IT IS WATER SOLUBLE VITAMIN.

IT ACTS AS ANTI-OXIDANT.
VIT.C IS NECESSARY FOR A NUMBER OF
METABOLIC PROCESS INCLUDING H2 ION
TRANSFER AND MAINTENANCE OF
INTRACELLULAR REDOX POTENTIAL.
FACILITATES UPTAKE OF IRON IN INTESTINAL
TRACT.
INVOLVED IN FORMATION OF ACTIVE FORM OF
FOLIC ACID (FOLINIC ACID)
ITS HIGHLY CONCENTRATED IN PITUATARY,
ADRENALS, EYES, PLATELETS AND WBCs.
 ITS A HEXOSE DERIATIVE.
ACIDIC PROPERTY OF VIT.C IS
DUE TO ENOLIC HYDROXYL
GROUPS.
VIT.C IS A STRONG REDUCING
AGENT IN AQ. PHASE OF LIVING
TISSUES AND IS EASILY AND
REVERSIBLY OXIDISED TO
DEHYDROASCORBIC ACID .
OXIDATION OF VIT.C IS RAPID
IN PRESENCE OF COPPER,
HENCE ITS INACTIVATED IF
FOOD IS PREPARED IN COPPER
VESSELS.
 MANY ANIMALS CAN SYNTHESIZE ASCORBIC
ACID FROM GLUCOSE VIA URONIC
PATHWAY.
MAN AND OTHER PRIMATES CANNOT
SYNTHESIZE VIT.C DUE TO THE LACK OF
SINGLE ENZYME L-GLUCONELACTONE
OXIDASE.
AS ITS NOT SYNTHESIZED ENDOGENOUSLY,
WE ARE DEPENDENT ON DIETARY SOURCES.
ITS VERY EASILY DESTROYED BY HEAT,
INCREASED pH AND LIGHT AND IS VERY
SOLUBLE IN WATER.
 CITRUS FRUITS
GOOSEBERRY
GUAVAS, BLACKCURRANTS
GREEN LEAFY VEG
MILK
SOME ANIMAL PRODUCTS
TOMATOES, POTATOES
GREEN PEPPERS,
BROCCOLI,CAULIFLOWER
(RAW)
BRUSSELS SPROUTS,
CABBAGE
 THE RECOMMENDED DIETARY ALLOWANCE FOR
VIT.C RANGES FROM 35MG IN INFANTS TO
60MG IN ADULTS.
PREGNANT AND LACTATING WOMEN SHOULD
INCREASE THEIR INTAKE BY 20MG AND 40MG
RESPECTIVELY
 COLLAGEN FORMATION
ANTI-OXIDANT
BONE FORMATION
ITS FUNCTION IN VARIOUS METABOLISMS
SYNTHESIS OF CORTICOSTERIOD HORMONE
IMMUNOLOGIC FUNCTION
 IT PLAYS THE ROLE OF
COENZYME IN HYDROXYLATION
OF PROLINE AND LYSINE WHILE
PROTOCOLLAGEN IS
CONVERTED TO COLLAGEN.
THE HYDROXYLATION IS
CATALYSED BY LYSYL
HYDROXYLASE (FOR LYSINE)
AND PROLYL HYDROXYLASE
(FOR PROLINE)
INADEQUATELY HYDROXYLATED
PRECURSORS CANNOT
ACQUIRE STABLE HELICAL
CONFIGURATION AND CANNOT
BE ADEQUATELY CROSSLINKED
SO THEY ARE POORLY
SECRETED FROM FIBROBLAST.
 THE SECRETED FIBRES LACK TENSILE STRENGTH,
ARE MORE SOLUBLE AND MORE VULNERABLE
TO ENZYMATIC DEGRADATION.
COLLAGEN ( CONTAINS HIGHEST AMOUNT OF
HYDROXYPROLINE) IS MOSTLY AFFECTED
PARTICULARLY IN BLOOD VESSELS LEADING TO
HAEMORRHAGES IN SCURVY.
LACK OF VIT.C LEADS TO SUPRESSION OF THE
RATE OF SYNTHESIS OF PRO-COLLAGEN PEPTIDES
 VIT.C CAN SCAVENGE FREE RADICALS
DIRECTLY IN AQUEOUS PHASES OF CELL
AND CAN ACT INDIRECTLY BY
REGENERATING THE ANTIOXIDANT FORM OF
VIT.E.
