What Is Liver Cirrhosis ? Symptoms, Treatment & Causes

What Is Liver Cirrhosis ? Symptoms, Treatment & Causes

What is Liver Cirrhosis?

Cirrhosis is a type of chronic disease (slow processing) that’s relative to the liver. Cirrhosis is identified when the cells of the liver are getting replaced by fibrosis (i.e. fibrous thickening of tissue) or the replacement of normal tissue with scar tissue. Basically, cirrhosis leads to damage to our liver and their functions. The liver plays a significant role in metabolism, detoxifying harmful substances, purify the blood and also including bile production and excretion too. Mostly, cirrhosis caused in alcoholic person and also more chances in a patient of viral hepatitis (B and C).

By examing and performing various experiments the medical science finds out a way to limit the further effects of cirrhosis but still cannot be able to cure. The ultimate way to rescue from cirrhosis is liver transplantation.

Globally, At present, there are more than 1 million cases of liver cirrhosis are.

 

Symptoms of Liver Cirrhosis

  • Joint pain
  • Fever
  • Fatigue
  • Vomiting
  • Abnormal personality
  • Neurologically deprived
  • Hepatic encephalopathy
  • Peripheral neuropathy
  • Asterixis
  • Integumentary
  • Jaundice (icterus)
  • Spider angiomas
  • Palmar erythema
  • Purpura
  • Caput medusa
  • Itchy skin
  • Gastrointestinal
  • Dull abdomen pain
  • Dyspepsia
  • Fetor hepaticus
  • Flatulence
  • Varices
  • Gastritis
  • Gynecomastia’ testicular atrophy
  • Hematemesis
  • Feel like overeating
  • Hemorrhoidal varices
  • Digestion problem
  • Increase size of liver
  • Loss of appetite
  • Hematologic
  • Anemia
  • Thrombocytopenia
  • Leukopenia
  • Coagulation disorders
  • Splenomegaly
  • Metabolic
  • Hypokalemia
  • Hyponatremia
  • Hypoalbuminemia
  • Fluid retention
  • Peripheral edema
  • Ascites

 

Causes of Liver Cirrhosis

  • Hepatitis B
  • Hepatitis C
  • Biliary atresia
  • Wilson’s disease
  • Fat accumulated in the liver
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Infection (schistosomiasis, peritonitis)
  • Enlargement of the spleen (splenomegaly)
  • Portal hypertension
  • Esophageal varices
  • Malnutrition
  • Bone disease
  • Gallstones
  • Heart failure
  • Obstructed blood flow
  • Hormonal imbalance
  • Production of toxins
  • Prevent the functions of protein and drugs too
  • Non- alcoholic fatty liver disease (NAFLD)
  • Non- alcoholic steatohepatitis (NASH)
  • Greater chance of Liver cancer

 

Prevention of Liver Cirrhosis

  • Stop or reduce intake of alcohol
  • Focus on the balanced diet
  • Less intake of salt
  • Less intake of sugar too
  • Prevent from taking of non-veg and spices.

Tests to be Performed for Liver Cirrhosis

  • Blood test
  • Liver function test ( ALT, AST, ALP)
  • Creatinine
  • Hepatitis B And C
  • Imaging test (CT, MRI, ultrasound, MRE)
  • Biopsy
  • TREATMENT
  • Endoscopy
  • Medication
  • vaccination
  • Rehabilitation
  • Consume diet with low sodium content
  • Avoiding nonsteroidal anti-inflammatory drugs
  • Hemochromatosis (reduce the levels of iron)
  • By the excretion of copper in urine
  • Liver transplant

 

Conclusion

The liver is the most workable organ within our body, performs various functions relating to circulation too. The liver performs both functions like production and excretion too.

LIVER CIRRHOSIS is the most advanced form of liver disease that’s related to generally drinking alcohol and viral hepatitis B and C. Liver cirrhosis occurs when the liver cells are killed or injured, and after that when the inflammation occurs, the injured want to repair itself by forming scar tissue that consequences in forming new liver cells in clusters form that leads to regeneration of nodules of liver within the scar tissue.

The disease is a part of the progression. It may start with the fatty liver disease, then progress to alcoholic hepatitis, and then to liver cirrhosis.

Liver cirrhosis main identified by jaundice, loss of appetite and fatigue. There are various types of complications occur in liver cirrhosis including liver cancer.

