International Journal of Medical Students https://ijms.pitt.edu/IJMS <p>The <em>International Journal of Medical Students </em>(<em>IJMS</em>) is an open-access, peer-reviewed scientific journal (ISSN <a href="https://portal.issn.org/resource/ISSN/2076-6327" target="_blank" rel="noopener">2076-6327</a>) that publishes original research and experiences in all fields of medicine. The <em>IJMS</em> was created in 2009 to share scientific production and experiences where there is at least one author enrolled as a medical student (including MBBS students, MD students, DO students, MD/MSc students, and MD/PhD students) in any medical school in the world or a recently graduated physician. These early-career scientists must be accompanied by a senior researcher that must be also responsible for the research, guaranteeing the quality of the work. The <em>IJMS</em> aims to be the leading publication platform for early-career scientists' medical research. Read more in the <a href="https://ijms.info/IJMS/about" target="_blank" rel="noopener">About the Journal section</a>.</p> en-US <p id="copyright">Authors who publish with this journal agree to the following terms:</p> <ol> <li class="show">The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.</li> <li class="show">Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.</li> <li class="show">The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a&nbsp;<a href="http://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">Creative Commons Attribution 4.0 International License</a>&nbsp;or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions: <ol> <li class="show">Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.</li> <li class="show">The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.</li> <li class="show">Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.</li> <li class="show">Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.</li> <li class="show">The Author represents and warrants that:<br> <ol> <li class="show">the Work is the Author’s original work;</li> <li class="show">the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;</li> <li class="show">the Work is not pending review or under consideration by another publisher;</li> <li class="show">the Work has not previously been published;</li> <li class="show">the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and</li> <li class="show">the Work contains no libel, invasion of privacy, or other unlawful matter.</li> </ol> </li> <li class="show">The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.</li> </ol> </li> </ol> <p><em>Enforcement of copyright</em></p> <p>The IJMS takes the protection of copyright very seriously.</p> <p>If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.</p> <p>If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to <a href="mailto:contact@ijms.org">contact@ijms.org</a></p> <p>&nbsp;</p> <p><em>Infringing material</em></p> <p>If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to&nbsp;<a href="mailto:contact@ijms.org">contact@ijms.org</a></p> ijms.eic@library.pitt.edu (Francisco Javier Bonilla-Escobar, MD, MSc, PhD(c)) e-journals@mail.pitt.edu (IJMS Contact) Fri, 12 Apr 2024 15:12:08 -0400 OJS 3.3.0.13 http://blogs.law.harvard.edu/tech/rss 60 Cover, Credits, & Content https://ijms.pitt.edu/IJMS/article/view/2625 Executive Committee of IJMS Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2625 Fri, 12 Apr 2024 00:00:00 -0400 Public Health Outreach in Impoverished Areas of Cambodia: Addressing the Issues Related to Prescription Practices https://ijms.pitt.edu/IJMS/article/view/2326 <p>During a two-week public health internship organized by Projects Abroad in impoverished areas in Cambodia, the authors participated in health check-ups and outreach activities. We identified issues such as polypharmacy and medication misuse. These problems stem from symptom-based prescriptions without considering individual patient conditions due to limited diagnostic equipments and medications. Our solution involved suggesting a documentation akin to Japan's prescription record books, and Drug Information Leaflets (DILs). Prescription record books would enable patients to record the medications they purchased at the pharmacy, so that physicians would know what medications patients are taking during their health checkups, and thus prevent polypharmacy. In addition, the DILs included medication details and illustrations, considering the low literacy rates in the areas. We emphasized the need for sustained non-communicable diseases (NCDs) treatment and the potential of external perspectives to introduce innovative healthcare approaches and improvements within local communities.