Effect of Daily Vitamin D Supplementation on Serum Vitamin D Levels in Children with Epilepsy Receiving Sodium Valproate Monotherapy: A Randomized, Controlled Trial.

OBJECTIVES: To compare the change in serum vitamin D levels and to compare the changes in serum levels of calcium, phosphate, alkaline phosphatase and parathyroid hormone in vitamin D supplemented and unsupplemented groups after 3 mo. METHODS: In this randomized, parallel group, nonblinded, controlled trial, 40 children, 2-12 y of age with newly diagnosed epilepsy, and vitamin D sufficient status, and started on valproate monotherapy, were randomized into the intervention group (n = 20), which was given daily oral 600 IU vitamin D supplementation, and the control group (n = 20), which was not given any supplementation. Changes in the biochemical parameters was measured in the two groups after 3 mo. RESULTS: There was a significant reduction in the median (IQR) vitamin D levels in the control group as compared to an increase seen in the intervention group [-6.64 (-8.4, -2.65) vs. 5.66 (1.81, 7.12); p < 0.001]. In the control group, 37.5% children developed vitamin D insufficiency and 12.5% developed deficiency whereas only 5% of the intervention group developed vitamin D insufficiency (p = 0.005). There was a significant decrease in ionized calcium (p = 0.02), increase in serum phosphate (p = 0.02), and alkaline phosphatase level (p = 0.003) in the unsupplemented group as compared to the supplemented group. CONCLUSION: Vitamin D supplementation can reduce the valproate-associated decline in vitamin D levels and the negative impact on other markers of bone mineral metabolism. TRIAL REGISTRATION: TCTR20200621002, 19.06.2020, retrospectively registered.

Diagnosis and Management of Pediatric Acute Liver Failure: ESPGHAN and NASPGHAN 2022.

Guidelines for management of pediatric acute liver failure (PALF) were recently published by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). We, herein, update the readers about the diagnosis and management of PALF with emphasis on the changes in assessment and staging of hepatic encephalopathy, administration and goals of supportive therapy, frequency of monitoring, and management of complications.

Performance, Emission, Energy, and Exergy Analysis of a C.I. Engine Using Mahua Biodiesel Blends with Diesel.

This paper presents an experimental investigation on a four-stroke single cylinder diesel engine fuelled with the blends of Mahua oil methyl ester (MOME) and diesel. The performance emission, energy, and exergy analysis has been carried out in B20 (mixture of 80% diesel by volume with 20% MOME). From energy analysis, it was observed that the fuel energy input as well as energy carried away by exhaust gases was 6.25% and 11.86% more in case of diesel than that of B20. The unaccounted losses were 10.21% more in case of diesel than B20. The energy efficiency was 28%, while the total losses were 72% for diesel. In case of B20, the efficiency was 65.74 % higher than that of diesel. The exergy analysis shows that the input availability of diesel fuel is 1.46% more than that of B20. For availability in brake power as well as exhaust gases of diesel were 5.66 and 32% more than that of B20. Destructed availability of B20 was 0.97% more than diesel. Thus, as per as performance, emission, energy, and exergy part were concerned; B20 is found to be very close with that of diesel.