Quantitative estimation of serum 25(OH) D and associated risk factors of vitamin D deficiency among pregnant women attending a tertiary care hospital in Udaipur, Rajasthan

Introduction: Insufficiency of vitamin D is now known globally and is exceptionally common in temperate and tropical countries. Due to its several negative maternal and fetal health consequences, vitamin D insufficiency in pregnancy is a growing concern worldwide. Methods: A cross-sectional study was conducted at a tertiary medical hospital for one year. A sample of 280 pregnant women attending antenatal clinic (ANC) were enrolled using a random sampling technique. A standard questionnaire was designed to collect socio-demographic details and the sun exposure of participants. To analyse dietary habits and consumption of vitamin D-rich foods, a food frequency questionnaire (FFQ) was used. Serum samples were obtained and analyzed for and calcium levels. Results: High prevalence of maternal vitamin D insufficiency 122 (43.57%) and deficiency 92 (32.85%) observed. Most 263 (94%) participants had adequate serum calcium levels (> 8.5 mg/dL). Younger participants (< 25 yrs.) had low mean vitamin D (17.61±13.89 ng/mL), adequate calcium (9.52±0.70 mg/dL) levels. Rural residence, multigravida, advanced trimester, poor education, joint family, unemployment, and lower socioeconomic status were found associated with vitamin D insufficiency. Conclusion: In the present study a high prevalence of maternal vitamin D deficiency was observed. The burden of Vitamin D inadequacy (76.39%) reflects poor nutritional status and health risks for mothers and fetuses. Sociodemographic factors (Residence, Education, Family, and Socioeconomic status) were linked to this micronutrient deficiency. There is a need for further community-based nutritional research on sociodemographic, biological, and nutritional determinants for in-depth understanding

Post-operative wound infiltration with dexmedetomidine and magnesium sulphate as adjuvant to levobupivacaine for lumbar laminectomy: a prospective, double blinded, randomized controlled study

Background: Wound infiltration with local anaesthetic is safe and effective technique for providing postoperative analgesia following lumbar laminectomy. The objective of this study was to compare the efficacy of local wound infiltration on postoperative analgesia with levobupivacaine, levobupivacaine plus magnesium sulphate and levobupivacaine plus dexmedetomidine in patient undergoing lumbar laminectomy.Methods: Ninety adult patients were randomly allocated into three groups. After the completion of lumbar laminectomy, the drug was locally infiltrated into the paravertebral muscles on either side. Group L received 10 ml of 0.5% levobupivacaine plus 10 ml normal saline, group LM received 10 ml of 0.5% levobupivacaine plus 500 mg magnesium sulphate (1 ml) plus 9 ml normal saline, group LD received 10 ml of 0.5% levobupivacaine plus 50 µg dexmedetomidine (0.5 ml) plus 9.5 ml normal saline. Postoperative visual analogue scale (VAS) pain score at 0, 1, 2, 4, 6, 8, 12 and 24 hours, time to first rescue analgesic drug and its total dose, quality of recovery score (QoR) and side effects were noted.Results: Postoperative VAS was significantly higher in group L as compared to group LM and LD (p<0.05). The time to first rescue analgesic drug was significantly longer in group LD (11.07±7.20 hr) than group LM (6.20±2.64 hr) and group L (3.93±2.70 hr) (p<0.001). The QoR score was significantly better in group LD as compared to group LM and L postoperatively (<0.01).Conclusions: Addition of magnesium sulphate or dexmedetomidine to levobupivacaine for local wound infiltration demonstrated enhanced postoperative analgesia.

Supplementary Figures from Differential cell-matrix responses in hypoxia-stimulated aortic versus mitral valves

Appendix A - Preservation of endothelium in hypoxic stimulated valves; Appendix B - Colocalization of HIF-1α and angiogenesis-associated factor

Data Supplement from Differential cell-matrix responses in hypoxia-stimulated aortic versus mitral valves

All data used in figure