21 year-old patient suffering from acute alcoholic hepatitis. Plz suggest what to do better.n

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Alcoholic Hepatitis associated with Rt basal pleural effusion. Investigation:LFT, Viral marker, Ammonia level, Electrolytes,RFT,PT c INR,BSL, Lipid Profile. Adv:No extra Salt, Avoid alcohol, spicy food.o Treatment:Glucose water to drink, Propranolol 10 mg BD, Ursedeoxycholic Acid 300 mg BD, Lecithin 1 gm bd, Pantaprazole 40 mg BDAC, Furesemide 40 mg 1/2 tab daily morning, Lactulose 30 ml HS(Stop if L/M, again to start),Rpt USG after 4 weeks
Thanks Dr P S Sahana Sir
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To stop alcohol drinks PREDNISOLONE IN TAPERING DOSE 1 MONTH + PPI VITAMIN B1 CHLORDIAZEOXIDE FOR SLEEP SOS WATCH HYPOGLYCEMIA & TREAT IF RESTLESS SERENACE IF CONVULSION IV DIAZEPAM PROTEIN RICH FOOD
Tab.Ursodeoxycolic300mg o.d... Tab.Truliv plus ...bd.. Sup.silybon 10ml b.d... Cap.Pataprazole...o.d Treat for 1month and repeat u.s.g Take plenty FLUID and glucon d as it is Avoids r same as u advice on prescription..
Advice some lab tests L.F.T VIRAL MARKERS C.B.C....STOP ANASPAS IF ABDOMINAL PAIN THAN U CAN GIVE TRAMADOL AND MEFNAMIC ACID ONLY
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What is MBBS{AM},WHY U USED DICLOFENAC IN LIVER DISORDER PLS REFERRED THE PATIENT TO MD{MEDICINE}/MS {GEN.SURGERY}/hepatologist
Patient has been already referred to Asian Institute of Gastroenterology, Hyderabad.
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Needs further investigation before labelling alcoholic hepatitis like LFt, INR, CBC, HBsAg,Anti HCV ....If patient is stable then calculate Discriminant function score DF ...If it is alcoholic hepatitis and DF is more than 32 do urine ,blood culture , CRP and start steroid..
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Add methylprednisolone too in tapering dose for 1 month the reason behind is :it is alcohol induced hepatitis. And avoid pcm contains analgesic
Pl do HBsAg Test of this pt, if negative give hepatitis b vaccine
Thank you Doctors for your valuable advice
U should add Benfotiamine too
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