Amoebic liver abscess is a serious but curable hepatic illness predominantly seen in tropical countries. We describe our experience of clinical presentation, laboratory parameters, radiological findings and treatment strategies. This is a retrospective analysis of 114 patients who were admitted from January 2012 to September 2014 at our centre. The mean age of presentation was 41.7 ± 13.9 years, the majority of patients were male (86.8%) with chronic alcoholism (63.2%). Most of the patients had a solitary right lobe liver abscess. Abdominal pain, fever, tachycardia and hepatomegaly were the most common clinical findings while hypoalbuminaemia, anaemia, leucocytosis and electrolyte imbalance were the most common laboratory abnormalities. A significant number of patients could be managed with antibiotics only (45.6%), percutaneous radiological drainage techniques being an important adjunct in selected cases (percutaneous needle aspiration, 20.2%; percutaneous pigtail catheter drainage, 30.7%). Surgical intervention was required in only a few cases (3.5%). Mortality was 3.5%.

Pruritus is a well-known manifestation of various cholestatic disorders. Increased opioidergic tone is one of the mechanisms for this. This prospective, uncontrolled study was done to determine the efficacy of intravenous naloxone in pruritus of acute cholestasis. Twenty-two patients with severe pruritus (based on visual analogue scale [VAS] score of 0-100 and associated symptoms) were treated with intravenous naloxone (0.4 mg every 8 hours) for at least 48 hours. Viral hepatitis E was found to be the most common etiology for cholestatic pruritus (n=12). Eighteen patients (81.8%) patients had significant reduction in VAS after 48 hours of starting naloxone; these patients also showed reduction in alkaline phosphatase and gamma glutamyl transpeptidase. There was no side-effect or 'breakthrough' phenomenon noted in any patient over next 6 weeks. Naloxone is safe and efficacious in symptomatic improvement in cholestatic pruritus.

Serum IL-8 and -12 levels were markedly elevated in AH with increasing levels as the severity increases. Serum levels of IL-8 and -12 were better predictors of short-term mortality as compared to conventional prognostic scores.

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Temporal shifts have been known to occur in antibiotic sensitivity patterns of organisms causing cholangitis.The aim of this prospective study conducted on 100 patients of extra hepatic biliary obstruction (EHBO) was to identify the common microorganisms cultured from bile obtained during Endoscopic retrograde cholangiography and to study their local sensitivity pattern.Sixty six patients had growth in bile culture,the maximum growths amongst all micro-organisms were of Escherichia coli (40.9%) and Pseudomonas aeruginosa (40.9%). Growth rates were significantly higher in patients with non- malignant causes of biliary obstruction than those with malignant causes. Polymixins had the highest sensitivity to cultured bacteria followed by aminoglycosides and Imipenem.Study of culture & sensitivity pattern helps in deciding empirical antibiotic therapy in patients with cholangitis and it should be based on local sensitivity patterns