The document discusses obesity, cancer, diabetes mellitus, and blindness. It defines obesity as abnormal growth of adipose tissue resulting in weight 20% over standard weight. Cancer is characterized by abnormal uncontrolled cell growth and ability to invade tissues. Diabetes mellitus is a metabolic syndrome resulting from insulin deficiency or resistance leading to high blood glucose. Prevention strategies include diet, exercise, and health education.

1. OBESITY,CANCER
DIABETIS MELLITUS AND
BLINDNESS

2. OBESITY
 It is characterized by the abnormal
growth of the adipose tissue,
resulting in an increase in the body
weight to theextentof 20% or more
of standard weight for the person's
age , sex and height.

3.  Corpulence index: this is based on only weightof
the individual.
 =Actual body weight of theindividual
 Expected bodyweight
 Expected weight formula:
 Broca’s = height in cm – 100

4.  Body mass index: This is based on weightand
height of the individual.
 = Weight in Kg
 ( Height in mtr)2
 Waist circumference: It is measured at a mid
point between the lower borderof the rib cageand
the iliac crest. Men > 102 cm and women > 88cm.

5. Risk factors
 Non modifiable risk factors
 Age: Obese children continues to adultlife.
 Sex: over weight is more among men but
obesity among women. It's because of
physiological process contribute to an
increased storage of fat in female andduring
pregnancy.
 Genetic factors:

6. Modifiable risk factors
 Physical activity: Regular activity burns Cal
 Socioeconomic status: High socio-
economic status corelates positivelywith
obesity in developingcountries
 Literacy level: less literacy level
 Body image: Thin and slim bodysymbolizes
competence, while obesity represents
laziness
 Eating habits: Overnutrition (95%)

7.  Alcoholism: Every gram = 7 k Cal of energy.
 Smoking: Smoking and obesity is inverselyrelated.
 Psychological factors: Emotional strains people
find satisfaction in eating thefood.
 Drug use: use of corticosteroids, oral contraceptive
pills, insulin, beta adrenergic blockers can promote
weightgain.
 Environmental factors: Modernization of standard
of living.

8. Prevention and control
Aim
 Tomaintain BMI between 18 to 25 throughout
adulthood.
 Toprevent thedevelopmentof overweight
 Toprevent the progression of overweight toobesity.
 Toprevent regain of weight among thoseobese
patients, who have already lost soweight

9. Strategies
 Dietarychanges
 Refrain from over consumption of fats andcarbohydrates
 -cereal, legumes and vegetables, fiber content shouldbe
increased.
 Physical activities:
 Regular physical activity helps in increasing theenergy
expenditure.
 Health education: on hazards of obesity andit's
prevention by healthy diet andlifestyle

10. CANCER
 Cancer is a most fearfuldisease.
 It is characterized by the followingfeatures:
 Abnormal and uncontrolled growth of thecells.
 The presence of aberrations in thenucleus.
 Ability to invade the surrounding tissues andeven
distant organs later.
 Eventual death of the person, if the tumor has
progressed beyond a certain stage atwhich itcan be
successfully removed.

11. Agent factors
Types
 Physical agents: Heat, solar radiation, ionizingradiation
 Mechanical: Friction
 Chemical: Aniline, asbestos dye, benzol, nickel, coaltar
 Biological: hepatitis b virus, cytomegalovirus virus, Epstein-
Barr virus, human papilloma virus, human T cell lymphoma
virus, aspergillusflavus and herpesvirus.
 Nutritional: smoked fish, beef, high intake of fat,alcohol.
 Socio-environmental: Tobacco, over use of estrogen drug,
sunlight.

12. Host factors
 Age: in developing countries, (young people)
 Sex: among men than amongwomen.
 Occupation: in certain types of industries
 Example: coal tar, soot, pitch, dyes, U-V radiation,
 Habits: smoking, alcoholism, sun bath, pan,
zarda, low fibre diet, excessive sex withmultiple
partners.
 Environmental Factors: air pollution andozone
layerdepletion.

13. Prevention:Health promotion
 A. " Danger signal" of cancer
 A lump in thebreast
 A non healing ulcer
 Sudden change in the wart or mole
 Persistent indigestion ordifficulty in swallowing
 Hoarseness of voice
 Unusual bleeding from any natural orifice
 Any change in the usual bowelhabit
 In explained loss of weight

14.  B. People are also educated to avoid alochol,smoking,
pan,
 C. Toincrease the use of legumes, grains, fruits and
vegetables and to avoid coloring agents, fast foodetc
 D. Tomaintain high standard of personal hygiene,
specially among industrial workers.
 E. Women are educated about self examination ofthe
breasts.

15.  Control of air pollution:By dilutions, replacementand
legislation from a part of cancercontrol activities.
 Oral hygiene: Maintenance of oral hygiene and
correction of non- alignment of teeth resulting in
aphthous ulcers, goes a long-way in preventionof oral
cancers.
 Legislation: Tocontrol consumption of alcohol, tobacco
and food related carcinogens.
 Tocontrol airpollution
 Toprotect "at- risk" industrial workers.

