Changinglives...Oursuccessstories

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MAROOFNEWSLETTERFebruary 2018

IT’S ALL ABOUT CHAMPIONS

BrandsTM

cAward

LectureonCardiovascularDiseasesandCPRatMOL,KARAKMaroofInternationalHospitalorganizedalectureforMOLemployeesatKarakKPKonCardioVascularDiseases&CPR.ThislectureandtrainingwasconductedbyProf.Dr.ShahbazA.Kureshi,ProfessorofCardiology.ThepurposewastoenlightentheMOLemployeesregardingCardioVascularDiseases,symptomsofCardiacArrest,preventionandhealthylifestyle.Dr.KureshialsogavehandsontrainingofCPRtotheattendees. This session was attended by 150 employees. Management andemployeesofMOLhighlyappreciatedthistrainingandensuredtheircooperationforallsimilarinformativesessionsinfutureaswell.

Itwasalmost10yearsago,IhadcomebacktoPakistanand

only recently had joined a hospital, Maroof International

hospitalinF-10Islamabadwhichhadjuststarted.

Itwasearlyintheevening,whenIreceivedafranticcallfrom

thehospitalthataoneyearoldchildhadbeenbroughtin.The

childhad jumpedonaglass table, resulting inhis leggoing

throughthebrokenfragmentsoftheglasstable.Hisleghada

large and deep cut. The child was brought to Maroof

InternationalHospitalwithbloodspurtingoutlikeafountain.I

drovetothehospitalwithspeedthatIcannotevenmention

here.WhenIenteredtheemergencydepartmentIdidn'thave

toaskforthelocationofthechild,thetrailofbloodfromthecar

park, through the hospital corridors, ledme straight to the

procedureroomoftheER.

Thesituationinsidewasnotgood.Therewasthislittlebabywho had no pulse no blood pressure and a diminishingheartbeat.Myanesthetistcolleague,Dr.NadeemQamarwasperformingchest compressionson thebaby to re- start theheartandgivinghimintravenous�luidstokeephiscirculationgoingasbynowhehadverylittlebloodinsidehistinybody.

Thewholeteamwasawarethatsecondswerepreciousandwewere working against all odds. Several arrangements weregoingonsimultaneouslytotakethebabytotheoperationtheatreasfastaswecould.

Alleyeslookedtowardstheanesthetistwhogavea�inalnodtomovethebabyinunisontotheoperatingtheatrewherewewouldmakea�inalattempttorescuethechild.Irememberthecryingmothertellingmeaswewhiskedhimawaythatifyouneedtocutoffhislegtosaveherson'slife,donothesitateforasecond.

Wewereintheatrethroughthefastestpossibleroute.The�irstthingIdidwasputabloodpressurecuffonthebaby'sthighandin�lateditasfastasIcould.Thisstoppedthebloodcirculationimmediatelyandhencethebloodloss.Thisgaveusafewmoreminutestopreparesomething'sthatweweregoingtoneedinthemomentstocome.Theclocktickedveryfastbutatleasthewasnotbleedingmore.Thesituationwasstillverydismal.Bagsofbloodhadalreadyarrivedandwerebeingpumpedin.

Verysoonmy�ingershadwalkedtheirwayrightintothewoundwhereIwassprinklingjetsofsalineandremovingfragmentsofglassfromtheleg.

Thedeepcutwasnowclearedoutofglasspiecesandwecouldnowseethatthemajorarterialbloodsupplytothelegwasseveredintotwo.WithoutlosingamomentIaskedforthevery�inestitchesthatwouldbeneededtojointogetherthisbloodvesselinthebaby.

Puttingtogetherthecutendswasnotdif�icultexceptfortheawkwardangleIwasin,duetothelocationofthedeepcut,andthefactthatIhadtoberealquickasthecompressiononthethighcouldbeplacedforalimitedtimeplusalsothefactthattheleghadnotreceivedanybloodandoxygenforquiteawhilebythattime.Oncetheedgesofthetinyvesselwerejoined,weslowlyreleasedthecompressionappliedonthethightorestarttheblood�low.Whenthebloodstarted�lowingthroughthearteryIneededtoputoneortwomorestitchestillitwastotallysealed.Theprevailingcrisiswasover.Wecouldtakeabowatleastforthatmoment.Whatremainedtobeseenwasthat,wouldthelegsurviveafterbeingwithoutbloodforsuchlengthoftimeplusotherfactors.Nothingwasguaranteed.Allofushaddonewhatwecould.But�inallytherewasaGoduptherealso,andweneededamiracle.

