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Study reveals prevalence
of surgical “Never Events”

According to a report published in Wall Street Journal, the journal Surgery published a Johns Hopkins University School of Medicine study - based on data from the National Practitioner Data Bank - that shows surgical mistakes, dubbed “never events,” happen more than 4,000 times a year in the US.
Between September 1990 and September 2010, researchers found 9,744 malpractice payments tied to surgical “never events,” which include leaving an object inside a patient, wrong-site surgeries, wrong procedures, and wrong-patient surgeries. Six percent of those 9,744 cases died, 32.9% had permanent injury, and 59.2% suffered temporary injury. According to a breakdown of the data, wrong procedures ranked as the most costly malpractice payout, while foreign objects left behind ranked among the lowest payouts.

9th Anniversary of Sambros Hospital
About eight hundred patients examined 
at Free Medical Camp - Dr. Sami Ahmed

KARACHI: Neonatal ICU and pediatric care at Sambros Hospital is one of the best facility in Karachi where patients from various hospitals are received. It is our mission to provide quality healthcare at affordable cost providing specialized care to the needy patients. This was stated by Dr. Sami Ahmed, CEO and Medical Director of Sambros Hospital Karachi while speaking at the 9th Anniversary celebrations of Sambros Hospital at Federal B, Area, Karachi. A free medical camp was organized at the occasion where about eight hundred patients were examined by a team of doctors which includes, pediatricians, Dermatologists, General Surgeons, Ophthalmologists Obstetricians/Gynecologists and Physicians. Free medicines were also provided to the needy patients.

On left Dr. Sami Ahmed examining a patient at a free medical camp
organized by Sambros Hospital on December 25, 2012. On right
Mr. Asif receiving memento from Al Haj Aziz Ahmed,
Founder and Chairman Sambros Hospital.

Dr. Sami Ahmed speaking at the occasion said that people working in Sambros Hospital are backbone of this organization. He appreciated the services and dedication of Sambros Hospital staff which has played major role in the progress of this facility. Management of the Hospital, Dr. Sami said honours and appreciates the services of the staff of Sambros hospital every year which encourage them to work hard. We believe in quality care, personalized services and immediate medical attention to our patients. Al Haj Aziz Ahmed, Founder and Chairman Sambros Hospital presented the awards, mementoes to the staff of the hospitals to acknowledge their services.
Dr. Khursheed and Dr. Jamil lauded the efforts of Sambros Hospital Management which is also providing continuing medical education for healthcare providers besides mothers are being trained as Master Trainers under its Mother Club platform which hold its activity after every two months.

CPSP Regional Center Multan
2nd ATLS Course

MULTAN: College of Physicians and Surgeons Pakistan in collaboration with American College of Surgeons organized second ATLS (Advanced Trauma Life Support) course at CPSP regional centre Multan from 30th November to 02nd December 2012.

CPSP Regional Center Multan organized an ATLS course recently. Picture taken on the occasion shows
course participants along with facilitators, Prof. Dr. Babar Ali and Prof. Ghulam Mujtaba. 

Prof. Moeed Iqbal Qureshi was the course director while the facilitators included Prof. Mustafa Kamal Pasha, Prof. Ghulam Mustafa Arain, Dr. Ashar Ahmad Khan, Dr. Syed Farrukh Hassan Razvi, Dr. Nauyan Ali and Dr. Muhammad Armughan, Miss Saima Jamil, and Miss Sana Younas served as National Coordinator for ATLS Workshop.
The course coordinators at regional centre Multan were Prof. Ghulam Mujtaba and Prof. Dr. Babar Ali, Prof. of Surgery and Senior Executive Officer. Sixteen candidates participated in the course. The feed back from candidates was extremely positive and everybody felt that they it was extremely useful. The opined that it should be attended by all the doctors dealing with trauma and emergency. (PR)

50% diabetics remain undiagnosed
One in Ten Adults in the 
Middle East Have Diabetes