</p> Chisato Iba, Mira Namba, Yudai Kaneda, Takayuki Ando Copyright (c) 2023 Chisato Iba, Mira Namba, Yudai Kaneda, Takayuki Ando https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2326 Fri, 12 Apr 2024 00:00:00 -0400 Grassroots HPV Vaccine Education in Phnom Penh, Cambodia: A Personal Reflection https://ijms.pitt.edu/IJMS/article/view/2256 <p>I visited two primary schools, and concerningly, more than half of the teachers had never heard of HPV or HPV vaccine. Furthermore, the students demonstrated limited knowledge of HPV or the vaccine to the extent that they struggled to comprehend the questionnaire. However, after I delivered a 15-minute lecture about HPV and the vaccine, it was encouraging to note an increase in the number of students expressing an intention to get vaccinated. It became clear that until now, health education, including sexual health, has not been sufficiently implemented in primary schools, and thus, knowledge about HPV has not been provided by teachers sufficiently. Therefore, expanding this type of educational intervention to deliver reliable information is necessary, prioritizing teachers and parents as targets, since the intention of teachers and parents is considered to have a significant influence on the vaccination of children. A world free of cervical cancer can only be achieved through continuous education and awareness initiatives especially at the grassroots level, such as I practiced in Cambodia, to facilitate informed decision-making.</p> Mira Namba, Miyu Shinohara, Samrith Sela, Ken Khouch, Yudai Kaneda, Rei Haruyama Copyright (c) 2023 Mira Namba, Miyu Shinohara, Samrith Sela, Ken Khouch, Yudai Kaneda, Rei Haruyama https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2256 Fri, 12 Apr 2024 00:00:00 -0400 From Theory to Practice: Reflections of a Medical Student's Rural Posting in a Leprosy Hospital https://ijms.pitt.edu/IJMS/article/view/2416 <p><span style="font-weight: 400;">This article reflects on a medical student's rural posting at a Nigerian Leprosy Hospital. Despite Nigeria's 1998 Leprosy elimination achievement, the disease has persisted in marginalized communities. Leprosy, a Neglected Tropical Disease (NTD), is associated with poverty and social stigma. The rural posting offered insight into the clinical and psychosocial aspects of Leprosy. The article also emphasized the role of medical students in eradicating diseases via awareness campaigns, collaboration with health organizations, early case identification, and improved rural healthcare.</span></p> Glorious Kate Akpegah Copyright (c) 2024 Glorious Kate Akpegah https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2416 Fri, 12 Apr 2024 00:00:00 -0400 The Importance of Understanding Social Determinants of Health as Medical Students: My Experience with the Cincinnati Homeless Coalition https://ijms.pitt.edu/IJMS/article/view/2194 <p style="margin: 0cm; line-height: 150%;">Medical education traditionally emphasizes academic rigor, often at the expense of practical community engagement. This experience article describes my journey beyond the confines of a medical school's preclinical curriculum to engage with the social determinants of health through a partnership with the Cincinnati Homeless Coalition. My narrative begins with my initial foray into the community, detailing the inception and execution of a project aligned with the organization's mission to combat homelessness. I discuss the challenges encountered, propose enhancements to overcome these limitations, and reflect on the project's implications for future medical cohorts. The article underscores the value of understanding social determinants of health, such as socioeconomic status and education, and their influence on health outcomes. It advocates for the integration of community-based experiences in medical training, asserting that such involvement can enrich the educational journey of medical students by providing a broader perspective on healthcare needs and patient advocacy.