Some Non-communicable Diseases

Low Blood Pressure

We have already learned that blood pressure less than 130 (systolic)/85 (diastolic) mmHg (according to American Heart Association) are normal blood pressure in adults. On average it may be 120/80 mmHg. But when the blood pressure decreases than the normal it is explained as a low blood pressure. Low blood pressure, medically known as a ‘Hypotension’ is generally considered as systolic blood pressure of 90mmHg or less in adults.

         

Blood pressure varies, depending on factors such as age, race, sex and environment. On rare occasions, individuals may have medical problems that cause low blood pressure.

Causes

       There are different factors that cause low blood pressure; some of them are:

.      Lack of balanced diet and nutritive diet.

.      Dehydration and abnormal decreases in body weight.

.      Fatigue for a longer duration.

.      Over exertion and physical work.

.      Excessive bleeding due to wound and other causes.

.      Heredity and racial factors.

.      Emotional stress and hormonal factors.

.      combination with Addison’s disease (pernicious anaemia) and alcoholism.

.      Medication for high blood pressure.

.      Environment or psychological dysfunction.

Signs and Symptoms

        Several studies suggested that low blood pressure may be associated with non-specific symptoms, such as:

.      Feeling or weakness and dizziness.

.      Decreases in diastolic and systolic pressure.

.      Headache referred to the back of head or neck.

.      Tiredness and fainting.

.      Swaying.

.      Focal cerebral ischemia (low blood flow).

.      Communicating difficulties.

.      Tunnel vision.

.      Uncontrolled body balance.

.      Emotional instability.

Prevention and Control

        Hypotension is a benign condition and is often attributed to psychological problems. So, the best ways of preventive measure should be:

.      Making healthy lifestyle.

.      Control of dehydration.

.      Changing the timing of meals.

.      Proper treatment of Addison’s disease.

.      Control on alcohol consumption.

.      Proper rest and sleep and physical work and exercise.

.      Proper balanced diet.

.      Maintenance of healthy recreation.

.      Control on stress and anxiety.

.      Regular health check-up.

Stone

      Stone or calculus is a disease in which an abnormal stone is formed in body tissues by accumulation of mineral salts. Stones or calculi, consisting chiefly of cholesterol, bile pigment and calcium salts, may form usually and are found within hollow organs or ducts and can cause obstruction and inflammation in persons of either at any age, but are more common in middle age. It may form at various internal organs such as bile duct, gallbladder, liver, kidney, urinary bladder, urethra and glands.

Causes: In the majority of cases, causes are unknown. However, excess salt consumption, increased amount of serum cholesterol in blood, which occurs in obesity, diabetes, inflammation of the biliary system, accumulation of bile pigment and calcium salts are some of the major causes known to be responsible for the formation of stones.

Symptoms: The signs and symptoms of stone formation may differ according to their nature and place. Still the formation of stone is accompanied by the following symptoms:

.      Tendency of nausea, vomiting and loss of appetite.

.      Severe pain at the affected area.

.      Radiating to the back and shoulder.

.      The dehydrated patient may have chills, fever and jaundice.

.      Inflammation of affected organs.

.      Obstruction in bile duct and urethra.

.      There is much pain in the back along with high temperature.

Prevention and Control

The following measures can be adopted for prevention:

.      Water and fat-free liquid should be taken as much as possible.

.      Regular exercise.

.      Regular periodical health examination.

.      If the stone cannot pass through a natural process, it should be surgically

       removed.

.      Doctors should be consulted about the treatment.

.      Intensive nursing care and support is required.

.      The patient should be given complete bed rest.

Healthy Tips

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The Glandular System

There are many kinds of glands in the human body. These glands are made up of special kinds of cells. All these glands and their functions comprise the glandular system.

The glands found in the body are of two types. They are as follows:

1. Exocrine glands, and

2. Endocrine glands.

Exocrine Glands

       Exocrine glands pour their secretions out through a duct, for example, salivary gland and liver. The secretions of exocrine glands are called enzymes. The enzymes secreted by exocrine glands produce chemical changes when they come in contact with other substances.

