Childhood immunization; awareness among pregnant women in Pakistan

Introduction: Childhood immunization remains one of the most important ways of preventing outbreaks of deadly diseases. Even with full-fledged active Expanded programme of immunization [EPI] initiated in Pakistan, the percentage of children getting vaccinated remain far below our required levels. Infant mortality in Pakistan is highest among SAARC countries, which at present stands at 70 deaths per 1,000 live births, according to a report compiled by the Society for the Protection of the Rights of the Child [SPARC]

Objective: This study was carried out to assess mother's education, knowledge and level of awareness of childhood immunization among the pregnant women. Study design: Cross sectional descriptive study. Setting: Jinnah Medical and Dental College Karachi in department of community Health sciences [CHS]. Study period: April 2012 to June 2012

Methods: A total number of Four hundred pregnant [400] women were interviewed in both OPDs and wards of Lady Dufferin Hospital and JMCH Karachi. The questionnaire contained a total of nineteen questions. All of them were self-asked in local language

Results: A significant number of child bearing women [81.5%] had good knowledge and aptitude about childhood immunization and are likely to get their children vaccinated

Conclusion: The higher the people are aware regarding childhood immunization, the more they are likely to get their children vaccinated. The level of awareness invariably correlated with the level of education of pregnant women. This tells us the literacy rate along with efficient immunization campaigns can help us fight against the war of high infant mortality rate against curable diseases

Chronic idiopathic urticaria; suggested/hypothetical role of elevated serum TSH in pathogenesis of chronic idiopathic urticaria

Urticaria is a condition in which itchy red bumps or wheals appear on the skin unexpectedly. There are two main types ,acute condition which last for up to six weeks while chronic idiopathic urticaria [CIU] last for more than six weeks. There are multiple factors in causation of chronic idiopathic urticaria [CIU] and therefore association with elevated thyroid stimulating hormone [TSH] was evaluated in this study. Prospective case control. Department of Physiology Dow University of Health Sciences Karachi. December 2004 to January 2006. A total number of ninety subjects/patients were enrolled. They were divided in three groups having 30 subjects/ patients in each group. Group A consist of diagnosed cases of chronic urticaria. Group B consist of diagnosed cases of hypothyroidism and group C consist of age and sex matched healthy subjects. In all selected patients/subjects, serum antithyroid autoantibodies and thyroid profile [serum TSH, T3 and T4], complete blood count, IgE levels, ESR were done. All patients were selected from dermatology and medical units of civil hospital, Agha Khan Hospital, JPMC and community health clinics in Karachi. Out of 90 patients, 47[78%] were found to have chronic urticaria compared to control. Out of 47 patients, serum TSH [thyroid stimulating hormone] was found to be elevated in 20[42.6%] patients with or without hypothyroidism compared to control group.[P <0.001] Statistically significant association was found between elevated serum TSH and chronic urticaria symptoms

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