Clinical and Biochemical Profile of Nutritional Rickets in Infants: A Study from Peshawar
Keywords:
Nutritional rickets, breast feeding, malnourished, sun exposureAbstract
Objective: To determine the factors associated with nutritional rickets among infants in Peshawar and its surrounding.
Methods: This descriptive cross-sectional study was conducted at Khyber Teaching Hospital Peshawar, Pakistan among mothers and their infants. Clinical and biochemical examination of all infants were performed.
Results: A total of 65 infants were included. There were 42 (65%) infants from urban while 23 (35%) cases from rural areas. Out of 65 cases, 47 (72%) were breast feeding and none of them (0%) benefited by sunlight. Among these 47 breastfed infants, 42 (89%) had lactating mother those were malnourished and only 5 (11%) nutritional rickets were found in breast feeding infants of nourished mother. Radiological abnormalities of rickets were found in 23 (55%) infants of malnourished mother and none in nourished mother.
Conclusion: Nutritional Rickets is prevale nt problem among infants and a great risk in those who along with their malnourished mothers are deprived exposure to sun shine.
Downloads
References
Pettifor JM, Nutritional rickets: deficiency of vitamin D, calcium, or both. Am J Clin Nutr 2004; 80:1725-9.
Kaplan FS, August CS, Fallan MD, Gannon F, Haddad JG. Osteopetro rickets. Clinc Orthop1993; 29:64-78.
Creo AL, Thacher TD, Pettifor JM, Strand MA, Fischer PR. Nutritional rickets around the world: an update. Paediatr Int Child Health 2017; 37:84-98.
Renton P. Radiology of rickets, osteomalacia and hyperparathyroidism. Hosp Med 1998; 59:399-403.
Högler W. Complications of vitamin D deficiency from the foetus to the infant: One cause, one prevention, but
who's responsibility? Best Pract Res Clin Endocrinol Metab 2015; 29:385-98.
Underwood P, Margetts B. High level of childhood rickets in rural North Yemen. Soc Sci Med 1987; 24:37- 41.
Elzouki AY, Markestad T, Elgarrah M, Elhoni N, Aksnes L. Serum Concentration of Vitamin D Metabolites in rachitic Libyan Children. J Pediatr Gastroentrol Nutr 1989; 9: 507-12.
Hag Al, Karrar ZA. Nutritional vitamin-D deficiency Rickets in Sudanese Children. Ann Trop Paediatr 1995; 15:69-76.
Walker AR. Etiology of nutritional rickets: geographic variations. J Pediatr 1997; 130:501-3.
Davey M. Rickets Prevention. Can J Public Health 1995; 87:375-6.
Barness LA. Rickets: The chiken or the egg. J Pediatr 1996; 129:941-2
Gessner BD, Petersen KM, Lewandowski C. Nutritional rickets among breast-fed black and Alaska Native children. Alaska medicine 1997; 39:72-4.
Kriester SR, Schwartz RP, Kirkman HN, Charlton PA, Calikoglu AS, Davenport ML. Nutritional Rickets in
African American Breast-fed infants. J Pediatr 2000;137:153-7.
Welch TR, Bregstorm WH, Tsang RC. Vitamin D Deficient Rickets: The Reemergence of a once conquered
disease. J Pediatr 2000; 143-45.
Holick MF, Shao Q, Liu WW, Chen TC. The vitaminD content of fortified milk and infant formula. N Engl J Med 1992; 326:1178-81.
Atiq M, Suria A, Nizami SQ, Ahmad I. Vitamin–D status of breast fed Pakistani Infants. Acta Paediatr 1998; 87:737-40.
Jagdeo DG, RambiharVS, Liu PC. Ricket presenting as seizures in the emergency Department: medico-cultural
implications. Pediatr Emergency Care. 1998; 14:215- 6.
Behrman RE, Kliegman RM, Arvin AM (eds). Nelson Text Book of Pediatrics, WB Saunders Philadelphia, 15th edition. 1996; 525-7.
Rab SM, Bashir A. Occult osteomalacia among healthy and pregnant women in Pakistan. Lancet 1976; 2:1211- 3.
Jadgdeo DG, Rambihar VS, Liu PC. Rickets presenting as Seizures in the emergency department. Ped Emergency Care 1998; 14:215-6.
Andreas NJ, Kampmann B, Le-Doare KM. Human breast milk: a review on its composition and bioactivity. Early Human Development 2015; 91:629-35.
Greer FR. Issues on establishing vitamin D recommendations for infants and Children Am J Clin Nutr 2004; 80:1759S-62S.
Journal of the Dow University of Health Sciences Karachi 2018, Vol. 12 (1 ): 3-6
Ward, LM. Vitamin D deficiency in 21st century: a persistent problem among Canadian infants and
mothers. Can Med Assoc J 2005; 172:769-70.
Jacobus CH, Holick MF, Shao Q, Chen TC, Holm IA, Kolodny JM, et al. Hypervitaminosis D associated with drinking milk. N Engl J Med 1992; 326:1173-7.
Greer FR. Issues on establishing vitamin D recommendations for infants and Children. Am J ClinNutr 2004; 80:1759S-62S.
Norman AW. Vitamin-D and endocrine System.Physiologist 1985; 28:219-32.
Specker BL, Valanis B, Hertzberg V, Edwards N, Tsang RC. Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. J Pediatr 1985; 107:372-6.
Alfahan M, Woodhead S, Pask G, Daves D. Vitamin D. A concern in Pregnant Asian women. Brit J Nut 1995;73:881-7.
Deluca HF. The vitamin D story: a collaborative effortof basic science and clinical medicine. FASEB J 1988;2:224-36.
Ward LM. Vitamin D deficiency in 21st century: apersistent problem among Canadian infants and mothers. Can Med Assoc J 2005; 172:769-70.
Tangpricha V, Kontika P, Rieke SM, Chen TC, Perez AA, Holick MF. Fortification of orange juice with vitamin D: a novel approach for enhancing vitamin D nutritional health. Am J Clin Nutr 2003; 77:1478-83.
Lo CW, Paris PW, Holick MF. Indian and Pakistani immigrants have the same capacity as Caucassians to produce vitamin D in response to ultraviolet Irradiation. Am J Clin Nutr 1986; 44:683-5.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Tanveer Hussain, Tahir Saeed Siddiqui
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
