Anesthesia Department and ICU

INTRODUCTION

Anesthesia Department of Sheikh Zayed Medical College/Hospital Rahim Yar Khan is a tertiary care center providing medical services for Southern Punjab and adjacent areas of Sindh and Balochistan.  It is one of the largest clinical departments of this hospital catering the patients more than its capacity i.e. more than 70% of the hospital load and is involved in teaching and training of undergraduates as well as Post-graduates to international standards and highest ethics of medical profession. Department was started with 2 operation theatres & manpower of 5 anaesthetists which is now expanded to 20 OTs, 3 ICUs with 26 beds, 11 beded recovery rooms, a pain medicine unit and a total manpower of 62 Anaesthetist.

Date of Recognition:

• Date of Recognition of Department with PMDC 03-01-2022
• Date of Recognition of Department with UHS 09-07-2018
• Date of Recognition of Department with CPSP 31-12-2009

HEAD OF THE DEPARTMENT

DR.  SAIRAH SADAF

HEADS OF DEPARTMENT:

• Sairah Sadaf                                2019 to Date
• Abdul Majid Khan                       2018-2019
• Mohammad Anwer Rehan        2015- 2018
• Haq Dad Durrani                         2013-2015
• Dr. Khalid Javed Butt                  2010-2013
• Haq Dad Durrani                          2009-2010
• Mohammad Anwer Rehan        1992-2009
• Dr. Muhammad Ali Bukhari       1984-1992

FACULTY OF DEPARTMENT

Sr. No.	NAME	DESIGNATION	Photograps
1	Dr. Sairah Sadaf	Associate Professor/HOD
2	Dr. Zeeshan Khan	Assistant Professor

TEAM OF CONSULTANTS

FACULTY AND STAFF

DEPARTMENT OF ANESTHESIOLOGY, ICU & PAIN MEDICINE

ORGANIZATION OF ANESTHESIA DEPARTMENT

CLINICAL SERVICES

Detail of Operation Lists                                        

ICUs

10 MOST COMMON PROCEDURES/CASES LAST 12 MONTHS

ADVANCE EQUIPMENT

STATISTICS

ANAESTHESIA DEPARTMENT IS RUNNING FOLLOWING “DEGREE/DIPLOMA PROGRAMS”

• Sc (Hons.) Operation Theatre Technology 4 Years Degree Program
• MCPS 2 Years Degree Program
• FCPS 4 Years Degree Program
• MS-Anaesthesia 5 Years Degree Program
• Diploma in Anaesthesia (D.A) 2 Years Degree Program

ACADAMICS

UNDERGRADUATES:

• 4^th Year MBBS
• BSc. (Hons.) Operation Theatre Technology

POSTGRADUATES:

• MCPS
• FCPS
• DA
• MS Anesthesia

ASSESSMENT& FEEDBACK

Undergraduates:

• MBBS 4^th year:
• At the end of session through MCQs.
• Hands-on BLS

• Sc OTT:(MCQs, SAQs)
• 1^st Term: after summer break
• 2^nd Term: after winter break
• Send-Ups: one month before final exams.

Post graduates:

• Theory:
• Class tests (MCQs/SAQs)
• Assignment based
• Clinical:
• Mini-CEX / OSCE (end of year)
• Procedures check-lists (frequent)
• General Performance:
• Log book entries
• Performance-register entries

FEEDBACK:

• Google feedback performa for difficult cases for PGs
• CPSP e-portal PGR performa
• MS students feedback performa

POST GRADUATE TRAINEES

DEPARTMENT OF ANESTHESIOLOGY, ICU & PAIN MEDICINE

SHEIKH ZAYED MEDICAL COLLEGE/HOSPITAL, RAHIM YAR KHAN

Trainees under Supervision of Dr.  Sairah Sadaf (ANS-S-110-232)

(Associate Professor)

(01-12-2014)

PREVIOUS RESIDENTS

FACULTY DEVELOPMENT

Workshops attended by the faculty members during 2012-2021.

• Dr. Sairah Sadaf

• Basic ICU course by Ministry of national health services, Regulations & Coordination (Health services Academy)
• CHPE/ICMT by CILT
• Online course of Medical writing & Biostats (UHS)
• Online course of “SPSS made easy” (BRESC)
• Online course of advanced Biostatistics and SPSS (UHS)
• 13^th SAARC AA International Anesthesia Conference 2019

• • ACLS (AHA)
  • BLS (AHA)
  • 17th Annual Conference of Anesthesiology & Critical Care
  • 8th Annual Convergence of Pain Management.
  • Medical Writing Organization by UHS & Pakistan Association of Medical Auditors, Health Research Advisory Board.
  • Key Concepts in the Medical Education, Educational Leadership & Professionalism.
  • Key Concepts in the Emerging Trends in Curriculum Development.
  • Workshop on Dengue Awareness.
  • Workshop on management of Dengue Shock Syndrome.
  • Education Planning & Evaluation.
  • Assessment of competence
  • Research Methodology & Biostatics
  • ACLS

• Dr. Zeeshan Khan
  • Education Planning & Evaluation.
  • Research Methodology & Biostatics.
  • Workshop on Dengue Awareness.
  • Workshop on management of Dengue Shock Syndrome.

