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Background: Preeclampsia is a life-threatening multisystem disorder of pregnancy which has been observed in 2%–10% of pregnancies. The prevalence of Vitamin D deficiency ranges from 15% to 80%. Deficiency of Vitamin D is associated with the development of preeclampsia. This study was done to find out the prevalence of Vitamin D deficiency among preeclamptic/eclamptic and normal pregnant females, to establish Vitamin D deficiency as a causal factor of preeclampsia, and to elucidate the relation between 25 (OH) Vitamin D status and the severe preeclampsia. Materials and Methods: Blood samples were collected from 50 normotensives (controls) and 50 hypertensive pregnant females with preeclampsia/eclampsia (cases), and 25 (OH) Vitamin D level was measured by chemiluminescence Immunoassay. Results: Among the preeclamptic/eclamptic group, 32 (64%) were noted with Vitamin D deficiency and 18 (36%) with Vitamin D insufficiency. In the control group, 30 (60%) pregnant women showed Vitamin D deficiency, 19 (38%) with Vitamin D insufficiency, and a sufficient level of Vitamin D was observed in one woman (2%). Conclusion: Although it is difficult to demonstrate the correlation between Vitamin D levels and preeclampsia, there is a widespread global prevalence of Vitamin D deficiency during pregnancy. Hence, Vitamin D supplementation can be included routinely in the antenatal care program in India. [ABSTRACT FROM AUTHOR]

Objective of the study was to find the association of vitamin D receptor (VDR) polymorphisms (Fokl, Taql and Apal) with vitamin D levels in diabetic foot ulcer (DFU) patients in South India. In this case–control study, plasma vitamin D levels and VDR genotype frequencies of 70 cases (DFU patients) were compared with 70 diabetic (diabetes mellitus [DM] [non‐DFU]) patients and 70 apparently healthy controls (HC) from South India. Plasma vitamin D levels were measured using the ELISA technique, and genotyping of VDR polymorphisms was carried out using real‐time polymerase chain reaction. Logistic regression was used to find the association between DFU versus HC and DFU versus DM traits. Association analysis was performed based on additive, dominant and recessive models with age and gender as covariates. A 45.7% of DFU patients have sufficient vitamin D levels than 48.6% and 40% of DM patients and HC, respectively. Linkage disequilibrium analysis for DFU versus HC and DFU versus DM traits shows that single nucleotide polymorphisms (SNPs) Taq1 (rs731236) and Apal (rs7975232) are in strong linkage disequilibrium in DFU patients. The alleles and genotype frequencies were similar in all three groups. Although the additive model does not show statistical significance, age and sex correlate with the three SNPs (Fokl, Taql and Apal). No association was found between VDR gene polymorphisms and vitamin D levels in DFU patients in Southern India. On the other hand, age and sex correlate with the three SNPs. [ABSTRACT FROM AUTHOR]

Background: Vitamin D (VD) plays a crucial role in regulating calcium and phosphorus metabolism and bone growth and has emerging roles beyond the skeleton. Deficiency is linked to various health issues, especially in postmenopausal women. The burden of T2DM in India, particularly among women, emphasizes the need for exploring the VD-diabetes connection. Aim and Objective: To investigate VD levels in postmenopausal women with T2DM compared to premenopausal women, assessing the association between VD deficiency and glycemic control. Materials and Methods: A case-control study was conducted in Chennai, India, involving pre-menopausal and post-menopausal women with T2DM. Ethical clearance was obtained, and participants were recruited with informed consent. Fifty pre-menopausal and post-menopausal women, each with T2DM, were included. Exclusions involved individuals taking calcium and vitamin D supplements, anticonvulsants, and those afflicted with osteoporosis, renal disease, asthma, and hypertension. Blood samples were collected for glucose and VD level assessments, employing standard methodologies. Results: Pre-menopausal women exhibited significantly higher VD levels compared to their post-menopausal counterparts. Blood sugar levels did not significantly differ based on menopausal status. Conclusion: This study contributes valuable insights into the complex interplay between VD, menopausal status, and glycemic control in women with T2DM. The high prevalence of VD deficiency and its association with suboptimal glycemic control emphasize the need for further research. Understanding these relationships is crucial for developing targeted interventions for postmenopausal women with diabetes. [ABSTRACT FROM AUTHOR]

Background and Aim: Evidence suggests a beneficial effect of sun exposure on type 2 diabetes mellitus (DM). However, little is known about the characteristics of sun exposure among DM patients or individuals at risk of developing DM. The aim of this study was to analyze the sun exposure behaviors of individuals diagnosed with DM and those susceptible to developing DM within a semi-urban community in North India. Materials and Methods: A population-based cross-sectional study was conducted in northern India with 494 participants aged 25-60, with or without DM. The participants' sun exposure characteristics were assessed through a sunlight exposure questionnaire, and total sun exposure in a day was computed using the veritable sun exposure (VSE) index. Fasting blood sugar, anthropometric measurements, and demographic details were also collected. Results: The study had 56.5% female participants, and 9.1% of the participants had DM. The VSE of the study participants ranged from 0.01 to 0.81, with a mean of 0.15 (±0.14) and a median of 0.10, indicating that more than half of the study samples had less than 10% h/day of sunlight exposure. The use of sunscreen, gender, and disease status all influenced VSE. Our data suggest that the characteristics of sun exposure among Indians significantly deviate from standard recommendations. Conclusion: Our results propose a need for evidence-based guidelines and policies that promote awareness about sun exposure among DM patients as well as those at risk of developing DM. Nevertheless, these findings need to be validated through large-scale observational studies. [ABSTRACT FROM AUTHOR]

Aim and background: Sepsis is a major global health affecting millions worldwide, hence understanding its contributing factors becomes paramount. This cross-sectional study at a tertiary care center explores the relationship between iron profile, vitamin D levels, and outcomes in sepsis and septic shock patients. The primary objective was to explore the prevalence of iron profile and vitamin D parameters during early intensive care unit (ICU) admission and their association with 28-day mortality. Materials and methods: Spanning 18 months, the study enrolled adult patients meeting sepsis or septic shock criteria at the ICU. Data collection included demographic information, clinical characteristics, and blood samples for iron profile and vitamin D levels at admission. Disease severity was assessed using sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores, and treatment was administered as per surviving sepsis-3 guidelines. Results: The research involved 142 participants, uncovering prevalent organisms such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Noteworthy connections to mortality were identified for factors including vasopressor support, ICU stay duration, SOFA score, and APACHE-II score. Interestingly, age, gender, and vitamin D levels showed no significant associations. However, the study did reveal a significant association between iron, ferritin, and transferrin saturation levels with increased 28-day mortality. Conclusion: Our study concluded that low Iron, elevated ferritin, and decreased transferrin saturation levels maintained associations with the outcome of interest. While no such relationship was established with vitamin D levels. These results suggest potential implications for patient management and prognosis, warranting further exploration in future research. [ABSTRACT FROM AUTHOR]

Vitamin D (VitD) is a naturally occurring, fat-soluble vitamin which regulates calcium and phosphate homeostasis in the human body and is also known to have a neuroprotective role. VitD deficiency has often been associated with impaired cognition and a higher risk of dementia. In this study, we aimed to explore the relationship between levels of VitD and cognitive functioning in adult individuals. 982 cognitively healthy adults (≥ 45 years) were recruited as part of the CBR-Tata Longitudinal Study for Aging (TLSA). Addenbrooke's cognitive examination-III (ACE-III) and Hindi mental status examination (HMSE) were used to measure cognitive functioning. 25-hydroxyvitamin D [25(OH)D] levels were measured from the collected serum sample and classified into three groups— deficient (< 20 ng/ml), insufficient (20–29 ng/ml) and normal (≥ 30 ng/ml). Statistical analysis was done using IBM SPSS software, version 28.0.1.1(15). The mean age of the participants was 61.24 ± 9 years. Among 982 participants, 572 (58%) were deficient, 224 (23%) insufficient and only 186 (19%) had normal levels of VitD. Kruskal–Wallis H test revealed a significant difference in age (p = 0.015) and education (p = 0.021) across VitD levels and the Chi-square test revealed a significant association between gender (p = 0.001) and dyslipidemia status (p = 0.045) with VitD levels. After adjusting for age, education, gender and dyslipidemia status, GLM revealed that individuals with deficient (p = 0.038) levels of VitD had lower scores in ACE-III verbal fluency as compared to normal. Additionally, we also found that 91.2% individuals who had VitD deficiency were also having dyslipidemia. It is concerning that VitD deficiency impacts lipid metabolism. Lower levels of VitD also negatively impacts verbal fluency in adult individuals. Verbal fluency involves higher order cognitive functions and this result provides us with a scope to further investigate the different domains of cognition in relation to VitD deficiency and other associated disorders. [ABSTRACT FROM AUTHOR]

