Hepatitis

Hepatitis simply refers to inflammation and/or injury of the liver. There are many causes of hepatitis -- too many to list here. The most common causes of hepatitis include infections (viral being the most common, but also bacterial and fungal), alcohol abuse, medications (certain over-the-counter and prescription medications can lead to liver injury), autoimmune disorders and fatty deposits in the liver, such as those that may form in diabetic patients.

Causes of acute hepatitis

-Viral hepatitis

Non Viral hepatitis-

-Viral hepatitis

Hepatocyte specific virus  A, B, C. D

          no Hepatocyte specific virus

virus hepatitis A –HAV-

When most people refer to hepatitis, they are probably talking about viral hepatitis, which is classified into several types. Hepatitis A, which is very common in underdeveloped countries, is acquired from water or food sources. This type of hepatitis is usually mild and may sometimes be discovered only by blood testing. Hepatitis A never leads to chronic liver disease.

Hepatitis A is caused by eating food and drinking water infected with a virus called HAV. It can also be caused by anal-oral contact during sex. While it can cause swelling and inflammation in the liver, it doesn't lead to chronic, or life long, disease. Almost everyone who gets hepatitis A has a full recovery.

it accounts 20-25% of clinical hepatitis -

Incubation period:15-50 days

-Clinical manifestation :

May patient are an citric and symptom less

Flea like upper respiratory tract infection.

Anorexia on early symptom and is often sever.

Later on jaundice and dark urine.

Marked vague epigastria and hypochonderum pain

Nausea heart burn.

Diagnosis lab-

Raised liver enzymes.

Bilirubin and bilurbincere in urine.

Raised severe bilrbine total and direct and of mixed type.

HAV antibodies(HAVIGM) in the serum

Prevention-

Body health education ,hygiene.

Vaccination

-Management:

Bed rest and diet regime (casohychites).

With restriction of animal protein.

iv. plain 5% glucose in care of sever vomiting and sever anorexia.

hepatitis B virus-HBV-

The hepatitis B virus is most often contracted via blood contact -- such as with IV drug abusers sharing needles or health care workers who are stuck by tainted needles. It can also be spread via sexual contact and from mother to baby during childbirth. And  can lead to chronic liver disease and the complications that result from it

With hepatitis B, the liver also swells. Hepatitis B can be a serious infection that can cause liver damage, which may result in cancer. Some people are not able to get rid of the virus, which makes the infection chronic, or life long. Blood banks test all donated blood for hepatitis B, greatly reducing the risk for getting the virus from blood transfusions or blood products.

-Made of transmission

Which is transmitted primarily by the fecal- oral rout, hepatitis B is transmitted primarily by sexual act.

-Incubation period: long 1p from 6weeks to 6 months

-Risky people:

Medical staff ,surgeon ,gynecology ,dentists.

Para medical staff, lab, worker.

Nurses.

Addicts ,drug abusers.

Potions in hemodylessia and oncology.

Homosexual and bisexual men.

-Clinical manifestation:

Loss of appetite, dyspenia, abdominal pain ,weakness

Jaundice may or may not be evident but of jaundice occurs, it is accompanied by light colored stools and dark urine.

Liver may be tender and enlarged,.

Prevention:-

Preventing transmission.

Continudued screening of potential blood donors for the presence of hepatitis B

Antigens using of deposable syringes and needles.

Medical management-

The goal of treatment are to minimize infectivity. Normalize liver inflammation, and decrease symptoms.

Alfa interferon:3000,000 , 5000,000 with3 injections/ month. Can be helpful.

Bed rest ,diet regime, high caloric nutrition , restrictions high animal protein food.

Hepatitis C virus: (HCV)-

Hepatitis C is spread via blood and body-fluid contact (as with Hepatitis B). Hepatitis C used to be the most common type of hepatitis acquired via blood transfusions until a test for it became available in the 1980s. Hepatitis C commonly leads to chronic hepatitis and over many years can lead to chronic liver disease manifested by cirrhosis

Hepatitis C is caused by the virus HCV. It is spread the same way as hepatitis B, through contact with an infected person's blood, semen, or body fluid. Like hepatitis B, hepatitis C causes swelling of the liver and can cause liver damage that can lead to cancer. Most people who have hepatitis C develop a chronic infection. This may lead to a scarring of the liver, called cirrhosis. Blood banks test all donated blood for hepatitis C, greatly reducing the risk for getting the virus from blood transfusions or blood products.

Incubation period, variable and may rang from 15 – 160 days.

Hepatitis D virus  HDV

-Hepatitis D is caused by the virus HDV. You can only get hepatitis D if you are already infected with hepatitis B. It is spread through contact with infected blood, dirty needles that have HDV on them, and unprotected sex (not using a condom) with a person infected with HDV. Hepatitis D causes swelling of the liver.

