RESEARCH

REPORT
HEALTH ISSUES ASSOCIATED WITH
USAGE OF MASKS AMONG MEDICAL
STUDENTS IN KERALA

BATCH OF 2018 MBBS

DEPARTMENT OF COMMUNITY MEDICINE
GOVERNMENT MEDICAL COLLEGE
THIRUVANANTHAPURAM

CERTIFICATE
HEALTH ISSUES ASSOCIATED WITH USAGE
OF MASKS AMONG MEDICAL STUDENTS IN
KERALA

GUIDED BY SUBMITTED BY
DR MINI S S ABHIRAM KRISHNA
DR BETSY VARGHESE ACHYUTH VINU
ADARSH A
ADARSH GOPAN
ADARSH S CHANDRAN

CERTIFIED THAT THIS IS A BONDAFIDE RECORD OF THE

RESEARCH PROJECT UNDERTAKEN TO FULFIL THE
CURRICULUM REQUIREMENTS OF GRADUATES IN MEDICAL
COUNCIL OF INDIA AND WAS DONE DURING THE YEAR 2021-
22.

DATE:

HEAD OF DEPARTMENT
COMMUNITY MEDICINE

OFFICE SEAL
 HEALTH ISSUES ASSOCIATED WITH
USAGE OF MASK AMONG MEDICAL
STUDENTS IN KERALA
STATEMENT ABOUT RESEARCHERS
INVESTIGATORS
Abhiram Krishna
2018 MBBS
6282581402

Achyuth Vinu
2018 MBBS
8848443931

Adarsh A
2018 MBBS
8547191446

Adarsh Gopan
2018 MBBS
7356850017

Adarsh S Chandran
2018 MBBS
9207641259
GUIDE
Dr. Mini S S
Professor,
Department of Community Medical,
Government Medical College,
Thiruvananthapuram
CO-GUIDE
Dr. Betsy Varghese,
Junior Resident,
Department of Community Medicine,
Government Medical College,
Thiruvananthapuram
 ACKNOWLEDGEMENT
We wish to thank the almighty God. A volume of this magnitude could
not have been possible without the contributions and guidance of many.
We would like to recognize few specific individuals whose contributions
have been especially helpful.

We would like to thank our guide Dr Mini S S, Professor and Dr Betsy

Varghese, Junior Resident, Department of Community Medicine,
Government Medical College, Trivandrum, for their advice, guidance,
constant and encouragement in preparing this project.

We express our humble thanks to our respected teachers for their

guidance and encouragement throughout the course of this study.

We would also like to thank Dr Sara Varghese, Principal, Government

Medical College, Trivandrum, for allowing us to conduct our study.

We are also thankful to the rest of our batch of 2018, Government

Medical College, Trivandrum, for their co-operation and suggestions.
Last but not the least, we are thankful to all subjects for their consent and
co-operation in this work, it would have never seen the light of day
without you. We extend out thanks to all others who helped us directly or
indirectly.
 CONTENTS

1. ABSTRACT 7

2. INTRODUCTION 9

3. OBJECTIVE 11

4. REVIEW OF LITERATURE 12

5. METHODOLOGY 13

6. RESULT ANALYSIS 15

7. DISCUSSION 23

8. CONCLUSION 24

9. INFORMED CONSENT 25

10. QUESTONNAIRE 26

11. REFERENCES 29
 ABSTRACT

BACKGROUND

On January 30, 2020 WHO announced a global public health emergency

of SARS COV2 causing Corona virus disease 2019 (COVID 19), 99% of
detected cases are asymptomatic or have mild conditions [3]. The overall
clinical consequences of Covid 19 are similar to much seasonal flu, with
most deaths occurring in the elderly and ally ill.

The virus mainly spreads among people through close contact via
aerosols and respiratory droplets that are exhaled during talking,
breathing, coughing and sneezing.

Face masks are among the non-pharmaceutical interventions that reduce

the transmission of respiratory pathogens. There are two main types of
masks. NIOSH (National Institute for Occupational Safety and Health)
certified masks and N95 surgical masks are designed to reduce inhalation
from the wearer’s exposure to infectious and harmful particles. Other
types of face masks are fabric or fabric masks.

