Vitamin B12- definition, functions, absorption, storage, transportation, deficiency, pernicious anemia, relationship between vitamin B12 and folate deficiency, sign & symptoms, deficiency in case of maternal & child health care, RDA, sources, prevention and treatment.
Vitamin B12- Chemistry, functions and clinical significanceNamrata Chhabra
Vitamin B12- Chemical structure, Forms of B12, Sources, absorption, storage, transportation, metabolic role, deficiency, megaloblastic anemia and neurological changes, laboratory diagnosis and treatment
Information about megaloblastic anemia and it's etiology and its classification.
Vitmain b12 deficiencies
Folic acid deficiencies
Signs and symptoms of megaloblastic anemia
Neural tube defects
Vitamin B12- definition, functions, absorption, storage, transportation, deficiency, pernicious anemia, relationship between vitamin B12 and folate deficiency, sign & symptoms, deficiency in case of maternal & child health care, RDA, sources, prevention and treatment.
Vitamin B12- Chemistry, functions and clinical significanceNamrata Chhabra
Vitamin B12- Chemical structure, Forms of B12, Sources, absorption, storage, transportation, metabolic role, deficiency, megaloblastic anemia and neurological changes, laboratory diagnosis and treatment
Information about megaloblastic anemia and it's etiology and its classification.
Vitmain b12 deficiencies
Folic acid deficiencies
Signs and symptoms of megaloblastic anemia
Neural tube defects
Megaloblastic anaemia is a type of anaemia characterized by the formation of unusually large, abnormal and immature red blood cells called as megaloblasts by the bone marrow, which are released into the blood. To know more visit here: www.lazoi.com
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
Megaloblastic anaemia is a type of anaemia characterized by the formation of unusually large, abnormal and immature red blood cells called as megaloblasts by the bone marrow, which are released into the blood. To know more visit here: www.lazoi.com
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
Mistry Shivangi, M.pharm in Pharmacology, Assistant Professor in BMCP, Definition, Difference between COPD and Asthma, Causes, Pathophysiology, symptoms, Complication, Diagnosis, Treatment and Pro-diagnosis
Mistry Shivangi, M.pharm in Pharmacology, Assitant professor in Bhagwan Mahavir College of PHarmacy. definition, epidermiology, etiology, symptoms, pathophysiology and treatment....
Mistry shivangi, M.pharm in Pharmacology, Assistance professor in Bhagwan mahavir college of pharmacy, introduction, epidermiology, etiology, pathophysiology, treatment
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Basic principles of cell injury and adaptationshivangimistry3
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The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
3. definition
• The megaloblastic anaemias are macrocytic anaemias
(raised MCV).
• There is an abnormality in the maturation of
haematopoietic cells in the bone marrow.
• In addition to abnormal red cells the white cells and
platelets may be affected.
• The two major causes are folate deficiency and vitamin B12
deficiency.
• Pernicious anaemia is a specific disease caused by
malabsorption of vitamin B12. 3
4. Epidermiology
A. Folate deficiency anaemia
• Much of the world's population has a marginal dietary
intake of folate.
• Body stores are low, and as soon as there is a decrease in
dietary intake or there is increased folate demand,
deficiency readily occurs.
4
5. B. Vitamin B12 deficiency anaemia
• Strict vegans, for example Hindus, commonly have low
vitamin B12, levels due to their dietary deficiency though
actual anaemia is rarer.
• All patients who have had a total gastrectomy and 6%
of those with a partial gastrectomy will develop vitamin
B12 deficiency anaemia.
5
6. C. Pernicious anaemia
• Pernicious anaemia (reduced vitamin B12 absorption due
to a lack of intrinsic factor) is found most commonly in
people of Northern European descent.
• In Britain the incidence is about 120 per 100 000, being
higher in Scotland than in the south of England.
• Pernicious anaemia is usually a disease of the elderly, the
average patient presenting at 60 years of age.
6
7. aetiology
A. Folate deficiency anaemia
• Fruit, green vegetables and yeast all contain
relatively large amounts of folate.
• Despite this relative abundance of folate in many
foods, dietary deficiency is common, either as the
sole cause of the folic acid deficiency anaemia or
in conjunction with increased folate utilization.
7
8. B. Vitamin B12 deficiency anaemia
• Deficiency occurs from inadequate intake or
malabsorption.
• The only dietary source of vitamin B12 (cyanocobalamin)
is from food of animal origin. It is present in meat, fish,
eggs, cheese and milk.
• Daily requirements are between 1 and 3 micrograms.
• Deficiency arises either from inadequate intake over a
prolonged period or, more commonly, in Western Europe,
from impaired absorption. 8
9. • Malabsorption occurs if the distal ileum is removed; it
may also occur with certain intestinal pathologies,
particularly stagnant loop syndrome, tropical sprue and
fish tapeworm infestation.
• Passive absorption does take place in the jejunum, but this
is very inefficient and usually accounts for less than 1% of
an oral dose.
9
10. Pathophysiology
• The common biochemical defect in all megaloblastic anaemias
is the inhibition of DNA synthesis in maturing cells.
