Thyroid carcinoma is the most common endocrine system malignancy with a fast rising incidence in the last decade for unknown reasons. Fine needle aspiration (FNA) biopsy, the gold standard in thyroid cancer (TC) screening has still its own challenges and in some cases needs a proceeding surgery.This review highlights the role of the two most recent "omics" approaches, "metabolomics" and "lipidomics", in the field of TC research.All the previous studies have been extracted from the literature and major concepts were detailed in the field of TC metabolomics and lipidomics.Metabolomics and lipidomics, have potential in finding biomarkers related to thyroid carcinoma. Among the previous studies, the most important introduced altered tissue metabolites and lipids included glucose and galactose, lactate, Scyllo- and Myo inositol, hypoxanthine, citrate, cholesterol and choline.Metabolomics methods have been widely used in the field of biomarker discovery in TC and attempts are still in progress to use these methods to find a reliable biomarker panel besides current diagnostic tools.
Abstract Objectives To determine the most important knowledge sources that can influence clinical practice and to cluster them in conceptual groups based on their relative importance. Methods Faculty members, fellows and residents of a large teaching tertiary care hospital were asked to rate the importance of different resources in their daily clinical practice and their understanding of some common terms from evidence‐based medicine. The knowledge sources were distributed in a two‐dimensional map using multidimensional scaling and hierarchical cluster analysis. Results A total of 250 of 320 recruited hospital staff returned the questionnaires. The most important resources in daily practice were English journals, text books and literature searching for faculty members, experience, text books and English journals for fellows and text books, experience and peers for residents. Regional journals were the least important resources for all study groups. About 62.7% of residents did not know the meaning of ‘number needed to treat’, 36.8%‘confidence interval’, 54.9%‘confounding factor’ and 44.6%‘meta‐analysis’. The percentages for faculty members were 41.3%, 37%, 42.2% and 39.1%. The knowledge sources were placed in four clusters in a point map derived from the multidimensional scaling process. Conclusion The dominance of the traditional information resources and experience‐based medicine debate which is the consequence of traditional approaches to medical education may be one of the considerable barriers to the dissemination of evidence‐based medicine in developing countries. The evidence‐based clinical practice guidelines could be used as a useful passive‐predigested source for busy clinicians to make informed decisions. A considerable Western bias may undermine the local research in developing world.
Introduction: Medical resident workload has been shown to be associated with learning efficiency and patient satisfaction. However, there is limited evidence about it in developing countries. This study aimed to evaluate the medical resident workload in a multidisciplinary teaching in Tehran, Iran.Methods: All medical residents at Shariati Hospital, a teaching affiliated with Tehran University of Medical Science, who were working between November and December 2011 were enrolled in this cross-sectional study. A self–reported questionnaire was used to gather information about their duty hours (including daily activities and shifts) and financial issues.Results:135 (52.5%) out of 257 residents responded to the questionnaire. 72 (53.3%) residents were in surgical departments and 63 (46.7%) were in non-surgical departments. Mean duty hours per month were significantly higher in surgical (350.8 ±76.7) than non-surgical (300.6±74.2) departments (p=0.001). Three cardiology (a non-surgical group) residents (5.7%) and 30 residents (41%) in surgical groups (p<0.001) declared a number of on-calls in the hospital more than the approved number in the curriculum. The majority of residents (97.8%) declared that their salary was not sufficient to manage their lives and they needed other financial resources. Conclusion: Medical residents at teaching hospitals in Iran suffer from high workloads and low income. There is a need to reduce medical resident workload and increase salary to improve worklife balance and finances.
Introduction: Medical resident workload has been shown to be associated with learning efficiency and patient satisfaction. However, there is limited evidence about it in developing countries. This study aimed to evaluate the medical resident workload in a multidisciplinary teaching hospital in Tehran, Iran. Methods: All medical residents at Shariati Hospital, a teaching hospital affiliated with Tehran University of Medical Science, who were working between November and December 2011 were enrolled in this cross-sectional study. A self–reported questionnaire was used to gather information about their duty hours (including daily activities and shifts) and financial issues. Results:135 (52.5%) out of 257 residents responded to the questionnaire. 72 (53.3%) residents were in surgical departments and 63 (46.7%) were in non-surgical departments. Mean duty hours per month were significantly higher in surgical (350.8 ±76.7) than non-surgical (300.6±74.2) departments (p=0.001). Three cardiology (a non-surgical group) residents (5.7%) and 30 residents (41%) in surgical groups (p<0.001) declared a number of “on-calls in the hospital” more than the approved number in the curriculum. The majority of residents (97.8%) declared that their salary was not sufficient to manage their lives and they needed other financial resources. Conclusion: Medical residents at teaching hospitals in Iran suffer from high workloads and low income. There is a need to reduce medical resident workload and increase salary to improve worklife balance and finances.
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