Thursday, September 29, 2011


A strong heart is a result of healthy lifestyle choices. 

Be active and stress-free

 Fast-paced life & workplace pressures escalate stress levels, taking a toll on one's heart. The healing power of the body decreases when under stress, leading to many complications like hypertension and poor immunity. Even youngsters are prone to heart ailments. It's very important to stay healthy with a healthy heart and manage stress levels by understanding the risk factors, high cholesterol levels, stressful lifestyle, smoking, and lack of exercise. By following simple changes in lifestyle we can have a healthy heart & lead a healthy life.

Symptoms of Heart attack:

Discomfort / pain in the chest
Can feel like a tight ache, pressure, fullness or squeezing in the centre of the chest lasting for a few minutes or more. The sensation may come and go in spurts.
Pain in the upper body
Pain or discomfort may spread beyond the chest to the shoulders, arms, back, neck, teeth or jaws.
Upper body pain may not always be accompanied by chest discomfort
Pain in the stomach
This heart burn-like pain may extend downward
into your abdominal area
Shortness of breath
You may pant for breath or want to take deep breaths. This often occurs before the onset of chest discomfort.
You may feel a sense of doom or panic.
You may feel giddy or like you might faint.
You may suddenly break into a sweat with cold, sweaty skin.
Nausea and Vomiting
You may feel sick to your stomach or vomit.

How to prevent Heart Attack

Avoid smoking: Smoking reduces life expectancy by 15-25 years. If you are a smoker, you are twice more likely to have a heart attack than a non-smoker. The moment you stop smoking, the risk of heart attack begins to reduce.

Exercise: At least aim for 30 minutes of moderate exercise a day. Keeping yourself fit not only benefits the heart but also improves mental health and well-being. Monitor your BP, blood sugar and cholesterol levels: Routine medical check-ups will ring an alarm, if you need medical help.

Cut down on salt: Too much salt can cause high blood pressure, which increases the risk of developing coronary heart disease.

Watch your diet: Try to have a balanced diet. Eat fresh fruits and vegetables, starch foods such as wholegrain bread and rice.

Manage your waist: Cholesterol deposition in blood vessels begins in the first decade of life. Carrying a lot of extra weight as fat can greatly affect your health. Make small but healthy changes in your diet.

Check your family history: If a close relative had coronary heart disease at a younger age (less than 50 years), then you could be at risk too.

Manage your stress level: If you find things are getting on top of you, you may fail to eat properly, smoke and drink too much. This may increase your risk of a heart attack. Practice yoga/meditation. Take a vacation.

Monitor your alcohol: Too much alcohol can damage the heart muscle, increase blood pressure and also lead to weight gain. Avoid intake of alcohol or at least limit it to one to two pegs occasionally.

Laughter is the best therapy: Laughter anytime will work wonders for you. It is an instant way to unleash the pressure and it makes you feel light.


  • Most victims of heart attack do not know about the heart disease until the heart attack
  • Indians are genetically 3 times more vulnerable than their European counterparts
  • Every 4th person develops a simple or complex heart problem around the age of retirement
During Emergencies Remember the Golden Hour

Emergency treatment during the first hour of any critical medical case is it a heart attack or an accident, makes the difference between life and death. It is termed as the 'golden hour', and the first 10 minutes of that hour are termed as the 'Platinum 10 minutes'.
The wisest recommended action is to seek expert medical help at the earliest by calling the Accident & Emergency number and taking the necessary precautions till it arrives.
Make an ‘Assessment of Response’ by checking whether the victim is conscious or unconscious. Please avoid shaking the victim, particularly if he is a child. Instead, use ‘talk and touch’ process using simple sentences like “Can you hear me?”, “Open your eyes.”, “What's your name?” and “Squeeze my hands.” Consider the victim conscious if any response is noticed. Otherwise take care to avoid the following actions. Firstly, don’t attempt to make him drink water as an unconscious person’s reflexes disappear and the water may cause choking. Secondly, don’t leave him on his back, as the tongue and soft tissues may block the air passage of the throat. Call the Accident & Emergency number in either case.


