Congenital Hypothyroidism in Neonates of a Tertiary Care Hospital

Objective: To determine neonatal congenital hypothyroidism among neonates born in a tertiary care hospital of Lahore Pakistan

Methods: This cross-sectional study was carried out at Pathology Department of Allama Iqbal Medical College, Lahore in collaboration with Pediatrics and Gynecology and Obstetrics Department, Jinnah Hospital, Lahore Pakistan. A total of 770 babies were included in this study, both male and female. About 2 ml venous blood samples were collected aseptically from the neonates in sterile clotted tube. Serum was separated and serum TSH was determined by ELISA method

Results: Out of total 770 neonates, 48.9% were female and 51.0% were males with the ratio of 1:1.04. Neonatal congenital hypothyroidisim [TSH, >30 mlU/L], was observed in 0.4% [Frequency, 1:257] nenates, with the incidence rate of 1:257. Female to male ratio of hypothyroid neonates was 2:1. The mode of delivery vise distribution showed, among n=251 neonates born by normal delivery, only a single case of hypothyroidism was detected, and among n=519 neonates delivered by cesarean section, only two neonates were belong to hypothyroidism

Conclusion: The frequency of Congenital Hypothyroidism is notably higher in pediatric community than reported in most other countries. This result emphasizes the necessity of a nationwide screening program

In vitro antioxidant, hepatoprotective potential and chemical profiling of Syzygium aromaticum using HPLC and GC?MS

The objective of the present study was to evaluate the in vitro antioxidant and hepatoprotective potential of Syzygium aromaticum [clove] against CCl[4]-induced hepatotoxicity using rat liver slice culture [LSC] model. Antioxidant activity in terms of DPPH radical scavenging activity and ferric reducing antioxidant power [FRAP] of different concentrations of S. aromaticum was in the range of 41.01-90.33% and 138.15-595.63 Fe [II] mg/mL, respectively. Plasmid pBR322 DNA protection activity was observed with all three concentrations of S. aromaticum against H2O2 induced oxidative damage, as no strand breaks were observed. Chemical profiling through HPLC confirmed the presence of six major phenolic acids and 13 volatile bioactive compounds were identified though GC-MS. Significant hepatoprotection [p<0.05] was observed in liver slice culture [LSC] as liver slices treated with various concentrations of S. aromaticum extract presented very low percentage cytotoxicity [7.35-16.16%] as compared to the CCl4 treated liver slices [75.58 %]. The hepatoprotective potential of S. aromaticum may be due to the presence of bioactive components as confirmed by HPLC and GC-MS. The results of present study support the use of S. aromaticum in the formation of potential hepatoprotective drugs against various liver diseases

Development of systemic lupus erythematosus following interferon-alpha therapy for hepatitis C infection

Interferon-alpha [IFN-alpha] therapy has been associated with de novo development of systemic lupus erythematosus [SLE]. We report a 48-year woman with chronic hepatitis C, who developed low grade fever, joint aches and pains, painful mouth ulcers, shortness of breath, dry cough and pleuritic chest pain after 2 months of completion of treatment with pegylated interferon-alpha. These clinical manifestations and the relevant immunologic investigations were in favour of SLE. She responded well to corticosteroids and hydroxychloroquine treatment

Quality of colonoscopy and spectrum of lower gastrointestinal disease as determined by colonoscopy

