scholarly journals Serum calcium and serum phosphate levels in transfusion dependent beta thalassemia

2018 ◽  
Vol 13 (2) ◽  
pp. 54-58
Author(s):  
Mst Ariza Sultana ◽  
Qazi Shamima Akhter

Background: Patients with transfusion dependent beta thalassemia with severeanemia require regular blood transfusion to improve quality of life. This can lead to iron overload which might cause various complications including hypocalcaemia. Objective: To estimate the serum calcium and phosphate levels in transfusion dependent beta thalassemia patients. Methods: This cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2016 to June 2017. After fulfilling the ethical aspect, a total number of 60 subjects were selected with the age ranging from 5 to 25 years. Among them, 40 transfusion dependent beta thalassemia patients were selected as the study group and 20 age and sex matched apparently healthy individuals were considered as control group for comparison. The study population were selected from Thalassemia foundation hospital, Dhaka. Theserum calcium and phosphate levels were estimated by autoanalyzer.. For statistical analysis, unpaired Student’s‘t’ test, Chi-square test were performed as applicable. Results: In this study, serum calcium level were significantly (p < 0.001) lower and serum phosphate level were significantly (p < 0.001) higher in transfusion dependent beta thalassemia patients as compared to healthy controls. In addition, 67.5% thalassemia patients had hypocalcemia (calcium level < 8.5 mg/dl) and 85% of thalassemia patients had hyperphosphatemia(phosphate level > 4.7mg/dl). Conclusions: This study concludes transfusion dependent beta thalassemiapatients have low calcium level and high serum phosphate level which should be monitored to avoid complications related to hypocalcaemia and hyperphosphatemia. J Bangladesh Soc Physiol. 2018, December; 13(2): 54-58

Author(s):  
Ivana Skoumalova ◽  
Peter Kolarcik ◽  
Andrea Madarasova Geckova ◽  
Jaroslav Rosenberger ◽  
Maria Majernikova ◽  
...  

Non-adherence to dietary and fluid intake recommendations (NADFIR) is an important factor for the effective treatment of dialyzed patients and may be hindered by low health literacy (HL). Therefore, we assessed whether low HL of dialyzed patients is associated with their NADFIR. We performed a multicentric cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; response rate: 70.1%; mean age = 63.6 years; males: 60.7%). We assessed the association between nine domains of HL and non-adherence (high serum potassium, high serum phosphate, relative overhydration, and self-reported NADFIR) using general linear models adjusted for age and gender. Moreover, we assessed the moderation by socioeconomic status (SES). We found higher NADFIR among patients with less sufficient information for health management (high serum phosphate level; odds ratio (OR): 0.77; 95% confidence interval (CI): 0.63–0.94), with a lower ability to actively manage their health (self-reported diet non-adherence; OR: 0.74; 95% CI: 0.62–0.89), and those less able to actively engage with healthcare providers (overhydrated; OR: 0.78; 95% CI: 0.65–0.94). Moreover, SES modified this relation. Low HL affects the adherence of dialyzed patients. This shows a need to support patients with low HL and to train healthcare providers to work with these patients, taking into account their SES.


