Effect of Alternate Day Fasting Over Standard Medical Management Alone to Reverse Non-alcoholic Steatohepatitis.

Inclusion Criteria:

• Age 18-65 years. BMI 25-40kg/m3, and CAP more than 290

• Stable weight in the last 3 months prior to enrolling in the study(<5kg weight variation)

• Imaging showed steatotic liver disease, liver stiffness <14kPa measured by fibroscan

• Histologically proven NASH/MASH, fibrosis up to F3

• Subjects willing to participate in the study

Exclusion Criter

• Liver stiffness >14kPa measured by fibroscan or Fibrosis >F3

• Diabetes with HbA1c>8.5%

• Patients with another co-existing active liver disease e.g. hepatitis B or C, alcoholic liver disease

• Patients with cirrhosis, hepatocellular carcinoma(HCC), or other malignancy

• Chronic kidney disease, cardiovascular disorders, uncontrolled hypertension

• Chronic infections, chronic inflammatory diseases

• Patients on weight loss medications e.g semaglutide

• Pregnant or lactating women and those planning a pregnancy A patient who is not willing to participate in the study or failed to provide the consent