Non-deficient Group Research Articles

Vitamin D status influences cytokine production and MALAT1 expression from the PBMCs of patients with coronary artery disease and healthy controls.

This study aimed to investigate the long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA MALAT1) expression and its role in cytokine production from peripheral blood mononuclear cells (PBMCs) in patients with coronary artery disease (CAD) and non-CAD participants (NCAD). Blood samples were taken from 15 patients with CAD and 15 NCAD individuals. The plasma was used for biochemical analyses. MALAT1 and CD36 expressions were evaluated in the isolated peripheral blood mononuclear cells (PBMCs) by real-time PCR. Furthermore, the levels of inflammatory cytokines e.g. interleukin (IL)-6, IL-10, and IL-22 were measured in the supernatants of the cultured PBMCs by flow cytometry. The levels of MALAT1 and CD36 were not significantly different between the CAD and NCAD groups. However, a lower level of MALAT1 and CD36 was observed in PBMCs of vitamin D deficient (<15 ng/ml) CAD and NCAD participants. Furthermore, the vitamin D deficient (<15 ng/ml) group showed a significantly higher plasma level of IL-6, IL-10, and IL-22 compared to the non-deficient (≥15 ng/ml) group. In addition, significant positive correlations were found between CD36, IL-22, and fasting blood sugar (FBS) with MALAT1. Given that in vitamin D deficient individuals a decreased level of MALAT1 was associated with CD36 expression and increased IL-22 production, vitamin D supplementation may play a role in reducing MALAT1/CD36/IL-22 mediated complications such as T2DM and CAD, especially in vitamin D deficiency.

Serum level of vitamin D as a predictor for severity and outcome of pneumonia

of the study: Pneumonia is the most common medical illness causing hospital admissions and the most common cause of sepsis and septic shock. Vitamin D deficiency is a global health problem that affects several populations worldwide. Unfortunately, data regarding the relationship between vitamin D concentrations and outcomes of pneumonia in adult patients are sparse. Thus, we aimed to assess the prevalence of vitamin D deficiency among pneumonia patients and to correlate its levels with patients' outcomes. This is a prospective study of 100 patients with pneumonia admitted to Al-Azhar University hospital at New Damietta City. Data from history, Physical examination and biochemical analyses were collected. Grouping was based on vitamin D status. A comparison was made between groups regarding pneumonia severity and outcome. Also, correlation between Vit D level and outcome was studied. Our study showed that 63% of patients had vitamin D level below 12ng/mL, and patients with vitamin D level below 20 was 84%. We found an association between vitamin D deficiency and pneumonia severity. The severity of pneumonia was significantly higher among the deficient group. We also found that there was statistically significant increase of complications in deficient group. The patients improved without complications had the highest levels of vitamin D, while ARDS and septicemia complicated patients had the lowest levels of vitamin D. In addition, there was a difference between the two groups regarding to mortality. The mortality rate was higher in the deficient group as compared to non-deficient group. Vitamin D deficiency is a common problem among critically ill patients. Its status affects pneumonia severity and outcome.

A Multi-Omic Analysis for Low Bone Mineral Density in Postmenopausal Women Suggests a RELATIONSHIP between Diet, Metabolites, and Microbiota.

The effect of microbiota composition and its health on bone tissue is a novel field for research. However, their associations with bone mineral density (BMD) have not been established in postmenopausal women. The present study investigates the relation of diet, the microbiota composition, and the serum metabolic profile in postmenopausal women with normal-BMD or with low-BMD. Ninety-two Mexican postmenopausal women were classified into normal-BMD (n = 34) and low-BMD (n = 58). The V4 hypervariable region was sequenced using the Miseq platform. Serum vitamin D was determined by chemiluminescence immunoassay. Serum concentrations of acyl-carnitines and amino acids were determined by electrospray tandem mass spectrometry. Diet was assessed by a food frequency questionnaire. The low-BMD group had fewer observed species, higher abundance of γ-Proteobacteria, lower consumption of lycopene, and lower concentrations of leucine, valine, and tyrosine compared with the normal-BMD group. These amino acids correlated positively with the abundance of Bacteroides. Lycopene consumption positively correlated with Oscillospira and negatively correlated with Pantoea genus abundance. Finally, the intestinal microbiota of women with vitamin D deficiency was related to Erysipelotrichaceae and Veillonellaceae abundance compared to the vitamin D non-deficient group. Associations mediated by the gut microbiota between diet and circulating metabolites with low-BMD were identified.

