title: Precipitating factors of hepatic encephalopathy at a tertiary care hospital Jamshoro, Hyderabad.
abstract: OBJECTIVE
  To determine the precipitating factors of hepatic encephalopathy (HE) in patients with liver cirrhosis at Liaquat University Hospital Hyderabad/Jamshoro.
  
  
  METHODS
  This hospital based descriptive study was conducted from April 2007 to September 2007. All the patients who were more than 12 years of age and were diagnosed as hepatic encephalopathy were studied. During this period, 87 patients of hepatic encephalopathy were admitted. All patients were carefully examined, relevant investigations were performed and data was collected through pre-designed proforma.
  
  
  RESULTS
  Male patients were 65 (75%), above 40 years of age 58 (67%), belonging to interior/periphery of Sindh 54 (62%), in grade IV of hepatic encephalopathy 70 (80%) and Anti-HCV positive were 52 (60%). The most common precipitating factors detected were infection 58 (67%), constipation 43 (49%) and gastrointestinal bleeding 39 (45%). Out of 87 patients, 68 had increased total leucocytes count, 09 patients had hypokalaemia, 24 patients, hyponatraemia, 64 hypoalbuminaemia and 54 patients had a disturbed coagulation profile. Fifty nine patients recovered and were discharged while 20 patients expired. Majority of expired patients had Child-Pugh score 10-15 and were in grade IV of hepatic encephalopathy.
  
  
  CONCLUSIONS
  The study concluded that there were different factors which play a key role in hepatic encephalopathy. In these factors, infection was the most common.
authors.affiliation: Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad.
authors.forename: Bikha Ram
authors.initials: BR
authors.lastname: Devrajani
authors.forename: Syed Zulfiquar Ali
authors.initials: SZ
authors.lastname: Shah
authors.forename: Tarachand
authors.initials: T
authors.lastname: Devrajani
authors.forename: Dileep
authors.initials: D
authors.lastname: Kumar
mesh_terms: D000328:Adult; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires