Dr Nikhil Juneja

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Hepatits C

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). Some of those infected with hepatitis C are able to clear the virus from their blood within about 6 months from the time of infection. However, about 75% of people with hepatitis C infection do not get rid of the virus and therefore have chronic (long-term) hepatitis C. Chronic infection can lead to serious liver problems, including cirrhosis or cancer of liver.
As already mentioned that Hepatitis C infection is caused by the hepatitis C virus.
Hepatitis C is primarily transmitted by direct contact with blood.
There are certain risk factors which mediate the spread of hepatitis c infection and those are as following ::
* Unprotected sexual contact
* Organ transplants and blood transfusions prior to 1992
* Long-term kidney dialysis
* Received blood from the infected donor
* Child born to the mother having hepatitis c
* Contact with HCV-infected blood through sharing of needles or other injecting equipment during intravenous drug use that have not been properly cleaned. At present, injection drug use is the most common risk factor for contracting the disease.
Most individuals with hepatitis C do not have signs or symptoms. About 1 in 10 have jaundice. Liver disease progresses so slowly that a person can have hepatitis C for years without having symptoms. Many individuals with chronic hepatitis C have mild to moderate liver damage but do not feel sick. Of people who get infected with hepatitis C, most develop a long-term (chronic) infection. If the infection has been present for many years, the liver may be permanently scarred. This is called cirrhosis.
The following symptoms could occur with hepatitis C infection:
* Mild persistent fever and fatigue
* Right upper abdominal pain and swelling
* Pale coloured stool and urine
* Nausea, vomiting, loss of appetite
Acute infection
Often, people with an acute HCV infection have no symptoms. Some of them might suffer from jaundice.
Chronic Infection
Most people with chronic HCV will have only mild to moderate liver disease and they develop symptoms such as jaundice, fatigue, loss of appetite, nausea, or malaise.
If a person develops cirrhosis (scarring) of the liver then symptoms such as muscular weakness, weight loss, itching, dark urine, jaundice, fluid retention, and abdominal swelling may develop.
There are several blood tests that can be done to determine if a person has hepatitis C.
* EIA assay to detect hepatitis C antibody
* Hepatitis C RNA assays to measure viral load
These tests look for antibodies to HCV in the blood.
* The average time it takes for a person infected with hepatitis C to develop antibodies to the virus is 8-9 weeks after exposure. Most people will develop the antibodies by 6 months, but it can take up to 12 months. If you believe you have been recently exposed to hepatitis C and the test comes back negative, consider retesting at a later time.
* RNA tests are able to detect the presence or absence and amount of HCV in the blood. With these tests, it is possible to find HCV in the blood within 1 to 2 weeks after being infected with the virus.
* None of the available tests to detect hepatitis C virus or its antibody can tell the difference between acute or chronic infections.
* People who clear the virus from their bodies may still have antibodies to hepatitis C virus in the blood for many months.
Other tests
* Albumin level
* Liver function tests
* Prothrombin time
* Liver biopsy
* It is found that chances of spread of hepatitis c infection through sexual contact is more in those persons who do not have a steady sex partner or have multiple partners than those who have a steady and a single sex partner for a long time.
* There are ways to protect against sexual transmission of hepatitis C:
* Abstinence and mutual understanding
* Using condom
* It is good to have hepatitis A and hepatitis B vaccine.
Other ways to prevent hepatitis C:
• Avoid sharing your work--needles, syringes. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds. Also, consider getting vaccinated against hepatitis A and hepatitis B.
• Avoid sharing personal objects, such as toothbrushes, razors or other items that might have blood on them.
• Healthcare workers should follow standard precautions when handling sharps and body fluids. They should also be vaccinated against hepatitis B.
Sudden and violent inflammatory fever, with stitching pain in the region of liver; pressure and constriction in hepatic region, with oppressed breathing; pains are intolerable ; jaundice, tossing about in bed with anguish and dread of death.
Hepatic congestion, with burning and cutting pain in right hypochondriac region. Chronic hepatitis with suicidal tendency, averse to motion; jaundice with pain in liver region and pit of stomach; greenish brown urine; foul breath and putrid taste.
• Arsenic Album:
It is one of the commonly used homoeopathic drugs. It's a good drug for hepatitis wherein the patient has enlargement of the liver and soreness in the abdomen due to the same. Intense nausea and vomiting are other important symptoms during this state. Most of the complaints in such patients are associated with intense weakness and debility, restlessness and lot of anxiety.
Acute pain in hepatic region, worse from pressure, breathing, coughing and lying down upon the right side, extending towards shoulder and neck; bloated stomach, pressure across the epigastria; agonizing pain, tossing about in bed and sleeplessness.
• BRYONIA Sharp stitches in right hypochondria, ( from any motion, ) when lying on right side, pain under the right shoulder blade, swelling of the liver, bitter taste in the mouth, yellow coating on the tongue; stools either hard,, dry, brown, or papascent and profuse, with colic; stools sometimes have odour of cheese; intolerance of vegetable food; patient cannot bear heat of sun; in summer; fullness and bloatedness of abdomen with a sensation as if a stone or heavy weight were lying clogged in stomach; great thirst.
• CALCAREA CARB Pressure is felt in the hepatic region with every step when walking ; stitches during and after stooping; enlargement and induration of liver; sensitive to pressure in epigastria and abdomen, which is greatly distended; cold feet at night in bed.
