Mean Levels Of Calcium Research Articles

Continuous versus intermittent bolus infusion of calcium in preterm infants receiving total parenteral nutrition: a randomized blind clinical trial

BackgroundPremature neonates need adequate nutritional support to provide sufficient essential nutrients for optimal growth. Calcium (Ca) is one of the important nutrients in parental nutrition support of premature infants. This study aimed to compare the effect of continuous and intermittent bolus infusion of Ca on the incidence of metabolic bone disease (MBD) in preterm infants.MethodsThis randomized double-blind clinical trial was conducted on ninety preterm infants in the NICU of Al-Zahra Hospital in Tabriz, Iran. The preterm infants were randomly allocated to either a continuous infusion group (received 4–5 ml/kg/day of Ca gluconate 10% by PN solution in a 24-h period) or an intermittent bolus administration group (received 1–2 ml/kg/day Ca gluconate 10% three to four times per day). Serial serum levels of Ca, phosphorous, alkaline phosphatase (ALP), vitamin D and parathyroid hormone (PTH) were assessed on the 7th day, 30th day and 45th day of life.ResultsA total of 78 infants completed the study. The serum ALP level on the 45th day after birth was 753.28 ± 304.59 IU/L and 988.2 ± 341.3 IU/L in the continuous infusion and intermittent bolus administration groups, respectively (P < 0.05). MBD in preterm infants with ALP levels above 900 IU/L on the 45th day of life was significantly lower in the continuous infusion group than in the intermittent bolus administration group (p < 0.05). The mean serum levels of calcium, phosphorus, vitamin D and PTH in 45-day-old infants were not significantly different between the two groups.ConclusionThe MBD in preterm infants who received continuous infusion of Ca was lower than that in preterm infants who received intermittent bolus administration of Ca.Trial registrationThe Iranian Registry of Clinical Trials (http://www.irct.ir) with the identification No. IRCT20210913052466N1.

Serum Alkaline Phosphatase, Iron and Calcium Levels in BreastCancer and Leukemia Patients in Salah Al-Din Province

This study was conducted on 19 breast cancer and 23 leukemia patients with ages ranged between 25-70 years old registered in Tikrit teaching hospital, Tikrit city, rvith the fifty four normal subject's volunteers and age ranged between 30-60 years old. Statistical analysis, show there lvere highly significant differences (p&lt;0.05) between the mean levels of calcium, iron and alkaline phosphatase in breast cancerand leukemia compared rvith the normal strbjects. We found that the mean levels of serum calcium were higher in ler.rkemia than in breast cancer and normal subjects, also we found higher mean values of serllm iron in breast cancer compared with the leukemia and healthy subjects. The activity of the ALP 'uvas found elevated in both patients and increzrsed levels of ALP depends on the concentration of serurn iron. . We done this study to show effect of the age on calcium, iron and ALP levels in breast cancer and leukemia.

Determination of Essential Minerals in Manures of Selected Domestic Animals in Karatina and Their Effects on Soil and Plants

Calcium and Magnesium are part of the macro-nutrients required by plants from the soil for growth and development, they are also necessary for soil health to keep crops healthy. Calcium is needed in plants for the formation of new cells, roots, stems, and leaves. For the soil, calcium plays an important role in ensuring the Pretention capacity of water and nutrients. Magnesium is an important component of photosynthesis in plants and is found in chlorophyll which,the green pigment. The study investigated and compared the presence of calcium and magnesium levels in manures of several animals from different households around the Kagochi area. The samples collected were dried, blended and acid digested. AAS, A-A-700,0 (Atomic Absorption Spectroscopy) was used to analyze the manure samples. The data provided was presented in tables and graphs comparing the manures from both households. The mean levels of calcium and magnesium for both households one and two were found to be Ca 27.99 mg/L and Mg 6.23mg/L for household 1 and Ca 27.26 mg/L and Mg 6.32 mg/L for household 2. A strong correlation was found between manures in household one and those of household two in their calcium and magnesium concentrations. The manures were found to contribute a significant rise in soil pH. The information from the study will form a basis for manure’s importance and application for small-scale and large-scale crop growers and bring more value to manures as a source of plant and soil nutrients. Keywords: Manure, Calcium, Magnesium, Nutrients, PH, Fertilizer. DOI: 10.7176/CMR/15-1-03 Publication date: May 31 st 2023

