scholarly journals Serum Calcium Level in Mild and Severe Preeclampsia- A study in Combined Military Hospital, Dhaka

2018 ◽  
Vol 9 (1) ◽  
pp. 255-257
Author(s):  
Marlina Roy ◽  
Asma Rahman ◽  
Hafsa Begum ◽  
Rokeya Khan ◽  
Nasrin Hasan ◽  
...  

Background : Hypertensive disorders are the most common medical complications during pregnancy and are associated with high maternal and fetal mortality and morbidity.Half of the pregnant women with hypertension have preeclampsia. Association of low serum calcium level with preeclampsia(PE) is known decades together.Objectives : To assess serum calcium level in mild and severe preeclampsia(PE).Materials and Method : This was a comparative cross sectional study conducted in the department of Obstetric and Gynaecology, Combined Military Hospital (CMH),Dhaka, Bangladesh. The data were collected from 50 mild preeclampsia and 50 severe preeclampsia patients admitted in Obstetric and Gynaecology ward of CMH who fulfill the inclusion criteria. Study period was July 2015 to December 2015. Serum calcium was measured in Auto analyzer machine in the clinical pathology of Armed forced Institute of pathology (AFIP). Data were analyzed by statistical software, SPSS version 20.Results : Serum calcium level was found in severe PE was 8.12mg/dl and in mild PE was 8.85mg/dl. Study also reveals that routine calcium supplementation was consumed less in severe PE than mild PE patients.Conclusion : Serum calcium is markedly reduce in severe preeclampsia than in mild preeclampsia. Therefore routine examination of serum calcium level may be useful as diagnostic marker in high risk pregnancy.Northern International Medical College Journal Vol.9(1) July 2017: 255-257

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.


2020 ◽  
Vol 51 (2) ◽  
pp. 160-167
Author(s):  
Sayaka Kuroya ◽  
Masahiko Yazawa ◽  
Yugo Shibagaki ◽  
Naoto Tominaga

Background: Patients with permanent postsurgical hypoparathyroidism, a complication of total thyroidectomy, often require high calcium supplementation with vitamin D to maintain serum calcium levels. The epidemiology of calcium-alkali syndrome (CAS) in patients with hypoparathyroidism after total thyroidectomy remains unclear. This study aimed to investigate the incidence of hypercalcemia, renal impairment, metabolic alkalosis, and CAS in patients treated for presumed hypoparathyroidism after total thyroidectomy. Methods: Twenty-seven patients with neck cancers who underwent total thyroidectomy without parathyroid autotransplantation between January 2010 and October 2013 at our hospital were consecutively included. All patients received calcium lactate and alfacalcidol for postsurgical hypocalcemia. We defined hypercalcemia as a corrected serum calcium level (cCa) ≥10.5 mg/dL, metabolic alkalosis as a difference in serum sodium and serum chloride ([sNa-sCl]) ≥39 mEq/L, and renal impairment as a ≥50% increase in serum creatine and/or ≥35% decrease in estimated glomerular filtration rate (eGFR) compared to baseline. Results: cCa peaked (11.1 ± 1.5 mg/dL) at a median of 326 days (interquartile range 78–869) after surgery. At peak cCa, [sNa-sCl] was significantly higher (p < 0.01), and eGFR was significantly lower (p < 0.01) than that at baseline. Fifteen patients (55.6%) had hypercalcemia, 19 (70.3%) had alkalosis, 12 (44.4%) had renal impairment, and 9 (33.3%) had CAS. Patients with CAS (mean age 67.1 ± 10.8 years) were older than those without CAS (56.7 ± 13.6 years, p = 0.06). The mean dose of alfacalcidol in the CAS group (3.1 ± 1.2 μg/day) was significantly larger than that in the non-CAS group (2.1 ± 1.0 μg/day, p = 0.03). Conclusions: This retrospective study reveals the high incidence of CAS in patients with hypoparathyroidism after total thyroidectomy. Furthermore, these findings suggest that the serum calcium level, acid-base balance, and renal function should be closely monitored in patients with postsurgical hypoparathyroidism who receive large doses of active vitamin D.


2020 ◽  
Author(s):  
Jun Cheng ◽  
Wen Zhang ◽  
Yi Zhao ◽  
Xiayu Li ◽  
Rong Lv ◽  
...  