It is scientifically proven that all it takes for someone to let go a bad habit and develop a good one is just 21 days. So, go ahead, take the 21 day challenge and let go the “heart unfriendly” habit or develop a “heart friendly” habit. Consistently pursue the habit for at least 21 days; the chances that it will lead to a change in your lifestyle could increase.

  • 21 days of no smoking
  • 21 days of a healthy diet
  • 21 days of at least 5 helpings of a fruit
  • 21 days of 30 minutes of brisk morning walking
  • 21 days of playing a sport
  • 21 days of saying no to oily food
  • 21 days of 10 minutes of meditation
  • 21 days of stress free living

Go ahead, you can do it. Fall in love with your heart!

Dr. Ravi Kumar Aluri, Chief Interventional Cardiologist, Global Hospitals, Hyderabad.

Dr. Ravi Kumar Aluri has been in the field of Interventional Cardiology with over a decade of experience in complex angioplasty stenting procedures and one of the pioneers in Transradial interventions.. With an immense experience in cardiac care and coronary interventions, he has to his credit over 9000 coronary procedures and over 4000 transradial procedures. Dr. Ravi Kumar is a Senior Consultant Cardiologist at Global Hospitals, Hyderabad and he can be reached on Email:; Ph: 09848024638.

Saturday, September 17, 2011

Cadaver Donor Liver Transplant

In the case of a cadaveric donor organ, the transplant center receives a liver offer from ORBO for a specified patient. . The patient is then notified and admitted to the hospital. While the donor team is procuring the donor liver, the recipient team begins to prepare the patient. The diseased liver is removed and the healthy liver is put in its place. The operation usually takes 6-8 hours. After the operation the patient begins taking medications to prevent the new liver from being rejected by the body. Complete recovery may take several weeks. The quality of life for transplant patients usually improves dramatically with most leading healthy, normal lives.
Such donation is possible from a brain dead person whose family wishes to donate the person's organs before discontinuing life support. This situation arises only in a hospital ICU in a person after brain injury in an accident or in someone who has suffered fatal brain hemorrhage etc. In these circumstances, the whole liver can be used for an adult, and a part of it for a child. After removal from the donor (a process called liver retrieval) the liver can safely be kept preserved outside the body in special preservation solutions for 12-15 hours. Allocation of such organs is strictly according to blood group which must match, time on waiting list and urgency of requirement.
There are different sources of donor livers. Usually the liver is obtained from a cadaveric donor (a person diagnosed as "brain dead" but whose other organs and systems are functioning properly). Due to a continuous shortage of donor livers and the high incidence of liver disease, the waiting time is increasing every year. Hundreds of people die each year while waiting for a cadaveric liver to be offered.
One of the biggest problems is the unavailability of compatible cadaveric donor livers.
A major factor in patient survival following transplantation is the degree of hepatic decomposition and associated debility at the time of transplantation. However, outcomes of liver transplantation have markedly improved due to effective immunosuppressant, improved surgical preservation techniques, and enhanced strategies to treat postoperative complications. 
An important flaw with this kind of transplantation is that the impact of transplantation on pulmonary gas exchange is more pronounced in patients receiving organs from cadaveric donors. This difference may arise from longer cold ischemia times present in the cadaveric donor group.

Visit Hospitals in India for more details.

