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Abdominal wall hernia is a protrusion of the abdominal contents through an abnormal ring or hole in the abdominal cavity of the body. A mixed breed female cat, 3 years old, weighing 2.5 kg, complaining of a lump in the left lateral abdominal area accompanied by a ring with a mass that can be pushed in. Based on the history, the protrusion is approximately 3 weeks and is thought to be caused by trauma. The results of a complete blood count showed normal results. Accompanied by the results of the x-ray examination, the patient was diagnosed with a traumatic hernia of the abdominal wall with a faustal prognosis. Case management involves repositioning the content into the abdominal cavity and suturing the hernia ring. Postoperative therapy was given injection cefotaxime antibiotics followed by amoxicilline (20 mg / kg BW; q 12h; for 5 days), anti-pain mefenamic acid (for 5 days), and Vitamin B, C (until patient healed).

IntroductionThe direction of the causal link between solid cancers and elevated plasma vitamin B12 (B12) remains uncertain.Material and methodsWe retrospectively included patients having two B12 measurements with a B12 initially ≥ 1000 ng/l and a solid cancer diagnosed between the measurements. Patients were included in the Curative or Supportive group according to their treatments.ResultsB12 changes over time differed among groups (p = 0.001): +157.4 ng/L/month in the Supportive care group versus -171.6 ng/L/month in the Curative care group.ConclusionsThe decrease of plasma B12 in cases of curative care could suggest that this B12 elevation is secondary to solid cancers.

Background The irreversibility of cognitive impairment of Alzheimer’s disease (AD) prompts that preventing or delaying the onset of AD should be a public health priority. Vitamin B supplements can lower the serum homocysteine (Hcy) level, but whether it can prevent cognitive decline or not remains unclear. We aimed to evaluate the preventive efficacy of vitamin B supplements on the cognitive decline of elderly adults. Methods We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, Science Direct, PsycINFO from inception to December 1, 2019, and then updated the retrieved results on June 1, 2020. The randomized controlled trials (RCTs) which evaluated the efficacy of vitamin B in mild cognitive impairment (MCI) patients or elderly adults without cognitive impairment were selected. Standardized mean difference (SMD) or mean difference (MD) as well as their 95 % confidence interval (CI) were calculated by performing random effects models or fixed effects models. Results A total of 21 RCTs involving 7571 participants were included for meta-analysis. The forest plots showed that there is significant effect in global cognitive function (15 RCTs, SMD: 0.36; 95 % CI: 0.18 to 0.54, P Conclusions Vitamin B supplements might delay or maintain the cognitive decline of elderly adults. We can recommend that the vitamin B supplements should be considered as a preventive medication to MCI patients or elderly adults without cognitive impairment. More well-designed RCTs with large sample sizes were required to clarify the preventive efficacy in the future.

Although levodopa remains the most effective drug for symptomatic management of Parkinson's Disease (PD), treatment during advanced disease stages may raise unpredictable motor fluctuations and other complications. Counteracting these complications with other pharmacological therapies may prompt a vicious circle of side effects, and here, nutritional therapy may have great potential. Knowledge about the role of diet in PD is emerging and multiple studies have investigated nutritional support specifically with respect to levodopa therapy. With this systematic review, we aim to give a comprehensive overview of dietary approaches to optimize levodopa treatment in PD. A systematic search was performed using the databases of PubMed and Scopus between January 1985 and September 2020. Nutritional interventions with the rationale to optimize levodopa therapy in human PD patients were eligible for this study and their quality was assessed with the Cochrane risk-of-bias tool. In total, we included 22 papers that addressed the effects of dietary proteins (n = 10), vitamins (n = 7), fiber (n = 2), soybeans (n = 1), caffeine (n = 1), and ketogenic diets (n = 1) on levodopa therapy. Interventions with protein redistribution diets (PRDs), dietary fiber, vitamin C, and caffeine improved levodopa absorption, thereby enhancing clinical response and reducing motor fluctuations. Furthermore, supplementation of vitamin B-12, vitamin B-6, and folic acid successfully reduced high homocysteine concentrations that emerged from levodopa metabolism and promoted many metabolic and clinical complications, such as neuropathology and osteoporosis. In conclusion, dietary interventions have the potential to optimize levodopa efficacy and control side effects. Nutrition that improves levodopa absorption, including PRDs, fiber, vitamin C, and caffeine, is specifically recommended when fluctuating clinical responses appear. Supplements of vitamin B-12, vitamin B-6, and folic acid are advised along with levodopa initiation to attenuate hyperhomocysteinemia, and importantly, their potential to treat consequent metabolic and clinical complications warrants future research., Statement of significance: In contrast to adjuvant drug therapy to optimize levodopa treatment, nutritional therapy is a highly acceptable, nonpharmacologic approach to this matter with virtually no side effects. Of all dietary interventions, simple supplementation of vitamin B-12, vitamin B-6, and folic acid is highly promising given its ability to reduce drastic metabolic side effects of levodopa.

Vitamin B12 deficiency is common in vegetarian population in India and can present with variable Hematological (megaloblastic anemia), Neuropsychiatric, Mucocutaneous (glossitis, angular stomatitis), Skin (pallor, hyperpigmentation) and Hair changes (dry, brittle, thin, lustreless, prematurely grey). Knuckle hyperpigmentation has been described in vitamin B12 deficiency but usually these patients are dermatologically asymptomatic but they have systemic manifestations like megaloblastic anemia, pancytopenia or neurological deficits. The foreground of this study is highlighting the importance of knuckle hyperpigmentation as an early cutaneous sign of vitamin B12 deficiency which points an important clue towards the aetiology of Megaloblastic anemia.

