الفهرس 
Introduction
OverviewOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
Minimal HE adversely affects health-related quality of life (HRQOL); complex activities involving attention, information procesing, and psychomotor skills such as driving a car and planning a trip are mainly affected. However, the basic activities of daily life, such as shopping, dressing, and personal hygiene, are preserved.
Considering the high prevalence of liver diseases in Egypt, early identification of those at risk is of outmost importance, as treatment of MHE would improve the psychometric performance and quality of life and may nullify many occupational risks, including road traffic accidents. In our study a self-reported driving history with a statistically significant number of traffic offences was obtained from the screened drivers with MHE (45%) compared with non-MHE patients (0%)(p < 0.001).
Our data revealed a high prevalence of MHE (40%) among Egyptian drivers with liver cirrhosisthe . MHE diagnosed by psychometric tests was 12% in screened drivers with cirrhosis in comparison to 36% diagnosed by CCF.
So we conclude that; CFF is a simple, reliable tool for the diagnosis of MHE. The data are not influenced by education level or age and could be useful in the management of patients with cirrhosis. A value of CFF≤ the cutoff of 39 Hz diagnose a MHE.
Recommendations:
-Relevant studies revealed that the driving instructor had to intervene more often to avoid accidents in minimal HE patients. Therefor, driving simulation improves insight into driving skills in cirrhosis and may be the first step toward the cognitive rehabilitation of driving skills in patients with cirrhosis.
- Driving performance also improves significantly with reversal of minimal HE in cirrhotic patients after 8 weeks of rifaximin therapy.
- Detection of minimal HE and subsequent treatment with lactulose have been demonstrated to be the most cost effective strategy by substantially reducing social costs by preventing motor vehicle accidents among patients with minimal HE.
-Driving history as well as regular pencil–paper standard psychometric testing are ideal in evaluating those at risk, especially in the outpatient setting, for early identification and proper management.