Search

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]

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]

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]

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]

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]

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: 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]

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 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]

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]

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: 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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

Introduction: Vitamin D deficiency is one of the most common nutritional deficiencies worldwide. The amount and quality of bone at the implant installation site have an impact on the implant's prognosis however, the effects of menopause on jaw bone remain unknown. Few studies have looked at the prevalence of vitamin D deficiency in India's general population, but none have looked at the link between vitamin D deficiency (osteoporosis) and postmenopausal women's jaw Bone Mineral Density (BMD). This is the first study of its sort in India to look at postmenopausal women's vitamin D levels and jaw BMD. Aim: To evaluate and correlate vitamin D levels and jaw BMD in pre and postmenopausal females undergoing implant therapy. Materials and Methods: This cross-sectional study will include 50 partially or completely premenopausal (n=25) and postmenopausal females (n=25) having edentulous anterior and posterior maxillary and mandibular jaws. Females will be tested to evaluate their vitamin D levels and jaw BMD with Cone Beam Computed Tomography (CBCT) and results will be recorded in Hounsfield Units (HU) using Planmeca romexis viewer software. Chi-square test and Students t-test will be used. [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: SARS-COV-2 is also known as coronavirus causes an infectious disease has caused a global concern due to its pandemic nature. In India, nearly 36 million cases and 5.1 lakh deaths have been recorded so far. Laboratory biomarkers play an important role in improving the clinical situational awareness by predicting risk stratification and by discriminating between severe and non-severe cases. There is no sufficient information available regarding the role of C-reactive protein (CRP), lactate dehydrogenase (LDH), Vitamin D, and interleukin-6 (IL-6) in the prognosis of COVID-19 patients in Southern part of India. Aims and Objectives: We aim to retrospectively analyze CRP, LDH, Vitamin D, and IL-6 in COVID-19 patients. Materials and Methods: The observational and retrospective study was carried out from the case records of 103 patients from November 2021 to February 2022 in which CRP, LDH, Vitamin D, IL-6, COVID-19 Reporting and Data System (CO-RADS), and CT sore were analyzed during admission and follow-up period in the hospital. Mean, mean difference, standard deviation, standard error difference, and P value were calculated. P<0.05 was considered to be significant. Results: CRP, LDH, IL-6, Vitamin D, CO-RADS, and CT score were decreased during the follow-up period when these levels were compared at the time of admission in the hospital, while there is an increase in Vitamin D levels during the follow-up period. Conclusion: The use of reliable and easy to use assays such as CRP, LDH, Vitamin D, and IL-6 plays an important role in the diagnosis and prognosis of COVID-19. [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]

Introduction: Cholecalciferol plays vital role in bone mineralization. Major circulating and storage form of vitamin D is 25-hydroxycholecalciferol {25(OH)D3} which is formed in the liver after 25-hydroxylation. It is also the form of vitamin D that is measured in blood tests to detect deficiency of vitamin D. There is scarcity of literature to support the best therapy at the lowest effective dose that is practicable, cost efficient, and devoid of probable side effects. Oral medication compliance is a major stumbling block to replenishing vitamin D levels in the body. Vitamin D administered intramuscularly (i.m.) may be able to overcome this limitation. Aim: To compare the effectiveness of oral versus intramuscular vitamin D in adults with fracture around hip and vitamin D deficiency. Materials and Methods: This prospective interventional study was conducted in Orthopaedics Ward in Mahatma Gandhi Institute of Medical Sciences, Jaipur, Rajasthan, India, from January 2020 to June 2021. Total 60 male and female, above 18 years, with fractures around the hip and vitamin D levels less 30 ng/mL were included in the study. In group O (n=30) patient received oral vitamin D supplementation of 60000 IU once a week for 6 weeks . In group I (n=30) patient received single dose of 600000 IU vitamin D injection (i.m.). Follow-up of patients was done at baseline, 6 weeks and 12 weeeks for serum values of vitamin D, calcium, alkaline phosphatase and parathyroid hormone levels. Bivariate analytical techniques has been used to measure the improvement of group I with group O. results: The mean age in group I was 60.40±16.38 years and in group O was 59.47±15.17 years (p-value=0.82). There were total 31 females, 13 in group I and 18 in group O. No significant difference was observed among the groups in vitamin D level at the baseline, {group I: 13.84 ± 3.54 ng/mL; group O: 16.45 ± 6.3 ng/mL, p-value=0.053}. At 6 weeks, the mean value of the vitamin D significantly increased in both groups (p-value=0.001; group I: 40.94±4.67 ng/mL and group O: 33.64±9.89 ng/mL). At the 12th week, the mean value of the vitamin D was significantly higher in group I (44.52±7.09 ng/mL) compared to group O (24.65±10.92 ng/mL), p-value<0.001. The vitamin D mean was significantly raised with the time in group I and group O at 6 weeks and still remained increased at 12 weeks in group I but not in group O. conclusion: The present study concluded that although both administration routes are effective and appear to be safe, intramuscular application is more effective in increasing 25(OH) D levels and sustaining it for a longer period of time as compared to oral dose. [ABSTRACT FROM AUTHOR]

