HEALTH CONSCIOUSNESS HEALTH CONSCIOUSNESS AND AND

MEDICAL EXAMINATIONMEDICAL EXAMINATION

HEALTH CONSCIOUSNESS HEALTH CONSCIOUSNESS AND AND

MEDICAL EXAMINATIONMEDICAL EXAMINATION

V.V.L.N.S.N.GuptaV.V.L.N.S.N.Gupta

22

Three levelsThree levels of of

Preventive measures Preventive measures

Three levelsThree levels of of

Preventive measures Preventive measures

33

1. Primary prevention1. Primary prevention1. Primary prevention1. Primary prevention

Health promotion – Health promotion – I Level I Level

Specific protection – Specific protection – II LevelII Level

44

2. Secondary Prevention 2. Secondary Prevention – – III III LevelLevel2. Secondary Prevention 2. Secondary Prevention – – III III LevelLevel

Early diagnosis & treatmentEarly diagnosis & treatmentEarly diagnosis & treatmentEarly diagnosis & treatment

55

3. Tertiary Prevention3. Tertiary Prevention3. Tertiary Prevention3. Tertiary Prevention

Disability limitation Disability limitation

RehabilitationRehabilitation

Disability limitation Disability limitation

RehabilitationRehabilitation

66

Three factors when interact Three factors when interact then disease process startsthen disease process startsThree factors when interact Three factors when interact then disease process startsthen disease process starts

•AGENTAGENT

•HOSTHOST

•ENVIRONMENTENVIRONMENT

•AGENTAGENT

•HOSTHOST

•ENVIRONMENTENVIRONMENT

are of cardinal importance in are of cardinal importance in disease process and are disease process and are called Ecological or called Ecological or Epidemiological triadEpidemiological triad

are of cardinal importance in are of cardinal importance in disease process and are disease process and are called Ecological or called Ecological or Epidemiological triadEpidemiological triad

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AGENTAGENTAGENTAGENT HOSTHOSTHOSTHOST

ENVIRONMENTENVIRONMENTENVIRONMENTENVIRONMENT

88

AGENTAGENTAGENTAGENT

1.1. LIVINGLIVING

2.2. NON LIVINGNON LIVING

1.1. LIVINGLIVING

2.2. NON LIVINGNON LIVING

99

AGENTS CALSSIFIED INTO:AGENTS CALSSIFIED INTO:AGENTS CALSSIFIED INTO:AGENTS CALSSIFIED INTO:

1.1. Biological Agents Biological Agents

-Virus-Virus

-Bacteria -Bacteria

-Fungus -Fungus

-Parasites-Parasites

1.1. Biological Agents Biological Agents

-Virus-Virus

-Bacteria -Bacteria

-Fungus -Fungus

-Parasites-Parasites

1010

NUTRIENT AGENTSNUTRIENT AGENTSNUTRIENT AGENTSNUTRIENT AGENTS

-Protein-Protein-Fat-Fat-Carbohydrates-Carbohydrates-Vitamins-Vitamins-Minerals-Minerals-Water-Water

-Protein-Protein-Fat-Fat-Carbohydrates-Carbohydrates-Vitamins-Vitamins-Minerals-Minerals-Water-Water

1111

CHEMICAL AGENTSCHEMICAL AGENTSCHEMICAL AGENTSCHEMICAL AGENTS

ENDOGENOUSENDOGENOUS

•Produce in bodyProduce in body

-Diabetes-Diabetes

-Acidosis-Acidosis

-Uraemia-Uraemia

ENDOGENOUSENDOGENOUS

•Produce in bodyProduce in body

-Diabetes-Diabetes

-Acidosis-Acidosis

-Uraemia-Uraemia

1212

EXOGENOUS AGENTEXOGENOUS AGENTEXOGENOUS AGENTEXOGENOUS AGENT

MetalsMetalsFumesFumesDustDustGasesGasesAcquired by inhalationAcquired by inhalation Ingestion or inoculationIngestion or inoculation

MetalsMetalsFumesFumesDustDustGasesGasesAcquired by inhalationAcquired by inhalation Ingestion or inoculationIngestion or inoculation

1313

PHYSICAL AGENTSPHYSICAL AGENTSPHYSICAL AGENTSPHYSICAL AGENTS

HeatHeatColdColdHumidityHumidityPressurePressureRadiationRadiation

HeatHeatColdColdHumidityHumidityPressurePressureRadiationRadiation

1414

MECHANICAL AGENTSMECHANICAL AGENTSMECHANICAL AGENTSMECHANICAL AGENTS

FrictionFrictionMechanical forces resulting inMechanical forces resulting in

Crushing Crushing TearingTearingSprainsSprainsDislocation or FractureDislocation or Fracture

FrictionFrictionMechanical forces resulting inMechanical forces resulting in

Crushing Crushing TearingTearingSprainsSprainsDislocation or FractureDislocation or Fracture

