A Cross-Sectional Study on Empathy and its Association With Stress in Medical Students

Introduction: Empathy is the cornerstone of the doctor-patient relationship and a crucial quality associated with better patient compliance and clinical outcomes. This study aims to assess the level of empathy and its association with the level of stress in 3rd and 4th year medical students Methods: This cross-sectional study was conducted in Kathmandu Medical College after taking ethical approval from the Institutional Review Committee and informed written consent from all the participants. The respondents completed a structured questionnaire including demographic profile, Jefferson Scale of Empathy-Student Version, and Perceived Stress Scale. Data were entered and analyzed in Statistical Package for the Social Sciences version 20. Results: A total of 255 questionnaires were obtained with a response rate of 85.2%. The mean empathy score was 101.79 (SD  =  11.26) and the mean perceived stress score was 18.55(SD = 5.56). There was a statistically significant negative correlation between empathy and stress (p-value <0.01) and similar negative correlations were seen in sub-group analysis. Female students had higher empathy scores compared to their male counterparts (p-value <0.01). Fourth-year students reported lower empathy scores than third-year students (p-value <0.05).  Conclusion: Stress was found to be a significant determinant of empathy among medical students. Medical educators must be aware of this and should try to incorporate means to alleviate stress in medical education. Furthermore, effective stress management techniques to preserve empathy in medical students with a view to improve clinical competency and achieve optimum patient care needs to be studied.

Diffuse Systemic Sclerosis with Left Ventricular Diastolic Dysfunction: A Case Report

Systemic sclerosis is a connective tissue disease characterized by wide-spread vascular lesions and fibrosis of the skin and internal organs. It is an immune mediated rheumatic disease with the presence of an immunological dysfunction of T lymphocytes, especially Th1 and Th17 subtypes. It affects gastrointestinal, pulmonary, vascular, musculoskeletal, cardiac and various other systems. This disease is rare but has high morbidity and mortality with less known effective management. We report a case of 70-year-old female with systemic sclerosis presented with pain along with swelling over multiple joints since 18 months which exacerbated since last 6 months and wound over finger tips since last 2 weeks. We present here other various signs, investigations and management of this uncommon disease systemic sclerosis, also known as scleroderma. Various systems are evident to be involved including cardiac (left ventricular diastolic dysfunction) and peripheral vascular system (Raynaud's phenomenon).