Introduction: Breast carcinoma is one of the most prevalent types of carcinoma and the leading cause of death among all carcinomas. Recently, vitamin D deficiency has been reported as a risk factor for breast carcinoma. Vitamin D, as an anticarcinoma agent, prevents cellular differentiation, stimulates cell death, reduces angiogenesis, tumour progression, and metastasis. Aim: To investigate the relationship between vitamin D deficiency and the risk of breast carcinoma. Materials and Methods: An observational study was conducted at the Armed Forces Medical College, Pune, Maharashtra, India, between November 2018 and October 2020. A total of 57 cases diagnosed with breast carcinoma and 57 healthy controls were analysed. Physical and reproductive health parameters were compared, along with vitamin D status using student's t-test and Mann-Whitney U test. Logistic regression was used to assess the risk of breast carcinoma. Results: Out of 114 women, 57 were cases and 57 were controls with a mean age of 52 vs 48 years. The mean value of serum vitamin D levels was significantly lower (19.45 vs 27.91 ng/mL, p<0.001) than controls. The percentage of serum Vitamin D deficiency was significantly higher in cases (28 (49.1%) vs 12 (21.1%), p<0.001) compared to controls. Vitamin D concentration <20 ng/mL was significantly associated with a higher risk of breast carcinoma (OR 10.8, 95% CI 3.1-37.6). Multiparity =3 was associated with a decreased risk of breast carcinoma (OR 2.250, 95% CI 0.599-8.447) compared to parity =2 (OR 3.241, 95% CI 0.916-11.466). In luminal A and triplenegative subtypes, severe vitamin D deficiency (<20 ng/mL) was observed (p=0.045) compared to other subtypes. Conclusion: The present study findings showed that women diagnosed with breast carcinoma had low vitamin D levels, which were linked to an increased risk and prognosis of breast carcinoma. Furthermore, multiparity lowers the risk of breast carcinoma. [ABSTRACT FROM AUTHOR]

Objective: To observe the correlation of serum Vitamin D levels in male alcoholic individuals. Materials and methods: A total of 54 male individuals, aged between 21 to 70 years with history of alcohol consumption were included.. Analysis of serum vitamin D by Vitros autoanalyser was done. Result: It was observed that maximum number of individuals consumed 15-16 drinks per week. Very few individuals consumed 20 - 21 drinks per week. Vitamin D levels were in sufficient range in participants who consumed 15 - 16 drinks per week. Whereas levels were lowered as the number of drinks consumed were increased. Moderate negative correlation between number of drinks consumed per week and Vitamin D levels which was statistically significant was observed. Conclusion: Our results clearly show that individuals who consume more than 15 drinks per week have insufficient serum Vitamin D levels compared to the normal reference range. This was statistically proven using Karl Pearson's correlation formula, establishing a moderate negative correlation. Therefore, we can conclude that as the number of drinks per week increases, serum Vitamin D values decrease. It is necessary to develop national monitoring systems to track alcohol consumption and its consequences, raising awareness among the public and policymakers. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes leads to many microvascular complications, including diabetic nephropathy, also referred to as diabetic kidney disease. Vitamin D deficiency may play a role in the development of type 2 diabetes and nephropathy. The functions of vitamin D are mediated through vitamin D receptor (VDR). Three single nucleotide polymorphisms (SNPs) in VDR gene, namely, TaqI (rs731236), ApaI (rs7975232), and BsmI (rs1544410), have been widely studied in association with diabetes and nephropathy. The objective of this study was to investigate the association of these VDR gene SNPs with nephropathy in the South Indian population. Additionally, the effect of VDR gene variants on vitamin D levels was also investigated. Subjects and Methods: Two hundred forty-eight individuals with type 2 diabetes without nephropathy (T2DM) and 399 individuals with type 2 diabetes with nephropathy (T2DN) were genotyped for this study. Genotyping of TaqI was performed using the polymerase chain reaction-restriction fragment length polymorphism method. BsmI and ApaI were genotyped using MassArray. Anthropometric and biochemical data were collected for all participants. Vitamin D levels were measured in a subset of 47 T2DM and 74 T2DN individuals. Statistical analysis was performed using Statistical Package for the Social Sciences version 21.0 (IBM Corporation, Armonk, NY). Results: The genotype and minor allele frequencies of TaqI, BsmI, and ApaI were not significantly different between T2DM and T2DN groups. However, vitamin D levels were significantly reduced in T2DN (15.5 ± 1.16ng/ml) compared to T2DM (20.5 ± 2.11ng/ml, P = 0.027). No significant differences were found in the vitamin D levels when the T2DM and T2DN groups were stratified based on TaqI, BsmI, and ApaI genotypes. Conclusion: This study did not find a significant association of VDR SNPs (TaqI, BsmI, and ApaI) with T2DN. However, the study suggested a protective role of vitamin D levels in T2DN. [ABSTRACT FROM AUTHOR]

Background: The incidence of type 1 diabetes (T1D) is showing a rising trend all over the world, and these patients are living longer than before. With increasing longevity, they are at increased risk of chronic complications including fractures. However, the bone mineral density (BMD) data in T1D patients are conflicting and variable across the studies. Here, we aimed to study the BMD in adult patients with T1D and delineate its predictors. Material and methods: We recruited 40 T1D patients and equal number of age- and sex-matched control subjects. Clinical, biochemical, hormonal, and densitometric assessments were performed for each of the participants and compared between the two groups. Results: The median age of T1D and control subjects was 23.5 (21–27.75) years and 24 (22–26) years, respectively. The median duration of diabetes in T1D patients was 12.5 (9–15.75) years with a mean HbA1C of 8.7 ± 1.9%. The serum corrected calcium, phosphorous, alkaline phosphatase, creatinine, and plasma 25-hydroxyvitamin D and iPTH levels were comparable between the groups. In T1D subjects, the mean lumbar spine and left hip BMD were 0.876 ± 0.154 gm/cm2 and 0.780 ± 0.112 gm/cm2, respectively, which corresponded to mean Z-scores of -1.5 ± 1.4 and -1.4 ± 0.9, respectively, which were significantly lower compared to control group. Multiple linear regression analyses showed that BMI and serum albumin were significant determinant of lumbar spine and hip BMD, respectively, in patients with T1D. Conclusion: Patients of T1D have apparently reduced BMD, which is being influenced by BMI and serum albumin level. [ABSTRACT FROM AUTHOR]

Background: Congenital ichthyoses are a rare Mendelian group of disorders affecting the integument with a heterogeneous clinical presentation amongst which scaling is a constant feature. There is scanty epidemiologic data regarding the clinical profile and histologic patterns of inherited ichthyosis from resource-poor countries. Aims and Objectives: The study was aimed at assessing the clinic-epidemiologic characteristics associated with the different forms of non-syndromic congenital ichthyosis. Materials and Methods: This was a retrospective chart review of ichthyosis patients that presented between July 2016 and Jun 2020. Details including demographic profile, clinical characteristics along with any relevant investigations done were included. Results: During the study period of 4 years, 107 patients with congenital non-syndromic ichthyosis were seen. The most frequent diagnosis was of common ichthyoses, followed by autosomal recessive congenital ichthyosis, epidermolytic ichthyosis and erythrokeratoderma, in decreasing order. Conclusion: Important clinical findings like erythema and the type of scales as well as histological differences including an absent or reduced granular layer in ichthyosis vulgaris can help differentiate among the clinical phenotypes of inherited non-syndromic ichthyosis especially in resource-poor settings. Also, there is a high prevalence of vitamin D deficiency and hence a need for screening for the same in all patients of congenital ichthyosis including the milder phenotypes. [ABSTRACT FROM AUTHOR]

Research on vitamin D status in Indian children has been confined to studies conducted on small samples from certain regions and using non-standard techniques to quantify 25(OH)D3. Vitamin D insufficiency was observed in this multicenter research that used a standardized technique to evaluate 25(OH)D3 concentrations from dried blood spots (DBS) in children and adolescents from 5 to 18 years old in India. This school-based cross-sectional observational research used a multi-stage stratified random sampling technique. We picked a city and its surrounding hamlet from six states in India, which span a lot of ground. Data was gathered on demographics, anthropometry, body composition, food intakes, and DBS samples. Liquid chromatography with tandem-mass spectrometry was used to evaluate 25(OH)D3 in DBS. A total of 2450 youngsters had their vitamin D level checked, with a subset (n = 672) having extra data obtained for the purpose of evaluating predictors. In the study, 36.8% of participants had adequate vitamin-D levels (> 50 nmol/L), with greater concentrations seen in rural respondents and boys (p < 0.05). The mean vitamin-D concentration was 45.8 ± 23.9 nmol/L. [ABSTRACT FROM AUTHOR]

