“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.

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.

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

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.

Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.

Correlation between QoTc and serum as well as ionised calcium in sick neonates

Background: Hypocalcemia is a frequently observed clinical and laboratory abnormality in neonates with risk factors such as prematurity, infant of diabetic mothers and perinatal asphyxia. Hypocalcemia can be asymptomatic or can cause apnoea, seizures, jitteriness, stridor, cardiac abnormalities. Clinically as calcium levels are maintained within narrow ranges. It is therefore imperative to measure and correct any deficit at the earliest. Unfortunately, total serum calcium level correlates poorly with ionized calcium level. Measurement of ionized calcium is both time consuming and expensive and therefore the need for more rapid, inexpensive and non-invasive method for screening at risk-neonates. Serum calcium levels are known to affect the duration of the QoTc interval. Therefore establishing a good correlation between serum/ionized calcium levels and QoTc will validate ECG as a reliable marker of hypocalcemia. Objective was to find correlation between QoTc interval and serum calcium levels in sick neonates.Methods: Total 730 infants were for serum total calcium and ionized calcium levels. Off these 142 infants with hypocalcemia, 29 infants were excluded based on exclusion criteria. The remaining 113 neonates were subjected to three cycles of ECG measurement before correction of calcium and were taken as cases. QoTc intervals were measured and were correlated with corresponding serum total calcium and ionized calcium levels.Results: In this study, a moderate negative or downhill correlation was found between total serum calcium QoT (r = -0.694 and p = <0.001) and QoTc (r = -0.680 and p = <0.001). The ionized calcium levels were found to have strong negative or downhill correlation with QoT (r = -0.837 and p = <0.001), QoTc (r = -0.819 and p = <0.001). All these correlations were found to be statistically significant with p<0.05.Conclusions: QoTc interval can be used as a surrogate marker for blood total or ionized calcium levels.

Total Serum Calcium Level Is Negatively Correlated With Systemic Lupus Erythematosus Activity

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and hypocomplementemia signifies disease activity. Several studies have shown that calcium may help maintain optimum function of immune system and metabolism in SLE. The aim of our study was to analyze the relationship between total serum calcium level and SLE activity. A total of 66 patients with SLE and 214 healthy controls were included in this study. Our results showed lower serum levels of calcium ( P < .001), complement C3 ( P < .001), complement C4 ( P < .001), and albumin ( P < .001) in patients with SLE. A negative correlation was found between serum calcium level and systemic lupus erythematosus disease activity index (SLEDAI) rating ( r = −0.394, P = .001). Additionally, serum level of calcium was positively correlated with serum complement C3 level ( r = 0.366, P = .003) in patients with SLE, while no such correlation was found between serum calcium level and complement C4 ( r = −0.190, P = .126). Likewise, patients with SLE with normal serum calcium level showed higher complement C3 level ( P < .01) than that of patients with low serum calcium level. Overall, the results displayed that patients with SLE have lower serum calcium level compared to healthy controls, and the serum calcium level is positively correlated with SLEDAI rating and serum complement C3 level in patients with SLE. In conclusion, the total serum calcium level is negatively correlated with SLE disease activity.

Duration and dose of antiepileptic drugs and serum calcium levels in children

Background Antiepileptic drugs (AEDs) may affect calcium metabolism through several mechanisms. Much evidence has confirmed that carbamazepine and valproic acid, as the most widely used AEDs in epileptic children, leads to decreased serum calcium levels. This effect was suggested to be time and dose dependent. However, correlations between AEDs and calcium levels in Indonesian epileptic children have not been well studied.Objective To investigate possible correlations between total calcium levels and durations of therapy as well as doses of carbamazepine and valproic acid.Methods This analytical, cross-sectional study was performed from March to May 2015 in the Neuropediatric Outpatient Ward of Mohammad Hoesin Hospital, Palembang, South Sumatera. A total of 60 epileptic children taking carbamazepine and or valproic acid monotherapy were included and grouped accordingly. A single blood test was done for every participant to measure total serum calcium level. Correlation between daily dose or duration of AED with calcium level was assess using the Spearman-rho test.Results The mean total serum calcium levels in the carbamazepine and valproic acid groups were 9.48 (SD 0.83) mg/dL and 9.58 (SD 0.63) mg/dL, respectively. There was a statistically significant moderate correlation between the duration of carbamazepine therapy and total calcium level (r = 0.36; P=0.001). The cut-off point for duration of therapy was 23 months. There were no significant correlations between total calcium level and mean daily carbamazepine dose, nor between total calcium level and duration and dose of valproic acid therapy.Conclusion Longer duration of carbamazepine therapy is associated with low total serum calcium level, but carbamazepine dose is not. In addition, duration and dose of valproic acid are not associated with low total serum calcium level.