Serum Vitamin B12 Levels Research Articles

ASSOCIATION OF VITAMIN B12 DEFICIENCY AND MUCO-CUTANEOUS FINDINGS IN DERMATOLOGY: A CASE-CONTROL STUDY

Background:Vitamin b12 deficiency is considera common nutritional deficiency in Indian population.Vitamin B12 deficiency related to hair and cutaneous features like hair-fall, and cutaneous pigmentation are not well described in literature. Aim:To study serum vitamin b12 level in relation to diffuse hair-fall and muco-cutaneouspigmentation. Study design: Case-control observational study Materials and methods:Total 240 patients presented with diffuse hair-fall or muco-cutaneous pigmentation were taken as cases and screened for serum vitamin b12 level at tertiary health care centre. Other 240 patients of same age group presented with other dermatological conditions were taken as control. Also associated symptoms like weakness, malaise, numbness, tingling, paresthesia, burning sole, glossitis, angular cheilitis, angular stomatitis, aphthous stomatitis, graying of hair, mild memory impairment, irritability, psychosis, delusion of paresthesia, dementia and depression were noted in each patient. Results:Out of 240 patient females: male ratio was 3.52:1. Vegetarian:non-vegetarian ratio was 3.36:1. Out of 240 patients 42% patient presented with hair fall, 33% with hyperpigmentation and 25% had both complain. Facial pigmentationin 20%, extra-facial in 15%, both (facial & extra-facial) in 45% of patients were noted. Mucosal pigmentation was present in 20%. Serum vitamin b12 level was low in 198 cases and 87 control. Hemoglobin level was low (<10 gm/dl) in 196 0f cases and 127 of control. Amongst 240 cases weakness in 58, malaise in 22, numbness in 5, tingling in 15, paresthesia in 2, burning sole in 108, glossitis in 76, angular stomatitis in 13, aphthous ulcer in 31, graying of hair in 92, memory impairment in 18, irritation in 64, psychosis and delusion of paresthesia in 1, dementia in 8 patients were noted. Conclusions:Vitamin B12 deficiency is not rare, but data are insufficient regarding its prevalence. In our study, 240 patients with diffuse hair fall and muco-cutaneous pigmentation as case group and 240 patients as control group were included. Among groups, vitamin b12 deficiency was found in 198 cases and 87 control. We found that there was significant association with vitamin b12 deficiency, diffuse hair fall and muco-cutaneous pigmentation as clinical markers for dermatologists.

Serum vitamins and trace elements in vitiligo patients: A systematic review and meta‐analysis of observational studies

AbstractVitiligo is one of the most common pigmentary skin disorders, which significantly impacts the quality of life. The aetiology and pathophysiology of vitiligo are still unclear, but one of the proposed mechanisms is oxidative damage interrupting melanogenesis. The purpose of this study was to demonstrate the serum levels of trace elements and vitamins and to systematically review the evidence comparing vitiligo patients with a healthy group. We comprehensively retrieved all studies related to vitiligo and the serum levels of vitamins and minerals from databases such as PubMed, EMBASE, Scopus, Web of Science, Magiran, SID and ISC up to December 2022. Quality assessment and data extraction were conducted by two independent reviewers. Pooled standard mean differences with 95% confidence intervals were estimated using random‐effects models. Our meta‐analysis revealed no significant differences in serum levels of Vitamin B12 and copper. It was concluded that serum concentrations of Vitamin D, Vitamin E, and zinc were lower in vitiligo patients. Conversely, these patients exhibited higher levels of selenium and folic acid compared with healthy individuals. These results might affect the potential use of vitamin and mineral supplementation in vitiligo treatment.

Association of Maternal Vitamin B12 and Folate Levels with Gestational Diabetes Mellitus and Insulin Resistance

