scholarly journals Serum Vitamin D Level and Risk of Community-Acquired Pneumonia: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Guwani Liyanage ◽  
Anusha Kaneshapillai ◽  
Suthesan Kanthasamy
Keyword(s):  
Vitamin D ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Community Acquired Pneumonia ◽  
Conclusive Evidence ◽  
Unconditional Logistic Regression ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Severe Community Acquired Pneumonia

Introduction. Recent research has shown conflicting evidence on the connection between vitamin D deficiency and community-acquired pneumonia (CAP) in children. Thus, we hypothesized that vitamin D deficiency could be a risk factor for CAP. Methods. Hospitalized children between 2 and 60 months with physician-diagnosed, radiologically confirmed severe community-acquired pneumonia (CAP) were enrolled as cases. Age-matched controls were enrolled from immunization and weighing clinics. A blood sample was collected to assess serum 25-(OH)D concentration. Unconditional logistic regression was done to examine the independent association of vitamin D level with community-acquired pneumonia. Results. Seventy-four children (females: 68%) were included. Overall, 27% had vitamin D deficiency (<20 ng/mL) and 37.8% had insufficiency (20–29 ng/mL). The vitamin D level ranged from 8.67 to 46.2 ng/mL. There was no statistically significant difference in 25(OH)D levels in controls and cases ( p = 0.694 ). In unconditional logistic regression, 25(OH)D concentration was not a determinant of CAP (OR: 0.99, CI: 0.937–1.044, p = 0.689 ). This lack of association remained after adjustment for age, gender, income, crowding, and exposure to passive smoke (OR: 0.99, CI: 0.937–1.065, p = 0.973 ). Household income was significantly associated with CAP (OR: 0.11, 95% CI: 0.021–0.567, p = 0.008 ). Conclusion. Two-thirds of the children with CAP had vitamin D deficiency/insufficiency. In comparison with healthy controls, vitamin D level was not a significant determinant of community-acquired pneumonia. It informs that further multisite research is required using more rigorous scientific methods for conclusive evidence on the relationship between vitamin D and CAP.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

Vitamin D Deficiency in Patients With Idiopathic and Traumatic Osteochondritis Dissecans of the Talus

2019 ◽  
Vol 40 (11) ◽  
pp. 1309-1318 ◽  
Author(s):  
Lukas Fraissler ◽  
Sebastian Philipp Boelch ◽  
Thomas Schäfer ◽  
Matthias Walcher ◽  
Jörg Arnholdt ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Osteochondritis Dissecans ◽  
Serum Vitamin ◽  
Vitamin D Status ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Significant Difference

Background: Low vitamin D levels are common in patients with foot and ankle disorders. We have previously demonstrated that juveniles diagnosed with osteochondritis dissecans (OCD) have a high prevalence of vitamin D deficiency. Moreover, there is evidence that OCD might be related to vitamin D deficiency in general. However, whether or not hypovitaminosis D is associated with OCD of the talus has yet to be elucidated. Methods: The aim of this study was to determine serum vitamin D levels [25(OH)D] of patients diagnosed with traumatic and idiopathic OCD of the talus. The vitamin D status of patients was measured and correlated to age, sex, season, etiology, laterality, degree of disease, and nicotine abuse. Moreover, parathyroid hormone and serum calcium levels of patients were obtained to assess for severe vitamin D deficiency and secondary hyperparathyroidism. Between January 2015 and December 2017, 65 patients with a mean age of 38.9 years and a total of 68 lesions were identified. Results: In total, 75.4% of patients had low vitamin D levels with a mean overall 25(OH)D level of 24.2 ng/mL. Specifically, 35.4% of patients were vitamin D deficient; another 40% were vitamin D insufficient, and only 24.6% of patients presented with sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels of patients with idiopathic OCD to patients with traumatic OCD. Conclusion: We could not find any significant differences in the vitamin D status of patients with OCD of the talus compared with patients with foot and ankle disorders in general. However, we found that vitamin D deficiency was frequent in patients presenting with traumatic and idiopathic OCD of the talus. We believe it might be beneficial to routinely assess and treat the vitamin D status of patients. Level of Evidence: Level III, retrospective comparative study.

