ORIGINAL RESEARCH PAPER Volume - 9 | Issue - 9 | September - 2020 | PRINT ISSN No. 2277 - 8179 | DOI : 10.

36106/ijsr

INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

EFFECT OF LOCKDOWN ON HEALTH PROFILE OF MEDICAL STUDENTS OF

ASSAM

Physiology
Dr Arpana
Hazarika
Dr Madhurima *Corresponding Author
Bora*
ABSTRACT
Covid 19 pandemic has caused worldwide havoc. India is also passing through a challenging situation as the number of infected or positive cases is
increasing day by day. With strict preventive measures and restriction by the Indian government in the form of nationwide lockdown is trying to
contain the contagious disease . The citizens are going through a range of psychological and emotional reactions, ,fear and uncertainity being one
of them. Schools and colleges are closed for almost ve months the lockdown has affected mental and other the health prole of the students
immensely. Disturbance in the mental health not only have negative impact to the particular student but also have negative impact on the
community as today's students are tomorrow's future AIM: This study was conducted out on 486 students of six medical colleges of Assam to
assess the effect of lock down due to covid 19 on health of the students.
RESULT: It was seen that sleep prole was much affected. Sleep increased in most cases ( 69.11%). appetite( 41.77%), intake of water ( 49.25%),
intake of fruits( 49.46%), and intake of vegetables(57.63%) increased during lockdown. Diagnosed cases of depression had frequent attacks
(52.3%) during lockdown. However hours spent on mobile increased (82.4%) excessively. Physical activities decreased during lockdown leading
to increased body weight ( 54.15%)
KEYWORDS
Lock down Mental health Depression Anxiety
INTRODUCTION ,nurses, administrators. Hence the mental health of the student has to
The outbreak of this novel respiratory virus has been associated with be given at most importance. Till date there is no proven treatment to
reports of increased anxiety, depression, insomnia and fear among the manage the novel corona disease. As the rate of spread is increasing
general population [1]. In addition, extensive media coverage, stay at day by day, lock down is the only option available to slow down the
home orders and unprecedented unemployment rates have only rate of spreading infection. In this process all the educational
intensied the sense of societal anxiety and panic [2] Existing studies institution were lock down all of sudden. The students were in different
suggest that patients with psychiatric disorders are more susceptible to phase of their academic years, some were about to write their entrance
stress than the general population and may have heightened symptoms examination and some are writing their examination .It is well known
during a time of crisis [3]. In the USA, approximately 20% of adults that the students experience lot of stress especially before and during
experience mental illness [4] Healthcare crises such as pandemics have the examinations. The examinations were postponed due to lockdown
a profound psychological impact. Multiple studies have demonstrated effect and the actual date is awaited. In this context many students were
that heightened stress responses during or following a crisis are undergoing mental Stress and there is a strong need to consider their
associated with potentially long lasting adverse physical and mental mental health status which also affect other health parameters .The
health outcomes [5]]. The outbreak of the Ebola virus in West Africa in students were preparing the examinations specially the entrance
2014 received global media attention. A team, led by Dr. Maria Loades, examination for years together. the medical students were also Under
clinical psychologist from the Department of Psychology at the mental stress due to sudden transition from routine teaching method to
University of Bath, established how loneliness and disease online method .There should be mental health cell that comprises of
containment measures could impact the mental health of both children psychiatrist, psychologist and senior faculty members.
and adolescents. For the last few months the majority of children and
adolescents in the US are experiencing a prolonged state of physical Aim :
isolation from their friends, as well as teachers, extended family and To see the health prole (both physical and mental status) of medical
community networks. While quarantining adults has generally led to students of Assam
negative psychological effects, including confusion, anger, and post-
traumatic distress, it is unknown how these measures have impacted Study Design: Descriptive study
children. [6] The studies were mainly from the US, China, Europe, and Study Population: Medical students both undergraduate and post
Australia, but also included studies conducted in India, Malaysia, graduate within the age group of 18ys to 28yrs of age.
Korea. Thailand, Israel, Iran, and Russia. Overall, the investigators
found that social isolation and loneliness increased the risk of INCLUSION CRITERIA : Medical students (undergraduates
depression, as well as the possibility of anxiety at the time of belonging to all semesters and post graduate students.)
loneliness, which was measured between 0.25-9 years later. The
duration of loneliness was strongly correlated with mental health Exclusion criteria :
symptoms than the intensity of loneliness.[7] The investigators found 1) general category students
young people were as much as 3 times more likely to develop 2) Medical students of other states
depression in the future due to social isolation, with the impact of
loneliness on mental health lasting up to 9 years later.[8] “Children and METHODOLOGY :
adolescents are probably more likely to experience high rates of A digital questionnaire was prepared and circulated among the medical
depression and probably anxiety during and after enforced isolation students of Assam. The form was duly lled up by willing 486 students
ends,” the authors wrote. “This may increase as enforced isolation of six medical colleges of Assam. Then the answers were analyzed
continues. Clinical services should offer preventative support and taking into account the mental health, physical health and food habits
early intervention where possible and be prepared for an increase in of the students. The parameters used to see the health status of students
mental health problems.”[9] So it is evident Mental health of the were shown by bar diagram and Pi Charts.
students is the topic of interest throughout the world. The entire STATISTICAL ANALYSIS :
performance of the students depends on his mental health. As students All the parameters to check the mental and physical health of the
are our futures, disturbance in mental as well as other health student were shown in percentage when compared with the same
parameters affect not only the student but also has negative impact on parameters at time of lockdown. To assist it the bar diagram and pi
society as well, because they are our future teachers ,doctors, engineers charts are also used.
International Journal of Scientific Research 1
Volume - 9 | Issue - 9 | September - 2020 PRINT ISSN No. 2277 - 8179 | DOI : 10.36106/ijsr

