Assessing Physiological and Psychological Factors Contributing to Stress among Medical Students: Implications for Health.

Background: Physiological responses to stress disturb internal homeostasis, leading to serious health consequences. Medical students experience high stress levels that should be managed promptly to prevent stress-related impacts on students' health and education. Aim: This study aims to identify the relationship between stress factors, general health, and academic performance. Methods: This study recruited 421 medical students of all academic years. Participants completed an online survey assessing stress levels using a validated 10-item Perceived Stress Scale. Stress was also compared with students' health and academic performance. Results: We found that 93.6% of our sample experienced moderate to severe stress, and 31% reported increased stress due to the coronavirus disease (COVID-19) pandemic. Except for internship students, stress significantly decreases as students progress each academic year (p < 0.05). Students with higher GPAs and with comorbidities are more stressed. Comorbidities were primarily reported in students in their final years of education with a 4% lower GPA than healthy students. Although we had three stress-related themes (general, academic, and pandemic), students' perceptions of stress factors were primarily academically related. Conclusions: Students experience high stress levels in their final educational years, which might increase the risk of health issues and low academic performance. It is essential to innovate stress-coping strategies specially designed for medical students and mandatorily provided by all medical colleges and to educate students on the effects of stress on their health.

Post-Traumatic Bilateral Facial Paralysis Associated with Temporal Bone Fracture.

Bilateral traumatic facial paralysis is a very rare clinical condition. Loss of taste sensation, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 23-year old male, who developed bilateral facial paralysis with loss of taste sensation and hearing impairment, following a motor vehicle accident, is presented. He had initially presented with unconsciousness for about 2 hours after he sustained closed head injury after a motor vehicle accident. Initial Computed Tomography (CT) scans revealed a small epidural hematoma, right temporal bone fracture and air densities around the basal cistern. On the 4th day after trauma, he was noted to have incomplete closure of both eyes and was feeling difficulty with chewing and drooling of saliva. Electrodiagnostic testing confirmed the diagnosis of bilateral facial paralysis-House-Brackmann (HB) grade V. Electroneuronography (ENoG) showed degeneration of 90% nerve fibres bilaterally. The high-resolution CT scans showed bilateral temporal bone fractures. At 3 months of follow-up, the patient had partial recovery of facial nerve function bilaterally and improvement in HB classification to grade III and ENoG of 60% was observed.

PPAR-γ activator induces neuroprotection in hypercholesterolemic rats subjected to global cerebral ischemia/reperfusion injury: in vivo and in vitro inhibition of oxidative stress.

Hypercholesterolemia (HC) and aging combine to increase the incidence of cerebrovascular disease through oxidative stress. Our investigation examined the effects of diet-induced hypercholesterolemia (2% for 8weeks) on the extent of brain injury in response to global cerebral ischemia/reperfusion (GCI/R) and the neuroprotective potentials of rosiglitazone in relation to oxidative stress. HC exacerbated the decline in the brain levels of GSH and the increase in MPO, proinflammatory markers and hippocampal lesions in response to GCI/R. HC rats receiving rosiglitazone, PPAR-γ agonist, demonstrated preservation of cell viability of CA1 hippocampal region and attenuation of brain edema. They also showed elevated levels of GSH and low levels of the other parameters similar to non-HC rats subjected to GCI/R. In vitro, rosiglitazone dose-dependently inhibited ROS generation by neutrophils. The results suggest exacerbation of brain lesions by HC in response to GCI/R. The neuroprotective therapeutic potentials of rosiglitazone are comparable to non-HC animals. Mechanisms of protection are possibly due to anti-oxidant, anti-inflammatory effects and scavenging properties of rosiglitazone. These results add to the beneficial therapeutic effects of rosiglitazone and its significance for age-associated diseases including hypercholesterolemia.

Effect of duration of exposure to cement dust on respiratory function of non-smoking cement mill workers.

This study aimed to determine the effect of long term exposure to cement dust on lung function in non-smoking cement mill workers. This is a cross-sectional study of respiratory functions. Spirometry was performed in 100 apparently healthy volunteers; 50 non-smoking cement mill workers and 50 non-smoking un-exposed subjects. Based on the duration of exposure, cement mill workers were divided into three groups, less than 5, 5-10 and greater than 10 years. All subjects were individually matched for age, height, weight, and socioeconomic status. Pulmonary function test was performed by using an electronic spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV(1)), Peak Expiratory Flow (PEF) and Maximal Voluntary Ventilation in cement mill workers who had been working in the cement industry for more than 10 years compared to their matched un-exposed group. Lung functions in cement mill workers were significantly impaired and results show a long term duration response effect of years of exposure to cement dust on lung functions.