| Suspect Infective Hepatitis when patient complains of sudden weakness, and loss of apetite, with nausea, fever and tender palpable Liver. Examine the sclera of eyes in bright sunlight. - Compete bed rest is very essential till S. Bilirubin < 1.5 mg.%, and enzymes are normal.
- Diet:
Fat free diet. Noil, ghee and friend foods. Pluenty of sweets, sugar, sugarcane juice. Boiled water for all at home Strictly No alcohol. - All hepatoxic drugs should be stopped. E.g Antoi-tuberculous drugs, Aspirin, Methyl dopa, alcohol
- No sedatives should be given if jaundice is deep.
- Drug Treatment
Glucose: Glucon D 50gm. Orally daily. During acute phase and when nausea and vomiting are severe, give I.V> Glucose –IV 2 x 540ml 10% dextrose + 1 amp M.V.I in one bottle (multivitamin) + 25% dextrose 3-4 ampules/ Day. + 1 amp Redoxone 1amp I.C. Tab. Liv 52 2 tds x 30 (Ayurvedic Liver support) Syp. Sorbilin tsp tds (sorbitol + tricholin) Tab. Essential 2 tds (Phospholipids to regenerate Liver cells) Inj. Neo-hepatex 2cc IM x alt days x 4 (Liver extract) or Inj. Neurobion 2cc IM x alt x 5 Calamine lotion to skin, if itching Steroids should be generally avoided. In acute phase, a short course may be given e.g Tab. Eysolone 5mg tds x 3-5 days Investigations Urine for bile salts and bile pigments. S.Bilirubin – every week. Australia Antigen for Hepatitis B if jaundice is recurrent, chronic or with weight loss. Ultra sound for Gall bladeder if obstructice jaundice is suspected. Routine Hb%. WBC. How to Prevent Boiled water for all at home (and for all locality if it is an epidemic.) Personal Hygeine and cleanliness (as faeces are infectious) Use Disposable Needles and syringes (to be destroyed after use) Inj. Human Immunoglobulin 10% 2ml IM single dose to contacts. Inj. Havrix (Hepatitis A Vaccine) 1440 units IM IM x stat 1mth, 6mths (booster) for travelers and close contact children = 720 units. Suspect obstructive jaundice if color of scelra is deep lemon yellow. If there is no loss of apetite, If gall bladder is palpable and if direct bilirubin is more. If jaundice is deep or increasinf, If S. Bilirubin is increasing. If patient is drowsy or irritable, Then refer the patient to physician immediately. These are signs of impending Liver cell failure. For prevention of Hepatitis-B, Hepatitis-B vaccine (14-10) Energix-B 1ml IM x 3 doses + stat, 1 month and 6 months. Indicated for all doctors, dentists, nurses, Lab technicians, Blood bank staff etc. Travellers likes salesmen should be advised Prophylactic Immunogobulin 2CC IM, esp. during epidemics of Hepatitis A. Inj. 10% Dextrose Multivitamin + 10% Dextrose Redoxone Tab. Liv 52 Syp. Sorbilin Tab. Essential 2. Inj. Neo-hepatex 2cc Inj. Neurobion Calamine lotion Tab. Eysolone |
