-3.82, p=0.004) and a family history of mental illness (b=-3.41, p=0.014). <strong>CONCLUSION</strong>: These findings underscore the need for targeted mental health awareness programmes for those with lower education and socioeconomic groups to improve their awareness and mental help-seeking behaviour.</p> Nur Ilani Ishak Ahmad Shahril Ab. Halim Raishan Shafini Bakar Nor Asyikin Fadzil Asrenee Ab. Razak Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3371 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3372 <p><strong>INTRODUCTION</strong>: Community-based surveillance (CBS) plays a crucial role in early detection and response to communicable disease outbreaks. Understanding the determinants of community participation in CBS is essential for developing effective public health strategies. This study aimed to identify and quantify the key determinants of community participation in communicable disease surveillance, utilising factors from the Theory of Planned Behaviour and Health Belief Model to form a comprehensive predictive model.<strong> MATERIALS AND METHODS</strong>: A cross-sectional study design was used, with a sample of 470 participants interviewed to assess their likelihood of CBS participation using the KAP-CBS-ID questionnaire. Multiple linear regression analysis was utilised to test the relationships between the predictor variables and the likelihood of engaging in CBS. <strong>RESULTS</strong>: The final model demonstrated good predictive capacity, accounting for 51.7% of the variance in behavioural likelihood (F= 99.49, p&lt;0.001). Five predictors showed significant relationships with CBS participation behaviour. Perceived susceptibility showed the highest predictive power (β=0.255, p&lt;0.001), followed by perceived benefits (β=0.231, p&lt;0.001), intention to accept involvement (β=0.209, p&lt;0.001), and subjective norms (β=0.202, p&lt;0.001). There was a significant negative association between attitudes toward participation (β=-0.104, p=0.002). Knowledge of infectious diseases, self-efficacy, and perceived barriers were not significant predictors and were excluded from the final model. <strong>CONCLUSION</strong>: A multi-theoretical approach to understand CBS participation is supported empirically by these findings. Initiatives to increase CBS participation should emphasize community susceptibility to disease outbreaks, explain the advantages, foster positive social norms, and address unfavourable perceptions of surveillance practices.</p> Ahmed Azeez Hasan Anis Kausar Ghazali Abbas Ali Alkinani Rasha Mohammed Jumaah Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3372 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3373 <p><strong>INTRODUCTION</strong>: Weight stigma contributes to negative physical and psychological outcomes and reduced healthcare engagement. Obesity in Malaysia is increasing, yet exploration of weight stigma is scarce. This study aimed to translate and validate the Universal Measure of Bias-Fat (UMB-Fat) for assessing obesity stigma among Malaysians. <strong>MATERIALS AND METHODS</strong>: A cross-sectional study was conducted among 456 staff and students at USM Health Campus. The UMB-Fat was translated into Malay using forward and backward translation by research team members and a certified translator. The Malay UMB-Fat underwent face validity, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and reliability testing. <strong>RESULTS</strong>: Face validity demonstrated excellent clarity and comprehensibility, with item-level face validity indices (I-FVI) ranging from 0.90 to 1.00 and a scale-level average (S-FVI/Ave) of 0.94. EFA (n=206) using principal-axis factoring and Promax rotation yielded three factors with 16 items retained, all of which had satisfactory factor loadings with KMO = 0.841 (p&lt;0.001), and the total variance explained was 61.37%. Subsequent CFA analysis (n=250) revealed a three-factor model of 15 items with a goodness of fit index of comparative fit index = 0.952, Tucker-Lewis index = 0.938, chi-squared/degree of freedom = 2.11, and root mean square error of approximation = 0.068. The reliability testing using Cronbach’s alpha was satisfactory for 3 factors (0.860, 0.836, and 0.852, respectively). <strong>CONCLUSION</strong>: The Malay version of UMB-Fat is a valid and reliable tool for assessing weight stigma among Malaysians.