• Dr. Amjad Siddique
  • Education Planning & Evaluation.
  • Research Methodology & Biostatics.
  • Workshop on Dengue Awareness.
  • Workshop on management of Dengue Shock Syndrome.

• Dr.  Abdul Majid Khan
  • Critical Care and Nutrition Conference Zurich, Switzerland June 2011.
  • Critical Care and Nutrition Conference Germany.
  • Critical Care and Post Surgery Conference Shanghai, China July 2012.
  • Critical Care and Nutrition in ICU Patients Conference Dubai August 2013.
  • Anesthesiology and Intensive Care Conference Istanbul, Turkey June 2013.
  • Smile Train Cleft Lip and Cleft Palate International meet Jalandhar, India April, 2013.
  • Anesthesia for Gynae and Obs. Madina Munawara, Saudi Arabia March 2013.
  • Intensive Care Conference Bangkok, Thailand 2013.
  • Intensive Care Conference Brisbane, Australia March, 2015.

DEPARTMENTAL LATEST ACHIEVEMENTS

• Establishment of Dry skill lab.
• Establishment of Medical Research Wing & CME
• Establishment of  20 bedded ICU for Infectious diseases
• Establishment of Pain Medicine
• Accreditation for M.S. Anesthesiology and Diploma in Anesthesiology by UHS (University of Health Sciences.
• Two new developments have taken place. Department of Cardio-Thoracic Surgery with 02 operation rooms and 04 bedded Cardiac ICU has started working for cardiac illness patients. CABG with beating heart is a great achievement & this was a breakthrough in providing highest standards of medical as well as surgical services to the ailing humanity.
• A new 08 bedded ICU was made working in Emergency under Anesthesia Department.
• 1st Central Supply of Liquid Oxygen was made available in 2012 this was a breakthrough for Sheikh Zayed Medical College/Hospital, Rahim Yar Khan by which whole of the hospital was facilitated.
• 2^nd Central Supply Liquid Oxygen was made available in 2015 for Emergency Department, Operation Theatres & ICUs.
• Day Care Surgery Room for OPD surgical procedures was also made available in Phase-II. Which is fully equipped with routine & emergency equipments & monitors.

FUTURE PLANS

• Establishment of Difficult airway management Teams
• Establishment of skill Lab. With Advanced gadgets.
• Establishment of CSSD
• Expansion of exiting ICUs

MEDICAL RESEARCH WING

Organization:

• Sairah Sadaf
• Zeeshan Khan
• Amjad Siddique
• Alina Zafar
• Mubashir Javed

Research/publication:

Publication in credit of;

• Sairah Sadaf Associate Professor                          

1. Original article “Comparison of I-Gel and LMA classic in Anesthetized, spontaneously breathing patients during elective surgical procedures” is published in “Apicare journal”. (2013).

1. Original article “Comparison of Supraclavicular and Infraclavicular Subclavian venous catheterization in a tertiary care hospital” is published in “Journal of Sheikh Zayed Medical College”. (2013)
2. Original Article “Pediatric surgical patients; Comparison of the effects of balanced salt solution with 1% Dextrose & pead’s solution on blood glucose& sodium levels intra-operatively” is published in The Professional journal of Medical & Health Sciences. (2015)
3. Original article “A study to compare effects of shoulder position on infraclavicular central venous catheterization in critically ill patients”, is published in The Professional journal of Medical & Health Sciences.(2020)
4. Original article “Factors resulting in underutilization of pediatric spinal anesthesia in South Punjab (Pakistan)” published in Apicare journal, (2020)
5. Original article “Comparison of effects of Tocillizumab and Standard of care on the outcome of covid-19 patients in critical care: a retrospective cohort”. published by Apicare journal. (2021)

1. Editorial Review “Vitamin D Deficiency—Still A Dilemma!” is published in Apicare journal. (2019)
2. Review article on “Drugs in Anesthesia & Intensice Care” 5th Edition by Oxford publications, is published in Apicare journal. (2016)
3. Original article “Depression, Anxiety and stress among Healthcare workers in COVID-19 ICUs” is under review in Apicare journal. (2022).
4. Original article “Effectiveness of Non-Invasive vs. Invasive Ventilation in Acute Hypoxic Respiratory Failure in COVID-19 Patients in Critical Care: A Retrospective Cohort in Rahim Yar Khan published in “Pakistan Journal of Medical Research”. (2021)
5. The effect of Local Tramadol Infiltration in Post Pyelolithotomy pain published in The Professional Medical Journal. (2021)
6. Outcome of Covid-19 related ARDS patients at a Tertiary Care Hospital published in “Pakistan Journal of Medical Research”. (2022)