IN THIS WAY BOTH VIT.C AND E ACT
TOGETHER.
 BONE TISSUES POSSESS AN ORGANIC
MATRIX, COLLAGEN AND INORGANIC
CALCIUM AND PHOSPHATE ETC.
THE NORMAL DEVELOPMENT OF
INTERCELLULAR GROUND SUBSTANCES IN
BONE, DENTIN AND OTHER CONNECTIVE
TISSUES IS IMPAIRED IN VIT.C DEFICIENCY.
 ASCORBIC ACID ENHANCES IRON ABSORPTION BY
KEEPING IT IN FERROUS FORM WHICH IS DUE
TO REDUCING PROPERTY OF VIT.C.
ITS ESSENTIAL FOR HYDROXYLATION OF
TRYPTOPHAN TO HYDROXY TRYPTOPHAN IN
SYNTHESIS OF SERATONIN.
ITS REQUIRED FOR OXIDATION OF p-HYDROXY
PHENYLPYRUVATE IN TYROSINE METABOLISM.
 ADRENAL GLAND HAS HIGH LEVELS OF
ASCORBIC ACID ESP. IN PERIODS OF STRESS.
VIT.C IS ESSENTIAL FOR THE HYDROXYLATION
REACTIONS IN THE SYNTHESIS OF
CORTICOSTEROID HORMONES.
 VIT.C ENHANCES THE SYNTHESIS OF
IMMUNOGLOBULINS.
IT ALSO INCREASES THE PHAGOCYTIC ACTION
OF LEUCOCYTES.
 VIT.C IS A THRESHOLD SUBSTANCE AND IS
EXCRETED PRIMARILY THROUGH KIDNEY.
DEGREE OF TISSUE SATURATION DETERMINES
THE AMOUNT EXCRETED.
IF INTAKE IS NORMAL, SLIGHT INCREASE IN
INTAKE ABOVE NORMAL WILL BE EXCRETED.
IF TISSUES ARE UN-SATURATED THROUGH
LOW INTAKE OR EXCESS METABOLISM OF
VIT.C EVEN HIGH DOSES MAY BE RETAINED
 LASSITUDE
ANOREXIA
PAIN IN LIMBS
ENLARGEMENT OF COSTOCHONDRAL JUNCTIONS
(SCORBUTIC ROSARY)
SUB-PERIOSTEAL HAEMORRHAGES
GINGIVITIS
SWOLLEN AND SPONGY GUMS
PAPILLAE IN BETWEEN TEETH GIVE APPEARANCE OF
SCURVY BUDS WHICH BLEED EASILY
RETROBULBAR AND SUBARACHNOID HAEMORRHAGE
SEVERE TO MODERATE NORMOCYTIC NORMOCHROMIC
ANAEMIA
 PERIFOLLICULAR HAEMORRHAGES
GUM INVOLEMENT
CORK SCREW HAIR APPEARANCE
PETECHIAL HAEMORRHAGES
ECCHYMOSES ANYWHERE ON THE BODY
HAEMORRHAGES MAY OCCUR INTO NERVE
SHEATH, JOINTS, GIT
EPISTAXIS MAY OCCUR
DELAYED WOUND HEALING
NORMOCYTIC NORMOCHROMIC ANAEMIA
LONGITUDINAL SECTION OF A
COSTOCHONDRAL JUNCTION
WITH WIDENING OF EPIPHYSEAL
CARTILAGE
 DEFICIENCY OF VIT.C CHIEFLY OCCURS IN GINGIVAL
AND PERIODONTAL TISSUES.
 THE INTERDENTAL AND MARGINAL GINGIVA IS
BRIGHT RED WITH SWOLLEN, SMOOTH, SHINY
SURFACE.
IN ALMOST ALL CASES OF ACUTE OR CHRONIC
SCURVY, THE GINGIVAL ULCERS SHOW THE
TYPICAL ORGANISMS AND PATIENTS HAVE TYPICAL
FOUL BREATH OF PERSONS WITH
FUSOSPIROCHETAL STOMATITIS.
IN THE SEVERE CHRONIC CASES OF SCURVY,
HEMORRHAGES AND SWELLING OF PERIODONTAL
MEMBRANES OCCUR, FOLLOWED BY LOSS OF BONE
AND LOOSENING OF TEETH WHICH EVENTUALLY
EXFOLIATE.
