Serum Calcium Levels In Patients Research Articles

Association between thymic hyperplasia and serum calcium level in Graves’ disease

BackgroundGraves' disease increases bone resorption in hyperthyroidism, leading to elevated serum calcium levels and a negative bone balance. Thymic hyperplasia is observed in some Graves' disease patients. What's more, there have been a few reports of increased serum calcium and severe osteoporosis induced by Graves’ disease with thymic hyperplasia. It remains unclear whether Graves’ disease with thymic hyperplasia is associated with higher serum calcium levels. Our study aimed to investigate the possibility of elevated serum calcium levels and aggravated bone mobilization in Graves’ disease patients with thymic hyperplasia.MethodsNewly diagnosed and untreated patients with Graves' disease (n = 96) were enrolled. They were divided into two groups based on the incidental detection of thymic hyperplasia during imaging. Albumin, alkaline phosphatase, calcium, free triiodothyronine, free thyroxine, thyroid-stimulating hormone, and thyrotrophin receptor antibody (TRAb) were measured, and a computerized tomography of the chest was obtained.ResultsPatients with Graves’ disease who had thymic hyperplasia were notably younger (P=0.018) and exhibited higher serum calcium levels (P=0.001) compared to those with Graves’ disease without thymic hyperplasia. In the multiple regression analysis, thymic hyperplasia, TRAb, and female gender were significant variables associated with elevated serum calcium levels in patients with Graves' disease, collectively accounting for 31.7% of the variation in serum calcium.ConclusionsGraves’ disease patients with thymic hyperplasia showed higher serum calcium levels. thymic hyperplasia, TRAb, and female gender were found to be correlated with increased serum calcium levels in Graves’ disease, suggesting a potential association between thymic hyperplasia and bone mobilization in Graves’ disease.

A New Calculation Model for Calcium Requirements After Parathyroidectomy in Patients With Secondary Hyperparathyroidism.

We aimed to develop a new calculation model for calcium requirements in dialysis patients following parathyroidectomy. A total of 98 patients with secondary hyperparathyroidism receiving parathyroidectomy from January 2014 to January 2022 were enrolled in this study. Among these patients, 78 were randomly selected for construction of the calcium requirement calculation model, and the remaining 20 patients were selected for model validation. The calcium requirement model estimated the total calcium supplementation for 1 week after surgery using variables with significant relationships in the derivation group by stepwise multiple linear regression analysis. Bias, precision, and accuracy were measured in the validation group to determine the performance of the model. The model was as follows: calcium requirement for 1 week after surgery=33.798-8.929×immediate postoperative calcium+0.190×C-reactive protein-0.125×age+0.002×preoperative intact parathyroid hormone+0.003×preoperative alkaline phosphatase (R2=0.8). The model was successfully validated. We generated a novel model to guide calcium supplementation. This model can assist in stabilizing the serum calcium levels of patients during the early postoperative period. Furthermore, it contributes to the individualized and precise treatment of hypocalcemia in patients following parathyroidectomy.

ODP102 Indicators for the effects of calcimimetics on hypercalcemia in the elderly patients with primary hyperparathyroidism.