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Ji-hyun Lee ◽  
Seo-rin Doo ◽  
Dongha Kim ◽  
Yoo-kyoung Park ◽  
Eun-jeong Park ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Serum Vitamin ◽  
Surgical Patients ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Deficiency Group ◽  
Critically Ill Surgical Patients

Abstract. Critically ill patients in intensive care units (ICUs) are exposed to various risk factors for vitamin D deficiency. Vitamin D deficiency in extended-stay patients may result in decreased muscle mass and increased fat tissue, which may impair rehabilitation and recovery. Our study aimed to evaluate the degree of serum vitamin D deficiency in critically ill surgical patients and its association with clinical outcomes. Clinical data from 186 adult male (n = 121; 65.1%) and female (n = 65; 34.9%) patients hospitalized in surgical ICUs at Ajou University Hospital from April 2015 to September 2016 were retrospectively analyzed. All adult surgical patients between the age of 18 and 88 years were enrolled. The mean serum 25-hydroxyvitamin D (25[OH]D) level of all patients was 17.8 ng/mL. A total of 120 patients (64.5%) with serum 25(OH)D levels < 20 ng/mL were classified as the deficiency group. A prolonged hospital stay was observed among the deficiency group but was not statistically significant ( p = 0.824). Serum 25(OH)D levels were significantly correlated with age but inversely correlated with Sequential Organ Failure Assessment (SOFA) score, selenium, triglyceride, and C-reactive protein levels. There was no significant difference in mortality rates between the group with a vitamin D injection and the group without a vitamin D injection (14.6% vs. 16.9%, p = 0.074). Vitamin D deficiency was common in surgical ICU patients; however, vitamin D levels were higher in older patients. In conclusion, vitamin D deficiency was inversely associated with the SOFA severity score (Correlation Coefficient –0.165, p = 0.024) but was not associated with the length of hospital or ICU stay and mortality.

scholarly journals Association of Gut Microbiome and Vitamin D Deficiency in Knee Osteoarthritis Patients: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1272
Author(s):  
Boopalan Ramasamy ◽  
Fabien Magne ◽  
Sujit Kumar Tripathy ◽  
Giriprasad Venugopal ◽  
Diptasree Mukherjee ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pilot Study ◽  
Knee Osteoarthritis ◽  
Vitamin D Deficiency ◽  
Gut Microbiome ◽  
Bacterial Species ◽  
Serum Vitamin ◽  
Core Microbiome ◽  
Serum Vitamin D ◽  
Significant Difference

Background: Few preclinical studies have shown that Knee osteoarthritis (KOA) is linked to gut microbiome dysbiosis and chronic inflammation. This pilot study was designed to look at the gut microbiome composition in KOA patients and normal individuals with or without vitamin D deficiency (VDD, serum vitamin D <30 ng/mL). Methods: This pilot study was conducted prospectively in 24 participants. The faecal samples of all the participants were taken for DNA extraction. The V3-V4 region of 16s rRNA was amplified, and the library was prepared and sequenced on the Illumina Miseq platform. Results: The mean (±SD) age was 45.5 (±10.2) years with no defined comorbidities. Of 447 total Operational Taxonomic Units (OTUs), a differential abundance of 16 nominally significant OTUs between the groups was observed. Linear discriminate analysis (LEfSe) revealed a significant difference in bacteria among the study groups. Pseudobutyrivibrio and Odoribacter were specific for VDD, while Parabacteroides, Butyricimonas and Gordonibacter were abundant in the KOA_VDD group, and Peptococcus, Intestimonas, Delftia and Oribacterium were abundant in the KOA group. About 80% of bacterial species were common among different groups and hence labelled as core bacterial species. However, the core microbiome of KOA and VDD groups were not seen in the KOA_VDD group, suggesting that these bacterial groups were affected by the interaction of the KOA and VDD factors. Conclusion: Parabacteroides, Butyricimonas, Pseudobutyrivibrio, Odoribacter and Gordonibacter are the predominant bacteria in vitamin D deficient patients with or without KOA. Together these results indicate an association between the gut microbiome, vitamin D and knee osteoarthritis.

scholarly journals Vitamin D and Parathyroid Hormone Status in Female Garment Workers: A Case-Control Study in Bangladesh

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Shakil Mahmood ◽  
Matiur Rahman ◽  
Subrata Kumar Biswas ◽  
Shaikh Nazmus Saqueeb ◽  
Shiblee Zaman ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Control Group ◽  
Case Group ◽  
Serum Vitamin D ◽  
Garment Workers ◽  
Significant Difference ◽  
The Status ◽  
The Mean

