Nonobese was 25.6 % among NAFLD patients of Bangladesh, and 53.1 % of nonobese NAFLD cases were NASH. Though they were nonobese by BMI grade, they were metabolically similar to obese. Males were predominant in the nonobese, whereas females in the obese. NASH and fibrosis were similar in the obese and nonobese.

Females were the predominant sufferers of NAFLD in Bangladesh. The prevalence of NASH was high. Diabetes was found to be the main culprit in developing NASH. GGT was the only biochemical marker of NASH. We recommend liver biopsy in NAFLD patients who have diabetes and elevated GGT.

Fatty liver is a common cause of chronic liver disease in developed as well as developing countries.We have designed this study to estimate the prevalence and predictors for non alcoholic steatohepatitis (NASH) in non alcoholic fatty liver disease (NAFLD). We have included 493 patients with sonographic evidence of fatty change in liver and 177 of them had done liver biopsy for histopathological study. Other causes of liver disease and alcohol consumption were excluded. Metabolic syndrome and biochemical and anthropometric evaluation was done.

<p><strong>Background:</strong> Nonalcoholic steatohepatitis (NASH) and advanced fibrosis are the spectrum of nonalcoholic fatty liver disease (NAFLD) that may progress to cirrhosis.</p><p><strong>Objective:</strong> We aimed to determine the detecting capacity of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) for NASH and <br />significant fibrosis.</p><p><strong>Methods:</strong> Demographic and laboratory data of 502 sonologically diagnosed NAFLD patients were retrospectively analysed. Area under receiver operating characteristics curve (AUROC) was performed for NASH and fibrosis score ≥2 (significant fibrosis) with ALT, AST and GGT of 233 biopsied patients.</p><p><strong>Results:</strong> Of 502 patients ALT, AST and GGT was elevated in 252 (50.1 %), 184 (36.7%) and 138 (27.4%) respectively. There was no difference in histological activity and fibrosis score between normal and elevated ALT and AST. Forty two (40.2%) NASH and 23(20.2%) significant fibrosis had normal ALT level. GGT was differed in NASH and Non NASH (p&lt; .005) and between significant fibrosis (p&lt; .01) and insignificant fbrosis. To detect NASH AUROC curve ofGGT was 67.5%, whereas of ALT and AST was 55.2% and 55.7%. For significant fibrosis AUROC curve of ALT, AST and GGT was 44, 50 and 68.4 % respectively. GGT level of39.5 U/L could detect NASH with a 63% sensitivity and 65% specificity irrespective of sex. GGT 40.5U/L had 60% sensitivity and 59 % specificity to detect significant fibrosis. For fibrosis ≥2 AUROC curve was 75.4% in male.</p><p><strong>Conclusion:</strong> No optimal ALT and AST level could detect NASH and fibrosis. GGT level of 40 U/L had a better detecting capacity for NASH and fibrosis especially in male. </p>

Background: Nephrotic syndrome (NS) is one of the most common renal diseases in children. It is a chronicchildhood disorder with a course of relapse and remission. Hyperlipidemia is a constant feature (95% cases)of minimal change nephrotic syndrome (MCNS) having serum cholesterol >250 mg/dl. Both increased synthesisand decreased clearance of lipoproteins may contribute to the hyperlipoproteinemia which frequently complicatesthe NS. Persistent hyperlipidemia can lead to relapse of NS which is a potential risk factor for progression ofglomerular injury. Persistent hyperlipidemia and frequent relapse of NS are further responsible forcardiovascular disease and progressive glomerular damage leading to renal failure. This study was done todetermine relationship between plasma lipids and relapse of idiopathic NS in children. Methods: This prospective study was carried out from July 2015 to June 2017 at the Department of Paediatricsin Sylhet MAG Osmani Medical College Hospital. Patients with the diagnosis of NS fulfilling the inclusioncriteria were included in this study purposively. A total of 50 children were included into this study. Theprimary end point was to determine plasma lipids level in children having idiopathic NS at acute phase, inremission and at 6 months after completion of treatment. The secondary end point was to evaluate the relationshipbetween persistent hyperlipidemia in remission phase and relapse of NS. Results: Among 50 children with clinical diagnosis of NS, 35 were first episode and 15 were in relapse cases.Among the first episode NS cases serum lipids level were decreased significantly during remission but HDLwas increased, whereas in relapse cases even during remission serum lipids level were significantly higher.After six months of follow up, out of 50 patients 28 patients had persistent remission and 22 patients hadrelapsed. The relationship between plasma lipids level and the incidence of relapse showed that acute lipidfraction levels were not risk factor in relapsing NS. Only the triglyceride level during remission was a riskfactor in relapsing NS (p<0.035) with OR 5.4 and 95% CI [1.06, 25.4]. Conclusion: Persistent hypertriglyceridemia and hypercholesterolemia in remission phase is a risk factor forrelapse of idiopathic NS in children. Birdem Med J 2020; 10(2): 97-102