Zinc is an essential mineral that is vital for many bodily functions. It is found naturally in many foods and is also used industrially and medically. Zinc deficiency can cause numerous health issues, while excess zinc consumption can also be toxic. The document discusses zinc's properties, roles in the body, dietary sources, causes and effects of deficiency, diagnosis of deficiency, treatments for deficiency and toxicity, and other clinical uses of zinc supplements.
This document summarizes information about zinc, including its dietary sources, recommended daily allowances, physiological functions, deficiency, and treatment. Some key points include:
- Zinc is an essential micronutrient found in high amounts in oysters, meat, and nuts. It plays roles in over 300 enzymes and 2000 transcription factors.
- Recommended daily zinc intake ranges from 2-11 mg per day depending on age. Pregnant and lactating women should have 11-12 mg.
- Zinc deficiency can cause impaired immunity, growth retardation, skin disorders, and is common in developing countries. It is diagnosed through blood tests.
- Treatment involves oral zinc supplementation, with doses ranging from 0.
Introduction of Zinc, Zinc Chemistry, Zinc functions, Zinc metabolism , Role in diarrhea , role in wound healing, immunity , hormones , catalytic zinc atom structure zinc atom , zinc enzyme, acrodermatitis enteropathica, toxicity
Zinc is a micronutrient that is essential for cellular metabolism and the function of over 100 enzymes. It is absorbed in the small intestine and transported to tissues like the liver and blood cells. Zinc is lost from the body primarily through gastrointestinal excretion and helps control hormone release and nerve signaling. Zinc deficiency can cause growth retardation and skin disorders, while adequate zinc supports immune function and reduces the duration of diarrhea. Therapeutically, zinc treatment has proven highly effective for decreasing the occurrence of prolonged childhood diarrhea in developing countries.
Zinc is a trace mineral that is important for many functions in the body. The total body content of zinc is about 2 grams, with high concentrations found in the prostate gland, muscle tissue, and bone. Good dietary sources of zinc include meat, dairy products, legumes, nuts, and spinach. Zinc is required for the function of many enzymes and is involved in processes like DNA synthesis, wound healing, growth, and taste sensation. Zinc deficiency can result in issues like hypogonadism, growth failure, and skin lesions. Toxicity from excess zinc intake is rare but can cause nausea and gastrointestinal issues.
Zinc deficiency can have serious negative health impacts, especially in children. It is estimated that 25% of the world's population is at risk of zinc deficiency. Zinc plays a critical role in cell metabolism, immunity, growth, and cognitive function. Zinc deficiency increases the risks of prolonged diarrhea, frequent respiratory infections, poor growth and stunting in children under 5 years of age. Treatment of zinc deficiency involves oral zinc supplementation, especially for children with acute diarrhea or those at risk of zinc deficiency due to malnutrition. Preventive measures like zinc supplementation and multiple micronutrient powders can help reduce the risks of zinc deficiency and its associated negative health outcomes in children.
Copper- sources, daily requirement, absorption, transportation, storage, excretion, role in enzymatic action, role in iron metabolism, role in elastin maturation, role in bone formation, copper deficiency, copper toxicity, Wilson disease, Menkes disease.
Selenium is an essential mineral that plays an important antioxidant role in the body. It is present in tissues like the liver at around 10 mg total. Sources of selenium include meats, seafood, grains and organs like liver and kidney. Selenium is absorbed in the duodenum and transported bound to proteins in the bloodstream. It is mainly excreted through urine and has a recommended daily intake of 50-200 μg. Selenium is an important component of the antioxidant enzyme glutathione peroxidase, which helps convert harmful oxygen free radicals into less toxic forms. It also aids in thyroid hormone conversion and protects against heavy metal toxicity. Selenium deficiency can result in conditions like cardiomyopathy, muscular dystrophy and Keshan disease.
Magnesium is an essential mineral that plays many important roles in the body. It is the second most abundant cation found intracellularly where it helps with enzyme reactions and energy production. About 60% of magnesium is stored in bones with the rest found in soft tissues. The kidneys and intestines work together to regulate magnesium levels in the body through absorption and excretion. Magnesium deficiency can occur due to poor intake, excess loss, or impaired absorption/transport and can impact many physiological functions if not addressed.
This document summarizes information about zinc, including its dietary sources, recommended daily allowances, physiological functions, deficiency, and treatment. Some key points include:
- Zinc is an essential micronutrient found in high amounts in oysters, meat, and nuts. It plays roles in over 300 enzymes and 2000 transcription factors.
- Recommended daily zinc intake ranges from 2-11 mg per day depending on age. Pregnant and lactating women should have 11-12 mg.
- Zinc deficiency can cause impaired immunity, growth retardation, skin disorders, and is common in developing countries. It is diagnosed through blood tests.
- Treatment involves oral zinc supplementation, with doses ranging from 0.
Introduction of Zinc, Zinc Chemistry, Zinc functions, Zinc metabolism , Role in diarrhea , role in wound healing, immunity , hormones , catalytic zinc atom structure zinc atom , zinc enzyme, acrodermatitis enteropathica, toxicity
Zinc is a micronutrient that is essential for cellular metabolism and the function of over 100 enzymes. It is absorbed in the small intestine and transported to tissues like the liver and blood cells. Zinc is lost from the body primarily through gastrointestinal excretion and helps control hormone release and nerve signaling. Zinc deficiency can cause growth retardation and skin disorders, while adequate zinc supports immune function and reduces the duration of diarrhea. Therapeutically, zinc treatment has proven highly effective for decreasing the occurrence of prolonged childhood diarrhea in developing countries.
Zinc is a trace mineral that is important for many functions in the body. The total body content of zinc is about 2 grams, with high concentrations found in the prostate gland, muscle tissue, and bone. Good dietary sources of zinc include meat, dairy products, legumes, nuts, and spinach. Zinc is required for the function of many enzymes and is involved in processes like DNA synthesis, wound healing, growth, and taste sensation. Zinc deficiency can result in issues like hypogonadism, growth failure, and skin lesions. Toxicity from excess zinc intake is rare but can cause nausea and gastrointestinal issues.
Zinc deficiency can have serious negative health impacts, especially in children. It is estimated that 25% of the world's population is at risk of zinc deficiency. Zinc plays a critical role in cell metabolism, immunity, growth, and cognitive function. Zinc deficiency increases the risks of prolonged diarrhea, frequent respiratory infections, poor growth and stunting in children under 5 years of age. Treatment of zinc deficiency involves oral zinc supplementation, especially for children with acute diarrhea or those at risk of zinc deficiency due to malnutrition. Preventive measures like zinc supplementation and multiple micronutrient powders can help reduce the risks of zinc deficiency and its associated negative health outcomes in children.
Copper- sources, daily requirement, absorption, transportation, storage, excretion, role in enzymatic action, role in iron metabolism, role in elastin maturation, role in bone formation, copper deficiency, copper toxicity, Wilson disease, Menkes disease.
