National Journal of Medical Research
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Editor in Chief: Dr. Viren Patel
ISSN: 2249 4995 (Print)
Frequency: 4 issues a year
Language: English
Online peer reviewed journal
Web site: https://njmr.in/
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Item Study of Stress Hyperglycaemia as an In-Hospital Prognostic Factor in Acute ST Elevation Myocardial Infarction Patients(Medsci Publications, 2022-01) Nagocha, Sureshkumar; Gagiya, Ashok; Gurjar, VivekIntroduction: According to the American Diabetes Association and American Association of Clinical Endocrinologists' consensus on inpatient hyper glycemia, any blood glucose level higher than 7.8 mmol/l (140 mg/dl) without symptoms of preceding diabetes is considered stress hyper glycemia or hospital-related hyper glycemia. Methodology all patient admitted with acute onset of ST elevation myocardial infarction within 12 hours of onset, age more than 18 and less than 80 years at tertiary care hospital were included in this study. Result In case group mean age was 55.4 years while in control group mean age 57.5 years was In case group mean Hba1c 5.6 and SD 1.0 was while in control group mean Hba1c 5.3 and SD was 1.1 with p value 0.234. Conclusion Mortality was commonly noted in the stress hyperglycemic groups. 5(25%) deaths were noted in group, while in euglycemic group 4 (11.4%) death were noted in group.Item Unusual Presentation of a Thyroid Malignancy: A Case Report(Medsci Publications, 2022-01) Sunkara, Lakshmi S; Chinnam, Aparna; kasa, Lakshmi; Golla, BaleswariMedullary thyroid carcinoma is a rare malignancy. We report a case of Medullary thyroid carcinoma in a 56-year-old male patient. Patient presented with lower limb paresis and severe hypokalemia. Cushing’s syndrome is a rare complication of Medullary thyroid carcinoma [MTC] and is due to ectopic Adrenocorticotropic [ACTH] secretion by tumor cells. Cushing’s syndrome presents a challenging diagnostic and management issue in patients with MTC. Entire clinical history, laboratory investigations, microscopic pictures are discussed in detail.Item A Cost Variation Analysis of Drugs Prescribed for The Treatment of Rheumatoid Arthritis(Medsci Publications, 2022-01) Panchal, Yash N.; Vyas, Bhavesh M.Background: The rheumatologists have several drugs to choose from, either alone or in combination; each with different costs, monitoring protocols, and potential risks and benefits. Pharmacoeconomic analysis results help rheumatologists choose drugs for their patients. Objective: Objective of this prospective observational study was to perform a cost-variation analysis of drugs prescribed for the treatment of rheumatoid arthritis (RA) in a Western-Indian tertiary care teaching hospital. Materials and Methods: This prospective observational study was conducted in the rheumatology department of the study site. Study population included patients of both gender male and female, diagnosed with rheumatoid arthritis and on treatment. Prices of the drugs prescribed to the patients were obtained from different offline and online sources. The lowest and highest cost of brands in rupees (INR) for each drug, the cost ratio, percentage cost variation, and monthly cost for all the prescribed drugs were calculated. Results: In our study, out of total 142 patients, 93 were females and 49 were males and the mean age was 49.11±15.89 years. Most patients were prescribed with Disease-modifying antirheumatic drugs (DMARDs). Frequently used nonsteroidal anti-inflammatory drug (NSAID) was Diclofenac (n=48). A maximum cost ratio (15.6) was observed with prednisolone 5 mg TDS. The costliest and cheapest brand of prednisolone 5 mg TDS accounted for the maximum cost variability (1460%). Mean monthly cost varied among different drug classes. Conclusion: Average cost of illness of patient with RA was estimated to be in the range of 2406/month to 2858/month in the year 2021.Item A Study of Hypomagnesemia in Patients Admitted in Medical ICU and Its Correlation with Final Outcome(Medsci Publications, 2022-01) Gosalia, Harshil; Patel, Om; Doctor,Nilesh M; Shah, HemantIntroduction: Magnesium is the second most common intracellular cation found in the body that is required as cofactor in numerous enzymatic reactions, smooth functioning of cardiac and neurological systems. Magnesium deficiency is often overlooked in critically ill patients and is linked with risk of electrolyte imbalance, difficulty weaning off ventilator, sudden cardiac deaths and poorer outcome. Objective- To assess prevalence of magnesium deficiency in critically ill patients admitted to Medical ICU and its association with requirement & duration of mechanical ventilation, ICU stay, APACHE-II & mortality. Methods- Prospective