European Journal of Cardiovascular Medicine

Background: Prematurity is a burden on any country for being the leading cause of infant mortality in the world. APGAR score, being a component of the degree of birth asphyxia,  is an important tool to assess the quality of  care used for observing neonatal outcome in the delivery room itself. Vitamin D has important role in decreasing the mortality and morbidity in the neonatal period as it helps in prevention of sepsis and respiratory complications .

Aim of the study: To determine the relationship between serum vitamin D level and APGAR score in premature infants.

Patients and methods: This cohort study was done in Sri Guru Ram Das Hospital, Vallah, Sri Amritsar from April 2021 to July 2022on 82 preterm (< 37 weeks ) neonates admitted to the NICU. Patients were divided into 3 groups based on their serum vitamin D levels : deficient , insufficient and sufficient. APGAR score of these preterm neonates at 1 minute and 5 minute was recorded. Later these were analyzed and relationship between serum vitamin D level and APGAR score at 1 minute and 5 minutes was noted.

Results: The lowest APGAR score at 1 minute (between 0-3 ) belonged to the neonates in the deficient group whereas majority of neonates in the insufficient group and in sufficient group had good APGAR scores (>6) at 1 minute. At 5 minutes, all neonates in the insufficient and sufficient group improved their APGAR scores to >6 and in the deficient group, 23.1 % neonates still had low score (4 to 6 ). Therefore, the relationship between APGAR score and serum vitamin D levels in the neonates was statistically significant with p value of 0.006 for APGAR at 1 minute and p value of <0.001 for APGAR at 5 minutes.

Conclusion: In this study, lower vitamin D levels were associated with lowerAPGAR score at 1 minute and 5 minutes

Introduction: Chronic kidney disease (CKD) is characterized by a progressive loss of renal function that often leads to end-stage renal disease (ESRD), high risk for cardiovascular disease, and high mortality. Diabetes mellitus is a growing epidemic and is the most common cause of chronic kidney disease (CKD) and kidney failure. Diabetic nephropathy affects approximately 20–40 % of individuals who have diabetes, making it one of the most common complications related to diabetes. Screening for diabetic nephropathy along with early intervention is fundamental to delaying its progression in conjunction with providing proper glycemic control. The kidneys play a vital role in the excretion of waste products and toxins such as urea, creatinine and uric acid, regulation of extracellular fluid volume, serum osmolality and electrolyte concentrations, as well as the production of hormones like erythropoietin and 1,25 dihydroxy vitamin D and renin. Material and Methods: This is a prospective and observational study was conducted in the Department of Biochemistry at Tertiary care Teaching Hospital over a period of 1 year. Either Gender aged between 18 and 70 years. The study participants were signed written informed consent before the start of data collection. The study participants were selected based on a convenient sampling technique and total of 120 study participants were included.  Subjects suffered from an acute infection and critically sick individuals were excluded from the study.  Results: There was a significant difference  between case when compared to  Control in Male and female.  There was a significant difference in case group in FBS, HbA1c, Urea and S. Creatinine when  compared to control group and no significant difference between both groups in SBP and DBP. Conclusion: The present study it can be inferred that serum urea and creatinine levels were significantly higher in CKD subjects then control subjects. Increased amount of urea and creatinine levels were seen only in CKD subjects and no difference was seen in controls. Thus, it can be recommend that urea and creatinine values can be used for screening of renal status in CKD subjects

Background and Objective: It is well established that intact parathyroid hormone (iPTH) and blood 25(OH) D levels have an impact on bone mineral density (BMD). There are few Indian statistics relevant to the aforementioned finding. In this study, we looked at the correlations between intact parathyroid hormone (iPTH), serum 25(OH)D levels, and bone mineral density (BMD) in a group of patients from India. Methodology: Individuals with low BMD at the hip or lumbar spine, whether or not they had fragility fractures, underwent clinical evaluations and laboratory tests. From BMD-DEXA, hip and spine T-scores were generated (dual-energy X-ray absorptiometry). The associations between serum 25(OH) D, iPTH, and BMD were examined using multivariate regression models. Results: A total of 102 patients were enrolled in the study, with a male to female ratio of 38:64 and a mean age of 62.5 6.4 years. Osteopenia affected 44 people. There was osteoporosis in 58 individuals. Serum 25(OH)D and iPTH levels were, respectively, mean values of 21.3 0.5 ng/ml and 53.1 22.3 pg/ml. Vitamin D deficiency was confirmed in 84.3% of patients by blood 25(OH)D levels that were below 30 ng/ml (normal range: 30-74 ng/ml). 25(OH) D levels and BMD at the hip or lumbar spine did not correlate (P = 0.473 and 0.353, respectively). iPTH levels, male gender, body mass index (BMI), and age were discovered to be significant predictors of BMD at both the hip and lumbar spine. BMD and T-score were considerably decreased in patients with increased BMI. Conclusion: There was no correlation between serum 25(OH) D levels and BMD among our group of patients with poor BMD. However, at serum 25(OH) D concentrations below 30 ng/ml, there is a negative connection between iPTH and 25(OH) D. A substantial inverse relationship between BMD at the hip and lumbar spine and serum iPTH levels was observed. Our results highlight the crucial part that parathyroid hormone plays in the health and metabolism of bones

Background: Various factors like physiological and emotional stress, drugs and nutritional deficiencies can result in hair loss. Results of laboratory tests examining the underlying aetiology of hair loss vary in patients. Materials and methods: Fifty-four patients with hair loss (47 females, 7 males) and 55 healthy individuals within the control group (47 females, 8 males) were included in this study. Serum levels of ferritin, folate, vitamin B12, zinc, thyroid stimulating hormone and 25-hydroxyvitamin D were evaluated in all participants retrospectively. Result: A total of 70 patients were studied which included 45 males and 25 females. Out of these mild AA was seen in 15 males and 10 females, moderate AA was found in 30 males and 15 females. We did not get any cases of alopecia totalis (AT), alopecia universalis (AU) or ophiasis. Conclusion: Women with hair loss can benefit from higher ferritin levels

Background: Asthma is a heterogeneous disease, usually represented by chronic airway inflammation leading to variable respiratory symptoms and variable expiratory airflow limitation. Vitamin D has been shown to have several effects on the innate and adaptive immune systems that might modulate the severity of asthma exacerbations. Vitamin D deficiency and insufficiency is common in asthma patient, which causes frequent asthma attacks, respiratory tract infections, reduced lung function, poor asthma control, poor steroid responsiveness and severe asthma exacerbations. Objective: To determine serum vitamin D levels among asthmatic patients and to correlate them with the severity of bronchial asthma. Methods: A total of 50 patients with stable bronchial asthma between 18 to 60 years ages groups were included in the study. This Observational Study was conducted from April 2022 to December 2022 in Department of Respiratory medicine, Kamla Nehru Chest Hospital, Jodhpur. After taking proper clinical history and system examination, spirometry was done in each patient to obtain forced expiratory volume (FEV1), FVC and FEV1/FVC ratio for determination of the severity of asthma. Asthma control was assessed by using of asthma control questionnaire. Serum vitamin D level and absolute eosinophils count were measured in all participants. Results: In our study out of 50 cases, male patients (n=24) and female (n=26) which Association of Allergic history in Group with Severity of asthma was statistically significant (p=0.0240) and mean Vitamin-D Levels (ng/ml) was significantly higher in Mild [29.2182± 6.0880] compared to Moderate [23.3583± 5.2467] and Severe [14.9067± 5.1568] (p<0.0001). The mean Vitamin D Levels was significantly higher in “well controlled” [27.9071 ± 6.3191] compared to “partly controlled” [22.8706 ± 6.8941] and “uncontrolled” [17.2158 ± 7.0243] (p=0.0002). Conclusion: Vitamin D deficiency and insufficiency are highly prevalent in asthma patients in which prolonged duration of illness, frequently asthma exacerbation and poor asthma control. Hence, vitamin D is a useful for prevention and treatment of bronchial asthma

