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Background: A strong relationship between serum vitamin D concentration and muscle function has been documented in various studies. Vitamin D deficiency can lead to impairment of pelvic floor muscle strength and hence pelvic floor disorders (PFD) i.e. urinary incontinence, faecal incontinence and prolapse symptoms. Objectives: 1) To determine serum vitamin D levels in women with PFD symptoms and healthy controls. 2) To correlate serum vitamin D levels with severity of PFD symptoms, pelvic floor muscle strength and quality of life in patients with PFD. Materials and Methods: This was a hospital based case control study conducted on women attending gynaecology OPD. Eighty women were enrolled in our study and comprised of two groups - Group A of 40 patients with PFD symptoms and Group B of 40 healthy subjects. Serum vitamin D estimation, history, clinical examination, and pelvic floor muscle strength by Oxford scale was recorded in all the subjects on a predesigned proforma. Patients in group A were further divided on the basis of vitamin D status as vitamin D sufficient and vitamin D insufficient groups. PFD symptoms severity and its impact on quality of life were recorded on 'Pelvic Floor Distress Inventory-Short form 20' (PFDI-SF 20) and 'Pelvic Floor Impact Questionnaire-7' (PFIQ-7) questionnaire respectively in group A. Results: In group A, 90% of patients were vitamin D deficient compared to 57.5% in group B (p = 0.002). Vitamin D level had positive correlation with pelvic floor muscle strength in both group A (p = 0.034, r value=0.336) and group B (p = 0.004, r value = 0.448). Mean PFDI-SF 20 summary score was significantly more in vitamin D insufficient group compared to vitamin D sufficient group. A negative correlation with PFIQ-7 scoring (p = 0.017, r value = - 0.392) and vitamin D was observed, suggesting poor quality of life in vitamin D deficient women. Conclusion: Vitamin D deficiency is associated with pelvic floor disorders, poor pelvic floor muscle strength and quality of life. [ABSTRACT FROM AUTHOR]

Background Postoperative pain can cause physiological distress, postoperative complications, and extended lengths of hospitalized stay. In children, management of postoperative pain is still recognized as being inadequate. Objective The aim of this trial was to investigate the effects of intraperitoneal ropivacaine on postoperative pain, and recovery of bowel function and emetic events after laparoscopic herniorrhaphy in toddlers. Methods Seventy-six children aged from 9 months to 3 years were recruited between August 2013 and June 2014 at Tongji Hospital and randomly assigned into two groups. One group received intraperitoneal ropivacaine right before surgery and the control group received intraperitoneal saline. A standard combined general anesthesia procedure was performed under regular monitoring. Postoperative pain was assessed by the FLACC scale. Postoperative analgesic consumption, time to flatus, time to first stool, and postoperative emetic events were also recorded. Results When compared with the control group, children who received intraperitoneal ropivacaine experienced less pain 0-4 h after surgery [ P < 0.001, difference in median FLACC (95% CI) for 2 h time point is 2.00 (0.87-3.13), for 4 h time point is 1.00 (0.55-1.45)]. In addition, the number of toddlers who received analgesia 0-24 h after surgery in the ropivacaine group was lower than that in the control group [ P < 0.001, difference in proportions (95% CI) is 0.575 (0.3865-0.7638)]. Compared with the control group, time to flatus in ropivacaine group was also much shorter [21.1 h vs 16.7 h, P = 0.04, difference in mean (95% CI) is 4.4 (1.49-7.28)], and the time to first stool after surgery was earlier in the ropivacaine group [30.7 h vs 25.6 h, P = 0.003, difference in mean (95% CI) is 5.1 (1.78-8.45)]. Furthermore, the incidence of emetic events in the ropivacaine group was significantly lower than the control group [32.4% vs 11.1%, P = 0.03, difference in proportions (95% CI) is 0.212 (0.0246-0.4002)]. Conclusion The present results indicate that intraperitoneal ropivacaine reduces early postoperative pain and improves recovery after laparoscopic herniorrhaphy in toddlers. Therefore, IPLA is a good stratagem for postoperative pain management after laparoscopic surgery in toddlers. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Our aim was to characterize the relationship between 25-hydroxyvitamin D [25(OH)D] status with pelvic floor symptom distress and impact on quality of life. Methods: A retrospective chart review was performed in women with a 25(OH)D level drawn within 1 year of their gynecology/urogynecology visit. Validated questionnaires including the Colorectal-Anal Distress Inventory (CRADI)-8 and Incontinence Impact Questionnaire (IIQ-7) were used. Multivariate analyses characterized pelvic floor disorder (PFD) symptom differences among women by vitamin D status. Results: We studied 394 women. Mean ± standard deviation (SD) 25(OH)D levels were higher in women without than with PFD symptoms (35.0 ± 14.1 and 29.3 ± 11.5 ng/ml, respectively ( p < 0.001)]. The prevalence of vitamin D insufficiency was 51% (136/268). CRADI-8 and IIQ-7 scores were higher among women with vitamin D insufficiency ( p = 0.03 and p = 0.001, respectively). Higher IIQ-7 scores were independently associated with vitamin D insufficiency ( p < 0.001). Conclusions: Insufficient vitamin D is associated with increased colorectal symptom distress and greater impact of urinary incontinence on quality of life. [ABSTRACT FROM AUTHOR]