Emergence of coronavirus disease 2019 (COVID-19) forced the worldwide higher educational institutes to adopt distance learning mode. Further, remote electronic exams (E-exams) were considered as mode of assessment. Objectives: This cross-sectional study evaluated the students' experience of remote E-exams during the COVID-19 pandemic among Medical Sciences students in Jordan. Materials and Methods: A survey of 29 questions was prepared on Google forms and distributed among students at Faculties of Medical Sciences (Medicine, Dentistry, Pharmacy, Nursing and Applied Medical Sciences) at Jordan University of Science and Technology. The questions include students' demographics, stress experience, and factors contributing to stress as well as behavioral changes related to remote E-exams. Responses were analyzed using descriptive, cross tabulation and Chi-square tests. Results: Among 1019 respondents, 32% reported more stress with remote E-exams. This was associated with academic major and gender. Among students with more stress during remote E-exams, the exam duration, mode of questions navigation and technical problems (exam platform and internet connectivity) appeared as the main factors related to stress in 78%, 76% and >60%, respectively. Other factors include concern regarding the teaching methods, exam environment and students' dishonesty. Remote E-exams had negative impact on students' dietary habits (increase consumption of caffeine and high energy drinks, high sugar food, fast food), sleep (reduction in sleeping hours, more consumption of insomnia medications), physical activity (less exercises) and smoking habits (increase). Conclusion: Results suggested a negative impact of E-exams on students within Medical Faculties. Robust exam platform and remote mock E-exams are recommended to reduce students' potential stress. A stress-free environment is very essential to encourage students to adopt remote E-exams, particularly if the pandemic will take longer. Various awareness programs about students' habits related to dietary, sleep quality, physical activity and smoking are highly valuable for students' health benefits. This is of particular importance since the current students at Faculties of Medical Sciences are the future health care providers.

Stress and behavioral changes with remote E-exams during the Covid-19 pandemic: A cross-sectional study among undergraduates of medical sciences.

Background: Many researches in the past have proved that medical students experience elevated level of stress throughout their medical school life Aims and Objective: The aim of the study is to study the prevalence and degree of stress among medical and dental students, find out the various stressors among them and the association of stress with various sociodemographic variables Materials and Methods: A cross-sectional study was conducted among 159 medical and dental students of first and second year in Kist medical college and hospital 81 medical and 78 dental students participated in the study General Health Questionnaire (GHQ-12) and Medical students stress Questionnaire (MSSQ-40) was used Statistical analysis was done by using SPSS version 25 Chisquare test was done to find the association of stress with various factors and to compare the degree of stress between medical and dental students Results: Among 159 medical and dental students, 109 students (686%) were found to have stress 48 out of 81 (593%) were medical students and 61out of 78 (782%) were dental students Moderate stress was observed in 50/81(617%) medical students and 38/78 (487%) dental students Similarly, high stress was observed in 10/81(123%) medical students and 11/78 (141%) dental students Difference in the degree of stress between dental and medical students was not statistically significant (p value >05) Academic related stress was the major source of stress in both medical and dental students Gender, accommodation and motivation for study were found to be significantly associated with stress Conclusions: The first two years of medical and dental students is stressful with academic related stress being the most prevalent stressor Prevalence of stress was found to be more in dental students and the difference in the degree of stress between medical and dental students was not statistically significant

A comparative study of stress among medical and dental students

Introduction: Academic stress is anxiety and stress that comes from schooling and education. There is often a lot of pressure that comes along with pursuing a degree and one’s education.
Methods: A descriptive cross-sectional study design was used to find out academic stress and relationship of academic stress with parent-adolescent relationship, and academic achievement which was conducted in two college of Kathmandu Metropolitan. Study populations were students of the management stream who were studying in class XII. This study adopted non probability purposive sampling method to select college of Kathmandu metropolitan whereas simple random sampling with lottery method was used to select sample of 253 students. Data was coded, categorized and then entered into SPSS 16 and analyzed using both descriptive and inferential statistics.
Results: The findings revealed that nearly half of the respondents (47%) had moderate academic stress and 23.7% have high academic stress. Regarding overall level of relationship with both parents more than half of the respondents (64.4%) have favorable relationship. There is significant relationship between academic stress, academic achievement of previous level and association was seen between academic stress and mother’s education. Students have moderate and high academic stress in their academic path. Irrespective of parent adolescent relationship, majority of adolescent had low or moderate academic stress, research hypothesis was rejected. Respondents who have scored higher grade or academically achieved comparatively had high academic stress, research hypothesis was accepted.
Conclusions: Academic staffs and related concerned authorized individual need to identify early as interventions to assess students' academic stress, in order to reduce academic stress, helps to improve the quality of life and mental health for students.

A Study on Academic Stress, Parent Adolescent Relationship with Parents and Academic Achievement of Adolescent Students

ABSTRACT Introduction: Chronic obstructive pulmonary disease is a preventable and treatable disease marked by persistent airflow limitation. Abnormal rise of haemoglobin and/or hematocrit in peripheral blood is known as polycythemia which includes increased haemoglobin: greater than 16.5 g/dl in men or greater than 16.0 g/dl in women and increased hematocrit: >49% for men and >48% for women. Men, current smoking, impaired carbon monoxide diffusing capacity, severe hypoxemia, and high altitude living are risk factors associated with an increased risk for secondary polycythemia. Polycythemia contributes to the development of cor-pulmonale and pulmonary hypertension, which are linked to poor prognosis. This study aimed to find out the prevalence of polycythemia among patients with chronic obstructive pulmonary disease admitted to the department of medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with chronic obstructive pulmonary disease admitted to the Department of Medicine in a tertiary care centre after receiving ethical approval from Institutional Review Committee (Reference number: 153/079/080). The study was conducted from 15 September 2022 to 2 December 2022. Data were collected from the hospital records. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 185 patients, Polycythemia was seen in 8 (4.32%) (1.39-7.25, 95% Confidence Interval) patients among which 7 (87.5%) were females and 1 (12.5%) were male. Conclusions: The prevalence of polycythemia was lower compared to other similar studies done in similar settings.