Despite the abundant sunlight, vitamin D deficiency is prevalent in South Asian countries including Bangladesh. Information on vitamin D level is insufficient in adults particularly in female garment workers in Bangladesh. This study was designed to evaluate the status of vitamin D, parathormone (PTH), calcium, and alkaline phosphatase (ALP) among the female garment workers in Bangladesh. Blood samples were collected from female garment workers (n=40, case group) and general female workers (n=40, control group) in Dhaka. Serum vitamin D, PTH, calcium, and ALP were measured by chemiluminescence microparticle immunoassay. The mean level of vitamin D was significantly (p<0.001) lower in case (14.2±2.6 ng/mL) than in the control (22.4±2.4 ng/mL) group. No significant difference was found at mean of PTH and calcium between case (33.9±17.2 pg/mL;9.1±0.6 mg/dL, resp.) and control (35.9±16.3 pg/mL;9.3±0.6 mg/dL, resp.) group. The mean ALP in case (117.2±14.4 U/L) group was significantly (p<0.001) higher than the control group (80.5±30.6 U/L). Overall, PTH level did not show significant correlation with vitamin D. However, calcium and ALP levels showed a significant positive (p<0.05) and negative (p<0.001) correlation with vitamin D, respectively. This study indicates a high prevalence of vitamin D deficiency in the female garment workers in Bangladesh.

scholarly journals VITAMIN D DEFICIENCY IN PATIENTS WITH PSORIASIS AND PSORIATIC ARTHRITIS

2020 ◽  
pp. 168-170
Author(s):  
JINAN Q MOHAMMED ◽  
ABDULSATAR J MATHKHOR ◽  
AMER S KHUDHAIRY
Keyword(s):  
Vitamin D ◽  
Psoriatic Arthritis ◽  
Vitamin D Deficiency ◽  
Disease Duration ◽  
Serum Vitamin ◽  
Control Group ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Lower Vitamin

Objective: The objective of this study is to investigate the association between Vitamin D level and psoriasis, in particular in our city of the long, hot, and sunny weather, in an attempt to add a clarification to this controversial subject. Methods: A case–control study included 120 patients with psoriasis and 38 patients with psoriatic arthritis (PsA); 89 (56.3%) patients were male. Psoriasis area and severity index (PASI) was calculated for all patients with psoriasis and disease activity score using 28 joints (DAS28) and erythrocyte sedimentation rate (DAS28) was measured for all patients with PsA. The control group comprised 164 age- and sex-matched participants (91 males and 73 females). Vitamin D serum level was performed for both patients and controls. Results: Vitamin D levels in both patients and controls were 17.4±7.7 and 28.3±5.6, respectively. The level of Vitamin D was lower in a patient with disease duration equal and more than 10 years than those with a disease duration <10 years. There is no significant difference in Vitamin D levels between the two patient subgroups. Lower Vitamin D levels were associated with high PASI and high DAS28 in psoriasis and PsA, respectively. Conclusion: Patients with psoriasis and PsA associated with low levels of serum Vitamin D. Vitamin D deficiency was found to be associated with long disease duration in both psoriasis and PsA. Patients with active disease have lower Vitamin D levels.

Serum vitamin D status does not correlate with the severity of obstructive sleep apnea in male adults: A controlled study design with minimized factors influencing serum vitamin D levels

2020 ◽  
Vol 90 (5-6) ◽  
pp. 470-476 ◽  
Author(s):  
Ozge Yagcioglu Yassa ◽  
Saime Fusun Domac ◽  
Gulay Kenangil
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Significant Relationship ◽  
Serum Vitamin ◽  
Controlled Study ◽  
Vitamin D Status ◽  
Anthropometric Measures ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Significant Difference

Abstract. Observational studies performed in homogeneous groups to objectively investigate the cause and effect relationship between vitamin D deficiency and sleep disorders are scarce. In this study, it was aimed to analyze the relationship between the severity of OSAS and vitamin-D levels among the participants whose features affecting serum vit-D levels were minimised. Serum 25-OH vitamin-D levels in 121 OSAS Male patients diagnosed by polysomnography without any systemic disease or vitamin-D supplement that may effect the vitamin-D metabolism were measured. The study was conducted in winter (latitude: 41°). Anthropometric measures and biochemical tests were also performed. The distribution of vitamin-D levels was determined as severe deficiency, deficiency, insufficiency and sufficiency. Apnea-hypopne index (AHI) < 5 was considered as a control group. Patients were categorized into four groups according to AHI as control, mild, moderate and severe. The groups were similar in terms of age, BMI, lipid profile, serum calcium, anthropometric measures and smoking. There was no significant difference in the distribution of vitamin-D levels between the patient and control groups and also within OSAS subgroups (p = 0.57, p = 0.86, respectively). Odds ratio to have OSAS in patients with vitamin-D deficiency was found as 0.745 (95 %CI: 0.33–1.7). Multinominal regression analysis showed no significant relationship between the OSAS severity and the extent of vitamin-D status. Correlation analysis showed no significant relationship between vitamin-D and AHI (r = 0.017, p = 0.877). Vitamin-D status does not alter the severity of OSAS. Vitamin-D deficiency might be the result of lifestyle changes due to OSAS rather than a cause.

