Disease, Nutrition, smoking and narcotics

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UNIT-6

Disease, Nutrition, smoking and narcotics

Any change from the normal stage that causes discomfort or disability or disturbs the health called a disease. All human disease can be classified into following;

1. Congenital Disease: They are anatomical or physiological abnormalities present in the person from birth also called natural diseases. For example; sickle cell anaemia, diabetes mellitus, haemophilia , etc.

2. Acquired disease: These are acquired by the person at any time after birth. They are of two types namely; communicable and non- communicable.

Types of disease:

A. Communicable and

B. non- communicable disease

Communicable and non- communicable disease

Diseases which are not transmitted from one person to another through any media are called non communicable diseases. It is believed that non communicable diseases are mostly the result of physiological disturbances, genetics, lifestyle, negligence and nutritional disorders. In some of the diseases, physiological function of our body system looks disturbed whereas in some of the diseases weakness and disabilities in organs are observed. The diseases like cancer, diabetes and asthma are the examples of non communicable diseases. Some of the communicable diseases may develop due to nutritional disturbances. Non communicable diseases are considered more dangerous than communicable diseases because the result of psychological disturbances, genetics, lifestyle, negligence and nutritional disorder. Non communicable diseases mostly have chronic nature such as cancer, Diabetes, so far no perfect cure has been found for such diseases.

Modes of transmission of communicable diseases:

Modes of transmission of communicable diseases are;

1. Contact transmission

2. Food and drinks

3. Air-borne infection

4. Insect born infection

5. Transplancental transmission

6. Skin infection

7. Transmission of contaminated blood

8. Transplantation of infected organs

Communicable diseases

Typhoid

It is one of the communicable disease and commonly called Enteric fever or Salient fever.

Symptoms:

At the beginning slow fever follow higher fever, headache, sweating, chill fever, nausea, gastro intestinal problems, slight abdominal pain, diarrhea, heart beat raises, number of WBCs reduces about 3000 per cubic mm, swelling of liver, spleen, loss of appetite, body weight loss and at the chronic stage blood may comes out in the stool shows ulceration in the intestine etc.

Causative agent:

The main causes of the Enteric fever is due to bacillus called salmonella of enterobacterioceae group. Salmonella constitute species;

S.paratyphi

S.typhi

S.enteridis

S.typhimurium

Shape and size: cylindrical or thread like, 3-4 µm.

Salmonella in patient blood can be easily identify by culturing blood to 24-48hrs.

Typhoid is also commonly called water borne disease because bacteria transmit very fastly through water media or any other contaminated foods.

Control Measures:

1.Patient must be isolate from other family members.

2.Patient belongings should sterilized well the direct sunlight for 4-6hrs.

3.Patient belongings can be treat by 1% phenol solution or dettol solution.

4.Patient urination and solid waste should be disposed scientifically.

5.Live in most hygienic way is the best control method.

Treatment:

The conformed typhoid should be checked by physician and medicines are given according to the advised of physician.

a.Cetamol

b.antibiotics as ciprofloxacin

c.chlorophenical

Ascariasis

Commonly called as warm disease or pet disease of South asian countries specially India, Nepal, Bangladesh, etc.

Symptoms:

In the children: very acute in children, expose gastro- intestinal disorders, severe abdominal pain, continous crying habit, eye balls looks like xeropthalmia, belly protrude out, nausea, vomiting, diarrhea, coughing, excessive growth of parasites may comes out from the mouth during vomiting, body weight loss, loss of appetite.

In adult: Disease is mild, expose slight pain in the abdomen, chances of pharyngitis, laryngitis, nausea, loss of appeitite,etc.

Causative agent:

Caused by endoparasites Ascaris lumbricoides commonly called roundworm.

Shape: body is long, cylindrical, unsegmented, colourless, sexes are separated ,etc.

Male: short with posterior end cured have a pair of pineal seta as copulatory organs and female is long, both ends straight, complete life cycle in 2 or more hosts. Its Juvenile stage is the main which reaches the blood vessels of brain may cause brain cyst.

Site or location: Intestine, Ileum and colon

Control Measures:

1.Live in most hygienic way.

