• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7467-7472
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• 2015

Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1590-1596
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• 2007

Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.51-60
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• 1995

This study was to examine the awareness of health and the utilization of primary health care in rural areas. The data were obtained from self-administered questionnaire conducted 450 parents of Mi Gum md Su Dong middle school students in Nam yang Ju city, Kyung Gi-Do, Korea, from December 15 to 20 in 1993. The results were as follows : 1) Among the causes of disease, 'insufficient health care' was the highest(39.1%), and 'bad environment'(28.9%), 'complexity of life style'(17.8%) in next order. 2) In the priority between 'daily farm work' and 'primary health care', only 45.6% of respondents answered that primary health care is more important than the daily farm work. The 29.8% of respondents answered 'daily farm work', and the 23.1% answered 'the equal of the both'. 3) The 63.6% of the respondents recognized correctly, the meaning of primary health care. And the rate of information source in primary health care were 'TV and Radio'(42.2%), 'medical facilities'(23.3%), and 'newspaper and magazine'(11.3%) in order. 4) In the choice rate of medical facilities for primary health care, 'drug store' was the highest(34.9%), and 'local private clinic'(34.7%), 'health (sub)center'(15.8%), 'hospital'(10.2%) in next order. 5) The 53.5% of the respondents had experienced to visit the health (sub)center more than once. And the disfavorite reasons of health (sub)center were 'insufficient equipment'(36.7%), 'inavailable time to visit'(26.9%), and 'poor treatment'(9.1%). 6) Among the preference of the physicians for primary health care, 'specialist' was the highest rate of the respondents(54.2%), and 'general practitioner'(32.4%), and 'family doctor'(9.8%) in next order. The major obstacles in utilizing the medical facilities for primary health care were 'daily farm work'(41.6%), 'distance'(21.1%) and 'medical cost'(10.4%) in order. 7) The weakened reasons in health (sub)center function were 'insufficient medical equipment'(44.4%), 'the lack of resident's understanding for health (sub)center'(21.8%), and 'short thought of duty in health (sub)center personnel'(16.9%) in order.

• Child Health Nursing Research
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• v.7 no.4
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• pp.434-450
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• 2001

This study is designed to understand the meaning and nature of raising children with cerebral palsy. It researches the experience of mothers of schoolchildren with cerebral palsy by the research method of hermeneutic phenomenology. The study was conducted from November 10, 1999 to December 20, 2000. When children with cerebral palsy usually show symptoms in the early stage of cerebral palsy, mothers do not take children to a doctor for diagnosis. And, most of mothers have a difficult time to accept the reality; they usually respond to the initial diagnosis with shock, reproach, and deny. When mothers start recognizing the reality, they consider that their children have cerebral palsy due to the their mismanagement during pregnancy, delivery, nursing, and initial treatment. They shelter their children from view and feel guilty that they cannot afford to try folk remedies for their children. As time passes, mothers face conflicts between families in diverse ways. Families put the blame on genetic effects. Mothers-in-law give their daughters-in-law a hard time, husbands shift the responsibility of raising children onto their wives, and trouble arises between families-in-law and mothers native families. When children grow up, it is physically difficult for mothers to take care their children. In addition, they suffer from all the troubles in family due to childrens handicap. Mothers try the diverse methods of bringing up children. However, they start getting tired of raising children as they experience failures and financial difficulties. Mothers feel collapsed recalling the ways of raising children. They feel anxiety, miserable, lonely, and worrying when they think how children would attend school, make friends, and live in the future. In this stage, mothers do their best to raise their children with hope. They tend to compare their children with others without handicap and spend money and time in attempting all the treatments. When mothers and children join the society at school, they find that the society does not understand disabled people, teachers show inconsiderate attitude, friends avoid them, and children hardly follow classes. Such experiences make mothers feel angry and frustrated. However, when children adapt to school, mothers see the possibility that children could accomplish schoolwork. They appreciate teachers help and others consideration. Mothers place appropriate expectations on their children and help them to prepare for the future. I would make following suggestions based on the results. 1. As a primary basic course of rehabilitation nursing intervention, solution-centered nursing intervention system should be developed. The intervention needs to be based on the understanding of mothers, who raise children with cerebral palsy, through in-depth interview. 2. Advance researches on the development of individual nursing intervention should be conducted. Individual nursing intervention needs to prevent and release actual pain focusing on mothers raising children with cerebral palsy. 3. Integrated curriculum that help children with cerebral palsy lead a normal school life with ordinary children should be developed. 4. Basic research on using of facilities and effective application of service volunteer to help children with cerebral palsy in school needs to be conducted.

