Department of Medicine

The Department of Internal Medicine came into being since the establishment of Patan Hospital in 1982. In keeping with the mission and goals of PAHS, the department strives to provide quality health services to the people and to impart the culture of academic excellence and social responsibility to its graduates.

The major goals and activities of the Department are three-pronged: service, education, and research.

 A.    Health Services

a.     Out-patient services (OPD)

OPD services are provided in all working days (Sunday-Tuesday, Thursday, Friday) via general OPD (Medical referral clinic or MRC) and extended OPDs (Patan private clinic or PPC and Patan Private Practice or PPP). General Medicine as well as specialty services in Cardiology, Pulmonology, Gastroenterology, Nephrology, Rheumatology, Hematology, Oncology, and Infectious Diseases are available. There are special OPD services for patients with cancers like chronic myeloid leukemia, gastrointestinal stromal tumor, kidney cancers, certain types of lung cancer, &  (Gleevec international patient assisted program), type 1 diabetes mellitus in children and adolescents (Life for a child with diabetes program), and certain types of breast cancer (Max access solution for breast cancer). In average, Department of Internal Medicine caters OPD services to around 1500 patients per week.

b.     In-patient services

Department of Internal Medicine provides in-patient services through 152 beds (excluding cabin beds which are not specifically for Internal Medicine only):

            Medicine ward A                    46 beds

            Medicine ward B                     13 beds

            Geriatric ward                         10 beds

            Medical ICU                            21 beds

Medical HDU                           14 beds

Coronary care unit (CCU)       7 beds

Hematology ward                   18 beds

Oncology ward                       23 beds (including 5 palliative care beds)

Specialty services available in various specialty units include:

●      Cardiology Unit:

Cardiology unit has been expanding its services in both invasive and non-invasive arena. OPD services are available on all working days. Non-invasive cardiology services include electrocardiography (ECG) echocardiography (including routine 2D-echo, stress echo, strain echo, and tranesophageal echo), treadmill test (TMT), Holter, ambulatory BP monitoring (ABPM). Invasive cardiology services include coronary angiography (CAG), peripheral angiography, percutaneous coronary intervention (primary and elective PCI), pacemaker implantation (temporary and permanent), pericardiocentesis, and IVC filter. A 7 bedded coronary care unit has been providing cardiac intensive care services to the needy.

●      Pulmonology & Critical Care Unit:

Pulmonology unit runs OPD on all working days and is involved in the inpatient care of critically ill patients admitted in the medical ICU. Besides that, the unit provides various diagnostic and therapeutic services like pulmonary function test (PFT), bronchoscopy, transbronchial needle aspiration, transbronchial biopsy, & medical thoracoscopy.

●      Gastroenterology Unit

Gastroenterology unit has been providing various diagnostic and therapeutic services along with out-patient and in-patient services. Diagnostic procedures include UGI Endoscopy, Colonoscopy, Endoscopic Ultrasonography, Duodenoscopy, Urea breath test and Therapeutic procedures include polypectomy, variceal band ligation, glue injection for fundal varices, endoluminal stenting, percutaneous endoscopic gastrostomy, endoscopic nasojejunal tube insertion, ERCP, Argon plasma coagulation.

●      Nephrology Unit

Nephrology unit provides general OPD service on Monday and Thursday, and paying clinics on Sunday, Tuesday, Wednesday and Friday. Hemodialysis service is being provided via 16 dialysis machines which provide scheduled dialysis as well as emergency dialysis (available 24 hours). Two additional dialysis machines are available in medical ICU. Besides that, continuous renal replacement therapy (CRRT) and renal biopsy services are also available.

●      Rheumatology Unit

Patan Hospital is currently the only hospital in the country with a dedicated rheumatology unit. Out-patient services are available via general OPD on all working days and also via paying clinics on Sunday, Monday and Thursday. Besides OPD and in-patient services the unit delivers special services like arthrocentesis, intraarticular injections, nail-fold capillaroscopy, musculoskeletal ultrasonography, skin biopsy.

●      Hematology Unit

Hematology unit has been providing services to patients with various benign and malignant hematolymphoid disorders. Besides the hematologic workups including bone marrow analysis available in-house, special tests like immunophenotyping, karyotyping, FISH, molecular tests like BCR/ABL, PML/RARA, mutation analysis are being done in collaboration with other labs. Out-patient, In-patient, Day-care services, PICC line insertion and care services are also being provided. Currently, this unit has more than 800 CML patients in follow up along with other patients with AML, ALL, APML, MDS, AA, PNH, CLL, hairy cell leukemia, MM, lymphomas, thalassemia, sickle cell anemia, hereditary spherocytosis.

●      Oncology Unit

Oncology unit has been involved in patient care services in almost all divisions of oncology including Breast, Gastrointestinal, Head & neck, Lung, Bone, Soft tissue sarcomas, Gynae-oncology, Uro-oncology. In-patient as well as day-care services are available.

B.    Education

Department of Internal Medicine is involved in medical training from undergraduate to postgraduate and subspecialty levels:

●      Undergraduate: MBBS

●      Post-graduate: The department runs MD Internal Medicine residency program. Besides, it provides short-term rotational training to MD residents from other disciplines like MDGP, Dermatology.

●      Subspecialty training: The department conducts subspecialty fellowship courses in Rheumatology, and Infectious Diseases with intake of two fellows in each of these streams.

●      Internal Medicine quiz for undergraduate and postgraduate students from various medical colleges in the country.

●      A primer course in musculoskeletal medicine has been started with the aim to provide an orientation to junior doctors working in various parts of the country towards approach to common musculoskeletal and rheumatologic disorders.

C.    Research

Several research activities are being carried out in the department by the residents and the faculties.