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7/10/2019 Bangladesh Journal of Medical Science
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7/10/2019 Bangladesh Journal of Medical Science
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ZAMH Zabidi Hussin
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7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
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Home / Archives / Vol 17 No 3 (2018)
Published: 2018-06-29
Editorial
Zika virus: raising awareness to prevent a pandemic
Review Article
“Human Papilloma Virus Vaccination for cervical cancer prevention. Is it safe and
effective?”
Original Articles
Calcidiol serum levels and blood pressure responses in normotensive patients with
dietary goat milk
Mohammad Khursheed Alam, Anas Imran Arshad
327-328
Damitha Asanga Gunawardane
329-336
Yusni Yusni
7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
https://www.banglajol.info/index.php/BJMS/issue/view/1940 2/7
Pain Threshold, Pain Severity and Sensory Effects of Pain in Fibromyalgia Syndrome
Patients: A new scale study
Comparative study on differences in lung parameter between the obese and non obese
collegiate sedentary students
Effect of dairy milk, eggs, meat, fish and fruits intake on academic performances of
secondary school students in Bangladesh
Influence of altiazem pp-180 on hemodynamic parameters in arterial hypertension
patients under outpatient conditions
Knowledge, Attitude and Practice of Primary Care Physicians Toward Adult Vaccination
in Abha City
Acoustic analysis of voice in post-tonsillectomy patients
337-241
Handan Ankarali, Safinaz Ataoglu, Seyit Ankarali, Hasan Guclu
342-350
Jessie Kho S’Sia Yen, Mahadevi Bharathi, Arun B
351-354
MS Hossain, MR Islam, MA Ferdous, AA Trisha, MM Rahman, F Islam
355-359
Gulzhakhan Ryskalievna Zhakiyeva, Lyubov Muratovna Tulegenova, Nuria Zakarievna Ibragimova,
Saubet Molbaevich Kelimberdiyev, Kulsin Kolganatovna Tokbayeva
360-368
Hassan Mohd Ali Al Musa, Turki Abdullah Al Ghanem, Awad Saeed Alsamghan, Mohamed Abadi S Al
Saleem, Rishi Kumar Bharti, Safar Abadi S Al Saleem, Khalid Mohd Al Qahtani, Abdullah Abdul Mohsen Al
Sabaani Al Shehri
369-381
Lee Kai Lea, Nik Fariza Husna Nik Hassan, Irfan Mohamad
7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
https://www.banglajol.info/index.php/BJMS/issue/view/1940 3/7
Study on the Length and the Breadths of Tendoachilles of Human Cadaver
Investigation of calcium metabolism in patients with coronary heart disease
complicated by chronic heart failure, stage ii-a
Simple and rapid detection of Porphyromonas gingivalis and Aggregatibacter
actinomycetemcomitans by loop-mediated isothermal amplification assay
An analysis of NESTROFT and Red cell indices in evaluating antenatal mothers for Beta
Thalassemia trait
Analysis of Problems Posed in Problem Based Learning Cases: Nature, Sequence of
Discloser and Connectivity with Learning Issues
A Comprehensive Comparison of DNA Extraction Using Fresh and Stored Bloods in
Molecular Hematology Diagnostic Study
382-387
Lutfun Nahar, Ahmad Seraji, Soniya Fahmi, Khandaker Nadia Afreen, Mahbuba Aktar, Omma Hafsa Any
388-394
Pohoretska Khrystyna, Patskan Liudmyla, Stoikevych Halyna, Andriy Miz, Marushchak Mariya,
Krynytska Inna
395-401
Nurul Izzati Hamzan, Fatin Hazwani Fauzi, Haslina Taib, Suharni Mohamad
402-410
Rana Safia, Zeeba S Jairajpuri, Shaan Khetrapal, MJ Hassan, Monika Gupta, Sujata Jetley
411-416
Abdus Salam, Mohamad Nurman Yaman, Rahanawati Hashim, Farihah Hj Suhaimi, Zaiton Zakaria,
Nabishah Mohamad
417-423
Siti Nazihahasma Hassan, Suharni Mohamad, Rosline Hassan, Selamah Ghazali, Wan Suriana Wan Ab
Rahman
7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
https://www.banglajol.info/index.php/BJMS/issue/view/1940 4/7
Spatial Analysis of HIV/AIDS in Pakistan
Relationship between Coping Mechanisms to Psychosocial Stress with Blood Pressure in
Young Adults: A Pilot Study
Maternal outcome in pregnant women with anaemia
Prediction of difficult airway by thyromental height test- a comparison with modified
mallampati test.
