Gender differences in the factors influencing the choice of future career among the final stage Turkish medical students

Background: Turkey has a marked increase in the proportion of female medical students and graduates doctors compared to males. However, females are still underrepresented in some disciplines and grouped in other branches of medicine. It is essential to regularly assess the medical students' trends toward the specialty and avoid the shortage and maldistribution in some critical specialties. This study aims to investigate the gender differences in Turkish medical students’ specialty preferences and influencing factors. Methods: A descriptive cross-sectional study carried out among final year students at the Bezmialem Vakif University (BVU), Faculty of Medicine in Istanbul, Turkey. Data collected from March to April 2018 using a pre-tested self-administered questionnaire included socio-demographic characteristics of the population, first choices for specialization, and the factors influencing those choices. An independent sample t-test performed to test the gender differences in different influencing factors. Data were analyzed using SPSS version 16. Results:  A total of seventy (70) students (response rate of 69.5 %) included in the data analysis. The mean age of total respondents was 24.9 ± 0.96 (ranged 23-27), and the male to female ratio of students was approximately 1:1.4. Out of nineteen (19) factors, statistically significant gender differences noted in the mean scores of six factors. Male students were more influenced by family expectations (2.76 ± 0.87, p=0.008), geographical consideration (2.97 ± 0.91, p=0.053), and high income expectations (2.90 ± 0.90, p=0.024) compared to female students. However, female students were more influenced by personal interests (3.61 ± 0.49, p=0.041), personality characteristics (3.59 ± 0.55, p=0.010) and malpractice (2.73 ± 1.03, p=0.015) compared to male students. Conclusion: There is a significant difference between the sexes in terms of priorities; family, income, and geographical distribution significantly impacted on men, while women were more concerned with lifestyle, well-being and avoiding responsibility

Neck pain among smartphone users: an imminent public health issue during the pandemic time

COVID-19 Pandemic resulted in social mobility and travel restrictions to contain the infection. It has been reported that there happened post-pandemic surge in the use of the internet and social media as people rely on it more often for entertainment, work, and learning purposes. It is also been used as an unhealthy coping strategy for pandemic related stress. The smartphone was found to be the most common gadget used for accessing internet-based services. Owing to the postural alterations related to the small screen size of smartphones, neck pain was reported very commonly among smartphone users. Neck pain among smartphone users is a public health concern needing immediate attention in the pandemic time. Many of the risk factors leading to neck pain among smartphone users are modifiable. The authors outline preventive strategies that are mostly self- regulated. The strategies recommended include reducing Smartphone usage time (Smartphone-Free Time, Smartphone-Free Zone), maintaining ideal posture (Focus Breaks, Mobility Breaks, How am I keeping my posture?, Hands-free alternatives), doing regular exercises, preparing and following an activity schedule, and inculcating healthy habits.   References Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71–6. https://doi.org/10.1016/j.ijsu.2020.02.034 Király O, Potenza MN, Stein DJ, King DL, Hodgins DC, Saunders JB, et al. Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance. Compr Psychiatry 2020; 100:152180. https://doi.org/10.1016/j.comppsych.2020.152180 Sun Y, Li Y, Bao Y, Meng S, Sun Y, Schumann G, et al. Brief Report: Increased Addictive Internet and Substance Use Behavior During the COVID‐19 Pandemic in China. 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Appl Ergon.2017 Mar;59:132–42. https://doi.org/1016/j.apergo.2016.08.020 Alsalameh AM, Harisi MJ, Alduayji MA, Almutham AA, Mahmood FM. Evaluating the relationship between smartphone addiction/overuse and musculoskeletal pain among medical students at Qassim University. J Fam Med Prim care. 2019;8(9):2953–9. https://doi.org/4103/jfmpc.jfmpc_665_19 Toh SH, Coenen P, Howie EK, Smith AJ, Mukherjee S, Mackey DA, et al. A prospective longitudinal study of mobile touch screen device use and musculoskeletal symptoms and visual health in adolescents. Appl Ergon. 2020; 85:103028. https://doi.org/1016/j.apergo.2019.103028 Lee S, Kang H, Shin G. Head flexion angle while using a smartphone. Ergonomics. 2015 Feb 17;58(2):220–6. https://doi.org/1080/00140139.2014.967311 Guan X, Fan G, Chen Z, Zeng Y, Zhang H, Hu A, et al. Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics. 2016;59(11):1453–61. https://doi.org/10.1080/00140139.2016.1147614 Han H, Shin G. Head flexion angle when web-browsing and texting using a smartphone while walking. Appl Ergon. 2019; 81:102884. https://doi.org/1016/j.apergo.2019.102884 Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. J Chiropr Med. 2017;16(3):220–9. https://doi.org/1016/j.jcm.2017.03.004 Park J-H, Kang S-Y, Lee S-G, Jeon H-S. The effects of smart phone gaming duration on muscle activation and spinal posture: Pilot study. Physiother Theory Pract. 2017;33(8):661–9. https://doi.org/10.1080/09593985.2017.1328716 Xie Y, Szeto GPY, Dai J, Madeleine P. A comparison of muscle activity in using touchscreen smartphone among young people with and without chronic neck–shoulder pain. Ergonomics. 2016;59(1):61–72. https://doi.org/10.1080/00140139.2015.1056237 Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014; 25:277–9. Li W, Yang Y, Liu Z-H, Zhao Y-J, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci. 2020;16(10):1732–8. https://doi.org/7150/ijbs.45120 Namwongsa S, Puntumetakul R, Neubert MS, Boucaut R. Factors associated with neck disorders among university student smartphone users. Work. 2018;61(3):367–78. https://doi.org/3233/WOR-182819 Ko P-H, Hwang Y-H, Liang H-W. Influence of smartphone use styles on typing performance and biomechanical exposure. Ergonomics. 2016;59(6):821–8. https://doi.org/10.1080/00140139.2015.108807

