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1 Diabetes Mellitus

Cause: Normally, your body breaks down the sugars and carbohydrates you eat into a special
sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone,
in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus,
either your body doesn't make enough insulin, it can't use the insulin it does produce, or a
combination of both.Since the cells can't take in the glucose, it builds up in your blood. High
levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes,
or nervous system. That's why diabetes -- especially if left untreated -- can eventually cause
heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.

Symptoms:

Frequent urination (polyuria)

Excessive thirst polydipsia

polyphagia (increased hunger)

Unexplained weight loss

Extreme hunger

Sudden vision changes

Tingling or numbness in the hands or feet

Feeling very tired much of the time

Very dry skin

Sores that are slow to heal

More infections than usual

Tests for Diabetes

Fasting blood glucose is measured after an 8 hour fast.

Normal: less than 100 mg/dl Prediabetes: 100-125 mg/dl Diabetes: 126 mg/dl or higher

Oral glucose tolerance test (OGTT) is performed after consumption of a high-glucose solution.

Normal: less than 140 mg/dl Prediabetes: 140-199 mg/dl Diabetes: 200 mg/dl or higher

Random blood glucose of 200 mg/dl or higher indicates diabetes.

Medications Patients with diabetes are advised to reduce their consumption of refined
carbohydrates and adhere to a high-fiber, low-fat, and low-calorie diet. Daily aerobic exercise is
recommended because exercise naturally lowers blood sugars and helps control the disease.
Insulin therapy is absolutely essential for most patients with type 1 DM, and insulin is also
required in some cases of type 2 DM. Insulin is administered by injections or an insulin pump.
Oral glucose-lowering medications work to lower blood sugar by either stimulating the pancreas
to produce more insulin; inhibiting glucose production by the liver; enhancing the body’s
response to insulin; or blocking digestive enzymes involved in the metabolism of carbohydrates.
Pancreas transplants may be performed in patients when treatment with medications fails.

Prevention Type 2 DM is considered a preventable disease, and people with prediabetes can
prevent a progression to diabetes by losing weight, eating a healthy diet, and exercising. A
combination of daily aerobic exercise and resistance training (twice a week) is very beneficial for
maintaining blood sugar control.

2 Rickets
Causes: deficiency or calcium or vitamin d or phosphorus Vitamin D promotes the absorption of
calcium and phosphorus from the gastrointestinal tract. A deficiency of vitamin D makes it
difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets.
occur if your child's body doesn't get enough vitamin D or if his or her body has problems using
vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D
can cause rickets Sunlight. Your skin produces vitamin D when it's exposed to sunlight. But
children in developed countries tend to spend less time outdoors. They're also more likely to use
sunscreen, which blocks the rays that trigger the skin's production of vitamin D. Food. Fish oils,
fatty fish and egg yolks contain vitamin D. Vitamin D also has been added to some foods, such
as milk, cereal and some fruit juices.

Symptoms

Delayed growth

Pain in the spine, pelvis and legs

Muscle weakness

Bowed legs or knock knees

Thickened wrists and ankles

Breastbone projection

bone pain

bone tenderness

bones break easily

a soft skull

short height and low weight

Prevention Exposure to sunlight provides the best source of vitamin D. During most seasons, 10
to 15 minutes of exposure to the sun near midday is enough. However, if you're dark-skinned, if
it's winter or if you live in northern latitudes, you might not be able to get enough vitamin D
from sun exposure. In addition, because of skin cancer concerns, infants and young children,
especially, are warned to avoid direct sun or to always wear sunscreen and protective clothing.
To prevent rickets, make sure your child eats foods that contain vitamin D naturally — fatty fish,
fish oil and egg yolks — or that have been fortified with vitamin D, such as: Infant formula
Cereal Bread Milk, but not foods made from milk, such as yogurt and cheese Orange juice

Treatments the treatment of rickets focuses on increasing the patient's intake of calcium,
phosphates, and vitamin D. This may involve exposure to sunlight, consuming fish oils, and
ergocalciferol or cholecalciferol, which are both forms of Vitamin D. Exposure to UVB light and
consuming calcium and phosphorus is usually enough to reverse or prevent rickets. If rickets is
caused by a poor diet, the patient should be given daily calcium and vitamin D supplements and
an annual vitamin D injection, as well as being encouraged to eat vitamin-D-rich foods. When
treating rickets that has a genetic cause, the patient will be prescribed phosphorus medications
and active vitamin D hormones. If rickets has an underlying medical cause, such as kidney
disease, that disease will need to be treated and controlled.

