ObjectiveThis study aimed to determine and compare degrees of psychological stress and inducing factors thereof among first to fifth year medical students (MS).MethodsThis cross-sectional study was conducted on 468 female MS. We used the Kessler 10 Psychological Distress Inventory consisting of questions on a range of stress-inducing factors.ResultsA total of 67.9% students reported physiological stress. The percentage of MS without stress and with mild, moderate, and severe stress was 32%, 24%, 22%, and 21.8%, respectively. The highest prevalence of physiological stress was found among first-year students (82.6%). Stress scores significantly decreased with advancement in the year of study, except for the final year (p = 0.001). We found that the first year of medical studies (0.022), academic stress (0.001), the presence of a physical problem (0.001), and being married (0.002) were independent risk factors for high perceived stress (HPS), as shown by K10 scores >24. A total of 11.1% students consulted a psychiatrist, whereas 3.4% admitted taking some medication for stress.ConclusionThis study infers that the first year of medical studies, academic stress, the presence of a physical problem, and being married are independent risk factors for HPS. We recommend mandatory stress screening for MS in all medical colleges. Ideally, the screening should be repeated every six months and students identified as having HPS should be provided with counselling, mental health services, and a proper follow-up.

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Abstract:Background: Cocoa polyphenols have been shown to reduce stress in highly stressed, as well as normal healthy individuals, we wondered whether commercially available chocolate could reduce perceived stress in medical students or not, so we decided to conduct this study.

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Objective: There is a lack of studies exploring the effects of Zamzam water on human physiology. The present study determined the effects of Zamzam water on blood pressure and heart rate variability (HRV). Methods: This comparative interventional study was conducted at the Department of Physiology, of our university in March 2018. A total number of 97 female subjects drank 500 ml of either Zamzam water or mineral water in one minute. Finometer Pro and PowerLab (ADInstrumentsR) with ECG electrodes through bioamplifier and attached finger pulse transducer were used to collect data at the baseline (for five minutes), during (for one minute) and after the drink (for five minutes). Paired and uunpaired student’s t-test, one-way ANCOVA and one-way repeated measure ANOVA were used for analysis. Blood pressure parameters were followed minute by minute and HRV parameters were compared as a 5-minute of baseline segment to 5-minute post drink segment. Results: Within-the-group comparison exhibited significant increases in blood pressure parameters (systolic, diastolic, pulse and mean arterial pressure), over a 5-minute post-drinking period in both groups. Zamzam water caused a significant increase in SDRR (an indication of overall HRV) and RMSSD (an indication of vagal activity) as compared to baseline. Conclusion: Both drinks cause a significant increase in systolic, diastolic, pulse and mean arterial pressure within five minutes post-drinking period. Zamzam water produce a significant increase in cardiac vagal tone but has no effect on cardiac sympathetic activity. Mineral water has no significant effect on both, cardiac vagal and sympathetic activity. doi: https://doi.org/10.12669/pjms.36.4.1755 How to cite this:Latif R, Majeed F, Al-Sunni A, ALamrie RMK, AlNaimi SN. Acute effects of Zamzam water on blood pressure and heart rate variability. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1755 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.