APCNAAPCNA Association of Pakistani-Descent Cardiologists of North Americamarch 2007newsletter : Volume 2, number 2

PRESIDENT’s MESSAGEDear Colleagues:

One of my priorities was to promote membership and develop our relationship with other national and international organizations. The past year has been a very exciting period for APCNA. We were able to build upon the strong foundation

that was laid down by the founding members.

The soul of any organization is its membership base. For the success of our projects, we need the support, expertise and guidance from our members. Recently, we mailed over 500 membership packets to the prospective members. With limited resources, this was indeed a major task. I must thank my wife and my son for their help. I am confi dent that this effort will soon bear fruits.

For any new organization, the biggest challenge is disseminating information to the prospective members. For this, we need your help and urge all of you to get involved in APCNA and ensure its growth. By increasing our membership we will have a stronger organization and effective voice. We are now able to accept membership online on our website.

The Third Annual Winter Conference in Lahore, Pakistan was a great success. A large delegation of 15 cardiologists went with us. Dr. Immad Sadiq was the chair person for the conference and he deserves to be commended for his effort. Dr. M. Haseeb did great job facilitating the meeting at KEMU. I must also thank our hosts Prof. Jawwad Khan and Dr. Ahmad Shahbaz at the Punjab Institute of Cardiology (PIC) and Prof. Bilal Zakaria and Prof. Mansoor Hussain at the Mayo Hospital/KEMU for their hospitality. The camaraderie that developed amongst our members will most certainly last a lifetime. Javed, Wamique, Rizwan, Zia Kidwai, Immad and I stayed together for several days and it gave us a chance to brainstorm on multiple occasions. We will be discussing our ideas with all of you soon.

One project that I am really proud of is the establishment of a Pacemaker Bank in Pakistan. I would like to thank Mr. Wil Mick of Heartbeat International and Mr.Ovais Kohari of Rotary Club in Pakistan for working with us on this project.Once all necessary due diligence is done and logistical matters are settled, this Pacemaker Bank will provide absolutely free Permanent Pacemakers and ICDs to the non affording and deserving patients in Pakistan. Dr. Bashir Hanif and Dr.Zahid Jamal are the Co-Medical Directors of this Pacemaker Bank. We are confi dent that this project will succeed and become a model for setting up Pacemaker Banks in different parts of Pakistan.

This year we were granted Tax-Exempt Status by the IRS as a 501(c) (3) organization. We are a Non-Profi t, Professional and Philanthropic organization.This status will help us to accept donations to carry out philanthropic projects both here in the US and in Pakistan.

Our website is coming of age. If you have not visited it; I encourage you to do so at WWW.APCNA.NET . Your comments will help us improve it.

It has been a busy year and I have enjoyed leading this association.I could not have done this without the help of our Executive Committee. I would like to thank all of you. As I look to the future I feel very comfortable that we have a dedicated colleague Rizwan Karatela moving into my position. I know that the growth and progress of the association is in good hands. S.Fazal Rehman, Asif Rehman and Javed Suleman have again stepped up to the plate and helped us with fund raising to ensure the fi nancial stability of APCNA, and I thank them.

Thank you all for having given me the opportunity to serve as your President and I will continue to work with the future leadership. APCNA will continue to grow because of all of you.

Thank you,

Sincerely,

WAJID BAIG MD FACC

PresIDenTDr. M. Wajid Baig, MD, FACC

PresIDenT-eLecT:Dr. Rizwan A. Karatela, MD, FACC

ImmeDIaTe PasT PresIDenT:Dr. Javed Suleman, MD FACC

GeneraL secreTary:Syed Wamique Yusuf, MD, FACC

Treasurer:Asif Rahman, MD, FACC

bOarD OF TrusTee:Shahbudin RahimtoolaMD, MACC (Chairman)Sultan S. Ahmed, MD, FRCP, SQAS. Tanveer Rab, MD, FACCZia Moiz Ahmad, MD, FACCJaved Suleman, MD, FACC

eDITOr:Rizwan A. Karatela, MD, FACC

arTIcLe submIssIOnWe encourage all APCNA members to please submit their articles for the publication through out the year. We are also seeking cardiology news, meeting information or any news that you would like to share with other members. Articles to be submitted by email to baigwajid@yahoo.com in word document, pdf or plain email format will be acceptable. The Editor reserves the right to edit all the submitted material.

