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Jaundice, (also known as icterus, attributive adjective: icteric) is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae (whites of the eyes), and other mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Typically, the concentration of bilirubin in the plasma must exceed 1.5 mg/dL ( > 35 micromoles/L), three times the usual value of approximately 0.5 mg/dL, for the coloration to be easily visible. Jaundice comes from the French word jaune, meaning yellow.
The conjunctiva of the eye are one of the first tissues to change color as bilirubin levels rise in jaundice. This is sometimes referred to as scleral icterus. However, the sclera themselves are not “icteric” (stained with bile pigment) but rather the conjunctival membranes that overlie them. The yellowing of the “white of the eye” is thus more properly termed conjunctival icterus. The term “icterus” itself is sometimes incorrectly used to refer to jaundice that is noted in the sclera of the eyes, however its more common and more correct meaning is entirely synonymous with jaundice.
It was once believed persons suffering from the medical condition jaundice saw everything as yellow. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. Alexander Pope, in “An Essay on Criticism” (1711), wrote: “All seems Infected that th’ Infected spy, As all looks yellow to the Jaundic’d Eye.” Similarly in the mid-19th century the English poet Alfred Lord Tennyson wrote in the poem Locksley Hall: “So I triumphe’d ere my passion sweeping thro’ me left me dry, left me with the palsied heart, and left me with a jaundiced eye.”
When a pathological process interferes with the normal functioning of the metabolism and excretion of bilirubin just described, jaundice may be the result. Jaundice is classified into three categories, depending on which part of the physiological mechanism the pathology affects. The three categories are:
Category Definition Pre-hepatic The pathology is occurring prior to the liver. Hepatic The pathology is located within the liver. Post-Hepatic The pathology is located after the conjugation of bilirubin in the liver.
Pre-hepatic jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia, spherocytosis, thalassemia and glucose 6-phosphate dehydrogenase deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as hemolytic uremic syndrome, can also lead to coloration. Defects in bilirubin metabolism also present as jaundice, as in Gilbert’s syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population)and Crigler-Najjar syndrome.
In jaundice secondary to hemolysis, the increased production of bilirubin, leads to the increased production of urine-urobilinogen. Bilirubin is not usually found in the urine because unconjugated bilirubinn is not water-soluble, so, the combination of increased urine-urobilinogen with no bilirubin(since, unconjugated)in urine is suggestive of hemolytic jaundice.
Laboratory findings include:
- Urine: no bilirubin present, urobilirubin > 2 units (i.e., hemolytic anemia causes increased heme metabolism; exception: infants where gut flora has not developed).
- Serum: increased unconjugated bilirubin.
- Kernicterus is associated with increased unconjugated bilirubin.
Hepatocellular (hepatic) jaundice can be caused by acute hepatitis, hepatotoxicity, and alcoholic liver disease. Cell necrosis reduces the liver’s ability to metabolize and excrete bilirubin leading to a buildup of unconjugated bilirubin in the blood. Other causes include primary biliary cirrhosis leading to an increase in plasma conjugated bilirubin. Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age. Rat fever (leptospirosis) can also cause hepatic jaundice. In hepatic jaundice, there is invariably cholestasis.
Laboratory findings depend on the cause of jaundice.
- Urine: Conjugated bilirubin present, urobilirubin > 2 units but variable (except in children). Kernicterus is a condition not associated with increased conjugated bilirubin.
Post-hepatic jaundice, also called obstructive jaundice, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct, and pancreatic cancer in the head of the pancreas. Also, a group of parasites known as “liver flukes” can live in the common bile duct, causing obstructive jaundice. Other causes include strictures of the common bile duct, biliary atresia, ductal carcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi’s syndrome.
In complete obstruction of the bile duct, no urobilinogen is found in the urine,since bilirubin has no access to the intestine and its in the intestine that bilirubin gets converted to urobilinogen to be later released into the general circulation. In this case, presence of bilirubin(conjugated) in the urine without urine-urobilinogen suggests obstructive jaundice, either intra-hepatic or post-hepatic.
The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from bile pigments. However, although pale stools and dark urine are a feature of biliary obstruction, they can occur in many intra-hepatic illnesses and are therefore not a reliable clinical feature to distinguish obstruction from hepatic causes of jaundice.
Patients also can present with elevated serum cholesterol, and often complain of severe itching or “pruritus” because of the deposition of bile salts.
No single test can differentiate between various classifications of jaundice. A combination of liver function tests is essential to arrive at a diagnosis.