• Zeeshan Khan Assistant Professor                          

1. Comparison between paracetamol vs voltral suppositories for post operative pain in gynaecological procedures.
2. Efficacy of Dexmedetomidine vs Morphine as an adjunct in a paravertebral Block with bupivacaine in postoperative Analgesia following modified radical mastectomy.
3. Comparison of Dexamethasone with ondansetron for prevention of postoperative Nausea and vomiting.
4. Comparison study of IC Fentanyl versus IV paracetamol for Pain relief in Postoperatively after Cardiac Surgery.
5. Comparison of Supraclavicular vs Intraclavicular subclavian venous catheterization in a tertiary care hospital.
6. Evaluation of glottis visualization and ease of intbation at induction of general anesthesia: A comparison between macintosh and mccoy Blade laryngoscope.
7. Determine the effectiveness of Nulbuphine with Ropivacaine in supraclavicular Brachial plexus block.
8. Prevention of emergencies agitation with dexmedetomidine in patients undergoin nasal surgery under anesthesia with desfluance
9. Comparison of ultrasound guided femoral nerve block with adductor cannal block for analgesia after total knee replacement.

• Amjad Siddique Assistant Professor                          

1. Factors Resulting in Underutilization of Pediatric Spinal Anesthesia in South Punjab (Pakistan)
2. Covid-19 Pandemic and Chronic Pain Management: Impact and Suggestions.
3. Hypothesis: Dexmedtomidine is Superior than opioids in alternating stress response and in reducing in mac Value of inhalation agents.

• Abdul Majid Khan

1. A comparison of Efficacy of Supracalvicular versus Infraclavicular Subclavian venous Catheterization in a Tertiary Care Hospital.
2. Comparison of L.M.A. Classic and I-Gel in Anesthetized Spontaneously Breathing Patients during Elective Surgical Procedures.

PGRs Research Work:

• Comparison of Pain Relief of Bupivacaine With Dexmedetomidine and Bupivacaine Alone in Transversus Abdominis Plane Block For Postoperative Anelgesia in Patients Undergoing Abdominal Surgeries. (Dr. Alina Zafar)

• Comparison of Epidural Dexmedetomidine and neostigmine as adjuvants to bupivacaine used for lower Limb surgeries alone and in combination.                       (Dr. Mubashir Javed)

• Comparison of Sedative Effects of Dexmedetomidine and Midazolam For TIVA In Children Undergoing Inguinal Hernia Repair. (Dr. Barzah Durrani)

• Sedating effects of dexmedetomidine vs midazolam in icu in agitated patients undergoing weaning.(Dr. Momal Jaleel Khan)

• Efficacy of i/v lignocain vs i/v nalbiphine for attanuation of stress response during laryngoscopy and intubation in middle age patient planned for thyroidectomy. (Dr. Amna Sarwar)

• Comparison the efficacy of intravenous dexemetomidine, tamadol and ketamine for control of post spinal shivering in obstetric patients undergoing lower segment C-Section. (Dr. Obaid-ur-Rehman)

• Comparison of upper lip bite test and modified mallampati score in difficult airway assesment in obstetric patients undergoing general anesthesia.(Dr. Maria Ikram)

• Comparison of Dexmedetomidine and Midazolam for Sedation In patient Undergoing Weaning in Intensive Care Unit.(Dr. Nazish Syed)

• Video laryngoscopy versus conventional laryngoscopy in anticipated difficult intubation in thyroid surgery patients.(Dr. Saima Batool)

• Comparison Of Predictive Values Of Mallampatti Score And Upper Lip Bite Test For Tracheal Intubation In Adult Surgical Patients Undergoing General Anesthesia.              (Dr. Aliya Afzal)

UNDERGRADUATE RESEARCH WORK:

• Pre-operative anxiety among adult patients undergoing elective surgeries at Sheikh Zayed Hospital RYK.

• Prevalence of hypertension in surgical patients during pre-operative period.

• Comparison of frequency of headache post-operative backache, nausea, vomiting after spinal anesthesia in obstetric patients and non-obstetric patients during post operative period.

• Comparison of propofol injection pain in large antecubital vein versus small vein on dorsum of hand in patient undergoing general anesthesia.

• Comparison of complications at induction of emergence in surgical pediatric patients receiving IV Atropine versus Glycopyrolate.

Recent advancements:

• USG Nerve Blocks is started under supervision of Dr. Amjad Siddique (Consultant Anaesthetist) and Dr. Sairah Sadaf (HOD).