INDEX

SL. NO. TOPIC Pg Teacher’s signature

No.
1. INTRODUCTION AND 1 to 2
THE DISEASE.

2. DESCRIPTION 3

3. PHYSIOLOGY OF 4
JAUNDICE

4. TYPES OF JAUNDICE 5 to
AND THEIR TESTS. 10

5. TREATMENT 11

6. DIET CHART 12 to
15

7. DO’S AND DON’T’S 16

8. CASE STUDIES 17 to
21

9. STATISTICAL
REPORTS
22

10. CONCLUSION.

23

11. BIBLIOGRAPHY.

24

12. ACKNOWLEDGEMENT

25
INTRODUCTION

What is a disease?
A disease is a particular abnormal condition that negatively affects the structure or function of part or all of an
organism, and that is not due to any external injury. Diseases are often construed as medical conditions that are
associated with specific symptoms and signs. A disease may be caused by external factors such as pathogens or
by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of
different diseases, including various forms of immunodeficiency, hypersensitivity, allergies and autoimmune
disorder..
In humans, disease is often used more broadly to refer to any condition that causes pain, dysfunction, distress,
social probles, or death to the person afflicted, or similar problems for those in contact with the person. In this
broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms,
deviant behaviours, and atypical variation of structure and function, while in other contexts and for other purposes
these may be considered distinguishable categories. Diseases can affect people not only physically, but also
emotionally, as contracting and living with a disease can alter the affected person's perspective on life.
JAUNDICE
 JAUNDICE

A yellow tint to the skin or eyes caused by an excess of bilirubin, a substance created when red blood cells break
down.
Jaundice is a term used to describe a yellowish tinge to the skin and the whites of the eye. Body fluids may also
be yellow.

The colour of the skin and whites of the eyes will vary depending on levels of bilirubin. Bilirubin is a waste
material found in the blood. Moderate levels leads to a yellow colour, while very high levels will appear brown.

About 60% of all infants born have Jaundice. However, Jaundice can happen to people of all ages and is normally
the result of an underlying condition.
Jaundice is also known as icterus, is a yellowish or greenish pigmentation of the skin and whites of the eyes due
to high bilirubin levels. It is commonly associated with itchiness.The feces may be pale and the urine dark.

Jaundice in babies occurs in over half in the first week of following birt h and in most is not a problem. If
bilirubin levels in babies are very high for too long, a type of brain damage, known as Kernicterus, may occur.
 PHYSIOLOGY OF JAUNDICE

The red blood cells in our circulation carry oxygen to all parts of the body and have a life span of about 120
days.

At the end of their life, they are broken down and removed from the circulation by special cells called
phagocytes, which are found within the bone marrow, spleen and liver.

New red blood cells are of course continually manufactured, and this also takes place within the bone
marrow.

Following breakdown of the red blood cells some of their component parts – such as amino acids and iron –
can be re-used by the body. Other components such as bilirubin need to be removed.

Knowing how this removal pathway works is the key to understanding how jaundice occurs.

Most waste products of the body are excreted in the urine via the kidneys, but the liver and bile system is
the other main physical route out of the body for these substances.

By 'waste products', we mean the many compounds that arise in the course of the body's metabolism. But
almost all forms of drugs must also be eliminated either via the urine or bile routes.

In the case of bilirubin released from old red blood cells, it passes through the bloodstream to the liver,
where the liver cells process it.

These cells carry out many complex chemical functions and also produce the liquid bile that is the 'vehicle'
by which the cells discharge their output to the bile duct system. This is a branching network of tiny tubes
throughout the liver that merge in the same way as the branches of a tree.

Ultimately, a single main bile duct comes out of the liver and joins the first part of the small intestine
(duodenum). Bile (and therefore bilirubin) then passes out through the small and large intestines and is
excreted in the stool (faeces).

Bile is green in colour. But bacteria in the large bowel act to change the bilirubin to substances that are
brown, which gives stool its characteristic colour.

Some of the bilirubin is reabsorbed back into the body through the bowel wall – eventually appearing in the
urine as a substance called urobilinogen (although the typical yellow or orange colour of urine is in fact due
a different pigment called urochrome).

