The Liver inflammation (hepatitis).pptx

Hepatitis

1. HEPATITIS

2. AYURVEDIC CORELATION- कामला  पाण्डुरोगी तु यो अत्यर्थं पित्तलानि निषेवते | तस्य पित्तमसृङ्गमांसं दग्ध्वा रोगाय कल्पते || If a patient of Pandu roga indulges in eatables and habits that promote pitta , his blood and muscle tissues are vitiated. In addition, this situation generates the disease known as Kamala

3. THE FEATURES OF कामला  हारिद्रनेत्रः स बृशं हारिद्रत्वङ्ग नखाननः | रक्त पीत शकृन्मूत्रो भेकवर्णो हतेन्द्रियः || १७ || दाहाविपाक – दौर्बल्य – सदनारुचिकर्षितः | कामला बहुपित्तैषा कोष्टशाखाश्रया मता || १८ || Deep yellow colouration of the eyes, skin, nails and faeces ; Yellow faeces and urine Skin colour resembling a frog (greenish, brown, or brownish yellow), Weakness of sense organs, Burning sensation Indigestion Weakness Debility Anorexia It involves both the kostha (alimentary tract) and also the sakha ( rakta blood) and other dhatus (tissues).

4. कुम्भकामला कालन्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला | If left untreated the above situation makes the organs, hard and subsequently turns into a difficult disease called Kumbha Kamala. PROGNOSIS OF कामला कृष्णा – पीत शकृन्मूत्रो बृशं शूनश्च मानवः || १९ || सरक्ताक्षि – मुख – च्छर्दि विणमूत्रो यश्च ताम्यति | दाहारुचि – तृडानाह – तन्द्रा – मोह – समन्वितः || २० || नष्ताग्निसंज्ञः क्षिप्रं हि कामलावान् विपध्यते | If a patient of jaundice is passing faeces and urine has turned blackish yellow in colour , if he has developed severe oedema , has reddish discolouration of eyes as well as oral cavity or is passing blood red vomit, faeces or urine, is suffering from giddiness, burning sensation, anorexia, thirst, tympanitis , drowsiness, confusion, subnormal temperature and coma, it would mean that the patient has reached a fatal stage.

5. PROGNOSIS OF कुम्भकामला च्छर्द्यरोचक – हृल्लास – ज्वर – क्लमनिपीडितः || २१ || नश्यति श्वास कासर्तो विड्भेदी कुम्भकामली | A patient of kumbha kamala would soon die if he has reached a stage when his disease has got combined with such symptoms as Chardi — vomiting, Arochaka — anorexia, Hrllasa — nausea, Jwara — fever, Klama — fatigue, Shvasa — dyspnea , Kasa — cough and Vidbhedi — diarrhoea .

6. HEPATITIS Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected .  Depending on its course, hepatitis can be acute, which flares up suddenly and then goes away, or chronic, which is a long-term condition usually producing more subtle symptoms and progressive liver damage.

7. LIVER ANATOMY ANATOMICAL POSITION The liver is predominantly located in the  right hypochondrium  and   epigastric  areas, and extends into the left hypochondrium .

8. LOBES OF LIVER There are four anatomical lobes, which are further divided into even smaller segments in accordance with the blood supply of the liver. The right lobe is the largest of the four lobes and the left lobe is a flattened smaller one. These two lobes are separated by the fossae for the gallbladder and the inferior vena cava. The caudate lobe sits between the fissure for the ligamentum venosum and the  i nferior vena cava , while the quadrate lobe is located between the  gallbladder  and the fissure for the ligamentum teres hepatis . 

9. SEGMENTS OF LIVER

10. SURFACES OF LIVER Diaphragmatic surface  – the anterosuperior surface of the liver. It is smooth and convex, fitting snugly beneath the curvature of the diaphragm. The posterior aspect of the diaphragmatic surface is not covered by visceral peritoneum, and is in direct contact with the diaphragm itself (known as the ‘bare area’ of the liver). Visceral surface  – the posteroinferior surface of the liver. With the exception of the fossa of the gallbladder and porta hepatis , it is covered with peritoneum. It is moulded by the shape of the surrounding organs, making it irregular and flat. It lies in contact with the right kidney, right adrenal gland, right colic flexure, transverse colon, first part of the duodenum, gallbladder,  oesophagus and the stomach.