Evaluation of self-medication among Iraqi pharmacy students

Background: Practicing self-medication is common and a worrisome issue because of irrational drug use. This study aimed to evaluate self-medication knowledge and views among the final year pharmacy students in Iraq.  Methods: A cross-sectional descriptive study was conducted from December 2018 to January 2019. A pre-validated and self-administered questionnaire was recruited to survey pharmacy students at the University of Baghdad and Al-Rafedain University College. The Statistical Package for the Social Sciences version 20 (SPSS v. 20) software used to save and analyze the data. Results expressed as numbers and percentages. Results:  A total of 344 students (response rate: 94.24%) with a mean age of 22.10 years included in this study. Most of them were female (61.60%). Self-medication was high in the past year (84.88%), and most of them (86.04%) got their medications from pharmacies. About (62.79%) of students used antibiotics as self-medication for a few days, although a significant number were aware of bacterial resistance. The main reasons to self-medicate were quick relief desired, convenience, and avoiding waiting at clinics. The reasons against it were a misdiagnosis, adverse effects' risk, and wrong medication use. Doctor visits sought necessary in cases of worsening symptoms, severe pain, and serious problems. Headache, cough, and diarrhea were the most frequent indications. Conclusion: The self-medication prevalence is high; the knowledge is moderate, and the views about the self-medication concept are generally appropriate

Laboratory manifestations of COVID-19 associated with hemostatic abnormalities

Hemostatic abnormalities had been reported in COVID-19 patients, which may include disseminated intravascular coagulation (DIC), hypercoagulability, and alterations in platelets parameters. Articles that investigate the alterations of hemostatic abnormalities during the COVID-19 disease (2020-2021) and their predictive value of disease outcome have been thoroughly reviewed. Among the reviewed articles, thrombocytopenia is observed in 5.0-41.7% of COVID-19 patients, which is related to disease severity. Moreover, other platelets parameters, including Platelets/lymphocytes ratio (PLR), Mean platelets volume (MPV), and aggregation, may also be affected. On the other hand, findings of coagulation tests such as D dimer; fibrinogen, Antithrombin (AT), and Fibrin degradation products (FDP) are significantly elevated in COVID-19 patients, while in a single study, most of the patients had positive Lupus anticoagulants (LA) and normal protein C (PC). In the same perspective, these alterations showed significant correlations with disease severity. Overall, hemostatic laboratory markers are significant predictors of COVID-19 disease outcome as indicated by the increased risk of venous and arterial thrombotic events, especially in ICU patients. &nbsp

