RESUMO
BACKGROUND: Developing countries like face dire shortage of medical manpower due to brain drain. Young doctors intending to specialize usually prefer certain specialties and sub-specialties to the neglect of others. This creates avoidable gaps in health care delivery. AIM: The aim of the following study is to determine the choices of career and reasons for those choices among young medical doctors. SUBJECTS AND METHODS: A cross-sectional study of fresh interns using a pre-validated 13 item questionnaire was done at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu Nigeria. RESULTS: A combination of the various surgical specialties was the most common choice made in 29/110 26.4% of the respondents. The top four specific choices were pediatrics 28/110 (25.5%), internal medicine 11/110 (10%), obstetrics and gynecology 10/110 (9.1%) and public health 8/110 (7.3%). The most common factor influencing choice of specialty was interest in 86/109 (78.9%) of the respondents. A higher proportion of males 24/69 (34.8%) compared with females 4/41 (10%) chose a specialty because of brighter prospect (P = 0.01). CONCLUSION: The most frequently chosen specialties by young interns were a combination of surgical specialties, internal medicine, pediatrics and obstetrics and gynecology. Interest was the most common reason for choice of specialty although males are significantly influenced by brighter prospects.
RESUMO
BACKGROUND: Assessment of patients prior to cytotoxic chemotherapy usually includes absolute neutrophils count. Other cellular markers of susceptibility to infection as well as immunocompetence include the T Helper lymphocyte count. In cancer patients, decrease in these lymphocytes has been observed to be associated with decreased overall survival. AIM: To assess the degree of CD4 lymphopenia encountered during cytotoxic chemotherapeutic treatment for cancer and evaluate the differences observed for the various drug combinations. SUBJECTS AND METHODS: Eighty patients with various histologically diagnosed malignancies had their CD4 lymphocyte counts carried out at days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed with breast cancer 36/80 cases (45%), non-Hodgkin's lymphoma 8/80 cases (10%), Hodgkin's lymphoma 13/80 cases (16.3%), multiple myeloma 7/80 cases (8.8%), colorectal carcinoma 6/80 cases (7.5%), and other malignancies 10/80 cases (12.5%). CD4 lymphocyte count was done using the Partec Cyflow(®) 2000 CD4 cell counter, and their socio-demographic data of the patients were assessed using a questionnaire. RESULTS: The mean (sd) CD4 lymphocyte count pre- and post-chemotherapy was observed to be 567 (341) cells/µLand 349 (207) cells/µL while the median values were 454 cells/µLand 349 cells/µL respectively. There were significant differences in CD4 lymphocyte counts after chemotherapy compared to the pre-chemotherapy values. CONCLUSION: Epirubicin combinations used in breast cancer patients as well as (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) ABVD regimen used in treatment of Hodgkin's lymphoma were found to be significantly less lymphotoxic than other chemotherapeutic combinations. These drugs or their combinations may be less immunotoxic than other known regimen used for these malignancies.
