Rakhshaan Khan

An Ounce of Discretion Is Worth a Pound of Wit — Ergonomics Is a Healthy Choice

Objective The objective of the study was to identify the occurrence and outcome of low back ache amongst computer users and their relation to age, gender, occupation and duration of computer use. Materials and Methods A self reported questionnaire tailored from Occupational Health and Safety Act of the Ministry of Labor, Ontario, Canada was used. Results 416 participants 55.5% males and 45% females using computers for a minimum of five years with age range 22 to 59 years belonged to different occupational groups. Consecutive hours of computer work was found to be associated with work related backache or discomfort in 27.4% (n = 114) participants (16.1% male, 11.3% female). Frequent short breaks improved backache (p value <0.001) in 93 (22.4%) participants (13.2% male, 9.2% female). No significant relation was observed with the duration of computer usage or usage per day; between the two genders or occupational groups. Backache had no significance within age groups. Conclusion Our study identifies the occurrence of low back pain among those who are using computer for consecutive hours without breaks and the results suggest the need to create health awareness especially use of short breaks to minimize the risk and occurrence of low back pain. The result of this study can also be used to improve ergonomic design and standards.

Impact of peak estradiol levels on reproductive outcome of intracytoplasmic sperm injection.

Objective: To observe effect of peak estradiol (E2) levels on outcome after intra cytoplasmic sperm injection (ICSI). Methods: Quasi experimental design conducted in “Islamabad Clinic Serving Infertile Couples” from June 2010 till August 2011. Down regulation with mid luteal suppression of 564 females aged 18-41 years was done with gonadotrophin releasing hormone agonist followed by controlled ovarian stimulation, ovulation induction (OI), oocytes pickup and embryo transfer. Samples for peak serum E2 at the time of OI was estimated by Enzyme Linked Immuno Sorbent Assay. The association of peak E2 with outcome groups of Intracytoplasmic sperm injection (ICSI) (Group I) beta hCG <5 m IU/ml, (Group II) with beta hCG>5 mI U/ml and no cardiac activity and (Group III) with beta hCG>5mIU/ml and cardiac activity on trans vaginal scan was identified. Statistical comparison by one way analysis of variance (ANOVA) via SPSS version 15 was done. Results: A clinical pregnancy rate of 36% was achieved, pregnant females(Group III) had higher peak E2 2269 ± 80.97 as compared to 1419 ± 37.07 and 1807±90.28 pg/ml (mean ± SD) in Groups I and II respectively (p<0.0001) Elevated serum E2 was significantly associated with better oocyte recovery, fertilization, cleavage and implantation rates (p<0.0001) . Conclusion: A high serum E2 measured on OI day can predict success of treatment after ICSI. Females who had high peak E2 had greater number of retrieved, mature and fertilized oocytes with thick endometrial lining that helped in implantation and clinical pregnancy.

Financial wellness awareness: A step closer to achieve Millennium Development Goals for Pakistan.

Objective: To explore financial wellness (FW) awareness amongst public and private sector medical college students of Karachi. Methods: A cross sectional questionnaire based survey was conducted on medical students from 3 public and 5 private sector medical colleges of Karachi from February 2011 to December 2011. All ethnic groups having age range of 18-23 years were included. A questionnaire tailored from wellness wheel evaluated the responses of FW on a four point Likert’s scale ranging from 0-3(never, sometimes, mostly, and always). Factor analysis explored common FW factors among both public and private sector medical college (MC) students. Results: Private MC Students were better in terms of making short and long terms financial goals compared to students in public sector. The students of public MC were more focused to make and restricting to given budgets (p=0.05). The FW element of keeping savings in bank account was responded more by private MC candidates (P < 0.0001) but was spent thrift as well (P < 0.0001). Factor analysis revealed two factors; ‘Financial Security Wellness’ which was better in Private MC Students (p=0.001) and ‘Care towards Expenses Wellness” in which results were not significant. Conclusion: Both groups of medical college students lacked FW awareness element in terms of caring towards financial expenses. The awareness of importance of financial security was practiced better by private MC students in terms of making short and long term financial goals and keeping savings in bank accounts. They were however deficient in the knowledge of making and restricting themselves to budgets.

Dimensions of physical wellness among medical students of public and private medical colleges in Pakistan

Objectives: To determine adherence to dimensions of physical wellness among medical students of public and private medical colleges in Pakistan. Methods: This cross-sectional study was carried out from January to July 2011 among 820 students of private and public medical colleges in Karachi, Pakistan. Results: Overall, medical students scored low in dimensions of physical wellness. Private medical colleges students were fond of vigorous activities such as aerobics and swimming, whereas public medical colleges students were involved in moderate intensity activities such as walking and use of stairs (p<0.0001). Private students reported to consume more fast food (p=0.0001), had less sleep (p=0.0001), but attended regular annual medical checkups (p=0.009) as compared with their public institute counterparts. Safe practices such as avoidance of tobacco were almost the same. Conclusion: Comprehensive adherence to all dimensions of physical wellness was lacking among medical students.

Exploring emotional wellness: The art of being cheerful about life at medical campus

Objective: To identify and compare the awareness of emotional wellness (EW) in Private and Public Sector Medical University (MU) students of Pakistan. Materials and Methods: Qualitative and quantitative aspects of EW were evaluated by; a structured questionnaire tailored from wellness wheel by four points Likerts scale; score ranging from 0 to 3. Comparison of scores in Private and Public MU students was done by Mann–Whitney test. Focus group discussions (FGDs) were conducted with 20 students from each MU after taking the informed consent, a week after the questionnaires were administered. Results: The aggregate of EW scores was 21.36 ± 4.54 versus 20.54 ± 4.34 in Public versus Private MU students (P = 0.028). Private MU students were; significantly less cheerful and hopeful (P = 0.008), considered not always valued by their family and friends (P < 0.0001) as compared to Public MU candidates. Private students lived life autonomously and did not consider to consult or take help from parents or any other family members (P = 0.0003). They however consulted psychologist/psychiatrist more than Public MU students (P = 0.024). Both type of students nearby significantly helped people during emotional outbursts (P = 0.096). The results of FGDs highlighted the absence of formal advising, mentoring process, wellness organizations, and facilities available to cope with the emotional distress of medical students. Conclusion: Public MU students had sound emotional well-being and took help only from their family members rather than consultation with psychiatrists. The EW being an important indicator of mental health thus needs to be catered at the undergraduate level.