To document the quality of colonoscopy practice and the pattern of colonic disease including polyp detection rate at Shifa International Hospital, Islamabad, Pakistan. An observational study. Shifa International Hospital, Islamabad, Pakistan, from May 2013 to June 2014. This retrospective study recorded demographics of patients, indications and quality indices of 505 colonoscopies performed during the study period. Preparation was done with low residue diet and polyethylene glycol. Conscious sedation was generally used. Quality indices studied were compared with guideline standard. Out of 505 colonoscopy patients, 305 were males and 200 were females. The indications for colonoscopic examination were lower gastrointestinal bleeding [26.5%, n=134], screening for colorectal cancer [14.1%, n=71], chronic diarrhea [12.9%, n=65], abdominal pain [10.9%, n=55], anemia [9.1%, n=46], constipation [7.3%, n=37], hematochezia and diarrhea [6.3%, n=32], altered bowel habits [5.1%, n=26], weight loss [3.6%, n=18], colonic thickening on CT scan [3.0%, n=15] and others [1.2%, n=6]. Bowel preparation was adequate [in 92%, n=465] cases. Cecal intubation rate was 88.71% [n=448]. Endoscopic diagnoses were hemorrhoids [36.2%, n=183], normal [22%, n=111], polyps [11.3%, n=57], ulcerative colitis [8.7%, n=44], cancer [4%, n=20], diverticulosis [3.4%, n=17], infective colitis [2.6%, n=13], intestinal TB [2.6%, n=13], non-specific colitis [2.2%, n=11], proctitis [1.8%, n=9] and others [5.3%, n=27]. There is room for improvement in quality of colonoscopy, cecal intubation rate is slightly below the recommended standard and polyp detection rate is quite low however, it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence. Time to reach caecum and withdrawal time should clearly be documented in the notes which can help to evaluate quality of the procedure in a better way

Review of dental operative procedures and the causes of tooth extraction at the railway general hospital rawalpindi

To study the frequency of various dental procedures and the causes of dental extractions at Railway General Hospital Rawalpindi and to suggest measures to improve the existing scenario. A descriptive cross-sectional study The study was conducted at IIMCT, Railway General Hospital from June 2014 to May 2015. All consecutive patients undergoing dental operative procedures at IIMCT Railway General Hospital were studied. The patients were examined clinically and by dental X-Ray when required. The extent of caries was ascertained and Miller's Mobility Index was used to grade the extent of Periodontitis. Tooth extraction was done in patients having broken down roots, gross caries, tooth mobility grade >2 and those with impaction, trauma, cysts etc. A total of 3116 dental procedures were done that included 1902 [61.0%]tooth extractions, 930 [29.8%] fillings, 166 [5.3%] scalings and 118 [3.8%] root canal treatments. The number of scalings and root canal treatments significantly, increased with addition of an extra dental surgeon [p<0.001]. A total of 1902 teeth were extracted from 1560 patients. Caries was the leading cause of tooth extraction [60%]. Most of the patients with advanced caries presented with broken down root [763/1902,40%]. Gross caries was the reason for extraction in 380/1902 [20%], periodontitis with mobile teeth [grade >2] in 569/1902 [30%] and other reasons like cysts, impaction and trauma etc. in 190/1902 [10%] of patients. Conclusion: Caries and periodontal infections are the commonest dental problems and the reason for tooth extraction at the Railway General Hospital Rawalpindi where people mostly come from the lower socio-economic status. The quality of work in a public sector dental setting like Railway General Hospital can be improved by providing adequate number of dentists and other resources

Supracondylar humeral fracture in children: management by percutaneous lateral-entry pin fixation

This case series was conducted at the Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar, from January 2007 to June 2008 to assess the outcome of two percutaneous lateral-entry pins in the operative management of supracondylar humeral fractures. The study included management of Type II and III displaced supracondylar humeral fractures according to Wilkins's modification of Gartland's classification system in 193 patients. The fractures were fixed with two percutaneous lateral-entry pins. Seventy-two children had Type II fracture and One Hundred and Sixty-five children presented with Type III fracture according to Wilkins's modification of Gartland's classification system. A comparison of perioperative and final radiographs showed no loss of reduction of any fracture. There was no hyperextension, loss of motion, cubitus varus, iatrogenic nerve palsies and no patient required additional surgery. Six patients had pin tract infection. Follow up rate was 81.5% Results were evaluated by Flynn's Criteria, 93.3% Excellent/good results were obtained. In this case-series, the use of lateral-entry pins was found to give excellent/very good results. It is an effective treatment option for unstable supracondylar fractures of humerus in children. This method provides the greatest skeletal stability and prevents neurovascular complications in children, as in other techniques, hence giving excellent results

Cardioprotective and Antilipidemic Effect of Gemmotherapeutically Treated Glycyrrhiza glabra against Isoproterenol Induced Myocardial Injury.