What textual copying does not count as plagiarism? Elaborate examples and problem-solving

Scientists are motivated to publish original and high-quality articles. The only right way to accomplish that is through a long and daunting academic career. Sometimes illegal shortcuts and tortuous methods are attempted by some people. Bolstered with elaborate examples and problem-solving, this treatise explains the legal ways of textual copying and proper referencing techniques. Moreover, it teaches how to steer away from copyright violations. In addition, it warns off all forms of literary theft and the catastrophic consequences of research misconduct

Gender differences in the domains of job satisfaction: a questionnaire survey among doctors

Background: The impact of gender differences in the labor market cannot be neglected when studying job satisfaction among doctors. This study aimed to assess the gender differences in a ten-items Warr–Cook–Wall (WCW) job satisfaction scale among Iraqi medical doctors.  Methods: A cross-sectional study was conducted between January and June 2014 in Iraq. The multistage sampling technique was recruited to collect the data from 20 health institutions. A total of 576 doctors returned the self-administered questionnaire (response rate= 87.3%). Student t-test and the Pearson correlation tests were used to analyzing the data. Results:  Female doctors rated the overall job satisfaction index significantly higher than their peer male colleagues (P <0.001). Findings of student t-test showed a significant gender difference; women doctors appeared more satisfied than men in the freedom to choose the method of working, satisfied with their colleagues and fellow workers, amount of responsibility given to them, income, opportunity to use their abilities, hours of work and the amount of variety in the job. In contrast, the Pearson correlation coefficient results indicated a high satisfaction among male doctors than females in terms of recognition for good work (P =0.02) and the physical working condition (P =0.04), respectively. Conclusion: Analysis of data based on indices rather than the only overall job satisfaction appeared as an efficient method to understand gender differences. The possibility of increasing the representation of women in recognition and awards may raise the level of job satisfaction

A juxtaposition of safety outcomes between various doses of sodium-glucose co-transporter inhibitors, in insulin-treated type-1 diabetes mellitus patients: a protocol for systematic review and meta-analysis of randomized controlled trials

  Background: Several clinical trials have tested the safety profile of sodium-glucose co-transport inhibitors’ (SGLTis) in adult type 1 diabetes mellitus (T1DM) patients. However, no systematic review has yet compared its variation between large and low dose SGLTis. Henceforth, a review protocol is proposed here to review it. Methods: Different electronic databases will be searched for randomized-controlled trials (published in the English language) studying the above objective, irrespective of their publication date. After selecting the eligible trials, their data on the study design, population characteristics, compared interventions, and outcomes of interest will be extracted. Then, utilizing the Cochrane tool, each trial's risk of selection bias, detection bias, performance bias, attrition bias, reporting bias, and other bias will be judged. Next, depending on clinical heterogeneity among the trials, a random-effect or fixed-effect model meta-analysis will be used to compare the respective outcomes. Via the Chi2 and I2 statistics, the statistical inconsistency among the trials will be estimated. When this is substantial, subgroup analysis will follow. Publication bias will be evaluated by funnel plots and Egger’s test. A sensitivity analysis will be done to check different assumptions. If a quantitative juxtaposition is not possible, a narrative reporting will ensue. Conclusion: The proposed study will perform a dose-wise juxtaposition of the safety profile of SGLTis in insulin-treated T1DM patients. Registration: Prospective Register of Systematic Reviews (PROSPERO) (Registration no. CRD42019146578)   &nbsp

Determinant factors of treatment adherence of hypertensive patients in a rural area of Indonesia

