Total Serum Calcium Levels Research Articles

Management Practices, Perceived Constraints and Estimation of Biochemical Parameters in Indigenous Goats of Gwalior City of Central India

Aim: A study was conducted in order to analyze goat rearing practices prevailing in the Gwalior City of Central India and to identify the constraints in goat farming.
 Study Design: Data of ninety six indigenous goats of 2 to 5 age group from thirty respondents from the district was collected.
 Place and Duration of Study: The study was carried out in Gwalior City of Central India during July 2023.
 Methodology: The data pertaining to goat rearing practices being followed and constraints being faced were collected with the help of pre-structured interview schedule after ensuring its reliability and validity. To evaluate the nutritional status of the animals the blood sample of twenty four randomly selected female goats of 2 to 5 years of age was taken from Jugular vein for the normal biochemical profile.
 Results: It was observed that total protein and serum calcium level was significantly lower than normal value, while. Alkaline phosphates, SGOT and SGPT and blood urea levels are higher than the normal values.
 Conclusion: It is concluded that goats reared on extensive system of rearing have poor reproductive performance (higher age at first kidding and kidding interval and low twinning rate) due to lack of scientific management and feeding practices by goat farmers of Gwalior City of Central India

STUDY TO KNOW THE EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVEL IN NEONATAL HYPERBILIRUBINEMIA

Background: Phototherapy is the most common method to treat neonatal jaundice. The effect of phototherapy on serum calcium levels is a questionable issue. Objective: To study to know the effect of phototherapy on serum calcium level in neonatal hyperbilirubinemia. Methods: Cohort study compared total serum calcium level before and after phototherapy in neonates with hyperbilirubinemia. Study was conducted on 54 neonates with high total serum bilirubin levels, according to the Bhutani curve and was treated with phototherapy at neonatal intensive care unit in the Department of Pediatrics at Mayo Institute of Medical Sciences from November 2021 to April 2022. Results: Hypocalcaemia was observed in 33.33% of neonates after phototherapy. The difference between pre- and post-phototherapy serum calcium levels was found to be statistically significant (p<0.005). Conclusion: Hypokalcemia has a significant association with phototherapy.

Association of Vitamin D and Calcium Levels with Thyroid Status in the Southern Region of Saudi Arabia

Thyroid dysfunction is the most prevalent endocrine disorder worldwide. Thyroid hormone has a crucial role in maintaining a wide array of metabolic homeostasis. In addition to calcium and bone metabolism, vitamin D influences nonskeletal activities, including the thyroid gland. Therefore, hypovitaminosis D is considered a risk factor for the emergence of many thyroid dysfunctions. In this investigation, we aimed to investigate the association of vitamin D and serum calcium levels with thyroid dysfunction. In this investigation, 2,735 (1,438 females and 1,297 males) laboratory findings from the public, government hospital laboratories, and medical clinics serving chronic patients in the south region (Asir region) of Saudi Arabia were screened over the course of one year. The vitamin D level was significantly lower in both female and male patients in the hypothyroidism category than in the hyperthyroidism and euthyroidism groups. The influence of total serum calcium level was not significant in any thyroid dysfunction category. A high prevalence of normal levels of total serum calcium was observed in all thyroid status groups. A partial correlation between total serum calcium and vitamin D and TSH among thyroid dysfunction patients demonstrated a significant negative correlation between vitamin D and TSH and a nonsignificant negative correlation between total serum calcium level and TSH among hypothyroidism categories. However, in the hypothyroidism group, total serum calcium demonstrated a negative correlation with TSH, while vitamin D showed a positive correlation with TSH.

