Prevalence and risk factors for vitamin D deficiency among mothers in labor and their newborns

Vitamin D deficiency is recognized as a global public health problem. Studies of vitamin D levels in mothers in labor and their newborns in Bahrain are lacking. The aim of this study is to identify the prevalence of vitamin D [25[OH]D] deficiency among mothers in labor and their newborns in Bahrain. A cross-sectional multicenter study. Four Public and Four Private Maternity Hospitals in Bahrain. The study was conducted in April 2012. It included mothers in labor and their newborns. Differences between the subgroups were analyzed using Chi-Square or Student's t-test as appropriate. Linear regression analysis was used to evaluate independent predictors of 25[OH]D level. The study included 403 mothers and 403 newborns. Overall prevalence of 25[OH]D deficiency [<50 nmol] was 358 [88.8%] of the mothers and 364 [90.3%] of the newborns. The mean maternal alkaline phosphatase level was significantly higher than the neonatal level and the maternal mean calcium was significantly lower than the neonatal level. Significant association with vitamin D deficiency was found among Bahraini and non-Bahraini Arab mothers, delivering in public rather than private hospital, living in flats, low education, the use of veil, gravida >/= 4, not using multivitamins, vitamin D or calcium supplements. Vitamin D deficiency among mothers and their newborns is high. This mandates increasing awareness, vitamin D supplementation among mothers in labor and their infants; in addition to the introduction of vitamin D fortification of dairy products and flour at the national level

role of aspirin in thrombotic thrombocytopenic purpura: a randomized control trial

To assess the safety and efficacy of aspirin in acute Thrombotic Thrombocytopenic Purpura [TTP] and to evaluate it as a maintenance therapy. Randomized controlled trial. Hematology/Oncology Department, Salmaniya Medical Complex [SMC], Kingdom of Bahrain. Nine patients with TTP admitted between August 2003 to December 2005 were included in the study. Seven were females [77.8%] and one was pregnant. Five Patients were randomized to receive the standard therapy with aspirin [group I] and four [group II/control] received the standard therapy only [plasma exchange, one single plasma volume daily using fresh frozen plasma from healthy donors and Methylprednisolone 1 gram intravenously once daily for three days]. Safety and efficacy of aspirin were assessed during the acute phase [4 weeks] and as maintenance for one year. Statistically significant reduction in the number of plasma exchange sessions were noted in the aspirin group [p = 0.0315]. Other parameters such as days of hospitalization, red blood cells transfusion were lower in the aspirin group compared to non aspirin group. No cases of mortality or morbidity were observed in patients receiving aspirin. Two patients [50%] developed deep vein thrombosis [DVT] in the control group and one of them eventually died [25%]. Though these were statistically insignificant, possibly due to the small number of patients, it would suggest the efficacy of aspirin in TTP. The study showed a significant reduction in the number of plasma exchange sessions in the aspirin group and probable advantages. Accordingly, we recommend a multicenter RCTs to address the role of aspirin in the management of TTP patients