Program evaluation of postgraduate obstetrics and gynecology training in Lao people's democratic republic - using the CIPP model.

BACKGROUND: The obstetrics and gynaecology (OB-GYN) residency training program in Lao People's Democratic Republic (PDR) began in 2003 based on the Millennium Development Goals (MDGs) and 'Reproductive, maternal, newborn, and child health interventions (RMNCH) strategies and action plan'. However, the training program had not been properly evaluated previously. The purpose of this study is to evaluate the current postgraduate OB-GYN residency training program in Lao PDR by using CIPP model to identify the current problems (the strengths and weaknesses) and suggest a future plan to promote continuous improvement. METHOD: The context, input, process, and product classification (CIPP) model was used to develop criteria and indicators. A mixed-methods approach was used for this study. To capture instructional material for quantitative analysis, a Google survey with 38 items and a t-test were used to determine a significant difference in responses between residents and lecturers (N = 120). Based on qualitative analysis, an in-depth interview was done (four questions based on study outcomes, including satisfaction, strengths and weaknesses, and future opportunities), and six interviews provided different viewpoints on the course. The SPSS software program was used to measure validity, with p-values = 0.05. RESULTS: The overall average response rate was 97.5%. Two significant differences in program perspectives were revealed between lecturers and residents, difficulties in maintaining the course (professors 3.66 ± 1.03 and residents 3.27 ± 0.98, p = 0.04) and learning outcomes achieved (professors 3.57 ± 0.85 and residents 3.14 ± 0.95, p = 0.01 The overall average for the context part of the questionnaire was under 3.00, with the lowest scores for overlapped learning outcomes and difficulties in maintaining the course. The input part, lack of the classroom, skills lab and staff; the process part, lecturer to collect student opinions and the product part on learning outcomes. CONCLUSION: Curriculum improvement based on the program evaluation results, including regular evaluation and feedback, will advance the residency training program based on the RMNCH strategy and contribute to the promotion of maternal health in the Lao PDR.

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea.

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

Lifestage Sex-Specific Genetic Effects on Metabolic Disorders in an Adult Population in Korea: The Korean Genome and Epidemiology Study.

Although many genome-wide association studies (GWASs) have evaluated the association with metabolic disorders, the current study is the first attempt to analyze the genetic risk factors for various metabolic disorders according to sex and age groups of the life course in Korean adults. A total population of 50,808 people were included in this GWAS. The genetic traits for eight metabolic phenotypes were investigated in peri-, and postmenopausal women compared to a younger group or men of corresponding age groups. The metabolic phenotypes include general obesity, abdominal obesity, hypertension, type 2 diabetes, hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein cholesterolemia, and metabolic syndrome. In the total participants, GWAS results for eight metabolic phenotypes found 101 significant loci. Of these, 15 loci were the first reported to be associated with the risk of metabolic disorder. Interestingly, some of the significant loci presented the association with the various phenotypes, which presented when there was a correlation between phenotypes. In addition, we analyzed divided by gender and age (young adult, peri-menopausal group, older adult), and specifically identified specific loci in peri-menopausal women. Meanwhile, several genetic factors associated with metabolic disorders were newly reported in our study. In particular, several genes were significantly associated with one of the metabolic phenotypes in only a single specific group. These findings suggest that menopausal transition rather than aging itself potentiates the influence of genetic risks on metabolic disorders. In addition, some genetic loci with low frequencies may play a role in the metabolic disturbances in a specific sex and age group. The genetic traits derived from our study may contribute to understanding the genetic risk factors for metabolic disorders in the Korean population.

Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data.

Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.

Serum leptin level and incidence of CKD: a longitudinal study of adult enrolled in the Korean genome and epidemiology study(KoGES).

BACKGROUND: Chronic kidney disease(CKD) is a major public health issue and is highly prevalent in the general population. Leptin is an adipose tissue-derived endocrine factor that has been associated with several metabolic factors involved in cardiovascular diseases. Several studies have investigated the association between leptin and renal diseases so far. But the results are conflicting between the studies. The objective of our study was to verify the direct association of serum leptin level with CKD development. METHODS: This prospective cohort study included 2646 adult aged 40-70 without CKD in the Korean Genome and Epidemiology Study(KoGES) across South Korea from November 2005 to February 2012. The primary outcome was the development of CKD as defined by National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI). Multivariate stepwise logistic regression analysis was done to assess the independent associations, for with the incident of CKD as the dependent variable, in tertiles of leptin values. RESULTS: Among 1100 men and 1546 women with 2.8 mean years of follow-up, incidence of CKD was 18(1.63%) for men and 50(3.23%) for women. In the multivariate logistic regression models, individuals in the highest serum leptin tertile showed significant associations with risk of CKD after adjustment compared to the lowest tertiles in the population. The crude odds ratio for trend was 2.95(p = 0.004) for men. After adjusting for age, baseline eGFR variables showed correlation with statistical significance (OR for trend = 2.25, p = 0.037) for men. The same trends were also seen observed in all population and women also, but no statistical significance was found. CONCLUSIONS: Higher plasma leptin levels are associated with the incidence of CKD, independent of traditional factors such as age, baseline eGFR. Our results suggest that leptin may partly explain part of the reported association between obesity and kidney disease.