Background: Vitamin D, a key nutrient in the body, has been linked to a decrease in prostate cancer (PCa) morbidity and mortality rates. The study concluded that any compensation mechanism may no longer be adequate for patients with PCa, and further research is needed to understand the mechanisms underlying the relationship between serum Vitamin D and parathyroid hormone (PTH) homeostasis. The findings will help determine cancer prevalence and trends in India and support public health initiatives to control cancer. Aims and Objectives: The aim is to assess the mean values of Vitamin D and PTH in patients with PCa and also to compare these levels with that of healthy controls (non-PCa). Materials and Methods: One hundred participants in the outpatient department of the Department of Biochemistry were assigned as control subjects, and another 100 participants were participants with PCa. 5 mL of fasting venous blood were drawn into red top vials using a disposable syringe and needle in an aseptic manner. PTH and serum Vitamin D were estimated. Results: When comparing PCa patients to healthy controls, the observed Vitamin D level was significantly lower in the former group. Furthermore, a notable distinction in Vitamin D levels was noted between the two groups. Furthermore, we found that PCa patients had higher PTH values than healthy controls. When we compared the PTH values of the two groups, we found a substantial difference. Conclusion: The authors conclude from the study that with alterations in the study parameters in patients with PCa, any compensation mechanism may become insufficient. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D is essential for bone mineral metabolism and for the growth and development of the skeleton. The American Academy of Paediatrics and the Indian Academy of Paediatrics recommend the administration of 400 IU per day of oral Vitamin D to all infants in the first year of life. The authors hypothesised that routine supplementation of 400 IU of Vitamin D to exclusively breastfed infants would result in better physical growth. Aim: To examine the effect of routine vitamin D supplementation (400 IU/day) on the weight, length, and head circumference of term, exclusively breastfed infants at six months of age. Materials and Methods: An observational study was conducted at Department of Paediatrics, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India, from November 2018 to March 2020, comparing the weight, length, and head circumference at birth and at six months of age for 111 exclusively breastfed term, appropriate for gestational age, healthy infants who were not supplemented with oral Vitamin D (Group-I) with 111 infants who were supplemented with 400 IU of oral Vitamin D daily (Group-II). Infants who presented at the Paediatric Out-Patient Department of SKNMC, Pune at around six months of age were enrolled in the study. Birth data and anthropometry at birth were recorded from available medical records. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0. Quantitative data were presented with the mean and standard deviation. Comparison among the study groups was done using an unpaired t-test as per the results of the normality test. Association among the study groups was assessed with the help of a Student's t-test. A p-value of <0.001 was considered statistically significant. Results: The mean birth weight, length, and head circumference of infants who were not supplemented with vitamin D (Group-I) were 2907.57±250.18 gm, 53.34±1.47 cm, 35.99±1.067 cm, respectively, and those who were supplemented (Group-II) were 2901.08±231.63 gm, 53.75±1.51 cm, and 35.85±1.09 cm, which were comparable in both groups. At six months, the mean weight, length, and head circumference in Group-I and Group-II were 7211.08±626.39 gm, 70.25±1.58 cm, 43.82±1.19 cm, and 7973.87±532.31 gm, 70.90±1.75 cm, and 45.01±1.34 cm, respectively. There was an increase in anthropometric parameters in both groups. The increase was greater in Group-II than in Group-I and was statistically significant (p<0.001). Conclusion: Infants supplemented with vitamin D (400 IU/ day) demonstrated better physical growth in terms of higher anthropometric values. [ABSTRACT FROM AUTHOR]

Introduction: There is rising concern about vitamin D deficiency around the globe due to its increasing association with multiple medical disorders. Diabetes Mellitus (DM) is an established risk factor for atherosclerotic disorders, and Carotid Artery Intima- Media Thickness (CIMT) is considered a radiological marker of subclinical atherosclerosis. Aim: To find a correlation between serum 25-hydroxy vitamin D (25-(OH)-D) levels and CIMT among patients with DM. Materials and Methods: A hospital-based cross-sectional study was conducted, including 100 adult patients with Type 2 DM who were admitted to the Department of Medicine at SCB Medical College and Hospital in Cuttack, Odisha, India from October 2020 to September 2021. Vitamin D deficiency was defined as serum 25-(OH)-D levels <20 ng/mL, and insufficiency as <30 ng/mL. The demographic profile of patients, family history of Type 2 DM, smoking history, blood pressure, haemogram, blood sugar, serum electrolytes, and lipid profile were studied. CIMT of the bilateral Common Carotid Artery (CCA) was measured by B-mode ultrasonography. CIMT values ≥ 0.8 mm were considered abnormal. Data were analysed using appropriate statistical tests in Statistical Packages for Social Sciences (SPSS) version 26.0. Results: The present study included 55% males (n=55) and 45% females (n=45). The average age of the patients was 60 ±10 years, ranging from 26-75 years. Vitamin D deficiency was highly prevalent among patients with Type 2 DM (73% deficient, 12.5 ng/mL; 21% insufficient, 24.7 ng/mL). Vitamin D deficiency/ insufficiency was higher among male participants (57.5%, 62%) compared to females (42.4%, 38%). Vitamin D levels were significantly associated with dyslipidemia. Mean CIMT among the vitamin D deficiency versus insufficiency versus normal group were 0.87 versus 0.87 versus 0.7 mm on the right Common Carotid Artery (CCA), and 0.95 versus 0.86 versus 0.75 mm on the left CCA, respectively. Significant negative correlations were observed for HbA1c (r=-0.025), Triglycerides (r=-0.274), right CIMT (r=-0.284), and left CIMT (r=-0.264) with serum 25-(OH)-D levels. Conclusion: The majority of patients with Type 2 DM have concurrent vitamin D deficiency. A significant inverse linear association between serum vitamin D levels and CIMT was observed, indicating the association of vitamin D deficiency with subclinical atherosclerosis. Although unproven in the present study, the role of vitamin D supplementation in the improvement of atherosclerosis remains unclear. [ABSTRACT FROM AUTHOR]

Background: Primary hyperparathyroidism (PHPT) is a common endocrine condition but rare in the pediatric and adolescent populations. The presentations can be unique, accounting for significant morbidity in the case of untimely detection. Aim: To study surgically treated pediatric PHPT retrospectively. Methods: Surgically treated children of PHPT up to 20 years of age between 2010 to 2022 were analyzed. All of them were operated on by an endocrine surgeon and team. Results: There was a total of 712 parathyroidectomies over 12 years, out of which there were 52 children (7.3%) had PHPT at less than 20 years of age. This group included 32 male children. The mean age was 16.1 years, including 7 cases of neonatal severe HPT. Multiple Endocrine Neoplasia type 1 was confirmed in 12 children. Presentations were more severe like bone pain (35.13%), renal stones (27.02%), incidental asymptomatic detection (18.9%), failure to thrive (10.8%), and pancreatitis (8.1%) as compared to adults. Mean serum calcium was 12.9 mg/dl (highest-14.1, N-8.8-10.8 mg/dl), mean parathormone levels were 386.91 pg/ml (N-10-65) and vitamin D levels ranged from 2.9-22.8 ng/ml. Localization was done with ultrasound and 99mTc- SESTAMIBI scans. Mean serum calcium levels in NSPHPT were 28.6 mg/dl (N-8.8-10.8 mg/dl). There were a total of 45 cases (6.32%) of PHPT less than 20 years of age, excluding the cases of NSPHPT. All children underwent parathyroidectomy, with 14 cases having an additional thymectomy, 2 cases with thyroidectomy, and a single case of hemithyroidectomy. The cure rate was 97.3%, while one baby with NSPHPT had persistent disease (postop PTH-110 pg/ml). The uniglandular disease was seen in 54.05% and the rest had a multiglandular disease. Adults accounted for 559/660 cases with 80% uniglandular disease. All cases had a postoperative histopathological confirmation with an average follow-up of 1 year. Conclusion: Childhood PHPT has a few features same as the adult population. Symptomatic presentations like adults, though pancreatitis and fatigue were more commonly seen as compared to bone pain. Calcium, phosphorus, and parathormone levels were comparable. Uniglandular involvement was seen just like the adult population. There are a few others that make them a distinct subtype like their symptoms of bone pain and being more common among boys. One-fourth of them had MEN1. Fewer cases in this age group make them unique. [ABSTRACT FROM AUTHOR]

Introduction: In diabetes, role of vitamin D in insulin sensitivity and its protective effect from complications has been proven by many animal model studies. However, place of vitamin D as a preventive or therapeutic measure in diabetes mellitus is yet not established. Aim: To study the association between vitamin D level and micro vascular complications of diabetes mellitus. Methods: A hospital based observational study on 119 Patients of type 2 diabetes mellitus at a tertiary care center India was done between Jan 2020 to Dec 2022. All routine lab parameters were done and patients were evaluated for diabetic retinopathy and neuropathy and nephropathy. Statistical analysis was done by pearson correlation test, fisher's exact test and ANOVA. Linear regression analysis was also done. Results: out of 119 patients, with mean age of 49.5 year, mean duration of diabetes 6.5yr. On comparison between vitamin D level and frequency of diabetic neuropathy, significant association was found whereas no significant association was found between vitamin D deficiency and diabetic nephropathy and retinopathy. Conclusion: Vitamin D deficiency may be a risk factor for development of diabetic neuropathy and dyslipidaemia, in patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency in inflammatory bowel disease (IBD) patients may have important clinical implications.Therefore, it is important to investigate the prevalence of vitamin D deficiency in patients with IBD to better understand its impact on disease management and outcomes. Objectives: To assess the prevalence of vitamin D deficiency in patients with IBD using a radioimmunoassay method. Material & Methods: This was a prospective, observational study conducted at the Department of Medicine, Government of Medical College Jammu, India for a year from 1 November 2021 to 31 October 2022. Adult patients from OPD and IPD with biopsy proven IBD were included. Results: A total of 40 patients were included in the study with mean age of 38.7 years. Majority of patients (70%) were male and 50% patients belonged to age group of 30-60 years. The mean vitamin D level was 25.6 ng/mL and 62.5% of patients observed with vitamin D deficiency. Both genders and age were affected, with a significant proportion of patients having abnormal vitamin D levels. The vitamin D level was found to be comparable between both genders (P>0.05)and age groups (0.229). Conclusion: The present study investigated the high prevalence of vitamin D deficiency among patients with IBD. Additionally, patients were supplemented with vitamin D and were followed for further monitoring and evaluation for their outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives: The occurrence of Down syndrome and chromosomal nondysjunction is more prevalent in the progeny of mothers who conceive at an advanced age. The primary objectives of the study were to investigate the prevalence of Vitamin D deficiency through the evaluation of 25(OH) Vitamin D levels in children diagnosed with Down syndrome. Material and Methods: This study employed a prospective descriptive design. The research was carried out at the Department of Pediatrics, Gayatri Vidya Parishad Institute of Health Care and Medical Technology, Visakhapatnam, Andhra Pradesh, which is a medical center providing specialized care in India. The study spanned from May 2022 to April 2023. A total of 50 children who were thought to have Down syndrome were subjected to examinations. Results: A total of 50 youngsters who were thought to have Down syndrome were subjected to interviews. Two individuals exhibited a cytogenetic profile consistent with Down syndrome; nevertheless, they expressed a lack of willingness to undergo additional diagnostic pro cedures. Three individuals exhibited clinical characteristics consistent with Down syndrome, however, they declined to provide a blood sample for subsequent diagnostic testing and verification. The cytogenetic study of the youngster, consisting of 50 samples, did not reveal any evidence of Down syndrome. The analysis comprised a total of 50 children, consisting of 40 boys and 10 girls. The following table and graph provide an overview of the demographic composition of the children in terms of age and gender. Conclusion: Children with Down syndrome had a prevalence of 25 (OH) Vitamin D deficiency of 26.8%. Deficiencies in 25 (OH) Vitamin D had no appreciable effect on these children's height, bone age, or other biochemical indicators. [ABSTRACT FROM AUTHOR]