Thursday, September 15, 2011

Partial Liver Transplants

Partial liver transplants are having amazing results in recipients, reducing the need for medication and the risk of organ rejection. Because the operation is so rare, organ transplant networks and organizations do not track the number of partial transplants performed or have specific guidelines for it.
Doctors say children fare better with the operation because their livers have better rejuvenating abilities than adults, and that this procedure can only be used for cases of acute liver failure. Chronic liver problems, like hepatitis or cancer, would not be cured with this procedure.
While the procedure is covered by insurance companies, the cost is roughly the same as traditional transplants. The long-term health care savings however are huge: After patients get off anti-rejection drugs, they save thousands of rupees a year.
In the last two decades, liver transplantation (LTx) has become the treatment of choice for several liver diseases including hepatocellular carcinoma in selected cases. Living-donor liver transplantation and split liver transplantation are measurements to reduce the severe lack of cadaveric grafts by expanding the donor pool. Major centers around the world now routinely perform partial LTx in infants and adults with survival success equivalent to that after full-size liver transplantation.
Although wide-ranging investigations such as intraoperative ultrasound, angiography, computed tomography, and magnetic resonance imaging are used routinely to delineate the hepatic vascular and biliary anatomy, not all anomalies can be demonstrated with certainty by these investigations. Therefore, the transplant surgeons should have a profound knowledge of normal liver anatomy and should recognize the presence and implications of anatomical variations. Normally, patients with haemodynamic instability, obesity, multiple upper gastrointestinal surgeries, and severe debilitation are usually excluded from partial liver transplantation.
Vascular and biliary complications may lead to loss of valuable grafts and cause significant morbidity and mortality. It is hoped that increasing experience, center effects, coupled with refinement of technique and a sound knowledge and application of anatomy, modern diagnostic tools such as the 3-dimensional visualization of the liver will lead to an improved outcome for patients undergoing partial liver transplantation. The use of reduced-sized, split grafts, and live-donor livers has reduced the size but not eliminated the problem. Donor-to-recipient size mismatch was an additional limitation to LTx in children until the development of partial liver transplantation techniques. Although these techniques have significantly reduced waiting list mortality in children, they do not completely address the major problem of limited organ availability.

Visit Hospitals in Chennai for more details.

Monday, September 12, 2011

Auxiliary Liver Transplant

In patients with acute liver failure (ALF) who fulfil criteria, liver transplantation is the only effective treatment which can substitute metabolic and excretory function of the liver. Auxiliary liver transplantation was developed because a significant minority of patients with ALF who fulfil transplant criteria can have a complete morphological and functional recovery of their liver.
In the majority of cases the auxiliary graft is a right graft which is placed orthotopically after a right hepatectomy in the recipient. After standard immune-suppression, the recovery of the native liver is assessed by biopsies, hepatobiliary scintigraphy and computed tomography. When, on the basis of histological, scintigraphical and morphological data, there is evidence of sufficient regeneration of the native liver, immune-suppression can be discontinued progressively. Complete regeneration of the native liver can be observed in >50% of patients, who can be withdrawn from immune-suppression. Therefore the advantages of auxiliary transplantation seem to balance favourably with the potential inconvenience of this technique in selected patients.
Auxiliary liver transplantation entails attaching a portion of a healthy donor's liver to a portion of a recipient's diseased liver. The donor liver remains intact until the native organ recovers, at which point the diseased liver may be removed. This procedure now accounts for a substantial proportion of liver transplants in children today.

This technique is an innovative way to treat patients with acute liver failure, in order to allow the patient's own liver to recover. While liver transplantation requires patients to take immunosuppressant medications for the remainder of their lives, auxiliary partial liver transplantation does not. The procedure entails attaching part of a donor liver to the failing liver in the recipient, where it supports the patient, clears toxins, and prevents brain injury during recovery. After the patient's native liver recovers, the donor liver withers in most patients, and the majority of patients are able to withdraw from immunosuppressant medications.

This procedure is particularly suited to children because the regenerative capacity of their livers is optimal. This technique may also be applied in young adults. This is also an advantage to patients with genetic errors of metabolism because the function of their own liver is perfectly normal except for one genetic defect. Auxiliary liver transplants are preferred because the patient is not entirely dependent upon the transplanted liver, should it be rejected.
Auxiliary liver transplant provides temporary support until the native liver recovers and immune-suppression can be withdrawn. Once you’re diagnosed with a liver disease, your physician will be able to determine whether or not you require a liver transplant. The type of transplant that you should undergo will also be decided based on the condition of your liver.

Visit Hospitals in Chennai for more details.

Split Liver Transplant

The shortage of available organs was previously most acute for pediatric patients. Because of the small number of pediatric donors, the mortality rate among patients on the wait list was commonly high when only whole-organ transplantation was performed. In 1984, the introduction of reduced-liver transplant in which a portion of the adult liver was given to infants and children dramatically reduced this mortality rate. Over the past 20 years, the risk of death among patients on the pediatric weight list has substantially declined because of the ability to use these reduced-size grafts and because of the subsequent introduction of live-donor transplantation.

As most commonly performed, split-liver transplantation (SLT) involves the division of donor liver from a deceased adult between a pediatric recipient and an adult recipient to maximize the benefit of each available donor organ.

