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Vitamin a
- 1. VITAMIN A
- 2. β carotene All-trans retinol retinal All-trans retinal retinol Visual cycle retinyl esters Retinoic acid retinyl palmitate Nuclear receptor
- 3. SOURCES
- 4. LIFE STAGE DAILY REQUIRMENT ( μg/day) Infants 0-6 months 400 7-12 months 500 Children 1-3yr 300 4-8yr 400 Males 9-13yr 600 >13yr 900 Females 9-13yr 600 >13yr 700 Pregnancy 750 Lactation 1200
- 5. Vitamin A deficiency WHO CLASSIFICATION OF XEROPTHALMIA XN Night blindness (nyctalopia) X1A Conjunctival Xerosis X1B Bitot’s spots X2 Corneal Xerosis X3A Corneal ulceration (<1/3rd) X3B Corneal ulceration(>1/3rd ) XS Corneal scar XF Xeropthalmic fundi
- 6. Bitot spots
- 8. Other manifestations Skin and Epithelial cells: Phrynoderma/toad skin Keratinization of GI,respiratory and urogenital tracts Reproductive system: Degeneration of germinal epithelium- infertility Growth retardation
- 10. Hypervitaminosis A Symptoms and signs: Fatigue,malaise,anorexia,vomiting,headache and diplopia Dermatitis Skeletal decalcification Tenderness of long bones Hepatomegaly
- 11. Carotenemia
- 12. Treatment Children 1-6 yr and above • Immediately on diagnosis - 2 lakh IU • Following day - 2 lakh IU • Four weeks later - 2 lakh IU Children <1yr and <8kg(at any age) • <6 months - 50,000 IU • 6-12 months - 1 lakh IU For night blindness and Bitot spots Daily dose( 2 wks) -10,000 IU
- 13. Prevention National Prophylaxis Vitamin A Program Ministry of Health and Family Welfare • Children(1-5 yr) - 2 lakh IU, every 6 months • 9 months – 1 lakh IU • 15 months – 2 lakh IU