Selenium is an essential mineral that plays an important antioxidant role in the body. It is present in tissues like the liver at around 10 mg total. Sources of selenium include meats, seafood, grains and organs like liver and kidney. Selenium is absorbed in the duodenum and transported bound to proteins in the bloodstream. It is mainly excreted through urine and has a recommended daily intake of 50-200 μg. Selenium is an important component of the antioxidant enzyme glutathione peroxidase, which helps convert harmful oxygen free radicals into less toxic forms. It also aids in thyroid hormone conversion and protects against heavy metal toxicity. Selenium deficiency can result in conditions like cardiomyopathy, muscular dystrophy and Keshan disease.
Magnesium is an essential mineral that plays many important roles in the body. It is the second most abundant cation found intracellularly where it helps with enzyme reactions and energy production. About 60% of magnesium is stored in bones with the rest found in soft tissues. The kidneys and intestines work together to regulate magnesium levels in the body through absorption and excretion. Magnesium deficiency can occur due to poor intake, excess loss, or impaired absorption/transport and can impact many physiological functions if not addressed.
fourth important cation , Second most abundant cation in intracellular fluid after K+., co- factor for more than 300 enzymes , functions of magnesium,Mg-ATP substrate , Mg-GTP substrate, ATP metabolism, muscle contraction and relaxation,normal neurological function and release of neurotransmitters are Mg dependent, green leafy vegetables are particularly rich in magnesium. Absorption in intestine and re absorption in Kidney .Paracellular -Claudin-16/-19, TRPM 6/ 7. Factor affecting for absorption and res absorption ,Action potential conduction in nodal tissue. Neuromuscular Irritability,As Constituent of Bones and Teeth: Hypomagnesemia Causes of Hypomagnesemia -Decreased intake, Redistribution from extracellular to intracellular, Increased losses -Renal Gastrointestinal. hypermagnesemia. sing and symptom of Mg deficiency, familial hypomagnesemia . Hypomagnesemia clinical manifestation, endocrinological manifestation , biochemical manifestation, method of estimations , calmagite , methylbule, Xylidyl blue, forzaman dye, enzymatic method, Magnesium Tolerance Test
The document discusses zinc, an essential trace element that is involved in numerous cellular processes. Zinc is required for the activity of approximately 100 enzymes and is found throughout the body, especially in bone. It plays important roles in the immune system, growth, vision, wound healing, taste, and male reproductive functions. Zinc is absorbed in the small intestine and transported through the bloodstream, with absorption influenced by various enhancers and inhibitors. Deficiency can cause issues like impaired immune function and delayed growth.
This document discusses iron absorption and iron deficiency anemia. It states that iron absorption primarily occurs in the duodenum and jejunum, and is regulated by both dietary intake and iron stores. Iron deficiency is the most common cause of anemia worldwide, especially impacting women and children. The key signs of iron deficiency anemia are a decreased hemoglobin level and red blood cell size.
Metabolism of zinc and its clinical significancerohini sane
A comprehensive presentation on Metabolism of Zinc and its clinical significance for MBBS,BDS,B.Tech,B.Pharma and Biotechnology students for self-study.
Sodium is the main electrolyte found in extracellular fluid. The total sodium content in the body is approximately 3,700 mmol, with 75% being exchangeable and 25% non-exchangeable in tissues like bones. Sodium is absorbed through sodium pumps in intestinal and renal cells and is essential for maintaining osmotic pressure, water balance, acid-base balance, muscle and nerve function, and cell membrane permeability. Disorders of sodium balance can result in hyponatremia or hypernatremia. Hyponatremia is a low serum sodium level below 130 mEq/L caused by water retention or sodium loss, while hypernatremia is a high level above 145 mEq/L due to water loss
Vitamin D deficiency is very common globally, including in Saudi Arabia where prevalence is around 90-95%. Vitamin D is important for bone and skeletal health and development during childhood, as it regulates calcium and phosphorus balance and bone mineralization. Beyond skeletal benefits, vitamin D has roles in reducing infection risk, autoimmune disease, asthma, COPD and cancer. Deficiency is diagnosed through blood tests measuring vitamin D levels, with normal being 30-100 ng/ml. Deficiency can cause rickets or osteomalacia and is often due to lack of sun exposure or intake of vitamin D sources like fortified foods. Prevention involves sun exposure, intake of vitamin D foods or supplements. Treatment requires high dose vitamin D
Copper is an essential trace element that is present in all tissues, especially the liver, kidneys, heart and skeletal muscles. It serves as a cofactor for several enzymes involved in processes like iron transport, collagen crosslinking, melanin synthesis and oxidative phosphorylation. Copper deficiency can result in neutropenia, anemia, bone abnormalities and neurological issues. Menkes and Wilson's diseases are genetic disorders of copper metabolism that involve defects in copper transport and result in copper accumulation in tissues.
Magnesium is an essential mineral found in bones, muscles, and body fluids. It plays important roles in regulating nerves and muscles, protein synthesis, and metabolism. Approximately one third is absorbed from digestion, with the rest excreted. Deficiency can result from conditions like chronic diarrhea, renal failure, or alcoholism, causing symptoms like weakness, tremors, and convulsions. Treatment involves fluid/electrolyte replacement and modifying diet/intake of foods high in magnesium.
Copper -trace element, Biochemical role of copper, RDA of copper, Deficiency diseases of Copper, Cobalt - Introduction, Biochemical role of cobalt, RDA of cobalt, Deficiency diseases of cobalt, Selenium - introduction, Biochemical role of selenium, RDA of selenium, Deficiency diseases of selenium
This document discusses iron metabolism and iron deficiency. It begins by outlining how iron is essential for many metabolic processes and exists in both ferric and ferrous states. It then discusses iron transport and storage in the body, as well as iron absorption, distribution, and regulation. The document also covers the causes, pathogenesis, morphology, diagnosis of iron deficiency and the role of hepcidin in various iron-related diseases.
Essential fatty acids like DHA and GLA play important roles in pregnancy. DHA is important for fetal brain and eye development. Studies show that DHA supplementation in pregnancy increases birth weight and gestation duration, and may reduce the risk of preeclampsia. GLA supplementation may help prevent pregnancy-induced hypertension by increasing production of vasodilatory prostaglandins. International organizations recommend 300 mg of DHA and 150-300 mg of GLA daily during pregnancy.
Vitamin D may help reduce the severity of COVID-19 infections through two mechanisms:
1) It supports production of antimicrobial peptides in the respiratory epithelium, making viral infection and symptom development less likely.
2) It helps reduce the inflammatory response to SARS-CoV-2 infection by interacting with the renin-angiotensin system, whose deregulation is associated with poorer COVID-19 prognosis.
Vitamin D deficiency prevalence in European countries appears to be closely aligned with COVID-19 mortality rates, with sunny southern countries having high rates of deficiency and worse outcomes compared to northern countries with sufficient vitamin D levels.
The document discusses the biological functions of zinc. It begins with an introduction to zinc, including its history of use in ancient India and its discovery in 1746. The document then outlines topics to be covered, including sources of zinc, requirements and homeostasis, deficiency and toxicity, biochemical and molecular functions, and immunological and endocrinological roles. It proceeds to cover these topics in depth over several slides, focusing on zinc absorption, transport, regulation, storage, and distribution within the body and cells.
Calcium is the most abundant mineral in the body and is primarily stored in bones and teeth. It performs many important biochemical functions including bone and teeth formation, muscle contraction, blood coagulation, and nerve transmission. Calcium levels are regulated by parathyroid hormone, vitamin D, and calcitonin. These hormones work to maintain calcium homeostasis by impacting absorption in the intestine and kidneys and mobilization from bones.
