Infectious Diseases
Dengue Fever
Most dengue is survived at home. The danger opens on days three to seven, usually as the fever falls. These are the warning signs that mean hospital now.
28 Aug 202614 min read
Jaundice
Pronounced JAWN-dis
Also known as Icterus, Yarqan, Kamla
Jaundice is a yellow discolouration of the whites of the eyes and the skin caused by too much bilirubin in the blood. It is a sign rather than a disease, and the cause ranges from a harmless newborn phase to serious liver or bile duct illness.
Bilirubin is the yellow pigment left when old red cells are broken down. The liver collects it, converts it into a water-soluble form and sends it into the bile, from where it leaves in the stool. Jaundice appears when that chain is overloaded or broken anywhere along it, and the whites of the eyes yellow first because the tissue binds the pigment readily.
Where the problem can be
- Before the liver — too many red cells are being destroyed, as in haemolysis, malaria or thalassaemia. Here the is usually the more pressing problem.
- In the liver — hepatitis A and E from contaminated food and water, hepatitis B and C, alcohol, some medicines and herbal preparations, and cirrhosis. Hepatitis B and C are common in Pakistan and often silent until late.
- After the liver — bile cannot escape, because a gallstone, a stricture or a tumour is blocking the duct. The clue is pale, putty-coloured stools with dark urine, and it usually needs prompt imaging.
Investigation begins with a to see which part of the pattern is disturbed, a , viral hepatitis tests, and an of the abdomen to look at the liver, gallbladder and ducts. There is no useful home remedy: sugarcane juice, sacred threads and turmeric preparations do not clear bilirubin, and time spent on them is time the underlying cause is untreated.
Where this comes up
Medicines & Safety
Paracetamol: How Much Is Safe, and the Liver Risk
The safe adult maximum is 4 g in 24 hours. Above that it damages the liver, and for the first day or two an overdose causes almost no symptoms at all.
28 Aug 202611 min read
Pulmonology
A Cough That Will Not Go: When to Worry and What Causes It
In Pakistan a cough lasting two weeks or more should be tested for tuberculosis. What else causes a long cough, and the signs that mean see a doctor now.
27 Aug 202610 min read
General Medicine
Fever in Adults: What It Means and When to Worry
Most fevers settle within three days. In Pakistan a fever that lasts longer needs testing for dengue, typhoid or malaria — and a few need help the same hour.
27 Aug 20269 min read
Related terms
- Liver function testLFT, Liver panelA liver function test is a group of blood measurements that together show whether liver cells are being damaged, whether bile is flowing freely, and how well the liver is doing its manufacturing work. Most of what it reports is not, strictly, function.
- AnaemiaAnemia, Low haemoglobinAnaemia means the blood carries less haemoglobin than it should, so less oxygen reaches the tissues. It usually shows itself as tiredness, breathlessness on exertion and pallor, and in Pakistan the commonest cause by a wide margin is a shortage of iron.
- UltrasoundSonography, Ultrasound scanAn ultrasound scan builds images from high-frequency sound waves reflected back off the body's tissues. It uses no radiation, which is why it is the scan used in pregnancy.
- VirusViral infectionA virus is genetic material in a protein coat that can only reproduce inside a living cell. Antibiotics have no effect on viruses, which is why they are not prescribed for a common cold.