Purbanchal Cancer Hospital

Radiation Oncology

Radiation Oncology Radiation Oncology is a medical specialty that involves the controlled use of radiation to treat cancer and is distinct from radiology. Recent advancements in radiation therapy have revolutionized the treatment of cancer, leading to better clinical outcomes for patients. A specialty physician called a Radiation Oncologist manages and oversees each patient’s radiation treatment. The precise treatment intent (curative, adjuvant, neoadjuvant therapeutic, or palliative) will depend on the tumor type, location, and stage, as well as the general health of the patient. Only a radiation oncologist can help in determining if radiation therapy is right for the patient. There are two ways by which radiation can be administered to patients: <ul> <li style="text-align:justify">External Beam Radiation: External beam radiation therapy delivers radiation through the use of a large machine called a linear accelerator that precisely aims radiation beams from outside of the body at the cancerous tumor.</li> </ul> <ul> <li style="text-align:justify">Brachytherapy or Intracavitary Radiation Therapy: Brachytherapy is a type of radiation therapy in which radioactive particles known as seeds are placed within the body on the tumor or nearby the cancer cells.</li> </ul> About half of all cancer patients receive some type of radiation therapy at some point during the course of their cancer care. There are two ways by which radiation can be administered to patients: <ul> <li>External Beam Radiation: External beam radiation therapy delivers radiation through the use of a large machine called a linear accelerator that precisely aims radiation beams from outside of the body at the cancerous tumor.</li> <li>Brachytherapy or Intracavitary Radiation Therapy: Brachytherapy is a type of radiation therapy in which radioactive particles known as seeds are placed within the body on the tumor or nearby the cancer cells.</li> </ul> About half of all cancer patients receive some type of radiation therapy at some point during the course of their cancer care. There are several different types of radiation treatment available to patients. These include: Three-Dimensional Conformal Radiation Therapy (3D-CRT) 3D-CRT is a commonly used treatment type that aims the radiation beam with high precision at the tumor location using advanced computer software and treatment machines.3-D conformal radiation is a technique that allows doctors to direct radiation beams to conform to the shape of the tumor. Compared with historical, 2-D radiation therapy, 3-D conformal radiation more precisely delivers radiation to cancer cells, while reducing the amount of radiation to healthy cells. This conventional form of radiation therapy is used to treat cancerous and noncancerous tumors throughout the body. Intensity Modulated Radiation Therapy (IMRT) IMRT is a treatment option that delivers radiation through the use of hundreds of tiny radiation beam-shaping devices, called collimators. Collimators allow the radiation oncologist to target and deliver varying doses of radiation to different areas of the tumor in a meticulous way. The level of precision achieved allows the doctor to spare greater portions of surrounding healthy tissue, leading to fewer side effects.   Rapid Arc Rapid Arc is a rotational form of IMRT in which daily treatment is shorter than IMRT (Rapid Arc is 4 times faster than IMRT in delivering radiation). The ability of Rapid arc to spare healthy tissues is better than IMRT. Hence reduced daily treatment time translates into better patient comfort and compliance.   Image-Guided Radiation Therapy (IGRT) IGRT is a radiation delivery method used for tumors located in areas of the body that may change between treatments due to organ filling or movements while breathing. In order to account for these changes, IGRT uses repeated imaging scans. These scans are usually conducted in the treatment room just before the patient receives a daily radiation therapy treatment. These images allow the radiation oncologist to adjust the dosage delivered based on any small changes that may have taken place since the time of the patient’s last treatment.   Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiosurgery (SRS) SBRT is typically selected for small, isolated tumors throughout the body such as cancers in the lung and liver. This treatment option is usually delivered in fewer sessions with higher doses of radiation. SRS is a treatment option that delivers a very high dose of radiation in a single fraction. It is most commonly used to treat brain or spinal tumors. Brachytherapy (Gammamed plus ix): Brachytherapy is a form of internal radiation in which small radiation sources, or radioactive seeds, about the size of a grain of rice, are either permanently or temporarily implanted into the tumor site. There are two types of brachytherapy, high dose rate (HDR) with Irididum192 isotopes and low dose rate (LDR) brachytherapy.

