An audit of vitamin D monitoring and management of deficiency in women's secure services

AimsTo audit the investigation, identification and treatment of vitamin D deficiency within Women's Secure Services.BackgroundIt has been suggested that vitamin D and vitamin D deficiency may play a role in the pathogenesis of psychiatric illness. There is evidence that vitamin D inadequacy is prevalent among patients in long-term hospital settings. Patients within secure hospitals are considered to be at high risk due to their often lengthy admissions, having been transferred from other hospital or prison settings. Ardenleigh in Birmingham is a blended female secure unit. Here we present the findings of an audit, completed in 2019, of vitamin D monitoring and treatment in this service.MethodA retrospective review of electronic patient records, for all inpatients admitted within women's secure services at Ardenleigh as of 1st September 2019 (n = 27). Standards were based on the Trust accepted guidelines for management of vitamin D deficiency.ResultKey findings included:-The majority of inpatients were Caucasian (44%) and African-Caribbean (41%). Median age was 31 years (range 20–56).Approximately two-thirds (60%) had been in hospital for over a year.89% of patients had their vitamin D level checked at some point during admission.Of those checked, 25% were tested within 1 week of admission. Seven patients were tested after being in hospital for over one year (30%).Only 25% of patients tested were found to have adequate vitamin D levels. Nine patients were found to have insufficient levels of vitamin D (37.5%) or deficiency (37.5%).89% of those identified as requiring treatment were prescribed supplementation, of which the majority was prescribed at the correct dose for the appropriate duration (94%). One patient refused treatment. Of those with sufficient levels, 67% were prescribed ongoing maintenance treatment due to previously detected deficiency.Of those found to have sufficient vitamin D in the last 12 months (n = 14), 71% were continued on maintenance treatment.ConclusionWe identified a high prevalence of vitamin D insufficiency in women admitted to secure services. Testing was delayed for a number of patients from the point of admission. However, once identified, the vast majority of those in need of treatment were managed appropriately by the medical team. We advise that vitamin D be considered an essential routine blood test at the point of admission to minimise delays in identifying those with deficiency and establishing necessary supplementation.

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Vitamin D monitoring and management in the inpatient services – reaudit

BJPsych Open ◽

10.1192/bjo.2021.266 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S86-S87

Author(s):

Vasudevan Krishnan ◽

Ciara Doyle ◽

Maciej Rusilowicz

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Health ◽

Clinical Guideline ◽

Scientific Advisory Committee ◽

Inpatient Ward ◽

Number Of Patients ◽

Vitamin D Levels ◽

Laboratory Results ◽

Sufficient Vitamin

AimsTo survey the prevalence of monitoring of vitamin D on an inpatient ward.To audit the treatment if there is identified vitamin D deficiency or insufficiencyTo compare differences between findings in auditsMethodAll inpatients admitted to Milford centre between August 2019 and August 2020 were selected as part of the sample size.Data were collected by FY1 and FY2Patients’ laboratory results were accessed to determine vitamin D levels.E-notes were used to conclude who were vitamin D sufficient or deficient for treatmentThe standard for the audit were as per:Management of vitamin D deficiency or insufficiency in adults – CKS (2018)The above was based on National Osteoporosis Society (NOS) guideline Vitamin D and bone health: a practical clinical guideline for patient management [National Osteoporosis Society, 2013] and Scientific Advisory Committee on Nutrition (SACN) guidelineResult201748/188 patients had vitamin D levels measured36/48 patients had sufficient vitamin D levels12/48 patients were either deficient or insufficient12/12 patients were treated where found deficient or insufficient202090/115 patients had vitamin D levels measured47/90 patients had sufficient vitamin D Levels43/90 patients had either insufficient or deficient vitamin D levels22/43 patients had treatment documented in noted where found deficient or insufficientConclusionDifficult to make comparisons with previous audit due to difference in number of patients testedVitamin D is routinely tested on Milford ward on admission hence the large number compared to the last audit52% had noted to have sufficient levels of vitamin DConcerning were results that only 51% of those deemed to have insufficient or deficient were treated based on notesPotential reasons could be:Prescribed in medication card and not documented in notes.Vitamin D results checked in another ward, no supplementation given, and then transferred to Milford house.Patients refused treatment but not documented adequately.Patient discharged before results were received due to quick aroundResults were deemed insufficient in terms of the range but very close to normal hence decision made not to start supplementationResults to be disseminated with medical and nursing colleaguesRe-audit in September 2021

