ABSTRACT Background: All doctors must be aware of medical ethics to mitigate professional errors and safeguard patients from potential ethical lapses during the conduct of research on human participants and patient management. This goal can be achieved through intensive training in bioethics during their residency years. Materials and Methods: The present study aimed to determine the effectiveness and assess the perception of the “Course in Ethics” for postgraduate students. A total of 150 postgraduate residents underwent this 2 days course in five batches of 30 students each. The effectiveness of the course was determined by comparing pre-and post-test scores, and the perception was assessed by feedback forms evaluated on a Likert scale of 1–5. Results: There was a significant difference between the mean pre-and post-test scores (5.12 ± 1.48 and 9.27 ± 0.46, respectively, P ≤ 0.05), with an average percentage increase of 81.05%. The perception of students for the course was strongly positive. Conclusion: A structured course in medical ethics employing an interactive learning approach can be very effective.
Introduction: Emotional Intelligence (EI) is a critical attributefor medical professionals, encompassing self-awareness, selfregulation, motivation, empathy, and social skills. Indian medical students face exceptional stress due to intense academic competition, hierarchical structures, and limited mental health resources. Although structured EI interventions have demonstrated promise internationally in reducing burnout and improving clinical performance, systematic EI training remains largely absent from Indian medical curricula. Aim: To explore the perceptions and experiences of Indian medical graduates regarding the application of EI skills in their clinical and academic lives after completing a structured Value Added Course (VAC). Materials and Methods: This qualitative study was conducted at the Department of Psychiatry, Pramukhswami Medical College, Karamsad, affiliated with Shree Krishna Hospital, a tertiary care Institute in Gujarat, India, between September 2024 and April 2025. The study involved medical students who had participated in a three-month VAC titled “Developing Emotional Competencies,” based on Goleman’s EI model. The course addressed self-awareness, self-management, social awareness, and relationship management through interactive learning and reflective activities. The primary inclusion criterion was participation in the VAC on EI. A total of 10 students were eligible, of whom five students participated in the Group Interview (GI). The interview, conducted approximately one year after course completion, was audio-recorded and transcribed. Thematic analysis was performed following Braun and Clarke’s framework to identify patterns across the data. Results: Seven overarching themes emerged: EI in clinical practice, self-awareness management, social awareness and relationships, professional development, stress and burnout management, EI educational programs, and personal benefits. Students demonstrated concrete applications of EI in patient interactions, emphasising empathetic care while maintaining professional boundaries. Self-awareness emerged as foundational to all EI domains. Participants reported enhanced confidence in navigating emotionally charged interactions, improved recognition and management of stress and normalised emotional experiences. Cross-cutting patterns revealed an evolution from theoretical understanding to practical application. Conclusion: Medical students perceive structured EI training as beneficial for fostering emotional awareness, interpersonal sensitivity, and adaptive coping during medical education. Embedding EI within medical curricula may offer a meaningful avenue to support the holistic development and emotional wellbeing of future healthcare professionals.
BackgroundIdiopathic normal pressure hydrocephalus (iNPH) presents with gait disturbance, cognitive impairment, and urinary incontinence. The cerebrospinal fluid tap test (CSF-TT) and lumbar infusion test (LIT) are commonly used to predict postoperative improvement after shunt surgery; however, their validity remains debated.MethodsWe performed a systematic review and meta-analysis to assess the sensitivity and specificity of CSF-TT and LIT. The protocol was registered in PROSPERO (CRD42023454502). Reporting followed the PRISMA-DTA guidelines, and the certainty of evidence was assessed using the GRADE approach.ResultsOf 1,955 studies, 15 were included, reporting on 721 CSF-TT and 393 LIT patients, with shunt surgery as the reference standard. Nine CSF-TT studies (n = 700) and five LIT studies (n = 368) contributed to the primary meta-analysis. Considerable heterogeneity existed in test protocols, timing of assessment, and outcome measures. Several studies were retrospective with a high risk of bias. The pooled estimates were derived from a limited number of heterogeneous studies. Using a bivariate random-effects model, pooled sensitivity and specificity of CSF-TT were 64.1% (95% CI 49.2–76.6%, I2 81.3%) and 54.8% (95% CI 41.8–67.2%, I2 59.7%), respectively. The certainty of evidence was very low for sensitivity due to bias, inconsistency, and imprecision, and low for poor specificity due to bias and inconsistency. LIT showed a pooled sensitivity of 77.5% (95% CI 70.2–83.4%, I2 14.7%) and a specificity of 28.3% (95% CI 19.0–39.9%, I2 4.6%), with moderate certainty for sensitivity and moderate certainty for poor specificity.ConclusionBoth CSF-TT and LIT show poor specificity for predicting shunt responsiveness in iNPH, with low-certainty evidence for CSF-TT and moderate-certainty evidence for LIT. A positive result from either test should not be used in isolation to guide surgical decisions. Standardized prospective studies with clearly defined patient selection criteria and outcome measures are needed to establish the true diagnostic value of these tests.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42023454502.
Background Chemotherapy adverse drug reactions (ADRs) among geriatric cancer patients (≥65 years) are a major cause of morbidity. Real-world data for the Western Indian population are lacking. In the absence of data and guidelines, geriatric patients either suffer treatment-related toxicities or remain undertreated. The present study aimed to study the clinical profile, geriatric assessment (GA), chemotherapy-related ADRs, and survival outcomes. Methods This prospective, observational study enrolled patients aged ≥65 years who were starting curative-intent chemotherapy. Baseline clinical and GA was performed. Treatment details, including planned chemotherapy regimens and modifications in chemotherapy dosing, schedule, or protocol selection based on initial assessments, were recorded. Chemotherapy-related ADRs were assessed using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). Grade 3-5 adverse events were defined as severe. In total, 150 patients were accrued. Patients were followed up for one year post-chemotherapy. Results Out of 150 patients, 72 patients (48%) completed all planned cycles. Forty-nine patients (32.66%) reported severe-grade ADRs (CTCAE grades 3, 4, and 5). A total of nine (6%) deaths were reported during chemotherapy (i.e., CTCAE grade 5). The baseline GA parameters were not associated with CTCAE grade (p value > 0.05, nonsignificant). The estimated Kaplan-Meier survival at the end of four years of follow-up suggests worse outcomes in patients who experienced severe-grade ADRs and were unable to complete all the planned chemotherapy cycles. Conclusions A significant proportion of geriatric cancer patients experience severe-grade chemotherapy ADRs. Completing planned chemotherapy cycles in patients being treated with curative intent is an important determinant of survival. Patients who experience severe-grade toxicities have adverse survival outcomes, emphasizing the need for personalized toxicity management.
