Pulmonary and Critical Care Medicine

Setting High Standards in Clinical Care and Research

The Pulmonary Section’s quest for improved patient care and treatment is supported by ongoing research activities and continuing medical education. The Section is a pioneer on many fronts and its expertise in non-invasive ventilation services is recognised nationally. AKU has been the leader in developing services for the diagnosis and management of sleep apnea and remains the only well-equipped referral centre in the country.

Pulmonary or lung diseases are a common cause of ill health and loss of life in the community. Developing countries like Pakistan have been hit hard by the rising prevalence of tuberculosis (TB), including multi-drug resistant TB, and smoking-induced lung diseases. There has also been a worldwide rise in the incidence of other pulmonary diseases such as allergy and asthma.

Other challenges faced by Pulmonary and Critical Care Medicine include the management of respiratory failure patients who need ventilator therapy and/or Intensive Care Unit (ICU) admission. The task for the Pulmonary Section faculty in AKU's Department of Medicine is to provide cost-effective yet state-of-the-art treatment to a wide range of patients. Established in 1999, the Pulmonary Medicine Section is headed by Dr S. Fayyaz Hussain, Associate Professor, who leads a team of full-time faculty comprising Dr Javaid Khan, Professor; Dr Nawal Salahuddin, Assistant Professor; Dr Javed Hussain, Assistant Professor; and Dr Ali Zuberi, Assistant Professor. Since July 2004, the Section has had a full-time staff of six with the addition of Dr Ahmed Suleman Haque, Assistant Professor, and four part-time faculty members. The service provides round-the-clock assessment and admission to patients from the Emergency Medicine Section. The Section also provides faculty cover to ICU for at least two weeks each month, and a prompt pulmonary consultation service for patients under the care of other services. Twenty-four pulmonary clinics are held every week at AKU with off-site clinics in Clifton and Karimabad. Dedicated asthma, allergy and smoking-cessation clinics also take place every week.

The pulmonary function laboratory provides a broad range of tests at AKUH, many of which are not available at other medical centres in Pakistan. In 2001, the Section played a key role in training two dedicated pulmonary technologists who are vital to maintaining standards, developing new techniques and increasing volume in the pulmonary function laboratory.

Nursing services provide high quality of patient care in pulmonary medicine. The Respiratory Special Care Unit, which started operations recently and provides modern non-invasive ventilation services, is another unique facility available only at AKUH. Regular workshops are held to train nurses and doctors in this new technique. Allergy testing and patient education is provided by nurses in the pulmonary clinics, where the bronchoscopy suite is equipped with video-bronchoscope facilities.
The Pulmonary Section is a pioneer on many fronts and its expertise in non-invasive ventilation services is recognised nationally. AKU has been the leader in developing services for the diagnosis and management of sleep apnea and remains the only well-equipped referral centre in the country. Increasing awareness of the harmful effects of tobacco on human health has, meanwhile, been at the forefront of public educational campaigns.

A three-year fellowship training programme was initiated in 1999 and is recognised by Postgraduate Medical Education and the College of Physicians and Surgeons Pakistan. The Section has a busy commitment towards Continuous Medical Education activities within and outside AKU, which is evident through regular seminars and workshops. Faculty members have held key positions in the Pakistan Chest Society and represented AKU at various international forums. A strong educational programme has contributed towards understanding the risk factors associated with lung diseases and their management, and research relevant to pulmonary diseases in the community continues to be at the forefront of scholarly activities. Research grants have been received from WHO, University Research Commission, Seed Money and pharmaceutical firms for research in TB, sleep apnea, pulmonary function and pulmonary infections. Students and junior doctors are encouraged to participate in research. Last year, a large number of research papers were presented in international conferences and accepted for publication in peer-reviewed journals. This resulted in 11 research abstracts, 17 publications and one book chapter.
"All this has been possible through the support of a dedicated team of highly qualified faculty members who have helped the Pulmonary Section in keeping pace with new developments in the speciality," says Dr S. Fayyaz Hussain, who attributes the success of the Section to encouragement offered by the University. "Over the coming years, new sub-speciality services will continue to evolve, maintaining the pioneering role of AKU in Pulmonary and Critical Care Medicine in Pakistan."