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The main aim of this paper is to develop an approach based on trapezoidal fuzzy numbers to optimize transportation problem in fuzzy environment. The present algorithm has representation of availability, demand and transportation cost as trapezoidal fuzzy numbers. This algorithm is found quicker in terms of runtime as comparison to fuzzy VAM discussed in [Kaur A., Kumar A., A new method for solving fuzzy transportation problem using ranking function, Appl. Math. Model. 35:5652–5661, 2011; Ismail Mohideen S., Senthil Kumar P., A comparative study on transportation problem in fuzzy environment, Int. J. Math. Res. 2:151–158, 2010]. On the other hand this technique gives much better results than some classical methods like north-west corner and least cost method. Another benefit of this algorithm is that for certain transportation problems it directly gives optimal solution. It is one of the simplest methods to apply and perceive. Practical usefulness of the new method over other existing methods is demonstrated with two numerical examples.

Purpose: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of nonalcoholic fatty liver disease (NAFLD), and the presence of T2DM tremendously drives NAFLD progression. The use of transient elastography (TE) for assessment of NAFLD has been increasing due to its high sensitivity and specificity. This study aimed to measure liver stiffness in patients with T2DM and ultrasonography (USG)-diagnosed NAFLD and assess the correlations between liver stiffness and other clinical and biochemical parameters. Patients and Methods: This cross-sectional study assessed 205 adult patients with T2DM and USG-diagnosed NAFLD who were being treated at a specialized endocrine private practice in Bangladesh. All subjects underwent TE for hepatic fibrosis assessment, which was performed using a FibroScan ® 402 device. A fibrosis score ≥9.7 kilopascals (kPa) was used to define advanced fibrosis (≥F3). Results: Out of 205 (65.9% female, mean age 45 ± 27 years, 67.3% obese) patients, the frequencies of Grade 1, Grade 2, and Grade 3 fatty liver on USG were 46.3%, 51.2%, and 2.4%, respectively. According to the TE results, 41 (20%) had advanced fibrosis (≥F3). Subjects with advanced fibrosis had a higher body mass index (BMI), higher levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and higher frequencies of individuals with elevated ALT and AST and advanced fatty liver grades on USG. The fibrosis score (kPa) was strongly and positively correlated with age, BMI, waist circumference, obesity, serum ALT and AST levels, and the fatty liver grade in USG; the AST:ALT ratio did not correlate with kPa. Conclusion:The data showed that 20% of the subjects with T2DM having NAFLD on USG exhibited advanced fibrosis, demonstrating the need for early diagnosis and treatment of NAFLD in T2DM. The use of TE with other serum markers can be helpful for the diagnosis of advanced fibrosis.

54.7 ± 11.55 (range 35-80) years and mean duration of diabetes was 5.5 ± 5.2 years (range 9 months-18 years). In this study mean weight of the patients decreased significantly from 60.5 ± 12.6 kg to 58.5 ± 11.3 kg (p<0.001). Blood pressure reduced but not significantly. Fasting blood glucose showed significant reduction from 10.7 ± 4.2 to 8.9 ± 3.7 mmol/L (p=0.002) Fasting in Ramadan is one of the five pillars of Islam. During this month all adult Muslims abstain not only from eating, drinking, smoking and sexual relations but also from oral drug intake and nutritional intravenous injection from sunrise (dawn) to sunset. 1 Diabetes is a metabolic disorder characterized by high level of blood glucose resulting from defects in insulin production and/or insulin action.