Vitamin A deficiency

◾ Plays essential roles in vision , growth and development , maintenance of health skin ,hair ,mucous membranes, immune function and reproduction.
◾ Vitamin A is includes preformed vitamin- retinol and pro vitamin – beta carotene.

*Sources:-
◾Widely distributed in animal foods as preformed vitamin A and plant foods as provitamins(carotenes)

1.Animal food=liver ,egg, butter,cheese, whole milk ,fish and meat.
2.plant food=green leafy vegetables,carrot,yellow frouts ( mango,papaya and pumpkin) avocados.

*Function:-
◾ essential for Norma vision .
◾integrity and normal functioning or glandular and epithelial tissue.
◾ supports skeletal growth.
◾anti infection .

*Problem of VAD in India
◾in India level of bitot’s spot which was 2% in 1979 has declined to 0.7% in 2001,indicates that it is public health problems.
◾volnerability-young children<the age of 3 years.
,Pregnant and lactating women.
◾ Sex- male children >female children

*Deficiency:-
◾sign of vitamin A deficiency= 2 types.
1.ocular and 2.extra ocular
◾ ocular manifestations:-are most common onecs:-
. night blindness
. conjunction xerosis
.bitots spots
.corneal xerosis
.keratomalasia .
◾first clinical signs of vitamin A deficiency- conjunctivital xerosis.
◾first clinical symptoms of vitamin A deficiency – night blindness.

*Signs and symptoms:-
◾dryness , itching,redness of conjunctiva.
◾Night blindness (inability to see in dim light.
◾ other signs of xerophthalmia:bitot spots,corneal xerosis.
◾keratomalacia.
◾dry,rough , itchy skin ,rash.
◾dry,brityle hair and nails.
◾loss of acuity of senses:smells&taste.
◾loss of appetite. ◾anaemia,fatigue
◾poor growth
◾low immunity: increased vulnerability to infection.
*Night blindness:-
◾initial ocular manifestation of vitamin A.
◾ inability to see in dim light.
◾ condition may worsen unless the child is supplemented with vitamin-A.
◾condition may worsen in children suffering from diarrhoea and other infections.

* causes of blindness:-
◾ vitamin A deficiency.
◾trauma,retinoblastoma
◾cataract,other congenital eye anomaly.
◾diabetic retinapathy and hypertensive retinopathy.

*conjunctival xerosis:-
◾first clinical sign of vitamin deficiency.
◾conjunctive becomes dry and non-wet table.
◾looks muddy & wrinkled instead of smoot and shiny.
◾most common in children aged 1-3 years.
◾associated with PEM.
◾most wides pread & serious nutritional disorder leading to blindness.
◾andhra,TN karnataka ,bihar and WB-badly affected status.

*Keratomalacia:-
◾keratomalacia or liquefaction of cornea is a grave medical emergency.
◾the cornea may be soft & may burst open.
◾the process is a rapid one &the vision is lost permanently.
◾most associated with PEM.

 

*Prevention and control:-
◾improve the diet to include more intake of food rich in vitamin A.
◾reducing frequency and serverity of contributory factors like PEM, respiratory in fections,diarrhoea & measles. ◾every half yearly a massive dose 200,000 IU of vitamin A in oil(retinol palmitate) is administered orally to preschool children(1yr-6yr).
◾A massive dose 100,000 IV of vitamin A to children between 6 months -1 year of age.
◾ensure breast feeding & the mother should be given adequate vitamin A completed food.
◾in pregnant mother doses of vitamin capsule in 3 maternal visits or 1capsule at least at last trimester.
◾sufficient does of green leafy vegetables should be given to the child.

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