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Hepatitis B Virus

Hepatitis B Infection & Treatment



Hepatitis B Infection and inflammation of the liver. It can acute but often progress into chronic liver disease. Hepatitis B leads to cirrhosis, and liver failure and is the leading cause of liver-related death globally. Chronic Infection is among the most common cause also behind primary liver carcinoma. A potentially life-threatening infection and need immediate intervention.

Mode of Transmission:

Hepatitis spread from mother to child. Children under the age of five are more prone to develop chronic hepatitis Infection. Blood from an infected person also another major source of transmission of this infection. Sharing needless, used syringes, tattooing or piercing and dental procedures done with contaminated equipment can spread this infection from one person to another. There a high risk of infection in male-male sex partners and heterosexuals having multiple partners.

Any medical or surgical equipment contaminated with infected blood can transmit the Infection. Syringes sharing in drug abusers and blades contaminated with blood are potential sources of infection. The virus can survive outside the human body for at least seven days and still can be a source of infection if it enters the body of an unvaccinated person. The incubation period of the virus from 30 to 180 days.


In the early stage of hepatitis B, most people don’t feel any symptoms. After the incubation period, acute hepatitis also develops, and the patient experiences extreme fatigue. loss of appetite, fever, nausea, vomiting, weight loss, jaundice, dark urine, and abdominal pain. Hepatitis B can cause acute liver failure in some people and may progress into chronic hepatitis in others. Gradually progressing into cirrhosis and liver failure if left untreated.

Most of the adults will recover from acute hepatitis B and only 5% of infections will progress into chronic hepatitis. But this not the case with children below 6 years of age. Nearly 50% of them will suffer from chronic hepatitis after acquiring the infection. Patients with HIV often co-infected with the virus.

Hepatitis B diagnosed with the help of a blood test. Antibodies against the virus are formed in the initial stage of infection and HBsAg and IgMbecome positive. Patients are also positive for HBeAgindicating active replication of the virus.


There is no specific need for treatment in case of acute hepatitis B. Symptomatic treatment given and the patient’s condition also monitored. Dietary supplements and enough fluid intake advised. Unnecessary use of medication discouraged.

Chronic Hepatitis B needs to be treated with medicine including some antiviral drugs. Although only a few people need treatment. The timely intervention will result in the prevention of cirrhosis and reduce the incidence of liver cancer. Treatment in most people results in only suppression of the virus and not its eradication that’s why people need life long medicine for this infection. Antivirals used for it expensive and countries with a majority of the low-income population can not afford it. The best way is also prevention. Vaccines for the virus are widely available with very good protection parameters.

Hepatitis B in Pakistan:

The prevalence of hepatitis B varies among different groups of populations and different localities in Pakistan. Recent data shows HBV is more prevalent in the Afghan population and in prison inmates, professional blood donors. People with multiple drug transfusion history, health care professional, and psychiatric patients. The general population of some areas shows as much as 5% of people infected from it. These specific areas include Southern Punjab also interior Sindh, Tatta, Kurram Agency, Baltistan, and some areas of Lahore. All these areas have the highest rate of infection among its residents.

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Gastroenteritis – Sysmtoms & Treatment

Introduction: Gastroenteritis the inflammation of the gastrointestinal tract mainly caused by viruses but also some bacteria, parasites, and fungi. More prevalent in third world countries due to unhygienic conditions. Symptoms include diarrhea, vomiting, low-grade fever, and abdominal cramps.  A self-resolving condition but can become complicated and life-threatening if severe dehydration and bloody stools occur. Antibiotics often not needed, ORS and symptomatic management, preferred to avoid any complications.


Gastroenteritis the inflammation of the gastrointestinal tract mainly caused by viruses (sometimes bacteria, parasites, and fungus) and characterized by diarrhea, vomiting, dehydration, fever, and asthenia. Contaminated food and water can spread the infection. The infection may resolve within two weeks.

Gastroenteritis commonly resolves by itself but severe complications may develop in some cases. In some third world countries, the leading cause of infants’ death. Complications of gastroenteritis included dehydration. Vomiting for more than two days in adults and for several hours in children. High-grade fever, bloody diarrhea, blood in vomit, severe abdominal cramps, and irritability in children.

