• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.10039-10043
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• 2014

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography (US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins, microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnostic accuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology as the reference standard. Materials and Methods: A cross-sectional analytical study was designed to prospectively collect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan University Hospital, Karachi, Pakistan. A total of 100 patients of both genders were enrolled after informed consent via applying non-probability consecutive sampling technique. Patients referred to Radiology department of Aga Khan University to perform thyroid ultrasound followed by fine-needle aspiration cytology of thyroid nodules were included. They were excluded if proven for thyroid malignancy or if their US or FNAC was conducted outside our institution. Results: The subjects comprised 76 (76%) females and 24 males. Mean age was $41.8{\pm}SD$ 12.3 years. Sensitivity and specificity with 95%CI of ultrasound in differentiating malignant thyroid nodule from benign thyroid nodule calculated to be 91.7% (95%CI, 0.72-0.98) and 78.94% (0.68-0.87) respectively. Reported positive predictive value and negative PV were 57.9% (0.41-0.73) and 96.8% (0.88-0.99) and overall accuracy was 82%. Likelihood ratio (LR) positive was computed to be 4.3 and LR negative was 0.1. Conclusions: Ultrasonography has a high diagnostic accuracy in detecting malignancy in thyroid nodules on the basis of features like echogenicity, margins, micro calcifications and shape.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8473-8477
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• 2016

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p<0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

• Journal of Gastric Cancer
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• v.4 no.1
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• pp.27-31
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• 2004

Purpose: This study was designed to explore quality of life (QOL) in patients with stomach cancer by using the World Health Organization Quality of Life (WHOQOL) Instrument- Korean version. Materials and Methods: Thirty-one (31) patients with stomach cancer after curative resection were recruited with informed consent. Age- and gender-matched hospital staff served as controls. The 100-item WHOQOL Instrument, including physical domain, psychological domain, social domain, independence domain, environment domain, and spiritual domain, was employed for the all subjects. Results: In patients with stomach cancer after operation, only two domains, physical and independence, were associated with worse quality of life. In those domains, patients with advanced stage, with total gastrectomy, with adjuvant chemotherapy, and early or late postoperative period ($\leqq$2 years or >5 years after operation), could be perceived of having a worse quality of life. Conclusion: Not only scientific objective success but also individual subjective perception of condition could be important for managing patients with stomach carcinomas after curative resection. In this context, the WHOQOL reflecting multi-dimensional state of well being could be a useful tool across a variety of cultural and value systems in the world.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.37-48
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• 2010

Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7407-7411
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• 2014

The incidence of urban female breast cancer has been continuously increasing over the past decade with unknown etiology. One hypothesis for this increase is carcinogen exposure from tobacco. Therefore, the objective of this study was to investigate the risk of urban female breast cancer from tobacco smoke exposure. The matched case control study was conducted among Thai females, aged 17-76 years and living in Bangkok or its surrounding areas. A total of 444 pairs of cases and controls were recruited from the Thai National Cancer Institute. Cases were newly diagnosed and histologically confirmed as breast cancer while controls were selected from healthy women who visited a patient, matched by age ${\pm}5$ years. After obtaining informed consent, tobacco smoke exposure data and information on other potential risk factors were collected by interview. The analysis was performed by conditional logistic regression, and presented with odds ratio (ORs) and 95% confidence intervals(CI). From all subjects, 3.8% of cases and 3.4% of controls were active smokers while 11.0% of cases and 6.1% of controls were passive smokers. The highest to lowest sources of passive tobacco smoke were from spouses (40.8%), the workplace (36.8%) and public areas (26.3%), respectively. After adjusting for other potential risk factors or confounders, females with frequent low-dose passive smoke exposure (${\leq}7$ hours per week) from a spouse or workplace had adjusted odds ratio 3.77 (95%CI=1.11-12.82) and 4.02 (95%CI=1.04-15.50) higher risk of breast cancer compared with non-smokers, respectively. However, this study did not find any association of breast cancer risk in high dose passive tobacco smoke exposure, or a dose response relationship in cumulative passive tobacco smoke exposure per week, or in the active smoker group. In conclusion, passive smoke exposure may be one important risk factor of urban female breast cancer, particularly, from a spouse or workplace. This risk factor highlights the importance of avoiding tobacco smoke exposure as a key measure for breast cancer prevention and control.

• Korean Journal of Applied Biomechanics
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• v.26 no.3
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• pp.285-292
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• 2016

Objective: This study collected data on muscle fatigue and ground reaction force during walking to provide a basis for development of custom-fitted outdoor walking shoes. The study analyzed an upright body exercise program using spine stabilization technique to determine the effect on foot plantar pressure in archers, demonstrate the effectiveness of upright body exercise, and develop a new, effective, and efficient training program. Method: A 12-week upright body exercise program was evaluated for the effect on plantar pressure in archers. Ten prize-winning archers (3 men, 7 women) in B metropolitan city, each with ${\geq}10years$ of experience, were given an explanation of the content and purpose of the program, and provided informed consent. Upright body exercise was performed 3 times a week for 12 weeks. A resistive pressure sensor was used to measure foot plantar pressure distribution and analyze quantitative information on variation in postural stability and weight shifting in dynamic balance during shooting, as well as plantar pressure in static balance with the eyes open and closed. Results: There were no significant differences in foot plantar pressure before and after participation in the exercise program. There was no statistically significant difference in foot plantar pressure in static balance with the eyes open or closed, or in foot plantar pressure in dynamic balance during shooting. Conclusion: An upright body exercise program had positive effects on foot plantar pressure in static and dynamic balance in archers by reducing body sway and physical imbalance during shooting and with eyes closed. This program is expected to help archers improve their posture and psychological state, and thereby improve performance.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.117-123
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• 2011