11. LIGAMENTS OF LIVER

12. HEPATOCYTES Microscopically, the cells of the liver (known as hepatocytes ) are arranged into  lobules . These are the structural units of the liver. Each anatomical lobule is hexagonal-shaped and is drained by a  central vein . At the periphery of the hexagon are three structures collectively known as the portal triad: Arteriole  – a branch of the hepatic artery entering the liver. Venule   – a branch of the hepatic portal vein entering the liver. Bile duct  – branch of the bile duct leaving the liver. The portal triad also contains  lymphatic vessels  and  vagus nerve  (parasympathetic) fibres .

13. LIVER PHYSIOLOGY Bilirubin metabolism Carbohydrate metabolism Lipid metabolism Protein and ammonia metabolism Storage function

14. BILIRUBIN METABOLISM

15. HEPATITIS CAUSES Hepatitis can be caused by: AUTOIMMUNE HEPATITIS- Immune cells in the body attacking the liver VIRAL HEPATITIS- Infections from viruses (such as hepatitis A, hepatitis B, or hepatitis C), bacteria, or parasites Liver damage from alcohol or poison Medicines, such as an overdose of acetaminophen Fatty liver Liver disease can also be caused by inherited disorders such as cystic fibrosis or hemochromatosis , a condition that involves having too much iron in your body. Other causes include Wilson disease, a disorder in which the body retains too much copper and ingestion of toxic mushrooms.

16. CLASSIFICATION AUTOIMMUNE HEPATITIS VIRAL HEPATITIS NEONATAL HEPATITIS HEPATITIS - A HEPATITIS -B HEPATITIS-C HEPATITIS-D HEPATITIS-E

17. SYMPTOMS The symptoms of hepatitis include: Pain or bloating in the belly area Dark urine and pale or clay-colored stools Fatigue Low grade fever Itching Jaundice (yellowing of the skin or eyes) Loss of appetite Nausea and vomiting Weight loss

18. PATHOPHYSIOLOGY AUTOIMMUNE HEPATITIS: Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. The exact cause of autoimmune hepatitis is unclear, but genetic and enviromental factors appear to interact over time in triggering the disease. VIRAL HEPATITIS: Virus enters the blood stream Reaches the liver and multiplies Infect the hepatocytes and damage Infammation of liver cells

19. AUTOIMMUNE HEPATITIS The liver is a large organ that sits up under your ribs on the right side of your belly (abdomen). It helps filter waste from your body, makes bile to help digest food, and stores sugar that your body uses for energy. Autoimmune hepatitis occurs when your body’s infection-fighting system (immune system) attacks your liver cells. This causes swelling, inflammation and liver damage. It is a long-term or chronic inflammatory liver disease.

20. AUTOIMMUNE HEPATITIS DIAGNOSIS Liver function tests . These check for inflammation or damage to your liver Complete blood count or CBC . Looks at the number and types of cells in your blood. Coagulation panel . This test looks at how well the clotting proteins are working. Electrolyte panel . Checks to see if you have an electrolyte imbalance. Autoimmune antibodies . These are used to see if you have autoimmune hepatitis or another liver disease with similar symptoms. CT scan,MRI,Ultrasound,Liver biopsy.

21. Autoimmune hepatitis: May occur at any age Affects women more than men Is often linked to other diseases where the body attacks itself (autoimmune disorders)

22. AUTOIMMUNE HEPATITIS-TREATMENT  Autoimmune hepatitis is treated with medicines that suppress—or decrease the activity of—your  immune system , reducing your immune system’s attack on your  liver . The medicines doctors most often prescribe are corticosteroids also called steroids immunosuppressants

23. VIRAL HEPATITIS-CAUSE Hepatitis A is mostly a food-borne illness and can be spread through contaminated water and unwashed food. It is the easiest to transmit, especially in children, but is also the least likely to damage the liver and is usually mild and is completely resolved within six months.

24. VIRAL HEPATITIS-CAUSE Hepatitis B can be transmitted through exposure to contaminated blood, needles, syringes or bodily fluids and from mother to baby. It is a chronic disorder and in some cases may lead to long-term liver damage, liver cancer and cirrhosis of the liver after many years of carrying the virus.

