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Background: Macrovesicular fat accumulation in more than 5% of hepatocytes without significant alcohol consumption is the defining criteria of Non-alcoholic fatty liver disease (NAFLD). Nonalcoholic fatty liver disease is often associated with diabetes mellitus which is associated with a 60- 70% of frequency of Non-alcoholic fatty liver disease. The prevalence of NAFLD among the Type 2 Diabetes mellitus (T2DM) patients is higher compared to non-diabetics. Type 2 Diabetes mellitus and Non-alcoholic fatty liver disease are common conditions that commonly co-exist and can act reciprocally to bring adverse outcomes. Aim and objectives: The aim of this study was framed to determine the prevalence of Non-alcoholic fatty liver disease in Type 2 Diabetes mellitus patients and also to study the risk factors. Material and methods: The present cross sectional, prospective study was conducted at Indira Gandhi Institute of Medical Sciences, Patna, a tertiary care hospital of Bihar, over a period of 5 months. A total of 140 patients with Type 2 Diabetes mellitus that satisfied inclusion criteria were included in the study. All patients included in the study were subjected to ultrasonography and relevant history, thorough clinical examinations and biochemical tests were performed and recorded. Results: Out of 140 patients participated in the study, 44 (31.43%) were found to have Non-alcoholic fatty liver disease (NAFLD). The most common ultrasonographic grade of NAFLD was grade I (mild) fatty liver disease 30(21.43%), followed by grade II (moderate) fatty liver disease 13 (9.29%). The grade III (severe) fatty liver disease was found in 1 (0.71%) of the diabetic patients. NAFLD patients were compared with those with normal liver ultrasonographic findings. The risk factors of NAFLD Naresh Kumar, Jyoti Kumar Dinkar, Chandrakishore. Prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar. IAIM, 2017; 4(9): 54-58. Page 55 were also evaluated. The highest prevalence of NAFLD was recorded in the age group of 51-60 years and it was more prevalent among females than males. Conclusion: An observation into the predisposing factors of Non-alcoholic fatty liver disease, revealed a higher prevalence of obesity, hypertension, hyperlipidemia, hyperglycemia and sedentary lifestyle in the subjects with NAFLD. Type 2 Diabetes mellitus patients having non-alcoholic fatty liver disease are at increased risk of developing progressive forms of the disease. The liver disorder constitutes another potential complication in T2DM patients that requires early and prompt intervention in the associated risk factors and prevents the emergence of chronicity of NAFLD.
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Background: Enteric fever (Typhoid fever) is a common systemic infectious disease worldwide, especially in developing countries like India and continues to be one of the leading causes of morbidity and mortality. It is caused by the bacterium Salmonella typhi or Salmonella paratyphi serotypes A, B and C. The clinical diagnosis of Enteric fever traditionally depends on Blood culture and Widal tests. However limitations such as longer time for Blood culture results and difficulties in the interpretation of Widal tests make them unpractical for screening patients in endemic regions and lead to misdiagnosis and missed diagnosis. Aim and objectives: Purpose of the study was to compare the sensitivity and specificity of Widal test and Typhidot based IgM and IgG assay with the Blood culture (taken as gold standard) in the diagnosis of Enteric fever. Materials and methods: This comparative study was done on 120 patients in the General Medicine Department of Indira Gandhi Institute of Medical Sciences, Patna. All patients above 11 years of age of either sex with acute febrile illness suspected to have Enteric fever were included in this study. Febrile patients with other diagnosis were excluded. Blood culture, Widal test, Typhidot (IgM and IgG) test and other routine investigations were performed in all patients. Typhidot tests and Widal tests were compared for sensitivity and specificity. Results: Out of 120 clinically diagnosed cases of Enteric fever, 18(15%) patients were Blood culture positive for Salmonella typhi, 27(22.5%) patients were positive on Widal tests and 36(30%) were Typhidot positive. Out of 18 Blood culture positive patients for Salmonella typhi, 10 patients were Jyoti Kumar Dinkar, Naresh Kumar, Chandrakishore. A comparative study of Widal test and Typhidot (IgM and IgG specific assay) test in the diagnosis of enteric fever. IAIM, 2017; 4(7): 126-130. Page 127 positive and 8 were negative on Widal testing. Out of 36 Typhidot positive patients 16 patients were positive and 20 were negative on Blood culture. Conclusions: Traditionally Blood culture and Widal test are used in the diagnosis of Enteric fever. However Typhidot (IgM & IgG assay) tests are simple and rapid screening tests that simultaneously detect and differentiate between IgM and IgG antibody to Salmonella typhi and paratyphi produced in response to infection, thus aiding in determination of current or previous exposure. It offers the advantage of early and rapid diagnosis and helps in early institution of therapy. Preliminary data have shown sensitivity and specificity of 95% and 86% respectively of Typhidot tests.
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In this Research, an effort has been done for the development of effervescent controlled release floating tablet [ECRFT] from solid dispersions [SDs] of diclofenac sodium [DS] for upsurge the solubility and dissolution rate. ECRFT of DS was prepared by using SDs of DS and its SDs prepared with PEG as carrier using thermal method [Simple fusion]. SDs of DS were formulated in many ratio [1:1, 1:2, 1:3 and 1:4]. Prepared SDs was optimized for its solubility, % drug content and % dissolution studies. Tablets were formulated by using optimized SDs products and all formulation was evaluated for various parameters. A clear rise in dissolution rate was detected with entirely SD, amid that the optimized SD [SD4] was considered for ECRFT. Among all the tablet formulations, its F3 formulation was better in all the terms of pre compression and post compression parameters. It had all the qualities of a good ECRFT, based on this F3 formulation was selected as the best formulation. Data of in vitro release was fitted in several kinetics models to explain release mechanism. The F3 formulation shows zero order release. From this study we can concluded that ECRFT containing SDs of DS can be successfully used for achieving better therapeutic objective
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We present the imaging findings in 2 adolescent girls with abdominal cocoon formation, a rare cause of intestinal obstruction. It may be primary/idiopathic or secondary in nature and is characterized by small bowel encapsulation. Familiarity with the imaging findings and a high index of suspicion helps in reaching the diagnosis pre-operatively in this rare condition and hence planning surgical management