ABSTRACT
Background: Non Alcoholic Fatty Liver Disease (NAFLD) is a common liver disorder that is strongly associated with insulin resistance and Type 2 Diabetes Mellitus (T2DM). This study was designed to determine the prevalence of NAFLD among T2DM patients and to evaluate whether there is an association between NAFLD and diabetic micro-and macro vascular complications. Methods: In a cross-sectional design study, 120 type 2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. They were divided into fatty liver group and non-fatty liver group and various laboratory and clinical variables were compared in these two groups. Statistical analysis included bivariate tests, chi square test, univariate and multivariate logistic regression. Results: Out of 120 type 2 diabetic patients, 68 (56.66%) had fatty liver on ultrasonography. An increase in the waist circumference, BMI, systolic blood pressure, diastolic blood pressure and levels of HBA1c, AST, ALT, Total Cholesterol, Triglycerides and a decrease in HDL was observed in the fatty liver group as compared to non-fatty liver group. NAFLD group had higher prevalence of retinopathy (67.67% vs. 17.30%, P <0.001), neuropathy (52.94% vs. 19.23%, P = 0.0002), nephropathy (83.82% vs.53.84%, P = 0.0003). The prevalence of CAD (70.58% vs. 21.11%, P <0.0001) and POVD (10.25% vs. 0%, P <0.05) was higher in NAFLD patients. All patients with severe fibrosis had raised BMI, HbA1c and hypertension. The results of multiple logistic regression analysis showed that NAFLD was associated with BMI, HbA1c, Triglyceride and CAD. Univariate analysis showed significant association between retinopathy, neuropathy, CAD, POVD and NAFLD. Conclusion: Cognitive. The prevalence of NAFLD is higher in type 2 diabetic patients. Obesity, dysglycemia, dyslipidemia, elevated liver enzymes and coronary artery disease are seen to be significantly associated with fatty liver than non-fatty liver type 2 diabetic patients.
ABSTRACT
Ascites in chronic myeloid leukemia (CML) as an extramedullary manifestation is rarely reported in the literature. A young 23 year old female of chronic myeloid leukemia presenting with extramedullary disease as massive ascites. All stages of granulocytes and a few blasts similar to peripheral blood smear was present in ascitic fluid. Based on clinical symptoms and signs, bone marrow examination, ascitic fluid cytology and ultrasonography of abdomen she was diagnosed as a case of Chronic myeloid leukemia in chronic phase with extramedullary disease as massive ascites. After starting treatment with Imatinib mesylate favourable response was observed.
ABSTRACT
Human intoxication with abamectin is not frequently reported. It is an uncommon but potentially fatal cause of pesticide poisoning. In contrast to common organophosphate poisoning the toxic effects of avermectin in humans are not clearly defined. Ingestion of a large dose of avermectin may be associated with life-threatening complications. The therapy for avermectin poisoning is mainly symptomatic and supportive. The prognosis of patients with avermectin poisoning is likely to be favorable unless they are complicated by severe hypotension or aspiration. We hereby report a case with abamectin poisoning with neurological toxicity and respiratory failure which responded to supportive line of therapy.