Liver diseases pose questions

May be Medanta-TK tie-up provides answers

JK Health

DR. JAVID IQBAL

While cardiac states and kidney disorders remain much in focus, apart from alarmingly rising incidents of trauma in JK health care scenario, liver disorder is not much talked of. Medanta Medicity health care facility in Gurgaon seeks to address the concern in a tie-up with the oldest private health care concern in the valley—Tahira Khanam’s (TK’s) Hospital and Nursing Home, situated at Hazuri Bagh, Srinagar. The tie-up promises home based expert services, saving a trip to Delhi to get the second opinion and perhaps ultimate in care. It might be bad news that liver diseases are on rise - the good news is that in overwhelming majority of cases, disorder is treatable.
The management aspect was laid bare by a renowned name in the realm of liver disorders management - Dr. A.N Soin, India’s leading liver transplant surgeon. Dr. Soin—Chairman Medanta Liver Institute is a Padma Shri awardee [2007] and of Birla award [2008]. He has figured in Limca Book of World Records [2007-2011]. In a widely publicized media interaction, Dr. Soin and Dr. Sanjay Goja, is colleague, a native Kashmiri, bought home the challenges involved in liver disorders management. The interaction held at TK hospital on December, the 22nd 2012 was later joined by Prof. Khuroo and Dr. Omar—Hepatic Surgeon, SKIMS. Prof. Khuroo is one of the pioneers in liver diseases research. Dr. Soin’s clamour for Prof. Khuroo being a part of interaction underlined the esteem, he is held in.  The galaxy of experts talked of likely responses in meeting the challenge.
Dr. Soin initially and later Goja - the duo outlined four main disorders which lead to chronic Liver Disease—Hepatitis ‘B’ Virus [HBV] Hepatitis ‘C’ Virus [HVC] Alcoholic Liver Disease and Fatty Disorder/ Fatty Liver—that follows high lipid levels/cholesterol in blood. These disorders could lead to liver damage, the symptoms of which could be indigestion, pitting edema over feet and legs [swelling which forms a pit under pressure] jaundice [yellowish discoloration in sclera (white) of the eye, later of skin] and hepatic encephalopathy—disorder affecting the nervous system in which patient may have deteriorating level of consciousness-becoming drowsy and slipping into coma [Hepatic Coma—coma due to liver disorder].
Dr. A.S Soin underlined that these cases are treatable, if detected early and treated effectively before liver failure sets in. It is on the management side in selected number of cases that valley based institutions do not provide all the answers. These could be the cases that do not seek an early management, or cases that are inadequately treated. Such cases might need liver transplant, unless the patient is in an irreversible state of multi-organ failure. Majority of liver transplant cases stay within margins of effective management, given the desired parameters. Cases needing liver transplant need a donor, a blood relative—a part of donor’s liver is removed and transplanted in the recipient. With regeneration both have normal livers within months. Asked about dangers to the donor, Dr. Soin said that grade five risk—death is just negligible 0.1 to 0.2 %, grade three to four—8 to 9 % may need hospital treatment for some days, grade one to two are the minimal risk cases, quite manageable without admission.
There could be snags—readiness of the donor being one. Love for near and dear ones, plus the manner in which the minimal risk, almost ignorable is explained leads to donor readiness. Medanta Liver Diseases Institute having done about 1200 cases over the last decade stands second in number worldwide to a South Korean Institute. It proves the obvious. 1200 cases over a decade averages 120 a year. That means a donor getting ready every third day on an average. Dr. Soin stressed the role of media in promoting awareness. Later, in a communication, he was highly appreciative of the role of local media, as it responded readily.
Another snag—a forbidding one could be affordability. On an average, liver transplant costs eighteen lacs. Dr. Soin while admitting that it might be highly priced was at pains to stress that it has cost Medanta Medicity 35 crores to set-up the center. The running costs of investigations, pre and post operative care, as well as per [intra] operative management remain high, and in near future, it may not be feasible to workout a much more affordable rate. He stressed though that once the patient and his family get the needed explanation, funds do appear, as the promise is tempting—a new life, the chance to live a normal life. 
Dr. Soin will be holding a clinic every three months at TK, Dr. Sanjay Goja every month, while as Dr. Burhan of Medanta Medicity has been posted to screen cases on a daily basis from 10 A.M to 2 P.M. Additionally, it may be noted that Medanta-TK tie-up extends to cardiac [heart] and renal [kidney] disorders. In these health care concerns too, Medanta medical experts would be available once every month, with Dr. Burhan screening cases on daily basis.
Yaar Zinda, Sohbat Baqi [Reunion is subordinate to survival]

Feedback on: iqbal.javid46@gmail.com         

Lastupdate on : Tue, 29 Jan 2013 21:30:00 Makkah time
Lastupdate on : Tue, 29 Jan 2013 18:30:00 GMT
Lastupdate on : Wed, 30 Jan 2013 00:00:00 IST




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