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1. Department of Medicine, Khyber Teaching Hospital, Peshawar

Objective: To examine the association of serum ammonia with hepatic encephalopathy. Material and Methods: This descriptive study was accomplished at Medical Unit A of Khyber Teaching Hospital, Peshawar from July to December, 2016. The study included 100 patients with viral hepatic encephalopathy. Serum ammonia levels were checked for every patient. SPSS version 23 was used for data analysis while taking P value of less than 0.05 as significant. The Spearman's correlation test was run to assess any association of serum ammonia with the grade of hepatic coma. Results: Out of 100 total patients, 12 (12%) presented in grade 1 hepatic encephalopathy, 39 (39%) in grade 2 hepatic encephalopathy, 34 (34%) in grade 3 encephalopathy and 15 (15%) in grade 4 encephalopathy. The serum ammonia levels of these patients widely ranged between 14 and 178 mcg/dl, at the mean values of 74.17 mcg/dl in grade I, 57.79 mcg/dl in grade II, 71.88 mcg/dl in grade III, and 81.13 mcg/dl in grade IV hepatic encephalopathy. The spearman correlation was 0.097. Conclusion: Increasing serum ammonia levels were not related to higher grades of hepatic encephalopathy.

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