Icameoutofthetheatreandhalfadozenfacesweretryingtogetacuefrommybodylanguage.Igavethemathumbsupandtearsrolleddownfrommanycheeks.

Yearswentbyalmost10,thewholeincidentalmostslippedmymindandIwentabroadtowork.Fewdaysback,Ihadanappointmentbyacertainname.Afamilywalkedinwiththreekids.TheyaskedmeifIrecognizedthem.IapologizedthatIdidnot.TheytoldmethattheyfoundoutthatI'mbackinPakistannowforgood,thefathersaidifIrememberedmanyyearsago,aoneyearoldbabywhohadbeenbroughttome,thisboyof10ishim.Theyjustcametosaythankyou.Ihuggedthechild.HetoldmethateversincehewaslittleheheardhisparentstalkaboutyouandpromisedmethatonedayIwillmeetyou.Todaywasthatday.

SuccessStoriesThatNeverDie

Employeeofthemonth

Mr.NaseerMasihfromLaboratoryServiceswas

selectedasemployeeofthemonthforhisoutstanding

performance.Hewasawardedcerti�icateandprizeby

ExecutiveDirectorBilalBinZaheer,Mrs.Mussarat

NaseerHoDMMDandCEOCh.HaroonNaseer.Sr.ManagerFinanceandAccountsAfsarAlialso

present.

FebruaryNewsletter FebruaryNewsletter2 3

(Jerkingofthearms, legsorface),Tonic-Clonic(Stiffeningfollowedbyjerking),Atonic(Lossofmuscletoneleadingtoafall),Myoclonic(Suddenbriefjerk).Thetypeofseizurecanalso be due to mutations of various ionic channels on aneuron.ForexampleitcouldbeduetomutationofSodiumchannel, Potassiumchannel orCalciumchannel.A typicalseizureusuallylasts1-2minutesfollowedbyexhaustion.

Whocangetseizures?Fromanewborntoanoldadult,anyonecanhaveseizures.

Whatpredisposesonetohaveseizures?Genetic mutations in molecular channels are usuallycommon among the children and can lead them to haveseizures. There is usually a family history in such acircumstance. On top of a pre-existing mutation, somefactorscantriggeronetohaveseizuressuchaslackofsleep,tiredness, infection, dehydration, �lickering lights, strongsmellsetc.Ontheotherhand,inolderindividuals,strokeistheleadingcauseofseizures.Othercausesincludeinfectionsandcancerthathasspreadtothebrain.

Whyareseizuresdangerous?Seizures are dangerous because they can lead to death,simply put. If a seizure reaches the area of heart rhythmcontrol,patientcandieofcardiacarrest.Alsoifseizuresaregiven enough time, they can establish themselves and bedif�iculttocontrolwithmedicines.

Howareseizuresdiagnosed?Mostimportantlyseizuresarediagnosedbyaskingpatientandfamilyquestionsandthenexaminingthepatient.Also,Electroencephalogram (EEG) and Magnetic ResonanceImaging(MRI)canhelpuscometoaconclusivediagnosis.

WhatisEpilepsy?Epilepsy is a recurrent tendency to have a seizure. Ifsomeonehasoneseizurewithaclearprovokingfactor,itisnotcalledepilepsy.Ontheotherhandifapersonalwayshasasimilar kind of seizure and it is frequent, it canbe calledEpilepsy.

IsitimportanttocontrolEpilepsy?It is extremely important to control epilepsy. But why?Becauseifepilepsycontinues,thecircuitsthatareabnormalbecome stronger. If circuits become stronger, it is verydif�icult to break that abnormal circuit with medicines.Therefore,theearlierthetherapy,thebettertheoutcome.As

TodaywearegoingtotalkaboutSeizureandEpilepsy,thedifferencebetweenthetwoandothersymptomsthatcanbemistaken for seizure or epilepsy. Before understanding aseizureweneedtounderstandhowbrainworks.

