Dr. Umama Najam, Dr. Pervez Rashid Birmani, Dr. Shazia Munawar
Objective: Liver cirrhosis is one of the major causes of morbidity and mortality worldwide but the exact frequency of liver cirrhosis is unknown. The incidence of hepatic encephalopathy (HE), also called s porto- systemic encephalopathy (PSE), is 24% in patients with cirrhosis. Aim: To compare the efficacy of neomycin and ciprofloxacin for secondary prophylaxis of secondary porto-systemic encephalopathy (PSE) in patients with liver cirrhosis. Place and duration: In the Medicine department of Benazir Bhutto Hospital, Rawalpindi for six months duration from March 2019 to March 2020. Study design: Randomized Control Trail. Method: 280 cases were randomly divided into two groups. Patients coming with PSE were included after they became conscious. Ciprofloxacin was given to one group and neomycin was given to the other group after discharge. Patients were observed for recurrence of PSE for 6 months. Results: Among 280 patients, the average age of patients in the neomycin group was 50.35 ± 6.72, and as in the ciprofloxacin group - 50.33 ± 7.09. A total of 59.6% of patients were male and 40.4% of patients were female. 1.07% of patients with grade I hepatic encephalopathy, 37.14% with grade II, 39.28% with grade III, 22.5% of patients with grade IV hepatic encephalopathy. After 3 months, in the neomycin group, 46.32% of patients did not develop systemic encephalopathy, 13.23% of patients developed systemic encephalopathy, 26.47% of patients died. , 69% of patients developed systemic encephalopathy, 31.94% of patients expired, 9.94% of patients lost observation. Pearson chi-sq. = 66.619 P = 0.000. During a 6-month follow-up in the neomycin group, 46.32% of patients did not develop port systemic encephalopathy, 13.23% of patients developed port-systemic encephalopathy, 26.47% of patients died. In the ciprofloxacin-treated group, 10.41% of patients did not develop systemic encephalopathy in the port system, 50.69% of patients developed in the port system encephalopathy, 31.94% died. Conclusion: Neomycin is more effective than ciprofloxacin in the prevention of systemic encephalopathy. Mortality in the neomycin group is lower than in the ciprofloxacin group. Key words: liver cirrhosis, PSE, secondary prevention.