Although there are innumerable studies on vitamin D deficiency in India, there is limited data in Mizoram. Keeping this in view the aim of our study is to find out the deficiency of Vitamin D in our region, Mizoram (NE India). Our study population included patients attending Genesis Laboratory, Aizawl, Mizoram (November 2021 – November 2022) for various ailments who were advised serum Vitamin D level estimation. The study population was grouped according to gender and age in decades. Blood was collected in plain vials and serum obtained was used for vitamin D estimation. Out of 480 patients, 180 were male and 300 were female. Age of the study population ranged from 11 – 79 years. 17% of the total study population had normal values, 62.7% was vitamin D Deficient and 20.3 % showed Vitamin D insufficiency. The prevalence of Vitamin D Deficiency was high in all age groups, there were a higher percentage of females in the vitamin D insufficient and deficient groups. Maximum numbers of patients with vitamin D deficiency were in the age group of 60-69 years with a female predominance. Prevalence of Vitamin D deficiency is very high in our region that is in Mizoram, as is reflected from our study. This pattern is seen in other parts of our country too. Also, the deficiency is high in the age groups N – N years and females outnumbered male

Diabetes Mellitus is a metabolic disorder of multiple aetiology characterized by presence of hyperglycaemia with disturbances of carbohydrate, protein and lipid metabolism due to defects in insulin secretion, action or both. The link of vitamin D with insulin insensitivity or abnormal glucose metabolism gained much more scientific attention in the last 10 years. Various observations or associations were cited. Exploring the possible role for either altered vitamin D status and its metabolites or altered Insulin sensitivity in the pathogenesis of the each disease. In view of increased prevalence of diabetes mellitus, vitamin D deficiency and association of vitamin D with diabetes mellitus the present study is undertaken to evaluate vitamin D levels in type 2 diabetes mellitus and its correlation with HbA1c levels Aim: To study vitamin D levels and its correlation with HbA1c level in type 2 diabetes mellitus. Methods: An observational study was carried out over a span of 1.5 years who were previously diagnosed case of type 2 Diabetes Mellitus attended Medicine department OPD and IPD between age group 30-70 years were included in study Serum vitamin D3, HbA1c, FBS, PPBS and other clinical features were noted based on history and clinical examination of these patients. Results:  25% had HbA1c of less than 7, 39 patients (39%) had HbA1c more than 9. The mean HbA1c level was 8.65 ± 1.93. We observed in 41 patients (41%) the level of Vitamin- D were deficient, in 17 patients (17%) the levels were inadequacy and in remaining 42 patients (42%) the levels were either normal or more than normal. In our study Vitamin D levels were found to be lower in the diabetic cases with >5 years of duration compared to recently diagnosed diabetic cases. The difference is statistically significant (P value 0.001) as compared with recently diagnosed (P value 0.63). It was found that patients with poor glycaemic control had maximum Vitamin D deficiency (12%) which was statistically significant with p value of  0.001 than those with good glycaemic control had sufficient Vitamin D levels (9%) with p value of 0.07. We compared the mean Vitamin D levels with duration of diabetes of mellitus and HbA1c and it was observed that the mean levels of Vitamin D were reduced with increasing duration of diabetes mellitus and increasing HbA1c levels. This difference was statistically significant. (P<0.05). Conclusion: There was an association between Vitamin D levels and HbA1c in patients with type 2 diabetes mellitus. In the present study of 100 patients with type 2 diabetes mellitus we found that lower vitamin D levels were associated with poor glycaemic control

Introduction: Vitamin D plays a significant role in the functioning of the immune system and it influences many dermatological diseases such as psoriasis and atopic dermatitis. The prevalence of vitamin D deficiency is growing globally with around 30–50% of people are known to have low levels of vitamin D.  Acne vulgaris is a common inflammatory disorder of the pilosebaceous unit. Studies about the role of vitamin D in the pathogenesis of acne vulgaris have shown conflicting and nonconclusive results. Thus, the precise purpose of vitamin D has not yet been established.  Aims & Objective: To evaluate serum levels of vitamin D in sample of patients with acne vulgaris and compare it with matched healthy controls & to investigate if there is any relation between serum vitamin D level and the severity of acne vulgaris. Materials and Methods: This cross-sectional study included 40 patients with acne vulgaris and 40 matched healthy controls. Serum 25-hydroxyvitamin D [25 (OH) D] levels were measured for both patients and healthy controls.  Results: Patients with acne are younger than healthy controls and female preponderance was observed as compared with male patients.  The mean (± SD) concentrations of 25[OH]D in patient group and the control group were 21.3 ± 9.7 ng mL and 29.6 ± 11.2 ng/mL respectively. The difference was found to be statistically significant (P < 0.05). Thus our study yielded lower levels of serum 25-hydroxyvitamin D in patients with acne vulgaris than its level in healthy controls. Conclusion: This study has shown clearly that in patients with acne Vulgaris vitamin D deficiency is more evident with P-value P < 0.05. Moderate to severe vitamin deficiency was observed in 27 cases (67.5%) and in 20 controls (50%) (P < 0.05). Further clinical studies with larger sample size are required to address the importance of vitamin D in pathogenesis & grading of Acne vulgaris. Specifically, to determine the effects of treatment of acne with both topical vitamin D analogs and vitamin D supplementation.

Background. ECG is a simple non-invasive tool for assessing prognosis in the Adult Sickle cell anaemia patient as pathological changes occur early in adolescents. It is suggested that ECG should be done annually for SCA   patients and those with LVH should be placed on primary prophylaxis. Aims and Objective: This study was undertaken with an aim to ascertain the electrocardiogram analysis in adult patients with sickle cell anemia and without sickle cell anaemia Methodology. In this case control, cross sectional study 60 sickle cell patients from study and control group attending the medicine OPD were confirmed by HPLC analysis by using D-10TM Dual HbA2/F/A1c 220-0201kit. Anthropometric parameters like age, weight, height, BMI, sex and medications of all patients were taken. A 12 lead ECG was recorded on all subjects, speed of a paper was 25 mm/sec and standardized at 0.1mv/mm. A single observer was analysed the ECG. The Heart rate, Cardiac Axis, PR interval, QRS duration and QTc interval were measured. The dispersion of P-wave, QRS and QTc intervals were measured manually. ST-segment was taken as the interval between the j point (or end of the ORS complex) and the beginning of the T wave. Elevation or depression of the ST-segment by 2mm or more the isoelectric line was considered abnormal. The Data was analysed by using EPI Info 7. Result. HPLC analysis confirmed 60 adult patients with Hb SS SCA had a mean age of 20±4.6. The SCA patients matched the control group in and sex, with a higher preponderance of males of 62% in both groups. SCA patients had body surface area and BMI compared with control patients of 1.19±0.01 versus 1.53±0.03 (p less than 0.01) and 20.2±1.5 versus 26.4±2.7 (p less than 0.001), respectively. The biochemical analysis in the SCA group compared with the control group are Ferritin 382.38±94.4 versus 84.1±9.3 ug/L, Hemoglobin 7.5±0.9 versus 12.19±1.6 g/dL, Reticulocyte 4.34±0.6 versus 2.52±0.3%, Vitamin D3 44.6±4.9 versus 75.3±7.1 and LDH 272.9±50.97 versus 154.5±41.6 0.1 mmol/L for each 5 g/L (p less than 0.01).  The mean QTc interval of SCA patients was 0.38±0.035 seconds and controls 0.37±0.02 seconds (p=0.123). The mean PR interval of SCA was 0.186±0.06 seconds and controls 0.169±0.036 seconds (p=0.369). the mean QRS duration of SCA was 0.07±0.09 and controls 0.043±0.14 seconds (p=0.055). Conclusion. Sickle cell anaemia is associated with significant electrocardiographic abnormalities.  Cardiac abnormalities particularly pulmonary and diastolic left ventricular dysfunction have been to be risk factors in sickle cell anaemia. The study should stimulate the use of ECG to assess adult SCA patients for early intervention to prevent cardiac events.