Aims: To evaluate preventive (pre- treated) and curative (post treated) potential of gemmomodified and native extract of Glycyrrhiza glabra for alleviating harmful changes in lipid profile (HDL, LDL, TG, TC) and cardiac enzymes (CK-MB, LDH, SGOT, SGPT) against isoproterenol (ISO) induced myocardial injury in rabbits. Study Design: In vivo study. Place and Duration of Study: Department of Chemistry and Biochemistry, University of Agriculture, Faisalabad, Pakistan, between February 2011 and April 2011. Methodology: Thirty six rabbits weighing 1.25 ± 0.2 Kg were allocated into six groups (Control, Ischemia, Gemmo curative, Native curative, Gemmo preventive and Native preventive) having six animals each. Rabbits were fed normal diet for 20 days. Gemmo preventive and Native preventive groups were also given gemmo modified and native extract (100 mg kg-1). On 20th day and 21st day rabbits were given ISO (50 mg kg-1). Five days after the ischemia the Gemmo curative and Native curative groups were given gemmo and native extracts (100 mg kg-1). Serum activities of lipid profile and cardiac enzymes were determined. Results: ISO administration significantly lowered (P=.05) HDL level and increased (P=.05) LDL, TG and TC as compared with control rabbits. ISO injury significantly increased (P=.05) the levels of cardiac enzymes CK-MB. LDH, SGOT and SGPT as compared with control rabbits. Curative treatment with gemmo and native extracts of Glycyrrhiza glabra significantly increased (P=.05) level of HDL and lowered (P=.05) the level of LDL, TG, TC and cardiac enzymes as compared with ischemic rabbits. Pre treatment with gemmo and native extracts prevented the reduction (P=.05) in HDL level and resisted the rise (P=.05) in other lipid parameters and cardiac enzymes as after ISO induced myocardial injury. Pretreatment with extracts was significantly better (P=.05) than curative treatment. Gemmo extract was significantly better (P=.05) than native extract in preventive and curative treatment in normalizing serum levels of lipid parameters and cardiac enzymes in ISO injured rabbits. Conclusion: The results provide evidence for the first time that gemmo extract of Glycyrrhiza glabra prevents myocardial injury induced by ISO in rabbits.

Isolation and characterization of irritant components of Euphorbia pilulifera L.

Euphorbia pilulifera is commonly found weed along road sides and loamy soils. This weed is commonly used as treatment of female disorders and respiratory problems. The latex of this weed causes irritation on hand on contact. To evaluate its irritant potentials, the dermatological investigation of irritant principles from locally occurring Euphorbia pilulifera was carried out. For this purpose, after collection and drying, a series of solvents with increasing polarity were used for the successive extraction of non-polar compounds [petroleum ether extract], constituents of intermediate polarities [chloroform extract] and polar constituents [methanol extract] from the whole herb of Euphorbia pilulifera. The chloroform extract of this weed was found most irritant to rabbit's skin. Chloroform extract was further subjected to column chromatography; four fractions Ep 1 to Ep 4 were isolated from active chloroform extract by column and thin layer chromatography. The irritant potentials of these isolated fractions were evaluated on rabbit's skin. Two fractions out of the four, Ep 1 and Ep 3 appeared to be the most irritant than others. A possible structure activity relationship of these active compounds was discussed in order to establish their activity