2.Scientific disposal of solid wastes.

3.Sterilization of foods before feeding.

4.Nails of the children must be cut.

5.Education about impact of the disease should be known to common people, etc.

Treatment:

For children: antiwar syrup of Albendazole or Hebendazole.

For adult: tabs of Albendazole, Mebendazole, Piperizine.

Tuuberculosis:

Tuberclosis (T.B) is one of the very common communicating diseases, especially in village areas. It is said that more people died of T.B then other diseases in Nepal. Before 1960s T.B is the most dangerous diseases because of unknown treatment. From 1960-1970 yrs. Are called golden year of diseases, because most of the treatment of the diseases were discovered.

Symptoms of the disease:

Based upon the symptoms T.B is categorized in to two types.

1.Pulmonary T.B:

Gradually low fever raises to 105-106o F, increases in the chest pain, continuous coughing, body weight drastically looses, patient body looks skinless, appearances of fine holes in the lungs and at the coma, heart beat increases, pulse rate increases, fresh blood releases continuously in the sputum finally dies.

2.Extra pulmonary T.B:

a.Skin T.B: Change the colouration of skin wrinkling skin, skin damages etc.

b.Muscular T.B: Frequent muscular cramps, muscles damages due to tuber cluing chemical secreted by the agent.

c.Blood T.B: Fever ups and downs, no. of RBCs Reduces, lead anaemia, etc.

d.Abdominal T.B: Undigestion, gastro intestinal problem, stomach pain etc 

e.Brain T.B: loss of memory, Thinking dullness, body lethargy.

f.Bone T.B: low production of RBCs and WBCs, slow fracture heal up, etc.

Causative agent:

The main cause of T.B is due to Bacillus tubercle commonly known as Mycobacterium tuberculosis of the enterobacteacea group. It is common in man but in other domestic animals infected by M.bovis.

Modes of infection:

T.B is highly infectious diseases which can easily transmitted through any infective media such as infected food materials, vegetables, water, milk, patients belonging infected sputum, etc.

Incubation period:

Depending upon the site of infection incubation period of the bacteria changes, the average time period is about 4-6 weeks.

Control measures:

1.Due to infectious diseases, patient should be keep in isolation.

2.The belongings of the patient should be sterilized well.

3.Disease can be conform by skin inflammatory test.

4.Patient should keep in rehabilitation or completely in rest.

5.Patient should take BCG vaccine.                                                     

Treatment:

T.B can be cured completely either in primary stage or in secondary stage. If the patient is in primary stage, medicines are given at least for 9 months and in secondary stages medicine should given 18 month regularly on the basis of age, weight of the body.

Major medicines:

Refampsin capsule, Isonex tab., Ethambutol tab, pyraginamide tab, streptomycin injection.etc

AIDS (Acquired Immune Deficiency Syndrome):

It means with the loss of body immunity after the birth whose exact fact and treatment unknown. It is believed that an AIDS disease was transmitted by certain green monkeys found in central Africa. The first AIDS patient was found in Haiti, later in 1981 AIDS patient was identified in loss Angle USA. From European countries and after 1985 reported from Asian countries. In Nepal First AIDS patient was declared in 1988 from Biratnagar quarantine office.

General symptoms shown by the AIDS patient by checking the test in the blood

1.Unexplained long term fever-low or high

2.Unexplained loss of body weight.

3.Change in voice nature.

4.Appearence of glands in the body.

5.Appearence of white or pink spots in around the mouth cavities or in the abdominal region.

6.Maximum dancing night sweating and thirst.

7.Unexplained long term nagging cough.

Symptoms shown by the confirmed AIDS patient called ARC diseases.

Patients enter into ARC when damages T lymphocytes of the blood.

1.Diarrhoea or dysentery.

2.fever low or high frequently.

3.Suceptive to any diseases due to loss of body immunity.

4.Partial body paralysis sometimes whole body paralysis, dull memory, body lethargy, etc.

5.loss of body weight.

Mode of infection:

1.Person having the habit of polysex.

2.Person having the habit of homosex.