Background : HIV continues to be a major global public health issue, having claimed 36.3 million [27.2–47.8 million] lives so far. The human immunodeficiency virus (HIV) targets the immune system and weakens people's defense against many infections and some types of cancer that people with healthy immune systems can fight off. Low vitamin D levels have been associated with HIV disease progression and HIV-related complications. Materials and Methods: Cases will be selected from patients presenting to KIMS hospital, IPD section with history Of HIV infection considering the inclusion and exclusion criteria. A total of 110 consecutive patients presenting with HIV positive status, whose inclusion and exclusion criteria are fulfilled are considered for study. It’s a single centered, time- bound prospective study carried out for a period of 2 years. Each patient was evaluated with History, clinical examination, and lab investigations.  Results : In the present study involving 110 HIV patients. The mean CD4+ Count (/cu.mm) was 186.86 ± 104.35 and the mean Viral Load (x103) was 55.20 ± 68.61. vitamin D deficiency was present in 96.4% of population. There was a strong positive correlation between CD4+ Count (/cu.mm) and S. Vitamin D (ng/mL). There was a strong negative correlation between Viral Load (x103) and S. Vitamin D (ng/mL). Conclusion: In this study, with deficiency of Vitamin D level there was positive corelation with CD4 Count causing reduction in CD4 Count and negative correlation with viral load causing increased viral load with reduction in vitamin D levels in HIV affected individuals.

Background: It has recently been demonstrated that vitamin D, long thought to be a hormone that regulates calcium and phosphate, is essential for the treatment of a number of non-skeletal illnesses, including cardiovascular disease. Numerous research have been conducted on the connection and potential causal involvement of vitamin D in cardiovascular diseases and the well-known risk factors associated with them. There aren't many research conducted in this region of the world, though. This study's primary goal was to measure the 25-hydroxyvitamin D levels in heart failure patients. Methods: This was a institute based Observational Cross Sectional Study, done at General Medicine Ward, Department of General Medicine, Burdwan Medical College and Hospital, West Bengal, India, from March 2021 to May 2022. Total 100 patients with heart failure and fulfilled the inclusion criteria were included in this study data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and Graph Pad Prism version 5. Result: In present study maximum participants 57 (57%) were from the age group of 61-80 years. Mean age of the participants was 65.38±13.7656l. In our study, 46 (46.0%) patients were Normal BMI, 14 (14.0%) patients were Obese BMI and 40 (40.0%) patients were Overweight BMI. In the present study 100 (100%) of the participants had Exertional Dyspnoea followed by PND and fine crepts 79 (79%) each. Vitamin D ≤30 was present in 88 (88%) off study population and >30 was present in 12 (12%) of study population.  Conclusion: In our study we found that 88 out of 100 study participants were Vit D deficient. It was also found that, 25(OH) Vit D levels had negative correlation with LVEF

Introduction: Diabetes mellitus is one of the common non-communicable diseases in India. Dyslipidemia is also associated with diabetes mellitus. Role of vitamin D is described in diabetes mellitus in multiple studies owing to its facilitation/inhibition of transcription factor and immune-modulator property. Aim: to evaluate association of vitamin D level with parameters of fasting lipid profile. Methods: It was an analytical observational case study. Patients of type 2 diabetes mellitus were included in the study. All routine lab parameters were done. Statistical analysis was done by pearson correlation test, fisher’s exact test and ANOVA. Linear regression analysis was also done. Results: 119 patients were included in the study. Vitamin D deficiency was found in 77 patients (64.71%). Negative correlation was present between vitamin D level and HbA1c. Vitamin D deficiency was found to be significantly associated with high HbA1c (p = 0.024). Furthermore, Negative correlation was found between vitamin D level and total cholesterol (r = -0.0134, p = 0.8987), serum triglyceride (r = -0.0310, p = 0.7690) and serum LDL (r = -0.0149, p = 0.8873). Positive correlation was present between vitamin D level and serum HDL (r = 0.0296, p = 0.7782). On ANOVA test, mean values of serum triglyceride in vitamin D deficient, vitamin D insufficient and vitamin D sufficient groups were 206 ± 147.3 mg/dl, 152.78 ± 64 mg/dl and 147.84 ± 72.6 mg/dl respectively. (p = 0.0510), near significant association was found between vitamin D deficiency and increased serum triglyceride level. Conclusion: Vitamin D deficiency in type 2 diabetes mellitus is associated with poor glycemic control. Vitamin D deficiency in type 2 diabetes mellitus may be a risk factor for dyslipidemia.

Background: This study was conducted to evaluate the serum vitamin D levels in patients with type 2 diabetes mellitus with and without nephropathy. Methods: This was a hospital-based cross-sectional case control study conducted among 100 patients who attended OPD and IPD at the Department of Medicine, Dr. B.R. Ambedkar Medical College and Hospital, Bangalore, over a period of 18 months from December 2020 to May 2022, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: In comparison between diabetic nephropathy and non-diabetic nephropathy between both groups, a statistically significant difference (p<0.001) was noted between them with regard to serum creatinine, eGFR, UACR and vitamin D levels, suggesting that the diabetic nephropathic group has increased creatinine levels, highly reduced eGFR, highly elevated UACR and significantly decreased vitamin D levels, which are not present in the non-diabetic nephropathy patients. The eGFR and vitamin D levels were compared among the diabetic nephropathic subjects. The eGFR was split into three groups and by the ANOVA test measure, a significant association was obtained between them suggesting decreased eGFR also decreases vitamin D levels. On correlating vitamin D levels with serum creatinine and UACR a statistically significant (p<0.001) strong negative correlation was obtained (0.85 and 0.91) respectively. Conclusion: The study found that individuals with diabetic nephropathy had a higher prevalence of vitamin D insufficiency. However, at more advanced stages of diabetic kidney disease, their severity is more prevalent. Patients with CKD (Chronic Kidney Disease) should get information from health care providers on vitamin D monitoring and its dietary sources.

Background: The prevalence of asthma has been rising over the past few decades, making it one of the most prevalent chronic diseases in the world. Although the precise cause of asthma is still unknown, it most likely results from intricate interactions between a number of hereditary and environmental factors. According to the World Health Organisation (WHO), 300 million people worldwide suffer from asthma. The effects of vitamin D as a hormone have drawn more attention recently. Every component of the immune system seems to be regulated by vitamin D, with a lack of the vitamin being associated with a number of immunologically based illnesses, including asthma. Therefore, it is beneficial to check serum vitamin D levels in bronchial asthma patients. Aim and objectives: To identify any correlations between vitamin D deficiency and the severity of asthma and the objective of the study is to evaluate the serum 25(OH) D level in patients with mild, moderate, and severe asthma. Material and Methods: This is a cross-sectional observational study, which involved 100 participants between the ages of 15 and 50, of both genders with a mean age of 37.40±9.46 years. They were divided into two groups: Group A (control) consisting of 40 healthy individuals (22 males and 18 females) and Group B consisting of 60 asthmatic patients (34 males and 26 females). Group B was further subdivided into three subgroups (A, B, C), based on FEV1% and symptom severity as per the Global Initiative for Asthma (GINA) guidelines. An assay of serum vitamin D levels by ELISA was performed in both groups. Results: The results of the study demonstrated that asthmatic patients had considerably lower serum vitamin D levels than the control group. Conclusions: There is a significant inverse association between serum vitamin D levels and the severity of asthma symptoms, and vitamin D deficiency is rather common in people with asthma. As a result, when routinely evaluating individuals with asthma, serum vitamin D levels should be taken into account. It could be used to indicate the severity of asthma.

