Safety, Tolerability, and Associated Side Effects of Direct- Acting Antivirals

Hepatitis C virus (HCV) infection is one of the major reasons for causing chronic hepatic disease worldwide. Treatment options for patients infected with chronic hepatitis C (CHC) have effectually ameliorated over the last few years. Now, various novel antiviral drugs have been licensed for its treatment. Introduction of direct-acting antivirals (DAAs) for HCV therapy represents a major advancement with regard to sustained virologic response (SVR) rates and associated adverse effect (AEs) profiling. Systematically, DAAs specifically impede different nonstructural proteins of HCV including NS3/4A protease, NS5A protein, and NS5B polymerase. In spite of those DAAs, therapy is confronting multiple challenges such as possible drug-drug interactions and severe side effects including liver failure. This chapter discusses the safety and tolerability of DAAs relevant to associated side effects emphasizing their clinical pharmacology. Considering the increased HCV prevalence rate and interpreting safety data of DAA regimens approved in the USA, Europe, Russia, Australia, and Japan, this chapter also presents the pre- and post-marketing safety data. Eventually, the important safety issues of drug–drug interactions (DDIs) have also been discussed in brief

Sub-retinal abscess as presenting feature of endogenous candida endophthalmitis

Background: Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of our knowledge, this is the first case report of Candida sub-retinal abscess as initial presentation in an immunocompetent patient. Case Presentation: A 32-year old, generally fit and well, female presented to us with gradually deteriorating vision in her right eye. Visual acuity was counting fingers in the right eye and, 20/30 in the left eye. Right eye fundus examination showed a full thickness, yellowish-white foveal lesion, and significant vitreous haze. Left eye examination was normal. Upon direct questioning, the patient disclosed history of backstreet abortion 3 weeks prior to the onset of her ocular symptoms. She underwent vitreous tap and intravitreal antibiotics (amphotericin B, 5 μg/0.5 ml). Vitreous culture showed profuse growth of Candida albicans. Because her condition was progressively deteriorating, she underwent 25 g vitrectomy plus repeat intravitreal amphotericin B under general anaesthesia. Three weeks post-vitrectomy, vitreous inflammation resolved completely, and the sub-retinal abscess healed with a macular scar formation. Over a follow-up of 4 years, no recurrences were observed. Conclusion: Our case highlights the importance of considering Candida albicans infection in the differential diagnosis of sub-retinal abscesses. Although immunocompromised states are traditionally identified as predisposing factors for fungal infections, fungal endogenous endophthalmitis can occur in healthy individuals as well

Essays on Income Shocks and Human Capital

Human capital is an important predictor of economic growth. A higher initial stock of human capital boosts productivity and encourages knowledge diffusion, thereby generating higher levels of growth. Given its importance in determining growth, it is imperative to study the mechanisms through which human capital accumulation is affected. This is particularly important in the context of low-income countries that perform poorly on indicators relating to the quality and quantity of human capital accumulation. What follows are three essays that explore the topic of human capital accumulation for developing countries. The chapters explore the implications of income shocks for human capital accumulation both at the household level as well as at the school level. The first chapter surveys the literature on income shocks and its impact on human capital. The second and third chapters explore the impact of income shocks, such as aggregate income shocks and idiosyncratic income shocks, on human capital accumulation at the school and household levels in selected low-income countries. These shocks impact human capital accumulation through two main effects: the purchasing power of households and the opportunity cost of schooling. The total impact on human capital investment therefore depends on which effect dominates. In the first chapter, I find that the regional context as well as the nature of the shock can be important in determining outcomes. While in Latin America, robust analysis points towards the substitution effect dominating, in the case of Asia and Africa the evidence largely points towards the dominance of the income effect. In this chapter, the various studies reviewed are summarized, and the methodologies are critically examined. In the second chapter, I use negative rainfall shocks as a proxy for agricultural income shocks in Pakistan where negative rainfall shocks are defined as rainfall that is lower than average. I study the impact of negative rainfall shocks on enrollment in public schools across the province of Punjab. Punjab proves to be an interesting setting given its high reliance on agriculture as well as the possibility to test the heterogeneity of the impact of rainfall due to its vast irrigation network. I find that, while crop yields and enrollment are, in general, adversely affected by negative rainfall shocks, the heterogeneity of the impact indicates that income may not be the only channel at play. In the third chapter, I use panel household survey data for Uganda to explore concerns regarding human capital accumulation in the context of idiosyncratic income shocks which can impact education expenditure allocation at the household level. I find some evidence suggesting that shocks impact total consumption as well as education expenditure. While some forms of financial instruments play a role in mitigating the negative impact of shocks, others do not. Furthermore, I explore the heterogeneity of the impact of shocks by certain selected characteristics of the household. In conclusion, income shocks have important implications for low-income countries’ human capital accumulation, which in turn is a cornerstone for their development and growth prospects. Negative income shocks can have adverse effects on human capital accumulation in the long-run, where their impact in the short-term can translate into long-term negative outcomes for human capital accumulation. Therefore, if developing economies want to improve their growth prospects, they need to invest in education and provide buffers so that income shocks do not hinder the accumulation of human capital

THE EFFECT OF COMMITMENT AND MOTIVATION ON HUMAN TALENT AND ITS CONTRIBUTION TO ORGANIZATIONAL PERFORMANCE

Human Capital has received major attention in present era research. Talent can be any individual who is committed, motivated and performs effectively. The successful utilization of individual capabilities can contribute positively to performance and enhance organizational image. It is very challenging to retain talent with in organization and keep them motivated. Most importantly they are one of the sources of competitive advantage. Talent drain and executive theft is the major challenge faced by the HR managers throughout the corporate world. Therefore it is important to retain them by keeping them motivated and committed to the organization. This research studies the effect of commitment and motivation on individual and how that contributes towards organizational performance. If employees perceive that their efforts are recognized by the organization they feel motivated and level of commitment will rise. Paper is based on conceptual study. In future empirical study will be conducted to test the conceptualized model.commitment, individual performance, motivation, organizational performance, talent.

