It is a slowly and gradually progressing disease in which healthy liver tissue is replaced with scar tissue, hence preventing the liver from proper functioning. The developed scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver. In other words, Cirrhosis is a condition in which the liver does not function properly due to long-term damage. Typically, the disease comes over months or years.

Although there are many other causes for cirrhosis, the commonest is excessive use of alcohol, viral hepatitis B and C infections and non-alcoholic fatty liver disease. Thus the scarring is most often caused by long-term exposure to toxins such as alcohol or viral infections.

According to the National Institutes of Health, it is the 12th leading cause of death. Men are more prone to develop cirrhosis than women. Globally approximately 57% of cirrhosis is attributable to either hepatitis B (30%) or hepatitis C (27%).Alcohol consumption accounting for about 20% of cirrhosis.

Persons most commonly affected: Adults of both sexes.

Unani approach to Cirrhosis of Liver (Talayyuf-e- Kabid)-

In Unani literature Cirrhosis of the liver is known as  Talayyuf-e- kabid ,  Sighr-al- kabid  or  Jigarki laghari . It is of two types.

1. AcuteType of Cirrhosis of Liver (Talayyuf-e- Kabid Hadd)-

It is rare but very dangerous. It is also called Yarqaan-e- khabees or Huzaal-e- asfar. Mainly occurs due to inflammation in hepatic cells, in which hepatic cells squeeze in few days resulting in improper functioning of liver. It is a disease in which cells throughout the liver are destroyed. Although they are replaced by areas containing normal new cells but also by much scar tissue, which alters the structure of the liver.

Causes and risk factors: Excessive use of alcohol/ chronic alcoholism, poor nutrition, highly toxic condition of the body system, viral infections caused by chronic viral hepatitis (types A, B and C), metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders,inherited diseases such as Wilson's disease and hemochromatosis, biliary cirrhosis, toxic hepatitis due to severe reactions to prescription drugs or prolonged exposure to environmental toxins and repeated bouts of heart failure with liver congestion etc.

Signs and Symptoms: The main signs and symptoms of this type are jaundice, pain at the site of liver, vomiting, headache, dizziness, increased body temperature, increased pulse rate, brownish coloured and dry tongue, increased thirst, initially whitish coloured diarrhoea, later on, colour becomes blackish due to contamination of blood, urine passes in less quantity and reddish in colour due to contamination of yellow bile in it,  haemorrhage from nose, stomach, intestine and uterus even abortion in women are seen. The size of the liver feels small on palpation.

2. Chronic type of Cirrhosis of Liver (Talayyuf-e- KabidMuzmin)

This type of the disease occurs due to the improper blood supply to the hepatic cells resulting in the size of liver very small in appearance but liver cells stay normal.

Causes and risk factors: The main causes of this type are the application of permanent pressure at the site of the liver such as ascites, alcohol abuse, hepatitis C virus infection, cardiomegaly, poor nutrition, highly toxic condition of the body system, peritoneal inflammation, improper diet in old age and starvation etc. Other causes which develop this disease are, obstruction of the external bile duct by stone, scar, inborn defect or tumour, use of certain medications, syphilis and passive liver congestion. Obesity has recently been recognized as a risk factor in non-alcoholic hepatitis and cirrhosis.

Signs and Symptoms: It is a slowly progressing disease. In early-stage symptoms, of indigestion like flatulence, constipation and diarrhoea may be present. General weakness, the feeling of being unwell, loss of appetite, loss of weight, and a loss of interest in sex may also be there. There may be a dull abdominal ache, nausea and vomiting. Eventually, the patient dies due to anaemia or ascites. The feeling of dullness is the peculiar sign of the disease. Other symptoms and signs include low-grade fever, bad breath, jaundiced skin and bloated and swollen abdomen.

Complications and Risks associated with Cirrhosis of Liver (Talayyuf-e-Kabid)-

Ascites (retention of fluid in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from oesophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis, the only option is a liver transplant.