Clinical presentation, Signs, and Symptoms

Gastroenteritis predominantly caused by viruses ( Particularly rotavirus) and the bacteria E.coli and Campylobacter species. Other less common causative agents no parasites and fungi. Noninfectious agents may also cause these diseases but very uncommon. Children, immunocompromised, and people who ignore hygiene practices highly vulnerable.

Gastroenteritis is characterized by diarrhea with or without vomiting, low-grade fever, abdominal cramps, headache, and muscle pain. The symptoms start to appear between 12 and 72 hours of contacting infection and resolve by itself with 3 to 9 days. The symptoms may continue to present for weeks in children and immunocompromised individuals. If their blood in diarrhea the causative agent probably not a virus.

Gastroenteritis clinically diagnosed by the symptoms present. Blood tests are rarely needed, stool culture performed if food poisoning suspected. In very old age and young children, serum glucose level and kidney function might need to monitored.

Gastroenteritis may cause severe dehydration clinically presented by sunken eyes, irritability, poor skin turgor, and abnormal breathing. The inhabitants of the area with poor sanitation may experience repeated infections causing stunted growth and poor cognitive abilities in children.


Gastroenteritis is an acute, self-limiting disease. Hands washed with soap and contaminated food should avoid. Enough fluid intake advised. If there a risk of dehydration, ORS should be used. If the patient unconscious or severely dehydrated then intravenous infusion used instead of ORS.

Antibiotics not necessary except in extreme cases where the causative agent is known. Macrolide a better choice than fluoroquinolones. Antiemetic agents such as metoclopramide are used to control vomiting. Antispasmodic can prescribe sometimes but motility modulators are best avoided. A rotavirus vaccine also available and recommended by the WHO.


Gastroenteritis the inflammation of the gastrointestinal tract caused by viruses, bacterias, parasites, fungi, and other nonpathogenic agents. Self-limiting disease and often don’t need any medications. As it causes diarrhea and vomiting so dehydration the main risk factor esp in children. Gastroenteritis prevented by using a rotavirus vaccine, by avoiding contaminated food and by following simple hygienic practices such as washing hands with soap.

For any further guidelines feel free to contact us

Dr. Faisal Dar Liver Clinic Quaid e Azam Hospital Islamabad.

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Viral Hepatitis E

Viral Hepatitis A and E


Hepatitis A and E are viral infections of the liver caused by Hepatitis A virus and Hepatitis E virus respectively. Both viruses cause acute liver infection with debilitating symptoms but progressing into advanced chronic liver diseases is very uncommon.

Mode of spread:

Both hepatitis A and E are predominantly spread through the fecal-oral route and can cause epidemic worldwide. If a healthy and unvaccinated person ingests food contaminated with a virus. He/she can develop Hepatitis A or E infection. Hepatitis A one of the most frequent causes of foodborne infection. Water or food contaminated with human fecal matter the leading cause of this infection in Pakistan. Poor sanitation, contamination of drinking water ( even a few drops of sewage mixing) can spread hepatitis A and B rapidly. Recent research in areas of Karachi shows that vegetables irrigated with the sewage water. A considerable amount of hepatitis A virus in them.

Closed contact with a person infected with hepatitis A or E, transfusion of infected blood. The male having sex with male and illicit drug use (not only injectable) other modes of spread. Immunocompromised individuals and those on immunosuppressive medication after liver transplant at a significantly higher risk of hepatitis E infection.

Viral Hepatitis A

The situation in Pakistan:

Hepatitis A and E a matter of increasing concern in Pakistan. With poor urban and rural sanitation facilities and lack of awareness among the general population. Our country a fertile ground for these infections. It estimated that 90 of Pakistani children get infected with hepatitis A before the age of 10. Adult infection ratio remained at 6.0% but has shown a sharp increase in recent years. Hepatitis A considered a self-limiting mild disease with few or no symptoms in some adults but to our dismay. An alarming number of hepatitis A related liver failure cases have reported in recent studies (Amnasubhan butt and Fatima Sharif, Euroasian journal of Hepato-Gastroenterology).

Hepatitis E showed a sporadic outbreak in areas with contaminated water in Pakistan. Up to 22% of adults and 2.4% of children found acute hepatitis due to the hepatitis E virus. The infection produced catastrophic effects on pregnant women. Resulting in maternal mortality rates ranging between 20 and 29.3 percent and perinatal mortality rate of up to 30.3 per 1000 live births(Yasmeen T, Hashmi HA, Taj A. Fetomaternal outcome with hepatitis e in pregnancy. J Coll Physicians Surg Pak. 2013 Oct;23(10):711–714. [PubMed] [Google Scholar]).

