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Fulltext Determinants of Pap smear screening among urbanite older female in North Klang Valley. [Abstract]

Abdullah NN, Ahmad Saman MS

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):85-85.
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ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019)
Introduction: As cervical cancer is the third most common cancer among women and ten percent of cervical cancer incidence among those 65 years and above, Pap smear is still relevant to be performed among older women. The aim of this study was to determine the determinants of Pap smear screening among older women in an urban setting.
Methods: This cross-sectional study was conducted among 515 women aged 50 and above in two urban health centres in Gombak, Selangor. The sampling technique conducted was random systematic sampling. The indepen-dent variables were age, marital status, employment status, gynaecological history (family history of cervical cancer, menopause, hysterectomy), obstetric history (number of live births, ever had contraception), presence of chronic diseases (hypertension, Diabetes Mellitus, heart disease). Results: Only 202 (39.2%) out of 515 undergone Pap smear screening. An estimated 80.7% of them had their last Pap smear a year ago. The mean age of the respondents was 58.83± 7.05 years old and 77.3% had one and more comorbidities. The respondents preferred health care person-nel as the source for the pap smear information compared to reading materials and internet. Married vs divorced (aOR=1.89,p=0.02); those with heart disease (aOR=0.32,p value=0.01; those with Diabetes Mellitus (aOR=0.57,p value=0.01; those who had hysterectomy (OR=2.89, p value=0.04) and those who had contraception (aOR=3.72, p value =
Abbreviated breast magnetic resonance imaging (MRI) or digital breast tomosynthesis for breast cancer detection in dense breasts? A retrospective preliminary study with comparable results

Ramli Hamid MT, Ab Mumin N, Abdul Hamid S, Ahmad Saman MS, Rahmat K

Clin Radiol, 2024 Jan 10.
PMID: 38267349 DOI: 10.1016/j.crad.2023.12.016

AIM: To compare the diagnostic performance of abbreviated breast magnetic resonance (AB-MR) imaging (MRI) and digital breast tomosynthesis (DBT) for breast cancer detection in Malaysian women with dense breasts, using histopathology as the reference standard.
MATERIALS AND METHODS: This was a single-centre cross-sectional study of 115 women with American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BIRADS) breast density C and D on DBT with breast lesions who underwent AB-MR from June 2018 to December 2021. AB-MR was performed on a 3 T MRI system with an imaging protocol consisting of three sequences: axial T1 fat-saturated unenhanced; axial first contrast-enhanced; and subtracted first contrast-enhanced with maximum intensity projection (MIP). DBT and AB-MR images were evaluated by two radiologists blinded to the histopathology and patient outcomes. Diagnostic accuracy (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]) was assessed.
RESULT: Of the 115 women, the mean age was 50.6 years. There were 48 (41.7%) Malay, 54 (47%) Chinese, and 12 (10.4%) Indian women. The majority (n=87, 75.7%) were from the diagnostic population. Sixty-one (53.1%) were premenopausal and 54 (46.9%) postmenopausal. Seventy-eight (72.4%) had an increased risk of developing breast cancer. Ninety-one (79.1%) women had density C and 24 (20.9%) had density D. There were 164 histopathology-proven lesions; 69 (42.1%) were malignant and 95 (57.9%) were benign. There were 62.8% (n=103/164) lesions detected at DBT. All the malignant lesions 100% (n=69) and 35.7% (n=34) of benign lesions were detected. Of the 61 lesions that were not detected, 46 (75.4%) were in density C, and 15 (24.6%) were in density D. The sensitivity, specificity, PPV, and NPV for DBT were 98.5%, 34.6%, 66.3%, and 94.7%, respectively. There were 65.2% (n=107/164) lesions detected on AB-MR, with 98.6% (n=68) malignant and 41.1% (39) benign lesions detected. The sensitivity, specificity, PPV, and NPV for AB-MR were 98.5%, 43.9%, 67.2%, and 96.2%, respectively. One malignant lesion (0.6%), which was a low-grade ductal carcinoma in-situ (DCIS), was missed on AB-MR.
CONCLUSION: The present findings suggest that both DBT and AB-MR have comparable effectiveness as an imaging method for detecting breast cancer and have high NPV for low-risk lesions in women with dense breasts.
Fulltext Perspective of a smoke-free home among second-hand smokers during pregnancy: a qualitative study

Mohd Asri IA, Abd Rani NA, Dzulkifli Z, Muhamad Jamil MI, Ahmad Saman MS, Yasin SM

