Frequency of Vitamin D Deficiency among Patients Presenting with Stroke
Amir Taj KhanKalim Ullah KhanMuhammad IshfaqNaveed AhmadMuhammad KhalidMuhammad Zubair KhanIzhar Ahmad
0
Citation
7
Reference
10
Related Paper
Abstract:
Background: Stroke is the leading cause of both mortality and disability on a global scale. The documented incidence of cerebral hemorrhages at Pakistan's CT scan facilities varies from 31-40% of cases, whereas ischemic stroke is claimed to be responsible for 60-90% of cases Objectives: The objective of the study was to assess the prevalence of vitamin D deficiency in patients presenting with stroke Methodology: The current study was descriptive and cross-sectional carried out at the Medicine Department, Hayatabad Medical Complex Peshawar for duration of six months February 2018 to August 2018. Patients were enrolled from both the emergency and accident department and outpatient department. The blood samples were taken and transferred to the hospital diagnostic laboratory for the assessment of deficiency of vitamin D in serum. The data analysis was done by using IBM SPSS version 16. Results: In this study, totally 341 patients were enrolled. There were 239 (70.09%) male patients while female patients were 102 (29.91%). The vitamin D deficiency in serum was observed in 50.1% patients. Conclusion: Stroke is still a calamity, and vitamin D could have played pivotal role in the pathogenesis of stroke. Since most of our population is already deficiency in 25-hydroxyvitamin D, therefore, relationship between stroke and vitamin D deficiency cannot be studied at hospital settings. We recommend more analytical research projects not only at hospital level but also at community level to draw conclusions about the relationship between vitamin D status and occurrence of stroke. Keywords: Stroke, Cerebrovascular accident, acute ischemic stroke, hypertension, vitamin D, 25-hydroxyvitamin DKeywords:
Stroke
Outpatient clinic
Cross-sectional study
Topics:
Background And Objective: Poor sunlight exposure leads to vitamin D deficiency even in the sunniest places.So screening for vitamin D deficiency in outpatient clinics and inhospital setting in King Fahad Hospital , Al Madina Al Monwara.METHODS: Screening for vitamin D deficiency by assessment of serum 25(OH)D with radioimmunoassay in 60 female patients aged 18 -40 years.Serum calcium, phosphorous and alkaline phosphatase were assessed, too.Results: 6 female patients (10%) showed significant vitamin D deficiency with 25(OH) D < 20 ng/ml.However 54 female patients (90%) showed severe vitamin D deficiency with 25 (OH) D < 10 ng/ml.Conclusion: Vitamin D deficiency is very common in Saudia Arabia especially females due to poor sunlight exposure.So being underrecognized and undertreated, vitamin D deficiency represents an important health problem in MADINA REGION, KSA.
Outpatient clinic
Sun Exposure
Sunlight
Cite
Citations (1)
A survey of West Midlands paediatricians in 2001 identified 24 cases of symptomatic vitamin D deficiency in children less than 5 years of age. The overall incidence was 7.5 per 100,000 children per year with notable differences in incidence per ethnic group.
Cite
Citations (133)
Objective To understand the current situation and the trend of incidence of stroke in monitored population in Shanghai trial communities for comprehensive preventing and controlling cardio - cerebrovascular diseases from 1999 to 2001, and to explore the effective measures for decreasing the incidence rate of stroke in the community population. Methods Data on morbidity of stroke were collected and analyzed from the monitoring system of cardio - cerebrovascular diseases in Shanghai. Results In the recent three years, the average incidence rate of stroke was 154.84/105 (the standardized morbidity was 77.00/105) in 1.2 million monitored population in Shanghai trial communities, in which the urban and the rural population accounted for 51% and 49%, respectively. The average incidence rate of stroke in the urban and the rural areas was 174.92/105 (the standardized morbidity was 75.88/105) and 133.77/105 (the standardized morbidity was 84.7/105), respectively. During the recent three years, the total incidence rate of stroke in monitored population had a tendency of declining. The declining of incidence rate was more remarkable lower in the urban areas than that in the rural areas. In both of the urban and the rural areas, the incidence rate of ischemic stroke was in the highest ranking of the incidence of all types of stroke. However, the incidence rate of stroke in males was higher than that in females. The incidence rate of stroke ascended exponentially with the age increasing. The numbers of stroke patients aged above 60 years old accounted for 88.79% in total numbers of stroke patients. Conclusions It was demonstrated that the comprehensive intervention measurements for preventing and controlling stroke, which were conducted in Shanghai trial communities, made it possible to decline the total incidence rate of stroke in monitored population. It is suggested that more attention should be paid to preventing and controlling stroke in Shanghai, especially in the rural areas, and the population aged above 60 years old should be considered as the most important target persons for community- based intervention.
