Comparison of outcome of total thyroidectomy with and without pre-operative calcium and vitamin D supplements in terms of post-operative hypocalcemia.

Objective: The objective of this study is to compare the effect of pre-operative calcium and vitamin D supplements in terms of hypocalcemia in patients with total thyroidectomy. Study Design: Comparative study. Setting: EAST Surgical Ward, MAYO Hospital Lahore, Pakistan. Period: 1st July 2018 to 30th June 2020. Material & Methods: Sample size of 342 patients and duration of 2 years. 2 groups were created including 171 patients each. Group A patients received calcium and vitamin D supplements 1 week prior to total thyroidectomy while Group B patients didn’t receive any supplements. The results of both groups were compared. Data was collected by pre designed proforma and evaluated by SPSS 21. Results: 164 (47.9%) patients were male and 178 (52.0%) were females. Most common age group which undergone total thyroidectomy was between 31 years to 40 years. Total 140 patients (40.93%) experienced hypocalcemia. In group A, 32 (18.71%) experienced hypocalcemia while in group B 108 (63.1%) experienced hypocalcemia. The most common occurrence of hypocalcemia was noted on 1st post-operative day where 52 (37.14%) cases of hypocalcemia were reported. Conclusion: In a country with prevalent calcium and vitamin D deficiency the addition of these supplements one week prior to total thyroidectomy will lead to lesser incidence of hypocalcemia after total thyroidectomy and early discharge of the patient.

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Is preoperative calcium and vitamin D supplementation effective in prevention of postoperative hypocalcaemia in thyroidectomised patients?

Archives of Medical Science ◽

10.5114/aoms/121044 ◽

2021 ◽

Author(s):

Anna Grzegory ◽

Lech Pomorski ◽

Konrad Pagacz ◽

Karol Sieniawski ◽

Krzysztof Kaczka

Keyword(s):

Vitamin D ◽

Calcium Carbonate ◽

Total Thyroidectomy ◽

Vitamin D Supplementation ◽

Oral Supplementation ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Group A ◽

25 Hydroxyvitamin D ◽

Group B

IntroductionHypocalcaemia remains the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.Material and methodsOne hundred fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not to receive (group A) calcium carbonate (3 g/d) and alfacalcidol (1 µg/d) on the day before surgery and calcium carbonate (1 g/d) and alfacalcidol (1 µg/d) taken once in the morning on the day of operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 hour postoperatively and 6 weeks after surgery.ResultsSymptomatic hypocalcaemia was observed in 41/153(26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p<0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium <2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p=0.04, p<0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p=0.06). 112(73.20%) participants had 25-OHD<20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p=0.98).ConclusionsOral supplementation of calcium and alfacalcidol may help in the prevention of postthyroidectomy hypocalcaemia. Vitamin D deficiency was widespread among operated patients.

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To study the effect of oral vitamin D supplements on wound healing in patient with diabetic foot ulcer and its effect on lipid metabolism

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i2.2290 ◽

2020 ◽

Vol 11 (2) ◽

pp. 2701-2706

Author(s):

Ajoinish Kamble ◽

Ranjit S. Ambad ◽

Mangesh Padamwar ◽

Anupam Kakade ◽

Meenakshi Yeola

Keyword(s):

Vitamin D ◽

Wound Healing ◽

Diabetic Foot ◽

Density Lipoprotein ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Vitamin D Levels ◽

