Aastha Hospice

Aastha Hospice Aastha is a Hospice and Palliative Care Center for those whose illness may no longer be curable. It may be provided at home, hospital or hospice.

It enables them to achieve the best quality of life especially during the final stages of their illness.

02/12/2025

Today Dr. Abhishek Shukla explained why patients with diabetes can suddenly lose consciousness when their blood sugar drops below 50 mg/dL, a condition known as severe hypoglycaemia. At this level, the brain is deprived of glucose, leading to symptoms like sweating, tremors, confusion, seizures, and eventually unconsciousness if not corrected immediately. Hypoglycaemia is a medical emergency and often happens in patients who take insulin or oral hypoglycaemic medicines, especially if they skip meals, exercise excessively, or have kidney/liver issues.

Dr. Abhishek highlighted that immediate management is crucial. In an unconscious patient, an IV line should be established without delay, followed by the administration of 25% dextrose to rapidly raise blood glucose levels. If IV access is not possible, a glucagon injection is the next best option because it quickly stimulates the liver to release stored glucose. Caregivers should never try to give food or liquids orally to an unconscious person due to the risk of choking.

He further discussed DKD (Diabetic Kidney Disease), explaining how uncontrolled diabetes over time damages the small blood vessels of the kidneys. This leads to protein leakage in urine, rising creatinine levels, and eventually chronic kidney disease. DKD increases the risk of both hypoglycaemia and hyperglycaemia because impaired kidneys cannot properly metabolize medications. Regular monitoring, controlled sugars, kidney-friendly medications, and timely specialist intervention is important to prevent progression.


30/11/2025

Today Dr. Abhishek Shukla explained some common mistakes that happen during Foley’s catheterisation, especially when blood is seen coming from the urethra. One frequent cause is that the catheter coils inside the urethra instead of entering the bladder. When this happens, distilled water is mistakenly pushed into the balloon while the catheter is still in the urethra, which can cause urethral injury or even rupture. He stressed that distilled water should never be instilled unless there is clear urine flow, confirming the catheter is correctly placed in the bladder.

He also discussed how urethral strictures can make catheter insertion difficult. In such cases, forcing the catheter can lead to trauma and bleeding. If resistance is felt, the procedure should be stopped immediately. Forcing the catheter through a narrowed urethra is one of the most common reasons for false passage formation and bleeding.

Another important point he highlighted was insufficient lubrication. When adequate xylocaine or lubricant is not used, friction increases, causing mucosal tears, pain, and bleeding. Proper lubrication not only protects the urethra but also makes the insertion smoother and safer. Dr. Abhishek emphasised that gentle handling, correct technique, confirming urine flow before inflating the balloon, and recognizing anatomical difficulties are essential to preventing complications during catheterisation.


29/11/2025

It is a matter of great honour for me to be felicitated by the Indian Society of Hypertension. This recognition in the areas of geriatrics, palliative care, ageing, sarcopenia and hospice work encourages me to continue serving our elderly with even greater commitment. I am grateful to all the distinguished seniors whose guidance has always inspired me, Prof. Neil Poulter, Prof. Rajeev Gupta, Prof. C M Singh.

My heartfelt thanks to Prof. Anuj Maheshwari, Prof. Narsingh Verma sir, for their constant support and for bringing everyone together on one platform. His leadership and encouragement mean a lot to all of us working in this field.

I look forward to carrying this responsibility with sincerity and working collectively to improve care for those who need it the most.

27/11/2025

Today Dr. Abhishek Shukla discussed how to approach a patient with a high pulse rate in the ICU and why it should never be ignored. One of the most common reasons is severe dehydration, where the body increases the heart rate to maintain blood pressure and circulation. In such cases, the first step is to restore hydration through IV fluids. Monitoring urine output, electrolytes, and hemodynamic response is essential to ensure the patient stabilizes appropriately.

He also explained that a persistently high pulse can be due to untreated fever or underlying infection, which may progress to septicaemia. When infection spreads in the bloodstream, the heart compensates by beating faster to maintain perfusion to vital organs. Along with fluids, the patient requires broad-spectrum antibiotics, fever control, and continuous monitoring. Early identification and treatment of sepsis are crucial to preventing organ failure.

In severe cases where blood pressure drops despite fluid, known as septic shock, the patient may require vasoconstrictors like norepinephrine to maintain adequate blood pressure. Sometimes inotropic drugs are also needed to support the heart’s pumping capacity. Tachycardia in the ICU is not a symptom to treat in isolation; it is a sign that something serious is happening inside the body, and timely, targeted intervention can be lifesaving.