1515

HOSTHOSTHOSTHOST

Man is hostMan is hostMan is hostMan is host

1616

ENVIRONEMENTAL FACTORSENVIRONEMENTAL FACTORSENVIRONEMENTAL FACTORSENVIRONEMENTAL FACTORS

Aggregate of all external Aggregate of all external conditions & influences which conditions & influences which affect life and development of affect life and development of an organism, human an organism, human behaviourbehaviour

Or SocietyOr Society

Aggregate of all external Aggregate of all external conditions & influences which conditions & influences which affect life and development of affect life and development of an organism, human an organism, human behaviourbehaviour

Or SocietyOr Society

1717

TWO TYPESTWO TYPESTWO TYPESTWO TYPES

1.1. INTERNALINTERNAL

2.2. EXTERNALEXTERNAL1.1. INTERNALINTERNAL

2.2. EXTERNALEXTERNAL

1818

INTERNALINTERNALINTERNALINTERNAL

Disease represents Disease represents

mal-adjustment of human mal-adjustment of human organism to his environmentorganism to his environment

Disease represents Disease represents

mal-adjustment of human mal-adjustment of human organism to his environmentorganism to his environment

1919

EXTERNALEXTERNALEXTERNALEXTERNAL

PHYSICALPHYSICALNon Living & Physical forcesNon Living & Physical forces

-Water-Water-Soil-Soil-Air-Air-Climate-Climate-Weather-Weather

PHYSICALPHYSICALNon Living & Physical forcesNon Living & Physical forces

-Water-Water-Soil-Soil-Air-Air-Climate-Climate-Weather-Weather

2020

EXTERNALEXTERNALEXTERNALEXTERNAL

-Geography-Geography-Food-Food-Housing-Housing-Heat-Heat-Light-Light-Radiation-Radiation

-Geography-Geography-Food-Food-Housing-Housing-Heat-Heat-Light-Light-Radiation-Radiation

2121

BIOLOGICALBIOLOGICALBIOLOGICALBIOLOGICAL

MicrobesMicrobes- VirusVirus- BacteriaBacteria- FungusFungus- ParasitesParasites- Even other people with whom man Even other people with whom man

is livingis living

MicrobesMicrobes- VirusVirus- BacteriaBacteria- FungusFungus- ParasitesParasites- Even other people with whom man Even other people with whom man

is livingis living

2222

SOCIAL ENVIRONMENTSOCIAL ENVIRONMENTSOCIAL ENVIRONMENTSOCIAL ENVIRONMENT

Cultural ValuesCultural Values- ReligionReligion- EducationEducation- OccupationOccupation- Standard of livingStandard of living- Community lifeCommunity life- Health servicesHealth services

Cultural ValuesCultural Values- ReligionReligion- EducationEducation- OccupationOccupation- Standard of livingStandard of living- Community lifeCommunity life- Health servicesHealth services

2323

SOCIAL ENVIRONMENTSOCIAL ENVIRONMENTSOCIAL ENVIRONMENTSOCIAL ENVIRONMENT

- Social & Political organizationSocial & Political organization- Psycho-social environmentPsycho-social environment- Harmonious adjustment to the Harmonious adjustment to the

social environment enables social environment enables man to enjoy health & man to enjoy health & happinesshappiness

- Social & Political organizationSocial & Political organization- Psycho-social environmentPsycho-social environment- Harmonious adjustment to the Harmonious adjustment to the

social environment enables social environment enables man to enjoy health & man to enjoy health & happinesshappiness

HEALTH PROMOTIONHEALTH PROMOTIONHEALTH PROMOTIONHEALTH PROMOTION

Increase in general health & well Increase in general health & well beings of individual & community.beings of individual & community.Increase in general health & well Increase in general health & well beings of individual & community.beings of individual & community.

Health of a person can be improved byHealth of a person can be improved by

1.Adequate Nutrition1.Adequate Nutrition

2.Provision of Sanitary 2.Provision of Sanitary Environment Environment

-Water supplyWater supply-Adequate sewage and disposal Adequate sewage and disposal of human wasteof human waste-HousingHousing-Control of insects and rodentControl of insects and rodent

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Health of a person can be improved byHealth of a person can be improved by

-Safe working conditionsSafe working conditions-Recreational facilitiesRecreational facilities-Personal hygienePersonal hygiene-Health educationHealth education-Physical educationPhysical education-Periodical health screening Periodical health screening -Improvement of standard of Improvement of standard of living living of peopleof people

2727

SPECIFIC PROTECTIONSPECIFIC PROTECTION

-Specific immunizationSpecific immunization-Use of specific nutrientsUse of specific nutrients-Protection against Protection against occupational occupational hazardshazards-Protection against accidentsProtection against accidents-Protection against toxic and Protection against toxic and harmful chemicals harmful chemicals -Avoidance of allergensAvoidance of allergens

2828

SECONDARY PREVENTIONSECONDARY PREVENTION

This is III level of preventionThis is III level of prevention

Early diagnosis & treatment Early diagnosis & treatment - Action which stops the - Action which stops the

disease disease process at initial process at initial stage.stage.

