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Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease

World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 44-54页

作者： Suprabhat Giri prajna anirvan Sumaswi Angadi Ankita Singh Anurag Lavekar Department of Gastroenterology and Hepatology Kalinga Institute of Medical SciencesBhubaneswar 751024OdishaIndia Department of Gastroenterology Kalinga Gastroenterology FoundationCuttack753001OdishaIndia Department of Gastroenterology Nizam’s Institute of Medical SciencesHyderabad 500082TelanganaIndia Department of Gastroenterology Seth GS Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Gastroenterology Sagar HospitalBengaluru 560041KarnatakaIndia

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its

关键词： Non-alcoholic fatty liver disease Sarcopenia Hepatic fibrosis Low muscle mass Hand grip strength Bioelectric impedance analysis Dual X-ray absorptiometry

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Nonalcoholic Fatty Liver Disease(NAFLD)Name Change:Requiem or Reveille?

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Journal of Clinical and Translational Hepatology 2021年第6期9卷 931-938页

作者： Shivaram P.Singh prajna anirvan Reshu Khandelwal Sanjaya K.Satapathy Department of Gastroenterology Sriram Chandra Bhanj Medical CollegeCuttackOdishaIndia Division of Hepatology Sandra Atlas Bass Center for Liver Diseases and TransplantationDonald and Barbara Zucker School of Medicine at Hofstra/Northwell HealthManhassetNYUSA

Nonalcoholic fatty liver disease(NAFLD)affects about a quarter of the world’s population and poses a major health and economic burden globally.Recently,there have been hasty attempts to rename NAFLD to metabolic-associated fatty liver disease(MAFLD)despite the fact that there is no scientific rationale for this.Quest for a“positive criterion”to diagnose the disease and destigmatizing the disease have been the main reasons put forth for the name change.A close scrutiny of the pathogenesis of NAFLD would make it clear that NAFLD is a heterogeneous disorder,involving different pathogenic mechanisms of which metabolic dysfunction-driven hepatic steatosis is only one.Replacing NAFLD with MAFLD would neither enhance the legitimacy of clinical practice and clinical trials,nor improve clinical care or move NAFLD research forward.Rather than changing the nomenclature without a strong scientific backing to support such a change,efforts should be directed at understanding NAFLD pathogenesis across diverse populations and ethnicities which could potentially help develop newer therapeutic options.

关键词： Heterogeneity MAFLD Metabolic NAFLD NASH Nomenclature Steatohepatitis

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Association of non-alcoholic fatty liver disease and COVID-19: A literature review of current evidence

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World Journal of Hepatology 2021年第8期13卷 916-925页

作者： prajna anirvan Shivaram P Singh Alexa Giammarino Sanjaya K Satapathy Department of Gastroenterology Sriram Chandra Bhanj Medical College and HospitalCuttack 753007OdishaIndia Department of Internal Medicine Donald and Barbara Zucker School of Medicine at HofstraManhassetNY 11030United States Division of Hepatology at Sandra Atlas Bass Center for Liver Diseases and Transplantation Donald and Barbara Zucker School of Medicine at HofstraManhassetNY 11030United States

The coronavirus disease 2019(COVID-19)pandemic has swept through nations,crippled economies and caused millions of deaths worldwide.Many people diagnosed with COVID-19 infections are often found to develop liver injury,which,in a small portion of patients,progresses to severe liver disease.Liver injury in the form of elevated transaminases,hyperbilirubinemia and alterations in serum albumin has been observed to be higher in patients with severe forms of the disease.Those who already have insult to the liver from chronic disease,such as nonalcoholic fatty liver disease(NAFLD)may be at the greatest disadvantage.The severity of COVID-19 also seems to be driven by the presence of NAFLD and other co-morbidities.About 25%of the global population has NAFLD.With such a widespread prevalence of NAFLD,understanding the disease progression of COVID-19 and the occurrence of liver injury in this vulnerable population assumes great significance.In this review,we present an overview of COVID-19 infection in patients with NAFLD.

关键词： SARS-CoV-2 Fatty liver Mitochondria Nitrosative stress Oxidative stress COVID-19 Metabolic associated fatty liver disease Nonalcoholic fatty liver disease Progressive liver disease Nonalcoholic steatohepatitis

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Liver injury in COVID-19:The hepatic aspect of the respiratory syndrome-what we know so far

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World Journal of Hepatology 2020年第12期12卷 1182-1197页

作者： prajna anirvan Pankaj Bharali Mrinal Gogoi Paul J Thuluvath Shivaram P Singh Sanjaya K Satapathy Department of Gastroenterology Sriram Chandra Bhanj Medical CollegeCuttack 753007OdishaIndia Department of Gastroenterology Sriram Chandra Bhanj Medical College and HospitalCuttack 753007OdishaIndia Department of Surgery and Medicine Mercy Medical CenterBaltimoreMD 21202United States Division of Hepatology Sandra Atlas Bass Center for Liver Diseases and TransplantationDonald and Barbara Zucker School of Medicine at Hofstra/Northwell HealthManhassetNY 11030United States

The 2019 novel coronavirus disease(COVID-19)pandemic due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has posed a serious threat to global public health.Although primarily,the infection causes lung injury,liver enzyme abnormalities have also been reported to occur during the course of the disease.We conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic injury.The present review summarizes available information on the spectrum of liver involvement,the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 infection,and the prognostic significance of the presence of liver injury.Hopefully,this review will enable clinicians,especially the hepatologists,to understand and manage the liver derangements they may encounter in these patients better and provide guidance for further studies on the liver injury of COVID-19.

