Objective: To study the frequency of occurrence of hepatocellular carcinoma (HCC) in hepatitis C virus patients treated with direct acting antiviral (DAA) agents. Methods: This hospital based cross-sectional study was conducted in Mayo Hospital, Lahore from June, 2016 to January, 2018. Total 300 patients with HCV genotype 3, selected via Non-Probability Purposive Sampling technique, without prior or concurrent history of HCC, were given DAA agents and were followed up for 6 months after completion of therapy. Results were based on Quantitative PCR to assess Sustained Virological Response (SVR) and Ultrasound Abdomen to look for the appearance of any new lesion. Data was presented as mean±SD, frequency and percentages and was analyzed using SPSS Version 24.0. Results: Out of 300 patients, 179 (59.7%) were males and 121(40.3%) were females. Mean age of the patients was 55.08 ± 5.602 years. 214(71.3%) patients had compensated cirrhosis at the start of treatment and 86(28.7%) had decompensated cirrhosis. SVR was achieved in 200(93.4%) out of 214 patients with compensated cirrhosis and in 76(88.3%) out of 86 patients with decompensated cirrhosis. At six months post- treatment, 10(3.33%) patients developed HCC,2(0.7%) in the compensated group and 8(2.7%) in the decompensated group, out of which 5(6.6%) patients had achieved SVR. Conclusion: The frequency of HCC following DAA agents is significant (3.3%) even after achieving SVR. Caution must be exercised in prescribing DAA agents to HCV patients keeping this complication of HCC in mind. How to cite this:Aziz B, Nazar T, Akhlaq S. The frequency of occurrence of Hepatocellular Carcinoma after direct antiviral therapy in Hepatitis C virus patients. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.109 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This cross-sectional study was conducted in Mayo Hospital, Lahore, from  July 16, 2018 to  January 15, 2019 to observe the frequency of occurrence of non-alcoholic fatty liver disease in non-obese young medical professionals. One hundred and fifty-three subjects were selected using Simple Random Sampling Technique. SPSS version 25.0 was used to analyse the data. Out of a total of 153 medical professionals, 67 (43.8%) were males and 86 (56.2%) were females, median age was 23 years (inter-quartile range of 5 years), mean BMI was 22.79 + 1.57 kg/m2, 122 (79.7%) subjects had normal texture of liver on ultrasonography and normal ALT levels, 21 (13.7%) had fatty liver with normal ALT levels, and 10 (6.5%) had fatty liver and elevated ALT levels (NASH). NAFLD and NASH are common ultrasonographic findings in seemingly healthy young adults with normal BMI. Awareness programmes should be carried out at the national level to educate the general public about the prevention and treatment of this disease through lifestyle and dietary modifications. Continuous...

Systemic lupus erythematosus has different presentations and the outcome of this illness is variable. It is associated with significant psychological distress and the outcome of this disease has been shown to be influenced by socioeconomic factors. Objective: To determine the association between socioeconomic status, depression and disease activity in patients with systemic lupus erythematosus. Methodology: It was a cross sectional study carried out at department of Rheumatology, Mayo Hospital, Lahore. 150 patients with systemic lupus erythematosus who fulfilled the inclusion criteria were enrolled. Demographic detail, clinical history and examination findings were noted down. Socioeconomic status was assessed by history, depression was assessed by Beck Depression Inventory and disease activity was assessed by SLEDAI-2K and findings were noted down and was subjected to statistical analysis. Results: The mean age of the patients was 29.12±7.44, mean BDI score was 19.2±10.7 and mean SLEDAI-2K score was 9.94±4.91. There were 33.7% males and 66.3% females. Depression was present in 32% of the patients. Depression was more common in patients with higher scores of disease activity. This association between depression and its severity and the disease activity was found to be statistically significant as indicated by a p value of 0.04. The scores of disease activity were found to be higher in patients who were of middle socioeconomic status and low socioeconomic status i.e. in 48% and 34% respectively and the association was statistically significant (p-value 0.000). Conclusion: Depression, socioeconomic status and disease activity are significantly associated with each other in patients with systemic lupus erythematosus and must be screened in every patient. Keywords: Systemic Lupus Erythematosus, Depression, Socioeconomic status, disease activity