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Fatty Liver: A modern day life style disease


Fatty Liver: A modern day life style disease

What is fatty liver disease?

The liver is the second largest, the multifunctional organ inside our body which helps in digestion, energy storage, and detoxification. A healthy liver contains little or no fat. Fatty liver is a condition in which fat builds up in the liver. There are two main types:

  • Alcoholic fatty liver disease: related to the consumption of large amounts of alcohol.
  • Nonalcoholic fatty liver disease (NAFLD): related to a wide range of conditions other than alcohol. In fact, routinely used terminology fatty liver is shorthand for NAFLD.

How common is Fatty Liver disease?

It is also projected as one of the leading indications of liver transplantation in the present decade. The increasing incidence of NAFLD is tied to the growing obesity epidemic but not every obese develops fatty liver, and vice versa. Owing to rising childhood obesity, fatty liver is expected to become the leading cause of liver disease and failure, and indication for liver transplantation even in children and adolescents, within the next 10 years.

What are the risk factors for fatty liver?

  • Obesity
  • Diabetes
  • High blood cholesterol
  • High blood pressure
  • Family history
  • Drugs (steroids, anticancer drugs)
  • Rapid weight loss/ poor eating habits
  • Certain infections (hepatitis C)

What are the stages of fatty liver?

The spectrum of Fatty liver disease can be divided into 4 stages:

Stage 1 (simple fatty liver or steatosis): when fat accounts for more than 5 to 10 % of the liver’s weight without any inflammation or liver cell damage. It is one of the most common forms of reversible, harmless liver disease, with an estimated 30-40% prevalence in India. There are usually no symptoms and diagnosed incidentally.

Stage 2 (Non-alcoholic steatohepatitis, NASH): This means when the liver gets inflamed along with fat accumulation. Around 5-8% of the Indian population has NASH. NASH is a more aggressive form. A person may have a dull or aching pain in the top right of the abdomen or fatigue.

Stage 3 (Fibrosis): When the healthy liver tissue is replaced by fibrous scar tissue.

Stage 4 (cirrhosis or chronic liver disease): the most severe irreversible stage, bands of scar tissue develop, liver shrinks, becomes hard, functions less and leads to liver failure.

Apart from these, fatty liver can lead to liver cancer in a few circumstances.

How can Fatty Liver be diagnosed?

Fatty liver is often diagnosed incidentally when ultrasonography picks excessive fat content in the liver or routine blood tests show raised liver enzymes (ALT/AST) signifying ongoing inflammation in the liver. At-risk persons should get liver function tests and ultrasonography of the upper abdomen regularly.

Once the fatty liver is diagnosed, a newer technique called fibroscan/ transient elastography, which measures the liver’s stiffness, can help in the staging of fatty liver disease. Greater stiffness suggests greater scarring. A liver biopsy may be recommended if tests are inconclusive.

What are the treatment options for non-alcoholic fatty liver disease?

Diet, Exercise, and Healthy Lifestyle are the first and foremost treatment options.

  • Gradual weight reduction (>10% of baseline) can remove some fat from the liver
  • Eat a healthy diet with lots of fruits, vegetables, and whole grains, limiting salt and sugar.
  • Do daily moderate-intensity exercise such as walking or cycling, at least 150 minutes a week. All types of exercise can help improve NAFLD, even if you don’t lose weight.
  • Use cautiously dietary supplements, vitamins, or herbal remedies as these can damage the liver.

According to the latest American and European Liver society guidelines, no specific drug therapy can be firmly recommended for NAFLD at present.

What is the long-term prognosis of fatty liver?

The progression rate of simple fatty liver to advanced disease is low, and it may go away with simple lifestyle modification. But that doesn’t mean it’s not a serious condition as few people can eventually develop stage 2 disease.

In patients diagnosed with stage 2 fatty liver disease i.e. NASH, there are about 25% chances of developing cirrhosis within a decade and of this, about 50% will develop liver failure with the survival rate of no more than two years. So here is the importance of lifestyle changes at early stages to prevent the disease from getting worse.

To summarize, fatty liver is plaguing our modern society in parallel with other common lifestyle diseases. It is not a single entity rather a sequential spectrum of stages, out of which simple fatty liver is the most common earliest reversible phase which can be taken care of by lifestyle modification and weight loss; else it can progress to liver cell damage in 10- 25 % from where there is no turning back. Hence ‘ an ounce of prevention is worth a pound of cure’ holds true for fatty liver.

Advanced Urology Infertility

Truth about male infertility

Infertility problems are no longer a rare phenomenon and reports suggest that out of 10 couples, 2 are suffering from problems with conceiving. It was not very long back that infertility was considered as a female factor; however, the recent developments show that in over 20% of the total cases of infertility, the problem is with the sperm and not the egg.

We all know that it takes an egg and a sperm to meet and create a baby. The failure of any of them can cause infertility. The recent development suggests that in most of the cases, it is the male sperm that is the root cause of the problem. Here are some details that you need to know about male infertility.

What causes male infertility?

There are various factors responsible for male infertility, including physical, hormonal, genetic, or immunologic problems. It can also be a result of some long-time chronic illness or a sexual condition that hinders the natural flow and disposal of semen in the vagina.

Sperm production is widely affected by chronic diseases such as diabetes, high blood pressure, obesity and more. In fact, smoking and drinking a large amount of alcohol is a leading reason for male infertility in modern times.

Semen analysis

Semen analysis is a test that is used to diagnose the male infertility condition. It is a comprehensive test that analyses a range of factors including the number of sperm, the quantity of ejaculate, percentage of moving sperm, shape of individual sperm and more. The test is focused on assessing the amount of moving and living sperm, also known as total motile count, in an ejaculate sample.

