Alcoholic liver disease (ALD) is one of the major public health problems in Bhutan. The incidence of alcohol liver diseases (per 10,000 populations) in the year 2016 was 46.
The burden of mortality associated with it is alarming, going by the size of the population of the country. It is one of the all-time top five killer diseases in the country. In 2016, the mortality attributable to alcohol liver disease was 184 corresponding to 97% of deaths due to reported liver diseases. The ALD is responsible for 15% of all deaths on an average in the last 3 years.
The World Bank. Health indicators of Bhutan. Washington (DC): The World Bank; Available from: https://data. worldbank.org/indicator/SP.DYN.LE00.IN.
Dorji, L. Alcohol use and abuse in Bhutan. Bhutan: National statistical Bureau; 2009.
Policy and Planning Division, Ministry of Health. Health management information system (HMIS). Bhutan: PPD, MoH; 2017.
Ministry of Health. Annual health bulletin (AHB). Bhutan: Ministry of Health; 2017.
Pan CQ, Duan ZP, Bhamidimarri KR, Zou HB, Liang XF, Li J, Tong MJ. An algorithm for risk assessment and intervention of mother to child transmission of hepatitis B virus. Clin Gastroenterol Hepatol 2012 May;10(5):452-459.
Amarapurkar DN, Hashimoto E, Lesmana LA, Sollano JD, Chen PJ, Goh K; Asia-Pacific working party for NAFLD. How common is non-alcoholic fatty liver disease in the Asia-Pacific region and what are the local differences? J Gastroenterol Hepatol 2007 Jun;22(6):788-793.
Dassanayake AS, Kasturitane A, Rajindrajith S, Kalubowila, Chakrawarthi S, De Silva AP, Makaya M, Mizoue T, Kato N, Wickremasinghe AR, et al. Prevalence and risk factors for nonalcoholic fatty liver disease among adults in urban Sri Lankan population. J Gastrenterol Hepatol 2009 Jul;24(7):1284-1288.
Pinidiyapathirage MJ, Dassanayake AS, Rajindrajith S, Kalubowila U, Kato N, Wickramasinghe AR, de Silva HJ. Non alcoholic fatty liver disease in a rural, physically active, low income population in Sri lanka. BMC Res Notes 2011 Nov;4:513.
Niriella MA, Pathmeswaran A, De Silva ST, Kasturiratna A, Perera R, Subasinghe CE, Kodisinghe K, Piyaratna C, Rishikesawan V, Dassanayaka AS, et al. Incidence and risk factors for non-alcoholic fatty liver disease: a 7-year follow up. Liver Int 2017 Nov;37(11):1715-1722.
De Hewavisenthi SJ, Dassanayaka AS, de Silva HJ. Clinical biochemical and histological characteristics of a Sri Lankan population of non-alcoholic steatohepatitis (NASH) patients. Ceylon Med J 2005Sep;50(3):113-116.
Rajindrajith S, Dassanayake AS, Hewavisenthi J, de Silva HJ. Advanced hepatic fibrosis and cirrhosis due to non-alcoholic fatty liver disease in Sri lankan children: a preliminary report. Hepatol Int 2008 Jun;2(2):209-212.
Byrne CD, Targher G. NAFLD: A multisystem disease. J Hepatol 2015Apr;62(1 Suppl):S47-S64.
Kasturiratne A, Weerasinghe S, Dassanayake AS, Rajindrajth S, de Silva AP, Kato N, Wickremasinghe AR, de Silva HJ. Influence of nonalcohlic fatty liver disease on development of mellitus. J Gastrenterol Hepatol 2013 Jan;28(1):142-147.
Romeo S, Koslitina J, Xing C, Pertemlidis A Cox, D Pennachio LA, Boerwinkle E, Cohen JC, Hobbs HH. Genetic variations in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease. Nat Genet 2008 Dec;40(12):1461-1465.
Krawczyk M, Portincasa P, Lammert F. PNPLA3 associated steatohepatitis: towards gene based classification of fatty liver disease. Semin Liver Dis 2013 Nov;33(4):369-379.
