Effectiveness of STOSS Therapy in Nutritional Rickets among Pediatric age Group in Bangladesh

Dr. Shahnaz Pervin Sumi, MBBS, MCPS (General Paediatrics), Dr. Md. Abu Tayab, Professor Md. Jahangir Alam, Professor Dr. A. AS. M. Nawshaduddin Ahmed, Dr. Md. Jahid Hasan, MBBS, MPH, Dr. Md. Mahabubalam


Volume 17, Issue 3 Ver.5 March. (2018), PP 01-06

IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)



Background:Nutritional rickets resulting from vitamin D deficiency has become an increasing concern in both developed and developing countries. However, recommended treatment options are eithersmall doses dailysupplementation of vitamin D for few months or single-dayhigh-dose vitamin D, an approach referred to as stoss therapy. As fewer studies examine the effectiveness of this stoss therapy among Bangladeshi children; the study was designed so.

Materials and Methods:The prospective, cross-sectional study was conducted in Dhaka Sishu (child) Hospital for 3-year period. Formal ethical clearance was taken prior commencement of the study. Total 50 child suffering from nutritional rickets were selected according to selection criteria. Written informed consent were taken from the parents of the child. Stoss therapy were administered under the guidance of the researcher. Before starting therapy base line clinical features and relevant investigation were recorded and it was compared with the value at 3 weeks, 3 months and 6 months follow up visit. Recoded data was analyzed by statistical software, SPSS 23 with 95% CI and acceptable 5% error. Results:Among the 50 rachitic child, mean age was 29.30±2.00 SD months (age range: 12-60 months). Median age was 26 months with 56% male and 44% female respondents. Following stoss therapy, significant clinical improvement was seen at 3 months and almost complete resolution of the most of the features over a period of 6 months. Significant improvement ofdifferent biochemical parameters (serum calcium, phosphate, ALP, and vitamin D) were seen and restored to almost normal level during 6 months therapy (p<.001). Radiological improvement was measured by Thacher’s 10 pointscale and significant improvement starts at 3 weeks which become completely normal at 6 months post therapy (p<.001).

Conclusion: Stoss therapy can be a safe and effective measure for children of Bangladesh with Nutritional rickets.

Keywords: Nutritional rickets, STOSS therapy, compliance to stoss therapy, vitamin D deficiency management

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