NON COMMUNICABLE DISEASES

NON COMMUNICABLE DISEASES

nutritional disorders

Every organism requires an adequate supply of nutrients in proper proportion in their diet for proper growth and development. There are two types of nutritional disorders :overnutrition and undernutrition. The undernutrition is also called malnutrition.

• Undernutrition : A disease which arises due to lack of nutrient in the diet. It affects growth in children, their physical and mental abilities and work performance as well as resistance to infection. People with inadequate food are frequently thin and underweight.
• Overnutrition : Consumption of more food than one needs causes problems of overweight and obesity resulting in diabetes, hypertension and heart disease. Nutritional disorders, due to the lack of adequate quantity of a specific nutrient in the diet are called 3.Deficiency diseases. Deficiency diseases are due to deficiency of carbohydrates, proteins, fats, vitamin or minerals in the diet. Deficiency diseases are of three types:
• Protein-Energy Malnutrition (PEM)
• Mineral deficiency diseases
• Vitamin deficiency diseases

protein-energy malnutrition (PEM)

Proteins are the main body building components among all the components of food. They are necessary for the growth and development of the body. Deficiency of proteins and carbohydrates in the body is called Protein Energy Malnutrition (PEM).

Protein and energy deficiency go hand in hand and for this reason the terminology protein-energy malnutrition (PEM) or protein calorie malnutrition (PCM) is used for these deficiencies.

PEM occurs in all age groups but is more frequently found in children . It occurs due to less in take of food weak digestive system, poor absorption and excessive loss. The two common forms of PEM are

(i) Kwashiorkor

(ii) Marasmus.

Communicable diseases

Cholera

Cholera is an acute infectious disease of gastro-intestinal tract. Outbreaks of the disease are common at fairs, pilgrimages and after floods and it affects all age groups.

• Pathogen :Vibrio cholerae.
• Incubation period :Few hours to 2-3 days.

Symptoms:

Acute diarrhoea with profuse watery stool, vomiting, rapid dehydration, muscular cramps and anuria.

Appear in three stages:

• First stage (Stage of evacuation) severe attack of diarrhoea, headache, vomiting and colic pain; upto 40 painful evacuation/day.    Second stage (Stage of collapse) sunken eyes, hollow cheeks, bluish colour (cyanosis); subnormal temperature, shallow and quick breathing, loss of urination, severe pain in abdomen and cramps.
• Third stage (Stage of recovery) acute symptoms of previous stage subside. Blood pressure, body temperature and urine secretion return to normal. Inflammation of kidneys, lungs and intestine.

Typhoid

Typhoid is an acute infectious disease of alimentary canal and blood which is most common communicable diseases in India. It is common in children in the age group of 1-15 years.

• Pathogen:Salmonella typhi (Anaerobic, flagellate bacillus)
• Incubation period:1-3 weeks.

Though the disease occurs throughout the year but the frequency is higher during the rainy season.Symptoms

• Characterised by continuous fever which increases day by day in the first week and is higher in the afternoon than in the morning.
• Fever is accompanied with headache.
• High fever in the second week, gradually declines in the third and fourth week.
• Red rashes developed on upper abdomen at the end of the first week.

    In untreated cases, patient may develop haemorrhage from an ulceration in the small intestine.

Acquiredimmuno-Deficiency Syndrome (Aids)

• Acquired immunodeficiency syndrome (AIDS or aids) is caused by the human immunodeficiency virus, or HIV. This virus belongs to a group of viruses called retroviruses.

• HIV gradually reduces the efficiency of the human immune system, it destryos the body’s ability to fight diseases. This makes the body vulnerable to other life-threatening diseases that finally cause the patients’s death.

• As it is an acquired disease, so it is called secondary immunodeficiency. HIV was first recognized in Hatai (USA) in 1981, while it was first isolated from human blood by Moulagnieret. al. (1983) and Gallo et. al. (1984). In India, it was first reported among prostitutes of Chennai in 1986.

• Once a person is infected, the virus remains in the body life-long. The risk of developing AIDS increases with age. Since HIV infection can take many years to manifest itself, the carrier (who is symptomless) can infect other persons for years.

