title: Hypovitaminosis-D: Frequency and association of clinical disease with biochemical levels in adult patients of RMI Medical OPD.
abstract: OBJECTIVE
  Vitamin D is steroid hormone essential for maintaining many important functions in the body. Hypovitaminosis D has become worldwide problem affecting all age groups and both genders, but its prevalence is very high in South Asia. Therefore this study was aimed to determine frequency of hypovitaminosis D in adult patients of RMI Medical Out Patients Department (OPD) and find association of clinical disease with biochemical levels.
  
  
  METHODS
  It was a cross sectional study carried out on all patients visiting RMI Medical OPD from 1(st) Jan, 2015 to 30(th) April, 2015 with clinical indications using universal sampling technique involving 400 subjects. Data was analyzed using SPSS 16.
  
  
  RESULTS
  Out of 400 subjects 85(21.3%) were males, 315(78.8%) were females, biochemical hydroxyvitamin-D3 deficiency was present in 320 (80%) subjects with 86(21.5%) having severe deficiency, 176(44%) having moderate deficiency and 58(14.5%) having mild deficiency. There was statistically significant association between biochemical deficiency and severity of clinical disease manifestation, calculated using chi square test. (p < 0.001).
  
  
  CONCLUSIONS
  Most of the patient with musculoskeletal symptoms had vitamin D deficiency affecting all age groups and mostly female gender. There is a statistically significant association between low biochemical hydroxyvitamin-D3 levels and severity of clinical signs and symptoms which can provide evidence for replacement therapies in rural and far flung areas where biochemical assays are not available. Early recognition and replacement can prevent the massive complications, which deficiency of vitamin D makes us prone to develop.
authors.affiliation: Humaira Achakzai, MBBS, FCPS, Assistant Professor, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan.
authors.forename: Humaira
authors.initials: H
authors.lastname: Achakzai
authors.affiliation: Hammad Shah, MBBS, Resident Trainee FCPS, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan.
authors.forename: Hammad
authors.initials: H
authors.lastname: Shah
authors.affiliation: Shahzada Bakhtyar Zahid, MBBS, MRCPCH (UK), Associate Professor, Department of Pediatrics, Rehman Medical Institute, Peshawar, Pakistan.
authors.forename: Shahzada Bakhtyar
authors.initials: SB
authors.lastname: Zahid
authors.affiliation: Muhammad Zuhaid, MBBS, Resident Trainee, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Zuhaid
keywords: Adults; Biochemical levels; Clinical severity; Hypovitaminosis D