Medical professionals use face masks for hours on end, so there are many
logical adverse health and psychic effects associated with long-term use
of face masks. In this context, the study was conducted to estimate these
risks and discover possible correlations between them.

OBJECTIVE

1. Primary Objective: To study the Health, physical, physiological,

effects of long term usage of face mask among medical students in
Kerala.

2. Secondary Objective: To find out association between the symptoms

and factors such age, sex, place of Place of stay etc.
METHODOLOGY

A cross sectional study was conducted among medical students in Kerala.

Data was collected using an online semi- structured Questionnaire
administered to 501 eligible participants from January to March 2022.
Data was entered into Excel and analysed using SPSS.

RESULT

A total of 501 responses were received out of which 291 were females,
209 were males and a transgender. The mean age of participants in this
study was 21.62 and median age was 22. The main health issues studied
were nasal symptoms, skin symptoms and mouth symptoms. Regarding
the nasal symptoms 44.9% of participants reported feeling of nasal
discomfort, 29.9% reported nasal congestion or stuffiness, 22.8%
reported nasal blockage or obstruction, 17.2% reported dry nose while
only 8.8% and 8.4% reported burning nose and altered sense of smell
respectively. Among the skin symptoms, 63.5% reported excessive
sweating around the mouth, 54.9% reported acne on concerned area, and
43.7% reported irritation or itchy feeling of nose while only 23.0%
reported rashes or redness of face. Regarding the mouth symptoms 28.1%
reported was dryness around the mouth, 25.3% reported bad breath or
halitosis, while only 17% reported sore throat. Regarding the physical
symptoms 79.0% reported pain behind the ear caused by strap of the
mask, 35.5% reported pain over the nasal bridge due to nose piece and
finally 24.2% reported scar over the nasal bridge. After statistical analysis
of prevalence of various factors and symptoms with the help of Pearson
Chi-Square method, we have found association between the symptoms
and two factors- Place of Place of stay and Whether having Single/Shared
room .

CONCLUSION
Among the health problems studies the main nasal problem reported was
the feeling of nasal discomfort (44.9%), the main skin problem reported
was excessive sweating around the mouth (63.5%), the main mouth
symptoms were dryness around the mouth (28.1%), the main pressure
symptom reported was pain behind the ear caused by the mask strap
(79.0%). After statistical analysis associations was found between more
number of symptoms and place of Place of stay and having shared rooms
 INTRODUCTION
The Nose is an important organ in the natural pathway of breathing. It is
also an integral part of face which has multiple functions. Primary
functions of nose are respiration, air conditioning of inspired air,
protection of lower airways, vocal resonance, nasal reflex functions and
olfaction. An average adult inspires about 10000L of air daily. Nose
primarily protects lower airways from infections and other airborne
particles. Nasal vibrissae at entrance act as filter to sift larger particle,
finer particles & bacteria are adhered to mucus which spread like a sheet
all over surface of mucus membrane.

The COVID-19 pandemic that has raged throughout our world was
declared a pandemic on March 11, 2020 by the World Health
Organisation [3]. The cases continue to mount, in waves, across all major
countries of the world and even still continue to do so despite multiple
vaccines being available.

To deal with the rapid spread of this virus the government of India and all
the respective state governments made masks mandatory for all those in
the public sphere. Individuals in the healthcare sector such as doctors,
medical students, nurses recommended wearing N 95 masks for their
protection while at work, leading to prolong usage as a consequence [6].

This prolonged usage was a novelty for all the healthcare providers and
alike. This has not been without its due share of concerns with many
complaining of the mess being uncomfortable, cumbersome, disturbing.
Many have even ventured to say that it may lead to potential ills and
disease. In this study, we will be looking at the physiological and effects
that prolonged usage of masks have on medical students in Kerala [5].
Face masks are vital importance in protective the health workers from the
corona virus disease. The uses of masks became present to forestall the
unfold of Covid 19. It’s been suggested by the government as mandatory.
A study done by Antonio Scarano et al states that N-95 respirators
resulted in facial discomfort associated facial skin symptoms leading to
lower compliance on comparison with surgical masks [2]. as a result of
their prolonged usage of face mask there may an increasing heat at a
lower place the mask that successively decrease the water carrying
capability of air in nose resulting in sensation of dry nose. A study by
Raymond Roberge et al stated that exaggerated thermal perception is one
of the explanations for intolerance of carrying N 95 respirators [10].