Abstract Background: A number of studies have shown that serum calcium has a crucial role in many types of cancers. However, few studies have determined the association between serum calcium levels and renal impairment (RI) and all-cause death in Chinese patients with multiple myeloma (MM).Methods: Two hundred forty-six of 566 participants who were followed for > 6 months from a MM cohort at our institution between January 2011 and June 2017 were eligible for the retrospective study. A generalized additive model and smooth curve fitting were conducted to investigated the cross-sectional relationship between serum calcium level and RI and eGFR at baseline;Multivariate-adjusted Cox regression models were fitted to assess associations between baseline serum calcium levels and onset of end-stage renal disease(ESRD) or death in patients with MM followed for > 6 months.Results: Using the IMWG criteria,162 of 566 patients (28.6%) with newly diagnosed MM presented with RI . The mean duration of follow-up was 26.64 months. Twenty-one patients (8.54%) died and 28 patients(11.52%)had ESRD.The serum calcium level was independently associated with the occurrence of MM-related RI. There was a non-linear relationship between the serum calcium level and the presence of RI in patients with MM in the cross-sectional analysis of the baseline data. Cox regression analysis showed that baseline serum calcium levels were consistently associated with a higher risk of all-cause death after adjustment for various clinical and laboratory factors, but were not associated with the occurrence of ESRD. When patients were categorized into 2 groups according to baseline mean serum calcium level, deaths occurred in 13 patients (15.1%) with mean serum calcium level > 2.44 mmol/L compared to 8 patients (5.0%) with mean serum calcium level < 2.44 mmol/L (p < 0.05); Eighteen patients (11.46%) with a mean serum calcium level < 2.44 mmol/L progressed to ESRD compared to 13 patients (11.6%) with a serum calcium level > 2.44 mmol/L (p > 0.05).Conclusions: This observational study showed that there was a non-linear relationship between the serum calcium level and the occurrence of RI. An elevated baseline calcium level can predict all-cause death in patients with MM, but cannot predict the occurrence of ESRD, suggesting that the serum calcium level may serve as a useful clinical biomarker for the survival rate of patients with MM followed for > 6 months. Additional data from larger prospective longitudinal studies are required to validate our findings.


2013 ◽  
Vol 4 (1) ◽  
pp. 4-9 ◽  
Author(s):  
MS Islam ◽  
D Paul ◽  
T Sultana ◽  
MQ Rahman ◽  
Z Rehena ◽  
...  

Postoperative hypocalcemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose hypocalcemia immediately after total thyroidectomy for minimizing complications. The objective of this study was to measure and to evaluate the serum calcium level in total thyroidectomy patients. This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Total 65 patients were enrolled those came for total thyroidectomy irrespective of age and sex. Hypocalcemia was found in 25 cases and normocalcemia was found in 40 cases. Male were 16.0% and female were 84.0%. Females were predominant. The incidence of hypocalcemia was 38.5%. Asymptomatic hypocalcemia was found in 22 and symptomatic hypocalcemia was found in 3 cases. Hypocalcemia was developed mostly in malignant thyroid diseases. The mean difference of intraoperative (20 minutes after total thyroidectomy), after 24 hours and after 48 hours calcium levels were statistically significant (p<0.05) between patient with hypocalcemia and patient with normocalcemia in unpaired t-test. Serum calcium level significantly decreased after total thyroidectomy and most critical time is first 24 hours of post-thyroidectomy period. If clinical sign symptoms of hypocalcemia are not developed in this period, patient is safe and can be discharged from hospital.DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13775 Bangladesh J Med Biochem 2011; 4(1): 4-9


2020 ◽  
Author(s):  
Jun Cheng ◽  
Wen Zhang ◽  
Yi Zhao ◽  
Xiayu Li ◽  
Rong Lv ◽  
...  

Abstract Background: A number of studies have shown that serum calcium has a crucial role in many types of cancers. However, few studies have determined the association between serum calcium levels and renal impairment (RI) and all-cause death in Chinese patients with multiple myeloma (MM).Methods: Two hundred forty-six of 566 participants who were followed for > 6 months from a MM cohort at our institution between January 2011 and June 2017 were eligible for the retrospective study. A generalized additive model and smooth curve fitting were conducted to investigated the cross-sectional relationship between serum calcium level and RI and eGFR at baseline;Multivariate-adjusted Cox regression models were fitted to assess associations between baseline serum calcium levels and onset of end-stage renal disease(ESRD) or death in patients with MM followed for > 6 months.Results: Using the IMWG criteria,162 of 566 patients (28.6%) with newly diagnosed MM presented with RI . The mean duration of follow-up was 26.64 months. Twenty-one patients (8.54%) died and 28 patients(11.52%)had ESRD.The serum calcium level was independently associated with the occurrence of MM-related RI. There was a non-linear relationship between the serum calcium level and the presence of RI in patients with MM in the cross-sectional analysis of the baseline data. Cox regression analysis showed that baseline serum calcium levels were consistently associated with a higher risk of all-cause death after adjustment for various clinical and laboratory factors, but were not associated with the occurrence of ESRD. When patients were categorized into 2 groups according to baseline mean serum calcium level, deaths occurred in 13 patients (15.1%) with mean serum calcium level > 2.44 mmol/L compared to 8 patients (5.0%) with mean serum calcium level < 2.44 mmol/L (p < 0.05); Eighteen patients (11.46%) with a mean serum calcium level < 2.44 mmol/L progressed to ESRD compared to 13 patients (11.6%) with a serum calcium level > 2.44 mmol/L (p > 0.05).Conclusions: This observational study showed that there was a non-linear relationship between the serum calcium level and the occurrence of RI. An elevated baseline calcium level can predict all-cause death in patients with MM, but cannot predict the occurrence of ESRD, suggesting that the serum calcium level may serve as a useful clinical biomarker for the survival rate of patients with MM followed for > 6 months. Additional data from larger prospective longitudinal studies are required to validate our findings.