scholarly journals Vitamin D Level in Predialysis Chronic Kidney Disease Patients Stage 3 to 5 and Predictors of its Deficiency

2021 ◽  
pp. 64-72
Author(s):  
Mohamed G. Mohamed ◽  
Hanaa I. Okda ◽  
Hossam A. Hodeib ◽  
Mostafa T. Gabr
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Ckd Stage ◽  
Significant Difference

Background: Vitamin D deficiency is commonly encountered in patients with chronic kidney disease (CKD) with or without undergoing dialysis. This study was conducted to assess vitamin D level in patients diagnosed with predialysis CKD stage 3 – 5, and to determine the predictors of its deficiency in such patients. Materials and Methods: This cross-sectional study included 75 patients who were divided into three equal groups of CKD-3, CKD-4 and CKD-5. All cases were subjected to detailed history taking, physical examination and measurement of estimated glomerular filtration rate (eGFR) according to Cockcroft-Gault formula. In addition, laboratory investigations included CBC, renal function tests, serum ferritin, intact parathyroid hormone (iPTH) and vitamin D level. Results: Patient demographics and other co-morbidities were comparable among the three groups. Serum vitamin D had mean values of 24.84, 20.52 and 11.24 ng/ml in patients with stages III, IV and V respectively, with significant difference between the three groups. Vitamin D deficiency was more common in CKD-5 cases. On the contrary, serum parathyroid hormone and ferritin were significantly higher levels, in patients with higher stages. There was statistically significant positive correlation of serumvitamin D with eGFR, Hb, calcium and albumin. On the other hand, serum vitamin D was negatively correlated with phosphate, PTH, urea andcreatinine. Conclusion: It is evident that higher stages of CKD are associated with more vitamin D deficiency.

Abstract MP024: Low Serum Vitamin D is Associated with Musculoskeletal Pain in Statin Users

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Catherine Buettner ◽  
Travis Y Morioka
Keyword(s):  
Vitamin D ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Musculoskeletal Pain ◽  
Serum Vitamin ◽  
Population Based ◽  
Logistic Regression Models ◽  
Serum Vitamin D ◽  
Pain Medications ◽  
Statin Use

Introduction: Statin use is associated with higher prevalence of self-reported musculoskeletal pain in the general population. Non-blinded studies have shown improvement in myalgia symptoms and increased tolerance to statin use after treatment of vitamin D deficiency. In this study, we hypothesized that lower serum vitamin D concentration would be associated with a higher odds of self-reported musculoskeletal pain among statin users. Methods: Using the National Health and Nutrition Examination Survey (NHANES) 2001–2004, we performed logistic regression to examine the association between vitamin D concentration and self-reported musculoskeletal pain and to evaluate if statin use modified the association. We evaluated vitamin D deficiency using a serum vitamin D concentration considered in the deficient range in clinical practice and representing the lowest quintile of vitamin D concentrations in the population studied (less than15 ng/mL). We adjusted for the effects of age, sex, race, smoking, BMI, physical activity, health status, peripheral vascular disease, coronary heart disease, diabetes, osteoporosis, arthritis, statin use and use of pain medications in logistic regression models. We also explored concentration-related trends of the effect of vitamin D on musculoskeletal pain. Results: Among 6217 participants age 40 years and older, the mean vitamin D concentration was 23.5 ng/mL (95%CI 22.4 ng/mL, 24.2 ng/mL). Statin medications were used by 17% of the participants in the last 30 days. Statin users had higher odds (aOR 1.6, 95%CI 1.2, 2.1) of self-reported musculoskeletal pain in any area (specifically including the lower extremities, lower back, upper extremities, and upper back) compared with non-users. Vitamin D deficiency was not a predictor of musculoskeletal pain (aOR 1.0, 95%CI 0.8, 1.3) in the overall sample. Among 1145 statin users, we found statin use modifies the effect of vitamin D deficiency on musculoskeletal pain (p for interaction = 0.02). Compared to statin users with a vitamin D concentration 15 ng/mL or higher, those with vitamin D concentration less than 15 ng/mL had higher odds of musculoskeletal pain (aOR 1.8, 95% CI 1.1, 3.1). We did not observe a concentration-related trend between increasing vitamin D concentrations and musculoskeletal pain (p for trend=0.7). Conclusion: In conclusion, after controlling for multiple confounders, a vitamin D concentration less than 15 ng/mL was not found to be associated with musculoskeletal pain in the overall sample in this population-based study. However, statin use modifies the relationship between vitamin D deficiency and musculoskeletal pain, such that a vitamin D concentration less than 15 ng/mL is associated with higher odds of self-reported musculoskeletal pain among statin users.