Medical & Clinical Oncology

Medical Oncology uses specialized medications, referred to as chemotherapy drugs, to control and eradicate cancerous cells throughout a patient's body. A medical oncologist is a physician responsible for managing and oversight a patient's chemotherapy regimen and the complications that may be given over several weeks, months, or years. <h1 style="margin-left:29px; text-align:justify">Chemotherapy</h1> Chemotherapy, also referred to as Chemo, is a form of cancer treatment in which drugs are used to kill cancer cells, stop cancer cells from spreading and slow the growth of cancer cells. Chemotherapy can be given alone or in conjunction with other treatments. Chemotherapy that is given before surgery or radiation therapy in order to reduce the size of a tumor is known as neoadjuvant chemotherapy. In turn, adjuvant chemotherapy is given to patients after radiation treatment or surgery. How is Chemotherapy Administered Chemotherapy is generally administered over several treatment cycles. Depending on the doctor's prescription and how the patient's body reacts, Chemotherapy can be delivered daily, weekly, or monthly followed by a period of rest. This period of rest is vital to continuing chemotherapy because it allows the body to recover and rejuvenate to produce healthy new cells. Chemotherapy is typically administered in the following ways: <ul> <li style="text-align:justify">Intravenous (IV): The chemotherapy is administered directly into the vein.</li> <li style="text-align:justify">Injection (Intramuscular – IM): The chemotherapy is administered by an injection into the muscle.</li> <li style="text-align:justify">Oral: The chemotherapy is in pill, capsule, or liquid form that is swallowed.</li> <li style="text-align:justify">Intra-arterial (IA): The chemotherapy is administered directly into the artery.</li> <li style="text-align:justify">Intra-peritoneal (IP): The chemotherapy is administered directly into the peritoneal cavity which contains organs such as the stomach, intestines, and liver.</li> <li style="text-align:justify">Topical: The chemotherapy is in a cream form that is rubbed onto the skin.</li> </ul> Benefits of Chemotherapy Although chemotherapy is a rigorous treatment option for patients, the overall clinical outcomes can outweigh the associated side effects. Since cancer cells can rapidly evolve, it is important to target the malignant cells with chemotherapy in hopes of controlling, reducing, and preventing cell division. Chemotherapy can prevent cancer cells from metastasizing, a term used to describe the spread of cancer cells from their origin to other regions of the body. Depending upon the type of cancer and stage of cancer, chemotherapy can be used for curative purposes. A patient is considered cured when all of the cancer cells within the body have been eradicated and cancer does not return for many years. Also, medical oncologists often use chemotherapy in conjunction with radiation therapy and surgery. Because chemotherapy is systemic, meaning it can affect the entire body, it can kill off cancerous cells that radiation or surgery cannot address. Therefore, chemotherapy makes these other treatment options more effective in eliminating cancer when combined.

Surgical Oncology

Surgical Oncology Surgical oncology is one of the fields of oncology that focuses on treating cancer surgically. Surgery is the mainstay of the treatment of solid organ tumors. Purbanchal Cancer Hospital has a dedicated and experienced team of surgeons who are always keen to work in a team for the betterment of patients. We are backed by a multidisciplinary team of radiologists, pathologists, anesthesiologists, medical oncologists, radiation oncologists, internists, nursing, physiotherapists, and dieticians. Here in Purbanchal Cancer Hospital, we have a state-of-art operation theatre with a well-equipped intensive care unit and post-operative unit for smooth post-operative recovery of the patients. We provide surgical care in various aspects of surgical oncology. We have the expertise for: Thoracic and breast oncosurgery GI oncosurgery, Hepatobiliopancreatic oncosurgery, Urooncosurgery Every patient is discussed on the tumor board and a consensus is made according to the recent advancements in the field of oncology so that the patient gets the best available care. Besides treating the patients surgically, we take active participation in diagnosing cancers. We are well trained in different diagnostic procedures like routine upper GI endoscopy, colonoscopy, cystoscopy and bronchoscopy. We also perform therapeutic endoscopic procedures like endoscopic polypectomies, stentings and band ligations. We are trained in minimally invasive surgeries for various malignancies including VATS (video assisted thoracoscopic surgery) and laparoscopic procedures. We routinely perform VATS and laparoscopic procedures in diagnosing various intrathoracic and intra-abdominal malignancies as well. Since, Purbanchal Cancer Hospital is a comprehensive cancer center, all the facilities for cancer care are available within the hospital premises. As we have a team of experienced clinical oncologists, our patients get both the neo-adjuvant and the adjuvant treatment in the hospital itself. This prevents the number of treatment defaulters as the patients do not need to be referred to any other center. We have been performing various surgical procedures including complex thoracic and abdominal surgeries with good results. In a short journey of 2 years, we have come a very long way and have established ourselves as one of the comprehensive cancer centers in the country. We are working hard to improve further. Patients with a diagnosis of cancer or with suspicion of cancer can visit us. We ensure that our patients will be provided with the best possible cancer care.