Preventive measures for cirrhotic patients (Talayyuf-e- Kabid ke Mareezon ke liye Ehtiyaati Tadaabir):

Cirrhotic patients must completely avoid alcohol. Alcohol accelerates liver failure and hastens death in cirrhotic patients.
Avoid liver toxins. Acetaminophen (Tylenol), should be avoided because they can be toxic in cirrhotic patients.
Juice therapy helps the liver to detoxify toxins from the body. Cirrhotic patients should mix one part of pure juice with one part of water before drinking.
Cirrhotic patients are strongly advised to eat smaller meals. To avoid overworking the liver, five or six smaller, lighter meals per day are recommended.
Avoid fatty foods and processed foods, especially foods prepared with animal fats or hydrogenated oils. These types of foods put additional load on the liver.
Cirrhotic patients are also advised to eat only lean proteins (containing no fats) and in limited amounts.
Vegetable proteins are very beneficial in Cirrhotic patients. High protein intake causes increases of ammonia levels in the blood, possibly resulting in mental confusion, and in severe cases, coma. However, do not severely limit protein intake, as this may cause protein deficiency and impair the healing process.
Routinely increase consumption of fruits and steamed vegetables as fruits and vegetables are easy to digest, thus less work for the liver. In addition, they are good sources of vitamins, minerals, and antioxidants that help the liver detoxify and heal.
Cirrhotic patients are advised to practice intermittent fasting.
They are also advised to protect against hepatitis B, C and E.
Fundamentals of Management in Unani Medicine-

Identify the cause of the disease and treat it accordingly
Correct the digestive processes
Use hot dresses
Use mild and early digestible diet
In case of ascites treat it
Management/ Treatment-

In Unani medicine, very effective treatment is available for the Cirrhosis of Liver by strengthening the Liver cells and restoring normal size and functions of the Liver. In Unani medicine, there is a number of hepatoprotective drugs that protect the Liver either acute or chronic type.

SootshekharRas Swarna yukta 125 Mg twice a day
PittariAvleh 10 gm twice a Day
Duration of the treatment: 3 to 6 months or it depends upon the condition of the patients. If the patients with cirrhosis have diabetes, then the treatment may take long time for curing the disease. Diet plays a key role along with Unani Medicines. Hence, it is strictly advised to follow a proper diet plan.

Talayyuf - E - Kabid Or Cirrhosis Of The Liver - Know More About It!

People have a common perception that most injuries, medical conditions only affect those who spend several hours working outdoors. But what if we tell you that people who stay indoors- such as homemakers - are also susceptible to numerous health problems?

There s a saying:  Home is where the heart is.  But for countless homemakers, home is the place where  hurt  is! Scores of Indian homemakers encounter various injuries every year while engaging in household chores like cleaning and washing. The most common ones are-

Sprain- if you re a neat freak, you wouldn t mind spending half of your day cleaning the entire house. Here s a small tip- go slow if your cleaning duties include shifting heavy appliances and furniture from one place to another. There s a high chance that you may end up with a sprain injury. Sprains occur when you accidentally twist your ligaments. Another major cause of sprain injuries is a sudden fall. If you re mopping the floor or cleaning the bathroom, there s a fair chance that you may slip or lose balance. One must be cautious when working with water.
Back injuries- These are the most common types of injuries at home. Bending, lifting a heavy bucket or an abrupt movement, can strain your back muscles or ligaments leading to back injury. Many times the injury can result in a persistent, sharp stabbing pain, and hinder your usual routine.
Joint compression- Homemakers spend a considerable amount of time standing in the kitchen. As tiring as it is, standing for prolonged periods puts pressure on your joints- knee joint, hip joint as well as those in the feet and the ankle. This leads to wear and tear of the synovial joints, eventually causing them to tear. In due course of time, you will find it difficult to move around and walk even a meagre distance.
Prevention-
Starting to get worked up? Don t be. These problems can easily be prevented if you follow these steps-

Avoid overstretching, bending and twisting
Avoid lifting heavy weights. If possible, use a waist belt to keep away from traumatic injuries.
Keep your body weight in check. Mild exercises can help you with that.
Maintain a healthy diet- calcium intake can help your bones get stronger.
Use muscle braces to keep your joints protected.
Treatment-
The most preferred and effective choice of treatment for curing muscle injuries and joint inflammation is physiotherapy. Physiotherapy uses manual therapy, mechanical force and exercise therapy to promote mobility.

The most common method of treating such injuries is the RICE technique.  RICE  stands for Rest, Ice, Compression and Elevation. Keep the injured part at rest. Put an ice bag on the injured portion. Compress the injured area. Elevate the wound/injury for faster relief.
Anti-inflammatory drugs like Ibuprofen and Aspirin are prescribed to reduce inflammation and swelling. Painkillers can offer you instant relief from pain.
Physiotherapy treatment can effectively cure you of such injuries, that too in a short span of time. If you follow the treatment guidelines, recovery will take about 2-4 weeks. 

