Improvements in medical technology and surgery techniques have made so much possible. With organ transplants becoming relatively simpler and less risky, many critical health conditions can now be resolved. Liver transplants are one of the most common and patients going through the agony of life-threatening liver diseases now have hope.

What is a Liver Transplant?

When the patient s liver is damaged to the extent that functioning is severely impaired and regeneration is not possible, a liver transplant is advised. In the transplant surgery, the diseased liver is removed and replaced by whole or part of healthy liver from the donor.

Types of Liver Transplants

Based on the type of donor, liver transplant can be classified as deceased donor and live donor transplantation.

Deceased Donor Transplants (DDLT): A "brain dead" person can be a liver donor if they had pledged their organs previously or if their relatives consent for organ donation. The healthy liver can give a new lease of life for an ailing patient.
Live Donor Liver Transplants (LDLT): A blood relative or spouse may donate a part of their liver to the patient (subject to compatibility). As the liver is a regenerative organ, the donor's liver will function normally and the recipient will have a completely new liver. At Kauvery Hospital, a detailed evaluation of the prospective donor is done to ensure that the health risks are minimized and complete recovery is achieved.
Donor Safety

Donor can lead a normal and physically active life with no restrictions. Lifelong medications are not required and women can enjoy pregnancy and motherhood.

Who Needs A Liver Transplant?

A person with end-stage liver disease is a candidate for a liver transplant. The failure can happen over a period of time or be a sudden occurrence, due medical conditions or reactions to drugs (ALF). Following are some of the common reasons for liver failure.
Alcoholism: Long term drinking can lead to end stage liver disease.
Biliary Atresia: Absence of bile ducts since birth.
Chronic viral Hepatitis: (Hepatitis B & C)
Haemochromatosis: An inherited disorder that overwhelms the body with abnormal levels of iron deposits including liver.
Liver Cancer: (Hepatocellular carcinoma) Cirrhosis increases risk of liver cancer. Transplantation early would offer potential cure.
Primary Biliary Cirrhosis: (PBC) An unusual condition with immune mediated destruction of the bile ducts resulting in failure of the liver.
Non Alcoholic SteatoHepatitis (NASH): It is a common cause of liver disease seen in those with metabolic syndrome (Obesity, Diabetes Mellitus, Hypothyroidism and Dyslipidemia with or without Hypertension). Unlike alcoholic or viral hepatitis, it occurs in people with no inherent liver problem.Primary Sclerosing Cholangitis: (PSC) The bile duct gets scarred and narrowed, which blocks bile drainage, ultimately leading to failure of the liver.
Wilson's disease: A very rare inherited disease that causes abnormal levels of copper deposition throughout the body including liver, ultimately causing liver failure.
What does a Liver Transplant Involve?

First stage: Evaluation: A team of specialists will evaluate the patient to determine if transplant is the best option or if any other course of action will be better. This includes review of the patient's medical history and a number of investigations.

If a patient is found to be a suitable candidate to undergo transplant, we proceed to the second stage where his or her name is placed on the waiting list if he or she opts for cadaveric liver transplant.

A scoring system based on medical criteria determines the priority. In general, sicker the patient, greater is the necessity for transplant.

Third stage: Donor becomes available. When a suitable donor has been identified, the patient is contacted and informed about donor's medical condition. If the patient consents, he or she will have to come to the hospital. Some basic tests will be repeated to ensure that the current condition is safe for surgery. Surgeons and anesthetists involved in the transplant will meet the patient and brief him or her about what to expect. Once all the test results are found to be satisfactory, we proceed for surgery.

 The Procedure

While aspects of the surgery vary from patient to patient, the procedure typically takes between 8 to 12 hours to complete. Once the surgery is over, the patient is shifted to the ICU where he or she will stay for 3 to 7 days. At this stage, various tubes are connected to the body to enable it to carry out its natural functions. These are gradually removed as and when deemed appropriate. From the ICU the patient is shifted to a room for 2-3 weeks. In total, patient spends about 3-4 weeks in the hospital while undergoing transplant.

Discharge & Recovery

Once the doctors deem that the patient can return home, he or she is discharged from the hospital.
A follow up schedule is given to the patient so that complete recovery is monitored. Before discharge, patient and family will be trained on how to take medicines and what precautions to take. The number of medications will reduce over time as the recovery progresses.
The pace of recovery depends upon several factors. In general, a patient may be able to resume daily activities by 1 month and resume work by about 3 months after the surgery.

The Liver Transplant Process!