Nutritional status of chronic kidney disease patients undergoing hemodialysis in Colombo, Sri Lanka

Introduction: Malnutrition is a common condition among patients receiving hemodialysis and one of the principal indicators of mortality and morbidity.Objectives: The main aim of the study was to assess the nutritional status of hemodialysis recipients.Methods: A cross-sectional study was conducted on fiftyfive patients in two nephrology clinics in Colombo. Data were collected under four categories; an interviewer administered questionnaire, anthropometric measurements, biochemical investigations and derived calculations. Urea reduction ratio and Kt/V were calculated to assess the dialysis efficiency. Nutritional Risk Index was employed to evaluate the malnutrition risk.Results: In the study population, 70.9% were males and mean age, mean dialysis duration were recorded as 56.05±13.16 years and 13±12 months respectively. According to BMI, 10.9% of the patients were underweight, 38.2%; normal, 14.5%; overweight and 36.4% were obese. Low levels of serum albumin, total protein, iron and hemoglobin were reported among 30.9%, 14.5%, 41.8% and 89.1% of patients respectively. More than 50% of the population had an increased CRP level, depicting an inflammatory reaction. Mean URR and Kt/V of the population were 65.8±9.6% and 1.3±0.3 respectively, which were above the recommended level. Malnutrition risk was negatively correlated with serum total calcium level (r=-0.49, p<0.001), total protein level (r=-0.415, p<0.05), dialysis duration (r=-0.351, p<0.05), diastolic blood pressure (r=-0.35, p<0.05) and MUAC (r=-0.332, p<0.05) and positively correlated with absolute lymphocyte count (r=0.332, p<0.05).Conclusion: Majority of the patients had an efficient dialysis session. High, moderate and low risk of malnutrition were analyzed as 7.3%, 29.1% and 63.6%. In a binomial logistic regression, total calcium level (p<0.001, Exp(B); 0.027) and appetite of patients (p=0.04, Exp(B);13.816) were identified as strong predictors of malnutrition risk.

Maternal Calcium and Vitamin D Deficiency and Their Relation with Fetal Neural Tube Defects

Background: NTDs are major birth defects associated with significant fetal loss, mortality, morbidity, and healthcare costs. Although periconceptional folic acid supplementation has reduced their occurrence, NTDs remain a global concern. Recent studies have suggested a possible link between low maternal serum calcium and vitamin D levels and the development of NTDs. Objective: The objective of this prospective observational study was to investigate the relationship between maternal calcium and vitamin D deficiency during early pregnancy and the development of fetal neural tube defects (NTDs). Materials and Method: A total of 207 pregnant mothers in their first trimester were included in the study. Data on age, BMI, gestational age, and serum levels of total calcium and 25-hydroxyvitamin D were collected. Calcium deficiency was identified in 61 (29.5%) participants, while vitamin D deficiency was present in 139 (67%). Ultrasound scans between 18-22 weeks of gestation were conducted in 173 participants to search for fetal NTDs. Results: Among the study population, only 1 (0.6%) fetus was found to have an NTD on sonographic scan. The mother of this fetus exhibited both calcium and vitamin D deficiencies. However, statistical analysis did not reveal a significant relationship between maternal calcium and vitamin D deficiency and the development of fetal NTDs. Conclusion: Deficiency of calcium and vitamin D during early pregnancy does not appear to be associated with the development of fetal NTDs. Further research is needed to explore other potential risk factors for NTDs

Impact of exercise-induced irisin on bones of osteoporotic male rat model

This study aimed to evaluate the impact of exercise-induced irisin on bone mineral density (BMD), bone turnover and bone microarchitecture in normal and glucocorticoid-induced osteoporotic rats. Four groups of rats (10 rats each) were included in the study; group1 (control group), group 2 (normal exercised) which its rats underwent an exercise protocol, group 3 (osteoporotic rats) where Methylprednisolone was administered intravenously to the rats in order to induce osteoporosis. And group 4 (osteoporotic exercised rats), its rats underwent the same exercise protocol as group 2 after induction of osteoporosis by methylprednisolone. At the end of the study, BMD was measured then the rats were sacrificed and their serum levels of irisin, alkaline phosphatase (ALP), total calcium, serum C-terminal telopeptide of type I collagen (CTX1) were measured, Osteocalcin (OCN) and Osterix (OSX) mRNA in bone tissues were also assessed. Bone microarchitecture was also histologically examined. The study results revealed that exercise improved BMD, increased the levels of serum irisin, ALP, total calcium, (OCN) and (OSX) mRNA levels with decreased serum CTX1 levels. Furthermore there was significant difference in microarchitecture of bone in normal exercised and osteoporotic exercised rats as compared to control and osteoporotic rats, respectively. Moreover, significant positive correlations were found between serum irisin levels and each of BMD, OCN and OSX mRNA and osteocytes and osteoblasts numbers. Conversely, a negative correlation was found between serum irisin level and CTX1.In conclusion, this study highlighted irisin as a new target for preservation of bone in glucocorticoid-induced osteoporosis.

