Mean Values Of Calcium Research Articles

Changes in biochemical profiles of children with severe acute malnutrition on admission and after nutritional rehabilitation

Purpose: The given study was done to find out the changes in biochemical profiles before and after nutritional rehabilitation of the children admitted at the Department of Paediatrics, Assam Medical College with severe acute malnutrition (SAM). Materials and Methods: A hospital based observational study was conducted from May 2020 to April 2021 with 55 consecutive cases of SAM. Vitros System 5600 was used for analysis of 13 biochemical parameters. Results: The mean values of serum sodium, potassium, and chloride at admission were 134.59±19.37 mEq/L, 4.22±0.80 mEq/L, and 101.12±16.36 mEq/L and that after rehabilitation were 136.66±19.95 mEq/L, 4.42±0.68 mEq/L, and 103.97±4.83 mEq/L. While that for magnesium, calcium, and phosphorous on admission were 2.11±0.38 mg/dL, 8.70±1.00 mg/dL, and 4.33±1.23 mg/dL and that after rehabilitation were 2.10±0.29 mg/dL, 9.45±0.65 mg/dL, and 4.76±0.84 mg/dL, respectively. The mean values of serum total protein, albumin, globulin, and A: G on admission were 6.53±1.44 g/dL, 3.30±0.88 g/dL, 3.23±0.87 g/dL, and 1.06±0.33, respectively, and that after rehabilitation were 6.84±0.98 g/dL, 3.86±0.57 g/dL, 2.98±0.69 g/dL, and 1.34±0.28, respectively. The mean of urea and creatinine on admission were found to be 26.25±19.30 mg/dL and 0.34±0.24 mg/dL, respectively, and that after rehabilitation were 23.91±11.76 mg/dL and 0.31±0.15 mg/dL respectively. Random blood sugar (RBS) on admission was 85.20±17.88 mg/dL and that after rehabilitation was 94.18±14.82 mg/dL. After rehabilitation, the mean value of calcium, phosphorous, albumin, A: G, and RBS were significantly raised. The minimum duration required for rehabilitation was 12 days with prevalence being maximum among the Tea-tribes (80.00%). Conclusion: The biochemical derangements in a patient with SAM are associated with significant morbidity and get improved after nutritional rehabilitation.

Evaluation of mineralization balance in patients with hypoparathyroidism

Aims: Surgical complications play a major role in the etiology of hypoparathyroidism. Calcium and phosphorus metabolisms are disrupted by hypoparathyroidism. As a result, bone mineralization is impaired and may cause many pathologies. In clinical practice, parathyroid transplantation is not possible in every patient. In this study, we aimed to evaluate whether it would be possible to prevent the complications caused by hypoparathyroidism with mineral-supplemented medical therapy, even if we could not replace the lost parathyroid tissue. Methods: A total of 79 individuals with hypoparathyroidism (parathormone levels below the reference range for more than one year) secondary to thyroidectomy admitted to our hospital were included in the study. Calcium, phosphorus, alkaline phosphatase (ALP), vitamin D, and creatinine levels were recorded in the last three controls. The relationship between parathormone levels, mineral levels, and ALP, which is an indicator of bone turnover, was analyzed. Results: The mean calcium value was 8.57±0.90 and the mean phosphorus value was 4.46±0.99 in individuals diagnosed as hypoparathyroid with biochemical data. When the relationship between parathormone and the average of the last three calcium values, the relationship between the average phosphorus value, and the relationship between ALP and vitamin D were examined, no significant difference was found (p<0.05). When the relationship between the calcium phosphorus product and its effect on bone mineralization was examined, the mean calcium phosphorus product was 37.64±7.37, and no statistically significant difference was found with parathormone level (p<0.05). Conclusion: Preservation of parathyroid tissue is important for calcium-phosphorus metabolism. Although loss of parathyroid tissue is irreversible, it may be possible to prevent complications with mineral supplementation. As long as calcium and phosphorus balance are maintained externally, bone turnover will be preserved, along with many pathologies caused by hypocalcemia. No matter how low the parathormone level is, the bone mineralization problem caused by hypoparathyroidism can be reduced or even eliminated with mineral levels normalized with medical treatment.

Correlation of FGF-23 With Biochemical Markers and Bone Density in Chronic Kidney Disease-Bone Mineral Density Disorder.

