DEPARTMENT OF PATHOLOGY
Professor Dipak Shah, MB BS, DCP Baroda (I), DM (Path) UWI
– Head of Department
WORK OF THE DEPARTMENT
For the past several years the Depart-ment has been operating under
continuing budgetary constraints with no
immediate solution to the problem.
Despite the fact that a comprehensive
budget has been submitted we have not
received the allotment.
A review of the Department was
undertaken jointly by UWI and UHWI
and comprehensive report was produced
which was discussed by all the parties
concerned. It was concluded at the time of discussion that UHWI
would contribute 50% of reagents costs towards the budget; however, to
date this has not materialized.
In addition to the continuing constraints of recurrent budget, the
Department is also in need of capital equipment. This is a laboratory
based department which require (and has requested for some time)
equipment to perform the many tests it offers to UHWI patients. The
Department tried to keep the standards for these tests at an
international level but had somewhat fallen in the past few years.
The morale of the staff was at an all time low but they must be
congratulated for their exemplary performance in both quality research
and teaching. We lost one staff member in Anatomical Pathology by
way of resignation but were blessed by the addition of another staff
member in Haematology. The Department has a complement of 19
academic staff. They were actively involved in teaching and research in
addition to diagnostic work. Some staff (Haematology section) do treat
patients as well. Despite the low morale and trying conditions, the per
capita publication of their research work in Refereed peer reviewed and
non-peer reviewed journals was just under one per staff in the year under
review. In addition, they presented their work at various local, regional
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and international conferences which were of extremely high standards
and were well received by the conference attendees.
TEACHING
The Department was heavily involved in teaching Pathology in the MB
BS programme at both Stages I and II. The classes taught at Stage I
during the period under review were classes of 2009, 2010 and 2011.
The number of students in each class was approximately 150, 165 and
170 respectively. The methods of teaching included didactic lectures,
seminars, tutorials and POL’s. Students (Stage II) from the Class of
2007 which approximate 117 rotated throughout the year for clinical
clerkship. The teaching in the clerkship is intensive and is undertaken
by academic staff and residents.
The students at both stages were highly motivated and were satisfied
with the teaching and assessed lecturers and course highly with scores
ranging from 3.8 to 4.9.
The DM programme saw three (3) students (1 from Barbados, 1 from
Dominica and 1 from Jamaica) graduating with DM in Anatomical
Pathology. The Anatomical Pathology programme had two students
one Jamaican and one Barbadian who were in their second year of
training. The Haematology section had two graduate students in their
first year of training.
The academic and resident staff continued to teach courses in basic and
general pathology to students enrolled in the BSc in Pharmacy
(University of Technology), BSc Physical Therapy (UWI) and Diploma
in Radiography (UWI).
STAFF
Dr. T. Gibson who returned to the Department after acquiring MSc in
Medical Genetics from Glasgow, Scotland made progress in trying to
establish a Cytogenetic laboratory which is now awaiting approval from
the Dean of the Faculty of Medical Sciences. Dr. K. Bishop who
returned with her Fellowship in Paediatric Pathology from Toronto,
Canada started work in her area of specialty. The Department has been
enriched by these two young lecturers whose specialty was not
previously available not only in this Department but I believe
throughout the region. Their expertise will also help in both
undergraduate and post-graduate training.
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This Department is one of few in the Faculty where staff members are
actively involved in curriculum development and planning. Dr. E.
Williams was appointed Deputy Chairperson for the Curriculum
Committee. She along with Drs. N.Williams, G.Wharfe, E. Choo-Kang
were active members on the Stage I and Stage II Committees.
Dr.E.Williams also continues to serve on Staff/Students liaison
committee. Professor K. Coard and Dr. E. Williams continued to serve
on theAssessment and Examination Committee and Professor K. Coard
continued to conduct “item writing” workshops, this time for the
academic staff of the Department of Anesthetics and Intensive Care.
She along with Dr. E. Williams also participated in special professional
workshops entitles “What’s New in Item Writing” conducted by
Professor Robert Carroll.
LABORATORIES
Pathology is a laboratory based department which has various
laboratories including surgical pathology, autopsy pathology,
cytopathology, haematology, blood bank and chemical pathology.
These laboratories not only produce various results on various samples
submitted from out-patients and from the patients admitted on the
wards of UHWI but also provides invaluable material for teaching and
research.
