scholarly journals A STUDY OF THE CLINICAL PROFILE OF CIRRHOSIS OF LIVER AND ANALYSIS OF PRECIPITATING FACTORS IN HEPATIC ENCEPHALOPATHY

2015 ◽  
Vol 4 (66) ◽  
pp. 11478-11486
Author(s):  
Sai Lakshmikanth Bharathi ◽  
Vengadakrishnan K ◽  
Rajkumar M
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Profile ◽  
Precipitating Factors ◽  
Cirrhosis Of Liver

Clinical Profile, Precipitating Factors and Outcome of Hepatic Encephalopathy in Patients with Liver Cirrhosis

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 23-27
Author(s):  
Subash Bhattarai ◽  
Dipesh Karki
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Profile ◽  
Decompensated Cirrhosis ◽  
Precipitating Factors ◽  
Early Management ◽  
Child Class ◽  
Grade Ii ◽  
Cirrhotic Patients ◽  
Class C ◽  
Upper Gastrointestinal

Introduction: Hepatic encephalopathy (HE) is characterized by reversible neuropsychological features and is observed with advanced and decompensated cirrhosis of the liver. Patients outcomes and survival depends on clinical presentation, identification of the precipitating factor, early management, and treatment of complications. This study aims to find out the clinical profile of cirrhotic patients with hepatic encephalopathy, their precipitating factors, and clinical outcomes in patients admitted at a tertiary care Teaching Hospital in Gandaki province, Nepal. Materials and Methods: An observational, cross-sectional, hospital-based prospective study comprising of 140 cirrhotic patients with encephalopathy was conducted over a study period of 18 months. Their clinical profile, precipitating factors, and outcomes during hospitalization including mortality were studied. The data analysis was done using SPSS version 20 and a P-value of ≤0.05 was considered significant. Results: Majority (36.5%) of the patients presented with Grade II HE. Upper gastrointestinal (GI) bleeding and spontaneous bacterial peritonitis were the most common precipitating factors. Inpatient mortality was 22.9%. The increased mortality rate was observed in patients with Child class C and with higher grading (Grade III and IV) of hepatic encephalopathy and in presence of more than two precipitating factors Conclusion: Most of the patients presented with Grade II HE. Upper gastrointestinal bleed and infections were the most common precipitating factors. Patients with Hepatic encephalopathy of Grades III and IV, those with CTP Child class C, and in presence of more than two precipitating factors have high mortality.

Clinical Profile of Patients with Hepatic Encephalopathy in Cirrhosis of Liver

2019 ◽  
Vol 14 (3) ◽  
pp. 130 ◽  
Author(s):  
AmanPratap Singh ◽  
Shilpa Bawankule ◽  
Sunil Kumar ◽  
Abhay Gaidhane ◽  
Mahalaque Quazi
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Profile ◽  
Cirrhosis Of Liver

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

2019 ◽  
Vol 31 (3) ◽  
pp. 251-256
Keyword(s):  
Clinical Practice ◽  
Hepatic Encephalopathy ◽  
Zinc Deficiency ◽  
Serum Zinc ◽  
Zinc Level ◽  
The Body ◽  
Serum Zinc Level ◽  
Cross Sectional ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver

Cirrhosis of liver is one of the common medical problem in daily clinical practice and one of the leading causes of morbidity and mortality. Zinc is an essential trace elements for human and plays in many biological roles in the body. Among them, zinc deficiency is thought to be involved in metabolism of ammonia and causes hyperammonia that worsen hepatic encephalopathy. This study aimed to find out the severity of cirrhosis of liver was by Child Turcotte Pugh score and to investigate the associations between serum zinc level and severity of cirrhosis. A hospital-based cross-sectional descriptive study was performed on 78 patients with different underlying causes of cirrhosis of liver at the Medical Units of Yangon General Hospital and Yangon Specialty Hospital. Among the study population, Child grade A was found to be 28.21%, Child grade B was 30.77% and Child grade C was 41.03%. Regarding result of serum zinc level, 62.8% were low level, 28.2% were within normal level and 8.9% were high level. Mean value of serum zinc level in grade A was 0.68 mg/l, grade B was 0.54 mg/l and grade C was 0.48 mg/l (p=0.00). It was found out that there was a high prevalence of zinc deficiency in severe cirrhotic patients. The zinc level was significantly lowest among patients with Child-Pugh C as compare to those with Child-Pugh B and C. Severity of zinc deficiency should be requested for supplementation therapy in cirrhotic patients as to prevent complications such as hepatic encephalopathy, hepatocellular carcinoma and liver failure. Screening for zinc deficiency may need in these patients with more advanced cirrhosis because it seems to be a marker of advanced liver disease and it can be deducted that awareness of serum zinc level among cirrhotic patients is very important in clinical practice.

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

Study of Clinical Profile and Outcome of Metabolic Encephalopathy in Patients Admitted at HSK Hospital, Bagalkot, Karnataka

2021 ◽  
Vol 8 (33) ◽  
pp. 3134-3138
Keyword(s):  
General Medicine ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Clinical State ◽  
Common Symptom ◽  
Cross Sectional ◽  
Altered Level ◽  
Metabolic Encephalopathy ◽  
Altered Sensorium ◽  
Cirrhosis Of Liver

BACKGROUND Metabolic encephalopathy (ME) is one of the most frequently encountered and broadly defined diagnoses by the physicians in the intensive care setting. ME is a clinical state characterized by cerebral dysfunction in the absence of structural brain disease. The causes are many and often multifactorial. The purpose of study was to evaluate various causes, clinical profile, and outcome in patients with ME. METHODS This is a hospital based, observational, cross sectional study, conducted in ICU of Department of General medicine, S.N. Medical College, Bagalkot. Patients with head trauma, organic causes of altered sensorium, psychiatric conditions were excluded. RESULTS Mean age was 51.22 ± 17.24 years. Majority were males. Diabetes was the most common comorbidity found followed by cirrhosis of liver and hypertension. Septic causes were found to be the most common aetiology. 80.7 % recovered from the disease and death was noted in 19.3 % patients. CONCLUSIONS All the patients with ME had altered level of consciousness with fever being the most common symptom. Most of them were males, most common aetiology was septic cause, and recovery was seen in about 80.7 % of patients. KEYWORDS Metabolic Encephalopathy, Altered Sensorium, Sepsis

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