Dileep K Rohra, Jaipal, Ameer A Khowaja, Khalid Mahmood, Kanya Lal Ahuja.
Precipitating factors of hepatic encephalopathy in patients with chronic liver disease at Civil Hospital Karachi.
J Coll Physicians Surg Pak Jan ;18(2):130-1.

The objective of this study was to determine the frequency of factors likely to precipitate the hepatic encephalopathy in patients with CLD presenting to the Medical Wards of Civil Hospital, Karachi. Patients admitted to Medical Wards at Civil Hospital, Karachi, from August 1, 2006 to December 31, 2006 were selected. Inclusion criteria included those patients who already had the established diagnosis of CLD on the basis of history, physical examination, laboratory, and radiological tests. The diagnosis of the hepatic encephalopathy and the likely precipitating factor was made by the Incharge of the ward. Once, the patients became stabilized, they were also interviewed in order to know more about the precipitating factor. Two hundred fifty-six patients with CLD were recruited in this study to determine the most likely precipitating factor of hepatic encephalopathy. The results are summarized in Table I. Infections including spontaneous bacterial peritonitis were noted to be the major inciting stimuli for precipitating hepatic encephalopathy. Among the drug-precipitated hepatic encephalopathy patients, frusemide and propranolol were identified as the likely culprits.

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