aDVerTIsemenTFor advertisement information, rate and deadline for submission please email baigwajid@yahoo.com

cOrresPOnDence47 Carriage Road Roslyn, NY 11576.TEL: 347-678-2734Email: baigwajid@yahoo.com

Website:www.apcna.netlist-serve: APCNA@Yahoogroups.com

APCNA Annual Winter Meeting 2006Lahore, PakistanDecember 19-20, 2006

APCNA had its third Annual Winter Conference in

Lahore, Pakistan in December 2006. It was ineed a great success. We had a very strong delegation with us. This year the members who traveled to Lahore and participated in our meeting included: Javed Suleman. NY, Wamique Yusuf. TX, Rizwan Karatela. FL, Immad Sadiq. RI. (Conference Chair), Zia Kidwai. MA, Zia Moiz Ahmed. MO., Mohammed Haseeb. IL, Khusrow Niazi. GA, Mushabbar Syed. KY, Nadeem Afridi. MA, Aamir Hameed. NE, Bashir Hanif. Karachi, Manzoor Tariq, MO, Wajid Baig. RI, Zulfiqar Bhatti, GA

APCNA Annual Winter MeetingDay 1: Punjab Institute of Cardiolog y

TuesDay, December 19Th 2006

The first day of our conference was at the Punjab Institute of Cardiology (PIC). PIC is one of the premier Cardiovascular

Centers in Pakistan. . ( http://pic.gop.pk/)They have one of the largest volume of Cardiac procedures in Pakistan. In the most recent year they have performed over 1200 open heart surgeries, over 1500 cardiac Catheterizations and Interventions, 20,000 Echocardiograms and over 4000 Nuclear Medicine tests. The Journal of Cardiovascular Diseases (JCVD) is also published from PIC. Professor Jawad Sajid Khan is the Head of the Institution. The Research and CME department is led by Dr. Ahmad Shahbaz. Dr. Shahbaz was instrumental in arranging our conference.

The format consisted of Didactic Lectures and Presentation by the Faculty; these were followed

by Question and Answers from the attendees. The attendees included local Faculty, Post-graduate Fellows, Cardiology House-staff and Cardiac Nurses.

Lectures were presented on: Advances in Management of Acute Myocardial Infarction Interventional approach to Valvular Heart Disease, ACS, CT Angiography, Carotid Stenting, Sudden Cardiac Death, Radiation and Cardiac Diseases, Intervention in Bifurcation Lesions, Advances in Doppler Echocardiography, Peripheral Intervention for the Cardiologists, Interesting Echocardiographic cases were presented.

Live Interventional Cases were broadcast to the audience from the Cath. Lab and interesting discussions were held in terms of management and type of interventional procedure to be undertaken. This was an opportunity to share knowledge amongst the different cardiologists present, who all work at different institutions all over the globe.

Some members also did consultations on inpatients at the request of local faculty. The Punjab Institute of Cardiology takes care of Over 120,000 patients each year. Many of these patients are from the rural areas. Most of them cannot afford the expensive interventions that they undergo.

APCNA report 2007 2

PAKISTAN Visit 2006 Report

Dr. Immad Sadiq, Dr. Haseeb and Dr. Wajid Baig answering questions at KEMU

APCNA report 2007 3

On behalf APCNA we presented dozens of Stents, Balloon catheters, Guide wires and other equipment used during the Cardiac catheterization procedure to the management of PIC. These supplies are to be used for these deserving patients. For any of them these are truly life saving.

Prof. Jawad Sajid Khan, as editor of The Journal of Cardiovascular Diseases (JCVD); has invited APCNA members to submit articles for publication in the journal. Punjab Institute of Cardiology has a very active Research and CME department. Medical students and Cardiology postgraduate fellows are actively pursuing research activities. APCNA members were invited to participate in joint research projects. In Pakistan the amount of cardiovascular pathology especially Rheumatic Heart Disease is truly astounding.I encourage all members interested in joint research projects at PIC to get in touch with Dr. Ahmad Shahbaz. He can be contacted via the PIC website.

APCNA Annual Winter MeetingDay 2: King Edward Medical University

and Mayo Hospital, LahoreWeDnesDay, December 20Th 2006

The second day of the Conference was held at King Edward Medical University (KEMU) - Mayo Hospital in Lahore. King Edwards is

now a medical University. It is the oldest Medical College in Pakistan. It has produced some of the finest physicians in practice both in Pakistan and the United States.

