All posts by prasannaks

Alcohol and liver damage- I drink alcohol regularly on weekend is it going to damage my liver?

I drink alcohol regularly on weekend is it going to damage my liver?

Being a Hepatologist its a common question i come across every day. with the changing attitude and life style most of the professionals and those who are into business live on weekends. And for many enjoying weekend means having alcohol.

To be simplistic and to answer the question my answer would be both YES & NO.

YES because alcohol is not good for liver beyond certain limit, unless i know how much you drink and what you drink and what is your eating habits are like, whats your life style during weekdays i wont be able to say no with certainty. Even your genes matter in this aspect!!

If i have clear answers to above mentioned questions i can give an individualized answer, it may be most of the times NO, but that should not encourage somebody to drink more. I answer would be specifically in reference to liver damage, still those people might face other problems related to alcohol even with weekend binge.

Common nest question following YES answer i face would be is there any medicine i can take to prevent liver damage?

For this my straight answer would be a big NO, some pop LIV 52 to protect their liver with alcohol!!! that sound very funny to me. Just as it has LIV written it doesn’t mean you can live normally consuming any amount of alcohol or that its going to protect your liver like a shield. Still people take it religiously, i cant help it.

If some body still presses for some medicine to protect liver i would suggest at least healthy diet &  healthy lifestyle during weekdays. Regular exercise and a good vegetarian diet would protect you to a great extent.

I hope i have answered the basic questions here.



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Fatty liver is a new epidemic in India, it affects as high as 20-30% of the general population and up to 80% in those with diabetes.

I would try and educate you in Q&A format as it will be simple to grasp. i would try and answer all the common questions one might have when diagnosed with fatty liver


Fatty liver in simple terms is excessive accumulation of fat in liver i.e visceral fat

What causes fatty liver?

to answer this i would explain in short about fat metabolism. when we eat all the calorie which is extra would be converted into fat (triglycerides) in the liver which is the manufacturing unit. this fat is stored in the adipose tissue mostly i.e your belly fat !! but if its constantly high would slowly accumulate in the liver itself this causes fatty liver.

So now you know what causes fatty liver; it’s extra calories you consume. it will be because of two reasons

a. You keep consuming extra sweet, refined sugar in the form of carbonated drinks, alcohol, bakery products etc.. and fried food which in turn is fat directly.

b. You are mostly sedentary, no exercise to burn the extra calories you consume.

Because of these two factors you end up accumulating lot of fat. If some body has other risk factors like diabetes the chances and complications are even more.

There are few more rare causes like hepatitis C, Wilson’s disease, storage disorders to name a few.

I am scared, what will happen to my liver once i am diagnosed with FATTY LIVER

Usually fatty liver is a benign (harmless) condition by itself in most (80%) cases, but has many implications for you in terms of your lifestyle.

Interesting point is mostly fatty liver is diagnosed in 25-40 year age group.

Fatty liver would typically progress over 10-15 years into advanced disease causing complications.

Most common cause of death among patients with fatty liver is found to be heart diseases.

The risk factors for fatty liver like diabetes, increased cholesterol and obesity also causes heart diseases.

once patient is found to have fatty liver should give attention towards his/her lifestyle and is of at most importance

How to get evaluated further once fatty liver is detected on ultrasound?

Once fatty liver is diagnosed in the ultrasound the next best thing would be to consult a specialist (Hepatologist) and discuss regarding your disease.

Doctor would assess regarding the modifiable risk factors and would test for common causes like hepatitis C, increased cholesterol, ceruloplasmin and diabetes. would also do a liver function test (LFT).

According to the test results would advise regarding special tests like Fibroscan


What is the treatment for fatty liver disease?

Fatty liver as i explained above happens mainly due to lifestyle problems. so the mainstay of treatment is life style modification

There is no magic pill available which you can take for some time and cure fatty liver. Fatty liver treatment needs your hard efforts in terms of regular physical exercise and weight loss

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First of all” HAPPY INDEPENDENCE DAY” to all of you

It has been quite some time since you all first heard about MERESIA which started coming up in your whatsapp, facebook pages as we were putting up lots of messages and blogs. I hope most of you have at least seen the posts if not read. In between for last 3- 5 months we were silent and it was with a reason. Here we are again making some nose and this time it is real.

MERESIA HEALTHCARE PVT LTD is coming up with an app in the coming week which will be called MERESIA HEALTH ASSISTANT.

