Cause Of Vitamin Research Articles

Inadequate consumption of vitamin A-rich foods among preschool children in Wolaita Sodo, Southern Ethiopia.

The primary cause of vitamin A deficiency in developing countries like Ethiopia is the inadequate consumption of vitamin A-rich foods. Preschool children are particularly vulnerable due to their higher nutritional requirements and increased susceptibility to infections. This study aims to assess the prevalence of inadequate consumption of vitamin A-rich foods and identify the associated factors among preschool children in Wolaita Sodo, Southern Ethiopia. A community-based cross-sectional study was conducted using multi-stage sampling to select 471 households with preschool children between July 15 and August 15, 2021. Data analysis was performed using SPSS version 25. Binary logistic regression was employed to identify predictors of inadequate consumption of vitamin A-rich foods. Variables with a p-value <0.25 in the bivariate analysis were included in the multivariable logistic regression. The strength of the associations was estimated using adjusted odds ratios with 95% confidence intervals. Statistical significance was determined at a p-value <0.05. The prevalence of inadequate consumption of Vitamin A-rich foods among pre-school children in this study was 381 (81.1%) with a 95% confidence interval of 77.3 to 84.9%. Predictors for inadequate consumption of Vitamin A rich foods were being a girl [AOR = 0.41, 95% CI: 0.24, 0.69], aged 46-59 months [AOR = 0.46, 95% CI: 0.23, 0.93], rural residence [AOR = 2.36, 95% CI: 1.22, 4.57], family size of five or more [AOR = 2.36, 95% CI: 1.15, 4.86], household income of <2000 Ethiopian Birr [AOR = 3.98, 95% CI: 1.18, 13.40], and morbidity in last 2 weeks [AOR = 0.36, 95% CI: 0.17, 0.74]. This study showed that the participants' consumption of vitamin A-rich food was inadequate. Greater emphasis be placed on food-based tactics to increase pre-schoolers' intake of foods high in vitamin A. Enhancing socioeconomic status is also crucial for increasing the intake of foods high in vitamin A.

Serum Vitamin D Status Among Workers Coming from Middle East

Background: Vitamin D deficiency is common in the Middle East. To maintain health, vitamin D holds a very important place. Its deficiency is a major global health problem and affects both genders at all stages of life. Lack of exposure to sunlight is among the foremost causes of vitamin D deficiency. Methods: This hospital based cross sectional observational study carried out in the Department of Medicine in Comilla Medical College Hospital, Comilla, with a total of 100 cases purposively selected for the study. Detailed information was obtained in each individual according to protocol. Complete history was taken from patients. Thorough clinical examinations were done. Relevant investigations reports were collected. All the information was recorded in the fixed protocol. Collected data were classified, edited, coded and entered the computer for statistical analysis by using SPSS-23. Results: Out of 100 cases, 76.0% of participants belonged to age 21-40 years. The mean age was found 35.3±8.4 years with range from 18 to 62 years. Majority (95.0%) of participants were male with a ratio of 19:1. The majority (86.0%) of participants were exposed to sunlight ≤15 min/day. Only 3(3.0%) participants used sun block. More than three fourth (79.0%) of the participants used to eating sea fish (≥3 days per/weeks) followed by 52(52.0%) drink milk (≥3 days per/weeks) and 12(12.0%) was supplement with omega-3 fatty acid (fish oil). Majority 41(41.0%) of the participants had back pain followed by 12(12.0%) muscle cramp, 8(8.0%) neck pain and 8(8.0%) headache. Almost two third (65.0%) of the participants had deficiency, 31(31.0%) had insufficiency and 4(4.0%) had normal 25-hydroxyvitamin D. Significant association was also found between inadequate drinking milk with decreased 25-hydroxyvitamin D level. Conclusion: In conclusion 25-hydroxyvitamin D deficiency (65.0%) and insufficiency (31%) common among Bangladeshi workers coming from Middle East. It was influenced by their decreased sunlight exposure (≤15min/day) &amp; clothing style. Inadequate consumption of milk and milk products may also play a role in decreasing vitamin D levels. J Rang Med Col. September 2024; Vol. 9, No. 2: 67-71

