title: Magnitude of peripheral neuropathy in cirrhosis of liver patients from central rural India.
abstract: BACKGROUND
  Cirrhosis of liver is an important cause of morbidity and mortality and if associated with peripheral neuropathy (PN) it also poses a huge financial, psychological burden for the patients and their families.
  
  
  OBJECTIVE
  The aim of the present study was to study the magnitude of PN among subjects with cirrhosis of liver presenting to tertiary care teaching hospital in central rural India.
  
  
  METHODS
  A cross-sectional study was performed in a tertiary care teaching hospital.
  
  
  METHODS
  In all patients of cirrhosis of liver irrespective of etiology, aged 15 and above, undergone clinical assessment for peripheral nervous systems damage and confirmed by nerve conduction studies.
  
  
  METHODS
  We used chi square test to study associations. P value ≤0.05 was considered as significant. Crude odds ratios were computed to assess the strength of association between independent variables and dependent variables along with their 95% confidence intervals.
  
  
  RESULTS
  We included 207 of cirrhosis of liver patients admitted in medicine department from November 2010 through November 2013. Nearly 83% patients were male and 63.2% patients were under the age of 45 years. Common features in these patients were ascites (71%) splenomegaly (63.3%) pedal edema (61.4%) icterus (46.4%) tingling (44.9%) gastrointestinal bleeding(39.1%), ataxia (26.6%), numbness(26.6%), distal motor weakness (21.7%) and paresthesia(20.8%). Among the manifestation of peripheral nerve involvement, loss of ankle reflex was the most common feature in 51.7%, followed by loss of temperature sense 29.5%, loss of vibration sense 20.8%, loss of touch 16.4%, loss of position sense 14.5% and loss of pain in 6.3% of the patients. Peripheral neuropathy was found in 53.6% [95% CI: 46.58- 60.56] study subjects on electrophysiological study.
  
  
  CONCLUSIONS
  Analysis of electrophysiological study shows that the PN is very common in study subjects with cirrhosis of liver, especially in male subjects, during the middle age group.
authors.affiliation: Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Jain
authors.affiliation: Department of Physiology, All India Institute of Medical Sciences, Patna, Bihar, India.
authors.forename: Ramji
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Ophthalmology, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India.
authors.forename: Shashank
authors.initials: S
authors.lastname: Banait
authors.affiliation: Department of Physiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Verma
authors.affiliation: Department of Physiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
authors.forename: Satish
authors.initials: S
authors.lastname: Waghmare
keywords: Chronic liver disease; cirrhosis of liver; nerve conduction studies; peripheral neuropathy