Lahore General Hospital, Lahore Postgraduate Medical Institute, Lahore

LAHORE GENERAL HOSPITAL

Department of Interventional Neuroradiology


On 23rd December 2014, the Neuroradiology Department at Lahore General Hospital successfully treated two patients suffering from Ischemic stroke through mechanical thrombectomy. It was a major breakthrough as this was the first time such a procedure was performed in Pakistan. An Ischemic stroke occurs because of a loss of blood supply to parts of the brain leading to permanent disability and in many cases, death. Even though many countries are successfully performing mechanical thrombectomy, in Pakistan patients are only offered conventional treatment through medication leading to disability or death that in majority cases could have been prevented. International experience demonstrates that through mechanical thrombectomy, effects of an Ischemic stroke may be reversed and paralysis can be avoided.

The Neuroradiology Department at Lahore General Hospital has the required trained personnel and medical equipment to perform mechanical thrombectomyhowever the Department urgently needs the following to develop a Stroke Center:

1.     Disposable medical items
2.
     Availability of anesthesia services throughout the week
3.
     Availability of post care services
4.
     Availability of medical staff for round the clock care

Stroke is the most common cause of disability and a leading cause of mortality worldwide. Even though the incidence of stroke is falling in developed countries, it is projected to increase enormously in Pakistan due to increasing risk factors associated with stroke.The proposed Stroke Center will be the first such center set up in Pakistan and would vastly improve the treatment, well-being and survival rate of stroke patients in the country.
                                            BACKGROUND
Lahore General Hospital (LGH) is renowned for its Neurological services. The first and only dedicated Neuroradiology Department was developed as an integral part of the Neurosurgery in 1970. By 1994, the Nueroradiology Department at LGH was declared as a separate and autonomous specialty. In 2000, through the efforts of the Department’s own personnel, the Neuroradiology Department evolved from a diagnostic facility to a treatment facility offering neuroendovascular treatment and spinal intervention. By 2010, the treatment facilities were expanded to include neuroendovascular treatment for aneurysm (coiling), AVM and Dural AVF (embolization) that in the last four years alone has saved 600 lives.

EXISTING FACILITIES
·       
5 trained doctors
·       
6para-medical staff
·       
Latest and only Bi plane Neuro-Angio Machine in Pakistan
·       
MRI, Carotid Doppler and 2 CT Scans  

ACHIEVEMENTS

Today the Neuroradiology Department functions as a diagnostic and treatment center for blood vessel diseases in the brain and spine including head and neck. Since 1990, the Department has diagnosed over three hundred thousand patients. After evolving into a treatment center in 2000, it has treated over fifteen hundred patients through different treatment facilities that have been added over the years.

       

TREATMENT

NO. OF PATIENTS

DETAILS

Vertebroplasty

140

Minimally invasive surgical procedure for painful spine fractures

Endovascular Coiling for Brain Aneurysm (since 2003)

450

Life saving, minimally invasive technique to treat brain aneurysms

Pre-surgical Embolization/ Angiofibroma

250

Blood-less surgery in ENT tumors

Pre-Surgical Embolization /Dural Tumors

20

Safe intra cranial surgery

AVM Embolization (since 2009)

120

Life-saving technique for patients suffering from seizures and bleeds

Dural AVF (since 2011)

30

To cure uncontrollable headaches, vertigo, tinnitus and vision loss

Vein of Galen of Malformation (since 2010)

30

Life saving technique for infants and children

Venous malformation

550

To correct disfigurement caused by venous malformations

 

1, 590

 

DIAGNOSTIC FACILITY

NO. OF PATIENTS

DETAILS

Myelography / MiloCT

15, 000

For patients unable to get an MRI

CT Scan (since 1990)

201, 600

 

MRI (since 2005)

21, 600

 

Transcranial Doppler (since 1996-2001)

54, 000

Diagnosis of brain death, vasospasm and early diagnosis of vascular lesions; discontinued after the donated machine developed problems and was not replaced

Diagnostic Cerebral Angiography

3, 500

Early and accurate diagnosis of vascular diseases of the brain

Spinal Angiogram

280

Early and accurate diagnosis of vascular diseases in the spine; only facility in the public sector

Vertebral Biopsies

210

Accurate diagnosis for bony lesions to correctly identify tumors

 

327,690

 

 

STROKE CENTER

 Due to the increasing incidence of patients suffering from stroke, a letter dated September 2008 (Annex I& II) was issued to develop a state of the art Stroke Center within the department.However as that did not lead to any tangible results, the personnel of the department made every effort to receive international training and experience in mechanical thrombectomy.On 23rd December 2014 a team of professionals led by the Head of the Neuroradiology Department, Dr. Umair Rashid and assisted by local and international experts successfully performed the first mechanical thrombectomy on two patients in Pakistan. (Annex III)

 Building on this success, it is proposed that a Stroke Center located in the Neuroradiology Department, LGH be set up to cater to patients suffering from strokes. The Stroke Center will give patients the opportunity to avoid paralysis and disability that are caused as a direct result of strokes.

