CURRICULUM VITAE

DR AJIT KUMAR KAYAL

MBBS, MD, FRCA

Lead Consultant Bariatric Anaesthetist

St Georges NHS Trust, London

United Kingdom

Advisory member NECOPD Bariatric

United Kingdom 2012

Visiting Specialist(consultant)

Newfoundland,

Canada

PERSONAL DETAILS

NAME: AJIT KUMAR KAYAL

ADDRESS: 239 Raeburn Avenue

Surbiton, Surrey

KT5 9DF

TELEPHONE: 020-****-**** (home)

077*-***-**** (mobile)

E-mail: acumhg@r.postjobfree.com

acumhg@r.postjobfree.com

Nationality British

GMC REGISTRATION: 4549006 (Full)

SPECIALIST REGISTRATION: April 2007

MDU NO 390169G

PROFESSIONAL QUALIFICATIONS

1990 M.D. (Anesthesia)

Postgraduate Institute of

Medical Education and Research

Chandigarh, India

2001 FRCA

Royal College of Anaesthetists, London

2007 CCT- Entry to Specialist Register

MEMBERSHIP OF PROFESSIONAL BODIES:

Royal College of Anaesthetists

Association of Anaesthetists of Great Britain and Ireland

Medical Defence Union

Society of Bariatric Anaesthesia

Society of Regional anaesthesia of London

.

HOSPITAL APPOINTMENTS

Present appointment

Nov 2006 to date Consultant. Bariatric Anaesthetist

St George¢s Hospital NHS Trust, London

United Kingdom

April 2009 to date Visiting Specialist (consultant)

Newfoundland, Canada

Post CCT appointments in Canada

Aug 2007 – Oct 2007 Specialist (Consultant)

And Jan2009- Nov 2011 Carbonear University Hospital,

Newfoundland Canada

Training appointments in United Kingdom

Feb 2002 to Aug 2006 CCT and Post CCT Specialist Registrar

London Deanery

St George¢s NHS Trust, UK

Mar 2000 to Feb 2002 Intensive care

University Hospital London

Aug 1996 to Feb2000 Mid Staffordshire NHS Trust, UK

Sandwell Healthcare NHS Trust UK

Appointments in India

Sep 1993 to Jul 1996 Assistant Professor Anaesthesia

All India Institute of Medical Sciences New Delhi India

Jan1988 to Sept 1993 Junior and Senior Resident anaesthesia and ICM

Postgraduate Institute of Medical Education and

Research, Chandigarh, India

.Jan 1987 to Dec1987 SHO in General Medicine, AIIMS. New Delhi,

Bariatric Consultant St Georges NHS Trust

Development of Anaesthesia for Bariatric Service (2006-2015)

St Georges NHS Trust, London, Aspire St Anthony PVT Healthcare London

Aspan Parkside Hospital Wimbeldon London

I was appointed as a consultant with an interest in anaesthesia for bariatric surgery and regional anaesthesia at St. George’s Hospital in Oct 2006. We are doing now about 350 – 400 cases per year

The experience of working as a consultant in a busy teaching hospital has been very valuable both in terms of the clinical environment, as well as in teaching and management. I enjoy the challenges of managing bariatric patients with their multiple associated co-morbidities.

I am familiar with pre-operative optimisation, intra-operative invasive and non-invasive hemodynamic monitoring and the use of thoracic epidurals in bariatric patients

I am experienced with adjustable gastric banding, Sleeve gastrostomy, vertical banded gastro-plasty. I am also familiar with more complex procedure such as duodenal switch, Roux-en-Y gastric bypass, and (2831 cases).

I am involved in preoperative preparation for difficult and complex cases with preoperative assessment team. I am also developed post-operative recovery guidelines for bariatric patients

I am start with one consultant in St Georges and now we have three consultant provided the service

Development of High Risk Bariatric Clinic at St Georges Hospital and St Anthony Hospital

I am also Running the high risk bariatric clinic in St Georges Hospital, specially patient with Respiratory and Cardiac problems, we have done 269 cases of bariatric surgery associated with various cardiac( CABG, Stent insertion), Respiratory problem. Renal failure on dialysis including cases of Severe sleep apnoea, severe pulmonary hypertension on wheel chair and Cardiomyopathy with obesity waiting for Cardiac Transplant

Development of Sedation list for Bariatric patients for gastric balloon insertion:

The flexible lists have helped me keep my knowledge and experience up-to-date with different specialities. I regularly provide sedation for gastric balloon insertion. This has been an exciting, and at times challenging, experience and has highlighted the importance of remote site sedation

Development Regional anaesthesia for Bariatric Patients and Development of Regional anaesthesia Module for Trainee

I am a faculty member of London Society of Regional Anaesthesia course (LSORA)

I have used lumber and thoracic epidural for open gastric bypass surgery

TAB block for Laparoscopic Gastric Bypass in patient with severe respiratory problem

My current post has given me the opportunity to further my skills and confidence in regional anaesthesia using ultrasound.