Abstract Primary hyperparathyroidism (PHPT) is the most common disorder causing hypercalcemia, in which parathyroid hormone (PTH) is excessively secreted from a parathyroid tumor. PHPT occurs mainly in elderly women, and patient with PHPT present symptoms including nephrolithiasis, bone fracture, and cognitive impairment or can be asymptomatic. Excessive secretion of PTH leads to elevated serum levels of alkaline phosphatase as well as calcium and decreased serum inorganic phosphate level. Parathyroid surgery is the only established treatment, and the treatment reduces elevated serum levels of calcium and PTH, increases bone mineral density, reduces the occurrence of bone fractures, and decreases the risk of renal stones. However, some PHPT patients, especially elderly patients, refuse to undergo surgical therapy for various reasons including perceived risk. Calcimimetic treatment, including cinacalcet and evocalcet administration, has also been reported to be effective for reducing serum calcium level in patients with PHPT. However, the relationship between the efficacy of calcimimetic treatment for PHPT and patient characteristics related to the effectiveness of calcimimetics remains to be elucidated. To investigate the relevance of clinical parameters to the effectiveness of calcimimetics for PHPT, we retrospectively analyzed patients with PHPT who received calcimimetic treatment in our department. We included nine patients including 8 females (88.9%) and one male (11.1%) in the study. The median age of the patients was 81 years (interquartile range (IQR): 61-86 years). Laboratory tests before calcimimetic treatment revealed that median level of serum corrected calcium (cCa) was high (11.1 (IQR: 10.5-12.7) mg/dL), serum inorganic phosphate was low (2.3 (2.3-2.4) mg/dL), and plasma intact PTH was high (251. 0 (198.3-498.5) pg/mL). The fractional excretion of calcium was higher than 1% (1.3% (1.12-1.48%)), %tubular reabsorption of phosphate was low (79.9% (77.1-83.9%)), nephrogenous cyclic adenosine monophosphate (cAMP) was high (3.4 (2.4-4. 0) nmoL/dL GF), and urinary cAMP was normal (4.3 (4. 0-5.3) μmoL/day). Median reduction rate of serum cCa level due to calcimimetic treatment was 5.8% (0-13.4%) at the first follow-up (median treatment duration: 22 (20-29) days). Notably, reduction rate of serum cCa level had significant correlations with age (R=0.95), dual energy X-ray absorptiometry % young adult mean (DEXA %YAM) in the femoral neck (R=-0.92), and urinary cAMP level (R=-0.85). Thus, the present study suggested that elevated serum cCa levels may be reduced by treatment with calcimimetics more effectively in PHPT patients of relatively advanced age, patients with low DEXA %YAM, and patients with low urinary cAMP. Presentation: No date and time listed

Evaluation of serum calcium levels in patients with COVID-19 in Shahid Sadoughi Hospital in Yazd

COVID-19 produced by SARS-CoV-2 is still distributing and its dangerous cases are related to electrolyte disorders such as calcium levels disturbance. The aim of current study was to investigate serum calcium levels in patients with COVID19 in Shahid Sadoughi Hospital of Yazd. In this cross-sectional study, COVID-19 patients admitted to Shahid Sadoughi Hospital in Yazd from March 2019 to March 2020 were studied. The following data were extracted from patients' records: age, sex, time elapsed from onset of symptoms to hospitalization, severity of COVID-19, serum calcium level at hospitalization, and disease outcome (recovery or death). The serum calcium level mean of patients was 8.2 ±0.7 mg/dl. Most patients had hypocalcemia. Patients who died had lower serum calcium levels than patients who recovered. Therefore, hypocalcemia is common in hospitalized COVID-19 patients and is associated with mortality.

Surgical Treatment for Empyema Thoracis: Prognostic Role of Preoperative Transthoracic Echocardiography and Serum Calcium.

Background: Empyema is a major cause of mortality and hospitalization. Symptoms include difficulty breathing and chest pain. Calcium plays an essential role in the physiology of the cardiovascular system. However, there is little evidence on the role of echocardiography and the serum calcium levels of patients undergoing video-assisted thoracoscopic surgery (VATS) for empyema. This study aimed to investigate the risk factors for postoperative mortality in patients with empyema who required surgery. Methods: This single-institution retrospective study compared the outcomes of VATS for thoracic empyema (in terms of survival and mortality) in 122 patients enrolled between July 2015 and June 2019. Results: This study examined patients with thoracic empyema. The majority of the patients were males (100/122, 81.9%). The in-hospital/30-day mortality rate was 10.6% (13 patients). The calcium levels were 7.82 ± 1.17 mg/dL in the survival group and 6.88 ± 1.88 mg/dL in the mortality group (p = 0.032). In the mortality group, the utilization of echocardiography and serum calcium levels independently contributed to the risk prediction more than clinical variables. Patients in our cohort exhibited elevated pulmonary artery systolic pressure (PASP) and hypocalcemia, which were associated with increased postoperative mortality. Conclusion: Elevated PASP and calcium levels at the low end of the normal range demonstrated significant prognostic value in predicting mortality in patients with thoracic empyema who required surgical intervention. Recognizing this potential is critical in order to obtain better outcomes.

