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CRISPR/Cas mediated gene-editing has opened new avenues for therapies that show great potential for treating or curing cancers, genetic disorders, and microbial infections such as HIV. CRISPR/Cas9 tool is highly efficacious in revolutionizing the advent of genome editing; however, its efficient and safe delivery is a major hurdle due to its cellular impermeability and instability. Nano vectors could be explored to scale up the safe and effective delivery of CRISPR/Cas9. This review highlights the importance of CRISPR/Cas9 genome editing system in cancer treatment along with the effect of lipid-based nanoparticles in its safe delivery to cancer cells. The solid-lipid nanoparticles, nanostructured lipid carrier, lipid nanoparticles and niosomes have shown great effect in the delivery of CRISPR compounds to the cancer cells. The design and genome editing application in cancer therapy has been discussed along with the future concern and prospects of lipid nanoparticle based CRISPR/Cas9 has been focused toward the end.

Nicotine is the primary component in cigarettes that is responsible for the negative effects that tobacco has on the body. Nicotine is also the primary component responsible for the addiction that can develop from smoking. Tobacco addiction is also primarily caused by nicotine, which is another component of tobacco. Aim: The effect that nicotine has on the rate at which bones can recover after being shattered is still a topic of ongoing debate. The study of bone repair and regeneration is made a great deal easier by the utilisation of a model that is known as distraction osteogenesis. The mandibular extension of a rabbit model is serving as the subject of the inquiry that is now being conducted. Duration & Place of Study: October 2018 to March 2021 Rashid Latif medical college Lahore Method: Using the rabbit as a test subject, the purpose of this study is to evaluate the influence that nicotine has on blood perfusion, angiogenesis, and bone formation. There were a total of forty rabbits, and they were distributed among the control group, which received no nicotine, and the nicotine group, which received nicotine. The bunnies were distributed to the several groups in a haphazard manner. It was discovered that each rat had been exposed to nicotine or a placebo for a total of seven weeks during the course of the experiment. After a period of consolidation time ranging from two to four weeks post osteotomy, the animals were slaughtered and their mandibles were removed. After this, there was a lag time of three days, and then there was active distraction for eleven days. Utilizing the techniques of Laser Doppler monitoring and Collagen IV immunohistochemical labelling, respectively, allowed for the assessment of both vascularization and blood perfusion. Studies that were radiographic, histological, and immunohistochemical in nature were carried out in order to investigate the development of bone. Result : According to the findings, being exposed to nicotine led to an increase in the density of microvessels, but it had a detrimental effect on the flow of blood and the development of bones. In addition to this, it was found that the expression of bone morphogenetic protein (BMP)-2 in osteoblasts was lower than it had been in the past. In the process of distraction regeneration, ischemia and a low oxygen tension were both present, and the creation of cartilage islands on a consistent basis was a sign of both of these circumstances. Result: As a result of our investigation, we got to the realisation that nicotine consumption slows down the process of bone regeneration. We hypothesise that this takes place as a result of the fact that nicotine leads to ischemia and has an effect that is directly inhibitory on osteoblastic cells. It has been demonstrated that nicotine causes an increase in angiogenesis; however, this improvement is not adequate to compensate for the harmful effect of vasoconstriction caused by nicotine.

Aims: COVID-19 pandemic brought the medical community into action, to introduce safe and effective strategies to combat the disease. Pakistan has also experienced a significant increase in COVID-positive cases. The objective of this study is to assess the disease-related characteristics and evaluate different treatment responses in patients infected with SARS-CoV-2. Data was collected from January to September 2021. Methodology: An online survey was circulated and analyzed using SPSS and results were reported as frequency and percentages. 1000 questionnaires were distributed, of which 257 responses were received. Results: The majority of the population 90.3% survived however, a few 9.7% deaths were reported. Fever (65.7%) and cough (53.6%) were the most frequently observed symptoms. Ninety percent (n=230) of the patients required no hospital admission. The results show that 16.3% received anti-viral treatment, mainly Remdesivir. This study will help in assessing the COVID-19 patient’s response to different treatment strategies. It will also provide an insight into the psychological impact of COVID-19. Conclusion: This study showed encouraging data regarding the disease characteristics of COVID-19 observed in the population.