Influence of Vitamin D Deficiency on the Development of Opportunistic Infection in People Living with HIV/AIDS (PWHAs)

Background It is known that vitamin D is associated with immune cell growth, and an association between vitamin D deficiency and development of chronic infections such as tuberculosis has been reported. However, there have been few studies concerning the association between vitamin D deficiency and opportunistic infection (OI) in people living with HIV/AIDS (PWHA). Method PWHAs who had vitamin D (25-OH vitamin D, 25OHD) test results from 2012 to 2017 were enrolled. All enrolled PWHAs were divided into a vitamin D-deficient group and non-deficient group according to the 25OHD cutoff set by ROC curve analysis. The rates of OIs were compared between the two groups. Results Among 440 enrolled PWHAs, 394 (89.5%) were male, 32 were ≥ 65 years (13.4%), 237 (53.9%) were ART-naïve, and 107 (24.3%) had CD4 + T cell < 200/L. Seventy-three cases of OIs occurred in 63 PWHAs (14.3%); the most common OI was tuberculosis (27, 6.1%) followed by pneumocystis pneumonia (PCP) (25, 5.7%), and Cytomegalovirus (CMV) diseases (10, 2.3%). In the ROC curve analysis, the AUC was 0.71 (95% CI 0.64- 0.79, P < 0.001) and the optimal cutoffs of 25OHD to predict OIs was 14 ng/mL. Overall OI development was significantly more prevalent in the vitamin D-deficiency group (aOR 3.05, 95% CI 1.43-6.48); tuberculosis (aOR 3.51, 95% CI 1.22-10.05) and CMV disease (aOR 10.13, 95% CI 1.11-92.03) were significantly associated with vitamin D deficiency, whereas PCP was not (aOR 1.32, 95% CI 0.44-3.98). Conclusion Stringent cutoffs of vitamin D deficiency (< 14 ng/mL) were well correlated with development of OIs in PWHAs. Vitamin D deficiency was associated with development of OIs, particularly tuberculosis and CMV infections.

Maternal Vitamin D Levels during Late Pregnancy and Risk of Allergic Diseases and Sensitization during the First Year of Life-A Birth Cohort Study.

Allergic diseases are the most common chronic illness in childhood. Findings from developed countries have reported associations between Vitamin D levels during pregnancy and offspring allergy risk. This prospective cohort study aimed to determine the associations between maternal Vitamin D levels during late pregnancy and allergic diseases in Malaysian infants during the first year of life. Serum 25(OH)D concentrations of 380 pregnant women in the third trimester were measured using a chemiluminescent immunoassay. Children’s allergic outcomes were assessed at 3, 6, and 12 months based on parental reports. Specific IgE antibodies against food and inhalant allergens were measured in infants at 12 months of age. A total of 43.2% pregnant women were Vitamin D deficient (<30 nmol/L) and 56.8% were nondeficient (≥30 nmol/L). A total of 27.6% of the infants had eczema, 6.1% had wheeze, 27.4% had food sensitization, 10.8% had inhalant allergen sensitization, and 3.8% had IgE-mediated food allergy during the first year of life. Compared with the nondeficient group, maternal Vitamin D deficiency in late pregnancy was not associated with any allergic outcomes after adjustment for potential confounding factors. In conclusion, the present study does not support an association between maternal Vitamin D levels in late pregnancy and allergic outcomes during the first year of life.

