1) Vitamin D is produced in the skin from sunlight exposure and is also obtained in small amounts from dietary sources like fatty fish.
2) In the liver and kidneys, vitamin D is activated to its biological form which acts to regulate calcium and phosphate levels in the body by increasing their absorption in the intestines and mobilization from bones.
3) Vitamin D deficiency can lead to rickets in children and osteomalacia in adults, characterized by soft, weak bones due to poor mineralization.
Vitamin D- Introduction , source, synthesis of vitamin D in body, absorption of vitamin D in the body , action of vitamin D,
vitamin D deficiency & toxicity, Dietary reference value,
Vitamin D- Introduction , source, synthesis of vitamin D in body, absorption of vitamin D in the body , action of vitamin D,
vitamin D deficiency & toxicity, Dietary reference value,
Chemistry, and biochemical role, rda, vitamin dJasmineJuliet
Vitamin D - Chemistry,n Metabloism, Biosynthesis in our skin, Recommended dietary Allowance, Dietary sources of vitamin D, Deficiency symptoms of vitamin D, Hypervitaminosis of vitamin D.
Vitamin C introduction, Chemistry of Vitamin C, Biochemical Role of Vitamin C, (Collagen formation, Bone formation, Immunological response, Synthesis of Catacholamines, ), Recommended dietary Allowance of Vitamin C, Dietary Sources of Vitamin C, Deficiency symptoms of Vitamin C, Food preparation to retain Vitamin C.
Chemistry of Vitamin K, Biochemical role of Vitamin K, Recommended dietary allowance of Vitamin K, Dietary sources of Vitamin K, Deficiency symptoms of vitamin K, Hypervitaminosis of vitamin K, Toxicity of Vitamin K
vitamin d is one of the fat soluble vitamin on which there is great emphasis in the present scenario. it is present in breast milk in very minute amount so it is recommended that it must be supplemented right after birth to prevent it deficiency which in children can result in rickets. if not diagnosed and treated in time it may result in number of bony deformities . in adults besides oesteomalacia it is associated with n umber of non communicable diseases.
a ppt about vitamins especially about vitamin b9 or folate or folic acid
this is definitely helpful for medical students
prepared based on their characteristics
Chemistry, and biochemical role, rda, vitamin dJasmineJuliet
Vitamin D - Chemistry,n Metabloism, Biosynthesis in our skin, Recommended dietary Allowance, Dietary sources of vitamin D, Deficiency symptoms of vitamin D, Hypervitaminosis of vitamin D.
Vitamin C introduction, Chemistry of Vitamin C, Biochemical Role of Vitamin C, (Collagen formation, Bone formation, Immunological response, Synthesis of Catacholamines, ), Recommended dietary Allowance of Vitamin C, Dietary Sources of Vitamin C, Deficiency symptoms of Vitamin C, Food preparation to retain Vitamin C.
Chemistry of Vitamin K, Biochemical role of Vitamin K, Recommended dietary allowance of Vitamin K, Dietary sources of Vitamin K, Deficiency symptoms of vitamin K, Hypervitaminosis of vitamin K, Toxicity of Vitamin K
vitamin d is one of the fat soluble vitamin on which there is great emphasis in the present scenario. it is present in breast milk in very minute amount so it is recommended that it must be supplemented right after birth to prevent it deficiency which in children can result in rickets. if not diagnosed and treated in time it may result in number of bony deformities . in adults besides oesteomalacia it is associated with n umber of non communicable diseases.
a ppt about vitamins especially about vitamin b9 or folate or folic acid
this is definitely helpful for medical students
prepared based on their characteristics
Hello
This ppt were on the basic information for synthesis of vitamin D and vitamin K in our body.
Along with their RDA , Source , biochemical function and disease state.
Thank you
Calcitriol hormone and its up and down regulationArubSultan
Description: these slides explain the calcitriol hormone production and regulation. The effects of calcitriol on body and the related disorders. and also explain the up and down regulation of calcitriol hormone.
Minerals and vitamins are interrelated in the sense that both belongs to the same class of nutrients called as micro nutrients, because both are needed in the body in small quantity as compared to other nutrients like carbohydrates, fat and protein.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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ASA GUIDELINE
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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This document describes the acute management of AV block.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Vitamin d
1. UNIVERSITY PUTRA MALAYSIA
FACULTY OF MEDICINE AND HEALTH SCIENCES
DEPARTMENT OF NUTRITION SCIENCES
VITAMIN D
MICRONUTRIENTS IN HEALTH AND DISEASE
By
Mohammed Ellulu
2. Introduction
Vitamin D is represented by:
1. cholecalciferol (vitamin D3)
2. ergocalciferols (vitamin D2) (in plant, fungi, yeast)
they are structurally similar, derived from the UV irradiation
of provitamin D sterols.
Vitamin D3 is produced by the action of sunlight on
7-dehydrocholesterol in the skin.
