Rabia Haq, Muhammad Jamil Azhar, Muhammad Saleem, Aneela Zareen, Arsalan Arshad, Asma Shams.
Comparison of efficacy of injectable vs oral iron supplementation in severe protein energy malnutrition children - a double blinded randomized control trial.
Pak J Med Health Sci Jan ;12(4):1631-4.

Background: Protein energy malnutrition is quite common in our country. One of the common preventable and treatable effect of malnutrition is iron deficiency anaemia. Malnourished children have multiple problems including anorexia and poor absorption from the gut. We decided to conducted a study Aims : To compare the efficacy of injectable vs oral iron supplementation for treatment of iron deficiency anaemia inchildren with severe protein energy malnutrition and make recommendation for IV iron therapy in malnourished children with iron deficiency anaemia as first line therapy. Study Design : A double blinded randomized case controlled trial (RCT) Settings: This was a double blinded randomized case controlled clinical trial which compare the efficacy of oral iron vs IV iron supplementation in children with iron deficiency anaemia and severe protein energy malnutrition based on WHO Z-score charts. This study was carried out at pediatric department Avicenna Medical College . Study Period: Jan uary 2017 to Dec ember 2017. Methods : All the children were examined and investigations were carried out to establish diagnosis of iron deficiency anaemia and important information were recorded on proforma. The diagnosis of anaemia was based on WHO guidelines for anaemia in children and malnutrition was assessed using WHO growth chart (Z-Scoring ). After diagnosis they were given oral iron and IV Venofer twice weekly using formula given below. These children were followed up fortnightly for a period of one months. Children with hemoglobin less than 10 gm/dl were considered as anaemic. Iron deficiency diagnosis was established using low serum ferritin level along with microcytic, hypochromic picture on peripheral smear examination . Results: Study results were analyzed using SPSS and chi square test was employed as test of statistical significance. Results were considered significant statistically if (P value < 0.05).Conclusion: Children with severe protein energy malnutrition and IDA showed significant and early improvement as compared to children with oral iron therapy. Injectable iron therapy is safe as only few minor side effects like pain abdomen, diarrhea, and constipation were observed.

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