2. Non communicable diseases
(NCD)
Non communicable disease is a disease which is
caused due to multiple causes and can not be
transmitted directly or indirectly from one person to
another by an agency
Risk factors for Non communicable diseases:
1. Smoking.
2. Alcohol consumption.
3. Insufficient health services for management and
control of NCD.
4. Life style pattern.
5. Environmental factors (air and water pollution etc)
6. Stress.
3. Cancer
Cancer is a group of disorders characterized by:
1. An abnormal multiplication of cells.
2. Ability to infiltrate the adjacent tissues or even distant
organs.
3. The eventual death of the patient, if the tumour has
progressed beyond that stage when it can be
removed successfully.
Classification:
Cancer is classified into 2 main categories:
1. Solid tumours
2. Leukaemias and lymphomas
4. Causes of cancer:
(1)Smoking or chewing of tobacco.
(2)Excessive alcohol consumption.
(3)Dietary factors like high fat diet.
(4)Occupational factors : exposure to chemicals such as
benzene, arsenic, cadmium, chromium, asbestos etc.
(5)Viruses :
Eg: Hepatitis B can produce liver cancer.
Human papiloma virus (HPV) cause cervical
cancer.
(6)Parasites:
Many infections due to parasites can increase the risk
of malignant diseases.
(7)Customs, habits and life styles (smoking, chewing
tobacco, betel chewing, pan masala etc).
(8)Other environmental factors: (Sunlight, radiations etc).
5. Cancer control:
Early diagnosis, proper treatment , after care &
rehabilitation.Primary prevention Secondary prevention
1. Control of tobacco and alcohol
consumption.
2. Improvement of personal
hygiene.
3. Reduction in the amount of
radiation.
4. Protect workers from industrial
carcinogenic chemicals.
5. Immunization against Hepatitis B
6. Testing of food, drugs and
cosmetics for their carcinogenic
activity.
7. Control of air pollution.
8. Early detection and treatment of
precancerous lesions.
9. Help of law to control known
carcinogens.
10.Cancer education to motivate
people for early diagnosis and
1. Registration of cancer cases to
assess the severity of problem
and for providing necessary
services.
2. Early detection can be done by
cancer screening at a
premalignant stage.
3. Treatment facilities should be
available to all cancer patients.
• Cancer treatment consists of:
Surgery
Radiotherapy
Chemotherapy
6. Diabetes mellitus
Diabetes is a chronic , metabolic disease
characterized by elevated levels of blood glucose
(blood sugar), which leads over time to serious
damage to heart, blood vessels, eyes, kidneys and
nerves.
WHO Classification:
(1)Diabetes Mellitus(DM)
a. Insulin dependent diabetes mellitus(IDDM type 1)
b. Non insulin dependent diabetes mellitus(NIDDM
type 2)
c. Malnutrition related diabetes mellitus (MRDM)
d. Other types (secondary to pancreatic disease,
hormonal imbalance, drug induced or genetic
disorder).
7. Clinical classification:
(1)The Juvenile onset type (IDDM):
Develops during the first 40 years of life in patients of
normal or less than normal weight.
Insulin administration is required
(2)The adult or maturity onset type:
In middle aged or elderly persons who are generally
obese.
It can be controlled by dietary control and by using oral
hypoglycemic drugs.
Causes of Diabetes mellitus:
Insulin deficiency (due to disease of pancreas,
defective formation of insulin, destruction of beta cells
in pancreas, viral infections , genetic defects, etc).
In diabetes glucose utilization is decreased which leads
to hyperglycemia (increased blood sugar level) and
8. Prevention and care of Diabetes:
Includes primary , secondary and tertiary prevention.
Primary prevention:
Two strategies of primary prevention are:
1. Population strategy: Maintain normal body weight,
diet control, excercise
2. High risk strategy: change in life style, correction of
over eating and control of body weight.
Secondary prevention:
Adequate treatment to reduce blood glucose level .
Control diet, use of oral hypoglycemic drugs, use of
insulin.
Tertiary prevention:
Diabetes produce many complications like blindness,
kidney failure etc.
The objective of tertiary care is to organize specialized
clinics called Diabetic Clinics and Units for the
Prevention of IDDM is not possible presently
9. Blindness
Visual acuity of less than 3/60 or its equivalent.
Causes of Blindness:
Cataract , trachoma and associated infections of the
eye, smallpox, injuries and glaucoma.
Malnutrition is an important cause of blindness
(vitamin A deficiency)
Other causes include congenital diseases, uveitis,
tumours of eye, retinal detachment, diabetes,
hypertension and diseases of the nervous system.
Occupation of the person : people working in
industries and mines get injuries of eyes often.
