Author name: Dr. Chetan Kalal

The effects of long COVID on severe liver injury and liver stiffness are becoming increasingly apparent as more research is conducted. Recent study has shown that covid infection can cause increase in liver stiffness. The liver stiffness is a surrogate marker for liver fibrosis (scarring of the liver) and was measured by using shear wave elastography. Those people who got covid infection were more likely to have increased stiffness of liver. This suggests that the injury to the liver may not be limited to just increased liver enzymes transiently during the infection but persistent scarring and damage to the liver way beyond the covid infection. Severe liver injury can lead to a buildup of scar tissue in the organ, resulting in impaired function, said Dr. Chetan Ramesh Kalal, Liver Transplant Physician, Masina Hospital, Byculla, Mumbai. Additionally, recent studies have suggested that long COVID may cause an increased level of liver stiffness due to inflammation from cytokines released during persistent infection or elevated levels of endotoxins. Elevated levels of endotoxins can cause increased fibrosis which increases the risk for further complications such as portal hypertension or cirrhosis, he said. According to Dr. Akash Shukla,Director and Consultant in Department, Hepatology at Sir H. N. Reliance Foundation Hospital and Research Centre, covid virus has a special affinity to the cholangiocytes, cells which line the bile duct within and outside the liver. Additionally, liver being the largest immune organ of the body is the target of antigen-antibody complexes following covid infection. Therefore, covid, tends to affect the liver in over half of the cases. Most often, this liver affection is asymptomatic and is diagnosed by transient elevation of liver enzymes like SGOT & SGPT. However, occasionally the liver injury is more severe and can cause acute hepatitis and manifest as jaundice. Those patients who have pre-existing liver disease especially cirrhosis have a risk of development of worsening of liver disease with covid infection. Dr. Chetan Ramesh said that long term symptoms associated with long covid have also been shown to include fatigue and malaise which could further exacerbate underlying conditions and potentially worsen any existing cases of severe liver injury or fibrosis leading to increased rigidity within the organ over time.

Spanish woman Teresa Maria Fernandez visited India, where she suffered a hemorrhagic stroke in Mumbai on January 5. He was admitted to the hospital for treatment. Donated everything from heart to bones… Spanish woman who died in Mumbai saved five lives Mumbai A dead Spanish woman saves five lives. here Jaslok Hospital I was under treatment of a woman who was declared brain dead by the doctor. The lives of four Indians and a Lebanese citizen were saved after the family of a 67-year-old woman agreed to donate her organs. Spanish woman Teresa Maria Fernandez visited India, where she suffered a hemorrhagic stroke in Mumbai on January 5. He was admitted to the hospital for treatment.Doctors at Jaslok Hospital said there was no improvement in his health and he was declared brain dead. The woman’s family also reached Mumbai after she was admitted to the hospital. The Spanish woman’s daughter is a doctor by profession, who said her mother had always wanted to donate her organs. The family itself has talked about organ donation. Donated everything from heart to bone According to the Regional Cum State Organ and Tissue Transplant Organization (ROTTO-SOTTO), the woman’s lungs, liver and kidneys have been donated to an Indian patient. The woman’s heart was given to a Lebanese citizen. His bones were also donated. His liver was given to a 54-year-old doctor in Mumbai, which saved his life. He had heart disease since 2019. Dr. Chetan Kalal, Program Director of Hepatology and Transplant Medicine, Nanavati Hospital, performed the transplant. Spanish women should learn from family Dr Ambedkar of Jaslok Hospital said people should learn from the family of a Spanish woman, who donated her organs without hesitation, that too to a stranger from another country. Doctor said we didn’t even go to him for blood donation, he agreed to it himself. He showed that geographical boundaries cannot stop humanity.

