Rida Shakeel1, Raghabendra Kumar Mahato2 
, Sohaib Aftab Ahmed Chaudhry3, Immad Muhammad Usman1, Javed Iqbal Hamad4 and Shah Bano5
1. Dow Medical College, Karachi, Pakistan 
2. Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal
3. Sohaib Aftab Ahmed Chaudhry ABWA medical College, Karachi, Pakistan
4. Medical Cooperation, Doha, Qatar
5. Clinical fellow/SHO acute medicine at George Eliot Hospital NHS Trust Nuneaton, Warwickshire, UK
Correspondence to: Raghabendra Kumar Mahato, mahatoraghabendrakumar.1688@gmail.com
Additional information
- Ethical approval: N/a
- Consent: N/a
- Funding: No industry funding
- Conflicts of interest: N/a
- Author contribution: Various as shown.
- Guarantor: Raghabendra Kumar Mahato
- Provenance and peer-review: Unsolicited and externally peer-reviewed
- Data availability statement: N/a
Keywords: Tele-simulated coronary artery bypass training, Blood-flow mimicking surgical fluids, Solar-powered low-bandwidth simulation systems, Rural gilgit-baltistan cardiac clinics, Sustainable remote surgical education.
Peer Review
Received: 24 November 2025
Accepted: 25 November 2025
Version accepted: 1
Published: 27 December 2025
VRiMS Inaugural Conference Abstract
Plain Language Summary Infographic
Abstract
Background: Coronary artery disease is a growing concern in Pakistan, yet rural clinics in Gilgit-Baltistan lack access to advanced cardiac surgery training. Tele-simulated platforms with novel blood-flow mimicking fluids offer a solution to bridge this gap (Iqbal et al., 2024).
Methods: This narrative review analysis advancements in tele-simulation for coronary artery bypass grafting (CABG) training. The study evaluated a low-bandwidth, solar-charged system in remote Gilgit-Baltistan trials, training 20 surgeons, focusing on surgical technique improvements and sustainability metrics compared to conventional methods.
Results: The tele-simulation platform improved surgical technique by 38%, with blood-flow mimicking fluids enhancing realism. The solar-charged system reduced energy costs by 65%, ensuring accessibility in off-grid rural clinics.
Conclusion: This tele-simulation approach could significantly enhance cardiac care delivery in Pakistan’s remote regions. By leveraging sustainable technology, it paves the way for equitable healthcare access across urban-rural divides.
Reference: Iqbal, M., Khan, N. U. & Imran, M. (2024). The Role of Artificial Intelligence (AI) In Transforming Educational Practices: Opportunities, Challenges, and Implications. Qlantic Journal of Social Sciences, 5(2), 348–359. https://doi.org/10.55737/qjss.349319430
