ABSTRACT
Objective: To study the frequency of occurrence of hepatocellular carcinoma [HCC] in hepatitis C virus patients treated with direct acting antiviral [DAA] agents
Methods: This hospital based cross-sectional study was conducted in Mayo Hospital, Lahore from June, 2016 to January, 2018. Total 300 patients with HCV genotype 3, selected via Non-Probability Purposive Sampling technique, without prior or concurrent history of HCC, were given DAA agents and were followed up for 6 months after completion of therapy. Results were based on Quantitative PCR to assess Sustained Virological Response [SVR] and Ultrasound Abdomen to look for the appearance of any new lesion. Data was presented as mean+/-SD, frequency and percentages and was analyzed using SPSS Version 24.0
Results: Out of 300 patients, 179 [59.7%] were males and 121[40.3%] were females. Mean age of the patients was 55.08 +/- 5.602 years. 214[71.3%] patients had compensated cirrhosis at the start of treatment and 86[28.7%] had decompensated cirrhosis. SVR was achieved in 200[93.4%] out of 214 patients with compensated cirrhosis and in 76[88.3%] out of 86 patients with decompensated cirrhosis. At six months post- treatment, 10[3.33%] patients developed HCC,2[0.7%] in the compensated group and 8[2.7%] in the decompensated group, out of which 5[6.6%] patients had achieved SVR
Conclusion: The frequency of HCC following DAA agents is significant [3.3%] even after achieving SVR. Caution must be exercised in prescribing DAA agents to HCV patients keeping this complication of HCC in mind
ABSTRACT
Chronic rheumatic heart disease is the commonest cause of mitral stenosis. Incidence of rheumatic MS parallels that of acute rheumatic fever. Atrial fibrillation usually develops in the presence of pre-existing ECG evidence of left atrial enlargement and is related to the size of the chamber, the extent of fibrosis of the left atrial myocardium, the duration of the atriomegaly and the age of the patient. The tendency for development of systemic embolization correlates directly with the patient's age and the size of the left atrial appendages and inversely with the cardiac output. Eighty percent of the patients of MS in whom systemic emboli develop are in atrial fibrillation. A descriptive study was designed in the Department of Medicine, K E Medical College / Mayo Hospital and Punjab Institute of Cardiology, Lahore. A total of 129 conservative cases of mitral stenosis were included in this study, based upon convenient patient sampling. A total of 112 patients were followed up properly, the remaining 17 were lost to follow. The results showed left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]. It was thus concluded that left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]