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nutritional problems part 2

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8 views

nutritional problems part 2

Uploaded by

Aakash Sp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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You are on page 1/ 17

NUTRITIONAL

PROBLEMS IN PUBLIC
HEALTH

BY, AAKASH S P
ROLL NO. 2
Synopsis

• ENDEMIC FLUROSIS
• LATHYRISM
ENDEMIC FLUROSIS

• In many parts of world where drinking water contains


excessive amount of fluorine (3-5mg/l)
• In India -Andhra pradhesh(Nalgonda and prakasam
districts),Punjab,Haryana,Karnataka,Kerala,Tamilnadu
Toxic manifestaion of flurosis :

A. Dental flurosis:
 Flurosis of Dental enamel occurs when excess fluoride is ingested
during the year of tooth cacification (1st 7years of life)
 Mottling starts above 1.5mg/l intake
B.Skeletal flurosis:
Associated with lifetime daily intake of 3-6mg/L or more
When concentration exceeds 10mg/L->crippling flurosis
occurs, it leads to crippling disability
C.Genu valgum:
New form of flurosis characterised by genu valgus and osteoporosis of
lower limb in some districts of Andhra pradesh and Tamilnadu

Was observed among people whose staple was sorghum(jowar)


INTERVENTION:
• Changing the water source with low fluoride content (0.5-
0.8mg/L)
• Chemical process =>Defluoridation of water

Called Nalgonda technique


• Use of fluoride toothpaste in areas of endemic flurosis Is not
recommended for children upto 6years of age
Lathyrism:
• Paralyzing disease of humans and animals in humans
referred to as neurolathyrism
• Crippling disease of nervous system characterised by
gradually developing spastic paralysis of lower limb
• Mostly in adults consuming pulse Lathyrus sativus in large
quantities
• DISTRIBUTION
• Neurolathyrism is present in parts of Madhya pradesh,uttar
pradeshBihar,Orissa

• Also reported in Maharashtra, West bengal,Rajasthan,Assam,Gujarat


where pulse is grown

• According to reports no fresh outbreaks have been reported to occur

• Mostly Consumed by poor agricultural labourer because it is relatively


cheap
The pulse
• Lathyrus sativus is commonly known as "Khesari dal"

• Local names =>Teora dhal,lak dhal,batra,gharas,matra

• Has triangular shape and grey color

• is a good source of protein but has toxin which affects


nerves

• Studies shown that diets containing >30% of this dhal if


taken over a period of 2 to 6 months will result in
neurolathyrism
The Toxin
• Toxin is beta oxalyl amine alanine(BOAA)

• Isolated in crystalline form and is water soluble

• This property is used in removing toxin from pulse by soak it


in hot water and rejecting soak water

• There is blood-brain barrier to this toxin , in order to


overcome this barrier ,the pulse must be eaten for period of
2months or more
The disease
• Affects mainly young men between 15 to 45 years
• Stages ;
1.Latent stage :
Apparently healthy ,subjected to physical stress exhibit ungainly gait
Neurologic examination show characteristics physical signs
Important from preventive aspect

2.No stick stage =>short Jerky steps

3.One stick stage =>crossed gait ,walk on toes ,muscle stiffness makes it necessary to use one stick for
balance

4.Two stick stage=>severe symptoms due to bending of knees and crossed legs ,gait is slow and clumsy

5.Crawler stage =>knee joint cannot support weight of body ,atrophy of thigh and leg muscles
INTERVENTION
A. Vitamin C prophylaxis; 500 to 1000mg for week

B.Banning the crop; an extreme step but is not feasible for immediate
implementation

C.Removal of toxin:
1.Steeping method
2.parboiling :
Simple soaking in lime water overnight followed by boiling is credited to
destroy toxin

D.Education
E.Genetic Approach

F.socio-economic changes
References
Park's textbook of preventive and social medicine
THANK YOU

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