Background: The incidence of gestational diabetes mellitus (GDM) has increased in recent decades. Established prevention methods for GDM include diet and exercise. Recent interest has focused on the roles of vitamin B12 and folate in the development of GDM. These micronutrients are essential for one-carbon metabolism, which is involved in many metabolic pathways. However, the study results were conflicting and varied by geographic area. Objectives: The aim of this study was to evaluate the relationship between GDM and vitamin B12 levels in our region. Methods: This case-control study enrolled 180 pregnant women at 24 - 28 weeks of gestation. Half of the participants had GDM, and the other half were healthy individuals. All participants attended outpatient pregnancy care clinics at Shiraz University of Medical Sciences from June 2020 to April 2021. Gestational age, age, and body mass index were matched between the two groups. Vitamin B12, folate, insulin, and homocysteine levels were measured in both groups and insulin resistance was calculated. The results were compared between the two groups, and the relationship between vitamin B12 levels and insulin resistance in each group was investigated. Results: Vitamin B12 deficiency was present in 15.6% of the women with GDM. There were no cases of vitamin B12 deficiency in the control group. The GDM group had lower vitamin B12 levels (365.22 ± 136.82 pg/mL vs. 496.08 ± 156.46 pg/mL, P = 0.001). There was a negative correlation between serum vitamin B12 level and insulin resistance index (P = 0.001, r = -0.62). Folate levels were higher in the GDM group (17.93 ± 3.66 ng/mL vs. 14.60 ± 5.32 ng/mL, P = 0.001), but these levels did not significantly relate to insulin resistance or GDM. Conclusions: In our region, there is a significant relationship between low levels of vitamin B12 and both insulin resistance and GDM, which suggests the need for larger studies and attention to the detection and treatment of vitamin B12 deficiency during pregnancy.

Serum folate and vitamin B12 levels and their association with neurodevelopmental features in preschool children with autism spectrum disorder

To investigate the levels of serum folate and vitamin B12 (VB12) and their association with the level of neurodevelopment in preschool children with autism spectrum disorder (ASD). A total of 324 ASD children aged 2-6 years and 318 healthy children aged 2-6 years were recruited. Serum levels of folate and VB12 were measured using chemiluminescent immunoassay. The Social Responsiveness Scale and the Childhood Autism Rating Scale were used to assess the core symptoms of ASD children, and the Gesell Developmental Schedule was employed to evaluate the level of neurodevelopment. The levels of serum folate and VB12 in ASD children were significantly lower than those in healthy children (P<0.05). Serum folate levels in ASD children were positively correlated with gross and fine motor developmental quotients (P<0.05), and serum VB12 levels were positively correlated with adaptive behavior, fine motor, and language developmental quotients (P<0.05). In ASD children aged 2 to <4 years, serum folate levels were positively correlated with developmental quotients in all domains (P<0.05), and serum VB12 levels were positively correlated with language developmental quotient (P<0.05). In male ASD children, serum VB12 levels were positively correlated with language and personal-social developmental quotients (P<0.05). Serum folate and VB12 levels in preschool ASD children are lower than those in healthy children and are associated with neurodevelopmental levels, especially in ASD children under 4 years of age. Therefore, maintaining normal serum folate and VB12 levels may be beneficial for the neurodevelopment of ASD children, especially in ASD children under 4 years of age.

Serum vitamins and homocysteine levels in autoimmune liver disease: A systematic review and meta-analysis.

Vitamins and homocysteine (Hcy) are involved in liver metabolism and related to the pathogenesis of autoimmune liver disease (AILD), but consensus is lacking. This study aims to systematically summarize relevant evidence to clarify the association of serum vitamins and Hcy levels with AILD. The English and Chinese literature was searched until August 29, 2023. Studies were included if they were observational studies of investigating serum vitamins and Hcy levels in patients with AILD and their healthy comparisons. Quality assessment was performed by using the Newcastle-Ottawa Scale, and a meta-analysis was conducted using ReviewManager 5.3. The protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42023455367. A total of 25 case-control studies comprising 3487 patients (1673 patients and 1814 healthy controls) were included for analysis. There were 548 autoimmune hepatitis (AIH) cases, 1106 primary biliary cholangitis (PBC) cases, and 19 primary sclerosing cholangitis (PSC) cases. We found that serum A and E were decreased in both AIH and PBC/PSC; but vitamin C was reduced only in patients with PBC, not AIH. In addition, decreased content of 25(OH)D3 was found in both AIH and PBC. However, levels of 25(OH)D did not differ between the patients and controls, and were independent of disease types and the country. Only one study that met the inclusion criteria reported vitamin B6, B9, B12, and Hcy changes, and found that vitamin B6 and B9 were significantly decreased in patients with PBC, while serum vitamin B12 and Hcy levels were significantly elevated in them. One eligible study each confirmed a reduction in plasma vitamin K1 and 1,25(OH)2D3 in patients with PBC. Most vitamins are deficient in AILD, so appropriate vitamin supplementation should be necessary. Further studies with larger sample sizes are needed to validate these findings.

