CALCIUM METABOLIC PROFILE IN VARIOUS CATEGORIES OF PULMONARY TUBERCULOSIS  PATIENTS

PALLAVI TAPARIA; Dr B P Meena; Dr Faridh R; Dr Suresh Koolwal

Volume : IV, Issue : XII, December - 2015

CALCIUM METABOLIC PROFILE IN VARIOUS CATEGORIES OF PULMONARY TUBERCULOSIS PATIENTS

Pallavi Taparia, Dr B P Meena, Dr Faridh R, Dr Suresh Koolwal

Abstract :

BACKGROUND: Pulmonary Tuberculosis is a deadly infectious disease caused by acid fast bacilli Mycobacterium Tuberculosis and is responsible for more than 1.5 million deaths every year, hence is a major global health problem specially in developing countries. Interrelationship between Tuberculosis and malnutrition is as old as the disease itself. Disease outcome and mortality in PTB depends on strength of immune system which in turn influenced by the nutritional status of an individual. Calcium, is an essential macromineral is altered in various infection including granulomatous diseases. Vitamin D not only maintains calcium homeostasis but also acts as immunomodulator in cell mediated immunity. Thus, calcium profile constitutes important part of nutritional monitoring in patients with PTB . AIM It deals with study of macronutrient Calcium, Phosphorus Vitamin D and Parathyroid Hormone (PTH) level in various categories of PTB patients . MATERIAL AND METHOD: The study was conducted on 100 adults (both males and females) from low socioeconomic status out of which 40 were newly diagnosed (Group A) , 30 were relapsed PTB cases (Group B) and 30 were healthy age and gender matched non family members of patients that served as controls (Group C) . After an informed consent, all were subjected to Anthropometric measurements and Biochemical investigations i.e Total protein (Biuret Method, Accurex), Albumin (BCG dye binding method, Accurex), Total Calcium (Arsenozo III Method, Accurex), Phosphorus ( Phosphomolybdate UV Method, Accurex) and ALP (Kinetic Method), Vitamin D and PTH (Chemiluminescene). RESULT AND DISCUSSION: No significant difference was seen in ages among all the groups. BMI, Total protein and Albumin were significantly (p<0.05) low in Pulmonary Tuberculosis (PTB) than controls. Since TB is associated with severe chachexi ,wasting and low albumin, Ionic and corrected TCa was calculated and were significantly (p<0.05) higher in cases than control. Prevalence of Vitamin D deficiency (VDD) was maximum group A, followed by Group B and C . This was partly due to utilization of calcitriol in antimicrobial activity of macrophages in CMI response and partly due to TB associated undernutrition of selected population. CONCLUSION: The study concluded exsistence of hypercalcemia in PTB cases ( both newly diagnosed and relapsed) causing clinical manifestation in some. High incidence of Vitamin D and PTH deficiency is found in PTB that compromised Cell mediated immunity and increases susceptibility to infection and possibility of relapse. This further support immunomodulator rple of Vitamin D.