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  1. Beneficial effects of natural products on female sexual dysfunction: A systematic review and meta-analysis
    Sha'ari N, Woon LS, Sidi H, Das S, Bousman CA, Mohamed Saini S
    Phytomedicine, 2021 Dec;93:153760.
    PMID: 34638031 DOI: 10.1016/j.phymed.2021.153760
    BACKGROUND: Female sexual dysfunction (FSD) includes female orgasmic disorder, female sexual interest or arousal disorder, and genito-pelvic pain or penetration disorder. FSD affects 40% of women worldwide, but it is understudied and likely undertreated. Natural products are frequently used by women to treat FSD, but scientific evidence of their efficacy is lacking.

    OBJECTIVE: This systematic review and meta-analysis focused on the study of the efficacy of natural products on FSD.

    STUDY DESIGN: Systematic review and meta-analysis of existing studies on natural products in the treatment of FSD.

    METHODS: The literature search included MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trial databases for studies published from January 2000 to February 2020. The quality and the level of evidence of the studies were assessed. The association between natural products and FSD was summarized using standardized mean differences (SMD) with a 95% confidence interval (CI).

    RESULTS: A total of 536 studies were identified, with 20 of them meeting the criteria. According to this meta-analysis, Tribulus terrestris showed a significant positive effect in improving overall female sexual function (SMD = 1.12, 95% CI = 0.46 - 1.79, p = 0.001) and individual sexual arousal (SMD = 1.03, 95% CI = 0.22 - 1.84, p = 0.013), sexual desire (SMD = 1.08, 95% CI = 0.52 - 1.63, p ≤ 0.001) and sexual orgasm (SMD = 0.51, 95% CI = 0.02 - 1.00, p = 0.040) domains compared to placebo. Panax ginseng was found to be effective in treating sexual arousal (SMD = 0.54, 95% CI = 0.11 - 0.97, p = 0.014) and sexual desire (SMD = 0.59, 95% CI = 0.27 - 0.90, p < 0.001) compared to placebo. Meanwhile, other natural products reviewed in this study, such as Trifolium pretense, did not differ significantly from placebo in terms of improving FSD.

    CONCLUSION: Preliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.

  2. Sexual dysfunction and its determinants in Malaysian women with rheumatoid arthritis
    Shahar MA, Hussein H, Sidi H, Shah SA, Mohamed Said MS
    Int J Rheum Dis, 2012 Oct;15(5):468-77.
    PMID: 23083037 DOI: 10.1111/j.1756-185X.2012.01753.x
    AIM: To determine the prevalence of sexual dysfunction (FSD) among women with rheumatoid arthritis attending the Rheumatology Clinic in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Putrajaya, Malaysia, and to determine its associations with potential clinical and disease activity factors.
    METHOD: This was a cross-sectional study involving women with rheumatoid arthritis between the ages of 20 and 60 years. A validated Malay Version Female Sexual Function Index (MVFSFI) was administered to diagnose FSD. Sociodemographic and disease activity profiles were obtained and those who had and did not have FSD were compared.
    RESULTS: Among 63 respondents, 51 patients were included in the analysis for FSD. The prevalence of FSD in women with rheumatoid arthritis attending UKMMC and Hospital Putrajaya Rheumatology Clinic was 29.4%. Erythrocyte sedimentation rate (ESR) and Disease Activity Score in 28 joints (DAS28-ESR) correlates with MVFSFI score with r=-0.364 (P=0.009) and r=-0.268 (P=0.057), respectively. Sociodemographic factors that correlate with MVFSFI score were: patient's age (r=0.520, P<0.001); duration of marriage (r=-0.355, P=0.001); husband's age (r=-0.460, P=0.001); age of oldest child (r=-0.449, P=0.001); and age of youngest child (r=-0.627, P<0.001).
    CONCLUSION: We found in this study that the prevalence of FSD in rheumatoid arthritis in our centers was 29.4%. Age and family dynamics appear to be more important predictors compared to disease activity.
