assess the correlation between serum albumin levels and the severity of hepatic encephalopathy in patients with chronic liver disease.

assess the impact of albumin level on clinical course and outcomes of HE.

sample size calculation will be performed based on anticipated incidence rates of HE and variability in serum albumin levels, aiming for a study population of 100-150 patients to achieve adequate statistical power.

- All patients included in the study will be subjected to : Glasgow Coma Scale (GCS) score. Clinical Assessment: Baseline evaluation of patients to confirm chronic liver disease diagnosis and determine clinical characteristics.

History of prior episodes of HE, presence of ascites, variceal bleeding, and other complications of chronic liver disease .

Age, gender, etiology of cirrhosis (e.g., viral hepatitis, alcohol), comorbid conditions (e.g., diabetes, hypertension)

• Laboratory investigation :

Serum albumin level AST ALT Total bilirubin and direct CBC Serum creatinine Proth time and concetntration

Inclusion Criteria:

• patients aged >18 years.
• Confirmed chronic liver disease (by imaging ,
• liver function tests , and clinical history).
• Diagnosed with hepatic encephalopathy based on clinical criteria.
• Patients able to provide informed consent.

Exclusion Criteria:

• Patients age less than 18 years old
• Acute liver failure.
• Chronic renal failure on dialysis.
• Pregnant women.
• Patients with active malignancy.

sample size calculation will be performed based on anticipated incidence rates of HE and variability in serum albumin levels, aiming for a study population of 100patients to achieve adequate statistical power.