Background: Non-alcoholic fatty liver disease (NAFLD) is a common association of Type 2 diabetes mellitus and diabetes mellitus is a leading risk factor for coronary artery disease (CAD). This study aims at estimating the prevalence of NAFLD by ultrasonography and to correlate NAFLD with CAD in a group of patients with Type 2 DM.Methods: Consecutive patients of Type 2 diabetes fulfilling the inclusion criteria were recruited. Clinical and biochemical parameters were recorded. NAFLD was diagnosed by ultrasonography.Results: The prevalence of NAFLD was 41.2% in the study group (n=114) and was higher in females. Prevalence of NAFLD in the younger age group was significantly higher than that in the older age group. Elevated liver enzymes, elevated HbA1C, duration of diabetes, obesity, acanthosis nigricans and metabolic syndrome were all significantly associated with NAFLD. CAD was significantly higher in the NAFLD subgroup (72.46%) compared to the non-NAFLD subgroup (52.63%) (p=0.001). Using binary logistic regression analysis, it was found that NAFLD is an independent predictor of CAD (p=0.002).Conclusions: NAFLD is extremely common in people with Type 2 diabetes and is associated with a higher prevalence of CAD.NAFLD is an independent risk factor for development of CAD. Thus, identification of NAFLD in diabetics might help in predicting the risk of CAD and to adopt the necessary preventive strategy.
Background: Exposure to high fluoride levels in drinking water can lead to a number of adverse effects in children, including cognitive dysfunction. Despite being endemic for fluorosis, studies on its effect on the cognitive function of children are lacking in Kerala. Aims: The aim of this study was to compare the cognitive function of school children with fluorosis with that of normal children and to correlate between the severity of dental fluorosis and cognitive function. Settings and Design: Cross-sectional study, conducted in collaboration with the National Fluorosis Control Programme, among school children in Alappuzha district, Kerala. Methods: Children aged 8–10 years, studying in 2 lower primary schools in Alappuzha district with confirmed fluorosis were selected, and compared with healthy age- and sex-matched children from the same school. Raven's Standard Progressive Matrices and MISIC digit span subtest were used to assess the cognitive function. Statistical Analysis: Continuous variables were assessed by independent samples t test and categorical variables by Chi-square test. The relationship between severity of dental fluorosis and grade of cognitive impairment was assessed using Spearman's correlation. Results: There were 60 children each in fluorosis and control groups. The mean age of the children was 8.95 ± 0.50. Only 15% of the children with fluorosis scored Grade I and II Raven's SPM grades (Intellectually superior/above the average) versus 30% in the control group. None of the children without fluorosis scored Grade V (intellectually impaired) category versus 20% in the fluorosis group. The mean digit span was significantly higher in the control group. A strong positive correlation between severity of dental fluorosis and Raven's SPM grades was found (Spearman's correlation coefficient = 0.740). Conclusions: Fluorosis is associated with impaired cognition in children. There is a positive correlation between severity of dental fluorosis and the grade of cognitive impairment.
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