This is a case of Pellegra**
ভিটামিন B3( Niacin) এর Deficiency তে হয়ে থাকে।শুধু স্কিন এ না,, এইটা Multisystem কে Involve করে।
পেশন্ট ৩ টা Symtoms নিয়ে আসতে পারে–3D
• Diarrhoea
• Dermatitis
• Dementia ( vit B12 er deficiency তেও হতে পারে)
শুরুতে git প্রব্লেম গুলো হয়, So Pt এর Diarrhoea হবে শুরুর দিকে, কিছু দিন পর দেখা যাবে,, সে ভুলে যাচ্ছে কোথায় কি রাখছে,, বা মনে রাখতে পারবে না বেশি
সাথে হাতে পায়ে মুখে Hyperpigmented patch হবে
শুরুর দিকে Red clr পরে Dark ,Scaly, itchy হয়…casal necklace appearance
Sun exposure Area তে শুরুর দিকে হয়ে থাকে____
খাদ্য সংকট ,বা যেখানে মানুষ খাবার পায় না, আফ্রিকার কিছু দেশে বেশি, দেখা যায়…যারা Beef,chikn ,fish, whole grain, vegetable এগুলা পায় না তেমন
Tahle আমরা কিভাবে Dx করবো
Specific কোনো Investigation নেই,ক্লিনিকেল Symptoms,git prblm, rash এগুলা দিয়েই Diagnosis করা যায়
sometimes urin test দেয়া হয়
Treatment__
Rx.. Niacin supplements
Tablet 1. Nicoson 500 mg
0+0+1—-6 month
Tablet1:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Indications of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Inositol (Nicosit) is indicated in adults for the treatment of:
- Polycystic ovary syndrome (PCOS)
- Anovulation
- Menstrual disorders such as amenorrhea
- Hyperandrogenism complaints such as hirsutism, alopecia, acanthosis nigricans, acne
- Ovarian hyperthecosis
- Insulin resistance
- Male infertility
Composition of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Each film Coated tablet contains Inositol (Myo-inositol) USP 750 mg.
Pharmacology of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Inositols are important molecules in promoting female fertility and in sustaining physiological pregnancy. Myo-inositol, a major form of Inositol, has an established role in human physiology. Myo-inositol represents the most abundant inositol isomer in humans, and it is commonly found in almost every tissue, particularly in brain, blood, fat, kidney, lung, ovaries, and testes, where it participates in several cellular pathways,
Inositol (Myo-inositol) as second messenger of gonadotropins and insulin, it guarantees the correct development of oocytes and the progression of embryogenesis. Available evidence demonstrates that the supplementation with Inositol (Myo-inositol) enhances the probability of achieving pregnancy and reduces the onset of adverse maternal effects and neonatal outcomes. Specifically, in the pursuit of pregnancy, Inositol (Myo-inositol) proved to induce ovulation and restore the physiological menstrual cycle in infertile women, particularly in those with Polycystic ovary syndrome (PCOS). Moreover, Inositol (Myo-inositol) supplementation is also useful for women undergoing Assisted reproductive technology (ART), improving oocyte and embryo quality. During pregnancy, Inositol (Myo-inositol) reduces the risk of altered metabolic conditions like Gestational Diabetes Mellitus (GDM), which may lead to miscarriages or stillborn babies. In addition, Inositol (Myo-inositol) seems to reduce the risk of Neural tube defects (NTDs) in folate-resistant women.
Dosage & Administration of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Recommended dosage for lipid-lowering and improving conditions related to peripheral vascular insufficiency ranges from 1500 mg to 4000 mg daily, in divided dosages of two to three times daily with or without food for at least 3 months.
Use in children and adolescents: There is a lack of long-term safety data to support the safe use of Inositol (Myo-inositol) in children and adolescents.
Interaction of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Concomitant use of anti-diabetic drug and Inositol (Nicosit) may result in more reduced blood glucose than only anti-diabetic drug therapy
Contraindications of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Patients with a known hypersensitivity to any component of this product.
Side Effects of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Common: Well tolerated in recommended dose. Only mild gastrointestinal side effects can be shown with higher doses.
Pregnancy & Lactation
Inositol is possibly safe when taken by mouth during pregnancy. There isn’t enough reliable information to know if Inositol (Myo-inositol) is safe to use when breast-feeding.
Precautions & Warnings
Patient with diabetes should be cautious about use of this medication.
Overdose Effects
Generally, Inositol (Nicosit) seems to be safe and relatively well tolerated in recommended dose.
Therapeutic Class of Tablet:Nicosit 500 mg 1+0+1 AM (As A Myo-Inositol As A Nicotinic acid group, Oral nutritional preparations).
Nicotinic acid group, Oral nutritional preparations
সাথে খাবারের chnge আন্তে হবে
+Niacin containing food
Treatment এর কিছুদিনের মধ্যেই পেশেন্ট ভালো Feel করবে ,কিন্তু স্কিন er pigmentation যেতে কয়েক মাস লেগে যায়
আর যদি ৪/৫ বছর Untreated থাকে
তখন 3D থেকে 4D( Death) হতে পারে
আগে 3D blto bt এখন 4D
According to Mayo clinic
Raiyyan Tahsan Date:-25-01-2025 Saturday Time:12-33-47 PM
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