Your SlideShare is downloading. ×
Vitamin A
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Vitamin A

3,934
views

Published on

Published in: Health & Medicine

0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
3,934
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
262
Comments
0
Likes
3
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. VITAMIN A DR KAUSIK SUR D.C.H,DNB ASSISTANT PROFESSOR DEPARTMENT OF PEDIATRICS VIVEKANANDA INSTITUTE OF MEDICAL SCIENCES RAMAKRISHNA MISSION SEVA PRATISTHAN KOLKATA,INDIA
  • 2. SOURCES
    • ANIMAL FOODS
    • Liver
    • Egg
    • Butter
    • Cheese
    • Whole milk
    • Fish
    • Meat
    • PLANT FOODS
    • Spinach
    • Cabbage
    • Lettuce
    • Curry
    • Reddish leaves
    • Yellow pumpkin
    • Mangos
    • Papaya
    • Tomatos
  • 3.  
  • 4.  
  • 5.  
  • 6.
    • Most of the retinol is esterified with saturated fatty acids incorporated into lymph chylomicron enter bloodsteram converted to chylomicron remnants taken up by liver together with their content of retionol
  • 7. THIS REACTION IS ACCOMPANIED BY A CONFORMATIONAL CHANGE THAT INDUCES CHANGE IN PERMEABILITY OF CATIONS, INCRSED POLARIZATION OF MEMBRANES AND TRIGGERING OF A NERVE IMPULSE
  • 8. RETINOIC ACID PARTICIPATES IN GLYCOPROTEIN SYNTHESIS
    • Retinoic acid participates in promotion of growth and differentiation of tissues
    • Retinoyl phosphate functions as a carrier of oligosaccharides across the lipid bilayer of cell
  • 9. VITAMIN A IS ESSENTIAL FOR
    • Normal maintenance and function of body tissues
    • Vision
    • Cellular integrity
    • Immune competence
    • Growth
  • 10.
    • BETA CAROTENE –
    • Antioxidant property
    • Scavenger of free radicles
    • Vitamin a and beta carotene may reduce the incidence of lung, breast, oral, esophageal, bladder cancer
  • 11. RECOMMENDED DAILY INTAKE
    • INFANTS 350 µg
    • 1-6 YEARS 400 µg
    • 7-12 YEARS 600 µg
  • 12. DIAGNOSIS OF VIT A DEFICIENCY
    • Assessment of dietary vit.A
    • Eye examination
    • SERUM RETINOL level(normal level is 28 to 86 μg/dl (1 to 3 µmol/L) not an acurrate indicator unless the deficiency is severe and liver stores depleted
    • ROSE BENGAL STAIN TEST(RBST) for early conjunctival xerosis
    • CONJUNCTIVAL IMPRESSION CYTOLOGY(CIC) for preclinical VAD
    • Night vision threshold test
  • 13. WHO CLASSIFICATION OF XEROPTHALMIA
    • CIassification of xerophthalmia World Health Organization, 1976)
    • XS Night blindness
    • XI A Conjunctival xerosis
    • XIB Bitot’s spot
    • X2 Corneal xerosis
    • X3A Corneal ulceration-keratomalacia > 1/3 corneal surface
    • X3B Corneal ulceration- keratomalacia < 1/3 corneal surface
    • XS Corneal scar
    • XF Xerophthalmic fundus
  • 14.  
  • 15.
    • Conjuctiva becomes dry- CONJUNCTIVAL XEROSIS
    • Conjunctive keratinizes and develops plaques- BITITS SPOT
  • 16.  
  • 17.  
  • 18.
    • Cornea keratinizes, becomes opaque, is susceptible to infection and forms dry, scaly layer of cells
    • Infection occurs, lymphocytes infiltrates and the cornea becomes wrinkled
    • Degenerates irreversibly (KERATOMALACIA)
  • 19.  
  • 20.  
  • 21.  
  • 22. OTHER FEATURES OF VITAMIN A DEFICIENCY
    • SKIN CHANGES- Scaly, toad like (phrynoderma)
    • Squamous metaplasia of respiratory mucosa more prone to RESPIRATORY INFECTIONS
    • Alteration in mucosa of renal pelvis and UB formation of RENAL AND VESICAL CALCULI
    • Atrophy of germinal epithelium may interfere with REPRIDUCTIVE FN
  • 23.
    • DIARRHEA
    • ANEMIA
    • APATHY
    • MR
    • INCREASED INTRACRANIAL PRESSURE
  • 24. TREATMENT OF VITAMIN A DEFICIENCY
    • SPECIFIC-
    • ORAL VIT.A 50,000 IU (<6 months)
    • 1 LAKH IU (6-12 months)
    • 2 LAKH IU (> 1 year)
    • SAME DOSE NEXT DAY
    • SAME DOSE 4 WEEKS LATER
  • 25.
    • PARENTERAL WATER SOLUBLE VIT. A
    • DOSE- 3/4 th DOSE <6 months
    • ½ DOSE 6-12 months
    • INDICATION-
    • Impaired oral intake
    • Persistent vomiting
    • Severe malabsorption
  • 26.
    • LOCAL TREATMENT
    • CORNEAL ULCER-
    • ANTIBIOTICS DROPS/OINT . THRICE DAILY
    • (to prev. sec. infection)
    • PADDING OF EYE (to prevent dehydration and furthur corneal exposure)
    • MYDRIATIC- ATROPINE DROP 1% OR OINT. ONCE DAILY
  • 27. PREVENTION
    • NOT BREAST FED INFANTS-
    • 50,000 IU BY 2 MONTHS AGE
    • ( OR 2 DOSES OF 25000 IU AT I MOMTH INTERVAL)
    • EVERY INFANT-
    • ONE DOSE OF 1 LAKH IU VIT A ALONG WITH MEASLES VACCINE AT 9 MONTHS
    • 4 MORE DOSES OF 2 LAKH IU EACH AT
    • 18,24,30,36 MONTHS
  • 28.
    • IN VIT.A ENDEMIC AREAS
    • CHILD SUFFERING FROM
    • MEASLEA
    • SEVERE PEM
    • 2 DOSES OF ORAL VIT.A ON 2 CONSECUTIVE DAYS
    • (1 LAKH FOR <1 YEAR AND 2 LAHS >1 YEAR)
  • 29.
    • PERSISTENT DIARRHEA, OTHER PROLONGED FRBRILE CONDITION
    • One dose in each episode with 1 month interval
  • 30.
    • CONSUMPTION OF FOODS RICH IN VIT A
    • LONG TERM PREVENTION STRATEGIES
    • Nutrition education and dietary diversification
    • HORTICULTURAL INTERVENTION incl. Home gardening
    • Nutritional supplementation
    • Selective fortification for high risk and special groups
  • 31.
    • All Infants with birth weight of ≤1 kg should receive 5000IU of Vitamin A i.m 3 times a week for first 4 weeks- slightly reduce the incidence of chronic lung disease
    • Manual of neonatal care – john p cloharty, 6 th ed