Tests Blood tests: These tests measure the levels of calcium and phosphorus. Levels of alkaline
phosphatase may also be high. Arterial blood gases: This test checks how acidic the blood is. X-
rays: These may reveal calcium loss in bones, or alterations in the structure or shape of the
bones. Bone biopsy: This can confirm rickets but is rarely used.

Artherosclerosis

causes: Arteries are blood vessels that carry bloodfrom the heart throughout the body. They're
lined by a thin layer of cells called the endothelium. The endothelium works to keep the inside of
arteries toned and smooth, which keeps blood flowing. Atherosclerosis begins with damage to
the endothelium. It’s caused by high blood pressure, smoking, or high cholesterol. That damage
leads to the formation of plaque. When bad cholesterol, or LDL, crosses the damaged
endothelium, the cholesterol enters the wall of the artery. That causes your white blood cellsto
stream in to digest the LDL. Over years, cholesterol and cells become plaque in the wall of the
artery. Plaque creates a bump on the artery wall. As atherosclerosis progresses, that bump gets
bigger. When it gets big enough, it can create a blockage. That process goes on throughout your
entire body. As a result, not only is your heart at risk, but you are also at risk for stroke and
other health problems. Atherosclerosis usually doesn’t cause symptoms until middle or older
age. But as the narrowing becomes severe, it can choke off blood flow and cause pain.
Blockages can also rupture suddenly. That’ll cause blood to clot inside an artery at the site of
the rupture.

Symptoms

If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain
or pressure (angina). If you have atherosclerosis in the arteries leading to your brain, you may
have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty
speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your
face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a
stroke. If you have atherosclerosis in the arteries in your arms and legs, you may have
symptoms of peripheral artery disease, such as leg pain when walking (claudication). If you
have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or
kidney failure.

Tests Blood tests These measure how much sugar, fat, and protein there is in the blood. If
there are high levels of fat and sugar, it could indicate an increased risk of atherosclerosis.
Physical exam The doctor will listen to the arteries using a stethoscope to see if there is an
unusual "whooshing" sound as a result of uneven blood flow. If this is heard, it can mean there
is plaque obstructing blood flow There may also be a very weak pulse below the area of the
artery that has narrowed. Sometimes, there is no detectable pulse.An affected limb may have
abnormally low blood pressure. There may be a pulsating bulge behind the knee or in the
abdomen, indicating the presence of an aneurysm. Where blood flow is restricted, wounds may
also not heal properly. The doctor may check for this type of wound.
Ultrasound: An ultrasound scanner can check blood pressure at distinct parts of the body.
Changes in pressure indicate where arteries may have an obstructed blood flow .CT scan: This
can be used to find arteries that are hardened and narrowed. Those who are at risk of
developing atherosclerosis will likely be told by their doctor to change their lifestyle and
maintain a healthy weight. In some cases, treatment may include medication or surgery.

Treatment Lifestyle changes: These focus on weight management, physical activity, and a
healthy diet. A doctor may recommend eating foods high in soluble fiber and limiting intake of
saturated fats, sodium, and alcohol. Medication: Antiplatelet medications can prevent the build
up of plaque or help prevent blood clots. Others, such as statins, might be prescribed to lower
cholesterol, and angiotensin-converting enzyme (ACE) inhibitors can help lower blood pressure.
Surgery: Severe cases of atherosclerosis may be treated by surgical procedures, such as
angioplasty or coronary artery bypass grafting (CABG). Angioplasty involves expanding the
artery and opening the blockage so that the blood can flow through properly again. CABG is
another form of surgery that can improve blood flow to the heart by using arteries from other
parts of the body to bypass a narrowed coronary artery

Prevention Diet: Try to avoid saturated fats, they increase levels of bad cholesterol. The
following foods are high in unsaturated fats and can help keep bad cholesterol levels down: olive
oil avocados walnuts oily fish nuts seeds Exercise: Exercise will improve fitness levels, lower
blood pressure, and help weight loss. Not smoking: Smoking is one of the major risk factors for
atherosclerosis, and it also raises blood pressure. Smokers should quit as soon as possible and
arrange a meeting with their doctor about ways to give up and manage withdrawal symptoms.