Genome-wide association of individual vulnerability with alcohol-associated liver disease: A Korean genome and epidemiology study.

BACKGROUND AND AIMS: The quantity of alcohol leading to alcohol-associated liver disease (ALD) varies individually. Genetic backgrounds contributing to the divergence in individual susceptibility to alcohol-induced liver damage have not been elucidated in detail. APPROACH AND RESULTS: Based on the Korean Genome and Epidemiology Study Health Examination (KoGES_HEXA) cohort data, 21,919 participants (40-79 years old) were included and divided into cases and controls based on the ALD diagnostic criteria proposed by the American College of Gastroenterology. Data generated by a genome wide-association study were analyzed using logistic regression to assess the risk of ALD development in nondrinkers, light drinkers, and heavy drinkers. We detected three loci, gamma-glutamyltransferase 1 (GGT1), zinc protein finger 827 (ZNF827) and HNF1 homeobox A (HNF1A), which were significantly associated with ALD risk. The GGT1 rs2006227 minor allele was strongly associated with all groups. Among the minor alleles of single nucleotide polymorphisms (SNPs) in HNF1A, rs1183910 had the strongest association with a protective effect from ALD in light drinkers. However, this association was not observed in heavy drinkers. Five SNPs on chromosome 11 showed suggestive significance in protective effects against ALD. CONCLUSIONS: SNPs, including HNF1A rs1183910 minor allele, are the most promising genetic candidates for protection against ALD. The expression of genes contributing to ALD development may be altered by the amount of alcohol consumed.

Potentially inappropriate prescribing of cardiovascular system and antiplatelet/anticoagulant drugs among elderly patients: a Korean population-based national study.

OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) for cardiovascular system (CVS) and antiplatelet/anticoagulant (AP/AC) drugs among Korean elderly patients, using the Screening Tool of Older Persons' Prescriptions (STOPP) criteria version 2 and to identify the risk factors related to PIP. METHODS: The 2016 National Aged Patient Sample data, comprising National Health Insurance claim records for a random sample of 20% of patients aged ≥ 65 years, were used to calculate PIP prevalence of outpatient prescriptions. For criteria including drug-disease interactions, PIP prevalence per indication was estimated. RESULTS: Among 1,274,148 elderly patients and 27,062,307 outpatient prescription claims, 100,085 patients (7.85%) and 341,664 claims (1.27%) had one or more PIP. The most frequent PIP was "non-steroidal anti-inflammatory drug with concurrent antiplatelet agent (s) without proton-pump inhibitor prophylaxis" in the claim-level (0.97%) and patient-level (6.33%) analyses. "Beta-blocker with bradycardia" (16.47% of claims) and "angiotensin receptor blockers in patients with hyperkalaemia" (23.89% of claims) showed the highest PIP prevalence per indication. Logistic regression analysis revealed that, among the patient and health care provider characteristics, female, older age, more severe comorbidities, polypharmacy, higher level of healthcare organization, and specialty of prescriber were significantly associated with a higher risk of PIP. CONCLUSIONS: Our findings of a high prevalence of PIP for CVS and AP/AC drugs among the elderly suggest that an effective strategy is urgently needed to improve the prescription practices of these drugs.

Interprofessional education program for medical and nursing students: interprofessional versus uniprofessional.

