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In so far as is known, the guinea pig, the primate apes and monkeys, and man are the only species which require vitamin C in the diet. Other species synthesize the vitamin within the body.

The discase is characterized primarily by faulty formation of the “cement substance” between cells and the faulty formation of collagen. The fragile eapillary walls which result allow bleeding upon slight trauma. This is particularly evident in the gums. Bone formation is impaired. The joints become sore and painful, the teeth loose. Ascorbic acid is higly specific although some isomers apparently have some slight activity.

Ascorbic acid is easily oxidized, particularly at high temperature and is the vitamin most readily lost during cooking.  Storage of food is usually associated with vitamin C losses except under modern methods of freezing and canning. Scurvy is usually seen in children not given the vitamin orange juice or other appropriate sources. Milk is not a reliable source. In the past scurvy was serious on voyages and campaigns where dried rations were necessary.

The function of vitamin C is little understood. In scurvy the amino acids tyrosine and phenylalanine are incompletely oxidized and the oxidation product, dihydroxy phenylalanine  occurs in the urine. The vitamin also apeear to be necessary for the transformation of frolic acid into citrovorum factor. This is the probable cause of the anemia seen in scurvy.

The minimum requirement of vitamin C is about 0 mg per day. This will prevent scurvy in the adult. However, there is considerable disaggreement as to whether much higher levels are beneficial. Recommendation intakes thus vary from 30 mg per day in England to 70 mg per day in the United States of America. The latter amount is required to maintain a blood level similar to that found in animals which synthesize their own vitamin C. Blood levels clearly reflect the vitamin C intake. The white cells of the plasma maintain their their vitamin C content after all vitamin C has disappeared from the plasma. When the level in the white cells begins to fall scruvy is imminent.

The better sources of the vitamin are the citrus fruits, tomatoes, cabbage, green peppers etc. Although the vitamin content of materials such as potatoes is not high these are often consumed in sufficient amountsbto be the chief protection against scurvy. Nearly all fresh vegetables andfruits contain significant amounts while cereals and most meats are not good sources.

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Post by our Guest Blogger:

Kylie Robinson is a webmaster and blogger, as well as being a student in the city of Toronto. Kylie has performed hours of research the importance of the Human Growth Hormone for our bodies. Due to this, Kylie is an expert when it comes to finding the best HGH, buying HGH, and the HGH supplements.

With the passage of time, our lifestyle has changed a lot. Today, most of us lead a busy and hectic life and the more we try to ecel, the more we pose a danger to our health. Of all the organs, our heart is most severely affected by the stress. Regular exercise can guarantee safety for the heart. There is no better way to improve the efficiency of the heart than exercise. Remember the following facts :

• Heart is like a muscle that works better when it is in shape.
• Exercise makes it stronger, helping it to pump more blood.
• A healthy heart can pump a large amount of blood with fewer heart-beats than an unhealthy heart does.
• During exercise, blood is pumped at a much faster rate - as much as 20 times the normal volume of blood.
• Cardiovascular or aerobic exercises target the large muscles of the body and create an increased demand for oxygen.
• Exercise - such as walking, cycling, jogging and swimming - improves the circulatory and pulmonary systems.
• Five to six days a week, we must think of 20-60 minutes of continuous activity of an intensity of 55% to 90% of maximum heart rate.
• Those who have undergone a bypass surgery or angioplasty, can simply start by walking. They can, however, increase it gradually.
• Heart rate must be monitored when one indulges in exercise, to keep track of its prescribed limit.
• For specific exercise recommendations a physician should be consulted.

Manipulating the body’s “energy pathways” with hair-thin needles - as esoteric as

that sounds - is easily the most well respected complementary therapy popular in many countries around the world. Even NIH researchers, America’s medical standard bearers say - there’s plenty of evidence that acupuncture works (much of it in the more than 2300 studies conducted on the technique). Dr. Hiranandani, a renowned acupunturist pioneered the use of Laser & Ultrasound in acupuncture area and is now a standard text in acupuncture institutes all over the world. Most common uses of this technique is in back pain, asthma, headaches, bladder problems. Dr. Hiranandani’s studies led him to -

“the conclusion that few illness had single causes and that healing the mind body and soul required help from many sources.”

According to him acupuncture can relieve migraine headaches and can often lead to a cure. One study found that after several treatments, women who had three or more urinary tract infections in a year, all experienced less pain and fewer recurrences. Plan on 6 to 10 visits before seeing results in some instances of acute migraine attack, says Dr. Hiranandani,

“pain relief may occur within 5-7 minutes which is faster than any drug.”

As small as the needles are, acupuncture isn’t always painless. It’s usually not awful, just a dull ache. But it’s the action behind that ache that counts. The needle, paced at key points on the body, is thought to stimulate the release of chemicals and balance energy flow (or qi) , says Marshall H. Sager, D.O., President of the AAMA. Charles May, MD, a family physician in Cleveland, finds the therapy soothing and ha sought treatment for muscle injuries, even bronchitis and the flu:

“I didn’t know what to expect my first time, but I found it incredibly relaxing and there was minimal discomfort.”

Mouth nourishes a population of commensal microorganisms which is normally controlled by the reasonable standard of oral hygiene. If it is neglected bacterial population may proliferate and this causes stomatitis. Stomatitis may occur when resistance to commensal population is lowered by disease, particularly in immune-compromised host. Stomatitis can also be due to nutritional deficiencies or some other factors.

