Today 19th April, is World Liver Day .Obesity and liver diseases seems to have a direct correlation and obesity seems to be a trigger for liver diseases . Doctors say tha sedentary lifestyle is a major cause for ” Liver disease and obesity”

With liver transplants bringing in a bill of between Rs 12 to Rs 30 lakh, on World Liver Day doctors emphasize the need for nipping the problem in the bud so that liver disease can be prevented.

With the increase of obesity there seems to be a silent epidemic of non-alcoholic fatty liver problem, which gradually leads to severe liver damage.

“With changing dietary habits and a sedentary lifestyle, more obese people are showing up with fatty liver disease.

He said that since the cost is so high when it comes to liver transplants, it is of utmost importance that the cause is tackled at the root. Most of the causes which lead to end stage liver disease like alcoholism, obesity or hepatitis are controllable factors. “So it is essential that people are made aware of the triggers and how to prevent them,” added the doctor.

The increasing problem of Nonalcoholic fatty liver disease (NAFLD) occurs because of diversion of excess calories to synthesise fat in the liver and the inability of the liver to export the synthesised fat.

“Insulin resistance is the primary pathophysiology of this disorder. Excess fat in the liver causes inflammation, a stage called Non Alcoholic steatohepatitis (NASH) which is seen in around 25 per cent of NAFLD patients. Over time this inflammation causes progressive liver damage leading to cirrhosis and liver failure,” Dr. Poorna Chandra, Consultant Gastroenterologist, Fortis Hospitals.

The pricy transplant procedures and the expenses incurred for being on immunosuppressant drugs for one’s whole life are so high, that doctors insist on the need to tackle the problem at its onset, so that it does not graduate to end-stage liver disease.

Some of the Common Liver Related Diseases

• Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons

• Non-alcoholic fatty liver disease, a spectrum in disease, associated with obesity and characterized as an abundance of fat in the liver

• Cirrhosis Of The Liver :This  is the formation of fibrous tissue in the liver from replacing dead liver cells. Diagnosis is done by checking levels of Alanine transaminase and Asparatine transaminase (SGOT).

• Haemochromatosis, a hereditary disease causing the accumulation of iron in the body, eventually leading to liver damage.

• Cancer of the liver (primary hepatocellular carcinoma or cholangiocarcinoma and metastatic cancers, usually from other parts of the gastrointestinal tract).

• Wilson’s disease, a hereditary disease which causes the body to retain copper.

• Budd-Chiari syndrome, obstruction of the hepatic vein.

• Gilbert’s syndrome, a genetic disorder of bilirubin metabolism, found in about 5% of the population
  
  The best way to take preemptive steps to take care of your live is doing a  Liver Function Tests

A number of liver function tests are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products. LFT’s , serum proteins , serum albumin , serum globulin , A/G Ratio, alanine transaminase , aspartate transaminase , prothrombin time , partial thromboplastin time, platelet count.

Fortis Hospitals Ltd– India’s leading super specialty healthcare group forays into Assam with the launch of its first Information Centre & outpatient consultation clinic in Bongaigaon.

Addressing the media Mr. Himadri Das, said, “Fortis has been present in Kolkata for a considerable period of time and has extensively catered to the people of neighboring states by offering them quality medical services with utmost care. We have been receiving a large number of patients from this part of East India who come for complex surgeries like cardiac, joint replacement etc and have gone back healthy and satisfied. We thought now it was time for us to bring Fortis’ care close to the people of this region and the information centre & outpatient clinic is just a beginning.”

The Information centre is a unique concept where people can get information regarding specialties and various offerings at Fortis Hospitals. In the outpatient clinic cardiac specialist from Fortis Hospitals Kolkata will be conducting consultation. This will help the people of Bongaigaon and in and around areas to have access to super specialty care.

Addressing the media Dr. Itesh Bardolai said, “It is our pleasure to welcome such a super specialty hospital network to begin their services in Assam starting with their first information centre in Bongaigaon. There was an utmost need of advanced quality medical services in Bongaigaon and I believe with this information centre the people will now have easy access to super specialists and consult them in their city itself. They don’t need to travel miles to consult doctors and get an expert opinion. I congratulate Fortis Hospitals in this endeavor and wish them the very best and hopefully they will come with much more larger medical facility for the people of North East in the near future.”

Fortis Hospitals has a strong presence in the country and combines expert clinical talent, high end infrastructure and technology, a robust team of paramedics & nursing and a strong pedigree in specialties like cardiac, orthopaedics and neuro sciences serving people across the nation and offering them quality care. “For cardiac problems immediate treatment is what is required. In case of cardiac emergency loss of a second can be fatal. Hence having a one-stop facility for all the medical information and treatment would be real helpful and life saving for the people here.” said Dr. David Rozario, Consultant Cardiologist, Fortis Hospitals.

