Browsing by Author "de Silva, H.J."

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Absence of anti-Purkinje cell antibodies in patients with cerebellar ataxia following falciparum malaria
(SEAMEO Regional Tropical Medicine and Public Health Project, 1994) de Silva, H.J.; Senanayake, N.
Immunological mechanisms have been implicated in the pathogenesis of delayed cerebellar ataxia following falciparum malaria (DCA). We tested serum and CSF samples obtained from 39 Sri Lankan patients with DCA for the presence of antibodies (Ab) directed against cerebellar Purkinje cells by an immunofluorescence (IF) technique and Western blot analysis. For the IF test 7 mu thick frozen sections of histologically normal cerebellum obtained at post mortem were used. Proteins obtained from crude preparations of Purkinje cells isolated from the cerebellum were used for Western blot analysis. Sera obtained from patients known to have antineuronal antibodies associated with cerebellar degenerations and paraneoplastic disorders (anti-Hu and anti-Yo Ab) and sera from normal blood donors served as positive and negative controls, respectively. All serum and CSF samples obtained from patients with DCA were negative for Ab directed against cerebellar Purkinje cells. Humoral mechanisms are, therefore, unlikely to be important in the pathogenesis of this delayed complication of falciparum malaria.
Accidental scrotal burns due to paraquat while handling a patient with deliberate self-harm
(Sri Lanka Medical Association, 2007) Premaratna, R.; Rathnasena, B.G.N.; de Silva, H.J.
INTRODUCTION: The main risk of paraquat poisoning is from deliberate ingestion. Serious accidental or occupational poisoning is comparatively rare. We report two patients who had accidental exposure to paraquat resulting in scrotal burns in both, and systemic poisoning in one, while attending to a patient who had ingested paraquat for deliberate self harm. CASE REPORT: Two days after death of a patient who had ingested paraquat for deliberate self harm, his brother and a friend who had accompanied him to hospital presented with painful swelling of the scrotum. The brother had severe burns in the scrotal skin sparing the penile skin, and the friend had milder burns in the scrotum. The patient had vomited several times onto the laps of these two men while being brought to hospital in a vehicle. The brother developed mild derangements in hepatic and renal functions suggesting significant systemic absorption. His biochemical and clinical parameters returned to normal over the next 2 weeks on conservative management. In both these patients, the scrotal skin healed without scarring over the next 4 weeks after treatment with silver sulphadiazine local application and amoxicillin given orally. CONCLUSIONS: Precautions should be taken by persons attending to those who have ingested poison. This is especially applicable to patients who have ingested corrosive substances
Accidental scrotal burns from paraquat while handling a patient
(Sri Lanka Medical Association, 2008) Premaratna, R.; Rathnasena, B.G.N.; de Silva, H.J.
The main risk of paraquat poisoning is from deliberate ingestion. Serious accidental or occupational poisoning is comparatively rare. We report two patients who had accidental exposure to paraquat, resulting in scrotal burns in both and systemic poisoning in one, while attending to a patient who had ingested paraquat for deliberate self harm
Acute Dermato-Lymphangio-Adenitis Following Administration of Infliximab for Crohn's Disease.
(American College of Gastroenterology, 2019) Liyanage, I.K.; Niriella, M.A.; de Silva, A.P.; de Silva, N.; de Silva, H.J.
Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before initiation of therapy. We report the case of a patient who developed a localized painful swelling near the injection site, which was diagnosed as acute dermato-lymphangio-adenitis due to filarial infection. This adds to the limited number of case reports on parasitic complications following TNF-α therapy
Acute hearing loss due to scrub typhus: a forgotten complication of a reemerging disease
(Oxford University Press, 2006) Premaratna, R.; Chandrasena, T.G.A.N.; Dassanayake, A.S.; Loftis, A.D.; Dasch, G.A.; de Silva, H.J.
We describe 6 patients with scrub typhus who presented with acute hearing loss, a forgotten complication of this reemerging disease. They were admitted with fever of 10-14 days' duration and had clinical evidence of deafness and pneumonitis. Five patients had eschars, which prompted the diagnosis of typhus fever and led to early institution of treatment. Deafness has been described as a clue to the diagnosis of scrub typhus; awareness of this symptom facilitated early diagnosis in 4 of 5 patients who recovered. Acute hearing loss or hearing impairment in a febrile patient should arouse strong suspicion of scrub typhus.