</p> Shivatej Dubbaka, Taylor Lentz Copyright (c) 2023 Shivatej Dubbaka, Taylor Lentz https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2194 Fri, 12 Apr 2024 00:00:00 -0400 Becoming a Physician: A 40-year Retrospective on Medical Socialization https://ijms.pitt.edu/IJMS/article/view/2508 <p>The medical training and socialization process can be stressful and at times even traumatic. Medical students must develop ways to nurture their vitality, refine their values, be true to theirselves, and develop their capacities as healers in the face of the difficult medical socialization processes. This article outlines the challenges of medical training and socialization, and then reviews well-established principles and practices for becoming a vital, skillful, and healing physician.</p> Michael McGee Copyright (c) 2024 Michael McGee https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2508 Fri, 12 Apr 2024 00:00:00 -0400 Artificial Intelligence in Medicine and Medical Education: Current Applications, Challenges, and Future Directions https://ijms.pitt.edu/IJMS/article/view/2626 <p data-sourcepos="1:1-1:290">AI's rise in medicine promises personalized care, better diagnoses, and innovative training. It analyzes images, predicts diseases, and tailors treatments. However, ethical concerns loom. Biased data can lead to unfair diagnoses, and some AI systems lack transparency, raising trust issues. The editorial proposes solutions: ethical frameworks, transparent AI, and legal regulations. It envisions a future where AI complements doctors, requiring collaboration across fields. To prepare future physicians, medical schools need to integrate AI and ethics into their curriculum. AI holds immense potential, but challenges must be addressed. Through collaboration and responsible development, AI can revolutionize medicine alongside human expertise.</p> Manali Sarkar, Mihnea-Alexandru Găman, Juan C. Puyana, Francisco J. Bonilla-Escobar Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2626 Fri, 12 Apr 2024 00:00:00 -0400 Fulminant Hepatic Failure as the Initial Presentation of Hodgkin's Disease and Liver Transplantation: A Case Report https://ijms.pitt.edu/IJMS/article/view/2422 <p><strong>Background</strong>: Hodgkin's disease, a B-cell neoplasm, primarily impacts lymph nodes or extranodal lymphoid tissue. It includes two distinct entities: classical (95%) and lymphocyte-predominant nodular. While the disease commonly manifests as the growth of cervical and intrathoracic lymph nodes in 60-90% of cases, there are rare instances where Hodgkin’s disease has been linked to fulminant liver failure, carrying a very poor prognosis.</p> <p><strong>The Case</strong>: We present the case of a 13-year-old Hispanic female, who started with an insidious condition that evolved to fulminant hepatic failure of unknown etiology with an AST of 770 mg/dl. It was decided to perform an orthotopic liver transplant, the histopathological analysis of the explant and a lymph node reported mixed cellularity Hodgkin's disease. Subsequently, the hematology service requested a lumbar puncture, with no evidence of infiltration. It was decided to initiate six cycles of chemotherapy (CTX) with BEACOPP (bleomycin, etoposide, adriamycine, cyclophosphamide, vincristine, procarbazine, and prednisone) scheme, evolving without complications and achieving a complete response eleven months later; currently, she has been free of disease for three years.</p> <p><strong>Conclusion</strong>: The etiology of Hodgkin's disease in our 13-year-old patient remains elusive, emphasizing the importance of early diagnosis and diverse treatment approaches. Despite limited hospital resources, the decision to proceed with the transplant was driven by the potentially fatal outcome if left untreated. Future considerations may necessitate individualizing each case, and carefully assessing the risks and benefits associated with transplantation.</p> Mauricio Alejandro Saldaña Ruiz, Federico Ortiz-Alonso, Adriana Carolina Sandoval-González, Liliana Sayuri Tapia-Brito, Laura Carolina Lozano-Galván, Karla Monserrat Ramírez-Pintor Copyright (c) 2023 Mauricio Alejandro Saldaña Ruiz, Federico Ortiz-Alonso, Adriana Carolina Sandoval-González, Liliana Sayuri Tapia-Brito, Laura Carolina Lozano-Galván, Karla Monserrat Ramírez-Pintor https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2422 Fri, 12 Apr 2024 00:00:00 -0400 Severe Hyperkalemia: Electrocardiographic Tips for Early Recognition Based on a Case Report https://ijms.pitt.edu/IJMS/article/view/1907 <p><strong>Background: </strong>Rapid correction of severe hyperkalemia is mandatory to survival due to its induction of fatal cardiac arrhythmias. The electrocardiogram serves as the diagnostic tool that can provide insight into such fatal arrhythmias. We present two relevant alterations seen in an 84-year-old female patient with previous anterior myocardial infarction, angioplasty of the circumflex coronary artery, left ventricular ejection fraction of 35%, hypertension, dyslipidemia, paroxysmal atrial fibrillation, and diabetes.