Human disease

Dr. SAROJ SHRESTHA

MBBS , CAIRO UNIVERSITY
• HEALTH is state of complete physical , mental and social wellbeing
• Not absence of disease
• Disease is any change from normal state
• Study of cause of disease
• Study of spread of disease
• Preventive measure for a disease
• Study of disease
DAYS
• World TB day : 24th March
• World AIDS day : 1ST December
• World No Tobacco day: 31st May
• World Leprosy day : 30th January
• World population day : 11th July
• Doctors day : 1st July
• Disease since birth
• Disease after birth
• Communicable disease
• Non-communicable disease
• Social disease
Very important terminologies
• Mode of transmission
Incubation period
vs latent period ??
Window period
Host
Agent/ Etiological factor
• Pathogen causing disease
VECTOR
Carrier
• Pandemic
• Epidemic
• Endemic
• Sporadic
Mental health
• Hallucination
• Illusion
• Delusion
Pyschosis & neurosis
Drugs
• Abuse : self-use without medical purpose
• Addiction
• Dependance
Some imp examples

• Sedatives
• Tranquilizers
• Stimulants
• Depressants
• Hallucinogens
• Opiate / narcotics
Smoking
• Most common abused substance in Nepal
• Highest female smokers in world
• Derived from nicotiana tobacum
• Contain nicotine, carbon monoxide ,
• aromatic hydrocarbon, tar
Alcoholism
• Most commonly abused substance in the world
• CNS depressant
• Maximum absorption occurs from stomach
• Hangover symptoms are due to formation of ……………..
• Diuretics effect
• Fatty liver
• Cerebellum
• Cirrhosis
• Chronic pancreatitis
CANCER
• Abnormal growth
• Oncology
• Oncogene
• Carcinogen
• Carcinoma
• Sarcoma
• Leukemia
• Metastasis
• Biopsy
• Pap smear
• Mammogram
• Most common cancer in Nepal in female cervical cancer
• Most common cancer in world in female breast cancer
• Most common in male lung cancer
• Most common cancer is lung cancer
Giardiasis
• Giardia lambia ( Grand old man of intestine )
• Habitat: duodenum and upper jejenum
• Mode of infection: feco-oral route
• Most common cause of diarrhea in adults
• In children & infants ???
• Dimorphic parasite
• Feeding stage
• Infective stage
• Diagnostic test : cyst in stool
• Treatment : Metronidazole
Ascariasis / round worm/ juka
• Most common worm infestation in nepal
• Causative organism
• Habitat: lumen of small intestine especially
jejenum
• Infective stage :
• Mode of infection :
• Symptoms : asymptomatic
• Passing of worm in stool
• Abdominal pain
• Constipation
• Diagnostic ; egg in stool with irregular ambuminous coat
• Eosinophilia
• Treatment: albendazole , mebendazole
• Lofflers pneumonia
Typhoid fever/ enteric fever
• Causative organism: Salmonella typhi
• Gram negative bacillus
• Mode of transmission : feco-oral route
• Diagnosis : @BASU
• MOST SENSITIVE TEST
• Treatment : ciprofloxacin , chloramphenicol & amoxicillin
• Recent drug ceftriaxone
Q. DOTS stands for :
R. Directly observed treatment system
S. Directly observed treatment short course
T. Daily observed treatment system
U. Daily observed treatment short course
Q. Alpha interferon and lamivudine are used in treatment of:
A. Hepatitis
B. Malaria
C. Aids
D. Diarrhoea
Q. Chronic alchohol use may harm :
A. Peritoneum
B. Pericardium
C. Pleura
D. None
Q. The major group of cells depleted in AIDS :
R. Helper T-lymphocyte
S. Cytotoxic T-lymphocyte
T. Monocytes
U. Neutrophils
Q. Isoniazid is the drug for the disease:
A. Leprosy
B. Typhoid
C. Tuberculosis
D. Encephalitis
AIDS
• Causative organism:
• Retrovirus
• RNA virus
• Mode of transmission
• High risk patients
• Affects cell mediated immunity
• High affinity to CD4 cells
• Clinical symptoms : flu like , lymphadenopathy
• There are ……… stages
• End stage AIDS
• Opportunistic infection
• Most common is ……………….
Diagnosis
• Screening test : ELISA test HIV antibodies
• Confirmatory test : western blot test
• Northern blot
• Southern blot
• Prognostic test : CD4 count , viral load by RT-PCR
• Tumors common in AIDS patient
• Kaposi sarcoma , non-Hodkgins lymphoma, Peri genital tumour
• HAART : zidovudine , lamivudine
Highly Active Anti retroviral Therapy
Tuberculosis
• Also called Koch disease
• Causative organism : Mycobacterium tuberculosis
• M. bovis
• Acid fast bacilli
• Staining by Zeilh-nelsen staining
• Mode of transmission
• Risk factors immunocompromised state
• HIV , malnutrition , overcrowding , poverty , diabetes mellitus
• Leading cause of death in HIV
• Primary tuberculosis : first contact of organism
• Occurs in lung , intestine & lymph node
• Pulmonary TB occurs in lungs
• Extrapulmonary occurs anywhere except hair & nail .
• Ghons focus primary lesion
Diagnosis
• Chest xray
• Zn stain
• Mantoux test / tuberculin test
• Sputum culture
• PCR
Treatment
• Multiple drug regimen
• Pyrazinamide
• Rifampicin
• Isoniazid
• Streptomycin
• Ethambutol
• DOTS
• Directly observed treatment short course
• Intensive phase: 2 months
• Continuation phase : 4 months
Live attenuated vaccine obtained from
M.bovis
Leprosy
• Called hansens disease
• Mycobacterium leprae
• Test lepromin test
HEPATITIS
HAV HBV HCV HDV HEV

RNA DNA RNA RNA RNA

Feco-oral Blood , BLOOD BLOOD feco-oral

parenteral,
sexual

IgM anti- IgM anti HCV-RNA IgM-anti IgM-anti HEV

HAV HBV HDV
HBsAg

Vaccine Vaccine No Of B

No Chronic Chronic chronic No

• Treatment of hepatitis B
• Vaccine is second generation vaccine
• EBV- infectious mononucleosis
• Syphilis – Treponema pallidium
Q. Which of the following is the largest class of immunoglobulin?
A. IgG
B. IgA
C. IgM
D. IgE
Q. Hansens disease is :
A. Leprosy
B. Typhoid
C. AIDS
D. Tetanus