DR. PRADEEP DUBEY MD(PED). DCH. CONSULTANT PEDITRICIAN. DR. PRADEEP DUBEY MD(PED). DCH. CONSULTANT...
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DR. PRADEEP DUBEY MD(PED). DCH. CONSULTANT PEDITRICIAN. DR. PRADEEP DUBEY MD(PED). DCH. CONSULTANT PEDITRICIAN. VITAMIN –D DIFICIENCY IN CHILDREN “AADIGURU”
DR. PRADEEP DUBEY MD(PED). DCH. CONSULTANT PEDITRICIAN. DR.
PRADEEP DUBEY MD(PED). DCH. CONSULTANT PEDITRICIAN. VITAMIN D
DIFICIENCY IN CHILDREN AADIGURU NEURO PEDITRIC CENTRE PREM MANDIR
CHOWK, WRIGHT TOWN, JABALPUR.
Slide 2
20 th century witnessed - Discovery of Vit D Nutrition
Research, Vol. 19, No. 11, pp. 1683-1718, 1999
Slide 3
Slide 4
The Evolution of Vit D Bone health Vitamin Miracle Drug For
strong bones
Slide 5
Vitamin D & Cancer J. Nutr. 135: 2739S2748S, 2005.
Slide 6
First evidence for anticancer effects of Vit D Biochem Biophys
Res Commun. 1981 Oct 15;102(3):937-43.
Slide 7
Clinical trials - Vit D & Cancer Ann Epidemiol
2009;19:468483.
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Infections TB Epidemic influenza HIV Vaginal infections
Slide 9
Nobel Prize in Physiology or Medicine, 1903 Dr.Niels Ryberg
Finsen
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Finsen extended his work to all forms of internal TB
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Sputum Conversion Rate RCT Sputum conversion rates from AFB
positive to negative- Vit D 0.25 mg/day supplemented patients -100%
Non-supplemented patients- 77% South Med J. Author manuscript;
available in PMC 2010 November 1.
Slide 12
Refractory case of PTB- Improvement with Vit D
Slide 13
Vitamin D & Autoimmune diseases Who are you? Where am I?
You look delicious!
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N Engl J Med 2007;357:266-81. J. Nutr. 135: 2739S2748S, 2005.
Multiple sclerosis IBDT1DM RA
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Vit D deficiency- An Important, Common, & Easily Treatable
Cardiovascular Risk Factor?
Vitamin D deficiency in healthy South Indians Am J Clin Nutr
2007; 85: 1062-7 Deficient (
Slide 18
Vitamin D deficiency in healthy South Indians Am J Clin Nutr
2007; 85: 1062-7 Deficient (
Slide 19
Groups at Risk of Vitamin D Inadequacy Breastfed infants AAP
recommends that exclusively and partially breastfed infants be
supplemented with 400 IU of vitamin D per day Older adults Older
adults are at increased risk of developing vitamin D insufficiency
People with limited sun exposure Homebound individuals, people who
wear long robes and head coverings, & people with occupations
that limit sun exposure People with dark skin People with fat
malabsorption People who are obese or who have undergone gastric
bypass surgery
Slide 20
Cause of Rickets The First Insight
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Vit D physiology N Engl J Med 2007;357:266-81.
Slide 22
RICKETS ROSARY
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SKELETAL CHANGES
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HEALING RICKETS
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LINE OF CALCIFICATION
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NORMAL PELVIS
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DEFORMED PELVIS
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Loading dose 60,000 IU/Week for 8 weeks 60,000 IU/Week for 8
weeks Blood test Maintenance dose 60,000 IU/ 60,000 IU/ Mont h Dose
of Vitamin D For treatment of Vitamin D Deficiency
Slide 29
Recommended Vitamin D Intake by Endo. Society Guidelines, 2011
Reasonable daily allowance (IU/ day) Reasonable allowance (IU/
month) 0-6 months400-100012000-30000 6-12 months400-100012000-30000
Children (1-18 yrs)1000-200030,000-60,000 Adults (19-50
yrs)1500-200045,000-60,000 Elderly (51-70
yrs)1500-200045,000-60,000 Elderly (71 yrs)1500-200045,000-60,000
Pregnancy1500-200045,000-60,000
Lactation1500-200045,000-60,000