#3724 CHANGES IN CARDIOVASCULAR CALCIFICATION AFTER PARATHYROIDECTOMY IN DIALYSIS-DEPENDENT PATIENTS

Abstract Background and Aims Vascular calcification (VC) is common in patients with end stage kidney disease on dialysis and with secondary hyperparathyroidism (SHPT). There is a lack of knowledge regarding dynamics of VC after surgical treatment of SHPT. We aimed to evaluate evolution of coronary artery calcification (CAC) and abdominal aortic calcification (AAC) after parathyroidectomy (PTx) in dialysis patients with SHPT. Method The prospective cohort study included 33 dialysis-dependent patients (mean age of 50±13 years) with severe SHPT who underwent subtotal (n = 16) or total PTx with autotransplantation of parathyroid tissue (n = 17). Cardiac computed tomography scan (quantification of coronary calcium by Agatston method) and lateral lumbar X-ray (semi-quantitative Kauppila score) were used to assess prevalence of VC before and 18 months after surgery. Levels of serum total calcium, phosphorus, parathyroid hormone (PTH), and alkaline phosphatase (AP) before and 18 months after surgery were also evaluated. Results In our cohort median dialysis vintage before surgery was 71 [Q1-Q3: 29; 136] months, total serum Ca was 2.47±0.23 mmol/l, median PTH was 139 [Q1-Q3: 90; 161] pg/ml. Prevalence of CAC before PTx was 79% (n = 26), and 61% (n = 20) of patients had AAC. Of note, 54.5% of the patients had severe coronary calcification (>400 AU), while only 12% were considered to have severe calcification using Kauppila score (>12). We observed moderate positive correlation between CAC and AAC scores (Spearman's ρ = 0.699 [95% CI: 0.48; 0.84], р<0.0001). Both CAC and AAC scores correlated moderately with age of the patients (ρ = 0.57 [95% CI: 0.3; 0.76], р = 0.0002, and ρ = 0.64 [95% CI: 0.39; 0.8], р<0.0001, respectively), AAC had weak correlation with their dialysis vintage (ρ = 0.45 [95% CI: 0.14; 0.68], р = 0.005. Median of baseline CAC was 458 [Q1-Q3: 23; 1585] AU, after 18 months - 491 [Q1-Q3: 58; 1956] AU, no statistically significant differences were observed (p = 0.91, Wilcoxon test). We did not find statistically significant differences between median of Kauppila scores before and after PTx as well: 3 [Q1-Q3: 0; 10] and 2 [Q1-Q3: 0; 10], correspondingly, p = 0.17 (Wilcoxon test) – Fig. 1. As it can be seen from Fig. 1, dynamics of both CAC and AAC values before and after PTx varied markedly across subjects. To investigate the factors that can promote VC we divided patients into 2 groups based on dynamics of САС (as the most accurate assessment method) 18 months after surgery: group 1 with CAC progression of more than 50 AU (n = 9) and group 2 with regression or progression less than 50 AU (n = 24). Patients who had progression of coronary calcification by the end of the follow-up had higher age (59±11 vs 46±12 years in 2nd group, p = 0.0128) higher serum calcium levels (2.57±0.24 vs 2.29±0.32 mmol/l in 2nd group, p = 0.0267), and higher AP levels at follow-up (69.8 [Q1-Q3: 62.8, 96.0] vs 51.7 [Q1-Q3: 41.4; 57.1] U/ml in 2nd group, p = 0.003). Univariate analysis showed no significant differences between groups comparing dialysis vintage (p = 0.53), phosphate levels (p = 0.54), PTH levels (p = 0.32). In addition, CAC progression risk was not associated with type of surgery (total vs subtotal PTx RR = 1.11 [95% CI: 0.71; 1.8], OR = 1.48 [95% CI: 0.3; 5.7], p = 0.708). Conclusion Prevalence of vascular calcification in dialysis-dependent patients with severe SHPT is high. Progression of CAC by 18 months after PTx was associated with higher age of the patients, higher follow-up levels of serum total Ca and AP.

