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.

30/01/2026

Seeing these surgical staples immediately suggests that the patient has undergone a major surgical procedure requiring skin closure. Such staples are commonly used where a long incision is made and strong wound support is needed for proper healing and to prevent wound dehiscence.

28/01/2026

While taking over a patient in the Intensive Care Unit (ICU), Dr. Abhishek Shukla explains that the primary responsibility of the treating team is to ensure continuity of care without missing any critical detail. ICU patients are often unstable, dependent on multiple life-support systems, and vulnerable to complications. A systematic approach is therefore essential during handover. One of the most reliable tools used worldwide is the evidence-based mnemonic FAST HUG BID, which acts as a daily safety checklist.

FAST HUG begins with Feeding and Fluids, ensuring adequate nutrition and optimal fluid balance. Analgesia is reviewed to confirm that pain is properly controlled. Sedation levels are assessed to avoid both over-sedation and agitation. Thromboembolism prophylaxis is essential to prevent deep vein thrombosis in immobilized patients. Head-of-bed elevation (30–45 degrees) reduces the risk of aspiration and ventilator-associated pneumonia. Ulcer prophylaxis helps prevent stress-related gastric bleeding, while Glycemic control maintains blood sugar within a safe range.

Dr. Abhishek Shukla further explains the BID components: Spontaneous breathing trials to evaluate readiness for ventilator weaning, Bowel care to prevent constipation and ileus, Indwelling catheter removal through daily assessment to reduce infection risk, and De-escalation of antibiotics to limit resistance and drug-related complications.

By consistently applying FAST HUG BID during ICU takeovers, healthcare teams improve patient safety, enhance communication, reduce errors, and ensure comprehensive, high-quality critical care—especially important for frail and critically ill patients.

27/01/2026

Sir, my aunt has been advised by her doctor to undergo a heart transplant. Please explain how safe this procedure is.” In response, Dr. Abhishek Shukla, Geriatrician, explained that a heart transplant is a major and high-risk surgical procedure, as the heart is a vital organ and the only one of its kind in the human body. Therefore, this operation is recommended only in very severe and life-threatening conditions.
Dr. Shukla further explained that the most common indication for a heart transplant is dilated cardiomyopathy. In this disease, the muscles of the heart become dilated and weak. Due to this dilation, the heart loses its ability to contract and relax effectively, leading to poor pumping of blood. As a result, patients develop severe symptoms such as extreme weakness, breathlessness even at rest, and inability to walk or perform daily activities. When medical treatment and other surgical options fail, heart transplantation becomes the last life-saving option.
He also clarified that a donor heart can be taken only from a brain-dead patient, and strict medical and legal protocols are followed during organ donation. With advances in medical science, the success rate of heart transplantation has improved significantly, though lifelong medicines and regular follow-up are required.
Dr. Shukla cited a recent article published in the Times of India about a 51-year-old woman who underwent a heart transplant 25 years ago and is still living a healthy and active life. She had her transplant on 23 January 2000 at the All India Institute of Medical Sciences (AIIMS), New Delhi, performed by a team led by Dr. P. Venugopal, Cardiologist, and Dr. K. K. Talwar, Cardiac Surgeon. This remarkable case shows that although the average survival of a transplanted heart is often quoted as around 5 years, many patients can live much longer with proper care and follow-up.

On the occasion of the 77th Dr. Abhishek Shukla, Founder of Centre for Geriatric Medicine, while greeting the Honor...
26/01/2026

On the occasion of the 77th Dr. Abhishek Shukla, Founder of Centre for Geriatric Medicine, while greeting the Honorable Chief Minister of Uttar Pradesh, highlighted the theme “ for .” He noted that increased life expectancy reflects national progress but also demands readiness to address the complex needs of older adults. Ageing is a natural phase, often associated with chronic illness and dependency, requiring continuous and compassionate care. “Preparing Healthcare for Ageing India” is therefore both a commitment and a call—to rethink care delivery, redesign systems with foresight, and ensure ageing is met with preparedness, compassion, and dignity.

23/01/2026

Thank you, for the beautiful birthday wishes. Your love, kindness, and faith in me truly touched my heart. You made my day incredibly special and memorable, and I feel blessed to have such amazing people around me always. Thank you all for the constant support.

23/01/2026

A young medical staff member, Ms. Vaishnavi Soni, experiences chest pain off and on and wanted to know which tests can help differentiate cardiac chest pain from non-cardiac causes. She discussed her concern with Dr. Abhishek Shukla, Geriatrician, who explained the approach in a clear and practical manner.

Dr. Shukla first clarified that not all chest pain is related to the heart. Chest pain can occur due to muscle strain, acidity or gas, anxiety, panic attacks, or stress. Such pain is termed non-cardiac chest pain. However, when chest pain is due to reduced blood supply to the heart muscle, it is called acute coronary syndrome, which includes conditions like heart attack and requires urgent attention.

