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saurabh.singh@brainpan.co SAURABH SINGH

OVERVIEW

1. CARDIOLOGY

2. PULMONOLOGY

3. GYNECOLOGY

1
1.1. CARDIOLOGY: ISCHEMIC HEART DISEASES
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Blocking of arteries -

Sudden or Gradual

Plaque buildup in arteries

PREDISPOSING
 Diabetes Mellitus  High Cholestrol Levels  Unawareness
FACTORS
 Hypercholestrolemia  Fatty Diets Consumption  Low educational groups in
 Genetic, Heriditary  Sedentary Lifestyle more urbanised communities
factors  Obesity  Inadequate treatment
 Arteriosclerosis  Smoking practices
 High Blood Pressure  Tobacco Usage  Low socio economic status
 Blood Vessel
Inflammation

2
1.2. CARDIOLOGY: MYOCARDIAL INFARCTION
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Sudden Blockage in

Coronary Artery

Blood Clot (Thrombus)

That Blocks Coronary
Artery

PREDISPOSING
 Abnormally High Blood  Family History of CAD at  Unawareness
FACTORS
Cholestrol [Value] an Early Age  Low educational groups in
 Abnormally Low Levels  Obesity more urbanised communities
of HDL [Value]  Trans Fat Consumption  Inadequate treatment
 High Blood Pressure  Sedentary Lifestyle practices
 Diabetes  Anxiety  Low socio economic status
 Smoking
 Over Sweating
 Shortness of Breath

2
1.3. CARDIOLOGY: CONGESTIVE HEART FAILURE
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Fluid Buildup around Heart

causing Inefficient
Pumping

PREDISPOSING
 High Blood Pressure  Overworking the Heart  Unawareness
FACTORS
 Hypertension  Obesity  Low educational groups in
 CAD  Smoking more urbanised communities
 Diabetes  Inadequate treatment
 Value Conditions practices
 Heart Murmurs  Low socio economic status
 Thyroid Disease
 Kidney Disease
 Anaemia
 Leg Swelling
 Excessive Tiredness
 Shortness of Breath

2
1.4. CARDIOLOGY : RHEUMATIC HEART DISEASE
DIRECT
Clinical
MAIN CAUSES Rheumatic Fever
(Mainly in children of 5-15
years of age)
PREDISPOSING
 Streptococcal infection
FACTORS
 Chest pain
 Heart Palpitations
 Strep infection
 Scarlet fever
 Heart murmurs
INDIRECT DISTANT
Diet, Exercise, Addiction Socio, Economic,
Employment, Literacy
Gender, etc
 Family history of this  Overcrowding
disease  Undernutrition
 Poor housing conditions
 Lack of access to healthcare
 Poor sanitation
 Lack of clean water
2
1.5. CARDIOLOGY : STROKE
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES High blood pressure

(Value)
Low HDL levels (Value)

PREDISPOSING
 Hypertension  Smoking   Urbanisation
FACTORS
 Diabetes  Tobacco use  Unawareness
 Obesity  Low haemoglobin levels  Overcrowding
 Family history of stroke (Value)  Lack of access to healthcare
 Rheumatic Heart Disease  Alcohol consumption
 Transient ischemic  Low consumption of
attack fruits and vegetables
 Vascular malformation  Sedentary lifestyle
 Past infection with C.  High psychological stress
Pneumoniae levels
 Clinical infections

2
2.1. PULMONOLOGY: TUBERCULOSIS
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Bacterial Infection

Mycobacterium
tuberculosis

PREDISPOSING
 Diabetes Mellitus  Malnutrition  Poverty/Low Socioeconomic
FACTORS
 HIV Infection  Smoking  Overcrowding
 Silicosis  Alcohol  Illiteracy
 Close Contact  Unawareness
 Unimmunized Child  Male > 45 yrs have more
 Patients on probability
Immunosuppressove
Therapy
 Lack of Diagnostic &
Treatment Facilities

2
2.2. PULMONOLOGY: ASTHMA
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Main cause not completely