Pediatric Hematology Oncology

Department of Pediatric Hematology-Oncology Purbanchal Cancer Hospital is one of the well-versed comprehensive cancer hospitals in eastern Nepal. Pediatric Hematology-Oncology service has been one of the highlights of this center since it vouches to treat childhood cancer and blood disorders to the best of its abilities. We offer holistic care for children with malignancy and hematological disorders from 0-19 years of age group. Our multi-disciplinary team of well-trained and experienced pediatric hemato-oncologists, radiation oncologists, surgeons, anesthetists, in-house hematopathologists, and radiologists along with specially trained pediatric/oncology nurses, pharmacists, and paramedical personnel are committed to treating these children with utmost care and dedication. Our services include outpatient clinics, in-patient care, daycare services, intensive care unit, palliative care, psychosocial and nutritional support, cancer survivor clinics particularly to monitor late effects, and facilities to perform bone marrow examinations, and intrathecal therapies. Diseases under our umbrella are: <ol> <li style="text-align:justify">Acute / Chronic leukemias</li> <li style="text-align:justify">Lymphomas</li> <li style="text-align:justify">Solid tumors: </li> </ol> <ul> <li style="text-align:justify">Brain tumors</li> <li style="text-align:justify">Bone tumors</li> <li style="text-align:justify">Sarcomas</li> <li style="text-align:justify">Neuroblastoma</li> <li style="text-align:justify">Retinoblastoma</li> <li style="text-align:justify">Renal tumors</li> <li style="text-align:justify">Germ Cell tumors</li> </ul> <ol start="4"> <li style="text-align:justify">Hemoglobinopathies: </li> </ol> <ul> <li style="text-align:justify">Thalassemia</li> <li style="text-align:justify">Sickle cell anemia</li> </ul> <ol start="5"> <li style="text-align:justify">Iron deficiency anemia, Megaloblastic anemias</li> <li style="text-align:justify">Aplastic anemia</li> <li style="text-align:justify">Inherited bone marrow syndromes</li> <li style="text-align:justify">Platelets and coagulation disorders</li> </ol>

