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

Bilateral multifocal renal cell carcinoma

Bilateral synchronous renal cell Carcinomas occur in approximately 1-3% of all patients with RCC. Ultrasound and contrast-enhanced CT scan are the most useful tests for diagnosing and staging. US has an advantage over CT in determination of nature of the lesion [solid/cystic]. CT is more sensitive in evaluation of lesion size and detection of calcification and necrosis. CT also has an advantage over US in evaluation of perinephric extension, adjacent organ infiltration and regional lymphadenopathy. Both US and CT are equally sensitive in detection of IVC thrombus

Role of ultrasonography in clinically suspected cases of acute appendicitis

This study was conducted at CMH Rawalpindi to evaluate the diagnostic rate of ultrasonography in clinically suspected cases of acute appendicitis. In our study which was conducted from 1998 to 2000, a total number of 100 patients with the clinical suspicion of acute appendicitis were included. There were 47 male patients and 53 female patients. Male to female ratio was 1:1.12. The age of the patients ranged from 8 to 70 years. The subject were studied with Aloka SSD-630 machine equipped with 7.5 MMz short focused high resolution probe. A final diagnosis of appendicitis and allied appendix disorders was made in 72 patients while 26 patients were true negative. Out of 72 patients suffering from diseases of appendix, 63 patients had acute appendicitis. Out of 63 patients suffering from appendicitis, 56 patients had positive ultrasound examination for appendicitis. Ultrasound has shown the sensitivity of 88.8% in diagnosis of appendicitis while it has shown a specificity of 83.9%. We, therefore, conclude that the use of ultrasound helps to make prompt decision in suspected cases of acute appendicitis especially in patients at extremes of age, females of child bearing age and pregnant women and also in establishing alternate diagnosis, so it should be recommended as a routine screening method in suspected cases