Lower concentration of vitamin D is associated with lower DAS28 and VAS-pain scores in patients with inflammatory rheumatic diseases treated with infliximab: a pilot study.

Vitamin D is beneficial in patients with immune-mediated rheumatic diseases as it has been shown that it lowers the incidence risk and the level of inflammation. To examine the association between clinical outcomes and initial 25-hydroxyvitamin D [25(OH)D] concentrations in patients with the immune-mediated rheumatic diseases treated with infliximab for 9months. This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer's instructions.This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer's instructions. The study included 23 patients (14 with RA, 6 with AS and 3 with PsA), median age 54years, 15 females. Vitamin D deficient and non-deficient groups had median initial concentrations of 38 and 61nmol/L, respectively. DAS28 and pain on VAS calculated at the 2nd and 38th week showed a statistically significant decrease only in RA and PsA patients with vitamin D deficiency (P = 0.02 and 0.06, respectively). Lower initial concentration of 25(OH)D in patients treated with infliximab was associated with better improvement of clinical measures (DAS28 and VAS) of disease after 9months of therapy.

Association between MGMT status and response to alkylating agents in patients with neuroendocrine neoplasms: a systematic review and meta-analysis.

Background: O6-methylguanine-DNA methyltransferase (MGMT) is a specific DNA damage reversal repair protein. The influence of MGMT status on alkylating agent sensitivity in patients with neuroendocrine neoplasms (NENs) is controversial. We conducted a meta-analysis to assess the influence of MGMT status on the therapeutic sensitivity of alkylating agents in patients with NENs.Methods: We searched PubMed, EmBase, and Cochrane library public databases through 3 July 2019. The objective response rate (ORR) was the outcome data of interest. Subgroup analysis was performed according based on MGMT methylation and expression of MGMT protein.Results: Eleven studies were included in the meta-analysis. The proportion of patients with NENs that achieved an ORR after alkylating agent treatment was higher in the MGMT-deficient group than the non-deficient group (OR: 5.00; 95% CI: 3.04–8.22; P < 0.001; I2: 3%). Similar results were noted in the MGMT methylation and MGMT protein expression subgroups.Conclusion: Patients with NENs and MGMT methylation or low protein expression had a higher ORR proportion than patients without MGMT methylation or high protein expression. The MGMT status can be used as a biological indicator of the response to alkylating agent treatment in patients with NENs.

Study on the relationship between vitamin D, grip strength and muscle mass in elderly diabetic patients

Objective To study the relationship between vitamin D level and muscle mass and grip strength in elderly patients with type 2 diabetes mellitus (T2DM). Methods From May 2016 to January 2018, 201 patients with type 2 diabetes mellitus aged ≥ 60 who were admitted to the Department of endocrinology of Xuanwu Hospital were selected for prospective study. According to 25-hydroxyvitamin D level(25(OH)D), the patients were divided into the vitamin D deficiency group (25(OH)D<20 μg/L, 140 cases) and the non-deficiency group (20 μg/L≤25(OH)D<70 μg/L, 61 cases). The grip strength, walking speed and muscle mass of upper and lower limbs were measured.Physical examination and laboratory examination were carried out. Results There was no significant difference between the two groups (P>0.05). The grip strength, upper limb and lower limb muscle contents in the non deficiency group were significantly higher than those in the deficiency group ((33.49±9.43) kg vs.(29.59±10.30) kg, (4.99±1.09) kg vs.(4.57±1.11) kg, (15.69±3.10) kg vs.(14.54±3.03) kg, P=0.01, 0.015, 0.017). Multivariate logistic regression analysis showed that vitamin D deficiency was independently related to grip strength and lower limb muscle mass(OR=1.286, 95% CI: 1.197-1.346, P<0.01; OR=1.231, 95%CI: 1.102-1.283, P<0.05). Conclusion Vitamin D deficiency is a risk factor for the decrease of grip strength and lower extremity muscle mass in elderly patients with type 2 diabetes. Key words: Type 2 diabetes; Vitamin D; Grip; Muscle mass

