Thursday, July 4, 2013

Treatment of Scurvy


Scurvy (N.Lat scorbutus) is a deficiency disease, caused by lack of vitamin C, which is required for collagen (an element of normal tissues) synthesis in humans. The chemical name of vitamin C is ascorbic acid, which is derived from the Latin name of scurvy, scorbutus. Vitamin C is found mainly in fresh fruits and vegetables, particularly citrus fruits such as oranges, olives, lemon, sweet lemon. Reduction in intake of Vitamin C rich food products, leads to scurvy.

History of the disease:

Scurvy historically affected mostly those nations, which were dependent more on military power. During military campaigns and long ocean voyages, food consumed by the ship crewmembers largely lacked in fresh fruits and vegetables, thus causing inadequacy of Vitamin C and leading to outbreak of scurvy epidemics.

The first clue to the treatment of scurvy occurred during Jacques Cartier's arrival in Newfoundland in 1536, when he was advised by the native Indians to give his crewmembers, who were dying from this epidemic, a potion made from spruce tree needles. The foliage, rich in vitamin C, cured most members of Cartier's crew.

What are the symptoms of scurvy?

Symptoms of Scurvy include one or any of the following -

o Swollen, blackened and bleeding gums with loosened teeth.

o Soreness and stiffness of the joints and lower extremities

o Bleeding under the skin and in deep tissues

o Anaemia

o Wounds that don't heal, and scar tissue from old wounds dissolve causing reopening of wounds

o Tiredness and weakness, along with muscle cramps

o Appearance of tiny red blood-blisters to large purplish blemishes on the skin of the legs.

Who are more at risk of contracting Scurvy?

Scurvy is common in persons who follow a very restricted diet especially lacking in ascorbic acid, or who are under extreme physiological stress or are chronic alcoholics. Infants can also develop scurvy if they are devoid of mother's milk, and switched to top-up milk, without providing sufficient Vitamin C supplements. Babies of mothers who take extremely high doses of vitamin C during pregnancy may also develop infantile scurvy.

Treatment for Scurvy:

Increase in intake of fresh vegetables and fruits, especially citrus fruits are necessary to treat scurvy. Additionally, adults need to consume around 300-1,000 mg of ascorbic acid per day and 50mg/day in case of infants to effectively treat the disease.

Since the body does not produce vitamin C, it must be obtained from fruits and vegetables. Some excellent sources of vitamin C are oranges, olives, guava, green peppers, watermelon, papaya, strawberry, kiwi fruit, mango, honey, mango powder, broccoli, tomatoes, cauliflower, cabbage, and citrus juices or juices fortified with Vitamin C.

Amla or the Indian gooseberry is one of the richest sources of Vitamin C, whether fresh or the dried, powdered form.

Raw and cooked leafy greens (turnip, spinach), red and green peppers, fresh tomatoes, potatoes, pineapple are also rich sources of Vitamin C.

Vitamin C is sensitive to light, air, and heat, so it is best to eat fruits and vegetables raw, or minimally cooked in order to retain their full vitamin C content.

Treatment of Scurvy with vitamin C is usually successful, if the deficiency is recognized early enough. If left untreated, the condition can even cause death.

Preventive diet for Scurvy:

For Infants -

The most important factor in the prevention and treatment of scurvy is proper feeding of mother's milk, atleast for the initial six months. After birth, all children should preferable be breast-fed because it is pure and fresh and contains most of the nutrients necessary for the growth and development of the baby. If, for any reason, it is not possible to breast-feed the baby, then cow's milk or commercially available milk should be supplemented with vitamin C.

For Adults

A well balanced diet plays an important role in the prevention and treatment of scurvy in adults. The patient should take a well-balanced diet consisting of grains, seeds, nuts, fresh vegetables and fruit. This diet should always be supplemented with milk, eggs, fruits and honey.

Recommended Vitamin C intake:

Scurvy is rare in countries where intake of fresh fruits and vegetables is more. The Vitamin C present in them acts as important antioxidant, thus enhancing the development of connective tissues, lipid and vitamin metabolism, immune function and wound healing.

Currently, the recommended dietary allowance (RDA) for vitamin C is

o For adults: 50-60 mg/day;

o For infants: 35 mg/day;

o For pregnant women: 100 mg/day

o Lactating mothers: 150 mg/day

However, requirement for vitamin C increases when a person is under stress, smoking, or under some medication.

Although rare, but scurvy remains a malaise condition that is still prevalent in the pediatric population, especially among certain groups with unusual eating habits. A heightened awareness towards intake of Vitamin C rich foods is required to prevent a potentially fatal, but easily curable disease.
Thus, take the suggestion - "An orange a day keeps scurvy away."

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