Maternal Blood Trace Element Levels in Preeclampsia: Comprehensive Systematic Review and Meta-Analysis

Introduction: Deficit in trace elements was frequent in pregnant women and could lead to preeclampsia development. This meta-analysis aimed to determine calcium, magnesium, zinc, iron, and copper serum levels in preeclampsia women compared to healthy pregnant women. Methods: A systematic search is conducted in PubMed, ScienceDirect, and Google Scholar from inception into March 25th, 2022 using keywords of “("calcium" OR "magnesium" OR "zinc" OR "copper" OR "iron" OR "trace element" OR "trace elements") AND ("serum" OR "blood") AND ("preeclampsia")”. Articles obtained from PubMed, ScienceDirect, and Google Scholar were 62, 31, and 119 respectively. The article screening process was based on the PRISMA 2020 guidelines. Study quality was assessed using NOS. Results: Fifty-four studies were included in this systematic review. Pooled analysis revealed that serum calcium (SMD = (-1.66; 95% CI = -2.05 to -1.28, magnesium (SMD = -1.28; 95% CI = -1.37 to -1.20, and zinc were significantly lower in preeclampsia (SMD = -2.4; 95% CI = -4.11 to -0.7. Serum iron was higher in preeclampsia (SMD = 1.71; 95% CI = 0.21 to 3.21). No significant different difference in serum copper level. Conclusion: The mean blood levels of calcium, magnesium, and zinc were considerably lower, while blood iron levels were higher in preeclamptic women compared to the healthy pregnant group. Copper levels were not significantly different between the two groups.

MO806: Change in Pth Measuring Method Affects the Cost of Pth-Lowering Treatment

Abstract BACKGROUND AND AIMS To control mineral and bone disorders in haemodialysis (HD) patients, doses of vitamin D analogues and calcimimetics are adjusted based on serum parathyroid hormone (PTH) levels. Accordingly, method-related differences in PTH results may influence the prescribed dose of those drugs and PTH-lowering treatment costs. The aim of this study was to clarify the influence of inter-method variability in PTH measurement on PTH-lowering treatment costs. METHOD We used data from 30 maintenance HD patients in our facility. The Intact-PTH measuring assay was changed from the Elecsys PTH to the Alinity Intact PTH Reagent Kit (Alinity PTH) in March 2021, following a 2-month transitional period when PTH levels were measured using both assays. We examined method-related differences in PTH levels, using the results obtained in the transitional period. Using prescription records from October to December 2020, when the Elecsys PTH assay was used, and those from March to May 2021, when assay system was fully changed to the Alinity PTH, we examined the influence of the PTH measuring method on medication cost by evaluating the monthly cost of vitamin D analogues and calcimimetics in our facility. We evaluated the mean levels of serum calcium, phosphorus and PTH in 30 patients in the corresponding period. RESULTS Inter-method variability in PTH results was evaluated using 60 specimens from 30 patients. PTH results of 60 specimens ranged from 11 to 802 pg/mL and 8.8 to 1198 pg/mL in the Elecsys PTH and in the Alinity PTH, respectively. Compared with PTH levels obtained with the Elecsys PTH, those measured with the Alinity PTH were significantly higher (P &amp;lt; .001). On average, results obtained with the Alinity PTH were 1.58-fold higher than those provided by the Elecsys PTH. When the Elecsys PTH assay was used, the average monthly cost of vitamin D analogues and calcimimetics was €44 and €1668, respectively. After the assay was changed to the Alinity PTH, the average monthly costs were €40 for vitamin D analogues and €2471 for calcimimetics (€1 = ¥130). There were no notable changes in the mean serum levels of calcium, phosphorus and PTH throughout the study period. CONCLUSION Inter-method variability in PTH results would have an influence on the cost-effective assessment of PTH lowering therapy. Standardization of PTH measurement is required.

Monitoring of bone fractured healing using biochemical markers among patients attending federal teaching hospital abakaliki and bone setter home in onueke ebonyi state, Nigeria

The monitoring of bone fractured healing using Alkaline phosphatase, calcium ion and inorganic phosphate was evaluated among patients with fractured bone in two different centers, Alex Ekwueme Federal University Teaching Hospital Abakaliki and Bone Setters Home, Onueke, Ezza in Ebonyi State between August 2017 and September 2018. : A total of 90 adults patients from 18 years to 78 years were examined using phenolphthalein monophosphate colorimetric end point method. Out of the 90 patients, 30 were healthy normal subjects, another 30 were patients in AE-FUTHA while the remaining 30 patients were in bone setter home. : Patients without bone fracture had the least mean serum level of alkaline phosphatase, 28.5 ± 9.0µl followed by those admitted in bone setter home with a mean serum level of 38.2±17.9µl while patients admitted in AE-FUTHA had the highest mean serum level of 41.4±6.5µl (P&amp;#60;0.05). The mean serum level of calcium was significantly higher 10.9± 2.6mg/dl in healthy normal patients compared to mean serum level of 9.2 ± 3.3mg/dl and 7.4 ± 1.3mg/dl for patients admitted in AE-FUTHA and bone setter home respectively. The mean serum level of inorganic phosphate indicate that patients admitted in bone setter home had the highest mean of 4.1 ± 1.0mg/dl followed by patients admitted in AE-FUTHA 3.4 ± 0.2mg/dl while that of healthy normal individuals had the least mean serum level of 3.2 ± 0.5mg/dl. : Out of the three parameters examined, alkaline phosphatase test was more precise, reliable and patient doctor friendly; hence it can be used as a veritable tool to monitor the process of bone fracture healing effectively.

Association of Serum Calcium and Vitamin D with Benign Paroxysmal Positional Vertigo

Introduction Benign paroxysmal positional vertigo (BPPV) is one of the common disorders of the peripheral vestibular system. The prevalence of BPPV is found to be higher among middle-aged women. Objectives To estimate the serum levels of calcium and vitamin D in patients with BPPV, and to study their association. Methods The present is a hospital-based prospective case-control study. Venous blood samples of the 49 patients with BPPV and an equal number of age- and gender-matched individuals were recruited and submitted to an analysis of the serum levels of calcium and vitamin D. Results Among the cases, 67.3% were found to be females, and 32.7% were males. Most of the 30 cases (61.3%) were aged > 40 years. The mean age of the cases was 44.39 years. The mean serum level of vitamin D in the cases was of 21.26 ng/ml compared with 17.59 ng/ml in the controls. The mean serum level of calcium was of 9.33 mg/dl in the cases, compared with 8.95 mg/dl in the controls. There was no significant difference in the serum levels of vitamin D and calcium between cases and controls. Conclusion We could not establish any correlation between the serum levels of calcium and vitamin D with BPPV. However, a negative relationship was found between the serum levels of vitamin D and the number of episodes of BPPV ( p = 0.012).

Role of Fracture Liaison Service Program in Reducing Refracture Rate in the Elderly Osteoporotic Trauma Patients Presenting With Vertebral Compression Fracture: A Six-Year Study.

