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.

29/03/2026

Today, Dr. Abhishek Shukla explained the physiological changes that lead to weakening of bones with advancing age. He described this process as part of degenerative changes, where there is a gradual decline in bone mineral density (BMD). As bone mass decreases, the structural integrity of bones weakens, making them more prone to fractures and functional limitations.

He outlined the progression of bone health deterioration, beginning with osteopenia, a stage of reduced bone density that precedes more severe conditions. If not addressed, this can progress to osteoporosis, where bones become significantly fragile. Over time, degenerative joint involvement may lead to osteoarthritis, characterized by pain, stiffness, and reduced mobility, and in advanced stages, this may result in deformities affecting posture and overall quality of life.

Dr. Shukla also discussed the role of bone-forming and anti resorptive agents in management. Medications such as teriparatide (a bone forming agent) and denosumab (which reduces bone resorption) are used in appropriate cases to improve bone strength and reduce fracture risk. He emphasized that early identification, along with medical management and lifestyle modifications, is essential to prevent progression and maintain skeletal health.

28/03/2026

Today, Dr. Abhishek Shukla discussed a case of a 21 year old girl diagnosed with diabetes, highlighting the concept of early onset Type 2 diabetes. He explained that the rising incidence in young individuals is often linked to lifestyle factors such as poor diet, physical inactivity, and obesity, along with a strong family history of diabetes. He also introduced MODY (Maturity Onset Diabetes of the Young), a genetically inherited form of diabetes that presents early and differs from typical Type 1 and Type 2 diabetes.

He further elaborated on various risk factors and triggers that can contribute to the development of diabetes at a young age. These include chronic stress, alcohol consumption, smoking, metabolic dysfunction, and the use of certain medications such as steroids, antipsychotic drugs, and diuretics. Additionally, hormonal imbalances or endocrine disorders can also predispose individuals to abnormal glucose metabolism, making early screening and awareness crucial.

Dr. Shukla emphasized that one of the most serious complications of uncontrolled diabetes is diabetic ketoacidosis (DKA), a life threatening condition that requires immediate medical attention. He also stressed the importance of dietary and lifestyle management, recommending a balanced, controlled intake of sugar and fats, along with regular monitoring and medical guidance. Early diagnosis, preventive care, and disciplined lifestyle habits are key to managing diabetes effectively and avoiding complications.

27/03/2026

Today, Dr. Abhishek Shukla explained to nursing students the importance of effective emergency planning in clinical settings. He emphasized that preparedness begins with the ready availability of essential instruments and equipment, including Foley’s catheter, Ryle’s tube, endotracheal tube, ABG machine, emergency medications, and necessary injections. Ensuring that these resources are accessible and functional is critical for timely intervention during emergencies.

He further highlighted that nurses must adopt a holistic approach while assessing patients, rather than focusing on a single presenting symptom. A comprehensive evaluation, considering vital signs, systemic involvement, and overall clinical condition, is essential for accurate and timely decision-making. He also stressed the importance of appropriate tests and investigations to support clinical judgment and guide further management.

Dr. Shukla encouraged the use of modern technology in emergency care, particularly in situations where a doctor may not be immediately available. He advised that nurses should utilize tools such as phone calls or video consultations to connect with doctors and receive real-time guidance for initiating immediate care. This integration of preparedness, clinical insight, and technology can significantly enhance patient outcomes in critical situations.

26/03/2026

Today, Dr. Abhishek Shukla discussed with nursing students an important clinical and ethical concern regarding the administration of care beyond the defined scope of nursing practice. The students raised questions about what might happen if nursing staff provide all forms of care, including medical interventions that are typically prescribed and performed by doctors, and whether such actions could lead to disciplinary or legal consequences.

Medical care, particularly diagnosis and prescription, is the responsibility of a doctor. However, he directed the discussion toward the realities of emergency medicine, where rigid role boundaries may momentarily blur in the interest of patient survival. The concern, he suggested, should not be limited to the fear of repercussions when a patient’s life is at immediate risk.

He highlighted that in emergency situations, the initial 5–7 minutes are critical, and the foremost priority must be rapid stabilization and life-saving intervention. During this crucial window, the focus should remain entirely on saving the patient’s life rather than on potential consequences. Once the patient is stabilized, appropriate medical protocols and responsibilities can then be resumed and followed accordingly.

25/03/2026

Today, Dr. Abhishek Shukla addressed an important clinical question raised by nursing students regarding the rise in creatinine levels in kidney disorders. He explained that the kidneys play a vital role in filtering metabolic waste products from the blood, primarily blood urea, blood urea nitrogen (BUN), and serum creatinine. Under normal physiological conditions, the kidneys efficiently maintain these parameters within a narrow range by excreting excess waste through urine.

He further elaborated that when kidney function is compromised, these waste products begin to accumulate in the bloodstream. An elevated serum creatinine level is particularly significant, as it serves as a sensitive marker of impaired renal function. Such derangements may occur in conditions like acute kidney injury (AKI) or chronic disorders such as diabetic nephropathy, where progressive damage to the kidney’s filtering units leads to reduced clearance of toxins.