Common Problems Faced By Homemakers Who Stay Indoors - How Physiotherapy Can Be Of Help?

Often most couples face difficulty in trying to conceive and are distraught by the fact that they cannot have a child of their own by natural methods. Nowadays, there are countless alternative options for trying couples to find a solution to this pressing issue.

In vitro Fertilization or IVF is a procedure in which the doctor combines the sperm from the man and egg from the woman to develop an embryo in a laboratory. This step is carried out in a test tube and is therefore referred to as a test tube baby.

Afterwards, the embryo will be transferred back into the woman s womb. The in vitro fertilization procedure was advanced in order to help women suffering from dysfunctional fallopian tubes. In a situation where IVF fails to provide help to the concerned couple, surrogacy is suggested.

Procedure of IVF:

The IVF procedure begins with hormone therapy on the female candidate s body. This is done in order to promote the development of eggs within her ovary. The eggs are then collected and put in a test tube for fertilization. This facilitates the production of a number of embryos. After four days in the incubator, one of the embryos will be transferred within the mother s womb for implantation.

What is Surrogacy and How is it Different?

Surrogacy comes as the next obvious step in light of an IVF procedure failing to make the mother pregnant. In this procedure, the eggs are implanted within the womb of another woman who is referred to as the surrogate. The surrogate keeps the baby within her womb for nine months and gives birth to the child.

Compared to an IVF procedure surrogacy is a very complex process where there are a number of legal, emotional and financial factors involved.

Often couples might take the route to surrogacy as the first option after the woman experiences repeated miscarriages when both the partners have been trying for a number of years and have not met with any success. Other reasons for considering surrogacy include Hysterectomy and frail health condition of the woman that makes her prone to further complications and risks.

Basic Difference:

The basic difference between IVF and surrogacy is that in IVF the egg is fertilized outside the body of the woman whereas in surrogacy, the egg is implanted in another woman s womb and she carries the child for nine months.

The Major Differences Between IVF & Surrogacy!

When you experience shortness of breath for no reason, you might wonder if there is something to worry. Breathing difficulty (dyspnea) affects around 1 in every 10 adults. The causes are varied, and just like other health problems like dizziness, fatigue, and abdominal pain, shortness of breath too has several causes. While a few are harmless, a few may be the signs of a possible complication. Though a common complaint in adults, it is a tough diagnostic challenge. Being aware of the symptoms will take you a step further in deciding whether or not the breathing difficulty is a cause of concern.

Causes

In older people: If you are an older person, then your breathing problems will most likely be associated with a heart or lung disease such as COPD, pneumonia, and heart failure. Other causes include a stroke and cancer. It is advised to consult a doctor if you are experiencing serious breathing problems since the past few days and more so if you see other symptoms. Symptoms to worry about are pain or trouble staying upright.
In the young: The common causes of shortness of breath in younger people are usually minor and partially treatable. Shortness of breath may occur due to myofascial pain syndrome. This is a condition in which trigger points or muscle knots occur in the respiratory muscles. Other causes are pneumonia and bad respiratory habits and/or weak breathing muscles.
Stress can be the cause: Another common cause of shortness of breath in teenagers and working professionals is anxiety. This is a very significant cause and should be taken seriously because this may not necessarily be a minor problem. Its diagnosis is still reassuring when compared to other medical problems since this can be worked upon with a few techniques.
Should you worry or not?

When the breathing difficulty is caused due to an acute condition like pneumonia or a chronic condition like asthma, treating the cause is imperative. Because, when the cause is treated, the episodes of shortness of breath is reduced.
Any patient suffering from any one or more of the problems mentioned above can still take a sigh of relief as remedies are available. Various pressure point massages can be performed with proper technique to ease out the trigger points when you are suffering from muscle knots.
When it comes to bad breathing habits, old habits die hard. Although changing your bad breathing habits may seem frustrating at first, it is relatively easier to achieve this if taken up with the mentality of achieving a goal. If regular breathing exercises are performed, respiratory strength can be increased. Moreover, breathing correctly has many long-term benefits as well.
Anxiety is more of a mind over body kind of thing. Although it may seem tough to overcome, determined and head strong people can find relief if they try.
Ensuring safety first
If you are wondering about whether your condition is serious or not, it is advised to tell your doctor about any persisting symptom. If you have developed any new symptoms such as a chronic wheeze or a cough, fatigue and pale appearance, dry, painful cough and shortness of breath during physical activity, then these are slow and sneaky indicators of an onset of some serious medical problem. 