Background: Chronic kidney failure will lead to decline in immune system. Vitamin B considered has essential roles in immune system, including lymphocyte count. Aims: Measure the effects of vitamin B combination injection on lymphocyte count in chronic kidney failure patients. Methods: This was quasi-experimental study with one group pretest-posttest design from the period of August 2018 - October 2018 at Bethesda Hospital and Panti Rapih Hospital, Yogyakarta, Indonesia. Subjects received vitamin B combination injection (intravenous) after each hemodialysis. Lymphocyte count were measured 3 times namely visit I (before first hemodialysis), visit II (after second hemodialysis), and visit III (after third hemodialysis). Results: The data were obtained from 115 chronic kidney failure patients, consist of 75 male and 40 female. The most common age group in this study was 40-59 years old. There were no significant improvements of lymphocyte counts, both on visit II compared to visit I (1285.713±475.9829/mm3 vs 1504.219±1148.974/mm3; p: 0.065) as well as visit III compared to visit I (1285.713±475.9829/mm3 vs 1315.192±658.6673/mm3; p: 0.766). Conclusion: Vitamin B combination injection has no significant effects on lymphocyte count in chronic kidney failure patients. Intravenous vitamin B was safe for chronic kidney failure patients.

Introduction: Anaemia is one of the preventable disease burden worldwide, especially in developing nations like India. There are varied aetiologies for anaemia; Iron deficiency being the most common cause. Age, sex, geographical and comorbid factors play important role in the morphological patterns of anaemia. Anaemia, if undetected can cause morbidity and mortality which can be prevented. Aims and objectives: To identify morphological patterns and severity of anaemia in patients of all age groups andcorrelate the findings of automatic hemoanalyser, peripheral smear and biochemical parameters like iron studies, vitamin B 12 and folic acid; to correlate these findings with age, sex, morphological type and to find out the commonest pattern. Materials and Methods: This cross sectional study comprised of 300 anaemic patients over a period from December 2015 to July 2017 in Mahatma Gandhi Medical College and Research Institute, Pondicherry. Results: In our study of 300 cases, microcytic hypochromic anaemia was the commonest anaemia in all age groups (66%), followed by dimorphic anaemia (23%). Also, prevalence of microcytic hypochromic anaemia was highest in our study (p value

Introduction Supplementation of water-soluble vitamins is a common practice in hemodialysis patients, but dosages are largely based on conventional hemodialysis techniques. The aim of this study was to assess the status of water-soluble vitamins in patients on hemodiafiltration (HDF), and attempt to determine optimal dose of vitamin supplements. Methods This monocentric study included 40 patients on thrice-weekly chronic HDF. At baseline, all patients received 2 tablets of Dialvit containing B and C vitamins after each dialysis session. Predialysis samples of B and C vitamins were measured in both blood (n = 40) and a subgroup of dialysate (n = 6) samples. A second blood sample was obtained in 24 patients 3 months after dose adjustment of the vitamin supplement. Results At baseline, B-vitamin levels were high with, respectively, 0.4%, 10.0%, and 89.6% of patients in the low, normal, and high reference range. For vitamin C, most patients were in the normal range (5.0%, 82.5%, and 12.5% in low, normal, and high reference range). Three months after dose reduction, B vitamin levels decreased but stayed mostly at or above the normal range (1.4%, 25.7%, 72.9% in low, normal, and high reference range). Three patients (12.5%) developed vitamin C deficiency on low-dose substititon. Conclusion This study shows that the levels of most vitamins are above the normal range in patients on HDF receiving a classic dose of vitamin supplements, vitamin C excepted. Our study suggests that the classic dose of postdialysis vitamin B supplements may be reduced.

Objective. To study the significance of the presence and absence of carbohydrate metabolism disorders as a factor affecting the development of vitamin B 12 deficiency. Materials and methods. The data of 206 subjects, forming two main groups were analyzed: the group of carbohydrate metabolism disorders (CMDs), which included 76 women and 71 men ( n = 147); the control group, which included 33 women and 26 men ( n = 59). The inclusion criteria were the following: age over 35, availability of anamnestic data on pharmacotherapy, availability of data to clarify the state of carbohydrate metabolism, availability of data on vitamin B 12 and some other biochemical indices. Vitamin B 12 levels > 221 pmol / l were considered normal, vitamin B 12 levels from 148 pmol / l to 221 pmol/l were considered borderline (or mild deficiency), and levels of 148 pmol / l or less were considered severe vitamin B 12 deficiency. Results. The group of absent carbohydrate metabolism disorders included 59 persons and the group of carbohydrate metabolism disorders (CMDs) included T2DM patients ( n = 123) and individuals with prediabetes ( n = 24), i.e. the total number of the examined persons in CMD group was equal to 147. The average level of vitamin B 12 in the control group ( n = 59) was 401.6 ± and 138.06 pmol / l, and in CMD group ( n = 147) it was equal to 342.1 ± 133.10 pmol/l. The differences between the groups were statistically significant ( p < 0.01), that suggested the significance of CMDs as a risk factor for vitamin B 12 deficiency. Vitamin B 12 deficiency was combined with the presence of CMDs in 32 (21.8 %) cases. In 115 cases (78.2 %), the presence of CMDs was combined with the absence of vitamin B 12 deficiency. In 8 cases (13.5 %), there were no CMDs, but there was vitamin B 12 deficiency. In 51 cases (86.4 %), no CMDs and vitamin B 12 deficiency was noted. Conclusions. Despite the presence of a statistically significant decrease in vitamin B 12 levels in CMD group (342.1 ± 133.10 pmol / l vs 401.6 ± and 138.06 pmol/ l; p < 0.01) and a high incidence rate of vitamin B 12 deficiency in CMD group (21.8 % and 13.5 %, respectively), the study results do not allow us to consider the presence of CMDs to be the risk factor for vitamin B 12 deficiency.