Table of diagnostic tests Function test Pre-hepatic Jaundice Hepatic Jaundice Post-hepatic Jaundice Total bilirubin Normal / Increased Increased Conjugated bilirubin Normal Increased Increased Unconjugated bilirubin Normal / Increased Increased Normal Urobilinogen Normal / Increased Increased Decreased / Negative Urine Color Dark(urobilinogen) Dark (urobilinogen + conjugated bilirubin) Dark (conjugated bilirubin) Stool Color Normal Pale Alkaline phosphatase levels Normal Increased Alanine transferase and Aspartate transferase levels Increased Conjugated Bilirubin in Urine Not Present Present
(more at: http://en.wikipedia.org/wiki/Jaundice)
[Contributed by: User – Chetan Bhatt on 03/06/2013]
- Look at this carefully…it is a brilliant example of British Humour!
The British government has scrapped the Harrier fleet and on their farewell formation fly past over the Houses of Parliament they gave the government a message.
Lean back a bit from your computer monitor and squint. Seriously…push your chair back a couple of feet..
Hat’s off to the man that was leading this Squadron.
(contributed by: Mohan Rao on 05.09.2011)Look at this carefully…it is a brilliant example of British Humour! The British government has scrapped the Harrier fleet and on their farewell formation fly past over the Houses of Parliament they gave the government a message. Lean back a bit from your computer monitor and squint. Seriously…push your chair back a couple of feet.. Hat’s off to the man that was leading this ...
Goddess Saraswati is universally recognized in Hinduism as the Goddess of learning and knowledge. Students in any and all fields of learning pray to Saraswati for success in completion of their studies. Saraswati is the companion of Lord Brahma (the creator). She represents speech (Vach), the mechanism or divine energy with which Brahma created the universe. The importance of Goddess Saraswati (saras = fluid, wati = easily, i.e. easily flowing energy) is her ability to bring into manifestation the concept of Creation thought by Brahma in his thoughts. The words (or Vach) spoken by Brahma to create the universe is indeed Sarswati!
The Goddess Gayatri is synonymous with Goddess Saraswati in the sense that Gayatri is another form of Saraswati. Hence, the Gayatri Mantra is indeed the best invocation for Goddess Saraswati. Legend has it that Saraswati appeared as Gayatri in order to assist Brahma in the completion of an important yagna being conducted in homage to the Sun God (Surya Devataa).
Mantra for Goddess Saraswati
An invocation to Goddess Saraswati is as follows – she who holds the (musical instrument) veena in her hands and opens the channels of learning for her disciples. Saraswati is also revered as the Goddess of music and creative (particularly, the spoken) arts.
yaa kundendu tushhaar haara dhavalaa yaa shubhravastraavR^itaa .
yA vINaavarada.nDa ma.nDitakaraa yaa shvetapadmaasanaa .Salutations to the supreme Goddess Saraswati…whose face is fair as a jasmine flower, luminiscient like the moon and delicate as a snow flake ; who is dressed in brilliant white (shubhra-) garments (vastraA). She holds the musical instrument (vINA-) in her hands to bestow boons (varada.nDa-) to her disciples as she sits on her white (shveta-) lotus (padma-) throne (aasanA).This is an extract of the Beej (or Seed) Mantra invoking Goddess Saraswati. Beej Mantra(s) are based on mono-syllables. The Beej Mantra for Saraswati is based on the two words “Bhreem” and “Shreem”. The mantra is simple – “AUM Shreem Bhreem Saraswat-yea Namaha”. (ॐ श्रीम भ्रीम सरस्वतये नमः)
Saraswati Gayatri Mantra
The Saraswati Gayatri is a mantra written specifically to invoke Goddess Saraswati in the 24-metre tradition of the Gayatri Mantra.
Om Vaakdeviyai cha Vidhmahe
Virinji Pathniyai cha Dheemahe
Thanno Vani Prachodayath.
Om, Let me meditate on the goddess of speech,
Oh, wife of Lord Brahma, give me higher intellect,
And let Goddess Vani illuminate my mind.
Another version of the Saraswati Gayatri which may of relevance to those seeking blessings for success in the areas of education, fine arts (like theatre, painting etc.) is
ॐ वाकदैव्यै च विद्महे कामराजाय धीमहि। तन्नो देवी प्रचोदयात्।
AUM Vaakdeviyai cha Vidhmahe
tanno devi prachodayaat.
(source: http://www.eaglespace.com/spirit/saraswati.php)Goddess Saraswati is universally recognized in Hinduism as the Goddess of learning and knowledge. Students in any and all fields of learning pray to Saraswati for success in completion of their studies. Saraswati is the companion of Lord Brahma (the creator). She represents speech (Vach), the mechanism or divine energy with which Brahma created the ...
