Blood Vitamin Research Articles

A Study to Assess Anti-Inflammatory Effect of Vitamin D on Gingivitis: A Dose Dependent Randomised Controlled Trial.

Vitamin D deficiency increases gingivitis risk. Studies show that higher vitamin D levels reduce inflammation. College conducted a double-blind, randomized, controlled trial on 451 people's vitamin D and gingival health at baseline. For three months, participants were given a placebo (group A), 1000 international units (IU) of vitamin D3 per day (group B), 500 IU per day (group C), or 2000 IU per day (group A). Gingival scores were recorded for three months to assess the anti-inflammatory effect (the first, second, and third). Vitamin D levels also affected gingivitis. Vitamin D dose-dependently reduces gingivitis inflammation. Vitamin D administration negatively correlated with gingival index score. Anti-inflammatory vitamin D levels are 32-37 ng/ml. Vitamin D supplementation can reduce gingivitis severity. The optimal blood vitamin D level is 30-35 ng/ml.

Prevalence and Impact of Vitamin D Deficiency Among Individuals Diagnosed with Chronic Liver Disease

Introduction: Chronic liver disease is characterized by multi-nutrient deficiency. The propensity for individuals to have vitamin D insufficiency is greater in comparison to other essential minerals. Fibrosis results in a decline in the liver's ability to perform synthetic functions ultimately leading to lack of vitamin D due to poor activation caused by drop in proteins binding the vitamin. The situation is exacerbated by the decrease in productivity and the presence of nutritional deficiencies. Materials and Methods: The present descriptive research was carried out in the Department of Medicine at DHQ Teaching Hospital Haripur spanning from 1st January 2022 to 31st December 2022. The study population consisted of individuals between the ages of 40 and 70 years who were diagnosed with chronic liver disease. The concentration of vitamin D was assessed in blood samples obtained from patients at the hospital laboratory. The established threshold for identifying vitamin D insufficiency is a blood vitamin D level below 30 nmol/L. Data analysis was performed using statistical software SPSS version 24. Results: The age of the patients ranged from 40 to 70 years. The mean age of the patients was 53.40 years with standard deviation 12.194. Age wise distribution revealed 60.1% patients (n = 89) in the age group 40-55 years and 39.9% participants (n = 59) had age 56-70 years. The number of male participants were 94 (63.5%). Vitamin deficiency was observed in 64.9% patients (n = 96). The association of vitamin D deficiency with disease duration, child class and gender were statistically significant (p < 0.05). Conclusion: The potential association between vitamin D insufficiency and the extent of liver function impairment, degree of fibrosis, and susceptibility to infection consequences suggests that it may serve as a valuable prognostic indicator and diagnostic tool. Additional research is required to thoroughly assess and substantiate the significance of vitamin D in the context of liver cirrhosis. This necessitates the undertaking of extensive prospective cohort studies and randomized trials. Keywords: Vitamin D deficiency, Chronic Liver Disease (CLD)

Relationship between impulsivity, aggression and blood ghrelin, vitamin D, lipids levels in borderline personality disorder

Purpose: This study aimed to investigate the correlations between impulsivity and aggression, and blood ghrelin, lipids, and vitamin D levels in Borderline Personality Disorder (BPD).
 Materials and Methods: Thirty female patients with BPD and 30 healthy controls were included to the study. Sociodemographic Data Form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Barratt Impulsivity Scale Short Form (BIS-11-SF), Buss-Perry Aggression Questionnaire (BPAQ) were applied.
 Results: Ghrelin, cholesterol, and triglyceride (TG) levels were higher in BPD patients (p=0.013, p=0.042, p=0.019, respectively); however, there was no significant difference between the groups based on vitamin D, High-density lipoprotein (HDL) and Low-density lipoprotein (LDL) levels. There was no correlation between ghrelin, and lipid and vitamin D levels. The BIS-11 and BPAQ scores were higher in BPD group. A positive correlation was determined between ghrelin and BIS-11 scores. A positive correlation was found between vitamin D and ‘anger’ subscale score of BPAQ. A negative correlation was identified between triglyceride and the ‘verbal aggression’ subscale score of BPAQ. 
 Conclusion: BPD is a disorder with several hospital admissions, frequent comorbid conditions, problematic social relationships, and functionality, and the treatment is quite difficult. Regulation of Ghrelin, vitamin D and lipid levels could assist clinicians in the treatment and clinical follow-up of the disease.