Background: The surging prevalence of hypertension due to lifestyle brought forth an increase in degenerative diseases. Adherence is important in achieving the effectiveness of therapy. This study aims to analyze the factors affecting medication adherence in patients with hypertension.  Methods: A cross-sectional study was conducted between 20-24 February 2023 at Turirejo Village, Lawang District, Malang, Indonesia. Participants were hypertensive patients currently receiving treatment. The MMAS-8 questionnaire was used to classify adherence to medication for hypertension. Analysis with binary logistic regression test was performed on variables to display odds ratio values was conducted at a significance level of p<0.05. Results: A total of 37 adults diagnosed with hypertension participated in this study. Patients were dominantly consisting of elderly (≥ 56 years old; 73.0%) and females (86.0%). Seventy-six percent of patients have low adherence, twenty-four percent of patients have moderate adherence, and no patient has high adherence. Duration of illness, knowledge, and attitude variables significantly affect adherence (low and moderate) to medication for hypertension. Multivariate analysis showed that patients with a duration of illness above 10 years (Adjusted OR 18.27; 95% CI 1.72-194.47; p-value 0.016) and positive attitude towards treatment (Adjusted OR 12.76; 95% CI 1.25-130.40; p-value 0.032, respectively) increase the possibility of moderate adherence towards the medication of hypertension. Conclusion: Improvements in factors that affect adherence to hypertension treatment are needed to increase the success of the Non-Communicable Disease Prevention Program. Further research in identifying factors of economic capacity and access to health service providers is needed to validate the results of this study

Perceived stress among Sri Lankans during the economic crisis: an online survey

Background: The Sri Lankan population's mental health was undoubtedly significantly impacted by the county’s economic crisis. This study investigated the prevalence of perceived stress and its socio-demographic predictor.  Methods: A web-based cross-sectional survey was undertaken in July-August 2022, using google forms. The respondents were assessed for socio-demographics, and the level of stress experienced over the previous month. Ten-item self-reported perceived stress scale (PSS) was used to assess stress levels analysis. Descriptive statistics and logistic regression analysis were used. Results: A total of 1214 respondents, aged ≥18 years were included in the survey. The majority were females (60%). The mean PSS score of this population was 21.95 ±6.09. More than half of the respondents reported moderate levels of stress (68.5%), while 23% registered high levels. A significant association was demonstrated between stress levels and variables age, gender, and residential area. Respondents below the age of 40 years (OR 1.936, 95% CI, 1.365-2.748, P<0.001) were more likely to report higher odds of having increased PSS scores, while men (OR 0.640, 95% CI, 0.491-0.835, P=0.001), and those without children (OR 0.556, 95% CI, 0.409-0.756, P<0.001) had significantly lower odds of reporting PSS. Conclusion: Respondents experienced moderate to high levels of stress during the financial crisis in Sri Lanka. Higher stress was predicted by younger age, female gender, and having children. The results highlight the urgent need for stress management interventions to boost resilience and improve psychological well-being in this situation.

Assessment of obesity and central obesity among patients with knee osteoarthritis in Al-Sadder Hospital, Baghdad, Iraq

Background: Obese individuals are at increased risk for many chronic and life-threating conditions. The most significant burden on the musculoskeletal system resulted from osteoarthritis, mainly knee osteoarthritis. This study aimed to determine the prevalence of obesity and central obesity among a group of patients with knee osteoarthritis, analyze the effect of demographic variables, and examine the relationship between these two types of obesity. Methods: A cross-sectional study was conducted in Al-Sadder hospital in Baghdad from June through September 2017. A convenience sample of 200 patients with knee osteoarthritis was collected. Those with body mass index (BMI) equal to or more than (30 kg/m2) considered obese. The cutoff point for central obesity was the waist-hip ratio (WHR) above (0.9) for men and above (0.85) for women. The risk ratio and 95% confidence interval (95% CI) calculated to determine the strength of the relationship. P-value ≤ 0.05 was considered statistically significant.  Results: The number of obese patients, according to BMI, was 163 (81.5%). For central obesity, the men and women with unhealthy WHR were 53 (96.4%) and 131 (10.3%), respectively. No significant difference in the rate of obesity among age groups (p= 0.986). Central obesity is significantly lower in those less than 45 years (p=0.023). In men, the risk of obese to have central obesity is (1.06) with no significant association (95% CI = 0.89 - 1.27, P = 0.481). In women, risk ratio = 1.56 and association is significant (95% CI = 1.03 - 1.36, P = 0.037). Conclusion: The increasing age was associated with a rise in the rate of central obesity, but not with obesity. The overlap between the two types of obesity was evident and significant only in women