Abstract

‘Why is this column called carphology? Carphology is from the Greek – karphos is straw such as birds collect to build a nest, and logeiâ is gathering. This ‘neurological’ collection is a personal and non-systematic gathering of straw, twigs and wool from other journals and inspired by the BMJ’s Minerva, with whom I occasionally have lunch. You may rightly wonder if it will be as productive and woolly as the plucking of bedclothes – carphology to the neurologist – we sometimes see in delirious people. Let’s hope not!

Rajendra is a very old Sanskrit name, a combination of ‘Raj’ and ‘Indra’ (a vedic god), which conjugates into Rajendra. Lactulose and lactilol are considered standard treatment for hepatic encephalopathy but a systematic review of 22 trials finds insufficient evidence to support or refute their use. This means that these compounds need no longer be used as comparators in trials of new treatments for hepatic