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Vitamin a

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  • 1. VITAMIN A
  • 2. β carotene All-trans retinol retinal All-trans retinal retinol Visual cycle retinyl esters Retinoic acidretinyl palmitate Nuclear receptor
  • 3. SOURCES
  • 4. LIFE STAGE DAILY REQUIRMENT ( μg/day)Infants0-6 months 4007-12 months 500Children1-3yr 3004-8yr 400Males9-13yr 600>13yr 900Females9-13yr 600>13yr 700Pregnancy 750Lactation 1200
  • 5. Vitamin A deficiencyWHO CLASSIFICATION OF XEROPTHALMIAXN Night blindness (nyctalopia)X1A Conjunctival XerosisX1B Bitot’s spotsX2 Corneal XerosisX3A Corneal ulceration (<1/3rd)X3B Corneal ulceration(>1/3rd )XS Corneal scarXF Xeropthalmic fundi
  • 6. Bitot spots
  • 7. Keratomalacia
  • 8. Other manifestationsSkin and Epithelial cells:Phrynoderma/toad skinKeratinization of GI,respiratory and urogenital tractsReproductive system:Degeneration of germinal epithelium- infertilityGrowth retardation
  • 9. Hyperkeratosis
  • 10. Hypervitaminosis ASymptoms and signs:Fatigue,malaise,anorexia,vomiting,headache anddiplopiaDermatitisSkeletal decalcificationTenderness of long bonesHepatomegaly
  • 11. Carotenemia
  • 12. Treatment Children 1-6 yr and above• Immediately on diagnosis - 2 lakh IU• Following day - 2 lakh IU• Four weeks later - 2 lakh IUChildren <1yr and <8kg(at any age)• <6 months - 50,000 IU• 6-12 months - 1 lakh IUFor night blindness and Bitot spots Daily dose( 2 wks) -10,000 IU
  • 13. PreventionNational Prophylaxis Vitamin A ProgramMinistry of Health and Family Welfare• Children(1-5 yr) - 2 lakh IU, every 6 months• 9 months – 1 lakh IU• 15 months – 2 lakh IU