A study conducted in North India examined the effects of vitamin D therapy on the quality of life in patients with fibromyalgia, a non-inflammatory illness characterized by widespread musculoskeletal pain and fatigue. The study found that a majority of fibromyalgia patients were deficient in vitamin D, and after vitamin D therapy, there was a significant improvement in their quality of life. While there is no clear evidence that vitamin D deficiency directly causes fibromyalgia, the study suggests that vitamin D replacement therapy can be beneficial for patients. However, more research is needed to fully understand the relationship between fibromyalgia and vitamin D levels and to determine the effectiveness of vitamin D therapy for fibromyalgia patients. [Extracted from the article]

Aim & Objective: To analyse the vitamin D levels in COPD patients and to correlate with disease severity Methodology: A case control study was carried out during the period of January 2018 to June 2019. Chronic obstructive pulmonary disease patients and healthy volunteers with age group of more than 30 to 75 years were selected for the study. The total numbers of samples for the study were 40 cases and 40 control attending the outpatient & inpatient Department of Pulmonary medicine and General medicine, Ayaan Institute of Medical Sciences, Hyderabad, Telangana, India. Results: The study concludes that there is an increase in the incidence of COPD amongmales (64%). The mean age of the COPD cases and Controls are 55.9 ± 6.90 and 52.74 ±8.62. 62.5% of the COPD patients are smokers, while 38% had COPD due to various factors like Biomass fuel exposure, Occupational exposure. Most of the COPD patients were within the normal BMI (75%). 15% of them are underweight and 10% had high BMI. The mean Vitamin D level among COPD patients and Healthy volunteers in thepresent study are 30.11 ± 11.58 and 50.05 ± 2.99 respectively. Vitamin D deficiency is present in 40% of COPD patients and 12% of controls. Vitamin D levels correlate inversely with the increase in severity of COPD. In the present study the mean Vitamin D levels among COPD patients with less than 2 exacerbations/year and more than ≥2 exacerbations/year are 39.26±6.41 and 31.04±13.11 respectively. Conclusion: Vitamin D levels are reduced with increase in the severity of COPD. There is also reduction in vitamin D level with increased exacerbations of COPD. [ABSTRACT FROM AUTHOR]

Background and objectives: Vitamin D has a significant impact on glucose metabolism. Increased insulin exocytosis, direct activation of insulin receptors, and increased glucose absorption by peripheral tissues all contribute to decreased insulin resistance. The study's goal is to look at vitamin D levels in people with type 2 diabetes and how they relate to diabetic nephropathy. Material and Method: This study lasted, from March, 2022 to February, 2023, at Department of General Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India. The connection between circulating vitamin D levels and the presence of diabetic nephropathy in type 2 diabetes mellitus outpatients and inpatients of medical wards was investigated in this cross-sectional investigation. Result: Our study included 200 patients, 100 of whom were female and 100 of whom were male. When comparing genders, there is a statistically significant increase in female patients with Vitamin D. Here, 70 patients with vitamin D shortage were found to have diabetic nephropathy, which is statistically insignificant, and 30 patients with vitamin D sufficiency were found to have diabetic nephropathy, which is statistically negligible. Conclusion: Vitamin D has been found to have both direct and indirect action via vitamin D receptor activation, as well as effects on various pathogenesis and type 2 diabetes, including pancreatic beta cell dysfunction, insulin action impairment, and systematic information. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown that vitamins reduce the risk of cancers, but the relationship between serum vitamin levels of vitamin D and B12 in breast cancer is still controversial. In this study, we evaluated serum levels of vitamin D and B12 in Haryana, India among patients with carcinoma breast and investigated their association with clinical and laboratory parameters. Aims and Objectives: The study aimed to estimate and correlate the serum vitamin D and vitamin B-12 levels in patient with diagnosed carcinoma breast and in control subjects. Materials and Method: The present study comprises 60 subjects of both pre and post menopause women whom 30 are healthy controls and 30 are clinically confirmed cases of Breast Cancer, with an age group ranging from 38 to 70 years. Serum Vitamin D and B12 were estimated by ELISA Method. Results: The levels of vitamin D in serum was significantly (P > 0.05) low in clinically diagnosed breast Cancer patients (9.96 ± 2.45ng/dl) as compared to age and gender-matched healthy control subjects (24.54 ± 6.22ng/dl) and Serum vitamin B12 was significantly (P > 0.05) high in clinically diagnosed breast Cancer patients (1163.83 ± 135.77ng/dl) as compared to healthy control subjects (645.43 ± 134.22ng/dl). Conclusion: Many studies have shown that vitamin deficiency can be the primary cause of breast cancer. The current cogitation proved that raised serum Vitamin D and B12 are linked with the pathogenesis of autoimmune abnormal masses in Breast. It seems that Vitamin B12 level was no significant High and vitamin D levels are significantly low in the cases of Breast cancer. [ABSTRACT FROM AUTHOR]

Non-segmental vitiligo (NSV) is an autoimmune disorder due to the destruction of melanocytes, where cytokines like interleukin 17 (IL-17) and biomolecules like vitamin D play a theoretical role in pathogenesis. Previous studies in this regard yielded inconsistent results. This study aimed to compare the serum levels of IL-17 and vitamin D between NSV patients and healthy controls and to know the association of these biomarkers with disease activity and extent. This was a case-control study including adult patients with NSV and age and gender-matched healthy controls. Cases and controls with conditions likely to alter the serum levels of IL-17 and vitamin D were excluded. Serum levels of IL-17 were estimated by ELISA and vitamin D levels by chemiluminescence assay. 42 adult patients of NSV and 42 age and sex-matched healthy controls were recruited over a period of eighteen months. The mean value of serum vitamin D levels in the control group was 19.053 ± 5.340 ng/ml, whereas in the case group, it was 17.336 ± 6.931 ng/ml (P > 0.05). The mean value of serum IL-17 levels in the control group was 199.824 ± 51.244 pg/ml and 213.566 ± 69.018 pg/ml in the case group (P > 0.05). These molecules did not show any association with the disease activity and extent. In contrast to the previous studies, we could not establish the role of IL-17 in the pathogenesis of vitiligo. Furthermore, we could not find any association between vitamin D and vitiligo in our study, even though there is an inconsistent association between the two in the available literature. [ABSTRACT FROM AUTHOR]

Aim. The leading cause of early cardiovascular death worldwide is systemic hypertension (HTN). It is accountable for 57% of stroke and 24% of coronary heart disease deaths in India. Vitamin D indirectly regulates blood pressure through regulating the RAAS across clinical, pathophysiological, and molecular domains. This study examines Vitamin D deficiency in South Indian hypertensives. Materials and Methods. In this cross-sectional observational study, 500 routine health checkup patients at our clinic were assessed and enrolled. Demographics, symptoms, and lifestyle were collected using a standard questionnaire. Patients with chronic and newly diagnosed hypertension were included in the study. Blood was drawn to test Vitamin D (25-OH) levels. The data was evaluated to compare hypertensives who were already on medication and those who were newly diagnosed. Results. The population showed hypovitaminosis D, with an average Vitamin D level of 20.2 ± 10.3 ng/mL. A considerable number of newly diagnosed hypertensives had Vitamin D deficiency, with an average value of 17.7 ± 8.7 ng/mL. The observed value was significantly lower than the chronic hypertensive group (17.7 ± 8.7 ng/mL vs. 21.4 ±10.9, p <0.001). LDL, HDL, cholesterol, creatinine, and HbA1C levels were not significantly different across groups. Vitamin D levels were similar for outdoor and indoor workers (p = 0.727). Conclusion. Our study demonstrates there is a high prevalence of vitamin D insufficiency in the hypertensive South Indian population. There were substantially lower levels of Vitamin D identified in those who were newly diagnosed hypertensives compared to chronic hypertensives on treatment. [ABSTRACT FROM AUTHOR]

