newsletter july 2017 · chest pain or discomfort which may travel into the shoulder, arm, back,...

Newsletter July 2017

[email protected] | www.maroof.com.pk

MAROOFInternational Hospital

eliminateHEPATITIS

28th july 2017

“400 Million people areinfected with chronic viralHEPATITIS worldwide”

MAROOF INTERNATIONAL HOSPITAL2

MAROOF DONATION CAMPAIGNRamzan is the holy month where the reward for every good deed is multiplied several times and people are encouraged to adopt better deeds as their life style. Keeping in view the spirit of Ramazan, the management of Maroof International Hospital organized “Clothes Donation Campaign” throughout the holy month. This was open for everyone especially employees to donate as much clothes as they can for the deserving people. The whole donation goods were then given to Eidhi Welfare Organization. Employees participated whole heartedly in this activity and appreciated this initiative by management.

MIH Donation Campaign

World Hepatitis Day, observed on July 28 every year, aims to raise global awareness of hepatitis — a group of infectious diseases known as Hepatitis A, B, C, D, and E — and encourage prevention, diagnosis and treatment.

Consultants On Board

Dr. Rubab HasanSpecialist in clinical dermatology, aesthetic and anti-aging medicine, skin lasers including medical and aesthetic lasers, Dr. Rubab has joined our team as Consultant Dermatologist and Head of Dermatology. She has vast experience and trained in Pakistan, Dubai, Singapore, Thailand as well as Canada, and brings over 20 years of experience and knowledge. Dr. Rubab is a member of highly prestigious dermatological societies such as AAAM, A4M, IDS & EMA.

Dr. Ishtiaq Ur RehmanDr. Ishtiaq Ur Rehman Orakzai, MBBS, FCPS ”PLAST”, MRCS (1&2), Member Pakistan Association of Plastic Surgeons is now on board at Maroof International Hospital. He has joined team Maroof as Consultant plastic, reconstructive, burns and cosmetic Surgeon. Dr. Ishtiaq has more than ten years’ experience in Cosmetic Surgery, Pediatric Plastic Surgery and Adult Plastic Surgery. His expertise range from Hair transplant, PRP therapy, Otoplasty, Browlift, Blepharoplasty, Facelift, Botox, Rhinoplasty (nose job), Fat grafting, Gynaecomastia, Breast reshaping, Liposuction, Tummy tuck, Scar revision, Moles removal, Keloid to Cleft lip/ palate, CMN/Birthmark, Hand anomalies, Hypospadia, Vascular malformations, Haemangiomas, Prominent ears, Microtia, Facial palsy, Torticolis to Head and neck cancer, Skin/soft tissue cancer, Breast cancer/reconstruction, Brachial plexus/ peripheral nerve injuries, hand and limbs surgery, Facial trauma/reconstruction, Chronic wounds and Burns/post burn deformities.

Maroof International Hospital is pleased to welcome them all as part of our team and wish them all the best.

Dr. Imran Ghani KhattakMaroof International Hospital welcomes Dr. Imran Ghani Khattak MBBS, M.D (USA), FCPS (Cardiology) as a new member of its experts’ team.Dr. Khattak has joined as Consultant Interventional Cardiologist and his expertise are ECHO, ETT, Coronary Angiography, Coronary Angioplasty, Cerebral Angiography, Cerebral Angioplasty, Cardiac Catheterization and Periperiphal Arteriogram. He has six years’ experience in field of cardiology.

MAROOF INTERNATIONAL HOSPITAL 3

MAROOF INTERNATIONAL HOSPITAL4

Dr. Shamail AnwarConsultant GynecologistMBBS, FCPS

Air Travel and PregnancyThe information is relevant for short haul (under four hours), medium and long haul (over four hours) flights.

Will flying harm me or my baby?If your pregnancy is straightforward, flying is not harmful for you or your baby: • If you have a straightforward pregnancy and are healthy, there is no evidence that the changes in air pressure and/or the decrease in humidity have a harmful effect on you or your baby. • There is no evidence that flying will cause miscarriage, early labour or your waters to break. Anyone who flies is exposed to a slight increase in radiation. Occasional flights are not considered to present a risk to you or your baby.