Endocrine Glands

       Endocrine glands are usually a group of cells and glands without ducts. They produce special substances called hormones, which are poured directly into the blood stream from the glandular cell. So, they are also known as ductless glands. The endocrine system consists of a number of distinct glands. The main endocrine glands are:

a) Pituitary glands,                                  b) Pineal glands,

c) Thyroid glands,                                   d) Parathyroid glands,

e) Thymus glands,                                   f) Adrenal glands,

g) Pancreas, and                                      h) Gonads.

a) Pituitary Glands: The pituitary gland is a small, oval-shaped body like a big pea. It is located in the base of the brain. It controls all the glands as the master. It has great influence on skeletal growth. It also affects the functions of ovaries and testes.

b) Pineal Gland: The pineal gland is a small body resembling a pine cone, which is situated under the brain.

c) Thyroid Gland: The thyroid gland is located in the neck where the larynx joins the trachea. This gland helps to regulate the rate of metabolism. The thyroid gland secretes thyroid hormones called ‘Thyroxin’ and ‘Tridothyroxin’. An overactive thyroid gland will cause a bulging of the eyes and other symptoms. The thyroid gland requires a certain amount of iodine. When there is too little iodine in the water supply or in the food, a swelling called goiter may appear in the neck.

d) Parathyroid Glands: The parathyroid glands are small oval bodies, and are about the size of a pea. There are four parathyroid glands. The secretion of the parathyroid glands is called parathormone, which influences calcium and phosphorus metabolism, and controls the excretion of phosphate.

        Over secretion of parathormone causes loss of calcium, which goes from the bones into the blood, and from there it is excreted in the urine. The bones become porous and brittle and the increased level of blood calcium may cause the formation of kidney stone.

        Under-secretion of this hormone leads to a sharp decrease of calcium in the blood plasma. This condition is characterized by intense spasm of many of the muscles.

e) Thymus: The thymus gland is located in the thoracic cavity behind the sternum. It is believed that it is related to the production of antibodies.

f) Adrenal Glands: The adrenal glands are paired organs each of which is located at the top of each kidney. The hormones secreted from the adrenal glands regulate the level of glucose in the blood, and influence fat, carbohydrate and protein metabolism. Under-secretion of these hormones causes the disturbance in metabolism, loss of weight, muscular weakness, low-blood pressure, etc. whereas; over-secretion causes change in the genital system. In women, it may result in secondary male characters.

g) Gonads: The sex glands, the testes in male and ovaries in female are known under the common name of gonads. These glands internally secrete sex hormones which are delivered into the blood and influence the various functions.

         The ovaries secrete estrogen and progesterone, which influence the sexual maturation of the female organs, regulate the monthly period, prepare the uterus for ovulation, and influence the normal course of pregnancy.

h) Pancreas: The pancreas lies across the posterior abdominal wall behind the stomach. It is a mixed gland composed of lobules. Pancreas produces pancreatic juice, which is delivered to the duodenum. It also secretes a hormone known as insulin. In case of insulin deficiency, only a portion of carbohydrate is used by the body. The remaining carbohydrate is secreted in the form of sugar in urine. Thus, the deficiency of insulin results in diabetes.

Glands and Health

          Glands of our body secrete various enzymes and hormones, which are essential for the proper growth, development and regulation of our body. Over secretion or under secretion of these glands may create physiological disturbances in the body which is the sign of ill health. In fact, these glands only work efficiently in a healthy situation, and the healthy condition can be maintained only through the balanced diet, maintenance of personal hygiene, healthy habits and proper exercise.

General

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Asthma

Asthma is an ancient Greek word meaning “painting or short drawn breath”. It is the most troublesome of the respiratory diseases. Asthma is a chronic inflammatory disease of the airways in the human body. The inflammation causes the airways to narrow from time to time. This narrowing can produce wheezing and breathlessness. An asthma attack affects the bronchi and bronchioles in the lungs. In people with asthma, certain materials, such as dust and pollen, can irritate these tubes. As these tubes become irritated, they swell and give off mucus, a sticky liquid. The liquid fills air spaces in the bronchi and bronchioles. Both swelling and mucus narrow the tubes, making it more difficult for air to get in and out of the lungs. As a result, an asthmatic person has to make a much greater effort to breathe in air and to expel it.

 

Causes

 It is a complex disorder involving bio-chemical, infectious, endocrinological and psychological factors. Asthma in children is usually extrinsic; that is, most attacks are associated with an allergenic hypersensitivity to a foreign substance, as airborne pollen, house dust, certain foods, animal hair and skin, insect, smoke and various drugs. A few cases may be caused by and inherited or acquired defects.

