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!

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Sinusitis refers to an extremely painful condition caused due to the inflammation and swelling of sinuses. A host of causes contribute to sinusitis, chief among them being allergies, air pollution or sometimes infection. It causes extreme discomfort, throbbing headache, sore throat and a blocked nose. Though different branches of medicines have tried in their own ways of dealing with this problem, ayurveda with its reliance on natural products as remedial measures have emerged as a clear favorite. Some of the ayurvedic remedies for sinusitis are-

1. Inhalation of steam with tulsi
The benefits of tulsi are widespread and need little introduction. The ambit of its advantages is expansive, making its presence felt even in treating sinusitis. In case of severe bouts of sinusitis, it is highly recommended that you inhale steam with tulsi almost every day in the week.

2. Have ginger along with honey
Another way of treating acute pangs of sinusitis is by making a paste of ginger and honey. Make small tablets of this mixture and for most effective results it is advisable that you have it every day.

3. Avoid certain food
Just how incorporating certain food in the diet help in reducing the pain of sinusitis, eliminating few, often times help you to achieve the same purpose. When you suffer from sinusitis, it is only advisable that you diligently avoid dairy products like milk, yoghurt as well as intoxicants like cigarettes and alcohol.

4. Lemon juice and water
In the initial stages of sinusitis, having a daily concoction of lemon juice and water is considered very beneficial. During this phase maintaining a light diet is advisable.

5. Practice pranayama
The gamut of ayurvedic remedies includes not only the prescription of what to eat and what to avoid but also several exercises that help in expediting the process of recovery. Among them, pranayama with its focus on control and regulation of breath is particularly beneficial in curing sinusitis.

Ayurvedic Remedies for Sinusitis

Lupus is an autoimmune disease, which is chronic i. e. Lasts for years or more than at least six weeks and may affect any part or organ of the body. The immune system fights off viruses, bacteria and germs by producing proteins known as antibodies. Autoimmune means that due to some defect, your immune system is unable to differentiate between the healthy tissues in your body and foreign invader that harms your body; thus creating antibodies that destroy the healthy tissues. This causes inflammation and damage to various parts of the bodies, leaving the sufferer in excruciating pain. 

Symptoms:
1. Fatigue: most of the people suffering from lupus experience weariness and fatigue. People usually take afternoon naps to remedy this. However, this may lead to insomnia. Talk to a doctor to successfully cure this symptom.
2. Unexplained fever: if you suffer from recurrent fever that hovers around 99 to 101 degrees fahrenheit, visit the doctor as soon as possible since this is a sign of infection or inflammation.
3. Hair loss: one of the most prominent symptoms of lupus is hair loss or thinning of hair. You may find your hair looking brittle, thin and ragged, including the hair on your eyebrows, eyelashes and other parts of the body. 
4. Lesions or skin rash: another prominent symptom is the butterfly rash that covers both the cheeks and the bridge of the nose and appears right before a flare up. This rash may occur all of a sudden or when exposed to the sunlight. Lupus also causes lesions and discoloration on various parts of the body due to exposure to sunlight or artificial light.
5. Pulmonary issues: lupus causes pleuritic chest pain due to painful inflammation in the lungs as well as the areas surrounding it such as diaphragm and lung blood vessels. This affects the patient's breathing process. Moreover, lupus is also known to decrease the size of the lung also called the" vanishing lung syndrome" that is identified by shortness of breath and chronic chest pain.
6. Kidney inflammation: most individuals suffering from lupus tend to develop nephritis that is inflammation in the kidneys. It is imperative to visit the doctor if you have symptoms of nephritis as it may cause end-stage renal disease (esrd) if untreated.

Symptoms of Lupus

When particular nerve cells in the brain don't function properly, it leads to epilepsy, which is a common brain disorder. There are several variants of epilepsy, and the one that you are suffering from would play a major role in the type of seizure you are likely to have. Here are the two most common type of seizures:

Common types of Seizures

Generalized seizures: This type of seizures take place when nerve cells on both sides of the brain start misfiring. They may lead to black out, fall or muscle spasms.
Focal seizures: It starts in a particular area of the brain, and the names of the seizure are based on the affected area of the brain. They may lead to both emotional and physical effects which may affect the way a person feels or sees or hear things that have no real presence. In particular cases, the symptoms of focal seizures are regarded of some other kinds of mental or nervous disorder.
Seizures are not considered an either-or thing since some people tend to have a particular type of seizure which gradually alters its course. It is not always easy to classify certain types of seizures which are called unknown-onset seizures and may lead to both physical and sensory symptoms. Both focal and generalized seizures can be categorized into various groups. The most common are listed below:

Subcategories of focal and generalized seizures

Simple focal seizures: It may change how the senses read the surroundings of a person. It can make a familiar taste or smell appear strange. Some people feel dizzy or visualize flashes of light or make the affected individual feel nauseated or sweaty.
Complex focal seizures: It normally happens when a part of the brain which controls emotion and memory gets affected. The affected person may feel awake even when he has lost consciousness. It can take several minutes for a person to come out of the problem.
Secondary generalized seizures: It starts when a part of the brain spreads to the nerve cells. They may lead to a few physical symptoms including muscle slackness and convulsions.
On the other hand, there are six variants of generalized seizures:

Clinic seizure: The muscles tend to have spasms which make a face, neck, and arms jerk rhythmically. It can last for minutes together.
Tonic-clonic seizure: These are the most notable type of seizures and leads to stiffening of the body, jerking and shaking along with the loss of consciousness. It can last between 1 to 3 minutes, and in case they go for a longer span, it is important to seek immediate medical attention. It may lead to breathing issues and may cause the person to bite his tongue or cheek.
Tonic seizures: When the muscled in the legs or arms or trunk tense up for more than 20 seconds, it is called a tonic seizure. If the affected person is in standing position, he or she may end up falling.
Other types of generalized seizure include atonic seizure, absence seizure and myoclonic seizure which are commonly seen in people who have epilepsy.

Seizures - Know The Common Types!

Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

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