Medical board recommends sending Nawaz abroad

LAHORE: The special medical board, constituted for treatment of former prime minister Nawaz Sharif, has recommended sending the patient abroad for some of his medical tests including genetic tests, which are not available in Pakistan, to ascertain the real cause of drop in his platelets count time and again. Nawaz Sharif’s diagnosis of suffering from idiopathic thrombocytopenic purpura (ITP), characterised by unusually low platelets, requires genetic testing for investigation to identify root-cause of disorder to determine the exact treatment method.

“The medical board is ready to give in writing to the Health Department with a view to sending Nawaz Sharif abroad for genetic testing in synchronisation with tissues, which will eventually determine the effects of various medicines on platelets,” said Prof Dr Mahmood Ayyaz, principal SIMS/SHL and head of special medical board, while talking to the media here on Tuesday.

The Services Hospital administration discharged Nawaz Sharif on Tuesday but, according to sources, he himself postponed his plan to leave the hospital till Wednesday due to non-issuance of release orders of his daughter Maryam Nawaz Sharif on Tuesday.

Sources said Nawaz Sharif was compelled to delay his discharge; otherwise, Maryam Nawaz, who was only permitted by the Punjab government to look after her father in hospital, had to go back to Kot Lakhpat jail in the absence of court’s release orders. Reportedly, Maryam Nawaz’s lawyers arrived in the accountability court after its closing time.

It was learnt that special medical board had advised Nawaz Sharif to start walk and minor exercise; therefore, it did not object to Nawaz Sharif’s shifting to another hospital in view of his present condition.

Dr Adnan Khan, Nawaz Sharif’s personal physician, also expressed his grave concern with regard to complexities of ailments in relation to the treatment. In his twitter message, he said that Nawaz Sharif’s platelets count remained below acceptable cut-off line (30*10^3/uL yesterday), thereby it’s unsafe to introduce DAPT (blood thinner medicines) to minimise threat of a cardiac event and/or stroke. The risk of spontaneous bleeding still remains.

He said Nawaz Sharif’s critically unstable clinical picture warrants aggressive management. “His platelets count is again on the decline. The underlying cause and a definitive diagnosis is un-established, requiring further extensive clinical work-up without delay,” he added.

Earlier in the day, all had been set to discharge Nawaz Sharif from Services Hospital after a marathon treatment by a 10-member highly professional team of experts in various specialties over a period of 16 days since his admission to the hospital on Oct 21. Prof Dr Tahir Shamsi, a renowned haematologist from Karachi, was called in to be made part of the special medical board, who helped diagnose Nawaz Sharif’s malady as immune thrombocytopenic purpura (ITP) and suggested its treatment accordingly. Besides, eminent cardiologists including Prof Dr Saqib Shafi, head of Punjab Institute of Cardiology, and Prof Dr Zubair Akram, head of Cardic Unit in Jinnah Hospital, were called in from time to time for monitoring and treatment of Nawaz Sharif’s cardiac ailment.

It was learnt that Nawaz Sharif was supposed to be shifted to Sharif Medical City Hospital on Tuesday as doctors and nurses, along with a fully-equipped ambulance, were called in Services Hospital to transport him to the Sharif Medical City. Prof Mahmood Ayyaz had also briefed the Sharif Medical City’s doctors about Nawaz Sharif’s medical history, diagnosis, medication and treatment. Nawaz Sharif and his daughter’s all belongings were packed too. His mother Shamim Begum and brother Shahbaz Sharif had also arrived in the hospital to take him from the hospital.

The anti-climax was preceded by a minor confusion as SHL Medical Superintendent Dr Saleem Cheema had confirmed issuance of discharge notification of Nawaz Sharif, while Prof Mahmood Ayyaz had not confirmed it saying that Nawaz Sharif would himself decide in this regard. “When I would want to leave, I’ll let you know,” the former prime minister reportedly told the head of medical board. Therefore, Prof Mahmood Ayyaz told the media that Nawaz Sharif would be treated at Services Hospital as long as he remains in the hospital.

With regard to Nawaz Sharif’s genetic tests from abroad, he said that some of (genetic) tests were conducted here and those not available in Pakistan are recommended to be conducted from abroad. “Although, these tests can be conducted by sending samples abroad, yet, he said, the patient needs to be sent abroad as well in order to examine the tests in synchronisation with the tissues to diagnose the exact cause of his illness,” he added. He added the PML-N leader was not facing a minor genetic issue.

The medical board recommended the genetic test after they noticed that Nawaz Sharif’s platelets level could not be restored to normal level.

He said that the medical board had also recommended various other tests of heart, blood vessels and kidney functions in relation to the treatment of platelets. He informed that Nawaz Sharif’s platelets were not stable and consistently fluctuating irregularly, adding that currently platelets count was hovering around 30,000. During his over two weeks stay in Services Hospital, Nawaz also suffered a minor heart attack, while his BP, blood sugar and kidney functions also remained inconsistent. However, the special medical board had done a remarkable job by correctly diagnosing the ailment and maintaining a fine balance in medication in relation to the functions of various indicators simultaneously.

Meanwhile, it was also learnt that 10-member special medical board will automatically be dissolved after Nawaz Sharif would be shifted from Services Hospital. However, head of medical board said they would continue to provide guidance and assistance to Nawaz Sharif’s doctors as and when requested.

Besides, a large number of PML-N leaders and workers gathered outside Services Hospital on Tuesday and prayed for his early recovery.

On Oct 29, the Islamabad High Court suspended Sharif’s sentence in the Al-Azizia corruption reference for eight weeks on medical grounds. Lahore High Court also granted bail to Maryam Nawaz in Chaudhry Sugar Mills case on Nov 4.

Meanwhile, in another statement, Dr Adnan Khan said that amidst unprecedented and unusual delay in Maryam Nawaz’s release, former PM Nawaz Sharif refused to leave hospital without his daughter. “All arrangements were in place for Nawaz Sharif to be shifted to Sharif Medical City Hospital on Tuesday but he waited all day for the release orders,” he said, and demanded immediate release of Maryam Nawaz Sharif.