Health Safety and EMS-4455

Name:
Sabahat Mazhar
Roll #:
BZ486737
Program:
BS Environmental Sciences (7th Semester)
Course Instructor:
Dr. Shazia Akhtar
Practical 1
 Diabetes mellitus
What is diabetes mellitus?
 Diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired ability
of the body to produce or respond to insulin and thereby maintain proper levels of sugar
(glucose) in the blood. It occurs either when the pancreas does not produce enough insulin
or when the body cannot effectively use the insulin it produces.
 Diabetes mellitus is a disease in which the body does not control the amount of glucose (a
type of sugar) in the blood and the kidneys make a large amount of urine.

Types of Diabetes mellitus:

There are two major forms of the disease. Type 1 diabetes, formerly referred to as insulin-
dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, usually arises in childhood.
Type 2 diabetes, formerly called non-insulin-dependent diabetes mellitus (NIDDM) or adult-
onset diabetes, usually occurs after age 40 and becomes more common with increasing age.

Type 1:
o Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is
characterized by deficient insulin production and requires daily administration of insulin.
o This type of disease accounts for about 5 to 10 percent of cases of diabetes.
o It is usually caused by autoimmune destruction of the islets of Langerhans of the pancreas.

Causes:
Doctors don’t know exactly what causes type 1 diabetes. For some reason, the immune system
mistakenly attacks and destroys insulin-producing beta cells in the pancreas. Genes may play a
role in some people. It’s also possible that a virus sets off an immune system attack.

Type 2:
o Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the
body’s ineffective use of insulin.
o This type of diabetes is far more common than type 1 diabetes, accounting for about 90
percent of all cases.
o It is strongly associated with obesity and is a result of insulin resistance and insulin
deficiency.

Cause:
Type 2 diabetes stems from a combination of genetics and lifestyle factors. Having overweight or
obesity increases your risk, too. Carrying extra weight, especially in your belly, makes your cells
more resistant to the effects of insulin on your blood sugar. This condition runs in families. Family
members share genes that make them more likely to get type 2 diabetes and to be overweight.

Gestational diabetes:
Gestational diabetes is hyperglycemia with blood glucose values above normal but below those
diagnostic of diabetes. Diabetes mellitus also may develop as a secondary condition linked to
another disease, such as pancreatic disease; a genetic syndrome, such as myotonic dystrophy; or
drugs, such as glucocorticoids. Gestational diabetes is a temporary condition associated with
pregnancy. In this situation, blood glucose levels increase during pregnancy but usually return to
normal after delivery. However, gestational diabetes is recognized as a risk for type 2 diabetes
later in life.

Causes:
Gestational diabetes occurs as the result of hormonal changes during pregnancy. The placenta
produces hormones that make a pregnant person’s cells less sensitive to the effects of insulin. This
can cause high blood sugar during pregnancy. People who are overweight when they get pregnant
or who gain too much weight during pregnancy are more likely to get gestational diabetes.

Impaired glucose tolerance and impaired fasting glycaemia:

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate
conditions in the transition between normality and diabetes. People with IGT or IFG are at high
risk of progressing to type 2 diabetes, although this is not inevitable.

Insulin:
Insulin is a hormone secreted by beta cells, which are located within clusters of cells in the pancreas
called the islets of Langerhans. Insulin’s role in the body is to trigger cells to take up glucose so
that the cells can use this energy-yielding sugar.

Sugar Level:
A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have
prediabetes, and 126 mg/dL or higher indicates you have diabetes.

General Symptoms:
The general symptoms of diabetes include:
 Increased hunger
 Increased thirst
 Weight loss
 Frequent urination
 Blurry vision
 Extreme fatigue
 Sores that don’t heal

Health impact:
Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.
 Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes.
  Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the
chance of foot ulcers, infection and eventual need for limb amputation.
 Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term
accumulated damage to the small blood vessels in the retina. Close to 1 million people are
blind due to diabetes.
 Diabetes is among the leading causes of kidney failure.
 People with diabetes are more likely to have poor outcomes for several infectious diseases,
including COVID-19.

