Introduction: Jaundice is the most common symptom observed in liver, gall bladder and haematological diseases. For a definitive diagnosis, every physician depends on correlation with biochemical, serological and radiological investigations. Our present study describes the clinical profile of patients of jaundice admitted in rural tertiary care hospital in Haryana. The aim of our research was to study age and sex distribution of patients, to associate clinical signs, symptoms & risk factors, to investigate biochemical & serological profile in different aetiologies of jaundice.

Material and Method: The study was conducted on 200 patients admitted in the Department of Medicine during period of six months. A Predesigned questionnaire was used. Routine lab investigations were done for every patient. Patients went ultrasound examination of abdomen whenever necessary.

Observations: Out of 200 patients, 141(70.5%) were males and 59(29.5%) were females. Most common cause of jaundice was viral hepatitis (40%), followed by alcoholic liver disease, obstructive jaundice, chronic liver disease. Fatigue (86%) was the most common symptom, followed by anorexia, pain abdomen and fever. Hepatomegaly was found in 132 patients (66%).SGOT and SGPT were found to be raised in 188 and 172 cases respectively. Albumin Globulin ratio was less than 1 in 72 cases.

Conclusion: The variability in nature of the disease regarding its presenting signs and symptoms, clinical course and development of complications are important aspects.  So, it is very essential for health care professionals to be aware of all aspects of it so that the disease is detected and treated early. There should be some surveillance system to regularly monitor the portability of drinking water from time to time to avoid HAV and HEV infection. Proper screening of blood prior to transfusion would prevent HBV and HCV infection. Chronic alcoholics should undergo treatment and behavioural modification in rehabilitation centres.

1. "Jaundice". Medline Plus. Retrieved 13 August 2016
2. Buttaro, Terry Mahan; Trybulski, JoAnn; Polgar-Bailey, Patricia; Sandberg-Cook, Joanne (2012). Primary Care: A Collaborative Practice(4 ed.). Elsevier Health Sciences. p. 690. ISBN 0323075851.
3. Sherlock S. Virus hepatitis B, A, non-A, non-B. J Heptol.1989.8(2):254-258.
4. Nandi B, Hadimani P, Arunachalam R, Ganjoo RK. Spectrum of acute viral hepatitis in Southern India. Med J Armed Forces India 2009; 65:7‑9.
5. Mathur P, Arora NK. Epidemiological transition of hepatitis A in India: Issues for vaccination in countries. Indian J Med Res 2008; 128:699‑704.
6. Chen YC, Huang LT, Wang SM, Tiao MM, Liu JW. Acute hepatitis A infection in children: A 20‑year experience of a medical center in Southern Taiwan. Acta Paediatr Taiwan 2007; 48:131‑4.
7. Stránský J, Honzáková E, Vandasová J, Kyncl J. A relapsing and protracted form of viral hepatitis A: Comparison of adults and children. Vnitr Lek 1995; 41:525‑30.
8. Tandon BN, Gandhi BM, Joshi YK. Etiological spectrum of viral hepatitis and prevalence of markers of hepatitis A and B virus infection in north India. Bull World Health Organ 1984; 62:67–73.
9. Prakash S, Jaiswal B, Chitnis DS, Jain AK, Inamdar S, Jain KS, et al. Etiologic spectrum among acute viral hepatitis cases in Central India. Indian J Gastroenterol 1998; 17:113.
10. Dasarathy S, Misra SC, Acharya SK, Irshad M, Joshi YK, Venugopal P, et al. Prospective controlled study of post-transfusion hepatitis after cardiac surgery in a large referral hospital in India. Liver1992; 12:116–20.
11. Saxena R, Thakur V, Sood B, Guptan RC, Gururaja S, Sarin SK. Transfusion-associated hepatitis in a tertiary referral hospital in India: A prospective study. Vox Sang 1999; 77:6–10.
12. Naik SR, Aggarwal R, Salunke PN, Mehrotra NN. A large waterborne viral hepatitis E epidemic in Kanpur, India. Bull World Health Organ 1992; 70:597‑604.
13. Ahmed A, Ali IA, Ghazal H, Fazili J, Nusrat S. Mystery of hepatitis e virus: Recent advances in its diagnosis and management. Int J Hepatol 2015; 2015:872431.
14. Chandra NS, Sharma A, Rai RR, Malhotra B. Contribution of hepatitis E virus in acute sporadic hepatitis in north western India. Indian J Med Res 2012; 136:477‑82.
15. Viral Hepatitis the Silent Disease Facts and Treatment Guidelines. National centre for disease control 22-Sham Nath Marg, Delhi 110054. Directorate General of Health Service, Ministry of Health and Family Welfare Government of India. Available from: www. ncdc.gov.in/ writereaddata/ linkimages / guideline_hep20158 117187417.pdf
16. Vij JC, Tandon BN. Evaluation of prognostic factors in fulminant hepatitis. JAPI; 1979, 27: 200-203.
17. AK Malhotra et al: Pattern of infective hepatitis in Jhansi - a 5-year appraisal. Indian Medical Gazette, 1985: 254 – 257.
18. Dabadghao V, Barure R, Sharma S, Mangudkar S. A study of the clinical and biochemical profile of acute viral hepatitis. Int J Biomed Adv Res. 2015;6(10):68993.
19. Acharya SK, Madan K, Dattagupta S, Panda SK. Viral hepatitis in India. Natl Med J India. 2006;19(4):20317.
20. Chandra NS, Sharma A, Rai RR, Malhotra B. Contribution of hepatitis E virus in acute sporadic hepatitis in North Western India. Indian J Med Res. 2012;136(3):477-82.
21. Dabadghao V, Barure R, Sharma S, Mangudkar S. A study of the clinical and biochemical profile of acute viral hepatitis. Int J Biomed Adv Res. 2015;6(10):68993.
22. Zhang S, Wang J, Yuan Q, Ge S, Zhang J, Xia N, et al. Clinical characteristics and risk factors of sporadic hepatitis E in Central China. Virol J. 2011;8:1-5.
23. Tong MJ, El-Farra NS, Grew MI. Clinical manifestations of hepatitis A: recent experience in a community teaching hospital. J Infect Dis. 1995;171:S15-8.

Dr Manoj Rawal

Associate Professor & HOD, Paediatrics, Bhagat Phool Singh Government Medical College for Women, Sonepat, Haryana, India