Osteoporosis and Type 2 diabetes mellitus are two common chronic conditions with potentially significant impacts on patients' health. Osteoporosis, characterized by decreased bone density and increased fracture risk, is influenced by various factors, including parathormone (PTH) and vitamin D levels. Aim: To study the association between PTH, vitamin D levels and BMD in Type 2 diabetic patients. Material And Methods:This cross-sectional observational study was conducted in the Department of Medicine. A total of 50 participants were included in the study. A semi-structured questionnaire was administered and relevant clinical data was obtained. Result: The results show a statistically significant association between vitamin D status and BMD (p = 0.008). Patients with normal vitamin D levels were more likely to have normal BMD, with 57.14% falling into this category. In contrast, 92.3% of patients with osteopenia and 75% of those with osteoporosis had low vitamin D levels. Conclusion: Low vitamin D levels were associated with a higher prevalence of osteoporosis and osteopenia, particularly in patients with low PTH levels.

breast cancer accounts for 14% of cancers in Indian women. It is reported that in every four minutes, an Indian woman is diagnosed with breast cancer. Vitamin D deficiency is assumed to be one of the risk factor for breast cancer. Objective: To study the association between vitamin D and risk of breast cancer among postmenopausal women.  Methodology: This was an observational cross sectional study.About 74 females of known breast cancer and 74 healthy females were evaluated. Appropriate statistical analysis was done to find association between vitamin D deficiency and risk of Breast Cancer. Our study demonstrated that number of subjects with Vitamin D level below 20 ng /dl i.e Vitamin D deficiency from the cases, in age group 41 to 50 years are 11, in the age group of 51 to 60 years were 39, in the age group of 61 to 70 years are 19, and in the age group of more than 70 years were 5 in number. The statistical difference between vitamin D levels, in patients having breast cancer and patients not having breast cancer was highly significant (p value 0.0001), showing the strong association between decreased vitamin D level and breast cancer in postmenopausal women. Conclusion: Our study showed that vitamin D and levels were inversely associated with risk of developing breast cancer. Vitamin D helps in prevention of cancer by reducing inflammation, anti-apoptotic, and anti-proliferative property. Vitamin D supplementation are needed in premenopausal women in order to reduce the risk of breast cancer in peri and post menopausal women

Research and consideration on vitamin D physiology is crucial as approximately half of the people is being detected with this deficiency. Thus, the study was undertaken to estimate serum vitamin D and plasma cytokines in patients of diabetic retinopathy. More than fifty percent of worldwide population at risk because of vitamin D inadequacy has achieved contagion amounts. It also considered as a multifunctional hormone. In comparison to healthy control, pro-inflammatory cytokines were noticed to be elevated in patient with Type 2 Diabetes mellitus. Several studies reported significant elevation of plasma IL6(p less than 0.001), C reactive protein (CRP) (P less than 0.001) and elevated levels of TNFα in patients of diabetes. Materials and methods: A cross sectional hospital-based study was undertaken on 160 patients, who attended the ‘Retina Clinic’ of the Institute of Ophthalmology and the Out Patient Department of Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. A well informed written consent for blood sampling was taken from all the patients included in the study and ethical approval was obtained from the institutional ethics committee. Demographic data, serum lipid profiles, HbA1c, fasting blood glucose, arterial blood pressure, visual History and treatment history were documented for all participants using pretested Performa. Results: Maximum and minimum value of different variables. In PDR group range of serum vitamin d level were 4.0ng/mL and 36.0ng/mL. While in NPDR group minimum and maximum levels were 3.50ng/mL and 58.50ng/mL. Minimum and maximum plasma TNFα level in PDR group were1.02pg/mL and 232.2pg/mL. Range of plasma IL10 in PDR patients were 4.6pg/mL and 196.74pg/mL. Minimum and maximum plasma IL1beta level in PDR patients were 11pg/mL and 119.16pg/mL. Range of plasma IL6 in patients with PDR were of 0.07pg/mL and 16pg/m. The mean and standard in various groups. In which, mean serum vitamin D in PDR patients was 15.45±6.15ng/mL whereas in the NPDR patients mean serum vitamin D was 18.99±8.25ng/mL. Conclusion: It concluded that patients with PDR, had lower vitamin D levels as compared to No DR. Showing decline trend in all patients with type 2 diabetes mellitus. On cytokine study it was found that plasma levels of TNF alpha, IL10, IL 1 beta and IL6 are elevated in patients with Type 2 diabetes mellitus patients as compared to non-diabetic healthy controls. 

Background: Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. Materials and Method: A prospective study, for a period of 3 years at Department of Paediatrics, Tertiary care Teaching Hospital was conducted after obtaining ethical committee clearance of the institute. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. An informed consent was taken from parents, detailed history was recorded with particular emphasis on symptoms suggestive of anaemia such as weakness and easy fatiguability, breathlessness on exertion, pica. A thorough clinical examination of every child was done. Results: The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion: In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour

INTRODUCTION Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. MATERIALS AND METHODS A prospective study, for a period of 1 years at Department of Pathology, Chalmeda AnandRao Institute of Medical Sciences was conducted. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. Routine Investigations for anaemia and its causes were done. Anaemia was classified morphologically based on peripheral smear findings. Packed-cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) were determined by automated cell counter. Hemoglobin was estimated by Sahli’s method and expressed in gm%, peripheral smear was stained by Leishman’s stain. Reticulocyte count was done by brilliant crystal stain method, serum iron determination was done by Ramany’s dipyridyl method, Total iron binding capacity was determined by Ramsay’s method, serum vitamin B12 and folic acid was determined by architect method. Results The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour. The current study was taken up, keeping this need in view

Introduction: Omega-3s have been studied extensively for their potential benefits in reducing cardiovascular diseases (CVDs). While some studies suggest positive outcomes, recent evidence shows limited overall effects. The study aims to provide an updated synthesis of the existing evidence, but limitations in study design and individual circumstances need to be considered when interpreting the results. Additional research is required to fully understand the impact of omega-3s on CVDs and guide clinical practice recommendations. Aims and Objectives: To investigate the effect of omega-3 fatty acids (DHA or Docosahexaenoic Acid, and EPA or Eicosatetraenoic Acid) in patients who have cardiovascular abnormalities. Methods: The authors conducted a primary literature search using various online libraries and keywords related to omega-3 and cardiovascular outcomes, resulting in 198 retrieved studies. After applying inclusion and exclusion criteria, 12 appropriate studies were included in the meta-analysis. The outcomes considered were mortality, myocardial infarction, atrial fibrillation, coronary events, and other cardiovascular abnormalities. Statistical analysis was performed using Review Manager 5.3, and odds ratios with 95% confidence intervals were calculated. The significance level was set at p<0.05 to assess the impact of omega-3 fatty acids on cardiovascular events. Results:  The studies vary in design and sample size, with participants ranging in age from 62 to 77.6 years. The main treatments investigated are EPA+DHA, EPA, and Vitamin D3, compared to control groups receiving no treatment or placebos. Daily doses of EPA+DHA range from 0.84 to 4.0 grams. Meta-analysis results show that omega-3 consumers have a lower risk of adverse cardiovascular events. Some studies did not find significant effects, but overall, omega-3 supplementation appears beneficial in preventing cardiovascular diseases (P<0.00001). Conclusion: The study has concluded there is evidence found in support of omega-3 fatty acids that can reduce adverse cardiovascular events in the form of cardiovascular diseases or mortality. 

Introduction: Chronic Kidney Disease (CKD) represents a major global health concern characterized by the progressive deterioration of renal function. Patients with CKD often experience endothelial dysfunction, a pivotal role in the pathogenesis of cardiovascular complications. Haemodialysis, a common renal replacement therapy, further exacerbates the risk of endothelial dysfunction. Emerging evidence suggests that Vitamin D, a multifunctional secosteroid hormone, plays a significant role in modulating endothelial function and may hold the key to reducing endothelial dysfunction in CKD patients undergoing haemodialysis. Material and Methods: It is a prospective – Multicentric study and observational study of vitamin D supplementation in patients with various stages of CKD were included. Duration of study period is 2 years 6 months A total number of 150 samples were collected and divided into three groups as per the stages of CKD. Group 1 with CKD stage 1 and 2 (n=50), Group 2 with CKD stage 3 and 4( n=50), Group 3 with CKD stage 5 (n=50). 3 ml of Venous sample was collected and centrifuged at 3500 rpm to obtain the serum sample and it was processed for the analysis of Vitamin D and Nitric Oxide by endpoint ELISA method at 450 nm. Results: The Mean Vitamin D and Nitric Oxide levels in Group I (Individuals with CKD stage 1 and 2) are 21. 2 ng/ml and 29.24 Micromoles/L, Mean Vitamin D and Nitric Oxide levels in Group II (Individuals with CKD stage 3 and 4) are 14.32 ng/ml and 24.26 Micromoles/L, Mean Vitamin D and Nitric Oxide levels in Group III ( Individuals with CKD stage 5) are 10. 34 ng/ml and 23.98 Micromoles/L respectively. Conclusion: Critical role of Vitamin D in preserving endothelial function and reducing the risk of endothelial dysfunction in CKD patients with irrespective of their disease stage. Understanding the intricate relationship between Vitamin D and endothelial health offers valuable insights for clinicians, researchers, and healthcare providers in the quest to improve the cardiovascular outcomes and overall well-being of CKD patients undergoing haemodialysis. Further research and clinical trials are warranted to establish the optimal dosing and timing of Vitamin D supplementation for maximum therapeutic benefit in this vulnerable population.