Effectiveness of a Nutritional Mobile Application for Management of Hyperphosphatemia in Patients on Hemodialysis: A Multicenter Open-Label Randomized Clinical Trial.

This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed.

Association between Serum Calcium Level and Hemorrhagic Progression in Patients with Traumatic Intraparenchymal Hemorrhage: Investigating the Mediation and Interaction Effects of Coagulopathy.

In this study, we investigate the association of serum calcium with coagulopathy and hemorrhagic progression contusion (HPC) in patients with traumatic intraparenchymal hemorrhage (tIPH), and further explore the interaction and mediation effect between serum calcium and coagulopathy on HPC. We conducted retrospective analyses of patients with tIPH admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2016 to December 2019. The clinical data, coagulation parameters, and serum calcium levels were collected for further analysis. Multi-variate logistic regression analysis was applied to identify the association of serum calcium level with coagulopathy and HPC. Causal mediation analysis (CMA) and additive interaction model were used to estimate the interaction and mediation effect between serum calcium as well as coagulopathy on HPC. Additionally, we repeated the analysis using corrected calcium. A total of 473 patients were included in this study. Of these, 54 (11.4%) patients had hypocalcemia at admission, 105 (22.2%) presented with coagulopathy, and 187 (39.5%) experienced HPC. Admission serum calcium level in patients presented with coagulopathy and HPC were 8.84 (interquartile range [IQR]: 8.44-9.40] and 8.92 (IQR: 8.48-9.40) mg/dL respectively, which were significantly lower than that of patients without coagulopathy (9.10 [IQR: 8.68-9.88] and 9.12 [IQR: 8.72-9.89] mg/dL; all p < 0.001). Multi-variate logistic regression analysis identified that hypocalcemia emerged as an independent risk factor for coagulopathy and HPC. However, no significant interaction was detected between hypocalcemia and coagulopathy. CMA showed that the mediator coagulopathy explained 24.4% (95% confidence interval: 4.7-65.0%; p = 0.006) of the association between hypocalcemia and HPC. Moreover, comparable results were held using corrected calcium, as well. Admission serum calcium level is associated with the HPC for patients with tIPH and this relationship is partially mediated by coagulopathy, but no significant interaction is detected. Further studies are needed to validate the findings and explore its mechanisms.

Evaluation of serum calcium differences in hypertensive crises and control patients: A randomly matched case-control study.

The role of calcium in blood pressure has been widely studied among hypertensive patients; however, no study has explored the role of calcium in hypertensive crises. The primary objective of this study is to evaluate the differences in serum calcium levels between hypertensive crises patients and a 1:1 random matched controls (age‐, sex‐, race‐, diabetes, and body mass index matched). This study is a single‐center, retrospective, chart review, case‐control study of patients with hypertensive crises (case group) and patients without hypertensive crises (control group). Patients were included in the case group if they were 18 years of age or older with hypertensive crises and have a documented calcium level. The control group patients were required to be 18 years of age or older, have a documented calcium level, and have no diagnosis of hypertensive crises. The primary outcome of the study was to compare the mean serum calcium in patients with hypertensive crises vs patients without hypertensive crises. Five hundred and sixty‐six patients were included in the study: 283 patients in both the case group and control group. The primary outcome results showed that serum calcium concentration was not significantly different between the case group (8.99 ± 0.78 mg/dL) and control group (8.96 ± 0.75 mg/dL) (P = .606). This study found no significant difference in serum calcium levels in patients with hypertensive crises compared to a random matched control group. Larger observational or experimental studies may be useful to evaluate the effect of calcium on blood pressure in hypertensive crises.

