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Papers by ejaz gul

Research paper thumbnail of Gender Differences in the Prevalence of Depression Amongst Medical Students

Background: Depression is known to be prevalent among medical students particularly in the initia... more Background: Depression is known to be prevalent among medical students particularly in the initial academic years. It is known to adversely affect their physical and mental well being along with academic performance. Objective: The objective of this study was to determine the prevalence of depression amongst medical students and to observe gender differences in the prevalence rates of depression. Material And Methods: 100 students which comprised students from 3rd, 4th and 5th year were consecutively selected and were asked to complete Beck Depression Inventory. Results: The mean age was 21.40 ± S.D 1.46 years. There was an equal gender distribution. Amongst the male students, 30% had minimal depression, 12% mild depression, 16% moderate depression and 42% severe depression; whereas amongst female students, 38% had minimal depression, 36% mild depression, 8% moderate depression and 18% severe depression. However the difference in prevalence of depression in both genders was not stat...

Research paper thumbnail of Frequency of Depression among Patients with Backache presenting to Mardan Medical Complex, Mardan

Journal of Saidu Medical College, Swat, Dec 13, 2020

Background: Chronic pain accompanies emotional element in the form of psychiatric disorders. Chro... more Background: Chronic pain accompanies emotional element in the form of psychiatric disorders. Chronic medical conditions such as backache may make a person at higher risk for depression. Depressed patients also have somatic symptoms as headache, fatigue, and backache. To understand the relationship, we conducted this study at neurosurgery Outpatient department of Mardan medical complex, Mardan. Objective: The aim of this study was to clarify the causal relationship of backache and depression. The study also aimed to explore the frequency of depression among patients with backache. Material and Methods: This cross-sectional study was conducted at outpatient department of Mardan Medical Complex. Patients presenting with chief complaints of backache were invited for participation in the study. initial medical and neurological screening was conducted by consultant neurosurgeon and afterwards HAM-D was administered for assessment of depression. Results: We included 114 male and female patients ranging in age from 22 to 58 years, who presented to neurosurgery OPD with chief complaints of backache. More than half 58% of the patients were female. Minimal depression was found among 22 (19.3%) of the patients, 19 (16.7%) patients had mild depression, 47 (41.2%) had moderate depression, and 26 (22.8%) had severe depression. Highest frequency of depression was observed among patients with infection/ tumor (84.5 %) and those with degenerative backache (79 %). The correlation of type of backache and severity of depression was significant (p= .049). Conclusion: Depression is common among patients with backache, therefore screening patients with complaints of backache for psychiatric co morbidity in primary care is important because psychopathology may have significant consequences for prognosis, outcome and health care utilization.

Research paper thumbnail of Depression

The Professional Medical Journal, 2018

Depression is a common problem among women. Different variables contributein influencing depressi... more Depression is a common problem among women. Different variables contributein influencing depression among women. Menopause is one variable that may trigger symptomsof depression. Different variables jointly contribute in influencing the presentation of menopausalsymptoms including sociocultural, psychological and environmental factors. No studies havebeen conducted to assess mean age and symptoms of depression among menopausalwomen of Mardan. Objectives: To assess accompanying symptoms of depression and theirseverity among menopausal women. Study Design: Cross-sectional study. Setting: GynaeOut-patient Department at Mardan Medical Complex. Period: February 2017 to October 2017.Methods: The sample consisted of 200 women ranging in age from 45-71 years. Each patientwas assessed using sociodemographic sheet, menopausal symptoms were assessed usingMenopausal rating scale and severity of depression was measured using Hamilton depressionscale. Data was entered and analyzed using SPSS Vers...

