Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication

Bone mass density (BMD) has been used universally in osteoporosis diagnosis and management. Adherence to anti-osteoporosis medication is related to mortality risk. This study aimed to investigate the relationship between mortality and low BMD of the femoral neck and vertebra among patients self-discontinuing anti-osteoporosis medication. Between June 2016 and June 2018, this single-center retrospective study recruited 596 participants who self-discontinued anti-osteoporosis medication. Patients were categorized into four groups by BMD of the right femoral neck and lumbar spine. Occurrence and causes of mortality were obtained from medical records. Independent risk factors and the five-year survival of various levels of BMD were analyzed by Cox regression and the Kaplan–Meier survival analysis. BMD value and serum calcium level were significantly lower in the mortality group (p < 0.001). Compared to the reference, the adjusted hazard ratio (HR) for all-cause mortality in patients with lower BMD of both the lumbar spine and femoral neck was 3.03. The five-year cumulative survival rate was also significantly lower (25.2%, p < 0.001). A low calcium level was also associated with mortality (HR: 0.87, 95% CI: 0.76–0.99, p = 0.033). In conclusion, lower BMD and calcium levels were associated with higher mortality risk in patients with poor adherence. Hence, patients self-discontinuing anti-osteoporosis medication should be managed accordingly.

A study on effect of phototherapy in term new-born in a tertiary care centre in south Rajasthan

Background: Phototherapy is a safe and effective method for management of neonatal hyperbilirubinemia with no serious untoward side effects. Hypocalcemia is a common and lesser observed adverse effect of phototherapy.Methods: This study was a prospective observational study done in department of pediatrics, RNT Medical College, Udaipur (Rajasthan). Serum calcium level was observed in term neonates admitted for phototherapy.Results: Out of total 80 neonates included in study 40 received phototherapy and 40 were control. Neonates receiving phototherapy had significantly lower level of serum calcium. Other complication were rashes, loose stool, fever and dehydration.Conclusions: We can conclude from this study that hypocalcemia is a significant complication of phototherapy in newborn and probably monitoring of serum calcium level in babies under phototherapy is warranted.

The Effect of Smoking on Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing in Female

Introduction. Smoking is a bad habit that affects both systemic and oral conditions. Nicotine in cigarettes reduces estrogen production that can alter salivary calcium levels. Nicotine also causes vasoconstriction of the gingival blood vessels and decreases gingival bleeding. Low dietary calcium intake is also suspected to influence the low serum calcium levels in smokers. In this study, we evaluated the effect of smoking on salivary calcium levels, calcium intake, and BOP in women. Method. This was an analytical study using a cross-sectional approach. The subjects were 26 female smokers and 37 nonsmokers. Unstimulated saliva was collected by the spitting method. Salivary calcium levels were measured using an Atomic Absorption Spectrophotometer (AAS). The calcium intake was obtained by the Semiquantitative Food Frequency Questionnaire. BOP was measured by a gingival bleeding index by Ainamo and Bay in 1975. Results. All the basic characteristics including age, BMI, level of education, and occupation were statistically different between groups. The mean calcium level of female smokers was significantly lower than that of nonsmokers, whereas the mean BOP of female smokers was significantly higher. The total calcium intake per day of the two groups was not statistically different. The mean salivary calcium level and BOP decreased when the duration of smoking was longer. There was a positive correlation between salivary calcium level and BOP in the smokers’ group. Conclusion. A low level of education may be contributing to the smoking habit of subjects in this study. Salivary calcium levels were correlated with BOP in female smokers, which might be affected by the duration of smoking.

Calcium Signaling, Calcineurin and NFAT3 Molecular Pathway in Reprogramming of Fetal Gene (BNP) Expression in Cardiac Hypertrophy and Inhibitors of Cardiac Hypertrophy-Review

G-Protein Coupled Receptor (GPCR) plays a major role in cardiac hypertrophy. Isoproterenol is an agonist which binds to GPCR. This results in the activation of GS subunit. Activated Gs subunit stimulates cAMP mediated pathway. This activates the calcium signaling and elevates the calcium level. Increased calcium activates the phosphatase activity of calcineurin. Activated calcineurin dephosphorylates NFAT in cytoplasm. Dephosphorylated NFAT translocates to nucleus and binds to target region in DNA and activates re-expression of fetal genes in synergy with GATA-4 trascription factor. Reprogramming of fetal genes by NFAT- 3 and GATA-4 results in cardiac hypertrophy. Calcineurin inhibitors and rephosphorylation of NFAT can prevent cardiac hypertrophy.

“COMPARATIVE STUDY OF CALCIUM LEVEL IN PREECLEMPTIC AND NORMAL PREGNANT TRIBAL & NON-TRIBAL WOMEN IN JHARKHAND”

Introduction- Pregnancy is a physiological stress in which many biochemical changes changes occur in the body. Preeclampsia, the complication of pregnancy, refers to a syndrome of new onset of hypertension proteinurea after 20 weeks of gestation in previously normotensive women, is due to rise in blood pressure,which is related with calcium change in blood. Recent study, implicated alterations in calcium metabolism in the pathogenesis of hypertension in pregnancy. Serum calcium level of 75 Material & Methodnd rd normal pregnant and 75 preeclemptic Tribal & non-tribal women at 2 & 3 trimesters were estimated by using Arsenazo 3 method, one of the most standard method used for estimation of serum calcium based on colorimetric principle and compared.Observation & Result- The Mean serum calcium level in cases of normal pregnant women in Jharkhand 9.65±0.58mg/dl while mean total serum calcium level of pre-eclamptic was 6.97mg/dl is lesser in comparison to normal pregnancy. There is signicant Conclusion- decrease in total serum calcium level in preeclemptic as compare to normal pregnant women in Jharkhand.

