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A Survey on Treatment Trend for Allergic Rhinitis in Korean Medicine Clinic (알레르기 비염의 한의 진료 현황 설문조사)

  • Kim, Young-Eun;Jeong, Ui-Min;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.4
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    • pp.75-96
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    • 2017
  • Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

Evaluation of the Quality of Case Reports in Journal of Oriental Neuropsychiatry Using CARES Guideline (CARES 지침에 따른 동의신경정신과학회지의 증례보고에 대한 질 평가 연구)

  • Lee, Hwan Seong;Lee, Junyeop;Han, Ji Han;Chae, Han
    • 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.

Medication Use and Drug Expenditure in Inflammatory Bowel Disease: based on Korean National Health Insurance Claims Data (2010-2014) (국내 염증성장질환의 약물치료 및 약제비 현황: 2010-2014 국민건강보험자료 활용 연구)

  • Ha, Jung Eun;Jang, Eun Jin;Im, Seul Gi;Sohn, Hyun Soon
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.79-88
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    • 2019
  • Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

A Case Report of Treating Developmental Abnormality Child by Cerebral Palsy with Korean Medical Treatment (뇌성마비로 인한 발육이상 아동 한방치료 1례)

  • Seul Woo, Leem;Jang Hyeon, Jo;Jin Yub, Kim;Jung Ki, Shin;Dong Lim, Ha;Jun Hyung, Kim;Na Yeon, Hur;Hong Jun, Kim
    • Herbal Formula Science
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    • v.30 no.4
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    • pp.339-349
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    • 2022
  • Objectives : The purpose of this study is to report one case of Korean medical treatment of patient with developmental abnormality by cerebral palsy whose main symptoms are difference in left and right leg length, foot size and construction of right ankle. Methods : We did retrospective study for one developmental abnormality patient who had been treated by herbal medicine(Samul-tang, Yookmijihwang-tang hap Yijin-tang + Sungjang-hwan), acupuncture, and moxibustion for more than one year. The effects of treatment were evaluated by measurement of leg length, foot size and dorsiflexion ROM. Results : After treatment, length and foot size difference between both leg, ROM difference between both ankle were almost reduced. According to the ratio of the right to the left, leg length was improved from 0.91 to 0.98 and foot size was improved from 0.93 to 0.98. The difference in left and right ankle dorsiflexion ROM was improved from 55° to 27.5°. Conclusions : This clinical case study has demonstrated that Korean medicine may be an safe and effective option for treating developmental abnormality.

Treatment of central diabetes insipidus with anemia in a dog

  • Kim, Sol;Lee, Han Joon;Seo, Kyoung Won;Song, Kun-Ho
    • Korean Journal of Veterinary Service
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    • v.45 no.2
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    • pp.139-143
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    • 2022
  • A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

Three Cases of Postpartum Hyperhidrosis Patients Treated with Korean Medical Treatment Including Sanhuhyulpung-tang (산후혈풍탕을 포함한 한방치료로 호전된 산후다한 치험 3례)

  • Hyo-Won Yun;Deok-Sang Hwang;Chang-Hoon Lee;Jun-Bock Jang;Jin-Moo Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.3
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    • pp.211-225
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    • 2023
  • Objectives: The purpose of this study is to report the effects of Korean medical treatment including Sanhuhyulpung-tang on three postpartum patients who suffered from hyperhidrosis. Methods: We treated three patients complained of postpartum symptoms including hyperhidrosis. The patients were treated by Traditional Korean Medicine including herbal medicine, acupuncture, moxibustion, and cupping therapy. Sanhuhyulpung-tang is a herbal medicine prescription which is used in clinical practice for the treatment of postpartum sweating, anxiety, flushing, and joint pain. Three patients were hospitalized for treatment for 6, 8, and 19 days respectively. During hospitalization, patients took Sanhuhyulpung-tang three times a day, and acupuncture, moxibustion, and cupping were performed once a day. To evaluate the degree of improvement, we used VAS score of the patient's chief complaint during hospitalization. Results: After the treatment, symptoms including hyperhidrosis were improved. The degree of excessive sweating decreased to 30% in two patients, and 55% in one patient. Combined symptoms including lower coldness, burning sensation, chilling, and multiple site pain also improved on discharge day. Conclusions: This case report shows that Korean medicine treatment including Sanhuhyulpung-tang can improve postpartum symptoms including hyperhidrosis.

