Kwashiorkor (Fukenas)

Kwashiorkor is a disease caused by the deficiency of protein. It suffers mainly the children under five years of age. The children lack enough protein after stopping breastfeeding as a result of next birth. Then, they will be malnourished in the lack of breast milk because breast milk contains enough and high quality protein. The patients are suffered from loss of appetite, swelling and diarrhea.

Symptoms of Kwashiorkor

• Swelling (oedema) of body due to retention of water. It starts from feet to head. But the skin of hip and legs are wrinkled.
• Retardation of physical growth and underweight.
• Skin cracks, descaling and wound.
• Different skin color. In some places, it is dark whereas in some place, it is light.

Prevention of Marasmus and Kwashiorker

• Increase community awareness on nutrition. Identify the patients and  support for the treatment of them.
• Support for the treatment of them.
• In order to increase protein in the body, provide the food like milk, fish, meat, egg, beans (soyabean, gram, pea etc.) which are rich in protein.
• Physical check up and measurement of height and weight regularly.
• Provide nutrition and healthy education to parents.
• Provide local food and seasonal fruits instead of expensive instant food with low nutritive value.
• Manage treatment if the children are suffering from other infection disease.

Marasmus (Sukenas)

Marasmus is a protein-energy malnutrition (PEM). It causes children lean and thin because of the lack of enough food and essential nutrients (both carbohydrates and protein) for a long time. This disease mainly suffers the children. The skin of children wrinkles due to the loss of fat. Average weight of children becomes 60 percent less than other healthy children of similar age.

Symptoms of Marasmus

• Getting lean and thin
• Faces wrinkle like old person
• Low weight for age (underweight)
• Regular reduction in fat and muscle
• Suffering from diarrhea
• Not interested on food despite the hunger.

Rickets

Rickets is caused mainly in the children of the age of two or four. This disease is caused by the deficiency of vitamin D. In the absence of vitamin D, Calcium and Phosphorus are not absorbed well in the body. Because of the absence of calcium, phosphorus etc. the growth of bone and teeth is obstructed. The bones become soft and weak. Unable to bear the weight of the body, the bones of the feet are crooked and bent. The following are visible symptoms of the disease rickets.

Symptoms of rickets

• Bones of the legs seem crooked and bent.
• The wrists and ankles are swollen and enlarged.
• The physical growth of the children is very slow.
• There is deformity in the ribs.
• The head seems enlarged and flattened.
• The stomach seems swollen and looks like pot-belly.

Preventive Measures

We must have a daily diet containing vitamin D. Foodstuff containing vitamin D are the yellow part of the eggs, oil of the fish, milk, butter etc. The children should be given foods containing calcium and phosphorus like green vegetables, liver, eggs etc.

Massaging the baby with the oil in the sum is a good system that is traditionally followed in our society. This is a good way of obtaining vitamin D from the rays of sun. On a sunny day, children should be allowed to play outside in the field. This helps to prevent the disease rickets. A baby suffering from rickets can easily be recognized. So, the baby should be immediately given the food containing vitamin D, calcium and phosphorus. Such food can prevent this disease.

Post-Hepatic Jaundice

Post-hepatic (or obstructive) jaundice, also called cholestasis, is caused by interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct, ductal careinoma, pancreatitis and pancreatic pseudo cysts. A rate causes of obstructive jaundice is Mirizzi's syndrome.

The complicators or the damages to the lever cause jaundice. A person suffering from it cannot sleep well, feels bored, dizzy and sometimes become unconscious in the extreme cases. This disease is mostly found in alcoholic people. Alcoholism enlarges the liver and makes it delicate. The soft liver may give in any time. People usually suffer from jaundice when they have complications of liver.

If the jaundice has been caused by the alcoholism, it is cured with the patient abstaining from alcohol. The extreme stage of this disease may kill the patient. The severity of the effects of alcoholism may differ from person to person. Therefore, this disease has been regarded as one of the most fatal diseases.

Causes and symptoms of Jaundice

The increase in the deposition of the substance called Bilirubin in blood causes jaundice. Its patients have yellow eyes and skins. The urine also seems very yellow.

Hepatitis A virus causes jaundice. These viruses are transferred from excreta of the patient suffering from jaundice. Patients loses appetite, feels nausea and has fever. After four to seven days, the skin and the eyes start turning pale. During this period, the liver becomes large and soft. This stage remains for two to six weeks and it takes many months to completely recover.

Sometimes, liver is damaged very badly and the patient dies within ten days. Such damage is seen in people who came in regular contact with its victims without any immunity. Therefore, this disease should be prevented from being transferred from one person to another. The next  microbe that causes jaundice is Hepatitis B virus. They are transferred especially through blood transfusion. Another Jaundice causing microbe is yellow fever virus. It is the most dangerous virus. This virus has already been eradicated from the world.