• Journal of Korean Medical classics
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• v.23 no.3
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• pp.1-11
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• 2010

King of Jujeong(周定王) named Jusuk(朱橚) was thought to be an exemplary character as a scholar and a politician, who was not an Oriental medical doctor but a compiler publishing a set of three medical books and a set of volumes on famine relief to save people in the areas of natural disasters or spring poverty. He was born on July 1, 1361 as the fifth son of Juwonjang(朱元璋), the first Emperor (1368-1398) of the Myeong-dynasty (1368-1644) of China. It was not clearly known about his mother other than assuming, but hard to ascertain, that she was from Goryeo, the ancient country in the Korean Peninsula, and became a loyal concubine of Juwonjang(朱元璋). He was the brother of Yeongrakje(永樂帝), the third Emperor(1402-1424) of the Myeong-dynasty. As a focal figure in the political forces at that time in the Myeong-dynasty, he had a life full of vicissitudes such as being removed from office, being exiled to a remote place, being scattered far and wide between family members, being implicated in the rebellion and so on. It seemed that he brushed up on his study, taking a class on an emir until the year of 1380 at the age of twenty. And he published "Bosaeng-yeorok(保生餘錄)" and "Bojebang(普濟方)" for eight years from 1381 to 1389 (at age 21-29), "Sujinbang(袖珍方)" in 1391 (at 31), and "Guhwangboncho(救荒本草)" in 1406 (at 46), republishing "Sujinbang(袖珍方)" in 1415 (at 65). Endowed with a brilliant talent from early days, Yeong-rakje(永樂帝) wrote the poem(the poem paying a high tribute to a King) well and composed one hundred pieces of poetry on the story of the Won Dynasty (1271-1368) of China. He leaded a quiet life in his later years and died a natural death at Gaebong(開封, a city in China) at 65 in 1425. He had 15 sons including king of Juheon(朱憲王) Yudon(有敦) and 11 daughters. His books contributed absolutely to the growth of Oriental medical field, and also to the increase in population, having influence on bringing about compilation of the books on Oriental medicine and famine relief of the Joseon Dynasty (the old Korean kingdom from AD 1392 to 1910).

• Journal of Acupuncture Research
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• v.22 no.1
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• pp.91-97
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• 2005

Objective : This study was designed to evaluate the effect of moxibustion with various scales on symptoms of idiopathic Parkinson's disease. Methods : Subjects were voluntarily recruited by newspapers and internet. All the subjects are confirmed as idiopathic parkinson's disease by a neurologist. The moxibustion therapy was performed 5 times a week by patient's family at home and once a week by oriental medical doctor at hospital. Moxibustion points were GV2O, CV12, ST36, BL18, BL2O. Intensity was up to pain threshold according to patients not to get burned. The patient's symptoms were assessed before, after 4 weeks and after 8 weeks treatment by unified Parkinson's disease rating scale(UPDRS), modified Hoehn-Yahr(H-Y) stage, Schwab & England activity of daily living and freezing of gait questionnaire(FOGQ). Results : Total UPDRS scores were significantly improved after 4 weeks(p<0.01) and after 8 weeks(p<0.01) compared to the pre-treatment. There were significant changes in H-Y stage after 4 weeks(p<0.05), but there were no significant changes in H-Y stage after 8 weeks. The scores of ADL were not significantly improved after 4 weeks(p>0.05) and after 8 weeks(p>0.05). There were significant changes in FOGQ scale after 4 weeks(p=0.05) and but there were no significant changes in FOGQ scale after 8 weeks(p=0.13). Conclusion : This study suggests that moxibustion treatments can be applicable to improve symptoms in the patients with idiopathic Parkinson's disease.

