Context:The perception of non-alcoholic fatty liver disease (NAFLD) as an uncommon and benign condition is rapidly changing. Approximately, 70% type 2 diabetes mellitus (T2DM) patients have a fatty liver, which may follow an aggressive course with necroinflammation and fibrosis.Aims:To assess the profile of liver enzymes in subjects with impaired glucose tolerance (IGT), new onset treatment naive T2DM and normal glucose tolerance (NGT) with and without NAFLD.Settings and Design:Cross-sectional clinic-based study.Subjects and Methods:152 IGT and 158 recently detected T2DM subjects aged between 30 and 69 years, along with 160 age and gender matched controls with NGT. An ultrasonography scan of the upper abdomen was done in all patients in order to examine presence of fatty liver. Anthropometry, lipid profile, liver enzymes were also analyzed in all patients.Statistical Analysis Used:Unpaired t-test, Chi-square/Fisher Exact test (for categorical variables), Pearson/Spearmen correlation test to find significant difference, association and correlation between two or more groups respectively.Results:NAFLD was significantly associated with higher alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) but not ALP levels in IGT and T2DM patients. ALT, GGT significant correlated with waist circumference, body mass index, fasting insulin, homeostatic model assessment- insulin resistance, fasting blood glucose, high density lipoprotein cholesterol, triglyceride. 57% of NAFLD patients had normal ALT between 25 and 40 U/L, 53% of NAFLD subjects had normal GGT between 15 and 30 U/L. ALT <25 U/L and GGT <15 U/L had highest negative predictivity whereas ALT >40 U/L and GGT > 30 U/L had highest positive predictivity for presence of NAFLD in our study sample.Conclusions:Mild elevations of liver enzymes in the upper normal range are associated with features of metabolic syndrome and NAFLD even in IGT and recently detected T2DM patients. Novel cut-offs for liver enzymes are warranted in order to prevent unnecessary diagnostic work-ups and early detection of NAFLD to reduce the risk of cirrhosis, hepatocellular carcinoma and classical cardiovascular disease in T2DM and IGT patients.

Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome. Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma. Conclusion. Spontaneous rupture of ovarian artery should be considered as one of the differential diagnoses in the immediate postpartum period especially when the clinical symptoms do not correlate with the amount of blood loss. A high index of suspicion, prompt diagnosis, intervention, and a multidisciplinary approach in the management were the elements of a successful outcome in this case.

There appears to be no need to routinely culture quinsy aspirates, based upon our findings (of 16 hospital years) and previous studies (which found no recorded episodes of treatment change as a result of culture sensitivities). The combination of penicillin or a cephalosporin, plus metronidazole appeared to be theoretically effective in 99.2 per cent (118/119) of our specimens; this finding is supported by other studies. However, the rare but potentially life-threatening complications of quinsy must be recognised.

Enhancing the sluggish kinetics of the electrochemical oxygen evolution reaction (OER) is crucial for many clean-energy production technologies. Although much progress has been made in recent years, developing active, stable,...

The construction of highly active and durable nonnoble-metal electrocatalysts for the oxygen evolution reaction (OER) is an ongoing challenge. Here, we report the development of a hybrid nanostructure of PBA cubes wrapped with mixed W-Co oxysulfides in a hair-like structure through sulfurization of polyoxometalate (Co III W 12 POM) as a bimetallic precursor. These unique heterostructures of PBA@CoÀ WÀ OÀ S grafted on carbon cloth afford abundant active sites and improved charge transfer kinetics that synergistically enhance the OER activity (overpotential of 250 mV at 10 mA cm À 2 ). The synthetic approach used in this report can be extended for developing inexpensive, durable and efficient catalysts with diverse structures.

Intrapulmonary teratomas are rare tumors that are presumed to develop in association with mediastinal teratomas. This report describes the management of a rare case of a benign cystic intrapulmonary teratoma in the left upper lobe in a 26-year-old lady, which was successfully treated by lobectomy, with no recurrence after 4 years of follow-up.

Controllable defects and interface engineering are perceived as promising routes for developing efficient noble-metal-free electrocatalysts for oxygen evolution reaction (OER), the bottleneck of overall water splitting. Herein, we prepared molybdenum...

HighlightsThis case presentation, emphasizes the typical manifestations of hepatic but associated asymptomatic pericardial HCs.Hepatic hydatid cyst presenting as a painless abdominal lump preceded painful presentation for a few months.Asymptomatic pericardial hydatid cyst could have presented with pericardial tamponade due to rupture, if ignored further.The origin of the pericardial hydatid cyst could have been due to trans diaphragmatic passage of scolices from the hepatic location, as the usual pulmonary involvement was absent.