Introduction: Effective glucose control and better prevention of complications resulting from diabetes could be the crucial task in managing people with diabetes mellitus during the COVID-19 pandemic for reducing the vulnerability of people with diabetes toward the disease and preventing the severe outcomes resulting from COVID-19. Materials and Methods: This is a prospective observational study conducted at a tertiary care hospital in Andhra Pradesh. The present study involved 200 diabetic patients through a convenient sampling method (males: 100 and females: 100) who presented to the tertiary care hospital of Andhra Pradesh between August 2020 and January 2021. Results: The highest age of individuals included in the study was 88 years, whereas the lowest age of participants included was 35 years. The majority of the patients (72%) have their blood glucose levels measuring <200 mg/dl. Discussion: Vitamin C is a well-known antioxidant having significant immune-modulating effects through transformation of T-cells, phagocytic function, and interferon production. Zinc is an element having several physiological functions in the human body as antioxidant and anti-inflammatory effects. Zinc is also a cofactor in the action of around 300 enzymes. Conclusion: Nutrient supplementation with zinc, Vitamin C and D can be a good option as it is a safe, low cost, and readily available measure, helpful to get along with the fear of getting infected during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The association between altered serum Vitamin D levels and schizophrenia has been an area that has evoked a recent fervor. The neurohumoral and neuro immunomodulatory functions of Vitamin D might have a role to play in understanding the causation of the disease and thus appear promising in the diagnostic and therapeutic frontiers of the disease. Aims and Objectives: We aimed to estimate and compare serum Vitamin D levels in drug-free cases of schizophrenia and in healthy control groups. The comparison was also made among the subgroups of positive and negative schizophrenia. Materials and Methods: The study, a hospital-based cross-sectional comparative study was carried out in the Department of Psychiatry, in a hospital in Assam over a period of 1 year. Fifty drug-free subjects of schizophrenia (Group A) diagnosed and confirmed according to International Classification of Diseases 10 were selected by consecutive sampling and 50 age and sex frequency-matched subjects (Group B) were selected from the healthy population. The cases (Group A) were divided into positive and negative groups (Group A1 and A2) based on the composite scoring of the Positive and Negative Syndrome Scale. After approval from the institutional ethics committee and obtaining written informed consent, Vitamin D levels were assessed in both groups of cases and controls and comparison was made. Results: After statistical analysis, it was seen that males were more in proportion and mostly in the age group of 20-39 years. The median Vitamin D level among the cases was 12.45 ng/mL and that among controls was 20.03 ng/mL which was statistically significant (P value .00932). Among the positive and negative schizophrenia subgroup, there was no statistically significant difference in Vitamin D levels at means of 16.54 ng/mL and 16.25 ng/Ml, respectively. The variation in Vitamin D levels in schizophrenics and the healthy population is thus discernible. Conclusion: It can be said that serum Vitamin D levels were significantly low in people with schizophrenia compared to the general population. Furthermore, it is seen that mean Vitamin D status is similar in both the groups of positive and negative schizophrenia negating the possibility of alteration of Vitamin D levels depending on the differences in symptomatology or in pathophysiology of the two groups. [ABSTRACT FROM AUTHOR]

Background: In females of the South Asia region, vitamin D deficiency has been highly prevalent. This can be due to non-access to sunlight, sunblock, home-stay, and poor dietary intake, Insufficient intake of vitamin D and calcium can lead to bone loss, especially in postmenopausal females. Aim: The present study aimed to comparatively assess the bone mineral density and vitamin D levels in premenopausal and postmenopausal females of India. Methods: The study assessed 200 premenopausal females constituting the controls and 200 postmenopausal females constituting the test group. In all 400 subjects, vitamin D levels were assessed to note vitamin D deficiency. This was followed by scanning (DEXA scan) for bone mineral density. The data gathered was statistically assessed to get results. Results: Moderate deficiency of Vitamin D was higher in a post-menopause group with 43% (n=86) females and had a lower incidence in the pre-menopausal control group with 15% (n=30) females with moderate deficiency of vitamin D. For the severe deficiency, it had a high incidence in post-menopausal females with 36% (n=72) females and a low incidence of severe vitamin D deficiency was seen in the pre-menopausal control group with 2% (n=4) females. In premenopausal females, low bone mineral density was seen in 34% (n=68) of study subjects and was very low in 1% (n=2) females. In the study group of post-menopausal females, the bone mineral density was low in 62% (n=124) of the study subjects and was very low in 24% (n=48) of the study subjects. For BMD and 25 OHD levels, the difference in the two groups was statistically significant with p<0.001. Conclusion: The present study shows the effect of menopause on bone mineral density and vitamin D levels. There is a significant difference in bone mineral density and levels of vitamin D in postmenopausal females and females of reproductive age. [ABSTRACT FROM AUTHOR]

Vitamin D (VD) deficiency (serum 25 hydroxy vitamin D (25(OH)D) concentration of < 20 ng/ml), in endemic proportions, demands a supplementation strategy with optimal dosing regimens. A randomised parallel-group, active-controlled trial was conducted among apparently healthy, VD-deficient subjects, aged 18–60 years who received 600 μg/d (Group A), 1000 μg/d (Group B), 2000 μg/d (Group C) and 60 000 μg/month (Group D) of oral cholecalciferol. The intervention was carried in two phases (I and II) of 12 weeks each, with same dose, separated by a washout phase of 12 weeks. Serum 25(OH)D, intact parathyroid hormones (iPTH), Ca, phosphorous (PO4), alkaline phosphatase (ALP) and spot urine Ca/Cr were measured at baseline, 12, 24 and 36 weeks following the intervention, and adverse events were recorded at each occurrence and at 12, 24 and 36 weeks. A statistically significant time–group interaction was found in serum 25(OH)D concentration (P < 0·05). Serum 25(OH)D concentration increased significantly from baseline to 12 weeks (P < 0·05) in all the groups with no change at 24 weeks but further increase at 36 weeks (P < 0·05). At the end of the study, Group C had maximum increment in serum 25(OH)D concentration, while as Groups C and D (95 %, and 90 %) had higher proportion of subjects VD sufficient than Groups A and B (65 % and 78 %) (P < 0·05). No significant time–dose interactions were observed in serum iPTH, Ca, PO4 and ALP or urine Ca/Cr ratio. Three subjects (two in Group C and one in Group D) developed transient hypercalciuria. Supplementation with daily 2000 μg or monthly 60 000 μg of oral cholecalciferol among adults seems optimal and safe. [ABSTRACT FROM AUTHOR]

Context: Polycystic ovarian syndrome (PCOS) is a polygenic and multifactorial endocrinopathy. Vitamin D deficiency (VDD) is found to be interlinked with insulin resistance (IR), dyslipidemia, and obesity in PCOS. Aims: To find out the correlation of VDD with IR and dyslipidemia in PCOS population of West Bengal (WB). Settings and Design: The study was conducted in and around Kolkata, WB with PCOS patients and their age-matched controls. Materials and Methods: Nutritional status, vitamin D profile, obesity indices, and IR index of both PCOS and control groups were studied. Statistical Analysis Used: The statistical analysis was performed to estimate the difference and correlation of quantitative variables by using Statistical Package for the Social Sciences (SPSS, version 20, IBM). Results: Dietary fat and carbohydrate intake was significantly higher in PCOS individuals relative to recommended dietary allowance (RDA) and the control group. Deficiency of serum 25-OH vitamin D (VDD) is evident in both the control and PCOS groups. However, the prevalence of IR among PCOS patients is significantly higher (64%) than in control (4%), and it is significantly correlated with VDD (P < 0.01). homeostatic model assessment for insulin resistance is found to be a comorbidity of dyslipidemia in PCOS patients. Conclusions: VDD, IR, and obesity potentially aggravate the phenotypic manifestations of PCOS. VDD in the control individuals of young age might be an alarming forecast for the development of PCOS in future life. [ABSTRACT FROM AUTHOR]

Context: Growing pain (GP) is a common presentation in primary care settings. Aims: To find out the prevalence of GP and to observe its characteristics and associations. Settings and Design: General paediatric outpatient department (OPD). Methods and Material: Children coming to the general paediatric OPD of a tertiary centre in India between April 2019 and March 2020 for 'chronic leg pains' were screened with Peterson's criteria. Patients with systemic illness were excluded. All received vitamin D and calcium supplementation. Patients with haemoglobin less than 11 gm% received additional 3 mg/kg iron supplementation. Then, patients were asked for follow-up. Statistical Analysis Used: Chi-square test. Results: A total of 333 children were diagnosed as GP out of the total OPD attendance of 26750. The prevalence was 1.24% and 72.7% among the children with chronic leg pain. Highest prevalence was in winter (1.74%). The mean age of the patients was 7.88 years. The mean duration of symptoms was 10.92 months. After 3 months, 267 patients could be followed up. Seventy-two out of 107 (67.3%) children, who received iron became symptom-free. Only 43 (28.8%) patients became symptom-free out of 160, who received only calcium and vitamin D3 and did not receive iron. The difference was highly significant statistically (P < 0.0001). Conclusions: The prevalence of GP in the OPD was 1.24% and 72.7% among the children with chronic leg pain. Iron supplementation along with vitamin D3 and calcium was associated with faster resolution of the symptoms. [ABSTRACT FROM AUTHOR]

