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Hepatitis Areej Al_dhamin 201201910 Writing and Research, Section 205 Dr. Runna Alghazo 1 Table of Contents Proposal Introduction…………………………3-4 Research Questions…………………4 Research Thesis……………………..4 Research Importance………………..4-5 Methodology………………………..5 Important Definitions.………………5 Literature Review Introduction…………………………..6 The Importance of the Liver………….6 Infection………………………………6-7 Symptoms……………………………7-8 Diagnosis…………………………….8 Disease Prevention…………………..8 Conclusion…………………………..8 Results Q1 Results…………………………..9 Q2 Results…………………………..9-10 Q3 Results…………………………..10 Discussion Q1 Discussion….......………………. 11 Q2 Discussion………...……………. 11-12 Q3 Discussion………………………12-13 Conclusion………………………….13 References Reference List……………………… 14 Appendix A…………………………15 2 Introduction: The world hepatitis is made up of the prefix "hepat-," from the Greek referring to anything pertaining to the liver and the suffix "-itis," means inflammation. The liver has been variously described as the seat of the soul, the source of emotions, and a predictor of the future. It is the largest organ in the human body where weighting almost half a kilogram. A lot of patients are undergoing liver function tests and supersonic appraisal of the liver, affecting in the identification of abnormalities that necessity to be put into perspective. Viral hepatitis is a public health issue in the world affecting five hundred millions of people. It is a cause of considerable morbidity and mortality in the human population. The electronic microscope and modern techniques help in detecting these viruses. Jaundice and Anorexia are the most important features of viral disease which cause hepatitis. Viral hepatitis disproportionately affects people who often lack access to medical care such as immigrants and poor people. Moreover, hepatitis is more infection than HIV which causes AIDS. In the United States, three hundred thousand of people infected almost every year die as five thousand nine hundred of people annually as a result of the disease. The virus infects approximately 1, 4 million of people worldwide each year. The first known hepatitis virus is virus A which causes inflammation of the liver mainly then discovered the hepatitis B various. After that appeared other liver infections which are called G, D, H and F. Over half of the population of Southeast Asia, China and Africa are infected with the hepatitis B various. Some patients, perhaps fewer than three percent, are unable to obliterate the virus but manage to 3 control it. While ninety percent of adults infected with hepatitis B various overcome the disease and obliterate the virus, about five percent develop chronic hepatitis. With chronic inflammation, fibrosis slowly accumulates, finally becoming profuse enough to be classified as cirrhosis. There are five percent of people that their body cannot get rid of it and become carriers of the disease. The disease may develop in some patients to cirrhosis of the liver, cancer liver and failure of the liver. In addition, it develops in ten percent of patients to become chronic and capable of transmitting the disease to others. In the Arab World, there are more than one million people living with the virus in Kingdom. Research Questions: - What are the methods of infection? - What are the symptoms of hepatitis? - What is the treatment to get rid of the disease? Research Thesis: Hepatitis comes in second place after tobacco as a cause of cancer. People infect hepatitis by eating and drinking contaminated with the virus from an infected person. Also, people infect this disease through the use of contaminated needles and through wound in the skin. The symptoms of hepatitis are loss of appetite, nausea, jaundice, turning to the dark color of urine and pain in the upper right corner of the abdomen. These symptoms are common in the elderly. There is medication named interferon proven effective in controlling the disease in approximately 30% of patinas. Research is still ongoing to find other drugs highly effective and less complications. Research Importance: The important of this research is to raise the level of awareness of this viral disease which spreads dramatically. Hepatitis which has more than five main viruses 4 causing damage staggering health care system around the world likely to cause epidemics as well as being the main cause of cirrhosis and liver cancer. Also, it's necessary to inform people how hepatitis can be infected. The research will benefit people by knowing the methods of preventions and treatment. Methodology: The methods that will be used in this research are Google Scholar and PMU electronic books. The research paper will mention an interview with specialist doctor. Also, this research will collect information about the methods of infection and symptoms of hepatitis from publisher academic websites and books. Important Definitions: Hepatitis B: type of hepatitis spread from mother to child at birth and cause to liver cancer. Hepatitis D: type of hepatitis infected people who use drug. Liver: the largest solid organ in the body. Jaundice: blockage in the liver with high bilirubin. Nausea: a feeling of illness with tendency to puke. Interferon: a group of proteins that produces in human cells and in animals for the treatment of viral disease. Loss of appetite: loss of lust to eat. Cirrhosis: a disease in which the liver cells become constantly damaged. 