3. Person having the habit of drug addiction.

4.Transfusion of infected blood.

5.Use of single needle or operating equipment for several times.

Causative agents: Main causes of AIDS is virus, named as human immune virus(HIV), Human T-lymphocyte virus HTLV, Human lymphodenopathy associated virus HTLAV etc.

Control measures:

1.Stop polysex and homosexual habit.

2.Check the blood before transfusion.

3.Use of sterilized equipments.

4.Give up drug addication.

5.Use condom during sex with unknown person.

Treatment:

Still there are no such drugs yet discovered which can completely cure AIDS. The drug available in the market are only to extend lifespan.

Available Drugs: Azidothymidine(AZT) or Zidovudine, Rebavarium.

 Didonosine(DDS) and Zalcitabine.

Non communicable diseases

Cancer:

Hippocrate was the first who gave the word karkinos or cancer diseases. Later karkinos word change in to carcinomes which means cancer in the epithelial tissue. Cancer is non communicable but most dangerous diseases after AIDS. Cancer is mainly two types;

1.Benign cancer:

It is not dangerous cancer in which cells grows within limited area by connective tissue. At the place of growth may or may not have pain. In this type cell never migrate from one organ to the next. It is not fetal.

2.Malignant cancer :

Malignant cancer is commonly called as true cancer which also called tumor. On the basis of the site, cancer can be classified in to following types;

A.Carcinomas cancer: Cancer in epithelial tissue.

B.Leucomias Cancer: Blood cancer.

C.Sarcomas cancer: Cancer in the bone muscles etc.

D.lymphomas cancer: cancer in the lymph nodes or vessels.

Symptoms:

Early symptoms can hardly seen because primary stage of cancer do not exposes serious symptoms. Major symptoms are appears in secondary stages.

The symptoms shown by secondary stage of cancer

a.Blood cancer:

Body temperature raises, swelling of body, body looks pale coloured, Similarly anaemia disease, no of RBCs reduce, etc.

b.Abdominal cancer:

Appearances of malignant tumor, gastro intestinal problem,  nausea, vomiting, dysentery, diarrhea etc.

c.Lungs cancer:

Development of chest pain, coughing, Nagging or dry, development of fine pores in the lungs, lungs alveoli gradually filled with body lymph etc.

d.Brain cancer:

Mental retardness, slow body growth, abnormal size of the head, facial paralysis, check body movement or locomotion, etc.

Causative agent:

Till now, there is no such exact fact which causes cancer in the various organs of the body. There are many factors which causes are;

1.Smoking

2.Chewing of tobacco.

3.Physical Irritations or Injuries.

4.chemicals.

5.Ultraviolet Rays.

6.Viruses

7.Oncogenes.

Symptoms of cancer;

1.Any thickening or lump in the breast or elsewhere.

2.Any change in a mole or wart.

3.Any wound that does not heal.

4.Unusual bleeding or discharge.

5.Persistant cough or hoarseness.

6.Any change in normal bowel habits.

Diagnosis:

Cancer can be confirmed on the basis of certain pathological examinations. These include biopsy, microscopic examination of body fluids, Blood studies and x-ray.

Preventive measures:

1.To give up smoking and chewing tobacco as theses increase the changes of cancer.

2.To protect the body from excessive exposure of x-rays, ultra-violet rays, sunlight, etc.

3.To be aware of possible dangerous symptoms mentioned above.

4.To have regular medical checkup after age of forty.

Treatment:

The treatment of cancer varies according to the nature of cancer. The common weapons used to fight cancer are surgery, radiotherapy and chemotherapy.

Nutrition:

Nutrition is a process by which an organism obtains substances required for its proper growth, maintenance and to provide energy for all the activates.  Nutrition includes food intake, absorption, assimilation, biosynthesis, energy metabolism, catabolism and excretion.

Food or nutrient:

Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as fats, proteins, vitamins, or minerals. The substance is ingested by an organism and assimilated by the organism's cells to provide energy, maintain life, or stimulate growth.

Functions of food:

Food provides our bodies with what they need to;

1.stay alive, be active, move and work;

2.build new cells and tissues for growth;

3.stay healthy and heal themselves;

4.prevent and fight infections.

