Non-alcoholic fatty liver disease is a common cause of chronic liver disease, and its incidence is rising worldwide. Understanding its pathogenesis, biochemical parameters, histological grading and staging, and its management is a vital issue in today’s clinical practice. It appears to be linked directly to the growing epidemic of obesity in adults as well as in children. Thus, in a sense, NAFLD is a self-inflicted liver disease, much like alcoholic liver disease. The exact causes responsible for the development of NAFLD have not been established yet. However, some researchers consider that cluster of disorders that increases the risk of developing heart disease, diabetes, and stroke may be the factor behind development of NAFLD. Most patients with NAFLD have no symptoms or signs of liver disease at the time of diagnosis. In these patients, abnormal liver function tests are often discovered incidentally. Non-alcoholic steatohepatitis (NASH) is that stage of the spectrum that involves fat accumulation (steatosis), inflammation (hepatitis), and scarring (fibrosis) in the liver. Those who have fatty liver or hepatic steatosis with non-specific inflammation as fatty liver with non-specific inflammation generally have a benign longterm prognosis, whereas those who have NASH can progress to cirrhosis. NASH-related cirrhosis may have similar prognosis as cirrhosis from other causes. Hepatocellular carcinoma (HCC) is part of the spectrum of NAFLD, and screening for HCC seems reasonable in patients who have NASH-related cirrhosis. No established treatment is available for NAFLD. Some empiric treatment strategies have been suggested. Presumably, weight loss through exercise and diet modification along with insulinsensitizing agents will help reverse fatty infiltration of the liver. Its incidence is reportedly on the rise the world over as well as in India. Realizing its significance, there is now greater understanding of its etiology, pathogenesis, and management. The efforts of Elsevier have been directed toward addressing these aspects. Elsevier has thus pooled its existing resources with those of the internationally acclaimed Gastroenterologists of India who have chosen to share their rich clinical knowledge, experience, and expertize to serve the practitioners and patient community.

ECAB Non-alcoholic Fatty Liver Disease - E-Book

Alcoholic liver disease involves an acute or chronic inflammation of liver occurring as a consequence of alcohol abuse. The pathological changes occur in 3 stages namely, fatty liver, alcoholic liver disease and cirrhosis, with the final stage traditionally considered to be irreversible. Alcoholic liver disease is responsible for a significant number of premature deaths per annum all around the globe. There is an urgent need to educate the masses about the hazards of alcohol abuse. An efficient system to encourage and prolong the period of alcohol abstinence is the need of the hour. The importance of lifestyle modifications like weight reduction and cessation of smoking in the progression of liver disease needs to be communicated to the patients and the medical community as well. Moreover, realization of the role of nutrition in the management and recovery of ALD would enhance the treatment strategies for this condition. This book has been designed to update the readers on the important aspects of ALD and is a step forward to enable the society in combating the social and economic losses that occur as a result of alcohol abuse. The book has stressed upon various aspects of ALD like the role of nutrition, epidemiology and pathogenesis, and the possible therapeutic strategies involved. Supportive case scenarios have also been incorporated with relevance to the topics covered under the book. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country.

India in particular and South-Asia in general have witnessed a rapid increase in the prevalence and incidence of cardiovascular disease over the past 25 years. Lifestyles changes, unhealthy diet, lack of regular physical exercise, and obesity have all led to rising prevalence of metabolic syndrome. It is of no wonder that metabolic syndrome is being increasingly recognized as a clinical entity which is believed to be associated with increased risk of cardiovascular disease beyond individual risk factors, though this is at times debated. This monograph addresses the total nuance of metabolic syndrome in its entirety and answers questions frequently asked on this subject. The authors are internationally respected investigators in their own right having made major contributions in the particular field and are revered teachers as well. The book itself has clear sections which makes it very user friendly and divided into two volumes. The first volume has the evaluation of metabolic syndrome and the vastness of the problem and how it leads to smouldering dysfunctional endothelium making such a patient vulnerable to vascular disease. It purely deals with clinical issues we face daily in metabolic syndrome and patients. It is fairly broad-based to answer most of the queries which arise in a busy clinician’s head while dealing with metabolic syndrome on a day-to-day basis. Of special interest are chapters on metabolic syndrome in children, non-alcoholic fatty liver disease and hypogonadism.

ECAB Recent Advances in Hepatology - E-Book

Cell health depends on a steady supply of fuel from glucose and free fatty acids. Both these major fuels are regulated by insulin. Cells in the muscle, liver, and fat need insulin to receive glucose, and hence do not become exposed to high blood glucose levels when the blood sugars are high and insulin levels are low. The lack of insulin slows the movement of glucose into these cells, and probably spares them from damage when blood sugars are high. However, other cells such as those in the brain, nervous system, heart, blood vessels and kidneys pick up glucose directly from the blood without using insulin. These cells, except the brain, are more prone to damage from high blood sugars because they become exposed to high internal levels of glucose. This to quite an extent explains why damage tends to occur in specific organs such as in nerve and kidney cells, and in small blood vessels like those in the eyes. This project on the organ damage in diabetes is an attempt to elaborate on the various factors to be considered in managing these patients, the pointers for early diagnosis and prevention of the same.

(Medicine Update 2019_2 Volumes) SECTION 1: CARDIOLOGY SECTION 2: HYPERTENSION SECTION 3: PULMONOLOGY SECTION 4: ENDOCRINOLOGY SECTION 5: DIABETOLOGY SECTION 6: NEUROLOGY SECTION 7: RHEUMATOLOGY SECTION 8: NEPHROLOGY SECTION 9: GASTROENTEROLOGY AND HEPATOLOGY SECTION 10: ONCOLOGY AND HEMATOLOGY SECTION 11: INFECTIOUS DISEASES SECTION 12: CRITICAL CARE MEDICINE SECTION 13: POISIONING AND TOXICOLOGY SECTION 14: PREGNANCY SECTION 15: HIV SECTION 16: GERIATRICS SECTION 17: LIPIDOLOGY SECTION 18: NUTRITION SECTION 19: ENVIRONMENTAL MEDICINE SECTION 20: MISCELLANEOUS (Progress in Medicine 2019) SECTION 1: CARDIOLOGY SECTION 2: ENDOCRINOLOGY AND DIABETOLOGY SECTION 3: GASTROENTEROLOGY SECTION 4: GERIATRICS SECTION 5: GENERAL MEDICINE SECTION 6: INFECTIOUS DISEASES SECTION 7: NEPHROLOGY SECTION 8: NEUROLOGY SECTION 9: ONCOLOGY SECTION 10: PULMONOLOGY SECTION 11: POISONING SECTION 12: RABINDRANATH TAGORE ORATION SECTION 13: RHEUMATOLOGY Index