Decreased levels of perfluoroalkyl substances in patients receiving hemodialysis treatment

Perfluoroalkyl substances (PFAS) have been reported to be harmful to multiple organs in the human body. Based on a previous study suggesting that hemodialysis (HD) may be a means of eliminating PFAS from the human body, we aimed to compare the serum PFAS concentrations of patients undergoing regular HD, patients with chronic kidney disease (CKD) and controls. Additionally, we also investigated the correlation between PFAS and biochemical data, as well as concurrent comorbidities. We recruited 301 participants who had been on maintenance dialysis for >90 days, 20 participants with stage 5 non-dialysis CKD, and 55 control participants who did not have a diagnosis of kidney disease, with a mean creatinine level of 0.77 mg/dl. Eight different PFAS, namely perfluorooctanoic acid (PFOA), total and linear perfluorooctanesulfonic acid (PFOS), perfluoroheptanoic acid (PFHpA), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), were measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Spearman correlation and multivariable linear regression with 5 % false discovery rate were used to evaluate the relationships between PFAS and clinical parameters in HD patients and controls. Circulating concentrations of seven PFAS, including total and linear PFOS (T-PFOS and L-PFOS) PFDA, PFNA, PFHxS, PFOA, and PFUnDA, were significantly lower in the HD group compared to the CKD and control group. For the interplay between biochemical data and PFAS, all of the studied PFAS were positively correlated with aspartate aminotransferase, alanine aminotransferase, glucose, blood urea nitrogen, ferritin, and vitamin D in the controls, while in HD patients, the PFAS were all positively correlated with albumin, uric acid, iron, and vitamin D. These findings may offer valuable insights for future studies seeking to eliminate PFAS.

Association of Secondhand Smoke Exposure During Pregnancy and Umbilical Cord Blood Vitamin D Levels with Newborn Weight

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Newborn weight is an important predictor of the growth and survival of infants. Low birth weight affects newborns at risk of experiencing health problems and the risk of death Women in developing countries experience many pregnancies with malnutrition, and exposure to cigarette smoke can reduce micronutrient deficiencies. Exposure to cigarette smoke damages the health of pregnant women and their fetuses. Vitamin D is a micronutrient that supports every stage of pregnancy, the placenta, and the fetus to achieve a healthy pregnancy. This study aims to determine the association of secondhand smoke exposure during pregnancy and umbilical cord blood vitamin d levels with newborn weight. This research is a quantitative analytic observational study with a Cross-Sectional Study design. This research was conducted at Hermina Padang Hospital. The time of research was carried out from 14 December 2022 to 10 January 2023. The population in this study were all mothers who gave birth at Hermina Hospital. The sampling technique uses non-probability sampling. The number of samples in this study was 55 samples. Data analysis using the ANOVA test. The study results showed a significant mean difference between the level of exposure to cigarette smoke and birth weight. This can be seen from the p-value <0.05 (p=0.002) and no significant difference in the average blood vitamin D levels. Umbilical cord with birth weight, can be seen from the p-value>0.05 (p=0.484) at Hermina Padang Hospital. It is recommended that health workers provide counseling about exposure to cigarette smoke to pregnant women and mothers to pay attention to meeting the needs of vitamin D during pregnancy.</em></p><p><strong><em> </em></strong><strong><em> </em></strong></p></td></tr></tbody></table></div><p><strong><em>Keywords: Newborn Weight, Secondhand Smoke Exposure, Vitamin D , Newborn Weight</em></strong></p>

Association between Acid-Lowering Agents, Metformin, and Vitamin B12 among Boston-Area Puerto Ricans

