Departments

Department of Pulmonology

Introduction

The Department of Pulmonology is a separate department under Division of Medicine of Shree Birendra Hospital. Since its commencement in Tokha Sanitorium (2017 BS), this department was established with an aim of treating pulmonary tuberculosis. However, in the context of diversified respiratory diseases, increasing number of respiratory patients, increasing number of geriatric population and increased  life expectancy; the domain of our department has diversified to managing other diseases including bronchial asthma, chronic obstructive pulmonary disease, bronchiectasis, pneumonia, pleural diseases such as pneumothorax, empyema, hydropneumothorax,  haemothorax, complex pleural effusion, mediastinal diseases (such as sarcoidosis, TB, bronchogenic carcinoma, etc), lung cancer,  Acute Respiratory Distress Syndrome, complicated pneumonias, respiratory failure, pulmonary complications of HIV/AIDS and so on.

Our department is providing facilities like chest tube thoracostomy, pigtail thoracostomy, therapeutic  pleurocentesis, closed pleural biopsy, intrapleural fibrinolytic therapy and adhesiolysis, thoracoscopy, bronchoscopy, to cite some. In near future, we envision to evolve this department into Department of Interventional Pulmonology. For meeting that aim, we plan to introduce new technology for diagnosis lung cancer, TB, sarcoidosis, etc in very early stage so that those diseases can be cured before they became complicated or incurable. We plan to introduce EBUS, rigid bronchoscopy, bronchial thermoplasty,  cryobiopsy  and cryotherapy, etc.

Since 2070 BS to 2075, the number of patients benefited from our department has increased from 8,000 to 20,000 respectively. Around 1,500 patients are being seen in single month and 100 – 150 patients in single OPD day. Approximately 50 – 100 patients are admitted in our ward for acute breathing problems of which 15 – 20 patients are admitted and managed in ICU with assisted  ventilation (NIV, BiPAP and mechanical ventilation). About 37 beds are dedicated to patients with tuberculosis.  They are given supervised DOTS treatment for whole course of therapy. Similarly patients with MDR tuberculosis are being managed with DOTS plus therapy.

Our department is carrying out academic activities besides providing services to patients. Our faculty have been delivering lectures, taking tutorials and clinical classes to the students of 3rd, 4th and 5th year MBBS students of Nepalese Army Institute of Health Sciences.

Landmarks of development of the Department of Pulmonology


Date

Milestone

 

2017 BS

Tokha Sanitorium

8 beds

2031 BS

 

50 beds

2034 BS

Bronchoscopy

 

2050 BS

TB ward shifted to Trichandra Military Hospital, Spirometry started

40 beds

2052 Poush 13

Respiratory OPD shifted to Shree Birendra Hospital (1 consultant room, 1 bronchoscopy room, 1 registration room)

8 beded respiratory ward

2060 BS

Independent Respiratory Ward

 

2068 Jestha 12

TB Ward shifted from Trichandra Military Hospital to Shree Birendra Hospital, recognized  as DOTS  center

50 beds

2072 Baishakh

Respiratory and TB ward have been incorporated into single ward

7 bed respiratory ward, 30 bed TB ward

2073 Baishakh

Medical thoracoscopy started

 

Head of the Department (HOD): Maj Dr Bhushan Kumar Rajbhandari

Services

Clinical procedures
Pulmonary clinical procedures include the following pulmonary tests and procedures

  1. Laboratory investigation of blood (blood tests). Sometimes arterial blood gas measurements are also required.
  2. Spirometry the determination of maximum airflow at a given lung volume as measured by breathing into a dedicated machine; this is the key test to diagnose airflow obstruction.
  3. Pulmonary Function Tests including spirometry, as above, plus response to bronchodilators, lung volumes, and diffusion capacity, the latter being a measure of lung oxygen absorptive area
  4. Bronchoscopy with bronchoalveolar lavage (BAL), endobronchial and transbronchial biopsy and epithelial brushing
  5. Chest X-rays
  6. CT scanning
  7. Scintigraphy and other methods of nuclear medicine
  8. Positron emission tomography (especially in lung cancer)
  9. Polysomnography (sleep studies) commonly used for the diagnosis of sleep apnea

Surgical procedures
Major surgical procedures on the heart and lungs are performed by a thoracic surgeon. Pulmonologists often perform specialized procedures to get samples from the inside of the chest or inside of the lung. They use radiographic techniques to view vasculature of the lungs and heart to assist with diagnosis.

Sub Dept

Specialists

SN

Faculty

Degree

Designation

1

Lt Col Dr Ushab Rana Mohsin

MD, Respiratory Medicine

Asst Prof

2

Maj Dr Bhushan Kumar Rajbhandari

MD, Pulmonory Medicine,
Fellowship Interventional Pulmonology

Asst Prof

3

Maj Dr Ekta Malla Rana

MD, Pulmonory Medicine

Asst Prof

Working Schedule

Days

Services

Procedures

 

Sunday

OPD:
Officers, ex officer and their family
Emergency, acutely ill cases
Cases referred from other OPDs

 

Routine procedures

 

Monday

OPD:
Regular soldiers, ex servicemen and their family Emergency, acutely ill cases
Cases referred from other OPDs

 

 

Tuesday

Bronchoscopy, Thoracoscopy
Emergency, acutely ill cases
Cases referred from other OPDs

 

Routine procedures
Spirometry

 

Wednesday

OPD:
Regular soldiers, ex servicemen and their family Emergency, acutely ill cases
Cases referred from other OPDs

 

 

Thursday

Bronchoscopy, Thoracoscopy
Emergency, acutely ill cases
Cases referred from other OPDs
DOTS Clinic

 

Routine procedures
Spirometry

 

Friday

OPD:
Regular soldiers, ex servicemen and their family Emergency, acutely ill cases
Cases referred from other OPDs

 

Saturday

Round

 

Faculty Members

SN

Faculty

Degree

Designation

1

Lt Col Dr Ushab Rana Mohsin

MD, Respiratory Medicine

Asst Prof

2

Maj Dr Bhushan Kumar Rajbhandari

MD, Pulmonory Medicine,
Fellowship Interventional Pulmonology

Asst Prof

3

Maj Dr Ekta Malla Rana

MD, Pulmonory Medicine

Asst Prof

Head of Department


Maj Dr Bhushan Kumar Rajbhandari