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BMI versus waist to hip ratio

 DEFINITION  Obesity is a state of excess adipose tissue mass. It is often viewed as equivalent to an increased body weight. This is not true because muscular individuals may have increased body weight but are not obese. Weight follows a continuous distribution pattern in human population. The point at which mortality and morbidity becomes statistically significant is the cut-off to call a patient obese.  METHODS  Various methods have been used to measure obesity. These include: 1) Anthropometry (skin-fold thickness) 2) Densitometry (underwater weighing) 3) CT/MRI 4) Electrical impedance. Still the most common techniques used in clinical practice are: 1) BMI measurement 2) Waist-to-hip ratio measurement.  BMI  It is not an accurate measure of obesity but since it is simple to calculate, it is the most frequently measured parameter. At similar BMI, women usually have more fat than men. When the BMI > 25 Kg/m2, morbidity starts to increase and if associated with ris

Alcoholic liver disease

 INTRODUCTION  Chronic and excessive use of alcohol is one of the major causes of liver disease. 90% of daily heavy drinkers (>60 g alcohol/day) as well as binge drinkers have fatty liver but a smaller percentage (10-35%) of drinkers progress to alcoholic hepatitis which is a precursor for cirrhosis. The long-term risk is 9 times higher in patients with alcoholic hepatitis compared to those with fatty liver alone. Some population-based surveys have documented that men must drink 40 to 80 g of alcohol daily and women must drink 20 to 40 g daily for 10 to 12 years to achieve a significant risk of liver disease. Liver pathology consists of  3 major lesions  that are progressive and rarely exist in a pure form: 1) fatty liver (usually reverses quickly with abstinence), 2) alcoholic hepatitis and 3) cirrhosis. Prognosis of severe alcoholic liver disease (ALD) is bad. Mortality of patients with alcoholic hepatitis concurrent with cirrhosis id nearly 60% at 4 years. Alt