Decline In Calcium Levels Research Articles

Serum calcium and glucose level in asphyxiated neonates: a prospective study

Background: Birth asphyxia is the primary cause of both mortality and death in newborns. Neonates that experience birth asphyxia are more likely to develop hypocalcemia and hypoglycemia. The primary objective of this study was to assess the calcium and glucose in newborns who had asphyxia and compare with the hypoxic-ischemic encephalopathy (HIE) severity. Methods: This prospective observational study conducted on 75 asphyxiated neonates admitted to NICU. The serum calcium, ionized calcium and glucose level were measured using standard biochemical methods. The severity of HIE was assessed using the Sarnat and Sarnat staging system. The calcium and glucose level were compared across different stages of HIE using one-way ANOVA. Results: The mean total calcium level was 7.87±1.87 mg/dl, mean ionized calcium level was 3.27±0.76 mg/dl and mean serum glucose level was 44.43±6.5 mg/dl respectively. Out of 75 neonates, majority 32 (42.7%) were in were in HIE stage II moderate risk. There was a significant decline in calcium level among the neonate in HIE stage III severe risk when compared to HIE stage II (3.65±0.97 vs 4.05±1.06) and HIE stage I (3.65±0.97 vs 5.76±1.32). The mean serum glucose level was significantly (p=0.001) lower in HIE stage III severe risk when compared to HIE stage II (38.12±4.65 vs 44.76±5.45) and HIE stage I (38.12±4.65 vs 50.43±6.28). Conclusions: The ionic calcium and glucose levels were decreased in asphyxiated neonates and early intervention is required to reduce the neonatal mortality.

SAT-LB309 Amphotericin B Induced Hypocalcemia in a Patient With Severe Hypercalcemia Due to Acute T-Cell Leukemia/Lymphoma

SAT-LB309 Amphotericin B Induced Hypocalcemia in a Patient With Severe Hypercalcemia Due to Acute T-Cell Leukemia/Lymphoma

MON-LB73 Incidence Rate of Post-Thyroidectomy Immediate Hypocalcemia and Its Relation to Pre-Operative Vitamin D and Parathyroid Hormone Levels

Aim: To find out the incidence rate of post-thyroidectomy immediate hypocalcemia within 48 hours and explore the association of pre-operative vitamin D and parathyroid hormone (PTH) levels.Methods: This retrospective study was conducted among 122 patients who underwent total thyroidectomy over one year (from January 2018 to December 2018) in Prince Sultan Military Medical City, Riyadh, Saudi Arabia. After thyroidectomy, all patients were admitted and observed for at least 24-48 hours. The postoperative hypocalcemia, alkaline phosphatase (ALP), phosphate (PO4), parathyroid hormone (PTH), and vitamin D level were collected.Results: During 2018 a total of 122 (mean age 41.6±1.2 years; females 90.2%) patients underwent total thyroidectomy. The mean calcium level in the first two days was 2.07 mmol/L and 2.01 mmol/L. Most of the cases of hypocalcemia occurred on day 1 postoperatively. Hypocalcemia mainly occurs in patients with benign pathology. The level of vitamin D in those patients with benign pathology was significantly lower as compared to those with malignant pathology (49±23 vs 62±25; P=0.009). The overall mean level of vitamin D was 54.6±25 (50-150 nmol/L). Interestingly, there were no correlation between pre-operative vitamin D, PTH level and postoperative hypocalcemia. There were no statistically significant differences between postoperative hypocalcemia with other parameters except for pre-operative alkaline phosphatase which was barely positive (P=0.052).Conclusion: The outcomes of this study manifestly illustrated that a significant decline in calcium level after the surgery. In contrast to previous studies, our findings did not show a significant correlation between vitamin D level and hypocalcemia. This could be due to small sample size. Furthermore, the mean level of vitamin D in our cohort was 54 which was within the normal range. Further, well-designed randomized controlled trials with greater sample sizes are necessary to validate our findings.

Determination of Leucocyte CaSR Gene Expression Level and Plasma Calcium Level in Lactated Goats

