Impact of duration of therapy on side effect profile of anti-HCV protocol: A retrospective cohort study from two tertiary health facilities in Pakistan

Purpose: To evaluate the plausible risks and adverse effects related to the duration of therapy in hepatitis C (HCV) patients in Lahore, Pakistan.Method: A retrospective observational study involving 250 HCV patients who received combination therapy with ribavirin and interferon was conducted. The patients were segregated into two groups on the basis of duration of therapy (≤ 6 months and > 6 months). Adverse effect profiles of patients under treatment were collected using a pre-validated questionnaire and compared using Pearson’s Chi- Square Test/Chi-Square Goodness-of-Fit tests and unpaired t-test.Results: Patients who underwent treatment for ≤ 6 months frequently encountered side-effects such as GIT disturbance (23.77 %) and joint pains (29.63 %). Additionally, diabetes mellitus (27.86 %) and frequent injections (74.59 %) were the most commonly observed co-morbid condition and disease risk, respectively. On the other hand, in patients who underwent therapy for > 6 months, skin disorders (30.46 %) and gastric acidity (10.15 %) were the most frequently observed side-effects with less frequent reporting on co-morbid conditions and disease risk factors. Moreover, there was a significant reduction in body weight (p = 0.03), serum bilirubin (p = 0.0005), albumin (p = 0.003) and triglycerides (p = 0.006) levels due to longer duration of treatment.Conclusion: The data suggest that treatment-related risks are higher among HCV patients on shorter treatment duration whereas adverse events subside in patients on longer duration of therapy (>6 months). Changes in biochemical profile were also more evident in those receiving treatment for periods >6 months.Keywords: Interferon, Ribavirin, Side effects, Duration of therapy, Outcomes of therap

In vitro antibacterial activity and phytochemical analysis of hexane extract of Vicia sativa

Vicia sativa is traditionally used medicinal plant in skin infections, asthma, bronchitis, urinary diseases and also used as antiseptic, anti-poison, aphrodisiac, anti rheumatic and antipyretic. In the present study n-hexane extract of V. sativa was evaluated for the antibacterial activity against pathogenic bacteria Staphylococcus aureus, Bacillus atrophaeus, Escherichia coli and S. epidermidis by disc diffusion method. Minimum inhibitory concentration of the n-hexane extract against all bacteria was determined by broth dilution method. Preliminary phytochemical analysis and HPLC analysis showed the presence of a number of bioactive constituents which exhibits antibacterial activity. So the current study showed that V. sativa possesses the significant antibacterial activity

Hepatoprotective effect of aqeous methanolic extract of Rumex dentatus in paracetamol induced hepatotoxicity in mice

Rumex dentatus is well known plant of Polygonaceae family which is widely used in traditional medicine to treat gastrointestinal tract. R. dentatus at doses 250 and 500 mg/kg significance decreased (p<0.001) the elevated level of ALT, AST, ALP and bilirubin induced by paracetamol and results are comparable (p<0.001) with silymarin. The results were supported by histopathological investigations, phytochemical screening and detection of hepatoprotective active constituents e.g quercetin, kaempferol, myricetin by HPLC. So, it is concluded that R. dentatus has hepatoprotective effect against paracetamol liver damage in mice

Hepatitis C Treatment: current and future perspectives

Hepatitis C virus (HCV) is a member of Flaviviridae family and one of the major causes of liver disease. There are about 175 million HCV infected patients worldwide that constitute 3% of world's population. The main route of HCV transmission is parental however 90% intravenous drug users are at highest risk. Standard interferon and ribavirin remained a gold standard of chronic HCV treatment having 38-43% sustained virological response rates. Currently the standard therapy for HCV is pegylated interferon (PEG-INF) with ribavirin. This therapy achieves 50% sustained virological response (SVR) for genotype 1 and 80% for genotype 2 & 3. As pegylated interferon is expensive, standard interferon is still the main therapy for HCV treatment in under developed countries. On the other hand, studies showed that pegylated IFN and RBV therapy has severe side effects like hematological complications. Herbal medicines (laccase, proanthocyandin, Rhodiola kirilowii) are also being in use as a natural and alternative way for treatment of HCV but there is not a single significant report documented yet. Best SVR indicators are genotype 3 and 2, < 0.2 million IU/mL pretreatment viral load, rapid virological response (RVR) rate and age <40 years. New therapeutic approaches are under study like interferon related systems, modified forms of ribavirin, internal ribosome entry site (HCV IRES) inhibitors, NS3 and NS5a inhibitors, novel immunomodulators and specifically targeted anti-viral therapy for hepatitis C compounds. More remedial therapies include caspase inhibitors, anti-fibrotic agents, antibody treatment and vaccines

