{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:30:04Z","timestamp":1784835004130,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Intra-mural Research Grant of University College of Medical Sciences, Delhi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aim and objectives<\/jats:title>\n                  <jats:p>We compared the effect of different doses of oral folic acid (FA) supplementation (5\u2009mg\/day vs. 2.5\u2009mg\/day vs. 5\u2009mg\/week) on the proportion of children with folate excess (serum folate &amp;gt;20\u2009ng\/ml) and plasma homocysteine (Hcys) excess (&amp;gt;15\u2009\u00b5mol\/l) in transfusion-dependent thalassemia (TDT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>Children with TDT aged 5\u201318\u2009years received oral FA in doses of 5\u2009mg\/day (Group 1), 2.5\u2009mg\/day (Group 2) and 5\u2009mg\/week (Group 3) for 9\u2009months, after a wash-off period of 8\u2009weeks. Folate levels (Serum and RBC) and plasma Hcys levels were measured after the therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ninety children were randomized to receive one of the three interventions (30 per group). After wash-off period, the median serum folate levels were significantly lower and five children developed folate deficiency; the median [interquartile range (IQR)] serum folate levels (ng\/dl) were comparable in the three groups [Group 1: 6.5 (3.3\u201314.2), Group 2: 5.1 (2.6\u201310.5) and Group 3: 4.8 (3.4\u201310.0)]. After 9\u2009months of intervention, the median (IQR) serum folate levels (ng\/ml) were comparable in all participants [Group 1: 18.0 (6.5\u201328), Group 2: 13.5 (6.4\u201324.5) and Group 3: 9.7 (5.3\u201322.5); p\u2009=\u20090.11]. Proportion of children with serum folate excess was 40%, 26.7% and 26.7% in Group 1, Group 2 and Group 3 (p\u2009=\u20090.48). Proportion of children with RBC folate excess was 92%, 86.7% and 86.7% in Group 1, Group 2 and Group 3 (p\u2009=\u20090.79). Hyperhomocysteinemia was seen in eight children with no significant difference between median Hcys levels in the groups (p\u2009=\u20090.75).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Folic acid supplementation is recommended in TDT with 5 mg weekly dose being adequate.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/tropej\/fmac087","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T20:06:48Z","timestamp":1665691608000},"source":"Crossref","is-referenced-by-count":1,"title":["Optimum dose of oral folic acid supplementation in transfusion-dependent thalassemia: a randomized controlled trial"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3538-8757","authenticated-orcid":false,"given":"Titiksha","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University College of Medical Sciences , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7373-5679","authenticated-orcid":false,"given":"Pooja","family":"Dewan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University College of Medical Sciences , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Gomber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University College of Medical Sciences , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachna","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurochemistry, Institute of Human Behaviour & Allied Sciences (IHBAS) , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neuropsychopharmacology, Institute of Human Behaviour & Allied Sciences (IHBAS) , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinalini","family":"Kotru","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences , Delhi 110095, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"2022101320064041700_fmac087-B1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1146\/annurev.nutr.24.012003.132306","article-title":"New insights into erythropoiesis: the roles of folate, vitamin B12, and iron","volume":"24","author":"Koury","year":"2004","journal-title":"Annu Rev Nutr"},{"key":"2022101320064041700_fmac087-B2","first-page":"46","volume-title":"2021 Guidelines for the Management of Transfusion Dependent Thalassemia","author":"Trompeter","year":"2021"},{"key":"2022101320064041700_fmac087-B3","first-page":"14","article-title":"S. 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Inadequate dietary intake in patients with thalassemia","volume":"112","author":"Fung","year":"2012","journal-title":"J Acad Nutr Diet"},{"key":"2022101320064041700_fmac087-B20","doi-asserted-by":"crossref","first-page":"674","DOI":"10.12691\/jfnr-6-10-9","article-title":"Nutritional deficiencies are common in patients with transfusion-dependent thalassemia and associated with iron overload","volume":"6","author":"Goldberg","year":"2018","journal-title":"J Food Nutr Res (Newark)"},{"key":"2022101320064041700_fmac087-B21","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/ajcp\/84.5.668","article-title":"Vitamin B12, folate, and iron studies in homozygous beta thalassemia","volume":"84","author":"Kumar","year":"1985","journal-title":"Am J Clin Pathol"},{"key":"2022101320064041700_fmac087-B22","first-page":"266","article-title":"The effect of folic acid supplementation in beta-thalassemia major: a randomized placebo-controlled clinical trial","volume":"9","author":"Mojtahedzadeh","year":"2006","journal-title":"Arch Iran Med"},{"key":"2022101320064041700_fmac087-B23","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1097\/MPH.0000000000000675","article-title":"Discontinuation of folic acid supplementation in young patients with sickle cell anemia","volume":"39","author":"Nguyen","year":"2017","journal-title":"J Pediatr Hematol Oncol"},{"key":"2022101320064041700_fmac087-B24","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00043426-199905000-00010","article-title":"Plasma homocysteine levels and folate status in children with sickle cell anemia","volume":"21","author":"Rodriguez-Cortes","year":"1999","journal-title":"J Pediatr Hematol Oncol"},{"key":"2022101320064041700_fmac087-B25","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1007\/s13312-019-1611-6","article-title":"Serum folate levels in patients with chronic hemolytic anemia on regular folic acid supplementation before and after dose modification","volume":"56","author":"Azzam","year":"2019","journal-title":"Indian Pediatr"},{"key":"2022101320064041700_fmac087-B26","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/ajh.10083","article-title":"Optimization of folic acid, vitamin B(12), and vitamin B(6) supplements in pediatric patients with sickle cell disease","volume":"69","author":"van der Dijs","year":"2002","journal-title":"Am J Hematol"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/68\/6\/fmac087\/46500879\/fmac087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/68\/6\/fmac087\/46500879\/fmac087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T20:07:12Z","timestamp":1665691632000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmac087\/6760805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,10,6]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmac087","relation":{},"ISSN":["0142-6338","1465-3664"],"issn-type":[{"value":"0142-6338","type":"print"},{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12,1]]},"published":{"date-parts":[[2022,10,6]]},"article-number":"fmac087"}}