Assessment of Quality of life and Academic Performance among Asthmatic Medical Students at Al-Neelain University, 2020

Assessment of Quality of life and Academic Performance among Asthmatic Medical Students at Al-Neelain University, 2020 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Quality of life and Academic Performance among Asthmatic Medical Students at Al-Neelain University, 2020 Rasheeda Abdulbagi, Mustafa Sabir This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2747581/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Severe asthma has a great impact on the quality of life (QOL) of patients and their families. The magnitude of this morbidity is affected by several personal factors including age. Appropriate asthma control and modifications of Social, physical, emotional roles are expected to improve QOL. Medical students life can be affected by several ways specially the academic side, such effect should be controlled to keep their lives healthy. The study aims to give a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. Also, this study will help universities to take action and consideration to those students by providing specific clinics or health education about their disease. Methods An institution based cross sectional study design of 58 asthmatic medical students was done, who were selected by convinced sample, and data were collected using valid available Asthma Quality of Life Questionnaire (AQLQ). Some of the questions was modified to screen for other objectives of the study. Pretested, structured and self-Administered Google form questionnaire was used to collect the data. The data was pretested, an excel copy of the data was obtained, analysis was done by IBM SPSS statistic version 25. Results The study showed that the asthma affect the physical activity, social activity and psychological health of the participant in mild degree. And it effects the academic achievement of the students by 34.5%. And showed significant effect in focusing during lectures and clinical rounds by 43.6% and 41.8% respectively. Conclusions asthma has a significant effects on the QOF among medical students, and has a notice effect in the performance of the medical students. The study recommends that universities take in consideration the a healthy environment for asthmatic medical students and provide clinics to improve their health. And further researches recommends to assess QOF of asthmatic medical students. Asthma Awareness Public health Quality of Life Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 Figure 21 Figure 22 Aims and Scope statement 1. What is known? Bronchial asthma is a chronic inflammatory disorder of the airways associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. The prevalence of asthma worldwide is around 200 million with a mortality of around 0.2 million per year. The estimated burden of asthma in India is more than15 million. The population prevalence of asthma reported in different field studies and specific population group is reported to be variable. Research has shown that asthma and it is associated symptoms can negatively affect a child’s quality, and increase the likelihood of poor self-esteem, anxiety, and depression when compared with same-age peers. Asthma has also been shown to affect academic performance, children with asthma miss 2.48 more days of school yearly than their counterparts without asthma. In fact children are estimated to miss 14.7 million school days per year due to overall asthma-related issues. The effect of asthma on quality of life is expected to occur with different characteristics and magnitude according to several patient factors, including age. Moderate to severe asthma has led to a worse quality of life as compared to mild persistent asthma 2. What does the study add? There are a few such types of research contacted in general and in East Africa specifically, but those researches don't elucidate how the medical student's life can be affected by asthma. Therefore, this research has given a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. This study constitutes a good baseline for more studies and others universities in different settings. Also, it aims to help universities to take action and to consider those students by providing specific clinics or health education about their disease. 3. What are implications for clinical practice, public health and / or research? Starting by the universities they should offer clinics for asthmatic medical students which include lifesaving medications, and referral to hospital, and educational programmers. Moreover the universities should concern more about the environment and avoid overcrowding, and improve the ventilation in the lecture rooms. And it is highly recommended to minimize the number of students in the round groups to avoid overcrowding. It highly recommended to offer psychological and academic support for the asthmatic students to combat the effect of the absent from the lectures and clinical rounds cause of their disease. All of which representes a public health implication by changing the policies by which these universities are made and constrcuting a national strategy on how to build a university that is suitable for all kind of students. Finally starting a medical education ampaigns targeting families and paerents on how to deal with an asthmatic patient and to reduce stress upon them and provide a clear environment, which will aid in raising the population’s awareness and decreasing the burden of the disease. Introduction Background : Within the last few decades the concept of “good health” has moved from the “absence of disease or illness” to a more positive concept which embraces the subjective experience of wellbeing and quality of life. In pediatrics, as in other areas of health care, awareness is growing that medical parameters such as mortality and morbidity are not the only important outcome variables to be considered when we evaluate child health interventions. A quality of life perspective can identify sensitive child and adolescent issues that may be affected by illness or disability of treatment. Definition of Quality of life: The term QOL, health and functional status are not interchangeable, nor are the instruments used to assess them. WHO definition of health: “A state of complete physical, mental, social wellbeing, not merely absence of disease or infirmity.” WHO definition of QO L (1993): Individual perception of their position in life in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. Assessment of QOL can help the physicians in better understanding the results of their treatment not only in dimension of physical wellbeing but also in spirit of treatment or QOL. This is for the first time that QOL has been assessed in our country. Comparison of our results with other nations and ethnics can be precious because we can find: 1) the effects of asthma standard therapy (GINA'S GUIDELINES) on different ethnics and genders. 