community sheet # 11 - Asma2 7annon

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Post by Shadi Jarrar on 17/5/2011, 3:21 pm

بسم الله الرحمن الرحيم

_________________________ Community__11_2.html

Last community lec. For dr Samar.

In the last lecture we said that an important part of the primary health care is to monitor or to follow up as a clinical service, and this is applied in Jordan.

We also said that in the poor countries the highest percentage of death is caused by INFECTIONS… where as the main reason of death in the developed countries are the NON-COMMUNICABLE CHRONIC diseases.

Non-communicable diseases are ''as the name indicates'': non-infectious diseases which can't be transmitted between people, but the main reason about these diseases is NOT well known, ''unknown etiology''!!... for ex: there are many theories about the reasons of diabetes like: its relation with obesity.. So we consider this relation as a risk factor not a reason!.

Now the Dr showed us a table:
We can notice that the stroke and vascular diseases are considered as NO.1 diseases that causes death in the middle income countries,, Infection is NO.1 reason for death in the low income countries, and coronary heart disease is considered as NO.2 that causes death in the low and middle income countries, whereas in the industrial and rich countries it is considered as NO.1… so in general in the world the most common disease that causes death is the coronary heart disease.
Now… what are the major non-communicable diseases??
-cardiovascular diseases: ischemic heart disease, vascular problems, thrombo-embolism, cerebro-vascular accidents…
-chronic obstructive pulmonary diseases: specially in industrial countries where there is a high percentage of smoking.
-cancer: it is used to be NO.5 or 6 in the world, but now it is becoming NO.2 after ischemic and coronary heart disease, but why does cancer becoming more and more common??
Because of the life style: environmental effects, smoking, fast food, and with the new technology we can diagnose the diseases earlier and make scanning in early stages so this helps in discovering cancer and consider it as a common cause of death in the world.

Back to the non-communicable chronic diseases. They are considered as degenerative diseases and they are more common in elderly. The main characteristics of these diseases:
-unknown etiology.
-long latency period: ya3ni at the time of diagnosis the disease will be already spread for along period before we discover it ''its symptoms appears late'', for ex: hypertension is considered as a silent killer cz its symptoms appears too late ''it may take months or years, or even it may be asymptomatic like some cancers. Unlike other infectious diseases where it takes max. 10 days ,then the symptoms begin to appear .

*strategies for prevention of these diseases:
-primary prevention.
-secondary prevention.
-tertiary prevention.

-Pre????(Please go back to the slides) :it's the period before the disease happen.. to know the risk factors in the general population, for ex: smoking is a risk factor for chronic obstructive airway disease ,so we try to avoid this factor in general despite if the patient considered as being in a high or in a low risk group.

-primary prevention: where the person has a high risk to have certain disease ,for ex: if we found a family history of breast cancer ,so this person has higher risk to be affected than the rest of people, so this lady must do diagnosis, screening and self examination as soon as possible entebho lal note t7it!!!!.

-secondary prevention: to avoid the complications of the disease, when we have symptoms of the disease if we have the disease already.

-tertiary prevention: it aims to prevent the inability, for ex: in the late stages of diabetes we try to prevent the amputation.

NOTE: Dr Ahmad will talk about these stages for prevention with examples of the diseases, and he will consider the screening as secondary prevention, although Dr Samar says that a primary prevention, ,so in the exam answer as Dr.Ahmad says cz Dr Samar will not ask about this subject!!! ''musalimeh el doctora'' :P
so just stress on the definitions of the previous stages with out the examples.

* other chronic incommunicable diseases may not cause mortality, but they may cause morbidity ex:
- Al-zheimer: it is degenerative disease.
-disk and back pain.
-foot problems: fungal infections.
-scoliosis: eltiwa2 fel vertebra in children.
-Parkinson disease.
-multiple sclerosis MS: auto immune disease that may cause ''talaf bil jodran elli bi3'azo el nerves.
-congenital disorders.
-genetic disorder: down syndrome.
-head ache and migraine.
-psychiatric disorders.

*all of these diseases are being discovered in early ages bcz of the new technology
*NO.1 cancer in men is colon cancer.
*the onset age of depression is the youth ''golden age''.
*bipolar psychiatric disorder: up ad down.

Psychiatric disorders:

1-neurosis: the patient still in touch with reality, no hallucination, wrong ideas, and the patient knows that he is sick, ex:
: OCD: الوسواس القهري-
The patient has wrong ideas like when he clean his hands several times ….so they give him cognitive behavioral therapy to reduce the wrong idea by relaxing exercises in the developed countries
*another Ex of the wrong ideas ''neurosis'': if some one goes and make AIDS test, and they told him that the result is normal , but he keeps thinking that he has the disease and that there was something wrong with the diagnosis in the lab ,,,so this is an Ex of wrong ideas.

Panic, phobia, anxiety.-

2-psychosis: like schizophrenia, hallucination…., the patients suffer less than neurosis but their situation is worse!

*psychiatric diseases don't cause mortality, but they cause morbidity and disability, when we define the Health we said that it is a psychological, physical and social well being.

*after cardiovascular disorders the mental diseases are second cause of disability and some times cause pre mature mortality
*the burden of mental disorder is more than 15% of over all burden of diseases and even it is more than the burden associated with cancer.

*Depression: is a disease but it must be managed.

Sadness considered as depression if it prevents the persons normal life from continuing normally ,not going to the work, not taking care of children… *

*the most common age of depression is the youth.

*some times back pain is caused by depression so if you give anti-depression drug, you stop the pain.

*Another kind of depression: post-mortem depression, depression for a long time, 2 months.

*15-20% of disability is from depression.

*depression may occur in middle age because of hormonal imbalance, post menopausal depression.

*depression is more common in women!! 


Done by Asma Hanoun.

Shadi Jarrar
Shadi Jarrar
مشرف عام

عدد المساهمات : 997
النشاط : 12
تاريخ التسجيل : 2009-08-28
العمر : 28
الموقع : Amman-Jordan

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