Signs and Symptoms

Asthma is characterized by the following symptoms:

.         May have increased pulse, anxiety or fear,

.         Wheezing, prolonged expiration and imitative cough,

.         Over-inflation of the chest,

.         Inflammation of the bronchial wall.

.         Muscles around the airways tighten up,

.         Disturbed sleep caused by shortness of breath, cough or wheezing,

.         Shortness of breath and feeling of suffocation,

.         Interrupted talking,

.         Presence of allergic reactions and familial allergic disease,

.         Presence of large number of eosinophils,

.         In severe cases, the patient may have bluish skin around the lips and fingers,

.         The patient mat sit upright, lean forward, or take some other position to make

          breathing easier.

.         Children with chronic asthma develop a barrel chest.  

Prevention and Control

The following preventive measures can be adopted:

.         Ensure personal hygiene and environmental sanitation,

.         A patient should be guarded against cold and kept in a ventilated and warm room,

.         A patient should be given liquid food,

.         Avoid exposure to tobacco smoke,

.         Remove stuffed toys or wash them each week in hot water,

.         As much as possible, avoid contact between an asthma patient and family pets

          To which he or she is allergic,

.         Proper treatment of allergy and its causes,

.         Keep indoor air clean,

.         Avoid outdoor exercise when air pollution levels are high,

.         Constipation should be avoided,

.         Exposure to workplace allergens can be avoided by following simple

          Precautions,

.         Manage immediate and intensive treatment under the supervision of

          Doctors in a severe attack,

.         A chest x-ray and more elaborate pulmonary function tests may be necessary,

.         Regular follow-up visits are important to maintain asthma control,

.         As early as possible, asthma patients should be trained in the treatment and

          Control of their disease,

       

.        

     

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Heart Attack

Heart attack, also known as a myocardial infarction, generally occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a blood clot. This may cause the heart to stop beating and from pumping blood effectively and leads to death or permanent damage to the heart. A heart attack, or myocardial infarction is permanent damage to the heart muscle. The conditions leading to heart attack often develop over many years.

         

Like all organs, the heart and heart muscles require a constant supply of oxygen-rich blood to nourish it. It gets that blood from arteries that lead into the

heart. In some cases, those arteries become narrow and blood cannot flow as well as it should; fatty matter, calcium, proteins and inflammatory cells build up within the arteries and form ‘plaques’ of different sizes. Over time the plaques become larger and larger. Eventually, the plaque greatly reduces the amount of blood reaching the heart. It can also close off the artery entirely. When that happens, the blood supply to the heart is completely cut off and the heart muscles become ‘starved’ for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. This is called myocardial infarction, or heart attack.

Causes and Risk Factors

           It is difficult to estimate exactly how common heart attacks are because many people die each year before medical help in sought. Heart attacks are usually caused by severe coronary artery diseases. A number of risk factors increase the chance of developing coronary artery disease and heart attack. Some major risk factors can be changed and other cannot. Among those:

i)  That cannot be changed are:

.       Heredity.

.       Gender: Men under the age of sixty are more likely to have heart attacks than

        women of the same age.

.       Age: Men over the age of 45 and women over the age of 55 are at higher risk

        than younger people. People over age of 65 are more likely to die of heart

        attack.

ii)  Some risk factors that can be changed are:

.        Smoking.

.        High levels of cholesterol in the blood.

.        High blood presuure.

.        Unhealthy lifestyle and lack of physical exercise.

iii)  Other conditions: Other conditions may affect the risk of coronary artery disease and heart attack. Scientists are not certain how these factors are involved in these conditions. The factors are:

.        Diabetes

.        Obesity

.        Stress and anger

.        Elevated homycysteine fibrinogen level

.         Sudden excitement/depression.

Signs and Symptoms: Most of the heart patients experience symptoms before the attack actually begins. Some people have no symptoms. This is called a ‘silent’ attack. Typical symptoms include:

a) Pain in the centre of the chest. It can feel like:

.      Uncomfortable pressure

.      Fullness/a tight band on the chest

.      squeezing

.      Indigestion or heart burn.

b) Pain radiates from chest to arms or shoulder; neck, teeth or jaw; abdomen or back.

c) Chest discomforts accompanied by:

.       Light – headedness/ dizziness

.       Fainting

.       Sweating, which may be profuse

.       Nausea or vomiting

.       Shortness of breath

.       Cough

.       Feeling of “impending doom”

d) Anxiety/Extreme weakness

e) Rapid or irregular heart beats

f) Crackles in the lungs, a heart murmur or other abnormal sound in the chest while listening with stethoscope.

