ABSTRACT
OBJECTIVES: High-quality research forms the basis of evidence-based practice and sets the foundation for trainees to develop critical thinking skills and approach clinical problems with an inquisitive mind. The attitudes to research however vary widely and there are significant barriers to conducting research relevant to each clinical discipline. Understanding both the attitudes of residents to research and the barriers to conducting research could allow for strategies to improve this core aspect of clinical development. This aim of this study was to characterise current attitudes and perceived barriers towards conducting research among residents in Obstetrics and Gynecology in Trinidad and Tobago. METHODS: An online survey was sent to all residents in the four major public hospitals in Trinidad and Tobago. The 10-min previously piloted questionnaire contained questions related to demographics, career level, research experience, attitudes to research as well as perceived barriers to conducting research. RESULTS: The response rate was 74% (48/65). Although most (77%) respondents were interested in performing research, lack of time (56%) and insufficient training in research (59%) were the main barriers. Lack of mentorship or supervision as well as departmental issues such as access to case notes, electronic databases and bureaucratic issues were also found to hamper a research-oriented environment. CONCLUSION: For residents in Obstetrics and Gynecology, curricula revision is urgently required to include protected research time, training in research methodology, formal and dedicated research mentors in order to promote a research-oriented culture that ensures a greater understanding and output of research in this specialty.
ABSTRACT
OBJECTIVE: Diffusion-weighted magnetic resonance imaging (DWI) has shown promise in predicting response to therapy in several malignancies. This systematic review and meta-analysis aimed to evaluate DWI in the prediction of response to treatment in patients with cervical cancer. METHODS: A systematic search was conducted on PubMed, Web of Science, Cochrane and Google Scholar databases Studies that evaluated DWI and apparent diffusion coefficient (ADC) for response evaluation before, during and after treatment with a correlation to conventional response criteria were included. The primary endpoint was the mean ADC values of cervical cancer at these timepoints. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess the quality of the studies. RESULTS: Nine studies, comprising 270 patients, were included. Pre-treatment ADC values showed no correlation with eventual response. However, in our meta-analysis, there was a significant correlation with early treatment ADC values obtained within the first 3 weeks of therapy and response, as well as a significant correlation with the percentage change in ADC (ΔADC) and response. In addition, the pooled mean ΔADC percentage was also significantly higher in responders than in non-responders (49.7% vs 19.7%, respectively, p = 0.016). CONCLUSION: DWI shows potential as a biomarker of early treatment response in patients with cervical carcinoma. Use of the change in ADC particularly within the first 3 weeks of therapy seems to be predictive of response and may serve as a suitable marker in the determination of early response.
ABSTRACT
Lymphangioleiomyomatosis (LAM) is an unusual lung disease which can be diagnosed by its characteristic appearance on a high-resolution CT, and may not always require a biopsy.
ABSTRACT
Urinary tract infections are common in pregnancy. In pregnancy urinary tract infections have an associated risk of premature labour. This study looks at the incidence of urinary tract infections and the method of perineal hygiene used after urination. Wiping back to front is associated with a greater risk of developing urinary tract infection than wiping front to back.