understood

Attributed to genetic
susceptibility
andenvironmental factors
PREDISPOSING  Physical exercise  Air pollution
 Indoor allergens( pet
FACTORS
 Extreme emotional  Cold air
dander, dust mites in
arousal of anger, fear,  Tobacco smoke
furniture)
etc  Urbanisation
 Outdoor
 Chemical irritants in
allergens(pollens and
work place
mould)
 Stress
 Side effect of medicines
 Sulphites and food
like aspirin and beta
preservatives in food,
blockers
beverages, fruits, etc
 Gastroesophageal reflux
 Hormonal changes
disease
during mentrual cycle
 Sinus, pneumonia, sore
throat 2
.3. PULMONOGY: COPD
DIRECT
Clinical
MAIN CAUSES Emphysema
Chronic Bronchitis
PREDISPOSING
 Deprivation of regular flu
FACTORS
vaccination
 Non smokers who lack
alpha-1 antitrypsin
 Genetic disposition
 Prior asthma patient
 Second hand smoke
 Frequent lung infections
as a child
 Frequent respiratory
track illness in childhood
INDIRECT DISTANT
Diet, Exercise, Addiction Socio, Economic,
Employment, Literacy
Gender, etc
 Smoking, especially  Air pollution
Tobacco (a very distinct  Poorly ventilated housing
cause) conditions
 Bad air – airway irritants  Air with burnt biomass fuel
 Long term exposure to
chemical fues or dust
 Prenatal exposures
 Use of cooking fire
without proper
ventilation
2
2.4.PULMONOLOGY: PULMONARY HYPERTENSION
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Left ventricular heart

disease
Changes in the inner lining
of pulmonary arteries

 Heritable pulmonary
PREDISPOSING  Sleep disorders  Common in young adults
FACTORS arterial hypertension
 Long term exposure to
 COPD
high altitudes
 Chronic liver disease
 Overweight
 HIV infection
 Genetic disposition
 Connective tissue
 Consumption of illegal
disease
drugs likecocaine,
 Valvular disorders
metamphetamines,
 Blood clot in lungs
toxins, etc
 Eisenmenger‘s disease
 Consumption of appetite
 Chronic infectious
suppresant medicines
diseases, and rheumatic
heart disease
2
2.5. PULMONOLOGY: PNEUMONIA
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Streptococcal pneumoniae

Haemophilis influenzae B
Usually followed by
common flu
PREDISPOSING
 HIV infection  Airborne by virus,  Most common in young
FACTORS
 Measles bacteria and fungi children
 Acute meningitis  Weakened immune  Indoor air pollution
 Asthma system  Crowded homes
 Cystic fibrosis  Malnutrition  Discordance between
 Anatomic problems like  Exposure to parental availability of heath care and
easophegal fistula smoking treatment seeking behaviour
 Gastro easophegal reflux  Smoking  Improper/ inadequate early
with aspiration  Childcare by non-parent treatment due to low
 Neurological disorders  Prior lung/ chronic income/restricted facilities
that interfere with kidney or heart disease  Living in modern cities
protection of airways
 Haemoglobin pathogens

2
 2.6.PULMONOLOGY: OCCUPATIONAL LUNG DISEASE
DISEASE DIRECT CAUSES COMMON INDIRECT COMMON DISTANT
CAUSES CAUSES
Clinical
Diet, Exercise, Addiction Socio, Economic,
Employment, Literacy
Gender, etc

• Upper
 Irritant gases
respiratory tract
irritation  Solvents
•Sillicosis  Inhalation, retention and
pulmonary reaction to
large amounts of silica
dust (SiO2) , particularly
seen in miners, stone-
cutters, brick makers,
ceramic industry
labourers, slate pencil
makers
•Sensitization  Diisocyanites
(Low Mol. Wt.)
 Anhydrides
 Wood dust
 Not using the required
protective gear
 Late diagnosis
 Delayed/ improper
treatment
 Lack of a periodic health
checkup
 Lack of health education
 Dose of exposure to
irritant / stimulant
 Individual differences to
susceptibility
 No preemployment
health check
 Misdiagnosis
 Progressive emergence due
to industrilization
 Absence of National Policy
on Prevention and
Elimination of Silicosis
 Absence of central authority
to coordinate activities of
various agencies, small scale
and unorganised sectors
 Official statistics on
morbidity and mortality not
available
 No large scale recent
epidemiological studies
 Inadequate infrastructure for
diagnosis and management
2
DISEASE DIRECT CAUSES

Clinical

• Toxic pneumonitis
 Inhalation of irritant gases
 Metals

•Metal fume fever  Metal oxides : zinc, copper

•Polymer fume fever  Plastics

•Acute inhalation injury  Combustion products

•Hypersensitivity pneumonitis  Bacteria, fungi

 Animal proteins
 Moldy hay, Bagasse, Bird droppings

•Infectious disorders eg. Tuberculosis  Viruses

 Bacteria

•Pneumoconioses
 Asbestos, coal, silica, beryllium, cobalt, etc mineral dust
inhalation in workplace
DISEASE DIRECT CAUSES

Clinical

• Sinonasal cancer • Exposure to wood dust

•Mesothelioma • Exposure to asbestos in asbestos textile industry, asbestos

mining and milling and asbestos cement factories

•Lung Cancer • Exposure to Asbestos, Radon in asbestos textile industry,

asbestos mining and milling and asbestos cement factories

•Asbestosis • Exposure to asbestos in asbestos textile industry, asbestos

mining and milling and asbestos cement factories

•Byssinosis •Cotton, flax and hemp dust, reported maximum in cotton

textile industry

•Asthma  Red Cedar Dust

•Sensitization (High Mol. Wt.)  Animal derived allergens

 Latex

•Irritant induced, RADS

 Mineral tests
 Coal
3.1. GYNECOLOGY: ANAEMIA
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Iron deficiency