2020 ◽  
pp. 32-34
Author(s):  
Ashok Badakali ◽  
Deepti Shetty ◽  
Manohar MR

Chronic transfusions inevitably lead to iron overload as humans cannot actively remove excess iron. The cumulative effects of iron overload lead to significant morbidity and mortality, if untreated. The combination of transfusion and chelation therapy has dramatically extended the life expectancy of thalassemia patients, but with complications like hypocalcaemia. Hence, present study was undertaken to determine pattern and clinical profile of patients with β- thalassemia who are receiving repeated blood transfusion Methods: Hospital based study conducted at S. Nijalingappa Medical College and Hanagal Shri Kumareshwar hospital, Bagalkot. The study period was one and half year from 2015 to 2016. 53 beta thalassemia major cases fulfilling inclusion criteria were investigated after an informed consent, for serum calcium, serum phosphorous, serum ALP and paratharmone levels. Result: Among 53 transfusion dependent children studied, the mean age is 5.249 years. The study consisted of 32 (60.4%) males and 21 (39.6%) females. Maximum number of cases i.e. 29 (54.7%) were diagnosed at the age of 4-6 months. 50 (94.3%) were on iron chelation therapy. The mean serum calcium is 8.28 + 0.89 mg/dl. The mean serum phosphate is 6.40 + 0.80mg/dl, mean PTH is 14.96 + 15.49ng/L. The mean value of serum phosphate level is 14.96 + 15.49 ng/L. The mean ALP is 166.789 U/L. Conclusion: To get better results, regular testing is needed to detect the complications of the early stages with proper treatment of the factors and complications. Therefore, should be monitored to avoid complication related to hypocalcemia.


Author(s):  
Laxmi Poonia ◽  
Swati Kochar ◽  
Shweta Chaudhary ◽  
Priyanka Gaur ◽  
Kirti Solanki

Background: Hypertensive disorders of pregnancy, including preeclampsia complicates about 10% of pregnancies worldwide. Preeclampsia is one of the major cause of maternal and perinatal morbidity and mortality worldwide. According to the National Health Portal of India, the incidence of preeclampsia is reported to be about 8-10% among pregnant women. The present study was aimed to compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation and assess relationship between maternal serum calcium levels, severity of disease and overall maternal and perinatal outcome.Methods: This was a cross sectional study conducted on 200 females divided into two groups (i.e. Study and Control Group) from 1st November 2019 to 31st October 2020. Informed consent was obtained for subjecting. Detailed history and clinical examination were performed. Serum calcium level was measured in both groups by spectrophotometric method.Results: Mean serum calcium level in study group (preeclamptic) was 7.84+0.74mg/dl while in control group (normotensive) mean serum calcium level was 9.68+0.97mg/dl. Serum calcium level was significantly lower in preeclamptic women than normotensive pregnant women (p<0.001).Serum calcium showed significant negative correlation with systolic and diastolic blood pressure.Conclusions: This study concludes that hypocalcaemia may have a role in aetiology of preeclampsia and adverse maternal and perinatal outcome. Thus intake of calcium supplements may help in reduction of incidence of preeclampsia especially in a population of a developing country. 


2019 ◽  
Vol 6 (4) ◽  
pp. 1171
Author(s):  
Arvind Kumar ◽  
Prem Singh ◽  
Mohd. Imran Khan ◽  
Mehtab Alam

Background: Serum phosphate level correlate with atherosclerosis in both animal models and humans with advanced chronic kidney disease and coronary calcification is a known impact of higher serum phosphate, but whether this relationship exists among individuals with Non-CKD is unknown. we conducted this study to observe role of higher serum phosphate level in cardiovascular comorbidities like MI and CHF in Non-CKD patients.Methods: In this observational study, 300 patients were enrolled, half of the patients having Clinical features or positive biochemical markers (Troponin-I for MI and serum BNP for CHF) suggestive of myocardial infarction and heart failure were taken as case group and half of the subjects were taken as control group with similar baseline characteristics. All participants in this study were consenting and more than 18 years of age.Results: The mean value of serum phosphate level in case group was 4.41±1.40 while in control group was 3.19±1.07 showing statistically significant difference (p-value <0.001). In case group 65% patients were having MI with higher serum phosphate level (4.22±1.40).Conclusion: Higher serum phosphate level is related to increased cardiovascular morbidities even in non-CKD patients.


