Journal of Integrative Medicine and Public Health

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BACKGROUND AND AIMS: Successful treatment of hepatitis C virus (HCV) infection is associated with improved outcomes in different clinical domains. The treatment of HCV infection in high-risk groups like chronic kidney disease (CKD) is challenging. We conducted a study on the efficacy of the fixed-dose combination of sofosbuvir–velpatasvir in CKD patients. MATERIALS AND METHODS: The study was conducted in our hospital, Sher I Kashmir Institute of Medical Sciences Soura. Patients with HCV infection (detectable RNA levels) with an estimated glomerular filtration rate (eGFR) >15 mL/min were included in the study. All the patients were evaluated for liver disease. Patients with prior exposure to a direct-acting antiviral agent, portal vein thrombosis, or hepatocellular carcinoma were excluded from the study. All the patients received an open-label combination of sofosbuvir and velpatasvir (400/100 mg). The primary endpoint was to assess sustained virological response 12 (SVR12), and the secondary endpoint was to assess the side effect profile of the patients. RESULTS: A total of 33 patients were enrolled in the study, with 17 in Group A (GFR 15–30 mL/min/1.73 m²) and 16 in Group B (GFR >30 mL/min/1.73 m²). In total, 142 (87.6%) achieved viral clearance at 4 weeks of therapy. Sixteen out of 17 (94.1%) in Group A and 13 out of 16 (81.25%) in Group B achieved viral clearance at 4 weeks of therapy [early virological respsone (EVR)]. All patients in both groups achieved end-of-treatment response viral clearance, and the same number of patients maintained viral clearance 12 weeks after stopping the treatment (SVR12). In Group A, no significant improvement was seen in the mean level of any parameters pre and posttreatment. In Group B, there was an improvement in all the parameters except serum creatinine after the completion of treatment. However, the difference was significant between pre and posttreatment values of serum alanine transaminase (U/L) and liver stiffness measurement levels (P value of −0.04 and 0.01, respectively). CONCLUSION: We conclude that treatment with sofosbuvir–velpatasvir is a safe and effective treatment option in HCV infection in CKD.

One strategy for treating acute malnutrition in the community is the outpatient therapeutic program (OTP), which involves the community involvement, providing children with good appetites and management of uncomplicated severe acute malnutrition among children of 6–59 months old by providing them ready-to-use therapeutic food at home along with standard medical care. Approximately 85%–90% of kids with severe acute malnutrition are effectively treated at home in OTP by coming in frequently till they become well. With OTP, severe acute malnutrition management services are offered closer to the community at primary healthcare institutions, where children with simple severe acute malnutrition get varying amounts of ready-to-use therapeutic food such as Plumpy’ Nut sachets depending on their body weight. OTP are a vital component of the global effort to address malnutrition in children. These programs typically involve providing nutrient-dense therapeutic foods to children, along with regular medical checkups and counseling for caregivers on feeding practices and nutrition. Studies have shown that OTPs can lead to significant improvements in weight gain, recovery rates, and reduction in mortality among children with severe acute malnutrition. OTPs have also been found to be cost-effective and can be scaled up to reach a large number of children. OTPs can provide life-saving treatment to children suffering from SAM and help prevent the long-term consequences of malnutrition.

BACKGROUND: Roleplay is not commonly used as a tool for teaching/learning and training in the majority of medical schools in Pakistan. Bilawal Medical College, the newly established constituent college of Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan, organized roleplay sessions for second-year undergraduate medical students and took feedback from them. The objective of this study was to assess the perceptions of students about roleplay as a teaching-learning/learning and training tool. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted on June 2022 with a purposive sampling technique. The questionnaire comprised 10 closed-ended questions on a Likert scale of 1–5 (5=strongly agree, 4=agree, 3=to-some-extent agree, 2=disagree, and 1=strongly disagree) besides age and comments as open-ended questions. The validity was checked with pilot testing. The data were entered in Microsoft Excel and analysis was done in SPSS version 23. The frequency with the percentage of each item and median with interquartile range were calculated. The reliability of the questionnaire was calculated using Cronbach α. RESULTS: The reliability of the questionnaire was confirmed by Cronbach’s α, which was 0.75 falls within the acceptable level. The mean age of students was 20.057 ± 1.027 years. The perceptions of students are notable; the median value on nine statements (items) is 4 and one is 5, whereas the interquartile range of eight statements is 4–5 and 2 statements 3–5. CONCLUSION: The perceptions of medical students were positive regarding the role of roleplay in teaching/learning and training learners. A remarkable percentage of students strongly agreed to agree on all 10 items related to the cognitive, skills, and attitude domain of learning.

BACKGROUND: The COVID-19 pandemic has caused a global health crisis, with over 6 million deaths and over 500 million cases reported as of February 2023. Vaccination is a critical tool for preventing the spread of COVID-19 and protecting people from severe illness, hospitalization, and death. MATERIALS AND METHODS: This paper reviews the evidence on the safety, appropriateness, and effectiveness of mandatory COVID-19 vaccination. The paper also discusses the ethical and legal considerations of mandatory vaccination. RESULTS: The available evidence suggests that COVID-19 vaccines are safe and effective. The vaccines have been rigorously tested and have been shown to be safe for most people. The vaccines are also highly effective at preventing severe illness, hospitalization, and death from COVID-19. Mandatory vaccination is a controversial issue, but it may be an appropriate tool for protecting public health during a pandemic. Mandatory vaccination can help to ensure that everyone is vaccinated, which can help to stop the spread of disease and protect the most vulnerable members of society. CONCLUSION: The evidence suggests that mandatory COVID-19 vaccination is safe, appropriate, and effective. Mandatory vaccination may be an important tool for protecting public health during the COVID-19 pandemic.

Purpose: A flipped classroom is a type of blended learning technique. In modern times, the teaching techniques need to be improved and changed. The aim of the study was to assess the perception of students with regard to flipped classroom. Materials and Methods: The study was a descriptive cross-sectional study design. A total of 152 students participated in this study. Results: After watching the video and before the actual interaction, about 84.2% felt confident. About 56.6% of respondents thought flipped classrooms were superior to traditional classroom instruction. The flexibility of the “flipped classroom,” according to 44.1% of respondents, makes it the most useful feature. The aspect of flipped learning that 43.4% of students liked the most was learning about new ideas before class. A total of 98.2% thought they needed to be more accountable for their education. Conclusion: Although the flip classroom cannot completely replace the traditional classroom but when used in conjunction, it can help students learn more effectively. It has paved the path for improvements to teaching techniques and unquestionably produced a better manner of instruction.

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