2. » Definition:
Hepatitis B is irritation & swelling(inflammation)of liver due to
infection with hepatitis B virus.(HBV)
» Symptom:
Yellowish skin& dark urine
fever,malaise,anorexia, nausea, vomiting,arthralgia ,fatigue,
Myalgia, splenomegally, hepatomegally,appetite loss
Less common cough,pharyngitis,arthritis,urticaria.
» Transmission:
Parentrally ( iv drug, blood transfussion, tattos),sexual contact,
organ transplantation share needle during drug
use, share personal item
3. Test:
HBs Ag(surface antigen)is present from 1 to 6 month after
exposure.
HBeAg( e antigen)is present for 1 to 3 month after the
acute illness &implies high infectivity.
The persistence of HBsAg for more than 6 month define
carrier status & occur in 5-10 % of infection(chronic
infection)
Treatment:
Interferon, lamivudine, adefovir , entecavir, tenafovir ,
adefovir,(antiretroviral)
4. • IPnumber : 31757/12
• Admission Date: 11.12.12
• Discharge Date: 24.12.12
• Department/Unit: medicine / 2
• Age: 59
• Sex : F
5. Chief Complains & H/O Present illness:
• C/o yellowish discoloration of eye since 20 days
• c/o nausea since 20 days
• Patient was normal 20 days back ,when she noticed yellowish
discoloration of urine & eye.
• Previous history:
• No H/O fever/loose stool/abdominal pain /chest pain /palpitation
• No H/O TB/ asthma/HTN /epilepsy /DM
7. • Blood Pressure: 110/70 mm /Hg
• Pulse Rate: 78 beat/min
• Temperature: Afebril
P I + C C L E
8. ˃ Respiratory system: : NVBS+, no added sound, chest wall symmetric
˃ CVS : S1S2 + , no murmur
˃ P/A : soft , non tender ,no organomegaly
˃ CNS: HMF (N) , motor & sensory system (N)
9. Laboratory data:
Test Normal value Test value
HB g/dl 12-16 13.2
TC cell/cmm 4.5-11k 8.2 k
P 40-75 60
L 25-33 28
E 1-3 04
M 3 -7 06
platelet 1.3-4 1.99lakh
S.ELECTROLYTE
NA mmoll 135-145 139
K mmol/l 3.5-5 3.5
CL mmol/lit 96-106 101
BUN mg/dl 11 - 23 13
SR.CREATININ
mg/dl
0.9-1.5 0.9
10. TEST NORMAL
VALUE
Test value
urine examination
Albumin Nil
PC Nil 2-3
EP trace 0-1
ESR mm/hr 0-20 15
TB (mg/dl) 0.3 -1 23.6
DB (mg/dl) 0.1-0.3 20.8
SGOT (AST) 8- 40 iu/l 972
SGPT (ALT) 8 -40iu/l 489
Alb (g/dl) 3.5 -5.5 5.5
HBsAg Positive
HCV Non reactive
HBeAg Non reactive
11. ˃ Based on the subjective and objective evidences the patient was diagnosed
to have hepatitis B.
12. Brand Name Generic Name
Dose &
Frequency
Date
Begun
Date Ended
T Livopill-Ds Silymarin 70mg ,
metadoxine 250mg
ornitine aspartate
Thiamine 10mg
1-0-0 11.12.12 24.12.12
Iv Fluid DNS Dextrose normal saline 12.121.2 15.12.12
Iv Emeset amp Ondansetron 4mg sos 11.12.12 19.12.1.2
Iv veloz Pantoprazole 40mg 1-0-0 11.12.12 15.12.12
T Pan Pantoprazole 40mg 1-0-0 15.12.12 19.12.12
Inj Vit K Vit k 1-0-0 11.12.12 22.12.12
Inj vegacef Ceftriaxone 1gm 1-0-1 11.12.12 18.12.12
Syp Bevon Vitamine & mineral 10ml 1-0-1 11.12.12 24.12.12
Syp Duphalac Lactoluse 15ml 14.12.12 22.12.12
T Zifi CV Cefexime 200mg 1-0-1 18.12.12 23.12.12
T Zofer MD onadansetron 4mg sos 18.12.12 23.12.12
T Zolfresh zolpidem 20mg 0-0-1 20.12.12 22.12.12
13. Brand name Generic name Dose & frequency Date begun Date ended
T udilive Ursodeoxycholic acid 300mg 1-0-0 20.12.12 24.12.12
T lamivir lamivudin 150mg 1-0-1 22.12.12 24.12,12
14. Test Test value
17.12.12
Test value
20.12.12
Normal value
TB mg/dl 20.6 20.4 0.3-1 mg/dl
DBmg/dl 18.4 18.1 0.1 -0.3 mg/dl
SGOT (AST) 534 372 8 – 40 iu/l
SGPT (ALT) 221 156 8-40 iu /l
TP 8.2 8.2 6.6-8.3
ALb g/dl 5 5 3.5-5
15. Brand Generic name Dose frequency
T livopill-DS Silymarin 70mg ,
metadoxine 250mg
L ornitine aspartate
Thiamine 10mg
folic acid 1mg
1-0-0 1 month
T zofer MD onadansetron 1-1-1 3 days
Syp duphalac Lactoluse 0-0-1 15ml 2 wks
T lamivir lamivudin 1-0-1 150mg TC
T pantodac pantoprazole 1-0-1 40mg 2 wks
T udiliv Ursodeoxycholic
acid
1-0-1 300mg TC
16. Suggestion to the physician :
The 2 first line medicine lamivudin & interferon should
be given in case of hepatits B.
17. Avoid alcohol.
Drink plenty of fluid.
Do not eat oily food.
Avoid carbohydrate a& protein rich food.( red meat
,potato, nut)
Take sugar can juice
Reduce salt intake ,to prevent bloating that may cause
swelling of liver
Don’t donate blood ,body organ
Don’t share tooth brush,wash cloth,syringe