BackgroundVitamin B12 involves several physiological functions, and malabsorption is reported with medication use. ObjectivesStudies have reported an inverse association between the use of metformin or acid-lowering agents (ALAs), such as proton pump inhibitors, histamine 2 receptor antagonists, and blood vitamin B12 concentration, because of malabsorption. The concomitant use of these medications is underreported. We sought to examine these associations in a cohort of Boston-area Puerto Rican adults. MethodsThis analysis was conducted within the Boston Puerto Rican Health Study (BPRHS), an ongoing longitudinal cohort that enrolled 1499 Puerto Rican adults aged 45–75 y at baseline. Our study comprised 1428, 1155, and 782 participants at baseline, wave2 (2.2 y from baseline), and wave3 (6.2 y from baseline), respectively. Covariate-adjusted linear and logistic regression was used to examine the association between baseline medication use and vitamin B12 concentration or deficiency (vitamin B12 <148 pmol/L or methylmalonic acid >271 nmol/L), and long-term medication use (continuous use for ∼6.2 y) and wave3 vitamin B12 concentration and deficiency. Sensitivity analyses were done to examine these associations in vitamin B12 supplement users. ResultsAt baseline, we observed an association between metformin use (β = –0.069; P = 0.03) and concomitant ALA and metformin use (β = –0.112; P = 0.02) and vitamin B12 concentration, but not a deficiency. We did not observe associations between ALA, proton pump inhibitors, or histamine 2 receptor antagonists, individually, with vitamin B12 concentration or deficiency. ConclusionsThese results suggest an inverse relationship between metformin, concomitant ALA, metformin use, and serum vitamin B12 concentration.

Comparison between Vitamin-D and Urinary Angiotensin Converting Enzyme Levels in Type 2 Diabetic Hypertensive Patients with Non-Diabetic Hypertensive Patients

&#x0D; Objective: To correlate urinary Angiotensin Converting Enzyme–2 (ACE-2) with serum Vitamin D levels in Type 2 Diabetic-Hypertensive and non-Diabetic-Hypertensive patients. Methodology:The Department of Physiology at the University of Health Sciences in Lahore undertook this observational, correlational study from March 2018 to February 2019. The Services Institute of Medical Services (SIMS), Lahore's medical OPD and diabetic centers were used to select 95 hypertension patients between the ages of 30 and 60, divided into 2 groups. Anthropometric parameters, as well as Blood Sugar Random (BSR) and serum Vitamin D were recorded. Urine samples for evaluating angiotensin converting enzyme 2 were collected.Results: Urinary ACE2 showed negative correlation with serum Vitamin D level (r=-0.336, p=0.034) in group A non-diabetic hypertensive patients, but not in group B diabetic hypertensive patients (r=0.07, p=0.677). Despite somewhat greater vitamin D levels in group B, this difference was not statistically significant.Conclusion: There was no link between ACE2 and blood Vitamin D levels in the diabetic hypertensive patients, despite the fact that we hypothesised that vitamin D would be considered as a viable treatment alternative for treating these individuals.&#x0D;

Comparison of Blood Levels of Vitamin B12, Folic Acid (B9), Riboflavin (B2), and Homocysteine in Keratoconus and Healthy Subjects.

Blood levels of vitamin B12, folic acid (B9), riboflavin (B2), and homocysteine were evaluated in keratoconus (KC) and healthy subjects. Eskişehir Osmangazi University. Cross-sectional study. In this prospective study, 100 KC patients (patient group) between the ages of 18-35 years and 200 healthy individuals (control group) in the same age range were included in the Eskişehir Osmangazi University (ESOGÜ) Hospital Eye Clinic between October 2019 and March 2020. In all cases, a complete ophthalmologic examination and corneal tomography evaluation with a Pentacam Scheimpflug camera were performed. In blood samples, vitamin B12 and folic acid levels were measured using an electrochemiluminescence immunoassay analyzer, and homocysteine and riboflavin levels were measured using high-performance liquid chromatography. Chi-square tests were used in the analysis of categorical variables, and Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of numerical variables. Homocysteine (13.0±6.6 vs 12.1±5.4 µmol/L, p=0.190), vitamin B12 (313.5±119.4 vs 322.9±128.3 pg/mL, p=0.619), folic acid (7.0±2.7 vs 7.4±2.9 ng/mL, p=0.230) levels were not different between KC and control groups. The mean riboflavin level was 84.0 ± 21.8 µg/L in the patient group and 183.6±74.3 µg/L in the control group, with a significant difference between the two groups ( p <0.001). Riboflavin levels were below 180 µg/L in 99% (n=99) of the cases in the KC group and 53.5% (n=107) in the control group ( p <0.001). Low blood riboflavin levels in KC patients may be a possible risk factor in the pathogenesis of KC.

