Vitamin D Status as a Predictor of Postoperative Hypocalcemia after Thyroidectomy

2020 ◽  
Vol 163 (3) ◽  
pp. 501-507
Author(s):  
Samuel J. Rubin ◽  
Jong H. Park ◽  
Elizabeth N. Pearce ◽  
Michael F. Holick ◽  
David McAneny ◽  
...  
Keyword(s):  
Vitamin D ◽  
Retrospective Study ◽  
Serum Calcium ◽  
Study Design ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Single Center ◽  
Postoperative Hypocalcemia ◽  
Vitamin D Levels

Objective To determine whether perioperative vitamin D levels are predictive of postoperative hypocalcemia in patients receiving thyroidectomy. Study Design Single center retrospective study. Subjects and Methods This study included all patients receiving total or completion thyroidectomy between January 2007 and March 2017 at a single tertiary care hospital. 25-Hydroxyvitamin D (25[OH]D) levels were measured within 42 days prior to surgery or 1 day postoperatively. Hypocalcemia was defined as an adjusted serum calcium <8.0 mg/dL (based on albumin levels) or symptomatic hypocalcemia. Univariate analysis was performed with a 2-sample t test and chi-square test, while multivariate analysis was performed with logistic regression analysis to determine whether perioperative 25(OH)D level is a predictor of postoperative hypocalcemia. Results A total of 517 subjects were included in the study, 15.7% (n = 81) of whom experienced postoperative hypocalcemia with a mean ± SD serum calcium level of 7.6 ± 0.5 mg/dL as compared with 8.9 ± 0.5 mg/dL in the normocalcemic population ( P < .01). The mean 25(OH)D level for patients with hypocalcemia was 24.4 ± 12.0 ng/mL as compared with 27.5 ± 12.2 ng/mL in patients with normocalcemia ( P = .038). Subjects who were hypocalcemic experienced a significantly longer hospital stay (2.9 ± 2.5 vs 1.4 ± 1.1 days, P < .01). After adjusting for preoperative calcium, age, and performance of a neck dissection, subjects with a 25(OH)D level <30 ng/mL were significantly associated with postoperative hypocalcemia (odds ratio, 1.9; P = .041; 95% CI, 1.0-3.3). Conclusion Using a single-center retrospective study design, we demonstrated that 25(OH)D level is a significant predictor of postoperative hypocalcemia after thyroidectomy.

scholarly journals A Practical Mathematic Method to Predict and Manage Hypocalcemia After Parathyroidectomy and Thyroidectomy

2019 ◽  
Vol 129 (1) ◽  
pp. 70-77
Author(s):  
Changxing Liu ◽  
Liyang Tang ◽  
Pedram Goel ◽  
Tamara Chambers ◽  
Niels Kokot ◽  
...  
Keyword(s):  
Vitamin D ◽  
Calcium Level ◽  
Tertiary Care ◽  
Clinical Information ◽  
Care Hospital ◽  
Postoperative Hypocalcemia ◽  
Good Reliability ◽  
Primary Treatment Modality ◽  
Vitamin D Levels ◽  
Pth Level

Objective: Prediction and early intervention for hypocalcemia following parathyroidectomy and total thyroidectomy can decrease hospital cost and prevent severe hypocalcemia-related complications. This study aims to predict the severity of hypocalcemia after parathyroidectomy or thyroidectomy and to stratify patients into groups with different levels of risk for developing severe hypocalcemia, so that higher risk patients may be monitored more closely and receive earlier interventions. Methods: This was a retrospective cohort study of 100 patients with primary hyperparathyroidism who underwent parathyroidectomy as the primary treatment modality at a tertiary care hospital. Clinical information, including demographic information, perioperative PTH and calcium levels, vitamin D levels, weight of the pathologic glands removed, gland pathology, and re-admission rates, were retrieved. Statistical analysis was performed to analyze the association between collected variables and percentage of calcium drop following parathyroidectomy with statistical significant set at P-values <0.05. Results: Age, sex, and vitamin D level provided very minimal information to quantify risks of postoperative hypocalcemia. The percentage of decrease from preoperative PTH level to the lowest PTH level after the removal of the abnormal gland(s) is the most significant predicting factor for the severity of postoperative hypocalcemia. There is a mathematic regressional correlation between them. A formula was generated to quantify this linear relationship between them, and the nadir calcium can be calculated as [Formula: see text], where Canadir = the lowest postoperative calcium level, and PTHintraop = PTH level 15 minutes after removal of the abnormal gland, with the value of R2 > 0.7. The formula has been tested primarily in our patient population with good reliability. Conclusions: The highest preoperative, lowest postoperative, and change in PTH level can help us reliably calculate the trend of postoperative calcium level. Decision to pursue early interventions can be made based on the calculated result from the formula we obtained.

