Non Communicable Human Diseases

• The non-communicable diseases remain confined to the persons who suffer from them.
• These diseases are not transmitted from infected persons to healthy persons. Some important non- communicable diseases include diabetes, cardiovascular diseases, arthritis, cancer, and genetic disorders.
Diabetes mellitus (Hyperglycaemia)
• The most common endocrine disorder of the pancreas is the diabetes mellitus, now recognised to exist in two forms- Insulin-dependent (Type-1) and non-insulin- dependent (Type-ll).
• In both disorders, the blood glucose concentration is elevated above the normal range.
Differences between Type I and Type II Diabetes

IDDM (Type1)- Juvenile Diabetes NIDDM (Type II)
1 Onset less than 20 years. Onset more than 30 years
2 Normal weight Obese
3 Ketoacidosis common. Ketoacidosis rare
4 Severe insulin deficiency Relative insulin deficiency
5 Beta-cell depletion. Mild beta-cell depletion

• The insulin-dependent diabetes mellitus (IDDM) is caused by a failure of the Beta-cells to produce adequate amounts of insulin while the non-insulin- dependent diabetes mellitus (NIDDM) appears to involve failure of insulin to facilitate the movement of glucose into cells.
Symptoms
• Some of the glucose is excreted in the urine, and water follows the glucose, causing excessive urination and dehydration of body tissues.
• This causes frequent drinking because of extreme thirst (polydipsia).
• The cells are unable to utilize glucose and other carbohydrates for energy production; thus, they utilize their proteins for it. The person becomes very weak.
• Degradation of fats increases, producing ketone bodies (ketosis). The latter are acidic and poisonous.
• Blood cholesterol level rises. Healing power is impaired.

Treatment

  • Administration of insulin lowers the blood-glucose level.

Cardiovascular diseases

  • The diseases that affect the blood vessels and the heart are called cardiovascular diseases. These are as follows:

Hypertensive heart diseases

(i) Arteriosclerosis

  • Hardening and loss of elasticity of the arteries is commonly referred to as arteriosclerosis. It causes hypertension or high blood pressure.

(ii) Atherosclerosis

  • In this disease, a lumpy thickness develops on the inner walls of the arteries that prevents the dilation of vessels (arteries).

(iii) Hypertension (High blood pressure)

  • It is defined as a resting arterial pressure exceeding 120/80 mmHg over a prolonged period of time.
  • Disorders that can result from untreated hypertension include heart failure, kidney damage and cerebrovascular accident (rupture of a cerebral artery, sometimes called a stroke).
  • Treatment involves the use of drugs that inhibit the action of the sympathetic nervous system.
  • Dietary sodium is sometimes restricted.

Coronary heart diseases

  • Coronary arteries supply blood to the muscles of the heart.
  • Coronary heart diseases include:

(i) Angina pectoris

  • Sclerosis of the coronary arteries can cause “pain in the chest”.
  • This anginal pain usually starts in the centre of the chest and spreads down the left arm. The chest pain may be associated with restlessness, fear or anxiety, a pale skin, heaviness, profuse sweating and vomiting.
  • The pain lasts for only a few moments.

(ii) Coronary thrombosis or Myocardial infarction (Ml)

  • A clot may form in the lumen of a coronary artery, resulting in coronary thrombosis.
  • Hence, a large portion of the heart muscle is deprived of blood and the patient develops a “heart attack”. Anticoagulant treatment helps to prevent the formation and extension of blood clots.

Rheumatic heart disease (RHD)

  • This is the more frequent cardiovascular disease in India below the age of 20 years.
  • Its causative factor is Streptococcus bacteria.
  • Recently, Coxsackie B-4 virus has been suggested as a conditioning agent.
  • The patient may have an acute rheumatic fever, joint pains and infection of throat.
  • Rheumatic fever may cause permanent damage of one or more valves (mitral or aortic semilunar valves), pericarditis and myocarditis.
  • The risk of acute rheumatic fever is greatest where there is bad housing, overcrowding and inadequate conditions of hygiene.
  • RHD is also called poor persons’ disease.

Stroke (Cerebrovascular Accident or CVA)

  • It is the sudden interruption of blood flow to a portion of the brain because of block or rupture of a cerebral blood vessel.
  • Thus, the brain cells do not get oxygen and glucose. This can cause paralysis, loss of speech, etc.

Arthritis

  • Arthritis is a general term that can be applied to as many as twenty-five malfunctions of the joints. Some important types of arthritis are:

(i) Rheumatoid arthritis (RA)

  • It is an inflammation of the synovial membrane in synovial joints.
  • When this membrane, which is the source of synovial fluid, becomes inflamed, it produces too much fluid. The joints swell and become extremely painful.
  • In response to the inflammation and swelling, a hard tissue forms over the cartilage articulations. This tissue makes the joint stiff. Movement then becomes more painful.
  • In a course of time, the new tissue can grind away the entire cartilage. When this happens, the two bones fuse and the joint becomes totally immovable.
  • Several joints get affected in RA. RA is an auto-immune disease.

