Screening and Prevention of Disease Conditions:

As we know “Prevention is always better then cure”. A primary goal of health services is to prevent disease or to detect early so that early interventions can be made. A primary goal of screening is early detection of the risk factor or the disease at a stage where it can be cured. Screening would be effective if it’s going to carry out in conditions as heart diseases, cancer, lung diseases which results in high death rates in each part of world. Screening of risk factors for lung diseases and cancer as smoking can be identified early, it puts on to your life when quitted at the start of your symptoms. Also identifying these risk factors and providing counseling helps. There are several conditions where screening is considered helpful in early diagnosis of diseases. Such conditions may or may not run in families. But, the conditions like breast cancer, colon cancer, poly-cystic kidney disease and many more may run in families if presented in early age group. These conditions can be ruled out or treated in other members if screening can be done in its earliest.

Here are few diseases whose screening methods are simple and effective by some means:

• Breast Cancer Screening in females: Mammography at age of 40 then every 1-2 years

• Cervical Cancer screening: Pap smear at age of 21 or within 3 years of onset of sex, then every 3hrs until age 65.

• Colon Cancer Screening: Colonoscopy at age 50 and every 10years. If family history is present then 10 year early to the age group of member diagnosed. If more than 3 members start from age of 25 and be done every 1-2 years.

• Diabetes: >45 years or earlier if additional risk factors present. Then every 3years.

• Blood Pressure, height, weight: >18 years and yearly

• Cholesterol: men >35; Women> 45 years of age and every 5years.

Some Questions of Medication

As we grow older above the age of 30, we begin to lose a part of our “organ reserve.” In youth, our hearts van pump ten times the amount of blood required to sustain life, our kidneys can excrete six times the waste products that we produce in our bodies each day, and every other organ has similar reserve powers that fortunately are very seldom required. After age30, we begin to lose this reserve at a rate of 1 or 2 percent each year. We don’t even notice the loss, unless we are in a situation in which we really need it. Loss of reserve power means that it is more difficult to restore the equilibrium of the body after a severe insult to a body function.

As we age, our bodies detoxify drugs at a slower rate. In medical terms, the drug is metabolized more slowly. A little goes along way. In essence, we can get the same effect for a lower dosage; the regular dose of a drug can become an overdose. The first rule that a good doctor observes with an older patient is to keep the dose low.

Side effects of medications can simulate disease, and unwary doctors and patients often mistake a drug reaction for an underlying medical problem. A small dose of codeine may cause severe fatigue and sleepiness, a little digitalis may cause profound nausea and vomiting, a diuretic to remove fluid from the ankles may cause dizziness and kidney problems. The second rule that a good doctor observes is to suspect that the whole problem might be a minor drug reaction, cured simply by removing the offending drug. The largest problems come from the anti-inflammatory drugs, such as aspirin, naproxen, piroxicam, ibuprofen, indomethacin, and meclofenamate. These drugs frequently cause bleeding from the stomach and often cause hospitalization or even death. Older people are at three times the risk of younger ones.

Entirely new side effects can appear in the elderly. A sleeping pill may keep the patient awake. A tranquilizer may excite the patient or cause severe depression. These paradoxical reactions are not fully understood, but they are very common. Again, the good doctor and the thoughtful patient or relative will suspect the drug first.

Skin Fungus Treatment

Anti-Fungul Preparation
Fungal infections of the skin are not serious, so treatment is not urgent. In general, the fungus needs moist, undisturbed areas to grow and will often disappear with regular cleansing, drying, and application of a powder to keep the area dry. Cleansing should be performed twice daily.
If you need a medication, there are effective non-toxic agents available. For athlete’s foot use one of the zinc undecylenate creams or powders, such as Desenex. In difficult cases, tolnaftate (Tinactin) is very effective. This agent is useful for almost all sin fungus problems, but it is more expensive.

Dosage
For athlete’s foot, use as directed on the label. For other skin problems, selenium sulfide is available by prescription in a 2.5% solution. Over the counter, a 1% solution is available as Selsun Blue shampoo. Use the shampoo as a cream and let it dry on the lesions; repeat several times a day to compensate for the weaker strength.

Side Effects
There are very few. Selenium sulfide can burn the skin if used to excess, so decrease application if you notice any irritation. Selenium may discolor hair and will stain clothes. Be very careful when applying any of these products around the eyes. And don’t take them by mouth.