Introduction Vitamin B12 (VitB12) deficiency rarely manifests with visual symptoms. Optic nerve damage in VitB12 deficiency is thought to be via degeneration. However, optic neuritis, though infrequent, has been reported secondary to VitB12 deficiency. Material and methods We conducted a systematic review of all the reported cases of VitB12 deficiency with optic nerve involvement in Pubmed, Cochrane, and Google Scholar any date up to September 6, 2020. We have discussed the findings and compiled the available information on ophthalmological manifestations of VitB12 deficiency. We aim to provide a unified knowledge about the evidence related to types of optic neuropathies reported to date secondary to VitB12 deficiency. We also present a case of bilateral optic neuritis secondary to VitB12 deficiency. Presentation of case We present a 29-year-old previously healthy male with progressive, painful, bilateral, but asymmetric visual deterioration for forty-five days. A detailed history, examination, and laboratory workup were carried out. He was diagnosed as having optic neuritis secondary to VitB12 deficiency. He showed partial improvement with the replacement of VitB12. Conclusion We suggest promptly identifying and replacing VitB12 in patients with optic neuritis with proven VitB12 deficiency to prevent permanent damage to the optic nerve. Patients with VitB12 deficiency should have a baseline fundoscopic exam to rule out subclinical optic nerve damage. Moreover, patients who present with visual disturbances should be screened for VitB12 deficiency, especially the vegan population., Highlights • B 12 deficiency can present with optic neuropathy as an initial manifestation. • B 12 deficiency-induced optic neuropathy may be reversible if identified timely. • In patients with visual disturbance, B12 levels should be checked with a fundus exam. • A subclinical optic neuropathy should be ruled out in B12 deficient patients.

Several studies have suggested a role for the vitamin B group in bone physiology. This article discusses a systematic review of the literature on the interaction of vitamin B with homocysteine and their relationship with bone metabolism and osteoporosis. Some studies have suggested that low levels of vitamin-B, particularly B12 and B9, have been associated with a low bone mineral density and an increased risk of fracture, in addition to participating in the metabolism of homocysteine; therefore, the deficit of these vitamins may lead to hyperhomocysteinemia. Recent publications suggest that hyperhomocysteinemia is associated with bone demineralization, low quality of bone mass, and increased levels of bone turnover biomarkers, since it affects the osteoclastic activity and the cross-linking of collagen molecules. Therefore, hyperhomocysteinemia could play a role in reduced bone density and quality. Further information is needed to establish whether each vitamin directly impacts bone health, or if their influence is merely through the homocysteine serum concentrations.

Background: Metabolic syndrome (MeS) is a risk factor for cardiovascular disease, chronic lung disease, fatty liver disease and kidney disease. Elevated serum homocysteine level is an independent risk factor for cardiovascular disease and lung disease. Vitamin B12 and folic acid deficiency causes hyperhomocysteinemia. Objective: To measure serum homocysteine, vitamin B12 and folic acid levels in metabolic syndrome. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka from March 2019 to February 2020. Total 30 female metabolic syndrome patients aged 25 to 45 years and 30 age and sex matched apparently healthy female subjects were enrolled for this study. The patients were selected from the outpatient department of Endocrinology of BSMMU. Fasting plasma glucose, lipid profile, serum creatinine, serum alanine aminotransferase levels were measured by autoanalyzer and serum homocysteine, vitamin B12 and folic acid levels were measured by Chemiluminescent immunoassay. For statistical analysis, independent sample ‘t’test was done. Results: In this study, the mean value of serum homocysteine level was significantly higher in MetS than those of control group (p value

Introduction: Hyper homocysteinemia has been considered as a potential risk factor for deep venous thrombosis (DVT) but it is still controversy. This study was aimed to assess the prevalence of hyper homocysteinemia in our population with DVT. Our second objective was to document the prevalence of folate, Vitamin B6, and Vitamin B12 level in this patient population. Results: Mean serum homocysteine levels among DVT patients was 15.12±5.47 μmol/L. Most of the patients of DVT were from 41-60 years of age group with mean age being 50.11±13.66 years. Of all the patients, 15 patients had homocysteine level above the 15 µmol/L, 22 had folic acid level below 3 ng/ml, 14 had vitamin B12 level below 150 pmol/L, and 3 had vitamin B6 level below 30 nmol/L. In the hyper homocysteinemic group, eleven patients had low folic acid level, ten had low vitamin B12 level and two had low vitamin B6 level.Conclusions: Hyper homocysteinemia and related Vitamin B group deficiency are risk factors for Deep vein thrombosis. Hyper homocysteinemia and risk of DVT, this correlation is high among older age group and female patients.

B vitamins involved in one-carbon metabolism have been implicated in the development of inflammation- and angiogenesis-related chronic diseases, such as colorectal cancer (CRC). Yet, the role of one-carbon metabolism in inflammation and angiogenesis among CRC patients remains unclear. The objective of this study was to investigate associations of components of one-carbon metabolism with inflammation and angiogenesis biomarkers among newly diagnosed CRC patients (n 238) in the prospective ColoCare Study, Heidelberg. We cross-sectionally analysed associations between twelve B vitamins and one-carbon metabolites and ten inflammation and angiogenesis biomarkers from pre-surgery serum samples using multivariable linear regression models. We further explored associations among novel biomarkers in these pathways with Spearman partial correlation analyses. We hypothesised that pyridoxal-5’-phosphate (PLP) is inversely associated with inflammatory biomarkers. We observed that PLP was inversely associated with C-reactive protein (CRP) (r –0·33, Plinear < 0·0001), serum amyloid A (SAA) (r –0·23, Plinear = 0·003), IL-6 (r –0·39, Plinear < 0·0001), IL-8 (r –0·20, Plinear = 0·02) and TNFα (r –0·12, Plinear = 0·045). Similar findings were observed for 5-methyl-tetrahydrofolate and CRP (r –0·14), SAA (r –0·14) and TNFα (r –0·15) among CRC patients. Folate catabolite acetyl-para-aminobenzoylglutamic acid (pABG) was positively correlated with IL-6 (r 0·27, Plinear < 0·0001), and pABG was positively correlated with IL-8 (r 0·21, Plinear < 0·0001), indicating higher folate utilisation during inflammation. Our data support the hypothesis of inverse associations between PLP and inflammatory biomarkers among CRC patients. A better understanding of the role and inter-relation of PLP and other one-carbon metabolites with inflammatory processes among colorectal carcinogenesis and prognosis could identify targets for future dietary guidance for CRC patients.

BACKGROUND: Detoxification of inorganic arsenic (iAs) occurs when it methylates to form monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Lower proportions of urinary iAs and MMA, and higher proportions of DMA indicate efficient methylation. The role of B-vitamins in iAs methylation in children with low-level arsenic exposure is understudied. OBJECTIVES: Our study objective was to assess the association between B-vitamin intake and iAs methylation in children with low-level arsenic exposure (

Early recognition of nutritional optic neuropathy is essential to avoid irreversible atrophy of the optic nerves and blindness. The disorder is characterized by slowly progressive or subacute bilat...

