This is a busy tertiary hospital with 150 bed capacity and 35 bed ICU. I manage acute and chronic lung diseases leading unselected pulmonary take and running busy OPD’s. I perform bronchoscopies, EBUS-TBNA, pleural procedures such as chest drain, ultrasound guided pleural aspiration and Medical thoracoscopy. Seldinger chest drains and indwelling pleural catheters are also performed as needed.
I provide pulmonary support for surgical specialties for pre op clearance and post pulmonary emergencies and complications. I perform bronchoscopies in the ICU on a regular basis and manage complicated pulmonary issues in liaison with ICU physicians. I support general physicians and other physician specialties by providing referral services.
I manage all pulmonary cases including Asthma, COPD, Tuberculosis, lung cancer, pulmonary embolism, COVID, pneumonia, pulmonary fibrosis, pleural effusions, sleep disorders with high degree of skill and adept clinical judgement.
Pulmonary department is supported by advanced PFT lab with DLCO and lung volumes. FENO (Fractional exhaled Nitric Oxide) is also available and utilized for clinical care of Asthma patients. We are also equipped with level 1 sleep lab.
I have done numerous educational health talks and CME in the region to doctors and public. I appeared on local news channels and All India Radio on invitation for discussion on topics related to my area of work.
I have been doing outreach clinics in Rajamundry and Shadnagar on a monthly basis.
This was a substantive post in a teaching hospital. I delivered acute and specialist services in respiratory medicine. I performed, supervised and trained registrars in performing practical procedures such as seldinger chest drains, thoracic ultrasound, bronchoscopy, trans bronchial biopsies and supervised noninvasive ventilation (NIV) on wards. My sub-specialty was COPD. I participated in and lead COPD MDT’s, provided clinical support to COPD nursing team, oxygen nursing team and longterm ventilation nursing team.
Rotation consisted of 2 years in Hull, which is a regional centre, one year in Scarborough and 1.5 year in York. I took time out for 3year clinical research fellowship at University of Manchester, one year of which was counted towards clinical training.
Respiratory clinical training consisted of 2-3 out-patient clinics per week, 1-2 bronchoscopy lists per week, regular pleural procedures on wards. I am competent in bronchoscopy, trans bronchial biopsies, level 1 thoracic ultrasound, seldinger chest drains for pleural effusions and pneumothorax, diagnostic and therapeutic pleural aspirations, ward based acute non-invasive ventilation. Also trained in reporting lung function, bronchial challenge tests, sleep studies. I have also performed EBUS procedures. I have observed the placement of endbronchial valves for severe emphysema and trained on mannequins to do the same.
During training, I have attained subspecialty experience with attendance at subspecialty clinics in domiciliary ventilation for chronic type 2 respiratory failure, pulmonary hypertension, allergy and immunology, occupational lung disease, lung transplant (2-3 clinics each).
During my rotation at Manchester post, I have had significant amount of research training in pharmaceutical medicine by working as a sub investigator at one of the finest Phase 1 accredited respiratory clinical trials unit in the UK (Medicines Evaluation Unit), on several COPD, Asthma, chronic cough and Cystic Fibrosis studies. Working with latest molecules in these diseases, I have been at the forefront of medical advances in these areas. The volume of studies and subjects in this unit are very high which gave me significant experience. I have successfully represented the unit at ethics committee meetings. I have been involved in critical review of protocols and investigator brochures. I have written risk management plan (RMP) and standard operating procedures (SOP). I have performed research bronchoscopies on clinical trial subjects independently on a weekly basis.
As a registrar, I supervised and trained candidates for MRCP ( UK) exam.
General Medicine training consisted of working in busy district and teaching hospitals leading general medical take under limited supervision. I supervised junior medical trainees and foundation trainees. I covered coronary care unit and other medical specialty wards during on calls. I provided referral service to non-medical specialties and emergency department. I lead cardiac arrest calls (ALS certified and valid). I am trained in performing and supervising wide range of procedures including central line insertion, arterial lines, lumbar puncture, ascitic drains, DC cardioversion and external pacing.
My rotation included 4 months each in Cardiology, Oncology, Geriatrics, Gastroenterology, Diabetes and Respiratory medicine.
The training lead to successful completion of MRCP from Royal College of Physicians, London.
This is a 2year training program at junior house officer level across various medical and surgical specialties and A&E.
This is an observership role in a rheumatology unit.