Kasturiratne A, Akiyama K, Niriella MA, Takeuchi F, Isono M, Dassanayake AS, de Silva AP, Wickremasinghe RA, Kato N, de Silva HJ. Association of genetic variants with non-alcoholic fatty liver disease in an urban Sri Lankan community. Liver Int 2015 Feb;35(2):676-679.
Siriwardana RC, Niriella MA, Dassanyake AS, Liyanage CAH, Gunetilleke B, de Silva HJ. Recurrence of graft steatosis after liver transplantation for cryptogenic cirrhosis in recently commenced liver transplant programme. Indian J Gastrenterol 2016 May;35(3):222-224.
Silva H, Siriwardena RC, Niriella MA, Dassanayake AS, Liyanage CA, Gunatilleke B, de Silva HJ. Non alcoholic fatty liver disease among potential live liver donors—a preliminary experience from Sri Lanka. Indian J Gastrolenterol 2014 Nov;33(6):573-574.
Dassanayake AS, Manamperi A, Gunawardena N, Abeyewickreme W, de Silva AP, de Silva HJ. Low prevalence of Hepatitis B and C molecular markers in a cohort of Sri Lankan patients with hepatocellular carcinoma. Ceylon Med J 2007;52(Suppl 1):14.
Batbold, D.; Baigalmaa, D.; Badamjav, S.; Chimedsuren, O.; Baatarkhuu, O. Prevalence of hepatitis B and hepatitis C virus infections among nurses in a tertiary hospital in Mongolia. APASL STC 2017, Mongolia. 6th HCV Conference on HCV and co-infections, Ulaanbaatar, Mongolia. Abstract book, June 16–17, 2017. p. 196.
Baatarkhuu O, Tsatsralt-Od B, Bolrmaa C, et al. Prevalence and genotype distribution of dual or triple infection of hepatitis B, C, and D viruses among patients with chronic liver diseases of Mongolia. Hepatol Int 2012 Jan;6(1):145.
Baatarkhuu O, Kim DY, Bat-Ireedui P, Han KH. Current situation of hepatocellular carcinoma in Mongolia. Oncolog y2011;81(Suppl1):148-151.
WPRO. Country programme on viral hepatitis prevention and response. Mongolia: WPRO; 2016. Available from: www. wpro.who.int/mongolia/mediacentre/releases/20160318_ viral_hep.../en/.
Baatarkhuu, O. Presidential Lecture. APASL STC 2017, Mongolia. 6th HCV Conference on HCV and co-infections, Ulaanbaatar, Mongolia. Abstract book, June 16-17, 2017. pp. 62-64.
Baatarkhuu O, Kim DY, Nymadawa P, Kim SU, Han KH, Amarsanaa J, Gonchigsuren D, Sanduijav R, Lkhagvasuren Z, Khorolsuren N. Clinical features and prognosis of hepatocellular carcinoma in Mongolia: a multicenter study. Hepatol Int 2012;6:763-769.
Frith J, Day CP, Henderson E, Burt AD, Newton JL. Nonalcoholic fatty liver disease in older people. Gerontology 2009 Aug;55(6):607-613.
Chhatwal J, Verma M, Riar SK. Obesity among pre-adolescent and adolescents of a developing country (India). Asia Pac J Clin Nutr 2004 Feb;13(3):231-235.
Roberts EA. Pediatric nonalcoholic fatty liver disease (NAFLD): a “growing” problem? J Hepatol 2007 Jun;46(6): 1133-1142.
Xu L, Ma H, Miao M, Li Y. Impact of subclinical hypothyroidism on the development of non-alcoholic fatty liver disease: a prospective case-control study. J Hepatol 2012 Nov;57(5): 1153-1154.
Mintziori G, Poulakos P, Tsamet is C, Goul is DG. Hypogonadism and non-alcoholic fatty liver disease. Minerva Endocrinol 2017 Jun;42(2):145-150.