Split-liver transplantation takes advantage of the knowledge gained in reduced-liver transplantation to increase the organ supply by using the right lobe or tri-segmental graft that remains after the left lateral segment or left lobe is removed for a pediatric recipient. Split-liver transplantation has now been applied in all patient groups, including status 1 patients and patients requiring re-transplantation. In the young pediatric population, split-liver transplantation or reduced-liver transplantation has become an increasingly frequent procedure.
The goal of split-liver transplantation (SLT) is to produce 2 grafts with preserved vascular supply (i.e., portal vein, hepatic artery), venous drainage and bile duct. Anatomic variations (replaced arteries, biliary anomalies) are not considered to be a contraindication to liver splitting as long as both right and left-sided allografts have a complete set of vessels and biliary drainage. In most cases, the vena cava and the common bile duct are maintained with the right-sided allograft, and the left hepatic vein and left bile duct are divided for the left allograft.

Two approaches are available to generate split-liver allografts: ex vivo, in which the organ is removed from the donor and divided on the back table after the organ has been flushed and cooled, and in situ, in which the dissection and parenchymal division is performed in the donor while the organs are still being perfused.

Cooperation between different surgical teams is crucial, and the decision to proceed to in situ splitting should be based on the stability of the donor's condition and on the conditions of all waiting recipients. In general, acceptable outcomes can be achieved by using either approach.
Complications after split-liver transplantation (SLT) are similar to those of whole-organ liver transplantation. The rate of bile leaks may be slighted elevated because of the large cut surface, particularly in livers that are split into right and left lobes. Otherwise, the rate of delayed graft function and allograft non-function is not increased in properly selected split-liver grafts.

Visit Hospitals in Bangalore for more details.

Thursday, September 8, 2011

Pediatric liver transplantation

Pediatric liver transplantation has been a major success and is now an established therapeutic entity. The use of innovative surgical techniques has allowed the application of liver transplantation to even very young infants with excellent results. Selection criterion for adults is properly based on outcome measures. The major driving force for this has been the mismatch between the number of donor organs and potential recipients. While the same general principles apply to children there are notable differences. The success of liver splitting allows many children to benefit from liver transplantation with little net effect on the overall donor organ pool. Also in some circumstances a smaller probability of long-term success may be a very worthwhile outcome for some children and their families. The liver is the only solid organ that can regenerate itself. That means surgeons can transplant a small segment of a donor’s liver (small enough to fit the baby or child), and the segment will grow as the child grows. Segmental transplants can use liver tissue from living or deceased donors.

The particularly high mortality in children awaiting liver and intestinal transplantation has been recognized by allocating this group a higher priority in the allocation sequence. Patients assessed for liver transplantation usually suffer from Chronic liver disease, Acute liver failure, Liver tumors and Metabolic liver disease with life-threatening extra-hepatic complications. Common symptoms that may indicate the need for further testing and possible transplant include: jaundice, ascites (accumulation of fluid in the abdomen), bleeding episodes or poor growth pattern.

The ability of the child's family to comply with instructions and follow-up plans are relevant factors which must be considered in the transplant assessment process. However the aim of the process is to identify support required to enable successful transplantation. Children should not be disadvantaged by family factors beyond their control. Age is not itself a contraindication, but the outcome of transplantation in the neonatal period is inferior to transplantation later in childhood.

Long-term monitoring is important to assure the child’s ongoing health. Outpatient medical visits and blood testing continue at a frequency that tapers over time, according to the child’s condition and absence of complications or illnesses.

Visit Hospitals in Chennai for more details.

