ABSTRACT
To maintain a healthy skeleton, vitamin D is crucial for phosphate as well as calcium uptake. It is of great significance for maintaining the various adaptive and innate immune response components. To reduce the development of various immune-related disorders, such as diabetes, hypertension, cardiovascular diseases, rheumatoid arthritis, and coronavirus disease 2019 (COVID-19), numerous studies evaluating the optimal threshold levels for serum 25-hydroxyvitamin D [25(OH)D]. It is documented in various evidence to increase the serum 25(OH)D intake from the current mindset of 30–50 ng/mL to attain the best overall vitamin D benefits. These values are in line with the results of various research showing that increased vitamin D intake is linked to a decreased risk of cancer and cardiovascular diseases. Therefore, it becomes vital to understand the “right” vitamin D levels to avoid deficiency along with its related disorders. In contrast to 30 ng/mL, this review emphasizes the significance of increasing vitamin D levels to 50 ng/mL to obtain several physiological benefits. An individual needs at least 60000 IU for 12 weeks to maintain serum vitamin D levels above 30 ng/mL. The article will interest physicians who desire to profit fully from vitamin D’s influence on clinical practice.
ABSTRACT
Background & objectives: Prediabetes is associated with increased prevalence of cardiovascular disease (CVD). In participants with prediabetes, the effects of exercise and metformin were evaluated on high-sensitivity C-reactive protein (hsCRP) and carotid intima-media thickness (CIMT), surrogate markers of atherosclerosis and CVD compared with standard care. Methods: In a pilot randomized control trial, the participants were randomized in to three arms: standard care (STD), intensive lifestyle modification (ILSM) or ILSM and metformin (ILSM+Met) and followed up for six months. Monitoring of ILSM was done by a trained healthcare facilitator. hsCRP, CIMT and other relevant parameters were measured before and after intervention. Results: A total of 103 participants were randomized into three arms and followed up for six months. At six months, there was a reduction from baseline in weight and fasting blood sugar (FBS) (P <0.01) in all three arms and a reduction in haemoglobin A1c (P =0.03) only in the ILSM+Met arm. The differences in hsCRP over six months within the STD, ILSM and ILSM+Met arms were ?0.12 (95% confidence interval, ?1.81, 2.08), ?0.58 (?2.64, 0.43) and ?0.11 (?1.84, 1.56), respectively. There was no difference in hsCRP, CIMT (right) or CIMT (left) between the three arms at six months. Interpretation & conclusions: There was a reduction in weight and FBS from baseline in all three arms. There was, however, no difference seen in hsCRP and CIMT in the two intervention arms compared to standard care. Larger studies with long-term follow up need to be done to detect differences in risk markers for CVD in prediabetes.
ABSTRACT
Ovotesticular DSD is not an uncommon disorder. The presence of Y chromosome confers a high risk of neoplastic transformation in dysgenetic gonads. The neoplastic development in these patients is associated with the presence of Y chromosome and intra abdominal location of the abnormal gonad. We report histogenetic details of a rare occurrence of bilateral gonadoblastomas and left sided dysgerminoma in a XY ovotestes DSD (disorder of sexual differentiation) in an 18 year old with a female phenotype.