RESULT:
The questions answered are shown in the following tables: Table 1
parameters Increased Decreased Same as No
during LD during LD before answer
Sleep prole 69.11% 11.02% 19.87% 23
Time taken to fall asleep 61% 16% 23% 23
Appetite during LD 41.77% 24.03% 34.2% 24
Intake of coffee during 18.57% 30.02% 51.4% 23
LD
Intake of water during LD 49.25% 11.83% 38.92% 21
Intake of fruits during LD 49.46% 23.44% 27% 21
Intake of vegetables 57.63% 14.41% 27.96% 21 FIG-9 Fig-10
during LD
Body weight 51.15% 14.38% 33.48% 20
Hours in mobile 82.4% 2.36% 15.24% 8
Table 2

FIG-11 Fig-12

Table 2:
diseases Familial On Frequent Need to No
medication attacks increase answer
medication
during LD
Diagnosed 31.61% 6.32% 52.30% 9.77% 312
case of
FIG-1 Fig-2 depression
Diagnosed 58.33% 17.26% 21.43% 2.98% 318
case of asthma
or allergy
Table 3:
Habits during lockdown No Occasional daily No answer
Smoking habits 90.04% 7.14% 2.18% 23
Alcohol consumption 89.78% 10% 0.22% 25
Sleep inducing 93.06% 6.05% 0.86% 25
medication
Table 4:
Natural habits during lockdown Regular Irregular No answer
Fig-3 Fig-4 Bowel habits 78.62% 21.28% 23
Menstrual cycle 82.14% 17.86% 290
DISCUSSION:
A decrease in mental and physical wellbeing, which likely resulted
from the exceptional situation due to the pandemic and was associated
with decreased sleep quality and sleep duration. In table1, the sleep
prole was affected a lot . The strength of these effects may even have
masked a link between reduced social jetlag and positive effects on
sleep quality, which has previously been reported [8]. According to
table 1, 61% students took longer time to fall asleep and 69% of
students had longer duration of sleep. Around 6.05% took medication
to induce sleep as lockdown hampered their routine of life. On a more
Fig-5 Fig-6 positive note, we were also able to identify factors that limited the
decline in sleep quality during the lockdown. These included a
reduction in social sleep restriction, that is, the harmonisation of sleep
duration across work and free days, as well as a reduction in working
hours. Moreover, increases in daylight exposure and exercise may
have buffered the negative effects of the lockdown and were associated
with less decreased sleep quality and increased sleep duration.
Possibly, these factors were able to reduce lockdown-induced stress
[9]. In the three European countries included in the study, the COVID-
19 lockdown, during which public life came to a standstill and many
people experienced increased exibility regarding social schedules,
led to improved individual sleep–wake timing and overall more sleep.
At the same time, however, many people suffered from a decrease in
sleep quality in this burdening and exceptional situation. Potential
strategies to mitigate the adverse effects of the lockdown on sleep
Fig-7 Fig-8 quality may include exposure to natural daylight and exercise.[10]