OBJECTIVE
PRIMARY OBJECTIVE:
To study the Health, physical, physiological, effects of long term usage of
face mask among medical students in Kerala

SECONDARY OBJECTIVE:
To find out association between the symptoms and factors such age, sex,
place of Place of stay etc.

REVIEW OF LITERATURE
 In a cross sectional study to assess the Facial Skin Temperature and
Discomfort When Wearing Protective Face Masks: Thermal Infrared
Imaging Evaluation and Hands Moving the Mask' by Antonio Scarano et
al, the increases of skin temperature observed under the mask were
between 0.7±3.3◦C and 1.9±3.5◦C in the respirator [2 7]. These were lower
when the volunteers wore surgical masks. For both types (surgical masks
and N95 respirators), increased skin temperature was observed
at>34.5◦C, a level which may induce slight sensations of thermal
discomfort.

In another cross sectional study to find Effects of Prolonged Use of

Facemask on Healthcare Workers in Tertiary Care Hospital During
COVID-19 Pandemic conducted in 250 health care workers of SRM
medical college, Kattankulathoor by P. K. Purushothaman et al [1] ,it is
found that 48.8% of the participants had generalised nasal discomfort on
wearing the facemask for a prolonged period of time,67.6% of healthcare
workers have developed excessive sweating around the mouth. 56.0% of
the participants developed acne and about 39.0% of the participants
developed redness on the face. Around 30.0% of the participants
developed pain in the nose and 45.2% proportion of the participants
developed pain behind the ear due to elastic straps of the face
masks.35.3% of the participants developed dry mouth and 22.4% had
developed halitosis due to the prolonged usage of the facemask. This
shows that use of facemask plays a pivotal role in causing significant
discomfort during its prolonged usage which can limit the efficient usage
of facemask, leading to decreased protection.

Zuo et al showed that pre-existing acne, rosacea and seborrheic dermatitis

were exacerbated by using face masks [5].

In another study to assess the Physiological Impact of the N95 Filtering

Face piece Respirator on Healthcare Workers by Raymond J Roberge
MD MPH et al draws that the protection afforded by respiratory
protective equipment is partly counterbalanced by the physiological and
burden the equipment imposes on the user [10].

METHODOLOGY
 Study Design: Cross sectional study
 Study Setting: Medical College across Kerala

 Study Period: January to March 2022 after getting ethics clearance

 Study Population: MBBS Students across Medical Colleges in Kerala

 Exclusion Criteria: MBBS students who were not willing to give

consent were excluded from the study

 Sample Size: Sample size was determined based on the formula

N= 4*PQ/d2
Where,
“P” is Prevalence (from previous study)
“Q” is 100 - P
“d” is the allowable error ( 5 - 20% of P )
Here,
 In a study conducted by Purushothaman, P. K et al among the
various symptoms they studied the lowest prevalence was for
halitosis. So considering the symptoms with lowest prevalence the
prevalence of bad breath or halitosis in the parent study was 22.4%,
hence P= 22.4, Q= 77.6 and d= 20% of 22.4 (which is equal to
4.48).
 Substituting these values in the above formula we get a minimum
sample size of 346.
 The minimum sample size needed was 346 and our study had a
maximum of 501 entries

 Sampling Technique: A Google Questionnaire was distributed to

student groups in various medical colleges and those who responded were
considered for study procedure.

 Study Procedure: All the MBBS students of Medical colleges in Kerala

satisfying the study criteria, giving the informed consent to participate
through Google sheet were recruited into the study. Using a pre validated
questionnaire information regarding mask usage and associated issues.

 Data collection tool: Data was collected through online data collection
tool Google forms.
 Statistical Analysis and data management:
 Data was automatically entered into excel sheet from Google forms
and was analysed using SPSS statistical software( version 28.0.1.1 )
 Qualitative variables were summarised as frequency and proportion.
 Quantitative variables were summarised as mean with Standard
deviation and median with interquartile range

Ethical Consideration: Ethical consent was obtained from Institutional

Ethics Committee of Government Medical College, Thiruvananthapuram.

