BLK-Max Super Speciality Hospital

Hello,

Friends, I am Dr. Sunil Prakash, head of nephrology and renal transplant service. Today I am going to tell you something about kidneys, which is a major organ in our body. We all have two kidneys, one on each side of our spine and they are of the size of a fist in the shape of beans and they are very hard-working organs. 24*7 they are working, even while we are sleeping. The important function of kidneys is to excrete all the waste products of our bodies. So they are basically very efficient cleaners, just like as we clean our skin from outside, they clean the body from inside and throw all the waste products of our body like acids, excess water, salt, potassium, and other protein weight down products like nitrogen, urea, creatinine, and indos, etc.. So if these kidneys get damaged or working become affected, it is very easy to understand that all these toxins will remain inside our body and our body will suffer. So first and foremost thing we have to remember is that our kidneys are mostly affected by diabetes which is high blood sugar, high blood pressure, hypertension, and obesity, other causes may be due to inflammation of the kidneys or by lifestyles. Kidneys are also intimately connected to the heart so the diseases of the heart will affect the kidneys and vice versa, we call it cardiorenal syndrome. To know more about kidneys, as I said first they do the cleaning jobs, they throw the acid, salt and excess water from our body, so if they are not functioning well the salt and water will collect in our body, we will have anemia, will become obese and will have high blood pressure. And the other functions of the kidneys are to make blood, so if our kidneys are not functioning well they will not produce blood, so the blood will be less in the body and the patient will become anemic.

So these patients have high blood pressure, have anemia they have big hearts, and they have weak bones because kidneys also produce active vitamin D and in the weak kidneys it is not there, so your bones are also weak. So it produces bone pains, these are some of the important functions of the kidneys. So, now what happens if the kidneys fail? If the kidney damages diagnosed earlier, we have 5 stages of the kidney, stage one, two, three, four, and five. Stage one, two, three if you can diagnose it early, we can manage it very well by diet, salt, fluid, manipulation by living the right kind of lifestyle, by taking proper medications of blood pressure and sugar and other elements. And we can stop the kidney diseases very very satisfactorily. But unfortunately in India people don’t believe in going for medical check-up and sometimes the disease has run its course and we get more of the patient in stage 5, which is a stage of advanced kidney disease, it is also called as end-stage renal disease, in which only three things will help, first is dialysis, dialysis people have all wrong notions about dialysis, they feel that dialysis is death, it is not so, it is that if one starts dialysis on time, one can live satisfactorily on dialysis for 10-15 years and lead a normal lifestyle and complete one’s family responsibility. Dialysis can be done at a hospital, it’s called blood hemodialysis and sometimes hemodialysis now can also be done at home it is called home hemodialysis.

