scholarly journals COMPARISON OF THE PARENTERAL AND ORAL VITAMIN D SUPPLEMENTATION IN THE TREATMENT OF NUTRITIONAL RICKETS IN TERMS OF MEAN CHANGE IN SERUM CALCIUM, PHOSPHORUS, AND ALKALINE PHOSPHATASE

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Nisar Khan Sajid ◽  
Sumaira Tehseen ◽  
Tahir Mehmood ◽  
Tanveer Ahmed ◽  
Ramsha Abbas ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Calcium ◽  
Serum Alkaline Phosphatase ◽  
Oral Route ◽  
Vitamin D Supplementation ◽  
Serum Phosphorus ◽  
Oral Vitamin ◽  
Baseline Serum ◽  
Nutritional Rickets

ABSTRACT:  BACKGROUND & OBJECTIVE: Rickets is a common presentation on the pediatric floor, with nutritional rickets being the cause of leading significant morbidity, disability, especially in the developing countries of the world. The objective is to compare the efficacy of parenteral and oral vitamin D supplementation in the treatment of nutritional rickets  METHODOLOGY: This comparative interventional, prospective analysis was conducted at Aziz Fatimah Hospital Faisalabad (1-1-2017 to 30-6-2017) outdoor patients divided into parenteral and oral groups. All of the outcome variables were measured at baseline and one month after treatment. RESULTS: In this study, mean age was calculated as 2.12 + 0.76 years and 2.15+0.77 in parental and oral groups respectively. 49.29% (n=69) and 45%(n=63) were male and 50.71%(n=71) and 55% (n=77) were female respectively in both groups.  At baseline, serum calcium was 8.68 + 0.35 and 8.71 + 0.37 (p=0.62) serum phosphorus was 3.92 + 9.22 and 3.84 + 0.20 (p=0.03), and serum alkaline phosphatase was 230.01 + 13.09 and 228.89 + 13.80 (p=0.48) in parenteral and oral groups respectively. After treatment the mean change seen in serum calcium was 1.14 + 0.26 and 0.72 + 0.19 (p=0.001), serum phosphorus was 1.42 + 0.33 and 0.71 + 0.26 (p=0.001), serum Alkaline phosphatase was 79.48 + 14.84 and 23.65 + 12.21 (p=0.001) in parenteral and oral groups respectively. CONCLUSION:  We concluded that the parenteral route for vitamin. D supplementation is significantly better than the oral route in treating nutritional rickets in terms of mean change in serum calcium, serum phosphorus, and serum alkaline phosphatase.

Low Dose Depot Oral Vitamin D3 Versus Daily Oral Vitamin D3 for Treating Nutritional Rickets: A Randomized Clinical Trial

2021 ◽  
pp. 1-18
Author(s):  
Ravneet Kaur Saluja ◽  
Pooja Dewan ◽  
Sunil Gomber ◽  
SV Madhu ◽  
Shuchi Bhatt ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D3 ◽  
Low Dose ◽  
Care Hospital ◽  
Oral Vitamin ◽  
Nutritional Rickets ◽  
Vitamin D Levels ◽  
Radiological Healing ◽  
25 Oh Vitamin D

Abstract Objective: To compare the efficacy of daily versus low dose depot oral vitamin D3 for treating nutritional rickets. Design: Randomized Controlled Trial Setting: Paediatrics department of a tertiary care hospital catering to semi-urban and rural population in Delhi, India Methods: We randomized 66 children aged 3 months to 5 years with nutritional rickets to receive either daily oral vitamin D3 drops (3-12 months: 2000 IU; >12 months-5y: 4000 IU; n=33) for 12 weeks duration, or a single oral depot dose of vitamin D3 granules (3-12 months: 60,000 IU; >12 months-5y: 150,000 IU; n=33). Results: Participants in both groups had comparable demographic characteristics, laboratory features and radiological severity of rickets. 33 participants in each group received the assigned intervention and all were followed up till 12 weeks. At 12 weeks follow up, children in both groups showed a significant improvement in all biochemical parameters [serum calcium, phosphorus, alkaline phosphatase, parathormone and 25(OH) vitamin D levels] as well as radiological healing. At 12 weeks, the mean (SD) serum 25(OH) vitamin D levels (nmol/L) were statistically comparable in both groups [daily: 120.2 (83.2), depot: 108 (74), P=0.43] and 31 (94%) children in each group had radiological healing (Thacher score <1.5). Two children in each group persisted to have raised alkaline phosphatase and one child each in the daily group continued to have hypocalcemia and hypophosphatemia at 12 weeks. Conclusion: Low dose oral depot vitamin D3 is an effective alternative to daily oral vitamin D3 for nutritional rickets.

