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Bilawal Inaugurates Latest CyberKnife Facility At JPMC
Pakistan Peoples Party (PPP) Chairman Bilawal Bhutto-Zardari on Monday inaugurated two different departments of over one hundred beds each and the latest cancer fighting technology CyberKnife S7-FIM at Jinnah Hospital, Karachi.
CyberKnife is a robotic technology that uses high cancer-killing doses of radiation in a precise, painless and non-invasive manner, according to the JPMC based in Sindh's capital city.
The two departments launched today by the PPP chief include a 120-bed Department of Psychiatry and Behavioural Sciences, and a 110-bed Department of Neurology and Stroke Unit.
Addressing a ceremony at the Jinnah hospital, Bilawal said that the CyberKnife is the most expensive machine in the world and the provincial government is providing these facilities to people free of charge.
"People talk about the Sindh government that it does not do anything. But, the Sindh government's work speaks for itself," he said, adding that the National Institute of Cardiovascular Disease (NICVD), National Institute of Child Health (NICH) and JPMC are the best examples of the government's performance.
"All these three hospitals are an example of good governance of the provincial government while in other provinces even a CT scan facility is not available to the public free of charge."
The CyberKnife facility is available only at the JPMC in the entire country, he added.
It is pertinent to mention that the CyberKnife system was set up at the JPMC for the first time in December 2012.
The PPP leader also directed Sindh Chief Minister Syed Murad Ali Shah to continue serving the people with the best healthcare facilities.
Bilawal, who served as the foreign minister in the last government, also directed the Sindh chief executive to take Prime Minister Shehbaz Sharif to visit the hospital whenever he trips to the city.
The PPP leader said that he would tell the premier that the PPP-led government is ready to assist the Punjab government in the health sector.
A Medical First — Patient Turned Ottawa Hospital Nurse Develops Never-seen-before Brain Tumour
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by The Ottawa Hospital FoundationBreadcrumb Trail Links
At age 21, Erin Brown received the shocking news that she had a brain tumour. Later, tests showed she had a tumour that had never been seen before, which took her down an unprecedented path and into the medical history books.
Published Sep 01, 2024 • Last updated 1 hour ago • 9 minute read
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Erin Brown is a nurse on F7 of the Civic Campus. SUPPLIED PHOTOS Article contentLike many university students, Erin Brown, a kinesiology undergrad at uOttawa, was burning the candle at both ends. When she started to complain about headaches, nausea and seeing stars, those close to her believed she was pushing herself too hard. Even her doctor initially said, "You need to take a break." But as symptoms worsened, Erin soon learned it wasn't stress or exhaustion; she had a brain tumour — and it was a type the world hadn't seen before.
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The 21-year-old was in her fifth year of her undergrad in human kinetics studies in 2018 when the symptoms started. When they worsened, she paid another visit to her family doctor who did some neurological tests but couldn't pinpoint the cause. "He said if the symptoms continued, I should go to the nearest emergency room and get some imaging done," explains Erin.
It wasn't long before her dad took her to an area hospital, and after initial tests, Erin was sent to the Civic Campus of The Ottawa Hospital. Dr. Safraz Mohammed, a neurosurgeon specializing in brain and spine, was on call when Erin arrived at the Emergency Department.
"After reviewing her CT scan, we immediately ordered an MRI scan, and that unfortunately revealed a brain tumour in her right frontal lobe," says Dr. Mohammed.
He remembers those early interactions with Erin quite well. "She had such an uplifting spirit, even at the time of diagnosis. I could see that she was an amazing person, and she was going to be a great patient."
For Erin, the feeling is quite mutual. This young doctor, just two years into his career, brought her much ease. She was admitted to F7 (the neurosciences in-patient floor) and had another MRI the next morning. When Dr. Mohammed came to meet with Erin and her family, he sat down.