When is the safest time to fly during pregnancy? When you are pregnant, the safest time to fly is: • Before 37 weeks, if you are carrying one baby. From 37 weeks of pregnancy you could go into labour at any time, which is why many women choose not to fly after this time.• Before 32 weeks, if you are carrying an uncomplicated twin pregnancy. Most airlines do not

allow women to fly after 37 weeks. It is important that you check with your airline before flying. It may also be more difficult to get travel insurance after 37 weeks.

Am I at increased risk of problems if I travel by air?Some pregnant women may experience discomfort during flying. You may have: • Swelling of your legs due to fluid retention (oedema). • Nasal congestion/problems with your ears – during pregnancy you are more likely to have a blocked nose and, combined withthis, the changes in air pressure in the plane can also cause you to experience problems in your ears. • Pregnancy sickness – if you experience motion sickness during the flight, it can make your sickness worse.

Deep Vein Thrombosis (DVT) A DVT is a blood clot that forms in your leg or pelvis.If it travels to your lungs

(pulmonary embolism) it can be life threatening. When you are pregnant and for up to six weeks after the birth of your baby, you have a higher risk of developing a DVT compared with women who are not pregnant.There is an increased risk of developing a DVT while flying, due to sitting for a prolonged length of time. The risk of a DVT increases with the length of the flight. Your risk is also increased if you have additional risk factors such as a previous DVT or you are overweight.

What can I do to reduce the risk of a DVT? If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures. To minimize the risk of a DVT on a medium or a long haul flight (over four hours), you should: • Wear loose clothing and comfortable shoes. • Try to get an aisle seat and take regular walks


around the plane. • Do in-seat exercises every 30 minutes or so – the airline should give you information on these.( Standing , stretch your leg, gently flex your foot to stretch your calf muscles. When sitting rotate ankles and wiggle toes.)

• To ease in flight discomfort, avoid gaseous foods and drinks before flying. • Have cups of water at regular intervals throughout your flight. • Cut down on drinks that contain alcohol or caffeine (coffee, fizzy drinks) • Wear graduated elastic compression stockings – your doctor will need to provide the correct size and type for you as they are different from standard flight socks.• Should take aisle seat to allow free mobility.If you have other risk factors for a DVT, regardless of the length of your flight, you may be advised to have heparin injections. These will thin your blood and help prevent a DVT. A heparin injection should be taken on the day of the flight and daily for a few days afterwards. For security reasons, you will need a letter from your doctor to enable you to carry these injections onto the plane. Low-dose aspirin does not appear to reduce the risk of a DVT but you should continue to take it if it has been prescribed for another reason.

Are there circumstances when I may be advised not to fly? A medical condition or health problem can complicate your pregnancy and put you and your baby at risk. For this reason, if any of the following apply, you may be advised not to fly: • You are at increased risk of going into labour before your due date.

• You have severe anaemia. This is when the level of red blood cells in your blood is lower than normal. Red blood cells contain the iron-rich pigment haemoglobin, which carries oxygen around your body. • You have sickle cell disease (a condition which affects red blood cells) and you have recently had a sickle crisis. • You have recently had significant vaginal bleeding. • You have a serious condition affecting your lungs or heart that makes it very difficult for you to breathe.• Pregnancy induced hypertension, poorly controlled Diabetes. It is important that you discuss any health issues or pregnancy complications with your doctor before you fly. If you have an increased chance of miscarriage or ectopic pregnancy, ask for an ultrasound scan for reassurance before you fly. Be aware that the unexpected can happen while travelling which could delay your return home. Some airlines may not allow you to fly if you have fractured a bone, have a middle ear or a sinus infection or have recently had surgery to your abdomen that involved your bowel, such as having your appendix removed.

• If you are over 28 weeks pregnant, your airline may ask you to get a letter from your midwife or doctor stating when your baby is due andconfirming that you are in good health, are having a straightforward pregnancy and are not at any increased risk of complications.Any document needed to confirm your due date and that you are fit to fly. Some airlines have their own forms/documents that will need to be completed at any stage of pregnancy.