</p> Nur Afifah Zolkefili@Zulkifli Aisyah Ali Nor Akma Mat Junoh@Yunus Siti Azrin Ab Hamid Razlina Abdul Rahman Imran Ahmad Rosediani Muhamad Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3373 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3375 <p><strong>INTRODUCTION</strong>: Histone deacetylases (HDACs) regulate chromatin and gene expression, and their dysregulation contributes to multiple myeloma (MM). This study evaluated the epigenetic effects of the HDAC inhibitor Trichostatin A (TSA) on U266 MM cells, its impact on proliferation, transcriptomic alterations, core gene clusters, and association with MM survival. <strong>MATERIALS AND METHODS</strong>: U266 cells were treated with TSA and assessed by MTT assays to determine IC₅₀ values. Cell cycle arrest and apoptosis were measured by flow cytometry. RNA-Seq identified differentially expressed genes, followed by KEGG analysis. PPI networks and core gene clusters were generated using STRING and Cytoscape MCODE, and Kaplan-Meier plots evaluated their associations with survival outcomes. <strong>RESULTS</strong>: TSA induced dose-dependent cytotoxicity (IC₅₀ =54.46±4.0 nM) and triggered significant G₀/G₁ arrest (82.98±1.99%), reduced S-phase (9.02±1.99%), and early and late apoptosis rates increased (24.88±2.08% and 24.86±3.81%, respectively. Transcriptomic analysis revealed enriched KEGG pathways including ECM receptor interaction (q=2.05×10⁻⁴), microRNAs in cancer (q=7.52×10⁻⁴), and cell cycle (q=9.05×10⁻⁴). Three core gene clusters emerged: Cluster 1 (seed gene OASL; includes IFI44, RSAD2, IFIT3, MX1, IFIT1, IFI44L, XAF1, IFI6), Cluster 2 (NRCAM; includes SPTBN4, SPTA1, ANK1), and Cluster 3 (LRP1; includes APOE, LRP2). APOE upregulation was most strongly correlated with improved survival (log rank p&lt;1×10⁻¹⁶), with RSAD2, XAF1, IFIT1, and SPTBN4 also significant (p≤0.05). <strong>CONCLUSION</strong>: TSA exerts potent anti-proliferative effects in U266 MM cell line via several mechanisms. Survival-associated core genes Apolipoprotein E (APOE) and Radical S-Adenosyl Methionine Domain Containing 2 (RSAD2) have potential as candidate survival-associated biomarkers and therapeutic targets warrant further validation.</p> Nor Hayati Ismail Shafini Mohamed Yusoff Muhammad Farid Johan Azlan Husin Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3375 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3376 <p><strong>INTRODUCTION</strong>: Chronic Rhinosinusitis (CRS) is a common condition causing a significant worldwide burden, affecting 5%-12% of the general population. The immunoregulatory mechanisms underlying eosinophilic and non-eosinophilic CRS with polyps (CRSwNP) remain incompletely understood, particularly with respect to regulatory T cells, FOXP3⁺. <strong>MATERIALS AND METHODS</strong>: Using immunohistochemistry, nasal polyp tissues from eosinophilic (ECRS) and non-eosinophilic (NECRS) CRSwNP patients were examined for FOXP3⁺ Treg expression, and symptoms and disease severity measures were obtained, including on quality of life. <strong>RESULTS</strong>: Comparative analysis along with clinical severity assessment did not demonstrate significant differences between eosinophilic and non-eosinophilic CRSwNP in FOXP3⁺ score (5.14 vs. 4.81, p=0.453), nasal polyp score (p=0.315), SNOT-22 (p=0.510), SST (p=0.295), or VAS (p=0.182), with small to medium effect sizes (Cohen’s d=0.25-0.50). Correlation analysis revealed no significant associations between FOXP3⁺ expression and clinical parameters, although SST showed a weak inverse association (ρ= –0.335, p=0.070). Significant correlations were observed between VAS and SNOT-22 (ρ= –0.549, p=0.0017) and between SNOT-22 and SST (ρ= –0.470, p=0.0088), indicating consistency between subjective and objective measures. <strong>CONCLUSION</strong>: These findings suggest that FOXP3⁺ regulatory T cell infiltration alone may not distinguish CRSwNP endotypes, underscoring the complexity of immune regulation beyond eosinophilic status. Larger, functionally focused studies are required to further elucidate the role of Tregs in CRSwNP.</p> Gnanasoundari Gokulakannan Nur Asyilla Che Jalil Ramlah Kadir Ramiza Ramza Ramli Baharudin Abdullah Normayazi Mohemed Ali Ahmad Talha Mohamad Yunus Mohd Farhan Saroni Norasnieda Md Shukri Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3376 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3377 <p><strong>INTRODUCTION:</strong> Mood disorders, such as Major Depressive Disorder (MDD) and bipolar disorder, deeply affect a person’s spirituality and Quality of Life (QoL). While spirituality is a vital part of mental health care, especially in deeply religious communities like Kelantan, Malaysia, local research on this connection remains limited. <strong>MATERIALS AND METHODS:</strong> This cross-sectional study was conducted between December 2024 and May 2025 at two major hospitals in Kota Bharu. We recruited adults (aged 18–60) diagnosed with mood