Overview of renal osteodystrophy in Brazil: a cross-sectional study.

The epidemiologic profile of renal osteodystrophy (ROD) is changing over time and cross-sectional studies provide essential information to improve care and health policies. The Brazilian Registry of Bone Biopsy (REBRABO) is a prospective, nationalmulticenter cohort that includes patients with chronic kidney disease (CKD) undergoing bone biopsy. REBRABO aims to provide clinical information on ROD. The main objective of this subanalysis was to describe the profile of ROD, including clinically relevant associations. From Aug/2015 to Dec/2021, 511 patients with CKD who performed bone biopsy were included in the REBRABO platform. Patients with no bone biopsy report (N = 40), GFR > 90 mL/min (N = 28), without asigned consent (N = 24), bone fragments inadequate for diagnosis (N = 23), bone biopsy indicated by a specialty other than nephrology (N = 6), and < 18 years old (N = 4) were excluded. Clinical-demographic data (e.g., age, sex, ethnicity, CKD etiology, dialysis vintage, comorbidities, symptoms, and complications related to ROD), laboratory (e.g., serum levels of total calcium, phosphate, parathormone, alkaline phosphatase, 25-hydroxyvitamin D, and hemoglobin), and ROD (e.g., histological diagnosis) were analyzed. Data from 386 individuals were considered in this subanalysis of REBRABO. Mean age was 52 (42-60) years; 198 (51%) were male; 315 (82%) were on hemodialysis. Osteitis fibrosa (OF) [163 (42%)], adynamic bone disease (ABD) [96 (25%)] and mixed uremic osteodystrophy (MUO) [83 (21%)] were the most frequent diagnosis of ROD in our sample; 203 (54%) had the diagnosis of osteoporosis, 82 (56%) vascular calcification; 138 (36%) bone aluminum accumulation, and 137 (36%) iron intoxication; patients with high turnover were prone to present a higher frequency of symptoms. A high proportion of patients were diagnosed with OF and ABD, as well as osteoporosis, vascular calcification and clinical symptoms.

Prevalence of hypocalcemia in term newborns requiring phototherapy

Background: Neonatal hyperbilirubinemia in the first week of life is one of the most prevalent clinical entity observed, affecting 60% of term-babies and 80% of preterm newborn babies, many requiring intervention in the form of phototherapy. The effect of phototherapy on serum calcium levels has not been studied much in Indian literature. The objectives of this study was to evaluate the prevalence of hypocalcemia in healthy, term newborn babies receiving phototherapy for unconjugated hyperbilirubinemia and to determine the association, if any between serum calcium and birth weight, postnatal age at start of phototherapy, weight at enrolment, gestational age at birth, maternal age and duration of phototherapy. Methods: This was a prospective observational study conducted over a period of 10 months among 80 term neonates admitted to the inpatient department at a tertiary care centre in Mumbai. Total serum calcium and ionised calcium levels were measured at the start of phototherapy and on stopping phototherapy/discharge. Data were analysed using statistical package for social sciences (SPSS) version 21 software. Results: Two (2.5%) out of the 80 neonates were found to have hypocalcemia after phototherapy with serum ionic calcium levels less than 1 mmol/l. Even though a larger proportion of neonates showed a decrease in the serum total calcium (56.25%) and serum ionic calcium (58.75%) levels after phototherapy, none of the neonates developed symptomatic hypocalcemia at those levels. A statistically significant association was found between maternal age in years with the serum total calcium levels after phototherapy and age at starting phototherapy (in hours) with the serum ionic calcium levels after phototherapy. Conclusions: The present study concludes that there is significant decrease in the levels of ionised calcium after phototherapy, however there was no significant decrease in the total serum calcium levels and none of the neonates were symptomatic. Hence, we do not recommend regular serum calcium monitoring in healthy term neonates receiving phototherapy and find no indication for the prophylactic use of calcium supplementation in these neonates.

