Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A crosssectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected using the General Health Questionnaire (GHQ-12), Medical Students Stress Questionnaire (MSSQ-20), and Drug Abuse Surveillance Test (DAST). Data were analyzed using SPSS version 20.0. Logistic regression analysis and Student's -test were applied. Results. The mean age of the respondents was 23.02 (SD = 2.074) years. The current prevalence of stress was 52.4%. Academic related stressor domain was the main source of stress among 281 (88.6%) students. Stress was significantly associated with khat chewing [AOR = 3.03, 95% CI (1.17, 7.85)], smoking [AOR = 4.55, 95% CI (1.05, 19.77)], and alcohol intake [AOR = 1.93, 95% CI (1.03, 3.60)]. The prevalence of stress was high during the initial three years of study. Stress was significantly ( = 0.001) but negatively ( = −0.273) correlated with academic achievement. Conclusion. Stress was a significant problem among medical students and had a negative impact on their academic performance. Year of study, income, and substance use were associated with stress. Counseling and awareness creation are recommended.

Background. Mental problems can negatively impact physical and psychological well-being of junior medical students and predispose them to many unhealthy behaviors. Objective. We aimed to determine the prevalence and severity of depression, anxiety, and stress among medical undergraduate students of Arsi University and their association with substance use. Methods. Institutional-based cross-sectional study was conducted on 265 sampled medical students. Participants were selected by systematic random sampling. Data were collected by a pretested self-administrative questionnaire and analyzed using SPSS-21 software. Logistic regression analysis was employed, and statistical significance was accepted at p < 0.05 . Result. In the present study, 5 questionnaires were rejected for incompleteness giving response rate of 98.1%. The mean age was 22.03 (SD = 2.074) years. The current prevalence rates of depression, anxiety, and stress were 52.3%, 60.8%, and 40.4%, respectively. The overall prevalence of khat chewing, cigarette smoking, and alcohol drinking was found to be 21.5%, 15.4%, and 33.8%, respectively. Depression was significantly associated with monthly income [AOR = 2.13], residency [AOR = 13.10], and alcohol drinking [AOR = 1.68]. Anxiety was associated with gender [AOR = 0.51], marital status [AOR = 0.46], educational year [AOR = 20.43], residency [AOR = 58.72], and cigarette smoking [AOR = 2.60]. Stress was significantly associated with monthly income [AOR = 2.21], educational year [AOR = 3.05], residency [AOR = 4.82], khat chewing [AOR = 1.90], and drinking alcohol [AOR = 1.84]. Conclusion. To sum up, depression, anxiety, and stress are common problems among medical students of Arsi University. Monthly income, residency, and alcohol drinking were identified as risk factors of both depression and stress. In addition to other mentioned factors, educational year and khat chewing were identified as risk factors of stress. However, gender, marital status, educational year, residency, and cigarette smoking were identified as risk factors of anxiety. Counselling and awareness creation are recommended.

Background. Students’ mental health deteriorates after they enter medical school and continues to deteriorate throughout their training. Every individual has a certain number of coping resources, and once these coping resources are challenged, mental illness usually results. Objective. We aimed to determine the prevalence and severity of depression, anxiety, and stress as well as coping strategies used by medical undergraduate students enrolled in Arsi University. Methods. Institution-based, cross-sectional design was conducted on 265 sampled medical students. Participants were selected by a systematic, random-sampling technique. Data were collected by pretested, structured, and self-administrated questionnaires. Afterwards, logistic regression analysis was employed, and statistical significance was accepted at p < 0.05 . Results. In the present study, 5 questionnaires were rejected for incompleteness, resulting in a response rate of 98.1%. The mean age of the respondents was 22.03 (SD = 2.074) years. The current prevalence rates of depression, anxiety, and stress were 52.3%, 60.8%, and 40.4%, respectively. The proportion of respondents who had extremely severe symptoms of depression, anxiety, and stress was 6.2%, 16.2%, and 2.3%, respectively. Depression was specifically associated with monthly income and residency. Anxiety was significantly associated with residency and educational level. Stress was associated with monthly income, educational level, and residency. The main coping strategy adopted by the respondents was religion with a mean (±SD) of 5.94 (1.85). The coping mechanisms of denial, substance use, behavioral disengagement, venting, and self-blame were significantly associated with depression, anxiety, and stress. Conclusion. Overall prevalence rate of depression, anxiety, and stress is alarmingly high. Therefore, implementing stress reduction interventions and establishing a student counseling center are highly recommended.