A. Folate deficiency anaemia
• The folate found in food is mainly conjugated to polyglutamic
acid. Enzymes found in the gut convert the polyglutamate
form to monoglutamate, which is readily absorbed.
• During absorption the folate is methylated and reduced to
methyltetrahydrofolate monoglutamate.
10
12. • This travels through the plasma and is transported into cells via
a carrier specific for the tetrahydrofolate form.
• Within the cell the methyl group is removed (in a reaction
requiring vitamin B12) and the folate is reconverted back to a
polyglutamate form (Fig.)
• It has been suggested that the polyglutamate form prevents the
folate leaking out of cells.
• The folate eventually acts as a co-enzyme involved in a number
of reactions including DNA and RNA synthesis. 12
13. • DNA synthesis mainly affects cells with a rapid turnover, such as
gastrointestinal cells and precursors of red blood cells in bone
marrow, hence the sore tongue and anaemia seen in folate
deficiency.
• During DNA synthesis the folate co-enzyme is oxidized to the
dihydrofolate form, which is inactive and has to be reactivated by
the enzyme dihydrofolate reductase.
• This is the enzyme inhibited by methotrexate and to a lesser extent
by trimethoprim and pyrimethamine.
• Co-trimoxazole has been shown to increase the severity of
megaloblastic anaemia. 13
14. B. Vitamin B12deficiency
• Absorption of vitamin B12 is mainly by an active process. Enzymes in
the stomach release vitamin B12, from protein complexes.
• One molecule of vitamin B12 then combines with one molecule of a
glycoprotein called intrinsic factor.
• The intrinsic factor protects the vitamin B12 from breakdown by
micro-organisms.
• There are specific receptors in the distal ileum for the intrinsic
factor-vitamin B12 complex.
• The vitamin B12, enters the ileal cell and is then transported through
the blood attached to transport proteins. Intrinsic factor does not
appear in the blood.
14
15. • Since intrinsic factor is only produced by the gastric parietal
cells, a total gastrectomy always leads to vitamin B12
deficiency.
• Approximately 10-15% of patients who have had a partial
gastrectomy also develop deficiency.
• vitamin B12 is a co-enzyme for the removal of a methyl group
from methyltetrahydrofolate.
• Lack of vitamin B12, traps the folate as methyltetrahydrofolate,
and prevents DNA synthesis.
• The exact mechanism by which vitamin B12 deficiency causes
neuropathy is not clear but may be due to defect in the
methylation reactions needed for myelin formation.
15
16. investigations
A. Folic acid deficiency anaemia
• Many patients are symptomless initially, and the diagnosis is made following
a full blood count carried out for another reason.
• The peripheral blood reveals large oval red cells. Anisocytosis (RBC in
size unequal) and poikilocytosis (abnormally shaped RBC) are common.
• Some of the neutrophils are hypersegmented, and thrombocytopenia may
be present.
• The red cell folate concentration accurately reflects folate stores and is a
preferable parameter to the serum folate concentration, which is subject to
changes in diet and does not correlate as closely with anaemia.
16
17. B. Vitamin B12 deficiency anaemia
• Following the recognition of megaloblastic anaemia from
the full blood count, one of the first investigations will be
the determination of the serum vitamin B12 level.
• Oral vitamin B12 absorption can be measured by the most
common test being the Schilling test.
• The test is based on giving a radiolabelled oral dose of
vitamin B12 and an unlabelled parenteral dose that
saturates the vitamin B12-binding proteins.
17
18. • The amount of labelled vitamin in the urine gives a measure
of absorption.
• The test can be repeated by giving the radiolabelled oral dose
with intrinsic factor.
• The absorption should now be approaching normal if the
patient has intrinsic factor deficiency but remains low if there
is ileal disease.
• Although 90% of patients with pernicious anaemia have
parietal cell antibodies, their presence is not diagnostic
because 50% of patients with gastric atrophy without
pernicious anaemia also have the antibodies present.
18
19. Treatment
• It is necessary to establish whether the patient with
megaloblastic anaemia has vitamin B12 deficiency or folic
acid deficiency, or both.
A. Folate deficiency anaemia
• The normal daily requirement of folic acid is
approximately 100 micrograms a day; despite this, the
usual treatment doses given are 5-15 mg a day.
• Even in malabsorption states, because of these large doses,
sufficient folate is usually absorbed.
19
20. • Therefore parenteral folic acid treatment is not
normally required. Treatment for 4 months will
normally be sufficient to ensure that folate deficient
red cells are replaced.
• In pregnancy :
Prophylaxis with folate (350-500 micrograms
daily) is now frequently given in pregnancy, often
in combination with iron.
20
21. Vitamin B12 deficiency anaemia
• The standard treatment is hydroxocobalamin 1 mg
intramuscularly repeated five times at 3 day intervals to
replenish body stores.
• This is followed by a maintenance dose, usually 1 mg
intramuscularly every 3 months.
• US texts recommend cyanocobalamin rather than
hydroxocobalamin because of the fear that some patients
appear to develop antibodies to the vitamin B12 transport
protein complex in the serum.
• In the UK, hydroxocobalamin is the treatment of choice.
21