The conference hall had standing room only. Medical Students and House Physicians made the majority of attendees. There were some faculty members of KEMU also present.APCNA members were welcomed by Prof. Mansoor Hussain, Chief of Cardiothoracic Surgery at KEMU. Dr. Hussain is no stranger to

APCNA. Since our inception he has been a strong supporter of our activities and has guided us in how we can help promote cardiac care in Pakistan. Prof. Bilal Zakaria, Chief of Cardiology at KEMU hosted this conference at The Mayo Hospital.

The morning session consisted of didactic lectures. These were a Core Curriculum in Cardiology geared towards the medical students. There was a very enthusiastic question and answer session at the end of the lectures.

On behalf of APCNA we gave the KEMU/Mayo Hospital a very large amount of Cardiac equipment including prosthetic heart valves and permanent pacemakers. This is meant for the deserving patients who make up the vast majority of those treated at the Mayo Hospital.

The afternoon session was at the Mayo Hospital. The APCNA members were divided up into teams who did CCU rounds with the students, house officers and postgraduate cardiology fellows. This session was very well organized. Cases were presented in an excellent format. The students and our members both felt that in future conferences we should schedule a whole day for such teaching rounds.

Dr. Nadeem Afridi. Conducted an ACLS/BLS workshop. Dr. Haseeb, Dr. Sadiq and the local organizers are to be commended for making this a very well organized event.

APCNA Teaching rounds at Mayo Hospital CCU

APCNA report 2007 4

APCNA Workshops and Training Sessions Karachi, Pakistan

Several of our members conducted sessions at different hospitals in Karachi. Javed Suleman performed several high risk procedures

with local physicians at different institutions in including the NICVD. Zia Moiz participated in several interventions at Civil Hospital, Dow Medical College Karachi. He was able to use some of the donated catheters etc. Immad Sadiq and Bashir Hanif similarly performed procedures at Tabba Heart Institute. I conducted an EKG and Echocardiography Workshop at Civil Hospital, Dow Medical College. We donated stents, catheters etc. to NICVD, Civil Hospital and Tabba Heart Institute to be used for the deserving patients.

I would like to thank our members and their respective Institutions in the United States who were generous to give APCNA life saving equipment which we donated to the various teaching hospitals in Pakistan.

APCNA Members Donated Cardiac and Medical Supplies

worth about one million dollars

We are very please to announce that through the efforts of many of our members we were able to donate

cardiac and medical supplies to various institutions across Pakistan. These supplies can be used for the needy and deserving patients.

I am especially grateful to Dr. Saqib Masroor (Hackensack Medical Center, NJ) for sending Cardiac Valves to be used for deserving patients in Pakistan. These prosthetic valves no doubt will save many lives. I am also thankful to Dr. Mohammed Haseeb, IL for the Permanent Pacemakers he donated to the Mayo Hospital in

Lahore. We estimate that amongst all of us we carried with us almost a million dollars worth of equipment which was donated to different hospitals in Pakistan.

In December several of our members were able to send supplies to Peshawar for Lady Reading Hospital. Dr. Naeem Khan, one of our founding members took with him a very large supply of cardiac equipment to be donated to Prof. Hafeezullah.

APCNA members visitedMANSERA and ABBOTTABAD

Javed Suleman, Rizwan Karatela and Wajid Baig also made a visit to Mansera. Nadeem Afridi had already been there for an extended period. There is a Rehabilitation unit in Mansera which is jointly supported by APPNA and PICOS.

Many of our members have visited the earthquake affected areas and have volunteered in different activities. They are all to be commended for their work.

We also visited Ayub Medical College in Abbotabad. They were at the forefront of emergency efforts at the time of the earthquake. Nadeem Afridi has worked very hard in raising funds for this center as well as conducting courses there on emergency response efforts.

The success of our visit to Pakistan was due to a joint effort by all those involved. Taking time away from work and family to participate in voluntary work is never easy. Please accept my collective ‘thank you” to all of you. The camaraderie that has developed during this trip I am sure will last for all times.

Report prepared by Wajid Baig MD FACCImmad Sadi, MD FACC

APCNA report 2007 5

Basic Life Support in Pakistan: Results of a Pilot Study

Pakistan in many ways is a land of opportunity for the prepared. Although the basic health care delivery system is quite extensive, major gaps exist in basic life support systems. No structure exists in the country for formal

training of basic life support (BLS) in Pakistan such that hundreds of lives are lost due to lack of know how and equipment.