2) the difference in emotional fragility due to the asthma between sexes according to their ethnicity Another important factor is impact of asthma as a chronic disease on day to day functions of their caregivers. Any negative reflections as a vicious cycle will have non compensatory effects on the course of the disease in the patients, thus in this study we also assessed the QOL in the main caregivers of asthmatic patients.( 1 ) Asthma: Numerous evidence based guidelines for diagnosis and management of bronchial asthma are available throughout the world, because of the differences in the health care infrastructure, risk factors, disease pattern and prevalence. Bronchial asthma is a chronic inflammatory disorder of the airways associated with airway hyper responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. The prevalence of asthma worldwide is around 200 million with a mortality of around 0.2 million per year. The estimated burden of asthma in India is more than15 million. The population prevalence of asthma reported in different field studies and specific population group is reported to be variable. Onset of asthma can occur at any age, but children and young adults are commonly affected. Although asthma cannot be cured, clinical episode can be prevented and controlled by proper management. The exact cause of asthma is not known. There are a variety of host and the environmental risk factors. The host factors are genetic predisposition, atopy, airway hyper responsiveness, gender and race/ethnicity. The environmental risk factors are indoor and outdoor allergens, occupational sensitizers, tobacco smoke and air pollution, respiratory infections, parasitic infections, socio economic factors, family size, diet, drugs and obesity. There is no permanent cure for asthma however the disorder can be adequately controlled with drugs. The optimal asthma control would include minimal chronic symptoms, minimal exacerbations, minimal need for use of 2-agonist, no limitations on activities, including exercise and PEFR variability of less than 20 percent. Assessment of severity is important before treatment is initiated (Table 2) and patient should be placed in the highest category of severity based on any of the clinical features or lung function tests. Basic drug therapy: Asthma is an inflammatory disorder and the aim of treatment is to decrease inflammation by anti- inflammatory drugs and exposure to triggers. The drugs can be grouped under controllers; those which control inflammation and relievers; those which offer symptomatic relief. Inhaled route is the best route of corticosteroid (CS) therapy as it provides targeted drug delivery, acts faster, small dose is required and is easy to take. Oral steroids have more side effects and have no superiority.( 2 ) Problem statement : Asthma-related impairment in pediatric populations is well-documented. Research has shown that asthma and it is associated symptoms can negatively affect a child’s quality, and increase the likelihood of poor self-esteem, anxiety, and depression when compared with same-age peers Asthma has also been shown to affect academic performance, children with asthma miss 2.48 more days of school yearly than their counterparts without asthma. In fact children are estimated to miss 14.7 million school days per year due to overall asthma-related issues ( 3 ). The effect of asthma on quality of life is expected to occur with different characteristics and magnitude according to several patient factors, including age. Moderate to severe asthma has led to a worse quality of life as compared to mild persistent asthma ( 4 ). Quality of life of the student is an important issue to tackle the physical, mental, social, problem as early as possible to produce future leaders for the future developed nations ( 5 ). Children with chronic illness, such as asthma, can be affected in their academic performance when the illness keeps them out of school. children with asthma are often viewed as being different and physically challenged, and they experience lowered expectations from their teachers.( 6 ) Justification There are a few such types of research contacted, but those researches don't elucidate how the medical student's life can be affected by asthma. Therefore, this research will give a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. This study can be a good baseline for more studies and others universities in different setting. Also, it will help universities to take action and consideration those students by providing specific clinics or health education about their disease. Research questions 1-How quality of life of medical students can be affected by asthma? 3-How asthma can affect the academic performance of asthmatic medical students? Research objectives : General objective The aim of this study is to assess the impact of asthma on the quality of life of medical students in Alneelain university. Specific objectives - To identify the effect of asthma on the psychical and psychological health of asthmatic medical students. - To assess the effect of asthma on the academic performance of asthmatic medical students. - To identify the effect of asthma on the social life of asthmatic medical students Methods Study design/Setting An institutional based descriptive cross-sectional study design, it was conducted at Al-neelain University at faculties of medicine, dentistry, medical laboratory sciences, nursing science, pharmacy, and physiotherapy. The location of the university is in Khartoum, Sudan. And all of these faculties are located together in the district. Study population Asthmatic medical students in Alneelain university. Inclusion criteria Asthmatic, both gender, Sudanese medical students. Exclusion criteria Non asthmatic, Non-Sudanese, and refused asthmatic medical students, other conditions that mimic asthma. Study variable Background variables: -Age -Gender -Level of education Independent variables: - Asthmatic medical students Dependent variables: - Attendance of lecture -Social activity -Study in reading week - Performance of students-contribution to the activities in the university -Physical activity -Psychological state Sampling All batches in each faculty were asked about the diagnosed asthmatic medical students, the number of asthmatic medical students were 58 students, then all of them were taken into account and the sampling technique was total coverage. Data collection methods and tools Data was collected using the Asthma Quality of Life Questionnaire (AQLQ)(8). Some of the questions were modified to screen for other objectives of the study. Pretested, structured, and self-Administered online Google form questionnaire was used to collect the data. Data management and analysis Excel copy of the data was obtained, then data was cleaned, pretested, and then analyzed by using IBM SPSS statistic version 25 according to the objectives. Both dependent and independent variables were displayed as frequency tables