Eltrombopag is a 2nd generation thrombopoietin-receptor agonist. It binds with the thrombopoietin-receptors found on the surfaces of the megakaryocytes & increases platelet production. Many recent studies have suggested a potential role for this novel agent in the treatment of thrombocytopenia associated with hepatitis-C infection. Studies have shown that adjunct treatment with Eltrombopag can help avoid dose reductions/withdrawals of pegylated interferon secondary to thrombocytopenia. It may also have a role in priming up platelet levels to help initiate antiviral therapy. Similarly, chronic liver disease patients with thrombocytopenia who need to undergo an invasive procedure may be potential candidates for short two-week courses of eltrombopag in the periprocedural period to help reduce the risk of bleeding. Besides the price (deemed very expensive and probably not cost-effective), there are some legitimate concerns about the safety profile of this novel agent (most importantly, portal vein thrombosis, bone marrow fibrosis and hepatotoxicity). In this article, the potential role of eltrombopag in the context of hepatitis C virus (HCV)-related thrombocytopenia is reviewed. To write this article, a MEDLINE search was conducted (1990 to November 2012) using the search terms “eltrombopag,” “HCV,” and “thrombocytopenia.”
Background: Self-directed learning is a way of learning in which learner is the main regulator of learning and manages learning on its own according to the requirements. This concept implies that whatever a postgraduate trainee (PGT) will learn during his or her training is dependent on his self-ability to learn. Objective: To determine the self-directed learning readiness (SDLR) among postgraduate trainees of multiple specialties and to examine factors affecting it.Material and Methods: It was a cross-sectional study in which self-directed learning readiness of PGTs working at Shifa International Hospital Islamabad was investigated using a 58-item validated SDLR questionnaire.Results: Mean SDLR score of females (213.36) was more than males (206.13). Maximum mean score of SDLR was found at age of 37(n=1) (252.00) and at 33years (n=10) (236.40), respectively. Highest mean SDLR score was found among PGTs of Gynecology and Obstetrics (n=28), (230.11). Meantotal SDLR score initially increased from 204.65 to 218.50 from 1st to 2nd year but then remained static and start dropping at regular pace and became lowest at 5th year (200.36). Mean total SDLR score was highest among PGTs of poor socioeconomic background 237.33. Departments in which research activities were ongoing their postgraduate trainees showed an average SDLR score of 215.41.Conclusion: Study concluded that self-directed learning readiness of PGTs of Gynecology was highest with average SDLR in General Medicine and General Surgery PGTs. The SDLR was found more among PGTs with poor socioeconomic status and in departments with high ongoing research activities. However, SDLR has not shown any significant difference regarding gender and age.
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