A total of 644,060 tests were performed by Chemical Pathology
laboratory and 163,388 by Haematology laboratory. The Blood Bank
collected 3887 units of blood from voluntary donors for the patients
requiring whole blood transfusion or transfusion of various blood
products and a total of 11,492 blood products were manufactured by
them. In addition, the blood bank performed 21,030 tests. The Cytology
Laboratory processed 6,016 pap smears and 846 non-gynaecological
specimens. The histopathology laboratory processed a total of 10,000
surgical cases and produced 30,154 paraffin blocks and a total of 49,660
slides. These included routine H & E stained slides, some special stains
(histochemistry) and some immuno-stained slides including breast
receptor. The unavailability of various monoclonal antibodies precluded
this laboratory to do other more common and routine immunostain to
further identify phenotype of cells. This would help pathologists to cone
down on a specific diagnosis which is important for clinicians to treat
effectively. This was one of the areas where we had fallen down in our
standards.
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The major portion of the recurrent budget is spent on reagents for
thousands of tests performed by the various laboratories on samples
received from UHWI patients. As previously mentioned, the 50%
funding for reagents from UHWI to UWI did not materialize.
The long affiliation (23 years) with the National Cancer
Institute/National Institute of Health (NCI/NIH), Bethesda, USA and
the Department of Pathology for the HTLV-1 project came to an end in
December 2006. Over the period the project gathered and analyzed
data on several aspects of epidemiology, transmission, disease
association and natural history of HTLV-1 both locally and
internationally.
Although field work and data collection on this project has been
concluded, data analysis and publication of data continues in
conjunction with the Viral Epidemiology Branch of the NCI/NIH,
Bethesda, USA. A new project for treatment study protocol was signed
between NIH and this Department. The Principal Investigator for this
project was Dr.Gilian Wharfe.
Although funding for the HTLV-1 Laboratory has ceased from
NCI/NIH, the Flow Cytometry for leukemia patients was done from
departmental funds and immunoassaying lymphoma cases by UHWI
funds.
RESEARCH
Despite the low morale of staff, budgetory constraints, equipment
breakdown, heavy teaching and service load, the department has kept
the practice of producing quality research work. This is borne out by the
number of publications of original work in peer reviewed and non-peer
reviewed journals and presentations at local, regional and international
conferences by the various staff members. The department was honored
by the Principal research award for “Research Project Attracting the
most research Fund.” This was for the HTLV-1 research project
(Principal Investigator Professor Barrie Hanchard)
The staff produced 18 original publications in peer and non-peer
reviewed journals and presented 20 papers at various local, regional and
international conferences.
The staff is actively involved in research work despite all odds. Although
the HTLV-1 project has come to an end, the treatment protocol has
been continuing with the Principal Investigator Dr. GilianWharfe. The
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other research being persuaded includes prostate cancer,
neuropathology, immunology, breast cancer, HPV-DNA Studies,
medico-legal autopsies, aspiration cytology, HTLV-1 associated
diseases, nephropathology, gastrointestinal disease, Haemophilia, Blood
ordering audit, treatment trial in ATL, hysterectomy and osteoporosis,
fibroids and renal failure, renal and liver Cadmium concentration study.
PAPERS PRESENTED
Hanchard B.
• “Clinical Outcomes of HTLV 1 Infection” The Infections Basis
of Cancer - Pathogenic Insights and Therapeutic Opportunities
Symposium, September 2007.
• “HTLV-1 in Jamaica” Advancements in Medicine – A US and
Caribbean Perspective Conference, Runaway Bay, February
2007
Coard KCM.
• “Cancer in the Caribbean” New Approaches to Cancer
Chemoprevention – Ross University School of Medicine,
Dominica, 28th Research Day Conference, October 2006.
• “AReview of Granular Cell Tumours at the University Hospital
of the West Indies: 1965 to 2006”, 52nd Scientific Meeting of
the Caribbean Health Research Council, Montego Bay,
Jamaica, April 2007.
Escoffery CT.
• “Borderline tumours of the ovary: Pathologist’s perspective”,
12th Annual Symposium of the Jamaican Association of
Clinical Pathologists, Kingston, Jamaica. November 2006.
Williams, Elaine
• (with Joseph Branday, Annette Crawford-Sykes, and Donna
Beman). “The Administrative Challenge of New Curricula in
Old Medical Schools”, 7th Annual conference, Association of
Caribbean Higher Administrators (ACHEA) Barbados, July
2007.
N. Williams
• (with H. Fletcher, S. Mitchell, FI Bennett, D. Simms-Stewart,
P. Scott, G.Wharfe and RJWilks): Difference in cardiovascular
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risk profile and osteoporosis in Jamaican black women with
surgical and natural menopause. Caribbean Health Research
Council 52nd Annual Council and Scientific Meetings,
Montego Bay, Jamaica, May 2007.
