Management of Nutritional Rickets in Indian Children: A Randomized Controlled Trial
Creators
- 1. Associate Professor, Department of Community Medicine, LNMCH, Indore, MP, India
- 2. Assistant Professor, Department of Orthopedics, GMC Bhopal, MP, India
- 3. Assistant Professor, Department of Orthopedics, CIMS, Chhindwara, MP, India
- 4. Assistant Professor, Department of Pediatrics, Ram Krishna Medical College, Bhopal, MP, India
Description
Background: A prominent cause of rickets is a deficiency in vitamin D. Recent researches have suggested that a lack of dietary calcium may be a contributing factor to its cause. The relative efficacy of calcium, vitamin D, or a combination of them in treating rickets is not well-established. Objective: To ascertain the effect of vitamin D therapy, calcium therapy, or a combination of the two on the nutritional rickets healing process in young children. Material and Methods: A randomized controlled experiment with 67 patients with nutritional rickets, ages ranging from six months to five years, was conducted. For a period of 12 weeks, they were randomized to receive either calcium (75 mg/kg/day elemental calcium orally), vitamin D (600000 IU single intramuscular injection), or a combination of the two. Each person’s demographic information, nutritional status, calcium intake from food, and phytate intake were assessed. In order to measure the degree of healing, baseline, 6-week, and 12-week radiographs of the wrist and knee as well as biochemical markers such as blood calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxycholecalciferol, and parathyroid hormone were evaluated. Results: The average daily intake of calcium from food was 204.01 ± 129.01 mg, which was inadequate in every case. The mean serum 25-hydroxycholecalciferol D level was 15.91 ± 12.41 ng/ml. Serum vitamin D levels below 20ng/ml were found in 82.1% of the patients, suggesting a deficiency in vitamin D. After 6 and 12 weeks of treatment, all therapy groups showed some degree of radiological and biochemical signs of curing rickets, but to different degrees. Compared to 15.7% on vitamin D alone and 11.7% on calcium alone, 50% of patients on combination therapy attained the integrated end objective of normal blood alkaline phosphatase and complete radiographic healing at 12 weeks. Conclusion: Children who developed rickets had lower dietary calcium intake and a blood vitamin D deficit. The most effective treatment outcome was shown when vitamin D and calcium were combined, rather than when each was administered alone.
Abstract (English)
Background: A prominent cause of rickets is a deficiency in vitamin D. Recent researches have suggested that a lack of dietary calcium may be a contributing factor to its cause. The relative efficacy of calcium, vitamin D, or a combination of them in treating rickets is not well-established. Objective: To ascertain the effect of vitamin D therapy, calcium therapy, or a combination of the two on the nutritional rickets healing process in young children. Material and Methods: A randomized controlled experiment with 67 patients with nutritional rickets, ages ranging from six months to five years, was conducted. For a period of 12 weeks, they were randomized to receive either calcium (75 mg/kg/day elemental calcium orally), vitamin D (600000 IU single intramuscular injection), or a combination of the two. Each person’s demographic information, nutritional status, calcium intake from food, and phytate intake were assessed. In order to measure the degree of healing, baseline, 6-week, and 12-week radiographs of the wrist and knee as well as biochemical markers such as blood calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxycholecalciferol, and parathyroid hormone were evaluated. Results: The average daily intake of calcium from food was 204.01 ± 129.01 mg, which was inadequate in every case. The mean serum 25-hydroxycholecalciferol D level was 15.91 ± 12.41 ng/ml. Serum vitamin D levels below 20ng/ml were found in 82.1% of the patients, suggesting a deficiency in vitamin D. After 6 and 12 weeks of treatment, all therapy groups showed some degree of radiological and biochemical signs of curing rickets, but to different degrees. Compared to 15.7% on vitamin D alone and 11.7% on calcium alone, 50% of patients on combination therapy attained the integrated end objective of normal blood alkaline phosphatase and complete radiographic healing at 12 weeks. Conclusion: Children who developed rickets had lower dietary calcium intake and a blood vitamin D deficit. The most effective treatment outcome was shown when vitamin D and calcium were combined, rather than when each was administered alone.
Files
IJPCR,Vol16,Issue3,Article5.pdf
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Additional details
Dates
- Accepted
-
2024-02-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue3,Article5.pdf
- Development Status
- Active
References
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