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Vitamins  Reqirement And Deficiencies
 

Vitamins Reqirement And Deficiencies

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    Vitamins  Reqirement And Deficiencies Vitamins Reqirement And Deficiencies Presentation Transcript

    • VITAMINS Requirement And Deficiencies Dr Soumar Dutta CDMO Guwahati Refinery Hospital
    • DEFINITION
      • These are organic compounds occurring in natural foods either as such or as utilizable precursors which are required in minute amounts for normal growth, maintenance and reproduction.
      • CLASSIFICATION: broadly classified based on solubility
      • A. Fat soluble vitamins B. Water soluble vitamins
      • 1. Vitamin A 1. Vitamin C
      • 2. Vitamin D 2. Vitamin B-complex group
      • 3. Vitamin E
      • 4. Vitamin K
    • VITAMIN A
      • SOURCES
      • Animal sources
      • Liver oil
      • Butter
      • Milk
      • Cheese
      • Egg yolk
      • Plant sources
      • Tomatoes
      • Carrot
      • Green-yellow vegetables
      • Spinach
      • Mangoes
      • Papaya
      • Corn
      • Sweet potato
      • RDA : Adults 3000-5000 IU/day
      • Children, pregnant and lactating women
    • Absorption, Storage and Transport
      • Vit A and its precursors absorbed in Small Intestine
      • Stored in Liver
      • Transported in blood with a special Retinol Binding Protein (RBP)
      • FUNCTIONS
      • Role in normal vision
      • Role in bone and teeth formation
      • Role in epithelialization
      • Normal growth
      • Body metabolisms
      • Role in reproduction
    • Deficiency symptoms
      • Xeropthalmia
      • Follicular conjunctivitis
      • Keratomalacia
      • Nyctalopia (night blindness)
      • Follicular hyperkeratosis and keratizing metaplasia
      • Urolithiasis
    • Follicular Hyperkeratosis
    • HYPERVITAMINOSIS A
      • Excess of vitamin A induce series of toxic effects known as hypervitaminosis A syndrome. Seen usually among Eskimos who consume livers of polar bear and arctic foxes.
      • SYMPTOMS
      • Alteration of skin and mucous membrane
      • Hepatic dysfunction
      • Headache
      • Drowsiness
      • Peeling of skin about the mouth and elsewhere
    • VITAMIN D
      • It is a steroid hormone.
      • Biologically active form
      • is Calcitriol
      • SOURCES
      • Fish liver oil
      • Egg yolk
      • Milk
      • Butter
      • Cheese
      • Margarine
      • RDA : 100 IU/day in adults
      • pregnancy, lactation, infant and children ( 220 IU)
    • FUNCTIONS
      • Intestinal absorption of calcium and phosphates
      • Mineralization of bones
      • Promotes bone resorption and calcium mobilization to raise blood Ca and P in relation to PTH.
      • Renal reabsorption of Ca and P
      • DEFICIENCY
      • Ricket
      • Osteomalacia
      • Renal osteodystrophy
    • RICKETS OSTEOMALACIA
    • HYPERVITAMINOSIS D
      • Effects are mainly due to hypercalcaemia
      • IMMEDIATE DELAYED Anorexia Urinary lithiasis. Thirst Metastatic calcification Lassitude
      • Constipation
      • Polyuria
    • VITAMIN E (Tocopherols)
      • Alpha –tocopherol is the most active forms
      • SOURCES
      • Cottonseed oil
      • Corn oil
      • Sunflower oil
      • Wheat germ oil
      • Margarine
      • Green leafy
      • vegetables
      • RDA : 25-30 IU/day
    • FUNCTIONS
      • Antioxidant property
      • DEFICIENCY
      • Muscular dystrophies
      • Nocturnal muscular cramps
      • Intermittent claudication
      • Fibrocystic Breast Disease
      • Atherosclerosis
      • Hemolytic anemia- susceptibility of RBCs to hemolysis
      • Dietary hepatic necrosis
      • Neurological disorders
      • TOXICITY
      • None
    • VITAMIN K
      • Antihemorrhagic /coagulation vitamin or prothrombin factor.Three variants K 1, K 2 and K 3 .All are napthoquinone derivatives.
      • SOURCES
      • Cabbage
      • Cauliflower
      • Tomato
      • Alfa alfa
      • Spinach
      • Green leafy vegetables
      • Egg yolk
      • Meat
      • Liver
      • Cheese & dairy products
      • RDA: 70-140 microgm/day
    • FUNCTIONS
      • Blood coagulation:
      • Blood factors such as prothombin, factors II,VII,IX,X.
