Cervical cancer (CaCx) is the second most fatal cancer contributing to 14% of cancers in Indian females, which account for 25.4% and 26.5% of the global burden of CaCx prevalence and mortality, respectively. Persistent infection with high-risk human papilloma virus (HPV- strains 16 and 18) is the most important risk factor for precursors of invasive CaCx. Comprehensive prevention strategies for CaCx should include screening and HPV vaccination. Three screening modalities for CaCx are cytology, visual inspection with acetic acid, and HPV testing. There is no Indian national policy on CaCx prevention, and screening of asymptomatic females against CaCx is practically non-existent. HPV vaccines can make a major breakthrough in the control of CaCx in India which has high disease load and no organized screening program. Despite the Indian Government's effort to introduce HPV vaccination in the National Immunization Program and bring down vaccine cost, challenges to implementing vaccination in India are strong such as: inadequate epidemiological evidence for disease prioritization, duration of vaccine use, parental attitudes, and vaccine acceptance. This paper reviews the current epidemiology of CaCx and HPV in India, and the current status of HPV vaccination in the country. This article stresses the need for more research in the Indian context, to evaluate interventions for CaCx and assess their applicability, success, scalability and sustainability within the constraints of the Indian health care system.
Pourfarzi, Farhad;Fouladi, Nasrin;Amani, Firouz;Ahari, Saeid Sadegieh;Roshani, Zohre;Alimohammadi, Sara
Asian Pacific Journal of Cancer Prevention
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v.17
no.8
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pp.3939-3943
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2016
Background: According to recent statistics, the breast cancer rate is growing fast in developing countries. In North West of Iran, the incidence of breast cancer after esophageal and gastric cancers has the highest rate. Previous studies have also indicated that women in this region show reluctance to do breast cancer screening. There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience. Materials and Methods: In the present qualitative study, thirty-two women with breast cancer were interviewed about their experiences of breast cancer screening. A semi-structured interview guide was designed to elicit information specific to the 4 P's in social marketing. Results: Three main categories emerged from the analysis: price, service and promotion. Subcategories related to these main categories included factors effective in increasing and decreasing cost of screening, current and desirable features of screening services, and weakness of promotion. Conclusions: Screening programs should be designed to be of low cost, to meet patients' needs and should be provided in suitable places. Furthermore, it is essential that the cultural beliefs of society be improved through education. It seems necessary to design an executive protocol for breast cancer screening at different levels of primary health care to increase the women's willingness to undergo screening.
Journal of Korean Academy of Fundamentals of Nursing
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v.16
no.2
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pp.232-241
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2009
Purpose: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). Method: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). Results: The mean score for importance was $2.58{\pm}0.29$, for difficulty, $2.11{\pm}0.31$, and for frequency, $2.18{\pm}0.31$. OPD nurses recognized 'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as 'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p=.026; F=4.089, p=.018) and hospital size (F=4.274, p=.006; F=3.154, p=.025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. Conclusion: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate 'preparation for medical service', and 'management of facility and environment' to nonmedical health-care workers.
Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.
Urinary incontinence is defined as the involuntary and inappropriate loss of urine to failure to emit normal responses as the bladder fills, or inability to reach the bathroom in sufficient time. This study was undertaken to estimate the incidence of urinary incontinence and to determine the correlates of urinary incontinence among women. Subjects of this survey consisted of 408 women, 26 to 83 years old in Incheon. The results of this study are as follows. 1. Of the subjects 50.7% reported urine loss once or twice per year and 28.5% reported incontinence on a regular basis at least once per month. 2. 40.5% of women reported small volume accidents of only 1 to 2 drops, 31.4% ; 1 t-spoon, 16.9% : 1 T-spoon, while 10.1% of women couldn't estimate the volume of urine loss. 3. The volume of urine loss was great enough to require a change of garment (undergarments or outer garments) in 73%. But only 3.8% of those used some type of pads. 4. 56.5% of incontinent women didn't talk about their urinary incontinence with other persons because they felt that urinary incontinence was shameful(38.4%), was not a disease(31.6%), was incurable in spite of treatment(27.4%) and was fearful of being uncured (2.6%). 5. Only 15.5% of urinary incontinent women had sought treatment. 6. The incidence of urinary incontinence was significantly higher in women who had more pariety and uterine-ovarian disease, older age, worrying about where toilets were when they visited new places or voiding anxiety, nocturia and frequency, but was significantly lower in women who had coffee intake. The incidence of urinary incontinence was not related to smoking and enuresis. The results indicate that urinary incontinence is common among young and middle-aged women. That few seek treatment for urinary incontinence suggests a need for more information about women's attitudes toward urinary incontinence and more attention to this problem by health care providers.
The purpose of this study was to evaluate the quality of internet information about childhood fever and fever management. A total of 48 web sites with information about childhood fever and fever management in Korea were analyzed. Each web site was evaluated in terms of degree of the latest, creator, source, disclosure, and the accuracy of information. Accuracy of information was checked by comparison with published childhood fever management guidelines and current best evidences. The quality of internet information about fever and fever management was generally poor and not consistent. Moreover, it did not reflected current scientific evidences. It is important that parents should aware of these deficiencies and internet information can not substitute for consultation with health care professionals. Moreover, there was an urgent need to improve evidence-based fever management information on the internet.
Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.
Inversion therapy has been used to relieve backpain, decrease pressure on the discs between vertebrae and stretch musdes as early as 400 BC. Gravity Guidance Inversion Table was introduced in 1960's and has been commercialized mostly for relieving backpain. in United States. But this machine needs to adjusted and possible sudden movement can cause severe injury to the users. In the 1990's, motor assisted inversion cram was introduced in Germany. But this inversion cram is too heavy and inconvenient to be used at home. In these days, the inversion machine become popular equipment in fitness clubs and health care places for relieving backpain as well as stretching muscles. And there is a growing need for home use version of motorized inversion machine. In this study, the motorized inversion machine was developed to be used for stretching exercise at home. The design became compact, simple and foldable as the results of adapting the wabble mechanism. And the machines are optimally designed by analyzing the torques applied to the machine by diverse physical size of users.
Journal of Physiology & Pathology in Korean Medicine
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v.26
no.4
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pp.572-576
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2012
In this research, we examined the courses of the colleges of Korean medicine in Korea to find out how well the education on medical ethics is being conducted so that we could make good use of our findings as basic material to make arrangements to develop ethics education in Korean medicine. In the same research, we conducted a survey to find detailed information on the current state of ethics education and its actual application at 12 colleges of Korean medicine in Korea. As a result, 8 colleges out of 12 included medical ethics in their courses. They were among the subjects in the first year or second year of a preparatory program. Most of them were classified as requirements while some of them were classified as electives in humanities or liberal arts. As ethical issues in the medical community become more diversified and important, it is imperative that health care providers maintain firm ethics. As the need for medical ethics and ethics education is getting larger, ethics education at colleges of oriental medicine is becoming a more important focus. Therefore, it is necessary to expand ethics education at the colleges of Korean medicine in Korea and set a precedent for studying ethics in Korean medicine based on that.
Journal of Korean Academy of Fundamentals of Nursing
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v.17
no.4
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pp.575-587
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2010
Purpose: The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies. Methods: Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria. Results: Forty research papers were related to nursing, and there was only one research paper focused 011 elderly people with CAD. There were no papers using concept analysis, qualitative study. or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation', Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies. Conclusions: The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.
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