: Burnout is a state of physical and mental exhaustion that results from long term involvement in work situations that are emotionally demanding. Doctors in emergency fields like obstetrics & gynecology of a tertiary care hospital, have to work vigilantly at odd times under immense pressure during long duty hours, thus are more likely to burnout, especially in the tedious time of COVID-19 pandemic. This study measured the burnout in doctors of the department of OB/GYN at RMU allied hospitals by using Questionnaire based on Copenhagen Inventory with addition of questions about PPE, COVID testing facility and family burnout. Results showed inadequate provision of PPE & Covid testing, fear of transmission of infection to family and friends, effect on care of elderly at home, relationship with partner and increased mood irritability. Personal burnout was 54, work related burnout 49.6, and patient related burnout was 37 There is significant family and personal burnout but still patient burnout is not present, showing high professionalism in our doctors. Facilitation in the form of reduced working hours, safer working environment, appreciation of work, financial incentives, social support and care of psychological well-being by cognitive behavioral therapy & counselling must be offered to the doctors of the department of obstetrics and gynecology.  

BACKGROUNDSelf-directed learning is believed to impart more efficient learning than the traditional one. However, it requires learners to possess the readiness for it, which varies in individuals. Measuring the readiness for self-directed learning in the indigenous population would help evaluate self-directed learning in a particular setting.OBJECTIVETo measure the readiness for self-directed learning in medical students for its possible impact on their learning.MATERIAL AND METHODSThe study was done during 2017-2018 amongst the medical students of Princess Nourah University, Riyadh, by using the Fisher’s readiness scale. One-way Anova and bivariate and partial correlation were employed for statistical analysis.RESULTSTotal students were 350 with 96 (27.4%) responding - 73 (76%) of preclinical and 23 (24%) of clinical classes.The total mean readiness score was 123.97(SD16.15) versus the desired >150. Mean scores for the domains of self-management, desire-for-learning, and self–control were 37.8(SD5.9), 38.07(SD5.5), 48.09(SD6.7) versus the desired 47.31, 44.26, and 58.98, respectively.In the pre-clinical group, the total mean readiness score was 122.34(SD16.8), and for self-management, desire-for-learning, and self-control, 37.12(SD6.2), 37.52(SD5.6), and 47.69(SD7.1) respectively. In the clinical group, the respective scores were 129.13(SD12.4), 39.95(SD4.7), 39.82(SD5.02), and 49.34(SD5.09).Preclinical and clinical groups differed significantly in the self-management score (P=.04) but not in total readiness (P=.07), desire-for-learning (P=.08), and self–control (P=.3) scores.Self-control and desire-for-learning had a positive correlation, and also self-control and self-management if self-management or desire-for-learning were controlled respectively (P< .05).CONCLUSIONMean scores for readiness for SDL and its three domains were lower than the desired levels. A hybrid system thus seems more appropriate for the setting.

Uterine leiomyosarcoma (uLMS) is an aggressive mesenchymal neoplasm associated with a poor prognosis. Systemic chemotherapy is the standard therapy for patients with uLMS. However, it is unclear which treatment regimen results in the most favorable clinical outcome. We performed a meta‐analysis and meta‐regression analysis to assess the efficiency of different treatments received by patients with advanced, metastatic, and relapsing uLMS by evaluating the objective response rate (ORR) and disease control rate (DCR) as primary endpoints. The frequentist random effects meta‐analysis model was used to compare the outcomes of different treatment regimens for advanced uLMS. A meta‐regression analysis was performed to estimate the association between the study‐specific hazard ratios and specific demographic variables. A meta‐analysis of 51 reports including 1664 patients was conducted. Among patients who received adjuvant chemotherapy (916 patients; 55%), gemcitabine and docetaxel were the most frequently used drugs. First‐line monotherapy with alkylating agents (pooled ORR = 0.48; 95% confidence interval [CI]: 0.44–0.52) and second‐line monotherapy with protein kinase inhibitors (pooled ORR = 0.45; 95% CI: 0.39–0.52) resulted in favorable prognoses. The combinations of anthracycline plus alkylating therapy (pooled DCR = 0.74; 95% CI: 0.67–0.79) and of gemcitabine plus docetaxel (pooled DCR = 0.70; 95% CI: 0.63–0.75) showed the greatest benefits when used as first‐line and second‐line chemotherapies, respectively. Subgroup meta‐analysis results revealed that dual‐regimen therapies comprising anthracycline plus alkylating therapy and gemcitabine plus docetaxel are practical therapeutic choices for International Federation of Gynecology and Obstetrics stages III–IVb with distant metastases when assessed by computed tomography (p = 0.001). Furthermore, neoadjuvant chemotherapy and local radiotherapy resulted in favorable outcomes for patients with earlier stages of distant relapsed uLMS (p < 0.001). Our findings provide a basis for designing new therapeutic strategies and can potentially guide clinical practice toward better prognoses for uLMS patients with advanced, metastatic, and relapsing disease.

Purpose To measure the readiness for self-directed learning in medical students for the evaluation of self-directed learning in the study population. Materials and Methods The survey was conducted in undergraduate students. The instrument used was Fisher’s readiness scale comprising of self-management, desire for learning, and self-control domains. The data were analyzed by Mann–Whitney U -test and bivariate and partial correlations. The results were compared with the reported ones. Results Total students surveyed were 300. Of these, 96 responded - 73 (76%) of preclinical and 23 (24%) of clinical classes. The mean readiness score was 124. The mean domains’ scores for self-management, desire for learning, and self-control were 38, 38, and 48, respectively. The preclinical group had a mean score of 122 for readiness,  37 for self-management and desire for learning each, and 48 for self-control. The clinical group’s scores were 129, 40, and 49, respectively. Preclinical and clinical groups differed significantly in self-management domain (P = 0.03). The difference was not significant in desire for learning (P = 0.08), self-control domains (P = 0.40) and readiness score (P = 0.12). The domains of self-control and desire for learning had a positive correlation if self-management was controlled, and self-control and self-management had a positive correlation if desire for learning was controlled (P < 0.05). Conclusion The measurement of readiness for self-directed learning helps in knowing the true value of self-directed learning in a particular setting. Relatively lower scores in our study mean self-directed learning alone cannot be relied upon to achieve optimum students’ learning. There is also a need for implementing strategies that will help students in improving their readiness for independent learning.