Challenges in case finding of tuberculosis control program in Iran: A qualitative study
A perceptual evaluation of speech disorders in children with repaired unilateral cleft lip
and palate in Hospital UniversitiSains Malaysia
Maternal and Neonatal outcome in premature rupture of membranes
424-432
Syed Rizwan Ul Haq Tirmizi, Syed Talha Tirmizi, Nasir Uddin Khan
433-438
Sithu Aung, Ramli Musa, Jamalludin Rahman A, Azarisman Shah M, Aszrin Abdullah
439-445
Neerja Singal, Geetanjali Setia, Bal Krishan Taneja, Kiran Kumar Singal
446-454
Md Nurullah, Md Shah Alam, Mahmud Hossen, Marufa Shahnawaz
455-461
Mahmood Moosazadeh, Mohammadreza Amiresmaili
462-469
Mohammad Khursheed Alam, Aimi Syahidah Zulkipli, Sandra Elizabeth Percival, Sanjida Haque
470-478
7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
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Survey of Penetration Injuries Caused to Major Operation on Patients Refer to
Tonekabon Shahid Rajaee Hospital, Mazandaran North of Iran during 2015-2016
Case Reports
Chondro-osseous Respiratory Epithelial Adenomatoid Hamartoma (COREAH) : A rare
entity of nasal mass
Medial migration of grommet: Iatrogenic foreign body.
A Rare Finding In The Hand Irrigation
Management of Heart Rate and Blood Pressure of a Patient after Successful Coronary
Angioplasty and Stenting: A Case Study
Endoscopic Chemocauterization Of Congenital Piriform Fossa Sinus Tract In Children
Salma Lovereen, Mst Afroza Khanum, Nazlima Nargis, Shahanawaj Begum, Rumana Afroze
479-483
M Pouya, Babak Khodadadi, V Khodadadi
484-488
Anuar Idwan Idris, Ramiza Ramza Ramli, Ida Sadja’ahSachlin
489-492
Farah Wahida Abd Manab, Nor Shahida Abdul Mutalib, Hamidah Mamat, Hisham Abdul Rahman
493-495
Humberto Ferreira Arquez
496-500
Nadeem Rahman, Md Ataur Rahman, APM Sohrabuzzaman, Mohammad Abdus Sattar Bhuiyan
501-506
Ahmad Hafiz Ali, Hashimah Ismail, Suzina Shiekh Ab Hamid
507-510
7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
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Atypical Leiomyoma: a rare histologic variant - A Diagnostic Challenge
A Radiolucent Foreign Body Ingestion as a Cause of Acute Dysphagia
Short Communication
The influx of Yaba continues to ravage the Bangladeshi population- a short summary
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Mukta Pujani, Mohammad Jaseem Hassan, Safia Rana, Sujata Jetley
511-514
Nurul Syeha Abdull Rasid, Irfan Mohamad, Norasnieda Md Shukri
515-517
Mostofa Jamal, Asuka Ito, Naoko Tanaka, Ayaka Takakura, Kiyoshi Ameno, Hiroshi Kinoshita
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7/10/2019 Vol 17 No 3 (2018) | Bangladesh Journal of Medical Science
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Bangladesh Journal of Medical Science
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337
Bangladesh Journal of Medical Science Vol. 17 No. 03 July’18
Original articleCalcidiol serum levels and blood pressure responses in normotensive patients with dietary goat milk
Yusni Y
AbstractBackground: Calcidiol(25-hydroxyvitaminDor25(OH)D)istheactiveformofvitaminDthatcanbemeasuredintheblood.VitaminDfunctionsasaregulatorofbloodpressureanda vitaminD deficiency is associatedwith an increased risk of hypertension.Goat’smilk isthoughttohaveantihypertensiveeffect.ThatislikelyduetotheamountofvitaminDfoundingoat’smilk,butrequiresfurtherinvestigation.Thisresearchwasconductedtoanalyzetheeffectofconsuminggoat’smilkonbloodpressureanditsrelationshipwithcalcidiolseruminnormotensivepatients.Materials and Methods: Thedesignofthisresearchwasexperimentallaboratorywith randomizedpretest-posttestwithacontrolgroupusing18sedentarywomenaged18-19years. The treatmentwas250ml/dayofgoat’smilkgiven in themorningafterbreakfast for110days.Thedatawereanalyzedby the statistical t-test (p<0.05).Results: A significantdecreaseofsystolicbloodpressure(p=0.00)andnosignificantdecreaseofdiastolicbloodpressure (p=0.51)wereobserved in the trial group.Levelsof calcidiol serumdidnotincreasesignificantly(p=0.06)afterconsuminggoat’smilkinthetrialgroup.Conclusion: It canbe concluded that goat’smilk can decrease blood pressure but does not affect calcidiolseruminnormotensivepatients.Furtherresearchisneededtodeterminetheeffectofgoat’smilkonbloodpressureinhypertensivepatients.Keywords: blood pressure; 25-hydroxyvitamin D; vitamin D; goat milk; hypertension
Correspondence to: Yusni Yusni, Department of Physiology, Faculty of Medicine, Syiah Kuala University, 23111 Banda Aceh, Aceh, Indonesia, Email: [email protected]