 

REQUIREMENTS FOR THE STROKE CENTER

 1.      Disposable medical items

To perform mechanical thrombectomy at the proposed Stroke Center, disposable medical equipment including catheters, micro-wire, stents and other small medical appliances will be required.

 2.      Availability of Anesthesia services throughout the week

Currently the Neuroradiology department at LGH has access to anesthesia services only once a week causing significant delays in the treatment of the patients. Due to the nature of strokes, timely intervention ranging from 8-24 hours will be critical for successful treatment thus making it absolutely essential that anesthesia services be made available throughout the week.

 3.      Availability of Post Care Services

The current treatments being offered by the Neuroradiology Department do not require aggressive post-care services however for patients with strokes, it will be essential to develop intensive post-care services. It is being proposed that at least 5 facilities for post-care services be set up next to the Angio Suite

 4.      New Staff comprising 3 Doctors, 5 nurses and 2 Angio technicians

The Stroke Center will require 3 doctors (related to Neuroradiology), 5 nurses with ICU and Angio experience and 3 Angio technicians to ensure that round the clock services are offered to the patients.

ADVANTAGES OF THE PROPOSED STROKE CENTER

  • Patient care will vastly improve by significantly reducing the chances of continued paralysis, disability and death

  • It will serve as the first and only Stroke Center in Pakistan 

  • It will offer an internationally recognized form of treatment previously unavailable to patients in Pakistan 

  • Through Post Graduate training facilities, it will train other medical professionals in neurointervention 

  • It may be affiliated with international societies and centers in the field of Neuroradiology  

  • No significant financial investmentin machines and/or training is required.


                        6th Neurointervention and Therapeutic Workshop

    17 - 22 December 2014

    In Collaboration with

    Alexandria University School of Medicine, Egypt, Lahore General Hospital, Post Graduate Medical Institute, Lahore-Pakistan, Neuroradiology Section PPRC, Radiological Society of Pakistan

     In a major medical breakthrough for Pakistan, the first catheter-based treatment of ischemic stroke was performed last night at Lahore General Hospital, Lahore.

    A multinational team of specialized neurointerventional physicians was assemble by Dr. Umair Rashid Chaudhry, a Lahore based neurointerventionalist. Dr. Umair’s local team included Dr. ShahzadBhatti, Major Dr. JahanzebLiaqat, Neuropsychician, Military Hospital Rawalpindi and assisted by Dr. Hamid, Dr. Saima and Dr. Atif. International Neurointerventional experts included Dr. OssamaYassin Mansour from Alexandria, Egypt and Dr. HasnainHaider Shah, from Dubai UAE. The team was also assisted by Residents, House Officers and Medical Officers at Lahore General Hospital, Lahore.

    The team was assembled for five days in order to wait for an emergency case of Stroke paralysis that would present in time for emergency mechanical thrombectomy. This is similar to a heart attack where an artery gets blocked, the brain arteries can also become blocked and need to be treated within 6 hours from the start of the “Brain Attack”.

    Last night a 60 years retired army professional was brought to CMH Lahore and his left side of his body was nearly completely paralyzed.  The team quickly moved into action and in less than 4 hours from presentation patient was brought from emergency room to neuroangiography room, Lahore General Hospital.

    In less than 1 hour the team was able to successful placed a very specialized stent retriever (Covidien solitaire FR), which is a clot capture device. If one is able to remove the clot from the main artery the flow in the brain is restored and neurological function will improve i.e. paralysis can improve.

    The clot was partially removed from the patient and flow in the artery was reestablished and the patient started to move the left side of his body more and he regained his strength.

