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.
J Obstet Gynaecol
November 2018
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregnancy. The World Health Organization (WHO) in 2015 revised the definition into either diabetes in pregnancy (DIP) which includes pre-existing diabetes (type 1 or type 2) that antedates pregnancy or diabetes diagnosed during pregnancy with the WHO diagnostic criteria for diabetes mellitus (DM) in the non-pregnant state, and GDM for milder forms of hyperglycaemia in pregnancy. The main purpose of the screening and diagnosis of GDM is to identify pregnancies in which the foetus is at a high risk of an adverse perinatal outcome, and the mother and the offspring are of serious long-term sequelae.
View Article and Find Full Text PDFBackground: Fish is an essential and traditional element in the diet of most Caribbean people. However it also contains methylmercury which can have severe effects on fetal neurodevelopment. The objective of this study was to assess the fish intake of a selected group of pregnant women from Jamaica and Trinidad & Tobago and evaluate prenatal mercury exposure, using the placenta as a biomarker.
View Article and Find Full Text PDFThe aim of this randomised prospective study was to investigate the impact of preoperative gonadotrophin-releasing hormone agonist (GnRHa) compared with a control group with myomectomy. A total of 36 women (n = 36, group 1) with fibroids were randomised to receive either two monthly doses (n = 18/36, group 1a) or three monthly doses of goserelin (n = 18/36, group 1b) prior to myomectomy. The 32 women who received no treatment (group 2) comprised the controls.
View Article and Find Full Text PDFCervical cancer remains a major reproductive health problem among women especially in developing countries where about 190,000 women die from this disease annually. Despite efforts to reduce the burden of this disease, most attempts in low-resourced countries have not been successful partly from lack of awareness by women of this common cancer, as well as the role the human papilloma virus (HPV) plays in its aetiology and pathogenesis. To determine knowledge, attitudes and practice of women in Trinidad (a developing country) on HPV, cervical cancer and the HPV vaccine, we conducted a cross-sectional survey among 426 women in the reproductive age.
View Article and Find Full Text PDFWe performed a prospective study involving 400 consecutive pregnant patients to determine whether the administration of a lime-flavoured glucose drink followed by a blood test 1 h later was a better method of screening for gestational diabetes (GDM) than the use of selective screening based on risk factors (maternal age over 30 years, East Indian ancestry and obesity). Complete data were available for 388 women, 76 were screen positive (1 h blood glucose ≥ 140 mg/dl) and GDM was diagnosed in 42 (using a 75 g oral glucose tolerance test) giving a positive predictive value of 55%. Selective screening applied to the same population would have identified only 34 cases, eight fewer with GDM.
View Article and Find Full Text PDFWest Indian Med J
December 2011
With the significant changes taking place in health and education as well as the rising demands and expectations, deans of medical faculties must exhibit strong and effective leadership skills. Deans need to focus on the broad scope and to translate their dreams into applied institutional operations and functions. It is thus necessary that the deans must identify the institution's core ideology, lead strategic planning, create a common vision and offer direction to the collective membership of the institution.
View Article and Find Full Text PDFWest Indian Med J
January 2007
To test the hypothesis that obesity represents a risk factor in pregnancy, we conducted a prospective case-control study to determine whether or not there was any divergence in the obstetric outcome among 132 obese women from that in a control group of 136 non-obese patients. Obese mothers had an increased incidence of pregnancy-induced hypertension and gestational diabetes but there was no significant difference in the duration of pregnancy or in the frequency of low Apgar score at 1 minute. The favourable fetal outcome in obese parturients reflects an increased awareness of the possible medical and obstetric complications and an early recourse to abdominal delivery.
View Article and Find Full Text PDFA prospective randomised clinical trial comprising 510 pregnant patients was performed to determine whether supplementation with calcium, low-dose aspirin or a combination of calcium and low-dose aspirin can lower the incidence of hypertension in pregnancy. Greatest benefits were obtained with calcium. Perinatal mortality was lowest in the aspirin group.
