Cross-Sectional Analysis of the Effect of Physical Activity, Nutrition, and Lifestyle Factors on Medical Students' Academic Achievement.

BACKGROUND: Unhealthy dietary habits, decreased physical activity, poor sleep quality, and increasing levels of stress and burnout have all been identified as major concerns of medical students. Due to the rigorous environment of medical school, maintaining a well-balanced and nutritious diet is often replaced by more convenient and nutrient-poor options. Improper dietary habits and a sedentary lifestyle both play an essential role in the development of type II diabetes, obesity, hypertension, and hyperlipidemia. These unhealthy trends commonly stem from the innate drive for medical students to achieve at the highest level, sacrificing healthy lifestyle choices to maximize studying. Unfortunately, this dynamic creates a paradox where students create an unhealthy lifestyle to increase academic achievement; however, these destructive living conditions lead to a diminished sense of well-being. As a result, greater rates of burnout, comorbidities, and other maladaptive tendencies diminish success in school. OBJECTIVE: The objective of this study is to investigate the effects of lifestyle habits such as nutrition, physical activity (PA), and stress on academic performance (grade point average: GPA) among first- and second-year students at Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine (KPCOM). METHODS: A cross-sectional study was conducted on medical students (n = 161) under institutional review board (IRB) approval. The students voluntarily completed a self-reported survey containing questions about diet, exercise (frequency and type), stress, and self-reported GPA. About 800 students were invited to complete the survey between June 15, 2022, and June 28, 2022. A simple lifestyle indicator questionnaire (SLIQ) score was determined for each student based on their diet, PA, and stress responses. RESULTS: The results showed a significant positive correlation between SLIQ score and high academic achievement. A significant positive association was found between the low academic-achieving (LAA)(2.00-2.99 GPA) vs the high (3.60-4.00 GPA) academic-achieving (HAA) cohorts for physical activity (p = 0.012) as well as diet (p = 0.043). Further, the HAA cohort reported higher satisfaction with their mental and physical health (74% and 54%, respectively) as compared to the LAA cohort (29% each). CONCLUSION: This study demonstrated positive correlations between diet and physical activity with high academic achievement. The HAA cohort recorded the highest rates of fruit/vegetable and home-cooked meal consumption and the greatest participation in light, moderate, and heavy exercise when compared to the middle academic-achieving (MAA) (3.00-3.59 GPA) and LAA cohorts. Interestingly, the HAA students also recorded the highest rates of satisfaction with their mental and physical health. As a result, there is a need to promote healthier lifestyle trends among medical students with a focus on diet and physical activity.

The Management of Spinal and Epidural Anesthesia-Related Hypotension in the United States During Cesarean Childbirth.

This study delves into the prevalence of spinal anesthesia-induced hypotension during cesarean (c-section) childbirth, focusing on existing treatments and their efficacy. Currently, neuraxial analgesia is the most efficient method for alleviating pain during c-sections, but its major side effect, hypotension, necessitates a thorough understanding of the available treatment options. A scoping review was conducted using PubMed and Rayyan, with inclusion criteria being English peer-reviewed articles from the last five years, involving nulligravida/primigravida women under 35 years old in the United States. The research reveals various treatments to mitigate spinal anesthesia-induced hypotension. Norepinephrine and epinephrine have demonstrated effectiveness in maintaining blood pressure while reducing adverse maternal outcomes following delivery. When comparing fixed-rate infusions of norepinephrine to phenylephrine, norepinephrine demonstrated lower rates of bradycardia (p=0.004), thereby reducing the necessity for bolus atropine rescue (p=0.01). Furthermore, the use of colloid solutions during c-sections significantly decreased the incidence of hypotension when compared to crystalloid solutions (p<0.00001). Non-pharmacological methods, such as lower extremity wrapping and elevation, exhibited higher systolic and diastolic blood pressures, along with higher usage of ephedrine when compared to control groups. Pharmacological treatments proved more effective than non-pharmacological interventions in preventing maternal hypotension during c-sections. Notably, colloid preloading emerged as the most effective approach, helping to maintain maternal blood pressure, cardiac output, and heart rate while also minimizing the amount of ephedrine required and reducing anesthesia-related adverse effects. However, the study suggests the need for further investigations to determine the optimal dosage for colloid preloading. This research provides valuable insights into enhancing maternal well-being during c-sections by addressing the issue of neuraxial anesthesia-induced hypotension.