Friday, December 3, 2010

SLM on Non Communicable diseases


                                         NON - COMMUNICABLE DISEASES (Life Style Diseases)

UNIT-1 Non Communicable diseases-General Introduction
UNIT-2 Cardiovascular Diseases and Stroke
UNIT-3 Cancer
UNIT-4 Diabetes Mellitus
UNIT-5 Blindness
UNIT-6 Asthma

       Introduction

         In this block there are 5 units.  Unit 1 is about the problem of non-communicable disease and risk factors. Unit 2 gives the details of cardiovascular diseases like coronary heart disease, hypertension etc. Unit 3 deals with cancer and Unit 4 is about Diabetes. Unit 5 deals with blindness in detail and Unit 6 is on Asthma.
     This block deals with the occurrence of non- communicable diseases like cancer, diabetes, stroke etc. Here the causative agent may be non-living instead of living agent in the case of communicable diseases. Majority of them are chronic and slowly killing diseases.
              Hope you will seriously work through the units of this block.
Assess yourself
  1. State some risks factors which are responsible for the occurrence of the non communicable diseases
  2. Which are the risk factors that lead to the development of cardio vascular diseases?
  3. Why should prolonged throat infection must be treated seriously?
  4. Suggest some effective means for preventing Hypertension
  5. Which are the major features of Cancer?
  6. Which are the frequently occurring types of cancer in men and women?
  7. Which are the usual treatments given to Cancer patients?
  8. What are the main causes of Diabetes mellitus?
  9. Give two preventive measures to avoid Diabetes.
  10.   Give some name of diseases, which cause blindness in India. 
  11.   Briefly state the secondary prevention programmes of blindness in India. 

Unit 1Non Communicable Diseases – General Introduction


 Objectives  
               This unit presents the important aspects of non- communicable diseases.
           At the end of this unit, you will be able to
 (i)           Understand about the seriousness of chronic diseases.
(ii)          Identify the risk factors of these diseases.
(iii)        Avoid conditions lead to many non- communicable diseases.
(iv)         Explain reasons for the occurrence of a life style disease.
 The Problem
    Chronic non-communicable diseases are increasing among the adult population in both developed and developing countries. Cardio vascular diseases and Cancer are at present the leading causes of death in developed countries.
              The prevalence of these chronic diseases is showing an upward trend is most countries. One reason is the increasing life expectancy and another is the changing life styles and behavioural patterns of people. The important non-communicable diseases are Cardio vascular diseases like coronary heart disease and hypertension, Stroke, Cancer, Diabetics etc. Modern medical care enables many people to live long along with these chronic diseases.

     Any way the impact of chronic diseases on the lives of people is serious when measured in terms of loss of life, disablement, family hard ship, poverty and economic loss to the country.

                                                 Check your progress 1

  1. State any two reasons for the increasing occurrence of chronic non-communicable diseases.
  2. ……... is a non-communicable disease which forms the leading cause of death in many countries.
  3. State the impacts of chronic diseases.
 Risk factors
                   The risk factors responsible for the occurrence of adult non- communicable diseases are
  1. Cigarette use and other forms of smoking.
  2. Alcohol abuse.
  3. Failure or inability to obtain preventive health services (eg. for hypertension control, cancer detection, management of diabetes.)
  4. Life- style changes (eg. Dietary patterns, physical activity).
  5. Environmental risk factors. (eg. occupational hazards, air and water pollution and possession of destructive weapons).
  6. Stress factors.


          Check your progress 2

1.   State briefly some risk factors, which are responsible for the occurrence of non- communicable diseases.
        Let us sum up
We have discussed about the actual problem of non- communicable diseases and certain risk factors, which increase the rate of occurrence of these chronic diseases. Among them life style changes and addiction to certain bad habits form the most important ones.
   Assignments
1.   Conduct a survey to find out the frequency of the occurrence of chronic non-communicable diseases among people with different life styles.
2.  Make a list of the risk factors responsible for the occurrence of adult non- communicable diseases.  



