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Effect of Exercise on NAFLD and Its Risk Factors:Comparison of Moderate versus Low Intensity Exercise

Journal of Clinical and Translational Hepatology 2020年第2期8卷 120-126页

作者： Preetam Nath Manas Kumar Panigrahi Manoj Kumar Sahu Jimmy Narayan Ranjan Kumar Sahoo Ananya Apurba Patra Satyaswarup Jena Arun Kumar Patnaik Anjan Jena shivaram prasad singh Department of Gastroenterology&Hepatology Kalinga Institute of Medical SciencesBhubaneswarOdishaIndia Department of Gastroenterology All India Institute of Medical SciencesBhubaneswarOdishaIndia Department of Gastroenterology IMS and SUM HospitalBhubaneswarOdishaIndia Department of Radiodiagnosis&Imaging Kalinga Institute of Medical SciencesBhubaneswarOdishaIndia Department of Radiology IMS and SUM HospitalBhubaneswarOdishaIndia Dispensary Biju Patnaik State Police AcademyBhubaneswarOdishaIndia Department of Gastroenterology S.C.B.Medical College753007 CuttackOdishaIndia

Background and Aims: Lifestyle (exercise and dietary) modification is the mainstay of treatment for non-alcoholic fatty liver disease (NAFLD). However, there is paucity of data on effect of intensity of exercise in management of NAFLD, and we aimed to study the effect of variable intensities of exercise on NAFLD. Methods: The study was performed in the Department of Gastroenterology of the SCB Medical Col-lege, Cuttack and the Biju Patnaik State Police Academy, Bhu-baneswar. The subjects were police trainees [18 in a moderate intensity exercise group (MIG) and 19 in a low in-tensity exercise group (LIG)] recruited for a 6-month physical training course (261.8 Kcalorie, 3.6 metabolic equivalent in MIG and 153.6 Kcalorie, 2.1 metabolic equivalent in LIG). NAFLD was diagnosed by ultrasonography, with exclusion of all secondary causes of steatosis. All participants were eval-uated by anthropometry (weight, height, body mass index (BMI), waist circumference), assessed for blood pressure and biochemical parameters (blood glucose, liver function test, lipid profile, serum insulin), and subjected to transabdo-minal ultrasonography before and after 6 months of physical training, and the results were compared. Results: Both the groups had similar BMI, fasting plasma glucose, AST, gamma-glutamyl transpeptidase, insulin, and homeostatic model as-sessment-insulin resistance (known as HOMA-IR) (p>0.05). However, subjects in the LIG were older and had lower alanine transaminase, higher triglycerides and lower high-density lip-oproteins than MIG subjects. There was a significant reduc-tion in BMI (27.0±2.1 to 26.8±2.0;p=0.001), fasting blood glucose (106.7±21.6 to 85.8±19.0;p<0.001), serum trigly-cerides (167.5±56.7 to 124.6±63.5;p=0.017), total choles-terol (216.8±29.2 to 196.7±26.6;p=0.037), low-density lipoprotein cholesterol (134.6±21.4 to 130.5±21.9;p=0.010), serum aspartate transaminase (39.3±32.2 to 30.9±11.4;p<0.001), serum alanine transaminase (56.6 ±28.7 to 33.0±11.3;p<0.

关键词： Exercise NAFLD Intensity Physical activity

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A Study of Prevalence of Diabetes and Prediabetes in Patients of Non-Alcoholic Fatty Liver Disease and the Impact of Diabetes on Liver Histology in Coastal Eastern India

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Journal of Diabetes Mellitus 2014年第4期4卷 290-296页

作者： shivaram prasad singh Ayaskanta singh Girish Kumar Pati Bijay Misra Debasis Misra Sanjib Kumar Kar Manas Kumar Panigrahi Chudamani Meher Omprakash Agrawal Niranjan Rout Kaumudi Pattnaik Pallavi Bhuyan Amarendra Mohapatra Department of Gastroenterology S. C. B. Medical College Cuttack India Department of Radiology Beam Diagnostics Centre Cuttack India Department of Oncopathology A. H. Regional Cancer Center Cuttack India Department of Pathology S. C. B. Medical College Cuttack India Regional Medical Research Centre Bhubaneswar India