2 International Journal of Scientific Research

Volume - 9 | Issue - 9 | September - 2020
It was seen that most of the students stayed with parents[89.16]% as
hostels were closed down due to lockdown. Physical distancing and
self-isolation strongly impacted citizens' lives, affecting in particular
eating habits and everyday behaviours. There are two major
inuences: staying at home (which includes digital-education, smart
working, limitation of outdoors and in-gym physical activity) and
stockpiling food, due to the restriction in grocery shopping. In
addition, the interruption of the work routine caused by the quarantine
could result in boredom, which in turn is associated with a greater
energy intake [10]. Moreover in this study there is increase in the use of
mobile phones [82.40%], among the students, this may have a relation
with online classes which are organized by the college in order to carry
out the academics and to relieve themselves from the boredom of
lockdown.
In this study, there is increase in the intake of water [49.25%], fruit
intake [49.46%], Vegetable intake [57.63%] among the students. It is
likely as the diet is supervised by the parents. In addition to boredom,
hearing or reading continuously about the COVID-19 from media can
be stressful. Stress leads subjects toward overeating, especially
'comfort foods' rich in sugar, dened as “food craving” [11]]. Those
foods, mainly rich in simple carbohydrates, can reduce stress as they
encourage serotonin production with a positive effect on mood 12].
However, this food craving effect of carbohydrates is proportional to
the glycemic index of foods that is associated with the increased risk of
developing obesity and cardiovascular diseases, beyond a chronic state
of inammation that has been demonstrated to increase the risk for
more severe complications of COVID-19 [13]. This new condition
may compromise maintaining a healthy and varied diet, as well as a
regular physical activity. For example, limited access to daily grocery
shopping may lead to reduce the consumption of fresh foods,
especially fruit, vegetables and sh, in favour of highly processed
ones, such as convenience foods, junk foods, snacks, and ready-to-eat
cereals, which tend to be high in fats, sugars, and salt. Moreover,
psychological and emotional responses to the COVID-19 outbreak
[12,], may increase the risk of developing dysfunctional eating
behaviors. It is well known how the experience of negative emotions
can lead to overeating, the so-called “emotional eating” [13]. In this
study it is seen that physical activity of the students decreased by
[32.80%] leading to gain in body weight [52.15%]. In table 2, we see
frequent [52.30%] of diagnosed case of depression [21.43%]
diagnosed case of allergy or asthma. According to table 3, smoking
habit and alcohol consumption was found to be minimal. According to
table 4, bowel habit and menstural cycle of female students were found
to be regular In order to contrast and respond to the negative
experience of self-isolation, people could be more prone to look for
reward and gratication physiologically associated with food
consumption, even overriding other signals of satiety and hunger [14].
In addition, boredom feelings, which may arise from staying home for
an extended period, are often related to overeating as a means to escape
monotony [15]. On the other hand, negative experiences may lead to
eating restriction, due to the physiological stress reactions that mimic
the internal sensations associated with feeding-induced satiety.[16]
Finally, lifestyle may be substantially changed due to the containment
measures, with the consequent risk of sedentary behaviours,
modication in smoking and sleeping habits[17]. Of interest, different
studies reported an association between sleep disturbances and obesity
due to increase the secretion of pro-inammatory cytokines by the
increased visceral adipose that could contribute to alter the sleep–wake
rhythm [18]. In addition, alsodiet seems to inuence the quality of
sleep, in fact very recently in a cross-sectional study included 172
middle-aged adults it has been reported that good sleepers had higher
adherence to the Mediterranean diet (MD) and lower body mass index
(BMI) compared to poor sleepers [19].
Considering the smoking, there are a signicant association exists