It also shows a significant mortality rate in patients with pre-existing chronic liver disease.

Sign and symptoms:

Hepatitis A and E are acute viral infections and their symptoms may range from mild to severe. Symptoms develop usually within 2 to 6 weeks of infection. And include jaundice, severe itching, fever, weakness, diarrhea, vomiting. Pain under the right lower ribs, pale stool, and dark-colored urine. Most of these symptoms may not be present in children and jaundice particularly found to be non-existent in infected adults in Pakistan.

Treatment and Prevention:

Practice good hygiene, wash hands with soap and water after using toilets. Used clean drinkable water not only for drinking but also for doing toothpaste. Avoid improperly cooked fish and meat. Raw cooked food a great source of the hepatitis E virus. Avoid illicit drug use.

Hepatitis A and E diagnosed by the presence of antibodies in the blood and by a reversed transcriptase-polymerase chain reaction.

Both hepatitis A and E considered mild infections that will resolve within a few weeks. No treatment advised for normal healthy people. Pregnant and those with chronic liver diseases should consult their physician. Avoid self-medication, especially Paracetamol and drugs to control vomiting.

Vaccines for Hepatitis A available and very effective even in single-dose but for added immunity, two shots recommended. A vaccine for hepatitis E licensed for use in China but not available elsewhere yet.


Liver Diseases

Liver Diseases & Symptoms

Liver Diseases:

The liver is the largest organ of the human body. A functional powerhouse and a true miracle of nature’s perfect design. The liver synthesizes protein, produces hormones, detoxifies chemicals or regulates glycogen storage. And synthesize metabolites necessary for human growth and adds indigestion. With such wide and varied functions, any disease that affects the liver can devastating effects on the whole body.

The liver affected by more than 100 diseases, some with acute onset where most of the damage happens within days or weeks. Some chronic where liver damage takes place gradually in a matter of years. Most of these liver diseases cause DNA damage, accumulation of toxins in the liver. And anatomical changes and may lead to permanent damage or liver failure.

Symptoms of Liver Diseases:

There is not a single class of liver diseases so the clinical presentation and symptoms varied but most common symptoms include.

  • Jaundice
  • Confusion, disorientation, and other CNS symptoms associated with hepatic encephalopathies.
  • Thrombocytopenia and blood coagulation disorders.
  • Bleeding in the gastrointestinal tract.
  • Accumulation of fluid in the abdominal cavity.
  • Muscular asthenia
  • Unexplained weight loss.
  • Fever and body aches.

The liver affected by more than 100 diseases and below a few notable classes of hepatic diseases discussed in brief.

classes of hepatic diseases:
  • Parasitic diseases of the liver are common and worldwide mostly caused by a genius of liver fluke.
  • Liver infections are very common in the developing world and are often the leading, also cause of cirrhosis in Pakistan. Viral infections like viral hepatitis, ( including A, B, and C varieties) can cause much damage before any symptoms appear. These are rightly termed as silent killers as well as they go unnoticed for years. The only sure way to know about your liver health is to routinely get yourself checked by the Hepatic clinic. Dr. Faisal Dar Clinic Quaid e Azam Hospital. State of the art liver care facility and offering unmatched diagnostic, treatment, surgical and transplant facilities in Pakistan. With robust expertise and the highest qualified staff, and also you can confide in us for every matter pertaining to liver health.
  • Alcohol abuse results in the accumulation of toxins in the liver causing alcoholic hepatitis. It causes fatty liver diseases and eventually cirrhosis.
  • Some hereditary conditions can lead to liver inflammation and cause autoimmune hepatitis.
  • Various drugs, toxins, and other chemicals may cause acute or chronic liver damage. Leading to cirrhosis/liver failure.
  • More about hepatic diseases:
  • Fatty liver disease may be non-alcoholic. These are characterized by the accumulation of large amounts of triglycerides in liver tissues and mainly caused by obesity or metabolic syndrome.
  • Hereditary diseases like Wilson disease, hemochromatosis(a large amount of iron deposition in the body). And hereditary amyloidosis( faulty protein synthesis with severe cardiopathiceffects) are less common. A liver transplant the only treatment option in this condition.
  • Cirrhosis of the liver may progress to chronic liver failure, where transplant remains the only chance at life.
  • Primary liver cancer and secondary liver cancer the leading causes of liver-related deaths. Secondary liver cancer metastasized cancer from other organs such as the gastrointestinal tract, kidney, lungs, etc.
  • Primary bile cirrhosis an autoimmune disease of the bile capillaries.
  • Another serious chronic inflammatory disease of the bile duct is primary sclerosing cholangitis. The exact cause of which debated but thought to be of autoimmune origin.
  • Occlusion of the hepatic vein manifests clinically through various symptoms collectively called as Budd-Chiari syndrome.
More about the liver disease:

Many of these liver diseases can be either cured or controlled to minimize the damage effectivity if timely diagnosis takes place and treatment initiated at an early stage. Remember our liver a vital organ and we can not survive without it. It demands extra care and protection. Diagnosis and treatment facilities specifically aimed at liver health are rare in Pakistan, and your go-to health care professional may lack the required expertise that liver demands.

We at, Dr. Faisal Dar Liver Clinic Quaid e Azam Hospital Islamabadare the pioneers of liver transplant with the right team and right skill to cater to all problems pertaining to your liver. For detail guidelines, diagnostic, treatment and transplant facilities reach to us at

Dr. Faisal Dar Liver Clinic Quaid e Azam Hospital Islamabad

For appointment and Quarries contact us at


Email: info@faisaldar.com


Cardiovascular Health

Cardiovascular Health & Fasting

Cardiovascular Health: Cardiovascular disorders are leading cause of death globally. In today’s world many people are living with heart diseases and fear of impending death. Modern lifestyle, tobacco smoking, fast food, obesity and stress are factors that deteriorate cardiac diseases.

We as Muslims are blessed with bounty of almighty Allah in the form of Ramadan. The sacred ritual of fasting can protect us from cardiovascular disease and even cure pre-existing cardiovascular disease. Fasting acts in multiple ways to protect heart and associated system from developing complications. It not only act directly on body cardiovascular system but it also control predisposing factors that might develop into advanced cardiac diseases. How Ramadan fasting can protect us from cardiovascular disease let’s have a look.

Direct Function in Lowering Blood Pressure:

Fasting activate parasympathetic system and release acetylcholine in blood stream. This in turn can slow heart rate and open up blood vessels. This combination results in lower blood pressure to a greater extent. All the underlying mechanism is not well understood but it is asumed that the effect is bring about by vagus nerve activation.

Weight loss:

Obesity is predisposing factor to cardiac diseases. Another benefit of fasting is control of obesity by multiple ways. Fasting is safe and effective mechanism of reducing weight that also help in control of cardiovascular diseases. Recent research shows that although the caloric intake me be constant pre and post Ramadan but there is considerable weight loss due to intermittent fasting. Optimal weight and lower BMI have positive impact on Cardiovascular Health.


Diabetes is another risk factor for heart diseases. Fasting improves glucose metabolism and decrease insulin tolerance. Fasting release stored energy from liver and help in burning of adipose tissues. Diabetes can progressively cause reduction in elasticity of blood vessels promoting atherosclerosis and cardiac malfunction.


Tobacco smoking is the leading cause of cardiovascular diseases. During fasting people abstain from smoking for longer period of time. This results in better outcome for Cardiovascular Health.

Impact of fasting on inflammatory biomarkers:

Atherosclerosis is leading cause of cardiovascular related death in the World. It clinically manifest in the form of  ischemic heart diseases, artery disease and stroke. It is a chronic condition in which plaque form in arteries gradually. One of the most important factor for developing atherosclerosis is high level of low density lipoproteins, elevated triglycerides that in turn activate inflammatory biomarkers through a complex mechanism eventually leading to plaque formation at various sites. Intermittent fasting not only lowers LDL but also helps in reduction of inflammatory biomarkers, resulting in increased protection from cardiovascular diseases.

Impact of fasting on lipid metabolism:

Intermittent fasting can decrease body mass index and can increase lipid metabolism. Fasting cause marked decrease in visceral body fat and reduce level of triglyceride, low-density lipoprotein and overall reduction of size of these molecules which could lead to good Cardiovascular Health.

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