Ulcerative Stamatitis (vincent’s infection):- It occurs mainly in adults with malnutrition and poor dental hygiene. Ulcers with ragged necrotic margins occur particularly on gums. It may involve palate, lips or inner aspects of cheeks. Ulcers are covered by grey slough surrounded by erythematous margin. The stained smear shows several spirochaetes and fusiform bacilli. Those organisms are present in small number in normal commensal population of mouth and condition may be regarded as endogenous infection because of impairment of the host resistance. That condition is infectious, so that patient’s food vessels and the cutlery should be sterilized. This is treated with metronidazole (200mg 8hourly for 4 days) or penicillin.

Viral Infections: - Herpes Simplex type 1 may cause recurrent problems of the herpes Labialis in normal individuals. It may cause much more severe stomatitis in AIDS.

Candidosis:- Fungus ‘candida albicans’ is normal commensal in mouth. It may proliferate to cause thrush in babies, in aged and especially in debilitated patients. The thrush is common in those receiving prolonged treatment with oral antibiotics and in patients who are immuno suppressed by the corticosteroids or AIDS. White patches appear on tongue and buccal mucosa also may enlarge. There is a little surrounding inflammation. During severe infection the pharynx and the oesophagus may be affected causing dysphagia.

Stomatitis due to deficiency of nutritional factors: - It may arise directly from insufficient intake or indirectly as the result of impaired absorption of vitamins, particularly niacin, folic acid, riboflavin and vitamin B. When this deficiency is acute and severe the tongue is red, raw and also painful because of atrophy of papillae. Tongue appears to be moist and unduly clean when the deficiency is less severe and chronic. The angular stomatitis sometimes accompanies glossitis particularly in case of gross iron deficiency. During severe vitamin C deficiency gums become swollen and spongy.

Aphthous Ulceration: - It is a common recurrent condition of the unknown aetiology characterized by painful superficial ulcers in mouth. Lesion begins as indurated erythematous area in one day or so by ulceration. Ulcers are often multiple and also remain painful for about one week before healing commences. They can recur every few weeks. The emotional stress may also precipitate an attack. In many women ulcers tend to recur in the cyclical fashion during premenstrual phase. When most of the patients are healthy, severe chronic aphthous ulceration can be found in association with Crohn’s disease, ulcerative colitis, coeliac disease and Behcet’s syndrome.

Hydrocortisone hemisuccinate lozenges (2.5mg, 8 hourly) can be effective at early stage of the lesions. The pain may be reduced with tropical anesthetics. The secondary infection can be controlled with tetracycline mouth washer. Suspension of sucralfate can be tried for healing.

Other forms of stomatitis: - Allergic reaction to the chemicals in some toothpaste, destures, foodstuffs and many drugs, particularly antibiotics, may cause stomatitis. Blue-black punctuate line may be visible where gum margins adjoin teeth in lead poisoning. Skin diseases like lichen planus, pemphigus and erythema multiforme involve mouth often before being visible on the skin. The stomatitis may also be the manifestation of blood dyscrasias.

Pancreas Division (Dominal Dorsal Duct Syndrome): - This problem occurs in up to 10% of the whole population. It results from dorsal and ventral pancreas to unite. Consequently most of the pancreas is drained through accessory papilla that is proximal to papilla of Vater. These types of patients are more prone to pancreatitis for condition appears to be associated with stenosis of opening of one or other papilla.
Diagnosis in made via endoscopic retrograde cholangiopancreatography (ERCP).

Annular Pancreas: - Ventral pancreas surrounds the second part of duodenum and it is frequently associated with other congenital defects such as mal-rotation of intestine, artesian and cardiac defects. Pancreas may constrict duodenum causing obstruction soon after the birth or in adult life. This may predispose to duodenal ulcer and acute pancreatitis. Diagnosis is made by barium studies and treatment is surgical bypass of constriction.

Ectopic Pancreatic Tissue: - It may occur in gastric antrum or duodenum and it takes the form of smooth nodule. It is normally asymptomatic and it does not require any treatment. If it is found coincidentally during surgery, the nodule is excised for it is subject to same conditions including carcinoma, as the pancreas itself.

Pathology: - The pathological findings and clinical features result from obstruction by abnormal viscid secretion of the ducts in salivary glands, digestive and biliary tracts and pancreas causing atrophy
Clinical Features: - The exocrine insufficiency leading to steatorrhoea and diarrhea is almost universal in childhood. If patient survives to adulthood, malabsortion tends to be less troublesome. The intestinal obstruction, commonly called “meconium ileus equivalent”, may occur in the children and in the adults, caused by inspissated food and secretions. Rectal prolapse is frequent in children because of the large bulky stools and frequent coughing. The recurrent episodes of the acute pancreatitis may also occur. The incidence of the diabetes mellitus increases with the age. Chronic pancreatitis may supervene. The disease of liver or biliary tract may occur.
Investigation: - The gastrointestinal problems are investigated according to suspected problems. There may be disorder in the gut epithelium and pancreas. 80% of the patients with cystic fibrosis have both pulmonary disease and pancreatic disease. But 15% patients have lung sepsis with clearly normal pancreatic function.

Management: - Optimal treatment in adolescent and adult depends on a team approach to the complicated respiratory, nutritional and hepatobiliary problems. Many treatment centers have established special clinics for such kind of patients with specialist care. Read more…