Independence Day Celebrations

In the face of advances in cancer treatment and decreases in mortality rates, cancer is still seen by individuals, first and foremost, as a death sentence. For many who are diagnosed with the disease, their initial thoughts are about death and dying (Loney, 1998)

Cancer patients deal with the different side effects and life changes during cancer treatment, it affects not only physical health, but it does bring wide range of feelings. Their emotions change daily, hourly, or even minute to minute. This is true whether you’re currently in treatment, done with treatment, or any of your friend or family members is affected. Diagnosis of cancer is a very stressful event for the patients and their families. In spite of all these mood swings patients at Dr Ziauddin Cancer Hospital were fully boosted with energy to celebrate Independence Day celebrations.

Looking at the JOSH & JAZBA of patients despite of full occupancy of the hospital Dr Ziauddin Cancer hospital organized an Independence Day for cancer patients in the hospital premises in which patients shared their feelings about the day, sung mili naghme while being on bed as they could not come to the arena. Few of the patients came from home to participate in the event and shared their feeling and experiences while their stay during treatment.

We all witnessed the smiley faces, happiness and sparkling eyes of our patients who were seeing death and were feeling pain and anxiety two days ago. No expensive medicines can replaced liveliness of their faces which we have seen by celebrating this small event for them.

This colorful event was witnessed and well appreciated by all patients, family members as well as hospital staff and management.

Article on “The role of red meat in liver disease”

Published URL : National Courier

Published Date: 11th Aug 2016

By: Itrat Siddiqui

Your liver is the processing plant of your body. Its job is to designate nutrients like proteins and Fats for use and to send the toxins that result from protein breakdown to your Kidneys. How red meat can affect your liver. Because your liver is responsible for breaking down and packaging protein. If you are a healthy individual your liver should be able to breakdown these foods with little difficulty. It is possible that long term excess consumption of red meat could worsen liver problems . If your body cannot breakdown red meat properly the waste product can build up. These toxins can affect your brain functioning known as Hepatic encephalopathy. Each person may react differently to red meat intake .When you have liver disease certain protein may be better tolerated than others, according to the Hepatitis Foundation International. If your liver disease is advanced red meat may not be tolerated as effectively as vegetable and dairy proteins. Few studies have examined whether meat and fat intake are associated with chronic liver disease. Meat processing and its heme iron, Nitrate, and Nitrite content were associated with CLD. Patients can eat as much vegetable protein (dried beans and peas, soya products, peanut butter and others) as they like. In patients with chronic liver disease, anemia may be exacerbated by deficiency of folic acid and/or vitamin B12 that can occur secondary to inadequate dietary intake or malabsorption. A major cause of anemia associated with chronic liver disease is hemorrhage, especially into the gastrointestinal tract. For people who have liver disease, eating a healthy diet makes it easier for the liver to do its jobs and can help repair some liver damage. An unhealthy diet can make the liver work very hard and can cause more damage to it. Dietary changes for liver disease may involve: * Cutting down the amount of protein you eat .This will help the buildup of toxic waste products. * Increasing your intake of carbohydrates to be in proportion with the amount of protein you eat. * Limit your salt intake .Salt in the diet may worsen fluid build up and swelling in the liver. * Try to eat small frequent meals. * Turn 3 large meals into 5 or 6 small meals to get enough calories and protein for muscles and organs. * Choose nutrient rich foods, such as whole milk, instead of skim and dried fruit, instead of fruit juices. * Always have a bedtime snack. Try crackers or bread with unsalted peanut butter to make a sandwich with a glass of whole milk. * Talk to your doctor or dietitian about a nutritional supplement if you cannot eat enough to maintain your muscles.