and figures. Ethical consideration Ethical approval was obtained from the department of community medicine in Al-Neelain University faculty of medicine, then informed consent was obtained online from each participant by asking if he/she would like to participate in the study or Results Most of participants are in the age 18–25, then some of them fall in category "less than 18", there is a few in the age 26–35 as shown in Table (1) Table (1): Age of the participants. Age Frequency Percent 18–25 43 78.2 26–35 5 9.1 Less than 18 7 12.7 Total 55 100.0 Out of all participants 34 of them were females, were as 21 of participants were males as shown in table (2) Table (2): Gender of the participants. Gender Frequency Percent Female 34 61.8 Male 21 38.2 Total 55 100.0 Discussion Asthma is chronic inflammation of respiratory tract, so that's mean patients who's live with this disease should know how to deal with it to minimize it is effect in their life, asthma affect QOF in many ways it can affect the physical, social, financial, psychological, emotional, even academically can affect the students life, the aim of this study was to assess the impact of asthma in the quality of life of medical students, it can also be a good baseline for more studies and for others universities in different settings. Also, it will help universities to take action and consideration to those students by providing specific clinics or health education about their disease, and offer recommendations for further researches. In this study, the results showed that 19 (34.5%) of participants asthma can sometimes affects the physical activates and sport, and 22 (40%) of participants sometimes get breathless during academic activities, while 16 (29.1%) sometimes asthma affect their social interaction with others, in compression with a study, by perran boran and his colleagues in Turkey in 2008, 51% of the patients reported that asthma affected their lives, 55% reported impairment in physical activities, 55% reported impaired QOL due to asthma symptoms like shortness of breath, cough or wheeze, and 52% felt irritable, frustrated or left out and that they could not keep up with others because of their asthma.( 17 ) The results showed that participants strongly agreed 14 (25.5%) and 16 (29.1%) greed that environment of the university has a big role in their asthma attack, there is a study which was done by Mark J. Mende and Garvin A. Heath in California in 2005 they found that persuasive evidence links higher indoor concentrations of nitrogen dioxide to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g., low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants.( 11 ) Based on current finding it appear that focusing during lectures, clinical rounds, examination get disturbed due to asthma, rang of marks of participants were 22 (40%) achieve 70–79 ( B), 17 (30.9%) achieve 60–69 (C), 9 (16.4%) achieve 80–100 (A), 7 (12.7%) achieve 50–59 (D). attendance of participants also affected by asthma, study was done by Susan Krenitsky-Korn in new York in 2011 he found that students with asthma were absent more frequently, scored lower in mathematics, and participated less in school activities than their peers without asthma. Their level of illness did not predict the number of days absent, which was negatively correlated with achievement and positively correlated with students’ permissive attitudes toward absenteeism. Findings indicate that school nurse interventions were sources of physical, social, emotional, and academic support.( 6 ), nineteen (34.5%) of the participants was agreed that asthma affect their academic achievements, Overall asthma can lower the academic performance by affecting the focusing and attendance of students, study was done by Nduagubam OC and his colleagues in Nigeria in 2017, they concluded that the academic performance of children with asthma compares favorably with that of children without asthma.( 13 ) Chronic illness outcomes research mandates longitudinal testing to capture the dynamics of an illness with multiple sequelae spanning a range of time. Cross-sectional studies do not offer causative or comparative data for an individual patient, but establish general trends in the population. The results of this study can be the point for further researches to assess QOF of asthmatic patients. Conclusion One third of participants asthma affected their Physical, emotional, psychological, social aspect of their life. One third of participants showed that asthma affect their Academic performance. Two third of participants showed that asthma affect their focusing during lectures and clinical rounds Declarations Ethical Approval Ethics approval was obtained from the Research and Ethics Committee of Alneelain University. Ethical clearance and approval for conducting this research was obtained from the general manager of the Ministry of health (Khartoum State). Ethical principles of autonomy, beneficence, non-maleficence and justice, as stipulated in the ethical guidelines of the community department at Alneelain university faculty of medicine. Informed written consent was obtained from every respondent who agreed to participate in the study. The respondents informed that the study is not associated with experimental or therapeutic intervention while information was collected from them. Competing interests Not Applicable. Authors' contributions All the authors played a major role and real contribution to achieve this project. Mustafa Sabir participated in data collection and analysis, Rasheeda participated in manuscript plan, editing and writing of the article. Funding Our research project was self-sponsored by me and help of my colleague and coauthors. There was no funding from any institute or organization for this paper. Availability of data and materials All data and material are available when request from the corresponding author References Zandieh F, Moin M, Movahedi M. Assessment of Quality of Life in Iranian Asthmatic Children , Young Adults and Their Caregivers. 2006;5(June):79–83. Rai SP, Patil AP, Vardhan V, Marwah V, Pethe M, Pandey IM. Best Treatment Guidelines For Bronchial Asthma. :1–5. Fedele DA, Mullins LL, Ph D, Eddington AR, Ryan JL, Junghans AN. Health-related Quality of Life in College Students with and without Childhood-Onset Asthma. 2009;(4):835–40. Hossny E, Caraballo L, Casale T, El-gamal Y, Rosenwasser L. Severe asthma and quality of life. 2017;1–8. Al-Naggar RA, Osman MT, Musa R. Quality of life among university students in a single Malaysian Institute. Pensee J. 2013;75(10):167–79. Krenitsky-korn S. High School Students with Asthma : On Academic Achievement. Pediatr Nurs. 2011;37(2):61–XX. Profile SEE. The effectiveness of an indoor intermittent training program for improving lung function , physical capacity , body composition and quality of life in children with asthma The effectiveness of an indoor intermittent training program for improving lung fun. 2014;(January). Yang M, Chiang C, Yao G, Wang K. E FFECT OF M EDICAL E DUCATION ON Q UALITY OF M ethods. 