Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis

Abstract Background: The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods: Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results: This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations: Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions: This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.

Decreased circulatory levels of Vitamin D in Vitiligo (ViViD Study): a meta-analysis

Abstract Background: The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods: Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results: This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations: Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions: This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.

Cervical Infantile Fibrosarcoma: a rare cause of paediatric parapharyngeal neck mass

Soft tissue tumors are not uncommon in childhood and comprise entities that range from common to very rare malignancies. Infantile fibrosarcoma (IFS) is a rare pediatric malignancy mainly seen in the first two years of life. The data about the incidence of infantile fibrosarcoma occurring in the neck in the Indian subcontinent is scarce. To the best of our knowledge, only one case of infant cervical IFS has been reported previously in the Indian subcontinent. We present another case of an eight-year-old male patient with a rapidly growing mass on the left side of the neck. He was successfully treated with a combined modality of surgery and chemotherapy with a good outcome. Among the soft tissue tumors of childhood, IFS is a rare entity. It has a good prognosis and lesser chance of distant metastasis as compared to adult fibrosarcoma. Though surgical excision is the mainstay of treatment, chemotherapy also has a significant role in the treatment of primary tumor and metastasis. We discuss the stated case to bring to the notice this uncommon cause, which can be considered as a differential diagnosis of upper cervical swellings. A better understanding of this entity would help in early diagnosis and aggressive treatment, reducing the overall morbidity and mortality.

Habits and beliefs pertaining to tobacco among undergraduates of medical college in the state of Uttarakhand.

Background: Tobacco surveillance among medical students offers an opportunity to assess the preparedness for tobacco control among future healthcare professionals in India. The purpose of the present study was to evaluate the use of tobacco in the undergraduate medical students and to assess the factors influencing medical students to indulge in tobacco use. Objective: To assess the prevalence of tobacco use among undergraduate students and to assess the attitude and awareness towards participating in tobacco cessation. Material and methods: A cross-sectional questionnaire-based study to assess the prevalence of tobacco use among undergraduate students of Himalayan Institute of Medical Sciences, Dehradun (Uttarakhand State) was conducted from January 2010 to January 2011. A pre-designed structured questionnaire was used to study various correlates of the tobacco use. Data was collected and analysed. Global Health Professional Students Survey (GHPSS), questionnaire given by the Centers for Disease Control (CDC), Atlanta, USA, which is a standard pre-tested questionnaire for assessing prevalence of tobacco use among health care professionals around the world was used. Results: Overall, 386 of 400 eligible students (97%) participated in the survey. The mean age and standard deviation of the study group was 21.47 ± 3.70 years. The rates of smoking among male medical and female medical students were 38.6% and 6.5%, respectively (p < 0.001). A 6-times higher tobacco use was found among male medical students as compared to females. Out of the 386 participants, current tobacco use (last 30 days) was reported by 11.1% of students. About 21.7% of students had never used tobacco. More than 80% favoured a ban on tobacco sales to adolescents, tobacco advertising, and tobacco use in public places. Over 90% reported interest in further training in tobacco control. There was a familial aggregation of the use of tobacco. The factor initiating the use of tobacco was peer pressure in most of the cases. Conclusion: This study reflects an alarming situation and demands urgent measures to be adopted by health professionals, who happen to be health promoters and health role models for the society.

Lupus Vulgaris of Nose.

Lupus vulgaris represents a rare manifestation of infection by Mycobacterium tuberculosis.It is important to consider tuberculosis in the differential diagnosis of all nasal lesions and take biopsy samples for histological and bacteriological studies. Antitubercular chemotherapy is satisfactory with good result. We hereby report 3 cases of Lupus vulgaris of nose.

Neglected Bronchial Foreign Body in an Adult

Foreign body inhalation is a clinical emergency requiring prompt action to ensure speedy recovery and minimize the complications. This is common in children rather than in adults. We hereby report a case of a neglected foreign body which remained in the bronchus of an adult for more than 10 months before the diagnosis was made and appropriate treatment was given.