Counter irritant activity of carthamus oxycantha

Many locally occurring species of Asteraceae are used as medicinal plants by various tribal and ethnic communities in Pakistan. Carthamus oxycantha is often occurs as weed in cultivated fields. Folk medicines indicated its use as an anti inflammatory and wound healing plant. It is used for wound healing by the local population in the form of powder paste. No scientific report, about the behavior of this plant has so far been published. The counter irritant studies of locally occurring Carthamus oxycantha was carried out. The main objectives of the project were to evaluate its wound healing effects on animal skin and the identity and characterization of chromatographically isolated fractions. For this purpose, different solvents with a broad range of polarity were successively used to extract non-polar compounds [petroleum ether extract], constituents intermediate polarities [chloroform extract] and polar constituents [methanol extract] from the whole herb of Carthamus oxycantha. The counter irritant activity of the crude extracts and isolated fractions was evaluated on rabbit's skin. Five fractions Co-1 to Co-5 were isolated from the active chloroform extract by column and thin layer chromatography. Co-1, Co-3 and Co-5 appeared to be the most potent counter irritant than others. A possible structure-activity relationship of these active compounds was investigated by using spectroscopy [UV and FTIR analysis]

comparison between open and closed hemorrhoidectomy

Haemorrhoidectomy is associated with complications including pain, bleeding and wound infection which can result prolonged hospital stay. Haemorrhoidectomy is considered to provide a better outcome in terms of postoperative pain and wound healing. Aims were to compare postoperative pain, bleeding, operating time and wound healing in patients undergoing open and closed haemorrhoidectomy. This comparative study was conducted in the surgical department at Fauji Foundation Hospital, Rawalpindi from December 13, 2006 to December 31, 2011. Consecutive patients, both male and female, presenting with 3[rd] and 4[th] degree haemorrhoids in the surgical Outpatient Department were included in this study. Half of the patients were assigned to the open haemorrhoidectomy group while the other half was put in the closed haemorrhoidectomy group. Each patient was evaluated by detailed history and examination. Both digital rectal examination [DRE] and proctoscopy were done to confirm the diagnosis. A total of 260 patients were assessed, 130 in each group. In the open group, 52 patients experienced mild pain and 78 moderate while in the closed group, 30 patients experienced mild pain, 87 moderate and 13 patients severe pain. All 130 patients in the closed group showed complete wound healing after 2 weeks as compared to only 66 patients in the open group with a p<0.001. Early and late postoperative bleeding was similar in both groups. The closed technique provides a better outcome in terms of less postoperative bleeding and complete wound healing, but it is associated with more pain

Epidemiology and outcome in patients of diabetic foot

The aim of study was detailed analysis of the presentation of diabetic foot ulcers, characteristics and predictors of outcome [incidence of amputation in neuropathic, ischemic, neuro ischemic] in patients presenting with diabetic foot at our hospital. This prospective analytic study was conducted from January 2009-August 2010 at POF Hospital Wah Cantt. Diabetic patients who presented with foot ulcers were enrolled in this study. Demographics of patients along with ulcer size, type, site and Grade according to Wagner Classification were recorded. Wounds were managed with daily dressings, nursing care and de-sloughing of necrotic tissue along with appropriate antibiotic cover. Patients were followed over period until wound healed completely or a lower limb amputation performed, the outcome noted and patient was deemed to have completed study. One hundred and fifteen patients with mean age 55.46 +/- 8.23 years, both male and female were included in this study. Out of 115 patients 111 patients had Type-II diabetes while only 4 presented with Type-I. Mean Duration of diabetes was 14.61 +/- 2.17 years. With respect to underlying causes 18.3% foot ulcers were ischemic, 22.6% were neuropathic and 59% were neuro-ischemic. Median ulcer size was 74% of ulcer classified as Wagner grade-II and III while 24% were of Grade-V. Lower limb amputation were performed in 25% of patients whereas limb salvage achieved in 75% of patients with wounds healed [median healing time 5 [3-10 weeks]. Preservation of the limb function without endangering the patient must be a goal of treating diabetic foot. Once foot amputation is successful, rehabilitation with orthotic or prosthetic devices may allow years of a functional extremity along with preventive measures like cessation of smoking, daily foot hygiene and foot inspection

