Module III- IMMUNODEFICIENCY DISORDERS - • Cancer; • Aids; •

Obesity; • Alcoholism; • Smoking; • Lifestyle disorders

CANCER ( Lifestyle Disorder)

Cancer refers to any one of a large number of diseases characterised by the development
of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy
normal body tissue. Normal cells show a property called contact inhibition, by virtue of
which contact with other cells inhibits their uncontrolled growth. Cancer cells appear to
have lost this property. As a result of this, cancerous cells just continue to divide, giving
rise to masses of cells called tumours. Hence, most types of cancer have tumours (except
for cancers of the blood).

● Types of Tumour
A tumour is classified into one of these three types based on its ability to undergo
metastasis (spreading):
➔ Benign Tumour - These tumours are localised at a particular location in the body.
It does not spread to other parts of the body and is generally harmless. However,
when a benign tumour occurs in areas such as the brain, it can cause death.
➔ Premalignant Tumours - This type of tumour may be benign, but it is observed
to have the characteristics of a malignant tumour. In other words, a premalignant
tumour is a type of tumour that has an increased risk of becoming cancer. Benign
tumours become premalignant and, eventually, malignant.
➔ Malignant Tumour - These tumours are cancerous, which means that they will
grow rapidly and spread to other normal tissues in the body. The ability to spread
is known as metastasis. Cancer cells typically metastasize when they enter the
bloodstream or lymph nodes, causing secondary tumours throughout the body.
 ● Types of Cancer
Cancers are named after the organs or tissues in which they develop. The classification
process also takes into account the particular cell type—such as squamous or epithelial
cells—that gives rise to cancer.
a. Carcinoma: The Most CommonType- The most common type of cancer is
carcinom. It originates from the epithelial cells ( a type of cell that covers the
inside and outside of the surfaces of your body)

b. Sarcoma: Affecting Bone and Soft Tissues - It develops in bone and soft tissues,
encompassing muscle, fat, blood vessels, and lymphatics, as well as fibrous tissues
like tendons and ligaments.

c. Leukaemia: Blood-Related Cancer- Leukaemia is a cancer originating from

bone marrow,that causes abnormal white blood cells to accumulate in the blood
and bone marrow, displacing normal blood cells, unlike other cancers.

d. Lymphoma: Involving Lymphocytes- Lymphoma is characterised by the

malignancy of lymphocytes, a type of white blood cell crucial for the immune
system. In this type of cancer, abnormal cells accumulate in the body's lymph
nodes, lymphatic vessels, and other organs.

e. Melanoma: Skin and Beyond - Melanoma is a cancer that begins in

specialised melanocytes, cells responsible for producing melanin. While
most melanomas develop in the skin, they can also occur in other pigmented
tissues, including the eye.

● Causes of cancer :
Cancer is primarily caused by mutations in DNA, which can be inherited or acquired
through exposure to specific drugs and environmental conditions. Carcinogens, which
can be physical, chemical, or biological, increase the risk of cancer by transforming
normal cells into cancerous, neoplastic ones.
a. Physical Carcinogens:Ionizing radiations like X-rays and gamma rays and non-
ionizing radiations like UV cause DNA damage, leading to neoplastic
transformation.
b. Chemical Carcinogens: Examples include cigarette smoke, asbestos, alcohol, air
pollution, and certain chemicals found in contaminated food and drinking water.
These are substances that, when encountered, can potentially lead to cancer.
 c. Biological Carcinogens: several genes called cellular oncogenes (c-onc) or proto
oncogenes have been identified in normal cells that, when activated under certain
conditions, could lead to oncogenic transformation of the cells.

● Diagnosis of Cancer
Various methods and techniques are employed to identify the presence of cancer cells
and tumours in the human body.
➔ Biopsy - A biopsy is a medical procedure where a sample of tissue is collected
from the suspicious area and examined under a microscope.

➔ Radiography Techniques - Radiography techniques, such as X-rays, are often

used to capture images of affected areas in the body. These images help in the
identification of abnormalities, including tumours or irregular masses that might
be indicative of cancer.

➔ Computed Tomography (CT) - Computed Tomography, commonly known as

CT or CAT scans, provides detailed cross-sectional images of the body. It aids in
the detection and localization of cancerous growths. CT scans are particularly
valuable for visualising solid organs and bones.

➔ Magnetic Resonance Imaging (MRI) MRI is another imaging technique that

provides high-resolution images for the assessment of cancer, especially in soft
tissues. It offers excellent contrast and is highly effective in identifying
abnormalities in various parts of the body.

