Department of Medical Unit-III

Prof. Dr. Muhammad Arif Nadeem FCPS Head of Department of Medicine, Gastroenterology & Hepatology, Medical Unit-III Dean Department of Medicine & Allied arifnadeem1234@gmail.com

 

 

Department of Medicine, Gastroenterology & Hepatology, Medical Unit-III

 

Medical Unit 3, Department of Medicine, Gastroenterology & Hepatology, located at first floor, of Administration Block, Services Hospital, Services Institute of Medical Sciences is a 50 bedded ward, providing medical, gastroenterology, hepatology & panctreatobiliary care to patients either planned or emergency. Our Unit has been recognized for postgraduate training in Medicine (2006) and Gastroenterology (2009) by CPSP and UHS for Medicine and Gastroenterology since 2018. The Unit has myself as Professor & Dean of Medicine & Gastroenterology and other trained clinical staff e.g., one Associate Professor of Medicine & Gastroenterology, 2 Senior Registrars of Medicine and 5 Fellows of Gastroenterology and one Fellow of Medicine to teach and trained Clinical classes of MBBS and post graduate trainees of FCPS & MD of both Medicine and Gastroenterology. The focus of the unit is to develop and enhance patient’s assessment skills and to identify acute medical care needs within a multidisciplinary context. As a multidisciplinary team, Medical Unit 3 promotes a friendly environment for patients and their families, focusing on individualized patient centered care. We also make sure that post graduate trainees and house physicians have ample opportunities and time for academics in Ward and they are encouraged to participate in national events, research and other activities. Besides compulsory workshops conducted by CPSP and UHS, Medical Unit 3 maintains a regular calendar for academic activities which includes case based presentation, journal club, basic and advanced life support skills workshop, mortality reports, ward audits etc. In addition, regular formative assessments and feedback are exercised routinely. They include Clinical Rounds Q & A, Individual assignments, Mini CEX, DOPS.

Medical Unit 3 has also multitude of other facilities for the needy patients:

1. Recognized Advanced Endoscopic facilities like both diagnostic and therapeutic Gastroscopies, Colonoscopies, Endoscopic Retrograde Cholangio Pancreatography (ERCPs), Endoscopic Ultrasonography (EUS), Enteroscopy and Bispectral Index Score Monitoring for Portosystemic Encephalopathy.
2. High Dependency Unit: Medical Unit 3 has its 5 bedded fully monitored HDU facility with HDU graded patients’ beds. These beds are of high quality with fully motorized capabilities of various positioning and CPR level if needed.
3. Availability of Advanced Ultrasound machine is available and helps in diagnosis and intervention if needed.
4. Maintenance of computerized record of admission, procedures, mortalities by use of Google Forms which were self-developed and are being used by Trainees to enter data to prepare various audit reports.
5. Introduction to day care services. We are in providing daycare services to the patients after the Endoscopic procedures as well.
6. Running Medical, Gastroenterology and Hepatology OPD twice a week.

In short, Medical Unit 3 is taking lead in managing and treating the patients in disciplined and friendly environment as well as providing state of the art environment and teaching for the training of its residents and Clinical Classes of MBBS. Medical Unit III is a 55 bedded ward, consisting of 1 male bay, 1 female bay and 1 HDU. It has 3 procedure rooms including 1 ERCP /EUS room and 2 endoscopy rooms.

Services provided by Medical Unit III include 7-8 medical emergencies of 24 hour per month, outdoor patient management via 3 OPD rooms working 7-8 days per month, indoor patient management via admission in ward. On average 1500 patient are attended in every single medical emergency, 250 patients on every single OPD, about 250 patients per month are given indoor facilities. Medical Unit III is providing Medical, Gastroenterology, Herpetology & Panctreatobiliary care to patients either planned or emergency. Two ERCP lists are conducted weekly with an average of about 50 procedures per month, whereas about 15 EUS, 200 gastroscopies and 50 colonoscopies are performed per month in Medical Unit III. Our department also arranges mocks examination for IMM and final FCPS examination along with routine classes and mortality meeting of PGRs. Medical unit -3 have also organised various BLS courses in year 2021 and 2022 for training of post graduate residents of various department to improve their emergency skills. Along with this various workshops including stress management, research methodology, communication skill, introduction to spirometry have been arranged in ward to increases knowledge and facilitate post graduate residents.