26/11/2025

A volcano is an opening in the Earth's crust through which molten rock, ash, gases, and steam erupt. When molten rock, called magma, is beneath the surface, it rises and is expelled during an eruption, at which point it is called lava. Volcanic eruptions can create mountains as lava and ash accumulate around the vent with each eruption.
Volcano Activity : Active, Dormant, Extinct.
Eruption: The process of a volcano releasing material from the Earth's interior.
Magma vs. Lava: Magma is molten rock beneath the Earth's surface, while lava is the molten rock once it has erupted onto the surface.
Formation: Volcanoes often form a conical or mountain shape as ejected material cools and solidifies around the vent with each eruption.
Types of eruptions: Eruptions can be explosive, sending material high into the sky, or calmer, with gentler flows of lava. The type of lava flow depends on its silica content and viscosity.
Location: Volcanoes can be found on Earth and other planets and moons. On Earth, many are found along tectonic plate boundaries, like the Pacific "Ring of Fire".

25/11/2025

Today, Dr. Abhishek Shukla discussed the various classes of medications used in the management of diabetes and how each of them works through distinct mechanisms to control blood sugar levels. He explained that the most commonly prescribed first-line drug is Metformin, which belongs to the Biguanide group. Metformin lowers blood glucose by reducing hepatic gluconeogenesis (glucose production from the liver) and decreasing intestinal glucose absorption, while also improving insulin sensitivity — making it easier for the body to utilize glucose effectively.

He further explained that Sulfonylureas, such as Glimepiride and Glipizide, act by binding and blocking ATP-sensitive potassium channels on the pancreatic beta cells. This blockage causes depolarization of the cell membrane, leading to the opening of calcium channels. The influx of calcium triggers the release of stored insulin, thereby helping to lower blood glucose levels. Dr. Shukla also discussed DPP-4 inhibitors (like Sitagliptin and Saxagliptin), which work by blocking the DPP-4 enzyme responsible for breaking down incretin hormones. This action increases incretin levels, which in turn enhances insulin release and reduces glucagon secretion after meals.

He also mentioned newer drug classes such as SGLT2 inhibitors (like Dapagliflozin and Empagliflozin), which help remove excess glucose through urine and have added benefits for heart and kidney health. Another group, Thiazolidinediones (like Pioglitazone), improves insulin sensitivity at the cellular level. For some patients, injectable medications such as Insulin and GLP-1 receptor agonists are required to maintain optimal glucose control. Dr. Shukla emphasized that understanding the mechanism of each drug is vital to managing diabetes effectively and preventing long-term complications.

23/11/2025

Today, Dr. Abhishek Shukla discussed how the printed names on medicine packaging can sometimes get cut or misaligned during manufacturing or while opening the strip. When the brand name or drug name is partially printed, folded, or torn, it becomes difficult to identify the medicine correctly. This can easily lead to confusion, especially when multiple strips look similar.

He explained that using a medicine without clearly identifying its name is risky. If the label is cut or unclear, one might take the wrong drug or repeat a dose by mistake. In hospitals, this can lead to medication errors, incorrect treatment, or even adverse reactions if the wrong medicine is given to a patient.

Dr. Abhishek advised that whenever the printed name on a strip or bottle is not fully visible, healthcare staff should immediately get it verified from the pharmacy. The pharmacy team can cross-check the batch, packaging, and appearance to ensure the correct medicine is being used. This small step can prevent serious errors and keep patients safe.


21/11/2025

Dr. Abhishek Shukla explained today that tuberculosis treatment involves multiple medicines because the TB bacteria are slow-growing and can easily develop resistance if only one drug is used. To prevent this, treatment is given as a combination therapy, usually including isoniazid, rifampicin, pyrazinamide, and ethambutol in the initial phase. Each medicine targets the bacteria in a different way, ensuring maximum killing of the germs and reducing the risk of drug-resistant TB.

He further discussed that TB bacteria exist in different states inside the body, some are actively dividing while others remain dormant. The dormant ones are harder to kill and respond slowly to medicines. Because of this, treatment is divided into two parts: an intensive phase to rapidly reduce the bacterial load and a continuation phase to eliminate the remaining slow-growing bacteria. This structured approach is essential to achieve complete cure.

