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Thursday, April 7, 2011

Causes of Beriberi,Symptoms and Treatment


What Is Beriberi:
Beriberi is a disease in which the body does not have enough thiamine.beriberi, nutritional disorder caused by a deficiency of thiamin (vitamin B1) and characterized by impairment of the nerves and heart. General symptoms include loss of appetite and overall lassitude, digestive irregularities, and a feeling of numbness and weakness in the limbs and extremities.(The term beriberi is derived from the Sinhalese word meaning “extreme weakness.”) In the form known as dry beriberi, there is a gradual degeneration of the long nerves, first of the legs and then of the arms, with associated atrophy of muscle and loss of reflexes.
                    In wet beriberi, a more acute form, there is edema (overabundance of fluid in the tissues) resulting largely from cardiac failure and poor circulation.In infants breast-fed by mothers who are deficient in thiamin, beriberi may lead to rapidly progressive heart failure.
                  Probably the most important factor in the reduction of beriberi is the general increase in overall food consumption so that the staple diet is varied and contains legumes and pulses, which contain a large amount of thiamin. There are two main clinical types of beriberi, which, surprisingly, only rarely occur together.

History:
 
In Asia, where polished white rice was the common staple food of the middle class, beriberi resulting from lack of vitamin B1 was endemic. In 1884, Takaki Kanehiro, a British-trained Japanese medical doctor of the Japanese Navy, observed that beriberi was endemic among low-ranking crew who often ate nothing but rice, but not among crews of Western navies and officers who consumed a Western-style diet.In 1883, Kanehiro learned of a very high incidence of beriberi among cadets on a training mission from Japan to Hawaii, via New Zealand and South America that lasted for 9 months. On board, 169 men out of 376 developed the disease and 25 died. With the support of the Japanese Navy, he conducted an experiment in which another ship was deployed on the same route and under identical conditions, except that its crew was fed a diet of meat, fish, barley, rice, and beans.At the end of the voyage, this crew had suffered only 14 cases of beriberi and no deaths.
                      This convinced Kanehiro and the Japanese Navy that diet was the cause of beriberi.This was confirmed in 1897, when Dr. Christiaan Eijkman, a Dutch physician and pathologist, demonstrated that beriberi is caused by poor diet. He discovered that feeding unpolished rice instead of the polished variety to chickens helped to prevent beriberi in the chickens.The following year, Sir Frederick Hopkins postulated that some foods contained "accessory factors"—in addition to proteins, carbohydrates, fats, and salt—that were necessary for the functions of the human body.
                        In 1901, Gerrit Grijns (May 28, 1865 – November 11, 1944), Dutch physician and assistant to Christiaan Eijkman in Netherlands Indies, correctly interpreted the disease as a deficiency syndrome.Indeed, it was later shown that beriberi results from the deficiency of thiamine (vitamin B1).

symptoms: 
1)Appetite loss
2)Tiredness
3)Irritability
4)Muscle aches
5)Limb pains
6)Swollen joints
7)Hand paralysis
8)Foot paralysis
9)Heart problems

Causes:
Beriberi is caused by a lack of thiamine (vitamin B1). Thiamine occurs naturally in unrefined cereals and fresh foods, particularly whole grain bread, fresh meat, legumes, green vegetables, fruit, milk, etc. Beriberi is therefore common in people whose diet excludes these particular types of nutrition e.g. as a result of famine.
                        Beriberi may be found in people whose diet consists mainly of polished white rice, which is very low in thiamine because the thiamin-bearing husk has been removed. It can also be seen in chronic alcoholics (Wernicke-Korsakoff syndrome), Arsenic poisoning causes alterations in cellular metabolism resulting in blockage of thiamine use which results in thiamine deficiency without any dietary shortfall.The mechanism of arsenic neuropathy may be similar to the neuropathy of thiamine deficiency [Sexton and Gowdy 1963], whereby arsenic inhibits the conversion of pyruvate to acetyl coenzyme A and thus blocks the Krebs cycle.The disease was often found in Asian countries (especially in the 19th century and before), due to those countries' reliance on white rice as a staple food.


Treatment: 
The goal of treatment is to provide the thiamine the body is lacking. This is done with thiamine supplements which are given by injection or taken by mouth.Other vitamins may also be recommended.
                   Subsequent blood tests will determine if the thiamine supplements are being effective.Treatment for beriberi is with thiamine hydrochloride, either in tablet form or injection. A rapid and dramatic recovery within hours can be made when this is administered to patients, and their health can be improved within an hour of starting treatment.In emergency situations where concentrated thiamin supplements are unavailable, feeding the patient with a thiamin-rich diet (e.g. whole grain brown bread) will lead to recovery, though at a much slower rate.

Prevention:
Eating a proper diet that is rich in thiamine and other vitamins will prevent beriberi.Nursing mothers should make sure that their diet contains all vitamins and be sure that infant formulas contain thiamine.

People who drink heavily should try to cut down or quit, and take B vitamins to make sure their body is properly absorbing and storing thiamine.

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