Objective:To study the level of job satisfaction among doctors serving in a tertiary care hospital in Lahore and ascertain its co-relation with multiple demographic variables which had a profound impact.Methods:This cross sectional study with non-probability purposive sampling was conducted at Combined Military Hospital, Lahore, from February 2014 to November 2014. Subjects were doctors serving in that hospital for minimum six months duration. Pre-formed questionnaires were distributed to volunteers (average filling time was 3 ½ to 7 minutes). Multiple demographic features were independent variables. Outcome variable was job satisfaction. Statistical analysis was done via descriptive statistics (SPSS 20), data expressed as mean ± standard deviation (SD).Results:Out of 263 doctors serving in hospital, 203 (77.91%) volunteered to participate; response rate by depositing the filled forms was 47.78% (97 doctors). Amongst the respondents, 10 (10.3%) doctors had below average job satisfaction, 32(33.0%), 21(21.6%), 21(21.6%) and 13(13.3%) had average, above average, well above average and outstanding job satisfaction respectively. There was significant relation between job satisfaction and age group of the doctors (p 0.025), education (p 0.015), service years (p 0.013) income per month (p<0.001). There was no significant impact of gender (p 0.540), marital status (p 0.087), number of children (p 0.153), current employment (p 0.71), nature of job (p 0.204), working hours (p 0.089), additional duties p 0.421) and socioeconomic class (p 0.104) on outcome variable.Conclusion:A significant number of doctors was found discontented with their job, which may consequently impact their yield/performance. The job satisfaction can be substantially improved if these contributory factors are aptly addressed at all tiers.

Background: Dust exposure at quarry mines is inevitable and can result in poor air quality. This research aimed to assess pulmonary symptoms and lung functions of dust-exposed workers at an iron-ore mine in eastern Iran. Methods: An environmental cross-sectional study sampled 174 dust-exposed mine workers and 93 unexposed administrative employees as the reference group. A standardized questionnaire on respiratory symptoms was completed in accordance with recommendations of the American Thoracic Society(ATS). Calibrated spirometer measured Pulmonary Function Tests (PFTs). Data were analyzed via SPSS-21, integrating independent samples t-test, Chi-square and linear or logistic-regression models. Results: There was no significant variation between dust-exposed and reference groups in terms of age, weight, height, work experience and the number of smokers (P>0.05). Mean levels of exposure to inhalable and respirable mineral-dust were 15.09±2.34 and 3.45±2.57 mg/m3 respectively. Pulmonary capacities of dust-exposed group were considerably decreased as compared to others (Forced Vital Capacity [FVC] 86.55±13.77 vs. 105.05±21.5; Forced Expiratory Volume in 1 second [FEV1] 88.06±16.8 vs. 105.81±21.55; FEV1/FVC 103.03±18.17 vs. 93.3±12.49; and Peak Expiratory Flow [PEF] 89.82±22.58 vs. 98.09±20.60) (P<0.001); with a higher prevalence of cough (P=0.041), wheezing (P=0.032), and dyspnea (P=0.035) among formers. Age along with exposure to respirable-dust significantly reduced FVC, FEV1 and FEV1/FVC. Cigarette consumption attenuated FVC and FEV1 on an average of 5 to 9 units. Conclusion: Controlled occupational dust-exposure is a definitive pre-requisite to reduce respiratory problems among quarry workers, with an explicit consideration towards mineral- mine workers. Modifiable accomplices like smoking and non-compliance of PPEs usage should be amicably resolved.

Objectives:To analyze prevalence of anxiety and depression among doctors serving in a tertiary care hospital in Lahore, with a study of impact of relevant demographic features.Methods:A cross sectional study was conducted at Combined Military Hospital, Lahore, from February 2014 to Jan 2015. Participants were doctors serving in subject hospital for at least six months duration. Standardized Hospital Anxiety Depression Score (HADS) inventory was selected as inventory. Formal approval from hospital ethical committee and written informed consent from participants were obtained. Demographic characteristics of participants were recorded as independent variables; anxiety and depression scores being outcome variables. Data analysis was done via descriptive statistics (SPSS-20), qualitative data expressed as frequencies, percentages; quantitative as mean ± standard deviation(SD). Cross tabulation was done via chi-square, p-value < 0.05 considered as significant.Results:Out of 203 volunteers, 97(47.78%) responded. Score of anxiety was 7.04±4.470, maximum being 19, scores of depression was 4.94±3.605, maximum score being 15. Mild to moderate anxiety and depression were revealed in 33(34%) and 24(24.8%) respectively, while 7(7.2%) and 1(1.0%) had severe anxiety and depression respectively. There was strong positive relation between anxiety and depression (p<0.001). There was significant impact of service years on depression (p-0.011) and gender on anxiety (p-0.002), 9(17.31%) males and 24(53.33%) females had mild to moderate anxiety while 4(7.69%) males and 3(6.66%) females revealed severe anxiety and other variables did not reveal significant impact on HADS scores.Conclusion:Doctors showed high grades of anxiety and depression. They must be promptly screened and managed at all medical institutions.