The second dialysis is by the abdomen route, it is called the water dialysis or peritoneal dialysis. This the patient can do himself with the help of his attendant at the privacy of his home. So both these dialysis are very effective. And the third modality of treatment is transplants, we all must have heard about the transplants. What is a transplant? Kidney transplant is an act in which we operate and put the kidney in the patient so that the kidney takes over the function of his damaged kidneys and the patient recovers and he can lead a normal life. But the caveat here is that because it is not a self of the body it is some foreign protein to the body so the body's immune system tries to reject it, tries to damage it. To prevent the rejection of that transplanted kidney, one has to take Immuno suppressive strong medicines life-long. Although doses of these medicines are gradually reduced, they have to be taken life-long. If you take these medicines regularly, the kidneys will function well and the person can live very satisfactorily in a normal way for the next 10,15, 20 years. This is a kidney transplant. The problem with kidney transplant today and that is why it always comes in the very grey and black shade is the unwanted commerce attached to it. Rich people want to buy kidneys from the poor, this is organ prostitution. Now we have very strong laws by Indian parliament which is called HOTA(human organ transplant issue act) in which the kidneys can not be bought or sold for money. One can take kidneys from one’s relative out of love and compassion. Even friends can give, but it has to be an altruistic basis. One can not sell one’s kidney. So, one can, if unfortunately, somebody has damaged kidneys, he can get the kidneys from his relatives, or from his altruistic friends. The other most important way of doing kidney transplants is through brain-dead people. Now, these brain dead people are those unfortunate people who may have a road accident and have irreversible brain damage. If they a irreversible brain damage, although their heart may be bitten for some time but I tell you, if the brain has damaged irreversibly, the heart will stop in a day or two, so in this golden window of 24 to 48 hours if the family of that person is willing to donate the organs of the dying person, he or she can save the lives of 8 people by organs, by donating heart, kidneys, liver, pancreas, intestine, other tissues, eyes, and cornea, etc. In western countries, in developed nations, it is a routine thing for people to donate their organs before dying, but unfortunately in India in other parts of the world it has not taken of in a way it should have, although some good work is coming on from south India but in northern parts of India this is still in very very infancy, people have wrong prejudices about it and not willing to donate kidneys. Friends, in a situation where the brain has died, in a matter of a day or two our body will become dust, from dust thou will return from where we came. In this golden hours, we can save lives of so many people, we can bring joy to so many people, even once we are gone, our organs will live through them, our heart will go on, our kidneys will go on and I believe this is the biggest act of altruism, biggest act of charity one can do. Friends, don’t take your organs to the heavens, heaven knows that we need them here. I believe that it is the duty of all responsible citizens of society, press, and other people to encourage and foster brain-dead cadaveric transplantation because that is only the way forward. It will not only give life to so many people but it will also prevent the exploitation of the poor by commercialization and exploitation by selling and buying kidneys.

Thank You!

Hello,

Friends, I am Dr. Sunil Prakash, I am head of Nephrology and dialysis, transplant service. I take this opportunity to tell you a little bit about kidney diseases. Today worldwide kidney diseases are increasing exponentially and nearly 8 to 10% of people have some sort of kidney disease. This is a huge number, the problem with kidney diseases is that they are without any symptom, they are like silent killers, so we have to be very careful and only by some tests we can diagnose kidney diseases. First of all, I would like to tell you that most of the kidney diseases are due to diabetes, high blood pressure, glomerulonephritis which is inflammation of the kidneys and sometimes some hereditary diseases and then stone diseases or obstructive diseases. Let’s concentrate on the common causes of kidney diseases which are diabetes and high blood pressure and obesity. In modern lifestyle today we are facing an epidemic of diabetes and obesity, even school children are obese, they are fat, they are not playing physically, they are busy with their video games and mobiles. So this obesity and diabetes cause stress on the heart and kidneys and other organs of the body and we have an epidemic of kidney diseases. So we must endeavor to keep our blood sugars, our blood pressure, our weight under check and under control. For this, a healthy lifestyle is most important and in that the foremost thing of the importance is our diet. We are what we eat, if you don’t eat a good diet, a regular diet then we will fall into problems.

Today due to the stress of life we are used to fast food, we are running and having coffee, having meals while driving or doing other things, this is certainly deplorable. We have to get time for ourselves and for our food and enjoy our food in a way it should be and besides having the right diet, it should contain the right amount of proteins, the right amount of carbohydrates, salt. You should not fall for fats. Another thing is that sometimes youngers fall for the prey to strong protein products which are recommended by the people who are running the gym and all those institutions and they sometimes have very very fast renal failures requiring dialysis. So if we take care of our diet, if we are physically active, we walk for 30-40 minutes or do some brisk exercise like jogging, cycling, swimming or maybe you go to a gym, do regular aerobics, cardio, will remain fit just by these two things and third thing of importance will be to avoid strong medicines, pain killers, or other indigenous medicines are also not safe. We should be very careful about what is going in our body, in our mouth.