Variation of Serum Vitamin B12 Level in the Blood from Patients of Different Age Among the Latvian Population

Abstract The reference intervals and median values of serum vitamin B12 level in blood from patients among the Latvian population were established for different age groups with a two-year step using data for a large number of patients, accumulated in E. Gulbis Laboratory in Latvia. The data represents the general population of Latvia. An indirect in silico method, developed in E. Gulbis laboratory for determination of serum vitamin B12 blood level reference intervals, was used. Strong elevation of serum vitamin B12 blood level was observed in children who were between 2 and 10 years old. The paper discusses the serum vitamin B12 values for children and a different serum vitamin B12 reference interval for young children is suggested.

Identifying Typical Presentations of Vitamin B-12 Deficiency among Individuals Attending Tertiary Care Hospital in Central Gujarat: A Case Control Study.

Introduction: Vitamin B12 is mainly obtained through non vegetarian diet, milk and milk products. Malabsorption and inadequate intake leads to haematological and neurological disorders. Objective:To determine the symptoms and signs associated with Vitamin B12 deficiency. Method: A case control study was conducted at the medicine department of tertiary care hospital. Patients visiting hospital with serum Vitamin B12 level below 200pg/ml were labelled as cases and more than 200 pg/ml were labelled as controls, irrespective of signs and symptoms of Vitamin B 12 deficiency.Controls were matched for age to minimize confounding. 160 cases and 160 controls were selected. Pretested semi structured questionnaire was used to identify signs and symptoms of Vitamin B12 deficiency among cases and controls. Chi square test was applied for each symptom between cases and control, of which 10 were significant (p&lt;0.05). ROC curve was plotted for the 10 symptoms to check their usefulness for diagnosing vitamin B12 deficiency. Results: Area-Under Curve (AUC) was maximum under knuckle pigmentation (0.794), (Positive Likelihood Ratio (PLR)=3.24) followed by poor memory (0.684), (PLR=3.25) tingling and numbness (0.624), (PLR=1.84) and dizziness (0.605), (PLR=1.38) in respective order. Whereas fatigue, sore and swollen tongue, pale skin, breathlessness, palpitation, insomnia, memory loss were not associated with Vitamin B12 deficiency(p&gt;0.05).Conclusion: Presence of knuckle pigmentation, poor memory, tingling and numbness, and dizziness can be defined as hallmarks of Vitamin B12 deficiency and can be used to predict and start Vitamin B12 supplementation.

Association of Serum Folate and Vitamin B12 Concentrations with Obesity in Chinese Children and Adolescents*

ObjectiveThis study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents. MethodsA cross-sectional study was conducted including 3,079 Chinese children and adolescents, aged 6 to 17 years, from Jiangsu, China. Anthropometric indices, such as, children’s body mass index (BMI), BMI z-scores, waist circumference, and waist-to-height ratio were utilized. Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity. ResultsWe observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity [odds ratio (OR) = 0.68; 95% confidence interval (CI) = 0.59, 0.78] and abdominal obesity (OR = 0.68; 95% CI= 0.60, 0.77). When compared to participants with both serum vitamin levels in the two middle quartiles, those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general (OR = 0.31, 95% CI = 0.19, 0.50) or abdominal obesity (OR = 0.46, 95% CI = 0.31, 0.67). Conversely, participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity (OR = 2.06, 95% CI = 1.09, 3.91). ConclusionHigher serum vitamin B12 concentrations, but not serum folate concentrations, were associated with lower odds of childhood obesity. Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.

Hematological parameters in patients with recurrent Aphthous Stomatitis: a systematic review and meta-analysis

