Assessment of clinical and etiological factors in nail dyschromias

2021 ◽  
Vol 7 (4) ◽  
pp. 324-330
Author(s):  
Shwetha S ◽  
Lalitha C ◽  
Asha G S
Keyword(s):  
Nail Plate ◽  
Vitamin B12 Deficiency ◽  
Antiretroviral Drugs ◽  
Careful Examination ◽  
Systemic Diseases ◽  
Cross Sectional ◽  
Detailed History ◽  
Root Cause ◽  
Systemic Disorder ◽  
B12 Deficiency

Healthy nails appear smooth and have consistent coloring. Nail dyschromias have a wide variety of presentation. There are numerous causes of discoloration of the nail affecting the nail plate, nail attachments, or the substance of the nail. Different pattern of nail dyschromias can point out certain dermatological or systemic diseases. To evaluate the causes of nail dyschromias in our clinical setting.  Cross sectional observational study. 200 patients presenting with nail dyschromias were included in the study from April 2015 to July 2015. Detailed history was taken and cause for nail dyschromias was evaluated.  115 (57.5%) were males and 85 (42.05%) were females. The most seen nail dyschromia in this study was melanonychia (86.5%) followed by leukonychia (5%), blue chromonychia (5%), brown chromonychia (2%) yellow chromonychia (1.5%). The cause of nail dyschromias were:60 cases(%) were due to antiretroviral drugs, 25(12.5%) due to HIV, 30(15%) physiological melanonychia, 7(3.5% of onychomycosis, 8(4%) of lichen planus, 7(3.5%) of eczema, 15(7.5%) vitamin B12 deficiency,   10(5%) chemotherapy induced blue chromonychia, 3(1.5%) haematoma, 10(5%) leukonychia, 3(1.5%) jaundice 2(1%) Addison’s disease induced, 3(1.5%) cosmetic induced and 17(7.5%) due to other dermatological and systemic conditions. Examination of nail should always be a part of routine cutaneous examination and presentation with nail dyschromias should be worked up with the help of a good history and examination. Careful examination of the nail may help in identifying the root cause and many a times unravels some underlying systemic disorder

scholarly journals A Cross-Sectional Study on Malnutrition in Inflammatory Bowel Disease: Is There a Difference Based on Pediatric or Adult Age Grouping?

2019 ◽  
Vol 25 (8) ◽  
pp. 1428-1441 ◽  
Author(s):  
Valérie Marcil ◽  
Emile Levy ◽  
Devendra Amre ◽  
Alain Bitton ◽  
Ana Maria Guilhon de Araújo Sant’Anna ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional Study ◽  
Additional Risk Factor ◽  
Cross Sectional ◽  
Adult Age ◽  
Reactive Protein ◽  
B12 Deficiency ◽  
Inflammatory Bowel

Abstract Background Malnutrition, commonly observed in inflammatory bowel disease (IBD), is associated with increased morbidity and mortality and is attributed to multiple causes. The added energy costs of growth in the child and adolescent with IBD are an additional risk factor. Methods The aim of the study was to perform a cross-sectional comparison of nutritional parameters in IBD between pediatric and adult cases. Results We found that prevalence of undernutrition (low body mass index) and hypoalbuminemia was not different in pediatric, compared with adult patients. Anemia and iron deficiency were more often observed in pediatric subjects, compared with adults (59.1% vs 36.9%, respectively, P < 0.0001; and 37.9% vs 25.3%, P < 0.002). Vitamin B12 deficiency was significantly less common in the pediatric than in the adult group (5.4% vs 19.4%, P < 0.0001). Elevated C-reactive protein was more frequent in pediatric compared with adult cases (49.8% vs 38.4%, P < 0.01). Conclusions Patients with active Crohn’s disease were more likely to be undernourished in both pediatric and adult populations. In both groups, predicators of undernutrition included low albumin levels (odds ratio [OR], 2.53; P < 0.006) and active disease (OR, 1.99; P < 0.03). Our results call for close surveillance of nutritional status for IBD patients, regardless of age.

scholarly journals Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: a cross-sectional study

2016 ◽  
Vol 134 (6) ◽  
pp. 473-479 ◽  
Author(s):  
Charbel Pereira Damião ◽  
Amannda Oliveira Rodrigues ◽  
Maria Fernanda Miguens Castellar Pinheiro ◽  
Rubens Antunes da Cruz Filho ◽  
Gilberto Peres Cardoso ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
H2 Antagonists ◽  
H2 Antagonist ◽  
B12 Deficiency

