Blood Pressure

How is non alcoholic fatty liver disease diagnosed?

Liver disease is also called hepatic disease. This is in terms of group of single number of diseases affecting the liver.

Non-alcoholic fatty liver disease is a liver disease.
- This is one cause of a fatty liver.
- This occurrs when fat is deposited (steatosis) in the liver.
- It is not due to excessive alcohol use.
- It is related to insulin resistance and the metabolic syndrome.
- This is involved with symptoms such as weight loss, metformin and thiazolidinediones.
- Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD.
- This is regarded as a major cause of cirrhosis of the liver of unknown cause.

Causes of Non Alcoholic Fatty Liver Disease
- Fatigue
- Malaise
- Dull right-upper-quadrant abdominal discomfort
- Mild jaundice
- Abnormal liver function tests
- Alcohol consumption of over 20 g/day
- Insulin resistance
- Metabolic syndrome
- Obesity
- Combined hyperlipidemia
- Diabetes mellitus (type II)
- High blood pressure

Secondary Causes
NAFLD can also be caused by some medications.
- Amiodarone
- Antiviral drugs (nucleoside analogues)
- Aspirin rarely as part of Reye’s syndrome in children
- Corticosteroids
- Methotrexate
- Tamoxifen
- Tetracycline

Diagnosis of Non Alcoholic Fatty Liver Disease
- Elevated liver enzymes
- A liver ultrasound showing steatosis.
- An ultrasound may also be used to exclude gallstone problems (cholelithiasis).
- Computed Tomography (CT) —a method of body imaging in which a thin X-ray beam rotates around the patient which provides a detailed view of the liver.
- A biopsy (tissue examination) of the liver is the only test widely accepted.
- FibroTest that estimates liver fibrosis.
- SteatoTest that estimates steatosis.
- Apoptosis has been shown to be the mechanism of hepatocyte destruction and caspase-cleaved cytokeratin 18 (M30-Apoptosense ELISA) in serum/plasma.

Relevant Blood Tests
- Erythrocyte sedimentation rate
- Glucose
- Albumin
- Renal function
- Coagulation related studies
- The INR (international normalized ratio)

Blood tests (serology) are usually used to rule out:
- Viral hepatitis (hepatitis A, B, C, EBV, CMV andherpes viruses),
- Rubella,
- Autoimmune related diseases
- Hypothyroidism

Diagnosis
- Abdominal Ultrasound
- AMA Test
- ERCP (Endoscopic Retrograde Cholangiopancreatography)
- Liver Biopsy
- Liver Panel
- Manifestations of Liver Disease
- Needle Biopsy

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How to handle some medical emergencies during health crisis?

Medical emergencies are not pre-planned. They occur all of a sudden. There is an emergency room available in all hospitals. What can be done to handle some medical emergencies that occur all of a sudden is described below:

- Asthma
When the symptoms of asthma like wheezing, chest tightness, coughing, breath shortness worsens until he / she is unable to speak more than four words, blueness around lips and reliever medication is ineffective, person should be admitted to the emergency room in which he would be put on a nebuliser in which oxygen is directly delivered to the lungs. Oxygen mask can also be used.

- Heart Attack
Symptoms of heart attack include pain across chest, arms, jaws or neck and it does not lessen with rest, nausea, vomiting, difficulty in breathing, rapid weak and irregular pulse. Move to an emergency room and on the way to hospital chew a 160mg aspirin to stop clumping of blood platelets. In an emergency room, ECG is done and blood studies are done. Intravenous nitroglycerine reduces heart’s oxygen need and improves coronary circulation. The chance of death is halved if you reach in first hour.

- Fractures
When a fracture is suspected, pain worsens with the movement, that particular area swells, a limb is crooked. Transport to an emergency room very carefully. In the emergency room, x-ray of the limb is done and broken bone ends are treated.To relieve pain, a muscle relaxant is given. The area is immobilized with plaster cast or splint.

