1. SHEQ FOUNDATION
HEALTH IMPROVEMENT PROGRAM

2. TOPICS CO
O CS COVERED INCLUDE
C U
DIABETES
HYPERTENSION
SO
CHOLESTROL
EATING HABITS
S U
SEXUALLY TRANSMITED DISEASES
NS
S S S
DRUG & ALCOHOL ABUSE

3. DIABETES

4. DIABETES DEFINITION
S
O
• Diabetes mellitus (DM) is a g p of diseases characterized by high levels
(
)
group
y g
of blood glucose resulting from defects in insulin production, insulin
action, or both.
• Diabetes mellitus is a chronic metabolic disorder caused by an absolute or
relative deficiency of insulin, an anabolic hormone.
insulin
hormone
• The term diabetes mellitus describes a metabolic disorder of multiple
aetiology characterized by chronic hyperglycaemia with disturbances of
carbohydrate, fat and protein metabolism resulting from defects in insulin
secretion, insulin action, or both.
• The effects of diabetes mellitus include long–term damage, dysfunction
and failure of various organs.

5. TYPES O DIABETES
S OF
S
• Type 1 di b
diabetes develops when the body’s immune system destroys pancreatic
d l
h h b d ’ i
d
i
beta cells, the only cells in the body that make the hormone insulin that regulates
blood glucose. This form of diabetes usually strikes children and young adults,
although disease onset can occur at any age.
• Insulin – dependent diabetes mellitus (IDDM)) - is as a result of the absence or
destruction of the beta cells.
• Most children with diabetes have IDDM and a lifetime dependence on exogenous
insulin.
• Type 2 diabetes is associated with older age, obesity, family history of diabetes,
history of gestational diabetes, impaired glucose metabolism, physical inactivity,
and race/ethnicity African Americans, Hispanic/Latino Americans American
race/ethnicity.
Americans
Americans,
Indians, and some Asian Americans and Native Hawaiians or Other Pacific
Islanders are at particularly high risk for type 2 diabetes.
• non-insulin dependent diabetes mellitus (NIDDM) - i a heterogeneous disorder.
i li d
d di b
lli (
) is h
di d
• Most patients with NIDDM have insulin resistance and their beta cells lack the ability
to overcome this resistance.

6. TYPE 1 &2
&

7. INSULIN IN THE BODY
SU
O

8. CAUSES AND TREATMENT OF
DIABETES
CAUSES
• Obesity and inactivity
• Family history o type 2 d be es
y s o y of ype diabetes
• Environmental factors interacting with a genetically
susceptible person.
person
TREATMENT
• Th goal of therapy is to achieve and maintain euglycemia as
The
l f th
i t
hi
d i t i
l
i
well as near-normal hemoglobin A1c (HBA1c) levels (<7%).
• Patients who are not ill at di
i
h
diagnosis can b treated i i i ll
i
be
d initially
with lifestyle changes (e.g. diet, exercise, weight control).
• Insulin therapy is indicated in symptomatic patients with
persistent hyperglycemia or with ketoacidosis.
• Pharmacologic therapy.

9. Values of Diagnosis of Diabetes Mellitus
g

10. Management of Diabetes
• The major components of the treatment of diabetes
are:
Objectives
A
• Diet and
Exercise
B
• Oral
hypoglycaemic
therapy
C
• Insulin
Therapy
• To achieve optimal blood
glucose concentrations.
• To achieve optimal blood lipid
concentrations.
• To provide appropriate energy
id
i
for reasonable weight, normal
growth and development,
including during pregnancy and
lactation.
• To prevent, delay, and treat
diabetes-related complications.
To improve health through
balanced nutrition.

11. A. Diet
• Diet is a basic part of management in every case. Treatment cannot be effective unless adequate
attention is given to ensuring appropriate nutrition.
• Dietary treatment should aim at:
• ensuring weight control
• providing nutritional requirements
• allowing good glycaemia control with blood glucose levels as close to normal as possible
• correcting any associated blood lipid abnormalities
i
i d bl d li id b
li i
• Recommended Carbohydrate consumed should be in the form of starch (polysaccharides)
• maize, rice, beans, bread, potatoes, cassava, wheat, couscous, semovita, plantain, ‘amala’,
garri, pap, etc.
• Non recommended Carbohydrate - All refined sugars
• Honey, glucose, sucrose, and their products (soft drinks, malt drinks, sweets, toffees, etc.)
should be avoided except during severe illness or episodes of hypoglycemia (reduced blood
glucose).
l
)
• Reduce Animal fat
butter, lard,
yolk pork,
cholesterol
• butter lard egg yolk, pork other foods high in saturated fatty acids and cholesterol, replaced
with polyunsaturated fats such as vegetable oils.