This document provides an overview of vitamins presented by three students. It defines vitamins as organic compounds needed in small quantities to sustain life that humans obtain from food. The document discusses the characteristics, classifications, functions and examples of various vitamins including Vitamin A, D, E, C. It also explains the mechanisms of action, sources, deficiencies and daily allowances of these vitamins.
Vitamin C or L-ascorbic acid, or simply ascorbate (the anion of ascorbic acid), is an essential nutrient for humans and certain other animal species. Vitamin C refers to a number of vitamers that have vitamin C activity in animals, including ascorbic acid and its salts, and some oxidized forms of the molecule like dehydroascorbic acid. Ascorbate and ascorbic acid are both naturally present in the body when either of these is introduced into cells, since the forms inter convert according to pH.
Selenium- chemistry, functions and clinical significanceNamrata Chhabra
1. Selenium is an essential trace element that functions in the body as part of selenoproteins but can be toxic at high levels.
2. A misformulated liquid dietary supplement resulted in 201 cases of selenium poisoning due to the selenium concentration being approximately 200 times the labeled amount.
3. Symptoms of selenium toxicity included hair loss, nail discoloration, and worsening of gastrointestinal symptoms.
This document discusses nutrition for the elderly. It notes that aging brings physiological, psychological, and immunological changes that influence nutritional status. Key nutritional needs for the elderly include reduced daily energy needs but stable or increased needs for protein, calcium, vitamins D and B12, and omega-3 fatty acids. Common nutritional problems for seniors are obesity, malnutrition, osteoporosis, cardiovascular diseases, and immune system weakness. The principles of nutrition for older adults emphasize balanced meals, adequate hydration and fiber, limited salt and sugar, and regular fish consumption.
Chloride is a major anion found primarily in the extracellular fluid of the body. It is absorbed rapidly from food in the gastrointestinal tract and excreted mainly through urine. Chloride plays important roles in water balance, acid-base balance, and activation of enzymes. Disorders of chloride involve abnormal levels, with hypochloremia caused by gastrointestinal or renal losses and hyperchloremia associated with conditions like dehydration, Cushing's syndrome, or respiratory acidosis.
El documento proporciona información sobre las propiedades y funciones del zinc. Explica que el zinc es un metal de transición esencial para la salud humana. Se encuentra naturalmente en los alimentos y desempeña un papel importante en más de 300 enzimas y 3000 proteínas del cuerpo. La deficiencia de zinc puede provocar retraso en el crecimiento, alteraciones óseas y dermatitis, entre otros problemas. Industrialmente, el zinc se usa principalmente para proteger otros metales de la corrosión.
The document discusses the refining and purification process of zinc. It begins with an introduction to zinc including its chemical formula, atomic number, and color. It then discusses the history of zinc discovery and production. The main uses of zinc are then outlined, followed by global zinc production and reserve statistics. The key steps in the zinc refining and purification process are then described in detail, including roasting, leaching, purification, electrolysis, melting and casting. Gas cleaning and sulfuric acid production are also summarized. Finally, the main applications of zinc in automotive, construction, hot dip galvanizing, and zinc castings are briefly outlined.
fourth important cation , Second most abundant cation in intracellular fluid after K+., co- factor for more than 300 enzymes , functions of magnesium,Mg-ATP substrate , Mg-GTP substrate, ATP metabolism, muscle contraction and relaxation,normal neurological function and release of neurotransmitters are Mg dependent, green leafy vegetables are particularly rich in magnesium. Absorption in intestine and re absorption in Kidney .Paracellular -Claudin-16/-19, TRPM 6/ 7. Factor affecting for absorption and res absorption ,Action potential conduction in nodal tissue. Neuromuscular Irritability,As Constituent of Bones and Teeth: Hypomagnesemia Causes of Hypomagnesemia -Decreased intake, Redistribution from extracellular to intracellular, Increased losses -Renal Gastrointestinal. hypermagnesemia. sing and symptom of Mg deficiency, familial hypomagnesemia . Hypomagnesemia clinical manifestation, endocrinological manifestation , biochemical manifestation, method of estimations , calmagite , methylbule, Xylidyl blue, forzaman dye, enzymatic method, Magnesium Tolerance Test
The document discusses zinc, an essential trace element that is involved in numerous cellular processes. Zinc is required for the activity of approximately 100 enzymes and is found throughout the body, especially in bone. It plays important roles in the immune system, growth, vision, wound healing, taste, and male reproductive functions. Zinc is absorbed in the small intestine and transported through the bloodstream, with absorption influenced by various enhancers and inhibitors. Deficiency can cause issues like impaired immune function and delayed growth.
This document discusses iron absorption and iron deficiency anemia. It states that iron absorption primarily occurs in the duodenum and jejunum, and is regulated by both dietary intake and iron stores. Iron deficiency is the most common cause of anemia worldwide, especially impacting women and children. The key signs of iron deficiency anemia are a decreased hemoglobin level and red blood cell size.
Metabolism of zinc and its clinical significancerohini sane
A comprehensive presentation on Metabolism of Zinc and its clinical significance for MBBS,BDS,B.Tech,B.Pharma and Biotechnology students for self-study.
Sodium is the main electrolyte found in extracellular fluid. The total sodium content in the body is approximately 3,700 mmol, with 75% being exchangeable and 25% non-exchangeable in tissues like bones. Sodium is absorbed through sodium pumps in intestinal and renal cells and is essential for maintaining osmotic pressure, water balance, acid-base balance, muscle and nerve function, and cell membrane permeability. Disorders of sodium balance can result in hyponatremia or hypernatremia. Hyponatremia is a low serum sodium level below 130 mEq/L caused by water retention or sodium loss, while hypernatremia is a high level above 145 mEq/L due to water loss
Vitamin D deficiency is very common globally, including in Saudi Arabia where prevalence is around 90-95%. Vitamin D is important for bone and skeletal health and development during childhood, as it regulates calcium and phosphorus balance and bone mineralization. Beyond skeletal benefits, vitamin D has roles in reducing infection risk, autoimmune disease, asthma, COPD and cancer. Deficiency is diagnosed through blood tests measuring vitamin D levels, with normal being 30-100 ng/ml. Deficiency can cause rickets or osteomalacia and is often due to lack of sun exposure or intake of vitamin D sources like fortified foods. Prevention involves sun exposure, intake of vitamin D foods or supplements. Treatment requires high dose vitamin D
Copper is an essential trace element that is present in all tissues, especially the liver, kidneys, heart and skeletal muscles. It serves as a cofactor for several enzymes involved in processes like iron transport, collagen crosslinking, melanin synthesis and oxidative phosphorylation. Copper deficiency can result in neutropenia, anemia, bone abnormalities and neurological issues. Menkes and Wilson's diseases are genetic disorders of copper metabolism that involve defects in copper transport and result in copper accumulation in tissues.
Magnesium is an essential mineral found in bones, muscles, and body fluids. It plays important roles in regulating nerves and muscles, protein synthesis, and metabolism. Approximately one third is absorbed from digestion, with the rest excreted. Deficiency can result from conditions like chronic diarrhea, renal failure, or alcoholism, causing symptoms like weakness, tremors, and convulsions. Treatment involves fluid/electrolyte replacement and modifying diet/intake of foods high in magnesium.