Aim The purpose of this study was to determine the relationship between biochemical markers such as serum calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), 25(OH) vitamin D, and fibroblast growth factor 23 (FGF23) in our study group, as well as to correlate dual-energy X-ray absorptiometry (DEXA) findings with these biochemical markers. Methodology An eligible group of 50 chronic hemodialysis (HD) patients, age 18 and older, who have undergone HD two times a week for at least six months participated inthis retrospective cross-sectional study. We compared serum FGF23, intact parathyroid hormone (iPTH), 25(OH) vitamin D, calcium, phosphorus, and dual-energy X-ray absorptiometry scan showing bone mineral density disorder (BMD) around the femoral neck, distal radius, and lumbar spine. Human FGF23 Enzyme Linked Immuno Sorbent Assay (ELISA) Kit PicoKine®(Catalog # EK0759; Boster Biological Technology, Pleasanton, CA) was used in the optimum moisture content (OMC) lab to measure FGF23 levels. For the analysis of associations with various studied variables, the levels of FGF23 were split into two groups, which were high (group 1, FGF23 50 to 500 pg/ml), that is, up to 10 times the normal levels and extremely high (group 2, FGF23 > 500 pg/ml) FGF23 levels. All the tests were conducted for routine examination where the data obtained was analyzed in this research project. Results The mean age of patients was 39.18 ±12.84 years, of whom 35 (70%) were males and 15 (30%) were females. For the entire cohort, serum PTH levels were consistently high, and vitamin D levels were low. FGF23 levels were high in the whole cohort. The average iPTH concentration was 304.20 ± 113.18 pg/ml, while the average 25(OH) vitamin D concentration was 19.68±7.49 ng/ml. The mean FGF23 levels were 1877.36±1378.67 pg./ml. The mean calcium value was 8.23±1.05 mg /dl and the mean phosphate of 6.56±2.28 mg /dl. In the whole cohort, FGF23 showed a negative correlation with vitamin D and a positive correlation with PTH, but not statistically significant. Extremely high FGF23 levels were associated with lower bone densitycompared to high FGF23 values. Considering that in the whole cohort of patients, only nine had high FGF-23 and the rest of 41 patients had extremely high FGF23, we could not ascertain differences in PTH, calcium, phosphorus, and 25(OH) vitamin Dlevels between the two groups. The average length of time on dialysis was eight months, and there was no link between FGF-23 levels and the length of time on dialysis. Conclusion Bone demineralization and biochemical abnormalities are a hallmark in chronic kidney disease (CKD) patients. Abnormalities in serum phosphate, parathyroid hormone, calcium, and 25(OH) vitamin Dplay critical roles in the development of BMD in CKD patients. With the discovery of FGF-23 as a biomarker that is increased early in CKD patients, new questions arise about the effects and actions of FGF-23 in controlling bone demineralization and other biochemical markers. Our study found no statistically significant correlation to suggest an effect of FGF-23 on these parameters. But the findings need to be looked at more in prospective, controlled research, especially to find out if therapies that successfully target FGF-23 can make a big difference in how people with CKD feel about their health.

Real-life data of patients with hypoparathyroidism: a case-control study

Objective: This study aims to investigate real-life data of patients with hypoparathyroidism.
 Material and Method: This retrospective case-control study was carried out in a tertiary endocrine center between 1 January 2010 and 31 December 2019. Patients with a confirmed diagnosis of persistent hypoparathyroidism and healthy controls were included. Demographic characteristics of the patients, laboratory findings, etiologies of hypoparathyroidism, treatments they received, reasons for hospitalization, and complications were investigated. 
 Results: Sixty-five patients (mean age 42.80±13.4 years, 91% female) with hypoparathyroidism, and 54 healthy controls (mean age 33.58±11.9 years, 65% female) were included. Mean calcium level 7.95±0.92 mg/dl, and mean PTH level 9.99±6.30 pg/ml in hypoparathyroidism. Regarding the etiology of HypoPT, 51 (78%) patients had hypoPT due to surgery; 14 (22%) patients developed HypoPT due to non-surgical causes. In patients with hypoPT who underwent surgery, the mean calcium value was 8.03±0.93 mg/dl; the mean calcium value in patients with non-surgical HypoPT was 7.67±0.85 mg/dl. The mean PTH levels in non-surgical group, other group 10.16±6.21 pg/ml and 9.36±6.82 pg/ml, respectively. The most common surgery was due to multinodular goiter (72%). In 46 percent, the most common treatment was calcitriol 0.5 mcg/day and calcium 2000 mg/day. Nearly half of the patients had treatment non-compliance (46%). Eighteen percent of patients had kidney stones. Forty-three percent of the patients had been hospitalized in the last year. The most common reason for the hospitalization of patients with hypoparathyroidism was hypocalcemia, and the most common reason for this was treatment non-compliance.
 Conclusion: In our study, the most common cause of hypoparathyroidism is surgery due to multinodular goiter. The most common reason for hospitalization is treatment non-compliance. Up to one-fifth of patients had kidney stones.

Determination of Blood Calcium and Lead Concentrations in Osteoporotic and Osteopenic Patients in Pakistan.

