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Abstract:
Background: Minimal Hepatic Encephalopathy, the mildest
from of Hepatic Encephalopathy is characterized by subtle
motor and cognitive deficits and impairs health related
quality of life. Though the prevalence of Minimal Hepatic
Encephalopathy in cirrhotic patient is high but awareness
regarding MHE is yet not satisfactory. Moreover diagnosis
of MHE, the cut off normative value for psychometric test is
yet not established in Bangladesh. This is the first study in
Bangladesh to find out the normative value for psychometric
test and see the prevalence of Minimal Hepatic
Encephalopathy in cirrhotic patient.
Methods: Cross sectional study done in Department of
Hepatology, BSMMU, Dhaka from July 2012 to June 2014.
Total 150 patient of which 50 patient with cirrhosis and
remaining 100 healthy individual were included in the study.
By doing number connection test, Serial dotting test and
line tracing test in healthy individual, first normative values
for psychometric test was detected then these test was done on
cirrhotic patient, whose 2 psychometric test result among 3
above normal value were enrolled as a case of Minimal
Hepatic Encephalopathy. None of the patient previously
diagnosed as any type of Hepatic Encephalopathy.
Results: Cut off normative value for NCT, SDT, LTT is 52
seconds, 52 seconds and 84 seconds respectively (Mean+2SD).
Prevalence of Minimal Hepatic Encephalopathy in this study
was 66% and it is more prevalent in advanced cirrhosis.
Conclusion: MHE is frequent in patient with liver cirrhosis,
manifested even in patient with child pugh A liver cirrhosis.
Every attention should be given to detect Minimal Hepatic
Encephalopathy in patient with cirrhosis of liver well before
the development of overt Hepatic Encephalopathy.
Key Word: Number connection test (NCT), Serial dotting
test (SDT), line tracing test (LTT).
Abbreviation Used: MHE: Minimal Hepatic Encephalopathy,
HE: Hepatic Encephalopathy EEG: Electroencephalography,
CP: Child Pugh, LFT: Liver function test.
(J Bangladesh Coll Phys Surg 2018; 36: 59-63)

 

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