Finally, it is said that our air, water, our food chain is polluted and this is perhaps also giving rise to an exponential geometric progression of kidney diseases. I would like to say in the end that the diagnosis of kidney disease will depend upon early symptoms which could be very very vague. So I would say that if any young person who has high blood pressure, should not ignore that high blood pressure. He should investigate himself by doing simple urine and a blood test and an ultrasound of the kidney. These three simple tests will tell him most of the times and if whatever treatment is required, that person must take. So young person having high blood pressure, people having anemia, less blood in their body or young people who are unable to complete their family and people who have lot of aches and pains, sometimes people who are passing lot of urine especially at night, If there is froth in the urine, so all these symptoms point to some kidney ailment and they should go for a check-up to their physician and do simple blood and urine tests which I have already envisages. So if by the act of good diet, regular physical activity, by avoiding unnecessary stresses in our lives we can be living a healthy life, we can have a healthy kidney, healthy heart and we must regularly take some checks to diagnose the diseases early. I thank you for your hearing.

Thank You!

Hi,

I am Dr. Nargesh Agrawal aaj mai aap ko club foot ke baare mein bataunga. Ismein bachon ke paair ghume hue hote hain. Is bimari ke baare mein bache ke paida hone se pehle hume ultrasound ke time pe hi pata chal jaati hai. So, treatment should be started as early as possible. Jaise hi bacha paida hota hai, from day 1 hi hume treatment shuru kar dena chaiye. Parents question karte hain ki aisa mere bache ke sath kyun hua hai? Iske kayi sare karan hai jaise maa mein pani ki kami hona, kuch genetic reasons bhi hote hain, mascular reasons hain. Isko hum idiopathic clubfoot bolte hain. Ismein parents puchte hain ki iska ilaj kya hai? Kya unka bacha chal payega ki nahi? Jitna jaldi aap treatment shuru karte hain, uska utna hi acha result ata hai. Isko hum jaldi hi correct kar sakte hain. Ismein 3-4 plasters lagaye jate hain. Uske baad chote se operation ki jarurat padti hai jismein hum pairon ki ek nerve ko repair karte hain. Ismein bohot chota cut diya jata hai jismein stitches dene ki bhi jarurat nahi padti hai. Ise hum local anasthesia mein kar dete hain.

Bache ko admit karne ki jarurat bhi nahi padti hai. Uske baad 4-5 plasters mein bache ka pair thik ho jata hai. Parents question karte hain ki bache ko operation se koi problem toh nahi ayegi. Toh aisa nahi hai. Bacha bilkul thik rehta hai. Ismein bache mein nayi nus develop hoti hai. Operation ke baad bache ko hum braces se bandh dete hain. Ismein patient question puchte hain ki kya rod lagana jaruri hota hai. Yes, ye important hai kyuki tabhi pair correct position mein aata hai. 3 months me bache ko acha result mil jata hai. Shuru mein bache ko dikkat hoti hai but dheere dheere bacha bilkul thik ho jata hai. Humein plaster 4-5 years tak bache ko pehnana hota hai. Bache ko shoes shuru ke 3 months tak pehnane hote hain. Bache ko ye shoes 4-5 years tak pehnaye jaate hain aur jab vo soo raha ho tab pehnaye jate hain. Humare paas aaj ek parents available hain. Mai unka feedback aap ko dilvata hun. Ye aap ko btayenge ki total treatment kaisa raha or kya kya problems hui. Kya outcome aaya hai.

Parents: Humara beta clubfoot ke sath paida hua tha. Hum kafi preshan the ki kis tarike se uske pair thik honge. Mene kafi search kiya online and tab jake mujhe in Dr. ke baare mein pata chala. Maine online review bhi dekhe. Mere bete ko inhone 6 plasters lagaye the jisse mera beta bilkul thik ho gaya. Dr. ne jo shoes recommend kiya hain vo hum apne bache ko pehna rhein hain. Ye 3 months ka process hain and hume ye shoes 3 months tak pehnane hain.

Dr: Aap ka operation kaisa raha. Aap ko kya kya problem hui.

Parents: Surgery kafi achi rahi. Bacha thoda roya tha baki koi bhi problem nahi hui. Ab after treatment hum kafi satisfied hain results se. Abhi humare bete ke pair bilkul thik hain. Sath folllow-ups bhi chal rhein hain.

Dr: Ye parents mere pass right clubfoot ki problem leke aaye the. Jab ye bache ko leke aaye the tab bache ki age 3 months thi. Ye parents dusre Dr. ke pass bhi gaye the but uske baad acha result naa milne ki vajha se mere pass aaye hain.