Acute hearing loss in febrile patients: a predictor of scrub typhus
(Sri Lanka Medical Association, 2005) Premaratna, R.; Chandrasena, T.G.A.N.; Dassanayake, A.S.; Loftis, A.; Dasch, G.A.; de Silva, H.J.
INTRODUCTION: Rickettsial infections are re-emerging in Sri Lanka. Complications such as pneumonitis, myocarditis and encephalitis can occur late in the disease, and result in a high mortality. Early diagnosis reduces morbidity and mortality, but as laboratory facilities for definitive diagnosis are lacking, early diagnosis depends on clinical suspicion. Acute hearing loss which occurs in about 30% of patients has been recognised as a predictor of scrub typhus. METHODS: Six patients admitted to hospital with high fever and hearing impairment were further investigated. RESULTS: All were females with a mean age of 65 years (SD 2). The mean duration of fever at presentation was 12 days (SD 1), Hearing impairment was observe
Acute inflammation in ideal pouches(pouchitis)
(Lippincott Williams And Wilkins, 1991) de Silva, H.J.; Kettlewell, M.; Mortensen, N.J.; Jewell, D.P.
Acute systemic paraquat intoxication: survival without long-term complications
(Sri Lanka Medical Association, 2008) Mettananda, K.C.D.; de Silva, A.P.; de Silva, H.J.
No Abstract Available
Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)
(Springer International, 2009) Sarin, S.K.; Kumar, A.; Almeida, J.A.; Chawla, Y.K.; Fan, S.T.; Garg, H.; de Silva, H.J.; Hamid, S.S.; Jalan, R.; Komolmit, P.; Lau, G.K.; Liu, Q.; Madan, K.; Mohamed, R.; Ning, Q.; Rahman, S.; Rastogi, A.; Riordan, S.M.; Sakhuja, P.; Samuel, D.; Shah, S.; Sharma, B.C.; Sharma, P.; Takikawa, Y.; Thapa, B.R.; Wai, C.T.; Yuen, M.F.
The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on acute-on-chronic liver failure (ACLF) in 2004, with a mandate to develop consensus guidelines on various aspects of ACLF relevant to disease patterns and clinical practice in the Asia-Pacific region. Experts predominantly from the Asia-Pacific region constituted this working party and were requested to identify different issues of ACLF and develop the consensus guidelines. A 2-day meeting of the working party was held on January 22-23, 2008, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and subsequently presented at the Annual Conference of the APASL at Seoul, Korea, in March 2008. The consensus statements along with relevant background information are presented in this review.
Adjusting for spatial variation when assessing individual-level risk: A case-study in the epidemiology of snake-bite in Sri Lanka
(Public Library of Science, 2019) Ediriweera, D.S.; Kasturiratne, A.; Pathmeswaran, A.; Gunawardena, N.K.; Jayamanne, S.F.; Murray, K.; Iwamura, T.; Lalloo, D.G.; de Silva, H.J.; Diggle, P.J.
BACKGROUND:Health outcomes and causality are usually assessed with individual level sociodemographic variables. Studies that consider only individual-level variables can suffer from residual confounding. This can result in individual variables that are unrelated to risk behaving as proxies for uncaptured information. There is a scarcity of literature on risk factors for snakebite. In this study, we evaluate the individual-level risk factors of snakebite in Sri Lanka and highlight the impact of spatial confounding on determining the individual-level risk effects.METHODS:Data was obtained from the National Snakebite Survey of Sri Lanka. This was an Island-wide community-based survey. The survey sampled 165,665 individuals from all 25 districts of the country. We used generalized linear models to identify individual-level factors that contribute to an individual's risk of experiencing a snakebite event. We fitted separate models to assess risk factors with and without considering spatial variation in snakebite incidence in the country.RESULTS:Both spatially adjusted and non-adjusted models revealed that middle-aged people, males, field workers and individuals with low level of education have high risk of snakebites. The model without spatial adjustment showed an interaction between ethnicity and income levels. When the model included a spatial adjustment for the overall snakebite incidence, this interaction disappeared and income level appeared as an independent risk factor. Both models showed similar effect sizes for gender and age. HEmployment and education showed lower effect sizes in the spatially adjusted model.CONCLUSIONS:Both individual-level characteristics and local snakebite incidence are important to determine snakebite risk at a given location. Individual level variables could act as proxies for underling residual spatial variation when environmental information is not considered. This can lead to misinterpretation of risk factors and biased estimates of effect sizes. Both individual-level and environmental variables are important in assessing causality in epidemiological studies.