- Internal Bleeding
Sometimes, there is internal bleeding after an injury. Symptoms are pale and clammy skin, rapid weak pulse, shallow and rugged breathing, fainting, swelling, pain and tenderness. While you are waiting for ambulance to go to an emergency room, raise the legs and cover with blanket and do not offer an food or water. In an emergency room, the person is diagnosed and then treated.

- Diabetes
Sometimes, the blood sugar falls below 50 because of delayed and missed meals, sudden vigorous activities, irregular medications. It results in blurred vision, numbness, paleness, headaches, unconsciousness, tingling in lips and and fingers. When a person is admitted to an emergency room, the IV fluids are administered.

- Poison
Induce vomiting if poison is not in the form of kerosene, gasoline, turpentine, cleaning fluid, insect sprays. In an emergency room, urine and blood tests are done to identify the poison and specific antidotes are suggested.

- Urinary Retention
Sometimes a person has a full bladder but they could not urinate. When you are admitted to an emergency room, a catheter is inserted to allow the person to empty the bladder.

- Heat Exhaustion
It can hit you in a hot, noisy, smoke filled disco or pub resulting in loss of electrolytes. In an emergency room, patient is pumped with IV fluids to revive the blood pressure.

Some quick tips for maintaining good health…

There are a lot of things one can do to get to a good healthy body. You can have a whole book dedicated to tips for maintaining a good health, but in today’s fast paced life, everybody looks for a summary rather than a whole novel. What we will try to do in this post is to look at some of the most common issues that can affect health and provide suggestions on how to overcome these issues.

- One of the major problem that a person face now-a-days is falling hair. Protein is very essential for maintaining good hair. To reduce hair fall, including good quality protein like soyabean or egg whites in the daily diet is very important. Also, taking vitamin B12 and consuming Brewer yeast tablets can help in reducing hair fall.

- Diabetes is getting so common now-a-days. Every second person is suffering from this disease. There are some simple tips that one can do at home to treat diabetes. One teaspoon of jamun powder or fenugreek seeds(methi) in the morning helps to reduce diabetes. Maintaining a good and healthy lifestyle is the most important measure that needs to be taken if one wants to get rid of this disease. Consumption of excess fat from your diet will improve the body’s insulin resistance.

- Constipation is another problem that people are facing now-a-days. To a greater extent, today’s lifestyle is responsible for an irregular bowel functioning. Consumption of junk food is increasing and also the stress level of the human being. Some simple tips to control constipation is to drink plenty of water daily and reduce the caffeine intake. Daily exercise which included walking for at least 45 min to 60 min is important. Also, include fresh vegetable juice in your diet.

- Dull skin can be a fairly common issue now-a-days. Some simple ways to address this issue is by ensuring that you drink enough water and fluids during the day to keep your skin hydrated. Drinking fresh vegetable juice and eating multiple servings of green vegetables and fruits during the day is also required. This needs to be supplemented with adequate amount of proteins, vitamin E and omega 3 supplements.

- To improve cardio vascular health, daily exercise which may include walking for atleast 45 min to 60 min at least 4-5 times a week is very important. In addition to walking, yoga and some breathing exercises three times a week reduces any kind of stress. In your diet, include one or two tbsp of roasted flaxseeds as it helps to increase the good cholesterol levels in the body.

- To improve metabolism, the most important tip that can be followed is eating during the first hour of having woken up. Walking is also very important to improve metabolism. Protein digestion asks the body to burn more calories and hence increasing the metabolism. So, include protein in your diet.

- To increase energy and immunity, instead of taking three big meals like breakfast, lunch, dinner, eat small frequent meals. It improves the digestion and keeps your body energetic. Include vitamin B12 supplements and wheat grass juice at least three to four times in a week.

- Discomfort during menopause is very common. To reduce it, include soya supplement in your diet as it mimics the estrogen function in the body. Also, include vitamin B6 as it prevents bloating.