Osteoporosis is the leading cause of deformity and bones fracture all over the world and has some relationship with the blood concentrations of calcium and lead. Therefore, in the current study, the blood samples of 58 control and 56 clinically diagnosed osteoporotic and osteopenic patients were taken from different hospitals in Pakistan and analyzed for calcium and lead concentrations using atomic absorption spectrometry. In female control samples, the mean calcium value was found to be 98.53 ± 4.81 μg/mL, and in male control samples, the mean blood calcium level was found to be 121.33 ± 7.27 μg/mL. In female control samples, the mean lead value was found to be 0.133 ± 0.005 μg/mL, and in male control samples, the mean lead level was found to be 0.183 ± 0.008 μg/mL. All the male and female control samples showed a mean value of calcium of 115.63 ± 5.2 μg/mL and a mean value of lead of 0.153 ± 0.007 μg/mL. In osteoporotic female patients, the decline in the mean calcium value was found to be 34.93 ± 1.9 μg/mL, and in male patients, the decrease in the mean calcium level was found to be 47.73 ± 2.5 μg/mL. The increase in the mean value of lead in osteoporotic females was 4.13 ± 0.22 μg/mL, whereas in male patients, the increase in the mean lead value was 0.95 ± 0.07 μg/mL. All the male and female patients showed a decrease in the mean value of calcium of 41.43 ± 2.2 μg/mL and an increase in the mean value of Pb of 3.63 ± 0.16 μg/mL.

Clinical analysis of peritonitis in peritoneal dialysis patients

Introduction/Objective. Peritoneal dialysis is a method of treating patients in the terminal phase of renal failure (end-stage renal disease). Peritonitis represents most severe and most common complication of peritoneal dialysis. The most common peritonitis causes are Gram negative microorganisms: Staphylococcus-coagulase-negative, Staphylococcus aureus, Streptococcus sp, Neisseria sp. Gram negative microorganisms are: Pseudomonas sp, Enterococcus, Klebsiella sp, Proteus sp, Acinetobacter sp. The aim of the study was to examine the incidence of peritonitis and to determine the differences between patients with and without peritonitis and catheter infection. Other goals of the work were: the most frequent causes of peritonitis, the outcome of treatment, the influence of the length of treatment on the development of peritonitis, the influence of the peritoneal dialysis adequacy on the development of peritonitis, the influence of anemia, nutritional status, iron status, secondary hyperparathyroidism (Ca, P, CaxPO4, parathormone), protein status ? albumin and the effect of acid uricum on the development of peritonitis. Methods. Retrospectively, 84 patients were analyzed of peritoneal dialysis (2012?2016) at the Kragujevac Center for Nephrology and Dialysis of Clinical Center. The diagnosis of peritonitis was based on clinical picture, biochemical analyses, leukocyte in sediment of dialysis, findings of peritoneal-culture, signs of inflammation (C-reactive protein, leukocytes). The analysis included: the most common causes, the outcome of treatment, the influence of the length of treatment, the influence of the peritoneal dialysis adequacy, the influence of anemia, the influence of iron status, the influence of secondary hyperparathyroidism, the influence of protein status - albumin, and the effect of acid uricum on the development of peritonitis. Results. In total, 22 patients had one, six patients had two, six patients had three, six patients more than three episodes of peritonitis. The difference in mean values of the number of erythrocytes, hemoglobin, hematocrit, iron, albumin, diastolic pressure, systolic pressure between patients with peritonitis, and those without it, were statistically significant (p < 0.05). The difference in mean values of calcium (Ca), phosphor (P), CaxPO4, uricum value, parathormone, peritoneal dialysis adequacy, systolic pressure was not statistically significant (p > 0.05). The incidence of peritonitis and death were not associated (p = 1.000). Conclusion, Peritonitis is severe complication of peritoneal dialysis. Anemia and nutritional status are risk factors that affect the development of peritonitis in patients on peritoneal dialysis.

Correlation of Parathyroid Hormone Levels with Mineral Status in End-stage Renal Disease Patients.

Parathyroid hormone (PTH) is the main regulator of calcium, phosphate, magnesium, sodium, and potassium homeostasis. Therefore, this study was conducted to evaluate the relationship between PTH and aforementioned minerals in end-stage renal disease (ESRD) patients.Aim:The aim of this study was to estimate serum intact parathormone (iPTH) and other biochemical parameters in ESRD patients and to find correlation between serum iPTH and biochemical parameters in the study group.Results:This cross-sectional study included 60 clinically diagnosed patients of ESRD of age (>18 years), either sex. Disordered mineral metabolism is common complications of ESRD patients. The mean value of calcium, phosphorus, and magnesium was 7.90 ± 1.16 mg/dL, 6.44 ± 1.72 mg/dL, and 2.57 ± 0.62 mg/dL, respectively, indicating hypocalcemia, hyperphosphatemia, and hypermagnesemia in ESRD patients. To compensate the deranged mineral status, increased levels of PTH were seen in ESRD patients with mean value of 173.93 ± 62.62 pg/mL. There was a statistically significant positive correlation found between PTH and S. creatinine (P ≤ 0.001; r = 0.596), whereas the statistically significant negative correlation found between PTH and eGFR (P ≤ 0.001; r = −0.525). A significant positive correlation found between PTH and phosphorous (P = 0.003; r = 0.378) and potassium (P ≤ 0.001; r = 0.421). On the other hand, significant negative correlation found with calcium (P ≤ 0.001; r = −0.805) and corrected calcium (P = <0.001; r = −0.769). But nonsignificant association was found with magnesium, sodium, and calcium × phosphorous (P > 0.05).Conclusion:It was concluded that PTH is playing crucial role in mineral metabolism; it should be frequently assessed in order to prevent any untoward mineral decompensation and to prevent complications like bone disease and extra skeletal calcification, and decrease cardiac disease risk in ESRD patients.

