Screening for non-alcoholic fatty liver disease among obese and overweight children: Prevalence and predictors.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized in obese and overweight children. NAFLD is the commonest cause of chronic liver disease in these children. We undertook a study to assess the prevalence of NAFLD and to identify the associated anthropometric and metabolic risk factors. METHODS: This cross-sectional study was done with 154 overweight and obese children. The study population was divided into 2 groups based on the presence or absence of NAFLD by screening with ultrasonography and/or alanine transaminase levels. Anthropometric (body mass index [BMI], waist circumference) and biochemical parameters (triglyceride, high density lipoprotein, low density lipoprotein, very low density lipoprotein, total cholesterol, insulin, homeostasis model assessment of insulin resistance [HOMA-IR], alanine transaminase, aspartate transaminase) were compared between these two groups. RESULTS: NAFLD was diagnosed based on abnormal screening in 79 (51.3%) overweight and obese children. No age or gender difference was noted between the 2 groups. There were no significant differences in BMI, systolic blood pressure, diastolic blood pressure, and waist circumference between patients with and without NAFLD. Low-density lipoprotein (LDL) cholesterol levels were found significantly higher in the NAFLD group. There was no significant difference in lipid profile apart from LDL cholesterol, aspartate transaminase, and HOMA-IR between the 2 groups. CONCLUSION: NAFLD is common in overweight and obese southern Indian children. High LDL cholesterol level is a risk factor for NAFLD in these children. Screening of this high-risk group for early diagnosis of NAFLD is essential to prevent and monitor further progression of the disease.

Primary Vesical Amyloidosis Masquerading as Vesical Calculus in a Retroviral Positive Patient.

The common causes of irritative voiding symptoms in women include cystitis, vesical calculi, carcinoma bladder and neurologic disorders. Isolated primary vesical amyloidosis (VA) is a rare cause of irritative voiding symptoms. A 50-year-old female, a known case of retroviral disease but not on anti-retroviral therapy, presented with right flank and suprapubic pain for six months, worsening over the past 15 days with dysuria. She also presented with increased frequency of micturition with nocturia and urgency for the same duration. She had no hematuria, other lower urinary tract symptoms or fever. Clinical examination revealed suprapubic tenderness. Ultrasonogram (USG) revealed 1.7 cm vesical calculus. Cystoscopy revealed three spiky vesical calculi. There was a fluffy lesion with mucosal edema over the right lateral wall in the region of the right ureteric orifice, which was biopsied. Biopsy showed fragments of urothelial mucosa with focal areas of ulceration. The underlying stroma was edematous with amorphous pale eosinophilic acellular deposits. Congo red stain showed apple-green birefringence under polarized microscopy suggestive of amyloid. Sections were negative for dysplasia, granulomas or malignancies. VA presents with intermittent gross hematuria in up to 77% patients and irritative voiding symptoms in 23% patients. VA is an uncommon differential diagnosis of cancer urinary bladder, with less than 200 cases reported in the literature. Hence we report this case to highlight that primary VA should also be considered in the evaluation of irritative voiding symptoms.

Role of Thermography in the Diagnosis of Chronic Sinusitis.

Introduction Thermography is a form of radiography that images the skin surface temperature. Thermograms are pictorial representations of thermal maps of the entire body's outer surface. Thermography was applied as an attempt to evaluate its usefulness in the diagnosis of chronic sinusitis (CS). Hence, this study was done to determine the diagnostic value of thermography for patients suffering from CS. Methodology Patients attending the Department of Otorhinolaryngology and Head and Neck Surgery over a two years' duration with symptoms suggestive of CS were included in this diagnostic evaluation study. X-ray paranasal sinuses (PNS) and nose, thermography of head and neck, and computed tomography (CT) of PNS and nose (axial and coronal sections) were performed on them. The thermograms and X-ray sinuses obtained were compared with the computed tomography of PNS findings. Results The study population consisted of 167 patients (75 males and 92 females) and the mean age of the study population was 38.6 years. The sensitivity and specificity of thermography of the head and neck in diagnosing frontal, ethmoidal, maxillary, and sphenoidal sinusitis were 92.59% and 68.58%, 100% and 66.32%, 70.06% and 85.88%, 99.18% and 0%, respectively. Whereas the sensitivity and specificity of the X-ray PNS and nose in diagnosing frontal, ethmoidal, maxillary, and sphenoidal sinusitis were 92.59% and 77.88%, 73.61% and 81.05%, 89.19% and 98.92%, 74.44% and 99.18%, respectively. Conclusion Thermography is better than X-rays in diagnosing frontal and ethmoidal sinusitis and as good as X-ray PNS and nose in diagnosing maxillary sinusitis. Thermography failed to pick up sphenoidal sinusitis. The advantages of thermography are that it is a radiation-free, non-invasive, and cost-effective method for diagnosing CS.

Evaluation of low back pain with low field open magnetic resonance imaging scanner in rural hospital of Southern India.

BACKGROUND: Low back pain (LBP) is the most common symptom which is associated with limitation of normal activities and work-related disability. Imaging techniques are often essential in making the correct diagnosis for prompt management. Plain Radiography though remain a first imaging modality, magnetic resonance imaging (MRI) due to its inherent softtissue contrast resolution and lack of ionizing radiation remains invaluable modality in the evaluation of LBP. AIM: To find the common causes of LBP in different age groups and the role of MRI in detecting the spectrum of various pathological findings. MATERIALS AND METHODS: This is a prospective study done in the Department of Radiodiagnosis during a period of 2 years from July 2013 to July 2015. The study population includes all the cases referred to our department with complaints of LBP. Patients with ferromagnetic metallic implants and uncooperative cases were excluded. HITACHI 0.4 Tesla open MRI machine was used for imaging. RESULTS AND CONCLUSION: This study involved a total of 235 cases. There were 121 males and 114 females. The age of the patient ranged from 21 to 68 years with an average of 41.3 years. Back pain was commonly observed in the third to fifth decade. The common causes for back pain are disc herniations (disc bulge - 35.3%, disc protrusion - 39.6%, disc extrusion - 7.2%) accounting to 82.1%, followed by normal study (10.2%), vertebral collapse (traumatic - 2.1%, osteoporotic - 1.7%), infections (2.1%), and neoplasm (1.7%). MRI provides valuable information regarding the underlying causes of LBP, especially in disc and marrow pathology.