POST GRADUATE TRAINEES TRAINED                                                                    266

1. Current FCPS Trainees                   (Medicine)                                               15
2. Current FCPS Trainee                     (Gastroenterology)                                01
3. Current MD Trainees                      (Medicine)                                              06
4. Current MD Trainees                      (Gastroenterology)                                07
5. Previous FCPS Trainees                  (Gastroenterology)                                43
6. Previous FCPS Trainees                  (Medicine)                                               40
7. Rotational FCPS Trainees               (Gastroenterology)                              127
8. Rotational FCPS Trainees               (Medicine)                                               19
9. Rotational MD Trainees                  (Medicine)                                              08

 

 

Faculty Member

 

 

 

List of Faculty Members

 

1. Prof. Dr. Muhammad Arif Nadeem

2. Associate Professor Dr. Muhammad Irfan

3. Senior Registrar Dr. Bushra Mohayuddin

4. Senior Registrar Dr. Abdul Basit

5. Fellow Gastroenterology Dr. Muhammad Haseeb Nawaz

6. Fellow Gastroenterology Dr. Muhammad Salim Ullah Zafar

7. Fellow Gastroenterology Dr. Muhammad Jamil

8. Fellow Gastroenterology Dr. Muaaz Ahmad

9. Fellow Gastroenterology Dr. Ghulam Mhiyuddin

10.Fellow Medicine Dr. Adeel Riaz

 

Research Papers published since 2006 as Assistant, Associate & Professor of the Unit

 

1. Statistical Prediction Model for Relapse Rate in Chronic Hepatitis C Patients Treated

with Conventional Interferon and Ribavirin Therapy. British Journal of Medicine & Medical Research, 2011; 1(3): 122-131. (2^nd author)

