This document summarizes progress made in eliminating iodine deficiency through universal salt iodization programs globally and in Central and Eastern Europe and Central Asia specifically. It finds that:
1) Nearly all countries achieved over 90% household coverage of iodized salt by 2009, up from less than half in 2000, largely eliminating iodine deficiency disorders.
2) Successful country programs enacted strong regulations mandating adequate iodine levels in all food-grade salt and had oversight to manage progress, while less successful programs focused only on household salt or had weak standards.
3) Studies show correction of even mild iodine deficiency through salt iodization programs improved cognitive test scores and school performance in children.
Iodine is essential for thyroid hormone production. Iodine deficiency can cause goiter and intellectual impairment. While iodine is found in seafood and iodized salt, over half the global population remains at risk for deficiency. Universal salt iodization is the recommended strategy to eliminate iodine deficiency disorders. Progress has been made with iodized salt consumption increasing in Pakistan from 17% to 69%, though continued efforts are still needed to ensure all salt is iodized and populations worldwide receive adequate iodine.
Iodine is essential for thyroid hormone production. Iodine deficiency disorders affect over 7% of the global population and cause a spectrum of health issues from goiter to cretinism. Prevention focuses on universal salt iodization, iodized oil supplementation, monitoring iodine levels, training programs, and increasing public awareness. Controlling iodine deficiency through these measures can eliminate its health impacts across the lifespan.
Iodine deficiency disorder and metabolic syndromeGunJee Gj
Iodine deficiency can cause goiter and impaired brain development. Symptoms include enlargement of the thyroid gland, neurological deficits, and delayed sexual maturation. It is assessed by palpation, ultrasound, and urinary iodine levels. Daily iodine requirements range from 50 μg for infants to 150 μg for those over 12 years old. The metabolic syndrome is defined as abdominal obesity plus two other risk factors and increases the risk of cardiovascular disease and diabetes. It involves central obesity, high triglycerides, low HDL, high blood pressure, and elevated fasting glucose. Lifestyle modifications including diet, exercise, and weight loss are first-line treatment approaches.
Iodine deficiency is a lack of the trace element iodine, an essential nutrient in the diet. It may result in metabolic problems such as goiter, sometimes as an endemic goiter as well as cretinism due to untreated congenital hypothyroidism, which results in developmental delays and other health problems.
Iodine deficiency is a common disorders in developing like Bangladesh. It affects both maternal and child heath. Dietary intake of iodine is necessary to avoid such disorders.
A presentation on Iodine deficiency disorder for women & children in developing country
Learning Objectives:
By the end of the session students will be able
To define iodine deficiency
To define goitrogens
To identify sources of iodine
To list Epidemiological assessment of iodine deficiency
To Name International Iodine Control Strategies
To name Iodine Control Program of Pakistan
Iodine is essential for thyroid hormone production. Iodine deficiency can cause goiter and intellectual impairment. While iodine is found in seafood and iodized salt, over half the global population remains at risk for deficiency. Universal salt iodization is the recommended strategy to eliminate iodine deficiency disorders. Progress has been made with iodized salt consumption increasing in Pakistan from 17% to 69%, though continued efforts are still needed to ensure all salt is iodized and populations worldwide receive adequate iodine.
Iodine is essential for thyroid hormone production. Iodine deficiency disorders affect over 7% of the global population and cause a spectrum of health issues from goiter to cretinism. Prevention focuses on universal salt iodization, iodized oil supplementation, monitoring iodine levels, training programs, and increasing public awareness. Controlling iodine deficiency through these measures can eliminate its health impacts across the lifespan.
Iodine deficiency disorder and metabolic syndromeGunJee Gj
Iodine deficiency can cause goiter and impaired brain development. Symptoms include enlargement of the thyroid gland, neurological deficits, and delayed sexual maturation. It is assessed by palpation, ultrasound, and urinary iodine levels. Daily iodine requirements range from 50 μg for infants to 150 μg for those over 12 years old. The metabolic syndrome is defined as abdominal obesity plus two other risk factors and increases the risk of cardiovascular disease and diabetes. It involves central obesity, high triglycerides, low HDL, high blood pressure, and elevated fasting glucose. Lifestyle modifications including diet, exercise, and weight loss are first-line treatment approaches.
Iodine deficiency is a lack of the trace element iodine, an essential nutrient in the diet. It may result in metabolic problems such as goiter, sometimes as an endemic goiter as well as cretinism due to untreated congenital hypothyroidism, which results in developmental delays and other health problems.
Iodine deficiency is a common disorders in developing like Bangladesh. It affects both maternal and child heath. Dietary intake of iodine is necessary to avoid such disorders.
A presentation on Iodine deficiency disorder for women & children in developing country
Learning Objectives:
By the end of the session students will be able
To define iodine deficiency
To define goitrogens
To identify sources of iodine
To list Epidemiological assessment of iodine deficiency
To Name International Iodine Control Strategies
To name Iodine Control Program of Pakistan
PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS & NIDDCPNeyaz Ahmad
This document discusses prevention and control of iodine deficiency disorders (IDD) in India. IDD affects all age groups and can cause goiter, cretinism, mental retardation and other issues. The primary prevention methods include health education, fortifying salt with iodine, and lifestyle changes. India has a national program to control IDD that aims to reduce prevalence below 10% by 2012 through universal access to iodized salt, monitoring programs, and increasing iodization plants. The program's activities, achievements, and levels of intervention from individual to national levels are described.
Iodine deficiency disorder (IDD) refers to health issues caused by inadequate iodine intake, ranging from abortions and stillbirths to mental and physical retardation. Over two billion people worldwide are at risk of IDD, with iodine deficiency being the leading preventable cause of intellectual disabilities. Universal salt iodization, health education, and monitoring programs are recommended to prevent and control IDD.
Iodine deficiency disorders of thyroid glandKarandeep Virk
This document discusses iodine deficiency disorders of the thyroid gland. It describes how low iodine intake can lead to goiter formation as the thyroid attempts to maintain normal thyroid hormone levels. It classifies goiter sizes and discusses the epidemiology of endemic goiter. It also describes how iodine deficiency can cause cretinism and outlines methods for diagnosing iodine deficiency disorders. The document concludes by discussing prevention through iodine supplementation and treatment by ensuring adequate iodine intake through foods like iodized salt.
Iodine deficiency disorders (IDDs) refer to a spectrum of health consequences caused by inadequate iodine intake. Iodine is essential for thyroid hormone production which are important for physical and mental development. IDDs range from goiter and hypothyroidism to severe intellectual disabilities. Nepal has a high prevalence of IDDs affecting an estimated 10 million people. Prevention strategies in Nepal include mandatory iodization of salt at the production level and social marketing campaigns to increase awareness and consumption of adequately iodized salt. Monitoring of iodine levels in salt and urine are also conducted to evaluate IDD control programs.
