Nationwide hepatitis C virus screening and treatment of adolescents in Egyptian schools.

Until 2018, Egypt had the highest prevalence of hepatitis C virus (HCV) infection globally, affecting approximately 7% of the population. Despite efforts in diagnosis and treatment since 2006, nearly 2 million individuals with chronic HCV infection had yet to be diagnosed as of early 2018. In December, 2018, a mass HCV screening campaign for adolescents aged 15-18 years was initiated. Among 3 024 325 adolescents screened, the HCV antibody seroprevalence was 11 477 (0·38%), of whom 8187 (78·7%) were HCV RNA-positive. Sustained virological response 12 weeks after completion of treatment (SVR12) was attained by 7327 (99·6%) adolescents with a fixed-dose combination of generic ledipasvir 90 mg plus sofosbuvir 400 mg. Although mass screening in this age group might not be regularly adopted by many health systems and its cost-effectiveness might be lower than the screening of adults and high-risk groups (eg, patients on haemodialysis, people who inject drugs), breaking the chain of transmission in younger populations should lead to a reduction in HCV incidence and complications, and hasten the elimination of the disease.

Sociodemographic and clinical characteristics of patients with recurrent psychiatric readmissions in Qatar.

OBJECTIVE: To examine the sociodemographic and clinical characteristics of psychiatric patients with recurrent psychiatric readmissions (RPR). METHODS: A retrospective study was conducted at Hamad General Hospital in Qatar on psychiatric patients with recurrent readmissions from August 2018 to January 2019. RESULTS: Of 380 psychiatric patients admitted during the study period, 40 (10.5%) were readmitted within 30 days of discharge. Most of the patients who were readmitted were single, male and unemployed. Psychotic spectrum disorder was the most frequent psychiatric condition and was diagnosed in 18 (45%) patients. A total of 30% of the patients were receiving treatment with anti-psychotics, and a similar number received more than one medication. Most patients showed poor or no compliance. Only 12.5% of patients stayed in the hospital for more than 5 weeks in their last admission during the study period. CONCLUSIONS: Poor compliance, male sex and single status were the most common demographic and clinical features of patients with RPR. Post-discharge psychiatric care should be tailored to meet the requirements of patients prone to RPR.

Medical treatment of inflammatory punctual stenosis monitored by anterior segment optical coherence tomography.

AIM: To evaluate the role of medical treatment in the management of inflammatory punctum stenosis guided by spectral domain anterior segment optical coherence tomography (OCT). METHODS: This prospective study included 60 patients complaining of epiphora due to inflammatory punctual stenosis. They were divided into two groups: Group A (30 patients) treated with a combination of preservative free hydrocortisone sodium phosphate 3.35 mg/mL eye drops, and preservative free artificial tears based on sodium hyaluronate, polyethylene and propylene Glycol; Group B (30 patients) treated with the same preservative free artificial tears only. Thirty normal subjects were included for comparison of pre-treatment anatomical parameters. Before starting treatment, all patients underwent anterior segment assessment including slit lamp examination, measurement of intraocular pressure (IOP), fluorescein dye disappearance test, and measurement of the outer punctum diameter (OPD) by Spectral domain anterior segment OCT. All assessments were repeated at each follow up done at 1 and 3mo later, together with subjective evaluation of patient's satisfaction of the treatment outcome by simple rating questionnaire. RESULTS: Punctual diameter increased significantly with treatment in both groups (P<0.0001); although the widening was more in Group A as compared to group B (16.2% vs 8% of the original punctual size, mean difference of 28.933 µm, P=0.0076). Subjective satisfaction with treatment outcome was also better in group A (70% vs 40%, Chi-square P=0.0397). CONCLUSION: A combination of preservative free steroid eye drops and artificial tears causes significant widening of inflammed stenotic punctae and improvement of the associated epiphora.