• (with Robert Riddell, and Trevor Seaton): “A Clinical
Potpourri in Gastroenterology” Association of West Indian
Gastroenterologists, 21st Annual Meeting and International
Postgraduate Course 2007, San Jose, Costa Rica, June 2007
• “H Pylori: Is it just a pain in the gut, or is it something serious”
Association of West Indian Gastroenterologists Mini-
Symposium, San Jose, Costa Rica, June 2007.
Shirley SE.
• (with Sinclair PA, Stennett MA, Codrington G, Bhatt R and
Escoffery CT.) “The Pathology of Breast Cancer in Jamaica:
The National Public Health Laboratory Study” 15th Annual
Research Conference, Faculty of Medical Sciences, UWI,
Mona, November 2006.
Jaggon, J.
• “Meningioma: A ten year experience at the University Hospital
of the West Indies 1994-2003 – Caribbean Neurosciences
Symposium 2007, Montego Bay, Jamaica
Wharfe G.
• “Fertility and Cancer” Jamaican Association of Clinical
Pathologist Meeting, Kingston, November 2006
• “Treatment for head and neck cancer” Otolaryngology section
Meeting, Texas, USA. November 2006
Lowe D.
• (with Adams P.) “Haemophilic Arthropathy – Prevention and
Cure”, UWI Clinicopathological Conference (World Haemo-
philia Day), University Hospital of theWest Indies, April 2007.
• “Familial Extra intestinal GIST – Case Report”, Annual
Research Symposium, Department of Surgery, Radiology,
Anaesthesia and Intensive Care, University Hospital of the
West Indies, May 2007.
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• “An Update in the Management of Cutaneous T-cell
Lymphomas”, Dermatology Association of Jamaica, Annual
Symposium, Kingston, September 2007.
McGrowder, D.
• “Assessment of iron status in patients with cystic fibrosis using
soluble transferring receptor.” 15th Annual Research
conference andWorkshop on Drug Development from Natural
Products: Past, Present and Future, UWI, Mona Kingston,
Jamaica, November 2007.
• “The Importance of Accreditation to Jamaican Laboratories”,
GOJ/SIDA ISO/IEC 15189 – Standard for Medical
Laboratories Training Workshop and Implementation
Programme, Medallion Hall Hotel, Kingston, Jamaica.
• “How Prepared is Medical Laboratories in Jamaica for
Accreditation?” Laboratory Accreditation Meeting Caribbean
Epidemiology Centre, (CAREC/PAHO/WHO) Port of Spain,
Trinidad, June 2007.
PUBLICATIONS
Refereed Journals
WIMJ = West Indian Medical Journal
* Chaturvedi AK, Wilson M, Sanders-Lewis KA, Kati HA,
Urquhart N,WaltersMA,MileyW,Cranston B, Hanchard B,
Hisada M, “Hematologic and biochemical changes associated
with HTLV-1 infection in Jamaica: a report from the
population-based Blood donors Study” Clinical Infectious
Diseases 2007.
* Fletcher H, Wharfe G, Williams E, Hanchard B, Mitchell D,
“Multiple metachronous malignancies, one patient with three
primary malignancies: a case report” Journal of Medical Case
Reports May 2, 2007;1:15
* Goedert JJ, Li HC, Gao XJ, Chatterjee N, Sonoda S, Biggar RJ,
Cranston B, Kim N, Carrington M, Morgan O, Hanchard B,
Hisada M. “Risk of human T-lymphotropic virus type I-
associated diseases in Jamaica with common HLA types”
International Journal of Cancer Sept. 1, 2007; 121(5):1092-7
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* Tseng FC, Brown EE, Maiese EM, Yeager M, Welch R, Gold
BD, Owens M, Cranston B, Hanchard B, El-Omar E, Hisada
M. “Polymorphisms in cytokine genes and risk of Helicobacter
pylori infection among Jamaican children”, Helicobacter Oct.
11, 2006 (5):425-30.
* Maloney EM, Yamano Y, Vanveldhuisen PC, Sawada T, Kim
N, Cranston B, Hanchard B, Jacobson S, HisadaM. Journal of
Infectious Diseases Sept. 1, 2006; 194(5):552-60
* Horace Fletcher, Gilian Wharfe, Elaine Williams, Barrie
Hanchard, Derek Mitchell, “Multiple metachronous
malignancies, one patient with three primary malignancies: A
case report”, Journal of Medical Case Reports, 1-5 (2007)
May.
* Coard K, “Primary Tumors of the Heart: Experience at the
University Hospital of the West Indies” Cardiovascular
Pathology 16; (2007) 98-10.