Soft copies of the data obtained with the permission and interview
schedule will be kept with the primary researchers.
Informed consent was obtained from participants through Google forms.
All data will be kept confidential and will be used for purpose of this
study only.

RESULT ANALYSIS
Data was collected from 501 participants out of which 58.1% were
females (n=291), 41.7% were males (n=209) and 0.2% were transgender
(n=1). The mean age of participants in the study was 21.54 years (SD =
1.478). The figure 1 and 2 shows age and gender distribution of study
participants.

Age Distribution of study participants

Table 1: Age Distribution

Frequency per cent
Age of 18 11 2.2
participants 19 38 7.6
20 73 14.6
21 92 18.4
22 169 33.7
23 81 16.2
24 24 4.8
25 13 2.6
Frequency

Total 501 100.0

Figure 1
Histogram
200 Mean = 21.54
Std. Dev. = 1.478
N = 501

150

100

50

0
16 18 20 22 24 26

Age

Gender distribution of the participants

 Table 2: Sex
Frequency per cent
Gender of Female 291 58.1
participants Male 209 41.7
Transgender 1 .2
Total 501 100.0
Figure 2:
Sex
Female
Male
Transgender

0.20%

41.72%

58.08%

Place of Place of stay of study participants

Regarding the Place of stay of the participants who took part in the study
is given in table 3. The study showed that 16.2% (n=81) was Day scholar
and 83.8% ( n=420) was Hostellers.

Table 3: Place of Place of stay

Frequency per cent
Place Day Scholar 81 16.2
of stay Hosteller 420 83.8
Total 501 100.0

Mode of transport
Regarding the mode of transport of the participants are given the table 4.
The study showed that 45.5% (n=225) participants depended on own
vehicles for transportation while 54.5% (n=273) participants depended on
public transportation.

Table 4: Mode Of Transport

 Frequency per cent
Transport Own Vehicle 228 45.5
mode Public Transport 273 54.5
Total 501 100.0

Whether having single room or shared room.

Details regarding whether the participants shared a room with anyone or
they were in a single room is given in table 5. The study showed that
78.0% (n=391) participants shared a room and only 22.0% (n= 110)
participants were having a single room

Table 5: Whether having single room/Shared(Hosteller/Day Scholar)

Frequency per cent
Single/ Shared 391 78.0
Shared Single room 110 22.0
Total 501 100.0

Any known health Conditions.

The health conditions considered was any allergies, asthma, diabetes,
hypertension etc. Out of all these conditions, 10.8% (n=54) reported of
having allergies of any form, 5.0% (n=25) reported of having asthma,
1.2% (n=6) reported of having hypertension, 5.2% (n= 26) reported of
having some other comorbidities, 3.0% (n=15) reported of having some
skin conditions and 1.6% (n=8) reported of having some kind of
conditions. The rest 72.9% (n=365) reported of having no known
comorbidities.
Table 6: Any known health conditions
Frequency per cent
Health Allergies (Food/drug etc.) 54 10.8
Conditions Asthma 25 5.0
Diabetes 2 .4
Hypertension 6 1.2
No known comorbidities 365 72.9
Other comorbidities 26 5.2
Skin Conditions 15 3.0
Total 501 100.0

Nasal problems reported by the participants.

The table given below (table 7) shows the details of nasal symptoms of
the participants who took part in the study. Out of the 501 participants
44.9%(n= 225) reported feeling of nasal discomfort, 17.2%(n=86)
reported dry nose, 8.8%(n=44) reported a feeling of burning nose, 8.4%
(n=42) reported altered sense of smell, 22.8%(n=114) reported nasal
blockage/ obstruction, and 29.9%(n=150) reported of nasal congestion/
stuffiness.

Table 7: Nasal Symptoms

Nasal Symptoms Frequency per cent
1. Feeling of nasal discomfort Yes 225 44.9

2. Dry Nose Yes 86 17.2

3. Burning Nose Yes 44 8.8

4. Altered sense of smell Yes 42 8.4

5. Nasal blockage/obstruction. Yes 114 22.8

6. Nasal congestion/ stuffiness Yes 150 29.9

Skin symptoms reported by participants.

