Types of Jaundice

Daily Haealth  Tip

For 4  Sep 2019

Types of Jaundice

By Prof Dr R R Deshpande ( M- 9226810630 )

Mail ID – professordeshpande@gmail.com

Types of Jaundice

There are main 3 Types

1)   Infective Hepatitis –Due to Virus A ,due to drinking Contaminated water .Anorexia ,Nausea ,Pain in abdomen are main Symptoms .Urine shows Bile Salts & Bile Pigments .Serum Direct  Bilirubin ,SGPT Levels are High .Physical Rest for 3 weeks is main Treatment

2)   Serum Hepatitis – Due to Virus B .Australia Antigen test of Blood is Positive . History of Blood Transfusion or STD ( Sexual Transmitted Disease) .Chronic in nature . Complications like Liver Cirrhosis & Liver Cancer may occur

3)   Obstructive Jaundice – This is due to obstruction from Gall stones or any Tumor in CBD ( Common Blie Duct ) .In addition to Jaundice there is Spasmodic Pain in abdomen ,Severe Itching of the body .Serum Alkaline Phosphatase level is  high/Confirmation is done by sonography or USG of abdomen ,specially of Liver & Gall bladder 

Which are the other diseases ,where Liver is Enlarged ( Hepatomegaly ) & Jaundice ?

1)   Leptospirosis – This is Infective disease caused by Leptospira .This Spirochaete is present in rats & is excreted in their urine .They enter the human body through abrasion or wound in the skin ,in rainy season .This is common in sewage workers ,miners ,rice or cane sugar field workers . There is High Fever + Jaundice + Haemorragic tendency .Urine & Blood test confirm the diagnosis

2)   Amoebic Hepatitis – History of repeated Amoebic Dysentry ( Amoebiasis = E.histolytica is found in stool Examination ) .Hepatomegaly ,Liver is tender ,Splenomegaly ,Jaundice ,marked anorexia ,White Blood cells are less .No Bile salts & Bile Pigments in Urine

3)   Carcinoma or Cancer of Liver – Middle aged patient ,Liver is hard & nodular .Gradual weight loss + Anorexia .Jaundice progressively increases .Metastatic glands may be present in neck .No Fever ,No Splenomegaly .USG Abdomen & Biopsy can confirm Diagnosis

4)   Acute Malaria – Typical pattern of periodical Fever is prominent .There are  cold stage ( Rigor or Shivering ) ,Hot stage ( High Fever) ,Stage of sweating .Splenomegaly is more than Hepatomegaly .Anorexia is absent .Jaundice is mild & of Haemolytic type .No Bile salts & Bile Pigments in Urine .MP ( Malarial Parasite) can be seen in PBS ( Peripheral Blood Smear )

So what is to note –that First we have to confirm ,cause of Jaundice .Then only take proper Treatment .So only saying --- There is No Treatment for Jaundice – So let us take Ayurvedic Treatment for Jaundice ! One can take treatment from any pathy .But do not do any thing Blindly .Diagnosis is First & then only Treatment .

Daily Health  Tip

For 3 Sep 2019

Laboratory Tests for Jaundice ( Infective Hepatitis )

By Prof Dr R R Deshpande ( M- 9226810630 )

Mail ID – professordeshpande@gmail.com

If any patient comes with complaints like Severe Anorexia ,Nausea ,Vomiting ,Pain in right  upper quadrant of abdomen ,also some times fever with chill .Loss of Appetite or Anorexia is so severe that even patient do not want see at food .--Then Doctor suspects Jaundice 

When doctor examines he finds soft & tender Liver .Then doctor checks upper Palpebral Conjunctiva in sun light or day light ( & not in Tube light or Lamp Light ) for Yellow discoloration .This is called as Icterus . some times patient may complain dark yellow or High coloured urine

Then doctor suspects that patient may have Jaundice or Infective Hepatitis due to Virus A ,due to contaminated water .

Then  to confirm this provisional diagnosis doctors asks to  do Urine Routine Examination .In the report if Bile Salts & Bile Pigments are present ,then patient is suffering from Jaundice

Jaundice is a inflammation of Liver i.e Hepatitis .Next Doctor advice LFT = Liver Function Tests

These tests gives more idea about Type of Jaundice & Severity of Jaundice

Let us see details of LFT  & their Normal values & if raised ,what is it’s significance ?

Serum Bilirubin  -- Bilirubin is breakdown product of Haemoglobin .Unconjugated or Indirect Bilirubin is converted to Conjugated or Direct Bilirubin in Liver .This is excreted through bile into small intestine .

