scholarly journals COMPARISON OF SERUM CALCIUM LEVELS AMONG EXTREMELY PRETERM AND SEVERLY PRETERM NEONATES AT A PERIPHERAL MILITARY HOSPITAL

2021 ◽  
Vol 71 (4) ◽  
pp. 1292-95
Author(s):  
Sohail Aslam ◽  
Fawad Ahmad Khan ◽  
Omer Tufail ◽  
Naila Mumtaz ◽  
Syed Uzair Maqsood ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Gestational Age ◽  
Venous Blood ◽  
Military Hospital ◽  
Preterm Neonates ◽  
Total Serum ◽  
Cross Sectional ◽  
Very Preterm ◽  
Total Serum Calcium ◽  
Extremely Preterm

Objective: To determine the frequency and compare serum calcium levels amongst extremely preterm and very preterm neonates. Study Design: Comparative cross sectional study. Place and Duration of Study: Combined Military Hospital, Multan Pakistan, from May to Oct 2018. Methodology: A total of 217 preterm neonates, born at Combined Military Hospital Multan up to the gestational age of 32 weeks completed from last menstrual period, were included in the study. They were divided in to two group’s i.e. very preterm and extremely preterm neonates. Those born between 28-32 weeks completed of gestation were categorized as severely preterm. Extremely preterm were those born between 24-28 weeks completed of gestation. Venous blood samples were acquired at approximately 36 hours after birth and total serum calcium levels were analyzed. Neonates having total serum calcium levels <7 mg/dL were declared as suffering from hypocalcaemia. Results: Out of 217 neonates, 117 (53.9%) were male while 100 (46.1%) were female. Mean gestational age was 30.98 ± 2.12 weeks while mean parity of the mothers was 2.82 ± 1.08 children. Mean birth weight was 1510.26 ± 142.38 grams. One hundred and seventeen (53.9%) of the preterm neonates suffered from hypocalcaemia with the mean total serum calcium level being 6.58 ± 0.86 mg/dL. Hypocalcaemia was more common in extremely preterm neonates compared to very preterm neonates (p<0.05). Conclusion: Hypocalcaemia is a frequent complication encountered in preterm neonates born between 24-32 weeks gestation. Within these neonates, the frequency of hypocalcaemia is higher in extremely preterm compared to severely preterm babies.

scholarly journals A Study of Serum Calcium and Magnesium Levels in Idiopathic Epilepsy Patients of Hubli, Karnataka, India

2021 ◽  
Vol 8 (25) ◽  
pp. 2187-2191
Author(s):  
Chandrashekar Kachapur ◽  
Seetaram N. Kallimani ◽  
Gayathri B.H ◽  
Ishwar S. Hasabi ◽  
Zahura M. Devarhoru
Keyword(s):  
Serum Calcium ◽  
Calcium Influx ◽  
Serum Magnesium ◽  
Idiopathic Epilepsy ◽  
Total Serum ◽  
Cross Sectional ◽  
Total Serum Calcium ◽  
Study Results ◽  
Significant Difference ◽  
Calcium And Magnesium

BACKGROUND Magnesium is a potential modulator of seizure activity because of its ability to antagonize the excitatory calcium influx through N-methyl-D-aspartate (NMDA) receptor which is thought to play a role in many human forms of epilepsy. When the extracellular concentration of calcium ion falls below normal, the nervous system becomes more excitable, allowing easy initiation of action potentials. Consequently, hypocalcaemia causes seizures because of its action of increasing excitability in the brain. We wanted to estimate the serum concentration of calcium and magnesium in idiopathic epilepsy patients and its co-relation. METHODS 94 cases of idiopathic epilepsy with breakthrough seizures admitted to KIMS Hospital, Hubli, meeting the inclusion criteria were considered for the study which was for 2-years’ time period. It’s a single centred, time bound and cross sectional study. RESULTS Mean serum calcium was low 8.36 ± 0.45 mg / dL and mean serum magnesium was 1.79 ± 0.28 mg / dL. 64.9 % had total serum calcium less than 8.5 mg / dL and 44.7 % had serum magnesium of < 1.8 mg / dL. 35.1 % had both low calcium and magnesium. There was significant difference in mean serum calcium with respect to number of episodes. There was no significant difference in mean serum magnesium with respect to number of episodes. CONCLUSIONS Serum calcium and magnesium levels which play a role in seizure initiation should be measured in all idiopathic epilepsy patients with breakthrough seizures as a seizure trigger. Considering the role of calcium and magnesium in the pathophysiology of seizures and by evaluating the results from the present study, breakthrough seizure could be provoked by hypocalcaemia and hypomagnesemia. Hence they may be used for the treatment of intractable seizures. KEYWORDS Calcium, Magnesium, Idiopathic Epilepsy

scholarly journals The Role of Serum Calcium Levels in Pediatric Dyslipidemia: Are There Any?

