Neeru Bhaskar

Effect of BMI and urinary pH on urolithiasis and its composition

Urolithiasis is a common urological disease predominantly affecting males. The lifetime risk of urolithiasis varies from 1% to 5% in Asia, 5% to 9% in Europe, 10% to 15% in the USA and 20% to 25% in the middle-east; lowest prevalence is reported from Greenland and Japan. Such differences have been explained on the basis of race, diet and climate factors. Furthermore, changing socio-economic conditions have generated changes in the prevalence, incidence and distribution for age, sex and type of lithiasis in terms of both the site and the chemical as well as the physical composition of the calculi. The aim of our study was to determine the association between body mass index (BMI) and urine pH in patients with urolithiasis and the influence of body size, as reflected by the BMI, on the composition. The study was conducted in the Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, on urolithiatic patients. The data included patients age, sex, BMI, urine pH, serum calcium, serum uric acid, serum creatinine and stone composition. Data from 100 patients, 70 men (70%) and 30 women (30%), were analyzed, with 28 patients having normal weight, 38 patients being overweight and 34 patients being obese. The mean age of the patients was 36.58 ± 9.91 years in group I, 40.47 ± 14.48 years in group II and 37.85 ± 12.46 years in group III (P > 0.05). The stone composition was calcium oxalate (CaOx) in 66 patients, calcium phosphate (CaP) in 60 patients, uric acid (UA) in 38 patients, combined calcium oxalate and calcium phosphate in 28 patients and three stones in 10 patients. The urinary pH levels (mean ± SD) were 7.78 ± 1.49 in group I, 7.15 ± 1.11 in group II and 6.29 ± 1.14 in group III patients (P = 0.0001). Urine pH showed a stepwise decrease with increasing BMI (inverse correlation). Urine pH is inversely related to BMI among patients with urolithiasis, as is the occurrence of urate, calcium oxalate and calcium phosphate stones. Similarly, the serum creatinine increased as the BMI and number of stones increased among the study population.

Effect of vitamin D supplementation and magnesium sulfate therapy in pre-eclampsia

Background: Vitamin D insufficiency has been associated with several adverse health outcomes, including pregnancy outcomes, and is increasingly recognised as a public health concern. It is responsible for approximately 50,000 maternal deaths yearly worldwide, 25% of all cases of fetal growth restriction, and 15% of preterm births in developed countries. Objective: Vitamin D and magnesium sulfate act by altering the calcium levels so this study was conducted to see if vitamin D supplementation has any additive role to magnesium sulfate treatment in preeclampsia and in preventing its progression to eclampsia. Materials and Methods: This cross sectional study was conducted in the Department of Biochemistry, in collaboration with Department of Obstetrics and Gynecology, at MMIMSR, Mullana (Ambala), Haryana, India. One hundred and fifty pregnant females attending the Obstetrics clinic were selected for the study and were divided into three groups of fifty each. Group I (Control): Normotensive healthy pregnant females, Group II: Preeclamptic patients receiving magnesium sulfate therapy and Group III: Preeclamptic patients receiving magnesium sulfate therapy along with vitamin D supplementation (33000 IU once every two weeks, orally after 28 weeks up to 36 weeks). The samples were analysed for serum total calcium, ionized calcium, serum phosphorous, serum magnesium, serum albumin, serum alkaline phosphatase, serum creatinine and serum uric acid. Results: Mean levels of total calcium, ionised calcium, phosphorous, magnesium, albumin, alkaline phosphatase, creatinine and uric acid before and after delivery were calculated in all the three groups. Serum calcium (total and ionised), albumin and magnesium were decreased in preeclamptic women whereas serum phosphorous and uric acid were increased in preeclamptic. Vitamin D supplementation improved calcium status, uric acid level and albumin level were also improved. Conclusion: Vitamin D supplementation in early pregnancy improves the calcium status and reduces the severity of preeclampsia.