Objectives: To determine Vitamin B12 and Folic Acid Deficiency among Malnourished Children with Pancytopenia. Study Design: Cross-Sectional study. Setting: Department of Pediatric including both indoor and outdoor, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan. Period: 1st April 2017 to 25th February 2018. Material & Methodology: In this study 60 children having malnutrition and pancytopenia were included. The given performa was filled and record was maintained. Children visiting Paediatric OPD or admitted in the ward having severe malnutrition and pancytopenia in Complete Blood Count were included in the study. While the malnourished Children with normal blood count and children with malignancy e.g; Leukemia, lymphoma etc. were excluded from the study. Results: In this study, mean age of patients was 5 ± 4.2 years, mean weight 10.3± 7.6 kg, mean hemoglobin was 6 ±6.5 g/dl, mean folic acid was 7.7± 6.7 (median 5.6) and mean vitamin B12 563± 537(median 367). Out of total 37 (61.7 %) were male. In this study, grade I malnutrition was 2 (3.3 %), grade II, 17 (28.3%) and grade III, 41(68.3%). Conclusion: Vitamin B 12 & Folic Acid deficiency is found to be a major factor of bone marrow suppression in malnourished children and our result showed that folic acid deficiency was significantly low in females and Vitamin B12 in males.

Background: Chronic kidney disease (CKD) patients often have a chronic fatigue and lower QoL, thus may increase morbidity and mortality in CKD patients. Objective: The objective was to identify the benefit and safety of administration of intravenous vitamin B combination to reducing fatigue, measure the prevalence of fatigue and QoL in CKD patients. Method: This study was an observational non control study for 4 weeks in CKD patients with routine hemodyalisis 2 times/week. Every subject has a routine administration of intravenous vitamin B combination, consist of 100 mg vitamin B1, 100 mg vitamin B6, and 5000 mcg vitamin B12, after each hemodyalisis. Visual analogue scale (VAS) used to measure the degree of fatigue. QoL measured using SF-8 questionnaire, consist of total, physical (PCS), and mental component (MCS). Results: The prevalence of fatigue is high. The mean VAS score was 3.4±2.1 at baseline and there were 46.7% subjects with VAS score above the mean VAS score. After 4 weeks administration of vitamin B combination intravenously, the mean VAS score was decreasing from 3.4 to 2.7. The prevalence of fatigue was decreasing from 46.7% to 41%. This shifting was statistically significant (p:0.008). There was a score reduction in total component (20.19±4.8 to 19.29±4.9), PCS (13.44±3.1 to 12.99±3.5), and MCS (6.75±2.1 to 6.31±1.9). This score reduction indicated a better QoL. However, the reduction was not statistically significant. Conclusion: The prevalence of fatigue is high. Intravenous vitamin B combination considered to be effective and safe to reducing the degree of fatigue in CKD patients. Keywords: chronic kidney disease, fatigue, hyperhomocysteinemia, vitamin B combination, quality of life

Introducción: El acné es una enfermedad inflamatoria crónica de la unidad pilosebácea de origen multifactorial presente en cara, espalda y pecho. En este estudio quisimos conocer cuál era la frecuencia y los factores asociados a la presencia de acné en los estudiantes de medicina. Materiales y Métodos: Se realizó un estudio de casos y controles, en alumnos de 1° a 5° año de la escuela de Medicina de la Universidad Nacional Hermilio Valdizán. Se consideró un IC de 95% con un alfa de 0,05 y una potencia de 80% con una beta igual a 0,20. Resultados: La media de la edad fue de 22,31 + 3,22 años. El consumo de frutas obtuvo significancia (p=0,04; OR=6,09) como factor protector. La ansiedad no fue significativa (p=0,59; OR=1,34), asi como el estado nutricional (p=0,57; OR=1,14) y el consumo de suplemento vitamínico B (p=0,35; OR=0,56). Se encontró significancia en la herencia biológica (p=0,01; OR=3,74 con rango inferior=10,61 y rango superior=1,31). Conclusiones: El consumo frecuente de frutas demostró actuar como factor protector en el desarrollo de acné; además, se concluye también que la herencia biológica juega un papel importante en el mismo.

Vitamin B12 is a water soluble micronutrient found in animal foods. Its deficiency is not uncommon in India owing to vegetarianism but often unrecognized due to diverse clinical manifestations. This review aims to collate the current data on vitamin B12 status in healthy Indian adult and elderly population. Online database Pubmed was searched for articles published in English between 2000 and 2019. Inclusion criteria consisted of original studies conducted on apparently healthy adult and elderly Indian population reporting serum/plasma vitamin B12 levels. Comprehensive literature search identified 14 studies eligible for inclusion. The deficiency prevalence reached 78.5% and 61.7% among adults and elderly, respectively, based on varying cut offs. Higher vitamin B12 levels were reported in women than men. Hyperhomocysteinemia (Hcy >15 μmol/L) was lower in females as compared to males (60% vs 90%, 14.9% vs 57.4% and 3.6% vs 20.9% respectively in three studies). Vitamin B12 deficiency was higher in vegetarians. The results indicate that inadequate vitamin B12 status is a wide spread problem in the Indian population. However, variety of laboratory methods and cut-offs of vitamin B12 deficiency and the heterogeneity in results pose challenges to draw clear conclusions on the extent of vitamin B12 deficiency in India. This review, therefore, highlights the need for more evidence based research to define age and sex specific cut offs for defining vitamin B12 deficiency.

Background: Peripheral neuropathy can induce marked disability and negative effects on quality of life and is the most common therapy-related complication in multiple myeloma patients treated with ...

