Aggravating factors of hepatic encephalopathy in patients with chronic liver disease: our experience at teaching hospital in southern Punjab, Pakistan

Background: Multiple aggravating factors can complicate a case of chronic liver disease, leading to hepatic encephalopathy

Objective: To enlist aggravating factors of hepatic encephalopathy in patients with chronic liver disease

Methodology: This cross sectional study was carried out at Sheikh Zayad Hospital Rahim Yar Khan, from 1[st] April to 31[st] December 2016. Convenient sampling technique was used in this study and 50 patients with hepatic encephalopathy who came for consultation included in this study. The detailed medical history was asked to fill in specially designed forms

Results: 50 patients with hepatic encephalopathy were included in this study. 35 [70%] were men and 15 [30%] women. The patient's age ranged from 35-65 years. Mean age of the study subjects was 46.45 +/- 5 years. The most common aggravating factor was infection in 42 [85%] of cases; Spontaneous bacterial peritonitis [SBP] in 33[65%] and 9 [19%] patients with urinary tract infections [UTI]. Other causes were dehydration 19[37%], constipation 15 [30%] and 13 [26%] patients with gastrointestinal bleeding. Two or more risk factors were present among 29 [58%]

Conclusion: Infection, especially spontaneous bacterial peritonitis, is a commonest aggravating factor of hepatic encephalopathy; followed by dehydration, constipation and gastrointestinal bleeding in this study

Clinical study on haemorrhoids and therapeutic evaluation of habb-e-rasaut and habb-e-muqil in its management

Haemorrhoid [Bawaseer] is a common problem characterized by an abnormally distended sub-mucosal arterio-venous shunt, embedded in swollen and inflamed anal cushion. Caused by accumulation of blood that is mixed with excess of Sauda and Balgham [Black bile and Phlegm], predisposed by improper venous drainage exacerbated by injury and inflammation. This study was done on 30 patients of 1st and 2nd degree internal haemorrhoids of either sex belonging to age group 20 to 60 years. Habb-e-Rasaut and Habb-e-Muqil were used daily for 60 days and promising results were found. Bleeding Per rectum, peri-anal pain, peri-anal itching, constipation and haemorrhoidal mass was improved in 80%, 94.4%, 90%, 85.7% and 53.3% cases respectively, after 60 days of treatment