between SARS-CoV-2 infection and air pollution, and in this context
in smokers, more severe COVID-19 symptoms occur [20].Low
physical activity levels have been suggested to interact both with body
fat and appetite dysregulation [21].
In table 2 we see frequent attacks [52.30%] of diagnosed case of
depression [21.43%] diagnosed case of allergy Or asthma. According
to table 3, smoking habit and alcohol consumption was minimal
among the students.
The COVID-19 outbreak has prompted most countries opt for
PRINT ISSN No. 2277 - 8179 | DOI : 10.36106/ijsr
population connement and social distancing measures as a way to
control the spread of the virus. However, important psychological
effects have been pointed out in previous connement experiences (
Hawrylucketal., 2004). The current pandemic has already shown
signicant psychological symptoms related to anxiety, stress and
depression Wang et al., 2020Bao et al., 2020, Xiang et al., 2020Yang et
al., 2020 [24]. A higher prevalence of high scores on psychological
impact measured by IES was observed compared to the prevalence of
large scores on depression, anxiety and stress measured by DASS-21.
Similar results were also recently found in China by
Wangetal.(2020)[25]. As these authors point out, this difference in
prevalence may be due to the specic evaluation of the impact of the
event by IES versus a non-specic evaluation by DASS-21. Regarding
the different groups at the university, signicantly higher depression,
anxiety and stress scores were observed in students compared to the
different groups of employees[26]. The high prevalence of
psychological symptoms in university students has been frequently
pointed out (Auerbachetal., 2016; Bayramand Bilgel,2008;
Bruffaertsetal., 2018)[27]. While there is evidence from several
studies in which students from the HS or Engineering area were found
to present higher symptomatology scores than those in the Humanities
area (Elias et al., 2011; Posseltand Lipson,2016), our results show
precisely the opposite.[28]
In fact, the lowest scores are shown by E&A students and workers on
all three subscales. In line with our results, the study of
Lipsonetal.(2016) showed that A&H students have a greater tendency
to develop mental illnesses compared to the other areas, such as the
Engineering and Business students, who also seem to undergo
treatment less frequently29].
A study with a large sample size performed in China obtained similar
percentage oIES scores with respect to our study ( Wangetal., 2020).
Furthermore, that study also highlights the high levels of
symptomatology in students, indicating that the uncertainty and the
potential negative impact on academic progress may have motivated
the impact on students' mental health.[30]
However, results from another study in the general population of
China, evaluated using the same instrument (IES), seem to show a
much lower percentage of moderate or severe scores on the impact of
the event, 7.6% ( Zhangand Ma,2020). The reasons for the difference
between that study and our results may perhaps be related to the
considerable age difference between the respondents of both studies,
with younger respondents in our case, and a signicantly smaller
sample size in the study on the Chinese general population..[31]
This study has some strengths and limitations. Among the strengths,
the large sample size (2530 respondents) allowed us to perform a
robust analysis and extract solid tendencies and associations. Also, this
is an early study that offers a unique opportunity to investigate the
emotional impact of the COVID-19 pandemic in a university
environment. It provides valuable information about the current
situation useful to gain some insight about the situation in other
universities or in possible future global crises.
It is important to explore why younger students are suffering a greater
psychological impact, which could be related to factors such as their
perception of the future, their way of consuming information media,
etc.
CONCLUSION-.
This study suggests that mental health of students and should be
carefully monitored during this crisis, and authorities should provide
psychological services oriented and adapted to these circumstances to
mitigate the emotional impact on medical students.
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