Category Archives: Health care

Ramadan Fasting:

Ramadan is the most sacred month of the Islamic calendar that brings immense Ajar for fasting Muslims. Every Muslim is required to fast from dawn till dusk for 29 or 30 days during the month of Ramadan. Patients, minors, pregnant and nursing mothers, and psychologically unstable are exempted from fasting. Studies showed no significant ill effect of fasting upon liver transplant recipients. In fact, biochemistry and liver enzymes appear to at the same level pre and post-Ramadan. Only serum bilirubin observed to slightly elevated during fasting but that too returns to normal after a carbohydrate-rich meal. The decision of whether to fast or not dependent upon individual patient’s underlying health condition and consideration of transplant physicians.

Introduction:

Muslims all over the world follow strict abstinence from any fluid, food intake, and any sexual activity. Fasting observed from dawn till dusk for 29 or 30 days. Ramadan Fardh and carries an immense reward. but patients, minors, pregnant and nursing mothers and psychologically unstable are exempted from fasting. if their physician advises them not to do so. The same rules for travelers if they choose not to fast then they allowed.

No doubt Ramdan carries immense religious, psychological, and physical benefits. But if there strong evidence that fasting during Ramadan may deteriorate the patient’s condition. Increase illness, or can cause any sort of harm, then not fasting only permissible but also the best practice according to sharia. Islam does not allow any self-harm.

During Ramadan Fasting thoroughly researched and widely debated for kidney transplant recipients but unfortunately for liver transplant recipients. the data still not very widely available. There a few recent research studies particularity aiming at liver transplant patients (most notably recent research of Qatar University) but none of them can provide strong enough foundation to arrive at any final conclusion. These research studies termed preliminary at the most. 

Here discuss how fasting during Ramadan affects liver transplant recipients and living donors.

Liver Transplant Recipients and Ramadan Fasting: 

Before considering fasting for liver transplant recipients few things must be kept in mind. First and foremost, liver transplant outcome highly specific and one model never fit for all. Second liver transplant recipients may have other underlying conditions that affect their overall health and the decision to observe fasting during Ramadan. Third, every liver transplant patient should individually monitored. and if he/she wish to fast. the decision was taken by their transplant physician.

There a lack of comprehensive data regarding the effects of intermittent fasting in liver transplant recipients. Recently research studies emerging that show fasting no significant impact on the overall health of liver transplant recipients.

According to recent research;

• In stable allograft patients without any underlying disease fasting does not cause any negatives effects.
• Liver enzymes, biochemistry, and all other factors have been found to almost identical pre and post fasting.
• As the total calorie intake remain uniform before during and after Ramadan, no significant weight loss observed. BMIs reported decreasing so patients with fatty liver disease may actually benefit from fasting.
• Patients of liver cirrhosis advised avoiding fasting.
• Serum bilirubin level might slightly increase in liver recipients but it returns to normal after Iftar with enough carbohydrates intake.
• If liver transplant recipients wish to fast during Ramadan it advised increasing protein intake.
• Last but not least consult your transplant surgeon before taking any decision. Whether you may fast or not dependent upon your very specific health condition and only your physician is in the position to guide you prior to making any choices. 
• Immunosuppressive medication dosage needs not adjusted during Ramadan. Patients have actually shown better drug compliance during Ramadan.

Ramadan Fasting for Living-donors:

Healthy liver donors do not need to take extra precautions during Ramadan. The liver size has grown back to normal size then it perfectly ok to observe fasting during Ramadan. donor wants to donate liver in the coming months after Ramadan then not fasting might be suggested to preserve the size of the liver. 

If you need any further assistance reach to us at

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

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

Email us at info@faisaldar.com

Liver transplant:

Liver transplant is the only treatment option available for end-stage liver diseases. Patients of liver cancer, cirrhosis, fibrosis, and acute or chronic liver failure ultimately need liver from a donor. For many, the donated liver is the only hope of a second chance at life. Liver transplantation is a relatively new, fairly complicated, and very advanced form of life-saving surgery. Currently, both deceased and living donor liver transplants are performed globally. But the problem remains the same as for all types of organ transplants, long queues of awaiting patients with very few available livers from deceased donors. There is a large gap in no of patients waiting for liver transplant and no donors. The picture is more gloomy in third world countries like Pakistan. 

Living donor liver transplant can bridge this gap rapidly, with not only better outcomes but also with the minimum waiting time. Deceased donor liver transplant had been the classic choice for liver transplant in the past. Although carrying the added benefit of using a deceased donor’s liver for two recipients simultaneously, with the undeniable drawbacks.

drawbacks:

• Very few deceased donor livers are available
• Unlike kidney failure patients, that can be put on dialysis until a donated kidney is available for transplant, liver failure lack any such option. So the only option remains, is the immediate liver transplant. Deceased donor livers are hard to find with long waiting lists, so liver transplants are prioritized according to “Model for end-stage liver disease”.
• This priority system help reduces deaths on the waiting list but also requires patients to be critically ill ( in fact on the verge of death) to be qualified for a life-saving transplant.
• Without a suitable and timely transplant, families have to bear the tragedy of seeing their loved ones inching near death with each passing day.

