IRON DEFICIENCY ANEMIA IN RELATION TO PINCH STRENGTH AND HAND DEXTERITY IN PRESCHOOL CHILDREN

i. Instrumentations for selection:

• Fully automated blood cell counter. A complete blood count (CBC) is one of the most commonly and routinely done laboratory tests It will be obtained through the use of fully automated blood cell counter (sysmex-Xs 800i).
• Beckman coulter-AU 480- blood chemistry auto-analyzer. It is the ideal primary chemistry analyzer for measurement of the amount of serum iron in the blood. ii. Instrumentations for assessment:

Updated 23/11/12

4

• Baseline mechanical Pinch gauge (0-60 lb.) used to measure tripod pinch strength of dominance and non-dominance hands for all participated children.
• Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) The Bruininks-Oseretsky Test of Motor Proficiency is a standardized, norm-referenced measure

Inclusion criteria

• Their age will be ranged from 5-6 years
• The fifty anemic children will have microcytic hypochromic anemia: their Hb < 11.5 g/L (Hb from 11.0-11.4 is mild anemia and in moderate anemia Hb is from 8.0-10.9 (WHO, 2011). The serum iron is below 60 mcg/dL (Elngar et al., 2021). The Ferritin level

<12 µg/L for children in absence of infection (WHO, 2017). ( Appendix I).

• They will be right handed.
• They had no history of previous hand injuries, surgeries or other functional hand limitation.
• All children will able to follow instructions and understand commands given during test procedures.
• Their body mass index (BMI) will be ranged from 15.2 to 15.5 kg/m2 (WHO, 2007). (Appendix II).

B. Exclusion Criteria:

Children will exclude if they have:

• Congenital or acquired deformity in the joints of upper limb.
• Unhealed fracture in upper limb bones.
• Systematic disease that cause anemia such as renal or hepatic failure or a history of bone disease.
• Blood transfusion within 3 months before measuring the hematological indices.
• Documented trauma in the previous 12 months in the muscle fibers, or those taking medication that affecting strength.
• Children begin with musculoskeletal problems or neurological disorders that affected their upper extremities

Inclusion criteria

• Their age will be ranged from 5-6 years
• The fifty anemic children will have microcytic hypochromic anemia: their Hb < 11.5 g/L (Hb from 11.0-11.4 is mild anemia and in moderate anemia Hb is from 8.0-10.9 (WHO, 2011). The serum iron is below 60 mcg/dL (Elngar et al., 2021). The Ferritin level

<12 µg/L for children in absence of infection (WHO, 2017). ( Appendix I).

• They will be right handed.
• They had no history of previous hand injuries, surgeries or other functional hand limitation.
• All children will able to follow instructions and understand commands given during test procedures.
• Their body mass index (BMI) will be ranged from 15.2 to 15.5 kg/m2 (WHO, 2007). (Appendix II).

Exclusion criteria

• Children will exclude if they have:

• Congenital or acquired deformity in the joints of upper limb.
• Unhealed fracture in upper limb bones.
• Systematic disease that cause anemia such as renal or hepatic failure or a history of bone disease.
• Blood transfusion within 3 months before measuring the hematological indices.
• Documented trauma in the previous 12 months in the muscle fibers, or those taking medication that affecting strength.
• Children begin with musculoskeletal problems or neurological disorders that affected their upper extremities
• Children who practice in any regular sport activities involving the upper extremities.8)