* Coard K, Plummer J, “Massive Multilocular Cystic
Leiomyoma of the Uterus: An Extreme Example of Hydropic
Degeneration” Southern Med. J. 100; (2007 309-312.
* McCaw-Binns A, Alexander SF, Lindo JLM, Escoffery C,
Spence K, Lewis-Bell K, Lewis G. “Epidemiologic transition in
maternal mortality and morbidity: New challenges for
Jamaica.” International Journal of Gynecology & Obstetrics
96: (2007) 226-32.
* Duncan ND, Gabay L, Williams E, Dundas SE, Plummer N,
Leake PA, “Hermaphrodism: “Cytogenetics, Gonadal
Pathology and Gender Assignment: A Case Report” WIMJ,
Vol. 55, 6 (2006) 430-433
* Barrett K, McGrowder D, Brown P, Ragoobirsingh D,
“Increased PC -1 phosphodiesterase activity and inhibition of
glucose uptake in adipocytes of type 2 diabetic rats”Molecular
and Cellular Biochemistry 293 (2006)1-2:9-14
* Kahalid S, McGrowder D, Kemp M, Donovan J, “The
usefulness of sTfR in assessing iron status in cystic fibrosis
patients” Clinica Chimica Acta 378 (2007)1-2: 194-200.
* Rainford Wilks, Novie Younger, Jasneth Mullings, Mamvar
Zohoori, Peter Figueroa, Marshall Tulloch-Reid, Trevor
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Ferguson, Christine Walters, Franklyn Bennett, Terrence
Forrester, Elizabeth Ward and Deanna Ashley, “Factors
affecting study efficiency and item non-response in health
surveys in developing countries: the Jamaica national healthy
lifestyle survey. BMC Medical Research Methodology, 7:13
(2007)
Refereed Journals
* Dupuis C, Coard, K, “A review of Granular Cell Tumours at
the University Hospital of the West Indies; 1965 to 2006.
WIMJ. 56 (Suppl 1) 54: 2007.
* Gibson TN, Shirley SE, Escoffery CT, Reid M, “Discrepancies
between Clinical and Postmortem Diagnosis in Jamaica: An
Evaluation of Clinical Overdiagnosis” Internet Journal of
Pathology 6; 2 (2007).
* Shirley SE, Sinclair PA, Stennett MA, Codrington G, Bhatt
R, Escoffery CT. “The Pathology of breast cancer in Jamaica:
the National Public Health Laboratory Study. WIMJ, 55
(Suppl.) 27 (2006).
* Brooks A, Wharfe G, Pedican M, Fletcher H, Williams N,
“Fatal Pulmonary Embolism in Jamaican Women: A five year
review of Post Mortems at UHWI “ WIMJ, (Supp 4) 55:32
(2006)
* Fletcher H, Mitchell S, Bennett F, Simms-Stewart D, Scott P,
Reid M, Williams N, Wharfe G, Wilks R, “Difference in
Cardiovascular disease risk profile and Osteoporosis in
Jamaican black women with surgical and natural menopause.”
WIMJ, (Suppl) 56:40 (2007)
PUBLIC SERVICE
Professor B. Hanchard
– Board Member, Jamaica Cancer Society
Professor K. Coard
– Treasurer, Caribbean Cardiac Society
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– Chairman, Research Grants Awards Committee, Caribbean
Cardiac Society
Professor D. Shah
– Deputy Chairman, Council, Profession Supplementary to
Medicine, Ministry of Health
– Cytopathology Consultant, Jamaica Cancer Society
Dr. E. Williams
– Cytopathology Consultant, Jamaica Cancer Society
Dr. N. Williams
– Executive Member, UWI Medical Alumni Association
– Member, UWI Mentorship Programme
Professor C. Escoffery
– Cytopathology Consultant, Jamaica Cancer Society
Dr. T. Gibson
– Cytopathology Consultant, Jamaica Cancer Society
Dr. J. Jaggon
– Cytopathology Consultant, Jamaica Cancer Society
Dr. L. Buchner
– Board Member, Penwood Dental Clinic
Dr. J. Taylor-Houston
– Member, Leukaemia Care Foundation
Dr. D. McGrowder
– Member, Asian Journal of Biochemistry
– Member, Trends in Medical Research
AWARDS
Principal’s Research Award for the “Project Attracting the Most
Research Funds” for “Research on Epidemiology of HTLV-1 in
Jamaica”. Hanchard B, Wharfe G, Williams N, East-Innis A, Williams
E, Cranston B. Research Day 2007.
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