8586 A Case Of Vitamin D Toxicity: From Michigan To Hawaii, Vitamin D Is Very High

Abstract Disclosure: A. Abu Limon: None. S.A. Aldasouqi: None. K. Patel: None. F. Akanbi: None. S. Khan: None. P. Kachhadia: None. We report a patient case who is a 46-year-old male, managed for Type 2 diabetes and Vitamin D deficiency (Defined by 25-hydroxy vitamin D levels less than 20ng/ml) at Michigan State University Endocrinology specialty clinic.He started taking 5000 IU daily Vitamin D supplements and on subsequent follow up his levels corrected to 88 ng/ml. His supplements were held.On a routine repeat lab check, his 25-hydroxy vitamin D level is reported to be higher than 200 ng/ml. Which meets the biochemical diagnosis of Vitamin D toxicity. His Calcium level was 9.7 mg/dL (N 8.7-10.3 mg/dL) and PTH-intact level was 38.3 pg/mL (N 14.0-72.0 pg/mL).On questioning the patient, he assured us he is still not on any Vitamin D supplements and that he just got back from a two-weeks long trip from Hawaii and spent hours daily on the beach without using sunblock.He is sure he didn't get tanning, sunburns, or any burns during that period.He was feeling fine without any symptoms or complications.While in Michigan during the winter, with limited number of sunny days, His 25-hydroxy vitamin D levels trended down slowly over the following few months, while Vitamin D supplements kept on hold.The most common cause of Vitamin D toxicity is excessive supplemental Vitamin D use. Other reasons can be related to excessive tanning or burns, that our patient didn't have. Excessive sun exposure or dietary intake is not a known reason to raise Vitamin D levels to a toxic range.Our patient lives in Mid-Michigan, an area known for low number of sunny days (150-180 sunny/ partly sunny days per year ), Which is a reason for high prevalence of vitamin D deficiency in the population. This is Compared to mostly sunny days on the Hawaiian Islands.Coming Back home for the winter season did help his Vitamin D levels to continue trending down back to a safe, non-toxic range. Presentation: 6/2/2024

8706 Hypoparathyroidism and Hypercalcemia in Premature Secondary to Excessive Vitamin D: Everything in Excess is Opposed

Abstract Disclosure: D.M. Bastos: None. A. Bastos: None. Introduction: Vitamin D intoxication in children is rare but its incidence is increasing as vitamin D is supplemented more often and in higher doses. Coma, ventricular fibrillation, and acute renal insufficiency are possible life-threatening presentations of vitamin D-induced hypercalcemia. Nephrocalcinosis, renal lithiasis, vascular calcifications, and arterial hypertension are known late complications of severe or longstanding hypercalcemia. The most common causes of vitamin D intoxication in children are manufacturing errors, parental dosing errors, and erroneous medical prescriptions. Case Presentation: A premature girl admitted to the neonatal ICU 3 months ago due to poor weight gain and was taking vitamin D and infant formulas and developed tachycardic heart rhythm with irregular rhythm and kidney changes. The investigation of the condition was re-evaluated, and the patient was seen with hypercalcemia, an increase of more than 100x in the dosage of 25(OH)vitamin D, an increase in the dosage of 1.25(OH)vitamin D, suppressed PTH, an increase in creatinine and urea. In addition, an ultrasound was performed showing the presence of small kidney stones, none of which were obstructive. After discontinuing vitamin D supplementation, the patient progressed satisfactorily with a reduction in cardiac and renal changes. Discussion: Currently, vitamin D supplementation has been carried out more frequently, as, in addition to increasing the absorption of calcium in the body, it reduces the risk of diseases, such as rickets and osteopenia of prematurity. The body is only able to produce vitamin D after exposure to sunlight. In the absence of regular exposure, dietary sources alone are not sufficient to maintain adequate levels. Cases of hypervitamin D generally occur in situations of excessive supplementation. In the present report, the dose used was 40 times higher than recommended. Initial tests revealed elevated calcium and undetectable PTH levels. The diagnosis of vitamin D intoxication is not common in cases of hypercalcemia, as it is infrequent, especially before the advent of vitamin D supplementation. Vitamin D toxicity is usually iatrogenic, or due to accidental overdose. These factors, along with a lack of public education about safe dosing, have likely contributed to the increase in reported cases of vitamin D toxicity. Conclusion: Vitamin D supplementation, especially when using compounded medications, must be adequately monitored due to the potential risk of poisoning. Vitamin D toxicity remains a pressing issue and its incidence will likely continue to grow, primarily because of the widespread availability of over-the-counter formulations and public interest. Presentation: 6/3/2024

