ABSTRACT
Hepatitis C is a major public health problem globally. It is one of the commonest cause of chronic liver disease in Pakistan. The prevalent genotype is "3" in our country. The standard of care treatment is combination of interferon and ribavirin. This combination has important adverse effects especially hemolytic anemia
AIMS and OBJECTIVES: This study has been conducted to determine the frequency of anemia [< 10gm/dl] at 4, 12 and 24 weeks of interferon and ribavirin treatment CAH-C Genotype-3patients along with assessment of associated risk factors
PLACE AND DURATION: This study was conducted in department of Gastroenterology and Hepatology, Isra University Hospital, Hyderabad, Sindh from April 2009 to October 2010. STUDY DESIGN: Prospective and case series study
MATERIALS AND METHODS: All patients who fulfilled the inclusion and exclusion criteria were enrolled. The proforma was filled after patients verbal consent, by asking questions .Their BMI was recorded and other demographic characteristics were also noted .Patients were followed at 4,8,12,16,20 and 24 week. Their Blood CP was checked and if Hb fall within the range of 10.1- 11.9 mg/dL then the dose of ribavirin was reduced [200 mg/day reduction] and if Hb was <8.5 g/ dL then both drugs were stopped altogether
RESULTS: A total of 140 patients were remained for final analysis. Male were 73 [52%, n = 140]
Only 18 [13%, n = 140] patients developed anemia at week 4 of treatment. Compared to baseline mean Hb% SD 13.31+1.18 [12 to 17 gm/dl], week 4 post treatment mean Hb +SD [Range] was 11.2 + 1.15 [gm/dl. Almost 76.4% [107] of patients dropped hemoglobin more than two grams at week 4 from baseline. The mean Hb% level at week 12 of treatment was 11.2 gm/dl. There were 31 [22%] patients developed anemia Hb<10.0 gm/dL .It was significantly seen in females. One hundred and seven [76.4%] patients dropped Hb more than 2 gm at week 12
Total of 30 [18%] patients developed anemia [Hb<10.0 gm/dL] at week 24. Mean hemoglobin level at week 24 was 11.1 gm/dl. Anemia at week 4 and 12 were the two strong predicators of anemia at week 24. Other significant factors associated with anemia at week 24, were female sex and body weight less than 60kg at baseline
CONCLUSION: Anemia is a frequent complication of Anti HCV therapy
ABSTRACT
Objective: To identify socio-demographic correlates of stigma attached to psychiatric illnesses
Method: This is a retrospective study. Data of the patients who had attended psychiatry department; either as a referral or direct consultation; and as in-patient or outpatient; at Isra University Hospital at Hyderabad during the years 2001 to 2004, were reviewed and presence or absence of stigma feelings were compared to their socio-demographic backgrounds. Demographic characteristics of a total of 1208 patients with different psychiatric illnesses were recorded. Data obtained, was subjected to analysis using SPSS 13[th] version
Results: Feelings of stigma was present in forty seven percent of the studied population. Males had slightly more feelings of stigma. People from urban areas were also carrying more feelings of stigma but it was statistically insignificant. Apart from people with no formal education who had maximum stigma feelings; education level was found to increase such feelings, in the population studied
Conclusion: In our studied population, feeling of stigma seems to prevail in every demographic class; this is specially so among neurotics, male gender, urban patients. Level of education has interesting relation with the feeling of Stigma, which is found to increase with level of education