BRUSSELS, BELGIUM: Marketwire/Asianet-Pakistan) One adult in ten has diabetes in the Middle East and this is set to rise according to new figures released by the International Diabetes Federation (IDF) to mark World Diabetes Day. IDF estimates that half of these people are yet to be diagnosed. By the end of the year, diabetes will have killed 357,000 people in the region, compared to 280,000 in 2011. The new regional figures also show that the prevalence of type 2 diabetes in the region for younger age groups is substantially higher than the global average.
By the end of 2012, 34 million people in the region will be living with diabetes. Kuwait and Saudi Arabia have the highest prevalence of diabetes in the region. Egypt has the highest number of cases at 7.5 million.
“We are in the middle of a public health emergency,” said Dr Amir-Kamran Nikousokhan Tayar, Chair of IDF’’s Middle East and North Africa region. “We must focus our health resources on prevention where possible and education around this disease to prevent even more deaths in the region.”
The figures from the Middle East, which form part of IDF’’s Diabetes Atlas 2012 Update, echo the shocking increase in diabetes on a global level. The number of people globally living with diabetes in 2012 has risen to 371 million, compared to 366 million in 2011.
“In every country and in every community worldwide, we are losing the battle against this cruel and deadly disease,” said Jean Claude Mbanya, President of the International Diabetes Federation (IDF). “On World Diabetes Day, we want to raise awareness that with the right education and care this disease can be controlled and in some cases prevented.”
“Millions of people are dying from diabetes in their most productive years,” added Ann Keeling, CEO of IDF. “The stability of societies is threatened and huge economic and political burdens are imposed on countries and communities. However this disease remains marginalized on the global health and development agenda and vastly under-resourced.”
It is hoped that campaigns such as World Diabetes Day will continue to raise the voice of people with diabetes and to encourage all stakeholders to move from advocacy to action on a regional and global scale. For more information on the 5th edition Diabetes Atlas, 2012 updates and country/regional factsheets:

Foods that Heal

Apples: Protects your heart, prevents constipation, Blocks diarrhea, Improves lung capacity,
Cushions joints.

Apricots: Combats cancer, Controls blood pressure, Saves your eyesight, Shields against Alzheimer’s, Slows aging process.

Artichokes: Aids digestion, Lowers cholesterol, Protects your heart, Stabilizes blood sugar, Guards against liver disease.

Avocadoes: Battles diabetes, Lowers cholesterol, Helps stops strokes, Controls blood pressure, Smoothes skin.

Bananas: Protects your heart, Quiets a cough, Strengthens bones, Controls blood pressure, Blocks diarrhea.

Beans: Prevents constipation, Helps hemorrhoids, Lowers cholesterol, Combats cancer, Stabilizes blood sugar.

Beets: Controls blood pressure, Combats cancer, Strengthens bones, Protects your heart, Aids weight loss.

Blueberries: Combats cancer, Protects your heart, Stabilizes blood sugar, Boosts memory, Prevents constipation.

Broccoli: Strengthens bones, Saves eyesight, Combats cancer, Protects your heart, Controls blood pressure.

Cabbage: Combats cancer, Prevents constipation, Promotes weight loss, Protects your heart,
Helps hemorrhoids.

Cantaloupe: Saves eyesight, Controls blood pressure, Lowers cholesterol, Combats cancer, Supports immune system.

Carrots: Saves eyesight, Protects your heart ,Prevents constipation, Combats cancer, Promotes weight loss.

Cauliflower: Protects against Prostate Cancer, Combats Breast Cancer, Strengthens bones, Banishes bruises, Guards against heart disease.

Cherries: Protects your heart, Combats Cancer, Ends insomnia, Slows aging process, Shields against Alzheimer’s.

Chestnuts: Promotes weight loss, Protects your heart, Lowers cholesterol, Combats Cancer, Controls blood pressure.

Chili Peppers: Aids digestion, Soothes sore throat, Clears sinuses, Combats Cancer, Boosts immune system.

Figs: Promotes weight loss, Helps stops strokes, Lowers cholesterol, Combats Cancer, Controls blood pressure.

Fish: Protects your heart, Boosts memory, Protects your heart, Combats Cancer, Supports immune system.

Flax: Aids digestion, Battles diabetes, Protects your heart, Improves mental health, Boosts immune system.

Garlic: Lowers cholesterol, Controls blood pressure, Combats cancer, kills bacteria, Fights fungus.

Grapefruit: Protects against heart attacks, Promotes Weight loss, Helps stops strokes, Combats Prostate Cancer, Lowers cholesterol.

Grapes: Saves eyesight, Conquers kidney stones, Combats cancer, Enhances blood flow, Protects your heart.

Green Tea: Combats cancer, Protects your heart, Helps stops strokes, Promotes Weight loss, Kills bacteria.

Honey: Heals wounds, Aids digestion, Guards against ulcer, Increases energy, Fights allergies
Lemons: Combats cancer,Protects your heart, Controls blood pressure, Smoothes skin, Stops scurvy.

