Displaying publications 1 - 20 of 34 in total

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  1. Al-Naggar RA, Anil Sh
    Asian Pac J Cancer Prev, 2016 10 01;17(10):4661-4664.
    PMID: 27892680
    Background: Artificial light at night (ALAN) has been linked to increased risk of cancers in body sites like the breast
    and colorectum. However exposure of ALAN as an environmental risk factor and its relation to cancers in humans has
    never been studied in detail. Objective: To explore the association of ALAN with all forms of cancers in 158 countries.
    Materials and Methods: An ecological study encompassing global data was conducted from January to June 2015,
    with age-standardized rates (ASR) of cancers as the outcome measure. ALAN, in the protected areas, as the exposure
    variable, was measured with reference to the Protected Area Light Pollution Indicator (PALI) and the Protected Area
    Human Influence Indicator (PAHI). Pearson’s correlations were calculated for PALI and PAHI with ASR of cancers for
    158 countries, adjusted for country populations, electricity consumption, air pollution, and total area covered by forest.
    Stratified analysis was conducted according to the country income levels. Linear regression was applied to measure the
    variation in cancers explained by PALI and PAHI. Results: PALI and PAHI were positively associated with ASR of all
    forms of cancer, and also the four most common cancers (p < 0.05). These positive correlations remained statistically
    significant for PAHI with all forms of cancer, lung, breast, and colorectal cancer after adjusting for confounders. Positive
    associations of PALI and PAHI with cancers varied with income level of the individual countries. Variation in all forms
    of cancers, and the four most common cancers explained by PALI and PAHI, ranged from 3.3 – 35.5%. Conclusion:
    Artificial light at night is significantly correlated for all forms of cancer as well as lung, breast, colorectal, and prostate
    cancers individually. Immediate measures should be taken to limit artificial light at night in the main cities around the
    world and also inside houses.
  2. Al-Naggar RA, Al-Jashamy K
    Asian Pac J Cancer Prev, 2011;12(12):3397-401.
    PMID: 22471487
    BACKGROUND: The media play big roles in the public understanding of many health issues, and the information relayed to the public through the media clearly influences behavior.

    OBJECTIVES: The objectives of this study were to determine whether the content of articles on breast cancer in women published in the Star newspaper in 1997 differed from that of those published in 2007 and also to determine what factors may have caused any differences.

    METHODOLOGY: About 45 articles were identified for the year 1997 and 97 from the year 2007. Copies of the articles were obtained through the Star newspaper library. All the articles were read an initial time. The final sample for analysis consisted of 18 newspaper articles published in 1997 and 79 in 2007. Once data collection sheets were completed for all articles, the data were transferred to two spreadsheets and analyzed manually.

    RESULTS: Living with breast cancer was the main theme of many articles in both years. Family history was emphasized as a risk factor in articles from 2007, while an inappropriate bra, electrical power lines, stress, smoking and alcohol were emphasized in 1997 as risk factors. In general, articles in 2007 focused on overall health practices, especially exercise, while in 1997, mammography was considered as the dominant prevention method.