ObjectivesRecurrent Aphthous Stomatitis (RAS) known as recurrent aphthous ulcer is a common and painful ulcerations in oral cavity. It has been suggested that hematological parameters seems to be considered as an etiologic factor. So, this meta-analysis and systematic review was aimed to examine the relationship between RAS and hematological parameters.MethodsRelevant studies were found using online international databases including Scopus, Science direct, Web of science (ISI), PubMed, and Google Scholar search engine between 2000 and October 2023. The quality of all papers was determined by NOS checklist. Heterogeneity between the results of primary studies was evaluated with I-square index and publication bias was performed by Egger’s test and funnel plots. Also, sensitivity analysis was done to check the effect of each of the primary studies on the overall estimate. Also, the statistical analyses were done using Stata software Ver. 11.ResultsBy combining the results of primary studies, the standardized mean difference (SMD) of vitamin B12, ferritin, folic acid, hemoglobin, iron and zinc indices with a 95% confidence interval (CI) between the case (patients with RAS) and control (Healthy) groups were estimated -0.52(-0.89, -0.14), -0.20(-0.51, 0.11), -0.42(-0.95, 0.11), -0.58(-0.90, -0.27), 0.01(-0.12, 0.15), -0.33(-0.81, 0.14) respectively. The patients with vitamin B12, ferritin, folic acid, and iron deficiencies and reduced hemoglobin (Hb) level reported 2.93(2.28, 3.78), 2.50(1.48, 4.22), 1.51(0.53, 4.29), 1.46(0.70, 3.03), and 2.14(1.38, 3.32), times more susceptible to develop RAS than healthy individuals.ConclusionThe results of the meta-analysis indicated that the SMD of vitamin B12 serum and Hb levels in the case group was 52%. Our result have also showed that the odds ratio of vitamin B12, ferritin deficiencies, and decreased Hb level in case group was 2.93, 2.50, and 2.14 times more than healthy group.

RELATIONSHIP BETWEEN VITAMIN B12 LEVELS AND ADVERSE LIPID PROFILES IN APPARENTLY HEALTHY INDIVIDUALS VISITING WELLNESS ASSESSMENT CENTER: A PROSPECTIVE STUDY

Objective: For metabolic disorders, an abnormal lipid profile stands alone as a risk factor. Since most research has been done on unhealthy populations, a relationship in vitamin B12 deficiency and lipid profile is unclear.&#x0D; Methods: We conducted a cross-sectional research with 201 apparently healthy vitamin B12 deficient people, aged 25 to 60, in order to evaluate a relationship in serum vitamin B12 levels and lipid profiles.&#x0D; Results: Sociodemographic, anthropometric, and biochemical data has been collected. Serum vitamin B12 deficiency has defined as serum B12 level of&lt;159 pmol/l.25% of the subjects had raised cholesterol, 70% had raised LDL, 35% had raised triglycerides, and 71% had low HDL. We observed that only MCV was negatively associated with vitamin B12 levels (P&lt;0.0001). A remaining other variables, including lipid profile were not associated with vitamin B12 levels. We also found that presence of comorbidities was not significantly associated with vitamin B12 levels (P=NS).&#x0D; Conclusion: Therefore, in apparently healthy individuals, low serum vitamin B12 levels are not linked with abnormal lipid profiles.

Serum interleukin-17 A and homocysteine levels in children with autism

BackgroundAutism Spectrum Disorder (ASD) is a neurodevelopmental condition that typically emerges early in childhood. This study aimed to explore the potential link between serum levels of vitamin B12 and homocysteine (Hcy) and the severity of ASD symptoms in children.MethodsIn this study, 50 children diagnosed with ASD comprised the observation group, while 50 healthy children constituted the control group. Serum levels of IL-17 A, Hcy, folate, and vitamin B12 were compared between the study group and control group, as well as among children with different degrees of ASD severity. The correlation between the Childhood Autism Rating Scale (CARS) score and serum levels of IL-17 A, Hcy, folate, and vitamin B12 was examined. Additionally, the relationship between serum IL-17 A and Hcy levels and their association with the severity ASD were explored.ResultsCompared to the control group, the observation group demonstrated elevated serum Hcy and IL-17 A levels alongside decreased folate and vitamin B12 levels. Individuals with severe ASD exhibited higher Hcy and IL-17 A levels but lower folate and vitamin B12 levels compared to those with mild to moderate ASD. The CARS score showed negative correlations with serum folate and vitamin B12 levels and positive correlations with serum IL-17 A and Hcy levels in ASD patients. Additionally, serum Hcy and IL-17 A levels were correlated with ASD severity.ConclusionChildren diagnosed with ASD presented with reduced serum vitamin B12 levels and increased levels of Hcy, potentially contributing to the onset and severity of ASD.

Correlation between maternal and infant vitamin B12 levels in severe malnutrition in infants under 6months.