PURPOSE: This study determined the effects of interprofessional education (IPE) on self-efficacy and attitude by comparing an interprofessional (IP) group of medical students (MSs) and nursing students (NSs) and a uniprofessional (UP) group of MSs. METHODS: An experimental IP group consisting of 49 MSs and 62 NSs was selected, alongside a UP control group of 48 other MSs. The groups participated in a class titled "Team Communication and Interprofessional Collaboration." A sub-analysis of the two groups' professions was also conducted. The groups participated in the same lesson separately, with a week's interval. The Interprofessional Attitudes Scale (IPAS) and the Self-Efficacy Perception for Interprofessional Experiential Learning (SEIEL) scale were used before and after the class to compare changes in reports of self-efficacy and attitudes in both groups. Students' responses to learning experiences and satisfaction were also evaluated. RESULTS: IPAS and SEIEL values increased after the class for MSs in both groups; there were no differences between the groups. IPAS and SEIEL values increased after the class in MSs and NSs in the IP group, and the effect size for IPAS was larger for IP-group NSs than for IP-group MSs. Satisfaction scores exceeded 3.70 in both groups. CONCLUSION: The UP group showed similar IPE effects as the IP group, as measured by SEIEL and IPAS, in a single IPE program that used role-play and case-based discussion. However, it would be desirable for the UP group to interact with other professions to improve understanding and experience.

Development of a mobile-based self-management health alarm program for obese children in South Korea and a test of its feasibility for metabolic outcomes: A study based on the information-motivation-behavioral skills model.

PURPOSE: This study aimed to develop a mobile-based self-management health alarm (MSHA) program for modifying obese children's lifestyle based on the information-motivation-behavioral skills (IMB) model and to test its feasibility. METHODS: A methodological study for the development of the MSHA program and pilot study with a one-group pretest-posttest design for feasibility testing was conducted. The MSHA program was designed to provide obesity-related information (I), monitor daily diet and exercise, provide motivational text messages (M), and enhance healthy diet and exercise skills (B) via a mobile-based web platform. In the feasibility test, six obese children participated in the 4-week program, and the number of days per week that they achieved their goals and differences in metabolic components were assessed. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. RESULTS: Participants successfully achieved their diet and exercise goals ≥ 5 days per week. Body mass index (z=-1.99, p=.046), waist circumference (z=-2.20, p=.028), and triglyceride levels (z=-2.21, p=.027) significantly decreased. CONCLUSION: The MSHA program showed positive effects on health behaviors and metabolic syndrome risk. The program may be effective in improving metabolic syndrome in obese children by promoting self-health management behaviors.

Longitudinal Observation of Muscle Mass over 10 Years According to Serum Calcium Levels and Calcium Intake among Korean Adults Aged 50 and Older: The Korean Genome and Epidemiology Study.

The aim of this study was to investigate the longitudinal change in muscle mass over 10 years according to serum calcium levels and calcium intake. A total of 1497 men and 1845 women aged 50 years and older were included. Significant muscle loss (SML) was defined as a 5% or greater loss from baseline, while time-dependent development of SML was assessed according to quartiles for corrected calcium level and daily calcium intake using Cox regression models. The incidence of SML was 6.7 and 7.7 per 100-person-years among men and women, respectively. Groups with the lowest corrected calcium levels had more prominent SML than those with higher calcium levels, regardless of sex. The relationship between SML and calcium intake was significant only among women. The hazard ratio for SML per 1 mmol/L increase in corrected calcium level was 0.236 and 0.237 for men and women, respectively. In conclusion, low serum calcium levels may predict SML among adults aged ≥ 50 years, while low calcium intake may be a predictor for muscle loss among women. Therefore, encouraging dietary calcium intake among middle-aged and older adults for preservation of muscle mass should be considered.

Association Between Duration of Reproductive Years and Metabolic Syndrome.

BACKGROUND: The incidence of metabolic syndrome (MetS) has gradually increased in recent years. MetS has been associated with age at menarche and menopause; however, the association between MetS and the reproductive span remains unclear. MATERIALS AND METHODS: This study examined MetS and the reproductive span among 1,214 participants of the 2014 Korea National Health and Nutrition Examination Surveys, a stratified, complex, multistage, probability cluster survey conducted by the Division of Chronic Disease Surveillance of the Korea Center for Disease Control and Prevention since 1998. MetS was defined by using the joint interim statement of the International Diabetes Federation; National Heart, Lung, and Blood Institute; and American Heart Association. The reproductive span or duration of reproductive years was calculated from age at menarche to age at menopause for postmenopausal women. RESULTS: The prevalence of MetS in this study was 36% (437 of 1,214). In multivariate analysis adjusted for age, longer reproductive years were associated with a higher prevalence of MetS (odds ratio [OR] 1.059, 95% confidence interval [CI] 1.055-1.063). However, after adjusting for covariates (age, residential area, income, dyslipidemia medication, education, current smoking, regular exercise, alcohol consumption, body mass index, years after menopause, aspartate aminotransferase, alanine aminotransferase, and white and red blood cell counts), longer reproductive years were associated with a lower prevalence of MetS (OR 0.751, 95% CI 0.745-0.747). CONCLUSION: Longer reproductive years were significantly associated with a decreased prevalence of MetS.

