Professional Documents
Culture Documents
8/14/2018 1
-The study of
how your
body uses the
food that you
eat.
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What is a Nutrient
A nutrient is a chemical substance
in food that helps maintain the
body. Some provide energy. All
help build cells and tissues,
regulate bodily processes such as
breathing. No single food supplies
all the nutrients the body needs to
function.
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Protein Sugars
Carbohydrat Starches
es Cellulose
Fats
Vitamins
Minerals
Water
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4
Nutrients that have
Calories:
Proteins
Carbohydrates
Fats
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Definition of a Calorie:
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Protein 1 Gram = 4
K.calories
Carbohydrates 1 Gram = 4
K.calories
Fat 1 Gram = 9 K.calories
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Variables which affect nutrient
needs:
1. Age
2. Gender
3. Activity Level
4. Climate
5. Health
6. State of nutrition
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Nature-Complex org.Compound composed
of C,H,O,N & Some Of P,Sulpher.
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Simple –These are composed of amino acid
only
Albumine in egg white
Serum in blood
Globulins of muscle
Zein of corn
Gladine of Wheat
Derived-Product of partial break down of
protein
Coagulated protein
Proteoses
Peptides.
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Complete protein- Contain all E.A. Acids.
Partially incomplete –May not contain one or
more E.A. acids
Incomplete protein- Content of amino acids
incapable either maintaining of life or
supporting growth e:g Goletine
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Animal Sources
Plant sources
Milk & Milk product
Cereals,Pulses,Oilseeds,Beans
Eggs,Meat,Poultry, & Fish
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Essential Amino Acid
Tryptophane Non Essential Amino Acid
Isoleucine Alanine
Lysine Asparagine
Methionine Aspartic Acid
Phenylalanine
Cystine
Threonine
Valine
Cysteine
Arginine Glutamic Acid
Histidine Glutamine
Glycine
Hydroxy Proline
Hydroxy Lysine
Proline
Serine
Tryrosine
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Protein Source Limiting amino acid
Wheat Lysine
Rice Lysine
Maize Lysine & Tryptophan
Pulses Methionine(or Cysteine)
Phenylalanine(or
Beef
tyrosine)
None;the reference for
Egg,Chiken
absorbable protein
Milk Or Whey, bovine Methionine(or Cysteine)
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Synthesis of new protein
Body Building
Protective & Regulative Substance like enzyme,
hormones, Antibodies
Protein as carrier- Hemoglobin
Energy Giving- 1 gm 4 Kcal
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Group Particular Protein
Man 60
Woman 50
Pregnancy +10
Lactation +20
Infants 0-6 months 2.3-1.8/K.g
7-12months 1.8-1.5/K.g
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Children 1 year 17
2 year 18
3 year 20
4-6 years 22
7-9 years 33
10-12 years 41
Adolescents 13-15 years Boy 55
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Two Clinical Forms
Marasmus
Kwashiorkor
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Important cause of child hood morbidity &
Mortality
Two clinical pictures – Kwashiorkor &
Marasmus. Marasmus is more common
Causes of PEM-
Inadequate food intake, Low incom,Education
Infections- Respiratory infections, measles,intestional
worms,Diahorrea
Large family, poor maternal health, failure of lactation,
premature termination of breast feeding, poor
distribution of food within family are other causes of
PEM
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First indicator of PEM is Under weight for age
Marasmus-Low Weight,Dewasting of
Mussules,Wrinkles on skin,Hungry,Infection
Kwasiorkor-Edema,Liver enlarge, Hair color
change
Grade
ad
III
III
Grade III
II
Grade I
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Marasmus-Low
Weight,Dewasting of
Ravenously
Mussules,Wrinkles on
hungry
skin,Hungry,Infection
Gross
weight
loss &
no fat
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Edema on face, Hands & Lags
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Infection Sparse
hair
Kwasiorkor-
Edema Swollen
Liver enlarge belly
Hair color change
Dermatitis Decreased
Poor Appetite muscle
mass
Pellagra
Apathy
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Health Promotion
Health education & distribution of supplements
to pregnant & lactating women
Promotion of breast feeding
Family planning & spacing of births
Food & personal hygiene
Early diagnosis & treatment of all infection
Specific Protection
Low-cost High protein & energy rich diet to child
Immunization
Food fortification
Improve family diet
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Early Diagnosis & Treatment
Periodic Surveillance
EDPT of infections & Diarrhea
Early diagnosis of lag in growth
Deworming of infested children
Rehabilitation
Nutritional Rehabilitation services
Hospital services
Follow – up care
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Nature
Contain Carbon, Hydrogen & Oxygen.