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"When I meet patients, I sit down at eye level. I sit on the bed sometimes or sit on a chair close to them, because I think it's important to be at eye level to have good patient interaction rather than having a height difference."
He also jokes that it's a good opportunity to sit down after operating all day or being on rounds.
Erin with Dr. Safraz Mohammed.A type of tumour never seen before
Erin's tumour was quite large — the size of a small apple — and all signs indicated it was a meningioma, which is a type of tumour that develops from the membrane that covers the brain and spinal cord. In Erin's case, it was invading the middle vein in the brain known as the superior sagittal sinus, which is a major vein. Damage to it can result in devastating consequences, according to Dr. Mohammed.
"Those devastating consequences include a massive stroke, massive bleed into the brain, and unfortunately, even death. It's a big vessel, but it has a thin wall. It would take a lot of planning for the surgery."
After careful planning, Erin was prepped for surgery with Dr. Mohammed and his team. A continuous trans-esophageal echocardiogram was used to ensure that no air was sucked in through the main vein, as this could result in death. Dr. Mohammed wanted to remove the entire tumour, given that Erin was so young. During the six-hour procedure, the tumour was completely extracted and sent for analysis.
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The testing yielded the most unusual results. Dr. Mohammed learned it was a Grade 3 tumour, which meant it was cancerous. "It wasn't benign, as we suspected. It also didn't follow the criteria for meningioma. As a result, we sent it for further testing in Toronto, and that's when we discovered this tumour had elements to it that were never seen or discovered before," explains Dr. Mohammed.
This new type of tumour is called a dural-based spindle cell neoplasm, characterized by a novel MN1-KMT2A fusion gene, based on the type of cells and genetics discovered within it. This tumour was unlike anything ever seen or described before. With the neuropathologist's help, the team was able to publish this new tumour in the medical journals.
I just knew I was in good hands, and I just had to trust my team.
It was difficult news for Erin to grasp. "I remember becoming so overwhelmed with emotions that I just started crying. This is a lot more serious than I thought, but Dr. Mohammed calmed me down. The nurse in the room, Nancy Mongeon, was so sweet and nice," explains Erin.
"My parents gathered themselves too, and then we just talked about next steps. I was never scared after that because of all the reassurance I got — I just knew I was in good hands, and I just had to trust my team," adds Erin.
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Dr. Vimoj Nair is a radiation oncologist.Ready for treatment
Because the team was working with a new type of tumour, there was no precedent for treatment. But since they knew they were dealing with a Grade 3 tumour, they recognized radiation was required.
That's when Dr. Vimoj Nair, a radiation oncologist who specializes in the treatment of children and young adults, stepped into the picture. He brings a particular skill and knowledge in high-precision radiation therapy, including his work with the CyberKnife — a radiosurgery robot that can destroy inoperable brain tumours, as well tumours in other parts of the body. This important piece of equipment was acquired thanks to donors of The Ottawa Hospital.
It was Dr. Nair and his research collaborators who first published the made-in-Ottawa platinum seeds used to improve an already incredibly powerful and precise radiosurgery treatment system for tumours in the liver, pancreas and kidneys. "We are proud to have access to cutting-edge technology here at The Ottawa Hospital and of our decades of experience when it comes to radiation treatment," explains Dr. Nair.
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As Erin was so young, Dr. Nair wanted to give her the best chance at a full life, without recurrence. "It's not just giving radiation, but there's ensuring the patient can have good survivorship and maintain all their capacities. She's young, and we wanted a plan to spare her memory centre, so she has full use of her brain."
That meant targeting the tumour but also covering the area around the tumour to treat any potential microscopic disease that human eyes or scans cannot detect. "It's like a tree on the lawn. You can cut it down, but you still must go after the roots of the tree," he explains. "This meant using the linear accelerator machine, which could give a lower dose per day to a wider area and allow normal irradiated brain tissue to recover, instead of using the CyberKnife, where an intense radiation treatment is given to only any visible tumour."