16. Specific protection
 Avoidance of carcinogens
 Immunization against hepatitis B to preventliver
cancer.
 Treatment of pre-cancerous lesions.
 At risk industrial workers should wearprotective
gadgets.


17. Secondary prevention
 Early diagnosis andtreatment
 Early diagnosis- is done by history, clinical exam and
investigation. Screening of those who comes withwarning
signals and those atrisk.
 Exfoliativecytology todetect ca cervix
 X-raychestand sputum cytology - todetect bronchogenic
ca.
 Mamography- to detect cabreast.
 Endoscopic examination- to detect caof stomach, colon
and other hallowviscera.

18. Treatment
 Surgery
 Chemotherapy
 Radiation therapy
 Immunotherapy

19. Tertiary prevention
 Disability limitations
 Rehabilitation
 Rehabilitation with a prosthesis and training,later
placed in a suitablejob.


20. DIABETES MELLITUS
 It is a metabolic syndrome, clinically characterized
by polyuria, polyphagia, polydypsia, hyperglycemia
and glycosuria due to absolute or relative
deficiency of the harmone insulin, that control the
metabolism of carbohydrates, protien, fat and
electrolytes.

21. Classification of diabetes mellitus
Primary
 Type 1 Insulin dependent diabetesmellitus
 Type 2Non insulin dependent diabetesmellitus
Secondary
 Pancreatic pathology
 Excessive production of harmone antagonist toinsulin
 Long term use of drugs like corticosteroids, thisidea,
phenytoin, oral contraceptive
 Liverdisease
 Geneticsyndrome

22. Agent factors
 Underlying cause of DM is deficiency of insulin.
 The overall effects of these mechanism isreduced
utilization of glucose leading to Hyperglycemia
and glycosuria.
 Other causes could be decreased insulinsensitivity
and increased insulin resistance or synthesis of
abnormal, biologically less active insulin molecule

23. Host factors
 Age: Type 1 (younger age ) and Type 2 amongmiddle
aged and elderly.
 Sex: Type 1 DM (men) and type 2 (women)
 Genetic factors: Type 2 shows 90% concordance
geneticcomponentwhereas Type 1 shows only 50%.
 Obesity: obesity increases the insulin resistanceand
reduces the number of insulin receptors on target
cells.

24.  Environmental Factors:
 Pregnancy: Itplaces a burden on beta cells of
pancreas to secrete moreinsulin.
 Viral infection: rubellavirus, mumps, rheoviris type 1.
 Diet: wheat and cow's milk have diabetogenicfactors,
A high saturated fat intake
 Malnutrition: diabetes directly cause byprotien
deficiency.
 Alcoholism: Excessive intake can lead to type 2DM.

25.  Lifestyle: lack of exercise is risk factor for DM type2.
 Immunological factors: Auto immune disordercan
causediabetes.
 Stress and strain: pregnancy, surgery, trauma canlead
to DM.
 Socioeconomicclass: change in lifestyle.

26.  Potential diabetic: It is a one who has risk of
developing DM due to geneticreasons.
 Latent diabetic: It is a one who has risk of developing
DM due to stressful conditions like pregnancy, surgery,
trauma, infection. They may returns to normal if stress
is removed.
 Black zone: is a stateof affairs in a type 2 DM patients,
in whom blood glucose levels are high but do not have
symptoms, although the process of complications is
going on.

27. Prevention and care of diabetes
 Population statergy
 Improvement in the nutritional habits
 Maintenance of bodyweight
 Genetic counseling: consanguineous marriageto
bediscouraged.
 Prospective eugenics: one diabetic shouldnot
marry anotherdiabetic
 Retrospective eugenics: if they are alreadymarried,
they should not havechildren.

28. Highrisk strategy
 Correction of obesity
 Avoiding over nutrition andalcohol
 Changing lifestyle
 Regularexercises
 Maintainace of normal bodyweight
 Avoidance of oral contraceptive andsteroids
 Reduction of factors promoting atherosclerosis
 Yoga exercise and meditation to beencouraged

29.  Secondary prevention
 Aim
 Tomaintain normal blood glucose level
 Tomaintain normal bodyweight

 Principle treatment:
 Diet : Small balanced meals morefrequently.
 More of raw vegetables and lesscereals

30. Self-care in diabetes mellitus
 Personal hygiene: Feet hygiene is important.
 Person should
 Look for changes in color, temperature, swelling
crakes and wounds
 Always wear footwear.
 Keep the feet clean, dry and warm

31.  Change socksdaily
 Habits: Should avoid smoking, spirit andsteroids.
 Exercise regularly
 Diet:
 Drug: take regularly
Tertiary Prevention
 Disability limitation
 Rehabilitation