• HIV attacks the helper T-lymphocytes (or T4 cells–a type of leucocyte). In the first stage of infection, the virus grows and multiples in these cells.

• After some time, the virus starts destroying the T4 cells. T4 cells produce antiobodies to fight microorganisms that invavde the body. So, when they are destroyed, the body is uable to fight infections. This is the final stage of the infection, and the infected person is now siad to have AIDS.

• The patient easily catches infections such as pneumonia and often develops various forms of cancer.
• Incubation period is uncertain, varying from a few months to 10-12 years.

Symptoms

• Short flu-like illness.

• Chronic diarrhoea and severe weight loss.

• Swollen lymph nodes.

• Decreased count of blood platelets causing blood loss.

• Development of a disfiguring form of skin cancer (Kaposi’s sarcoma).

• Sweating at night.

• Severe damage to brain, leading to loss of memory and ability to think and speak.

• Due to breakdown of immune system, the victim becomes susceptible to other infections.

• HIV thus causes immunogenic imbalance.

• Immune system collapse and patient die due to uncontrolled secondary infections.

• Swollen lymph nodes, prolonged mild fever, diarrhoea.

Advance stage is characterised by one of 24 specific opportunistic infections; common are - Pneumocystis carinii pneumonia(PCP) and Kaposi’s sarcoma(KS), type of skin cancer.

Transmission

The disease is transmitted from an infected person to a healthy person through:

• Sexual contact and infected blood contact, (blood transfusion) are common means of transmission.
• Use of contaminated needles, syringes, blades or razors.
• Through cuts and wounds during close contact between infected and non-infected people.
• From infected mother to foetus through placenta and through breast feeding.
• Homosexual relationship and sharing of needles for drug abuse are high risk groups.

POLIO (POLIOMYELITIS)

It is very frequent in children.

• Pathogen :Polio virus (smallest known virus)
• Mode of transmission :Disease spreads through the intestinal discharges of the patient. It may also spread through food or drinks contaminated by flies.
• Incubation period :7 to 14 days.

Symptoms:

• When the virus enters the digestive tract, it multiplies, and then passes to the bloodstream, and finally reaches the spinal cord. The virus causes inflammation of grey matter of the spinal cord, inability of the head to bend forward and stiffness of the neck.
• It also destroys motor nerve cells on the spinal cord. Muscles fail to work due to lack of nerve impulses. This may cause paralysis of limbs.

Prevention

• Screening of food from flies and safe disposal of pharyngeal and bowel discharges of the patient, as they have polio viruses. OPV (Oral Polio Vaccine) is an effective preventive vaccine.
• These day Polio vaccines are given to children below 5 year age group at National Level Campaign.

RABIES

A type of rhobdovirus causes rabies, which is highly fatal disease of the central nervous system. Rabies is also known as hydrophobia.

• Pathogen :Rabies is caused by a virus (Lyssavirus type 1). Rabies virus is commonly called is street virus.
• Incubation period :10 days to 1 year.

Transmission

• An animal affected by the disease is called rabid.

• Rabies in human beings is generally caused by a rabid dog. It may also be caused by the bite of rabid wolves, jackals, cats, etc.

• The virus is present in the saliva of infected animals.

Symptoms

The virus after reaching the nervous system, first stimulates the nervous system and then damages the cells of the spinal cord and the brain, and finally results into extreme excitation and

• High fever
• Severe headache
• Pain or itching at the site of the bite.
• Painful contraction of muscles of throat and chest.
• Patient suffers from anger, irritation, depression and fear of death.
• There is restlesness, choking feeling and difficulty in taking even liquid food.
• The patient develops a fear of water, for this reason, the disease is also called hydrophobia.
• Severe damage to central nervous system causes paralysis and painful death.

Vitamin deficiency diseases

Vitamins can be defined as organic compounds required in minute quantities in the diet for normal metabolism, growth and good health. Deficiency or lack of vitamins in diet for prolonged periods results in hypovitaminosis (deficiency of vitamins) or avitaminosis (lack of vitamins). Serious disorders develop on account of the above two conditions. Some of these are discussed below.Vitamins are either fat-soluble (like vitamin A, D, E and K) or water-soluble (vitamin B complex and vitamin C).