2003;102(161):768–74. Ekici A, Ekici M, Kurtipek E, Keles H, Kara T, Tunckol M, et al. Association of Asthma-Related Symptoms With Snoring and Apnea and Effect on Health-Related Quality of Life *. 2017; Gibson PG, Henry RL, Vimpani G V, Halliday J. Asthma knowledge , attitudes , and quality of life in adolescents. 1995;321–6. Heath GA. Do Indoor Pollutants and Thermal Conditions in Schools Influence Student Performance ? A Critical Review of the Literature. 2005;15(1):27–32. Christiansen SC, Martin SB, Schleicher NC, Koziol JA, Mathews KP, Zuraw BL, et al. Evaluation of a school-based asthma education program for inner-city children. 1997; Nduagubam OC. ACADEMIC PERFORMANCE OF PRIMARY. 2018;1497903898(April):71–9. Ismagilova G. No 主観的健康感を中心とした在宅高齢者における 健康関連指標に関する共分散構造分析Title. 2014;11(c):363–7. Alneelain univiersity. Res IJA. Manuscript Info Abstract ISSN : 2320-5407 Introduction : - Methodology : -. 4(9):1135–40. Boran P, Tokuç G, Pişgin B, Öktem S. Assessment of quality of life in asthmatic Turkish children. 2008;18–22. 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10","display":"","copyAsset":false,"role":"figure","size":163964,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance of the work of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"10.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/b060c3040791092bf6a2516f.jpg"},{"id":35272545,"identity":"2e14ac28-e6c5-4b80-a926-85e4d00d04ae","added_by":"auto","created_at":"2023-04-04 14:34:43","extension":"jpg","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":146364,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance of daily activates of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"11.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/c00eea3457cf10524e1b498e.jpg"},{"id":35271407,"identity":"1e4c7026-0f22-4717-8ef0-66721ec53d28","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":158944,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance of physical activities and sport of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"12.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/8bc24d294287c0233a7d912b.jpg"},{"id":35271398,"identity":"79ac1875-d63c-4668-82b8-70117739cd0f","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":13,"title":"Figure 13","display":"","copyAsset":false,"role":"figure","size":145923,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eBreathing problem due to transportation of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"13.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/2a591b0ebdf497bd61857ba1.jpg"},{"id":35273685,"identity":"b8a1f203-d35d-4b30-beb5-37f8092b12df","added_by":"auto","created_at":"2023-04-04 14:50:43","extension":"jpg","order_by":14,"title":"Figure 14","display":"","copyAsset":false,"role":"figure","size":192419,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThe percentage of the participants that they feel sleepy/ drowsy during lecture.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"14.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/e1dfa7170e1b583b62c8ce9e.jpg"},{"id":35271394,"identity":"3a10aedb-8456-48f2-9203-556a2106bcfc","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":15,"title":"Figure 15","display":"","copyAsset":false,"role":"figure","size":140383,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eFocusing during clinical rounds of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"15.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/d84134b2906324504f657a27.jpg"},{"id":35272840,"identity":"67cc5b48-63cd-4e9e-8b84-b1fc5ab4ae2f","added_by":"auto","created_at":"2023-04-04 14:42:43","extension":"jpg","order_by":16,"title":"Figure 16","display":"","copyAsset":false,"role":"figure","size":166121,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance of the study of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"16.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/16e7bed7b10c2c6a0f66a36d.jpg"},{"id":35271409,"identity":"ba098770-a848-42e8-8936-05232335bdca","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":17,"title":"Figure 17","display":"","copyAsset":false,"role":"figure","size":193604,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance of study during reading weeks of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"17.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/6d93da80f07a7bedb118af5e.jpg"},{"id":35271402,"identity":"3717c82d-38f6-4d6f-88d4-a3d3262349fd","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":18,"title":"Figure 18","display":"","copyAsset":false,"role":"figure","size":163295,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDisturbance during examination of the participants\u003c/em\u003e.\u003c/p\u003e","description":"","filename":"18.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/283c6845b8635739f10a78ae.jpg"},{"id":35271932,"identity":"2c7d96b6-595c-4f52-bea7-060e4273da14","added_by":"auto","created_at":"2023-04-04 14:26:43","extension":"jpg","order_by":19,"title":"Figure 19","display":"","copyAsset":false,"role":"figure","size":152956,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eRange of the marks of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"19.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/c0d507dacb7682e6152912e4.jpg"},{"id":35272841,"identity":"9c614264-3ccb-463c-8393-2a265907e917","added_by":"auto","created_at":"2023-04-04 14:42:43","extension":"jpg","order_by":20,"title":"Figure 20","display":"","copyAsset":false,"role":"figure","size":162558,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eEffect of asthma on academic achievement of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"20.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/8e17d0eaba1e787f2c9aaea2.jpg"},{"id":35271408,"identity":"1b3ccf4e-ee78-4d21-a49a-2cb19b267f17","added_by":"auto","created_at":"2023-04-04 14:18:43","extension":"jpg","order_by":21,"title":"Figure 21","display":"","copyAsset":false,"role":"figure","size":163506,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eTaking asthma medications with you.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"21.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/dda183dd7a816be2d1090c19.jpg"},{"id":35272537,"identity":"958820ab-271f-4d3f-81b5-7f23006c73ed","added_by":"auto","created_at":"2023-04-04 14:34:43","extension":"jpg","order_by":22,"title":"Figure 22","display":"","copyAsset":false,"role":"figure","size":118342,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eAlert because of absence of the participants.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"22.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/1f773fcc077d0fd03dc5215a.jpg"},{"id":35273726,"identity":"429f85fc-a800-4f29-b480-25f181db0745","added_by":"auto","created_at":"2023-04-04 14:50:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1331593,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2747581/v1/fcde7655-4d8b-4da9-b518-a578e21c6050.