الفهرس 
Liver cirrhosis
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Abstract
Liver cirrhosis is a frequent consequence of the long clinical course of all chronic liver diseases. It is characterized by tissue fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. Hepatic encephalopathy is a neuropsychiatric condition affecting patients with cirrhosis, acute liver failure and porto-systemic bypass. The neuropsychiatric abnormalities include changes in levels of consciousness, behavior, intellect, and neurologic exam. The changes in levels of consciousness can range from altered sleep habits to coma. Detailed pathophysiology of HE remains unknown. Ammonia is most frequently listed among substances contributing to encephalopathy but high level of ammonia in blood is not detected in all patients with encephalopathy, indicating that other chemical substances should be also considered as pathogenetic factors. Melatonin has been discovered as a hormone of the pineal gland, but it is meanwhile known to be also synthesized in various other organs, tissues and cells. Pineal melatonin is secreted in a circadian fashion with its peak at nighttime. Melatonin regulates the biological functions of the body including sleep-wake cycle.