scholarly journals Effect of vitamin D and calcium alone or in combination in the treatment of nutritional rickets

2020 ◽  
Vol 11 (1) ◽  
pp. 39-46
Author(s):  
Fatema Yasmin ◽  
Farzana Yasmin ◽  
Fahmida Chowdhury ◽  
Mujibul Hoque ◽  
Minakshi Chowdhury ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Female Ratio ◽  
Nutritional Rickets ◽  
Radiographic Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Nutritional rickets has emerged as a public health problem in Bangladesh during the past two decades, with up to 8% of children being clinically affected in some areas. Insufficiency of vitamin D and dietary calcium is thought to be the underlying cause. Vitamin D administered with or without calcium is commonly regarded as the mainstay of treatment. Calcium alone or in combination with vitamin D has also been used in the treatment of nutritional rickets. So this study was done to assess the effects of vitamin D, calcium or combination of vitamin D and calcium for the treatment of nutritional rickets in Bangladeshi children. Methods: This open labeled randomized comparative study was done in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from July 1, 2010 to June 30, 2012 A total 48 rickets patient was enrolled in this study. After selection of cases patients were divided in to three groups by lottery method. Group A received single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock), Group B received calcium (750 mg per day) for 6 weeks and Group C received both calcium (750 mg per day) for 6 weeks and single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock). Response was evaluated by serum alkaline phosphatase level and using 10-point radiographic score developed by Thacher and colleagues at baseline, 6 weeks, and 12 weeks. Results: Mean age of the study participants was 35.83 months. Male to female ratio was 2:1. The radiographic score was significantly improved in first and second follow up (p<0.001) in all groups. But there was significant difference of improvement in Group C than Group A and Group B. In Group C, the percent reduction from base to first follow up was 80.05±7.04 and 90.65±3 in second follow up which showed quick improvement in combination therapy. Serum alkaline phosphatase also significantly reduced in all three groups. Conclusion: Combination use of vitamin D and calcium in the treatment of nutritional rickets is more effective than prescribing either vitamin D or calcium alone. Birdem Med J 2021; 11(1): 39-46

scholarly journals Evaluation of Vitamin D (25OHD), Bone Alkaline Phosphatase (BALP), Serum Calcium, Serum Phosphorus, Ionized Calcium in Patients with Mandibular Third Molar Impaction. An Observational Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1938
Author(s):  
Vito Crincoli ◽  
Angela Pia Cazzolla ◽  
Mariasevera Di Comite ◽  
Lorenzo Lo Muzio ◽  
Domenico Ciavarella ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Calcium ◽  
Negative Correlation ◽  
Third Molar ◽  
Bone Alkaline Phosphatase ◽  
Serum Phosphorus ◽  
Bone Biomarkers ◽  
Whitney Test ◽  
Mandibular Third Molar

The aim of this study was to evaluate the levels of vitamin D (25OHD) and other bone biomarkers in patients with third molar impaction (TMI). Thirty males and 30 females with unilateral or bilateral impacted mandibular third molar, and 15 males and 15 females as a control group (CG) were recruited. Rx-OPT was used to evaluate dental position and Pederson index to measure the difficulty of the intervention. Bone biomarkers were measured through blood venous sample in TMI group and CG. Mann-Whitney test, Pearson’s correlation coefficient, linear regression model were used to compare the different parameters in the two groups. 25OHD showed lower values in TMI group than in CG (p < 0.05) with values significantly lower in bilateral impaction (p < 0.05). Pearson’s coefficient for 25OHD presented a negative correlation with the Pederson index (ρ = −0.75). Bone alkaline phosphatase (BALP) showed significantly lower dosage in TMI group than CG (p = 0.02), Pearson’s coefficient for BALP presented a negative correlation with the Pederson index. Serum calcium, serum phosphorus, ionized calcium levels in TMI and CG groups were similar and Mann-Whitney test did not significantly differ between TMI and CG. TMI could be a sign of vitamin D deficiency and of low BALP levels that should be investigated.

Nutritional rickets under 16 years: UK surveillance results

2020 ◽  
Vol 105 (6) ◽  
pp. 587-592 ◽  
Author(s):  
Priscilla Julies ◽  
Richard M Lynn ◽  
Karina Pall ◽  
Marina Leoni ◽  
Alistair Calder ◽  
...  
Keyword(s):  
Vitamin D ◽  
South Asian ◽  
Motor Development ◽  
Serum Alkaline Phosphatase ◽  
Calcium Deficiency ◽  
Vitamin D Supplementation ◽  
Case Definition ◽  
Annual Incidence ◽  
Nutritional Rickets ◽  
The Uk