Wednesday, September 7, 2011

Living Donor Liver Transplant

Living donor liver transplant offers an alternative to waiting for a deceased donor liver. Its main benefit is timeliness because it decreases the risk of complications and death while waiting for a match. For both patient survival and liver function, Global Hospitals India scores above the national average at one year post-transplant.
All liver transplant candidates undergo a similar evaluation whether they are considered for deceased donor liver or living donor liver transplantation. People who have progressive diseases and disorders can benefit from the timeliness of a living donor liver transplant, including those with: Liver tumors, Bile duct tumors, Cholestatic liver disease and Highly symptomatic patients with low priority for transplantation.
Potential donors undergo Health evaluation, Social and psychological screening, Anatomical assessment. The donor's liver size and unique anatomy, including placement of blood vessels and bile ducts, must be favorable for donation. The transplant team counsels and supports recipients, potential donors and families through every phase of the process.
The living donor's liver regenerates to full size within a few weeks of the surgery, and there is no long-term impairment of liver function. The transplanted liver portion also regenerates, increasing until it's the appropriate size for the recipient’s body.
The donor spends about a week in the hospital recovering, and should plan for two to three months off work. For the recipient, post-transplant care and follow-up is the same as for deceased donor liver transplant.
Adult-to-child living donor liver transplantation uses the left lateral portion of the adult donor's liver. The procedure has been proven safe and effective, and has helped reduce the number of children who die awaiting liver transplant. Although living donor liver transplant has been proven safe and effective for both donor and recipient, it is a major operation and not without risk.  The donor is also at risk for temporary problems related to the surgical incision and the possibility of blood clots following the operation. However, the great majority of donors have recovered completely within a few months of their operations.

Visit  Hospitals in Bangalore for more details.

Monday, September 5, 2011

Liver & Drug usage habits

The liver acts like a clearing house for almost all drugs, vitamins, herbal remedies and supplements. Therefore it is prone to bearing the brunt of extended use or inadvertent overdoses and unexpected interactions. It is imperative that we take care of the health of our liver and that the medications consumed by us have only the desired result and nothing else.

The following are some tips to help safeguard your liver health and ensure that the medications and remedies you need to take achieve their desired effect:
• To avoid potentially life-threatening complications, you should talk to your doctor about all medications or supplements - pharmaceutical and herbal – that you are taking or thinking of taking.
• If your doctor prescribes a long-term medication, ask for a liver test before you start the medication and after the first few weeks of taking the drug to determine how your liver is tolerating it. Follow up with regular liver tests throughout the duration of your treatment.
• Always read and follow the dosing instructions as dictated by your doctor or the medication label. Never take more than the recommended dose and be sure to take into consideration other medications that you may be taking at the same time that may have similar ingredients.
• Never mix medication with alcohol. Alcohol increases the risk of possible liver damage. Acetaminophen can be especially toxic when combined with alcohol.
• Be careful about mixing Tylenol® with other products that contain acetaminophen. By taking more than one pain reliever or cold remedy at a time, you may accidentally take more acetaminophen than is safe. Consult your doctor
·         Avoid certain herbal supplements as well as certain vitamins in high doses as they have the potential to cause damage to the liver. For example, high doses of vitamins E, K - and especially vitamins A and D - may be harmful.
·         Avoid grapefruit, grapefruit juice or supplements with grapefruit bioflavonoids if you are taking medication. The chemicals in grapefruit (both rind and pulp) can interfere with the liver enzymes that break down drugs. A variety of different medications – including some anti-depressants, blood pressure medications, cholesterol-lowering drugs and tranquilizers -- have been shown to have potentially serious interactions with grapefruit products. For more information, consult your doctor or pharmacist
·         Avoid the use of any form of recreational or ‘street’ drugs because they can put you at risk of contracting hepatitis B or C and can cause serious harm to your liver. Even a single ‘experiment’ could lead to a potentially life-threatening liver disease. If you do use drugs, make sure you use sterile drug-use equipment (e.g., syringes, cookers, filters, water, tourniquets, pipes, straws) and never share any of it.
If you have a chronic liver disease or other liver condition, consult your doctor before taking any form of prescription or non-prescription medication or herbal remedy. Liver disease compromises the liver’s ability to perform its normal processing functions so you may be unable to take medications to treat other health conditions.

Visit Hospitals in Hyderabad for more details.

Sunday, September 4, 2011

Liver Infection & Safe Sex Practice

Prior to getting involved in any kind of sexual activity, it is of utmost importance to know the risks and take steps to stay protected. Hepatitis, of which the most common forms are Hepatitis A, B & C, is a liver disease that can be transmitted sexually. Here are few safe practices and dos and don’ts you may follow to protect both, yourself and your partner. 