➔ Molecular Biology Techniques - These methods involve analysing genetic and

molecular markers to detect cancer-related mutations and abnormalities. Scientists
can identify particular genetic abnormalities linked to certain forms of cancer by
examining cell DNA and RNA

● Treatment of Cancer
Cancer treatment is a collaborative effort that involves various approaches, each tailored
to address specific aspects of the disease. In this comprehensive guide, we will explore
the primary methods of cancer treatment, their objectives, and how they contribute to the
well-being of cancer patients.
 - Primary Treatment - The basic goal of cancer treatment is to remove cancer
from the body or destroy all cancer cells. While different basic treatment options
exist, surgery is the most typical strategy for the most common kinds of cancer.
- Adjuvant Treatment - Adjuvant therapy focuses on eliminating any residual
cancer cells after primary treatment to reduce the risk of cancer recurrence.
- Palliative Care - Palliative care treatments are intended to decrease treatment-
related adverse effects or cancer-related symptoms. They include a variety of
therapies, such as surgery, radiation, chemotherapy, and hormone therapy, that can
alleviate pain and discomfort.

Treatment involves-
➔ Surgery- The primary goal of surgery is the complete removal of malignant tissue,
whenever possible.
➔ Chemotherapy - Chemotherapy employs drugs to target and eliminate cancer
cells.
➔ Radiation Therapy - Radiation therapy uses high-energy rays, such as X-rays or
protons, to obliterate cancer cells.
➔ Bone Marrow Transplant -, also known as a stem cell transplant, involves using
either the patient's own bone marrow stem cells or those from a donor to restore
healthy blood cell production.
➔ Immunotherapy Procedure -, a biological treatment, leverages the body's
immune system to combat cancer. It addresses the challenge where the immune
system fails to recognize cancer as a threat, allowing it to proliferate unchecked.
➔ Cryoablation - is a treatment that uses cold temperatures to destroy cancer cells.
A cryoprobe, filled with gas, is inserted into the tumour, freezes the tissue, and
then thaws ( to (cause to) change from a solid, frozen state to a liquid or soft one,
because of an increase in temperature) it multiple times to effectively eliminate
cancer cells.

AIDS
The word AIDS stands for Acquired Immuno Deficiency Syndrome. This means
deficiency of the immune system, acquired during the lifetime of an individual indicating
that it is not a congenital disease. ‘Syndrome’ means a group of symptoms.

HIV (human immunodeficiency virus), a member of a group of viruses called

retroviruses, which have an envelope enclosing the RNA genome, attacks cells that help
the body fight infection, making a person more vulnerable to other infections and
diseases. It is spread by contact with certain bodily fluids of a person with HIV.
AIDS is the late stage of HIV infection that occurs when the body’s immune system is
badly damaged because of the virus.
● Symptoms include :

● Transmission Of HIV
The virus is transmitted through specific body fluids like blood, semen, rectal fluids,
vaginal fluids, and breast milk, but cannot be spread through sweat, saliva, or urine.
HIV can be spread if these fluids come into contact with:
● Mucous membranes (inside of the mouth, penis, vagina, rectum)
● Damaged tissue (tissue that has been cut or scraped)
● The blood stream by injection
Transmission of HIV-infection generally occurs by
a. sexual contact with infected person,
b. by transfusion of contaminated blood and blood products,
c. by sharing infected needles, as in the case of intravenous drug abusers and
d. from an infected mother to her child through the placenta.
HIV/AIDS is transmitted through body fluids, not through touch or physical contact.
Therefore, it's crucial for infected individuals to maintain their physical and
psychological well-being by not being isolated from family and society.
There is always a time-lag between the infection and appearance of AIDS symptoms.
This period may vary from a few months to many years (usually 5-10 years).

➔ After getting into the body of the person, the virus enters into macrophages where
virus replicates to form viral DNA with the help of the enzyme reverse
transcriptase continuing to manufacture viruses, acting as an HIV factory.
➔ HIV infects helper T-lymphocytes (TH), replicates, and produces offspring
viruses.
➔ These offspring attacks other T-lymphocytes, resulting in a decline in helper T
cell numbers. This leads to fevers, diarrhea, and weight loss.
➔ As the number of helper T cells decreases, the person becomes susceptible to
diseases caused by bacteria, viruses, fungi, and parasites.
The patient becomes so immuno-deficient that he/she is unable to protect himself/herself
against these infections

● Diagnosis of AIDS
There are three types of HIV tests:
➔ Antigen/antibody Tests- Antigen tests check for markers on the surface of HIV
known as p24. Antibody tests examine the molecules your body makes when it
reacts to those markers. HIV antigen/antibody tests detect both.
 Blood is drawn from your arm to be analysed for p24 and its antibodies.
Antigen/antibody tests typically detect HIV within 18 to 45 days after exposure.
Rapid tests can be taken, which use a finger prick, require at least 18 days and may
take up to 90 days for accurate results. Rapid tests may require up to 90 days for
accurate results.

