Hepatic encephalopathy in Saudi Arabia: retrospective analysis of 51 patients.

The clinical features, prognostic factors, and outcome of 51 patients with hepatic encephalopathy (HE), were retrospectively reviewed. The mean (+/- SD) age of patients was 47.2 (+/- 14.8) years. Seventy-five percent of patients were males and 73% were Saudi. All identified episodes of hepatic encephalopathy were associated with chronic underlying liver disease and no episode occurred as a result of acute fulminant hepatic failure. Most patients presented in advanced stage of hepatic dysfunction and had one or more precipitating factors. In-hospital mortality rate was 41% (21 out of 51 patients). Gastrointestinal tract bleeding, electrolytes imbalance and alkalosis were associated with significantly higher mortality rate. However, unadjusted analysis failed to identify certain base-line independent prognostic factors.

A single nocturnal dose of famotidine for the treatment of duodenal ulcer: evaluation of efficacy and safety.

The efficacy and safety of a single nocturnal dose of famotidine (40 mg) was evaluated in 30 consecutive patients of duodenal ulcer (DU). Three patients were lost for follow-up and therefore were excluded. The mean age of remaining 27 patients was 34.3 (+/- 9.9) years and male to female ratio was 8:1. The mean size of the DU was 1.21 (+/- 0.79) cm. After a 4-week therapy all patients showed significant improvement and repeat endoscopy in 24 out of 27 patients (89%, 95% confidence interval; 78% to 100%) showed healed ulcer. Clinical assessment of pain relief at 4-week showed significant drop in the mean score of baseline daytime (from 1.85 to 0.13) and baseline nocturnal pain (from 1.70 to 0.10) (p less than 0.0001 and less than 0.0001, respectively). Also shown was the significant decrease in the mean gastrointestinal symptoms score from 5.89 at baseline to only 0.89 at 4-week (p less than 0.0001). Despite that all those who failed to show ulcer healing at 4-week were smokers, logistic regression analysis could not identify smoking or any other risk factors as adverse predictors of ulcer healing. None of the patients experienced significant side effects or adverse reactions. We conclude, that a single nocturnal dose of famotidine is a practical, highly effective and safe approach for the management of DU.