Introduction: Heart Failure is a leading cause of mortality worldwide including India. Most cross sectional studies have demonstrated heart failure is associated with deficiency of essential micronutrients including Vitamin D which may play a important role in pathogenesis of ventricular remodelling in heart failure. Aim: Our study performed aimed to determine the effect of supplementation in patients of Heart Failure presenting with Vitamin D deficiency to our institute on severity of Heart Failure. Design and Method: 97 patients of Heart failure coming to our institute were given conventional therapies for Heart Failure along with Vitamin supplementation based on serum Vitamin D levels and followed up for 3 months. Results: Patient of Heart failure having Vitamin D deficiency had significant reduction in cardiac biomarkers (NT-pro BNP levels), improvement in Left ventricular ejection fraction (LVEF) and more favourable reverse remodelling determined by Left ventricular end diastolic and systolic diameter (LVEDD & LVESD) though quality of life determined by WHODAS 2.0 score did not changed following 12 weeks supplementation of High Dose Vitamin D. Conclusion: Recognising and treatment of Vitamin D deficiency may determine long term prognosis in patients of Heart Failure. [ABSTRACT FROM AUTHOR]

Introduction: Despite an agricultural country, India confronting malnutrition as a major public health challenge, where every second child is at risk of malnutrition. The nation ranking second in population with disproportionate rural and urban demography, further poor penetration of government assisted programs in remote, underserved areas fuelling the malnutrition in rural areas. Methods: This cross-sectional study was conducted in Department of Community Medicine of Rohilkhand Medical College and Hospital. Total 465 schoolchildren in rural and urban areas of Bareilly district were screened for malnutrition and their socio-demographic profiles were studied. Results: Overall, the prevalence of malnutrition in schoolchildren of Bareilly district was %40.2. Fraction contributed by urban and rural territories was %35.2 and %43, respectively. The prevalence of malnutrition was found higher in rural area as compared to urban area and the difference was statistically significant (P<0.001). Conclusion: The study shows %43 prevalence of malnutrition in rural areas and under nutrition was the main cause of malnutrition attributed by poverty and illiteracy. However, urban areas reported %7.8 lower prevalence of malnutrition, but alarming trends of overweight and obesity %15.2. [ABSTRACT FROM AUTHOR]