Vitamin D levels in Smith-Lemli-Opitz syndrome.

Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive congenital malformation syndrome caused by mutations in the 7-dehydrocholesterol reductase gene. This inborn error of cholesterol synthesis leads to elevated concentrations of 7-dehydrocholesterol (7-DHC). 7-DHC also serves as the precursor for vitamin D synthesis. Limited data is available on vitamin D levels in individuals with SLOS. Due to elevated concentrations of 7-DHC, we hypothesized that vitamin D status would be abnormal and possibly reach toxic levels in patients with SLOS. Through a retrospective analysis of medical records between 1998 and 2006, we assessed markers of vitamin D and calcium metabolism from 53 pediatric SLOS patients and 867 pediatric patients who were admitted to the NIH Clinical Center (NIHCC) during the same time period. SLOS patients had significantly higher levels of 25(OH)D (48.06 ± 19.53 ng/ml, p < 0.01) across all seasons in comparison to the NIHCC pediatric patients (30.51 ± 16.14 ng/ml). Controlling for season and age of blood draw, 25(OH)D levels were, on average, 15.96 ng/ml (95%CI 13.95-17.90) higher in SLOS patients. Although, mean calcium values for both patient cohorts never exceeded the normal clinical reference range (8.6-10.2 mg/dl), the levels were higher in the SLOS cohort (9.49 ± 0.56 mg/dl, p < 0.01) compared to the NIHCC patients (9.25 ± 0.68 mg/dl). Overall, in comparison to the control cohort, individuals with SLOS have significantly higher concentrations of 25(OH)D that may be explained by elevated concentrations of serum 7-DHC. Despite the elevated vitamin D levels, there was no laboratory or clinical evidence of vitamin D toxicity.

Biochemical abnormalities and Vitamin D levels in sputum positive pulmonary tuberculosis

Background: Tuberculosis has been associated with various biochemical abnormalities including low hyponatremia, serum albumin, hypocalcaemia, low vitamin D levels. Methods: 50 patients aged ? 18years of age with of sputum positive pulmonary tuberculosis were included in the study. Renal function, liver function, electrolytes and Vitamin D levels were measured at 0, 2 and 6 months of anti-tuberculosis treatment. The qualitative variables were analysed by chi-square tests. The quantitative variables were analysed by using paired t test. Five percent probability level was considered as statistically significant i.e., p<0.05. Results: The mean age was 38.5 years with a male to female ratio of 1.08:1. Hyponatremia was present in 24% of the patients. The mean total serum protein value were 6.720.89,7.420.74 and 8.150.68 g/dl and serum albumin of 2.970.50, 3.370.39 and 3.750.37 g/dl respectively at 0, 2 and 6 months. The mean serum calcium values observed were 8.20.63, 8.820.68 and 9.450.63 mg/dl at 0, 2 and 6 months respectively. The mean values for vitamin D at 0, 2 and 6 months were 9.146.94, 15.336.42 and 23.176.86 ng/ml respectively. 92% of the patients had low serum levels of vitamin D and 66% of the patients had serum vitamin D levels less than 10 ng/ml at presentation. Conclusion: Various biochemical abnormalities including hyponatraemia, low serum albumin and protein levels and low serum calcium levels are seen in pulmonary tuberculosis. Vitamin D levels are significantly lower in patients with TB and there is a significant improvement in the vitamin D levels with treatment of TB.

An attempt to correlate biochemical parameters in saliva with dental carries in children of two different age groups: A comparative study

Aim: Dental caries is one of the most common chronic dental diseases of childhood. Saliva by virtue of its chemical composition provides the main host defence in the oral cavity and plays an essential role in maintaining the integrity of oral structure. The present study was an attempt to correlate the changes in biochemical parameters with dental caries in the saliva samples of children of two different age groups. Materials and Methods: The level of calcium, phosphorous, α-amylase, and pH was measured in the saliva of caries-free (control group with decayed, missing, and filled teeth [DMFT] = 0) and caries-affected (test group with DMFT ≥5) children of 3–8 years and 9–14 years of age. Results: Statistical analysis of the data thus obtained revealed no significant difference in the mean values of calcium, phosphorus, α-amylase, and pH in caries-affected children when compared to their age-matched control group except phosphorous which increased significantly in caries-affected children of 3–8 years of age. There was also a significant correlation between calcium and phosphorous levels (r = 0.192*, P = 0.04) irrespective of age group. Conclusions: This study indicated a direct relationship between phosphorous level and dental caries in children of younger age group (3–8 years of age) and was attributed to their greater susceptibility to dental caries leading to their more DMFT status than children of 9–14 years of age. Greater susceptibility of primary enamel to demineralization is well documented in the literature, and it is because of its less mineralized, significantly softer and less elastic nature and higher organic content that dissolves faster in the acidic environment than the permanent enamel. Increased phosphorus in the saliva sample of caries-affected children might be due to the hydrolysis of organic phosphates of their enamel. Significant correlation between calcium and phosphorous supports the involvement of these two minerals in the formation of hydroxyapatite of tooth.