(ii) Osteoarthritis

  • It affects only the cartilage at synovial joints.
  • From years of use, the cartilage erodes and new bone is deposited in lumps.
  • The lumps make movement difficult and finally impossible.
  • Many people who suffer this form of arthritis have no pain, but their fingers may curl and permanently arch and their wrists and other joints may display lumps of bone formation.

(iii) Gout

  • It is another form of arthritis related to diet.
  • In fact, gout is the accumulation of uric acid crystals in synovial joints. The accumulation makes movement both difficult and painful.
  • Uric acid, a by-product of protein metabolism is normally excreted in the urine.
  • Gout sufferers should avoid eating meat and seafood, drinking alcohol and fructose sweetened drinks.

(iv) Infectious arthritis

  • Various types of microorganisms can lodge in joints. It occurs mainly due to bacterial and viral infection.

Cancer

  • Cancer or malignant neoplasm is a disease of abnormal and uncontrolled proliferation of cells without any differentiation.
  • Due to uncontrolled divisions, an abnormal growth called tumour occurs.

Tumour or neoplasm is any abnormal swelling, lump or mass in the body. Tumour is of two types: Benign and Malignant.

Types of cancer

  • Cancers are also classified on the basis of the tissue, from where they arise.

(i) Carcinomas

  • This type is mainly derived from epithelial cells.
  • They include cervical (cervix is part of uterus) cancer,breast cancer, skin cancer, lung cancer, stomach cancer, etc.
  • About 80% of all tumours are carcinomas.

(ii) Leukaemias

  • Leukaemias are commonly called as blood cancers. They result from excessive formation of WBCs in the bone marrow and lymphatic nodes.

(iii) Sarcomas

  • These cancers are located in connective and muscular tissues derived from mesoderm. Thus, they include the cancers of bones, cartilages, tendons, adipose tissue, lymphoid tissue and muscles.
  • Lymphomas are the cancers of the lymphatic tissues.
  • Hodgkin’s disease is an example of human lymphoma. In this, there is chronic enlargement of the lymph nodes and spleen, resulting in excessive production of lymphocytes.

(iv) Melanoma

  • It is the cancer of the pigment producing cells especially in the skin (melanocytes).

(v) Germ cell tumour

  • These tumours are derived from totipotent cells, found in adults, most often in the testes and ovaries.

(vi) Blastic tumour

  • A tumour which resembles an immature or embryonic tissue is called blastic tumour. Many of these tumours are most common in children.

(vii) Myeloma (Multiple myeloma or Kahler’s disease)

  • It is a cancer of plasma cells (B-lymphocytes) which are immune system cells in bone marrow that produce antibodies.

Causes of cancer

Chemical and physical agents that can cause cancer are called carcinogens. Carcinogens fall into three basic categories:

(i) Oncogenic transformation: They are the carcinogens which bring about changes in genetic material. They are of two types, radiations (X-rays, cosmic rays, UV rays etc.) and chemicals.
(ii) Tumour promoters: They promote proliferation of cells which have undergone oncogenic transformation, e.g., some growth factors, hormones etc.
(iii) Tumour viruses: Some viruses are known to be involved in oncogenic transformations.

Carcinogens and organs affected

Carcinogens Organs Affected
1 Soot Skin, lungs
2 Coal tar(3, 4-benzo-pyrene) Skin, lungs
3 Cigarette smoke (N-nitrosodimethylene) Lungs
4 Cadmium Oxide Prostate gland
5 Aflatoxin (a mould metabolite) Liver
6 2-naphthylamine and 4-aminobiphenyl Urinary bladder
7 Mustard gas Lungs
8 Nickel and Chromium compounds Lungs
9 Asbestos membrane Lungs
10 Diethylstilboestrol (DES)Vagina
11 Vinyl chloride (VC) Liver

Possible symptoms of cancer
(i) A persistent cough or hoarseness in a smoker.
(ii) A peristent change in digestive and bowel habits.
(iii) A change in a wart or mole.
(iv) A lump or hard area in the breast.
(v) Unexpected diminished or lost appetite.
(vi) Unexplained low-grade fever.
(vii) Unexplained loss of weight.
(viii) Any uncurable ulcer.
(ix) Bleeding in vagina at times other than the menstruation.
(x) Non-injury bleeding from the surface of the skin, mouth or any other opening of the body.
Treatment
The common approaches for treatment of cancer are surgery, radiation therapy, chemotherapy and immunotherapy.

Possible symptoms of cancer

(i) A persistent cough or hoarseness in a smoker.
(ii) A peristent change in digestive and bowel habits.
(iii) A change in a wart or mole.
(iv) A lump or hard area in the breast.
(v) Unexpected diminished or lost appetite.
(vi) Unexplained low-grade fever.
(vii) Unexplained loss of weight.
(viii) Any uncurable ulcer.
(ix) Bleeding in vagina at times other than the menstruation.
(x) Non-injury bleeding from the surface of the skin, mouth or any other opening of the body.

Treatment

The common approaches for treatment of cancer are surgery, radiation therapy, chemotherapy and immunotherapy.

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