Maternal child-health Division2022-06-21T08:40:52+00:00
607, 2022

Risk Factor for Nutritional Rickets among 0-5 Years Children in Bangladesh

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Publication status: Published
Brief description: Nutritional rickets (NR)or vitamin D deficiency rickets remain prevalent in developing regions of the world and rank among the 5 most common diseases in children. In Bangladesh, it is the second most common micronutrient deficiency. Despite scope of abundant sun exposure, increasing number rickets incite the mind to search for the risk factors associated with it. Therefore, to evaluate the risk factor for nutritional rickets among 0-5 years children in Bangladesh was the objective of the study. This observational study was conducted in Dhaka Sishu (child) Hospital for 2-year period following formal ethical clearance. Total 120 children were include into the study. Of all, 60 children of NR were consideredas cases and another 60 age and sex matched children were taken as control. NR diagnosis was based on clinical, radiologic and biochemical parameters. In all cases, formal informed consent were taken from the parents. Detailed history taking were done based on a preformed questionnaire, which was made on the basis of prior studies in this topics. During interview, data collection was done in a separate case record form. Finally, recorded data was analyzed by a statistical software, SPSS 23. Among the 120 study children, mean age of cases and controls were 29.40±11.65 &28.66±13.57 months respectively. Significant difference were present in-between case and control for residence, parent’s education, occupation of the family head, monthly income and number of siblings. Moreover, exclusive breast-feeding (OR= 3.59, 95% CI:1.67-7.74, p<.001), sun exposure (OR=2.25, 95% CI:1.08-4.67, p<.03) and skin color (OR=2.76, 95% CI: 1.24-6.14, p<.01) were significantly associated with NR in comparison to control. Exclusive breast-feeding for >4 months, sunlight exposure <30 minutes/day, dark skin color, number of siblings, urban slum residence, deficit monthly income, and parent’s education are the risk factors for NR in Bangladeshi child.

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1606, 2022

Intravenous iron sucrose vs. blood transfusion in the management of moderate postpartum iron deficiency anemia: A non-randomized quasi-experimental study

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Publication status: Published
Brief description: Postpartum anemia is often over-treated with blood transfusion without clear indication despite having a potential alternative of parenteral iron therapy. The present study aimed to compare the efficacy of intravenous (IV) iron sucrose with blood transfusion in increasing the hematological parameters in postpartum women with moderate anemia. This prospective non-randomized quasi-experimental study was conducted among 44 hemodynamically stable postpartum women with moderate anemia (Hb 7-8 g/dl) in the Obstetrics department of Dhaka Medical College Hospital (DMCH) from January to June 2021. Among them, 22 patients received 600 mg of IV iron sucrose after 48 h of delivery for three subsequent days and the other 22 patients received two units of blood transfusion after 48 h of delivery in two subsequent days. The primary endpoint was increase in Hemoglobin (Hb) and serum ferritin level after 6 weeks of the intervention. Two-way repeated measures ANOVA (mixed factor ANOVA) was applied to compare between before and after effect in the two intervention groups. Baseline Hb and ferritin were 7.4 g/dl and 73.5 μg/l in IV iron group and 7.3 g/dl and 73.2 μg/l in blood transfusion group. Mean Hb level was increased 4.2 g/dl in IV iron sucrose group and 4.5 g/dl in blood transfusion group at sixth week. Besides, serum ferritin level was increased 40.5 μg/l and 44.8 μg/l after six weeks in IV iron sucrose group and blood transfusion group respectively. Other hematological parameters like reticulocyte count, MCV, MCH, and MCHC also increased significantly after intervention in both groups. However, no significant difference was noticed in the change of hematological parameters in between the groups. The IV iron sucrose is as effective as blood transfusion in replenishing the hemoglobin and iron storage status in hemodynamically stable women with moderate post-partum anemia. This could be an effective alternative of blood transfusion in treating these patients, especially in resource-poor settings.

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1606, 2022

Frequency of Nutritional Rickets among Suspected Rickets Cases in Dhaka Shishu (Children) Hospital, Sher-e-Bangla Nagar, Dhaka

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Publication status: Published
Brief description: Nutritional rickets (NR) is one of the common form of growing bone disease resulting significant disability unless treated properly. Despite scope of adequate sunlight exposure, which is a source of vitamin D in young child in Bangladesh, increased trend of NR is observed. Considering this fact, the study was designed to explore the frequency of nutritional rickets among suspected rickets cases. Materials and Methods: The prospective cross-sectional study was conducted in Dhaka Sishu Hospital (DSH) in Bangladesh over a period of 2 years. Child aged 1-5 years attending in DSH with complaints bowing of leg and/or clinical symptoms consistent with rickets were approached. Suspected rickets cases were investigated further and total 100 cases were analyzed. Informed consent and ethical measures were ensured in each cases. Data analysis was done by SPSS 23. Among the 100 suspected rickets child, mean age was 29.36±13.09 SD (months). There  were 64% (n=64) male and rest of them (36%, n=36) were female. Of all, the frequency of rickets was 90%, wherein the frequency of nutritional rickets was 87.78% (n=79). Male sex is associated with higher proportion of NR than female child. Limb deformity is the most common features in group of child and bowing leg, swelling and widening of wrist, rickety rosary and knock knee were present in 51.9%, 27.8%, 26.6% and 25.3% children respectively. Whereas, delayed growth and delayed dentition were present in 26.6% and 21.5% respectively. Nutritional rickets is the commonest subtype of rickets in Bangladesh.

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