12. B. Exercise
e c se
• Physical activity promotes weight reduction and
improves insulin sensitivity, thus lowering blood
glucose levels.
• Together with dietary treatment, a programme of
regular physical activity and exercise should be
considered for each person Such a programme
person.
must be tailored to the individual’s health status
and fitness.
• People should, however, be educated about the
potential risk of hypoglycaemia and how to
i l i k fh
l
i
dh
avoid it.

13. C. Insulin Therapy
Short-term use:
• Acute illness, surgery, stress and emergencies
• Pregnancy
eg cy
• Breast-feeding
• Insulin may be used as initial therapy in type 2 diabetes in marked
hyperglycaemia
• S
Severe metabolic d
t b li decompensation (di b ti k t id i
ti (diabetic ketoacidosis,
hyperosmolar nonketotic coma, lactic acidosis, severe
hypertriglyceridaemia)
Long-term use:
• If targets have not been reached after optimal dose of combination
therapy or BIDS, consider change to multi-dose insulin therapy. When
initiating hi i li
i i i i this,insulin secretagogues should be stopped and insulin
h ld b
d d i li
sensitisers e.g. Metformin or TZDs, can be continued.

14. CHOLESTROL

15. Cholesterol
Soft, fat-like,
S ft f t lik waxy substance found in your body and in many
bt
f
di
b d
di
foods.
• Bl d
Bloodstream and cells
d ll
• Needed for cell membranes and hormones and to make vitamin
D
• Comes from 2 sources
– Body p
y produces it (
(mostly g
y genetic) in liver (
)
(1000 mg day)
g y)
– Food sources (animal products – meats, poultry, fish, eggs, butter,
whole milk, and cheese, not from plant sources) (100 – 500 mg day)
– Foods with trans fats or saturated fats may cause the body to produce
more cholesterol
• D we need cholesterol ??
Do
d h l t l
Yes, for our body to work well. But in excess amount,
cholesterol will build up inside the walls of our blood vessels.
vessels

16. GENDER AND HEART DISEASE
(WOMEN)
Most important risk factors
• Diabetes
• Low HDL
• High triglycerides
• Waist measurement of 35 inches or more
• I fl
Inflammatory di d
disorders
Symptoms/disease
• Fatigue, malaise, shortness of breath, nausea, depression
g ,
,
,
, p
• First heart attack at average age 70 with higher fatality rate than men
• More likely to have microvascular disease
Diagnostic procedures
• ECG stress test less informative than nuclear test
• When angiography shows no discrete lesions: IVUs and pressure flow studies
Treatment
T t
t
• Less likely to have bypass surgery or angioplasty for coronary lesions
• Longer hospital stays, higher complication rate
High LDL is responsible for 70% of heart diseases (leading killer of men and women after 45)
Every 2% raise in HDL = 2% in men and 3% in women decrease in CAD risk

17. GENDER AND HEART DISEASE (MEN)
(
)
Most important risk factors
• High LDL
• High blood pressure in young men
Symptoms/disease
• Unstable angina warrants immediate attention
• First heart attack at average age 65
g
p
Diagnostic procedures
• Stress tests more reliable than in women
• Angiography more likely to be informative
Treatment
• More likely to receive bypass surgery, angioplasty for coronary lesions
• Shorter hospital stays
• More likely to enter cardiac rehabilitation

18. ABOUT CHOLESTEROL
• Must be transported through blood
• Carriers are called lipoproteins
– Low-density lipoprotein (LDL)
– High-density lipoprotein (HDL)
• Lipoprotein = protein + fat
– LDL, more fat, less protein
– HDL, more protein, less fat
• LDL = “bad”
– Too much can clog arteries by forming plaque
– Atherosclerosis can cause heart attack or stroke
• HDL = “good”
– Tends to carry cholesterol away from arteries
and back to liver
– May also remove excess cholesterol from
plaque in arteries, slows buildup
•
Triglyceride not a cholesterol, also made in body (body fat stored as triglyceride)
cholesterol
and from food. Help transport dietary fat, metabolism. Trigger liver to make more
cholesterol, rising LDL and total cholesterol

19. Cholesterol Healthy Levels
y

20. C O S O &
CHOLESTROL &DIET

21. CHOLESTEROL & FAT COUNTER

22. What affects cholesterol?
• Diet
– Poly and monounsaturated fats may help lower
cholesterol when used in place of saturated fats, but still
limit
– High carbs, excessive alcohol may increase triglycerides
– S l bl fib may l
Soluble fiber
lower LDL not HDL
LDL, t
•
•
•
•
•
Weight
Physical activity
Age
Gender
Heredity
H di

23. Prevention o high c o este o
e e t o of g cholesterol

24. Why does it matter?
y
• Coronary heart disease is caused by atherosclerosis
• Single leading cause of death
• The higher LDL you have plus risk factors increases
risk for heart attack
–
–
–
–
–
Smoking
High Blood pressure
g
p
Low HDL
Family history of early heart disease
Age

