Comparison of early postoperative outcome of laparoscopic and open inguinal hernia mesh repair

Background: Laparoscopic hernia has all the benefits of a tension free repair. The aim of this study was to compare the early postoperative outcome of laparoscopic and open inguinal hernia mesh repair.Methods: This is a prospective study conducted at Ramaiah hospital Bangalore from June 2016 to July 2017. 70 cases of inguinal were included in the study hernia diagnosed clinically and radiologically who fulfilled the inclusion & the exclusion criteria. The principal operative techniques were laparoscopic hernioplasty (LH) and open inguinal mesh hernioplasty (OH).Results: 35 patients each were allotted to two group (LH and OH). The mean age was 50.53. LH group had significantly less postoperative pain than the OH group on 12, 24 and 72 hrs (P <0.05). Although the vas pain scores of LH group were also comparatively lower on postoperative day 14, these differences were not statistically significant. Than mean operative time was significantly higher for LH group (131.86 vs 80.29 min) although in bilateral cases the difference was considerably less but was still significant (138 vs 107 min). The mean hospital stay after surgery was less for LH group (2.68 vs 3.25 days) but was not statistically significant. (p = 0.073). Chronic pain persisted for 2 patients (5.7%) in OH group whereas none had chronic pain in LH group.Conclusions: Laparoscopic hernioplasty is equivalent to open repair in the treatment of inguinal hernia, with less post-operative pain, lower risk of wound infection, shorter duration of hospital stay, and less incidence of chronic pain however requires a long learning curve and is more expensive.

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Phẫu thuật nội soi TAPP điều trị thoát vị bẹn

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.73.13 ◽

2021 ◽

Author(s):

Thanh Xuan Nguyen

Keyword(s):

Inguinal Hernia ◽

Postoperative Complications ◽

Prospective Study ◽

Hospital Stay ◽

Operative Time ◽

Postoperative Hospital Stay ◽

Tapp Repair ◽

The Mean ◽

A Prospective Study

TÓM TẮT Đặt vấn đề: Thoát vị bẹn là một bệnh lý ngoại khoa thường gặp và có nhiều tác giả đưa ra nhiều kỹ thuật mổ khác nhau. Phẫu thuật xuyên phúc mạc tiếp cận khoang trước phúc mạc (TAPP) với nhiều ưu điểm như tiếp cận phẫu trường nội soi rộng rãi, các mốc giải phẫu rõ ràng, có thể quan sát, đánh giá và xử trí tạng thoát vị khá dễ dàng, có thể phát hiện thoát vị bẹn đối diện và xử trí những bệnh lý kèm theo trong ổ phúc mạc. Phương pháp: Nghiên cứu mô tả có theo dõi 125 bệnh nhân được chẩn đoán thoát vị bẹn tại Bệnh viện Trung Ương Huế và Bệnh viện trường Đại học Y - Dược Huế từ tháng 6/2016 đến tháng 3/2019. Kết quả: Tuổi trung bình 56,25 ± 19,06. Nam chiếm 97,6%. Thoát vị bẹn có triệu chứng 76,8%, có biến chứng 23,2%. Thoát vị bẹn 1 bên 92%, 2 bên 8%. Thoát vị bẹn ẩn đối bên phát hiện trong mổ 2,4%. TAPP 1 bên 92,8%, TAPP 2 bên 7,2%, TAPP kèm phẫu thuật khác 2,4%. Thời gian mổ trung bình 1 bên là 48,62 ± 13,05 phút, 2 bên là 66,11 ± 12,19 phút. Không có tai biến trong mổ. VAS sau mổ 24 giờ: 3,53 ± 0,56. Tụ dịch vùng bẹn sau mổ 11,2%. Thời gian nằm viện sau mổ 4,41 ± 1,25 ngày. Kết luận: Phẫu thuật TAPP là một phẫu thuật an toàn, có thể thực hiện được. Phẫu thuật TAPP có thể phát hiện và xử trí những tổn thương trong ổ phúc mạc cũng như các bệnh lý đi kèm. ABSTRACT LAPAROSCOPIC TRANS - ABDOMINAL PRE - PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans - abdominal pre - peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Methods: A prospective study was carried in 125 cases with inguinal hernia that have been treated by laparoscopic trans - abdominal pre-peritoneal (TAPP) repair. Results: The mean age was 56.25 ± 19.06 years old. 96.7% were male. 76,8% of hernia were symptomatic, and 23.3% were complicated. 92% of hernia were unilateral, 8% were bilateral, 2.4% were occult. 92.8% would perfom an unilateral TAPP repair, 7.2% bilateral TAPP repair, 2.4% simultaneous TAPP and cholecystectomy. The mean operative time was 48.62 ± 13.05 minutes for unilateral TAPP, 66.11 ± 12.19 minutes for bilateral TAPP. The mean VAS 24h post - op was 3.53 ± 0.56. Regarding postoperative complications, inguinal seroma was detected in 11,2% of cases. The mean postoperative hospital stay was 4.41 ± 1.25 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases. Keywords: Inguinal hernia, laparoscopic, trans - abdominal pre - peritoneal (tapp)