      • Calcium binding protein
      • DEFICIENCY
      • Rare, present sufficiently in food.
      • Hemorrhagic conditions. Prothrombin level and clotting time
      • Hemorrhagic disease of newborn
      • HYPERVITAMINOSIS K
      • Hemolytic anemia and jaundice (in large doses)
      • ANTAGONIST TO VITAMIN K
      • Heparin, Dicumarol, Salicylates
    • WATER SOLUBLE VITAMINS
      • Non B-complex B-complex
      • Vitamin C
      • Energy releasing Hematopoietic
      • Thiamine (B 1 ) Folic Acid
      • Riboflavin (B 2 ) Vitamin B 12 / Cyanocobalamin
      • Niacin(B 3 )
      • Pantothenic Acid(B 5 )
      • Pyridoxine(B 6 )
      • Biotin(B 7 )
    • VITAMIN C (Ascorbic Acid)
      • SOURCES
      • Citrous fruits- orange, lemon
      • Papaya
      • Pineapple
      • Banana
      • Strawberry
      • Green leafy vegetables
      • Cabbage
      • Cauliflower
      • Germinating seed
      • Green peas and beans
      • Gooseberry(Amla)
      • (richest source)
      • RDA : Adults 60-70 mg/day
    • FUNCTIONS
      • Collagen formation
      • Iron and hemoglobin metabolism
      • Tryptophan metabolism
      • Tyrosine metabolism
      • Folic acid metabolism
      • Cholesterol synthesis
      • Cellular respiration
      • Immunological function
      • Prevents cataract formation
      • Preventive action on chronic diseases
    • DEFICIENCY
      • SCURVY- defect lies in the failure of intercellular cement substance
            • Fragile capillaries-petechial, sub-cutaneous ,sub-periostial
            • or internal hemorrhages.
            • Poor /Delayed wound healing.
            • Poor dentine formation
            • Gum bleed- gums are swollen, spongy bleeds on pressure
            • Poor mineralization of bones
            • Anemia- microcytic - hypochromic
    • Vitamin B 1 (Thiamine)
      • SOURCES
      • Cereals
      • Pulses
      • Oil seeds
      • Nuts
      • Yeast
      • Meat
      • Fish
      • Egg
      • Milk
      • RDA: Adults 1.2-1.5 mg/day
    • FUNCTIONS
      • Essential for normal growth
      • Essential for normal functioning of nerves
      • Co-enzymatic activities- carbohydrate, nucleic acid and energy
      • synthesis
      • DEFICIENCY
      • Beri beri
      • Earliest symptoms:
      • anorexia
      • dyspepsia
      • heaviness and weakness of legs.
      • calf tenderness
    • Wet beri beri Dry Beri beri
      • Oedema of legs, face Progressive muscle weaknes and
      • trunk and serous cavities. disability
      • Calf muscles are swollen and tender Neurological manifestations
      • Palpitation and breathlessness
      • Low diastolic BP, high systolic.
      • Fast pulse
      • Heart becomes weaker
      • and patient dies of heart failure
      • Infantile Beri beri
      • Infants born to mother with low thiamine in their breast milk.
      • Restlessness and sleeplessness
      • Anorexia, vomiting and breathlessness
      • Symptoms d/t cardiac dilatation and failure.
      • Sudden death if not treated urgently with thiamine.
    • Wernicke-korsakoff psychosis
      • Seen mostly in chronic alcoholics
      • Body demand of thiamine increases in alcoholism
      • Characterized by:
      • Dementia
      • Apathy
      • Nystagmus
    •  
    • VITAMIN B 2 (Riboflavin)
      • SOURCES:
      • Yeast
      • Whole grain
      • Dry beans and pea
      • Green vegetables
      • RDA: 1.5-1.8 mg/day in adults
      • FUNCTIONS:
      • In two active forms FMN and FAD serves as coenzyme in various reactions
      • DEFICIENCY
      • Cheilosis-fissuring at angle of the mouth
      • Glossitis-tongue smooth and purplish
      • Seborrhagic Dermatitis:scaly,greasy,desquamation
      • Eyes: corneal vascularization
      • Chronic alcoholics are susceptible to deficiencies.
