Frequency of Hypothyroidism in Chronic Hepatitis C patients treated with Standard Interferon Therapy Hypothroidism in HCV patients on Interferon Therapy

Chronic hepatitis C is a major health problem associated with high mortality and morbidity. It is the most common chronic blood borne infection leading to chronic liver disease and hepatocellular carcinoma. One of the treatment used for hepatitis C is interferon therapy which can lead to thyroid dysfunction i.e. Hyperthyroidism and hypothyroidism. OBJECTIVE: “To assess the frequency of hypothyroidism in chronic hepatitis C patients treated with standard interferon therapy”. METHODS: Thisdescriptive case series study was carried out at Outpatient Department of Medicine, King Edward Medical University/ Mayo Hospital Lahore for 06 months from July to December 2014. After ethical approval of the study, 200 patients of ages 15 to 65 years with both genders having chronic hepatitis C on Polymerase chain reaction (PCR)& normal thyroid functionstest were taken by Non-probability, purposive sampling technique. Informed written consent was taken from all the patients. Serum thyroid stimulating hormone level (TSH) was sent of all patients to Centre for Nuclear Medicine (CENUM), Mayo Hospital Lahore before and after the completion of three months of interferontherapy and hypothyroidism was considered as TSH>4.0 mIU/L (normal range: 0.2-4.0 mIU/L). RESULTS: The mean age of the patients was 36.29 + 8.5 years. Out of total 200 patients, 123 (61.5%) were male and 77 (38.5%) were female. At baselines mean TSH of the patients was 3.16 + 2.57 mIU/L. After 3 months of therapy 163 patients (81.5%) were euthyroid and 37 patients (18.5%) were having thyroid dysfunction. Among patients with thyroid dysfunction 29 (14.5% of total patients) were hypothyroid. Among hypothyroid patients, according to gender distribution 8 (27.6%) patients were male and 21 (72.4%) patients were female. The difference was statistically significant (P=0.0003). CONCLUSION: It is concluded from this study that there is significant frequency of hypothyroidism in patients of chronic hepatitis C treated with standard interferon therapy and females are at more risk of developing thyroid dysfunction particularly hypothyroidism after standard interferon therapy.

Growth-And-Obesity Vector-Roadmaps of the Pakistani Children

This dissertation fine-tunes earlier mathematical solutions of childhood obesity, proposed during 2013-2016, by fitting a parabolic curve to desired percentile trajectories originating at the age of the most-recent checkup and terminating at 10 years. Both height and mass percentiles are made to approach the reference percentile, as the child nears tenth birthday. As compared to ‘Growth-and-Obesity Scalar-Roadmap’, proposed in 2015, which tries to cover up height and mass deficiencies, totally, within half-a-year, ‘Growth-and-Obesity Vector-Roadmap’ sets up softer targets for height and mass management so that deficiencies are totally corrected at the age of ten years. These targets are expected to avoid unwanted stress on the body of a youngster and are in harmony with the fact that height gain represents tissue synthesis and must be managed through a process, which is quasistatic. ‘Growth-and-Obesity Vector-Roadmap’ is constructed from a series of height and mass measurements to least counts of 0.005 cm and 0.005 kg, respectively, obtained by reproducible anthopometrists following laid-down, standardized protocols — child barefoot, stripped to short underpants, elbows and knees not flexed, instructed to inhale completely. These measurements are fed in software to generate profiles for each checkup from the first to the most-recent one using ‘Extended CDC Growth Charts and Tables’, which have heights and masses listed for extreme percentiles. Values of height and mass percentiles at age of the most-recent checkup as well as the reference percentile are substituted in mathematical framework of the vector model to draw the desired percentile trajectories. Height- and massmonth-wise targets are determined by reading off values, where these trajectories intersect with lines parallel to the percentile (vertical) axis. These lines cross the age (horizontal) axis at the ages for which targets are proposed