    Study site: Rheumatology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Hospital Putrajaya, Malaysia
  3. Fulltext The Relationship between Emotion Regulation (ER) and Problematic Smartphone Use (PSU): A Systematic Review and Meta-Analyses
    Shahidin SH, Midin M, Sidi H, Choy CL, Nik Jaafar NR, Mohd Salleh Sahimi H, et al.
    Int J Environ Res Public Health, 2022 Nov 28;19(23).
    PMID: 36497921 DOI: 10.3390/ijerph192315848
    Emotion Dysregulation (ED) and Problematic Smartphone Use (PSU) are two rising global issues requiring further understanding on how they are linked. This paper aims to summarize the evidence pertaining to this relationship. Five databases were systematically searched for published literature from inception until 29 March 2021 using appropriate search strategies. Each study was screened for eligibility based on the set criteria, assessed for its quality and its level of evidence was determined. The Comprehensive Meta-Analysis software program (CMA) was employed to run further analyses of the data. Twenty-one studies were included in the systematic review. Nine studies with extractable data for meta-analysis had high across-studies heterogeneity, hence subgroup analyses were performed that confirmed a significant moderate positive correlation between ED and PSU (pooled correlation coefficient, r = 0.416 (four studies, n = 1462) and r = 0.42 (three studies, n = 899), respectively) and a weak positive correlation between "expressive suppression" and PSU (pooled correlation coefficient, r = 0.14 (two studies, n = 608)). Meta-regression analysis showed a stronger correlation between ED and PSU (R2 = 1.0, p = 0.0006) in the younger age group. Further studies to establish and explore the mechanisms that contribute towards the positive link between ED and PSU are required to guide in the planning of targeted interventions in addressing both issues.
  4. Generalization of cognitive training in an Australian sample of schizophrenia patients
    Sharip S, Michie P, Schall U, Drysdale K, Case V, Sankaranarayanan A, et al.
    Compr Psychiatry, 2013 Oct;54(7):865-72.
    PMID: 23602388 DOI: 10.1016/j.comppsych.2013.03.015
    The present study was undertaken to evaluate the effect of cognitive training in improving trained and untrained cognitive processes in schizophrenia.
  5. Knowledge and attitude on sex among medical students of a Malaysian university: a comparison study
    Sidi H, Loh SF, Mahadevan R, Puteh SE, Musa R, Wong CY, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:103-9.
    PMID: 23857845 DOI: 10.1111/appy.12053
    INTRODUCTION: The objective of this study was to determine the relationship between clinical/socio-demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).
    METHODS: A cross-sectional study assessing 452 students using a self-administered questionnaire of knowledge and attitude was performed and had a response rate of 80%.
    RESULTS: The majority of respondents were Malays (56%), females (57.5%), lived in urban areas (66.4%), had a median family income of RM3000 and perceived themselves as moderately religious (60%). The overall score on knowledge about sex was 21.7 of 35 (a higher score indicates better knowledge about sex). It was noted that 73.2% of students felt that they did not receive adequate training in medical school to deal with patients' sexuality and sexual problems, while 51.5% felt uncomfortable talking to patients about these issues. Students in the clinical year were more knowledgeable than those in pre-clinical years (22.67 versus 20.71, P 22 marks [median score]).
    DISCUSSION: The students' attitude on sex was considered conservative as the majority of them disagreed on premarital sex, masturbation, abortion, homosexuality and oral sex. Gender and religiosity have a large influence on attitudes on controversial sexual issues, whereas clinical status plays a small role. Knowledge on sex among UKM medical students is inadequate and their attitudes on sex are considered conservative. Integration of sexual medicine and health modules in the medical curriculum is crucial for students to more effectively address patients' sexual problems and promote non-judgmental attitudes towards patients.
    KEYWORDS: attitude; knowledge; medical student; sex
  6. Hypoactive sexual desire among depressed female patients treated with selective serotonin reuptake inhibitors: a comparison between escitalopram and fluoxetine
    Sidi H, Asmidar D, Hod R, Jaafar NR, Guan NC
    Int J Psychiatry Clin Pract, 2012 Mar;16(1):41-7.