Group A ◽

Vitamin D Supplements ◽

Group B

To Critically Assess the effect of oral vitamin D supplements on wound healing in a patient with diabetic foot ulcer and its impact on lipid metabolism. This is a single-Centre prospective randomised, control-controlled study was conducted in Department of Surgery Datta Meghe Medical College, Hingna, Nagpur, in collaboration with Datta Meghe Institute of Medical Sciences (DMIMS) Deemed to be University from June 2019 TO March 2020. A total of sixty patients were included in this study. A randomised grouping was done, group A vitamin d supplements and group B as an x-control group. In the group, A vitamin D levels were significantly increased after 12 weeks of intervention as compared to baseline while in group B, no change was seen after the intervention. There was a significant change in HbA1c level after intervention as group A vs group B. similar results were seen in total cholesterol levels after intervention in group A, and group B. Wound surface area was (29.83±15.02 vs 21.76±11.30, p=0.02) in group A and (25.06±14.02 vs 21.3±13.19, p=0.28) in group B respectively. The level of high-density lipoprotein in the group was significantly lower in level when compared to group A after 12 weeks of intervention. No significant changes were seen in the triglycerides level in group A and group B., A comparison of group A vs group B after 12 weeks of intervention, was done. It revealed that Vitamin D Glycosylated total haemoglobin cholesterol, High-density lipoprotein and Wound surface area, significantly improved. At the same time, there was no change seen in triglycerides levels in both the group.After intervention with vitamin D supplements for 12 weeks among patients with diabetic foot ulcer had a good result and beneficial effect on glucose metabolism, vitamin D levels, lipid profile and wound healing

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Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers

Scientific Reports ◽

10.1038/s41598-020-77093-z ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 3

Author(s):

Anshul Jain ◽

Rachna Chaurasia ◽

Narendra Singh Sengar ◽

Mayank Singh ◽

Sachin Mahor ◽

...

Keyword(s):

Vitamin D ◽

Serum Ferritin ◽

Inflammatory Markers ◽

Clinical Severity ◽

Medical College ◽

Marked Variability ◽

Group A ◽

The Difference ◽

Vitamin D Supplements ◽

Group B

AbstractCOVID-19 is characterized by marked variability in clinical severity. Vitamin D had recently been reviewed as one of the factors that may affect the severity in COVID-19. The objective of current study is to analyze the vitamin D level in COVID-19 patients and its impact on the disease severity. After approval from Ethics Committee, M.L.B Medical College the current study was undertaken as continuous prospective observational study of 6 weeks. Participants were COVID-19 patients of age group 30–60 years admitted during the study period of 6 weeks. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Serum concentration of 25 (OH)D, were measured along with serum IL-6; TNFα and serum ferritin. Standard statistical analysis was performed to analyze the differences. Current Study enrolled 154 patients, 91 in Group A and 63 patients in Group B. The mean level of vitamin D (in ng/mL) was 27.89 ± 6.21 in Group A and 14.35 ± 5.79 in Group B, the difference was highly significant. The prevalence of vitamin D deficiency was 32.96% and 96.82% respectively in Group A and Group B. Out of total 154 patients, 90 patients were found to be deficient in vitamin D (Group A: 29; Group B: 61). Serum level of inflammatory markers was found to be higher in vitamin D deficient COVID-19 patients viz. IL-6 level (in pg/mL) 19.34 ± 6.17 vs 12.18 ± 4.29; Serum ferritin 319.17 ± 38.21 ng/mL vs 186.83 ± 20.18 ng/mL; TNFα level (in pg/mL) 13.26 ± 5.64 vs 11.87 ± 3.15. The fatality rate was high in vitamin D deficient (21% vs 3.1%). Vitamin D level is markedly low in severe COVID-19 patients. Inflammatory response is high in vitamin D deficient COVID-19 patients. This all translates into increased mortality in vitamin D deficient COVID-19 patients. As per the flexible approach in the current COVID-19 pandemic authors recommend mass administration of vitamin D supplements to population at risk for COVID-19.

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A prospective analysis of vitamin D and recurrent benign paroxysmal positional vertigo

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194924 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1548

Author(s):

N. Gopinathan Pillai ◽

Induvarsha Gopinath

Keyword(s):