VIT.C DEFICIENCY IN
INFANT

IN INFANTS THE
ENLARGED TISSUES MAY
COVER THE CLINICAL
CROWNS OF TEETH
BLEEDING GUMS - IN
FULLY DEVELOPED
SCURVY THE GINGIVA
BECOMES BOGGY,
ULCERATES AND
BLEEDS. COLOR
CHANGES TO
VIOLACEOUS RED.
VITAMIN.C DEFICIENCY
IN ADULT
 IN SCURVY, OSTEOBLASTS FAIL TO FORM OSTEOID.
THE CARTILAGE CELLS OF EPIPHYSIS PLATE CONTINUE
TO PROLIFERATE IN NORMAL FASHION AND SALTS ARE
DEPOSITED IN MATRIX BETWEEN COLUMNS OF
CARTILAGE CELLS.
THE OSTEOBLASTS FAIL TO LAY DOWN OSTEOID ON THE
SPICULES OF CALCIFIED CARTILAGE MATRIX.
THE CALCIFIED MATRIX MATERIAL IS NOT DESTROYED, SO
THAT A WIDE ZONE OF CALCIFIED BUT MONOSSIFIED
MATRIX CALLED SCORBUTIC LATTICE DEVELOPS IN
METAPHYSIS.
THIS SPICULES ARE NONRESISTANT TO WEIGHT BEARING
AND MOTION STRESSES SO THEY ARE LIABLE TO
FRACTURE. THEY LEAD TO CHARACTERISTIC LESIONS IN
SKELETON IN SCURVY.
 AS THE LATTICE INCREASES IN WIDTH, MORE FRAGILE
ZONE DEVELOPS, SO THAT COMPLETE FRACTURE OF
SPICULES OCCUR WITH THE SEPERATION AND
DEFORMITY OF CARTILAGE SHAFT JUNCTION.
THIS FRACTURING OF CALCIFIED MATRIX MATERIAL
LEADS TO CLASSIC PICTURE OF SCURVY I.E.,
TRUMMERFELD ZONE OR REGION OF COMPLETE
DISINTEGRATION.
THERE IS PINK STAINING HYALINE MATERIAL, IMMATURE
LOOKING FIBROBLASTS AND MACROPHAGES CONTAINING
HEMOSIDERIN.
THE AREA BENEATH TRUMMERFELD ZONE IS FREE OF
HEMOPOIETIC CELLS, THE SO CALLED GERUSTMARK.
THE MIGRATION OF MARROW CELLS LEAVING ONLY
CONNECTIVE TISSUE ELEMENTS IS NOT CLEAR.
SUBPERIOSTEAL HEMORRHAGES ARE FREQUENT IN
SCORBUTIC ANIMALS.
Photographs of incisor teeth of
guinea pig with complete or early
vit.c deficiency showing abnormal
irregular dentin cross section
In vit.c deficiency, odontoblasts
eventually fail to lay dentin.
 MOTHERS MILK AND PROPRIETORY MILK
PREPARATIONS ARE GOOD SOURCE VITAMIN.C
OLD AND SOLITARY PATIENTS SHOULD BE GIVEN
50MG OF VITAMIN.C DAILY.
ADEQUATE AMOUNT OF VIT.C SHOULD BE GIVEN TO
PATIENT DURING TRAUMA, SURGERY, BURNS,
INFECTIONS, SMOKING AND DURING
ADMINISTRATION OF ASPIRIN, TETRACYCLINS,
STEROIDS AND INDOMETHACIN.
FOR TREATMENT, 250MG VIT.C 8-HOURLY BY MOUTH
SHOULD SATURATE THE TISSUES QUICKLY.
IF PATIENT IS ANAEMIC, IRON AND FOLIC ACID ARE
ALSO INDICATED
 SOME REPORTS CLAIM THAT ITS EFFECTIVE IN
THE PREVENTION OF COMMON COLD.
LARGE AMOUNTS OF IRON MAY BE ABSORBED
AND MAY PRECIPITATE HAEMOCHROMATOSIS.
LARGE AMOUNTS OF OXALATE CRYSTALS ARE
PASSED IN URINE WHICH MAY PRECIPITATE
OXALATE STONE FORMATION.
LONG TERM USE OF VIT.C MAY INTERFERE
WITH ABSORPION OF VIT.B12 HENCE MAY
CAUSE ANAEMIA.
THANK YOU