The interplay between vitamin C and thyroid.

Vitamin C (ascorbic acid) is a water-soluble vitamin, that plays a key role in the prevention and treatment of scurvy. As vitamin C is an antioxidant and thyroid function may be affected and may affect vitamin C levels, for the first time, we aimed to provide a detailed review of all human studies evaluating the different roles of vitamin C in the thyroid gland. Thyroid cancers, goitre, Graves' disease and other causes of hyperthyroidism and hypothyroidism were the conditions discussed in this study. Furthermore, vitamin C addition to other medications such as levothyroxine was also reviewed. In this study, we reviewed the relevant literature regarding the association between vitamin C and thyroid diseases using original studies from PubMed, Scopus, Embase, and Web of Science. In this review, we found anti-cancer effects for intravenous (IV) administration of vitamin C in addition to the beneficial effects of using it in combination with radiotherapy and chemotherapy. As autoimmune diseases affect some antioxidant markers, some studies reported a significant difference in blood vitamin C levels in patients with autoimmune thyroid diseases such as Graves' disease. Despite many studies evaluating the effects of IV administration of vitamin C in mentioned diseases, there is a lack of evidence for oral consumption of vitamin C. To conclude, there is a lack of evidence, especially clinical trials, for the therapeutic effects of vitamin C on thyroid diseases; however, promising results were reported in some studies in the literature.

An automatic eye surface-fundus double imaging system for estimation of vitamin A levels in Japanese Black Cattle

Blood vitamin A levels during fattening have a crucial influence on beef marbling. As an alternative of conventional blood assays, eye imaging method has been raised as a potential non-invasive way to monitor vitamin A levels in cattle. However, current image capture systems merely acquire cattle eye surface images, which cannot adequately reflect the chromatic information of eye retina that indicates vitamin A level changes. Based on previous research, we propose a novel, automatic double imaging system that combined two illuminating system as well as the installation of polarising filters to eliminate eye surface reflection and consequently, obtain clear fundus images. This greatly facilitated subsequent image processing and feature extraction for vitamin A prediction. The proposed imaging system demonstrated a stronger correlation between vitamin A levels and chromatic features in fundus images than previous systems. An improved classification (accuracy 82%) of vitamin A deficiency level than previous study (56.6%) strongly supports this system’s advantage. Being non-invasive cost-effective and rapid, this double imaging system is expected to play an important role in precision livestock farming as well as clinical diagnosis in veterinarian.

The effectiveness of laserpuncture associated with vitamin B12 in the treatment of temporomandibular disorders and orofacial pain

A low-power laser is presented as a treatment proposal for painful Temporomandibular Disorders (TMD). This randomized clinical trial evaluated the effectiveness of laserpuncture using low power laser in the treatment of pain in patients with temporomandibular disorders with and without concomitant administration of vitamin B12 (methylcobalamin). A questionnaire was applied to the participants to assess the location of the orofacial pain in conjunction with the request for blood vitamin B12 dosage. The groups were randomly divided, being Group 1: placebo laserpuncture and placebo vitamin B12; Group 2: effective laserpuncture and placebo vitamin B12, and Group 3: effective laserpuncture and effective vitamin B12. The study consisted of 45 adult patients (over 18 years old), regardless of sex and race, with signs and symptoms of TMD, where pain was the main complaint. In all sessions, pain was assessed using a visual analogue scale, before and after laser therapy. Laserpuncture was applied to points of Traditional Chinese Medicine, used for treating Temporomandibular Disorders, using a laser device with an infrared wavelength and energy of 3J. Eight sessions were heldand two sessions per week for 4 weeks. Groups 2 and 3 showed improvement in pain symptoms after treatment. Group 3 patients in the fourth session already showed the effective result of the treatment. Laserpuncture when associated with the use of vitamin B12 becomes more efficient for treating TMD.

