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Objective; To compare the outcome of lactulose alone versus lactulose with Rifaxamin in cases with hepatic encephalopathy. Study design; Randomized control trial. Place and duration of study; Lahore General Hospital, Jinnah Hospital Lahore, RHC Kalapani Abbottabad, during June 2018 to December 2018. Patients and methods The cases of hepatic encephalopathy of any grade within last 7 days of its onset with age range of 20-60 years were included. The cases with end stage cardiac or renal failure were excluded. The cases were divided into two groups labelled as A and B. The group A was treated with lactulose alone in a dose to 20 to 100 ml per day to maintain stool frequency of at least 2 per day and the group B was treated with same amount of lactulose along with Rifaxamin in a dose of 550 mg thrice a day. The efficacy was assessed daily till there were no signs and symptoms of hepatic encephalopathy till day 7 where final outcome was seen to label efficacy or mortality as yes or no. Results; In the present study, 100 cases of hepatic encephalopathy were included. Out of these 50 were in each group. The maximum cases were in child pugh class in both groups comprising 26 (52%) and 25 (50%) in group A and B respectively. The mean age at presentation was 46.73± 9.13 years in A as compared to 51.25± 9.04 years in group B with p= 0.54. The efficacy in group A was seen in 28 (56%) of cases and in group B as 38 (76%) of cases with p= 0.01. This difference was also statistically significant in terms of mortality which was seen in 22 (44%) of cases in group A and 12 (24%) in group B (p=0.01). Conclusion; Combination of lactulose plus Rifaxamin is significantly better as compared to lactulose alone for the treatment as well as mortality benefit in cases of hepatic encephalopathy. Key words; Lactulose, Rifaxamin, Cirrhosis, Encephalopathy

African art had a consequential inspiration for its aesthetic value over avant-garde mutiny, while the European artistic thought came to recognize the perpetual aspect of its composition and adapted these characteristics to evade naturalism which defined Western art, since the Renaissance. Architecture has opprobrium for its late response to any transformation of what other arts embrace certainly. But still, this ‘frozen music’ echoes the African ‘muddy or woody’ lyrics in its most constructive era of evolution; the zenith of Bauhaus. Why was this synthesis possible? To architecture, it is still regarded as a craft and the craftsmanship steered this communication to materialize both in elegiac comprehension and lucid scrutiny. The search for the sculptural need over architectural similes was probably to stimulate architecture in such way that is somewhat more humane. In fact, our retort to the nature is inevitable and such desire creates Metaphor and fabrics over symbolic representations which are experienced through climate, obtained by sensuous discernment of human being in what is referred to‘primitive’. Supplementary curriculum from the early Bauhaus school demonstrates the emphasizing practice of its unique connotation. Likewise, Uses of indigenous constituents got a different dimension, which were distinct in Modernist practice of African architecture. This, along with the curse of ‘unaesthetic’, could be better explained by the modern theory of fractal art; which is something beyond our conformist splendor. Keywords: African art, African artifacts, Fractals, Cultural Exchange, Stylistic Influences, Bauhausand Modernism