Inverse relationship between vitamin D levels and platelet indices in Korean adults.

BACKGROUND AND AIMS: Vitamin D deficiency and increased platelet indices are associated with increased rate or risk of several diseases such as cardiovascular disease and metabolic syndrome, respectively. We investigated whether vitamin D deficiency is associated with increased platelet count (PC) and mean platelet volume (MPV). METHODS AND RESULTS: The study included 3190 subjects older than 20 years. Subjects were divided into three groups based on their vitamin D levels: vitamin D deficiency (<10.0 ng/ml); insufficiency (10-20 ng/ml); and sufficiency (>20.0 ng/ml). The associations between platelet indices and various parameters were analyzed by Pearson's correlation analysis and t-tests. Then, multivariate linear regression analyses were done correcting for associated parameters. PC and MPV showed a negative correlation with vitamin D groups by ANOVA and multiple linear regression. PC was inversely related with vitamin D group after adjusting for sex, age, regular exercise, white blood cell count, total cholesterol, hemoglobin, and creatinine levels (ß ± SE = -3.461 ± 1.512, P = 0.022). MPV was also inversely related with vitamin D group after adjusting for regular exercise, hemoglobin level, and total cholesterol level (ß ± SE = -0.080 ± 0.026, P = 0.002), and this relationship remained statistically significant after adjusting for regular exercise, hemoglobin level, total cholesterol level, diabetes, hypertension, and body mass index (ß ± SE=-0.082 ± 0.026, P = 0.002). CONCLUSION: PC and MPV are inversely associated with vitamin D levels in adults.

Correction Equation for Estimation of Actual Potassium Concentration in Hemolyzed Specimen.

BACKGROUND: A spuriously elevated serum potassium value could possibly cause medical decision errors because it leads to masked hypokalemia or pseudohyperkalemia. The aim of this study was to develop a correction equation for falsely elevated potassium level caused by hemolysis. METHODS: A total of 988 samples with a hemolysis index (HI) value greater than the potassium alert HI value were recollected within two hours from initial collection. We divided 988 paired samples into 3 groups: hypokalemia, normal, and hyperkalemia. When samples were checked after recollection within 2 hours, 525 cases showed HI of 1. We analyzed the relationship between the delta of initial and recollected samples' HI values and the delta of initial and recollected samples' potassium levels, resulting in 5 different delta groups. RESULTS: The proportion of masked hypokalemia and pseudohyperkalemia was 17.6% (125/710) and 64.1% (139/217), respectively. The trend and distribution of potassium concentration for each of the 5 delta HI groups according to delta HI level showed an exponential curve. From this exponential curve function, a correction equation for estimation of true potassium concentration in hemolyzed specimens was calculated: measured potassium (-0.0561e 0.6578* delta HI + 0.0804). CONCLUSIONS: The clinical application of the correction equation for adjusting the hemolysis effect on potassium concentration could be useful for the detection of masked hypokalemia or pseudohyperkalemia.

Use of benzodiazepine and risk of cancer: A meta-analysis of observational studies.

Several observational epidemiological studies have reported inconsistent results on the association between the use of benzodiazepine and the risk of cancer. We investigated the association by using a meta-analysis. We searched PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in January 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Of 796 articles meeting our initial criteria, a total of 22 observational epidemiological studies with 18 case-control studies and 4 cohort studies were included in the final analysis. Benzodiazepine use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.19; 95% confidence interval 1.16-1.21) in a random-effects meta-analysis of all studies. Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study showed consistent findings. Also, a significant dose-response relationship was observed between the use of benzodiazepine and the risk of cancer (p for trend <0.01). The current meta-analysis of observational epidemiological studies suggests that benzodiazepine use is associated with an increased risk of cancer.

Longer Duration of Sleep and Risk of Cognitive Decline: A Meta-Analysis of Observational Studies.

BACKGROUND: Previous observational epidemiological studies have reported inconsistent findings about the association between longer durations of sleep and the risk of cognitive impairment and dementia. To investigate the association between longer durations of sleep and the risk of cognitive decline, we performed a meta-analysis of observational studies. METHODS: We searched PubMed, EMBASE, and the bibliographies of relevant articles to retrieve additional studies in July 2015. A total of 53,942 participants (mean age 66.9 years) were included in the final analysis. Three evaluators independently reviewed and selected articles, based on pre-determined selection criteria. RESULTS: Among a total of 695 articles, 10 observational epidemiological studies with 3 case-control studies and 7 cohort studies were included in the final analysis. Compared to the average sleep duration, the odds ratio or relative risk of the longest sleep duration was 1.42 (95% CI 1.27-1.59) for cognitive decline in the fixed-effect meta-analysis, 1.38 for cognitive impairment (95% CI 1.23-1.56), and 1.42 for dementia (95% CI 1.15-1.77). Subgroup meta-analyses by various factors such as study design, type of cognitive decline, gender, region, age, and methodological quality of study showed consistent findings. CONCLUSION: The current meta-analysis found that longer duration of sleep is associated with an increased risk of cognitive decline.

