The words 'great' and 'passing' show up interesting expressions; characterizing any demise as 'great' may on a superficial level seem unreasonable. However we all working in medicine will have seen persistent passings which in some sense were 'better' than others and, whenever pushed to ponder our own mortality, recognized angles we would welcome at our own demise: family at the bedside, great torment control, admittance to mind at home or a hospice, end of dynamic and vain clinical intercessions, time to accommodate broken connections.
Dr. J.S Rajkumar who is the Chairman and pioneer with unstinted duty and most extreme commitment. Affectionately known as Dr. JSR, he began his clinical practice following finishing his scholastics and was one of the chose not many to be essential for the First Indian Liver Transplant group at Apollo Hospitals in Chennai. So he had great motivation, that made our winning possible as one of the leading and Best Gastroenterology hospital in chennai
He said, actually I am certain, our experience for medicine drives us to review a lot more cases where a patient's demise was definitely bad. Presumably there is a negative inclination in just observing passings in intense hospital clinical beds, however a superficial reflection on patients who have kicked the bucket under our consideration in the course of the most recent a year will rapidly observe incredible breadth for development in the manner we care for biting the dust patients.
Giving superb finish of life care is a test over all fortes however conveying this to patients with end stage liver sickness is especially testing. Let me delineate this with an ongoing case I was engaged with.
Small Case study
In the autumn a lady in her 50s with a long history of alcohol excess was admitted with jaundice and diagnosed with alcoholic hepatitis. She was a steroid responder on the Lille score and therefore continued prednisolone for 28 days while managed in the outpatients following discharge.
Despite maintaining abstinence post discharge with the help of a caring and supportive family, over the next 4-5 months she had multiple acute admissions with ascites, fluid overload and then renal impairment. Despite nutritional supplements she became progressively sarcopenic. Ultimately, she was admitted with severe type 1 hepatorenal syndrome (HRS) and lobar pneumonia, from which she never recovered. This brief vignette is entirely typical of a patient with advanced liver disease but encapsulates well many of the features that make planning and delivering palliative and end of life care in patients with liver disease so challenging. First, the patient is relatively young, and therefore there is always the hope of making it to the only definitive, life-saving treatment in liver transplantation.
Conclusion
If you are involved in the care of inpatients with advanced liver disease, why not engage a keen junior to do an audit on all the patients who died on your ward over the last year? This article could provide the tools to address some of the deficiencies in your own service and tailor them to local need, perhaps forming a quality improvement initiative.
Glimmers of ‘good’ can shine out of the darkness of death. We would all want it ourselves; what a rewarding thing to be involved in delivering it to others. However, We have set the high level of standard and norms that establishes ourself as one of the efficient & recognized Top multispeciality hospitals in chennai. We are ready at anytime to offer our latest effective treatments and solutions satisfying all your health needs at best.