In Jaundice Blood Bilirubin Level Increases

Normal Values

Total Bilirubin = 0.1 to 1.2 mg %

Direct Bilirubin = up to 0.3 mg %

Indirect Bilirubin = 0.1 to 1 mg%

Indirect Bilirubin increases in Jaundice due to Pre Hepatic Causes like Haemolytic Jaundice

Direct Bilirubin Increases in Infective Hepatitis or Obstructive Jaundice

In Jaundice Liver Enzymes levels are also increased

SGPT = Serum Glutamate Pyruvate Transaminase

This is also called as ALT = Alanine Amino Trasferase

Norma Value = 5 to 35 IU /Lit

In Obstructive Jaundice ,due to Gall stones or Cancer ,Serum Alkaline Phosphatase level becomes very High

Normal value = In Adults = 100 to 250 IU /L

In Children = 250 to 770 IU/L

In obstructive Jaundice patients complains of severe Itching & spasmodic pain in abdomen .Here Jaundice is deep & serum Bilirubin is too high .Then Doctor advice USG abdomen ,to find out cause of obstruction in Bile duct

There is another Type of Jaundice ,where Anorexia is not severe .But there is history of Blood Transfusion or STD ( Sexual Trasmitted Disease) .In this case Doctor will suspect Jaundice due to Hepatitis B virus .This is also called as Serum Jaundice .Diagnosis is confirmed by doing Blood Tests as Australia Antigen or HBsAg .This Test becomes Positive

Here we must understand that ,even if you are taking Ayurvedic or Homeopathic or Naturopathy Treatment ,above  said Investigations are must to get done !

Part 49 Types of Pitta Dosha Alochak Pitta

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Kriya Sharir Viva Questions

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Compilation --- By Dr Amar Ande

Motivation & Guidance -- Prof Dr R R Deshpande

Date -  --- XYZ

External Examiner  --- ABC

 Internal Examiner ----  ABC

Some Specific Questions by Examiners

1. Derivatives of Hb?

2. Vitamins in RBC formation?

3. Def. of Specific gravity?

4. Areas of Auscultation of Heart sound?

5. How to take Bicep Reflex?

6. Where is insertion of Bicep and triceps tendon? Show on Body?

7. What is Bucket handle movement in Respiration?

8. Why only 80 squares are counted in RBC Practical instead of 400 square?

9. How 10000 Number is inculcate in WBC Practical?

10. What is RBC  & WBC Ratio?

11. What is Erythroblastosis Foetalis?

12. Significance of Systolic and Diastolic Pressure?

13. Which are Bile salts and Bile Pigment? And its Threshold?

14. Which are heamoglobinopathies?

15. What is Lan Steiner’s law?

16. Blood Groups Details and Blood Transfusion?

17. Why Hb is encorporated in RBC’s? Why not Separately in Blood?

18. Arjavam Means?

19. Why Cedar wood oil is only used in DLC Practical?

20. Healing of wounds is quick in which type of sarata?

21. Definition of Serum?

22. Role of Platelets in hemostasis?

23. What does Purpura under the skin Indicates?

24. What is Invivo and invitro coagulation of Blood?

25. Definition of erythropoiesis and its stages?

26. What is shell temperature and core temperature?

27. Difference between Albuminometer and Urinometer?

28. Difference between Lung Volume and Lung Capacity?

29. What is Spirometry?

30. Importance of Prakruti Parikshan?

31.Blood Pressure regulation and harmones responsible for it ?

32. Difference between terms Kshalan, Ruksha, Khara, Parushak?

33. Definition of sarata?

34. Difference between Vyahar and Vihar?

35. What is Ashritvatsal and Uddhatam Medha?

36. Name the Proteins in Plama?

37. Factors responsible for Hb Formation?

38. Types of Agni according to Dosha?

39. Prakruti Nirmankar Bhava?

40. Functions of Rakta Dhatu?

41. Describe muscles required for inspiration and expiration?

42. What is Ejection fraction and its value with significance?

43. Difference between Vriddhi, Kshay and Sarata?

44. What is Clot Retraction?

45. Significance of Bleeding and Clotting time?

46. Difference between Leukemia, leucocytosis and Polycythemia?

47. What is cardiac reserve, cardiac output?

48. Why EF is 60-65 % in normal and not 100%?

49. What is the need of cross match before blood transfusion?

50. Explain Coagulation Process.

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