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The diagnosis of HE was based on clinical, biochemical and/or liver histological data and the grade was on the widely used West-Haven criteria introduced by Conn.12 Exclusion criteria were: Non-randomized trials and observational studies

Epithalon is a synthetic peptide composed of four amino acids (Ala-Glu-Asp-Gly), formally known as a tetrapeptide. It was developed in the 1980s by researchers at the St