2. Effects of Octreotide Infusion prior to Sclerotherapy in Esophageal Varices. Journal of the College of Physicians and Surgeons Pakistan (Jcpsp), 2001; 11 (11): 689-692. (1^stauthor)
3. Correlation of Polymorphoneutrocyte Count and Ascitic Fluid Culture in diagnosis of Spontaneous Bacterial Peritonitis. The Pakistan Journal of Gastroenterology (PJG), 2010; 24 (2): 23-26. (2^nd author)
4. Comparison of In-Hospital Course of Patients having First Acute Myocardial Infarction with or without Pre-Infarct Angina. Esculapio, 2007; 03 (03):20-25. (1^st author)
5. Comparison of Early Echocardiographic Findings Patients having First Acute Myocardial Infarction with or without Pre-Infarct Angina. Esculapio, 2007; 03 (02):07-12. (2^nd author)
6. Endoscopic Healing of GERD using Esomeprazole Therapy. Esculapio, 2008; 04 (02): 18-22. (2^nd author)
7. Hydrolytic enzymes and rutosid for treatment of chronic hepatitis C. The Pakistan Journal of Gastroenterology (PJG), 2009; 23 (1): 21-25. (2^nd author)
8. A Study Comparing Artemether and Quinine in Adults with Falciparum Malaria. Esculapio, 2009; 05 (02):09-13. (2^nd author)
9. Etiology of Renal Failure in Patients of Liver Cirrhosis having Renal Impairment. The Pakistan Journal of Gastroenterology (PJG), 2011; 25 (1): 29-35. (1^st author)
10. Outcome of Upper GI Endoscopy of Patients Presenting with Upper Gastrointestinal Bleed. Pakistan Journal of Medical & Health Sciences, 2012; 6(4): 985-987. (2nd author)
11. Colonoscopy - An Annual Audit of Cases at Medical Unit III, Services hospital, Lahore. Pakistan Journal of Medical & Health Sciences, 2012; 6(3): 522-524. (2nd author)
12. Diagnostic Evaluation of Patients Presenting with Bleeding Per Rectum by Sigmoidoscopy. Pakistan Journal of Medical & Health Sciences, 2012; 6(3): 517-519. (2nd author)
13. Etiological Spectrum of Liver Cirrhosis patients Presenting to a Tertiary care Hospital in Pakistan. Annals of Punjab Medical College, 2011; 5(1): 43-46. (2^nd author)
14. Viral load & Genotype are the Major Determinants of SVR in Chronic hepatitis C Patients of Azad Kashmir, Pakistan. Pakistan Journal of Medical & Health Sciences, 2013; 7(1): 223-226. (2nd author)
15. Effect of 1.5 litre Infusions on Serum Creatinine and other Factors in Patients of                Cirrhosis of Liver with Renal Impairment. The Pakistan Journal of Gastroenterology                 (PJG), 2012 / 2013; 26 / 27 (2 & 1): 9-14. (2nd author)
16. The Frequency of the Retinopathy in Patients of Chronic Hepatitis C Treated with Interferon Alpha – Ribavirin Combination Therapy. Journal of Fatima Jinnah Medical College (JFJMC), 2012; 06 (04): 36-39. (2nd author)
17. Retinal Changes: In Patients of Chronic Hepatitis C Treated with Interferon Alpha – Ribavirin Combination Therapy. Journal of Fatima Jinnah Medical College (JFJMC), 2013; 07 (01): 70-73. (2nd author)
18. Upper GI Endoscopy – an Annual Review of Cases at Medical Unit III (Department of Gastroenterology & Hepatology) Services Hospital, Lahore. The Pakistan Journal of Gastroenterology (PJG), 2012 / 2013; 26 / 27 (2 & 1): 29-31. (2nd author)
19. Hepatocellular Carcinoma in Cirrhotic Patients: Frequency, Seroprevalence of Hepatitis B and C, and Patients Profile. Esculapio, 2011; 07 (03):27-29. (3^nd author)
20. Frequency of Helicobacter Pylori in Distal Oesophageal Mucosa of Patients with Dyspepsia. J Ayub Med Coll 2014; 26 (3): 307-309. (2^nd author)
21. Frequency of Gallstones in Patients with Liver Cirrhosis. J Ayub Med Coll 2014; 26 (3): 341-343. (2^nd author)
22. Characteristics of Ischemic Heart Disease Patients Dying with Drug Induced Bone Marrow Suppression. International Journal of Preventive Medicine Research 2015; 1(1): 12-16. (3^rd author)
23. Frequency of Helicobacter Pylori Infection in patients with Minimal Hepatic Encephalopathy. Pakistan Journal of Medical & Health Sciences, 2015; 9(2): 720-722. (3rd author)
24. Upper gastrointestinal Bleed, a Grave yet Precipitating factor of Hepatic Encephalopathy in Cirrhotic patients. Pakistan Journal of Medical & Health Sciences, 2015; 9(2): 723-725. (3rd author)
25. Frequency of Rectal varices in patients with Portal hypertension secondary to Cirrhosis. Pakistan Journal of Medical & Health Sciences, 2015; 9(2): 726-728. (3rd author)
26. Frequency of Low Zinc Levels in Cirrhotic patients with Hepatic Encephalopathy.  Pakistan Journal of Medical & Health Sciences, 2015; 9(3): 834-837. (3rd author)
27. Diagnostic Accuracy of Doppler ultrasonography for Diagnosing esophageal Varices in Cirrhotic Patients. Esculapio, 2015; 11 (01):25-27. (3^nd author)
28. Frequency of Minimal hepatic Encephalopathy in Cirrhotic Patients with Normal Neurological  Exam. Pakistan Journal of Medical & Health Sciences, 2016; 10 (2): 396-398. (3rd author)
29. Frequency of Iron Overload in Patients of Chronic Hepatitis C Undergoing Therapy and Treatment Response in Patients with Iron Overload. Pakistan Journal of Medical & Health Sciences, 2016; 10 (2): 399-401. (3rd author)
30. Frequency of Diabetic Nephropathy in Tertiary Care Hospital. Pakistan Journal of Medical & Health Sciences, 2016; 10 (2): 402-404. (3rd author)
31. Serum Bilirubin as a Predictor of Malignancy in Patients Presenting with Obstructive Jaundice. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 41-46 (3rd author)
32. Hematochezia, its Frequency Distribution in Various Age Groups and Sigmoidoscopic Diagnoses: A Retrospective Cohort Study. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 51-54. (6th author)
33. Frequency of Metabolic Syndrome in Patients with Non-Alcoholic Fatty Liver Disease. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 58-61. (3rd author)
34. Prevalence of gastritis and gastropathy among upper GI endoscopies in Pakistani patients. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 62-65. (4th author)
35. Upper GI Endoscopic Evaluation of Esophageal Varices: A Retrospective Analysis from Liver Clinic, Lahore, Pakistan. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 66-69.  (5th author)
36. The Diagnostic Accuracy of Raised Serum Amylase Level at 4 Hours Post ERCP in Predicting Acute Pancreatitis. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 70-74. (3rd author)
37. Portal Hypertension Related Gastric Mucosal Changes in Patients Suffering from Liver Cirrhosis. The Pakistan Journal of Gastroenterology (PJG), 2014; 29 (1): 75-79. (6th author)
38. Liver and Gastrointestinal Aspects of dengue Infected Patients, in Lahore Pakistan. Esculapio, 2018; 14 (02):83-88. (4th author)
39. Effect of Self-monitoring of Blood Glucose With Glycemic Control of Patients with Type 2 Diabetes. Esculapio, 2018; 14 (01): 83-86. (2^nd author)
40. Association of Serum Cholesterol Levels with Decompensated Chronic Liver Disease. The

       Journal of Allama Iqbal Medical College (JAIMC), 2018; 16 (3): 121-126. (3^rd author)

