Vitamin Deficiency

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					17.2 Vitamin Deficiency
         Vitamin A Deficiency
• Major cause of blindness.
• Mostly affects small children but can affect
adults and younger women.
• Caused from a lack of food containing Vitamin
  A.

• Vitamin A is found in leafy green vegetables,
  eggs, many kinds of meat, mango, papaya,
  pumpkin, breast milk, and many fruits
                 Prevention
• To prevent disease, encourage a
  healthy diet and distribute Vitamin
  A capsules to children




• One dose of 200,000 IU will
  provide enough Vitamin A for a
  child for 4-6 months.
                 Prevention
• Before giving a preventative dose, check if one
  has been given in the last 4 months.

• Do not give high doses to pregnant women or
  to women who could be pregnant.

• Page 162 for Vitamin A dosing.
          Signs and Symptoms
• Night blindness (‘chicken
  blindness’)

• Bitot’s spots: grey and white
  spots on conjunctiva

• Dry cornea
                  Treatment

• Give a treatment dose to:
  – Patients with confirmed S/S of Vitamin A
    deficiency
  – All cases of moderate and severe malnutrition
             Treatment
– Children with measles
– Children with severe respiratory
  infections and severe diarrhea requiring
  IPD treatment.
 Vitamin B1 Deficiency (Beriberi)
• Caused from a lack of Vitamin
  B1 in the diet.



• It is often seen in pregnant or
  breastfeeding women and small
  children.
                 Prevention
• Eat a variety of foods to prevent Beriberi.
• For example: yellow beans, meat, fruits, and
  vegetables.
          Signs and Symptoms
• Dry Beriberi:
  – Mild: numbness, burning sensation or tingling in
    lower legs and hands.
  – Severe: weakness (patient cannot walk alone),
    reduced tendon reflexes
                 Treatment
• Mild Dry Beriberi
  – give 100 mg PO OD x 7 days then 10 mg OD x 6
    weeks
            Signs and Symptoms
• Wet Beriberi
  –   Oedema to legs, trunk, and face
  –   Hepatomegaly
  –   Difficulty Breathing
  –   A rapid pulse that can lead to heart failure
                   Treatment
• For Wet Beriberi and severe Dry Beriberi:
  –   Admit to IPD
  –   Give Vitamin B1 IM 100mg TID the 1st day
  –   Give Vitamin B1 PO 100 mg OD x 7 days
  –   Then give 10 mg PO OD x 6 weeks.
• The patient may be lacking other vitamins
  including Vitamin B1, ask about their diet



• Consider giving B-complex or a multivitamin.
• Do not chew betel-nut when taking vitamin B
  supplements: betel-nut destroys vitamin B1.

• Take vitamin B1 tablets 1 hour before meals.