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Vitamin c and scury
 

Vitamin c and scury

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    Vitamin c and scury Vitamin c and scury Presentation Transcript

    • VITAMIN C AND SCURY BY DR.RISHAV RAJ
    • VITAMIN C • It is a water soluable. • Vitamin C is not stored in the body but is taken by all the tissues • High level of vit C is found in the pituitary glands. • Also known as L-ascorbic acid it is an essential nutrient for humans. • Ref:american journal of paed. 2001
    • HISTORY OF VITAMIN C • 17th century – sailors got scurvy on ships and ship surgeon, James Lind, prescribed lemon juice as preventative. Performed an experiment that proved that lemon juice prevents scurvy. • We now know today that it is because of the Vitamin C in the lemon that prevents scurvy or a vitamin C deficiency
    • CHEMISTRY • It is L-Ascorbic Acid. • its oxidized derivative L-dehydroacorbic. • The acidic property of vitamin C is due to enolic hydroxyl groups. • It is a strong reducing agent. They form a reversible redox system • Oxidation of ascorbic acid is rapid in the presences of copper..Hence ,vit C becomes in active if the foods are prepared in copper vessels.
    • structure OH OO H HO HO HO
    • SOURCES • Mostly in citrus fruit and juices (limes, lemons, oranges, strawberries, banana s, and grapefruits) • Also in cabbage, broccoli, cauliflower, tomatoes, potat oes, and beans. • There are also vitamin C pills and other things for supplements. • Ref:leninger biochemistry
    • SYNTHESIS • All Plants can synthesize Vitamin C • Most animals can synthesize vitamin C except : Humans, Guinea pigs, fruit eating bat • They lack: L-gulono-γ-lactone oxidase
    • BIO CHEMICAL FUNCTION • 1.COLLAGEN FORMATION: vit C Plays the role Of a coenzyme in hydroxylation of proline and lysine . The hydroxylation reaction is catalysed by lysyl hydroxylase (for lysine) and propyl hydroxylase(for proline). The hydroxyproline and hydroxylysine are essential for the collagen cross-linking and the strength of the fibre.
    • 2.Bone formation • Bone tissues possess an organic matrix, collagen and the inorganic calcium,phosphate 2.Iron and hemoglobin metabolism:Ascorbic acid enhances iron absorption by keeping it in the ferrous form. This is due to the reducing property of vit C.
    • 3.Tryptophan metabolism • Vitamin C is essential for the hydroxylation of Tryptophan to hydroxytryptophan in the synthesis of serotonin by hydroxylase. 4.Folic acid metabolism: The active form of the vitamin folic acid is tetrahydrofolate. Vitamin C is needed for the formation of tetrahydrofolate.
    • 5.Synthesis of corticosteroid hormones • Adrenal gland possess high level of ascorbic acid particularly in period of stress. • It is believed that vit C Is necessary for hydroxylation reaction. • 6.immunological function: vitamin C Enhances the synthesis of immunoglobins.
    • 7.Preventive action on chronic disease • Free radicals are constantly produced in the Normal metabolism .they cause serious damage To proteins ,lipids,DNA and the cell membranes. These free radical are implicated in the development of cancer, heart diseases .vit C prevent from these diseases.
    • Dietary needs • The recommended daily intake for Infants: 0-6month :40mg/day 7-12 month: 50 mg/day Children :1-3yr :15mg/day 4-8yr: 25mg/day. Dr. Linus Pauling believes that 10 grams a day will prevent cancer.
    • Clinical manifestation: • 1.age of onset is between 6 and 24 month • 2.Due vitamin C def. symptoms such as irritability, tachypnea,digestive disturbances and loss of appetite. • 3.pain in the limbs :limbs are like frog like position with hips and knees semiflexed with feet rotated outward. • 4.edematous swelling along the shaft of legs.
    • • 5.anaemia may be present due to bleeding,decrease absorption of iron and defective conversion of folic acid. • 6.purpuric ,petechiae and ecchymosis may be present. • 7.a rosary at the costochondral junctions and Depression of the sternum.
    • Investigations : • 1. Decrease of vitamin C LEVEL in blood Normal 0.6mg/dl 2.Vit C loading test:10 mg /kg of vit C is given and more than 80% of it is excreted in urine. If excretion is less than 20%.-It indicates deficiency of vitamin C. 3.VIT C LEVELS are decreased in WBC and platelet buffy coat.
    • Management • 0ral preparations are preferred to parenteral dose • Dose 0- 6 month :40 mg/day • 7-12 month :50mg/day • 1-3 year : 15mg./day • 4-8 yr :25mg/day.
    • Scurvy • It is a nutritional disorder due to deficiency of ascorbic acid(vitamin c). PATHOLOGY 1.Rarefaction of shaft and epiphysis resembling Ground glass appearance.Thinning of cortex is present. 2.Thickening of zone of provisional calcification is seen at epiphysis due to defective proliferation of cartilage cells. It is brittle and fractures may develop.
    • • 3.subperiosteal haemorrahages are seen due To leaking of blood from vessels,resulting in stripping of periostium. 4. Dentin is defective due to defective formation Of collagen resulting spongy gums and bleeding from gums.
    • CLINICAL FEATURES 1.IRRITABLE 2.LETHARGIC 3.PAIN IN THE LIMB 4.BLEEDING FROM GUMS 5.PURPURIC 6.PETECHIAE AND ECHYMOSIS MAY BE PRESENT. 7.Rarely, haematemesis ,malena and subdural hematoma
    • • 8.perifollicular bleeding • 9.anaemia may be present due to • A)bleeding • B)decrease in absorption of iron • C)defective conversion of folic acid. • 10.delayed wound healing. • 11. scorbutic rosary: a groove is present in between costal cartilage and rib due to depression of cartilage.
    • X.Ray of bones • 1.Wimberger’s sign: rarefaction and thickening • Of outerline of epiphysis. • 2.white line of frankel:thickening of zone of provisional calcification Cartilage proliferation is seen at the epiphyseal end of long bones. 3.pelken’s sign:-Thickened zone of provisional calcification Cartilage proliferation is seen at epiphyseal end of long bones
    • • 4.Corner’s sign: a groove is present just above ZONE OF PROVISIONAL CALCIFICATION. 5.Trummer feld zone:fragmented metaphysis 6.Scurvy line :area in between zone of provisional calcification and trummer feld zone. 7.Subperosteal hemorrhage 8.GROUND GLASS APPEARANCE OF SHAFT. 9.THINNING OF CORTEX IS PRESENT.
    • MANAGEMENT • 1. 500-1000 mg of vitamin C IS Given daily for 1week followed by 30-50 mg /day
    • THANK ….U…