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Objective Patients with Sheehan syndrome (SS) are predisposed to coronary artery disease (CAD) due to risk factors like abdominal obesity, dyslipidemia and chronic inflammation. In addition to estimate CAD risk enhancers like high sensitive C reactive protein (hsCRP), apolipoprotein B (ApoB) and lipoprotein A [Lp(a)], this study applies Framingham risk score (FRS) and coronary artery calcium (CAC) score to compute a 10‐year probability of cardiovascular (CV) events in SS patients. Design Case–control study Sixty‐three SS patients, on a stable hormonal replacement treatment except for growth hormone and 65 age, body mass index and parity‐matched controls. Measurements Measurement of serum hsCRP, ApoB and Lp(a) and estimation of CAC with 16‐row multislice computed tomography scanner. Results The concentrations of hsCRP, ApoB and Lp(a) were significantly higher in SS patients than in controls (p < .01). After calculating FRS, 95.2% of SS patients were classified as low risk, 4.8% as intermediate risk and all controls were classified as low risk for probable CV events. CAC was detected in 50.7% SS patients and 7.6% controls (p = .006). According to the CAC score, 26.9% SS patients were classified as at risk (CAC > 10) for incident CV events as against 1.6% controls. The mean Multi‐Ethnic Study of Atherosclerosis (MESA) score was significantly higher in patients with SS than controls. CAC corelated significantly with fasting blood glucose (r = .316), ApoB (r = .549), LP(a) (r = .310) and FRS (r = .294). Conclusion Significant number of asymptomatic SS patients have high coronary artery calcium score and are classified at risk for CAD.

Background: The evidence of nonalcoholic fatty liver disease (NAFLD) in absence of obesity and diabetes is not fairly adequate; furthermore, there is not much data on the markers of NAFLD for this patient population, especially in Indian patients. We aimed to evaluate the severity of NAFLD in nonobese and nondiabetic patients and determine the correlation of its severity with cytokeratin-18 (CK-18). We also aimed to analyze the data for correlation between the conventional marker alanine aminotransferase (ALT), cardiovascular surrogate markers carotid intima-media thickness (CIMT), and CK-18 in adults with NAFLD. Materials and Methods This prospective, single-center, and noninterventional study enrolled 200 nonobese, nondiabetic adults with ultrasonography-confirmed NAFLD (presence of any two of the features – increased liver echogenicity with a clear contrast between kidney and liver, clouding of vessels, or deep weakening of the ultrasound signal) and 100 healthy controls and was conducted in the Department of Gastroenterology at Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India. Results The CK-18 levels progressively increased with the severity of fatty liver, 68.54 (Grade 1), 167.5 (Grade 2), and 324.44 (Grade 3). In patients with Grade 2 and 3 NAFLD, the levels of CK-18 were significantly higher compared to controls as well as Grade 1 (P = 0.00). The correlation between ALT, CIMT (right and left), and CK-18 levels using Pearson's correlation coefficient showed that CIMT had a significant (P ≤ 0.0001) and positive correlation with both ALT and CK-18. The CIMT and ALT are highly correlated, whereas the CIMT and CK-18 are moderately correlated. Conclusion Apart from ALT, elevated CK-18 in patients with NAFLD appears to be promising as a signal for cardiovascular risk evaluation even in nonobese, nondiabetic adults.

This study evaluated the influence of insoluble fiber source on growth performance and digestive traits of the broilers from 1 to 35 d of age. In total 180, day-old, straight run broilers (Ross 308) were randomly assigned to 5 dietary treatments having 6 replicates of 6 broilers each. The dietary treatments included a control diet, and the diets containing oat hulls, rice hulls, wood shavings and sugarcane bagasse at 3% inclusion level. Diets were offered in mesh form in starter, grower and finisher phases. Growth performance was higher (P < 0.05) in the broilers fed oat hulls diets compared to those fed rice hulls, sugarcane bagasse and wood shaving as insoluble fiber source and control. The broilers fed oat hulls diets had 4% greater dressed weight with giblet, 5% improved dressed weight without giblet, 4% higher breast yield and 15% increased leg quarter yield among other dietary treatments. Oat hulls and sugarcane bagasse based diets resulted in higher (P < 0.05) relative gizzard weight. The oat hulls diets increased 15%villus height, 11% reduced crypt depth and 34% improved villus height to crypt depth ratio than for the rice hulls or wood shaving birds, whereas those fed control or sugarcane bagasse being intermediate. Oat hulls supplementation resulted in higher (P < 0.05) apparent ileal digestibility of dry matter, crude protein and amino acids in broilers. Overall, oat hulls and sugarcane bagasse supplementation resulted in greater growth performance and carcass characteristics, improved gut morphology and a better nutrients digestibility in the broilers.

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