This document discusses iodine deficiency disorder and endemic goiter. It defines endemic goiter as a type of goiter associated with dietary iodine deficiency, occurring in over 5% of a population. The document outlines iodine needs according to WHO, causes and risk factors of iodine deficiency including low dietary iodine, signs and symptoms like goiter and impaired development, diagnosis including urine iodine levels and thyroid imaging, treatment with iodine supplements or surgery, and prevention through iodized salt and supplements.
This document discusses programs and policies related to iodine deficiency disorders in Nepal. It begins by explaining what iodine is and its importance for human health. It then outlines the spectrum of iodine deficiency disorders and recommended daily intake levels. The main strategies for prevention of iodine deficiency disorders in Nepal include universal salt iodization, distribution of iodized salt in remote areas, and social marketing campaigns to promote iodized salt use. National policies aim to ensure all edible salt is iodized and monitor iodine status through national surveys.
This document discusses iodine deficiency disorders and the importance of iodine for health. It notes that iodine is essential for thyroid hormone production and proper development. Iodine deficiency can cause goiter, cretinism, lower IQ, and other developmental issues. The document advocates for universal salt iodization as a simple and low-cost strategy to eliminate iodine deficiency worldwide. It highlights India's policy from 1983 mandating iodization of all salt for human consumption.
Although the term "iodine-deficiency disorders" (!DD) is of
relatively recent provenance, having been introduced by Dr Basil Hetzel just two years ago, it is a term that very appropriately covers the tragic spectrum of mental and physical disability resulting from an inadequate dietary intake and supply of iodine to the developing brain of the foetus, infant and young child. At the benign end of the spectrum is the widely prevalent and largely cosmetic condition of goitre, while at the opposite end is the relatively uncommon syndrome of cretinism. Between these poles is a range of impaired mental and physical functions of varying severity.
Iodine is an essential trace mineral that is important for thyroid function and overall health. Iodine deficiency can be caused by low dietary intake, high intake of goitrogenic foods, and environmental factors like pesticides. Iodine is crucial for brain and physical development and a lack of iodine can lead to hypothyroidism, goiter, cretinism, and other health issues. Maintaining adequate iodine levels through iodized salt, seafood, or supplements is important for preventing iodine deficiency.
The patient, a 22-year-old female college student, was diagnosed with Graves' disease and hyperthyroidism. She was initially treated with methimazole and metoprolol but wanted a more permanent solution. She chose to undergo a total thyroidectomy. Pre-surgery testing showed her thyroid was diffusely enlarged and hyperfunctioning. She took SSKI prior to surgery to help control her hyperthyroidism and prepare for the thyroidectomy.
World Iodine Deficiency Day is observed annually on October 21st to raise awareness about iodine deficiency, which affects over 740 million people globally. Iodine is essential for human growth and development, but one-third of the world's population is at risk of iodine deficiency disorders due to insufficient iodine intake. Common effects include goiter, intellectual disabilities, hearing and speech problems. India has taken steps such as implementing a universal salt iodization program to address this issue and reduce iodine deficiency disorder rates.
Iodine is an essential mineral needed for normal thyroid function and metabolism. It is found in iodized salt, seafood, dairy, and foods grown in iodine-rich soil. Lack of iodine can cause goiter or hypothyroidism. Two studies in the early 1900s showed that supplementing with iodine reduced goiter rates. While iodized salt provides some iodine, it may not meet daily needs, and iodine levels in the US have dropped 50% in recent decades. Bromine in some foods can interfere with iodine uptake as well. Urine tests can check iodine status.
National iodine deficiency disorder control programmeShan Damrolien
The document discusses India's National Iodine Deficiency Disorder Control Programme. It outlines that iodine is an essential nutrient needed in small amounts daily for thyroid hormone production and optimal growth and development. Iodine deficiency was historically a major public health problem worldwide due to low iodine levels in soil and food sources. India established the National Goiter Control Programme in 1962 and renamed it the National Iodine Deficiency Disorders Control Programme in 1992 to promote universal salt iodization as a means of ensuring daily iodine intake and eliminating iodine deficiency disorders. Surveys show iodized salt consumption has increased significantly nationwide but further efforts are still needed in some states.
The document discusses India's National Iodine Deficiency Disorder Control Programme. It notes that iodine deficiency can cause goiter and other health issues. The programme aims to provide iodized salt to at-risk regions, educate the public, and monitor iodine levels. Key objectives include assessing iodine deficiency, supplying iodized salt, education, and monitoring impacts. The programme was later expanded to promote universal iodized salt consumption and strengthen monitoring.
The document provides information about biochemical and clinical indices used to assess nutritional status and response to nutritional interventions for vitamin A deficiency (VAD) and iodine deficiency disorders (IDD). It discusses indicators used to monitor IDD control programs, including iodine content in salt at different stages of production and distribution, as well as urinary iodine levels and goiter rates in populations. It also outlines indicators used to determine the existence, severity and extent of VAD, such as clinical symptoms, dietary intake, and liver and serum vitamin A concentrations.
Prevention against micronutrient malnutritionHealthXn
Micronutrident disorders are common and a major cause of morbidity in all populations. In this presentation we discuss the importance of iodine, folic acid and vitamin D deficiency. Prevention is the solution
National Iodine Deficiency Disorders Control Programme NIDDCP, 2017Aravind Periyasamy
This document provides an overview of national iodine deficiency disorders control program in India. It discusses that iodine is essential for thyroid hormone production. Over 350 million Indians are at risk of iodine deficiency disorders. The program aims to reduce prevalence below 10% through universal salt iodization, surveys to assess magnitude, and health education. Key activities include iodizing salt, monitoring salt and urine iodine levels, and information campaigns. The program has helped control goiter and improved iodine nutrition, though some areas still face deficiencies.
Iodine deficiency can result from a primary lack of iodine in the diet or secondary causes like high intake of plants containing goitrogens. It occurs most in areas with high rainfall and little ocean influence, where soils are low in iodine. Iodine is part of the thyroid hormone thyroxine, so a deficiency leads to enlarged thyroid glands and stillbirths or weak newborns. Diagnosis involves checking thyroid size, hormone levels, and iodine content of the gland. Treatment requires ensuring newborns suckle and get thyroid supplements or iodine injections, while prevention focuses on adequate iodine in the diets of pregnant and lactating animals.
