ABSTRACT
Non Alcoholic Fatty Liver Disease [NAFLD] is the most common cause of chronic liver injury, recently elevated uric acid [UA] level was found to be an important factor in the development of NAFLD so lowering the level of UA by allopurinol might play an important role in the improvement of NAFLD. The objective of the study is to evaluate the effect of treating hyperuricemia by allopurinol on NAFLD patients assessed by ultrasonography [U/S] and liver enzymes. 3l hyperuricemic patients suffering from NAFLD were enrolled in the study. These patients were randomly assigned into two groups; Group A [14 patients]: Placebo group who received starch based placebo for 2-3 months and Group B [17 patients]: Treatment group who received allopurinol for 2-3 months. Fatty liver [FL] grade and size were assessed by U/S before and after treatment; also liver enzymes [GPT , GOT] and UA were measured before and after treatment. The present study showed significant difference between GPT and GOT before and after lowering UA level [P<0.001 and P=0.013, respectively] in the treatment group while U/S parameters showed no significant difference in the FL size and grade before and after treatment [P:0.208 and 0.325 respectively]. We concluded that Allopurinol can be used to improve patients with NAFLD associated with hyperuricemia as assessed by improved liver enzymes
ABSTRACT
Cerebral palsy is a static non progressive motor disability that occurs at birth or early childhood. It results of injury to the neuromotor components of the central nervous system. Evoked potentials [EPs] are neurophysiological investigations used to demonstrate the existence of central nervous system lesions and were used as a screening method for neuropediatric diseases. Motor and somatosensory evoked potential [SEP] are the most sensitive methods of evoked potentials. They can provide a noninvasive objective method of evaluating the central and peripheral nervous system. The present study included 20 Egyptian children, 11 males and 9 females ranging in age from 3 to 6 years with a mean age of 3.9 years, presenting with spastic diplegia. All patients had mild to moderate motor disability and I.Q. above 50. Control group included 20 children, age and sex-matched with patients group. We studied motor and somatosensory evoked potentials in those patients and their correlation with motor functions. Transcranial magnetic stimulation [TMS] to the right upper limb [abductor pollicis brevis muscle] and somatosensory evoked potentials testing from the right median nerve and the left posterior tibial nerve were used to assess function of the corresponding systems. Motor evoked potentials from the right upper limb showed significant delay in cortical latencies and significant prolongation of central motor conduction time in CP patients compared to control group. However, the amplitude of cortical response showed no significant changes. Somato-sensory evoked potentials of right median nerve showed significantly prolonged cortical N[19]/ P[22] absolute latency, N[13] - N[20], Erb's - N[20], N[13] - N[20] inter peak latencies respectively, however, Erb's, N[13], Erb's - N[13] absolute latencies and inter peak latency showed non significant changes but N[20] amplitude was significantly decreased. Somatosensory evoked potentials of the left posterior tibial nerve showed significant prolonged cortical and lumber absolute latencies and inter peak latency. Also, significant decrease of amplitude of cortical wave. A statistically highly significant positive correlation was observed between the hand function and N[20] amplitude [P < 0.01] of SEPs of the right median nerve while all other variables showed no statistically significant correlation with each other. Also, a statistically significant positive correlation was observed between the foot function and cortical amplitude [P < 0.05] of SEPs of the left posterior tibial nerve while all other variables showed no statistically significant correlation with each other. A tendency towards positive correlation was observed between hand functions and cortical latency [P < 0.09] of motor evoked potentials to the right abductor pollicis brevis muscle. We concluded that somatosensory evoked potentials are sensitive, non-invasive techniques for detection of the severity of motor impairment. We recommend MEPs and SSEPs as a relatively fast and effective means of assessing the functional integrity of the central nervous system in cerebral palsy patients