4 kwashiorkor
Causes Kwashiorkor is caused by a lack of protein in the diet. Every cell in your body contains
protein. You need protein in your diet for your body to repair cells and make new cells. A
healthy human body regenerates cells in this way constantly. Protein is also especially important
for growth during childhood and pregnancy. If the body lacks protein, growth and normal body
functions will begin to shut down, and kwashiorkor may develop. Kwashiorkor is most common
in countries where there is a limited supply or lack of food. It is mostly found in children and
infants in sub-Saharan Africa, Southeast Asia, and Central America. A limited supply or lack of
food is common in these countries during times of famine caused by natural disasters — such as
droughts or floods — or political unrest. A lack of nutritional knowledge and regional dependence
on low-protein diets, such the maize-based diets of many South American countries, can also
cause people to develop this condition.

Symptoms

 loss of muscle mass


 an enlarged tummy ("pot belly")
 regular infections, or more serious or long-lasting infections than usual
 red, inflamed patches of skin that darken and peel or split open
 dry, brittle hair that falls out easily and may lose its colour
 failure to grow in height
 tiredness or irritability
 ridged or cracked nails

tests If kwashiorkor is suspected, your doctor will first examine you to check for an enlarged
liver (hepatomegaly) and swelling. Next, blood and urine tests may be ordered to measure the
level of protein and sugar in your blood. Other tests may be performed on your blood and urine
to measure signs of malnutrition and lack of protein. These tests may look for muscle
breakdown and assess kidney function, overall health, and growth. These tests include: arterial
blood gas blood urea nitrogen (BUN) blood levels of creatinine blood levels of potassium
urinalysis complete blood count (CBC)

Treatment Stabilization phase: this is the initial treatment phase that is done within the first
7 days of admission and involves treating the conditions that may easily cause death (life
threatening conditions) or complications Rehabilitation phase: this is started from the second
week to the sixth week. It involves proper investigations to know the cause of the Kwashiorkor
and appropriate treatment Follow up phase: this starts from week 6 to the 6th month. It
involves serial weight measurements during visits to ensure appropriate weight gain.

Prevention Kwashiorkor can be prevented by making sure you eat enough calories and protein-
rich foods. Dietary guidelines from the Institute of Medicine recommend that 10 to 35 percent of
adults’ daily calories come from protein. Five to 20 percent of young children’s and 10 to 30
percent of older children and teenagers’ daily calories should come from protein. Protein can be
found in foods like: seafood eggs lean meat beans peas nuts seeds

Beri beri

Causes Dialysis and usage of a heavy dose of diuretics may also increase the probability of a B1
deficiency. As told in the Nursing Nonprescription Drug Handbook (edition 2002), apart from
nutrient-deficient food, there are several major causes of beriberi in developed
countries. Hypothyroidism, poor absorption of nutrients from the diet, chronic alcoholism, etc

Symptoms
Wet beriberi symptoms include:

 shortness of breath during physical activity


 waking up short of breath
 rapid heart rate
 swollen lower legs

Dry beriberi symptoms include:

 decreased muscle function, particularly in the lower legs


 tingling or loss of feeling in the feet and hands
 pain
 mental confusion
 difficulty speaking
 vomiting
 involuntary eye movement
 paralysis

Tests You will need a series of medical tests to determine whether or not you have beriberi.
Blood and urine tests will measure the levels of thiamine in your body. If your body has trouble
absorbing thiamine, you will have a low concentration of thiamine in your blood and a high
concentration in your urine.Doctors will also perform a neurological exam to look for lack of
coordination, difficulty walking, droopy eyelids, and weak reflexes. People with later stages of
beriberi will show memory loss, confusion, or delusions.

Prevention Avoid Drinking After Meals: Vitamin B1, being a water-soluble compound, tends
to get drained out of the body if excess liquid is drunk after meals. Avoid Fish: Shellfish, clams,
mussels, shrimps, and raw tissue of animals contains an enzyme thiaminase which causes a
breakdown of thiamine. Therefore, consumption of fish must be avoided in order to retain the
existing vitamin B1 in the body. While any other complications involving the cardiac and nervous
system require the help of medical practitioners and a diagnosis, as soon as possible.

Treatment Beriberi is easily treated with thiamine supplements. Your doctor may prescribe a
thiamine shot or pill. For severe cases, a healthcare professional will administer intravenous
thiamine. Your progress will be monitored with follow-up blood tests to see how well your body is
absorbing the vitamin.