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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]

The clinical implications of calcium deficiency include rickets, poor bone mass accrual as well as abnormal foetal programming during pregnancy, poor peak bone mass due to poor accrual in childhood and adolescence, postmenopausal osteoporosis and osteoporosis of the elderly. Serum calcium is maintained within a narrow normal range, chiefly by resorption from the skeleton and alteration of urinary calcium loss and absorption from gut. Absorption is dependent on vitamin D sufficiency, presence of calcium binders in diet (such as phosphate, oxalate and phytate), age group and physiological state. A 2004 WHO expert panel has examined available data on calcium balance studies as well as calcium deficiency states and recommended daily calcium intake in the adult to be 1000 mg per day, with adjustments suggested for other age groups and physiological states. Daily calcium intake in India, both the reality and the recommendations, are far lower than the Western data. A reappraisal of dietary calcium recommendations may be necessary for India. [ABSTRACT FROM AUTHOR]

Background: Vitamin-D deficiency has been linked with impaired development in animal studies; however, the evidence from human studies is scanty. Evidence as to whether vitamin-D deficiency during early childhood affects growth is also limited and conflicting. We examined the extent to which vitamin-D deficiency (<10 ng/ml) is associated with neurodevelopment and physical growth in young children.Methods: We used data from a randomized controlled trial (RCT) of daily folic acid and/ or vitamin B12 supplementation for six months in children aged 6 to 30 months conducted in Delhi, India. We measured vitamin-D status and  neurodevelopment by the Ages and Stages Questionnaire-3 (ASQ-3) at 12 to 36 months of age. Multiple logistic and linear regressions were used to examine the association between vitamin-D deficiency at baseline and neurodevelopment and growth 6 months follow-up.Results: 25-hydroxy-vitamin-D (25OHD) concentration was measured at baseline for 960 (96%) children. Of these, 331 (34.5%) children were vitamin-D deficient. The total and subscale (except for the Personal social scale) ASQ-3 scores, were not different between the vitamin-D deficient and non-deficient children. Vitamin-D deficiency was also not associated with physical growth at baseline and at follow -up.Conclusion: Our data do not support the hypothesis that vitamin-D deficiency is associated with poor growth and neurodevelopment.Trial Registration: NCT00717730 and CTRI/2010/091/001090 . Date of registration: 08 October, 2010. [ABSTRACT FROM AUTHOR]

Background: Many studies show a high prevalence of vitamin D deficiency across various populations the world over . There is relative lack of prevalence data in Punjab, India. This cross-sectional study was carried out to assess the prevalence of vitamin D deficiency in the north-west Punjab population. Aim: To study the prevalence of vitamin D deficiency in the north-west Punjab population across various population characteristics such as gender, education, locality, occupation, and dietary habits. Materials and Methods: Healthy volunteers (N = 150) of either sex were enrolled and their fasting plasma samples tested for 25-hydroxy vitamin D [25(OH) D] levels. Data were compiled as percentages and means across different population characteristics. Statistical analysis was done using Chi-square test and Fisher's exact test. Results: A high overall prevalence (90%) of vitamin D deficiency was observed in the study subjects. There was a significant difference in the prevalence of vitamin D insufficiency between rural and urban subjects (P < 0.05) and among the subjects pursuing different occupations (P < 0.001). A significant gender-specific difference was also recorded at the cut-off level of 25 (OH) D, with women showing higher prevalence of deficiency compared to men (P < 0.05). Conclusions: There is a high prevalence of vitamin D deficiency in the population of Punjab. Lower prevalence is displayed by those subjects who have greater opportunities for sunlight exposure, such as like rural individuals, farmers, and housewives. [ABSTRACT FROM AUTHOR]