ABSTRACT
Objective:To evaluate the biochemical markers including serum triglycerides, ALT, and fasting plasma glucose in detection of fatty liver disease
Methodology:This cross-sectional analysis was carried out at the department of radiology and pathology, PNS Rahat hospital,Karachi between March-2010 to February-2011.Sixty-two subjects with an ultrasonographic diagnosis of fatty liver were compared with thirty-seven subjects with normal ultrasound for fatty liver, after excluding all other abnormalities on history and examination. The comparison included measurement of biochemical abnormalities including fasting blood glucose, triglycerides, total cholesterol and alanine transaminase [ALT]
Results:The results of fasting blood glucose[[Fatty liver group=7.06 +/- 3.51mmol/L][Without fatty liver disease=5.12 +/- 0.56 mmol/L] [p = 0.002]], serum triglycerides [[Fatty liver group=2.56 +/- 1.33 mmol/L ] [Without fatty liver disease=1.68 +/- 0.97 mmol/L ] [p = 0.001]] and ALT[[Fatty liver group=36.37 +/- 18.12 IU/L] [Without fatty liver disease=28.15 +/- 13.95 IU/L] [p = 0.026]] were significantly higher in subjects with fatty liver disease. The Receiver Operating Curve [ROC] analysis showed fasting blood glucose and serum triglycerides to have the most area under the curve [AUC] as 0.747 [95% CI: 0.647-0.847] and 0.731[95% CI: 0.622-0.840]; while the other parameters have AUCs as: Serum ALT-0.650 [95% CI: 0.532-0.767] and total cholesterol-0.509 [95% CI: 0.389-0.629]
Conclusion: Hyperglycemia and hypertriglyceridemia are associated with an ultrasonographic diagnosis of fatty liver. Raised transaminase levels in subjects with fatty liver disease also suggest underlying hepatocyte damage
ABSTRACT
Impetigo also known as pyoderma is a common paediatric skin infection presenting to clinics and hospitals in summer season. The illness is acquired from close skin contact with the victim and is highly contagious. The lesions are fluid filled vesicles that leave crust after rupture and usually heal without treatment. The infection is classified as bullous and non-bullous impetigo, the latter one having the least occurrence and is most commonly associated with complications, therefore prompt treatment is necessary. The case series holds a brief literature review of bullous impetigo, its clinical course, treatment options and complications. The author reports two cases presenting with bullous impetigo in the month of June. A five-year old boy and fifteen months old girl; both presenting with similar rashes involving limbs, trunk and neck with slight differences in the clinical symptoms. Both were treated with fluids, oral and topical antibiotics. The climatic conditions of Karachi favours the incidence of impetigo. Also, poor sanitation and overcrowded areas have further more increased the incidence of the disease. Families are unaware of these types of skin infections and hence do not isolate the victim which, in case of highly contagious illnesses like impetigo, is of great importance. Furthermore, not getting prompt treatment is another factor that cannot be ignored and results in complications in case of bullous impetigo. The most important conclusions which can be drawn from our case series are the lack of paediatric centres that treat dermatological conditions promptly and effectively. Lack of proper guidance convinces families to switch to self-medication and sometimes neglect. The role of a paediatrician is vital when creating understanding with the patient's attendant by explaining them the clinical features and course of treatment of bullous impetigo to avoid self-medication while dealing with skin diseases in children