As the elderly population of the United States and the world increases, so does the incidence of osteoporotic fragility fractures from a fall or minor injury. This results in a large cost to the health care system. This cost is further increased as more than 50% of individuals will have refractures within the first year. In order to reduce the refracture rate in such patients, we enrolled our elderly trauma patients with vertebral compression fractures and vertebral augmentation in a Fracture Liaison Service (FLS) clinic for two years and reevaluated their refracture rate. This is a retrospective analysis of 720 patients. 142 patients (Group A) were seen between 2012 and 2014 before establishing the FLS program and 578 patients (Group B) were seen between 2015 and 2020 after implementation of the FLS program. The patients enrolled in the FLS program were followed for two years after sustaining a vertebral compression fracture. The data collected included age, sex, serum calcium and vitamin D levels, dual energy X-ray absorptiometry (DXA) scan, 10-year fracture risk (FRAX) score, pressure measurements in PSI taken during vertebral augmentation, as well as the refracture rate. The data collected were analyzed and compared between the two groups using the Student's t-test and chi-square test. There was significant reduction in the refracture rate of pre-FLS vs post-FLS vertebral, as well as other fractures in the FLS group (pre-FLS: 48.9% vs post-FLS: 37.0%; P = .01). There was no significant difference between groups A and B in regard to the mean serum level of calcium (9.44mg/dL vs 9.53mg/dL), vitamin D level (35.04ng/mL vs 41.39ng/mL), DXA scan for spine (-.52 vs -.76) and for femur (-1.77 vs -1.52), and 10-year refracture risk for osteoporotic major fracture (FRAX score-mean: 22.6% vs 19.2%) and for hip fracture (9.18% vs 7.53%). There was a significant difference in the mean age between the groups (79.5 vs 73.5 years; P = .01). Of those who underwent vertebral augmentation, 235 had Pressure Scale Index (PSI) measurements taken. There was a trend in increasing refracture rate when PSI ≤199 compared with those who had PSI ≥200, although statistical significance was not met (33.9% vs 27.0%, P = .21). A Fracture Liaison Service program will improve the bone health of geriatric osteoporotic patients presenting to the trauma service with vertebral compression fractures and thus reduces the subsequent refracture rate. Further study is needed to evaluate the best PSI used to impact reduction in refracture rate.

A Study on Some Serum Biological Constituents during Different Days of Normal Oestrous Cycle of Manipuri Pony Mares

Background: The aim of this study was to estimate the serum biochemical (glucose, cholesterol, total protein, calcium, phosphorus and magnesium) and hormonal constituents (estrogen and progesterone) in female Manipuri pony mares during the different days of oestrous cycle. Methods: A total of 50 numbers of blood samples were collected from 10 numbers of apparently healthy, non-pregnant on the different days of oestrous cycle i.e. day 0, 4, 8, 14 and 18 by using commercial diagnostic kits. Result: The mean serum levels of glucose, cholesterol and phosphorus were found to be non-significant on the different days of oestrous cycle whereas the mean serum level of total protein and calcium was found significantly different (P less than 0.01). The serum magnesium level differed significantly (P less than 0.05) amongst the different days of oestrous cycle. Both estrogen and progesterone were also found to be significant (P less than 0.01) between the different days of oestrous cycle. The results showed significant influence on serum biochemical and hormonal assay during different days of oestrous cycle in female Manipuri pony.

Assessment of Serum Level of Vitamin D in Infants with Nephrolithiasis.

Introduction. Detection of nephrolithiasis is readily possible in infants with the advent of new imaging technology. Vitamin D is routinely given to newborn infants shortly after birth during infancy. Vitamin D is known to increase urinary calcium excretion which may be responsible for the increased incidence of nephrolithiasis during infancy. To test this hypothesis we studied the serum level of vitamin D and renal handling of calcium in infants with nephrolithiasis . Methods. In this prospective case-controlled study, we measured serum levels of vitamin D and calcium accompanied by urinary calcium level in infants between 1 to 12 months with nephrolithiasis who fed with breast milk and vitamin D supplement and compared these parameters with healthy infants without nephrolithiasis after matching for sex and postnatal age as the control group. All infants with nephrolithiasis were evaluated for metabolic disorders and other risk factors and positive cases were excluded from the study. Results. Fifty infants between 1 to 12 months with mean postnatal age 6.96 ± 2.29 months with nephrolithiasis and 50 control infants with mean postnatal age 6.94 ± 2.55 months were enrolled in the study. Mean serum level of vitamin D in the case and control groups was 41.49 ± 11.69 and 35.67 ± 6.76 ng/mL, respectively. Mean serum level of calcium in case group was 9.63 ± 0.32 vs. 8.59 ± 1.21 mg/dL in the control group. Mean urinary calcium- creatinine ratio (Ca/Cr) in the study and control groups was 0.15 ± 0.16 and 0.08 ± 0.02, respectively, Differences were statistically significant in all three variables (P < .05). Conclusion. Routine consumption of vitamin D increases urinary level of calcium and in presence of other predisposing factors could accelerate the genesis of nephrolithiasis in infants.