Food of human consists of;

1.Carbohydrates:

Carbohydrates are one of the main types of nutrients. They are the most important source of energy for your body. Your digestive system changes carbohydrates into glucose (blood sugar). Your body uses this sugar for energy for your cells, tissues and organs.

Daily requirement of carbohydrates;

Normal    -      2400kcl/day

Pregnant -       2400+300kcl/day

Lactating -        2400+500kcl/day

Infants     -         90+110kcl/day

Function of carbohydrates;

Carbohydrates have five major functions within the body:

1.Energy supply, carbohydrates are the principle source of energy.

2.Avoiding the breakdown of amino acid  for energy.

3.Avoiding  ketosis from the breakdown of fatty acids.

4.Cellular and protein recognition.

5.Carbohydrates as building blocks.

6.Carbohydrates as reserve food as they stored in form of starch and glycogen.

2.Protein;

Proteins are large molecules consisting of amino acids which our bodies and the cells in our bodies need to function properly. Our body structures, functions, the regulation of the body's cells, tissues and organs cannot exist without proteins. The human body's muscles, skin, bones and many other parts contain significant amounts of protein. In fact, protein accounts for 20% of total body weight. Protein is broken down in to amino acids.

Amino acids:

Amino acids are biologically important organic compounds composed of amine (-NH2) and carboxylic acid (-COOH) functional groups, along with a side-chain specific to each amino acid. The key elements of an amino acid are carbon, hydrogen, oxygen, and nitrogen, though other elements are found in the side-chains of certain amino acids. About 500 amino acids are known and can be classified in many ways

Characteristics of amino acid;

1.These are the basic unit of protein.

2.These are colorless, crystalline solids.

3.These are soluble in water and insoluble in organic  solvents such as alcohol, acetone, etc.

4.There are 20 types of amino acid in nature.

5.The simplest amino acid is glycine.

Categories of amino acids;

They are divided in to two classes.

1.Essential amino acids:

Essential amino acids cannot be made by the body. As a result, they must come from food.The nine essential amino acids are: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

2.Nonessential amino acids:

"Nonessential" means that our bodies produce an amino acid, even if we don't get it from the food we eat.They include: alanine, asparagine, aspartic acid, and glutamic acid.

Sources of protein:

The principle sources of proteins are both from plants and animals. In general the animal proteins are superior to plants proteins. There are two groups;

a.First class protein: The protein containing   all the types of amino acids. They are animal protein like egg, meat.

b.Second class proteins: The protein do not containing   all the types of amino acids. They are plant protein.

3. Lipids or fats:

Lipids are a group of naturally occurring molecules that include fats, waxes, sterols, fat-soluble vitamins (such as vitamins A, D, E, and K), monoglycerides, diglycerides, triglycerides, phospholipids, and others. The main biological functions of lipids include storing energy, signaling, and acting as structural components of cell membranes. Lipids have applications in the cosmetic and food industries as well as in nanotechnology.

Sources of fat:

Cooking oil, butter, ghee, oil seeds, milk, meat, cheese, eggs, etc.

Classification of lipids:

1. Simple Lipids:
On hydrolysis gives fatty acids and alcohol (trihydric or monohydric).

Oils: Unsaturated fatty acid + glycerol.
Fats: Saturated fatty acids + glycerol,
Waxes: Fatty acids + mono or dihydric alcohol.
Simple glyceride: Contains same fatty acids. .
Mixed glyceride: Contains different fatty acids.

2. Compound lipids: (Complex lipids):
On hydrolysis gives phosphoric acid, various sugars, sphingosine, ethanolamine and serine in addition to fatty acids and glycerol.

a.Phospholipid:  Fatty acids + glycerol + phosphoric acid + nitrogenous base.
e.g. Lecithin :Fatty acids + glycerol + phosphoric acid + choline
Cephalin: Fatty acids + glycerol + phosphoric acid + ethanolamine.

b. Glycolipids: Glycerol + fatty acid + Carbohydrates (on hydrolysis).

