Perception of medical interns and residents about specialty of microbiology and the role of microbiologists during COVID-19 pandemic

Background: The speciality of microbiology is closely associated with keeping people healthy and disease free by accurate diagnosis of infectious diseases. In spite of this, awareness about the speciality seems to be scarce. In the present scenario, public perception about microbiology has been changed a lot. The SARS-CoV-2 pandemic has highlighted the crucial role of microbiologists in the health care system. The aim of this survey was to determine the perceptions of medical interns and residents regarding the specialty of microbiology and the role of microbiologists in maintaining and promoting health of people.Methods: On-line survey using google form to identify perception of medical interns and residents about the speciality of microbiology.Results: A total 298 valid responses were obtained response rate 26.02% from the participants among them 167 (56.0%) were male and 131 (44.0%) females. Though, the attitude of medical interns and residents were found positive for the speciality of microbiology, they even recognize the importance of medical microbiology in their future role as medical practitioners, but only few (3.48%) wished to opt it as their career.Conclusions: The risks and responsibilities of a microbiologist involved in managing patients seldom get due acknowledgement. Adequate measures need to be taken to enlighten the authorities about microbiology and various responsibilities of microbiologists. The health care providers and medical teachers needed to appreciate the perception of young medical students regarding current and future trends in specialty choice and take concrete steps to meet the unmet need of health care.

Prevalence of Depression, Anxiety and Stress in Medical Students, interns and residents in Pakistan

Aim: To assess prevalence of depression, anxiety, stress in medical students, interns and residents in Pakistan Study design: Cross-sectional Survey (Questionnaire) based study. Place and duration of study: This study was conducted at Combined Military Hospital Lahore Medical College from March 2020 to May 2020. Results: 104 participants were included in the study. There was female predominance 58(55.8%), and the mean age was 23.55±1.42. The overall mean score of depression and anxiety was 21.2±12.67 and 15.7±10.67 respectively and most prevalent in third and fourth-year residents. The mean stress score was 13.7, 10. 27. Twenty-eight (26.9%) of the overall participants had extremely severe depression, 36 (34.6 %) had extremely severe anxiety and 13(12.5%) had severe stress. Conclusion: Multiple factors have been found to contribute to the poor mental health of health care workers, including financial trouble, sleep deprivation, abuse from colleagues, high expectations, female gender, broken relationships, and substance misuse. The prevalence of depression, anxiety, and stress in common in medical students. This calls for the development of strategies, workshops, and programs to identify modifiable stressors, encourage students to reach out to their family members and their teachers to verbalize their issues, and make psychiatric consultation accessible to them. Keywords: Anxiety Disorders, Depression, Medical, Mental Health Problem Solving, Psychological Distress,

Prevalence of Depression, Anxiety and Stress in Medical Students, interns and residents in Pakistan

Aim: To assess prevalence of Depression, Anxiety, Stress in medical students, interns, and residents in Pakistan Study design: Cross-sectional Survey (Questionnaire) based study. Place and duration of study: This study was conducted at Combined Military Hospital Lahore Medical College from March 2020 to May 2020. Results: 104 participants were included in the study. There was female predominance 58(55.8%), and the mean age was 23.55±1.42. The overall mean score of depression and anxiety was 21.2±12.67 and 15.7±10.67 respectively and most prevalent in third and fourth-year residents. The mean stress score was 13.7, 10. 27. Twenty-eight (26.9%) of the overall participants had extremely severe depression, 36 (34.6 %) had extremely severe anxiety and 13(12.5%) had severe stress. Doctors studying and practicing in the private sector have a higher DASS21 score (p = < 0.006) Conclusion: Multiple factors have been found to contribute to the poor mental health of health care workers, including financial trouble, sleep deprivation, abuse from colleagues, high expectations, female gender, broken relationships, and substance misuse. Keywords: Anxiety Disorders, Depression, Medical, Mental Health Problem Solving, Psychological Distress,

