Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and ...Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and for the staging of many gastrointestinal and pulmonary malignancies. Establishing a EUS program in a developing country presents many challenges. Doing so in Pakistan has led to the identification of the following challenges: initial investment, ongoing costs (particularly fine needle aspiration needle costs), awareness and cytopathology. Endoscopic ultrasonography has revolutionized aspects of the practice of gastroenterology and oncology in the West. This technique is becoming increasingly available in the developing world, where it poses unique challenges to its practice. These challenges include those relating to service initiation and maintenance costs, physician awareness, and onsite cytopathology access. If these issues are anticipated and addressed in ways appropriate to local circumstances, obstacles to the institution of EUS programs can be overcome.展开更多
Colorectal cancer screening has become a defining concern of current gastroenterological practice in many Western nations.This same focus does not exist in many developing countries,including Pakistan.There is a need ...Colorectal cancer screening has become a defining concern of current gastroenterological practice in many Western nations.This same focus does not exist in many developing countries,including Pakistan.There is a need to develop a model for the developing world.Here are several areas that need to be pursued:(1) epidemiological research;(2) physician and public education;(3) training of gastroenterologists,especially female ones;(4) less expensive and more culturally acceptable screening options(fecal occult blood testing); and(5) cost-effectiveness analyses.Gastroenterologists in developing countries need to step up to educate people and promote,where possible and in keeping with local conditions,the prevention and early diagnosis of colorectal cancer.展开更多
In our society and culture where family is of utmost importance,sometimes I wonder how much of a doctor's duty is to the patient and how much is to the whole family.As a medical student,I remember being told by my...In our society and culture where family is of utmost importance,sometimes I wonder how much of a doctor's duty is to the patient and how much is to the whole family.As a medical student,I remember being told by my professors that we should treat the patient as a whole and not focus on just one problem or organ system.Similarly when practicing medicine in Pakistan,one cannot treat the patient alone and ignore the family.How much should relatives' wishes be taken into account when dealing with a patient? Don't patients have a right to their medical information? When,how,and by whom can that right be waived? What role does culture play when debating medical ethics?展开更多
文摘Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and for the staging of many gastrointestinal and pulmonary malignancies. Establishing a EUS program in a developing country presents many challenges. Doing so in Pakistan has led to the identification of the following challenges: initial investment, ongoing costs (particularly fine needle aspiration needle costs), awareness and cytopathology. Endoscopic ultrasonography has revolutionized aspects of the practice of gastroenterology and oncology in the West. This technique is becoming increasingly available in the developing world, where it poses unique challenges to its practice. These challenges include those relating to service initiation and maintenance costs, physician awareness, and onsite cytopathology access. If these issues are anticipated and addressed in ways appropriate to local circumstances, obstacles to the institution of EUS programs can be overcome.
文摘Colorectal cancer screening has become a defining concern of current gastroenterological practice in many Western nations.This same focus does not exist in many developing countries,including Pakistan.There is a need to develop a model for the developing world.Here are several areas that need to be pursued:(1) epidemiological research;(2) physician and public education;(3) training of gastroenterologists,especially female ones;(4) less expensive and more culturally acceptable screening options(fecal occult blood testing); and(5) cost-effectiveness analyses.Gastroenterologists in developing countries need to step up to educate people and promote,where possible and in keeping with local conditions,the prevention and early diagnosis of colorectal cancer.
文摘In our society and culture where family is of utmost importance,sometimes I wonder how much of a doctor's duty is to the patient and how much is to the whole family.As a medical student,I remember being told by my professors that we should treat the patient as a whole and not focus on just one problem or organ system.Similarly when practicing medicine in Pakistan,one cannot treat the patient alone and ignore the family.How much should relatives' wishes be taken into account when dealing with a patient? Don't patients have a right to their medical information? When,how,and by whom can that right be waived? What role does culture play when debating medical ethics?