Copper -trace element, Biochemical role of copper, RDA of copper, Deficiency diseases of Copper, Cobalt - Introduction, Biochemical role of cobalt, RDA of cobalt, Deficiency diseases of cobalt, Selenium - introduction, Biochemical role of selenium, RDA of selenium, Deficiency diseases of selenium
This document discusses iron metabolism and iron deficiency. It begins by outlining how iron is essential for many metabolic processes and exists in both ferric and ferrous states. It then discusses iron transport and storage in the body, as well as iron absorption, distribution, and regulation. The document also covers the causes, pathogenesis, morphology, diagnosis of iron deficiency and the role of hepcidin in various iron-related diseases.
Essential fatty acids like DHA and GLA play important roles in pregnancy. DHA is important for fetal brain and eye development. Studies show that DHA supplementation in pregnancy increases birth weight and gestation duration, and may reduce the risk of preeclampsia. GLA supplementation may help prevent pregnancy-induced hypertension by increasing production of vasodilatory prostaglandins. International organizations recommend 300 mg of DHA and 150-300 mg of GLA daily during pregnancy.
Vitamin D may help reduce the severity of COVID-19 infections through two mechanisms:
1) It supports production of antimicrobial peptides in the respiratory epithelium, making viral infection and symptom development less likely.
2) It helps reduce the inflammatory response to SARS-CoV-2 infection by interacting with the renin-angiotensin system, whose deregulation is associated with poorer COVID-19 prognosis.
Vitamin D deficiency prevalence in European countries appears to be closely aligned with COVID-19 mortality rates, with sunny southern countries having high rates of deficiency and worse outcomes compared to northern countries with sufficient vitamin D levels.
The document discusses the biological functions of zinc. It begins with an introduction to zinc, including its history of use in ancient India and its discovery in 1746. The document then outlines topics to be covered, including sources of zinc, requirements and homeostasis, deficiency and toxicity, biochemical and molecular functions, and immunological and endocrinological roles. It proceeds to cover these topics in depth over several slides, focusing on zinc absorption, transport, regulation, storage, and distribution within the body and cells.
Calcium is the most abundant mineral in the body and is primarily stored in bones and teeth. It performs many important biochemical functions including bone and teeth formation, muscle contraction, blood coagulation, and nerve transmission. Calcium levels are regulated by parathyroid hormone, vitamin D, and calcitonin. These hormones work to maintain calcium homeostasis by impacting absorption in the intestine and kidneys and mobilization from bones.
This document provides an overview of vitamins presented by three students. It defines vitamins as organic compounds needed in small quantities to sustain life that humans obtain from food. The document discusses the characteristics, classifications, functions and examples of various vitamins including Vitamin A, D, E, C. It also explains the mechanisms of action, sources, deficiencies and daily allowances of these vitamins.
Vitamin C or L-ascorbic acid, or simply ascorbate (the anion of ascorbic acid), is an essential nutrient for humans and certain other animal species. Vitamin C refers to a number of vitamers that have vitamin C activity in animals, including ascorbic acid and its salts, and some oxidized forms of the molecule like dehydroascorbic acid. Ascorbate and ascorbic acid are both naturally present in the body when either of these is introduced into cells, since the forms inter convert according to pH.
Selenium- chemistry, functions and clinical significanceNamrata Chhabra
1. Selenium is an essential trace element that functions in the body as part of selenoproteins but can be toxic at high levels.
2. A misformulated liquid dietary supplement resulted in 201 cases of selenium poisoning due to the selenium concentration being approximately 200 times the labeled amount.
3. Symptoms of selenium toxicity included hair loss, nail discoloration, and worsening of gastrointestinal symptoms.
This document discusses nutrition for the elderly. It notes that aging brings physiological, psychological, and immunological changes that influence nutritional status. Key nutritional needs for the elderly include reduced daily energy needs but stable or increased needs for protein, calcium, vitamins D and B12, and omega-3 fatty acids. Common nutritional problems for seniors are obesity, malnutrition, osteoporosis, cardiovascular diseases, and immune system weakness. The principles of nutrition for older adults emphasize balanced meals, adequate hydration and fiber, limited salt and sugar, and regular fish consumption.
Chloride is a major anion found primarily in the extracellular fluid of the body. It is absorbed rapidly from food in the gastrointestinal tract and excreted mainly through urine. Chloride plays important roles in water balance, acid-base balance, and activation of enzymes. Disorders of chloride involve abnormal levels, with hypochloremia caused by gastrointestinal or renal losses and hyperchloremia associated with conditions like dehydration, Cushing's syndrome, or respiratory acidosis.
El documento proporciona información sobre las propiedades y funciones del zinc. Explica que el zinc es un metal de transición esencial para la salud humana. Se encuentra naturalmente en los alimentos y desempeña un papel importante en más de 300 enzimas y 3000 proteínas del cuerpo. La deficiencia de zinc puede provocar retraso en el crecimiento, alteraciones óseas y dermatitis, entre otros problemas. Industrialmente, el zinc se usa principalmente para proteger otros metales de la corrosión.
The document discusses the refining and purification process of zinc. It begins with an introduction to zinc including its chemical formula, atomic number, and color. It then discusses the history of zinc discovery and production. The main uses of zinc are then outlined, followed by global zinc production and reserve statistics. The key steps in the zinc refining and purification process are then described in detail, including roasting, leaching, purification, electrolysis, melting and casting. Gas cleaning and sulfuric acid production are also summarized. Finally, the main applications of zinc in automotive, construction, hot dip galvanizing, and zinc castings are briefly outlined.
1) Aproximadamente 1/3 de la población mundial vive en países con deficiencia de zinc. 2) El 82% de las mujeres embarazadas en todo el mundo tienen un consumo inadecuado de zinc. 3) La deficiencia de zinc causa casi el 4% de las muertes y años de vida ajustados por discapacidad en niños menores de 5 años en países de bajos ingresos.
The document discusses the evidence for using zinc supplementation in the treatment of childhood diarrhea. Zinc supplementation is now recommended as part of the global diarrhea treatment strategy based on multiple clinical trials showing it reduces diarrhea duration and severity. Zinc addresses diarrhea by maintaining gut integrity and functioning of the immune system. Proper dosage and duration of zinc treatment is important to gain its protective benefits against future diarrhea episodes. Ensuring widespread access to affordable zinc formulations is now a priority in developing countries.
Zinc plays an important role in reducing the severity, duration and recurrence of childhood diarrhea. The World Health Organization and UNICEF recommend all children with acute diarrhea be treated with zinc regardless of the cause of diarrhea. For children under 6 months, 10mg of zinc daily for 10-14 days is recommended, while for children over 6 months up to 5 years, 20mg of zinc daily for 10-14 days is recommended. Zinc supplementation helps stop diarrhea faster and prevents future occurrences by boosting the immune system and aiding in water and electrolyte absorption in the intestines.
The document discusses extractive metallurgy processes for zinc extraction. It describes the major zinc ores and details several pyrometallurgical and hydrometallurgical extraction processes. The key processes are roasting to produce zinc oxide from zinc sulfide ores, followed by leaching and electrolysis to recover zinc. Approximately 80% of zinc is produced via hydrometallurgical routes like roast-leach-electrowinning.
