Vitamin D level as a predictor of pneumonia and asthma in children less than 5 years of age

Background: Childhood pneumonia is a global health problem .It the leading cause of death for children under the age of five years. 95% of all pneumonia cases under the age of five occurs in developing countries. Asthma remains the most common chronic disease of childhood in the world. The observation that vitamin D deficiency and asthma share risk factors such as urban residence, obesity and African American ethnicity has generated interest in exploring a link between these two conditions. This study was taken up to assess the role of vitamin D as a predictor of pneumonia and asthma in children less than 5 years of age.Methods: A prospective observational case control study was conducted in MLB Medical college, Jhansi from January 2015 to December 2016 (1 year 11 months). A total of 60 children including 30 asthma cases, 20 pneumonia cases and 10 controls, aged, 6-60 months were enrolled. Controls were healthy children attending outpatient services for immunization.Results: The mean age of the pneumonia patient was 1.5 years, while mean age in asthma patients was 3.1yrs. Ratio of male and female in pneumonia cases was1.5:1, while is asthma ratio was 2:1. In our study 45% pneumonia cases had deficient level of vitamin D (<20ng/ml) and mean level was 11.08±4.68 while 40% of control had deficient level of vitamin D and mean level was 16.04±1.61, p value was 0.0166 and there was significant difference in both the groups. In Asthma cases 53.33% patient had deficient level of vitamin-D and mean level was 10.62±2.908 as compared to 40% control (mean : 16.04±1.62) ‘p’ value was <0.0001 and was highly significant.Conclusions: Our study has illustrated that vitamin-D levels were significantly low in pneumonia and asthma patients as compared to control.

The Evaluation of Effect of Phototherapy on Serum Calcium Level.

Jaundice is one of the most common problem that can occur in the newborn. The study group included 30 neonates (15 term and 15 preterm) and control group included 20 neonates (10 terms & 10 preterm). All had hyperbilirubinemia. The controls were fully matched with the study group. All the neonates included in the study group required management with phototherapy. The neonates in the control group were managed without phototherapy. Measurement of ionized serum calcium level was done before and after 48 hours of institution of phototherapy in study groups and controls. Before phototherapy, there was no statistical significant difference in mean serum calcium level in term & preterm neonates of both study & control group. After 48 hours of phototherapy in study group, a significant fall in calcium level in 66.6% of term & 80% of preterm neonates was observed. Whereas, no difference was observed in control group. It is suggested that calcium level be assessed in neonates treated with phototherapy for more then 48 hours and managed accordingly.