He emphasized that when anyone—young or old—comes with chest pain, the first test that should be done is an ECG (Electrocardiogram). ECG helps detect changes in the heart’s electrical activity and can be performed within 3 minutes. If the ECG is abnormal or if there is strong clinical suspicion, then cardiac biomarkers should be checked, especially Troponin T and Troponin I. These blood tests confirm whether there is injury to the heart muscle. A Troponin T card test can give results within 10 minutes.

In addition, Echocardiography (ECHO) is a very useful test and takes only 5 minutes. It shows heart muscle movement and pumping function, helping to identify areas of damage or reduced blood flow.

Dr. Shukla highlighted that if ECG, Troponin (T/I), and ECHO are readily available, the chances of missing a heart attack are significantly reduced. Early testing helps utilize the critical 6-hour golden window, allowing timely treatment and clear differentiation between cardiac and non-cardiac chest pain.

22/01/2026

Dr. Abhishek Shukla, explained that tracheostomy removal, also known as decannulation, is a planned medical procedure done when a patient no longer requires assisted airway support. Before removal, doctors ensure that the patient is breathing comfortably on their own, has good oxygen levels, an effective cough reflex, and can clear secretions properly. The patient should also be alert and able to protect their airway while swallowing.

The procedure is usually simple and done at the bedside. First, suctioning is performed to clear secretions. The tracheostomy tube is then gently removed, and the stoma (opening in the neck) is covered with a sterile dressing. In most cases, the opening closes on its own within a few days.

Dr. Shukla emphasized several important precautions after tracheostomy removal. The patient should be closely monitored for breathing difficulty, noisy respiration, low oxygen levels, or excessive coughing. The dressing must be kept clean and dry, and pressure should be applied during coughing or speaking to support healing. Oral feeding is resumed cautiously to avoid aspiration.

Special care is required because weak respiratory muscles or associated medical conditions can increase risk. Any signs of respiratory distress should be reported immediately. Proper monitoring and gradual recovery ensure safe and successful tracheostomy removal.

21/01/2026

Dr. Abhishek Shukla explained that the swelling seen in the patient’s hand is mainly due to prolonged use of the blood pressure (B.P.) cuff. In this patient, the B.P. cuff was attached to the arm throughout the night, and the monitor was programmed to record blood pressure at regular intervals of every 10 minutes. Because of these frequent inflations, the cuff repeatedly compressed the arm for long periods. This constant pressure interfered with normal blood circulation and lymphatic drainage in the hand and forearm. As a result, fluid started accumulating in the tissues, leading to visible swelling of the hand.

Dr. Shukla emphasized that such swelling is common in hospitalized or critically ill patients who require continuous monitoring. The problem is usually not serious, but it should be addressed promptly to prevent discomfort and further complications. One simple and effective method to reduce the swelling is proper positioning of the affected limb. If the hand is swollen, two pillows should be placed under the patient’s hand and forearm. Elevating the hand changes its angle in relation to the heart, which helps gravity assist in the return of blood and collected fluid back into circulation. This improves venous and lymphatic drainage and gradually reduces the swelling. Regular checking of limb position and alternating the B.P. cuff site can also help prevent such issues.

20/01/2026

r. Abhishek Shukla, Geriatrician, explained that when a person experiences chest pain, it is very common to confuse it with gas or acidity. Because of this confusion, the patient often ignores the symptoms or delays seeking proper medical care, thereby wasting the most critical initial time known as the golden hours. Many patients first visit a local doctor or small clinic, which may or may not be equipped with facilities like ECG or cardiac blood tests to immediately diagnose a heart attack.

From there, the patient is usually referred to a district-level hospital, where tests such as ECG and Troponin-T are done to confirm the diagnosis. After this, the patient is further referred to a bigger center with facilities for angiography and advanced cardiac care. This entire process takes a long time, and by the time the patient reaches a tertiary care hospital, the initial 6 golden hours are often already lost.

Dr. Shukla emphasized that if the patient had reached a well-equipped center on time, the blocked artery could have been opened early, saving the heart muscle from permanent damage. Once heart muscle dies, it cannot be revived. Even if the artery is opened later, the damage is already done, leading to lifelong compromised heart function.

He strongly advised patients to always inform doctors about the exact time when chest pain started and explained that heart artery narrowing occurs gradually due to cholesterol plaque buildup over years.

19/01/2026

Dr. Abhishek Shukla, MD, FRCP (Geriatrician), in conversation with Dr. Nirupama Jaiswal, MD (Psychiatry), discussed an important and clinically relevant topic: What is tactile hallucination? This condition is commonly misunderstood by patients and caregivers, especially in elderly individuals.

A tactile hallucination is defined as a false perception of touch, movement, or sensation on the skin or inside the body without any real external stimulus. Patients may complain of feeling worms moving under the skin, insects crawling over the body, unexplained pressure, tingling, burning, or being touched when no one is present. These sensations feel very real to the person experiencing them and can cause severe distress, anxiety, and sleep disturbance.

