Rifaximin significantly improves both cognitive functions and HRQOL in patients with MHE.

This study analyses the effects of anthropogenic disturbance on plant diversity and community attributes of a sacred grove (montane subtropical forest) at Swer in the East Khasi Hills district of Meghalaya in northeast India. The undisturbed, moderately disturbed and highly disturbed stands were identified within the sacred grove on the basis of canopy cover, light interception and tree (cbh $ 15 cm) density. The undisturbed forest stand had .40% canopy cover, .50% light interception and a density of 2103 trees per hectare, whereas the highly disturbed stand had ,10% canopy cover, ,10% light interception and 852 trees per hectare. The moderately disturbed stand occupied the intermediate position with respect to these parameters. The study revealed that the mild disturbance favoured species richness, but with increased degree of disturbance, as was the case in the highly disturbed stand, the species richness markedly decreased. The number of families of angiosperms was highest (63) in the undisturbed stand, followed by the moderately (60) and highly disturbed (46) stands. The families Rubiaceae, Asteraceae and Poaceae were the dominant families in the sacred forest. Rubiaceae was represented by 11, 14 and 10 species in the undisturbed, moderately disturbed and highly disturbed stands, respectively, whilst the family Asteraceae had 16 species in the moderately disturbed stand and 14 species in the highly disturbed stand. The number of families represented by a single species was reduced significantly from 33 in the undisturbed stand to 23 in the moderately and 21 in the highly disturbed stand. The similarity index was maximum (71%) between the undisturbed and moderately disturbed stand and minimum (33%) between the undisturbed and highly disturbed stands. The Margalef index, Shannon diversity index and evenness index exhibited a similar trend, with highest values in the moderately disturbed stand. In contrast, the Simpson dominance index was highest in the highly disturbed stand. There was a sharp 21 2 21 decline in tree density and basal area from the undisturbed (2103 trees ha and 26.9 m ha ) to the 21 2 21 moderately disturbed (1268 trees ha and 18.6 m ha ) and finally to the highly disturbed (852 trees 21 2 21ha and 7.1 m ha ) stand. Density-girth curves depicted a successive reduction in number of trees in higher girth classes from the undisturbed to the moderately and highly disturbed stands. The log-normal dominance-distribution curve in the undisturbed and moderately disturbed stands indicated the complex and stable nature of the community. However, the short-hooked curve obtained for the highly disturbed stand denoted its simple and unstable nature.

Background:The relationship between glucose metabolism and psychiatric illness is under the focus of clinicians for centuries. Depending on the definition used, the prevalence of depression among diabetics ranges from 8.5% to 32.5%, while that for anxiety disorders it is up to 30%.Aims and Objectives:To assess the prevalence of psychiatric morbidity among diabetic patients using standardized rating scales for depression and anxiety.Materials and Methods:One hundred diagnosed patients of diabetes were assessed on the Hamilton rating scale for depression and the Hamilton rating scale for anxiety, who were attending the diabetic clinic. They were assessed on sociodemographic profile, duration of illness, type of treatment, and oral vs insulin, and then the data were analyzed on different domains.Results:About 84% of the patients had comorbid depression. Females showed a high percentage of depression and anxiety, and the severity level was also higher in the females. Genital symptoms were usually reported by the males, while somatic symptoms were more prevalent in the females.

Background: Chronic kidney disease with metabolic acidosis is common in older people, but the effectiveness of oral sodium bicarbonate therapy in this group is unclear. We tested whether oral sodium bicarbonate provides net health benefit for older people with advanced chronic kidney disease and serum bicarbonate concentrations < 22 mmol/L. Methods: Pragmatic multicentre, parallel group, double-blind, placebo-controlled randomised trial. We recruited adults aged ≥ 60 years with estimated glomerular filtration rate of < 30 mL/min/1.73 m 2 , not receiving dialysis, with serum bicarbonate concentration < 22 mmol/L, from 27 nephrology and geriatric medicine departments in the UK. Participants received oral sodium bicarbonate (up to 3 g/day) or matching placebo given for up to 2 years, randomised in a 1:1 ratio. The primary outcome was between-group difference in the Short Physical Performance Battery (SPPB) at 12 months, adjusted for baseline values, analysed by intention to treat. Secondary outcomes included generic and disease-specific quality of life (EQ-5D and KDQoL tools), anthropometry, renal function, walk distance, blood pressure, bone and vascular health markers, and incremental cost per quality-adjusted life year gained.

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