Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 57888

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2012 | Month : June | Volume : 6 | Issue : 5 | Page : 859 - 862 Full Version

Prevalence of Stress among International Post-graduate Doctors at the University Malaya Medical Centre (ummc), Kuala Lumpur

Published: June 1, 2012 | DOI:
Omer Mohd Hussein, Nor Zurida bt. Zainal, Mohamed E Abdel-Latif

1. Associate Professor, Department of Psychiatry, Faculty of Medicine, National Ribat University, Khartoum-Sudan. 2. Professor, Department of Psychological Medicine, University Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia. 3. Associate Professor, Department of Neonatology, Canberra Hospital, Garran, ACT, Australia and The Clinical School, Australian National University, Garran, ACT, Australia.

Correspondence Address :
Associate Professor, Omer Mohd Hussein Department of Psychiatry, Faculty of Medicine National Ribat University, Khartoum, Sudan. E-mail:


The stress which affects the doctors is receiving increased attention. Researchers have shown that hospital doctors are under high levels of stress from a number of sources. This is of importance because it is known that the quality of care that the physicians give is directly related to their own health.

To study the prevalence of stress among international postgraduate doctors at the University Malaya Medical Centre (UMMC), Kuala Lumpur.

Post-graduate doctors completed General Health Questionnaires (GHQ-28) which covered Somatic Symptoms, Anxiety and Insomnia, Social Dysfunction and Severe Depression. The results were converted into a percentage scale by summing the scores of the individual items; in this overall scale, higher scores indicated increased stress. A total of 50 international doctors from different clinical and non-clinical medical subspecialties took part in the study.

The prevalence of stress among the international doctors was 54% (95% CI: 44–63%). The highest levels of stress were reported for “Anxiety and Insomnia” and the lowest level was reported for “Severe Depression”. Furthermore, the individual questions analysis revealed the highest scores for three questions: “felt constantly under strain”, “been feeling well and in good health” and “been managing to keep yourself busy and occupied”.

The results should be interpreted with caution, as the study is based on a small sample. However, it does provide a useful first insight into stress and dissatisfaction, which have important implications for the wellbeing of international post-graduate doctors.

Work has always been a major part of a person’s life and a common source of stress for many people. Most of the jobs produce some degrees of stress, which may be increased in individuals who work in occupational environments that are demanding. Health professionals work in such stressful environments and they are particularly vulnerable to severe forms of emotional distress as compared to those who do other types of organizational work.

The British Medical Association’s 1992 report which was entitled “Stress and the Medical Profession”, began a concern that UK doctors have high stress levels (1). Though this study was exclusively among the house-officers (interns), other studies showed that senior hospital doctors were not an exception to this. Caplan found that 47% of 389 hospital consultants, general practitioners, and health service managers were stressed (2).

International post-graduate students and doctors are more vulnerable to stress than their counterparts. This is because, making a transition to a new environment involves adjusting to unfamiliar people, tasks, and situations. Their mental and physical health are affected, because one’s existing personal network is no longer useful. In a study of various groups in cross-cultural transition, international students were found to exhibit the most adjustment problems (3).

While the stress among doctors in general has been extensively studied – only little is known about the stress which is experienced by international post-graduate doctors. The recent rapid and extensive changes in the post-graduate opportunities in Malaysia generally and in UMMC in particular, lead to many international doctors pursuing their post-graduate studies here in UMMC. This pilot study investigated the prevalence of emotional distress among international post-graduate doctors at the University Malaya Medical Centre, Kuala Lumpur, by using the General Health Questionnaire (GHQ-28) (4),(5).

Material and Methods

Study Centre
This study was conducted at the University Malaya Medical Centre (UMMC). UMMC is situated at the periphery of the Federal Territory. This centre serves as a training centre for medical students and doctors who undergo post-graduate training in various fields of specialization which are offered there. There were 476 doctors who were employed either by the University or by the centre. Of these, 70 were international doctors. A majority of the international doctors were registered with the University Malaya as post-graduate students.

