by Talat Zehra, MBBS, FCPS, Consultant Histopathologist in Pakistan


I passed my fellowship exam of Histopathology about two and a half years ago from the college of physicians and surgeons Pakistan (CPSP). After passing that exam, I joined a lab under the supervision of my senior pathologist along with my teaching job at a medical university. Life was going smoothly; then, all of a sudden, COVID-19 came and transformed into a pandemic around March 2020. All educational institutes closed physically and we moved towards digital tools as new norms of this pandemic. I left my lab job and restricted myself to home. My learning as a junior pathologist was effected badly. I started to think of how to adopt alternative ways to continue my learning in histopathology. Digital pathology appeared to be a ray of hope in the darkness of lockdown and I started to switch to this innovative field which will be the ultimate future of pathology. I joined the Digital Pathology Association about one and a half years ago, along with many other open source organizations which were promoting pathology education through digital tools.


All of these were extremely informative but I wanted to have some hands on practice of digital pathology and AI. However, I was restricted because I did not have the facility of a scanner in my work station. Not only at my work station but facility of a scanner is not available in most of the labs throughout the country. Buying a scanner was not an easy task at all; not only for me as an individual, but also for many organizations of the country. However, I did not lose hope. I just had a microscope connected camera in my university; through which I started making slides digital at different powers on previously diagnosed anonymized cases after taking permission from there ethical boards.


The second step was to implement AI on it which, again, was a challenge. I approached many commercial based international software organizations but was rejected due to the lack of a scanner and the cost of software. I kept on trying and then finally got an organization named Aiforia Oy who not only gave me there demo version, but also gave me one month hands on training. For that I am highly thankful to Aiforia Oy and their customer service manager who patiently supported and trained me throughout the process - all the way from Finland.


I, along with my colleagues, conducted three pilot projects by using AI. These projects include identification of malarial parasite detection on peripheral film, blast cells identification in cases of Leukemia on peripheral film, and identification of chorionic villi in cases of products of conception on H&E images. The results were really appreciating. All of these projects have been published in various journals of Pakistan.


In addition to this great hands on experience, I kept on writing international write ups on various platforms to highlight the issues of delayed adoption in developing parts of the world and also emphasized the potential of big data in these areas which contain more than two-thirds of the worlds population and the bulk of the worlds diseases including tumor cases and also endemic diseases. Therefore, this data must be saved digitally for making disease models, disease trends, and to predict the disease outcome. This, in turn, will open the new horizons of personalized medicine which will be beneficial for all humanity. The role of technology innovators will be crucial.


I also wrote about open source methods for adopting digital pathology and AI without the need of a scanner or purchasing an AI-based software. Though we cannot completely switch towards digitization by using these methods, we can start our journey towards digitization! To this point, I have written around twelve published write-ups on digital pathology and AI and working with various international organizations currently to promote digital pathology in Pakistan.


Then #PathVisions21 was coming and I heard that the DPA was offering a travel award to an individual from a developing country. I filled the application form with the hope that I might get the travel award. Though, for me, it was very difficult to be among all of the applicants. I was extremely surprised when I got the email from DPA that I had been selected as the recipient for the award. I really had no words to express my happiness over this selection. I immediately applied for the visa processing but, unfortunately, I could not get the visa. I became a bit dejected but soon overcome this dejection and continued my routine life. I followed Pathology Visions on the DPA website and got my e-certificate from the DPA. However, I wanted to receive it from Dr. Anil Parwani same as the other recipients. To me it was just a dream came true when I came to know that Dr. Anil was visiting Karachi and would present me with the award in person. We immediately arranged a session for him because we wanted to take maximum benefit from his presence. During his short and busy visit, he gave us an amazing talk on digital pathology which was attended both physically and virtually all over the country. This session came as giant leap in the field of digital pathology in Pakistan and also acceptance of this emerging technology among the pathologists working in Pakistan. Many pathologist joined DPA after that session.


What I learned from this small experience of my journey towards digital adoption is - don’t give up your efforts, believe in yourself, and always remain positive and humble. Success will be yours at the end of the day!




Disclaimer: In seeking to foster discourse on a wide array of ideas, the Digital Pathology Association believes that it is important to share a range of prominent industry viewpoints. This article does not necessarily express the viewpoints of the DPA, however we view this as a valuable point with which to facilitate discussion.