HUMAN DISEASE

Dr Milan Gaihre

Institute of Medicine

Teaching hospital

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• Mode of transmission;

• Incubation period:

• Host;

• Agent

Malaria kis cause by plasmodium parasite

Three types of malaria parasite

Plasmodium vivasx plasmodium ovale

Plasmodium falciparum

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• Communicable disease:

Tuberculosis,Giardiasis,Ascariasis,

AIDS,Typhoid

• Non communicable diseases: cancer,DM,coronary heart disease

Tuberculosis

Tuberculosis

• Causative organism;

a)Mycobacterium tuberculosis

b)Mycobacterium bovis(abdominal TB)

c)mycobacterium avium

• Incubation period:3 week to 3 month

Clinical features;

Diagnosis

• Zeihl neel(ZN) staining

• Sputum test-3 consecutive morning samples

• Chest x ray

• Mantoux test or tuberculin test

• PCR(polymerase chain rxn)

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Ghon focus

• Mantaux test

Ghon focus and Ghon complex

Treatment

• Multi drug regimen;@PRISE

• Pyrazinamide ;jaundice

• Rifampicin :Red color secretion (saliva and sweat)

• Isoniazide:peripheral neuritis

• Streptomycin: ototoxicity,nephrotoxicity

• Ethambutol;Eye toxicity(bacteriostatic

Giardia lifecycle

Giardiasis

• Giardia lamblia

• Duodenum,upper part of jejunum

• Faecooral transmission

• Incubation period;3 week@3G

• Two stages:

a)cyst;infective

b)trophozoite:feeding stage

Giardia lamblia

clinical features

Abdominal pain

Foul smelling stool

Fatty stool

Diarrhoea

Treatment

• @TIMES

• Tinidazole

• Metronidazole

• Secnidazole

Ascaris life cycle

Ascariasis

• Most common helminthic or worm infestations

• Most common infection in school children in kathmandu.

• Causative agent:Ascaris lumbricoides

• MOT:faecooral(embryonated egg ingestion)

• Incubation period:1-2 months

• Habitat ;lumen of small intestine(jejunum)

Clinical features

Vomiting • Abdominal pain• Gi Ulcer• Cough• Bile obstruction cause Obstructive

jaundice• Fever

Treatment

• Mebendazole

• Albendazole

• Piperazine

Typhoid

• Causative agent:salmonella typhi

• MOT:faecooral route (contaminated food and water)

• Incubation period:1o-14

Symptoms

• High grade fever

• GIdiscomfort(diarrhoea,nausea,vomiting)

• Bradycardia and neutropenia

• Rose spot(2nd week)

Diagnosis

• @BASU

• B-Blood culture 1st week

• A-Antibody-antigen reaction 2nd

week(WIDAL TEST)

• S-Stool culture 3rd week

• U –Urine culture 4th week

Treatment

• Chloramphenicol

• Ciprofloxacin

• Ceftriaxone

• Amoxicillin

AIDS(SLIM DISEASE)

• Agent ;human immuno dificiencyvirus(HIV)

reverse transcriptases enzymeretro virus

ssRNA

MOTSexual contact Blood contact Vertical

transmission

Homosexual More then 30% More then 90 %

Heterosexual Blood transfusion

Mother to child

Common mode of transmission

Vaginal fluid, breast,pus

During delivery and breast feeding

• Incubation period:few month to many years(5-10 years)

• Tumor present in AIDS patient;

a)kaposi’s sarcoma

b)non hodgkin lymphoma

Acute viral stage

Windowperiod

Asymptomatic stage

Aids related complex

Endstage(AIDS)

Nosymptom or flu like symptom

Antibody test is negativebut person can still transmit HIV

Antibody test is positive but patient has no symptom except generalisedlymphadenopathy

Chronicdiarrhea,persistantfever more than a month,Significant weight loss

Oppertunisticinfection (M avium)

Diagnosis

• Screening test-ELISA(enzyme linked immuno sorbant assay)

• Diagnostic test-western blot test

Highly active anti-retroviral treatment(HAART)

• ZIDOVUDINE

• LAMIVUDINE

• NEVIRAPINE

• SAQUINAVIR

Non communicable disease

• Tumor/Neoplasm

• Oncology

• Oncogene

• Carcinogen

Typhoid

• Causative organism; Salmonella typhi

• Resides in small intestine:Ileum(payers patch) in infected person but Gall bladder in chronic carrier

• MOT: contaminated food and water

• Incubation period:10-14

Clinical features

• Step ladder pattern fever

• GI symptoms

• Splenomegaly ,Hepatomegaly

• Bradycardia(decrease heart rate)

• Neutropenia(decrese in neutrophil level)

• Rose Spot

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Diagnosis:@ BASU

Diagnosis

• B=Blood culture

• A=Antibody antigen reaction

• S=Stool test

• U=Urine test

TypesBenign Malignant

Slow growing Fast growing

Well organised and capsulated

Disorganised and non capsulated

Metastasis absent Metastatsis present

Usually take suffix oma Usually takes suffix sarcoma and carcinoma

• Carcinoma:

• Sarcoma:

Diagnosis

• Histopathological test:Biopsy

• Imaging: MRI , CT scan, Xray, USG

Treatment

• Surgery

• Chemotherapy:cisplatin and vincristin

• Radiotherapy

Gender world nepal

male

female

children

Smoking

Smoking

• Most commonly abuse substance in nepal

• Tobacco contains:

i.Carbon monoxide

ii.Ammonia

iii.Nicotine

iv.Tar

Harmful effect of smoking:

• Respiratory:COPD,Lung cancer

• Oral cancer,Peptic ulcer,gastric cancer

Alcoholism

• Alcohol is most commonly abusedsubstance in world.

• It acts as:

Hypnotics

Anesthetic

Tranquilizer

Stimulats

• Absorption: Stomach

• Metabolism: Liver, Lungs, skin, kidney

Metabolism:

alcohol

acetaldehyde

acetic acid

Carbondioxide +water

Effect of alcohol

• Loss of balance (Cerebellum)

• Cirrhosis of liver

• Korsakoff Psychosis

• Wernickes encephalopathy

• Pericarditis

• Hampers Thiamine metabolism

Psychotropic Drugs

class effect examples

Narcotic/opiates

Action onCNS(drowsiness,anesthesia and analgesia)

Heroine,Codeine,Morphine, Ephedrine@Hero CoME

Stimulant Stimulate CNS(mood elevator)

Amphetamine,Cocaine,Caffines

Tranquilizer Reduce anxiety and tension

PhenathiazineCholoropromazineBenzodiazepines@PCB

Sedatives Makes drowsy Bartiturates,Alcohol@BASe

Hypnotics Induce sleep Hasis,Marijuana,Chares

Hallucinogens Psychedelic drug

LSDMescalinePsilolybinBhang,Chares,Ganja