Use of infected kajal
10. Prevention of Blindness:
Blindness can be controlled by improving nutrition, by
proper treatment of infectious diseases, by the
control of causative organisms of the infection , by
improving safety measures and working conditions.
National programmes for prevention of Blindness
include:
(1)Primary eye care:
A number of eye diseases can be treated by a trained
health worker.
Vitamin A solution, tetracycline ointment and eye
bandages are provided for this.
(2)Secondary care:
The care provided at hospitals or primary health
centers for cataract, eye trauma, glaucoma etc.
Camps are organized for cataract operations at
villages
11. (3)Tertiary care:
These services are provided by the medical colleges
and medical institutions.
The surgery for retinal detachment and corneal grafting
is done and eye banks are established.
Other measures include education of the blind in the
blind’s school
Specific programmes for prevention of blindness:
1. Vitamin A prophylaxis is done by giving 200,000 units
of vitamin A orally in the form of solution at 6 months
interval up to 6 years of age.
2. Eye check up of children is done in schools,
3. Control of trachoma is a measure to control
blindness.
4. Proper sanitation, safe water supply, consumption of
food rich in vit A, improvement of personal hygiene
and health education etc are helpful for the prevention
of blindness.
12. Cardiovascular diseases
Coronary heart disease (CHD)/Ischaemic Heart Disease
(IHD):
IHD is defined as the impairment of heart function due to
inadequate blood supply to the heart.
IHD is clinically manifested as:
Angina Pectoris
Acute myocardial infarction
Sudden death
Cardiac failure
Arrhythmias (abnormal heart rate)
Conduction defects.
13. Causes of IHD:
Smoking, hypertension, high level of cholesterol, low
level of high density lipoproteins(HDL), high level of low
density lipoproteins(LDL).
Other risk factors are diabetes, family history of CHD,
lack of physical activity, alcohol consumption, use of oral
contraceptives.
Genetic factors (high level of triglycerides)
Ethnic factors(consume too much milk , lassi, pure ghee,
coconut oil etc).
Prevention of IHD:
IHD is preventable.
Reduced fat intake, limited consumption of saturated fat,
reduction in LDL, increase in HDL, increase in vegetable
consumption, fruits and grains, reduction in salt intake,
avoid smoking and alcohol consumption, reduction in
blood pressure and increase in physical activity.
14. Hypertension
Hypertension is defined as the systolic pressure
equal to or greater than 160 mm of Hg and/ or a
diastolic pressure equal to or greater than 95 mm of
Hg.
Causes of hypertension:
Idiopathic hypertension: hypertension due to
unknown cause.
Hypertension due to some disorders are called
secondary hypertension.
The causes of secondary hypertension include renal
disorders, endocrine disorders, pregnancy etc.
15. Risk factors of hypertension:
Increasing age, genetic factors, obesity , high salt
intake, fatty diet, alcohol consumption, lack of
physical activity, smoking, anxiety or stress,
consumption of oral contraceptives, noise and
handling of vibrating tools
Prevention of hypertension:
Consumption of less salt and restriction of saturated
fat in the diet, weight reduction and exercise.
Behavioural changes like avoid smoking and alcohol
consumption, avoidance of stress, health education.
Secondary prevention is done by early detection of
cases and lower the blood pressure by the use of
drugs like atenolol, nifedipine, clonidine etc.
16. Stroke
Stroke is an acute severe manifestation of
cardiovascular disease.
WHO definition for stroke:
“A rapidly developed clinical signs of focal or global
disturbance of cerebral function lasting more than 24
hours or leading to death, with no appropriate causes
other than vascular origin”.
Causes of stroke:
Commonest cause of stroke is Hypertension and
Diabetes.
Control of stroke:
Stroke can be prevented by the control of
hypertension, control of diabetes and by the
17. Rheumatic heart diseases
(RHD)
Rheumatic fever is a disease of connective tissue
particularly in the heart and in the joints.
It is caused by the infection of throat by group A beta
haemolytic streptococci.
Rheumatic fever leads to Rheumatic heart disease
(RHD)
RHD damages the heart and causes premature
death.
Clinical features of the disease:
Fever, inflammation of joints and carditis.
Brain involvement can lead to tremors
18. Prevention of RHD:
Primary prevention is done by preventing the attack of
rheumatic fever in patients of streptococcal infection of
throat.
Intramuscular injection of penicillin containing 300,000
units of crystalline penicillin, 300,000 units of procaine
penicillin and 600,000 units of benzathine penicillin.
Secondary prevention is the prevention of recurrence of
rheumatic fever.
Intramuscular injection of benzathine benzyl penicillin at
intervals of 3 weeks for at least 5 years .
Non medical preventive measures includes
improvement of living conditions and improvement in
the socio-economic status of the population to reduce
incidence of streptococcal infection.