Research paper thumbnail of Depression

The Professional Medical Journal, 2018

… Depression is a common problem among women. Different variables contribute in influencing depre... more … Depression is a common problem among women. Different variables contribute in influencing depression among women. Menopause is one variable that may trigger symptoms of depression. Different variables jointly contribute in influencing the presentation of menopausal symptoms including sociocultural, psychological and environmental factors. No studies have been conducted to assess mean age and symptoms of depression among menopausal women of Mardan. Objectives: To assess accompanying symptoms of depression and their severity among menopausal women. Study Design: Cross-sectional study. Setting: Gynae Outpatient Department at Mardan Medical Complex. Period: February 2017 to October 2017. Methods: The sample consisted of 200 women ranging in age from 45-71 years. Each patient was assessed using sociodemographic sheet, menopausal symptoms were assessed using Menopausal rating scale and severity of depression was measured using Hamilton depression scale. Data was entered and analyzed using SPSS Version 21.0. Results: According to the findings of this study, mean age at menopause was noted to be 49.1 ranging from 44-59. Among the many predominant menopausal symptoms, the most common among these symptoms reported were joint and muscle discomfort in 62% of women, followed by sleep problem (17%), and physical and mental exhaustion (11%). The least reported menopausal symptoms were drying of vagina, sexual problems and anxiety. Depression was found among 26 % of the female participants according to Hamilton scoring criteria. Mild depressive symptoms were noted among 24%, moderate depressive symptoms 14%, severe 5% and very severe 7%. Conclusion: According to the results of the current study, 50 % of the participants lies in the range of depression according to Hamilton depression scores. Among these 50%, more than half 26 % lies in the range of severe to very severe depression while the rest 24% lies in the range of mild to moderate depression.

Research paper thumbnail of Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS)

British Journal of Psychiatry, 2011

BackgroundMost people with schizophrenia in low- and middle-income (LAMI) countries receive minim... more BackgroundMost people with schizophrenia in low- and middle-income (LAMI) countries receive minimal formal care, and there are high rates of non-adherence to medication.AimsTo evaluate the effectiveness of an intervention that involves a family member in supervising medication administration – supervised treatment in out-patients for schizophrenia (STOPS) – in improving treatment adherence and clinical outcomes.MethodIndividuals (n = 110) with schizophrenia or schizoaffective disorders were allocated to STOPS or to treatment as usual (TAU) and followed up for 1 year. The primary outcome was adherence to the treatment regimen. Positive and Negative Syndrome Scale for Schizophrenia and Global Assessment of Functioning scores were also assessed.ResultsParticipants in the STOPS group had better adherence (complete adherence: 37 (67.3%) in STOPS v. 25 (45.5%) in TAU; P<0.02) and significant improvement in symptoms and functioning.ConclusionsSTOPS may be useful in enhancing adherence t...

Research paper thumbnail of Prevalence of depression and anxiety in patients requesting physicians' aid in dying: cross sectional survey

BMJ, 2008

Objective To determine the prevalence of depression and anxiety in terminally ill patients pursui... more Objective To determine the prevalence of depression and anxiety in terminally ill patients pursuing aid in dying from physicians. Design Cross sectional survey. Setting State of Oregon, USA. Participants 58 Oregonians, most terminally ill with cancer or amyotrophic lateral sclerosis, who had either requested aid in dying from a physician or contacted an aid in dying advocacy organisation. Main outcome measures Diagnosis of depression or anxiety according to the hospital anxiety and depression scale and the structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders. Results 15 study participants met "caseness" criteria for depression, and 13 met criteria for anxiety. 42 patients died by the end of the study; 18 received a prescription for a lethal drug under the Death with Dignity Act, and nine died by lethal ingestion. 15 participants who received a prescription for a lethal drug did not meet criteria for depression; three did. All three depressed participants died by legal ingestion within two months of the research interview. Conclusion Although most terminally ill Oregonians who receive aid in dying do not have depressive disorders, the current practice of the Death with Dignity Act may fail to protect some patients whose choices are influenced by depression from receiving a prescription for a lethal drug.

Research paper thumbnail of Frequency of Depression in Patients suffering from Pulmonary Tuberculosis

Pakistan Journal of Chest medicine, 2017

Objective: To determine the frequency of depression in patients suffering from pulmonary tubercul... more Objective: To determine the frequency of depression in patients suffering from pulmonary tuberculosis. Methodology: This Cross-sectional descriptive study was conducted in OPD of pulmonology and psychiatry Mardan Medical Complex Mardan. First 265 patients diagnosed with tuberculosis based on sputum smear positive for AFB were selected. After collecting demographic and laboratory details structured questionnaire of Hamilton Rating Scale for depression (Urdu Version) was applied on all the patients for diagnosis of depression. Results: Out of 256 patients 154 (60.16%) were male and 102 (39.84%) were female. Age of patients ranged from18 to 59 years with mean of 43.14 14.9SD. Over all frequency of depression in patients suffering from pulmonary tuberculosis was 80.1%. In which 52 (20.3%) have mild, 102(39.8%) have moderate and 51 (19.9 %) have severe depression. Depression was more common in females (61.95 %)as compared to male patients (38.04 %). Conclusion: There was high incidence o...

