Information on Liver Diseases

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BEWARE! - LIVER FOR LIFE!

• World Liver Day 19th of April
• GI Rendezvous - 2019

Dr. Gurbilas P Singh
https//gastroenterologyservices.com/
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Campaign for Healthy Liver
Dr. Gurbilas P Singh
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Discussion points

• Why is World Hepatitis Day important?
• Why we come here to speak about it?
• What is the take home message?
• Are we any wiser?
• What are the dos to have a healthy liver?

Dr. Gurbilas P Singh
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What does the liver do?

• Hard working organ doing hundreds of complex
  functions
• Fighting infections and illness
• Regulating blood sugar
• Removing toxic substances from body
• Managing cholesterol levels
• Helping blood to clot
• Helps in digestion (particularly fats) with bile.

Dr. Gurbilas P Singh
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Liver Diseases causes

• Alcohol
• Hepatitis B
• Hepatitis C
• Drugs and diabetes
• Obesity

Dr. Gurbilas P Singh
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Alcohol and Liver diseases

• Liver diseases in USA 40 secondary to alcohol.
  More than 60 of the population over 18 years is
  taking alcohol.
• No safe limit of taking alcohol known.
• Females and youngsters livers get affected more
  readily!

Dr. Gurbilas P Singh
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United Nations Office on Drugs Crime (UNODC)

• Critical age for the initiation of substance
  abuse
• Early to late adolescence (12-17 years).
• Peak among young people (18-25 years).
• Global deaths directly caused by drug abuse have
  increased by 60 from 2000 to 2015.

Dr. Gurbilas P Singh
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INDIA Substance Abuse Stats

• According to a UN report, 1 million heroin
  addicts are registered.
• Unofficially, there are as many as 5 million.

Dr. Gurbilas P Singh
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Punjab Drug Abuse Stats

• According to a survey, 66 of the school going
  students in the state consume gutka or tobacco.
• Every third male and every tenth female student
  have taken to drugs.
• Seven out of ten college-going students are into
  drug abuse.

Dr. Gurbilas P Singh
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Hepatitis B and C - Spread

• Sharing of infected needles
• Receiving infected blood
• Accidental exposure to infected blood

• Hepatitis B is preventable
• (Vaccination available) and treatable!
• Hepatitis C is treatable

Dr. Gurbilas P Singh
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Hepatitis B

• 100 times more infective than HIV
• 45 of worlds population lives in high
  endemicity area for this virus.
• 350 million across the world are chronic carriers
  of this virus.
• 25 of these will go on to have chronic liver
  disease (Cirrhosis). Hence leading cause of
  Cirrhosis.

Dr. Gurbilas P Singh
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Hepatitis C

• Almost 3 of world population infected
• Free treatment in India and newer drugs are very
  effective
• No vaccination
• Second leading cause of chronic liver disease
  (Cirrhosis)

Dr. Gurbilas P Singh
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Drug Induced Liver Injury(DILI)

• Over the counter drugs!
• Unnecessarily prescriptions (patients in
  control)
• Indiscriminate use of alternative medicines
  without prescription
• Substance abuse

Dr. Gurbilas P Singh
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DILI

• gt 1000 HEPATOTOXIC DRUGS
• Predictable dose related, frequent
• Unpredictable not dose related, rare
• Immune mediated
• Idiosyncratic

Dr. Gurbilas P Singh
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NAFLD (Non Alcoholic Fatty Liver Disease)

• Fatty Liver (no symptoms)
• Blood tests, Ultrasound scan, Other imaging(Fibro
  scan,
• CT scan, MRI scan)
• Fatty Liver is one end of a spectrum which can
  lead to Hepatitis (inflammation of liver) and to
  chronic liver disease (Cirrhosis)

Dr. Gurbilas P Singh
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NASH Non Alcoholic Steato Hepatitis

• Associated with
• Obesity
• Diabetes
• Metabolic (hereditary and acquired)
• Drugs

Dr. Gurbilas P Singh
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Non Alcoholic Steato Hepatitis - Prognosis

• 15 50 --severe fibrosis
• 20 -- Cirrhosis
• Progressive liver disease within a decade of
  diagnosis

Dr. Gurbilas P Singh
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PROTECT YOUR LIVER

• Vaccination
• Avoid alcohol
• Diagnose diabetes early (screening and health
  checks) and treat appropriately
• Active life style with regular exercise
• Be vigilant and go to standardised places for and
  medical surgical procedures

Dr. Gurbilas P Singh
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Gastroenterology Services
Gastroenterology Hepatology Liver Specialist
Gastro Physician

• Dr. Gurbilas P. Singh practices at
• Jeevandeep, Centre of Digestive Diseases (No. 88,
  Sector, 16A, Chandigarh)
• Paras Hospital (Panchkula, Haryana)
• Apollo Clinics (Sector 8, Chandigarh)
• He also provides clinical services and is
  Director,
• Education Training at
• Sarvhit Gastrocity (Smt. Paarvati Devi Hospital,
  A-Block, Ranjit Avenue, Amritsar)