Article on “Use of ‘Port-a-Cath’ in cancer patients”

Published URL : National Courier

Published Date: 19th July 2016

By: Fauzia Pesnani

Cancer patients during their treatment get chemotherapy, blood transfusions, antibiotics, and intravenous (IV) fluids as well as to draw blood for tests. Some patients have difficult veins in their arms. Veins can be small, damaged by prior therapies or phlebotomies, or have a tendency to ‘roll’ away from needle. Therefore, sometimes the nurses may have to make three or four attempts each time in a different place in hands or arms to get the right kind of vein to give chemotherapy medicines. In our current scenario Port-a-Cath is not used commonly and most chemotherapy treatments are been given through an IV catheter. But this might not be the best option. Why is a chemotherapy port necessary? * Patient might need an IV every week or for several days in a row. It can be uncomfortable to be stuck with a needle so often. * Staff nurse might have difficulty putting a needle in a vein so often. * Some chemotherapy damages tissue if not injected directly into the vein. If the veins in patient’s hands and forearms are small or difficult to put a needle into, the risk is higher that chemotherapy will be injected into tissue around the vein. * If a cannula dislodges and is no longer positioned in the vein correctly then drug leaks into the area around the vein while being given, this is called extravasation. * Delivering chemotherapy to large veins is much preferred to the small veins in the arm. When chemotherapy runs into a small vein, it can damage the veins, causing scarring especially with repeated infusions. However, when infused into a large vein, the drug is immediately diluted by the bloodstream and delivered more efficiently to the entire body. * The hand veins are very fragile and can get easily destroyed by the medicines used in chemotherapy. To make these treatments easier, patient might get a medical device called a catheter or port. WHAT IS A PORT-A-CATH? A port-a-cath is an IV (intravenous) catheter that is placed under the skin in a patient who requires frequent administration of chemotherapy, blood transfusions, antibiotics, intravenous feeding, or blood draws. It is a central IV line, meaning that the catheter is threaded into one of the large central veins in the chest, which empties into the heart. The vein which is used most often is the right internal jugular vein. This vein is preferred because it is very close to the skin and easy to find with ultrasound. It runs straight down to the heart and has the lowest risk for problems during placement of the catheter, and subsequent use by oncology nurses. Patient just sees and feels a small lump, like a bottle cap under the skin. Commonly called a port, the term porta-cath is a combination of the words ‘portal’ and ‘catheter’. The ‘port’, or portal, is a small reservoir, about as big as a thimble, with a silicone septum that can be pierced with a needle. The silicone is self-sealing and can be punctured hundreds of times before the port must be replaced so it can remain in place for many years. The ‘cath’ or catheter portion is the plastic IV tubing which attaches to the port. The catheters are placed by an interventional radiologist or surgeon, under local anesthetic, using ultrasound to guide the catheter into the vein. The entire port-a-cath is inside the body, so that bathing and swimming are not affected. The catheters are placed by an interventional radiologist or surgeon, under local anesthetic, using ultrasound to guide the catheter into the vein. The entire port-a-cath is inside the body, so that bathing and swimming are not affected. Advantages of Port-a-Cath: * Ports make the administration of chemotherapy much safer. * Ports can remain in place for weeks, months, or years. * It reduces the need to insert needles into your arm veins making treatments more comfortable for you * It reduces the number of needle sticks. * It allows to give all IV medications and to take blood samples * Give treatments that last longer than 1 day. The needle can stay in the port for several days. * Do blood tests and chemotherapy the same day with 1 needle stick. * It gives more freedom to use arms normally in all daily activities. * When it is not in use, there is no special care of the port needed. * Blood transfusions or parenteral nutrition can also be administered through a port. How it is used: To use the port, the chemotherapy nurse feels the port between her/his fingers, disinfects the skin and inserts a special needle, called a Huber, through the skin and the silicone septum into the reservoir. The Huber needle is specially designed not to damage the silicone septum. Additionally, these needles are associated with a very low rate of infection. The port-a-cath can be used the same day it is put in. Caring for Port-a-Cath: Since Port-a-Cath is under the skin, there is very little need to do to take care of it. Once a patient has finished chemotherapy, the port is usually left in for a period of time, usually one year, in case further therapy or IV access is needed. It only needs to be ‘flushed” to keep it working every four weeks if it is not in use. If the port is no longer needed, it is removed by the surgeon or interventional radiologist, under local anesthesia. – – (The writer is head of Cancer Hospital (Nursing Services), Dr. Ziauddin Group of Hospitals).


