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Introduction: Exams are a relatively stressful period for all students, especially undergraduate medical students. Exams bring anxiety and stress for the students. Some students experience such high stress that it hinders their academic productivity and reduces their exam performance. The aim of this study is to assess the effects of pre-exam anxiety on the academic performance of medical students. Methods: Two hundred and twenty-five final year medical students completed Westside Test Anxiety (WTA) Scale one month before their exams. Grade Point Average (GPA) of these students was noted when the results were announced. Data was processed and analyzed using SPSS v 22.0Results: The mean anxiety score on WTA scale was 3.46 ± 0.87. All students (100%) who scored ≤ 2.50 GPA were highly-extremely highly anxious. In the 2.51-3.00 GPA group, 46% were highly-extremely highly anxious, 32% were moderately anxious, and 21% had low to normal anxiety. In the 3.01-3.50 GPA group, 30% were highly-extremely highly anxious, 30% were moderately anxious, and 39% had low to normal anxiety. In the 3.51-4.00 GPA group, 29% were highly-extremely highly anxious, 23% were moderately anxious, and 47% had low to normal anxiety. The correlation coefficient between GPA and test anxiety of students was -.314 which shows inverse relationship.Conclusion: Pre-exam anxiety and stress imparts negative effects on the exam performance of final year medical students. Poor academic performance was associated with high to extremely high pre-exam anxiety while high achievers had relatively lower anxiety levels.

Systemic mastocytosis (SM) is a state of disease that is related to the clonal, neoplastic proliferation of mast cells. Patients who present with SM-Acute Myeloid Leukemia (AML) often have the worst outcome. We present a case of an 18-year-old female who was diagnosed with AML (FLT3 (Fms like tyrosine kinase 3) and PML-RARA (promyelocytic leukemia-retinoic acid receptor alpha) translocation-negative) and after initial treatment with a standard induction regimen of cytarabine and daunorubicin (3+7 regimen), her bone marrow showed blast cells less than 5% and dense aggregates/sheets of atypical/immature mast cells with immunohistochemical stain CD117+ve and toluidine blue positive in mast cell aggregates. Mastocytosis is a clonal neoplastic proliferation of mast cells that accumulate in one or more organ system. Therefore, it is essential to diagnose systemic mastocytosis, particularly in patients of hematological neoplasms.

Introduction: COVID-19 pandemic has affected HCPs in multiple way. It has caused psychological impact in form of anxiety, depression, and insomnia. In this study, we aim to study and compare the stress level, anxiety and depression among HCPs who are posted in special COVID-19 units with the HCPs who are not posted in COVID-19 units.Methods: This cross-sectional study was conducted in June 2020, at various hospitals of Karachi, Pakistan. All health care professionals (HCPs) were invited to participate. A total of 301 HCPs completed this study, who were divided into two groups; those who are posted in COVID-19 ward (Group A) and those who are not (Group B). Psychological Impact was English version of the Depression Anxiety Stress Scale - 21 (DASS-21).Results: In Group A, 70.5% had moderate, severe, or extremely severe depression compared to 49.2% in group B. In Group A, 75.4% had moderate, severe, or extremely severe anxiety compared to 44.7% in group B. In Group A, 80.3% had moderate, severe or extremely severe stress compared to 54.2% in group B. Anxiety, depression and stress were significantly higher in HCPs who were posted in COVID-19 ward compared to those who were not posted in COVID-19 wardConclusion: There was significantly higher anxiety, stress and depression in health care professionals posted in COVID-19 ward. Both the government and health care agencies should take responsibility for protecting the psychological well-being of health care communities all over the world and ensuring a healthy work environment.

BackgroundA detailed understanding of the relationship between the occipital condyle (OC) and the deeper-lying hypoglossal canal (HC) is necessary for surgeons who place screws into the OC or drill through or around the HC. Therefore, this anatomical study was performed. MethodologyA total of 30 skulls (60 sides) underwent an analysis of the angle formed between the long axis of the OC and the HC, i.e., the OC/HC angle. Additionally, the lengths and widths of the OCs and foramen magnum (FM) of each skull were measured using a micrometer. Statistical analyses were performed between the left and right sides, and a Pearson's correlation coefficient was calculated between OC/HC angles and the sizes of the OCs and FM of the skulls. ResultsThe OC/HC angle for the left and right sides ranged from 30 to 56 degrees (mean 46 degrees). The width of the OCs ranged from 9 to 18 mm (mean 13 mm). The length of the OCs was 18 to 31 mm (mean 24 mm). The mean length and width of the FM were 36 mm and 30 mm, respectively. There was no statistically significant difference between the OC/HC angle comparing left and right sides or male or female specimens. Additionally, no statistically significant differences were found between septated and non-septated HC. Pearson's correlation coefficient for left and right OC/HC angles and left and right OC lengths was r = 0.4056 and r = 0.2378, respectively. Pearson's correlation coefficient for left and right OC/HC angles and left and right OC width was r = 0.3035 and r = 0.3530, respectively. Pearson's correlation coefficient for left and right OC/HC angles and the width of the FM was r = 0.2178 and r = 0.2048, respectively. Pearson's correlation coefficient for left and right OC/HC angles and the length of the FM was r = 0.3319 and r = 0.2683, respectively. ConclusionsThe OC/HC angle as measured here was relatively consistent with no statistically significant differences between sides. We did not find a strong correlation between the width or length of the OC or the width or length of the FM and the OC/HC angles. Therefore, based on our study, surgeons can expect that this angle will range between 30 and 56 degrees (mean 46 degrees). Such knowledge might decrease patient morbidity following invasive procedures involving the OC.