Süt verimi keçi yetiştiriciliğinde büyük öneme
 sahiptir. Sütün içeriğinde bulunan kalsiyum insan sağlığı için önemlidir. Kalsiyum
 hücre membran geçirgenliği, hormonların salınımı, enzim aktivitesi gibi birçok
 fizyolojik olayda görev almaktadır. Metabolizma bakımından değerlendirildiğinde
 laktasyon döneminde süt verimine bağlı olarak kalsiyum ihtiyacı artmaktadır.
 Kalsiyum düzeyi ise önemli oranda Kalsiyuma Duyarlı Reseptör (CaSR) geni
 aracılığıyla düzenlenmektedir. Bu çalışmada laktasyondaki Damascus keçilerinde
 CaSR geni ekspresyon seviyesi ile kan kalsiyum seviyesi ölçülerek laktasyon ile
 aralarındaki ilişki araştırılmıştır. CaSR geni ekspresyon seviyesi RT-qPCR ile
 ölçülürken plazma kalsiyum seviyesi mikroplazma atomik emisyon spektrofotometresi
 (MP- AES) ile ölçülmüştür. Laktasyonun 1. ayına göre 3., 5. ve 7. aylarında
 CaSR genine ait ekspresyon seviyesinin önemli derecede azaldığı tespit
 edilmiştir. Laktasyonun 1. ve 3. aylarına göre diğer aylarda kalsiyum seviyelerinde
 önemli derecede azalma tespit edilmiştir. Plazma kalsiyum miktarındaki azalma CaSR
 geninin ekspresyon seviyesindeki azalma ile uyumlu olduğu tespit edilmiştir. Böylece
 laktasyon ile kaybolan kalsiyumun plazmadaki düşüşünü engellemek için
 metabolizmanın koruma refleksi oluşturarak CaSR ekspresyonunu azalttığı
 görülmüştür. Yapılan bu çalışmayla laktasyon dönemindeki keçilerde süt ile
 birlikte ortaya çıkan kalsiyum kaybının kandaki regülasyonunu CaSR geni ile
 sağlandığı tespit edilmiştir. 

Management of Grade I Vaginal Prolapse in a Friesian Cross: A case report

A 350kg Friesian cross was presented to the Veterinary Teaching Hospital, University Putra Malaysia with a complaint of a bulging vagina one month after paturition. On physical examination, there was evidence of a grade I vaginal prolapse with presence of a yellowish mucoid secretion from the vulva. All the vital parameters were normal. Blood workout showed leucocytosis accompanied by neutrophilia with left shift, lymphocytosis and monocytosis. Creatine kinase was elevated ten folds, while serum globulin was only slightly elevated. There was a slight decline in calcium level in the blood. The prolapse was corrected surgically by applying Buhner's suture. Systemic analgesic, antibiotic, multivitamin and calcium infusion were administered to minimize pain, prevent bacterial complication and normalize the calcium level in the blood, respectively. The prognosis was good and the prolapse regressed completely after a week. Prompt and timely management of vaginal prolapse is necessary in order to avoid serious complications that may predispose to uterine infections, infertility and death due to septicemia. Keywords: Vaginal prolapse; Diary cow; Buhner's suture; Calcium

Hepoxilin signaling in intact human neutrophils: biphasic elevation of intracellular calcium by unesterified hepoxilin A 3

We have previously shown that the methyl ester of hepoxilin A 3 causes a receptor-induced rise in intracellular calcium through the release from intracellular stores in suspended human neutrophils. The corresponding free acid was devoid of activity. We now report that the action of the free acid form of hepoxilin A 3 is dependent on the type of vehicle used, i.e. it is active in releasing calcium when used in an ethanol vehicle but not in DMSO. The methyl ester is equally active in either vehicle. The pattern of calcium release between the free acid and the methyl ester is qualitatively different. Both compounds show a biphasic pattern, i.e. an initial rapid phase followed by a slow decline in calcium levels but never reaching pre-hepoxilin A 3 baseline levels. The methyl ester appears slightly more potent in the initial phase of calcium release than the free acid (methyl=188±14 S.D., free acid=135±11 S.D. nM, P<0.0005). Both compounds appear to reach the same calcium levels at the plateau of the second prolonged phase (methyl=88±8 S.D., free acid=107±15 S.D. nM, not significant). Lanthanum chloride (an inhibitor of calcium influx) interfered with the second phase of the curve causing calcium levels to return to normal pre-hepoxilin levels for both compounds. Addition of lanthanum chloride prior to the hepoxilin addition or carrying out the experiments in calcium-free medium, eliminated the second phase completely, with the calcium peak returning rapidly to normal baseline levels, suggesting that the second phase is due to calcium influx. Again the methyl ester is more active than the free acid (methyl, 189±12; free acid, 145±6 S.D. nM, P<0.005). Additional experiments with tritium-labelled methyl ester of hepoxilin A 3 demonstrated that the compound is hydrolyzed into the free acid intracellularly. These experiments demonstrate that DMSO interacts with hepoxilin free acid, interfering with its entry into the cell while ethanol does not. Once inside the cell, hepoxilin interacts with its own receptor to release calcium rapidly from stores, but it also causes a more prolonged influx of calcium from the extracellular milieu.

The role of calcitonin and parathyroid hormone in the pathogenesis of post-thyroidectomy hypocalcemia

Permanent hypocalcemia complicating thyroidectomy is a rare complication, whereas transient post-thyroidectomy hypocalcemia occurs frequently. Ten patients were studied in an attempt to elucidate the underlying mechanisms. An early and transient postoperative rise in calcitonin (CT) corresponding to a decline in calcium levels was demonstrated. Though there was no significant depression of parathyroid hormone (PTH) levels, the failure of the parathyroids to respond to hypocalcemic stimuli suggests a degree of at least transient parathyroid insufficiency. Transiently elevated CT levels appear to play a significant role in the commonly observed early, transient post-thyroidectomy hypocalcemia following subtotal and total thyroidectomy.