By late 2018, after 30 rounds of radiation, the team was hopeful.
Becoming a part of TOH family
It was during those weeks of radiation treatment that a switch flipped for Erin. It had nothing to do with her health but rather her career aspirations. Dr. Mohammed remembers when Erin shared this part of her journey. "She talked to me about how she was so much younger than the other patients around her and how much compassion she had for the older people who were also having radiation. She started helping them up, helping them move across the room, and getting paperwork or whatever it was they needed."
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This proved to be a defining experience in her life — a spark in her journey towards health care.
Dr. Mohammed could see what an exceptional nurse she would make, and he was there to support her. "I wrote her a reference letter for nursing school, and then her training led her to Sunnybrook Hospital in Toronto — that's where I trained during my residency. When her program was wrapping up, I encouraged her to come to work at the Civic because it's simply the best place to work."
In 2021, Erin became a nurse in neurology on F7 — the same floor where she was first admitted to when her care journey began three years earlier. The neurosurgical patient became the neurosurgical nurse.
New lesion appears in a different location
As Erin's career blossomed, she continued regular MRI scans every six months. Then in May 2022, a tiny dot on the right temporal lobe appeared in a scan.
"I discussed it at the tumour board," says Dr. Mohammed. "This is a group of neurosurgeons, radiation oncologists and neuropathologists from our hospital who discuss complex cases. I wasn't ready to put her through another operation just yet, so we watched this new lesion closely."
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Then two months later, the lesion grew quite a bit, to the size of a grape. By October 2022, Dr. Mohammed and his team returned to the operating room with Erin to perform a right-sided craniotomy in the temporal region, along the side of her head. "This is a new, small tumour in a different location. The original tumour was gone, and all the images that we've had so far show that nothing grew back there. So, we removed the lesion and as much dura layer or the covering of the brain as I could."
The way it was described to Erin is this new lesion was the result of a drop metastasis — where a small cell from the original tumour dropped down the side and developed into a new tumour.
At TOH we are proud to have access to cutting-edge technology and an experienced radiation planning and therapy team
Unfortunately, just over a year later, the lesion was back, and in January 2024, Erin faced a third surgery to fully resect it, followed by more radiation. Consensus from the tumour board was radiation helped long-term with the first tumour, so they should proceed with radiation on the second one.
This time, the challenge was to treat the brain in a different location but minimize overlap with the previous radiation plan, ensuring a good balance between tumour control and any short-term and long-term toxicity risks in a young patient.
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"At TOH we are proud to have access to cutting-edge technology and an experienced radiation planning and therapy team. We're able to spare the brain and it shows our expertise in treating younger brains," explains Dr. Nair.
Focused on a career of caring
Today, Erin continues to be monitored closely, and more treatments lie ahead, but she also takes what she's learned as a patient to the bedside when caring for her patients — knowing first-hand what they are going through. "It's such a privilege to take care of patients when they're in their most vulnerable state, knowing the degree of what they're going through even though each experience is different."
She has a special connection to those younger neuro patients with whom Erin can relate. "I've had a couple of younger patients who were in their 30s and 40s. They just look so scared. They're going home to their family. They have young kids. They don't know how to navigate it, and I feel for them because I've kind of been in their situation. Maybe not 100 per cent, but I know to a degree what they're going through, so I'm able to give them that support." As for the unprecedented tumour that put her in the history books, she jokingly wishes they had called it an "Erinoma." Regardless of what her future holds, she's grateful for the highly skilled team who brought not only their expertise, but also a sense of calm during the most challenging time in her life — a team she is proud to now be a part of.
Donate today to help give patients like Erin a better tomorrow.
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Breakthrough In Stroke Care, SAMAY By Artemis Hospitals To Transform Treatment And Save Lives
VMPL
Gurugram (Haryana) [India], August 30: Stroke is the second commonest cause of death in India. About 1,85,000 strokes occur every year in India with nearly one stroke every 40 seconds and one stroke death every 4 minutes, says an article published by news agency in 2023. The report also mention that India bore the maximum burden of stroke with 68.6 per cent incidence of stroke, 70.9 per cent stroke deaths and 77.7 per cent disability-adjusted life years (DALYs) lost.
