MESSAGE
The heart and soul of the most remarkable achievements of PAEC is the establishment of Atomic Energy Medical Centres primarily aimed to provide tertiary care service to the patient suffering from cancer. The philanthropic culture developed at these institutes is unmatchable. The people who conceived the idea and who caused them to realize that PAEC was capable of delivering service of excellence in this field need to be appreciated. The dedication, commitment, generosity, and traditions that now has spanned over generations, has made these facilities exemplary and the feeling of being a member of this distinct or distinguished community makes me proud.
Since its establishment in 1999, KIRAN has made significant contributions in the field of oncology and allied medicines. This Institute is providing diagnostic and therapeutic care to patients with both cancerous and non-cancerous disease. With the concept of providing quality care to all patients regardless of their affordability, KIRAN has managed to grow over the years. The timely support in up-gradation and improvement in services by PAEC has made it possible to maintain standards in terms of patient care. The generous support from the philanthropist through KIRAN patient welfare society (KPWS) has provided new insights into the achievement of welfare objectives of this Institute.
I would like to extend my appreciation for the amazing work done by my team at KIRAN. The endless hours they spend working in this institute, and the professionalism that they portray has impressed all. I deem myself honored to have such a wonderful team as a project head.
Dr. Akhtar Ahmad, Director KIRAN, Karachi
Cancer undoubtedly has become an important public health issue and its patients require multidisciplinary treatment. The incidence across the globe shows the enormous health problem caused by cancer, which is recognized as the second fatal disease in humans. Anticipating the emergence of cancer as a public health problem, Pakistan Atomic Energy Commission (PAEC) established its first Atomic Energy Medical Centre at Karachi in 1960. Since then, PAEC has established 18 Atomic Energy Cancer Hospitals in the country. To address the growing needs of the metropolitan, PAEC planned a second cancer hospital in Karachi in 1993. It is located in the vicinity of other major health institutes like Dow University of Health Sciences and Memon Medical Institute. Karachi Institute of Radiotherapy and Nuclear Medicine abbreviated as KIRAN, stood up to its name and goals since its inception. It has truly become a ray of hope for cancer patients from all across Pakistan and provides quality care and treatment to all, irrespective of their affordability, caste, creed and religion. This Institute is engaged in providing outreach services, diagnosis and referral treatments, development of treatment protocols, undertaking research and enhancing the capacity of personnel in the country. The success of the service delivery at KIRAN can be measured by the established yardstick of patients’ satisfaction.
KIRAN, cancer hospital as it is commonly known, is a comprehensive tertiary care hospital with facilities of Clinical oncology, Nuclear Medicine, Radiology, Clinical Laboratory, In-door unit, and Pharmacy.
CLINICAL ONCOLOGY: KIRAN was initially planned to have state of the art Radiotherapy facilities and with the growing demand of medical oncology, chemotherapy services were subsequently established here. This institute started its journey in the field of radiotherapy by successful commissioning of first Multileaf Collimator based Linear Accelerator in Pakistan about 15 years ago. Currently, radiotherapy department is equipped with two Linear Accelerators, two Cobalt-60 teletherapy machines, digital simulator, and treatment planning system, dosimetry, and brachytherapy. Annual new cancer patient registry at KIRAN has exceeded 4500 patients making it one of the largest cancer treatment facilities in the country. It offers chemotherapy service through its daycare and indoor facility. 140 bedded wards serve patients needing admission for various indications. The oncology specialists are backed by our skilled nursing and para-medical staff in the indoor section who work in tandem to ensure support in patient care.
MEDICAL PHYSICS: The Radiotherapy, Nuclear Medicine and Radiology departments of KIRAN are equipped with modern machines to deliver quality treatment/diagnostic services to patients. Medical physics department assures the quality control of these machines appropriately and ensures safe delivery of radiation for therapeutic as well as diagnostic procedures, as per national and international guidelines. The Medical Physics Department of KIRAN has pioneered and anchored establishment of modern radiotherapy services in PAEC medical centres across the country. Some of the achievements and contributions in this regard are, successful commissioning of the first Multileaf Collimator based Linear Accelerator in Pakistan. This was state of the art technology with advanced features like MLC, R&V System, and Online Portal Imaging, operation of computerized treatment planning system, establishment of first HDR based computerized brachytherapy services in Pakistan, the first computerized mould room facility in Pakistan was started at KIRAN, initiating 3D-Conformal radiotherapy planning (3DCRT) in PAEC Medical Centres, establishment of CT-Simulation/VSIM practice, established TLD monitoring laboratory to provide TLD reading and reporting services to different organizations for the radiation workers. This facility is the first of its kind in the southern region of Pakistan. Operation of first CR based radiotherapy verification system in any medical centre of the country. This department is regularly participating in the IAEA Postal Dose Audit Program to verify the beam output of the radiotherapy machines, and the results are found to be within the IAEA prescribed limits, imparting clinical training to the Medical Physics fellows of PIEAS and supervising thesis/ projects of M.Sc. (Medical Physics) of PIEAS and M.Sc.(Physics) of University of Karachi and also supporting other medical centres of PAEC in establishing Linear Accelerator based planning, beam data acquisition, and dosimetry. The medical physics services are rendered by highly qualified and trained physicists supported by trained and dedicated team of technologists that makes the maximum utilization of machines time by long working hours.
