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Published on: Jul 14, 2021
1 minute read
By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.

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Heat Exhaustion Warning Signs: Symptoms You Should Never Ignore

Heat-related illnesses are common during hot weather, particularly in tropical countries like India where summer temperatures can become extreme. Heat exhaustion is a serious condition that occurs when the body overheats due to prolonged exposure to high temperatures and inadequate hydration.

Recognizing heat exhaustion warning signs early can prevent life-threatening complications such as heatstroke.

What Is Heat Exhaustion?

Heat exhaustion is a heat-related illness caused by:

Excessive heat exposure
Dehydration
Loss of electrolytes through sweating

It often occurs during outdoor work, exercise or travel in hot environments.

If untreated, it may progress to heatstroke — a medical emergency.

Common Heat Exhaustion Warning Signs

1. Heavy Sweating

Excessive sweating is one of the earliest signs.

The body attempts to cool itself through perspiration, leading to fluid loss.

2. Dizziness or Lightheadedness

Low blood pressure due to dehydration may cause:

Feeling faint
Blurred vision
Weakness

3. Fatigue and Weakness

Muscle weakness and exhaustion occur as the body struggles to regulate temperature.

4. Nausea and Vomiting

Digestive discomfort is common in heat-related illnesses.

5. Headache

Dehydration and heat stress can trigger throbbing headaches.

6. Muscle Cramps

Electrolyte imbalance may cause painful muscle cramps, especially in legs.

7. Rapid Heartbeat

Increased heart rate helps circulate blood for cooling but may indicate strain.

8. Cool, Clammy Skin

Despite hot weather, skin may feel cool and moist due to heavy sweating.

Who Is at Higher Risk?

Certain groups are more vulnerable:

Outdoor laborers
Athletes
Elderly individuals
Children
People with chronic illnesses
Individuals on certain medications

Urban heat exposure increases risk during peak summer months in India.

Heat Exhaustion vs Heatstroke

Heat exhaustion is serious but manageable if treated promptly.

Heatstroke symptoms include:

High body temperature (above 40°C)
Confusion or disorientation
Dry, hot skin
Seizures
Loss of consciousness

Heatstroke requires immediate emergency medical attention.

Immediate Steps to Take

If heat exhaustion is suspected:

Move to a cool, shaded area
Loosen tight clothing
Drink water or oral rehydration solution
Apply cool cloths to body
Rest until symptoms improve

Seek medical care if symptoms persist beyond one hour.

Prevention Tips

Stay Hydrated

Drink water regularly, even if not thirsty.

Avoid Peak Sun Hours

Limit outdoor activity between 12 PM and 4 PM.

Wear Light Clothing

Choose loose, breathable fabrics.

Use Sun Protection

Wear hats and sunglasses when outdoors.

Take Frequent Breaks

Rest in shaded or air-conditioned areas.

Maintain Electrolyte Balance

Use oral rehydration solutions if sweating heavily.

Heat Illness in the Indian Context

India frequently experiences heatwaves, especially in northern and central regions. Public awareness about hydration and heat safety is essential to reduce hospitalizations and fatalities.

Community-level education can significantly improve prevention.

When to Seek Medical Help

Immediate medical attention is required if:

Symptoms worsen
Body temperature rises significantly
Confusion develops
Fainting occurs
Vomiting persists

Early treatment prevents severe complications.

Conclusion

Heat exhaustion is a preventable but potentially dangerous condition. Recognizing warning signs such as heavy sweating, dizziness, nausea and muscle cramps allows timely intervention.

With rising summer temperatures, especially in India, proactive hydration and heat safety measures are essential. Preventive care and awareness can protect vulnerable individuals and reduce health risks.

Staying cool and hydrated is the simplest way to safeguard your health during hot weather.

References

Indian Meteorological Department – Heatwave Reports
World Health Organization – Heat-Related Illness Guidelines
Indian Council of Medical Research – Public Health Advisory
National Disaster Management Authority (India) – Heatwave Action Plan
Lancet Planetary Health – Climate and Health Research

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