descriptive study was conducted on 69 critically ill patients admitted in medical ICU. After taking informed consent serum magnesium level of patients were collected and entered in spreadsheet and final analysis was done with help of Open EPI and SPSS software. Results-It was concluded that patients having hypomagnesemia were at increased risk of electrolyte abnormalities, longer ventilatory support, longer hospital and ultimately poorer outcome stay as compared to patients with normal magnesium levels. Conclusion- Magnesium remains an important but often side-lined cation in critically ill patients. However, Hypomagnesemia is a repeated finding seen in critically ill patients and is significantly associated with a higher mortality rate and frequent need for mechanical ventilation.Item Comparative Evaluation of Midazolam and Ketamine with Midazolam Alone as Oral Premedication in Children(Medsci Publications, 2022-01) Modi, Shreya; Patel, SubhashIntroduction: The main aims of preanesthetic medication in children are to reduce anxiety associated with the unfamiliar environment, facilitate the separation of the child from their parent and allow smooth induction of anesthesia. Both oral midazolam and oral ketamine fulfil many of these characteristics and are useful. Method: As 48 patients of ASA grade 1 and 2, aged between 2-10 years undergoing elective surgery were allocated to one of two study groups using random numbers: Group 1 received midazolam 0.5mg/kg and group 2 received midazolam 0.25 mg/kg with ketamine 3 mg/kg. The medications were prepared and mixed with 25% dextrose up to a maximum volume of 0.3 ml/kg. Result: Uniform and acceptable sedation scores were seen in both the groups, without any serious side effects. However, the combination offered significantly more children in an awake, calm and quiet state, who were easily separated from their parents. The induction scores, Recovery room characteristics and time to achieve satisfactory Aldrete score were also comparable between the two groups. Conclusion: Oral midazolam alone and a combination of midazolam with ketamine provide equally effective anxiolysis and separation characteristics. However, the combination provided more Benefits.Item Serum Lactate as a Predictor of Severity in Dengue Infection(Medsci Publications, 2022-01) Ladani, Meet; Shukla, Deepak; Raval, Rakesh; Goyani, Tejas; Vadodaria, SrushtiBackground Dengue infections caused by the four antigenically distinct dengue virus serotypes (DENV1, DENV2, DENV3, DENV4) of the family Flaviviridae are the most major arboviral diseases in humans in terms of geographic spread, morbidity, and mortality. Objective: The study was conducted to assess serum lactate in cases of dengue and correlate it with severity in dengue infection. Methodology: A prospective observational study was carried out among indoor patients admitted to the general medicine department of the tertiary care hospital SMIMER Surat. The study's duration was 15 to 18 months. Result: our study found out of total 154 cases; majority of cases were belonged from 83(53.90%) cases were from less than 30 years. male was contributed 96 (62.34%), majority of cases had duration of fever 39(25.32%), 66 (42.66%) case had high LDH, comparison of serum lactate dehydrogenase with severity of dengue mean lactate dehydrogenase of dengue without severity was mean was 148.45 and SD 11.81, while in severe dengue mean serum lactate dehydrogenase 388.23 and SD 99.47 with p value 0.001 which was statically significant. Conclusion According to this study, it is preferable to monitor serial lactate levels as opposed to using a single lactate number.Item Incidence of Neonatal Seizures and it's ClinicoEtiological Profile in A Tertiary Care Hospital in Western India(Medsci Publications, 2022-01) Patel, Sachin; Mehta, NiraliIntroduction: Neonatal seizure is defined as paroxysmal electrical discharge from the brain. The immature brain seems more prone to seizures. The incidence was found to increase with decreasing gestation and birth weight- preterm neonates (20.8 vs. 8.4 per 1000 live-births) while very low birth weight neonates had more than 4-fold higher incidence (36.1 per 1000 live-births). Objective: The study was conducted to estimate the incidence, etiological factor, time of onset, clinical types, and biochemical abnormalities among the different types of neonatal seizures. Methods: This is a hospital based prospective observational study conducted in NICU, Department of Pediatrics, SMIMER during the period of January 2020 to March 2021. Results: Total patients with neonatal seizures were 90 in our study. Incidence of neonatal seizures in our study was 1.1%. Incidence was higher in pre-term neonates (4.8%) and more in males (56.67%). Incidence of neonatal seizures was higher in LBW babies (4.3%) and more common in SGA babies (51.11%). Incidence among vaginal delivered babies was 0.9%, LSCS was 1.7% and forceps was 1.1%. Birth asphyxia (41.1%) was the most common cause of all neonatal seizures followed by hypoglycemia (17.8%), neonatal meningitis/septicemia (14.5%), hypocalcemia (12.2%), ICH (7.8%). Subtle seizures (44.4%) were the most common type of seizure followed by tonic (38.9%), focal clonic (11.1%), multifocal clonic (5.6%). 