Admission to medical schools in Sri Lanka: predictive validity of selection criteria
(Sri Lanka Medical Association, 2006) de Silva, N.R.; Pathmeswaran, A.; de Silva, N.; Edirisinghe, J.S.; Kumarasiri, P.V.R.; Parameswaran, S.V.; Seneviratne, R.; Warnasuriya, N.; de Silva, H.J.
OBJECTIVE: To assess the extent to which current selection criteria predict success in Sri Lanka's medical schools. METHODS: The study sample consisted of all students selected to all six medical schools in two consecutive entry cohorts. The aggregate marks of these students at the General Certificate of Education (GCE) Advanced Level examination, the district of entry, admission category, candidate type (school/private) and gender, were identified as entry point variables. Success in medical school was measured in four ways: the ability to pass the first summative examination and the final examination at the first attempt, and obtaining honours in either examination. Multivariate analysis using logistic regression was used to assess the extent to which these entry point factors predict variability in outcome measures.RESULTS: Aggregate scores among the 1740 students in the study sample ranged from 212 to 356, with a median of 285. The male:female ratio was 1.4:1. Private candidates (taking the examination for the third time) accounted for 22% of students. Being a school candidate, female and having a higher aggregate score, were the only independent predictors of success for all four outcome measures. The aggregate score alone accounted for only 1-7% of the variation in performance in medical school. CONCLUSIONS: Marks obtained at the A Level examination (the only academic criterion currently used for selection of medical students in SriLanka) is a poor predictor of success in medical school.
Adult respiratory distress syndrome complicating typhoid fever
(Published by the London School of Hygiene and Tropical Medicine by Blackwell, 1993) de Silva, H.J.; Kularatne, W.N.S.; Wijewickrema, R.; Thevanesam, V.
No Abstract Available
Advancd hepatic fibrosis and cirrhosis due to nonalcoholic fatty liver disease in Sri lankan children: a preliminary report
(Springer International, 2008) Rajindrajith, S.; Dassanayake, A.S.; Hewavisenthi, J.; de Silva, H.J.
Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases and may progress to advanced hepatic fibrosis and cirrhosis in some patients. Cirrhosis due to NAFLD is considered extremely rare in children in the Asia-Pacific region. We report the characteristics of 5 children with advanced hepatic fibrosis and cirrhosis due to NAFLD. Four of them were obese, and all of them had high alanine transaminase levels and ultrasonographic evidence of fatty liver. None had diabetes mellitus or hyperlipidemia. The calculated HOMA-IR was more than two in all five cases. Liver biopsy showed stage III fibrosis in 2 patients and stage IV fibrosis (cirrhosis) in 3.
Adverse reactions to snake antivenom, and their prevention and treatment.
(Wiley-Blackwell, 2016) de Silva, H.A.; Ryan, N.M.; de Silva, H.J.
Antivenom is the mainstay of treatment of snakebite envenoming. However, adverse reactions to snake antivenom that is available are common in many parts of the world where snakebite is prevalent; both acute (anaphylactic or pyrogenic) and delayed (serum sickness type) reactions occur. Acute reactions are usually mild but severe systemic anaphylaxis may develop, often within an hour or so of exposure to antivenom. Serum sickness after antivenom has a delayed onset between 5 and 14 days after its administration. Ultimately, the prevention reactions will depend mainly on improving the quality of antivenom. Until these overdue improvements take place, doctors will have to depend on pharmacological prophylaxis, where the search for the best prophylactic agent is still on-going, as well as careful observation of patients receiving antivenom in preparation for prompt management of acute as well as delayed reactions when they occur. This article is protected by copyright. All rights reserved.
Aedes albopictus the “underrated” Asian Tiger
(University of Kelaniya, 2010) Jayasooriya, D.H.S.W.; Gunawardene, Y.I.N.S.; Manamperi, A.; de Silva, H.J.; Abeyewickreme, W.
