Qualitative versus quantitative PCR in establishing response to chronic hepatitis C treatment with sofosbuvir

Objective: To determine the change in rapid virological response for chronic hepatitis C by qualitative PCR testing after treatment with sofosbuvir

Study Design: A descriptive study

Place and Duration of Study: Memon Medical Institute Hospital, Karachi, from January to September 2016

Methodology: The study population consisted of patients above 18 years, till 80 years of age, of both genders, having chronic infection with HCV. Patients included were treatment-naive, non-responders or relapsers; and among these categories, both cirrhotic and non-cirrhotic patients were included. Initially, genotyping and quantitative PCR test was done, one at the start of treatment then at 4 weeks that is till rapid virological response [RVR] was elicited. Qualitative testing was compared by Chi-square with quantitative assays simultaneously to check sensitivity by qualitative testing

Results: Out of 106 patients, the mean age of the patients was 46.40 +/- 14 years. There were 39 [36.8%] males and 67 [63.2%] females. One hundred [94.3%] were infected with genotype 3. One hundred and five [99.05%] patients responded to sofosbuvir with successful achievement of RVR after 4 weeks. One patient did not achieve RVR [0.94%]. The sensitivity of qualitative test was 99%

Conclusion: Qualitative analysis is a cost-effective and sensitive method in patients treated with sofosbuvir for confirming RVR, especially in developing countries where patients are self-paying with significant financial constraints

Gerd symptoms and body mass index: a study in outpatients of Abbasi Shaheed hospital

This study aimed to determine the association between GERD [Gastro-Esophageal Reflux Disease] symptoms and Body Mass Index [BMI] in the outpatients of Abbasi Shaheed Hospital, Karachi. A comparative cross-sectional study was conducted in Abbasi Shaheed Hospital, Karachi from December 2008 to March 2009. By convenient sampling method, 200 outpatients who met the inclusion criteria were enrolled in the study, visiting the hospital with symptoms of epigastric pain, nausea, vomiting, acid regurgitation, heart burn, burping, belching, and feeling of wind. A questionnaire was filled, which contained patient's demographic profile, information on the frequency of all GERD symptoms and severity of main GERD symptoms. History of smoking, alcohol, drugs or any illness were also inquired and noted. Statistical analysis was done by SPSS version 16. Among 200 outpatients, 65% were females and 35% were male. Mean age was 38.4 years. Nausea was complained in 87%, epigastric pain in 66%, acid regurgitation in 66% and heart burning in 64% of patients. The frequency of heartburn and acid regurgitation was seen once a week in 39% and 45% of patients respectively while severity of heartburn and acid regurgitation was found 25% and 33% of patients respectively and there relation with body mass index were found insignificant. Co-relation of body mass index was not associated with symptoms of gastro-esophageal reflux disease i.e.: nausea [p=0.06], epigastric pain [p=0.658], acid regurgitation [p=0.935], heart burn [0.525]. Our study concludes that in our setting, the symptoms of GERD occur independently of body mass index. It seems that high BMI plays a more important role to cause symptoms of GERD among western population but not in Asian populations. However, further studies in Asian communities are also required in this regard