Abstract
Objective: To compare the outcome of iron therapy alone versus iron therapy with piracetam in managing children with breath-holding spells (BHS) associated with iron deficiency anemia.
Methodology: This randomized controlled trial was carried out in the Department of Paediatrics, Aziz Bhatti Shaheed Teaching Hospital, Gujrat from 1st January 2022 to 31st December 2022. A sample size of 50 children diagnosed with BHSs and iron deficiency anemia was included and randomly divided into two groups. In group A, children were given oral iron alone. In group B, they were given oral iron plus piracetam. Children were followed up for 3 months and were evaluated for episodes of BHSs and hemoglobin levels. Data were analyzed in SPSS version 23. An Independent sample t-test was applied for comparison keeping p≤0.05 as significant.
Results: The mean age of the patients in oral iron was 2.37±1.86 and mean age in oral iron plus Piracetam was 2.01±1.62 years. In oral iron, males were 52% and females were 48% and in oral iron plus Piracetam, males were 44% and females were 56%. Mean BHS at baseline in oral iron was 19.20±1.04 and in oral iron plus Piracetam was 19.36±1.46. Mean BHS after 3 months in oral iron was 5.80±1.52 and in oral iron plus Piracetam was 3.52±1.08. Mean Hb at baseline in oral iron was 10.34±0.27 and in oral iron plus Piracetam was 10.71±0.15. Mean Hb after 3 months in oral iron was 11.19± with 0.06 SD and in oral iron plus Piracetam was 11.61±0.12. p-value<0.005 indicates a significant difference between oral iron plus piracetam for reduction in episodes of BHS and Hb after 3 months.
Conclusion: There was a difference in the outcome of oral iron alone versus oral iron plus piracetam for managing children with BHSs associated with iron deficiency anemia from 6 months to 5 years of age.

Key words: Iron therapy, piracetam, breath-holding spells, iron deficiency anemia, hemoglobin level.