Inaugration of Liver Foundation

The liver foundation was inaugurated on 20th Dec, 2009 at Gemini continental. The inaugural function was followed by launch of official website for the foundation. A 24x7 active helpline and Foundation’s blog was introduced to make doctors and patient networking effective. A unique software for management of records of patients with liver disease was launched. This software will be regulated amongst all the treating doctors in our network, so that better patient.

Internationally accepted guidelines for treatment of liver disorders were also discussed in order to implement the Foundation’s idea of following uniform line of treatment by doctors. Patients with liver disorders like liver cirrhosis,Hepatitis C were also invited to be part of active interactive session.Various issues related to patient care improvement were suggested and discussed by the doctors.

The need to create a separate body in the form of Liver Foundation was felt in a meeting of Gut Club held on 9th September 2008 in Lucknow. Here several members suggested that liver diseases (LD) have become very common in recent times and hence proposed the creation of a separate body that would concentrate on tackling liver diseases in U.P. The first meeting of liver foundation was held on 18th October, 2008 at Gemini continental to discuss the creation of Liver Foundation, Lucknow and was attended by leading Gastroenterologists and physicians from all over state.

Covered in Lucknow editions dated 21st Dec,2009 of following newspapers:

Hindustan Times

i-NEXT

Rashtriyasahara

Amar Ujala Mycity

Madhu and her new Liver

Madhu is in the 5th year of her new life. She had alsmost reached her end because of her failing liver, when on 14th February 2004, a new liver arrived in Lucknow almost by miracle.

She had been a healthy homemaker and mother till 1994 when she had an attack of jaundice. Unlike the common ones that pass away on their own, this episode, was persistent. One doctor after another and with one herbal tonic to be replaced by another, she finally reached the SGPGI. Tests revealed that her chronic liver ailment was not due to the common infective viruses B or C but due to a rare condition called autoimmune hepatitis, a condition in which the body’s defending cells and immune system start attacking its own organs, in her case, her liver.

Autoimmune hepatitis is somewhat rare: it accounts for 2% of all prolonged cases of hepatitis or liver cirrhosis. It affects women 5 times more often than men, and needs awareness for timely diagnosis. If detected on time, the disease can be controlled with immunosuppressants like corticosteroids.

Madhu had reached us somewhat late and a portion of her liver had already permanently damaged. She was however treated with immunosppressants to preserve the viable portion of her liver. She had her ups and downs, but remnained largely well for almost 8 years. By 2002, her liver had become weak; she had water in her abdomen, swelling of her feet and side effects of the medicines as well. It became obvious that only a liver transplantation could get her back to life and health at that stage.

Her husband, a bank emplyee, tried all he could; he consulted various liver transplant centers in India, offered to donate a part of his own liver and took large loans to provide for the increasing costs of her treatment. Unfortunately he was found to have fatty liver that was unsuiatble for donation, and his abdomen was closed. With that almost all hope diasappeared, as there were no suiatable relative in Madhu’s home who could donate her a part of his liver.

On 13th March 2004, a man who was on a ventilator in one of the hospitals in Delhi following an accident, was pronounced brain-dead. Under such trying circumstances, his relatives gallantly agreed to his liver being extracted for donation to a needy person. Dr Peush Sahni from AIIMS extracted the liver, and flew into Lucknow on 14th morning. Madhu was taken into the operation theatre and Dr Rajan Saxena and Dr Peush transplanted the new liver into Madhu. That indeed was destiny! The relatives of the donor were magnanimous enough not to seek publicity for saving someone else’s life, and requested anonymity.

Madhu continues to be well 5 years on. Her daughter got married this year. Madhu and her husband, and 5 more such heroes from Lucknow who have been through liver transplantation, have offered to provide counselling to patients and their relatives facing similar challenges, a service which we plan to provide through the Liver Foundation of UP that kicks off on 19th of this month

Hepatitis B:Is your family protected?

When Siddharth, a 22 year old, went to donate blood for his mother’s treatment, he was shocked to hear that he harboured the Hepatitis B infection! He was fit, played for his college cricket team and had not sufferred from jaundice. Hence his disbelief!

Hepatitis B is usually a silent infection. This year’s global awareness campaign “Am I number 12?” was aimed at drawng attention to this frequency. In India, the rate is somewhat less; 43 of 2500 apparently healthy people tested positive during a free checkup camp in the city. Around 20-40 million people in India are infected, 6 to 10 times more than HIV. It spreads through infected reused needles, poorly tested transfused blood, sharing of instruments such as shaving blades or ear piercing needles, from a “carrier” mother during child birth, or unprotected sex with an infected person.

What makes Hepatitis B worrisome is its silent nature for many years during which the virus nibbles away at liver cells, leading ultimately to liver failure (cirrhosis) or liver cancer. These individuals feel quite normal for years. When symptoms do appear, much of he liver is already badly damaged!

Siddharth was lucky to be diagnosed before his liver was damaged; he was put on medications with which the infection is now well suppressed. His mother, who had vomited blood, was diagnosed to have cirrhosis from a prolonged infection with the virus. His younger brother also tested positive, both children having probably acquired it from her during child birth.

Screening test for Hepatitis B has become a standard recommendation during antenatal checkups so that the newborn of a “carrier” mother can be protected with immediate vaccination and Hepatitis B immunoglobulin injections just after birth. It is however hardly followed as facilities for testing are not available in most government hospitals, community and primary health centers. Routine vaccination of new borns with the vaccine (cost Rs 8/- per pediatric shot, 3 shots required for full protection, after 1 and 6 months of the 1st) has still not been included in the government vaccination schedule in most parts of India. More than 150 countries, some less economically developed than ours, have adopted it and brought down the infection rates drastically.

The vaccine used to be fairly expensive, costing Rs 1500/- for 3 adult doses. With many companies manufacturing it, the cost for 3 doses has dived to around Rs 50/-, for a lifetime of protection. In spite of this, we found that only one third of school students in Lucknow had received the shots. The rates were as low as 0 to 6% in rural schools. The issue is less about cost now, and more about awareness. While the Gates and other foundations have helped spread awarenss about HIV infection, Hepatitis B, which infects and kills more than 10 times as HIV, is at large. HOPE Initiative, a Lucknow based organization,with support from Bristol Myers Squibb(BMS) Foundation ,through its unique B-Rodh project, is sending this message to 5 lac children and their families in Uttar Pradesh. You can become B-safe @Rs 50/- for your lifetime, certainly a worthwhile investment.

Article Published in Hindustan Times Lucknow City(October 25,2009)