UNDERSTANDING LIVER TRANSPLANTATION.

The liver is a vital organ which filters the blood coming from the digestive tract, before circulating it to the rest of the body. It detoxifies chemicals, metabolises drugs and also synthesises proteins required for building muscles, fighting infections and blood clotting.

What is liver transplantation and when is it needed? - Liver transplantation is a surgery performed to remove a diseased liver and replace it with a healthy one. A liver transplant is considered when the liver no longer functions adequately (liver failure). In adults, the most common reason for liver transplantation is cirrhosis and in children, it is biliary atrestia. The other situations are viral hepatitis, liver cancer and hereditary diseases.

The Transplant Team - Specialists from a variety of fields are needed to determine if a liver transplant is appropriate. The team includes:

1. Liver specialist (Hepatologist). 
2. Transplant surgeons.
3. Transplant coordinator.
4. Nutritionist.
5. Physiotherapist.
6. Psychiatrist.
7. Anaesthesiologist.

Checklist for an ideal hospital for liver transplantation - 

1. Meticuluous aseptic measures are required for surgery and hence separate OT facilities with laminar flow.
2. State-of-the-art technology for liver surgery such as the 320 slice CECT angiography and volumetry. Argon Beam are used in combination with tools of liver resection like CUSA and Water Jet.
3. Blood Bank facility available round the clock.
4. Specialised Pathology and Immunology facilities for the investigation of patients of liver transplantation - both doctors and recipients.
5. Dedicated Hepatobiliary Critical Care Unit, a Hepatobiliary physician on call, Anaesthesia staff and a specialised Nursing team.

Liver transplantation surgery - Living donor liver transplant involves removing a segment of liver from a healthy living donor and implanting it into a recipient. This is possible because of the large functional reserve capacity of the liver (70%) and its amazing capacity to regenerate. Both the donor and recipient liver segments grow to normal size in a few weeks. In deceased donor liver transplant, the donor is a patient whose brain has permanently and irreversibly stopped working. The liver is donated, among other organs, with the consent of the next of kin.

A liver transplant operation usually takes six to ten hours. The diseased liver is removed and replaced with the donor liver. The surgeon disconnects the diseased liver from the bile ducts and blood vessels before implanting the new liver. Subsequent post-transplant care at the hospital and at home involves use of medicines to ensure normal function and prevent rejection. Patients typically return to their work, social and familial lives following a successful liver transplantation.

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LEARN TO DEAL WITH STRESS TO AVOID HEART AILMENTS.

Stress has now become a part of life, due to the rapidly changing lifestyles. But, if left unmanaged, stress can lead to emotional, psychological and physical problems. Most importantly, stress is a risk factor predisposing people to heart disease. Among individuals with pre-existing heart disease, sudden stress can lead to heart attacks. Stress also disrupts the lining of the blood vessel walls and increase the clotting tendency of blood. This leads to total occlusion of blood vessels resulting in heart attacks. 

Even in individuals who do not have any heart ailment, long-term stress can lead to blockages in blood vessels leading to fatal heart attacks. Symptoms of stress can vary from individual to individual. Common physical symptoms include sleep disturbances, muscle aches, headache and severe fatigue, while emotional and behavioural symptoms include nervousness, anxiety, loss of enthusiasm and energy, excessive mood changes, over eating  or loss of appetite. There are many techniques you can apply to manage stress, some of which you can learn yourself, while other techniques may require the guidance of a trained therapist.

Some common techniques for coping with stress include sensible eating and drinking habits. It is important for smokers to kick the butt as nicotine acts as a stimulant to stress symptoms as well. Apart from improving physical fitness, aerobic exercise has been shown to release endorphin, which are natural substances secreted in the body that helps you feel better and maintain a positive attitude.  It is also important to set realistic goals and expectations in life and get enough rest and maintain an overall positive attitude in life. In this regard, yoga and meditation helps people to relax better.

It is therefore necessary to determine your stress triggers and learn how to avoid them or manage them in a way that reduces your stress.

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SOUNDS OF NATURE HELPS US RELAX.

Sounds of nature, such as the gentle burbling of a brook or the gushing of the wind in trees, may help us relax by changing our mind and bodily systems, a new study has found. Researchers at Brighton and Sussex Medical School in the UK found that activity in the default mode network of the brain (a collection of areas which are active when we are resting) was different depending on the sounds playing in the background. When listening to natural sounds, the brain connectivity reflected an outward-directed focus of attention. However, when listening to artificial sounds, the brain connectivity reflected an inward-directed focus of attention - similar to states observed in anxiety, post-traumatic stress disorder and depression.

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LONELINESS CAN MAKE YOUR COLD FEEL WORSE.

Suffering from a cold can be annoying enough, but you may feel even worse if you are lonely, say scientists. Researchers from Rice University studied 159 people aged 18-55, nearly 60 percent of them men. Participants were assessed for their psychological and physical health, given cold-inducing nasal drops and quarantined for five days. After adjusting for demographics like gender and age, season, and isolation, the results showed those who felt lonely were no more likely to get a cold than those who were not. However those who were screened in advance for their level of loneliness and became infected - not all of the participants did - reported a greater severity of symptoms than those recorded in previous studies used as controls.

The use of social networks did not have any bearing on how sick they felt. "Previous research has shown that different psycho-social factors like feeling rejected or feeling left out or not having strong social bonds do make people feel worse physically, mentally and emotionally", said Angie LeRoy of Rice University. "You can be in a crowded room and feel lonely. That perception is what seems to be important when it comes to these cold symptoms", LeRoy said.

"The effect may be the same for those under other kinds of stress, anytime you have an illness, it is a stressor, and it would probably occur", said Chris Fagundes.

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LACK OF SLEEP UPS RISK OF BONE LOSS.

Prolonged sleep disturbances due to jet lag or shift work may increase the risk of bone loss, a new study by University of Colorado has found. For three weeks, the subjects went to sleep four hours later than the prior day, resulting in a 28-hour 'day'. The men were allowed to sleep only 5.6 hours per 24-hour period, since short sleep is also common for night shift workers. While awake, the men ate the same amount of calories and nutrients. Blood samples were obtained at baseline and again after the three weeks of sleep manipulation. Six of the men were aged between 20 to 27 and the other four were aged between 55 to 65.

Researchers found after three weeks all men had reduced levels of bone formation marker PINP compared with baseline. This decline was greater for younger men than older men: a 27 percent versus 18 percent decrease. "This altered bone balance creates a bone loss window that could lead to osteoporosis and bone fractures", said Christine Swanson.

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