BrainanditsharmonyHumanbrain iscomprisedofbillionsofnervecellscalledneurons.Inbetweentheseneuronsaresupportingcellsthatgivetheneuronsanecessarysupport.Theneuronsandthesupporting cells have connections between themselves.These connections are called synapses. A neuron talks tomultipleneuronsatonetime,formingacircuit.Collectively,they form trillions of circuits in the brain. A particularneuronalcircuithasaparticularfunction.Forexample,ifyouarelookingataglassofwater,youreyeswilltransmitthesignal from retina to the back part of your brain calledoccipitalcortex(circuit1)throughneurons.Theseneuronsthentalktootherbrainareasthroughmillionsofsynapses(circuit 2) to decode the information received from theoccipital cortex. The decoded information is thentransferredtolanguagearea(circuit3)ofthebrainthroughthousandsofsynapsesandthusoneisabletotell:“Thisisag lass of water”. This sounds pretty s imple andstraightforwardbutthereisalotofharmonyinbraincellsinordertoappropriatelychoseacircuitandthenprocesstheinformationreceived.

WhatisaSeizure?Aseizure isde�inedasabnormalandexcessiveactivityofneuronsinthebrain.Youcansaytheharmonybetweenthenerve cells is lost. This abnormal activity can travelanywhere inthebrain inachaoticwayandcausevarioussymptoms.Forexampleiftheseizurereachesthelanguage

SEIZURE

area,onemayhavedif�icultyspeaking.Similarlyifitreachestheareaforarmcontrol,patientcanhavejerkymovementsoftherespectivearm.

Whatarethedifferenttypesofseizures?Therearevarioustypesofseizuresandthetypedependsonthemoleculesthatareaffectingthenervecellaswellastheareaofthebrainaffected.Togiveafewexamples,seizurescan be Tonic (Stiffening of the arms, legs or face), Clonic

anexample,youcanmemorizeathingbyrepeatingitoverand over, consolidating the circuit that is used in thatmemory.Consequentlyitislessdif�iculttoforgetthatthing.Similarly if seizure involves a circuit that becomesautomatically active, unless you break the circuit, it willbecomestronger.

Howcanepilepsybecontrolled?Epilepsycanbecontrolledthroughvariousmeasures.Theseinclude diet, avoiding triggers and by taking medicines.Dietarychangeshavebeenrecognizedasveryimportantincontrolofseizuresespeciallyinchildren.ThedietiscalledKetogenicdiet.Thisdietishighinfatandproteinsbutlowincarbohydrates.AsimilardietisAtkinsdiet.Whatthisdietdoesisthatitreplacesprimarysourceofenergyforbrain(glucose)withanalternateenergysource(Ketones).Avoiding triggers for seizures is also very helpful. Theseinclude having a good sleep, treating infections promptly,staying well hydrated, avoiding psychological stress andavoidingdrugs/alcohol.Medicinesarealmostalwaysnecessaryforepilepsycontrol.TherearevariousmedicinesavailableinPakistan.Thesearechosen on an individual basis to �it the patient's overallmedicalpicture.Lastly,Vagusnerve(thelongestcranialnerveinthebody)canbestimulatedattheneckthroughelectrodeswhichcanhelptreatingaspeci�ictypeofepilepsy.

Isthereacureforepilepsy?Yes but only for some speci�ic types. Epilepsy surgery iscurrentlybeingdoneinUnitedStatesandothercountriesforaparticular typeofepilepsy.Thisepilepsyhas tobe focalmeaning thereby that it has a particular region in brainwhichwecanidentifyandtakeoutwithneurosurgery.Thissounds easy and simple but there are a lot of things aneurologistandneurosurgeonhavetokeepinmindbeforesuchaprocedureisundertaken.Oftensuchpatientscanbecuredoftheirepilepsybutthereremainsaveryslightriskthatseizuresmaycomeback.

Cansomethingelsemimicaseizureorepilepsy?Yes.Therearealotofconditionsthatcanmimicaseizure.Themostcommonlyencounterediscalledpsychogenicnon-epilepticeventsorPNES.Theseareoftenmistakenbyevenaseasoned medical specialist and therefore a Neurologistmustevaluateeverypatientwithseizure.Psychogenicnon-epileptic events are abnormal movements that patientsexhibit that looksimilar toseizureshowever theyarenotseizures.Theyarebody'smechanismofdealingwithstressthathasbeengoingoninrecentorremotepast.Importantthingtonoteforallisthattheyarenotfakedbythepatientandpatientshouldnotbeblamedforthesemovements.Thepatient is unaware of the symptom that he or she ismanifesting.TreatmentofPNESispsychotherapy.