Classification
Mono-Saccharides. e.g. Glucose,Fructose,Gelectose
Di-Saccharides. e.g. Lactose, Maltose, Sucrose
Poly-Saccharides. E.g. Starch, Dextrin, cellulose ,
pectin
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Dietary Sources
Cereals, Pulses, Dry Fruits, Sugar, Jegary, roots &
tubers like potato, sweet potato, fruits-banana, dates
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Function
Supply energy for body function. 1 gram-4Kcal
Supply Certain sugar like ribose which constituents
nucleic acid
Sparing effect on protein
Fibers plays essential roll in functioning of intestinal
tract
Adds to the test of diet
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Disorder
Excess sugar in diet leads to obesity which connected
with Cardiovascular disorder
Less Sugar utilization of protein, reduce body weight
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Nature
Technically known as Lipids containing Carbon,
Hydrogen & Oxygen
Lipids are compound of glycerol & fatty acids
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Fatty acids
Saturated Unsaturated
Butyric acid Oleic acid
Caproic acid Linoleic acid
Caprylic acid Linolenic acid
Capric acid Arachidenic acid
Lauric acid
Myristic acid
Palmitic acid
Stearic acid
Arachidic acid
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Dietary sources
Edible vegetable oils,Ghee,oil seeds,millk & Milk
product, Eggs, Fish
Requirement
30 to 50gm per day
(Not more than 15% calorie from fat in the diet)
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Function
Source of energy- 1gm-9 kcal.
Source of essential fatty acids-
Linoleic,lenolenic,anachidonic
Protection of body
Vehicles of fat soluble vitamins-A,D,E,K.
Palatability
Satiety value
Reserve source of energy
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:Deficiency disorder
-Loss of body weight
-Skin disease
:Excessive consumption cause obesity
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INTRODUCTION
Micronutrients
Required by
human body
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VITAMINS MINERALS
Water Calcium
Fat
soluble Phosphorus
Soluble
Vit-B1(Thaiemine) Iron
Vit-A,D,E,K Iodine
B2(Riboflevin)
Fluorine
B3(Niacine)
Zinc
B6(Pyrodoxin)
Copper
B9(Folic Acid) Cobalt
B12(Cyanocobalmin) Chromium
Vit- C Selenium
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Nature
Complex higher alcohol with unsaturated structural
bond
Fat soluble
Heat stable
Well stored in body (Liver)
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Dietary sources
Animal sources- As Retinol-Milk & Milk
Product,Eggs,Liver,Pork,Fish liver oil
Vegetable sources-As Carotene-Yellow & orange
color fruits & vegetabls,Red palm oil, vegetable ghee
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FUNCTION
Essential for good vision
Necessary for reproductive system
Protecting mucosmembranes
Helping in immune function
Necessary for bone formation
Prevent dry skin
Anti oxidents
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Daily requirement
Adult Men & women-600mcg-Retinol
Pregnant mother,Adolecent(10-12 yrs)-600mcg
Lactating mother-950 mcg
Infant-350 mcg
Children(1-9 yrs)-400mcg
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Deficiency
Night blindness
Bitot spot
Xerophthelmia
Keretomalacia
Dermatosis on skin
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Primary signs:- X1A Conjunctiva Xerosis
X1B Bitot”s spot with Conjunctiva Xerosis
X2 Corneal Xerosis
X3A Corneal Ulceration with Xerosis
X3B Keratomalacia
Secondary signs:- XN Night blindness only
XB Bitot”s spot only
XF Typical fundus only
XS Corneal scars attributable to
Xerophhalmia
Most common in aged 1-3 years
Associated risk factors- ignorance, faulty feeding
practices, infections,Meassles,
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BITOT SPOT KERATOMALACIA
V
A
D
BILATERAL
BLINDNESS
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Short Term Action: Large doses of Vita. A
orally
Medium Term Action: Fortification of
certain foods with Vita. A
Long Term Action: - Consume green leafy
vegetables, Yellow &
Orange color fruits
& vegetables daily
- promotion of Breast feeding
- Immunization
- improved MCH services
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Nature
Activated sterols closely related to cholesterol
Fat soluble
Relatively heat stable
Well stored in body
Dietary sources
Fish liver oil, Egg
yolk,sardines,butter,Cream,Vegetable ghee
Ultraviloet Rays of sun
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FUNCTION
Essential for calcium & phosphorous absorption for
formation of teeth & bones
Essential for growth
Daily Requirement
Infant & Children-10mcg(400IU)
Pregnant & Lactating Mother-10mcg(400IU)
Adult Man & Woman-2.5mcg(100IU)
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Deficiency-RICKETS in children
Causes disturbances in metabolism of Ca.& P.