Will I have to go through a security scanner?You will have to go through the normal security checks before flying. This is not considered to be a risk to you or your baby.

Can I wear a seatbelt? You must wear a seatbelt. You should ensure the strap of your seatbelt is reasonably tightly fastened across the top of your thighs and then under your bump. Ask the cabin crew if you need a seatbelt extension.Because air turbulence cannot be predicted and the risk of trauma is significant pregnant women should be instructed to continuously wear the seatbelts.

What happens if I go into labour on the flight?Any pregnant woman has a small chance of going into labour early or for her waters to break early. If this happens to you on a flight, there is no guarantee that other passengers or crew members will be trained and experienced to help you give birth safely. As a result, the pilot may have to divert the flight to get help for you.

Sources and acknowledgements:Patient informationRoyal college of Obstetricians and Gynecologists UK

MAROOF INTERNATIONAL HOSPITAL

Dr. Imran Ghani KhattakConsultant Interventional CardiologistMBBS, MD(USA), FCPS(Cardiology)

Myocardial Infarction (MI), commonly known as a heart attack occurs when blood flow stops to a part of the heart causing damage to the heart muscle. Worldwide, about 15.9 million Myocardial Infarctions occurred in 2015. More than 3 million people had an ST elevation MI(major heart attack) and more than 4 million had an NSTEMI(minor heart attack). STEMIs occur about twice as often in men as women. About one million people have an MI each year in the United States. In the developed world the risk of death in those who have had an STEMI is about 10%. Symptoms: Chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it is in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling fainted, a cold sweat, or feeling tired. About 30% of people have atypical symptoms like dizziness, blackout, epigastric discomfort and syncope. Women more often have atypical symptoms than men. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms."Silent" myocardial infarctions can happen without any symptoms at all.These cases can be discovered later on through electrocardiograms, using blood enzyme tests, and echocardiography or at autopsy after a person has died. Such silent myocardial infarctions represent

between 22% and 64% of all infarctions and are more common in the elderly, in those with diabetes mellitus and after heart transplantation.

Risk Factors:High blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, excessive alcohol intake ,chronic kidney disease, family history, Old age and Stress.

Complication:Heart failure, arrhythmia, heart block, pericardial effusion, syncope, sudden death.

Diagnosis:ECG, Echocardiography, blood test (ckmb, troponine), coronary angiography.

Treatment:Oxygen, pain relief, antiplatelets( aspirin, clopidogrel), anticoagulation (heparin), revascularization (Thrombolytic or PCI or CABG).

Myocardial Infarction (MI)

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Prevention:• Lifestyle modification like regular brisk exercise for 30 to 45 minutes daily,• Weight reduction keeping BMI 18-24.9,• Smoking cessation,• Alcohol reduction,• Mediterranean diet

Risk factor modification:• Good control of Diabetes mellitus, Hypertension, Dyslipidemia• Compliance with medication• Regular follow up• Patient education

"Silent" myocardial infarctions can happen without any symptoms at all. These cases can be discovered later on electrocardiograms, using blood enzyme tests, and echocardiography or at autopsy after a person has died.

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Bed bugs have been around for thousands of years. They feed on blood, but are not known to spread any diseases to humans. Some people can be allergic to their bites. Getting rid of a bed bug infestation is not easy, but there are steps you can take to control the problem. There are also steps you can take to avoid bringing bed bugs home.

What are bed bugs?• Bed bugs are small, flat wingless insects that are reddish-brown in color and approximately one-quarter inch long, before feeding (about the size and shape of a small apple seed).• They hide during the day on beds (mattress seams, box springs, bed frames, headboards) and in cracks and crevices of walls, floors and furniture. They come out at night.• They do not fly or jump, but they can crawl rapidly.

How can bed bugs get into my home?• They can come from other infested areas or from used furniture. They can hitch a ride in luggage, purses, backpacks, or other items placed on soft or upholstered surfaces.• They can travel between rooms in multi-unit buildings, such as apartment complexes and hotels.