Evaluation of Serum Calcium Levels in Patients with Epileptic Seizure

ABSTRACT Introduction Epilepsy is a disorder of the central nervous system, characterized by an epileptic seizure. Epileptic seizures occur due to abnormal synchronous activity in the brain. Calcium is an essential component of bone. Hypocalcemia enhances neuronal excitability, and there are many causes of which include hypocalcemia, vitamin D deficiency, and PTH resistance. Materials and methods The study was conducted in Department of Biochemistry in association with the Department of Neurology of Mahatma Gandhi Medical College and Hospital, Jaipur. Fifty patients diagnosed for epileptic seizure and 50 controls, visiting the inpatient department (IPD) and outpatient department (OPD) of Neurology fulfilling the inclusion criteria, were enrolled for the study. Result The present study showed significantly lower level of serum calcium in patients with epileptic seizure when compared to controls. Conclusion The serum calcium was measured between epileptic seizure and controls. Our present study showed significantly lower value of calcium. It is therefore suggested that there should be regular screening for calcium in patients with epileptic seizure. The serum calcium is biomarker of bone metabolism; so, the correlation can be further studied with some more bone metabolism markers in epileptic seizure patients. How to cite this article Sharma S, Fiza B, Tiwari SK, et al. Evaluation of Serum Calcium Levels in Patients with Epileptic Seizure. J Mahatma Gandhi Univ Med Sci Tech 2020;5(2):35–37.

A Case of Resistant Hypocalcemia Treated with Teriparatide

Postsurgical chronic hypoparathyroidism is most commonly seen in adults. Synthetic recombinant human parathyroid hormone (rhPTH) 1-34 can be used to stabilize serum calcium levels in patients with resistant hypocalcemia in rare conditions. &#x0D; Here we report a 52-year-old woman with postsurgical uncontrolled hypocalcemia despite the usual therapy. Once-daily treatment with PTH 1-34 maintained serum calcium within the normal range and reduced the dose of previous medical therapies.

Prognostic Significance of Baseline Serum Calcium Levels in Patients with Acute Coronary Syndrome- An Observational Study

Introduction: The risk stratification is very important for the management of patients with Acute Coronary Syndrome (ACS). Extraskeletal calcium plays a critical role in a range of biological processes. There is an urgent need to accurately identify, the additional factors which are important in the clinical course and outcome of patients of ACS. Aim: To evaluate impact of baseline serum calcium levels in patients with ACS and to determine prognostic significance of baseline serum calcium levels in patients with ACS. Materials and Methods: The present observational study was conducted on 100 patients of ACS, over a period of one year from December 2018 to December 2019 at Acharya Shri Chander College of Medical Sciences, Sidhra, Jammu and Kashmir, India. They were divided into three tertile ranges as: hypocalcaemic (&lt;8.1), normocalcaemic (8.1-10.4), hypercalcaemic (&gt;10.4). The clinical outcome was measured in terms of Left Ventricular Ejection Fraction (LVEF) development of acute pulmonary oedema, rates of emergency revascularisation, development of arrhythmias, recurrence of chest pain, mortality within 7 days of admission, readmission rates with reinfarction or any other cardiovascular complication and finally, mortality within 90 days of follow-up. Quantitative variables were compared using ANOVA/Kruskal Wallis Test between the three groups. Results: The mean age of the study population was 73.29±8.11 years. Baseline calcium on admission was found to be &lt;8.1 mg/dL in ACS patients and more common in males, older age group, patients with higher Body Mass Index (BMI) and was associated with worse prognosis as compared to those with normal serum calcium levels. Mortality within 90 days of follow-up occurred in 42.86%, 20% and 6.25% in unstable angina and 39.29% 11.76% and 13.33% in AMI in hypocalcaemic, normocalcaemic and hypercalcaemic groups, respectively. It is inferred that 64% of the patients in hypocalcaemia tertile (n=14) were males in unstable angina and overwhelming 78.57% in AMI. Conclusion: Hypocalcaemia (corrected calcium &lt;8.1 mg/dL) is common in patients of ACS and a predictor of adverse outcomes.

Serum Calcium Levels Before Antitumour Therapy Predict Clinical Outcomes in Patients with Nasopharyngeal Carcinoma.