The reason TB treatment goes on for around 6–10 months (or longer for drug-resistant TB) is to ensure that all bacteria are eradicated and relapse does not occur. Stopping treatment early can lead to incomplete killing of the bacteria, treatment failure, or the development of MDR-TB (multidrug-resistant TB). Dr. Shukla emphasized that adherence is crucial, taking medicines regularly and completing the full course is the only way to fully cure TB and protect public health.


20/11/2025

An elderly woman presented with an intertrochanteric fracture of the femur, a common injury in older adults following a fall, especially in the presence of osteoporosis. This type of fracture occurs in the region between the greater and lesser trochanter of the femur and often results in severe pain, inability to bear weight, and significant functional limitation. Early evaluation with X-ray imaging confirms the diagnosis and helps determine the pattern and stability of the fracture.

Dr. Abhishek explained to her that intertrochanteric fractures generally require surgical management, most commonly with internal fixation depending on the fracture type and bone quality. Surgery is done not only to align and stabilize the bone but also to help the patient regain mobility quickly and reduce complications such as bedsores, pneumonia, and deep-vein thrombosis. Pre-operative assessment includes evaluating cardiac status, hydration, hemoglobin levels, and optimizing any existing medical conditions to ensure safe anesthesia and surgery.

She expressed worry and fear about the injury and the recovery process. Dr. Abhishek reassured her that these fractures are routinely managed and that the team will do everything necessary to relieve her pain, stabilize the fracture, and help her walk again as early as possible. With timely surgery, good post-operative care, physiotherapy, and adherence to medical advice, most elderly patients recover well and regain their function.

19/11/2025

Today, Dr. Abhishek Shukla discussed an important aspect of IV therapy safety. He explained that when a drip set is inserted into a 100 ml IV bottle, the spike must fit correctly into the port. If the spike is larger than the port opening or is forced in, it can compromise the integrity of the bottle, leading to potential leakage or contamination. A proper, compatible IV set must always be used to maintain sterility and ensure accurate fluid administration.

He further emphasized that if leakage occurs, improvised fixes like wrapping adhesive tape around the port are not acceptable medical practice. Taping does not create a sterile seal and may allow micro-organisms to enter the IV fluid, putting the patient at risk of infection, air entry, or inaccurate flow rate. Such temporary solutions give a false sense of security while compromising safety.

Dr. Shukla highlighted that the correct response is to replace the entire IV bottle and the drip set if a mismatch or breach is detected. Maintaining an aseptic technique during IV therapy is crucial, and any suspected contamination warrants immediate correction. He reminded the team that patient safety must always come before convenience, and no shortcuts should be taken in intravenous care.

18/11/2025

Dr. Abhishek Shukla explained that during a blood transfusion, some patients are given Lasix (furosemide) injection to prevent fluid overload, especially those who are elderly, underweight, or have weak heart or kidney function. A unit of blood adds extra fluid volume to the body, and if the organs cannot handle this sudden increase, complications may occur. Lasix helps remove excess fluid through urine, maintaining a safe fluid balance during the transfusion.

He highlighted the risk of TACO - Transfusion-Associated Circulatory Overload, a serious condition in which the heart becomes unable to manage the increased volume of blood. This can lead to breathlessness, high blood pressure, lung congestion, and swelling. Patients with reduced cardiac reserve, frailty, anemia, or compromised kidney function are more susceptible. Giving Lasix before or between transfusion units helps protect these vulnerable patients.

By using Lasix when needed, Dr. Abhishek ensures that cardiac strain is reduced and the transfusion proceeds safely. This preventive step supports the heart, maintains fluid balance, and minimizes the chances of overload, allowing patients to receive the blood they need without complications.

17/11/2025

At 97, Navruttam Singh ji stands as a living example of what graceful ageing truly looks like. Despite being close to a century in age, his functional independence, mental clarity, and daily activity levels reflect the power of purposeful living. When Dr. Abhishek met him, it was not just his age that inspired admiration, it was his spirit, discipline, and positivity. He moves, interacts, and thinks with an energy that many people decades younger often struggle to maintain.

Graceful ageing is not about avoiding age, it is about embracing it with dignity, and self-care. People like Navruttam Singh ji remind us that longevity is meaningful when it is accompanied by functional strength, emotional balance, and a zest for life. His humility and consistency in routine show that healthy ageing is possible when the mind stays active, the body keeps moving, and the heart remains grateful.

Address

Aastha Geriatric Hospital & Hospice, B-52 J Park Mahanagar LKO
Lucknow
226006

Telephone

+919415015050

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