disorders. Participants completed validated Malay versions of questionnaires measuring spiritual well-being, depression severity, and QoL, while clinicians assessed mania severity. Data were analyzed using SPSS version 29.0. <strong>RESULT</strong>S: Among the 169 participants, the majority were female (73.4%), Malay (93.5%), and Muslim (94.7%). Most reported moderate spiritual well-being (75.7%) and moderate average QoL scores. Regression analysis showed that being married (adjusted b=3.92, p=0.034), being female (adjusted b=5.66, p=0.007), having milder depression (adjusted b=-0.56, p&lt;0.001), and having higher mania scores (adjusted b=0.52, p=0.030) predicted better spiritual well-being. Additionally, better psychological (adjusted b=0.28, p&lt;0.001) and environmental QoL (adjusted b=0.36, p&lt;0.001) strongly predicted higher spirituality. Overall, spirituality was strongly tied to all areas of QoL. <strong>CONCLUSION</strong>: Demographic factors, symptom severity, and everyday quality of life are closely linked to a patient's spiritual well-being. In highly religious communities, bringing spiritual assessments and care into standard psychiatric practice is essential for truly holistic healing.</p> Muhammad Nursalam Abdullah Aisyah Che Rahimi Siti Nur Najibah Fauzi Nor Asyikin Fadzil Raishan Shafini Bakar Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3377 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3378 <p><strong>INTRODUCTION</strong>: Child sexual abuse remains a significant public health concern because of its long-term consequences for children’s psychological, emotional, and social well-being. Although school-based prevention programmes have consistently improved knowledge, their influence on attitudes toward self-protection has received less attention. SmartShield is a culturally adapted, video-based educational programme developed to promote positive attitudes toward child sexual abuse prevention among Malaysian primary school children. <strong>MATERIALS AND METHODS</strong>: A quasi-experimental controlled trial was conducted using stratified multistage cluster sampling. Six government primary schools were randomly selected from five geographic regions of Malaysia, with one lower and one upper primary class recruited from each school. A total of 912 students participated. Lower primary students received SmartShield 1 (one module), whereas upper primary students received SmartShield 2 (two modules), delivered through 20-minute video-guided sessions. Attitudes were measured using validated questionnaires at baseline and at Weeks 2 and 4. Repeated measures analysis of variance, adjusted for sex and geographic region, was used to evaluate intervention effects. <strong>RESULTS</strong>: The intervention group demonstrated significantly greater improvements in attitude scores than the control group at all follow-up assessments (p&lt;0.001). Among lower primary students, adjusted mean scores increased from 70.7% to 91.2%, compared with 75.1% to 83.1% in the control group. Among upper primary students, scores increased from 69.2% to 84.0%, whereas the control group improved from 67.6% to 80.4%. <strong>CONCLUSION</strong>: The SmartShield program effectively improved attitudes toward child sexual abuse prevention among Malaysian primary school children.</p> Mohamad Najib Mat Pa Norhayati Mohd Noor Zaharah Sulaiman Nik Hazlina Nik Hussain Azizah Othman Azliana Aziz Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3378 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3379 <p><strong>INTRODUCTION</strong>: Existing lung imaging lacks the dual assessment and spatial resolution needed for functional-avoidance radiotherapy. This proof-of-concept (PoC) feasibility study aimed to validate the technical feasibility of a novel voxel-level lung functional imaging technique based on ventilation-perfusion (VP) mapping and explore its preliminary utility in radiotherapy treatment planning. <strong>MATERIALS AND METHODS</strong>: We retrospectively analyzed 20 lung cancer patients with 4D-CT and PET/CT scans. Ventilation was calculated from 4D-CT deformable image registration, and perfusion from pre-processed PET images. High-function lung regions were defined as the top 40%. Three functional imaging modalities were generated: ventilation (V), perfusion (P), and VP imaging. The Dice Similarity Coefficient (DSC) and Bland-Altman plots evaluated agreement, and intensity-modulated radiation therapy (IMRT) plans were optimized for dosimetric comparison. <strong>RESULTS</strong>: The automated workflow took 45±15 minutes per patient, meeting clinical efficiency requirements. V-VP and P-VP showed moderate-to-good agreement in whole and low-function lungs (DSC up to 0.71; r up to 0.943) but poor agreement in high-function regions. VP-IMRT significantly reduced ipsilateral high-function lung V20Gy (81.03±56.03 to 61.14±64.44, p&lt;0.001), with favourable dosimetric differences versus single-modality plans and no increased dose to organs at risk. <strong>CONCLUSION</strong>: VP-Imaging effectively integrates ventilation and perfusion data, establishes a reproducible workflow, and shows preliminary dosimetric advantages. This study prioritizes technical viability over diagnostic accuracy relative to SPECT V/Q, supporting the feasibility of VP-Imaging for personalized RT.