    PMID: 22122658 DOI: 10.3109/13651501.2011.617457
    To determine the risk of hypoactive sexual desire (HSD) in depressed female patients treated with selective serotonin reuptake inhibitors, comparing escitalopram and fluoxetine. The associated factors were also examined.
  7. Female sexual dysfunction in patients treated with antidepressant-comparison between escitalopram and fluoxetine
    Sidi H, Asmidar D, Hod R, Guan NC
    J Sex Med, 2012 May;9(5):1392-9.
    PMID: 21477024 DOI: 10.1111/j.1743-6109.2011.02256.x
    Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD).
  8. Orgasmic dysfunction among women at a primary care setting in Malaysia
    Sidi H, Midin M, Puteh SE, Abdullah N
    Asia Pac J Public Health, 2008;20(4):298-306.
    PMID: 19124324 DOI: 10.1177/1010539508322810
    AIM: The aim of this study was to investigate the prevalence of orgasmic dysfunction and the potential risk factors that may be associated with orgasmic dysfunction among women at a primary care setting in Malaysia.
    METHODS: A validated questionnaire for sexual function was used to assess orgasmic function. A total of 230 married women aged 18 to 70 years participated in this study. Their sociodemographic and marital profiles were compared between those who had orgasmic dysfunction and those who did not, and the risk factors were examined.
    RESULTS: The prevalence of orgasmic dysfunction in the primary care population was 51.9%. Women with orgasmic dysfunction were found to be significantly higher in the following groups: age >45 years, being non-Malay, having lower academic status, married longer, having more children, married to an older husband, and being at menopausal state.
    CONCLUSION: Women with infrequent sexual intercourse are less likely to be orgasmic (odds ratio = 0.29, 95% confidence interval = 0.11-0.74).
  9. The Female Sexual Function Index (FSFI): validation of the Malay version
    Sidi H, Abdullah N, Puteh SE, Midin M
    J Sex Med, 2007 Nov;4(6):1642-54.
    PMID: 17608666
    Female sexual dysfunction (FSD) is a prevalent sexual health problem that has been inadequately investigated in Malaysia, a nation with a conservative multiethnic society.
  10. The female sexual response cycle: do Malaysian women conform to the circular model?
    Sidi H, Naing L, Midin M, Nik Jaafar NR
    J Sex Med, 2008 Oct;5(10):2359-66.
    PMID: 18086161
    The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Basson's circular model.
  11. The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women
    Sidi H, Puteh SE, Abdullah N, Midin M
    J Sex Med, 2007 Mar;4(2):311-21.
    PMID: 17040486
    Female sexual dysfunction (FSD) is a prevalent sexual health problem that does not spare the women in Malaysia, a nation with a conservative multiethnic society.
  12. Fulltext Voyeurism with sexual fantasy on female body parts: a subtype of obsessive-compulsive disorder?
    Sidi H, Midin M
    Malaysian Journal of Psychiatry, 2008;17(1):94-99.
    The compulsive behaviour of observing an unsuspecting person undressing or being naked in voyeurism may be related to Obsessive-Compulsive spectrum disorder. The aim of this paper is to report a case that reiterates a unique psychopathology of a Malaysian male voyeur with an obsession on female body parts. This 35 year-old voyeur man who attended psychiatric outpatient clinic in an academic medical centre presented to a psychiatrist for taking photos of his sisters' naked bodies and collected nails and hairs from their body, coded them with intend for masturbation. His voyeuristic thoughts and urges which came repeatedly and intrusively, involving attempts to resist them and was associated with an inner tension for the urges to be fulfilled. He responded both to Paroxetine and behaviour therapy. The possibility that voyeurism, a paraphilia can manifest itself as a subtype of OCD is discussed. Keywords: Malaysian voyeur, obsession-compulsive spectrum disorder, body parts
  13. Fulltext Sexual pain among Malaysian women receiving antidepressant: a comparison between escitalopram and fluoxetine
    Sidi H, Asmidar D, Seng LH, Jaafar NR, Midi M, Guan NC
    Psychopharmacol Bull, 2016 Mar 1;46(1):24-35.