Context: Primary hyperparathyroidism (PHPT) can occur due to a neoplastic process or hyperplasia. While the disease presentation is predominantly asymptomatic in developed countries, this is not the case yet in India. Differentiation of the type of lesion can only be done based on histomorphology but has its own challenges. Immunohistochemical markers like Ki-67 have been studied to aid in diagnosis but data on this is sparse from India. Aims: The aim of this study is to assess the clinical, biochemical and pathological profile of PHPT and to analyse the differences in immunohistochemical marker Ki-67 among the various lesions. Setting and Design: A descriptive study was carried out on 38 PHPT patients who were treated at our institute from January 2011 to March 2021. Materials and Methods: Post-surgery, the causative lesions were categorised as adenoma (31), hyperplasia (5) and carcinoma (2). Clinical, biochemical, radiological and histopathological features of all lesions were collected and analysed. Ki-67 proliferation index was calculated. The various parameters were compared across the three groups of lesions and correlated with Ki-67 index. Results: Out of 38 patients, 37 were symptomatic with skeletal symptoms being the most common followed by renal symptoms. There was no difference in clinical or biochemical parameters among the three types of lesions. Significant negative correlation was seen between serum iPTH and serum 25-OH Vitamin D levels (P0.006) The median Ki-67 index was found to be 0.40% in hyperplasia, 0.49% in adenoma and 5.84% in carcinoma. Conclusion: PHPT still presents as an overtly symptomatic disease in India. Diagnosis of the nature of lesion depends on the accurate application of morphological criteria. A high Ki-67 index was not found to be an absolute marker of carcinoma, as it was also seen in a small proportion of atypical adenomas. [ABSTRACT FROM AUTHOR]

Background: Many factors have been proposed to be associated with the severity of disease and mortality in COVID-19. Vitamin D had recently been reviewed as one of these factors. Aim and Objectives: To evaluate the association between Vitamin D and the disease severity and mortality in COVID-19. Materials and Methods: After approval from Institutional Ethics Committee, this prospective cohort study was carried out in selected tertiary care teaching medical institutes of Central India. Participants were COVID-19 patients of the age group of 18 years and above admitted during the study period. They were categorized into four groups as asymptomatic (Group A), mild (Group B), moderate (Group C), and severe (Group D) based on clinical symptoms, respiratory rate, oxygen saturation, and chest imaging. Serum level of Vitamin 25(OH) D was measured using chemiluminescent immunoassay. The outcome of the disease was classified as recovery and death during hospitalization. The association of sociodemographic and medical characteristics with treatment outcome was studied using an appropriate statistical test. A full logistic regression model was built for the assessment of the relationship between treatment outcomes with Vitamin D level. Further, one receiver operating characteristic curve was developed to examine the prognostic significance of Vitamin D levels in COVID-19 patients. Results: Out of 748 enrolled patients, 44 (5.88%), had severe disease (Group D). A total of 721 cases (96.39%) recovered and were discharged, whereas 27 (3.61%) died during hospitalization. Mean Vitamin D level was found to be significantly different in discharged patients compared to those who were deceased. Increasing age-adjusted odds ratio (AOR) (95% confidence interval [CI]=1.07 [1.02–1.12]), known hypertension AOR (95%CI) = 3.38 (1.13–10.08), and diabetes mellitus AOR (95%CI) =28.5 (6.04–134.13) were found to be significant predictors of death among COVID-19 patients. Increasing Vitamin D level was found to be protective against COVID-19-related death (AOR (95% CI = 0.87 [0.80–0.94]). Conclusion: Vitamin D was significantly associated with the disease severity and mortality in COVID-19. [ABSTRACT FROM AUTHOR]

This study aimed to document the method standardisation and assessment of micronutrient and inflammatory markers in women from indigenous tribal communities of Jharkhand using a low-volume, high-throughput assay. This cross-sectional study was done among women of the reproductive age group from Sauria Paharia and Santhal tribal households (HH) in selected villages. Capillary blood samples were collected from the women during a HH survey to estimate ferritin, soluble transferrin receptor, retinol binding protein 4 and inflammatory biomarkers, C-reactive protein (CRP) and α -1-acid glycoprotein (AGP) using a multiplex assay. Vitamin D and Hb were estimated using an LC-MS technique and cyanmethaemoglobin method, respectively. A multiplex Luminex-based method was developed and standardised. The assay was used to estimate biomarkers in samples from 413 women (178 and 235 from Sauria Paharia and Santhal tribes, respectively). Over 51 % of women had raised CRP or AGP levels. Fe status was significantly better in Sauria Paharia compared with the Santhal women. Anaemia prevalence was 72 % among Santhal women. The proportion of women with Fe deficiency increased after adjusting for inflammation. The overall prevalence of vitamin A deficiency and insufficiency was 25 and 34 %, respectively, with similar prevalence in both tribes. All Santhal women had sufficient vitamin D levels, while 25 and 20 % of Sauria Paharia women had insufficient and deficient vitamin D levels, respectively. Our low-volume, high-throughput multiplex assays may provide a feasible approach for assessing nutritional biomarkers in nutritionally vulnerable hard-to-reach communities. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is most common type of inflammatory arthritis. It is chronic autoimmune disease that affects joints as well as extra-articular structures. The prevalence of this condition could be due to both genetic and non-genetic factors (e.g., environmental, viral, and hormonal). Aims and Objectives: The aim of the study was to determine and correlate 25(OH) D level with disease severity in patients of RA. Materials and Methods: The prospective observational study consists of 70 patients of RA and 70 healthy controls. Assessed level of 25(OH) D, C-reactive protein (CRP), anti-cyclic citrullinated peptide (CCP), erythrocyte sedimentation rate (ESR), and Disease Activity Score (DAS) 28-CRP score were compared in both cases and controls. Correlation of Vitamin D level with parameters such as CRP, Anti-CCP, and ESR was performed. Correlation between Vitamin D level deficiency and disease activity among the RA patients was assessed. Results: The mean age of patients in the RA group was 37.77±13.31 years. The mean CRP in cases was 40.57±25.94 mg/L and in controls was 3.26±1.95 mg/L with significant intergroup difference (P<0.001). The mean anti-CCP in cases was 62.18±27.21 U/mL and in controls was 4.99±1.52 U/mL with significant intergroup difference (P<0.001). The mean 25(OH) D level in cases was 12.65±5.88 and in controls was 32.18±10.22. The 25(OH) D was significantly decreased in cases than controls (P<0.001). A significant inverse relationship between serum 25(OH) D levels and DAS28 was observed. Receiver operating characteristic (ROC) curves results showed that 25(OH) D<11.7 ng/mL indicates severe disease activity (Area under ROC curve=84%, Sensitivity 77.78%, and specificity 83.33%,). 25(OH) D between 11.7 ng/mL and 19.83 ng/mL indicates moderate disease activity. 25(OH) D˃19.83 ng/mL indicates low disease activity value below 4.13 is alarming situation. Conclusion: The study reveals high prevalence of Vitamin D deficiency and insufficiency in RA patients. There is also significant inverse correlation exist between serum Vitamin D levels and RA disease activity. Vitamin D level is good disease activity predictor in patients of RA. [ABSTRACT FROM AUTHOR]