Scavenger receptor B1 facilitates the endocytosis of \u3ci\u3eEscherichia coli\u3c/i\u3e via TLR4 signaling in mammary gland infection

SCARB1 belongs to class B of Scavenger receptors (SRs) that are known to be involved in binding and endocytosis of various pathogens. SRs have emerging role in regulating innate immunity and host–pathogen interactions by acting in co-ordination with Toll-like receptors.Query Little is known about the function of SCARB1 in milk-derived mammary epithelial cells (MECs). This study reports the role of SCARB1 in infection and its potential association in TLR4 signaling on bacterial challenge in Goat mammary epithelial cells (GMECs). The novelty in the establishment of MEC culture lies in the method that aims to enhance the viability of the cells with intact characteristics upto a higher passage number. We represent MEC culture to be used as a potential infection model for deeper understanding of animal physiology especially around the mammary gland. On E.coli challenge the expression of SCARB1 was signifcant in induced GMECs at 6 h. Endoribonuclease-esiRNA based silencing of SCARB1 affects the expression of TLR4 and its pathways i.e. MyD88 and TRIF pathways on infection. Knockdown also affected the endocytosis of E.coli in GMECs demonstrating that E.coli uses SCARB1 function to gain entry in cells. Furthermore, we predict 3 unique protein structures of uncharacterized SCARB1 (Capra hircus) protein. Overall, we highlight SCARB1 as a main participant in host defence and its function in antibacterial advances to check mammary gland infections

Health and social impacts of open defecation on women: a systematic review

Background The significance of sanitation to safeguard human health is irrefutable and has important public health dimensions. Access to sanitation has been essential for human dignity, health and well-being. Despite 15 years of conjunctive efforts under the global action plans like Millennium Development Goals (MDGs), 2.3 billion people have no access to improved sanitation facilities (flush latrine or pit latrine) and nearly 892 million of the total world’s population is still practicing open defecation. Methods The study provides a systematic review of the published literature related to implications of open defecation that goes beyond the scope of addressing health outcomes by also investigating social outcomes associated with open defecation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was used to frame the review, empirical studies focusing upon open defecation in women aged 13–50 in low and middle income countries were included in the review. Research papers included in the review were assessed for quality using appropriate critical appraisal tools. In total 9 articles were included in the review; 5 of these related to health effects and 4 related to social effects of open defecation. Results The review identified 4 overarching themes; Health Impacts of open defecation, Increased risk of sexual exploitation, Threat to women’s privacy and dignity and Psychosocial stressors linked to open defecation, which clearly present a serious situation of poor sanitation in rural communities of Lower-Middle Income Countries (LMICs). The findings of the review identified that open defecation promotes poor health in women with long-term negative effects on their psychosocial well-being, however it is a poorly researched topic. Conclusion The health and social needs of women and girls remain largely unmet and often side-lined in circumstances where toilets in homes are not available. Further research is critically required to comprehend the generalizability of effects of open defecation on girls and women

Exploring the Effects of Teacher Education on Teacher Quality and Student Achievement in Pakistan