Gyne-onco Surgery

Gynecologic cancer comes with the medical condition in which cancer or tumor cells develop in the reproductive organs of a woman’s body. Cancer is always named according to the part of the body where it starts. Types <ul> <li>Cervical Cancer is the most common gynecological cancer in developing countries like Nepal. It starts growing in the cervix which is the lower part of the uterus. </li> <li><a href="https://www.cdc.gov/cancer/ovarian/">Ovarian cancer</a> grows in the ovaries or fallopian tubes which are located on both sides of the uterus.</li> <li><a href="https://www.cdc.gov/cancer/uterine/">Uterine cancer</a> involves uterine muscles and endometrium. The tumor of uterine muscle is called sarcoma and that of endometrium is called endometrial carcinoma. The uterus is the pear-shaped organ where the baby grows during pregnancy.</li> <li><a href="https://www.cdc.gov/cancer/vagvulv/">Vaginal cancer</a> involves the vagina, which is the hollow tube-like structure</li> <li><a href="https://www.cdc.gov/cancer/vagvulv/">Vulvar cancer</a> begins in the vulva, the outer part of the female genital organs.</li> <li>Gestational trophoblastic Neoplasia: It involves mostly the uterus and infrequently ovaries.</li> </ul> Symptoms <ul> <li>Abnormal vaginal bleeding or discharge is common in all types of gynecologic cancers except vulvar cancer.</li> <li>Abdominal fullness, gastritis-like symptoms, and lower abdominal or back pain are commonly seen in ovarian cancer though most of the cases are asymptomatic in the early stages.</li> <li>Abnormal uterine bleeding like excessive, irregular bleeding and lower abdominal pain is common for uterine cancers.</li> <li>Increased frequency or urgency to urinate and constipation are common for ovarian and vaginal cancers.</li> <li>Vulvar Itching, burning, pain, and changes in the color of overlying skin are found only in vulvar cancer.</li> </ul>   Diagnosis Diagnosis of cancer requires a thorough history, clinical examination, and relevant investigations to reach to a conclusion. At PCH, we have the following modalities to suspect and diagnose the cases. <ol> <li style="list-style-type:none"> <ol> <li>History and Clinical Examination</li> <li>Imaging: Ultrasonography, CT scan, MRI, PET-CT for all kinds of gynecological cancer</li> <li>Colposcopy and biopsy for cervical cancer</li> <li>Endometrial biopsy for Endometrial cancer</li> <li>Tumor markers for diagnosis, prognosis, and follow-up in ovarian carcinoma</li> <li>IHC( Immunohistochemistry) as and whenever required to differentiate the type and origin of the tumor</li> <li>Diagnostic Laparoscopy in cases of doubtful ovarian malignancy</li> </ol> </li> </ol> Treatment Gynecologic cancers are treated in different ways. It depends on the type and stage of the cancer. At PCH we treat the disease following the most updated guidelines. Cases are discussed on the tumor board weekly and the best treatment modality is selected and individualized. Treatment modalities are <ul> <li>Surgery: Generally cancer surgery is more radical and involves the removal of surrounding tissues and lymph nodes. The principle of surgery in oncology is to remove all visible diseases. </li> </ul> Cervical cancer: We perform Radical hysterectomy either open or laparoscopically. Endometrial Cancer: Laparoscopic/Open Hysterectomy and bilateral salpingo-ophorectomy plus  pelvic and para-aortic lymphadenectomy and omentectomy Ovarian Carcinoma: Staging Laparotomy or Debulking surgery Vulvar Carcinoma: Radical vulvectomy and b/I inguinal lymphadenectomy +local flap reconstruction if required Vaginal cancer: Vaginectomy Chemotherapy: In unresectable cases or advanced cases, chemotherapy is given as neoadjuvant therapy or palliative therapy. Chemotherapy drugs are used to shrink or kill cancer. The drugs can be pills or injectables. Chemotherapy in ovarian cancer is usually given as neo-adjuvant and adjuvant therapy. Gestational trophoblastic cancer responds very well to chemotherapy <ul> <li>Radiation: It is the method in which high-energy rays are used to kill cancer. Mostly used in advanced cases of cervical cancer, vulvar cancer, and vaginal cancer.</li> <li>Immunotherapy and hormonal therapy </li> </ul>

