Résumé
@#Objective. We aim to study the prevalence and risk factors of hypovitaminosis D among healthy adolescents in Kota Bharu, Kelantan based on the most recent Paediatric Consensus guideline. Methodology. Ten public schools were selected from Kota Bharu, Kelantan. We analysed their demography (age, gender, ethnicity, income), measured their anthropometry (height, weight, BMI) and finally analysed their vitamin D and intact- Parathyroid hormone levels. Results. The prevalence of hypovitaminosis D was 16.9% among healthy teenagers with mean age of 15.9±1.39 years. Multivariate analysis showed female gender (adjusted OR, 95% CI): 23.7 (5.64, 100.3) and Chinese 0.24 (0.07, 0.84) were the significant predictors for hypovitaminosis D. Conclusion. The prevalence of healthy adolescents with hypovitaminosis D in Kota Bharu, Kelantan was 16.9% using the most recent cut off value of 30 nmol/L from the global consensus 2016. Female and Malay were the significant risk factors associated with hypovitaminosis D. Higher cut off value would result in overestimation of prevalence rate of hypovitaminosis D.
Sujets)
Carence en vitamine D , Rachitisme , AdolescentRésumé
Background: In developing countries, malnutrition's is one of the challenges that still need to be addressed. Undernutrition is usually a result of the unavailability of food and/or repeated infections in children. Countries with comparatively lower per-capita incomes as well as those with middle per-capita income have its increased prevalence in younger age. Social dilemma of mothers, like exclusively breastfeeding, heavy clothing's and practice of keeping babies inside the doors, lead vitamin D deficiency and ultimately into nutritional rickets. The objective of this study was to determine the frequency of factors leading to nutritional rickets in children ages 6 months to 24 months.Methods: This cross-sectional study was conducted at Department of Pediatrics, Ayub Teaching Hospital, Abbottabad, Pakistan from March to December 2017. After inclusion/exclusion criteria, total 160 patients of rickets were observed. Detailed history followed by vitamin D level (<15 ng/ml) was measure. Data was analyzed by SPSS-22 and all documents were locked with principal author.Results: Present study showed that 62% children were in age ranged 6-12 months and 38% children were in age range 13-24 months. Mean age was 12 months with SD'2.16. Seventy nine percent children were male, and 21% children were females. More over 52% children had exclusive breast feeding, and 48% children did not have exclusive breast feeding. Similarly, 15% children had limited sun-light exposure and 85% children did not have limited sun-light exposure.Conclusions: Present study concluded that a lack of health education and sunlight exposure and exclusive breastfeeding were the significant risk factors contributed to nutritional rickets among children of Abbottabad, Pakistan.
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We describe the clinical course of a 10-monthold breastfed infant with rickets and associated myelofibrosis presenting with anemia and hepatosplenomegaly. Over the follow up, on therapeutic supplementation of vitamin D, child showed reduction in liver and spleen size along with improvement in rickets, anemia, growth and developmental parameters.
Résumé
Nutritional rickets, which is caused by deficiency of calcium or vitamin D, is a rare disease in developed countries. However some cases have been reported recently, that developed as a result of a restricted and nutritionally imbalanced diet due to atopic dermatitis and related food allergy. We treated two infant cases of nutritional rickets. The infants had suffered from atopic dermatitis, and were fed "Sun-sik" (a powdery mixture of several grains and fruits) without receiving cow's milk or any milk products in their diet. After an adequate supply of calcium and nutritional management, they were markedly improved.