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The Hindu
10-06-2025
- Health
- The Hindu
The risks of undiagnosed gall bladder stones: doctors call for awareness, timely treatment
Globally, gallstone disease (cholelithiasis) is prevalent, with varying rates in different regions. In India, the prevalence of gallstones is estimated to be around 4% of the population. In contrast, studies in the West have shown a higher prevalence, with about 10% of American adults having gallstones. Within India, there are regional variations, with higher rates observed in certain areas like North and Northeast India. What are gallstones? Gallstones are hardened deposits in the gallbladder, and are increasingly being diagnosed across age groups in India. According to the World Gastroenterology Organisation (WGO), the most common types of gallstones are cholesterol stones ( accounting for approximately 80% of cases, and are primarily composed of hardened cholesterol), pigment stones (dark brown or black and are made of bilirubin), and mixed stones (contain a combination of cholesterol and bilirubin, falling somewhere in between the other two types in composition). Often asymptomatic, they are typically discovered during abdominal imaging for unrelated complaints. 'Many gallstones remain silent for years. But once symptomatic, patients usually present with pain in the upper abdomen, nausea, vomiting, jaundice or fever,' says Piyush Bawane, consultant – medical gastroenterology, Rela Hospital, Chennai. A sudden onset of abdominal pain, bloating or indigestion after meals may also be initial warning signs. 'People living with weight related health issues , diabetes, during pregnancy or on a high-fat diet are especially at risk,' notes Atul Sharma, clinical director of gastroenterology, Marengo Asia Hospitals, Gurugram. Gallstones and gallbladder cancer: what's the link? One of the more serious, but less-discussed complications of untreated gallstones, is gallbladder cancer, a relatively rare but aggressive malignancy. 'There is definitely a correlation between chronic gallstones and cancer of the gallbladder, but not everyone with gallstones develops cancer. The treating doctor assesses each patient's risk based on individual factors.' says Dr. Bawane. 'The persistent inflammation caused by stones can irritate the gallbladder lining over time, potentially increasing the risk of gallbladder cancer, especially with long-standing or large stones.' Dr. Sharma adds, 'The risk is not universal, but patients with large stones, a porcelain gallbladder, or other chronic biliary abnormalities are particularly vulnerable. Prophylactic removal of the gallbladder is often recommended in high-risk cases to prevent malignant transformation.' Even though prophylactic cholecystectomy ( the removal of the gallbladder to prevent future problems), is generally not recommended for individuals with asymptomatic gallstones. In certain situations asymptomatic patients with risk factors may also benefit from early surgical removal, as gallbladder cancer is often detected late and carries a poor prognosis. While gallstones have typically affected middle-aged women, recent years have seen a shift in demographics. 'We are seeing more cases in children and teenagers, especially those with obesity or underlying haemolytic disorders,' says Rasik Shah, paediatric surgeon at Lilavati Hospital and H.N. Reliance Foundation Hospital, Mumbai. He urges paediatricians to consider abdominal ultrasounds in children with persistent abdominal pain, and adds that laparoscopic cholecystectomy remains safe and effective in children. He also emphasis that in children, gallstones even though less common than in adults but can occur, often due to underlying hemolytic anemias like thalassemia or as a temporary result of antibiotic use (e.g., ceftriaxone), with some resolving spontaneously. Two other important paediatric hepatobiliary conditions (liver and bile duct diseases ) include choledochal cysts -- congenital bile duct dilatations that may be detected antenatally and should be surgically treated between 3–6 months to avoid cholangitis --- and biliary atresia, a serious developmental defect of the bile ducts and gallbladder. Biliary atresia presents as jaundice with pale stools in the first month of life and requires urgent surgical intervention before two months of age for optimal outcomes, as delays can lead to liver failure and the need for transplant. Early detection and timely referral to a paediatric surgeon are critical in managing these conditions. When gallstones go untreated Neglecting gallstones can result in acute cholecystitis, bile duct blockage, pancreatitis, and in severe cases, sepsis or gallbladder rupture. Thiagarajan Srinivasan, director – Liver Diseases and HPB Surgery, MGM Healthcare, Chennai, says, 'Even a small gallstone can migrate and block the bile duct, leading to life-threatening complications. Around 1–2% of asymptomatic patients can develop serious conditions.' Compounding this, myths and delays in seeking care remain major challenges, says Dr. Bawane. 