Hypocalcemia on Admission Is a Predictor of Disease Progression in COVID-19 Patients with Cirrhosis: A Multicenter Study in Hungary.

Hypocalcemia is a common condition in liver cirrhosis and is associated with the severity of SARS-CoV-2 infection. However, there is a lack of data demonstrating the prognostic value of hypocalcemia in COVID-19 patients with cirrhosis. This study aimed to evaluate the prognostic value of hypocalcemia for COVID-19 severity, mortality and its associations with abnormal liver function parameters. We selected 451 COVID-19 patients in this retrospective study and compared the laboratory findings of 52 COVID-19 patients with cirrhosis to those of 399 COVID-19 patients without cirrhosis. Laboratory tests measuring albumin-corrected total serum calcium were performed on admission, and the levels were monitored during hospitalization. The total serum calcium levels were significantly lower in cirrhosis cases (2.16 mmol/L) compared to those without cirrhosis (2.32 mmol/L). Multivariate analysis showed that hypocalcemia in COVID-19 patients with cirrhosis was a significant predictor of in-hospital mortality, with an OR of 4.871 (p < 0.05; 95% CI 1.566-15.146). ROC analysis showed the AUC value of total serum calcium was 0.818 (95% CI 0.683-0.953, p < 0.05), with a sensitivity of 88.3% and a specificity of 75%. The total serum calcium levels showed a significant negative correlation with the Child-Turcette-Pugh score (r = -0.400, p < 0.05). Hypocalcemia on admission was a significant prognostic factor of disease progression in COVID-19 patients with cirrhosis.

Association of Total Serum Calcium Level with Obesity Markers (Body Mass Index and Waist Circumference) among Healthy Young Saudis

Background &amp; Objective: The pathophysiology of obesity and comorbid diseases may be associated with the levels of intracellular and extracellular calcium. This study aimed to investigate the association between overweight/obesity measures and the total serum calcium level in young Saudis. Methods: This was a cross-sectional observational study that involved 121 healthy young Saudi participants of both genders. Venipuncture was performed to obtain blood samples of 4 ml. Serum specimens were extracted and aliquoted into Eppendorf tubes, then preserved at a temperature of -20°C until the time of analysis. Anthropometric Measures (BMI and WC) were measured. SPSS software was used for statistical analysis. The measurement of total serum calcium was conducted through the utilization of a Human Diagnostics kit (Wiesbaden, Germany) on a hospitex Diagnostics Eos-bravo Autoanalyzer. The statistical analysis was conducted using the SPSS software. Results: The sample population consisted of 87.6% males, 27.3% smokers, 57% students, and 66.9% individuals with a university degree or higher. Nearly 50% of participants were 15–23 years old. Obese subjects had considerably lower total serum calcium than normal weight subjects. BMI and WC inversely correlated with calcium levels. Conclusion: The present study confirms the inverse relationship between total serum calcium level and obesity in the Saudi healthy population. Calcium supplementation could lower obesity-related chronic disease mortality and morbidity and hence reduce healthcare expenses and increases healthy life years. Keywords: calcium; obesity; overweight; waist circumference; body mass index; Saudi Arabia.

Pattern of biochemical markers of mineral and bone disorders in kidney transplant recipients: real-world data

There is a lack of studies providing comprehensive data on the prevalence of mineral and bone disorders (MBD) laboratory abnormalities after kidney transplantation in Russia. to obtain real-world data on the prevalence of the main mineral abnormalities among kidney transplant recipients and to revise their concomitant MBD therapy. This cross-sectional study included 236 patients with successful kidney transplantation. Their serum intact parathyroid hormone (iPTH), total calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) levels were measured. Only 6.2% of our cohort had all laboratory parameters within the target range, whereas persistent HPT along with hypercalcemia was noted in almost one third of the patients (31%). Normal iPTH levels were observed in 13% cases; 84% of the patients had hyperparathyroidism. The fraction of patients with target iPTH did not differ between the groups with normal and decreased estimated glomerular filtration rate (eGFR) (p=0.118). Hypercalcemia was observed in 29% cases. The serum P level varied significantly in groups with different eGFR (p&lt;0.0001), increasing with declining graft function. Furthermore, 40.7% of patients had ALP above the target range. While 123 patients received active vitamin D (alfacalcidol), 33 received monotherapy with inactive vitamin D (cholecalciferol). The control group consisted of 57 medication-naïve patients. The serum total Ca level varied significantly between the groups (p=0.0006), being higher in patients supplemented with cholecalciferol. The fraction of patients with normocalcemia was lowest in the cholecalciferol group (chi-square, р=0.0018). The prevalence of biochemical abnormalities after kidney transplantation is high. Alfacalcidol usage may be safer than using cholecalciferol to prevent hypercalcemia development.