Dietary Intake and Milk Micronutrient Levels in Lactating Women with Full and Partial Breastfeeding.

Micronutrient intake and status in lactating women may impact micronutrient levels in milk. This study aimed to determine the micronutrient intake and status in lactating women, and their association with micronutrient levels in human milk. Lactating women were enrolled at 4-6months postpartum. A 24h food recall was examined and nutrient intakes were analyzed using INMUCAL software. Human milk samples were collected to analyze calcium, copper, iron, and zinc levels. Plasma zinc and serum ferritin levels were determined. Thirty-four women participated; 19 were classified as full breastfeeding and 15 as partial breastfeeding. Mean levels of calcium, copper, iron, and zinc in human milk were 243, 0.2, 0.2, and 1.56mg/L, respectively. The prevalence of zinc deficiency (plasma zinc < 10.7µmol/L) was 11.8%. No lactating women had iron deficiency. Nutrient intakes were lower than the recommended amounts in 38%-70% of participants, and were not correlated with corresponding nutrient levels in human milk. Multiple linear regression showed significant association between zinc levels in human milk and plasma for lactating women with full breastfeeding (β = 0.034, 95% confidence interval [0.003, 0.067], p = 0.040). Lactating women were at risk of micronutrient deficiency. There was an association between zinc levels in human milk and plasma of lactating women with full breastfeeding. As the nutritional status of lactating women influences the quality of human milk, we should encourage good nutrient intake for lactating women.

Comparison of the calcium-related factors in Parkinson's disease patients with healthy individuals.

Background:Parkinson’s disease (PD) is one of the most common neurodegenerative diseases (ND). Studies have demonstrated that biochemical markers have an association with PD. We aimed to investigate an association of biochemical markers including calcium, vitamin D, alkaline phosphatase (ALP), parathormone (PTH), and phosphorous with PD.Methods:This study was conducted on 139 PD patients and 100 healthy individuals. Serum levels of calcium, phosphorous, ALP, PTH and vitamin D were evaluated. Furthermore, student’s t-test and logistic regression models were used by SPSS.Results:The mean levels of calcium (9.4±0.7 and 9.0±0.8 ) and vitamin D (29.7±22.1 and 25.8±23.7) were higher in PD patients as compared with healthy controls, which only status of calcium being significantly different in the two groups (P<0.001). Levels of ALP (202.4±96.7 and 242.9±142.4) and phosphorous (3.6±0.6 and 4.22±1.1) were significantly different comparing PD patients with healthy subjects (P<0.01, P<0.001, respectively). ALP and phosphorous were significantly different in the two groups (OR=0.996, [CI 95%, 0.994-0.999], P<0.001, OR=0.475, [CI 95%, 0.325-0.694], P<0.001, respectively). Furthermore, increased levels of calcium resulted in an elevated risk of PD (OR=2.175, [CI 95% 1.377-3.435], P<0.001).Conclusion:Results show that mean levels of calcium are higher in PD patients relative to healthy controls. Thereby, higher levels of calcium may be associated with PD.