    CONCLUSION: The content of the articles on breast cancer that were published in the Star newspaper in Malaysia in 1997 totally differed from that of those published in 2007. The differences seem to reflect social, political, and scientific occurrences over the period studied.
  3. Anil S, Zawahir MS, Al-Naggar RA
    Front Med, 2016 Mar;10(1):91-100.
    PMID: 26715159 DOI: 10.1007/s11684-016-0428-0
    Preventive medicine has been incorporated in the medical school curriculum, but its effectiveness and the factors that affect it are yet to be widely looked into in the context of Malaysia. We aimed to measure the familiarity with, perception about the importance to learn, and the ability to practice preventive medicine as well as its determinants among the medical students in Malaysia. Thus, a cross sectional study was conducted through an anonymous online survey among 387 randomly selected final year medical students of four large public medical schools in Malaysia from March to September 2014. Of the total sample, 340 (response rate 87.8%) gave a written informed consent and took part in the survey. The familiarity of the sample with preventive medicine was measured in 19 preventive medicine areas, and their perception about the importance of preventive medicine and their ability to practice it were gauged on a Likert scale (low score indicates disagreement and high indicates agreement). Descriptive statistical analysis was performed, followed by logistic regression. The mean age of the respondents was 23.7 (SD 0.77) years, and 61.2% (n = 208) of them were females. Results showed that 22.9% of the sample (n = 78) had a low familiarity with preventive medicine, whereas 76.8% (n = 261) had a high familiarity. The study sample specified that among all the preventive medicine subjects, screening and control as well as smoking cessation and immunization are "extremely important to learn." In univariable analysis, being a female, medical school, family size, and perception about the importance to learn preventive medicine were associated with the ability to practice it. In multivariable analysis, the perception towards the importance to learn preventive medicine was the only significant determinant: aOR (adjusted odds ratio) for those who "agreed" 17.28 (95% CI aOR 4.44-67.26, P < 0.001) and for "strongly agreed" 35.87 (95% CI aOR 8.04-159.87, P < 0.001). Considering these findings, the familiarity of medical students with preventive medicine should be increased. The perception about the importance to learn preventive medicine is a strong determinant for the ability to practice it.
  4. Al-Naggar RA, Isa ZM, Shah SA, Nor MI, Chen R, Ismail F, et al.
    Asian Pac J Cancer Prev, 2009;10(6):1075-8.
    PMID: 20192587
    Survival after diagnosis of cancer is one of the major outcome measurements and a key criterion for assessing quality of cancer control related to both the preventive and the therapeutic level. The purpose of this study was to determine the 8-year survival time in Malaysia based on socio-demographic and clinical characteristics. A retrospective study of 472 Malaysian women with breast cancer from the Medical Record Department at University Kebangsaan Malaysia Medical Centre (UKMMC) was therefore performed with survival analysis carried out using the Kaplan-Meier with log-rank test for univariate analysis and Cox-regression for multivariate analysis. Women who had cancer or family history of cancer had a longer 8-year survival time (p = 0.008) compared with others who did not have such a history. Tamoxifen use, positive oestrogen receptor status, and race were prognostic indicators for 8-year survival time (p = 0.036, p = 0.018, p = 0.053, respectively) in univariate analysis. Multivariate analysis showed that being Malays and having no family history of cancer were independent prognostic factors for shorter survival time (p = 0.008, p = 0.012, respectively). In conclusion, being Chinese and having a family history of cancer are predictors of longer survival among the Malaysian breast cancer women.
  5. Al-Naggar RA, Alshaikhli H, Al-Rashidi RR, Saleh B
    ScientificWorldJournal, 2020;2020:4859496.
    PMID: 32802004 DOI: 10.1155/2020/4859496
    Background: According to the WHO, glaucoma is the second leading cause of blindness worldwide. About 50% of the world's glaucoma cases come from the Asian population, and in Malaysia itself, the prevalence of glaucoma is increasing. However, glaucoma is still a foreign word to our community despite the high prevalence. Therefore, there is an urgent need to determine the awareness of glaucoma among the community and its associated factors.

    Results: This study showed that only 25.2% of our respondents were aware of glaucoma and it is associated with ethnicity, religion, education, and household income. Besides, among those who were aware, they fall into the group of poor knowledge of glaucoma. On the other hand, the knowledge of glaucoma was associated with occupation and the awareness of glaucoma by definition. The validated questionnaire was distributed and the data were analyzed by SPSS software using t-test, one-way ANOVA, and chi-square test.

    Conclusion: Awareness and knowledge of glaucoma in this population is low. These findings suggest that there is a need for an efficient information and education strategy to be designed and conducted to increase the awareness and knowledge of glaucoma so that early detection can be made and effective management of individuals with this condition can be delivered.

  6. Al-Jashamy K, Al-Naggar RA, San P, Mashani M
    Asian Pac J Cancer Prev, 2009;10(6):1159-62.
    PMID: 20192603
    OBJECTIVE: The objective of this study was to determine the histopathological features and cell morphology of various cervical lesions observed among Malaysian women.

    METHODOLOGY: A retrospective study was conducted to evaluate 77 cervical cases collected from the histopathology laboratory of Ipoh hospital from 1st January, 2005, to 31st December, 2006.