Effect of Microdissection of Inferior Thyroid Artery on Post-operative Hypocalcemia in Total Thyroidectomy.

Hypocalcemia is one of the most common complication after bilateral thyroid surgery. Reported rates range from 5 to 35% and 0.5 to 4.4% for transient and permanent hypocalcemia respectively. Various methods have been devised to reduce the post-operative hypocalcemia and range from modification of surgical techniques to use of loops and avoidance of inadverant neck dissections. We conducted a randomised control trial of 50 patients divided into two groups, to evaluate the effect of microdissection and ligation of distal branches of inferior thyroid artery (group B) on incidence of temporary and permanent hypocalcaemia in patients of total thyroidectomy versus its ligation distally close to the thyroid capsule(group A). Postoperative mean total serum calcium levels were lower in group A as compared to group B (9.13mg/dl vs. 9.33mg/dl at 24h; 8.77 vs. 9.10 at 3rd day and 8.58 vs. 8.96mg/dl on 10 th day) with p > 0.05. The value of ionized serum calcium as recorded on 3rd day was 4.39mg/dl for group A and 4.72mg/dl for group B with p value ≤ 0.001 (Table 2). 19 patients in group A required calcium supplementation for 6months with incidence of transient hypocalcemia at 76% while 11 patients in group B had calcium supplementation for 6months with incidence of 40% and difference was significant statistically. Microdissection technique is better for preventing the temporary hypocalcemia and hence decreasing the hospital visits of the patient when compared to the ligation of inferior thyroid artery distally close to the thyroid gland. The incidence of permanent hypocalcemia doesn't varies significantly between both techniques.

TOTAL SERUM CALCIUM AND EUMELANISM IN JUVENILE BANK MYNA, ACRIDOTHERES GINGINIANUS (LATHAM)

A series of scarce minerals (Ca, Zn, Cu, Fe) obtained from the diet are known to act ascritical regulatory factors in the biosynthesis of eumelanin and phaeomelanin pigments in animals.Juvenile Bank myna is dull brown in colour, whereas adult is bluish grey coloured. A link has beenfound between degree of eumelanism, total serum calcium and bone weight in juvenile Bank mynawith increasing age. Gradual increase in total femur weight was corresponded by increasing degreeof eumelanin pigment and reduction in total serum calcium level.

Kadar Alkali Posfatase dan Kalsium Serum pada Kelompok Risiko Osteoporosis

This study aims to determine differences in the osteoporosis risk group's increase in ALP levels and total serum calcium. This type of research is an observational analytic using a cross-sectional design. The results showed that the ANOVA repeated measures (Bonferroni) test results for ALP levels obtained a P-value &gt; 0.05, and the total serum calcium level examination received ANOVA test results with a P-value &gt; 0.05. In conclusion, ALP levels and total calcium are not associated with osteoporosis risk groups such as age, sex, steroid use, and smoking habits.&#x0D; &#x0D; Keywords: Alkali Phosphatase, Degenerative, Calcium, Osteoporosis

Uric Acid in Primary Hyperparathyroidism: Assessment of Surgical versus Conservative Approach.