El documento describe los usos del zinc en la industria y la medicina. El zinc se utiliza en baterías, aleaciones metálicas, pinturas y fabricación de latón. También desempeña un papel importante en los organismos vivos y en procesos como la galvanización del acero. Sin embargo, con el tiempo pueden formarse "bigotes de cinc" en el acero galvanizado que pueden causar cortocircuitos.
Zinc is an essential micronutrient for plant growth. It plays important roles in carbohydrate metabolism, protein metabolism, and membrane integrity. Zinc deficiency can lead to chlorosis, necrosis, reduced growth and yield losses. Factors like high soil pH, phosphorus application, and liming can reduce zinc availability. Deficiency symptoms vary by crop but include interveinal chlorosis, small leaves, and premature leaf drop. Soil and foliar zinc application can increase dry matter production, grain yield, harvest index and zinc content of crops.
The document discusses zinc extraction processes. There are two main categories of processes: pyrometallurgical and hydrometallurgical. Approximately 80% of the world's zinc is produced via hydrometallurgical processes like the roast-leach-electrowin process. This process involves roasting zinc sulfide concentrate to produce zinc oxide, which is then leached and electrowon to extract zinc metal. An alternative is the pressure leach process, which combines roasting and leaching into a single step to produce zinc sulfate solution for electrowinning.
The document discusses the use of zinc supplementation in the treatment of diarrhoeal disease in children. It notes that while oral rehydration therapy saves lives, it does not reduce the duration of diarrhea. The WHO and UNICEF now recommend daily zinc supplements of 20 mg for 10-14 days for children ages 6 months to 5 years and 10 mg per day for infants under 6 months when experiencing acute diarrhea. Zinc has been shown to reduce the duration and severity of acute, persistent, and bloody diarrhea episodes as well as decrease stool volume and the proportion of episodes lasting over 7 days. The document concludes that zinc supplementation should be provided along with standard diarrhea treatment based on its significant beneficial impacts.
El documento resume las propiedades del zinc, incluyendo su número atómico, valencia, punto de fusión y ebullición. Explica que el zinc es un oligoelemento esencial para el cuerpo humano y participa en funciones como la formación del ADN y la cicatrización. También menciona algunos alimentos ricos en zinc y curiosidades como que la gente inteligente tiene más zinc en el cabello.
This document summarizes information about zinc, including its history of being recognized as an essential element, importance for growth, typical dietary sources, absorption and transport in the body, signs of deficiency, and treatment of deficiency. It notes that zinc is essential for growth, plays many roles in the body, and deficiency can cause issues like stunted growth, hypogonadism, and skin lesions. The primary causes of deficiency are listed as malnutrition, alcoholism, malabsorption, and certain diseases.
Zinc is an essential micronutrient that promotes immunity and cellular health. Research studies have found that zinc supplementation for children with diarrhea reduces the severity and duration of episodes, lowers the risk of future illnesses, and is more cost-effective than standard treatment without zinc. The document provides details on zinc's benefits, efficacy evidence from studies, dosage recommendations, and mechanisms for how zinc improves outcomes for childhood diarrhea.
El zinc es un metal blanco azulado que se encuentra ampliamente en la naturaleza. Tiene propiedades como buena conductividad eléctrica y térmica, y punto de fusión y ebullición elevados. Se utiliza principalmente para galvanizar el acero y prevenir la corrosión, y también en aleaciones como el latón. Otras aplicaciones incluyen pigmentos, baterías, monedas, fungicidas y suplementos dietéticos debido a sus propiedades antimicrobianas.
This document discusses various bacterial staining techniques used to visualize microorganisms under a microscope. It describes simple staining which uses a single dye, differential staining which allows differentiation using more than one dye, and special staining techniques to highlight specific structures. Gram staining is explained in detail as the most common differential staining method used to classify bacteria as gram-positive or gram-negative. Acid-fast staining and capsule, spore, and flagella staining are also summarized as important special staining methods.
1. Diarrhea is a major public health concern, being the second leading cause of mortality in children under five globally, with nearly 1.5 million child deaths attributed to diarrhea each year.
2. Diarrhea is caused by a variety of bacterial, viral and parasitic infections transmitted through contaminated food or water or contact with infected individuals.
3. Treatment involves oral rehydration and zinc supplementation to prevent dehydration, while prevention focuses on vaccination, breastfeeding, handwashing, water treatment and sanitation improvements.
The document provides an introduction to endemic fluorosis in India and outlines the National Programme for Prevention and Control of Fluorosis (NPPCF). It discusses how fluorosis is caused by excessive intake of fluoride through drinking water and affects dental, skeletal, and non-skeletal health. The NPPCF aims to prevent and control fluorosis cases through comprehensive management in endemic areas, including collecting baseline data, capacity building for managing cases, and surveillance of communities affected. The goals, objectives, and strategies of the NPPCF are described to guide its implementation in districts across India.
Zinc is a bluish-white metal that is found naturally in the Earth's crust. It was likely first discovered and purified in ancient China around 1000 AD, and was later described as a metal by the Swiss alchemist Paracelsus in the 15th century. Zinc is commonly used today to galvanize other metals and prevent corrosion, as well as in the production of many compounds for applications like rubber, paint pigment, animal feed supplements, and more. The largest producers of zinc today are China, Australia, Peru, the United States, and Canada.
full video link https://www.youtube.com/watch?v=SJNwC7fP0lM&t=433s
Mevalonate and cholesterol inhibit HMG-CoA reductase
STEROL REGULATORY ELEMENT BINDING PROTEINS[SREBPs]
• Three functional domains:
• N-terminal transcriptional regulatory domain
• DNA binding & gene regulatory functions
• Membrane anchoring domain
• 30 amino acid loop protruding into ER lumen
• C-terminal regulatory domain
• Interacts with cholesterol sensing protein embedded in ER membrane
• In case of low cholesterol SCAP escorts SREBP2 to the golgi for cleavage and activation
When cholesterol is high Precursor SREBPs remain anchored to the ER membrane in an inactive complex with sterol regulatory element binding protein (SREBP) and insulin-induced gene protein (INSIG). INSIG inhibits SCAP function. Cholesterol binding to SCAP or 25-hydroxycholesterol binding to INSIG results in formation of SREBP-SCAP-INSIG complex that maintains precursor SREBP in ER. Activating signals lead to disruption of inhibitory SCAP-INSIG complex, resulting in SCAP-mediated translocation of precursor SREBP to golgi apparatus. Sequential cleavage of SREBP by site 1 and site 2 proteases releases the N-terminal DNA binding domain which is translocated to the nucleus.
Increased intra cellular cholesterol is sensed by INSIG and as a consequence it ubiqutinilates HMG-CoA for degradation by proteasome
Effect of hormones:
• Increased activity:
• Insulin
• Thyroid hormone
• Decreased activity:
• Glucagon
• Glucocorticoids
• It is phosphorylated in presence of glucagon. Phosphorylation inactivates it. Dephosphorylated and activated by insulin
SCAP-INSIG complex retains SREBP in ER membrane when cholesterol is High
SCAP-INSIG complex dissociates and allows SREBP to move to golgi when cholesterol is low
Furanocoumarins in grape fruit juice inhibit cyt p450 leading to decreased metabolism of statins, so statins level will be high. Meaning cholesterol will be low inside cells, so SREBP will be freed of INSIG inhibition. SCAP will escort it to golgi for cleavage. Its DNA binding domain will move to nucleus and induce expression of LDL receptor gene.
