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The Journal of the Association of... Apr 2022Current study intends to study the etiological profile of Pancytopenia and to identify the complete blood count (CBC), peripheral smear (PS) findings which are helpful... (Observational Study)
Observational Study
UNLABELLED
Current study intends to study the etiological profile of Pancytopenia and to identify the complete blood count (CBC), peripheral smear (PS) findings which are helpful in narrowing the differential diagnosis and in planning the additional investigations to arrive at a specific diagnosis.
MATERIAL
Hospital based observational study being conducted at tertiary centre, Jaipur.
INCLUSION CRITERIA
Patients >18 years, CBC on admission fulfilling criteria of pancytopenia as mentioned in definition.
EXCLUSION CRITERIA
Patients > 80 years, Patients on radiotherapy and chemotherapy., Observation :Mean age of patients was 35.42 years with majority (29.90%) patients with majority of patients were in 2nd and 3r decade of their life with male preponderance Male: female ratio is 1.15:1). Vitamin B-12 deficiency (34.02%), folate deficiency (18.55%) CLD (9.27%) were the most common cause of pancytopenia.
CONCLUSION
Detailed clinical history and meticulous physical examination along with baseline hematological investigations, provides invaluable information in the complete workup of pancytopenic patients, helping in systematic planning of further investigations to diagnose and ascertain the cause.
Topics: Adult; Blood Cell Count; Diagnosis, Differential; Female; Folic Acid Deficiency; Humans; Male; Pancytopenia; Vitamin B 12 Deficiency
PubMed: 35443537
DOI: No ID Found -
Pediatric Annals Aug 2019The importance of vitamin D and its role in several biological processes has been a topic of interest in recent years. Vitamin D is an essential nutrient that is needed... (Review)
Review
The importance of vitamin D and its role in several biological processes has been a topic of interest in recent years. Vitamin D is an essential nutrient that is needed for metabolic bone health and for maintaining bone calcium homeostasis. It is primarily synthesized in the skin on exposure to sunlight. Of late, vitamin D deficiency has been associated with conditions such as obesity, poor control of asthma and other autoimmune diseases, which has led to questions about its potential role in causation and management of these conditions. Given the increase in data about this topic, providers may often have questions about whom to screen and what to tell patients. In this article, we address screening guidelines for vitamin D in children and adolescents, management of vitamin D deficiency, and current literature on the role of vitamin D in conditions such as obesity, asthma, and type 1 diabetes mellitus. [Pediatr Ann. 2019;48(8):e298-e303.].
Topics: Adolescent; Asthma; Child; Diabetes Mellitus, Type 1; Dietary Supplements; Humans; Pediatric Obesity; Sunlight; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 31426097
DOI: 10.3928/19382359-20190724-01 -
Nutrients May 2023This review aims to identify the current indications and gaps in the management of fat-soluble vitamins in pediatric patients with cholestasis. (Review)
Review
BACKGROUND
This review aims to identify the current indications and gaps in the management of fat-soluble vitamins in pediatric patients with cholestasis.
METHODS
A comprehensive review of the literature using PubMed, Scopus, Web of Science and Embase was performed. Two authors independently identified the most relevant studies published over the past 20 years up to February 2022, including original papers, narrative reviews, observational studies, clinical trials, systematic reviews and meta-analyses. The literature was screened, and preclinical studies about pathogenetic mechanisms were also included. Keywords searched for each fat-soluble vitamin (A, D, E and K), alone or in combination, were "cholestasis", "chronic liver disease", "biliary atresia", "malnutrition" and "nutritional needs". Studies published prior to the selected time range were searched manually and, when considered relevant, included within the list of references.
RESULTS
Eight hundred twenty-six articles were initially screened. From these, 48 studies were selected. A comparison of the recommended methods of supplementation for fat-soluble vitamins was then carried out. The causes of malabsorption were explained and current methods for defining deficiency and monitoring complications were summarized.
CONCLUSIONS
According to the literature, children with cholestasis are at a higher risk of fat-soluble vitamin deficiency. Although there are general recommendations, the treatment for vitamin deficiency is not uniformly validated.
Topics: Child; Humans; Vitamins; Cholestasis; Avitaminosis
PubMed: 37299454
DOI: 10.3390/nu15112491 -
Revue Medicale Suisse Feb 2019Vitamin D deficiency is increasing in Switzerland. If cases of rickets are scarce, pediatricians are often dealing with patients presenting vitamin D deficiency. The... (Review)
Review
Vitamin D deficiency is increasing in Switzerland. If cases of rickets are scarce, pediatricians are often dealing with patients presenting vitamin D deficiency. The increase in vitamin D deficiency is certainly due to modification of life habits in recent decades. Clinical presentation varies according to age and severity of deficit. Treatments differ based on the level of vitamin D deficiency and symptoms. Vitamin D deficiency rickets is the most common cause of rickets and is predominantly seen in patients with risks factors They are other types of rickets like pseudo-vitamin D deficiency and hypophosphatemic rickets that the clinician needs to recognize. In which situation should the clinician suspect vitamin D deficiency or rickets ? Different types of rickets and practical aspects of treatment are reviewed in this article.
