Efficacy of Atorvastatin Plus Pegylated Interferon and Ribavirin Versus Pegylated Interferon and Ribavirin Alone in Chronic Hepatitis C Patients with Genotype-3a Atorvastatin for the treatment of chronic HCV with Genotype-3a

Background: Chronic hepatitis C infection has created a huge burden of disease causing serious health effects. The combination therapy used to treat hepatitis C virus (HCV) infection includes Pegylated interferon and Ribavirin. As cholesterol biosynthesis plays a pivotal role in HCV replication, the use of various statins has been associated with higher sustained viral response Objective: To compare the efficacy of atorvastatin plus pegylated interferon and ribavirin versus pegylated interferon and ribavirin alone in patients of chronic hepatitis C with genotype-3a Methods: This Randomized controlled trial was conducted at outpatient department, Mayo Hospital Lahore for six months i.e. May to November 2017. After ethical approval, 60patients of ages 25 to 55 years of either gender with chronic hepatitis C with genotype 3a were included in the study. Informed consent was taken from all patients. Then patients were randomly allocated into two groups “A” and “B” using random number table. Patients in Group A received standard of care treatment for chronic hepatitis C i.e. Pegylated interferon and ribavirin while the patients in Group B also received tab atorvastatin along with the standard treatment. Patients were follow up for 4 week. Blood samples were collected and HCV RNA detection. All this information were entered in proformaResults: In standard therapy group, the mean age of patients was 39.50±8.39years. In atorvastatin plus standard therapy group, the mean age of patients was 34.30±6.78years. In standard therapy group, there were 25 (83.3%) males and 5 (16.7%) females. In atorvastatin plus standard therapy group, there were 16 (53.3%) males and 14 (46.7%) females. After 4 weeks, Rapid VirologicalResponse (RVR) was achieved in 4 (13.3%) patients in standard therapy group while in 14 (46.7%) in atorvastatin plus standard therapy group. The difference was significant (p<0.05) Conclusions: Atorvastatin in combination with Pegylated interferon and ribavirin have better efficacy as compared toPegylated interferon & ribavirin alone in chronic hepatitis C-3a.

Vegetation Analysis, Grassland Productivity and Carrying Capacity of Deosai National Park, Gilgit-Baltistan

Deosai Plateau is one of the most important alpine ecosystems in Pakistan. It was declared as Deosai National Park in 1993 to protect its unique ecology with Himalayan Brown Bear as the flagship species. The alpine flora and ecological characters of Deosai Plateau, important environmental variables responsible for species distribution, life forms, chorology and vegetation structure, analysis on pasture conditions and trends, biomass productivity and carrying capacity were studied. Possible influences of grazing on alpine grasslands were also investigated. Key issues of pasture use have been incorporated in the study with a variety of recommendations. Vegetation sampling was carried out through line transect and quadrat method, covering major habitats and elevation ranges for measurement of species composition and their relationship with environmental variables. Hierarchical cluster analysis technique of Two Way Indicator Species Analysis (TWINSPAN) was used for vegetation classification in the first order. Relationship of alpine plant communities with environmental factors were studied through Ordination method of Deterrended Correspondence Analysis. One hundred and seventy five species, representing 111 genera and 37 families were found. Compositae and Ranunculaceae were the dominant families. Hemicryptophyte (71.4 %) and chamaephyte (14.9 %) were the dominant life forms of Deosai Plateau, suggesting the extreme weather conditions similar to arctic tundra. The flora was predominantly West Himalayan (31 %) and Himalayan (13 %), followed by Central Asian and Circumpolar elements (11 %). Six communities were differentiated on the basis of indicator species and justified in the ordination plots. Species diversity and richness were recorded highest in Carex-Agropyron-Koberesia community. The greatest dissimilarity was found between Artemisia-Polygonum-Thallictrum community and Agropyron- Festuca-Nepeta community with 95% dissimilarity. Each plant community showed a marked dissimilarity from others with more than 55% dissimilarity index. Senwai block showed highest diversity with a diversity index of 3.7 and species richness of 58 with low evenness score. Grassland vegetation data showed a total variance xv("inertia") of 8.58. Ordination axis; DCA1 and DCA2 accounted for a total of 12.27 % of the variance, with DCA1 explaining a high proportion (6.72%). Altitude and soil moisture had significant correlation with ordination axes. Elevation (ele), topographic wetness index (twi), cos-transformed aspect (aspv), soil brightness index (sbi) and slope were found significantly related with species turnover. Vegetation cover was higher on northern slopes at lower elevations in areas of relatively good soil moisture. The variables gvi, sbi, and twi had strong positive correlation, while savi, elevation and aspv had strong negative correlation with DCA1. The soil moisture factor along axis1 seems to be the decisive factor in vegetation distribution. gvi and slope variables showed strong negative relationship with DCA2. Assessment of pasture conditions through hyper-temporal vegetation indices of NDVI image series showed an overall 8-10 % retrogression of vegetation in productive grasslands. Regressive trend at minor intensity was observed throughout the productive grasslands of DNP with the exception of HBB core zone. The average biomass production in DNP was found 1243 kg/ha suggesting that DNP is currently having low biomass productivity. The average carrying capacity was found as 1.37 ha/A.U/3 months. Heavy influx of nomads with severe grazing problems, free grazing by peripheral communities mainly concentrated in north eastern parts with established permanent animal corals, extraction and unwise exploitation of fuelwood and medicinal plants although illegal under the law, unmanaged tourism, absence of incentives to buffer-zone communities and habitat fragmentation were identified as major issues of the park. Future studies on these issues, especially with relation to ecological health of the park and initiation of modern agri-silvi-pastoral initiatives in peripheral valleys, adapting pragmatic strategies to minimize and restrict nomadic grazing and implementation of a viable management plan with sufficient financial resources for the park authorities are strongly recommended.