    RESULTS: Cervical intraepithelial neoplasia (CIN) was found in 33 (42%) cases, CIN III accounting for 27%, and CIN I, CIN II and CIN II-III 5% each. The highest rate for CIN cases was 43% in the 41-50 year age group and the lowest rate was 6% in the group aged 61-70 years. Non-keratinizing and metastatic squamous cell carcinomas (SCCs) accounted for 16% and 13%, respectively, the combination being second in majority (29%), followed by adenocarcinoma (17%). The histopathological results showed CIN I to be characterized by mild papillary projections of the epithelium with some degree of nuclear enlargement, pleomorphism, mild koilocytosis, bionucleated cells and a low nucleo-cytoplasmic ratio. CIN II demonstrated typical squamous epithelium with disorganization of the lower part of the epithelium accompanied by nuclear hyperchromatism, an increased nucleo-cytoplasmic ratio, and scanty mitotic figures. CIN III was characterized by pleomorphic nuclei, atypical cells with mitotic figures, nucleo-cytoplasmic ratio, anisokaryosis and hyperchromasia.

    CONCLUSION: Lesions related to cervical cancer showed tumor progression correlating with histopathological changes in cell morphology.

  7. Al-Naggar RA, Low WY, Isa ZM
    Asian Pac J Cancer Prev, 2010;11(4):867-73.
    PMID: 21133593
    OBJECTIVES: This study examined the level of knowledge and barriers towards cervical cancer screening of female university students.

    METHODOLOGY: A cross-sectional design was used for 287 female students at a tertiary institution located in Selangor, Malaysia. A name list of all students in the all faculties were obtained from each faculty's registrar and the ethics committee of the Faculty of Health and Life Sciences, approved the study. Respondents completed a consent form before they were given the questionnaire consisting of four sections: socio-demographic characteristics (six questions); risk factor of cervical cancer (six); knowledge about cervical cancer and the Pap smear test (ten); and finally barriers to Pap screening (eleven). Data were analyzed using SPSS version 13.

    RESULTS: The prevalence of ever having had a Pap test was 6%. Majority of the participants had adequate knowledge about risk factors of cervical cancer. The highest knowledge about cervical cancer risk factor reported by the respondents was having more than one sex partner (77.5%), whereas the lowest was the relationship between HPV and cervical cancer (51.2%). Age, marital status, ethnicity, monthly family income and faculty were significantly associated with knowledge of cervical cancer screening (p=0.003; p=0.001; p=0.002; p=0.002; p=0.001 and p=0.002; respectively). The most common barriers of cervical cancer screening were the Pap smear test will make them worry (95.8%) whereas the least common barrier reported among participants was no encouragement from the partner (8.8%).

    CONCLUSION: Some misconceptions and barriers in uptaking Pap smear test are still serious problems among young women. Although knowledge about cervical cancer screening is adequate they have a very poor practice of Pap smear test. The introduction of reproductive health subjects is warranted for all university students.
  8. Al-Naggar RA, Jillson IA, Abu-Hamad S, Mumford W, Bobryshev YV
    Asian Pac J Cancer Prev, 2015;16(3):1097-103.
    PMID: 25735338
    BACKGROUND: Few studies have explored the knowledge and attitudes of adolescents toward cancer prevention and treatment. This lack of research and its potential utility in the development of new educational initiatives and screening methods, or the reconstruction of existing ones, provided the impetus for this study. The primary research aim was to assess secondary school student knowledge of cancer and determine whether or not they possessed basic knowledge of cancer symptoms, risk factors, and treatments and to determine the relationship between cancer knowledge and key demographic factors.

    MATERIALS AND METHODS: The Management and Science University conducted a cross-sectional study analyzing responses through cross-tabulation with the socio-demographic data collected.

    RESULTS: The findings of our quantitative analysis suggest that Malaysian youth generally possess a moderate knowledge about cancer. Quantitative analyses found that socioeconomic inequalities and bias in education present as important factors contributing to cancer awareness, prevention, and treatment among Malaysian adolescents.

    CONCLUSIONS: The findings indicate that Malaysian youth generally possess a moderate knowledge about cancer but the current deficiencies in initiatives directed to cancer awareness continue to hinder the improvement in prevention of cancer among Malaysian adolescents.

