{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T20:04:21Z","timestamp":1779566661247,"version":"3.53.1"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Postgraduate Institute of Medical Education and Research"},{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The role of B-vitamins in septic shock is gaining attention, especially among patients with deficiencies. However, evidence beyond thiamine remains limited. This study aimed to evaluate the status of riboflavin, niacin, pyridoxine, folate, and cobalamin in children with septic shock in a low- and middle-income country (LMIC) setting, and to explore their potential association with patient outcomes. We enrolled 79 consecutive patients (aged 6\u2009months\u201312\u2009years) with fluid-refractory septic shock from July 2018 to December 2019. We also included 22 sibling controls and 64 external controls from an immunization clinic for comparison. Children with chronic illnesses or those receiving vitamin supplementation were excluded. Plasma levels of riboflavin, niacin, pyridoxine, folate, and cobalamin were measured at enrolment, and patient survival was assessed as the primary outcome. Patients and their siblings were more stunted than external controls, both in prevalence (P\u2009=\u2009.014) and severity (P\u2009=\u2009.012). Plasma levels of all five B-vitamins were significantly lower in patients compared to sibling controls (all P values less than .001). Sibling controls had lower levels of riboflavin (P\u2009&amp;lt;\u2009.001), niacin (P\u2009&amp;lt;\u2009.001), pyridoxine (P\u2009=\u2009.072), folate (P\u2009=\u2009.070), and cobalamin (P\u2009&amp;lt;\u2009.001) than external controls. Among the patients, non-survivors had lower levels of riboflavin (P\u2009=\u2009.20) and pyridoxine (P\u2009=\u2009.04), while folate levels were surprisingly higher (P\u2009=\u2009.037). With shared nutrition in families, findings suggest exacerbation of the likely pre-existing B-vitamin deficiencies during septic shock in children from LMICs. This highlights the need to evaluate the potential adjunctive therapeutic role of B-vitamins in paediatric septic shock in LMICs.<\/jats:p>","DOI":"10.1093\/tropej\/fmag030","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T11:38:35Z","timestamp":1776944315000},"source":"Crossref","is-referenced-by-count":0,"title":["Status of non-thiamine B-vitamins in children with septic shock from a lower middle-income country: a case\u2013control study"],"prefix":"10.1093","volume":"72","author":[{"given":"Ajay","family":"Kumar","sequence":"first","affiliation":[{"name":"Division of Paediatric Critical Care, Advanced Paediatric Centre, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-2652","authenticated-orcid":false,"given":"Arun Kumar","family":"Baranwal","sequence":"additional","affiliation":[{"name":"Division of Paediatric Critical Care, Advanced Paediatric Centre, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savita Verma","family":"Attri","sequence":"additional","affiliation":[{"name":"Paediatric Biochemistry Unit, Advanced Paediatric Centre, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Kumar-M","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5747-8975","authenticated-orcid":false,"given":"Arushi Gahlot","family":"Saini","sequence":"additional","affiliation":[{"name":"Division of Paediatric Neurology, Advanced Paediatric Centre, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Division of Paediatric Critical Care, Advanced Paediatric Centre, Postgraduate Institute of Medical Education & Research , Chandigarh 160012,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"2026052315122193000_fmag030-B1","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S2352-4642(24)00140-8","article-title":"The burden and contemporary epidemiology of sepsis in children","volume":"8","author":"Watson","year":"2024","journal-title":"Lancet Child Adolesc Health"},{"key":"2026052315122193000_fmag030-B2","doi-asserted-by":"crossref","first-page":"fmac053","DOI":"10.1093\/tropej\/fmac053","article-title":"Etiology, pathophysiology and mortality of shock in children in low (middle) income countries: a systematic review","volume":"68","author":"Assies","year":"2022","journal-title":"J Trop Pediatr"},{"key":"2026052315122193000_fmag030-B3","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S2352-4642(24)00141-X","article-title":"Susceptibility to childhood sepsis, contemporary management, and future directions","volume":"8","author":"Carter","year":"2024","journal-title":"Lancet Child Adolesc Health"},{"key":"2026052315122193000_fmag030-B4","doi-asserted-by":"crossref","first-page":"e367","DOI":"10.1097\/PCC.0000000000001584","article-title":"Suspecting hyperferritinemic sepsis in iron-deficient population: do we need a lower plasma ferritin threshold?","volume":"19","author":"Ghosh","year":"2018","journal-title":"Pediatr Crit Care Med"},{"key":"2026052315122193000_fmag030-B5","doi-asserted-by":"crossref","first-page":"e435","DOI":"10.1097\/PCC.0000000000001269","article-title":"Fluid bolus over 15\u201320 versus 5\u201310 minutes each in the first hour of resuscitation in children with septic shock: a randomized controlled trial","volume":"18","author":"Sankar","year":"2017","journal-title":"Pediatr Crit Care Med"},{"key":"2026052315122193000_fmag030-B6","doi-asserted-by":"crossref","first-page":"fmaa107","DOI":"10.1093\/tropej\/fmaa107","article-title":"Thiamine status in children with septic shock from a developing country: a prospective case-control study","volume":"67","author":"Raj","year":"2021","journal-title":"J Trop Pediatr"},{"key":"2026052315122193000_fmag030-B7","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.21037\/tp-20-390","article-title":"Challenges in pediatric post-sepsis care in resource limited settings: a narrative review","volume":"10","author":"Wiens","year":"2021","journal-title":"Transl Pediatr"},{"key":"2026052315122193000_fmag030-B8","first-page":"73","article-title":"Disorders of nutritional status in sepsis; 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