Table 8 given below shows the skin symptoms associated with the usage
of masks. The study showed that there is 43.7% (n= 219) participants
who reported an irritation or itchy feeling on the nose, 54.9 %( n= 275)
reported acne on face, 23.0 %( n= 115) reported rashes. Redness of face
and 63.5 %( n=318) reported excessive sweating around the mouth
Skin Symptoms Frequency per cent
1 Irritation/ itchy feeling of Yes 219 43.7
. nose.
2 Acne on face Yes 275 54.9
.
3 Rashes/redness of face Yes 115 23.0
.
4 Excessive sweating around Yes 318 63.5
. mouth.

Table 8: Skin Symptoms

Mouth symptoms reported by participants.

Some of the participants reported of having symptoms associated with
their oral cavity which is depicted in table 10. 25.3% (n=127) reported
having bad breath, 28.1% (n=141) reported dryness around the mouth
and 17.0% (n=85) reported of having sore throat associated with the long
term usage of masks.
Table 9: Mouth Symptoms
Mouth Symptoms Frequency per cent
1. Bad breath Yes 127 25.3

2. Dryness around the mouth Yes 141 28.1

3. Sore throat Yes 85 17.0

Pressure symptoms reported by participants

Table 9 give the data regarding the pressure symptoms experienced by
the participants. Of the 501 participants who underwent the study, 79.0%
( n=396) reported of pain behind the ear because of the mask strap, 35.5
%( n=178) reported of pain over the nasal bridge and 24.2 %( n=121)
reported scar over the nasal bridge.
Table 10: Pressure Symptoms

Pressure Symptoms Frequency per cent

1. Pain behind the ear because of Yes 396 79.0
mask strap
2. Pain over the nasal Bridge Yes 178 35.5

3. Scar over the nasal bridge Yes 121 24.2

Barriers in normal activities reported by participants.

Details given within side the table (table 11) beneath suggests the
statistics that changed into amassed displaying the share of individuals
who confirmed any shape of boundaries in everyday activities because of
the extended usage of masks. 57.7% (n=289) reported of having
difficulty in walking due to masks, 68.7% (n=344) reported difficulty in
exercising, 58.55 (n=293) reported difficulty in wearing spectacles due to
fogging of the glasses, 66.5% (n=333) reported of having difficulties
while climbing up the stairs. The number of people who said that they
had difficulties in normal communications in classes as well as between
peers was also high. 82.6% ( n=414) reported of having difficulties in
understanding the classes and 59.7% participants reported mask as a
barrier in normal day to day communication with friends and family.
Table 11: Barriers in Normal activities
Barriers in normal activities Frequency per cent
1. Walking Yes 289 57.7

2. Exercise Yes 344 68.7

3. Wearing Spectacles Yes 293 58.5

4. Climbing Stairs Yes 333 66.5

5. Inability to understand classes Yes 414 82.6

6. Normal Communication with Yes 299 59.7

friends and family

Type of mask used as reported by the participants.

Data regarding the type of mask used is given in the following table 12.
Majority of the participants used N 95 masks (79.6%, n=399). 3.2% (n=
16) reported using cloth masks, 6.2 %( n= 31) reported using double
masking method and 11.0 %( n= 55) reported using surgical masks. A
diagram representing this data is also given below.

Table 12: Type of Mask Used

Frequency per cent
Mask Used Cloth 16 3.2

Double masking 31 6.2

N 95 399 79.6

Surgical 55 11.0

Total 501 100.0

 Type of Mask Used
Cloth
Double masking
N 95
Surgical
10.98% 6.19%
3.19%

79.64%

Association between symptoms and factors.