Introduction The mosquito Aedes aegypti was thought to be the main vector responsible for virtually all dengue epidemics; while Aedes albopictus was considered a vector in which the virus is maintained but does not cause epidemics. Objective The study was conducted covering three endemic districts in Sri Lanka to determine the role of genus Aedes during dengue transmission. Methods and Material Mosquitoes were collected within a 350m radius from the location of the positive patients. Heads and abdomens of 63 pools were tested for DENV RNA with and RT-PCR-LH-(P32) assays Results Discussion Ae. albopictus was present in majority of the locations in all districts surveyed. Ae. albopictus was found in 13/17 (76.47%), 24/25 (96%)and 19/22 (86.36%) sites in Colombo, Gampaha and Kurunegala respectively. The RT-PCR-LH-(P32) assays indicated that 5/25 (20%) sites in Gampaha, 2/17 (11.76%) in Colombo and 6/22 (27.27%) in Kurunegala were positive for DENV. In Gampaha and Colombo there were 3 and 1 of DEN-2 positive pools respectively, while there were 2 and 1 of DEN-3 positive pools respectively. A higher number of positive pools (4/1or 21.05%) for DEN-1 and 1/1(5.26 %) for DEN-4 were found in Kurunegala. In Kurunegala one pool was positive for both DEN-2 and DEN-4 indicating the circulation of multiple serotypes within close proximity. Moreover one of the three DEN-2 positive pools in Gampaha consisting of only male Ae. albopictus mosquitoes is supportive of the belief of vertical transmission of DENV. In a DEN-4 positive location in Kurunegala HI was found to be10%, BI= 1and CI= 5.88 %while anotherDEN-2 positive site in Wattala showed HI of 5.55%and a BI of 5.55 suggesting active transmission. The abundance of Ae. albopictus in all districts and the findings indicating that100% of the positive pools were made of Ae. albopictus in this study highlights the importance of Ae. albopictus in the transmission dynamics dengue. The ability of Ae. albopictus to be infected with low viremia and the degree to which it permits replication within the mosquito itself could have an impact on the transmission and these verity of the disease. Co-circulation of two or more serotypes in a single pool or in different pools of mosquitoes within the same district is suggestive of hyper endemic transmission dengue in the three districts. The greater susceptibility of Ae. albopictus to infection by DENV is said to lead to greater virus adaptation. Sri Lanka as a whole would be at serious risks for multiple outbreaks in future. Our results indicate that Ae. albopictus is more efficient in dengue transmission than previously thought. The results shed light on the efficiency of Ae. albopictus as a vector in transmitting DENV in the absence or low abundance of Ae. aegypti in Sri Lanka. The present study suggests that Ae. albopictus sp is underrated in terms of transmission potential during peak transmission periods of dengue in Sri Lanka. Key words: RT-PCR-LH-(P32) RT-PCR-Liquid Hybridization with P32 radio isotope, HI-House hold Index, BI- Breteau Index, CI-Container Index,DENV-Dengue Virus Authors wish to acknowledge the financial assistance rendered by the NSF Sri Lanka (GrantNo:SIDA/2006/BT/02)and the IAEA (Grant NoTC SRL 6/028).
Aetiology of cirrhosis in a tertiary referral centre in Sri Lanka
(Sri Lanka Medical Association, 2007) Dassanayake, A.S.; Munasinghe, C.S.; Mettananda, K.C.D.; de Silva, A.P.; de Silva, H.J.