Background Individuals with low serum vitamin B-12 and high serum folate have higher plasma concentrations of methylmalonic acid (MMA). Whether folic acid (FA) causes an increase in MMA is not known. Objectives We aimed to determine the impact of FA supplementation on plasma MMA concentration in people with low or marginal serum vitamin B-12. Methods We conducted a multicenter double-blind placebo-controlled randomized trial of oral FA (5 mg/d for 12 wk) in middle-aged patients treated with antidepressant medication participating in the FoLATED (Folate Augmentation of Treatment—Evaluation for Depression) trial. Participants defined as having “low” serum vitamin B-12 (vitamin B-12 ≥150 and

Background Hyperglycaemia and diabetes have become major public health problems worldwide. There is increasing evidence that minerals and the vitamin B group might play specific roles in hyperglycaemia and the pathogenesis and progression of diabetes or metabolic complications. Objectives The main aim of this study is to investigate the effect of mineral and vitamin B group supplementation on the blood glucose levels of different populations. Design This was a cross-sectional study. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 were used in this study. A total of 8,322 participants (4,169 men and 4,153 women) were included in the study. Quantile regression (QR) was performed to identify the influence of mineral and vitamin B group intake on the level of fasting plasma glucose (FPG) in individuals in different quantiles of FPG. Results After adjusting for age, income, education, race, smoking, and alcohol consumption, FPG had a negative association with folic acid in individuals with normal or high FPG, with calcium in individuals with normal FPG, and with magnesium in males. FPG was negatively associated with folic acid and calcium in individuals with normal FPG, and magnesium in most of the quantiles for females. Discussion Hyperglycaemia and diabetes are currently becoming popular research topics. However, little is known about how the whole continuum of blood glucose is associated with commonly researched nutrient supplementation in terms of hyperglycaemia and diabetes. Conclusions The intake of calcium, folic acid and magnesium was negatively associated with blood glucose levels in individuals in different quantiles of FPG. Appropriate prevention and treatment strategies should be developed for people with different blood glucose levels.

Objective Both compound vitamin B mixtures and GeneTime® have been used in treatment of oral inflammation. This study aimed to assess the therapeutic effects of a compound vitamin B mixture combined with GeneTime® on radiation-induced oral mucositis. Methods A total of 100 patients with radiation-induced oral mucositis were randomly divided into a control group (vitamin B alone; n = 50 patients) and an observation group (vitamin B plus GeneTime®, n = 50 patients). Clinical outcomes were compared between the two groups for the following 3 weeks. Results The observation group had a significantly greater number of grade 0–I patients and significantly fewer grade II–IV patients than the control group. Among patients in the observation group, a significantly greater number of ulcers healed within 1–2 weeks, compared with those in patients in the control group. Significantly fewer ulcers healed among patients in the observation group at 3 weeks; notably, there were fewer ulcers to heal in the observation group, compared with the control group. Conclusions Use of a compound vitamin B mixture combined with GeneTime® exerted obvious therapeutic effects on radiation-induced oral mucositis and markedly shortened ulcer healing time. Therefore, this strategy may be useful in clinical applications.

Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because of the growing trend for bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy. People undergoing bariatric surgery are at high risk of developing neurological, cognitive, and mental disabilities and cardiovascular disease due to deficiency in vitamin B. Vitamin B is involved in neurotransmitter synthesis, including γ-aminobutyric acid, serotonin, dopamine, and noradrenaline. Deficiency of vitamin B increases the risk of depression, anxiety, dementia and Alzheimer’s disease. In addition, vitamin B deficiency can disrupt the methylation of homocysteine, leading to hyperhomocysteinemia. Elevated homocysteine levels are detrimental to human health. Vitamin B deficiency also suppresses immune function, increases the production of pro-inflammatory cytokines and upregulates NF-κB. Considering the important functions of vitamin B and the severe consequences associated with its deficiency following bariatric surgery, proper dietary intervention and administration of adequate supplements should be considered to prevent negative clinical outcomes.

Lardhi A, Alhaj Ali R, Ali R, Mohammed T. J Blood Med.2018;9:141—144. The authors have advised there is an error in the author liston page 141. The author name “Tarek Mohammed” shouldread “Tarek Mohamed”. The authors apologize for this error. Read the original article

Background and Objectives: Burning mouth syndrome (BMS) is an enigmatic, idiopathic, chronic, often painful clinical entity, where patients experience oral burning without clear clinical changes on the oral mucosa. There are yet to be well established standardized and validated definitions, diagnostic criteria or classifications for burning mouth syndrome. The aim of this study is to determine whether vitamin B complex and zinc supplements or 0.02% topical capsaicin rinse, can help alleviate BMS pain/burning levels. The objectives: (1) Gather data before and after treatment with vitamin B complex and zinc supplements (2) After the vitamin B complex and zinc protocol gather data before and after treatment with 0.02% topical capsaicin rinse (3) Data analysis and assessment for both treatment methods. Materials and Methods: 89 patients took part in the vitamin B and zinc supplement treatment regimen, out of those 20 patients took part in the capsaicin rinse treatment regimen. Before and after each treatment pain/burning levels were determined using the Visual analogue scale, salivary flow was also determined. Results: Both treatment methods showed statistically significant data in reducing pain/burning levels. There were no statistically significant changes in the salivary flow after any treatment. Conclusion: vitamin B and zinc supplement therapy and topical capsaicin rinse therapy can be an effective way to decrease pain/burning sensation levels in patients with BMS. More research should be conducted to determine the benefit of either vitamin B and zinc supplement therapy or topical capsaicin rinse therapy, so that BMS patients have treatment options, that have as few side-effects as possible.

Objective: Primary headaches are common and benign discomforts both in children and adolescents. However, they have a negative influence on the quality of life. This retrospective study aimed to determine the relationship between vitamin B12 results and primary headaches in Turkish children. Methods: Demographical features, headache types, laboratory results, including vitamin B12, were assessed retrospectively. Headache types were categorized as tension-type headache, migraine, and unclassified headache according to the International Classification of Headache Disorders-beta version (ICD-3 beta). Patients with seconder headaches, anemia, and macrocytosis were excluded. Results: The study group consisted of 133 (86 female, 47 male) patients with headache and a control group of 103 (57 female, 46 male) healthy children. There was no significant difference in terms of age and gender between groups (p>0.05). Vitamin B₁₂ levels in tension-type headache, migraine, and unclassified headache groups were significantly lower (p