33.3% of neonatal seizures occurred in < 24hrs & 40% in 24-72 hrs. The most common biochemical abnormality was hypoglycemia (17.8%) followed by hypocalcemia (12.2%). Conclusion: Incidence of neonatal seizures was 11.1/1000 live births (1.1%) & more common in preterm, LBW & LSCS deliveries. Birth asphyxia was the most common cause and subtle seizures were the most common type of seizure. Subtle seizures were more common in 24-72 hours of life. Most common biochemical abnormality was hypoglycemia followed by hypocalcemiaItem Metabolic Effects of Carbon Dioxide Insufflation During Laparoscopic Surgery: Changes in pH, Arterial Partial Pressure of Carbon Dioxide (PaCO2) And End Tidal Carbon Dioxide (ETCO2)(Medsci Publications, 2022-01) Bachh, Mohd Dawood; Farooq, Nyla; Gillani, Yousha MuneebBackground: Laparoscopy involves inspecting the abdomen and pelvis using an endoscope. Carbon dioxide (CO2) is the gas that is commonly used to insufflate the abdomen so as to facilitate the surgical view. Aim: The present study was under taken to determine the Metabolic effects of carbon dioxide insufflation during laparoscopic surgery. Methods: An observational study on 50 patients above 18 years of age with physical status of American Society of Anaesthesiologists (ASA) Class I and II after obtaining approval from institutional ethical committee and consent of the patient was conducted in the Postgraduate Department of Anaesthesiology and Critical Care, Government Medical College Srinagar. Results: There was a progressive decrease in the pH during pneumoperitoneum in keeping with the hypercarbia. An increase towards baseline was observed during recovery but pH was still significantly lower than baseline 15 minutes into recovery (p<0.118). The Pco2 increased after 15 mins Co2 insufflation & peaked at 30 mins with mean & SD 42.82,2.775 & 46.16,2.909 respectively which was statically significant. Etco2 also increased after 15 mins of Co2 insufflation & peaked at 30 mins with mean 41.56 & 44.50 respectively which was statically significant. Similarly, Hco3 decreased over period of time with peak decrease at 30 mins of Co2 insufflation with mean 23.70, SD 1.919 & range 19-27. Conclusion: Co2 insufflation does bring metabolic changes in Ph, Pco2, Etco2 & HCO3 but with proper monitoring & management laparoscopic procedure can be safely performed.Item Outcome of Patients with Sepsis Admitted in Intensive Care Unit of a Tertiary Care Hospital in India(Medsci Publications, 2022-04) Patel, Rashmi R; Karagatharavm, Vinayak H; Dudhrecha, BhavinIntroduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The rapid progression of sepsis requires correspondingly swift adjustments in therapy, and accurate identification of disease severity is therefore vitally important for predicting prognosis, treatment, preventing complications, reducing complication and mortality. With this background, the present research is aimed to study the relation of serum procalcitonin levels in cases with sepsis, to calculate APACHE II scores and to correlate the levels of serum PCT levels with APACHE II Score with the outcome. Methodology: This was a prospective observational non interventional cohort study was conducted in the Clinic of Intensive Care unit of a tertiary care hospital and medical college in western India from May 2020 to December 2020. Results: A total of 75 patients, admitted to the ICU with the diagnosis of sepsis, were included in this prospective observational study. Of them 47 (62.7%) were males and highest cases were aged between 60 to 69 years. Of the total 75 patients, 47 (62.7%) patients were survivors. Age, gender and involvement of system were not associated with mortality while lower APACHE II score and presence of co-morbidities were significantly associated with mortality. Conclusion: From this study we conclude that the lower APCHE II score and presence of co-morbidity significantly increases the mortality in ICU patients admitted with sepsisItem A Comparison of Functional Outcome of Intra Articular Distal Tibial Pilon Fracture Treated by One Stage vs Two Stage Surgically(Medsci Publications, 2022-04) Talwar, Punit; Kothari, Rahul; Singh, HeminIntroduction: The study was conducted to evaluate clinical and functional outcomes of