Malnutrition poses a significant global health challenge, affecting various age groups, with infants under 6months being particularly vulnerable. Vitamin B12, an essential micronutrient critical for neurological development, has been identified as a key player in the overall health of both mothers and infants. To find the correlation between serum vitamin B12 levels in infants, 1-6months of age with severe malnutrition and maternal levels at tertiary care hospitals in western Rajasthan. The cross-sectional study was conducted in the UNICEF Regional Center of Excellence-supported Nutrition Rehabilitation Center in Rajasthan, India, through simple random sampling. One hundred ten infants with their mothers were enrolled after consent and approval from the Institutional Ethics Committee. Severe malnutrition predominantly affected infants aged 1-2months, with 77% born small for gestational age and 66.4% belonging to the multiple birth order group. Serum vitamin B12 levels showed a significant positive correlation between mothers and infants (p < 0.001), while exclusive breastfeeding correlated positively with age-appropriate milestones (p = 0.033). The findings emphasize the importance of targeted interventions addressing maternal and infant nutrition, with a focus on ensuring adequate vitamin B12 levels.

Exploring the causal associations of micronutrients on urate levels and the risk of gout: A Mendelian randomization study

Growing evidence has indicated a potential association between micronutrient levels, urate levels, and the risk of gout. However, the causal association underlying these associations still remains uncertain. Previous observational studies and randomized controlled trials investigating the association between micronutrients, urate levels, and the risk of gout have been limited in their scope and depth. The aim of this study was to utilize Mendelian randomization (MR) to investigate the causal associations between genetically predicted micronutrient levels, urate levels, and the risk of gout. In this study, we conducted a comprehensive examination of 10 specific micronutrients (vitamin B6, vitamin B12, vitamin C, vitamin D, folate, calcium, iron, copper, zinc, and selenium) as potential exposures. Two-sample MR analyses were performed to explore their causal associations with urate levels and the risk of gout. In these analyses, gout data were collected from the Global Biobank Meta-Analysis Initiative (N=1,069,839, N cases=30,549) and urate levels data from CKDGen Consortium (N=288,649) by utilizing publicly available summary statistics from independent cohorts of European ancestry. We performed inverse-variance weighted MR analyses as main analyses, along with a range of sensitivity analyses, such as MR-Egger, weighted median, simple mode, weighted mode, Steiger filtering, MR-PRESSO, and Radial MR analysis, to ensure the robustness of our findings. The results of our study indicate that there were negative associations between serum vitamin B12 and urate levels, as well as serum folate and the risk of gout. Specifically, we found a negative association between vitamin B12 levels and urate levels, with a β coefficient of-0.324 (95% CI -0.0581 to-0.0066, P=0.0137) per one standard deviation (SD) increase. Similarly, a negative association was observed between folate levels and gout risk, with an odds ratio of 0.8044 (95% CI 0.6637 to 0.9750, P=0.0265) per one SD increase. On the other hand, we identified positive associations between serum calcium levels and both urate levels and the risk of gout. Specifically, there was a positive association between serum calcium levels and urate levels (β coefficient: 0.0994, 95% CI 0.0519 to 0.1468, P=4.11E-05) per one SD increase. Furthermore, a positive association was found between serum calcium levels and the risk of gout, with an odds ratio of 1.1479 (95% CI 1.0460 to 1.2598, P=0.0036) per one SD increase. These findings were robust in extensive sensitivity analyses. By employing MR-PRESSO and Radial MR to eliminate outliers, the observed associations have been reinforced. No clear associations were found between the other micronutrients and the urate levels, as well as the risk of gout. Our findings provided evidence that there were negative associations between serum vitamin B12 and urate levels, as well as serum folate and the risk of gout, while positive associations existed between the serum calcium levels and urate levels, as well as the risk of gout.

Assessing Iron Deficiency Anemia in Obese Adolescents and Identifying Contributing Factors

Objective: Clinical outcomes can be significant for obesity and iron deficiency, two public health issues for which adolescents are especially vulnerable. The aim of this study was to assess the iron parameters and blood vitamin B12 levels in obese adolescents and identify the contributing variables to the development of anemia. Material and Method: The present study involved a retrospective evaluation of 260 children (130 obese-130 control) who were admitted to the Ankara Pediatrics Haematology Oncology Training and Research Hospital, Pediatric Outpatient Clinics, between March 2013 and May 2015. Body mass index (BMI) above the 95th percentile for age and gender was required for inclusion in the study group, which included children aged 12 to 18 years without acute or chronic illnesses. Data from patient files were used to collect information on physical examination findings, sociodemographic characteristics, daily dietary status, and level of physical activity. All patients had evaluations for CRP, iron parameters, vitamin B12, and complete blood count. Results: The study revealed that the obese group had significantly higher serum ferritin levels (p=0.002) and lower serum iron and vitamin B12 levels (p=0.036 and 0.047, respectively) as compared to the control group. In the obese population, elevated BMI has been demonstrated to be correlated with elevated CRP levels. Conclusion: In obese children, low serum iron and high ferritin levels can be regarded as typical reference values. Furthermore, it was discovered that low vitamin B12 levels were not associated with nutrition in obese children, although they were at risk for developing low levels