Initial survey done by APCNA (Association of Pakistani Cardiologist of North America), APPNE (Association of Pakistani Physicians of New England) with the support of DMC (Disaster Management Center) in Abbott abad, reviled the following information. 1. Basic Life support is not taught in most public (Government) hospitals including large teaching hospitals due to lack of trained staff . 2. No code 99 protocols exist in most large public hospital. 3. Due to the lack of resources and infrastructure to produce training equipment for BLS, it is beyond the approach of most public hospitals in the country to name a few impediments.

APCNA along with the APPNE and DMC created a model in which two central areas were selected as teaching centers, one in Abbott abad and the other in Muzaff arabad. These areas also had an advantage of having a very receptive audience due to the recent disaster. Medical students, doctors, homeopathic students, nurses, paramedics and even house wives and children were att racted to these BLS courses.

BLS equipment was donated through APCNA and APPNE, and training CD’s form the AHA’s BLS courses were used for demonstration. Hands on training was provided by AHA certifi ed staff and students were tested for there skills on mannequins. A writt en test was administered along the lines of AHA certifi cation for BLS.

So far 5 trainers have been trained to administer BLS. 174 individuals have been certifi ed, including 16 young adults, 105 women and 73 men from 3 medical schools, and 3 hospitals.

APCNA has now obtained a certifi cation agreement from AHA to give BLS credentialing cards to successful trainees in Pakistan. Interestingly, small organizations and NGO’s have taken a notice of the usefulness of this program and are beginning to provide funding to the DMC in Abbott abad to conduct more BLS training courses at various sites.

Moral of the story is that with litt le motivation, persistence and few thousand dollars, similar programs can be initiated in teaching hospitals throughout the country and many lives may be saved by simple interventions.

Sincerely,DR. NADEEM AFRIDI

Ptraining of basic life support (BLS) in Pakistan such that hundreds of lives are lost due to lack of know how and equipment.

Initial survey done by APCNA (Association of Pakistani Cardiologist of North America), APPNE (Association of Pakistani Physicians of New England) with the support of DMC (Disaster Management Center) in Abbott abad, reviled

APCNA report 2007 6

APCNA-Rotary Club-Heartbeat International Pacemaker Bank Project

Karachi, PakistanDecember 27Th, 2006

by ImmaD saDIQ, mD. Facc

APCNA has partnered with the Pakistan Rotary Club and Heartbeat International, Tampa FL in establishing a Pacemaker Bank in Pakistan. The work had

been in the progress for the past one year and fi nally we are happy to announce establishment of the bank in Karachi.

On December 27th we had an offi cial signing of an agreement between the parties in Pakistan and APCNA for the establishment of this Pacemaker bank. It will be physically located at the Tabba Heart Institute but deserving patients from all over the city will be able to get a permanent pacemaker if they need.

All parties concerned made the assurance that there will be NO COST of any kind to the patient for this donated pacemaker. This includes implanting physician charges, hospital cost, follow up and other costs as may occur such as supplies etc. The Rotarians and the local institutions will subsidize any charges if necessary.We cannot say how delighted and thankful we are to the administration of Tabba Heart Institute and the Rotarians for helping APCNA in this endeavor. The two medical directors of the Pacemaker Bank, Dr. Bashir Hanif (Tabba Heart Institute) and Dr. Zahid Jamal (National Institute of Cardiovascular Diseases) were present at this event.

Once the extensive paperwork is completed in Pakistan we will send in our application to the Heartbeat International. Upon their approval we hope to proceed fast with this project. Everyone present was very excited about this eff ort and thanked APCNA for having taken the lead in providing truly life saving therapy for the deserving patients.

The First Pacemaker Bank Project for Pakistan

APCNAwith the Pakistan Rotary Club and Heartbeat International, Tampa FL in establishing a Pacemaker Bank in Pakistan. The work had

Dr. Wajid Baig, President APCNA signing papers for the project. On left, Dr. Bashir Hanif and no right Ovais Kohari representing Rotary Club Pakistan

Representatives of APCNA, Tabba Heart Institute and Rotary Club Pakistan.

APCNA report 2006 7

Javed Suleman, MD, FACCFor Treasurer APPNADo you want a better APPNA? An APPNA with hope and vision for a brighter future. An APPNA believing in professionalism, dignity and compassion. An APPNA not blinded by regionalism or ethnicity.