Effect of vitamin D on body mass index in football athletes

Background and Study Aim. Vitamin D deficiency is a critical issue for athletes, and the major cause of Vitamin D deficiency is the involvement of athletes in indoor sports activities. Indoor training of athletes has similar risk factors for vitamin D deficiency as compared to the rest of the population. Therefore, this study aimed to examine the influence of Vitamin D on BMI among football athletes in Pakistan. Material and Methods. Twelve football athletes (n=6 Experimental Group, n=6 Control Group) from Mian Kalay were recruited through a convenient sample with the average age of the participants being 19.08 ± 2.35 years. Weight, height, and body mass index were measured using a standard stadiometer (ZT-120, China) and analyzed using SPSS version 26. The Experimental Group was kept in games with sunlight exposure for a period of 120 days while the Control Group was restricted. Blood samples were collected by an Agha Khan Lab expert using a 3cc syringe, then transferred into a 3cc gel tube, and 1ml of serum was obtained after centrifugation from all participants. Results. The Experimental Group showed significant increases in Vitamin D levels (17.58 vs 43.36, p-value 0.003) and decreases in weight (p=0.001) and BMI (24.00 vs 22.32, p-value &lt;0.001). Meanwhile, the Control Group experienced decreases in Vitamin D levels (20.85 vs 10.86, p-value 0.036) and increases in weight (p&lt;0.001) and BMI (21.11 vs 21.60, p-value 0.023) due to restriction from sunlight. Conclusions. Training in sunlight significantly increased the Vitamin D levels of athletes and decreased their weight and BMI. Moreover, indoor sports activities significantly decreased Vitamin D levels and increased the weight and BMI levels of athletes.

Knowledge, attitudes and practices (KAP) of medical university students towards vitamin D deficiency in Saudi Arabia: a cross-sectional study.

Vitamin D deficiency is a serious health problem that is associated with many health consequences. The study aimed to assess the knowledge, attitudes, and practices of medical students at Qassim University, Saudi Arabia, regarding vitamin D deficiency. An observational cross-sectional study was conducted among students of Unaizah Colleges of Pharmacy (UCP) and Medicine (UCM) at Qassim University, Saudi Arabia, over a period of 3 months. A well-structured self-administered questionnaire was used for the data collection. Statistical analysis was applied by using SPSS version 22. A 0/1 scoring process was employed to assess the KAP of the participants. The midpoint is considered the cutoff point. A total of 337 complete responses were received. The majority of participants (62.3%) were female. 291 (86.3%) were considered to have good knowledge, with a mean score of 6.326 out of 9. Moreover, 220 (65.2%) of participants had positive attitudes, with a mean score of 4.077 out of 7. Unfortunately, only 9 (2.6%) participants demonstrated satisfactory practices, with a mean score a 0.911 out of 6. Female participants were significantly better than male participants in terms of knowledge and attitudes, but worse in terms of practices. Sun exposure during safe daytime hours is considered the main cause of vitamin D deficiency. Nearly 60% confirmed that KSA indoor activities and the COVID-19 lockdown might maximise vitamin D deficiency. The study reveals a gap in vitamin D knowledge among participants influenced by gender and study year. It suggests educational initiatives for male students to enhance their knowledge regarding vitamin D, while female students are encouraged to prioritise safe sun exposure, minimising the use of umbrellas and sunscreen. It also highlights the role of educational institutions as reliable sources of information and the influence of the COVID-19 pandemic on participants' attitudes and practices towards vitamin D.

Airway hillocks are injury-resistant reservoirs of unique plastic stem cells.