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Quality of life and Academic Performance among Asthmatic Medical Students at Al-Neelain University, 2020","fulltext":[{"header":"Aims and Scope statement","content":"\u003cp\u003e\u003cstrong\u003e1. What is known?\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBronchial asthma is a chronic inflammatory disorder of the airways associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment.\u003c/p\u003e\n\u003cp\u003eThe prevalence of asthma worldwide is around 200 million with a mortality of around 0.2 million per year. The estimated burden of asthma in India is more than15 million. The population prevalence of asthma reported in different field studies and specific population group is reported to be variable.\u003c/p\u003e\n\u003cp\u003eResearch has shown that asthma and it is associated symptoms can negatively affect a child\u0026rsquo;s quality, and increase the likelihood of poor self-esteem, anxiety, and depression when compared with same-age peers. Asthma has also been shown to affect academic performance, children with asthma miss 2.48 more days of school yearly than their counterparts without asthma. In fact children are estimated to miss 14.7 million school days per year due to overall asthma-related issues. The effect of asthma on quality of life is expected to occur with different characteristics and magnitude according to several patient factors, including age. Moderate to severe asthma has led to a worse quality of life as compared to mild persistent asthma\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. What does the study add?\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are a few such types of research contacted in general and in East Africa specifically, but those researches don\u0026apos;t elucidate how the medical student\u0026apos;s life can be affected by asthma. Therefore, this research has given a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. This study constitutes a good baseline for more studies and others universities in different settings. Also, it aims to help universities to take action and to consider those students by providing specific clinics or health education about their disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. What are implications for clinical practice, public health and / or research?\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStarting by the universities they should offer clinics for asthmatic medical students which include lifesaving medications, and referral to hospital, and educational programmers. Moreover the universities should concern more about the environment and avoid overcrowding, and improve the ventilation in the lecture rooms. And it is highly recommended to minimize the number of students in the round groups to avoid overcrowding. It highly recommended to offer psychological and academic support for the asthmatic students to combat the effect of the absent from the lectures and clinical rounds cause of their disease. All of which representes a public health implication by changing the policies by which these universities are made and constrcuting a national strategy on how to build a university that is suitable for all kind of students.\u003c/p\u003e\n\u003cp\u003eFinally starting a medical education ampaigns targeting families and paerents on how to deal with an asthmatic patient and to reduce stress upon them and provide a clear environment, which will aid in raising the population\u0026rsquo;s awareness and decreasing the burden of the disease.\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eWithin the last few decades the concept of \u0026ldquo;good health\u0026rdquo; has moved from the \u0026ldquo;absence of disease or illness\u0026rdquo; to a more positive concept which embraces the subjective experience of wellbeing and quality of life. In pediatrics, as in other areas of health care, awareness is growing that medical parameters such as mortality and morbidity are not the only important outcome variables to be considered when we evaluate child health interventions. A quality of life perspective can identify sensitive child and adolescent issues that may be affected by illness or disability of treatment. Definition of Quality of life: The term QOL, health and functional status are not interchangeable, nor are the instruments used to assess them. WHO definition of health: \u0026ldquo;A state of complete physical, mental, social wellbeing, not merely absence of disease or infirmity.\u0026rdquo; WHO definition of QO L (1993): Individual perception of their position in life in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. Assessment of QOL can help the physicians in better understanding the results of their treatment not only in dimension of physical wellbeing but also in spirit of treatment or QOL. This is for the first time that QOL has been assessed in our country. Comparison of our results with other nations and ethnics can be precious because we can find:\u003c/p\u003e\n\u003cp\u003e1) the effects of asthma standard therapy (GINA\u0026apos;S GUIDELINES) on different ethnics and genders.\u003c/p\u003e\n\u003cp\u003e2) the difference in emotional fragility due to the asthma between sexes according to their ethnicity\u003c/p\u003e\n\u003cp\u003eAnother important factor is impact of asthma as a chronic disease on day to day functions of their caregivers. Any negative reflections as a vicious cycle will have non compensatory effects on the course of the disease in the patients, thus in this study we also assessed the QOL in the main caregivers of asthmatic patients.(\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAsthma:\u003c/strong\u003e Numerous evidence based guidelines for diagnosis and management of bronchial asthma are available throughout the world, because of the differences in the health care infrastructure, risk factors, disease pattern and prevalence.