Nonsteroidal anti-inflammatory drugs has long been used to treat various pathological conditions like arthritis, gout, diabetes, cancer, and cardiovascular diseases. Although exploring the effective anti-inflammatory agents possessing antioxidant along with pain relieving properties is still challenging. Acetamide-containing compounds are known to possess analgesic and anti-inflammatory activity. The purpose of this study is to evaluate the anti-inflammatory, anti-oxidant, xanthine oxidase, and analgesic activity of an acetamide derivative, N-(2-Hydroxyphenyl) Acetamide. In-vitro anti-inflammatory and antioxidant activities were assessed by protein denaturation inhibition and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay, respectively. Xanthine oxidase potential was also evaluated. In-vivo anti-inflammatory activity was determined by the Formalin-induced paw edema method and analgesic potential was evaluated by an acetic acid-induced writhing test. Results of in-vitro anti-inflammatory activity showed significant (p< 0.001) inhibition of protein denaturation by N-(2-Hydroxyphenyl) Acetamide at both100 and 300 µg/ml. It also exhibited high radical scavenging activity (88.16%) by DPPH at 300 µg/ml. In-vivo Formalin-induced paw edema method revealed significant (p < 0.05) inhibition of paw edema when compared with control and formalin groups. Likewise, NA-2 also significantly (p < 0.001) reduced the number of writhes in the Acetic acid-induced writhing test. Moreover, in both aforementioned in-vivo tests, NA-2 showed comparable results with Indomethacin (10 mg/kg). This study demonstrates that N-(2-Hydroxyphenyl) Acetamide possesses substantial anti-inflammatory, antioxidant, and analgesic activity.

Aim: The purpose of this study was to investigate the effects of the cigarette smoke. Duration & Place of Study: Jan 2018 to may 2021 Rashid Latif medical college Lahore Material and Method: Two different groups of male albino rats were exposed to cigarette smoke using a specially developed smoking machine for duration of three months on a daily basis over the course of the experiment. Both populations of rats were made up entirely of albinos. Result: Significant histological abnormalities occurred in the tracheal epithelium of albino rats that were exposed to cigarette smoke for a period of three months. The rats were given the smoke. The multiplication of epithelial cells, the disruption of the cilia, and the formation of inclusion bodies were some of the alterations that occurred as a result of this. In addition to alveoli that had collapsed and blood extravasations, a considerable thickening of the alveolar wall of the lung alveoli was seen. Conclusion: These modifications show that nicotine may generate changes in tissue that are comparable to those induced by chronic irritation of tissue. This may result in a reduction in the efficiency of gaseous exchange in alveoli and may predispose to the development of neoplastic abnormalities.

Background: Since it is well-established that lead exposure can have negative effects on hematological, biochemical, and hepatic parameters, a significant number of research efforts have been focused on antioxidants that are capable of treating as well as preventing these alterations. Objective: The purpose of this study was to explore the influence of Ocimum Gratissimum (OG) extract on the hemato-biochemical parameters of the livers of adult Wistar rats and the lead-induced toxicity of the livers. Method: For the aim of this investigation, a total of 70 adult Wistar rats were separated into seven groups, with each group containing 10 rats. Group A acted as the control group, Group B received 120 mg/kg of lead, and Group C received 375 mg/kg of OG. Group A was the only group that received no treatment. The role of the control group was played by Group A. Before administering the OG dosages of 375 and 750 mg/kg to Group D and Group E, respectively, a lead dose of 120 mg/kg was administered to both groups. In Group F, participants received 375 mg/kg of OG extract followed by 120 mg/kg of lead, whereas in Group G, participants received 120 mg/kg of lead followed by 1,190 mg/kg of ascorbic acid. After the conclusion of each oral treatment, which lasted a total of 21 days, the animals were slaughtered and their blood and liver tissues were collected for subsequent histological and biochemical testing. The results of these tests will be shown in the following paragraphs. Results: The research led to the discovery that the Control group had a rise in their average body weight, but the B group experienced a fall in their weight. The findings of the biochemical tests revealed that when compared to the Control group and the other treatment groups, the levels of liver enzymes such as ALT, AST, GGT, and ALP in Group B were considerably higher than in the other treatment groups (p 0.05). The results of the histological analysis of the liver tissues revealed degenerative alterations, such as localized necrosis and aggregated inflammatory cells in Group B. These findings were found in the liver tissues of the group B patients. In contrast, the liver tissue in Groups D, E, F, and G that had been treated with the extract exhibited ameliorative alterations. These results may be seen in the table below.