Romeo S, Kozlitina J, Xing C, Pertsemlidis A, Cox D, Pennacchio LA, Boerwinkle E, Cohen JC, Hobbs HH. Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease. Nat Genet 2008 Dec;40(12):1461-1465.
Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, Cho YK, Sung IK, Sohn CI, Keum DK, Kim BI. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol 2006 Jan;21(1 Pt 1):138-143.
Dassanayake AS, Kasturiratne A, Rajindrajith S, Kalubowila U, Chakrawarthi S, De Silva AP, Makaya M, Mizoue T, Kato N, Wickremasinghe AR, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol 2009 Jul;24(7):1284-1288.
Chen CH, Huang MH, Yang JC, Nien CK, Yang CC, Yeh YH, Yueh SK. Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of Taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults. J Clin Gastroenterol 2006 Sep;40(8):745-752.
Griffiths PL, Bentley ME. The nutrition transition is underway in India. J Nutr 2001 Oct;131(10):2692-2700.
Carr MC, Brunzell JD. Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk. J Clin Endocrinol Metab 2004 Jun;89(6):2601-2607.
Jakobsen MU, Berentzen T, Sørensen TI, Overvad K. Abdominal obesity and fatty liver. Epidemiol Rev 2007 May; 29:77-87.
Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, Webb M, Blendis L, Halpern Z, Oren R. Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): a population based study. J Hepatol 2007 Nov;47(5):711-717.
Singh SP, Singh A, Misra D, Misra B, Pati GK, Panigrahi MK, Kar SK, Bhuyan P, Pattnaik K, Meher C, et al. Risk factors associated with non-alcoholic fatty liver disease in Indians: a case-control study. J Clin Exp Hepatol 2015 Dec;5(4):295-302.
Charlton M, Krishnan A, Viker K, Sanderson S, Cazanave S, McConico A, Masuoko H, Gores G. Fast food diet mouse: novel small animal model of NASH with ballooning, progressive fibrosis, and high physiological fidelity to the human condition. Am J Physiol Gastrointest Liver Physiol 2011 Nov;301(5):G825-G834.
Assy N, Nasser G, Kamayse I, Nseir W, Beniashvili Z, Djibre A, Grosovski M. Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Can J Gastroenterol 2008 Oct;22(10):811-816.
Ouyang X, Cirillo P, Sautin Y, McCall S, Bruchette JL, Diehl AM, Johnson RJ, Abdelmalek MF. Fructose consumption as a risk factor for non-alcoholic fatty liver disease. J Hepatol 2008 Jun;48(6):993-999.
Casiglia E, Spolaore P, Ginocchio G, Ambrosio G. Unexpected effects of coffee consumption on liver enzymes. Eur J Epidemiol 1993 May;9(3):293-297.
Modi AA, Feldman JJ, Park Y, Kleiner DE, Everhart JE, Liang TJ, Hoofnagle JH. Increased coffee consumption is associated with reduced hepatic fibrosis. Hepatology 2010 Jan;51(1): 201-209.
Gelatti U, Covol L, Franceschini M, Pirali F, Tagger A, Ribero M, Trevisi P, Martelli C, Nardi G, Donato F; Brescia HCC Study Group. Coffee consumption reduces the risk of hepatocellular carcinoma in dependently of its aetiology: a case control study. J Hepatol 2005 Apr;42(4):528-534.
Tverdal A, Skurtveit S. Coffee intake and mortality from liver cirrhosis. Ann Epidemiol 2003 Jul;13(6):419-423.
Gentile CL, Frye MA, Pagliassotti MJ. Fatty acids and the endoplasmic reticulum in nonalcoholic fatty liver disease. Biofactors 2011 Jan-Feb;37(1):8-16.
Gerber L, Otgonsuren M, Mishra A, Escheik C, Birerdinc A, Stepanova M, Younossi ZM. Non-alcoholic fatty liver disease (NAFLD) is associated with low level of physical activity: a population-based study. Aliment Pharmacol Ther 2012 Oct;36(8):772-781.
