WHile the patch did help/resolve some problems it certainly was not comprehensive enough to tackle all the various loose ends that were left in the programming (there is a nice post in BEST TIPS about what the patch does and what it takes away). I personally prefer to play without the patch. I never had any problems with the game running so for me it was a case of "if it isn't broke, don't fix it".
The Rat Skull - makes a nice paper weight but has no purpose in the game. Generally unimportant items are not something you can collect into your inventory so I suspect that there may have been plans to do something with the rat skull that got lost in the rush to market.
I always favored dropping things outside the west gate of Ishad N'ha but I'm not certain it matters, east or west. There are only a few items that you need from one area to another. For the most part, I think they are fairly obvious, but there should also be a list in the BEST TIPS on what exactly the items are. You can check that to be certain you are accidently risking an important item.
I always like to keep my inventory minimal. I clean out as much of it as I can every time I go to town. This gives me the maximum amount of space to collect new items in which ever area I explore next.
Have fun!!
Wyv
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