NUCLEAR MEDICINE: The Nuclear Medicine department at KIRAN is well equipped in-vivo and in-vitro nuclear medicine facilities. Three dual head SPECT, two single head SPECT and one dedicated dual head cardiac camera make this Institute the largest nuclear medicine facility in the country. The main workload of the department is Nuclear Cardiology, Endocrinology, Skeletal scintigraphy, renal imaging and Hepatobiliary imaging. KIRAN has the pride of installing first DEXA scan machine in public sector in country for the diagnosis of Osteoporosis. A dedicated Thyroid clinic with an average daily attendance of 75 patients operates 5 days a week. The in-vivo clinical tests are performed for patients having chemotherapy by measuring GFR by radioisotope method, gold standard for such evaluation. Radionuclide therapy is an integral part of the nuclear medicine mainly used for treatment of both benign and malignant diseases of thyroid cancer using radioactive I-131. KIRAN has 4 dedicated rooms for isolation of patients treated with high dose radioiodine therapy. This Institute is in the process of acquiring hybrid imaging technology for molecular imaging. Procurement of a SPECT/CT and a PET/CT scanner is in process and the facility will be available soon. Nuclear Medicine facility is provided by a team of qualified nuclear physicians supported by equally qualified technologists.
CLINICAL LABORATORY: The Clinical Labs (Path lab, RIA and ELISA lab), PCR and Molecular Biology Labs at KIRAN provide the medical and research communities with timely, accurate, high-quality testing, with expert interpretation and clinical consultation, through the delivery of excellent customer service, exemplary laboratory and clinical practices, and continual innovation in our processes. KIRAN’s Clinical Laboratories focus on routine cancer patients’ lab testing and follow-up patient care. The labs were started as the Clinical Chemistry Reference Lab to support cancer patients’ routine testing as well as development of hematological and other biochemistry tests. Over the years Lab has rapidly grown in size and scope, and is currently conducting and supporting research and diagnostics in a wide variety of areas including addition of new tumor markers, thyroid markers, vitamin D, HbA1C etc. Labs are EQAS certified and are able to provide support for research as well as specialty testing for patient care. Students from various Institutions are being supported for their scientific investigations at KIRAN. The Labs are equipped with modern equipment for example Selectra Pro-M Biochemistry analyzer, Nihon Kohden and Sysmex haematology analyzers, Gensys 20 well gamma counter, ELISA plate reader etc. The lab was recently renovated according to modern needs and is going to win ISO-15189 quality certification
Molecular Lab section is equipped with RT-PCR and all the tools needed for modern molecular diagnostic and research facilities, and is catering to the needs of patients suffering from cancer and Hepatitis. Molecular section is also working in collaboration with various universities and producing high quality researchers. Twenty-nine research students were co-supervised for their M.S., M.Phil, and Ph.D. work in different fields of Microbiology/molecular biology and on role of MIRNA in different cancers. In future molecular lab will be expanded and more accurate molecular diagnostic tests which include diagnostics of cancers on the basis of genetics will be incorporated. Histopathology and microbiology sections will be started soon.
RADIOLOGY: KIRAN was the first medical centre of PAEC with a dedicated radiology department. Currently it is equipped with two CT scanners, one MRI machine, mammography, ultrasound and x-ray machines. Radiology department provides services to the cancer patients registered at KIRAN as well to the referred patients for various imaging tests. A team of qualified radiologists is engaged in providing quality services to poor patients.
INFORMATION TECHNOLOGY: Realizing of the importance of information technology in the management of hospital, KIRAN has an IT department since its inception. An indigenous dedicated team of IT persons is working to digitize the most of processes running at this Institute. KIRAN Cancer Registry program (KCRP) has been developed and deployed with adoption of ICD-O, 3rd edition standards, interfaced with standard chemotherapy protocols and premedication. Central file record (CFR) module is helpful for monitoring patients’ file movement among various departments. The KIRAN’s network has more than 100 nodes with copper and fiber optic media.
BIOMEDICAL ENGINEERING: Biomedical department of KIRAN was setup to provide repair and maintenance services of the Hi-tech equipment installed here. A team of qualified engineers and scientists trained in-house and abroad provide the services. Almost all the equipments are maintained by this team without any service contract. The up-time of most of the machines is well above standards. This department is also providing consultancy and services to other PAEC medical centres.
TEACHING AND TRAINING: KIRAN from its initial operation has been actively engaged in teaching and training in various medical and allied fields. It is recognized for full time training for FCPS in the field of Radiotherapy, Nuclear Medicine and Radiology by College of Physicians and Surgeons. This Institute has been a key partner for imparting clinical training to MSc Nuclear Medicine and Radiation Oncology fellows of PIEAS and also for training in medical physics. KIRAN has been providing training facilities in the field of biochemistry, biomedical engineering and medical physics to students of Karachi University, NED University, Sir Syed University, MUET, and Isra University. The training engages students from MSc to Phd programmes. This Institute has a CME activity round the year which provides forum for education and discussion for participants and has organized many seminars conferences and workshops in the fields of oncology, nuclear medicine and radiology over the years.
KPWS: With the sole motivation and blessing of Allah (SWT) the motive of KIRAN Patient Welfare Society (KPWS) is to provide support to poor patients visiting this Institute for treatment. The society’s model was initiated in early 2000 and with its success the same model has been replicated in other medical centres of PAEC. KPWS provides costly chemotherapy as well as ancillary medicine free of cost to poor patients. It also supports patients by arranging surgery with co-operation of welfare societies at other hospitals. This society is also supporting this Institute in terms of fulfilling the deficiencies in human resource when and where needed. A dedicated pharmacy service is being extended by KPWS for patients of KIRAN at no-profit/no-loss basis and at highly subsidized rates. This society also operates chemotherapy dilution service which is equipped with Class-III dispensing units. The annual budget of KPWS for patient support in terms of chemotherapy medicines from zakat and donation has exceeded Rs.100 million. In addition zakat funds received from government are also utilized to provide chemotherapy drugs to poor patients.