They are sub classified as galactosyl diglyceride, cerebrosides and sulpholipids.

c) Sphingophosphoiplds: Fatty acids + sphingosine + phosphoric acid + choline.

3) Derived Lipids: Hydrolytic products of simple and compound lipids

i) Alcohols: Glycerol and other sterol
ii) Fatty acids
iii) Terpenoids

Functions of lipids:

1.Lipid provide energy fuel.

2.lipid act as thermal insulator.

3.Tryglycerides stored in adipose tissue as principle food reserve.

4.Lipids serve as solvents for fat soluble vitamins like A,D, E , and K.

5.They absorb mechanical impact around organs like eyeball preventing external shock.

6.Lipoprotein can prevent bacterial disease.

4.Vitamins:       

 A vitamin is an organic compound and a vital nutrient that an organism requires in limited amounts. An organic chemical compound is called a vitamin.

Fat soluble vitamins:

The fat-soluble vitamins, A, D, E, and K, are stored in the body for long periods of time and generally pose a greater risk for toxicity when consumed in excess than water-soluble vitamins. Eating a normal, well-balanced diet will not lead to toxicity in otherwise healthy individuals. However, taking vitamin supplements that contain megadoses of vitamins A, D, E and K may lead to toxicity. The body only needs small amounts of any vitamin.

Vitamin A (Retinol):

Vitamin A, also called retinol, has many functions in the body. In addition to helping the eyes adjust to light changes, vitamin A plays an important role in bone growth, tooth development, reproduction, cell division, gene expression, and regulation of the immune system.

Sources: Fish, liver oil, egg yolk, butter, cheese, milk, yellow and dark green leafy vegetable, papaya, tomatoes , carrots, guava, mango, etc.

Deficiency: Night blindness,  Xerophthalmia,  Reaterded growth, loss of glandular secretion, etc.

Vitamin D: Vitamin D plays a critical role in the body’s use of calcium and phosphorous. It works by increasing the amount of calcium absorbed from the small intestine, helping to form and maintain bones. Vitamin D benefits the body by playing a role in immunity and controlling cell growth. Children especially need adequate amounts of vitamin D to develop strong bones and healthy teeth.

Sources: Vitamin D is  found in oily fish (e.g., herring, salmon and sardines) as well as in cod liver oil. In addition to the vitamin D provided by food, we obtain vitamin D through our skin which produces vitamin D in response to sunlight.

Difeciency: Rickets or rachitis, Osteomalacea, teeth tetany.

Vitamin E:

 It is also known as beauty vitamin because it maintains germinal epithelium of gonads for proper reproductive function. Vitamin E benefits the body by acting as an antioxidant, red blood cells, and essential fatty acids from destruction.

Sources: About 60 percent of vitamin E in the diet comes from vegetable oil (soybean, corn, cottonseed, and safflower). Vitamin E sources also include fruits and vegetables, grains, nuts (almonds and hazelnuts), seeds (sunflower) and fortified cereals.

Deficiency: Reversible sterility in females, Sperm sterility in males, Macrocytic anaemina, muscular dystrophy.

Vitamin K:

Vitamin K is naturally produced by the bacteria in the intestines, and plays an essential role in normal blood clotting, promoting bone health, and helping to produce proteins for blood, bones, and kidneys.

Sources: Good food sources of vitamin K are green, leafy-vegetables such as turnip greens, spinach, cauliflower, cabbage and broccoli, and certain vegetables oils including soybean oil, cottonseed oil, canola oil and olive oil. Animal foods, in general, contain limited amounts of vitamin K.

Deficiency: Causes blood clotting, Hypoprothrombinaemia, Haemorrhage,

Water-Soluble Vitamins:

These types of vitamins require regular supply in the form of dietary sources or supplements. These are nontoxic and easily absorbed into the body through the gastrointestinal tract and then disseminated in the tissues. Water-soluble vitamins are easily dissolved in water, it would be advisable not to overcook them and use the left over cooking water as healthy options in soups and sauces.

Vitamin B 1 (thiamine): Part of an enzyme needed for energy metabolism, important to nerve function.