'Patients often wait until the pain becomes unbearable or jaundice sets in. Unfortunately, by then, the risks — including that of cancer — would have significantly increased.' Technology aiding early detection Experts say that modern imaging techniques have improved detection accuracy, particularly for bile duct stones. 'MRCP (Magnetic Resonance Cholangiopancreatography), contrast-enhanced ultrasound, and Endoscopic Ultrasound (EUS) allow non-invasive and precise detection of even small stones and sludge,' says Dr. Thiagarajan. While medications like ursodeoxycholic acid can dissolve certain cholesterol stones, they are time-consuming and rarely curative. 'They are not a practical option for most symptomatic patients, given the high recurrence rate,' notes Dr. Sharma. Laparoscopic cholecystectomy , a minimally invasive surgical removal of the gallbladder, is the preferred treatment. 'For complicated cases or patients with common bile duct stones, procedures like ERCP (Endoscopic Retrograde Cholangiopancreatography) may also be necessary,' adds Dr. Bawane. Surgical advancements now include single-incision laparoscopic surgery, robot-assisted procedures, and use of indocyanine green (ICG) dye for real-time visualisation, ensuring safer removal and reduced bile duct injury. Preventive care and management Lifestyle and dietary changes play a critical role in reducing risk. 'A high-fibre diet with whole grains, fruits, and healthy fats like olive oil, combined with regular meals and exercise, can reduce the risk significantly,' explains Dr. Thiagarajan. Rapid weight loss, fasting, and high-sugar diets should be avoided. For those awaiting treatment, dietary control can prevent attacks. 'Stick to low-fat, small meals and stay hydrated. Avoid fried and greasy food. Symptom relief can be supported by painkillers or antispasmodics under medical guidance,' says Dinesh Ramaswamy, senior surgical gastroenterologist at SIMS Hospital, Chennai. Post-cholecystectomy recovery is ideally not hard for most patients. 'The liver continues to produce bile, which now drains directly into the intestine. Some may have mild bloating or altered bowel movements initially, but this settles over time,' says Dr. Ramaswamy. 'There is no need for long-term medications, just mindful eating,'he says. He adds that the number or size of gallstones doesn't always reflect severity. 'Even sludge or small stones can block ducts and cause severe infection. That is why even early surgical intervention is sometimes advised -- to prevent complications, including cancer.' While there is no gallstone-specific national programme, doctors across hospitals follow protocols recommended by the Indian Council of Medical Research (ICMR) and surgical societies. These promote early ultrasound-based screening, timely intervention, and public education. 'Gallstones are manageable. But we must act early. With rising incidence -- even in young people -- awareness about risks like cancer is crucial,' says Dr. Shah.
Hindustan Times
15-05-2025
- Politics
- Hindustan Times
Appointment of RERA chief and 2 members: Plan to relocate RERA office delayed notification, Himachal tells HC
The Himachal government, through an affidavit, on Thursday informed the high court that delay in the notification for appointment of Real Estate Regulatory Authority (RERA) chairperson as well as two members was due to government's plan to relocate RERA office in Shimla to another location. The state government filed an affidavit through under secretary (housing) by Vikram Datt Dangwal in the high court on Thursday. 'The matter is under consideration on account of state government's ongoing deliberation regarding proposed relocation of HP RERA office within Shimla city to another location. The final decision on the appointment is likely to align with outcome of the administrative consideration,' said the state government through the affidavit. High court on May 9 had sought affidavit from state government asking 'Specific reason that the state has withheld the recommendations of the selection committee.' Denying any kind of 'intentional or undue' delay, the government said that the final authority regarding appointment is state government. The recommendation of selection committee were forwarded to state government through housing minister on March 20. Unconvinced by the reasons regarding delay in issue of the notification the HC had sought a fresh affidavit. The case is now listed for May 26. The high court on Thursday was hearing the petition filed by Atul Sharma, seeking quashing of extension given to Prabodh Saxena as chief secretary of the state government on the ground that it was given in clear violation of the Central Services Rules and guidelines of Department of Personnel & Training (DoPT). The petition argued that vigilance clearance cannot be granted to an officer who is an accused in a corruption case under the Prevention of Corruption Act.
