A good nutritious diet is essential for good health. Proper diet ensures intake of all essential nutrients which are essential for body growth as well as for performing various functions. Deficiency of even a single nutritious element will result in causation of following ailments or disorders.

BERIBERI:-

Beriberi is caused by deficiency of vitamin B1 which is also known as thiamine. In case of its deficiency, cardiac output increases along with dilation of blood vessels as excess of lactic acid and pyruvic acid will get accumulated in the body.

Types:-

• Dry Beriberi,
• Wet Beriberi,
• Wernicke's Encephalopathy,
• Korsakoff's Psychosis

Dry Beriberi:-

Dry beriberi severely affects limbs mainly on distal parts and also there is impairment of motor, sensory as well as reflex functions.

Wet Beriberi:-

It is characterized by swelling which is due to dilation of blood vessels causing fluid spillage through capillaries. Person experiences high cardiac output. Swelling is due to accumulation of sodium along with water in the body. Sometimes, there may arise a situation of cardiovascular collapse or biventricular failure. Circulation time also increases. Treatment is transfusion of thiamine intramuscularly followed by oral maintenance therapy along with bed rest.

Wernicke's Encephalopathy:-

It is a kind of beriberi affecting central nervous system. In this condition, patient will experience restriction of eye movement along with diplopia. Patient will be disoriented and always in a state of confusion, experiencing all sorts of mental disturbances. Patient can rarely pay attention to anything. Gait is also affected along with stance. To correct sight as well as gait and to bring back patient from his mentally disturbed state, thiamine administration should be done immediately.

Korsakoff's Psychosis:-

This kind of beriberi affects central nervous system and that too mainly imparts its ill-effects on memory of the patient. Patient always remains in a state of great confusion and finds difficult to learn anything new. He experiences drowsiness regularly along with amnesia. Most of the patients cannot recover completely. However, thiamine administration shows certain symptoms of recovery in them. This kind of beriberi either occurs on its own or may sometimes follow Wernicke's encephalopathy. Combination of symtoms like amnesia and ocular-ataxis in a person can be diagnosed as Wernicke- Korsakoff syndrome.

RICKETS:-

Vitamin D is essential to the body as it increases absorption of calcium along with phosphate absorption. It also helps to transport protein. It is available in plenty in eggs, fish, fish and cod liver oil. Thus, it is essential for the nourishment and growth. In its deficiency, it gives rise to rickets which is seen in children of growing age.

Rickets make growing child very susceptible to various infections mainly associated with gastrointestinal and respiratory. Child becomes restless and always appears pale. However, outwardly he may appear well nourished. His chest appears to be pigeon shaped. Skull appears to be relatively small in size. Teeth do not erupt at proper time i.e., delayed eruption and dentition and overall oral health does not appear to be good. Affected child faces difficulty to carry out his daily tasks as he faces difficulty in standing, sitting and in walking. His legs are bow shaped. He experiences epileptic fits. His voice becomes high- pitched and unclear. He develops knock knees.

This condition is very clear because of multiple signs and symptoms the affected child shows. However, to rule out other possibilities, investigations like wrist radiography can be done. Child also shows decreased level of calcium and phosphate level in serum. Treatment includes correction of any causative factor or underlying conditions causing deficiency of vitamin D in the body. Calcium and vitamin D supplements should be given to the affected child.

OSTEOMALACIA:-

Skeleton is composed of organic matrix made up of minerals. Osteomalacia develops in adults when disorder develops in their skeletal system. Matrix remains more and more devoid of minerals. Muscles of affected person becomes weak along with bones resulting in pain. Weak bones can result in frequent bone fractures even when subjected to an injury of mild grade. Gait of person gets affected.

Osteomalacia develops due to deficiency of vitamin D which may be due to dietary imbalance or due to disorder in its metabolism which can occur in several cases like kidney failure or in use of anticonvulsant drugs. Lead poisoning is also a reason for osteomalacia. In presence of several diseases like coeliac disease, disease of hepatomegaly system etc..... it may develop. It can be corrected by administration of vitamin D2 or D3 for certain period followed by maintenance therapy.

SCURVY:-

Connective tissue system is made up mainly of collagen. Deficiency of vitamin C is responsible for causing scurvy as it leads to the defective formation of collagen. Vitamin C is ascorbic acid and it is present in plenty in citrus fruits. Scurvy can be treated by consuming plenty of citrus fruits along with intake of vitamin C tablets for few days.

Scurvy is of two types i.e., infantile and adult. In case of infantile scurvy, lots of changes are seen in gingiva. Patient shows lesions on the skin. Bleeding occurs in shafts of long bones. Intracerebral hemorrhage is very common. Patient also displays signs of anorexia along with false paralysis.

OSTEOPOROSIS:-

We need mechanical support from bone mass to perform various functions. When mass of bone keeps reducing in comparison to unit volume below the normal range then mechanical support functions required also decreases. This is known as osteoporosis. It is mainly asymptomatic. Patient experiences pain only in case of fractures which are mainly in spine and sometimes in hip areas. Radiographs of concerned areas can help in the investigation along with CT scan and ultrasound.

Osteoporosis is mainly a result of malnutrition. It can also occur as a result of some underlying cause like liver disease, acromegaly, rheumatoid arthritis etc..... Excess of steroid or heparin intake during their respective therapies can also result in osteoporosis. Women during pregnancy and also during lactation period can experience it. Women in postmenopausal phase are at high risk particularly.

A good nutritious diet with adequate amount of calcium in it is essential. Biphosphonates is very helpful. Special care and precautions should be followed to prevent any injury leading to fractures. One should also quit smoking as it can worsen the condition.

PELLAGRA:-

Pellagra is caused by deficiency of niacin in body. Good balanced nutritious diet along with regular niacin intake can help in the treatment of pellagra. Diet should be rich in protein.

Patient shows dermatitis which may be chronic or acute. In case of chronic, patient shows pigments formed on the skin which has become thick and quite rough in texture. In case of acute dermatitis, patient shows formation of ulcers on skin along with formation of cracks. Patient develops erythema on exposed body parts which directly come into contact with sunlight. Nausea, diarrhea are very common symptoms. Patient experiences difficulty in swallowing. Cracks develop on the corners of the mouth. He often remains in a state of irritation and displays anxiety. He also shows symptoms of depression. Lack of sleep along with nervousness is also very common.