Comparison of Diabetogenic and Lipid Profile Among Vitamin D Deficient and Non-deficient Male Subjects

Objective: To evaluate diabetogenic and lipid profiles among subjects with or without vitamin D deficient male subjects. Design: Cross-sectional analysis Place and duration of study: From Jan- 2018 to Dec- 2018 at PNS HAFEEZ hospital Islamabad Subjects and methods: From a target population of adult male patients selected after several exclusion, we had a final total sample size of 133, which were evaluated among two groups formulated based upon whether having vitamin D deficiency or otherwise. We further compared diabetic and lipid indices including fasting plasma glucose, glycated hemoglobin (HbA1c), total cholesterol, fasting triglycerides, LDL cholesterol and HDL cholesterol among the vitamin D deficient group and vitamin D non-deficient groups by using Independent sample t-statistics. Results: HbA1c levels were higher in subjects with vitamin D deficiency [Mean: 7.43% (+2.45), n=87] in comparison to non-vitamin D deficient subjects [Mean: 6.54% (+1.67), n=45], (p=0.029). Fasting plasma glucose levels were higher in subjects with vitamin D deficiency [Mean: 8.12 mmol/L (+4.05), n=86] in comparison to non-vitamin D deficient subjects [Mean: 6.88 mmol/L (+2.85), n=43], (p=0.074). Lipid parameters did not demonstrate statistical significance among subjects with or without vitamin D deficiency. Conclusion: HbA1c and fasting plasma glucose levels were higher among subjects with vitamin D deficiency in comparison to non-vitamin D deficient male subjects.

Association between micronutrient deficiency and acute respiratory infections in healthy adults: a systematic review of observational studies

BackgroundAcute respiratory infections (ARI), including the common cold causes significant morbidity and economical losses globally. Micronutrient deficiency may increase ARI incidence risk and its associated duration and severity among healthy adults, but evidence are inconclusive. This study aims to systematically review all observations on the association between single micronutrient deficiency and ARI incidence, duration and severity in healthy adults.MethodsSystematic literature searches were conducted in PubMed, Cochrane Library, Embase and Scopus databases. Eligible studies were assessed for the reporting and methodological quality. Adjusted summary statistics with their relevant 95% confidence intervals or interquartile ranges were extracted for the outcomes of interest.ResultsThe literature search identified 423 unique studies. Of which, only eight studies were eligible and included in the final review. Only vitamin D deficiency (VDD) was observed among these eight studies. There were no eligible studies that focused on the association between other single micronutrient deficiency and ARI. The review found mixed observations on ARI incidence, and a lack of evidence on its associated severity to conclude the association between VDD and these outcomes. However, existing evidence consistently suggested that VDD is likely to lead to longer ARI duration (median duration in days: deficient group, 4 to 13; non-deficient groups, 2 to 8).ConclusionThis review found that VDD may be associated to longer ARI duration, but its effect on ARI incidence and its associated severity among healthy adults remains inconclusive. This review also highlighted the lack of a consistent regional and/or global definition for micronutrient sufficiency, and that future studies should explore and conclude the association between other micronutrient deficiency and ARIs in healthy adults before considering supplementation for ARI prevention and management.

Cardiovascular dysfunction and vitamin D status in childhood acute lymphoblastic leukemia survivors.

