VIRAL HEPATITIS

PATIENT DEMOGRAPHICS
 IP number: 350706
 Age: 31 years
 Gender: Male
 Date of admission: 20/01/10
 Date of discharge: 28/01/10
SUBJECTIVE EVIDENCE

 Fever associated with chills on off type since 1

month
 High coloured urine since 15days
 Yellowish discolouration of eyes since 15days
 Cough excpectorant since 1 week
OBJECTIVE EVIDENCE

PAST HISTORY : Known alcoholic since 10 yrs

Tobacco chewing since 7-8 yrs

PHYSICAL EXAMINATION

▪ Vitals
PR- 90b/min
BP- 110/80 mmhg

 Icterus- +ve
 Hepatomegaly +ve
LABORATORY INVESTIGATION
21/01/10
Hemoglobin (13-16gm%) ↓ 10.8
Bill.total (0.2-1.0 mg/dL) ↑ 3.6
Bill.dirct (0.2-1.0mg/dL) ↑2.7
AST (5-40IU/L) ↑ 187
ALT (5-40IU/L) ↑ 80
Total protein (6.0-8.0g/dL) ↓ 5.7
Albumin (3.5-5.0 g/dL) ↓ 2.2
Alkaline Phosphete(50-140 U/L) ↑201

PT INR Control 14.8sec

PT Time 15.8sec

INR 1.08
 Serum HCV - Negative
 HBsAg - Positive
PROVISIONAL DIAGNOSIS

VIRAL HEPATITIS
ASSESSMENT
THERAPEUTIC GOALS:
▪ To relieve fever and cough
▪ To provide treatment for Hepatitis
ASSESSMENT OF THERAPY INDICATED
DRUG INDICATION
Tab. L-Ornithine-L-Aspartate 150mg + To reduce liver enzyme level
Pencreatine (100mg)
1-1-1

Tab. Levofloxacin (500mg) To reduce Fever and cough

Syp. Phenylpropanolamine Hcl 12.5mg + To reduce cough as expectorant

Chlorpheniramine Maleate (2mg )2tsp
Cap. Zn Sulphate monohydrate,Vit. To increase Hb
B1,B2,B6,B12, Niacinamide, Ca.
pantothenate, Folic acid 0-1-0
Syp. Lactulose Laxative
 ASSESMENT OF CURRENT THERAPY
MEDICATION (NAME, DATE DATE USED AS
STREGNTH, STARTED STOPPED
ROUTE,DOSE)
Infusion 10% DNS with MVI 20.01.10 25.01.10 Nutrition supply
Tab. L-Ornithine-L-Aspartate
150mg + Pencreatine (100mg) 20.01.10 DM Hepato-Biliary Drugs
1-1-1
Tab. Levofloxacin (500mg) 21.01.10 DM Antibacterial
1-0-0
Syp. Phenylpropanolamine Hcl 21.01.10 DM Decongestant
12.5mg + Chlorpheniramine
Maleate (2mg )2tsp
1-0-1
Cap. Zn Sulphate monohydrate,Vit. 21.01.10 DM Nutrition supply
B1,B2,B6,B12, Niacinamide, Ca.
pantothenate, Folic acid 0-1-0
Syp. Lactulose 23.01.10 SOS Laxative
ALTERNATIVE THERAPY
 Tab. L-Ornithine-L-Aspartate 150mg + Pencreatine
(100mg)
Ursodioxycholic acid
 Lamivudine 100mg daily
 Interferone alfa-2B: 3 MU three times weekly
MONITORING
Therapeutic monitoring:
▪Fever was subsided
 Cough had reduced

▪Patient was symptomatically improved

Toxicity Monitoring
 Levofloxacin: Monitor fever,CBC, renal function
test
PLANNING
DISCHARGE MEDICATION:
Tab. L-Ornithine-L-Aspartate 150mg 15days
+ Pencreatine (100mg) Hepato-Biliary Drugs
1-1-1
Tab. Levofloxacin (500mg) Antibacterial 4days
1-0-0
Syp. Phenylpropanolamine Hcl 12.5mg Decongestant 4days
+ Chlorpheniramine Maleate (2mg )2tsp
1-0-1
Cap. Zn Sulphate monohydrate,Vit. Nutrition supply 15days
B1,B2,B6,B12, Niacinamide, Ca.
pantothenate, Folic acid 0-1-0

Follow up after 15 days.

 PATIENT COUNSELING

 Disease:
 inflammation and enlargement of liver

 Drugs:
 If any symptoms occur consult Doctor.
 Take proper Medication.

 Life style modification:

 Take high protein diet.
 Avoid fat contained diet.
 Avoid outside food and maintain good personal hygiene

THANK YOU