Head and Neck Onco Surgery

<h2 style="text-align:center">Head & Neck Oncology and Reconstructive Surgery</h2> About Department At Purbanchal Cancer Hospital (PCH), our treatment philosophy is based on multi-disciplinary team approach emphasizing on organ preservation and restoration of form and function by advanced reconstructive surgery, radiation treatment protocol and rehabilitative services. Our team consists of Head and Neck oncology, reconstructive surgery, radiation oncology, medical oncology, radiology, pathology, rehabilitation and pain and palliation services. All patients will be evaluated in a multidisciplinary tumor board to determine the most optimal treatment option. The Head & Neck surgical oncology provides organ preservation surgery, minimally invasive endoscopic laser surgery.   The mission of Head and Neck oncology department is to provide a one-stop comprehensive care for patients with head and neck cancers. A multidisciplinary team of well renowned head and neck and reconstructive surgeons strive to provide treatment optimized for complete tumor ablation followed by restoration of form and function. The department works closely with departments of radiation oncology, medical oncology, pathology, radiology and pain management to deliver State-of-the-Art treatment. Special emphasis is given to quality of life and functional rehabilitation of cancer patients. The department also runs an active community outreach programme for early detection and prevention of cancer. . Services & Facilities <ol> <li>Surgical management of </li> </ol> <ul> <li>Oral cavity tumors</li> <li>Pharyngeal tumors</li> <li>Laryngeal tumors</li> <li>Salivary gland tumors</li> <li>Thyroid and Parathyroid tumors</li> <li>Nasal and Paranasal tumors</li> <li>Skull Base tumors</li> <li>Vascular malformation</li> <li>Skin cancers of head & Neck Region</li> <li>Head and Neck Reconstructive( Plastics) surgery</li> </ul>   <ol start="2"> <li>Early detection and screening for Head and Neck Cancer</li> </ol>   <ol start="3"> <li>Key Procedures / surgery </li> </ol> <ol> <li>Head & Neck Cancer Ablative surgeries</li> <li>Microvascular free flap reconstructive surgeries</li> <li>Facial Plastic & Reconstruct Procedure</li> <li>Airway Surgeries</li> <li>Thyroid & Salivary gland surgeries</li> <li>Nose , Sinus & Skull Base Surgeries</li> <li>Orbital surgeries</li> <li>Endoscopic LASER Surgeries</li> <li>Laryngeal Surgeries</li> </ol>   About Head and neck cancer A group of cancers that begins in or around the throat, voice box, nose, sinuses, or the mouth is called head and neck cancer. This type of cancer is believed to start in the cells in the exteriors of these body parts. Head and neck cancers can further be categorized into five types; oral cavity, pharynx, larynx, nasal cavity and paranasal sinuses and salivary glands. Diagnosis A surgical oncologist may start the diagnosis of any head and neck cancer by evaluating the patient’s medical history and then conducting a physical examination and ordering other diagnostic tests. For a physical examination, the doctor may visually inspect the oral and nasal cavities, throat, neck and tongue. Small mirrors and lights are used to check for the presence of any lumps in and around the lips, gums, cheeks and neck. Endoscopic procedures may be followed to examine the areas inside the body with the help of a flexible tube called an endoscope. The samples of blood, urine or cells from the nodes are sent to the laboratory for other tests. For obtaining the images of the head and neck areas, X-rays, CT scan, PET scan and MRI can be used. A biopsy is the only sure procedure in head and neck oncology to determine whether a person has cancer or not. Here, a small part of the tissue is removed and examined under a microscope to make a diagnosis. Treatment Every cancer patient is different. Therefore, a special team of surgical oncologists, medical oncologists, onco-pathologists, radiation oncologists and imaging specialists evaluate the condition of the patient and chart out a customized treatment plan for them. Some of the modalities of head and neck cancer treatments available are mentioned below. Surgery: In head and neck surgery, the cancer is removed along with some of the healthy tissues around it. Radiation treatment may be given after the surgery. Radiation: Different types of radiation therapy may be suggested for the patients, such as 3DCRT, IMRT or IGRT. Chemotherapy: Chemotherapy is usually given along with radiation therapy. The anti-cancer drugs used can kill the fast-growing cells in the body. Targeted therapy: Unlike chemotherapy, the drugs used in targeted therapy selectively kill cancer cells. However, its application in the treatment of head and neck cancer is limited. Rehabilitation: Rehabilitation programs are doctor-supervised programs for patients who underwent treatment for cancer. It helps them to get back to their daily activities quicker as well as improves their well-being.

Neuro Onco Surgery

Musculo Skeletal Oncology

Nuclear Medicine

Purbanchal cancer hospital in Nepal has introduced PET/CT  Positron emission tomography/computed tomography is a rapidly growing modality that has made a tremendous impact on the care of patients with cancer. PET scans use a small amount of a radioactive substance, or tracer, to show differences between healthy tissue and diseased tissue. The most commonly used tracer is 18F-FDG (Fluoro-deoxy-glucose). The combination of PET/CT provides complete information about both structure (CT) and function (PET) in the human body. Application of PET:   Oncological Application (>95%): Lymphoma, Head and Neck Cancers, Lung cancer, Breast cancers, RCC, Gynaecological malignancies, Metastasis, Carcinoma of Unknown Primary etc.   Useful for: <ul> <li>Diagnosis of Malignancy</li> <li>Staging of various cancers</li> <li>Response Evaluation after Chemotherapy, Radiotherapy, Surgery or Immunotherapy</li> <li>Restaging</li> <li>Surveillance</li> <li>PET for guided biopsy etc.</li> </ul>   Non Oncological Application (~5%):   <ul> <li>Neurology: Dementia & Epilepsy (Temporal lobe epilepsy)</li> <li>Cardiology: Cardiac Viability, Infection of transplanted Valve</li> <li>Infection and inflammation: Sarcoidosis, Tuberculosis, Vasculitis, Polymyalgia Rheumatica (PMR), Relapsing Polychondritis, etc.</li> <li>Pyrexia of Unknown Origin (PUO)</li> </ul>

