scholarly journals Symptomatic Hypocalcemiain Neonates Due to Maternal Hypovitaminosis D in Rural Tertiary Care Center: A Case Series

2021 ◽  
pp. 81-87
Author(s):  
Nitin S. Lingayat ◽  
Saloni Manwani ◽  
Bratati S. Mishra
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Complete Blood Count ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Series ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Suspected Sepsis

Vitamin D deficiency in neonates is not uncommon and is characterized by severe hypocalcemic symptoms. In babies with poor vitamin D resources, calcium, phosphorus, and homeostasis are affected, leading to neonatal hypocalcaemia clinical manifestations. Newborn babies with vitamin D deficiency are at risk of deficiency and hypocalcaemia. Therefore, vitamin D supplementation in pregnant and lactating mothers should be routinely considered. Of newborns with symptomatic hypocalcaemia admitted in Level III NICU in the rural part of western Maharashtra from October 2019 to September 2020 were reviewed. These babies were admitted to NICU due to several illnesses, including suspected sepsis, tachypnea, jaundice, etc. They were investigated for sepsis screen including Complete Blood count, CRP, Blood culture, CSF analysis. Cranial USG through anterior fontanelle and Neuro imaging and Electroencephalogram were done wherever necessary. This study intends to highlight the manifestation of maternal hypovitaminosis D on the mother and its effects on the neonate. Maternal hypovitaminosis leads to neonatal hypovitaminosis D and can present as hypocalcaemia.

scholarly journals Vitamin D status and 3-month Glasgow Outcome Scale scores in patients in neurocritical care: prospective analysis of 497 patients

2018 ◽  
Vol 128 (6) ◽  
pp. 1635-1641 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
Ilyas M. Eli ◽  
Gabrielle M. Manton ◽  
...  
Keyword(s):  
Vitamin D ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Glasgow Outcome Scale ◽  
Neurocritical Care ◽  
Care Center ◽  
Hypovitaminosis D ◽  
Simplified Acute Physiology Score ◽  
Vitamin D Supplementation ◽  
Vitamin D Levels

OBJECTIVEVitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outcomes after discharge from a neurocritical care unit (NCCU).METHODSThe authors prospectively analyzed 25-hydroxy vitamin D levels in patients admitted to the NCCU of a quaternary care center over a 6-month period. Glasgow Outcome Scale (GOS) scores were used to evaluate their 3-month outcome, and univariate and multivariate logistic regression was used to evaluate the effects of vitamin D deficiency.RESULTSFour hundred ninety-seven patients met the inclusion criteria. In the binomial logistic regression model, patients without vitamin D deficiency (> 20 ng/dl) were significantly more likely to have a 3-month GOS score of 4 or 5 than those who were vitamin D deficient (OR 1.768 [95% CI 1.095–2.852]). Patients with a higher Simplified Acute Physiology Score (SAPS II) (OR 0.925 [95% CI 0.910–0.940]) and those admitted for stroke (OR 0.409 [95% CI 0.209–0.803]) or those with an “other” diagnosis (OR 0.409 [95% CI 0.217–0.772]) were significantly more likely to have a 3-month GOS score of 3 or less.CONCLUSIONSVitamin D deficiency is associated with worse 3-month postdischarge GOS scores in patients admitted to an NCCU. Additional study is needed to determine the role of vitamin D supplementation in the NCCU population.

scholarly journals High Prevalence of Hypovitaminosis D in Indian Chronic Low Back Patients

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E853-E862
Author(s):  
Dipika Bansal
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Pain Clinic ◽  
Care Hospital ◽  
Low Back