</p> <p><strong>The Case:</strong> The patient had 4-days with asthenia, adynamia and dyspnea. Lung auscultation showed bilateral base rales with cardiomegaly and interstitial edema identified on chest x-ray. Lab work revealed severe metabolic acidosis, increased plasma urea, creatinine, and severe hyperkalemia (7.9 mEq/liter) considered secondary to acute renal failure. Treatment was initiated with 0.9% sodium chloride, bicarbonate, ASA diuretics and polarizing solution (insulin), resulting in a reduction of hyperkalemia to 6.1 mEq/liter. The patient suffered a cardiorespiratory arrest with recovery and needed intubation and dopamine for hemodynamic support but died 15 hours after admission.</p> <p><strong>Conclusion:</strong> The electrocardiographic findings characteristic of severe hyperkalemia were: (i) regular rhythm (cycle length 920-950 ms) without discernible P-waves, which may have a junctional or ventricular origin and less probably could be a manifestation of sinoventricular conduction (preferential conduction from the sinus node to the AV node through specialized tracts without activation of the atrial cardiomyocytes), and (ii) sine wave morphology (markedly wide QRS, absence of ST-segment and broadly based T-waves). These electrocardiographic features, typical of hyperkalemia exceeding 7.0 mEq/liter, are harbingers of malignant arrhythmias and should prompt immediate therapy.</p> Jorge Gonzalez-Zuelgaray, Patricio I. Frangi , Damián A. Longo, Luisina B. Tosoni, Adrian Baranchuk Copyright (c) 2024 Patricio I. Frangi , Jorge Gonzalez-Zuelgaray, Luisina B. Tosoni, Adrian Baranchuk https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/1907 Fri, 12 Apr 2024 00:00:00 -0400 Prevalence of Generalized Anxiety Disorder and Associated Risk Factors Among Medical Students in Sudan: A Cross-Sectional Study at Omdurman Islamic University https://ijms.pitt.edu/IJMS/article/view/2095 <p><strong>Background: </strong>Generalized Anxiety Disorder (GAD) is a mental illness that significantly affects various domains of daily functioning. Limited research has been conducted on GAD among medical students in Sudan, particularly during the socio-political and economic crises. This study aimed to assess the prevalence of GAD, identify risk factors, and evaluate its impact on academic performance and daily activities among Sudanese medical students.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted among undergraduate medical students at Omdurman Islamic University. Data were collected using a self-administered online questionnaire via Google Forms, consisting of two parts: socio-demographic information and the Generalized Anxiety Disorder Questionnaire (GAD-7), a validated tool for screening and measuring the severity of GAD.</p> <p><strong>Results:</strong> A total of 374 medical students participated, with 64.7% being female. The GAD-7 scores were high (above 9), suggesting GAD among 33.7% of participants, with severity levels of 41.2% for mild anxiety, 21.4% for moderate anxiety, and 12.3% for severe anxiety. Comparison of means showed significant associations between GAD and female students (p&lt;0.001) and students with chronic diseases (p=0.034). GAD significantly impacted daily activities (p&lt;0.001). Multiple logistic regression analysis found that students in the final year had significantly higher GAD-7 scores (Adjusted Odds Ratio=4.25, 95% Confidence Interval=1.27-14.22).</p> <p><strong>Conclusions:</strong> The higher scores on the GAD-7 measure among Sudanese medical students are concerning. This emphasizes the urgent need to raise awareness, normalize mental health discussions, and provide accessible counseling services tailored to the students' needs.