European Journal of Molecular & Clinical Medicine

Introduction: Nephrotic Syndrome is characterised by nephrotic range proteinuria and the triad of clinical findings i.e., hypoalbuminemia, edema and hyperlipidemia. Glucocorticoid-sensitive nephrotic syndrome remits completely and quickly in response to glucocorticoids. Steroids are known to cause osteoporosis and loss of bone mineral density in NS patients.  So, we decided to study requirement of vitamin D in nephrotic syndrome in patients who are on remission during steroid therapy and Comparison of normal and high dose of vitamin D supplementation to achieve normal vitamin D level in nephrotic syndrome patient, in remission on prednisolone therapy.
Material And Methods: The present descriptive observational study, was conducted amongst 31 patients from August 2014 to August 2016 in the pediatric department of tertiary care centre on both indoor (IPD) and outdoor (OPD) patients of Nephrotic syndrome those who are in remission on steroid. Patients having normal 25 OH Vitamin D level were included in study. These patients were randomly divided in two groups using random sampling by lottery method. a. First group was given vitamin D therapy as 20, 000 IU/month (600IU/day) for three months b. Second group was given 60,000 IU /month (2000IU/day) for three month.
Results: Out of 31 patients in this study, mean age at inclusion in group A was 5.4 years whereas, it was 7.2 years in group B. Majority 12 of the patients were having SDNS as diagnosis. Both the groups showed elevated levels of 25(OH) after supplementation.  The levels of serum ionic calcium levels were not affected in both the groups, but the mean values of serum Ionic Calcium was found to be on higher side after Calcium supplementation especially in group B. The serum values were not affected in both groups.
Conclusion: The results concludes that there is no need for vitamin D supplementation in higher doses in steroid-sensitive nephrotic syndrome in patients those who are in remission and on minimal dose of steroids. So, dosage of vitamin D should be according to Recommended Dietary Allowances (RDA) when patient is on minimal dose of steroids.

Objective:  To study occurrence of major post-operative outcomes like surgical site infection,wound dehiscence and anastomotic leak in patients with hypoalbuminemia and normal serum albumin level.
Materials and Methods:  Hundred patients  who underwent emergency exploratory laparotomy in the Department of Surgery, Krishna Institute of Medical Science Karad  from January 2021
to June 2022 were taken for this  study and preoperative albumin level was checked.Complications occurring post-operatively were noted
Results: Of the 100 patients who underwent emergency laparotomy, hypoalbuminemia was seen in 85% of patients,while 15% had normal albumin level. Total 60 patients had post-operative complications. Percentage of complication in patients with hypoalbuminemia was 65.88%, while it was 26.87% in patients with normal albumin level. Hypoalbuminemia had positive correlation with adverse post operative outcome following emergency laparotomy.
Conclusion: It can be concluded from the study that serum albumin is an effective and simple marker for predicting post-operative outcome in patients undergoing emergency laparotomy.

BACKGROUND and OBJECTIVE: The incidence of multiple myeloma varies among different ethnic group and among different countries but from past few years its incidence is increasing in Asian countries. In India due to financial constraints, lack of adequate health infrastructure and lack of knowledge among people lead to delay in the treatment of Multiple Myeloma and it became a challenge to medical field in India. The objective of the study is to study the various parameters and its incidence in Multiple Myeloma patients.
METHODS: This is a cross sectional study conducted in the department of medicine and oncology of tertiary care hospital of north India. Data was taken from 2015-2022, 102 cases of multiple myeloma was diagnosed out of which 2 were excluded. The diagnosis was made based on the International Myeloma Working Group: Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorder. The demographic profile, clinical symptoms and laboratory parameters were studied.
RESULTS: Multiple Myeloma was most common in 5^th decade with male predominance and more common in urban population. Most common symptom was bone pain 63 (63%) and weight loss (9%) least common.  65% had anaemia, 18% had renal insufficiency and 34% had hypercalcemia. All of the patients had M-band in gamma globulin region with 48% had ISS stage 1. 70(70%) had lytic lesions in the skull.
INTERPRETATION AND CONCLUSION: To conclude majority of the patients of Multiple Myeloma were males and majority were farmers. Majority of patients were from urban area. Bone pain being the most common symptom followed by the fatigue. Anaemia and Hypercalcemia were less common in our study population. Most of the patients had ISS stage 1. The presentation of MM varies among patients and with adequate health infrastructure better outcome and early diagnosis of multiple myeloma will be there.