    On the 4th day of the workshop 2nd patient FaqeerHussain 55 years old was brought in a critical state to emergency department Lahore General Hospital. He was found to have a Glasgow Coma Score of 4/15 which is a considered to be very severe. He was completely paralysed of all four limbs with breathing difficulty. After initial stabilization at emergency, he was rushed to neurosurgical department of LGH and was found to have complete obstruction of basilar artery with thrombus extending to both post cerebral arteries. He underwent thrombectomy with Penumbra ACE Clot Extraction Device and clot was removed with successful recanalization and establishment of flow.

    The patient is currently admitted to intensive care unit of LGH and recovering from this dreadful attack of paralyzing stroke.

    This emergency clot removal for paralyzing stroke is performed very frequently is USA & Western Europe for over 10 years. In more recent year the treatment has become available in Middle East and India.

    Dr. Umair Rashid Chaudhry when asked about the implication of this treatment. He said “with the right government and private support patients and their families now will no longer to face life long paralysis after stroke, because treatment options are now available in Pakistan”.  Dr. Chaudhry stressed, “now the country needs to establish multiple stroke centres in major cities of Pakistan, since stroke is 2nd highest cause of mortality in Pakistan and number one cause of life long disability”.

     

 

 


 
Polio Drops Timings
08:00 AM to 01:00 PM (Outdoor)
Friday 08:00 AM to 12:00 AM (Outdoor)
__________________
If someone asks money through Omni or etc services
All these things ar Bogus & Fraud
__________________
WORKSHOP ON NEONATAL RESUSCITATION
with hands on training

Organizing Secretary:
Prof. Dr. Agha Shabbir Ali
Head of Department of Pediatrics
PGMI / AMC / LGH, Lahore.


Time & Date: 11:00 AM TO 1:30 PM
Date: 22-07-2017
Venue: DEPARTMENT OF PAEDIATRICS, LGH, Lahore
Registration:CONTACT/SMS
DR RIZWAN GOHAR
03004204215
rizwangohar@gmail.com

__________________
PGMI / AMC / LGH oganizing its 7th Annual Symposium as decided in last Academic Council meeting.

Organizing Secretary:
Prof. Agha Shabbir Ali
Head of Department of Pediatrics
PGMI / AMC / LGH, Lahore.

Patron & Chairman:
Prof. Ghias un Nabi Tayyab
Principal, PGMI / AMC / LGH, Lahore.

Venue: 5th Floor, PINS, LGH, Lahore
Date:  15th - 16th - March 2017.

__________________
The Administration of LGH has cancelled the MOU
with NTS Authority regarding recuritment of staff

Applications submitted through NTS will not be
entertained.LGH will soon announce the date of
receipt of applications.
__________________
March for Army Public School(Peshwar)
Chief Organizer:
Prof. Khalid Mehmood
Principal PGMI/AMC/LGH
Chief Guest:

Guest of Honour:
Mr. Khawaja Salman Rafique (Advisor to CM on Health)
Date:14th December 2015
Venue:
From PGMI to Shadman Chowk
__________________
Workshop on Lysosomal Storage Diseases (LSDs)
Chief Organizer:
Prof. Agha Shabbir Ali
Head of Pediatrics Department
Venue:
Conference Room Pediatric Ward , LGH, Lahore.

Date:Tuesday, 5th January 2016th,
Time:9:00 AM 12:00
__________________
Walk on World Diabetes Day
Chief Organizer:
Prof. Ghias Un Nabi Tayyab
Prof. of Medicine.
Organising secretary:
Dr. Muhammad Imran Hasan
Associate Prof. of Medicine PGMI/LGH
Organize By:
DEMC/PGMI/LGH, Medical Unit-I, LGH, Lahore.
Chief Guest:
Mr. Sohail Ahmed (Azizi).
Date:14th November 2015
Time:
11:00 AM
Venue:
From LGH Emergency Gate to Stall Area
Last date for registration:
26-10-2015
__________________
Diabetes Education Workshop
Chief Organizer:
Prof. Ghias Un Nabi Tayyab
Prof. of Medicine.
Organising secretary:
Dr. Muhammad Imran Hasan
Associate Prof. of Medicine.
Venue:
Gastro Auditorium, Medical Unit-I, LGH, Lahore.
Date:30th - 31st October 2015
Contact:
0332-2368486
Last date for registration:
26-10-2015
__________________
15th Workshop on Dengue Fever
Chief Organizer:
Prof. Agha Shabbir Ali
Head of Pediatrics Department
Venue:
Conference Room Pediatric Ward , LGH, Lahore.

