Association Of Low Gfr And Non-Alcoholic Hepatosteatosis On Fibroscan Of Liver.

BACKGROUND: Chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD) are becoming a health concern, owing to their increasing incidence and prevalence. Both entities are linked to poor outcomes and increased costs, hence greatly impacting the healthcare system and economy. Therefore, it is imperative to establish the link between the two, so as to prevent disease progression and complications. METHODS: The study was an observational retrospective study done in Karachi, from November 2021 to May 2022. It was conducted on 255 patients who were diagnosed with NAFLD, and the presence of CKD was then determined by calculating their GFRs. RESULTS: Out of the 255 patients diagnosed with hepatosteatosis, 76% had a normal GFR, 20% had a mild decrease and 4% were noted to have a moderate reduction in their GFR. When cross-tabulated with CAP score, it was found that 28% had S1 grade steatosis, out of which 85% had a normal GFR, 13% had a mild decrease and 2% had a moderate decrease in GFR. 22% had S2 grade steatosis, out of which 76% had a normal GFR, 18% had a mild decrease and 6% had a moderate reduction in GFR. 50% patients had S3 grade steatosis, out of which 70% had a normal GFR, 25% had a mild decrease and 5% had a moderate reduction in GFR. CONCLUSIONS: There is an association present between NAFLD and the development of low GFR. Therefore, it is important that patients diagnosed with NAFLD are regularly screened for CKD, so as to prevent its development and complications.

Urinary metabolomics using gas chromatography-mass spectrometry: potential biomarkers for autism spectrum disorder.

BACKGROUND: Diagnosis of autism spectrum disorder (ASD) is generally made phenotypically and the hunt for ASD-biomarkers continues. The purpose of this study was to compare urine organic acids profiles of ASD versus typically developing (TD) children to identify potential biomarkers for diagnosis and exploration of ASD etiology. METHODS: This case control study was performed in the Department of Pathology and Laboratory Medicine in collaboration with the Department of Pediatrics and Child Health, Aga Khan University, Pakistan. Midstream urine was collected in the first half of the day time before noon from the children with ASD diagnosed by a pediatric neurologist based on DSM-5 criteria and TD healthy controls from August 2019 to June 2021. The urine organic acids were analyzed by Gas Chromatography-Mass Spectrometry. To identify potential biomarkers for ASD canonical linear discriminant analysis was carried out for the organic acids, quantified in comparison to an internal standard. RESULTS: A total of 85 subjects were enrolled in the current study. The mean age of the ASD (n = 65) and TD groups (n = 20) was 4.5 ± 2.3 and 6.4 ± 2.2 years respectively with 72.3% males in the ASD group and 50% males in the TD group. Parental consanguinity was 47.7 and 30% in ASD and TD groups, respectively. The common clinical signs noted in children with ASD were developmental delay (70.8%), delayed language skills (66.2%), and inability to articulate sentences (56.9%). Discriminant analysis showed that 3-hydroxyisovalericc, homovanillic acid, adipic acid, suberic acid, and indole acetic were significantly different between ASD and TD groups. The biochemical classification results reveal that 88.2% of cases were classified correctly into ASD& TD groups based on the urine organic acid profiles. CONCLUSION: 3-hydroxy isovaleric acid, homovanillic acid, adipic acid, suberic acid, and indole acetic were good discriminators between the two groups. The discovered potential biomarkers could be valuable for future research in children with ASD.

Role of Pregabalin to Decrease Postoperative Pain in Microdiscectomy: A Randomized Clinical Trial.

Purpose The purpose of this study is to compare the effect of pregabalin in reducing the neuropathic pain in postoperative patients who have undergone single-level microdiscectomy for prolapsed intervertebral lumbar disc. Methods A randomized control clinical trial was conducted from June 2018 to April 2020 in three campuses Dr. Ziauddin University Hospital, Karachi, by two spinal surgeons. This study included 84 patients who underwent either emergency or elective microdiscectomy surgery. The patients randomized into two equal groups of 42, (group-A: pregabalin) and (group-B: placebo). Both groups also received routine analgesia along with the pregabalin and placebo capsules. In the intervention group, pregabalin was administered preoperative and postoperative defined times. The pain scores were recorded by visual analog scale (VAS) and Roland-Morris score system on the preoperative day and compared to the scores on follow-up on postoperative day seven. Results The pain scores were significantly better in group-A compared to group-B with similar baseline variables. The mean VAS scores of pains in group-A on postoperative day seven on follow-up were compared to VAS pain scores in group-B showing better pain control. The Roland-Morris scores were also significantly better for group-A. Conclusions The use of pregabalin in addition to the routine analgesia has better control of postoperative neuropathic pain in patients with single-level microdiscectomy compared to the patients who are receiving only routine analgesia. Other factors like cost, dose, side effects, and frequency should also be considered.