Severe Jaundice

HBsAg, HCV,HIV - Non reactive LFT is deranged and attached USG WA doesnt reveal anything significant.

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It is a case of non alcoholic fatty disease of liver. This usually present with fatty person. The end result of non alcoholic fatty liver also known as steatohepatitis which with infection may lead scarring and ultimately end with cirrhosis of liver causing severe jaundice with all liver enzyme raised. MRI may be helpful .

Do CECT abdomen

IT'S A..CASE OF. . ? LIVER PATHOLOGY.. ? VIRAL HEPATITIS.. NEED'S.. HEPATITIS..VIRAL STUDY.. FIBRO TEST.. ANA..PROFILE.. MRI STUDY.. MEANWHILE TREAT SYMPTOMATICALLY..

Tnx Dr Rajendra Rai
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CLD, Any alcoholic history, Give I/V inj. Hepamerz 1amp. Conc. With D5%, Need completed Pt. History

No history of alcohol intake sir
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Do ERCP

Cryptogenic chronic hepatitis, resulting in cryptogenic cirrhosis liver. Need to recheck Hepatits B, ( HBs Ag antibody, core antigen, envelope antibody , viral load) , hepatitis C and E . HIV ANA profile to rule out autoimmune hepatitis Check Ceruloplasmin levels . Rule out alcoholic hepatitis. Suggest Fibro scan of liver Liver biopsy CBD normal size ,6 mm to 8 mm. In this case CBD is smaller in size, ? due to cirrhosis Supportive measures , Ursedeoxy cholic acid, liver protective.

Thank you, Doctor
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Looks Viral hepatitis Look for HEV and HAV IGM Admit patient and treat conservatively Rull out pancreatic malignancy by CT Abdomen Adv: PT, PTT

Ask for CT scan of ABDOMEN to ruled out malignancy

Give the following tt with ful confidence, Tapyadi loh 100 mg Kamdudha ras 250 mg Mukta shukti 500 mg Swarn basant malti 125 mg This is 1 dose,give tds. Liv 52 ds + Nirocil each bd. Faltrikadi qath 30 ml after meals bd. MOOLI Swaras + yavakshar+ lemon 1tsf Empty stomach. Tt 4 atleast 2 weeks.

What about head of pancreas ? HbsAg report Consult Gastroenterologist

Attached sir HBsAg report
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