Political Source: The Latest Criteria for ICU Admission [My Letter in The Frontier Post]

Admission to ICU!
Posted on February 18, 2012

A young lady, aged between 25-30, came to the civil hospital with severe abdominal pain, she was referred from casualty department to surgical emergency ward, where she was diagnosed as a case of “Tuberculous Intestinal Perforation” after all the necessary laboratory & radiological investigations and clinical examination.The possible and necessary treatment for her was Surgical Repair of the perforation, all her attendants and relatives present in the ward were informed about it. She came with a huge protocol, full of political source, all her relatives belonged to a political party.They told the doctors that give her the VIP protocol, in other words they meant that give her the VIP protocol otherwise it won’t be good for you and hospital. After surgery, her relatives didn’t allow doctors to keep the patient in the ward, as they were not satisfied with the cleanliness of the ward. They forced the doctors and administration to vacate a bed in ICU and shift their patient to ICU. This patient was stable after surgery, and she really didn’t need ICU management, patients like her are easily managed in the ward without ICU support and monitoring.Now the important thing is this that the ICU in civil hospital comprises only 8 beds, and the count of ICU needy patients is more than that. So if people will force administration on political source to shift their patients to ICU although they don’t need ICU support, will let the other ICU needy patient, who is poor and has no political source, to suffer and may die.

Dr. Mubashir H. Shaikh
Hyderabad

[Published in The Frontier Post on Sunday, 18th Feb 2012]

Learn CPR: Become a Life Saver (My Letter in The Frontier Post)

‘Become a life saver’
Posted on February 15, 2012

Last month I had a chance to attend a 4-hour Basic Life Support (BLS) workshop in Dow University, Karachi, in which techniques and procedures of Cardio-Pulmonary Resuscitation (CPR) were taught to us. CPR is a combination of artificial breathing given mouth to mouth and an artificial heart beat produced by chest compressions, given to victims of sudden cardiac arrest (who stops breathing) in order to save the life until advanced life support can be given by health care providers. In our part of the world, this workshop is mandatory for healthcare proffesionals only, but if you look around in developed countries, you will see that this life saving procedure is commonly taught in schools, colleges, universities and other institutes, not only this but their adults learn this technique on their own will. In USA, there are many government and independent institutes who teach CPR, and many people attend this because they know the importance of this life saving procedure. The point I want to raise here is that the health ministry of Pakistan should initiate a national CPR teaching programme, not only for health care providers but for all adults. As we all know that in Pakistan, programmes like Polio, TB, Malaria, and Hepatitis prevention and control programmes have done quite well. They have not achieved 100% success, but still have managed things very well. Many of our people are taking benefits through these programmes specially in rural areas. It also reminds me of PPHI (people’s primary healthcare initiative), through which medical facilities have reached in remote areas, and have re-opened the closed BHUs (basic health units) to help the poor patients free of cost. If our officials start such project country wide to teach Basic Life Support Techniques, it will surely decrease the number of deaths, and will save the lives. Ambulance may get late, so every citizen should be armed with the CPR technique, it will not only benefit others but you also.

Dr. Mubashir H. Shaikh
Hyderabad

(Published in The Frontier Post - 15th Feb 2012)

Patients Nibbled by Rodents (My Letter in The Frontier Post))

Patients nibbled by rodents
Posted on February 13, 2012

Recently I read a news report in an Indian newspaper, that a comatose patient, being kept on ventilator in an ICU of Mathura Das Mathur Hospital Jodhpur, was nibbled by rodents on ear, lips, cheeks and nose, while the nursing staff slept. In reaction, the responsible staff was suspended.
This story reminds me of some scenes that I have seen in Civil Hospital, Hyderabad, a hundred times. One being healthy cannot take care of him/her self here, I have seen staff nurse being bitten by a cat twice, one doctor friend, while examining a patient was bitten by a cat on foot. Cats are not only inside hospital but in the wards too. Poor people, accompanying patients, usually sleep on floors along with their food and other stuff, beacuse of lack of place.
Cats touch their stuff, half eat their food and lot more. In or near surgical OTs, these cats have been noticed eating the human flesh, which is taken off from body during some opertation, like placentas, appendix, etc. Patients visit hospitals for cure or care, but here unfortunately the caretakers are not even safe. At night, when the hospital is quiet and the inside roads are empty, one is scared to walk there because of stray dogs.
Before we experience a bad scene due to presence of these animals in the hospitals, the authorities should take them out of hospitals, and they should seal all such entrances of the wards and rooms where from cats and rodents can enter. This was one of the several basic problems of government hospitals. By focusing and taking care of these basic things, one can make these public sector hospitals, better place for the sick ones.