The impact of maternal and fetal thyroid hormone deficiency: iodine deficienc...HealthXn
Thyroid hormone deficiency at critical periods of brain development may cause permanent mental and neurological disability and impairment. Iodine deficiency is the commonest preventable cause of mental disability
Maternal urinary iodine and pregnancy outcomes in ngargoyoso sub district, ce...Alexander Decker
The study measured urinary iodine levels in 153 pregnant women in Ngargoyoso sub-district, Central Java, Indonesia, a known area of iodine deficiency. Over half (54.3%) of pregnant women were found to be iodine deficient based on urinary iodine levels below 150μg/L. There were 2 abortions (13.1/1000 live births) and 5 stillbirths (32.7/1000 live births) reported. No correlation was found between maternal urinary iodine levels and birthweight. Iodine deficiency appears to be adversely affecting pregnancy outcomes in the area.
PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS & NIDDCPNeyaz Ahmad
This document discusses prevention and control of iodine deficiency disorders (IDD) in India. IDD affects all age groups and can cause goiter, cretinism, mental retardation and other issues. The primary prevention methods include health education, fortifying salt with iodine, and lifestyle changes. India has a national program to control IDD that aims to reduce prevalence below 10% by 2012 through universal access to iodized salt, monitoring programs, and increasing iodization plants. The program's activities, achievements, and levels of intervention from individual to national levels are described.
Iodine deficiency disorder (IDD) refers to health issues caused by inadequate iodine intake, ranging from abortions and stillbirths to mental and physical retardation. Over two billion people worldwide are at risk of IDD, with iodine deficiency being the leading preventable cause of intellectual disabilities. Universal salt iodization, health education, and monitoring programs are recommended to prevent and control IDD.
Iodine deficiency disorders of thyroid glandKarandeep Virk
This document discusses iodine deficiency disorders of the thyroid gland. It describes how low iodine intake can lead to goiter formation as the thyroid attempts to maintain normal thyroid hormone levels. It classifies goiter sizes and discusses the epidemiology of endemic goiter. It also describes how iodine deficiency can cause cretinism and outlines methods for diagnosing iodine deficiency disorders. The document concludes by discussing prevention through iodine supplementation and treatment by ensuring adequate iodine intake through foods like iodized salt.
Iodine deficiency disorders (IDDs) refer to a spectrum of health consequences caused by inadequate iodine intake. Iodine is essential for thyroid hormone production which are important for physical and mental development. IDDs range from goiter and hypothyroidism to severe intellectual disabilities. Nepal has a high prevalence of IDDs affecting an estimated 10 million people. Prevention strategies in Nepal include mandatory iodization of salt at the production level and social marketing campaigns to increase awareness and consumption of adequately iodized salt. Monitoring of iodine levels in salt and urine are also conducted to evaluate IDD control programs.
This document discusses iodine deficiency disorder and endemic goiter. It defines endemic goiter as a type of goiter associated with dietary iodine deficiency, occurring in over 5% of a population. The document outlines iodine needs according to WHO, causes and risk factors of iodine deficiency including low dietary iodine, signs and symptoms like goiter and impaired development, diagnosis including urine iodine levels and thyroid imaging, treatment with iodine supplements or surgery, and prevention through iodized salt and supplements.
This document discusses programs and policies related to iodine deficiency disorders in Nepal. It begins by explaining what iodine is and its importance for human health. It then outlines the spectrum of iodine deficiency disorders and recommended daily intake levels. The main strategies for prevention of iodine deficiency disorders in Nepal include universal salt iodization, distribution of iodized salt in remote areas, and social marketing campaigns to promote iodized salt use. National policies aim to ensure all edible salt is iodized and monitor iodine status through national surveys.
This document discusses iodine deficiency disorders and the importance of iodine for health. It notes that iodine is essential for thyroid hormone production and proper development. Iodine deficiency can cause goiter, cretinism, lower IQ, and other developmental issues. The document advocates for universal salt iodization as a simple and low-cost strategy to eliminate iodine deficiency worldwide. It highlights India's policy from 1983 mandating iodization of all salt for human consumption.
Although the term "iodine-deficiency disorders" (!DD) is of
relatively recent provenance, having been introduced by Dr Basil Hetzel just two years ago, it is a term that very appropriately covers the tragic spectrum of mental and physical disability resulting from an inadequate dietary intake and supply of iodine to the developing brain of the foetus, infant and young child. At the benign end of the spectrum is the widely prevalent and largely cosmetic condition of goitre, while at the opposite end is the relatively uncommon syndrome of cretinism. Between these poles is a range of impaired mental and physical functions of varying severity.
Iodine is an essential trace mineral that is important for thyroid function and overall health. Iodine deficiency can be caused by low dietary intake, high intake of goitrogenic foods, and environmental factors like pesticides. Iodine is crucial for brain and physical development and a lack of iodine can lead to hypothyroidism, goiter, cretinism, and other health issues. Maintaining adequate iodine levels through iodized salt, seafood, or supplements is important for preventing iodine deficiency.
The patient, a 22-year-old female college student, was diagnosed with Graves' disease and hyperthyroidism. She was initially treated with methimazole and metoprolol but wanted a more permanent solution. She chose to undergo a total thyroidectomy. Pre-surgery testing showed her thyroid was diffusely enlarged and hyperfunctioning. She took SSKI prior to surgery to help control her hyperthyroidism and prepare for the thyroidectomy.
World Iodine Deficiency Day is observed annually on October 21st to raise awareness about iodine deficiency, which affects over 740 million people globally. Iodine is essential for human growth and development, but one-third of the world's population is at risk of iodine deficiency disorders due to insufficient iodine intake. Common effects include goiter, intellectual disabilities, hearing and speech problems. India has taken steps such as implementing a universal salt iodization program to address this issue and reduce iodine deficiency disorder rates.
Iodine is an essential mineral needed for normal thyroid function and metabolism. It is found in iodized salt, seafood, dairy, and foods grown in iodine-rich soil. Lack of iodine can cause goiter or hypothyroidism. Two studies in the early 1900s showed that supplementing with iodine reduced goiter rates. While iodized salt provides some iodine, it may not meet daily needs, and iodine levels in the US have dropped 50% in recent decades. Bromine in some foods can interfere with iodine uptake as well. Urine tests can check iodine status.
National iodine deficiency disorder control programmeShan Damrolien
The document discusses India's National Iodine Deficiency Disorder Control Programme. It outlines that iodine is an essential nutrient needed in small amounts daily for thyroid hormone production and optimal growth and development. Iodine deficiency was historically a major public health problem worldwide due to low iodine levels in soil and food sources. India established the National Goiter Control Programme in 1962 and renamed it the National Iodine Deficiency Disorders Control Programme in 1992 to promote universal salt iodization as a means of ensuring daily iodine intake and eliminating iodine deficiency disorders. Surveys show iodized salt consumption has increased significantly nationwide but further efforts are still needed in some states.