Background: Vitamin D has a significant role to play in bone metabolism and neuromuscular function. Several researchers have indicated that Vitamin D deficiency may be possibly related to chronic musculoskeletal pain including chronic low back pain (CLBP). Objectives: The present study was conducted to determine the prevalence of hypovitaminosis D and its contribution to chronic lower back pain. Study Design: Controlled study Setting: Outpatient pain clinic of tertiary care hospital. Methods: Data presented in this manuscript are from patients who were screened for inclusion in an open label, single arm clinical trial aimed to assess the effectiveness of vitamin D supplementation in patients with CLBP. Consecutive patients visiting the outpatient pain clinic of a tertiary care hospital with a diagnosis of CLBP with or without leg pain were recruited. A visual analogue scale (VAS) was used to measure low back pain intensity, and the Modified Oswestry disability questionnaire (MODQ) was used to measure functional ability. Plasma 25-OHD levels of all patients were measured and the prevalence of hypovitaminosis D was calculated. The multivariate logistic regression model was used to investigate the association between vitamin D deficiency and patient characteristics. Results: A total of 328 patients were included in the study. Mean age of the study population was 43.8 years. Two hundred eighty-two (86%) (men 153/172 [89%], women 129/156 [83%]) of patients had below normal plasma vitamin D levels. Among these, 217 (66%) (men 126 [73%], women 91 [58%]) were found to be deficient and 65 (20%) (men 27 [16%], women 38 [24%]) were had insufficient levels. Multivariate regression analysis found that men were significantly more prone to have deficiency as compared to women (OR = 1.78 (1.10 – 2.88), P = 0.02). We also found a significantly positive relationship between vitamin D deficiency and increased functional disability (OR = 1.53 (1.24 – 1.87), P = 0.01). However, we did not find any relationship with pain severity, presence of other co-morbidities and educational level. Limitations: Not possible to access a good quality data on sun exposure and vitamin D dietary inake dieat in study population. No bone scans were performed. Conclusion: The result of this study provides a message about the high prevalence of hypovitaminosis D in the Indian CLBP population. Clinical guidelines for managing CLBP should include assessment of vitamin D status, together with advice on appropriate vitamin D supplementation in those found to be deficient. Clinical trial registration: CTRI/2014/03/004459 Key words: Chronic low back pain, disability, hypovitaminosis D, India, pain severity, prevalence, vitamin D, visual analogue scale

scholarly journals To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

2018 ◽  
Vol 12 (1) ◽  
pp. 226-247 ◽  
Author(s):  
Alessandra Nerviani ◽  
Daniele Mauro ◽  
Michele Gilio ◽  
Rosa Daniela Grembiale ◽  
Myles J. Lewis
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Systemic Lupus ◽  
Vitamin D Receptors ◽  
Vitamin D Levels

Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterised by abnormal activation of the immune system, chronic inflammation and organ damage. Lupus patients are more prone to be vitamin D deficient. However, current evidence is not conclusive with regards to the role played by vitamin D in SLE development, progression, and clinical manifestations. Objective: Here, we will summarise the current knowledge about vitamin D deficiency prevalence, risk factors, molecular effects, and potential pathogenic role in SLE. We will focus on the link between vitamin D deficiency and lupus clinical manifestations, and on the clinical trials assessing the effects of vitamin D supplementation in SLE. Method: A detailed literature search was performed exploiting the available databases, using “vitamin D and lupus/SLE” as keywords. The relevant interventional trials published over the last decade have been considered and the results are reported here. Conclusion: Several immune cells express vitamin D receptors. Thus, an immunomodulatory role for vitamin D in lupus is plausible. Numerous observational studies have investigated the relationship between vitamin D levels and clinical/serological manifestations of SLE with contrasting results. Negative correlations between vitamin D levels and disease activity, fatigue, renal and cardiovascular disease, and anti-dsDNA titres have been described but not conclusively accepted. In experimental models of lupus, vitamin D supplementation can improve the disease. Interventional trials have assessed the potential therapeutic value of vitamin D in SLE, but further larger studies are needed.

Scrub Typhus with Varied Clinical Presentations

2017 ◽  
Vol 13 (04) ◽  
pp. 319-322
Author(s):  
Susrita Banerjee ◽  
Satyabrata Roychowdhuri ◽  
Mihir Sarkar
Keyword(s):  
Scrub Typhus ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Series ◽  
Dengue Shock Syndrome ◽  
Tertiary Care Center ◽  
Eastern India ◽  
Clinical Presentations ◽  
Diagnostic Difficulties

AbstractWe present four cases of pediatric scrub typhus from a tertiary care center of eastern India, emphasizing on varied unusual clinical manifestations posing diagnostic difficulties. A low index of suspicion is required to prevent under diagnosis. We report a case series of four patients with scrub typhus having uncommon clinical manifestations (two patients with hemophagocytic lymphohistiocytosis, one patient with myocarditis, and one patient presenting with shock reminiscent of dengue shock syndrome). The response to doxycycline was good, with fever subsiding within 48 to 72 hours of starting the treatment. Three out of four cases completely recovered once appropriate medication was given.