comminuted pilon of distal tibial fractures after surgical management and fixation by modalities available ranging from temporary external fixation, simple distal tibial plates to moderate plating system and intra medullary nails for fibula. Methodology: Total 24 cases with intraarticular distal tibial pilon fracture were randomly divided in to two group. One group was managed by one stage procedure and second group was operated by two stage procedure. Results: From this study we infer that patient who had undergone one stage procedure had shorter hospital stay. In present study we observed that arthrosis, superficial infection and arthritis was higher in two stage procedure. Assessed by Ovadia Beals Evaluation Score - Objective Evaluation as well as subjective evaluation. Furthermore, the rate of complications was also identical. However, functional outcome assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score revealed that the patients underwent one stage procedure had better functional outcome. Conclusion: Considering the better functional outcome and the shorter hospital stay, we preferred using one stage operative procedure in better skin condition, less soft tissue damage, closed fracture of type b and C AO/OTA Pilon fractures.Item Partograph(Medsci Publications, 2022-04) Sharma, UmaThis article briefly describes principle and use of Partograph in obstetrical practices. This article includes objectives and scope of the tool, the WHO partograph model, the principle of partograph use, components of partograph, problems with the who partograph and advantages and disadvantages of partograph use.Item Assessment of Perception about Immunization Among the Mothers of Under-Five Children at Urban Slum Area of Vijayapura City(Medsci Publications, 2022-04) Ganganahalli, Praveen; Tellur, Laxmi; Patil, Santosh D; Yankanchi, SandeepIntroduction: Immunization is one of the most cost-effective health investments worldwide. The World Health Organization (WHO) launched the expanded programme on immunization (EPI) in 1974 with the aim of immunizing children throughout the world. Objective: Assessment of perception about immunization among the mothers of under-five children at urban slum area of Vijayapura city. Methods: Cross-sectional study was conducted in Urban Field practice area of Community Medicine department among the mothers of under-five children residing permanently in the area and were interviewed regarding the perception about immunization to their children by using pre-structured proforma. Results: level of knowledge & perception was found average (around 50%). Nearly 40 to 60% of the participants agreed to the statements which signifies the immunization is very important to the child’s growth and development and should not be avoided. Conclusions: Providing mothers of under-five children with information about vaccination effectively increases the immunization coverage and was highly cost-effective alsoItem Role of Procalcitonin Levels in Patients with Sepsis in Medical Intensive Care Unit(Medsci Publications, 2022-07) Sarkar, Dattatreya; Chatterji, RajeevIntroduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The Acute Physiology and Chronic Health Evaluation II (APACHE II) is the standard method for assessing sepsis. Serum PCT level can be increase in case of sepsis. With this background, the present research is aimed to study the survival among the sepsis cases and correlate them with serum procalcitonin levels, APACHE II Score and other risk factors. Methodology: The study was conducted among 75 cases diagnosed having sepsis admitted in medical ICU. APACHE II score, serum procalcitonin (PCT) and other investigation were carried out along with clinical history and examination. Data were analysed using epi-info software. Results: The cases fatality rate of sepsis cases in medical intensive care unit in our hospital was 37.3%. The mortality rate was significantly higher patients with comorbidities, especially cases with respiratory or CNS involvement. The serum PCT levels were significantly higher in the group of non survivors as compared to group of survivors. Higher APACHE II score associated with higher mortality. Serum PCT levels go on increasing along the spectrum of sepsis. A PCT level was significantly hire in culture positive cases compare to sterile cases. Conclusion: From this study we conclude that serum PCT level is useful investigation in sepsis cases to predict mortalityItem Diagnostic Hysteroscopy and Saline Infusion Sonography in Abnormal Uterine Bleeding(Medsci Publications, 2022-07) Gupta, AmardeepOne of the commonest reasons for women seeking gynecological advice is Abnormal uterine bleeding (AUB). Most common anatomical causes of abnormal uterine bleeding in women