PREDISPOSING
 Malabsorption  Poor Intake of Iron  Poverty/Low Socioeconomic
FACTORS
 Worm Infestation  Intolerance to Iron  Illiteracy
 Malaria  Poor Fe Reserves in  Unawareness
Women  Non-compliance
 Multiparity  Teenage Marriage/Pregnancy
 Lack of Birth Spacing  Poor Supply of Iron Tablets

2
3.2. GYNECOLOGY : ECLAMPSIA, PRE-ECLAMPSIA
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Anterpartum eclampsia

Pulmonary oedema

 Lack of intensive care  Early pregnancy (18-22  Education

PREDISPOSING
FACTORS monitoring years)  Poor antenatal care
 Poorly monitored fluid  Lack of ventilatory  Promoting hospital delivery
therapy due to lack of support  Residing in eastern,
central venous pressure  Late referral northeastern and central
monitoring and  Transfer of moribund parts of India mostly with
pulmonary capillary patients just before reference to their
wedge pressure death to the tertiary counterparts
monitoring hospital  Unemployment
 Severe to mild anaemia  Tobacco smoking
 Diabetes  Consuming fruits
 Asthma weekly/occasionally,
 Twin pregnancy, first eggs daily, fish weekly
pregnancy  Occasional/no
 Hypertension consumption of milk 2
3.3. GYNECOLOGY : POSTPARTUM HAEMORRHAGE
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Uterine atony, placenta

accreta
Any amount of blood loss
that threatens the
hemodynamic stability of
the woman

 Pre-existing anaemia  Obesity  In devloping countries, lack

PREDISPOSING
FACTORS  Underlying cardiac  Uterine structural of widespread availability of
condition abnormality medications used in the
 Pre-eclampsia  Trauma of the lower active management of the
 Retained placenta genital tract third stage
 Lacerations  Failure to progress  Lack of experienced
 Instrumental delivery through second stage of caregivers
 Hypertensive disorders labour  Lack of blood transfusion
 Augmentation of labor  Volume-contracted services, anaesthetic
with oxytocin condition secondary to services, and operating
dehydration capabilities

2
3.4. GYNECOLOGY : OBSTRUCTED LABOUR
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Addiction Socio, Economic,

Employment, Literacy
Gender, etc

MAIN CAUSES Cephalopelvic

disproportion

PREDISPOSING
 Improper antenatal care  Delayed diagnosis  Low socio-economic groups
FACTORS
follow-up  Bladder injury  Unbooked, not pre-admitted
 Malposition,  Urinary track infection in the hospital
malpresentation during pregnancy  Illiteracy
 Fetal congenital  Shock  Rural areas, underdeveloped
abnormality  Trauma to the bladder facilities
 Myoma and/or rectum due to
 Non-dilation of cervix pressure from the fetal
 Cesaerian operation head
 Ruptured uterus  Damage during delivery
 Subinvolution  Obesity
 Hysterectomy
 Vaginal fistula
 Locked twins 2
3.5. GYNECOLOGY : SEPTICEMIA
DIRECT INDIRECT DISTANT

Clinical Diet, Exercise, Socio, Economic,

Addiction Employment, Literacy
Gender, etc

MAIN CAUSES Presence of bacteria or

toxins in blood

PREDISPOSING
 Urinary track infection,  Secondary infections  Very yound or very old
FACTORS
intravenous catheter while in hospital  Unhygenic conditions
 Lung infection, eg.  Severe wounds or burns  Rural areas
Pneumonia  Intake of medicines that  Lack of immediate care
 Kidney infections weaken the immune facilities
 Infections in the system like  Most common in intensive
abdominal area chemotherapy or care units of hospitals
 Compromised immune steroid injections  Abuse of antibiotics
system, due to HIV or  Improper first aid given  Rampant self-medication
leukemia to wounds
 Are on medical  Infection in previous
ventilation surgery
 Bedsores, intravenous
lines, surgical wounds
and surgical drains 2
 REFERENCES
1.1. Cardiology : Ischemic Heart Disease
• http://www.srspharma.com/ischemic-heart-disease-treatment-causes-symptoms.htm
• https://www.healthgrades.com/conditions/ischemic-heart-disease
• https://www.nhlbi.nih.gov/health/health-topics/topics/cad/causes
• http://icmr.nic.in/ijmr/2010/november/1119.pdf
• http://indianheartjournal.com/ihj09/july_aug_09/358-367.html
• http://dcp-3.org/sites/default/files/resources/Circulation%20article_DP.pdf