Therefore, any failure of the bilirubin removal pathway will lead to a build-up of bilirubin in the blood.
When this happens the individual's skin turns yellow – causing jaundice.
 TYPES OF JAUNDICE

 Pre-hepatic: before the liver

 Hepatic: in the liver

 Post-hepatic: after the liver

PRE-HEPATIC JAUNDICE:

Pre-hepatic jaundice is caused by conditions that heighten your blood’s rate of hemolysis. This is the process
through which red blood cells are broken down, releasing hemoglobin and converting into bilirubin.

Because the liver can only process so much bilirubin at once, bilirubin overflows into bodily tissues.

The most common causes of pre-hepatic jaundice are:

 Malaria, a blood infection caused by a parasite

 Sickle cell anemia, a genetic condition in which red blood cells become crescent-shaped rather than the typical
disc shape

 Spherocytosis, a genetic condition of the red blood cell membrane that causes them to be sphere-shaped rather
than disc-shaped

 Thalasemia, a genetic condition that causes your body to make an irregular type of hemoglobin that limits the
number of healthy red blood cells in your bloodstream

Common symptoms of pre-hepatic jaundice include:

 fever, including chills or cold sweats

 feeling itchy

 dark urine or pale stool

Some risk factors for this type of jaundice include:

 drug use

 having a family member with a blood disorder

To diagnose pre-hepatic jaundice, doctor will likely order the following tests:

 A urinalysis to measure the amount of certain substances in your urine

 Blood tests, such as a complete blood count(CBC) of liver functin tests to measure bilirubin and other
substances in the blood

Doctor will likely diagnose you with pre-hepatic jaundice if there aren’t any issues with bilirubin being processed
by your liver or within the gallbladder and biliary ducts.

Treatment for pre-hepatic jaundice may include:

For malaria:

 medications to help destroy the parasite and prevent parasites from reinfecting your liver again

For sickle cell anemia:

 blood transfusions from a healthy donor

 rehydrating with intravenous (IV) fluid

 medications for any infections that can cause a sickle cell crisis

For spherocytosis:

 folic acid supplements

 blood transfusions for anemia

 spleen removal surgery to help increase red blood cell life and lower the chance of gallstones.

For thalassemia:

 blood transfusions

 bone marrow transplants

HEPATIC JAUNDICE:

Hepatic jaundice happens when your liver tissue is scarred (known as cirrhosis), damaged, or dysfunctional. This
makes it less effective at filtering out bilirubin from your blood.

Since it can’t be filtered into your digestive system for removal, bilirubin builds up to high levels in your blood.

The most common causes of hepatic jaundice are:

 Liver cirrhosis, which means that liver tissues are scarred by long-term exposure to infections or toxic
substances, such as high levels of alcohol

 Alcoholic hepatitis, in which your liver tissues are scarred by the heavy, long-term drinking of alcohol

 Leptospirosis, is a bacterial infection that can be spread by infected animals or infected animal urine or feces

 Liver cancer, in which cancerous cells develop and multiply within liver tissues

Common symptoms of hepatic jaundice include:

 loss of appetite

 bloody nose

 skin itching

 weakness

 throwing up

Some risk factors for this type of jaundice include:

 drug use

 drinking a lot of alcohol over a long period of time

 use of medications that can cause liver damage, such as acetaminophen or certain heart medications

 previous infections that affected your liver

To diagnose hepatic jaundice, doctor will likely order the following tests:

 imaging tests, such as an MRI or ultrasound, to examine your liver for damage or for the presence of
cancerous cells

 an endoscopy, which involves inserting a thin, lighted tube into a small incision to look at your liver and take
a tissue sample (biopsy) if necessary for analysis for cancer or other conditions.
Treatment for hepatic jaundice can include:

For liver cirrhosis:

 quitting drinking

 beta-blockers

For viral hepatitis:

 antiviral medications

 hepatitis vaccination

For primary biliary cirrhosis:

 bile acids to help with digestion

 bile-lowering medication

For alcoholic hepatitis:

 quitting alcohol

 nutrition supplements

For leptospirosis:

 antibiotics for infection

For liver cancer:

 chemotherapy or radiation to kill cancer cells

POST-HEPATIC JAUNDICE:

Post-hepatic, or obstructive jaundice, happens when bilirubin can’t be drained properly into the bile ducts or
digestive tract because of a blockage.

