Triggering and protective factors of burnout in medical resident physicians in a lower-middle-income country: A cross-sectional study

Background: Residents and interns are prone to emotional and physical exhaustion, also known as burnout. Burnout has not been studied much in physicians working in lower-middle income countries. We conducted this study to determine the burden of burnout among internal medicine residents and to identify triggering and protective factors associated with burnout.Materials and methods: A cross-sectional study was conducted at two institutes in Karachi from 2018 to 2019. All residents registered in the internal medicine program for at least 6 months were invited to participate via an online survey. An abbreviated version of the Maslach Burnout scale was used to measure burnout, and protective and triggering factors were recorded according to known factors.Results: A total of 71 out of 92 (77%) residents participated. The mean (SD) age of the participants was 28 (3.1) years, 51 (71.8%) were females and 51 (71.8%) were junior residents. A total of 33 (46.5%) residents had burnout. Burnout and emotional exhaustion were more in female residents (p \u3c 0.05). None of the triggering factors attained statistical significance. The protective factors for burnout which showed significant association were good relationship with friends (OR 0.1-95% CI 0.0, 0.6), exercise and extra-curricular activities (OR 0.2-95% CI 0.0, 0.7), celebrating accomplishments (OR 0.2-95% CI 0.0, 0.7), having enough money (OR 0.2-95% CI 0.0, 0.4), and ability to plan for future (OR 0.1-95% CI 0.0, 0.6).Conclusion: More than a third of medicine residents suffered from burnout. We need to focus on rejuvenating activities for medicine residents to decrease burnout among them. If not addressed adequately this may result in a compromise in the quality of care being provided to patients

ACTUALIZATION OF RELIGIOUS MODERATION TOWARDS A SOCIETY 5.0 ERA THROUGH UNDERSTANDING EDUCATION MANAGEMENT, MENTAL HEALTH AWARENESS, AND ORGANIZATIONAL ACTIVITY

Currently the presence of the millennial generation is sunnatullah, the emergence of this generation is due to advances in science and technology. Millennials rely heavily on social media, however, they do not yet have a strong filter to be able to filter the information they receive. The millennial generation also has challenges in facing a new era in their life, namely the era of society 5.0 as a complement to the 4.0 Industrial Revolution. In this instantaneous era, various religious problems that never end, such as rampant politicization, terrorism, radicalism, extremism, disintegration, misuse of da'wah, exploitation of the people, so many hate speeches, hoaxes and slander are now flooding the faces of the diversity of the nation. In relation to this impact, the level of understanding of education management, mental health awareness, and organizational activeness turned out to be greatly influences human behavior, especially for new students who are vulnerable to invitations from outside influences. Facing an era like this, it is time for the millennial generation to take part in actualizing the moderation of religion as a solution to religious problems

نوآبادیاتی اور شعریاتی تناظر میں انیسویں صدی کے نظری مباحث

Nineteenth-century theoretical discourse in a colonial and poetic context .When nineteenth-century ideological debates are discussed in a colonial and poetic context, the names Azad, Hali, and Shibli come to the fore. The search for references to poetry in Urdu literature and the study of its applied forms rely heavily on contemporary literary criticism. The poetic landscape of the 19th century does not reflect the oppression of the colonial system, but it is nonetheless a favor of the West and a response to the impulses of colonial thought. There is also room for preference. There is also room for experimentation on ghazal structure and identification. The mind is also interested in resources. The main theme of ghazals is love, and the sweetness of the love element of ghazals is called tagzal. Ghazal, an Urdu language, also has expressions for sex, but sex here is a human emotion, not an animal one. But above all, it has become a center of pleasure and soul aesthetics. Ghazal's sexual passion, the quest for beauty, the concept of caste perfection, the breadth, universality, and balance of his intellectual area was created

Formulation and evaluation of niosomes-based chlorpheniramine gel for the treatment of mild to moderate skin allergy

Purpose of present study was to develop eight formulations of chlorpheniramine (CPM) niosomes according to 23 factorial design, characterise on the basis of various evaluation tests, i.e. in vitro drug release, SEM, FTIR, TGA and release kinetics, optimise the eight formulation on the basis in vitro drug release data, formulate gel of optimised dispersion, and to perform in vivo and histopathological study using gel of optimised dispersion on rabbits. Here, N3 having low level of cholesterol and span-80 but high level of span-60(0.1:0.2:0.05) was selected as optimised dispersion of niosomes that showed highest drug release i.e. 88.25% at pH 6 over 24 h of study and followed Korsmeyers-Peppas release kinetics with Fickian diffusion mechanism. After application of statistic by Analysis of variance (ANOVA) with 3D surface plots construction, gel of optimised dispersion of CPM niosomes was formulated, and evaluated by tests for i.e. viscosity, Spreadability, Extrudibility, drug content, drug entrapment, stability, SEM, FTIR, TGA, in vitro drug release, in vivo drug release following first order kinetics and histopathological study. Niosomal gel of CPM ensured successful development using suitable combination of non-ionic surfactants, and effective loading of drug for targeted delivery of drug

Effect of COVID-19 on lipid profile parameters and its correlation with acute phase reactants: a single-center retrospective analysis

Background and objective: The development and correlation of dyslipidemia is unknown in COVID-19. This investigation was performed to assess the pathological alterations in lipid profile and their association in COVID-19. Methods: This was a retrospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 patients (mild: 319; moderate: 391; critical: 357). Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results: LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 patients when compared with the control group (P Conclusion: Hypolipidemia develops in increasing frequency with severe COVID-19 disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.</p

Depression is linked to uncontrolled hypertension: a case-control study from Karachi, Pakistan.

Background: High blood pressure is an important risk factor for cardiovascular disease and may be more prevalent in persons with psychopathology. Objective: To determine the association between uncontrolled hypertension with depressive and anxiety disorders in two tertiary care centers in Karachi. Methods: It was a case–control study conducted in two hospitals in Karachi. Cases were patients with uncontrolled hypertension and controls were patients with controlled hypertension. History of anxiety or depression as measured by Hospital Anxiety and Depression Scale (HADS) was the exposure. HADS of 48 was suggestive of having anxiety or depression. Results: A total of 700 participants were approached, out of whom 590 fulfilled the inclusion criteria and consented to participate, 323 (54.7%) participants were enrolled as cases and 267 (45.3%) as controls. Mean (SD) age was 54.98 (12.38) years, 229 (38%) were males. Odds ratio (OR) (95% CI) of having uncontrolled hypertension and being depressed (HADS-D48) was 2.02 (1.44–2.83), p value 0.001. The association remained significant even after adjusting for age and gender in Model 1 OR (95% CI): 1.82 (1.27–2.60), p value ¼ 0.001, ethinicity and education in Model 2 OR (95% CI): 1.87 (1.29–2.71), p value ¼ 0.001 and comorbids, history of hospitalization body mass index in Model 3 OR (95% CI): 1.94 (1.31–2.85), p value ¼ 0.001. Conclusion: There is association between uncontrolled hypertension and depression that is independent of sociodemographic factors, comorbids and history of hospitalization