In adults osteomalacia
Excess vit-d –Toxic-calcification & damage to
kidney muscular weakness, nausea.
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Rickets
& osteomalasia
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Nature
A pyrimidine thiozol compound Having Sulphur
Water soluble
Heat labile, poor stored in body
Dietary sources
Lean pork,Peanuts,dried peas & beans,
liver, chicken, green beans, Whole cereals &
pulses
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Daily Requirement
0.5mg per 100K.cal.(1-2mg per day)
Deficiency diseases
Infantile beriberi
Wet beriberi
Dry beriberi
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Cardiac beriberi (wet beriberi)
edema & cardiovascular symptoms
Dry beriberi
numbness, burning sensation, muscles
tenderness, loss of wt.,loss of
appetite,dizziness,indigetion
Infantile beriberi
cardiac failure & ultimate death.
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Nature
Flavin compound, Yellowish green fluorescence
Water soluble, Heat stable
Detoration when exposed to light
Dietary sources
Liver, lean meat, egg yolk,
peanuts,spinach,lttuce,carrots,culiflower,beats,milk,
buttermilk,whole grain.
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Function
Production of co-enzyme for proper utilization of
carbohydrates
Help in oxidative process of living cell
To form enzyme flavo protein
Daily Requirement
0.6mg/1000K.cal(About 1-2-3mg/day)
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Inflammation of lips
Angular stomasis
Dermatitis of nasolabial folds
Phtophobia,burning,itching,irritation of the
eyes
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Nature
Organic compound related to nicotine
Heat stable, Water soluble
Dietary Sources
Liver,meat,leanbeef,milk,egg
yolk,spinach,lettuce,green cabbage, green
peas,soyabeans,groundnutt,Whol cereals & pulses,
Niger seeds.
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Function
A constituent of co-enzyme
Necessary for health of epithelium & nervous system
Requirement
6.6mg/1000K.cal.
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Dermatitis,stmatitis,diarrhoea,Sunbur
n,
Mild redness,sorness & smoothness of
toung & mouth, ulceration
Nausea & vomiting
Mentally not concentrated
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Water soluble, Heat labile.
Dietary sources
Liver,green,spinach,GLV,Soyabeans
Function
Necessary for red blood cell formation & assist vit-
B12 function in this process
Essential component in DNA Synthesis
Essential for growth
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Deficiency
Pernicious anemia
Poor growth in children
Depression, Mental confusion
Excessive intake associated with
gastrointestinal problem
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Nature
Sparingly soluble in water
Stable to heat
Red-pink color with cobalt element
Dietary sources
Liver, egg, meat, fish,& milk
Requirement
1.0mcg/day for adults
Lactating mother-1.5mcg/day
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Function
Development of D.N.A
Co-enzyme in amino acid(metionine) metabolism
Building in epithelial tissue
Promotes maluratin of red blood cell
Utilized in formation of white blood cells &
blood platelets.
Deficiency
Megaloblastic anemia
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Nature
Alaetone haxuronic acid
Water soluble, Heat labile, Poorly stored in the body
Dietary sources
All citrus fruit,spinach,cabbage,cucumber,
guava,drumstic, coriander leaves amla,& germinated
cereals & pulses
Requirement
Adult-40mg/day
Lactating mother-80mg/day
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Function
Important for healthy immune system
Essential for collagen formation 7 healthy
bones,teet,gums,
Facilitates iron absorption
Helps in wound healing
Acts as antioxidants
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Deficiency
Leads to scurvy Excessive bleeding, loose gums &
teeth.
Inflammation of joints & edema
Reduce risk of heart attack, cancer.
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Weakness,Anamia,swelling of gums &
multiple hemorrages,joint effusion
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Dietary sources
Milk & Milk
product,GLV,Soya,Almonds,Custard
Apple,Bajra,Jowar,Pulses,Sesame seeds etc.