25. Prevention of high cholesterol
g
•
•
•
•
•
•
Get it checked
Watch fats, eat healthy
Consume l than 300 mg of cholesterol a day
C
less th
f h l t l d
Be active
Quit smoking
Some may need medication

26. HYPERTENSION

27. HYPERTENSION
Hypertension means high blood pressure. High
blood pressure is an increased pressure in your
blood
bl d vessels, and th f
l
d therefore th
there i l
is less space
for your blood to travel through
It can be caused by many factors such as
stress, high cholesterol, and inactivity. It is
classified into mild, moderate, and severe
yp
you
,
,
hypertension. If y have mild, moderate, or
severe hypertension, you have an increased risk
of having a heart attack or a stroke.

28. U
UNTREATED HYPERTENSION
SO

29. BLOOD PRESSURE
 Hypertension is a major cause of morbidity and mortality.
yp
j
y
y
 Normal Blood pressure (BP):
o Systolic BP< 120mmHg or/and
o Diastolic BP < 80mmHg.
 Classification of BP is based on the average of two or more properly measured
seated BP readings on each of two or more office visits.
d
di
h f
ffi
ii
Blood Pressure classification
Normal
<120
And <80
Pre-Hypertension
120-139
Or 80-89
Stage 1 Hypertension
ype te s o
140-159
0 59
O 90 99
Or 90-99
Stage 2 hypertension
SBP mmHg
DBP mmHg
> 160
Or > 100

30. SYMPTOMS OF HYPERTENSION
• 1 in 3 adults has hypertension
• No symptoms, nearly 1/3 of those people don’t know they have
it
• No known cause
• 2 forces
– Blood pumps to arteries and through circulatory system
– Arteries resist blood flow
• Arteries elastic, stretchy
• Heart beats 60-80 times a minute
• Sodium/salt
– Holds excess fluid in body, heart has to work harder
• Potassium
– Blunts effects of salt on blood pressure

31. Factors Influencing the Development of
Hypertension
• Alcohol consumption
• Lack of exercise
• High-normal blood pressure
g
p
• Family history of hypertension
• Af i
African-American ancestry
A
i
• Stress management
g
• Overweight, reduce fat and
exercise..don't be a coach potato

32. LIFE STYLE MODIFICATION
 P i i l of lifestyle modification include:
Principles f lif t l
difi ti i l d
o Encourage healthy life styles for all individuals
o Prescribe life style modifications for all patients with prehypertension
and hypertension.
 Components of lifestyle modifications include
o weight reduction,
o DASH eating plan
plan,
o dietary sodium reduction,
o aerobic physical activity and
o moderation of alcohol consumption.

33. HEART DISEASE RISK FACTORS
• Uncontrollable
– A
Age
– Male gender
– Heredity (including race) – African Americans = higher blood pressure Also
pressure.
higher among other races
• Controllable
– Smoking (2-4x higher than non-smokers)
– High cholesterol (high HDL can be positive risk factor)
– Hi h blood pressure
High bl d
– Physical inactivity
– Obesity/overweight (especially in abdominal area)
– Diabetes
• Other factors
– Stress
– Too much alcohol
• Moderate drinkers = less risk than non-drinkers (may increase HDL
cholesterol)

34. WEIGHT MANAGEMENT

35. FAT IS A REQUIREMENT FOR LIFE
Q
FACTS:
• W can’t live without fats
We
’t li
ith t f t
• A fat-free diet is not healthy
• Too much may result in obesity & risks for diseases
FUNCTIONS:
• Supplies energy for our activities & body processes in building cells, bile
formation, hormone production, etc.
• Cushions our organs & protects our bones from injury
injury.
• Keeps us warm in cold weather.
V
, , ,
• A carrier for Vitamins A, D, E, K
• Source of the Essential Fatty Acids for:
– Growth
– M i t
Maintenance of healthy skin
f h lth ki
– Normal functions of brain & nervous system
• Adds flavor to food & satisfies our hunger longer.

36. FAT & CHOLESTEROL LIMITS
C O S
O
S
HOW MUCH FAT?
• No more than 30% of total calories
• E.g. if you consume 2000 calories/day,
g y
y
• 30% x 2000 calories = 600 calories
• 1 g fat = 9 calories
• 600 calories = 600 / 9 = 67 g of fat/day
HOW MUCH CHOLESTEROL?
• • Not more than 300 mg/day