Association between of vitamin B12 status during pregnancy and probable postpartum depression: the ECLIPSES study

ABSTRACT Background B12 vitamin is essential for the functioning of the nervous system and the production of mood-related neurotransmitters. However, information on its association with postpartum depression (PPD) is limited. Objective To examine the effect of serum vitamin B12 levels during pregnancy on PPD, in healthy pregnant women from the Mediterranean region of Catalonia, Spain. Method This longitudinal study included a subsample of women at 54 days (7.7 weeks) postpartum (n = 336), who participated in the ECLIPSES Study conducted out in Tarragona, Spain. Maternal concentrations of vitamin B12 were determined in the first and third trimester of pregnancy and sociodemographic, nutritional, and psychological data were collected. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Results The prevalence of probable PPD was 21%. After adjusting for sociodemographic, lifestyle, biochemical parameters, and postpartum characteristics the regression model showed a negative association between EPDS scores and the highest quartile of serum vitamin B12 (first quartile (reference) vs. fourth quartile), (β = -1.267, 95% CI = -2.461, −0.073, p = 0.038). Conclusion Maintaining a normal-high level of vitamin B12 during early pregnancy can contributes to preventing PPD.

Association between vitamin B12 deficiency and risk of Paediatric narcolepsy: Evidence from cross-sectional study and Mendelian randomization analysis

BackgroundNarcolepsy, a chronic neurologic sleep disorder, has sparked growing interest in the potential role of vitamin B12 in its pathogenic mechanism. However, research on this association has predominantly focused on adults. Our objective was to delineate the phenotypic and genetic connections between serum vitamin B12 levels and paediatric narcolepsy. MethodsTo investigate the causal relationship between vitamin B12 and paediatric narcolepsy, we conducted a retrospective analysis involving 60 narcolepsy patients and a matched control group. Univariate and multivariate logistic regression models were employed to identify independent factors influencing paediatric narcolepsy. Furthermore, a bidirectional two-sample Mendelian randomization (MR) analysis was performed to assess the causal connection between serum vitamin B12 levels and narcolepsy. ResultsPaediatric narcolepsy patients showed significantly lower serum levels of vitamin B12 and folate compared to the control group (P < 0.05). Multivariate logistic regression analysis identified serum vitamin B12 as the exclusive independent factor influencing paediatric narcolepsy (P < 0.001; OR = 0.96; 95%CI: 0.94–0.98). Additionally, IVW model results provided compelling evidence supporting a potential causal association between serum vitamin B12 levels and paediatric narcolepsy (OR: 0.958, 95% CI = 0.946–0.969, P = 0.001). ConclusionThis study establishes connections at both phenotypic and genetic levels, associating vitamin B12 deficiency with an increased risk of paediatric narcolepsy. These findings provide innovative perspectives for clinical strategies in the prevention and treatment of narcolepsy.

Effect of Serum Vitamin B12 Levels on Premature Ejaculation.

To assess the impact of vitamin B12 levels in the failure of the dapoxetine used in premature ejaculation (PE) treatment. Experimental study. Place and Duration of the Study: Andrology Clinic, between May and December 2020. Patients with premature ejaculation complaints completed the Premature Ejaculation Diagnostic Tool (PEDT) questionnaire. Patients were also asked to fill in the Premature Ejaculation Profile (PEP) surveys. Intravaginal ejaculation latency time (IELT) were recorded based on the estimates of patients. Serum vitamin B12 levels were evaluated based on blood samples. All patients were advised to use dapoxetine 30 mg, 1-3 hours prior to intercourse. After four weeks, patients were asked to complete the PEP questionnaire again. IELT times were recorded. A total of 62 patients were included in the study. A total of 39 patients (62.90%) were satisfied with the treatment of the dapoxetine. In comparison to patients who benefited from dapoxetine treatment and those who did not, vitamin B12 levels of patients who did not benefit from dapoxetine were found to be significantly lower (p=0.005). Vitamin B12 deficiency can reduce the effectiveness of dapoxetine treatment in patients with PE. It is important to evaluate serum vitamin B12 levels for the evaluation of patients with PE. Premature ejaculation, Dapoxetine, Vitamin B12, Serotonin, Treatment.

