Frequency of Congenital Hypothyroidism [CH] in Neonates of a Tertiary Care Hospital of Karachi, Pakistan

Objective: To determine the frequency of congenital hypothyroidism among healthy newborns presenting to a public health facility in Karachi, Pakistan

Methods: This cross sectional study was carried out for six months duration at the Well Baby Clinic, Paediatric unit III, Civil hospital Karachi. Neonates of both sex delivered after 37 weeks of gestation, at Civil Hospital Karachi and visited the well baby clinic, after 48 hours of birth to <4 weeks of age for follow up were included in the study. A 3 cc venous blood sample taken for serum Thyroid Stimulating Harmone [TSH] level. Data analysis was done using SPSS statistics version 16

Results: A total of 215 healthy newborns were included, 112 were male and 103 female patients

Congenital hypothyroidism was considered according to the TSH value. The results showed that 35 patients had TSH >40 [microU/ml]

Conclusion: This study shows that in the screening for the congenital hypothyroidism, 16.3% had a TSH level of >40 [microU/ml]

This suggests that screening of hypothyroidism should be mandatory in all newborns especially in our region for early diagnosis and treatment of congenital hypothyroidism

Factors associated with cessation of breast feeding

To determine factors associated with cessation of breast feeding in children. This was a cross sectional study carried out at Lyari general hospital from 1[st] January to 30[th] June 2009. Children up to two years of age were included. Information entered in a pre-designed proforma. Total of 543 children included. Maternal factors were insufficient milk secretion 57% and insufficient rest during first six weeks of post partum 43%. Among factors in children, formula feeding 41% and disruption during feeding 36% were common. No enough milk during first few days after birth 64% and baby remains hungry after breast feeding for enough time 62% were common myths. The major maternal and child factors and myths responsible for termination of breast feeding were insufficient milk secretion, breast problems, maternal stress, bottle feeding and initial breast milk is harmful to the babies. These misconception must be addressed during antenatal visit

Analysis of risk factors cotnributing to releak in duodenal ulcer perforation: experience of surgical closure by Graham's patch

Free perforation of peptic ulcer into the general peritoneal cavity is a catastrophic event. Although laparoscopic approach has been successfully used for its management, primary closure of the perforation using an omental patch [Grahm's patch] is the immediate alterative. This study was planned to analyse risk factors, which could predict releak following Grahm's patch closure. This study was carried out for five years from April 2003 to March 2008, at department of surgery Muhammad Medical College Mirpurkhas. All patients undergoing surgery for perforated duodenal ulcer were included in the study. 53 patients underwent Grahm's Patch Closure. 6 patients developed releakage post operatively. Therefore two groups were made. Patients with releak were kept in case group [n=6] and the patients with no leak [n=47] were included in control group. In this study all patients were assessed for age, pulse rate, systolic blood pressure, hemoglobin and serum Protein / albumin, total leukocyte count [TLC] on arrival, delay in arrival since sign and symptom [probable] of perforation and size of perforation on operation were also documented. Age greater than 50 years [p=0.05], pulse greater than 110/min [p=0.22], systolic blood pressure less then 90mmHg [p=0.02l], hemoglobin less than 10gm% [p=0.25], serum albumin less than 2.5gm% [p=0.018], delay in arrival for more then 36 hour [p=0.00017], and size of proportion greater then 5mm in it maximum dimension were identified as risk factor for releak. Delay in arrival was the single most significant factor influencing mortality rate after omental patch closure of perforated duodenal ulcer

Family planning: knowledge, attitude and practice among married couples in northern Pakistan

To assess knowledge, attitude and practice among married couples regarding contraceptive measures in Baltistan [Northern Areas of Pakistan]. Cross sectional study The study was carried out in Baltistan, which is a district in northern areas of Pakistan with headquarter at Skardu. Duration of study was from June 2002 to August 2003. A study was done on married couples with female partner of childbearing age. A study questionnaire was designed and response was obtained from 200 randomly selected married couples [females: 152, males: 48], which reported to health care facilities for some other minor ailment. Majority of the study participants [67%] were of the view that rapidly increasing population is a problem affecting socioeconomic development of the country. There is wide gap between knowledge and practice of family planning. The contraceptive prevalence rate of Baltistan is 8.5% much low from rest of the country, which is above 36%. Important reasons for not using contraceptive measures were that family planning was considered against religious, beside illiteracy, poverty and poor communication. Most of the respondents were in support of early marriage for girls. Efforts are required from family welfare programme, besides long-term measures such as enhancement of women literacy