Prevalence of Ultrasound-diagnosed Non Alcoholic Fatty Liver Disease Among Rural Indigenous Population in Malaysian and Its Association With Biochemical and Anthropometric Measures

@#Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, especially in the Western world and Asia-Pacific regions. This study was designed to determine the prevalence of NAFLD detected by sonographic assessment among the rural indigenous population in Peninsula Malaysia and its association with anthropometric and biochemical factors. Methods: A cross-sectional survey was carried out from January 2014-February 2016. Subjects were recruited among indigenous peninsula Malaysia population in rural villages, aged ≥18 years old. The survey was questionnaire-based followed by anthropometric and blood parameters measurements. All subjects underwent abdominal ultrasound assessment to screen for the presence of NAFLD. Semi-quantitative visual grading was performed to assess for mild, moderate or severe NAFLD. Results: A total of 270 subjects underwent the screening program (mean age 43.3 ±14.0 years). Approximately 53 subjects (19.6 %) were identified with NAFLD. Of those with NAFLD, approximately 83% had moderate grade of fatty liver and the remainder were diagnosed with mild grade. NAFLD was closely associated with age, body mass index (BMI), central obesity, hypertension, total cholesterol (TC), triglyceride/high density lipoprotein-cholesterol (TG/HDL-C) ratio. On multivariate logistic regression, a high BMI (≥23.0 kg/m2), central obesity, and raised TG/HDL-C ratio were independent risk factors for developing NAFLD. Conclusion: This pioneer study defines the prevalence of NAFLD among rural indigenous population in Peninsula Malaysia. Lifestyle-related diseases, such as NAFLD can affect both rural and urban communities with equal severity. High BMI, central obesity, and elevated TG/HDL-C ratio were independent risk factors for developing NAFLD.

Diagnosis of systemic fungal infection by polymerase chain reaction versus conventional blood culture method in patients of oncology center Mansoura University

Background: Systemic fungal infection remains a major cause of morbidity and death in patients undergoing treatment for cancer. Therefore sensitive, quick and inexpensive testes essential for diagnosing systemic fungal infecton. In our labs we commonly diagnose fungemia using convential blood culture. Convential blood culture is time-consuming and with poor sensitivity. Polymerase chain reaction [PCR] has the potential to provide a quick and inexpensive method for diagnosis of systemic fungal infection. We studied these two different methods in the diagnosis of systemic fungal infection. Aim : The aims of this study were to compare convential blood culture and PCR in the diagnosis of systemic fungal infection and to determine sensitivity, specificity of PCR

Methods: Blood samples were collected from patients in Oncology center clinically suspected of systemic fungal infection. Whole blood samples were collected. First part of the sample was inoculated into blood culture bottle and the other part of the sample was subjected to DNA extraction and PCR which was carried out using pan-fungal primers

Results: One hundred thirty three samples were collected. Seventy six positive samples were positive by conventional blood culture bottle and/or PCR. Nine samples were positive by conventional blood culture. They yielded Candida species, these samples were also positive by PCR. The other 67 samples were positive by PCR reaction only using panfungal primer. The most common isolated organisms by conventional blood culture bottle were Candida albicans six isolates [66.7%]. Three non albicans Candida isolates [C. tropicalis, C. krusi and C. dubliniensis] were isolated. Using blood culture as gold test, sensitivity of PCR was 100%, and specificity was 46%. The most common underlying malignancy was leukaemia [84.2%], followed by lymphoma [13.1%], and solid tumours [2.6%]

Conclusion: The application of PCR technology directly to the whole blood samples will allow early and accurate diagnosis of systemic fungal infection?

New onset diabetes mellitus after renal transplantation: impact of immunosuppresssive and antihypertensive therapy

The purpose of the present study was to assess the influence of immunosuppresssive and antihypertensive therapy in the diabetic state after renal transplantation especially impaired fasting glucose [IGF], and impaired glucose tolerance [IGT]. A total of 67 consecutive renal transplant recipients without previously known diabetes underwent a 75gm oral glucose tolerance test [OGTT] 3 months after renal transplantation. BMI, daily prednisolone dose, creatinine clearance, hypertension, number of antihypertensive agents and the use of diuretics or 3 blockers were POSITIVELY associated with, impaired glucose tolerance [IGT], namely impaired fasting glucose [IGF], and abnormal glucose tolerance [ACT] [p<0.05]. After multiple regression analysis, BMI [p<0.001], daily prednisolone dose [p<0.001], cytomegalovirus infection [p<0.03], and triglycerides [p<0.034], were shown to be independent predictors of posttransplant ACT. Increasing daily prednisolone dose is an independent predictor of impaired fasting glucose after renal transplantation. Hypertension and the use of diuretics and beta blockers may also deteriorate glucose tolerance [CT] in this group of patients

community-based study of viral hepatitis infection in Giza Governorate, Egypt: Seroprevalence, risk factors and associated morbidity