Bangladesh Journal of Medical Science Vol. 17 No. 03 July’18. Page : 337-341DOI: http://dx.doi.org/10.3329/bjms.v17i3.36986
HeadlinesConsuming goat milk regularly can lower bloodpressure but the decrease of blood pressure doesnot occur through increased secretion of serum 25-hydroxyvitaminD.Goat’smilkhasthepotentialto be developed as an antihypertensive agent,but further research is required to determine themechanism of action of goat’s milk in controllingbloodpressureandasanantihypertensiveagent.IntroductionCurrently,numerousstudiesexplain thatvitaminDplaysaroleinregulatingbloodpressure.1,2 Vitamin D orCholecalciferolhasmanyphysiologicalfunctions,including: asabloodpressureregulatory,estrogenbiosynthesis, inflammation, regulator of calciumhomeostasisand rennin–angiotensinsystem(RAS),and regulating the activity of vascular muscles.1,2 Vitamin D directly regulates blood pressure.1,2 Vitamin D deficiency is associated with higherpredispositionandriskofvariousdiseases,including:
osteoporosis, cardiovascular disease (CVD), andhypertension.Calcidiollevelsareabiomarkerofthestate of vitamin D in the body.3
Severalstudieshaveshownthat there isan inverserelationship between levels of calcidiol serumandbloodpressure,with reports that low levels ofcalcidiolincreasebloodpressureandisapredictablecause of hypertension.1.2,3 Supplementation ofvitaminD in controllingbloodpressure inpatientswith hypertension has been studied.1.2 However,further studies must address how the consumptionof goat’s milk can lower blood pressure and if itstimulates the secretion of calcidiol.ThemainsourceofvitaminDisfromexposuretothesunwhile smaller amountsofvitaminDare foundinfoodssuchasgoat’smilk.4-6Goat’smilkcontainsvitamins A, B, C, D and E.4-6Consuminggoat’smilkregularlycouldbeexpectedtolowerbloodpressure,anditisbelievedtobeusefulasanantihypertensive.However,theinfluenceoftheconsumptionofgoat’s
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Calcidiolserumlevelsandbloodpressureresponsesinnormotensivepatientswithdietarygoatmilk
milk in controlling blood pressure is still unclear.Goat’s milk can also stimulate increased serum25-hydoxyvitamin D, but still needs further study.Thepurposeofthisstudywastoanalyzetheeffectofregularconsumptionofgoat’smilkonbloodpressureand its relationship with calcidiol serum levels innormotensivepatients.Materials and MethodsThis studywas an experimental laboratory using arandomizedpretest-posttestwithacontrolgroup.Thesample included 18 sedentary women aged 18-19years.Criteriafortheresearchsubjectsare:female,healthy, completely follow the research procedures,not to consume foods and supplements (other thangoat’smilk), and normal blood pressure (accordingtocriteriaofJNC-8).Subjectsweredividedintotwogroups,namely: (1)controlgroup (notgivengoat’smilk)and(2)trialgroup(givengoat’smilk).Selectionofsubjectresearchwasconductedbysimplerandomsampling.Thetrialwasfreshgoat’smilk,250ml/day,giveninthemorningafterbreakfast,for110days.Examination of serum 25-hydroxyvitamin Dlevels was conducted using ChemiluminescenseImmunoassays (CLIA). Systolic and diastolicblood pressure were measured using mercurysphygmomanometer with the auscultator method.The examination of blood pressure and calcidiolserumlevelswerebeforeandafterthetrial.Thedatawereanalyzedbythetestofhomogeneityofvarianceof Levine’s test (p<0.05), the test of normality ofKolmogorov-Smirnov(p<0.05)andastatisticalt-test
(p<0.05).ThisresearchhasreceivedapprovalfromtheEthicsCommittee for Medical and Health Research,Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh-Indonesia, based on the letter number: 304/KE/FK/2015.All of the study subjects had toprovide written permission before the examinationand treatment.Results Table1showsthatthecharacteristicsoftheresearchsubjects such as: age (years), weight (kg), height(cm2), and body mass index (BMI=kg/m2). Thecharacteristics across the trial and control groupswerenotsignificantlydifferent(p>0.05).Table 1. Physiologicandanthropometricfeaturesofsubjects
Trial group Control groupMean±SD Mean±SD
Age(years) 18.77±0.44 18.66±0.50Weight(kg) 51.77±8.60 47.72±3.91Height(cm2) 154.33±2.69 153.56±2.12BMI(kg/m2) 21.80±3.98 20.25±1.77
In order to confirm homogeneity of variance, theLevine-test (p<0.05)wasused and theKolmogorof-Smirnov(p<0.05)testwasusedtodeterminewhetherthe datawere normally distributed.Datawere foundto be homogeneous and normally distributed. Theaveragechangesinsystolicanddiastolicbloodpressureandcalcidiolserumlevelsinallthesubjectsbeforeandafterconsuminggoat’smilkareshownintable2.
