Hep-net opinion about the management of patients with chronic hepatitis C in Pakistan in the era of available direct acting antivirals

In Pakistan, we have 4.9% prevalence of HCV in general population, with 79% genotype 3. Recently Sofosbuvir has been made available at compassionate price in Pakistan. Management of chronic hepatitis C includes counseling of HCV patients, their proper assessment to select those who need antiviral therapy, initiation of appropriate antiviral agents and duration of therapy, along-with careful monitoring for safety and efficacy. Hepatic status as well as previous history of HCV therapy needs to be taken in the consideration before starting antiviral therapy. Other factors include co-morbid conditions like obesity, DM, NASH, etc. Treatment of special populations like liver transplant patients, patients with HBV co-infection, chronic kidney disease and hemoglobinopathies need special considerations when initiating HCV therapy

Effect of variable incubation temperatures and salt concentration on susceptibility testing of methicillin resistant staphylococcus aureus [MRSA]

The effect of variable incubation temperatures and variable salt concentration in the sensitivity agar on susceptibility testing of MRSA was evaluated. For this purpose 58 MRSA strains were tested. For each MRSA strain nine Mueller Hinton agar plates, three plates each with 2%, 5% and 7.5% sodium chloride [NaCl] supplement were inoculated. One plate from each of the salt concentration was incubated at 30°C, 37°C and 40°C. It was found that with increase in temperature of incubation the size of inhibition zones increased. In the presence of 2% NaCl supplement in the sensitivity agar, 5 MRSA appeared falsely intermediate sensitive on incubation at 40°C. While on incubation at 37°C although all MRSA remained methicillin resistant, statistical analysis revealed the effect on inhibition zone size to be approaching significance level [0.1 > P > 0.05]. The effect of incubation temperature on inhibition zone size was statistically insignificant [P>0.05] if 5% or 7.5% NaCl was incorporated in the sensitivity agar. Therefore we recommend the use of 5% NaCl supplemented sensitivity agar and incubation temperature of 37°C for the accurate detection of methicillin resistance in Staphylococcus au aureus