An extremely useful, informative book which
highlights the evolution of cardiology in Pakistan
KARACHI: Healthcare professionals in Pakistan are mostly not interested in history or literary activities but for the last few years, there are some positive developments. One can see this visible positive change taking place with more and more active participation of members of the medical profession in literary activities, writing books in addition to their routine work of looking after patients, teaching, training and some are also interested in research. It is extremely important to document historical facts to help the new generation of healthcare professionals know how and from where we started and what have we achieved over the years.
Prof. Muhammad Ishaq
This book under review is an excellent effort by Prof. Muhammad Ishaq a noted cardiologist who retired from National Institute of Cardiovascular Diseases a few years ago which documents the stepwise evolution of the discipline of cardiology in Pakistan since 1960s in particular. Writing in the preface, the author has described his objective which was “to pay tributes to those who played a vital role in establishing this specialty in Pakistan under limited resources.” The information it contains; he says is “mostly based on his personal information”. He has also made it clear that” it may not contain complete information and he might have missed some events and names”. While writing history it is essential that whatever information is provided is properly referenced to ensure its authenticity but when no such information has ever been documented, those taking such an initiative find themselves in a difficult situation and this is certainly one of the shortcomings of this book. Despite this, Prof. Ishaq has done well to undertake this initiative for which he deserves to be commended.
Maj. Gen. Ashur Khan another noted cardiologist of the country writing in the Foreword has rightly termed this book a concise history of cardiology in Pakistan which is a tribute to the untiring efforts of pioneers in the field of cardiology who did their best to improve cardiac care when no modern gadgets, equipment and instruments were available. They mostly relied on clinical skills and did a commendable job.
The book is divided into numerous small sections, chapters and gives details of almost all the cardiac institutions in Pakistan, their brief history and the pioneers who established those tertiary cardiac care facilities. Brief information is provided about all the cardiac institutes in the country, provision of basic cardiac care to interventional cardiac procedures and surgical procedures being performed in these institutions both in public and private sector have been covered. It also provides details about the start of postgraduate teaching and training in cardiology starting with Diploma course at NICVD to Fellowship in cardiology in many sub-specialties as well. It pays tributes to all those who started close heart and later open heart surgery at various institutions in the country. Establishment of various professional specialty organizations related to cardiology have also been covered.
The valuable information is supplemented with some historic and memorable photographs of founders, pioneers in the field of cardiology. Special mention has been made of some eminent physicians who also took keen interest in cardiology, their pictures and those of female cardiologists has further enriched its contents. Contributions of some Pakistani cardiologists like late Prof. Bunyad Haider and Prof. Shakeel Qureshi who are settled abroad who visited Pakistan frequently to teach and train their colleagues have also been documented. The author has also done well to acknowledge the services of a noted Indian interventional cardiologist Dr. Mathews from Apollo Hospital in India who visited Pakistan many times to train the Pakistani cardiologists in various interventional procedures.
Pictures of various leading cardiac institutes in the country, logos of various professional specialty organizations related to cardiology, reference to the establishment of Pakistan Heart Journal and its progress to date has also been included which the readers will find quite informative. Of special mention is the information provided at the end of the book related to landmark achievements in cardiology which covers the world renowned medical personalities in the field of cardiology and their achievements in their respective fields.
These include Inge Edler the Swedish Cardiologist, F. Mason Sones the American French Physician who performed selective coronary angiography, William Harvey from UK who described circulation of blood, Raymond Damadian the American Physician who invented MRI, Andreas Gruentzg the German Radiologist who is credited with first Balloon Angioplasty, Christian Barnard the South African Surgeon who performed the World’s first heart transplant in 1967, Stephen Hales who was the first physician to measure blood pressure in 1730, William Withering who introduced the use of Digitalis in dropsy(Heart Failure), Robert Goetz The German Surgeon who did the first CABG in 1960, William Einthoven the Dutch Physiologist who invented the first practical Electrocardiogram in 1895, Rune Elmquist the Swedish Cardiologist who developed the first permanent pacemaker in 1958 and Riva Rocca the Italian Physician who invented the Mercury Sphygmomanometer in 1895. The author has taken lot of pains to dig out all this information which must have taken some time.