Amongst a variety of resources present, a teacher is considered to be the primary tool for enhancing the process of student learning. To be able to act as effective “agents of change” for their student, the teacher needs to enhance personal and pedagogical skills which can primarily be achieved through teacher education. This paper aims to be contributing to a broader understanding of language teacher education in the context of Pakistan. Employing a case study research method, the present study explored the ways in which teachers’ pre-service education affects teacher quality and student learning. A total of two tertiary-level novice teachers and seven first year undergraduate students from a public sector university in Pakistan participated in this study. Data were generated using teacher observation, teacher and student interviews, document analysis including teacher lesson plans and diary, course outlines and students’ work samples. Thematic analysis of the data showed contradictory results between the classroom practices of the teachers and their effect on students’ learning. The teacher with pre-service education used appropriate methodology and made well informed decisions which resulted in improvement of students’ learning. In contrast, the other teacher used traditional modes of teaching. Though happy with the classes, students found no practical use of what they learnt in the lessons. The study concludes that pre-service teacher education should to be made compulsory for individuals who wish to become teachers

Exploring the Effects of Teacher Education on Teacher Quality and Student Achievement in Pakistan

Amongst a variety of resources present, a teacher is considered to be the primary tool for enhancing the process of student learning. To be able to act as effective “agents of change” for their student, the teacher needs to enhance personal and pedagogical skills which can primarily be achieved through teacher education. This paper aims to be contributing to a broader understanding of language teacher education in the context of Pakistan. Employing a case study research method, the present study explored the ways in which teachers’ pre-service education affects teacher quality and student learning. A total of two tertiary-level novice teachers and seven first year undergraduate students from a public sector university in Pakistan participated in this study. Data were generated using teacher observation, teacher and student interviews, document analysis including teacher lesson plans and diary, course outlines and students’ work samples. Thematic analysis of the data showed contradictory results between the classroom practices of the teachers and their effect on students’ learning. The teacher with pre-service education used appropriate methodology and made well informed decisions which resulted in improvement of students’ learning. In contrast, the other teacher used traditional modes of teaching. Though happy with the classes, students found no practical use of what they learnt in the lessons. The study concludes that pre-service teacher education should to be made compulsory for individuals who wish to become teachers

QuackFinder: A Probabilistic Approach

Quackery is profoundly rooted in rural areas, , but cities are also considerably affected. Countries, whether developed or developing, are experiencing this curse. Quackery is one of the primary reasons for the recent AIDS epidemic among children in Pakistan. In this research, we have conducted two separate surveys to study the causes of quackery. The sample sizes for the public and physicians were 157 and 58, respectively. The first questionnaire was handed to the respondents based in Pakistan to reveal the reasons behind the quackery and its widespread existence. The second questionnaire was designed to examine physicians' perceptions of quackery. The data were analyzed and we physicians having permit granted by the PMDC (Pakistan Medical and Dental Council) should be placed in doctor's clinics to help people distinguish between quacks and physicians. According to the conducted survey government may be held accountable behind the spread of quackery whereas lack of awareness from the media and high illiteracy rates are also the lead causes. Moreover, according to doctor’s perspective, awareness campaigns will surely help us to overcome this menace. It is not simple for common people to differentiate a quack from a doctor. To assist the common person, we have created a prototype android app called "Quack Finder"' based on our survey outcomes to predict whether an individual is a quack or a doctor. Full Tex

QuackFinder: A Probabilistic Approach

Quackery is profoundly rooted in rural areas, , but cities are also considerably affected. Countries, whether developed or developing, are experiencing this curse. Quackery is one of the primary reasons for the recent AIDS epidemic among children in Pakistan. In this research, we have conducted two separate surveys to study the causes of quackery. The sample sizes for the public and physicians were 157 and 58, respectively. The first questionnaire was handed to the respondents based in Pakistan to reveal the reasons behind the quackery and its widespread existence. The second questionnaire was designed to examine physicians' perceptions of quackery. The data were analyzed and we physicians having permit granted by the PMDC (Pakistan Medical and Dental Council) should be placed in doctor's clinics to help people distinguish between quacks and physicians. According to the conducted survey government may be held accountable behind the spread of quackery whereas lack of awareness from the media and high illiteracy rates are also the lead causes. Moreover, according to doctor’s perspective, awareness campaigns will surely help us to overcome this menace. It is not simple for common people to differentiate a quack from a doctor. To assist the common person, we have created a prototype android app called "Quack Finder"' based on our survey outcomes to predict whether an individual is a quack or a doctor. Full Tex