Prevention and Control

         Some risk factors for heart attack cannot be controlled. There may be hereditary factors that make a person more or less likely to have coronary artery disease and a heart attack. However, many risk factors can be managed by leading a healthy lifestyle. Some ways a person can reduce the risk of coronary artery disease and heart attack are:

       .       Eat healthy diet that includes a variety of food, low in fat, low in cholesterol,  

               And high in fibre. The diet should be include plenty of fruits and vegetables,

               and limited sodium.

      .        Heavy meals should be avoided.

      .        Get regular moderate exercise. Bed rest up to 8-10 hours a day is considered

               desirable.

      .        Maintain a proper body weight by watching one’s diet and exercise.

      .        Strenuous physical exercise after 40 years of age should be avoided.

      .        Don’t start smoking. If you smoke, quit smoking.

      .        Control to consume alcohol.

      .        Adopt a more moderate lifestyle and healthy recreation that reduces stress

               and anxiety.

     .         Maintenance of healthy relationship among with the family members.

     .         Control blood pressure and diabetes.

     .         Regular health check-ups.

     .         Heart-attack patients must follow the doctor’s advice to prevent a second

               heart attack

.

.          Make sure to have an emergency action to plan in case of having the sign of a second heart attack.

.         In case of having or have had heart attack call the local emergency medical service immediately and get to the hospital emergency room as soon as possible.

   

   

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High Blood Pressure

The circulatory system is the network of organs and blood vessels through which blood travels in the body. Blood is pumped out of the heart into blood vessels is known as arteries. After passing through the body, blood returns to the heart by way of blood vessels known as veins. As blood flows through arteries and veins, it pushes on their walls. Thus, blood pressure is defined as the force exerted by blood inside arteries.

           

Blood does not flow steadily through the circulatory system. At one moment, the heart muscle squeezes blood out of the heart into the arteries. At this point, the blood pressure is high because of the force exerted by the heart. At this time, next moment, the heart muscle relaxes to let fresh blood into the heart. At this point, the highest pressure reached by blood in the arteries is called the systolic pressure and the lowest pressure reached by blood in the arteries is known as the diastolic pressure. In such a process, when a doctor or nurse takes a person’s blood pressure, he or she records two readings: the systolic (highest) and the diastolic (lowest) pressure. The readings are measured in units called “millimeters of mercury” or mm Hg. This unit is commonly used by scientists to measure pressure.

             In the light of the above explanation, according to the American heart association, high blood pressure (medically know as ‘Hypertension’) means systolic blood pressure is consistent at 140 or over 140 or diastolic blood pressure is consistent at 90 (140/90 mm Hg).

             Hypertension is a serious problem because people with this condition have a higher risk for heart disease and other medical problems than people with normal blood pressure. If left untreated, hypertension can lead to a number of medical conditions and complexities, including: heart attack, stroke, paralysis, enlarged heart, kidney damage, vision-loss.

Causes

In the majority of cases, causes are obscure, but it is usually caused by:

.        Family history of high blood pressure (heredity),

.        Kidney disorder, blood vessel diseases,

.        Disorders of the thyroid or other glands,

.        Heavy alcohol consumption and excessive smoking,

.        Overweight, nervous tension excitements,

.        Emotional stress and sedentary life,

.        Excess salt consumption and high sodium level in serum,

.        Lack of proper exercise and physical work,

.        Use of oral contraceptives

Signs and Symptoms

              Hypertension is a major health problem, especially because it has no symptoms. Many people have hypertension without knowing it and thus it is known as a ‘silent killer’. There is no single point at which a person is said to have hypertension. Hypertension or high blood pressure is characterized by:

.         Sub-occipital headache, nausea, vomiting,

.         Shortness of breath, significant sweating,

.         Easy fatigability and palpitation,

.          Blurred vision and confusion,

.          Rise of diastolic and systolic pressure,

.          Chest pain,

.          Irregular heart beat,

.          Ear noise or buzzing,

.          Blood in urine, nose bleeding,

.          Emotional and loose temperament,

.          Unconsciousness and hemorrhages,

.          Paralysis and swelling of organs.