Everybody has experienced headaches at some time or other in their lives. It is the most common pain which one suffers from and usually goes away on its own without any treatment. In rare cases, this pain may be a sign of a serious medical condition and you need to see a specialist for headaches. Normally headaches which are moderate or severe in nature and are not responsive to over-the-counter pain relievers are a cause of concern.

However, here are some signs that can be warnings that should not be ignored:

It occurs more than three times per month
Headache with nausea and vomiting
Headache with fever
Headache with pain in the eye or ear
Headache accompanied by other neurological symptoms such as seizures or change in vision, numbness, and difficulty with speech or weakness
It awakens you from sleep
A sudden headache that feels like explosion or thunderclap
It causes confusion or loss of consciousness
Headache after head injury
Headaches beginning after the age of 50
The reason why you need to see a specialist in such cases is first to identify the cause of headache and then to get a pain management plan accordingly. The pain management specialist doctors have completed additional training and have additional certification in treating headaches. They may also work in a clinic dedicated to treating headaches. This empowers them to identify the cause of headache accurately. You might be surprised that headaches can be caused due to simple reason like dehydration or in some cases be an early sign of a life threatening brain tumor.

Pain management plans offered by the specialist
Depending on the signs and symptoms of your headache the pain management specialist will guide you if you have tension headaches, migraine headaches, or cluster headaches and treat it appropriately.

Tension headache   These are the most common headaches caused due to the stress of day to day living and the specialist will mostly treat it with a prescription of over the counter pain medication and sometimes meditation too.
Migraine headache - A person with a migraine headache has a more severe headache pain and may also experience sensitivity to light and sound, nausea and vomiting. Hence along with medication the specialist will guide you to keep a journal of the possible triggers and help you eliminate them.
Cluster headache - Cluster headaches typically occur on one side of the head and are quite rare. They are more painful and usually will not respond to over-the-counter medication. People with cluster headaches usually have to take medication every day to prevent their headaches, because they are difficult to stop once they have started and they are utterly incapacitating.
What the specialist will actually do for your headache depends not just on the type of headache but also its cause and severity. So reach out to a specialist if you have any of the above mentioned signs and symptoms for an accurate diagnosis and to recover sooner.

When To See A Specialist For Headache?

Most families refer to their newborn baby as their 'bundle of joy'. The news of a child being born brings immense joy to the entire family. However, due to various reasons, a child could be born with some medical abnormalities, which would be known as congenital abnormalities. There are several different types of heart defects that can be congenital. These usually manifest themselves either immediately after birth or in the early years of life. In some cases, the abnormality could be detected on prenatal ultrasounds. In others, it may not be and the family could be caught off guard about the condition. This causes a lot of stress, both for the child, who does not receive regular postnatal care and for the parents immediately after the delivery process.

If the baby has the following symptoms within the first few hours of life, there could be a serious underlying condition, which requires medical attention. The presence and severity of the symptoms would depend on the actual abnormality.

The skin is pale gray or blue in color due to excessive venous flow in the system
Excessive sweating
The child is exerting to breathe regularly
Rapid breathing causes added load on the heart accompanied by a grunting noise
Flared nostrils i.e. the baby attempts to take in more oxygen with each breath causes flared nostrils
Swollen legs, eyes, and abdomen: Fluid retention in the legs and abdomen is quite common, and this could be characteristic of newborns with congenital heart disease
Shortness of breath, even during feeding
Clubbed fingernails
Lethargy and low energy, even with feeding, therefore very poor feeding pattern
Chest pain, which may cause the newborn to cry incessantly
Low weight gain, as they feed less
In some children, symptoms manifest only during the teenage years or early adulthood. These conditions are not very severe and the symptoms include:

Swelling of the hands, feet, and ankles due to fluid accumulation
Lowered energy levels, leading to easy fatigue
Shortness of breath with even minimal physical activity
Inability to exercise
Developmental delays and changes in growth milestones
Recurrent respiratory tract infections including sinus infections, bronchitis, and pneumonia
Endocarditis
Pulmonary hypertension
Heart failure, where the heart is not able to effectively function and pump blood to all parts of the body.
Some or more of these symptoms should trigger a warning to get the child tested for congenital heart disease. While some would just require a monitoring until severe symptoms develop, severe conditions like holes, abnormal valves, narrowed arteries, and blood vessel abnormalities might require immediate intervention.

Congenital Heart Disease - Signs Your Kid is Suffering from It!

Nails are an important part of your physiology, although they are mostly used for either utilitarian purposes such as gripping or for beauty purposes such as nail decorations. Nails themselves can go through infections which need not have underlying causes and thus can cause damage to that part of the tissue. One such disorder of the nail is onycholysis.

