RESUMO
Objective: To study the frequency of occurrence of hepatocellular carcinoma [HCC] in hepatitis C virus patients treated with direct acting antiviral [DAA] agents
Methods: This hospital based cross-sectional study was conducted in Mayo Hospital, Lahore from June, 2016 to January, 2018. Total 300 patients with HCV genotype 3, selected via Non-Probability Purposive Sampling technique, without prior or concurrent history of HCC, were given DAA agents and were followed up for 6 months after completion of therapy. Results were based on Quantitative PCR to assess Sustained Virological Response [SVR] and Ultrasound Abdomen to look for the appearance of any new lesion. Data was presented as mean+/-SD, frequency and percentages and was analyzed using SPSS Version 24.0
Results: Out of 300 patients, 179 [59.7%] were males and 121[40.3%] were females. Mean age of the patients was 55.08 +/- 5.602 years. 214[71.3%] patients had compensated cirrhosis at the start of treatment and 86[28.7%] had decompensated cirrhosis. SVR was achieved in 200[93.4%] out of 214 patients with compensated cirrhosis and in 76[88.3%] out of 86 patients with decompensated cirrhosis. At six months post- treatment, 10[3.33%] patients developed HCC,2[0.7%] in the compensated group and 8[2.7%] in the decompensated group, out of which 5[6.6%] patients had achieved SVR
Conclusion: The frequency of HCC following DAA agents is significant [3.3%] even after achieving SVR. Caution must be exercised in prescribing DAA agents to HCV patients keeping this complication of HCC in mind
RESUMO
Objective: To explore the affects of multi source feedback [MSF] on the attitudes of post-graduate trainees
Study Design: Prospective mixed method study
Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital [LGH] and Postgraduate Medical Institute [PGMI] Lahore, from Jul 2012 to Jun 2013
Material and Methods: This prospective mixed method study was conducted in the Department of Ophthalmology, LGH and PGMI, Lahore from July 2012 to June 2013. Participants were FCPS trainees and raters were the consultants, postgraduate trainees, house officers, nursing and paramedical staff. Modified mini-PAT Questionnaire was used. Survey I was followed by Survey II conducted after three months to determine any change. SPSS version 20 was used and paired sample t-test was applied to compare residents' mean scores. A p-value <0.05 was considered significant
Results: Mean score for question 1-12 was 4.00 +/- 0.16 and 4.43 +/- 0.14 for survey I [before intervention] and survey II [post intervention] respectively. Mean difference in overall score from two surveys was 0.43 +/- 0.06, which was statistically significant [p-value=0.000] showing overall improvement in scores from survey I to survey II. The highest mean score was awarded to question number 7 i.e. trainee respects patient's confidentiality and lowest to question 4 i.e. ability to manage time effectively, in both surveys
Conclusion: There was improvement in practice if MSF was delivered in accurate and timely manner with maintenance of the confidentiality and facilitative feedback