Radio Diagnosis & Imaging

Department Radio Diagnosis and Imaging   The Department of Radiodiagnosis has expanded over the years. With skilled staff who are committed to quality.   Core Competencies <ul> <li>A radiograph (X-Ray) of all parts of the body</li> <li>Special procedures (X-ray): HSG, IVU</li> <li>Mammography, Dexa Scan</li> <li>USG: All body parts (Abdomen/Pelvis, Neck, Musculoskeletal, Cranial, Soft tissue, Breast)</li> <li>Obstetric and fetal USG with anomaly scan</li> <li>Special USG: Vascular/Doppler USG, Fetal Doppler</li> <li>CT: CT of any body parts, HRCT chest, Temporal CT, triphasic CT of the abdomen, IVU, etc.</li> <li>CT Angiogram: Brain, Neck, Pulmonary, Thoracoabdominal aorta, Renal and Peripheral vascular</li> <li>MRI: Whole-body MRI (Brain, Spine, Neck, Abdomen, Musculoskeletal, Soft tissue) </li> <li> Special MRI: MRCP, Fistulogram, Brachial plexus, Dynamic MRI</li> <li>USG and CT guided FNAC and biopsy of all kinds.</li> <li>Intervention: USG guided PTBD, Pigtail, Chest tube insertion, Any kinds of drainage/aspiration, etc.</li> </ul>

Anesthesia

Department of Anesthesia     The Department of Anaesthesiology at Purbanchal Cancer Hospital includes an experienced team of anaesthesiologists working 24 hrs. a day for providing Safe Anaesthesia Care to patients of all age groups.   Anesthesia care in operating theatres for all types of surgical, diagnostic and therapeutic procedures. <ul> <li>PAC Clinic daily (Preoperative patient assessment and preparation)</li> <li>Perioperative care</li> <li>Ambulatory anesthesia</li> <li>Regional anesthesia under ultrasound guidance</li> </ul> Critical Care Service Sedation and anesthesia in radiology suites (CT Scan & MRI) and Endoscopy rooms.

Clinical Hematology

Pediatric Hematology-Oncology

Purbanchal Cancer Hospital is one of the well-versed comprehensive cancer hospitals in eastern Nepal. Pediatric Hematology- Oncology service has been one of the highlights of this center since it vouches to treat childhood cancer and blood disorders at best of its abilities. We offer holistic care for children with malignancy and hematological disorders from 0-19 years of age group. Our multi- disciplinary team of well trained and experienced pediatric hemato-oncologists, radiation oncologist, surgeons, anesthetists, in- house hematopathologists and radiologists along with specially trained pediatric/oncology nurses, pharmacists and paramedical personnel are committed to treat these children with utmost care and dedication. Our services include outpatient clinics, in patient care, day care services, intensive care unit, palliative care, psychosocial and nutritional support, cancer survivor clinics particularly to monitor late effects, facilities to perform bone marrow examinations and intrathecal therapies. Diseases under our umbrella are: <ol> <li style="text-align:justify">Acute / Chronic leukemias</li> <li style="text-align:justify">Lymphomas</li> <li style="text-align:justify">Solid tumors: </li> </ol> Brain tumors, Bone tumors, Sarcomas, Neuroblastoma, Retinoblastoma, Renal tumors, Germ Cell tumors <ol start="4"> <li style="text-align:justify">Hemoglobinopathies: </li> </ol> Thalassemia, Sickle cell anemia <ol start="5"> <li style="text-align:justify">Iron deficiency anemia, Megaloblastic anemias</li> <li style="text-align:justify">Aplastic anemia</li> <li style="text-align:justify">Inherited bone marrow syndromes</li> <li style="text-align:justify">Platelets and coagulation disorders</li> </ol>

