Diversification is a Business Development Strategy allowing a Company to Enter Additional Lines of Business

Dr Keyurkumar M Nayak

Volume : V, Issue : X, October - 2015

Diversification is a Business Development Strategy allowing a Company to Enter Additional Lines of Business

Dr Keyurkumar M Nayak

Abstract :

Introduction. Low Backache is the most common neurologic complaint of patients attending outpatient clinics of Orthopedics, Neurology and in general practice. In most cases, the cause may be difficult to determine. In such cases, Vitamin D deficiency or insufficiency is observed as the predominant biochemical marker. Most of the patients are having low serum vitamin D levels. Many patients uniformly point to low 25 (OH)D levels in the population studies despite abundant sunshine in our country. The low levels of 25 (OH)D are most prevalent in the dark skinned individuals despite they are mostly exposed to the sun during their daily activities. Aim. To study the association between low vitamin D levels, dark skin and chronic low back pain. Methods. From April, 2014 to March, 2015, total number 50 patients with chronic low back pain were assessed clinically and with investigations like CBP including ESR, serum creatinine, plain radiograph, CT, and MRI of the lumbosacral spine. Local pathologic conditions, renal impairment, chronic liver disease were excluded and they are labeled as patients with idiopathic chronic low back pain. Serum calcium, phosphate, PTH, and 25–hydroxy vitamin D level (Electro Chemiluminescence assay) were performed and patients are categorized as having deficient, insufficient and sufficient levels of vitamin D. Of the 50 patients studied, 45 patients were dark skinned. Oral therapy with 25(OH) cholecalceferol was administered with doses ranging from 3000–5000units/day with higher doses to dark skinned patients having deficient and insufficient vitamin D levels. Clinical reassessment of lower back pain was made after three months of vitamin D therapy. Oral painkillers were strictly avoided from use. Results. All the patients were deficient in vitamin D, 84% of patients having insufficient vitamin D levels and 42.85% of patients with sufficient vitamin D levels have shown remarkable symptomatic relief. Conclusions. It is prudent to include measurement of vitamin D in investigation protocol of patients, particularly of darker skinned individuals, suffering from lower back pain which is amply revealed by this study