Prevention:
Lifestyle measures have been shown to be effective in preventing diabetes. To help prevent
diabetes and its complications, people should:
 Achieve and maintain a healthy body weight.
 Be physically active – doing at least 30 minutes of regular, moderate-intensity activity on
most days. More activity is required for weight control.
 Eat a healthy diet, avoiding sugar and saturated fats.
 Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.

Diagnosis and treatment:

Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose.
Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and
the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also
important to avoid complications.
Interventions that are both cost-saving and feasible in low- and middle-income countries
include:
 Blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require
insulin, people with type 2 diabetes can be treated with oral medication, but may also
require insulin.
 Blood pressure control.
 Foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear;
seeking professional care for ulcer management; and regular examination of feet by health
professionals).
Other cost saving interventions include:
 Screening and treatment for retinopathy (which causes blindness);
 Blood lipid control (to regulate cholesterol levels);
 Screening for early signs of diabetes-related kidney disease and treatment.
Practical 2
 Questionnaire
OPTOMETRIST
Q1: Name of the Doctor?
Answer: Dr. Maria Ramzan.

Q2: Field of specialization degree and year in which the Doctor has completed
his/her degree?
Answer: Optometry, graduated in 2021.

Q3: My Location?
Answer: Shaheen town phase II lehtrar road Islamabad.

Q4: Does he/she work in a private clinic or in a hospital?

Answer: In an Eye Trust Hospital.

Q5: Location where he/she serves as a doctor (location of clinic/ hospital)?

Answer: Khanna pul Rawalpindi.

Q6: How many patients do visit at his/her clinic or hospital on daily basis?
Answer: 80+ patients do visit.

Q7: What type of disease do most of the patients have?

Answer:
 Refractive error
 Conjunctivitis
 Dry eye

Q8: What type of medicine do you mostly given to patients?

Answer:
 Glasses
 Lubricants
 Multivitamins

Q9: How often you had a patient come to you more than once with the same
disease?
Answer: Ptxs with refractive error come after every 3 to 5 months and allergic ptxs have to visit
after 1 month follow up.
Q10: Apart from medicine, what are the preventive measures for the patients of
the disease that you see most often?
Answer: Advice to ptxs to minimize the screening time and take small break during screen time
use artificial tears and don’t rub eyes, some homemade remedies are also recommended.

Q11: What is the age group of patients who come to you for treatment on a daily
basis and how many of them are male and female?
Answer: Between 5 to 65 age group, equal ratio.

MEDICAL SPECIALIST
Q1: Name of the Doctor?
Answer: Dr. Sana.

Q2: Field of specialization degree and year in which the Doctor has completed
his/her degree?
Answer: Medical.

Q3: My Location?
Answer: Shaheen town phase II lehtrar road Islamabad.

Q4: Does he/she work in a private clinic or in a hospital?

Answer: Private hospital.

Q5: Location where he/she serves as a doctor (location of clinic/ hospital)?

Answer: Ali Medical Centre Islamabad.

Q6: How many patients do visit at his/her clinic or hospital on daily basis?
Answer: 20 to 25 patients do visit.

Q7: What type of disease do most of the patients have?

Answer: Anemic.

Q8: What type of medicine do you mostly given to patients?

Answer:
 Iberet folic
 Sangobian
 Fefolvit
  Neurobion
 Painkillers and Multivitamins.

Q9: How often you had a patient come to you more than once with the same
disease?
Answer: Rarely.

Q10: Apart from medicine, what are the preventive measures for the patients of
the disease that you see most often?
Answer: Advice for patients to have healthy lifestyle, healthy diet and healthy environment free
of stress.

Q11: What is the age group of patients who come to you for treatment on a daily
basis and how many of them are male and female?
Answer: Mostly are females and the age group lies between 20 and30.