Empty stomach together with menstrual bleeding as predictors of committed suicides among women of reproductive age: What a primary physician must know.

Background: Women of reproductive age group (WoRAG) are among the most vulnerable groups to suicide in India. The present study intended to develop a mathematical model to differentiate suicides from homicides among WoRAG. Methods: It was a cross-sectional study based on a record review of autopsy at Patna, India, from 2016 to 2021. The cause of deaths was ascertained by autopsies and other records independently by two investigators to reduce the interobserver bias. Independent variables were tested with confirmed suicides to calculate statistically significant association. These variables were further used for developing prediction models for the suicides by multivariate logistic regression analysis. Results: Out of total of 520 autopsies of WoRAG performed by investigators, the cause of death has been confirmed for 62. Of them, 30 were confirmed as suicides. In univariate analysis, suicides were associated with the menstrual bleed (OR 35 CI 6.9,179), gastric emptying (OR 3.9 CI 1.2,12.8), hanging, poisoning, and drowning as mode of death (OR 435 CI 37.4,5061.9). By logistic regression, three prediction models were built to predict suicide; Model I: gastric emptying, Model II: menstrual bleed, and Model III: including both. The area under the curve (AUC) for Models I, II, and III was 0.67 (95%CI 0.34,0.99), 0.92 (95%CI 0.75,1.00), and 0.94 (95%CI 0.82,1.00), respectively. The AUC of Model III differs significantly from that of Model I (P value 0.03) but not with Model II (P value 0.11). Conclusion: Menstrual bleed, gastric emptying, and mode of death may be used as a supplement tool in ascertaining the cause of death among WoRAG in medical and legal proceedings.

The usefulness of crossword puzzle as a self-learning tool in pharmacology.

INTRODUCTION: Pharmacology is perceived as a volatile subject as it's difficult to recall and recite the core of the subject. Enriching the learning environment through incorporation of a variety of teaching and learning strategies and methods yields enhanced learning. Crossword puzzles provide expansion of vocabulary, stimulate thinking capacity, boost confidence, and fasten up the learning capacity; hence, the present study was conducted to investigate the usefulness of crossword puzzle as an innovative self-learning tool in pharmacology. METHODS: This prospective study was conducted among 5th semester students of the second professional MBBS course. A total of 139 students participated in this study and were evaluated with formative examination and feedback questionnaire. Permission was taken from Institutional Ethics Committee for the study. A crossword puzzle consisting of 32 questions on endocrine pharmacology was prepared and divided into two sections: the across section had 17 questions and the down section contained 15 questions. The data were analyzed, using Graph Pad Software and presented as percentage of the responses. RESULTS: On average, out of 32 questions, one mark each, the students scored 52.69% and all students responded correctly on questions on the topic of hormonal contraceptives. 75.5% of the students had an enjoyable experience and the majority of them agreed that it helped them enhance their knowledge of drugs, remember diseases and drug names, and overall learning about the topic. They were also of the opinion that this should be inculcated in pharmacology curriculum. CONCLUSION: Incorporation of crossword puzzles, as an adjunct tool, was useful as majority of the students reported that this improved their attitude of learning, thereby improving their performance.

Socioeconomic characteristics of alcohol and other substance users, seeking treatment in Sikkim, North East India.

OBJECTIVES: The present study was conducted to generate information for better understanding of socioeconomic and CAGE characteristics of alcohol and other substance users who were undergoing treatment in Sikkim. SUBJECTS AND METHODS: Socioeconomic and CAGE questionnaire was administered to alcohol and other substance abusers of Sikkim (n = 241) who were undergoing treatment in different treatment centers of Sikkim. Information was collected on printed instrument after taking participant's consent and data was statistically analyzed. RESULTS: Male participants (93.8%) outnumbered female (6.2%). Majority of the sample were either in the school dropout group or school completed (36.1%) group. Most of the samples were occupationally unemployed, urban residents, Nepali by ethnicity, single, and Hindu (48.5%) by religion. Minimum age for starting of alcohol and drug was 5 years and 7 years respectively. Knowledge about AIDS and its transmission was satisfactory. All the four CAGE characteristics were present in majority of samples. CONCLUSIONS: Climate, geographical location, wide and easy availability of alcohol in Sikkim make this state vulnerable for alcohol abuse. Alcohol drinking among parents, sibling and friends found to be important risk factor. Outreach to the community for better acceptability of treatment is an important area to fill the gap of treatment demand and treatment supply.