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It is parenchymal liver damage due to many agents : Viral infection Non viral (toxoplsma,leptospira & coxiella burntii) Drugs ( paracetamol – halothane ) Poisons ( Mushrooms – carbon tetrachlorid ) Others ( pregnancy – circulatory insufficiency – Wilson disease ) Alcohol .THE LIVER ORGAN: THE LIVER ORGAN LIVER PANCRIASE DUDENUMWhat is the common forms ?: What is the common forms ? Virus ( A ) Virus ( B ) Virus ( C ) Virus ( D ) Virus ( E ) Epstein Barr virus Cytomegalovirus Yellow fever virus Others – rare.What is the main effect of viral hepatitis ?: What is the main effect of viral hepatitis ? Chronic viral hepatitis usually with viral hepatitis ( B-C ) Acute viral hepatitis usually with viral hepatitis ( A-B-D-E )Slide7: Post mortem for liver cirrhosis What is the mode of viral hepatitis infection?Take care!!!: What is the mode of viral hepatitis infection? Take care!!!What are the viral hepatitis symptoms?: What are the viral hepatitis symptoms? Specific symptoms: Yellowish discoloration of skin & mucous membrane Distaste for cigarettes Dark urine . Pale stool . Nonspecific : Fatigue , tiredness . Anorexia. Fever. Muscular pain. Rarely skin rash.How can you suspect jaundice ?: How can you suspect jaundice ? Yellowish discoloration appears in sclera . It will be seen if you look to eyes during day light or white light .What is the disease signs ?: What is the disease signs ? Hepatomegaly. Splenomegaly (10% of the patient). Rarely skin rash. Generalized lymphadenopathy. Dark urine & pale stool . What are the complications ?: What are the complications ? Acute complications (rare): Arthritis,vasculitis,myocarditis & renal failure. Relapses occasionally occur . Dangerous complications (very rare): Fulminant hepatitis . Hepatic encephalopathy &death.Slide13: Chronic Complications : Chronic a symptomatic carriers of HBV . Chronic Viral Hepatitis . Liver cirrhosis (on long run complication) Primary hepatocellular carcinoma . Complications of cirrhosis it self . What are the investigations of the disease?: What are the investigations of the disease? Specific: Viral markers antibodies (IgM to HAV,HBV,HCV). Antigens (HBsAg,HBcAg,HBeAg). PCR to detect virus ( C ) Nonspecific: Raised serum aminotransferase :- (AST.ALT) A.phosphatase . Raised s.bilirubin (bilirubinemia). Increased prothrombin time . Increased E.S.R . Increased bleeding time. Leucopoenia with relative lmyphocytosis . What is the treatment available ?: What is the treatment available ? Admitted and isolate the patient to the hospital. Complete rest. Specific regimen on high carbohydrate diet ,low protein & fat. Symptomatic treatment for fever , vomiting & pain . Treatment of complications . We can use antiviral therapy (interferon) to treat acute cases with hepatitis ( B – C ).How can we avoid risk factors?: How can we avoid risk factors? Avoid direct contact with contaminated blood :- Avoid contaminated needles , surgical tools , dentist tools. Avoid barbers equipments . Avoid transfusion of contaminated blood , plasma , & anti hemophilic agents . Avoid using patient tools ( shaver machine , table utensils & towel . Avoid direct contact with victim blood . Slide17: Avoid contaminated water , food that can spread of infection of viruses ( A – E ) . Avoid tattooing & similar habits might cause infection by viruses ( B – C ) . Lastly infected mother can transfer the disease to her fetus mainly HBV .What are the methods of prophylaxis?: What are the methods of prophylaxis? Passive immunization especially used to prophylaxis against HBV by giving hepatitis B immunoglobulin . Active immunization against : Hepatitis A virus . Hepatitis B virus .EPIDIMIOLOGY :: EPIDIMIOLOGY : Hepatitis ( A ) virus : It is the most common type of viral hepatitis occurring worldwide , often in epidemics . It is commonly seen in the autumn & usually affect the children and young adult . Hepatitis ( B ) virus : It is present worldwide and has infected more than 200 million people . There are estimated 300 million carriers . Lower carrier rate is in U.K & U.S.A but it is rises to 10% - 15% in parts of Africa , middle & far east .Slide20: Acute HBV Infection Transient sub clinical infection Acute hepatitis 25% 65% Recovery Death 100% 99% 01% Chronic HBV infection 10% Healthy HBsAg Carriers 70 – 90% Chronic Hepatitis Cirrhosis Hepatoma 10 – 30% Hepatitis ( C ) Virus : : Hepatitis ( C ) Virus : It was identified in 1988 and was found to be responsible for pos transfusion hepatitis . It is transmitted by blood and blood products and it is postulated that 80% of people with hemophilia in U.K may have been infected. The incidence in intravenous drug abusers is high, up to 90%. Vertical transmission from mother to child can occur . In 20% of cases the exact mode of transmission is unknown . Hepatitis ( D ) virus : Hepatitis D viral infection can occur either as a co-infection With HBV or as a super-infection in an HBsAg – positive patient .THANK YOU: THANK YOU Dr. Mahmoud Hussain You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.