The document discusses India's National Iodine Deficiency Disorder Control Programme. It notes that iodine deficiency can cause goiter and other health issues. The programme aims to provide iodized salt to at-risk regions, educate the public, and monitor iodine levels. Key objectives include assessing iodine deficiency, supplying iodized salt, education, and monitoring impacts. The programme was later expanded to promote universal iodized salt consumption and strengthen monitoring.
The document provides information about biochemical and clinical indices used to assess nutritional status and response to nutritional interventions for vitamin A deficiency (VAD) and iodine deficiency disorders (IDD). It discusses indicators used to monitor IDD control programs, including iodine content in salt at different stages of production and distribution, as well as urinary iodine levels and goiter rates in populations. It also outlines indicators used to determine the existence, severity and extent of VAD, such as clinical symptoms, dietary intake, and liver and serum vitamin A concentrations.
Prevention against micronutrient malnutritionHealthXn
Micronutrident disorders are common and a major cause of morbidity in all populations. In this presentation we discuss the importance of iodine, folic acid and vitamin D deficiency. Prevention is the solution
National Iodine Deficiency Disorders Control Programme NIDDCP, 2017Aravind Periyasamy
This document provides an overview of national iodine deficiency disorders control program in India. It discusses that iodine is essential for thyroid hormone production. Over 350 million Indians are at risk of iodine deficiency disorders. The program aims to reduce prevalence below 10% through universal salt iodization, surveys to assess magnitude, and health education. Key activities include iodizing salt, monitoring salt and urine iodine levels, and information campaigns. The program has helped control goiter and improved iodine nutrition, though some areas still face deficiencies.
Iodine deficiency can result from a primary lack of iodine in the diet or secondary causes like high intake of plants containing goitrogens. It occurs most in areas with high rainfall and little ocean influence, where soils are low in iodine. Iodine is part of the thyroid hormone thyroxine, so a deficiency leads to enlarged thyroid glands and stillbirths or weak newborns. Diagnosis involves checking thyroid size, hormone levels, and iodine content of the gland. Treatment requires ensuring newborns suckle and get thyroid supplements or iodine injections, while prevention focuses on adequate iodine in the diets of pregnant and lactating animals.
The impact of maternal and fetal thyroid hormone deficiency: iodine deficienc...HealthXn
Thyroid hormone deficiency at critical periods of brain development may cause permanent mental and neurological disability and impairment. Iodine deficiency is the commonest preventable cause of mental disability
Maternal urinary iodine and pregnancy outcomes in ngargoyoso sub district, ce...Alexander Decker
The study measured urinary iodine levels in 153 pregnant women in Ngargoyoso sub-district, Central Java, Indonesia, a known area of iodine deficiency. Over half (54.3%) of pregnant women were found to be iodine deficient based on urinary iodine levels below 150μg/L. There were 2 abortions (13.1/1000 live births) and 5 stillbirths (32.7/1000 live births) reported. No correlation was found between maternal urinary iodine levels and birthweight. Iodine deficiency appears to be adversely affecting pregnancy outcomes in the area.
The document discusses various topics related to brain health and trauma, including:
- The human brain contains hundreds of billions of neurons and synaptic connections that can process information rapidly.
- Trauma and certain disorders can cause permanent changes to brain structure and function, including conditions like Alzheimer's, Parkinson's, depression, and post-traumatic stress.
- The hippocampus plays a role in many functions including pleasure, rage, emotions, and is involved in mood disorders like depression and bipolar disorder. It has been found to be smaller in people with these conditions.
- Repeated head injuries increase the risk of chronic traumatic encephalopathy, while injuries to the upper neck can cause symptoms of multiple sclerosis and Parkinson's disease
Iodine is a non-metallic, violet colored halogen element with an atomic number of 53. It was discovered in 1811 in France by Bernard Courtois and gets its name from the Greek word "Iodes." Iodine naturally occurs in brines, Chilean nitrate deposits, and is found in trace amounts in the universe, sun, meteorites, crustal rocks, sea water, fresh water, and humans. Its main uses are in medicine, disinfectants, photography, and salt.
Hormones are chemical messengers that are secreted by endocrine glands directly into the bloodstream and have effects at low concentrations throughout the body. There are two main types of hormone receptors: steroid hormones bind to receptors in the cell cytoplasm and form complexes that enter the nucleus and affect gene transcription, while peptide hormones bind to receptors in the plasma membrane and activate intracellular second messenger systems. The hypothalamus controls hormone secretion from the pituitary gland which regulates growth, development, reproduction and homeostasis. Some athletes improperly use growth hormones in attempts to build muscle mass despite health risks.
Pheochromocytoma is a rare tumor that develops on the adrenal glands or nearby abdominal tissues. It causes the overproduction of hormones like epinephrine and norepinephrine. Pheochromocytomas can be benign or malignant. They most commonly affect humans in adulthood but can occur in dogs over 7 years old as well. Symptoms include high blood pressure, headaches, sweating, and abdominal or chest pain. Diagnosis involves tests like CT scans, MRI scans, urine/blood tests and biopsies. Treatment is usually surgical removal followed by medication to control hormone levels, with about a 10% recurrence rate.
A 35-year-old man presented with increasing headaches, palpitations, anxiety, and panic attacks over the past six months. His history and examination were consistent with possible conditions including anxiety disorders, hyperthyroidism, and pheochromocytoma. Pheochromocytoma was considered the most likely diagnosis given the classic signs and symptoms. Pheochromocytomas are rare catecholamine-secreting tumors that typically arise from the adrenal medulla or sympathetic ganglia. Diagnostic testing revealed elevated levels of catecholamines and metanephrines confirming the diagnosis of a pheochromocytoma. The patient was started on alpha- and beta-blockers in preparation for surgical removal of the tumor.
NATIONAL IODINE DEFICIENCY DISORDER CONTROL PROGRAMpramod kumar
The document discusses India's National Iodine Deficiency Disorder Control Program. Key points:
- Iodine deficiency can cause developmental issues and goiter. India launched the program in 1962 to distribute iodated salt to populations at risk.
- Over 350 million people in India are at risk of iodine deficiency. The program aims to reduce prevalence of disorders to below 10% by 2012 through iodated salt distribution, education, and monitoring.
- It is implemented through central coordination and state-level cells. Achievements include banning non-iodated salt, establishing quality standards, and expanding production and distribution of iodated salt nationwide.