Advanced Bone Tumor Treatment;

Radiofrequency Ablation (RFA) Of Osteoid Osteoma

At Dr. Ziauddin Hospital

Radiofrequency ablation (RFA) is a treatment that uses imaging guidance to place a needle electrode through the skin into a tumor. High-frequency electrical currents are passed through the electrode, creating heat that destroys the tumor cells. RFA is an effective treatment option for patients who might have difficulty with surgery .The success rate for completely eliminating small tumors is greater than 90 percent. Dr. Ziauddin hospital is offering this latest treatment at its two interventional radiology suits. Dr. M. Kashif Shazlee, HOD radiology, among two other interventional radiologist, Dr. I. A Lutfi& Dr. M. Ali, offers this minimally invasive curative treatment.


Radiofrequency ablation, sometimes referred to as RFA, is a minimally invasive treatment for cancer. It is an image-guided technique that heats and destroys tumor cells.

In radiofrequency ablation, imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide a needle electrode into a bone tumor. High-frequency electrical currents are then passed through the electrode, creating heat that destroys the abnormal cells.


Radiofrequency ablation is used to treat few types of bone lesions especially osteoid osteoma. Osteoid osteoma is a benign tumor of the bone. This tumor is most frequently found in the legs but may occur also at other bones in nearly any part of the body. Osteoid osteoma is a tumor of children and young adults, it is very rare in older adults over the age of 50.In general, radiofrequency ablation is most effective treating this tumor.


Radiofrequency ablation works by passing electrical currents in the range of radiofrequency waves between the needle electrode and the grounding pads placed on the patient’s skin. These currents create heat around the electrode, which when directed into the tumor, heats and destroys the tumor cells. At the same time, heat from radiofrequency energy closes small blood vessels and lessens the risk of bleeding. The dead tumor cells are gradually replaced by scar tissue that shrinks over time.


Image-guided, minimally invasive procedures such as radiofrequency ablation are most often performed by a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room. Dr. M. Kashif Shazlee & his dedicated specialized team is one of the fewer physicians who are specialized in this advanced technique.

Radiofrequency ablation is often done on an outpatient basis.

The area where the electrodes are to be inserted will be sterilized and covered with a surgical drape.

Your physician will numb the area with a local anesthetic if the procedure is to be done while you are awake. If general anesthesia is used, you will have a breathing tube placed through your mouth and into your trachea after you are asleep. The breathing tube will be connected to a breathing machine while you are asleep.

A very small nick may be made in your skin to make it easier to pass the RFA electrode into in the effected bone.

Using imaging-guidance, your physician will insert the needle electrode through the skin and advance it to the site of the tumor.

At the end of the procedure, the needle electrode will be removed and pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.



  • Rapid pain relief usually apparent within the first 2-3 days after the procedure,
  • No overnight hospital stay,
  • Return to work, school and other normal activities usually within the first week after the procedure, but no vigorous sports for 3 months,
  • Minimal damage to bones and muscle with no significant structural weakness,
  • Lower cost.
  • Treatment-related serious complications are infrequent and discomfort is minimal.
  • No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.


  • Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
  • Less than one percent of patients may develop a localized infection (abscess) at the site of the tumor ablation three to four weeks after the treatment.
  • Severe pain after RFA is uncommon, but may last a few days and require a narcotic to provide relief.