Seroepidemilogical survey of hepatitis b virus infection amongst Barbars in Faislabad

Barbers who have occupational hazard of accidental exposure to blood are at increased risk for acquiring blood borne infections. There are many blood borne infections but hepatitis due to hepatitis B and C viruses is leading cause of morbidity and mortality worldwide including Pakistan. The objective of this study was to find the frequency of HBsAg in barbers and to assess their knowledge of this occupational risk. This is a cross-sectional epidemiologic survey, that was conducted at Faisalabad between Jan 2007 to March 2007. A total of 139 barbers working in Faisalabad city were included in the study. A closed structured questionnaire was filled to asses the knowledge and attitude of the barbers. HBsAg test was carried out by rapid test method for each barber. Mean age of barbers was 37.3 years and they had worked in the trade for an average of 15.9 years. Only 37 [26.62%] regarded hepatitis B as occupational hazard for barbers. HBsAg was positive in 4.63% of barbers working at hair dresser shops and 6.45% of roadside barbers. Awareness about the occupational hazard of hepatitis B among barbers is poor. All means of prevention must be used to protect the health of these workers and of the general population

Lower extrimity amputation in diabetic patient

To evaluate the frequency of lower limb amputations in diabetic patients, hence emphasizing the importance of timely surgical intervention in salvage of lower limb and to reduce the morbidity and mortality. This descriptive study was conducted in Nishtar Hospital, Multan over a period of one year extending from January 2004 to December 2004. One hundred patients were included in the study. The incidence of amputations rose steeply with age; most amputation occurred in patients over 60 year. The incidence was a higher in men than in women. The incidences of major amputations were 32% than that of minor amputations. The main out come variables were the number of repeat operations and hospitalization for salvage of limb with recurrent or persistent infection, and time to complete forefoot healing or foot amputation. Amputations performed at healthy zones reduce the hospital stay of the patient but mortality was more consistently for proximal amputations

High anorectal malformations: surgical repair in neonatal age is better than delayed repair

The malformations of the anorectum are common congenital anomalies. The usual treatment of high anorectal malformations is creating a colostomy at birth, posterior sagittal anorectoplasty [PSARP] at 9-12 months of age and closure of colostomy 4 - 6 weeks later after regular anal dilatation. This 'delayed PSARP' has a number of disadvantages including poor development of normal defecation reflexes. To evaluate continence, cost of management and duration of hospitalization with primary PSARP and to compare it with delayed PSARP. This prospective study was done at the Department of Pediatric Surgery, Children Hospital, Lahore from Nov 1999 to No v 2001. Twenty-four infants [19 boys, 05 girls] with high anorectal malformation were included in the study. All had well developed sacrum and natal cleft, and weighed more than 3 Kg. Twelve patients underwent primary PSARP [Group A] and 12 underwent colostomy, PSARP and then colostomy closure as a three stage procedure [Group B]. The incidence of urinary tract infections [75%], distal loop fecal impaction [41.7%] peri-colostomy skin excoriation [41.7%] was high in Group B as compared to those in Group A. The rate of post PSARP complications and hospital stay was longer in Group B and the average cost including operative procedures, hospital admissions for each complication and follow-up was high [Rs 14,670 +/- 400] in Group B. These results suggest that one stage PSARP is a safe and viable approach to the management of high anorectal malformations in a selected group of neonates

Seroprevalence of hepatitis C virus antibodies among healthy young men in Pakistan

