China
Africa
Explore chapters and articles related to this topic
Osteomalacia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Calcium: Individuals with malabsorption or poor nutrition should receive calcium supplementation. Usually 1-1.5 gm/day of oral elemental calcium is a reasonable initial dose. Frequent small doses (e.g., three times a day) are more effective and tolerable than fewer larger ones. The absorbability of calcium supplements is enhanced with meals. Calcium preparations such as calcium carbonate (40% calcium as in Os-Cal or the equivalent) can be used. Some patients with adverse gastrointestinal side effects with the above preparations prefer using chocolate- or coffee-flavored formulations known as Viactiv (500 mg calcium per tablet). PPIs or H2 blocking drugs do not impair calcium carbonate absorption.7
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Calcium supplementation is recommended for all pregnant adolescents (aged < 20 years) and all pregnant women with low calcium intake and at high risk of pre-eclampsia (history of pre-eclampsia or eclampsia, twin pregnancy or chronic hypertension). Start supplementation before 20 weeks from the LMP and continue throughout the pregnancy. Prescribe calcium carbonate orally: one 1.25 g tablet (equivalent to 500 mg of calcium element) three times per day (equivalent to 1,500 mg calcium element daily in three divided doses). Wait two hours between the administration of calcium and ferrous salts.5
Nutritional requirements
Published in Judy More, Infant, Child and Adolescent Nutrition, 2021
Calcium has many key functions in the body and is needed for the structure of healthy bones and teeth. The calcium in bone acts as a store so that there is always a ready supply enabling the muscles, including the heart, to contract and the nerves and cells to function as necessary. Milk, cheese and yogurt are the best sources. Soya beans are a reasonable source of calcium but soya milk needs to be fortified with extra calcium to provide the same amount as cow’s milk. White bread has been fortified with calcium since the 1940s and tinned fish with bones such as sardines is another good source. Calcium carbonate is usually used in calcium supplements and food fortification and calcium in this form is less bioavailable than that in milk and milk products.
Recent advances on small molecular gels: formation mechanism and their application in pharmaceutical fields
Published in Expert Opinion on Drug Delivery, 2022
Meiling Su, Jingwen Zhang, Zudi Li, Yuanfeng Wei, Jianjun Zhang, Zunting Pang, Yuan Gao, Shuai Qian, Weili Heng
The gelation of small molecular drugs could also be weakened and even eliminated via addition of appropriate excipients. The formulation design strategy exhibits great advantages over the crystal engineering technology for the drug–gel elimination, such as simple preparation process, low cost, and friendly to the environment, but takes some luck. Lenvatinib mesylate would form hydrogel upon contacting aqueous medium, and the formed gel could wrap the drug powder to form a sticky gel mass, which dramatically delayed the in vitro drug dissolution, thus affecting its in vivo absorption [55]. Nevertheless, this issue was overcome by adding calcium carbonate in the formulation of Lenvima® developed and patented by Eisai Co., Ltd. Calcium carbonate is a conventional excipient commonly used in effervescent tablets, which will produce a large number of bubbles in the acidic environment, thus preventing the aggregation of particles and weakening the effect of gelation on dissolution of lenvatinib mesylate. Similarly, other carbonate excipients could also improve the dissolution of lenvatinib mesylate due to the disintegration action arising from the production of bubbles [145]. Heng et al. found that the gelation of amorphous indomethacin could be weakened and even eliminated after adding hydrophobic silica (4% w/w). It is speculated that the addition of hydrophobic silica would adhere on the surface of amorphous powders, which is conducive to prevent the aqueous medium from penetrating into the amorphous texture, and slow down or suppress the decrease of Tg, thus inhibiting gel formation [47].
Purtscher-Like Retinopathy Secondary to Medication Induced Calcium-Alkali Syndrome and Acute Pancreatitis in a Pregnant Female
Published in Ocular Immunology and Inflammation, 2022
Ravin Alaei, Carl Shen, Brian J. Chan, James Martin
Pregnancy promotes physiologic conditions that can predispose to calcium-alkali syndrome, acute pancreatitis, and Purtscher-like retinopathy. Pregnancy stimulates increased calcium absorption to support the fetus, raising the risk for hypercalcemia.4 Moreover, pregnant women commonly experience GERD and nausea, at times leading to excessive ingestion of calcium carbonate tablets.4,5 TUMS® regular strength tablets contain 500 mg of calcium carbonate (200 mg of elemental calcium) and the manufacturer label recommends a maximum daily dose of 10 tablets for pregnant women. Our patient ingested an estimated 2,400 mg of elemental calcium from the anti-acids 24 hours before presenting to hospital (and approximately two to six tablets per day during pregnancy until then). Although not well understood, hypercalcemia in calcium-alkali syndrome is able to activate pancreatic proteases, potentiating an acute pancreatitis in certain cases.3 Acute pancreatitis can then activate the complement cascade, leading to occlusive coagulation within precapillary arterioles in the retina.1 Pregnant women also have increased levels of complement factors and clotting activity.6 Independent of hypercalcemia or acute pancreatitis, Purtscher-like retinopathy has been observed in the peripartum period primarily due to HELLP syndrome and pre-eclampsia.6
Evaluation of gallstone classification and their diagnosis through serum parameters as emerging tools in treatment: a narrative review
Published in Postgraduate Medicine, 2022
Bhavna Sharma, Shubha Rani Sharma
Shareef (2008) studied gallstones using Fourier transform infrared spectroscopy (FTIR) of patients in the Erbil region of Iraq and found that cholesterol stones were the most abundant type. They are found in combination with calcium bilirubinate and calcium carbonate. The concentration of cholesterol is high both in the center and periphery of the gallstones. Also, the gallstones are found more in females as compared to males. The analysis of gallstones is more prominent in the age group of 45 years and above [38]. The main risk factors for gallstones were cholesterol and bilirubin [38]. Jarrar and Al-Rowaili, (2011) observed that cholesterol gallstones were chiefly found in developed as well as developing countries and analyzed them using colourimetric and semiquantitative titrimetric methods. They classified the gallstones as pure cholesterol (54.3%), pure bilirubin (2.2%), or mixed stones (43.5%) [39].