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.

Values-Based Culture: Development of Multidimensional Measure and Multilevel Assessment of Theoretical Construct Through Servant Leadership Theory

This study was designed to enhance the concept of the values-based group cul ture (VBC) through empirical application by developing a consistent and robust measure. This dissertation addresses the deficiencies from both the empirical and conceptual perspectives regarding what the VBC is. For this study, the VBC is defined as a culture of humane orientation. The VBC measure is created by identi fying five dimensions, ideology infused, caring for employees, pro diversity, helping and having employee-centric organization identification. A series of survey items were developed, and tested them with 20 doctoral student raters for content valid ity. The remaining survey items were tested by exploratory factor analysis with a sample of 540 students, which results in a five-factor solution. Next, an organiza tional sample of 397 individuals and 106 groups were used to verify the five-factor model through group level confirmatory factor analysis (CFA). A nomological net of VBC was developed through servant leadership theory in which five dimensions of VBC were taken as mediators between servant leader and meaningfulness at work. Two moderators (Leader ethical sensitivity and Leader spiritual wisdom) were also proposed. Cross level structural equation modeling was performed on MPLUS. The results confirm that the VBC is a multidimensional construct and makes a unique contribution to explaining individual level outcome. Two out of five dimensions proved suppressor mediators, other two proved confounder me diators and one could not mediate the proposed cross level relationship between servant leader and meaningfulness at work. Ethical sensitivity failed to moderate the cross-level relationship between servant leader and employees sense of mean ingfulness at work. But the spiritual wisdom was found to be antagonistically moderating the cross-level relationship between servant leader and meaningful ness at work. The dissertation ends with the practical implications and proposes future research directions.