ABSTRACT: CONTEXT AND OBJECTIVE: The prevalence of vitamin B12 deficiency varies from 5.8% to 30% among patients undergoing long-term treatment with metformin. Because of the paucity of data on Brazilian patients, this study aimed to determine the frequency of B12 deficiency and related factors among Brazilian patients with type 2 diabetes mellitus (T2DM) using metformin. DESIGN AND SETTING: Cross-sectional study at a public university hospital. METHODS: Patients with T2DM and a control group of non-diabetics were included. Serum B12 levels were measured and biochemical B12 deficiency was defined as serum levels < 180 pg/ml. Associations between B12 deficiency and age, duration of T2DM, duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) or histamine H2 antagonists were determined. RESULTS: 231 T2DM patients using metformin (T2DM-met) and 231 controls were included. No difference in the frequency of PPI or H2-antagonist use was seen between the groups. B12 deficiency was more frequent in the T2DM-met group (22.5% versus 7.4%) and this difference persisted after excluding PPI/H2-antagonist users (17.9% versus 5.6%). The factors that interfered with serum B12 levels were PPI/H2-antagonist use and duration of metformin use ≥ 10 years. Use of PPI/H2-antagonists was associated with B12 deficiency, with an odds ratio of 2.60 (95% confidence interval, 1.34-5.04). CONCLUSIONS: Among T2DM patients, treatment with metformin and concomitant use of PPI/H2-antagonists are associated with a higher chance of developing B12 deficiency than among non-diabetics.

scholarly journals Prevalence of Iron, Vitamin B12 deficiency and inflammatory anaemia in treatment naive individual consecutive cancer patients: A cross sectional study.

2020 ◽  
Author(s):  
Avinash Pandey ◽  
Shivkant Singh ◽  
Raj Aryan ◽  
Krishna Murari
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cancer Patients ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Treatment Naïve ◽  
B12 Deficiency

Background: In treatment naive Indian cancer patients, prevalence of iron, B12 deficiency and inflammatory anaemia in poorly known. Aims and Objectives : To evaluate prevalence of anaemia and iron, B12 deficiency along with inflammation in treatment naive individual consecutive cancer patients. Material and Methods: All patients registered from 1st July 2019 till 31st December 2019 in Medical Oncology Outpatient Department were offered to undergo Iron profile, Serum B12 levels and Serum ferritin along with routine haematological investigations. Anaemia was defined as Haemoglobin < 11gm/dL. Transferrin saturation <20%, Serum Ferritin >300 microgram/litre and Vitamin B12 level <200 picogram/millilitre were 'cut-offs' used to define iron deficiency, inflammation and Vitamin B12 deficiency respectively. Data was analysed using descriptive statistics, frequency distribution, crosstabs and Bar Diagram in SPSS version 17.0. Pearsons Chi square test and Odds ratio was used to measure the strength of association with variables. Results: 311/441 (70.5%) were found eligible. Median age was 52 + 15.9 (Range 18-84 ) years with 144/331(46%) females. The prevalence of anaemia was 61% + 2.7 (95% CI 55-66%). Mean Haemoglobin was 9.86 + 2.08 (range 3-16) gram/decilitre. 21/311(7%) had severe anaemia (Haemoglobin < 6.9 gm/dl). 135/311 (71%), 61/189 (32%) and 89/189 (47%) anaemic patients had iron deficiency, inflammation and B12 deficiency respectively. More than 70% of Gastrointestinal (50/69), Gynaecological(17/24) and Lung Cancer(18/22) patients had underling Iron deficiency. Conclusion: Two-third of cancer patients are iron deficient. B12 deficiency and inflammation are present in half and one-third patients respectively.

scholarly journals Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

2020 ◽  
Vol 20 (1) ◽  
pp. 90
Author(s):  
Ahmed Al-Hamdi ◽  
Mohammed Al-Gahhafi ◽  
Shihab Al-Roshdi ◽  
Sanjay Jaju ◽  
Ali Al-Mamari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
B12 Deficiency