Purpose : We investigated the change of antibody titer to measles, mumps and rubella according to age after vaccination. Methods : The IgG antibody titers to measles, mumps and rubella were tested on the residual serum from patients aged 7-20 years old after routine laboratory testing in the hospital with informed consent from the parents. Results : Antibody to measles was present in 275 cases out of 408 cases with a positive rate of 67.4%, the mean IgG titer was 2.77${\pm}$1.18 Index. Antibody to mumps was present in 112 cases out of 408 cases with a positive rate of 27.5%, the mean IgG titer was 2.08${\pm}$1.29 Index. Antibody to rubella was present in 367 cases out of 408 cases with a positive rate of 90.0%, the mean IgG titer was 60.46${\pm}$63.47 IU/mL. Conclusion : It is important to maintain a high rate of vaccination coverage in order to prevent an outbreak of measles, mumps, or rubella. It is also important to stress the maintenance of vaccination records for further reference.

• Journal of Oriental Neuropsychiatry
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• v.30 no.2
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• pp.59-69
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• 2019

Objectives: Case report is a description of medical experience that contains a patient's information and treatments. It has been used to determine the effectiveness and side effect of the treatments. Case report can be used for medical, scientific, or educational purposes. The objective of this study was to evaluate the quality of case reports published in Journal of Oriental Neuropsychiatry from 2013 to 2017 using CARE and CARES guideline. Methods: Case reports were selected from Journal of Oriental Neuropsychiatry and their quality assessed using CARE guideline and CARES guideline. The items of CARE and CARES guideline were assessed as 'Sufficient', 'Not sufficient', 'Not reported', 'Not applicable'. The outcome was analyzed using case reports and items. Results: 26 case reports were selected. For CARE guideline, 'Sufficient' percentage was min at 22.2%, max at 46.4% with a median of 39.3%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 59.3%, max at 85.7% with a median of 75.0%. Items 'Timeline', 'Diagnostic assessment', 'Follow up and outcomes', 'Informed consent' were not reported in more than 50% of all case reports. Items 'Keywords', 'Abstract', 'Introduction', 'patient information', 'Diagnostic assessment', 'Therapeutic interventions', 'Follow up and outcomes' were not sufficiently reported in more than 50% of all case reports. For CARES guideline, 'Sufficient' percentage was min at 0%, max at 50% with a median of 0%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 33.3%, max at 100% with a median of 92.9%. Items of herbal prescription 'herb', 'decoction', 'use', items of acupuncture treatment 'materials', 'techniques', items of moxibustion treatment 'materials', 'techniques' were not sufficiently reported in more than 50% of all case reports. Conclusions: The reporting rate of items was good. But the quality of reporting was low. Also, particular items were not reported frequently. Therefore, there is a need to improve the quality of case reports in Journal of Oriental Neuropsychiatry.

• PNF and Movement
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• v.10 no.1
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• pp.61-70
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• 2012

Purpose : The purpose of this study was to investigate thigh muscle-bone CSA and leg strength during low-intensity exercise program with leg blood flow restriction by external compression to reduce muscle outflow. Methods : Eighteen health students gave informed written consent to participate in this investigation. An occlusion cuff was attached to the proximal end of the leg so that blood flow was reduced during the training. The training was conducted one times a day, three times a week, for 8 weeks using one sets of 30 minutes. The training program performed to squat with standing, lunge with standing and heel raise with one leg standing. Measurements of thigh muscle-bone CSA(cross-sectional area) and leg strength were evaluated pre and post-training. Statistical evaluation of these data was accomplished utilizing a paired t-test by SPSS 12.0 program for windows. Significance level was set at p <.05. Results : All data are reported as means and standard deviations(SD) for all variables. The result of the study is followed; After the training, muscle-bone CSA, gluteus maximus m, quadriceps m, hamstring m of both legs were significantly improved but not calf muscle(p<.05). There was no significant difference of change quantity between muscle-bone CSA and leg strength in Lt. and Rt. side. But the variation in leg muscle strength of Rt. leg(dominant) was much more increased than Lt. leg(non-dominant) after 8 weeks training. Conclusion : Low-intensity training with leg blood flow restriction offers a potentially useful method for improving leg muscle strength.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.216-225
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• 2023

Background: Tuberculosis (TB)-related stigma has been well-documented. Since the emergence of the coronavirus disease 2019 (COVID-19), different organizations have been alerted to the fact that stigma could arise again. Due to stigma's negative effects, this qualitative study aimed to explore the stigma felt by patients by evaluating the following: COVID-19 stigma and its temporal progression through the pandemic; stigma perceived by different patients with TB before and during COVID-19 pandemic; and difference perceived by individuals who contracted both diseases. Methods: A semi-structured interview was developed according to the available literature on the theme. It was performed individually in 2022 upon receiving signed informed consent. Participants were recruited with a purposive sampling approach by searching medical records. Those who currently or previously had pulmonary TB and/or COVID-19 were included. Data were subjected to thematic analysis. Results: Nine patients were interviewed, including six (66.7%) females. The median age of patients was 51±14.7 years. Four participants (44.4%) had completed high school and four (44.4%) were never smokers. Three had both TB and COVID-19. Four only had TB and two only had COVID-19. Interviews identified eight main themes: knowledge and beliefs, with several misconceptions identified; attitudes towards the disease, varying from social support to exclusion; knowledge and education, assumed as of extreme importance; internalized stigma, with self-rejection; experienced stigma, with discrimination episodes; anticipated stigma, modifying actions for avoiding stigma; perceived stigma, with judgment by others prevailed; and temporal evolution of stigma. Conclusion: Individuals expressed strong stigma for both diseases. De-stigmatization of respiratory infectious diseases is crucial for limiting stigma's negative impact.