Airway hillocks are stratified epithelial structures of unknown function1. Hillocks persist for months and have a unique population of basal stem cells that express genes associated with barrier function and cell adhesion. Hillock basal stem cells continually replenish overlying squamous barrier cells. They exhibit dramatically higher turnover than the abundant, largely quiescent classic pseudostratified airway epithelium. Hillocks resist a remarkably broad spectrum of injuries, including toxins, infection, acid and physical injury because hillock squamous cells shield underlying hillock basal stem cells from injury. Hillock basal stem cells are capable of massive clonal expansion that is sufficient to resurface denuded airway, and eventually regenerate normal airway epithelium with each of its six component cell types. Hillock basal stem cells preferentially stratify and keratinize in the setting of retinoic acid signalling inhibition, a known cause of squamous metaplasia2,3. Here we show that mouse hillock expansion is the cause of vitamin A deficiency-induced squamous metaplasia. Finally, we identify human hillocks whose basal stem cells generate functional squamous barrier structures in culture. The existence of hillocks reframes our understanding of airway epithelial regeneration. Furthermore, we show that hillocks are one origin of 'squamous metaplasia', which is long thought to be a precursor of lung cancer.

THE USE OF VITAMIN D PREPARATIONS TAKING INTO ACCOUNT VITAMIN D-DEFICIENT CONDITIONS

Currently, much attention is being paid to the status of vitamin D as a biomarker of the general state of human health, since low levels of vitamin D are associated with a wide range of diseases. Vitamin D metabolism is complex. Vitamin D and its containers can have genomic and non-genomic activity. The article presents the most common causes of vitamin D deficiency. Screening for vitamin D deficiency is shown in groups of patients with risk factors for its development. Individual features of vitamin D influence caused by genetic polymorphism of the VDR gene are described. For the prevention and treatment of vitamin D-deficient conditions, the use of the vitamin D preparation colecalciferol is recommended. Drugs with high activity calcitriol and alfacalcidol are necessary in certain groups of patients for strict indications, in particular in the complex therapy of osteoporosis.

Adoption of Golden Rice: A Boon for the Children Suffering from Vitamin A Deficiency

Many poor people worldwide cannot afford nutritious food and depend on rice for their daily food needs. In 2022, Asia was home to 55% (402 million) of the people in the world affected by hunger, while more than 38% (282 million) lived in Africa. India is the world’s secondlargest producer of rice, wheat, vegetables, and fruit. Malnutrition is a major problem that causes many immediate and long-term health problems. Over 33 lakh children in India are malnourished, with Maharashtra, Bihar, and Gujarat having a major share. Vitamin A deficiency causes irreversible blindness in 500,000 children annually, which ultimately results in large-scale deaths. In Southeast Asia, due to VAD, every year, five million children develop symptoms that may lead to blindness. VAD is also a matter of concern in several areas of Africa, Latin America, and the Caribbean. It is estimated that vitamin A nutrition may prevent approximately 1 to 2 million deaths every year among children aged 1 to 4 and an additional 0.25 to 0.5 million during the higher age group of children. One of the major causes of vitamin A deficiency is that milled rice does not contain β-carotene, which is the precursor of vitamin A synthesis. In this scenario, adopting Golden Rice which is genetically modified rice could benefit the population living in developing countries. This review article gives emphasis on the importance of overcoming vitamin A deficiency.

Vitamin D knowledge, awareness and practices of female students in the Southwest of Saudi Arabia: A cross-sectional study.