• Journal of agricultural medicine and community health
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• v.47 no.2
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• pp.99-108
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• 2022

Objectives: This study aimed to identify the vaccination coverage for hepatitis B among aged 19 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The survey was conducted through a Mixed-Mode Random Digit Dialing Survey (RDD) method. The survey included hepatitis B vaccination status, reasons of vaccination and non-vaccination, sources of information on vaccination, and other related factors. Results: The vaccination coverage for hepatitis B among adults 19 years of age and older were 38.0%, 32.5%, and 26.9% for the first, second, and third doses. A related factors with high rate of hepatitis B vaccination was women, younger than 65 years of age, rural residents, having a job, highly educated, health insurance subscribers, living with spouse, family members living together. In addition, the vaccination rate was higher in those who was aware of the states recommended adult vaccination, were explained by a doctor about the need for adult vaccination, kept their vaccination records, and recognized that it helped prevent infectious diseases, and had seen promotional materials. Conclusions: In the future, it is necessary to check the antibody retention rate along with the hepatitis B vaccination coverage of adults on a regular basis. In addition, in order to accurately and quickly identify the hepatitis B vaccination coverage, it is necessary to prepare a plan to improve the computerized registration rate to manage adult vaccination records.

• Pediatric Infection and Vaccine
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• v.7 no.1
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• pp.129-135
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• 2000

Purpose : We previously reported the short-term immunogenecity and safety of 47 passaged Oka strain live attenuated varicella vaccine in healthy children in 1997. Now, we conducted this two-year follow-up study to confirm the maintenance of immunity, the occurrence of natural varicella infection and the activation of vaccine induced latent infection on the same vaccine. Methods : 99 children who had been immunized by 47 passaged Oka strain live attenuated varicella vaccine in 1997 were followed up by questionnaire, and 46 children out of study group were followed up serologically. They were asked to report any instance of varicella or herpes zoster since they had been immunized. If there was any evidence of varicella or herpes zoster, they should be clinically or serologically confirmed by doctor. Also, those patients' parents were asked to report any instance of varicella or herpes zoster in their family, playmate, kindergarten, school, or other settings. The immunity to VZV was confirmed by EIA and FAMA test. Results : 6 recipients developed breakthrough varicella after exposure to VZV in family, kindergarten and school during follow-up period. However, clinical features of those patients were very mild and self limited without therapy. And none of the recipients developed herpes zoster during this observation period. The results of EIA test showed that study subjects were all seropositive except one, and the antibody titers and GMT of FAMA test were seropositively maintained in all subjects. Statistically, the antibody titers of EIA and FAMA test confirmed two years after vaccination were higher than those results confirmed one month after vaccination. Conclusion : Our study results suggest that the immunity of 47 passaged Oka strain live attenuated varicella is well maintained until 2 years later after vaccination, and mild natural infection after exposure to VZV can be occurred with low rate. There were not developing zoster in study vaccine after vaccination for two-years.

• Journal of Preventive Medicine and Public Health
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• v.3 no.1
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• pp.97-110
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• 1970

This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.143-153
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• 2002

This study was performed to examine the want for home-visit health care of health center and health sub-center in rural olders and to provide the basic data to develop strategies for efficient and effective home-visit health care delivery of public health facilities. The questionnaire survey by interview was conducted to 355 olders whose ages were all over 65 years, residing at a rural community, Myun, Gyeongsangbuk- do. Among study population, 64.5% replied that their self-rated health status were 'poor', 14.1% had low ADL and 14.9% had low IADL. Among study population, 73.5% replied that they had health problem which were in need of medical personnel's care. The existence of health problem were significantly different according to sex, age, marital status, health security status, occupation, economic status, circumstances for medical care, self-rated health status, ADL, and IADL(p<0.05). Among olders with health problem which were in need of medical personnel's care, 19.5% wanted to receive the home-visit health care. The degree of want for home-visit health care was higher significantly in olders whose ages were 75-year old or more(p<0.05), jobless olders(p<0.01), the aged persons who were not in harmony with other family members, olders whose self-rated health status were 'poor' and olders with low IADL. The major reasons why they wanted to receive the home-visit health care services were 'they had no helpers when they were sick' (64.7%), 'long distance to the medical facilities from their residence'(23.5%). The medication service was the most need service among home-visit health care services. The reasons why they didn't want to receive the home-visit health care services were 'we could walk and move' (60.0%), 'we wanted to have a direct contact with doctor' (25.7%) in the order of high rate. In multiple logistic regression analysis, the degree of want for home-visit health care were higher significantly in olders who were not in harmony with other family members and olders whose self-rated health status were 'poor'(p<0.05).