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.

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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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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.

Introduction

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Nose and Tongue

Nose is the sense organ for smelling. It is also the important organ of respiratory system.

        Our nose is divided into two parts – external nose and internal nose. The external nose consists of two openings called nostrils. The internal nose consists of a wide cavity known as nasal cavity. The nasal cavity is divided into two cavities by nasal septum. The nasal cavity consists of hairs which prevent the entry of dust particles during respiration. The upper part (roof) of the nasal cavity contains a special tissue known as olfactory mucosa. This mucosa consists of cells called sensory cells. When a smell reaches to nasal cavity, it activates the sensory cells of the olfactory epithelium. The sensory cells that send the smell to the brain. Then we find out the smell. 

         Actually, the nasal cavity is lined by mucous membrane. The olfactory epithelium covers the small area of mucous membrane in human beings. In hence, they can detect very faint smell also.

Defects of nose

         Common cold causes the inflammation of the nasal mucous membrane. It is due to the viral infection. The inflammation hinders the smells from reaching the olfactory are and results in loss of sense of smell. This is known as rhinitis.

         Bleeding from nose is common in children due to the minor trauma in nose. In such case, we should keep our head little up and pinch the nose for some minutes.

         Similarly, when a person inhales a substance with a strong smell again and again, the sense of smell for that substance decreases gradually and may disappear altogether. This is due to the changes in sensory cells of nose and olfactory region of the brain. This process is known as olfactory adaptation.

Care of nose

          We should be careful for the cleanliness and protection of our nose. We should take the following precautions to protect our nose:

1.              We should blow and wash our nose to keep it clean.

2.              Fingers, pencils, matchsticks, etc should not be inserted into the nostrils.

3.              If our nose is blocked, we can use nasal drops. But excessive use of such drops is harmful. They should be used according to the advice of doctor.

4.              We should inhale the strong smells or stenches. They can damage our smelling capacity or make us sick.

5.              We should not take smell of flowers from a close distance.

Tongue

           The tongue is the sense organ of taste. You can see a number of tiny knobs if you deserve the upper surface of your tongue in a mirror. These tiny knobs present in the tongue are called taste buds. There are about ten thousands taste buds in our tongue.

           The surface of the tongue is very sensitive in sensing sweet, salt, sour and bitter tastes. There are  different regions to notice the different tastes in our tongue. The sweet taste is noticed by the tip of the tongue whereas the bitter taste is noticed by the back part of the tongue. That is why we know sweet taste earlier than the bitter one.

Sweet:        The sweet taste is noticed by the tip of the tongue.

Salty:         The salty taste is noticed by the region just inside (after) the tip.

Sour:          The sour taste is noticed by the middle of the tongue.

Bitter:        The bitter taste is noticed by the back part of the tongue.

Defects of tongue

          The taste buds can be damaged by very hot foods and drinks and the use of sharp things (while cleaning the tongue). The tongue with damaged taste buds cannot detect the taste of food properly. The sensory cells of the nose also help the taste buds while determining the taste. Therefore, we cannot find the taste of food while we are suffering from common cold.

          Our tongue is helpful not only to taste the food but also move food while chewing. It also helps to produce different sounds while speaking, talking, singing, etc.

Introduction

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Balanced Diet

 Food is essential for human existence just like air or water. A living organism is the product of nutrition. Food is the raw material from which our body is made. Intake of the right kind and amount of food can ensure good health, which can be reflected in our appearance, efficiency and emotional well-being. The food we use daily is made up of a number of chemical components called nutrients. Everyone knows that good diet is needed to maintain good health. A good or adequate diet is known as balanced diet. We can say that the food that supplies all the necessary substances needed by the body is known as a balanced diet. In fact, the nutrients in the proper amount and proportion required by the body according to age, s@x, physical activities, for the proper growth, development and health comprise our balanced diet. Every individual needs a specific amount of calories from the balanced diet, as their activities differ from each other. Besides this, age, s@x, occupation, physical and mental work also affect the requirements of the balanced diet. Lack of nutrients and the absence of the balanced diet for a longer time affect the physical and mental health of a person which may cause various health problems and diseases.

Methods of Selecting the Balanced Diet

         In order to make up for the loss sometimes and also to help the body provide us with necessary strength, we need food. The foods we eat daily have become a part of us. These foods are classified into the following three categories according their function and chemical composition:

1. Energy producing nutrients                                (i) Carbohydrates

                                                                                              (ii) Fat.

2. Body building nutrients                                      (i) Protein,

                                                                                (ii) Minerals and salts.

3. Nutrients necessary for regulating the body       (i) Vitamins,

   Process.                                                                (ii) water.

                 

(a)   Energy producing nutrients: Any type of food that we eat has one of these substances mentioned above. As discussed above, among the energy producing nutrients carbohydrates from the largest component of diet of most of the people and furnish most of the required energy. It is most easily available and most economical sources of energy for human. The best sources of carbohydrates are cereals like rice, wheat, millets, maize, potato, sweet potato, sugar, honey, etc. Banana, apple and drilled fruit are also good sources of carbohydrates. Fat is the concentrated source of energy and it is important due to its highest calorie density. The chief dietary sources of fat are ghee, butter, cream, oil, milk, fat from meat and vegetables oils, like- groundnut, mustard, sunflower, soyabean.

