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TITLE:

TO KNOW THE DETERMINANTS OF HEPATIC ENCEPHALOPATHY IN PATIENTS COMING TO JINNAH HOSPITAL AND THEIR CHILD-PUGH CLASSIFICATION

AUTHORS:

Dr. Sidra Riaz, Dr Sana Yasin, Dr Ammara Yaqoob

ABSTRACT:

Abstract: Hepatic encephalopathy is the derangement in functioning of CNS due to compromised liver function resulting in a range of neuropsychiatry manifestations. Child Pugh classification is used to access prognosis of liver disease mainly cirrhosis. Although previously used to predict mortality during surgery, it is now used to determine the prognosis as well as the required span of treatment and necessity of liver transplantation. Objectives: To know the determinants of hepatic encephalopathy in patients coming to Jinnah hospital and their Child Pugh classification. Place: Jinnah Hospital, Lahore. Study Period: 3 months. Subjects and Methods: A population based cross-sectional study was conducted. A total of 100 subjects were recruited in study. Selection was made on laid down criteria based on convenient sampling. Interviews were conducted through pretested proformas after taking due consent. Data was collected, compiled and analyzed through SPSS version 22. Demographic characteristics were defined using frequency tables, descriptive statistics were applied to determine mean, median, mode and standard deviation. Social determinants were shown graphically in the form of pie charts while clinical determinants were picturized in form of bar charts. Results: Out of 100 subjects, hepatic encephalopathy was more prevalent in people above 30 years of age (97%), males (61%) were more commonly affected than females (39%). It was also found to be more in people with education below or equal to primary (71%), and those belonging to poor class (70%). 57% of patients had history of hepatitis C infection. Other important factors making up less than 30% include hepatitis B, UTIs, pneumonia, use of diuretics, anti-tuberculosis drugs, sedatives, type 1 diabetes. 74 % of patients were found to have constipation, 62% had history of vomiting 51% had Hemetemesis, 54% had melena. Vitamin B12 deficiency was present in 58% of those studied. 80% of patients consumed proteins (fish, meat) less than 3 times a week and 92% hadn't undergone any significant operation (Porto systemic shunting, appendisectomy). Only 23% presented with hypoglycaemia and 9% with hypokalemia. 64% of the patients had Child-pugh class C, 35% had class B and only 1% had class A Keywords: Hepatic encephalopathy, Child Pugh classification, cross-sectional study.

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