Diagnosis of liver cirrhosis can be started firstly with examing patient history, family history also, the vital signs (physical examination), blood test, and we can also perform complete diagnosis by confirming liver cirrhosis by performing the liver biopsy.

Treatment of liver cirrhosis prevents further damage to the liver, liver cancer, other complications related to liver cirrhosis and other adjacent organs from any damage. By suppressing the immune system by prescribed medications like prednisone and azathioprine to prevent further inflammation related to the liver in such as autoimmune hepatitis.

We can’t cure liver cirrhosis, but we can provide treatment to the patient as medication and further types of test like endoscopy. The best recommendation for the liver cirrhosis patient is to liver transplant surgery, still, the medical science working on the curing of liver cirrhosis by medications and some other remedies.

 

” SISTER, BP CUFF! SISTER, GRABS! SISTER ROUNDS! “

” SISTER, BP CUFF! SISTER, GRABS! SISTER ROUNDS! “

Med school! Hospital!!
Everyone in chaos. Sisters, interns, residents, consultants. Everybody in a constant race. Each one of them has their own story.
“sister, bp cuff!  Sister, grabs! sister rounds!
Gosh! Sister, why the hell isn’t this monitor working?? Sister, this! Sister,  that! Omg!! The sisters are a way too clumsy man,” utters the intern.
And here the sisters are in hustle always. Continous running, loading medicines, withdrawing samples, dressing, preparing for dispatch, doing everything in the permitted time. Too much of rush.

Interns,  the beginners, super fresh in their carrier are not much in less haste. Within a week of joining,  get completely used to the new world. The day starts in a haste to reach the rounds without a time for breakfast. After finally finishing writing progress and collecting reports and even before feeling a bit glad to have skipped breakfast for their service, it’s a time to get a complaint about not being responsible towards patients. “Omg! Interns like these kill the patients, says your consultant. When I was on your phase, I solely looked after the ward and opds too”, adds the resident. Interns are under the constant pressure from almost every one,  starting from sisters to consultants. Sometimes more of a paperwork make them forget their profession. Running the entire day, they wanna get through every procedure. But their hard work and sleepless nights are always overruled by the silly mistakes, immaturity and the little ignorance which is definitely not acceptable in our beautiful world of healing. Neither the Residents are free of this vicious cycle. Well,  they are at the top to have the uncountable number of mishappenings and acquaintances at the end of residency. PG’s, the fastest runners of the medical marathon, responsible for every misshapenness and aberrations in their respective wards, from the cleanliness of ward,  infrastructures, patient progress and many more. Never too prepared for the rounds,  always sort of knowledge which seems and is definitely very basic to the consultants. In spite of daily learning,  insistent practice, hard work, they are still miles away from getting pro. On their attempt of getting more serious,  they often land up in misunderstandings with residents of other departments. Their best decisions for their patient are most of the times mistaken irrelevant and inessential investigations or consultation or expert opinion to the counter residents and vice versa.

And again,  cutting off some of them with an intention of helping out your copartners would again label you a negligent one. You are always in a hit to be so incompetent to the duty. They complete the entire residency in chaos and even at the end,  they are labeled as not very compatible.
Completing postgraduate doesn’t even ease you out or relieves you of pressure. Rather you ought to be more responsible and handle your juniors. Entire hospital is in your hand and you can’t afford a slight carelessness towards the patient. What you call little creates a huge difference in the treatment protocol.
Finally,  its all about life. Its all about healing and curing. You do your level best,  keep running and yelling and complaining and blaming to finally be a better healer,  better soother. You shout at others cause you to feel your way of healing is better and vice versa. All of us are on a single journey with one single motive but with different roads. It’s not easy to know others journey without walking on their shoe. Let’s complain less, be more kind and only a little more understanding. Afterall, all of us have a single aim. Better healing and curing!!!
EXPERIENCE AS AN INTERN

EXPERIENCE AS AN INTERN

 

 

Being a child, I was always afraid of doctors. They always seemed like a demon with a sword ready to pierce me through. But the reality would be just a simple man, wearing a bright white coat and standing right in front of me with a 2cc syringe. I never thought of them as a demon because of their deeds but the fact that they had a needle in their handmade my imagination go crazy. After all, I was just a normal kid waiting in the queue to get my routine vaccines and also watching every kid come out of the doctor’s cabin crying their lungs out, made my heart skip a beat. Those were the days when I had sworn to never get close to a doctor and here I am today, standing in a bright white coat, with a Littmann around my neck, entering my OPD for the very first time as an INTERN!