Introduction: Drug Resistant Tuberculosis (DR-TB) is a rapidly escalating problem. Vitamin D and calcium serum levels can be an important determinant of Multidrug-Resistant Tuberculosis (MDR-TB) infection, progression to disease. The link between the serum level of 25-hydroxy vitamin-D {25(OH) D and MDR-TB is an emerging area for conducting evidencebased research. Aim: To assess the serum 25(OH)D and calcium levels and its deficiency in all the patients with drug resistant tuberculosis. Materials and Methods: This retrospective, observational study was conducted in the Department of Pulmonary Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, from October 2019 to October 2020, in the newly detected 100 patients experiencing DR-TB. Patients sputum/body fluid samples were subjected for GeneXpert/Line Probe Assay (LPA) examinations to confirm resistance to anti-tubercular drugs. The frequency and prevalence of mean serum vitamin D and mean serum calcium levels were recorded based on age and gender. DR-TB categorised into H-Mono resistance, MDR-TB, Pre-Extensively Drug Resistant (Pre-XDR) and XDR-PTB, based on GeneXpert and LPA of sputum/body fluid. Descriptive statistics were used to determine the characteristics of all the patients. All the statistical analysis was done using the STATA software. Results: Mean age of study population was 31.12±15.49 years. Among them 63 were males and 37 were females. The mean serum vitamin D level of 10.87±8.49 ng/mL (deficient) and serum calcium level of 8.62±0.82 mg/dL (normal) was reported. Mean serum vitamin D levels were deficient in all the four types of DR-TB (p-value=0.04), while changes in mean serum calcium level was non significant (p-value=0.15). Conclusion: All patients with DR-TB have significant propensity to vitamin D deficiency. While changes in mean serum calcium level was non significant. [ABSTRACT FROM AUTHOR]

Objective: Aim of the present study is to find out the level of vitamin D in patients of early rheumatoid arthritis and investigate association of vitamin D deficiency with the disease activity in rheumatoid arthritis. Methods: A case control study comprising 90 case of early rheumatoid arthritis and 80 age and sex matched control carried out at tertiary care hospital in western province of Uttar Pradesh India between January 2017 and June 2021. Baseline data along with vitamin D level was recorded in both the group. Disease activity was recorded using clinical disease activity index (CDAI) in all patients of rheumatoid arthritis. Results: Vitamin D deficiency was significantly higher in rheumatoid arthritis patients compared to healthy control from same geographic region (56.7% vs 32.5%, p value = 0.002%). Disease activity assessed by clinical disease severity index (CDAI) was inversely correlated with vitamin D level(r= -0.23, p-value 0.028) and. Joint pain was also inversely correlated with vitamin d level(r= -0.37, p value <0.0001). However, there was no significant association of vitamin D level with joint swelling, tenderness and erythrocyte sedimentation rate. Conclusions: In our study vitamin D deficiency was more common in patients of rheumatoid arthritis. Disease activity and joint pain were inversely correlated with vitamin D level. However, there was no significant association of vitamin D level with joint swelling and tenderness. [ABSTRACT FROM AUTHOR]

Aim: To study the effect of vitamin D supplementation in severity and control of bronchial asthma in children in Bihar region Methods: A cross-sectional, prospective study was conducted in the Department of pediatrics, Vardhman institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India for 1 year, after taking the approval of the protocol review committee and institutional ethics committee. 53 asthmatic patients and 53 healthy controls were included in this study. The level of serum vitamin D in both groups was measured by radioimmunoassay (RIA) method at the reference lab and was categorized as sufficient (> 30 ng/ml), insufficient (20 to 30 ng/ml), or deficient (< 20 ng/ml). The severity of asthma was also stratified according to the asthma guideline into four grades of intermittent or mild, moderate, severe persistent. Results: Regarding rate of admission, 13.2% of patients were hospitalized once, 9.4% of patients were hospitalized twice, and 1.9% of them were also hospitalized three times. In the patients group and regarding the severity of asthma, 11.3% were classified as mild asthma, 45.3% as moderate asthma, and 43.4% as severe asthma. Also regarding control status of asthma, the disease was controlled in 18.9 %, partially controlled in 34.0 %, and uncontrolled in 47.2 %. According to the level of disease attack risk, 5 of 31 children aged less than 5 years (16.1%) classified as high-risk, while 7 of 22 children older than 5 years (31.8%) classified as high risk. Assessing the serum level of vitamin D showed that the asthmatic children had significantly lower level of vitamin D compared to normal cases (14.53 ± 8.10 ng.ml versus 22.45 ± 13.46 ng/ml, p < 0.001). Also, in the groups with and without asthma, the prevalence of vitamin D deficiency was 73.6 and 49.1%, and the prevalence of vitamin D insufficiency was 18.9 and 18.9 %, while normal vitamin D level was revealed in 7.5 and 32.1%, respectively with a significant difference (p = 0.005). In this regard, mean serum level of vitamin D in the patients with mild asthma was 12.85 ± 7.06 ng/ml, in the group with moderate asthma was 16.98 ± 8.63 ng/ml, in the patients with severe asthma was 12.42 ± 7.52 ng/ml, and in those with persistent asthma was 12.01 ± 5.00 ng/ml (p = 0.25). Conclusion: Vitamin D deficiency and insufficiency is a common finding among asthmatic children that may be associated by the physiological mechanism of this phenomenon. In fact, it seems that the use of supplement vitamin D can prevent progression of childhood asthma. [ABSTRACT FROM AUTHOR]