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Vitamin D Deficiency and Adverse Results in COVID-19

10.53350/pjmhs2115113499 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3499-3501

Author(s):

Maria Mehmood ◽

Zobia Mubarak ◽

Irum Javed ◽

Sarah Arif ◽

Sikandar Ali Khan ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Virus Disease ◽

Strong Association ◽

Vitamin D Insufficiency ◽

Negative Effects ◽

Severe Vitamin ◽

Severe Deficiency ◽

Number Of Patients ◽

Vitamin D Levels

Aim: The goal of this study is to find out how common vitamin D deficiency is in patients with corona virus disease and what the consequences are. Study Design: Observational /Prospective Place and Duration: Institute of Basic medical sciences, Khyber Medical University (KMU), Jan 2021-Oct 2021. Materials & Methods: This study included 120 patients of both genders who had been diagnosed with covid-19. Patients ranged in age from 15 to 75 years. After receiving written agreement, demographically detailed such as age, sex, and BMI were recorded. All of the patients had a 5 mL blood sample obtained to check their vitamin D levels. 25(OH)D < 25 nmol/L (10 ng/dL) was considered severe Vitamin D insufficiency. The prevalence of vitamin D insufficiency as well as negative effects were investigated. SPSS 23.0 was used to analyse the data. Results: The mean age of the 120 patients was 40.11±8.64 years, with 68 (56.7%) males and 52 (43.3%) females. There were 52 patients (43.3%) with severe vitamin D insufficiency. There were 17 deaths of the total number of patients in the study. Vitamin D deficiency was associated with a higher mortality rate in patients with covid-19 disease than in those who had normal levels of vitamin D, a finding that was statistically significant at the 0.05 level. Conclusion: It was found that severe deficiency of vitamin D and death in individuals with covid-19 illness had a strong association. Keywords: Mortality, Vitamin D Deficiency, Covid-19,

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Vitamin D supplementation does not prevent the recurrence of Graves’ disease

Scientific Reports ◽

10.1038/s41598-019-55107-9 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 5

Author(s):

Yoon Young Cho ◽

Yun Jae Chung

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Recurrence Rate ◽

Disease Recurrence ◽

Vitamin D Supplementation ◽

Graves Disease ◽

Vitamin D Levels ◽

Vitamin D Supplements ◽

One Year ◽

Sufficient Vitamin

AbstractRecent literature has reported a higher prevalence of vitamin D deficiency among people with Graves’ disease. No study has examined the effect of vitamin D supplementation on the clinical outcomes of Graves’ disease. We aimed to evaluate whether daily vitamin D supplementation reduces Graves’ disease recurrence. We enrolled 210 subjects with Graves’ disease and vitamin D deficiency and followed them for at least one year after anti-thyroid drug (ATD) discontinuation. Among 210 individuals, 60 (29%) were amenable to taking vitamin D supplements, resulting in sufficient vitamin D levels (from 10.6 to 25.7 ng/mL), whereas the mean vitamin D level was 11.6 ng/mL in the 150 patients who did not take vitamin D supplements. The recurrence rate was similar in both groups (38% vs. 49%, P = 0.086). However, recurrence occurred earlier in the latter group (7 months vs. 5 months, P = 0.016). In the multivariate analysis, vitamin D levels and TSH-binding inhibitory immunoglobulin (TBII) titers at ATD discontinuation remained significant factors for recurrence. Vitamin D levels and TBII titers at ATD discontinuation exhibited a weak negative correlation (R = −0.143, P = 0.041). Vitamin D supplementation might have a protective effect against Graves’ disease recurrence with a borderline significant recurrence rate reduction.

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Vitamin D deficiency: how prevalent it is?