Living donor liver transplant:

Living donor liver transplant is the most viable option in such a situation. Our liver has the wonderful ability to regenerate itself. Using this potential as much as 60% of a person’s healthy liver is removed and transplanted into the recipient. Both the donor and recipient’s liver will grow to their normal size and function within a few weeks (as little as 6 weeks often). As much as 70% of the healthy liver has been removed with wonderful subsequent regeneration to its full size and potential. 

Living donor liver donations carry multiple benefits, most notable among them are

• Most donors know their recipients, often they are family members or close friends. So the decision of donation is rapid and chances of compatibility are higher.
• Living donations eliminates the waiting time needed for the availability of the deceased’s liver, so the patient receives a life-saving transplant before his/her condition worsens. A living donor can jump the line and turn things around. 
• A transplant from living donations go more smoothly with fewer complications.
• This is a gift of a lifetime, a life-saving act, a sadaqa Jaria and a source of immense reward in the hereafter.

More about liver transplant:

Despite these benefits, living donor liver donations are rare, in fact only 5% of all liver transplants. In Pakistan alone, more than 2 million (some analysts claim more than 2.5 million) will ultimately need a liver transplant. Nearly 10000 Pakistanis die of liver failure every year waiting for liver donations. This is partly because the surgery can frighten people. And largely because of misconceptions/lack of knowledge surrounding living donations.

Living donor transplant a very complicated surgery and needs robust knowledge and experience. we  have the expertise that is unparalleled in the local market. We pioneered living donor liver transplant, before us the only option was to travel abroad for this type of surgery.

Living donor liver transplant does not carry any risk in itself and the matching criteria are straightforward. Anybody between the ages of 18 to 55, sufficiently healthy, not extremely obese. And with blood group matching the recipient can volunteer for donation. Studies show that long term outcomes for both donor and recipients are good or better. There is no evidence that liver donations shortens the life span or increases the chances of liver diseases of the donor in any form.

Details for liver transplant donor:

This April Let’s pledge to Clear our doubts and misconceptions about living donor liver donations, encourage our friends and families. Educate the masses about the utmost importance of liver donations. Liver transplant surgery speaks volumes, see the nearly dead patients after successful transplant, and you will not recognize them, looking like new people, color in their faces, muscle mass, enthusiastic, vigorous, energetic, and teeming with new hope of a new life. To see what happens with the miracle and generosity of living donation is unbelievable.

For any information and further assistance please contact us

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

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

E.mail: info@faisaldar.com

Facebook: dr.faisaldar

Introduction:

The March observed as Colorectal Cancer Awareness Month. Cancer the second and third leading cause of cancer-related death in men and women respectively. Pakistan although classically considered as the low-risk zone experiencing a surge in cases of Colorectal Cancer. And to our dismay, that too in the younger population. This high time to aware our masses about this underreported issue. Colorectal Cancer the cancer of colon or rectum. What exactly causes it, still unknown but there are several risk factors. That can be avoided to lower the risk of Colorectal Cancer. Lifestyle changes such as abstinence from alcohol, avoid frequent use of red meat, increased use of vegetables, fruits, and good fats. intake of vitamin c and coffee may considerably lower the risk of Colorectal Cancer.

Symptoms of Colorectal Cancer include fatigue, weakness, weight loss, abdominal distension. irritable bowel moment, sense of fullness, and blood from the colon. Colorectal Cancer is divided into five stages based on the spread and nature of cancer.

More about Colorectal Cancer Awareness:

March 2020, as the “Colorectal Cancer Awareness” month. Rare opportunity to aware of the masses regarding this less known type of cancer, on a global scale. It’s estimated to be the second leading cause of cancer-related death in women and the third for men. The American Cancer Society estimates that one in 21 men and one in 23 women in the United States. Will develop Colorectal Cancer at some point in their lifetime. 

Pakistan a South Asian country, although placed in the low-risk zone for Colorectal Cancer. Experiencing a surge in Colorectal cases in recent decades. Previously believed that Colorectal Cancer is predominantly seen in patients above the age of 50 in Pakistan and Bangladesh. But recent data paints a very gloomy picture and in fact very alarming situation of a rapid increase in Colorectal Cancer among young Pakistani population. Moreover, young Cancer cases are underreported, with late diagnosis (When the cancer is in a fairly advanced stage) and very poor prognosis. 

The robust awareness campaign and adoption of early diagnostic facilities the cry of the hour. Pakistan Kidney & Liver Institute & Research Centre, Dr. Faisal Dar, and our team of experts focus this march on Colorectal cancer awareness. To educate and motivate Pakistanis about this silent killer.

