Former prime minister Nawaz Sharif, who had earlier been discharged on his request from Lahore's Services Institute of Medical Sciences (SIMS), changed his mind on Tuesday evening and requested that he spend the night at the hospital, a member of the medical board said.

Nawaz was to be shifted to Sharif Medical City Hospital, but since the release orders for his daughter Maryam Nawaz could not be obtained from Lahore High Court, the former premier decided to delay his departure from the hospital so the two could leave together.

Maryam's bail

Maryam Nawaz has also been under treatment at the Services Hospital since October 23, a day after her father was admitted.

She is awaiting her release on bail in the Chaudhry Sugar Mills case after the LHC had granted her request a day earlier.

The PML-N leader has been ordered to furnish two surety bonds, each worth Rs10 million, and deposit an additional Rs70million and surrender her passport to secure her release.

While her husband retired Captain Mohammad Safdar submitted the additional amount of Rs70 million along with her passport to the court, Maryam's lawyers were late in completing documentation and the surety bonds could not be submitted within the court's working hours.

Discharge slip issued

Nawaz's discharge slip was issued by the hospital on Tuesday evening after a medical check-up was done. An ambulance from Sharif Medical City Hospital had arrived to transport the former premier. PML-N president and brother of the former premier, Shehbaz Sharif, had also arrived to review the arrangements made.

Later, when Nawaz decided to stay on at the hospital till Maryam's release was secured, the ambulance was sent back.

Dr Ayaz said that the former prime minister had himself expressed a desire to be shifted to Sharif Medical City Hospital.

The doctor had earlier informed the media that certain medical tests — including a genetic test — that have been recommended for Nawaz are not available in Pakistan.

His remarks followed a meeting between a 12-member board of the hospital to review Nawaz's health situation and decide the future course of his treatment.

The medical board recommended that a genetic test be carried out after it was observed that Nawaz's platelets could not be raised to normal levels and that his sugar and blood pressure levels were also inconsistent.

Dr Ayaz said that Nawaz's health, overall, had seen an improvement. "If he wishes to travel, he can."

Nawaz has procured bail on medical grounds in the ongoing Chaudhry Sugar Mills case from the Lahore High Court. His seven-year jail sentence in the Al Azizia case has also been suspended by the Islamabad High Court for eight weeks on medical grounds.

Nawaz's health indicators

When asked about Nawaz's health indicators, the doctor said that while his condition has seen a slight improvement, his CBC report has shown a decline in platelet levels yet again. His platelet levels now stand at 30,000 per microliter, he said.

Furthermore, his sugar levels have not been able to be stabilised in the past 15 days. According to the medical board, the former premier's sugar levels are checked 5-6 times daily. The levels have spiked as high as 150-190.

Members of the board said Nawaz's medicines undergo a revision every day and that despite the use of steroids, his sugar levels are unable to be controlled. They said that the use of steroids is necessary to maintain normal functioning of the kidneys. A low dose of these steroids is being given, the board added.

According to Dr Ayaz, during the meeting, it was decided that the dose of steroids should be lowered even further.

The medical board said that Nawaz's blood pressure and cholesterol levels are also beyond what is considered normal.

"We have now removed restrictions from his diet plan," said the board, adding that he will now have a simple diet instead of a restricted one. It was also decided that his water intake should be increased and that he should go for walks daily.

Additionally, some samples were taken so that cardiac, kidney and sugar level tests can be carried out.

Drop in platelet levels

The former premier was rushed to the Services Institute of Medical Sciences (SIMS) on October 22 after his personal physician raised an alarm about his deteriorating health.

That day, doctors at the hospital had termed Nawaz's condition as 'serious' despite the transfusion of three mega units of platelets within hours of his admission.

According to the medical tests carried out at the time, the platelet count of the former premier had "dropped from 16,000 to a critical level of 2,000" when he was brought to hospital that night, prompting the medical board members to go for "immediate transfusion of the platelets to save his life", one of the board members had said.

After a struggle of three days, a six-member medical board, headed by Services Hospital Principal Ayaz Mahmood, had diagnosed the reason for Nawaz's declining health.

"It is acute immune thrombocytopenic purpura (ITP), a bleeding disorder, in which the immune system destroys platelets," a board member had told Dawn.