Then vote for: Javed Suleman as TreasurerENERGY ENTHUSIASM EXCELLENCE

Services to APPNA and Pakistani American Physicians:• Active member of APPNA since 1990’s, life member since 2002.• Organizer of APPNA project “ Relief Center for 9/11 victims in NY”.• Co-Chairman, APPNA Fall Meeting 2001 in New York City.• Co-Chairman, APPNA Winter Meeting of 2003 in Karachi, Pakistan.•ActivememberofAPPNA’sResearch,Education&ScientificComm.RESA)2002

to present. Moderator-presenter Cardiology Sections in many APPNA CME’s since 2002.

• Chairman, Registration Committee, APPNA Summer Meeting of 2002, New York.

• Councilor, New York Chapter of APPNA, 2002.• Member Executive Council of APPNA in 2004.•RegionalCouncilorArea#2(NY)andmemberExecutiveCouncilofAPPNA2003.• Founding member of SMC Alumni. Served as its elected Treasurer, Secretary, Vice

President, and as President in 2004. Member, Board of Trustees, SMC Alumni.• Actively organized and worked for the “Earthquake Relief Efforts of Northern

Pakistan” with the APPNA New York Chapter .• Chairman, Membership Committee of APPNA in 2006, (results: 33% increase in lifemembershipand17%increaseofannualmembershipcomparedto2005).

• Member, Finance Committee in 2006.• Attended and actively participated in most of APPNA meetings since 1995.• Founding President of the “Association of Pakistani-descent Cardiologists of North America”(APCNA),apurelyprofessionalorganization,formedinMarch2004,tohave a platform of Pakistani American Cardiologists in US, and to contribute in cardiac related education and philanthropic work in Pakistan, realizing the fact that “cardiac diseases are the number killer disease in Pakistan”.

• Co-Chair Finance Committee of APPNA, 2007.

APCNA report 2007 8

APCNA ---- The Visionby: JaVeD suLeman, mD, Facc, ImmeDIaTe PasT PresIDenT

Cardiovascular Disease is an epidemic in making, in developing countries like Pakistan. This disease has immense impact, as a cause of death and disability, especially among people of working age and among women,

and is a major cause of loss of productive years of life. Seeing the catastrophe of CVD and realizing the public unawareness of the issue back in Pakistan, a dire need of an active platform was felt among CV professionals of Pakistani origin. So APCNA was born on March 7th 2004.

Many of us have participated or witnessed the creation of APCNA just three years ago in New Orleans, and now we are seeing its steady acceptance national and internationally, and pursuit of the noble goals to help intervene in the epidemic of CVD in Pakistan, in a small but growing way. And to have an established platform of Pakistani-descent Cardiovascular specialists in North America, already acknowledged by prestigious organizations like American College of Cardiology. I will not go into the details of the glorious achievements of APCNA in a short span of time, as they are well outlined in the President and offi cer’s report, but would like to emphasize that this remarkable growth was only possible because of your contribution in strengthening APCNA and your trust upon its leaderships.

APCNA has committ ed leaders from the beginning who actively participated in its growth and devoted their time and resources to advance the goals and prestige of the organization. The leaderships were lucky to have visionary senior advisors to help and direct them at all times of need. Now, we got to bear in mind, that, leadership constantly changes in a professional and democratic organization like APCNA, but the charter of the organization never changes. It is the duty of the members of the executive committ ee and Board of Trustees, to provide checks and balances to make sure that organization keeps progressing on the charted path and bylaws and constitution of the organization is always upheld.

APCNA has taken off admiringly, but we have a long journey ahead of us. Beside having a professional and social platform, If we truly believe that whatever we do through APCNA, litt le or large, is directed towards a greater objective – of helping our fellow human being, then we will build APCNA a truly great organization. We need to accomplish our responsibilities before resting. Like Robert Frost said: The woods are lovely, dark and deep.But I have promises to keep,And miles to go before I sleep,And miles to go before I sleep.

Cand is a major cause of loss of productive years of life. Seeing the catastrophe of CVD and realizing the public unawareness of the issue back in Pakistan, a dire need of an active platform was felt among CV professionals of Pakistani origin. So APCNA was born on March 7th 2004.

Many of us have participated or witnessed the creation of APCNA just three years