Cut off Value for Parathormone Level in Children with Vitamin D Deficiency

Background: When serum level of 25-hydroxy vitamin D [25(OH) D] decreases, intact Parathormone (iPTH) level increases compensatory. This study aimed to determine the cut off value for iPTH level in 2-14-year-old children with vitamin D (VD) deficiency. Methods: This cross-sectional study was performed on 153 children aged 2-14 years old who referred to the endocrinology clinic of Amirkola Children's Hospital for growth assessment. Census sampling was conducted from January 2016 to June 2017 according to the eligibility criteria including height and weight above the percentile of 3% of growth charts and normal serum of calcium level (>8.5 mg/dl). Laboratory parameters such as serum calcium, 25(OH) D and iPTH levels were assessed. The children were divided into three groups based on serum levels of 25(OH) D as mild, moderate and severe VD deficiency. The Receiver Operating Characteristic (ROC) curve was used to analyze the cut-off point of iPTH and 25(OH) D. P-Value< 0.05 was considered significant. Results: The mean VD and iPTH levels in children were 11.8 ± 4.59 ng/ml and 28.3 ± 13.3 pg/ml, respectively. At the iPTH serum level of 23.5 pg/ml, with a sensitivity of 66.1%, there was a possibility of moderate to severe VD deficiency. In the severe deficiency group, at the iPTH serum level of 23.5 pg/ml and above, with a sensitivity of 78.9%, there was a possibility of severe VD deficiency. The cut-off point of 25(OH) D and iPTH, at the serum VD level ≤10 ng/ml were determined. Conclusions: The results of the present study showed that the cut-off value for iPTH in children with VD deficiency is serum level of 25OHD≤10ng/ml

Effect of the Local Heat on the Pain of Vitamin K Injection in the Infants

BackgroundThe absence of pain relief in infants can lead to harmful effects; so, this study aimed to investigate the effect of local heat on the pain of vitamin K injection in the infants.Materials and MethodsThis randomized clinical trial was conducted on 80 healthy infants. For the control group, 1 mg vitamin K was injected into the vastus lateralis muscle by a nurse. In the 3 intervention groups, respectively 5, 10 and 15 minutes before the injection, hot-water bag at 37 °C was placed on the quadriceps muscle and then injection was done with the same condition as in the control group. Immediately after the injection, the Neonatal Infant Pain Scale (NIPS) was completed. Data analysis was done using SPSS version 21.0 software.Results41(51.25%) girls and 39 (48.75%) boys were participated. First-minute Apgar of all samples were 8.64±0.557. Birth weight was 3335.37±339.51 grams and the minimum gestational age 36.37±1.01 weeks. The mean pain score in the first minute in the control group was 3.6± 2.136, which was 3.3± 1.976 in the 5-minute warm-up group, and this amount was reached to 1.6± 1.569 in 10-minute warm up group, and 0.6± 0.821 in 15 minute warm-up group (P=0.008). The mean pain scores in the control group for the second minute was 1.0±1.835, which was reduced to 0.25± 0.716 in the 10-minute and 15-minute warm-up group (P=0.023).ConclusionLocal heating before the injection procedure can be effective in reducing pain in infants and the pain will reduce by increasing the local heating time (15 minutes)