This study was restricted to the international post-graduate doctors because this group was comprised of a majority of the doctors at UMMC and also, it was the most stress-vulnerable group.

All of the international post-graduate doctors (clinical or non-clinical students) were approached. Their names were obtained from the Post-Graduate Secretariat at the Deans office, Faculty of Medicine, UMMC. Each doctor was given a package which consisted of an information sheet regarding the details of the study, a proforma for personal details and the General Health Questionnaire (GHQ-28) (Appendix 1). The packages were personally delivered and they were collected by the researcher and 5 intermediaries from different departments in the UMMC. No doctor declined from participating in the study.

Data collected
The following data was collected in addition to the GHQ-28 questionnaires: age, gender, marital status, type of residence (students’ hostel vs. others), major field of specialization, length of stay in Malaysia, country of origin and a past history of psychiatric disorders.

Stress Assessment
The GHQ-28 was used for the stress assessment among the study samples. GHQ-28 is a self-report scale which consists of 28 items, which is used to measure the general well being or the quality of life. It tests 4 areas of stress: Somatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression (4),(5). The GHQ scoring was assessed by using the Likert method in which each item has a score of zero to three (0-1-2-3), with the maximum score being 84. For convenience, the score was taken as the ‘stress score’. The GHQ was validated as a suitable measure of the mental health at the work place (5),(6).

Statistical Analysis
Statistical analyses were performed by using SPSS version 11.5.0 (SPSS Inc, Chicago, IL). Mean (standard deviation) and percentages were used wherever appropriate to describe the study variables. The Two independent-sample t-test and the Chi square test were used to test the significance wherever appropriate. The correlation coefficient, r was used to evaluate the correlation between the GHQ score and its subscales. A p-value of < 0.05 was considered to be statistically significant.


Sociodemographic data
Fifty out of the total 70 international post-graduate doctors returned their questionnaires, which resulted in a response rate of 71.4%. (Table/Fig 1) shows the demographic and the descriptive data of the study sample. The median (interquartile range, IQR) of the age and the duration of stay in Malaysia were 35 (32.7-37) and 4 (2.7 - 4) years respectively. A majority of the sample (46, 92%) were males. Married students constituted 33 (66%) of the sample. Most of the doctors (37, 74%) were enrolled in non-clinical or research projects (public health, parasitology, … etc). 44 (88%) of the study sample was from Sudan and the remaining 22% were from Pakistan (3), Bangladesh (1), Myanmar (1) and other countries (1). None of the respondents reported any history of a psychiatric disorder.

GHQ-28 Score
The mean (SD) of the 4 GHQ-28 components (the score ranged from 0 to a maximum of 21 points) for the whole study group ranged from 7.6 (4.5) for the “Anxiety and Insomnia” to 4.5 (4.4) for the “Severe Depression” components (Table/Fig 2). This indicated high levels of anxiety and insomnia, followed by somatic and social dysfunction with less severe depression among the studied group.

Overall, the study group showed a relatively high mean (SD) GHQ-28 score of 26.4 (13.3) (the overall total score ranged from 0 to a maximum of 84 points) (Table/Fig 3). This result was translated to a stress prevalence of 54% (95% CI: 44 – 63%) among the studied international post-graduate doctors.

Differences in the GHQ-28 score which were caused by the study variables
There were no statistically significant differences in the GHQ-28 components (somatic symptoms, anxiety and insomnia, social dysfunction and sever depression) which were caused by the study variables (gender, marital status, residence, field of study and the length of stay in Malaysia).

Correlation (r) between the GHQ score and its subscales
(Table/Fig 4) shows that there was a statistically significant correlation between the GHQ-4 components and the overall GHQ-28 (r ranged from 0.43 to 0.87, p < 0.05).


