Frequency of thyroidal dysfunction in chronic hepatitis C sero positives

Background: Hepatitis C virus is proving to be a global disease causing serious and debilitating effects on the general health of the public. It has been recognized that hepatitis C manifests itself through hepatic and a variety of extra hepatic diseases. The common two being; diabetes mellitus and thyroidal dysfunctions. A range of thyroid hormones disturbances are reported in association with hepatitis C infectivity, for example,Overt and Subclinical hyperthyroidism along with Overt and Subclinical hypothyroidism. To determine the relation between Hepatitis C Sero-Positivity and Thyroidal Dysfunction

Methods: We studied 274 Chronic Hep C sero positive, non cirrhotic cases [Jan 2010 -Jun 2014] in OPD of an urban tertiary care hospital [i.e Baqai Medical University Hospital Nazimabad].Out of this, 203[b/w 20 to 60years of age] cases were found to be evaluable [i.e undergone TSH/FT4 evaluation at baseline]. TSH, was taken according to age groups [i.e age 20y-54y [0.4-4.2] micro IU/ml and 55-87[0.5-8.9] micro IU/ml] and FT4 [all age group]0.8-2.7ng/dL

Results: Thyroid dysfunction was found in 17 patients [8.4% [n = 203]].The Thyroidal dysfunction among the study group include; 01 patient with Overt Thyrotoxicosis [5.88% [n = 17]], 05 with Clinically Hypothyroid [29.41% [n = 17]] status and 11 cases with Sub-Clinical Hypothyroidism [64.70% [n = 17]]

Conclusion: An association of thyroidal dysfunction and Chronic HCV infection is noted in the study population without known pre-existing thyroidal disease

Pegylated interferon associated thyroidal dysfunction among hepatitis C patients

Background: Chronic hepatitis C and interferon both have their effect on thyroid gland function including clinical and subclinical thyroidal dysfunction [TD] that form major clinical manifestations of chronic hepatitis c

Objective: To assess Pegylated interferon based therapy related thyroidal dysfunction in chronic hepatitis C patients and to compare it with those who are hepatitis C Sero positive but have not receive interferon based treatment

Methods: A case control study in which, 203 patients of Chronic, compensated hepatitis C[130 females,73 males] were included from Baqai University Hospital Karachi Liver Clinic [b/w Jan 2010-Jun 2014]. The participants were checked for thyroid dysfunction at the onset, 17 patients were found to have thyroidal dysfunction in the beginning and were excluded from the total 203 cases, then out of the remaining 186 cases, 101 patients [who were not having TD initially] opted treatment with pegylated interferon/ribavarin [Treated Group] and the rest [85 cases] were taken as control group

Results: Thyroid dysfunction was identified in 7 patients giving a frequency of 6.9%. Out of these 7 patients only one patient was male while the rest were females. The mean age of the patients with thyroid dysfunction was 39.2 +/- 7.13 years. Amongst the patients identified with the thyroid dysfunctions, 2 [28.5%] had overt hypothyroidism and 5 [71.4%] had sub-clinical hypothyroidism. The treatment with combination therapy was significant for development of thyroid dysfunction in patients with hepatitis C [p=0.013] as compared to control group in which 85 patients of chronic hepatitis C who have not developed [TD] during the study period

Conclusion: dysfunction after pegylated interferon/ribavarin treatment in chronic hepatitis C is statistically significant with sub-clinical hypothyroidism is the predominant type in the study population

Frequency of impaired oral glucose tolerance test in high risk pregnancies for gestational diabetes mellitus

To determine the frequency of impaired oral glucose tolerance test in high risk pregnancies for Gestational Diabetes Mellitus [GDM]. Cross-sectional study. The study was conducted in Obstetric Ward and outpatient department, at Baqai Hospital, Nazimabad and Fatima Hospital, Baqai Medical University, Karachi, from May to October 2005. A total of 50 high risk pregnancies for gestational diabetes mellitus were selected through outpatient department of obstetrics. Data was collected according to certain obstetric and non-obstetric risk factors for GDM as inclusion criteria through a designed proforma i.e. family history of diabetes, macrosomia [i.e, wt > 3.5 kg], abortions, grand multiparity, a sudden increase in weight [>1 kg/wk] during pregnancy, age > 35 years, early neonatal deaths/sudden IUDS, polyhydramnios, urogenital infections [vulvo-vaginal candidiasis and UTI], previous history of GDM, congenital abnormalities [with or without polyhydramnios] and multiple pregnancy. Oral glucose tolerance test was performed and analyzed according to American Diabetic Association criteria, 2004. The most frequent risk factors were family history of diabetes mellitus in 1st degree relative and large for dates babies in 18 patients. Similarly, high risk factors such as history of abortions and grand multiparity were present in 16 and 14 pregnant women respectively. Least common factors, which contributed for GDM, were polyhydramnios in 4 cases and perinatal mortality [due to congenital anomalies of foetus, intrauterine deaths or neonatal deaths] seen only in 5 cases. Overall impaired oral glucose tolerance test was found in 24%. Most patients had one [17%] or two risk factors commonly [23%]. Only 2% had shown five or more risk factors. Oral glucose tolerance test is a useful diagnostic tool to detect GDM in high risk pregnancies, depending upon the high frequency of number of risk factors in each individual