Prevalence of Precipitating Factors of Hepatic Encephalopathy at Nangarhar Regional Hospital

##plugins.themes.academic_pro.article.sidebar##

Published Sep 30, 2023
Download
PDF 16
Statistic

Downloads

Download data is not yet available.
Vol. 2 No. 03 (2023): September

##plugins.themes.academic_pro.article.main##

Ameerullah Razai
Ismail Khan Safi
Said Abdul Jamil Saidi
Said Inam Saidi

Abstract

‌Backgroud: Hepatic encephalopathy (HE) or portosystemic encephalopathy (PSE) is a satiuation of disordered in central nervous system’s functions characterrized by the failure of the liver to detoxify noxious substances of gastrointestinal origin due to hepatocellular dysfunction and portosystemic shunting. HE is a complication of chronic liver disease brought on by a number of precipitating circumstances and factors. The aim of this study is to analyze the precipitating factors of HE in cases seen in the Infectious Diseases Ward of Nangarhar Regional Hospital.
Materials and Mehtods: A non-interventional hospital based descriptive study was conducted on 50 HE patients in the Infective Ward of Nangarhar Regional Hospital during May 2021 – December 2021. This study also included patients with liver cirrhosis developing HE, known as acute fulminant hepatitis. A comprehensive questionnaire was developed for a better data collection. Detailed clinical history of the patients were taken regarding the present and past diseases. All patients were carefully examined with special attention to anemia, jaundice, asterixes, fever and ascites. Laboratory examinations that recommended for these diseases were also investigated.
Results: The results revealed that most of the patients were aged between 40 – 70 years old (82%). The highest frequency of HE disease was recorded in the age of 60-69 (42%). There were four classes of patients according to the classification. Majority of the patients were in fourth class (52%), followed by second class (20%), third class (16%) and first class (12%) of hepatic encephalopathy. It is found that the most crucial exacerbating factors were including infections, constipation and gastrointestinal bleeding. Among them, infections were more frequent which were recorded in 22 patients (44%), followed by constipation in 10 patients (20%) and gastrointestinal bleeding in 6 patient (12%). Among the type of infections the urinary tract infections were accounted for 19% followed by gastrointestinal tract infections (16%) and respiratory tract infections (12%).
Conclusion: To determine which precipitating factor is responsible for HE in the eastern region of Afghanistan, frequency of several precipitating factors was examined. Knowing the primary triggering factor makes it simple to develop a plan of action to significantly reduce the incidence of HE. In our investigation, gastrointestinal bleeding, constipations, and infections were the most typical precipitating factors. Due to the fact that hepatitis C is the main and leading cause of liver cirrhosis in Afghanistan.

Keywords

Gastrointestinal bleeding, Hepatic encephalopathy, Infections, Liver cirrhosis, Precipitating factors

##plugins.themes.academic_pro.article.details##

How to Cite
Razai, A., Safi, I. K., Saidi, S. A. J., & Saidi, S. I. (2023). Prevalence of Precipitating Factors of Hepatic Encephalopathy at Nangarhar Regional Hospital. NUIJB, 2(03), 34–41. Retrieved from https://nuijb.nu.edu.af/index.php/nuijb/article/view/67

References

  1. Alam, I., Razaullah, H. I., Humayun, M., Taqweem, M. A., & Nisar, M. (2005). Spectrum of precipitating factors of hepatic encephalopathy in liver cirrhosis. Pakistan Journal of Medical Research, 44(2), 96-100.
  2. Bajaj, J. S. (2010). Current and future diagnosis of hepatic encephalopathy. Metabolic Brain Disease, 25, 107-110.
  3. Dieperink, E., Willenbring, M., & Ho, S. B. (2000). Neuropsychiatric symptoms associated with hepatitis C and interferon alpha: a review. American Journal of Psychiatry, 157(6), 867-876.
  4. Farogh, A., Naeem, H. A. G., & Ahmad, U. (2014). Spontaneous bacterial peritonitis in liver cirrhosis patients having hepatic encephalopathy. Pakistan Journal of Medical & Health Sciences, 8(2), 429-431.
  5. Gad, Y. Z. (2012). Precipitating factors of hepatic encephalopathy: An experience at Mansoura Specialized Medical Hospital, Egypt. Annals of Tropical Medicine & Public Health, 5(4).
  6. Hunot, S., & Hirsch, E. C. (2003). Neuroinflammatory processes in Parkinson's disease. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 53(S3), 49-60.
  7. Khan, I. M., Hameed, K., & Ahmad, S. (2003). Effects of aminoleban on consciousness level in patients with hepatic encephalopathy secondary to chronic liver disease. Journal of Postgraduate Medical Institute, 17(2).
  8. Lim, C. G., Hahm, M. H., & Lee, H. J. (2023). Hepatic encephalopathy on magnetic resonance imaging and its uncertain differential diagnoses: a narrative review. Journal of Yeungnam Medical Science, 40(2), 136.
  9. Maqsood, S., Saleem, A., Iqbal, A., & Butt, J. A. (2006). Precipitating factors of hepatic encephalopathy: experience at Pakistan Institute of Medical Sciences Islamabad. Journal of Ayub Medical College Abbottabad, 18(4), 57-61.
  10. Mathers, C. D., Boerma, T., & Ma Fat, D. (2009). Global and regional causes of death. British Medical Bulletin, 92(1), 7-32.
  11. Menon, K. N., Gores, G. J., & Shah, V. H. (2001, October). Pathogenesis, diagnosis, and treatment of alcoholic liver disease. In Mayo Clinic Proceedings (Vol. 76, No. 10, pp. 1021-1029). Elsevier.
  12. Mullen, K. D. (2007). Review of the final report of the 1998 working party on definition, nomenclature and diagnosis of hepatic encephalopathy. Alimentary Pharmacology & Therapeutics, 25, 11-16.
  13. Mumtaz, K., Ahmed, U. S., Abid, S., Baig, N., Hamid, S., & Jafri, W. (2010). Precipitating factors and the outcome of hepatic encephalopathy in liver cirrhosis. Journal of the College of Physicians and Surgeons Pakistan, 20(8), 514.
  14. Ong, J. P., Aggarwal, A., Krieger, D., Easley, K. A., Karafa, M. T., Van Lente, F., ... & Mullen, K. D. (2003). Correlation between ammonia levels and the severity of hepatic encephalopathy. The American journal of medicine, 114(3), 188-193.
  15. Rado, J. (2017). Hepatitis C among the mentally ill: Review and treatment update. Current Psychiatry, 16(3), 41-47.
  16. Romero-Gómez, M., Boza, F., Garcı́a-Valdecasas, M. S., Garcı́a, E., & Aguilar-Reina, J. (2001). Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy. The American Journal of Gastroenterology, 96(9), 2718-2723.
  17. Romero-Gómez, M., Montagnese, S., & Jalan, R. (2015). Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure. Journal of Hepatology, 62(2), 437-447.
  18. Sivakrishnan, S., & Pharm, M. (2019). Liver disease overview. World Journal of Pharmacy and Pharmaceutical Sciences, 8(1), 1385-1395.
  19. Weissenborn, K. (2019). Hepatic encephalopathy: definition, clinical grading and diagnostic principles. Drugs, 79(1), 5-9.