                             Unit 2 -   Cardio Vascular Diseases and Stroke
          


                                                         Fig: 1 Coronary heart diseases                       



 Objectives
          In this unit we will have a discussion on the important aspects of cardio vascular diseases. At the end of this unit, you will be able to
  1. Recognize major cardio vascular diseases.
  2. Identify coronary heart diseases.
  3. Understand the risk of rheumatic fever.
  4. Explain the conditions lead to hypertension.
 Cardiovascular Diseases               
Cardiovascular diseases constitute the leading cause of death in developed countries. twelve million persons die annually worldwide due to diseases of heart and arteries.50% of these deaths are preventable. 40 million persons in India are estimated to be suffering from cardio-vascular diseases.
          The high prevalence of cardio-vascular diseases motivated the WHO to choose “Heart Beat-The Rhythm of Health” as the theme for the World Health Day 1992.
                                         Coronary Heart Diseases (CHD)
     It is a defect in the heart function due to inadequate blood flow to the heart compared to its needs, causing changes in the circulation to the heart. This may be due to the blockage in the coronary artery.

Coronary heart disease may show up as
(i ). Angina pectoris
(ii ) Myocardial infarction
(iii )  Irregularities of the heart.
(iv ) Cardiac failure
(v ) Sudden death
         CHD is a worldwide disease and it forms the largest public health problem in many developed and developing countries. The risk factors of coronary heart disease, which place an individual in a high-risk category, include.
1.            Cigarette smoking
2.            High blood pressure (Hypertension)
     3.    Elevated cholesterol
     4.    Diabetes
5.      Obesity
6.      Sedentary habits
7.      Stress
8.      Alcohol

The degree of risk of developing CHD is directly related to the number of cigarettes smoked per day. Cigarette smoking seems to be the most important cause of sudden death from CHD in men under 50 years of age.
Hypertension accelerates the risk of causing CHD. The increased serum cholesterol level is also an important risk factor for the incidence of CHD (leads 220mg./dl or more). The risk of CHD is 2­-3 times higher in diabetics than non-diabetics. Sedentary life style is associated with a greater risk of the development of early CHD. High alcohol intake, defined as 75 gm or more per day is a risk factor for CHD.
Prevention of CHD
The diseases can be prevented by population education for changing their life styles. Avoiding bad habits, low fat diet and regular exercise can reduce the occurrence of CHD.
                                    Check your progress  1

                 

1.       Which are the risk factors, which lead to the development of CHD?
2.       What are the common symptoms shown by a patient with CHD?
3.       How can the onset of CHD be prevented?
4.       ………….is the theme WHO for the World Health Day 1992.
 Rheumatic Heart diseases (RHD)
Rheumatic heart disease is a major public health problem in India. Rheumatic heart disease (RHD) cannot be separated from rheumatic fever (RF). Rheumatic Fever often leads to RHD, which is a crippling disease.
Rheumatic fever is a disease that starts as a throat infection, which later affects the connective tissue of heart. A communicable disease     (Streptococcal Pharyngitis) leads to Rheumatic fever (RF), which later leads to RHD. R.F is a typical disease of childhood and adolescence (5-15 years).
The consequences of RHD include: continuing damage to the heart increases disabilities, repeated hospitalization and premature death usually by the age of 35 years or even earlier.

Prevention

The Primary prevention is to prevent the attack of R.F. by identifying all patients with streptococcal throat infection and treating them with Penicillin. In order to prevent single case of RHD, several thousands of cases must be identified and treated. The high-risk group is school age children and so they should be kept under observation.
The non-medical measures for the prevention of R.F are related to improving living condition and breaking the poverty-disease- poverty cycle.
           
                      Check your progress 2

  1.       Why should prolonged throat infection be treated seriously?
  2.       How can Rheumatic heart disease be prevented?
  3.       ……………… is the communicable disease that may leads to Rheumatic fever.
Hypertension (High blood pressure)
              Hypertension is the commonest cardiovascular disorder all over the world. It is not easy to define hypertension because blood pressure (BP) is not a constant figure and show marked fluctuations during 24 hrs. Normal BP is 140/90 mm Hg or lower. Blood pressure 140/90 and 160/95mm Hg are defined as borderline hypertension.
              Blood pressure equal or greater than 160/95 mn of Hg is defined as hypertension.