What is onycholysis?
This is a disorder where the nail on the finger or the toes starts to separate from the skin below. This happens little by little and usually starts at the tip and then progresses backward. The further back it progresses, the more nail tissue it destroys. While the entire nail may not be detached from the nail bed, parts of it may chip off, showing the tissue underneath.

Symptoms of onycholysis:

Jagged border between the pink flesh of the nail bed and the yellow edge of the nail
Detached nails become opaque, yellow or may turn green in color
Nail may become irregular in shape and size
Bits and chunks of nails can break off easily
Primary causes for onycholysis:

Let's look at some of the primary causes of onycholysis:

Frequent trauma - if you have a profession or work at home where you constantly require tapping away, it might cause minute injuries to build up within the nails and the fingers. Tapping on keyboards is one area where you could get repetitive trauma like this.
Manicure problems - many salons may aggressively try to clean the underside of the nails and in the process, slowly dislodge the nail form the nail bed and cause onycholysis. This has known to be the case with many people.
Water immersion - if you have work where your nails are immersed in water for long periods of time, this could also affect the development of onycholysis.
Skin diseases - certain skin conditions can also end up giving onycholysis. Psoriasis and contact dermatitis are other conditions that may lead to onycholysis as a consequence.
Allergy to nail glue - many makeup artists and customers have complained that certain brands of nail glue can also cause allergies resulting in onycholysis.
Medications - medications meant for the treatment of other ailments within the body can have the unintended consequences of causing onycholysis.
Treatment-
The underlying problems need to be corrected which may cause onycholysis. Once the underlying problem is corrected, onycholysis usually corrects itself. The nail may take some time to re-grow but will grow back on its own eventually and may take 4 to 6 months to cover the entire affected area again.


All About Onycholysis

Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.

In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.

Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.

Need for dialysis

A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.

When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.

Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:

Hemodialysis
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.

Peritoneal Dialysis
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.

Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.

A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling. 

Dialysis May Save Your Life!

Borderline personality disorder (bpd) is a mental illness. A patient suffering from bpd maintains unstable relationships with other people, shows inappropriate emotional reactions and possesses suicidal or self-harm tendencies. It is purely a personality disorder caused due to multiple factors. Patients suffering from bpd may find it difficult to stay alone. They fear abandonment and loneliness. Yet they have a tendency of showing mood swings, sudden emotional outburst or anger and hostility. This prevents them from having a long lasting relationship in life.

It usually starts affecting the patient's life from early adulthood. It however seems to improve with age. The patient also has distorted self-image. He or she is unclear about what they want from life or what they are in reality. Even minor incidents can trigger intense reactions in people with bpd.

Symptoms of borderline personality disorder.

The signs of suffering from bpd are listed below:

Intense and frantic effort to avoid abandonment or loneliness
Unstable relationships with people and changing the attitude towards them drastically. It can change from being in immense love with each other to intense hatred.
Developing paranoid thoughts and having dissociative feelings-the patient often lacks the feeling of self and suffers from identity crisis.
Suicidal feelings and attempts
Tendency to cause self harm or destruction by drug abuse, driving irresponsibly or be having unprotected sex
Reflecting intense depression
Chronic boredom
Sudden anger and hostility
Causes for borderline personality disorder.

Borderline personality disorder can be caused due to multiple reasons. Usually it has been found by researchers that it occurs to patients who have had a disturbed childhood. Complex and unpleasant happenings in the childhood may leave a deep impact on the patient's personality, which comes back as a disorder in his or her early adulthood. From mental, physical to sexual abuse in the childhood can lead to this condition in adults.

Besides, researchers have discovered recently that this illness has hereditary links. Some genes may be responsible for bpd. Improper functioning of the brain is also another factor. Especially, the portion of brain that controls emotions might not be functioning properly in co-ordination with other parts of it.

Diagnosis.

There is no particular clinical test that can diagnose bpd. It can be diagnosed by a series of interactive session with the patient by a psychiatrist.

Treatment.

The treatment of bpd involves three steps- psychotherapy, medications and support from peer and family. Dialectical behavioral therapy, cognitive behavioural therapy and psychodynamic psychotherapy are used in treating the patient. There are no specific medicines to cure identity crisis, boredom and loneliness. However, other symptoms like mood swings, depression and anxiety can be treated with anti-depressants and mood stabilizers. Antipsychotic drugs are also helpful to a certain extent. In extreme cases, hospitalization may be needed.

A Guide to Borderline Personality Disorder

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