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

Searching the way to keep students awake in class room

Team Based Learning [TBL] is gaining popularity as a small group teaching methodology in Medical institutions. Owing to its property of being less resource intensive it is especially useful in developing countries. Students being most important stakeholders need to be focused on research for implementation of the study was conducted to access the students' perceptions as they compare traditional lectures with new methodology in our context. A fifteen item five point Likert's scale questionnaire duly prepared by experts and piloted in students, was distributed among students of fourth year at the end of second module of Team based learning in the subject of internal medicine for fourth year MBBS class and collected after completion. Data was analyzed using SPSS 15. Independent t-test was performed and means were compared for TBL and Lecture methodology. Global rating was also comparedfor both. Total 174 students responded out of which 53 were males and 121 females. 61 students marked "excellent" category in overall rating with preference to TBL by 51 and lectures by 10. Among 121 marking in [good] category 81 were for TBL and 40 for lectures. All fifteen responses in the questionnaires favoured TBL. Comments included [excellent way of retention] for TBL. There was active participation of students throughout the sessions. Students favoured TBL as compared to lectures and therefore TBL is a suitable preferred methodology to incorporate active learning in our undergraduate curriculum

Comparison of therapeutic values between leukotriene receptor antagonist [montelukast] and inhaled glucocorticoide [beclomethasone propionate] in bronchialasthma of adults

To compare therapeutic values between leukotriene receptor antagonists [Monteleukast] and inhaled glucocorticoide [Beclomethasone] in naturally occurring bronchial asthma of adults. A total of 765 patients suffering from various respiratory disorders were examined. All of them were adults and belonged to the male gender. Comparison of therapeutic values between the administration of Monteleukast and inhalation of Beclomethasone in naturally occurring bronchial asthma in adults was studied. Out of 765 patients examined, sixty [7.8%] were diagnosed to be asthmatics on the basis of characteristic symptoms, physical and clinical examinations and Lab tests. The patients had persistent cough, wheezing, chest tightness, suffocation and shortness of breath, anxiety and nocturnal paroxysms. They represented 36.6% businessmen, 28.3% textile workers, 18.3% teachers, 10% hospital employees and 6.6% students. All of them were hospitalized for two weeks in the Ali ward of the Divisional Headquarters [DHQ] hospital; Faisalabad. The first group of 30 patients selected randomly was treated for 8 weeks with Monteleukast and the second group of the remaining 30 patients with inhalation of Beclomethasone for the same period. The enzyme, Alanin Transaminase [ALT] was found elevated in all the 30 patients treated with Monteleukast [P<0.001]. The Peak Expiratory Flow Rate [PEFR] of the patients treated with both Monteleukast and Beclomethasone was measured. The mean values of PEFR values obtained with Monteleukast differed favourably for the 1 [st] and 3 [rd] week [P<0.05] and relatively so during Later weeks which was also statistically similar to that of Beclomethasone. The age of the patients appeared to remain uninfluenced with the protocols of the two medicines. The treatment with Montelukast resulted in rise of the enzyme, ALT in all the asthmatic patients and their PEFR values showed more favorable results for the 1st and 3 [rd] weeks and relatively so around 6 [th] week and later which was statistically similar to that of Beclomethasone. The age of the patients showed no variations in PEFR values obtainrd with the two types of medication used