Objectives: This study aimed to determine the prevalence of vitamin B12 deficiency amongst diabetic patients on metformin therapy. Methods: This cross-sectional study was conducted at general clinics at the University Health Center and diabetes outpatient clinics at Sultan Qaboos University Hospital, Muscat, Oman, between January and December 2017. All Omani adults who were diagnosed with type 2 diabetes mellitus and took metformin were invited to participate in the study. The variables included in this study were age, gender, duration of diabetes, dose and duration of metformin therapy, haemoglobin and glycosylated haemoglobin level. Results: A total of 248 subjects were included (response rate = 95.4%) of which 26 (10.5%) were vitamin B12 deficient and 53 (21.4%) were borderline deficient. The mean daily dose of metformin was highest among vitamin B12 deficient group (1,981 ± 222 mg; P = 0.004). Conclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Further research is needed to confirm the need for routine screening and monitoring.Keywords: Type 2 Diabetes Mellitus; Prevalence; Metformin; Vitamin B12 Deficiency; Oman.

scholarly journals Prevalence of Vitamin B12 Deficiency In Patients With Type II Diabetes Mellitus On Metformin

2021 ◽  
Vol 5 (1) ◽  
pp. 39-43
Author(s):  
D. Malla ◽  
M.R. Bajracharya ◽  
B.B. Karki ◽  
A.D. Rajouria ◽  
P.S. Shrestha
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin B12 ◽  
Medical Science ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
B12 Deficiency

Background: Diabetes Mellitus is one of the most encountered disease in our out patient department and metformin is the first drug of choice to treat Diabetes mellitus. As metformin is one of the cheapest drug, many patients use these drug for long period of time with consultation and without consultations with doctors. Patients under long term metformin use are not aware of Vitamin B12 deficiency and its associated signs and symptoms. In Nepal due to poverty, lack of education and awareness on diabetes mellitus we doctors find much difficult to explain patients on the consequences of diseases. So I decided to do this study which could be much easier to explain patients on effect of metformin of vitamin B12 levels and the consequences life style modifications and supplement of Vitamin B12 to the patients. Methods: This is a Cross-Sectional Study done in the patients with Type 2 diabetes were selected based on inclusion and exclusion criteria. Basic biochemical investigation were sent the lab of the National academy of medical science. Serum B12 assay were done. Vitamin B12 deficiency is defined as values <150pg/ml. Association between vitamin B12 deficiency with duration of metformin therapy, duration of diabetes, with age, sex were done. Results: The mean vitamin B12 level is low as the duration of metformin treatment increases. The sex, age relation with development of vitamin B12 deficiency was not significant. In my study out of 210 patients 107 patients were having severe vitamin B12 deficiency level and 63 patients had a borderline Vitamin B12 deficiency level which shows that the deficiency increases as per longer use of metformin, which shows prevalence of 50.95%. Conclusions: Vitamin B12 deficiency occurs in type 2 diabetes mellitus patients treated with long term metformin. The duration of metformin therapy significantly affects the development of vitamin B12 deficiency. As a treating physician we always need to explain our patients about the side effect of metformin and regular follow up and investigations must be done to early diagnosis of vitamin B12 deficiency to improve the quality of life.

Vitamin B12 Deficiency and the Role of Gender: A Cross-Sectional Study of a Large Cohort

2018 ◽  
Vol 72 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Ili Margalit ◽  
Eytan Cohen ◽  
Elad Goldberg ◽  
Ilan Krause
Keyword(s):  
Gender Differences ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Healthy Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
B12 Deficiency

Background: Vitamin B12 deficiency is associated with hematological, neurological, and cardiovascular consequences. Epidemiologic data on these related illnesses indicate gender differences. Methods: A cross-sectional study was designed to examine gender differences in vitamin B12 deficiency among a healthy population. Data from healthy individuals aged 18–65, who were provided with a routine medical evaluation during 2000–2014, were retrieved from the medical charts. Individuals with background illnesses and those who had used medications or nutritional supplements were excluded. Vitamin B12 deficiency was defined by 2 cutoff values (206 and 140 pmol/L). The multivariate analysis was adjusted for age, body mass index, estimated glomerular filtration rate, hyperhomocysteinemia, folate deficiency, albumin, and transferrin saturation. Sensitivity analyses were implemented by excluding individuals with anemia, hyperhomocysteinemia, or folate deficiency and by age stratification. Results: In all, 7,963 individuals met the inclusion criteria. Serum vitamin B12 mean levels were 312.36 and 284.31 pmol/L for women and men respectively (p < 0.001). Deficiency prevalence was greater for men (25.5%) in comparison with women (18.9%; p < 0.001). Men were strongly associated with severe deficiency (adjusted OR 2.26; 95% CI 1.43–3.56). Conclusions: Among the healthy population, men are susceptible to vitamin B12 deficiency. This can be explained by neither diet habits nor estrogen effects. Genetic variations are therefore hypothesized to play a role.

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