In another report published in the Lancet Neurology journal (ICMR Release), Stroke, a highly preventable and treatable condition, could lead to nearly 10 million deaths annually by 2050. This projection comes from the collaborative effort of the World Stroke Organization and the Lancet Neurology Commission under which four studies have been published. The report underscores that stroke deaths are expected to surge from 6.6 million in 2020 to a daunting 9.7 million by 2050.
To redefine India's stroke emergency, Artemis Hospitals has unveiled a new program, SAMAY - Stroke, Acting Within, Minutes, Adds to, Years during a meet here today at the hospital premises. The program promises to revolutionize stroke care and tackle India's growing crisis. SAMAY, signifies a major leap forward in acute stroke care and underscores Artemis Hospitals' dedication to advancing medical services and enhancing patient outcomes.
Present at the event were Dr Sumit Singh (Chief of Neurology & Stroke Services), Dr. Aditya Gupta (Chairperson - Neurosurgery & CNS Radiosurgery & Co-Chief - Cyberknife Centre), Dr. S.K Rajan (Chief - Neuro Spine Surgery & Additional Director - Neurosurgery), Dr. Tariq Matin ( Chief & Director of Neuro-intervention ) & Dr Saurabh Anand (Chief of Neuroanaesthesia & Neuro Critical Care)
Talking about the initiative, Dr Devlina Chakravarty, MD, Artemis Hospitals, said, "Our goal with SAMAY is to ensure that every stroke patient receives immediate and specialized care, With this we are taking our Neuroscience Center of Excellence to newer heights because we are committed to addressing critical challenges in stroke care. Despite advancements, many patients face delays due to insufficient awareness, limited access to healthcare facilities, and inefficiencies in emergency responses. With one stroke death occurring every 4 minutes in India, the need for immediate action is paramount.
Time is critical when it comes to stroke treatment, and SAMAY will significantly enhance our ability to act swiftly and effectively, thus improving survival rates and outcomes, she added
The program's slogan, "#TimeIsBrain" is more than a slogan; it represents the urgency required to effectively address strokes. The public is encouraged to recognize the F.A.S.T. Acronym--Face Dropping, Arm Weakness, Speech Difficulty, Time to call Helpline--to facilitate quick response and intervention.
According to the doctors present at the event "With SAMAY, we are setting a new benchmark in stroke management. By combining advanced technology with round-the-clock availability of intervention stroke neurologists, we are not just treating strokes; we are reshaping the way stroke care is delivered in India."
As discussed during the conference, SAMAY offers a comprehensive approach to acute stroke management with its 24x7 integrated pathway, featuring dedicated stroke specialists for rapid response. The center boasts state-of-the-art infrastructure, including the latest Bi-Plane DSA with 3D and Angio CT technology. As one of India's leading high-volume neuro-intervention centers, SAMAY is equipped to handle a significant number of neuro-intervention cases. Additionally, it provides round-the-clock expertise through specialized stroke neurologists and a cutting-edge neuro-critical care setup, ensuring optimal care at all times.
During the conference, the panel of esteemed neuro specialist's team at Artemis highlighted the significance of teamwork in neurosciences, showcasing a spectrum of services, intriguing case studies, and the innovative SAMAY approach. They collectively stressed that SAMAY represents a transformative shift in stroke care, aiming to set a new standard in combating this pressing health issue.
Artemis Hospitals emphasizes the need for improved public awareness, enhanced healthcare access, and better training for healthcare professionals and developing robust data collection systems are essential for effective stroke management.
(ADVERTORIAL DISCLAIMER: The above press release has been provided by VMPL. ANI will not be responsible in any way for the content of the same)
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