Vitamin D deficiency is a common health problem among adults in Saudi Arabia, particularly females. Vitamin D deficiency is associated with many diseases, including cardiovascular diseases, diabetes, autoimmune diseases, neurological disorders, and cognitive decline. This study aimed to assess the knowledge, awareness and practice of vitamin D deficiency among female students in Jazan University as well as to determine the sociodemographic related factors. A cross-sectional study was conducted among 204 female undergraduate and postgraduate students (18 years of age and older) in March 2022 from Saudi Arabia. Students completed a web-based survey about vitamin D and their demographic characteristics. Statistical analyses were conducted using Statistical Package for the Social Sciences software. Descriptive statistics, the Chi-squared test of homogeneity, and univariate and multivariate logistic regression were used. The results revealed that the participants had limited knowledge related to vitamin D normal level (49.5%), and the recommended daily amount of vitamin D (26.5%). Most of the participants were unaware of its benefits for vision, muscle integrity, weakness, and fatigue. Most of them recognized the importance of sunlight for maintaining suitable levels of vitamin D (94.1%). However, only 43.1% identified that decreased intake of foods rich in vitamin D is a cause of vitamin D deficiency. Participants (33.7%) preferred exposure to sunlight to improve their vita-min D levels, and 32.4% used vitamin D supplements. However, only 39.2% had ever examined their vitamin D status. Univariate and multivariate logistic regression models demonstrated a significant association between knowledge, and residence, and source of information (odds ratios = 3.48 and 2.79, respectively, P < .05). Most respondents had a basic understanding of vitamin D, vitamin D insufficiency, and the environmental and dietary factors contributing to it. Given the findings obtained, cognitive interventions need to be carried out.

SAT176 Comparison Of Prevalence For Normocalcemic Primary Hyperparathyroidism (NPHPT) Using Different 25(OH)D Levels: A Systematic Review

Abstract Disclosure: I.N. Farooqi: None. X. Wang: None. The familiar topic of vitamin D deficiency remains controversial in the context of bone metabolism and health, with findings supportive of differing thresholds for supplementation. While the Fifth International Workshop has not delineated exact cutoffs for 25(OH)D to rule out the secondary cause of vitamin D deficiency in evaluations of NPHPT, we believe higher thresholds will yield fewer rates of diagnosis. We postulate that a review of existing literature yields significant differences in the reported prevalence of NPHPT when comparing 25(OH)D cutoffs of ≥30ng/mL versus ≥20ng/mL. PubMed searches were conducted using the key words “normocalcemic primary hyperparathyroidism,” “prevalence,” “trial,” and 7400 studies were initially found. Excluding studies from before 2010, those using population sizes less than 100 subjects, and abstracts, we found a total of 14 articles for which full-text review was performed. We examined 9 studies using the 25(OH)D cutoff ≥20ng/mL and 5 studies using ≥30ng/mL for our analysis. Although research on NPHPT has been done worldwide, including Europe, East Asia, North and South Americas, none were found in Africa, South Asia, and Australia. Our review identified 9/14 studies in Canada, USA, UK, Sweden, Czech Republic, Italy, Belgium, and China which used 25(OH)D ≥20ng/mL to exclude vitamin D deficiency, with a prevalence range of 0.18-21%, averaging 5.81%. Conversely, the remaining 5/14 studies from Brazil, USA, Spain, and Italy using ≥30ng/mL as the lower limit of 25(OH)D for diagnosing NPHPT yielded prevalence rates ranging 0.02-8.9% with an average of 3.17%. The prevalence of NPHPT is 8.9% in the Brazilian study by Marques et al. in 2011 and 6% in the Spanish study by Garcia-Martin in 2012, while the remainder of North American and European studies using the ≥30ng/mL cutoff from 2015 onward reported prevalence rates of only 0.02-0.6%. Of the total number of publications reviewed since 2015, 30% of the studies implemented the higher threshold of ≥30ng/mL. Previously documented prevalence rates of NPHPT among healthy adults have used 25(OH)D ≥20ng/mL to define the exclusion of vitamin D deficiency; however, our current review of several studies since 2010 demonstrates a significantly lower prevalence of the disease when the cutoff is raised to ≥30ng/mL. Our findings suggest greater specificity in the exclusion of vitamin D deficiency in more recent publications. Recent research examining free 25(OH)D as a more effective marker for vitamin D status suggests total 25(OH)D ≥30ng/mL may still be insufficient to completely exclude vitamin D deficiency in NPHPT. Thus, the role of varying 25(OH)D cutoffs is interesting and requires further investigation on a geographic level, as it may provide more insight into interethnic variations, correlation with seasonality and sunlight exposure, and healthcare access in regions where such studies have yet to be conducted. Presentation: Saturday, June 17, 2023