Iodine Deficiency Symptoms - 20 Iodine Rich Foods to avoid Iodine Deficiency Symptoms
http://iodinedeficiencysymptoms.org/
Since the introduction of iodized salt in the 90's, cases of iodine deficiency have went down considerably. However, findings reveal that thyroid problems are set to increase over the years because many people are opting for natural salts that doesn't contain iodine in their meals and diets. Before you dash off to your neighborhood health stores to buy some iodine supplements, do a simple self check to see whether you are deficient in iodine by taking the following steps:
1) Begin by feeling the front of your neck and check out whether is it swollen or feeling painful when you gently press it. One of the most common symptoms of people who are seriously deficient in iodine has an enlarged thyroid gland and it can be fairly obvious because it's protruding out. Also called a goiter, this kind of swelling happens frequently to population in Asian countries where the soil is already depleted of iodine and iodized salt is not common there.
2) Monitor for any difficulty in swallowing food for 1 week because there are some cases where the swollen goiter protrudes inwards instead of outwards. It presses against the esophagus, causing a slight obstruction when you try to swallow anything.
3) You should check out the sound of your breathing especially you are resting on the bed. The pressure on the windpipe caused by the swollen thyroid gland can result in noisier breathing patterns and even snoring at night. Sometimes you can feel that there's something in your throat that you want to cough out but you just can't.
4) People who are deficient in iodine often experiences muscle fatigue, depression, intolerance to cold and always feeling tired. There are some cases when some people also experience a thinning of skin around eyebrows.
5) The most accurate way is to probably just go for a thyroid scan by your doctor to determine whether the swelling is caused by the swollen thyroid gland or something else. If it really is a swollen gland, a biopsy test will further confirm your deficiency in iodine.
Iodine Deficiency Symptoms - 20 Iodine Rich Foods to avoid Iodine Deficiency Symptoms
http://iodinedeficiencysymptoms.org/
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Pheochromocytoma is a catecholamine-producing tumor that arises from chromaffin cells of the sympathetic nervous system. It occurs in about 0.1-0.2% of hypertensive patients and can cause paroxysmal or sustained hypertension. Diagnosis involves measuring catecholamines or metanephrines in plasma or urine, which are elevated in most patients. Localization is typically done with CT or MRI imaging. Treatment involves pre-operative alpha-blockade to prevent hypertensive crises during tumor removal, followed by beta-blockers if needed. Complete surgical removal can cure patients if the tumor is benign.
Iodine is essential for thyroid hormone production and is obtained through foods like seaweed and seafood or iodized salt. Iodine deficiency can cause goiter and irreversible intellectual and growth impairments while excess iodine can inhibit the thyroid. Various indicators are used to assess iodine status including urinary iodine and thyroid size. Iodine interacts with medications for hyperthyroidism and high blood pressure and deficiencies in selenium or vitamins A, E, zinc and iron can exacerbate effects of iodine deficiency.
The document discusses a plan to increase awareness of iodine deficiency and promote the use of iodized salt in rural India. It notes that many people in India suffer from iodine deficiency and consume non-iodized salt. The plan has four phases: identifying key rural areas with iodine deficiency issues, gathering promoters and essential materials, using edutainment to educate people on iodine and encourage salt purchases, and repeating communication efforts over time using appropriate local media. The goal is to ultimately improve health and reduce iodine deficiency disorders in rural India.
This document discusses the diagnosis and management of pheochromocytoma. Key points include:
- Pheochromocytomas are rare catecholamine-secreting tumors that can cause hypertension. Diagnosis involves measuring plasma or urine metanephrines and imaging tests.
- Preoperative management aims to control blood pressure and prevent hypertensive crises during surgery. This involves alpha-blockade using drugs like phenoxybenzamine for 1-2 weeks before surgery.
- Surgery is the main treatment and involves an experienced multidisciplinary team. For inoperable or malignant tumors, nuclear medicine treatments or lifelong medical management may be used. Close postoperative monitoring is important.
This document summarizes an upcoming medical conference on iodine supplementation. It discusses the history of iodine use, current iodine deficiency issues, and conditions that may be helped by iodine. Key points include that an estimated 95% of individuals are iodine deficient; bromine competes with iodine uptake; and iodine may help conditions like fibrocystic breast disease, thyroid disorders, and detoxification.
The document discusses iodine deficiency disorder (IDD) and its causes, symptoms, diagnosis, and prevention. The key points are:
1. IDD is caused by insufficient iodine intake and results in goiter (enlarged thyroid gland) and hypothyroidism. Left untreated, it can cause intellectual and developmental disabilities.
2. Symptoms of IDD include neck swelling, squinting, poor growth, and mental retardation. Diagnosis involves examining for goiter and testing thyroid and iodine levels.
3. Prevention strategies include universal salt iodization programs, nutrition education, and monitoring iodine levels in communities through regular surveys. Proper iodine intake is essential during
Iodine is an important nutrient for brain and thyroid health. Iodine deficiency has become a significant problem in Australia, leading to reduced IQ scores and increased rates of thyroid cancer and developmental delays. Universal salt iodization is recommended as the best strategy to address iodine deficiency, as iodized salt provides effective population coverage and is a cheap and simple solution.
Assessment of Iodine Levels of Secondary Schools Girls in Sokoto State, NigeriaPremier Publishers
Urinary iodine excretion is a good marker of dietary iodine intake and is the index for evaluating the degree of iodine deficiency, correction and toxicity. Studies on urinary iodine excretion level in school girls of Sokoto State are scanty. Multi-stage sampling procedure was adopted to determine current iodine status in 246 school girls in three zones of Sokoto State, Nigeria aged 14 - 17 years. Urinary iodine level was measured using the standard method of ammonium persulphate reaction. Thyroid Stimulating Hormones (TSH), Triiodothyronine (T3) and thyroxine (T4) were measured using Competitive Enzyme linked Immunoassay. Validated questionnaires were used to test the knowledge of iodine nutrition among the respondents. World Health Organization and International Council for the Control of Iodine Deficiency Disorders recommendations were used to classify the urinary iodine levels. The results show that of the 246 school girls studied, 49 (20%) had mild iodine deficiency 37 (15%) had moderate iodine deficiency, 156 (63%) had adequate status and 5 (2%) had above normal urinary iodine excretion level. These findings suggest that 86 (35%) of the study subjects were iodine deficient. Measures should therefore, be taken to improve iodine nutrition in the study area to avoid functional and developmental abnormalities.
This document discusses trace elements and microminerals that are essential for human nutrition. It defines trace elements as minerals needed in small amounts like iron, iodine, fluorine, zinc and copper. It outlines the functions, dietary requirements and sources of these key microminerals. It further describes deficiencies that can arise from inadequate intake of minerals like iron-deficiency anemia and iodine deficiency disorders. The document concludes with highlighting national programs in place for prevention and control of micromineral deficiencies in populations.