As we all know taking medicines is a nightmare for most of us, to remember it is even worse. Moreover, if one thinks of side effects, what for particular medicine has been prescribed and how it really works, most of us will be clueless. Especially for those who have to take medicines for the rest of their life like in diabetes, hypertension these questions remain haunting forever.

Here we have put in our sincere efforts to tackle this problem with the help of technology. MERESIA HEALTH ASSISTANT app will help you keep list of all medicines and details of when and how to take. It will remind you about medicines at prefixed timings. You all can share the prescriptions; can send messages to your near and dear ones making sure that they take medicines as prescribed.

The exiting feature of this app is it will assist you with health related problems. You can post your queries related to medicines, its side effects, regarding the diseases for which the medicines are prescribed. By doing so you will be clear about your disease and the medicines, you will know about possible side effects and importance of sticking to the schedule.

I know why it is so important to stick to schedule and to know about disease will be your next doubt. You should know that in India and rest of the world antibiotic resistance is a big problem and is mostly due to repeated, improper usage of antibiotics, similarly in chronic disease like in diabetes and hypertension people skip medicines, have irregular timing. All these things over long terms, say over 2-3 years lead to complications like stroke, heart attacks, kidney failure which would have been very well prevented by taking simple steps one of which is taking medicines as prescribed by doctor.

One more important thing is lack of information. In India doctors have limited time to spend explaining about medicines to patients as doctor population ratio is way below global standard. Patients hardly know anything about the medicines they take and its importance, details of their disease and their long term complications. These days few of them who do try to know about their diseases, complications and medications resort to Google which has answers but hard to understand. MERESIA is trying to bridge this gap with this app. People can get answers to their queries from experts in the field which is reliable and in a way which they can understand. We believe information/ knowledge will enable each patient take control of their health in a positive way leading to a healthy and happy life.

In the long run we shall try and improve this as per your requirements, suggestions and response. Just wait for a week and MERESIA will be on your smart phones to assist you.

We are taking the first step in this long journey ahead and hope all of you will join us and help us in this journey and make it a success. MERESIA intend to help people in all possible ways to be healthy and happy.



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I drink for my liver, Doc: emerging evidence that coffee prevents cirrhosis

This is link for a new study which explains benefits of coffee in liver disease patients.

In the current era of nonalcoholic liver disease epidemic its very important that we keep check on our lifestyle, coffee may be one of the good think we can include in our habit.

Recently there are many more studies supporting same.


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Online doctor appointment booking- the way to go

At present to consult a doctor one has cross many hurdles before reaching the right place.
First, problem is which doctor and which speciality to consult.
Once you decide that with difficulty and multiple opinions, the next worry is about standard of care you get in these places.
Finally after deciding the right speciality and doctor the biggest hurdle will be to actually get an appointment.
To get an appointment itself you will have to spend lot of time and money, at the end you may end up getting an appointment a month later.
Technology has played a great role in solving similar problems in day to day life. You can book a ticket online so also rooms in hotels, flight tickets etc..
Technology has not yet found a significant place in healthcare. There are some platforms for appointment booking like practo and lybrate and they are solving this problem to certain extent. However healthcare is about continuing care of sick patients which needs much more than just appointment booking which needs to be addressed.
Even though you can book appointments through above mentioned portals there is no suggestions about whom to select and which speciality to go to which you will have to decide before booking the appointment. My strong feeling is that this problem can be solved with technological developments, like artificial intelligence or just even by creating simple algorithm.
There are many advantages of this online appointment booking
1. Can look out for suggestions about which specialist to consult based on your symptoms/ problems
2. You can choose doctors based on your preferences like experience of doctor, patient rating, doctor’s achievements etc…
3. You can choose the doctor nearest to your place by which you can save travelling time and money
4. Can save lot of time too as you will know exact time of your visit and even the doctor has idea about time of appointment.

With above mentioned advantages its obvious that this trend will grow over time and will become better.
We are coming with, a portal aiming to solve healthcare related problems our nation is facing including online appointment booking. Our efforts will address all the above mentioned problems and make healthcare better, reachable and affordable in the near future. Only a healthy nation can be a wealthy nation is our belief and our team at is working on this to realise dream of healthy India.

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Rota virus vaccine to be launched in four states by government soon!

Indian government is preparing to launch rota virus vaccine on trial basis in four states, Odisha, Haryana, Andra Pradesh and Himachal Pradesh on 26th March.