37. FOODS TO AVOID & USE
OO S O
O
US

38. C
CHANGE EATING HABITS
G
G
S
•
•
•
•
•
•
•
•
•
Eat right
Avoid food that are rich in saturated fat.
y g
p
y
Look for the word “Hydrogenated” or “partially
hydrogenated” or “Trans fat “ on food labels.
Avoid food which has this label.
Limit how
Li it h much fried foods you eat.
hf i df d
t
Limit how many prepared baked goods you eat.
Eat fewer egg yolks, hard cheese, whole milk,
cream, butter and fatty meals.
Eat food that are high in fibre – Oats, peas, lentils,
beans, cereals and brown rice.
,

39. FOOD & EXERCISE REQUIRED TO BURN
OFF (1 0F 8)
Sandwich 5 pieces – 580 Calorie
Activity
• Swimming – 1 hr 20 min
• Walking moderate – 2 hr 10 min

40. FOOD & EXERCISE REQUIRED TO
BURN OFF (2 0F 8)
Banana 1 No. – 140 Calorie
Activity
» Singing – 9 min
» Walking moderate – 5 min

41. FOOD & EXERCISE REQUIRED TO
BURN OFF (3 0F 8)
Red Wine 175 ml glass – 119 Calorie
g
Activity
• Gardening for – 25 min
• Mowing for
- 20 min

42. FOOD & EXERCISE REQUIRED TO
BURN OFF (4 0F 8)
Beer one can 375 ml (or)
Whisky with soda 75 ml - 156 calorie
Activity
• Golf – 35 min
• Table tennis – 35 min
• Climbing stairs – 15 min

43. FOOD & EXERCISE REQUIRED TO
BURN OFF (5 0F 8)
Deep fried pork one piece – 84 Calorie
Activity
• ironing – for 40 min
•h
house work – f 20 min
k for
i

44. FOOD & EXERCISE REQUIRED TO
BURN OFF (6 0F 8)
Rice and Fish Curry – 514 Calorie
Activity
» Bowling - 3 hour 40 Min
g
» Bicycling – 2 Hour 40 min
» Child Care - 3 hour 10 min

45. FOOD & EXERCISE REQUIRED TO
BURN OFF (7 0F 8)
Indomie noodle 1 Bowl . – Calorie
Activity
• Health club exercise – 1 hr
• Moderate walking – 1 hr 30 min
366
Cal

46. FOOD & EXERCISE REQUIRED TO
BURN OFF (8 0F 8)
Jollof 1 plate . – Calorie 1000 Cal
Activity
• Carrying heavy loads– 2 hr 10 min
loads–

47. LACK OF SLEEP
Leptin - satiety hormone
Ghrelin - hunger hormone
low
high
DOs
• have regular sleep-wake pattern
• l
leave bedroom & d something relaxing
b d
do
thi
l i
• relax at the end of the day
Adults - 6 to 10 hours
DON’Ts
• avoid stimulating food / activities
• avoid arguments / debates
• avoid long afternoon naps

48. The Choice is Yours!
OBESE
OR
SLIM

49. Points to Ponder
•
Anything ingested contains
CALORIES except water and
green tea
•
Any
A unconsumed excess
d
calories will be stored for
future need as FAT cells
•
Balance between intake and
requirement
•
Simplest way is to
WATCH
YOUR
WEIGHT

50. Sexually Transmitted diseases

51. S
STD’S
S
SEXUALLY TRANSMITTED DISEASES
•
•
•
•
•
•
•
•
SYPHILIS
GONORRHEA
GENITAL HERPES
CONDYLOMATOSIS
AIDS
TRICHOMONIASIS
INGUINAL GRANULOMA
VENEREAL ULCERS
•
•
•
•
•
•
•
CHLAMYDIA
CANDIDOSIS
HEPATITIS B
NON SPECIFIC URETHRITIS
PEDICULOSIS
SCABIES
AMEBIASIS
IN 1995 WHO ESTIMATED THE NUMBER OF NEW CASES
OF STD AT 340 MILLION VULNERABLE GROUPS
•ADULTS
ADULTS
•DRUG USERS
•MIGRANT WORKERS
•SEX WORKERS

52. SYPHILIS
•
It is caused by a micro-organism
y
g
(Treponema Pallidum) that can be
found in the blood, skin and mucosal
lesions of the sick persons.
•
It is subdivided in three stages:
1. 10-90 days after infection the first
symptom (painless ulcer) begins at the
entrance spot.
t
t
2. Even if not treated, it regresses
spontaneously, b t th microorganism
t
l but the i
i
spreads throughout the whole body.
3.
3 The microorganism is almost non
nonexistent in the body, but it has already
created severe damages to different
organs. It can go on for decades.
Treponema Pallidum

53. Primary syphilis
y yp
Early syphilis (primary stage) – Ulcer of the penis: There is a
primary lesion of the penis.
Early syphilis (primary stage) – Ulcer: The ulcer is round with a well defined
edge. Th b
d
The base i clean. S hiliti ulcers are painless and are not t d until
is l
Syphilitic l
i l
d
t tender til
secondarily infected. Typically they are indurated.
Early syphilis (primary stage) –
Ulcers located on other areas: These
lesions are of a fi
l i
f finger and i th mouth
d in the
th
(oral lesion).
Thursday, October 10, 2013