Kistler KD, Brunt EM, Clark JM, Diehl AM, Sallis JF, Schwimmer JB; NASH CRN Research Group. Physical activity recommendations, exercise intensity, and histological severity of nonalcoholic fatty liver disease. Am J Gastroenterol 2011 Mar;106(3):460-468.
Ghevariya V, Sandar N, Patel K, Ghevariya N, Shah R, Aron J, Anand S. Knowing what's out there: awareness of nonalcoholic fatty liver disease. Front Med (Lausanne) 2014 Mar;1:4.
Leung CM, Lai LSW, Wong WH, Chan KH, Luk YW, Lai JY, Yeung YW, Hui WM. Non-alcoholic fatty liver disease: an expanding problem with low levels of awareness in Hong Kong. J Gastroenterol Hepatol 2009 Nov;24(11):1786-1790.
Grattagliano I, D'Ambrosio G, Palmieri VO, Moschetta A, Palasciano G, Portincasa P; “Steatostop Project” Group. Improving nonalcoholic fatty liver disease management by general practitioners: a critical evaluation and impact of an educational training program. J Gastrointest Liver Dis 2008 Dec;17(4):389-394.
Kallman JB, Arsalla A, Park V, Dhungel S, Bhatia P, Haddad D, Wheeler A, Younossi ZM. Screening for hepatitis B, C and non-alcoholic fatty liver disease: a survey of communitybased physicians. Aliment Pharmacol Ther 2009 May; 29(9):1019-1024.
Singh SP, Misra B, Misra D, Pati GK, Singh A, Kar SK, Panigrahi MK, Meher C, Agrawal O. P841 Awareness and opinion of nonalcoholic fatty liver disease (NAFLD) patients about obesity and its consequences. J Hepatol 2014 Apr;60(1):S352.
Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001 May;344(18):1343-1350.
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002 Feb;346(6):393-403.
Bae JC, Suh S, Park SE, Rhee EJ, Park CY, Oh KW, Park SW, Kim SW, Hur KY, Kim JH, et al. Regular exercise is associated with a reduction in the risk of NAFLD and decreased liver enzymes in individuals with NAFLD independent of obesity in Korean adults. PLoS One 2012 Oct;7(10):e46819.
Perseghin G, Lattuada G, De Cobelli F, Ragogna F, Ntali G, Esposito A, Belloni E, Canu T, Terruzzi I, Scifo P, et al. Habitual physical activity is associated with intrahepatic fat content in humans. Diabetes Care 2007 Mar;30(3):683-688.
Lawlor DA, Sat tar N, Smith GD, Ebrahim S. The associations of physical activity and adiposity with alanine aminotransferase and gamma-glutamyltransferase. Am J Epidemiol 2005 Jun;161(11):1081-1088.
Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, Webb M, Zvibel I, Goldiner I, Blendis L, Halpern Z, Oren R. Role of leisuretime physical activity in nonalcoholic fatty liver disease: a population-based study. Hepatology 2008 Dec;48(6):1791-1798.
Dalle Grave R, Calugi S, Centis E, El Ghoch M, Marchesini G. Cognitive-behavioral strategies to increase the adherence to exercise in the management of obesity. J Obesity 2011 Oct;2011:348293.
National Heart, Lung, and Blood Institute. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. Bethesda (MD): National Institutes of Health; 2000.
Trovato FM, Martines GF, Brischetto D, Catalano D, Musumeci G, Trovato GM. Fatty liver disease and lifestyle in youngsters: diet, food intake frequency, exercise, sleep shortage and fashion. Liver Int 2016 Mar;36(3):427-433.
Park HS, Jang JE, Ko MS, Woo SH, Kim BJ, Kim HS, Park HS, Park IS, Koh EH, Lee KU. Statins increase mitochondrial and peroxisomal fatty acid oxidation in the liver and prevent non-alcoholic steatohepatitis in mice. Diabetes Metab J 2016 Oct;40(5):376-385.
