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Mental health disorders and substance abuse are prevalent issues that significantly impact individuals and societies. Medical students are particularly vulnerable due to the intense pressures and challenges inherent in medical education. This current investigation aims to explore the mental health status and patterns of substance abuse among medical students, identifying associated factors and potential interventions. A cross-sectional study was executed with 421 undergraduate and post graduate medical students from a tertiary care centre. Multivariate logistic regression was used to determine the factors associated with psychological distress and substance abuse. Substance abuse was reported by 21.4% of participants, while 20.7% experienced psychological distress. There was a statistically significant association between substance abuse and psychological distress (p=0.005). Factors associated with psychological distress included sleep deprivation (Adjusted OR: 24.8, p=0.001), whereas factors associated with substance abuse included male gender (Adjusted OR: 2.3, p=0.001), older age, staying with friends (Adjusted OR: 1.8, p=0.04) and sleep deprivation abuse (OR: 2.0, p=0.01). This study highlights a significant occurrence of psychological distress and substance abuse among medical students. Interventions to improve mental health and reduce substance abuse among medical students should consider these associated factors, emphasizing the importance of sleep hygiene, stress management and supportive environments.
RESUMO
Objective Lipemia is an important cause of preanalytical errors in laboratory results. They affect the specimen integrity and trustworthiness of laboratory results. The present study was to assess the impact of lipemia on routine clinical chemistry analytes. Methods Anonymous leftover serum samples with normal levels of routine biochemical parameters were pooled. Twenty such pooled serum samples were used for the study. The samples were spiked with commercially available intralipid solution (20%) to produce lipemic concentrations of 0, 400 (mild, 20 µL), 1,000 (moderate, 50 µL), and 2,000 mg/dL (severe, 100 µL). Glucose, renal function test, electrolytes, and liver function test were estimated in all the samples. Baseline data without the effect of interference was considered as true value and percentage bias for the spiked samples was calculated. Interference was considered significant if the interference bias percentage exceeded 10%. Result Parameters like glucose, urea, creatinine, direct bilirubin, sodium, potassium, and chloride showed negative interference at mild and moderate lipemic concentration and positive interference at severe lipemic concentration. Parameters like aspartate transaminase (AST) and alanine transaminase (ALT) showed negative interference at mild and positive interference at moderate and severe lipemic concentration. Whereas uric acid, total protein, albumin, total bilirubin, alkaline phosphatase, gamma-glutamyl transferase, calcium, magnesium, and phosphorous showed positive interference at all concentrations. Significant interference (> 10%) was shown for magnesium (mild lipemia), albumin, direct bilirubin, ALT, and AST at moderate lipemic concentration. All parameters showed significant interference at severe lipemic concentration. Conclusion All the study parameters are affected by lipemic interference at varying levels. Laboratory-specific data regarding lipemic interference at various concentrations on the clinical biochemistry parameters is needed.
RESUMO
Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes mellitus, leading to sensory abnormalities, decreased balance, and increased risk of foot problems. Although tumor necrosis factor-alpha (TNF-α) has emerged as a potential factor in the pathogenesis of DPN, its role remains contested. This study intends to thoroughly analyze the association between TNF-α and DPN by combining data from various global studies. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included 23 articles investigating TNF-α levels in DPN patients for systematic review and 11 articles for meta-analysis. Data were extracted, and heterogeneity was examined. A random-effect model was chosen due to high heterogeneity. The major outcome measure across studies was serum TNF-α levels. The meta-analysis found a significant mean difference of 15.2464 (95% confidence interval = 4.4963; 25.9965) under the random-effect model due to the substantial heterogeneity (I2 = 98.1%) among included studies. The meta-analysis indicates a consistent elevation in TNF-α levels in individuals with DPN compared to those without neuropathy. This underlines the potential of TNF-α as a biomarker and contributor to diabetic neuropathy. Despite heterogeneity, the study's extensive scope and systematic approach enhance the trustworthiness and generalizability of the findings.
