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11/09/2024

LAPROSCOPIC EXCISION OF LARGE LIVER TUMOUR DONE SUCCESSFULLY AT SAFA MARWA HOSPITAL.

The ground breaking achievement was carried out successfully by team of doctors at Safa Marwa Hospital when an elderly patient from Ganderbal district presented to Dr Faroze Khan , Senior Surgical Gastroenterologist with pain abdomen and vomiting on and off . She was examined and investigated thoroughly and diagnosed as Cholelithiasis and Large Cyst ( Benign Tumour) of Liver . CECT whole abdomen was suggestive of Septate Liver Cyst around 8x8x7cm .
She was planned for laparoscopic cholecystectomy and excision of liver cyst . Laproscopic surgery was carried out with minimal loss of blood and in addition to 4 ports of classical cholecystectomy , one 5 mm extra port was used for excision of liver tumour .Patient did well ,was allowed orally and mobilised on first post operative day .
During past few months number of malignant and benign tumours were successfully operated at Safa Marwa Hospital. We provided the best and effective treatment options at nominal cost . We are very thankful to our staff and efficient doctors who carried out such complex procedure successfully. Dr Faroze who is Senior Surgical Gastroenterologist and Advanced Laproscopic Surgeon operated open the patient & surgical team Mr Aijaz wani, Mohsin,Mudasir khan,Tawseef & Senior Anesthetist Dr Amir Nazir with Sr. Anaesthesia team Mr shākīr Råjã Mr Muzamil Ashaq

18/07/2024

Radical Cholecystectomy done for Cancer of Gall Bladder at Safa Marwa Hospital

We are glad to express our achievements in the field of health care in J&K . Our centre has now become a high volume centre for almost all General , Urological and Gaynea - Obstetrics surgeries. Recently Dr Faroz Khan , who is a senior Surgical Gastroenterologist operated upon an elderly female from outskirts of Srinagar for cancer of gall bladder . Dr Faroz has huge experience in Gastrointestinal malignancies and other advanced Laparoscopic Surgeries. Patient visited Dr Faroz Khan with complaints of pain abdomen. She was examined, thoroughly investigated and diagnosed as Gall bladder growth . Patient attendants were explained the course of management and all other related issues . Radical cholecystectomy in which liver along with gall bladder and lymph node dissection was done. This surgery lasted for about 3 hours with less than 100 mL of blood loss .
The team included Dr Faroz khan ( Surgeon) & team(Mr aijaz,mohsin,sahib,Mudasir) Anaesthetist Dr Masood Rashid & team Mr Shakir Raja , ms Iqra.Patient did well , was orally allowed and ambulated on first post operative day . Patient was discharged on 3rd day and advised to follow regularly in Opd .

24/02/2023

Which 𝗈𝖿 𝗍𝗁𝖾 𝖿𝗈𝗅𝗅𝗈𝗐𝗂𝗇𝗀 𝗂𝗌 𝗆𝗈𝗌𝗍 𝗅𝗂𝗄𝖾𝗅𝗒 𝗍𝗈 𝗂𝗇𝗃𝗎𝗋𝖾 𝗍𝗁𝖾 𝗥𝗲𝗰𝘂𝗿𝗿𝗲𝗻𝘁 𝗹𝗮𝗿𝘆𝗻𝗴𝗲𝗮𝗹 𝗡𝗲𝗿𝘃𝗲?
𝖠. 𝗨𝘃𝘂𝗹𝗼𝗽𝗮𝗹𝗮𝘁𝗼𝗽𝗹𝗮𝘀𝘁𝘆
𝖡. 𝗠𝗮𝘅𝗶𝗹𝗹𝗼𝗳𝗮𝗰𝗶𝗮𝗹 𝘁𝗿𝗮𝘂𝗺𝗮
𝖢. 𝗨𝗽𝗽𝗲𝗿 𝗰𝗲𝗿𝘃𝗶𝗰𝗮𝗹 𝗳𝗿𝗮𝗰𝘁𝘂𝗿𝗲
𝖣. 𝗛𝘆𝗽𝗼𝗽𝗵𝗮𝗿𝘆𝗻𝗴𝗲𝗮𝗹 𝗶𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝗻𝘀
𝖤. 𝗧𝗵𝘆𝗿𝗼𝗶𝗱 𝗦𝘂𝗿𝗴𝗲𝗿𝘆

18/10/2022

https://call.whatsapp.com/voice/gnHCox001GZPhm9IOxRZuQ

22/07/2022

✨Right Ventricular Hypertrophy (RVH)
Right ventricular hypertrophy occurs when the right ventricular wall thickens due to chronic pressure overload, similar to that of left ventricular hypertrophy.

14/07/2022

SOME TIPS 👓 ABOUT APPLYING THE FACEMASK (For The Non Rapid Sequence Induction Of General Anesthesia)

A. BEFORE ANESTHESIA😊
▪ Ensure that the anesthetic machine connections and breathing circuit are intact (ie No Leaks) with the correct circuit mode selected.
▪ Keep the APL valve open
▪ Speak to the patient
▪ Check Oxygen Saturation
(This gives you a baseline oxygenation status which will help you in both the Intraoperative and in the recovery phases)
▪ TURN ON OXYGEN
▪ Apply The Mask Gently Covering The Nose And Mouth. (🚫Do not press the mask on to the face and maneuver the head and neck at this stage❗️)

B. POST ANESTHETIC INDUCTION😴💤
▪ Ensure That The Volatile Agent Or TIVA/TCI Pump is SWITCHED ON✅
▪ Apply The Facemask In A More Snug Way Lifting The Chin Into It (Jaw Thrust Maneuver).
This ensures that the tongue is hoisted away from the nasopharynx and the retro pharyngeal areas to facilitate a patent airway.
▪ Head-Neck positioning with Atlanto occipital extension and cervical spine Flexion (Sniff Position) may be required.
▪ The APL Valve Can Now Be Regulated To Ensure Bag Mask Ventilation (if need arises).
▪ Observe The Capnogram.