1.2. Cardiology : Myocardial Infarction

• https://www.drugs.com/health-guide/heart-attack-myocardial-infarction.html
• http://www.healthline.com/health/acute-myocardial-infarction

1.3. Cardiology : Congestive Heart Failure

• http://www.healthline.com/health/congestive-heart-failure#Symptoms4
• http://www.webmd.com/heart-disease/guide-heart-failure#2

1.4. Cardiology : Rheumatic Heart Disease

• https://www.heartandstroke.ca/heart/conditions/rheumatic-heart-disease
• http://www.world-heart-federation.org/press/fact-sheets/rheumatic-heart-disease/
• http://www.healthline.com/health/rheumatic-fever#Complications8
1.5. Cardiology : Strokes

• http://www.scopemed.org/?mno=152201
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782523/
• http://stroke.ahajournals.org/content/46/7/1764
• https://www.hindawi.com/journals/srt/2011/368629/tab1/

2.1. Pulmonology : Tuberculosis

2.2. Pulmonology : Asthma

• http://acaai.org/asthma/about
• http://www.who.int/respiratory/asthma/causes/en/

2.3. Pulmonology : Chronic Obstructive Pulmonary Disease

• http://www.webmd.com/lung/copd/tc/chronic-obstructive-pulmonary-disease-copd-prevention
• https://medlineplus.gov/copd.html
• https://www.nhlbi.nih.gov/health/health-topics/topics/copd
• http://www.healthline.com/health/copd
• https://www.lung.ca/copd
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1745556/pdf/v054p00737.pdf
2.4. Pulmonology : Pulmonary hypertension

• http://www.healthline.com/health/high-blood-pressure-hypertension
• http://www.mayoclinic.org/diseases-conditions/pulmonary-hypertension/symptoms-causes/dxc-201
97481
• https://www.ncbi.nlm.nih.gov/pubmed/25840090
• https://www.thoracic.org/patients/patient-resources/breathing-in-america/resources/chapter-17-pu
lmonary-hypertension.pdf

2.5. Pulmonology : Pneumonia

• http://www.jhsph.edu/research/centers-and-institutes/ivac/resources/factsheets/Pneumonia%20in
%20India%20eaflet.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519012/
• http://zeenews.india.com/exclusive/pneumonia-is-the-single-largest-cause-of-death-in-children-in-i
ndia_1497412.html
• http://timesofindia.indiatimes.com/life-style/health-fitness/health-news/Living-in-modern-cities-ups
-pneumonia-risk/articleshow/20860838.cms
• http://cid.oxfordjournals.org/content/54/suppl_2/S124.full

2.6. Pulmonology : Occupational Lung Disease

• http://www.cese.iitb.ac.in/uploadedfiles/StudyMatrial/Occupational%20lung%20diseases.pdf
• http://
www.indiachest.org/wp-content/uploads/2016/07/Occupational-lung-disease-India_lakshmi_2014.p
df
• http://
gmch.gov.in/e-study/e%20lectures/Pulmonary%20Medicine/occupational%20lung%20diseases.pdf
• http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@
safework/documents/publication/wcms_125137.pdf
3.1. Gynecology : Anaemia

3.2. Gynecology : Eclampsia

• http://www.interesjournals.org/full-articles/maternal-mortality-associated-with-eclampsia-in-an-ind
ian-medical-college-a-four-year-retrospective-study.pdf?view=inline
• http://paa2014.princeton.edu/papers/140379
• http://www.iosrjournals.org/iosr-jdms/papers/Vol13-issue3/Version-6/B013360710.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478261/
• http://www.healthline.com/health/eclampsia#RiskFactors3

3.3. Gynecology : Postpartum Haemorrhage

• http://emedicine.medscape.com/article/275038-overview#a7
• https://www.ncbi.nlm.nih.gov/pubmed/21510550
• http://file.scirp.org/pdf/OJOG_2015092116115550.pdf

3.4. Gynaecology : Obstructed labor

• http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2013;volume=6;issue=2;spage=146;
epage=150;aulast=Mondal
• http://www.who.int/healthinfo/statistics/bod_obstructedlabour.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275845/

3.5. Gynecology : Septicemia

• http://www.healthline.com/health/septicemia#Diagnosis5
• http://www.fortishealthcare.com/india/diseases/sepsis-886/risk-factors
• http://timesofindia.indiatimes.com/india/1-in-4-ICU-patients-gets-sepsis-1-in-2-dies/articleshow/16
360235.cms
• http://www.medindia.net/patients/patientinfo/septicemia.htm
THANK YOU
BRAINPAN INNOVATIONS PRIVATE LIMITED

saurabh.singh@brainpan.co