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Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-016728 ◽

2020 ◽

pp. neurintsurg-2020-016728

Author(s):

Joshua S Catapano ◽

Andrew F Ducruet ◽

Stefan W Koester ◽

Tyler S Cole ◽

Jacob F Baranoski ◽

...

Keyword(s):

Hospital Stay ◽

Hospital Costs ◽

Length Of Hospital Stay ◽

Diagnostic Procedures ◽

Femoral Access ◽

Catheter Size ◽

The Mean ◽

The Difference ◽

Procedure Type ◽

Angiographic Findings

BackgroundTransradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.MethodsElective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.ResultsOf the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).ConclusionNeuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.

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The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

10.53350/pjmhs2115102712 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2712-2714

Author(s):

Muhammad Aamir Jamil ◽

Muhammad Asif ◽

Imran Yousaf ◽

Muhammad Faheem Anwer ◽

Muhammad Waseem Anwar

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Recovery Time ◽

Mesh Repair ◽

Operative Procedure ◽

Total Extraperitoneal ◽

Outcome Comparison ◽

Group A ◽

The Mean ◽

Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

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Epistaxis as a marker for severe acute respiratory syndrome coronavirus-2 status – a prospective study

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001863 ◽

2020 ◽

Vol 134 (8) ◽

pp. 717-720 ◽

Cited By ~ 1

Author(s):

MH Hussain ◽

M Mair ◽

P Rea

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Prospective Study ◽

Control Group ◽

Study Group ◽

Chain Reaction ◽

Polymerase Chain Reaction Testing ◽

The Mean ◽

Polymerase Chain ◽

The Difference ◽

A Prospective Study

AbstractObjectiveTo evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 infection in patients presenting with epistaxis to a tertiary otolaryngology unit.MethodsA prospective study was conducted of 40 consecutive patients presenting with epistaxis referred to our tertiary otolaryngology unit. A group of 40 age-matched controls were also included. All patients underwent real-time reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2. Symptoms of fever, cough and anosmia were noted in the study group.ResultsThe mean age was 66.5 ± 22.4 years in the study group. There were 22 males (55 per cent) and 18 females (45 per cent). The mean age in the control group was 66.3 ± 22.4 years (p = 0.935). There were six positive cases for severe acute respiratory syndrome coronavirus-2 (15 per cent) in the epistaxis group and one case (2.5 per cent) in the control group. The difference was statistically significant (p = 0.05).ConclusionEpistaxis may represent a presenting symptom of severe acute respiratory syndrome coronavirus-2 infection. This may serve as a useful additional criterion for screening patients.

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Involvement of Workers in Closed and Semiclosed Institutions in Outbreaks of Acute Gastroenteritis Due to Norovirus

Viruses ◽

10.3390/v12121392 ◽

2020 ◽

Vol 12 (12) ◽

pp. 1392

Author(s):

Ignacio Parrón ◽

Irene Barrabeig ◽

Miquel Alseda ◽

Thais Cornejo-Sánchez ◽

Susana Guix ◽

...

