Role of thyroid peroxidase antibodies in the outcome of pregnancy

To assess the prevalence of Thyroid peroxidase [TPO] auto antibodies among pregnant women and its relation with their pregnancy outcome. Cross-sectional analytical study. The study was carried out at Zayed Medical Complex, Lahore, in the department of Obs/Gynae and NHRC from July 2000 to July 2002. The study included 1500 Euthyroid pregnant women, ages 18 - 40, registered for antenatal care at Obs/Gynae department. Previous fertility history was recorded and thyroid peroxidase antibody level was assessed by ELISA method. A cut off value of TPO antibody of upto 100U/ml was considered negative and more than 100 U/ml was considered positive.The cases were followed for the outcome of their pregnancy and compared with TPO antibody levels. A comprehensive proforma was used to collect the data. The prevalence of positive TPO autoantibodies was found to be 11.2%. The raised TPO autoantibodies were found to have higher risk of abortion [O.R 49.2] and prematurity [O.R.8.1]. The complications were found to be significantly raised among positive TPO autoantibodies cases, when analysed by parity and age of mother at time of registration. Thyroid autoimmune diseases among euthyroid pregnant women may contribute to low-birth-weight of neonates and high abortion rate in all pregnancies. Raised levels of TPO autoantibody is a good marker to assess early hypothyroidism state and should form a screening modality in Pakistan

PAP smear screening in hospital based population

To reduce the mortality rate in women due to cervical cancer by early detection. To calculate magnitude pattern and proportion of PAP positive cases among high risk population and associate variables to PAP positive cases. Descriptive, cross-sectional Gynaecology and Obstetrics out patient department of Shaikh Zayed Medical Complex and Sir Ganga Ram Hospital Lahore from June 2005 to May 2006 The smears were analysed in Histopathology department of Shaikh Zayed Medical Complex. A total of 1500 smears were taken, 511 [34.1%] from Sir Ganga Ram Hospital and 989 [64.9%] from Shaikh Zayed Medical Complex. The mean age was 42 +/- 8 years with a range of 35-80 years. Prevalence of positive cases was 3.9% with majority of [2.5%] falling in the age group 35-40 yrs. Cases with positive cervical intraepithelial neoplasia [CIN] had strong association with family history of cancer [p-<0.002, OR=3.284,CI: 1.497-7.2203]. On examination cervix bled to touch in 25 cases [p-<0.0001.0R=2.721,Cl: 1.595-4.645], it was suspicious looking in 8 cases [p-<0.0001,OR=8.714,CI:3.758-20.21] and 5 cases had post menopausal bleeding [p-<0.006. OR=3.582,CI: 1.354-9.481]. However no association was found with smoking, hormonal intake or post coital bleeding. PAP smear should be used as a routine test for every woman aged 35 or above coming to the gynaecology department for symptoms of abnormal vaginal discharge, bleeding, or low backache for early detection of cervical cancer