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Impact of maternal marital status on birth outcomes among young Malaysian women: a prospective cohort study

Mohd Zain N, Low WY, Othman S

Asia Pac J Public Health, 2015 Apr;27(3):335-47.
PMID: 25005933 DOI: 10.1177/1010539514537678

This study evaluated the impact of maternal marital status on birth outcomes among young Malaysian women and investigated other risk factors influencing the birth outcomes. Pregnant women with and without marital ties at the point of pregnancy diagnosis were invited to participate in this study. Participants were interviewed using a structured questionnaire at pregnancy diagnosis and shortly after childbirth. From a total of 229 unmarried and 213 married women who participated, marital status was significantly associated with preterm birth (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.61) and low birth weight (OR, 3.61; 95% CI, 1.98-6.57). Other factors significantly associated with birth outcomes was prenatal care (OR, 4.92; 95% CI, 1.43-16.95), "use of drugs" (OR, 10.39; 95% CI, 1.14-94.76), age (OR, 1.12; 95% CI, 1.07-1.16), and number of prenatal visits (OR, 1.03; 95% CI, 1.00-1.07). Promoting access to prenatal care and social support programs for unmarried mothers may be important to reduce adverse pregnancy outcomes.
Fulltext The Relationship between Type of Music and Anxiety Level among Malaysian Women during Mammography

Mohd Zain, N., Ab Malek, N. N. F., Che Mut, N. A. I., Mohd Norsuddin, N., Abdullah Suhaimi, S. A., Ahmad Dahari, M., et al.

Physics and Technology in Medicine, 2020;1(2):7-12.
MyJurnal

Music is one of the suggested interventions that can reduce stress caused by pain from mammography procedures. The different types of music might affect the anxiety level during a mammogram screening. Thus, the study aimed to determine the anxiety level of women who underwent mammogram screening according to different types of music. A cross-sectional study was conducted on 60 women by using the purposive sampling technique in the radiology department at randomly selected private hospitals in Klang Valley from November 2018 to November 2019. Respondents were randomly divided based on the day of mammogram screening into two groups; namely slow and upbeat music. Descriptive analysis was used to determine the anxiety level for each group and T-test analysis was used to compare the significance of anxiety level between both groups. A total of 60 respondents had participated in this study with a total of 30 (50.0%) respondents allocated in slow music, while another 30 (50.0%) respondents were allocated in upbeat music. Patients who underwent mammography screening while listening to slow music had a high anxiety level (70.0%) as compared to upbeat music group (63.3%). There was no significant effect for music, t (60) = -0.54, p = 0.59, despite slow music (M = 1.70, SD = 0.47) attaining higher anxiety level than the upbeat music (M = 1.63, SD = 0.49). Upbeat music has the potential in reducing the anxiety level of women undergoing mammography screening.
Exploring Intimate Partner Violence Among Women Attending Malaysian Primary Care Clinics

Othman S, Yuen CW, Mohd Zain N, Abdul Samad A

J Interpers Violence, 2021 08;36(15-16):NP7920-NP7941.
PMID: 30938233 DOI: 10.1177/0886260519839426

Victims of intimate partner violence (IPV) are frequent attendees at health care facilities. Although most literature on this subject focuses on developed or Western countries, there is a dearth of information from Asian countries. This study aims to estimate the prevalence of IPV among women attending urban primary care services in Malaysia and to identify the risk factors associated with IPV. Six out of 15 available public primary care clinics in the federal territory of Kuala Lumpur, Malaysia, were randomly selected. The sampling size for each clinic was conducted proportionate to the clinic's average daily patient attendance. A total of 882 women participated in this study via a self-administered questionnaire. We administered the women's experience with battering scale (WEB-scale) to estimate the prevalence of psychological violence and included a screening question for physical and sexual assault. The results showed that 22.0% of the women surveyed reported experiencing IPV. Ethnicity appears to be a significant predictor, with Chinese and Indian women reporting IPV at a higher rate than Malay women. Women with IPV are more likely to come from lower income households, have witnessed parental IPV, receive less social support, and have poorer psychological well-being. Our findings indicate that the prevalence of IPV among women attending urban public primary care clinics is high. Health care providers should pay close attention during clinical encounters for any sign of IPV, particularly among those presenting with risk factors.
Acute necrotizing encephalopathy in a child secondary to dengue fever: A case report