Vitamin D (25-OHD) has a role in bone health after treatment for cancer. 25-OHD deficiency has been associated with risk factors for cardiovascular disease, but no data focusing on this topic in childhood cancer survivors have been published. We investigated the 25-OHD status in children treated for acute lymphoblastic leukemia (ALL), and evaluated its influence on vascular function. 25-OHD levels were evaluated in 52 ALL survivors and 40 matched healthy controls. Patients were grouped according to 25-OHD level (< 20ng/m or ≥ 20ng/ml). Auxological parameters, biochemical and hemostatic markers of endothelial function (AD, HMW-AD, ET-1, vWFAg, TAT, D-dimers, Fbg, and hs-CRP), ultrasound markers of vascular endothelial function (flow-mediated dilatation, FMD, common carotid intima-media thickness, C-IMT, and antero-posterior diameter of infra-renal abdominal aorta, APAO) were evaluated in the patients. Cases showed higher prevalence of 25-OHD deficiency than controls (p = 0.002). In univariate analysis via mean comparisons, 25-OHD deficient (< 20ng/ml) patients showed higher C-IMT values compared to the 25-OHD non-deficient (≥ 20ng/ml) group (P = 0.023). Significant differences were also found for ET-1 (P = 0.035) and AD-HMW (P = 0.015). In the multiple regression models controlling for some confounders, 25-OHD still was associated with C-IMT (P = 0.0163), ET-1 (P = 0.0077), and AD-HMW (P = 0.0008). Childhood ALL survivors show higher prevalence of 25-OHD deficiency as compared to controls. The 25-OHD levels appear to be linked to indicators of endothelial and vascular dysfunction. Careful monitoring of 25-OHD balance may help to prevent cardiovascular diseases in childhood ALL survivors, characterized by high cardiovascular risk.

Low levels of vitamin D are associated with nosocomial infections but not with short-term mortality in critically ill patients

Background/aim: A prospective observational study was conducted to determine the relationship between vitamin D deficiency and nosocomial infections among intensive care unit (ICU) patients. Materials and methods: Demographic data, season of admission, vitamin D levels at admission, premorbid lifestyle scores, comorbid conditions, and admission diagnosis were recorded in 306 ICU patients. Infections that developed at least 48 h after admission to the ICU were the primary outcome, and ICU, hospital, and 1-year mortality were the secondary outcomes. Infections were evaluated for 28 days, and for the entire duration of ICU stay independently. Multiple logistic regression analysis was performed to control for confounding factors that were statistically significant in univariate analysis. Results: All infection and mortality rates were significantly higher in low 25 (OH) D groups in univariate analysis. After adjusting for confounding factors, infection rates remained higher in the deficient group. However, ICU and hospital mortality did not show any statistically significant difference between deficient and nondeficient groups. Only the 1-year mortality rate was significantly higher among patients with 25 (OH) D levels less than 20 ng/mL. Conclusion: Low vitamin D levels are significantly associated with ICU-related infections but not with ICU or hospital mortality. However, further studies are needed to identify the role of vitamin D deficiency in predicting ICU outcomes.

Intravenous Thrombolysis for Stroke Patients with G6PD Deficiency

No reports regarding the safety of thrombolysis in acute stroke patients with a G6PD deficiency have been published to date. Here we aimed to evaluate the safety of intravenous thrombolysis for G6PD-deficient stroke patients. We enrolled each patient with acute ischemic stroke who arrived in our stroke unit within the therapeutic window and received systemic thrombolysis using recombinant tissue plasminogen activator (rt-PA), between January 2015 and March 2016. The primary clinical outcome was measured 3 months after treatment, and defined as a "good" outcome by a modified Rankin Scale (mRS) score of 0-2. Major safety outcomes were incidences of intracranial hemorrhage (ICH) or mortality at 90 days. A total of 96 individuals were analyzed, of which 20 patients were G6PD deficient. The rates of ICH after rt-PA treatment were 12% the in G6PD-deficient group versus 15% in G6PD non-deficient group, and the incidences of symptomatic intracranial hemorrhage were also similar between the G6PD-deficient and non-deficient cohorts. No hemolysis crisis occurred, and no significant difference in mortality rate was found between the 2 groups. The overall rate of a good outcome at 3 months after stroke in the whole cohort was 60%, whereas 50% of patients achieved an excellent outcome (mRS 0-1) in the G6PD-deficient cohort, and 42% in the G6PD non-deficient group. Thrombolytic therapy for patients with G6PD deficiency seems to pose a similar risk of ICH and clinical outcome to those with G6PD non-deficiency.