2
3. Structural differences of D2 and D3
3
In C-17 side chain, vitamin D2 has double bond and
additional methyl group.
4. Human activation
4
1. Endogenous or dietary origin of vitamin D will be
hydroxylated in the liver at carbon 25 to yield 25-
hydroxyvitamin D [25(OH)D].
2. This compound circulates in the blood and,
3. In the kidney, hydroxylation at the α-position of
carbon 1 to generate 1α,25-dihydroxyvitamin D
[1α,25(OH)2D].
5. The active form
5
The dihydroxylated vitamin D2 and D3 metabolites
are the active hormones.
6. Dietary sources
6
The proportion of vitamin D obtained from the diet
is very small compared with that synthesized in skin
in response to sunlight.
Fish-liver oils,
Fatty fish as sardines,
Eggs and dairy products,
Cereals, vegetables and fruit contain no vitamin D,
Meat and poultry contribute insignificant amounts.
7. Cutaneous synthesis
7
Vitamin D3 is synthesized in the skin from 7-
dehydrocholesterol (provitamin D3).
Provitamin D3 is converted photochemically to
previtamin D3, which converted to vitamin D3 by a
temperature-dependent process (non enzymatic).
The waveband of solar radiation responsible for the
conversion of the provitamin to the previtamin is
that between 290 and 315 nm, known as the UV-B
band (less than 290 does not reach the earth).
8. Factors affecting vitamin D3 production
8
1- Ageing
The skin becomes progressively thinner. The epidermal
concentration of 7-dehydrocholesterol decreases.
Young adults produce 3 times more than elderly.
2- Degree of skin pigmentation
Skin pigmentation is a limiting factor for previtamin
D3 synthesis because melanin competes with 7-
dehydrocholesterol in absorbing UV-B radiation.
3- Use of sunscreens
9. Intestinal absorption and transport
9
Vitamin D is incorporated into chylomicrons, when
released, the chylomicrons convey the vitamin in the
mesenteric lymph to the systemic circulation.
In the lymph, an appreciable amount of the vitamin
D in the chylomicrons is transferred to the DBP.
After lipolysis of the chylomicrons, the vitamin D
remaining on the chylomicron remnants, and also the
vitamin D bound to protein, is initially taken up by
the liver.
10. Calcium and phosphate homeostasis
10
1α,25-Dihydroxyvitamin D restores low plasma
concentrations of Ca2+ and Pi to normal by action at the
three major targets; intestine, bone, kidney.
a) stimulates the intestinal absorption of Ca2+ and Pi by
independent mechanisms,
b) stimulates the transport of Ca2+ (accompanied by Pi)
from the bone fluid compartment to the extracellular
fluid compartment,
c) facilitates the renal reabsorption of Ca2+. These
three mechanisms provide calcium for bone
mineralization and prevent hypocalcaemic tetany.
11. 11
1α,25-Dihydroxyvitamin D3 regulates the synthesis
of two classes of calcium-binding proteins
(calbindins) found in mammalian intestine and
kidney.
An intestinal protein (calbindin-D9k) binds two
calcium ions per molecule,
A renal protein (calbindin-D28k) binds five to six
calcium ions per molecule.
Calcium and phosphate homeostasis
12. Intestinal calcium absorption
12
Calcium is present in foods and dietary supplements as
relatively insoluble salts.
Calcium is absorbed only in ionized form, it must be
released from the salts (mostly acidic medium).
On reaching the alkaline environment of the small
intestine, some of the Ca2+ complex with minerals or
other specific dietary constituents, thereby limiting
calcium bioavailability.
Calcium absorption takes place by the translocation of
luminal Ca2+ through the enterocytes (transcellular
route) and between adjacent enterocytes via the tight
junctions (paracellular route).
13. The calbindin-based diffusional-active
transport model13
This transcellular pathway is a complex process
involving three steps:
(1) entry by movement of Ca2+ from lumen through
the brush-border membrane of the enterocyte,
(2) intracellular diffusion,
(3) extrusion from the cell across the basolateral
membrane. The major action of vitamin D in
regulating this process is on the steps involved in
Ca2+ movement beyond brush-border entry.
14. Intestinal phosphate absorption
14
Dietary phosphorus is a mixture of inorganic and
organic phosphorus.
Phosphorus in meat and fish exists largely in the
form of phosphoproteins and phospholipids
(enzymatic hydrolysis).
80% of phosphorus in grains is found as phytic acid
(bioavailability reduced).
Milk protein (casein) is highly phosphorylated.
Phosphate absorption takes place mainly in the
jejunum by an energy-dependent transcellular route.
15. Vitamin D action on bone
15
1α,25(OH)2D3 is required for normal development and
mineralization of bone, and for bone remodelling.
The effect of 1α,25(OH)2D3 on bone is indirect, being
attributable to the increased availability of calcium and
phosphate for incorporation into bone that results from
the increased intestinal absorption.