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is more common in diabetic patients. There are limited studies on clinical, biochemical and histological features of NAFLD patients who are diabetic. The aim of the study was to determine the prevalence of diabetes and prediabetes in a cohort of NAFLD patients and to compare anthropometry, biochemical and metabolic parameters and hepatic histology of diabetic NAFLD patients with non-diabetic NAFLD patients. Methods: 515 consecutive NAFLD patients diagnosed by abdominal ultrasound and 100 healthy controls were subjected to detailed anthropometric measurements and biochemical assays including blood sugars, LFT, lipid profile and HOMA. Diabetes and prediabetes were defined according to WHO criteria. Patients were categorized and compared according to the presence or absence of diabetes. Liver biopsy was performed in 240 NAFLD patients and the liver histology was also compared between the two groups. Statistical analysis was performed on SPSS 16. Results: 124 out of the 515 (24.08%) NAFLD patients were diabetics, 118 out of 515 (22.9%) were pre-diabetics, while only 3 out of 100 controls had impaired glucose tolerance. Diabetic patients were older. NAFLD patients with diabetes had significantly higher waist circumference [98.02 ± 12.01 vs 93.89 ± 8.8, p = 0.000] as compared to the NAFLD patients without diabetes. Fasting blood sugar [124 ± 46.3 vs 90.8 ± 10.2, p = 0.000], triglyceride level [218.4 ± 17.6 vs 192 ± 9, p = 0.03] and HOMA-IR [2.6 ± 0.36 vs 1.84 ± 0.2, p < 0.001] were significantly higher in NAFLD-diabetes group. Hypertension [35% vs 11.7%, p = 0.000] was commoner in diabetic NAFLD patients. Histopathology in the diabetic patients revealed steatosis alone in 34.2% cases, borderline NASH in 31.4% and definite NASH in 34.2%. Fatty change alone was noted in 16.5% cases, borderline NASH in 34.1%, while 49% had definite NASH on liver biopsy of NAFLD patients without diabetes. Fibrosis was noted

关键词： Fatty Liver Diabetes Prediabetes Liver Histology Insulin Resistance Steatohepatitis

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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 ***,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 *** 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 *** NAFLD with MAFLD would neither enhance the legitimacy of clinical practice and clinical trials,nor improve clinical care or move NAFLD research *** 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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Non-alcoholic fatty liver disease in diabetes:When to refer to the hepatologist?

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World Journal of Diabetes 2021年第9期12卷 1479-1493页

作者： Reshu Khandelwal Anuradha S Dassanayake Hari S Conjeevaram shivaram P singh Department of Gastroenterology Srirama Chandra Bhanja(SCB)Medical College and HospitalCuttack 753007OdishaIndia Department of Medicine Colombo North Centre for Liver DiseaseUniversity of KelaniyaKelaniya 11600Sri Lanka Division of Gastroenterology and Hepatology University of Michigan Medical SchoolAnn ArborMI 48109United States

Non-alcoholic fatty liver disease(NAFLD)has become one of the most common chronic liver diseases worldwide.A strong relationship exists between NAFLD and diabetes *** is growing evidence of a mechanistically complex and strong association between the two *** data also shows that one disease actually leads to worsening of the other and vice *** of the various pathophysiological mechanisms involved,natural history and spectrum of these two diseases is essential not only for early diagnosis and management but also for prevention of severe disease *** the tremendous progress made in recent times in acquiring knowledge about these highly prevalent diseases,the guidelines and recommendations for screening and management of diabetics with NAFLD remain *** interdisciplinary approach is required to not only raise awareness of the prevalence of NAFLD in diabetics but also for better patient *** can help attenuate the development of significant complications,such as cirrhosis,decompensation and hepatocellular carcinoma in these patients,thereby halting NAFLD in its *** review focuses on the pivotal role of primary care physicians and endocrinologists in identification of NAFLD in diabetics in early stages and the role of proactive screening for prompt referral to hepatologist.