Table 2. Effect of goat’s milk supplementation on blood pressure and calcidiol serum levels in normotensive patients
Group Variable Before trialMeans±SD
After trialMeans±SD t-test p-value
Control Systolic(mmHg) 112.22±9.71 110.00±8.66 -1.51 0.16
Diastolic(mmHg) 75.55±5.27 80.00±0.00 2.53 0.03*
25-hydroxyvitaminD(ng/mL)
14.38±3.35 13.52±2.88 0.90 0.39
Trial Systolic(mmHg) 101.11±9.27 93.33±5.00 -3.5 0.00*
Diastolic(mmHg) 70.00±7.07 67.78±9.71 -0.68 0.51
25-hydroxyvitaminD(ng/mL)
13.56±2.75 14.27±2.25 2.17 0.06
Discussion:Resultsshowedthatconsuminggoat’smilkregularlyresulted in significantly (p=0.05) lower systolicbloodpressure(7%reduction).Goat’smilkdidnotsignificantlyreduce(p=0.51)diastolicbloodpressure
(3.17%reduction).Theregularconsumptionofgoat’smilkdidnotsignificantlyincrease(p=0.06)levelsofcalcidiol serum (5% increase).This study suggeststhatthedecreaseinbloodpressureduetotheregularconsumption of goat’s milk has no effect on the
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YusniY
levelsof25-hydroxyvitaminDserum.Thefindingsindicate that goat’smilk can lead to a decrease inbloodpressure,butthemechanismofactionofgoat’smilk in lowering blood pressure was not throughan increase in the secretion of 25-hydroxyvitaminD. That is likely due to several reasons, namely:(1)thedoseofgoat’smilkwasnotenoughtoraiselevels of calcidiol serum, suggesting a need for the continuation of this research using a higher dosage of goat’smilk,(2)Thisstudyusesfemalesubjectswhoweartheveilsothatexposuretothesunisreduced,(3)Thestudywasconductedonpatientswithnormalbloodpressure,soitisnecessarytodoacomparisonwith hypertensive patients using variable doses ofgoat’smilk,(4)Thisresearchisbeingcontinuedbyusinggoat’smilkwithvaryingdosesandmethodsofresearcharedifferentbymeasuringseveralhormonesrelatedtobloodpressurecontrol.Goat’smilkmay also lower blood pressure throughother mechanisms. Some results of experimentalstudiessuggeststhatgoat’smilkeffectsthecontrolofblood pressure and has the potential to prevent andtreathypertension.4-8Resultsofclinicaltrialsshowedthat theproteins ingoat’smilkhave thepotential toimprove some diseases, including: cardiovasculardisease, hypertension, metabolic syndrome, and theincidence of many chronic diseases.6,8 Clinical trial resultsalsoshowedthatgoat’smilkhasthepotentialtoregulatebloodpressure.7,8Goat’smilkcanbeusedasananti-hypertensive.5-8Theproteincontentofgoatmilkcaseinisallegedlyoneofthefactorsthataffectstheroleofgoat’smilkasananti-hypertensive.7 Goat’s milkcontainstwokindsofproteins,namely:caseinsandwhey proteins.7 Casein hydrolysis of goatmilkeffectivelylowersbloodpressureandactsasatherapyforpatientswithhypertension.7 Bothoftheseproteinscontainlotsofangiotensin-convertingenzyme(ACE)inhibitorpeptides,whichcanbeextractedfromboththe goat milk proteins.6,7 Goat’s milk is one of themainsourcesofACEinhibitorpeptides.5,6,7
Theangiotensin-convertingenzyme(ACE)inhibitorisinthefirstlinedrugsusedforthemanagementofhypertension.9,10,11ACEinhibitorsworkbyinhibitingthesecretionofaldosteroneandvasopressin,andnotbyblockingtheactionofangiotensinIIanddoesnotinteractdirectlywithothercomponentsofthereninangiotensinaldosteronesystem(RAAS).9,12,13 RAAS isa target tocontrolbloodpressure inpeoplewithhypertension.12,13 RAAS is a hormone that is formed byrenin.Angiotensinogen,withthehelpofrenin,ishydrolyzedtoangiotensin-I,which,withthesupport