Four series of tetrahydro-2H-1,3,5-thiadiazine-2-thiones (series A and B including two novel enantiopure isomers), tetrahydro-2H-1,3,5-thiadiazine-6-thiones (series C) and N-3 ester derivatives of tetrahydro-2H-1,3,5-thiadiazine-6-thiones (series D) were synthesized and evaluated for their anti-inflammatory, analgesic and anti-oxidant activities. These THTT analogues specially series D were first time examined for their in vitro anti-inflammatory, in vivo analgesic and anti-oxidant activities. Among them lipophilic compounds (series B and D) were found to be highly active for anti-inflammatory evaluation with IC

PurposeThe breakout of the COVID-19 pandemic has forced governments all over the globe to bring radical changes to all walks of life. Strict lockdowns are not only adversely affecting the social, economic, and psychological wellbeing of individuals but also questioning the sustainability of most businesses. In wake of the current scenario, this study is aimed at exploring how the COVID-19 pandemic is influencing the sustainability of entrepreneurship particularly from a female perspective and further providing insights into the role of Islamic financial institutions in the sustainability of businesses during COVID-19.Design/methodology/approachThis is a qualitative study that takes social constructivism approach to study the underlying phenomenon. Semi-structured interviews are conducted to collect primary data. Secondary data are also utilized in this study to theoretically define various concepts relating to entrepreneurial sustainability. The application of thematic analysis revealed various risks associated with sustainability. The interviews reveal the ground realities and tell us about the hardships being faced by the entrepreneurs due to ongoing crises. The participants of the study also shed light on the role of Islamic financial institutions during the pandemic.FindingsThe study results revealed that it may look impossible for women entrepreneurs to halt or avoid the adverse consequences of the pandemic; however, a few female entrepreneurs strived to guard their existing portfolios with the help of Islamic microfinance institutions. Whereas, several women, especially those running home-based businesses, lost their income streams. Despite these rapid challenges, most female entrepreneurs are working on inventive online systems to sustain their business activities during the crisis. Finally, guidelines are suggested which can help achieve sustainability of the entrepreneurial startups.Research limitations/implicationsThe outcomes of this study are expedient for funding agencies, government authorities and Islamic financial institutions as well as for non-government institutions to establish sustainable and broader policies for women to become successful entrepreneurs during severe disasters like COVID-19. Moreover, the study is a helpful tool for women entrepreneurs to avert the worst impact of the pandemic with the help of Islamic microfinance institutions. The themes of this study help generate realistic information to appraise the strategies to create facilitating business environments that drive the women to carry out the entrepreneurial activity during any crisis like the COVID-19.Practical implicationsThe results of this study provide evidence that crisis can be anticipated up to some extent if entrepreneurs become able to take proactive decisions in case of expected or identifiable threats. The study may also help the women entrepreneurs to comprehend the serious consequences of the pandemic by shifting their mode of financing to Islamic finance. Although this pandemic is a cause of physical discomfort instead this research may encourage the female entrepreneurs not to lose heart, just find the potential opportunities for their home-based and small businesses and manage funding from the Islamic microfinance institutions.Originality/valueThe study adds to the existing literature on entrepreneurial sustainability with a particular focus on the role of Islamic microfinance institutions for women entrepreneurs' sustainability in Pakistan. Secondly, the study employs the entrepreneurial sustainability model (ESM) that, according to the best of our knowledge, has not been used by the researchers earlier to study the given research phenomenon. Thirdly, the study findings are expedient for funding agencies, government authorities and financial institutions as well as for non-government institutions to establish sustainable and broader policies for women to become successful entrepreneurs during disasters like COVID-19.

