Mr .Shivakumar age 27 years married laboure in coffee estate on daily wages long and well nourished.
Came on 8-6-2013 for consultation with the following complaint
1. vomiting by bilious 2- 3 times associated with the constant nausea since 1 week
2. Passive yellow colour urine since last few days
3 felling of uneasiness and prostration for last few days
4 pain in abdomen especially right hyp0chondrium and peri umbilical region , nausea intense and perpetual and history high color urine . with 100.4 deg ree farinete temperature. suspecting hepatitis . L.F.T were advised . he developed high colour urine and pale stools with nausea and vomiting .
5. loss of appetite giddiness fatigue tiredness high fever
6 body itching severe abdominal pain severe joint and body ache cramping pain in legs and thighs sleeplessnes. eyes nails dark yellow c olour walking from tiredness cough muscles pain
Mouth ulcer night head ache specially over the eyes aggravation headache dryness of mouth and thick white coating of tongue
GENERALITITIES – were as follows chilly patient likes to take meat . egg . salted and spicy food sweat was average thirst was average sleep was disturbed . mentally he was very responsive . co operative tidy . physical examinations gave following findings
Weight was recorded 55 kg pulse 80 /minute B.P. 120/75 regular conjunctival discoloration( yellow)
Was visible . liver was just pulpable and tender tongue was moist coated under surface showed yellowish discolouration. skin itching jaundice during –Kent repertory page 1328 .
L.F.T REPORT
Name shivakumar date 8-6-2013
Liver function test
Total bilirubin 3.32mg/dl
Direct 1.74 mg/dl i
Indirect 1.58mg/dl
Total protein 5.44 mg/dl
Serum albumin 3.14mg/dl
Serum globulin 2.3 mg/dl
S..G.O.T (AST): 86.0 UL ml
S.G.P. T (ALT) ;90.8 UL ml
ALKALINE phosphatase ; 136.5ulml
URINE color-dark yellow
Appearance slightly
Reaction-acidity
Albumin –absent
Sugar-nil
Microscopic examination
Pus cells -4.6
Rbcs 1-2
HBSHG- negative
U.S. G. report
Patient name Shivakumardate7-6-2013
Abdomen ultra sound report
LIVER ENLARGED IN SIZE AND SHOWS REDUCED ECHOTEXTURE
No focal mass , no intra hepatib illary dilation seen .
Portal vain and C.B.D normal caliber .
GALL BLADER
Normal distended no calucalii normal wall thickness
PANCREAS Normal no cyst or mass seen
Aorta and para aortic area normal
Kidneys right kidney shows normal size echopattern no calculi
No hydronephrosis , normal corticomedullary junction . left kidney shows normal size Achopattern , no calculi. No hydro nephrosis , normal corticomedullary junction .
The right kidney measures 9.6X 1.4 CMS cms
The left kidney measures 9.7×1.5 CMS
Urinary bladder
Well distended normal wall thickness no calculi no mass .
Prostrate shows normal echopattern , capsule intact , volume 22cc no ascities no mass in abdomen cavity
RIF NO MASS , no fluid collections seen
IMPRESSION –HEPATITIS
Suggested clinical correlation .
First prescription 8-6-2013 treatment
1 .chelidonium 30 was given daily 3 times morning afternoon and night 2. Natrum phos 6x
3 times daily 3 times
3 cardusmarinus Q
Daily 3 times M/A/N 3 times
4 .Arsenicum alb.200. daily 2 times for one week
5. china 200 daily 2 times prescribed and was advised to to be taken correctly . he was also advised rest glucose intake plenty of water to drink simple diet and examination of blood and urine .
Date 28th june 2013
No further vomiting . passing good stool (formed) , feeling better , but slight feverish feeling was with him though temperatur elevated . . on examination pulse was recorded 80/min regular liver was still pa lpable and tender . blood and urine report as on28th june 2013 were as follows confirmatory diagnosis infective appetites
TREATMENT
- Chellidonium 30 daily 3 times for 15 days m/a/n
- 2. Cardus marinus Q –daily 3 times for 15 days
- 3. China 200 daily 3 times m/a/n
- 4. Natrum sulph6x m/a/n for 15 days
Reported on test report date-28-6-2013
Liver function test
Total bilirubin -5.8 mg /dl
Direct billirubin 1.0 mg / dl
Indirect bilirubin -4.8mg dl
Total protein 8.0 gm /dl
Serum albumin 5.0gm/dl
Serum globulin 3.0 gm/dl
S .G .O.T (AST) 39.2 u/l
S . G.P.T (ALT) 26.1 u/l
Alkaline phosphates 47.0u/l
He was started on chelidonium 30 and chionanthus Q with in 24 hours vomiting almost stopped fever stopped he could retained high intake of advised fluids appetite improved . he developed intense pruritus all over . hephar sulph 30 was given (skin itching jaundice during –Kent Rep 1328 no change he almost scratched he self to bleeding – sulphur 200 3 dose were given for 3 days itching completely relieved ictrus cleared up . urine colored returned to normal and so did he L F T . 4th September 2013 S. bilirub in 3.6 S. G.O.T (AST) 28.5 S .G .P.T (ALT) 14.1 alkaline phosphate 60.0
Test report
Liver function test date 4th September 2013
Total biliru bin 3.6 mg/ dl
Direct b ilirubin 1.9 mg /dl
Indirect bilirubin 1.7 mg/dl
Total protein 8.1 gm /dl
Serum albumin 4.8 gm/dl
Serum albumin 4.8 gm/dl
Serum globulin 3.3gm/dl
S.G .O.T( AST ) 28.5U/L
S.G.P .T (ALT) 14.1 U/L
Alkaline phosphatase 60.0 IU/L
Urine Analysis 4-sep-2013
Physical examination
Color –yellow
Reaction /pH acidic
Specific Gravity 1.0200 Nr – 1.010- 1.030
Chemical examination
Protein absent
Glucose –Nil
Ketone Absent
Bile salts Absent
Bile pigments Absent
Urobilinogen –normal (0.1mg/dl )
Nitrate absent
MICROSCOPIC EXAMINATION
WBCs 1-2 /hp f
RBCS not seen /hpf
Epithelial cells 0.1 hpf
Bacteria +
Casts not seen /hpf
Crystals calcium oxalate( +)/hpf
Chelidonium. 30 t d d from 2 months completely recovery. Homoeopathic remedies in infective hepatitis and their ability to cut short the total duration and morbidity of this ailment for which
There is no specific treatment in allopathy.
Improved further ,urine becoming light coloured. No fever. Mouth ulcer cured .skin itching cured .Appetite is good. Good sleep. Weight is 57 k.g. feeling much better.
Recent follow up—S bilirubin i.2 mg/dl.