Minimally invasive parathyroidectomy without using intraoperative parathyroid hormone monitoring or gamma probe.

Minimal invasive parathyroidectomy (MIP) is a common surgical technique for the treatment of primary hyperparathyroidism (PHPT) and is usually done in conjunction with positive imaging techniques. We aimed to assess the results of this technique, performed without the use of intraoperative tests, in cases with PHPT caused by a single parathyroid adenoma. The data for patients who were diagnosed with PHPT were assessed retrospectively. Only those who had undergone a parathyroid adenoma localization study with ultrasonography (US) and parathyroid scintigraphy (PS) before the surgery, along with those patients for whom the MIP technique was routinely performed with frozen pathology, were included. The study group was made up of 65 patients who had undergone the MIP technique. The mean age of the patients was 56±14 (20-81), with most being females [M/F: 19 (29.2%)/46 (70.8%)]. The mean calcium values before the operation were 11.24±1.26 mg/dL (8-15.5) (normal range: 8.4-10.2), and the parathyroid hormone (PTH) values were 388 pg/mL (249-707.75). These same values, measured 24 hours after the operation, were determined as 9.04±1.04 mg/dL (6.8-13.9) and 27 pg/mL (6-86), respectively. The follow-up period for the patients was an average of 26.6±9.4 (3-76) months, and only 3 (4.6%) cases of persistent hyperparathyroidism were detected within this period. Our success rate with MIP in PHPT cases was determined to be 95.4%; therefore, this technique may be applied with a high success rate without any assistance from intraoperative tests, such as rapid serum PTH (rPTH) assays or gamma probes, in the presence of localization results of PS and US.

Comparative Analysis of Serum Biochemicals of Sahiwal, Badri, Cross-Breed and Tulsi Cows

The Sanskrit word Panchagavya means ‘mixture of five products’, and has been used in traditional Indian rituals throughout the history. The Ayurveda has detailed the importance of cow's milk, curd, ghee, urine and dung in treating various human ailments. This kind of treatment is called Panchagavya therapy or Cowpathy. Cattle rearing is different in mountainous regions in comparison to the plains, pertaining to the climatic changes, which directly result in their different biochemical compositions. Mineral deficiency limits productivity of livestock in developing tropical countries. To prove the relevance of the fact that indigenous cows are unique and have better qualities than other breeds as well are better suited for the preparation of Panchagavya and other medicinal preparations, a comparative study was done between Sahiwal breed, Cross-Breed, Badri cows (of the hilly regions) and Tulsi cows (local breed of Chattisgarh). A total of 100 blood samples were collected, which comprised of 38 Sahiwal cows, 34 Badri cows, 18 Cross-Breed and 10 Tulsi cows. Serum was separated and biochemical tests were performed to quantify various parameters such as lipids and minerals over a period of six months. For the mineral profile, Badri cows showed maximum mean values for calcium (09.50 ± 0.18), chloride (102.89 ± 2.20) and phosphorus (07.62 ± 0.53). Whereas Tulsi and Sahiwal showed maximum values for potassium (05.84 ± 0.09) and sodium (05.84 ± 0.09), respectively. Cross-Breed animals showed lower values. For the lipid profile, Badri cows showed maximum mean values for HDL-cholesterol (108.34 ± 3.08) and triglycerides (30.63 ± 2.17). Also their LDL-cholesterol (bad cholesterol) was low as compared to Cross-Breed cows. Also, Cross-Breed animals showed maximum value for cholesterol (183.95 ± 4.28).

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Moringa oleifera Lam. (MO) is a small size multipurpose tree of approximately 5 to 10 m in height which is cultivated all over the world. The study was conducted in the Guinea Savanna and the semi-deciduous forest zones of Ghana in December 2011 to compare the nutrient levels of MO leaves from the two agro-ecological zones. Leaf samples were collected from three randomly selected districts in each ecological zone for proximate and chemical analysis of some macro and micro nutrient. The results show no significant difference in crude protein and carbohydrate levels of MO leaves from the two ecological zones, however MO leaves from the semi-deciduous forest zone recorded a slightly higher mean crude protein value of 26.54% than the Guinea savanna value of 25.65%. MO leaves from the semi-deciduous forest and the Guinea Savanna recorded mean calcium values of 1880 and 1474.33 mg per 100 g of leaf powder, respectively. The comparison of mean values of potassium and iron of MO leaves showed no significant difference between MO leaves from the two ecological zones. The research concluded that agro ecological zonation had no significant effect on the levels of most nutrients in MO leaves. Key words: Moringa oleifera, ecological zone, Guinea Savanna, semi-deciduous forest, nutrients.

