REASONS FOR PREVALENCE OF NCD

1. demographic transition

2. epidermiological tra

3. nutritional

4. multifactorial nature

risk factors

significantlt associated

modifiable by intervention

suggestive

prevention

1ary, 2ary and 3ary

primary health care dr role

1. identify high risk

2. health education

3. nutritional education

4. early detection

5. referral of identified

6. follow up of referred cases

CVD

leading cause of death in NCD

NMRF

1. age, male sex, FH, genetic factors

MRF

1.cigarette smoking

2.hypertension

3.serum cholesterol(220mg/dl), LDL:HDL >5 indicates risk

4. serum homocysteine

5. diabetes m

6. obesity

7. exercise

8. hormones

primary prevention

1.population strategy based on reduction of blood pressure and cholesterol

2. high risk stragey by identifying people at risk and encouraging them to take action via screening

priomordial prevention- mass education of children

secondary prevention- preventing of recurrence by cessation of exposure to RF

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hypertension

Case definition quantitive deviation from normal levels

higher among urban countries

rule of halves

HTN is an iceberg

half know about their condition

half under treatment

half under treat having adequate treatment

tracking of BP in children

screening for HTN

not drink coffe or smoke within 30m

evacution of urijnary bladder

sit for 5m back rested on chair and feet on floor

exposed arm

2 readings 5m apart average taken

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congenital heart diseases

cynotic and acynotic

multifactorial and external agents ( drugs, alcohol and x ray)

prematurity-VSD and PDA

maternal age Fallot

sex of child- Bicuspid valve male and PDA is female

90% unknown causes

prevention by:

education on:genetic counselling, sanguineous marriage, late pregnancy, smoking, alcohol, drugs,
iodized salt, diabetes control, vaccination, antenatal care

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rheumatic heart disease

Aschoff nodules are pathognomic finiding

Jones criteria

prevention

primordial: health education improvement of living conditions, nutition, overcrowding

specific protection chemoprophylaxis

early diagnosis and treatment : school survey on sore throat

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DM

hyperglycemia that leads to macro and micro vascular problems

type 1: beta destruction

type 2 : insulin deficiency and resistance

gestational

paraneoplastic

endocrine

drugs: coticoids and thiazide

type 2 prevlance in develpoing countries

screening tests

fasting <110 normal, 110-125pre, >126 clinical

2hrs post glucose load <140 normal, 140-190pre, 200+ clinical

1ary prevention of type 1:

MMR vaccine, breast feeding, avoidance relatives in marriage, preconception counselling

1ary prevention type 2

diet: high fibre, complec CHO, monosaturated fat

healty lifestyle: excercise, avoid anxiety/tension, drug abuse

2ary for both

screening both at risk not at risk, management of cases to prevent complications and management
of complications

3ary

medical, social, psychological and vocational rehabilitation

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cancer

many RF: pollution, food industry, smoking, occupational, genetic

classified into

1.demographic and personal

2. lifestyle

3. environmental

4. medical procedures and drugs

5. reproductive health factors

6. infectious

basically know RF for cancer development for each organ (from pathology)

diet rich in fribres

1.dilute contents especially bile acids

2.increase motility

3.shorten contact of carcinogens with wall of inestine

4. facilitate elimination of carcinogens

5.reduce fat absorption and fat carcinogenic affect

vitamins are protective

radiations: skin cancer, leukemias etc

immunosuppresive drugs increase risk of Non-hodgkin lymphoma

estrogen replacement therapy: breast and endometrial cancers

1ary prevention: dec pollution, infectious diseases, food sanitation, health education, policies related
to pharmaceuticals, industrial health programs, precaustions in medical settings,

2ary: screening and management of cases: pap smears, mamography,serum tumor markers

3ary: rehabilitation

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accidents and injuries

measurements: mortality, morbidity and disability

types of accidents

RTA, domestic( burns, drowning, etc, industrial, railway, violence( war, homocide, suicide)

precipitating factors: emotional tension etc

human factors: lack of protection, age, sex, medical conditions, fatigue, bad judgement

environmental: bad weather, bad roads, mixed traffic, speed of vehicles