Effectiveness Of Sofosbuvir And Ribavirin In Hepatitis C Genotype 3 Relapsers.

BACKGROUND: Combination of DAAs, Sofosbuvir and Ribavirin has been known as an effective treatment for HCV genotype 3. The aim of our study is to assess the efficacy of Sofosbuvir and Ribavirin in relapsed HCV genotype 3 patients. METHODS: A cross-sectional retrospective analysis of hospital records between January 2015 and December 2016. Data was taken of only those patients who were followed for one year. A total of 193 cases were included in this study who were HCV genotype 3 relapsers and out of these 28 patients failed to be followed. Data was entered and analysed in IBM SPSS software package 23. RESULTS: Out of the total 193 cases, 74.1% of cases achieved RVR at 4 weeks of therapy. ETR was achieved by 91.2% cases, while 8.8% of cases were non-responders. There was statistical significance in gender achieving ETR with a p-value of .008. 84.5% of cases achieved SVR-12. Statistical significance was noted between haemoglobin levels at presentation and 4 weeks follow-up with a p-value <0.005, and also between 4 weeks and 12 weeks follow-up with a p-value <0.005. Statistical significance was also found between age and PCR at 4 weeks (p-value of .002), age and PCR at 24 weeks (p-value of .051) and between ALT levels and PCR at 4, 12 and 24 weeks follow up (p-value <0.005). At 1-year follow-up, 79.3% of cases achieved a negative PCR, 28 patients failed to be followed, 6.2% of cases had a positive PCR. 5.5% of cases of the total 163 SVR cases had a relapse at 1 year. CONCLUSIONS: HCV genotype 3 patients can benefit from Sofosbuvir and Ribavirin. With the SVR of more than 80%, this combination is cost-effective and safe. Treatment duration should be dependent on RVR and viral load at 4 weeks follow-up.

The Urdu Version Of The Safety Attitude Questionnaire (Saq) For Inpatient Settings In Pakistan: Psychometric Properties And Baseline Data.

BACKGROUND: This study aimed to test the psychometric properties of the Urdu version of the Safety Attitudes Questionnaire for inpatient settings in Pakistan. METHODS: The SAQ short form (inpatient version) was translated with the back-translation technique into Urdu. The SAQ-Urdu was administered in three teaching hospitals in Pakistan to a sample of 483 front line healthcare personnel from August 2016 through December 2017. Confirmatory factor analysis was performed to test the factor structure of the responses. Cronbach's alphas and correlation coefficients were computed. Mean and percentage agreement scores for items were reported. RESULTS: The response rate was 75%. Goodness-of-fit indices from the confirmatory factor analysis showed a reasonable model fit (χ2=213.27, df=125, p<0.001; CFI 0.94, RMSEA 0.044). Cronbach's alphas of survey factors (teamwork climate, safety climate, job satisfaction, perceptions of management, and working conditions) ranged from 0.71 to 0.87. In terms of mean percentage agreement scores, substantial variability was found at the clinical unit level. CONCLUSIONS: The Urdu version of the SAQ showed satisfactory internal psychometric properties. The attitudes around patient safety considerably vary and indicate a need for improvement.

Clozapine Can Be the Good Option in Resistant Mania.

Bipolar mood disorder is a mental disorder with a lifetime prevalence rate of about 1% in the general population and there are still a proportion of individuals who suffer from bipolar mood disorders that are resistant to standard treatment. Reporting clozapine responsive mania that was not responding to two previous consecutive atypical antipsychotics and one typical antipsychotic was aimed at. A 17-year-old male manic patient was admitted into the psychiatry inpatient department and was nonresponsive to Risperidone 12 mg daily for 4 weeks, Olanzapine 30 mg daily for 3 weeks, and Haloperidol 30 mg daily for 3 weeks, along with valproate preparation 1500 mg daily. He was started on clozapine as he was nonresponsive to Lithium in previous episodes and did not consent to starting Electroconvulsive Therapy (ECT). He responded adequately to 100 mg clozapine and 1500 mg valproate preparation and remission happened within 2 weeks of starting clozapine. Clozapine can be a good option for resistant mania and further RCT based evidences will strengthen the options in treating resistant mania.