关键词： Fibrosis Diabetes Insulin resistance Non-alcoholic fatty liver disease Nonalcoholic steatohepatitis Steatosis

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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 *** people diagnosed with COVID-19 infections are often found to develop liver injury,which,in a small portion of patients,progresses to severe 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 *** who already have insult to the liver from chronic disease,such as nonalcoholic fatty liver disease(NAFLD)may be at the greatest *** severity of COVID-19 also seems to be driven by the presence of NAFLD and other *** 25%of the global population has *** 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 *** 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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Spontaneous bacterial peritonitis

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World Journal of Gastroenterology 2009年第9期15卷 1042-1049页

作者： Anastasios Koulaouzidis shivaram Bhat Athar A Saeed Endoscopy Unit Centre of Liver & Digestive DisordersRoyal Infirmary of Edinburgh51 Little France CrescentEdinburghScotlandEH16 4SAUnited Kingdom Gastroenterology Belfast Trust Matter Hospital47-51 Crumlin RoadBelfastNorthern IrelandBT14 6ABUnited Kingdom Gastroenterology Department Queen Elizabeth HospitalGatesheadTyne & WearNE9 6SXUnited Kingdom

Since its initial description in 1964,research hastransformed spontaneous bacterial peritonitis (SBP)from a feared disease (with reported mortality of 90%)to a treatable complication of decompensated cirrhosis,albeit with steady prevalence and a high recurrencerate. Bacterial translocation,the key mechanism in thepathogenesis of SBP,is only possible because of theconcurrent failure of defensive mechanisms in *** of SBP should be treated. Leucocyte esterasereagent strips have managed to shorten the 'tap-to-shot' time,while future studies should look into theircombined use with ascitic fluid pH. Third generationcephalosporins are the antibiotic of choice becausethey have a number of advantages. Renal dysfunctionhas been shown to be an independent predictor ofmortality in patients with SBP. Albumin is felt to reducethe risk of renal impairment by improving effectiveintravascular volume,and by helping to bind pro-inflammatory molecules. Following a single episodeof SBP,patients should have long-term antibioticprophylaxis and be considered for liver transplantation.

关键词： Spontaneous bacterial peritonitis Infection Ascites Leucocyte reagent strips Portal hypertension,Ascites

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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 *** primarily,the infection causes lung injury,liver enzyme abnormalities have also been reported to occur during the course of the *** conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic *** 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 ***,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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Neurocognitive Dysfunction After Treatment for Pediatric Brain Tumors:Subtype-Specific Findings and Proposal for Brain Network-Informed Evaluations

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Neuroscience Bulletin 2023年第12期39卷 1873-1886页

作者： Charlotte Sleurs Paul Fletcher Conor Mallucci shivaram Avula Thankamma Ajithkumar Department of Cognitive Neuropsychology Tilburg University5037 ABTilburgThe Netherlands Department of Oncology KU Leuven3000LeuvenBelgium Department of Psychiatry University of CambridgeAddenbrookes HospitalCambridgeCB20QQUK Wellcome Trust MRC Institute of Metabolic Science University of CambridgeCambridge Biomedical CampusCambridgeCB20QQUK Department of Neurosurgery Alder Hey Children’s NHS Foundation TrustLiverpoolL145ABUK Department of Radiology Alder Hey Children’s NHS Foundation TrustLiverpoolL145ABUK Department of Oncology Cambridge University Hospital NHS TrustCambridgeCB20QQUK

The increasing number of long-term survivors of pediatric brain tumors requires us to incorporate the most recent knowledge derived from cognitive neuroscience into their oncological *** the lesion itself,as well as each treatment,can cause specific neural damage,the long-term neurocognitive outcomes are highly complex and challenging to *** number of neurocognitive studies in this population grows exponentially worldwide,motivating modern neuroscience to provide guidance in follow-up before,during and after *** this review,we provide an overview of structural and functional brain connectomes and their role in the neuropsychological outcomes of specific brain tumor *** on this information,we propose a theoretical neuroscientific framework to apply appropriate neuropsychological and imaging follow-up for future clinical care and rehabilitation trials.