Hepatitis viruses are major causes of acute and chronic liver diseases in Egypt. The aim of this study was to investigate the seroprevalence, risk factors and associated morbidity of viral hepatitis in Giza Governorate, Egypt. The study was conducted in 4 rural and 4 semiurban communities and included 2305 subjects selected by a cluster r and om method. They underwent complete clinical and abdominal ultrasonographic [US] assessment and laboratory tests including stool and urine examination, hemoglobin, ALT estimation and viral hepatitis markers by enzyme immunoassay. The latter included anti-HAV IgG, HBsAg, anti-HBc, anti-HBs, anti-HCV and anti-HEV IgG. Subsets of sera were tested for HBV DNA and HGV RNA by specific PCR. The overall prevalence of anti-HCV was 20.9% [age-adjusted prevalence = 24.5%; CI: 22.7-26.3%] and was significantly rising with age from 10% below age of 20 years to 40% among those above 50 years. The infection rate of hepatitis B virus [HBV] was 57.1% with HBsAg carrier rate of 3.6%. Seropositivity of anti-HBs and anti-HBc was very high [45.8% and 44.7%, respectively] and correlated positively with age with no sex-related difference. Combined HCV and HBV infection was evident in 13% of subjects. HBV DNA was detected in 86% of HBsAg-positive cases and in 20% of HBsAg-negative anti-HBc- and anti-HCV-positive cases. Seromarkers for hepatitis B and C were significantly commoner in semiurban than in rural communities. Dental manipulation and previous parenteral antischistosomal therapy were significant risk factors for hepatitis B and C infection. Anti-HAV was positive in 99.7% whereas anti-HEV was positive in HBV= Hepatitis B virus. CLD = Chronic liver disease. HCC = Hepatocellular carcinoma. US = Ultrasonography. ALT = Alanine transaminase. OR = Odds ratio. CI = Confidence interval. 9.2%. HGV RNA was detected in 16.5% of the studied samples. It was always associated with HBV and /or HCV infection. History of hematemesis was recorded in 1.2% of individuals. US examination revealed hepatomegaly in 19.2% of subjects, splenomegaly in 8.2%, bright liver in 31%, coarse liver texture in 10%, periportal fibrosis in 20% and ascites in 2%. These findings were significantly more common in anti-HCV- and HBsAg-positive subjects. ALT elevation was commonest and highest in individuals with positive HBsAg or with HBV-HCV coinfection. Hepatitis B and C infection and associated morbidity still constitute a great health problem in Egypt. Hepatitis A is holoendemic and hepatitis E is endemic. Hepatitis G is always associated with HBV or HCV infection. Occult hepatitis B should be considered in future studies

Heterogeneous t(4;11) fusion transcripts in two infants with acute lymphoblastic leukemia

An RT-PCR assay detected the t(4;11) translocation in two infants with acute lymphoblastic leukemia (ALL). Case P76 was a 10-month-old, female infant, who presented with a WBC of 137.4 x 10(9)/l and a pre-pre-B ALL immunophenotype. Case P120 was a 6-month-old female infant, with a WBC > 615 x 10(9)/l and a pre-pre-B ALL immunophenotype. RT-PCR of cDNA from both these cases generated a 656 bp and a 542 bp respectively, which sequencing confirmed as t(4;11) fusion transcripts. The primers and conditions selected for this assay are compatible with a one-step multiplex PCR for the main translocations in childhood ALL.

Foot planter pressure measurement in diabetic patients with at-risk feet and healthy subjects

This study included two groups of patients: Group 1 included 33 diabetic patients at risk of foot ulceration and group 2 included 33 healthy subjects. The mean peak pressure under the heel, the first metatarsal head and the fifth metatarsal head of right and left feet was measured. The results showed a significant difference of the mean peak planter pressure under heel. In contrast, there was no significant difference of the peak pressure under the fifth metatarsal head for both limbs. The study concluded that the measure of foot pressure may be particularly helpful for diabetic patients at risk of peripheral neuropathies in redistributing foot pressure and reduce the pressure on high planter pressure points to prevent ulceration and other complications

Electromyographic activities of selected leg muscles and range of motion during wearing high heeled shoes.

The aim of this study was to examine the ankle and knee joints range of motion and to investigate the electromyographic activities of selected leg muscles [calf and quadriceps muscles] during wearing of high-healed shoes. A total of 100 young healthy females with an age range from 17 to 25 years was included in this study. Three shoes with 1.7, 5 and 7 cm heel height were used. The range of motion of the ankle and knee joint using universal goniometer was calculated. Electromyographic data were collected from calf and quadriceps muscles during wearing of different heel heights. There were a decrease in ankle dorsiflexion and an increase in planter-flexion range of motion. The electromyographic data showed a significant increase in the activity of calf and quadriceps muscles with the increased heel height

Study of risk factors for Ischaemic heart disease in middle aged women

This is a prospective study conducted to examine the relationships of obesity, lipids and apolipoproteins, menopausal status, prior combined oral contraceptive [COC] use, and parity with the risk for ischemic heart disease [IHD] among middle aged women. A total of 160 women, aged 35 to 59 years were recruited, 100 cases with IHD, and 60 healthy women as controls. High apolipoprotein-B [Apo-B], low density lipoprotein cholesterol [HDL-C], and high triglyceride [TG] levels, were found to have independent influence on the risk of developing IHD in the studied cases. Other risk factors that were found to have significant relation to IHD were increased body mass index [BMI], postmenopause particularly before 50 years, increased low- density lipoprotein cholesterol [LDL-C], increased total cholesterol [TC], decreased apolipoprotein-A-I [Apo-A-I]. Parity and prior combined oral contraceptive use were not found to be significant risk factors. An equation including all the studied factors was suggested to be used for prediction of IHD in middle-aged women