Our data suggested that the stress prevalence is 54% (95% CI: 44 – 63%) among the international post-graduate doctors in UMMC. There is a lack of similar studies in Malaysia to compare with ours. However, on comparing our findings with those of other studies on the stress among doctors from other countries, the prevalence in our study was found to be comparable with that in those studies. For example, Firth-Cozens found that the emotional distress was 50% in a group of 170 junior house officers, out of which 28% showed an evidence of depression (7). A study which was done by Caplan found that 47% of 389 hospital consultants, general practitioners, and health service managers were stressed (2).

In addition to the universal stressors that doctors encounter, the foreign post-graduate doctors face additional stressors including culture shock, change in the social status, change in the economic status, expectations about their academic performance, and family-related pressures.

Male and female doctors showed comparable stress scores in this study. Others found that the incidence of depression, depressive symptomatology and the risk of suicide in female doctors was higher than in their male colleagues (8),(9),(10),(11). This was speculated to reflect on the conflict of motherhood, spousal duties and career targets.

Marital status did not make any difference in the stress scores among doctors in this study. However, several studies from western countries have indicated that marriage was a preventing factor for depression (12),(13),(14). A study from the UK showed the protective effect of marriage (14).

A limitation of this study was its small sample size and its cross-sectional design. Furthermore, we did not look at the causes for the stress among the foreign doctors. However, our study was the first to describe stress among this vulnerable group in Malaysia. Our use of valid stress scales increases the validity of our results and the generalizability of our results to other academic institutions in Malaysia.


The prevalence of stress among the international post-graduate doctors was found to be 54% (95% CI: 44 – 63%). These results should be interpreted with caution, as this study was based on a small sample size. However, it does provide a useful first insight into the stress among the international post-graduate doctors in UMMC, which have important implications for their wellbeing. Further studies to investigate the causes of stress among international postgraduate doctors are needed.

UMMC University Malaya Medical Centre. GHQ-28 General Health Questionnaire.


British Medical Association. Stress and the Medical Profession. London: British Medical Association, 1992.
Caplan RP. Stress, anxiety, and depression in hospital consultants, general practitioners and in senior health service managers. British Medical Journal 1994;309:1261-63.
Jou YH, Fukada H. The causes and the influence of transitional stress among Chinese students in Japan. The Journal of Social Psychology Washington 1996;136(4):501-09.
Goldberg DP, Williams P. A User’s Guide to the General Health Questionnaire. Winsdor NFER-Nelson 1988.
Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 1997; 27:191-97.
Banks BH, Clegg CW, Jackson PR, Stafford EM, Wall TD. The use of the general health questionnaire as an indicator of the mental health in occupational settings. Journal of Occupational Psychology 1980;53:187-94.
Firth-Cozens J. Emotional distress in junior house officers. British Medical Journal 1987;295:533-36.
Godlee F. Stress in junior doctors. 2–Stress in women doctors. BMJ 1990;301:76.
Whitley TW, Gallary ME, Allison EJ Jr, et al. Factors which are associated with stress among emergency medicine residents. Ann Emerg Med 1989;18:1157–61.
Whitley TW, Allison EJ Jr, Gallary ME, et al. Work-related stress and depression among physicians who were pursuing postgraduate training in emergency medicine: an international study. Ann Emerg Med 1991;20:992–96.
Arnetz BB, Horte LG, Hegberg T, et al. Suicide patterns among physicians who are related to other academics as well as to the general population: results from a national, long-term, prospective study and a prospective study. Acta Psychiatr Scand 1987;75: 139–43.
Lloyd S, Streiner D, Shannon S. Burnout, depression, life and job satisfaction among Canadian emergency physicians. J Emerg Med 1994;12:559–65.
Linn LS, Yager J, Cope DW, et al. Factors which are associated with life satisfaction among practising internists. Med Care 1986;24:830–7.
Burbeck R, Coomber S, Robinson SM, et al. Occupational stress among the consultants in accident and emergency medicine: a national survey on the levels of stress at work. Emerg Med J2002;19:234–38.

DOI and Others

Date of Submission: Dec 04, 2011
Date of Peer Review: Jan 30, 2012
Date of Acceptance: Mar 31, 2012
Date of Publishing: Jun 22, 2012

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)