FREQUENTLY ASKED QUESTIONS



  • What happens if we get Covid after the first dose?
  • Can cancer spread by using a lipstick of a cancer patient?
  • Does gallbladder removal decrease immunity?
  • Will abdominal ultrasound show fatty liver?
  • How is the Gilbert’s syndrome diagnosed?
  • Can I do abs exercises after 6 months of an open appendectomy?
  • Do all patients with cirrhosis have some degree of portal hypertension or is there a period of time early on where the portal pressure gradient is completely normal?
  • Can pancreatic cancer come back after 13 years?
  • Does gallbladder removal decrease immunity?
  • Is hemorrhoid a sign of cancer?
  • Which is the busiest organ – the heart or the liver?
What happens if we get Covid after the first dose?

If you contract COVID after the first dose of vaccination, you are more likely to have a less severe infection compared with if you were not vaccinated at all.

However, this is conditional. The vaccine takes about 2 weeks to stimulate the immune system to develop protective antibodies against the virus. If you were exposed to the virus prior to, during or immediately after vaccination, you can get an infection similar to the unvaccinated population. Secondly, if your immune system is compromised due to any reason (diabetic, cancer, organ failure, immunosuppressive medication) you may not form adequate protective antibodies to prevent an infection.

Therefore, the solution is to follow all preventive measures before, during and after the vaccination till the present wave and subsequent waves are over (do not travel outside unless necessary, maintain social distancing, wear a mask, wash hands, feet & face with soap and water whenever coming from outside). Get both doses of vaccine as recommended.

Can cancer spread by using a lipstick of a cancer patient?

No, absolutely not.

Cancer is the body’s own cells which have turned rogue. It is not an infectious condition and cannot spread from person to person. Environmental carcinogens such as toxins (smoking, alcohol, aflatoxin) can be common to a group of people living in the same area with similar cultural, dietary habits etc.

Does gallbladder removal decrease immunity?

Gall bladder removal does not have any impact on immunity or digestion.

Bile is produced by the liver and carried to the intestine by the bile duct. The gallbladder is an organ for storage of bile in the inter-digestive period. After gallbladder removal, bile continues to be produced by the liver as before. The bile duct adapts to store bile by increasing in diameter thus increasing storage capacity.

Will abdominal ultrasound show fatty liver?

Yes. An abdominal ultrasound scan is one of the most widely available, economical and least invasive diagnostic procedure performed for screening abdominal organs including liver. Fatty liver, gallbladder stones are commonly diagnosed on ultrasound. In most patients, no further diagnostic imaging is required and treatment is directed at the underlying cause (obesity, diabetes, dyslipidemia, alcohol abstinence etc). However in certain cases, further tests to evaluate fat content and associated changes such as inflammation may be required. These are performed using Liver Elastography (Fibroscan or MR) or a biopsy.

How is the Gilbert’s syndrome diagnosed?

The diagnosis of Gilbert’s is usually clinical as it is a benign liver condition that does not affect normal lifespan or general health. Genetic testing is available but not generally indicated as the cost-benefit ratio is low.

Mild hyperbilirubinemia (usually not exceeding 3–4 mg/dl) with predominant elevation of the indirect bilirubin component with normal liver enzymes is suggestive of Gilbert’s syndrome. It is usually detected incidentally on a medical checkup and and persists with minor fluctuations over time. Imaging of the liver is normal and screening for other common causes of jaundice such as viral hepatitis is negative.

Can I do abs exercises after 6 months of an open appendectomy?

Yes, you can.

Open appendectomy incision involves a muscle splitting rather than a cutting incision. Even after routine abdominal surgeries, abdominal exercises are allowed (in fact, recommended to maintain muscle tone and strength), after a reasonable period of time to allow for healing (~3 months). It is important to take it slow and easy to begin with and increase the intensity over time according to your tolerance.

Do all patients with cirrhosis have some degree of portal hypertension or is there a period of time early on where the portal pressure gradient is completely normal?

Cirrhosis causes increased resistance to the flow of blood through the liver resulting in portal hypertension. Compensatory mechanisms are activated to maintain adequate portal blood flow. The clinical term for this stage is compensated cirrhosis. Although clinically not apparent, the resistance to blood flow through the liver is higher than normal.

With worsening cirrhosis, there is increasing portal hypertension and compensatory mechanisms are overwhelmed resulting in decompensated cirrhosis. This becomes apparent with the onset of ascites (accumulation of fluid in the abdomen or legs) or bleeding from ruptured gastrointestinal varices.

Can pancreatic cancer come back after 13 years?

Yes, cancers can recur at any time during the patient’s lifetime.

The possibility of recurrence varies depending on the location and extent of the cancer (pancreatic cancer is traditionally aggressive), effectiveness of the treatment applied (curative or palliative), biologic behaviour of the cancer as assesed on pathology analysis of the biopsy or surgical specimen (well, moderate or poorly differentiated, vascular and lymphatic involvement etc). Additional treatment such as chemotherapy may be recommended after complete surgical removal of the cancer to kill micrometastases and reduce the likelihood of recurrence.

A less agressive cancer that is well contained and is completely removed at surgery has a lower chance of recurrence than one that is not. Surveillance with periodic blood tests for tumor marker levels and imaging is recommended after curative treatment to detect recurrence early and manage them effectively. Longer the recurrence free duration, lower the likelihood of recurrence. However, there are no features or time duration that can rule out cancer recurrence completely.

Does gallbladder removal decrease immunity?

Gall bladder removal does not have any impact on immunity or digestion.

Bile is produced by the liver and carried to the intestine by the bile duct. The gallbladder is an organ for storage of bile in the inter-digestive period. After gallbladder removal, bile continues to be produced by the liver as before. The bile duct adapts to store bile by increasing in diameter thus increasing storage capacity.

Is hemorrhoid a sign of cancer?

Hemorrhoids are not a sign of cancer.

However, hemorrhoids and colorectal cancer can coexist in a patient. Since both conditions present with bleeding after passing stools, it is possible to identify hemorrhoids as the cause and overlook the cancer. Hence there are guidelines that prescribe colonoscopy or sigmoidoscopy for patients presenting with lower gastrointestinal bleeding.

Which is the busiest organ – the heart or the liver?

Visibly, the heart…but in the background, the liver is the busiest organ.

The heart can be understood as a pump and it’s function is to circulate blood throughout the body, it is composed largely of muscle. There are artificial machines that can take over the function of the heart, at least temporarily.

The liver on the other hand has many types of specialised cells performing several functions from digestion, assimilation of nutrients to immune surveillance, detoxification etc. There is no machine in clinical use, that can take over all the functions performed by the liver..


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