Risk factors for hypertension

1. Obesity
   The greater the weight gain, the greater the risk of high B.P

           Table -  Weights of Humans indicating overweight and obesity

Height without shoes (m)
Men Weight without clothes (kg)
Women Weight without clothes (kg)
Desirable average
Desirable weight range
Obese
Desirable average
Desirable weight range
Obese
1.45



46.0
42-53
64
1.48



46.5
42-54
65
1.50



47.0
43-55
66
1.52



48.5
44-57
68
1.54



49.5
44-58
70
1.56



50.4
45-58
70
1.58
55.8
51-64
77
51.3
46-59
71
1.60
57.6
52-65
78
52.6
48-61
73
1.62
58.6
53.-6
79
54.0
49-62
74
1.64
59.6
54-67
80
55.4
50-64
77
1.66
60.6
55-69
83
56.8
51-65
78
1.68
61.7
56-71
85
58.1
52-66
79
1.70
63.5
58-73
88
60.0
53-67
80
1.72
65.0
59-74
89
61.3
55-69
83
1.74
66.5
60-75
90
62.6
56-70
84
1.76
68.0
62-77
92
64.0
58-72
86
1.78
69.4
64-79
95
65.3
59-74
89
1.80
71.0
65-80
96



1.82
72.6
66-82
98



1.84
74.2
67-84
101



1.86
75.8
69-86
103



1.88
77.6
71-88
106



1.90
79.3
73-90
108



1.92
81.0
75-93
112



BMI
22.0
20.1-25.0
30.0
20.8
18.7- 23.8
28.6
      
                                             BMI = Body Mass Index
BMI  = Weight(kg)/Height 2 (m)
     

2.           2. Salt intake
               High salt intake (ie 7-8gm/day.) increase blood pressure proportionately. 
                 3. Saturated fat 
        Saturated fat raises BP as well as serum cholesterol
             4. Environmental stress 
              Struggle for job, competition, loss of job, difficulties at home and work place, death in the family etc. induce mental stress and strain leading to increase in BP.
Prevention and Control   
Primary prevention
This can be achieved by population education of the following areas. 
(i)           Nutrition
                                              (a)  Reduction of salt intake (not more than 5g/day)
  (b)  Moderate fat intake
                      (c)  Avoidance of high alcohol intake
         (ii)          Weight reduction
Prevention and correction of obesity  (Body Mass Index) (BMI) greater than 25)
               (iii)        Exercise promotion
                (iv)         Behavioral Changes
Reduction of stress and smoking, modification of personal  life-style, practice of yoga etc
(v)                                                     (V)       Health Education
                                              Educating the community about risk factors

     Secondary prevention 

                               (i)           Early case detection
                               (ii)          Treatment
      
                 Treatment of high BP is normally life long as it depends on patient’s behaviour ie. his attitude to follow the diets and executing other life style changes.  

 Check your progress 3
                            1. Hypertension is blood pressure greater than  . . . . . . . mm of Hg 
2. What are the main risk factors of hypertension?
                 3. Suggest some means for the prevention of hypertension?
              4. BMI greater than.  . .. .  . included in the category obese.







     Stroke 
          Stroke is a worldwide health problem and it is one of the leading causes of deaths and disability. This is a disturbance in the brain, caused due to the blockage of blood vessels to the cells of the brain, which may lead to paralysis or death.
Fig:1  Stroke
 The risk factors of stroke are
(i)        Hypertension
(ii)    Abnormalities of heart (cardiovascular diseases)
(iii)     Diabetes
(iv)   Obesity
(v)        Glucose intolerances
(vi)   Smoking
(vii)    Blood clotting
Prevention and Control
         Controlling hypertension, diabetes, smoking etc and early detection and treatment of all cardiovascular diseases will reduce the occurrence of stroke. Prevention of other risk factors and population education will also reduce the cases.
                                           Check your progress 4


                                1.     Stroke affects ------------ of the human body.
                                2.     What are the main risk factors of stroke?
                                3.     Early detection and treatment of -------- disease will reduce the occurrence of stroke
      Let us sum up
We have discussed the cardiovascular diseases and stroke. Coronary heart diseases, Rheumatic heart diseases and hypertension are included in the first category. Stroke is a fatal disease, which affects the brain. All these chronic diseases can be controlled and prevented by leading a healthy life with a low fat diet and proper exercise.
Assignments
1.     Make a list of the risk factors responsible for the development of coronary heart diseases.
2.     Prepare a report about the activities of Rheumatic Heart Club in your locality.
3.     Conduct a survey among your classmates and prepare a BMI chart to classify the high risk group and low risk group.
4.     Discuss and prepare a short note on primary and secondary preventive measures of Hypertension.
5.     What is Stroke? Discuss the risk factors of Stroke. 
                                                 