Topics: Humans; Research; Rickets; Risk Factors; Switzerland; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 30762999
DOI: No ID Found -
Spinal Cord Dec 2016Narrative review. (Review)
Review
STUDY DESIGN
Narrative review.
OBJECTIVES
This review provides an overview of the etiological factors and consequences of vitamin D insufficiency in relation to spinal cord injury (SCI) as well as important considerations for vitamin D supplementation.
SETTING
Montreal, Canada.
METHODS
Literature search.
RESULTS
Vitamin D insufficiency is common in SCI individuals owing to the presence of many contributing factors including limited sun exposure and intake, use of medication and endocrine perturbations. Although there are several biological plausible mechanisms by which vitamin D may act upon musculoskeletal and cardiometabolic health, the impact of vitamin D insufficiency on such systems remains ill defined in SCI. In the absence of guidelines for the management of vitamin D insufficiency in this high-risk population and in an attempt to provide clinical guidance, considerations for vitamin D supplementation such as the type of vitamin D, dosing regimens and toxicity are discussed and tentative recommendations suggested with particular reference to issues faced by SCI patients.
CONCLUSION
Although high rates of vitamin D insufficiency are encountered in SCI individuals, its consequences and the amount of vitamin D required to prevent insufficiency are still unknown, indicating a need for more intervention studies with well-defined outcome measures. Routine screening and monitoring of vitamin D as well as treatment of suboptimal status should be instituted in both acute and chronic setting. The close interactions between vitamin D and related bone minerals should be kept in mind when supplementing SCI individuals, and practices should be individualized with clinical conditions.
Topics: Animals; Humans; Spinal Cord Injuries; Vitamin D Deficiency
PubMed: 27645263
DOI: 10.1038/sc.2016.131 -
Critical Pathways in Cardiology Sep 2017Vitamin D has been traditionally recognized as a vitamin quintessential for bone-mineral health. In the past 2 decades, numerous experimental and observational studies... (Review)
Review
Vitamin D has been traditionally recognized as a vitamin quintessential for bone-mineral health. In the past 2 decades, numerous experimental and observational studies have highlighted the role of vitamin D in immunity, metabolic syndrome (obesity and diabetes), cancers, renal disease, memory, and neurological dysfunction. In this article, we review important studies that focused on the impact of vitamin D on blood pressure, myocardial infarction, peripheral arterial disease, heart failure, and statin intolerance. Amidst the current pool of ambiguous evidence, we intend to discuss the role of vitamin D in "high-value cardiovascular health care".
Topics: Cardiovascular Diseases; Dietary Supplements; Humans; Vitamin D Deficiency
PubMed: 28742648
DOI: 10.1097/HPC.0000000000000122 -
Child: Care, Health and Development May 2019Studies suggest that trace element and vitamin deficiencies are common in children with autism spectrum disorder (ASD). Data describing the rates of vitamin and trace...
BACKGROUND AND OBJECTIVES
Studies suggest that trace element and vitamin deficiencies are common in children with autism spectrum disorder (ASD). Data describing the rates of vitamin and trace element deficiencies in the ASD population of the northwest of Ireland is lacking. We wished to determine the prevalence of zinc and vitamin A deficiency in the ASD population compared with controls within this geographical area.
METHODS
Parents of children aged 2-18 years with ASD were invited to participate in the study. The control group consisted of well children attending the paediatric department for routine blood sampling. Children on vitamin supplements were excluded from both ASD and control groups. Informed written consent was obtained prior to recruitment. Samples were analysed for zinc and vitamin A levels according to standardized laboratory procedures.
RESULTS
Seventy-four of the 150 children with ASD who were invited and 72 controls underwent blood sampling. Mean zinc and vitamin A levels were normal in both groups. There were significantly more males in the ASD group (88% versus 56%, p value < 0.001). The mean (SD) zinc level was not different between the groups (ASD 11.7 [1.7] versus control 11.6 [2.1] μmol/L, p value = 0.86). The mean (standard deviation) vitamin A level was higher in the ASD group (ASD 350.6 [82.6] versus 319.2 [82.8] μg/L, p value = 0.03), but this was likely confounded by age.
CONCLUSION
Children with ASD in the northwest of Ireland have mean zinc and vitamin A levels within the normal range. It is important that these findings are relayed to health professionals and to parents of children with ASD so that informed decisions on vitamin supplementation can be made.
