Burnout prevalence and associated factors in medical students in integrated modular curriculum: A cross-sectional study.

Objectives: The present study aimed to explore the prevalence of burnout syndrome and to find the association of burnout symptoms with sociodemographic factors in medical students. Methods: A cross-sectional study was conducted between September 2019 to January 2021 at Shifa College of Medicine, Islamabad. A total of 284 medical students from the first year to the fifth year participated in this cross-sectional study. After taking informed consent, students were asked to record responses on the Burnout Clinical Subtype Questionnaire BCSQ-12. In addition, a structured questionnaire was developed to obtain information about the sociodemographic status. Results: Prevalence of burnout was observed among day scholars, females, and students having a relatively sedentary lifestyle. Low family income showed a significant association of burnout in medical students (p=0.025). A significant association was found in the mean scores of neglect subtype of burnout with low family household income (p = 0.010). The mean scores of the overload subtype of burnout and daily duration of sleep also showed a significant association (p = 0.039). Conclusion: The prevalence of burnout was associated with low household income and sleep deprivation. Gender, academic year and physical activity did not have a significant association with burnout syndrome. The high prevalence of burnout syndrome necessitates appropriate interventions to identify and reduce the prevalence of burnout in medical students.

Association of postexercise heart rate recovery with body composition in healthy male adults: Findings from Pakistan.

BACKGROUND: This study investigated the effect of body mass index (BMI) and body fat ratio with postexercise heart rate recovery (HRR) after 2 minutes of rest. METHODS: Sixty-four healthy males aged between 25 and 55 years participated in the study. BMI, body fat ratio, waist circumference, and physical activity were recorded. Peak heart rate after exercise and HRR after 2 min of rest were obtained. RESULTS: Mean age of participants was 35.53 ± 6.57. Mean BMI and HRR were 25.06 ± 4.62 and 26.07 ± 7.43, respectively. BMI and body fat ratio had significant negative correlation with HRR with r values of -.833 and -.877, respectively (p < .001*). Linear regression showed BMI and body fat ratio with significant coefficient of -0.426 (p = .04*) and -0.627 (p < .001*) with HRR, respectively. Participants with BMI Ë‚ 25 had higher HRR in comparison to participants with BMI ≥ 25 (p < .001*). Participants with body fat ratio of ˂25 had significantly higher HRR of 35.9 ± 3.98 in comparison to participants with body fat ratio ≥ 25 (p = <.001*). CONCLUSION: Body mass index and body fat ratio are strong predictors of HRR in Pakistani healthy male adults, suggesting a strong link between metabolic risk factors and impaired autonomic nervous system.

Effects of Recombinant Irisin on Body Mass Index, Serum Insulin, Luteinizing Hormone and Testosterone Levels in Obese Female BALB/c Mice.

OBJECTIVE: To determine the effects of recombinant irisin on body mass index (BMI), serum insulin, luteinizing hormone (LH) and testosterone levels, and to correlate the serum insulin levels with serum luteinizing hormone and testosterone levels and to correlate the body mass index with serum insulin levels in obese female BALB/c mice. STUDY DESIGN: Laboratory-based experimental study. PLACE AND DURATION OF STUDY: Department of Physiology, Shifa College of Medicine, Islamabad in collaboration with Research Laboratory of Shifa College of Medicine, National Institute of Health (NIH) and Reproductive Physiology Laboratory, Quaid-e-Azam University, Islamabad, from March 2015 to September 2016. METHODOLOGY: Ninety female BALB/c mice were divided into three equal groups. Group A which was the control group was fed with normal chow diet. Group B and Group C were fed with high fat-high sucrose (HF-HS) diet for five weeks to induce obesity. After four weeks group C was divided into two subgroups. Group C-low dose (LD) was injected with low dose irisin and group C-High dose (HD) was injected with high dose irisin for one week. After five weeks, the BMI, serum insulin, LH and testosterone levels were measured in all the groups. Data was analysed by SPSS version 21. P-value of <0.05 was considered significant. RESULTS: Group B showed statistically significant elevation in BMI, serum insulin, LH and testosterone levels as compared to Group A (p <0.001, <0.001, 0.007 and 0.014, respectively). Group C-HD showed statistically significant decrease in BMI, serum insulin, and LH as compared to Group B (p <0.001, 0.013 and 0.028, respectively). Serum testosterone level was also decreased in group C-HD as compared to Group B, however the difference was not significant. CONCLUSION: Obesity increases the serum insulin, LH and testosterone and irisin significantly lowers the elevated BMI, serum insulin and LH levels in female BALB/c mice. It also lowers the elevated testosterone levels, but not significantly.

Effect of Kisspeptin on Serum Prolactin and Gonadotropins Levels in Balb-c Mice with Induced Chronic Stress.

OBJECTIVE: To determine and compare effects of kisspeptin on serum prolactin, luteinizing hormone and follicle stimulating hormone levels in Balb-c mice with and without exposure to chronic restraint stress. STUDY DESIGN: An animal experimental study. PLACE AND DURATION OF STUDY: Shifa College of Medicine / Shifa International Hospital Islamabad, in collaboration with National Institute of Health, Islamabad and Centre for Research in Experimental and Applied Medicine Laboratory, Army Medical College, Rawalpindi, from April 2014 to June 2015. METHODOLOGY: Mice divided into three groups, each containing 30 mice. Control group (group A) received intraperitoneal injection of saline, group B was administered with intraperitoneal injection of saline and restrained stress, and group C was administered with both stress and kisspeptin 100 ng daily for four weeks. Restraint stress was applied to groups B and C for three hours per day by immobilising individual mice in wire-mesh restrainers. At the end of four weeks blood sampling was done. Serum luteinizing hormones (LH), serum follicular stimulating hormone (FSH) and serum prolactin (PRL) were analysed by ELISA. RESULTS: Serum prolactin level increased in group B (stressed) and group C (stressed + kisspeptin treated) as compared to control group; and decreased in group C as compared to group B. Serum LH and FSH in group B was decreased as compared to control, and it was increased in group C as compared to control and group B. CONCLUSION: Administration of kisspeptin increases level of gonadotropins and reduces stress-induced hyperprolactinemia, which may improve fertility despite stress in animal.

Competency-based integrated practical examinations: Bringing relevance to basic science laboratory examinations.

BACKGROUND: The practical examinations in subject-based curriculum have been criticized for lack of relevance and clinical application. We developed competency-based integrated practical examinations (IPEs) for first two years incorporating basic science principles with clinical relevance in our integrated curriculum. AIM: To bring relevance to basic science laboratory practical examinations by conducting competency-based IPEs. METHODS: IPEs were developed according to competency-based blueprinting for each integrated module. Clinical scenarios were used as triggers followed by tasks pertaining to laboratory tests, relevant physical diagnosis and ethics/professional aspects utilizing standardized patients. Checklists were developed for standardized marking. A feedback questionnaire and two focus group discussions were administered to a random group of students from both first and second year students. Faculty members' feedback was also recorded on a questionnaire. RESULTS: Almost all the students agreed that IPE was a useful experience. Eighty-nine percent agreed that it was a fair examination and elicited a lesser degree of psychological stress. Eighty-two percent agreed that IPE encouraged critical thinking and application of knowledge. However, students suggested better organization and longer duration of stations. Faculty members also liked the experience. CONCLUSION: In conclusion, IPEs were well-received and valued both by students and faculty members.