54. Secondary Syphilis
Early
E l syphilis
hili
(secondary stage) –
Skin lesions:
syphilitic rash of the
forehead.
Early syphilis
(secondary stage)
– Skin lesions:
leukoderma coli
(“collar of Venus”):
Whitish patches in
areas of increased
pigmentation are
visible on the neck of
this patient.
Early syphilis
(secondary stage) –
(
d
t
)
Condylomata lata:
Multiple condylomata lata
of the perineum. These
raised, flat, wart-like skin
lesions are a t i l pale
l i
typical l
pink-gray in color. They
are highly infectious.

55. Syphilis - General Issues
yp
•
Nowadays it’s curable and rarely exceeds the first stage, obviously
if treated on time.
•
It can be diagnosed with blood analysis too.
•
It gives no immunity and reinfection is possible.
•
Treponema Pallidum goes beyond placental barrier infecting the
fetus and causing congenital syphilis.
•
It is extremely susceptible to high temperature and common
disinfectant.
disinfectant Therefore is transmissible only trough direct contact
with blood or skin lesions or mucous membranes full of
spirochetes.
Thursday, October 10, 2013

56. GONORRHEA
•
•
•
•
•
•
First symptoms appear 3-5 days after
the infecting contact
contact.
The bacterial agent is called: Neisseria
Gonorrhoeae.
Distinguished by abundant purulent
secretion, yellowish in color, from
urethra or uterus - particularly i th
th
t
ti l l in the
morning.
More than ever resistant to penicillin
If neglected or not treated at all brings
serious complications - sterility, chronic
p
y,
infections, narrowing of urethra, etc.
It is transmitted with any kind of sexual
intercourse.
Thursday, October 10, 2013

57. GONORRHEA
Gonorrhea – Cervicitis and Vaginitis: a white mucopurulent exudate
which is draining through the terminal p of womb (
g
g
part
(center of p
picture) and
)
vagina.
Gonorrhea – Urethral discharge: There is mild erythema of the external aperture of
urethra, which is a common f
feature.
Gonorrhea - Gonococcal arthritis: There is swelling and redness of the hand joints .
Arthritis is a common feature of extended gonococcal infection.
CLINICAL FEATURES
– URETHRAL
DISCHARGE
– PAINFUL URINATION
COMPLICATIONS
– EPIDIDYMITIS
– DISSEMINATED
SS
N
INFECTION
– URETHRALSTRICTURE

58. GONORRHEA GENERAL ISSUES

59. Chlamydia Infections
Chlamydial cervicitis
•
•
Chlamydial conjunctivitis
Chlamydial venereal lymphogranuloma
It is a very common disease and ma create sterilit both in men and women.
er
may
sterility
omen
After 1 - 3 weeks from infection the symptoms appear:
IN MEN it manifests with urethral inflammation and watery secretion associated with
burning. If not cured may cause testicle inflammation.
IN WOMEN it is manifested with prickly pain, vaginal secretion, abdominal pain. The
infection
i f ti can progress t th womb an i id abdomen causing severe i fl
to the
b
inside bd
i
inflammation
ti
with consequent sterility.

60. TRICHOMONAS
•
•
•
Parasite di
P
it disease, pathogen agent th t can b f
th
t that
be found i th urine,
d in the i
in vaginal secretion and sperm.
The man often do not present the disease symptoms When
symptoms.
present, they are the same as of urethral infection with whitish
secretion.
In women the abundant, white or yellow, frothy secretion with
unpleasant smell is observed, accompanied by burning and
vaginal pain as well as with pain during the sexual intercourse
pain,
intercourse.
Trichomoniasis – Vaginal discharge :There is a
profuse white discharge. P i d i th sexual
f
hit di h
Pain during the
l
intercourse is common

61. CANDIDOSIS
•
It is caused by a fungus called Candida Albicans.
•
Symptoms appear 3-90 days after infection.
•
g
p p
g
p
In men the redness of glandis and preputium together the white spots and
itching can be seen.
•
pp
In women this infection can appear also without sexual intercourse because
of the humidity and heat normally present in the genital region. It appears
with severe itching and redness of entire surface, with appearance of small
g
pp
white spots.
•
y
p
y
y
May be provoked by an indiscriminate use of antibiotics or by diabetes.
•
It requires a long treatment.
•
Candidal balanitis: Several discrete areas of redness on the
glandis penis. Such lesions may be asymptomatic but are
often associated with i it ti
ft
i t d ith irritation, soreness and mild pain
d ild i
during urination

62. VENEREAL DISEASES CAUSED BY PARASITES
Pediculosis, Scabies
,
•
•
•
•
•
•
These diseases are caused by insects. While the first is almost exclusively due
to sexual transmission, it has tendency to locate only in pubic area, the second
is transmitted with other kind of contacts too
too.
Both of them indicate the low level of personal and/or environmental hygiene
and can transmit also other types of diseases.
The most important symptom is itching, mostly during the night.
While crab-louse lives on pubic hair, Sarcoptes Scabies (element that gives the
disease called Scabies) lives under the skin where it bores real channels and
lays its eggs.
Scratching often creates skin lesions.
Besides the use of insecticides, the best treatment is the increment of hygiene.