25. VIRAL HEPATITIS-CAUSE Hepatitis C is only transmitted through infected blood or from mother to newborn during childbirth. It too can lead to liver cancer and cirrhosis in the long term. Hepatitis D is only found in people who are also infected with hepatitis B

26. VIRAL HEPATITIS-CAUSE Hepatitis E is predominantly found in Africa, Asia and South America. Certain generally safe medications can be toxic to the liver and cause hepatitis (drug-induced hepatitis) when taken in excess or in very high doses. These include acetaminophen (Tylenol) and even vitamin A. Also caused by uncooked food ,contaminated water etc.,

27. VIRAL HEPATITIS-SYMPTOMS HEPATITIS-A Unusual tiredness and weakness Sudden nausea and vomiting and diarrhea Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs, which is over your liver Clay- or gray-colored stool Loss of appetite Low-grade fever Dark urine Joint pain Yellowing of the skin and the whites of your eyes (jaundice) Intense itching HEPATITIS-B Abdominal pain Dark urine Fever Joint pain Loss of appetite Nausea and vomiting Weakness and fatigue Yellowing of the skin and the whites of the eyes, also called jaundice HEPATITIS-C Bleeding easily. Bruising easily. Fatigue. Not wanting to eat. Yellowing of the skin, called jaundice. This might show up more in white people. Also, yellowing of the whites of the eyes in white, Black and brown people. Dark-colored urine. Itchy skin. Fluid buildup in the stomach area, called ascites . Swelling in the legs. Weight loss. Confusion, drowsiness and slurred speech, called hepatic encephalopathy. Spiderlike blood vessels on the skin, called spider angiomas .

28. VIRAL HEPATITIS -SYMPTOMS HEPATITIS-D Yellow  skin  and  eyes  (jaundice) Stomach  upset Pain  in your belly Throwing up Fatigue Not feeling hungry Joint pain Dark urine Light-colored stool If you already have hepatitis B, HDV can make your symptoms worse. HEPATITIS-E Mild  fever Feeling very  tired Less  hunger Feeling sick to your  stomach Throwing up Belly  pain Dark pee Light-colored poop Skin rash  or  itching Joint pain Yellowish  skin  or  eyes

29. VIRAL HEPATITIS-DIAGNOSIS Liver function test (LFT) Albumin Total bilirubin Direct bilirubin ALT ( alanine aminotransferase ) ALP(alkaline phosphatase  ) AST(  aspartate aminotransferase ) Total protein hepatitis test panel  Hepatitis B Surface Antigen (HBSAG) Hepatitis B Core Antibody IgM (HBCMA), Hepatitis A Antibody, IgM (AHAV) Hepatitis C Antibody (HCAB) Liver ultrasound Liver biopsy

30. VIRAL HEPATITIS-TREATMENT AND PREVENTION HEPATITIS-A Usually body clears on its own Rest Medication Balanced diet HEPATITIS-B An injection of immunoglobulin (an antibody) given within 24 hours of exposure to the virus , should get the hepatitis B vaccine at the same time if you never received it. A ntiviral injections I nterferon injection liver transplant

31. VIRAL HEPATITIS-TREATMENT AND PREVENTION HEPATITIS-C Vaccination Liver transplant Anti viral medication HEPATITIS-D Liver transplantation Interferon injection Medication HEPATITIS –E Rest Balanced diet Avoid alcohol Stay hydrated

32. NEONATAL HEPATITIS Neonatal hepatitis is inflammation of the liver that occurs only in early infancy, usually between one and two months after birth . About 20 percent of infants with neonatal hepatitis are infected by a virus that caused the inflammation before birth by their mother or shortly after birth.

33. NEONATAL HEPATITIS-SYMPTOMS An infant with neonatal hepatitis usually has jaundice (yellow eyes and skin), that appears at one to two months of age, is not gaining weight and growing normally and has an enlarged liver and spleen. The infant cannot absorb vitamins for proper growth.

34. NEONATAL HEPATITIS-B VIRUS Neonatal hepatitis B virus infection is usually acquired during delivery. It is usually asymptomatic but can cause chronic subclinical disease in later childhood or adulthood. Symptomatic infection causes jaundice, lethargy, failure to thrive, abdominal distention, and clay-colored stools.

35. NEONATAL HEPATITIS INVESTIGATION Blood tests Doctors do blood tests to look for the hepatitis B virus as well as antibodies to the virus. Doctors also do blood tests to determine whether a liver disease has developed (see   Liver Blood Tests ). Ultrasonography  is done to provide images of the liver

36. NEONATAL HEPATITIS -TREATMENT No specific treatment Vitamin supplements are given Formulas that contain more easily digestible fats Mother is given a dose of HBIG and HBV vaccine

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