Psychological morbidity in medical students after entering into clinical training Psychological morbidity among medical students

Psychological morbidity is emerging as animportant issue for medical students after entering clinical training due to extensiveworking hours. Students find themselves unable to balance competing demands on their time and cannot allocate appropriate time to family, spouses and even to themselves; this leads to complaints about exhaustion and lack of efficiency in their profession. Objective: To assess Psychological morbidity in interns, medical officers and residents Methods: a cross sectional study was conducted. A google form was designed with questions adopting from the three scales of the Maslach Burnout Inventory-General Survey (MBI-GS). Question from all three categories of MBI-GS such as emotional exhaustion, depersonalization and personal accomplishment were considered. The form was distributed via email and Whatsapp to 87 house officers, medical officers and residents of six public healthcare facilities in Lahore. Responses were captured from 73 participants who completed the General Health questionnaire. Seven of these forms were filled by nurses, so in the present study only the response ofthose 66 participants who conformed to the study cross-section were considered. The results were analyzedusing SPSS version 22 for descriptive statistics and chi-square association. Results: A significant association was found between long working hours and emotional exhaustion, depersonalization and personal accomplishment questions in particular. The findings suggests long working hours ruin the mental health of medical professionals, which ultimately produce psychological health impacts. Conclusions: It was concluded that these factors should be considered to reduce psychological morbidity in health professionals.  

Prostate Specific Antigen As a Risk Factor for Skeletal Metastases in Black African Men With Prostate Cancer

Background: Prostate cancer is one of the commonest cancers in men worldwide. Several recognised risk factors are associated with this disease, amongst them, race. Despite this, there is a paucity of data in the native African setting. The skeletal system is a common site of metastasis, its incidence increasing with increase in prostate specific antigen (PSA) levels. Bone scans are used to detect skeletal metastases. Its use in prostate cancer patients with abnormal but low PSA has been subject of debate. Objectives: To test the association of PSA levels with skeletal metastasis in men with histologically proven prostate cancer. Methodology: Case control study. Using Radiology and Pathology records, a registry of prostate cancer patients recorded as being of Black African ethnicity previously investigated in the institution was assembled. Following anonymisation and coding, archive images were presented to a nuclear physician blinded to the PSA level, to determine presence and sites of skeletal metastases. The risk factor for the outcome of interest (skeletal metastases) was PSA level above 20ng/ml. The reliability of image reporting for bone scans was also analysed. Results: Of 122 patients, 50 (41%) had skeletal metastases, while 72 (59%) had no skeletal metastases. The prevalence of metastases among the high PSA group was 55.9% (44.1% to 67.7%) and 22.2% (11.1% to 33.3%) among the normal/low PSA group. The Odds Ratio (OR) for skeletal metastases in the exposed group was 4.4 (95% CI, 2.01 – 9.78.) There was an intra-observer agreement of 88.5% with a Kappa statistic of 0.76. Inter observer agreement was 85.3% (Kappa statistic of 0.70.) Conclusion: Significantly higher prevalence of skeletal metastasis is seen in regional Black African males with prostate cancer, at both low and high PSA levels. Bone scanning in this population should therefore be considered even at PSA levels below 20ng/ml.