-Non viral hepatitis:

Toxic hepatitis lead to  Toxemia infection

Drug induced hepatitis : paracetamal larga; etil.

Therapeutic Exercise

Exercise (purposeful physical activity) is beneficial to people of all age groups ,and the health risks of a sedentary lifestyle are well documented.

Benefits of Physical Exercise

Improved cardiopulmonary function

Reduced blood pressure

Increased muscle tone and strength

Greater physical endurance

Increased lean mass and weight loss

Decreased low-density blood lipids

Improved physical appearance

Increased bone density

Regularity of bowel elimination

Promotion of sleep

Reduced tension and depression

Reduced blood glucose level

Fitness Assessment

Fitness means capacity to exercise. Factors such as a sedentary lifestyle, health problems, compromised muscle and skeletal function, obesity, advanced age, smoking, and high blood pressure can impair a client's fitness and stamina.

Body Composition

Body composition is the amount of body tissue that is lean versus the amount that is fat. Determining factors include anthropometric measurements such as height, weight, body-mass index, skin fold thickness, and mid arm muscle circumference.

 Inactivity without reduced food intake tends to promote obesity.

Vital Signs

Vital signs temperature, pulse rate, respiratory rate, and blood pressure reflect a person's physical status.

 

Fitness Tests

Fitness tests provide an objective measure of a person's current fitness level and potential for safe exercise.

Two methods of fitness testing are a stress electrocardiogram and an ambulatory electrocardiogram. Another is a submaximal fitness test, which is an exercise test that does not stress a person to exhaustion. Examples of submaximal fitness tests include a walk-a-mile test.

Stress Electrocardiogram

A stress electrocardiogram tests electrical conduction through the heart during maximal activity and is performed in an acute care facility or outpatient clinic.

 

An ambulatory electrocardiogram is a continuous recording of heart rate and rhythm during normal activity. It requires the client to wear a device called a Holter monitor for 24 hours.

    

 

Walk-a-Mile Test

The walk-a-mile test, measures the time it takes a person to walk 1 mile. The person is instructed to walk 1 mile on a flat surface as fast as possible. The examiner calculates the time from start to finish and interprets results using the guidelines as picture.

  

 Exercise Prescriptions

The prescription for an exercise program involves determining the person's target heart rate.

Target Heart Rate

Target heart rate means the goal for heart rate during exercise. It is determined by first calculating the person's maximum heart rate (highest limit for heart rate during exercise). Maximum heart rate is calculated by subtracting a person's age from 220.

The target heart rate is 60% to 90% of the maximum heart rate.

Beginners should not exceed 60%, intermediates can exercise at 70% to 75%, and competitive athletes can tolerate 80% to 90% of their maximum heart rate.

Exercising at the target rate for 15 minutes (excluding the warm-up and cool-down periods) three or more times per week strengthens the heart muscle and promotes the use of fat reserves for energy. Exercising beyond the target heart rate reduces endurance by increasing fatigue.

Types of Exercise

The two major types of exercise are:

1- fitness exercise.

2- therapeutic exercise.

 Fitness Exercise

Fitness exercise means physical activity performed by healthy adults. Fitness exercise develops and maintains cardiorespiratory function, muscular strength, and endurance ,The two categories of fitness exercise are isotonic and isometric.

 Isotonic exercise is activity that involves movement and work. The example is aerobic exercise, which involves rhythmically moving all parts of the body at a moderate to slow speed without hindering the ability to breathe. In other words, the person can talk comfortably if the exercise is within his or her level of fitness.

 

Isometric exercise consists of stationary exercises generally performed against a resistive force.

Examples include body building, weight lifting, and less intense activities such as simply contracting and relaxing muscle groups while sitting or standing.

 

 

 

 Therapeutic Exercise

Therapeutic exercise is activity performed by people with health risks or being treated for an existing health problem. Clients perform therapeutic exercise to prevent health-related complications or to restore lost functions.

Active Exercise

Active exercise is therapeutic activity that the client performs independently after proper instruction.

For example, clients who have undergone a mastectomy learn to exercise the arm on the surgical side.

 

Passive Exercise

Passive exercise is therapeutic activity that the client performs with assistance and is provided when a client cannot move one or more parts of the body.

For example, for clients who are comatose or paralyzed from a stroke or spinal injury.

Range-of-Motion Exercises

Range-of-motion (ROM) exercises are therapeutic activities that move the joints. They are performed for the following reasons:

To assess joint flexibility before initiating an exercise program.

To maintain joint mobility and flexibility in inactive clients.

To prevent ankylosis (permanent loss of joint movement).

To stretch joints before performing more strenuous activities.

To evaluate the client's response to a therapeutic exercise program.