Dr. Shukla emphasized that before labeling these symptoms as psychiatric, medical causes must be ruled out first. Conditions such as peripheral neuropathy, vitamin deficiencies (especially Vitamin B12 and Vitamin D), diabetes, electrolyte imbalance, and age-related nerve damage can produce similar abnormal sensations. Therefore, detailed clinical examination and basic investigations are essential in the initial evaluation.

Dr. Jaiswal added that substance use is another important cause. In particular, co***ne addiction can lead to tactile hallucinations, classically described as the sensation of insects crawling under the skin, also known as “co***ne bugs.” In such cases, the hallucinations are drug-induced and require urgent medical and psychiatric intervention.

Once physical causes are excluded, consultation with a psychiatrist is crucial. Early diagnosis and appropriate treatment with medications can significantly reduce symptoms and improve quality of life. Both doctors stressed that tactile hallucinations should never be ignored, and prompt medical attention is essential for safe and effective management.

18/01/2026

During the lecture, Dr. Abhishek Shukla explained the purpose and function of the green-coloured balloon commonly seen in critical care settings. He clarified that this green coloured balloon is called a Banes circuit, and it is used for lung recruitment, a process meant to open the collapsed alveoli of the patient. A pipe from the Banes circuit is connected to the tracheostomy tube and helps in supporting the patient’s respiration.

Dr. Shukla explained that when the Banes circuit balloon is gently pressed, air is pushed directly into the lungs through the tracheostomy. This manual ventilation temporarily increases airway pressure and helps expand areas of the lung that may have collapsed due to illness, prolonged bed rest, weak respiratory muscles, or ventilator dependency, which are commonly seen in elderly patients.

He further elaborated on the concept of lung recruitment, which involves specific maneuvers designed to reopen collapsed air sacs (alveoli) in the lungs. These maneuvers mainly use increased airway pressure, either manually with the Banes circuit or through mechanical ventilation. By applying temporary higher pressure, the collapsed alveoli are forced open, leading to better lung expansion and improved oxygen exchange.

Dr. Shukla emphasized that lung recruitment is especially beneficial in conditions like Acute Respiratory Distress Syndrome (ARDS), severe pneumonia, and respiratory failure, where oxygenation is compromised. Improved alveolar opening helps maintain adequate oxygen levels and reduces the work of breathing.

In conclusion, he stressed that lung recruitment using the Banes circuit should always be performed carefully and under medical supervision, particularly in geriatric patients, to avoid lung injury while ensuring effective respiratory support

17/01/2026

Falls are a major cause of injury, disability, and loss of independence among older adults. As people age, factors such as poor balance, muscle weakness, vision problems, chronic illnesses, and medications increase the risk of falling. To address this, geriatrician Dr. Abhishek Shukla has emphasized the importance of structured fall-prevention planning, starting with early risk assessment.
One of the most widely used tools is the Morse Fall Scale (MFS). It is a rapid, simple, and practical method to assess a patient’s likelihood of falling, especially in hospital and long-term care settings. The Morse Fall Scale has a minimum score of 0 and a maximum score of 125, with higher scores indicating greater fall risk.
The scale consists of six key questions:
1. History of falling (recent or during current admission)
2. Secondary diagnosis (more than one medical condition)
3. Ambulatory aid (none, crutches/cane, or furniture)
4. IV therapy or heparin lock
5. Gait (normal, weak, or impaired)
6. Mental status (awareness of own limitations)
Dr. Shukla highlights that fall prevention is not only about assessment but also about action—ensuring safe environments, reviewing medications, encouraging strength and balance exercises, proper footwear, and adequate lighting.
It is especially important for nursing officers to perform Morse Fall Scale scoring for all elderly patients. Nurses are often the first to observe mobility issues and behavior changes. Regular scoring helps in early identification of high-risk patients, timely preventive interventions, reduced hospital falls, and improved patient safety and quality of care.
https://email.americandatanetwork.com/e3t/Ctc/RG+113/cy-t904/VWGbT676_gTCW57yVlm4B8XzNW6phD5r5JmYRRN3NdJHF3qgz0W95jsWP6lZ3pJW4Bjfrs3GBRMdW6ZSLSX3ZXKnqW7byLmQ1v9MymW2nJJsw14TmXlW1zn1s63WdczNW4CVLXC7S2wffW5LxBtb9dRQJ-W5J8HST6pVN1zN2_fpmg3XDttW24dl0n61smz_W3bJSP28g-t6ZW2tR3_k7c_m5qN19x4VWzn4WmW7ybYfY9hFZFbW4nQgjr37_8dbW4-f3Hz6pd07zW8PZRN44GyNQmN24lkKrjmPTYW9dHSNS8cnTHxW66n_V83sY44pN3T7QpXfsgkDVSZZFK8z6581W3TrHJf98nhDfW5Q1wGZ3qplxQW6HbXS943dDYvVCR7Yh57KP-XW9bCf4z5MbX2VN6Y82sLPTHF7W1y8Jn_45qxhvW42gs5F5wZkgCf8td7vs04

Address

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

Telephone

+919415015050

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