Specialty choices of medical students and house officers in Karachi, Pakistan

Understanding patterns of career choices in medicine is important for educators and policy-makers to plan the supply of specialists. This study analysed the career choices made by medical students and house officers in 2 private and 2 public medical schools in Karachi, Pakistan. An anonymous, self-administered questionnaire was completed by 850 students. Internal medicine, paediatrics, general surgery and obstetrics and gynaecology were the 4 highest ranked specialties, with internal medicine ranked top as both the 1st and 2nd choice. Internal medicine was the 1st choice for significantly more students in public than private medical colleges [22.2% versus 14.9%]. Students from private medical institutions chose a wider range of specialties than those from publicly-funded colleges. A high proportion of medical students and graduates in Karachi favour the same medical specialties, which may lead to saturation in those areas of specialization

Cancer esophagus Karachi 1995-2002: epidemiology, risk factors and trends

To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors. Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses. The Age Standardized Incidence Rates [ASIRs] of cancer esophagus in Karachi South for males were 6.5/100,000 [1995-1997] and 6.4/100,000 [1998-2002]. In females the observed rates were 7.0/100,000 [1995-1997] and 8.6/100,000 [1998-2002]. In the moderately high incidence, cancer esophagus zone of Karachi, the ASIRs in males remained stable during the last decade, but in females, an upward trend was observed suggesting a progressively higher exposure to risk factors in the latter. The potential risk factors in Karachi are use of all forms of tobacco, areca nut, infrequent consumption of raw fruits and vegetables and diet deficiencies. There is a necessity to actively control the proven risk factors and address the existence of other risk factors. The primary recommended strategy for the control of cancer esophagus would therefore be legislation against tobacco and areca nut in Pakistan and public health education. The risk factors of cancer esophagus identified in this article need to be further confirmed

Breast diseases: a histopathological analysis of 3279 cases at a tertiary care center in Pakistan

To know the frequency of breast diseases in Pakistani females. A retrospective analysis of 3279 breast specimens received over a period of 4 years [1993-1996] at the department of pathology, the Aga Khan University Hospital. Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of them showed 3 or >3 positive lymph nodes. Grade I tumours were 11.38%, grade II 59.17% and grade III tumours 29.47%. Correlation of grade with lymph node metastases [3 or >3+ve nodes] showed 15 cases [1.53%] of grade I, 178 cases [18.25%] of grade II and 68[6.97%] cases of grade III tumours. This study shows that in Pakistani females, the most commonly encountered lesion in carcinoma of the breast followed by the benign lesions such as fibro adenoma, fibrocystic disease and others. Breast carcinoma occurs at a younger age group with predominance of high-grade lesions and with frequent lymph node metastasis

Immunophenotypic analysis of non-Hodgkin's lymphoma

One hundred and three cases of Non-Hodgkin's lymphoma were evaluated immunohistochemically using a panel of monoclonal antibodies which includes leucocyte common antigen [LCA], CD45R [Pan-B marker], L-26 [CD 20-Pan-B marker] and UCHL-1 [Pan-T marker]. Of the total 63 cases [61.17%] showed a B-cell phenotype while 40 [38.83%] were of T-cell origin. Most B-cell neoplasms belonged to intermediate [79.36%] or high grade [15.87%] according to the International Working Formulation [WF]. Most T-cell lymphomas were of either intermediate [52.5%] or high grade [32.5%] neoplasms. Some T-cell neoplasms presented as specific clinicopathological entities like lymphomatoid granulomatosis [2 cases], mycosis fungoides [1 case] and AILD type NHL [1 case]. In 27 cases the immunostaining pattern of two. Pan-B markers i.e., L26 and CD45R was compared. L26 staining was expressed in all 27 cases [100% sensitivity] while CD45R showed positive reaction in 22 cases [82% sensitivity]. UCHL-1 is proved to be a sensitive and lineage specific T-cell marker and in 67% cases the staining pattern was moderate [+2] to intense [+3]. The mean age for the B-cell lymphomas was 49 years and 36 years in T-cell neoplasm. Male to female ratio in both types of lymphomas was 2:1. The study indicates a high prevalence of T-cell when comparing the data from western countries and lower to those from Japan and Caribbean countries