• For a patient on regular lovastatin therapy there may be Low intra cellular cholesterol
• SCAP-INSIG complex likely to be active
• Loss of INSIG inhibition on translocation of SREBP to golgi
• LDL-receptor synthesis
Phytosterols bind cholesterol in enterocyte and are thrown back into intestinal lumen by ABCG5 and ABCG8.
For a person person on saturated fat enriched diet Saturated fatty acids will be delivered to adipose tissue and liver via chylomicrons. Saturated fatty acids will lead to formation of smaller VLDL particles that contain relatively more cholesterol. These are utilized by extrahepatic tissues at a slower rate compared to large particles. These tendencies may be regarded atherogenic
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Zinc
1. DR. M. S. PRASAD 1
ZincZinc
Dr. M. S. PrasadDr. M. S. Prasad
Consultant & Head
Dept. of Paediatrics
Safdarjung Hospital &
Vardhaman Mahavir Medical College
New Delhi
Dr. M. S. PrasadDr. M. S. Prasad
Consultant & Head
Dept. of Paediatrics
Safdarjung Hospital &
Vardhaman Mahavir Medical College
New Delhi
2. DR. M. S. PRASAD 2
ZincZinc
♦ Atomic No. 30
♦ Atomic Weight: 65.409
♦ Melting point: 7870
F [4200
C]
♦ Since 2500 yrs: in the production
of Brass.
♦ Romans used brass to make coins,
kettles and decorative items.
3. DR. M. S. PRASAD 3
Zinc in natureZinc in nature
♦ Zinc constitutes approximately
0.02% of the earth’s crust.
♦ Zinc is a poor conductor of
electricity and heat.
4. DR. M. S. PRASAD 4
ZincZinc
♦ Metallic zinc first produced in IndiaMetallic zinc first produced in India
sometime in 1400s.sometime in 1400s.
♦ Initial methodInitial method:: By heating mineralBy heating mineral
Calamine (ZnCOCalamine (ZnCO33) with wool.) with wool.
♦ Later methodLater method:: By heating calamineBy heating calamine
with charcoal [Andreas Sigismundwith charcoal [Andreas Sigismund
Marggraf 1746]Marggraf 1746]
5. DR. M. S. PRASAD 5
Industrial Uses
♦ Galvanization.
♦ Dry Cell Batteries.
♦ Roof Cladding.
♦ Die Casting.
♦ Making alloys: Brass, Prestal, German Silver,
Typewriter Metal, Nickel Silver, Spring Brass.
♦ Red Oxide: protects from rusting.
6. DR. M. S. PRASAD 6
Industrial Uses
Paints.
Rubber Products.
Cosmetics
Pharmaceuticals
Plastic
Printing Ink.
Soap.
7. DR. M. S. PRASAD 7
Industrial Uses
ZnS: Glows when exposed to UV light. Used in
Luminous watch dials.
Television Screen.
Florescent light bulbs.
ZnCl2: Protects wood from decay and insects.
9. DR. M. S. PRASAD 9
1979
♦ A 3 yr old girl suffering from ALL
developed “common cold”.
♦ She took unsweetened zinc
gluconate lozenges.
♦ This cured her common cold.
10. DR. M. S. PRASAD 10
19841984
Numerous manufacturerNumerous manufacturer
placed on the marketplaced on the market
““improved”improved” zinc lozengeszinc lozenges
that were sweetened.that were sweetened.
11. DR. M. S. PRASAD 11
1985 - 1995
♦ Many patents.
♦ Many trials by manufacturers.
♦ Zinc Gluconate forms very bitter
complexes with all carbohydrates
(except fructose).
♦ At least two formulations made
the cold worse.
♦ Trials dropped and discovery
discredited.
13. DR. M. S. PRASAD 13
Areas of Zinc concentrationAreas of Zinc concentration
♦ Pancreas,
♦ Prostate,
♦ Kidney,
♦ Liver,
♦ Muscles, and
♦ Retina.
14. DR. M. S. PRASAD 14
Co-factors of many enzymes
♦ As many as 300 enzymes require
zinc for optimum function.
♦ Carbonic Anhydrase.
♦ Alkaline Phosphatase.
16. DR. M. S. PRASAD 16
Nucleic Acid Metabolism
and Protein synthesis
Zinc Finger Motif.
Receptor for Steroid-Thyroid,
1, 25 (OH)2 – D3
TF III-A Protein.
A single amino acid mutation
results in resistance to this
hormone and may lead to
Rickets.
17. DR. M. S. PRASAD 17
FUNCTIONS OF ZINCFUNCTIONS OF ZINC
♦ Zinc is anZinc is an antioxidantantioxidant nutrient.nutrient.
♦ Necessary for:Necessary for:
– Protein SynthesisProtein Synthesis
– Wound HealingWound Healing
♦ Vital for:Vital for:
– Development of Reproductive OrgansDevelopment of Reproductive Organs
– Prostate FunctionProstate Function
– Male Hormone ActivityMale Hormone Activity
18. DR. M. S. PRASAD 18
FunctionsFunctions [Continued][Continued]
Governs theGoverns the contractility of musclescontractility of muscles
Important forImportant for blood stabilityblood stability
Maintains body’s alkaline balanceMaintains body’s alkaline balance
Helps in normal tissue functionHelps in normal tissue function
Helps in digestion and metabolismHelps in digestion and metabolism
of phosphate.of phosphate.
19. DR. M. S. PRASAD 19
FunctionsFunctions (Contd)(Contd)
♦ Involved in cell-membrane
structure.
♦ Anti-oxidant metallo-
thionine synthesis.
♦ Part of several transcription
factors: nucleophile.
20. DR. M. S. PRASAD 20
Functions (Continued)
AA component of many enzymes.component of many enzymes.
Multiple role in:Multiple role in:
Nucleic Acid MetabolismNucleic Acid Metabolism
Protein SynthesisProtein Synthesis
Important for membraneImportant for membrane
structure and functionstructure and function.
Acts as antibacterial in semen
23. DR. M. S. PRASAD 23
Dietary SourcesDietary Sources
Oysters.
Liver, Meat.
Grains,
Wheat Bran, Whole meal wheat
flour and Bread, Oatmeal.
Sardines, Crab.
Nuts, Legumes.
Cheese.
Milk.
24. DR. M. S. PRASAD 24
Causes of Zinc Deficiency
♦ Protein Energy Malnutrition.Protein Energy Malnutrition.
♦ DietaryDietary
– During periods of rapid growth
– High phytate intake in diet
♦ TPN without ZincTPN without Zinc
♦ Impaired AbsorptionImpaired Absorption
– Regional Enteritis
– Cystic Fibrosis
♦ Excessive LossesExcessive Losses [e.g. Chronic Diarrhoea]
♦ Inborn Error of Zinc MetabolismInborn Error of Zinc Metabolism
[Acrodermatitis enteropathica]
25. DR. M. S. PRASAD 25
Effects of Deficiencies
Acrodermatitis Enteropathica.