Cheo SW, Low QJ, Teh YG, Rajahram GS, Mohd Zain NR, Chia YK

Med J Malaysia, 2021 Sep;76(5):750-752.
PMID: 34508389

Dengue fever (DF) is an important public health problem, and it is now endemic in more than 100 countries worldwide. Dengue associated neurological complication is estimated to be affecting 0.5 to 6.2% of patients. Even though this is rare, neurological manifestation of DF is an increasingly recognized entity in recent years due to significant mortality and morbidity reported/seen. Reported central nervous system manifestations due to dengue include encephalitis, encephalopathy, myelitis, myositis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, stroke and etc. We report here a case of acute necrotizing encephalopathy secondary to DF in a previously healthy 12-year-old girl.
Managing sexual dysfunction for women with breast cancer: the perspective of healthcare providers in North East Malaysia

Chanmekun SB, Zulkifli MM, Muhamad R, Mohd Zain N, Low WY, Liamputtong P

Support Care Cancer, 2022 Jan;30(1):401-411.
PMID: 34297219 DOI: 10.1007/s00520-021-06417-0

PURPOSE: Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers' (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using a phenomenological approach.
METHODS: This qualitative study was conducted using a face-to-face interview method with HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis.
RESULTS: Three key barriers were identified through the thematic analysis: a scarcity of related knowledge; the influence of socio-cultural ideas about sex; and the specialty-centric nature of the healthcare system. Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that are both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients.
CONCLUSION: Therefore, interventions to empower the knowledge, break the socio-cultural barriers, and improve the clinic settings are crucial for HCPs in managing FSD confidently.
Systematic review and meta-analysis on the classification metrics of machine learning algorithm based radiomics in hepatocellular carcinoma diagnosis

Mohd Haniff NS, Ng KH, Kamal I, Mohd Zain N, Abdul Karim MK

Heliyon, 2024 Aug 30;10(16):e36313.
PMID: 39253167 DOI: 10.1016/j.heliyon.2024.e36313

The aim of this systematic review and meta-analysis is to evaluate the performance of classification metrics of machine learning-driven radiomics in diagnosing hepatocellular carcinoma (HCC). Following the PRISMA guidelines, a comprehensive search was conducted across three major scientific databases-PubMed, ScienceDirect, and Scopus-from 2018 to 2022. The search yielded a total of 436 articles pertinent to the application of machine learning and deep learning for HCC prediction. These studies collectively reflect the burgeoning interest and rapid advancements in employing artificial intelligence (AI)-driven radiomics for enhanced HCC diagnostic capabilities. After the screening process, 34 of these articles were chosen for the study. The area under curve (AUC), accuracy, specificity, and sensitivity of the proposed and basic models were assessed in each of the studies. Jamovi (version 1.1.9.0) was utilised to carry out a meta-analysis of 12 cohort studies to evaluate the classification accuracy rate. The risk of bias was estimated, and Logistic Regression was found to be the most suitable classifier for binary problems, with least absolute shrinkage and selection operator (LASSO) as the feature selector. The pooled proportion for HCC prediction classification was high for all performance metrics, with an AUC value of 0.86 (95 % CI: 0.83-0.88), accuracy of 0.83 (95 % CI: 0.78-0.88), sensitivity of 0.80 (95 % CI: 0.75-0.84) and specificity of 0.84 (95 % CI: 0.80-0.88). The performance of feature selectors, classifiers, and input features in detecting HCC and related factors was evaluated and it was observed that radiomics features extracted from medical images were adequate for AI to accurately distinguish the condition. HCC based radiomics has favourable predictive performance especially with addition of clinical features that may serve as tool that support clinical decision-making.
"I Lost My Gift to Him": The Consequences of Female Sexual Dysfunction on Breast Cancer Survivors in Malaysia

Che Ya SN, Muhamad R, Zakaria R, Mohd Zain N, Ishak A, Hassan II, et al.