Now what is Colorectal Cancer;

Colorectal Cancer is any Cancer that affects the colon ( large intestine) and rectum. It also is known as bowel cancer, colon cancer, or rectal cancer. Colorectal Cancer may be benign or malignant, if malignant it can spread to other body organs.

Symptoms of Colorectal Cancer includes;

• Fatigue or tiredness.
• Weakness.
• Unexplained weight loss.
• Anemia or unexplained iron deficiency.
• Changes in bowel habits, constipation, or diarrhea.
• Blood in stools esp bright red blood that indicates it is coming from rectum.
• Pain and bloating in the abdomen, lump in the lower abdomen, and sense of fullness.
• Feeling of the bowl not emptying after passing stools.
• Many of these symptoms are not exclusively associated with Colorectal Cancer and many mild abdominal. disorders can cause one or more of the above symptoms. but if the symptoms persist for more then 4 weeks, immediately consult your physician.

How to prevent yourself from Colorectal Cancer:

• Although the exact cause of Colorectal Cancer, is unknown few risk factors can increase the chances of this type of cancer. Lifestyle changes and avoiding risk factors can protect us from Colorectal Cancer. Adopt the following measure to protect yourself and your dear ones from Colorectal Cancer.
• Regular screening can reduce the risk of developing malignancy. especially for those who have a family history of Colorectal Cancer, are above 50 years of age, or have Crohn’s disease. 
• Intake of fiber, fruit, vegetables, good quality carbohydrates, limiting our use of red meat. switching from processed fats to good fats such as avocado and olive oil. greatly reduce the risk of developing Colorectal Cancer.
• Stay away from alcohol consumption, the leading cause of Colorectal Cancer in young people.
• Moderate, regular exercise can reduce the risk of Colorectal Cancer.
• Obesity carries an increased risk of Colorectal Cancer, so keep your weight in check.
• New research shows that the intake of enough amount of vitamin C. The uses of coffee may lower the risk of Colorectal Cancer.

Stages of Colorectal Cancer

There are different ways of assigning stages to Colorectal Cancer. but the generalized categorization based upon the spread of cancer and the size of tumors.

• Stage 0, or carcinoma in citu, the stage in which Colorectal Cancer. At the very early stage, not growth father then the inner layers of the large intestine, and usually easy to treat.
• Stage 1, indicates that cancer has spread into the next layer of colon tissue but not reached any lymph nodes or other organs.
• In stage 2, Colorectal Cancer reaches other layers of colon or rectum but still limited to colon/ rectum only.
• stage 3, the cancer growth takes place to outer layers of the colon, reaches two to three lymph nodes but still not spread to other organs.
• In stage 4, Cancer cells spread to other tissue beyond the walls of colon/rectum. and progressively spread to distant body organs.

Unhealthy Liver:

The Liver helps with the detoxification of the human body. Which is a very important and essential process in keeping the human body healthy. For that reason, it essential that the liver itself is in good and healthy condition. because only then would it be able to perform its functions in a proper manner.

It is very important that we take care of our liver. One may end up with an unhealthy liver due to many factors. Such as an unhealthy diet, consuming excessive alcohol, or an unhealthy lifestyle, etc.

Liver related diseases common, but they may often go unnoticed or diagnosed. Therefore, one needs to watchful of the symptoms. signs that may relate to an unhealthy liver or liver disease.

Like every disease, liver-related diseases too have symptoms that can tell you that you may an unhealthy liver.

Some of the symptoms are mentioned below:

• Itchy Skin: Your skin itching occasionally a normal thing, but if started to happen more and more regularly. it may an early symptom.
• Skin and Eyes turning Yellow: This condition could Jaundice and a result of an increase of Bilirubin in your body.
• Change in your weight: If you gained a lot of weight, or have lost a lot of it. it might a symptom of an unhealthy liver.
• Weak Memory: If your memory getting weaker. it could a sign of liver damage.
• Abnormal Sleep Cycle: If you having trouble sleeping, or having a good sleep cycle, your liver co damaged. As it too one of the symptoms.
• You are often tired: If you often tired, even without doing anything, or by doing very little, you may unhealthy liver.
• Loss of appetite: If you started losing your appetite. A good idea to get your liver checked, as it may be damaged.
• Lack of Concentration: Another symptom, that if you are finding it hard to concentrate on day to day tasks, your liver might be damaged.
• Feeling confused: If you remain confused much more than normal, it might the result of a damaged liver.
• Body ache: If your body aching more than normal, you might want to get your liver checked.

There are many other symptoms as well including but not limited to a dry mouth. swollen ankles, and feet, dark urine, a shift or change in your overall personality, etc.

The symptoms of liver damage both physical and mental. And important that they don’t go unnoticed by the person, and if they note any of the symptoms within themselves. They should get themselves checked by a professional.