Vitamin D ◽

Benign Paroxysmal Positional Vertigo ◽

Vitamin D Supplementation ◽

Vitamin Deficiencies ◽

Positional Vertigo ◽

Group A ◽

Vitamin D Supplements ◽

Group B ◽

Paroxysmal Positional Vertigo

Background: The aim of the present study was to prospectively evaluate the role of vitamin D in the recurrence of Benign paroxysmal positional vertigo (BPPV). The BPPV is one of the commonest causes for peripheral vertigo. Many studies stated that BPPV can be associated with many co-morbidities and vitamin deficiencies.Methods: In our study, we prospectively conducted an observational study in patients suffering from BPPV, from a study period of June 2015 to June 2018, to evaluate the role of vitamin D and calcium in those patients.Results: Three forty eight patients between the age group of 40 to 82 years, suffering from BPPV were included in the study. It includes 235 females and 113 male patients. Out of these 108 patients had noticed vitamin D deficiency and were randomly divided into 2 groups in which group A received Vitamin D supplementation and Group B did not received vitamin D supplements. Calcium levels were found to be less in 15 patients between 7 and 10.5 mg/dl, however a larger sample is required for its correlation. All patients were followed up for 1 year.Conclusions: The study showed a significant decrease of BPPV in those who received vitamin D supplementation.

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Advancing the Understanding of Vitamin D Status in Post-Thyroidectomy Hypocalcemia

International Journal of Endocrinology ◽

10.1155/2021/5598319 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Gurdeep Singh ◽

Fatima Irshaidat ◽

Christopher Lau ◽

Ariel Pedoeem ◽

Christine Feng ◽

...

Keyword(s):

Vitamin D ◽

Total Thyroidectomy ◽

Reference Range ◽

Common Complication ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Group A ◽

25 Hydroxyvitamin D ◽

Group B

Background. Post-thyroidectomy hypocalcemia is the most common complication after total thyroidectomy. Studies to examine the role of low vitamin D in increasing post-thyroidectomy hypocalcemia incidence have produced varying results. This study aimed to assess whether vitamin D deficiency increases the risk of post-thyroidectomy hypocalcemia. Methods. This retrospective study involved 244 patients who underwent total thyroidectomy between 2014 and 2019. Patients were divided into two groups based on pre-operative vitamin D levels. Group A and Group B had pre-operative vitamin D (25-hydroxyvitamin D) levels of ≥20 ng/ml and <20 ng/ml (reference range for vitamin D is 30–100 ng/dl). The effect of vitamin D, gender, body mass index (BMI), and ethnicity on post-operative calcium and PTH levels was analyzed. Results. Post-operative calcium levels for Group A were not statistically different compared to Group B (8.52 ± 0.64 mg/dl vs. 8.45 ± 0.58 mg/dl (mean ± S.D.; p value = 0.352). The average post-operative PTH of the two groups did not differ significantly (Group A: 32.4 ± 27.5 pg/ml; Group B: 34.4 ± 41.7 pg/ml; p value = 0.761). Conclusion. Pre-operative vitamin D levels are not predictive of post-thyroidectomy hypocalcemia.

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Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v2i2.34097 ◽

2017 ◽

Vol 2 (2) ◽

pp. 69-74

Author(s):

Mohammad Aminullah ◽

Fahmida Akter Rima ◽

Asraful Hoque ◽

Mokhlesur Rahman Sazal ◽

Prodip Biswas ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Ejection Fraction ◽

Cardiac Remodeling ◽

Septal Defect ◽

Left Ventricular ◽

Age Group ◽

Surgical Closure ◽

Group A ◽

Group B ◽

Fractional Shortening

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

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Impact of the 25-Hydroxycholecalciferol Concentration and Vitamin D Deficiency Treatment on Changes in the Bone Level at the Implant Site during the Process of Osseointegration: A Prospective, Randomized, Controlled Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10030526 ◽

2021 ◽

Vol 10 (3) ◽

pp. 526

Author(s):

