Frequency of autoimmune thyroid disease in chronic urticaria

To determine the frequency of autoimmune thyroid disease in diagnosed cases of chronic urticaria [CU] and the association between hypothyroidism and chronic urticaria if any. Non-interventional, descriptive study. Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006. The patients were selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre, the Aga Khan Hospital and community clinics. A total number of 60 patients were enrolled in this study. In all patients, serum antithyroid autoantibodies [antithyroglobulin and antimicrosomal/thyroperoxidase], thyroid profile [serum TSH, T3 and FT4], complete blood count, erythrocyte sedimentation rate and IgE levels were carried out. The proportions were compared using chi-square test with significance at p <0.05. Forty seven [78%] patients were found to have chronic urticaria [history and laboratory reports]. Out of 47 patients with diagnosis of CU, elevated titres of antithyroglobulin [TGA] and antimicrosomal antibodies [TMA] were found to be present in 20 [42.6%] and 27 [57.4%] patients respectively. Serum TSH level [thyroid stimulating hormone] was increased and T3, FT4 were decreased in 20 [42.6%] patients [p < 0.001]. A total number of 20 [42.5%] patients were found to be hypothyroid with chronic urticaria of greater than 6 weeks duration. This study shows a statistically significant association between hypothyroidism and chronic urticaria. Full thyroid profile [serum thyroid autoantibodies, serum TSH, T3 and FT4] is highly recommended in patients with diagnosis of chronic urticaria

Serum antithyroid antibodies in female patients with chronic urticaria

To determine the frequencies of serum antithyroglobulin and antimicrosomal autoantibodies in female patients with chronic urticaria, and the association between thyroid autoantibodies and chronic urticaria, if any. Non-interventional, case-control analytic study. This study was carried out by the Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006 on patients selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre and The Aga Khan University Hospital, Karachi and from the Community Clinics in Karachi. A total number of 90 subjects were enrolled and divided in three groups consisting of 30 patients each. Group 1 comprised of patients with diagnosis of chronic urticaria, Group 2 of diagnosed cases of hypothyroidism with/without urticaria, and Group 3 of normal age and gender-matched healthy volunteers. In all patients, serum antithyroid autoantibodies [antithyroglobulin and antimicrosomal] and thyroid profile [serum T3, T4 and TSH levels] was carried out. Chi-square test was used to determine significance of proportion of variables at p< 0.05. Elevated titres of antithyroglobulin antibodies were found to be present in 9 [30%] patients in Group 1 [chronic urticaria], 24 [80%] patients in Group 2 [known cases of hypothyroidism] compared to control. Elevated titres of antimicrosomal antibodies were found to be present in 13 [43.3%] patients in Group 1, 27 [90%] patients in Group 2 [known cases of hypothyroidism] compared to control. The association between hypothyroidism and chronic urticaria with regard to autoantibodies titres was highly significance [p <0.001]. A highly statistically significant association was found between chronic urticaria and hypothyroidism with special regard to antithyroglobulin and antimicrosomal autoantibodies. Therefore, assays of these two autoantibodies are justified for the early diagnosis of autoimmune thyroiditis in combination with chronic urticaria for better treatment options

Cutaneous Leishmaniasis: An emerging childhood infection

Cutaneous Leishmaniasis [CL] has been an endemic parasitic infection in certain areas of Pakistan. New outbreaks have occurred in many areas not identified previously especially in the province of Sindh. The object of this study was to see the prevalence of CL as a childhood disease. It was a cross sectional study in which 400 cases coming to various skin disease clinics were included for confirmation of CL by microscopy, culture and PCR. Out of 400 cases, 185 cases of ages from 1-14 years were diagnosed clinically and confirmed by Lab. Tests for CL. Both dry and wet types of lesions were observed that indicated presence of more than one strain of the parasite. Cutaneous Leishmaniasis was found to be significantly prevalent in children. The strains were found to be L. tropica and L. major as was indicated by the nature of lesions and confirmed by PCR

Age and symptomatology of menopause in Karachi, Pakistan

Menopause depicts end of woman's reproductive life usually occurring between ages 45 and 55. Many studies have been carried out to determine the mean age at menopause in different countries. In Pakistan, the greatest hurdle is ascertainment of correct age of women causing difficulty in determining the correct age at menopause. The objective of this study was to overcome this hurdle and to determine the mean age at menopause and occurrence of different symptoms at menopause in Pakistan. An observational cross sectional study was carried out in which the correct ages of 212 women from different hospitals, workplaces and housewives were estimated using Matriculation Certificates and/or National Identification Cards between February-November 2004. Age at menopause and associated symptoms were recorded. Menopausal age of the subjects' mothers was also documented. Epi Info Version 3.3 was used for data analysis. Mean age at menopause was determined to be 44.5 years [ +/- 0.8 years] ranging from 32-62 years. The predominant symptom experienced was hot flashes [82%]. There was no significant negative impact of menopause on libido in our subjects [p>0.05]. A significant similarity was observed between menopausal ages of 110 women and their mothers [p<0.001]. Mean age at menopause in Karachi, Pakistan is significantly lower than in West, which highlights need for studying social, economic and cultural basis of this difference. However, strong conclusions about menopausal age can only be made by large scale population-based studies. The symptoms experienced are similar as elsewhere in the world, although occurring with varying frequencies. There is a familial pattern to the onset of menopause