An accumulating body of evidence has established that one of the clinical implications of vitamin D deficiency in diabetes mellitus (DM) is the contribution of cardiovascular disease (CVD) among different groups. Objectives: This study aims to investigate the correlation of Vitamin D levels with cardiovascular risk and their association in diabetic patients compared to healthy controls, along with the correlation with significant biomarkers. Materials and Methods: This cross-sectional study was conducted on 240 participants (120 diabetic patients and 120 control group). Standardized approaches were used to evaluate Serum Vitamin D concentrations, lipid profiles, glycaemic parameters, pro-oxidant biomarkers, and inflammatory biomarkers. T-tests and correlation analyses were performed to conduct statistical analyses of significant associations. Results: The diabetic group had significantly lower vitamin D status (13±5 ng/mL) compared to healthy subjects (28.2±8 ng/mL, p<0.001). Vitamin D was found to have strong inverse correlations with low-density lipoprotein (LDL) (r = -0.65, p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (r = -0.58, p < 0.001), and systolic blood pressure (r = -0.52, p < 0.001). Based on sex, it was found that the prevalence of vitamin D deficiency was 65 % among women as compared to 45 % among men (p < 0.05).

Introduction: There are a number of causes for Vitamin D deficiency in chronic liver disease, including insufficient sun exposure, inadequate dietary intake, steroid use, deterioration of vitamin synthesis in the skin caused by jaundice, and decreased Vitamin D absorption brought on by intestinal edema secondary to portal hypertension. Present study was aimed to study vitamin D deficiency and its relationship with Child Pugh score in patients with chronic liver disease. Material and Methods: The present study was carried out in the patients who were clinically diagnosed with chronic liver disease. All necessary investigations were performed, and the severity of chronic liver disease (CLD) was defined as per Child Pugh Criteria and MELD scoring system. Results: In the study, the mean age of the subjects was 47.36 ± 10.56 years. Majority were males(80.7%), normal BMI (53.5%). The prevalence of Vitamin D deficiency among the subjects with chronic liver disease was 60.5%. About 28.9% of the subjects were deficient of Vitamin-D, while remaining 10.5% cases showed normal levels of Vitamin D. The mean Vitamin D levels among the subjects was 22.15 ± 5.72 ng/mL. On cross-analysis, the Vitamin D status found to deteriorate significantly with increase in the age group and BMI, more among males and increase in the severity of hepatic encephalopathy. The mortality rate was 2.9% and 30.3% among the subjects with insufficient and deficient levels of Vitamin D respectively. The study also found statistically significant difference in the levels of Vitamin D with respect to severity of liver disease, thereby suggesting that Vitamin D levels reduce significantly among the subjects with severe liver disease. Conclusion: Statistically significant difference was observed in the levels of Vitamin D with respect to the severity of chronic liver disease based on Child Pugh Score.

Background: Retinal Vein Occlusion (RVO) is a prevalent cause of vision impairment in the elderly population. Emerging evidence suggests a potential link between vitamin D deficiency and the incidence of RVO. This study aims to compare serum vitamin D levels in RVO patients with those in age-matched control groups to elucidate this association and highlight the significance of vitamin D as a potential risk factor for RVO. Materials and Methods: This hospital-based case-control study was conducted at the Department of Ophthalmology, Government Medical College and Hospital, Bettiah, Bihar, India, with 50 RVO patients and 50 age-matched controls. Participants were recruited consecutively, and written informed consent was obtained. Comprehensive ophthalmologic evaluations, including fundus photography and OCT, confirmed RVO diagnoses. Medical histories and systemic evaluations, including blood pressure, blood glucose, lipid profiles, and serum vitamin D levels, were recorded. Vitamin D was measured using tandem mass spectrometry, and statistical analysis was performed using GraphPad software. Results: In this study, 50 RVO patients and 50 age-matched controls were analyzed. No significant differences in age and gender distribution were found between the groups. Superotemporal BRVO was the most common RVO type (48%), followed by CRVO (34%) and inferotemporal BRVO (18%). Notably, all RVO patients had suboptimal vitamin D levels compared to controls, with a significant association (p < 0.05). The mean vitamin D level in RVO patients was 21.08 ± 5.08 ng/mL, with no significant differences among subtypes. The study also found a higher prevalence of hypertension and dyslipidaemia among RVO cases compared to controls, indicating these as additional risk factors. Statistical analysis confirmed significant differences in the prevalence of both conditions between cases and controls. Furthermore, the findings suggest that vitamin D deficiency may play a crucial role in the pathogenesis of RVO, underscoring the importance of screening and managing vitamin D levels in at-risk populations. Conclusion: Our study confirmed that low vitamin D levels are prevalent in RVO cases compared to age-matched controls. This suggests vitamin D deficiency is a significant risk factor in RVO development. Routine investigation of vitamin D levels in RVO patients, alongside other risk factors, is recommended. Additionally, patients with vitamin D deficiency should undergo ophthalmological examinations and vitamin D supplementation should be given as prophylaxis in cases of deficiency.

Background: Aim: This study aimed to determine the prevalence, severity, and contributing factors of iron deficiency anemia among school-aged children (6-14 years). The findings provide insights into anemia prevalence and its correlation with iron deficiency, emphasizing the need for preventive interventions. MATERIALS AND METHODS: This observational study was conducted in the Department of Pediatrics over one year (January 1, 2024 – December 31, 2024). A total of 150 children were enrolled from outpatient pediatric clinics and school health programs. Demographic data, dietary habits, and clinical history were collected using a structured questionnaire. Laboratory investigations included a Complete Blood Count (CBC), serum ferritin, serum iron, total iron-binding capacity (TIBC), and a peripheral blood smear. Anemia classification was based on WHO criteria. Statistical analysis was performed to evaluate the association between anemia and various demographic and clinical parameters. RESULTS: The prevalence of anemia among the participants was 45.33%, with mild anemia in 35.82%, moderate anemia in 50.75%, and severe anemia in 13.43% of anemic children. Age and gender did not show a significant effect on hemoglobin levels (p > 0.05). Serum ferritin levels indicated that 10.00% of children had iron deficiency, highlighting that other factors, such as vitamin deficiencies or infections, may contribute to anemia. CONCLUSION: Iron deficiency anemia remains a significant health concern among school-aged children, affecting nearly half of the study population. While iron deficiency plays a role, other nutritional and health-related factors may contribute to anemia. The study underscores the importance of early screening, dietary interventions, and public health initiatives to mitigate the impact of anemia on children's health and academic performance

Background: William Cole introduced the term "stroke" in 1689.1 A stroke is a neurological injury resulting from a sudden localized interruption in the central nervous system. This interruption can arise from intracerebral bleeding, subarachnoid haemorrhage, or cerebral infarction.2 The World Health Organization characterizes a stroke as a rapid onset of clinical symptoms due to a specific disruption in cerebral function.  Objectives: • To find the serum levels of vitamin D in patients with acute stroke and without stroke. • To find out the association between vitamin D and acute ischaemic stroke. Material & Methods: Study Design: Observational Case-Control study.   Study area:  The study was conducted in a Teaching hospital AIMSR & District headquarters hospital, Chittoor. Study Period: 1 year.   Study population: This study included a total of 120 subjects out of which 60 are cases (acute ischaemic stroke) and 60 are controls. Sample size: The study consisted of a total of 120 cases. Results: Among the cases, 28 participants (46.7%) were classified as deficient in vitamin D, 27 participants (45%) were classified as insufficient, and 5 participants (8.3%) were classified as having sufficient levels of vitamin D. The p-value associated with serum vitamin D levels was less than 0.001, indicating a significant difference in the distribution of vitamin D levels between cases and controls. Conclusion: In conclusion, this study found significant differences in serum vitamin D levels and other risk factors, such as hypertension, diabetes, TLC, and FBS, between acute ischemic stroke patients and healthy controls. Lower vitamin D levels in stroke cases suggest a potential link between vitamin D deficiency and increased stroke risk, highlighting its role as a modifiable risk factor.