2021 ◽  
Vol 9 ◽  
Author(s):  
Yaguang Peng ◽  
Lixin Hu ◽  
Xiaolu Nie ◽  
Siyu Cai ◽  
Ruohua Yan ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Dose Response ◽  
Calcium Level ◽  
Pediatric Population ◽  
Reference Intervals ◽  
Total Serum ◽  
Response Analysis ◽  
Cross Sectional ◽  
Total Serum Calcium ◽  
Increased Risk

Background: No previous study explored the association between serum calcium levels and dyslipidemia in children. This study aimed to explore this relationship in children, based on a multicenter cross-sectional study population in China.Methods: Cross-sectional data was derived from the Pediatric Reference Intervals in China (PRINCE) study conducted between 2017 and 2018 involving 5,252 males and 5,427 females with a mean age of 10.0 ± 4.6 years. Multivariable logistic regression models were applied to calculate odds ratios (ORs), with 95% confidence intervals (CIs), for dyslipidemia of each serum calcium level and albumin-corrected calcium levels, which were sorted into quartiles. The restricted cubic spline model was fitted for the dose-response analysis. An L-shaped dose-response relation between calcium levels and the probability of dyslipidemia was found after the adjustment for multiple potential confounding factors, p for non-linear &lt; 0.001.Results: Using the middle category of calcium level as the reference, multivariable-adjusted ORs and 95% CIs of the lowest and the highest quartile categories were 0.96 (0.82–1.12) and 1.29 (1.12–1.48), respectively, for total serum calcium levels and 1.06 (0.91–1.23) and 1.39 (1.21–1.60) for albumin-corrected calcium levels.Conclusions: Individuals with higher levels of serum calcium were associated with increased risk of dyslipidemia in a sample of a healthy Chinese pediatric population. The association between serum calcium levels and dyslipidemia needs to be examined prospectively in future studies.

Ionized Calcium, Cardiac Function, and Electrocardiogram in Preterm Neonates

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 541-542
Author(s):  
JENS MÖLLER ◽  
F. K. TEGTMEYER
Keyword(s):  
Cardiac Function ◽  
Causal Relationship ◽  
Serum Calcium ◽  
Cardiac Failure ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Preterm Neonates ◽  
Total Serum ◽  
Total Serum Calcium

To the Editor.— We would like to add some comments on the article by Venkataraman et al.1 In one respect it might be quite dangerous not to measure the ionized calcium in preterm neonates. If you find prolongation of QTc or QoTc intervals in the ECG during cardiac failure in these infants and find subnormal total serum calcium levels, you might make a wrong conclusion on causal relationship. Until now, we have seen five preterm neonates with OTc/QoTc prolongation and profound low total serum calcium levels, whereas the measured ionized calcium level was normal.

scholarly journals Clinical Approach to Hypocalcemia in Newborn Period and Infancy: Who Should Be Treated?

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Dogus Vuralli
Keyword(s):  
Preterm Infants ◽  
Serum Calcium ◽  
Gestational Age ◽  
Late Onset ◽  
Ionized Calcium ◽  
Total Serum ◽  
Specific Reference ◽  
Clinical Approach ◽  
Newborn Period ◽  
Total Serum Calcium

Introduction. Hypocalcemia is a common metabolic problem in newborn period and infancy. There is consensus on the treatment of the symptomatic cases while the calcium level at which the treatment will be initiated and the treatment options are still controversial in asymptomatic hypocalcemia. Methods. This review article will cover hypocalcemia with specific reference to calcium homeostasis and definition, etiology, diagnosis, and treatment of hypocalcemia in newborn and infancy period. Results. Hypocalcemia is defined as total serum calcium <8 mg/dL (2 mmol/L) or ionized calcium <4.4 mg/dL (1.1 mmol/L) for term infants or preterm infants weighing >1500 g at birth and total serum calcium <7 mg/dL (1.75 mmol/L) or ionized calcium <4 mg/dL (1 mmol/L) for very low birth weight infants weighing <1500 g. Early-onset hypocalcemia is generally asymptomatic; therefore, screening for hypocalcemia at the 24th and 48th hour after birth is warranted for infants with high risk of developing hypocalcemia. Late-onset hypocalcemia, which is generally symptomatic, develops after the first 72 h and toward the end of the first week of life. Excessive phosphate intake, hypomagnesemia, hypoparathyroidism, and vitamin D deficiency are commonest causes of late-onset hypocalcemia. Hypocalcemia should be treated according to etiology. Calcium replacement is the cornerstone of the treatment. Elementary calcium replacement of 40 to 80 mg/kg/d is recommended for asymptomatic newborns. Elementary calcium of 10 to 20 mg/kg (1–2 mL/kg/dose 10% calcium gluconate) is given as a slow intravenous infusion in the acute treatment of hypocalcemia in patients with symptoms of tetany or hypocalcemic convulsion. Conclusion. Since most infants with hypocalcemia are usually asymptomatic, serum total or ionized calcium levels must be monitored in preterm infants with a gestational age <32 weeks, small for gestational age infants, infants of diabetic mothers, and infants with severe prenatal asphyxia with a 1 min Apgar score of <4. The treatment of hypocalcemia should be initiated immediately in infants with reduced calcium levels while investigating the etiology.

scholarly journals Is calcium a concern in neonates undergoing phototherapy?