Access to clean drinking water is essentially required for human existence. It is a formalized fact that contaminated drinking water poses a serious threat to human life as the endowment of unpolluted drinking water to Pakistan’s inhabitants is the local government’s foremost duty. Thus, to conquer this purpose, the local government, with the coordination of the community development department (CD), fixed drinking water filtration plants at several places in Lahore. This study aimed to discover the health threats and health-associated costs endured by households in the target study areas and the effects of drinking water on infants’ and children’s health in areas having and lacking water filtration plants by employing the health lifestyle model. Moreover, this study compared waterborne disease incidence in households in targeted areas with and without local government filtration plants. For this purpose, a multistage random sampling technique was employed to collect the data from 300 households residing at different locations in Pakistan. This study revealed that people who make life choices to drink filtration plants’ water installed by the local government are less likely to contract waterborne diseases. Besides, class circumstances such as the size of the family, education of the family head, and plant water usage are highly correlated to the quality and use of drinking water and, ultimately, to the health-associated outcomes by improving a healthy lifestyle. In contrast, the age of the household head was found to be insignificant in making choices regarding drinking water choices and reducing waterborne illness. The more the education of the family head, the fewer family members found to indulge in practices for using plant water. Thus, infants/children and other people are less likely to contract waterborne incidents in areas equipped with these filtration plants. Moreover, the probability of contracting waterborne illness is higher in males than in females in areas lacking filtration plants.

Introduction: When it comes to pollution, smoking, infections, tuberculosis (TB), and allergies, the lungs are the most sensitive organs to damage. Pleural fluid is a fluid that fills the parietal and visceral layers of the pleura that surround the lungs and helps to keep them moist. An investigation of the link between age, gender, and immunohistochemistry findings in lung and pleural biopsy samples was conducted. Materials and procedures: This is a four-year retrospective study that will take place between May 2017 and May 2021. In the current study, a total of 112 cases were submitted for histological investigation, with 100 instances using lung biopsy and 12 cases involving pleural biopsy being the most prevalent. Immunohistochemical testing was carried out as and when it was necessary. Results: A total of 100 lungs were examined. There were 56 cases of neoplastic tumours, 35 cases of non-neoplastic tumours, and nine cases of inconclusive tumours. The most common type of cancer was squamous cell carcinoma. The most prevalent non-neoplastic lesion was angioedema, which was the most common type of lesion (4 percent ). Patients with lung tumours who have malignancy outweigh those who have inflammatory illnesses at our institution. Seven of the 11 pleural biopsy cases were malignant, whereas the other eleven were not. Adenocarcinoma was the most common kind of neoplastic pleural lesion, followed by tuberculosis. Conclusion: The use of histopathology in the diagnosis of lung and pleural lesions is essential. It is possible to increase the accuracy of histological diagnosis with the use of immunohistochemistry. Keywords: Lung biopsy, pleural biopsy, histopathological examination.

Background: Diabetes, low nighttime blood pressure, and nonarteritic ischemic optic neuropathy may be associated. Not too many studies present whether this relationship applies to patients. Objective: Diabetes mellitus, low blood pressure at night, and nonarteritic ischemic optic neuropathy were studied in a group of individuals. Methods: The ophthalmology clinic will conduct a cross-sectional research on patients with nonarteritic ischemic optic neuropathy from March 2019 to December 2021. Nonarteritic ischemic optic neuropathy patients were tested for diabetes. Some participants wore ambulatory blood pressure monitors during the trial. Nighttime blood pressure drops are typical, muted, severe, and reverse. Results: Nonarteritic ischemic optic neuropathy was identified in 67 individuals. 587 of 67 patients were selected. 34 patients (50.7%) had diabetes, while 39 (58.2%) had hypertension. 32 people's blood pressure dropped during sleep. Only four (5.9%) saw substantial drops. Conclusions: Diabetes may be linked to nonarteritic ischemic optic neuropathy, but not nocturnal blood pressure declines. Keywords: Optic Neuropathy, Diabetes Mellitus, Hypertension