The relation between vitamin D insufficiency and thyroid hormones in Iraqi women living in Al-Khalidiya, Anbar Province

Background: Vitamin D insufficiency is a worldwide issue in all age groups. It wasdiscovered that vitamin D insufficiency is linked to autoimmune disorders such as Irritablebowel illness, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, andrheumatoid arthritis. Vitamin D is also connected to the development of thyroid autoimmunedisease and plays an important role in endocrinopathies including type 1 and type 2 diabetes,adrenal diseases, and polycystic ovarian syndrome.Materials and methods: 100 samples were collected for women from Al-Khalidiya city inAnbar province (50 samples likely to have thyroid problems, 50 healthy samples). The levelsof vitamin D and thyroid hormones were measured using A Minividus system (whichcombines a two-step enzyme sands assay with an ELFA, or End Fluorescent DetectionMethod).Results: The current findings revealed that there are significant variations in vitamin D andT4 levels between patients and healthy controls ( P-value 0.05). There is also a positiveassociation between vitamin D levels and T4 (r = 0.378, P-value = 0.007), as well as anegative correlation between vitamin D levels and TSH (r = -0.373, P-value = 0.008).Conclusion: According to our result, Individuals with hypothyroidism in Alkhaldia have avitamin D3 deficiency. In addition, blood vitamin D levels show a positive correlation with T4and a negative correlation with TSH levels. To avoid developing osteoporosis ifhypothyroidism persists, all hypothyroid Iraqi patients should be checked for Vitamin Ddeficiency.

The Association between Vitamin D Intake and Gestational Diabetes Mellitus: A Systematic Review

Background: Several studies have focused on the role of vitamin D in preventing gestational diabetes mellitus (GDM) but also in improving or preventing the unwanted perinatal outcomes of GDM. Even today, efforts to clarify the relationship between vitamin D deficiency (VDD) in pregnancy and GDM continue. Methods: We conducted research to search for systematic reviews (SRs) of randomized controlled trials (RCTs), in databases at PubMed, Google Scholar, Web of Science, Science Direct, Embase, Cochrane, Crossref and CAS, published from 2016 to 2021. These concerned maternal vitamin D status or taking vitamin D supplements, alone or in combination with other vitamins or minerals in pregnancy and their association with GDM. We used the AMSTAR (assessment of multiple systematic reviews) scoring scale quality and scoring checklist, which assessed the quality of each SR, at low medium or high. Results: Seven SRs of RCTS involving 7902 participants were selected. The results suggest that if pregnant women with GDM take vitamin D supplements, they improve blood vitamin D levels, as well as biomarkers related to blood glucose. It was also shown that pregnant women with GDM who took vitamin D supplements (1000–4762 IU/day) improved the primary GDM outcome measurements such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), serum insulin and homeostasis model of assessment of insulin resistance (HOMA-IR). In addition, improvements were observed in their lipid profile markers, such as total cholesterol (TC), low-dense lipoprotein (LDL), high-dense lipoprotein levels (HDL) and high-sensitivity C-reactive protein (hs-CRP). Also, the adverse outcomes of GDM in both the mother and the newborn appear to have decreased. However, there are studies that do not support the therapeutic effect of vitamin D intake by pregnant women with GDM. Conclusions: In conclusion, taking vitamin D, during pregnancy, for the prevention or treatment of GDM, is controversial and the real benefit unclear. Further RCTs are necessary.