Introduction: Although suggested in early papers, the association between primary hyperparathyroidism (PHPT) and hyperuricemia is still debated, as is the potential benefit of parathyroidectomy compared to conservative treatment in serum uric acid (SUA) metabolism. Material and Methods: Our retrospective study of 125 Caucasian PHPT patients with surgical criteria evaluated between 2017 and 2021 at Elias Emergency and University Hospital, Bucharest, Romania aims to describe the characteristics of hyperuricemia in PHPT patients and to assess the differences in SUA levels between 38 surgically cured and 41 conservatively managed patients. Results: Our hyperuricemic PHPT patients (N=34) had significantly higher levels of calcium (11.55[11.05;12.42] vs. 11.2[10.8;11.96], p=.039) than the normouricemic subjects (N=91). At baseline, SUA correlated with age, serum total calcium (p=.004, r=.328), creatinine, triglycerides, and magnesium levels. A linear regression model identified calcium as a covariate with unique contribution for SUA variability. After successful parathyroidectomy, the 38 cured patients showed significantly lower serum calcium (9.3[8.7;9.75] vs. 11.55[11;12.12], p .001) and SUA (4.95[3.52;6.3] vs. 5.65[4.49;7.45], p=.011) levels compared to baseline. Conclusions: Hyperuricemic PHPT patients have significantly higher levels of serum calcium, which is also an independent determinant of SUA variability. Patients who undergo successful parathyroidectomies show a significant decrease in SUA during 1 year of follow-up.

Serum calcium levels as biomarkers of birth asphyxia in neonates

&lt;p&gt;Background and objective: Birth asphyxia is a common pathological condition seen in newborns with increased morbidity and mortality. Grave consequences following birth asphyxia require earlier recognition of the precipitating factors and prompt treatment in intensive care units. Multiple electrolyte imbalance has been related to this condition. This study aimed at determining the mean serum total calcium levels in neonates with birth asphyxia.&lt;/p&gt;&#x0D; &lt;p&gt;Methods: This cross sectional study was performed at the neonatal intensive care unit of the Pediatric Department of Fauji Foundation Hospital, Rawalpindi, Pakistan over a period of 6 months. A total of 100 full-term neonates of either gender with evidence of birth asphyxia of any stage were enrolled on their first hour of birth. Serum calcium levels were estimated in each neonate at 24 hours after birth.&lt;/p&gt;&#x0D; &lt;p&gt;Results: A total of 60 (60%) neonates were males. Mean serum calcium levels were found to be 7.64 mg/dl &amp;plusmn; 0.59 with no significant difference among males and females (7.67 &amp;plusmn; 0.64 and 7.59 &amp;plusmn; 0.50 mg/dl, respectively). Neonatal distribution in Stages I, II, and III was 64 (64.0%), 23 (23.0%), and 13 (13.0%), respectively. Hypoxic-ischemic encephalopathy stage stratification with mean serum calcium levels with higher stages deciphered significant correlation (7.89 &amp;plusmn; 0.54, 7.36 &amp;plusmn; 0.28, and 6.88 &amp;plusmn; 0.28 mg/dl, respectively, in stage I, II, and III).&lt;/p&gt;&#x0D; &lt;p&gt;Conclusion: Markedly decreased levels of mean serum calcium were seen in higher hypoxic stages with ischemic encephalopathy hence delineating a linear correlation with the onset and progression of disease.&lt;/p&gt;

Relationship between serum ferritin and parathyroid function in adult male patients with transfusion dependent thalassemia

Background: Thalassemia is a genetic disorder of defective hemoglobin synthesis. In transfusion dependent thalassemia (TDT), iron overload is caused by repeated blood transfusion for a long time. This increased iron is deposited in body tissue and may lead to endocrine dysfunction. Objective: To evaluate the relationship between serum ferritin and parathyroid dysfunction in adult male patients with TDT. Methods: It was a cross sectional study which was conducted from March 2018 to February 2019 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. For this study, 35 TDT male patients aged 18 to 40 year, were considered as study group and 35 age and sex matched apparently healthy subjects were considered as control group. The outpatient department of Hematology and Transfusion Medicine was the point of collection of study group. Parathyroid function was assessed by plasma intact para thyroid hormone (iPTH), serum total calcium and serum inorganic phosphate. Plasma iPTH and serum ferritin levels were estimated by Electrochemiluminescence Immunoassay method using automated analyzer. Serum total calcium and serum inorganic phosphate levels were estimated by colorimetric method using automated analyzer. Independent sample t test and Pearson’s correlation coefficient (r) test were applied for statistical analysis using SPSS version 16. Results: In this study, serum ferritin level was significantly (p &lt;0.001) higher in patients with TDT than that of healthy control. Correlation analysis showed negative correlation of serum ferritin with plasma iPTH and serum corrected calcium and positive correlation with serum inorganic phosphate in patients with TDT. Among them correlation with serum corrected calcium and inorganic phosphate were statistically significant (p &lt;0.05). Conclusion: This study concluded that TDT may be associated with elevated iron status which is inversely related with parathyroid function. J Bangladesh Soc Physiol. 2022, June; 17(1): 1-5