Parents: Humne kahi aur bhi apne bache ko dikhaya tha but hume vahan se acha result nahi mila. Fir hum in Dr. ke paas aaye aur shuru mein inhone 3-4 plasters kiya. Uske baad mein choti surgery ki. Surgery ke baad 2 plasters aur lgaye gaye and ab shoes pehanaye gaye hain. Ab mere bete ka pair kafi thik hai. Kafi acha experience bhi raha humara. Dr. ne jo humein exercises btayi hain vo hum apne bache ki daily karte hain. In Dr. ne hume vo sab btaya ki ye problem bache me kab aati hai. Dr. ki baatein sunte hi humne apne bete ko plaster lagvaya. Uske baad se humara regular Dr. ke sath contact hai.

Parents: Mene apne bache ka operation bhi kraya but us se bache ko koi benefit nahi hua. Mene ek baar aur operation kraya but vahan se bhi acha result nahi mila. Tab mai in Dr. se mila. Inhone mere bache ka ilaj kiya aur ab mera beta legs ki movement kar sakta hai. Pair ab sidha ho gaya hai and upar niche bhi ho raha hai. Ab mera beta sidha bhi chal paa raha hai. Pehle mera beta ulta pair rakh ke chalta tha. Hum in Dr. se bohot satisfied hain.

Hello!

I am Dr. Dhruv Zutshi, I'll be talking about stroke now. Stroke is an illness jisme hum common tongue mein bolte hai paralysis or one part of the body becomes totally paralyzed and we are not able to move it. Now this is a very severe disease and a medical emergency. So, whenever you notice anybody like your relative, friend suddenly develops weakness on one part of the body, you should immediately bring the patient to the hospital. Initially, many years back it was believed that stroke cannot be treated, there is no treatment for paralysis but that is not true. Today, we have best treatments available and by giving some injections within a four and half hour period you can even reverse the symptoms of stroke completely. We can even up to 6 hours use some catheters and certain amount of interventions so as to prevent the patient from becoming paralytic for the rest of his life. So that is why stroke has to be realised immediately and patients should immediately rush to the hospital. For this these is an acronym called as FAST.

FAST means: F for any kind of deviation of the face, A for any arm weakness, S for any slurring of speech and T is for time which is up to four and a half hours. So if you ever see anybody in your family, your own relatives anybody who is suddenly developing paralysis or one side weakness you should remember these four things and immediately rush him to the closest big hospital. Now other things are this is for the management of stroke, that when a stroke happens what you can do. Now further why does it happen? Stroke is generally a condition wherein the blood vessels of the brain can become blocked due to a thrombus getting formed or a clot or there may be a rupture of the blood vessel of the brain due to raised blood pressure or any other reason. Of this the kind of stroke wherein a clot gets formed in the blood vessel or ischemic stroke it forms about 80-85% of the cases. The hemorrhagic strokes are only 15%.

So, most patients will mostly generally have ischemic strokes. For the ischemic strokes the common risk factors are diabetes, hypertension, age more than 60 years of age, smoking, then patients who are using recreational drugs, then dislipidemia and many other risk factors. With hemorrhagic strokes, the most common risk factor is hypertension following which if there is uncontrolled hypertension then the blood vessels of the brain can rupture and haemorrhage can occur in the brain. Then, how do you go about managing your these symptoms? So whenever any person above 45 years of age if he has diabetes, hypertension or any other risk factor, he should be very particular about the medicines that he should take them regularly, should have yearly checkups so that he can identify the risk factors and you know modify them. Then there are some completely modifiable risk factors like healthy lifestyle, if you are taking smoking then you should quit smoking, eat a healthy diet, exercise, maintaining a good sleep-wake pattern; this help to retain and control your risk factors.