Prevention and Control

              Some risk factors of hypertension cannot be eliminated. For example, a person may have inherited disorder. But may risk factors can be prevented or reduced. The following measures should be adopted for the prevention and control of hypertension:

.          Lifestyle changes may help control high blood pressure,

.          Reduce overweight,

.          Eat healthy/balanced diet and adjust your diet as needed,

.          Reduce salt intake,

.          Reduce fat intake,

.          Quit smoking,

.          Reduce alcohol consumption,

.          Begin a programmer of regular physical exercise,

.          Checking of blood pressure at regular intervals,

.          Learn to manage personal, family, occupational and social stress,

.          Proper medication according to the doctor’s suggestion.

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First Aid and Safety for Various Injuries

Electric Shock

It usually involves accidental contact with exposed parts of electric circuits in home appliance and domestic power supplies. It may also result from lightning or contact with voltage wires. Severe electric shock commonly causes unconsciousness, respiratory paralysis, cardiac disorder.

Safety Measures

.       Turn off the main electricity supply before starting any work.

.       Do not handle any switches, plugs or appliances with wet hands.

.       Do not overload sockets with adaptors.

.       Make sure that your electrical appliances and home wiring are in good working

        order.

.       Naked wire should be covered properly.

.       Replace loose connections and fit correct fuse.

.       Remember to turn off sockets when not in use.

First Aid

1)     Turn the electricity supply off at the main point. Do not touch the victim until

         You have done this.

2)      If you cannot turn the current off, use a dry implement made of non-conductive

         materials- to separate the casualty from the ‘live’ apparatus.

3)     Make sure that you and the patient are in a safe zone.

4)     When the victim is free, check his breath. He may need artificial respiration.

5)     Care should be provided for spinal injuries, fracture and burns.

6)     Cool the burnt areas and apply dry sterilised dressing to the burn sites.

7)     Do not allow crowd to gather around him.

8)     Keep the victim warm and comfortable.

9)     If the victim’s heart stops beating then give him heart massage.

10)   If the victim is in sense, provide him hot tea, milk and other liquid foods.

11)   Transport the casualty as soon as possible to a hospital for medical help.

Snake Bite

       Snake bites are very common in the Tarai region of our country where many types of poisonous snakes are found. Their bites are generally fatal if proper care and treatment is not provided immediately. Snake- bites require special care. The symptoms and signs of poisoning may take several hours to develop. Very few people die of snake bites. Most victims who die later , normally survive at least one or two days.

Safety Measures

The following measures can be adopted as safety measures for snake-bite:

.       The surroundings of the house should be kept clean.

.       Shoes should be used while walking (anywhere).

.       Grass, bushes should be cleared at the surroundings of residential area.

.       Light or torch-light should be used while walking at night.

First Aid

1)     Keep the patient calm.

2)     Treat for shock and conserve body heat.

3)      Locate the fang marks and clean this site with soap and water.

4)      Remove any rings, bracelets or other constricting items on the bitten extremity.

5)      Keep any bitten extremities immobilized.

6)      Apply a light constricting band above and below the wound. Each band should

         be about two inches from the wound.

7)      Sometimes a cut is required to be made at the spot of the bite so as to let the

         blood flow. But do not cum into the bite unless you are directed to do so by a

         physician.

8)      Never suck the venom from the wound using your mouth. Instead, use a suction

         cup.

9)      If breathing fails, artificial respiration should be given.

10)    Transport the patient to the hospital for medical help, carefully monitoring the

         vital signs.

  

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Harmful Goods and Healthy Lifestyle

Foodstuff in the market may have less weigh in the packet and they may be of low quality. Sometimes, there may be adulteration in the food available in the market. The adulterated food may not have adequate nutrition. Some of the things may be harmful to our body
.

Harmful Stuffs of Daily Use

Several industrialists produce stuffs and traders supply them to different markets in villages and towns. We use all these to fulfil our needs. Some of these stuffs may be pure but some may be harmful. Drugs for drug abuse, tobacco related stuffs and alcohol are harmful. We have taboos and misconception related to food in our society. As a result, people prepare harmful stuffs.