 

Every senior doctor will tell you that these twelve months of your life will help you decide your future course and with no surprise, it did help me understand what I really wanted in life.

 

So I started my internship with the department of community medicine. Little did I know that this would be the time when I would learn the most. Yes, it was this period of two months that taught me the most valuable lesson of my life – humanity. I can still remember my first day and my very first patient. She was a 70years old granny, a known diabetic as well as a hypertensive for the past 20years, came for her routine checkup. Her name was Mrs. Lakshmi. I clearly remember her peculiar voice and her interest in her medicines. She was an active woman with all the knowledge about her drugs as well as her doctors. She very well knew about the system of our department. She was aware that every two months the PHC would have a new batch of doctors, which is why she made sure her new doctor thoroughly went through her history and did n’t mess up with her medicines. This was something rare for an uneducated lady to do and also the reason why I remembered her so well. She made me nervous, as I was a beginner. I did not want to fail in any circumstances. Later, after reading her records, I handed her the prescription with my name and initials signed on it. She smiled with gratitude, with a blessing in return. That was the moment which made me realize that my journey had now begun. I spent two months traveling to various villages, set out camps, provided health education, distributed free drugs to those who need it. And that’s when I learnt that there are endless people who need medical help and also people who are unaware of their illnesses needed  education and our duty is not just to sit within four walls and sign off prescriptions, our duty includes to stretch a hand of humanity towards those who are suffering and bring them to a better world and at least try to give them a better life to live . I learned, we doctors, are the ray of hope they were in search of.

 

After completing a posting filled with mixed emotions, I entered the world of surgeons. General surgery was my next department, where I saw myself turning into the imaginary demon I was once afraid of as a kid. Every procedure I did, every step I took, involved my patient under a scalpel. My hands were shaking as I assisted my professor for my first surgery. I was all decked up and a tad bit excited to read my name on the surgeon’s walls for the scheduled surgery. But, the first time I had to bury my gloved hands into someone’s wound made me obnoxious. I felt miserable for the patient. Had just one question throughout my surgery, “God, why must a human suffer so much ?” I could barely concentrate on what was going on. I had a sigh of relief once we closed up. Happy for the patient who had made it, but still a thought in the back of my mind – what if he wouldn’t have?

 

As days passed, my hands stopped shaking and my thoughts started diminishing. I started emphasizing learning how to save a life. There were no options apart from reading those huge books which would weigh more than a sack of rice and to practice the art of butchering. While I was a student, I would often hear doctors being referred to as a butcher. I used to get offended. But today, while I stand wrapped in my gown, with my patient completely sedated, lying down with his fate in my hands, I don’t feel less like a butcher. The only difference is we save lives.

 

Weeks after weeks, I started feeling strong and confident in what I did. The feeling of helping people cure their illnesses started growing on me. It was a magical land where drugs would do the magic and a surgery would cut the illness totally where and when required. I shifted from general surgery to orthopedics, and then kept moving to other departments as in the routine, and I could feel the magic of a scalpel until I entered the department of obstetrics and gynecology. Being in gynecology didn’t make me feel any different from being in any other surgical department. But what changed my complete mindset was the department of obstetrics.

 

My first few hours in obstetrics gave me a panic attack. I was in shock to see patients screaming in pain. I took a minute to see all around the department and realized this is something beyond the magic of a scalpel. I can’t help the ones crying for help. I just can not sedate them and cut them open to cure them. I felt very helpless. All I could do was console each and every mother and wait with them for the birth of their precious ones. I could see them struggling for hours together. And their struggle taught me to tranquilize my temper and be patient. After all, it was I, who could cheer them up and regain their confidence in the process they were going through. I could not wait to deliver a baby, but at the same time, I could not rush at any given cost.

