scholarly journals Profile of Vitamin B12 Deficiency and Analysis of Contributory Factors among Inpatients in a Tertiary Care Hospital in Madurai, South India

2020 ◽  
Vol 7 (46) ◽  
pp. 2674-2679
Author(s):  
Vairapraveena Ramesh ◽  
Sangeetha Ashokan ◽  
Anu Sengottaiyan ◽  
Vijay Anto James
Keyword(s):  
Vitamin B12 ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Cooking Methods ◽  
Care Hospital ◽  
Contributing Factors ◽  
History Of ◽  
B12 Deficiency

BACKGROUND It is well known that Vitamin B12 deficiency is common among vegetarians as Vitamin B12 is obtained predominantly from animal sources. However, recent reports show that Vitamin B12 deficiency is becoming more common among nonvegetarians too and surprisingly the major factor attributing to this is found to be due to dietary deficiency. We hypothesized that this could also be due to the type of non-vegetarian food consumed, cooking methods, type of utensil used, and other modifiable risk factors like smoking, alcohol and diseases causing Vitamin B12 deficiency. We wanted to assess the proportion of vegetarians and nonvegetarians with vit. B12 deficiency and analyse the contributing factors among inpatients with vitamin B12 deficiency in a tertiary care hospital in South India. METHODS This observational, prospective study was done between June and September 2019 & involved 200 Vitamin B12 deficiency patients in the age group of 20 - 50 years of both the genders. Patients were identified after reviewing their medical records and laboratory tests for MCV, MCH, MCHC, Hb & vitamin B12. A detailed history of their food habits, practices & other relevant factors was obtained using a questionnaire. Statistical analysis was done using Mann Whitney U test. RESULTS There was no statistical difference (p = 0.379) in the vitamin B12 levels among vegetarians and non-vegetarians. 54.6 % of participants consumed poultry, 32.5 % consumed fruits & vegetables less than 4 times a week, 36 % & 42 % consumed fried & boiled food, 58 % used ever-silver vessels for cooking, 70.6 % used packaged milk, 23 % consumed alcohol & 21 % were smokers. CONCLUSIONS Vitamin B12 deficiency is common both among vegetarians and non-vegetarians. Among non-vegetarians, deficiency is seen more with poultry eaters, packaged milk consumers, with fried / boiled method of cooking using ever-silver vessels. Alcoholism, caffeinated beverages, smoking, presence of other diseases like diabetes, hypertension, peptic ulcer, drug intake also contributes to Vitamin B12 deficiency. KEYWORDS Vitamin B12 Deficiency, Non-Vegetarians, Vegetarians, Contributing Factors

scholarly journals Clinicohematological profile of pancytopenia: a study from a tertiary care hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 478
Author(s):  
Rakesh Kumar Yadav ◽  
Sujit Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Clinical Feature ◽  
Study Group ◽  
Care Hospital ◽  
Female Ratio ◽  
B12 Deficiency

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.

scholarly journals Study of the prevalence of isolated vitamin B12 deficiency related dementia in patients presenting to a tertiary care hospital

2020 ◽  
Vol 7 (4) ◽  
pp. 694
Author(s):  
Patirla Devendra Reddy ◽  
Pranavendra Nath Seela ◽  
Pravin Gulab Rao Maske
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Vitamin B12 Deficiency ◽  
Peripheral Blood Smear ◽  
Vegetarian Diet ◽  
Care Hospital ◽  
History Of ◽  
B12 Deficiency ◽  
One Year

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.

scholarly journals Vitamin B12 deficiency in psychiatric patients admitted in a tertiary care hospital

2020 ◽  
Vol 4 (2) ◽  
pp. 196
Author(s):  
Sunayna Pandey ◽  
NimeshC Parikh ◽  
HarshJ Oza ◽  
ShreyaseeS Bhowmick
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Care Hospital ◽  
B12 Deficiency

scholarly journals Prevalence and Correlates of Vitamin B12 Deficiency among Depressive Patients Presenting in the Tertiary Care Hospital of Gandaki Province of Nepal

2020 ◽  
Vol 4 (3) ◽  
pp. 822-825
Author(s):  
Jai Bahadur Khattri ◽  
Srijana Thapa Godar ◽  
Anil Subedi
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care ◽  
Geographical Area ◽  
Vitamin B12 Deficiency ◽  
Demographic Variables ◽  
Care Hospital ◽  
B12 Deficiency ◽  
Depressive Episodes ◽  
Depressive Patients

Introduction: The prevalence of vitamin B12 deficiency in depression is not clear and more research is needed. Objectives: The objective of this study is to find the prevalence of deficiency of vitamin B12 level in the depressed patient. The second objective is to find the prevalence of deficiency of vitamin B12 according to different socio-demographic variables. Methodology: The patients diagnosed as depressive episodes according to the International Classification of Disease – 10 Classification of Mental and Behavioural Disorders were selected from the Psychiatric Out-Patient Department of Manipal Teaching Hospital, Pokhara.  The proforma was used to collect the socio-demographic profile of the patient. The serum sample of the 50 patients was sent for vitamin B12 estimation. Serum concentrations less than 239 pg/ml was considered deficient in this study. Results: The overall prevalence of vitamin B12 deficiency was 22% in the depressed patients. The mean age of the total patients were 39.2 years with the standard deviation of 13.75 years. Vitamin B12 deficiency was more prevalent in the socio-demographic variables like age above 61 years, Brahmin and Chhetri caste, female gender, unmarried groups, and in the patients living in the urban area as compared to other variables. Conclusion: The result shows that vitamin B12 deficiency is common in the patients with depression. Clinicians should be aware of the risk for vitamin B12 deficiency in depressive patients.  As this study was done in limited geographical area and sample size being small, further larger studies are needed before generalizing these results.