  9. Al-Naggar RA, Bobryshev YV
    Asian Pac J Cancer Prev, 2013;14(3):1969-74.
    PMID: 23679301
    The objective of this study was to determine the knowledge and associated factors regarding colorectal cancer screening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographic characteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conducted among 300 students (21.3±1.4 years old). The majority of the participants were Malay with a monthly family income of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regarding their lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%, respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy, barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate and multivariate analysis revealed that their age and the discipline which the students were studying significantly influenced their level of knowledge about colorectal screening. The present study results indicate that education campaigns about colorectal cancer should be promoted.
  10. Al-Naggar, Redhwan Ahmed, Al-Jashamy, Karim, Ramli Musa, Zaleha Mohd Isa
    ASEAN Journal of Psychiatry, 2010;11(1):6-12.
    MyJurnal
    Objective: To determine the knowledge, attitude and practice (KAP) of sleep among medical students of IIUM towards and to determine the impact of socio-demographic data on the knowledge, attitude and practice. Methods: A cross-sectional study was carried out among 106 students from first, second and third year medical students of IIUM. Verbal consent was taken from the students who were willing to take part in this study. Student knowledge about sleep was studied using a questionnaire. Results: A total of 106 medical
    students completed the survey, there were 54 female and 52 male. The mean age of the students was 20 ± 0.56 and ranged from 18 to 22 years. In terms of their sleep knowledge, the mean ± SD knowledge, attitude and practice scores were 81.8 ± 16.8, 65.9 ±15.3 and 176 ± 26.3 respectively. In univariate analysis, there was a significant difference between parents’ marital status regarding knowledge of the students (p = 0.03). There was a significant difference between gender regarding attitude of the students (p=0.05). In
    multivariate analysis, gender and smoking status were significantly affected the overall KAP. Conclusion: This study showed that sleep medicine knowledge was generally low among medical students. Therefore, educational strategies to improve knowledge regarding sleep-related problems and the development of proper sleep practices among medical students are needed.
  11. Al-Dubai SA, Alshagga MA, Al-Naggar RA, Al-Jashamy K, Baobaid MF, Tuang CP, et al.
    Asian Pac J Cancer Prev, 2010;11(4):887-92.
    PMID: 21133596
    A cross-sectional study was conducted among 300 Malaysian women in the obstetrics and gynecology outpatient clinic in a selected hospital in Bangi, Selangor to determine the level of knowledge of HPV and HPV vaccines, attitudes toward HPV vaccination and barriers of being vaccinated. Factors associated with knowledge and attitudes were also addressed with a questionnaire. Seventy eight women (26%) had heard about the HPV virus and 65 about HPV vaccines (21.7%). Marital status was associated significantly with awareness of HPV and HPV vaccine (p=0.002, p=0.002; respectively), in addition to level of education (p=0.042). The percentages of women who reported correct answers for the questions on knowledge of HPV and HPV vaccine ranged from 12% to 25%. One hundred fifty nine respondents (53%) had a positive attitude toward HPV vaccination. Age, marital status, and level of education were associated significantly with attitude (p<0.001, p<0.001, p=0.002; respectively). The most important barriers reported were 'unawareness of the vaccine' 'concerned about side effects' and 'afraid of needles'. This study found a very low level of knowledge of HPV and HPV vaccine. Education of population is highly recommended and barriers to being vaccinated should be dealt with seriously.
    Study site: Hospital, Bangi, Selangor, Malaysia
  12. Al-Naggar RA, Bobryshev YV, Mohd Noor NA
    Asian Pac J Cancer Prev, 2013;14(3):1895-903.
    PMID: 23679290
    BACKGROUND: It is well established that a healthy lifestyle is of benefit in the prevention of diseases such as cancer and promotion of well-being. Therefore, the objective of this study was to determine lifestyle practice and associated factors among university students in Malaysia.

    MATERIALS AND METHODS: A cross sectional study was conducted over six months from November 2011 until May 2012 among the students from the Management and Science University. This study was approved by its ethical committee , the students being explained the objective and invited to participate. A consent form was signed by all study participants. Questionnaire was distributed randomly to the students of the five faculties through their lecturers in different faculty. For univariate analysis t-test and ANOVA test were performed. Multiple linear regression used for multivariate analysis using SPSS 13.0.

