JAUNDICEANDHEPATITIS BBy ifsha Akhlaq

JAUNDICE Yellowing of the skin and eyes condition

occurs when too much bilirubin is present in body.

EPIDEMIOLOGY In United states 6.1% infants in 1986 4.3 % in 2003 2.9% in 1994 reported. In Turkey 10.5% reported.

PATHOPHYSIOLOGY Bilirubin is produced by breakdown of

hemoglobin into unconjugated bilirubin. Un conjugated bilirubin binds to albumin in

the blood and transport to liver. In liver the enzyme uridine

diphosphogluconurate glucuronasyltransferase (UGT) conjugated this bilirubin with glucronic acid which is taken up by hepatocytes.

This conjugated bilirubin excreted in bile. In patients or neonates the conjugated

bilirubin is deconjugates and recycled into the circulation and not excreted from body.

SIGNS & SYMPTOMS Yellow tinted skin and eye Whites of eye turn brown but in severe

condition Dark urine Pale stool Excessive fatigue Vomiting

DIAGNOSTIC TEST CBCs Liver function test Imaging test Abdominal ultrasounds Computed tomography scans Magnetic resonance imaging Liver biopsies

TREATMENT Supportive care Jaundice caused by medication/drugs the

antidote is required. Steroids in which have autoimmune diseases

with jaundice. Diuretics and lactulose is used in jaundice with

cirrhosis. Antibiotics for infectious causes of jaundice. Blood transfusions may be required in

individuals who have anemia from hemolysis. Surgery is requiring for jaundice with gallstones. Jaundice with liver failure need liver transplant.

HEPATITIS B Hepatitis B is a viral infection that attacks the

liver and can cause both acute and chronic disease.

EPIDEMIOLOGY 780,000 people die in a year due to hepatitis

B. In Middle East and Indian subcontinent 2-5 %

chronically infected. Less than 1 % of the population of western

Europe and North American is chronically infected.

PATHOPHYSIOLOGY Blood become exposed to HBV the body cell

mediated immune response sending cytotoxic T cells and naturally killer cells against the virus and release inflammatory cytokines.

As the hepatocytes are attacked and infiltrated by the HBV. Because hepatocytes are continually proliferating the virus is constantly being shed into the blood which leads to the chronic illness.

SIGNS & SYMPTOMS Dark urine Joint pain Loss of appetite Fever Abdominal discomfort Weakness Yellow skin and eyes

DIAGNOSTIC TEST Hepatitis B surface antigen test Hepatitis B core antigen test Antibody Hepatitis B surface antigen test Liver function tests

TREATMENT Hepatitis B immune globulin Within 24hours

in contact with HBV Antiviral medication Liver transplant