Comparative safety and efficacy of conventional interferon versus pegylated-interferon based therapy for HCV: A retrospective cohort study from Gujranwala, Pakistan.

Numerous studies on risk factors, clinical presentation and treatment of hepatitis C are known to the world. However, no data is available about the safety and efficacy of anti-hepatitis C therapy among the patients of Gujranwala, Pakistan. This retrospective study compared two dosage forms of interferon; conventional interferon (IR) and Pegylated interferon (PIR) in 370 Hepatitis C patients selected through non probability convenient sampling technique. Clinical data were collected related to therapy outcomes at the start of therapy, after each follow up and at the end of therapy. The study indicated that HCV 3 was the most prevalent genotype of hepatitis C. Main side effects associated with therapies were pain at injection site (PIR; 49%, IR; 48%), inflammation at injection site (PIR; 34%, IR; 48%), fever (PIR; 56.12%, IR; 61.5%), myalgia (PIR; 24.5%,IR; 22.99%), malaise (PIR; 7.14%, IR; 5.75%), anorexia (PIR; 46%, IR; 39%), vomiting (PIR; 43%, IR; 41%), irritability (PIR; 4%, IR; 11.5%) and impaired concentration (PIR; 13%, IR; 21). The sustained viral response rate was significantly better in PIR group as compared to IR group (PIR; 80.61%, IR; 66.67%). In conclusion Pegylated interferon based therapy showed better clinical response with less adverse events as compared to conventional interferon based therapy. However, there is dire need to shift from these intravenous dosage forms to relatively new oral dosage forms for the treatment of hepatitis C to further improve clinical outcome and minimize the risks of adverse events.

Do parents have knowledge of first aid management of burns in their children? A hospital based survey.

OBJECTIVE: To ascertain knowledge of first aid among parents of children suffering from burns. METHODS: The cross-sectional study was conducted at Mayo Hospital, Lahore, Pakistan, from July 2017 to January 2018, and comprised parents of patients in the paediatric burns unit. Questionnaires were filled by the duty doctor after interviewing parents, and data was collected regarding first aid, application of traditional remedies and demographic details. Optimal knowledge was defined as parent's knowledge of application of tap water on burns as first aid. SPSS 20 was used for data analysis . RESULTS: There were parents of 310 patients who had a mean total body surface area of burns of 25.11}13.80%. All (100%) accidents had occurred at home. All (100%) parents had removed their children from heat and electric source immediately after the accident, while 282(91%) stripped their children of their clothes. Only 41(13.2%) parents irrigated the burn area with tap water and 93(30%) applied traditional remedies. Further, 21(6.8%) parents had covered the burnt area with sterile dressing, while 25(8.1%) had covered the child to avoid hypothermia. One (0.3 2%) parent had attended a first aid course, while 13(4.2%) had knowledge of first aid because of previous history of a child having suffered from burns. Optimal knowledge wasstatistically associated with previous knowledge of first aid (p=0.0001), level of education of the parent (p=0.003) and monthly income (p=0.01). CONCLUSIONS: The knowledge of first aid among parents was found to be inadequate and there was an urgent need to introduce campaigns focussing on prevention and first aid to manage burns, especially among illiterate and poor classes.

Duodenal Perforation due to Ingested Partial Denture.

Ingestion of foreign bodies including dentures can be a cause of morbidity and mortality. We report a case of poor-fit denture in an elderly male with pulmonary and musculoskeletal comorbidities, who presented as an acute abdomen. The pin attached to the denture caused perforation of first part of duodenum. The only positive finding prior to surgery was a radiopaque density in the abdominal radiograph of the patient and air under the diaphragm. It is important for all the surgeons dealing with acute care patients to be aware of different designs and constructions of dentures.

Penile Shaft Strangulation with Wrought Iron Metallic Pipe.

Penile strangulation due to any solid encircling ornament or metal is rarely reported. Venous outflow obstruction due to any constricting item around the shaft leads to venous congestion, urinary obstruction, and rarely gangrene of the penile shaft skin. We report a case presenting with penile near-strangulation due to iron-lead metallic junction pipe which was cut using a heavy electric metal cutter.

Evaluation of medication use in Malaysian predialysis patients.

Chronic kidney disease (CKD) patients suffer from multiple comorbidities and complications as a cause or consequence of kidney disease. Information regarding medication- prescribing patterns in predialysis patients is sparse. We conducted a retrospective study to evaluate the medication prescription patterns among predialysis patients. Medical records (both paper based and computerized) of patients at CKD Resource Centre, Hospital Universiti Sains Malaysia, were reviewed. A total of 615 eligible cases were included in the study. The mean number of medications prescribed per patient was 8.22 ± 2.81, and medication use was correlated to the renal function (stage 3a < stage 3b < stage 4 < stage 5; P <0.001). The top three prescribed medication groups were found to be lipid-lowering agents, calcium channel blockers, and antiplatelet agents. Some medication classes such as nonaluminum/noncalcium phosphate binders, erythropoietin-stimulating agents, and renin-angiotensin-aldosterone system blockers, particularly in advanced stage, were found to be underutilized. In conclusion, predialysis patients are prescribed a large number of medications. Our findings highlight the need for assessing the impact of current medication-prescribing patterns on morbidity and mortality rates in Malaysian predialysis population.