关键词： COVID-19 Hepatitis Infectious disease Liver injury SARS-CoV-2 Management

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PEGylation in anti-cancer therapy: An overview

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Asian Journal of Pharmaceutical Sciences 2016年第3期11卷 337-348页

作者： prajna Mishra Bismita Nayak R.K.Dey Centre for Applied Chemistry Central University of Jharkhand Department of Life Science National Institute of Technology

Advanced drug delivery systems using poly(ethylene glycol)(PEG) is an important development in anti-cancer therapy. PEGylation has the ability to enhance the retention time of the therapeutics like proteins, enzymes small molecular drugs, liposomes and nanoparticles by protecting them against various degrading mechanisms active inside a tissue or cell, which consequently improves their therapeutic potential. PEGylation effectively alters the pharmacokinetics(PK) of a variety of drugs and dramatically improves the pharmaceutical values;recent development of which includes fabrication of stimuli-sensitive polymers/smart polymers and polymeric micelles to cope of with the pathophysiological environment of targeted site with less toxic effects and more effectiveness. This overview discusses PEGylation involving proteins, enzymes, low molecular weight drugs, liposomes and nanoparticles that has been developed, clinically tried for anti-cancer therapy during the last decade.

关键词： PEG PEGylation Targeted drug delivery Polymers

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Comparing accuracy of cochlear measurements on magnetic resonance imaging and computed tomography:A step towards radiation-free cochlear implantation

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中华耳科学杂志:英文版 2023年第4期18卷 208-213页

作者： Anurita Swarup Vinusree Karakkandy Preetam Chappity Suprava Naik Sanjay Kumar Behera Pradipta Kumar Parida Mohnish Grover Gaurav Gupta prajna Paramita Giri Saurav Sarkar Pradeep Pradhan Dillip Kumar Samal Aswathi Kallyadan Veetil Asutosh Adhikari Saurav Nayak Department of ENT and HNS All India Institute of Medical Sciences(AIIMS)BhubaneswarOdishaIndia Department of Radiodiagnosis All India Institute of Medical Sciences(AIIMS)BhubaneswarOdishaIndia Department of Community and Family Medicine All India Institute of Medical Sciences(AIIMS)BhubaneswarOdishaIndia Department of Biochemistry All India Institute of Medical Sciences(AIIMS)BhubaneswarOdishaIndia Department of ENT Sawai Man Singh Medical CollegeJaipurRajasthanIndia Department of ENT Sardar Patel Medical CollegeBikanerRajasthanIndia

Objective:Computed Tomography(CT)and Magnetic Resonance Imaging(MRI)are commonly employed in pre-operative evaluation for cochlear implant surgery.However,with a decrease in the age of implantation,even minor radiation exposure can cause detrimental effects on children over their lifetime.The current study compares different cochlear measurements from CT and MRI scans and evaluates the feasibility of using only an MRI scan for radiological evaluation before cochlear implantation.Methods:A longitudinal observational study was conducted on 94 ears/47 children,employing CT and MRI scans.The CT and MRI scan measurements include,A value,B value,Cochlear duct length(CDL),twoturn cochlear length,alpha and beta angles to look for cochlear orientation.Cochlear nerve diameter was measured using MRI.The values were compared.Results:The mean difference between measurements from CT and MRI scans for A value,B value,CDL,and two-turn cochlear length values was 0.567±0.413 mm,0.406±0.368 mm,2.365±1.675 mm,and 2.063±1.477 mm respectively without any significant difference.The alpha and beta angle measures were comparable,with no statistically significant difference.Conclusion:The study suggests that MRI scans can be the only radiological investigation needed with no radiation risk and reduces the cost of cochlear implant program in the paediatric population.There is no significant difference between the measurements obtained from CT and MRI scans.However,observed discrepancies in cochlear measurements across different populations require regionally or race-specific standardized values to ensure accurate diagnosis and precision in cochlear implant surgery.This aspect must be addressed to ensure positive outcomes for patients.