Controlling Measures

The patients of jaundice should take enough rest. Special care should be taken in nutrition. The well ripen food should be given to the patient as they tend to vomit the unappetizing food. The person having jaundice should not take oily food because they cannot digest fats. Since the intestines of the patient lacks bile, they cannot digest fats and digest the food. Patient should be given plenty of carbohydrates to maintain energy. Milk and other nutritious foods should be given to the patient after they have felt a bit better.

Janudice

Jaundice comes from the French word jaune, which means yellow is a yellowing of the skin, sclera and mucous membranes caused by increased levels of bilirubin in the human body.

Causes of Jaundice

When red blood die, the heme in their hemoglobin is converted to bilirubin in the spleen and in the kupffer cells in the liver. The bilirubin is processed by the liver, enters bile and is eventually excreted through feces.

Consequently, there are three different classes of causes for jaundice. Pre-hepatic or hemolytic causes, where too many red blood cell are broken down, hepatic causes where the processing of bilirubin in the liver does not function correctly, and post-hepatic or extra hepatic causes, where the removal of bile is disturbed.

Pre-hapatic

Pre-hepatic (or hemolytic) jaundice is caused by anything that causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia and glucose 6-phosphate dehydrogenase deficiency can lead to increase red cell lysis and therefore hemolytic jaundice. Defects in bilirubin metabolism also present as jaundice. Jaundice usually comes with high fevers.

Hepatic Jaundice

Hepatic causes include acute hepatitis, hepatotoxicity and alcoholic liver disease whereby cell necrosis reduces the liver's ability to metabolize and excrete bilirubin leading to a build up in the blood. Less common causes include primary biliary cirrhosis, Gilbert's syndrome and metastatic carcinoma. Jaundice commonly seen in the newborn baby is another example of hepatic jaundice.

Goitre

All human beings have a thyroid gland in their neck. The swelling of this thyroid gland is called goitre. This disease is caused when there is lack of iodine. The thyroid gland produces thyroxin hormone which helps the growth and development of the person to perform various functions of the body. This gland deposits the iodine received from the food and on the need of the body, it changes into the thyroxin. Thus, it supplies the iodine.

But when the food taken the iodine, the thyroid gland cannot produce thyroxin. In order to produce thyroxin, the thyroid gland itself enlarges and appears swelling in front of the neck. This condition of the thyroid gland at the neck is known as goitre. The occurrence of goitre is a preliminary symptom of the deficiency of iodine. It can be treated at the primary stage. As it becomes too large, it is difficult to treat and reduce it.

Symptoms of Goitre

• The thyroid gland enlarges in the throat. As a result, a swelling is visible in front of the neck.
• The weight of the thyroid gland increases from its usual weight (25 grams to 200 grams even up to 500 grams.)
• It disturbs the physical and mental development.
• Dwarfness if not treated timely.

Preventive measures of Goitre

The food in our daily meal should contain iodine. Among the sources of iodine, the fished of the sea and the vegetables grown near sea sides are found highly rich in iodine compound. If these items of food are not available, we can use the salt mixed with iodine. In case, iodine is not available, we can use iodine tablets or even iodine injection too. If the goitre has already appeared, according to the advice of the physician it is better to take an injection of iodine or potassium iodine and thyroxin. This type of treatment reduces the goitre. But if goitre has already grown too large, it cannot be treated at all. So, adopting preventive measure in time is the best solution.

Night Blindness

Night blindness is a disease of a person who cannot see well at early dawn and in the evening time. But during the day, the person suffering from this disease can see like other healthy people. This disease is caused by the deficiency of vitamin A in their daily diet. If a pregnant mother can not get food that contains vitamin A, her baby may suffer from night blindness. Mainly, children and pregnant women are suffered from this disease. Apart from it, if babies are not treated in time, they may become completely blind in their future.

Causes of Night Blindness

Vitamin A keeps retina healthy. There are two types of cells in retina, which are called rods and cons. Rods help to see at dim light and cons help to see at bright light. The capacity of vision depends upon the substances called Rhodopsin which is found in retina. Rhodopsin is obtained from vitamin D. The deficiency of vitamin A minimizes the vision power. Deficiency of vitamin A causes dryness in cornea and conjunctivitis of eyes.

Symptoms of Night Blindness

• In dim light and in the evening, they can not see the objects well.
• If the children have this disease, they cannot move here and there in the evening. They are found to be sitting inn one place.
• They cannot see very well in the bright light.
• Their eyes seem bright, rough and dried.
• There appear small spots called Bitot's spot in the white part of the eyes.

Preventive measures of night Blindness

In order to prevent this disease, the babies should be saved from diseases like diarrhea, hookworms and measles. Children should be immunized. Proper hygiene should be maintained to prevent these diseases. Foods containing vitamin A like green vegetables, carrot, pumpkins, papaya, eggs, fish, meat, milk, ghee, mango, orange etc. should be taken which keep our eyes healthy. If there is a slight doubt about this disease we must consult physician.