Association between vitamin D deficiency and risk of thyroid cancer: a case-control study and a meta-analysis.

Although vitamin D is reportedly associated with various cancers, the association between vitamin D and thyroid cancer is indefinite. We aimed to investigate whether this association applies to thyroid cancer (TC). A total of 276 Chinese Han people were recruited in a current matched case-control study. Multivariable conditional logistic regression was computed to estimate the association between plasma 25(OH)D and papillary thyroid cancer (PTC). In addition, we searched relevant studies in PubMed and Web of Science databases before December 2017 to conduct a meta-analysis. In our case-control study, plasma 25(OH)D concentration was inversely associated with PTC risk (highest tertile vs lowest tertile: adjusted OR=0.25; 95% CI 0.10, 0.61; Ptrend=0.003). This association was independent of body mass index and physical activity (all adjusted Pinteraction>0.05). A total of 11 studies were included in the meta-analysis, among which ten studies have been published and one was our case-control study. Compared with 25(OH)D non-deficient group, the pooled OR of TC was 1.42 (95% CI 1.17, 1.73) in the deficient group. Similarly, blood 25(OH)D levels in patients with TC were tend to be lower than those in the controls (SMD=-0.20, 95% CI -0.36, -0.03). A high level of circulating 25(OH)D was associated with a decreased TC risk. This association has important significance in public health and should, therefore, be further studied.

Relationship between some electrocardiographic parameters of ventricular repolarization and Vitamin D status in apparently healthy individuals

Background: Vitamin D (VitD) is a vitamin affective on the cardiovascular system. VitD deficiency has been related to increased cardiac and all-cause mortality even in healthy controls. Evidence showed that such relatively novel electrocardiographic (ECG) parameters of ventricular repolarization (EPVR) as Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios might be related to increase cardiac arrhythmias and even sudden cardiac death. Little data are available about the effect of VitD deficiency on EPVR. The purpose of this study was to evaluate the EPVR in apparently healthy controls with VitD deficiency. Methods: A total of 72 consecutive VitD deficient and 51 consecutive VitD nondeficient healthy controls who presented to our hospital's outpatient clinics were included in the study as two different groups. The relevant data were obtained through physical examination, electrocardiography, and echocardiography. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were calculated from surface ECG and compared between the two groups using the Mann–Whitney U-test. Results: Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were all observed to be greater in VitD deficient group compared with the VitD nondeficient group, with robust statistical significance (68.1 ms [61.7–75.4] vs. 58 ms [54–66.2]; 0.197 [0.179–0.210] vs. 0.164 [0.147–0.187]; and 0.172 (0.156–0.191) versus 0.150 (0.137–0.164); respectively; P ≤ 0.001]). Conclusion: Our study reveals that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio increase in VitD deficiency in apparently healthy controls, which may be related to SCD. Further studies are needed to support our results.

Serum 25-hydroxyvitamin D levels in children with recurrent wheezing and relation to the phenotypes and frequency of wheezing.