Hepatitis after vexation or taking cold, with gastric disturbances; dull aching pains in liver, not ( by pressure, motion or breathing; patient hot and sweating.
• CHELIDONIUM Sharp stitching pains, shooting from liver down into the stomach or down into the back from posterior part of liver; pain under the lower border of the right scapula; abdomen distended and sensitive to pressure; pain in hepatic region, by eating; diarrhoea and constipation alternating, stools clay coloured or yellowish, great weariness and anorexia; desire for milks or acids.
Pain in hepatic region from touch and very sensitive to pressure; swollen, hard liver, tympanitic abdomen, wants to belch, eructation with no relief; bitter taste, yellowish skin, after eating and at night; with great debility; constipation, stool difficult, even when soft, painless black, green, often offensive diarrhoea.
• Cardus marianus
It is an excellent remedy for affections of the liver, for cirrhosis, gall stone disease, enlarged liver, etc.
It is a good drug for complaints occurring after abuse of alcoholic beverages, especially beer. Patient gets nausea, retching, vomiting of green, acid fluid. Liver is engorged, especially left lobe, swelled laterally in the transverse direction and is painful to pressure. Pain in liver most marked when lying on left side. Right hypochondriac region is very tender, even when liver is not congested or enlarged. The pain is worse from motion and deep inspiration. Patient has an aversion to salt, meat.
Commonly, the patient suffers from constipation and the stools are hard, difficult, knotty. Constipation alternates with diarrhea. Good remedy for Jaundice.
Chronic engorgement of liver; during inflammatory process in cirrhosis of liver; soreness and stitches in liver when walking; hepatic abscess; depressed and irritability of mind; craving for sour and strong tasting articles; difficult expulsion of faeces and urine; jaundice.
Stitching pains in right side of the body, commencing in back and going up and through the chest, at night, when lying down or rising up; cutting, lancinating and tearing pains, suddenly appearing and of great severity and darting all over the abdomen; epigastrium hard, swollen; pains in hepatic and umbilical region.
• LACHESIS Enlarged liver of drunkards and at climatrix, inflammation and abscess of liver; jaundice; tenderness on pressure all the time, intolerance of clothing, deep throbbing on the right side. Pains as if something have lodged in the right side, with stinging pains; much flatulence, palpitations, pain when coughing as from ulcerated spot; constant urging in anus, but no stool follows, or excessively offensive stools; in spring; gastric pains decreasing on eating and returning after one or two hours; aching pains in shin bones; mental depression.
Cirrhosis of liver with ascites, especially in drunkards; tongue coated, sour, putrid taste in the morning on rising, hunger but a few mouthfuls of food fill him up to the throat, quickly followed by hunger; distress in stomach immediately after eating; tension in hypochondria after a meal, as from a cord, cannot stretch or stand upright, very sensitive to touch; flatulence tends upwards rather than downwards; great fermentation of bowels and ineffectual urging to stool, and after stool feeling as if a great quantity remain unpassed
Liver enlarged and often indurated; dirty, yellowish white coating of tongue, which takes imprint of the teeth; yellowness of the skin and conjunctiva; liver sore to touch; abdomen tympanitic and swollen; cannot lie on right side.
Dull and heavy aching and distention about liver after eating, as distention advances; stitches and tension in liver, skin, yellow, obstinate constipation; paretic feeling in upper and lower extremities; in summer and in thunderstorms.
Liver enormously enlarged; jaundice with clay colored stools; cadaverous smell from mouth, bloody saliva with excessive weakness.
• NUX VOMICA Hepatic affections from alcoholic excesses and allopathic drugging. Liver hard, swollen and sensitive to pressure of clothing; attacks of faintness, leaving him sick and weak, haemorrhoidal colic or from gastric and bilious derangements, with sudden , severe pains in right side; stitches in hepatic region, from contact or motion.
Chronic hepatitis, jaundice, constantly rubbing hypochondrium, hyperaemia of liver, with flatulence, pain and soreness; great irritability of the liver and excessive secretion of bile; twisting pains in right hypochondrium with sensation of heat there; jaundice; with gall stones; pain from region of stomach towards gall bladder, with excessive nausea; with constipation and diarrhoea. Polycholia.
• Phosphorus: It is a very good remedy for hepatic affections in general such as hepatitis, atrophy of liver, cirrhosis of liver, etc. Pressure and heaviness in the abdomen with jaundice is noted in the patient. Pain in the abdomen is relieved by rubbing. Some of the other common indications of this drug are:
Highly sensitive to external impressions such as light, sound, odours, touch, thunderstorms, etc. Restless, excitable, nervous individuals. Affects the kidneys also causing albuminuria and haematuria; patient has profuse, pale, watery urine with intense weakness. There is increased susceptibility to colds amongst children.
Darting and sticking pains in hepatic region, particularly when walking; frequent attacks of anguish, especially at night, with diarrhoea; greenish or slimy stools; bitter taste; oppression in chest and pressure at stomach.
Throbbing pain in hepatic region, worse from touch or walking; abscess of liver; hardness, distension of liver, worse from motion, when lying on right side; burning or throbbing in pit of stomach; disgust for warm food, desires only cold things; painless diarrhoea, with exhaustion or constipation from inactivity of rectum.