Respiratory sound classification for crackles, wheezes, and rhonchi in the clinical field using deep learning

Auscultation has been essential part of the physical examination; this is non-invasive, real-time, and very informative. Detection of abnormal respiratory sounds with a stethoscope is important in diagnosing respiratory diseases and providing first aid. However, accurate interpretation of respiratory sounds requires clinician’s considerable expertise, so trainees such as interns and residents sometimes misidentify respiratory sounds. To overcome such limitations, we tried to develop an automated classification of breath sounds. We utilized deep learning convolutional neural network (CNN) to categorize 1918 respiratory sounds (normal, crackles, wheezes, rhonchi) recorded in the clinical setting. We developed the predictive model for respiratory sound classification combining pretrained image feature extractor of series, respiratory sound, and CNN classifier. It detected abnormal sounds with an accuracy of 86.5% and the area under the ROC curve (AUC) of 0.93. It further classified abnormal lung sounds into crackles, wheezes, or rhonchi with an overall accuracy of 85.7% and a mean AUC of 0.92. On the other hand, as a result of respiratory sound classification by different groups showed varying degree in terms of accuracy; the overall accuracies were 60.3% for medical students, 53.4% for interns, 68.8% for residents, and 80.1% for fellows. Our deep learning-based classification would be able to complement the inaccuracies of clinicians' auscultation, and it may aid in the rapid diagnosis and appropriate treatment of respiratory diseases.

MO1042SCREENING FOR CHRONIC KIDNEY DISEASE IN PATIENTS WITH HIGH BLOOD PRESSURE: A SURVEY OF TRAINEES’ ATTITUDES AND PRACTICES IN MOROCCO

Background and Aims High blood pressure is a leading cause of end stage renal disease (ESRD). However; early detection of chronic kidney disease (CKD) delays progression of kidney failure and reduces the risk of cardiovascular complications. Therefore, the aim of our study was to assess the attitudes and practices of interns and residents regarding screening for chronic kidney disease in patients with high blood pressure at a Moroccan University hospital. Methods A cross-sectional survey was conducted among 100 medical interns and residents at Mohammed VI university hospital of Marrakesh. Results Overall, 82% of the trainees who responded (response rate 89%) stated that they were sensitized to screening for chronic kidney disease in patients with high blood pressure, mainly during their medical studies. However, trainees who systematically monitor renal function in their hypertensive patients did not exceed 13%. While 34% of respondents preferred to refer them to a cardiologist or a nephrologist, and 35% looked for renal impairment only in special situations, dominated by the presence of diabetes or severe hypertension. The main tests used by the participants for monitoring kidney function were represented by blood renal function (100%) and 24h urine protein (61%). Microalbuminuria was mentioned by only 23% of the trainees. The major limits reported by the surveyed physicians were the lack of experience and the non- compliance of patients. Conclusion Our findings revealed inappropriate practices among our training doctors concerning the screening of CKD in hypertensive patients. Therefore, more educational workshops and courses are recommended, especially in low-income countries where access to dialysis is not always affordable.

The Implementation of the WHO Mental Health Gap Intervention Guide (mhGAP-IG) in Ukraine, Armenia, Georgia and Kyrgyz Republic

Despite the increasing burden of mental disorders, a lot of people worldwide suffer a gap in receiving necessary care in these countries. To close this gap, the WHO has developed mhGAP training modules aimed at scaling up mental health and substance use disorders services, especially in low- and middle-income countries. This article presents the experience of implementing the Mental Health Gap Action Programme (mhGAP) in Ukraine, Armenia, Georgia, and Kyrgyz Republic. Data were gathered from an electronic questionnaire administered to representatives from higher educational institutions where the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was implemented in existing curricula for medical students, interns, and residents in family medicine and neurology, practicing physicians, and master’s program in mental health students. More than 700 students went through the programs that provided the feedback. Evaluations of program effectiveness mainly involved standard discipline tests or pre- and post-tests proposed in the mhGAP trainer manual. This finding suggested that mhGAP-IG can be successfully adapted and implemented both on undergraduate and on postgraduate education levels and among medical and nonmedical specialists. Future evaluations need to more definitively assess the clinical effectiveness of mhGAP-IG implementation.