The most common causes of post-hepatic jaundice are:

 Gallstones hard calcium deposits in the gallbladder that can block bile ducts

 Pancreatic cancer the development and spread of cancer cells in the pancreas, an organ that helps produce
digestive substances

 Biliary atresia a genetic condition in which you have narrow or missing bile ducts

Common symptoms of post-hepatic jaundice include:

 feeling sick

 throwing up

 dark urine or pale stool

 abdominal pain

 diarrhea

 abnormal weight loss

 skin itching

 abdominal swelling

 fever

Some risk factors for this type of jaundice include:

 being overweight

 eating a high-fat, low-fiber diet

 having a family history of gallstones

 being female

 aging

 being exposed to industrial chemicals

To diagnose post-hepatic jaundice, doctor will likely order the following tests:
 A urinalysis to measure levels of substances in your urine

 An endoscopy, which involves inserting a thin, lighted tube down the esophagus to look at your liver,
gallbladder, or bile ducts and take a tissue sample if necessary for analysis for cancer or other conditions

Treatment for post-hepatic jaundice will address the cause. This includes:

For gallstones:

 changing your diet to stop producing gallstones

 removing gallstones or your gallbladder entirely

For pancreatic cancer:

 surgery to remove cancerous tissue or your whole pancreas

 radiation or chemotherapy to destroy cancer cells

For bile duct cancer:

 surgery to remove bile ducts and parts of your liver and pancreas

 radiation or chemotherapy to destroy cancer cells

For pancreatitis:

 rest

 intravenous (IV) fluids or pain medication

For biliary atresia:

 the Kasai procedure to remove and replace ducts

 liver transplant
 TREATMENT

The medical treatment of jaundice targets the specific cause, rather than the jaundice itself. For example:

 Hepatocellular jaundice is treated with anti-viral medications and steroids

 Hemolytic jaundice is treated with iron supplements
 Obstructive jaundice is treated with surgery to remove the obstruction followed by medication
 There is also medication induced jaundice, in other words, jaundice which occurs as a side effect to
consuming certain medicines. In such cases the medicines are discontinued and alternative medicines are
prescribed.

For infants with jaundice the treatments include:

 Phototherapy
 Blood transfusion

Complications:----- The complications of jaundice will depend on your medical conditions, the jaundice type and
severity. Some common complications include:

 bleeding
 infections
 abdominal bloating
 swelling of legs
 liver failure
 kidney failure
 stomach pain
 flatulence

If it is Infant Jaundice or jaundice in a baby, the complications that may affect the infant include:

 fever
 vomiting
 dazedness
 difficulty waking up or being alert
 continuous high pitched crying

Severe jaundice in an infant may lead to permanent brain damage, apart from hearing loss, uncontrolled bodily
movements, and improper development of tooth enamel.
 DIET CHART:

DIET CHART FOR PATIENTS SUFFERING FROM JAUNDICE

If one suffers from this disease it is best to avoid certain foods that provide the liver with complex chemicals to
process.

Foods that are recommended are:

1. At least eight glasses of water: Water helps to flush out the harmful waste-products of the liver which is
Bilirubin and helps keep it level in the blood under check.
2. Fresh fruits and vegetables should be consumed.
3. Coffee should be consumed in a moderate fashion as it has been observed to benefit the patient.
4. Milk thistle, it is known to boost the recovery process by protecting the liver from harmful toxins.
5. Honey, Pineapple and Mango: It has natural digestive enzymes.
6. Fibre-rich vegetables and nuts: Fibres are known to absorb Bilirubin.

Also, avoid:

1. Alcohol: It causes tremendous pressure on the liver to break down the by-product of digestion of alcohol.
2. Saturated Fats: Found in animal fats, they are the hardest to digest.
3. Refined sugar and Sodium

Sunday
Breakfast
(8:00-8:30AM)

Vegetable soup (1 cup)

Mid-Meal
(11:00-11:30AM)
Tender coconut water (1 cup) + 1 Apple (Unskinned)
Breakfast
(8:00-8:30AM)
Khichdi (1/2 cup)
Breakfast
(8:00-8:30AM)
Boiled Black grams (1/3rd cup) + Black Tea (1 cup)

Monday
Breakfast
(8:00-8:30AM)
Boiled White Chickpeas n Tomato (1 cup)

Mid-Meal
(11:00-11:30AM)
Tender coconut water (1 cup) + Grapes (1/2 cup)

Breakfast
(8:00-8:30AM)

Chapati (2) + Fish(1pc.) stew

Breakfast
(8:00-8:30AM)