INTRODUCTION: Alcoholic liver disease is believed to be the commonest cause of cirrhosis in Sri Lanka. However, with the rising prevalence of obesity and diabetes, non-alcoholic steatohepatitis (NASH) is increasingly being diagnosed. The prevalence of both Hepatitis B (<2%) and C (<1 %) is low in our population. OBJECTIVE: To study the aetiology of cirrhosis in a tertiary referral centre in Sri Lanka. DESIGN, SETTING AND METHODS: We analysed the database of outpatients with cirrhosis maintained since 2001, reviewing records with regard to aetiology. Diagnosis of cirrhosis was established on clinical, biochemical and radiological evidence, and confirmed histologically when required. A detailed alcohol and drug history was obtained. Hepatitis B and C serology, iron and copper studies, and an autoimmune screen were also performed. RESULTS: Records of 204 patients were analysed [male: female =160:44, mean age 51.2y (SD 12.2)]. The aetiology of cirrhosis was: alcohol in 116 (57.1%, male: female= 110:6); cryptogenic in 63 (31%, male:female 38:25), chronic Hepatitis B in 7 (male: female = 4:3), Wilson disease in 6 (male: female= 4:2), confirmed NASH in 6 (male: female= 2:4), autoimmune hepatitis in 4 (ai! females), chronic Hepatitis C in 1 (male) and haemochromatosis in 1 (male). Prevalence of diabetes was 44% among patients with cryptogenic cirrhosis and 24% among others. CONCLUSIONS: Alcohol remains the commonest cause of cirrhosis. Cryptogenic cirrhosis was the second commonest cause, and the leading cattse among females. The high prevalence of diabetes in cryptogenic cirrhosis suggests an aetiology of burned out NASH. Chronic viral hepatitis remains an uncommon cause for cirrhosis.
Aetiology of cirrhosis in a tertiary referral centre in Sri Lanka
(Wiley Blackwell Scientific Publications, 2005) Dassanayake, A.S.; Mettananda, K.C.D.; de Silva, A.P.; de Silva, H.J.
INTRODUCTION: Alcoholic liver disease is widely believed to be the commonest cause of cirrhosis in Sri Lanka. However, with the rising prevalence of obesity and diabetes, non-alcoholic steatohepatitis (NASH) is increasingly being diagnosed. Despite being situated in an intermediate to high transmission region, the prevalence of both hepatitis B (o2%) and C ( 1%) is low in our population. AIMS: To study the aetiology of cirrhosis in a tertiary referral centre in Sri Lanka. METHODS: We analysed the database of outpatients with cirrhosis maintained since 2001, reviewing records with regard to aetiology. A diagnosis of cirrhosis was established on clinical, biochemical and radiological evidence, and confirmed histologically when required. A detailed alcohol and drug history was obtained from all cirrhotic patients. Hepatitis B and C serology, iron and copper studies, and an autoimmune screen were also performed. RESULTS: Records of 101 patients were analysed (male:female 5 78:23, mean age 38.3 years (SD 17.5)). The aetiology of cirrhosis was as follows: alcohol 64 patients (63.4%, male:female 5 60:4), cryptogenic 24 (23.8%, male:female 5 12:12), chronic hepatitis B four (all males), autoimmune hepatitis four (all females), Wilson’s disease two (both females), previously diagnosed NASH two (one male, one female), and chronic hepatitis C one (male). The prevalence of diabetes was 45% among patients with cryptogenic cirrhosis compared to 27% among patients with other causes. CONCLUSIONS: Alcohol remains the commonest cause of cirrhosis in our patients. Cryptogenic cirrhosis was the second commonest cause overall, and the commonest among females. The high prevalence of diabetes among patients with cryptogenic cirrhosis suggests an aetiology of previously undetected NASH.
Aetiology of recurrent abdominal pain in a cohort of Sri Lankan children
(Wiley-Blackwell, 2008) Devanarayana, N.M.; de Silva, D.G.H.; de Silva, H.J.
AIMS: Recurrent abdominal pain (RAP) has a multifactorial aetiology with many affected children having no evidence of organic pathology. This study assessed the functional and organic causes for RAP in a cohort of Sri Lankan children. METHODS: Fifty-five Sri Lankan children (45.5% males, aged 5-15 years) having RAP were screened for organic diseases. RAP was defined using Apley criteria. Children without clinical or laboratory evidence of organic diseases were classified into functional gastrointestinal diseases (FGD) using Rome II and III criteria. Thirty-nine patients with functional RAP and 20 healthy children (50% males, age 5-15 years) from same area were tested for Helicobacter pylori using a stool antigen test. RESULTS: Thirteen (23.6%) children had organic RAP. According to Rome II, 33 (60%), and according to Rome III, 39 (71%) (functional abdominal pain 19, irritable bowel syndrome nine, functional dyspepsia nine, abdominal migraine one, aerophagia one) children had FGD. Two (5.1%) patients and one (5%) control tested were positive for Helicobacter pylori (P > 0.05). Except for constipation, pain characteristics and associated symptoms were not significantly different between organic and functional RAP. CONCLUSIONS: Organic pathology accounted for symptoms in less than a quarter of Sri Lankan children with RAP. The majority had functional bowel diseases, of which the commonest was functional abdominal pain. Rome III criteria were more effective than Rome II criteria in identifying FGD. Helicobacter pylori infection did not appear to be associated with RAP.