    RESULTS: A total number of 1100 students participated with a mean age of 22.1±2.21 (SD) years. The majority were 22 years or younger (56.3%), female (54%), Malay (61.5%), single (92.3%), with family monthly income ≥5000 Ringgit Malaysia (41.2%). Regarding lifestyle, about were 31.6% smokers, 75.6% never drank alcohol and 53.7% never exercised. Multivariate analysis showed that age, sex, race, parent marital status, participant marital status, type of faculty, living status, smoking status, exercise, residency, brushing teeth, fiber intake and avoid fatty food significantly influenced the practice of drinking alcohol among university students (p=0.006, p=0.042, p<0.001, p=0.003, p=0.002, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.003, p<0.001; respectively). It similarly showed that sex, race, parent marital status, participant marital status, monthly family income, exercise, residency, brushing teeth and fiber intake significantly influenced the practice of sun protection (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.017, p<0.001, p<0.001, p<0.001; respectively) and that age, sex, parent marital status, participant marital status, type of faculty, living status, exercise, taking non- prescribed medication, brushing the teeth, coffee consumption and fiber intake were significantly influenced the practice of fruits consumption (p=0.008, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.002, p<0.001, P<0.001; respectively).

    CONCLUSIONS: This study showed a poor practice of healthy lifestyle among university students. Therefore universities should emphasize a healthy lifestyle in all faculties as a required subject. Socio-demographic characteristics significantly influenced practice and thus should be considered when planning preventive measures among university students. Frequent campaigns and educational seminars are to be encouraged.

  13. Al-Naggar RA, Kadir SY
    Asian Pac J Cancer Prev, 2013;14(1):103-9.
    PMID: 23534705
    BACKGROUND: The objective of this study is to determine knowledge about lung cancer among secondary school male teachers in Kudat, Sabah, Malaysia.

    MATERIALS AND METHODS: A cross-sectional study was conducted among three secondary schools located in Kudat district, Sabah, Malaysia during the period from June until September 2012. The protocol of this study was approved by ethics committee of Management and Science University, Malaysia. The aims were explained and a consent form was signed by each participant. Respondents were chosen randomly from each school with the help of the headmasters. Self-administrated questionnaires, covering socio-demographic characteristics and general knowledge of lung cancer, were distributed. Once all 150 respondents completed the questionnaire, they passed it to their head master for collecting and recording. All the data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. ANOVA and t-test were applied for univariate analysis; and multiple linear regression for multivariate analysis.

    RESULTS: A total of 150 male secondary school teachers participated in this study. Their mean age was 35.6 ∓ 6.5 (SD); maximum 50 and minimum 23 years old. More than half of the participants were Malay and married (52%, 79%; respectively). Regarding the knowledge about lung cancer, 57.3% of the participants mentioned that only males are affected by lung cancer. Some 70.7% mentioned that lung cancer can be transmitted from one person to another. More than half (56.7%) reported that lung cancer is not the leading cause of death in Malaysian males. As for risk factors, the majority reported that family history of lung cancer is not involved. However, 91.3% were aware that cigarettes are the main risk factor of lung cancer and more than half (52%) believed that second-hand smoking is one of the risk factor of lung cancer. More than half (51.3%) were not aware that asbestos, ionizing radiation and other cancer causing substances are risk factors for lung cancer. Quitting smoking, avoiding second-hand smoking and avoiding unnecessary x-ray image of the chest (53.3%, 96.0%, 87.3%; respectively) are the main preventive measures mentioned by the participants. For the factors that influence the participants knowledge, univariate and multivariate analysis showed that only race was significant.

    CONCLUSIONS: Overall, the knowledge of school male teachers about lung cancer was low. However, few items were scored high: cigarettes are the main risk factor; avoiding second-hand smoking; and avoiding x-rays. Interventions to increase lung cancer awareness are needed to improve early detection behavior. Increase the price of pack of cigarettes to RM 20 and banning smoking in public places such as restaurants are highly recommended as primary preventive measures.

