Cost effectiveness evaluation of hepatitis C therapy in Lahore

Approximately 10 million Pakistan's of population is a victim of Hepatitis C virus. A comparative study of two treatments for Hepatitis C being provided in private clinics and government hospitals was conducted to evaluate the cost effectiveness of these treatments. The quality adjusted life years [QALYs] for each treatment plan was determined with the help of health utilities, using EQ-5D scores. A comprehensive data collection form aided in scrutinizing the cause and effect of each treatment on the patient's quality of life. The total sample size for this study is 200 total from the public and private sectors. For both the treatment strategies, values for quality adjusted life years [QALYs], incremental cost effective ratio [ICER] and cost effective analysis [CEA] were calculated. The Hepatitis C virus 3a and 3b genotypic patients who were treated with pegylated interferon a-2a and ribavirin combination [strategy 2] showed an increased quality adjusted life years [QALYs] of two years, as compared to those who received interferon a-2a and ribavirin regimen [strategy 1]. An incremental cost effectiveness ratio [ICER] of Rs 144673.5 per quality adjusted life year [QALYs] was gained by patients treated with strategy 2. The therapy followed by the government sector [strategy 1] is relatively inexpensive accounting for Rs 654.5/quality adjusted life years [QALY] and therapy provided at the clinic sector [strategy 2] is relatively expensive Rs 5620.67 quality adjusted life years [QALY]. However, the cost effectiveness analysis for the pegylated interferon therapy is quite comparable with the other standard treatments; hence it can be called cost effective according to the quality adjusted life years [QALYs] gained and efficacy of the said therapy

Selenium in human health and disease: a review

Selenium is an essential trace element for humans and animals, and selenium deficiency is associated with several disease conditions such as immune impairment. Free radicals are produced in the body as a result of many biochemical processes in the body. All aerobic organisms possess antioxidant defense system to combat oxidative stress. Selenium is an important constituent of antioxidant enzymes, especially, glutathione peroxidase and some other selenoproteins that participate in various physiological activities and protects the cell against the deleterious effects of free radicals by modulating the cell response. However, their exact role is still unknown. Moreover, many human diseases are related to the cell cycle regulation. Selenium intakes, greater than the recommended daily allowance [RDA], appear to protect against certain types of cancers by finding its role in regulation of cell proliferation and apoptosis. The role of selenium has been explored in normal thyroid functioning, enhancing immune function, carcinogenesis, cardiovascular diseases, in the prevention of pre-eclampsia, diabetes mellitus and male reproduction etc. This article reviews introductory aspects of selenium as an essential micronutrient, different sources of selenium, Pharmacokinetics and its role in various pathologies and aims to provide an update on selenium profile