Mumbai has surpassed last year’s number of gastroenteritis cases with 6,677 reported cases so far in 2023. The civic health department has advised against consuming street food to prevent the disease, which is primarily attributed to unhygienic food and water supply. Doctors have also seen a rise in leptospirosis cases and attribute the increase to Covid-19 lockdown restrictions being lifted, leading to more outdoor activities and negligence towards hygienic practices. The BMC has issued an advisory cautioning citizens to avoid wading in stagnant rainwaters to prevent leptospirosis. Mumbai: Only halfway through 2023, and with the monsoon in the city yet to officially arrive, Mumbai has surpassed the number of gastroenteritis cases compared to last year. Data received from Brihanmumbai Municipal Corporation (BMC) showed the city saw 5,539 and 3,110 cases respectively in 2022 and 2021. However, this year till June 11, the civic hospitals have already reported 6,677 cases. In an advisory issued by the BMC, the health department has cautioned the citizens against consuming street food to prevent gastroenteritis. “We are seeing a rise in waterborne diseases-gastroenteritis, hepatitis, typhoid cases. As a precautionary measure, we advise against consuming street food and washing hands or sanitising hands before eating,” said Dr Mangala Gomare, executive health officer, BMC. Private hospitals, too, have reported a rise in gastroenteritis cases. Dr Chetan Kalal, program director — hepatology & transplant medicine, Nanavati Max Super Speciality Hospital- Vile Parle said, their hospital has seen a 25% rise in gastroenteritis cases in the outpatient department. “As the BMC data suggests, we have also observed a notable increase in gastroenterology cases, primarily attributed to the unhygienic supply of water and food. A probable cause for this year’s sudden surge, in contrast to the post-pandemic years of 2021 and 2022, might be the increase in people resuming outdoor activities and negligence towards hygienic practices, thereby leading to increased unhygienic practices,” he said. Dr Kalal added that most of the gastroenteritis cases are either just viral gastroenteritis or Hepatitis A and E or typhoid fever. “Even simple flu or culture illness also causes gastroenteritis in many cases,” he said. Doctors said standard symptoms manifest as vague abdominal pain, nausea, vomiting, and loose stools. Dr Neeraj Tulara, infectious disease specialist at Dr L H Hiranandani Hospital, Powai said the sudden rise in gastroenteritis cases can be attributed to Covid-19 lockdown restrictions being lifted. “Till last year, owing to Covid-19 restrictions, people were not eating outside, and we were not travelling during summer holidays. This year, we are back to the pre-Covid era where people are out, travelling and eating outside food. Many are landing up with gastroenteritis. Also due to scorching heat, food gets spoiled faster and is likely to cause infection if consumed,” he said. According to doctors, most of the patients are recovering in three to five days but there are a few requiring hospitalisation because of severe dehydration. Like gastroenteritis cases, the number of leptospirosis cases has surpassed the 2022 and 2021 numbers. While in 2022 and 2021, BMC data said there were 286 and 224 cases, in 2023 the BMC said 370 cases were reported.Seeing the rise in leptospirosis cases, the BMC has issued an advisory saying one should avoid wading in stagnant rain waters and if exposed, should consult a doctor and take prophylactic treatment.

Hepatitis E is generally self-limiting and, thus, no specific treatment is required. The treatment depends upon the type of hepatitis which includes taking rest, eat smaller nutritious diet, avoid oily food and maintain adequate hygiene. Exposure to various toxins, including industrial chemicals, and certain medicines may cause hepatitis. Hepatitis is a condition characterised by inflammation of the liver. World Hepatitis Day is celebrated each year on July 28, to raise awareness about Hepatitis, an inflammation of the liver, that causes a range of health problems and affect people all over the globe. The theme this year is I can’t wait. According to Dr Chetan R Kalal, chief hepatologist and liver transplant physician, Masina Hospital, Mumbai there are five main Hepatitis viruses – referred to as types A, B, C, D and E. “These five types are the most concerning due to the high burden of illness and death they cause, as well as the potential for outbreaks and epidemic spread. Hepatitis B and C are the leading causes of death, accounting for 1.3 million deaths each year,” Dr Kalal said. Hepatitis A and E are primarily caused by consuming contaminated food and water. Hepatitis B, C, and D are typically caused by contact with infected blood and bodily fluids. In India, viral Hepatitis is a major cause of health-care burden and is now regarded as a threat comparable to the big three communicable diseases: HIV/AIDS, malaria, and tuberculosis. What is Hepatitis? It is a condition characterised by inflammation of the liver. Hepatitis in some cases can progress to severe liver damage and liver cancer. Though alcohol abuse, certain medications, autoimmune diseases can lead to hepatitis, a viral infection is the most common cause. Viral Hepatitis is one of the most common causes of morbidity and mortality worldwide. How common is viral hepatitis in India? According to the reports by the World Health Organization, approximately 52 million people are estimated to be living with Hepatitis B and C in India. The diagnosis rate of HBV and HCV is only about eight per cent and 18 per cent respectively globally. “Another major challenge is increasing the HBV vaccine coverage as it is not a part of a universal vaccination programme. One report suggests that only 55 per cent of health workers were vaccinated against HBV,” Dr Kalal said. Symptoms to watch out for Many patients with Hepatitis infection do not experience symptoms. Symptoms of acute Hepatitis include: Abdominal pain Loss of appetite followed by weight loss Fatigue Nausea and vomiting, yellowing of skin and eyes Itching Joint pain; swelling in ankles and legs Easy bruising and bleeding Dark urine and pale stool Since Hepatitis can cause serious liver diseases, it is important to protect newborns from infection. “At birth, all newborns should be immunised against Hepatitis B, followed by at least two additional doses. It is also necessary to stop the transmission of disease from mother to child. All pregnant women should be tested for hepatitis B, HIV, and syphilis on a regular basis and treated if necessary,” Dr Kalal said. He said that there are several causes of non-viral Hepatitis. Excessive intake of alcohol may result in liver inflammation. The disease may progress to cause severe damage to the liver tissues causing cirrhosis or liver cancer. “Exposure to various toxins, including industrial chemicals, and certain medicines may cause Hepatitis. In some cases the immune system of the body attacks healthy liver cells and causes inflammation in the liver. This condition is known as autoimmune Hepatitis. There are various genetic diseases like hemochromatosis, alpha-1-antitrypsin deficiency, and Wilson’s disease that can results in liver inflammation. Reduction or blockage in blood flow to the liver lead to liver inflammation. Venous insufficiency, shock, and heart failure may result in ischemic Hepatitis,” Dr Kalal explained. All these condition, according to Dr Kalal can lead to serious complications. “Acute liver failure, cirrhosis of the liver, liver cancer, portal hypertension (elevated pressure in your portal venous system that leads to the liver), bleeding disorders and blood vessel inflammation and kidney disease,” Dr Kalal warned. Is there a treatment? The treatment depends upon the type of Hepatitis. “In general, the doctor will recommend taking enough rest, eat smaller meals, nutritious diet, avoiding oily food, alcohol and unnecessary medications, take adequate fluids and maintain adequate hygiene,” Dr Kalal said. Hepatitis A: It is generally mild and does not require treatment. Hepatitis B: In chronic infection, treatment includes interferon injections, antiviral medications, and liver transplant. Hepatitis C: The treatment options for Hepatitis C includes antiviral medications and liver transplant. Hepatitis D: There is no drug or vaccine for HAD. As the Hepatitis D virus requires the Hepatitis B virus for replication, vaccination for Hepatitis B prevents infection from the Hepatitis D virus. Hepatitis E: The disease is generally self-limiting and, thus, no specific treatment is required. Taking good care and avoiding unnecessary medications are usually recommended.  