Background & aims: Low micronutrient levels in critical illness have been reported in multiple studies. Because of the antioxidant properties of various micronutrients, micronutrient deficiency may augment oxidative stress in critical illness. However, it remains unclear whether micronutrient concentrations in ICU patients are different from those in healthy age-matched controls. It is also unclear whether micronutrient deficiency develops, worsens, or resolves during ICU admission without supplementation. Methods: We prospectively studied a cohort of adult critically ill patients. Micronutrient levels, including selenium, β-carotene, vitamin C, E, B1 and B6 were measured repeatedly during the first week of ICU admission. We compared the micronutrient concentrations at ICU admission to those of healthy age-matched controls. In addition, associations between micronutrient concentrations with severity of illness, inflammation and micronutrient intake were investigated. Results: Micronutrient blood concentrations were obtained from 24 critically ill adults and 21 age-matched healthy controls. The mean micronutrient levels at admission in the ICU patients were: selenium 0.52 μmol/l, β-carotene 0.17 μmol/l, vitamin C 21.5 μmol/l, vitamin E 20.3 μmol/l, vitamin B1 129.5 nmol/l and vitamin B6 41.0 nmol/l. In the healthy controls micronutrient levels of selenium (0.90 μmol/l), β-carotene (0.50 μmol/l), vitamin C (45 μmol/l) and vitamin E (35.5 μmol/l) were significantly higher, while vitamin B1 (122 nmol/l) and B6 (44 nmol/l) were not significantly different between patients and controls. Selenium, vitamin B1 and vitamin B6 levels remained stable during ICU admission. Vitamin C levels dropped significantly until day 5 (p < 0.01). Vitamin E and β-carotene levels increased significantly on days 5–7 and day 7, respectively (p < 0.01). Micronutrient levels were not associated with severity of illness, CRP or micronutrient intake during the admission. Conclusions: At admission, ICU patients already had lower plasma levels of selenium, β-carotene, vitamin C and vitamin E than healthy controls. Vitamin C levels dropped significantly during the first days of ICU admission, while β-carotene and vitamin E levels increased after 5–7 days. No association between micronutrient levels and severity of illness, C-reactive protein (CRP) or micronutrient intake was found. Progressive enteral tube feeding containing vitamins and trace elements does not normalize plasma levels in the first week of ICU stay. This was a hypothesis generating study and more investigation in a larger more diverse sample is needed.

(1) Background: Tuberculosis (TB) is one of the world’s top infectious killers, in fact every year 10 million people fall ill with TB and 1.5 million people die from TB. Vitamins have an important role in vital functions, due to their anti-oxidant, pro-oxidant, anti-inflammatory effects and to metabolic functions. The aim of this review is to discuss and summarize the evidence and still open questions regarding vitamin supplementation as a prophylactic measure in those who are at high risk of Mycobacterium tuberculosis (MTB) infection and active TB; (2) Methods: We conducted a search on PubMed, Scopus, Google Scholar, EMBASE, Cochrane Library and WHO websites starting from March 1950 to September 2021, in order to identify articles discussing the role of Vitamins A, B, C, D and E and Tuberculosis; (3) Results: Supplementation with multiple micronutrients (including zinc) rather than vitamin A alone may be more beneficial in TB. The WHO recommend Pyridoxine (vitamin B6) when high-dose isoniazid is administered. High concentrations of vitamin C sterilize drug-susceptible, MDR and extensively drug-resistant MTB cultures and prevent the emergence of drug persisters; Vitamin D suppresses the replication of mycobacterium in vitro while VE showed a promising role in TB management as a result of its connection with oxidative balance; (4) Conclusions: Our review suggests and encourages the use of vitamins in TB patients. In fact, their use may improve outcomes by helping both nutritionally and by interacting directly and/or indirectly with MTB. Several and more comprehensive trials are needed to reinforce these suggestions.

Chronic kidney disease is characterized by a decrease in glomerular filtration rate and lasts over 3 months. Meanwhile, patient perspectives include patient compliance in treatment and care programs. Vitamin B combination plays a role in reducing the risk of mortality for cardiovascular disease. This study aims in measuring perspective on patients with chronic kidney disease undergoing hemodialysis to intravenous vitamin B injection. This is a cohort retrospective study of patients on dialysis that were injected with intravenous vitamin B two times a week after dialysis. The subjects studied were chronic kidney disease patients who underwent hemodialysis at Bethesda Hospital Yogyakarta and Panti Rapih Hospital Yogyakarta, Indonesia. This study involved 58 patients, comprising 38 male (65.5%) and 20 females (34.5%). Total 41 patients (70.7%) with age under 60 years. The most common comorbidities were hypertension (86.2%), diabetes mellitus (25.9%), and cardiovascular disease (20.7%). Patients' perspectives on improvement of fatigue symptoms are higher in patients with hypertension comorbidity (88.9%), sleep quality higher in diabetes mellitus comorbidity (80%), daily activity higher in patients with other comorbidity (84.6%) and mood higher in other comorbidity (88.9%). Overall, most of the patients were satisfied with the treatment (98.3%), satisfied that it reduced fatigue (96.6%), said no side effects appeared (91.4%), were confident in the treatment (94.8%), considered it resulted in greater benefit than costs (84.5%). Patients' perspectives in the treatment of intravenous vitamin B combination injections for chronic dialysis patients have satisfactory treatment quality.

