Ambulance officer certification was a poor predictor of involuntary psychiatric admission in the Royal Prince Alfred Hospital Emergency Department. ED physicians should have the authority to revoke the certificate if, following assessment and treatment, the patient no longer fulfils criteria for detention under the MHA.

The changes in all parameters and discontinuation rates in the two groups were compared after one and four months of the therapy. Results In total 71 patients were included in the study, 18 patients of them lots follow up during the study, while 53 continued. There were no significant differences in the baseline demographic and biochemical baseline data between the two groups (P>0.05).After one month, there was statistically significant difference between the two groups in the PGS as it decreased by <1.5x base line in the T-group compared to the C-group (P <0.02).After four months, there were statistically significant between the 2 groups regarding decreased ALT levels below 1.5x base line levels, AST, GGT and bile acid levels in favour of the T-group (P< 0.02, 0.047,0.026 and 0.001 respectively). Summary and ConclusionThe use of FF in combination with UDCA provided satisfactory clinical outcomes, which could be a promising alternative, but patients should be monitored closely as side effects may occur despite achieving improvements in pruritus.

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