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190560 ◽

2019 ◽

Vol 5 (2) ◽

pp. 271

Author(s):

Irwant V. Pallewad ◽

Jayshree J. Upadhye

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D Insufficiency ◽

Research Centre ◽

Normal Body Mass Index ◽

Medical Sciences ◽

Number Of Patients ◽

Vitamin D Levels

Background: Vitamin D deficiency is frequently seen nowadays due to inadequate exposure to sun and pollution. The present study was undertaken to evaluate the prevalence of vitamin D deficiency in patients presenting with suggestive complaints.Methods: The present study is a retrospective study done at Srinivas Institute of Medical Sciences and Research Centre, Mukka, Suratkal, Mangaluru. Patients who have musculoskeletal or other problem suggestive of vitamin D deficiency were advised vitamin D levels. We went through OPD papers of only those patients with reports of Vitamin D levels.Results: In present study, out of 100 patients, 42 (42%) patients had normal BMI, 23 (23%) patients were overweight, 24 (24%) patients were obese while 11 (11%) patients were underweight. 46 (46%) patients were having walk for exercise purpose, 21 (21%) were doing work out at gym while 33 (33%) patients were walking only for doing some work. 47 (47%) patients had normal levels of vitamin D, 31 (31%) had insufficient levels while 22 (22%) patients had deficient levels of vitamin D. So, prevalence of vitamin D deficiency was 22% and for vitamin D insufficiency was 31%.Conclusions: In present study, we conclude that irrespective of normal body mass index or physical activity, patients presented with various complaints. In them, vitamin D levels were either insufficient or deficient in large number of patients. So, vitamin D levels should be done as screening or at least when patients present with suggestive complaint.

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Vitamin D monitoring and management within men's secure services

BJPsych Open ◽

10.1192/bjo.2021.885 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S337-S338

Author(s):

Jason Niblett ◽

Shay-Anne Pantall ◽

Anis Ahmed

Keyword(s):

At Risk ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Treatment Effectiveness ◽

Average Length ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

High Rate ◽

List Type ◽

Electronic Patient Records

AimsTo audit the investigation, identification and treatment of Vitamin D deficiency within Men's Secure Services.BackgroundVitamin D and/or vitamin D deficiency has been suggested to play a role in the pathogenesis of mental illness. There is evidence that Vitamin D inadequacy is pandemic among rehabilitation patients in inpatient settings. Patients within secure hospitals are similarly considered to be at high risk, due to their limited solar exposure during often lengthy admissions. It has been suggested that these patients should be considered an ‘at-risk’ cohort, for whom Vitamin D supplementation should be routine. Men's secure services in Birmingham comprise of two medium secure units and a low secure rehabilitation unit. Here we present an audit of Vitamin D monitoring and treatment completed in 2019.MethodA three year retrospective review of electronic patient records, for all inpatients admitted within men's secure services as of 1 September 2019 (n = 188). Standards were based on the Trust accepted guidelines for management of Vitamin D deficiency.ResultKey findings included:- The majority of inpatients were Caucasian (43%) and African-Caribbean (24%). Ages ranged from 18 to 70, with a mean age of 39.Approximately two-thirds (65%) had been in hospital for over a year, of which 44% had been admitted for more than 3 years. The average length of admission was 885 days.Only 47% of patients had their Vitamin D level checked within the study period.Of those checked, 24% were tested within 1 month of admission. The mean duration between admission and Vitamin D testing was 464 days.Results ranged from 10.3 to 118.5nmol/L. A high rate of Vitamin D deficiency was identified (54%), whilst a further 16% had ‘inadequate’ levels.23% of those identified as requiring treatment did not receive any supplementation, whilst 59% of those with sufficient Vitamin D were prescribed treatment.Only 48% had their levels rechecked following treatment; of these, only 59% now had an adequate Vitamin D status.ConclusionThis audit demonstrates limited Vitamin D monitoring within male forensic inpatients. There was a high prevalence of Vitamin D insufficiency in this population, yet a substantial proportion of patients with identified deficiency were not prescribed any treatment. Ongoing monitoring and review of treatment effectiveness was poor. We argue that more consideration should be given to this population, with robust guidelines introduced for the treatment of this specific ‘at-risk group’.

