Prevalence of Hepatic Encephalopathy and Its Precipitating Factors in CLD Cirrhotic Patients

2017 ◽  
Vol 10 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Anam Khalid ◽  
Amna Afsar ◽  
Mohammad Arshad ◽  
Ammarah Ghafoor ◽  
Sadaf Khalid ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Precipitating Factors ◽  
Cirrhotic Patients

scholarly journals Spectrum of hepatic encephalopathy admitted in a tertiary care center

2020 ◽  
Vol 72 ◽  
pp. 206-210
Author(s):  
Amit Soni ◽  
Shavi Nagpal ◽  
Amit Mittal
Keyword(s):  
Hepatic Encephalopathy ◽  
Hospital Mortality ◽  
Care Center ◽  
Tertiary Care ◽  
Abdominal Distension ◽  
Meld Score ◽  
Tertiary Care Center ◽  
Precipitating Factors ◽  
Cirrhotic Patients ◽  
Class C

Objectives: Few of the common symptoms for which cirrhotic patient seeks medical care are gastrointestinal bleed, abdominal distension (ascites), altered sensorium (hepatic encephalopathy [HE]), etc. This study was done to look at the spectrum of HE among cirrhotic patients admitted in a tertiary care center. Material and Methods: This hospital-based study was carried on 36 HE patients (with liver cirrhosis and age >18 years) admitted in the department of gastroenterology of a tertiary care center, between April 2019 and November 2019. Results: Constipation and infections were the two most frequent precipitating factors identified. Majority patients (77.8%) belonged to CTP Class C. In-hospital mortality was observed in seven patients. The OR was significant for infections and in-hospital mortality (OR – 28.80 and P < 0.05). A moderate positive correlation (Pearson’s correlation, r = 0.335) was seen between MELD score and in-hospital mortality among HE patients. Conclusion: A larger mass of HE patients belongs to CTP Class C. Constipation and infections are the two most common precipitating factors for HE. All HE patients who have concomitant infection and/or high MELD score should be managed on priority basis.

THE STUDY ON PRECIPITATING FACTORS OF HEPATIC ENCEPHALOPATHY IN CIRRHOTIC PATIENT IN WEST BENGAL

2021 ◽  
pp. 28-30
Author(s):  
Partha Pratim Dey ◽  
Debarshi Jana
Keyword(s):  
Hepatic Encephalopathy ◽  
Cirrhotic Patient ◽  
West Bengal ◽  
General Medicine ◽  
Electrolyte Imbalance ◽  
Precipitating Factors ◽  
Medical College ◽  
Cirrhotic Patients ◽  
One Year ◽  
Time Of Presentation

Introduction: Hepatic encephalopathy is a frequent complication and one of the most debilitating manifestations of liver diseases, severely affecting the lives of patients. Aims and objective: i. To study the precipitating factors of hepatic encephalopathy. ii. To observe the clinical manifestation at the time of presentation of hepatic encephalopathy. iii. To observe the seasonal variation of hepatic encephalopathy in cirrhotic patient. Materials and method: General Medicine, Murshidabad Medical college and R. G. Kar Medical college in West Bengal. All adult cirrhotic Patients admitted with encephalopathy in the medicine ward within the study period. One year starting from 1st Nov 2019 to 31st October 2020. Conclusion: This study found that most common precipitating factors of hepatic encephalopathy in our patients are infection, constipation electrolyte imbalance and Variceal Haemorrhage bleeding. These are potentially preventable and reversible.

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.

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.

scholarly journals Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function

2021 ◽  
Vol 10 (2) ◽  
pp. 239
Author(s):  
Dalia Rega ◽  
Mika Aiko ◽  
Nicolás Peñaranda ◽  
Amparo Urios ◽  
Juan-José Gallego ◽  
...  
Keyword(s):  
Nervous System ◽  
Hepatic Encephalopathy ◽  
Quantitative Sensory Testing ◽  
Autonomic Function ◽  
Thermal Sensitivity ◽  
Somatosensory System ◽  
Minimal Hepatic Encephalopathy ◽  
Heat Pain ◽  
Sensory Testing ◽  
Cirrhotic Patients

Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibration, cooling, and heat pain detection) by electromyography and quantitative sensory testing. The detection thresholds for cold and heat pain on the foot were higher in patients with, than those without MHE. This hyposensitivity was correlated with attention deficits. Reaction times in the foot were longer in patients with, than without MHE. Patients with normal sural nerve amplitude showed altered thermal sensitivity and autonomic function, with stronger alterations in patients with, than in those without MHE. MHE patients show a general decrease in cognitive and sensory abilities. Small fibers of the autonomic nervous system and thermal sensitivity are altered early on in MHE, before large sensory fibers. Quantitative sensory testing could be used as a marker of MHE.

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