Sources: Found in all nutritious foods in moderate amounts: pork, whole-grain or enriched breads and cereals, legumes, nuts and seeds

Deficiency: Bery-bery, weight loss, weakness, nausea, constipation, etc.

Vitamin B2 (Riboflavin): Part of an enzyme needed for energy metabolism; important for normal vision and skin health.

Sources: Milk and milk products; leafy green vegetables; whole-grain, enriched breads and cereals.

Deficiency: Cheilosis, Glossitis, Keratitis, Saborrhic dermatitis.

Vitamin B3: Part of an enzyme needed for energy metabolism; important for nervous system, digestive system, and skin health.

Sources: Meat, poultry, fish, whole-grain or enriched breads and cereals, vegetables (especially mushrooms, asparagus, and leafy green vegetables), peanut butter.

Deficiency: Pellagra

Vitamin B5: It act as cheek anti-dermatitis factor.

Sources: Widely distributed in foods.

Deficiency: Rare

Vitamin B6: Part of an enzyme needed for protein metabolism, helps make red blood cells.

Sources: Meat, fish, poultry, vegetables, fruits.

Deficiency:  Dermatitis, paralysis

Vitamin B7: It directly participated in the carboxylic rexn.

Sources: Liver, kidney, egg, yolk, milk, grains, etc.

Deficiency: Acne vugaris, anemia, nausea, etc.

Vitamin B9: It act s as the coenzymes for synthesis protein. Part of an enzyme needed for making DNA and new.

Sources: Green leafy vegetable, cereals, liver, kidney, eggs, etc.

Deficiency: marcocytic  anaemia.

Vitamin B12: Part of an enzyme needed for making new cells; important to nerve function.

Sources: Meat, poultry, fish, seafood, eggs, milk and milk products; not found in plant foods.

Deficiency: pernicious anaemia.

Vitamin C:

Vitamin C is a water-soluble vitamin that is necessary for normal growth and development. Water-soluble vitamins dissolve in water. Leftover amounts of the vitamin leave the body through the urine. That means you need a continuous supply of such vitamins in your diet.

Sources:

Cantaloupe, Citrus fruits and juices, such as orange and grapefruit, Kiwi fruit, Mango, Papaya, Pineapple, Strawberries, raspberries, blueberries, cranberries, Watermelon, etc.

Deficiency:  Anemia, Bleeding gums, Decreased ability to fight infection, Decreased wound-healing rate, Dry and splitting hair, Easy bruising, Nosebleeds, Rough, dry, scaly skin, Swollen and painful joints, Weakened tooth enamel.

Minerals:

Minerals are important for your body to stay healthy. Your body uses minerals for many different jobs, including building bones, making hormones and regulating your heartbeat.

Macrominerals

Major minerals
Mineral	Function	Sources
Sodium	Needed for proper fluid balance, nerve transmission, and muscle contraction	Table salt, soy sauce; large amounts in processed foods; small amounts in milk, breads, vegetables, and unprocessed meats
Chloride	Needed for proper fluid balance, stomach acid	Table salt, soy sauce; large amounts in processed foods; small amounts in milk, meats, breads, and vegetables
Potassium	Needed for proper fluid balance, nerve transmission, and muscle contraction	Meats, milk, fresh fruits and vegetables, whole grains, legumes
Calcium	Important for healthy bones and teeth; helps muscles relax and contract; important in nerve functioning, blood clotting, blood pressure regulation, immune system health	Milk and milk products; canned fish with bones (salmon, sardines); fortified tofu and fortified soy milk; greens (broccoli, mustard greens); legumes
Phosphorus	Important for healthy bones and teeth; found in every cell; part of the system that maintains acid-base balance	Meat, fish, poultry, eggs, milk, processed foods (including soda pop)
Magnesium	Found in bones; needed for making protein, muscle contraction, nerve transmission, immune system health	Nuts and seeds; legumes; leafy, green vegetables; seafood; chocolate; artichokes; "hard" drinking water
Sulfur	Found in protein molecules	Occurs in foods as part of protein: meats, poultry, fish, eggs, milk, legumes, nuts

Trace minerals (microminerals)

The body needs trace minerals in very small amounts. Note that iron is considered to be a trace mineral, although the amount needed is somewhat more than for other microminerals.