Jakub Kwiatek ◽

Aleksandra Jaroń ◽

Grzegorz Trybek

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Controlled Clinical Trial ◽

Randomized Controlled ◽

Group A ◽

Bone Level ◽

Group B ◽

Implant Treatment ◽

Correct Level ◽

25 Hydroxycholecalciferol

Introduction: The most important factor which is responsible for the positive course of implant treatment is the process of osseointegration between the implant structure and the host’s bone tissue. The aim of this study was to assess what effect the 25-hydroxycholecalciferol concentration and vitamin D deficiency treatment have on changes in the bone level at the implant site during the process of osseointegration in the mandible. Materials and Methods: The study was with 122 people qualified for implant surgery, who were assigned to three research groups (A, B, and C). Laboratory, clinical, and radiological tests were performed on the day of surgery, and after 6 and 12 weeks. The bone level in the immediate proximity of the implant was determined by radiovisiography (RVG). Results: The bone level after 12 weeks in Groups B and C was significantly higher than after 6 weeks. The bone level in the study Group B was significantly higher than in Group A. The study showed that the higher the levels of 25-hydroxycholecalciferol were observed on the day of surgery, the higher was the level of bone surrounding the implant after 6 and 12 after surgery. Conclusion: The correct level of 25-hydroxycholecalciferol on the day of surgery and vitamin D deficiency treatment significantly increase the bone level at the implant site in the process of radiologically assessed osseointegration.

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RANDOMIZED COMPARATIVE STUDY OF ONDANSETRON AND COMBINATION OF ONDANSETRON AND DEXAMETHASONE, AS A PROPHYLAXIS OF POST-OPERATIVE NAUSEAAND VOMITING IN ADULTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERIES

10.36106/ijsr/3207561 ◽

2021 ◽

pp. 48-49

Author(s):

Rumani Ruku ◽

Jasmeen Chowdhary

Keyword(s):

Laparoscopic Surgery ◽

Surgical Care ◽

Demographic Variables ◽

Nausea And Vomiting ◽

Age Group ◽

Patient Response ◽

High Incidence ◽

Group A ◽

Group B ◽

Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) is quite associated with laparoscopic surgery. In-spite of advances in surgery and post surgical care, nausea and vomiting still has a high incidence. This study was planned to explore the efcacy of a combination therapy of ondansetron with dexamethasone against PONVand compare the results with the efcacy of ondensetron-only. Method:Arandomized clinical trial study was conducted in the Department of Anesthesia, GMC Jammu, over a period of 6 months, on 50 patients in the age group of 18-50 years, of either gender, undergoing laparoscopic surgeries under general anesthesia. Patients were divided into two groups of 25 each: Group A received 4 mg of Ondansetron intravenously, while Group B received 4 mg of Ondansetron and 8 mg of Dexamethasone intravenously, soon after intubation. Results: The demographic variables of two groups were similar. While 19 (76%) patients showed post-operative nausea in Group A, while in Group B, only 8 (32%) patients experienced nausea, which was very signicant. Similarly, 11 (44%) patients showed post-operative vomiting in GroupAand only 2 (8%) complained of vomiting. 24% patients did not complain about any kind of nausea or vomiting in GroupA. Mild nausea was observedin60%patientsinGroupA,while amongonly32%patientsingroupB.Nocomplications of anykindwereobservedduringthisstudy. Conclusion: Ondensetron and dexamethasone, administered intravenously, after intubation, in laparoscopic surgery, is safe and has a better patient response in preventing post-operative nausea and vomiting.

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A CLINICAL EVALUATION OF MATRA BASTI AND KATI BASTI WITH DHANWANTARAM TAILA IN THE MANAGEMENT OF GRIDHRASI

International Journal of Ayurveda and Pharma Research ◽

10.47070/ijapr.v9i4.1910 ◽

2021 ◽

pp. 17-31

Author(s):

N. Haritha ◽

Rashmi. R ◽

Nighil Gigi ◽

Binu.M.B

Keyword(s):