63. VENEREAL DISEASES CAUSED BY VIRUSES
GENITAL HERPES
It shows up with small blisters on
external genitalia grouped lik
t
l
it li
d like
branch or chain. They are painful
and produce burning sensations.
The symptoms begin after 3-14
days after the infection
encountered during a non
protected sexual relationship with a
sick person. E
i k
Even after the
ft th
symptoms have disappeared virus
remains in the body and
periodically can cause the
reappearance of the symptoms.
Genital herpes – Ulcers of the penis
(foreskin retracted): Herpes lesions start
as redness or small blisters, which progress
to pustule formation and ulcer formation.
The lesions are usually painful and itchy
itchy.
Pain during urination is often present.

64. CONDYLOMATA
Symptoms begin 1-3 month
after the infection, with warts
grouped like a cauliflower, gray
Genital warts: Warts on penis.
or reddish in color sometimes
color,
with purulent secretion and
unpleasant smell. They can
appear on penis, vagina,
uterus, anus and rectum.

65. CHANCROID
• CLINICAL FEATURES
– ULCERS ON GENITAL
AREAS
– ENLARGED LYMPH
NODES
• COMPLICATIONS
– INFECTION OF ULCERS
– RUPTURE OF LYMPH
NODES

66. HEPATITIS B
Hepatitis is a serious disease of the
Liver. It is the inflammation (swelling) of
the Liver. It is also transmissible with
sexual intercourse, because the virus
that causes it can be found in saliva,
sperm,
sperm vaginal secretions blood etc
secretions, blood, etc.
• The symptomathology may appear
even 6 months after the infecting
g
contact.
• It damages liver cells and often
becomes
a
chronic
disease,
disease
worsening further with cirrhosis and
malign liver tumors.
• The contact with the virus can be
diagnosed trough specific blood tests.
• Today safe and effective vaccines
Today,
exist.

67. HEPATITIS

68. AIDS
It is a disease caused by the Human Immune Deficiency Virus (HIV) –
a virus that attacks and reduces the defense forces of the human body
and can cause AIDS;
Serum positive - Carrier of the HIV virus can transmit the infection to the
others and is likely t get sick of AIDS
th
d i lik l to t i k f AIDS;
AIDS (sickness) Acquired Immune Deficiency Syndrome, disease caused
by HIV virus (Final stage)
stage).

69. AIDS - Transmission
1. Sexual transmission – HIV is transmitted by both homosexual and
heterosexual contact; HIV infection is predominantly a sexually transmitted
disease; the virus has been demonstrated in sperm and vaginal fluid.
2.
2 Transmission by blood and blood products – 90 to 100 percent of
individuals who were transfused with HIV infected blood became infected;
among IDUs (injectable drugs users), HIV infection occurs trough parenteral
exposure to infected blood via contaminated drug paraphernalia (needles
and syringes).
3. Maternal-Fetal/Infant transmission – HIV infection can be transmitted
from an infected mother to her fetus during pregnancy or to her infant during
delivery.
delivery Postnatal transmission has been clearly documented strongly
documented,
implicating colostrum and breast milk as the vehicles of infection.

70. Primary infection
y
•Has an average incubation
period of 2 4 weeks
2-4
•Lasts approximately 1-2 weeks
Is
self limiting
•Is often self-limiting
FREQUENT SIGNS/SYMPTOMS:
 Fever
 Fatigue
 Pharyngitis
 Joints and muscular pain
 Night sweats
 Inflammation of lymphatic nodules
Loss of appetite and weight loss
 Rash and/or skin ulcerations
A 25 year old male with HIV
25-year-old
seroconversion rash and associated
fever and Lymphadenopathy.

