Islamabad, Pakistan
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Taqi A.,Hameed Latif Hospital | Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2013

The journal presents this special issue dedicated to drug errors, with just two aspects highlighted; syringe swap and inadvertent wrong drug administration due to look-alike drug containers. This article gives the background of this decision and a victim's vivid narrative of her terrific experience related to drug error during anesthesia.


Khan T.H.,KRL General Hospital | Khan T.H.,Pakistan Institute of Engineering and Applied Sciences
Anaesthesia, Pain and Intensive Care | Year: 2011

AIMS: The purpose of this study is to provide empirically-based evidence about Pakistani anesthesiologists' job satisfaction, upon which recommendations can be made to physicians, managers, and policy makers. Type of study: A questionnaire based, cross-sectional study. Place & Duration: Islamabad; July 2008-January 2010. Methodology: A questionnaire was designed so as to accumulate evidence about the level of JS, mailed by post to known addresses of all anesthesiologists across the country and was also e-mailed to anesthesiologists via direct e-mailing. All heads of anesthesiology departments of major hospitals were requested to get the questionnaire filled by all the anesthesiologists in their departments. Results: A total of 40 responses were received. Mean age of the respondents was 41.77 years (SD = 10.39) with a range of 27-69 years. Among the respondents, 21(52.5%) were higher diploma holders, 12(30%) were lower diploma holders and 7(17.5%) were postgraduate trainees. The respondents ranged from a professor to PG trainees, including 6(15%) senior anesthesiologists, 27(67.5%) junior anesthesiologists and 7(17.5%) PG trainees. Anesthesiology was the first choice specialty of 19(47.5%). 13 (32.5%) of the respondents repented at some point after joining the specialty. 50% of anesthesiologists were fully satisfied with their job, the great majority of senior consultants were satisfied as compared to juniors 12 (63%) vs. 8(38%). 20(50%) of the respondents were satisfied with the working conditions in the operating rooms. Only 5(12.5%) of the respondents were satisfied with anesthesia fee paid to them as compared to 35 (87.5%), who were not. 36(90%) including a majority of PG trainees (71%) opined that the anesthesia fee should be based on ASA physical status of the patients. 35(87.5%) of the respondents expressed their dissatisfaction about the public awareness about their role in the operating rooms and the healthcare system. The rating of public awareness about their role in operating rooms, intensive care, pain management and resuscitation was 3.52±.28, 2.92±.26, 2.18±.25 and 2.88±.37 respectively on a scale of 1-10. Various measures suggested to improve it included pre-anesthetic rounds (25%) and media talks (37.5%). Others favoured public awareness meetings, television programs + writing article in newspapers and proper legislation etc. 33(82.5%) suggested that PSA could play a role in improving public perception. Conclusion: We conclude that JS in anesthesiologists in Pakistan is low and correlates with low anesthesia fee as well as low public awareness about the vital role played by them in the patient care in the operating rooms as well as other fields e.g. in intensive care setting, pain management and resuscitation. JS can be improved with more attention to improving working conditions, improving fee structure and public awareness about the specialty and the players in this specialty.


PubMed | KRL General Hospital and IBM
Type: Journal Article | Journal: Journal of neonatal surgery | Year: 2016

Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here.This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available. However the method of surgical procedure, progress, complications, and advantages encountered have been highlighted.Presently we have data of 7 patients; others are lost to follow up. Three had died with other associated problems, namely one with multiple atresias, two with septic shock and prematurity. Two stomas did not require formal closure because stoma shriveled and disappeared. Two other stomas had grown very long like a diverticulum when these were closed after 5 and 8 months.This technique is another attempt to decrease morbidity of patients of intestinal atresia especially in those cases where short bowel syndrome is feared after resection of proximal dilated gut.


Muazzam A.G.,Institute of Biomedical and Genetic Engineering | Qureshi S.,KRL General Hospital | Mansoor A.,Institute of Biomedical and Genetic Engineering | Ali L.,Institute of Biomedical and Genetic Engineering | And 4 more authors.
Genetic Vaccines and Therapy | Year: 2011