Conclusion:Seizuresorepilepsyareabnormalbrain functionthatcanhappenatanyage.Itcanmanifestinvariouswaysandnotjustbyjerkymovements.Ifyouseeanyabnormalbehaviororactivityinaperson,heorsheshouldbeevaluatedbyaneurologistforpossibleintervention.

EPILEPSYAND

Waqar Hafeez, MD (USA)Member American Academy

of Neurology

FebruaryNewsletter FebruaryNewsletter 54

Parkinson'sdiseaseisabraindisorderthatcausesagraduallossofmusclecontrol.ThesymptomsofParkinson'stendtobemildat�irstandcansometimesbeoverlooked.Distinctivesignsofthediseaseincludetremors,stiffness,slowedbodymovements, and poor balance. Parkinson'swas originallycalleda"shakingpalsy,"butnoteveryonewithParkinson'shasatremor.

Parkinson'sProgressionWhile Parkinson's can be a frightening diagnosis, lifeexpectancy is about the same as for people without thedisease.Forsomepeople,symptomsevolveslowlyover20years.Earlytreatmentcanprovideyearsthatarevirtuallysymptom-free.About5%to10%ofcasesoccurbeforeage50.TwoadvocatesforresearchdevelopedParkinson'searly:BoxerMuhammadAliatage42andactorMichaelJ.Foxatage30.

EarlySignsofParkinson'sThe early signs of Parkinson'smay be subtle and can beconfusedwithotherconditions.Theyinclude:Ÿ Slightshakingofa�inger,hand,leg,orlipŸ Stiffnessordif�icultywalkingŸ Dif�icultygettingoutofachairŸ Small,crowdedhandwritingŸ StoopedpostureŸ A'masked'face,frozeninaseriousexpression

Symptoms1)TremorTremorisanearlysymptomforabout70%ofpeoplewithParkinson's. Itusuallystarts ina �ingerorhandwhenthehandisatrest,butnotwhenthehandisinuse.Itwillshakerhythmically,usuallyfourtosixbeatspersecond,orina"pill-rolling"manner,asifrollingapillbetweenthethumbandindex �inger. Tremor also can be a symptom of otherconditions, so by itself it does not mean someone hasParkinson's.

2)BradykinesiaAspeoplegrowolder,theynaturallyslowdown.Butiftheyhave "bradykinesia," a sign of Parkinson's, the slowmovementmayimpairdailylife.Whentheywanttomove,thebodymaynotrespondrightaway,ortheymaysuddenlystop or "freeze." The shuf�ling walk and "mask-like" face

sometimes found in thosewithParkinson's canbedue tobradykinesia.3)ImpairedBalancePeoplewithParkinson'stendtodevelopastoopedposture,with drooping shoulders and their head jutted forward.Alongwiththeirothermovementproblems,theymayhaveaproblemwithbalance.Thisincreasestheriskoffalling.4)RigidityRigidityhappenswhenthemusclesstaystiffanddon'trelax.For example, the arms may not swing when a person iswalking.Theremaybecrampingorpaininthemuscles.MostpeoplewithParkinson'shavesomerigidity.

SymptomsBeyondMovementOther symptoms are common, but not everyone withParkinson'swillhaveallofthem.Theymayinclude:Ÿ RestlesssleepordaytimefatigueŸ AsoftvoiceorslurredspeechŸ Dif�icultyswallowingŸ Memoryproblems,confusion,ordementiaŸ OilyskinanddandruffŸ Constipation

DiagnosingParkinson'sBrainscansarenotgenerallyusedtodiagnoseParkinson's,although they may be used to rule out other conditions.Instead,yourdoctormayaskyouto:Ÿ Tapyour�ingerandthumbtogetherortapyourfootto

checkforslowedmovementŸ RestyourhandtoobserveyourtremorŸ Relax,whilehemovesyourneck,arms,andlegstocheck

forrigidityŸ Standwhilebeinggentlypulledfrombehindtocheckfor

balance

Parkinson'sorEssentialTremor?IfyouhaveatremorbutnootherParkinson's-likesymptoms,such as rigidity or slowmovement, youmayhavebenignessentialtremor.ThistremorrunsinfamiliesandismuchmorecommonthanParkinson's.Itusuallyaffectsbothhandsequally.UnlikeParkinson's,thetremorisworsewhenyourhandisinmotion.Essentialtremordoesnotrespondtothecommonly-used Parkinson's drug levodopa, but may betreatedwithothermedications.