关键词： Cochlear implant Hearing loss Cochlea anatomy Radiology

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Molecular evidence on the occurrence of co-infection with Pichia guilliermondii and Wuchereria bancrofti in two filarial endemic districts of India

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Infectious Diseases of Poverty 2014年第1期3卷 118-127,117页

作者： Suprabhat Mukherjee Niladri Mukherjee Prasanta Saini prajna Gayen Priya Roy Santi P Sinha Babu Parasitology Laboratory Department of Zoology(Centre for Advanced Studies)Visva-Bharati UniversitySantiniketan-731235West BengalIndia

Background:Lymphatic filariasis(LF),a vector-borne parasitic disease,is endemic in several parts of India and mostly affects the poor or those with a low-income.The disease results in huge numbers of morbidities,disabilities,and deaths every year.Association of co-infection with other pathogens makes the condition more severe.Although co-infection is becoming a growing area of research,it is yet to emerge as a frontier research topic in filarial research specifically.This study reports the occurrence of a fungal infection in a large number of patients suffering from bancroftian filariasis in two districts of West Bengal,India.Methods:Nocturnal blood samples from filarial patients containing parasites and fungus were initially co-cultured,and further the fungus was isolated and characterized.Molecular identification of the isolate was carried out by PCR-based selective amplification and sequencing of highly-conserved D1/D2 region of 26S rDNA,whereas pathogenicity was determined by amplification of the RPS0 gene.A phylogenetic tree was constructed to study the relationship between the isolate and common pathogenic yeasts.The isolate was studied for antibiotic sensitivity,whereas morphological characterization was performed by microscopic techniques.Results:The isolate was identified as Pichia guilliermondii and this fungus was found to exist in co-infection with Wuchereria bancrofti in filarial patients.The fungus showed resistance to azole antifungals,griseofulvin,and,amphotericin B,whereas significant susceptibility was evident in cases of nystatin and cycloheximide.A total of 197 out of 222 patients showed this co-infection.Conclusion:This study revealed,for the first time,that P.guilliermondii exists as a co-infection in microfilaraemic individuals living in a filarial endemic zone.The findings are important and have relevance to human health,especially for filarial patients.

关键词： Lymphatic filariasis Pichia guilliermondii Co-infection Polymerase chain reaction Molecular identification

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Spatial distribution of leprosy in India:an ecological study

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Infectious Diseases of Poverty 2018年第1期7卷 206-214页

作者： Kyra H.Grantz Winnie Chabaari Ramolotja Kagiso Samuel Buri Gershom Laura Blum Lee Worden Sarah Ackley Fengchen Liu Thomas M.Lietman Alison P.Galvani Lalitha prajna Travis C.Porco Department of Biology University of FloridaGainesvilleFLUSA Emerging Pathogens Institute University of FloridaGainesvilleFLUSA DST/NRF Center for Excellence in Epidemiological Modeling and Analysis(SACEMA) StellenboschSouth Africa Stellenbosch University StellenboschSouth Africa African Institute of Mathematical Sciences MuizenbergSouth Africa University of California BerkeleyCAUSA Francis I.Proctor Foundation for Research in Ophthalmology University of CaliforniaSan FranciscoCAUSA Department of Ophthalmology University of CaliforniaSan FranciscoCAUSA Department of Epidemiology and Biostatistics University of CaliforniaSan FranciscoCAUSA Yale University New HavenCTUSA Aravind Eye Hospital MaduraiTamil NaduIndia

Background:As leprosy elimination becomes an increasingly realistic goal,it is essential to determine the factors that contribute to its persistence.We evaluate social and economic factors as predictors of leprosy annual new case detection rates within India,where the majority of leprosy cases occur.Methods:We used correlation and linear mixed effect regressions to assess whether poverty,illiteracy,nighttime satellite radiance(an index of development),and other covariates can explain district-wise annual new case detection rate and Grade 2 disability diagnoses.Results:We find only weak evidence of an association between poverty and annual new case detection rates at the district level,though illiteracy and satellite radiance are statistically significant predictors of leprosy at the district level.We find no evidence of rapid decline over the period 2008-2015 in either new case detection or new Grade 2 disability.Conclusions:Our findings suggest a somewhat higher rate of leprosy detection,on average,in poorer districts;the overall effect is weak.The divide between leprosy case detection and true incidence of clinical leprosy complicates these results,particularly given that the detection rate is likely disproportionately lower in impoverished settings.Additional information is needed to distinguish the determinants of leprosy case detection and transmission during the elimination epoch.

关键词： Leprosy Hansen’s disease India Poverty Spatial

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眼科保健工作中如何应对新冠肺炎

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实用防盲技术 2022年第3期17卷 93-93页

作者： Victor Hu Fatima Kyari N Venkatesh prajna Astrid Leck Simon Arunga Esmael Habtamu Elmien Wolvaardt Heiko Philippin 刘超凡(译) 不详中国科学技术大学附属第一医院安徽合肥230001

新型冠状病毒(也称严重急性呼吸综合征冠状病毒2号,SARS-CoV-2)目前已致数百万人感染,其中许多患者病重难治。这一突发的危机超出了医疗系统的应对能力,甚至很多卫生保健工作者都因此丧生。为了控制新冠肺炎的传播,世界各国都采取了不... 详细信息

新型冠状病毒(也称严重急性呼吸综合征冠状病毒2号,SARS-CoV-2)目前已致数百万人感染,其中许多患者病重难治。这一突发的危机超出了医疗系统的应对能力,甚至很多卫生保健工作者都因此丧生。为了控制新冠肺炎的传播,世界各国都采取了不同的政策,例如:·鼓励勤洗手,在公共场所佩戴口罩及保持至少1-2米的社交距离。

关键词：社交距离医疗系统肺炎严重急性呼吸综合征冠状病毒应对能力公共场所如何应对

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