Nutritional status assessment and intervention with a red palm oil biscuit among pre-school children attending informal crèches, in the Eastern Cape, South Africa

Little information is available on the nutritional and health status of pre-school children attending informal crèches. The study aimed to determine the status of blood carotenoid, vitamin E, inflammatory markers and omega-3 fatty acids in children attending crèches in the Eastern Cape, South Africa. Baseline measurements were followed by an intervention to determine the effect of a biscuit baked with red palm oil (RPO) shortening on these parameters. Forty-seven (n=47) children were randomly assigned to a RPO (Group A) (n=25) and non-RPO (Group B) (n=22) group. Group A received biscuits providing carotenoids, tocotrienols and α-tocopherol while Group B biscuits provided only tocotrienols and α-tocopherol. Biscuits were distributed daily during the school week. Blood samples were obtained at baseline, 3 months and 6 months during intervention as well as 6 months post intervention. At baseline, children showed a mild (10%) vitamin A deficiency, severe vitamin E deficiency (69%) while 98% presented with omega-3 fatty acid indexes below 8%. For vitamin E data was pooled as both groups received similar amounts of vitamin E while no significant differences were observed between the groups during the intervention. Significant increases (p ≤ 0.05) in α-tocopherol levels were observed in both groups at 3-, 6- and 6- months post intervention. Deficiency levels declined to 10% and 0% at 6- and 6-months post, respectively. In group A, plasma α-carotene levels (p ≤ 0.05) increased significantly from baseline (0.04 μmol/L; 95% CI: 0.03 – 0.06) at 3 (0.36 μmol/L; 95% CI: 0.29 – 0.45) and 6 months (0.48 μmol/L; 95% CI: 0.39 – 0.60). Similar significant (p ≤ 0.05) results were observed for plasma β-carotene levels (3 months (0.31 μmol/L; 95% CI: 0.27 – 0.40) and 6 months (0.33 μmol/L; 95% CI: 0.28 – 0.40). Consumption of a biscuit baked with RPO can play a significant role in alleviating vitamin E deficiency and can significantly increase plasma α- and β-carotene levels in pre-school children. Key words: Vitamin A, carotenoids, vitamin E, CRP, IL-6, fortification, omega-3 fatty acids

Sexual Dysfunctions in Females with Parkinson's Disease: A Cross-Sectional Study with a Psycho-Endocrinological Perspective.

Background and Objectives: Normal human sexual functioning is a complex integration of an intact neuroanatomic substrate, vascular supply, a balanced hormonal profile, and a predominance of excitatory over inhibitory psychological mechanisms. However, sexual functioning in Parkinson's disease (PD) is often overlooked in clinical practice, especially in female patients. Materials and Methods: In this cross-sectional study, we have investigated the frequency of sexual dysfunction and the possible correlation with psycho-endocrinological factors in a sample of women with idiopathic PD. Patients were assessed using a semi-structured sexual interview, in addition to psychometric tools, including the Hamilton Rating Scale for Anxiety and for Depression and the Coping Orientation to the Problems Experiences-New Italian Version. Specific blood tests, including testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen E2, prolactin (PRL), and vitamin D3 were also evaluated. Results: Our results reported a statistical difference in sexual intercourse frequency before and after the onset of PD (p < 0.001). The percentage of women who complained about reduced sexual desire increased after diagnosis (52.7%) compared to the period before the onset of the illness (36.8%). The endocrinological profile in females with PD revealed statistically significant differences regarding testosterone (p < 0.0006), estradiol (p < 0.00), vitamin D3 (p < 0.006), and calcium (0.002). Depression (44% characterized by perceived feelings of anger and frustration during sexual intercourse) and anxiety symptoms (29.5% reported feelings of fear and anxiety for not satisfying the partner) with abnormal coping strategies (48.14% experienced feelings of anger and intolerance) were also found to be statistically significant. This study showed a high frequency of sexual dysfunction in female patients with PD, which correlated with sexual hormone abnormalities, mood/anxiety, and coping strategies alterations. This supports the idea that there is a need to better investigate the sexual function of female patients with PD to provide them with an adequate therapeutic approach and potentially improve quality of life.

Effect of Long-Term Proton Pump Inhibitor Use on Blood Vitamins and Minerals: A Primary Care Setting Study.