Stroke
Cite
Citations (1)
The data on the prevalence of vitamin D deficiency (VDD) in apparently healthy children from India is limited.To assess the prevalence of VDD in apparently healthy children.Prospective study.Apparently healthy children from the age groups of 3 months-12 years, from the upper socioeconomical status (USES), attending the outpatient department (OPD) of a private pediatric hospital in Chandigarh, India, for minor ailments were enrolled over a period of 6 months (March-August 2013).Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive electrochemiluminescence immunoassay.In total, 338 children (188 boys, 150 girls) with mean age of 3.31 years were enrolled. The percentages of children with deficient, insufficient, and sufficient levels of 25(OH)D were 40.24%, 25.44%, and 34.32%, respectively. Clinical signs of VDD were seen in only 8.53% of the children. The mean (±SD) levels of 25(OH)D were 27.48 (15.99) ng/mL. On univariate analysis, deficient levels of 25(OH)D were associated with relatively younger age group, female sex, failure to thrive, exclusive breastfeeding, inadequate sun exposure, and no vitamin D supplements.A high prevalence of clinical and biochemical VDD was noted in apparently healthy children belonging to the USES.
Outpatient clinic
Failure to Thrive
Univariate analysis
Cite
Citations (48)
Background and Purpose— Many advances were made in stroke prevention strategies during the 1990s, and yet temporal trends in stroke incidence and case-fatality have not been reported in the United States. Blacks have a 2-fold higher risk of stroke; however, there are no data over time showing if any progress has been made in reducing racial disparity in stroke incidence. The objective of this study was to examine temporal trends in stroke incidence and case-fatality within a large, biracial population during the 1990s. Methods— Within a biracial population of 1.3 million, all strokes were ascertained at all local hospitals using International Classification of Diseases, 9th Revision codes during July 1993 to June 1994 and again in 1999. A sampling scheme was used to ascertain cases in the out-of-hospital setting. Race-specific incidence and case-fatality rates were calculated and standardized to the 2000 US Census population. A population-based telephone survey regarding stroke risk factor prevalence and medication use was performed in 1995 and 2000. Results— There were 1954 first-ever strokes in 1993–1994 and 2063 first-ever strokes in 1999. The annual incidence of first-ever hospitalized stroke did not significantly change between study periods: 158 per 100 000 in both 1993–1994 and 1999 ( P =0.97). Blacks continue to have higher stroke incidence than whites, especially in the young; however, case-fatality rates continue to be similar between races and are not changing over time. Medication use for treatment of stroke risk factors significantly increased in the general population between study periods. Conclusions— Despite advances in stroke prevention treatments during the 1990s, the incidence of hospitalized stroke did not decrease within our population. Case-fatality also did not change between study periods. Excess stroke mortality rates seen in blacks nationally are likely the result of excess stroke incidence and not case-fatality, and the racial disparity in stroke incidence did not change over time.
Stroke
Case fatality rate
Cite
Citations (214)
Objective To study the effects of comprehensive intervention on hypertension and the incidence and mortality of stroke in community population. Methods From 1997～2000,comprehensive intervention was carried on to some hypertensive population over 35 years old urban community in Changsha. Incidence and mortality of stroke were under surveillance from 1996 to 2000. Results The average of systolic blood pressure(SBP) decreased 4.25mmHg in the hypertensive population after intervention,diastolic blood pressure(DBP) decreased 1.06mmHg . The means of SBP and DBP decreased both in male and female. Comprehensive intervention decreased the incidence of stroke in community population by 50%. Conclusion The comprehensive intervention can decrease the average level of hypertension in community population. It's effective way to prevent stroke in community.
