Colorectal Diseases Unit starts functioning at Civil Hospital Karachi affiliated with DUHS

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Colorectal Diseases Unit starts functioning
at Civil Hospital Karachi affiliated with DUHS

Project located in Surgical Unit-5 has been renovated
and equipped at a cost of 7.5 Crore rupees

KARACHI: Keeping pace with the new era of specialization, Surgical Unit-5 at Civil Hospital Karachi located on the third floor has been designated as General Surgical Unit with focus on Colorectal Diseases. The project has been completed and the unit renovated, equipped at a cost of 7.5 Crore rupees. This is reported to be the first such dedicated unit for colorectal diseases at a public healthcare facility in the country. According to Prof. Amjad Siraj Memon who is heading this unit, he conceived this project in 2009 and requested the DUHS administration which issued a notification to this effect the same year. The scheme was prepared and submitted for funding along with some other projects at CHK to the authorities two years ago and it has now been completed. It was formally commissioned on February 17th 2014. This function was attended by Vice Chancellor DUHS, Principal Dow Medical College, Medical Superintendent and Sindh Health Secretary besides some philanthropist and faculty member.
This unit has designated areas for both males and females with high dependency unit in addition to routine surgical set up. Total bed-strength of the unit is forty five of which twenty five will be for general surgery and about twenty will be for colorectal diseases. The unit has all new beds with fiber side tables, trolleys. It has LCD lights which provide more light with no choke and starter. Following investigation facilities are currently available in the unit:

* Diagnostic and Therapeutic upper and lower GI endoscopies
* Endo-Anal Ultrasound
* Anorectal Endoscopy
* Capsule Endoscopy

The procedures which are being performed include the following:-

* Injection Sclerotherapy and Band Ligation of Piles
* Video-Assisted Anal Fistula Treatment (VAAFT)
* Doppler Guided Haemorrhoidal Artery Ligation + Recto-Anal Repair (DHAL+RAR)
* Advanced GI Stapled Anastomosis
* Laparoscopic and Open:
* Colorectal Benign and Cancer Surgery
* Ulcerative Colitis surgery with ileo-anal pouch
* Surgery for Rectal Prolapse (abdominal/perineal)
* Simple and Complex Anorectal Fistula Surgery.

Prof. Amjad Siraj was of the view that with increasing awareness about the diseases among the patients some of whom know much more about their diseases, they demand specialized care. So far most general surgeons have been performing colorectal surgeries as and when required but now it is time that one should take up a particular specialty, get referred patients in that particular area so that with increased workload, the results become better decreasing morbidity and mortality besides complications. Hopefully now when we have provided this service, other surgical colleagues will start referring patients suffering from colorectal diseases to this unit. Hence, in the days to come we will be training surgeons in this particular sub-specialty.
Apart from the Professor’s office, one of the rooms has three cubicles with computers and internet facility for one Associate and two Assistant Professors in the unit. A digital library with internet connection has been provided in the Ward Library so that the faculty members, postgraduates and other trainees can do the literature search and conduct research without having to go to the main library in the university. There are separate male and female duty rooms with two beds for them to relax besides a General RMO office for administrative work. There are separate Bath Rooms for male and female patients. The whole unit including the floor has been tiled, walls plastered again before electrical fittings and fixtures were installed.
There is a central Nursing Station with counter and computers to order drug supplies for the patients for twenty four hours. The drugs requirement is indented through computerized system and then someone goes from the Ward and gets it collected. IT people have trained the nurses for this purpose. Similarly blood and other samples are collected in the ward, ordered for investigations through computerized programme and once the main laboratory gives the identification, it is marked and someone then delivers all the samples in the Laboratory. The reports come through the computerized system. Similarly through digital X-ray, the images can also be accessed in the unit. Thanks to Prof. Saeed Qureshi, Medical Supdt. Of Civil Hospital Karachi who working quietly has undertaken many innovative projects including installation of this Hospital Information System. Details regarding the interesting cases admitted in the Ward are highlighted on a Black Board in the Ward for the benefit of medical students and postgraduate students. The ward has a 6-Bed High Dependency Unit besides a Mobile X-Ray with digital films. Whenever needed, the radiographer comes with Digital film and the X-rays are taken in the Ward. Hepatitis-B and Hepatitis-C positive cases as well as other serious infections are identified with special marks to protect the healthcare professionals so that they take extra precautions while managing these patients. Recitation from Holy Quran with translation in the Ward through built-in system presents a pleasant environment in the ward in the morning and it is very much liked by the patients.

Stoma Care Room: The Ward has a special Stoma Care Room where all the registered patients will be managed. Their complete record will be computerized. Their bags will be changed in this room. Prof. Amjad Siraj Memon disclosed that they have also provided home service and all the registered patients in the unit will have the facility of getting their colostomy bags changed at home. They will have to buy the bags but the service will be free.
There is a separate dressing room and a minor operation theatre for teaching and training the doctors how to suture the wound and undertake minor procedures. The Corridors in the Ward has been provided with cemented benches for the patients and their attendants to sit and relax in the evening enjoying fresh air. Lighting and fans have also been provided in the corridor. The main entrance to the offices, Prof. Amjad Siraj Memon stated is open only from 8.00 AM in the morning till 3.00 PM and then it is closed while access to the ward remains open for the patients round the clock. Special security arrangements have also been made to protect the patients as well as medical and nursing staff from any expected violence and unforeseen circumstances. Since the unit is located on third floor, for the patient’s convenience a twin lift is being installed specially for this unit and landing facilities will also be provided to patients on First and the Second Floor. Work is in progress and the lifts will be installed in the coming few months when it will become fully operational. Family members of colorectal cancer patients are at high risk of developing cancer; hence a screening programme for the family members of colorectal cancer patients has also been initiated in the unit.

Seminar Room: The Ward has a Seminar Room with fifty plus seating capacity equipped with multimedia, screen, other audiovisual facilities and internet. Whosoever has to make a presentation is asked to e mail the presentation to him/her and then use that since internet connection is available. That is how we have decided to overcome the problem of viruses which are transmitted through CDs and Flash, Prof. Amjad Siraj stated.
Responding to a question how they are going to ensure the same standard of cleanliness, neat and clean environment and security in the long run, Prof. Amjad Siraj said that we are mindful of these difficulties and it requires lot of funding to sustain these services and facilities. Hence to generate funds for these services, we have formed an NGO which has been registered and has its own Board of Directors with the name of “Colo-Rectal Diseases Patients Welfare Association”. It will generate funds and cater to all these needs. We are already managing many patients through Zakat Funds. I am from the 1988 Batch of Dow and Dow Class of 1988 has already provided us over 6.5 lac rupees. I studied at Cadet College, hence my colleagues at Cadet College are also helping me in addition to friends and well wishers in UK and United States. We have had fruitful discussions with some donors and philanthropists and God willing we will have no problem of funding. We will maintain adequate stock of useable, instruments, equipment and other material in our Stores and hopefully meet the entire needs of patients coming to this unit. While purchasing instruments, equipment and useable, we have always gone for quality ensuring that those made in USA, UK or Japan are acquired rather than going for cheap stuff available from many other sources and efforts will be made to ensure their maintenance as well.
How you are going to motivate the nursing staff, paramedics and Medical Officers, House Officers besides technicians in government service to give their best to ensure satisfaction of the patients and efficient running of the ward, service was my next question? Responding to this Prof. Amjad Siraj said that we hope to offer appreciation, provide them incentives, certificate course, motivation and incentives to work hard. We also intend to hire some private staff including security staff besides offering incentives to the staff in government service, he remarked.