Athyros VG, Boutari C, Stavropoulos K, Anagnostis P, Imprialos KP, Doumas M, Karagiannis A. Statins: an underappreciated asset for the prevention and the treatment of NAFLD or NASH and the related cardiovascular risk. Curr Vasc Pharmacol 2017 Jun;15:1-28.
Kostapanos MS, Kei A, Elisaf MS. Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease. World J Hepatol 2013 Sep;5(9):470-478.
Shiri-Sverdlov R, Wouters K, van Gorp PJ, Gijbels MJ, Noel B, Buffat L, Staels B, Maeda N, van Bilsen M, Hofker MH. Early diet-induced non-alcoholic steatohepatitis in APOE2 knock-in mice and its prevention by fibrates. J Hepatol 2006 Apr;44(4):732-741.
Brandi G, De Lorenzo S, Candela M, Pantaleo MA, Bellentani S, Tovoli F, Saccoccio G, Biasco G. Microbiota, NASH, HCC and the potential role of probiotics. Carcinogenesis 2017 Mar;38(3):231-240.
Anderson EL, Howe LD, Fraser A, Callaway MP, Sattar N, Day S, Tilling K, Lawlor DA. Weight trajectories through infancy and childhood and risk of non-alcoholic fatty liver disease in adolescence: the ALSPAC study. J Hepatol 2014 Sep;61(3):626-632.
Ayonrinde OT, Olynyk JK, Marsh JA, Beilin LJ, Mori TA, Oddy WH, Adams LA. Childhood adiposity trajectories and risk of nonalcoholic fatty liver disease in adolescents. J Gastroenterol Hepatol 2015 Jan;30(1):163-171.
Sandboge S, Perala MM, Salonen MK, Blomstedt PA, Osmond C, Kajantie E, Barker DJ, Eriksson JG. Early growth and non-alcoholic fatty liver disease in adulthood-the NAFLD liver fat score and equation applied on the Helsinki Birth Cohort Study. Ann Med 2013 Sep;45(5-6):430-437.
Zimmermann E, Gamborg M, Holst C, Baker JL, Sørensen TI, Berentzen TL. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood: a prospective study based on the Copenhagen School Health Records Register. BMJ Open 2015 May;5(4):e006998.
Reece EA, Hagay Z, Roberts AB, DeGennaro N, Homko CJ, Connolly-Diamond M, Sherwin R, Tamborlane WV, Diamond MP. Fetal Doppler and behavioral responses during hypoglycemia induced with the insulin clamp technique in pregnant diabetic women. Am J Obstet Gynecol 1995 Jan;172(1 Pt 1):151-155.
Patrick J, Campbell K, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol 1982 Feb;142(4):363-371.
Ornoy A, Ratzon N, Greenbaum C, Peretz E, Soriano D, Dulitzky M. Neurobehavior of school age children born to diabetic mothers. Arch Dis Child Fetal Neonatal Ed 1998 Sep;79(2):F94-F99.
Wolf, A. Developmental evaluation on early school age children born to gestational diabetic mothers. Israel: Hebrew University; 1997.
Mulder EJ, Leiblum DM, Visser GH. Fetal breathing movements in late diabetic pregnancy: relationship to fetal heart rate patterns and Braxton Hicks’ contractions. Early Hum Dev 1995 Nov;43(3):225-232.
Schulte FJ, Michaelis R, Nolte R, Albert G, Parl U, Lasson U. Brain and behavioral maturation in newborn infants of diabetic mothers. I. Nerve conduction and EEG patterns. Neuropadiatrie 1969 Jan-Jul;1(1):24-35.
Devoe LD, Youssef AA, Castillo RA, Croom CS. Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus. Am J Obstet Gynecol 1994 Aug;171(2):298-303.
Dierker LJ Jr, Pillay S, Sorokin Y, Rosen MG. The change in fetal activity periods in diabetic and nondiabetic pregnancies. Am J Obstet Gynecol 1982 May;143(2):181-185.