Risk Factors for Neural-Tube Defects Detected in Utero: A Prospective Community-Based Study from Addis Ababa

BackgroundA recent community-based study from Addis Ababa identifying NTD cases by ultrasound examination of pregnant women showed a higher prevalence of 17 per 1000 foetuses. The risk factors behind the high prevalence remain unclear. MethodsAltogether 891 of the 958 women participated in the ultrasound examination. Thirteen with unaffected twin pregnancies were excluded. Among 878 singleton pregnancies, 15 NTD cases were identified. Serum Folate, vitamin B12 and homocysteine levels were measured in case-mothers and a sub-set of 28 non-case mothers. Because of the modest sample size, exact logistic regression analysis was used to estimate associations between risk factors and NTDs. ResultsSerum vitamin status was generally poor for participants in the study. Still, relatively higher values of folate or vitamin B12 in serum, appeared to be protective for NTD (OR=0.61 per ng/ml, 95% CI: 0.42-0.85 and OR=0.67 per 100 pg/ml, 95% CI: 0.41-1.02, respectively). High serum homocysteine was associated with higher risk of NTD (OR=1.3 per μmol/l, 95% CI: 1.02-1.8). Women aged 30 years or more had an odds ratio of 3.5 (95% CI: 1.1-12) for having a NTD child, and families with NTD children had lower household income. Women in the NTD group also had more spontaneous abortions or stillbirths in previous pregnancies. Self-reported intake of folate did not appear to protect against NTDs. ConclusionWithin this high-prevalence community, poor vitamin status was identified as a risk factor for NTDs detected at ultrasound examination. Improving food security and fortification of foods or food ingredients could be alternative measures.

A Cross-Sectional Study for the Spectrum of Clinical Diagnosis in Patients Presenting With Macrocytosis.

Objective The objectives of this study were to determine the frequency of the clinical spectrum of diseases in patients with macrocytosis and to summarize the diagnostic evaluation of patients found to have macrocytosis on laboratory testing. Background This was a cross-sectional study that took place at the Department of Medicine in Combined Military Hospital, Rawalpindi, Pakistan, from January to June 2023. Methodology One hundred and five patients with macrocytosis with mean corpuscular volume (MCV) values > 100 fL (80 to 100 fL) were inducted as per inclusion and exclusion criteria. Informed consent was obtained from all patients. Complete blood counts (CBC), peripheral blood film, serum vitamin B12 levels, serum folate levels, renal function tests (RFTs), liver function tests (LFTs), and thyroid function tests (TFTs) were performed during the assessment. Results The commonest cause of macrocytosis was vitamin B12 deficiency followed by folate deficiency, combined vitamin B12 and folate deficiency, and other causes were also found in a few cases. Conclusion Serum vitamin B12 and folate deficiency are the most common preventable causes of macrocytosis.

Anemia profiling in antenatal women at a tertiary care center in northern India: An observational study

: Anemia is a common health issue during pregnancy, with various factors influencing its occurrence. Iron deficiency often leads to iron deficiency anemia (IDA), significantly impacting maternal and fetal health.: This study aims to investigate the complete blood count and nutritional status, including serum iron profile, vitamin B12, and folate levels in antenatal patients. : The study involved 160 participants, predominantly from rural areas. The severity of anemia among the participants was classified according to WHO guidelines.: Iron deficiency was observed in 33.75% of women, folate deficiency in 20%, and vitamin B12 deficiency in 11.25%. Some women exhibited a combination of deficiencies. The average hemoglobin level was found to be 8.69 g/dL, and the mean iron level was 35.95 µg/dL. The average ferritin levels were observed to be 49.65 ng/mL. Lastly, the Vitamin B12 and folate levels averaged at 130.21 pg/mL and 14.76 ng/mL respectively.: These findings provide valuable insights into the nutritional status of pregnant women and highlight the need for targeted interventions to address micronutrient deficiencies during pregnancy.