Aim: To determine the frequency of recurrence of hepatic encephalopathy in patients treated with Rifaximin. Study design: Observational cross-sectional study. Setting & duration: Department of Medicine, Services institute of Medical Sciences Lahore for duration of 12 months. Methodology: Hepatic encephalopathy was diagnosed using West-Haven classification in patients of chronic liver disease. Recurrence was considered if a new episode of hepatic encephalopathy occurred within 3 months after initiation of treatment. A total 120 patients of chronic liver disease having had an episode of recent hepatic encephalopathy within the last 3 months, of both genders, above 20 years of age with hepatic encephalopathy were included in the study. The patients were followed for 3 months after initiation of therapy and any episode of recurrence of hepatic encephalopathy was recorded. Results: Mean age was 51.5±12.2 years and 52.3±12.8 years respectively in Rifaximin and Placebo groups. Fourteen (23.3%) patients in Rifaximin group and 17(28.3%) in placebo group were younger than 40 years of age. Thirty-three (55%) patients in Rifaximin group were male versus 29(48.3%) patients in Placebo group. Fifteen (25%) patients in Rifaximin Group developed hepatic encephalopathy by 3 months of follow up as compared to 31(51.7%) patients in Placebo Group Conclusion: Frequency of recurrence of hepatic encephalopathy is significantly lower in Rifaximin treated patients. Keywords: Hepatic Encephalopathy, Recurrence, Rifaximin.

Objective: To find out the differences in disease severity of Rheumatoid Arthritis (RA) depending on clinic-demographic variables and determine association between clinic-demographic variables and disease severity of RA. Study Design: Cross-sectional Analytical study. Setting: Department of Medicine & Allied at CMA Hospital, Azra Naheed Medical College, Superior University Lahore. Period: August 2021 to April 2022. Material & Methods: After IRB approval 266 patients, aged 21 to 80 years, of both sexes, diagnosed with RA were enrolled. DAS-28 score was employed to assess disease severity. Demographic information and medical records of the patients were assessed and recorded. SPSS version 21 was used for data analysis. Results: Among the 133 patients with active disease, 113 (85.0%) were females and 20 (15.0%) male having mean age 40.0+12.8 years. Mean duration of disease in years was 8.3+6.2 and mean DAS-28 score was 5.5+0.9. RA Factor was positive in 96 (72.2%) and Anti-CCP antibody was seen in 78 (58.8%). Mean Hemoglobin level was 11.7+1.1 g/dl and anemia was found in 47 (35.5%) patients. Mean TLC and platelet count were 8.8+2.2 ×109/L and 375.9+83.5 ×109/L respectively. Among the 133 patients with LDA/remission, 106 (79.7%) were females and 27 (20.3%) male having mean age 44.5+15.5 years. Mean duration of disease in years was 8.5+7.6 and Mean DAS-28 score was 2.5+0.5. RA Factor was positive in 106 (79.7%) and Anti-CCP antibody was seen in 94 (70.7%). Mean Hemoglobin level was 12.6+1.8 g/dl and anemia was found in 29 (21.8%) patients. Mean TLC and platelet count were 9.5+3.5 ×109/L and 333.7+109.1 ×109/L respectively. Conclusion: Anti-CCP antibody positive patients with anemja and having disease for more than 3 years are more likely to have active rheumatoid arthritis whereas there was no significant difference with regards to age, sex and RA Factor status.