</p> Khalid Osman Mohamed, Ahmed ALemam Ahmed, ElShimaa Ammar Zaki, Sozan Mudather Soumit, Wamda Ahmed Ali, Asmaa Mohamed Abbas Copyright (c) 2024 Khalid Osman Mohamed, Ahmed ALemam Ahmed, ElShimaa Ammar Zaki, Sozan Mudather Soumit, Wamda Ahmed Allam, Asmaa Mohamed Mohamed https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2095 Fri, 12 Apr 2024 00:00:00 -0400 Prioritizing Mental Health: A Cross-Sectional Investigation of Depression Prevalence and Risk Factors among Medical Students in Peshawar, Pakistan https://ijms.pitt.edu/IJMS/article/view/2173 <p><strong>Background</strong>: Depression is a significant problem among medical students worldwide, affecting their well-being and potentially compromising patient care. This study aimed to determine the prevalence of depression among medical students in Peshawar, Pakistan, and to identify the associated risk factors.</p> <p><strong>Methods</strong>: A cross-sectional study was conducted from April to June 2023, involving medical students from seven colleges in Peshawar. We employed stratified sampling to distribute surveys to students. We collected data on socio-demographic characteristics, prevalence of depression using the Hospital Anxiety and Depression Scale (HADS), and depression risk factors. We used multivariate logistic regression, clustered by university, to assess factors associated with depression.</p> <p><strong>Results</strong>: Out of 400 distributed questionnaires, 324 were returned (response rate: 81%). The participants' mean age was 21.70 ± 1.65 years, with 53.1% being females. The prevalence of depression was 19.4% and 26.2% were borderline cases. No variables were found to be significantly linked to depression in our multivariate regression model. However, male gender, year of study, experiencing discrimination or harassment in medical school, and having negative perceptions of medical school's impact on mental health had odds ratios above 1, with confidence intervals including the null value.</p> <p><strong>Conclusion</strong>: This study reveals a high prevalence of depression among medical students in Peshawar, Pakistan. It emphasizes the need to address risk factors and establish support systems to minimize the impact of depression on students' well-being and academic performance. Further studies are necessary to identify modifiable factors associated with depression in medical students.</p> Nida Gul, Ayaz Ali, Rizwanullah, Khayam, Manahil Saeed Khan, Faiza Gul, Aiysha Gul, Shehriyar, Kashif Ali, Syed Owais Haseeb Copyright (c) 2024 Nida Gul, Ayaz Ali, Rizwanullah, Khayam, Manahil Saeed Khan, Faiza Gul, Aiysha Gul, Shehriyar, Kashif Ali, Syed Owais Haseeb https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2173 Fri, 12 Apr 2024 00:00:00 -0400 Antibiotic Appropriateness on Mondays vs. Fridays: Empiric Treatment of Simple Cystitis in the Emergency Department https://ijms.pitt.edu/IJMS/article/view/2105 <p><strong>Background:</strong> The treatment of urinary tract infections (UTIs) has contributed to the rise of antibiotic resistance. Antibiotic appropriateness in the outpatient setting is lower than expected. We hypothesized that prescribing practices may vary based on the day of the week. We sought to determine the percentage of antibiotic prescriptions that met criteria for antibiotic appropriateness on Mondays vs. Fridays.</p> <p><strong>Methods: </strong>This is a retrospective cohort study of adult females with simple cystitis presenting to the Emergency Department (ED) between 2019 and 2021. We defined antibiotic appropriateness based on the Infectious Diseases Society of America guidelines in conjunction with a regional outpatient UTI antibiogram. Each prescription was assessed for drug selection, dose, frequency, and duration. Categorical data is reported as counts (%) and compared with chi-square. Nonparametric continuous data is reported as median (range) and compared with Mann-Whitney.</p> <p><strong>Results:</strong> 160 subjects were included: 80 came to the ED on a Monday and 80 on a Friday. Demographics were similar; except, more subjects had antibiotic allergies on Mondays. The number of appropriate antibiotic prescriptions was similar between Mondays and Fridays: 54 (68%) and 60 (75%), respectively (p=0.3). Overall, 44 subjects had an inappropriate duration of antibiotics and 14 subjects had an inappropriate antimicrobial prescribed, with no differences between Mondays and Fridays. Dose and frequency were always correct. In total, there were 46 (29%) antibiotics that failed to meet appropriateness criteria.