Research paper thumbnail of Gender Differences in the Prevalence of Depression Amongst Medical Students

Background: Depression is known to be prevalent among medical students particularly in the initia... more Background: Depression is known to be prevalent among medical students particularly in the initial academic years. It is known to adversely affect their physical and mental well being along with academic performance. Objective: The objective of this study was to determine the prevalence of depression amongst medical students and to observe gender differences in the prevalence rates of depression. Material And Methods: 100 students which comprised students from 3rd, 4th and 5th year were consecutively selected and were asked to complete Beck Depression Inventory. Results: The mean age was 21.40 ± S.D 1.46 years. There was an equal gender distribution. Amongst the male students, 30% had minimal depression, 12% mild depression, 16% moderate depression and 42% severe depression; whereas amongst female students, 38% had minimal depression, 36% mild depression, 8% moderate depression and 18% severe depression. However the difference in prevalence of depression in both genders was not stat...

Research paper thumbnail of Frequency of Depression among Patients with Backache presenting to Mardan Medical Complex, Mardan

Journal of Saidu Medical College, Swat, Dec 13, 2020

Background: Chronic pain accompanies emotional element in the form of psychiatric disorders. Chro... more Background: Chronic pain accompanies emotional element in the form of psychiatric disorders. Chronic medical conditions such as backache may make a person at higher risk for depression. Depressed patients also have somatic symptoms as headache, fatigue, and backache. To understand the relationship, we conducted this study at neurosurgery Outpatient department of Mardan medical complex, Mardan. Objective: The aim of this study was to clarify the causal relationship of backache and depression. The study also aimed to explore the frequency of depression among patients with backache. Material and Methods: This cross-sectional study was conducted at outpatient department of Mardan Medical Complex. Patients presenting with chief complaints of backache were invited for participation in the study. initial medical and neurological screening was conducted by consultant neurosurgeon and afterwards HAM-D was administered for assessment of depression. Results: We included 114 male and female patients ranging in age from 22 to 58 years, who presented to neurosurgery OPD with chief complaints of backache. More than half 58% of the patients were female. Minimal depression was found among 22 (19.3%) of the patients, 19 (16.7%) patients had mild depression, 47 (41.2%) had moderate depression, and 26 (22.8%) had severe depression. Highest frequency of depression was observed among patients with infection/ tumor (84.5 %) and those with degenerative backache (79 %). The correlation of type of backache and severity of depression was significant (p= .049). Conclusion: Depression is common among patients with backache, therefore screening patients with complaints of backache for psychiatric co morbidity in primary care is important because psychopathology may have significant consequences for prognosis, outcome and health care utilization.

Research paper thumbnail of Depression

The Professional Medical Journal, 2018

Depression is a common problem among women. Different variables contributein influencing depressi... more Depression is a common problem among women. Different variables contributein influencing depression among women. Menopause is one variable that may trigger symptomsof depression. Different variables jointly contribute in influencing the presentation of menopausalsymptoms including sociocultural, psychological and environmental factors. No studies havebeen conducted to assess mean age and symptoms of depression among menopausalwomen of Mardan. Objectives: To assess accompanying symptoms of depression and theirseverity among menopausal women. Study Design: Cross-sectional study. Setting: GynaeOut-patient Department at Mardan Medical Complex. Period: February 2017 to October 2017.Methods: The sample consisted of 200 women ranging in age from 45-71 years. Each patientwas assessed using sociodemographic sheet, menopausal symptoms were assessed usingMenopausal rating scale and severity of depression was measured using Hamilton depressionscale. Data was entered and analyzed using SPSS Vers...