I have taken courses for ultrasound guided regional which I have practiced regularly for last 8 years.

I have done more than 1000 regional anaesthesia blocks in last 18 years. I am proficient in blocks under ultrasound guidance for the following

Upper limb: Cervical, brachial(supraclavicular, axillary)

and peripheral nerves blocks

Shoulder Surgery: interscalene blocks and suprascapular

Blocks

Lower limb: fascia iliac block,femoral, sciatic nerve

Blocks, 3in 1 block, lumber plexus block,

Obdurate block, saphenous nerve block,

and popliteal fossa block

Carotid Endartrectomy deep and superficial cervical blocks

Thoracic paravertebral, intrapleural and intercostals

blocks.

Ophthalmic Surgery sub-tenons, peribulbar block and retro-bulbar

block

I have regularly anaesthetised for paediatric squint surgery. I am familiar with the anaesthetic procedures for vitrectomy and retinal surgery. I do regular ophthalmic theatre list in Moorefield Eye Hospital attached to St Georges NHS Trust.

Day Surgery and Bariatric Patients

I have broad exposure to a wide range of day surgery specialities including ENT, orthopaedics, urology, general surgery, ophthalmology and dental procedures and the specific requirements of day case surgery and anaesthesia. Some of patients having BMI more than 45.

Working Experience: Canada

I have had worked in Carbonear University Hospital attached to St John’s University Newfoundland Canada. In this community, 31% of the population are obese (average BMI 30- 55) compared with 21% in the rest of Canada in 2004 -06. I worked as a specialist (Consultant) in this hospital and was involved in managing various type of laparoscopic procedures including partial gastrostomy, gastroplasty, gastric bypass, and splenectomy. Hemi colectomy in patients with a BMI from 55 to 96. As a specialist, I was responsible for the theatre staff and patient management. I regularly visit this hospital and exchange experience and knowledge about the management of complex bariatric cases.

Hospital Visits: Massachusetts USA

Miriam Hospital, Rhode Island, USA

Tobey Bariatric Centre South Coast Hospital Group Hospital USA

I visited these two hospital twice in 2008 -2009 and I regularly exchange views about the management of difficult cases. They do 300 to 400 cases per year, I have learnt about the setup of the bariatric centre, and the delivery of health care in large private health organisations.

Hospital Visits: Catherine Hospital, Holland

I visited this Hospital in 2013 .They do 600 cases per year, I have learnt about the setup and theatre efficiency and new way of providing Health care called Fast Track Bariatric surgery.

Development of Guidelines in Department of Anaesthesia,

St George’s Hospital London,

St Anthony PVT Healthcare London

Developed post operative recovery guidelines for bariatric patients in

St George’s Hospital

Changed the guidelines for grouping and cross-match for patients undergoing for elective hysterectomy

I with the help of my colleagues have written guidelines for pre-operative testing for endoscopy patients.

ADMINISTRATIVE AND MANAGEMENT EXPERIENCE

My engagement in management roles as locum consultant has expanded my communication and interpersonal skills essential for good working relationships with clinical colleagues and management. It has also given me better insight into working of anaesthetic department, its role within the hospital and broader understanding of the NHS as an organisation. This has enabled me to play a more active role in effective and efficient delivery of training and service

My experience includes

Organisation and management of High Risk Bariatric anaesthesia Clinic for last 5 years

Selection of the appropriate patients for Surgery and management of Staff in clinic and Theatre.

