Impact of transition in socio-economic status on sonographically detected non-alcoholic fatty liver disease: a study based on modified Kuppuswamy classification in an urban population

Background: The transition in the socioeconomic status is associated with physical and mental challenges. The lifestyle modification is one of the key implicatory for this change. Non-alcoholic fatty liver is an ever-growing health concern. This study evaluates the socioeconomic categories based on Kuppuswamy classification and other correlated in sonographically detected Non-alcoholic fatty liver disease (NAFLD).Methods: This cross-sectional study was conducted on 300 sonographically detected NAFLD patients in the age group of 18-60 years. Detailed history, including the demographic profile, socio-economic status (Modified Kuppuswamy scale was followed for calculating the Socio-economic status of the family), occupation, dietary habits (vegetarian or non-vegetarian, exposure to junk food), drinking water supply, etc. Detailed assessment of the morphological parameters including the anthropometric measurements, height, BMI was also assessed.Results: The study finds 62 (41%) females and 88 (59%) males with NAFLD and 51-60 age group with maximum prevalence. Diabetes (63%), Soft drink consumption and obesity are important risk factors. New observation of our study is that amongst various Kuppuswami sociodemographic scales, the maximum patients belonging to Upper middle class and upper lower class presented with fatty liver.Conclusions: There is higher prevalence of NAFLD amongst males, diabetics, obese, soft drinks, tea and coffee consumers. Authors also find a unique correlate based on socio-demographic class of Kuppuswami scale. People belonging to upper middle class and upper lower class suffer from NAFLD more commonly than other sociodemographic classes.

Thyroid dyshormonogenesis.

Dyshormonogenesis is an uncommon cause of congenital hypothyroidism. The most common abnormality is absent or insufficient thyroid peroxidase enzyme. Perchlorate discharge test can be used to diagnose thyroid peroxidase deficiency. We report three siblings with hypothyroidism due to thyroid dyshormonogenesis. Early institution of therapy in these patients can prevent mental retardation and other features of hypothyroidism.

Differences in risk factors, atherosclerosis and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in ethnic groups (SHARE).

Cardiovascular disease rates vary greatly between ethnic groups in Canada. To establish whether this variation can be explained by differences in disease risk factors and subclinical atherosclerosis, we undertook a population-based study of three ethnic groups in Canada: South Asians, Chinese and Europeans. A total of 985 participants were recruited from three cities (Hamilton, Toronto and Edmonton) by stratified random sampling. Clinical cardiovascular disease was defined by history or electrocardiographic findings. Carotid atherosclerosis was measured with B-mode ultrasonography. Conventional (smoking, hypertension, diabetes, raised cholesterol) and novel risk factors (markers of a prothrombotic state) were measured. Within each ethnic group and overall, the degree of carotid atherosclerosis was associated with a higher prevalence of cardiovascular disease. South Asians had the highest prevalence of this condition compared with Europeans and Chinese (11%, 5% and 2%, respectively; p=0.0004). Despite this finding, Europeans had more atherosclerosis (mean of the maximum intimal medial thickness 0.75 [0.16] mm) than South Asians (0.72 [0.15] mm) and Chinese (0.69 [0.16] mm). South Asians had an increased prevalence of glucose intolerance, higher total and low-density lipoprotein cholesterol, higher triglycerides and lower high-density lipoprotein cholesterol, and much greater abnormalities in novel risk factors including higher concentrations of fibrinogen, homocysteine, lipoprotein(a), and plasminogen activator inhibitor-1. Although there are differences in conventional and novel risk factors between ethnic groups, this variation and the degree of atherosclerosis only partly explains the higher rates of cardiovascular disease among South Asians compared with Europeans and Chinese. The increased risk of cardiovascular events could be due to factors affecting plaque rupture, the interaction between prothrombotic factors and atherosclerosis, or as yet undiscovered risk factors.

A comparison of practice patterns for acute myocardial infarction between hospitals in Canada and India.

The increasing burden of cardiovascular disease in India, and the established efficacy of mortality-reducing therapies in acute myocardial infarction (AMI) served as the impetus to compare the management practices of AMI in an Indian hospital and a similar hospital in Canada. A retrospective chart review in each hospital was conducted to identify differences in risk factors, presentation, and acute in-hospital management in patients with AMI. Indian patients were younger (47 +/- 9 years versus 54 +/- 8 years), more likely to have a history of diabetes (21/87 versus 6/69) and less likely to have a previous history of angina (5/87 versus 22/69) compared to Canadian patients (all p < 0.001). The delay from symptom onset to hospital arrival was greater in Bangalore, India (median time 330 min versus 101 min, p < 0.001), yet the in-hospital delay in receiving thrombolytic therapy was greater in Hamilton, Canada (70.5 min in Hamilton versus 30 min in Bangalore, p < 0.0001). There was similarity and appropriate use of thrombolytic therapy, aspirin, beta-blockers and angiotensin-converting enzyme (ACE) inhibitors in both centres. The pattern of presentation and risk factors differ in Indian and Canadian patients. However, once patients present, the patterns of practice appear to be similar.