    PMID: 27738371
    OBJECTIVES: The current study compares the risk of sexual pain in depressed female patients in remission between those who were treated with Escitalopram and Fluoxetine. The associated factors were also examined.
    METHODS: This is a cross-sectional study involved 112 depressed female patients (56 treated with Escitalopram and 56 treated with Fluoxetine) who were in remission (as defined by Diagnostic and Statistical Manual-IV (DSM-IV) in the past 2 months and Montgomery-Asberg Depression Rating Scale (MADRS) score of ≤ 10) from the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC). They were interviewed using Structured Clinical Interview for DSM-IV (SCID). Hypoactive sexual desire was assessed using the Pain subscale of Malay Version of the Female Sexual Function Index (MVFSFI).
    RESULTS: The results show that risk of sexual pain was relatively low (16.07% for all patients), with no statistical significant between the two groups (17.86% for fluoxetine group, 14.29% for escitalopram group). Older age (adjusted odds ratio = 1.524, 95% CI = 1.199, 1.938) was the only factor significantly associated with sexual pain disorder.
    CONCLUSIONS: There should not be any barrier when continuing the use of escitalopram or fluoxetine as antidepressants amongst the female patients.
    KEYWORDS: depression; escitalopram; female; fluoxetine; sexual pain

    Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  14. Fulltext Female sexual dysfunction among Malaysian women in a primary care setting: Does the frequency of sexual activity matter?
    Sidi H, Wan Puteh SE, Midin M, Abdullah N
    Medicine & Health, 2007;2(1):48-57.
    MyJurnal
    The aim of the study was to compare sexual functioning among Malaysian women in a primary care setting between those with a low and high frequency sexual intercourse. Across-sectional study on 230 married Malaysian women in a primary-care setting was conducted at the Bandar Tun Razak Clinic, Cheras. A validated Malay version of Female Sexual Function Index questionnaire (MVFSFI) was used to assess the sexual functioning profiles among women with low and high sexual activity.  The percentage of women who had sexual intercourse 3-4 times a week, 1-2 times a week and < 1-2 times a month were 13.4%, 44.3 % and 42.4 % respectively. Women with a low frequency of sexual intercourse (Low SI) tended to suffer from more sexual dysfunction, (χ²=28.98, p < 0.001) compared to those with a high frequency of sexual intercourse (High SI) group. Women who were less sexually active (having low frequency intercourse, ie. ≤ 1 – 2 times per week) were found to be less sexually aroused (χ²= 25.9, p< 0.001), less orgasmic (χ²=19.8, p< 0.001), less lubricated during sexual activity (χ²=11.1, p< 0.001), complain of sexual pain (χ²=4.3, p = 0.033) and feels less satisfied sexually (χ²=12.6, p< 0.001).The problem of female sexual dysfunction (FSD) in the Malaysian primary care population with low sexual activity needs to be addressed.
  15. The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia
    Sulaiman AH, Said MA, Habil MH, Rashid R, Siddiq A, Guan NC, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S89-94.
    PMID: 23433219 DOI: 10.1016/j.comppsych.2013.01.003
    The objective of this study was to determine the risk of lifetime and current methamphetamine-induced psychosis in patients with methamphetamine dependence. The association between psychiatric co-morbidity and methamphetamine-induced psychosis was also studied.
  16. Fulltext The prevalence and risk factors of sexual dysfunction in gynaecological cancer patient
    Tee, B.C., Ahmad Rasidi, M.S., Mohd Rushdan, M.N., Ismail, A., Sidi, H.
    Medicine & Health, 2014;9(1):53-61.
