A Patient's Jaundice Case Diary

Personal diary: 21 february 2010 sunday name: xxxxxx gender: female age:40 Place : Delhi,India twodays back I was having severe stomach pain on the right side stomatch. i was vomitting what ever i ate. severe headache also. felt very weak.   The following is the test report and the test results showed i was having JAUNDICE   Test Name Result Unit Normal Range Test 1 haemoglobin(colorimtric method) 12.7 gm/dl 12.0 - 14.0   TLC(imedeance method) 5800 /cumm 4000-11000   DLC-segmented neutrophils 66 % 40-70   DLC-lymphocytes 28 % 20-40   DLC-monocytes 02 % 1-7   DLC-basophils 00 % 0-2   ESR(westergren method) (H)30 mm/hr 0<20   PCV 38.1 % 37-54   platelet count(impedance method) 2.13 lacs/cmm 1.5 - 4.5   rbc count(impedance method) 4.53 mill/cumm 3.5-5.2   mcv 84.3 fl 80-97   mch 28.0 pq 26.5 - 33.5   mchc 33.3 q/dl 33.0 - 37.0   `       Test 2 General Blood Picture rbc series cell count is within normal limits. cells are predominantly normocytic normochromic with mild anisopoikilocytosis as few target cells. There is no evidence of hemolysis   wbc serices total lecocyte count is normal for age. DLC is within normal limits.No immature cells of the myeloid/lymhoid series are seen. No toxic granules/cytoplasmic vacuolations are present.   Platelet plateltes are adequate in number and normal in morphology.   impression no hemoparasite is seen   advice lft,kft       TYPHEDOT TEPHEDOT-IGM NEGATIVE       LIVER FUNCTION TEST sgot(ast) (H)1552 IU/L 0-46   sgpt(alt) (H) 1572 IU/L 0-49   alkaline phosphatase(mod.ifcc) (H) 259.2 IU/L 53-128   TOTAL PROTIEN 8.6 gm/dl 6.6 - 8.8   albumin 4.3 gm/dl 3.5-5.0   globulin (H)4.3 gm/dl 2.0-3.0   gama-gt (H)122.6 IUI/L 4-25           BILIRUBIN Total Direct(DCA ATCS method) Total (H)8.30 mg/dl 0.2-1.0   Direct (H)6.70 mg/dl 0<0.5   Indirect (H)1.6 mg/dl 0.2-0.5 prothrombin time (electromechnical clot detection method) test (H)19.8 seconds 12.6   contol 12.0 seconds     inr 1.89 seconds     Ultrasound of whole abdomen LIVER: measures 132mm in span, hypoechoeic echotexture and apparent increase in perprtal echogenesity. vascular chanels are clear. no evidence of IHBD. GALL BLADDER is partially distended. diffuse wall thickening noted with pericholecystic fluid. no calculi seen. cbd is normal. SPLEEN measures 100 mm in span, normal in outline and echopattern. NO focal SOL noted. PANCREAS show normal outline and echo pattern. no focal SOL noted. RIGHT KIDNEY measure 107 x 37 mm in size , normal in outline and parenchymal echopattern.CMD is wll preserved. PCS is compact No calculi seen. No evidence of ascites. No significant retropertitoneal lmyphadenopathy noted. URINARY BLADDER is empty. IMPRESSION:features of acute hepatitis/acalculus cholecystitis.

expenditure for the above tests: 1. Rs. 24.00 haemoglobin(calormetriac method). 2. Rs. 24.00 TLC (impeda ce metbod) 3. Rs.25.00 DLC 4. Rs. 24.00 ESR(westergren method) 5. Rs.30.00 Platelet count(impedance method) 6. Rs. 25.00 PCV 7. Rs. 100.00 MCH 8. Rs. 100.00 H.Rate MCHC 9. Rs.100.00 H.Rate MCV 10.Rs. 30.00 RBC COUNT(impedance method) 11. Rs. 32.00 General blood picture 12. Rs. Rs.358.00 H.Rate TYPHIDOT 13. Rs.230.00 Liver function test 14. Rs. 100.00 HBSAG 15. Rs.350.00 ULTRASOUND WHOLE ABDOMEN (note: 1 usd = Rs.46 on this date) ====================================================== With this report i went to the doctor again and after seeing the report. He asked certain questions like this: What about vomiting: Now I am not vomiting. are you having pain in the stomatch? pain is there in the upper abdomen not in the lower stomach. and he asked some more questions and prescribed the following medicines for 5 days each is to be taken one in the morning and one in the evinging. 1. TAB STUGIL 10 tabs Rs. 73.50 2. TAB-NORMAXIN 10 tabs Rs. 17.00 3. TAB-UDILI 300MG 10 tabs Rs. 169.00 4. SYRUP-CREMAFFIN WHITE 170 ml Rs. 64.00 5. TBA DORAN-O 10tabs Rs.... ============================================== Apart from the above medicines, he has prescribed some more tests: 1. HBSAG........................................Rs. 100.00 2. HAV-IGM(MEIA METHOD).....Rs..880.00 3. hev-igm(ELISA METHOD).......Rs.1331.00 I have given blood for these test. Report will be ready in two days.... +++++++++++++++++++++++++++++++++++++++++++++++++++++

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The gentle stool softener

Cremaffin is the leading laxative in the country and is available in two variants, viz.: Cremaffin and Cremaffin Plus.

Presentation and Composition :
Bottle of 170 ml.

Cremaffin is a pleasantly flavoured white emulsion.
Each 15 ml (1 tablespoonful approx.) contains:
Liquid Paraffin I.P. : 3.75 ml
Milk of Magnesia I.P. : 11.25 ml

Indications :
For the symptomatic relief of constipation. e.g. in patients with cardiovascular disease, hernia and anorectal disorders and post-operatively

For Precautions and Drug Interactions please consult full Product Information / Package Insert.