关键词： Connectome Pediatric brain tumor Neuroimaging Neurocognition-Neuropsychological assessment

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Impact of sodium glucose cotransporter-2 inhibitors on liver steatosis/fibrosis/inflammation and redox balance in non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2022年第26期28卷 3243-3257页

作者： Francesco Bellanti Aurelio Lo Buglio MichałDobrakowski Aleksandra Kasperczyk Sławomir Kasperczyk Palok Aich shivaram P singh Gaetano Serviddio Gianluigi Vendemiale Department of Medical and Surgical Sciences University of FoggiaFoggia 71122Italy Department of Biochemistry Medical University of Silesia in KatowiceZabrze 41-808Poland School of Biological Sciences National Institute of Science Education and ResearchKhurdha 752050India Department of Gastroenterology SCB Medical CollegeCuttack 753007India

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT2-I)are the most recently approved drugs for type 2 diabetes(T2D).Recent clinical trials of these compounds reported beneficial cardiovascular(CV)and renal outcomes.A major cause of vascular dysfunction and CV disease in diabetes is hyperglycemia associated with inflammation and oxidative ***-clinical studies demonstrated that SGLT2-I reduce glucotoxicity and promote anti-inflammatory effects by lowering oxidative *** To investigate the effects of SGLT2-I on markers of oxidative stress,inflammation,liver steatosis,and fibrosis in patients of T2D with non-alcoholic fatty liver disease(NAFLD).METHODS We referred fifty-two consecutive outpatients treated with metformin monotherapy and exhibiting poor glycemic control to our *** introduced the outpatients to an SGLT2-I(dapagliflozin,empagliflozin,or canagliflozin;n=26)or a different hypoglycemic drug[other glucose-lowering drugs(OTHER),n=26].We evaluated circulating interleukins and serum hydroxynonenal(HNE)-or malondialdehyde(MDA)-protein adducts,fatty liver index(FLI),NAFLD fibrosis score,aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio,AST-to-platelet-ratio index(APRI),and fibrosis-4 on the day before(T0)and following treatment for six months(T1).We also performed transient elastography at T0 and *** Add-on therapy resulted in improved glycemic control and reduced fasting blood glucose in both *** note,following treatment for six months,a reduction of FLI and APRI,as well as of the FibroScan result,was reported in patients treated with SGLT2-I,but not in the OTHER group;furthermore,in the SGLT2-I group,we reported lower circulating levels of interleukin(IL)-1β,IL-6,tumor necrosis factor,vascular endothelial growth factor,and monocyte chemoattractant protein-1,and higher levels of IL-4 and *** did not observe any modification in circulating interleukins in the OTHER ***,serum HNE-and MDA-protein a

关键词： Sodium glucose cotransporter-2 inhibitors Non-alcoholic fatty liver disease Oxidative stress Type 2 diabetes Liver fibrosis Inflammation

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An Experimental Study on the Response of Model Footings Resting on Reinforced Flyash Beds under Repeated Load

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Journal of Civil Engineering and Architecture 2014年第5期8卷 633-638页

作者： shivaram Gangadhara Honnagondanahalli Chikkaranganna Muddaraju Department of Civil Engineering Bangalore University Bangalore 560 056 India

In the present, investigation an attempt has been made to study the behavior of reinforced flyash beds under repeated loads by conducting carefully designed experiments. The main objective of the experiments conducted is to evaluate the beneficial effects of using flyash as a backfill material in the reinforced beds to resist the repeated loads. As no unique standard equipment is available for the application of repeated loads and to measure the response, different researchers have designed and fabricated different types of equipments for the testing. The repeated load of known intensity with waveform type and frequency is applied on the surface and embedded footing in unreinforced and reinforced flyash beds. The response of the flyash beds, in the form of settlement is measured using linear variable differential transducers. The experimental results clearly demonstrated that the provision of reinforcement in the flyash beds is effective in improving the performance of both surface and embedded footing under repeated loads.

关键词： Reinforced fly ash bed repeated loads cyclic resistance ratio settlement ratio.

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