Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19—A multicenter cohort study

BackgroundDespite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients.MethodsA multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate.ResultsA total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87–1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00–0.47), p = 0.05 and beta coefficient 0.16 (95% CI −0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03].ConclusionThe use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding

Prevalence of vincristine induced-peripheral neuropathy among Sudanese cancer patients

Background: Increasing clinical evidence suggests treatment of cancer with neurotoxic agents results in some degree of peripheral neuropathy. Objective: The main objective of the study was to evaluate vincristine induced peripheral neuropathy among Sudanese cancer patients. Methods: A descriptive cross-sectional study was carried out at Radiation and Isotopes Center, Khartoum State, Sudan. All patients suffering from cancer with an age of 18 to 65 years were reviewed. A self-developed data collection form was used to collect the demographic data; drug use history; medical diseases; and vincristine cycles. The World Health Organization criteria were used to grade the side-effects. Data was collected for a period of two months and were analyzed descriptively. Results: Out of 78 patients reviewed, majority were females (n=47, 60.3%). Most of the patients were in the age group of 18-30 (n=27, 34.6%) and 51-60 (n=27, 34.6%) years. Twenty six (33.3%) of the patients took analgesic and 15.3% (n=12) experienced hypertension. Most of the patients went through more than 6 cycles of therapy with vincristine (n=24, 30.9%). Our study showed that 'altered bowel function (i.e constipation)' was the most important neuropathic change, which occurred in 62 (79.5%) of the patients who received vincristine. The second common neuropathic change was the 'lack of ability to go upstairs un-aided', which occurred in 37 (47.4%) of patients receiving vincristine. Majority of the patients (n=37, 47.5%) showed mild paresthesia as graded by the 'WHO grading scale'. Conclusion: More than three-fourth of the cancer patients experienced vincristine induced peripheral neuropathy. Healthcare professionals need some understanding regarding medical management that may decrease occurrence of neuropathy and a better planning and implementing special care for patients at risk.Scopu

Prevalence, reasons, and determinants of dietary supplements use among undergraduate female students of health and non-health colleges in a Saudi public university.

PurposeThe aim of this study was to gather data from female students studying in both health and non-health colleges at Imam Abdulrahman Bin Faisal University and report the prevalence, reasons, and determinants of dietary supplements use.MethodsA month-long cross-sectional study was conducted in health and non-health colleges affiliated to Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia. Convenient sampling was employed, and the data was gathered through an online survey using the English and Arabic versions of the Dietary Supplement Questionnaire (DSQ). The data was analyzed using SPSS version 23 and Medcalc. The study was approved by an ethics committee.ResultsData from 545 participants was collected. The overall prevalence of dietary supplement use was 32.7% (95% CI: 29.06%- 36.51%). The prevalence was 29.77% (95% CI: 25.29%- 34.56%) among students at all health colleges combined and, it was 37.50% (95% CI: 31.36%- 43.96%) among students at all non-health colleges. Most students used a brand product, spent a monthly cost of SAR 286 (USD 76.3) on supplements and agreed that supplements were good for health (N = 392, 71.9%). Students from non-health- colleges agreed that dietary supplements are good for health in greater numbers as compared to non-health college students (p ConclusionSupplements were commonly used among female students at this university however, it was quite low as compared to students from other local and regional universities. Prevalence was higher in non-health colleges as compared to health colleges and the most commonly used supplements were brand products and, multivitamins, used for general health and well-being. This highlights the inclination of students towards supplement use