Comparison of serum lipid profile in non alcoholic fatty liver disease

Objective: To compare serum lipid profile in different ultrasonographic grades of non alcoholic fatty liver disease [NAFLD]

Study Design: Cross sectional study

Place and Duration of Study: PNS SHIFA hospital, Karachi, from Oct 2015 to Jul 2016

Material and Methods: Seventy three adults of either gender were consecutively inducted after diagnosis of non alcoholic fatty liver disease [NAFLD] on ultrasonography [USG]. These individuals were further classified into grade I, II and III of NAFLD depending on US findings. Fasting blood sample of all the subjects was analyzed for serum fasting lipid profile comprising of total cholesterol [TC], triglycerides [TG], high density lipoprotein cholesterol [HDL-C] and low density lipoprotein cholesterol [LDL-C]. Serum non HDL cholesterol [nonHDL-C] was calculated by subtracting HDL-C from TC

Results: Among 73 subjects with NAFLD, 42.5%, 37% and 20.5% had grade I, II and III NAFLD respectively. All parameters showed significant increase in frequency of abnormal results with increasing grade of NAFLD except TG. Significant difference was found in mean TC [p=0.000], LDL-C [p=0.000], HDL-C [p=0.005] and nonHDL-C [p=0.000] between grades of NAFLD. Post hoc analysis revealed that only mean nonHDL-C was significantly different amongst all the grades of NAFLD

Conclusion: The increasing severity of NAFLD was found associated with increased frequency of dyslipidemia. Though most frequent dyslipidemia in NAFLD was low serum HDL-C followed by hypertriglyceridemia, only serum nonHDL-C was statistically different amongst all the grades of NAFLD

Decreased serum 25-hydroxycalciferol levels in pre-diabetic adults

Objective: To determine the serum 25-hydroxycalciferol levels [25[OH]D] in adults with pre-diabetes and normoglycaemia to examine a possible association of vitamin D deficiency with pre-diabetes

Study Design: Case control study

Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from November 2012 to July 2013

Methodology: A total of 272 adults including 136 pre-diabetics and 136 normoglycaemics of either gender aged 20 years and above were consecutively inducted. Patients with diabetes mellitus, pregnancy, rickets and osteomalacia, ischemic heart disease, chronic kidney disease and chronic liver disease were excluded. Fasting Plasma Glucose [FPG] was estimated with hexokinase method on Modular p800 Roche chemistry analyzer while serum 25[OH]D was measured on Diasorin Liaison immunoassay analyzer using the chemiluminescent technique. Mean 25[OH]D levels in pre-diabetic and normoglycaemic groups were compared using Mann-Whitney U test. Spearman's correlation coefficient 'r[s]' was determined between serum 25[OH]D and FPG. Odds ratio for vitamin D deficiency was also calculated

Results: Mean serum 25[OH]D level was low in pre-diabetics [23.2 nmol/L] as compared to normoglycaemics [29 nmol/L; p=0.001]. Serum 25[OH]D level had inverse correlation with FPG [r[s] = -0.448, p=0.000]. There was also significant association of vitamin D deficiency with pre-diabetes compared with normoglycaemia [OR: 2.21, p= 0.016; 95% CI: 1.15-4.27]

Conclusion: Vitamin D deficiency with pre-diabetes suggested that vitamin D may have an important role in pathogenesis of pre-diabetes

Diagnostic value of ultrasonography in evaluation of blunt abdominal trauma

To evaluate the diagnostic value of ultrasound in detecting intraabdominal injuries in patients with blunt abdominal trauma. The study was conducted in the department of radiology, Combined Military Hospital Lahore, from 13[th] September 2006 to 29[th] September 2007. A total of 70 patients with blunt abdominal trauma were included. They all underwent Ultrasonography [US] followed by Computed Tomographic [CT] scan of abdomen. Sensitivity, specificity, positive and negative predictive values and accuracy of US in detecting intraabdominal injury were calculated keeping CT findings as gold standard. The cases in which laparotomy was performed; the surgical findings were taken as the standard. US examinations were positive in 34 patients. Of these, US showed free fluid in 18 [52.9%], and abdominal organ injury in 12 [35.3%] and only abdominal organ injury in 4 [11.8%]. True-positive findings were seen in 28 [82.35%] of these on CT and/or laparotomy. There were two false negative cases. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US in detecting intraabdominal injury were 93.3%, 85.0%, 82.3%, 94.4% and 88.5%, respectively. Ultrasonography has high diagnostic performance in the screening of patients 2 with blunt abdominal trauma