Background: Vitamin D plays a vital role in insulin sensitivity and glucose metabolism. Postmenopausal women face a higher risk of vitamin D deficiency due to aging, reduced sun exposure, and estrogen decline, which worsens insulin resistance. This study examines the relationship between vitamin D deficiency and insulin resistance in postmenopausal women. Materials and Methods: This cross-sectional study was conducted at Shaheed Nirmal Mahto Medical College, Dhanbad, in the Departments of Physiology and Medicine, with a sample size of 175 postmenopausal women aged 45–70 years. Participants were recruited from outpatient and inpatient services based on inclusion and exclusion criteria. A structured questionnaire was used to collect demographic, lifestyle, and clinical data. Biochemical parameters assessed included serum 25-hydroxyvitamin D levels (ECLIA method), fasting plasma glucose, postprandial blood glucose, glycated hemoglobin (HbA1c), fasting insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Correlations between vitamin D levels and insulin resistance markers were analyzed using Pearson’s correlation and linear regression models. A p-value of less than 0.05 was considered statistically significant. Results: Vitamin D deficiency (<20 ng/mL) was prevalent in 56.0% of participants, with only 12.6% having sufficient levels (≥30 ng/mL). A strong inverse correlation was observed between vitamin D levels and insulin resistance markers, including fasting insulin (r = -0.39, p < 0.001) and HOMA-IR (r = -0.45, p < 0.001). Participants with vitamin D deficiency exhibited significantly higher fasting glucose (132.8 mg/dL), postprandial glucose (186.4 mg/dL), and HbA1c (7.4%), indicating poor glycemic control. Additionally, 81.6% of vitamin D-deficient individuals had an HbA1c >7%, compared to 22.7% in those with sufficient vitamin D levels (p < 0.001). The findings suggest a significant association between vitamin D insufficiency and increased insulin resistance in postmenopausal women. Conclusion: Vitamin D deficiency is highly prevalent in postmenopausal women and strongly correlates with insulin resistance. Routine vitamin D screening and targeted interventions, including supplementation and lifestyle modifications, may improve insulin sensitivity and metabolic health. Further studies are needed to explore vitamin D optimization in diabetes prevention

Background: Vitamin D is essential for calcium balance and immunity, and is linked to infections and sepsis-related mortality. Limited data exists on its impact on pediatric sepsis in India. This study investigates the relationship between Vitamin D status and outcomes in children with sepsis at Gulbarga Institute of Medical Sciences, Kalaburagi. Methods: A six-month prospective observational study included 40 children aged 1 month to 18 years with sepsis. Data on health history, illness duration, sunlight exposure, and supplement intake were collected. Serum vitamin D levels were measured within 24 hours of PICU admission. Outcomes were measured as hospital stay duration, ventilator support duration, and mortality. Results: Age positively correlated with Vitamin D levels (P<0.01), but no gender differences were found. Height, weight, BMI, and waist circumference positively correlated with Vitamin D levels (P<0.05). Negative correlations were observed between Vitamin D levels and heart rate, temperature, and ESR (P<0.05), while platelet count had a positive correlation (P<0.01). Sufficient Vitamin D levels were associated with shorter hospital and ventilator stays (P<0.05). Conclusion: Assessing and addressing Vitamin D deficiency in septic children may improve clinical outcomes, especially in vulnerable infants. Larger studies are needed to establish definitive evidence.

Vitamin D has emerged as a potential modulator of cardiovascular health. Epidemiological studies link vitamin D insufficiency with higher risks of hypertension and cardiovascular disease (CVD) events. Receptors of Vitamin D are expressed in cardiac and vascular tissues and severe deficiency of vitamin D is reported worldwide. However, does vitamin D play a causal protective role in cardiovascular health remains under debate, given inconsistent trial results. This review details the physiological role of Vitamin D in cardiovascular health which includes its role in the renin-angiotensin-aldosterone system (RAAS), vascular endothelial health, inflammation and oxidative stress, vascular calcification, disease risk in deficiencies and supplementation. In summary, vitamin D shows biological plausibility and modest signals of benefit for cardiovascular health, but robust evidence for routine supplementation to prevent heart disease or improve vascular outcomes is still lacking.

Background: Hyperglycemia and insulin resistance are hallmarks of type-2 diabetes mellitus (T2DM), a chronic metabolic disease. According to new research, the pathophysiology of type 2 diabetes may be significantly influenced by mineral metabolism, including that of calcium, phosphorus, and vitamin D. Aim: Evaluating the correlation of serum calcium, phosphorus and vitamin-D in Type-2 diabetic mellitus patients. Material & Methods: This was a Hospital Based Prospective Cross-sectional study between case and control group carried out for a period of One year in the Department of Biochemistry and Physiology at a Tertiary care Centre.A total of 100patients were assessed out of which 50were healthy individuals (control group) and other 50 were individulas with type-2 diabetes mellitus patients (cases) .Blood samples were collected after overnight fasting under all aseptic conditions for fasting plasma glucose level, postprandial glucose level, glycated hemoglobin, vitamin-D, calcium and phosphorous level were studied. Results: This study include 100individuals which was divided into two groups. Group I(CASE GROUP): include diabetic patients (n=50), in which males were 33(66%) and females were 17(34%). The maximum number of diabetic patients were found in the age group of 61-70 (30%) .In diabetic patients, 31(77.5%) individuals have phosphorous level recorded with <3.4mg/dl. 15(37.5%) individuals have serum calcium level less than 8.4mg/dl and  only 22.5% of diabetic patients were observed to be less concentration of Vitamin-D level. Conclusion: Measuring serum calcium, phosphorus, and vitamin D levels is essential for tracking type 2 diabetes prognosis. These are the early indicators that should be taken into account when diagnosing type-2 diabetes.

Background: Vitamin D is an essential vitamin with various vital functions in the body including calcium and phosphate homeostasis and bone formation. It is said that it also has various roles in immune function, inflammation, cell proliferation, differentiation and apoptosis. Vitamin D deficiency has been linked with a number of health outcomes such as osteoporosis, osteomalacia, diabetes, hypertension, heart disease, cancer, autoimmune disease and infectious disease. Vitamin D deficiency has been well documented in the general population. However, there are very few studies on Vitamin D deficiency among health care professionals. AIM: To assess the vitamin D status among health care workers in a tertiary care hospital. Materials And Methods: This was a cross-sectional study. After taking informed consent from the participants, each subject was interviewed personally by the investigator and their physical examination was carried out. Data regarding age, sex, body weight, height, body mass index (BMI), Sunlight exposure and use of sun screen usage were recorded from each subject. Serum Vitamin D levels were estimated using chemiluminescent immuno assay (CLIA) method. Vitamin D levels recorded and less than 20ng/ml was taken as deficiency. The prevalence of vitamin D deficiency among health care workers was estimated. Results: Total 75 participants were registered. Out of which 37 were males and 38 were females. The mean value of age of study subjects was 45.55±13.88 years. 65 out of 75 (87%) subjects were either deficient or insufficient of vitamin D. Conclusion: In this study we found that 87% of healthy health care professionals including doctors of various speciality were Vitamin D deficient which is highly prevalent. And there was no significant association between Vitamin D levels and age, sex, physical activity, and BMI. However inadequate sun light exposure seems to be the major cause for vitamin d deficiency.