Alas, it was time to conduct my first delivery. It was something I had to do without a scalpel. My hands had to be steady but tender. This time I was not about to cut an odious part of her body, but bring out the little one who has been growing in her womb for the past 9 months. This journey of mine continued for days together. I shared a very strong bond with each and every mother I came across. Each one was special. The joy of bringing another life into this world was incomparable to any other feeling I had ever felt. But as we all know, life is not a bed of roses. They always have thorns in it. And this time I was pricked by a thorn when I was informed I have to hold a scalpel in my hand once again. It was time for my first cesarean. Something I knew I would come across, but hoped I would never have to. Because unlike other surgeries, this one had another life struggling between my patient and my scalpel. I had to help protect a life unseen. As we painted and draped the patient, we prayed for the betterment of the little one who is yet to see the world. As we cut open in search of the juvenile soul, I could once again feel the pressure and fear which I had felt on the day of my very first surgery. This time the pressure had turned more intense and I had a sudden adrenaline rush to see the angel face safe. This was not something which was growing on me. Unlike my previous postings, this time I was not getting stronger with time, but I was definitely getting better with my skill. The task to get the mother and child safe from the surgery had become easier, but the worry I had before each every incision never reduced. I still pray before I start operating on a mother. I still feel the responsibility of keeping the mother and her offspring safe. There were sleepless nights, which I never regretted. Continuous duties which never stopped me. My journey in this department was like a roller coaster ride, where I  had numerous state of excitement which always encouraged me to move forward. I just wanted to stay back in the department, because for the very first time I felt like this is where I belonged.

 

It was my last day in the department as well as my last day as an intern. I had no emotions to express as I was going through my last few hours. That day we all sat together, recalled memories of our entire internship. All I could think of was how badly would I miss this department. As my seniors always used to say, this is when I would realize what my future holds for me, I agree with them, because  I have realized what I want my future to be.

 

Twelve months of the internship was nothing less than those twelve years of school life. We gradually learn as we grow. And that’s exactly what happened with me. It was the most difficult ‘goodbye’ of my life. Tears rolled then as they roll now while I conclude sharing my EXPERIENCE AS AN INTERN.

 

 

JOURNEY OF MY M.B.B.S

JOURNEY OF MY M.B.B.S

For starters, I want to share my experience with students who want to go on this route and with people who are just curious about what it’s all about – Becoming a doctor.
 I still remember the first day of landing to medical college; the cheerfulness, happy moment, excitement and dream that everybody carries to become a doctor.
Well, my journey was both sweet and sour. The first phase is one of the important years I believe, That is when students have to acclimatize to the new environment. Nevertheless, it’s the year when everyone is ready to get kick started to become a doctor. Everyone is usually more focused during the first phase and eventually, some people start drifting away from their goals. I can’t say that’s the worse thing in the world since that’s how most of us learn the major life lessons. However, I would say getting a good grip on the first phase subjects anatomy, pathology and physiology go a long way. They make the foundation for a smooth journey ahead. I must add, I am not saying that biochemistry isn’t important. Each and every subject carries its own importance. What I see, in the medical field seniors are the motivators, guides and helpers.there are so many books and every writer had their own opinion regarding the books. and they help us in choosing the finest book to read and pass an exam. I love to read ROBBINS PATHOLOGY and GUYTON’S physiology.these book changed the way what I saw in the entire medical field, Guyton telling the all the normal physiology that happens in our body where Robbins explained the detail possible cause where physiology goes wrong to cause disease. studying these books throughout the first phase of my basic science tells me the start from normal physiological cell to the concept of a necrosed cell.
The first year is very fast but at the same time its sort of slow. It might be because its hard to forget the memories made especially during this year. The big transition from school to college is difficult to forget for the most of us. Then comes the second year, which is 1 years long on TU. Well, my biggest mistake was to think “Oh no biggie, I have a lot of time to hit the books.” I was wrong. this year we have to study all system remaining after the first year. Pathology and Anatomy is a major subject of the second year and its best to get a head start rather than waiting until the end. In my opinion, the best case scenario will be a student who not only focuses on the second year subjects but also adds medicine to pathology. Worse case scenario would be waiting until the end to open books!! Well, this is also the year when students start planning trips and enjoying college life. Have fun but don’t overindulge to a point that you can’t come back.
The third year is the easiest year I think. But also because I studied decently throughout the year and it’s very feasible. The holy grail of M.b.b.s is the fourth and final year. Its the hardest I believe. Mostly because practicals weigh just as much as theory, and I was always terrified of vivas. So focus on both theory and practicals. Attend the clinical postings from the third year onwards and be well equipped with the history taking skills.
The internship is one year long. That’s when most of the students learn the basic procedures and get a good taste of the hospital life specifically being on call or night duties.
Moreover, I believe that my medical journey was both sweet and sour.W e are not alone in the journey there is a lot in the world who are with us on the journey. I want to share  a great word by ARISTOTLE
  -“NO GREAT MIND EVER EXISTED WITHOUT A TOUCH OF MADNESS”
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