  14. Al-Naggar RA, Isa ZM, Shah SA, Chen R, Kadir SY
    Asian Pac J Cancer Prev, 2009;10(5):743-6.
    PMID: 20104962
    A cross-sectional study was conducted at the main hospitals in Sana'a, Yemen to determine the attitude and practice of Yemen female doctors on mammography screening. Study subjects were all female doctors who were on duty during the questionnaire distribution. Those who agreed to participate were given the questionnaire to complete. Descriptive statistics were used to analyse socio-demographic variables and variables related to general health. Participants in this study were 105 female doctors with mean age of 32.1 years (SD = 7.17). Thirty-four respondents (36.6%) did not send asymptomatic women for mammography screening. The reasons were because of high cost (58.0%, n= 25), availability of other methods (23.3%, n= 10), instrument not available (11.6%, n= 5) and high risk of radiation (7.0%, n= 3). Twenty-five participants (26.9%) sent patients on regular basis if there was a family or personal history of breast cancer. Twenty-three participants (24.7%) sent the patients for mammogram screening every year regardless of the patients'history or symptoms. Although most doctors (36.5%) do not refer patients for mammography screening, seventy-seven (74.0%) indicated that they would refer patients for mammography screening on personal request by the patients. This study showed a low percentage of doctors who referred patients for routine mammography. The major reason given was the high cost of the procedure.
  15. Al-Naggar RA, Chen R
    Asian Pac J Cancer Prev, 2011;12(3):691-4.
    PMID: 21627365
    OBJECTIVE: The objective of this study was to determine the knowledge, attitudes and practices of university students toward nutrition related to cancer prevention.

    METHODOLOGY: A total of 396 students from the Management and Science University (MSU) participated during the semester of March 2010. Stratified random sampling was used and consent was obtained before the questionnaire was distributed. ANOVA and the t-test were used for the univariate analysis and multiple linear regression was used for the multivariate analysis.

    RESULTS: The participants ages ranged from 18 to 27 years (Mean ± SD = 23.3 ± 1.57), more than half being female (62.4%). The majority were 23 years old or younger, single, Malay and from non-Medical and Health Science faculties and with a family monthly income of less than 10,000 Ringgits Malaysia(79.5%; 99%, 65.9, 52.5%, 63.9%; respectively). Only 18.4% of participants reported a family history of cancer. About 32.1% had a medical check-up in the previous 12 months and 17.4% were smokers. Multivariate analysis showed the faculty type to be significantly associated with knowledge of cancer prevention (p = 0.04). Regular medical check-ups were associated with attitudes and practices of cancer prevention (p = 0.04, p=0.003 respectively), the latter being significantly influenced by sex, family history of cancer and smoking (p = 0.034, p=0.013, p=0.002; respectively).

    CONCLUSION: The majority of participants had poor knowledge of nutrition as related to cancer prevention. Attention should be given to regular medical check-ups, awareness of family history and smoking influence.

  16. Al-Naggar RA, Isa ZM
    Asian Pac J Cancer Prev, 2010;11(2):435-40.
    PMID: 20843130
    OBJECTIVE: the objective of this study is to explore the perceptions of medical students regarding the Pap smear test.

    METHODOLOGY: Focus group discussion was held with twenty three medical students. The students were divided into three focus groups; two groups of female participants consisting of 9 and 8 students; respectively. The third group consisted of 6 male students. Questions regarding Pap smear testing included barriers that prevented women from taking the test, gender preference for the physician to conduct the cervical screening test, willingness to suggest Pap smear test to the family or friends. The data obtained were classified into various categories and analyzed manually.

    RESULTS: Most of the study participants mentioned that the main barriers for women to not perform Pap smear test is lack of awareness 16 (70%), followed by shyness 12 (52%) and the cost of the test 12 (52%). Most agreed that the gender of the physician will affect the women decision to do Pap smear test. All mentioned that the advantage of a regular Pap smear test is to detect the abnormality at the early stage of cervical cancer. Some of the participants 9 (39%) mentioned that the disadvantages are expense, possible injury in the vagina due to the test procedures 8 (35%), associated infection 7(30.4%) and pain 7(30.4%) . The majority, 20 (87%) mentioned that the most effective prevention methods for cervical cancer are having sex only after getting married with the spouse only, HPV vaccination 15 (65%) and Pap smear 14 (61%).