Evaluation of pulmonary hypertension and its relationship with serum parathyroid hormone levels in hemodialysis patients

Introduction: Pulmonary hypertension is a progressive and severe disease associated with left or right ventricular dysfunction and is common in patients under hemodialysis. One of the factors in its development is parathormone but this relationship is unclear. Objectives: In this study, the difference between serum levels of parathyroid hormone (PTH) in hemodialysis patients with and without pulmonary artery hypertension (PAH) was investigated. Patients and Methods: We conducted a cross-sectional study among hemodialysis patients referred to a tertiary hospital in Iran. Characteristics of coronary artery and pulmonary arteries were recorded by echocardiography. The laboratory data were measured and recorded. Statistical analysis was performed at 95% confidence level and with a significance level of less than 5%. Results: Of 65 enrolled patients, 41 had normal pulmonary artery pressure, and 24 had pulmonary hypertension. The mean age in patients with and without pulmonary hypertension was significantly different (P=0.010). There was no significant difference in serum PTH levels between patients with and without pulmonary hypertension (P=0.496). The mean serum levels of calcium, albumin, triglyceride, and cholesterol in two groups of patients with and without pulmonary hypertension was not significantly different (P=0.906). Conclusion: In our study, no significant correlation between pulmonary hypertension and PTH was detected. The prevalence of pulmonary arterial hypertension in our study was relatively high, suggesting the need to pay attention to pulmonary hypertension in hemodialysis patients

Correlation of Calcium Levels With The Strenght of Uterus Contraction on The Active Phase of First Stage Labor

Contributing factor to uterus contraction mechanism is the imbalance of the extracellular calcium level. When extracellular calcium level is inadequate, response of the myometrium to oxytocin decreased and the calcium influx inter-cell membranes are suppressed, thus inhibit uterine contractions. The aim of this research is to know the correlation between levels of calcium and the strength of uterine contraction in the active phase of first stage labor. This was a cross-sectional analytic correlative study in the Dr. Rasidin Hospital Padang and UPTD Health Laboratory in West Sumatra province, in was conducted from November 1st, 2014 till February 2016. Sampling was takes by using non probability sampling with consecutive sampling. Subjects of this research were the active phase of first stage labor of 62 people. Kolmogorof Smirnov normality test was used to the normality of the data. Pearson correlation test was conducted to examine the correlation between dependent and independent variables. Mean levels of calcium in the the stage I of labor respondents active phase (8.94 ±0,71), while mean strength of uterine contractions in active phase of first stage labor(56.77±11,84), there was positive correlation (r = 0,62) between the levels of calcium in the strength of uterine contractions (p &lt; 0.05). The conclusion of the study there was a significant correlation between the levels of calcium in the strength of uterine contractions.

Plasma and urine levels of calcium, phosphorus and magnesium in growing cats

Feline lower urinary tract disease affects 1% worldwide population of cats. This disease may be predisposed by uroliths formation. Incidence of urolithiasis is related to feeding, mainly to macromineral composition. Balance of calcium, phosphorus and magnesium, and urinary pH are the main factors related to urolithiasis. The present work aims to study the metabolism of those minerals in growing cats, evaluating their plasma and urinary levels. There were used 10 cats of both sexes, 3 month-old, feeding a commercial ration until 1 year-old. Every 30 days, there were collected samples of blood and urine, to determine mineral concentrations and pH and creatinine levels of urine. At same intervals, there were determined the mineral content of the ration. Weekly feed consumption and body weight were registered. Mean levels of calcium, phosphorus and magnesium in plasma were, respectively, 8.77 ± 1.9mg/dL, 7.55 ± 1.8mg/dL and 2.66 ± 0.67mg/dL. Variation along the year is showed. Less variation was that of calcium, followed by magnesium and higher variation was that of phosphorus. Mean values of the minerals in urine, in relation to creatinine, were 1.29 ± 1.0 x10 -2 for Ca, 1.46 ± 1.1 for P and 7.87 ± 7.7 x10 -2 for Mg. Ca/P relation in the feed was 2.87 ± 1.2, considered high. Mg content in feed was higher than nutritional requirements. Mean value of urinary pH was 6.25 ± 0.54, considered adequate to prevent urolithiasis by struvite but not to prevent crystal formation of calcium oxalate.

Relationship between Bone Mineral Density and Serum Vitamin D with Low Energy Hip and Distal Radius Fractures: A Case-Control Study.