Trace minerals
Mineral	Function	Sources
Iron	Part of a molecule (hemoglobin) found in red blood cells that carries oxygen in the body; needed for energy metabolism	Organ meats; red meats; fish; poultry; shellfish (especially clams); egg yolks; legumes; dried fruits; dark, leafy greens; iron-enriched breads and cereals; and fortified cereals
Zinc	Part of many enzymes; needed for making protein and genetic material; has a function in taste perception, wound healing, normal fetal development, production of sperm, normal growth and sexual maturation, immune system health	Meats, fish, poultry, leavened whole grains, vegetables
Iodine	Found in thyroid hormone, which helps regulate growth, development, and metabolism	Seafood, foods grown in iodine-rich soil, iodized salt, bread, dairy products
Selenium	Antioxidant	Meats, seafood, grains
Copper	Part of many enzymes; needed for iron metabolism	Legumes, nuts and seeds, whole grains, organ meats, drinking water
Manganese	Part of many enzymes	Widespread in foods, especially plant foods
Fluoride	Involved in formation of bones and teeth; helps prevent tooth decay	Drinking water (either fluoridated or naturally containing fluoride), fish, and most teas
Chromium	Works closely with insulin to regulate blood sugar (glucose) levels	Unrefined foods, especially liver, brewer's yeast, whole grains, nuts, cheeses
Molybdenum	Part of some enzymes	Legumes; breads and grains; leafy greens; leafy, green vegetables; milk; liver

Balanced diet:

 A diet that consists of right amount of essential nutrients such as carbohydrates, proteins, fats, vitamins, minerals, roughage and water required by the body is called balanced diet.

 A balanced diet is important because your body’s organs and tissues need proper nutrition to work effectively. Without good nutrition, your body is more prone to disease, infection, fatigue, and poor performance. Children with a poor diet run the risk of growth and developmental problems. Bad eating habits can continue for the rest of their lives a person’s daily calorie intake should be based on age, gender, and physical activity level. Men generally need more calories than women, and active people need more calories than sedentary (inactive) people.

Malnutrition:

A term used to refer to any condition in which the body does not receive enough nutrients for proper function. Malnutrition may range from mild to severe and life-threatening. It can be a result of starvation, in which a person has an inadequate intake of calories, or it may be related to a deficiency of one particular nutrient (for example, vitamin C deficiency). Malnutrition can also occur because a person cannot properly digest or absorb nutrients from the food they consume, as may occur with certain medical conditions. Malnutrition remains a significant global problem, especially in developing countries.

Marasmus:

A rapid deterioration in nutritional status in a short time can lead to marasmus, one form of acute malnutrition. Marasmus is the most common form of acute malnutrition in nutritional emergencies and, in its severe form, can very quickly lead to death if untreated. It is characterized by severe wasting of fat and muscle which the body breaks down to make energy. Wasting can affect both children and adults.

Kwashiorkor:

Some children with acute protein-energy malnutrition develop oedema. Oedema is an accumulation of fluid in the tissue, especially the feet and legs. Such children may not lose weight when developing acute protein-energy malnutrition because the weight of this excess oedema fluid counterbalances the weight of lost fat and muscle tissue. These children may look fat or swollen. Such children have kwashiorkor.

Drug abuse:

Drug is chemical substances that alter the physiological state of a living organism. Drugs are widely use in medicine. The study of drug is called pharmacology.

Causes of drug addiction:

1. A person may experiment because he or her friend suggests it.

2.To satisfy own curiosity.

3.For the feeling of relaxation.

4.To escape from a difficult situation.

5.In search of a more satisfying life.

Types of drugs:

According to the mode of action the psychotropic drugs are classified into two types;

a.Narcotics drugs:

It leads temporary feeding of cell being, freedom from anxiety, produces normal sleep and relief from pain. The excess dose of these drugs lead rate of respiration reduces, reduces, reduces cardio vascular activities etc.

b. Stimulant or antidepressant drugs:

These drug Commonly called as mood elevating drugs. The right dose of intake may increase self confidence and mental alertness. The drug of these group can be called as Amphitamins. Such as tea, coffee.