Background: Administration of vitamin D to unselected heterogeneous critically ill patients did not demonstrate outcome benefit. The current study was undertaken to identify if early administration of vitamin D can reduce intensive care unit (ICU) length of stay and improve clinical outcomes in critically ill patients with sepsis. Methods: This single-center randomized double-blind placebo-controlled trial was done in the ICU and emergency inpatient ward of a tertiary care teaching institute in New Delhi, India. A total of 126 adult patients aged 18 to 80 years of either sex diagnosed to have sepsis were included within 24 hours of admission to the hospital and randomized into vitamin D or placebo groups. The patients in the intervention group received vitamin D3 540,000 units dissolved in 45 mL of milk. The placebo group received 45 mL of milk. Results: The median length of ICU stay (8 vs 9 days; p = 0.32), median length of hospital stay (12 vs 12 days; p = 0.33), median duration of vasopressors requirement (4 vs 3 days; p = 0.84), median duration of mechanical ventilation (5 vs 7 days; p = 0.23), requirement of tracheostomy (34 vs 39%; p = 0.71), and 90-day mortality [35 vs 46%; p = 0.29; HR 0.72 (0.42-1.24)] were similar in vitamin D and placebo arm. A subgroup analysis in patients with severe vitamin D deficiency (vitamin D <12 ng/mL) revealed a significantly decreased incidence of tracheostomy (28 vs 57%; p = 0.04), a trend toward decreased 90-day mortality [34 vs 66%; p = 0.08; HR 0.44 (0.19-1.01)], and duration of mechanical ventilation (6 vs 11 days; p = 0.05) in patients receiving vitamin D. Conclusion: Administration of large-dose vitamin D within 24 hours of admission does not reduce the length of ICU stay in critically ill sepsis patients. [ABSTRACT FROM AUTHOR]

Aim: Children with sickle cell disease (SCD) are at high risk of vitamin D deficiency (VDD). The prevalence of VDD in different countries is between 65-100% in these patients. The present study was undertaken to find the prevalence of VDD among sickle cell children and to assess the association of co-morbidities with VDD. Materials and Methods: Total 89 children who were attending a sickle cell clinic/admitted to paediatric wards of a Tertiary Care Centre were enrolled in this study. After their history, clinical examination and anthropometry were investigated, samples were taken for serum 25-hydroxy vitamin D ng/mL and calcium level assessment. The outcome was morbidity in sickle cell children in terms of frequency of pain episodes, number of febrile episodes, number of blood transfusions and total number of admissions. Results: Out of 89 cases, 58 (65.17%) cases were deficient in vitamin D (<20 ng/dL), 22 (24.72%) cases had insufficiency (20-30 ng/dL) and 9 (10.11%) cases had normal vitamin D levels (>30 ng/dL). The mean vitamin D level was 19.42ng/dL. Morbidity in SCD was more in VDD children compared to vitamin D sufficient children with significance in the number of pain episodes and the total number of hospital admissions but not in the number of admissions for acute febrile illness or the total number of blood transfusions. Conclusion: VDD was prevalent in 65.17% of children with SCD. Children between 4-12 years were more affected with a male predominance. As this study involved children with SCD alone, future studies need to be carried out involving children without SCD to establish a better possible link between vitamin-D and SCD morbidity. [ABSTRACT FROM AUTHOR]