People wish to have new taste style of using attractive and colourful foodstuffs. Children use harmful foodstuffs as they don’t get proper guidance from the parents. Consumers are cheated from black marketing, production and distribution of food with less weight, low quality and adulteration.

The following are the causes of harmful or low quality food:

a)     To mix one type of foodstuffs with another type of foodstuff.

b)     To use different chemicals in foodstuffs and drinks

c)     To use food even after expiry date.

d)    To minimize cost by preparing food with low nutrition in it

e)     To prepare food for taste just by roasting it

f)     To use colour to make foodstuffs attractive

g)    To pack food and drinks in plastic and cans

There must be guarantee of having quality in all the foodstuffs and goods of daily use like mobile, utensils, rope, cement, iron rods, bags, radio, belts, clothes, etc. we use several stuffs like gel, oil, shampoo, hair spray, hair colour, polish, balsam to make our hair, nail and body attractive. Such low quality gods may cause side effects like fall of hairs, skin disease, wrinkles on skin, crooked body. It may spoil beauty of your body. There may be some problem in other organs.

Precautionary Measures in the Use of Harmful stuffs

There is unemployment problem in the country. As a result, there is poverty. Poor consumers are attracted to cheaper stuffs a there is demand for low-priced stuffs and low quality stuffs. There is more production of harmful low quality stuffs. The government implemented has consumer’s protection Act to discourage production and distribution of such low quality stuff. At the same time, it is necessary to reduce poverty and unemployment in order to make such law effective. The following precautions have to be adopted to minimize the use of harmful stuffs:

.      Public awareness has to be brought about through consumer’s education.

.      Produced stuffs have to be taken to the market after laboratory examination.

.      Inspection and monitoring of go down of traders have to be made effective.

.      Industrialists and traders in producing and distributing harmful stuffs have to be

       punished by law strictly.

.      If anyone knows the sale and distribution of harmful stuffs in the locality, he/she

       must inform the government immediately for necessary action.

.      During landslides, floods, fire, wars, natural disaster there are chances of sale and

       distribution of harmful stuffs. Therefore, we have to be aware about it.

.       We have to make local agencies responsible to implement strict law against

        Production and sale of harmful stuff compulsorily.

.       Permits must be implemented for production, sale, storage and distribution of

        Consumers stuff.

.       The community must be informal of the information about food adulteration

         Through social organization, non-government organizations, voluntary

          organizations.

Healthy Lifestyle Plan

The state of being physically and mentally healthy is considered healthy lifestyle. If an individual and a family are healthy, the whole society becomes healthy. The guardian has to play a vital role in making children’s lifestyle healthy. All the members have to be conscious in making the family healthy. Guardians and all the members of the family have to play an important role in making the family lifestyle healthy.

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Introduction

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Importance of Primary Health Care

Different countries have used different kinds of health programs to improve the health condition of their citizens. But, they are not successful to bring a significant change in the health status of people. Especially, the third world countries are the places of experiment of new methods and techniques of health care. But people of some countries are facing the maximum health problems. They are the victims of common diseases like diarrhoea, cholera, measles, etc. It is proved that we should emphasize on primary health care. 90% of population of poor countries are illiterate and living in remote and village areas. They don’t even have basic knowledge of health care. They are not interested or cannot afford for preventive aspect of health. As a result, they have to suffer a lot or sometimes lose their life untimely even by the effects of minor diseases. Such facts prove the importance of primary health care. In order to improve the health condition of common people of developing countries, we should make them aware about their personal hygiene, community health and immunization programmes that are launched by the government for the targeted group. In the same way, lack of nutritious food, education, and inadequate health services provided by the state are major causes of poor health condition of people in backward countries.

The importance of Primary Health Care

.        Primary health care helps in controlling most of the preventable diseases which

         Are main causes of low status of people.

.        Primary health care promotes active participation of people in caring their health

         in the right way.

.        Primary health care gives emphasis on decentralization approach. As a result,

         We can make the maximum participation of local people in health programs. It

         helps to improve the health condition of the community.

.        Primary health care aims to provide minimum and basic health services to all the

         people living even in rural and remote areas. All the people living in the corner

         of the earth can get such health services facilities.

.        Primary health care deals not only with the preventive and curative health, but

         also with the promotive and rehabilitative health of individuals, families, and

         communities. In such a way, it plays a role of milestone in improvement of

         overall health status of the nation.