of ACE is hydrolyzed to angiotensin-II. Angiotensin II is a potent vasoconstrictor and associated withhypertension.12,13
Someof the literature suggests that bloodpressureis also associatedwith high levels of vitaminD.14-
17 Goat’s milk is a source of vitamin D derivedfrom food.4-6VitaminDplays a role in controllingblood pressure through several channels, namely:controls the levels of calcium and phosphorus,suppress proliferation of vascular smooth muscle,inhibits the secretion of parathyroid hormone, andregulates RAAS.12,13 Vitamin D is a fat-soluble vitamin stored in fat tissue and the liver.1,16 Vitamin D has two types, namely: ergocalciferol (vitaminD2) and cholecalciferol (vitamin D3).1,16 Vitamin DincirculationbindstovitaminD-bindingproteinto then be transported to the liver. In the liver,vitamin D is converted into calcidiol, also called 25-hydroxyvitamin D or [25(OH)D].14-16 Calcidiol is the active form of vitamin D and it is most often found in theblood.Thus, so the levelsofcalcidiolwilldescribethestatusofvitaminDinthebody.2
Recentresearchhasfoundthatlowlevelsofcalcidiolare associated with increased blood pressure.19-25 This ispresumablybecauseof the roleofcalcidiolin regulating the function of RAAS.19-23 Other studies havealsofoundthatthereisaninverserelationshipbetweenlevelsofcalcidiolandtherenin-angiotensinlevels.26-29Goat’smilkcanalsolowerbloodpressurethrough the stimulation of the secretion of Nitric Oxide(NO).8 Results of in vitro studies have found that people who regularly consume goat’s milkwill exhibit increased levels of NO released byendothelialcellsofbloodvessels.NOisknownasapotentvasodilatorandalsoactsasacardioprotectiveand antiatherogenic agent.8
Conclusion:It can be concluded that: consuming goat’s milkregularly has the potential to significantly reducesystolic blood pressure but not to significantlydecrease diastolic blood pressure in normotensivepatients. Regular consumption of goat’smilk doesnot significantly increase calcidiol serum levelsin normotensive patients. Consuming goat’s milkcanlowerbloodpressurebut thedecreaseofbloodpressuredoesnotoccurthroughincreasedsecretionof calcidiol serum levels. Goat’s milk has thepotentialtobedevelopedasanantihypertensive,butrequiresfurtherresearchtobeabletodetermineitsmechanism incontrollingbloodpressureandasanantihypertensiveagent.
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Calcidiolserumlevelsandbloodpressureresponsesinnormotensivepatientswithdietarygoatmilk
Acknowledgement:Theauthorwouldliketothankallthesubjectsfortheir willingness to participate in this study. Alsothanks to the Center for research and communityservice of Syiah Kuala University, Banda Aceh, Aceh-Indonesiaforoverseeingtheprojectandtothe
ClinicalLaboratoryofProdiaBandaAcehandJakartafor the collaboration and support in this research.This study was conducted with financial supportfrom the Ministry of Research and Technology,Higher Education (Kemenristek-DIKTI), Republicof Indonesia.
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Grimnes G. Serum 25-Hydroxyvitamin D LevelsAre Strongly Related to Systolic Blood Pressure But Do Not Predict Future Hypertension. Hypertension. 2010; 55:792-798. https://doi.org/10.1161/HYPERTENSIONAHA.109.143990.
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Vol 17, No 3 (2018) Calcidiol serum
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