Determination of Total Protein and Calcium in Gingival Mesenchymal Stem Cell-Conditioned Medium

Gingival mesenchymal stem cell-conditioned medium (GMSC-CM) is a conditioned medium obtained from cultured gingival mesenchymal stem cells. GMSCs are easily isolated from gingival tissue, whereas gingival tissue is easily obtained by minimally invasive techniques. On the other hand, CM contains proteins, cytokines, chemokines and growth factors that play an important role in osteogenic differentiation.This study aims to determine the total protein and calcium levels in GMSC-CM.GMSCs were grown in culture media with 10% of FBS. CM of GMSC was obtained from the media collection process with a 0.22 µm filter and concentrated with a centrifugal filter to obtain a concentrated GMSC-CM. The concentration of total protein was performed by bicinchoninic acid protein assay on GMSC-CM and concentrated GMSC-CM. Calcium level was performed by atomic absorption spectroscopy method. The results arethat GMSC-CM had a total protein concentration of 2502±0.06 µg/ml, and the concentratedGMSC-CM was 1.912±0.08 μg/ml.The calcium level of GMSC-CM was 0.009% and concentratedGMSC-CM was 0.009%. It can be concluded thatGMSC-CM had a high concentration of total protein and calcium. These parameters were used to develop bioprocesses to enhance the production of GMSC-CM, which will support the implementation of cell-free therapy for tissue regeneration.

Association Between Serum Calcium and the Prevalence of Hypertension Among US Adults

Background: Hypertension is a significant risk factor of cardiovascular diseases, posing a serious threat to global health. Calcium plays an important role in regulating body homeostasis. The association of calcium with hypertension remains uncertain in the general population.Methods and Results: Cross-sectional data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Adjusted multivariable logistic regression analysis and restricted cubic spline were used to investigate the association of serum calcium with the prevalence of hypertension. A total of 26,778 participants were included. The increase in calcium levels showed a positive association with the prevalence of hypertension in all three models with ORs of 1.347 (1.249–1.454), 1.522 (1.401–1.654), and 1.438 (1.306–1.583). The further subgroup analysis demonstrated a robust trend across all categories by sex, age, race, BMI, and eGFR. The restricted cubic spline plot exhibited an S-curve relationship between calcium and hypertension.Conclusion: Our cross-sectional study demonstrated a positive association between higher serum calcium level and the prevalence of hypertension. Our findings highlighted serum calcium level in hypertensive patients.

A study of serum calcium level in cases of malaria in a tertiary care hospital

Background: Malaria is a tropical disease caused by Plasmodium species, commonly P. falciparum and P. vivax. Carpopedal spasm has been noted in many patients presenting with malarial fever. Most of the patients are later found to have hypocalcaemia. Hypocalcaemia associated with malaria can cause many clinical manifestations, including life threatening conditions such as arrhythmias, convulsions etc.Methods: A cross-sectional study was conducted with the aim to determine the prevalence and clinical profile of hypocalcaemia in different types of malarial fever. 88 patients of malarial fever were studied. Patients were stratified according to the species of plasmodium and into complicated and uncomplicated malaria. Total serum calcium level and QTc interval were analysed in each patient. Data collected were analysed.Results: Prevalence of hypocalcaemia in malaria was found to be 54.45% in our study. Hypocalcaemia was more prevalent in complicated malaria than uncomplicated malaria. Complicated falciparum malaria showed highest prevalence of hypocalcaemia. Status of complexity of malaria was not found to be related to occurrence of hypocalcaemia in any types of malaria. Prevalence of QTc prolongation in malaria was found to be 48.46%. Prevalence of QTc prolongation was found to be more in complicated malaria than uncomplicated malaria. QTc prolongation was most prevalent in complicated falciparum malaria. 83.3% of those with QTc prolongation had hypocalcaemia.Conclusions: Hypocalcemia and QTc prolongation were more prevalent in complicated malaria than in uncomplicated malaria. Both Hypocalcaemia and QTc prolongation were most prevalent in complicated falciparum malaria.

To Study the Association of Total Serum Calcium Level in Assessing the Severity of Pancreatitis

Background: Pancreatitis is an inflammatory condition that affects the pancreas and may also affect other tissues or distant organ. In this study our aim is to see if blood calcium level can be used as a prognostic marker in determining the severity of acute pancreatitis because hypocalcaemia is linked to higher mortality and hospitalization. Method: A retrospective study was conducted in the medical records department of a tertiary care health facility. A total of 75 participants were included in the research. .demographic details of all patients were collected .Patients above 18 years who presented with of epigastric pain, pre-Diagnosed gallstones, alcoholism were included int this study. The lowest total calcium levels were collected in order to examine total calcium as a predictive factor for severity. All of these information were collected and analyzed to get the appropriate findings. Results: A total of 75 patients were included in the research. The age of patients in each severity grade did not differ significantly (p value>0.05). The gender distribution of the two groups did not differ. (P >0.05). For mild and severe acute pancreatitis, mean total calcium levels were 7.98 and 6.67, respectively, which was statistically significant (p< 0.05). Conclusion: The total serum calcium level is a useful indicator for assessing pancreatitis.