For the secondary objective of the study that is the association between
all these symptoms and other factors has to be analysed. So as to find an
association, the total number of symptoms reported individually was
calculated for the entire sample size and this ranged from participants
reporting no symptoms to 22 symptoms. As such the median symptoms
reported was calculated to be 9 and the participants were divided into 2
groups, participants who reported more than 9 symptoms and participants
who reported less than 9 symptoms. Using this criteria, the number of
reported symptoms and various factors such as age, sex, place of stay,
mode of transport, whether staying in single or shared room was analysed
and significant association was found with two factors- Place of stay and
Whether staying in single/shared room.
Table 13: Statistical analysis showing association.
Sl. Variables No. of Symptoms Chi P Value 95%
No Square Confidence
>9( per cent) <9( per cent)
. Interval
1. Gender

Male 36.0% (80) 46.2% (129)

Female 63.5% (141) 53.8% (150) 6.364 0.058 0.025

Transgender 0.5% (1) 0% (0)

2. Place of stay

Day scholar 14.9% (33) 17.2% (48)

0.499 0.048 0.518 - 1.362
Hosteller 85.1% (189) 82.8% (231)
3. Whether single room/ Shared

Shared Room 82.4% (183) 74.6% (208)

4.481 0.034 1.033 - 2.483
Single Room 17.6% (39) 25.4% (171)
4. Mode Of Transport

Own Vehicle 45.0% (100) 45.9% (128)

0.035 0.852 0.679 - 1.378
Public Transport 55.0% (122) 54.1% (151)
5. Type of Mask used
Cloth 2.3% (5) 3.9% (11)

Double Masking 8.1% (18) 4.7% (13)

7.507 0.057 0.058
N 95 75.7% (168) 82.8% (231)

Surgical 14.0% (31) 8.6% (24)

 DISCUSSION
The aim for study was to determine the health issues associated with
usage of masks among medical students in Kerala. The study was
conducted by distributing a self-made questionnaire via different forms of
media among medical students in Kerala.

A total of 501 students participated in the study out of which 291 (58.1%)
were females, 209 (41.7%) were males and a transgender (0.2%).
Participants were aged from 18 - 25 out of which 33.7% were aged 22
years.
The study mainly focussed on the symptoms of nose, skin, mouth,
pressure and physiological problems associated with long term usage of
masks.

About the nasal symptoms, 44.9% of participants reported feeling of

nasal discomfort, 29.9 % reported nasal congestion or stuffiness, 22.8%
reported nasal blockage or obstruction, 17.2% reported dry nose while
only 8.8% and 8.4% reported burning nose and altered sense of smell
respectively. In a study conducted by P. K. Purushothaman et al, these
same symptoms showed 48.8% of participants reported feeling of nasal
discomfort, 30.0% reported dry nose while only 26.1% reported burning
nose. Hence there is significant difference in prevalence of symptoms of
dry nose and burning nose [1].

When asked about the skin symptoms 63.5% reported excessive sweating
around the mouth, 54.9% reported acne on concerned area, 43.7%
reported irritation or itchy feeling of nose while only 23.0% reported
rashes or redness of face. In a study conducted by P. K. Purushothaman et
al, these same symptoms showed 67.6% reported excessive sweating
around the mouth, 56.0% reported acne on concerned area, 52.0%
reported irritation or itchy feeling of nose while only 39.0% reported
rashes or redness of face. So there id considerable difference in
prevalence of symptoms of itchy feeling of nose and rashes or redness of
face [1].
Regarding pressure symptoms 79.0% reported pain behind the ear caused
by strap of the mask, 35.5% reported pain over the nasal bridge due to
nose piece and finally 24.2% reported scar over the nasal bridge.
Regarding mouth symptoms 28.1% reported dryness around the mouth,
25.3% reported bad breath or halitosis, while only 17% reported sore
throat.

Regarding physiological symptoms 68.7% reported earlier feeling of

exhaustion while doing exercise, 66.5% reported difficulty while
climbing stairs, 58.5% reported fogging of spectacles especially while
driving, 57.7% reported early exhaustion while walking.

After statistical analysis of prevalence of various factors and symptoms

with the help of Pearson Chi-Square method, we have found association
between the symptoms and two factors- Place of stay and whether staying
in Single/Shared room since the P value is less than 0.05.

