<p><strong>INTRODUCTION: </strong>The present study was aimed to determine the prevalence and risk factors of GSD among a sample of general population in Karachi, South Pakistan.</p><p><strong>METHODOLOGY: </strong>A multistage random sampling method was employed on 30 clusters, where 60 subjects of age&gt;=25 years were randomly recruited from the study population from June 2013 till March 2015. Finally, data was analyzed and logistic regression models were used to find the correlation between selected variables and gallstone disease.</p><p><strong>RESULTS: </strong>It was found that 184 patients had echogenic mass with shadowing on ultrasonography; yielding a prevalence of 10.2% for gallstones in the study participants. The occurrence was higher in females (14.8%) than in male participants (5.7%). Further, participants over 40 years of age and single, widow/separated subjects had higher incidence of gallstones than married individuals. Moreover, an indirect correlation was obtained with daily physical activity, consumption of fruits, vegetables and fish with development of GD.</p><p><strong>CONCLUSION: </strong>It can be evaluated that daily physical activity, female gender, increasing age and marital status play an important role in progression of GSD. Understanding pathogenesis and physiological mechanism involved in GSD can help to determine therapeutic options other than surgical treatment.</p>

Background: Documentation of the effectiveness of sofosbuvir and ribavirin with or without pegylated interferon alfa for hepatitis C virus Genotype 3 (HCV GT3) is limited in a real world setting.Objectives: The present study aimed at examining the outcome of the above therapy in a real world setting. Methods: Dual therapy of sofosbuvir and ribavirin was given for 24 weeks and triple therapy with additional pegylated interferon for 12 weeks. Patients received dual therapy when there was unwillingness to take interferon or interferon ineligibility.Results: In this analysis, 241 patients were included, of whom 175 were treated with dual and 66 with triple therapy. The mean age of the patients was 46.6 years, ranging from 20 to 72, and 136 (56.4%) were male. Clinical cirrhosis was present in 151 (62.7%) patients, and 98 (40.7%) had treatment experience. HCV RNA became negative in 225 (93.3%) patients at week 4 of the treatment. End of treatment virologic response was observed in 221 (91.7%) patients, and 199 (82.6%) had sustained virologic response 12 weeks post treatment (SVR12). Undetectable HCV RNA at week 4 was an independent parameter predicting SVR12 (P = 0.001). SVR12 was achieved in 143 (81.7%) patients treated with dual therapy and 56 (84.8%) with triple therapy (P = 0.567). Prior HCV treatment status and presence or absence of cirrhosis did not significantly affect the outcome between the 2 treatment groups. Conclusions:Treatment of HCV GT3 infection with the sofosbuvir and ribavirin with or without PEG-IFNα achieved durable responses in a significant number of cases in a real world setting.

There is a need to improve the effectiveness of radiotherapy (RT) in hepatocellular carcinoma (HCC). Therefore, the purpose of this study was to explore the efficacy and toxicity of the anti-microtubule agent Vinorelbine as a radiosensitizer in HCC. The radio sensitivity of 16 HCC patient-derived xenograft (PDX) models was determined by quantifying the survival fraction following irradiation in vitro, and Vinorelbine radio sensitization was determined by clonogenic assay. Ectopic HCC xenografts were treated with a single dose of 8 Gy irradiation and twice-weekly 3 mg/kg Vinorelbine. Tumor growth and changes in the proteins involved in DNA repair, angiogenesis, tumor cell proliferation, and survival were assessed, and the 3/16 (18.75%), 7/16 (43.75%), and 6/16 (37.5%) HCC lines were classified as sensitive, moderately sensitive, and resistant, respectively. The combination of RT and Vinorelbine significantly inhibited tumor growth, DNA repair proteins, angiogenesis, and cell proliferation, and promoted more apoptosis compared with RT or Vinorelbine treatment alone. Vinorelbine improved HCC tumor response to standard irradiation with no increase in toxicity. HCC is prevalent in less developed parts of the world and is mostly unresectable on presentation. Vinorelbine and conventional radiotherapy are cost-effective, well-established modalities of cancer treatment that are readily available. Therefore, this strategy can potentially address an unmet clinical need, warranting further investigation in early-phase clinical trials.

Purpose: The purpose of this meta-analysis was to summarize the evidence of associations between obesity factors and spinal epidural lipomatosis (SEL) and to evaluate the strength and validity of these associations. Methods: Electronic databases such as Wiley Online Library, PubMed, Embase, Cochrane Library were searched and manual retrieval of references, the time limit was from the establishment of the database to May 2020. Methodological quality evaluations of the included studies were assessed using the bias risk assessment tool recommended by the Cochrane Guidelines. The RevMan 5.3 software was used for meta-analysis. Results: Finally, seven studies were included for meta-analysis, all of which were observational studies with mixed bias risk. These studies involved 807 patients, with an average age of 64 to 73.6 years, and 59.4 percent of the participants were male. The sample sizes for the included studies ranged from 28 to 288. The results of meta-analysis showed that high body mass index (BMI) was one of the factors affecting SEL ( P < 0.01, MD 1.37, 95% CI [0.81, 1.92]). All reviews had a high risk of bias, and the most common source of bias was that there was no strict unified case diagnosis standard between researches, and some studies (four items) did not clearly describe the confounders that they controlled. Conclusions: We suggest that physicians should consider high BMI as a factor leading to SEL, and to control body weight actively should be considered as the preferred treatment strategy before surgical intervention is conducted.

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