scholarly journals Practices of vitamin D supplementation leading to vitamin D toxicity: Experience from a Low-Middle Income Country

2022 ◽  
pp. 103227
Author(s):  
Siraj Muneer ◽  
Imran Siddiqui ◽  
Hafsa Majid ◽  
Nawazish Zehra ◽  
Lena Jafri ◽  
...  
2019 ◽  
Vol 25 ◽  
pp. 107602961986168
Author(s):  
Serdar Sahin ◽  
Sevil Sadri ◽  
Zafer Baslar ◽  
Muhlis Cem Ar

Increased number of patients with hemophilia have been identified to have osteoporosis at early ages. Low bone mineral density in the setting of hemophilia has been associated with decreased mobility, sedentary life style, on demand treatment or delayed prophylaxis, low body weight and viral infections. The aim of this study was to investigate the impact of hemophilia on bone health of adult patients living in a middle income country. A total of 61 adult patients with hemophilia who were followed at the Hematology Department of Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa were consecutively included in this study. Bone health of the patients was assessed using the bone mineral density (BMD) and vitamin D levels. Z and t scores are used for evaluation of BMD in patients with hemophilia aged < 50 and ≥ 50 years, respectively. Information on treatment and co-morbidities including viral diseases were obtained from the medical files of the recruited patients. Bone mineral density was found normal in 30, and low in 29 patients. Vitamin D levels were below 20 ng/ml in 46 patients. No significant relationship was found between the severity of hemophilia and bone density. Vitamin D levels were significantly lower in patients who had a history of joint intervention. Neither annual bleeding rate nor the treatment modality (on demand versus prophylaxis) were associated with the bone mineral density and vitamin D levels. Annual factor consumption was higher in patients whose bone mineral densities was low both in femoral and lumbar regions. The results of this study depicting the situation of adult hemophilia population from a middle income country show that bone mineral density and vitamin D levels were decreased in a considerable amount of patients at early ages.


2019 ◽  
Author(s):  
Quan-Hoang Vuong

Valian rightly made a case for better recognition of women in science during the Nobel week in October 2018 (Valian, 2018). However, it seems most published views about gender inequality in Nature focused on the West. This correspondence shifts the focus to women in the social sciences and humanities (SSH) in a low- and middle-income country (LMIC).


Author(s):  
Bridget Pratt

Health research funded by organizations from HICs and conducted in low- and middle-income countries has grown significantly since 1990. Power imbalances and inequities frequently (but not always) exist at each stage of the international research process. Unsurprisingly then, a variety of ethical concerns commonly arise in the context of international health research, such as inequities in funding, the semi-colonial nature of international research models, the brain drain of low- and middle-income country researchers, and inequities in partnerships between HIC and low- and middle-income country researchers. In this chapter, these (and other) ethical concerns are introduced and the following ethical concepts to address the concerns are then discussed: responsiveness, standard of care, benefit sharing, community engagement, and social value. Existing guidance and remaining debates about how to specify each of the concepts are summarized. The chapter concludes by highlighting the existence of epistemic injustices within the field of international research ethics.


Author(s):  
Margo S Harrison

Abstract Background A secondary analysis was conducted of two separate datasets to observe the association between maternal age and interpregnancy interval (IPI). Methods The IPI in a middle-income country (Guatemala) was compared with that of a very-high-income country (USA) among women with two pregnancies. Results A regression model found that with each increasing year of age, the IPI increases by 1.26 months (p&lt;0.001) in Guatemala. A regression model found that IPI decreased as women aged in the USA. Conclusions It is hypothesized that as countries progress in their development indices, women may delay childbearing, which may result in reduced IPI, as was the case in the USA compared with Guatemala in these datasets.


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