Published URL : National Courier

Published Date: 19th July 2016

By Itrat Siddiqui The Nutritional transition is associated with a change in dietary habits , decreasing physical activity and rising prevalence of obesity. Overweight and obesity are major risk factors for a number of chronic diseases. Obesity has more than doubled in children and quadrupled in adolescents in the last 30 years. Overweight is defined as having excess body weight for a particular height from fat, muscles , bone , water ,or combination of these factors. Obesity is defined as having excess body fat. Overweight and obesity are the result of “Caloric Imbalance “. Childhood obesity is increasingly being observed with the changing life style of families with increased purchasing power, increasing hour of in activity due to television, video games, and computers which are replacing outdoor games and other social activities. The most important consequence of childhood obesity is its persistence into adulthood . with all its health risks include cardiovascular disease , and some sex hormone sensitive cancers. Pakistan ranked 9th out of 188 countries in terms of obesity, according to the ( Global Burden of Disease study published in the Lancet journal. Pakistan needs to develop a national strategy to control obesity in its population by implementing the recommendations of the WHO global strategy on diet , physical activity and health. Healthy life style habits ,including healthy eating and physical activity , can lower the risk of becoming obese and developing related disease. Schools play a particularly role by establishing a safe and supportive environment with policies and practices that support healthy behaviors. Schools also provide opportunities for students to learn about and practice healthy eating and physical activity behavior’s . Special emphasis may be laid on healthy diet and avoiding use of extra fats and sugars for energy . Children should be encouraged to utilize fresh vegetable , fruits , legumes , whole grains and high fiber diets . cutting the amount of fatty, sugary foods in the diet. – Engaging in daily moderate physical activity for at least 30 minutes. Garden, go for family walks, play a pickup game of sports, swim, take the stairs, or walk to the grocery store or work Eat small portions. Use a smaller plate, weigh portions on a scale, or check the Nutrition Facts label for details about serving sizes Eating habits of children and teen agers should be monitored. State Should strictly regulate the marketing of foods and drinks for the children and ensure that for marketing companies are not playing with the health of our future generations . “ The battle to curb childhood obesity is critically tied to understanding its causes and focusing on the modifiable factors that can lead to positive health change for each and every child, Eagle said.” Fad diets are not the best way to lose weight and keep it off. These diets often promise quick weight loss if you strictly reduce what you eat or avoid some types of foods. Some of these diets may help you lose weight at first. But these diets are hard to follow. Most people quickly get tired of them and regain any lost weight. A serving of low-fat or fat-free food may be lower in calories than a serving of the full-fat product. But many processed low-fat or fat-free foods have just as many calories as the full-fat versions of the same foods-or even more calories. These foods may contain added flour, salt, starch, or sugar to improve flavor and texture after fat is removed. These items add calories. Skipping meals may make you feel hungrier and lead you to eat more than you normally would at your next meal. In particular, studies show a link between skipping breakfast and obesity. People who skip breakfast tend to be heavier than people who eat a healthy breakfast. Eating lean meat in small amounts can be part of a healthy plan to lose weight. Chicken, fish, and red meat contain some cholesterol and saturated fat. But they also contain healthy nutrients like iron, protein, and zinc. A number of factors such as your age, genes, medicines, and lifestyle habits may affect your weight. If you would like to lose weight, speak with your health care provider about factors that may affect your weight. A registered dietitian may also give you advice on a healthy eating plan and safe ways to lose weight and keep it off. – Writer of this article is a Clinical Nutritionist at Dr. Ziauddin Hospital


Dr. Ziauddin Hospital is proud to launch its first  Radio frequency ablation (RFA) of varicose veins at Dr Ziauddin hospital Clifton. It is a latest minimally invasive technique for endovascular ablation of varicose veins and, Ziauddin hospital is one of  the pioneer institutes in Pakistan offering this treatment. It is a day care procedure, performed under local anesthesia by Interventional Radiologist.

Apart from RFA, we are also performing percutaneous Sclerotherapy  for superficial Hemangiomas and,Arterial embolisations for AVMs.

You can refer patients to Dr Muhammad Ali ( Radiology Department)  EXT: 295  and  Mr. Akber Nasir (Manager Cath lab) EXT: 369/370.

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