The main purpose of this study was to determine the relationship between serum vitamin D and the status of bone mineral density in patients with low-energy hip and distal radius fracture. This retrospective case-control study was performed between January 2013 and January 2014. Participants aged 55 years or older were divided to case group including 85 patients with low-energy hip fracture and 83 patients with low-energy distal radius fractures, and 82 subjects as a matched control group. Bone mineral density was measured with dual energy X-ray absorptiometry and serum sample was obtained to check vitamin D, calcium, phosphorus, alkaline phosphatase, and protein. Study subjects for final evaluation consisted of 78 in hip and distal radius fracture groups and 80 in control group. There were no significant differences in the mean serum levels of calcium, phosphorus and alkaline phosphatase between the three groups. The overall mean serum level of vitamin D3 was significantly different among the three groups. Similar results were observed with hip and spine t-score between the groups. There is not only a direct relation between serum vitamin D and the risk of low energy hip and distal radius fractures, but also a significant relation between low bone density in hip and spine area with low serum calcium was observed.

Normohormonal primary hyperparathyroidism is a distinct form of primary hyperparathyroidism

Normohormonal primary hyperparathyroidism presents diagnostic and intraoperative challenges, and current literature is conflicting about management. We aim to better define normohormonal primary hyperparathyroidism in order to improve the care for these patients. In the study, 516 consecutive patients undergoing parathyroidectomy for primary hyperparathyroidismwere divided into 2 groups: classic primary hyperparathyroidism (classic primary hyperparathyroidism, increased serum levels of calcium, and parathyroid hormone) and normohormonal primary hyperparathyroidism (hypercalcemia, normal serum levels of parathyroid hormone). We evaluated inter-group differences in presentation, gland weight, pathology, and complications. The normohormonal primary hyperparathyroidism group was comprised of 116 (22.5%) patients. Mean serum levels of parathyroid hormone and calcium were 62.1 pg/mL ± 10.1 and 10.6mg/dL ± 0.63 in normohormonal primary hyperparathyroidism, and 142±89.0pg/mL and 11.0±0.88 (both P<.01) for classic primary hyperparathyroidism. Nephrolithiasis was more common in normohormonal primary hyperparathyroidism. Multigland hyperplasia was more common in normohormonalprimary hyperparathyroidism 23 (19.8%) vs 44 (11%; P=.04). Concordant imaging studies were less likely in normohormonal primary hyperparathyroidism (82 [73.2%] vs 337 [87.1%; P<.01]), had a lesser total gland weight (531.8mg±680.0 vs 1,039.6mg±1,237.3; P<.01), and lesser 2-week parathyroid hormone (32.5 pg/mL±18.95 vs 41.0 pg/mL±27.8; P=.01). There was no difference in hypoparathyroidism (parathyroid hormone <15 pg/mL; P=.93) at 2weeks postoperatively. Normohormonal primary hyperparathyroidism represents 22.5% of our primary hyperparathyroidism population, which is greater than reported previously. It is a distinct disease process from classic primary hyperparathyroidism in presentation, imaging, and operative findings. More hyperplasia and a lesser gland weight make it challenging to resect the ideal amount of tissue. Studies with long-term follow-up are needed to determine optimal operative management.

Assessment of vitamin D levels, awareness among Lebanese pharmacy students, and impact of pharmacist counseling

Vitamin D inadequacy, frequently underdiagnosed, affects people of all age groups worldwide. This prospective study aims at determining the percentage of inadequate vitamin D levels among students and evaluating the impact of pharmacist counseling on raising the awareness of the importance of sun exposure and adequate vitamin D intake. A total of 160 university students were recruited. Blood samples were taken to check the vitamin D, calcium, and phosphorous levels. Vitamin D levels ⩽30ng/mL were defined as inadequate. Scores were given to the questions and aimed at gathering patient knowledge about vitamin D before and after pharmacist counseling. A total of 115 (71.87%) patients had vitamin D levels <30ng/mL, with a mean vitamin D serum level of 16.80±5.85ng/mL. The mean level of calcium was 9.51±1.23mg/dL and, of phosphorus 3.62±0.95mg/dL. The mean difference in the knowledge score of the recommended daily amount of vitamin D before and after pharmacist counseling was 2.81 versus 5.88 (p<0.001). Concerning patient education for diseases and drugs that affect vitamin D levels, pharmacist counseling was effective in raising the awareness (p<0.001). Given that vitamin D inadequacy is linked to many disease progressions, it is important that health professionals provide interventional strategies and education measures to correct inadequate levels in patients of all age groups.