Limes: Combats cancer, Protects your heart, Controls blood pressure, Smoothes skin, Stops scurvy.

Mangoes: Combats cancer, Boosts memory, Regulates thyroid, aids digestion, Shields against Alzheimer’s.

Mushrooms: Controls blood pressure, Lowers cholesterol, Kills bacteria, Combats cancer, Strengthens bones.

Oats: Lowers cholesterol, Combats cance, Battles diabetes, prevents constipation, Smoothes skin.

Olive Oil: Protects your heart, Promotes Weight loss, Combats cancer, Battles diabetes, Smoothes skin.

Onions: Reduce risk of heart attack, Combats cancer, Kills bacteria, Lowers cholesterol, Fights fungus.

Oranges: Supports immune systems, Combats cancer, Protects your heart, Strengthens respiration.

Peaches: Prevents constipation, Combats cancer, Helps stops strokes, aids digestion, Helps hemorrhoids.

Peanuts: Protects against heart disease, Promotes Weight loss, Combats Prostate Cancer, Lowers cholesterol, Aggravates, diverticulitis.

Pineapple: Strengthens bones, Relieves colds, Aids digestion, Dissolves warts, Blocks diarrhea.

Prunes: Slows aging process, prevents constipation, boosts memory, Lowers cholesterol, Protects against heart disease.

Rice: Protects your heart, Battles diabetes, Conquers kidney stones, Combats cancer, Helps stops strokes.

Strawberries: Combats cancer, Protects your heart, boosts memory, Calms stress.

Sweet Potatoes: Saves your eyesight, Lifts mood, Combats cancer, Strengthens bones.

Tomatoes: Protects prostate, Combats cancer, Lowers cholesterol, Protects your heart.

Walnuts: Lowers cholesterol, Combats cancer, boosts memory, Lifts mood, Protects against heart disease.

Water: Promotes Weight loss, Combats cancer, Conquers kidney stones, Smoothes skin.

Watermelon: Protects prostate, Promotes Weight loss, Lowers cholesterol, Helps stops strokes, Controls blood pressure.

Wheat Germ: Combats Colon Cancer, prevents constipation, Lowers cholesterol, Helps stops strokes, improves digestion.

Wheat Bran: Combats Colon Cancer, prevents constipation, Lowers cholesterol.

Aspirin may reduce
risk of liver cancer

Aspirin use seems to be associated with a decreased risk of liver cancer and death from chronic liver disease, according to a large new study” published in the Journal of the National Cancer Institute. The study followed more than 300,000 people aged 50 to 71 for 10 to 12 years. The people in the study reported their non steroidal anti-inflammatory drug (NSAID) and aspirin use during this period. Over 400 of the participants died from chronic liver disease and 250 were diagnosed with liver cancer. According to the article, “Compared to people who didn’t take NSAIDs, people who took aspirin were 45 percent less likely to die from chronic liver disease and 41 percent less likely to be diagnosed with liver cancer. People who took non-aspirin NSAIDs were 26 percent less likely to die from chronic liver disease but no less likely to be diagnosed with liver cancer.”
According to the lead author Dr Vikrant Sahasrabuddhe, from the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, “This is the first large-scale, population-based evidence for reduced risks of liver cancer incidence and liver disease mortality associated with the use of non-steroidal anti-inflammatory drugs.”

Dr. Mazhar Malik
made Fellow by APA

RAWALPINDI: Prof. Mazhar Malik, Associate Professor of Psychiatry, Foundation University Medical College, Rawalpindi and President Elect- Pakistan Psychiatric Society (PPS) has been elected an Fellow of the APA - the highest category of membership for an international member of American Psychiatric Association. (PR)

Newly elected office
bearers of PMA Lahore

Dr. Muhammad Tanveer Anwar

Vice President (Male)
Dr. Umar Farooq Baloch

Vice president (Female)
Dr. Asma Yasin

General Secretary
Dr. Izhar Ahmad Ch.

Finance Secretary
Dr. Kamran Saeed

Joint Secretary (Male)
Dr. Qazi Muhammad Yasir Fiaz

Joint Secretary (Female)
Dr. Sabahat Habib Khan

Prof. Amir Aziz honoured
by AO Spine International

LAHORE: Prof Amer Aziz a noted orthopedic surgeon and councilor of CPSPI has been honoured by AO spine international in Davos Switzerland by presenting him an award being the best AO Spine faculty in the Middle East. AOspine, it may be mentioned here, is the largest organization of spine surgeons in the world. Picture shows awardees from Latin America, North America, Europe, Asia Pacific and Middle East.