Background: The primary objective of this study was to intervene with vitamin D supplementation in rural-based women with pre-diabetes (impaired fasting glucose or impaired glucose tolerance) to prevent development of type 2 diabetes (T2DM). Methods: This was an open-label randomized placebo-controlled trial conducted in rural women with pre-diabetes and vitamin D deficiency (Clinicaltrials.gov NCT02513888). Women aged 20-60 years with pre-diabetes were selected from rural Haryana (north India) and followed up for two years. A semi-structured questionnaire was used to collect information on socio-demographic and behavioral details, like sun exposure, dietary habits, etc., The intervention group received vitamin D supplementation while control group received lactose granules as placebo. Equal doses of calcium carbonate were given to both the groups. Results: A total of 132 participants were recruited in the study (58 each in the intervention and control groups). It was observed that there was no statistical significance in the incidence of diabetes in the control group as compared to the intervention group at the end of 2 years (P = 0.701). Conclusion: Though during the first year there was some delay in development of DM in the intervention group but at the end of two years there was no significant effect of vitamin D supplementation in delaying the incidence of diabetes in these women after two years. Trial registration: (Clinicaltrials.gov NCT02513888). [ABSTRACT FROM AUTHOR]

Background: Blood pressure (BP) is associated with serum levels of Vitamin D3, lipid profile, and thyroid hormones among adults. However, limited information is available regarding such associations in adolescents. Objectives: The objectives of this study were to estimate the prevalence of Vitamin D3 deficiency, dyslipidemia, and thyroid dysfunction among secondary school students of Agartala and to determine their associations with BP. Methodology: This cross-sectional study was conducted from April 1, 2018, to December 31, 2018, among 1000 secondary-level school students of Agartala municipal corporation area, chosen by multistage sampling ensuring proportionate representation. Results: The prevalence of Vitamin D3 deficiency, thyroid dysfunction, and dyslipidemia was found to be 79.4%, 62.8%, and 37.5%, respectively. Among the respondents, 58.1% had raised BP, 16.7% were overweight, 5.3% were obese, and 48.3% had high waist--hip ratio (WHR). Among them, 70.97% of the fatty participants, 82.27% with high body mass index (BMI), and 69.05% with either low or normal WHR had significantly raised BP (P < 0.05). Out of total, 58.26% of the participants with normal serum D3 level, 59.95% with either euthyroid or hyperthyroid status, and 62.13% with dyslipidemia had raised BP, though these were not significant (P > 0.05). Binary logistic regression model has identified higher BMI, higher body fat content, high WHR, habit of consuming extra salt, and fast food on a regular basis as significant determinants of raised BP in this population (P < 0.05). Conclusion: Hypovitaminosis D, thyroid dysfunction, and dyslipidemia are prevalent among adolescents of Northeast India, but they did not emerge as significant determinants of BP in this population. [ABSTRACT FROM AUTHOR]

In a defined geographic area in rural India (1,60,000 population), osteoporosis detection and calcium and vitamin D supplementation program was instituted. Of the eligible 15,386 subjects, 5,992 (38%) participated in the program; 2,882 (48%) had osteopenia and osteoporosis; supervised calcium and vitamin D supplementation was instituted; 2,113 (73.3% of those identified) completed 2 years of supplementation. The mean duration of the follow-up was 5 years (range 2–8 years). On follow-up, three groups emerged; those who were regular, those who were irregular, and those who did not take supplements. In those who were regular with calcium and vitamin D supplementation, we found a significant reduction in fractures (RR 0.27, 95% CI 0.09–0.81) compared with those who did not take supplements. There was no significant difference in falls between the three groups. Mortality was significantly lower (RR 0.53, 95% CI 0.31–0.91) in those who were regular with calcium and vitamin D supplements compared to those who did not take supplements. While the reduction in fractures was probably due to calcium and vitamin D supplementation, the reduction in mortality was probably because those who took regular supplements accessed healthcare services more readily for other comorbidities as part of their follow-up program. [ABSTRACT FROM AUTHOR]