Function
Bone & teeth formation,
Cell transport
Require for nerve cell transport
Essential for muscle contraction
Important for blood clotting
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Requirement
Adult-400mg /day
P/L mother-1000mg/day
Children-400-600mg/day
Deficiency
Osteoporosis(Thining of bones)
Rickets in children
Tiredness & muscular dysfunction
Excess calcium causes kidney disease &
development of kidney stones.
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IRON – A MICRONUTRIENT
1. Formation of Haemoglobin
4. Muscle activity
cells i. e. RBCs.
Oxygen Transport
&
Cell respiration.
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Sources of IRON
Animal Plant
Source Source
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Regulation of Iron
Normal losses that occur through the gut or skin are very
small.
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Total dietary Iron intake ( 28 mg/day)
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WHAT IS ANAEMIA ?
Normal Anaemic
Reduced Oxygen
blood blood
carrying capacity
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CAUSES OF ANAEMIA
Diet
Dietdeficient
deficient Poor absorption of Iron Blood Loss /
ininIron
Iron available in the diet Increased
demand of Iron
Absence of Iron
absorption Enhancers Hookworm infestation
Cereals based diet
Less consumption Presence of Iron Malaria,Typhoid
of Iron rich diet absorption Inhibitors Juondic,
Poor bioavailability of Start of menstruation
Iron in Diet During Childhood &
Adolescent
Deficiency of Vit.C,B12,&
folic acid Frequent Pregnancy
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Hemoglobin content of blood is lower than
normal
Most frequent cause- Iron deficiency
Less frequent cause – Follate or Vita. B12
deficiency
Increase risk of maternal & foetal mortality
& morbidity due to Anaemia
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PREVALENCE OF ANAEMIA
Lab Diagnosis :
By estimation of haemoglobin in blood
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Clinical Diagnosis :
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SYMPTOMS OF ANAEMIA
1. Excessive tiredness
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SIGNS OF ANAEMIA
A. In Children
2. School absenteeism.
4. Mental irritability.
5. Retarded growth.
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B. In Adolescent Girls
performance in school
4. Poor appetite
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5. Poor overall growth
6. Delayed menstruation
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C. In Pregnant Women
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Control of Anaemia
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DIETARY MODIFICATIONS
sprouted ones ),
Jaggery,
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3. Iron absorption enhancers -
absorption of iron.
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4. Iron absorption inhibitors – ‘ Tannins ’ present in
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Interventions
1. Iron and folic acid supplementation :
Dosage : Mothers – one tab. Daily
60 mg elemental iron +
0.5mg folic acid
Children- one tab daily
60 mg elemental iron +
0.5mg folic acid
2.Iron fortification
3.Other strategities – Control of parasites,
Nutritional education
4.Iron Rich Food
5.Public health measure-Control of Malaria
-Control of Hook worm
-Safe drinking water
-Personal hygiene & Sanitation.
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Iron
Loss, Phytate, Oxalate, Carbonate, Phosphate, Dietary Fibres, Milk, Tea, Eggs,
Or Interfere with iron Absorption.
Absorption Ascorbic acid increases absorption.
Total Daily Iron loss through haemorrhage & Basal loss through urine, sweat,
bile, surface cells.
Adult Male – 1 mg.
Mens. Female – 2 mg.
Daily
Age & Gender Absorption Intake
Requirement
Healthy Adult Male – 0.9 mg. 28 mg/day
Female (Mens.) – 2.8 mg 30 mg/day
Pregnant Women First Half – 0.8 mg. 38 mg/day
Second Half – 3.5 mg
Lactating Mother 2.4 mg. 38 mg/day
Children 1.0 mg. 26 mg/day
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Iodine deficiency causes Goiter & cretinism
The IQ Score of children less 13 points
Implication of loss of IQ
poor scholastic performance, frequent
failure/Grad repititions/Abseteeism,Dropouts
Daily Requirement – 150 microgram
Iodization of salt is best prophylactic measure
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Enlarged Thyroid Gland
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Thyroid Gland
Goiter
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• Endemic Cretinism
• Note normal man and three adult
women with cretinism:
• Short stature
• Protuberant abdomen
• Swollen features
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Excessive amounts of fluorine(3-5mg/L) in
drinking water causes fluorosis
Toxic manifestation –
Dental Fluorosis
Skeletal Fluorosis
Interventions –
Changing the water source
Chemical treatment
Avoid fluoride tooth paste
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