Background: In view of the rapidly growing number of aged population with dementia in India, widespread hypovitaminosis D in the elderly individual, high frequency of dementia of unknown etiology, many studies showing a definite role of Vitamin D in dementia as well as some of the literature showing inconsistent results and reverse causality of hypovitaminosis D in dementia, we planned to investigate the relation between low vitamin D and risk of dementia. Aims and Objective: The aim of the current study was to find out any relationship of Vitamin D with dementia. Materials and Methods: This cross-sectional observational study was performed at a neurology-teaching hospital, Kolkata, India. Ethical clearance was obtained from the hospital ethics committee. A total of fifty adults completed interviews on a semi-structured questionnaire. In addition, general medical and neurological examination and detailed cognitive assessment, including MMSE, were carried out after taking written consent. All individuals with dementia, and age-gender-matched healthy volunteers provided blood samples for routine and relevant biochemical examination, including the estimation of serum 25(OH) Vitamin D by Chemiluminescence Immuno Assay (CLIA). In addition, appropriate statistical methods were applied to analyse the results. Results: Overall, ninety percent of participants had low serum 25(OH)Vitamin D, defined as 25(OH)D < 20mg/ml. Hypovitaminosis D was associated with early and late-stage dementia and was statistically significant. Only five individuals were found to have sufficient 25 (OH) Vitamin D. Conclusion: The mean vitamin D level of demented patients was significantly lower compared to the control population. Our observations provide an association between Vitamin D deficiency and dementia and provides a background of longitudinal prospective study in future to show cause and effect relationship between dementia and hypovitaminosis D. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of sunlight exposure and oral vitamin D3 supplementation to achieve vitamin D sufficiency in infants at 6 months of age. Design: Open-label randomized controlled trial. Setting: Public hospital in Northern India (28.7°N). Participant: Breastfed infants at 6–8 weeks of age. Intervention: Randomized to receive sunlight exposure (40% body surface area for a minimum of 30 minutes/week) or oral vitamin D3 supplementation (400 IU/day) till 6 months of age. Outcome: Primary — proportion of infants having vitamin D sufficiency (>20 ng/mL). Secondary — proportion of infants developing vitamin D deficiency (<12ng/mL) and rickets in both the groups at 6 months of age. Results: Eighty (40 in each group) infants with mean (SD) age 47.8 (4.5) days were enrolled. The proportion of infants with vitamin D sufficiency increased after intervention in the vitamin D group from 10.8% to 35.1% (P=0.01) but remained the same in sunlight group (13.9%) and was significant on comparison between both groups (P=0.037). The mean (SD) compliance rate was 72.9 (3.4)% and 59.7 (23.6)% in the vitamin D and sunlight group, respectively (P=0.01). The geometric mean (95% CI) serum 25(OH) D levels in the vitamin D and sunlight group were 16.23 (13.58–19.40) and 11.89 (9.93–14.23) ng/mL, respectively; (P=0.02), after adjusting baseline serum 25(OH)D with a geometric mean ratio of 1.36 (1.06–1.76). Two infants in sunlight group developed rickets. Conclusion: Oral vitamin D3 supplementation is more efficacious than sunlight in achieving vitamin D sufficiency in breastfed infants during the first 6 months of life due to better compliance. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency (VDD) is a global health issue that affects both industrialized and emerging countries. With prevalence rates across all age categories in India, vitamin D deficiency is across the entire Indian continent. Regardless of the fact that there is sufficient sunlight in India which is required for endogenous vitamin D synthesis. Nutrient D inadequacy is probably going to play a significant part in the exceptionally high pervasiveness of osteoporosis, rickets, cardiovascular disease, diabetes, sicknesses and contaminations like tuberculosis in India. In India, regularly consumed foods only occasionally contain vitamin D supplements such as in dairy products. Numerous factors might contribute to vitamin D deficiency, such as skin color, lack of sunshine exposure, vegetarian eating habits, and low consuming of meals enriched with vitamin D. A sufficient amount of sun exposure, eating dietary sources of vitamin D, and fortifying foods with vitamin D can all help avoid VDD. [ABSTRACT FROM AUTHOR]

Background: The metabolic condition Type 2 Diabetes Mellitus causes insulin resistance and beta-cell malfunction. The presence of lowgrade inflammation caused by an elevation in the cytokine's tumour necrosis factor-alpha and interleukin-6 in the blood is the most crucial indicator of T2DM. Given its potent immunosuppressive properties, specific pro-inflammatory cytokine genes, including interleukin-2, interleukin-12, and tumour necrosis factor-alpha, can be inhibited by vitamin D. Methodology: Participants who satisfied the inclusion criteria and were already getting treatment for type 2 diabetes mellitus were screened from the general medicine outpatient department of a Tertiary Care Hospital in South India for this double-blind, randomised, controlled trial. Participants were split into two groups at random, with group 1 getting capsule vitamin D 6,000IU once a week for 16 weeks while group 2 got a placebo. Results: Low Dose vitamin D proved to be more effective and safer in controlling HbA1c after 16 weeks compared to placebo. Conclusion: Vitamin D is proven safe and cost-effective addition to anti-diabetic medicines. [ABSTRACT FROM AUTHOR]

Objective: The prolonged usage of antiepileptic medicines has been linked to a reduction in bone mineral density (BMD), resulting in the risk of fracture. However, most evidence has been from western countries, predominantly in institutionalized patients. Furthermore, only a single antiepileptic drug (AED) has been evaluated. This study explores the impact of AEDs on bone health in ambulatory patients from North India. Methodology: A hospital-based observational study on sixty adult patients with epilepsy. All patients were already on AED (valproic acid [VPA], levetiracetam, and phenytoin) either as monotherapy or polytherapy. The serum levels of calcium, phosphorus, alkaline phosphatase, albumin, 25 (OH) Vitamin D, and intact parathyroid hormone were estimated. BMD was assessed at the lumbar spine and femur using a dual-energy X-ray absorptiometry scan. Results: The mean age of patients was 32.75 ± 5.9 years. 56.7% of subjects were female, and 43.3% were male. 40% of patients were taking VPA. Both cytochrome P450 inducing and noninducing AED resulted in a decline in T-score at the lumbar spine (P < 0.01). The BMD declined significantly as the duration of AED intake was prolonged (P < 0.001). Conclusions: In some patients, the intake of AEDs is prolonged, even lifelong. People living with epilepsy are predisposed to falls, and the adverse effects of AED on bone metabolism over time compound the risk of fractures. Thus, the physician needs to monitor all patients on AED for bone health and advise early intervention. [ABSTRACT FROM AUTHOR]

Introduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) programme states that COPD is a common, treatable, and preventable disease that is characterized by a persistent airflow restriction that usually progresses and is connected to an exaggerated chronic inflammatory response in the airways and the lung to harmful particles or gases. The combined severity of a patient's co-morbid illnesses and exacerbations increases. The purpose of the study was to assess the vitamin D status of COPD patients and healthy participants. Methodology: This case-control study was conducted among 75 cases and 75 control at the Surat Municipal Institute of Medical Education and Research General Medicine department. Result: The mean vitamin D of subjects in cases was 32.21 ± 12.68 and it was 52.05 ± 1.99 in controls. The difference in vitamin D between the two groups was statistically significant (P Value<0.001). Conclusion: COPD patients had lower amounts of vitamin D. As COPD severity increases, vitamin D levels decrease. Along with a rise in COPD exacerbations, vitamin D levels are also decreasing. [ABSTRACT FROM AUTHOR]

CONTEXT: High prevalence of Vitamin D deficiency (VDD) has been reported in the pediatric population from the different parts of the country. However, there is a lacuna of data on the Vitamin D status of children from the north-eastern part of the country. AIMS: The aim of this study is to assess the serum Vitamin D level and also to find out the prevalence of VDD among children and adolescents in Agartala, a major city in North-east India. SETTINGS AND DESIGN: Cross-sectional descriptive study. MATERIALS AND METHODS: The serum 25 (OH) D levels of 258 children from age 1 to below 18 years, attending the outpatient clinics of the hospital were analyzed from June 2020 to June 2021. STATISTICAL ANALYSIS USED: Data being nonparametric was presented as median and inter quartile range. The group differences were computed by the Mann-Whitney U-test. P < 0.05 was considered statistically significant. RESULTS: Sixty percentage of the study population had insufficient levels of Vitamin D, with girls having significantly lower levels of serum Vitamin D. Only 27% of adolescents had optimum level of serum Vitamin D. CONCLUSION: A high prevalence of Vitamin D insufficiency and VDD was found among the children living in the urban and sub urban areas of Agartala city in North-east India. [ABSTRACT FROM AUTHOR]

Background: The etiology of hypercalcemia varies according to the clinical setting. Hitherto, data on the prevalence and profile of hypercalcemia in hospitalized Asian–Indian patients are limited. Hence, we conducted a prospective observational study to determine the prevalence and etiological profile of hypercalcemia in hospitalized Asian–Indian patients and its association with 6‑month mortality. Materials and Methods: We conducted a prospective observational study wherein all the patients (aged >12 years) admitted to the general medicine wards of a tertiary care hospital in North India between January 1, 2016, and June 30, 2017, were screened. Finally, patients with sustained hypercalcemia (defined as corrected serum total calcium ≥10.4 mg/dl documented twice at least 24 h apart) were included in this study. These patients were followed up throughout the hospital course and thereafter till 6 months from the date of discharge. Results: Out of 9902 patients, 150 patients had sustained hypercalcemia (prevalence 1.5%). The most common cause of hypercalcemia was malignancy (41.3%), followed by primary hyperparathyroidism (PHPT, 32.7%). Vitamin D intoxication was responsible for hypercalcemia in 8.7% of patients; 2.7% of patients had hypercalcemia of advanced chronic liver disease. Nevertheless, a definite etiology could not be identified in 7.3% of the patients with hypercalcemia. At the end of 6 months of follow‑up, the cumulative mortality rate was 28%. Underlying malignancy and higher calcium levels were the significant determinants of mortality. Conclusions: The prevalence of hypercalcemia in Asian–Indian patients admitted to a tertiary care hospital was 1.5%. The most common etiology was malignancy, followed by PHPT. [ABSTRACT FROM AUTHOR]