CONCLUSION
The primary objective of our project was to study the heath, physical,
physiological effects of long term usage of face mask among medical
students in Kerala. As we can infer from the studies, Pain behind the ear
because of mask strap (79.0%), excessive sweating around mouth
(63.5%), Acne on face (54.9%), difficulty in performing various
physiological activities such as walking, running, climbing stairs etc.
were found to be the symptoms with most prevalence.
The secondary objective of our project was to find whether there are any
associations between the symptoms and factors such as age, gender, Place
of stay etc. From statistical analysis, we got associations between
symptoms and two factors-Place of stay and whether staying in
Single/Shared room since the p value is less than 0.05 in both the cases.
Students who were staying in Hostels were having more symptoms as
compared to students coming from homes and those who were staying in
shared rooms had more symptoms compared to those who had a single
room.
 INFORMED CONSENT

I, Mr/Ms………………………………do hereby give consent for

participation in the study titled “HEALTH ISSUES ASSOCIATED
WITH USAGE OF MASKS AMONG MEDICAL STUDENTS IN
KERALA” going to be conducted by, MBBS students of Government
Medical College, Thiruvananthapuram.
I am also informed that a questionnaire on my knowledge about the same
has to be answered for the purposes of study. It is also made clear that
there will be no financial expenses to participate in this study.
I have read all the information pertaining to the study and I agree to
participate in this study. I understand that my participation is voluntary
and that my identity will be kept confidential. My answers are a
reflection of my personal opinion. I also understand that all information
remains completely confidential and there is no risk in participating in
this study. I hereby give my full consent to take part in the study.

Principle Investigator

…………………………… Signature:
MBBS Student Date:
Government Medical College,
Thiruvananthapuram

Name of the faculty: Signature:

 QUESTIONNAIRE
Informed Consent:
I have read the above information and I agree to participate in this study.
I understand that my participation is voluntary and my identity remains
anonymous. My answer is a reflection of my personal opinion. I also
understand that all information remains completely confidential and there
is no risk in participate in this study.
*I agree

Group 1: Personal Details

1. Name:
2. Age:
3. Sex: a. Male; b. Female; c. Other
4. Types of mask used: a) N 95; b) Surgical; c) Cloth;

d) Double Masking; e) Other

5. Institute:
6. Batch: a) 2015; b) 2016; c) 2017; d) 2018; e) 2019;
f) 2020; g) 2021.
7. Mail ID:
Group 2: Place of stay and Transit:
1. Place of stay:
a) Hosteller
b) Day Scholar
2. Mode of Transport:
a) Own Vehicle
b) Public Transport
 3. Whether single room/ Shared (Hosteller/ Day Scholar):
a) Single room:
b) Shared:
4. Number of roommates (Shared):
5. Any Known health conditions:
a) Diabetes
b) Hypertension
c) Allergies (Food/ Drug etc.)
d) Asthma
e) Skin Condition
f) No known comorbidities
g) Other comorbidities:
6. If other comorbidities specify:
Group 3: Nasal symptoms/ respiratory symptoms:
1. Is there a feeling of nasal discomfort: Y/ N
2. Dry Nose: Y/ N
3. Burning Nose: Y/ N
4. Altered sense of smell: Y/ N
5. Nasal Blockage/ Obstruction: Y/ N
6. Nasal congestion/ stuffiness: Y/ N
Group 4: Skin symptoms:
1. Irritation/ Itchy feeling of nose: Y/ N
2. Acne on face: Y/ N
3. Rashness/ redness of face: Y/ N
 4. Excessive sweating around mouth: Y/ N
Group 5: Pressure symptoms:
1. Pain behind the ear because of mask strap: Y/ N
2. Pain over the nasal Bridge: Y/ N
3. Scar over the nasal bridge: Y/ N
Group 6: Mouth Symptoms:
1. Bad breath: Y/ N
2. Dryness around the mouth: Y/ N
3. Sore throat: Y/ N
Group 7: Programs
1. If any specify:
Group 8: Barriers in normal activities:
1. Walking (Earlier feeling of exhaustion): Y/ N

2. Exercise (Earlier feeling of exhaustion): Y/ N

3. Wearing spectacles (Fogging, especially while driving or not

Getting correct fit while mask usage): Y/ N

4. Climbing stairs (Earlier feeling of exhaustion): Y/ N

5. Normal Communication with friends and family: Y/ N

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