Background. Recurrent wheezing may be related to various reasons. There is a lack of knowledge about the effect of vitamin D status in the children with recurrent wheezing. The aim of this study is to compare the level of vitamin D between recurrent wheezing children and healthy controls, and to investigate the relationship between vitamin D status and the clinical parameters of recurrent wheezing in preschool children. Methods. One hundred-ten children followed up in our hospital with recurrent wheezing were included in the study. The control group included fifty children without wheezing episodes. The serum 25-hydroxyvitamin D (25OHD) level was measured. The patients with recurrent wheezing were grouped according to their vitamin D status as "deficient group" and "non-deficient group (Vitamin D level is insufficient and normal)". We investigated the relationship between vitamin D status and the clinical and laboratory parameters of children with recurrent wheezing. Results. Mean 25OHD level was 21.66 ± 8.13 ng/mL (5.6-53) in the study group and 25.36 ± 10.17 ng/mL (6-59) in the control group. The difference was statistically significant (p = 0.015). When the patients with recurrent wheezing were compared according to their vitamin D status, number of hospitalizations, number of positive sensitivity, percentage of eosinophil, serum IgE levels, Asthma Predictive Index positivity and wheezing phenotypes were not found to be different between groups. However, the duration of wheezing, the number of wheezing episodes and systemic glucocorticoid need in the previous year, and the total number of wheezing episodes were significantly higher in the deficient group (p < 0.05). The serum 25OHD level was negatively correlated with the duration of wheezing (r: -0.238; p: 0.012), total number of wheezing episodes (r: -0.436; p: 0.001), number of wheezing episodes in the previous year (r: -0.395; p: 0.001), and systemic glucocorticoid need in the previous year (r: -0.324; p: 0.001). Conclusions. Mean 25OHD levels were lower in patients with recurrent wheezing than in healthy controls. The duration of illness and number of wheezing episodes were correlated with vitamin D levels. An evaluation of the serum levels of vitamin D and supplementation if needed should be recommended in patients with recurrent wheezing, especially in those with long-term and frequent wheezing episodes.

Prevalence and association of vitamin D deficiency and mortality in patients with severe sepsis.

BackgroundVitamin D is a steroid prohormone that regulates body calcium and phosphate metabolism. Recent studies have shown an association between low vitamin D status and high mortality in patients admitted to intensive care units. To date, there are limited data available specifically about severely septic patients in medical units.ObjectivesTo determine the prevalence of vitamin D deficiency in severely septic patients and its clinical outcomes, including mortality rate.MethodsA prospective observational study was conducted to investigate the prevalence of vitamin D deficiency and its association with 30-day mortality in patients with severe sepsis. Patients admitted to medical wards at our hospital between November 2014 and March 2015 were included in the study. A 25-hydroxyvitamin D level <20 ng/mL was defined as vitamin D deficiency, and <12 ng/mL as severe deficiency. For an association analysis, the patients were grouped into deficient versus not deficient and severely deficient versus not severely deficient.ResultsOne hundred and ten eligible patients were enrolled. A total of 83 patients (75%) had vitamin D deficiency and 42 (38%) had severe deficiency. Despite an insignificant higher 30-day hospital mortality rate in vitamin D deficient versus non-deficient groups (16% vs 4%, p=0.18), the differences were significant between the severely deficient versus non-severe groups (23% vs 4%, p=0.02). The odds ratio of the 30-day mortality rate was 4.83 (95% confidence interval [CI], 0.60–38.77, p=0.14) for vitamin D deficiency and 7.69 (95% CI, 2.00–29.55, p=0.003) for severe deficiency.ConclusionThe prevalence of vitamin D deficiency was very high in three-quarters of patients with severe sepsis. A significant higher mortality rate was observed, particularly in patients with severe vitamin D deficiency.

Iron deficiency anemia in children with cyanotic congenital heart disease and effect on cyanotic spells

BackgroundIron deficiency anemia (IDA) in cyanotic congenital heart disease (CCHD) and its association with cyanotic spells has been documented in literature. However, Indian data especially in the pediatric age group is scarce. This study was conducted to find out the prevalence of IDA in this population. MethodsAn observational study was conducted in a tertiary care hospital. Children with CCHD in the age group of birth–12 years were included in the study. Hematological parameters of these patients were determined and compared. An assessment of the incidence of cyanotic spells in the iron-deficient and iron non-deficient children was also done. Data analysis was done using Fischer's exact test. ResultsThe prevalence of IDA was 47.06% in the study population. The study also showed that hemoglobin and hematocrit levels were paradoxically higher in the iron-deficient group as compared to the non-deficient, though the iron studies revealed the iron deficiency. The incidence of cyanotic spells was higher in the iron-deficient group. The mean corpuscular volume (MCV), red cell distribution width (RDW), serum ferritin, serum iron, total iron binding capacity (TIBC), and transferrin saturation (TS) values were the parameters, which were found to be statistically significant to differentiate the study groups. ConclusionThe prevalence of IDA in children with CCHD was found to be high. Iron-deficient group had an increased frequency of cyanotic spells as compared to the non-deficient group, which was statistically significant.

