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OBJECTIVE: To assess burnout in medical educators and to identify factors associated with it. METHODS: A sequential mixed methods research study was conducted over eight months from July 2018 until February 2019. Participants included medical educators, who are studying for or graduated with a postgraduate qualification in medical education. An online questionnaire was developed using Maslach Burnout Inventory to collect quantitative data. The findings were explored in-depth qualitatively. Descriptive and inferential statistics were calculated for the quantitative data using SPSS 20. For qualitative data, we performed thematic analysis. RESULTS: Of total 160 medical educationists, 101 responded giving 63.1% response rate. Mean age was 41.4 years and majority 53.5% were females. Overall aggregate mean burnout level was 12.34 ± 7.36 whereas sub-domains of Maslach burnout inventory (MBI) like i) emotional exhaustion, ii) depersonalization and iii) personal accomplishment were found out to be 19.59, 10.42 and 11.21 respectively. Most respondents had moderate 71 (70.3%) emotional exhaustion and 8 (8.9%) had severe emotional exhaustion. Average level of depersonalization was suffered by 73 (72.3%) respondents and severe level was observed in 20 (19.8%) respondents. Personal accomplishment was found low in all 101 (100.0%) respondents. Selective in-depth interviews revealed that coping mechanisms like social gatherings, indoor and outdoor game facilities and outings and leisure time should be strategized for faculties. CONCLUSION: In this study medical educators were found to have quite high level of burnout. The early career medical educators feels emotionally exhausted, with low sense of personal accomplishment.
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BACKGROUND: Depression is defined as a psychiatric disorder characterized by depressed mood, lack of concentration, diminished energy, disturbed sleep, and low self-esteem. Depression is more prevalent in HIV/AIDS patients than the general population. There is no published study available that reveals the present status of depression among HIV patients in Pakistan. As such, the present study was conducted to determine the prevalence and associated factors of depression among HIV/AIDS patients attending the HIV clinic of Jinnah Hospital, Lahore, Pakistan. METHODS: A hospital-based cross-sectional study was carried out from February to March 2019 in Lahore. Data were collected from 158 HIV/AIDS patients using a pretested, standardized, structured interviewer-administered questionnaire. Nonprobability convenience sampling was used to recruit the study participants. Depression was evaluated using the Patient Health Questionnaire. SPSS version 23 was used to analyze the data. Binary logistic regression models were used to determine the various factors associated with depression. AORs with 95% CIs were used to assess the magnitude of associations between depression and associated factors. RESULTS: The mean age of the study participants was 35.03 years±9.123. Prevalence of depression among HIV/AIDS patients was 32.2%. Living in a rural area (AOR 5.60, 95% CI 2.20, 14.15), fear of stigma and discrimination (AOR 3.505, 95% CI 1.364, 9.008), having worked abroad (AOR 3.017, 95% CI 1.134, 8.031), and history of substance abuse (AOR 4.147, 95% CI 1.673, 10.28) were significantly associated with depression. CONCLUSION: The prevalence of depression among HIV/AIDS patients is very high in Pakistan. Therefore, it is suggested that guidelines formulated to screen and treat depression among HIV patients.
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Pakistan has second highest burden of hepatitis C virus (HCV) infected patients in the World. Little is known about the molecular epidemiology and risk factors for prevailing HCV genotypes in Pakistan. Considering this a multicenter cross-sectional study was conducted at 23different viral hepatitis control and prevention centers. A total of 175,897 patients were registered and screened for HCV, out of which 73,180 (41.6%) were found positive on Architect screening test. The screened positive patients were sequentially tested on RT-PCR; where 41,241 (56.35%) were detected positive. Molecular characterization results showed genotype 3 (73.9%) as the most prevalent type, followed by genotype 1 (9.7%), and genotype 4 (0.3%) was isolated for the first time in Pakistan. On regression analysis; risk factors associated with genotype 3 and 1 included; age group of 30-50 years, rural residence, exposure to >10 injections, barber shaving, circumcision by barbers, and low literacy rate. Phylogenetic analysis based on genotypes identified in this study and sequences isolated from Pakistan in last 10 years demonstrated that genotype 3 and 1 are endemic locally in Punjab province. The high prevalence rate of HCV is a threat for a generalized epidemic and genetic recombination with such variability of genotypes identified here is an alarming condition. More focused attention and resources should be spent in awareness of the population to prevent the spread of HCV among high risk population.