Vitamin D Deficiency and Heart Health: A Narrative Review

Vitamin D deficiency has developed into a global issue, impacting an estimated one billion people worldwide. Lack of sunlight exposure is the major cause of vitamin D deficiency, as very few foods contain natural vitamin D. Several epidemiological and random clinical trials have reported a close association between low vitamin D levels and cardiovascular disease development. This paper aims to discuss vitamin D deficiency and its role in developing cardiovascular disease. Vitamin D is an essential fat-soluble vitamin which plays an important role in skeletal maturation. Vitamin D deficiency is highly prevalent globally and is linked to a spectrum of cardiovascular disorders and is thought to promote atherogenesis. We have done a thorough review of the literature using a Pubmed search. Different keywords like vitamin D deficiency, cardiovascular diseases, coronary artery disease, atherosclerosis, heart failure were used to write the review. Here we report according to current evidence, vitamin D deficiency is associated with a higher risk of cardiovascular diseases. However, further study is necessary to evaluate whether vitamin D supplementation has a beneficial effect on cardiovascular outcomes. Keywords: Vitamin D deficiency, Cardiovascular diseases, Cholecalciferol, Coronary heart disease, Heart failure

Evaluation of vitamin D levels and affecting factors of vitamin D deficiency in healthy children 0-18years old.

This study showed that vitamin D deficiency still remains a major problem for healthy children and daily supplementation of vitamin D is mandatory. Prophylactic vitamin D supplementation and adequate sunlight exposure should be provided for all children, in particular healthy adolescents. In addition, future studies may focus on screening for vitamin D status in children who did not receive vitamin D supplementation. • Vitamin D is an essential component in bone metabolism. Seasonality, age, sex, dark skin pigmentation, and limited exposure to sunlight are causes of vitamin D deficiency. • The World Health Organization has drawn attention to this increased frequency, recommending lifelong, regular vitamin D prophylaxis. • The frequency of vitamin D deficiency and insufficiency was found to be 42.9% in healthy children and the frequency significantly increased with age. • There were almost no cases of prophylactic vitamin D usage in adolescent group which are at the highest risk.

Патогенетическое обоснование применения витамина D при синдроме поликистозных яичников

Objective of the Review: тo analyze the literature data concerning the etiology of vitamin D deficiency, the consequences of vitamin D deficiency, and the effectiveness of vitamin D supplementation in women with polycystic ovarian syndrome. Key Points. Polycystic ovarian syndrome, recognized as one of the most common endocrine metabolic disorders in women, is of increasing interest to researchers and practitioners worldwide. A large body of evidence suggests that vitamin D plays a regulatory role in the symptoms associated with polycystic ovarian syndrome (PCOS), including ovulatory dysfunction, insulin resistance, and hyperandrogenism. This article outlines the current understanding of the causes of vitamin D deficiency, the consequences of vitamin D deficiency, and the efficacy of vitamin D supplementation in the treatment of polycystic ovarian syndrome. Conclusion. Vitamin D deficiency is very common in women with PCOS and is associated with many symptoms, including insulin resistance, cardiovascular risk, infertility, and hirsutism. There is evidence of a positive effect of vitamin D supplementation on menstrual dysfunction and insulin resistance in women with PCOS. However, this area requires further study. Keywords: vitamin D deficiency, polycystic ovary syndrome, insulin resistance, menstrual cycle

Hubungan Tingkat Pengetahuan Ibu tentang Vitamin A dengan Pemberian Kapsul Vitamin A pada Balita

Vitamin A is one of the essential nutrients that are fat-soluble and stored in the liver, the body cannot make it, so it must be met from the outside (essential). Another most severe consequence of vitamin A deficiency (VAC) is night blindness, another form of xerophthalmias such as corneal damage and blindness. Vitamin A can increase the body's resistance to infectious diseases such as measles, diarrhea, and ARI and has a vital role in health eye. This study determined the relationship between a mother's level of knowledge about vitamin A and giving vitamin A to toddlers based on the data through the literature review method. They are using the literature review method. Journal searches use an academic database, namely Google Scholar, published in 2017-2020 using Indonesian and English. Cross-sectional study design. They obtained six research results according to the inclusion criteria. The research sample averaged 38-100 respondents. The results of the research analysis showed in six research journals that there was a relationship between the mother's level of knowledge about vitamin A and giving vitamin A capsules to toddlers with A mother's awareness of the importance of vitamin A in toddlers can be seen in the knowledge they have, one of the causes of the problem of vitamin A deficiency is the behavior or attitude of mothers who do not give vitamin A to their children. This is based on a lack of knowledge about the importance of vitamin A. P-value = 0.005. A mother's awareness of the importance of vitamin A in toddlers can be seen from the inside. One of the causes of vitamin A deficiency is the behavior or attitude of mothers who do not give vitamin A to their children. This is based on a lack of knowledge about the importance of vitamin A.

