Prevalence of non-alcoholic fatty liver disease and its correlation with coronary risk factors in patients with type 2 diabetes.

OBJECTIVES: To estimate the prevalence of non-alcoholic fatty liver disease (NAFLD) by ultrasonography, and to correlate NAFLD with coronary artery disease (CAD) and coronary risk factors in a group of Indian type 2 diabetics. METHODS: Consecutive patients of type 2 diabetes were recruited. History and physical examination were recorded. Laboratory investigations included fasting and 2-hour post-prandial blood glucose, blood urea, serum creatinine, liver function tests, lipid profile, glycated haemoglobin, microalbuminuria, and ultrasonographic measurement of carotid intimal-medial thickness (CIMT). NAFLD was diagnosed on the basis of ultrasound assessment of the liver. RESULTS: The study group (n=124) was divided into a NAFLD group (n=71) and a non-NAFLD group (n=53). The prevalence of NAFLD was 57.2%. CAD was more prevalent in the NAFLD subgroup (60.5%) compared to the non-NAFLD subgroup (45.2%). The NAFLD subgroup had higher prevalence of hypertension, smoking, obesity (measured by BMI), central obesity (measured by waist circumference and waist hip ratio), higher HbAlc, higher triglyceride levels and lower HDL levels, and higher mean CIMT. Using binary logistic regression analysis, it was found that hypertension (p=0.013), LDL cholesterol (p=0.049), microalbuminuria (p=0.034) and NAFLD (p=0.016) were significantly correlated with CAD. CONCLUSION: Among type 2 diabetics, NAFLD clusters with traditional coronary risk factors. It is a surrogate and fairly reliable marker of risk for CAD amongst type 2 diabetic patients. Ultrasonographically detected NAFLD is a simple, cheap, and safely assessable parameter for coronary risk stratification in type 2 diabetics.

Axillary node staging by ultrasonography and fine-needle aspiration cytology in patients with breast cancer.

BACKGROUND: This study evaluated the role of axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) in preoperative staging of the axilla in patients with invasive breast cancer. METHODS: Between October 2006 and March 2009, 502 patients scheduled to undergo surgery for invasive breast cancer had preoperative AUS. All patients with suspicious nodes on ultrasonography underwent FNAC, and those with positive cytology proceeded directly to axillary node clearance. Patients with normal findings on AUS or negative cytology underwent sentinel node biopsy (SNB). RESULTS: A total of 137 (27.3 per cent) of 502 patients had axillary node metastases on final histology. Thirty-nine (28.5 per cent) node-positive patients were identified by AUS-FNAC and spared unnecessary SNB. AUS-FNAC had a sensitivity of 28.5 per cent and a specificity of 100 per cent for detecting axillary nodal metastases. AUS-FNAC findings were normal in all 15 patients with nodal micrometastases and in 11 patients with isolated tumour cells on histopathology. The sensitivity of AUS-FNAC had a positive correlation with invasive tumour size (odds ratio 1.03) and grade (odds ratio 2.80). CONCLUSION: Preoperative AUS-FNAC avoided unnecessary SNB in 28.5 per cent of node-positive patients and in 7.8 per cent of patients overall.

Multi detector computed tomography (MDCT) evaluation of small bowel obstruction: pictorial review.

Small bowel obstruction (SBO) is one of the most perplexing clinical situations encountered by a surgeon in the emergency room. The decision to operate or not depends upon many factors including the probable cause and chances of bowel strangulation/ischemia. The clinical, biochemical and radiological features help the surgeon in making this decision. Plain X-rays have been the mainstay in the radiological diagnosis of SBO and its complications. In the last 20 years, CT scan has ushered in a revolution in establishing the diagnosis of SBO, its causes and complications earlier than the traditional methods and has helped in reducing morbidity and mortality. Here, we have summarised the role of multidetector CT scan in diagnosing various aspects of SBO.

Biochar aided aromatic grass [Cymbopogon martini (Roxb.) Wats.] vegetation: A sustainable method for stabilization of highly acidic mine waste.

Dumping of acidic mine waste poses severe threats to the ecosystem due to high acidity, nutrient deficiency and mobility of toxic metals. The present study has been undertaken on phytoremediation by amending the acidic soil/mine waste with biochar (BC) and plantation of palmarosa (Cymbopogon martini (Roxb.) Wats. A greenhouse experiment in different combinations of biochar and acidic mine waste was conducted to assess the phytoremediation efficiency of palmarosa by BC amendments. Results indicate that the palmarosa tolerates multiple stresses effectively with a 54 % metal tolerance index (MTI) and capable of reducing acid production from the acidic mine waste alone. BC incorporation in the mine waste and soil treatments significantly enhanced the palmarosa biomass (1.11-3.3 times) and oil content by liming the acid, immobilization of metals and improving the soil quality. BC addition in highly acidic mine waste amplified the phytoremediation efficiency and mitigates abiotic oxidative stress on plants (MTI 84 % to >100 %). BC aided palmarosa plantation shifted the soil from high-risk assessment code (RAC) to low RAC for vegetation. Biochar amendments along with palmarosa plantation offer a sustainable technology for phytostabilization of highly acidic mine waste along with the production of industrially important essential oil.

Comparative study of thermal properties of bio-coal from aromatic spent with low rank sub-bituminous coals.

In present investigation, biocoal samples were prepared from aromatic plant waste of two perennial grasses, i.e. Cymbopogon flexuosus (lemongrass) and Vetiveria zizanioides (khus) after oil extraction, root of Rosa damascene (rose), bark of Eucalyptus citriodora. These biocoals were characterized by proximate, ultimate, metal, thermogravimetric analysis (TGA), Fourier Transform Infra Red (FTIR) spectroscopy and ash analyses. Activation energies, initial temperature of devolatilization, maximum rate of weight loss (Rmax), fouling, slagging and alkali index were determined on the basis of TGA and ash analysis. These biocoals have good calorific values. There is possibility of slagging and fouling in combustion system but it is not severe. Owing to their similar fuel properties as high sulphur sub-bituminous coal, they can be good candidates for co-firing. Blending of these biocoals with high sulphur coals will serve dual purpose as (i) alternate fuel, and (ii) reduction in SO2 emission.

Unique features of polycythemia observed on plain non contrast CT scan of head.

We present two cases of polycythemia secondary to a congenital cardiac anomaly presenting with acute neurological complications showing hyperdense venous sinuses and cerebral vasculature in association with cerebral abscess.