Thus, breathing difficulty occurring often is a reason to worry, and you must seek medical advice at the earliest.


Shortness of Breath Reasons - Should I Be Worried?

The main task of the kidneys is to balance the electrolytes in the blood and maintain the pH homeostasis. The kidneys also remove waste products from the blood. Infections in the kidney aren t uncommon and affect women (majorly pregnant women) and children below the age of two in most conditions.

Kidney infections are of two types:

Uncomplicated kidney infection: The infections in this condition are minor and can be cured with minimal medication.
Complicated kidney infection: These infections are more complex and serious as compared to the uncomplicated ones.
If not treated on time, kidney infection can prove to become a serious condition and lead to various complications including kidney damage and blood poisoning (sepsis).

The most common causes of kidney infections are:

Weak immune system: If you have a weak immune system, you are prone to getting a bacterial or fungal infection on the surface of your skin which eventually enters the bloodstream. The infection might right reach the kidneys and cause an infection there.
Bacteria entering from the urethra: The pathogen which causes an infection can enter the body through the urethra and multiply in the bladder. The infection spreads to the kidneys and causes renal infection.
Kidney stones: People diagnosed with kidney stones are at a very high risk of developing kidney infections. Kidney stones are caused because of a build-up of dissolved minerals in the inner lining of the kidneys.
Enlarged prostate: Men with an excessively enlarged prostate are prone to developing kidney infections as compared to men with a normal-sized prostate.
Intercourse: Engaging in sexual (anal or vaginal) intercourse with an infected person can be a major reason for kidney infection as the bacteria can enter the body through the anus or the vagina and affect the kidneys.
It is not difficult to detect infection in the kidneys as they have very visible symptoms. A few symptoms of kidney infection are:

Excessive back pain
Sudden chills or fever
Nausea and puking
Blood in the urine
Pain while urinating

Kidney Infections - Factors That Put You At Risk!

The HIV (human immunodeficiency virus) is a critical disease. This virus invades a person's immune system which is the body's defense against infections such as viruses and bacteria. The immune system doesn't work properly and becomes deficient once attacked by HIV. One social acknowledgement to HIV that has gained enough recognition is the HIV counselling due to the crucial need to counsel the patient about sexual behavior and the risks associated with it. 

Importance of HIV counselling 
The human immunodeficiency virus has become an epidemic in nature and has reached to a distressing proportion worldwide as it is in its third decade. Thus, counselling becomes remarkably crucial part of the treatment. 

HIV prevention counselling is a significant mode of behavioral invasion particularly in the deficiency or lack of an effective curative treatment or vaccine. HIV counselling varies from other forms of counselling sessions. Apart from being a health obstacle, the disease is equally overwhelming for the family as well as people around you. family. It is also connected with endless and intense human suffering which stimulates multiple emotional responses. Such reactions involve self-denial, grief, fear, loss, anxiety, anger, annoyance, depression self-blaming, pity, self-condemnation isolation and suicidal thoughts. 

Also, the risk of passing the virus to the partner during sexual activity is high and the patient must be aware of safe sex and the risks associated with unprotected sex. Hence, counselling becomes paramount. 

Counselling session s information Self-care counselling: 
The patient must be well informed about the disease and should be supported in embracing attitudes, actions, and beliefs which will defend and serve as a protective shield to the body s immune system. Improving, enhancing, and transforming nutrition is required. A few other things that are emphasized are, encouraging physical activity, avoiding objects, actions, and events that threaten the body, overcoming anxiety and stress that compromise the psychological, mental, physical and welfare of the body, and seeking and giving support for self-care. 

Types of counselling: 

Patient centered counselling: It changed the focus of counselling from a single informative one to one that concentrated on a patient s circumstances and needs. This involved active listening, to render better support and managing client's particular prevention needs. 
Risk reduction counselling: This includes examining client s awareness about sexual activity and their feelings.Using their current HIV knowledge as an appealing tool, the limitations they have for protected sex is discussed. A better understanding is ensured in the patients so that unsafe behaviors can be avoided. 
Grief counselling: People who are contaminated with HIV have an elevated risk of acquiring depression. Counselling helps you to deal with any emotional outburst. 
Aims of counselling in HIV infection-

Prevention is the first purpose of HIV counselling. It decides whether the lifestyle puts that individual at a higher risk. Helping to recognize and distinguish the definitions of high-risk behavior. The counselling contributes to behavioral change and also aims at working with the person and his family to obtain and sustain that change in approach and behavior.

HIV Counselling - Why It Is Important To Get It?

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