Therapeutic Duplication as a Medication Error Risk in Fixed-Dose Combination Drugs for Dyslipidemia: A Nationwide Study

  • Wonbin Choi;Hyunji Koo;Kyeong Hye Jeong;Eunyoung Kim;Seung-Hun You;Min-Taek Lee;Sun-Young Jung
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.168-177
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    • 2023
  • Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

Long-term Results of Gamma Knife Radiosurgery for Craniopharyngioma (두개인두종의 감마나이프 치료 후 장기 추적 결과)

  • Kim, Yun Sok;Lee, Do Heui;Ra, Dong Suk;Chun, Young Il;Ahn, Jae Sung;Jeon, Sang Ryong;Kim, Jeong Hoon;Roh, Sung Woo;Ra, Young Shin;Kim, Chang Jin;Kwon, Yang;Rhim, Seung Chul;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.289-293
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    • 2001
  • Objectives : The optimal treatment of craniopharyngioma is controversial. Despite recent advances in microsurgical management, complete surgical removal of craniopharyngioma remains very difficult. Radiation added to surgery is effective, but radiation therapy resulted in untoward side effect in young patient. Gamma knife radiosurgery offers the theoretical advantage of a reduced radiation dose to surrounding structures during the treatment of residual or recurrent craniopharyngioma compared with fractionated radiotheraphy. We described retrospective analysis of tumor size and clinical symptoms of patients after gamma knife radiosurgery in residual or recurrent craniopharyngioma were performed. Material and Methods : From September 1990 to January 2000, 18 patients of craniopharyngioma were treated by gamma knife radiosurgery. All patient had undergone surgery, but residual or recurrent tumor was found and all of them treated postoperative gamma knife radiosurgery. The mean age was 19(from 6 to 66) and male to female ratio was 10 to 8 and 8 patients were below 15 years old. In young age group(below age 15), the average volume of the tumor was $2904.8mm^3$ and mean maximal gamma knife dose was 34.9Gy. In old age group(older than 15), the average volume of the tumor was $2590.4mm^3$ and mean maximal gamma knife dose was 45.2Gy. The size of the tumor was average $2730.1mm^3$($88-12000mm^3$), mean average radiation dose was 40.7Gy and the mean prescription dose was 17.6 Gy(4-35Gy) delivered to a median prescription 50.7% isodose. Results : The follow up was from 1 year to 9 years(mean 59.1 months) after gamma knife radiosurgery. The tumor was controlled in 13(72.2%) patients. The tumor decreased in 9 patients and not changed in 4 patients. The tumor size increased in 4(22.2%) patients during follow up period. In two cases the tumor size increased because of its cystic portion was increased, but their solid portion of the tumor was not changed. In another two patients, the solid portion of the tumor was increased. So, one patient underwent reoperation and the other patient underwent operation and repeated gamma knife radiosurgery. The tumor recurred in one case(5.6%) that is a outside of irradiated site. The presenting symptoms were improved in 4 patients(improved visual acuity in 1, controlled increased intracranial presure sign in 3 patients). In one case, visual acuity decreased after gamma knife radiosurgery. The endocrine symptoms were not influenced by gamma knife radiosurgery. Conclusion : Craniopharyngioma can be treated successfully by gamma knife radiosurgery. Causes of the tumor regrowth are inadequate dose planning because of postoperatively poor margination of the tumor, close approximation of optic nerve and residual tumors outside the target lesion. Recurrence can develop 4 years after gamma knife radiosurgery. Volume is important, but the accurate targeting is more important to prevent tumor recurrence. If the tumor definition is not clear during planning gamma knife surgery, long-term image follow up is required.

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Assesment of Absorbed Dose of Organs in Human Body by Cone Beam Computed Tomography using Monte Carlo Method (몬테칼로 기법을 이용한 CBCT의 인체 내 장기의 흡수선량 평가)

  • Kim, Jong-Bo;Im, In-Chul;Park, Eun-Tae
    • Journal of radiological science and technology
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    • v.41 no.3
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    • pp.215-221
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    • 2018
  • Cone beam Computed Tomography(CBCT) is an increasing trend in clinical applications due to its ability to increase the accuracy of radiation therapy. However, this leaded to an increase in exposure dose. In this study, the simulation using Monte Carlo method is performed and the absorbed dose of CBCT is analyzed and standardized data is presented. First, after simulating the CBCT, the photon spectrum was analyzed to secure the reliability and the absorbed dose of the tissue in the human body was evaluated using the MIRD phantom. Compared with SRS-78, the photon spectrum of CBCT showed similar tendency, and the average absorbed dose of MIRD phantom was 8.12 ~ 25.88 mGy depending on the body site. This is about 1% of prescription dose, but dose management will be needed to minimize patient side effects and normal tissue damage.

The Role of Community Health Nurse in Assay Written by a Nurse Practitioner of Primary Health Care Post (일 보건진료소장의 수필에 나타난 지역사회간호사의 역할)

  • Chin, Young Ran;Kim, Hyun
    • Journal of Korean Public Health Nursing
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    • v.30 no.2
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    • pp.300-310
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    • 2016
  • Purpose: The purpose of this study was to understand the role of community health nurse through a nurse practitioner of primary health care post. Methods: An assay, 'Even if we were allowed to look at', written by a nurse practitioner of primary health care post was analyzed with the contents analysis method. Results: In the assay, we checked the following roles: client-oriented, delivery-oriented, and population-oriented roles described and classified by Clark. In particular, direct care such as in-patient care, home visiting nursing care, and drug prescription was frequently performed. Moreover, community health nurse has been listening, counselling, expressing sympathy, and advocating vulnerable elderly people economically and psychologically. Conclusion: The assay gave us a better understanding of the role of community health nurse, and we need more assays delineating the role of community health nurse in others setting as well primary health care post.