After passing final MBBS examination in March 2004, I worked as an intern for one year as a part of compulsory rotating internship. I have spent two months each in General Medicine, General Surgery, Obstetrics & gynecology and 3 months in Community Medicine.
I reviewed the practice of York hospital against accepted standards in the diagnosis and management of patients presenting with papilloedema to York Hospital. Findings have been used to develop and improve trust policy and streamline papilloedema pathway.
Several shortcomings were identified in the practice of identifying current smokers presenting acutely to York hospital. Smoking cessation advice and treatment was often being missed mostly due to lack of awareness as noted in my knowledge based survey of health care professionals across the specialties. I have updated the trust policy and improved awareness of smoking cessation services among health care professionals through a grand round presentation and profile- raising campaign.
Performed audit plan and data collection and presented at departmental meeting.
BTS Pleural procedure audit 2010: Castle Hill hospital, Hull.
50% of patients with suspected meningitis were getting CTBS in the absence of any indication.
Local trust guidelines altered to improve compliance.
This audit aims to evaluate the performance in monitoring of patients on Oral Methotrexate with reference to BSR guidelines. I did it on my own initiative with guidance from the department. I was involved in idea, questionnaire preparation, data collection, analysis and final presentation at the departmental meeting.
Differential anti-inflammatory effects of budesonide and a p38 MAPK inhibitor AZD7624 on COPD pulmonary cells. Higham A, Karur P, Jackson N, Cunoosamy DM, Jansson P, Singh D. Int J Chron Obstruct Pulmon Dis. 2018 Apr 19;13:1279-1288.
Pulmonary inflammation in patients with chronic obstructive pulmonary disease with higher blood eosinophil counts. Kolsum, Damera, Pham, Southworth T, Mason S, Karur P, Newbold P, Singh D. J Allergy Clin Immunol. 2017 May 12. pii: S0091-6749(17)30751-0. doi: 10.1016/j.jaci.2017.04.027.
Optimum treatment for chronic obstructive pulmonary disease exacerbation prevention. Karur P, Singh D. Ann Transl Med. 2016 Dec;4(24):531. doi: 10.21037/atm.2016.11.58.
Neurological conditions presenting as airway reflux cough: Pradeep S Karur, Jaymin B.Morjaria, Caroline Wright and Alyn H. Morice : Eur Respir Rev September 1, 2012 vol. 21 o. 125 257-259.
I am the first author for this case series published in European Respiratory Review.
This is retrospective review of patient data. I looked at the discharge summaries of all patients admitted with COPD exacerbations and discharged on long term metoclopramide. I evaluated the number of exacerbations one year before and one year after starting metoclopramide. Exacerbation rates improved significantly after starting metoclopramide. Presented orally at YTS meeting with good feedback. Presented as a Poster (first author) at ATS 2014, San Diego.
I was the first author and presented this poster at the society meeting. I had a free place award to attend and present this poster.
Interventional Bronchoscopy and Medical Thoracoscopy Course, Preston: October 2017
Management course: Sheffield: July 2017
Medicolegal issues course: Sheffield, May 2017
UK Lung volume reduction Course, RCP, London, November 2016
Advanced Life Support: 06/10/15, Wythenshawe Hospital, Manchester
Critical appraisal of Research Papers, Manchester, November 2014
Medical statistics course, Manchester, November 2014
Academic writing course, Manchester, November 2014
Good Clinical Practice (GCP), Medicines Evaluation Unit, Manchester December 2013
BTS Thoracic Radiology Course: September 2013: Oxford
Difficult Lung Disease management: Sheffield, Sep 2013
BTS Thoracic Ultrasound Course: Bristol, March 2013
Teaching and Facilitation Skill course: Leeds Deanery: 24/01/13 and 06/02/13
Medical Ethics Course: Leeds, February 2013
BTS Bronchiectasis Short course: London, November 2012
Lung Transplant Course: Freeman Hospital, Newcastle:12/10/12
Bronchoscopy Simulation and Chest drain course: Pinderfields Hospital 06/03/2012
Thoracic ultrasound course: Maidstone hospital, Kent 2010.
IMPACT: Ill Medical Patients Acute Care and Treatment: Hull Royal Infirmary, October 2007
Pulmonary Hypertension Unit attachment: Sheffield Teaching Hospital; April 2017
Occupational Lung Disease Unit, Wythenshawe Hospital, Manchester, June 2016
Lung Transplant Unit attachment: Wythenshawe Hospital, Manchester, July 2016
Allergy and Immunology Unit Attachment: Hull Royal Infirmary, July2017