    MyJurnal
    Sexual dysfunction is highly prevalent in gynaecological cancer patients. Most of the time, sexual dysfunction in gynaecological cancer is underdiagnosed as there is overlapping of symptoms with other psychological morbidities, interplaying of multiple risks, patients’ reluctance to complain or incompetence of health care provider to assess. Determining the risk factors of sexual dysfunction in cancer patients enables us to pay more attention to those who are vulnerable and to device strategies for early detection, prevention and treatment of sexual dysfunction in them. The main aim of the study was to determine the prevalence of sexual dysfunction and its risk factors in gynaecological cancer patients in Hospital Sultanah Bahiyah, Alor Star, Malaysia. Sexual function of eighty-three gynaecological cancer patients who were married were assessed with self-rated MVFSFI (Malay version Female Sexual Function Index). Self-rated WHOQOL-BREF (World Health Organization- Quality of Life- 26) which assessed the domains of quality of life was used while MINI (Mini International Neuropsychiatry Interview) was used for diagnosis of major depressive disorder. The prevalence of sexual dysfunction among the married gynaecological cancer patients was 65% (54/83). Sexual dysfunction was significantly associated with low education level (OR 3.055, CI 1.009-9.250), shorter duration of cancer (OR 0.966, CI 0.966- 0.998), ongoing chemotherapy (OR 3.045, CI 1.149-8.067), pain perception (OR 3.230, CI 1.257-8.303), absence of sexual intercourse for more than one month (OR 1.862) and three domains of quality of life such as physical health, psychological health and social relationship (OR 0.942, CI 0.908-0.978; OR 0.955, CI 0.916-0.995; OR 0.933, CI 0.894-0.973, respectively). However, sexual dysfunction was not associated with major depressive disorder (χ2 ² = 1.224, p = 0.268). The prevalence of sexual dysfunction in gynaecological cancer patients was comparable to other studies of similar population. Since, the risk factors of sexual dysfunction in gynaecological cancer patients are multidimensional, the process of assessment and management need to be holistic and patient-oriented.
  17. Schizophrenia and Nicotine Dependence: What Psychopharmacological Treatment Options are Available for the Duo Perturbationes?
    Theng YM, Wahab S, Wahab NAA, Sidi H, Das S
    Curr Drug Targets, 2019;20(2):173-181.
    PMID: 29046149 DOI: 10.2174/1389450118666171017163741
    Nicotine dependence has progressively become a foremost community health interest in both the developed and developing nations due to the economic burden and health-related problems. Smoking was significantly higher among patients with schizophrenia in comparison to the general population. Nicotine dependence is not only associated with public stress, but among patients with schizophrenia, smoking brings major challenges to the management. Nicotine may diminish the therapeutic efficacy of the bioavailability of the psychopharmacological agents in-vivo. These duo perturbations, i.e. two clinical conditions co-existed may prevent psychotic symptoms remission among patients suffering from schizophrenia who smoke at the same time. The aim of this review was to highlight the role of pharmacological treatment options and strategies for patients with nicotine dependence in schizophrenia with emphasis on the underlying neurobiological process. The role of nicotine replacement therapy, i.e. norepinephrine-dopamine reuptake inhibition (NDRI) e.g. bupropion and selective partial agonist of α4β2 and full α7-nicotinic acetylcholine receptor e.g. varenicline was deliberated. An ideal choice of drug targets for patients with schizophrenia with nicotine dependence is pivotal to foster a better therapeutic alliance.
  18. Why do young adolescents bully? Experience in Malaysian schools
    Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.
    PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002
    INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
    METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
    RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
    DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.
  19. Employment program for patients with severe mental illness in Malaysia: a 3-month outcome
    Wan Kasim SH, Midin M, Abu Bakar AK, Sidi H, Nik Jaafar NR, Das S
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S38-45.
    PMID: 23602390 DOI: 10.1016/j.comppsych.2013.03.011
    OBJECTIVE: This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI).
    METHODS: A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment.
    RESULTS: The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]).
    CONCLUSION: Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.
  20. Fulltext Voyeuristic disorder and internet pornography addiction: a case report
    Wong DTL, Sidi H, Salleh H, Tajjudin I
    Malaysian Journal of Medicine and Health Sciences, 2018;14(3):54-56.
    MyJurnal
    With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.
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