JKSCD asks government to resume surgical treatment in hospitals

Srinagar: Jammu and Kashmir Society of Consultant Doctors (JKSCD) Sunday expressed concern about vital aspects of patient care amid the prevailing COVID-19 lockdown.
In a statement issued here, President, JKSCD Dr Maajed Jehangeer appealed the government to allow resumption of surgical treatment in a phased manner as per standard operating procedures in government hospitals.
While appreciating the recent order in which normal functioning of private hospitals, diagnostic centres, labs and dental clinics has been allowed to resume, Dr Jehangeer stressed on the need to replicate it in the government sector as well.
Dr Jehangeer suggested that semi-urgent surgeries in the government sector should be started in the first phase under proper scientific precautions and constant monitoring of resultant outcomes to reduce the risks of community transmission of COVID-19 in the interest of patient care and for benefit of society at large saying that a proportionately large number of patients will be unable to afford private surgical treatment.
The JKSCD President said that measures like mandatory COVID-19 diagnostic testing of the surgical patient, adherence to social distancing, restricting attendant visit to hospitals and wearing of proper personal protective equipment (PPE) by hospital /theatre staff should be adhered to in letter and spirit.
Dr Jehangeer said that all those surgeries which were previously elective were now turning into semi-emergencies and emergencies.
He said that there had been a lot of patients of cholelithiasis (gallstones) who, under normal circumstances were supposed to undergo elective laparoscopic surgery presenting to hospitals as cases of pancreatitis, cholangitis, obstructive jaundice and sepsis.
Dr Jehangeer further said that there had been more and more patients with gallstones and they were getting admitted to hospitals with acute cholecystitis (inflammation of gallbladder), mucocele (mucus in gallbladder), pyocele (pus in gallbladder) and acute cholangitis – all of these “potentially serious complications”.
He further said that most patients with acute appendicitis were being “managed conservatively and this lands some of them into complications like perforation, complicated appendicular lump formation among others, which is a bad clinical end-point”.
Anal fissures and haemorrhoids are presenting as thrombosed or prolapsed masses with abscess and fistula formation, Dr Jehangeer added.
He said that elective hernias were presenting in obstruction or incarceration.
“What complicates matters further is that for these emergencies and semi- emergencies patients need recurrent admissions in hospitals like SMHS and SKIMS for many days which further exposes them to the risk of COVID-19, ” he said.
Dr Jehangeer said that such patients need to undergo further procedures and investigations like ERCP, CECT, MRCP which could have been avoided.
The JKSCD urged government to consider allowing, in the first instance, semi-urgent surgical procedures in Jammu and Kashmir with instructions to hospitals to follow proper scientific precautions and recommended standard operating procedures in all cases in order to mitigate patient suffering and minimise their chances of exposure to COVID-19.

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