                                                     Unit – 3  -   Cancer

Objectives
          In this unit we will have a discussion about the important aspects of cancer. At the end of this unit you will be able to
(i)           Identify the characteristic of cancer
(ii)          Explain the occurrence of cancer.
(iii)        Avoid practices and habits causing cancer.
(iv)         Analyze the causes of cancer
 Characteristic Symptoms of Cancer
Cancer in all forms is causing about 12% of death throughout the world. In the developed world, cancer is the second leading cause of death, next to cardiovascular diseases. Although Cancer is widely perceived to be a disease of industrialized nations, the majority of deaths from cancer occur in the developing world.
Cancer may be regarded as a group of diseases characterized by
(a)  Abnormal growth of cells
(b)  Ability to invade adjacent tissues and even distant organs.
(c)  The eventual death of the patient if the tumor has progressed beyond that stage, when it can be successfully removed.
Cancer can occur at any site or tissue of the body
          The major categories of cancer are
(i) Carcinomas -  arise from epithetical cells (usually affecting areas are: mouth, oesophagus, intestine, and uterus)
(ii)    Sarcomas   - arise from mesodermal cells (found in fibrous tissue, fat and bone)


arising from the cells of bone narrow
(iii) Lymphomas }_
(iv)  Myelomas   }_                     
                                and
(v) Leukemias     -   immune system.

                                          Check your progress 1

  1. What are the major features of cancer?
  2. Give the different types of cancer occurring in human body.
                                                                          Cancer Pattern  
              There is wide variation in the distribution of cancer throughout the world. The following table shows the ranking order of cancer affecting organs.

                                   Table -  Ranking order by site of 8 selected cancers
Rank
Males
Females
Total
1
Lung
Breast
Lung
2
Stomach
Cervix
Stomach
3
Colon/Rectum
Colon/Rectum
Liver
4
Prostate
Stomach
Colon/Rectum
5
Oral
Lung
Oesophagus
6
Liver
Oral
Breast

         On a global basis, when two sexes are combined, the one which occur first is lung cancer which is followed by stomach cancer.




                     Check your progress 2

                  1. ------------- Cancer is most frequent type of cancer in men
                  2. The most common occurring Cancer form in woman are ---------.
                  3. In the world, the highest cancer occurring organ is-------.
        Causes of Cancer
The Cancer affecting factors are generally classified as
        A. Environmental factors
        B. Genetic factors
A. Environmental factors
(a) Tobacco
Smoking and chewing of tobacco leads to cancer of lungs, larynx, mouth, pharynx, oesophagus etc.
(b) alcohol
Excessive alcohol consumption leads to liver and oesophageal cancer.
(c) Dietary factors
A variety of dietary factors such as food additives and contaminants are causative agents of cancer. Smoked fish is related to stomach cancer, lack of dietary fiber to intestinal cancer, beef consumption to bowel cancer and high fat diet to breast cancer.
(d) Occupational exposures
This include exposure to benzene, arsenic, cadmium, asbestos, polycyclic hydrocarbon etc.
(e) Viruses
Hepatitis B and C viruses are related to the origin of hepatocellular carcinoma. Human papiloma virus is a chief suspect in cancer cervix. Human T cell Leukemia virus is associated with adult T. cell leukemia.
(f) Others
There are numerous other environmental factors such as sunlight, radiation, air and water pollution, medication, pesticides etc, related to cancer.
(g) Customs, habits and life-style
         Certain customs, habits and life styles of people such as tobacco and betal chewing (oral cancer) smoking (lung cancer) are associated with an increased risk.
B. Genetic factors
              Genetic influence of Cancer has long been suspected, but is difficult to identify. It is found that there is a complex interrelationship between hereditary susceptibility and environmental cancerous stimuli.



                         Check your progress 3
                           
                             1. ------------- is the cause of majority of lung cancers.
                             2. Name two virus infections that later leads to cancer.
                             3. Which are the major environmental factors causing cancer?
 Cancer Control
               Cancer control consists of a series of measures based on present medial knowledge in the fields of prevention, detection, diagnosis, treatment, after care and rehabilitation. It aims at reducing the number of new cases and increasing the number of cures.

Primary Prevention

 (i)              Control of tobacco and alcohol consumption.
(ii)              Personal hygiene
(iii)            Measures to protect workers from exposures to industrial carcinogens.
(iv)             Foods, drugs and cosmetics should be tested for carcinogens.
(v)              Pollution Control
(vi)             Reduce the amount of radiation received by each individual.
(vii)           Legislation to control known environmental cancer causing agents.

