Response to standard interferon alpha2b and ribavirin combination therapy in chronic hepatitis C treatment naive patients

Treatment of Chronic Hepatitis C is now well established with conventional interferon or pegylated interferon in combination with ribavirin. Peginterferon Alfa and Ribavirin for 6 to 12 months is currently approved initial therapy, which is expensive. Response of our patients to standard Interferon-alpha-2b and ribavirin for 24 weeks have been studied. The objective of this study was to asses Sustained Viral Response [SVR] with standard Interferon alpha2b and Ribavirin combination treatment in chronic Hepatitis C patients. This quasi-experimental study was conducted at Combined Military Hospital, Quetta from Jan 2006 to Jun 2007. One hundred and three patients, with 20-60 years of age suffering from chronic Hepatitis C were selected on the basis of raised ALT, positive anti-HCV antibodies, evidence of viraemia by quantitative PCR for HCV RNA and liver biopsy. All patients were started on same brand of Interferon alpha-2b, 3 MIU subcutaneously, thrice weekly and oral Ribavirin [1,000-1,200 mg/day] for 24 weeks. End treatment response [ETR] after completion of treatment and SVR six months after ETR were recorded. The 103 patients, 85 males and 18 females with mean age of 21-48 years completed the treatment for 24 weeks. Mean ALT was 96.17 [SD +/- 49.98]. End treatment response [ETR] was 89.3% [p=0.032]. Sustained Viral Response after 6 months of treatment was 86.4% [p=0.034]. Standard Interferon and Ribavirin had excellent SVR. It is effective as well as economical treatment in Chronic Hepatitis C patients

Maternal and neonatal complications in term breech delivered vaginally

To evaluate the maternal and neonatal complications in terms of genital tract trauma to mother, perinatal mortality, Apgar score at 5 minutes and neonatal trauma in all singleton term breech cases delivered vaginally. Case series. Department of Obstetrics and Gynaecology, Bolan Medical Complex Hospital, Quetta, from May 2005 to March 2006. A 100 consecutive patients with singleton breech presentation, whether booked or unbooked, were admitted and delivered vaginally in hospital during the study period. They were studied for maternal and neonatal complications. Maternal complication included any genital tract trauma during delivery while neonatal complications were perinatal mortality, low Apgar score [less than eight at 5 minutes] and birth trauma. There were a total 3977 deliveries during this study period, 145 breech presentation [incidence 3.6%]. Out of those, 100 were included in the study. All were unbooked cases, 87% were multigravida while 13% were primigravida. An Apgar score of eight was recorded in 87% babies while 10% had an Apgar score of less than eight after 5 minutes. There were 3 still births and one neonatal death. Aggregated perinatal mortality rate was 40/1000 live births. Only one baby had birth trauma [Erb's paralysis] during vaginal breech delivery. Ninety seven [97%] mothers had no complications while only 3 [3%] had complications. Out of these, one had cervical tear and 2 had vaginal tears. Offering a trial of vaginal breech delivery to strictly selected and well-counselled patients remains an appropriate option without compromising perinatal and maternal outcome. It also decreases the rate of operative delivery for this malpresentation