It is very important as presently, more that 1.50 lakh children die in the country due to the disease every year, of which rotavirus accounts to 50 per cent of the deaths

The government, along with Unicef, Bill & Melinda Gates Foundation and other stakeholders are launching the rotavirus vaccination programme and an estimated 8.53 lakh children under the age of one year will be administered the vaccine annually

This vaccine prevents diarrhea in children which is common cause of death among pediatric age group.

This will be a major step ahead towards a healthy India.


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Chronic hepatitis B- what should we know?

Chronic hepatitis B is a challenging problem in the world more so in the south East Asia region. India has intermediate prevalence of hepatitis B. Mostly it is transmitted from mother to child at the time of birth. Even after birth horizontal transmission in the family (with in family members) is quite high. As chronic hepatitis B is usually asymptomatic (without any problems) till adulthood this condition is diagnosed at a later stage i.e. liver failure.

Once chronic hepatitis B is diagnosed it is very difficult to decide on treatment, whether patient requires treatment or not. There are many guidelines but are different slightly in their indications for treatment.

Mainly ASSLD (American association for study of liver diseases) guidelines are followed. In simple terms once patient is diagnosed to have chronic hepatitis B following tests needs to be done.

Quantitative hepatitis B DNA levels

HBe antigen and antibody

Ultrasound abdomen

Liver function test

Serum creatinine

Based on results of these tests one has to decide on treating hepatitis B. In those with HBe Ag +, DNA levels >2000 IU/L, age >30 years and In those with HBeAg  negativity, DNA levels>20,000 IU/L antiviral treatment is indicated.

In case of chronic liver disease in ultrasound or in those with decompensated chronic liver disease, treatment is indicated irrespective of e Ag status or DNA level cut-off.

At present best available antiviral for hepatitis B are Entecavir and Tenefovir.  Economy mainly determines which is to be started as both have good efficacy and high barrier for resistance. These drugs have minimal side effects, Tenefovir can cause renal tubular defect rarely. It’s advisable to check serum creatinine and calcium once a year in those who are on Tenefovir.

Once patient is on treatment it is advisable to check DNA levels once a year and SGOT and SGPT once in 3 months.

Beyond 40 years of age those with chronic hepatitis B should undergo ultrasound abdomen as a part of hepatocellular carcinoma surveillance.

Once started on antiviral for all practical purpose treatment is to be continued for life long. Except for in specific conditions like in those who attains HBsAg loss can discontinue therapy.

One more important condition where in antiviral to be started irrespective of DNA levels is in those with malignancy planning chemotherapy or in those with diseases requiring long term steroid therapy. In these cases treatment needs to be continued for 6 months after discontinuing chemotherapy or steroid. This is to prevent acute flare which may be even life threatening rarely.



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Affordable health care

Affordability is the crux of most of the things we come across in our life. Government has been trying to fix the problem for the last 60 years but mostly unsuccessful. Most of the problems arise due to the sheer number (1.25 billion) and corruption India has in public funded services. As opposed to this in most of the industrialized countries the government takes care of health of its people by enlarge at a premium this makes health care affordable to citizens and is of equal standard to all.

In India affordable healthcare is available mostly only in the government run hospitals which is visited mainly by those who otherwise do not have money to afford a private hospital which leads to over burdening of those hospitals adding to this it is very difficult to get a qualified doctor in these hospitals due to many reasons (which can be a blog by itself) leading to compromise in the quality of healthcare in those hospitals (except some premier institutes).

With above mentioned problems is there any alternative permanent solution which is unique to India is the biggest question of the hour because, India is poised to become a developed country in the near future but without a well established healthcare system in the country it may be a difficult goal to achieve as only healthy people can build a healthy and wealthy nation.

If we can’t establish a affordable, standardized, easily accessible system soon it may create a challenge as India is economically growing the lifestyle related disease burden is significantly increasing. This may lead to significant increase in healthcare related expenditure and loss of quality of life.

As government is striving hard to have universal health insurance cover in the country for a long time if we can bring in technology which is playing crucial role in all aspects of life may augment this much needed revolution, I term it as “orange revolution” (as orange colour stands for vitality).

Technology can take healthcare to most remote places of our country, can improve medical data maintenance, can help standardization and at the same time can make it affordable as the patient can save time and money in travelling along with his work which can increase productivity significantly.

Here is an effort by us, to integrate technology into healthcare to make it affordable, to improve quality of care, to take it to the nooks and corners of our country and to better handle chronic diseases which eats into our nation’s productivity.

Please follow and like us: is a concept which is taking its shape to revolutionize healthcare scenario in India. Aim is to transform the way medicine is being practiced, to improve quality of care and make it affordable and available to each and every Indian.


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