Hepatic Encephalopathy; Prevalence, Precipitating Factors and Challenges of Management in a Resource-Limited Setting

Raphael, Kevin Charles; Matuja, Sarah Shali

doi:10.4172/2161-069x.1000441

Cited by 14 publications

(12 citation statements)

References 14 publications

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“…With regards to severity of cirrhosis assessed by CTP scores, 87.38% of our study subjects fell under class C. In the study by Nayak M et al 9 also, majority (60 %) were in Class C followed by 24 % in Class A and only 16 % in Class B. Similarly Raphael KC et al 15 also reported that 77.3% of their subjects had class C CTP score. Hepatic encephalopathy (HE) is a major complication of endstage liver disease and acute liver failure.…”

Section: Discussionsupporting

confidence: 51%

“…In our study, most of the subjects (56.31%) were aged between 41 to 60 years with the mean age of the study population at 49.58 (± 12.26) years. The mean age of the subjects was also 47 years in the study by Raphael KC et al15 45.63 % of our study subjects stayed in the hospital between 1 week to 3 weeks. Similarly Iqbal J et al 14 also reported a mean hospital stay duration of 11 days in their study.…”

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confidence: 64%

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Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Cirrhosis of Liver and Its Relation to Prognosis in a Tertiary Care Hospital - A Retrospective Study

Sethuraman¹,

Balasubramanian²

2019

IJCMSR

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Section: Discussionsupporting

confidence: 51%

supporting

confidence: 64%

Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Cirrhosis of Liver and Its Relation to Prognosis in a Tertiary Care Hospital - A Retrospective Study

Sethuraman¹,

Balasubramanian²

2019

IJCMSR

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“…Infections, constipation, and gastrointestinal bleeding were identified as the major precipitants of HE in the study conducted by Mumtaz et al [30], in Pakistan. Commonly observed precipitating factors of HE by Raphael et al [31] were the use of diuretics in massive ascites, infections, and GI bleeding. Literature from developed countries, however, has not identified infections among the most common precipitating events [32]; this probably reflects the hygienic, nutritional, and immune status in their patients.…”

Section: Discussionmentioning

confidence: 98%

The Prevalence, Predictors, and In-Hospital Mortality of Hepatic Encephalopathy in Patients with Liver Cirrhosis Admitted at St. Dominic Hospital in Akwatia, Ghana

Duah¹,

Agyei-Nkansah

Osei-Poku³

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Background. Hepatic encephalopathy (HE) is one of the most debilitating complications of cirrhosis leading to death. Decrease in HE mortality and recurrence has been linked with timely identification and early treatment. There is a need to document the burden, predictors, and treatment outcomes of HE in an adult population with liver cirrhosis in our setting as only reports from resource-endowed countries abound in the literature. This study aimed therefore to determine the prevalence, predictors, and treatment outcomes of patients with liver cirrhosis admitted at St. Dominic Hospital (SDH) in Akwatia, Ghana. Materials and Methods. A prospective study was conducted involving one hundred and sixty-seven (167) patients admitted at the medical wards in SDH with liver cirrhosis from January 1st, 2018, to March 24th, 2020. The demographic and clinical features of the patients were collected using a standardized questionnaire. Biochemical, haematological, and abdominal ultrasound scans were done for all patients. Patients were then followed up until discharge or death. Results. There were 109 (65.3%) males out of the 167 patients with a mean age of 45.8 and 47.5 years for those with and without HE, respectively. The prevalence of HE was 31.7% (53/167). Out of 53 participants with HE, 75.5% (40/53) died. There was a strong association between HE and death ( p < 0.001 ). The major precipitating factor of HE was infection (64.2%). Severe ascites (OR = 0.009) were clinical feature independently associated with HE, whereas high creatinine (OR = 0.987), blood urea nitrogen (BUN) (OR = 1.199), Child–Pugh score (CPS) (OR = 5.899), and low platelets (OR = 0.992) were the laboratory parameters and scores independently predictive of HE. Conclusion. HE was common among patients with liver cirrhosis admitted at SDH with high in-patient mortality. The commonest precipitating factor for HE was infection(s). Severe ascites, low platelet count, high creatinine, BUN, and CPS were independent predictors of HE.

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“…These manifestations are due to acute or chronic liver failure [ 1 ]. HE affects 45-70% of patients with liver cirrhosis and 10-20% of patients with Transjugular Porto Systemic Shunts, in developed countries [ 2 ]. HE causes hospitalization and high rates of mortality as a result of end-stage liver disease, reaching to coma [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Amelioration of Hepatic Encephalopathy Using Dunaliella salina Microalgae in Rats: Modulation of Hyperammonemia/TLR4

Baz

Elgohary

Salama

2021

BioMed Research International

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Hepatic encephalopathy (HE) is a neuropsychiatric disease that is developed as a complication of both acute and chronic liver failure affecting psychomotor dysfunction, memory, and concentration. This study is aimed at evaluating the therapeutic effects of Dunaliella salina (D. salina) microalgae in thioacetamide- (TAA-) induced HE in rats. HE was induced by TAA (200 mg/kg; i.p.) for three successive days. Forty male Wister albino rats were divided into 4 groups; the first group was served as a normal, and the second group was injected with TAA and served as TAA control. The third and fourth groups were administered D. salina (100 and 200 mg/kg; p.o.), respectively, after TAA injection for 7 days. The behavioral and biochemical markers as well as histological aspects of HE were estimated. This study revealed that TAA caused behavioral changes, oxidative stress, neuroinflammation, nuclear pyknosis, and neurons degeneration. D. salina improved liver function and decreased oxidative stress and inflammatory mediator as TLR4 protein expression. Also, D. salina elevated HSP-25 and IGF-1 as well as improved brain histopathological alterations. In conclusion, D. salina exerted a therapeutic potential against HE via its antioxidant, antiinflammatory and cytoprotective effects.

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Hepatic Encephalopathy; Prevalence, Precipitating Factors and Challenges of Management in a Resource-Limited Setting

Cited by 14 publications

References 14 publications

Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Cirrhosis of Liver and Its Relation to Prognosis in a Tertiary Care Hospital - A Retrospective Study

Clinical Spectrum of Precipitating Factors of Hepatic Encephalopathy in Cirrhosis of Liver and Its Relation to Prognosis in a Tertiary Care Hospital - A Retrospective Study

The Prevalence, Predictors, and In-Hospital Mortality of Hepatic Encephalopathy in Patients with Liver Cirrhosis Admitted at St. Dominic Hospital in Akwatia, Ghana

Amelioration of Hepatic Encephalopathy Using Dunaliella salina Microalgae in Rats: Modulation of Hyperammonemia/TLR4

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