RESUMO
Background: Due to the growing public health menace of metabolic syndrome, the Non-Alcoholic Fatty Liver Disease (NAFLD) has been recording a burgeoning global rise. The prognosis of NAFLD is largely depends upon its histological stage. Simple steatosis has a fairer prognosis, while Non-Alcoholic Steatohepatitis (NASH) has a poorer prognosis with tendency to progression into fibrosis and end stage liver disease. Until now, the diagnosis of varying grades of NAFLD has been dependent upon liver biopsy, which is indisputably the most reliable tool to distinguish between simple steatosis, steatohepatitis, and end stage liver disease. The sonographic grading of NAFLD is primarily based on subjective findings, the results of which may vary between different observers. Hence, there is a need to identify a reliable non-invasive objective substitute. To compare the sonographic grades of fatty liver on gray scale with liver stiffness (Kpa) values of shear wave elastography. Also, an attempt to establish objective criteria for grading of fatty liver with improved accuracy and increased specificity.Methods: Cross sectional, observational study comprising of 240 adults referred for routine abdominal sonography. All patient underwent gray scale sonography and shear wave elastography and results were analysed.Results: A significant positive correlation was found between various grades of NAFLD as assessed subjectively on grey scale sonography to the liver stiffness in kilopascal (Kpa) using shear wave elastography.Conclusions: Shear wave elastography being an objective imaging tool is a reliable modality compared to grey scale sonography in diagnosis of NAFLD and has the capacity to carry out quantitative evaluation of liver parenchyma in vivo.
RESUMO
Pain is a syndrome characterized by several neurophysiological changes including that of the autonomic nervous system. Chronic low back pain (LBP) is a major health problem and is a frequent reason for using unconventional therapies especially acupuncture. This study was conducted to evaluate the autonomic status and pain profile in chronic LBP patients and to observe the effect of electro acupuncture therapy. Chronic LBP patients (n=60) were recruited from the Department of Orthopaedics, GTB Hospital, Delhi. Age and sex matched healthy volunteers were selected as controls (n=30). Following a written consent, LBP patients were randomly allocated into two study groups – Group A received 10 sittings of electro acupuncture, on alternate days, at GB and UB points selected for back pain, while the Group B received a conventional drug therapy in the form of oral Valdecoxib together with supervised physiotherapy. Controls were assessed once while the patients were assessed twice, before and after completion of the treatment program (3 weeks). The autonomic status was studied with non-invasive cardiovascular autonomic function tests which included E: I ratio, 30:15 ratio, postural challenge test and sustained handgrip test. Pain intensity was measured with the visual analogue scale (VAS) and the global perceived effect (GPE). Statistical analysis was performed using repeated measure’s ANOVA with Tukey’s test. Pain patients showed a significantly reduced vagal tone and increased sympathetic activity as compared to the controls (P<0.05 to P<0.001 in different variables). Following treatment, both the study groups showed a reduction in vagal tone together with a decrease in the sympathetic activity. There was also a considerable relief of pain in both groups, however, the acupuncture group showed a better response (P<0.01). We conclude that there is autonomic dysfunction in chronic LBP patients. Acupuncture effectively relieves the pain and improves the autonomic status and hence can be used as an alternative/ additive treatment modality in these cases.
RESUMO
Callus was derived from cultured cotyledons on MS medium supplemented with 2,4-D (0.25 mg/l) and NAA (0.25 mg/l). Plantlets were regenerated from the callus and nodal explants on MS medium containing BAP (2.0 mg/l) and Kn (2.0 mg/l), and further multiplied on the same medium. Addition of adenine sulphate (25.0 mg/l), ascorbic acid (20.0 mg/l) and glutamine (150.0 mg/l) in the medium resulted in enhanced axillary branching. Multiple shoots formed after 6 weeks were separated and subcultured in the fresh medium of same composition. For rhizogenesis, microshoots of 2.0-2.5 cm length were dipped in sterilized IAA solution (10 mg/l) for 24 hr followed by transfer to half strength MS medium containing activated charcoal (0.02%) resulting in rooting (75%) within 8 weeks. The rooted plants were transferred to pots containing sterilized soil and sand mixture for hardening and 71% survival was recorded. Fifty true to type plantlets of A. catechu could be obtained within seven months of culture establishment.