As part of the treatment of stroke, after the first four and a half hours we are able to use alternate medicines so as to reduce or prevent further strokes. These include antiplatelets like ecosprin, clopidogrel, statins these are helpful in preventing strokes. However in the acute emergency when the stroke happens, you have to remember about the 4 hour window period wherein you have to immediately rush the patient to the hospital so that we can treat him and give him the medicines which are available today because of the scientific advances and give him the maximum benefit of stroke. After that, generally, we have to focus more on the rehab part of the stroke and let me tell you that there was once a time when we believe that stroke may not improve but today most patients will improve over a period of 2 to 3 months. So that is no reason to be pessimistic and all the reason to be optimistic regarding the treatment of stroke.

Thank you!

Headache is one of the most common maladies which refers to a pain sensation in the head. It may itself be an ailment or may be the symptom of any other illness. Headaches can last for a short time or may persist up to several weeks depending on its cause or type.

Hi,

I am Dr. Sunil Prakash, Nephrologist, today I will discuss about how to remain healthy. It is not about that we should worry about one part of the body as our body is one unit. The most important thing about health is a healthy mind, body, soul and lifestyle. Nowadays obesity is common. It is because we are eating and not doing any physical activity. Everyone is busy with their mobile phone.

Hume physical activities me jyada indulge hona hai. Iske lia important hai ki hum daily 10k steps chalen. Agar hum daily walk krenge to hmari 200 calories khtm ho jayegi. Agar hum kam khayenge and walk jyada krenge to hum mote nhi honge. Diabetes ke aap shikar nhi honge or agar hai apko diabetes to apka control ho jayega. Agar 100 people ko diabetes hai to 40 ki kidney khrab hogi and eyes bhi khrab hoti hain.

BP ki agar apki medicines chal rhi hai to bina Dr se consult kre band na kren medicines. BP silent killer hai. BP, heart, kidney and diabetes ka saal me 2 baar test krayein. Isllia primary prevention and positive thing bhut jruri hai. Early stage me agar problem dikh jaye to treatment easy ho jata hai. Annual checkup is a good mode of preventing disease.

For any help or query, you can contact me through Lybrate.

Thank You.

Hi,

I am Dr. Sunil Prakash, Nephrologist. Hmare India me metabolic diseases ka rate badhta ja rha hai. Like diabetes, BP, obesity, kidney and heart diseases. School se hi bachon ka weight kafi badhne lag gya hai. 1/5 young generation ko diabetes hai, 1/7 ko heart attack ka problem hai. Hume inse bachne ke lia lifestyle change krna hai. Unfortunately aisi koi medicines nhi hai ki apne khayi and sari bimariyan thik ho gyi. Inse bachne ke lia avoid 7 S. First S is excess sugar. Sugar and salt avoid krne se diabetes nhi hoga. Diabetes nhi hogi to weight gain nhi hoga and kidney bhi khrab nhi hogi and heart attack nhi ayega.

No.2 is excess salt. Salt kam lene se BP thik rhega. BP thik rehne se hmare dusre organs effect nhi honge. No.3 is sedentary lifestyle. Hume 10k steps daily chalna chaiye. No.4 is smoking. Quit smoking. No.5 is stress. Aaj kal modern lifestyle me har koi stressed hai. No.6 is alcohol. Alcohol heart, kidney ke lia nuskan hai. No.7 is lackness of sleep. Hume 7 hours jrur sona chaiye. Neend puri na hone se heart attack ke chances badh jate hain. So, invest your time in body, mind and soul. You should eat less and walk more.

Thank You!

Hello!

Mera naam Dr. Nargesh Agarwal hai. Mein pediatric orthopedic and deformity correction surgeon hun. Aaj me apke samne bachon ki ek aisi bimari jo bachon me janam se upasthit hoti hai, suke baare me batane ja rha hun. Jiska naam hai clubfoot. Clubfoot ko hum usually CTE k naam se bhi jante hain. Majority of parents mere se puchte hain ki ye bilkul correctable hai ya nhi hai, iska kya illaj hai. To mera answer hai ki ye almost 100% correctable hai. Lekin isme illaj hume jitna jldi ho sake utna jdli shuru krna dena chaiye.

