Zinc in paediatric health and diseases.

The nutritional need of various micronutrients is realised within the last decade with the advent of newer better diagnostic techniques. Lower intake of animal foods which are the prime source of zinc, lower quality of nutrients intake, higher faecal loss of Zn during diarrhoea and inhibition of absorption of Zn by phytates present in the vegetables are some of the causes resulting in zinc deficiency in children of developing countries. Its importance in the management of persistent diarrhoea is gaining momentum with satisfactory results are being reported worldwide particularly when associated with severe acute malnutrition. Further the potential role and consensus guidelines for routine use of Zn in the prevention of infective diseases like acute respiratory tract infections, malaria, tuberculosis and particularly in intrauterine growth retardation babies is to be proven in time to come. Better dietary habits, food fortification and increased awareness and health education can prevent the Zn deficiency to a large extent.

Efficacy of Zinc Supplementation as an Adjunct to Anti Tubercular Drug Therapy.

Zinc being a stronger electron acceptor than iron might replace iron from the critical thiol groups. So, Zinc supplementation in Tubercular Subjects might help the decompartmentalised state of iron in the body to revert back to normal compartmentalized state of iron. Again, Zinc inhibits the formation of superoxide radicals. Thus, Zinc supplementation might decrease the excess superoxide with simultaneous decrease in the formation of soluble oxygen made by dismutation reaction by the iron cofactored superoxide dismutase secreted extracellularly by the pathogenic M. tuberculosis. The study shows early and effective recovery with Zinc supplementation (50mgm. of elemental zinc orally / day for one month) along with anti - Tubercular drug therapy. This gets support by the significant changes in the serum level of three enzymes – Glutamine Synthetase, Superoxide Dismutase and Cholienesterase. Again, the dose of zinc supplementation instituted with a great benefit and without any toxic symptoms and signs, is below the Lowest Observed Adverse Effect Level (LOAEL) based on the superoxide dismutase activity in erythrocytes with zinc intake.