Haematology

Hematology (also spelled as haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood. The field of hematology integrates clinical and laboratory medicine. It involves treating diseases that affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, bone marrow, platelets, blood vessels, spleen, lymphoid tissue, and the mechanism of coagulation. Hematology treatments are conducted on an outpatient, day-care, or inpatient basis, depending on the specific needs of each patient.   Areas of study Major areas of study within hematology include Red cell disorders and hemoglobinopathy, hematological malignancies, anemia, and coagulopathy. <ul> <li style="text-align:justify">Hemoglobinopathy is the study of abnormality in the globin chains of hemoglobin molecules. It includes sickle cell anemia, thalassemia, and other hereditary hemolytic disorders.</li> </ul>   <ul> <li style="text-align:justify">Hematological malignancies are concerned with the diagnosis and treatment of cancers of the bone marrow, blood and lymph nodes. The commonly hematological malignancies are:</li> </ul>   <ul> <li style="list-style-type:none"> <ul> <li style="text-align:justify">Acute myeloid leukemia and Acute lymphoblastic leukemia, </li> <li style="text-align:justify">Chronic myeloid leukemia and Chronic lymphocytic leukemia, </li> <li style="text-align:justify">Myeloma (Multiply myeloma, Smoldering myeloma, MGUS) </li> <li style="text-align:justify">Lymphoma (Hodgkin’s and Non-Hodgkin’s)</li> </ul> </li> </ul>   <ul> <li>Anemia (Iron deficiency, Megaloblastic anemia & other hemolytic anemias)</li> </ul>   <ul> <li>Coagulation disorders (Hemophilia, Von Willebrand disorder, thrombophilia, deep vein thrombosis, pulmonary embolism)</li> </ul>   <ul> <li style="text-align:justify">Other disorders treated by a hematologist include: </li> </ul>   <ul> <li style="text-align:justify">Bone marrow failure syndromes (Aplastic anemia, PNH, Fanconi’s anemia)</li> <li style="text-align:justify">Bone marrow transplantation (Autologous and Allogenic stem cell transplantation)</li> <li style="text-align:justify">Myelodysplastic syndromes</li> <li style="text-align:justify">Myeloproliferative disorders (Polycythemia, Essential thrombocythemia, Myelofibrosis)</li> <li style="text-align:justify">Platelet disorders (ITP, congenital platelet disorders) </li> <li style="text-align:justify">Obstetrics blood disorders</li> <li style="text-align:justify">Hematological disorders in systemic diseases</li> </ul> Hematology tests One of the most common hematology tests includes complete blood count (CBC) and peripheral blood smear (PBS). This test is often conducted during a routine exam and can detect anemia, bleeding disorders, blood cancers, immune system disorders, and infections. Other common hematology tests for diagnosis and treatment include: <ul> <li style="text-align:justify">Bone marrow examination and Trephine biopsy</li> <li style="text-align:justify">Flowcytometry, immunophenotyping & Immunohistochemistry</li> <li style="text-align:justify">Fluorescence in situ hybridization (FISH) </li> <li style="text-align:justify">Molecular genetic analysis</li> <li style="text-align:justify">Iron profile, Vitamin B12 assay </li> <li style="text-align:justify">BT, CT, PT, INR & APTT</li> </ul>

Pathology & Clinical Laboratory

Department of Pathology and Clinical Laboratory The Department of Pathology and clinical laboratory is an integral part of our institution which has been playing important role in the diagnosis of disease. Why our laboratory for investigations? <ol style="list-style-type:upper-alpha"> <li>It is a hospital-based laboratory that performs tests under the supervision of full-time experienced consultant Pathologists and Master level laboratory scientists.</li> <li>Tests are performed by a fully automated analyzer with the gold standard method.</li> <li>Internal quality controls are performed on daily basis for all the tests to ensure quality reports.</li> <li>External quality control assessments are done through RIQAS to ensure quality reports.</li> <li>All the special tests and routine tests with quality reports are performed under the same umbrella.</li> <li>We ensure quality service from sample collection, and testing to dispatch of the reports.</li> <li>We ensure rapid quality diagnostic reports which aid in early management of the patient resulting in good outcomes.</li> <li>We have more than 50 efficient staff with good working experience to yield quality results.</li> </ol>   Coming Soon: To establish Immunohistochemistry and molecular test.   Subdepartments <ul> <li>Histopathology</li> <li>Cytopathology</li> <li>Hematology</li> <li>Biochemistry</li> <li>Immunology</li> <li>Microbiology</li> </ul>   Histopathology This section deals with biopsy samples where the diagnosis of diseases ranging from Cancer to benign tumors and infective cases are made. Histopathology is essential in the diagnosis of cancer and also aid in the further treatment plan. This sub-department also deals with the staging of cancer cases as well. More than 2000 major and minor samples are currently received per year and are now established as an integral part of our department. Cytopathology This section deals with cellular levels from FNAC, PAP smears, Fluid cytology, Bronchoalveolar lavage e.t.c. This section is essential for the early diagnosis of the disease with a minimally invasive procedure. Hematology This section deals with blood-related investigations like Complete blood count, peripheral blood smears, Bone marrow aspiration, and biopsy along with urine and stool routine examination.   Biochemistry and Immunology This section deals with routine and special tests. More than 200 types of tests are performed with fully automated chemical analyzers with the gold standard analyzing method.   Microbiology This section of the department deals with the growth and drug sensitivity of bacteria along with fungal culture.

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