Long-term proton pump inhibitor (PPI) use is frequently encountered in primary care. Its effect on micronutrient absorption is known, as vitamin B12, calcium or vitamin D insufficiency may occur in such patients. We recruited patients using a PPI (pantoprazole) for >12 months. The control group was represented by subjects attending the general practitioner not taking any PPI in the last 12 months. We excluded subjects using nutritional supplements or with diseases interfering with micronutrient blood levels. All subjects underwent blood sampling with full blood count, iron, ferritin, vitamin D, calcium, sodium, potassium, phosphate, zinc and folate. We recruited 66 subjects: 30 in the PPI group and 36 in the control group. Long-term pantoprazole users had lower red blood cell count but similar hemoglobin. We did not find any significant difference in blood iron, ferritin, vitamin B12 and folate. Vitamin D deficit was observed more frequently in the PPI group (100%) than in controls (30%, p < 0.001), with blood levels lower in pantoprazole consumers. No differences in calcium, sodium and magnesium were observed. Pantoprazole users had lower phosphate levels than controls. Finally, a non-significant trend for zinc deficiency was found in PPI users. Our study confirms that chronic PPI users may encounter alterations in some micronutrients involved in bone mineral homeostasis. The effect on zinc levels deserves further investigation.

Vitamin B12 Deficiency in Relation to Metformin Use in Adults with Type-2 Diabetes Mellitus

Objective: To find the correlation between serum vitamin B12 levels in metformin users among type-2 diabetics.Study Design: Cross-sectional Study.Place and Duration of Study: The study was carried out at the Department of Medicine of Combined Military Hospital, Peshawar, Pakistan from April 2021 to September 2021.Materials and Methods: Using a consecutive sampling technique, patients were selected from both outdoor and indoor medical health facility Blood tests were performed on all patients and serum vitamin B12 level was assessed, a level less than 200 pg/ml was considered deficient. The comparison was made among patients taking metformin and those not on metformin.Results: 148 patients were enrolled, consisting of an equal proportion of cases and controls i.e. 74 patients in each group, with a mean age of 44.09± 10.61 and 46.15± 10.64 respectively. Vitamin B12 deficiency was found more in metformin user group 34 (45.94%) than in patients not on metformin 11 (14.86%) (p&lt;0.001). The odd ratio was 4.87 (95% CI is 2.22 – 10.69).Conclusion: Metformin users taking at least 1000mg daily of minimum one-year duration experienced significant reductions in blood vitamin B12 levels as compared to patients not using metformin. A serum vitamin B12 test needs to be performed on regular basis after every three months in type-2 diabetic patients taking metformin of more than 1 gram daily for more than a year.

The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain.

Introduction Inflammatory bowel diseases (IBD) are chronic diseases that can affect nutrient absorption leading to micronutrient deficiencies and biochemical abnormalities.This study aimed to assess certain serum micronutrients and nutritionally related biochemical markers levels in patients with pediatric IBD and to compare the actual levels and the prevalence of micronutrients deficiencies and biochemical abnormalities between patients with Crohn's disease (CD) and those with ulcerative colitis (UC). Methods A retrospective cross-sectional study reviewing medical records of patients with IBD was conducted in the pediatric department,Salmaniya medical complex, Bahrain, from 1January 1984 to 31December 2021. Demographic data and laboratory resultsrelated to micronutrients and biochemical markers including full blood count, totalprotein,albumin,globulin,iron, ferritin, folic acid, vitamin B12, calcium, phosphorous, magnesium, and vitamin D levelswere collected upon presentation before starting the treatment. Nutritional deficiencies were compared based on sex, nationality, type of IBD, age at presentation, disease duration, weight at diagnosis, and inflammatory markers levels including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Results Of 157 patients with pediatric IBD, 117 (74.5%) were included. Sixty-six (56.4%) patients were males. Sixty-six (56.4%) had CD and 51 (43.6%) had UC. No patient had indeterminant colitis. The mean age at presentation was 10.8±3.8 years. Most patients had one or more micronutrient deficiencies (n=110, 94%). Anemia was a common finding (n=79/116, 68.1%), with iron deficiency anemia (IDA) being predominant. Low iron levels were noted in64/77 (83.1%) patients with a medianof 5.0 (2.0-9.3) µmol/L (normal range, 11.6-31.3);isolated iron deficiency (ID) in 11/18 (61.1%)and IDAin 53/59 (89.8%) patients. Vitamin D deficiency was the second most common (n=45/61, 73.8%). Serum albumin, ferritin, calcium, phosphorous, and magnesium were deficient in 29.2%, 27.8%, 31.7%, 12.5%, and 10%, respectively. One patient had vitamin B12 deficiency while nonehad folate deficiency. Patients with CD had significantly lower serum iron (5.4±5.6 versus 8.1±6.09 µmol//L, p=0.02) and lower serum protein (71.7±8.7 versus 75.4±9.9 g/L, p=0.043)but higher serum ferritin (45 (19-110.2) versus 21.3 (10.3-51.2) µg/L, p=0.046) compared to those with UC. Elevated ESR was noted in 62/105 (59.1%) patientswhile high CRP was found in 67/104 (64.4%).Patients with low ironhadhigher ESR (28 (17-47) versus 14 (10-33) mm/h, p=0.028) and higher CRP (13.3 (1.6-42) versus 1.8 (0.9-4.6) mg/L, p=0.019) levelscompared to those with normal levels. Conclusion Patients with pediatric IBD are at risk of multiple micronutrient deficiencies and biochemical abnormalities. Iron and vitamin D deficiencies are the most frequent. Patients with CD are more prone to have lower serum iron and protein levels than those with UC.ID was associated with elevated inflammatory markers.