Background: A recently discovered occult HCV entity reported by various investigators seems to be highly controversial. Especially, the clinical significance of these findings remains uncertain. For optimal outcome of antiviral therapy, investigation of occult HCV needs a broad-based probe in order to investigate the results of viral therapy and its host/viral interaction. The current study was aimed at determining the prevalence of occult HCV in peripheral blood lymphocytes of predominantly genotype 3 HCV-infected patients after completion of antiviral therapy and to investigate long term outcomes in the presence or absence of PBMC positivity.Method: A total of 151 chronic, antiHCV and serum RNA-positive patients were enrolled in the study. Patients with a complete virological response at the end of treatment were screened for the presence of viral RNA in their PBMCs and were followed for up to one year for the presence of serum and PBMC viral genomic RNA.Results: Out of 151 patients, 104 (70%) responded to the prescribed interferon treatment and showed viral-clearance from serum. These were screened for the presence of genomic RNA in their PBMCs. Sixteen samples were PBMC-positive for viral RNA at the end of treatment (EOT). All these patients had also cleared the virus from peripheral blood cells after the 6-12 month follow-up study.Conclusion: True occult hepatitis C virus does not exist in our cohort. Residual viremia at the EOT stage merely reflects a difference in viral kinetics in various compartments that remains a target of immune response even after the end of antiviral therapy and is eventually cleared out at the sustained viral response (SVR). © 2011 Muazzam et al; licensee BioMed Central Ltd.


Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2013

The incidence of transfusion has increased day by day due to many factors, including increasing population, enhanced expertise and facilities to operate once inoperable conditions and the willingness of the public to pay high cost of advanced surgical procedures. Trauma services have been well-organized now and victims may have massive transfusion. Many authors have pointed out the need of protocols and guidelines to be followed to avoid transfusion associated risks and complications. Under-transfusion has been preferred to over-transfusion and a need to have a 'Maximum Surgical Blood Order Schedule' has been stressed.


Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2012

Plagiarism is a universal phenomenon, not strictly restricted to medical writing, but encompassing almost all fields of life. Over a period of time, it has become customary to talk very loudly about it and even condemn it as a sin. A review of the past and present scientific knowledge as well as literature confirms that plagiarism has been and is still in wide practice in developed as well as undeveloped countries. The availability of scientific knowledge on the internet has made it easier to plagiarise as well as to identify plagiarized material. On the other hand much of the research methodology, reviews, discussion pans of original articles and even larger books and monographs do contain parts of copied material from already published material. This editorial review the prevalence of and the measures to control the plagiarism, and stresses a need to draw fresh lines in between good and bad plagiarism.


Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2016

Malignant hyperthermia is a genetically transmitted hypermetabolic syndrome, and thus will always continue to surface and test the wits of the anesthesiologists. This editorial compliments two case reports published in this issue, as well as a brief story on the related topic in the journal's permanent chapter 'My Most Unforgettable Experience'©. The high rate of mortality due to non-availability of dantrolene, and thus the need to chalk out a well-linked system to make dantrolene available even in the farthest corner of the country, with the help of army aviation, when the need arises, is emphasized.


Jadoon H.,KRL General Hospital | Khan T.H.,KRL General Hospital | Ahmed F.,KRL General Hospital | Tasneem S.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2016

We encountered a case of malignant hyperthermia in a 52 year old male undergoing open reduction/internal fixation of humerus fracture under general anesthesia. Isoflurane has been reported as a potent triggering agent of malignant hyperthermia. Dantrolene remains the gold standard for treating this life threatening syndrome but it is not available in many countries including Pakistan. However, we successfully managed our patient by timely recognition of this syndrome and administering prompt and effective symptomatic treatment.


Raza A.,KRL General Hospital | Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2014

Objective: Various supraglottic devices (SGD's) have been used as a conduit for tracheal intubation particularly in difficult airway situations when an endotracheal tube is a must. Various SGD's tried for this purpose include Intubating Laryngeal Mask Airway also called the C-Trach™ laryngeal mask, LMA Fastrach™, air-Q™ intubating LMA and the i-gel™ supraglottic airway. In this study we used air-Q™ LMA and i-gel™ for blind tracheal intubation in patients with normal airways and compared the rates of successful intubation. Methodology: 100 patients were randomly divided into two groups. For Group A, air-Q™ was used for blind tracheal intubation while for Group B i-gel™ LMA was used. Correct placement of ETT was confirmed by capnography. Results: Success rate for blind tracheal intubation through air-Q™ was 82% while that for i-gel it was 54% (p-value 0.003). Conclusion: The success rate for blind tracheal intubation through air-Q™ intubating laryngeal mask airway is higher as compared to that for blind tracheal intubation through i-gel™.


Khan T.H.,KRL General Hospital
Anaesthesia, Pain and Intensive Care | Year: 2015

Pain is usually regarded as of two types, pain caused by tissue damage, also called nociceptive pain, and pain caused by nerve damage, also called neuropathic pain. A less known third category is psychogenic pain, which becomes an integral part, in due course of time, of the first two types. It is pain that is affected by psychological factors. Pain physicians tens to focus usually on the first, less commonly on the second and very rarely on the last type of pain. This ignorance may be the prime factor in failure of otherwise more rational pain management regimen. It needs to be adequately addressed, and expert help from qualified psychologist and/or a psychiatrist may be required in selected patients to incorporate body-mind techniques in the pain management.

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