(b)   Body building nutrients: The second important group of nutrients consists of protein and minerals and salt. Protein are present in all living tissues of plants and animals. Protein is a tissue builder, and important for the growth. Wear and tear of the tissue is repaired by the protein. The dietary sources of protein are egg, milk, milk products, meat, fish, liver, pulses, cereals, nuts, beans, gram, green leafy vegetables, etc. whereas, minerals and salts are essential for the maintenance and growth of the body. The dietary sources of minerals and salts are fresh and dried fish, dark green vegetables, dried beans, dried fruits, milk, milk products, potatoes, almonds, cheese, liver, kidney, yolk of egg, onion, common salt, carrot, radish, spinach, cabbage, cauliflower, red gram.

(c)    Nutrients necessary for regulating the body process: The third important group of foods is nutrients necessary for regulating the body process and protection. This group consists of vitamins and water. Vitamins are essential in our daily life in order to maintain life, normal growth and optimum health development. The dietary  sources of vitamins are: liver, yolk of egg, milk, fish, cod liver oil, butter, ghee, sunlight, cereal embryos, peanut, green leaves of plants, wheat germ oil, cabbage, carrot, tomato, pork, curds, lemon, pineapple, papaya, mango, orange, amla, etc. water forms the major part of blood, the intra-cellular and body fluid. Water is injected through food and drinking.

               Food is essential but must be safe and balanced. We may select our food    items according to our needs, choice, economic status, and on the basis of availability. It is not necessary that we select costly and imported food items. We may balance our food from selection of locally available food products.                    

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Sexually Transmitted Diseases (STDs)

The sexually transmitted diseases are a group of communicable diseases that are transmitted through unsafe sexual contact. Virus, bacteria, pretoria, fungus and ectoparasites cause them. The common STDs are syphilis, gonorrhoea, HIV/AIDS, Hepatitis ‘B’, Hepatitis ‘C’, etc.

Syphilis

     Syphilis is a chronic sexually transmitted disease caused by ‘spirochete’ or ‘Treponema Pallidum’. It mainly effects the mucus membrane, heart, liver and central nervous system of the body. It is characterized by primary infection followed by recurrent secondary manifestation and paralysis leading to death. The average incubation period of syphilis is approximately three weeks, though it may be 10 days to 90 days.

Mode of Transmission

The modes of transmission of syphilis are as follows:

.          Unsafe sexual intercourse

.          Direct contact

.          Indirect contact, eg., toilet seats, eating utensils, etc.

.          Homosexual activity is also a means of transmission of early infection of syphilis.

.          Blood transfusion

.          Heredity

Signs and Symptoms

      The symptoms of syphilis appear from few weeks to many years. Thus, it has long communicability. Therefore, the symptoms of syphilis can be divided into primary, secondary and latest syphilis. When the primary and secondary signs and symptoms persist, the disease is highly contagious. The main symptoms of syphilis can be stated as follows:

.        Primary Stage

         A single, painless lesion or sore is called a chancre appears in the genitals, anus,

         lips, tongue, mouth, breast, fingers, etc and they disappear after 1-5 weeks of

         appearance.

.        Secondary Stage

         After one weeks to six months of primary stage, the secondary syphilis signs

         appear which are as follows:

-                A copper-colored rash lasting about six weeks appears on various parts

Of the body

-                Whitish patches in the mouth or throat

-                ‘Patchy’ falling hair

-                Low fever, poor appetite and loss of weight

-                Painless swelling of lymph glands

-                Pain in bones and joints

-                Enlargement of liver and spleen

.        Final Stage

         In the final stage, the disease is considered communicable for approximately four years following initial infection. Syphilis at latest stage can become destructive in nature causing,

-                Heart diseases

-                Paralysis (spinal cord damage)

-                Blindness (Eye problems)

-                Infertility of female and male importance.

Preventive and Controlling Measures

The preventive and controlling measures against syphilis are as follows:

.        Avoid prostitution and sexual promiscuity.

.        Use condom while sexual intercourse and avoid excremental sexual relation.

.        Provision of prompt treatment.

.        Avoid direct contact with infected person.

.        Use sterile syringe and needles.

.        Examine the blood before transmission.

.        Avoid personal belongings of infected person.

.        Health education and sex education should be provided at home, school and in

         the community.

Gonorrhoea

       Gonorrhoea is an infection of genitourinary tract caused by Neisseria Gonococcus. It mainly affects the mucus membrane of genitourinary tract. It is characterized by swelling and whitish discharge from genital organs and dysuria. The average incubation period is approximately 3-9 days.

Mode of Transmission

The modes of transmission of gonorrhoea are as follows:

.       Sexual intercourse

.       Direct contact

.       Mother to baby

.       Fomites of infected persons

Signs and Symptoms

Gonorrhoea affects male, female and newborn baby too. The major symptoms of gonorrhoea are as follows:

.        Frequent and painful experience in urination

.        Whitish discharge from penis in the male and vagina in the female

.        Red spots appear around the genitals

.        Swelling of genital organs, i.e., penis in male and vagina in the female

.        Conjunctivitis in newborn babies

.        Female may suffer from infertility.

Preventive and Controlling Measures

The preventive and controlling measures against gonorrhoea are as follows:

.        Avoid extra marital sexual relations and use of condom in sexual intercourse.

.        Avoid direct contact with infected persons.

.        Avoid infected persons pregnancy.

.        Discourage prostitution and maintain sexual hygiene.

.        Avoid Personal belongings on infected persons.

.         Provide health education along with sex education at home, school and in the

          Community.

.         Early detection and treatment.

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