</p> <p><strong>C</strong><strong>onclusions: </strong>There was no difference in antibiotic appropriateness between Mondays and Fridays; however, 29% of prescriptions did not meet criteria for appropriateness.</p> Kira A. LeBron, Adrienne Bielawski, Patrick Popiel , Setareh Shams , Cara L. Grimes Copyright (c) 2024 Kira A. LeBron, Adrienne Bielawski, Patrick Popiel , Setareh Shams , Cara L. Grimes https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2105 Fri, 12 Apr 2024 00:00:00 -0400 The Influence of Pre-Trip Medical Spanish Education on a US-Based, Medical Student Service Trip: A Cohort Study https://ijms.pitt.edu/IJMS/article/view/2441 <p><strong>Background: </strong>International service trips are increasingly common in medical school curricula. Medical Spanish is an essential tool in healthcare interactions with Spanish-speaking patients globally. Medical Spanish classes are offered at many medical schools, but it is not known whether they increase confidence for medical students on Spanish-speaking service trips.</p> <p><strong>Methods: </strong>A prospective cohort study of medical students attending one of two sister campuses who completed pre- and post-international medical service trip questionnaires. Data collected includes demographics, confidence, and perceived experiences. Data analyses involved a multivariable regression assuming an ordered multinomial response, FREQ procedure, and the GLIMMIX procedure on SAS STAT v.9.4.</p> <p><strong>Results: </strong>Demographics significantly associated with confidence categories are female sex, length of Spanish education, previously having lived in a Spanish country, and experience speaking Spanish with patients. Confidence communicating in Spanish shows the highest gain in significant categories post-trip while confidence working with interpreters and feeling adequately trained to treat Hispanics showed the lowest. Participants having taken Medical Spanish before did not improve their confidence. However, participants with prior Medical Spanish experience reported significantly higher benefit from this education in that it gave them an advantage and helped them connect better with patients.</p> <p><strong>Conclusion: </strong>Our findings reinforce the importance of language-concordance and confidence in patient interactions while demonstrating that prior Medical Spanish experience may not significantly improve confidence on a Spanish-speaking international trip, especially among non-fluent students. Spanish experience and proficiency should not be a deterring factor for students looking to go on a medical trip.</p> Maison Evensen-Martinez, Mariangela Santiago, Roger Martinez, Dallin Beck, Ann Trawick, Isain Zapata, Mark Wardle Copyright (c) 2024 Maison Evensen-Martinez, Mariangela Santiago, Roger Martinez, Dallin Beck, Ann Trawick, Isain Zapata, Mark Wardle https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2441 Fri, 12 Apr 2024 00:00:00 -0400 Prevalence and Burden of Disorders of Gut-Brain Interaction Among UK Medical Students https://ijms.pitt.edu/IJMS/article/view/2449 <p><strong>Background: </strong>Disorders of Gut-Brain Interaction (DGBI) affect 40% of the general population and are associated with substantial health impairment. Medical students reportedly have among the highest rates of DGBI, although data is mainly from Asia and Africa. We addressed this issue within a UK-based university.</p> <p><strong>Methods: </strong>An online survey was completed by 378 of 1621 medical students. Demographics, medical history, and gastrointestinal symptoms were collected, the latter using a modified Rome IV questionnaire to determine the presence of DGBI symptoms over the last 3 months. Additional validated questionnaires screened for somatization, psychological distress, eating disorders, quality of life, and burnout.</p> <p><strong>Results:</strong> DGBI were present in 76% (n=289/378), of which two-of-three had multiple affected sites. The most frequent DGBI were gastroduodenal (57%), followed by bowel (49%), esophageal (29%), and anorectal (26%) disorders. Approximately 50% of students with DGBI experienced painful gastrointestinal symptoms at least one day/week. Students with DGBI, compared to those without, had significantly higher anxiety and depression scores, increased somatic symptom reporting, reduced mental and physical quality of life, poorer eating habits, and more frequent medication use (p-values, all&lt;0.05). They were also at significantly higher risk of burnout, through study exhaustion and disengagement. The greatest health impairment was seen in those with multiple, painful, DGBI. Only 23% and 5% of students with DGBI had consulted a primary care provider and gastroenterologist, respectively.