A case report of hypocalcemia after chemotherapy with albumin‐bound paclitaxel

AbstractHypocalcemia is a fatal electrolytic disorder defined as corrected serum total calcium levels &lt;2.12 mmol/L (8.5 mg/dl). Drug‐induced hypocalcemia is uncommon. A female patient was admitted to Jiangsu Cancer Hospital and diagnosed with nasopharyngeal carcinoma; she developed hypocalcemia after chemotherapy with albumin‐bound paclitaxel. Its diagnosis is incredibly difficult. Confirmatory diagnosis depends on serum total calcium levels and electrocardiogram.

PSAT183 Severe Hypocalcemia Precipitated by COVID-19 Infection in a Patient with Albright Hereditary Osteodystrophy and Pseudohypoparathyroidism

Abstract Background Hypocalcemia is a common endocrine manifestation of COVID 19 infection. We present a rare case of severe hypocalcemia in a patient with a history of Pseudohypoparathyroidism (PHP) type 1A after COVID-19 infection. PHP is a genetic disorder that presents with hypocalcemia, hyperphosphatemia, and secondary hyperparathyroidism due to marked target-organ unresponsiveness to parathyroid hormone (PTH). PHP type 1A also has a characteristic somatic phenotype known as Albright Hereditary Osteodystrophy (AHO), including short stature, brachydactyly, shortened metatarsals, and often reduced intelligence. Case Presentation This is a 53-year-old female with PHP type 1A, diabetes mellitus type 2, hypothyroidism, vitamin D deficiency, mild intellectual disability, and hypertension. She presented with new onset of seizures. She was also found to be positive for COVID-19 infection. On Review of systems, she had diarrhea but denied perioral or extremity paresthesia, palpitations, muscle spasms and bone pain. She reported compliance with calcitriol and calcium supplements at home. She had short stature, round face, short neck, obesity, brachydactyly (short digits of right 4th and 5th fingers) and shortened left 4th metacarpal. Labs revealed corrected serum calcium from baseline of 7.8 mg/dL to 4.4 mg/dL, ionized calcium 2.9 mg/dL, vitamin D 12.8ng/ml, PTH 142pg/ml and phosphorus 6.2mg/dl. EKG showed T wave inversions and prolonged QT interval. She did not have tetany, carpopedal spasm, paresthesia, Chvostek's sign, or Trousseau's sign. After receiving a total of 11 grams of elemental calcium, calcitriol, and ergocalciferol, her corrected calcium level improved to 7.4 mg/dL and EKG normalized. She was discharged home with calcium carbonate 1,250 mg twice a day and calcitriol 0.5 mcg daily. Discussion PHP type 1A is an autosomal dominant mutation of the stimulatory G protein alpha subunit (G alpha or GNAS) derived from the mother due to genomic imprinting which leads to PTH resistance in the kidneys and parathyroid glands. Our patient had a long-standing history of mild hypocalcemia with calcium and calcitriol supplements. Sudden worsening of hypocalcemia was likely related poor calcium and calcitriol absorption induced by COVID-19 infection. Patient with chronic hypocalcemia may not present with typical hypocalcemia signs or symptoms due to their tolerance. Conclusion Clinicians should be aware of the risk of developing severe hypocalcemia in patients who are calcium dependent or vitamin D deficient, malnourished during critical illness, or have COVID-19 infection which may decrease serum albumin and reduce total serum calcium level. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.