Clinical Evaluation ◽

Combined Treatment ◽

Signs And Symptoms ◽

Age Group ◽

Group A ◽

Group B

Gridhrasi comes under 80 types of Nanatmaja Vatavyadhi. The cardinal signs and symptoms of Gridhrasi are Ruk (pain), Toda (pricking sensation), Spandana (twitching) in the Sphik, Kati, Uru, Janu, Jangha and Pada in order and Sakthikshepa Nigraha i.e., restricted lifting of the leg associated with Gourava, Aruchi. Kati Basti is widely being practiced throughout country as Bahyaupakrama which has both Snehana and Swedana effects. Matra Basti is Snehana procedure which does Vataanulomana, Vatashamana. Objectives: To evaluate the efficacy of Matrabasti and Katibasti with Dhanvantaram Taila in the management of Gridhrasi. Materials and Methods: Patients presenting with the classical features of Gridhrasi and between the age group of 16 to 50 years irrespective of sex were selected and allotted in Group A, B and C with 15 patients in each group. Group A was administered with Matra basti with Dhanwantram Taila and Group B with Kati basti with Dhanwantram Taila and Group C with both Matra basti and Kati basti with Dhanwantram Taila for 9 days. Results: In combined treatment of Kati Basti and Matra Basti in Group C there was tremendous response in relieving Ruk (73%), Toda (46%), Spandana (60%), Supti (80%), Gourava (73%), Aruchi (66%), Sparshasahyata (73.3%) SLR (60%). In Group A, patients subjected to Matra Basti was effective in relieving Ruk (26.7%), Toda (13.3%), Spandana (26.7%), Supti (66.7%), Gourava (46.7%), Aruchi (53.3%), Sparshasahyata (13.3%) SLR (6.7%). In Group B patients subjected to Kati Basti was effective in relieving Ruk (6.7%), Toda (0%), Spandana (0%), Supti (40%), Gourava (20%), Aruchi (0%), Sparshasahyata (20%) SLR (0%). Conclusion: On the basis of the results of this study, it can be clearly concluded that combined treatment of Matrabasti and Kati basti with Dhanwantaram taila provided significant relief in the signs and symptoms of Gridhrasi than individually performed Matra basti and Kati basti with Dhanwantaram taila.

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Time out: should vitamin D dosing be based on patient's body mass index (BMI): a prospective controlled study

Journal of Nutritional Science ◽

10.1017/jns.2021.100 ◽

2021 ◽

Vol 10 ◽

Author(s):

Mir Sadat-Ali ◽

Khalid W. AlTabash ◽

Haifa A. Al-Turki ◽

Sulaiman A. AlMousa ◽

Hasan N. AlSayed

Keyword(s):

Vitamin D ◽

Vitamin D3 ◽

Standard Dose ◽

Demographic Data ◽

Controlled Study ◽

Daily Dose ◽

Calcium Phosphorus ◽

Group A ◽

Pre Treatment ◽

Group B

Abstract The recommended daily dose of vitamin D is 2000 IU was found to be insufficient in many patients. The objective of the present study is to find whether the daily dose of vitamin D should be based on BMI. Two hundred and thirty patients with an established vitamin D deficiency (serum level of 25 Hydroxy vitamin D3 (25OHD3) of ≤20 ng/ml) and patients with BMI ≥30 kg/m2 were included in the study. Demographic data, comorbidities and BMI were recorded. Pre-treatment and post-treatment serum 25OHD3, calcium, phosphorus and parathyroid hormone (PTH) were tested at 0-, 3- and 6-month periods. Patients were treated with a standard dose of 50 000 IU of vitamin D weekly and 600/1200 mg of calcium a day. Once their level of 25OHD3 reached ≥30 ng/ml, patients were randomised into two groups. Group A received a standard recommended maintenance dose of 2000 IU daily and Group B patients received 125 IU/kg/m2 of vitamin D3. The data were entered in the database and analysed. The mean age of Group A was 50⋅74 ± 7⋅64 years compared to 52⋅32 ± 7⋅21 years in Group B. In both groups, pre-treatment vitamin D level was ≤15 ng/ml and increased to 34⋅6 ± 2⋅6 and 33⋅7 ± 2⋅4 ng/ml at the end of 3 months treatment with a dose 50 000 IU of vitamin D3 and calcium 600/1200 mg once a day for group A and group B, respectively. At 6 months, patients in Group A 25OHD3 level was 22⋅8 ± 3⋅80 and in Group B was 34⋅0 ± 1⋅85 ng/ml (P < 0⋅001). This preliminary study suggests that obese patients need higher dosage of vitamin D than the recommended dose. It is prudent that the dosage should be based on the BMI to maintain normal levels for a healthy musculoskeletal system.

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