Iilaj me humko plaster lgane hote hian. Jisme 4-5 plaster lgte hain. Uske baad me foot correct ho jata hai. Almost 10 se 7 bachon me choti si minor surgery ki jrurat pdti hai. Jisme hum jo piche se nus hoti hai, use dhilla krte hain. Vo day care procedure hota hai. Jise hum tenotomy k naam se jante hain. Parents mere se puchte hain, is surgery ka bache ke foot pe koi effect to nhi ayega? Nhi, bache k foot pe koi effect nhi aata. Jo tendon hum release krte hain, vo almost dubara se regenerate ho jata hai without any side-effect.

Or bachon ko future me chalne se is se koi dikkat nhi hoti. Bacha bilkul normal life jita hai. Isme humko correction k baad me braces dene hote hain. Un braces ko hum bolte hain DB splint or denic browne splint or CTV braces. Ye braces shuru k 3 mahine take, 23 hours in a day pehnane hote hain. Uske baad me 4 saal ki umar tak unhe pehnane hote hain jab bacha sota hai tab, night hours me ya fir din me jab bhi bacha soyega. Usually jo clubfoot hota hai, isme bache ko correction bada acha mil jata hai, Kayi bache hmare pas kafi der se aate hain. Suppose kro 6 mahine par, 1 saal me, 2 saale me aate hain. Jitna deri se hum iska treatment krate hain, usme correction me utni hi dikkat hoti hai.

Number of plasters bhi badh jate hain. Usme volume of surgery bhi badh jati hai. To mera kewal yhi salaha hai ki iilaj jldi se jldi krayein. In fact, within a week, within a month of life treatment start kr dena chaiye. Treatment bada hi simple hai. Plaster lgte hain. 4-5 plaster lgte hain. Uske baad me jrurat pdne par ek choti si minor surgery hai jisme baad me bachon ko brace dete hain. So, success rate is almost 95-98% and the results are very good. Aap is trha ki problem k lia, aap mere clinic pe aa skte hain,  budhwar or shaniwar shaam ko 5-7 available rehta hun aur budhwar or shaniwar, 2-4 afternoon me available rehta hun.

Thank You.

Good Evening Folks!

I am Dr. Sunil Prakash, nephrology. I want to talk to my friends about how to save our kidneys. Kidney diseases are becoming incrementally explosive in India. It is possible due to bad lifestyle and bad food habits and due to pollution and our food change and water change being poisoned by excessive use of fertilizers, chemicals and pesticides. That is why more and more patients are now coming with advanced renal failure. Some important causes of kidney failure are diabetes, high blood pressure and pyelonephritis. Pyelonephritis means inflammation of the kidneys. To prevent kidney disease, I would give you the small formula which I say avoid 5 S. First S is sugar. Avoid excess sugar because excess sugar causes diabetes.

And diabetes causes 50% of kidney diseases. 2nd S is extra salt to be avoided. Increased salt intake gives rise to high blood pressure which causes again lot of kidney failure. 3rd S is smoking. Smoking is bad for heart and kidney and causes damage of both. 4th S is stress. Modern lifestyle is full of stresses, but it is our ability to cope these stresses positively which will give us benefit in our life and inability to cope with stresses causes lot of damage to our organs. 5th is sedentary lifestyle. Sedentary lifestyle means couch potato. Such people will get high sugar. They will be obese, and they eventually get diabetes. Such patient also gets lot of kidney failure. So, if you can avoid these 5 S. Plus if you can avoid some Ds. What are these Ds? Ds are drugs. Like indigenous drug, homeopathic, ayurvedic and painkillers, allopathy should be avoided.

They damage the kidney. Even now some commonly used drugs like are also being implicated which causes kidney failure. Any drug which is taken without consideration or without consultation is competent to cause kidney damage. It is called interstitial nephritis. And sometimes it leads to irreversible damage. So, avoid drugs, avoid unnecessarily IV, angiography, CT scans. They should only be done when there is enough evidence that by doing this test and diagnosis, the patient will benefit. And the benefit is more than the risk of die. 3rd D is to avoid dehydration. Especially in summers, in India, especially north India, especially elderly people wo are diabetic, if anti-blood pressure medicines, they should avoid dehydration. Sometimes the dehydration will cause fall in blood pressure and will give rise to acute kidney failure.

