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vit. A and IDDs.pptx
- 1. Vitamin A Dr YashAlok Assistant Professor Dept. of Community Medicine KMC Manipal
- 2. Function of vitaminA: • Production of retinol pigments needed for proper vision • Normal functioning of glandular and epithelial tissue • Supports skeletal growth • Anti-infective • Protects against epithelial cancers like bronchial cancers
- 3. Sources of VitaminA: • Animal food- liver, egg, butter, milk, meat, fish • Plant food- carrot, papaya, mango, pumpkin • Fortified foods- Vanaspati, butter, milk
- 4. Deficiency of VitaminA: Ocular Night blindness Conjunctival xerosis Bitots spot Corneal xerosis Keratomalacia Non Ocular Hyperkeratosis Anorexia Growth retardation
- 5. Night Blindness Conjunctival xerosis Bitot’sspots Corneal xerosis keratomalacia
- 6. Treatment • Treated urgently •All early stages can be reversed by a massive dose of 2lac IU of retinol palmitate orally on two successive days • All children with corneal ulcers – vit. A
- 7. Prevention • 2 forms-improvement of people’s diet with foods rich in Vit. A • Reducing the frequency and severity of contributory factors eg. PEM, RTIs, diarrhea, measles
- 8. Vit. A prophylaxisprogramme • Under MoHFw • 9 months – 1st dose (1 lac IU) • 15 months – 2nd dose (2 lac IU) • Every 6 months upto 3 years • Severely malnourished children >3 years- 1 dose(2 lac IU) • Children with measles- additional dose as per age
- 10. Vitamin A toxicity •Nausea • vomiting • Anorexia • sleep disorders • Skin desquamation • enlarged liver • papilledema • teratogenicity
- 11.
- 12. 12 Introduction • Iodine isrequired for the synthesis of the thyroid hormones, thyroxine (T4) and triiodothyronine (T3) • essential for the normal growth and development and well being of all humans. • 100-150 microgram is reqd. for normal growth and development
- 13. Foods rich inIodine 13 • Iodised salt • Sea fish and prawns/shrimp • Milk • Bread • Peas • Potatoes • Banana • Dates • Pineapples
- 14.
- 15. 15 Deficiency of iodinemay cause following disorders: • Goitre • Subnormal Intelligence • Neuromuscular Weakness • Endemic Cretinism • Still Birth • Myxedema • Hypothyroidism • Defect in Vision, Hearing, and Speech • Spasticity • Intrauterine Death • Mental Retardation
- 16. Epidemiological assessment ofiodine deficiency • Prevalence of goiter • Prevalence of cretinism • Urinary iodine excretion (surveillance) • Thyroid function test- T3 and T4(free and bound), TSH • Prevalence of neonatal hypothyroidism (sensitive indicator of environmental iodine deficiency 16
- 17. 17 NIDDCP • 1962- NationalGoitre Control Program • 100% centrally sponsored program • 1992- renamed as NIDDCP
- 18. 18 • Goal: • Toreduce the prevalence of IDDs below 10 % in the entire country by 2012 AD • Objectives: 1. surveys to assess the magnitude of the IDDs 2. Supply of iodised salt in the place of common salt 3. Resurvey after every 5 years to assess the extent of IDDs and the impact of iodised salt 4. Lab monitoring of iodised salt and urine iodine excretion 5. Health education and publicity
- 19. 19 Organization • MOHFW :nodal ministry for policy decisions • DGHS: implementation of the program Technical guidance, intersectoral co ordination, monitoring the quality of salt, sample surveys, managing finances
- 20. 20 • Salt commissioner’soffice under Ministry of Industry- licensing, production and distribution of salt to states / UTs • State / union territory IDD cell • Conduct prevalece surveys, monitoring quality, issue notification – banning entry and sale of non iodated salt, conduct training and reporting to DGHS
- 21. 21 Achievements • Private sectorpermitted to produce salt • Ministry of railways provides category B priority for transport of iodised salt next to defence • Central govt issued ban on sale of non iodised salt • Stds laid- Iodine content at production level- 30 ppm and at consumption level – 15 ppm • NIDDCP included in PMs 20 point program
- 22. 22 • Each stateto establish IDD control cell • National Reference lab set up 4 regional lab set up – NIN , Hyderabad All India Institute of Hygeine and Public Health, Kolkata AIIMS, new Delhi NICDs , Delhi
- 23. 23 • Each stateis sanctioned one IDD monitoring lab • on spot test kits • A central steerng committee has been set up under chairmanship of Secretary of Health and Family Welfare
- 24. 24 Drawbacks • Universal iodisationof salt not yet achieved • Strengthening of transport by roads and railways needed • Boosting political and bureaucratic commitment reqd. • Difference in guidelines for assessment of IDD between Indian and international organizations • Resistance in the consumption of iodised salt • Low funding as compared to other National programs
- 25.