Management of palmoplantar psoriasis and its comorbidities using yoga and naturopathic lifestyle interventions: A case report

Palmoplantar psoriasis is an autoimmune disorder that contributes to significant functional disability. Apart from the chronic inflammatory reactions in the skin, psoriasis patients are more likely to develop chronic systemic disorders, which impose significant physical, mental, and economic burdens. This warrants a holistic, patient-centered approach that can address the prevailing multimorbidity in psoriasis patients. Yoga and Naturopathy-based Lifestyle Interventions (YNBL) are known for their whole-person approach and are reported to be beneficial in the management of autoimmune disorders. We report a case of a 63-year-old male treated with YNBL for palmoplantar psoriasis along with diabetes mellitus, coronary artery disease, low back pain, and insomnia. The patient underwent YNBL in an inpatient setting for 10 days each with a gap of 7 months, along with follow-up advises. The prognosis was measured through the Psoriasis Area and Severity Index, along with other biochemical markers like fasting blood sugar, random blood sugar, vitamins D and B12, and subjective visual analog scores for vitality and other symptoms. He achieved complete remission of psoriasis by the end of 8 months, and the results were sustained even during the follow-up. The results are encouraging for using the YNBL protocol in the management of palmoplantar psoriasis; however, these findings need to be validated using clinical trial designs.

Vitamin D levels in pregnancies and neonatal outcomes

Objective: We aimed to evaluate the differences in obstetrics and neonatal outcomes, such as mode of delivery, gestational diabetes mellitus, preeclampsia, and infant birth weight between pregnancies with normal and insufficient vitamin D levels. Methods: The study was designed as a retrospective study. One hundred and seventy-nine pregnant women who were followed up at our clinic and whose vitamin D levels were evaluated in each trimester were included. All patients were administered 1200 IU/day beginning from the 12 weeks of gestation in accordance with the national guidelines. Vitamin D levels above 20 ng/ml were defined as sufficient, and those below 20 ng/ml were defined as insufficient. Results: The median vitamin D level in the third trimester was significantly higher than that in the first and second trimesters (p&lt;0.001). There was a moderate positive correlation between vitamin D levels in infant cord blood at the time of birth and vitamin D levels in the third trimester (p&lt;0.001, R=0.496). Birth weights of the patients with insufficient vitamin D levels in the first trimester but with sufficient neonatal cord blood levels as a result of treatment were significantly higher compared to those in patients with insufficient cord blood vitamin D levels (3327 g vs. 3133 g, p=0.030). Conclusion: This study observed that neonatal cord blood vitamin D level is a better indicator than antenatal vitamin D levels. Regardless of first-trimester vitamin D levels, infant birth weights were significantly higher in the group with sufficient neonatal cord blood levels.