The document discusses Phenylketonuria (PKU) and congenital hypothyroidism. PKU is an inherited disorder that prevents the breakdown of phenylalanine. It can cause intellectual disabilities if not treated through a phenylalanine-restricted diet. Congenital hypothyroidism is caused by thyroid gland issues present at birth and can lead to developmental delays without thyroid hormone treatment. Both conditions are screened for at birth through blood tests and require lifelong management through specialized diets or thyroid hormone supplementation.
I am Dr Pendo Chaula, a senior resident at University of Dodoma in Tanzania. I am working at UDOM affiliated hospitals which are Benjamin Mkapa hospital, UDOM hospital, Dodoma regional referral hospital and Iringa regional referral Hospital. Am posting it for learning purpose, you can download it if you like it
Iodine supplementation into drinking water improved intelligence of preschool...Alexander Decker
This randomized controlled trial tested the effects of iodine supplementation through drinking water on 67 preschool children aged 25-59 months in an iodine-deficient area of Central Java, Indonesia. Children received either 100 μg of iodine per day or a placebo for 12 weeks. Urinary iodine levels and intelligence scores were measured before and after the intervention. The results showed that urinary iodine levels significantly increased and intelligence scores significantly improved in the treatment group compared to the control group, demonstrating that iodine supplementation through drinking water can effectively increase urinary iodine and intelligence in preschool children living in iodine-deficient areas.
This document discusses obesity in India from the perspective of experts Dr. Anoop Misra and Dr. Seema Gulati. It presents data showing rising rates of overweight and obesity among Indian adolescents. It dispels common myths about obesity, noting that excess weight in childhood often leads to health issues like diabetes and heart disease. While obesity was once seen as a problem only of developed nations, the data shows its growing prevalence in India and other developing areas. The experts attribute this to unhealthy diets high in processed foods and low physical activity levels among Indian youth. They call for initiatives to increase awareness about obesity prevention and healthy lifestyles.
Iodine is an essential trace element needed to synthesize thyroid hormones. Nearly 80% of iodine in the body is stored in the thyroid gland. Iodine is absorbed from dietary sources like iodized salt and is transported to the thyroid via sodium/iodide symporters, where it is used to produce thyroid hormones that regulate growth, metabolism and brain development. Iodine deficiency can cause a spectrum of disorders and remains a public health issue in many parts of the world including India, where programs aim to ensure adequate iodine intake through universal salt iodization and health education.
This document discusses nutrition and health issues related to teenagers aged 12-18. It notes that nutritional requirements are high during this period of rapid growth and development. Dietary recommendations encourage consumption of fruits/veggies, proteins, grains and dairy. However, surveys find average intakes among teens fall short of recommendations, with low fiber, iron, calcium and high saturated fat, sugar and salt. Maintaining good nutrition is important for health, cognitive ability and behavior. Eating disorders like anorexia and bulimia can impact both physical and mental health if left untreated.
Nutrition and health: Suboptimal thiamin status is common in Cambodian women ...IFSD14
The document summarizes a study investigating suboptimal thiamin status in Cambodian women of childbearing age. The study found high rates of thiamin deficiency in rural Cambodian women. To address this, researchers propose a randomized controlled trial to develop a thiamin-fortified fish sauce for consumption by women. The trial would compare different levels of thiamin fortification to a placebo, with the goal of increasing thiamin levels and reducing the risk of infantile beriberi, a condition caused by maternal thiamin deficiency. The fortified fish sauce, if successful, could potentially be scaled up across Cambodia.
Dr William Barnes - The case for Iodine SupplementationDr William Barnes
Dr William Barnes MbchB Bsc FACNEM 2010
Iodine is essential for normal thyroid function. There is a growing incidence of iodine deficiency in the general population. This can lead to loss of cognitive function in children and thyroid disease in adults.
Pregnant women are at a higher risk of iodine deficiency, because they excrete more iodine and have a higher demand for thyroid enzymes both for themselves and the fetus.
There is an association between thyroid disease and breast disorders.
Supplementation is recommended when the daily intake of iodine is less than 100 mcg / day.
This document discusses birth defects as an upcoming public health problem in Bangladesh. It notes that while overall child mortality has decreased, the impact of congenital malformations has increased due to a lack of prevention strategies and limitations in management. Bangladesh faces various risk factors for birth defects, including high fertility rates and practices like consanguineous marriage. The document estimates that globally about 4.8 million infants are born with birth defects each year, and birth defects are one of the leading causes of neonatal death in Bangladesh. It discusses challenges in addressing birth defects and the need for strategies like fortification of staple foods with folic acid, as well as developing resources and infrastructure to better define, collect data on, prevent, and manage birth defects
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
Nutrition for children and adolescents with chronic kidney diseaseFarragBahbah
This document discusses nutrition for children with chronic kidney disease. It outlines the importance of nutritional assessment and monitoring growth parameters like height and weight at least twice as frequently for these children compared to healthy children. The goals of nutrition management are to maintain optimal nutrition status, avoid uremic toxicity, and reduce risk of chronic issues. Causes of poor nutritional status in these children include reduced appetite and intake due to various factors. The document recommends individualizing nutritional intervention based on an assessment of each child's needs, age, and preferences. Energy needs should be 100% of estimated needs based on age and activity level.
The document summarizes a study on the feeding habits and nutritional status of young children and mothers in cocoa producing households in southwest Côte d'Ivoire. The study found that dietary diversity was low, with 80% of women and 94% of children consuming less than 3 food groups. Chronic malnutrition rates in children were high at 48.7% while 35.4% of households experienced food insecurity. The conclusions recommend adopting sustainable food production systems to address malnutrition and food insecurity in the region.
Can snacking really be good for today’s teens? - Vitafoods Europe 2016Nutrition & Biosciences
The Life Stages Theater presentation at Vitafoods Europe 2016 by Garry J. Mendelson, PhD, Applied Nutrition Science Manager, DuPont Nutrition & Health.
A 42-year-old woman presents with a solitary thyroid nodule. Physical examination revealed a mobile nodule measuring 2 by 3 cm without lymphadenopathy. Initial workup should include laboratory tests such as TSH, ultrasound of the thyroid, and ultrasound-guided fine needle aspiration of the nodule. The majority of thyroid nodules are benign, and fine needle aspiration is the most accurate way to determine if surgical intervention is needed. Iodine deficiency, which can cause goiter or hypothyroidism, is also a common cause of thyroid nodules in some regions and can be prevented by adequate iodine intake through diet.