2929

TERTIARY PREVENTIONTERTIARY PREVENTION

LAST TWO LEVELS OF PREVENTIONLAST TWO LEVELS OF PREVENTION

1.Disability limitation1.Disability limitation2. Rehabilitation cost is very high 1: 2. Rehabilitation cost is very high 1: 1616

3030

Non-communicable diseases risk Non-communicable diseases risk factorsfactors

1.1.SmokingSmoking2.2.Alcohol abuseAlcohol abuse3.3.Failure or inability to obtain preventive Failure or inability to obtain preventive

health services e.g., HTN, Cancer health services e.g., HTN, Cancer detection, Management of Diabetesdetection, Management of Diabetes

4.4.Lifestyle changes (e.g., diet, physical Lifestyle changes (e.g., diet, physical activity)activity)

5.5.Environmental risk factors (e.g., Environmental risk factors (e.g., Occupational hazards, air & water Occupational hazards, air & water pollution)pollution)

6.6.Stress factorsStress factors

3131

Coronary artery disease:Coronary artery disease:

•Angina PectorisAngina Pectoris•MI (Heart attack)MI (Heart attack)•Irregularities of HeartIrregularities of Heart•Cardiac failureCardiac failure•Sudden deathSudden death

3232

Coronary artery disease:Coronary artery disease:

Risk factors:Risk factors:•SmokingSmoking•HTNHTN•S.CholestrolS.Cholestrol•DiabetesDiabetes•GeneticsGenetics•Physical activityPhysical activity•HormonesHormones•Personality (Competitive people more at Personality (Competitive people more at risk than relaxed people)risk than relaxed people)•AlcoholAlcohol•Oral contraceptives Oral contraceptives

3333

Coronary artery disease:Coronary artery disease:

Prevention:Prevention:•Reduce fat intake to 20-30% of Reduce fat intake to 20-30% of total energy intaketotal energy intake•Reduce Saturated fat intake to Reduce Saturated fat intake to 10% of total energy intake10% of total energy intake•Increase Carbohydrate Increase Carbohydrate consumption (Vegetables, fruits, consumption (Vegetables, fruits, pulses, whole grains)pulses, whole grains)•Avoid alcoholAvoid alcohol•Decrease salt intake to 5g/ day or Decrease salt intake to 5g/ day or lessless

3434

HYPERTENSIONHYPERTENSION

Risk Factors: Risk Factors:

1.Non-modifiable 1.Non-modifiable •AgeAge•Genetic factors Genetic factors

3535

HYPERTENSIONHYPERTENSION

Risk Factors: Risk Factors:

2. Modifiable2. Modifiable•ObesityObesity•Salt intake Salt intake

•Saturated fatsSaturated fats•AlcoholAlcohol•Environmental stressEnvironmental stress

3636

HYPERTENSIONHYPERTENSION

Prevention:Prevention: 1.1.Nutrition – Reduce salt intake, Nutrition – Reduce salt intake,

moderate fat intake, avoid alcoholmoderate fat intake, avoid alcohol2.2.Weight reductionWeight reduction3.3.Exercise promotionExercise promotion4.4.Behavioral changes Behavioral changes

a.a.Reduce stressReduce stressb.b.Reduce smokingReduce smokingc.c.Meditation Meditation

5.5.Self-care - Learn to take your own Self-care - Learn to take your own B.P & Chart it B.P & Chart it

3737

Diabetes Mellitus: Diabetes Mellitus:

(Due to Insulin deficiency )(Due to Insulin deficiency )Risk factors:Risk factors:

• Age-all above 40 yrs Age-all above 40 yrs • Genetic factors-family historyGenetic factors-family history• Immune mechanismsImmune mechanisms• ObesityObesity• Sedentary lifestyleSedentary lifestyle

3838

Diabetes Mellitus: Diabetes Mellitus:

Due to Insulin deficiency Due to Insulin deficiency Risk factors:Risk factors:

• DietDiet• MalnutritionMalnutrition• Viral infection eg., Mumps, Viral infection eg., Mumps,

rubella etc.,rubella etc.,• Chemical agents e.g., AlloxanChemical agents e.g., Alloxan• Stress Stress

3939

Diabetes Mellitus: Diabetes Mellitus:

Self-care:Self-care:

• ExerciseExercise• Diet Diet Avoid sweets Avoid sweets• Increase intake of fiber dietIncrease intake of fiber diet• Weight reductionWeight reduction• Reduce alcoholReduce alcohol• Reduce smokingReduce smoking• Control B.PControl B.P• Reduce Cholestrol & TriglyceridesReduce Cholestrol & Triglycerides

4040

Diabetes Mellitus: Diabetes Mellitus:

For known diabetics:For known diabetics:

• Routine BSL testingRoutine BSL testing• Routine Urine for proteins, ketonesRoutine Urine for proteins, ketones• Routine B.P chartingRoutine B.P charting• Routine visual acuity checkingRoutine visual acuity checking• Routine weight checkRoutine weight check• Routine feet examinationRoutine feet examination• Look for loss of sensation, dryness of Look for loss of sensation, dryness of

skinskin• Home blood sugar monitoringHome blood sugar monitoring