Influence of anthropometric measures on age related cataract

To evaluate the Influence of Anthropometric measures on age related cataract. A cross-sectional study on local male population. This study was conducted in department of physiology basic medical science institute Jinnah post Graduate Medical Institute. [BMSI, JPMC] in collaboration with ophthalmology Department of JPMC and Physiology Department Dow Medical College Karachi. After selection of subjects by consecutive sampling, a prescribed proforma was filled. A complete eye examination was performed and the subjects were asked to attend the laboratory, after 12 hour fasting samples were collected. Serums were stored for analysis. Blood pressure was measured by mercury sphygmomanometer. Weight, Height, Body Mass Index, Waist Circumference, Hip circumference and Waist/Hip Ratio were recorded. Subjects were divided in to four groups. Group-A =Normotensive, Normoglycaemic with Cataract [as Control] Group-B=Hypertensive with Cataract Group-C=Diabetics with Cataract Group-D=Hypertensive, Diabetics with Cataract. This study revealed that age related Cataract is influenced by Anthropometric measures. In our population age related cataract is inversely influenced by body mass index in contrast to the developed countries

Frequency of cryptosporidium in childhood diaarrhoea-importance of modified acid fast technique

One of the important causes of childhood diarrhoea is cryptosporidium, a parasitic pathogen which is usually overlooked. This study was therefore designed to show the importance of modified acid fast stain in the diagnosis of cryptosporidium in childhood diarrhoea. Stool samples from 300 children with prolonged diarrhoea were examined by modified acid fast staining along with wet mounts in saline and iodine. Out of 300 samples five [1.7%] were diagnosed as positive for cryptosporidium. Results indicate that Cryptosporidiosis exists as a cause of diarrhoeal illness in our society. It was also noted that modified acid fast staining of stool samples is an important, non-invasive and useful diagnostic technique in identification of cryptosporidium

Plasma fibrinogen - a coronary risk factor

This study was carried out to measure the levels of fibrinogen in patients of ischaemic heart disease. Fibrinogen levels were determined in 43 patients of ischaemic heart disease and compared with thirty clinically healthy non-smoker controls. Levels of fibrinogen [mean +/- SEM] in patients were 431.51 +/- 7.89 Mg/dl and in controls 241.83 +/- 3.03 Mg/dl [P<0.001]. Patients were also sub-grouped as smokers and non-smokers. Plasma fibrinogen in thirty one non-smokers was 421.51 +/- 9.3 Mg/dl and in twelve smokers fibrinogen was 457.92 +/- 11.59 Mg/dl [P<0.001 when compared to controls] and P<0.05 when smoker patients were compared with non-smoker patients. Fibrinogen can be considered as coronary risk factor. It should be included in the assessment of coronary risk profile alongwith lipid profile and efforts should be made to reduce the elevated levels of fibrinogen. Clinical studies with agents which may reduce fibrinogen levels are needed to reduce the prevalence of coronary artery disease

Systolic blood pressure response to valsalva maneuver in cases of Chronic Obstructive Pulmonary disease

To observe the systolic blood pressure response to Valsalva maneuver in cases of chronic obstructive pulmonary disease [COPD]. To correlate the Valsalva responses with left ventricular ejection fraction [LVEF]. In all subjects the standard Valsalva maneuver was performed in the supine position and systolic blood pressure responses were characterized as a [a] Sinusoidal [Normal] [b] Absent over shoot and [c] Square wave [Abnormal]. LVEF was performed in all COPD subjects. Setting: Physiology Department BMSI, Medical Department, Chest Medicine Department J.P.M.C. and NICVD Karachi. A total of 95 male subjects were included, during the course of present study, out of which 30 subjects were healthy controls and 65 subjects were COPD with and without Cardiac failure. The Valsalva responses were strongly correlated with LVEF. Sinusoidal response was observed in all [100%] healthy control subjects, 21 [60%] of the 35 COPD subjects without cardiac failure and only 1 [3.33%] of 30 COPD subjects with cardiac failure, Absent overshoot was observed in 14 [40%] of the 35 COPD Subjects without Cardiac failure and 5 [16.67%] of the 30 COPD subjects with cardiac failure, square wave response was only observed in 24 [80%] of the 30 COPD subjects with cardiac failure. LVEF of 22 sinusoidal responses is 74.36 [ +/- 1.30], while 19 absent over shoot responses is 46.47 [ +/- 2.67] and 24 square wave responses is 29.67 [ +/- 1.69]. It is concluded that in the presence of physician systolic blood pressure response to Valsalva maneuver is a simple, safe and non-invasive technique than the more sophisticated test LVEF in early detection of cardiac failure