5 Literature Review Introduction Hepatitis is a wide range of clinical situations associated with the occurrence of pathological changes affecting the liver. Pathological changes are caused by exposure to many pathogens and viruses, which represents the bulk of them. Hepatitis is process characterized by varying degrees of liver infiltration by inflammatory cells of the immune system. According to the standards of clinical and chemical hepatitis is split to two types acute and chronic. Bacterial hepatitis, viral hepatitis, protozoal hepatitis, toxic hepatitis and alcoholic hepatitis are caused acute hepatitis. When symptoms go on for more than six months is called chronic hepatitis (Ahmed, 2012). Half of people are unaware of hepatitis infection. It's known as silent epidemic because some people are living with chronic hepatitis without having to suffer from any symptoms. Despite the lack of symptoms, but the virus silently damages the liver. Hepatitis may turn into a chronic disease that leads to cirrhosis of the liver cancer or injury in the event of non-treated. It is a serious disease that can pose a threat to human life in the event of non- processed in a timely manner. Hepatitis occurs prevalent in poor communities, nurseries and infirm (Mary, 2009). There is no specific treatment, but the patient is usually advised to rest and not stress with good sleep. The doctor may also advise not to eat certain medications and stop the use temporarily until the improvement of the liver, such as pills, In addition to the need to avoid alcohol. The Importance of the Liver: Liver is the largest organ in the human body. It's including at least five thousand jobs are important for the continuation of life. The liver produces bile and transported to the intestine via the bile ducts deployed there. It is produces many proteins, hormones and enzymes that lead to the regularity of the work of the human body. The liver produces the necessary energy to the human body, as they are also through metabolic processes. In addition, liver adjust the rate of sugar to the human body, through some sort of hormones. The virus infects the liver hepatic cell then cannot perform its functions and attic is healthy cells remaining bulk of the work required jobs (Djaas, 2012). Infection: 6 Hepatitis infection is more than HIV, which causes AIDS. Become infected between 3 and 4 million new people every year, and increase the percentage of transmission of the disease because some people do not show any symptoms and are unaware that they are infected with the virus. There are several reasons for hepatitis, which is not limited to viruses such as medications that can cause inflammation of the liver. Hepatitis can be transmitted through false medical practiced such as transfusions of contaminated blood, use of contaminated needles and by injection the drug into a vein. In addition, hepatitis spreads by eating foods and drinks contaminated with the virus. The most important method of transmission hepatitis is drug addiction by injection because the use of needless and circulation among injection drug addicts. Moreover, patients with renal insufficiency who are in the process of dialysis are at danger of infection with hepatitis. The future of blood is at risk of infection with hepatitis. Infection occurs also among people for unknown reasons. Some people are more susceptible than others because of the nature of their work especially who come into contact with blood in their jobs such as working in the field of medical care. About five percent of adults and ninety percent of newborn infected with hepatitis and cannot get rid of the virus and thus become carries of this virus. The carrier of the virus usually does not happen to him any signs or symptoms of the disease and the liver enzymes has to be normal, but it residue infected for many years or probably a lifetime and be able to transmit the virus to others(Charlene, 2013). Symptoms: Symptoms that are caused by different viral infections of the liver and this depends on the fact that these viral infections, either acute or chronic. The largest number of acute infections is usually simple to the point that the patient does not show signs of a distinctive. In some cases symptoms of hepatitis flu-like symptoms include fever, fatigue, loss of appetite and mild nausea. About one percent of people are suffering with severe symptoms, while the body tries to eliminate