How can I avoid bringing bed bugs into my home?• When staying in a hotel, place your bag on a suitcase stand rather than on the bed or floor. Keep the rack away from walls or furniture. When returning home,wash the clothes from your trip and put them in a hot dryer.• Inspect new and used furniture before bringing it inside. Look in seams, tufts and under cushions.

How do I know if I have a bed bug problem?• You can see the bed bugs themselves, their shed skins, or their droppings in mattress seams and other items in the bedroom.• There may also be blood stains on sheets. How do I control a bed bug problem in my home?It can be done, but it usually requires what is called an "integrated pest management" (IPM) approach. This combines techniques that pose the lowest risk to your health and the environment.

What They Are and How to Control Them

BEDBUGS

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Try these strategies:• Clean and get rid of clutter, especially in your bedroom.• Move your bed away from walls or furniture.• Vacuum molding, windows and floors every day. Vacuum sides and seams of mattresses, box springs and furniture. Empty the vacuum or the bag immediately and dispose of outside in a sealed container or bag.• Wash sheets, pillow cases, blankets and bed skirts and put them in a hot dryer for at least 30 minutes. Consider using mattress and box spring covers –the kind used for dust mite control–and put duct tape over the zippers.• Seal cracks and crevices and any openings where pipes or wires come into the home.

Should I also try pesticides?Pesticides may not be effective and can be dangerous if used improperly. If you decide to use pesticides, follow these rules:• Only use pesticides that are registered by the governement and make sure they are labelled to control bed bugs.• Do not apply pesticides directly to your body (there are no repellents registered to control bed bugs that can be used on the human body).• Do not use outdoor pesticides indoors.• If you decide to hire a pest control company, make sure they have experience with bed bugs. They should follow the steps of IPM, along with any pesticide application. Use a company that is registered and employs licensedapplicators.

It takes time and persistence to get rid of bed bugs, and in some cases, the cooperation of landlords, neighbors and others. It can be physically and emotionally exhausting. It can also be expensive when pest control companies are called in. Just remember - bed bugs are more of a nuisance than a health concern and, with vigilance, you can avoid or deal with infestations.

Reference:Online Sources

It takes time and persistence to get rid of bed bugs. It can also be expensive when pest control

companies are called in. Bed bugs are more of a nuisance than a health concern and, with vigilance,

you can avoid or deal with infestations.

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Dr. Rubab HasanHead of DermatologyMaroof International Hospital

The Ultimate Skincare Tips For Clear And Glowing Skin

parties etc. Please don’t ignore your children, they need skin protection as well! Please remember to moisturize your skin and apply sunblock and drink plenty of water to keep your skin hydrated. Sunblock is vital and the best time to apply is 20 minutes before you step out and you may reapply every 2-4 hours depending on the outdoor duration. SPF (30+) is generally adequate and you can choose a product according to your skin type.

“I would like to clear a common misconception of only wearing sunglasses, a hat and sunblock when going to the beach or the pool. Instead, this should be a daily ritual to prevent your skin from sun damage which can be in the form of sunburn, sun tan, pigmentation issues, early signs of aging like wrinkling of skin, photokeratitis.”Be sun safe!!

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It takes a few simple steps to get that fabulous skin:• Daily cleansing is a must, even if it gets too late, you must remove your make up.• Toning for oily to combination skin.• Moisturizing is the key to hydrated skin for all skin types, even acne prone skin.• Regular exfoliation to remove old dead skin and refresh it. It can be done once a week or once in 2 weeks or once a month depending on skin type.• Investing in anti-oxidant creams to prevent early signs of aging.• Sun-protection is vital for skin care as discussed below.• Drinking plenty of water (8 glasses per day).• You are what you eat! So eat raw fruits and vegetables (5portions/day).• Light Exercising (2/3 times a week, 30 minutes) to improve circulation which helps in a glowing skin.• Adequate sleep (7-8 hours).