scholarly journals AB0434 VITAMIN D IN SYSTEMIC SCLEROSIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1246.1-1246
Author(s):  
M. M. Sirufo ◽  
F. De Pietro ◽  
M. Raggiunti ◽  
M. De Martinis ◽  
L. Ginaldi
Keyword(s):  
Vitamin D ◽  
Systemic Sclerosis ◽  
Pulmonary Fibrosis ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Healthy Controls ◽  
Serum Vitamin D ◽  
Link Type ◽  
Vitamin D Levels ◽  
Significant Difference

Background:Systemic Sclerosis (SSc) is a generalized and systemic autoimmune disease that affects the connective tissue of the skin and internal organs, especially kidneys, heart and lungs [1].Objectives:Numerous data from recent literature confirm the regulatory action of vitamin D on the immune system and, therefore, how a deficit of this micronutrient can lead to alterations in the immune response, as is known to happen in many allergic and autoimmune diseases [2]. We studied the association between vitamin D levels and SSc, evaluating their correlation with the characteristic manifestations of the pathology.Methods:We dosed the serum levels of 25 hydroxy-vitamin D in 42 patients with SSc (average age 64.63 +/-7.33) and 40 healthy controls comparable for sex and age. The diagnosis of SSc was formulated in accordance to 2013 ACR/EULAR criteria. None of the subjects involved in the study took vitamin D products.Results:Patients’ vitamin D levels (26.22+/-9.82 ng/ml), although they tended to be lower than controls (27.80 +/- 16.53 ng/ml), showed no significant decrease. In patients with pulmonary fibrosis, vitamin D levels were 23.28 +/- 12.30 lower than in patients with trophic ulcers and compared to patients without complications 26.07 +/- 9.92, although with not statistically significant values. No statistically significant difference was found between vitamin D levels in patients with trophic ulcers compared to controls without complications.Conclusion:According to the studies in the literature, in our sample, vitamin D deficiency was therefore greater in patients with SSc, especially with pulmonary fibrosis, than in controls [3,4]. Vitamin D levels in diffused-type SSc patients were significantly lower than those in limited-type SSc patients. Further studies are needed to clarify the role that vitamin D deficiency plays in SSc, but lower vitamin D levels in these patients may suggest the need to monitor blood levels of vitamin D and supplement it appropriately.References:[1]De Martinis M, Ciccarelli F, Sirufo MM, Ginaldi L. An overview of environmental risk factors in systemic sclerosis. Expert Rev Clin Immunol. 2016;12(4):465-78. doi: 10.1586/1744666X.2016.1125782. Epub 2015 Dec 19. PMID: 26610037.[2]Yang, CY., Leung, P.S.C., Adamopoulos, I.E. et al. The Implication of Vitamin D and Autoimmunity: a Comprehensive Review. Clinic Rev Allerg Immunol45, 217–226 (2013). https://doi.org/10.1007/s12016-013-8361-3.[3]Trombetta AC, SmithV, Gotelli E, Ghio M, Paolino S, Pizzorni C, et al. (2017) Vitamin D deficiency and clinical correlationsin systemic sclerosis patients: A retrospective analysis for possible future developments. PLoS ONE 12(6): e0179062.https://doi.org/10.1371/journal. pone.0179062.[4]Sarita Gupta, Vikram K. Mahajan, Rajinder S. Yadav1, Karaninder S. Mehta, Satya Bhushan1, et al. Evaluation of Serum Vitamin D Levels in Patients with Systemic Sclerosis and Healthy Controls: Results of a Pilot Study Article July 2018 DOI: 10.4103/idoj.IDOJ_328_17.Disclosure of Interests:None declared

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