</p> Ahmad Lutfi Yusoff Suyan Bi Xiaoxu Wang Wan Fatihah Wan Sohaimi Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3379 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3380 <p><strong>INTRODUCTION</strong>: Heart failure is a global concern, with non-ischaemic cardiomyopathy (NICMP) contributing significantly. Myocardial fibrosis is a hallmark feature, and early detection is crucial for management and prognosis. Endomyocardial biopsy is the gold standard but invasive. Cardiac MRI offers a non-invasive alternative; however, late gadolinium enhancement (LGE) is limited in detecting diffuse fibrosis and unsuitable for chronic kidney disease. Native T1 mapping enhances tissue characterization. This study evaluates native T1 values in NICMP patients, comparing them with published reference values and LGE findings. <strong>MATERIALS AND METHODS</strong>: This retrospective study analysed 34 NICMP patients who underwent 3.0T cardiac MRI between January 2021 and October 2023. Mid-ventricular septal native T1 values were measured by two blinded readers and compared to a normal reference (1097 ms). Statistical analysis included one-sample T-tests for reference comparison and independent T-tests for differences between LGE-positive and LGE-negative groups. Inter-observer agreement was assessed using the intraclass correlation coefficient (ICC). <strong>RESULTS</strong>: The cohort (mean age 45.09 years) showed a mean native T1 value of 1307.97 ± 68.99ms, significantly higher than the reference (p&lt;0.001). Inter-observer agreement was excellent (ICC: 0.98). Twelve patients (35.3%) were LGE-positive. No significant difference in native T1 values was observed between LGE-negative (1291.68 ms) and LGE-positive (1337.83 ms) groups. <strong>CONCLUSION</strong>: Native T1 values are significantly elevated in NICMP, potentially detecting diffuse fibrosis missed by LGE. T1 mapping shows promise as a non-invasive, gadolinium-free tool for diagnostic assessment and may contribute to risk stratification. Larger studies are needed to establish local reference values and validate these findings.</p> Tasnim Muhamad Khairil Amir Sayuti Wan Yus Haniff Wan Isa Ahmad Aizuddin Mohd Jamali Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3380 https://journals.iium.edu.my/kom/index.php/imjm/article/view/3381 <p><strong>INTRODUCTION:</strong> The present study aimed to examine the impact of fish oil supplementation on the concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), cytokines (interleukin-10 and -12), and wound healing in rats with full-thickness burn injury (FTBI). <strong>MATERIALS AND METHODS</strong>: Thirty male Sprague-Dawley rats weighing between 350 to 400 grams subjected to FTBI were randomized into either the experimental group (n=15), which received a standard diet supplemented with fish oil intravenously (which provided 400 mg/kg/d of DHA and 275 mg/kg/d of EPA) for five days, or the control group (n=15), which received a standard diet only. <strong>RESULTS:</strong> Compared to the control group, rats in the experimental group had a greater increase in mean blood DHA (P=0.002) and EPA (P&lt;0.001) levels from baseline to day 21; a higher increase of mean IL-10 from baseline to day 10 (P=0.018); and a greater decrease in mean IL-12 from baseline to day 10 (P=0.04). When the burn wound tissues were examined, the experimental group showed greater blood vessel growth and a reduced presence of neutrophils compared to the control group. <strong>CONCLUSION</strong><strong>:</strong> In summary, giving fish oil through injection raised the levels of DHA and EPA in the blood, reduced the activity of the pro-inflammatory cytokine IL-12, and increased the activity of the anti-inflammatory cytokine IL-10, which helps improve the healing of wounds in rats with FTBI.</p> Shamsul Kamalrujan Hassan Ahmad Sabri Sharif Rhendra Hardy Mohd Zaini Wan Fadzlina Wan Muhd Shukeri Copyright (c) 2026 2026-09-09 2026-09-09 25 02 10.31436/imjm.v25i02.3381