2018 ◽  
Vol 30 (2) ◽  
pp. 57-60
Author(s):  
Heera Lal Roy ◽  
Susmita Nargis ◽  
Md Mahbubur Rahman ◽  
Mohammad Shahadat Hossain ◽  
Md Ruhul Amin ◽  
...  

Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Reduced serum calcium level are found associated with elevated blood pressure in preeclampsia. To evaluate serum calcium level in pre-eclamptic women. This cross sectional study was carried out in among 50 preeclamptic patients, aged 20 to 40 years, and gestational age ranges from 20 to 40 weeks and 50 age and gestational age matched normotensive pregnant women having no proteinuria. Serum calcium was measured by Colorimetric method. The mean age and mean gestational age of pre-eclampsia was not significantly different from those of normotensive pregnant women (p=0.203 and p=0.251 respectively). The mean body mass indexes of the test patients were significantly different from those of normotensive pregnant women (p<0.001). The mean serum calcium level was 7.27 ± 3.01 mg/dl in pre-eclampsia and 7.25 ± 2.59 mg/dl in normal pregnant women; did not differ significantly between the subjects of pre-eclampsia and normal pregnant women (p=0.963). Serum calcium has no association in occurrence of preeclampsia.Medicine Today 2018 Vol.30(2): 57-60


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jun Cheng ◽  
Wen Zhang ◽  
Yi Zhao ◽  
Xiayu Li ◽  
Rong Lv ◽  
...  

Abstract Background More studies have shown that serum calcium has a crucial role in many types of cancers. However, few studies have determined the association between serum calcium levels and renal impairment (RI) and all-cause death in Chinese patients with multiple myeloma (MM). Methods A total of 246 of 565 participants who were followed for > 6 months from a MM cohort at our institution were eligible for the retrospective study. A generalized additive model and smooth curve fitting were performed to investigate the cross-sectional relationship between the serum calcium level and RI at baseline. Multivariate-adjusted Cox regression models were fitted to assess the associations between baseline serum calcium levels and the onset of end-stage renal disease (ESRD) or death in patients with MM. Results A total of 172 of 565 patients (30.4%) with newly diagnosed MM presented with RI. The mean duration of follow-up was 26.64 months. Twenty-one patients (8.54%) died and 28 patients (11.52%) had ESRD. In patients with a serum calcium level > 2.30 mmol/L, the serum calcium level was independently associated with the occurrence of MM-related RI. Cox regression analysis showed that baseline serum calcium levels were consistently associated with a higher risk of all-cause death in the fully adjusted model, but were not associated with the occurrence of ESRD. When patients were categorized into two groups according to baseline mean serum calcium level, deaths occurred in 13 patients (15.1%) with a mean serum calcium level > 2.44 mmol/L compared to eight patients (5.0%) with a mean serum calcium level < 2.44 mmol/L (p < 0.05); Eighteen patients (11.46%) with a mean serum calcium level < 2.44 mmol/L progressed to ESRD compared to 13 patients (11.6%) with a serum calcium level > 2.44 mmol/L (p > 0.05). Conclusions This observational study showed that there was a nonlinear relationship between the serum calcium level and the presence of RI in patients with MM. An elevated baseline calcium level predicted all-cause death, but did not predict the occurrence of ESRD in patients with MM followed for > 6 months.


Author(s):  
Feriha Fatima Khidri ◽  
Hina Riaz ◽  
Farah Naz ◽  
. Almas ◽  
Arsalan Ahmed Uqaili ◽  
...  

Objectives: To determine the serum calcium levels in mild and severe preeclampsia and compare it with normal pregnancy. Methods: It was a comparative cross sectional study. Thirty five normotensive pregnant women, n=30 women with mild preeclampsia and n=70 with severe preeclampsia were recruited at Liaquat University of Medical and Health Sciences, Hospital. The serum calcium was measured and levels were compared among three groups. The data was analysed on SPSS v. 20. Results: The gestational age was more in the normal pregnancy compared to mild and severe preeclampsia (38.7±2.1 vs 36.7±3.6 and 36.2±2.8, p-value=0.0002). The calcium concentration was less in the both groups of preeclampsia i.e., 8.41± 0.96 mg/dl in mild and 8.02± 0.77 mg/dl in severe preeclampsia vs 9.2± 0.32 mg/dl in normal pregnant women, (p-value <0.001). Conclusion: We found lower levels of serum calcium in preeclampsia, suggesting its possible role in pathogenesis. Further studies to investigate the potential role of dietary supplementation of micronutrients during pregnancy are recommended.


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. 


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.


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