Vit. A def report edited.pptx
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Transcript of Vit. A def report edited.pptx
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Vitamin A deficiency, according to WHO is tissue concentration of Vitamin
A low enough to have adverse health consequences even if there is no
evidence of clinical Xerophthalmia.
Vitamin A deficiency can occur at any age but it is most common amongchildren under 6 years of age. Over 100 million preschool-age children are
thought to be affected.
Lack of vitamin A in children causes severe visual impairment and
blindness, and significantly increases the risk of severe illness, and even
death, from such common childhood infections as diarrheal disease.
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Vitamin A Deficiency
leading cause of preventable blindness in
children
increases the risk of disease and death from
severe infections
In pregnant women VAD causes night
blindness and may increase the risk of
maternal mortality.
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Vitamin A Deficiency
For children
causes severe visual impairment and blindness
significantly increases the risk of severe illness, andeven death, from such common childhood infections
as diarrhoeal disease and measles.
For pregnant women in high-risk areas, vitamin Adeficiency occurs especially during the lasttrimester when demand by both the unborn child
and the mother is highest. demonstrated by the high prevalence of night
blindness during this period.
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Vitamin A Deficiency
common in many developing countries
typically begins during infancy, when infants
do not receive adequate supplies of colostrum
or breast milk
Chronic diarrhea
leads to excessive loss of vitamin A in young
children, and vitamin A deficiency increases the
risk of diarrhea
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ETIOLOGY OF VITAMIN
A DEFICIENCY
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o PRIMARY VITAMIN A DEFICIENCY
- prolonged dietary deprivation- endemic in Southeast Asia
o SECONDARY VITAMIN A DEFICIENCY
- decreased bioavailability of provitamin A
- interference with absorption, storage or
transport
- common in prolonged protein-energy
undernutrition
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VITAMIN A DEFICIENCY CLINICAL
MANIFESTATIONS
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1. NYCTALOPIA
- Difficulty to adjust to dim light
- Insufficient adaptation to darkness
- Inhibits Rhodopsin production
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2. XEROPHTHALMIA
- Dry eyes- Conjunctiva becomes dry and thick and wrinkled
- Loss of goblet cells in the conjunctiva which is
responsible for mucus secretion
- Eyes fail to produce tears
- Dead epithelial and microbial cells accumulate on
the conjunctiva and form debris
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most common symptom of vitamin A deficiency in
young children and pregnant women
Corneal ulceration and necrosis
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3.) BITOTS SPOT
- Foamy, cheesy accretions of desquamated
keratin and saprophytic bacilli overlying an area of
conjunctival xerosis
-Build up of keratinized epithelial debris and
secretions found in the conjunctiva
- Usually associated with night blindness
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- In advanced deficiency, cornea becomes hazy and
develop erosions
- Liquefactive corneal necrosis
4.) KERATOMALACIA
-Softening of the cornea
- Leads to corneal scarring
that blinds at least a quarter
of a million each year
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5.) FOLLICULAR
HYPERKERATOSIS
-Rough
keratinized skin
-Resembles
goosebumps
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6.) Increased the severity and mortality risk
of infections (particularly diarrhea and
measles) malaria, and respiratory disease
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TREATMENTS FORVITAMIN A
DEFICIENCY
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TIMING VITAMIN A DOSE
Immediately on diagnosis
< 6 mos. of age 50,000 IU
6-12 mos. of age 100,000 IU
>12 mos. of age 200,000 IU
Next day Same age-specific dose
Atleast 2 weeks later Same age-specific dose
TREATMENT FOR XEROPHTHALMIA
For all age groups except for women of reproductive age
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For women of reproductive age:
Night Blindness/ Bitots Spot: ---- 10,000 IU
daily for atleast 2 weeks or weekly doses of
25,000 IU
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VITAMIN A TOXICITY
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ACUTE VITAMIN A TOXICITY
Accidental ingestion by children (>300,000)
Eating of polar bear or seal liver by arctic explorers
Headaches, drowsiness, irritability, nausea and vomiting,
skin peeling
CHRONIC VITAMIN A TOXICITY
Mega therapy/ massive daily doses (150,000-350,000 IU)
Coarse hair, cracked lips, dry, rough skin, alopecia of theeyebrows, frail bone
In children, hepatomegaly, splenomegaly and pseudotumor
cerebri
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PREVENTION
i i h l i S h d l
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Individual Oral dose Timing
Children 6-11 mos.old 55 mg. Retinylpalmitate (100,00 IU) Once every 4-6 mos.
Children > 12 mos.
old
100 mg.
(200,000 IU)
Once every 4-6 mos.
Infants 0-6 mos. old 1375 mg.
(25,000 IU)
1-3 times over the
first 6 mos. of life
Women ofchildbearing age
110 mg.(200,000 IU)
Within 1-2 months atmost of giving birth
Pregnant and
Lactating women
275 mg. (5,000-
10,000 IU)
Daily
Vitamin A Prophylaxis Schedule
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RDA of Vitamin A for different age group:
1 year or younger 375 mcg
1-3 years old 400 mcg
4-6 years old 500 mcg
7-10 years old 700 mcg
All males older than 10 years old 1000 mcg
All females older than 10 years old 800 mcg