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Paper 2
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Vitamin D deficiency, Ricket’s disease, is common in babies fed solely on milk until age 18 months. It is uncommon these days. It is commoner in Afro-Caribbean or Asian children. The child may display bowed legs, splaying of the wrists and ankles and may have a ‘rickety rosary’ (the enlargement of the costochondral joints) of the rib cage. Vitamin A deficiency can lead to blindness. Vitamin B deficiency can cause lethargy, paraesthesiae and heart palpitations. Vitamin C deficiency (scurvy) can cause bleeding gums and mucus membranes, joint pain and swelling. Vitamin E deficiency causes neurological symptoms and haemolytic anaemia.
Surgery to Improve Reservoir Function
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
The primary outcomes are the reversal of the patient's symptoms and stabilization of conditions that may impair renal function or other complications. These include reduction in episodes of urinary tract infection, reduction in episodes of pyelonephritis, stabilization of renal function, reduced or cured urinary incontinence, and improvement in quality of life for the individual patient. By the same token, patient expectations on the outcomes should be carefully reviewed and understood by the patient, so that the patient's and surgeon's expectations are set to a reasonable outcome. The complications of metabolic upset, long-term complications to bone, vitamin B deficiency, bowel habit changes, augmentation failure, and potential of cancer need to be thoroughly discussed with and understood by the patient and caregivers prior to undertaking these surgeries, particularly in female patients, who may desire childbearing later.
Common neurological patterns
Published in Hani Ts Benamer, Essential Revision Notes in Clinical Neurology, 2017
➤ The causes of predominantly sensory peripheral neuropathy are: ➣ diabetes➣ vitamin B deficiency (thiamine and B12), especially in alcoholics➣ paraneoplastic neuropathy➣ drugs such as antituberculosis drugs (isoniazid and ethambutol) and chemotherapeutic agents (cisplantinum and vincristine)➣ amyloidosis and chronic renal failure➣ idiopathic especially in older patients➣ paraproteinaemic neuropathy (mixed sensory and motor neuropathy).
Efficacy of vitamin and antioxidant supplements for treatment of diabetic peripheral neuropathy: systematic review and meta-analysis of randomized controlled trials
Published in Nutritional Neuroscience, 2023
Jinghong Huo, Yanzhong Xue, Xiaoying Dong, Jinming Lv, Lingyu Wu, Hua Gao, Xiuqin Yang, Huanhuan Liu, Qinghan Gao
The concern in the relation between vitamin B supplements and the DPN had been inconsistent for a long time. Sun Y et al. showed that treatment with a combination vitamin B complex seemed to improve symptomatic relief in patients with DPN in 2005 [40]. In 2008, a systematic review suggested that there being limited data on the effectiveness of vitamin B in the treatment of DPN in randomized trials, and it was hard to determine whether vitamin B is beneficial or harmful due to insufficient factors [18]. In 2016, Jayabalan B et al. found no evidence that vitamin B could benefit patients in terms of reduction of symptoms and improvement in electrophysiological measures [41]. In 2021, a review showed that it is uncertain whether vitamin B might have efficiency in patients with DPN, and suggested that trials with a larger sample size are needed to confirm this in the future [42]. Our findings are in accordance with the previous studies. However, vitamin B deficiency might influence the protective effects on DPN patients. For example, some studies have shown that metformin may cause vitamin B12 deficiency. Hence vitamin B12 treatment may correct deficiency and convert related neuropathy of DPN patients, but not for those without vitamin B12 deficiency. This reason may explain the inconsistent effects. We would like to suggest including patients who were vitamin B12 deficiency and vitamin B12 non-deficient, respectively, and then observe the therapeutic effects of vitamin B12 on DPN in future clinical trials.
Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials
Published in Nutritional Neuroscience, 2023
Jaqueline G. Borges-Vieira, Camila K. Souza Cardoso
In conclusion, our results suggest that supplementation with a combination of active (reduced) forms of B vitamins, or L-methylfolate alone or combined with methylcobalamin, or thiamine alone, along with an adequate dosage of vitamin D, is effective, safe, and well-tolerated for improving clinical symptoms of MDD or mild to severe depression. B vitamins can also decrease serum homocysteine concentration, which helps reduce the severity of depressive symptoms, even in the absence of serum vitamin B deficiency. Individuals with minimal sun exposure and inadequate vitamin D levels (< 30 ng/ml) may benefit from vitamin D therapy and its effects on mood regulation and GAD. Our findings also reinforce the need for therapeutic strategies for individuals with inadequate responses to antidepressants and low borderline levels of these vitamins (with a preference for biologically active coenzyme forms in the case of B-complex).
Did hypervitaminosis A have a role in Mawson’s ill-fated Antarctic exploration?
Published in Clinical Toxicology, 2022
Despite what seems to be a rational explanation for Mertz’s death, others have criticized Cleland’s theory. Clearly both Mawson and Mertz were functioning on a reduced caloric and nutrient diet. Carrington-Smith in a more recent analysis in 2005 [10], suggests that Mertz more likely just suffered the combined effects of severe psychological strain and starvation, and died as a result. Mawson, she suggests, suffered from other vitamin deficiencies such as vitamin B deficiency [10]. No proof of any theory will definatively be known, as serum samples from Mertz and Mawson would be the only way to prove hypervitaminosis A; speculation and retrospective interpretation of Mawson’s experience shall continue without an answer. In their memory, Mertz and Ninnis contributions to polar exploration are commemorated with a glacier named for each of them in East Antarctica, along the route they had taken with Mawson (Figure 2) [6,7].