Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study.

OBJECTIVES: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism. METHODS: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied. RESULTS: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group. CONCLUSIONS: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan.

Seasonal variation in trachoma prevalence among children, District Dera Ghazi Khan of Punjab, Pakistan.

OBJECTIVE: The study objective was to estimate trachoma prevalence in relation to seasonal variation among children. METHODS: Study Design was cross sectional and data was collected during all seasons of the year. After randomization of population units, 10% of them were identified by lottery and 5% of them were selected and examined for active trachoma case detection by simple random sampling technique. Total number of study participants were nine thousand seven hundred and ten (n=9710) from both urban and rural population units. The study was conducted during January -December 2018 during all three seasons of the year. After clinical examination, data was entered into a questionnaire Performa, which was used as tool for data collection. A Chi-square test was applied to compare trachoma cases among different seasons and among both boys and girls. RESULTS: Maximum burden of disease (62.4%) was reported during spring and winter season. Both spring and winter seasons have six months duration. During summer season, 70(37.6%) cases were reported. A highly significant (<0.01) relationship was reported between summer and spring seasons and trachoma prevalence (p < 0.01). A high prevalence was noted among female children. CONCLUSIONS: Higher prevalence of active trachoma was noted during summer season.

Indigenous leprosy in Dera Ghazi Khan Division, Punjab, Pakistan.

OBJECTIVE: The study objective was to identify the main foci of leprosy in Southern Punjab and identify the problems precipitating prevalence of disease. METHODS: This was a retrospective study, from 2017 to 2012. A total number of sixty-five cases (n=65) were detected during this period. Snowball sampling technique was used. Every year contact survey was carried out for new case detection and compliance of medication. Family members of patients were examined for any anaesthetic patch or nerve involvement or any deformity. Grading of the deformity, if present, was also done according to WHO criteria. Data analysis was carried out by using SPSS version 18.0. Chi square test was applied and P-value calculated. Snow ball sampling procedure was applied to study the disease burden. RESULTS: In this study, the total number of new leprosy patients detected were sixty-five; female patients were 49 (75.38%) and male patients 16 (24.6%). Prevalence of Pauci- bacillary disease was 50.77%. Maximum number of cases were reported from rural area of Southern Punjab. Main foci of disease were concentrated in tribal areas of Dera Ghazi Khan and Rajan Pur. CONCLUSIONS: Leprosy is still evidenced in tribal areas of Dera Ghazi Khan and Rajan Pur.

Active trachoma among children of District Dera Ghazi Khan, Punjab, Pakistan: A cross sectional study.

OBJECTIVE: This study was conducted to determine the prevalence of trachoma among children of age one month to 15 years. METHODS: Community based cross sectional study was conducted in district Dera Ghazi Khan from January to December 2014. The simple random sampling technique was employed. The total study participants were nine thousand seven hundred and sixteen (n=9716). The age of participants was one month to 15 years and all were residents of district, Dera Ghazi Khan. Data were collected by face to face interview and examination of subjects. Data were analyzed by using SPSS version 20.0. RESULTS: From total 9716 children screened for trachoma, 57.2% were males and 42.8% were females. A total 181 cases of trachoma were detected, out of which 95 were male and 91 female children. The overall prevalence of active trachoma was 1.91%. Female children showed high prevalence of active trachoma (2.18%). Two peak prevalence of disease were noted during winter season. CONCLUSIONS: Active trachoma is a public health problem among children. High prevalence is reported among female subjects. Community awareness programmes are needed for health education especially about facial hygiene.