the virus. Severe symptoms are including vomiting, jaundice and abdominal distension and suddenly appear this case which is a fatal if the patient did not get immediate medical care. Symptoms persist for more than four weeks. Often evolve into a chronic condition, especially when the person is exposed to infection at an early age. Acute hepatitis caused by the virus is endemic in the liver and breeding rapidly, resulting in 7 a bulge and rupture the cell walls of hepatic. A cute hepatitis often does not lead to chronic damage as chronic hepatitis (National Center for Diseases Control, 2014). Diagnosis: Diagnosis is based mainly on laboratory tests in addition to the clinical examination. Laboratory tests are expected to vary according to virus infection. There is a general analysis on suspicion of injury to any of the viruses such as blood tests reagents for autoimmune disease, analysis of liver enzymes and functions, Analysis of the components of a complete blood and analysis of blood sedimentation speed. The incubation time ranges between two weeks and 9 weeks. The people between 15-40 years are more prone to infection (Adham, 2013). Disease prevention: Vaccinations should be given to children and adolescents less than 18 years old who did not take the vaccine before. People who belong to groups at high risk should also be vaccinated such as travelers to countries where there is an inflammatory disease of the liver and people in need of blood. Avoid sharing tools potentially contaminated and can penetrate the skin, such as injections, toothbrushes, razors is important for the prevention of disease (Wjdan, 2013). Conclusion: In the United States about 1.25 million chronically infected human injuries and a big proportion of them do not show symptoms. For the Arab world, there are approximately millions of people who are suffering hepatitis disease in Saudi Arabia alone. Fortunately, it is potential to stop infection with the virus vaccination to take protection of it and following the methods of prevention. After infection with the immunoglobulin system to get rid the body of the virus when ninety five percent of adults and thus their recovery within a few months it will not be infected again due to the formation of antibodies to the virus, which can be detected by a blood test called HBS( Djaas, 2012). 8 Results Research question number 1 result: Q: What are the methods of infection? According to an interview with an internal medicine doctor infection hepatitis A can be transmitted by eating food contaminated with sewage such as oyster and fish and through the virus in food when eating products derived from animals infected with the virus. Infection with viral hepatitis B from a patient or a carrier of the virus to a person is infected by blood, saliva, semen, vaginal secretions and tears. Hepatitis B can be transmitted by sexual contact with an infected person and transmitted from infected mother to a child during birth and lactation. Patients with kidney failure who are in the process of dialysis are at danger of infection with hepatitis C. Also, through contact contaminated blood during treatment for health workers and laboratory staff. The use of needles and sharps contaminated such as cupping, tattoos and circumcision is also one of the methods of infection hepatitis C (N. Shakos, personal communication, April 16, 2014). Previous research showed the infection of hepatitis A usually spreads through impure food. People infected hepatitis B by body fluids, sexual contact and from mother to fetus. Also, hepatitis B is not transmitted by shaking, eating and visiting the patient. Hepatitis C is transmitted through blood transfusion and through the use of contaminated sharp instruments such as razors and tattoo kit. In addition, dialysis may cause inflammation of the liver (Albisona, 2007). Research question number 2 results: Q: What are the symptoms of hepatitis? As an internal medicine doctor mentioned that people infected with hepatitis are showing obvious symptoms similar to flu symptoms. Symptoms of hepatitis A may include loss of appetite, nausea, blockage in the liver with high bilirubin, high proportion of Alanine amino transaminase, turning to the dark color of urine, pain in the upper right part of the abdomen and fatigue. It may cause some complications such as Massive liver necrosis. Infected with hepatitis B may have itchy skin and muscles. Also, patients who have hepatitis B and C may not show any symptoms of the disease (N. Shakos, personal communication, April 16, 2014). People with hepatitis A may show fever and chill. They may have General feeling of pain in the body, particularly in the upper right of abdomen. Moreover, loss 9 of appetite resulting loss of weight and the color of urine becomes dark such as color of tea. The symptoms of hepatitis B and C are usually uncommon (Albisona, 2007). Research question number 3 results: Q: What is the treatment to