Is high prevalence of Vitamin D deficiency evidence for autism disorder?: In a highly endogamous population.

Aim:To determine the association between Vitamin D and autism, and the difference in level of Vitamin D in autism children and control.Design:Case–control study conducted between June 2011 and May 2013, among autism at the Hamad Medical Corporation and controls at the School Health Clinics and Primary Health Care ClinicsSubjects and Methods:A total of 254 cases and 254 controls. The Autism Diagnostic Observation Schedule-Generic is a semi-structured, standardized assessment of social interaction, communication, play and imaginative use of materials for individuals suspected of having autism spectrum disorders. Data on clinical manifestations and laboratory, family history, body mass index (BMI) and clinical biochemistry variables including serum 25-hydroxy Vitamin D, calcium, phosphorus and magnesium were obtained. Univariate and multivariate statistical analyzes were performed.Results:Of the total number of 508 children surveyed, 254 of autism and 254 of healthy children were contacted. The mean age (± standard deviation, in years) for autism versus control children was 5.51 ± 1.58 versus 5.76 ± 1.56. There were statistically significant differences between autism and healthy children control subjects with respect to educational level of mother (P = 0.016); occupation of mother (P = 0.005); BMI (P < 0.001); consanguinity (P = 0.015); exposure to sun (P = 0.002) and walking time per day <60 min (P < 0.001). The mean value of Vitamin D in autism children was much lower than the normal value, and there was a significant difference found in the mean values of Vitamin D between autism (18.39 ± 8.2 with median 18) and versus control children (21.59 ± 8.4) (P < 0.0001) and with median 21 (P = 0.004). Besides mean values of calcium, phosphorous, magnesium, glucose, potassium and alkaline phosphate were statistically significant higher in control healthy children compared to autism children (P < 0.001). Multivariate logistic regression analysis revealed that the mean serum Vitamin D level, calcium, consanguinity, BMI, physical activity, child order, and ferritin, were considered as the main factors associated with autism. Of total 254 of autism children, 14.2% had severe Vitamin D deficiency (<10 ng/ml), 43.7% had moderate insufficient levels (between 10 and 20 ng/ml), 28.3% had mild insufficient levels (between 20 and 30 ng/ml), and only 13.8% of autism had sufficient levels (>30 ng/ml). Similarly, of the total 254 of healthy children 8.3% had severe Vitamin D deficiency (<10 ng/ml), 37% had moderate insufficient levels (between 10 and 20 ng/ml), 37.4% had mild insufficient levels (between 20 and 30 ng/ml), and only 17.3% had sufficient levels (>30 ng/ml). Furthermore, there was statistically significant differences between autism and control subjects with respect to the serum level of Vitamin D (P = 0.023).Conclusion:The present study revealed that Vitamin D deficiency was higher in autism children compared to healthy children and supplementing infants with Vitamin D might be a safe and more effective strategy for reducing the risk of autism.

Predict Attention Deficit Hyperactivity Disorder? Evidence -Based Medicine

Background:Attention deficit hyperactivity disorder (ADHD) is the most common behavioral disorders in children and recent studies reported a relationship between low levels of Vitamin D and incidence of ADHD.Aim:The aim of this study was to investigate the association between vitamin D deficiency and attention deficit hyperactivity disorder (ADHD). Also, to study the impact and role of vitamin D on the development of ADH in children.Design:This is a case-control study which was conducted in children below 18 years of age from June 2011 to May 2013 at the School Health and Primary Health care Clinics, Qatar.Methods and subjects:The study was based on 1,331 cases and 1,331 controls. The data collection instrument included socio-demographic & clinical data, physician diagnosis family history, BMI, and serum 25(OH) vitamin D, calcium, albumin, billirubin, magnesium, calcium, cholesterol, urea, triglyceride and phosphorus. Descriptive and univariate statistical analysis were performed.Results:Of the total number of 3470 children surveyed, 1331 of ADHD and 1,331 of healthy children gave their consent to participate in this study. The mean age (± SD, in years) for ADHD versus control children was 10.63±3.4 vs. 10.77±3.4. Overweight (7.7% vs 9.4%) and obesity (4.6% vs 7.7%) were significantly lower in ADHD children compared to their counterparts (P=0.001). Vitamin D deficiency was considerably higher in ADHD children compared to healthy children. The mean value of vitamin D in ADHD children was much lower than the normal value and there was a significant difference found in the mean values of vitamin D between ADHD (16.6±7.8 with median 16) and control children (23.5±9.9) (p<0.0001) and with median 23 (p = 0.006). Mean values of Calcium and phosphorous were significantly higher in control compared to ADHD children (p<0.001). 1331 of all ADHD children had 19.1% had severe vitamin D deficiency (< 10 ng/ml), 44.9% has moderate insufficient levels (between 10-20 ng/ml), 27.3% has mild insufficient levels (between 20-30 ng/ml) and only 8.1% of ADHD had sufficient serum vitamin D levels (>30 ng/ml). Multivariate logistic regression analysis revealed that household income, poor relationship between parents, mothers’ occupation, consanguinity, BMI in percentiles, low duration of time under sun light, physical activity, low serum calcium level and low vitamin D level were considered as the main risk factors associated with the ADHD after adjusting for age, gender and other variables.Conclusion:The study showed that vitamin D deficiency was higher in ADHD children compared to healthy children. Supplementing infants with vitamin D might be a safe and effective strategy for reducing the risk of ADHD, but, further genomic and some other test and relevant studies need to be done.