ON VENTILATION
A. For A SPONTANEOUSLY Breathing Patient
-> Keep The APL Valve Open
-> Observe The Reservoir Bag,
B. For MASK VENTILATION
-> Regulate The APL Valve
-> Observe The Chest Rise & Fall.
(At the same time observe airway pressures as those higher than 20cmH20 will open the esophagus and insufflate💨💨 the stomach❗)

09/07/2022

Raja
My BEST POST
GENERAL ISSUES WITH THORACIC SURGERY

This I consider my BEST 🌟 post ever as it is a summary that gives substance to build on in the very difficult yet challenging block of thoracic anesthesia..

1. PRE-OPERATIVE
2. INDUCTION
3. SURGERY
4. POST- OPERATIVE

1. PRE-OPERATIVE

A. Collaborative discussion with the surgeon on what is being done

B. Assess Chronic Disease

i. Malignancy
- 4 M's mass. metastasis,metabolic,medication,
- Superior mediastinal syndrome

ii.Chronic Obstructive Airway Disease
- Bronchitis/emphysema
- Pulmonary hypertension
- Cor Pulmonale

iii. Pulmonary hypertension
- Loud P2 of RVH
- Prominent pulmonary arteries on Chest X-ray (pruning)

iv. Complications
- Hemoptysis
- Atrial fibrillation - issues with warfarin etc
- Infection - bronchiectasis,empyema,TB,fungal,hydatid etc

C. Viability for surgery
i. Lung function tests
ii. DLCO for gaseous exchange
iii.Cardiorespiratory reserve

D. Assess If One Lung ventilation is possible
- Airway obstruction - by tumor
- Check perfusion status of diseased lung

E. Room for optimization
- Stop smoking, Antibiotics, Chest physiotherapy

2. INDUCTION

A. Invasive lines, put femoral lines with superior vena cava syndrome
B. Epidural or Paravertebral block
C. Rapid lung isolation to prevent soiling vs elective intubation
D. Fibre optic confirmation of ETT placement
E. Lateral positioning - protect brachial plexus

3. SURGERY

Challenging
- Shared airway and the task of being able to control the two lungs independently
- Promote hypoxic pulmonary vasoconstriction to improve V/Q matching

A. Airway
i. Bleeding & soiling by surgery
ii. Bronchospasm
iii.Dynamic hyperinflation with COAD patients hence increase expiratory time
iv. Protective ventilation with a restrictive infiltrative condition
v. Atelectasis - treat with recruitment
vi.Management of bronchial stump at conclusion - assess for leaks

B. Cardiovascular
i. Hypotension
Compression of the great vessels by
- Surgeon
- Moving mediastinum in right lateral position
ii. Blood loss
- very vascular area
- more blood loss with superior vena cava syndrome
iii. Arrhythmias
- irritation of the heart by surgery etc

4. POST- OPERATIVE

A. Extubate as post op ventilation - stress to air leak and chest infections

B. Good Analgesia - Epidural, keep Warm, Alert & Comfortable

C. 40 % Oxygen to compensate for VQ mismatch

D. Encourage coughing, incentive spirometry and chest physiotherapy to improve lung function

Compiled by
Anesthesia

01/07/2022

Regarding anesthesia for neurosurgery, the following statements are true EXCEPT
A. Volatiles, ie Halothane, sevoflurane etc, cause a dose dependent increase in cerebral blood flow.
B. Isoflurane at 1 MAC is safe as far as maintaining a stable intracranial pressure is concerned.
C. Sodium Thiopentone, with its good anticonvulsant properties, reduction in cerebral metabolic requirements and blood flow, make it an good induction agent.
D. Patients in the prone position require a reinforced armoured endotracheal tube s
E. An end tidal carbon dioxide level of 50 mmHg (6.6kPa) is considered safe as far as intracranial pressure is concerne

22/06/2022

Which ventilator mode is being graphically displayed ?

A. Volume Control
B. Pressure Control
C. Assist Control
D. Spontaneous Breathing

21/06/2022

At what pressure does bag mask ventilation cause gastric insufflation?

20/06/2022

ANALGESIA FOR SEPTOPLASTY AND FESS

Maxillary Nerve Block: A Suprazygomatic approach to the nerve blocks to the pterygopalatine fossa - a safe procedure:

This block I mainly use for septoplasty and endoscopic sinus surgeries because the Nasal septum and lateral wall of nose is mainly supplied by branches of maxillary nerve and small contribution by anterior ethmoidal nerves:

Post operative patients were found pain free and a lot of patients were given no analgesic in post op ward because they were full pain free.

Address

Sub District Hospital Sogam Kupwara
Kupwara
193223

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Friday	9am - 5pm

Telephone

+917889449064

Website

http://Shakir.in/

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