Rising burden of Hepatitis C Virus in hemodialysis patients

<p>Abstract</p> <p>Aim</p> <p>High prevalence of Hepatitis C virus (HCV) has been reported among the dialysis patients throughout the world. No serious efforts were taken to investigate HCV in patients undergoing hemodialysis (HD) treatment who are at great increased risk to HCV. HCV genotypes are important in the study of epidemiology, pathogenesis and reaction to antiviral therapy. This study was performed to investigate the prevalence of active HCV infection, HCV genotypes and to assess risk factors associated with HCV genotype infection in HD patients of Khyber Pakhtunkhwa as well as comparing this prevalence data with past studies in Pakistan.</p> <p>Methods</p> <p>Polymerase chain reaction was performed for HCV RNA detection and genotyping in 384 HD patients. The data obtained was compared with available past studies from Pakistan.</p> <p>Results</p> <p>Anti HCV antibodies were observed in 112 (29.2%), of whom 90 (80.4%) were HCV RNA positive. In rest of the anti HCV negative patients, HCV RNA was detected in 16 (5.9%) patients. The dominant HCV genotypes in HCV infected HD patients were found to be 3a (n = 36), 3b (n = 20), 1a (n = 16), 2a (n = 10), 2b (n = 2), 1b (n = 4), 4a (n = 2), untypeable (n = 10) and mixed (n = 12) genotype.</p> <p>Conclusion</p> <p>This study suggesting that i) the prevalence of HCV does not differentiate between past and present infection and continued to be elevated ii) HD patients may be a risk for HCV due to the involvement of multiple routes of infections especially poor blood screening of transfused blood and low standard of dialysis procedures in Pakistan and iii) need to apply infection control practice.</p

Spontaneous perforation of urinary bladder secondary to Candida cystitis: Acute abdomen of urologic origin

Background: Spontaneous urinary bladder perforation is a rare event; presentation as an acute abdomen is rarer still. Fungal cystitis has seldom, and Candida albicans cystitis has never, to our knowledge, been reported as a cause of perforation. Methods: Case report and literature review. Results: A 70-year-old woman with diabetes mellitus presented with an acute abdomen and urinary symptoms. A diagnosis of an intraperitoneal bladder perforation was made during emergency operation; culture of the peritoneal fluid and urine yielded Candida albicans. The initial high blood urea nitrogen and serum creatinine concentrations mimicked acute renal failure but were caused by urine absorption across the peritoneum. The patient was treated successfully with emergency laparotomy, a three-week course of fluconazole, and a five-day course of bladder irrigation with amphotericin B. Conclusions: Spontaneous urinary bladder perforation secondary to Candida cystitis should be considered as a possible cause of acute abdomen, especially when the biochemical profile suggests urine absorption and yeast is reported in the urinalysis of an immunocompromised patient. © 2008 Mary Ann Liebert, Inc

Investigating types and causes of domestic violence against women and identifying strategies to deal with it from the perspective of victims

Domestic violence is a global plague that destroys families and societies and threatens people’s health. The present study was conducted in the city of Rasht to investigate types and causes of domestic violence along with coping strategies to deal with it from the perspective of its victims. The present cross-sectional study was conducted on 110 women referring to family courts in Rasht during the year 2014. The samples were selected using convenience sampling method. The data were collected via a questionnaire covering demographic characteristics of the subjects and the World Health Organization Violence against Women Instrument. Using the SPSS-18 software, the collected data were analyzed through descriptive statistics and repeated measures ANOVA (p<0.05). The average age of the participants was 33.94±6.92 years and the most prevalent type of domestic violence was psychological violence (44.13), including shouting and swearing as the most common forms (n=34; 61.8). From the perspective of women victims of domestic violence, the main causes of domestic violence were economic problems (47.3) and drug/alcohol abuse (43.6). A majority of the examined women (68.09) believed that logical talk is a good strategy to reduce domestic violence. Considering the high rate of domestic violence against Iranian women, preventive measures must be included in mental health policies and resources must be dedicated to reduce the rate of violence against women. It is also important to identify the causes of violence and strategies to deal with it. © RJPT All right reserved