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Background: Hepatitis C is a leading cause of liver fibrosis, cirrhosis, and cirrhosis associated complications. In this study, we compared readily available non-invasive fibrosis indexes with fibro scans for fibrosis staging and predicting its progression in Pakistani population. Methods: The retro prospective cross-sectional study was conducted in medicine unit 1 and 2 and hepatitis clinic of Lahore General Hospital, Lahore starting from February 12, 2018 to January 8, 2019. We studied 1464 HCV infected patients which were got CBC, LFTs, ELISA, PCR and fibro scan was done to perfectly diagnose ongoing hepatitis C infection. In order to differentiate HCV fibrosis progression, we compared the effectiveness of readily available AST to Platelet Index (APRI), and FIB-4 with fibro scan. Results: Readily available serum indexes AST to Platelet Index (APRI) and FIB-4 were able to stage liver fibrosis in advanced stages of fibrosis (F4 especially) with correlation coefficient indexes 0.462, and 0.131 with considerable specificities and sensitivities. For APRI >1.5, it did predict F4 stage with sensitivity of 87.6% and specificity of 74.8%. For Fib-4> 3.25, it did predict F4 stage with sensitivity of 72.3% and specificity of 53.2%. Conclusion: Readily available and cheap serum indexes, AST to Platelet Index (APRI) and FIB-4 accurately predicted distinguished between cirrhotic and non- cirrhotic stages in HCV infected patients in comparison to the costly and rarely available Fibro scan score.
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Background/objectives: The aim of our study was to review the safety and effectiveness of Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures, occurrence of major and minor adverse events followed by propofol sedation, level of patient satisfaction and possible choice of propofol as sedative agent in their future endoscopic procedures in Pakistani population. Materials and methods: Prospective data were collected from patients receiving diagnostic AGD, colonoscopy or ERCP. Subjects who stopped the emergency procedure or both EGD and colonoscopy were excluded on the same date. Other exclusions include over 20 years of age, pregnancy, the American society of associate psychologists (ASA) Class III or IV, overweight (body weight>100kg), or drugs or its components or components (Soybean or egg) allergies included. Result: In our study a total of 929 patients comprising 520 males (56%) and 409 females (44%) with mean age of 46.19 ± 15.3years, mean MBI 24.27 ± 2.7. Age-specific propofol dosage was similar across gender except for age group 60 years and above where higher mean propofol dosage was required for females as compared to males for EGD and Colonoscopy (82.8 ± 32.2 vs. 63.5 ± 29.8; p-value 0.005; 81.1 ± 26.1 vs. 75.3 ± 25.0; p-value 0.03). The required examination was completed in all cases. There was no major adverse event. Majority of the patients rated the procedure satisfactory and agreed to undergo same sedative for next time. Conclusion: Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures is safe and effective in selected patients.
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Objective: The goal of the current project was to identify the therapeutic benefits of Nigella sativa (NS) on enhancing thefertility of obese male rats. Methods: Rats were distributed into three group: controls which were fed by a normal diet (ND);the group which was fed by a high-fat diet (HFD); besides, the group which was fed by HFD, then supplemented with NS.Gonadal Hormones plasma levels were investigated by ELISA. Inflammatory cytokines IL-6, IL-1ß and IL10, were investigatedby Multiplex Assays. The animals were sacrificed after eight weeks, and their testes were extracted for histology. Results:Testosterone levels in the HFD group were significantly minor than from the control group. Moreover, the HFD group treatedwith NS seeds showed significantly increasing levels of testosterone compared to the group treated with HFD only. Theluteinizing hormone levels were unchanged amongst three groups. However, the follicle-stimulating hormone levels were thelowest in the HFD group compared to the other study groups. Cytokines were significantly raised in the HFD group comparedwith the controls. However, the rats treated with NS seeds showed lower cytokines than the group treated with HFD only. Thegonads of HFD group showed disrupted seminiferous tubules, degenerated Leydig cells, and atypical spermatogenesis.Interestingly, the HFD group treated with NS restored the normal testicular structure, similar to the control group.Conclusion: NS could improve the reproductive efficiency in the abnormally distorted hyperlipidaemic-inflamed reproductivetissues in obese male rats.
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Malaria is one of the most important global public health problems threatening the health of the population owing to prevailing socio-economic conditions and epidemiological reasons in Pakistan. This qualitative study has focused on the perspectives held towards the rational use of medicine intervention among malaria control program officials. Eight semi-structured interviews with all officials working for the malaria control program in Islamabad were conducted. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and by all authors. All respondents agreed on successful implementation of the malaria control program in Pakistan for controlling malaria by improving diagnostic and treatment facilities and promoting rational case management through training of prescribers. However, funding is still the major challenge faced by the program for its future implementation.
A malária é um dos mais importantes problemas sanitários globais, que ameaça a saúde população devido às condições socioeconômicas e por razões epidemiológicas no Paquistão. Este estudo qualitativo focou-se nas perspectivas no sentido do uso racional da intervenção médica entre os funcionários do programa de controle da malária. Oito entrevistas semiestruturas com todos os funcionários que trabalham no programa de controle da malária foram conduzidas em Islamabad. As entrevistas, que eram gravadas e transcritas, foram avaliadas por análise temática do conteúdo e por todos os autores. Todos os respondentes concordaram com o êxito da implementação do programa de controle da malária no Paquistão por meio do aprimoramento do diagnóstico e de facilidades do tratamento, promovendo a gestão racional por meio do treinamento dos prescritores. Entretanto, o financiamento é, ainda, o principal desafio enfrentado para a implementação futura do programa.