Summer Skin Care tips:As you know, Melanin is the pigment that creates your skin colour and exposure to sunlight increases melanin production. Thus, the higher the melanin in your skin, the darker your skin becomes. Avoiding direct exposure to sunlight is very important to protect yourself from photo-aging. It is getting really hot now and avoiding outdoor activities may be difficult, so scheduling these activities after 5 pm is better, be it going to the park, jogging, outdoor games and garden


Testimonial, Health Tips & Recipe

Grilled Chicken SandwichIngredientsChilli Sauce ½ cupUnsalted butter ¼ cup Ketchup 3 tbspBoneless chickenbreasts 4 Burger buns 4Mayonnaise dressing ½ cup Onion rings For GarnishingTomato slices For GarnishingLettuce leaves For Garnishing

Directions• Preheat grill to medium-high.• Chop Chicken to small pieces.• Combine Chilli sauce, butter, and ketchup in a bowl; reserve 1/4 cup mixture. Add chicken to remaining mixture and toss to coat. Marinate, 20 minutes. Remove chicken from marination.• Grill the marinated chicken, covered, until its tender and soft, approximately 5 to 7 minutes per side. Apply butter on buns and grill buns until lightly toasted, 1 to 2 minutes. Spread dressing on buns.• Spread chicken pieces• Garnish with onion rings, tomato slices and lettuce leaves.• Ready to serve.

Health Tips For Summertime: • Stay cool and active during the mid-day heat. Limit activities in the hot sun to 15 or 20 minutes at a time to help protect against heat exhaustion. Avoid prolonged sun exposure between the hours of 10 a.m. and 4 p.m. when the sun’s UV rays are the strongest.• Replace your shoes. Select the proper shoes for an activity and replace them often to prevent foot, ankle and knee pain.• Hydrate, hydrate, hydrate. Don’t wait until you are thirsty to drink water. Drink plenty of water before, during and after activities.• Go easy on your joints. Swimming is a great, low-impact exercise for summer and helps to prevent over-heating.

Testimonial: I would like to say a huge thanks to all the help we have received with regards to our visit, and a special thanks to Patient Coordination Department specially Mr. Abu Bakar and Mr. Waqar. So polite, friendly & helpful. Much appreciation to the help we received from Mr. Zeeshan Malik who was very helpful and sorted out our all issue. (Ms. Aleena Ahmed) Dr. Farzana (MSA) was very patient and knowledgeable. The service was great I had to get some tests done and Ms. Eraj faiz (Laboratory Department) did my blood work. She was very pleasant and professional. This is the reason I am switching from MEDICSI to Maroof International Hospital. Keep up the good work. (Ms. Aamna Arshad)

Mr. Naeem Ur Rehman (Laboratory Department) is a very nice person. He is very polite and decent man. He has administrated my blood in a very professional way and I did not feel any pain when he

was taking my blood sample. I wish him all the best for his future endeavors. He is an asset for the Maroof International Hospital. (Aamir Waqar)

Mr. Zahid (Nursing Department) was very polite, efficient and caring. May Allah give him Jaza. (Mr. Arshad Malik)

Dear concern, we stayed here for 5 days in labor room and NICU. During our stay the following staff members were amazing in service and professionalism. Dr Nafeesa(NICU) she is an extra ordinary person, Khurram Ayaz (Patient Services Department) and Raja Tahseen (Patient Coordinator Department) are very good and professionals. Especially Khurram Ayaz, you need more people like him.Dr Ghazala Bashir and Dr. Zafar half of tension and worries vanish if we only talk to them both. (Mr. Asim Hamid)

UAN: +92-51-111-644-9-11Fax: +92-51-2222939

Maroof Medical & Diagnostic Center, 22 West - sardar Plaza, Opposite Poly clinic, Fazal-e-Haq Road, Blue Area, IslamabadMaroof International Hospital, 10th Avenue, F-10 Markaz, Opposite F-9 Park, Islamabad

Tel: +92-051-8356165-6 Email: [email protected]


