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Bengaluru, Jan 21: A private hospital in Bengaluru, the capital of Karnataka, on Tuesday claimed that it has successfully performed a live liver transplant on a Jehovah's Witness from Nigeria, by not using blood or blood products, in order to protect the patient's religious beliefs.

It is said that Jehovah's Witnesses are followers of a Christian faith that prohibits the use of blood or blood products during their treatment. Gehojadak (37), a Jehovah's Witness follower, had developed decompensated liver disease and visited more than three countries seeking treatment over the last four years but was turned away by most doctors due to the highly risky nature of surgery, Aster CMI Hospital said.

The surgery was challenging compared to a normal liver transplant because in order to protect the patient's religious beliefs, the medical team could not use blood or blood products (Fresh frozen plasma, Cryoprecipitate, Platelets etc), it said in a release, adding that very few such surgeries have been successfully conducted worldwide.

The patient's brother was the donor, the hospital said, adding, without a liver transplant, Gehojadak's chances of survival were less than 10 per cent over the next two years. A team of liver specialists from the Hospital thoroughly reviewed the patient's medical history before recommending a bloodless liver transplant and charted out a feasible pathway to make the surgery a success.

"This transplant was especially challenging as we did not have the safety net (of using blood) even if the patient's life was at risk due to their advance directive. We have performed other non-transplant liver surgeries in Jehovah's Witnesses and this gave us the confidence to take on Gehojadak's transplant," Dr Rajiv Lochan, Consultant Liver Transplant Surgeon, said.

The critical surgery took a 12-hour period to complete where two teams of specialists with close to 25 doctors including anaesthetists, intensivists worked in absolute sync with each other and Gehojadak finally received a life-saving liver transplant, the Hospital said. In a period of two weeks, the patient and his brother were fit enough to go home and were discharged from the hospital.

"Even if their haemoglobin levels dropped to life-threatening levels, the patients were clear that they would not accept a blood transfusion. Keeping the limitations in mind, the most effective treatment path was planned, and we spent close to two months preparing the patients for surgery," Arun V, Consultant Anesthesiologist said. The hospital arranged customised artificial products like synthetic drug molecules, to conduct a bloodless liver transplant, he added.

Marriages will have to shed decadence as the state government, in an advisory, has restricted the number of guests to 50 and barred consumption of liquor at such events. 

The advisory was issued in anticipation that the COVID-19 lockdown will be eased in a phased manner. 

The advisory, issued by the Department of Health & Family Welfare, states that events can be held in a “suitable public place with good natural ventilation (no air condition).”

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All guests must have the Arogya Setu app on their phones and the contact details all marriage attendees should be maintained. 

No person from a containment zone will be allowed to attend the event, and persons aged above 65 years, pregnant women and children below 10 years are not permitted. 

Sanitizers are to be provided at the entry and at “appropriate” places. Thermal screening is a must at the entry point of the venue. The scanner should be held 3-15 cm away from a person’s forehead. “Anyone found having a fever (37.5 degree centigrade or 99.5 farenheit), cold, cough, difficulty in breathing shall not be permitted to attend the event and immediately referred to seek medical advice,” the advisory said. 

Besides prohibition on consumption of alcohol, the advisory said paan, gutka and tobacco will not be allowed. 

Face masks are compulsory and all persons should maintain a physical distance of more than one metre. The venue shall be clean and hygienic, with a prohibition on spitting in public places.

A nodal person should be identified to oversee the arrangements, the advisory said.

Bengaluru, June 22: Even as the covid-19 positive cases are steadily increasing in Karnataka, an expert has claimed that community transmission has begun in Bengaluru and cases could keep rising over the next two months.

“If you look at the natural course of this virus across countries around the world, it is about six months. Now we’re in the fourth month. This will go on for another two months. It also sounds like this is the beginning of the peak. There is also a possibility of the number of cases going up from now on. Even across India, cases are increasing,” says Dr CN Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research and State Task Force member.

Besides the increase in number of cases, the virus is advancing silently, stealthily. A lot of people who are testing positive are asymptomatic. In areas like Padarayanapura, Nanjangud and many places in north Karnataka, there have been positive cases who have not had any contact with infected individuals. Some cases recorded in Bengaluru over the last two to three days have not had any contact with Covid-positive people.

Dr Manjunath adds: “We are in community transmission. This will happen because nature is ahead of everything. We have to take all possible precautionary measures at our command. This has to happen. Only then some kind of herd immunity will be developed.”

“We are expanding the guidelines of testing to include a large number of people to be tested. Now, according to the Indian Council for Medical Research (ICMR) guidelines, only symptomatic Influenza like Illness (ILI) or Severe Acute Respiratory Infection (SARI), or a person coming in contact with an infected person are being tested.

But since we have crossed 100 days in Karnataka from the first reported case and we’re getting cases with no travel history or contact with a Covid-positive person, we have to start random testing across the sub-group population. Only then will we understand the burden of the disease and what precautions need to be taken,” he says.