- Nine Things That Will Disappear In Our Lifetime
1. The Post Office. Get ready to imagine a world without the post office. They are so deeply in financial trouble that there is probably no way to sustain it long term. Email, Fed Ex, and UPS have just about wiped out the minimum revenue needed to keep the post office alive. Most of your mail every day is junk mail and bills.
2. The Cheque. Britain is already laying the groundwork to do away with cheques by 2018. It costs the financial system billions of dollars a year to process cheques. Plastic cards and online transactions will lead to the eventual demise of the cheque. This plays right into the death of the post office. If you never paid your bills by mail and never received them by mail, the post office would absolutely go out of business.
3. The Newspaper. The younger generation simply doesn’t read the newspaper. They certainly don’t subscribe to a daily delivered print edition. That may go the way of the milkman and the laundry man. As for reading the paper online, get ready to pay for it. The rise in mobile Internet devices and e-readers has caused all the newspaper and magazine publishers to form an alliance. They have met with Apple, Amazon, and the major cell phone companies to develop a model for paid subscription services.
4. The Book. You say you will never give up the physical book that you hold in your hand and turn the literal pages. I said the same thing about downloading music fromiTunes. I wanted my hard copy CD. But I quickly changed my mind when I discovered that I could get albums for half the price without ever leaving home to get the latest music. The same thing will happen with books. You can browse a bookstore online and even read a preview chapter before you buy. And the price is less than half that of a real book. And think of the convenience! Once you start flicking your fingers on the screen instead of the book, you find that you are lost in the story, can’t wait to see what happens next, and you forget that you’re holding a gadget instead of a book.
5. The Land Line Telephone. Unless you have a large family and make a lot of local calls, you don’t need it anymore. Most people keep it simply because they’ve always had it. But you are paying double charges for that extra service. All the cell phone companies will let you call customers using the same cell provider for no charge against your minutes
6. Music. This is one of the saddest parts of the change story. The music industry is dying a slow death. Not just because of illegal downloading. It’s the lack of innovative new music being given a chance to get to the people who would like to hear it. Greed and corruption is the problem. The record labels and the radio conglomerates are simply self-destructing. Over 40% of the music purchased today is “catalog items,” meaning traditional music that the public is familiar with. Older established artists. This is also true on the live concert circuit. To explore this fascinating and disturbing topic further, check out the book, “Appetite for Self-Destruction” by Steve Knopper, and the video documentary, “Before the Music Dies.”
7. Television. Revenues to the networks are down dramatically. Not just because of the economy. People are watching TV and movies streamed from their computers. And they’re playing games and doing lots of other things that take up the time that used to be spent watching TV. Prime time shows have degenerated down to lower than the lowest common denominator. Cable rates are skyrocketing and commercials run about every 4 minutes and 30 seconds. I say good riddance to most of it. It’s time for the cable companies to be put out of our misery.. Let the people choose what they want to watch online and through Netflix.
8. The “Things” That You Own. Many of the very possessions that we used to own are still in our lives, but we may not actually own them in the future. They may simply reside in “the cloud.” Today your computer has a hard drive and you store your pictures, music, movies, and documents. Your software is on a CD or DVD, and you can always re-install it if need be. But all of that is changing. Apple, Microsoft, and Google are all finishing up their latest “cloud services.” That means that when you turn on a computer, the Internet will be built into the operating system. So, Windows, Google, and the Mac OS will be tied straight into the Internet. If you click an icon, it will open something in the Internet cloud. If you save something, it will be saved to the cloud. And you may pay a monthly subscription fee to the cloud provider. In this virtual world, you can access your music or your books, or your whatever from any laptop or handheld device. That’s the good news. But, will you actually own any of this “stuff” or will it all be able to disappear at any moment in a big “Poof?” Will most of the things in our lives be disposable and whimsical? It makes you want to run to the closet and pull out that photo album, grab a book from the shelf, or open up a CD case and pull out the insert.
9. Privacy. If there ever was a concept that we can look back on nostalgically, it would be privacy. That’s gone. It’s been gone for a long time anyway. There are cameras on the street, in most of the buildings, and even built into your computer and cell phone. But you can be sure that 24/7, “They” know who you are and where you are, right down to the GPS coordinates, and the Google Street View. If you buy something, your habit is put into a zillion profiles, and your ads will change to reflect those habits. And “They” will try to get you to buy something else. Again and again.
(source : http://interesting-amazing-facts.blogspot.in/search/label/strange%20facts?updated-max=2012-04-06T00:01:00-07:00&max-results=20&start=40&by-date=false)