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Viral Hepatitis A and E
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Viral Hepatitis A and E

Introduction:

Hepatitis A and E are viral infections of the liver caused by the 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 epidemics 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 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.

Hepatitis A and E symptoms

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. The 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 a 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, and 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 and two shots recommended. A vaccine for hepatitis E licensed for use in China but not available elsewhere yet.

 

Liver Diseases & Symptoms
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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 is 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 the 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 are 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 is 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 the liver demands.

Dr. Faisal Dar (Pakistan Kidney and Liver Institute, Lahore)

Call us at 0341–0543883, 042-111 117 554

Email: info@faisaldar.com

 

Cardiovascular Health
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Cardiovascular Health & Fasting

Cardiovascular Health

Cardiovascular disorders are the 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 the 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 the heart and associated system from developing complications. It not only act directly on the body’s cardiovascular system but also controls 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 activates the parasympathetic system and releases acetylcholine into the bloodstream. 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 assumed that the effect is brought about by vagus nerve activation.

Weight loss:

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

Diabetes:

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

Smoking:

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

Impact of fasting on inflammatory biomarkers:

Atherosclerosis is the leading cause of cardiovascular-related death in the World. It clinically manifests in the form of ischemic heart diseases, artery disease, and stroke. It is a chronic condition in which plaque forms in arteries gradually. One of the most important factors for developing atherosclerosis is the 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 the 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 caused a marked decrease in visceral body fat and reduce the level of triglyceride, low-density lipoprotein, an overall reduction of the size of these molecules which could lead to good Cardiovascular Health.

Benfits of fasting
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Benefits of Fasting for Overall Health.

Benefits of Fasting:

Fasting carries enormous health benefits. It can work wonders for human health. Nearly all the body organs and systems are benefited from it. Fasting is a powerful weight-loss tool. It improves brain functions, creates new proteins, accelerates ketone body formation. Slow aging, repair tissue, reduces inflammation, improves liver and heart functions, reduces insulin resistance. Reduce symptoms of multiple sclerosis, reduce LDL level, help in the repair of tissue, and increase Human Growth Hormone level.

Introduction:

“Fasting and its effects on human health” subjected to enormous research during recent years. The comforts, luxury, and ease of modern lifestyle turned us into couch potatoes. As the proverb goes,” everything comes at a price”, so our lifestyle, which has cost us our very precious commodity, our health. Modern humans are fighting with obesity, diabetes, metabolic diseases, and other countless ailments that were unheard of in the past. The human body never designed to be fed with calories rich diet three times a day. With snacks in between and with little or no physical activity.

In Detail:

Misuse and carelessness towards our natural tendencies and devastating effects on our overall health. As result hypertension, obesity, diabetes, elevated triglycerides, muscle lethargy and a slew of other diseases attack us at a very early age and we have to live with regular medication intake and speedy aging. Ramadan Fasting a gift from Allah, that overhauls, maintain, and repairs our body tissue. To negate a few of the negatives effects of a sedentary lifestyle.

Benefits of Fasting:

Ramadan Fasting immensely beneficial for our overall health. Here we explain some benefits of fasting.

  • Fasting prompts weight loss. How? Liver stores glucose as a preferential form of energy before turning to burn body fats. Research shows that it takes nearly 10 hours to deplete liver stores of energy and turning to the use of body fat.
  • People who fast regularly may experience less brain damage in case of stroke. As they are better capable to resist oxygen and energy deprivation.
  • Fasting carries robust-disease-modifying benefits esp in case of chronic diseases like obesity. Diabetes, cancer, bowel diseases, and neurodegenerative brain diseases.
  • It found that fasting improves health indicators and can slow or even reverse aging and disease processes.
  • Human studies of fasting found that independent of weight loss. improvement in disease indicators such as insulin resistance. Blood fat abnormality, hypertension, and inflammation are seen.
  • The patient of multiple sclerosis experience marked a reduction in symptoms just after two months of regular fasting.
  • More about the benefits of fasting:
  • Fasting can prompt recovery from injuries.
  • During fasting, a new protein is formed. Cells obtain protein from nonessential sources, break them down into amino acids, and these amino acids used to build new proteins. Then After Iftar, a lot of new proteins formed in the brain and elsewhere.
  • During fasting, fats used for energy, giving rise to the production of ketones. These ketones are known to influence many molecules and proteins involved in various health functions and aging.
  • A very wonderful benefit of fasting its effect on the Human Growth Hormone. HGH can skyrocket during fasting ( some research claims as much as 5 fold increase is observed).

In short, there are a lot of Benefits of Fasting and a very powerful mechanism. That reduces inflammation, protects from heart disease, reduces LDL, slows down aging. Prevents cancer, and promotes the growth of new nerve cells in the brain.

Fasting unparalleled and it has no alternative. So

Keep Fasting, Stay Healthy.

healthy liver and fatty liver
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Fasting and Liver, A Miracle

Fasting in the month of Ramadan is the religious obligation for Muslims. People all over the Muslim World observe fasting for religious reasons. Only a handful of us aware of the immense physical, psychological, and somatic benefits of fasting during Ramadan. Fasting affects all our organs and organ systems in a plethora of positive ways but the human liver can get exceptional and multiple benefits from it.

We must prostrate in gratitude to Almighty Lord for such a privileged Islamic ritual. Fasting is indeed a miracle for our liver. Science is still in a very early stage of understanding the positive impacts of fasting on the human liver. The preliminary research’ results are both astonishing and eye-openers at the same time. Liver and fasting, what a great combination, let’s have a look upon the benefits of fasting.

Liver and Fasting in Ramadan:

Fasting is known to be beneficial for the health and longevity of humans. It was thought that the positive effects may be due to caloric restriction but lo and behold the total caloric restriction is nothing to do with Ramadan Fasting. During Ramadan, the overall caloric intake remains the same and is comparable to pre and post-Ramadan. With even consistent calorie intake the benefits of Ramadan’s fasting still arise in unbelievable ways.

Ramadan’s Fasting likely triggers the same cellular maintenance mechanism. As play a role in the metabolic response to caloric restriction when practiced without fasting. During fasting, nearly everything in metabolic response affected. A fairly complex process, that’s why even after decades science still struggling to find answers to some pressing questions.

Although food intake does not differ much on fasting and non-fasting days. still, a very marked decrease in body mass, cholesterol, and triglycerides was seen in Fasting humans. Fasting increases insulin sensitivity and glucose tolerance. A decrease in lipogenesis and an increase in Beta oxidation in Fasting Muslims results in a reduction of liver steatosis and inflammation.

In new experimentation researchers identified how fasting affected proteins in the liver. showing unexpected impact on fatty acid metabolism and the surprising role played by a master regulator protein. That controls many biological pathways in the liver and other organs. In particular, the researchers found that the HNF4α protein, which regulates a large number of liver genes. Plays a previously unknown role during intermittent fasting.

Here an excerpt from original research:

“For the first time, we showed that HNF4α inhibited during intermittent fasting. This downstream consequences, such as lowering the abundance of blood proteins in inflammation or affecting bile synthesis. This helps explain some of the previously known facts about intermittent fasting. The researchers also found that fasting where no food consumed all day. changed the metabolism of fatty acids in the liver.  the knowledge that applied to improvements in glucose tolerance, and the regulation of diabetes. Link: https://www.eurekalert.org/pub_releases/2020-03/uos-hif030420.php

Dr. Faisal Dar (Pakistan Kidney and Liver Institute, Lahore)

Call us at: 0341–0543883, 042-111 117 554

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Drop us an email at : info@faisaldar.com

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