Nephrocalcinosis in children who received high-dose vitamin D

Vitamin D supplements are readily available as over-the-counter preparations. However, although rare, cases of vitamin D overdose still occur and are associated with nephrocalcinosis and life-threatening hypercalcemia. Errors in manufacturing of nutritional supplements may be a cause of vitamin D intoxication in children. This study aimed to identify factors associated with vitamin D overdose-related nephrocalcinosis in children due to manufacturing errors in supplements. This retrospective study reviewed medical charts of pediatric patients with non-registered supplement-related vitamin D overdose at a tertiary referral hospital between 2006 and 2011. Clinical and laboratory characteristics of patients with or without nephrocalcinosis were evaluated. Receiver operating characteristics curve and area under the receiver operating characteristics curve were used to determine the most predictive value of each characteristic. A total of 44 patients (males: 29; age: 7-62months) were included. Age ≤ 16.5months, body weight ≤ 10.25kg, body height ≤ 78.5cm, body surface area (BSA) ≤ 0.475 m2, 25-hydroxyvitamin D3 ≥ 143ng/mL, and calcium ≥ 10.65mg/dL were predictive of developing nephrocalcinosis with a sensitivity and specificity of > 60%. Univariant analysis revealed that BSA was the most significant anthropometric prognostic factor (odds ratio: 12.09; 95% confidence interval: 2.61-55.72; P = 0.001). Children with smaller BSAs were more vulnerable to high-dose vitamin D3-related nephrocalcinosis. Physicians and parents should be aware of the potential adverse effects of vitamin D overdose in children. A higher resolution version of the Graphical abstract is available as Supplementary information.

Incident Of Vitamin D Deficiency In Derna City\libya

The study explained the incident of vitamin D deficiency in Derna city, in the Eastern part of Libya. Aim: To find out the causes of Vitamin D deficiency. Material and Methods: Cross-sectional study for 590 samples were given a questionnaire, about demographic characters started in 01\05\2018 up to 15\ 01\2020. Result: A 590 case were 360 who suffering from Vit D deficiency, that the frequency &amp; the percent % of skin color, was the highest percent for wheaten skin color by 164 (45.6%), followed by white color skin 122 (33.9%), brownish color by 68 (18.9%), then black skin color by 6 (1.0%), Mean (2.15), SD (0.917), as followed by Smoking were 94 (26.1%) not smoking 266 (73.9%), Mean 1.74, SD (0.440), about sporting the percent was who keep exercising were 144 (40.0%), the percent who do not continue to exercise were 216(60.0%), the percent who do not exercise was 164 (45.6%), Mean (1.60), SD (0.491). As for the percent whose expose to sun were 103(17.5), then who not expose to sun were 213(36.1), who Sometimes exposed to the sun were 274(46.4), Mean (2.31), SD (0.710), p–value=0.000 that their relationship between Vitamin D Deficiencies and demographic characters, skin color, smoking, sporting, nutrition, expose to sun, diabetes, and hypertension. Conclusion: The obtained results prove that their relationship between, age, gender, skin color, smoking, nutrition, expose to sun, sporting, diabetes, hypertension, different type of diseases, and other type of vitamins, there is also a direct proportion between vitamin D deficiency and S.Ca+ deficiency.

An Update on Vitamin D Deficiency Status in Malaysia.