get rid of the disease? As an internal medicine doctor advice drinking fluids, using antipyretic and using vitamins to recover from hepatitis A. Moreover, treatment through needles, vaccinations and pharmaceutical may be a cure for the patients from hepatitis B. The most important drugs that patients should use are Interferon and Ribavirin for the treatment of hepatitis C. As doctor recommend studying the blood before being transferred to patients and sterilize tools (N. Shakos, personal communication, April 16, 2014). Vaccination provides protection for patients who have hepatitis C. Patients who have hepatitis A need to the rest and they have to eat healthy food. Interferon and Ribavirin are proven effective in controlling hepatitis C. Doctors and laboratory staff should be aware of transfer non contaminated blood to the patients. Also, they have to use clean tools when treating patients (Albisona, 2007). 10 Discussion Research question number 1 discussion: Q: What are the methods of infection? Sewage is considered one of the most serious public health problems in most countries, because most of these countries do not have an integrated sewerage network, but in some large countries there is no sewerage system. The microbial contamination of water is the most harmful to human health. Sewage has huge numbers of microorganisms such as bacteria, viruses and parasites that lead to many diseases, most notably hepatitis A. People can get this virus by eating seafood that undercooked. Globally, the children are the most vulnerable to hepatitis B infection where the virus is transmitted by the mother during the process of delivery. In Africa, Hepatitis B becomes a main problem with high average of transmission from a mother who is a carrier of the disease to her baby. Furthermore, more than ninety percent of pregnant women who had hepatitis transmit the infection to their babies at birth. The vast majority of them become carrier of the chronic virus. Transmit the infection to the child can be by fluids birth mother. Hepatitis B is transmitted mostly through sex and through the presence of the virus in the semen and vaginal secretions. It is the most common method prevalent in Europe and North America. Dialysis is directed the patient's blood from his body and passed through a machine that will be purified blood and then returned to the patient's body. Hepatitis C can be transmitted to kidney failure patients through use of the washing machine, which had been used with another patient suffering from kidney failure and hepatitis C. Negligent sterilization device such as dialysis device can leads to the transmission of hepatitis C to others. Drawing tattoos is linked closely associated injury hepatitis C, where this phenomenon has increased in the recent period by thirty six percent of young Americans in their twenties stage and about eight percent of school students in Canada. Researchers warned of tattoos machines because they are in direct contact with the blood. Infection disease cam move through it easily. Machines are not saved tattoos pigments in sterile containers and this lead to transmission of infection (Achord, 2002). Research question number 2 discussion: Q: What are the symptoms of hepatitis? At the beginning, hepatitis A patients have low temperature, queasiness and tiredness. After a few days, the urine is start changing to dark color. Then the 11 patients have jaundice especially smokers in this case hate smoking and avoid it. Fluid produced by the liver called bilirubin is increase in the body. These symptoms may last for more than five weeks. Generality, hepatitis B is called silent disease because people who are suffering from it did not know that they are infected. It is reticently damage the liver. People can live more than ten years without showing any of the symptoms of the disease. The symptoms appear in fifty percent of infected adults. For infants and children, symptoms are often less. Some people become very sick after having this virus they may appear yellowing of the eyes, yellowing of the skin, turned to light colored stool, headache, rash, pain in the right part of the abdomen and dislike of fat food. These symptoms do not appear for the majority of patients infected with this virus but these symptoms are common in those who develop infection when they are older. The only way that can determine the disease is to analyze the blood for this virus. Hepatitis C does not give signals easy discrimination. Patients may show a perfectly healthy, but they are infected and injuring others. Sometimes a patient come with symptoms indicate the presence of cirrhosis of the liver such as enlargement of the live and spleen. Symptoms are usually not common, and if found, this probably indicates the presence of an acute medical condition. The proportion of cases that turn from acute inflammation to a chronic estimated at fifty eight percent and 25 percent of the turn of