Simulation-based Boot-camp Improves the Self-efficacy of Newly Inducted Hospital Residents and Interns

IntroductionExpectation of competence from interns and residents from outset stresses the need for bridging the gap between undergraduate and post-graduate worlds, in terms of clinical skills. Worldwide, simulation-based boot camps ease this transition and equip novice trainees with essential foundation knowledge, technical skills, and effective communication. This study describes the introduction, change management process, and analyzes effectiveness of first-ever boot camp in Pakistan aimed at improving self-efficacy of PGME interns and residents. A boot camp of 4 days duration was conducted in December 2018 at The Aga Khan University Hospital (AKUH) for newly inducted PGME interns and residents. 40 residents and 68 interns completed a self-administered self-efficacy questionnaire after boot camp.ResultsThere was a significant overall improvement in self-efficacy of trainees across all skills. Self-efficacy improved most in CVC insertion, hospital management software) and communication, while, least gain was seen in infection control post-boot camp. Boot camp approach has proven to be an efficient, safe, forgiving, experiential learning environment for healthcare professionals and prepares them to thrive in a new hospital setting. Analysis supports effectiveness of boot camp in improving the self-efficacy of new trainees and provides direction for future planning of boot camps.

Prevalence and associated factors with mental health outcomes among interns and residents physicians during COVID-19 epidemic in Panama: a cross-sectional study

BackgroundA new coronavirus SARS-CoV-2 was associated with a newly identified respiratory syndrome, COVID-19 in Wuhan, China, in early December 2019. SARS-CoV-2 rapidly spread across the globe resulting in 117 million cases and 2.59 million deaths by March 2021. Rapidly increased numbers of COVID-19 cases overwhelmed public health systems across the world, imposing increased working hours and workloads for health care workers. Here, we have evaluated the prevalence of health outcomes and associated factors of interns and resident physicians in Panama.MethodsA cross-sectional study was undertaken during July 23, 2020, to August 13, 2020, to evaluate the prevalence of health outcomes and associated factors in interns and residents across Panama. Snowball sampling was used to recruit participants. Then an electronic questionnaire with scales to evaluate anxiety disorders (GAD-7), depression (PHQ-9) and post-traumatic stress (IES-R) was evaluated. In addition, socio-demographic variables, clinical history of mental disorders and COVID-19 exposure were evaluated. Independent analyses for each mental health outcome were undertaken using a logistic regression analysis.ResultsA total of 517/1205 (42.9%) interns and residents were nationwide recruited. Of these 274 (53.0%) were interns and 243 (47.0%) residents. The overall prevalence of depression symptoms was 25.3%, 13.7% anxiety and 12.2% post-traumatic stress. At least, 9.3% participants reported having suicidal ideation.The most parsimonious model showed females had a higher prevalence of mental health disorders, in all results and the married participants were more likely to present depression (OR, 1.73; 95% CI, 1.03-2.91; P = 0.039) or at least one alteration to mental health (OR, 1.66; 95% CI, 1.03-2.68; P = 0.039). Resident physicians in surgical specialties were less likely to have post-traumatic stress (OR, 0.20; 95% CI, 0.06-0.63; P = 0.006) or at least one mental health disturbance (OR, 0.46; 95% CI, 0.26-0.83; P = 0.010). A history of psychological trauma and psychiatric pathology were risk factors for most of the disorders investigated.ConclusionsA high prevalence of mental health disorders was found, showing the need to mitigate this emotional burden among healthcare workers in the current context of the COVID-19 pandemic.