scholarly journals Vitamin D status in pregnant women and their newborns in a tertiary care hospital

2018 ◽  
Vol 7 (12) ◽  
pp. 5071
Author(s):  
Harleen Kour ◽  
Shashi Gupta ◽  
Swarn K. Gupta ◽  
Bawa Ram Bhagat ◽  
Gagan Singh
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Vitamin D Status ◽  
Pregnant Females ◽  
Vitamin D Levels ◽  
Maternal And Newborn

Background: In the recent years there has been an increased understanding of the role that vitamin D plays in regulation of cell growth, calcium absorption and immunity and its impact on the developing fetus and maternal health is of significant concern. This study aims at evaluating the Vitamin D status in pregnant women and their newborns.Methods: A cross sectional study was done on 100 pregnant females according to inclusion and exclusion criteria. At the time of delivery, maternal blood was collected, and newborn samples were taken from newborn side of umbilical cord and sent for analysis.Results: The prevalence of Vitamin D deficiency has been found to be 85% of pregnant females and 91% of the newborns. Only 5% of pregnant females and 1% of the newborns showed Vitamin D sufficiency. Maternal and newborn vitamin D levels show a positive correlation. Mean maternal and newborn Vitamin D levels were found to be 16.78±7.04 ng/mL and 11.29±5.75 ng/ml.Conclusions: Vitamin D deficiency is highly prevalent among pregnant women in north India. Low maternal vitamin D levels lead to vitamin D deficiency in the newborns also.

scholarly journals Assessment of Vitamin D Levels in Patients Presenting With Chronic Low Back Pain at a Tertiary Care Hospital

Cureus ◽  
2020 ◽  
Author(s):  
Mukesh Kumar ◽  
Masroor Ahmed ◽  
Ghulam Hussain ◽  
Muhammad Bux ◽  
Naveed Ahmed ◽  
...  
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Vitamin D Levels

scholarly journals STUDY OF VITAMIN D LEVELS IN PULMONARY TUBERCULOSIS PATIENTS AT A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 6 (44) ◽  
pp. 3424-3426
Author(s):  
Rohit Vasant Deshpande ◽  
Bharat Sing Rathod ◽  
Parag Nemant Rahtekar ◽  
Amol Dandurang Bhore ◽  
Swati Harish Sharma ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tuberculosis Patients ◽  
Vitamin D Levels

scholarly journals High prevalence of vitamin D deficiency in school children in Jammu: a whistle blower

2019 ◽  
Vol 7 (5) ◽  
pp. 1524
Author(s):  
Harleen Kaur ◽  
Amarjeet Singh Bhatia
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
School Children ◽  
Tertiary Care ◽  
Care Hospital ◽  
Vitamin D Status ◽  
Jammu And Kashmir ◽  
Vitamin D Levels ◽  
High Prevalence ◽  
Good Nutrition

