Dr. N. C. Nayak

Indian childhood cirrhosis was, for decades, one of the few liver diseases named after the country it was found in — a fatal condition of young children whose cause was unknown and whose morphology was disputed. N. C. Nayak spent much of his career on it, and the literature that settled the question is substantially his.

Working in the Department of Pathology at AIIMS New Delhi, he published with V. Ramalingaswami on the ultrastructure of the liver in the disease, examining the cytoplasmic hyaline that characterises it. In 1972 he was part of the group — with S. Visalakshi, M. Singh, V. Chawla, R. K. Chandra and Ramalingaswami — that re-evaluated its pathomorphological features against clinical data and the natural history of the illness, in the Indian Journal of Medical Research.

He kept returning to it. An editorial in Indian Pediatrics in 1980 was titled “Indian childhood cirrhosis, yesterday, today and tomorrow”; further work followed in 1987; and he co-authored a reassessment in 2013 on ICC and ICC-like diseases and the changing balance of facts against notions. That is a forty-year engagement with a single question.

He also examined liver biopsies from the siblings of affected children by light and transmission electron microscopy — the kind of study that distinguishes a familial or environmental exposure from an inherited defect, and the reason the aetiology eventually became tractable. He later served as Chairman of Pathology at Sir Ganga Ram Hospital in New Delhi.