Arch Sex Behav, 2021 Nov 08.
PMID: 34750771 DOI: 10.1007/s10508-021-02051-3

Sexuality is currently neglected in the medical care of cancer patients although female sexual dysfunction (FSD) and sexual problems are highly prevalent among breast cancer patients in Malaysia. This paper explores the consequences of breast cancer and its treatment on the sexuality and sexual health of women with breast cancer using a qualitative design and a phenomenological methodology. Fourteen married women with breast cancer who fulfill the criteria for FSD from Kelantan, Malaysia participated in two interviews: in-depth interview and followed by photo-elicitation interview after two weeks duration. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. We identified overlapping themes that can be explained by sexual script theory. Breast cancer treatments disturb the sex response cycle, leading to changes in sexuality, from intimacy in marriage to women preferring physical affection to intercourse. The women struggled with a perceived imperfection about symbol of femininity after noticing changes in their husbands' sexual performance and after experiencing their own sentiments of inadequacy as a wife. Fear and guilt surfaced as part of the journey, accompanied by frustration on the part of the spouse, or him becoming more attentive. This study highlights the problem of breast cancer and its treatment as regards the sexual well-being of patients and their spouses. Hence, recognizing and addressing sexual health will improve the overall experience for survivors.
Fulltext Coping Strategies for Sexual Problems and Sexual Dysfunction Amongst Malay Women With Breast Cancer. A Qualitative Study

Che Ya SN, Muhamad R, Mohd Zain N, Zakaria R, Ishak A, Hassan II, et al.

Sex Med, 2021 Jun;9(3):100336.
PMID: 33794448 DOI: 10.1016/j.esxm.2021.100336

INTRODUCTION: Women' sexuality becomes complex after breast cancer diagnosis and sexual health is highly neglected in the management of the illness.
AIMS: To explore the coping and strategies to overcome sexuality problems and sexual dysfunction among women with breast cancer.
MATERIAL AND METHODS: Using the in-depth and photo-elicitation interview methods, this qualitative study following phenomenological analysis was conducted on fourteen married female respondents with breast cancer and had the positive result for female sexual dysfunction (FSD) screened by Female Sexual Function Index (FSFI-6 items) from Kelantan, Malaysia. The interviews data were audio-recorded, transcribed verbatim and managed in analytic computer software NVivo11 Pro. The transcriptions were analyzed using thematic analysis by referring to the meaning-making theory.
MAIN OUTCOME MEASURES: We identified overlapping themes of coping and strategies among women with breast cancer to overcome sexual problems and sexual dysfunction which correspond with meaning-making theory.
RESULTS: Three themes have emerged. Women with breast cancer that developed sexuality problem and sexual dysfunction strived to accept the illness using religious belief and conform by altering sexual practices. These individuals positively look for a solution by seeking formal healthcare advice, modify their physical appearance, active discussion with the husband and support from other survivors. A few of them passively struggle with the subject by averting the intimacy and receptive toward polygamy.
CONCLUSION: This study highlighted the various mechanisms that emphasized the pivotal role of religious belief and relationship context as key factors in the coping strategies among women with breast cancer in Malaysia. The finding may not be generalized to other countries. Che Ya SN, Muhamad R, Zain NM, et al. Coping Strategies for Sexual Problems and Sexual Dysfunction Amongst Malay Women With Breast Cancer. A Qualitative Study. Sex Med 2021;9:100336.