Hyperbilirubinemia management in neonates &lt;2000 g screened for glucose-6-phosphate dehydrogenase deficiency in a tertiary neonatal unit

Background: Prematurity and glucose-6-phosphate dehydrogenase (G6PD) deficiency are considered important risk factors in neonatal hyperbilirubinemia. G6PD screening is performed by many neonatal units to identify this risk factor. Few studies evaluated the role of this screening on the management of hyperbilirubinemia in preterm infants during their neonatal hospitalization. This study aims to evaluate effects of G6PD screening on treatment of hyperbilirubinemia in infants <2000 g admitted to Neonatal Intensive Care Unit. Methods: All neonates <2000 g who were admitted to neonatal unit for 3 years (2013–2015) were retrospectively included in the study. Data related to risk factors and management of hyperbilirubinemia were collected and analyzed on these infants. A number of phototherapy units used for treatment, duration phototherapy, and level of bilirubin were compared between G6PD deficient and nondeficient infants and presented. Results: Included in this retrospective study were 621 infants. About half on included infants were < 1500 g. Gestational age groups as follow: ≤28 weeks, 23.3%; 29–32 weeks, 37.5%; 33–36 weeks, 33.6%; and ≥37 weeks, 5.6%. Prevalence of G6PD deficiency was 10.3%. The highest recorded serum bilirubin was significantly higher in G6PD deficient group compared with nondeficient one (161.6 μmol/l ± 57.5 vs. 145.4 μmol/l ± 46.4, P = 0.01). G6PD deficient infants were treated with more phototherapy than nondeficient group (85.9% vs. 64.5%, P < 0.001). G6PD deficient low birth weight neonates were more likely to receive intensive phototherapy. None of the G6PD deficient patients was treated with exchange transfusion. Conclusion: Prevalence of G6PD deficiency among low birth weight infant in the United Arab Emirates is similar to data reported in full-term infants. Screening for G6PD in preterm infant is associated with more treatment using phototherapy and may contribute in preventing severe hyperbilirubinemia.

Role of Vitamin D supplementation in patients with depressive disorders and hypovitaminosis D: A longitudinal study

Background and Aim: Available literature is inconsistent for the role of Vitamin D supplementation in depression. With scarcity of Indian data, we aimed to study Vitamin D deficiency in patients with depression, its association with time to remission and role of Vitamin D supplementation. Methods: A total of 158 outpatients with depressive disorders were consecutively assessed for Vitamin D deficiency, severity of depression, physical activity, and nutritional habits and followed-up for 1 year. Eighty-seven patients completed follow-up for 1 year (55% retention). Results: Mean serum Vitamin D level was 11.9 ng/ml and the majority of patients (85%) had Vitamin D deficiency (<20 ng/mL). Significant predictors of hypovitaminosis D were being female, unemployed or homemaker, from nuclear family and with a smaller height. Vitamin D deficient patients took significantly longer time in remission than nondeficient patients (2.86 months vs. 1.35 months, P= 0.006). Patients with Vitamin D deficiency received Vitamin D supplementation and subsequently their time to remission was comparable to nondeficient group. Conclusions: The majority of patients had Vitamin D deficiency, took a longer time to remission and reported improvement with Vitamin D supplementation. It signifies the importance of treating hypovitaminosis D for effective management of depression, to avoid delay in response, and incomplete remission.