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Prevalence of Hepatic Steatosis As Diagnosed on Unenhanced Abdominal Ct

Thesis Info

Author

Sokwalla, Naushad H. Karim

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2016

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728061266

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Background: Hepatic steatosis is the accumulation of triglycerides within hepatocytes. It may be broadly classified into alcoholic and non-alcoholic fatty liver disease, whereby non-alcoholic fatty liver disease is steatosis secondary to causes such as steatogenic medication. Liver biopsy remains the gold standard for diagnosis of hepatic steatosis. However, it is invasive and may potentially suffer from sampling errors. Hepatic steatosis may be diagnosed on unenhanced CT if the hepatic attenuation is less than 40 HU, or if the attenuation of the liver is at least 10 HU less than the spleen. Over the past three decades, non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of liver cirrhosis in the West. It may be considered to represent another feature of metabolic syndrome. The prevalence of NAFLD has been found to be lower in the African American population when compared to European American or Hispanics, even after controlling for obesity and insulin resistance. The prevalence of hepatic steatosis in the local population is unknown. No studies looking at the association between metabolic syndrome and non-alcoholic fatty liver disease have been done in the local population. Objectives: To determine the prevalence of Hepatic steatosis in patients undergoing unenhanced abdominal CT at Aga Khan University Hospital Nairobi. To determine the association between non-alcoholic fatty liver disease and metabolic syndrome in these patients. Study design: Cross sectional analytical study of resident indigenous African patients undergoing an unenhanced CT abdomen at Aga Khan University Hospital, Nairobi’s (AKUHN) Radiology department. Study protocol: Data from 246 patients who meet the inclusion and exclusion criteria was collected. The prevalence of hepatic steatosis was determined in this population. Metabolic syndrome was diagnosed using the WHO definition. Association of the various components of metabolic syndrome and hepatic steatosis was determined. Findings and discussion: The prevalence of hepatic steatosis in the study population was 13.4%. The study was not powered to assess for difference in prevalence in the two sexes. There was a strong association of hepatic steatosis and diabetes, with diabetics 3 times more likely to have hepatic steatosis. An association was found between the components of metabolic syndrome and hepatic steatosis.
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شیخ احمد علی شوقؔ

جناب شیخ احمد علی شوقؔ

نہایت افسوس ہے کہ کہنہ ادیب و شاعر شیخ احمد علی صاحب متخلص بہ شوق نے ۲۷؍ اپریل کو گونڈہ میں انتقال کیا، مرحوم ۱۸۸۲؁ء اور ۱۸۹۰؁ء کے درمیان لکھنؤ سے ’’آزاد‘‘ نام کا اخبارنکالتے تھے، جو اس عہد کے معزز و مشہور اخباروں میں تھا اور اس زمانہ کے ادباء کا مظہر خیال تھا اور سرسید کی تحریکات سے کافی ہمدردی رکھتا تھا، کئی چھوٹی چھوٹی مثنویوں کے بھی وہ مصنف تھے، اسیرؔ مرحوم کے وہ شاگرد تھے اور غالباً وہ اس خانوادۂ تربیت کی آخری یادگار باقی تھے، انہیں کے عہد میں اردو کی نئی شاعری کا آغاز ہوا، مرحوم ان قدیم شعراء میں تھے، جنہوں نے اس نئے رنگ کے قبول کرنے میں جھجک نہیں کی۔
ترانۂ شوق کے علاوہ ان کی غالباً آخری مطبوعہ مثنوی عالم خیال کے چار رخ اردو شاعری میں ایک نئی چیز ہے، کاش ان کے احباب و اعزہ ان کے کلام کا مجموعہ شائع کرکے انکی روحانی یادگاروں کو زندہ رکھ سکیں۔ (سید سليمان ندوی، اپریل ۱۹۲۵ء)

نصاب سازی میں تربیتی واخلاقی جہات: عصری ترجیحات اور فقہ السیرۃ

For the development of Muslim society it is necessary that its people should be trained on the basis of Islamic teachings. This could not be possible until we design a curriculum of seerah which is according to the contemporary needs of character building. The purpose of designing such curriculum is to train our youth in such a way that they would be able not only to take advantage from our rich tradition but also they are well prepared to hold the leadership of the country. We have to keep in mind, while designing seerah curriculum, that it is not revealed. Infact we have to design it according to the needs of hour. If we keep in consideration the ideological and contemporary requisites than we would be able to get the desired results. Islam provides basic principals in this regard. Following these instructions we would be able to design a curriculum which produced the required results.