Habit of Eating Breakfast Is Associated with a Lower Risk of Hypertension.

BACKGROUND: The association between skipping breakfast and cardio-metabolic syndrome is well known. However, there are very few Korean studies about the habit of eating breakfast and hypertension. The present study aimed to investigate the relationship between the habit of eating breakfast and hypertension in a healthy Korean population. METHODS: Participants in the 2014 Korea National Health and Nutrition Examination Surveys (KNHANES) were enrolled for this study. Medical history, including hypertension, was measured using a 24-hour recall method. The habit of eating breakfast was estimated from self-reported questionnaires and was classified into two groups: the eating breakfast group, defined as those who ate breakfast more than 5 times per week, and the not eating breakfast group, defined as those who did not eat any breakfast for a week. RESULTS: The crude odds ratio of skipping breakfast for the prevalence of hypertension was 0.366. However, after adjusting for all considerable confounding factors (age, sex, regular exercise, current smoking, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and red blood cell counts), not eating breakfast was associated with a higher risk of HTN (OR = 1.065; 95% CI = 1.057-1.073; p-value < 0.001). CONCLUSION: The habit of eating breakfast was associated with a lower risk of hypertension among healthy Korean adults.

Delta neutrophil index discriminates true bacteremia from blood culture contamination.

BACKGROUND: Delta neutrophil index (DNI) has been reported to be useful in the diagnosis of sepsis. We evaluated the role of DNI for differentiating true bacteremia from blood contamination and compared the DNI value with previously validated markers such as procalcitonin (PCT) and C-reactive protein (CRP). METHODS: The blood culture positive group was subdivided into true bacteremia (n=199) and contamination (n=158). The blood cultures were incubated in the BacT/Alert 3D (bioMérieux, Marcyl'Etoile, France) and BACTEC FX (Becton Dickinson, Sparks, MD, USA) systems for 5days. Data of complete blood cell count were collected from an automatic cell analyzer (ADVIA2120 Hematology System, Siemens Healthcare Diagnostics) to calculate DNI. RESULTS: Concentrations for DNI, PCT, and CRP were significantly higher in the true bacteremia group. When the gram-positive and gram-negative infections were compared among true bacteremia, only PCT was increased significantly in GNB bacteremia. DNI levels were well correlated with PCT (r=0.564, P<0.0001) and CRP (r=0.344, P<0.001) using the Spearman test among the culture positive bacteremia. The area under the ROC curve was 0.75 for PCT, 0.69 for CRP, and 0.69 for DNI. CONCLUSIONS: We demonstrated the usefulness of DNI in differentiating true bacteremia from contamination in patients with a positive blood culture.

Correlation between Abnormal Pap Smear Finding and Brachial-ankle Pulse Wave Velocity in Korean Women.

BACKGROUND: Cervical cancer is caused by chronic human papilloma virus (HPV) infection. Pap smear is very efficient examination for early detecting cervical cancer. Inflammation reaction due to chronic infection is one of the major causes of atherosclerosis. Pulse wave velocity (PWV) is commonly used in predicting subclinical atherosclerosis. But no study was done about correlation between cervical cancer and PWV. METHODS: The research population, 1,779 people, had been chosen from the patients from Jan. 1st, 2008 to December 31st, 2010, visited health exam center who had done both PWV test and pap smear without any medical history of obstetrics and gynecological disease. The group was divided into two respective groups, 45 people with abnormal finding and 228 people with normal finding. The correlation was analyzed between risk factor of cervical cancer and brachial-ankle PWV. Multiple regression analysis was performed with associated variables. RESULTS: Average PWV of normal group was 1,313.06 ± 264.19 and 1,497.15 ± 359.58 was for abnormal. The PWV of abnormal group was statistically significant (p = 0.0006) with association between risk factors of cervical cancer and PWV, age, height, weight, income, gravidity. Multiple regression was done with correcting these variables. PWV was associated with abnormal Pap smear but result, were not found to be significant (p = 0.054). CONCLUSION: The result was not statistically confident but more mass studies are needed to correcting those limitation.