So, if you can avoid all these things and live the good lifestyle or top of it I would recommend, people who are above 50 years of age, who are diabetic, hypertensive or whose family has the history of diabetes, kidney failure or any other hereditary failure, they should go for a routine check-up at least once in 6 months. And the check-ups are very simple. Like doing your blood pressure, measuring your blood sugar, doing your serum creatinine and ordinary urine examination. In fact, all healthy people, middle age people should also do it. So, at this point of time, I think I want to say that the treatment of chronic kidney disease by dialysis and transplantation is very expensive. In a country where average income is 15,000/- to 20,000/- of a family for four people.

For them, dialysis and transplant are not possible. The future of kidneys diseases and management in our country lies in prevention and that is what friends, let us lead a good healthy lifestyle. Let us avoid pollution. Let us eat normal foods and lead a good active life. Another important thing is to eat little bit less and walk more. Middle-aged people at least should walk 10,000 steps every day. If we can follow these simple rules, we can be safe from dialysis and transplant.

And thank you very much for your time.

Good morning!

I’m Dr. Sunil Prakash. I’m director and head of nephrology of renal transplant services at BLK super specialty hospital, New Delhi.

Today I would like to share with you some newer things that are happening on nephrology. You all know that if somebody has a kidney failure they will eventually land up on dialysis. Dialysis is of 2 types: peritoneal dialysis which is done at home by person themselves or your relatives. It is also called colo-colic or water dialysis. Another is blood dialysis. This can also be done at home which is called home hemodialysis and there are simple machines which are available and there are people who can be trained who can come at home and do dialysis for such patients. Or these patients come to hospitals or dialysis centers for regular dialysis. Dialysis is normally give it to 2-3 times a week. Itis certainly a cumbersome procedure and it is also costing money. But at the end of the day the decision is either dialysis or death. So if somebody reaches the end stage kidney disease then he/she will require dialysis. The other option is to go for kidney transplant. The biggest problem of kidney transplant is how to get donors? How to get kidneys? Now friends everybody has 2kidneys. And if somebody is healthy and he doesn’t have diabetes, blood pressure or stone in the kidney and he is leading a good healthy life then by doing some test it can be found that person may be able to live on one kidney. So if we are certain that a donor if he can give one kidney to its relative to make him rehabilitate then he can live on one kidney and the recipient or the patient who gets the kidney will live on another kidney. This is called life-related donor program. This is a legal program. Now what is not legal? What is totally illegal is when somebody tries to buy kidneys for poor people by force or money or greed or whatever. This is illegal act and it is punishable by law. Another thing in transplant which we must encourage and our country is lacking very badly is deceased donor transplant. What is deceased donor transplant? It means unfortunately if somebody gets an accident. Young person leaves his house on bike or going for a job or something meets with the accident sometimes if the brain is irreversibly damaged but the organs like heart kidney and liver are functioning well these are called brain death patients. They are basically cadavers. Cadavers means death although technically, legally they are living at that point of time because there heart is beating but if somebody’s brain is death then that person ceases to be that person. And certainly within a day the all organs will also stop functioning because their master is gone the command center is gone. And all the organs of the body requires impulses from brain to survive. So now in such a situation a person’s heart is beating but it is certain to die in next 6-8-10 or maximum24 hours. So in this interim the organs of the patients are taken out and give it to people who are waiting on the organ list to be able to get these organs and get rehabilitated. In Spain the rate of donation is 50/million. In India it is 0.5/million. So we can very well imagine that how much organ shortage we are having and Indians or top of it have more proclivity of having kidney diseases and end stage kidney stages. So we badly needs these kidneys. So I request to all my listeners that let us join hands, let us do more social work, advertise and tell people that unfortunately if somebody has got brain damage then he/she is about to die then they must pledge their organs to people who are waiting below. Nothing can be better than this act of altruism and donation. Friends let us not take our organs to heaven because heaven knows that we need these organs here. Thank you for your time. I’m available at BLK super specialty hospital. For any issues, consulting dialysis refers to blood pressure and transplantation center.

Thank you! Again.