2020 ◽  
Vol 5 (3) ◽  
pp. 15
Author(s):  
Ajay Kumar ◽  
Abhishek Kumar ◽  
ManiRam Prasad ◽  
Chandra Prakash ◽  
Sunil Kumar Srivastav

The serum calcium level of vehicle injected fish (group-A) exhibits no alteration throughout the experiment. Vitamin D3 administration to fish Heteropneustes fossilis exhibited hypercalcemia from day 3 to day 7 (group-B). However hypophysectomized and vehicle injected fish showed hypocalcemia from day 3 to day 7 (group-C). While hypophysectomized and vitamin D3 injected fish exhibited hypercalcemia on day 3 till the end of experiment (group -D). The serum phosphate of group A fishes is unaltered throughout experiment. The phosphate level of vitamin D3   treated fish (group-B) exhibits hyperphosphatemia from day 3 to day 7. In group C fishes exhibited a significant decrease in phosphate level throughout the experiment. While the group D fishes showed hyperphosphatemia from day 3 to day 7. In group E fishes the serum calcium level remains unaffected up to day 3 the level decreases on day 5 to day 7. In group F fishes showed hypercalcemia from day 3 to day 7. In group H fishes a progressive decrease in serum calcium level is noticed on day 3 to day 7. The group H fishes shows increase in the serum calcium level from day 3 to day 7. The serum phosphate level of group E fishes showed a decrease from day 3 to day 5. The phosphate level increases from day 3 to day 7 in group F fishes. The phosphate level exhibited a decrease from day 3 to day 7 (group G). The phosphate level increases from day 5 to day 7 of group H fishes.


2016 ◽  
Vol 23 (08) ◽  
pp. 918-924
Author(s):  
Akbar Hussain Yousfani ◽  
Iqbal Ahmed Memon ◽  
Tariq Zaffar Shaikh ◽  
Zaheer Ahmed ◽  
Hamid Nawaz Ali Memon ◽  
...  

Objectives: To determine the frequency of hypophosphatemia in patientswith diabetes mellitus. Study Design: Cross sectional study. Period: Six months. Setting:Liaquat University Hospital Hyderabad. Patients and methods: All the patients of ≥35 yearsof age, either gender with known cases of diabetes mellitus type 2 for one year duration wererecruited, enrolled and evaluate for serum phosphate level. The data was analyzed in SPSS 16and the frequency and percentage was calculated. Results: During six months study period,total one hundred patients with type 2 diabetes mellitus were studied for serum phosphatelevel. The mean age ±SD for overall population was 53.85±7.63 whereas it was 54.53±6.87and 55.93±6.94 in male and female populations respectively while the mean ±SD for serumphosphate in male and female population was 1.52±0.74 and 1.90±0.93 respectively. Thehypophosphatemia was observed in 67% patients of which 37(55%) were males and 30(45%)were females (p=0.03) statistically significant. The HBA1c was raise in 72% patients of which52 cases had hypophosphatemia (p=0.05) statistically significant. Conclusion: One hundreddiabetic patients were studied and 67% shown significantly decreases serum phosphate level incontext to age and gender while raised HBA1c, shown inversely proportional relationship withHBA1c respectively.


Author(s):  
Zeina A Munim Al-Thanoon ◽  
Zeina A Munim Al-Thanoon ◽  
Mustafa Basil ◽  
Nasih A Al-Kazzaz

Iron chelation therapy with deferoxamine (DFO),the current standard for the treatment of iron overload in patients with betathalassemia,requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence,resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox (DFX) is an orally administered iron chelator that has been approved for use in many countries. The requirement of an effective,well tolerated iron chelator with a less demanding mode of administration has led to the development of deferasirox. The present study was aimed to compare the satisfaction and compliance with deferoxamine versus deferasirox (Exjade®),a novel oral iron chelator in patients with transfusion - dependent beta- thalassemia. A cross-sectional,single-center investigation study was carried out in the Thalassemia Center of Ibn-Atheer Teaching Hospital in Nineveh province,Iraq. One hundred and eight thalassemic patients aged between 2- 20 years old having received multiple blood transfusions and a serum ferritin greater than 1500 ng/ml. Patients were randomised into two groups. Group 1 received deferoxamine at a dose of 20-50mg/kg/day and group 2 received deferasirox at the dose of 10-30 mg/kg/day. Another 56 apparently healthy volunteers were used as a control group. The assessment of chelation was done during the period between November 2013 and February 2014 by measurement of serum ferritin. Satisfaction and compliance was assessed by using a special questionnaire prepared by the researcher. Out of the 108 thalassemic patients enrolled there was no discontinuation in treatment with the two drugs under study. The serum ferritin did not change significantly in any of the chelation groups. In comparison with the patients who were treated with DFO,those receiving DFX reported a significantly higher rate of compliance and satisfaction (P < 0.05). However,no significant difference was observed between the two groups regarding their satisfaction (P > 0.05).Compliance with deferasirox (50 %) was more than that with deferoxamine (20 %). Satisfaction with deferoxamine was significantly lower than deferasirox (p= 0.00).


