Undergraduate medical studentsChoice of specialty a b s t r a c t Background: Empathy is essentially a desirable quality among clinicians and can be developed during medical education. Studies from outside India have shown that higher empathy is related to better competency and choice of specialty may be related to empathy levels in them. Change in empathy levels among undergraduate medical students with progressive training has been often ascribed to reasons such as curriculum content, timing of clinical rotations. Gender differences in empathy levels also vary among different countries. Since many of such factors differ in India there is a need therefore to understand empathy and its correlates among medical students in India.Method: A cross sectional study was undertaken in a large medical college among the undergraduates of first, third, fifth, seventh and ninth semesters to measure their empathy levels. The evaluation was done using the Jefferson's Scale for Physician's Empathy-Student version.Results: The study revealed highest empathy at entry level and a significant fall by seventh semester (p ¼ 0.002). Female students had significantly higher empathy levels than male students (p ¼ 0.012) across all semesters. The variance in empathy scores according specialty chosen is not statistically significant (p ¼ 0.2468). Conclusion:The progressive decline in empathy levels with years in medical college here is seen much later than in western studies. Female students are more empathetic than male students. The relation of mean empathy scores and choice of specialty is inconclusive and at variance from other studies.ª 2014, Armed Forces Medical Services (AFMS). All rights reserved.* Corresponding author. Tel.: þ91 9657167900 (mobile). E-mail address: sribuj@yahoo.com (R. Shashikumar).Available online at www.sciencedirect.com ScienceDirect journal homepage: w ww.el sevier.com/locate/mjafi m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 0 ( 2 0 1 4 ) 1 7 9 e1 8 5

CI 6.29, 11.98) scoring above 7 (high level of autonomy). In the study population it was found that 273 (70.7%, 95% CI 66.2, 75.28) of the respondents were using contraceptives. Women's autonomy, years of marriage and number of children were significant variables.ª 2014, Armed Forces Medical Services (AFMS). All rights reserved.

No abstract

Background:Out of those who attempted self-harm and survived, many actually wanted to die and many did not. Presently, no distinctive nomenclature exists for these two groups, which causes difficulty in understanding as well as in management and research.Aim:To study whether there exist two such groups which are distinct and can be differentiated clinically.Methods:Seventy-eight persons who attempted self-harm were evaluated in detail by a psychiatrist. The data were recorded in an especially designed proforma which documented sociodemographic variables, psychiatric and physical illnesses, psychosocial stress factors, substance abuse, past and family history and details of suicide attempt.Results:Two groups emerged with distinct characteristics. The two groups were different in factors such as age, diagnosis, intentionality, lethality, mode, motive to kill oneself, past/family history, relation to stress, personality traits and precaution to prevent detection before and/or after the act. The group which had persons who really wanted to die but survived is suggested to be named as the ‘failed suicide’ group and the other group which had persons who did not actually want to die is suggested to be named as the ‘deliberate self-harm’ group.Conclusion:Those who cause harm to themselves but survive can be distinctly put into two groups: (i) the ‘failed suicide’ group constituting those who actually wanted to kill themselves and (ii) the ‘deliberate self-harm’ group constituting those who did not actually want to die. The criteria for distinctions are suggested.

BACKGROUND: COPD will become the third leading cause of death by 2020. There are many situations in which spirometry, the primary tool for diagnosis of COPD, cannot be performed, and thus, the staging and status of these patients cannot be determined. To date, there is no known biochemical marker used for diagnosing COPD. This study aimed to explore the utility of biomarkers for diagnosis of COPD. METHODS: This was an observational study composed of 96 stable subjects with COPD and 96 subjects with normal lung function. Each group contained an equal number of smokers and nonsmokers. Serum levels of superoxide dismutase 3, glutathione peroxidase, catalase, ceruloplasmin ferroxidase activity, C-reactive protein, and surfactant protein D (SPD) were estimated. Ferroxidase activity was estimated by a kinetic method, whereas the other analytes were measured by enzyme-linked immunosorbent assay. The cutoff value, sensitivity and specificity at the cutoff value, and area under the curve for each analyte were determined from receiver operating characteristic curve. RESULTS: Significantly decreased superoxide dismutase 3 and increased ferroxidase activity, SPD, glutathione peroxidase, and C-reactive protein levels were found in subjects with COPD. For all subjects and nonsmoking subjects with COPD, the area under the curve was highest for ferroxidase activity, followed by glutathione peroxidase, SPD, and C-reactive protein, with a sensitivity and specificity of > 73%. For smoking subjects with COPD, the area under the curve was highest for SPD, followed by glutathione peroxidase, ferroxidase activity, and C-reactive protein, with a sensitivity and specificity > 67%. Some combinations of markers were found to give either a sensitivity or specificity of > 95%, which can be utilized to rule in and rule out COPD. CONCLUSIONS: Biomarkers can be reliably utilized in the diagnosis of COPD. Of all the markers, SPD appears to be the most promising in smokers, whereas ferroxidase activity shows promise in nonsmokers. To rule out COPD, ferroxidase activity or glutathione peroxidase can be potentially useful, whereas to rule in COPD, ferroxidase activity and glutathione peroxidase appear to be the most promising combination in both nonsmoking and smoking subjects.