To Compare Efficacy and Safety of Lactulose Versus Polyethylene Glycol for Treatment of Overt Hepatic Encephalopathy in Cirrhotics.

Exclusion Criteria

• •1. Acute change in mental status due to a diagnosis other than hepatic encephalopathy
• •2. Patients who have received lactulose as an anticoma measure before enrollment
• •3. Patient who have developed encephalopathy post bleed
• •4. Patients with gut paralysis
• •5. Patients with tense ascites
• •6. Patients with altered sensorium due to organic brain disease.
• •7. Patients with coexistent psychiatric illness that may hamper the proper assessment of hepatic encephalopathy
• •8. Hemodynamic instability obviating vasopressors for resuscitation
• •9. Acute liver failure defined as severe acute liver injury with encephalopathy and international normalized ratio (INR)≥1.5 in a patient without pre-existing liver disease
• •10. Refusal of consent