Control measures of Drug addiction:

1.Treatment and hospitalization.

2.Rehabilitation

3.Psychological treatment

4.Imlemention of the strict rules and regulation.

5.Education and awareness program.

Alcoholism (Alcohol addiction)

Ethyl alcohol and alcohol is among the most commonly substances by human. Alcohol is manufactured by fermentation of sugar an organism like yeast.

Alcohol addiction: The prolonged use of alcohol may lead the dependence of the body on it is called alcohol addiction.

The reasons of alcohol addiction are;

1.Feeling of independence.

2.Overcoming frustration, failures and disappointments.

3.Desire of Excitement and to do more work.

4.Relief from pain and  worries.

5.Curiosity and use of drink in social, cultural and religious function.

Effects of alcohol drinks:

1.Ill-effects alcoholic drinks on individual and health:

Alcohol causes ill effects on various organs like on

a.Nervous system: Loss of will power, self control and judgment.

b.On stomach: Alcohol causes secretion of gastric juices which causes gastritis problem.

c.On liver: Liver changes alcohol in to highly toxic compound, which may the cause of death.

d.On heart: It increases the blood pressure and adversely affect on function of hearth.

e.On kidney: Alcohl interferes with the normal functioning of nephrons in kidney.

f.Alcohol lowers the blood sugar level.

g.On reproduction: In women, it particularly affects the ovulation and menstrual cycle.

2.Ill-effects of alcoholic drinks on family:

 Alcohol drinking has a socio-economic impact because excessive drinking or alcoholism affects the family, growth and development of children adversely.

3.Ill-effects of alcoholic drinks on community or society:

 Social crimes like corruption, rapes, accident, loss of social reputation and personality.

Symptoms of alcoholism:

1.Loss of will power, self-control, judgment and emotional control.

2.Visual problem like blurred vision , double vision and improper judgment of distances.

3.Leads to neuritis, amnesia, gastritis.

4.Increase the blood pressure and lower the sugar level.

5.In women it effect on menstrual cycle.

Control of alcoholism:

 1.Treatment and hospitalization.

2.Rehabilitation

3.Psychological treatment

4.Imlemention of the strict rules and regulation.

5.Education and awareness program.

Smoking

The regular consumption of tobacco in form of either cigarette, or chewing causes dependency on tobacco is called smoking. In Nepal 55% of total population consumes tobacco. Among them 48% are below 15 years.

Tobacco contains highly poisonous alkaloid drug called nicotine. Its smoke contains approximately 400 different chemicals. Such as formaldehyde, polycyclic hydrocarbons like tar, carbon monoxide, etc.

Effect of Nicotine: 

1.Stimulate the conduction of nerve impulses.

2.Stimulate adrenal medulla to secrete adrenaline hormone.

3.Increase rate of heart beat and blood pressure.

4.Increase constriction of blood vessels.

Effect of smoking:

Following diseases are associated with smoking

1.Cancer:Cigarete smoke contains chemical substances called carcinogens, which causes cancer.

2.Bronchitis: When person smokes, a tiny particles in the smoke get stuck on the lining of the trachea and bronchial tubes.

3.Emphysema: The breakdown of alveoli wall  reduces alveolar surface of gaseous exchange. Eventually, lung tissues destroy so much and finally the patient dies.

4.Asthma: It is more serious diseases, the walls of bronchioles contract and the tubes become narrower. Breathing become diffucut.

5.Heart diseases: A chemical substance nicotine affects the heart, cause constriction of peripheral blood vessels and  increases heart beat.

Symptoms of smoking:

1.A nagging morning cough may be one of the sign of tobacco habit.

2.Shortness of breath, wheezing, etc.

3.Increases fatigue, decreases the smokers sense of smell and taste.

4.Dry mouth and lips and red eyes.

Treatment:

There are wide ranges of treatments like hypnotherapy, herbs, Acupuncture etc can help a smoker quit the habit.