WhoGetsParkinson's?TheaverageagethatpeoplegetParkinson'sis62,butpeopleover60haveonlya2%to4%chanceofgettingthedisease.

HavingafamilymemberwithPDslightlyincreasesyourrisk.MenaremorelikelytohaveParkinson'sthanwomen.

WhatCausesParkinson's?Asmallarea in thebrainstemcalled thesubstantianigracontrols movement. In Parkinson's disease, cells in thesubstantia nigra stopmakingdopamine, a brain chemicalthat helps nerve cells communicate. As these dopamine-makingcellsdie, thebraindoesnotreceivethenecessarymessagesabouthowandwhentomove.

StagesofParkinson'sParkinson'sisprogressive,whichmeanschangescontinueinsidethebrainovertime.Doctorsmeasurethestagesbyacareful assessment your symptoms. The Hoehn and YahrScale is one common tool that looks at the severity of

symptoms. The Uni�ied Parkinson Disease Rating Scaleevaluatesmentalclarityandfunction,behaviorandmood,activities of daily living, andmovement. Staging can helpdeterminethebesttreatment.

CanSymptomsBePrevented?Researchers are investigating supplements or othersubstances thatmayprotectneurons from thedamageofParkinson's, but it is too soon to saywhether theywork.Coffee drinkers and smokers may have a lower risk ofdeveloping Parkinson's (although smoking obviously hasotherserioushealthproblems).

TheRoleofEnvironmentalToxinsPesticides and herbicides may increase the risk ofParkinson's. Some people may be genetically moresusceptible to environmental exposures. Research in thisimportantareaiscontinuing.

Parkinson'sandExerciseExercisemayhaveaprotectiveeffectbyhelpingthebraintouse dopamine more effectively. It also helps improvecoordination,balance,gait,andtremor.Forthebesteffect,youshouldexerciseconsistentlyandasintenselyasyoucan,preferablythreetofourtimesaweekforanhour.Workingout on a treadmill or biking have been shown to have abene�it. Tai chi and yoga may help with balance and�lexibility.

LivingWithParkinson'sParkinson's affects many aspects of daily life, but withmedicationsandchangestoyourlife,youcanremainactive.Medicationcanhelpyoucopewithmooddisorders,suchasdepression and anxiety. An occupational therapist canprovideahomesafetyevaluation.Youmayneedtoremovethingsyoucantripon,suchasthrowrugsorcords,andaddgrabbarsinthebathroom.Aspeechtherapistcanhelpwithswallowingandspeechproblems.

ANoteforCaregiversCaringforapersonwithParkinson'scanbechallenging.Asmotorskillsdecline,simpletasksmaybecomemoredif�icult,but the Parkinson's patient may struggle to maintainindependence.Boththemedicationsandthediseaseitselfcanleadtomoodchanges.Supportgroupsandonlineforumsare available from the American Parkinson DiseaseAssociation, the National Parkinson Foundation, and theParkinson'sDiseaseFoundation.

WhatIsParkinson'sDisease?

Dr.OsamaJavedRegistrarSurgery&HoDER

Substantia nigra,

dopamine -

producing cells

FebruaryNewsletter FebruaryNewsletter6 7

Vitamin D, also known as the sunshine vitamin, isproducedbythebodyasaresponsetosunexposure;itcanalsobeconsumedinfoodorsupplements.

HavingenoughvitaminDisimportantforanumberofreasons, including maintaining healthy bones andteeth;itmayalsoprotectagainstarangeofconditionssuchascancer,type1diabetes,andmultiplesclerosis.

VitaminDhasmultiplerolesinthebody,helpingto:Ÿ Maintainthehealthofbonesandteeth.Ÿ Supportthehealthoftheimmunesystem,brain,and

nervoussystem.Ÿ Regulate insul in levels and a id d iabetes

management.Ÿ Supportlungfunctionandcardiovascularhealth.Ÿ In�luencetheexpressionofgenesinvolvedincancer

development.

WhatisvitaminD?