Abstract T P377: Vitamin B12 Deficiency - A Poorly Recognised and Treatable Childhood Stroke Risk Factor

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Zarah Yusuf ◽  
Jayanthi Alamelu ◽  
Ming Lim ◽  
Nomazulu Dlamini
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Vitamin B12 ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Care Hospital ◽  
Childhood Stroke ◽  
Stroke Risk Factor ◽  
B12 Deficiency ◽  
Age Range

Introduction: Risk factors in childhood stroke are multiple and causality hard to determine. Current guidelines recommend prothrombotic workup, yet yield is variable, often without therapeutic consequence. Raised homocysteine is associated with vitamin B12 deficiency (B12), which is not routinely measured. Hypothesis: We hypothesised that B12 deficiency is a treatable risk factor for stroke in children not reliably identified by analysis of homocysteine only. Method: We retrospectively reviewed paediatric stroke patients admitted to a tertiary care hospital from 2010-2014. All patients with plasma homocysteine measured as part of their prothrombotic workup were selected. All clinical data closest to stroke diagnosis were reviewed. B12 deficiency was defined as low total and/or holo (functional) vitamin B12 with/without raised methylmalonic acid (MMA). Parental prothrombotic workup and B12 status was analysed where available. Results: Of 134 patients, 61 had homocysteine levels, 20 were tested for vitamin B12 (age range 0-14.8 years), 14/20 for MMA. B12 deficiency was found in 7/20 with median age of acute stroke presentation of 1 day (25th percentile= 0; 75th percentile= 51days). Median age of stroke presentation in B12 replete group was 3.5 years (25th percentile=2.0;75th percentile=7.0years). There was a statistical difference in age of stroke presentation between the B12 deficient and replete groups (Kruskal-Wallis, p=0.001). Raised homocysteine (10/20) was not sensitive in detecting B12 deficiency (sensitivity 42.8%, 95% CI 15.82-74.95). Two of seven had additional risk factors (1/7 iron deficiency, 1/7 MTHFR 667 homozygous). Seizures were the most common stroke presentation regardless of B12 status. Vitamin B12 (im) was given in 4/7 children and 3/9 parents (2 mothers, 1 father). Five of seven were breast fed. All treated parents were vegetarian. Conclusion: Our study suggests vitamin B12 deficiency is associated with early childhood stroke. Homocysteine alone is not a sensitive screen for this. Investigation with functional biomarkers such as holo B12 and MMA would allow for improved detection of a treatable risk factor in childhood stroke. Further studies may support this recommendation being added to guidelines.

scholarly journals Postelimination Status of Childhood Leprosy: Report from a Tertiary-Care Hospital in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
P. Chaitra ◽  
Ramesh Marne Bhat
Keyword(s):  
Medical Records ◽  
South India ◽  
Tertiary Care Hospital ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Care Hospital ◽  
Older Children ◽  
History Of ◽  
Clinicopathological Pattern ◽  
Different Parts

Introduction. Leprosy, a statistically “eliminated” disease from the globe, continues to linger around in its endemic countries including India.Objective. This study describes the epidemiological and clinicopathological pattern of the disease seen in children over a period of 8 years following its elimination in India.Materials and Methods. Medical records of all leprosy cases up to 14 years of age registered between April 2005 and March 2013 were retrospectively analyzed. Data were retrieved using a predesigned proforma and entered into the database system for analysis.Results. Child proportion of newly registered leprosy cases did not show a significant decline in the years following its elimination. The disease seemed to manifest frequently in older children with an insignificant gender predilection. More than half of child cases had a history of household contact. Paucibacillary leprosy dominated in them with a solitary skin lesion as the most frequent presentation. Although nerve thickening was seen in nearly half of these children, neuritis and lepra reactions were less common. Deformity at the time of diagnosis was noted in 13.89% of cases. Although smear positivity was not a common feature in children affected with leprosy, a good clinicohistopathological correlation was observed in those who underwent biopsy.Conclusion. Our study and reports from different parts of the country depict the unturned curves in the epidemiology of childhood leprosy which mirrors active transmission in the community, lacunae in diagnosis, and the need to strengthen contact screening activities in the pediatric population to sustain elimination.

scholarly journals Prevalence of vitamin D and B12 deficiency in pregnant women in Jammu, India

2020 ◽  
Vol 8 (4) ◽  
pp. 1245
Author(s):  
Sapneet Kaur ◽  
Harleen Kaur
Keyword(s):  
Vitamin D ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Care Hospital ◽  
Jammu And Kashmir ◽  
Vitamin D Levels ◽  
Good Nutrition ◽  
B12 Deficiency

Background: Micronutrient deficiency is pandemic proportions among pregnant women in India, but there is scarcity of searchable data on  coexistence vitamin D status  and Vitamin B 12 in pregnant women in Jammu and Kashmir, hence we have assessed the vitamin D as well as Vitamin B12 status in pregnant women 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 2019 to February, 2020 and after obtaining informed consent, a total of 150 pregnant women, attending SMGS Hospital Jammu were screened for their vitamin D (25 OH-D) and vitamin B12 status by using Abbott architect chemiluminescent micro particle immunoassay.Results: A total of 150 pregnant women were  screened in the study , 129 (86%) were found to be having insufficient vitamin D levels in their blood (<30 ngm/dl) and 105 ( 70%)  women showed severe deficiency with vitamin D levels below 20 ngm/dl.108 (72%) pregnant women had vitamin B12 deficiency with levels below 200 pgm/ml.Conclusions: The study revealed a high prevalence of coexistence of Vitamin D and Vitamin B12 deficiency in pregnant women, 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.

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