This study was to investigate the seroprevalence of antibodies against HCV [anti HCV] in healthy young men. The study was done at Combined Military Hospital, Attock, from Jan 2001 to Mar 2002. Blood samples of 4552 young healthy men belonging to all the provinces/regions of Pakistan, who presented for pre-employment physical examination, were tested for anti HCV by third generation Enzyme Immunoassay kit. The history of intravenous injections, blood transfusions, surgery, jaundice, jaundice in wife or in family and sharing of razors was sought in all subjects. Anti-HCV antibodies were positive in 183 subjects 4.0%. Young Sindhi males had significantly higher seroprevalence than men belonging to other areas. Major risk factors in seropositive subjects were sharing of razors 62.8% and use of injections 35.5%. Past history of jaundice in the family was present in 19%. No identifiable risk factor could be found in 13.1% of seropositive men. Sharing of razors and indiscriminate use of injections for various indications appear to be the major source of transmission of the disease; public education on a major scale is likely to reduce this trend

Hepatitis B surface antigen; screening in young Pakistani males

Hepatitis B is one of the most common infectious diseases in the world with over 350 million chronic carriers worldwide. In Pakistan, most of the studies have been done in high risk groups such as health care workers, voluntary blood donors etc. Few studies have been reported in general population so far. Therefore, there is dearth of knowledge regarding prevalence of HBV infection in young males seeking employment in various sectors of society. To investigate the prevalence of hepatitis B surface antigen [HBs Ag] in a population-based sample of healthy young males that were drawn from various regions of Pakistan for recruitment. Combined Military Hospital, Attock, from Jan 2001 to Mar 2002. Cross-sectional observational. A total number of 4552 healthy young males who reported for pre-recruitment physical examination, belonging to all the provinces of Pakistan, Northern areas and Azad Kashmir were screened for HBs Ag by immunochromatographic technique. The positive result was confirmed using Enzyme Immunoassay kit. Out of the total of 4552 healthy young males; HBsAg was positive in 190 subjects [4.2%]. Prevalence of HBs Ag in individuals from Sindh was significantly higher than those from other regions. Major risk factors for HBV infection were sharing of razors [56.8%], history of intravenous injections [39.5%], jaundice in the subject [18.4%] and jaundice in family [18.9%]. In HBs Ag positive subjects, 11.1% revealed no identifiable risk factor. There is more than two fold reduction in the HBs Ag prevalence over the last ten years. Major risk factors in the population are exposure to contaminated blood and use of needle sticks. However, a sizeable number of HBV infection do occur in our young healthy males which go undetected and are only detected on screening at the time of employment. Despite the already detailed knowledge about the transmission of hepatitis B, more work is required to search other mode of transmission on Hepatitis B

Insulin requirement in diabetic patients with chronic renal failure due to diabetic nephropathy [DN]

This study was performed in the Department of Medicine, Postgraduate Medical Institute and Lahore General Hospital, Lahore. One hundred patients of type 1 and type 2 diabetes with diabetic nephropathy induced chronic renal failure, of either sex; the ages above 18 years were included in the study. Patients, recruited, were investigated to rule out any other cause of renal failure. Data was collected on a questionnaire regarding duration of diabetes, previous diabetic treatment and compliance. Patients were put on insulin and their daily blood glucose charts were maintained. When the patients achieved optimal glycaemic control, total amount of insulin per day was recorded. This study included a total of 100 diabetics, 12 [7 men, 5 women] had type 1 and 88 [41 men, 47 women] had type 2 disease. Duration of diabetes was higher in type 1 [15.6 +/- 3.2 years] than in type 2 diabetes [9.7 +/- 5.0 years]. All patients with type 1 diabetes required insulin but there was reduction of 28.2%-60.0 % as compared to maximum units taken prior to renal impairment. About 35.2% patients of type 2 diabetes did not require any insulin. Mean insulin requirement was lower in type 2 diabetics [14.8 +/- 14.6 units/day] than in type 1 diabetics [34.3 +/- 9.9 units/day]. The Pearson correlation [2-tailed] between serum creatinine and 24 hour insulin requirement was significant [P=0.01]. The purpose of this study was to find out the requirement of insulin for optimal glycaemic control in diabetics with impaired renal function due to diabetic nephropathy. It was concluded that the patients with impaired renal function due to DN had lower requirement of insulin than before the development of DN. Type 1 diabetic patients had significant reduction in insulin compared to the requirement prior to DN. Some type 2 diabetic patients did not require any treatment