are endometrial polyps, sub mucosal fibroids and endometrial hyperplasia. Hysteroscopy is an effective procedure but is more expensive than Saline Infusion Sonography (SIS). Direct visualization of uterine cavity is possible by hysteroscopy, but it does not give any information about myometrium and adnexa. Saline infusion sonography is effortlessly accepted by most patients as it can be an outpatient procedure. This article present summary of salient features of the procedure which will help the practitioner to take informed decision.Item Orthostatic Hypotension and its Relationship with HbA1c Levels in Patients with Diabetes Mellitus(Medsci Publications, 2022-07) Bavaria, Deep R; Rathod,Asmita V; Patel, Ankur S; Chaudhari, Jigisha BIntroduction: For the diagnosis of diabetes mellitus, various tests are available such as FBS (Fasting blood sugar), PPBS ( Post Prandial Blood Sugar), Oral Glucose Tolerance Test, Random Plasma Glucose Test, HBA1c, etc, of which HBA1c is considered to be the most standard test.1,2 As diabetes mellitus can be asymptomatic initially, it can lead to important complications such as neuropathy, nephropathy, retinopathy, cardiovascular diseases, etc if not detected early.3 Postural blood pressure measurement which diagnoses orthostatic hypotension is a cheap, easy and useful tool to predict HBA1c level even in asymptomatic diabetic patients. Methods: This is a randomized cross-sectional study of 100 diabetic patients attending Medicine OPD or admitted in our tertiary care hospital of South Gujarat. Pretested proforma was used to collect data after taking informed consent. Investigations including blood pressure measured with a standard Sphygmomanometer at the end of 3 min after standing and HBA1c as mentioned in the proforma was carried out. Final analysis has been done with Open EPI and SPSS software. Results: 33% of patients of our study population were found with abnormal orthostatic hypotension. Our data shows orthostatic hypotension is directly associated with high HbA1c, longer duration of DM, and higher value of BMI. No correlation was found between age and gender. Conclusion: Among diabetic patients, high HbA1c, prolong duration of DM and high BMI were associated with abnormal orthostatic hypotension, which can be alarming sign of complications of diabetes mellitus.Item A Comparison of Misoprostol and Dinoprostone Gel for Induction and Cervical Ripening(Medsci Publications, 2022-07) Raidu, SandeepIntroduction: Labour induction at term is a universal conventional obstetric interference with an objective to stimulate uterine contractions artificially to attain a spontaneous vaginal delivery. The current study was aimed to compare the efficacy and safety profile of low dose vaginal Misoprostol with Dinoprostone gel for induction of labour in term pregnancies with unfavorable cervix and intact membranes. Methodology: This Randomized Controlled Trial was conducted among pregnant women with term pregnancy with obstetrical or medical indication for induction of labour after institutional ethical committee approval. A detailed history, complete physical examination and investigations were done for all patients. Result: Misoprostol and Dinoprostone gel are equally effective inducing agents. Both are equally effective in Primigravida and Multigravida. Failure of induction rate for Misoprostol and Dinoprostone was statistically not significant. The need of Oxytocin augmentation, maternal complication rate, NICU admission rate, caesarean section rate and occurrence of meconium-stained liquor are statistically not significant in both the study groups. Our study was unable to demonstrate superiority of any single drug compared to other. Only the difference is cost, induction with Conclusion: considering the easy to preserve and administer, we recommend use of Misoprostol as a safe, effective, cheaper, and more convenient drug for induction of labour.Item A Study of Serum Ferritin Level in Patients of Dengue Fever and Its Correlation with the Severity of Dengue Fever in Tertiary Care Hospital of South Gujarat(Medsci Publications, 2022-10) Prajapati, Maulikkumar K; Patel, Urvi C; Patel, Pritesh G; Kakadiya, Chintan M; Naik, Kamalchandra P; Patel, DeepikaIntroduction: In more than 100 endemic countries, there are 50 to 100 million new cases reported per year, according to the WHO. The dengue pandemic has caused significant death. There is usually only supportive care offered and no effective therapy. The purpose of the study was assess any effect on the level of serum ferritin in patients of dengue. Methodology: This was an observational, Prospective study conducted at Surat Municipal Institute of Medical Education and Research General Medicine department among dengue fever cases. Result: Serum ferritin level from on admission then on day 3 and then day 5 in non-severe and severe dengue cases showed p value <0.001 which was statically significant. Conclusion: The use of a serum ferritin level alone with a cut-off value of more than 900 ng/ml is indicated.Item Dengue Serotype Prevalence and Laboratory Profile Correlation in a Tertiary Care Hospital in Gandhinagar(Medsci Publications, 2022-10) Jadeja, Bindu J; Khokhar, Neeta; Patel, Parul; Makwana, Neha; Shrimali, GaurishankerBackground: Dengue fever and dengue haemorrhagic fever currently rank highly among the newly emerging infectious diseases and are the most important arboviral disease worldwide. Dengue virus can be distinguished by both serological and molecular methods. This study was aimed at analysing the prevalence and laboratory dynamics of the four dengue serotypes in tertiary care patients attending GMERS Medical College Gandhinagar. Material & methods: This study was an observational retrospective study. A total 105 samples were tested for Dengue serotyping by RT-PCR. Results: Among positive patients Dengue virus serotype-2 was the most common serotype 94 (89%) followed by DENV3 7(6%) and DENV4 2(2%). Co-infection with DENV 2/4 was 2(2%). A higher prevalence of dengue haemorrhagic fever was noted in serotype 2 compared to serotypes 3, 4, and coinfection. Thrombocytopenia was present in all serotypes of infection. There was a significant difference in the disturbance of liver function in DENV2, as compared to others serotype. Dengue serotype 2 was very common in rural areas, while dengue serotype 3 was seen in the urban Gandhinagar zone. Discussion: Dengue is the most extensively spread mosquito-borne disease. As per previous studies most common prevalent and severity of serotype wasDENV2, however in our study we were able to identify DENV3, DENV4 and confection with serotypes (DENV2 & DENV4).Item Association of Serum Level of Vitamin D3 and Pulmonary Function in Bronchial Asthma Patients in A Tertiary Care Hospital of South Gujarat, India(Medsci Publications, 2022-10) Parmar, Priyank; Dutt, Neha; Desai, Bijoy; Dhangar, VandanaIntroduction: Asthma is a chronic lung disease characterised by reversible airway obstruction, cellular infiltration, and airway inflammation. The reaction is characterised by the interaction of genetic and environmental variables, as well as the activation of cells in the innate and adaptive immune systems. Method: The study was conducted in the Department of General medicine, in Tertiary Care Center, to study association of serum level of Vitamin D3 and pulmonary function in bronchial asthma patients. As per inclusion and exclusion criteria ,137 patients of bronchial asthma were included in the study. Result: In cases having serum vitamin D3 level <20 ng/ml mean value of FVC, FEV1, FEV1/FVC ratio, was 108.10�.89, 68.56�.40, and 62.35�17. In cases having serum vitamin D3 20-29 ng/ml, mean value of FVC, FEV1, and FEV1/FVC ratio was 109.72�.22, 72.34�.48, and 64.39�97. In cases having serum vitamin D3 >30 ng/ml mean value of FVC, FEV1, and FEV1/FVC ratio, was 115.0�27, 81.0�09, and 70.52�00. Conclusion: Vitamin D3 deficiency was highly prevalent in asthmatic patients, there was a strong correlation between asthma severity and vitamin D3 concentrations and there was a direct and a positive significant correlation between vitamin D3 levels and pulmonary function test in asthmatic patients.Item A Case Control Study of Vitamin D Levels in Chronic Obstructive Pulmonary Disease Patients and Healthy Volunteers in South Gujarat, India(Medsci Publications, 2022-10) Patel, Kunal A; Patel, Parth H; Vaid, Manan P; Dandge, VinodIntroduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) programme states that COPD is a common, treatable, and preventable disease that is characterized by a persistent airflow restriction that usually progresses and is connected to an exaggerated chronic inflammatory response in the airways and the lung to harmful particles or gases. The combined severity of a patient's co-morbid illnesses and exacerbations increases. The purpose of the study was to assess the vitamin D status of COPD patients and healthy participants. Methodology: This case-control study was conducted among 75 cases and 75 control at the Surat Municipal Institute of Medical Education and Research General Medicine department. Result: The mean vitamin D of subjects in cases was 32.21 � 12.68 and it was 52.05 � 1.99 in controls. The difference in vitamin D between the two groups was statistically significant (P Value<0.001). Conclusion: COPD patients had lower amounts of vitamin D. As COPD severity increases, vitamin D levels decrease. Along with a rise in COPD exacerbations, vitamin D levels are also decreasing