Differences among Asian patients.
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Biomedical subjects
Publications and source records attributed to S Shaunak.
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The vitamin D state of 60 apparently healthy adult Hindu Asian couples living in Britain was studied on a community basis. Twenty six (22%) of the Asian subjects had pronounced vitamin D deficiency, defined as 25-hydroxycholecalciferol concentrations below 10 nmol/l (4 ng/ml), while none of the white controls had such low concentrations. Asian men and women were equally affected, and plasma concentrations were similar in husbands and wives. Vitamin supplements were being taken by only 31 (26%) subjects, most of whom were women. It is suggested that the spouses of patients with osteomalacia should be screened for vitamin D deficiency.
Small-intestinal function was studied in 10 patients with visceral leishmaniasis. Vitamin-A absorption was impaired in 7 and d-xylose in 1. In 5 of the 10 patients Leishmania were demonstrated in biopsy specimens of intestinal mucosa. Parasitised macrophages were present in villous tips and less commonly in the lamina propria and submucosa; a moderate inflammatory infiltrate was composed of lymphocytes and plasma cells. 2 patients had partial villous atrophy. There was no correlation between intensity of parasitisation and severity of malabsorption. After treatment with sodium stibogluconate there was a significant improvement in absorption of vitamin A and d-xylose, and biopsy specimens became normal. In 1 patient visceral leishmaniasis was thought to be the cause of chronic diarrhoea.
A case of Meckel's diverticulum in a middle-aged man presenting acutely with haematemesis and melaena is reported. Such a presentation has not to our knowledge been previously reported in this age group.