    CONCLUSION: The main barriers for women to not perform Pap smear test is lack of awareness, shyness and the cost of the test. Gender of the physician will affect the women decision to do Pap smear test.
  17. Al-Naggar RA, Al-Jashamy KA, Low WY, Mohd Isa Z, Alsaror MI, Al-Naggar AGA
    ASEAN Journal of Psychiatry, 2010;11(2):198-0.
    MyJurnal
    Objective: This study was aimed to explore the perceptions and opinions of happiness among university students. Methods: This qualitative study was conducted in January for the academic year 2010 among 33 Medical Science Students from Management and Science University (MSU), Shah Alam, Malaysia. The facilitator wrote down the conversation during the discussion. The data obtained was classified into various categories. Due to the small sample size, the data was analyzed manually. Results: All participants mentioned that the main source of happiness is money. Good relationship with friends and family is the second source of happiness among university students. Some of the students mentioned that the stability of life and good health are causes of happiness. Few participants mentioned that success in life is one of the causes of the happiness.
  18. Al-Naggar RA, Al-Naggar DH
    Asian Pac J Cancer Prev, 2012;13(1):243-6.
    PMID: 22502677
    OBJECTIVE: While the relatively common nature of female breast cancer has resulted in a high level of general awareness, male breast cancer is still comparatively unknown to the general public and to healthcare professionals. The objective of this study is to explore the perceptions and opinions about male breast cancer and male breast self-examination among male university students.

    METHODOLOGY: In-depth interviews were conducted among 36 male university students from the Management and Science University, Malaysia, selected by simple random sampling. The themes of the interview were: knowledge of male breast cancer and male breast self-examination, sources of knowledge and attitudes towards male BSE. The data obtained were classified into various categories and analyzed manually.

    RESULTS: The majority of participants mentioned that there is a low possibility for males to get breast cancer. They also believed that the cause of breast cancer among men is due to the carcinogens from cigarettes. The majority of participants mentioned that they know about breast self-examination from the mass media and that the presence of a lump in the breast is the main symptom of breast cancer in men. The majority of participants mentioned that they encourage their family members to practice breast self-examination but considered that BSE is not important for men because they have a low probability of getting breast cancer.

    CONCLUSIONS: Misconceptions regarding male breast cancer and breast self-examination among men still exist among male university students. Therefore special attention should be given to educate men about male breast cancer and male BSE.

  19. Al-Naggar RA, Al-Jashamy K, Chen R
    Asian Pac J Cancer Prev, 2010;11(6):1515-21.
    PMID: 21338190
    OBJECTIVE: The objective of this study is to explore the perceptions and opinions of young women about human papilloma virus (HPV) vaccination and associated barriers.

    METHODOLOGY: This qualitative in-depth interview study was conducted in January 2010 with 30 university students from different faculties, i.e.:International Medical School (IMS), Faculty of Health and Life Sciences (FHLS), Faculty of Business Management and Professional Studies (FBMP) and Faculty of Information Sciences and Engineering (FISE) of the Management and Science University (MSU), Shah Alam, Malaysia. After consent was obtained from all participants, the interviewer wrote down the conversations during the interview sessions. The data obtained were classified into various categories and analyzed manually.

    RESULTS: The majority of participants 25 (83%) had heard about cervical cancer, while 16 (53.3%) have never heard of HPV. Only five participants (17%) mentioned that HPV is the cause of cervical cancer. Ten participants (33.3%) did not know any causes. The majority 16 (53.3%) did not know the mode of HPV transmission. The majority of participants 22 (73.3%) mentioned that they had not been vaccinated against HPV. Out of 22, 16 (53.3%) agreed to be vaccinated in the future to protect themselves from cervical cancer and five (17%) participants mentioned they are not willing because of the uncertain safety of the available vaccines and their side effects.

    CONCLUSION: This study showed relatively poor knowledge about HPV and its vaccines, pointing to urgency of educational campaigns aimed at students in the public and government universities to promote HPV vaccination among this highly eligible population.

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