Polycythemia among Patients with Chronic Obstructive Pulmonary Disease Admitted to the Department of Medicine in a Tertiary Care Center: A Descriptive Cross-sectional Study

Educational environment in medical schools is highly demanding and stressful due to various factors. Thestudy was aimed to explore level of stress, stressors and the coping strategies among the undergraduatemedical, dental and nursing students of a medical college in Kathmandu. A cross- sectional observationalstudy was conducted among 174 consenting (95 medical, 51 dental and 28 nursing) first year undergraduatestudents with predesigned, pretested, semi-structured questionnaire which included socio-demographicdetails, Kessler psychological distress scale and Medical student stress questionnaire. Average age ofstudents was 19.54±1.28 years. Results revealed that 66.66% of students were under stress with 25.86%having mild, 18.96% having moderate and 21.83% having severe levels of stress. Highest prevalence ofstress was noted among nursing students (75.00%) with 32.14% under severe stress. Among 116 malesand 58 females, males were more stressed (75.00%) than females (50.00%). Most of the students enjoyedmusic and chatted with their close ones to cope with stress. Academic related stressor was found to be themajor stressor (2.65±0.69) with statistically significant association (p< 0.01) with the stress levels amongthe students. Informing students about the “must know” and “good to know” areas of the topics of everysubject may be helpful to decrease the academic related stress. Regular practice of meditation, sports andcultural activities may help to reduce stress.
Keywords : Kessler psychological distress scale,medical student stress questionnaire,stress, stressors

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Stressors and the Levels of Stress Among the Undergraduate Medical, Dental and Nursing Students of a Medical College in Kathmandu

Many studies have depicted that anemia is one of the most common co-morbidity among Chronic Obstructive Pulmonary Disease (COPD) patients. Therefore, its correction in those patients is an important aspect of the treatment protocol. Our study was designed to explore the prevalence of anemia and morphological alteration, if any, in RBC among COPD patients. The study was conducted from November 2020 to June 2021 among the COPD patients admitted in the Medical ward of Nepal Medical College Teaching Hospital. If hemoglobin level was <13gm/dl in males and <12gm/dl in females and/or hematocrit level was <39%, the patient was considered anemic. Anemia was morphologically classified following standardized procedure with RBC indices as a reference. Among the COPD patients (n=101), 40 (39.6%) were anemic, out of which 21(52.5%) was normocytic normochromic, 10 (25%) were microcytic hypochromic, 5 (12.5%) were normocytic hypochromic, 3 (7.5%) were microcytic normochromic and (2.5%) was macrocytic hyperchromic. Anisocytosis was commonly noted (25.7%) among the COPD patients with microcytosis (20.8%) and macrocytosis (4.9%) among them. Among the patients, 23.8% showed hypochromia while only 0.9% showed hyperchromia. Polycythemia was present in 24 (23.8%) of them. Inflammatory mediators and cytokines in COPD causes a compromised response of marrow cells to erythropoietin and shortens the survival of red blood cells. Corresponding author Dr. Seerina Adhikari Manandhar, Assistant Professor, Department of Physiology, Nepal Medical College, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal Email: seerina1978@gmail.com Orcid No: https://orcid.org/0000-0003-2214-8738 DOI: https://doi.org/10.3126/nmcj.v23i4.42224

Prevalence of Anemia and Morphological Variation in RBC among COPD Patients admitted at a Tertiary Health Care Center, Kathmandu, Nepal

The cyclical variation of ovarian hormones during the menstrual cycle has been implicated as the causative factor for many psychological and physical symptoms referred as premenstrual syndrome (PMS) causing varying degree of stress in females. This study is aimed to find out whether premenstrual stress might cause any alteration in the visual reaction time (VRT) in pre-menstrual and post-menstrual phase. Reaction time is an efficient non-invasive tool to evaluate the sensorimotor efficacy of a person. A cross sectional observational study was carried out in consenting and regularly menstruating 86 undergraduate medical and dental students of age ranging from 18-22 years, for a study period of April 2022 to June 2022. PMS was screened by using the PSST (premenstrual symptoms screening tool) to evaluate the incidence of PMS and the degree of premenstrual stress among the participants. All the participants showed some degree of PMS with 53.4% showing mild and 46.5% showing moderate to severe symptoms while none showed premenstrual dysphoric disorder (PMDD). A significant difference in body weight and visual reaction time (P<0.0001) was observed between the premenstrual phase and postmenstrual phase (54.6 ± 7.23 kg Vs 54.2 ± 7.24 kg and 0.959 ± 0.271ms vs 0.811 ± 0.138ms, respectively) irrespective of the PMS degree. The results indicate that premenstrual stress do affect the sensorimotor efficacy in females having PMS.

Seerina Adhikari Manandhar

Papers

Stressors and the Levels of Stress Among the Undergraduate Medical, Dental and Nursing Students of a Medical College in Kathmandu

Prevalence of Anemia and Morphological Variation in RBC among COPD Patients admitted at a Tertiary Health Care Center, Kathmandu, Nepal

Effect of Premenstrual Stress on Reaction Time among Medical and Dental Students of a Medical College in Kathmandu, Nepal