Vitamin D levels and left ventricular function in beta-thalassemia major with iron overload.

Heart disease is the primary cause of death in patients with beta-thalassemia major. The study aimed to determine the association between vitamin D and left ventricular function in patients with beta-thalassemia major with iron overload. A cross-sectional hospital-based study was conducted, where the vitamin D and ferritin levels of children living with beta-thalassemia major were measured, and left ventricular function was assessed utilizing ejection fraction (EF) and fractional shortening (FS) using 2D echocardiography. The mean serum ferritin was 4622 ± 2289 ng/ml, and the mean serum vitamin D levels were 22 ± 7.7 ng/ml. The mean values of EF were 62.30 ± 6.9%, and FS was 31.21 ± 4.8%. Statistically significant negative correlation (r = -0.447, p < 0.001) was found between vitamin D and serum ferritin values, and a significant positive association was found between vitamin D levels concerning EF and FS with a p-value of 0.034 and 0.014, respectively.Conclusion: It was observed  that increasing ferritin was associated with lower vitamin D levels which in turn influenced fractional shortening /cardiac function in these patients.  What is Known: • Patients with Beta Thalassemia major on long term transfusion are prone to develop heart disease / cardiac failure due to chronic iron overload. What is New: • Patients with beta thalassemia major on long term term transfusions with iron overload who are vitamin D deficient are more prone to the cardiac complications which inturn can be prevented by vitamin D supplementation.

Experiences and Perceptions Toward Integrative, Complementary, and Alternative Medicine Among Conventional Medicine Practitioners of Mangalore, India.

OBJECTIVES: The purpose of this study was to identify experiences and perception of conventional (Western, allopathic) medical practitioners toward integrative, complementary, and alternative medicine (ICAM). METHODS: There are approximately 1200 conventional medical doctors in Mangalore, India. In February 2017, semistructured self-administered questionnaires were distributed to 200 medical practitioners. The association between categorical variables was analyzed using a χ2 test and those involving continuous variables using unpaired t test, analysis of variance, and Karl Pearson's coefficient of correlation. A P value ≤ .05 was considered statistically significant. RESULTS: Of the surveys, 163 were returned and 129 were satisfactorily completed, giving a response rate of 64.5%. Mean age was 39.9 ± 11.9 years, and most 94 (72.9%) were male. A majority, 96 (74.4%), recommended ICAM to their patients. Nine had some training in ICAM modalities, and 76 (58.9%) participants reported personal usage of ICAM. Regarding perception toward effectiveness of ICAM, 33 (25.6%) felt that it was effective or somewhat effective. However, 82 (63.6%) participants felt that lack of sufficient scientific evidence was a major drawback of ICAM. However, 39 (30.2%) participants felt that ICAM should be part of Bachelor of Medicine and Bachelor of Surgery curricula. Favorable perception toward ICAM (P < .001) and personal usage of ICAM (P < .001) was associated with participants recommending any ICAM for their patients. Elderly practitioners (aged above 65 years) (P = .003) and practitioners with favorable perception regarding effectiveness of ICAM (P = .033) recommended a higher number of types of ICAM to their patients. Favorable perception toward effectiveness of ICAM was associated with favorable perception toward inclusion of ICAM in medical curriculum among participants (P = .002). CONCLUSION: Most participants recommended ICAM to their patients and also reported personal usage of the same.

Nutritional Supplement and Functional Food Use Among Medical Students in India.