71. Symptoms of late HIV infection





Fever
Dry cough
Persistent diarrhea
Unexplained weight loss
Retinitis
HIV Increases risk of
developing
life threatening illness
 Tuberculosis
 Pneumonia
 Meningitis
C
Cancers

72. Avoiding AIDS
g
• Unprotected sexual
intercourse
• Contaminated needles,
syringes etc
• Infected blood or blood
products
• Pregnancy, childbirth and
breast feeding

73. How STDs can be prevented?
Knowing very well your own partner - it is a fundamental precaution to
reduce the risk before having sex.
Avoiding frequent changing of partner - According to the experts
g
q
g g
p
g
p
change of more than one partner a year is considered promiscuous
behavior, therefore at risk.
Avoiding sexual relations with unknown persons or with those with
persons,
risky behaviors (promiscuous persons, drug addicts, homosexuals,
bisexuals) and with those whose attitudes we do not know.
Always using a condom - a mean not 100% safe against all venereal
diseases, but which undoubtedly reduces considerably the risk of
contagion.
g
Going to the physician - whenever suspecting to have a sexually
transmitted disease, or when unprotected sex with a partner having
STD,
STD especially by HBV or HIV has occurred
HIV,
occurred.
Abstaining from sexual intercourse - if having a sexually transmitted
disease, until completely cured.
p
y
Talking with the partner - regarding own sexual life and informing
him/her about eventual past sexually transmitted diseases.

74. ALCOHOL AND DRUG ABUSE

75. ALCOHOL & DRUG ABUSE
• Alcohol abuse means having unhealthy or dangerous drinking
habit such as drinking everyday or drinking too much at a time
• Drug abuse
g
 Using drugs in a way that harms the user or others.
 It includes abuse of :
i l d
b
f
o illegal drugs,
o prescription drugs
g
o over the counter drugs.

76. DRUG & ALCOHOL ABUSE IMPACTS
 Drug abuse and excessive alcohol consumption are p
g
p
plain dangerous.
g
 Alcohol and drug abuse affect
o health
o ability to function and think.
 Women are relatively affected even more than men.
 Al h l and drug abusers are danger to others
Alcohol d d
b
d
t th
o on the high ways,
o at work,
o at school and
o at home.
 Alcoholism
o often runs in families (genetic) but
(g
)
o drinking habits are influenced by your environment and
o Also influenced by life situation such as friends or stress levels

77. ALCOHOL AND DRUG ABUSE / DEPENDENCE
 Drug abuse like alcohol abuse can lead to
dependence
d
d
o where you become addicted to the drug.
 The drug eventually controls the life of the addicts
o Many consequences follows
o Taking more of the drugs over long period of time and need
more of the drugs to get “high”
o Spending and wasting valuable time trying to get drug and give
up other activities in your search for the drug.
Q
g
y
g
o Quitting difficulty – continue the use the drug even if it harms
your relationships and cause you physical problems.
o If you stop, you feel sick (withdrawal) syndrome

78. COMMON SIGNS OF ALCOHOL/DRUG ABUSE
 Changes in eating and sleeping habits.
g
g
p g
 Problems at work or school because of drunkenness. These range from lateness to
absenteeism.
 Less attention to dressing, grooming and less interest even in sex.
 Unnecessary anger/aggression towards others and treating others badly
badly.
 After drinking you can’t remember what happended while you were drinking
(blackouts)
 Poor family relationships.
 Dropping very good old friends for new ones-especially people who now indulge
with you in abuse of drugs.
 Sneaky behavior, lying or stealing.
 You cannot quit drinking or control how much you drink.
 Drinking more to get same effect.

79. PHYSICAL SIGNS OF DRUG ABUSE








Red eyes, sore throat, dry cough, feeling tired
Loss of weight
Needle marks on arms or other areas of the body
Small “pin point pupils
pin point”
Seeing things that do not exist (hallucinations)
Rapid heart rates, memory loss, impotence, infertility.
Tremors, convulsions,
Tremors convulsions violent conduct
Stupor, coma, death.

80. Commonly Abused Substance
•
ALCOHOL
•
METHAMPHETAMINE
cold pills,
cough syrups,
valium,
paracetamol
paracetamol,
codeine,
morphine,
•
MORPHINE
•
CANNABIS
•
COCAINE
•
•
BENZODIAZEPINE
AMPHETAMINE

81. Commonly Abused Substance
SUBSTANCE
ALCOHOL
METHAMPHE
TAMINE
MORPHINE
OTHER NAME /
BRAND NAME
ROUTE OF
USE
MEDICAL USE
ABUSE EFFECT
‘Beer,’ Wine,
‘Whisky’,
‘Brandy’,
Brandy
‘Cognac’, etc.
Orally
Antiseptic/ Disinfectant
(Ethyl / Methyl Alcohol External use only)
cirrhosis, major cause of deaths
and injuries due to accidents;
effects on a baby during pregnancy;
stomach pain due to a bleeding
ulcer or irritated stomach lining.
"speed "
speed,
"meth,"
"chalk," "ice,"
"crystal,"
"glass,"
" l "
“crank,”
and "tina."
Orally,
Orally
Intranasally
(snorting the
powder), by
needle
dl
Injection, or
by Smoking
Treatment for attention
deficit hyperactivity
disorder (ADHD); extreme
obesity, and narcolepsy
irritability, anxiety insomnia
irritability anxiety, insomnia,
confusion, tremors, convulsions,
and cardiovascular collapse and
death; (long-term effects) paranoia,
aggressiveness, extreme anorexia,
i
i
memory loss, visual and auditory
hallucinations, delusions, and
severe dental problems
p
Oramorph,
Astramorph,
Duramorph,
p
Infumorph
Orally, by IV
and IM
injection
j
Relief of pain associated
with myocardial infarction
(
(heart attack), sickle cell
)
crisis, surgery, trauma,
cancer, kidney stone;
adjunct to general and
epidural anesthesia
severe depression, anxiety,
insomnia, mood swings, amnesia
( g
(forgetfulness), low self-esteem,
)
confusion, paranoia, and other
psychological disorders