Roasted Rice Flakes (1/2 cup) + Black Tea (1 cup)

Tuesday
Breakfast
(8:00-8:30AM)
Carrot soup (1 cup)
Mid-Meal
(11:00-11:30AM)
Tender coconut water (1 cup) + Pomegranates (1/2 cup)
Breakfast
(8:00-8:30AM)
Boiled rice (1/2 cup) + Cabbage curry (1/3rd cup)
Breakfast
(8:00-8:30AM)
Boiled Potato n Black grams (1/2 cup) + Black Tea (1 cup)

Wednesday
Breakfast
(8:00-8:30AM)
Vegetable soup (1 cup)
Mid-Meal
(11:00-11:30AM)
Tender coconut water (1 cup) + 1 Guava
Breakfast
(8:00-8:30AM)
Carrot Uttappam (1) + Raita (1/3rd cup)
Breakfast
(8:00-8:30AM)
Puffed Rice (1/2 cup) + Black Tea (1 cup)
 Thursday
Breakfast
(8:00-8:30AM)
Baked Tomato n Brolli wity bell peper soup (1 cup)
Mid-Meal
(11:00-11:30AM)
Tender coconut water (1 cup) + Ripe Papaya (1/3rd cup)
Breakfast
(8:00-8:30AM)
Chapati (2) + Baked vegetables (1/2 cup) + Raita (1/3rd cup)
Breakfast
(8:00-8:30AM)
Boiled Black grams (1/3rd cup) + Black Tea (1 cup)
Breakfast
(8:00-8:30AM)
Boiled Rice (1/2 cup) + Bottle gourd curry (1/3rd cup)

Friday
Breakfast
(8:00-8:30AM)

Broccoli n Bell peper soup (1 cup)

Mid-Meal
(11:00-11:30AM)

Tender coconut water (1 cup) + 1 Orange

Breakfast
(8:00-8:30AM)
Boiled Rice (1/2 cup) + Lentil soup (1/2 cup)
Breakfast
(8:00-8:30AM)
Roasted Rice Flakes (1/2 cup) + Black Tea (1 cup)
Breakfast
(8:00-8:30AM)
Boiled Rice (1/2 cup) + Fish(1pc.) stew (1/3rd cup)

Saturday
Breakfast
(8:00-8:30AM)
Carrot n Beetroot soup (1 cup)
Mid-Meal
(11:00-11:30AM)

Tender coconut water (1 cup) + 2 Chikus

Breakfast
(8:00-8:30AM)
Dosa (1) + Samber (1/2 cup)
Breakfast
(8:00-8:30AM)
Boiled Potato n Black grams (1/2 cup) + Black Tea (1 cup)
Breakfast
(8:00-8:30AM)
Boiled Rice (1/2 cup) + Pointed gourd(without seeds n Unskinned) Curryurry

Food item to limit

1. Salt :For a quick recovery from jaundice the person must refrain from salt. Adding salt on a regular basis
to foods slow down the deterioration of liver cells. So salt rich foods like pickles and certain fish varieties
must be avoided.
2. Meat :All types of meat should be avoided when affected by jaundice. Meat have high level of saturated
fats in them which slows down the recovery from jaundice. After the patient recovers completely it is
permitted to eat meat.
3. Dairy Products : Milk products must be totally avoided if one has jaundice. The milk products include
cheese, butter, buttermilk, curd and margarines.
4. Eggs : Eggs are difficult to digest as they have high amount of protein. The livers finds it difficult to digest
the eggs so it is advised to refrain from eating eggs. After one recovers the eating of eggs are permitted.
5. Caffeine : Caffeinated drinks like tea and coffee should not be drunk when suffering from jaundice. They
may slow down the fast recovery from jaundice and damage liver further.
6. Junk Foods :These are most dangerous foods when it comes to avoiding foods when affected by jaundice.
They contain more amount of oil, fat and other adulterated materials that deteriorate the health and body
of the person.
7. Beans : At the time of jaundice the nitrogen cannot be excreted from the body because the body cannot
properly perform its metabolic activities. But eating beans will exert over load to the body and result in
delay in recovery from jaundice.
8. Banana : Banana should be avoided when suffering from jaundice. Bananas are rich in fibre content which
exert much pressure on the digestive system. It also increases the level of bilirubin in the body which
increases the effects of jaundice.
9. Butter and Clarified Butter :These two substances should not be consumed when suffering from jaundice.
These are rich in saturated fats that is harmful for the health and exerts further stress to the body. Daily
intake of butter must be only about 7 percent of the normal total calorific intake.
10. Pulses and Legumes :These are rich in proteins and fibre. These cause distress to the digestive system and
hence must be avoided during jaundice. They also cause putrefaction in the lower intestines which must be
refrained from by human beings.
Do's and Dont's

