The Lahore High Court (LHC) on Friday granted bail to former prime minister Nawaz Sharif on medical grounds in the Chaudhry Sugar Mills case.

PML-N President Shehbaz Sharif had filed the bail application for the release of his brother from the custody of the National Accountability Bureau (NAB).

According to the short order, the former premier will have to submit two surety bonds worth Rs10 million each for his release in the case.

“We applied for bail on the grounds that his health conditions were deteriorating and that he needs better treatment,” his lawyer, Azam Nazir Tarar, told Reuters after the ruling.

It is not clear if Nawaz would be moved to another hospital or allowed to go abroad for treatment, as his lawyer had requested.

Although the former premier is set to be released from the custody of NAB, he will not be free until a request seeking the suspension of his sentence, and release on bail, in the Al Azizia case is granted by the Islamabad High Court (IHC), which will next hear the matter on Tuesday.

Also on Friday, Nawaz's daughter Maryam's recent plea for an immediate release on humanitarian grounds was adjourned by the LHC till Monday.

The names of both Nawaz and Maryam are on the Exit Control List. Nawaz's counsel was informed that a separate request will have to be filed challenging the placement on the no-fly list.

Earlier today, the prosecution and defence had concluded their arguments in the case.

A two-member bench, headed by Justice Baqar Najafi, had heard the petition. The anti-corruption watchdog's prosecutor told the court that "every life, including that of Nawaz Sharif, is precious", adding that the former premier's condition was treatable.

After a struggle of three days, a six-member medical board, headed by Services Hospital Principal Ayaz Mahmood, had on Thursday 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 yesterday. “We are hopeful that his condition will improve in a few days."

Doctors have said that the disease is treatable.

Today, Dr Ayaz submitted a detailed medical report of the former premier. He told the court that a medical board, which also includes Nawaz's personal physician, meets twice every day to discuss the PML-N supremo's condition.

Nawaz's lawyer Ashtar Ausaf told the court today that the former premier's condition was "extremely serious".

Dr Ayaz told the court that Nawaz's platelet count was constantly reducing, adding that the hospital had conducted tests to see if Nawaz was suffering from dengue fever.

"We inject platelets every day but they destruct every day," Dr Ayaz said and added: "Something or the other is destroying Nawaz Sharif's platelets."

He said that steroids will have to be injected in order to treat Nawaz.

"We have to conduct a bone marrow test but we cannot inject a needle in Nawaz Sharif's bone."

Dr Ayaz informed the court that Nawaz is a diabetes patient and is suffering from several other ailments as well.

The bench had told the doctor to apprise the court about Nawaz's recent condition by 12pm and had adjourned the hearing until later in the day.

An accountability court had earlier this month granted NAB a 14-day physical remand of Nawaz in connection with the Chaudhry Sugar Mills case. The remand had expired today.

Court judgment

According to the court's verdict, which referred to an 11-member special medical board's report, "the petitioner (Nawaz) has severe external existent comorbid conditions like diabetes mellitus, hypertension, hyperlipidaemia, hyperuraecaemia, chronic renal disease and ischaemic heart disease.

"The condition of the patient is critical and the current scenario of very low platelet count has added to the seriousness of nature of disease [which] is visible."

The board, in its report to the court, had also said that Nawaz's "anti-platelet therapy can be resumed once platelets improve to thirty thousand and that travel may be considered once platelets improve to beyond fifty thousands and his cardiac status allows".

The court, in its judgment also observed that during the night between October 24 and 25, "the petitioner experienced episode of central chest pain radiating to both arms which was relieved with sublingual nitroglycerine spray".

According to the judgment, the head of the medical board, Prof Dr Mahmood Ayaz, also apprised the court of the main risk which is the "rapid decline of platelets to 6,000 per microliter". Dr Ayaz said that further investigation "will be possible only if the number of platelets have been increased to 20,000 per microliter" and that the board is "trying its best" in this regard.

Given the aforementioned observations, the court ruled that Nawaz's condition "is very precarious and critical, as at present there is no sign of further improvement in platelets despite the best available treatment being extended to him in the last few days".

"We consider it as a human right case as an ailing patient is entitled to the best treatment available on earth but within his reach. The petitioner is obviously sick and a senior citizen.

"The medical reports have remained unchallenged by the prosecution. The petitioner appears to be physically handicapped and his medical reports suggest the seriousness of his disease which can be fatal to his life. The condition of the petitioner is undoubtedly serious and as such, he needs the treatment in [a] conducive condition free from any kind of pressure with full peace of mind," ruled the court.

"Obviously, the purpose of bail on medical ground is to ensure that an under-trial prisoner was allowed to avail medical treatment and/or surgical intervention, if need be, in hospital of his choice in the country or outside the country to ensure stoppage of his further deterioration of health and not to set him at liberty till conclusion of the trial," the court further stated in its judgment.

IHC questions risk to Nawaz's health

In a parallel development, a two-member bench of the IHC comprising Justice Aamir Farooq and Justice Mohsin Akhtar Kayani heard Shehbaz's petition seeking the suspension of Nawaz's sentence in the Al Azizia case and release on bail.

During the proceedings, Services Hospital Medical Superintendent (MS) Dr Saleem Cheema, who is a member of the medical board, said that Nawaz's condition is dangerous.

The judge pointed out that the situation was not described as dangerous in the report. Dr Cheema, however, clarified that it had been mentioned towards the end of the report, which was presented in court.

The doctor said that the former premier's ailment had not yet been diagnosed, adding that while platelets were being formed, the levels were also falling. He said that they have to conduct some tests but can only do so once Nawaz's health improves.

Justice Kayani asked if the former premier was being provided with the best treatment, to which the doctor replied in the affirmative.

The IHC judge asked if there was a threat to the former premier's life, in response to which Dr Cheema said: "If he doesn't receive immediate treatment, his life is in danger."

He added that Nawaz's personal physician Dr Adnan Khan was aware of the situation.

"Is there any risk factor? Is this a fatal disease?" asked Justice Kayani, to which Dr Cheema responded: "If it is not treated."

Justice Farooq said that doctors are the best judges in this situation and they can provide the correct information regarding the medical treatment.

The court asked Dr Adnan Khan what his concerns were, adding that if he wanted he could attend the hearing or submit his concerns in writing.

The hearing was adjourned till Tuesday.

Concluding the proceedings, Justice Kayani said that they were not medical experts and the doctors would have to explain whether there was a threat to Nawaz's life.

He said that Nawaz could not be granted bail on a legal basis; however, the court was viewing the petition through the lens of the former premier's medical condition.

Accountability court hears Chaudhry Sugar Mills case

Meanwhile, an accountability court in Lahore, where a hearing of the Chaudhry Sugar Mills case was held, had demanded Nawaz's report by 1pm.

NAB produced Maryam Nawaz and Yousuf Abbas, both of whom are named in the case, before the accountability court. The court extended their judicial remand until November 8 and adjourned the hearing till then.

Maryam's bail plea deferred till Monday

The LHC also heard a petition filed by Maryam Nawaz, seeking her immediate bail on the basis of fundamental rights and humanity.

The PML-N leader had filed the petition yesterday while the court had issued a notice to NAB.

The accountability watchdog today sought time to submit its reply to the petition. The court granted the plea and directed NAB to submit the response by Monday, which is when the hearing was adjourned until.

Meanwhile, Maryam was shifted to a hospital for her medical checkup.