Objectives This study will evaluate the main hypothesis that supplementation with vitamins A, B, C, D, and E significantly improves the severity and mortality rate in ICU patients with COVID-19. Trial design This study is a randomized, single-blinded, two-arm (1:1 ratio) parallel group clinical trial. Participants We are conducting this study in patients with COVID-19 admitted to intensive care units at the Imam Khomeini Hospital Complex in Tehran, Iran. The inclusion criteria are as follows: (1) aged between 20 and 60 years, (2) both male and female patients with COVID-19, (3) clinical or definitive diagnosis (using polymerase chain reaction (PCR) test), (4) patients have not participated in other clinical trials, and (5) no renal or hepatic abnormalities. The exclusion criteria are as follows: (1) patients with specific and rare viral diseases such as HIV and (2) patients who have been undergoing chemotherapy for the past month. Intervention and comparator Duration of intervention: 7 days from randomization Intervention in the treatment group: Vitamin A 25,000 IU daily Vitamin D 600,000 IU once during study Vitamin E 300 IU twice daily Vitamin C is taken four times per day B vitamins are taken as a daily Soluvit [which included thiamine nitrate 3.1 mg, sodium riboflavin phosphate 4.9 mg (corresponding to vitamin B2 3.6 mg), nicotinamide 40 mg, pyridoxine hydrochloride 4.9 mg (corresponding to vitamin B6 4.0 mg), sodium pantothenate 16.5 mg (corresponding to pantothenic acid 15 mg), sodium ascorbate 113 mg (corresponding to vitamin C 100 mg), biotin 60 μg, folic acid 400 μg, and cyanocobalamin 5 μg] The control group will not receive any supplements or placebo. All supplements are made in Iran except for Soluvit (from Fresenius Kabi, New Zealand). Main outcomes 1. Weight, height, and BMI 2. Severity of pulmonary involvement according to CT scan 3. Respiratory support (invasive or non-invasive) 4. Percentage of oxygen saturation (SpO2 level) 5. Serum levels of WBC, CRP, ESR, IL6, IFN-G, and TNF-α 6. The patient’s body temperature 7. The presence or absence of involvement of organs other than the lungs (e.g., heart, liver, kidneys) 8. Duration of hospitalization 9. Mortality rate Randomization At baseline, eligible patients were randomly assigned to a 1:1 ratio to one of two groups: intervention and control. Block randomization is used based on the gender of patients. Blinding (masking) Patients are unaware of being placed in the intervention or control groups after signing consent. All treatment staff will be aware of which group each of the patients is in due to the specific conditions of the ICU and the absence of placebo for the control group. Numbers to be randomized (sample size) The researchers plan to include 60 patients in total, with 30 patients in each group. Trial status This is the first version of the protocol which started on April 2, 2020. Recruitment began April 2, 2020, and is expected to be complete by July 4, 2020. Trial registration The Iranian Registry of Clinical Trials IRCT20200319046819N1 . Registered on April 4, 2020 Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol (Fig. 1, Table 1).

The vitamin status of a child depends on many factors and most of the clinical studies do not take into account the different access to adequate nutrition of children coming from different countries and the consequent major differences in micronutrients or vitamin deficits between low-income and high-income countries. Vitamin supplements are included in the general field of dietary supplements. There is a large amount of not always factual material concerning vitamin supplements, and this may sometimes create confusion in clinicians and patients. Inadequate information may lead to the risk of attributing beneficial properties leading to their over-use or misuse in the paediatric field. Vitamin supplementation is indicated in all those conditions in which a vitamin deficiency is found, either because of a reduced intake due to reduced availability of certain foods, restrictive diets or inadequate absorption. The lack of guidelines in these fields may lead paediatricians to an improper use of vitamins, both in terms of excessive use or inadequate use. This is due to the fact that vitamin supplementation is often intended as a therapy of support rather than an essential therapeutic tool able to modify disease prognosis. In fact, various vitamins and their derivatives have therapeutic potential in the prevention and treatment of many diseases, especially in emerging conditions of paediatric age such as type 2 diabetes and the metabolic syndrome. The aim of the present article is to analyse the state of the art and consider new perspectives on the role of vitamin supplements in children.

OBJECTIVES: Serum total vitamin B12 (tB12) is the most commonly used biomarker to assess B12 status in healthy and patient populations but there is ambiguity as to its performance for early and reliable B12 deficiency diagnosis. Holotranscobalamin (holoTC) is the B12 form taken up by cells and may be a more sensitive B12 indicator. This descriptive, prospective study aimed to compare serum tB12 with serum holoTC concentration in their ability to detect functional B12 deficiency defined as elevated methylmalonic acid (MMA) concentration in a pediatric population at risk of B12 deficiency. METHODS: A total of 26 infants and children aged 3 mo-15 yrs with a history of ileal resection were recruited from the Children's Intestinal Rehabilitation Program at the British Columbia Children's Hospital, Canada. Between 1 to 7 samples per patient were collected over 2yrs, with complete biomarker data for 41 samples. Clinical, anthropometric and dietary data were also collected. Age-specific reference limits derived from a healthy pediatric reference sample were used as cut-offs to categorize B12 deficiency. RESULTS: Of the 41 samples, 29 (71%) had concordant biomarker results all indicating adequate B12 status. Elevated MMA (>398 nmol/L) was found in only 2 samples and those had holoTC concentration indicative of B12 deficiency (209 pmol/L). While holoTC exceeded tB12 in sensitivity for the detection of functional B12 deficiency, holoTC had reduced specificity, 75% compared to 85% for tB12, leading to a reduced positive predictive value (22%). Patients receiving total parenteral nutrition (TPN) had significantly higher tB12 but similar holoTC concentration compared to those not receiving TPN. CONCLUSIONS: Overall, the results suggest that serum holoTC detects patients with elevated MMA indicative of B12 deficiency, who are not identified by tB12 concentration, in children with short bowel syndrome. It also suggests that the current cut-off for tB12 may be too low. These descriptive findings warrant further evaluation and validation of B12 biomarkers and related cutoffs for adequate, suboptimal and deficient B12 status. FUNDING SOURCES: Healthy Starts Catalyst Grant from the British Columbia Children's Hospital Research Institute, Vancouver BC, Canada.