\u003c/p\u003e\n\u003cp\u003eBronchial asthma is a chronic inflammatory disorder of the airways associated with airway hyper responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. The prevalence of asthma worldwide is around 200\u0026nbsp;million with a mortality of around 0.2\u0026nbsp;million per year. The estimated burden of asthma in India is more than15\u0026nbsp;million. The population prevalence of asthma reported in different field studies and specific population group is reported to be variable. Onset of asthma can occur at any age, but children and young adults are commonly affected. Although asthma cannot be cured, clinical episode can be prevented and controlled by proper management. The exact cause of asthma is not known. There are a variety of host and the environmental risk factors. The host factors are genetic predisposition, atopy, airway hyper responsiveness, gender and race/ethnicity. The environmental risk factors are indoor and outdoor allergens, occupational sensitizers, tobacco smoke and air pollution, respiratory infections, parasitic infections, socio economic factors, family size, diet, drugs and obesity. There is no permanent cure for asthma however the disorder can be adequately controlled with drugs. The optimal asthma control would include minimal chronic symptoms, minimal exacerbations, minimal need for use of 2-agonist, no limitations on activities, including exercise and PEFR variability of less than 20 percent. Assessment of severity is important before treatment is initiated (Table\u0026nbsp;2) and patient should be placed in the highest category of severity based on any of the clinical features or lung function tests. Basic drug therapy: Asthma is an inflammatory disorder and the aim of treatment is to decrease inflammation by anti- inflammatory drugs and exposure to triggers. The drugs can be grouped under controllers; those which control inflammation and relievers; those which offer symptomatic relief. Inhaled route is the best route of corticosteroid (CS) therapy as it provides targeted drug delivery, acts faster, small dose is required and is easy to take. Oral steroids have more side effects and have no superiority.(\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProblem statement\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eAsthma-related impairment in pediatric populations is well-documented. Research has shown that asthma and it is associated symptoms can negatively affect a child\u0026rsquo;s quality, and increase the likelihood of poor self-esteem, anxiety, and depression when compared with same-age peers Asthma has also been shown to affect academic performance, children with asthma miss 2.48 more days of school yearly than their counterparts without asthma. In fact children are estimated to miss 14.7\u0026nbsp;million school days per year due to overall asthma-related issues (\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e). The effect of asthma on quality of life is expected to occur with different characteristics and magnitude according to several patient factors, including age. Moderate to severe asthma has led to a worse quality of life as compared to mild persistent asthma (\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e). Quality of life of the student is an important issue to tackle the physical, mental, social, problem as early as possible to produce future leaders for the future developed nations (\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e). Children with chronic illness, such as asthma, can be affected in their academic performance when the illness keeps them out of school. children with asthma are often viewed as being different and physically challenged, and they experience lowered expectations from their teachers.(\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJustification\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are a few such types of research contacted, but those researches don\u0026apos;t elucidate how the medical student\u0026apos;s life can be affected by asthma. Therefore, this research will give a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. This study can be a good baseline for more studies and others universities in different setting. Also, it will help universities to take action and consideration those students by providing specific clinics or health education about their disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch questions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1-How quality of life of medical students can be affected by asthma?\u003c/p\u003e\n\u003cp\u003e3-How asthma can affect the academic performance of asthmatic medical students?\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch objectives\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGeneral objective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe aim of this study is to assess the impact of asthma on the quality of life of medical students in Alneelain university.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSpecific objectives\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e- To identify the effect of asthma on the psychical and psychological health of asthmatic medical students.\u003c/p\u003e\n\u003cp\u003e- To assess the effect of asthma on the academic performance of asthmatic medical students.\u003c/p\u003e\n\u003cp\u003e- To identify the effect of asthma on the social life of asthmatic medical students\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design/Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn institutional based descriptive cross-sectional study design, it was conducted at Al-neelain University at faculties of medicine, dentistry, medical laboratory sciences, nursing science, pharmacy, and physiotherapy. The location of the university is in Khartoum, Sudan. And all of these faculties are located together in the district.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAsthmatic medical students in Alneelain university.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAsthmatic, both gender, Sudanese medical students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNon asthmatic, Non-Sudanese, and refused asthmatic medical students, other conditions that mimic asthma.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy variable\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBackground variables:\u003c/p\u003e\n\u003cp\u003e-Age \u003c/p\u003e\n\u003cp\u003e-Gender\u003c/p\u003e\n\u003cp\u003e-Level of education\u003c/p\u003e\n\u003cp\u003eIndependent variables:\u003c/p\u003e\n\u003cp\u003e- Asthmatic medical students\u003c/p\u003e\n\u003cp\u003eDependent variables: \u003c/p\u003e\n\u003cp\u003e- Attendance of lecture\u003c/p\u003e\n\u003cp\u003e-Social activity\u003c/p\u003e\n\u003cp\u003e-Study in reading week\u003c/p\u003e\n\u003cp\u003e- Performance of students-contribution to the activities in the university\u003c/p\u003e\n\u003cp\u003e-Physical activity\u003c/p\u003e\n\u003cp\u003e-Psychological state\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll batches in each faculty were asked about the diagnosed asthmatic medical students, the number of asthmatic medical students were 58 students, then all of them were taken into account and the sampling technique was total coverage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection methods and tools \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData was collected using the Asthma Quality of Life Questionnaire (AQLQ)(8). Some of the questions were modified to screen for other objectives of the study. \u003c/p\u003e\n\u003cp\u003ePretested, structured, and self-Administered online Google form questionnaire was used to collect the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData management and analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eExcel copy of the data was obtained, then data was cleaned, pretested, and then analyzed by using IBM SPSS statistic version 25 according to the objectives. Both dependent and independent variables were displayed as frequency tables and figures. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the department of community medicine in Al-Neelain University faculty of medicine, then informed consent was obtained online from each participant by asking if he/she would like to participate in the study or \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eMost of participants are in the age 18\u0026ndash;25, then some of them fall in category \"less than 18\", there is a few in the age 26\u0026ndash;35 as shown in Table\u0026nbsp;(1)\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;(1): Age of the participants.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Taba\" border=\"1\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePercent\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u0026ndash;25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e43\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e78.2\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e9.1\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLess than 18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e12.7\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e55\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e100.0\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eOut of all participants 34 of them were females, were as 21 of participants were males as shown in table (2)\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;(2): Gender of the participants.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tabb\" border=\"1\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePercent\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e34\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e61.8\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e21\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e38.2\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e55\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e100.0\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eAsthma is chronic inflammation of respiratory tract, so that's mean patients who's live with this disease should know how to deal with it to minimize it is effect in their life, asthma affect QOF in many ways it can affect the physical, social, financial, psychological, emotional, even academically can affect the students life, the aim of this study was to assess the impact of asthma in the quality of life of medical students, it can also be a good baseline for more studies and for others universities in different settings. Also, it will help universities to take action and consideration to those students by providing specific clinics or health education about their disease, and offer recommendations for further researches.\u003c/p\u003e \u003cp\u003eIn this study, the results showed that 19 (34.5%) of participants asthma can sometimes affects the physical activates and sport, and 22 (40%) of participants sometimes get breathless during academic activities, while 16 (29.1%) sometimes asthma affect their social interaction with others, in compression with a study, by \u003cem\u003eperran boran\u003c/em\u003e and his colleagues in Turkey in 2008, 51% of the patients reported that asthma affected their lives, 55% reported impairment in physical activities, 55% reported impaired QOL due to asthma symptoms like shortness of breath, cough or wheeze, and 52% felt irritable, frustrated or left out and that they could not keep up with others because of their asthma.(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThe results showed that participants strongly agreed 14 (25.5%) and 16 (29.1%) greed that environment of the university has a big role in their asthma attack, there is a study which was done by \u003cem\u003eMark J. Mende\u003c/em\u003e and \u003cem\u003eGarvin A. Heath\u003c/em\u003e in California in 2005 they found that persuasive evidence links higher indoor concentrations of nitrogen dioxide to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g., low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants.(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eBased on current finding it appear that focusing during lectures, clinical rounds, examination get disturbed due to asthma, rang of marks of participants were 22 (40%) achieve 70\u0026ndash;79 ( B), 17 (30.9%) achieve 60\u0026ndash;69 (C), 9 (16.4%) achieve 80\u0026ndash;100 (A), 7 (12.7%) achieve 50\u0026ndash;59 (D). attendance of participants also affected by asthma, study was done by \u003cem\u003eSusan Krenitsky-Korn\u003c/em\u003e in new York in 2011 he found that students with asthma were absent more frequently, scored lower in mathematics, and participated less in school activities than their peers without asthma. Their level of illness did not predict the number of days absent, which was negatively correlated with achievement and positively correlated with students\u0026rsquo; permissive attitudes toward absenteeism. Findings indicate that school nurse interventions were sources of physical, social, emotional, and academic support.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), nineteen (34.5%) of the participants was agreed that asthma affect their academic achievements, Overall asthma can lower the academic performance by affecting the focusing and attendance of students, study was done by \u003cem\u003eNduagubam\u003c/em\u003e OC and his colleagues in Nigeria in 2017, they concluded that the academic performance of children with asthma compares favorably with that of children without asthma.(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eChronic illness outcomes research mandates longitudinal testing to capture the dynamics of an illness with multiple sequelae spanning a range of time. Cross-sectional studies do not offer causative or comparative data for an individual patient, but establish general trends in the population. The results of this study can be the point for further researches to assess QOF of asthmatic patients.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e One third of participants asthma affected their Physical, emotional, psychological, social aspect of their life.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e One third of participants showed that asthma affect their Academic performance.