Chronic hepatitis B (CHB) is one of the leading causes of morbidity and mortality worldwide. Although various drugs are available for the treatment of CHB, emergence of the hepatitis B e antigen (HBeAg)-negative mutant variant, specifically in Asia, the Middle East and southern Europe, is creating a new challenge as this variant is less responsive to available treatments. HBeAg-negative CHB rapidly progresses to cirrhosis and its related complications. This review discusses the available literature on the approved and under-trial treatment options and their respective efficacies for HBeAg-negative CHB.

Despite nonrecommendation, prophylactic antibiotics are used frequently in AP. We emphasize on the need for multicenter randomized controlled trials on prophylactic antibiotics for AP based on a risk-directed approach, rather than a "blanket approach."

Epiploic appendagitis (EA) refers to primary or secondary inflammatory disease of the epiploic appendages: peritoneal pouches of subserosal fat, which run in parallel rows beside the taenia coli of the colon. It is an uncommon but self-limiting condition, which often mimics acute appendicitis or diverticulitis. An accurate diagnosis of EA can be made by performing an abdominal computed tomography scan. Establishing a correct preoperative diagnosis is important to avoid unnecessary exploratory laparoscopy or laparotomy. We report two cases of EA, which to our knowledge represent the first documented cases from India.

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Robin Spiller, editorA child with upper abdominal pain and pancreatitis CLINICAL PRESENTATION An 11-year-old male child presented at the emergency department with history of rapid onset upper abdominal pain of 8 h duration. The pain was associated with nausea and vomiting, and there was radiation of pain to the back. There was an increase in pain on taking food. However, there were no relieving factors. On clinical examination, he was found to be afebrile, his vitals were stable and he had tenderness over the epigastrium and left hypochondrium. Bowel sounds were sluggish. The rest of the systemic examination was normal.Routine blood investigation carried out in the emergency department revealed a total leucocyte count of 7800/mm 3 with 64% polymorphonuclear cells, haemoglobin of 12.4 gm/dl, erythrocyte sedimentation rate of 40 mm after 1 h, total bilirubin of 1.