chronic inflammation to cirrhosis. Chronic hepatitis such as acute has no symptoms except in some cases where the symptoms of feeling tired. Cirrhosis can be exposed the patient to liver cancer. The form of sharply hepatitis C is characterized by malaise, loss of appetite, nausea, vomiting and physical pain. In addition, yellowing of the skin continues to injury for several weeks after the patient being recovered gradually from the symptoms, not the virus. The evolution of hepatitis C needs a long time, so any decision to be made about treatment is not in a hurry (Gazelle& Abdul Aziz, 2007). Research question number 3 discussion: Q: What is the treatment to get rid of the disease? Hepatitis A patients need to use antipyretic to relieve the heat and pain. It is important that the patient take the necessary precautions to prevent infecting others by not participating in eating and drinking as well as in her personal belongings. The patients must be attention to hygiene and wash their hands several times a day especially after going to bathroom. They must continue on this system for a period of not less than three weeks from the onset of symptoms. One of the things that 12 contribute to the reduction of the spread of hepatitis A is adequate supply of clean drinking water and disposal of sewage produced by the local communities in way that are true. Interferon is available for hepatitis C patients in injectable form and works to stimulate the immune system against the virus. Doctors recommend using interferon developer called Peg interferon Alfa that given once a week. Chronic cases of hepatitis B disease can treat by drugs that help relieve pain such as calantrveron and antiviral drugs. After one month of giving a single dose of the vaccine the vaccinated patients can be all in protection level. Even after exposure to the virus is given a single dose of vaccine within two weeks of contact with virus gives protective effects (Alabdelkader, 2014). Conclusion: In the end, this research was focusing on the methods of infection, symptoms and treatment. It is important to perceive that hepatitis virus is cause death if the patient does not undergo to treatment. Liver disease is one of the main causes of death in Saudi Arabia and estimated as the second reason after accidents. The danger of being in liver disease remains dormant until it reaches the patient to a late stage of the disease and then show known symptoms such as yellowing of the body, ascites, muscle atrophy, hepatic coma and finally death. Treatment begins from dialysis center and repeated blood transfusions in terms of sterilization devices in technical and safety way. People's lifestyle has a significant impact on their health such as eating clean unpolluted food, using gloves when touching or cleaning the blood, avoiding joint use of tattoos kit and sterilizing needles. Also, it is necessary to inform people to take vaccination to prevent the disease. People ignore taking these vaccinations in spite of the danger that threatens their lives. 13 Reference List: Zuckerman, A. (1996). Medical Microbiology. Retrieved Feb 27, 2014, from http://www.ncbi.nlm.nih.gov Djaas, A. (2011). Sixth International Conference in the Arab world. Retrieved Feb 27, 2014, from http://www.aun.edu.eg/arabic/society/sept_2011.html Karyn- Kaplan, K. & Tracy- Swan, S. (2013). Hcv Project Puplication: Hepatitis C Virus and Coinfection with HIV. Retrieved Feb 27, 2014, from http://www.treatmentactiongroup.org Donald. (2009). The Danger of Hepatitis: What You Should Know from A to E. Retrieved Feb 27, 2014, from http://www.nlm.nih.gov/medlineplus/magazine/issues/spring09/articles/ Marie. (2009). Hepatitis is a silent Disease: Neglect the Risk of Live threating. Retrieved Feb 27, 2014, from http://www.janssenMah, t & Ogrady, j. (2006). Fast Fact: Liver Disorder. Retrieved Feb 27, 2014, from http://site.ebrary.com/lib/pmu/search.action?p00=liver disorder&fromSearch=fromSearch&search=Search Achord, j. (2002). Understanding Hepatitis. Retrieved Feb 27, 2014, from http://site.ebrary.com/lib/pmu/search.action?p00=liver disorder&fromSearch=fromSearch&search=Search Sargent, S. (2009). Liver disease. Retrieved Feb 27, 2014, from http://site.ebrary.com/lib/pmu/search.action?p00=liver disorder&fromSearch=fromSearch&search=Search Hussein, M. (2007). Virology. Riyadh: University of King Sauud. Gazelle, S & Abdul Aziz, Z. (2007). Health Education. Dammam: King Fahd Library. Manea, K. (2014). Tattoo. Retrieved Feb 27, 2014, from http://www.shaqrahospital.gov.sa/vb/showthread.php?t=403 Alabdulqader, M. (2014). This an Inflammation of the Liver. Retrieved Feb 27, 2014, from http://qh.gov.sa/articles.php?op=viewArticles&id=20&catID=6 14 Appendix A Interview Questions 1_What are the methods of infection? 2_What are the causes of infection? 3_What are the symptoms of infection? 4_What is the treatment of hepatitis? 5_ What are the most common types? 15 16 17 18 19 20