Stroke
Cite
Citations (0)
Background
Vitamin D deficiency is increasingly recognised as a global health problem. The important role of vitamin D in skeletal health is well established. Studies have shown vitamin D deficiency in many autoimmune rheuamtic disorders. These patients are commonly treated with corticosteroids which is an important risk factor for osteoporosis. Therefore detection of hypovitaminosis D is important.Objectives
The aim of this study is to determinine the prevalence of vitamin D deficiency in a cohort of patients attending the Rheumatology clinic at RIPAS hospital which is a tertiary hospital in Brunei and to compare between different gender, ethnic groups and disease groups.Methods
A cross sectional study was conducted among patients attending Rheumatology clinic from Jan 2000 to Dec 2010. Demographic and clinical data was abstracted from case notes. Quantitative determination of 25(OH) vitamin D is a direct, competitive chemiluminescence immunoassay. Vitamin D deficiency was defined as 25(OH) vitamin D <50 nmol/L and severe deficiency <25 nmol/L.Results
This study comprised 292 patients, 251 female and 41male. Their mean age is 49.9 (±SD 15.57) ranging from 15-95 yrs. The main racial groups were Malays (78.4%) and Chinese (19.2%). The mean vitamin D level is 49.57 (±SD 22.22) nmol/l. The overall prevalence of Vitamin D deficiency is 57.0% and severe deficiency is 8.2%. Deficiency is more common in female than male, 60.6% vs 39% (p<0.001). Malay has the highest prevalence of vitamin D deficiency at 63.7% compared to Chinese and others groups at 32.1% and 42.8% respectively (p<0.001). Severe deficiency was found in 9.6% Malays but not among other racial groups. An analysis of variance showed significant variation among the racial groups; a post-hoc Tukey test indicated that Malay differed significant from the Chinese but not the others. There is a very weak correlation of age with vitamin D serum concentration (Spearman9s rho r=0.285, p<0.05). No correlation of vitamin D level with body mass index was found.Conclusions
Hypovitaminosis D is common among Rheumagology patients in Brunei. Differences in gender and ethnic groups were found with higher prevalence among females and ethnic Malays. SLE patients have higher prevalence than those with RA. There is weak correlation of vitamin D level with age but no correlation was detected with body mass index.Disclosure of Interest
None declaredDOI
10.1136/annrheumdis-2014-eular.3883Cross-sectional study
Hypovitaminosis
Cite
Citations (0)
Cross-sectional study
Cite
Citations (14)
In Kuwait, as in many Arab states in the Gulf region, there are limited data on the prevalence of vitamin D deficiency among healthy adolescents. This study aimed to estimate the prevalence of vitamin D deficiency in a nationally representative sample of adolescents and investigate factors associated with vitamin D status.A cross-sectional study was conducted on 1416 adolescents aged 11-16 years, who were randomly selected from middle schools in all governorates of Kuwait. Data were collected from parents through self-administered questionnaire and from adolescents through face-to-face interview. Vitamin D was measured using liquid chromatography-tandem mass spectrometry. Logistic regression was used to investigate the independent factors associated with vitamin D status.The prevalence of vitamin D deficiency was 81.21% (95% CI 71.61% to 90.81%), while severe deficiency was 39.48%. Only 3.60% of adolescents were vitamin D-sufficient. The prevalence of vitamin D deficiency was significantly higher among girls compared with boys (91.69% vs 70.32%; p<0.001). There was a significant inverse correlation between vitamin D and parathyroid hormone (Spearman correlation=-0.35; p<0.001). In the final model, gender, age, governorate, parental education, body mass index, vitamin D supplement and the number of times adolescents walk to schools per week were all significantly related to vitamin D deficiency.High prevalence of vitamin D deficiency was noted among adolescents in Kuwait despite the abundant sunshine, which may reflect strong sun avoidance behaviour. Adequate outdoor daytime activities should be encouraged especially for girls. We call for locally tailored guidelines for vitamin D supplement in which girls should have a higher dose compared with boys.
Cross-sectional study
Cite
Citations (50)
Venous thromboembolism (VTE) includes the diagnosis of either deep venous thrombosis (DVT) and/or pulmonary embolism (PE). This review discusses an evidence-based approach to the outpatient treatment of VTE in the emergency care setting. Main findings: The majority of patients diagnosed with VTE in the acute care setting are at low risk for an adverse event. Outpatient treatment for patients deemed low-risk by validated clinical decision tools leads to safe, efficacious, patient-centered, and cost-effective care. From a patient perspective, outpatient treatment of VTE can been simplified by the use of direct oral anticoagulant (DOACs) medications, and is supported by clinical trial evidence, and clinical practice guidelines from international societies. Outpatient treatment of patients with DVT has been more widely accepted as a best practice, while adoption of outpatient treatment of low-risk patients with acute PE has lagged. Many acute care clinicians remain wary of discharging patients with PE, concerned about drug access, adherence, and follow-up. Patients with VTE should be risk stratified identically as emerging evidence has demonstrated efficacy and safety in the interdependence of acute care protocols for the outpatient treatment of low-risk DVT and PE. Clinicians who practice in the acute care setting should be comfortable with risk stratification, anticoagulation, and discharge of low-risk VTE.
Outpatient clinic
Cite
Citations (6)