PurposeThe prognostic value of serum calcium levels in nasopharyngeal carcinoma (NPC) remains unknown. This study aimed to evaluate the prognostic value of serum calcium levels in patients with NPC.Patients and MethodsA total of 2094 patients diagnosed with NPC between April 2009 and September 2012 were enrolled in this retrospective analysis. The median follow-up time was 96.3 months (range: 4.1–120.0 months). Univariate and multivariable Cox proportional hazards models were used to identify significant and independent prognostic predictors of overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and relapse-free survival (RFS).ResultsOverall, low serum calcium levels were detected in 1109/2094 (53.00%) patients and tended to be more frequently detected in older (P<0.001) and female (P=0.001) patients. Patients with low serum calcium levels had poorer OS (P=0.011), DFS (P=0.012) and DMFS (P=0.004) than those with high serum calcium levels, but serum calcium levels had no significant effect on RFS (P=0.376). In univariate and multivariable analyses, low serum calcium levels were a statistically significant and independent prognostic factor for OS, DFS, and DMFS but had no prognostic value for RFS.ConclusionSerum calcium levels can serve as a prognostic predictor and guide more individualized treatment for NPC patients.

Status of Serum Level of Vitamin D3 and Its Correlation with Serum Calcium Level in Patients Referred to Sarem Hospital in Tehrantal in Tehran

Status of Serum Level of Vitamin D3 and Its Correlation with Serum Calcium Level in Patients Referred to Sarem Hospital in Tehrantal in Tehran

Vitamin-D Level in Patients with Type-2 Diabetes Mellitus of different Age and Sex: its Effects on BMI, Calcium Level

Background: Type II diabetes is one of vital health problems in Pakistan. Type 2 diabetic patients are more prone to developVitamin-D deficiency and hypocalcaemia however, the effect of age, sex, ethnicity, BMI and socioeconomic status also has a role inaffecting the outcomes. The aim of this study was to compare Vitamin-D level in patients with type-2 Diabetic Mellitus of differentage and sex and to determine the association of vitamin-D level with BMI, calcium and blood sugar level.Objectives: The main objective of this study was to determine and compare the changes in Vitamin- D and serum calcium level inpatients with type- 2 diabetes mellitus with respect to their Body Mass Index (BMI), age, sex and ethnic groups.Material and Methods: This was a cross-sectional analytical study, carried out in the outpatient department of endocrine unit ofHayatabad Medical Complex, Pakistan from 1st July 2018 to 31st august 2018. Using convenient sampling technique, patients withknown cases of Type II diabetes mellitus of all age groups, regardless of gender, ethnic group were consented to be part of thestudy. Patients taking vitamin D and calcium supplements and patients with renal and liver diseases were excluded. For vitamin Dand Calcium concentration 5 ml blood was taken. Data was recorded on a structured Proforma and entered into SPSS version22.0. For comparison student's t-test was used while Pearson correlation was used for determining the association betweenvitamin-D, BMI, blood sugar level and calcium concentration, where P-value &lt;0.05 was considered as significant.Results: A total of 238 individuals with mean age of 51.24 ± 7.7 out of whom 103(49.2%) were males and 121(50.8%) werefemales. The mean vitamin-D concentration was 17.86 ± 15.3 ng/ml and mean calcium level was 8.50 ± 0.6 mg/dL respectively.Regarding vitamin D deficiency males were more affected as compared to females (p=0.04). However in case of calciumconcentration there was no significant difference (p=0.17). The relationship observed between blood sugar level and vitamin D wasweakly inverse (r =-0.035, P = 0.5). However the inverse relationship of sugar level and calcium was significant (r=-0.135, p=0.01).Conclusion: Type-II diabetes mellitus leads may lead to low calcium levels where males are more prone to be affected. Thiscondition aggravates with increase in age. This study basically concludes that vitamin-D deficiency in inversely associated withtype-2 diabetes.

Evaluation of bone mineral density and 25-(OH) vitamin D levels in middle-aged and elderly women with recurrent benign paroxysmal positional vertigo

Background: Middle-aged and elderly perimenopausal women are prone to developing BPPV without definite cause. Objectives: This study aimed to investigate the correlation between bone mineral density (BMD), 25-(OH) vitamin D, and serum calcium levels in patients with benign paroxysmal positional vertigo (BPPV) in middle-aged and elderly women.Material and methods: A total of 103 women with two or more recurrent BPPV episodes (group A) and 80 age-matched healthy controls (group B) were recruited. All subjects had BMD and serum 25-(OH) D levels measurements taken, and the results were compared.Results: BMD was reduced in group A, and the proportion of osteoporosis was higher than in group B (p = .039). The BMD T-score and 25-(OH) vitamin D level were lower in group A than in group B (p = .004 and p < .0001, respectively). In group A, the BMD T-score was lower (p = .017) and serum 25-(OH) vitamin D level was higher (p < .0001) in premenopausal women than in menopausal women.Conclusions and Significance: Our study found that middle-aged and elderly women with recurrent BPPV, especially postmenopausal women, may present decreased BMD and serum vitamin D levels.