🍃💪🌈🍎🚴‍♀🥦🌞🌟 Welcome to International NASH Day, a day dedicated to shedding light on fatty liver disease and empowering you to embrace a healthier liver for a happier, vibrant life! 🌍💚✨ In this blog, we will delve into the world of fatty liver disease, exploring its symptoms, treatment options, and the crucial role of FibroScan in diagnosing and monitoring this condition. Get ready to unlock the secrets and embark on a transformative journey towards a healthier liver and an extraordinary life! 💪🩺👩‍⚕🌱 🌿 Decoding Fatty Liver Disease: Fatty liver disease, also known as Non-Alcoholic Fatty Liver Disease (NAFLD), is a condition marked by the buildup of fat in liver cells. It’s a global health concern affecting millions of people. Lifestyle factors such as poor diet, sedentary habits, obesity, and diabetes play a significant role in its development. 🍔🛋💔 🔔 The Telltale Signs to Look Out For: ⚠ Fatty liver disease is often a silent condition, with minimal or no symptoms in its early stages. However, as the disease progresses, individuals may experience the following: 🔸 Persistent fatigue and weakness 🔸 Abdominal discomfort or pain 🔸 Unexplained weight loss or gain 🔸 Jaundice (yellowing of the skin and eyes) 🔸 Nausea and vomiting 🔸 Swelling in the legs and ankles If you notice any of these symptoms, it’s crucial to consult a hepatologist promptly. Early detection and intervention can halt further liver damage and ensure effective management. ⏰👀💡 🌟 The Path to Healing: Treatment Options for Fatty Liver Disease: The good news is that fatty liver disease is largely reversible with lifestyle modifications. Here are key steps to consider: 🔸 Embrace a nourishing, balanced diet packed with fruits, vegetables, whole grains, and lean proteins. Bid farewell to processed foods, sugary beverages, and saturated fats. 🔸 Embrace regular physical activity, such as walking, cycling, or swimming, to maintain a healthy weight and enhance insulin sensitivity. 🔸 Collaborate with your healthcare provider to manage underlying conditions like diabetes and high cholesterol. 🔸 Limit or avoid alcohol consumption altogether, as excessive intake can exacerbate liver damage. 🔸 Quit smoking, as it can contribute to liver inflammation and impair liver function. Remember, even small changes can yield remarkable results in improving your liver health and overall well-being. Your liver will thank you for the effort, paving the way for a brighter, healthier future! 💚🏋‍♀🥗💪 🌈 The Key Role of FibroScan in Fatty Liver Disease: FibroScan, a cutting-edge non-invasive diagnostic tool, plays a pivotal role in assessing liver health. By measuring liver stiffness, it provides valuable insights into liver fibrosis (scarring), enabling the determination of the disease’s stage. Unlike traditional biopsies, FibroScan is painless and delivers instant results. Regular monitoring with FibroScan empowers hepatologists to track disease progression, evaluate treatment effectiveness, and make informed decisions regarding patient care. This breakthrough technology revolutionizes the fight against fatty liver disease, enhancing diagnostic accuracy and patient outcomes. 🩺🔍💛 🌟 Healthy Liver, Healthy Life: The Key Take