2018 ◽  
Vol 5 (3) ◽  
pp. 988 ◽  
Author(s):  
N. L. Sridhar ◽  
Sreeram S. ◽  
Madoori Srinivas
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Calcium Absorption ◽  
Newborn Infants ◽  
Late Preterm ◽  
Ionized Calcium ◽  
Preterm Neonates ◽  
Total Serum ◽  
Study Group ◽  
Total Serum Calcium

Background: Neonatal hypocalcemia is defined as total serum calcium concentration of < 7 mg/dl or ionized calcium concentration of <4 mg/dl (<1 mmol/L). The current aim was to look the effect of phototherapy on ionized calcium levels before and after phototherapy in otherwise healthy term and late preterm (35 to 37 weeks) neonates.Methods: The study group included 50 neonates. Measurement of serum ionized calcium levels was done before and at the end of phototherapy.Results: At the end of phototherapy in study group, a significant fall in calcium level in 64% of term and 76% of late preterm neonates was observed, but almost all except one remained asymptomatic.Conclusions: The efficacy of phototherapy in the prevention and treatment of hyperbilirubinemia in newborn infants has been well established. The mean duration of phototherapy in our study was 32 hours. Duration of phototherapy may influence the severity of hypocalcaemia. The regulation of calcium homeostasis in the newborn period has been of considerable interest. Phototherapy increases calcium absorption by the bones and leads to the reduction of melatonin levels. Changes in melatonin levels affect the incidence of hypocalcaemia-induced phototherapy. The mechanism of hypocalcaemia effect of phototherapy was reported by inhibition of pineal gland via transcranial illumination, resulting to decline of melatonin secretion; which blocks the effect of cortisol on bone calcium. It is suggested that serum calcium levels be assessed in neonates treated with phototherapy. Neonatal Jaundice is one of the most common problems that can occur in the newborn. Hypocalcaemia during phototherapy has been reported in literature.

The Reference Intervals Used in Pediatric Medical Analysis Laboratories to Interpret the Results Analysis for Total Serum Calcium

2017 ◽  
Vol 68 (2) ◽  
pp. 243-245
Author(s):  
Elisabeta Antonescu ◽  
Maria Totan ◽  
Gheorghe Cornel Boitor ◽  
Julianna Szakacs ◽  
Sinziana Calina Silisteanu ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Colorimetric Method ◽  
Age Groups ◽  
Essential Element ◽  
Reference Intervals ◽  
Total Serum ◽  
Electronic Archive ◽  
Total Serum Calcium ◽  
Analysis Laboratory ◽  
Medical Analysis

Medical analysis laboratory must establish its own reference intervals depending on the facilities they are working with, the working substances and protocols. These reference intervals must be obtained depending on age groups in order to accurately interpret the results of the analyzes performed. The study is a retrospective one using 3217 data from the electronic archive of the S.C. Vladutiu&Garabedian S.R.L. Clinic in Medias. Total serum calcium was determined by the colorimetric method on the Konelab analyzer. Processing of the collected data was done using the Hoffmann method, considering 5% up to 95% of the values in the database, the values being randomly selected. For comparison, data from the literature was used. In children under 1 year old, it was not possible to calculate the reference intervals since data was insufficient. In the other age groups, reference intervals obtained in the current study were similar to the studied literature. Reference intervals established for calcium can provide important guidance for the reasonable supplementation of this essential element in children.

Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

2020 ◽  
Author(s):  
Sota Iwatani ◽  
Takao Kobayashi ◽  
Sachiko Matsui ◽  
Akihiro Hirata ◽  
Miwa Yamamoto ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Cord Serum ◽  
Very Preterm ◽  
Key Points ◽  
Extremely Preterm ◽  
Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s =  − 0.427, p = 0.004) and those with mild funisitis (r s =  − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

scholarly journals Association of dietary calcium intake, total and ionized serum calcium levels with preeclampsia in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel D. Gebreyohannes ◽  
Ahmed Abdella ◽  
Wondimu Ayele ◽  
Ahizechukwu C. Eke
Keyword(s):  
Serum Calcium ◽  
Calcium Intake ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Dietary Calcium ◽  
Ionized Calcium ◽  
Dietary Calcium Intake ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Abstract Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.

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