XEROPHTHALMIA

Cause : Deficienby of Vitamin A (Retinal). It is also called “anti-infective vitamin.”

Deficiency symptoms : Drying of eyeball occurs because tear glands do not produce tears. This increases the chances of bacterial infection. Other diseases caused due to the deficiency of Vitamin A are:

Night blindness : The person is unable to see in dim light or darkness. Vitamin A forms part of visual pigments, rhodopsin of rod cells and idopsin of cone cells for eyesight. Hence, due to Vitamin A deficiency, both these pigments are not formed in an adequate amount.

Dermatosis : Skin becomes rough and dry, often called “toad-skin” or “shark-skin.”

Prevention and cure : Vitamin A rich diet is recommended to a person suffering from Vitamin A deficiency.

Sources of Vitamin A

    Plant sources : Yellow fruits and yellow vegetables, like papaya, tomato, guave, ripe mango, carrot, pumpking, leafy vegetables like spinach, etc.

    Animal sources : Cod liver oil, fish, egg yolk, butter, ghee, milk, etc.

Rickets

This disease is caused by the deficiency of fat-soluble vitamin D, also called sunshine vitamin.Vitamin D is synthesized by the body in the skin in the presence of sunlight. The ultraviolet rays of the sunlight convert the cholesterol in the skin to vitamin D.Vitamin D is essential for healthy teeth and bone formation, alongwith calcium and phosphorus. Vitamin D regulates the absorption of calcium and phosphorus from the gastrointestinal tract. The deficiency of vitamin D, thus, leads to the deficiency of calcium and phosphorus in the bones.Deficiency of vitamin D leads to rickets in children. Rickets is usually observed in children between the age of six months and two years. There is reduced calcium deposition in the growing bones.

Symptoms

Deficiency of Vitamin D causes increased loss of Ca++ in urine. So, no Ca++ is deposited in the bones. This causes rickets in children.

Rickets is characterized by bow legs due to malformation of leg bones. These are called curved legs knock-knee and bow legs, delayed walking.Teething is delayed and loss of teeth enamel.Children suffering from rickets have pain in bones and being soft, bones are more susceptible to fracture.

Deficiency of Vitamin D in adults causes osteomalacia in which bones become soft, deformed and painful.

Osteomalacia occurs mainly in women, especially during pregnancy and lactation.

Prevention and Control

Vitamin D is a unique vitamin as it is derived both from sunlight and food. Sunlight is thus, an important source of vitamin D.

Among foods, vitamin D occurs only in foods of animal origin like egg yolk, butter, cheese and fish liver oils. Diet supplemented with above foods helps in prevention and control of the disease.

beri-beri

Beri-beri is a disease caused by the deficiency of Vitamin B1. Vitamin B1 also called thiamine or anti beri-beri vitamin or antineuritic factor.Vitamin B1 is essential for carbohydrate metabolism and hence in body growth.The disease was first observed among Japanese sailors who were given polished rice in their diet.During polishing or milling of rice, thiamine is readily lost. Being a water-soluble vitamin, it is further lost during washing and cooking of rice. Thiamine is also lost during prolonged storage, in case of fruits and vegetables.Thiamine loss also occurs when cereals are cooked with baking soda.

Symptoms

• Loss of appetite and weight.
• Retarded physical growth.
• Oedema–swelling of legs due to water logging in the tissues, accompanied by pain in the legs.
• Degeneration of nerves.
• Heart troubles.
• Disorders in disgestive tract
• Muscle atrophy.

Prevention and Control

• The main sources of this vitamin for Indian people are the cereal foods like rice and wheat.
• Other good plant sources include pulses, nuts, green leafy vegetables; whole wheat bread and ‘dalia’ are the richest sources of vitamin B1.
• Animal food sources include milk, egg yolk, liver and kidney.
• Diet supplemented with above food items help to prevent and control the disease.
• Polishing or milling of foods should not be done.