Background: Vitamin D deficiency is a common health concern globally and has been implicated in a range of musculoskeletal symptoms, particularly fatigue and muscle weakness. Despite increasing awareness, the extent to which vitamin D deficiency correlates with these symptoms in the general population remains underexplored. This study aims to evaluate the prevalence of vitamin D deficiency and its association with fatigue and muscle weakness among adults in a community-based setting. Materials and Methods: A cross-sectional study was conducted over a six-month period, enrolling 300 participants aged 18–60 years from outpatient clinics and community centers. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using a chemiluminescence immunoassay. Participants were categorized into three groups: deficient (<20 ng/mL), insufficient (20–30 ng/mL), and sufficient (>30 ng/mL). Fatigue was assessed using the Fatigue Severity Scale (FSS), and muscle strength was evaluated by handgrip dynamometry. Statistical analysis included Chi-square and ANOVA tests, with significance set at p<0.05. Results: Out of 300 participants, 162 (54%) were vitamin D deficient, 84 (28%) were insufficient, and 54 (18%) had sufficient levels. The mean FSS score in the deficient group was 5.6 ± 1.1 compared to 3.8 ± 0.9 in the sufficient group (p<0.001). Mean handgrip strength was significantly lower in the deficient group (18.4 ± 3.2 kg) than in the sufficient group (26.1 ± 4.5 kg) (p<0.001). A strong inverse correlation was observed between serum vitamin D levels and both fatigue severity (r = -0.61) and muscle weakness (r = -0.58). Conclusion: The findings suggest a high prevalence of vitamin D deficiency in the general population, which is significantly associated with increased fatigue and reduced muscle strength. Routine screening and correction of vitamin D levels may help alleviate these symptoms and improve quality of life.

Aim: The aim of the present study was to determine the effects of chronic liver disease on bone health. Methods: The present study was conducted in the General medicine and Gastroenterology Department at NIMS Hospital, Jaipur for the period of 18months and 171 patients were included in the study. Results: The mean age of the participants was 53.79 ± 11.79 years. Of the total sample, 85 (49.7%) were female and 86 (50.3%) were male. In terms of occupation, the largest group of participants were laborers (35, 20.5%), followed by self-employed individuals (33, 19.3%), and farmers (32, 18.7%). Regarding dietary habits, 88 (51.5%) of the participants followed a vegetarian diet, while 83 (48.5%) followed a non-vegetarian diet. In terms of alcohol consumption, 88 (51.5%) reported yes to alcohol consumption similarly, regarding smoking status, 97 (56.7%) were smokers. The duration of liver disease among the participants ranged from 3 to 8 years, with a median duration of 5 years. Regarding the provisional diagnosis, the most common diagnosis was Non-alcoholic fatty liver disease (NAFLD). For osteoporosis, a larger proportion of the participants, 143 patients (83.6%), did not have osteoporosis and the history of fractures was reported by a small number of participants, with 4 patients (2.3%) having a fracture history. Conclusion: In conclusion, this study underscores the critical importance of closely monitoring bone health in patients suffering from chronic liver disease (CLD). The findings reveal a significant prevalence of osteopenia and a noteworthy presence of osteoporosis, highlighting the detrimental impact that liver dysfunction can have on skeletal health. Key contributing factors, such as suboptimal vitamin D levels, hypocalcemia, and altered bone metabolism, were identified, emphasizing the interconnectedness of liver function and bone health.

Background: Hypothyroidism, a condition characterized by insufficient thyroid hormone production, is commonly caused by autoimmune thyroiditis, particularly Hashimoto’s thyroiditis. Vitamin D deficiency has been increasingly recognized as a factor in the development and progression of autoimmune diseases, including hypothyroidism. Despite growing evidence of a potential relationship between vitamin D levels and thyroid function, the exact correlation between vitamin D deficiency and hypothyroidism remains inconclusive. Objective: The objective of this study was to investigate the relationship between vitamin D deficiency and thyroid function in patients with primary hypothyroidism, specifically examining the association between serum vitamin D levels and thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). Materials and Methods: This was a study conducted between January  2023 and December  2024 at Andhra   medical college, King George hospital , Visakhapatnam. A total of 221 patients, aged 20-60 years, diagnosed with primary hypothyroidism were included. The study excluded patients undergoing treatment for hyperthyroidism, those receiving thyroid hormone replacement therapy, and individuals on medications affecting thyroid function. Participants underwent clinical examinations, and laboratory tests were performed to measure TSH, T3, T4, and 25-hydroxyvitamin D (vitamin D) levels. Vitamin D levels were categorized as deficient (<20 ng/ml), insufficient (20-30 ng/ml), and sufficient (>30 ng/ml). The relationship between vitamin D levels and thyroid function was assessed using Pearson's correlation coefficient. Results: Among the 221 patients, 69.64% were vitamin D deficient, 16.74% had insufficient levels, and 13.62% had sufficient levels. A significant negative correlation was found between vitamin D deficiency and TSH (r = -0.336), with lower vitamin D levels associated with higher TSH, particularly in patients with overt hypothyroidism. Pearson’s correlation analysis also indicated a positive correlation between vitamin D deficiency and T3 (r = 0.248) and T4 (r = 0.291), suggesting a potential regulatory effect of vitamin D on thyroid hormones. Conclusion : The study confirmed a high prevalence of vitamin D deficiency in patients with primary hypothyroidism, with a significant negative correlation between vitamin D levels and TSH. The findings suggest that vitamin D deficiency may contribute to the progression of hypothyroidism, particularly in more severe forms.

Background: Chronic Fatigue Syndrome (CFS), or Myalgic Encephalomyelitis (ME), is a debilitating disorder characterized by extreme fatigue that is not improved with rest and worsens with physical or mental exertion. Recent studies suggest a potential role of micronutrient deficiencies, particularly Vitamin D, in the pathophysiology and symptomatology of CFS. Objective: To assess the prevalence of Vitamin D deficiency in adults diagnosed with Chronic Fatigue Syndrome. Methods: A cross-sectional study was conducted involving 100 adult patients (aged 18–60 years) diagnosed with CFS based on CDC criteria. Serum 25-hydroxyvitamin D levels were measured, and deficiency was defined as <20 ng/mL. Demographic data, fatigue severity, and comorbidities were recorded and analyzed. Results: Among the 100 participants, 68% were found to have Vitamin D deficiency, 22% had insufficiency (20–30 ng/mL), and only 10% had sufficient levels (>30 ng/mL). A significant association was found between Vitamin D deficiency and higher fatigue severity scores (p<0.01). Conclusion: Vitamin D deficiency is highly prevalent among adults with Chronic Fatigue Syndrome. Screening for and correcting this deficiency may be a valuable adjunct in managing fatigue symptoms.

Background: Vitamin D deficiency is increasingly recognized as a global health issue and has been implicated in the development of several chronic metabolic conditions. Emerging evidence suggests a potential link between low serum vitamin D levels and components of metabolic syndrome (MetS), including central obesity, dyslipidemia, hypertension, and insulin resistance. This study aimed to evaluate the prevalence of vitamin D deficiency and its association with metabolic syndrome among urban adults. Materials and Methods: A cross-sectional study was conducted among 200 adults aged 25–60 years residing in an urban area. Participants were selected through stratified random sampling. Anthropometric measurements, blood pressure, and fasting blood samples were collected to assess serum 25-hydroxyvitamin D [25(OH)D], fasting glucose, triglycerides, and HDL cholesterol. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Serum vitamin D levels were categorized as sufficient (≥30 ng/mL), insufficient (20–29 ng/mL), and deficient (<20 ng/mL). Statistical analysis was performed using chi-square and logistic regression tests. Results: Among the 200 participants, 62% were found to have vitamin D deficiency, 24% had insufficient levels, and only 14% had sufficient vitamin D levels. The overall prevalence of metabolic syndrome was 38%. A significantly higher prevalence of metabolic syndrome was observed in individuals with vitamin D deficiency (49%) compared to those with sufficient vitamin D levels (18%) (p < 0.01). Logistic regression analysis showed that vitamin D deficiency was independently associated with increased odds of metabolic syndrome (OR: 2.7; 95% CI: 1.4–5.3, p = 0.003), even after adjusting for age, gender, and BMI. Conclusion: This study highlights a high prevalence of vitamin D deficiency in urban adults and suggests a significant association between low vitamin D levels and metabolic syndrome. Early identification and correction of vitamin D deficiency may be beneficial in reducing the risk of metabolic syndrome and related complications.