VitaminDisactuallynotavitamin.Despitethename,vitamin D is considered a pro-hormone and notactuallyavitamin.Vitaminsarenutrientsthatcannotbecreatedbythebodyandthereforemustbetakeninthrough our diet. However, vitamin D can besynthesizedbyourbodywhensunlighthitsourskin.

Itisestimatedthatsensiblesunexposureonbareskinfor 5-10 minutes 2-3 times per week allows mostpeopletoproducesuf�icientvitaminD,butvitaminDbreaksdownquitequickly,meaningthatstorescanrunlow,especiallyinwinter.

Recent studies have suggested that a substantialpercentage of the global population is vitamin Dde�icient.

Healthbene�itsofvitaminD

1)VitaminD forhealthybones:VitaminDplaysasubstantial role in the regulation of calcium andmaintenance of phosphorus levels in the blood, twofactorsthatareextremely important formaintaininghealthybones.

2) Reduced risk of �lu: Children given 1,200

InternationalUnitsofvitaminDperdayfor4monthsduring the winter reduced their risk of in�luenza Ainfectionbyover40percent.

3)Reduced riskof diabetes: Several observationalstudieshaveshownan inverserelationshipbetweenbloodconcentrationsofvitaminDinthebodyandriskof type 2 diabetes. In people with type 2 diabetes,insuf�icient vitamin D levels may negatively affectinsulinsecretionandglucosetolerance.

4) Healthy pregnancy: Pregnant women who arede�icient in vitamin D seem to be at greater risk ofdeveloping preeclampsia and needing a cesareansection.

5) Cancer prevention: Vitamin D is extremelyimportantforregulatingcellgrowthandforcell-to-cellcommunication.

SymptomsofvitaminDde�iciency

SymptomsofvitaminDde�iciencymayinclude:Ÿ Gettingsickorinfectedmoreoften.Ÿ Fatigue.Ÿ Painfulbonesandback.Ÿ Depressedmood.Ÿ Impairedwoundhealing.Ÿ Hairloss.Ÿ Musclepain.

IfVitaminDde�iciencycontinues for longperiodsoftimeitcanresultin:Ÿ obesityŸ diabetesŸ hypertensionŸ depressionŸ �ibromyalgiaŸ chronicfatiguesyndromeŸ osteoporosisŸ neurodegenerative diseases, such as Alzheimer's

disease

Vitamin D de�iciency may also contribute to thedevelopment of certain cancers, especially breast,prostate,andcoloncancers.

FebruaryNewsletter FebruaryNewsletter8 9

Awareness Seminar on“Eradicate Breast Cancerfrom Pakistan”Maroof Interna�onal Hospital in collabora�on with South Asian Women Empowerment (SAWE) organized an awareness seminar on “Eradicate Breast Cancer from

ndPakistan” at Islamabad Club on 22 January 2018. This seminar was a�ended by persons from different fields of life including but not limited to doctors, social workers, students and entrepreneurs.

Dr. Muhammad Kashif Khan, Consultant Cancer Surgeon Maroof Interna�onal Hospital, was speaker at the event. Dr. Kashif Khan gave a detailed lecture regarding what Breast Cancer is, what are its symptoms, who are at risk, precau�ons and treatment.

Dr. M. Qasim Bhugio, Chairman Academy of Le�er joined the seminar as Chief Guest. In his address, he highly appreciated the efforts of Maroof Interna�onal Hospital and SAWE for spreading awareness about this most common yet silent killer. Mr. Qaiser Sheikh, federal minister of finance, Dr. Asif Raza Sheikh Federal Deputy Secretary and Clinical Psychologist, Ms. Amna Malik and Dr. Zafar Iqbal Founder and Execu�ve Director Global Welfare Founda�on were also speakers at the seminar.

Malik Zeeshan Ali, Sr. Manager Marke�ng Maroof Interna�onal Hospital highlighted MIH's efforts for eradica�on of Breast Cancer and all the upcoming similar projects.

SUNSHINEVITAMINVITAMIND

TESTIMONIALS

CrepesIngredients4eggs11/3cupsmilk2tablespoonsmargarineorbutter,melted,oroil1cupall-purpose�lour1/2teaspoonsalt,ifdesired

Steps

1. In medium bowl, beat eggs slightly. Add allremainingingredients;beatuntilsmooth.

2. Heatcrepepan(youcantakenonstickfryingpantoo),or7or8-inchskilletovermedium-highheat(375°F.)untilhot.Greasepanlightlywithoil.