Don'ts

1. Avoid consuming foods that are high in fats like red meats and fried or oily foods as the liver is still weak
and these foods will increase strain on the liver. Likewise, avoid consuming sugar rich foods and foods
containing artificial sweeteners.
2. Avoid consuming juices or foods prepared by hawkers or even from restaurants.
3. Do not opt for large meals. Small frequent meals are advisable.

Do's

1. Plenty of oil-free cooked vegetables like potato, carrot, and cauliflower must also be eaten, because there
is a special requisite for vitamin B and C for a healthy recovery.
2. Thinned vegetable soups, custards, buttermilk, and cold milk shakes can also be taken in-between the
meals.
3. Take foods rich in carbohydrates like cereal porridge, bread, rice, potato, yam, custards to ensures
adequate supply of calories. And It will help to avoid the protein breakdown.
Food items you can easily consume

1. Cereals: White rice(Porridge)

2. Pulses: Avoid in intial day's of treatment for fast recovery
3. Vegetables: All gourds-bitter gourd, snake gourd, ridge gourd, bottle gourd, ivy gourd, ladies finger,
tinda,Potato,Yam,carrot,Beetroot and green leafy vegetables( All vegetables shuld be cooked)
4. Fruits: banana, citrus fruits-orange, mousambi, grape fruit, berries-strawberry, blueberry, black berry,
Pears, Watermelon,Grapes
5. Milk and milk products: low fat milk, low fat curd.

Other beverages:

1. Meat and Fish:Avoid in intial day's of treatment for fast recovery.

2. Oil: 2 tbsp (30ml)
3. Sugar: 2 tsp (10gm)

:CASE
STUDIES
ON
JAUNDICE:
 CASE STUDY-1

Vikram, a 24 year old, male suffering from Malaria was put on Primaquine. He developed malaise,fatigue and
yellow discolouration of sclera and skin.
TEST REPORT:-
The case detail is as follows:-
 CASE STUDY-2

Rita, a 50 year old woman had 8 day history of loss of apetite, nausea, and flu like symptoms. She has noticed that
her urine had been dark in colour over the pst two days. On examinaion she had tenderness in the right upper
quadrant.

TEST REPORT:-
The case detail is as follows:-
 Statistical Report:-

In a community study during a reference period of 1 year, 192 cases of jaundice were detected in an urban
population of 69,400 in Alwar, Rajasthan. Detected by paramedics and confirmed by physicians, these cases gave
an annual incidence of 2.76 (95% Cl: 2.37-3.15) per 1000 population. At least one of these patients died, giving a
case fatality ratio of 0.6%.

The jaundice case occured in all areas investigated and affected all socioeconomic strata. About 94% of the
affected familes had only single cases. Although cases occured throughout the year, more than 59% occured
during June and September, which are the summer and monsoon months.
 CONCLUSION:

While making the project, I came to know about various types of jaundice, its symptoms, treatments, many case
studies and the statistical report of this disease.

Finally I gained an ample amount of knowledge about this disease and also learned the basic treatments and
precaution for the application in practical life.

Hence, I really enjoyed a lot making this project.

 BIBLIOGRAPHY:

1. http://www.namrata.co/case-studies-jaundice/

2. https://www.britannica.com/science/human-digestive-system-disease/Biliary-tract#ref294394

3. https://www.healthline.com/health/food-nutrition/diet-for-jaundice#foods-to-limit-or-avoid

4. https://patient.info/health/abnormal-liver-function-tests-leaflet/jaundice

5. https://academic.oup.com/ajcp/article-abstract/5/1/40/1769259?redirectedFrom=PDF
ACKNOWLEDGEMENT:

I would like to express my gratitude to my Biology Teacher, respected madam who has given me the opportunity
to work on this. I would also like to thank our respected Principal Mrs Bose and my parents for their
unconditional support and also the science and technology for the gift of the computer without which working on
this project would become an impossible thought.

NAME:- Surjagnee Sannyamat

CLASS:- XII S1