Vitamin D is essential for maintaining serum calcium levels, ensuring sufficient bone mineralization, immunomodulatory properties, and a protective effect on the cardiovascular system, renal disease, cancer, as well as in pregnancy. Vitamin D deficiency is prevalent worldwide, and it is not related to a country’s development index. However, the data on vitamin D deficiencies are primarily taken from out-of-date, small-scale studies on target age groups or specific diseases, rather than from large-scale, population-based surveys. In Malaysia, for the past 16 years, studies were conducted involving adult men and women, pregnant women, postmenopausal women, adolescent, and children especially with specific diseases such as spina bifida, epilepsy, chronic liver disease, and atopic dermatitis. Only a few large surveys were conducted involving children and adolescents. Across the specific target population studied, vitamin D deficiency and insufficiency were seen particularly among females, Indians, and those of Malay ethnicity. This is related to widely known causes of vitamin D deficiency such as skin type (melanin) and sun avoidant lifestyles that include covering clothes, largely practiced by Malay Muslims in Malaysia. Other related causes or the high-risk groups are breastfed infants, the elderly, the obese, those on medications, and those characterized by fat malabsorption and geophysical factors. Vitamin D deficiency can be managed with pharmacological or non-pharmacological approaches, depending on the severity. The objective is to raise serum vitamin D to a normal level, hence, relieving the symptoms and reducing the adverse health outcomes. Despite no clear guidelines in treating vitamin D deficiency in Malaysia, this condition can be prevented with taking adequate vitamin D in food resources, sun exposure, or supplementation. Special attention should be given to high-risk groups including infants, obese patients, and the elderly.

ACQUIRED NEONATAL SEVERE FACTOR II DEFICIENCY- TWO CASES REPORT

In present study two cases of transient acquired and isolated factor II deficiency associated with severe bleeding are reported. Two infants were involved in severe coagulopathy. The blood clot time (CT) in case 2 was excessively prolonged over 16 hours. One-stage prothrombin time (PT) was remarkable prolonged. Haemostatic markers analysis showed an isolated deficiency of factor II at 2.5% and 4.5% respectively. No inhibitory activity against factor II could be detected. We successfully treated the deficiency with vitamin K1 during 15 days. It was interesting that in the case 2 female baby the cause of vitamin K deficiency might be breast feed problem (nutrition deficiency) and/or poor absorption from bowel. Physiopathological laboratory results and therapeutic aspects of two patients were presented. Peer Review History: Received: 1 November 2021; Revised: 9 December; Accepted: 28 December, Available online: 15 January 2022 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, sally.elzahaby@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. Ogbonna B. Onyebuchi, Nnamdi Azikiwe University, Awka, Nigeria, summitpharm@yahoo.com

Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis

Vitamin B-12 is a water-soluble vitamin that plays important roles in intermediary metabolism. Vitamin B-12 deficiency has many identifiable causes, including autoimmune and other gastrointestinal malabsorption disorders, dietary deficiency, and congenital defects in genes that are involved in vitamin B-12 trafficking and functions. Another putative cause of vitamin B-12 deficiency is the high-folate-low vitamin B-12 interaction, first suspected as the cause for observed relapse and exacerbation of the neurological symptoms in patients with pernicious anemia who were prescribed high oral doses of folic acid. We propose that this interaction is real and represents a novel cause of vitamin B-12 depletion with specific etiology. We hypothesize that excessive intake of folic acid depletes serum holotranscobalamin (holoTC), thereby decreasing active vitamin B-12 in the circulation and limiting its availability for tissues. This effect is specific for holoTC and does not affect holohaptocorrin, the inert form of serum vitamin B-12. Depletion of holoTC by folic acid in individuals with already low vitamin B-12 status further compromises the availability of vitamin B-12 coenzymes to their respective enzymes, and consequently a more pronounced state of biochemical deficiency. This hypothesis is drawn from evidence of observational and intervention studies of vitamin B-12-deficient patients and epidemiological cohorts. The evidence also suggests that, in a depleted state, vitamin B-12 is diverted to the hematopoietic system or the kidney. This most likely reflects a selective response of tissues expressing folate receptors with high affinity for unmetabolized folic acid (UMFA; e.g., hematopoietic progenitors and renal tubules) compared with those tissues (e.g., liver) that only express the reduced folate carrier, which is universally expressed but has poor affinity for UMFA. The biochemical and physiological mechanisms underlying this interaction require elucidation to clarify its potential public health significance.