</p> <p><strong>Conclusion: </strong>Medical students commonly experience DGBI and associated health burden, yet infrequently seek help. Greater awareness may lead to increased support, improved health, and better study engagement.</p> Lydia C. Brown, Imran Aziz Copyright (c) 2024 Lydia C Brown, Imran Aziz https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2449 Fri, 12 Apr 2024 00:00:00 -0400 Medical Students’ Stress Levels Are Correlated with Their Sleep Quality and Life Satisfaction https://ijms.pitt.edu/IJMS/article/view/2239 <p><strong>Background</strong>: Stress and sleep disturbances associated with low life satisfaction is frequently reported during medical education, intervening with the academic achievements and general well-being of medical students. We aimed to investigate the effects of stress levels on sleep quality (SQ) and life satisfaction (LS) of the students in Hacettepe University Medical Faculty (HUMF).</p> <p><strong>Methods:</strong> This cross-sectional study was conducted at HUMF between May and September 2022 after ethical approval. The participants (39 women and 48 men) completed a personal information form, State- Trait Anxiety Index (STAI)-I and II, Pittsburgh SQ Index (PSQI) and Satisfaction with Life Scale (SWLS). Their blood pressure, heart rate, and salivary cortisol levels were measured.</p> <p><strong>Results: </strong>The men and women were comparable for age, body mass index (BMI), stress parameters and PSQI scores, except the higher LS in women (P=0.045). Gender-based analysis revealed positively correlated BMI and STAI-I (r=0.357) and II (r=0.501) scores in women (P&lt;0.05), and a similar but a weaker correlation for STAI-II scores in men (r=0.291) (P&lt;0.05). The study group exhibited poor SQ (&gt;5). The higher STAI-II scores, cortisol concentration and caffeine consumption were significantly associated with poorer SQ and LS in both genders, however, the state scores and alcohol consumption exhibited a significant relation in men, only. Higher scores for trait inventory and cortisol concentrations correlated negatively with LS in all participants.</p> <p><strong>Conclusion:</strong> Awareness, a proactive approach, and sufficient support can help the relieve and/or manage the stress of medical students and improve SQ and LS.</p> Ervin Ozdemir, Yigit Yazarkan, Bilge Pehlivanoglu Copyright (c) 2024 Ervin Ozdemir, Yigit Yazarkan, Bilge Pehlivanoglu https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2239 Fri, 12 Apr 2024 00:00:00 -0400 Residency Program Website Content May Not Meet Applicant Needs https://ijms.pitt.edu/IJMS/article/view/1635 <p><strong>Background</strong>: Residency program applicants use a variety of resources during the application cycle. Program websites can vary substantially, and it is unclear how the website information is used by applicants. We aimed to determine the most popular information source used by applicants. We also sought to identify specific online content that was deemed important in the decision-making process.</p> <p><strong>Methods</strong>: A survey was distributed to fourth-year medical students at an academic institution. Demographic information was collected, and the importance of various online resources was gauged using a Likert scale. Subgroup analysis was performed for procedural versus non-procedural specialty applicants.</p> <p><strong>Results</strong>: 91 of the 169 fourth-year medical students (54%) completed the survey. The most utilized sources for the students were residency program websites (41%), the Fellowship and Residency Electronic Interactive Database (FREIDA) website (36%), and the Doximity website (14%). The most valued (Likert scale of 4 and 5) website content for the students included information on resident wellness (86%), resident fellowship acquisition (85%), faculty data (84%), residency location and resident lifestyle (81%), and application point of contact (79%). There were significant differences between what procedural specialty applicants deemed important versus what those applying to non-procedural specialties deemed important.