Background: Mental health problems can negatively impact physical and psychological well-being of junior medical students and predisposes them to many unhealthy behaviors.Objective: We aimed to determine the prevalence and severity of depression, anxiety and stress among medical undergraduate students of Arsi University and their association with substance use. Materials and Methods: Institutional based cross-sectional study was conducted on 265 medical students that were selected by systematic random sampling. Data were collected by pre-tested self-administrative questionnaire and analyzed by SPSS-21 software. Logistic regression analysis were employed and statistical significance was accepted at p<0.05.Result: In the present study, 5 questionnaires were rejected for incompleteness giving response rate of 98.1%. The current prevalence rate of depression, anxiety, stress, khat chewing, cigarette smoking and alcohol drinking was found to be 52.3%, 60.8%, 40.4%, 21.5%, 15.4% and 33.8% respectively. Depression was significantly associated with monthly income, residency and alcohol drinking. Anxiety was associated with gender, marital status, educational year, residency and cigarette smoking. Stress was significantly associated with monthly income, educational year, residency, khat chewing, and drinking alcohol. Conclusion: To sum up, depression, anxiety and stress are common problems among medical students of Arsi University. Monthly income, residency and alcohol drinking were identified as risk factors of both depression and stress. Furthermore, educational year and khat chewing were also risk factors for stress. Finally, identified risk factors of anxiety were gender, marital status, educational year, residency and cigarette smoking. Therefore, counseling and awareness creation are recommended.

Background Atherosclerosis is a chronic lipid-driven inflammatory disease with infiltration of low-density lipoprotein and is considered as the pivotal step in plaque formation. The aim of the review is to get into the fine details of pathophysiologic mechanisms responsible for atherosclerosis with atherosclerotic lesion classification. It also provides a summary of current biomarkers other than the traditional risk factors so that new treatment modalities can emerge and reduce the morbidity and mortality associated with atherosclerosis. Main body In the classification of atherosclerosis made by American Heart Association (AHA), AHA Type I lesion is the earliest vascular change described microscopically. AHA Type II lesion is primarily composed of abundant macrophages. AHA Type III lesion is the earliest of progressive lesions, while AHA Type IV lesion consists of an acellular necrotic core. Various biomarkers are implicated in different stages of the pathophysiological mechanism of plaque formation and evolution. C Reactive Protein plays a direct role in promoting the inflammatory component of atherosclerosis. Fibrinogen was demonstrated to be elevated among patients with acute thrombosis. Higher leukocyte count is associated with a greater cardiovascular risk. Cytokines have been implicated in atheroma formation and complications. High rates of protease activated receptor expression are also induced by interleukin-6 secretion in atherosclerotic lesions and areas of vascular tissue injury. Cluster of differentiation 40 receptor and its ligand have been also detected in atherosclerotic plaques. Osteopontin, acidic phosphoprotein, and osteoprotegerin have emerged as novel markers of atherosclerotic plaque composition. There are also overproductions of matrix metalloproteinases in the rupture-prone regions and promote lipid-necrotic core formation in the atherosclerotic plaque. Myeloperoxidase has been proposed as a marker of plaque instability. Oxidized low-density lipoprotein receptor 1 provides a route of entry for oxidized low-density lipoprotein into the endothelium. A human atherosclerotic lesion also expresses lipoprotein-associated phospholipase A2. Short conclusion Atherosclerotic plaques are the battlefield between an unbalanced immune response and lipid accumulation in the intima of arteries. Most of the biomarkers associated with atherosclerosis are indicators of inflammatory response and will also be used for medical purposes.