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Dr. SP Srivastava - Pediatric Oncall

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Effects of Iron deficiency on
Physical and Mental functions in
Children.
Dr. S.P. Srivastava
Normal Child No Iron Deficiency
Functions of Iron
Formulation of hemoglobin
Formulation of cytochrome myoglobin
Binding O2 to RBC and transport
Regulation of Body temperature
Muscle activity
Catacholamine metabolism
Immune system –
T cell
Brain Dev & function
Depressed thyroid function
antibodies
Iron Deficiency (6-24 months)
Difficulty with language
Poor Motor Co-ordination and balance
Poorer rating on attention
Poor Responsiveness
Poor Performance of motor
Physical Growth and performance
Weight gain, growth velocity
Further compounded associated with
infection anorexia
Poor work capacity
Endurance, work capability
Rapid gain of weight & endurance with
iron therapy.
Mental and psychomor dev
Poor attentiveness
Poor memory
Poor academic performance vocabulary,
reading, writing, arithmetic
Disruptive, irritable, restlessness
Poor performance in test
Iron Acquisition In Brain
The Basal Ganglia (Frontal Section)
Iron In Brain
Iron In Brain
Concentration of Iron in Brain
Highest at birth
Decrease at weaning
Increase at onset of Myelination
Maximum at expression of Tf mRNA
Iron Concentration In Brain
100%
Myelination
75%
50%
Maximum
25%
Birth
2 Years
10 Years
Adult Human
Iron def, Infection, physical growth
T cell and antibodies diminishes
Cell mediated immunity defective
Killing bacteria capabilities poor
Capacity of leucocyte defense poor
Iron and Neurotransmitor
Dopaminergic system dev in early post natal life
Rapid increase in number and density of
DA transporter, receptor
Monoamine for axonal growth and synapse
formation
Neurotransmission
Iron and Neurotransmitters
Enzyme involve in N.T are – Tryptorhan
hydrolase (Serotonin)
Tyrosin Hydolase (Ne. and Da)
Cp factor for Ribonucleotide reductase
Electron Transfer for lipid metabolism
Brain Energy
Restless leg syndrome
Iron Deficiency & Cognitive Development
Birth to 2 years
- Sensorimotor
Period
2 to 7 years
-Preoperation
period
7 to 12 years
-concrete
operations
Above 12 years
-Formal
operations
Behavioral and Emotion
65% Common
Behavioral
Midbrain Iron, DA
Transmitter & D1
Receptors
35% Anxity –
DA Transporter,
D2 Rece
Improve with Iron
Critical Period
Irriversible effect on nerve conduction in iron
deficiency
Timing of iron deficiency is of great importance
Lead to toddler developmental delay if iron def earlier
Sequence – Cell migration significant myelination
cellular differentiation increase expression of
neuropeptides
Study Scales
BS.ID – Bayley Scale of infant Dev
IBR – Infant behavior records
MDI – Mental dev index
PDI Psychomotor dev index
Wise – Wechsler intelligence scale of
childhood
Stages of Iron Deficiency
Decrease Iron Storage
Latent Deficiency serum feritin - <
10mcg/L
Iron deficiency – 0.80 to 1.8 mg/L
Iron Value per 100gm for Common Food
Food
Rice
Rice Pufed
Wheat
Bengal gram
Bengal G Dal
Rajma
Soyaneam
Milk
Gagery
Apple
Banana
Amranth
Iron (mg) Food
6.4
4.6
11.5
10.2
9.1
5.8
11.5
.1-.3
10.5
0.66
0.36
25.5
Iron (mg)
Bengal G Leave 23.8
Coriander L
18.5
Mustard L
16.5
Spinach
10.9
Ginger
10.5
Muster Seed
17.9
Date
7.3
Fish Dried
20-25
Fish Fresh
1-4
Egg
2.1
Mutton
2.5
Honey
0.69
Conclusion
Iron deficiency is major public health problem
It is an essential nutrition not only for normal growth
health and Survival of children but also for their development
and congnitive Functioning iron deficiency anemia is
associated with significantly poorer performance on
Psychomotar and mental development scale and behavioral
rating is in infant and children.
Iron supplimentation improves mental development score
modestly and improve physical capacity and endurance.0
Thanks
Dr. S.P. Srivastava
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