JAUNDICEJaundice is a yellowish discoloration of the skin and eyes caused by abnormally high levels of

the pigment bilirubin in the bloodstream

CAUSES:

• High levels of bilirubin in the blood may result from the problems originate either within the liver or outside the liver.

• Damage to the liver due to inflammation or scarring can impair its ability to excrete bilirubin into bile.

• Alternatively, the bile ducts, which carry bile from the liver to the small intestine may be blocked by a gallstone or a tumor.

• Less commonly, overproduction of bilirubin, due to excessive breakdown of RBC’S, can cause the liver to produce more bilirubin than the liver can process.

• Overproduction is most common in newborns with jaundice

• SYMPTOMS:

• In jaundice, the skin and whites of the eyes appear yellow.

• Urine is often dark due to excess bilirubin is excreted through the kidneys.

• People may have itching, light colored stools.

• Ex. Acute inflammation of liver (acute hepatitis) may cause loss of appetite, nausea, vomiting and fever.

• Blockage of bile may result in abdominal pain and fever.

DIAGNOSIS AND TREATMENT

• Laboratory tests and undertaken and imaging studies are done to determine the cause of jaundice.

• If the problem is a disease of liver , the jaundice usually disappears gradually as the condition of the liver increases.

• If the problem is blockage of bile duct, surgery or surgical endoscopy is performed.

• Itching caused by jaundice can be treated with cholestyramine.

HEPATITIS

• Hepatitis is a disease that affects liver causing it to swell and become inflamed.

• Common causes of hepatitis include some viruses that can damage liver cells, causing scar tissue to form and to prevent them from functioning .

• Hepetitis is of four types:

• 1. Hepatitis A

• 2. Hepatitis C

• 3. Hepatitis D

• 4. Hepatitis E

Hepatitis A

• It is the least threatening among the various forms of hepatitis, as it does not lead to chronic liver disease.

• Hepatitis A is mild illness, lasting one to two weeks, and rarely becomes serious.

• Hepatitis A Virus (HAV) causes temporary liver inflammation and is transmitted from contaminated food and water.

• Most HAV infections don’t have symptoms and are mild without jaundice.

• HAV Spread:

• It spreads by the fecal-oral route, i.e., through contaminated water or food with virus or by sewage or by food handlers who do not wash their hands thoroughly after using the bathroom.

• Eating raw or partially cooked shellfish from water containing raw sewages will cause outbreaks of HAV.

Symptoms:

• Adults may have dark urine and light stools, fatigue, nausea, vomiting, abdominal pain and fever.

• Children's usually don’t have symptoms.

• Full recovery takes up to six months and all symptoms disappear.

Prevention:

• The hepatitis A vaccine is given to people to an age of 2 or older.

• The vaccine is recommended for those who live in sanitary conditions, homosexual men, IV drug users, people infected with hepatitis B or C viruses and people who receive blood products, such as haemophiliacs.

• Wash hands with soap and water after using the bathroom.

• Use bleach to clean surfaces that have been contaminated by feces.

Diagnosis:

• Infection is confirmed with a blood test that determines the IgM antibody to the hepatitis A virus.

Treatment:

• There is no treatment, although immune globulin can provide temporary immunity to the virus for up to three months before exposure and two weeks after exposure.

Vaccination:

• The vaccine is recommended for day care center employees, laboratory workers who handle fecal specimens.

• For adults, a complete course of hepatitis A vaccine consists of two intra-muscular injections given six to 12 months apart.

• For children, ages 2 to 18, three injections are suggested: the first two are given one month apart, the third, and six to 12 months after the first.