CIRRHOSIS AND COMPLICATIONS JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY Table 1 Results From a Linear Regression Analysis on Venous Ammonia and Interleukins at Day 5 Adjusted for Baseline and Center. LOLA (mean ± SD) Placebo (mean ± SD) Adjusted difference (95% confidence interval) a P-value Ammonia (g/dL) # (L = 81, P = 81) 40.3 ±33.8 60.7 ±35.1 20.9 (10.4–31.3) 0.0001 Interleukin 1 (pg/ml) # (L = 85, P=78) 3.1 ±19.5 2.4 ±5.3 0.9 (−0.4 to 2.3) 0.15 Interleukin6 (pg/ml) # (L = 83, P = 79) 37.8 ±46.5 45.8 ±54.4 3.3 (−8.8 to 15.4) 0.59 Interleukin10 (pg/ml) # (L = 84, P=79) 12.5 ±32.0 19.1 ±21.4 6.7 (−0.2 to 12.7) 0.06 TNF alpha (pg/ml) # (L = 84, P = 78) 11.33 ±50.0 7.97 ±13.1 −1.30 (−8.67 to 6.1) 0.73 a LOLA–placebo. #: Number of patients tested. concentration of tumor necrosis factor , interleukin 1, interleukin 6, interleukin10, hemogram, liver, renal func- tion tests were performed at day 0 and 5. Primary outcome was mental state grade at day 5 of treatment. Results: After 5 days of treatment there was no signif- icant difference in mental state grade between LOLA and placebo groups. However the mean time taken for recovery was 1.92 ± 0.93 days in LOLA group and 2.45 ± 1.06 days in placebo group, P = 0.002 (95% CI −0.852 to −0.202). Venous ammonia at day 5 and length of hospital stay were significantly lower in LOLA group. No significant change was seen in interleukins and tumor necrosis factor  in both the groups. Conclusion: In patients with acute overt HE, intra- venous LOLA decreases venous ammonia, decrease the time of recovery and shortens the length of hospital stay (Table 1). CONFLICTS OF INTEREST The authors have none to declare. http://dx.doi.org/10.1016/j.jceh.2017.05.103 16 NECROTIZING FASCIITIS IN CIRRHOSIS—PREDICTORS OF MORTALITY Rony Thomas ∗ , Deepak Johnson, George C. Matteethra Believers Church Medical College Hospital, Thiruvalla, Kerala, India E-mail address: drronythomas@yahoo.com (R. Thomas). Background and Aim: Cirrhosis is associated with increase risk of infections resulting in sepsis and sepsis related mortality. Skin and soft tissue infection accounts for only minority of infections. However necrotizing fasci- itis, a rare soft tissue infection manifesting as necrosis of skin tissue, is associated with a high mortality rate in cir- rhosis. The study was done to assess the risk factors and the predictors of mortality in necrotizing fasciitis. Methods: A retrospective study was conducted at a ter- tiary care hospital between March 2016 and March 2017. Patients were categorized into two groups based on their in hospital outcome (survivors vs. non survivors). All patients with necrotizing fasciitis and cirrhosis were taken for the study. Results: 16 patients who were admitted in our hospi- tal were taken for the study. Most common presentation was local swelling and erythema, fever and pain. All were males had lower limb involvement with a median age of 54 years. Most common etiology of cirrhosis was alcohol related. The mortality rate was 68.75%. Patients with Child C status, low albumin, renal failure, septic shock, coagu- lopathy, diabetes and late presentation to hospital had a high mortality rate. 14 patients underwent debridement. None underwent amputation. The common organisms were gram-negative bacteria Klebsiella and Escherichia coli. All patients who died had developed multi organ dysfunc- tion syndrome including renal and lung involvement. Conclusion: Necrotizing fasciitis though a rare com- plication in cirrhosis has a high mortality rate. Early diagnosis and management with antibiotics and surgical debridement may reduce the mortality. CONFLICTS OF INTEREST The authors have none to declare. http://dx.doi.org/10.1016/j.jceh.2017.05.104 17 SPECTRUM OF BACTERIAL INFECTIONS IN CIRRHOSIS OF LIVER IN A RESOURCE CONSTRAINED REGION Subhendu Panigrahi ∗ , Kaibalya R. Das, Preetam Nath, Jimmy Narayan, Prasant K. Parida, Sambit K. Behera, Suryakant Parida, Debakanta Mishra, Chittaranjan Khatua, Shivaram P. Singh S.C.B. Medical College, Cuttack, India E-mail address: drsubhendu16@gmail.com (S. Panigrahi). Background and Aim: Patients with cirrhosis of liver are predisposed to bacterial infections and sepsis. Data on bacterial infections in cirrhosis of liver from India are scarce. The aim of this study was to study the spectrum of bacterial infections in hospitalized patients with cirrhosis of liver. Methods: This is a prospective cohort study including three hundred and twenty-six patients. All patients had an established diagnosis of chronic liver disease and were Journal of Clinical and Experimental Hepatology July 2017 Vol. 7 No. S2 S55