Secondary Prevention

  (a) Cancer Registration
It provides a base for assessing the magnitude of the problem and for planning the necessary service.
 (ii) Early detection of cases
               Cancer screening is mainly used for early detection of cancer at a pre malignant stage (before life threatening). This forms the best possible protection because by early detection, prompt treatment for early cancer and pre cancerous condition can be given to individuals.
(iii) Treatment
               Treatment like surgical removal, radiation, and chemotherapy are given to cancer patients.
                                               Check your progress 4                
1.   Which are the primary preventive measures of cancer?
  1.   Among the secondary prevention methods ---------forms the most effective one.
  2. Which are the usual treatments given to cancer patients?
  Let us sum up
               We have discussed about cancer, its main symptoms and occurrence. Among the main causes of cancer tobacco forms the most important one as lung cancer came first in the list of different types of cancers. Primary prevention of cancer includes many measures like alcohol and tobacco restriction, pollution control and personal hygiene. The most important way of secondary prevention is early detection of cases by cancer screening.
Assignments
1.  Conduct a survey and prepare a table showing the types of Cancer and year wise incidence of the Disease.
2.  Prepare a brief report on the causes of Cancer.
3.  Conduct a seminar on Cancer control and prepare reports based on it. 

Unit 4 -  Diabetes Mellitus



4.0 Objectives
In this unit we will discuss the prominent chronic disease Diabetes Mellitus
At the end of this unit you will be able to.
(i)      Aware about the life style that leads to this disease.
(ii)    Understand the rate of occurrence of Diabetes
(iii)   Analyze the preventive measures of Diabetes.

4.1 Diabetes Mellitus - Introduction
               Diabetes is a disease affecting at least 30 million people throughout the world. It is usually associated with obesity, hypertension and coronary heart disease.
               The underlying cause of diabetes is insulin deficiency. This may be due to a variety of conditions
(a)      Pancreatic disorders (infection or inflammation of pancreas)
(b)      Defects in the formation of insulin
(c)      Genetic defects etc.
              
                   
          The overall effect of these mechanism will lead to reduced utilization of glucose which leads to hyperglycemia (increased glucose level in blood) accompanied by Glycosuria  (glucose in urine).
(Note: - Insulin is a hormone produced in the pancreas by the beta cells of the islets of langerhans. This helps in the metabolism or absorption of glucose present in the food)
                                                                                        Check your progress 1
         1.   The deficiency of ----- leads to diabetes mellitus.
2.   Insulin is produced from------------
3.   Which are the specific conditions of Diabetes Mellitus?
4.2 Risk factors
            The risk factors in Diabetes Mellitus include
(i)           Sedentary life style,
(ii)          Diet   - high intake of sugar and fat,
(iii)        Malnutrition.
         Malnutrition in infancy and childhood may result in the partial failure of the function of pancreas especially the insulin producing cells.
(iv)         Viral infections
(v)          Chemical agents affecting the beta cells of pancreas.
(vi)         Stress
 High and low rates of diabetes have been linked to a number of social factors such as occupation, marital status, religion, economic status, education, change in life style etc. 50 years ago diabetes was the disease of the higher class of the society and now the gradient get reversed. This may be because of the rapid changes in the life style of lower classes.
                                     Check your progress 2
1.               State four risk factors of Diabetes Mellitus.
2.               How does malnutrition cause Diabetes?
3.               Diabetes is considered as a disease of the higher class Why?
4.3 Prevention and Control
1.  Urine test for glucose, 2 hours after a meal  and
2.  Blood sugar test are usually used for detecting diabetes.
Preventive measures include maintenance of normal body weight through adoption of healthy nutritional habits and physical exercise. Nutritional habits include.
(i)              Adequate protein intake.
(ii)            High intake of dietary fibers.
(iii)       Avoidance of sweet food.

                                                              Check your progress 3
1.   Which are the two tests used for screening Diabetes?
2.   Give two preventive measures to avoid diabetes.
4.4   Let us sum up
We have discussed Diabetes Mellitus and the causes of this chronic disease. The main cause of Diabetes mellitus is found to be insulin deficiency. The risk factors for this disease are sedentary life style, malnutrition and high intake of sugar and fat.   Hereditary factors also have some role to play in this aspect. This can be controlled by adequate nutritional intake and proper physical exercise.
Assignments
1.   Prepare a short note on the causes and risk factors of Diabetes Mellitus.
2.   Visit a Diabetes clinic and find out how patients lead successful life with Diabetes.
3.   Make a colourful poster showing ways of life in order to avoid the diseases Diabetes. 