To evaluate such abnormalities, Kidney Function Tests (KFT) are routinely performed, which include measurements of urea, BUN, and creatinine levels. In addition, imaging modalities like ultrasound of the kidneys are essential to assess structural changes, including reduced kidney size, features of chronic kidney disease, or conditions such as polycystic kidney disease. Therefore, a rise in creatinine is not a disease in itself but an important clinical indicator that warrants further investigation to identify and manage the underlying cause.

24/03/2026

student asked Dr. Abhishek Shukla whether CPR should be performed differently if a 100 kg person goes into cardiac arrest. Dr. Abhishek Shukla, a geriatrician, explained that in any emergency situation, especially on the road, the most important thing is to act quickly using common sense. Cardiac arrest is a life-threatening condition where every second counts, and there is only a short window of about 90 seconds to initiate life-saving measures.

He emphasized that the first step is to assess the situation and immediately call for help. One should ask someone nearby to contact emergency services and arrange for an ambulance. While waiting for professional help to arrive, basic life support should be started without delay.

CPR (cardiopulmonary resuscitation) should be performed by placing the person on a flat, hard surface. Even in a 100 kg individual, chest compressions must be given firmly and effectively at the center of the chest, ensuring adequate depth and rate. The rescuer should not hesitate due to the patient’s body weight, as proper compressions are crucial to maintain blood circulation.

If trained and comfortable, the rescuer can also provide mouth-to-mouth respiration to ensure oxygen supply to the lungs. The combination of chest compressions and rescue breaths helps maintain oxygen delivery to vital organs, especially the brain.

Dr. Shukla concluded that the priority in such emergencies is not perfection, but prompt action. Doing something is always better than doing nothing, as timely CPR can significantly improve the chances of survival.

23/03/2026

A patient explained to Dr. Abhishek Shukla that her health deteriorated during a recent trip. She shared that she had traveled to Khatu Shyam, then visited Balaji, and later went on to Jaipur. While the journey initially went smoothly, her condition worsened when she reached the hotel in Jaipur. She reported feeling significant breathlessness and was unable to sleep throughout the night due to discomfort. The symptoms caused considerable anxiety, prompting her to seek medical attention immediately after returning.

Dr. Abhishek Shukla carefully evaluated her condition and explained the possible reasons behind this sudden worsening. He noted that the patient is a known case of chronic kidney disease and undergoes dialysis twice a week, indicating reduced kidney function. He further explained that patients with chronic kidney disease commonly present with acute breathlessness. The two main reasons for this are either inadequate or missed dialysis sessions, or increased intake of salt and fluids, both of which can lead to fluid overload in the body. In this patient’s case, there was also evidence of fluid accumulation in the lungs, which further contributed to her symptoms.

He added that during travel, routine medical discipline often gets disrupted. The patient may have consumed excess fluids beyond her prescribed limit and eaten oily and spicy food, which can worsen fluid retention. These factors together likely triggered her breathlessness and sleeplessness. Dr. Shukla emphasized the importance of adhering to fluid and dietary restrictions, especially during travel, and advised careful monitoring and planning to prevent such complications in the future.

22/03/2026

student asked why patients with Parkinson's disease often suffer from constipation. Dr. Abhishek Shukla, a geriatrician, explained that research shows nearly 70% of people living with Parkinson’s experience constipation, and interestingly, it may begin up to 15 years before the disease is formally diagnosed.

He clarified that this early symptom is linked to changes in communication between the gut and the brain, known as the gut–central nervous system (CNS) axis. In Parkinson’s disease, there is degeneration of nerve cells that produce dopamine, but the disease also affects the enteric nervous system (the “brain of the gut”). This disrupts normal bowel movements, slowing intestinal motility and leading to constipation.

Dr. Shukla further explained that many patients develop chronic constipation due to pelvic floor dysfunction. The pelvic floor muscles, which help control bowel and urinary movements, may not relax properly during defecation. This results in difficulty passing stool despite the urge. Both muscular weakness and neurological impairment contribute to this problem.

Additionally, reduced physical activity, inadequate fluid intake, and side effects of medications used in Parkinson’s disease can worsen constipation. Therefore, constipation in these patients is not just a simple digestive issue but a combination of neurological and muscular dysfunction.

Early recognition of constipation is important, as it may serve as a warning sign of Parkinson’s disease and allows timely management through diet, lifestyle changes, and medical therapy.

21/03/2026

Dr. Abhishek Shukla, a geriatrician, explained that HRBP/LAR (Hydration/Renal Blood Profile–Lactate Albumin Ratio) is a clinically useful indicator for predicting patient outcomes, especially in critically ill individuals. This ratio combines markers of cellular injury and nutritional status, making it a valuable prognostic tool.

Serum albumin is a negative acute-phase protein, meaning its levels decrease during systemic inflammation, infection, or poor nutritional status. Low albumin often reflects compromised immunity, chronic illness, or malnutrition. On the other hand, Lactate Dehydrogenase (LDH) is an intracellular enzyme released into the bloodstream during cell damage or cell death. Elevated LDH levels are commonly seen in conditions such as sepsis, multi-organ failure, and tissue breakdown.