Co-ordinating Consultant at St. George’s Hospital. This involved ensuring the smooth running of the Department’s clinical activity and liaising with theatres, ITU and surgeons to ensure the smooth running of the theatre lists

Organisation of Regional Anaesthesia Course as Faculty Member at St Georges Oct 2008, Sept 2009 to 2013

Organisation of OSCE Course as Faculty member in Hartlepool Hospital 2000-2002

Attendance for the three-day St Thomas Management Course for Specialist Registrars in Anaesthesia, which helped me to understand some of the organisational structure of the wider NHS.

Member of the panel on the interview committee for selection of medical students to St. George’s Hospital Medical School in 2007. This gave me valuable insight into the admissions process for Medical Schools.

Successful completion of the Management Module training at St Richards Hospital. I arranged meetings with 5 of the management executives of the hospital, including the Medical Director. This gave me a much deeper understanding of their roles and responsibilities and the organisational structure of a NHS Hospital.

Attendance for the three-day Keele Management Course for Specialist Registrars in Anaesthesia, which helped me to understand some of the organisational structure of the wider NHS.

I consider my key management skills to be

Maintaining clear and open communication lines

Negotiation

Knowing when to control and when to persuade

Awareness of my own and my team strength and weakness

Being open to advice and opinion

Practicing personal and team review and analysis

TEACHING EXPERIENCE

I am currently taking regular tutorials for Final FRCA candidates, presented lectures and viva practice for the candidates within the anaesthetic department at St Georges Hospital.

I have taught on the one day courses for regional anaesthesia at St Georges Hospital.

I have been teaching on the London Society of Regional Anaesthesia Courses for the last two years as a Faculty member.

I taught on the National OSCE Course, as a Faculty Member, in Hartlepool in 2001 and 2002.

I am committed to teaching and regularly take the opportunity to teach anaesthetic trainees and members of staff in various settings.

Examples of this include;

I have presented many topics in the department meetings,

Skill based teaching to medical students, operating department practitioners and paramedics in theatre

Seminar based teaching to outreach nursing staff

I have attended 3 days of teaching training course in Cardiff University

I have attended the course for supervision and assessment in workplace (Case based discussions, DOPS, Multisource feedback, Mini CEX)

PAPER PRESENTATIONS

International

2014 IFSO Montreal Canada Bariatric Role of Suggamadex in bariatric Patients

2013 PGI Chandigarh CME and Conference India

Anaesthesia for bariatric Surgery

2007 South Asia Confederation of Anaesthesiologist Kathmandu, Nepal

Chairing the session for obesity and anaesthesia

Oral Presentations:-Presentation of paper

1996 Monitoring during Neuro-anaesthesia

International Symposium on Neurointensive Care and Neuro-anaesthesia; New Delhi

National

2006 Changes in electrolytes and base deficit following intraoperative

Fluid therapy in elective neurosurgical patients Poster

Presentation

Annual meeting Neuro-anaesthesia and Neuro Intensive Care, Brighton

2003 Outcome in elderly after critical care in Wrexham Maelor Hospital

2nd best paper in AGE AND ANAESTHESIA conference, Cambridge May

The SOCIETY OF ANAESTHETIST OF WALES Brecon Feb2003

1992 Comparative study of Vecuronium and Pancuronium on ICP

North Zone Anaesthetist Association, Chandigarh India

Regional

2005 Changes in electrolytes and base deficits following Intraoperative fluid therapy in elective neurosurgical patients

Hospital clinical governance meeting, PRH, Hayward Heath, West Sussex

2003 Failure of epidural for Caesarean section

Hospital clinical governance meeting, Kingston Hospital

Morbidity and Mortality after 2 years after discharged from ICU in Wrexham, Maelor Hospital, and North Wales Trust Symposium

AUDIT EXPERIENCE

2013

Analgesia for Shoulder surgery

TAP block for bariatric Patients

2012

NECOPD Bariatric service NECOPD United kingdom

2011

Sleep apnoea and post operative care for Bariatric Patients

2010

National Laparotomy Network

2009

Outcome of Bariatric Surgery in St Georges

Compared with published papers and other Hospital

Sedation for ERCP and Bariatric patients

Development of guidelines ( NCEOPD report)

Inadvertent perioperative hypothermia

NICE Clinical Guideline 65

2008

Cost effectiveness of cross matching all patient undergoing for

Hysterectomy, St George's NHS Trust.

Development of Guidelines .Only selective patient need cross match before surgery.

2006

Re-audit pre-operative fasting St Georges NHS Trust

2005

Changes in electrolytes and base deficit following intraoperative

Fluid therapy in elective neurosurgical patients

Use of Ringer lactate and saline in long surgical procedure.