6.0 Objectives
          In this unit you will get information about a major public health problem- Asthma.
                At the end of this unit you will be able to
                     i.        Identify the main symptoms of asthma.
                   ii.        Know the causes of asthma.
                  iii.        Understand the preventive measures of asthma.

                                                                 Unit 5. Asthma
                      
     Asthma is a chronic disease in the developed world that is becoming increasingly common. It is now the commonest reason for childhood admission to hospital. Asthma is a condition that affects the lungs and airways. Sufferers with asthma often find it difficult to breathe and may experience coughing, wheezing and tightness across their chest.
6.1   Symptoms of Asthma
a) Shortness of breath - Breathing difficulties, tightness in the chest and shortness of breath are the main symptoms of asthma.
b) Wheezing- This is a whistling sound heard most often when breathing out.
c)  Coughing - The characteristic cough of asthma is well known, and is often more common at night.
d)  Night-time - All the symptoms of asthma worsen at night. As the symptoms worsen through the night, the patient may have a restless night and feel very tired and low the next day.
e)  Exercise - Inhaling cold dry air when exercising leads to changes in the fluid lining of the lungs. This can lead to an asthma attack lasting 10 -20 minutes, having a devastating effect on a child who join games and sport.
                                 Check your progress 1

1.   Which part of the human body gets affected with Asthma?
2.   What is the main condition of asthma?
3.   State some of the main symptoms of asthma?
4.   Why does exercising worsen the conditions of asthma?

6.2 Causes of Asthma
         The exact causes of asthma are not clearly known. It does run in families along with other allergic conditions such as eczema (allergic dermatitis), hay fever (allergic rhinitis) and itchy eyes (allergic conjunctivitis). Some asthma sufferers may experience one or more of these related disorders. Smoking during pregnancy increases asthmatic symptoms in babies after birth.
        Things that make the asthma worse are called trigger factors. The most common trigger factors are - Colds and flu, Allergies, House dust mites, Cigarette smoking, Occupations, Weather changes, Emotions, Exercise and activity, Fumes, Medication, Pets etc.
    
                                 
                                       Fig:86  Trigger factors of Asthma


     
  Check your progress 2

      1.         Which are the conditions that exist along with asthma?
2.         What is a trigger factor?
3.         What are the common trigger factors of asthma?

6.3 Treatment of Asthma
      Asthma cannot be completely cured but it can be managed by using the proper medications correctly. This can be achieved by
-To make lungs and airways as normal as possible.
-To stay symptom free.
-To lead a full active life.
-To suffer no nighttime symptoms.
        Modern treatment involves two types of drugs. The first, a bronchodilator, acts within seconds and causes the airway to relax and the second are the anti inflamatories, which block the effects of irritants but cannot be used for instant relief.

                                                        Check your progress 3


1.    How can asthma be properly managed?
2.    Which are the two types of drugs used for the treatment of Asthma?         
6.4 Let us sum up
    Asthma is difficulty in breathing due to narrowing of the small airways in the lungs called bronchioles. It is a chronic disease in the developed world that is becoming increasingly common, probably due to rising levels of pollution. It is now the commonest reason for childhood admission to hospital. The muscles in the airways of asthmatics are abnormally sensitive and will contract at the least provocation. The three main provocations are infection, allergy and emotion.
Assignments
1.   Prepare a short note on the main symptoms of Asthma.
2.   Make a poster showing the trigger factors of Asthma.
3.   Visit an Asthma clinic and find out how people live successfully along with the diseases.

                                  Evaluate Yourself

  1. Explain the reasons for the occurrence of a disease
  2. Which are the life style conditions that lead to the occurrence of the non-communicable diseases like Coronary Heart Diseases, Diabetes etc.
  3. Explain the life style condition which lead to the development of Hypertension
  4. Rheumatic Heart Disease can be effectively prevented. How?
  5. What are the main risk factors of stroke?
  6. Which are the habits and conditions that are considered as the main causes of Lung Cancer?
  7. State the primary preventive measures of Cancer.
  8. Analyse the preventive measures of Diabetes mellitus
  9. State the main causes of blindness in India
10.    Briefly state the programmes that come under Eye Health Promotion

    

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