Evaluation of dietary exposure to minerals, trace elements and heavy metals from the muscle tissue of the lionfish Pterois volitans (Linnaeus 1758)

Twenty-five samples of Pterois volitans caught in Jamaican waters were analyzed for 25 essential, non-essential and toxic elements using Graphite Furnace Atomic Absorption Spectrophotometry (GF-AAS), Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES) and Instrumental Neutron Activation Analysis (INAA). The mean values for calcium (355 mg/kg), copper (107 μg/kg), iron (0.81 mg/kg), potassium (3481 mg/kg), magnesium (322 mg/kg), manganese (0.04 mg/kg), selenium (0.47 mg/kg), sodium (700 mg/kg) and zinc (4.46 mg/kg) were used to estimate dietary intake. The percentage contribution to provisional tolerable weekly intake for a 70 kg male and a 65 kg female were also estimated for the toxic elements arsenic (1.28% M, 1.38% F), cadmium (0.26% M. 0.28% F), mercury (3.85% M, 4.15% F) and lead (0.17% M, 0.18% F). To further assess the risk of mercury toxicity and the role of mitigation provided by selenium, selenium-mercury molar ratios were calculated for all samples. All samples were shown to have a molar excess of selenium. In addition the suggested selenium health benefit value was calculated, and was positive for all samples. It was concluded that P. volitans appears to contribute modestly to mineral and trace element nutrition, while not being a significant contributor to dietary exposure of toxic elements.

RELATIONSHIP BETWEEN THE LEVELS OF TRIIODOTHYRONINE (Tӡ), PARATHERMONE (PTH) HORMONES AND SOME BIOCHEMICAL CHANGES IN BLOOD SERUM OF BUFFALO CALVES AT ASSIUT GOVERNORATE.

Thyroid hormones have been recognized to be important in establishing the animal performance as, growth, maturation, reproduction, production and adaptation. The aim of this work was the estimation of triiodothyronine (Tӡ) and parathermon (PTH) hormones concentrations and their relations with some serum biochemical levels in buffalo calves. A total number of 50 male buffalo calves divided into two groups according to their age, 20 animals (3 to 6 months age) and the other 30 ones (6-9 months age). These animals were apparently healthy male buffalo calves selected from a privet farms at Assiut governorate. Blood serum sample were used for determination of triiodothyronine (Tӡ) and parathermon (PTH) hormones concentrations and the total protein, albumin, globulin, glucose, cholesterol, calcium, phosphorus, and magnesium levels. The results indicated a significant decrease of both blood serum hormones (Triiodothyronine (Tӡ) and Parathermone (PTH) concentrations in the older age group of buffalo calves were collected. There were a significant difference between the two age groups in both cholesterol and glucose levels. The mean values of calcium and magnesium showed significant difference between the two age groups. The correlation coefficient (r) between the estimated blood serum Triiodothyronine (Tӡ) concentrations and the different biochemical parameters only showed significant changes for glucose and cholesterol levels. Also, there was negative correlation only between parathermone (PTH) and, calcium, phosphorus, magnesium levels. Based on the current study, it could be concluded that the recorded biochemical parameters found to be lower than that recorded by other studies and this may attributed to many factors. The nutritional factor could be controlled for buffalo calves in Assuit province by giving balanced ration to improve such parameters and consequently improving animal performance.

Vitamin D homeostasis, bone mineral metabolism, and seasonal affective disorder during 1 year of Antarctic residence