A growing body of research has indicated a role for B vitamins in depression, with some previous studies suggesting that B vitamin status in patients with depression can impact on antidepressant response. Here we aimed to investigate B vitamin plasma concentrations in medicated patients with depression (n ​= ​94) compared to age- and sex-matched healthy controls (n ​= ​57), and in patients with depression after electroconvulsive therapy (ECT) in a real-world clinical setting. Our results show that nicotinamide (vitamin B3), N1-methylnicotinamide (vitamin B3 metabolite), and pyridoxal 5′-phosphate (PLP; vitamin B6) concentrations were significantly reduced in patients with depression compared to controls. The Cohen’s d effect sizes for nicotinamide, N1-methylnicotinamide, and PLP were moderate–large (−0.47, −0.51, and −0.59, respectively), and likely to be of clinical relevance. Functional biomarkers of vitamin B6 status (PAr index, 3-hydroxykynurenine: hydroxyanthranilic acid ratio, 3-hydroxykynurenine: xanthurenic acid ratio, and HKr) were elevated in depressed patients compared to controls, suggestive of reduced vitamin B6 function. Over 30% of the patient cohort were found to have low to deficient PLP concentrations, and exploratory analyses revealed that these patients had higher IL-6 and CRP concentrations compared to patients with PLP levels within the normal range. Treatment with ECT did not alter B vitamin concentrations, and B vitamin concentrations were not associated with depression severity or the therapeutic response to ECT. Overall, reduced plasma PLP, nicotinamide, and N1-methylnicotinamide concentrations could have wide ranging effects on pathways and systems implicated in depression. Further studies are required to understand the reasons why patients with depression present with low plasma B vitamin concentrations., Highlights • Plasma vitamins B3 and B6 are reduced in depressed patients versus controls. • Reduced B3 and B6 is likely to be clinically relevant (moderate-large Cohen’s d). • 32% of depressed patients had low/deficient pyridoxal 5′-phosphate (PLP; B6) levels. • Low PLP in depressed patients was associated with high IL-6 and CRP levels. • Treatment with a course of ECT had no effect on plasma B vitamin concentrations.

Pyridox(am)ine 5'-phosphate oxidase (PNPO) catalyzes oxidation of pyridoxine 5'-phosphate (PNP) and pyridoxamine 5'-phosphate (PMP) to pyridoxal 5'-phosphate (PLP), the active form of vitamin B6. PNPO deficiency results in neonatal/infantile seizures and neurodevelopmental delay. To gain insight into this disorder we generated Pnpo deficient (pnpo-/-) zebrafish (CRISPR/Cas9 gene editing). Locomotion analysis showed that pnpo-/- zebrafish develop seizures resulting in only 38% of pnpo-/- zebrafish surviving beyond 20 days post fertilization (dpf). The age of seizure onset varied and survival after the onset was brief. Biochemical profiling at 20 dpf revealed a reduction of PLP and pyridoxal (PL) and accumulation of PMP and pyridoxamine (PM). Amino acids involved in neurotransmission including glutamate, γ-aminobutyric acid (GABA) and glycine were decreased. Concentrations of several, mostly essential, amino acids were increased in pnpo-/- zebrafish suggesting impaired activity of PLP-dependent transaminases involved in their degradation. PLP treatment increased survival at 20 dpf and led to complete normalization of PLP, PL, glutamate, GABA and glycine. However, amino acid profiles only partially normalized and accumulation of PMP and PM persisted. Taken together, our data indicate that not only decreased PLP but also accumulation of PMP may play a role in the clinical phenotype of PNPO deficiency.

Chronic kidney disease (CKD) is a disease that causes a decrease in kidney function, which can be seen from GFR (Glomerulus Filtration Rate) value, which is less than 60 ml/minute/1.73 m2 in minimum three months. Depression is a psychological problem in a patient with chronic kidney disease undergoing hemodialysis. The previous study has shown that giving vitamin B combination can improve depression symptoms. To measure the benefit of vitamin B1, B6, B12 parenterally for depression symptoms in chronic kidney disease patients undergoing hemodialysis. This study used an experimental design (one group pre and post-test) in 117 patient that obtained using a consecutive sampling method. Depression score was measured by the HADS questionnaire before given vitamin B (pre-test) and after given vitamin B (post-test). Data were statistically analyzed using a licensed SPSS program with paired t-test/Non-Parametric Wilcoxon. The relationship between the history of the use of the antihypertensive, antidiabetic, folic acid drug, and depression scores were not showing significant results (p > 0.05). The relationship between administration of vitamins B1, B6, and B12 and the patient's depression score showed a decrease but not significant (p = 0.522). There was no significant difference after the administration of vitamin B1, B6, and B12 on the depression score of patients with chronic kidney disease undergoing hemodialysis at Bethesda and Panti Rapih Hospital in Yogyakarta.

We wish to propose an infection model to address some of the unique and unusual features observed in coronavirus disease 2019 (COVID-19), e.g., why were severe patients mounting more intense immune response compared to the mild cases, and why did severe patients demonstrate higher and more protracted viral shedding when their immune responses were more intense. In this exposition, we will first construct a pathogenic model for COVID-19, and followed with a discussion on how it may influence critical aspects of COVID-19 management. By extrapolating from this model, we will highlight important and potential therapeutic strategies. This proposed model is intended to provide a generalized framework, but it requires validation from further clinical studies.

Bone health is genetically determined in 75%–80% of cases. However, studies of the associations with polymorphisms show different results depending on the populations analyzed, probably due to interactions with external factors, including nutritional factors, of which the most important are calcium and vitamin D. Vitamin D receptor polymorphisms have been associated with changes in bone mineral density, showing different responses according to the intake of calcium and vitamin D supplements. Other polymorphisms, related to vitamin B and vitamin K, play a lesser role.

The article considers the ethiological factors for the formation of such a widespread disease of the peripheral nervous system as polyneuropathy. The classification, modern approaches to the diagnosis of various types of diseases are presented. The authors emphasize on the therapeutic approaches to the treatment of such common forms as diabetic and alcoholic polyneuropathies. Particular attention is paid to the complex of B vitamins. The effectiveness and safety of the injectable form of vitamins for the therapy of polyneuropathies are demonstrated.

Diabetic peripheral neuropathy (DPN) is highly prevalent and affects up to 50% of patients with diabetes. Painful neuropathic symptoms may occur in a third of patients with diabetes and is a major cause of sleep disturbance, morbidity and poor quality of life. Effective treatment of DPN remains a major challenge as current therapeutic options have a number of undesirable side effects and only provide a partial response to neuropathic pain. Furthermore, there are a lack of treatments that modulate the natural history of DPN. A growing body of evidence suggests that vitamin B and vitamin D may have analgesic effects and neuroprotective benefits in DPN. This narrative review explores the role of these vitamins in DPN. Given their limited side effects, further mechanistic studies and good quality randomized controlled trials of their putative analgesic ability are required to define the role of vitamin B and D in DPN.