IntroductionMedical students choose to pursue their careers based on multiple internal and external factors. These factors, in turn, not only affect their personal future but the overall status of the health care system of their country. A recent decline in the interest of medical students towards the surgical career is being observed and, therefore, the factors influencing their choice need to be evaluated. We aimed to identify these factors in medical students of a public sector university of Karachi.MethodsA cross-sectional study was conducted at Dow Medical College from April 2018 to May 2018. A pre-tested questionnaire was administered to a sample of 250 students. Besides sociodemographic factors, the choice of career was identified and the factors that influenced it were assessed. Students' opinions were collected using a Likert scale. Data were entered and analyzed using the IBM Statistical Package for the Social Sciences 23.0 (IBM, NY, USA). Frequencies were calculated for individual variables. The chi-square test was used to measure statistical differences between categorical variables and a p-value of <0.05 was considered to be significant.ResultsIn this study, 224 out of 250 questionnaires were returned with complete data, yielding a response rate of 89.6%. We found that 48.2% of students reported a desire to pursue a career in surgery. Students whose fathers were more qualified and belonged to the field of health care were more likely to pick a surgical career (p-value of 0.034 and 0.039, respectively). Students who were willing to pursue a path in surgery more often thought that the social standing of surgeons had its importance (p=0.037). These students also agreed that high salary has a role to play in affecting the choice of career (p=0.023). The most common factors that encouraged students for the choice of a surgical career included the practical implication of skills (57.4%) followed by an academic interest in the field (53.7%), and high income (42.6%). The most common discouraging factors included lifestyle and long working hours (56.9%), followed by less academic interest (31%).ConclusionOur study provides a valuable insight into the factors that influence the choice of medical students for pursuing a career in surgery. We also identified the factors that demotivated them from doing so. In our opinion, better incorporation of surgery into the curriculum, proper attention given to students during their surgical rotation and restructuring of the surgical training program are some of the ways that may improve the interest of students in the field of surgery.
Aim: To find out the role of listening to music during extracorporeal shockwave lithotripsy to reduce pain and anxiety during the procedure. Design: A randomised controlled trial. Place and Duration of Study: Lithotripsy department at The Kidney Centre Postgraduate Training Institute, Karachi, from January to July 2021. Methodology: One hundred ten patients were randomly assigned into two groups of fifty-five patients each; Group-M (first session of ESWL with music and second session without music) and Group-X (first session of ESWL without music and second session with music). Patients with the music group were provided headphones with soothing music throughout their procedure. Routine analgesic (intravenous nalbuphine 0.1mg/kg) was administered to patients as per treatment guidelines. Each patient received a total of 4000 shockwaves with energy levels varying from 11.45 to 13.1 kilovolts and frequency ranging between 2 to 3 Hertz. Patients filled out two questionnaires, Visual Analogue Scale (VAS) and State-Trait Anxiety Inventory (STAI). Baseline data for all patients was calculated and compared between the two groups. Data were analysed using IBM SPSS ver. 20. Results: Ninety-eight were males while twelve were females. Gender distribution between groups does not differ significantly (p = 0.862). The mean age in Group-M was 36.22 + 9.78 while in Group-X was 36.13 + 9.89 without any significant difference between groups (p = 0.422). BMI of Group-M patients (25.34 + 4.64) was not significantly different from Group-X (25.41 + 4.80) (p = 0.327). Median stone size of Group-M was 1.0 ; 0.30 while that of Group-X was 1.1; 0.40 (p=0.997). Stone laterality was not significantly different among the two groups (p = 0.961). The distribution of stone location among both groups was not significantly different from each other (p=0.949). In Group-M, first session patients (with music) had significantly lower median VAS score (2; 1) as compared to second session patients without music (4; 2), (p < 0.001). In Group-X, first session patients (without music) had significantly higher median VAS score (6; 1) as compared to second session patients with music (4; 2), (p < 0.001). Conclusion: Music therapy during ESWL sessions reduces both pain and anxiety and also improves overall compliance of stone disease patients by eradicating the fear of the procedure. Keywords: ESWL, Lithotripsy, Visual Analogue Scale, Renal calculi.
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