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Vitamin D levels in pregnant women in Uttarakhand, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175840 ◽

2017 ◽

Vol 7 (1) ◽

pp. 169

Author(s):

Nikita Pahuja ◽

Nidhi Chauhan ◽

Vinita Kalra

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Growth ◽

Innate Immune ◽

Vitamin D Status ◽

Medical Sciences ◽

Healthy Pregnancy ◽

Vitamin D Levels ◽

Increase Risk ◽

Sufficient Vitamin

Background: A balanced, nutritious diet is an important aspect of a healthy pregnancy and its outcome. Vitamin D plays an important role in regular bone growth and in adequate function of innate immune system, including barrier function of mucous membrane. Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. The present study was undertaken to find the prevalence of Vitamin D deficiency in the women of Uttarakhand, India.Methods: The study was conducted in the Department of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, India over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.Results: Out of 100 subjects, 21 (21%) had deficient, 69 (69%) had insufficient and 10 (10%) had sufficient vitamin D status. Out of 21 deficient subjects, 18 (85.71%) were Hindus, 2 (9.52%) were Muslims, 1 (4.76%) was Sikh and no deficiency was seen in Christian. In the present study, deficient vitamin D status was seen in 1 (4.76%) in lower, 16 (76.19%) in middle and 4 (19.04%) subjects in upper socioeconomic status.Conclusions: It is concluded from our study that there is serious vitamin D deficiency and insufficiency in the women of Uttarakhand, India.

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Prevalence and Treatment of Vitamin D Deficiency in Young Male Russian Soccer Players in Winter

Nutrients ◽

10.3390/nu11102405 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2405 ◽

Cited By ~ 3

Author(s):

Bezuglov ◽

Tikhonova ◽

Zueva ◽

Khaitin ◽

Waśkiewicz ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Young Male ◽

Vitamin D Insufficiency ◽

Soccer Players ◽

Football Players ◽

Duration Of Treatment ◽

Serum Vitamin D ◽

Vitamin D Levels

Vitamin D (25(OH)D) insufficiency and deficiency are highly prevalent in adult soccer players and can exceed 80% even in regions with high insolation; however, the treatment of this condition is often complicated. The aim of the present study was to examine the prevalence of vitamin D insufficiency and deficiency in youth Russian soccer players and the efficacy of its treatment. Participants were 131 young male football players (age 15.6 ± 2.4 years). Low vitamin D levels (below 30 ng/mL) were observed in 42.8% of the analyzed participants. These athletes were split in two groups composed of persons with vitamin D deficiency (serum vitamin D below 21 ng/mL) and insufficiency (serum vitamin D in range of 21–29 ng/mL). A dietary supplement of 5000 IU cholecalciferol per day was administered for two months. After the treatment, an average 92% increase in vitamin D concentration was observed (before treatment—19.7 ± 5.4 ng/mL, after treatment—34.7 ± 8.6 ng/mL, p<0.001) and 74% of the post-treatment values were within the reference range (30–60 ng/mL). Serum concentration of vitamin D increased by 200% ± 98% (p<0.001) during the first month of treatment with vitamin D deficiency and insufficiency being successfully treated in 83% of the football players. In summary, the prevalence of vitamin D insufficiency and deficiency was high in young Russian soccer players. Furthermore, it was indicated that the daily usage of cholecalciferol in a dose 5000 IU was an effective and well-tolerated treatment for vitamin D insufficiency. No linear dependency between the duration of treatment and increase in vitamin 25(OH)D concentration was observed.

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Is Vitamin D Insufficiency Associated with Mortality of Critically Ill Patients?

Critical Care Research and Practice ◽

10.1155/2013/856747 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Gulbin Aygencel ◽

Melda Turkoglu ◽

Ayse Fitnat Tuncel ◽

Burcu Arslan Candır ◽

Yelda Deligoz Bildacı ◽

...