2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.


2019 ◽  
Vol 15 (2) ◽  
pp. 120
Author(s):  
Rosita Kai ◽  
Bachtiar Murtala ◽  
Andi Alfian Zainuddin ◽  
Muzakkir Amin ◽  
Muhammad Ilyas

Increased serum calcium and phosphate associated with cardiovascular disease in patients with chronic kidney disease, but research on the relationship between coronary artery calcium scores with serum calcium and phosphate in individuals with normal kidney function is lacking. We explore the relationship of serum calcium and phosphate levels with coronary atherosclerosis as assessed by cardiac Multislice Computed Tomography (MSCT) in individuals with normal kidney function. This study aims to assess the correlation of calcium level scores on cardiac MSCT examination with serum calcium and phosphate levels, and assess the association with risk factors for coronary heart disease. This study was a cross-sectional study of 40 subjects who underwent cardiac MSCT examination with normal kidney function, at RSUP Dr. Wahidin Sudirohusodo Makassar during the March-July 2019 period. The results showed an correlation between coronary artery calcium scores with calcium and serum phosphate (serum calcium r = 0.67, serum phosphate r = 0.53, p <0.05).


2019 ◽  
Vol 9 (1) ◽  
pp. 59-62
Author(s):  
Muhammad Abdur Razzak ◽  
Debasish Kumar Saha ◽  
Muhammad Ehsan Jalil ◽  
Mohammad Omar Faruque Miah ◽  
Abu Noim Md Abdul Hai ◽  
...  

Background: The stiffness of the large elastic arteries increase the morbidity and mortality. The purpose of the present study was to estimate the risk of aortic stiffness among end stage renal disease patients on maintenance haemodialysis. Methods: This cross-sectional study was carried out in the Department of Nephrology at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka and National Institute of Cardiovascular Disease and Hospital (NICVD), Dhaka, Bangladesh from January 2013 to December 2014 for a period of two years. Chronic kidney disease in stage 5 [CKD-5(D)] patients older than 18 years on maintenance haemodialysis (MHD) for more than 3 months were designated as case group and age and sex matched non CKD patients were considered as control group. Serum calcium, serum albumin, serum phosphate and iPTH were estimated by semi-automated biochemistry analyzer from the Department of Biochemistry of NIKDU, Dhaka and NICVD, Dhaka. Plain Xray abdomen in lateral view was performed for all patients. Result: A total number of 100 patients were enrolled for this study of which 50 patients were in end stage renal disease (ESRD) group and the rest 50 patients were in non-CKD group. Mean (±SD) aortic stiffness index was significantly higher (P<0.001) among ESRD population (3.27±1.70) compared to non CKD group of population (2.00±0.73). Mean (±SD) serum calcium (corrected) level was significantly high (P<0.001) in ESRD patients (9.79±0.87) compared to non CKD group of population (9.13±0.70). Mean (±SD) serum phosphate level was significantly higher (P<0.001) in ESRD patients (5.71±0.96) compared to non CKD group of population (4.20±0.59). However, mean (±SD) iPTH level showed no significant difference between ESRD (25.33±51.98) and non CKD group of population (38.53±19.52). Conclusion: In conclusion, aortic stiffness is significantly higher among ESRD subjects. Birdem Med J 2019; 9(1): 59-62


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