Prevalence of NAFLD in Healthy and Young Male Individuals.

Introduction. Nonalcoholic fatty liver disease (NAFLD) is an important cause of liver disease in adults and the most common cause of liver disease in children (Lavine and Schwimmer 2004). The abnormalities include increased liver fat without inflammation (steatosis) and nonalcoholic steatohepatitis (NASH). NASH may lead to fibrosis, cirrhosis, and ultimately liver failure if it is not treated (Matteoni et al. 1999). The objective of the study is to estimate the magnitude of the problem which will help us to formulate strategies in managing the potentially difficult problem. Materials and Methods. We included 1000 individuals between the ages of 30 and 50 years who came for annual checkup. The patients with other comorbidities like diabetes, ischemic heart disease, chronic liver disease, or renal diseases were excluded from the study. History of alcohol ingestion was also taken; any individual with history of alcohol intake was also excluded. All of them underwent investigations including CBC, LFTs, height and weight. The individuals who were found to have increased ALT (50 to 150 u/L) further underwent investigations including ultrasound of abdomen hepatitis b and c serology RA and ANA antibodies. All the individuals who were found to have viral or autoimmune illness were excluded from the study. The individuals having raised ALT levels and ultrasound evidence of fatty liver were taken. Results. 13.5% of the individuals were found to have NAFLD among those selected for the study. Conclusion. Mass campaign regarding physical and dietary measures needs to be undertaken in general masses regarding the gravity and potential prevention of the disease.

Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology.

OBJECTIVE: To find the accuracy of sonographic information provided by transvaginal sonography (TVS) in pelvic pathology as compared to transabdominal sonography (TAS). DESIGN: A comparative study. PLACE AND DURATION OF STUDY: The study was carried out in Military Hospital (MH) and Combined Military Hospital (CMH) Rawalpindi from January 2002 to June 2002. MATERIALS AND METHODS: Hundred patients were included in the study from a total of 212 referred for pelvic sonography. Two radiologists independently performed transabdominal and transvaginal sonography of these patients. An independent observer compared the findings. TVS was graded as superior, equal or inferior to TAS depending on the score assigned by them. RESULTS: TVS was considered superior in 63%, equal in 27% and inferior in 10% of the cases as compared to transabdominal sonography. It was graded inferior to TAS in cases with large pelvic masses and superior in majority of cases of ovarian follicle monitoring, polycystic ovaries, endometrial carcinoma and suspected ectopic pregnancy. Cases in which both techniques were considered equal included patients with no abnormal finding, some pelvic masses and advanced pelvic inflammatory disease. CONCLUSION: Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. However, TAS should still be the initial sonographic technique for routine evaluation of the female pelvis followed by TVS if indicated. In cases of ovarian follicle monitoring, suspected polycystic ovaries, endometrial pathology and suspected ectopic pregnancy, TVS may be used as the initial sonographic technique and can even replace TAS.

Cerebrovascular stroke at high altitude.

OBJECTIVE: To asses the high altitude as a risk factor for cerebrovascular stroke in people residing at a height greater than 15,000 feet above sea level. DESIGN: A case control study. PLACE AND DURATION OF STUDY: The study was conducted at Military Hospital, Rawalpindi from June 2000 to May 2001. PATIENTS AND METHODS: Four thousand persons between the ages of 20-40 years, residing at the height of 15,000 feet or above, were studied for occurrence of stroke. All cases of stroke referred from Northern areas of Pakistan, with positive CT scan, were included in the study. They were then investigated at Military Hospital, Rawalpindi to find out any other risk factor for stroke. During the same period four thousand persons living at Rawalpindi (height-2,000 ft) in same age group were also observed as control group. RESULTS: Ten patients suffered from stroke at high altitude while just one case had stroke in indexed age group at lower heights (p-value<0.05). Relative risk was 10 times greater at high altitude. CONCLUSION: High altitude is a risk factor for stroke in persons residing at altitudes of over 15,000 ft.