When these two markers are combined into the Lactate-to-Albumin Ratio (LAR), it provides a more comprehensive picture of the patient’s physiological stress. A high LDH (indicating increased cell death) along with low albumin (indicating poor nutritional and inflammatory status) suggests a severe underlying condition, often associated with sepsis, multi-organ dysfunction, and dehydration.

Clinically, a LAR value greater than 10.57 has been associated with significantly increased mortality risk. This makes LAR a simple yet powerful bedside tool for early risk stratification, especially in ICU settings. It helps clinicians identify high-risk patients promptly and initiate aggressive monitoring and management.

Thus, HRBP/LAR serves as an integrated biomarker reflecting both metabolic stress and systemic health, aiding in better prediction of patient survival outcomes. albumin

20/03/2026

A patient asked Dr. Abhishek Shukla, “Why does urine pass involuntarily during sleep? Why does this happen?” Dr. Abhishek Shukla, Geriatrician, explained that adult bedwetting, medically known as nocturnal enuresis, is not a disease in itself but usually a symptom of an underlying problem. It occurs when the normal control over bladder function is disrupted during sleep. In healthy individuals, the brain signals the bladder to hold urine at night, but in some cases, this coordination is impaired.

He further elaborated that one of the most common causes is an overactive bladder, where the bladder muscles (detrusor muscles) contract involuntarily, even when the bladder is not full. Other medical conditions can also contribute. For example, diabetes can increase urine production due to high blood sugar levels, while prostate enlargement in men can obstruct urine flow and lead to incomplete emptying. Urinary tract infections may irritate the bladder, and neurological disorders like stroke, Parkinson’s disease, or multiple sclerosis can interfere with nerve signals controlling urination.

Dr. Shukla also highlighted that sleep-related disorders such as obstructive sleep apnea and hormonal imbalances, particularly low levels of anti-diuretic hormone (ADH) at night, can lead to excessive urine production. Certain medications, stress, chronic constipation, and lifestyle factors like excessive caffeine or alcohol intake may worsen the problem. He emphasized that anyone experiencing this issue should seek medical advice, as proper evaluation can identify the cause and guide effective treatment.

19/03/2026

There are several widespread myths about cancer that often create unnecessary fear and delay timely treatment. One of the most common misconceptions is that procedures like biopsy or FNAC (Fine Needle Aspiration Cytology) can cause cancer to spread faster. This belief is not supported by medical science. In reality, these diagnostic procedures are essential tools that help doctors accurately identify the type and stage of cancer, enabling appropriate and timely treatment. Avoiding a biopsy due to fear can actually worsen outcomes by delaying diagnosis.

Another common myth is that cancer is always hereditary or that it inevitably leads to death. In truth, only a small percentage of cancers (about 5–10%) are purely genetic, while most are influenced by lifestyle, environmental factors, and aging. Additionally, with advancements in medical science, many cancers are now treatable and even curable if detected early. There is also a misconception that cancer treatment always leads to unbearable side effects; however, modern therapies are much more targeted and better tolerated than before.

Dr. Abhishek Shukla discussed these myths in detail with Dr. Abhishek Verma, emphasizing the urgent need to educate both the general public and paramedical staff. They highlighted that misinformation can be dangerous and stressed the importance of relying on scientific evidence rather than hearsay. Busting these myths is crucial to ensuring early diagnosis, reducing fear, and improving cancer outcomes in the community.

18/03/2026

A medical student asked Dr. Abhishek Shukla, “Sir, is there any vaccine available to prevent cancer? I want to get vaccinated.”

Dr. Abhishek Shukla, Geriatrician, explained that while most cancers do not yet have preventive vaccines, there is an important vaccine that can significantly reduce the risk of certain cancers. He discussed the HPV vaccine, such as Gardasil 9 and Cervavac, which protect against infection caused by the Human Papillomavirus (HPV).

He explained that Gardasil 9 protects against nine HPV types—6, 11, 16, 18, 31, 33, 45, 52, and 58. These strains are responsible for the majority of HPV-related cancers and ge***al warts. The vaccine is highly effective, offering more than 95% protection in young individuals when given before exposure to the virus.

Dr. Shukla further explained that HPV vaccination can prevent several important cancers. These include cervical cancer, which is the primary target of the vaccine and whose incidence can be reduced by up to 90% in females vaccinated before age 17. The vaccine also helps prevent a**l cancer, oropharyngeal cancer (cancer of the throat and back of the mouth), vulvar and vaginal cancers in women, and pe**le cancer in men. In addition, it protects against ge***al warts.

The vaccine is recommended for both boys and girls, ideally between ages 9–14. In this age group two doses are usually sufficient, while individuals aged 15–45 require three doses. Dr. Shukla also reassured that the vaccine is safe, with only mild side effects such as pain at the injection site, mild fever, dizziness, or headache. He advised consulting a doctor to determine the correct vaccination schedule

Address

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

Telephone

+919415015050

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