Introduction: Cardiovascular diseases are the leading global cause of mortality, accounting for 31% of deaths, and AMI is responsible for 85% of fatalities. Acute myocardial infarction (AMI) in very young individuals is an emerging clinical concern with distinct risk factor profiles and presentations compared to older patients. This study aimed to compare the clinical characteristics and risk factor profile between very young (≤30 years) and older (≥50 years) patients presenting with first acute MI. Methods: This cross-sectional observational study was conducted Department of Cardiology of Dhaka Medical College & Hospital, Sir Salimullah Medical College & Mitford Hospital, National Institute of Cardiovascular Diseases (NICVD), Bangladesh Specialized Hospital (BSH), Dhaka, Bangladesh. This study was carried out from July 2022 to December 2023. In this study, we included 160 patients and divided them into two equal groups: Group I (very young, n = 80) and Group II (older, n = 80). Result: Males predominated in both groups with no significant difference in gender distribution (p = 0.137). Older patients had significantly higher frequencies of epigastric pain and nausea/vomiting (p < 0.05). Blood pressures were significantly higher in the older Group (SBP: p = 0.004, DBP: p = 0.029). Younger patients had a significantly higher prevalence of smoking, dyslipidemia, obesity, positive family history of CAD, and substance abuse (p < 0.05), while hypertension and diabetes mellitus were more common in older patients (p < 0.05). Cardiogenic shock and complete heart block were more frequent in younger patients, with cardiogenic shock reaching statistical significance (p = 0.008). Independent predictors for AMI in the very young included smoking (OR = 12.0), dyslipidemia (OR = 8.89), obesity (OR = 21.89), family history of CAD (OR = 17.69), substance abuse (OR = 4.34), and elevated CRP levels (OR = 1.08). In older patients, diabetes mellitus (OR = 12.69), hypertension (OR = 26.62), and low vitamin D levels (OR = 1.11) were significant predictors (all p < 0.001). Conclusion: This study showed that very young patients exhibited more typical clinical features, higher complication rates, and a greater prevalence of certain risk factors such as smoking, obesity, dyslipidemia, and family history of CAD. But older patients had more atypical symptoms with predominant conventional risk factors.

Background: Congenital heart disease (CHD) is one of the most common birth defects, and children affected by it are highly susceptible to malnutrition and anemia due to increased metabolic demands, poor feeding, and delayed surgical interventions. Objectives: To assess the nutritional status and anemia among children aged 1–12 years diagnosed with CHD admitted at a tertiary care hospital, and to compare findings between acyanotic and cyanotic heart defects. Methods: This was a cross-sectional study conducted over two years at the Institute of Child Health, Niloufer Hospital, Hyderabad. A total of 154 preoperative CHD patients aged 1–12 years were enrolled using purposive sampling. Nutritional status was evaluated using anthropometric measurements (W/A, H/A, W/H, BMI, MUAC), and anemia was assessed through hematological indices including hemoglobin, red cell indices, RDW, and serum ferritin levels. Data were analyzed using SPSS v20; p < 0.05 was considered statistically significant. Results: Among the 154 children, 69.5% were aged 1–5 years, with equal gender distribution. Acyanotic CHD was more prevalent (93.5%). Overall, 44.2% were underweight, and 48.7% were stunted. Pallor was present in 52.6% of cases, and vitamin D deficiency in 35.7%. BMI assessment showed 21.4% of children were underweight. Nutritional and hematological deficits were more marked in acyanotic CHD than cyanotic CHD. Conclusions: Children with CHD are at high risk of malnutrition and anemia. Routine nutritional assessment and early interventions are crucial to improving outcomes.

Background: Emerging evidence suggests a link between vitamin D deficiency and elevated cardiovascular risk. However, limited data exist from population-based cohorts in India. This study aimed to evaluate the association between serum vitamin D levels and cardiovascular risk factors in an adult population. Methods: In this prospective cohort study, 338 apparently healthy adults were evaluated over a six-month period at a tertiary care center. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured and categorized into deficient (<20 ng/mL), insufficient (20–30 ng/mL), and sufficient (>30 ng/mL) groups. Cardiovascular risk markers—including BMI, blood pressure, lipid profile, and fasting glucose—were assessed. Correlation and regression analyses were conducted to identify significant associations. Results: Vitamin D deficiency was present in 34.3% of participants. Deficient individuals had significantly higher mean BMI (27.3 ± 3.5 vs. 23.2 ± 2.9 kg/m²), systolic BP (138.4 ± 14.1 vs. 123.6 ± 10.5 mmHg), LDL (141.3 ± 31.1 vs. 118.7 ± 28.6 mg/dL), triglycerides (186.4 ± 50.5 vs. 142.3 ± 47.1 mg/dL), and fasting glucose (108.3 ± 15.4 vs. 94.7 ± 11.2 mg/dL) compared to the sufficient group (p < 0.001). Vitamin D levels were negatively correlated with BMI (ρ = -0.285), SBP (ρ = -0.350), LDL (ρ = -0.459), TG (ρ = -0.438), and fasting glucose (ρ = -0.295). Multivariate regression identified BMI, SBP, LDL, and TG as independent predictors of vitamin D levels. Conclusion: Vitamin D deficiency is highly prevalent and independently associated with unfavorable cardiovascular risk profiles. These findings highlight the potential utility of vitamin D screening in cardiovascular risk assessment.

Background: Type 2 diabetes mellitus (T2DM) and pre-diabetes are major global health concerns characterized by insulin resistance and impaired glucose metabolism. Vitamin D has been implicated in glucose homeostasis, and moderate physical activity is a well-established intervention to improve insulin sensitivity. This study investigates the combined effects of vitamin D supplementation and moderate exercise on plasma insulin levels in individuals with pre-diabetes and T2DM. Objective: To evaluate whether vitamin D supplementation in conjunction with moderate exercise enhances plasma insulin levels in pre-diabetic and T2DM patients. Methods: A randomized controlled trial was conducted with 200 participants (100 pre-diabetics, 100 T2DM patients) aged 30–65 years. Subjects were randomly assigned to four groups: Control (no intervention), Vitamin D only, Exercise only, and Combined (Vitamin D + Exercise). Vitamin D3 was administered at a dose of 4000 IU/day for 6 months. Exercise consisted of 45 minutes of moderate-intensity aerobic activity five days per week. Fasting plasma insulin levels were measured at baseline, 3 months, and 6 months. Results: The combined group showed a statistically significant increase in plasma insulin levels compared to the control and individual intervention groups (p<0.01). Improvements were more pronounced in the pre-diabetic subgroup. Multivariate analysis indicated synergistic effects of vitamin D and exercise on insulin secretion. Conclusion: Vitamin D supplementation combined with moderate exercise significantly enhances plasma insulin levels in pre-diabetic and T2DM patients. These findings support a multi-modal approach to diabetes prevention and management.

Background: Warts, also known as verrucae, are a prevalent kind of viral infection of the skin caused by the human papillomavirus. Benign tumors commonly occur in the skin and other epithelial tissues. Despite the availability of various therapies, effectively treating warts can be challenging, particularly when they are numerous and resistant to treatment. Recently, the treatment of warts has included the use of different immunotherapeutic drugs. Initially, Aktas et al studied the use of intralesional Vitamin D3 (Vit. D3) injection and documented encouraging results. Aim: To evaluate the efficacy of intralesional administration of Vit. D3 in the management of cutaneous warts. Objectives: 1. To provide a comprehensive analysis of the age distribution, sex distribution, number, duration, and kinds of cutaneous warts. 2. To evaluate the reduction in size and quantity of skin warts following each session of intralesional administration of Vit. D3. Material and Methods: This study comprised 30 patients with cutaneous warts who visited the Dermatology Outpatient Department (DVL OPD) at SVRRGG Hospital, Tirupati. The patients were treated with intralesional administration of Vit. D3 into the warts.  Results: The overall rate of total dissolution of cutaneous warts following the administration of Vit. D3 by injection was 66.67%.  Conclusion: Intralesional administration of Vitamin D3 injection is a novel therapeutic choice for the treatment of warts. The intervention is economically efficient, safe, and has shown significant benefits, especially in underdeveloped nations.