Anaemia

Anemia
Anemia is also known as Iron Deficiency Anemia (IDA) caused due to the shortage of iron, important micro nutrients of food. Iron is one of the most important micro nutrients essential for making hemoglobin, which supplies oxygen to each and every tissue of the body from lungs. Anemia is mostly found in children and pregnant women. Deficiency of iron in the body makes it weak and reduces immunity power. Females, especially pregnant and postnatal ones suffer from it. The babies, born from mother suffering from anemia have low weight and are more vulnerable from death. The adults, victims of anemia, seem feebler and have low capacity to perform different tasks. Children suffering from anemia grow slowly, understand very late and may die early.

Causes and symptoms

Anemia is a disease caused by the deficiency of haemoglobin or the lack of red blood cells. This problem is mostly found in small children, woman and pregnant mother. This caused due to the lack of iron in food. It may also be caused by hookworm parasites.
Symptoms

• Feeling of dizziness and tiredness
• In the case of babies, loss of appetite and weeping for no specific reason can be observed
• The facial appearance is pale and yellow
• Pigmentation of the skin, paleness in the eyes and the fingernails
• The patient feels giddiness
• Difficulty in breathing

Safety measures of Anemia

• We should take iron containing food like livers, meat, fish, eggs, green vegetables, grains, beans, cereals etc.
• Food that contains vitamin ‘C’ like lemon, orange, vegetables etc should be taken, which help to absorb the iron element in the food.
• Hookworm is one of the major causes of anemia. So, we must have a habit of wearing shoes.
• Iron tablets can also be given to babies for immediate supply of iron.

Diabetes

Diabetes 

Diabetes is also known as sugar disease. It is the disorder in which either the pancreas cannot secrete insulin at all or body cannot use the secreted insulin. The pancreas may still secrete insulin for all the ells of the body, but some cells may not respond to it. Again glucose can’t enter into the cells and energy is not produced to satisfy the body’s needs. Consequently, it causes extremely high concentration of sugar in the blood. This condition is called diabetes. Depending on the nature, diabetes can be grouped into two types: i.e. Diabetes Insipidus and Diabetes Mellitus.

Diabetes insipidus
In diabetes insipidus, there is insufficient production of pituitary hormone (vasopressin), that controls the function of kidneys. In this condition, a rare metabolic disorder appears in the patient’s body and the water passed by blood vessels to kidneys is not absorbed properly by them. As a result, the patient with diabetes insipidus produces large quantities of dilute urine and he is constantly thirsty. This type of diabetes is observed because of diseases like encephalitis, meningitis, syphilis or injury in brain especially at pituitary gland. Patient of this disease feels raging thirst, increased appetite and weakness. This disease can be treated with the intake of vasopressin injection.

Rheumatic Fever and Rheumatic Heart Disease

Rheumatic fever
Rheumatic fever is an auto immune disease which mainly occurs in children between ages of 5-15 years. It commonly occurs after throat infection by the causative agent of group ‘A’ beta hemolytic streptococcus. The body produces antibodies against these organisms but, there antibodies can cross reach with cells of the heart, joint and kidney. It affects joints to cause rheumatic arthritis, and affect heat to cause rheumatic heart disease. So, it is described as “Rheumatic fever licks the joint but bites the heart.”

Rheumatic heart disease

Rheumatic heart disease is caused by bacteria called ‘Beta-Haemolytic Streptococcus’. It is the most common acquired heart disease in Nepal. It commonly damages the vulves of the heart. This disease begins with pain in throat initially. Untreated throat infection (Tonsilitis and Pharyngitis) can later on lead to infection of heart and this condition is attributed to damage of the vulves of the heart in the secondary stage. This disease mostly attacks the children from 3 to 15 years age group.

Modes of Transmission of HIV/ AIDS and prevention

Modes of Transmission

• Unsafe sexual contact with HIV infected person
• With infected blood transfusion
• Use of skin-piercing injection, blade, etc. without sterilization
• Mother to baby (during pregnancy, during delivery and during breastfeeding)

Preventive measures of HIV/ AIDS and other STIs

• Sexual behaviors before matured age are unsafe. Sexual decisions in early age may not be appropriate. Sexual behaviors which are considered as safe may not be safe for the people in early age due to the lack of proper knowledge and skills. Therefore, we must avoid sexual intercourse in early age in order to prevent STIs.
• Abstain yourself. If not possible, adopt safe sex
• Between two or be mutually faithful for sexual intercourse. Avoid multiple sex partners because healthy looking persons might also be infected with STIs
• Consistent use of condom as it also prevents pregnancy
• Do not use unsterilized needles, blades, scissors etc
• Blood transfusion should be done after proper test
• Infected women must not give birth to a baby
• We must increase mass awareness and discourage girls trafficking and prostitution. Similarly, we have to emphasis on female education and female employment in order to save from this fatal disease
• We must adopt kind feeling and co-operation to STI victims for their treatment and care. Advise STI patients on the consistent use of condom and spermicides while they make sexual contact.