Estimation of Salivary and Serum Biomarkers in Diabetic and Non Diabetic Patients - A Comparative Study.

Blood is the gold standard body fluid for diagnosis of Diabetes Mellitus (DM) but saliva offers an alternative to serum as a biological fluid for diagnostic purposes because it contains serum constituents. The study was conducted to estimate and compare serum and salivary glucose, amylase, proteins, calcium and phosphorus levels in DM and healthy subjects and to evaluate whether saliva can be used as a diagnostic fluid in DM patients. Study consisted of 120 subjects from OPD of Surendera Dental College, Sriganganagar, Rajasthan, India. The study groups were divided into Group I-60 DM patients (Type I & II) and Group II-60 healthy subjects. The saliva and serum samples were collected from each subject and levels of different biochemical parameters were estimated. Mean serum level of glucose (211.50 ± 43.82), amylase (79.86 ± 16.23), total proteins (6.65 ± 0.84), calcium (7.17 ± 0.91) and phosphorus (3.68±0.65) as observed in Group I while in Group II, glucose (88.81±11.29), amylase (77.67±14.88), total proteins (6.35±0.76), calcium (7.52±0.97) and phosphorus (3.96 ± 0.91) were noted. Mean salivary level of glucose (14.10±6.99), amylase (1671.42±569.86), total proteins (1.33±1.11), calcium (10.06±2.76) and phosphorus (13.75±4.45) as observed in Group I while in Group II, glucose (5.87± 2.42), amylase (1397.59 ±415.97), total proteins (1.36±0.81), calcium (7.73±2.78) and phosphorus (8.39 ± 1.95) were noted. On comparing values in saliva and serum, among two groups, an insignificant difference (p>0.005) was found between few of them. Values regarding blood and salivary biochemical parameters were distinctly different between two groups suggesting salivary parameters can be used as a diagnostic alternative to blood parameters for diabetes mellitus.

A pilot study of synbiotic supplementation on breast milk mineral concentrations and growth of exclusively breast fed infants

Despite the crucial role of breast milk mineral contents for health and growth of the infants, they decrease with the duration of lactation. So, this pilot study aimed to determine the effects of synbiotic supplementation on breast milk mineral composition and infants’ growth. In this pilot, randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly divided into two groups to receive a daily supplement of synbiotic (n=30) or a placebo (n=27) for 30 days. Breast milk zinc, copper, Iron, magnesium and, calcium concentrations were determined by flame atomic absorption spectrometry. Weight for age Z-score (WAZ) and height for age Z-score (HAZ) were assessed for infants. Dietary intake was collected from lactating women using the 24-h recall method. Data analyses were carried out using nutritionist IV, Epi Info and SPSS soft wares. Synbiotic supplementation led to an insignificant increase of the mean breast milk levels of zinc (from 2.44±0.65 to 2.55±0.55mgL−1), copper (from 0.35±0.24 to 0.40±0.26mgL−1), iron (from 0.28±0.42 to 0.31±0.38mgL−1), magnesium (from 17.14±1.35 to 17.17±1.09mgL−1), and calcium (from 189±25.3 to 189.9±21.7mgL−1); whilst in the placebo group, these variables decreased significantly (P=0.001). The observed changes between two groups were statistically significant (P<0.05). Although WAZ and HAZ of infants increased slightly in the supplemented group (from 1.19±0.79 to 1.20±0.69 and 0.36±0.86 to 0.37±0.85 respectively), these two parameters decreased in the placebo group which was significant only for WAZ (P=0.01). Moreover, no significant association was found between mineral intake and breast milk mineral contents. It seems, synbiotic supplementation may have positive effects on breast milk mineral contents.