• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.2
• /
• pp.563-568
• /
• 2016

Background: Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. Purpose: The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. Materials and Methods: A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Results: Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (${\leq}46$) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.16
• /
• pp.6945-6948
• /
• 2014

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.3
• /
• pp.1327-1331
• /
• 2014

Background: Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors. Materials and Methods: One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer. Results: The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05). Conclusions: Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.6
• /
• pp.2577-2581
• /
• 2014

Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7409-7414
• /
• 2013

Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7301-7307
• /
• 2013

Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. Materials and Methods: An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. Results: Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. Conclusions: Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.

• The Journal of Korean Medicine
• /
• v.37 no.3
• /
• pp.62-73
• /
• 2016

Objectives: Dropout and weight regain are common problems in most obesity treatments. The purpose of this study was to review previously published study results of the predictive factors associated with dropout during weight loss treatment and weight loss maintenance after successful weight loss. Methods: Authors searched for the articles related to dropout and weight loss maintenance, published from 2007 to 2016 found on Pubmed, Scopus, RISS, and KISS. A total of 19 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to dropout and weight loss maintenance categories. Results: The unchangeable predictors of dropout were younger age, lower education level and female, whereas the changeable predictors of dropout were lower initial weight loss, symptoms of depression and body dissatisfaction. The strongest factor for predicting the dropout was initial weight loss. The unchangeable predictors of weight loss maintenance were old age, male and family history of obesity, whereas the changeable predictors of weight loss maintenance were regular exercise, dietary restraint, self-weighing and low depressive symptoms. Initial weight loss, depressive symptoms, body image, dietary restraint, physical activity, weight loss expectation and social support were considered to be dominant factors for weight loss treatments. Conclusions: Our review results suggest that unchangeable and changeable predictors of dropout and weight loss maintenance should be carefully examined during treatments of obesity.

• The Journal of Korean Medicine
• /
• v.41 no.2
• /
• pp.80-95
• /
• 2020

Objectives: The purpose of this study is to assess the quality of the Journal of Korean medicine case reports. Methods: Case reports published in the Journal of Korean Medicine from January 2015 to March 2020 were selected by using Oriental Medicine Advanced Searching Integrated System (OASIS) and the journal search system of the Korean Medical Association (https://www.jkom.org). The quality of the case reports was assessed using the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines. Results: 33 case reports were selected for the assessment. Based on the CARE guidelines, 61.54% of the case reports included necessary information, but the quality level was uneven. More than 60% of the reports were missing data regarding 'Discussion of the strengths and limitations in your approach to this case', 'Intervention adherence and tolerability', 'Timeline', 'Medical, family, and psychosocial history including relevant genetic information', 'Patient perspective or experience', 'Adverse and unanticipated events', 'Administration of intervention', and 'De-identified demographic information and other patient specific information'. In most reports of over 90%, data regarding 'Diagnostic challenges', 'Intervention adherence and tolerability', and 'Key word' were not included. Conclusions: Efforts are needed to improve the quality of case reports in the Journal of Korean Medicine, and it is necessary to develop appropriate guidelines for case reporting for the Journal of Korean Medicine. In addition, all articles submitted to the Journal of Korean Medicine are to be complied with submission instructions and CARE guidelines.

• Nutrition Research and Practice
• /
• v.1 no.4
• /
• pp.321-327
• /
• 2007

The purpose of this study was to assess the relationship between the mother's interest in weight control and its association with the preschooler's obesity and weight related concerns. This was a cross-sectional study based on 470 parents' self-reports. To score interests in weight control, mothers rated each of 6 items on a five-point Likert scale ranging from disagree (1) to agree (5). The perceptions of mothers' weights and their children's weights, mothers' Body Mass Index (BMI), preschoolers' Weight-Length Index (WLI) (%), and weight-related concerns were determined. The mothers' BMI was significantly correlated with interest scores of weight control in mothers (r=0.632, p<0.001) while their children's obesity was weakly correlated with the mothers' interest scores (r=0.133, p=0.025). Mothers with a high interest of weight control reported higher percentages of family history of obesity than mothers with lower interests (63.2% vs. 36.8%, p<0.001). Two-thirds of the mothers (65.4%) were accurate in their perceptions about their weights. Similarly, 63.7% of mothers knew exactly their children's weight-statuses. Compared with mothers with low interest in weight controls, mothers with high interest in weight control had lower correct-perceptions about their weights (p<0.05) but higher correct-perceptions about their children's weights. More than two-thirds of mothers (85%) reported not worrying about their children's obesity in the future. Only 14.3% of the mothers were satisfied with their current weight statuses. Three-fourths of mothers preferred exercise as an effective weight-control method for their children, 20% preferred diet therapy and 5.5% preferred behavior modification. More girls were overweight / obese, than boys (overweight: 16.1% (girl) vs. 12.8% (boy), obese: 5.4% (girl) vs. 4.5% (boy)). About 40% of overweight girls' mothers had low interests in their weight controls with low correct-perceptions in their children's weights, which suggests possible elevated risk of obesity, especially in girls, in the future.

• The Journal of the Korea Contents Association
• /
• v.7 no.10
• /
• pp.321-329
• /
• 2007

The form of travel has been changing to dynamic, experience and family. Festivals are popular, specially the historic culture festivals, whose themes are a history event, a time and the people, are preferred to families because they give visitors opportunities of education and experience. Evaluation of festivals is important that it diagnoses the problems and enhancement One of the evaluation methods, Importance-Performance Analysis is useful which it is easy to find priority with visual matrix without complex statistical technique and a technical terminology. This research used IPA to evaluate The Yeoncheon Jeongok Paleolithic Festival which is one of the popular historic culture festivals. From the result 'unique food', 'rest facility', 'other convenience facility', 'hygiene', 'crowding' were included in selected to 'concentrate' territory of the IPA matrix. Therefor the festival manager should put his efforts to develop unique food, build more rest and other convenience facilities, enhance hygiene, and lowered crowding.