Benefits of code-switching in language learning classroom at University of Education Lahore

Code-switching refers to the use of more than one language in a sentence or discourse. It is a natural commix that happens in utterances in bilingual and multilingual speakers reasoning one or more communal languages. Code-switching (CS) denotes an alteration that is recorded between more than one variation in language following in the context of a single conversation. In sociolinguistics, code-switching is considered not merely one element of social life but encircles the social strata of speakers’ social settings, linguistic variation and social variables. It is a linguistic strategy of bilingual or multilingual speakers. It is referred to as a “conversational scheme which is employed to constitute, cross or abolish group boundaries, to create, evoke or change interactive relation with their rights and commitments”. (Gal, 1988). In multilingual contexts like Pakistan, code-switching is a common phenomenon. It appears as a conscious choice of language teachers to promote second language (L2) learning and improve second language comprehension among L2 learners. This article highlights the benefits of code-switching in the course of learning, explores some of the aspects of code-switching and its effectiveness in increasing L2 comprehension among the students at UE

Multivariate Signal Denoising Based on Generic Multivariate Detrended Fluctuation Analysis

We propose a generic multivariate extension of detrended fluctuation analysis (DFA) that incorporates interchannel dependencies within input multichannel data to perform its long-range correlation analysis. We next demonstrate the utility of the proposed method within multivariate signal denoising problem. Particularly, our denosing approach first obtains data driven multiscale signal representation via multivariate variational mode decomposition (MVMD) method. Then, proposed multivariate extension of DFA (MDFA) is used to reject the predominantly noisy modes based on their randomness scores. The denoised signal is reconstructed using the remaining multichannel modes albeit after removal of the noise traces using the principal component analysis (PCA). The utility of our denoising method is demonstrated on a wide range of synthetic and real life signals

Decolourization and degradation of azo Dye, Synozol Red HF6BN, by Pleurotus ostreatus

The present paper focuses on the use of fungus, Pleurotus ostreatus, to decolorize and degrade azo dye, Synazol Red HF6BN. Decolorization study showed that P. ostreatus was able to decolorize 96% Synazol Red HF6BN in 24 days. It was also found that 94% Synazol Red HF6BN containing dye effluent was decolorized by P. ostreatus after 30 days of incubation at room temperature. The enzyme exhibited highest activity at 70°C and at pH 6.0. The enzyme activity was enhanced in the presence of metal cations. High performance liquid chromatography analysis confirmed that this fungal strain is capable of degrading Synazol Red HF6BN dye into metabolites. The observation of no zones of inhibition on agar plates and growth of Vigna radiata in the presence of dye extracted sample indicated that the fungal degraded dye metabolites are nontoxic to beneficial micro-flora and plant growth. Therefore, P. ostreatus has promising potential in colour removal from textile wastewater containing azo dyes.Key words:Azo dyes, decolorization, Pleurotus ostreatus, bioremediation

Comparison of choroidal thickness measurements between spectral-domain OCT and swept-source OCT in normal and diseased eyes

Purpose: Sub-foveal choroidal thickness (SFCT) is affected in many ocular diseases. The aim of this study was to compare SFCT measurements between Topcon 3D 2000 spectral-domain optical coherence tomography (SD-OCT) and Topcon swept-source OCT (SS-OCT), with different laser wavelengths, in normal and diseased populations.MATERIALS AND Methods: This was a prospective, cross-sectional, noninterventional study including 27 normal volunteers and 27 participants with retinal disease. OCT scans were performed sequentially and under standardized conditions using both SD-OCT and SS-OCT. The OCT scans were evaluated by two independent graders. Paired t-tests and intraclass correlation coefficients (ICCs) were used to assess the statistically significant difference between SFCT measurements as measured by the two devices.Results: Mean SFCT measurements for all 54 participants were 264.9±103.1 mum using SD-OCT (range: 47-470 mum) and 278.5±110.5 mum using SS-OCT (range: 56-502 mum), with an inter-device ICC of 0.850. Greater variability was noted in the diseased eyes. Inter-device ICCs were 0.870 (95% CI; 0.760-0.924) and 0.840 (95% CI; 0.654-0.930) for normal and diseased eyes, respectively. However, the difference was not statistically significant (P=0.132).CONCLUSION: Both machines reliably measure SFCT. Larger studies are needed to confirm these findings

Financial development, fiscal policy and economic growth: The role of institutional quality in Pakistan

The study examines the influence of financial development, fiscal policy , and institutional quality on Pakistan’s economic growth. We investigate whether financial development and or fiscal policies promote economic growth. We also analyse the effect of institutional quality on economic growth in Pakistan. We use time series data from 1985 - 2016 , and use GDP to proxy economic growth. We use unit - root tests to check for stationary of our sample. We perform a logarithmic transformation on the series to reduce outlier effects and use Autoregressive Distributed Lag (ARDL) Model . The results show that financial development and revenue have a positive impact on growth. Our study results implicate that sound, strategic, and result - oriented policies should be formulated to transform our institutions and financial sectors into the well organized, powerful, and trusted frameworks. These transformations will ensure efficient and productive utilization of savings