Objectives & background: Drug-induced hepatotoxicity (DIH) is a common side effect of anti-TB drugs. Acute viral hepatitis (AVH) may be confounded with chronic alcoholic hepatitis clinically, biochemically, and histologically (CAH). Place of Study: Rashid Latif Medical College Lahore Duration of Study: March 2019 to January 2021 Methods: This prospective research examined the effect of acute viral hepatitis as a contributing and confounding factor in patients with normal baseline liver function who acquired acute hepatitis while taking short-course anti-TB medication. All acute hepatitis patients' blood was analysed for hepatitis A, B, C, and E markers. Results: In 12 of 80 TB patients who developed viral hepatitis, the hepatitis E virus was present. Indicators of acute viral hepatitis included a delayed onset of acute hepatitis significant increases in aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and a longer period for abnormal levels to normalise. Conclusions: According to our statistics, 15% of anti-TB hepatotoxic patients had AVH. Before attributing the hepatotoxic impact of anti-TB medications to DIH patients, viral hepatitis should be evaluated and ruled out in all endemic-area patients.

Herein, chitosan‑zinc sulfide nanoparticles (CS-ZnS-NPs) were developed as an efficient photocatalyst for the degradation of toxic dyes. The as-synthesized CS-ZnS-NPs were analyzed using XRD, FTIR, SEM, and EDS. The functional groups of CS-ZnS-NPs were validated with FTIR spectroscopy. The SEM envisaged the average particle size as 40 nm, whereas EDS interpreted the compositional analysis of the nanocomposite. XRD analysis illustrated the crystallinity and hexagonal crystal structure of the CS-ZnS-NPs. The photocatalytic efficiency of CS-ZnS-NPs was evaluated using two carcinogenic azo dyes, Acid Brown 98 and Acid Black 234. A UV lamp (254 nm) was used as an irradiation source during the photocatalytic degradation of dyes. At the optimum conditions, the synthesized CS-ZnS-NPs showed 96.7% degradation for Acid Black 234 in 100 min and 92.6% for Acid Brown 98 in 165 min. The degradation phenomena followed pseudo-first-order kinetics. The values of rate constant (k) were 0.01464 and 0.04096 min−1 with correlation coefficient (R2) of 0.98891 and 0.99406 for Acid Brown 98 and Acid Black 234, respectively. The CS-ZnS-NPs were easily recovered and recycled for four successive batches. The results showed that CS-ZnS-NPs are considered as highly productive, cost-effective and promising photocatalyst in degrading pollutants in several consecutive cycles.

Background & objectives: Many pregnant women in Pakistan have iron deficiency anemia (IDA), a dietary deficit. It affects both the mother's and the foetal' health. Oral iron supplementation usually relieves IDA symptoms. Oral iron supplements are hazardous to the GI mucosa, and sensitivity is common. Poor therapeutic compliance leads to treatment failure. Ferrous ascorbate (FeA) and iron hydroxide polymaltose complex (IPC) reportedly improve gastrointestinal discomfort and increase patient compliance compared to ferrous sulphate (FS). These preparations reportedly improve hemoglobin levels and iron stores more quickly than FS. This analysis compared FS's efficacy and safety to IPC and FeA. Place of Study: Rashid Latif Medical College Lahore Duration of Study: February 2019 and October 2021 Methods: It was a randomized, parallel, open label, investigation among pregnant women of gestational age from 10 to 28 weeks with moderate anemia. Patients were randomly selected to receive either FS, IPC or FeA. They were then followed up for 3 months to look for improvement in the hemoglobin levels and other hematological indicators or any adverse drug response. Results: With the exception of 3 months, when the FeA group had a significantly higher hemoglobin level in comparison to the FS group (P