Background and Objective: Despite abundant sunshine, India is a country with high prevalence of vitamin D deficiency. It has been suggested that vitamin D deficiency could be a potential cause of chronic non-specific musculoskeletal pain. The study was conducted to evaluate the effect of supplementation of vitamin D and calcium on patients suffering with chronic non-specific musculoskeletal pain. Methodology: The experimental trial was a pre-post study conducted on 50 hypovitaminosis D patients aged 30–60 years visiting a local orthopedician or physician with complain of chronic non-specific musculoskeletal pain. Oral supplementation with vitamin D and calcium was given for 3 months. Before the intervention trial, pain, physical activity, serum vitamin D, serum calcium, body mass index and waist to hip ratio (WHR) of the respondents were assessed, which was statistically compared with post-intervention data of the same parameters. Assessment of pain was carried out using visual analog scale. Physical activity levels were compared pre and post the intervention. Also, fatigue, mood alteration, and sleep were compared. Results: Ninety percent of the subjects had vitamin D deficiency. Thirty-six percent of the subjects had severe chronic non-specific musculoskeletal pain, whereas 56% had moderate chronic non-specific musculoskeletal pain. The mean pain score prior to intervention was 6.22 which significantly decreased to 3.52. Mean vitamin D levels significantly rose from 17.38 ng/ml to 39.40 ng/ml. Serum vitamin D, serum calcium, and physical activity levels increased, whereas pain, weight, BMI, and WHR decreased significantly post-intervention. Conclusions: Supplementation with vitamin D and calcium decreases chronic non-specific musculoskeletal pain. [ABSTRACT FROM AUTHOR]

Introduction: Low Vitamin D levels have been associated with Chronic Obstructive Pulmonary Disease (COPD) and acute exacerbations. Objectives: There is a paucity of data on Vitamin D and COPD, its severity and exacerbations in populations that are exposed to sunlight regularly with high levels of physical activity most of their lives. Methods: Serum levels of 25‐OH‐Vitamin‐D were assessed in 100 COPD subjects and 100 age‐ and gender‐matched controls from the rural community‐based MUDHRA cohort in South India. Levels of <20 ng/mL were defined as Vitamin D deficiency. Smoking habits, occupation, Charlson co‐morbidity index, Standard of living index(SLI), body mass index(BMI), 6‐minute walking distance were examined for associations with logistic regression between controls and COPD subjects. Unconditional logistic regression was used to examine the association with exacerbation of COPD. Results: Vitamin D deficiency was observed in 64.5% (95%CI 57.7–70.8) of the subjects in spite of regular exposure to sunlight. Subjects with COPD had higher risk of Vitamin D deficiency (Adjusted OR: 5.05; 95%CI 1.4–17.8) as compared to controls. Amongst subjects with COPD, Vitamin D deficient subjects were three times more likely to have exacerbations in the previous year (Adjusted OR:3.51; 95%CI 1.27–9.67) as compared to COPD subjects without Vitamin D deficiency. Levels of Vitamin D <20.81 ng/mL and <18.45 ng/mL had the highest levels of combined sensitivity and specificity for COPD and acute exacerbation of COPD (AECOPD) respectively. Conclusion: In a rural population exposed to sunlight many hours a day throughout their lives, low Vitamin D levels were associated with COPD and exacerbations of COPD. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency is documented to be more prevalent in Type 2 Diabetes Mellitus (T2DM) and is associated with diabetic nephropathy. Aim and Objective: To investigate the vitamin D status in T2DM patients with and without nephropathy in eastern part of southern India. Material and Methods: This crosssectional study included 150 study subjects. Routine laboratory measurements were done using commercially available kits on Vitros 5,1 FS auto analyzer from Ortho Clinical Diagnosis (OCD), United Kingdom, based on the principle of Reflectance Photometry. Serum 25-hydroxyvitamin D was measured by using chemiluminescence immunoassay methods. Results were analysed using IBM-SPSS version 20. Results: Vitamin D levels were observed to be lower in the diabetic nephropathy (18.44 ± 8.69 ng/mL) as compared to control (26.55 ± 7.88 ng/mL) and T2DM (19.64 ± 9.93 ng/mL) subjects and were correlated significantly with HbA1c and microalbumin. A markedly higher proportion of study subjects with vitamin D deficiency as well as insufficiency in T2DM and diabetic nephropathy group. Conclusion: Patients with type 2 diabetes and diabetic nephropathy had a low serum vitamin D level than healthy control. Vitamin D estimation in such patients may aid in the diagnosis and treatment as well as to prevent further complication. [ABSTRACT FROM AUTHOR]