Fetal Hemoglobin, Serum Total Cholesterol, Plasma Phosphate and Serum Calcium Levels in Patients with Leukemia and Lymphoma

In this study, fetal hemoglobin (HbF), blood total cholesterol, phosphate and calcium levels of leukemia and lymphoma cases in Mandalay were determined. It was a cross-sectional, comparative study. Thirty adult cases of leukemia and lymphoma and equal number of control subjects of comparable age (14 to 80 yrs) and sex were studied. Mean HbF of leukemia group (n=9), acute myeloid leukemia (AML) subgroup (n=6) and controls (n=30) were 2.72±0.47%, 3.17±0.69% and 1.39±0.25% of total Hb, respectively. The HbF levels of leukemia group and AML were significantly higher than that of controls (p&lt;0.02). Mean serum total cholesterol levels of leukemia group, AML subgroup and controls were found to be 126.5±17.38 mg%, 137.96±24.66 mg% and 177.18±7.68 mg%, respectively. Cholesterol levels of leukemia group and AML were lower than that of controls. Mean plasma phosphate levels of leukemia and lymphoma cases (n=30), leukemia group (n=9) and lymphoma group (n=21) were 1.21±0.07 mmol/l, 1.33±0.17 mmol/l and 1.15±0.06 mmol/l, respectively. Mean phosphate level of controls was 0.94 mmol/l. Plasma phosphate levels of the whole cases and individual case groups were significantly higher than that of controls (p&lt;0.001). Mean serum calcium levels of the whole cases, leukemia group and lymphoma group were 10.16±0.36 mg%, 10.03±0.75 mg% and 10.21±0.45 mg%, respectively. Mean serum calcium level of controls was 8.55±0.14 mg%. Serum calcium levels of the whole cases and individual case groups were found to be significantly higher than that of controls (p&lt;0.01). The study showed that not only raised HbF but also hypocholesterolaemia might be the diagnostic clues in leukemia cases. Recognition of blood phosphate and calcium changes leads to appropriate therapy and a reduction of morbidity.

Correlation of Vitamin D and Calcium Levels in Children in New Diagnosed Epilepsy and Minimal 6 Months After Therapy

INTRODUCTION. Children with epilepsy should take long-term anti-epileptic drugs. Long-term use of anti-epileptic drugs can reduce vitamin D levels. Low vitamin D will lead to low blood calcium levels. This study aims to analyze the relationship between vitamin D and calcium levels in newly diagnosed epileptic children and ≥6 months after therapy. METHOD. These was an analytical observational study with cross sectional research design. The vitamin D examination instrument uses the ELFA method (enzyme linked fluorescent assay) with the Vidas instrument from bioMerieux. Samples were collected during June - August 2018 from Inpatient and Outpatient Clinics. The samples were divided into new diagnosis of epilepsy group and 6 months after therapy group. Each group was measured for vitamin D and serum calcium levels. The relationship between the two parameters were analyzed using T-Test independent. RESULTS. From the 19 new diagnosis of epilepsy, there were 57.9% low vitamin D and 10.5% low calcium levels. From the 20 subjects 6 months after therapy, 70% low vitamin D and 25% low calcium levels. There were a relationship between vitamin D and calcium levels in patients with newly diagnosed and ≥6 months after therapy. DISCUSSION. Low vitamin D and low calcium levels were found more in the anti-epileptic therapy group than the new diagnosis group of epilepsy. Low vitamin D levels can be caused by the use of long-term antiepileptic drugs that will affect serum calcium levels. CONCLUSION. This study showed a significant relationship between vitamin D and serum calcium levels in patients with newly diagnosed epilepsy and 6 months after therapy. Vitamin D and calsium serum examination should be done in every patient who gets long term therapy of antiepileptic drugs. KEY WORDS. Vitamin D, calcium, epilepsy, ELFA.