Rickets can be cured in vitamin D-deficient rats by
increasing the calcium and phosphorus content of the
diet or by maintaining normal circulating concentrations
of these minerals through infusion.
16. Vitamin D action on bone
16
A major physiological function of 1α,25(OH)2D3 in
calcium homeostasis is stimulation of bone resorption,
which refers to localized bone dissolution by osteoclasts
with resultant net calcium movement from bone to
blood.
The hormone acts by increasing the expression of
proteins essential to the resorptive process, proteins such
as carbonic anhydrase.
The hormone also inhibits bone formation by decreasing
alkaline phosphatase activity and collagen synthesis in
osteoblasts and increasing the synthesis of osteocalcin,
a potent inhibitor of mineralization.
18. Phosphate homeostasis
18
Unlike calcium, dietary phosphate usually exceeds the
body’s nutritional requirement, therefore a major component
of phosphate homeostasis is renal excretion. A diet that is
low in phosphorus is likely to be low also in calcium, which
complicates the picture of phosphate homeostasis.
A lowering of plasma phosphate will stimulate the kidney to
release 1α,25(OH)2D3, which elicits rapid and long-term
responses in the kidney, leading to increased renal
reabsorption of phosphate.
The 1α,25(OH)2D3 will also increase the intestinal
absorption of phosphate and calcium. The parathyroids will
not be stimulated to produce PTH.
19. Effects of vitamin D on insulin secretion
19
1α,25-Dihydroxyvitamin D3 is considered to be a
modulator of insulin secretion;
Because…. vitamin D deficiency in rats is associated
with marked impairment of insulin secretion and the
insulin-secreting β-cells of the pancreas contain the
vitamin D-regulated protein calbindin-D28k.
20. Vitamin D-related diseases
20
Rickets
The classic vitamin D deficiency disease in children.
The disease is characterized by bow legs or knocks
knees, curvature of the spine, and pelvic and
thoracic bone deformities.
These deformities result from the mechanical stresses
of body weight and muscular activity applied to the
soft uncalcified bone.
21. Vitamin D-related diseases
21
Osteomalacia
In adults, when the skeleton is fully developed,
vitamin D is still necessary for the continuous
remodelling of bone.
During prolonged vitamin D deficiency, the newly
formed, uncalcified bone tissue gradually takes the
place of the older bone tissue and the weakened
bone structure is easily prone to fracture.
22. Toxicity
22
Hypervitaminosis D results from the excessive
consumption of vitamin D supplements, and not from
the consumption of usual diets.
Toxic concentrations of vitamin D have not resulted
from unlimited exposure to sunshine.
Vitamin D toxicity is due primarily to the
hypercalcaemia caused by the increased intestinal
absorption of calcium, together with increased
resorption of bone.
23. Possible Interactions with Vitamin D
23
Vitamin D levels may be increased by the following
medications:
Estrogen: Hormone replacement therapy appears to
increase vitamin D levels in the blood; this may have a
beneficial effect on calcium and bone metabolism. In
addition, use of vitamin D supplements in conjunction
with estrogen increases bone mass more than ERT alone.
Isoniazid (INH): INH, a medication used to treat
tuberculosis, may raise blood levels of vitamin D.
Thiazide: Diuretics in this class increase the activity of
vitamin D and can lead to inappropriately high calcium
levels in the blood.
24. Possible Interactions with Vitamin D
24
Vitamin D levels may be decreased, or its absorption may be
reduced, by the following medications:
Antacids: Taking antacids for long periods of time may alter
the levels, metabolism, and availability of vitamin D.
Calcium channel blockers (as verapamil ): used to treat high
(bp) and heart conditions, may decrease the production of
vitamin D by the body.
Cholestyramine: cholesterol-lowering medication, known as a
bile acid sequestrant, interferes with the absorption of
vitamin D (as well as other fat-soluble vitamins).
Phenobarbital (anticonvulsant): may accelerate the body's
use of vitamin D.
25. Possible Interactions with Vitamin D
25
Weight loss products:
Orlistat, a medication used for weight loss, and
Olestra, a substance added to certain food products,
The both intended to bind to fat and prevent the
absorption of fat and the associated calories.
Because of their effects on fat, orlistat and olestra may
also prevent the absorption of fat-soluble vitamins such
as vitamin D.
In addition, multivitamins with fat soluble vitamins will
be prescribed with orlistat to the regimen.
26. Dietary requirement
26
The dietary requirement for vitamin D depends upon
the amount of vitamin synthesized by solar irradiation
of the skin.
Exposing hands, arms and face on a clear summer day
for 10–15 min, two to three times a week, should yield
sufficient cutaneous production of vitamin D to meet
daily needs.
To maintain satisfactory plasma 25(OH)D levels without
any input from skin irradiation, an oral input in the
region of 10–15 μg of vitamin D per day would be
required.