Keyword(s):

Prospective Study ◽

Confidence Intervals ◽

Personal Hygiene ◽

Occupational Category ◽

Hygiene Measures ◽

The Mean ◽

The Difference ◽

Rate Ratios ◽

A Prospective Study ◽

Mean Cycle

Norovirus outbreaks frequently occur in closed or semiclosed institutions. Recent studies in Catalonia and various countries indicate that, during outbreaks in these institutions, norovirus is detected in between 23% and 60% of workers, and the prevalence of infection in asymptomatic workers involved in outbreaks ranges from 17% to 40%. In this work, we carried out a prospective study to investigate the involvement of workers in closed and semiclosed institutions during outbreaks. The attack rates (ARs) and the rate ratios (RRs) were calculated according to the type of transmission and occupational category. The RRs and 95% confidence intervals (CIs) between workers and users were calculated. The mean cycle of quantification (Cq) values were compared according to the genogroup and the presence of symptoms. ARs were higher in person-to-person transmission than in common vehicle outbreaks, and 38.8% of workers were symptomatic. The RR between workers and users was 0.46 (95% CI 0.41–0.52). The ARs in workers were high, particularly in workers with closer contact with users. The mean Cq was lower in patients than in asymptomatic infected persons, although the difference was only significant for genogroup I (GI). The frequency of asymptomatic infected persons suggests that personal hygiene measures should be followed by all workers in the centers affected.

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Desarda’s versus Lichtenstein technique of inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20175553 ◽

2017 ◽

Vol 5 (1) ◽

pp. 92

Author(s):

Obaid Syed

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Complication Rate ◽

Mesh Repair ◽

Post Operative Pain ◽

Significant Difference ◽

Duration Of Surgery ◽

Operative Complications ◽

The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

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COMPLICATED INGUINAL HERNIAS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.3232 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Naveed Akhtar ◽

Syed Shams- Ul-Hassan ◽

Muhammad Sabir ◽

M. Nauman Ashraf

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Wound Infection ◽

P Value ◽

Emergency Setting ◽

Complication Rates ◽

Success Rates ◽

Inguinal Hernias ◽

Significant Difference ◽

The Mean

Background: Herniorrhaphy and hernioplasty are the two most common modalities used with different degree of success and complication rates in the treatment of inguinal hernia. Several studies show that use of mesh is superior to the non-mesh operations in inguinal hernia surgery.It is generally believed that the use of biomaterials should be limited to non-infected surgical fields.Now the concept regarding use of mesh in complicated hernias is changing as shown by many studies. Current study is being planned to observe the outcomes of the mesh hernioplasty in treatment of complicated inguinal hernias in emergency so that in future appropriate and safe technique may be suggested for repair of complicated hernias in emergency setting. Objectives: To compare the outcome of hernioplasty and herniorrhaphy in emergency for the treatment of complicated (Irreducible/obstructed) inguinal hernias regarding wound infection and hospital stay. Material & Methods:… Study Design: Randomized control trial. Setting: Surgical ward, Sheikh Zayed Hospital, Rahim yar khan. Period:09 months from 01-01-2016 to 30-09-2016. Sample Size: A total of 64 patients with 32 patients were included in each group, with confidence level of 95% and power of 80% and anticipated mean level of hospital stay in group 1 of 5±3.4 days versus 3±2.1 days in group 2. Sampling Technique: Non-probability, consecutive sampling. Results: In this study there were total 64 cases with 32 in each group. The mean age was 41.69±11.06 years and the mean duration of hernia obstruction was 12.83±4.97 hours. There was no significant difference in terms of age, duration of hernia and hernial obstruction between both groups. Seroma was seen in 5 (7.81%) out of 64 cases while wound infection was seen in 8 (12.50%) of cases. Seroma was seen in 2 (6.25%) out of 30 cases in herniorrhaphy as compared to 3 (9.38%) out of 32 cases with hernioplasty with p value of 0.64. Wound infection was seen in equally 4 (12.50%) out of 32 cases in both groups with p value of 1.0. Duration of hospital stay was 4.66±1.36 in patients with herniorrhaphy as compared to 4.53±1.37 days with hernioplasty with p value= 0.82. There was no significant difference in terms of age groups, duration of hernia and its obstruction between both groups regarding seroma. There was also no significant association among any of the confounding factors regarding the wound infection and length of the hospital stay between the both groups. Conclusion: We can perform hernioplasty as compared to herniorrhaphy for complicated inguinal hernia with similar complications and better success rates in the same emergency setting.

