Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

The CREATE-ECLA Randomized Controlled TrialThe CREATE-ECLA Trial Group Investigators* See also pp 427 and 489.

No abstract

No abstract

Careful clinical auscultation using a stethoscope remains a valuable tool for cardiac diagnosis. Decision on initial diagnosis and management of valvular and congenital heart diseases should be based on clinical examination and integrating such information with echocardiography as required.

tests. On these 33 patients, ICT and CFF were applied. 35 healthy subjects served as controls for the ICT and CFF. RESULTS: Taking > 9 lures as positive ICT according to receiver operator characteristic (ROC) curve, the sensitivity, specificity, PPV and NPV were 90.9%, 37.1%, 57.6%, 81.3% respectively. Cirrhotics with MHE had significantly higher lures (22 ± 7.8 vs 11 ± 5.6, p < 0.001) or (56% vs 28%) and lower target response (90% vs 97%) compared with controls. For CFF taking < 37 Hz as cut-off, the sensitivity, specificity, PPV and NPV were 57.5%, 94.3%, 90.5% and 70.2%. We also found that CFF is less time consuming as compare to ICT. CONCLUSION: ICT and CFF are useful tools to assess MHE. CFF to be less time to consume, less sensitive but more specific than ICT. INTRODUCTIONHepatic encephalopathy (HE) is a complex neuropsychiatric syndrome present in patients with chronic or acute liver disease after exclusion of other brain diseases. According to recent guidelines (AASLD/EASL 2014), hepatic encephalopathy is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting; it manifests as a wide spectrum of neurological or psychiatric abnormalities ranging from subclinical alterations to coma [1] . Patients with cirrhosis with normal neurologic and mental examination can present minimal forms of HE, showing intellectual function impairment that cannot be detected through general clinical examination but can be unveiled using specific neuropsychologic and neurophysiologic tests [2] . MHE has significant negative impact on

Dr Yash Lokhandwala, and 10 or more other experts, including non-CSI members wherever additional expertise was thought necessary. The first and second drafts were circulated to the Expert Panel in August and October 2011. The Expert Panel met in December 2011 during the Annual Meeting in Mumbai, and the third draft was presented to CSI in an academic session the next day, with over 3 h of discussion, and their recommendations were incorporated. v Members of Task Force/Writing Committee. w Late.

A case of pulmonary varices with mitral valve disease is presented with a detailed review of the literature. Two distinct categories of the disease, with and without left atrial hypertension, are emphasized.