Advance testing

While semen analysis is a very efficient tool to find the possible causes of male infertility, there are other advanced tests that must be performed. In case the brain does not signal the testes to make sperm, the body will have low production. This is a condition where hormones play a significant role. The advanced tests focus on measuring these hormones and finding out the possible cause.

Treatment for male infertility

The treatment that you get for your male infertility condition depends upon the count of your sperm. From “intrauterine insemination” or “IUI” to in vitro fertilization, the doctors may recommend the best treatment option based on your condition. Often, mild infertility is treated through medication or hormone therapy. In case the reason for infertility lies with some physical condition, the doctors also suggest surgery as a possible treatment option.

Male infertility cases are at a rise and there are plenty of reasons that contribute to it. It is best to contact a doctor as soon as the problem is experienced and seek treatment instantly. Any inhibition about opening up about the condition can cause a severe problem and hinder the chances to avail the best treatment.


Interpretation of Complete Blood Count

We all undergo a blood test sometime or another in our life. While most of us have basic knowledge about hemoglobin, hematocrit, and white blood cells (WBC), there are a number of other components of a CBC report that we do not understand. If they appear in the report, they must hold some significance.

What are the different blood components?

The two main components are plasma and cells. The cells flow freely in a liquid-like substance which is known as plasma. The cells are of different types and include erythrocytes (red blood cells or RBC), leukocytes (white blood cells or WBC), and the thrombocytes, also known as platelets.

What is analyzed in a CBC test?

CBC test measures the number of RBCs, hemoglobin, hematocrit, reticulocytes, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration in the blood. Additionally, platelets are also calculated in a CBC test.

Red blood cells

Commonly known as RBC, the measurement of the blood cells shows the number of erythrocytes in 1 cubic mm of whole blood. In the case of iron deficiency, blood loss, hemolysis, and bone marrow suppression the number of RBC decreases.


Hemoglobin is a pigment available in RBCs and is responsible for carrying oxygen to the different parts of the body. 14-18 g/dl and 12-16 g/dl is the normal level of Haemoglobin in males and females respectively.


This the measurement of cell volume as a percentage of the plasma and cell volume in the blood. Normally, the Haematocrit percentage is 3 times more than the hemoglobin count.


The new cells released by the bone marrow are known as Reticulocyte.


Indices are the measure of the average characteristics of the erythrocyte. This includes mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), the mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW).


They are also known as thrombocytes. Platelets are also formed in the bone marrow. They can be defined as the fragments of the megakaryocyte cytoplasm and are responsible for stopping the bleeding. An individual dealing with thrombocytopenia will have a low platelet count.

White blood cells

White blood cells are smaller in size than red cells. They are also known as leukocytes. They are responsible for the response to any type of inflammatory condition or injury.

Miscellaneous content of CBC

  • Bands: Also known as stabs. Their presence indicates that the inflammatory process is occurring.
  • Eosinophils: The number of Eosinophils increases in case of allergic and inflammatory reactions and parasite infections
  • Basophils: They contain heparin and histamine and are active in case of allergic and stress situations.
  • Monocytes: They are responsible for removing injured and dead cells, microorganisms and other particles from an injured site.
  • Lymphocytes: These are of two types – B cells and T cells and fight virus infections.

Hope this helps you read your CBC report efficiently the next time.

Advanced Urology Kidney Diseases

Natural Remedies for Kidney Stone & Doctor’s Advice

Kidney stones are also known as renal calculi and are sturdy rock-like structures made of crystals. Usually, kidney stones are found in the kidneys but they can also occur in any part of the urinary tract such as kidneys, ureters, bladder, and urethra. There are different types of kidney stones depending upon their formation. The key crystals that form kidney stones are Calcium, Uric, Struvite, and Cystine. A kidney stone is one of the most painful condition and immediate doctor consultation is advised. However, kidney stones can also be treated with natural ways. Let us are some natural remedies for kidney stones.

Natural remedies for kidney stones

  • Water: One of the best ways to avoid and treat kidney stones is by drinking plenty of liquids. You must drink at least 12 glasses of water and other liquids in a day. The excess liquid supply will cut the stones and help it pass through the body.
  • Apple Cider Vinegar: Apple Cider Vinegar is high in acetic acid which is able to cut kidney stones. It is also helpful in easing down the pain. A combination of Apple Cider Vinegar, water and lemon juice is very effective.
  • Wheatgrass juice: Wheatgrass juice offers a good supply of nutrients and is also an influencer of urine. When you urinate more, you have higher chances to pass out the kidney stones.
  • Pomegranate juice: Pomegranate is known to improve kidney function as it is responsible to flush out toxins from the body. A glass of pomegranate juice will help you eliminate kidney stones as well.
  • Basil Juice: The acetic acid content of basil is very high. It helps in breaking down the kidney stone and making it easy to pass through the urinary tract.

What do doctors advise for kidney stones?

The doctors explain that the treatment for kidney stones depends upon the type of deposits. It can vary anything from simple medications to surgery. While natural remedies must be tried, the doctors advise some more precautions including:

  • Reduce the amount of salt and sugar in your diet.
  • Reduce consumption of red meat and eat the right food.
  • Exercise regularly.
  • Maintain healthy blood pressure.
  • Ensure your blood sugar levels are in control.
  • Maintain a healthy weight and do not become overweight/obese.
  • Any pain killers and any type of over the counter medications.
  • Quit smoking.
  • Drink plenty of water.
  • Get the kidney check-up done regularly.

The doctor would assess your condition and offer you the best treatment option. In severe cases, kidney stone surgery is advised which must be performed by an expert surgeon only. If you are dealing with kidney stones, do not ignore the symptoms and consult with a reliable kidney stone surgeon or urologist right away.

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