</p> <p><strong>C</strong><strong>onclusion</strong>: Residency program websites are commonly used among applicants during the residency match process. Content on resident wellness was highly valued irrespective of specialty choice; however, this information was often not present on residency websites. These findings may help guide website content development initiatives for residency programs to reflect applicant needs more adequately.</p> Sangrag Ganguli, Sheena W. Chen, Sam Maghami, Florina Corpodean, Paul P. Lin, Yolanda C. Haywood, Khashayar Vaziri, Juliet Lee, Hope T. Jackson Copyright (c) 2024 Sangrag Ganguli, Sheena Chen, Sam Maghami, Florina Corpodean, Paul P Lin, Yolanda C Haywood, Khashayar Vaziri, Juliet Lee, Hope T Jackson https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/1635 Fri, 12 Apr 2024 00:00:00 -0400 A Review of Psychosocial Factors on Birth Outcomes in Women with Substance Use Disorder in the United States: The Importance of Preventing Relapse During Sustained Remission https://ijms.pitt.edu/IJMS/article/view/2166 <p>Infant mortality rate has been an area of concern for the United States for years. Many attributing factors, including psychosocial influences, have been identified. Pregnant patients with substance use disorder have also been shown to experience poor birth outcomes. This study examines trends related to socioeconomic hurdles and mental health in pregnant women with substance use disorder. Databases were searched to find resources that outlined these relationships. After assessing the study designs and associations of fifty-five resources, several patterns were observed, including an increased risk of adverse birth outcomes with higher maternal stress and lower socioeconomic status. In pregnant women with substance use disorder, post-traumatic stress and social stigma resulted in negative effects on mental health. Substance use-related pregnancy anxiety was amplified by triggers that resulted in feelings of fetal detachment and substance cravings. Most literature focused on pregnant patients with active addiction; however, these triggers may have an especially powerful effect on women who become pregnant while in substance use recovery. Studies on remission trajectories indicated a higher mortality risk in people with a history of substance use but have not yet calculated the proportion of women capable of bearing children in this category. This highlights the necessity to develop personalized treatment for pregnant women in sustained remission from substance use disorder to prevent relapse during this crucial time. This population would benefit from a screening tool that assesses for high-risk events like PTSD, psychological stress, and substance use triggers and intervention that includes evidence-based mental health resources.</p> Alexandra R. Dailey Copyright (c) 2024 Alexandra R. Dailey https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2166 Fri, 12 Apr 2024 00:00:00 -0400 Medical Students’ Study Habits Through a Sociocultural Lens: A Systematic Literature Review https://ijms.pitt.edu/IJMS/article/view/2200 <p>This study investigates the literature on medical students' study habits and the surrounding sociocultural factors. A systematic literature review was undertaken, aiming to establish what is known, identify gaps in the literature and suggest what further research needs to be done. The review followed the PRISMA guidelines and identified 13 papers that were within the inclusion criteria. These papers were analyzed and discussed through a sociocultural lens, dividing the results into four sociocultural groupings: Personal, Behavioral, Environmental and Cognitive. The findings suggest that while sociocultural factors influence medical students' study habits, individual behaviors and attitudes predominantly guide their study decisions. The findings also suggest that there is little research into the intersection of these factors. It is recommended that the factors drawn from this systematic review be used to formulate more direct research into study habits with a magnified approach to help provide medical institutions, policymakers, and students with information to better inform their decisions and produce efficient, healthy study habits.</p> Hamzah Shahid Rafiq, Erik Blair Copyright (c) 2024 Hamzah Shahid Rafiq, Erik Blair https://creativecommons.org/licenses/by/4.0 https://ijms.pitt.edu/IJMS/article/view/2200 Fri, 12 Apr 2024 00:00:00 -0400