Though Hepatitis A is not usually transmitted through sexual activity, any oral/fecal contact, including that which may occur during sexual activity, is a high risk for contracting Hepatitis A. This can include Anal sex, Anal or fecal contact to the mouth (e.g. from fingering partner’s anus or handling a used condom after anal sex then putting fingers on/in mouth).

Hepatitis B is significantly more infectious than AIDS and carries a high risk of sexual transmission. Contraction of Hepatitis B may take place as a result of exposure to blood, semen, vaginal discharge or other bodily fluids during sex. This can include unprotected vaginal, oral or anal sex, sharing of sex toys and also non-sexual activities that may carry a risk of exposure viz. tattooing, body piercing, manicures or pedicures with non-sterile equipment or inks and sharing of needles or other drug equipment.

The contribution of sexual activity to the risk of contracting Hepatitis C is very low. However, any activity that may lead to exposure of blood does carry some risk. This may include rough sex where blood is present, vaginal sex with a woman during menstruation and other non-sexual activities that may carry a risk of exposure like tattooing, body piercing, manicures or pedicures with non-sterile equipment or inks and sharing of needles or other drug equipment.


Hepatitis A
Vaccination is a safe option as a measure of protection from Hepatitis A. The vaccine is given in two injections 6 to 12 months apart. Further, maintain hygiene like washing hands carefully after bowel movements, after sex, before making food and before eating, drinking or smoking. Before having sex, ensure that you have kept your genital and anal areas clean. Always use a condom during sex.

Hepatitis B
Here again, a vaccine is available as an effective protective measure. Get vaccinated. Hepatitis B vaccines are given in three doses over a period of six months. Further, practise safe sex. Always ensure to sterilize sex toys before and after use and avoid sharing personal hygiene items that may retain traces of blood, including toothbrushes, nail clippers, razors or nail files.

Hepatitis C
Since no vaccine has yet been found for Hepatitis C, the best approach is to adopt safer sex practices and take precautions to avoid any accidental contact with blood. Use condoms during vaginal, oral or anal sex and do not share personal hygiene items that may retain traces of blood, including toothbrushes, nail clippers, razors or nail files.

In any case, whenever you suspect that you or your partner may have been exposed to Hepatitis A, B or C, contact your health care provider promptly.

Visit Hospitals in Hyderabad for more details.

Thursday, September 1, 2011

Liver Infection and Body Art

Are you going for a body piercing, tattoo, manicure/pedicure, or permanent cosmetics? Just like HIV, even Hepatitis B & C can spread by direct contact with the blood of an infected person. Since the tools used for all these treatments can come into contact with blood and since it's not really feasible to ensure whether the person who has got treated before you was infected, it becomes imperative that the service provider takes effective measures for infection control between clients. As you may be aware, there is no vaccine for Hepatitis C as yet.

Few precautions can help avoid catching any infection when you go for body decoration:
Before you get treated, check the awareness of the staff about the risk of transmitting Hepatitis & HIV. Confirm whether the salon uses an autoclave for sterilizing tools between clients and whether the autoclave is well maintained and regularly tested. An autoclave is the only effective machine that can kill the Hepatitis virus.
During the treatment check on the cleanliness and hygiene of the premises and that its set-up and arrangement is well done for the safe conduct of the required process, Ensure that the staff follows good hygiene practices like:
·         wearing clean outer clothing,
·         washing hands with soap & warm water before and after each procedure or using a sanitizer
·         wearing surgical gloves whenever a possibility exists of contact with blood or body fluids or tissues
·         wearing aprons or such protective clothing in case of possible contact of clothing with blood
·         working of surfaces that are non-porous and smooth
·         cleaning all work surfaces with bleach and water
·         disposing all contaminated needles and other sharp objects in an appropriate puncture-proof container
·         disposing all contaminated protective equipment in proper containers marked for bio-hazardous waste
·         using single-use needles and fresh inks and dyes for each customer
·         using surgical steel or gold single-use needles (far better in preventing infection than silver needles)
After having undergone a treatment, in case you suspect having contracted any infection or adverse reaction, see a doctor immediately and share the true facts about the treatment you underwent.

Visit Hospitals in Bangalore for more Details.