Date:Saturday, August 29th, 2015
Time:9:00 AM 11:15 AM
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2nd Alumni of PGMI
Venue:
Ali Institute Auditorium, Ferozepur Road, Lahore.
Near Gulab Devi Hospital
Registration (Last Date):Saturday, June 06, 2015
Registration Fee:
Professor Rs.2,000/-
Associate Prof. Rs.1,500/-
Assistant Prof. Rs.1,500/-
Demonstrator/PGR Rs.1,000/-
Date:Wednesday, June 10, 2015
Time:05:00 PM
__________________
2nd THALASSEMIA WORKSHOP
Venue:
Conference Room Pediatric Ward LGH, Lahore.

Date:Thrusday, June 11th, 2015
Time:9:00 AM 02:00 PM
__________________
2nd Workshop on Neonatal Resuscitation
Venue:
Conference Room Pediatric Ward LGH, Lahore.

Date:Saturday, June 13th, 2015
Time:10:00 AM 01:00 PM
Registration Contact:Dr Rizwan gohar Senior registrar
03004204215 email. rizwangohar@gmail.com
Headed By:Prof Agha shabbir ali , Prof Rashid Mehmood
__________________
5th 17th Annual Conference of
Anaesthesiology & Critical Care
Organised by:
Department of Anesthesia, PGMI/AMC/LGH
Supervised by:
Prof. Khalid Bashir,
HOD,Department of Anesthesia, PGMI/AMC/LGH
Venue:
Pearl Continental,Lahore
Date:Friday-Sunday, April 03-05, 2015
__________________
5th Symposium & Live Workshop on Endourology
(PCNL, TVT/TOT, LAPROSCOPIC SURGERY)
Organised by:
Department of Urology, PGMI/AMC/LGH
Supervised by:
Prof. Safdar Ali Shah,
HOD,Department of Urology, PGMI/AMC/LGH
Contact:
0333-8417898
Venue:
Department of Urology, PGMI/AMC/LGH
Date:Monday, February 23, 2015
Time:09:00 AM to 03:00 PM
__________________
5th Annual Scientific Symposium 2015
PGMI/AMC/LGH
Venue:
Neuro Auditorium, LGH, Lahore.
Date:February 18,19 2015
__________________
Fetal Surveillance
(Pre-Conference Workshop)
Antenatal Fetal Surveillance
Intrapartum Fetal Surveillance
NICHD-FHR Classification & Suggested Management
Fetal Surveillance of Surgically Correctable Fetal Anomalies
3rd Trimester Fetal Surveillance by Ultrasound
Organised by:
Department of Obs. & Gynae., PGMI/AMC/LGH
Prof. Nuzhat Khawaja
Prof. of Obs. & Gynae., PGMI/AMC/LGH
Dr. Naela Tarique
Associate Prof. of Obs. & Gynae., PGMI/AMC/LGH
Secretary:
Dr Farzana Latif, Assistant Prof., PGMI/AMC/LGH
Venue:
Neuro Auditorium, LGH, Lahore.
Registration:
Free.
Date:Friday, February 13, 2015
__________________
Basic Knee Arthroscopy Workshop
Organized By:
Department of Orthopaedic Surgery, PGMI/AMC/LGH
Collaboration with:
Pakistan Orthopaedic Association
Venue:
Learning Resource Center
Department of Orthopaedic Surgery, PGMI/AMC/LGH
Registration Fee:Rs. 1000
(Limited seats)
Contact:Mr. Muhammad Akram
0345 4703901
Date:February 11, 2015
__________________
Seminar: Dengue Fever Diagnosis & Management
Organizer:
Prof. Dr. Jawad Zaheer
Prof. of Medicine.
Presenter:
Dr. Kashif Aziz Ahmad
(MD, FCPS)
Venue:
Medical Unit-II, LGH, Lahore.
Date:Monday, January 19, 2015, 10:30 AM
__________________
Award Distribution Cermony
Organized By:
Prof. Irfan Mehboob
Prof. of Orthopaedic.
Venue:
Department of Orthopaedic Surgery, LGH, Lahore.
Date:January 17, 2015
Time:11:30 AM to 12:30 PM
__________________
5thAnnual Scientific Symposium
BLS Workshop
Organised by:
Department of Pediatrics, PGMI/AMC/LGH
Prof. Agha Shabbir Ali
Prof. of Pediatric, PGMI/AMC/LGH
Venue:
Conference Room, Pediatric Department, LGH, Lahore.
Date:Wednesday, January 14, 2015
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