Hypogonadism.
Growth Failure.
Impaired Wound Healing.
Decreased Taste and Smell acuity.
Skin Ulcers.
Decreased Immune Response.
Iron Deficiency Anaemia.
Altered Mood.
Jitteriness.
26. DR. M. S. PRASAD 26
Effects of DeficiencyEffects of Deficiency
♦ PEM + Zn Deficiency = Atrophy
of Thymus.
♦ Zinc supplementation
accelerates healing of skin
lesions.
27. DR. M. S. PRASAD 27
Effects of Zinc DeficiencyEffects of Zinc Deficiency
♦ Impaired growth.
♦ Poor wound healing
♦ Bullous Dermatitis.
♦ Immunity Defects
– Particularly T-Cell function with increased susceptibility to infection.
♦ Alopacia
♦ Night Blindness.
♦ GIT Disturbances.
♦ Nervous System Disorders.
♦ Impaired Carbohydrate Metabolism.
28. DR. M. S. PRASAD 28
Biochemical Methods used in
diagnosis of Zn deficiency
♦ Plasma Zinc.
♦ WBC Zinc.
♦ Hair Zinc.
♦ Urine Zinc.
29. DR. M. S. PRASAD 29
Plasma Zinc Levels
[Before Breakfast][Before Breakfast]
♠ NormalNormal:: 60 – 100 μg60 – 100 μg//dldl
♠ Moderate DeficiencyModerate Deficiency:: 40 – 60 µg40 – 60 µg//dLdL
♠ Severe DeficiencySevere Deficiency:: < 40 µg/dL< 40 µg/dL
In patients with mild deficiency, plasma concentration may be within the normal range
31. DR. M. S. PRASAD 31
Acquired acrodermatitisAcquired acrodermatitis
with erythematous scalywith erythematous scaly
lesions and candidalesions and candida
albicans superinfectionalbicans superinfection
occurs in prematureoccurs in premature
neonates on parenteralneonates on parenteral
nutrition with insufficientnutrition with insufficient
zinc supplements.zinc supplements.
32. DR. M. S. PRASAD 32
Treatment
Zinc Sulfate:Zinc Sulfate:
1 – 2 mg/kg/day orally1 – 2 mg/kg/day orally
[Elemental Zinc]
Separately from meals and from Iron supplementations
Duration: 3 months
Acrodermatitis Enteropathica
33. DR. M. S. PRASAD 33
Wilson Disease
Zinc has unique ability to impair theZinc has unique ability to impair the
gastrointestinal absorption of copper.gastrointestinal absorption of copper.
Zinc acetate is given in adults at a dose ofZinc acetate is given in adults at a dose of
25 to 50 mg three times a day.25 to 50 mg three times a day.
Pediatric dosing guidelines have not beenPediatric dosing guidelines have not been
established.established.
34. DR. M. S. PRASAD 34
Common Cold
3C Protease is an essential enzyme3C Protease is an essential enzyme
for replication offor replication of rhinovirusrhinovirus..
Zinc inhibits function of thisZinc inhibits function of this
enzyme.enzyme.
Further studies requiredFurther studies required..
35. DR. M. S. PRASAD 35
HyperbilirubinemiaHyperbilirubinemia
Zinc protoporphyrinZinc protoporphyrin oror mesophyrinmesophyrin
[ZnPP or ZnMP][ZnPP or ZnMP] are inhibitors ofare inhibitors of haemhaem
oxygenaseoxygenase, the enzyme that begins, the enzyme that begins
the break- down of haem.the break- down of haem.
Studies are under way involving aStudies are under way involving a
single injection of these substancessingle injection of these substances
shortly after birth to prevent theshortly after birth to prevent the
formation of bilirubinformation of bilirubin..
36. DR. M. S. PRASAD 36
Zinc Supplements
♦ Infants & ChildrenInfants & Children:
0.5 – 1 mg/kg/24 hrs
in 1 – 3 doses.
♦ AdultsAdults:
25 – 50 mg/dose tid
37. DR. M. S. PRASAD 37
Advantages of Zinc Supplementation in Community
♥ Improved immunocompetenceImproved immunocompetence
♥ Reduction in incidence of AcuteReduction in incidence of Acute
and Persistentand Persistent DiarrhoeaDiarrhoea inin
communitycommunity
♥ Increased activity levelsIncreased activity levels
39. DR. M. S. PRASAD 39
Other UsesOther Uses
Zinc is also used as ingredient inZinc is also used as ingredient in
shampoo and paste.shampoo and paste.
Zinc deficiency depresses appetite andZinc deficiency depresses appetite and
growth. It can be corrected with oralgrowth. It can be corrected with oral
zinc supplements given over 1-2 mo.zinc supplements given over 1-2 mo.
20 mg Zinc daily for 14 days in Severe20 mg Zinc daily for 14 days in Severe
Malnutrition, Acute and PersistentMalnutrition, Acute and Persistent
Diarrhoea and Measles.Diarrhoea and Measles.
40. DR. M. S. PRASAD 40
Excess of ZincExcess of Zinc
causes cirrhosiscauses cirrhosis
Excess of zinc has been associated
with cirrhosis of liver in river Nile belt.
41. DR. M. S. PRASAD 41
Other features of Zinc Toxicity
♦ G. I. Irritation.
♦ Copper Deficiency.
♦ Decreased HDL.
♦ Zinc Pneumonia:
– A form of Aspiration Pneumonia due to inhalation of
baby powder containing Zinc Stearate.
42. DR. M. S. PRASAD 42
Zinc ToxicityZinc Toxicity
♦ Acute Zinc Toxicity:
– GIT Disturbances
♦ Chronic Zinc Toxicity:
– Interferes with absorption of other essential
elements such as calcium.
♦ Causes of acute toxicity:
– Ingestion.
– I. V. Infusion.
– I. V. contamination during hemodialysis.
43. DR. M. S. PRASAD 43
Other Symptoms
♦ Zinc Chloride has caustic action
and can cause lacerations and
dermatitis of the exposed skin.
♦ Zinc pyrithione, found in
shampoos, also is reported to
cause dermatitis.
♦ Zinc chloride and zinc sulfate
can cause significant eye
injuries.
44. DR. M. S. PRASAD 44
Symptoms (Contd)
♦ Eye manifestations:
♦ Delayed Pulmonary vascular fibrosis.
♦ Drinking acidic beverages from galvanized
containers.
♦ Microscaopic haematuria.
♦ Acute Tubular Necrosis.
♦ Zinc Metal Fume Fever.
[Page 303, Chapter 66, Pediatric and Adolescent Environmental Health 2004. Vol.2]
45. DR. M. S. PRASAD 45
Specific Treatment of Zinc Toxicity
♦ Dimercaprol:
2.5 – 5 mg/Kg deep I.M. every 4 hrs for 2 days,
then 2.5 mg/kg x 2 for 7 – 14 days.
♦ Penicillamine:
250 mg – 2 g daily orally in divided doses.
