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Liver diseases silent, don’t ignore symptoms

The Kashmir Monitor

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Doctors say, most of the liver diseases are silent and by the time symptoms appear there is already 50% or above damage done to the liver, and cirrhosis (scarring) of the liver set in, especially in viral Hepatitis B and C.

When north Delhi resident Anil Kumar, 45, got high fever in August this year, he thought it was normal flu. He consulted a doctor when the fever didn’t subside even after a couple of days.

“The doctor gave me medicines and my fever came down. A few days later, however, I observed the colour of my urine had turned dark. I consulted my doctor again and he asked me to get a liver function test done,” says Kumar, a civil engineer, who works for a Gurugram-based company.

 

Kumar was diagnosed with jaundice, and since his liver parameters were unusually off the charts, he was advised admission to a hospital.

“I didn’t have any pain in the abdomen or any other symptoms but since the test readings were alarming I got admitted to a local hospital. The tests confirmed viral Hepatitis E on August 12. By evening of that day I was feeling worse,” he says.

The doctors recommended he be shifted to a bigger hospital after he started losing consciousness the next day.

“I got admitted to BLK Hospital and investigations began and it was diagnosed that I had acute liver failure. Only 50% of my liver was functioning,” he says.

Kumar recovered initially but from August 18, his condition got worse and he was advised liver transplant.

“In just a span of days, my liver was so damaged that I had to undergo a liver transplant. I was shocked. I didn’t know my liver was in such a bad state. I have never had any symptoms,” he says.

Fortunately for Kumar, he received timely treatment and from Monday he will resume work.

“What is important to note in his case is that he didn’t waste time. We mostly get cases too late and that affects the treatment outcome. Time is of essence in such cases,” says Dr Sanjay Singh Negi, director, department of hepato-pancreato-biliary surgery, BLK Hospital.

“It’s usually Hepatitis B and C that’s considered more dangerous but in a small proportion of cases, even A and E can lead to rapid liver damage,” he said.

Doctors say, most of the liver diseases are silent and by the time symptoms appear there is already 50% or above damage done to the liver, and cirrhosis (scarring) of the liver set in, especially in viral Hepatitis B and C.

Liver cirrhosis is one of the major contributors towards developing liver cancer.

“In cirrhotic cases, tumor may develop any time. In fact, in at least 70% of the cases cirrhosis leads to liver cancer, which is one of the fastest growing cancers,” says Dr SK Sarin, director, Institute of Liver and Biliary Sciences.

Vaccination is the key to control infection from spreading. However, there is vaccine to prevent only Hepatitis B.

Keeping in mind the magnitude of the disease, government of India also introduced Hepatitis vaccine in its Universal Immunisation Programme (UIP), to vaccinate newborns and protect them against the deadly disease.

An effective vaccination programme plays an imperative role in preventing HBV infection and is known to decrease the incidence of chronic liver disease and hepatocellular carcinoma (HCC) or liver cancer.

To provide protection to babies, the government is giving three primary doses of the vaccine at 6, 10 and 14 weeks, and to cut mother-to-child transmission, government had introduced the birth dose that is given within 24 hours of birth.

To protect against Hepatitis C, however, there is no vaccine but the infection can be cured with treatment that can last for three to six months. Doctors put a lot of emphasis on screening as timely treatment can prevent the liver from getting damaged beyond repair.

Since faulty lifestyle, which includes lack of exercise, increased intake of junk food and excessive alcohol consumption, is one of the contributing factors for developing Hepatitis, it will benefit to improve one’s lifestyle.

“Faulty lifestyle, primarily excessive alcohol in take, is one of top indications for liver transplant in India. So, people must lead a healthy lifestyle,” says Dr Negi.


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Health

Hepatitis A Causes and Symptoms

The Kashmir Monitor

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Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:

 

Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.

Symptoms

Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Headaches
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Busting myths around blood donation

The Kashmir Monitor

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As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.

 

The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Erectile dysfunction’s connection with lifestyle

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By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.

 

DIAGNOSIS OF ED

We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.

SHORT-TERM SOLUTION, LONG-TERM CURE

Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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