Research paper thumbnail of Depression

The Professional Medical Journal, 2018

… Depression is a common problem among women. Different variables contribute in influencing depre... more … Depression is a common problem among women. Different variables contribute in influencing depression among women. Menopause is one variable that may trigger symptoms of depression. Different variables jointly contribute in influencing the presentation of menopausal symptoms including sociocultural, psychological and environmental factors. No studies have been conducted to assess mean age and symptoms of depression among menopausal women of Mardan. Objectives: To assess accompanying symptoms of depression and their severity among menopausal women. Study Design: Cross-sectional study. Setting: Gynae Outpatient Department at Mardan Medical Complex. Period: February 2017 to October 2017. Methods: The sample consisted of 200 women ranging in age from 45-71 years. Each patient was assessed using sociodemographic sheet, menopausal symptoms were assessed using Menopausal rating scale and severity of depression was measured using Hamilton depression scale. Data was entered and analyzed using SPSS Version 21.0. Results: According to the findings of this study, mean age at menopause was noted to be 49.1 ranging from 44-59. Among the many predominant menopausal symptoms, the most common among these symptoms reported were joint and muscle discomfort in 62% of women, followed by sleep problem (17%), and physical and mental exhaustion (11%). The least reported menopausal symptoms were drying of vagina, sexual problems and anxiety. Depression was found among 26 % of the female participants according to Hamilton scoring criteria. Mild depressive symptoms were noted among 24%, moderate depressive symptoms 14%, severe 5% and very severe 7%. Conclusion: According to the results of the current study, 50 % of the participants lies in the range of depression according to Hamilton depression scores. Among these 50%, more than half 26 % lies in the range of severe to very severe depression while the rest 24% lies in the range of mild to moderate depression.

Research paper thumbnail of Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS)

British Journal of Psychiatry, 2011

BackgroundMost people with schizophrenia in low- and middle-income (LAMI) countries receive minim... more BackgroundMost people with schizophrenia in low- and middle-income (LAMI) countries receive minimal formal care, and there are high rates of non-adherence to medication.AimsTo evaluate the effectiveness of an intervention that involves a family member in supervising medication administration – supervised treatment in out-patients for schizophrenia (STOPS) – in improving treatment adherence and clinical outcomes.MethodIndividuals (n = 110) with schizophrenia or schizoaffective disorders were allocated to STOPS or to treatment as usual (TAU) and followed up for 1 year. The primary outcome was adherence to the treatment regimen. Positive and Negative Syndrome Scale for Schizophrenia and Global Assessment of Functioning scores were also assessed.ResultsParticipants in the STOPS group had better adherence (complete adherence: 37 (67.3%) in STOPS v. 25 (45.5%) in TAU; P<0.02) and significant improvement in symptoms and functioning.ConclusionsSTOPS may be useful in enhancing adherence t...

Research paper thumbnail of Prevalence of depression and anxiety in patients requesting physicians' aid in dying: cross sectional survey

BMJ, 2008

Objective To determine the prevalence of depression and anxiety in terminally ill patients pursui... more Objective To determine the prevalence of depression and anxiety in terminally ill patients pursuing aid in dying from physicians. Design Cross sectional survey. Setting State of Oregon, USA. Participants 58 Oregonians, most terminally ill with cancer or amyotrophic lateral sclerosis, who had either requested aid in dying from a physician or contacted an aid in dying advocacy organisation. Main outcome measures Diagnosis of depression or anxiety according to the hospital anxiety and depression scale and the structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders. Results 15 study participants met "caseness" criteria for depression, and 13 met criteria for anxiety. 42 patients died by the end of the study; 18 received a prescription for a lethal drug under the Death with Dignity Act, and nine died by lethal ingestion. 15 participants who received a prescription for a lethal drug did not meet criteria for depression; three did. All three depressed participants died by legal ingestion within two months of the research interview. Conclusion Although most terminally ill Oregonians who receive aid in dying do not have depressive disorders, the current practice of the Death with Dignity Act may fail to protect some patients whose choices are influenced by depression from receiving a prescription for a lethal drug.

Research paper thumbnail of Frequency of Depression in Patients suffering from Pulmonary Tuberculosis

Pakistan Journal of Chest medicine, 2017

Objective: To determine the frequency of depression in patients suffering from pulmonary tubercul... more Objective: To determine the frequency of depression in patients suffering from pulmonary tuberculosis. Methodology: This Cross-sectional descriptive study was conducted in OPD of pulmonology and psychiatry Mardan Medical Complex Mardan. First 265 patients diagnosed with tuberculosis based on sputum smear positive for AFB were selected. After collecting demographic and laboratory details structured questionnaire of Hamilton Rating Scale for depression (Urdu Version) was applied on all the patients for diagnosis of depression. Results: Out of 256 patients 154 (60.16%) were male and 102 (39.84%) were female. Age of patients ranged from18 to 59 years with mean of 43.14 14.9SD. Over all frequency of depression in patients suffering from pulmonary tuberculosis was 80.1%. In which 52 (20.3%) have mild, 102(39.8%) have moderate and 51 (19.9 %) have severe depression. Depression was more common in females (61.95 %)as compared to male patients (38.04 %). Conclusion: There was high incidence o...