Association between serum calcium levels and prognosis, hematoma volume, and onset of cerebral hemorrhage in patients undergoing hemodialysis

BackgroundHigh serum calcium levels should be avoided in patients on hemodialysis (HD) because they can induce cardiovascular diseases and worsen the patient’s prognosis. In contrast, low serum calcium levels worsen the prognosis of patients with cerebral hemorrhage in the general population. So far, whether serum calcium levels in patients on HD are associated with cerebral hemorrhage remains unknown. This study aimed to reveal the association between serum calcium and cerebral hemorrhage in patients on HD, including in-hospital death, volume of hematoma, and onset of cerebral hemorrhage.MethodsThis cross-sectional case-control study included 99 patients on HD with cerebral hemorrhage at a single center between July 1, 2007 and December 31, 2017. Controls included 339 patients on HD at a single HD center between July 1, 2011 and June 30, 2012. Data on serum calcium level, patient demographics, and comorbid conditions were collected, and associations between cerebral hemorrhage and subsequent death were evaluated by multivariate logistic regression analysis. Further, the association of these backgrounds and hematoma volume was evaluated by multiple regression analysis.ResultsOf the 99 patients, 32 (32%) died from cerebral hemorrhage. The corrected serum calcium level (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.43–4.35; P < 0.001) and antiplatelet drug use (OR, 3.95; 95% CI, 1.50–10.4; P = 0.005) had significant effects on the prognosis. Moreover, the corrected serum calcium (P = 0.003) and antiplatelet drug use (P = 0.01) were significantly correlated with hematoma volume. In the patients, the corrected serum calcium level (OR, 1.54; 95% CI, 1.07–2.22; P = 0.02) was associated with the onset of cerebral hemorrhage, as was pre-hemodialysis systolic blood pressure (per 10 mmHg) (OR, 1.40; 95% CI, 1.23–1.59; P < 0.001).ConclusionsAlthough the precise mechanisms remain unknown, a high serum calcium level is associated with cerebral hemorrhage in patients on HD. Thus, we should pay attentions to a patient’s calcium level.

Clinical Analysis of Serum Calcium Level in 86 Cases of Newly Diagnosed Multiple Myeloma

To investigate the serum calcium level in 86 patients with newly diagnosed multiple myeloma (MM) and its correlation with clinical features. The clinical data of 86 patients with newly diagnosed multiple myeloma in our hospital from 2009 to 2016 were retrospectively analyed. Clinical data of sex, age, hemoglobin, albumin, globulin, creatinine, uric acid, serum phosphorus, β2-microglobulin, immunophenotyping and disease staging were collected. After the serum calcium level was corrected, the patients were grouped into low serum calcium (<2.20 mmol/L), normal serum calcium (2.20-2.60 mmol/L) and high serum calcium (>2.60 mmol/L). The correlation between the clinical characteristics and the serum calcium level was analysed, the clinical characteristics between the low and non-low calcium group were compared. The number of cases in low, normal and high serum cnlcium groups before correction was 58 (67.4%), 18 (20.9%) and 10 (11.6%) respactively, while the number of cases in 3 group after correction was 34 (39.5%), 36 (41.9%) and 16 (18.6%) respectively. The age, globulin, creatinine, uric acid and serum phosphorus levels were positively correlated with serum calcium level in patients with multiple myeloma, while the sex, hemoglobin,albumin and β2-microglobulin levels did not correlated with serum calcium level. There was significant difference in the age, globulin, creatinine and serum phosphorus between low calcium and non-low calcium group (P<0.05). However the differences of sex, hemoglobin, albumin, uric acid, β2-microglobulin, immunophenotyping and clinical stage were not statistically significant (P>0.05). Multiple myeloma patients suffered from both hypercalcemia and hypocalcemia, and the incidence of hypocalcemia is not low. The levels of serum calcium in patients with multiple myeloma correlate with age, globulin, creatinine, uric acid, serum phosphorus level and other factors, thus it is necessary to correct the level of ionized calcium with physiological activity.

Serum calcium level in patients suffering from psoriasis and its correlation with severity of psoriasis: A case control study

Serum calcium level in patients suffering from psoriasis and its correlation with severity of psoriasis: A case control study