Supplementation with Three Different Daily Doses of Vitamin D3 in Healthy Pre-pubertal School Girls: A Cluster Randomized Trial

Objective: To compare the adequacy and efficacy of differentdoses of vitamin D3 in pre-pubertal girls.Design: Cluster Randomized controlled trial.Setting: Public school in Delhi, India, between August 2015 andFebruary 2016.Participants: 216 healthy pre-pubertal girls, aged 6.1-11.8 years.Intervention: Daily supplementation with 600 IU (n=74), 1000 IU(n=67) or 2000 IU (n=75) of vitamin D3 under supervision for 6months.Outcome measures: Primary: Rise in serum 25 hydroxy VitaminD (25(OH)D); Secondary: Change in bone formation andresorption markers.Results: Following 6 months of supplementation, the mean (SD)rise in serum 25(OH)D was maximum with 2000 IU (24.09 (8.28)ng/mL), followed by with 1000 IU (17.96 (6.55) ng/mL) and 600 IU(15.48 (7.00) ng/mL). Serum 25(OH)D levels of ?20 ng/mL wereseen in 91% in 600 IU group , 97% in 1000 IU group and 100% in2000 IU group. The overall mean (SD) rise in urinary calciumcreatinine ratio (0.05 (0.28) to 0.13 (0.12) mg/mg), and serumprocollagen type I N-terminal propeptide (538.9 (199.78) to 655.5(218.24) ng/mL), and reduction in serum carboxy-terminaltelopeptide (0.745 (0.23) to 0.382 (0.23) ng/mL) was significant(P<0.01). The change in the above parameters was comparableamong the three groups after adjustment for age.Conclusion: Daily vitamin D supplementation with 600 IU to 2000IU for 6 months results in Vitamin D sufficiency in >90% of pre-pubertal girls

Medial Rectus Dehiscence following Buckling.

Migration of silicone explants through rectus muscle insertion is a rare complication with very few cases reported. Anterior migration of a solid silicone band may occur if it is tight, placed anterior to the equator or not properly anchored to the sclera. The band slowly erodes through the tendon of one or more recti muscles allowing them to reattach spontaneously with scar tissue behind migrating element. The authors describe a rare case of anterior migration of the buckle following encirclage by a 4mm silicone band resulting in spontaneous disinsertion of medial rectus muscle where muscle disinsertion had not been performed peroperatively. This migration occurred in the absence of any predisposing factors. The muscle disinsertion was so gradual that the muscle got reinserted almost to its original insertion as a result of which there was no heterotropia .

Ocular manifestations of cysticercosis: a case report.

Ocular and extraocular cysticercosis is a commonly encountered manifestation of the disease caused by the cysticercus cellulosae. Any region of the eye may be afflicted including the subconjunctival space. We present the case ofa young female who developed a small mass at the medial canthus of the left eye, which was diagnosed as conjunctival cysticercosis subsequent to excision and histopathological examination.