NAMS Oration Award for Prof. Duseja

NAMS Oration Award for Prof. Duseja

Dr Ajay Duseja, Professor and Unit Head in the department of Hepatology, PGIMER, Chandigarh has been conferred with the prestigious Gen. Amir Chand Oration Award for the year 2021- 2022 by the National Academy of Medical Sciences (NAMS), India.

This award has been given to Prof Duseja for the title – ‘Non-alcoholic Fatty Liver Disease (NAFLD) – The Indian Scenario’ for his work in the area of NAFLD for more than two decades. His work on NAFLD includes almost all research areas including epidemiology to pathogenesis, risk factors, diagnosis and treatment. He has been invited to deliver this oration in the annual conference of NAMS.

NAFLD is a lifestyle disease which affects 25-30% of the world population. In India the prevalence of NAFLD in the general population is close to 40% but the work by Prof Duseja had shown it be prevalent in 53% of blood donors in Chandigarh. NAFLD is a spectrum which ranges from simple fat in the liver called simple steatosis or non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH) which in addition to fat in the liver is associated with inflammation (swelling) and scarring (fibrosis). Patients with NASH are at higher risk of progressing on to cirrhosis liver (scarred liver) and liver cancer.

Prof Duseja is a Fellow of the National Academy of Medical Sciences (FAMS), Fellow of the American Association for the Study of Liver Diseases (FAASLD), Fellow of the American College of Gastroenterology (FACG), Fellow of the Society of GI Endoscopy of India (FSGEI) and Fellow of the Indian Society of Gastroenterology (FISG). He has more than 25 years of experience as faculty with focussed research in different areas of Hepatology.

Prof Duseja is presently the Secretary-General of the Indian National Association for Study of the Liver (INASL) and is the Principal Investigator of the INASL’s large on-going multi-centre study called the Indian Consortium on NAFLD (ICON-D) study. The interim analysis of around 4000 patients of ICON-D study published last month had shown that around 20-30% of Indian patients with NAFLD already have significant fibrosis (scarring) in the liver and 10-15% have cirrhosis liver at their first presentation to the hepatologists. These figures become alarming keeping in mind a very high prevalence of NAFLD in the general population. In fact, NAFLD has now become the most common chronic liver disease the world over, including Asia and India. It is also the most common cause of cirrhosis and liver cancer in patients who do not consume alcohol and do not have hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.

In the same ICON-D study, Prof Duseja had shown that the main reasons for NAFLD in India are the metabolic risk factors related to sedentary lifestyle. Overweight or obesity, diabetes mellitus (Blood sugar), hypertension (high blood pressure) and dyslipidemia (deranged blood lipids) are the main risk factors for NAFLD, even though some patients may be predisposed genetically.

The diagnosis of NAFLD is usually simple based on blood tests, ultrasound and few other tests but may be delayed due to lack of symptoms in the early stage. The disease may also be ignored by the patients and physicians alike due to slow progression and lack of specific complaints. Hence, it is advisable that screening blood tests or ultrasound for NAFLD be done in those at a high risk and includes individuals with obesity, diabetes, hypertension and dyslipidemia.

In addition to affecting the liver, NAFLD has also become a very common risk factor for various extra-hepatic disease like cardiovascular diseases, chronic kidney disease, bone loss, obstructed sleep apnoea and cancers of various organs.

The treatment of patients with NAFLD revolves around maintaining a good lifestyle with good diet and regular exercise. Those with overweight and obesity are encouraged to lose weight by cutting down on their calorie intake and by burning more calories by aerobic or anaerobic exercises. Patients who progress on to severe form of disease (NASH with or without fibrosis, cirrhosis, liver cancer) do require other modalities of treatment including pharmacological drugs, endoscopy and liver transplantation for those with liver failure.

It is very humbling to receive this recognition and award for all the research done in last two decades said Prof Duseja. He said, he could achieve this only because of the team effort and the significant contribution by his collaborators and co-investigators within and outside the Institute.

He said that a constant effort is required at the individual level, at the level of the society and at the administration level to control this ongoing modern pandemic. The teaching for a healthy lifestyle needs to start early in life; at home, schools and colleges. He said the Ministry of Health and Family Welfare, Govt of India need to be complimented for the recent inclusion of NAFLD into one of its national programs [National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS)]. In fact, India has become the first country in the world to do so and it will definitely give a boost in controlling this disease at the ground level explained Prof Duseja.