Non-alcoholic fatty liver disease may not be a severe disease at presentation among Asian Indians

Aim: To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease (NAFLD) and to assess their histological severity at presentation. Methods: Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences (AIIMS) with raised transaminases to at least 1.5 times upper limit of normal, and histologically confi rmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profi le of this group was studied. Results: Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34(17-58) years and 26.7(21.3-32.5) kg/m2 respectively and 46 (90.1%) were males. The majority of the patients had mild inflammation, either grade 1 [32 (63%)] or grade 2 [16 (31%)] and only 3 (6%) patients had severe (grade 3) infl ammation. Twenty-three (45%), 19 (37%), 8(16%) and 1(2%) patient had stage 0, 1, 2 and 3 fi brosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % (OR = 7.1; 95% CI: 1.6-31.5, P = 0.002) and AST/ALT ratio > 1 (OR = 14.3; 95% CI: 1.4-678.5, P = 0.008) were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia >150 mg% was the only factor independently associated with presence of high grade of infl ammation (OR = 1.6; 95% CI: 1.3-22.7, P = 0.02), while none was associated with advanced fi brosis. Triglyceride levels correlated positively with infl ammatory grade (r = 0.412; P = 0.003). Conclusion: NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation

Modelling human choices: MADeM and decision‑making

Research supported by FAPESP 2015/50122-0 and DFG-GRTK 1740/2. RP and AR are also part of the Research, Innovation and Dissemination Center for Neuromathematics FAPESP grant (2013/07699-0). RP is supported by a FAPESP scholarship (2013/25667-8). ACR is partially supported by a CNPq fellowship (grant 306251/2014-0)

T Chart to evaluate consolidation test results

Using Terzaghi's degree of consolidation, U, and the time factor, T, relationship, if M<SUB>U1</SUB> and M<SUB>U2</SUB> (M<SUB>U1</SUB> ≠ M<SUB>U2</SUB>) are slopes of the U-√T curve at any two time factors T<SUB>U1</SUB> and T<SUB>U2</SUB>, then it can be shown that a unique relationship exists between T<SUB>U2</SUB>/T<SUB>U1</SUB>, M<SUB>U1</SUB>/M<SUB>U2</SUB>, and T<SUB>U1</SUB> (or T<SUB>U2</SUB>), and knowing any two of these, the third can be uniquely determined. A chart, called the T chart, has been plotted using these three variables for quickly determining T and U at any experimental time, t, to determine the coefficient of consolidation, c<SUB>ν</SUB>, corrected zero settlement, δ<SUB>0</SUB>, and ultimate primary settlement, δ<SUB>100</SUB>. The chart can be used even in those cases where settlement and time, at the instant of load increment, are not known

Development of a clinical score to estimate pancreatitis-related hospital admissions in patients with a new diagnosis of chronic pancreatitis : the trinity score

Background: The clinical course of chronic pancreatitis is unpredictable and there is no globally accepted score to predict the disease course. We developed a clinical score to estimate pancreatitis-related hospitalisation in patients with newly diagnosed chronic pancreatitis. Methods: We conducted a retrospective cohort study using two clinical chronic pancreatitis databases held in tertiary referral centres in Dublin, Ireland, and in Tarragona, Spain. Individuals diagnosed with chronic pancreatitis between 2007 and 2014 were eligible for inclusion. Candidate predictors included aetiology, body mass index, exocrine dysfunction, smoking and alcohol history. We used multivariable logistic regression to develop the model. Results: We analysed data from 154 patients with newly diagnosed chronic pancreatitis. Of these, 105 patients (68%) had at least one hospital admission for pancreatitis-related reasons in the 6 years following diagnosis. Aetiology of chronic pancreatitis, body mass index, use of pain medications and gender were found to be predictive of more pancreatic-related hospital admissions. These predictors were used to develop a clinical score which showed acceptable discrimination (area under the ROC curve = 0.70). Discussion: We developed a clinical score based on easily accessible clinical parameters to predict pancreatitis-related hospitalisation in patients with newly diagnosed chronic pancreatitis