Patients with type 2 diabetes mellitus (T2DM) are at increased risk of non-alcoholic fatty liver disease (NAFLD) and might eventually progress to advanced fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Recommendations on whether to screen for NAFLD in diabetic patients remains conflicted between major guidelines. Transient elastography using FibroScan with CAP (controlled attenuation parameter) can assess both liver steatosis and fibrosis simultaneously. This paper took a new look at the prevalence of NAFLD and the severity of fibrosis among T2DM patients in Vietnam. The study was conducted using a cross-sectional design in T2DM adults who attended Dai Phuoc Ho Chi Minh Polyclinic and Polyclinic of Pham Ngoc Thach University of Medicine. Liver steatosis and fibrosis was assessed by FibroScan. NAFLD was diagnosed if CAP > 233 dB/m (steatosis > 5%). Data were analyzed using STATA 12 software program. We found that a total of 307 type 2 diabetic patients qualified for the study’s criteria. The prevalence of NAFLD in T2DM patients based on FibroScan was 73.3%. Rates of mild, moderate and severe steatosis were 20.5%, 21.8% and 30.9%, respectively. The prevalence of significant fibrosis (≥ F2), advanced fibrosis (≥ F3) and cirrhosis (F4) was 13.0%, 5.9% and 3.6%, respectively. On multivariate analysis, aspartate aminotransferase (AST) (OR: 1.067; 95% CI: 1.017–1.119; p = 0.008) and platelet levels (OR: 0.985; 95% CI: 0.972–0.999; p = 0.034) were independent of risk factors of advanced fibrosis. Thus, our study supports screening for NAFLD and for evaluating the severity of liver fibrosis in T2DM patients.

BackgroundIt is important to identify the neuroimaging features that are associated with partial epilepsy in children. Advances in technology have recently been made to localize focal epileptogenic lesions, especially high-resolution structural imaging with magnetic resonance imaging (MRI). The recommendation that electroencephalography (EEG) should be the gold standard and that MRI should be optional has been questioned. The present study aims to evaluate the efficacy of MRI in children with partial epilepsy and to compare the diagnostic yields of MRI and EEG data. MethodsThe present study was conducted among one hundred twelve 1-to 6-year-old children with partial epilepsy. All patients underwent EEG and brain MRI. The epileptogenic lesions were identified on the basis of the signal intensities and morphological abnormalities seen on MRI. The correlation between MRI and EEG abnormal findings was analyzed using a chi-square test. ResultsAbnormal MRI findings were present in 34.8% (n = 39) of the sample. The EEG and MRI data agreed with respect to classifications into abnormal or normal in 48.2% of the sample (n = 54). Of the 27 patients with normal EEG findings, six (22.2%) had abnormal MRI findings. Interrater agreement showed the compatibility between EEG and MRI not significant (weighted Kappa = 0.105). ConclusionA number of MRI abnormalities were found in our study of otherwise normal children, although the correlation between these results was not clear. The follow-up of these children will help us identify the important abnormalities. Despite the small sample size, our results showed that normal EEG findings do not predict normal brain MRI data in children with partial epilepsy.

No abstract

No abstract

Objectives: Liver biopsy is the gold standard for diagnosing the extent of fibrosis in NAFLD/NASH; however, it is invasive with the risk of serious complications. This study aimed to validate the diagnostic usefulness of FIB4, NAFLD Fibrosis Score (NFS), FibroScan and ARFI in assessing liver fibrosis in patients with NAFLD/NASH. Patients and methods:The study was carried out on 101 patients with NASH. All patients underwent a liver biopsy for histological assessment of liver fibrosis and non-invasive methods for assessment of liver fibrosis including FIB4, NFS, FibroScan, and ARFI. Cutoff values along with the diagnostic accuracy of these methods were determined by receiver-operating characteristic (ROC) curves.Results: Histological liver fibrosis was evaluated by Metavir scoring (F0: 10 cases; F1: 47 cases; F2: 24 cases; F3: 17 cases; and F4: 3 cases). Liver stiffness determined by FIB4, NFS, FibroScan, and ARFI were significantly correlated with the fibrosis stages (Spearman rho: 0.32; 0.51; 0.56 and 0.54; p<0.05, respectively). AUROC of FIB4, NFS, FibroScan and ARFI for diagnosing ≥ F3 were 0.6, 0.8, 0.8, and 0.9, respectively. FibroScan, ARFI v/s NFS were more accurate than FIB4 for diagnosing ≥ F3 (p<0.05). Among those, NFS had the highest sensitivity for diagnoses of ≥ F3. The specificity values of NFS, ARFI and TE were greater than 80% for diagnosing ≥ F3.Conclusions: Liver stiffness determined by these methods had significantly correlated with the fibrosis stages. FibroScan and ARFI had more accurate than NFS and FIB4 in diagnosis of advanced fibrosis. NFS was the best method for screening advanced fibrosis (≥ F3) in patients with NASH.