~ Radio-frequency Ablation Device (RFAD) is used for resection of complex liver tumor in a patient with multiple diseases ~

Mumbai, July 19: Team of experts at Fortis Hospitals Mulund has successfully removed a liver tumor from a 57 year old Mr Rajesh Nair. Dr. S K Mathur, Senior Consultant Surgeon, HPB Surgery & Liver Transplantation, Fortis Hospitals Mulund & Dr. Nagy Habib, professor & HOD HPB Surgery Imperial College London has performed this complicated surgery with unique Radio-frequency Ablation Device (RFAD).

The surgery involved resection of liver, where the tumor part from the liver had to be cut and separated from the healthy one. In order to minimize blood loss during the surgery, doctors at the hospital decided to employ the unique Radio-frequency Ablation Device (RFAD), known as the Habib Sealer device developed by world renowned liver cancer surgeon Dr. Nagy Habib, professor & HOD HPB Surgery Imperial College London.

“Normally a liver resection involves a lot of blood loss. But in this case patient was having a history of coronary Angioplasty for Heart Attack also one year ago he had a renal failure for which he was dialysis. The condition of the patient was so critical that we could not afford loss of blood. Hence we employed RFAD in the surgery, which ensured there was no loss of blood. Its developer Dr. Nagy Habib was also present during the surgery, which was successful and the condition of the patient is improving,” said Dr. S K Mathur, Liver transplantation surgeon, Fortis Hospital, Mulund.

“The Habib Sealer device is designed to be used in open and laparoscopic surgical procedures for the resection of tissue. The product is designed to coagulate a “surgical resection plane” to facilitate dissection with very limited blood loss “ Says Prof Nagy Habib

“The RFAD device has been designed to reduce surgical complications. I believe this device could in the future become a standard instrument for elective cancer surgery in the liver, spleen, pancreas, kidney, uterus, and lung. I also feel strongly that the tool could greatly benefit trauma surgeons to help control bleeding during emergency surgery,” said Dr. Nagy Habib.

for appointments at Fortis Hospitals, Mulund,Mumbai, Email us at enquiries@fortishospitals.in

Adding another feat to the history of cardiothoracic surgery at Fortis Hospitals Bangalore, the team of experts led by noted cardiac surgeon Dr. Vivek Jawali and Dr. Ramcharan Thiagarajan, Consultant Surgical GI & Hepato-Pancreatic Biliary Surgen has performed a combined cardiac bypass and liver tumor surgery on a 63 year old Nigerian.

This is one the most rare and complicated case where a patient underwent a cardiac bypass and a liver surgery at the same time. Mr. Saidu Abubarkar, retired Executive Director of Nigerian Television Authority had visited Fortis Hospitals Bangalore couple of months ago for a cardiac consultation. Mr. Saidu was witnessing breathing problem and weakness while walking for quite some time. Upon consulting doctors at his native, he was advised to go for a second opinion with a cardiac expert as he was diagnosed of heart trouble.  Knowing about the cardiac expertise at Fortis Hospitals Bangalore he decided to come down to India for his treatment. He was diagnosed to have coronary artery disease with severe left ventricular dysfunction and had 6 blockages and was recommended for a bypass surgery. During his preoperative evaluation he was diagnosed to have compensated liver disease with a malignant tumor in the right lobe of the liver. He was known to be positive for Hepatitis B virus for which he was advised to take antiviral medication. The elevated liver marker was suggestive of Liver cancer and was advised for a liver resection.

“This is a very risky and complicated situation where the patient’s heart was weakened with 6 blockages, he was hypertensive, diabetic, cirrhotic liver and had liver tumor. We had to carefully understand and evaluate Mr. Saidu’s case to ensure that he receives the appropriate treatment and both his liver and cardiac problem was taken care of” said Dr. Vivek Jawali, Chief Cardiothoracic Surgeon, Fortis Hospitals Bangalore. After discussion between the cardiac and the liver teams the surgeons finally decided to go ahead with the combined surgery where the cardiac bypass was to be done first and then immediately followed by the liver surgery.

“We have done many combined cardiac surgeries in the past, but a cardiac bypass and a liver surgery of his nature is to my knowledge is one of its kind which has not been recorded in the medical history. Both the surgeries were high risk surgery and to perform both in the same sitting was a challenge which our team took and successfully accomplished” added Dr. Vivek Jawali.

“The tumor was resting deep inside and back of the liver and due to its location he was not a candidate for other palliative options and surgery was the best option. The liver had cirrhosis on visual examination. About 20 – 25% of his liver was resected along with the tumour completely with adequate surgical margin.  However since his liver is already affected by Hepatitis B and has cirrhosis, he has to ultimately get a liver transplant at a later stage” said Dr. Ramcharan Thiagarajan.