View Article and Find Full Text PDFWe determined the causal pathways of pregnancy-related deaths over a 16-year period. Pregnancy-induced hypertension was the chief contributor to our high maternal mortality rate of 36.9 per 100 000 births.
View Article and Find Full Text PDFJ Obstet Gynaecol
April 2004
The objective of this retrospective analysis of 344 singleton pregnancies of gestational ages greater than 24 weeks conducted at a tertiary hospital was to determine the fetal outcome in relation to the mode of delivery of the fetus with a breech presentation. Caesarean section was performed in 157 mothers, and 187 babies were delivered vaginally. There was no statistical difference in the perinatal outcome for breech fetuses delivered either abdominally or vaginally.
View Article and Find Full Text PDFThe Dundee Ready Education Environment Measure (DREEM) was administered to 70 final-year medical students and 36 first-year medical interns (pre-registration house officers). The overall total mean DREEM scores for the five subscales-namely, students' perceptions of the atmosphere, students' perceptions of learning, students' social self-perceptions, students'perceptions of teachers and students' academic self-perceptions-was 109.9 and the total mean scores for the subgroups-male students, male interns, female students and female interns-were 103.
View Article and Find Full Text PDFA 7-year retrospective survey was conducted in order to determine local trends in caesarean section rates, maternal outcome and indications for the procedure. The annual rate of caesarean births has not exceeded 10.0% of deliveries.
View Article and Find Full Text PDFAn objective analysis of our clinical experience with the intrapartum management of twin gestations was undertaken in order to determine whether or not routine caesarean section is justified when the first twin presents by the breech. The perinatal mortality rate for breech first twins delivered vaginally was not statistically different from vertex presentations. There was no perinatal loss among babies delivered vaginally by the breech.
View Article and Find Full Text PDFWith mounting evidence of the beneficial effects of the retained cervix, supracervical hysterectomy is gaining popularity worldwide. In this series of 123 patients, obesity and pelvic adhesions were the chief factors that prevented amputation of the cervix at the time of hysterectomy. We propose that these are cogent indications for planned supracervical abdominal hysterectomy in order to minimize damage to the adjacent viscera.
View Article and Find Full Text PDFPerinatal mortality rates are considered in the western world to be a quantitative barometer of maternity care. This 6-year prospective perinatal audit was conducted at a tertiary hospital in order to determine foetal outcome, and the common causes of foetal and early neonatal deaths. Of a total of 30,987 births, there were 469 stillbirths and 391 early neonatal deaths, giving a perinatal mortality rate of 27.
View Article and Find Full Text PDFA new maternity hospital was inaugurated in Trinidad in 1981 to provide access for pregnant women to specialist antenatal care and to trained attendants during childbirth. As an academic tertiary-care institution, it also became a referral centre for high-risk pregnancies and obstetric emergencies. The efficacy of the services provided since inception was evaluated by measurement of mortality statistics, which are the most sensitive indices of maternal care.
View Article and Find Full Text PDFWe analysed the outcome of the final MBBS (Bachelor of Medicine and Bachelor of Surgery) examinations at the St. Augustine Campus, University of the West Indies, for 686 students attempting them for the first time between 1975 and 1986. The mean failure rate was lowest in Medicine between 1975 and 1981, in Obstetrics & Gynaecology between 1982 and 1989 and in Surgery during the last 7 years.
View Article and Find Full Text PDFTwelve Caesarean section-associated maternal deaths were encountered over a 15-year period. The major operative risk factors were pregnancy-induced hypertension, obesity and general anaesthesia. Severe preeclampsia was the forerunner to postoperative cardiac failure, consumptive coagulopathy and difficult airway manipulation.
View Article and Find Full Text PDFObjective: To determine whether there is an association between the level of glycemic control and perinatal complications in pregnant diabetic patients.
Methods: Two hundred sixty confirmed cases of pre-existing diabetes, gestational diabetes and impaired glucose tolerance were analyzed to assess risk factors, modality of treatment, level of blood sugar control and effect on perinatal morbidity and mortality.
Results: Risk factors for the development of diabetes included age ( > 25 years), East Indian ethnic origin, glycosuria, and a history of diabetes in a first-degree relative.