Pertanika Journal of Science & Technology, 2017;25(104):191-204.
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Tobacco use is one of the largest causes of preventable diseases across the world. It is interesting to note that second-hand smoke exposure is a major public health problem in Malaysia. The objectives of this study are first, to explore the perspectives of pregnant mothers whose partners are smokers, and second, to explore barriers and facilitators to creating a smoke-free environment in their home. This study uses a qualitative method in analysing the experiences of 15 pregnant mothers taken from a specialist healthcare centre in Sungai Buloh, Malaysia. It discusses the perspectives of these pregnant mothers towards their partners’ smoking habits, as well as the barriers and facilitators in creating a smoke-free home. From the interviews, it became apparent that pregnant mothers despised their partners’ smoking habits due to smoke odour, lack of money, and poor health. The barriers in creating a smoke-free home include the attitude of the smoking spouse, difficulty in weaning off the habit, excessive encouragement by a spouse, difficultly in advising a smoking spouse, influences from friends, and wrong perceptions. Meanwhile, the facilitators towards creating a smoke-free home are illnesses developed through smoking, multiple reminders from family members, and nicotine replacement therapy (NRT) were perceived to work on certain smokers and habitual cues in quitting smoking. The transition process towards making homes smoke-free is complex and individualistic; healthcare professionals may need to tailor strategies to take into account the specific contexts of each individual. More education programmes on the impacts of smoking and second-hand smoke exposures to family members and smoking cessation are needed for both pregnant mothers and their smoking partners.
Study site: Gynaecology Clinic, public teaching hospital, Malaysia
Fulltext Magnetic resonance imaging features of invasive breast cancer association with the tumour stromal ratio

Ab Mumin N, Ramli Hamid MT, Abdul Hamid S, Chiew SF, Ahmad Saman MS, Rahmat K

PLoS One, 2023;18(8):e0290772.
PMID: 37624821 DOI: 10.1371/journal.pone.0290772

OBJECTIVE: To assess the association between breast cancer tumour stroma and magnetic resonance imaging (MRI) features.
MATERIALS AND METHODS: A total of 84 patients with treatment-naïve invasive breast cancer were enrolled into this retrospective study. The tumour stroma ratio (TSR) was estimated from the amount of tumour stroma in the pathology specimen of the breast tumour. The MRI images of the patients were analysed based on Breast Imaging Reporting and Data Systems (ACR-BIRADS) for qualitative features which include T2- weighted, diffusion-weighted images (DWI) and dynamic contrast-enhanced (DCE) for kinetic features. The mean signal intensity (SI) of Short Tau Inversion Recovery (STIR), with the ratio of STIR of the lesion and pectoralis muscle (L/M ratio) and apparent diffusion coefficient (ADC) value, were measured for the quantitative features. Correlation tests were performed to assess the relationship between TSR and MRI features.
RESULTS: There was a significant correlation between the margin of mass, enhancement pattern, and STIR signal intensity of breast cancer and TSR. There were 54.76% (n = 46) in the low stromal group and 45.24% (n = 38) in the high stromal group. A significant association were seen between the margin of the mass and TSR (p = 0.034) between the L/M ratio (p <0.001), and between STIR SI of the lesion and TSR (p<0.001). The median L/M ratio was significantly higher in the high TSR group as compared to the lower TSR group (p < 0.001).
CONCLUSION: Breast cancer with high stroma had spiculated margins, lower STIR signal intensity, and a heterogeneous pattern of enhancement. Hence, in this preliminary study, certain MRI features showed a potential to predict TSR.
Fulltext Prevalence of cyberbullying victimisation and its association with family dysfunction, health behaviour and psychological distress among young adults in urban Selangor, Malaysia: a cross-sectional study

Samsudin EZ, Yaacob SS, Xin Wee C, Mat Ruzlin AN, Azzani M, Jamil AT, et al.

BMJ Open, 2023 Nov 15;13(11):e072801.
PMID: 37967999 DOI: 10.1136/bmjopen-2023-072801

BACKGROUND: Cyberbullying is a growing public health concern with clear, negative impacts on the mental, physical and social health of targeted victims. Previous research on cyberbullying has largely focused on examining its occurrence among children and adolescents. The present study aims to examine the prevalence of cyberbullying victimisation and its association with family dysfunction, health behaviour and psychological distress among young adults in Selangor, Malaysia.
METHODS: A cross-sectional study was conducted in a locality within Selangor, sampling a total of 1449 young adults. The Cyberbullying and Online Aggression Survey was used to measure cyberbullying victimisation. The Family APGAR scale, General Health Questionnaire, Pittsburgh Sleep Quality Index and single-item measures were used to assess family dysfunction, psychological distress and health behaviour, respectively.
RESULTS: The 1-month prevalence of cyberbullying victimisation among young adults was 2.4%. The most common cyberbullying act experienced was mean or hurtful comments about participants online (51.7%), whereas the most common online environment for cyberbullying to occur was social media (45.8%). Male participants (adjusted OR (AOR)=3.60, 95% CI=1.58 to 8.23) had at least three times the odds of being cyberbullied compared with female participants. Meanwhile, participants with higher levels of psychological distress had increased probability of being cyberbullied compared with their peers (AOR=1.13, 95% CI=1.05 to 1.21).
CONCLUSIONS: As evident from this study, cyberbullying victimisation prevails among young adults and is significantly related to gender and psychological distress. Given its devastating effects on targeted victims, a multipronged and collaborative approach is warranted to reduce incidences of cyberbullying and safeguard the health and well-being of young adults.