Hypovitaminosis-D: Frequency and association of clinical disease with biochemical levels in adult patients

Background and Objective: Vitamin D is steroid hormone essential for maintaining many important functions in the body. Hypovitaminosis D has become worldwide problem affecting all age groups and both genders, but its prevalence is very high in South Asia. Therefore this study was aimed to determine frequency of hypovitaminosis D in adult patients of RMI Medical Out Patients Department [OPD] and find association of clinical disease with biochemical levels

Methods: It was a cross sectional study carried out on all patients visiting RMI Medical OPD from 1[st] Jan, 2015 to 30[th] April, 2015 with clinical indications using universal sampling technique involving 400 subjects. Data was analyzed using SPSS 16

Results: Out of 400 subjects 85[21.3%] were males, 315[78.8%] were females, biochemical hydroxyvitamin-D3 deficiency was present in 320 [80%] subjects with 86[21.5%] having severe deficiency, 176[44%] having moderate deficiency and 58[14.5%] having mild deficiency. There was statistically significant association between biochemical deficiency and severity of clinical disease manifestation, calculated using chi square test. [p < 0.001]

Conclusion: Most of the patient with musculoskeletal symptoms had vitamin D deficiency affecting all age groups and mostly female gender. There is a statistically significant association between low biochemical hydroxyvitamin-D3 levels and severity of clinical signs and symptoms which can provide evidence for replacement therapies in rural and far flung areas where biochemical assays are not available. Early recognition and replacement can prevent the massive complications, which deficiency of vitamin D makes us prone to develop

Spectrum of congenital heart disease in children admitted for cardiac surgery at Rehman Medical Institute, Peshawar, Pakistan

To assess age, gender distribution and relative frequency of congenital heart disease [CHD] in children who underwent palliative or corrective cardiac surgery at Rehman Medical Institute, Peshawar. This retrospective study was conducted in Department of Cardiac Surgery at Rehman Medical Institute [RMI], Peshawar from May 2008 till May 2010. One hundred and twenty three patients up to age group of 16 years with confirmed diagnosis of congenital heart disease admitted for Cardiac Surgery at Rehman Medical Institute, Peshawar were included. Out of 123 patients, there were 71 males [57.7%] and 52 females [42.2%], with male to female ratio of 1.3:1. Sixty five [52.8%] of the total cases had acyanotic heart defects. Cyanotic heart defects were seen in 58 patients [47.1%]. Ventricular Septal Defect [VSD] followed by Patent Ductus Arteriosus [PDA] and Atrial Septal Defect [ASD], were the commonest acyanotic heart lesions, 33.8%, 23.0% and 16.9% respectively. Tetralogy of Fallot [TOF] was the commonest cyanotic lesion. Majority of patients with congenital heart disease had acyanotic CHD with the commonest lesion being VSD. Tetralogy Of Fallot [TOF] was the commonest cyanotic lesion. Most of the patients were less than five years with no significant difference in sex distribution. Availability of expertise locally will lead to more patients getting surgical treatment at an earlier age thereby reducing morbidity and mortality and improving quality of life for these children

impact of parental education and socioeconomic status on routine childhood vaccination: an obsevational study

To assess the vaccination status of children less than 5 years and to determine the factors associated with low coverage vaccination status. This was a prospective study conducted at the department of pediatrics, Rehman Medical Institute Peshawar from 1[st] January to 31[st] July 2012. A total of 300 cases were selected attending out patient department. The parents and guardians were interviewed with a proforma regarding the vaccination status of all children from 1 month to 5 year of age. World Health Organization, Expanded Programme of Immunization, vaccine schedule was followed. The parents/guardians were asked for vaccination cards as confirmation of vaccination and failing to do so, the parents/guardians were thoroughly interviewed including direct and indirect questioning. A total of 240 out of 300 [80%] attending outpatient department were vaccinated while 43 [14.3%] were unvaccinated and remaining 17 [5.7%] were partially vaccinated. Ninety children belonged to highsocio economic status [SES], 25 to low and 185 belonged to middle SES. Seventy six out of 240 [31.6%] vaccinated children were from families of high socio economic status. The study revealed that 15 out of 27 [55.5%] of the illiterate parent's children were either partially vaccinated or unvaccinated. The overall rate of routine childhood vaccination remains below international benchmark. The rate of vaccination was significantly better in children of parents from educated and higher socioeconomic class