Objective: The effect of vitamin D, which is a steroid hormone, on bone health has long been known. Vitamin D is also found to be associated with various diseases such as diabetes, hypertension, chronic kidney disease, coronary artery disease, and cancer. Neuroprotective effect of vitamin D makes it an important marker in clinical course of neurological diseases such as cognitive impairment, dementia and Alzheimer's disease. Vitamin D deficiency is also associated with increased risk of stroke. In this study, we aimed to show the effect of vitamin D levels on severity and prognosis of stroke. Materials and Methods: This was a prospective, observational study conducted in a tertiary medical center in Rohtak on 200 stroke patients admitted in Medicine ward. The National Institute of Health Stroke scale (NIHSS) and modified Rankin Scale were used to assess the severity of stroke at admission and functional outcome at 3 months, respectively. The patients were divided into 4 groups on the basis of vitamin D levels. Results: Vitamin D deficiency was associated with higher NIHSS score and independently associated with poor functional outcome. Patients with severe and mild vitamin D deficiency, and vitamin D insufficiency had 9, 6.7, and 3.9 times higher adjusted odds of poorer functional outcomes at 3 months in comparison to the patients with normal vitamin D levels (p<0.01) when adjusted for age, sex, alcohol, smoking, body mass index, NIHSS score, and co-morbidities. Conclusion: Vitamin D is associated with severe stroke and poor functional outcome at 3 months. However, further studies need to be carried out to evaluate whether supplementation of vitamin D can help prevent stroke or associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 disease is more prevalent and severe in people who are more likely to be deficient in vitamin D, people with obesity and diabetes mellitus, and people who live in higher latitudes. Materials and methods: The study was an ambispective, analytical, observational study conducted at a tertiary care teaching hospital in New Delhi, India. The study population consisted of adults with a confirmed diagnosis of COVID-19. Results and conclusion: Eighty eight patients diagnosed with COVID-19 between February and July 2021 were enrolled, with mean (SD) age being 40(2) years and there were 55 (62.5%) males. The most common co-morbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) and the most common symptoms were fever, cough, and myalgia. Twelve (13.6%) patients had severe disease. Seven (7.9%) patients died. Sixty one (69.3%) patients had vitamin D levels <30 ng/mL and had severe disease, more symptoms, and increased oxygen requirement, but did not affect laboratory parameters and mortality. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is highly prevalent in India and worldwide. Mushrooms are important nutritional foods, and in this context shiitake (Lentinula edodes), button (Agaricus bisporus) and oyster (Pleurotus ostreatus) mushrooms are known for their bioactive properties. The application of ultraviolet (UV) irradiation for the production of substantial amounts of vitamin D2 is well established. Levels of serum 25-hydroxy vitamin D (25-OHD), parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) were significantly (p < 0.05) improved in vitamin-D-deficient rats after feeding with UVB irradiated mushrooms for 4 weeks. Further, microscopic observations indicate an improvement in the osteoid area and the reduction in trabecular separation of the femur bone. In addition, the level of expression of the vitamin D receptor (VDR) gene and genes metabolizing vitamin D were explored. It was observed that in mushroom-fed and vitamin-D-supplemented groups, there was upregulation of CYP2R1 and VDR, while there was downregulation of CYP27B1 in the liver. Further, CYP2R1 was downregulated, while CYP27B1 and VDR were upregulated in kidney tissue. [ABSTRACT FROM AUTHOR]

Background & objectives: Vitamin D deficiency (VDD) is prevalent across all age groups in general population of India but studies among tribal populations are scanty. This study aimed to evaluate the prevalence of VDD in the indigenous tribal population of the Kashmir valley and examine associated risk factors. Methods: In this cross-sectional investigation, a total of 1732 apparently healthy tribal participants (n=786 males and n=946 females) were sampled from five districts of Kashmir valley by using probability proportional to size method. Serum 25-hydroxy vitamin D (25(OH)D) levels were classified as per the Endocrine Society (ES) recommendations: deficiency (<20 ng/ml), insufficiency (20-30 ng/ml) and sufficiency (>30 ng/ml). The serum 25(OH)D levels were assessed in relation to various demographic characteristics such as age, sex, education, smoking, sun exposure, body mass index and physical activity. Results: The mean age of the male participants was 43.79±18.47 yr with a mean body mass index (BMI) of 20.50±7.53 kg/m2, while the mean age of female participants was 35.47±14.92 yr with mean BMI of 22.24±4.73 kg/m2 . As per the ES guidelines 1143 of 1732 (66%) subjects had VDD, 254 (14.71%) had insufficient and 334 (19.3%) had sufficient serum 25(OH)D levels. VDD was equally prevalent in male and female participants. Serum 25(OH)D levels correlated positively with serum calcium, phosphorous and negatively with serum alkaline phosphatase. Gender, sun exposure, altitude, physical activity and BMI did not seem to contribute significantly to VDD risk. Interpretation & conclusions: VD deficiency is highly prevalent among Kashmiri tribals, although the magnitude seems to be lower as compared to the general population. These preliminary data are likely to pave way for further studies analyzing the impact of vitamin D supplementation with analysis of functional outcomes. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency has been found to associated with numerous skeletal and non-skeletal diseases including Diabetes Mellitus. Insulin Resistance (IR) is considered as one of the primary reasons of Type-2 Diabetes Mellitus (T2DM). The association between vitamin D deficiency and IR has been extensively explore in previous studies, but none of them focused on Indian adolescents, and none of them used the TyG index as IR marker. Hence, this population-based cross-sectional study investigates the relationship between insulin resistance (IR) assessed using the Triglycerides Glucose Index (TyG index) and vitamin D measured by serum 25-hydroxyvitamin-D (25(OH)D). Methods: For this study, we utilized data from the Comprehensive National Nutrition Survey (CNNS, 2016–18). The study is based on a sample size of 10,167 adolescents aged 10–19 years. The TyG index cut-off value of 4.65 was used to classify IR. We examined associations between the TyG index and serum 25(OH)D using multiple linear regression models adjusted for potential confounders. Odds of Insulin Resistance among vitamin D deficient/insufficient adolescents were assessed using multivariable logistic regression. Results: A significant negative association was found between serum 25(OH)D and the TyG index, where a 10% increase in serum 25(OH)D was associated with 0.56 (95% CI = -0.67, -0.45) unit decrement in the TyG index. The odds of having IR were 90% higher among vitamin D deficient adolescents (OR: 1.90; 95% CI = 1.62—2.23) compared to adolescents with adequate levels of vitamin D. The association between vitamin D deficiency and IR was independent of sex; in other words, the association between vitamin D and IR was significant in both the sexes. Conclusion: Independent of sex, this study found a significant inverse association between vitamin D and insulin resistance in Indian adolescents. The findings of this study highlight the utility of TyG index and the importance of vitamin D in lowering the risk of T2DM in future generations of the country. [ABSTRACT FROM AUTHOR]

Vitamin D is one of the thoroughly studied risk factors in the pathogenesis of allergic rhinitis (AR). Low serum level of vitamin D is well documented in the urban population of India. The supplementation policy of vitamin D is not uniform among practitioners. The study aims to assess the impact of vitamin D deficiency on AR & long-term quality of life in perennial AR patients with low vitamin D levels after its supplementation in the urban population. The policy for evaluation of serum level of vitamin D & its supplementation in deficit patients in AR is not uniform in our hospital. The data was extracted from the hospital records & the patients came to OPD in the year 2018–2019. Inclusion criteria were the clinical diagnosis (ARIA guideline) of the perennial form of AR where vitamin D assessment was performed before prescribing treatment & the patients received a complete course of vitamin D as per the recommendation followed in our Institute. The patients received oral antihistaminic & topical steroids based nasal spray and were clubbed together as a control group whereas, in the study group, the patients were pooled together who received vitamin D supplementation along with oral antihistaminic & topical steroids based nasal spray. Pre-treatment & post-treatment (at 8 weeks, 6 months, and 12 months) SNOT-22 scores were obtained from the records. The data were analyzed statistically using repeated measures ANOVA test. The study showed a significant decrease in the SNOT-22 score in both Groups in comparison to pre-treatment scores, but post-treatment group comparison was not found statistically significant at each point of comparison. The scores were found on the lower side in the study group at the initial two evaluation points whereas it was higher at the third point of evaluation. This study showed the additional therapeutic effect of vitamin D supplementation as an adjunct in the treatment of perennial AR patients but the effectiveness of the treatment does not last forever so maintenance therapy is required especially in areas following the Indian lifestyle. [ABSTRACT FROM AUTHOR]

Background: Deficiency of vitamin D is widespread across the globe. Expectant women are one of the most vulnerable groups for vitamin D deficiency (VDD). Even in South India with abundance of sunlight, pregnant women are believed to be at a high risk of this deficiency. The objectives of this study are to assess the prevalence of VDD in antenatal women, associate it with modifiable risk factors and evaluate its correlation with low birth weight. Methods: This cross-sectional study was conducted in a tertiary care hospital, in Chennai, in 100 pregnant women in their last trimester on the basis of inclusion and exclusion criteria and their vitamin D and calcium levels were assessed. A detailed history regarding physical activity, diet, and sun exposure were collected and results were analyzed. Results: The point prevalence of VDD (serum 25-hydroxyvitamin D (25(OH) D) level <20 ng/mL) among antenatal women in our study is 62%. Univariate analysis revealed that sun exposure and socioeconomic status were the significant factors associated with higher percentage of VDD. Linear regression analysis showed that only sun exposure was a significant predictor for serum 25(OH) D levels. VDD is also associated with increased risk of low-birth-weight babies. Conclusion: VDD is highly prevalent among pregnant women in South India leading to adverse health consequences in the mother and offspring. Less physical activity, decreased sun exposure, darker skin complexion, lower socioeconomic status and lack of awareness are the major risk factors associated with VDD in our study population. [ABSTRACT FROM AUTHOR]