Elements of Primary Health Care

Different countries, organizations and communities have contributed to various ways to the services and facilities for primary health care. In spite of their various contributions, the international conference at Alma-Ata has outlined the following necessary aspects of primary health care:

a. Supply of Safe Drinking Water and Sanitation

There is deep relation between the supply of water and sanitation. If there is storage of water, it naturally affects the sanitary condition. Due to the lack of safe water and cleanliness, disease like diarrhoea, cholera, typhoid, worms, dysentery are likely to occur. Unless we prevent ourselves from such diseases, we cannon keep our health in a good condition. Therefore, the supply of safe drinking water is necessary. It is equally important to pay attention to hygiene.

b. Nutrition

A nutritious diet is necessary for living a healthy life. It is possible when we have sufficient supply of food and management of good nutrition. In the absence of a balanced diet, we may suffer from malnutrition and different health problems may appear. So, the supply of food and management of proper nutrition is taken as the second major aspect of primary health care.

c. Appropriate Treatment of Common Diseases and Injuries

Diseases such as diarrhoea, common cold, worms, fever, headache, stomach-ache, etc. adversely affect our health. Even the minor injuries, if not treated in time, can make us suffer much. If such health problems are treated in time, we can achieve a better health. So, the primary health care has given emphasis on the treatment of common diseases and minor injuries.

d. Management of Essential Medicine/Drugs

Primary Health Care has given emphasis on the management of necessary medicine. In rural areas, the health centres provide  medicines for diarrhoea, fever, pain, etc. Medicine is also provided for minor injuries and wounds.

When primary health care is considered in its essence, it makes us realize that one should take care of one’s health oneself. Health education is considered as a process and medium of taking care of themselves. To make primary health care a successful program, participation of the community is extremely needed. With the help of our minimum efforts, we can protect ourselves from more than 90 percent diseases prevailing in our surroundings. For this, there is a need of active participation of individuals, the community and the nation.

e. Protection from Local Diseases

Diseases may be found appearing differently according to the variations of the places. Thus, the first necessity arises in the treatment of diseases which especially appear in definite places.

f. Family Planning and Maternal and Child Health Care

Family planning is necessary to live a happy life. In family planning, the size family and education for them is managed according to the sources of family income. Along with the family planning, maternal and child health care should also be taken into consideration. Both child death rate and maternity death rate are high in Nepal. Therefore, the importance of the maternity and child care has increased more in Nepal.

g. Immunization against Major Communicable Diseases

Immunization is a preventive measure given against the diseases. If we are immunized, we become immune to diseases. we can immunize ourselves from the diseases such as tuberculosis, tetanus, whooping cough, measles, poliomyelitis, etc. The government Nepal has made these injections freely available to all the people in the country.

h. Health Education

Due to the lack of health education, it is hard to enjoy a normal health condition. Health education teaches us about the problems of health, the diseases and their causes. It also teaches us how those diseases can be prevented. That is why, health education is considered as one of the main aspects of primary health care.

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Introduction to Primary Health Care

Health is wealth. It is the fundamental human right. So, it is the major duty of government to make basic health services available throughout the country. Primary health means the basic health services that are needed for every individual to be healthy. For the healthy life of citizens of any country, the individual, community, family, nation, government, all should be conscious and responsible from their respective field.

More than half of the world population is deprived of even from the basic health care. Mostly, the people of rural and remote areas are losing their life untimely by common diseases which can be controlled and treated easily. They do not have access to the basic health care. In developing countries, emphasis is given on curative aspect rather than preventive aspect. This is because of economic problem, lack of awareness, and scarcity of health services provided by the nation to its citizens.

As the time changes, concept of people also goes on changing. They become more conscious about their health. New approaches to health have come into existence. In 1978, there was an international conference held on 6 to 18 September in the capital city of Alma-Ata of present Kazakhstan in the then USSR. The conference was organized by the WHO and the UNICEF. There was participation of 134 countries altogether including Nepal. Participation of our country initiated the trend of health strategies and plans according to the concept of Primary Health Care. The conference has defined primary health in the following way.

Primary Health Care is an essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost that the community and country can afford.

From the above definition, we can include the following points under primary health care:

.      Primary health care should have accessibility in all individuals and families in the

      community.

.      Primary health care should be easily available and must be affordable to all

       classes of people.