Stop HIV/ AIDS

Introduction

AIDs stands for Acquired Immune Deficiency Syndrome. Our body has the immune system that fights against diseases. When this immunity is lost, we get suffered from various diseases. As a result, various symptoms can emerge.  AIDS is not a disease but that stage in which various symptoms and syndromes can emerge. Though AIDS was medically recognized only in 1981 in USA, it is widely and rapidly spreading all over the world. Over 2 decades, more than 40 million people are suffering from this fatal disease. Though its virus appeared later in Asian countries, it is more rapidly spreading here than other regions. In Nepal, first case of AIDS was identified in 1988 but the cases are rapidly increasing. Now about more than 60 thousand people are estimated to be infected of HIV in Nepal.

Causes of HIV/ AIDS

The causative agent for this disease  is retrovirus which is called HIV (Human Immune-deficiency Virus). This virus destroys the immune system of producing the antibody to fight against the germs of disease. In the lack of antibody, we cannot be healthy. After entering it in our body, it takes about 6 to 12 weeks for virus to be seen in blood test. This unidentified period is window period. When HIV is detected, this stage is carrier stage. Similarly, when symptoms are seen, it is only the stage of AIDS.

Symptoms of HIV/ AIDS

Symptoms cannot be seen immediately in HIV infected patients and it may take 10-15 years. As the immunity of patients is lost any common disease may suffer them. The symptoms are seen according to the disease they have suffered. However, TB is found in almost HIV patients in Nepal.

The symptoms of AIDS can be classified as major and minor sign. A person can be AIDS patient if at least 2 major signs and one minor sign appear.

Major Sign of HIV/ AIDS

• Loss of weight more than 10% of usual body weight within one month
• Continuous fever for more than 1 month
• Continuous diarrhea for more than 1 month

Minor Sign of HIV/ AIDS

• Coughing of more than a month
• Itching and skin rashes
• Recurrent herpes zoster
• Chancres appear around lip and nostril
• Not recovery of some common and curable diseases like common cold, diarrhea, TB etc.
• Repeatedly suffering of pneumonia
• Thrush or inflammation in mouth and throat
• Swelling of glands for a long time

Gonorrhea

Gonorrhea is called Sujak or Dhatu in Nepali. It affects genitals, urinary tract, rectum, cervix etc. its causative agent is gonococcus of neisser. This bacterium can easily dies in sunshine. It found in the pus coming from genitals.

Mode of transmission

• Sexual intercourse with infected person
• The contact with virus containing vaginal discharge

Symptoms

The symptoms of gonorrhea are not clear but they differ according to the structure of sexual organs infected organs. Its dangerous effect is cause infertility. Some common symptoms are as follows:

• Painful, burning and frequent urination
• Discharge of yellow puss from penis and vagina
• Inflammation in urinary tract and genitals
• Small reddish rashes appear around genitals
• In women, abdominal pain in one or two sides, fever, nausea and irregularity of menstruation
• In male, pus is collected in prostate gland
• Eye infection and chancres in genitals in neonatal baby
• Uneasiness in genitals due to swelling

Preventive measures

• Adopt healthy and appropriate sexual behavior.
• Discourage unsafe sexual behavior with others.
• Mass awareness on reproductive and sexual health education
• Discourage girls trafficking, prostitution and multiple sex
• Both consult doctor if any one of the couple is infected
• Use clothing and utensils after proper disinfection (washing)
• Care to personal and genital hygiene
• Should increase female education and employment to avoid prostitution
• Immediately consult the doctor for treatment when you suspect

Syphilis

Syphilis is the oldest disease among sexually transmitted disease. It affects main organs of our body like heart, lever and brain. 'Treponema Pallidum' virus causes this disease. The virus can survive for longer period.

Mode of transmission:

• Through unsafe sex with patients of syphilis.
• With use of blood of its patient.
• To the baby through infected mother by birth.

Symptoms of Syphilis

First Stage

• A single typical chancre (wart) appears mainly in genital organ, lips, fingertip, tongue, breast or mouth. It appears 2-4 weeks after infection. The chancre does not ache or itch. And chancre itself disappears after 1 to 5 weeks.

Second Stage

• Reddish and pale skin rashes appear.
• Swelling in joints of bone.
• Hair loss and weigh loss can be felt.
• Patient suffers from common cold.

Third Stage

• If not treated timely, following symptoms are seen.
• Symptoms of heart problems
• Eye problems and blindness
• Patient become unconscious and mentally impaired