Sofosbuvir adverse events profile in a subset of Pakistani population

Objective: To determine frequency and pattern of adverse events reporting in a subset of Pakistani population being treated for chronic hepatitis C with sofosbuvir combination therapy

Study Design: Descriptive study

Place and Duration of Study: Department of Medicine, Gastroenterology Division, Shalamar Hospital, Lahore, from September 2015 to May 2016

Methodology: Patients who were offered sofosbuvir therapy for treatment of chronic hepatitis C were randomly enrolled. The study subset included both treatment naïve as well as retreatment groups. Patients were screened for subjective as well as objective evidence of adverse events at regular intervals. Frequency was determined

Results: Among 196 patients with chronic hepatitis C, 192 patients received dual therapy consisting of ribavirin and sofosbuvir. The most frequent complaints in these subjects were fatigue, fever, myalgias and nausea accounting for 55%, 42%, 44.2% and 50%, respectively. Twenty-seven percent of patients reported with drop in hemoglobin of >2g/dl, while absolute neutropenia and moderate to severe thrombocytopenia was observed in 3% and 5% of patients, respectively. One patient died as a result of severe pancytopenia. Later derangements were all observed in patients with decompensated disease

Conclusion: Sofosbuvir showed less severe adverse effects in terms of symptomatology and less frequent neutropenia and thrombocytopenia as compared to previous regimens. Careful monitoring is required, especially in those with decompensated liver disease

Decompensated cirrhosis; prevalence of gastric varices

Cirrhosis with subsequent portal hypertension is a major health problem worldwide. Among various etiologies, HCV is the leading cause of chronic hepatocellular injury. Cirrhosis being the commonest cause of portal hypertension results in a spectrum of complications. Approximately 5-15% of cirrhotic develop varices. Gastric varices although present less frequently as compared to esophageal varices but are associated with greater mortality and morbidity

Objectives: To determine prevalence of Gastric varices in patients with decompensated cirrhosis

Study Design: Cross sectional study

Place and Duration: Carried out at two centers, Pakistan Ordinance Factories Hospital Wah Cantt and Shalimar Hospital Lahore from Jan 2014 to Jan 2015

Subjects: A total of 421subjects of decompensate cirrhosis were included in the study

Methods: Patients with decompensate cirrhosis of any etiology who were visiting the two hospitals as inpatient or outpatient were included in the study. Upper GI endoscopy was done in all these subjects for determination of gastric varices

Results: Among 421 patients of decompensate cirrhosis, frequency of gastric varices was 10.9%, GOV1 as the most common variant. Gastric varices contributed to 5.4% of all variceal bleeds

Conclusion: Gastric varices are found in significant number of patients of decompensate cirrhosis. Since gastric varices are associated with increased mortality and poor outcomes, these should be carefully looked during upper GI endoscopy. Successful management of gastric variceal hemorrhage necessitates availability of expertise and newer diagnostic modalities

Trigeminal neuralgia [TN]: a case report on short-term follow up

Trigeminal neuralgia [TN] is one of the most common neuropathic syndromes. It is more common in females than males. This condition is described as a sudden severe pain, can be unilateral or it can be in the form of episodes. Patient conceive it as very severe pain which affects thequality of life and health status of the individual. The pain can be described as a sudden severe pain which is normally triggered by a slight stimulus like touch, eating, drinking, washing, and shaving or by any thermal changes. We report a case of a sixty five years old female patient who presented with right sided pain in upper and lower quadrant of the jaw which was not relived by medication. Investigations and regular follow up has revealed classical trigeminal neuralgia pattern

Assessment of socio demographic risk factors involved in coronary artery disease seen in patients presenting in coronary outdoor

The aim of the study is to assess the sociodemographic risk factor involved in Coronary Artery Disease seen in patients presenting in Coronary outdoor. A Case-Control study. The study was conducted between July 1[st] to July 28, 2004 in Lahore. It was a community based survey conducted on coronary outdoor departments in Lahore. Multistage followed by systematic random sampling methodology was used. 30 known patients of CHD were selected as cases along with inclusion of 30 healthy people as controls for the assessment of sociodemographic risk factors of CHD. The final result shows that there is a significant risk for persons over 50[OR:3, CI:0.93-94], male sex [OR:2.28, CI:0.71-7.3], smokers [OR:11.6 CI:2.95-49.00], sedentary life style [OR:6 CI0.82-8.89], persons having transport problems [OR:2. CI0.62-6.51], high cholesterol diet [OR:2.2 CI0.71-7.46], positive family history of CHD [OR:13.75,CI3.40-60.40] and underlying diseases like diabetes and hypertension [OR:4.75,CI0.40-16.74]. The study reveals an area that needs attention. The overall risk profile in our community showed increased risk of CHD in male sex, age over 50, high cholesterol diet, smoking. sedentary life style. positive family history of CHD and stressful conditions