Muhammad Awais Ahmad Manan, Bilal Aziz, Tazeen Nazar, Ambreen Butt, Bilquis Shabbir.
Effectiveness of Combination of Zinc and Lactulose Versus Lactulose alone to Decrease Recurrence of Hepatic Encephalopathy in patients with Hepatic Cirrhosis.
Esculapio J Services Inst Med Sci Jan ;15(3):225-8.

Objective: To determine the effectiveness of combination of Zinc and lactulose with lactulose alone to decrease recurrence of hepatic encephalopathy in patients with hepatic cirrhosis. Methodology: This Randomized Controlled Trial was conducted in South Medical Ward, Mayo Hospital, Lahore from 1st July, 2016 to 30th June, 2017. One hundred and two patients of both sexes were selected using simple random sampling technique. Patients were divided into 2 groups. Group A received Zinc in addition to lactulose and other standard treatment for hepatic encephalopathy whereas Group B received lactulose and standard treatment. Patients were then followed up every 4 weeks for six months or early in case of development of any complication. Results: Out of a total of 102 patients, 73(71.6%) were males and 29(28.4%) were females. Mean age of the patients was 51.43+-6.63. Out of the 51 patients enrolled in Group A, 16 (15.7%) developed recurrent hepatic encephalopathy whereas 37 (36.3%) of 51 patients in Group B developed recurrence during the follow up period. Oral zinc supplementation was significantly associated with reduction in recurrence of hepatic encephalopathy and showed statistical significance (p< 0.0001). Conclusion: Oral zinc supplementation in addition to standard therapy for hepatic encephalopathy leads to a decrease in its recurrence when compared with standard therapy alone.

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