KMU Observs
World Disabled Day

PESHAWAR: Khyber Medical University (KMU), Institute of Physical Medicine and Rehabilitation (IPM&R) in collaboration with Para Pelagic Center observed World Disabled Day here at Para Pelagic Center Hayatabad, Peshawar. Prof. Dr. Mohammad Hafizullah VC KMU was the chief guest. Beside others Prof. Dr. Shad Muhammad Director Academics KMU, Syed Muhammad Ilyas Chief Executive Paraplegic Center, Muhammad Bin Afsar Jan Director IPM&R, Mehboob Ur Rahman Principal Mehboob School of Physio Therapy and Muhammad Riaz Principal Rehman College of Rehabilitation Sciences along with a large numbers of faculty, students and patients of Peshawar based Physiotherpy Institutes were also present on this occasion.
Speaking on this occasion Prof. Mohammad Hafizullah said that World Disable Day aims to promote an awareness of disability issues and the fundamental rights of persons with disabilities. It is important to integrate disabled persons in the main stream of society. Disabled persons are often discriminated against and that is never an ideal condition. Society must take adequate steps to involve persons with disabilities in the main stream of each aspect of the social, political, economic and cultural status of their communities.
World Disabled Day Prof. Hafizullah, further stated provides an opportunity to initiate action to reach the target of full and equal pleasure of human rights and contribution in society by disabled persons. Over one billion people, or approximately 15 per cent of the world’s population, live with some form of disability. Persons with disabilities, the world’s largest minority often face barriers to participate in all aspects of society. The result is that persons with disabilities do not have equal access to society or services, including education, employment, health care, transportation, political participation or justice.
Prof. Hafizullah explained that evidence and experience shows that when barriers to their inclusion are removed and persons with disabilities are empowered to participate fully in societal life, their entire community benefits. Barriers faced by persons with disabilities are, therefore, a detriment to society as a whole, and accessibility is necessary to achieve progress and development for all. He said the commemoration of International Day of Persons with Disabilities in 2012 provides an opportunity to address this exclusion by focusing on promoting accessibility and removing all types of barriers in society.
He announced that KMU will take imitative to start community based services in addition to clinical facilities at IPM&R in the near future. He further said mobile repairing, computer learning and to develop motorized wheel chairs in joint collaboration with UET, Peshawar will also be materialized. KMU will provide all possible support in this regard, he added. Syed Muhammad Ilyas CE Paraplegic Center, Muhammad Bin Afsar Dir. IPM&R, Mehboob Ur Rahman Principal Mehboob School of PhysioTherpy and Muhammad Riaz Principal Rehman College of Rehabilitation Sciences also spoke on this occasion. (PR)

DUHS introduces Bariatric surgery

KARACHI: Obesity is a major health problem worldwide and has reached an epidemic proportion. Pakistan is one of those countries where obesity and diabetes are increasing at alarming rate. Every one out of four Pakistanis is either obese or overweight. Overweight and obesity are the fifth leading risk for global deaths. Evidence continues to accumulate that obesity is a major risk factor for many diseases and is associated with significant morbidity and mortality. Bariatric surgery is currently the only modality that provides a significant, sustained weight loss for the patient who is morbidly obese, with resultant improvement in obesity-related co-morbidities. Dow University of Health Sciences decided to offer weight reduction program including surgical option Bariatric Surgery. This program is comprehensive with multidisciplinary team approach including experienced Endocrinologist, Nutritionist and Bariatric Surgeon that helps lose excess body weight. These views were expressed by Prof. Dr. Masood Hameed Khan, Vice Chancellor, DUHS and Prof. Muhammad Jawed, Bariatric Surgeon, DUHS at a Press Briefing held at Ojha Campus of Dow University recently.
They pointed out that in Pakistan 22 percent male and 27 percent women are obese. 1.5 billion people are obese worldwide. Obesity is a health issue that has attracted concern only in the past few years. Urbanization and an unhealthy, energy-dense diet (the high presence of oil and fats in Pakistani cooking), as well as changing lifestyles, are among the root causes contributing to obesity in the country. Obesity causes adverse effects on your health like heart diseases, diabetes mellitus, sleep disturbance, joint pain psychiatric problems etc.
Prof. Masood Hameed further said that Bariatric Surgery has effectively treated obesity in people who retried to lose weight before and have failed. Laparoscopic Sleeve Gastrectomy (LSG) leads to 50 to 60% excess body weight loss within six to twelve months. It is safe, avoids foreign material like laparoscopic gastric banding, maintains normal gastrointestinal continuity. (PR)