Breast cancer is the most dominating malignancy in females worldwide. Treatment with conventional chemotherapeutics is associated with severe adverse effects. Thus need of new compounds, with better therapeutic potential and lesser side effects still exist. In this context the present study is planned to investigate therapeutic potential of anti-inflammatory compound N-(2- hydroxyphenyl) acetamide (NA-2) against breast cancer cells (MCF-7). The compound was selected on the basis of its reported anti-inflammatory, anti-arthritic and anti-glioblastoma activities in our previous studies. MTT, Annexin-V-FITC and wound healing assays were used to analyze the effect of compound on growth inhibition, apoptosis and metastasis. While flow cytometry, RT-PCR and immunocytochemistry techniques were used to assess the effect of NA-2 on cell cycle arrest, and expression of apoptotic markers (Bax and Bcl-2) at both mRNA and protein level respectively. Data analysis revealed that NA-2 significantly inhibits growth of MCF-7 cells after 48 h treatment (IC50 = 1.65 mM). NA-2 also delayed the wound healing process, arrested cell cycle at G0/G1 phase and induced apoptosis by enhancing Bax/Bcl-2 ratio. We concluded that NA-2 possesses strong anticancer activity against MCF-7 cells, which is mediated through different mechanisms, making it a useful molecule for the development of new antitumor drugs.

Aim: To determine the incidence of indirect inguinal hernia in men over 50 years of age and to evaluate the results of repair with prolene in primary indirect inguinal hernia in men over 50 years of age. Study Design: A prospective study. Place and Duration: In the Surgical Unit II of Jinnah Hospital Lahore for one year duration from April 2018 to April 2019. Material and methods: A total of 100 patients were operated on with primary inguinal hernia between 15 and 80 years of age. However, this study included primary patients with inguinal hernia with age from 51 to 80 years old. Direct inguinal hernia in this age group was excluded. All these patients underwent surgery and the results were evaluated. Results: Only 35 of 100 patients with inguinal hernia treated in the surgical ward were included. In our study, the incidence of indirect inguinal hernia was> 50 years> 34.57% and was quite high as expected. Thirty one patients (88.6%) had a reducible hernia. Four patients (11.42%) had an irreducible hernia at the outpatient clinic. Twenty eight (80%) patients had a hernia on the right and 7 (20%) had a hernia on the right. Superficial skin infection (SSI) was observed in one patient (2.85%). Hematoma was observed in one patient (2.85%). One patient (2.85%) had urinary retention. No recurrence was observed up to one year of follow-up. Conclusion: Repair of inguinal hernia with prolene is a safe and inexpensive method of repair. It has limited postoperative complications such as recurrence, pain and wound infection. Key words: indirect inguinal hernia, prolene, cover repair.

Objective: The goal was to recognize associated risk factors with placental abruption and determine the effect of abruption on the fetal outcome. Study Design: An Observational Study. Place and Duration: In the Obstetric and Gynecology Department Unit II of Services Hospital Lahore for one year duration from March 2018 to March 2019. Methods: A proforma was formed to collect data from 110 patients with early abruptio placentae reported during the study period. Fifty five percent had pregnancy-related hypertension, 30% had anemia, 10% had polyhydramnios, 15 percent had multiple pregnancy, and 6% percent smoked. Seventy percent of patients required an urgent invention. The frequency of abruptio placentae was 1.1 percent. Results: Perinatal mortality was 500/1000. 35 percent of live children born with an insufficient Apgar score. Anemia was noted in Eight percent of the fetuses, neonatal jaundice in 12 percent and 15 percent had respiratory distress syndrome. Forty percent of patients were done by caesarean section. The caesarean hysterectomy was performed in 5 percent. Coagulopathy was present in 10 percent and postpartum hemorrhage in 25 percent. On the third day after birth, 35% of anemia was found. There were five deaths of mothers. Conclusion: Early placental abruption was considered a high-risk condition. Most predisposing risk factors can be prevented by decreasing incidence, increase patient education and better obstetric care. Early placental abruption was found to be associated with high mortality and morbidity. Risk factors for placental abruption can be prevented. Key words: premature placental abruption, detachment, fetus, motherhood, perinatal outcome, morbidity.

