Neurosurgery Department at JPMC
JPMC has the only Neurotrauma Center in
Pakistan with two OTs providing 24 hour service
Last year 42,114 patients were seen in the OPD with 3700 admissions
and 1400 surgeries were performed
KARACHI: Jinnah Postgraduate Medical Center the premier postgraduate medical institution of the country has one of the busiest Neurosurgery Department providing tertiary care facilities. It has the only Neurotrauma Center in Pakistan with two Operations Theaters which provides 24 hour service. During the last year 42,114 patients were examined in the OPD while 3,700 patients were admitted and fourteen hundred surgeries were performed. It has a 6-Bed Intensive Care Unit with monitors and ventilators besides twenty beds in the High Dependency Unit (HDU). The staff consists of two professors Dr. Raza Zaidi, Dr. Lal Rehman, one assistant professor, two medical officers, fifteen postgraduates and twelve House Officers. Since, the fate of JPMC has not yet been finally decided whether it will remain a federal institution or provincial government will run and manage it, there have been no fresh inductions in staff for the last many years with the result that it is not only affecting the patient care but has also checked its growth and development.
Prof. S. Raza Khairat Rizvi
Department of Neurosurgery at JPMC once used to be headed by world renowned neurosurgeon Prof. O.V.Jooma who was succeeded by another eminent neurosurgeon Prof. I.H.Bhatti who did a lot to improve and expand the services available. Later Prof. Rashid Jooma who headed the department and also became Director of JPMC managed to get a PC-! Approved for an Institute of Neurosurgery at JPMC. He also persuaded the Rangoonwala Trust to provide funding and they constructed a multistory building at a cost of rupees eight crore and handed it over to JPMC in 2008 where the Department of Neurosurgery is now located on three floors of this building which also houses the Cyber knife facility. Dr. Raza Zaidi, current Professor and Head of the Dept. was earlier working at Ziauddin Hospital. He joined the department in 2011 and in 2013 he was promoted as Professor and Head of the Department.
Prof. S. Raza Khairat Rizvi told Pulse International that about four hundred admissions are made every month and during the last two months, one hundred ninety eight elective and emergency surgeries were performed. Since now we have our own anesthetist, it has increased our workload. Patient’s Aid Foundation which had contributed a lot for the development of JPMC has helped the Neurosurgery Dept. as well and was providing nine lac rupees assistance per month. This funding is used to pay for the salary of anesthetist, ventilator nurse, junior nurse, nursing assistant, Chowkidar, Security Guard and sweepers as no appointments against vacant posts could be made by the government due to court cases. The department has a busy postgraduate training programme which is evident from the fact that during the last three examinations of the CPSP ten PGs have passed their FCPS. It is for the first time that we have been able to enroll full strength of postgraduates and now sixteen PGs are under training, Dr. Raza Zaidi added.
There are twelve beds in the Intensive Care Unit, six male and six female but since there is always overflow of patients, arrangements have been made to accommodate another twelve male and twelve female patients. The ICU is fully air-conditioned. We have three Operations Theaters; two have general anesthesia and one has local anesthesia facilities. Until the fate of the JPMC is finally decided, with the help of Patient’s Aid Foundation, other donors and philanthropists, we are doing our best to keep the department running and also keep on adding and expanding the facilities available. With the public private partnership we have added a 75-seating capacity conference room. We have daily morning meeting here while on alternate day we have teaching programme which is attended by the senior faculty. Postgraduates are also trained for mock exam which has helped them a lot and they all passed.
Rangoonwala Trust which had gifted this building has now stopped providing further assistance saying that they do not invest in services. This has created some financial crisis for the department. Prof. Rashid Jooma invited them recently and persuaded them to continue the financial assistance for another six months to which they have agreed but we desperately need some donors who could provide us some Endowment Funds, Prof. Raza Zaidi remarked.
The department is spread on three floors. On the first floor there is an 18-bed female ward where elective and cold cases requiring surgery are admitted. Paediatric ward has seventeen cots. There are 25-beds in the Male Ward on second floor. The total number of beds in the wards including ICU, HDU and in Emergency comes to 140. Intensive Care Unit requires monthly expenditures of about three lacs and at present we are generating all this from donations. With the improvement of facilities, our mortality figures have also improved Prof. Raza Zaidi stated. Neurosurgery always has a very high mortality figures because of the serious head injuries which come to the department. Last year we had over forty two thousand patients and eight hundred thirty patients expired. Now last month we had just fifty two deaths as compared to the monthly mortality of about seventy eight. We have been able to control this mortality figures because now we have trained staff and they are private staff not paid by the government but by the Patient’s Aid Foundation. They do not mind even working for longer hours.
On the ground floor where the OPD is located, there are 25-beds in High Dependency Unit apart from the 6-beds in ICU. It is also fully air-conditioned with central monitoring and oxygen supply. This was also built by Patient’ Aid Foundation. OPD is fully computerized and record of all the patients is preserved. There are three consultant rooms in the OPD and in future we also plan to have a Pharmacy here so that the patients are provided drugs and medicine here instead of referring them to the hospital pharmacy. We have twelve ventilators out of which eight are not working at present.
Giving further details about the facilities available Prof.Raza Zaidi said that in the Operation Theater we have endoscope, neuronavigator, stereotactic instruments and equipment, microscopes, CUSA i.e. Computerized Ultrasonic Aspirator but unfortunately CUSA is not yet installed, hence it was not functioning. The reason being that the supplier has refused to install it as his guarantee money was returned. But we are after him. This was purchased in 2008 at a cost of eighty five lac rupees. Once this is installed, it will become much easier to do biopsy of deep seated lesions. At present we are doing it with the old system. Prof. Rashid Jooma, Dr. Raza Zaidi remarked had played a vital role in the uplift and modernization of this department and having a proper Department of Neurosurgery while previously it was located in a ward in the old OPD building. Now we have installed close circuit TV in the department and we can monitor the whole ward. Intercom system has also been installed so that every member of the staff is easily accessible. Prof. Rashid Jooma is also the project director of Road Traffic Injury Research and Prevention Center which has compiled lot of useful data helping the authorities to take measures which could reduce head injuries. Prof. I.H.Bhatti visits the Department whenever he is invited while Prof. Rasheed Jooma visits the department regularly.
Asked about the future plans Prof. Raza Zaidi said that we intend to name the Conference Room in the name of late Prof. O.V. Jooma. We are also planning to name one Ward as Prof. O.V.Jooma Ward and another as Prof. I.H.Bhatti Ward while the Operation Theater Complex will be named as Prof. Rashid Jooma OT Complex. This is being done to recognize the services which these eminent personalities have rendered to plan, equip, expand and modernize the neurosurgery facilities at Jinnah Postgraduate Medical Center. We also plan to establish a 20-Bed Ward for vegetative patients. Our objective is to train the family members of these patients here for ten to twelve days and then discharge these patients so that they can be better cared at home. However, it needs a major investment of about one crore rupees. It will have monitors, fully air-conditioned with false ceiling and tiles. Prof. Raza Zaidi hoped that some donor, philanthropist will come forward and contribute something for this noble cause.