BACKGROUND AND AIM: Minimal hepatic encephalopathy (MHE) is associated with poor quality of life and increased work disability. Treatment with lactulose and probiotics has shown some benefit. We compared lactulose and a combination of lactulose plus probiotics in the treatment of MHE. PATIENTS AND METHODS: Fifty cirrhotic patients without overt encephalopathy were evaluated by psychometry (Number connection tests, Block design test and Digit symbol test). MHE was diagnosed by abnormal psychometry. Patients were randomized to receive lactulose [group 1 (n = 25): dose 30-60 ml/day], and probiotics plus lactulose [group 2 (n = 25) same dose of lactulose plus probiotic one capsule three times/ day, each capsule contained Streptococcus faecalis 60 million, Clostridium butyricum 4 million, Bacillus mesentricus 2 million, lactic acid bacillus 100 million]. Response was defined by normalization of the abnormal test parameters at six weeks treatment. RESULTS: MHE was diagnosed in 50 patients. Of the 50 patients, all had abnormal psychometry tests. Significant improvement was seen in abnormal psychometry tests in lactulose alone and lactulose plus probiotics groups after treatment. Normalization of abnormal psychometry was seen in 63%, and 60% of patients treated with lactulose alone and lactulose plus probiotics groups, respectively. CONCLUSION: All the patients with cirrhosis had MHE. Lactulose alone or combinations of both lactulose plus probiotic are equally effective in the treatment of MHE.
AIM OF THE STUDY To study the various breast conditions during pregnancy and lactation. MATERIALS AND METHODS This was a cross sectional descriptive study conducted at various nursing homes in Jammu region during the period of one year (2011-2012). All pregnant/Lactating women with breast related problems were enrolled for the study. A detailed clinical examination was carried out on the first visit and all relevant investigations were carried out. RESULTS Majority of cases were of infective etiology like mastitis (94.11%) out of which 60 were lactating and 20 were pregnant, they all got treated with antibiotics and analgesics. Antibioma and abscesses was noted in 1% each, they were drained surgically. Galactocele was noted in one lactating female (1. 16%). Only one patient (1.17%). was noted to have a mass lesion on clinical examination which proved to be malignant on FNAC. CONCLUSION Invariably, most breast disorders during pregnancy or lactation will ultimately prove to be benign. Nevertheless, the possibility of cancer should be kept in mind so as to intervene earliest possible without any risk to mother or fetus.
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