A prospective analysis of hypovitaminosis D and mortality in 400 patients in the neurocritical care setting

2017 ◽  
Vol 127 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
Ilyas M. Eli ◽  
Holly K. Ledyard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Critical Care ◽  
Hospital Mortality ◽  
Vitamin D Deficiency ◽  
Neurocritical Care ◽  
Care Center ◽  
Demographic Data ◽  
Hypovitaminosis D ◽  
Vitamin D Levels ◽  
The Impact

OBJECTIVEHypovitaminosis D is highly prevalent among the general population. Studies have shown an association between hypovitaminosis D and multiple negative outcomes in critical care patients, but there has been no prospective evaluation of vitamin D in the neurological critical care population. The authors examined the impact of vitamin D deficiency on in-hospital mortality and a variety of secondary outcomes.METHODSThe authors prospectively collected 25-hydroxy vitamin D levels of all patients admitted to the neurocritical care unit (NCCU) of a quaternary-care center over a 3-month period. Demographic data, illness acuity, in-hospital mortality, infection, and length of hospitalization were collected. Univariate and multivariable logistic regression were used to examine the effects of vitamin D deficiency.RESULTSFour hundred fifteen patients met the inclusion criteria. In-hospital mortality was slightly worse (9.3% vs 4.5%; p = 0.059) among patients with deficient vitamin D (≤ 20 ng/dl). There was also a higher rate of urinary tract infection in patients with vitamin D deficiency (12.4% vs 4.2%; p = 0.002). For patients admitted to the NCCU on an emergency basis (n = 285), higher Simplified Acute Physiology Score II (OR 13.8, 95% CI 1.7–110.8; p = 0.014), and vitamin D deficiency (OR 3.0, 95% CI 1.0–8.6; p = 0.042) were significantly associated with increased in-hospital mortality after adjusting for other factors.CONCLUSIONSIn the subset of patients admitted to the NCCU on an emergency basis, vitamin D deficiency is significantly associated with higher in-hospital mortality. Larger studies are needed to confirm these findings and to investigate the role of vitamin D supplementation in these patients.

scholarly journals Effect of Vitamin D supplementation and outdoor activity on serum 25-Hydroxyvitamin D among children in North China: an observational study

2020 ◽  
Author(s):  
Xuguang Zhang ◽  
Yanping Chen ◽  
Shanshan Jin ◽  
Xinxin Bi ◽  
Dongkai Chen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Lower Risk ◽  
North China ◽  
Pediatric Population ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
High Latitudes ◽  
Vitamin D Status ◽  
Outdoor Activity

Abstract Background Living at high latitudes is one of the risk factors for vitamin D deficiency in children. However, evidence on vitamin D improvement for this pediatric population to date is limited. This study aims at evaluating the effect of different supplementation methods and outdoor activity time on the vitamin D status of children in North China. Methods A total of 55,925 children aged 1 month to 18 years old were recruited from pediatric outpatient departments from July 2016 to June 2017. Data on demographics, anthropometric measurements, vitamin D supplementation, and outdoor time were recorded. The serum levels of 25-hydroxycholecalciferol (25(OH)D) were determined by high performance liquid chromatography tandem–mass spectrometry. Logistic regression analysis was performed to assess the association of vitamin D supplementation or outdoor time with blood vitamin D status, adjusted for age, gender, BMI for age, and seasons. Results The overall rate of hypovitaminosis D was 65.60%. Of the children’s outdoor time, 35.63%, 31.95%, and 32.42% were below 30 min/d, 30–60 min/d and over 60 min/d, respectively. Furthermore, the proportion of iatrogenic supplementation, voluntary supplementation and no vitamin D supplementation among the children was 16.48%, 32.87%, and 50.65%, respectively. After adjusted for confounding factors, vitamin D supplementation was associated with a lower risk of hypovitaminosis D, with OR (95% CI) of 0.191 (0.180, 0.202) in children with iatrogenic supplementation and 0.423 (0.404, 0.443) in those with voluntary supplementation, compared with children without vitamin D supplementation. In addition, longer outdoor time was associated with a lower risk of hypovitaminosis D [0.479 (0.456, 0.504) for 60 min/d, 0.737 (0.701, 0.776) for 30–60 min/d], independent of vitamin D supplementation. Conclusions High prevalence of vitamin D deficiency was found in children living at high latitudes. Vitamin D supplementation and outdoor time are all negatively associated with children’s vitamin D deficiency. Routine 25(OH)D testing combined with vitamin D supplementation might be an effective approach to prevent hypovitaminosis D among children living at high latitudes.