Keyword(s):

Vitamin D ◽

Risk Factor ◽

Critically Ill ◽

Critically Ill Patients ◽

Independent Risk Factor ◽

Vitamin D Insufficiency ◽

University Hospital ◽

Median Serum ◽

Vitamin D Levels ◽

Sufficient Vitamin

Objective. To evaluate the vitamin D status of our critically ill patients and its relevance to mortality.Patients and Methods. We performed a prospective observational study in the medical intensive care unit of a university hospital between October 2009 and March 2011. Vitamin D levels were measured and insufficiency was defined as <20 ng/mL.Results. Two hundred and one patients were included in the study. The median age was 66 (56–77) and the majority of patients were male (56%). The median serum level of vitamin D was 14,9 ng/mL and 139 (69%) patients were vitamin D insufficient on admission. While we grouped the ICU patients as vitamin D insufficient and sufficient, vitamin D insufficient patients had more severe acute diseases and worse laboratory values on admission. These patients had more morbidities and were exposed to more invasive therapies during stay. The mortality rate was significantly higher in the vitamin D insufficient group compared to the vitamin D sufficient group (43% versus 26%,P=0,027). However, logistic regression analysis demonstrated that vitamin D insufficiency was not an independent risk factor for mortality.Conclusion. Vitamin D insufficiency is common in our critically ill patients (69%), but it is not an independent risk factor for mortality.

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Assessment of Relationship Between Serum Vitamin D Levels and Metabolic Syndrome Components in Hemodialysis Patients

Galician Medical Journal ◽

10.21802/gmj.2021.1.3 ◽

2021 ◽

Vol 28 (1) ◽

pp. E202113

Author(s):

Sevil Karahan Yılmaz ◽

Cuma Mertoğlu ◽

Aylin Ayaz

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Hemodialysis Patients ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

25 Oh Vitamin D

Aim: This study is aimed to evaluate the relationship between serum vitamin D levels and metabolic syndrome in hemodialysis patients. Materials and Methods: This study was conducted with participation of 80 patients undergoing hemodialysis for more than 6 months three times a week, aged > 18 years. Their height, dry weight, waist circumference were measured. Biochemical parameters such as serum 25-hydroxyvitamin D, lipid profile, and fasting blood glucose were analyzed. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Severe vitamin D deficiency, 25 (OH) vitamin D < 5 ng/ml; mild vitamin D deficiency, 25 (OH) vitamin D 5-15 ng/ml; vitamin D insufficiency, 25 (OH) vitamin D 16-30 ng/ml, and vitamin D sufficiency, 25 (OH) vitamin D > 30 ng/ml were categorized. Statistical analysis of the data was performed with the use of SPSS version 21.0. Results: 48.4% of hemodialysis patients were identified to have metabolic syndrome. According to the serum levels of vitamin D; 35.0% of patients had severe vitamin D deficiency, 37.4% of patients had mild vitamin D deficiency, 18.8% of patients had vitamin D insufficiency and 8.8% of patients had vitamin D sufficiency (> 30 ng/ml). Vitamin D insufficiency was significantly associated with metabolic syndrome and central obesity. Conclusions: Deficiency/insufficiency is observed in serum 25-hydroxyvitamin D levels in hemodialysis patients. Vitamin D insufficiency is associated with metabolic syndrome.

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Prevalence of vitamin D deficiency in antenatal women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192421 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2302

Author(s):

Anu Bala Chandel ◽

Rita Mittal ◽

Anoop Sharma ◽

Shivika Mittal ◽

Poonam Samyal

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Lung Development ◽

Immune Modulation ◽

Preterm Labour ◽

Obstetrics And Gynaecology ◽

Vitamin D Levels ◽

High Prevalence ◽

Sufficient Vitamin ◽

The Relationship

Background: Vitamin D has an increasingly recognised repertoire of non-classical actions, such as promoting insulin action and secretion, immune modulation and lung development. It therefore has the potential to influence many factors in the developing fetus. Several studies reported the relationship between maternal vitamin D deficiency and adverse maternal and fetal outcomes including gestational diabetes, preeclampsia, preterm labour, low birth weight and increased rate of caesarean section. The present study was undertaken to study the prevalence of vitamin D deficiency in antenatal women of Shimla, India.Methods: The study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru Hospital, Shimla, India over a period of 12 months. Six hundred women were included in the study.Results: Out of 600 subjects, 568 (94.67%) subjects had vitamin D deficiency and only 32 (5.33%) subjects had sufficient vitamin D levels. Vitamin D deficiency was more common in the vegetarians, dark skinned subjects and in those who were taking vitamin D supplements.Conclusions: It is concluded from this study that there is high prevalence of vitamin D deficiency in antenatal women of Shimla, India.

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