Editorial Board PatronCh.Naseer Ahmed

Sub EditorMashal Rasool

EditorMalik Zeeshan Ali

Chief EditorCh. Haroon Naseer|

DERMATOLOGY CLINICAL PROCEDURES• Cryo cautery for benign skin lesions like warts molluscum contagiosum and verrucae on feet and hand.• Electrocautery for cherry angiomas, seborrheic keratosis, xanthomas and xanthelasmas, syringomas, pyogenic granulomas.• Puncture & curettage of acne cysts, inflamed, epidermal cysts and contagiosum (White & Black Heads).• Intralesional injection for inflammatory pyoderma cysts, acne cysts, alopecia areata, prurigo nodularis, resistant psoriatic plaques and hypertrophic and keloidal scars (Surgical Scars).• Blister Drainage of vesicular bullous eruptions.• Incision & drainage of skin abscess• Dermoscopic evaluation of moles• Skin biopsies - Punch and shave biopsies of un- classified benign as well as suspicious growths. • Skin excision of benign lesions like pyogenic granuloma, angiokeratomas, compounds nevi, painful keratoderma plugs on feet and toes and calositis and corns. • Blood allergy testing – food and environmental allergens.• Viral studies for herpes, hpv and other STDs• Skin dressings - minor, major, complex inflammatory as well as contact burn dressing • Comedone extraction

Dr. Rubab HasanHead of Dermatology

Specialist in Clinical dermatology,Aesthetic and Anti-aging medicine, Skin lasers including medical and

aesthetic lasers. Dr. Rubab has vast experience and

is trained in Pakistan, Dubai, Singapore, Thailand as well as

Canada, and brings over 20 years of experience and knowledge. Dr. Rubab is a member of highly

prestigious dermatological societies such as AAAM, A4M, IDS & EMA.

For inquiries contact at [email protected]@gmail.com

Tel; +92-51-2222920-50 EXT 2220

SKIN LASERS AESTHETIC & CLINICAL• Laser hair reduction• Fractional RF resurfacing for wrinkles, acne scars, surgical/traumatic scars, stretch marks and malasma• Non-ablative radiofrequency face-lift• IPL Photo rejuvenation for wrinkle reduction, skin and neck rejuvenation• IPL Photo dynamic therapy for reduction of acne, actinic keratosis, large pore and sebaceous hyperplasia • RF body contouring and cellulite reduction

AESTHETIC DERMATOLOGY• Face-lift using fillers• PRP for dark under-eye, facial and neck rejuvenation as well as hair loss• Carboxy and topical therapies for dark under eye and stretch marks• Botox for wrinkle reduction for face and neck• Botox treatment for reduction of excessive sweating (Hyperhidrosis – underarms, hands and feet)• Lipolysis injections for localized fat reduction and cellulite• Microdermabrasion• Skin and facial rejuvenation using chemical peels (AHA, TCA and SA)• Treatment of Malasma and Hyperpigmentation• Mesotherapy for hair loss and facial rejuvenation• Face Thread Lift

AESTHETIC DERMATOLOGY• Face-lift using fillers• PRP for dark under-eye, facial and neck rejuvenation as well as hair loss• Carboxy and topical therapies for dark under eye and stretch marks• Botox for wrinkle reduction for face and neck• Botox treatment for reduction of excessive sweating (Hyperhidrosis – underarms, hands and feet)• Lipolysis injections for localized fat reduction and cellulite• Microdermabrasion• Skin and facial rejuvenation using chemical peels (AHA, TCA and SA)• Treatment of Malasma and Hyperpigmentation• Mesotherapy for hair loss and facial rejuvenation• Face Thread Lift

UAN: +92-51-111-644-911Fax: +92-51-2222939

Maroof Medical & Diagnostic Center, 22 West, Sardar Plaza, Opposite Poly Clinic, Fazal-e-Haq Road, Blue Area, IslamabadMaroof International Hospital, 10th Avenue, F-10 Markaz, Opposite F-9 Park, Islamabad

Tel: +92-051-8356165-6 Email: [email protected]


Editorial BoardPatronCh.Naseer Ahmed

Sub EditorMashal Rasool

EditorMalik Zeeshan Ali

Chief EditorCh. Haroon Naseer|

DERMATOLOGY EXPERTISE

LASER EXPERTISE AESTHETIC EXPERTISE

MAROOF DERMATOLOGY

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newsletter july 2017 · chest pain or discomfort which may travel into the shoulder, arm, back,...

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