Background: Vitamin D deficiency prevails in epidemic proportions among school going children in India, but there is scarcity of searchable data on vitamin D status in school children in Jammu and Kashmir; hence we have assessed the vitamin D status in school going children attending outpatient department in a tertiary care hospital Jammu.Methods: The study was conducted in the department of Biochemistry Government Medical College Jammu during June to December, 2018 and after obtaining informed consent, a total of 104 school going children between the age group of 6 years to 12 years, attending SMGS Hospital Jammu were screened for their vitamin D (25 OH-D) status by using Abbott architect chemiluminescent micro particle immunoassay.Results: Out of a total of 104 school going children screened in the study, 91 (87.5%) were found to be having insufficient vitamin D levels in their blood (<30ngm/dl) whereas 63 (60.5%) children showed severe deficiency with vitamin D levels below 20ngm/dl.Conclusions: Despite of abundant sunshine throughout the year and also with the consideration that people of this region are well off economically and can afford good nutrition, the results of our study revealing  high prevalence of Vitamin D deficiency in school going children can be taken as a whistle blower for the health policy makers of the region. 

scholarly journals Is there an association between vitamin D and risk of stroke?: a North Indian study

2019 ◽  
Vol 7 (4) ◽  
pp. 1026
Author(s):  
Mahajan M. ◽  
Hilal A. Sheikh ◽  
Anand Ish ◽  
Batra A. ◽  
Sethi P. K.
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Cross Sectional ◽  
Age And Gender ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D ◽  
And Gender

Background: Vitamin D deficiency is present in India in epidemic proportions despite plenty of sunshine. Reduced plasma 25(OH) D concentrations as a diagnostic marker of vitamin D deficiency have been in past decade associated with several well-established risk factors for ischaemic stroke, such as arterial hypertension, thrombosis, atherosclerosis. The aims and objectives of this study was to compare the serum 25(OH) D levels between the first ever acute stroke patients and healthy controls.Methods: A cross-sectional, case control study was conducted in a tertiary care hospital in New Delhi situated in north India. Serum 25‑hydroxyvitamin D (25(OH) D) levels in 85 patients of ischemic stroke, presenting within 7 days of onset of stroke was measured and was compared with 70 age and gender matched controls.Results: The mean age was 61.02±11.58 years and 58.63±11.28 years in cases and controls respectively. Females constituted 37.6% of the total number of cases and 43.4% of the controls. The age and gender-distribution were comparable between the cases and controls. The median value (IQR) of serum 25(OH) vitamin D level was 7.94 ng/mL (4.59-14.00) in the cases and it was 8.82 ng/mL (5.59-14.70) in the controls. The difference between the serum 25(OH) vitamin D levels of the two groups was not found to be statistically significant.Conclusions: There is a high prevalence of biochemical hypo-vitaminosis D in apparently healthy Indians of all age and sex groups despite adequate sunshine. There is no association between low vitamin D levels and stroke.

scholarly journals Incidence of vitamin D deficiency in pediatric neurology outpatient department of a tertiary care hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 1414
Author(s):  
Purva Keni Karnavat ◽  
Anaita Udwadia Hegde ◽  
Fazal Nabi
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Pediatric Neurology ◽  
Economic Class ◽  
Vitamin D Levels ◽  
Chi Squared

Background: Pediatric neurology outpatient populations are a vulnerable subgroup for vitamin D deficiency. The aim was to study the incidence of vitamin D deficiency in pediatric neurology patients by studying relevant biochemical profile and to assess the contributory factors for the same.Methods: A hospital based cross sectional study was conducted at a tertiary care setup in Mumbai between 2011 and 2012. A total of 284 children aged 0.5-18 years, attending pediatric neurology OPD were enrolled. Statistical analysis was carried out with SPSS version 17.0 and included descriptive statistics; Chi squared and unpaired t-tests to investigate significance of proposed predictors for vitamin D status.Results: 89.1% of the children were deficient in vitamin D levels (≤30 ng/ml); out of these 11% were severely deficient. Factors significantly associated with vitamin D deficiency were increasing age (p=0.034), absence of intake of calcium supplements (p=0.00) and upper socio-economic class (p=0.001). Low serum calcium levels (p=0.01) and high PTH levels (p=0.00) were associated significantly. Prevalence was similar in children with higher BMI as compared to lower BMI. Duration of AEDs rather than number of drugs was more associated with deficiency.Conclusions: A high prevalence of vitamin D inadequacy in noted in pediatric neurology patients.

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