Dietary fortification of sorghum ogi using crayfish (paranephrops planifrons)...Alexander Decker
This document discusses fortifying sorghum-ogi (a weaning food made from sorghum) with crayfish to improve its nutritional value for infants. Sorghum-ogi on its own lacks sufficient protein, fat, vitamins and minerals for infant nutrition. The study mixed sorghum-ogi with 10-50% crayfish by weight in three formulations: soaked sorghum with unroasted crayfish; roasted sorghum with roasted crayfish; and unroasted sorghum with unroasted crayfish. Analysis found the blends had higher protein and fat contents with more crayfish added. Taste tests showed the roasted sorghum with roasted crayfish formulation
This document summarizes research on the evolution of diagnostics and therapeutics for pediatric non-alcoholic fatty liver disease (NAFLD). It discusses how diagnostics have advanced from relying solely on liver biopsy to also considering proteomic biomarkers and developing non-invasive tests. For therapeutics, it describes past clinical trials that found vitamin E improved liver histology in children with NASH, while a recent trial of cysteamine found it reduced liver enzymes but did not significantly improve histology. Overall, the document outlines progress in understanding pediatric NAFLD and developing improved diagnostics and treatments.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
7. Effect Size of Iodine Interventions on IQ
performance, 37 Studies in China, 1984 - 1993:
Case-control studies with 12,291 children
0
St Dev IQ Points
A
B
C
-0.5
-1
Group A: ID areas, no iodine intervention
Group B: ID areas, uncontrolled iodized salt
Group C: ID areas, iodine supplements @ pregnancy or birth
Ming Qian et al, Asia-Pacific J Clin Nutr 2005
10. In the thyroid gland, iodide uptake and
thyroid hormone production is regulated by
TSH (thyrotropin) from the pituitary gland
Iodide is an essential ingredient for the
thyroid gland to make thyroid hormone
The thyroid gland secretes two types of
thyroid hormone into the blood: T4 and T3
In the blood stream, T4 and T3 are carried
by binding proteins
T4 is converted to T3 by deiodinase
enzymes active in the blood circulation and
in the tissue cells
The active thyroid hormone at the nuclear
receptor is T3
11. T4
T4 is the precursor hormone
The blood and the tissues have inner
and outer ring deiodinase enzymes
T3
rT3
The activity of the deiodinase
enzymes vary from tissue to tissue
rT3 is inactive
T3 is the active thyroid hormone at
the nuclear receptor
Inner ring deiodinase
Outer ring deiodinase
12.
13. Developing Brain needs normal levels of circulating T4
T4
from child
from mother
cochlea
Myelination
Cerebral cortex
Subarachnoid pathways
Corpus callosum
Cerebellum
Eye
Dentate of hippocampus
Face
0
1
2
3
4
5
6
7
8
Birth
16. Problem Statement
There is widespread iodine deficiency
of the common diet
•
One-half to two-thirds of the world population at risk
In affected populations, goiter and
cretinism in a few co-exist with
cognitive deficits in all
•
In populations where >5% of schoolchildren have
goiter, cognitive performance in apparently healthy
individuals is diminished by approx. 10-15 IQ points
18. Households Consuming Iodized Salt
Bangladesh
Percent
100
Bolivia
Central African Rep.
90
Chad
Chile
80
China
Congo Dem. Rep.
70
Ecuador
Ghana
Guatemala
60
Indonesia
Iran
50
Jordan
Kazakhstan
40
Lao PDR
Madagascar
30
Mexico
Myanmar
Nicaragua
20
Oman
Paraguay
10
Syria
Togo
0
1991
Unicef data
1992
1993
1994
1995
1996
1997
1998
1999
Year
2000
Uzbekistan
Viet Nam
Yemen
19. Year 2000: Household Salt Iodized
Percent 0
10
20
E/S Africa
W/C Africa
M East/N Africa
S Asia
E Asia/Pacific
C/S America
E Europe/CIS/B
Unicef data
Other
unknown
30
40
50
60
70
80
90 100
20. Changes in HH use of iodized salt, 2001-2006
0
20
40
60
80
100
E/S Africa
W/C Africa
M East/N Africa
2001
S Asia
2006
E Asia/Pacific
C/S America
E Europe/CIS/B
Source: ChildInfo.org
21. Global monitoring of household salt iodization
shows continuous progress in USI
Source: ChildInfo.org
23. Keys to Success
• Salt is not produced or
Realizing the
distributed by
roles and
governments, agencies or
responsibilities
health experts
of major
• A regulation and standard
are helpful in providing the
participating
legal framework
actors
• Agencies and academic
groups must be supportive
26. Cognitive Achievement Albania
Effect Size (Mean, 95% CI)
-2
0
2
4
6
8
Raven's Matrices
Bead threading
Rapid target marking
Digit span forward
Digit span backward
Symbol search
Coding
Rapid object naming
Correction of iodine deficiency in moderately deficient Albanian children was
followed by improvements in 50% of cognitive and motor scores
27. Cognitive Achievement N Zealand
•
•
•
•
Mild iodine deficiency
184 school children, 10-13y, 28 weeks, random allocation
Daily tablets containing either 150µg iodine (KIO3) or placebo
Cognitive tests at baseline and follow-up
Urinary iodine concentrations
Serum thyroglobulin concentrations
200
20
P<0.001
P<0.001
P<0.001
15
100
P<0.001
µg Tg/Liter
µg iodine/Liter
150
Baseline
10
50
5
0
Follow-up
0
iodine
Gordon et al, AJCN 2009
placebo
P<0.001
iodine
placebo
P<0.001
28. Cognitive Achievement N Zealand
Effect Size (SD Units)
-0.25
0
0.25
0.5
0.75
Picture Concepts
Matrix Reasoning
Symbol Search
Letter-number Sequencing
Overall Cognitive Score
Correction of iodine deficiency in mildly deficient NZ children was followed by
improvements in overall cognitive performance based on four tests applied
29. School Attainment Tanzania
Severely affected districts in Tanzania that benefitted of mass
oral iodized oil capsule distributions during 1986 - 1992
Assey et al, Public Health Nutrition 2007
30. School Attainment Tanzania
• Tanzania Household Budget Survey, 2000
• Schooling accomplishments of 10-13y old children
• 22,178 households, 25.1% in beneficiary districts
• Analysis adjusted for household wealth, age of
school enrolment, distance to school, etc