Evaluation of Trace and Toxic Elements in Smokeless Tobacco Products and Their Artificial Saliva Extracts Using Advance Extraction Methodologies: Related Health Risk

The present study is based on three central aspects (i) Evaluation of total toxic elements (TEs) i.e. arsenic (As), copper (Cu), cadmium (Cd), lead (Pb) and nickel (Ni) in smokeless tobacco (SLT) products (mainpuri, mawa, gutkha, dry and moist snuff), available and consumed in Pakistan, (ii) Method development for the assessment of As, Cd, Pb, Ni and Cu in artificial saliva extract (ASE) of different types of SLT products, (iii) To assess the contents of studied TEs in biological samples of oral, pharyngeal cancer patient and adolescent boys who have consumed SLT (mawa, mainpuri, gutkha, moist and dry snuff) products. ❖ To determine the trace levels of As, Pb, Cd, and Ni concentration in ASE of SLT products, simple and rapid pre-concentration methods were developed such as cloud point extraction, dual-cloud point extraction, temperature-controlled ionic liquid-based ultrasound-assisted dispersive liquid–liquid microextraction, non-dispersive ionic liquid based microextraction, followed by flame (FAAS) and electrothermal atomic absorption spectrometry (ETAAS). Total inorganic arsenic (iAs) and As3+ in ASE of SLT were determined by solid phase and cloud point extraction methods, respectively. ❖ The artificial saliva can extract studied TEs (As, Cd, Cu, Ni and Pb), which is immediately available, absorbed and affecting the lining of mouth. The artificial saliva extracted As, Cd, Cu, Ni and Pb corresponds to 15 - 24, 39 - 75, 30 - 50, 21 - 58, and 18 - 32%, respectively, of total contents of each TEs in different SLT (mawa, mainpuri, gutkha, dry and moist snuff) products. ❖ To determine the studied TEs concentrations in biological samples (scalp hair, blood), advance extraction methodologies were developed. The innovative vortex-assisted liquid– liquid microextraction and ionic liquid based microextraction in a single syringe system have been developed, prior to analysis by FAAS. The main factors which affect the recoveries of trace elements were studied. The detection limit and enhancement factor were also calculated at optimized values of significant factors. ❖ The reliability of methodologies was assured by analyzing virginia tobacco leaves (ICHTJcta-VTL-2), BCR 397 of human hair, Clincheck control-lyophilized® human serum SeroM10181 and whole blood Recipe (certified reference materials). ❖ The contents of As, Cd, Pb and Ni in scalp hair and blood samples were measured in three different adolescent (boys) subgroups consuming different SLT products alone or in conjunction with each other. The results revealed that adolescents who have used SLT have 2-3 folds higher contents of As, Cd, Pb and Ni in their biological samples than referent boys (p<0.001). ❖ The relationship between As, Cd, Ni and Pb exposure in oral cancer patients via consumption of SLT products with related to referents were investigated. The Cd, As, Pb and Ni in SLT products and biological samples (blood and scalp hair) of cancerous and healthy subjects were evaluated. The referents and oral cancer patients have similar age group (ranges from 30 to 60 years), localities and socio-economic status. The results showed that the Ni, As, Pb and Cd concentrations were higher in the blood and scalp hair samples of oral cancer patients related to the results obtained from referents (p<0.001). ❖ The Cu level in serum samples of oral (n=65) and pharyngeal (n=53) cancer patients (male), age ranged (30-60 years) has been assessed. For comparative study, the serum samples of referents (n=150), used/not consumed chewing SLT were also investigated for Cu level. The Cu contents in SLT and serum samples were evaluated by ETAAS. The levels of Cu in samples (serum) of oropharyngeal cancer patients were 1.5-2 and 3.0-4.0 folds higher than those referents consumed different SLT product and who had none of this habit, respectively.