3. Pour1/4cupbatterintohotpan,immediatelytilting pan until batter covers bottom. Cookuntil edges start to dry and center is set. Ifdesired,turntobrownotherside.

4. Fillwithdesired�illing.

Testimonials

Our experience of the patient care was fabulous.Nursingandsecuritystaffwashighlycooperative.Wewereupdatedbythedoctorsoneveryreportandvery timely.We foundMaroofbestamongprivatehealthprovisioninstitutesinIslamabad.Dr.SehrishandMs.Masoodawereverycaring.

“ShariqWaqar

Medical services are very satisfactory.Nursingstaffisverypolite.Doctorsareveryskillful and ef�icient. Overall a very goodhospitaltoberecommendedtofriendsandfamily.

“ZubairAhmedMalik

Hospital Services are excellent and staffbehaviorwasverygoodandprofessional.“

RehanaWe are quite satis�ied with the servicesbeingprovidedbythehospital.Thestaffisverygood,givefullattentiontopatientandprovideaveryfriendlyenvironment.

“FardaFarzeen

WearereallythankfultotheentireMaroofhospital staff for the care and theirprofessionalskills.Theytookgreatcareofourpatient.Wearepleasedthatourpatientis well now and we are going to homehealthy. We specially want to thank Dr.Ra�iqandDr.MunazzaJanjuafortheirextracare and friendly behavior towards thepatientaswellasattendants.

“GhulamKhan

Rehana

MedicalCampbyMaroofMedical&DiagnosticCentreatGPOIslamabadAnothersuccessfulmedicalcampfromtheplatformofMaroofMedicaland

DiagnosticCenter(MMDC)anextensionofMaroofInternationaltoBlueArea.

This one daymedical campwas organized at General PostOf�ice,Melody,

Islamabad.Inthiscamp,consultantsfromMMDCjoinedinandprovidedfree

consultationforEndocrinologyandGeneralMedicine.MMDCalsoorganized

for BMI, blood pressure and sugar check, Cholesterol check and free

medicines.Around500peoplevisitedthecampandavailedfreeconsultation

fortheprovidedspecialties.SpecialeffortsofteamMMDCfororganizingthis

camp,managingallthenecessariestothebestandmakingitahugesuccess

wereappreciated.

Healthybody leadstohealthymind.Toprovidethecitizensof

Islamabad with health check facilities, Maroof Medical and

DiagnosticCenter(MMDC)arrangedaonedayfreehealthcheck

campaign. For this, the MMDC consultants provided medical

advice to the visitors at no cost. Along with medical advice,

visitorscouldalsoavailthefacilityoffreeBloodPressurecheck,

BloodSugarCheck,Cholesterollevelcheck,BMI,UricAcidand

HbA1Candfreemedicines.Prof.Dr.RoohulAmin(Consultant

Rehab i l i t a t i on Med i c i n e and Med i c a l S p e c i a l i s t ,

Gastroenterologist) , Dr Madiha Ahmed (Consultant

Endocrinologist, Diabetologist), Muhammad Tahir Rashid

(Posture Alignment Specialist, DPT, Paralympic Coach),

NaushabahMannan(ClinicalPsychology)andtheentireteamof

MMDCmadethiscampsuccessfulwitheffortsandhardwork.

MMDC:HealthCheckCampaign

FebruaryNewsletter FebruaryNewsletter10 11

1.ExecutiveSuite

2.PremierRooms

3.PrivateRooms

4.SemiprivateRooms

5.ThreebeddedWards

Ÿ TeamofQuali�iedandexperiencedConsultants,RegistrarsandMos

Ÿ ExperiencedandcaringNursingandParamedicalStaffŸ Food&NutritionServicesinconsultationwith

quali�ieddietitianŸ LaboratoryandRadiologyPortableServicesavailableŸ DayCareŸ ICUŸ CCUŸ NICUŸ BabyDayCareŸ BackupsupportofmodernOTandLaborRoom

24/7ServicesServicesoffered

MAROOFInternationalHospitaloffersarangeofin-hospitalaccommodationsfromlower-pricedroomstoExecutive-Suites.Allhospitalroomshavebeendesignedwiththepatientscomfortandsafetyinmind.

MaroofIn-PatientDepartment(IPD)Services

Des

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& Pr

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