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e Two third of participants showed that asthma affect their focusing during lectures and clinical rounds\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval was obtained from the Research and Ethics Committee of Alneelain University. Ethical clearance and approval for conducting this research was obtained from the general manager of the Ministry of health (Khartoum State). Ethical principles of autonomy, beneficence, non-maleficence and justice, as stipulated in the ethical guidelines of the community department at Alneelain university faculty of medicine. Informed written consent was obtained from every respondent who agreed to participate in the study. The respondents informed that the study is not associated with experimental or therapeutic intervention while information was collected from them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors played a major role and real contribution to achieve this project. Mustafa Sabir participated in data collection and analysis, Rasheeda participated in manuscript plan, editing and writing of the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur research project was self-sponsored by me and help of my colleague and coauthors. There was no funding from any institute or organization for this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data and material are available when request from the corresponding author\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eZandieh F, Moin M, Movahedi M. Assessment of Quality of Life in Iranian Asthmatic Children , Young Adults and Their Caregivers. 2006;5(June):79\u0026ndash;83. \u003c/li\u003e\n\u003cli\u003eRai SP, Patil AP, Vardhan V, Marwah V, Pethe M, Pandey IM. Best Treatment Guidelines For Bronchial Asthma. :1\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eFedele DA, Mullins LL, Ph D, Eddington AR, Ryan JL, Junghans AN. Health-related Quality of Life in College Students with and without Childhood-Onset Asthma. 2009;(4):835\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eHossny E, Caraballo L, Casale T, El-gamal Y, Rosenwasser L. Severe asthma and quality of life. 2017;1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eAl-Naggar RA, Osman MT, Musa R. Quality of life among university students in a single Malaysian Institute. Pensee J. 2013;75(10):167\u0026ndash;79. \u003c/li\u003e\n\u003cli\u003eKrenitsky-korn S. High School Students with Asthma : On Academic Achievement. Pediatr Nurs. 2011;37(2):61\u0026ndash;XX. \u003c/li\u003e\n\u003cli\u003eProfile SEE. The effectiveness of an indoor intermittent training program for improving lung function , physical capacity , body composition and quality of life in children with asthma The effectiveness of an indoor intermittent training program for improving lung fun. 2014;(January). \u003c/li\u003e\n\u003cli\u003eYang M, Chiang C, Yao G, Wang K. E FFECT OF M EDICAL E DUCATION ON Q UALITY OF M ethods. 2003;102(161):768\u0026ndash;74. \u003c/li\u003e\n\u003cli\u003eEkici A, Ekici M, Kurtipek E, Keles H, Kara T, Tunckol M, et al. Association of Asthma-Related Symptoms With Snoring and Apnea and Effect on Health-Related Quality of Life *. 2017; \u003c/li\u003e\n\u003cli\u003eGibson PG, Henry RL, Vimpani G V, Halliday J. Asthma knowledge , attitudes , and quality of life in adolescents. 1995;321\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eHeath GA. Do Indoor Pollutants and Thermal Conditions in Schools Influence Student Performance ? A Critical Review of the Literature. 2005;15(1):27\u0026ndash;32. \u003c/li\u003e\n\u003cli\u003eChristiansen SC, Martin SB, Schleicher NC, Koziol JA, Mathews KP, Zuraw BL, et al. Evaluation of a school-based asthma education program for inner-city children. 1997; \u003c/li\u003e\n\u003cli\u003eNduagubam OC. ACADEMIC PERFORMANCE OF PRIMARY. 2018;1497903898(April):71\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eIsmagilova G. No 主観的健康感を中心とした在宅高齢者における 健康関連指標に関する共分散構造分析Title. 2014;11(c):363\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eAlneelain univiersity. \u003c/li\u003e\n\u003cli\u003eRes IJA. Manuscript Info Abstract ISSN : 2320-5407 Introduction : - Methodology : -. 4(9):1135\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eBoran P, Toku\u0026ccedil; G, Pişgin B, \u0026Ouml;ktem S. Assessment of quality of life in asthmatic Turkish children. 2008;18\u0026ndash;22. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Asthma, Awareness, Public health, Quality of Life","lastPublishedDoi":"10.21203/rs.3.rs-2747581/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2747581/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSevere asthma has a great impact on the quality of life (QOL) of patients and their families. The magnitude of this morbidity is affected by several personal factors including age. Appropriate asthma control and modifications of Social, physical, emotional roles are expected to improve QOL. Medical students life can be affected by several ways specially the academic side, such effect should be controlled to keep their lives healthy. The study aims to give a good knowledge about how asthma can affect the quality of life of medical students, the magnitude of this effect, and how medical students can combat these effects. Also, this study will help universities to take action and consideration to those students by providing specific clinics or health education about their disease.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn institution based cross sectional study design of 58 asthmatic medical students was done, who were selected by convinced sample, and data were collected using valid available Asthma Quality of Life Questionnaire (AQLQ). Some of the questions was modified to screen for other objectives of the study. Pretested, structured and self-Administered Google form questionnaire was used to collect the data. The data was pretested, an excel copy of the data was obtained, analysis was done by IBM SPSS statistic version 25.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e The study showed that the asthma affect the physical activity, social activity and psychological health of the participant in mild degree. And it effects the academic achievement of the students by 34.5%. And showed significant effect in focusing during lectures and clinical rounds by 43.6% and 41.8% respectively.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003easthma has a significant effects on the QOF among medical students, and has a notice effect in the performance of the medical students. The study recommends that universities take in consideration the a healthy environment for asthmatic medical students and provide clinics to improve their health. And further researches recommends to assess QOF of asthmatic medical students.\u003c/p\u003e","manuscriptTitle":"Assessment of Quality of life and Academic Performance among Asthmatic Medical Students at Al-Neelain University, 2020","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-04-04 14:18:38","doi":"10.21203/rs.3.rs-2747581/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ce91391c-06fa-4c4d-8459-6fdf18476c7a","owner":[],"postedDate":"April 4th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-04-04T14:18:38+00:00","versionOfRecord":[],"versionCreatedAt":"2023-04-04 14:18:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2747581","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2747581","identity":"rs-2747581","version":["v1"]},"buildId":"ehx78VzkSd0WSzXnipQa-","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}