• Separate analyses by gender
The children born to mothers who were supplemented
had accomplished 0.36-0.51 more years of education than
their siblings from other districts and than younger and
older children from their own districts
Field at al, Am Econ J Appl Econ 2009
31. Child Cognition, United Kingdom
• A longitudinal observational study in Avon, UK
• Enrolled 14,541 Pregnant Women in their 1st
trimester during 04/1991 to 12/1992
• Selection of 1,040 singleton women who had
volunteered a urine sample
• Offspring had cognitive tests at age 8 and 9
• Classified the maternal iodine status by urinary
iodine measurement
Bath et al. Lancet 2013
32. Sub-optimum cognitive outcomes by
maternal iodine status (unadjusted)
Urinary iodine-to-creatinine ratio
<150µg/g
≥150µg/g
IQ at age 8y
Verbal
Performance
Total
Reading at age 9y
Words read per minute
Accuracy
Comprehension
Reading score
p-value
186/646 (29%)
184/646 (28%)
177/646 (27%)
61/312 (20%)
70/312 (22%)
65/312 (21%)
0.002
0.05
0.03
170/161 (28%)
178/612 (29%)
182/612 (30%)
164/618 (27%)
62/293 (21%)
55/283 (19%)
62/293 (21%)
54/293 (18%)
0.03
0.001
0.007
0.007
Suboptimum = Scores in the bottom quartile
Bath et al. Lancet 2013
33. Risks of sub-optimum outcomes in the
offspring according to maternal iodine status
Unadjusted
OR (95% CI)
p-value
Adjusted
OR (95% CI)
p-value
1.66 (1.20-2.31) 0.002
1.38 (1.00-1.89) 0.05
1.43 (1.04-1.98) 0.03
1.58 (1.09-2.30) 0.02
1.22 (0.86-1.72) 0.27
1.35 (0.93-1.94) 0.11
1.44 (1.03-2.00)
1.78 (1.26-2.50)
1.58 (1.13-2.19)
1.60 (1.13-2.26)
1.20 (0.83-1.74)
1.69 (1.15-2.49)
1.54 (1.06-2.23)
1.47 (1.00-2.16)
IQ at age 8y
Verbal
Performance
Total
Reading at age 9y
Words read per minute
Accuracy
Comprehension
Reading score
Suboptimum = Scores in the bottom quartile
Bath et al. Lancet 2013
0.03
0.001
0.007
0.008
0.33
0.007
0.02
0.05
34. Elimination of IDD through Salt
Iodization
Progress made in CEE/CIS
2000 - 2009
Food Nutr Bull Supplement Dec 2011
35. Sample of 20 Post-Soviet Countries
Balkan Area
CIS Area
1.
2.
3.
4.
5.
6.
7.
8.
9. Armenia
10. Azerbaijan
11. Belarus
12. Georgia
13. Kazakhstan
14. Kyrgyz Republic
15. Moldova
16. Russian Federation
17. Tajikistan
18. Turkmenistan
19. Ukraine
20. Uzbekistan
Albania
Bosnia & Herzegovina
Bulgaria
Kosovo
Macedonia
Montenegro
Romania
Serbia
40. Armenia
FRY Macedonia
Bulgaria
Kazakhstan
Georgia
Turkmenistan
Bosnia and Herzegovina
Romania
Kosovo
Turkey
Albania
Moldova
Tajikistan
Uzbekistan
Azerbaijan
Kyrgyz Republic
Belarus
Russian Federation
Serbia
Ukraine
Montenegro
Percent of households
2009: CEE/CIS Household use of iodized salt
100
90
90%
80
70
60
50
1-14 mg/kg
40
≥ 15mg/kg
30
20
10
0
41. USI Attainment in South-East Europe and the
Commonwealth of Independent States, 2000-2009
100%
4 more countries attained USI
90%
Proportion of countries
80%
2 more are close to the goal
70%
Coverage
>90
70-89
50-69
20-49
<20
4 more have coverage of 50-69%
60%
50%
40%
The number of countries with
coverage <50% fell by 8
30%
20%
10%
0%
± 2000
± 2010
42. 350
Urinary Iodine Concentrations in
School-age Children
Balkan Area
CIS Area
300
250
200
150
100
50
0
BUL
300
MAC
ROM
BiH
ALB
MON
SER
KOS
TUR
ARM
GEO
BEL
MOL
AZE
and in Pregnant Women
Balkan Area
KYR
TAJ
CIS Area
250
200
150
100
50
0
BUL
MAC
ROM
ALB
MON
SER
BiH
KOS
UKR*
KAZ*
* Reproductive-age women
AZE
KYR
TAJ
43. Importance of Proper Strategy Focus
Regulation
Attainment by the
end of the decade
N
Successful
countries
All food-grade
salt
Household salt
only
9
9
0
Countries nearly
successful
6
3
3
With continued
deficiency
5*
0
3
* No mandatory legislation in Russian Federation and Ukraine
44. Importance of Proper Regulation:
Fortificant type and Standards
Details of Regulations
Date enacted Focus
Fortificant
Standard
Outcome
Romania
1993
HH salt only
KI and KIO3
15 to 25
Near success
Serbia
1993
True USI
KI and KIO3
12 to 18
Near success
Montenegro
2002
True USI
KI and KIO3
12 to 18
Near success
Bulgaria
2001
True USI
Only KIO3
17 to 33
Successful
Kosovo
2007
True USI
Only KIO3
18 to 23
Successful
2001, 2005
True USI
KI and KIO3
20 to 30
Successful
Macedonia
1999
True USI
Only KIO3
20 to 30
Successful
Albania
2008
True USI
Only KIO3
25
Too early to say
Bosnia & Herz
45. Lessons for Policy & Program Management
•
•
•
•
•
•
•
•
•
Joint, positive advocacy by stakeholders is essential
Legislation/regulation alone is not sufficient
Address all edible (food grade) salt supplies, and
Set proper, adequate iodization standards
Participate in oversight for managing of progress
Develop systemic capacity in small salt factories
Promote public acceptance of the strategy
Prepare for opposing opinions or negative publicity
Monitor both iodine exposures & iodine outcomes
The “inside-out” gradient of the cortex is established by newly formed neurons migrating farther as development proceeds: later-born neurons migrate past early-born neurons to form six layers – a process known as lamination. After formation at the basal lamina (BL), newly formed neurons migrate along scaffolds established by radial glia (RG), which extend through the successive layers through to layer I on top. Specialized neurons in layer I produce and secrete reelin, a protein involved in terminating the migration of new neurons as they climb the scaffold and reach their normal destination.In the developing cortex, thyroid hormone is also needed for normal neuronal migration. In rats born to dams with moderately low thyroid hormone, many neurons do not migrate to their normal destination, providing an explanation for the reduced cognition observed in individuals living in iodine deficient areas. Moreover, the action of thyroid hormone in this migration occurs during early fetal development. This type of “damage of iodine deficiency” is structural and cannot be reversed by correcting iodine deficiency later in life.
Time gap between enactment of legislation and achievement of universal coverage/optimum iodine nutrition is approx. 4-5 years.