Microalbuminuria and associated risk factors in type II diabetics

To determine the frequency of microalbuminuria [MA] and its associated medical risk factors in type II diabetic patients. Place and Duration of Study: This cross-sectional analytical study was conducted during Ist half of 2003 at Combined Military Hospital, Lahore. Non-probability purposive sampling was employed. Materials and Study population included 150 type II diabetic patients [70 women, 80 men] attending outpatient department of the hospital. Patients having clinical albuminuria and with other causes of proteinuria were excluded. Women and men were of comparable ages. Women [26.4 kg/m2] had higher body mass index [BMI] than men [24.3 kg/m2]. The frequency of MA was 46.7%, higher in males [50.6%] than females [41.5%]. Fasting plasma glucose and HbA1c levels were significantly higher in patients with MA compared to those with normoalbuminuria [p < 0.001]. The microalbuminuric patients had significantly decreased HDL-c levels compared to normoalbuminuric subjects [p< 0.001]. However, no relation of MA with age, gender, known duration of diabetes, BMI, history of smoking, hypertension and serum: total cholesterol, LDL-c, triglyceride, urea and creatinine was found. There is a strong association of poor glycaemic control and decreased HDL-c levels with the presence of microalbuminuria

Serum immunoglobulin G and haematological parameters in goitrous thyroid disease treated by radioiodine and surgery

They were aimed at determining the serum immunoglobulin G [IgG] and hematological parameters in goitrous patients treated by radioiodine and thyroid surgery. This prospective clinicopathologic study was conducted in Postgraduate Medical Institute, Lahore. Blood samples of 20 patients with toxic diffuse goiter [TDG] and 30 with non-toxic nodular goiter were analyzed for serum IgG, hemoglobin [Hb], total and differential white cell counts [TLC and DLC] at 0, 10d and 6-8 weeks of radioiodine or surgical treatment. Twenty age-and.sex-mulched healthy individuals were included as reference population. Goitrous patients had significantly higher IgG that was detected after sub total thyroidectomy in cases of nodular goitre. Patients with TDG showed significantly increased IgG after radioiodine therapy [p<0.01]. Hb level in patients was lower as compared to control group [p<0.05], Hb showed a significant increase after 6-8 weeks of therapy [p<0.05]. Changes in TLC and DLC were not significant. Serum IgG in goitrous patients was significantly higher than healthy controls. Patients with TDG showed an increase in IgG after radioiodine therapy. Changes in Hb, TLC, DLC were mostly insignificant after treatment with radioiodine as well as surgery

Prevalence of thyroid microsomal and thyroglobulin autoantibodies in goitrous lesions

This prospective study was done to evaluate the serum levels of Microsomal and Thyroglobulin autoantibodies in patients with toxic diffuse goiter and nodular goitre [non-toxic] undergoing radio-iodine therapy and thyroidectomy respectively. Forty eight patients suffering from thyroid disorders, 29 with nodular goiter and 19 with toxic diffuse goitre [TDG] and 15 age and sex-matched normal controls were studied. Thyroid microsomal [MSAb] and thyroglobulin autoantibodies [TGAb] were estimated in the sera of all the subjects using the commercially available kits based on tanned red cell hemaglutination technique. MSAb seropositivity in TDG and nodular goitre was found to be 78.9% and 51.7% respectively. On the other hand, TGAb seropositivity was 57.9% and 27.6% in cases of TDG and nodular goitre. 13.3% and 6.7% of the normal controls were positive for MSAb and TGAb respectively. These findings indicate that autoimmunity is implicated in the genesis of commonly occurring thyroid disorders