Introduction: HCV infection is frequent in patients undergoing maintenance haemodialysis, with prevalence between 8 and 10%. Hepatitis C has an adverse effect on both patient and graft survival in those who get renal transplants. There are relatively scarce reports on the natural fluctuation in viral load level in patients on chronic haemodialysis. Materials and Methods: This is a longitudinal short-term three months study, where 27 chronic haemodialysis patients infected with known HCV genotypes were recruited from seven haemodialysis centres in Pahang. Serum samples were collected monthly, both pre- and post-haemodialysis sessions, over a period of three months. Viral RNA was extracted from serum using QIAamp Viral RNA Extraction kit (Qiagen). The HCV viral load was measured using one-step reverse transcriptase qPCR (Applied Biosystems) targeting the 5`HCV non-coding region (5’UTR). The serum α-IFN level was measured using commercial ELISA kit (Amersham, UK). Six biochemical liver function tests (AST, ALP, TP, albumin, ALT and TB) were also done for all pre-haemodialysis samples. Results: All patients showed persistent low level viral load that varied significantly over the study period (p = 0.001). HCV genotype 1 viral load was significantly higher than that of genotype 3. Conclusion: No apparent correlation could be recognized between the viral loads and the corresponding interferon-alpha levels which were detectable in only a few patients during the period of study.

Concurrent morphological variations of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) are seldom reported in literature. Extra slips of APL and EPB are clinically significant as they are used to reconstruct the ruptured tendons in the hand. Herein, we report bilateral morphological variations of APB and EPB in a male cadaver. On each side of forearm, APL was divided into two tendinous slips within the first compartment of extensor retinaculum. One of these slips inserted on to the radial side of base of first metacarpal bone close to the insertion of EPB, and the other slip inserted on to both abductor pollicis brevis and opponens pollicis. EPB divided into two tendons slips deep to the extensor retinaculum. These slips were found to be inserted on to the dorsal surface of the base of proximal phalanx while the other inserted on to the radial aspect of the base of first metacarpal bone, close to the insertion of APL tendon. These additional slips are frequently associated with first carpo-metacarpal subluxation and de Quervain’s syndrome and may be responsible for the clinical manifestations of these diseases. In addition, knowledge of the morphological variations of APL and EPB can aid orthopaedic and plastic surgeons in performing successful tendon transplants.