    • VITAMIN B 3 (NIACIN/NICOTONIC ACID)
      • SOURCES:
      • Liver
      • Kidney
      • Meat
      • fish
      • Legumes(pea,beans,lentil)
      • Nuts
      • Green vegetables
      • Coffee
      • Tea
      • Synthesize from A. acid Tryptophan
      • RDA: 17-21 mg/day in adults
    • FUNCTIONS:
      • It has two active forms NAD + ,NADP + serves as co-enzymes in various oxido-reductive reactions in ETC
      • DEFICIENCY
      • PELLEGRA (pelle-skin; agra- rough)
      • “ 3D” Disease: Dermatitis, Dementia, Diarrhoea
      • Gingivitis and stomatis
      • Achlorhydria
      • Fatty liver
      • Effect on plasma
      • lipids
    • VITAMIN B 5 (Pantothenic Acid)
      • SOURCES
      • Kidney
      • Liver
      • Egg yolk
      • Yeast
      • Cereals
      • Legumes
      • Sunflower oil
      • RDA: 5-10 mg/day
      • FUNCTION
      • Acts through CoA and helps in the formation of
        • Energy
        • Triactlglycerol
        • Vit D
        • Steroid hormones
    • DEFICIENCY
      • Nausea, vomiting ,GI disorders,
      • Irritability.
      • Inadequate growth.
      • Fatty liver
      • Steroid synthesis.
      • Burning foot syndrome- Pain and numbness in the toes
      • Insomnia
      • Fatigue
    • VITAMIN B 6 (Pyridoxine)
      • SOURCE
      • Yeast
      • Rice polishing
      • Germinal portion of seeds
      • Liver
      • kidney
      • Fish
      • RDA: 2-2.2 mg/day
      • FUNCTION
      • Active form is Pyridoxal Phosphate (PLP).It serves as coenzyme in various bio-chemical reactions like Transaminase, Decarboxylation, Deamination.
    • DEFICIENCY
      • Neurological symptoms
        • Depression
        • Irritability
        • Nervousness
        • Mental confusion
        • Convulsions
        • Peripheral neuropathy
        • Demyelination of neurons
      • Anaemia
        • Hypochromic microcytic anaemia d/t reduced heme production.
        • Pyridoxine deficiencies are mostly seen in women taking OCPs, alcoholics infants and those on ATT especially INH
    • VITAMIN B 7 (Biotin)
      • SOURCES:
      • Egg yolk
      • Liver
      • Kidney
      • Yeast
      • Milk
      • Tomato
      • Fruits
      • Vegetables
      • RDA: 50-60 microgms/day
      • FUNCTIONS: it acts as co enzyme
      • In various carboxylation reactions
    • DEFICIENCY
      • Dermatitis of extremities
      • Pallor of skin & mucous membrane
      • Anorexia & nausea
      • Muscle pain and hyperesthesia
      • Depression, Lassitude and Somnolence
      • Hypercholesterolemia
      • A rare congenital disease of genetic deficiency to utilize Biotin
      • Characterized by :
      • Dermatitis Loss of hair
      • Grating of hairs Incordinated movements
      • Leiner’s disease: In exclusive breast fed infants with persistant diarrhoea
    • VITAMIN B 9 (Folic Acid)
      • SOURCES
      • Liver
      • Yeast
      • Kidney
      • Green leafy vegetables
      • Meat
      • Fish
      • RDA: 100 microgm/day
      • FUNCTIONS:
      • The active form of folic acid is Tetrahydrofolate.It acts as coenzymes in various bio-chemical reactions.
    • DEFICIENCY:
      • It is the most common vitamin deficiency observed primarily in pregnant women, lactating mother , women on OCPs and alcoholics.
      • In pregnancy decreased absorption and increased clearance is the cause.
      • Anaemia: macrocytic type
      • FIGLU test - to detect folate deficiency.
    • VITAMIN B 12 (Cyanocobalamine)
      • SOURCES
      • Liver
      • Kidney
      • Milk
      • Curd
      • Egg
      • Fish
      • Fish
      • Chicken
      • RDA: 3 microgm/day
      • FUNCTION:
      • Required with folic acid for development of RBCs.
      • Stimulates appetite and required for normal health.
      • Cures neurological symptoms of pernicious anaemia.
    • DEFICIENCY
      • Megaloblastic anaemia
      • Mucosal atrophy of mouth
      • Glossitis
      • Disease of nervous system both central and peripheral
      • Psychiatric symptoms
      • Amblyopia
      • A severe form of acidosis in children
    • CONCLUSION
      • Vitamins are required in trace amounts.
      • They do not directly provide energy.
      • They are not required by normal otherwise healthy individuals consuming a balanced diet, rather should be reserved for those who are under stressful conditions
        • ACUTELY ILL PATINTS
        • PREGNANT AND LACTATING MOTHER
        • CHRONIC DEBILITATING ILLNESS
        • DURING CONVALESCENCE
        • MALNOURISHED PERSON
        • UNDERTAKING CERTAIN DRUGS- ANTIMICROBIALS
    •