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BACKGROUND: Globally, 80 million people are suffering from chronic Hepatitis C virus (HCV) infection. Sofosbuvir ribavirin-based anti-HCV therapy is associated with anemia and other adverse effects. Polymorphisms of Inosine triphosphatase (ITPA) gene may cause functional impairment in the Inosine triphosphate pyrophosphatase enzyme, resulting in enhanced sustained viral response (SVR) and protection from ribavirin-associated anemia in patients on therapy. The study objective was to investigate the effect of Inosine triphosphatase gene polymorphism on SVR achievement, hemoglobin decline and ribavirin dose reduction in patients on therapy. METHODS: This prospective cohort study was of 170 hepatitis C infected patients received 6-month sofosbuvir ribavirin therapy. Patient viral load, reduction in ribavirin amount, liver function test, and complete blood count were noted monthly. Inosine triphosphatase variants rs1127354 and rs7270101 were assessed through the restriction fragment length polymorphism and confirmed using Sanger sequencing. The impact of polymorphism on cumulative reduction of ribavirin, and anti-HCV therapy outcome were studied. RESULTS: A total of 74.3% of patients had ITPA rs1127354 CC genotype, 25.7% were CA and AA 0%. The frequency of ITPA genotype rs7270101-AA was 95%, AC 5%, and CC was 0%. ITPA rs1127354-CA had a notably positive impact on SVR achievement with a zero-relapse rate. ITPA rs1127354-CA genotype was significantly (P Ë0.05) protective against ≥ 2 g/dl Hb reduction from baseline to 1st, 2nd and 6th months of therapy. During treatment, Hb reduction ≥ 10 g/dl was frequently observed in rs1127354-CC genotype and rs7270101-AA genotype patients. Ribavirin dose reduction was significantly (P Ë0.05) high in rs1127354-CC genotype as compared to genotype CA whereas no significant difference was observed in ribavirin dose reduction in rs7270101 AA and non-AA genotype. Patient baseline characteristics such as age, body mass index, rs1127354-CC genotype, and baseline Hb were significantly associated with significant Hb reduction. CONCLUSION: Pretreatment evaluation of ITPA polymorphism can be a diagnostic tool to find out patients at risk of anemia and improve treatment adherence. ITPA genotype rs1127354-CA contributes to improved compliance with ribavirin dose and protects against hemoglobin decline in HCV patients while taking ribavirin-based therapy. However, ITPA rs1127354, rs7270101 polymorphism have no significant impact on SVR achievement.
Assuntos
Anemia , Hepatite C Crônica , Hepatite C , Humanos , Ribavirina/efeitos adversos , Sofosbuvir/efeitos adversos , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/genética , Antivirais/efeitos adversos , Inosina Trifosfatase , Hepacivirus/genética , Estudos Prospectivos , Polimorfismo de Nucleotídeo Único , Pirofosfatases/genética , Pirofosfatases/uso terapêutico , Anemia/induzido quimicamente , Anemia/genética , Hepatite C/tratamento farmacológico , Genótipo , Hemoglobinas/genética , Resultado do TratamentoRESUMO
The high data rates detail that internet-connected devices have been increasing exponentially. Cognitive radio (CR) is an auspicious technology used to address the resource shortage issue in wireless IoT networks. Resource optimization is considered a non-convex and nondeterministic polynomial (NP) complete problem within CR-based Internet of Things (IoT) networks (CR-IoT). Moreover, the combined optimization of conflicting objectives is a challenging issue in CR-IoT networks. In this paper, energy efficiency (EE) and spectral efficiency (SE) are considered as conflicting optimization objectives. This research work proposed a hybrid tabu search-based stimulated algorithm (HTSA) in order to achieve Pareto optimality between EE and SE. In addition, the fuzzy-based decision is employed to achieve better Pareto optimality. The performance of the proposed HTSA approach is analyzed using different resource allocation parameters and validated through simulation results.
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Internet of Things (IoT) devices usage is increasing exponentially with the spread of the internet. With the increasing capacity of data on IoT devices, these devices are becoming venerable to malware attacks; therefore, malware detection becomes an important issue in IoT devices. An effective, reliable, and time-efficient mechanism is required for the identification of sophisticated malware. Researchers have proposed multiple methods for malware detection in recent years, however, accurate detection remains a challenge. We propose a deep learning-based ensemble classification method for the detection of malware in IoT devices. It uses a three steps approach; in the first step, data is preprocessed using scaling, normalization, and de-noising, whereas in the second step, features are selected and one hot encoding is applied followed by the ensemble classifier based on CNN and LSTM outputs for detection of malware. We have compared results with the state-of-the-art methods and our proposed method outperforms the existing methods on standard datasets with an average accuracy of 99.5%.
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Aprendizado Profundo , Internet das Coisas , Humanos , Internet , PesquisadoresRESUMO
OBJECTIVE: To assess the effectiveness of clarithromycin based standard triple therapy verses levofloxacin based first line therapy against Helicobacter pylori infection. METHODS: This prospective observational study was performed at Akhter Saeed Trust Teaching Hospital, Lahore, from May 2016 to 31st May 2017 and comprised of all patients with positive H. pylori, confirmed by gastroscopic biopsy; fulfill the inclusion criteria of this study. Patients were divided into two groups (Group A and Group B). Group A received clarithromycin 500mg, amoxicillin 1g and omeprazole 20mg twice a day for two weeks. In group B levofloxacin 250mg was replaced by clarithromycin whereas rests of medicines remain the same. Patients were followed up at end of first week, second week and at end of treatment to record any adverse effects and cure rate. Data was analyzed by using SPSS version 24.0 and MINITAB V.16.. RESULTS: Out of 300 enrolled patients (150 patients in each group), 123 (87.85%) patients cured in group A whereas 134 (92.4%) patients cured in group B. Both treatment regimens were almost equally effective in our population with no statistically significant difference in outcome. Significantly less adverse effects were observed in patients having levofloxacin as compared to standard triple therapy. CONCLUSIONS: Effectiveness of both standard triple therapy and alternate triple therapy were found satisfactory to be used for treatment in our region. Levofloxacin based alternate therapy is safer to the patients. It can be used in conditions where adverse effects caused by standard therapy are unbearable.