scholarly journals VITAMIN D STATUS IN A HEALTHY TUNISIAN POPULATION

2022 ◽  
Author(s):  
Asma KRIR ◽  
Afef BAHLOUS ◽  
Mehdi MRAD ◽  
BOUKSILA Mouna ◽  
KALAI Safa ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Rural Areas ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Tunisian Population ◽  
Diabetic Patients ◽  
Dietary Intakes ◽  
Vitamin D Status ◽  
Vitamin D Levels

Vitamin D deficiency is one of the most common medical conditions worldwide. In Tunisia, several studies evaluated Vitamin D status, but this was concerning specific populations (pregnant women, obese or diabetic patients and children with asthma). The only study that evaluated Vitamin D status in a healthy Tunisian population was conducted by Meddeb and al. in 2002. The update of data available, based on the currently recommended limits, is necessary. This study aimed to estimate the prevalence of hypovitaminosis D in a healthy Tunisian population, and correlate the values with potential risk factors. It was conducted on 209 Tunisian healthy subjects. Data collected included clinical characteristics and dietary intakes. We measured 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), glycemia, creatinine, calcium, phosphorus, proteins and alkaline phosphatase levels. Hypovitaminosis D was retained for 25(OH)D concentrations <30ng/ml. Vitamin D deficiency was defined by 25(OH)D concentrations <10 ng/ml. The prevalence of hypovitaminosis D and vitamin D deficiency were respectively 92.3% and 47.6%. The main factors that were significantly associated with low vitamin D levels in our multivariate analysis were veiling, living in rural areas and sunscreen use. However, sex, age, socioeconomic level, phototype, solar exposure score, smoking and bone mass index, were not statistically associated with hypovitaminosis D. The study of relationship between vitamin D status and serum PTH levels showed a significative and negative correlation (p< 0.005). Given the high prevalence of vitamin D, an adapted health policy is essential. A widespread vitamin D supplementation and food fortification seems to be necessary in Tunisia.

scholarly journals Prevalence of vitamin d deficiency and its correlation with anthropometric measurements in neonates in a tertiary care center: a cross sectional study

2021 ◽  
Vol 8 (2) ◽  
pp. 295
Author(s):  
Ashvini A. ◽  
Nalini A. ◽  
N. S. Raghupathy
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Care Center ◽  
Tertiary Care ◽  
Hypovitaminosis D ◽  
Cross Sectional Study ◽  
Anthropometric Measurements ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Background: Globally hypovitaminosis D is highly prevalent among all population unsparing pregnant mothers. Maternal hypovitaminosis has negative implications on growing fetus. In India, only limited data available on prevalence of neonatal vitamin D level. Hence this study was done to estimate the prevalence of cord blood vitamin D levels and its relation with anthropometric measurements in newborns.Methods: A cross sectional study was conducted in a tertiary care center on 30 newborns. Cord blood 25 OHD levels and anthropometric measurements were taken. Data were analyzed statistically.Results: Among 30 newborns, 10%, 43% and 46% of babies had vitamin D deficiency (<12 ng/ml), insufficiency and sufficiency respectively. 23% were low birth weight. 43% of low-birth-weight babies had statistically significant (p value<0.0001) hypovitaminosis D. No correlation found between vitamin D status and other anthropometric measurements.Conclusions: Prevalence of hypovitaminosis D has negative implications on birth weight which needs further studies.

Sign in / Sign up

Export Citation Format

Share Document