Dr. Mubashir H. Shaikh

Hyderabad, Sindh

Dog Bites on the Rise in Hyderabad: Posing a Potential Threat of Rabies

Dog bite on the rise
Posted on January 30, 2012

In Hyderabad, the number of stray dogs is increasing day by day, posing a potential threat of rabies in the city. Rabies is a very painful and deadly viral disease, that invades the central nervous system and disrupts its functioning. It is spread through the bite of affected animals, usually dogs, bats and foxes, but can affect any animal, it is present in their saliva. I am a young doctor from Hyderabad, have spent a year now in civil hospital, and on average have seen 5 to 6 cases of dog bites daily, including all age groups and children being the most affected one. These cases are not all from Hyderabad, few are referred from nearby villages and cities. In US, rabies is rarely spread through the bites of dogs and other rabid animals, because most of the animals are vaccinated in the states, but in our part of the world, where half of the human population is not vaccinated for the common preventable diseases, how can one talk about ‘vaccinating the animals’. Here, in our settings, killing dogs by giving them poisonous capsules or transferring them to some other place are the only valid options. Administration may adopt an animal birth control method to control the increasing population of stray dogs. I hope that the responsible administration is aware of the deadly outcome of rabies, and will soon initiate a full-fledged campaign to take some actions to prevent dog bites and rabies.

Dr. Mubashir H. Shaikh
Hyderabad

This was published in Dawn on 4th of feb 2012, and in Frontier Post on 30th of january 2012

Negligence of Doctors?

My Letter Published in The Frontier Post on Sunday 29th August 2010 Negligence of doctors?

Mubashir Shaikh - Hyderabad

In a leading Sindhi newspaper, I read that, on 24th August, a woman died in Orthopaedic ward PMC Hospital, Nawabshah, and the relatives of that woman refused to take away the dead body by saying that the doctor injected her a wrong injection, and that has caused her death, we won't take the body until we get justice. If the relatives know about the right injection and the wrong one, then why did they came to visit hospital ? Relatives are neither doctors nor paramedical staff, then how does they know? We all know that education in our part of world is not that much good that an ordinary man declares an injection as right or wrong. The journalist who reported this news, should have described the condition of the woman (patient) plus the name of that injection which according to their relatives caused her death. By reporting the patients history and name of injection, that journalist would have enabled all the readers especially doctors, to judge that whether the drug (injection) was right or wrong for that particular condition of the patient. This respected profession (doctoring) is losing its respect, not every doctor is careless, and doctor is also not the cause of every death. Our people and journalists should give them respect, otherwise if doctors will start taking actions in the form of protests then our people, including these journalists, will be the one most affected.

Link: http://www.thefrontierpost.com/News.aspx?ncat=le&nid=338

Controlling Infections - My Letter in Daily Times

My Letter in Daily Times (19th July 2010)

Controlling Infections [My letter in The Frontier Post and The Post]

My Letter, "Controlling Infections", published on Monday, 12th July,2010 in two English Dailies of Pakistan, i.e., The Post and The Frontier Post.

Something Like PPHI in Education Sector

People's Primary Healthcare Initiative (PPHI), the program that has reopened the closed rural health facilities, and till now many poor people of rural areas have got improved delivery of health services at their door steps.

Before PPHI, in rural areas, there were closed and non functional health facilities, shortage of doctors and other paramedical staff, no budgets, no lady doctors, no facility of mobile ultrasound, no punctuality in medical and paramedical staff, detoriated infrastructure, no telephone connectivity, no community participation & awareness efforts, no vaccines for dog and snake bite, and no working maternity homes.

But after PPHI, all health care centers in rural areas are now turned functional, new energetic and young Doctors and paramedical staff is appointed on contract basis, punctuality and work is monitored, lady doctors are available, Ultrasound facility is available, infrastructure is reconstructed, new furniture is given, wireless telephone connectivity is available, community participation and awareness programs in schools are held every week, vaccines and medicines are now available and Maternity Homes are working like never before.

The success of this program can be judged by the fact that the OPD turn over has increased to 255%. The pictorial album and facts figures are available at their website.

I have personally seen few Health centers. one of my relatives contract was not renewed just because she was absent for consecutive 5 days without any application, this shows that doctors are well monitored and strictness is present.

Now, govt should start the similar program with same goals and plans in Education Sector, it will really benefit the poor cihldren of rural areas. All those improvements which came after PPHI, are really needed in Education side also.