 In a recent randomized placebo controlled study conducted at Karachi 25, patients with acute HE were randomized to receive LOLA or placebo. NCT-A, ammonia level, clinical grade of HE and duration of hospitalization were assessed. Improvement in HE was higher n40, 66.7 in LOLA group n28, 46.7, p0.027. Duration of hospitalization was lower in LOLA group compared to placebo p0.025. No side effects were observed in either group. 