RELATIONSHIP OF LEARNED HELPLESSNESS AND SOCIAL INTEGRATION WITH PSYCHOLOGICAL DISTRESS IN MEDICAL STUDENTS

OBJECTIVE: To explore the relationship of learned helplessness with psychological distress and relationship of social integration with psychological distress in medical students. METHODS: This quantitative correlational survey research was conducted from September 2019 till January 2020, on 315 medical students, aging between 18-24 years, recruited from private and public medical colleges from Karachi, Pakistan. Data was collected through purposive sampling technique from students of all five medical years. To measure the variables, Learned Helplessness Scale, Social Inclusion Scale and Depression, Anxiety and Stress Scale were used. The institutes were visited as a part of survey-based methodology for this research. RESULTS: Out of 315 medical students, 223 (70.8%) were females and 92 (29.2%) were males. Mean age of students was 21.33±2.19 years and mean time spent by participants in university was 7.49±2.06 hours. Majority (n=272/315; 86.3%) were single. About 41.6% (n=131/315) completed three years of medical education. Majority (n=250/ 315; 79.4%) lived with their parents and 303 (96%) student’s parents could afford their medical education. Twenty-seven (8.6%) students consulted psychiatrist/psychologist at least once and 33 (10.5%) students had family history of psychological illness. Thirty-six (11.4%) students had other health-related problems. Outcomes depicts a weak positive correlation between learned helplessness and psychological distress (r= 0.218, p<0.01) and a weak negative correlation between social integration and psychological distress (r = -0.272, p<0.01). CONCLUSION: Medical students who had more robust social networks had a reduced chance of psychological distress than their counterparts who had weaker ties

Chronic Obstructive Pulmonary Disease Prevalence and Associated Factors in a Setting of Well-Controlled HIV, A Cross-Sectional Study

In Sub-Saharan Africa, COPD remains prevalent but its association with HIV is not well characterized especially in rural settings. We assessed for COPD prevalence, associated factors and lung function profile among HIV-infected individuals attending ART clinics in rural Nakaseke district of Uganda. We enrolled HIV-positive participants from four HIV treatment centers in rural Uganda. Participants underwent spirometry testing following standard guidelines. We defined COPD as a post-bronchodilator FEV 1 /FVC ratio less than the fifth percentile of the NHANES III African-American reference. We assessed for factors associated with COPD and lung function profiles using multivariable logistic and linear regression analyses. We analyzed data from 722 HIV-positive participants (mean age 48.0 years, 59.7% women). Over 90% of participants were on ART for a median duration of 4 years (IQR 2-7 years), with a median viral load of 0 copies/mL (IQR 0-0 copies/mL), current and baseline CD4 + T cell count of 478 cells/mm 3 (IQR 346-663 cells/mm 3 ) and 335 cells/mm 3 (IQR 187-523 cells/mm 3 ) respectively. The prevalence of COPD was 6.22%. COPD was associated with worse respiratory symptoms and health status. History of pulmonary tuberculosis was strongly associated with COPD (adjusted OR = 4.92, 95% CI 1.71 to 14.15, p = 0.003) and reduced lung function. Use of ART, CD 4 +T cell count and viral load were not associated with COPD or reduced lung function. In conclusion, we report a COPD prevalence of 6.22% in HIV-infected individuals in rural Uganda. Pulmonary tuberculosis remains the strongest predictor of COPD risk and reduced lung function in well-controlled HIV