VIEWS: 3 PAGES: 20 POSTED ON: 3/26/2012
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
"VITAMINE AND MICRONUTRIENT DEFFICIENCY"