Purpose: To study the efficiency of vitamin D3 (buccal spray) alone and combination of vitamin D3 with cyclosporine in the treatment of dry eye disease (DED) in patients with deficient serum 25(OH)D levels. Methods: Around 90 patients with DED with deficient serum 25(OH)D levels were included and randomized into three groups and were given treatment for dry eye (Group A- 0.5% carboxymethylcellulose (CMC), Group B- 0.5% CMC + 2000 IU vitamin D through buccal spray, Group C- 0.5% CMC + 2000 IU vitamin D through buccal spray + 0.05% cyclosporine). The patients were followed at day-15, day-30, and day-90 for improvement in tear breakup time (TBUT) and Schirmer’s, and ocular surface disease index (OSDI) score. Improvement in serum vitamin D level was assessed at day-90. One way ANOVA test, paired t -test, and Chi-square test were used for analysis. Results: Group B and Group C had significantly higher in Schirmer’s test-I values as compared to Group A ( P = 0.001, P < 0.001, P < 0.001 at day-15, day-30, and day-90, respectively). Significantly higher values of TBUT and mean serum vitamin D levels were obtained in Group B and Group C as compared to Group A at day-90 ( P < 0.05). OSDI scores of patients significantly decreased in all three groups at all follow-up visits ( P < 0.05). Overall, Group C and Group B were found statistically better than Group A. Group C showed better results than Group B but they were nonsignificant. Conclusion: Vitamin D supplementation leads to earlier and significant improvement in TBUT, Schirmer’s, and OSDI score in patients with vitamin D deficient DED.

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Objective: To determine the frequency of vitamin D deficiency among liver cirrhosis patients and presented at Isra university hospital Hyderabad Study design: Cross-sectional Study setting: Gastroenterology department of Isra university Hospital, Hyderabad Sind Pakistan Study duration: January 2018 to July 2018 All patients with age between 30 and 60 years, both genders and having evidence of cirrhosis of liver were selected in the study. Disease severity was evaluated by the Child–Pugh’s classification. For the assessment of vitamin D levels, the blood samples from all patients were sent to the diagnostic laboratory. During the hospital stay and subsequent follow-up visits, the patients were monitored. All the data were collected via study proforma for the purpose of analysis. Results: A total of 120 cases of liver cirrhosis were studied, their average age was 50.58+5.15 years. Males were commonest 55.0% compared to females 45.0%. Hepatitis C was the most common etiological factor 65.8%. Child–Pugh grade C was most common 57.5%. Mean of the vitamin D level was 19.16+ 6.74 ng/ml. Almost all patients were with vitamin D deficiency as 90.0%. Vitamin D deficiency was significantly associated to the old age, HCV, alcoholic and fatty liver disease (p-<0.05), while statistically insignificant according to gender (p-0.142). Conclusion: It was concluded that the deficiency of vitamin D was highly prevalent 90.0%. It was significantly linked to the HCV, age and alcoholic hepatic disease. Key words: Liver cirrhosis, vitamin D