Doherty NN, Hepper PG. Habituation in fetuses of diabetic mothers. Early Hum Dev 2000 Aug;59(2):85-93.
Kainer F, Prechtl HF, Engele H, Einspieler C. Assessment of the quality of general movements in fetuses and infants of women with type-1 diabetes mellitus. Early Hum Dev 1997 Nov;50(1):13-25.
Mulder EJ, O'Brien MJ, Lems YL, Visser GH, Prechtl HF. Body and breathing movements in near-term fetuses and newborn infants of type-1 diabetic women. Early Hum Dev 1990 Nov;24(2):131-152.
Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. I. Early growth patterns. Early Hum Dev 1991 May;25(2):91-106.
Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. II. Emergence of specific movement patterns. Early Hum Dev 1991 May;25(2):107-115.
Mulder EJ, Visser GH. Impact of early growth delay on subsequent fetal growth and functional development: a study on diabetic pregnancy. Early Hum Dev 1992 Dec;31(2):91-95.
Mulder EJ, Visser GH, Bekedam DJ, Prechtl HF. Emergence of behavioral states in fetuses of type-1 diabetic women. Early Hum Dev 1987 Jul;15(4):231-251.
Mulder EJ, Visser GH, Morssink LP, de Vries JI. Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns. Early Hum Dev 1991 May;25(2):117-133.
Aberg A, Westbom L, Kallen B. Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes. Early Hum Dev 2001 Mar;61(2):85-95.
Deregnier RA, Nelson CA, Thomas KM, Wewerka S, Georgieff MK. Neurophysiologic evaluation of auditory recognition memory in healthy newborn infants and infants of diabetic mothers. J Pediatr 2000 Dec;137(6):777-784.
Nelson CA, Wewerka S, Thomas KM, Tribby-Walbridge S, deRegnier R, Georgieff M. Neurocognitive sequelae of infants of diabetic mothers. Behav Neurosci 2000 Oct;114(5):950-956.
Reece EA, Homko CJ. Infant of the diabetic mother. Semin Perinatol 1994 Oct;18(5):459-469.
Reece EA, Homko CJ. Why do diabetic women deliver malformed infants? Clin Obstet Gynecol 2000 Mar;43(1):32-45.
Rizzo T, Metzger BE, Burns WJ, Burns K. Correlations between antepartum maternal metabolism and intelligence of offspring. N Engl J Med 1991 Sep;325(13):911-916.
Rizzo TA, Metzger BE, Dooley SL, Cho NH. Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Dev 1997 Feb;68(1):26-38.
Schwartz R, Teramo KA. Effects of diabetic pregnancy on the fetus and newborn. Semin Perinatol 2000 Apr;24(2):120-135.
Vaarasmaki MS, Hartikainen A, Anttila M, Pramila S, Koivisto M. Factors predicting peri- and neonatal outcome in diabetic pregnancy. Early Hum Dev 2000 Jul;59(1):61-70.
Robertson SS, Dierker LJ. Fetal cyclic motor activity in diabetic pregnancies: sensitivity to maternal blood glucose. Dev Psychobiol 2003 Jan;42(1):9-16.
Accardo PJ, Blondis TA, Whitman BY. Disorders of attention and activity level in a referral population. Pediatrics 1990 Mar;85(3 Pt 2):426-431.
Ornoy A, Uriel L, Tennenbaum A. Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADDADHD syndrome. Isr J Psychiatry Relat Sci 1993;30(3):155-163.
Smyth TR. Impaired motor skill (clumsiness) in otherwise normal children: a review. Child Care Health Dev 1992 Sep-Oct;18(5):283-300.
Petersen MB, Pedersen SA, Greisen G, Pedersen JF, Mølsted- Pedersen L. Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4. Br Med J (Clin Res Ed) 1988 Feb;296(6622):598-600.
Sells CJ, Robinson NM, Brown Z, Knopp RH. Long-term developmental follow-up of infants of diabetic mothers. J Pediatr 1994 Jul;125(1):S9-S17.
