Advancing Age as a Risk Factor for Acute Myocardial Infarction

Background: Acute myocardial infarction (AMI) is one of the leading causes of death in developed and developing countries. Age is an important non-modifiable risk factor for acute myocardial infarction. Objectives: The objective of the study was to explore the relationship of advancing age with the risk of acute myocardial infarction. Methods: It was a cross-sectional study conducted in 2019 after getting approval from Institutional Review board of University of Health Sciences, Lahore. Written informed consent and thorough history was taken from the study participants. Group 1 included 45 AMI patients aged 20-60 years. Group 2 included 45 healthy individuals aged 20-60 years. Independent sample t test and chi-square tests were applied for analysis of data. Results: Mean age was significantly higher in AMI patients (50.52±7.31) as compared to healthy controls (30.67±7.20). The risk of AMI increases with advancing age (p<0.001, OR= 2.78). Conclusions: Advancing age is an important risk factor for acute myocardial infarction.

Prevalence of Vitamin D Deficiency in Exclusively Breastfed Infants at the Aga Khan University Hospital, Nairobi

Introduction: Vitamin D deficiency in infants is a recognized cause of rickets. In the last few years, evidence has emerged of its association with lower respiratory tract infections, food allergy, type 1 diabetes, schizophrenia and various other extra skeletal health effects. Exclusively breastfed infants are especially vulnerable to vitamin D deficiency due to their dependence on previous trans-placental transfer of vitamin D from the mother, dietary vitamin D from breast milk and cutaneous synthesis of vitamin D on exposure to sunlight. The worldwide epidemic of Vitamin D deficiency in pregnancy and the low content of vitamin D in breast milk underlie the high risk of deficiency in exclusively breastfed infants. Data regarding the magnitude of vitamin D deficiency among exclusively breastfed infants in Kenya is needed to inform policies on supplementation of at risk groups. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in exclusively breastfed infants using 25(OH)D and to evaluate the relationship between PTH and 25(OH)D in a population of exclusively breast fed infants. Study Design: This was a cross sectional survey carried out in three to six month old exclusively breastfed infants at the Aga Khan University Hospital, Nairobi. Methods: Ninety-eight infants were enrolled in the study and all had data on their demographics and anthropometric measures recorded. Self-reported data on maternal vitamin D supplementation and sunlight exposure was also collected. A brief physical examination to assess for skeletal signs of rickets was then performed. A blood sample was collected for measurement of serum 25(OH)D, calcium, phosphate and PTH . Prevalence of vitamin D deficiency was analyzed using proportions with 25(OH)D levels below 20ng/ml. PTH, calcium and phosphate levels in the vitamin D deficient and non-deficient groups were compared using analysis of variance(ANOVA). The level of 25(OH)D beyond which there was no PTH elevation was identified by drawing a scatter plot of PTH against vitamin D levels. Tests of association using odds ratio were used to determine the correlation between infant serum vitamin D levels and maternal vitamin D supplementation and sunlight exposure. Skeletal manifestations of vitamin D deficiency in this population were described using bar charts. Results: Prevalence of vitamin D deficiency among exclusively breastfed infants at Aga Khan University Hospital was 23.5% (95% CI 14.9%-32.0%). A further 31.6% were found to have insufficient levels of vitamin D leaving only 44.9% of the population classified as having sufficient levels.