Biochemical Profile of Nonalcoholic Fatty Liver Disease Patients in Eastern India with Histopathological Correlation

Aminotransferase assay is often used as a screening test as well as an endpoint for resolution of disease in nonalcoholic fatty liver disease (NAFLD). Aim of the study was to evaluate the relationship of transaminase level with metabolic variables and histology in NAFLD. Single center observational study was conducted in a gastroenterology clinic at Cuttack in coastal Odisha. Subjects were consecutive patients presenting with functional bowel disease and undergoing abdominal sonography. All participants were evaluated for the presence of metabolic syndrome (MS), insulin resistance, liver function test and lipid profile. Various parameters were compared between NAFLD subjects and controls. 53.5 % of NAFLD had normal serum transaminases, whereas 20.8 % of healthy controls had transaminitis. NAFLD patients had significantly higher BMI, fasting plasma glucose, serum transaminases, serum triglycerides, serum insulin and homeostatic model assessment (HOMA) IR than controls. NAFLD patients who had transaminitis had significantly higher incidence of MS and higher mean HOMA IR than those without. There was no significant difference in histopathological features between NAFLD with and without transaminitis. To conclude, over half of NAFLD subjects do not have transaminitis while transaminitis is present in a fifth of healthy people without fatty liver. Hence serum transaminase should not be used as screening test for NAFLD. NAFLD patients with transaminitis had a higher incidence of MS and insulin resistance than those without. However, there was no significant difference in histopathological features between these two groups.     

Blended Perspectives: A Global Vision for High-Quality Early Childhood Education

What are the attributes of a high-quality early childhood education program worldwide? An group of experienced early childhood educators that represent diverse international backgrounds attempts to respond to this question by examining six dimensions of quality set forth by the Association for Childhood Education International: (1) philosophies and goals, (2) high-quality physical environments, (3) developmentally appropriate and effective pedagogy and curriculum, (4) attention to basic and special needs, (5) respect for families and communities, (6) professionally prepared teachers and staff, and (7) rigorous program evaluation. The article concludes with an annotated list of references, both in professional publications and online, that examine early childhood education from an international perspective.     

Early childhood education in India: History,trends, issues,and achievements

The changes in the social and economic structure of India have intensified the need for universal early childhood education. The formidable challenges before the Indian Government are: to provide high quality early childhood education programs; to preserve indigenous practices such as multilinguality, family/community involvement, participation of older children as caretakers of their younger siblings; and to provide early childhood education to all children despite serious financial constraints. This article presents a brief overview of the traditional childrearing practices in India, chronicles government initiatives in early childhood education, describes the range of programs available in India, and identifies goals that will shape the future of early childhood programs in India. Portions of this article will appear in Isenberg, J.P., & Jalongo, M.R. (Eds.). (1997, in press).Trends and issues in early childhood: Challenges, controversies, and insights. New York: Teachers College Press.     

Early Childhood Education and Care in the Time of COVID-19: Introduction to a Special Issue of Early Childhood Education Journal

Early Childhood Education Journal -     

Pleural fluid MDA and serum-effusion albumin gradient in pleural effusion

Pleural fluid malondialdehyde (PMDA) and serum effusion albumin gradient(SEAG) were estimated in 60 patients of pleural effusion of diverse etiologies. The results were compared with Light’s criteria to distinguish between transudates and exudates. The mean PMDA level was 0.68±0.24nmol/ml and 1.17±0.25nmol/ml in transudates and exudates respectively showing a statistically significant (p<0.05) rise in exudates in comparison to transudates. SEAG registered a significant fall in exudates (P<0.001) when compared with transudates. PMDA revealed a positive correlation with pleural protein(r=+0.30) and a significant negative association with SEAG (r= −0.33).Sensitivity and specificity of PMDA were better than the parameters of Light’s criteria. Whereas SEAG documented approximately equal sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with Light’s criteria. Therefore PMDA and SEAG can be taken together in addition to Light’s criteria to strengthen the discrimination between transudates and exudates in borderline cases of pleural effusion.