Time of India
30-04-2025
- Time of India
Woman alleges torture, abuse & confinement by her live-in partner
Gurgaon: A 38-year-old woman has alleged sustained physical abuse, mental torture, and confinement by her live-in partner. Atul Sharma, who is on the run, was already in jail due to such instances previously. You Can Also Check: Gurgaon AQI | Weather in Gurgaon | Bank Holidays in Gurgaon | Public Holidays in Gurgaon However, he was acquitted. The woman claimed there were multiple occasions where the accused beat her and her son. The complainant said on April 8, Sharma beat her, physically assaulted her ten-year-old son, and held both of them captive in their home for the entire day. She said Atul even took her phone away. The complainant said her phone contained evidence of the abuse. Similarly, she alleged that on April 3, the man had brutally beaten her when her son was at school. "The previous day, he tried to beat me, but when my son went to alert the police, he pushed me and ran away." She had filed a complaint in 2024, following which, Sharma was arrested. He was acquitted in Aug, following a settlement. She alleged that after his release, he returned to live with her under the pretext of reconciliation and a false promise of marriage, only to continue the abuse. A police officer said a medical examination confirmed multiple blunt injuries on her body. A case has been registered under sections 115 (voluntarily causing hurt), 305 (theft), 351(2), and 351(3) (criminal intimidation) of BNS.
Associated Press
30-04-2025
- Business
- Associated Press
Grazitti Interactive Named Leader in the ISG Provider Lens™ Salesforce Ecosystem Partners 2025 U.S. Quadrant Report
Grazitti Interactive was named a Leader in ISG's 2025 U.S. Salesforce Report for Core Cloud and AI Agents and Managed Services in the midmarket segment. 'Grazitti's success is driven by innovations in AI and the development of products that address specific business needs'— Rodrigo Barreto, Lead Analyst at ISG CA, UNITED STATES, April 30, 2025 / / -- Grazitti Interactive, a global digital services provider, has been named a leader in the ISG Provider Lens™ Salesforce Ecosystem Partners 2025 U.S. Quadrant Report. This recognition underscores Grazitti's commitment to delivering exceptional Salesforce solutions and services. The report names Grazitti as a Leader in two key categories: Implementation Services for Core Clouds and AI Agents — Midmarket: Recognized for its robust capabilities in implementing Salesforce's core cloud solutions tailored for midmarket enterprises. Managed Application Services — Midmarket: Commended for delivering efficient and reliable managed services that enhance the Salesforce experience for midmarket clients. Atul Sharma, Vice President of Salesforce Practice at Grazitti Interactive, stated, 'Being recognized as a Leader reflects our unwavering dedication to excellence in Salesforce implementations and managed services. We remain committed to leveraging Salesforce's evolving capabilities to drive innovation and deliver unparalleled value to our clients.' Praising Grazitti for its achievement in two key categories, Rodrigo Barreto, Lead Analyst at ISG, said, 'Grazitti Interactive's recognition as a leader in the ISG Report for Managed Application Services for Midmarket highlights its strong focus on delivering value through Salesforce. Their expertise in Optimization and Quality Assurance plays a key role in this achievement.' He further mentioned, 'Their transition from a Rising Star to a Leader in Salesforce Core Cloud Implementation Services for the Midmarket quadrant reflects their continuous innovation in AI and development of solutions tailored to meet specific business needs.' The ISG Provider Lens™ Quadrant research series evaluates service providers based on empirical data, market analysis, and insights from ISG's global advisory team. This year's report highlights Grazitti's strong portfolio, emphasizing its expertise in Salesforce core cloud implementations and managed services for the midmarket segment. To know more about our Salesforce Professional Services, click here. About ISG Information Services Group (ISG) is a leading global technology research and advisory firm. With a distinguished clientele, ISG empowers organizations to navigate the complexities of modern business landscapes with confidence and agility. About Grazitti Interactive® Grazitti Interactive is a digital technology leader with extensive experience developing innovative solutions that unlock data insights, increase operational efficiency, and drive customer success. The company has empowered businesses of all sizes—including Fortune 500 enterprises—to implement, customize, configure, optimize, integrate, and manage solutions such as CRM, marketing automation, online communities, eCommerce, and analytics. Download Summary Grazitti Interactive Grazitti Interactive +1 650-585-6640 [email protected] Visit us on social media: LinkedIn Bluesky Instagram Facebook YouTube X Other Legal Disclaimer: EIN Presswire provides this news content 'as is' without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.
