To Study the Prevalence of SBP in a Tertiary Care Center in Western India

Abstract

© 2011, INASL 24 and, 24-hour urine sodium (16.8 ± 21.3, range 1–82 to 61.0 ± 27.3, range 26–126 mEq/L), with decrease in Serum creatinine (1.9 ± 0.3 to 1.5 ± 0.6 mEq/L), and PRA 31.8 ± 9.9 to 18.2 ± 6.7 ng/mL/hr P 250 neutrophils/mL. Positive ascitic fluid culture was not included for the diagnosis of SBP so as to capture both culture positive and culture negative neutrocytic ascites. Exclusion criteria: 1. Immunosuppressed patients 2. Recent antibiotic exposure 3. Prior h/o SBP 4. Confounding etiology for ascites. Results: A total of 67 patients formed the study group. The number of patients of SBP was 14, prevalence (20.9%). The mortality rate in the SBP group was 28%. Conclusion: The prevalence of SBP was 20.9% at our center. Conflict of Interest: None Oral Plenary Session Inhibitory Control Test for the Detection of Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver S Taneja*, RK Dhiman*, A Khatri*, S Goyal*, KK Thumburu*, R Agarwal**, A Duseja*, Y Chawla* *Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India **Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India Background and Aims: Minimal hepatic encephalopathy (MHE) has significant impact on future clinical outcomes, such as occurrence of OHE and survival in patients of cirrhosis. In the absence of ‘gold standard’, psychometric hepatic encephalopathy score (PHES) is widely used for the diagnosis of MHE. This cross sectional and prospective study was carried out to determine the usefulness of inhibitory control test (ICT) for the diagnosis of MHE. Methods: One-hundred and eighty seven patients with cirrhosis were screened; 102 patients without OHE (54.5%) were subjected to PHES and ICT. MHE was diagnosed when the PHES was ≤ 5. Cut-off value of ICT for the diagnosis of MHE was determined using the ROC curves and was considered altered when the numbers of ICT lures were more than 14. Results: Forty-one (40.2%) patients had MHE as indicated by altered PHES. There were 40 patients with normal PHES and ICT, 32 with abnormal PHES and ICT, 9 with abnormal PHES and normal ICT, and 21 with abnormal ICT and normal PHES score. ICT had 78% sensitivity and 65.6% specificity and an area-under-the-curve value of [0.735 (95% CI = 0.632–0.830] for the diagnosis of MHE ICT lures did not correlate with age (r = 0.131, P = 0.189) and education (r = 0.039, P = 0.697). In patients with cirrhosis, ICT lures did not correlate with severity of liver disease as measured by CTP score (r = 0.044, P = 0.658) and MELD score (r = 0.176, P = 0.077). ICT does not have prognostic value on survival; 8 (19.5%) patients died among those who had altered PHES compared to 2 (3.3%) patients who did not have altered PHES (P = 0.013), while 6 (11.3%) patients died among those who had altered ICT compared to 4 (8.2%) patients who did not have altered ICT (P = 0.74). Conclusion: The ICT provides cognitive measures, which are insufficient to the recommended diagnostic standards for cognitive investigation of MHE. Hence the ICT is not useful for the diagnosis of MHE. Conflict of Interest: None 03_JCEH-Abstract.indd 24 3/18/2011 11:13:04 AM