Merit & Demerit of ECT

Col. S.M. Hussain

In one of your issues of Pulse International different ways of ECT given to patients, its merits and de merits were discussed in detail. I would like to add some of my personal observation on this subject.
“I was a trainee Medical Officer with General Shoaib in Psychiatric Centre M.H Rawalpindi. (1957 to 1960). That was the time when people in general would call a psychiatric as Dr. of Mental Patients. General Shoaib was an outstanding Psychiatrist. His fluid English and humorous attitude during lecture punctuated by examples of relevant patients he had treated and his alluring tone had hypnotizing effect on the audience. It would not be an exaggeration if he is called The Father of Psychiatry in Pakistan. The General would go to give lectures to officers of Staff College Quetta, PMA Kakool, Intelligence School Murree with the purpose of telling the officers to dispel that notion that psychiatrist is not only what they think about but an important member of medical profession.
As for the accommodation available there was a big room, half for ECT and half was Recovery Room. The psychiatrist had his own room just behind the General Office where he used to see patients. The Psychiatrist would give ECT to the patient with someone keeping his hands on shoulder joint and knee joint to control his jerky movements and soon turn the patients to one side to avoid biting his tongue and stop any surplus saliva down his throat. The patient was then shifted to the recovery room. After one to two hours the patient was taken by his relatives. No anesthetics was required and no patients died during my three years stay. The response of new and young schizophrenics an din acute depression to ECT is dramatic.
Given below are few examples:

1. I remember an Air-hostess brought her younger sister in violent condition. She was unmanageable, hitting her head against the wall. With 6 or 7 ECTs she was absolutely normal.
2. Son of DC Mardan was brought as acute schizophrenic state. His condition was pitiable, looking his only son’s condition he, himself became mental, begging me to treat his son in the best possible way. With few ECTs, he became normal.
3. A serving artillery major was admitted for bizarre symptoms with daily changing pattern from psychosis to petitmal epilepsy and neuroses. I talked to his CO but he could not give me any positive clue, except that he was going to staff surgeon for the last one month and was given Category-C. I was sure that the was maneuvering to get out of the army. His young wife would come daily at about midnight; I had to put someone outside his house with ith instructions to listen to what they were talking. He told me that he was telling his wife, “About 90% the Dr. has been befooled”. In a few days more I would be out of the Army, and they would go to the United States of America. Next morning I got him in my office and gave him a bit of my mind with special report to his CO for strict disciplinary action against him.
4. A serving Lt. General with big tummy was brought by his wife for acute depression, he had heart problems too as he had severe pain in the chest two years back for which he was treated conservatively. I refused to give him ECT. Then I took in writing from the General that if he dies during ECT he himself would be responsible. With 6 to 7 ECTs he was alright. Every patient with acute depression is potentially suicidal. A serving General in service was a dilemma for me. He should have been out of the service.

Maj. General Shoaib and Lt. General Ayub Director of Medicine examined me for final examination with long and short cases in different wards and verbal examination. I was declared successful and was posted to CMH Lahore as a Psychiatrist. In those days, lot of females patients came with hysterical behavior but a single sub conversion was enough to force them to speak the truth i.e love with somebody or Jins.

i. General Shoaib and I with were on a round in closed ward. All of a sudden a psychiatric patient caught him by his neck to strangulate him. With great difficulties we unlocked him from the clutches of the patients.
ii. General Shoaib was interviewing a chronic epileptic patient in his office when all of a sudden the patient caught him by his neck but we rushed to his room to unlock his neck. An epileptic patient is a very dangerous patient and should not be examined alone.
iii. An old man from Kohat, the General’s home town, brought his son to General Shoaib, the patient had (CSO Media). The patient died during ECT. His father raised a hue and cry but he kept him quiet with an iron hand. A patient with SOM should never be given ECT. We were all surprised to see the General’s callus behavior. After retirement I served for 3 to 4 years with Islamic Psychiatric Hospital, even then muscle relaxant was required in violent and unmanageable patients, which make the patients unconscious momentarily, the twitching of eyelids is enough to assure me that the current has passed through, the patient An anesthetist was never required.

These days the psychiatrists are adamant to give ECT to deserving patients. Even in the presence of the anesthetist, they depend on recent medicaions but they have multiple side effects on kidneys, liver and the vital parts of the brain. They are damaging to these organs.

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