ObjectiveThe UK national incidence of nutritional rickets is unknown. We aimed to describe the incidence, presentation and clinical management of children under 16 years with nutritional rickets in the UK presenting to secondary care.MethodsProspective data were collected monthly between March 2015 and March 2017 from 3500 consultant paediatricians using British Paediatric Surveillance Unit methodology. Clinicians completed online clinical questionnaires for cases fitting the surveillance case definition.Results125 cases met the case definition, an annual incidence of 0.48 (95% CI 0.37 to 0.62) per 100 000 children under 16 years. 116 children were under 5 years (annual incidence of 1.39 (95% CI 1.05 to 1.81) per 100 000. Boys (70%) were significantly more affected than girls (30%) (OR 2.17, 95% CI 1.25 to 3.78). The majority were of Black (43%) or South Asian (38%) ethnicity. 77.6% of children were not taking vitamin D supplements despite being eligible. Complications included delayed gross motor development (26.4%), fractures (9.6%), hypocalcaemic seizures (8%) and dilated cardiomyopathy (3%). Two children died (1.6%). In eight cases, rickets was confirmed radiologically and biochemically [raised serum alkaline phosphatase (ALP) and parathyroid hormone (PTH) levels ] but were excluded from the incidence analysis for not meeting the case definition of 25-hydroxyvitamin D of <25 nmol/L.ConclusionThe incidence of nutritional rickets in the UK is lower than expected. Serious complications and unexpected deaths, particularly in Black and South Asian children under 5 years, occurred. Both vitamin D deficiency and dietary calcium deficiency are role players in pathogenesis. Uptake of vitamin D supplementation remains low.

The validity of serum alkaline phosphatase to identify nutritional rickets in Nigerian children on a calcium-deprived diet

2019 ◽  
Author(s):  
Tom Thacher ◽  
Christopher Sempos ◽  
Ramon Durazo-Arvizu ◽  
Craig Munns ◽  
Philip Fischer ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Nigerian Children ◽  
Nutritional Rickets

scholarly journals The Clinical Effect of Oral Vitamin D2 Supplementation on Psoriasis: A Double-Blind, Randomized, Placebo-Controlled Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Wareeporn Disphanurat ◽  
Wongsiya Viarasilpa ◽  
Panlop Chakkavittumrong ◽  
Padcha Pongcharoen
Keyword(s):  
Vitamin D ◽  
Placebo Group ◽  
Adverse Events ◽  
Clinical Effect ◽  
Vitamin D Supplementation ◽  
P Value ◽  
Vitamin D2 ◽  
Oral Vitamin ◽  
Pasi Score ◽  
The Mean

Background. There are limited randomized controlled trials of oral vitamin D supplementation in psoriasis, especially in Asia, and the results are inconclusive. Objective. To investigate the clinical effect of oral vitamin D supplementation on psoriasis. Methods. Patients with psoriasis were randomized to receive vitamin D2 60,000 IU or similar-looking placebo pills once every 2 weeks for 6 months. The primary outcome was improvement of the Psoriasis Area and Severity Index (PASI) score at 3 and 6 months after treatment. Serum levels of 25(OH)D, calcium, phosphate, parathyroid hormone, and C-reactive protein and adverse events were monitored. The chi-square test, Fisher’s exact test, Student’s t-test, and Spearman’s correlation analysis were used in statistical analysis. Results. Of 50 subjects screened, 45 were eligible and randomized to the oral vitamin D2 group (n=23) or placebo group (n=22). At enrollment, the mean PASI score was 4.45, and 26.7% of patients had vitamin D deficiency. At 3 months, the oral vitamin D2 group had significantly higher PASI improvement than the placebo group (mean PASI improvement: 1.43 versus [vs.] -0.33, p-value=0.034; mean %PASI improvement: 34.21% vs. -1.85%, p-value=0.039). The mean serum 25(OH)D level was significantly higher in the oral vitamin D group than in the placebo group (27.4 vs. 22.4 ng/mL, p-value=0.029). Serum 25(OH)D concentrations were significantly inversely correlated with PASI scores at the 6-month follow-up. No major adverse event was observed overall. Conclusion. Oral vitamin D2 supplementation in patients with psoriasis increased the serum vitamin D level and significantly improved the treatment outcome without increasing adverse events. Trial Registration. This trial is registered with Thai Clinical Trials Registry TCTR20180613001.

scholarly journals A Case of Vitamin D Deficiency without Elevation of Serum Alkaline Phosphatase in a Carrier of Hypophosphatasia

2013 ◽  
Vol 22 (4) ◽  
pp. 73-76 ◽  
Author(s):  
Kumihiro Matsuo ◽  
Tokuo Mukai ◽  
Akiko Furuya ◽  
Shigeru Suzuki ◽  
Yusuke Tanahashi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Serum Alkaline Phosphatase
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