Introduction:Mental stress amongst pre-hospital Emergency Medical Services (EMS) workers is an iceberg phenomenon; owing to unique occupational stressors faced by them. This study was aimed to examine the mental health status of pre-hospital EMS workers and its correlation with Post-Traumatic Stress Disorder (PTSD) and Work Environment Scale (WES). Methods:This cross-sectional study incorporated 224 emergency EMS members from urban and road EMS bases in eastern Iran in 2018. General Health Questionnaire (GHQ-28), Post-Traumatic Stress Disorder Checklist-Civilian version (PTSD-C), and Work Environment Scale (WES) were used as research instruments. Data were analyzed via SPSS Statistics software (version 21); while p<0.05 was considered significant. Results:The mean age of participants was 31.91±6.9 years; 36(16.1%) had PTSD ≥50, which increased with age (p-0.01), number of offspring (p-0.022) and time working at the EMS (p-0.002). Mean WES scores were 73.41±12.27; with a significant impact of marital status (p-0.007), the number of offspring (p-0.023), qualification (p-0.019) and less time working at the EMS (p-0.008). Mental distress was recorded in 89(39.7%) individuals. Multivariate logistic regression revealed that members at higher risk of mental distress were; those with associate's degree (adjusted OR 3.192; 95% CI, 1.456-6.998), individuals with 1 or 2 offspring (adjusted OR 2.03; 95% CI, adjusted OR 3.380; 95% CI, respectively), and those with PTSD equal or higher than 50 (adjusted OR 2.504; 95% CI, 1.063-5.903), with a reverse impact of WES (p>0.05). Conclusion:PTSD adversely affected mental health and clinical performance of the subjects; while work-place environment augmented working spirit as well as psychological resilience. Strategies aiming at stress-dilution and improvements in a professional environment cannot be over-emphasized.

Objective: To compare the efficacy of single versus double burr-hole for drainage of chronic subdural hematoma, keeping in consideration pertinent demographic, pre and postoperative associations. Methods: A prospective cohort study carried out in Combined Military Hospital, Multan, (December 2016-August 2018), on adults with diagnosed chronic subdural hematoma (CSDH); being segregated by randomized control trial, non-probability purposive sampling into Group-A and Group-B (who underwent single and double burr-holes for CSDH-drainage respectively). Utilizing SPSS-21, data expressed as frequencies/percentages and mean± standard deviation (SD) and cross-tabulated; p-value <0.05 was taken as significant. Results: Age and GCS scores were 62±13.694 (range 38-94) and 11.00±3.350 (range 3-15) respectively, males being 40(66.7). Post-operative fatality was Nil, while 8(13.3%) and 14(23.3%) had post-operative seizures and recurrence of hematoma respectively. There was no significant association between type of burr-hole and hospital stay (p 0-884), seizures (p 0.448) or recurrence (p 0.542). Hospital stay (p<0.000) and seizures (p-0.005) were inversely proportional to GCS scores on presentation. Recurrence rates were not affected by age (p-0 .175) or gender (p-0 .281). Conclusion: There was no significant difference between outcomes of single and double burr-hole surgeries; the former must be preferred because of lesser iatrogenic trauma. GCS-score on presentation was validated as a negative association to anticipate post-operative outcomes. doi: https://doi.org/10.12669/pjms.35.4.543 How to cite this:Khan HU, Atif K, Boghsani GT. Single versus double burr-hole drainage for chronic subdural hematoma: A study of relevant prognostic factors conducted in Pakistan. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.543 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.

Background: To analyze prevalence of job dissatisfaction and psychological distress among doctors with exposure of significant socio-demographic aggravators.

Aim-Burnout is one of the major occupational hazards that precludes the efficiency and wastes human resources. The aim of this study was to determine the prevalence of job burnout and its related factors among the staff of a Medical University in Iran. Material and Methods-In this simple descriptive, Knowledge-Attitude-Practice educational cross-sectional study, 250 employees were enrolled randomly via non-purposive sampling technique in 2016. Standardized Maslach Job burnout Inventory (MBI) and organizational climate questionnaire were used as instruments. Data analysis was performed using Mann-Whitney, Kruskal-Wallis and Chi-2 tests. P-value less than 0.05 was considered as significant. Results-Mild, moderate and severe levels of job burnout were revealed by 66.4%, 25.6% and 7.6% respectively; while 28 (11.2%), 56 (22.4%) and 166 (66.4%) endorsed weak, moderate and strong organizational climate scores. There was significant negative relation between job burnout and organizational climate level (p<0.001). There was no significant impact of gender (p=0.782), employment type (p=0.672), work experience (p=0.48), and work unit (p=0.222) on outcome variable. None of the demographic variables had significant impact on organizational climate scores. Conclusion-A positive and employee-friendly organizational climate is mandatory to diminish the prevalence and arrest the incidence of job burnout in every setup. Affected employees must be identified and adequately managed.

Objective:To analyze desire for sons/daughters among ladies of Peshawar, Pakistan, with a view to rule out son preference and to study impact of various demographic characteristics on the subject.Methods:Cross-sectional descriptive study conducted at Combined Military Hospital, Peshawar, from August 2015 - January 2016; sampling technique was random/probability/non-purposive. Self-designed questionnaire was utilized; carrying questions pertinent to desire for sons/daughters during marital life, and demographic details. Data analyzed via descriptive analysis (SPSS-21), expressed as frequencies/percentages and mean ± standard deviation(minimum/maximum). Sons and daughters desired (dependent variables) were cross-tabulated with independent variables.Results:Response rate was 63.25% (n-506). Data revealed following: Sons desired 3.05±2.061(1/12); Daughters desired 1.15±0.767(0/4); 6.1%(n-31) and 0.6%(n-3) desired infinite number of sons and daughters respectively, 18.2%(n-92) did not desire to have even one daughter, while 2.2%(n-11) considered it immaterial to have daughters or sons. There was a significant relation between sons desired and client’s education (p<0.001), husband’s education (p<0.001) and socioeconomic class (p<0.001). There was no significant impact of religion (p-0.142) on desire for sons. Impact of independent variables on daughters desired was similar but less pronounced.Conclusion:There was candid son preference among the respondents. Gender discrimination can be attenuated by adequately addressing son preference at all tiers.