2004

Temperature monitoring in vascular anaesthesia.

2003

Failure of epidural for Caesarean Section,

Incidence of failure of epidural during CS in Kingston Hospital

Compared with published papers and other Hospital

Use of prophylactic anti- emetic

Compared the use of preoperative oral cyclizing and ondansetron,

Cost effective

Outcome after discharged from intensive care unit in Wrexham Maelor Hospital.

Patients admitted age 60 yrs and above, who were discharged from ITU. The average 2yr survival after discharged- Surgical 39 %(elective Surgery 34%, emergency Surgery 44%) and Medical 28%

Epidural experience and patients satisfaction, patients view

Aim- To find out the patients experience during and after epidural while awake and under anaesthesia. Conducted in 3 Hospitals to avoid bias.

Incidence of Epidural to GA or Spinal during caesarean Section

Low flow anaesthesia audit.

After audit most of the member in department use low flow anaesthesia

2002

Central line position audit

Repositioning of central line after X-ray, 21% were not repositioning

the central line.

Doctor communication to patient’s relatives in ITU and HDU meets RCA Recommended Standards.

Pre 2001

Re-audit on Post operative Hypothermia since 1997

Post operatively in recovery, hypothermia reduced by 30% in this audit compared to1997.

Evaluation of Anaesthetic Records during Elective Cases

RESEARCH EXPERIENCE

NSAID and asthma in children. A Survey

St Helier NHS Trust, Dr Ajit Kayal, Dr, Patrick Radford 2006-07

Hemodynamic Response following Application of Transdermal

Nifedipine during Trans-sphenoidal Pituitary Surgery 1995

The study showed that the rise of blood pressure and heart rate were less in those receiving transdermal nifedipine patch over the forehead in addition to inhalation anaesthetics. This is another way of controlling the haemodynamic responses of nasal speculum insertion during trans-sphenoidal pituitary surgery.

Comparative Study of Vecuronium and Atracurium on Intracranial Pressure” 1990

The study showed that the rise of intracranial pressure was less with vecuronium than pancuronium during intubation and post-intubation. In this study, I learned how to measure ICP using the subarachnoid bolt.

PUBLICATIONS

Does a transversus abdominis plane (TAP) local anaesthetic block improve pain control in

patients undergoing laparoscopic cholecystectomy

Keir A, Rhodes L, Kayal A, Khan OA.

International Journal of Surgery 2013;11(9):792-4

Abstract Changes in electrolytes and base deficit following intraoperative fluid therapy in elective neurosurgical patients

Kayal.A,Cerry C,

International Journal of Neurosurgical Anaesthesia P146 Vol19, Issue2Apr2007

Abstract Outcome in elderly after critical care in Wrexham Maelor Hospital

Kayal.A, Gemmell L

Anaesthesia Volume 58 Issue 10 Page 1048 October 2003

Hemodynamic Response following Application of Transdermal

Nifedipine during Trans- Sphenoidal Pituitary Surgery.

Kayal.A, Sexena.P and Bitha.P.Kl

Journal of Anaesthesiology Clinical pharmacology 1997 Vol 13(2), 145-148

Pulmonary Oedema following Posterior Fossa surgery in Sitting Position –

Kayal.A, Sexena.P and Bhithal.P.K,

Journal of Anaesthesiology Clinical pharmacology 1996 Apr.; 12(2): 147-9

"Fatal Air Embolism" - A case report

Kayal.A, Sexena.P,

Indian Journal of Anaesthesia 1996; 44(3): 215-7

Comparative Study of Vecuronium and Pancuronium on Intracranial Pressure

Kayal.A, Wig.J.

Neurology India 1993 Jan; 41(1): 25-8

Referees:

Dr Davinder Garewal Sr Consultant

Consultant anaesthetist

Department of Anaesthesia

St George’s Hospital

Blackshaw Road

London

SW17 0 QT

Phone :-020-****-**** Fax 020-****-****

Email address: acumhg@r.postjobfree.com

Dr Agnieszka Crerar-Gilbert

Consultant Anaesthetist and Intensivist

Department of Anaesthetics St George’s Hospital

Blackshaw Road,London SW17 0 QT

Phone:- 020-****-**** Fax 020-****-****

Email: acumhg@r.postjobfree.com

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