VITAMINE AND MICRONUTRIENT DEFFICIENCY

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VITAMINE AND MICRONUTRIENT DEFFICIENCY Powered By Docstoc
					MODERATOR…
DR. PAVAN HEGDE.
VITAMIN A
DEFICIENCY
   Globally 21% of children have vit A
    deficiency.

   About 8,00,000 deaths in children and
    women of reproductive age are due to vit A
    deficiency.

   1.8% of global DALYs
1. For normal VISION
2.For normal maintenance and function of body
   tissue.
3.Maintenance of cellular integrity , immune
   competence , and growth….
4.Antiinfective function.
5.Retinol is needed for spermatogenesis and and
   integrity of testicular & vaginal epithelium…
6. Antioxidant function
1.ANIMAL FOODS-liver, eggs, butter , cheese
  ,milk , fish and meat…fish liver oil.
2.PLANT FOODS- green leafy vegitables.
  Red palm oil
 Green & yellow fruits and veg( papaya,
  mango, pumpkin)
 Some roots (carrots)
3.FORTIFIED FOODS
   INFANTS- 300- 400 micro g.

   CHILDREN -400-600 micro g.

   ADOLECENTS – 750 micro g.
   1.Inadequte intake
   2. Decreased absorption- diarrhea, worms &
    other disorder….
   3. Increased demand- in measles, febrile
    infection, resp inf
   4. PEM - protien defficiency- RBP
   5.Preterm babys-have low retinol level
1. Subclinicall defi- RS ,UT, intestinal
 epithelium , and immune system are
 affected……
It contributes to an increased severity of
 certain infection…..
2 Early features- Defective dark adaptation.
3.Xerophalmia-- prevalent in 6 to 36 mts olds.
 WHO classification.
  PRIMARY SIGNS
X1A- Conjunctival xerosis
X1B-Bitots spots
X2-Corneal xerosis
X3A-Corneal ulceration < than 1/3 of cornea
X3B- Corneal ulceration > than 1/3 of cornea
  SECONDARY SIGNS
XN- Night blindness
XF- Fundal changes
XS-Corneal scarring
   Conjunctival xerosis – loss of lustre & moist
    appearance. It looks dry & wrinkled
   Bitots spots- chalky grey spots on the temp
    side of corneo scleral junctions…
   Keratomalacia –softening & ulceration of
    cornea….
   Xerophalmia fundus- pale yellow spots
4. Other features-
 - Skin scaly & toad like
 -more prone for infection
 -renal & vesicular calculi
- interfers with reproductive function…
- rarely hydrocephalus
SPECIFIC - immediately after diagnosis ,oral Rx
 with
      <6 months-50,000 IU
     6-12 months-1 lakhIU
      > 1 yr - 2 lakh IU
same dose NEXT DAY & 4 WKS later
Parenteral in case of impaired oral intake
    < 6 months- ¾ th of 50,000 IU
     6-12 months – half of 1 lakh IU
LOCAL Rx – EYE CARE
    antibiotic drop ,ointment should be
  instilled 3 times to prevent infection
 padding to prevent exposure keratitis . It
  enhancess healing, reducess pain,
  photophpbia
    mydriatics -atropine
Short term
 Children who are not breastfed- 50,000IU
  vit A supplement by 2 months of age
      or
 Two dose of 25,000 IU vit A with 1 month
  interval….
 Every infant should take 1 lakh IU with
  measles and 4 more doses of 2 lakh at 18, 24,
  30, 36 months….
-In endemic area , children suffering from measles &
   PEM ,
      < 1yr- 1lakh IU
      > 1yr- 2 lakh IU
     Should be given for 2 consecutive days.

-Persitant diarrhea & other febrile illness
     1 dose each episode , keeping at least 1month
  interval b/n 2 doses
   Medium term action- fortification of foods

   Long term- nutritional education
        - horticulture intervention
        - nutritional supplementation
        - improving the envirornmental
         health
        - diet – vit A rich foods

				
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posted:3/26/2012
language:English
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