Pharmacoeconomic analysis of treatment of patients infected with hepatitis C virus

Hepatitis C infection imposes a high economic burden globally. It has been estimated that in 2012, the healthcare cost of Hepatitis C virus [HCV] was dollars6.5 billion. Furthermore, it has been projected that the cost will reach at 9.1 billion dollars by the year 2024.Frequency of hepatitis C in Pakistan is significantly higher [4.5%] when compared to the populations like India [0.7%], Nepal [1.0], Myanmar [2.5%], Iran [0.8%], China [1%] and Afghanistan [1.1%]. The current standard of care for chronic infection with hepatitis C virus is 24 or 48 weeks of therapy with Pegylated interferon-alfa-2a [Peg INF] +Ribavirin [RV] or Interferon alfa-2a [INF] + RV. The objective of this study was to determine that which combination is more effective and the gain in sustained virologic response [SVR] is worth the incremental cost. In total 84 patients were enrolled who received current standard treatment of care for chronic infection with HCV either 24 or 48 weeks of therapy with Peg INF + RV or INF + RV. A pharmacoeconomic analysis was done including fixed and variable cost [comprising concomitant therapies, emergency visits and hospital admissions] of both treatment regimens were calculated and compared with the SVR accomplished by the patients. It was concluded that the Peg INF + RV is cost effective as compared with conventional INF + RV for the treatment of adult patients infected with HCV genotype 3a under a varied array of possibilities regarding treatment costs and effectiveness

Improvement in therapeutic ability of wharton's jelly derived mesenchymal stem cells with vitamin E in breast cancer

Objective: To assess the role of Vitamin E to improve the survival of Wharton's jelly derived mesenchymal stem cells [WJMSCs] in breast cancer conditions

Study Design: An experimental study

Place and Duration of Study: Centre for Research in Molecular Medicine, University of Lahore, from November 2016 to March 2017

Methodology: WJMSCs were obtained from umbilical cord tissue with enzyme digestion method. Isolated cells were characterized for CD90 and CD45 by immunocytochemistry. Pretreatment and conjugation therapies of vitamin E in 50mM and 100mM concentration were used on WJMSCs and breast cancer plasma was provided to mimic the cancer conditions, while WJMSCs provided with normal plasma were considered control. Cells' viability, proliferation and death were evaluated by crystal violet staining, MTT assay and LDH assay, respectively. Oxidative stress was observed by activity of anti-oxidant enzymes [GSH, catalase, SOD] and reactive oxygen species [MDA]

Results: The isolated cells expressed mesenchymal stem cells marker CD90 and lacked hematopoietic marker CD45. Vitamin E improved the viability and proliferation of WJMSCs in normal plasma, in conjugation with breast cancer plasma and in pretreatment groups but conjugation group showed even better results with concentration of 100mM as compared to the pretreatment group and opposite was observed for LDH assay for cells death analysis. Vitamin E also reduced the oxidative stress in 100mM more pronounced in conjugation group as compared to pretreatment group while left no harmful effects on WJMSCs in normal plasma

Conclusion: Vitamin E conjugation with breast cancer conditions significantly improved growth of WJMSCs. Thus vitamin E treated WJMSCs are better therapeutic options for breast cancer

Post-tonsillectomy hemorrhage: an analysis of incidence and risk factors in Kuwait

Introduction: Post-Tonsillectomy Hemorrhage [PTH] remains one of the commonest complications associated with tonsillectomies. Its incidence and risk factors vary widely in literature

Objective: To examine our local experience and assess the incidence of PTH in comparison to that in the literature and to identify factors that contribute in increasing the risk of PTH in our setup. Design: Retrospective study. Setting: Al-Sabah and Zain Hospital, MoH, Kuwait

Methods: A retrospective chart review was conducted on 2,038 patients who underwent tonsillectomy with or without adenoidectomy during a 12-month period [January to December 2010] in Zain and Al Sabah hospitals. Details regarding the patients' age, gender, surgical technique, and level of the operating surgeon were recorded in order to assess any correlation. Intervention: Tonsillectomy. Main Outcome Measure: Incidence of PTH

Results: Out of the 2,038 patients included in this study, a total of 98 patients [4.8%] developed PTH. Thirty-one patients [31.6%] who developed PTH were above the age of 26 years. Out of the 98 patients [4.8%] who developed PTH, 63 patients [64.3%] were male. 'Hot' dissection technique was associated with higher incidence of PTH [71 patients; 72.4%] in comparison to the 'cold' dissection [27 patients; 27.5%]

Conclusion: The incidence of PTH in our institution is 4.8%, which is comparable with that reported in the literature, ranging between 1.5% and 6.68%. Male patients, increasing age and 'Hot' dissection technique were all identified as risk factors for PTH in our setup

Bacillus sphaericus as mosquito larvicide

In Noorpur Shahan, a village in the outskirts of Islamabad, Bacillus sphaericus was tested to determine its efficacy against mosquito larvae. Since the creation of this new Islamabad district no mosquito control measure has been taken in the area and like so many other places in and around Islamabad, mosquito density is unusually high in this village. The efficacy of Bacillus sphaericus was studied up to seven weeks after its application and it gave good larval control

trial of Bacillus thuringiensis H-14 for mosquito control

Bacillus thuringiensis H-14 was tried to see its efficacy as a larvicide. It showed good initial toxicity but no residual effect. After 36 to 48 hours it did not kill the larvae and is therefore not recommended as a larvicide against mosquitoes for a country like ours unless further research is conducted to create a monomolecular layer on water surface for retaining the bacilli on the surface or else if some new strain is developed which has got longer residual effect

Potentiating effects of phenobarbitone on the induction of cirrhosis in rats by carbon tetrachloride

The potentiating effects of phenobarbitone sodium on the experimental induction of liver necrosis and cirrhosis by carbon tetrachloride [CCL4] were studied in 50 rats. CC14 was given by intraperitoneal injection, phenobarbitone in drinking water. Thirty rats received both agents; and 10 each received only one agent. In 7 of 10 animals given CC14alone, moderate cirrhosis without ascites developed within 6 to 8 weeks; the other 3 rats died before fourth week. All animals receiving both agents and surviving for as long as 5 to 8 weeks developed severe cirrhosis with marked proliferation of the bile ducts within 2 months. Most of these animals also had ascites. Five rats given only phenobarbitone remained healthy, although their livers increased in weight