Vladareanu R, Lebit D, Constantinescu S. Ultrasound assessment of fetal neurobehaviour in high risk pregnancies. DSJUOG 2012 Apr-Jun;6(2):132-147.
Talic A, Kurjak A, Ahmed B, Stanojevic M, Predojevic M, Kadic AS, Di Renzo GC. The potential of 4D sonography in the assessment of fetal behavior in high-risk pregnancies. J Matern Fetal Neonatal Med 2011 Jul;24(7):948-954.
Bekedam DJ, Visser GH, de Vries JJ, Prechtl HF. Motor behaviour in the growth retarded fetus. Early Hum Dev 1985 Nov;12(2):155-165.
Cioni G, Prechtl HF. Preterm and early postterm motor behaviour in low-risk premature infants. Early Hum Dev 1990 Sep;23(3):159-191.
Seme-Ciglenecki P. Predictive value of assessment of general movements for neurological development of highrisk preterm infants: comparative study. Croat Med J 2003 Dec;44(6):721-727.
Abo-Yaqoub S, Kurjak A, Mohammed AB, Shadad A, Abdel-Maaboud M. The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome. J Matern Fetal Neonatal Med 2012 Mar;25(3):231-236.
Athanasiadis AP, Mikos T, Tambakoudis GP, Theodoridis TD, Papastergiou M, Assimakopoulos E, Tarlatzis BC. Neurodevelopmental fetal assessment using KANET scoring system in low and high-risk pregnancies. J Matern Fetal Neonatal Med 2013 Mar;26(4):363-368.
Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012 Jan;97(1):28-38.e25
Sirmans SM, Pate KA. Epidemiology, diagnosis and management of polycystic ovary syndrome. Clin Epidemiol 2014; 6:1-13.
Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, et al. Contemporary genetic technologies and female reproduction. Human Reproduction Update 2011 Nov;17(6):829-847.
Balen A, Conway G, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995 Aug;10(8):2107-2111.
Azziz R, Sanchez L, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 2004 Feb;89(2):453-462.
Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000 May;52(5):595-600.
Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 2007 Jun;87(6): 1369-1376.
Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome. In: Givens JHF, Merriman G, editors. The polycystic ovary syndrome. Cambridge, MA: Blackwell Scientific; 1992. p. 377-384.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan;81(1):19-25.
Azziz R, Carmina E, DeWailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006 Nov;91(11):4237-4245.
Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 2013 May;28(5):1361-1368.
Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Womens Health 2011 Feb;3:25-35.
ACOG Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No 108: Polycystic ovary syndrome. Obstet Gynecol 2009 Oct;114(4):936-949.
Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril 2008 Mar;89(3): 505-522.
Balen AH. Ovulation induction in the management of anovulatory polycystic ovary syndrome. Mol Cell Endocrinol 2013 Jul;373(1-2):77-82.
Berridge DL, Winter TC. Saline infusion sonohysterography: technique, indications, and imaging findings. J Ultrasound Med 2004 Jan;23(1):97-112.
Allison SJ, Horrow MM, Kim HY, Lev-Toaff AS. Salineinfused sonohysterography: tips for achieving greater success. Radiographics 2011 Nov-Dec;31(7):1991-2004.
O'Neill MJ. Sonohysterography. Radiol Clin North Am 2003 Jul;41(4):781-797.
Bonnamy L, Marret H, Perrotin F, Body G, Berger C, Lansac J. Sonohysterography: a prospective survey of results and complications in 81 patients. Eur J Obstet Gynecol Reprod Biol 2002 Apr;102(1):42-47.
Lindheim SR, Adsuar N, Kushner DM, Pritts EA, Olive DL. Sonohysterography: a valuable tool in evaluating the female pelvis. Obstet Gynecol Surv 2003 Nov;58(11):770-784.
Lindheim SR, Sprague C, Winter TC. Hysterosalpingography and sonohysterography: lessons in technique. AJR Am J Roentgenol 2006 Jan;186(1):24-29.
Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med 2000 Aug;19(8):519-527.