The only names missing from the book which I could think of were of Dr. Muhammad Javed Consultant Cardiologist at District Headquarters Hospital Faisalabad who has done a commendable job of establishing an excellent Cardiac Unit with fully equipped Coronary Care Unit, Angiography facilities with the help of donors and philanthropists of the city of Faisalabad. Similarly, I could not see the name of Dr. Zafar Ahmad another noted cardiologist of Faisalabad who was affiliated with the Trust Hospital. Yet another important omission in the book is the name of Prof. Anjum Jalal an accomplished cardiac surgeon who served as Executive Director of Faisalabad Institute of Cardiology for many years and at present is Executive Director of Rawalpindi Institute of Cardiology. A keen researcher he pioneered the establishment of a database to ensure that all the hospital records, procedures being performed were computerized.
This database is being used at Multan Institute of Cardiology, Faisalabad Institute of Cardiology and now at Rawalpindi Institute of Cardiology. This data is extremely useful and helpful for conducting research and publications and the researchers in these institutions are benefiting from this. At the same time the author has also tried to please many of his friends praising them with superlatives.
For me as a student of medical journalism for the last over fifty-three years, this book is still an abstract and the full paper needs to be written. I hope someone will take it up some day and it should not be difficult either. One can simply ask all the cardiac institutions to prepare write-ups with their historical background and the services, facilities available and compile this. The basic frame work has been provided by Prof Ishaq. In particular contributions of people like Surgeon Rehman and late Prof. Col. M. Aslam Cheema deserve full chapters along with late Dr. Abdul Haque.
It was because of Surgeon M. Rehman who extended valuable help and assistance of training the perfusionists, medical and technical staff for Col. Cheema that he could start open heart surgery at Punjab Institute of Cardiology and he has acknowledged it in his book “Dil Darya”. Then it was Col. M. A. Cheema who acquired the services of Cardiac Surgeon Anjum Jalal and Prof. Altaf Rana while they were serving in Saudi Arabia and convinced them to come to Pakistan and thus we saw the institutions like Ch. Pervez Elahi Institute of Cardiology and Faisalabad Institute of Cardiology developing as Centers of Excellence.
While the book gives details regarding numerous professional specialty organizations in cardiology, there is still need for yet another organization of conscious, ethical physicians and cardiologists who are not infected with materialistic virus and are keen to work in the field of preventive cardiology and preventive medicine. It should strive to establish cardio metabolic clinics in all the major healthcare facilities in the country where the patients suffering from hypertension and diabetes, the new fast emerging epidemics in Pakistan, can be registered and provided free treatment including drugs. Simple pharmacological regimens can be worked out and with the help of pharmaceutical industry of Pakistan it is not at all difficult to accomplish that, in fact many pharma companies will welcome such an initiative.
However, it is important that the already established professional specialty organizations most of whom have become political entities, should be kept at a distance. They are most often happy at meeting in Five Star Hotels many of which turn out to be mostly social get together with very little academic scientific activities. Billions of rupees which they get in donations from the industry can be directed towards the running and managing these cardio metabolic clinics which will go a long way in reducing the burden of cardiac diseases and diabetes.
Prof. Khawar Kazmi an eminent cardiologist is quite interested in preventive cardiology and he needs to take this initiative and make a team to overlook this project.
This 78-page book has been published with the help of PharmEvo Pharmaceuticals, a progressive national pharmaceutical company which is known for ethical marketing practices besides promoting literary activities as one of their important Corporate Social Responsibility. The book is a must read for healthcare professionals who will find it extremely useful and informative for which Prof. Ishaq deserve our appreciation. SAJ