Alanine Transaminase (ALT) levels in normal adult Sri Lankans
(American Gastroenterological Association(AGA) Institute, Published by Elsevier Inc., 2009) Niriella, M.A.; Dassanayake, A.S.; Kalubowila, K.; Kalubowila, U.; de Silva, A.P.; Wickremasinghe, A.R.; Kato, N.; Makaya, M.; de Silva, H.J.
BACKGROUND : Alanine transaminase (ALT) levels are widely used in screening for liver disease.The upper limit of normal (ULN) of ALT (males 30 IU/l, females 19 IU/l) have been definedfor western populations. Normal levels have not been established for Asian populations. OBJECTIVES: To establish levels of ALT for a normal, adult Sri Lankan population METHODS: This study was part of a community based investigation - Ragama Health Study (RHS). The study population consisted of 35-64 year old adults, selected using stratified random sampling. Consenting adults were screened by a structured interview, liver ultrasound and collection of 10 ml venous blood. The “normal” population was defined as those not using potentially hepatotoxic drugs, safe alcohol consumption (14 units/week for males, 7 units/week for females), absence of fatty liver, and being HBsAg and anti-HCVab negative. ALT levels were estimated by a kit using the Bergmeyer method. The 95th percentile of the ALT levels was taken as the ULN. RESULTS: 3012 subjects participated in the study. The ALT level (U/l) among 831 normal males (mean 36, median 30, SD 20, ULN 68) was significantly higher than that of the 885 normal females (mean 29, median 25, SD 13, ULN 53) (p<0.001,Student's t-test ). CONCLUSION: The ULN for ALT levels of a “normal” Sri Lankan population was higher than observed in western populations. The levels were higher in males. ULN for ALT may need to be redefined for different population groups.
Alcohol use and alcoholic fatty liver disease: a prospective, communitybased study among adults in an urban community in Sri Lanka
(The Sri Lanka Medical Association, 2022) Niriella, M.A.; Kasturiratne, A.; Beddage, T.; de Silva, S.T.; Dassanayake, A.S.; Pathmeswaran, A.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.
Background: Data on alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL in a cohort of adults in an urban community in Sri Lanka. Methods: The study population (selected by age-stratified random sampling) was screened in 2007 (35-64 years) and re-evaluated in 2014. They were assessed by structured interviews, anthropometric measurements, liver-ultrasound, and biochemical and serological tests. AFL was diagnosed on ultrasound criteria, ‘unsafe’ alcohol consumption (Asian standards: males>14 units, females >7 units per week) and absence of hepatitis B/C markers. Controls were unsafe alcohol consumers who had no fatty liver on ultrasound. Results: 2985/3012 (99%) had complete data for analysis. 272/2985 (9.1%) were unsafe-drinkers in 2007 [males-270; mean-age-51.9, SD-8.0 years]. 86/272 (31.6%) had AFL [males-85; mean-age-50.2, SD-8.6 years]. Male gender [p<0.001], increased waist circumference (WC) [OR 4.9, p<0.01], BMI>23kg/m2 [OR 3.5, p<0.01] and raised alanine aminotransferase (ALT) [OR 2.8, p<0.01] were independently associated with AFL. 173/272 (63.6%) unsafe alcohol consumers from 2007 were re-evaluated in 2014. 134/173 had either had AFL or had changed to ‘safe’ or no alcohol consumption. 21/39 (53.8%) [males-21 (100%), meanage- 57.9, SD-7.9 years] who remained ‘unsafe’ alcohol users who had no fatty liver in 2007 developed AFL after 7-years (annual incidence 7.7%). On bivariate analysis, only male gender was associated with new-onset AFL. Of the 42 who had AFL at baseline but changed their drinking status from unsafe to safe or no alcohol, 6 had resolution of fatty liver in 2014. Conclusion: In this community-based study among adults from an urban community, unsafe alcohol use was found in 9.1%. Among unsafe alcohol users, the prevalence of AFL was 31.6% and the annual incidence of AFL was 7.7%. New-onset AFL was independently associated with male gender.