82. Commonly Abused Substance
OTHER NAME /
BRAND NAME
ROUTE
OF USE
MEDICAL USE
ABUSE EFFECT
Marijuana,
“ganja ”"grass "
ganja, grass,
"pot," and "weed"
Orally,
Smoking
Analgesia, or pain relief,
glaucoma treatment
problems with memory and
learning; distorted perception;
difficulty in thinking and problem
solving; depression, anxiety,
personality disturbances, loss of
coordination; increased heart rate;
di i
i
dh
and cancer of the lungs and other
parts of the respiratory tract
bennies, speed,
and uppers
SUBSTANCE
Orally, IV
injection
Treatment of attention
deficit hyperactivity
disorder (ADHD),
narcoplepsy and other sleep
disorder
inflammation of the heart lining,
damaged blood vessels, and skin
abscesses; increase blood pressure,
irregular heartbeat, rapid heart rate,
and irreversible, stroke-producing
damage to small blood vessels in
the brain, episodes of violent
brain
behavior, paranoia, anxiety,
confusion, and insomnia.
CANNABIS
AMPHETAMI
NE

83. Commonly Abused Substance
SUBSTANCE
COCAINE
OTHER NAME /
BRAND NAME
Blow, nose
d
candy,
snowball,
tornado, wicky
stick, Perico
,
(Spanish)
ROUTE OF
USE
MEDICAL USE
ABUSE EFFECT
Orally,
Sniffng/
S iff /
snorting or
blowing,
Smoking,
g,
Injection
Local (topical) anesthesia
bizarre, erratic, and violent
behavior, i it bilit
b h i irritability, restlessness,
tl
tremors, vertigo, muscle twitches,
paranoia, deaths resulting from
cardiac arrest or seizures followed
by respiratory arrest.
BENZODIAZE
PINE
Xanax, Lexotan,
Valium,
Midazolam,
Ativan,
Ai
Dormicum, etc.
Orally; IV
and IM
injection
Treatment of anxiety,
insomnia, agitation,
seizures, muscle spasm and
alcohol withdrawal
l h l i hd
l
hallucinations, slurred speech,
ataxia, coma, hypotonia, weakness,
altered mental status, impairment
of cognition, amnesia, paradoxical
f
ii
i
d i l
agitation, respiratory depression,
hypotension

84. EFFECTS ON BODY ORGAN AND SYSTEM
•
ANAEMIA -reduce oxygen carrying red blood cells leading to anaemia, trigger fatigue,
lightheadedness, shortness of breath etc.
• CIRRHOSIS -Alcohol/drug is toxic to liver cells, causing scarring of the liver and inhibiting
its functions (this may not be related to quantity) and is commoner in women.
•
CANCERS- increases the risk of cancers especially of the liver, cancers associated with
alcohol: oral (mouth) throat, esophagus, and breast
•
CARDIOVASCULAR DISEASES -leads to formations of blood clots in the blood vessels
Leads to heart attacks/stroke.
• HIGH BLOOD pressure-leads to kidney failure, heart diseases and stroke.
• Pancreatitis -causes stomach irritation (gastritis), Interfere with digestion leading to severe
abdominal pains, persistent diarrhea ,damage the organ that helps to regulate blood sugar
pains
damage
leading to diabetes.
cause
pins
needles
• DAMAGE TO NERVES -cause nerve damages leading to painful “pins and needles”
feelings, numbness of the extremities, as well as
• INFECTIOUS DISEASES - suppress the immune system providing a toehold for infections
like tuberculosis, HIV/AIDS, pneumonia & other STDs.
lik t b
l i HIV/AIDS
i
th STD
• OTHERS include seizures, depressions & dementia

85. CONCLUSIONS
• It is your choice to drink or use drugs;
• It is also your choice to seek advice, treatment or
QUIT

86. THANK YOU
OU
• IF YOU NEED MORE INFORMATION ON
TOPICS COVERED PLEASE CONTACT
YOUR HEALTH CLINIC
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