Watch Your Salt Intake

Too much sodium (salt) in the system tends to retain fluid in the body, increasing the blood pressure and predisposing to problems such as swelling of the legs. The heart has to work harder with the increased amount of blood volume. Thus, it is good to decrease salt intake, the average person in United States takes in about 12 grams (g) of sodium each day, one of the highest intakes in the world. Our convenience foods and our fast foods are usually loaded with salt.  Salt is in ketchup, in most sauces, and in hidden form in many foods. You need to read the labels to find it: look for “sodium,” not “salt”, the recommended amount is 4 grams a day of salt for a typical person. You will get plenty without adding anything. Under a doctor’s advice, patients with problems of high blood pressure, heart failure, or some other difficulties may need to reduce salt much more radically.

Do you have the typical craving for junk food? Don’t despair, there are healthy snacks! One of our favorites: popcorn, butterless, hot-air cooked, sprayed with butter-flavored PAM, and sprinkled with a little Parmesan cheese. Even better, try popcorn with olive oil instead of butter, unsalted peanuts in the shell, or French bread basted with olive oil and toasted with oregano or garlic.

Obesity and Its Consequences

Obesity is defined as excessive collection of fat (adipose tissue) in the body. Fat tissues which are widely present in adipose tissue in our body are used to store excess energy. It releases stored energy as free fatty acids for the use of other sites. This energy can be used for humans to survive starvation for as long as months. Due to the adaptation of sedentary life style these fats get deposited in our various body parts and result in many adverse health consequences.

Measures of Obesity:

• BMI (Body Mass Index) = wt. kg/ Ht2 m.

                Normal = 19-25
                Overweight= 25-3
                Obesity >30
                Morbid Obesity >40

• Waist to Hip ratio= > 0.9 (W); > 1 (M)
• Anthropometry (skin fold thickness) = mostly used in children <5>

BMI is the most important indicator used widely.

Consequences of Obesity:

The definitive cause of obesity is unknown some says it may be due to genetical inheritance or due to the high intake of foods more than required. Obesity can result from increased energy intake, decreased energy expenditure, or a combination of the two. Thus, identifying the etiology of obesity should involve measurements of both parameters. This results in many adverse health conditions as

• Diabetes Mellitus
• Reproductive Disorders: Male- hypogonadism, Gynecomastia; female- Polycystic Ovarian Syndrome
• Heart Disease: Coronary Disease, Stroke, Heart Failure, Hypertension associated
• Pulmonary Disease: may cause increased work in breathing, Severe Obesity results in Obstructive Sleep Apnea ( snoring while sleeping)
• Gallstones: Obesity is associated with enhanced biliary secretion of cholesterol, super saturation of bile, and a higher incidence of gallstones, particularly cholesterol gallstones.
• Cancer: In males cancer of the esophagus, colon, rectum, pancreas, liver, and prostate; obesity in females is associated with higher mortality from cancer of the gallbladder, bile ducts, breasts, endometrium, cervix, and ovaries.
• Bone, joint and cutaneous disease: Osteoarthritis, Gout.

Treatment:

• Behavior modification: Eating Habits, Counseling regarding weight loss.
  
• Diet: Reduced Caloric Intake. A deficit of 1000 kcal/d should cause a loss of 1 kg per week. Advantages of very low calorie diets are the greater rate of weight loss compared to less restrictive diets. In patients on such diets, blood pressure, blood glucose, cholesterol, and triglyceride levels fall, and pulmonary function and exercise tolerance improve. Sleep apnea may improve within a few weeks. Complications of very low energy diets are: fatigue, constipation or diarrhea, dry skin, hair loss, menstrual irregularities, orthostatic dizziness, and difficulty concentrating.
  
• Exercise: It plays a major role in decreasing obesity and is valuable to sustain diet. Daily means of light exercise or jogging keeps oneself healthy and prevents from other health conditions as heat diseases.
  
• Drugs: Despite modest short-term benefits from several agents, medication-induced weight loss is not a cure and is often associated with rebound weight gain after the cessation of drug use. The use of these drugs has their own side effects too. This makes it hard to prescribe for long term use in cases of Obesity.
  
• Surgery: In response to typically ineffective treatment using diet, exercise, and available drugs, surgical approaches are increasingly being employed. The potential benefits of surgery include major weight loss and improvement in hypertension, diabetes, sleep apnea, CHF, angina, hyperlipidemia, and venous disease. Two procedures in common use today are the vertical-banded gastroplasty and the Roux-en-Y gastric bypass.