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TLIF-MIS VS TLIF-OPEN: COST EVALUATION

Coluna/Columna ◽

10.1590/s1808-185120181702189439 ◽

2018 ◽

Vol 17 (2) ◽

pp. 138-142

Author(s):

Luis Muñiz Luna ◽

Rodolfo Echeagaray Sánchez ◽

Marco Antonio Marbán Heredia ◽

Karen Aida Ibarra Stone ◽

Erika Silva Chiang

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Transforaminal Lumbar Interbody Fusion ◽

Cost Evaluation ◽

Surgical Time ◽

Level Of Evidence ◽

Surgical Costs ◽

The Mean ◽

The Difference ◽

The Cost

ABSTRACT Objective: To evaluate the direct costs of transforaminal lumbar interbody fusion (TLIF) and minimally invasive surgery (MIS) or open technique (OPEN). Methods: The present study is descriptive and retrospective. Sixteen patients with degenerative spinal pathology operated on with the TLIF MIS technique and TLIF OPEN were included over a 13-month period. Days of hospital stay, blood loss, surgical time, medical care and costs were compared. Results: The mean number of days of hospital stay was 6.7 ± 4.3 days with TLIF MIS and 11.1 ± 6.5 days with TLIF OPEN. The blood loss was 307 ± 81.6 ml (range 200400 ml) with TLIF MIS and 803 ± 701.3 ml (range 200-1800 ml) with TLIF OPEN. The surgical time was 320 ± 92.6 minutes (range 210-500 minutes) in TLIF MIS and 372 ± 95.2 minutes (280-540 minutes) in TLIF OPEN. Conclusions: The difference in surgical costs and time between the two procedures was not statistically significant. There was less bleeding during the TLIF-MIS surgery, as well as a correlation between shorter days of hospital stay proportional to bleeding and surgical time, which translates into a reduction in the cost of these items. Level of Evidence III; Analysis based on alternatives and limited costs.

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Mesh Fixation versus Non Fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair

QJM ◽

10.1093/qjmed/hcaa050.027 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A B Lachin ◽

A A Abdrabbu ◽

A A F Darwish ◽

M M K Ali

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Mesh Fixation ◽

Operation Time ◽

Fixation Group ◽

Transabdominal Preperitoneal ◽

Transabdominal Preperitoneal Inguinal Hernia

Abstract Background inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Several studies have shown that laparoscopic repair offers the advantage of minimally invasive surgery to the patient. The mesh can be placed without fixation or can be fixed into place with tuckers. Aim of the Work this study aimed to compare mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia, as regards the operation time, hospitalization, postoperative complication, recurrence and chronic pain. Patients and Methods sixty adult males with inguinal hernia were repaired with laparoscopic transabdominal preperitoneal inguinal hernia repair, divided into; mesh fixation group (n = 35) versus non-fixation group (n = 25), and certain parameters were assessed during the operative, postoperative and follow-up periods. Results mean operation time and mean hospital stay time were significantly higher in mesh fixation group than non-fixation group. VAS scores 2days, 3months, and 6months postoperative were less for non-fixation group. Non-significant difference was found between both groups regarding intraoperative injury, hernia recurrence, wound seroma, mesh infection, chronic pain, return to physical activity. Conclusion TAPP inguinal hernioplasty without mesh fixation does not increase recurrence rate, but reduces operative duration, hospital stay duration and decreases the incidence of postoperative pain.

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Fall in Vitamin D Levels during Hospitalization in Children

International Journal of Pediatrics ◽

10.1155/2014/291856 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Devi Dayal ◽

Suresh Kumar ◽

Naresh Sachdeva ◽

Rakesh Kumar ◽

Meenu Singh ◽

...

Keyword(s):

Vitamin D ◽

Hospital Stay ◽

Vitamin D Supplementation ◽

Healthcare Associated Infection ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

25 Hydroxyvitamin D ◽

The Mean ◽

The Difference ◽

Healthcare Associated

Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L,Pvalue = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P=0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters.

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