.      There must be participation of people in dissemination of primary health care.

.      Services of primary health care should be bearable to the nation.

Characteristics of Primary Health Care

Availability of Health Services

Basic and minimum health services should be available to all the people of community. There must be physical presence of health service provider, i.e. health centers and health personal should be available easily in the community

Accessibility of Health Services

Health services provided by the government or other related agencies should be within the access of common people. It should be provided at affordable cost. Basic medicines needed for common health problems should be made available.

Full participation of Community in Primary Health Care Programs

Any kind of health program needs participation of local people to be successful and effective. Without participation of people, the program cannot be successful and it cannot bring changes in the health status of the concerned community.

Affordable for community and Nation

The components of Primary Health Care must have affordable price. In such a program, local resources and technologies should be used. Foreign technologies and medicines may be expensive but the government or health service providing organizations should manage it for the common people if these are included under primary health care.

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Some Communicable Diseases

Cholera

Cholera is an acute diarrhoea caused by vibrio cholera. It is characterized by the sudden onset of effortless watery diarrhoea followed by vomiting, rapid dehydration, muscular cramps and suppression of urine. The severity of cholera depends on its rapidity and duration of fluids loss. The outbreak of cholera is massive and epidemic in nature.

Modes of Transmission

The modes of transmission of cholera are as follows:

.          Faecally contaminated water.

.          Contaminated food and drinks.

.          Polluted water and drink it may transmit throny to mites of infected person.

.          Direct contact with an infected person.

.          Flies acts as mechanical carrier.

Signs and Symptoms

The symptoms of cholera are as follows:

.          Onset of painless watery diarrhoea and vomiting.

.          Diarrhoea like washed water of rice more than 4 times in a day.

.          Occurrence of the following symptoms of dehydration:

           -Sunken eyes                                    -Hollow cheeks

           -Wrinkled abdomen                         -Sub-normal temperature

           -Absence of pulse                            -Unrecordable blood pressure

           -Loss of skin elasticity                     -Shallow and quick respiration

.          The output of urine decreases and may ultimately cease.

.          The patient becomes restless and complains of intense thirst.

.          Muscle cramps in legs and abdomen.

.          Heart and kidney failure due to severe dehydration.

Prevention and Control

The prevention and controlling measures of cholera are as follows:

.          Start re-hydration therapy. Use of oral or intravenous therapy as per the degree

           of dehydration.

.          Provision of safe drinking water in all communities.

.          Proper disposal of human excreta and discourage open defecation practices.

.          Maintain food hygiene during preparation, storage and administration.

.          Eat raw foods and vegetables after careful washing.

.          Maintain personal and environmental sanitation.

.          Give health education to community people about causes and consequences of

           cholera.

Common Cold

Common cold is caused by an acute viral disease of the upper respiratory tract caused by rhino virus. Some common colds aaffect the whole respiratory tract, producing some bodily discomforts such as headache and mild fever.

           It is characterized by the inflammation of mucus membrane of nose, sinuses and throat. The most significant role of common cold is that it serves as a precursor to some serious disease by lowering the person’s resistance power. The incubation period of common cold is 12-72 hours.

Mode of Transmission

The mode of transmission of common cold are as follows:

.           Droplet infection: While sneezing, coughing and even talking many rhino

            viruses come from the respiratory tract to the air and thus the viruses are

            transferred to the susceptible person.

.           Direct contact with the infected person.

Signs and Symptoms

The signs and symptoms of common cold are as follows:

.           Irritation in nose and throat.

.           Congestion and dryness of nose and throat

.           Hoarseness of voice and sore throat

.           Coughing and sneezing

.           Water flows from the nose

.           Mild fever, headache and moist eyes.

Prevention and Control

The following are the preventive and controlling measures against common cold.

.            Avoiding colds as much as possible particularly in case of excessive coughing

             and sneezing.

.            Keeping up resistance by sufficient sleep, recreation and proper diet.

.            Washing hands with soap before eating or handling food.

.            Avoid towels, eating and drinking utensils, or toilet articles used by others.

.            Keeping the head, back of the neck and feet warm and dry.

.            Eating light meals with nourishing food.

.            Increasing the fluid intake by drinking plenty of water, fruit juice and soup.

.            Covering the nose and mouth with a handkerchief when coughing or sneezing.

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