ABSTRACT
Hepatic encephalopathy (HE), a morbid ordeal affecting chronic liver disease patients always insists for the search of a rational, superior & infallible agent beyond the time-proven standards i.e., Lactulose & Rifaximin. In this RCT, we compared the efficacy of intravenous (IV) L-ornithine-L-aspartate(LOLA) versus Oral LOLA in patients with chronic liver disease(CLD) enduring overt Hepatic Encephalopathy(OHE). 40 CLD patients with OHE were randomly assigned IV or oral LOLA in a 1:1 ratio. Patients were graded for HE and monitored for serum ammonia levels from day 1 to day 5. The aim was to compare IV versus oral LOLA efficacy in HE grades improvement and its correlation with ammonia levels. The study was registered with clinical trials registry-India, CTRI/2020/12/029943. Baseline characteristics of patients in both groups were similar. The mean difference in ammonia levels from day 1 to day 5 was 55.4 ± 32.58 µmol/L in the IV LOLA group and 60.75 ± 13.82 µmol/L in the oral LOLA group (p = 0.511). Significant reductions in ammonia levels were observed from day 1 to day 5 within each group (p < 0.001). HE grade & ammonia correlated positively in both groups. LOLA, regardless of administration route, has demonstrated efficacy in OHE.
Subject(s)
Administration, Intravenous , Ammonia , Dipeptides , Hepatic Encephalopathy , Humans , Hepatic Encephalopathy/drug therapy , Hepatic Encephalopathy/blood , Male , Female , Middle Aged , Administration, Oral , Dipeptides/administration & dosage , Dipeptides/therapeutic use , Ammonia/blood , Adult , Treatment Outcome , AgedABSTRACT
PURPOSE: To investigate the effects of cleft itself and palatoplasty on the development of dental-arch morphology. METHODS: Computed tomography scanning and imaging system for dental cast measurement were applied to statistically analyze the differences in dental-arch form among 30 adults with normal occlusion, 30 adult patients with operated unilateral complete cleft palate, and 30 adults with unoperated cleft palate. RESULTS: All maxillary arch widths and anterior arch length of the operated group are significantly smaller than those of the unoperated group (P < 0.01). In the unoperated group, the maxillary anterior arch width and maxillary and mandibular arch length are significantly smaller, whereas both maxillary and mandibular posterior arch widths are significantly larger as compared with the control group (P < 0.01). CONCLUSIONS: The influence of cleft palate on the development of maxillary arch is limited to the vicinity of the cleft in the anterior region only. Palatoplasty is the main cause resulting in the constriction of maxillary arch, while inhibiting the sagittal development of the anterior arch.