Low serum vitamin D and increased parathormone levels were found to be associated with depression and stress in a wintering expedition of 20 healthy male subjects over a period of 1year in Antarctica. The continuous daylight during summer and the dark polar winter affect endogenous vitamin D production. Long-term effects on bone health need to be studied further. Vitamin D plays a significant role in calcium and bone mineral metabolism and also affects cardiovascular, psychological, and cognitive functions. The ultraviolet B radiation component of sunlight, which shows marked seasonal variation in Antarctica, influences the synthesis of vitamin D. Depression and mood disorders are associated with this extreme photoperiod. In this study, we attempted to gauge the alteration of vitamin D homeostasis in Antarctica and its effect on bone mineral metabolism and mood over a period of 1year. Twenty male subjects who wintered over at India's Antarctic base Maitri (70°45'57″ S, 11°44'09″ E) from November 2010 to December 2011 were studied. Fasting serum samples were collected at baseline, 6months, and 12months for serum 25-hydroxyvitamin D, intact parathyroid hormone (PTH), total alkaline phosphatase (ALP), calcium, and phosphate. Beck Depression Inventory (BDI), Positive and Negative Affect Scale (PANAS X), and Perceived Stress Scale were used to measure depression, affect, and stress. Mild vitamin D deficiency was present in two (10%) subjects on arrival, which increased to seven (35%) subjects during the polar winter at 6months. The mean score on the BDI-II screen for depression was significantly higher during midwinter (4.8 ± 3.9) when compared with the baseline value (2.9 ± 2.1). Only 2/20 (10%) of subjects met the criteria for minor depression. Higher PTH levels at 6months correlated with a higher PANAS X score (p = 0.021). The mean values of calcium, inorganic phosphorus, and ALP were comparable during the course of the expedition. Low light exposure during the dark polar winter, lower vitamin D, and increased intact PTH levels were found to be associated with depression during 1year of Antarctic residence. The low dietary intake and decreased solar radiation exposure during the polar winter reduce serum vitamin D levels in otherwise healthy individuals, which suggests that supplementation may be necessary.

Effects of Paricalcitol in Calcium-Phosphorus Metabolism, Renal Function and Proteinuria in Kidney Transplantation

Introduction: Paricalcitol, a selective activator of the vitamin D receptor, is a viable alternative to treat secondary hyperparathyroidism in transplantation. In addition, studies have shown that combined treatment with paricalcitol and ACEI / ARA II improves proteinuria in patients with chronic renal disease, peritoneal dialysis and hemodialysis, but there are no studies in renal transplant population. Objectives: To study the effects of paricalcitol in the calcium-phosphorus metabolism, renal function and proteinuria in a renal transplant population. Materials: Retrospective cohort study. We evaluated medical records of 66 outpatient renal transplant recipients with a median time post transplantation of 88.4 months P25-75 (36.6 to 160.9). They were treated with paricalcitol (1mcg / 3 times per week) for a minimum period of 3 months. The following variables were analyzed before and after initiation of treatment: MDRD estimated glomerular filtration rate, Proteinuria (g/24hrs), Protein/creatinine ratio, serum creatinine, calcium, phosphorus, PTH and 25-OH-Vitamin D. Results: The mean values of calcium, phosphorus, vitamin D, creatinine, PTH and Protein/creatinine ratio before and after treatment with paricalcitol are described in the attached table. Paricalcitol treatment was able to reduce PTH without increasing serum calcium. There was no beneficial effect on proteinuria. 17 patients (25.75%) were not able to reduce PTH levels. This effect was observed in patients with higher baseline calcium levels and lower baseline PTH levels. Only 7 patients developed hypercalcemia.[Table 1]Conclusions: In our study, Paricalcitol reduced PTH levels during the monitoring period but there was no beneficial effect on proteinuria.

Minimally invasive video-assisted thyroidectomy (MIVAT): what is the real advantage?

The evolution of video-assisted or laparoscopic surgical techniques in the last several years has changed the surgical treatment approach to many diseases, also in endocrine surgery. From July 2005 to March 2009, we treated 211 patients with minimally invasive video-assisted thyroidectomy (MIVAT). The procedure was performed in accordance with Miccoli's technique using an Ultracision CS 14 (Ethicon Endosurgery) and/or Single Use Automatic Clip Applier S-90 (Autosuture). In all cases, we recorded the incidence of postoperative hypocalcaemia as a serum calcium value lower than 8 mg/dl with or without hypocalcaemic symptoms, postoperative haemorrhage or nerve palsy, mean operative time. All patients were also assessed for postoperative pain and given a visual analogue score from 0 to 10 at 1 and 24 h after surgery. We matched these results with a group of 587 patients treated during the same period with traditional thyroidectomy. The female/male ratio was 4:1; the mean age of the patients was 50.6 years. In the MIVAT group, the mean time of surgical procedure decreased by 52.4 min. We observed 16 hypocalcaemic cases with clinical symptoms (7.58%) (six of these cases were published in a previous article and were among the first 100 cases treated) and 59 cases of serologic hypocalcaemia (27.9%) (serum calcium lower than 8 mg/dl); the mean value of calcium concentration was 7.5 +/- 0.27 mg/dl. We observed six cases of monolateral nerve palsy, and after 6 months, a definitive palsy in two cases (0.9%); these two cases were in the first 25 cases treated. Comparisons with traditional thyroidectomy group showed statistically significant differences in postoperative serologic hypocalcaemia (p < 0.001), no difference in mean calcium value (p = 0.41) and no statistical difference in the incidences of nerve palsy and haemorrhage. Patients treated with MIVAT showed an improvement in incidence of postoperative hypocalcaemia, postoperative pain, postoperative stay, psychophysical recovery and cosmetic result.