Background: Non-ulcer dyspepsia is a treatment challenge due to multiple pathophysiological mechanisms and different symptoms. Several prokinetic drugs are tried without any unanimity regarding safety and efficacy. The objective of the study was to compare the efficacy and safety of Itopride and Domperidone in bloating predominant non ulcer dyspepsia patients.Methods: Patients were randomly assigned to two groups (20 each) to receive either 50mg of Itopride three times daily or 10mg of Domperidone three times daily. Only patients with predominant bloating were considered and their baseline symptoms recorded. The symptoms were graded on a 4-point scale - the Global Symptom Score scale and the patients were reassessed at the end of 2 and 4 weeks. The relief of symptoms was also assessed at the end of 2 and 4 weeks on a 5-point scale - The Patients’ Subjective Global Assessment of Relief scale.Results: Both the drugs significantly produced symptomatic relief. Though Domperidone is marginally beneficial compared to Itopride after 4 weeks treatment in terms of improvement in symptom scores, the Subjective Global Assessment of relief did not show any significant improvement between the two drugs.Conclusions: Treatment with Itopride was safe, well tolerated, resulted in good symptomatic relief, and was comparable in efficacy to Domperidone in relieving the symptoms of NUD. Hence it can be considered a good alternative for the treatment of non-ulcer dyspepsia.

BACKGROUNDHepatic encephalopathy is presented clinically as a combination of neuropsychiatric abnormalities. It is frequently observed in those with both acute and chronic liver diseases, such as hepatic cirrhosis, alcoholic liver disease. Insufficient hepatic clearance of toxins absorbed from the intestine, can result in neurochemical abnormalities across the blood brain barrier. Presently, nonabsorbable disaccharides like Lactulose and antibiotics like Rifaximin are the mainstay of therapy. In cirrhosis of liver there is severe catabolic state, and consequent degradation of body protein is the major determinant of the characteristic amino acid imbalance with increased aromatic amino acid and decreased branched chain amino acid. So branched chain amino-acids could be effective in the treatment of hepatic encephalopathy.The aim of the study is to compare the efficacy of treatment of group who take Rifaximin, and Lactulose (group A) with the group taking Rifaximin, Lactulose and Branched Chain Amino-Acids (Group B) in Grade 1 to Grade 3 of hepatic encephalopathy.