Topics: Adolescent; Autism Spectrum Disorder; Case-Control Studies; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Cohort Studies; Female; Humans; Ireland; Male; Prevalence; Vitamin A; Vitamin A Deficiency; Zinc
PubMed: 30821006
DOI: 10.1111/cch.12655 -
The Permanente Journal 2018Vitamin D is a lipophilic prohormone integral to musculoskeletal, autoimmune, oncologic, cardiovascular, and mental health. Of particular importance to the orthopedic... (Review)
Review
Vitamin D is a lipophilic prohormone integral to musculoskeletal, autoimmune, oncologic, cardiovascular, and mental health. Of particular importance to the orthopedic surgeon is the role of vitamin D in the regulation of bone mass, muscle strength, and physical performance. Although vitamin D-related skeletal pathologies are rare in industrialized nations, emerging research in the field has shown that most American adults have inadequate levels of vitamin D. Even among athletes, there is a high prevalence of vitamin D deficiency, which may place competitors at risk of stress fractures, illness, and delayed muscle recovery. Adequately identifying vitamin D-deficient individuals in need of supplementation is important to help optimize performance and prevent future injury. The goal of this review is to describe the epidemiology of vitamin D deficiency and its effects on athletic performance and musculoskeletal health. Future double-blinded studies of vitamin D supplementation in athletes are needed. We recommend treating athletes who have insufficient or deficient vitamin D levels.
Topics: Athletes; Athletic Performance; Humans; Muscle, Skeletal; Vitamin D Deficiency
PubMed: 30005732
DOI: 10.7812/TPP/17-216 -
Journal of Pediatric Nursing 2019No consensus on vitamin D deficiency (VDD) screening in children and adolescents exists. Early VDD detection can improve the health of children. VDD can cause bone... (Review)
Review
PROBLEM
No consensus on vitamin D deficiency (VDD) screening in children and adolescents exists. Early VDD detection can improve the health of children. VDD can cause bone mineralization diseases, such as rickets in children. The purpose of this review is to determine existing VDD screening recommendations or clinical practice guidelines in children and adolescents.
ELIGIBILITY CRITERIA
Inclusion criteria were VDD screening 'guideline', 'clinical practice guideline', and 'recommendations' for children and adolescents in English, published 2001-2018.
RESULTS
Eight current guidelines addressed VDD screening recommendations with the common recommendation results endorsing screening only for VDD in at-risk children and adolescents.
CONCLUSIONS
There is insufficient evidence for pediatric healthcare providers to recommend which VDD risk factors should be utilized for screening in children and adolescents.
IMPLICATIONS
Further studies should focus on developing a validated VDD screening tool for children and adolescents based on risk factors.
Topics: Adolescent; Child; Child Health; Child Welfare; Dietary Supplements; Humans; Rickets; Risk Factors; Vitamin D; Vitamin D Deficiency
PubMed: 30753957
DOI: 10.1016/j.pedn.2019.02.002 -
The Indian Journal of Medical Research Nov 2018Deficiency of vitamin D or hypovitaminosis D is widespread irrespective of age, gender, race and geography and has emerged as an important area of research. Vitamin D... (Review)
Review
Deficiency of vitamin D or hypovitaminosis D is widespread irrespective of age, gender, race and geography and has emerged as an important area of research. Vitamin D deficiency may lead to osteoporosis (osteomalacia in adults and rickets in children) along with calcium deficiency. Its deficiency is linked with low bone mass, weakness of muscles and increased risk of fracture. However, further research is needed to link deficiency of vitamin D with extra-skeletal consequences such as cancer, cardiovascular disease, diabetes, infections and autoimmune disorders. The causes of vitamin D deficiency include length and timing of sun exposure, amount of skin exposed, latitude, season, level of pollution in atmosphere, clothing, skin pigmentation, application of sunscreen, dietary factors and genetic factors. The primary source is sunlight, and the dietary sources include animal products such as fatty fish, food items fortified with vitamin D and supplements. Different cut-offs have been used to define hypovitaminosis D and its severity in different studies. Based on the findings from some Indian studies, a high prevalence of hypovitaminosis D was observed among different age groups. Hypovitaminosis D ranged from 84.9 to 100 per cent among school-going children, 42 to 74 per cent among pregnant women, 44.3 to 66.7 per cent among infants, 70 to 81.1 per cent among lactating mothers and 30 to 91.2 per cent among adults. To tackle the problem of hypovitaminosis D in India, vitamin D fortification in staple foods, supplementation of vitamin D along with calcium, inclusion of local fortified food items in supplementary nutrition programmes launched by the government, cooperation from stakeholders from food industry and creating awareness among physicians and the general population may help in combating the problem to some extent.
Topics: Dietary Supplements; Food, Fortified; Humans; India; National Health Programs; Prevalence; Vitamin D; Vitamin D Deficiency
PubMed: 30666982
DOI: 10.4103/ijmr.IJMR_1807_18