Objective: To evaluate liver histology of chronic hepatitis C patients, who were relapsers or non-responders to previous conventional therapy. Methods: The descriptive case series was conducted in the Hepatology section of Medical Unit-III at the Services hospital, Lahore, Pakistan, from June, 2018 to May 2019. The study had 109 hepatitis C patients who had relapsed or not responded to the conventional interferon and ribavirin for at least 24 weeks. All the patients were subjected to liver biopsy. The inflammatory activity and fibrosis shown by the liver biopsies were assessed according to the Batts-Ludwig classification. SPSS version 20 was used to analyze data. Results: A majority (n=57; 52.3%) of the 109 patients were female with hepatitis C virus genotype 3. Among these, 100 (91.7%) patients were non-responders and 9 (8.3%) were relapsers. The mean age of the patients was 38.9±8.8 years. The non-responders had elevated levels of serum aminotransferase. According to Batts-Ludwig classification, Grade 0 inflammation was not present in the non-responders and relapsers; grade 1 in 51 (46.8%); grade 2 in 47 (43.1%); grade 3 in 10 (9.2%); and grade 4 in 1(0.9%). Stage 0 fibrosis was present in 10 (9.2%); stage 1 in 34 (31.2%); stage 2 in 36 (33.0%); stage 3 in 13 (11.9%); and stage 4 in 16 (14.7%). Conclusion: Results suggested that even if it failed to eradicate hepatitis C virus, the conventional interferon and ribavirin therapy was able to halt the progress of necroinflammation and fibrosis. Keywords: Hepatitis C, Non-responder, Relapser, Conventional interferon, Ribavirin.

Objectives: To determine the frequency of deaths in hepatitis C virus infected hepatocellular carcinoma patients, and its relationship with raised serum alpha-fetoprotein levels. Methods: The cross-sectional study was conducted at Services hospital, Lahore from June, 2018 to May, 2019 and comprised all patients diagnosed with hepatitis C virus and hepatocellular carcinoma over 30 years of age. Blood sample was drawn for the measurement of serum Alfa fetoprotein levels. Data was analyzed using SPSS 20. Results: The mean age of the 165 patients was55.49±11.67 years. The mean tumor size was 5.63 ± 2.14cm. Of the total, 31(18.8%) patients had tumor size 5cm. The mean serum Alfa fetoprotein level was 7641.0±3665.32 IU/ml. Overall mortality rate was 70(41.9%). Tumor size >5cm was significantly associated with mortality (p=0.016). Conclusion: Serum Alfa fetoprotein levels were a useful tool for the detection of hepatocellular carcinoma in hepatitis C virus patients. Keywords: Hepatitis C virus, Hepatocellular carcinoma, Alpha fetoprotein levels.

Emergence of multidrug resistance (MDR) has limited the success of chemotherapeutic agents. Reversal of drugs efflux systems through combination therapy has got wider attention for increasing anticancer drugs efficacy. This study aims at co-encapsulation of Paclitaxel with Naringin in mixed polymeric micelles for enhanced anticancer activity of the drug. Drug-loaded micelles were prepared using two different amphiphilic block co-polymers and were characterized for morphology, size, zeta potential, drug encapsulation, in vitro release and stability using atomic force microscope (AFM), zetasizer, UV spectrophotometer, and FT-IR. MTT assay and fluorescence microscopy were used for in vitro cytotoxicity and cellular uptake studies. Nano-size micelles with spherical morphology and negative charge encapsulated 76.52 ± 0.94% and 32.87 0.61% Paclitaxel and Naringin, respectively. The micelles were thermally stable and retained 87.05 ± 0.69% and 92.88 ± 2.17% Paclitaxel and Naringin upon one-month storage. Maximum drug release was achieved at fourth hour of the study for both the loaded drugs. Paclitaxel co-encapsulation with Naringin synergistically improved its intracellular uptake and 65% in vitro cytotoxicity against breast cancer cells was achieved at its lower dose of 15 µg/mL. Results suggest that co-encapsulation of Paclitaxel with Naringin in mixed micelles is an effective strategy for achieving its higher anticancer activity.