46. DR. M. S. PRASAD 46
ZincZinc
againstagainst
DiarrhoeaDiarrhoea
47. DR. M. S. PRASAD 47
DiarrheaZn def
+
+
Zn & Diarrhea
Vicious Cycle
48. DR. M. S. PRASAD 48
Effect of zinc on time of recovery
4.7
6.2
0
1
2
3
4
5
6
7
Zinc Control
Days
Zinc Control
Arch Dis Child. 1997 Sep;
77(3):196-200
25% reduction in time to recovery
49. DR. M. S. PRASAD 49
♦ 2002:2002: Zn deficiency included as aZn deficiency included as a
major risk factor in the global burden ofmajor risk factor in the global burden of
diseases.diseases.
♦ 2004:2004: WHO/UNICEF included ZnWHO/UNICEF included Zn
supplements in the treatment ofsupplements in the treatment of
acute diarrhoea.acute diarrhoea.
50. DR. M. S. PRASAD 50
Effects of zinc supplements on Diarrheal incidence
in LBW children < 1 yr
1.36
1.96
0
0.5
1
1.5
2
2.5
Zinc Placebo
Pediatrics 2003 Dec;112(6 Pt 1):1327-32
51. DR. M. S. PRASAD 51
ZincZinc
supplementationsupplementation
has shown 18%has shown 18%
reduction inreduction in
incidence ofincidence of
diarrhoea.diarrhoea.
52. DR. M. S. PRASAD 52
Therapeutic EffectsTherapeutic Effects
Zinc was found to have a
therapeutic benefit in seven trials
of acute diarrhoea and five of
persistent diarrhoea.
53. DR. M. S. PRASAD 53
Mechanism of action of Zinc
♦ Direct GI effects:
– Intestinal water and electrolyte transport.
– Brush Border Enzymatic Functions.
– Intestinal Tissue Repair.
– Improvement of Intestinal permeability.
♦ Immunomodulatory effects:
♦ Antimicrobial effect:
♦ Antioxidant effect:
54. DR. M. S. PRASAD 54
Immunomodulatory effects
Enhances cellular immunity
Higher levels of secretary antibodies.
Facilitates functions of Neutrophils, NK Cells,
Monocytes and Macrophages.
T-helper & cytotoxic T-Lymphocyte activity.
55. DR. M. S. PRASAD 55
Antimicrobial Effect
♦ Zinc Sulphate has been shown to have anZinc Sulphate has been shown to have an
antimicrobial effect on the enteric pathogen.antimicrobial effect on the enteric pathogen.
♦ The following enteric pathogens tested were
inhibited:
– S. typhi [20% inhibition at conc. 0.8 mg/ml]
– S. paratyphi [1.2 mg/ml]
– V. cholerae 01 and Shigella flexneri [1.4 mg/ml]
– Shigella sonnei [1.6 mg/ml]
56. DR. M. S. PRASAD 56
Antioxidant EffectAntioxidant Effect
♦ Scavenging effect against NOScavenging effect against NO
– The excess production of NO triggers formation of cyclic
nucleotides, which causes secretion and malabsorption.
♦ Stabilizes thiol groups andStabilizes thiol groups and
phospholipids in membrane.phospholipids in membrane.
♦ Occupies sites of redox activeOccupies sites of redox active
metals such as iron.metals such as iron.
57. DR. M. S. PRASAD 57
WHO/UNICEFWHO/UNICEF
Consensus StatementConsensus Statement
Zinc supplementation, given at a dose
of about 2 RDA per day (10 to 20 mg/d)
for 14 days, is efficacious in
significantly reducing severity of
diarrhoea as well as duration of the
episode.
58. DR. M. S. PRASAD 58
RecommendationsRecommendations
of IAP Task Forceof IAP Task Force
A uniform dose of 20 mg of elemental
Zinc should be given during the period
of diarrhoea and for 7 days after
cessation of diarrhoea to children
older than 3 months.
Recommendations for below 3 months
must await further research.
59. DR. M. S. PRASAD 59
RecommendationsRecommendations
of IAP Task Forceof IAP Task Force
Iron containing
formulations should
not be used with zinc
as iron interferes with
zinc absorption.
61. DR. M. S. PRASAD 61
Sazawal S, Black RE, Bhan MK:
Zinc supplementation in young children with acute diarrhoea in India.
• This study evaluated the effects of daily
supplementation with 20 mg of elemental
zinc on the duration and severity of acute
diarrhoea.
• There was 23% reduction
(95% C. I.) in the risk of
continued diarrhoea.
62. DR. M. S. PRASAD 62
Sazawal et al (Contd.)
• The reductions in the duration and
severity of diarrhoea were greater in
children with stunted growth than in
those with normal growth.
• CONCLUSIONCONCLUSION:: For infants and young
children with acute diarrhoea, zinc
supplementation results in clinically
important reductions in the duration
and severity of diarrhoea.
N Engl J Med 1995 Sep 28; 333 (13): 839-44.
63. DR. M. S. PRASAD 63
Bhandari N, Bahl R, Taneja S.Bhandari N, Bahl R, Taneja S.::
Zinc Supplementation in Young North Indian ChildrenZinc Supplementation in Young North Indian Children
♦ Door to Door Survey.
♦ 4 months daily zinc supplementation.
♦ 6 to 30 months of age residing in urban
slums of Dakshinpuri in south Delhi.
♦ Zinc supplementation reduced the incidence
of severe, persistent and recurrent diarrhoea
PEDIATRICS Vol. 109 No. 6 June 2002, p e86
64. DR. M. S. PRASAD 64
Bhatnagar S, Bahl R, Sharma PK:
Zinc with oral rehydration therapy.
♦ The authors evaluated the effect of zinc
treatment as an adjunct to oral
rehydration therapy.
♦ Zinc treatment reduced total stool output
and stool output per day.
♦ The duration of diarrhoea was also low.
♦ The risk of persistent diarrhoea was low.
J Pediatr Gastroenterol Nutr. 2004 Jan; 38(1): 34-40
65. DR. M. S. PRASAD 65
Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat:
Therapeutic effects of Zinc.
♦ The effects of supplemental Zinc given
with Oral Rehydration Therapy.
♦ The study concluded that Zinc
supplementation reduces the duration
and severity of acute and persistent
diarrhoea.
Am J Clin Nutr 2000; 72: 15161522
66. DR. M. S. PRASAD 66
BMJ 2002; 325 (7372): 1059
♦ Children with diarrhoea were treated with
zinc 20 mg per day for 14 days.
♦ Bangla Desh: 8070 children aged 3 – 59
months studied.
♦ They had shorter duration and lower
incidence of diarrhoea.
♦ The incidence of ARI was also low.
♦ Hospital admission was low.
67. DR. M. S. PRASAD 67
Hospitalization due to diarrhoea
0.59
0.98
0
0.2
0.4
0.6
0.8
1
1.2
Zinc Placebo
Odds Ratio
68. DR. M. S. PRASAD 68
There is innumerableThere is innumerable
number of studies on thenumber of studies on the
role of Zinc in Diarrhoea,role of Zinc in Diarrhoea,
ARI and Malnutrition. AllARI and Malnutrition. All
show statisticallyshow statistically
significant beneficialsignificant beneficial
effect of zinceffect of zinc
supplementation.supplementation.
70. DR. M. S. PRASAD 70
ZincZinc is especiallyis especially
important in adolescenceimportant in adolescence
because of its role inbecause of its role in
growth and sexualgrowth and sexual
maturation.maturation.