“The advantages of the combined surgery are that the patient need not have to wait to recover from his heart surgery and then go through rigmorale of major liver surgery and recover again, faster recovery, financial benefit of one surgery rather two and he need not have to worry about the spread of Liver cancer during the waiting time. However there is a synergistic risk of bleeding especially after combined cardiac and liver surgery, but with the clinical expertise and facilities available at our institution, we were successful in handling the criticality of the situation and perform both the surgeries without much blood loss and help the patient recover at the earliest” added Dr. Ramcharan. The purpose of performing high risk surgery is to benefit the patient population.

Mr. Saidu has recovered phenomenally fast, has been discharged from the hospital and is ready to go back to his native in few days time.

“When my doctors in my hometown said I had heart problem I was not ready to believe them. I have been quite active all my life into tennis, football etc. I have 10 children and 12 grandchildren and love to spend my time with my grandchildren. But when my heart problem was confirmed I decided to get the treatment without much delay. On recommendation of my friend I searched on the internet about Fortis Hospitals and came to know about their expertise and decided to come here for my treatment. Today I am grateful to the hospital and doctors to have given a new life to my. I am eagerly waiting to fly back home to see my children and spend time with them” said Mr. Saidu.

Adding another feat to the history of cardiothoracic surgery at Fortis Hospitals Bangalore, the team of experts led by noted cardiac surgeon Dr. Vivek Jawali and Dr. Ramcharan Thiagarajan, Consultant Surgical GI & Hepato-Pancreatic Biliary Surgoen has performed a combined cardiac bypass and liver tumor surgery on a 63 year old Nigerian.

This is one the most rare and complicated case where a patient underwent a cardiac bypass and a liver surgery at the same time. Mr. Saidu Abubarkar, retired Executive Director of Nigerian Television Authority had visited Fortis Hospitals Bangalore couple of months ago for a cardiac consultation.

Mr. Saidu was witnessing breathing problem and weakness while walking for quite some time. Upon consulting doctors at his native, he was advised to go for a second opinion with a cardiac expert as he was diagnosed of heart trouble.  Knowing about the cardiac expertise at Fortis Hospitals Bangalore he decided to come down to India for his treatment. He was diagnosed to have coronary artery disease with severe left ventricular dysfunction and had 6 blockages and was recommended for a bypass surgery. During his preoperative evaluation he was diagnosed to have compensated liver disease with a malignant tumor in the right lobe of the liver. He was known to be positive for Hepatitis B virus for which he was advised to take antiviral medication. The elevated liver marker was suggestive of Liver cancer and was advised for a liver resection.

“This is a very risky and complicated situation where the patient’s heart was weakened with 6 blockages, he was hypertensive, diabetic, cirrhotic liver and had liver tumor. We had to carefully understand and evaluate Mr. Saidu’s case to ensure that he receives the appropriate treatment and both his liver and cardiac problem was taken care of” said Dr. Vivek Jawali, Chief Cardiothoracic Surgeon, Fortis Hospitals Bangalore. After discussion between the cardiac and the liver teams the surgeons finally decided to go ahead with the combined surgery where the cardiac bypass was to be done first and then immediately followed by the liver surgery.

“We have done many combined cardiac surgeries in the past, but a cardiac bypass and a liver surgery of his nature is to my knowledge is one of its kind which has not been recorded in the medical history. Both the surgeries were high risk surgery and to perform both in the same sitting was a challenge which our team took and successfully accomplished” added Dr. Vivek Jawali.

“The tumor was resting deep inside and back of the liver and due to its location he was not a candidate for other palliative options and surgery was the best option. The liver had cirrhosis on visual examination. About 20 – 25% of his liver was resected along with the tumour completely with adequate surgical margin.  However since his liver is already affected by Hepatitis B and has cirrhosis, he has to ultimately get a liver transplant at a later stage” said Dr. Ramcharan Thiagarajan.

“The advantages of the combined surgery are that the patient need not have to wait to recover from his heart surgery and then go through rigmorale of major liver surgery and recover again, faster recovery, financial benefit of one surgery rather two and he need not have to worry about the spread of Liver cancer during the waiting time. However there is a synergistic risk of bleeding especially after combined cardiac and liver surgery, but with the clinical expertise and facilities available at our institution, we were successful in handling the criticality of the situation and perform both the surgeries without much blood loss and help the patient recover at the earliest” added Dr. Ramcharan. The purpose of performing high risk surgery is to benefit the patient population.

Mr. Saidu has recovered phenomenally fast, has been discharged from the hospital and is ready to go back to his native in few days time.

“When my doctors in my hometown said I had heart problem I was not ready to believe them. I have been quite active all my life into tennis, football etc. I have 10 children and 12 grandchildren and love to spend my time with my grandchildren. But when my heart problem was confirmed I decided to get the treatment without much delay. On recommendation of my friend I searched on the internet about Fortis Hospitals and came to know about their expertise and decided to come here for my treatment. Today I am grateful to the hospital and doctors to have given a new life to my. I am eagerly waiting to fly back home to see my children and spend time with them” said Mr. Saidu.