This study was conducted to assess the pattern of use of nutritional supplements (NSs) and functional foods (FFs), reasons for their use, factors influencing their use, and perception toward their use among medical students. Data were collected from 400 randomly chosen participants using a self-administered semistructured questionnaire. The most common source of information on these substances was from medical professionals (n = 140 [35%]). Multivitamins were consumed by 48 (45.3%) participants. Most common reasons stated for the use of supplements were for good health (n = 39 [36.8%]), doctor's prescription (n = 36 [34%]), and to balance a poor diet (n = 34 [32.1%]). Sixty-six (62.3%) users used NSs on a daily or more than once daily basis. In 17.9% of the users, supplements were not recommended by a doctor or a dietician. The use of NSs was significantly more among females (p < .001), participants who exercised regularly (p < .001), participants who habitually skipped breakfast (p = 0.04), those with a family history of use of these products (p < .001), and those with "poor to fair" self-rated health (p = .017). Use of FFs was associated with family history of use (p < .001) and intensity of exercise (p = .039). Participants who significantly used multiple NSs in this study were those who were vegetarians (p = .044) and those with "poor to fair" self-rated health (p = .047). Participants who used multiple FFs were female (p < .001). Only 18 (16.9%) users felt that regular use of NSs results in side effects. In multivariate analysis, family history of NS use was found to influence its usage among participants (p < 0.001). It is a matter of concern that there is lack of knowledge on NSs and FFs among medical students. Therefore, they need to learn more about the indications and the safety of prescription of these products.

Effect of Conventional and LED Phototherapy on the Antioxidant-Oxidant Status in Preterm Neonates with Jaundice.

OBJECTIVE: To compare oxidative stress due to conventional and LED phototherapy among jaundiced preterm neonates. METHODS: Cross-sectional study conducted in NICU on 82 neonates (equal numbers received conventional and LED phototherapy). Total antioxidant capacity (TAC), total oxidant status (TOS) and Oxidative stress index (OSI) were assessed. RESULTS: Post-phototherapy, mean (SD) OSI increased significantly compared to baseline in both conventional [0.26 (0.24) vs. 0.61 (0.41); P<0.001] and LED groups [0.24 (0.20) vs. 0.32 (0.23); P<0.001]. Across groups, mean (SD) TAC was lower [0.28 (0.16) vs. 0.53 (0.27); P<0.001] mmol Trolox equiv/L; mean (SD) TOS higher [15.6 (10.9) vs. 14.6 (10.2); P=0.711] µmol H2O2/L and mean (SD) OSI higher [0.61 (0.42) vs. 0.33 (0.23); P<0.001] in conventional as compared to LED phototherapy. CONCLUSION: Both modes increased oxidative stress index; however, conventional phototherapy resulted in higher oxidative stress.

Prevalence, risk factors and treatment practices in diarrhoeal diseases in south India.

OBJECTIVES: This study was done to determine the risk factors, management practices and awareness about diarrhoea. METHODS: It was a cross sectional study done in a semi urban and rural areas of South Canara district of India in February 2013. A total of 167 households (575 study population) chosen systematic randomly were visited and one adult member in each house was interviewed. The houses were also inspected to assess the living conditions. RESULTS: Mean age of study population was 31.1 ± 20.2 years. The period prevalence of diarrhoea was 69 (12 %). Commonest associated symptoms in cases of diarrhoea were fever 30 (43.4 %) followed by abdominal cramps 29 (42 %). Nearly half of the cases with diarrhoea 34 (49.3 %) did not take any medications. Commonest treatment taken was allopathic medicines 26 (37.8 %) followed by home remedies 8 (22.9 %). Age ≤10 years (p < 0.001) was associated with risk of developing diarrhoea using binary logistic regression analysis. Among the 167 participants, awareness level about the disease was poor among 16 (9.6 %) and moderate among 149 (89.2 % participants). Awareness level was more among females (p = 0.001) and literate participants (p = 0.013). One hundred and sixteen (69.5 %) participants were not aware of any sign or symptom of dehydration other than loose stools. Majority of the participants 138 (82.6 %) preferred home remedies as the initial management of diarrhoea. Misconception about fluid restriction in diarrhoea was stated by 12(7.2 %) participants. CONCLUSION: Public education program on proper feeding and management practices is required to address the various issues identified and for containment of diarrhoea cases in future.