Correlation between platelet count and outcome of chronic HCV patients treated with direct-acting antivirals

Background: Egypt has the highest prevalence of chronic hepatitis C virus (HCV) infection. The direct acting anti-virus (DAAs) are available, with a reported 95% sustained virological response after treatment for 12 weeks (12w-SVR). Objectives: The current study aimed to assess the correlation between platelet count and the DAAs therapy outcome in chronic HCV (CHC) patients. Patients and methods: three hundred CHC patients, Child–Pugh grade A, both naïve and treatment experienced patients were enrolled in this study, from outpatient Clinic, Department of Gastroenterology, Hepatology and Tropical medicine, Qena university hospital, Qena, Egypt, treated with DAAs for 12 weeks, either dual or triple therapy, according to criteria recommended by the national committee for chronic viral hepatitis (NCCVH). Patients categorized into three groups: (1) Group I (non-thrombocytopenic group): included 100 CHC patients with platelet count ≥ 150 (109/L); (2) Group II (mild thrombocytopenic group): included 100 CHC patients with platelet count 100-149 (109/L); (3) Group III (moderate thrombocytopenia): included 100 CHC patients with platelet count 50–99 (109/L). Results: The Overall CHC patient's mean age were (48.2 ± 11), 226 (75.33%) were males and 74 (24.67%) were females. 97.6% (293/300)of CHC patients attainedSVR; 97 % in (Group I), and 98 % in both (Group II), and (Group III), after 12 weeks DAAs therapy with no significant difference between groups. Conclusion: both DAAs treatment modalities were efficient in the eradication of HCV; however, thrombocytopenia in CHC patients does not affect the DAAs therapy outcome

Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism

In the treatment of pulmonary embolism (PE) two groups of patients are traditionally identified, namely the hemodynamically stable and instable groups. However, in the large group of normotensive patients with PE, there seems to be a subgroup of patients with an increased risk of an adverse outcome, which might benefit from more aggressive therapy than the current standard therapy with anticoagulants. Risk stratification is a commonly used method to define subgroups of patients with either a high or low risk of an adverse outcome. In this review the clinical parameters and biomarkers of myocardial injury and right ventricular dysfunction (RVD) that have been suggested to play an important role in the risk stratification of PE are described first. Secondly, the use of more direct imaging techniques like echocardiography and CT in the assessment of RVD are discussed, followed by a brief outline of new imaging techniques. Finally, two risk stratification models are proposed, combining the markers of RVD with cardiac biomarkers of ischemia to define whether patients should be admitted to the intensive care unit (ICU) and/or be given thrombolysis, admitted to the medical ward, or be safely treated at home with anticoagulant therapy

Determinants of Obtaining COVID-19 Vaccination among Health Care Workers with Access to Free COVID-19 Vaccination: A Cross-Sectional Study

Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants of the attitudes of healthcare workers (HCWs) to receiving or refusing to receive the vaccine. Methods: The current study adopted an interviewed questionnaire between June and August 2021. A total of 341 HCWs currently working at Assiut University hospitals offered to receive the vaccine were included. Results: Only half of the HCWs (42%) accepted the COVID-19 vaccine. The most common reason that motivated the HCWs was being more susceptible than others to infection (71.8%). On other hand, the common reasons for refusing included: previously contracted the virus (64.8%); did not have time (58.8%); warned by a doctor not to take it (53.8%). Nearly one-third of nonaccepting HCWs depended on television, the Internet, and friends who refused the vaccine for information (p < 0.05). In the final multivariate regression model, there were six significant predictors: sex, job category, chronic disease, being vaccinated for influenza, and using Assiut University hospital staff and the Ministry of Health as sources of information (p < 0.05). Conclusion: Misinformation and negative conceptions are still barriers against achieving the desired rate of vaccination, especially for vulnerable groups such as HCWs