41. Frequency of Prediabetes in Patients Infected with hepatitis C Virus. The Journal of Allama Iqbal Medical College (JAIMC), 2018; 16 (3): 127-130. (4th author)
42. Health Related Quality of Life (HRQOL) and its correlation with academic performance of medical students. Pak J Med Sci, 2019; 35 (1): 1-5. (3^rd author)
43. Primary prophylaxis of hepatic encephalopathy in decompensated cirrhosis: Low dose vs. full dose rifaximin. Pak J Med Sci. 2019; 35(5):1446-1450. (4th author)
44. Factors affecting the outcome of hospitalization among liver cirrhosis patients. Pak J  Med Sci. 2019; 35(5):1382-1386. (5th author)
45. Response and tolerability of sofosbuvir plus daclatsvir in elderly patients with chronic hepatitis C. J Ayub Med Coll 2019; 31 (4). (4th author)
46. Role of Rapid Virological Response in Predicting the Adverse effects of Sofosbuvir and Ribavirin Therapy in Chronic hepatitis c Patients. The Pakistan Journal of Gastroenterology (PJG), 2014; 28 (1): 4-7. (7^th author)
47. Frequency of Asymptomatic Spontaneous Bacterial Peritonitis in Decompensated cirrhotic Patients with Ascites. The Pakistan Journal of Gastroenterology (PJG), 2014; 28 (1): 21-24. (2nd author)
48. Savary-Guilliard Dilators for Management of Corrosive Esophageal Strictures without using Fluoroscope: Five-year Experience in Pakistani Population. Esculapio, 2019; 15 (03): 214-216. (6th author)
49. Comparison of Rifaximin with Norfloxacin in the primary prophylaxis of Spontaneous Bacterial Peritonitis. Esculapio, 2020; 16 (01): 20-24. (6th author)
50. Post-ERCP Pancreatitis: Risk factors and role of NSAIDs in primary prophylaxis. Pak J Med Sci. 2020; 36 (3):426-431. doi: https://doi.org/10.12669/pjms.36.3.1804. (3^rd author)
51. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet 2020; 395: 1927–36. (The HALT-IT Trial Collaborators and 17th author)
52. Frequency of Cirrhotic Cardiomyopathy in Cirrhotic Patients at Services Hospital Lahore.

The Journal of Cardiovascular Diseases (JCVD); 2020 16 (2):69-73. (5th author)

53. Bed side teaching: Student’s perception and its correlation with academic performance

Pak J Med Sci. 2020; 36 (6): 1-6. doi: https://doi.org/10.12669/pjms.36.3.1804. (3^rd   author)

54. Comparing Daclatsvir plus Sofosbuvir with or without Ribavirin, for Hepatitis C Virus

Genotype 3 Management. The Professional, 2020; 27 (4): 784-789. (4th author)

55. COVID19: Clinical Presentation and Diversity Related to Age and Gender. Esculapio, 2020; 16, Supplement 01, Special COVID-19 Issue: 3-6. (6th author)
56. Hyperglycemia and Its Impact on Length of Stay in Patients Hospitalized with Community-Acquired Pneumonia. Esculapio, 2020; 16 (03): 1-6. (6th author)
57. Endoscopic Observation Around the Gastroesophageal Junction in Patients with symptomatic Reflux Disease. J Pak Soc Intern Med., 2020; 1(1); 50-54. (4th author)
58. Frequency of Gastroesophageal Variceal Bleeding in Cirrhotic Patients with and without  Diabetes. J Pak Soc Intern Med., 2020; 1(1); 60-66. (2nd author)
59. Concomitant Therapy versus Triple Therapy: Efficacy in H. Pylori Eradication and Predictors of Treatment Failure. J Coll Physicians Surg Pak 2021; 31(02):1-4. (3^rd author)
60. Frequency of Metabolic Syndrome in Newly Diagnosed Type II Diabetes Mellitus Patients. J Pak Soc Intern Med., 2020; 1(2); 37-42. (3rd author)
61. Frequency of Erectile Dysfunction in Patients Receiving Pegylated Interferon and Ribavirin for the Treatment of Chronic Hepatitis C. Journal of Pharmaceutical Research International 2021; 33(22B): 38-43; Article no.JPRI.67050. (4th author)
62. Predictors of Mortality within 8 weeks after Endoscopic Treatment of Gastric Variceal Bleed with N-Butyl 2-Cyanoacrylate in Cirrhotic Patients. Pak Armed Forces Med J 2021; 71 (4): 1314-17. (6^th author)
63. Platelet Indices in Diabetes Mellitus Indicating Severity of Diabetic Microvascular Complications. J Pak Soc Intern Med. 2021; 2(3): 209-214. (5^th author)
64. Neutrophil to Lymphocyte Ratio As A Predictor of Endoscopic Damage in Caustic Injuries. Esculapio - JSIMS 2023; 19(02):172-176. (3rd author) DOI: https://doi.org/10.51273/esc23.251928
65. Response and Tolerability of Sofosbuvir Plus Velpatasvir in Patients With Hepatitis C Related Liver Cirrhosis. Esculapio - JSIMS 2023; 19 (03):313-317. (6^th author)

DOI: https://doi.org/10.51273/esc23.251319311