➔ Nucleic Acid Tests (NATs) - Blood is drawn as a sample from your arm, which is
then tested for HIV using a National Antiretroviral Test (NAT). This test can
identify HIV 10 to 33 days after exposure but is not commonly used unless high-
risk exposure occurs. If positive, additional tests may be recommended, including
a complete blood count, viral hepatitis screening, chest X-ray, and tuberculosis.

➔ ELISA- known as enzyme-linked immunosorbent assay,is a blood test that helps

detect HIV antibodies. The Elisa test is a biochemical method mainly used in
immunology to detect the presence of an antibody or antigen in a sample.
Antibodies are proteins your immune system produces in response to the presence
of foreign substances, such as viruses. If you test positive for HIV on the ELISA
test, your provider will order the Western blot test to confirm HIV infection.

● Treatment and Medication

There is currently no cure for HIV and AIDS but there are many treatment options that
can slow the progression and can only prolong the life of the patient but cannot prevent
death, which is inevitable
It is treated with a combination of medicines (pills) called antiretroviral therapy (ART),
as combinations of pills are the most effective way to keep HIV from multiplying and
destroying your cells.
ART aims to reduce HIV levels in the blood, slowing its immune system's weakening,
and prevent the virus from spreading to sexual partners. It is crucial for pregnant women
with HIV to take ART as soon as possible to protect their health and prevent HIV
transmission to the fetus or baby through breast milk.
Antiretroviral drugs given to people without HIV can prevent the disease, but they must
be taken every day for the rest of a person’s life. Types of ART medications include:
● Fusion inhibitors.
● Attachment inhibitors.
● Post-attachment inhibitors.
● Combination of HIV medicines.
 ● Prevention Of AIDS
AIDS has no cure, so prevention is crucial. The National AIDS Control Organization
(NACO) and NGOs are educated about the disease, ensuring safe blood from blood
banks, using disposable needles and syringes, free condom distribution, controlling drug
abuse, advocating safe sex, and promoting regular HIV check-ups in susceptible
populations. These measures reduce the risk of contracting AIDS:-
● Use latex condoms for all sex types, avoid animal-based condoms like lambskin,
● Use water-based lubricants, like lotion.
● Avoid sharing needles for drug use
● Get tested and treated for other sexually transmitted infections (STIs), as they
increase HIV infection risk.

ALCOHOLISM
Alcoholism is the continued drinking of alcohol despite negative results. The term
alcoholism was first used, but alcoholism and alcoholic are stigmatising and discourage
seeking treatment, so clinical diagnostic terms such as alcohol use disorder or alcohol
dependence are used instead. Alcoholism, as it is commonly understood, is referred to
as AUD.
Alcohol is addictive, and heavy alcohol use leads to negative health and social
consequences, including sleep issues, cognitive disorders like dementia, brain damage,
heartbeat irregularity, poor immune response, liver damage, increased cancer risk,
withdrawal symptoms, and a ten-year life expectancy. Pregnant women's health may also
be affected. Alcoholism is linked to increased violent and nonviolent crime.

● Effects Of Alcoholism
If you are drinking more than that at any one time, you may be misusing alcohol.
Excessive drinking is defined as 15 drinks or more a week for men and 8 drinks or more a
week for women, but AUD is different. In addition, AUD is an addiction disorder, which
means you may have a difficult time stopping alcohol consumption, even when you want
to. The definition of AUD also includes the impact that such drinking has on your health
and life.
➔ LONG TERM MISUSE ISSUE
Alcoholism is a condition characterized by increased tolerance to alcohol and physical
dependence, making it difficult for individuals to control their consumption. This
dependency can lead to a strong urge to drink, reducing the ability to stop drinking in
individuals with an alcohol use disorder.

➔ PHYSICAL EFFECT
◆ Short-term effect
- Drinking enough alcohol can improve mood, euphoria, self-confidence,
sociability, anxiety, flushed face, impaired judgement, and fine muscle
coordination, with a BAC (blood alcohol content) of 0.03-0.12% causing
increased happiness, self-confidence, and decreased anxiety.
- An increase in BAC can cause lethargy, sedation, balance issues, and blurred
vision. Further increases in BAC can lead to confusion, impaired speech,
staggering, dizziness, and vomiting. A BAC from 0.25% to 0.40% can cause
stupor, unconsciousness, amnesia, vomiting, and respiratory depression.
- And more increases can lead to a coma, life-threatening respiratory depression,
and possibly fatal alcohol poisoning.

◆ Long-term effects
1. Alcohol consumption increases heart disease, high blood pressure, stroke, and
violence. It can cause physical symptoms like liver cirrhosis, pancreatitis,
epilepsy, alcoholic dementia, heart disease, nutritional deficiencies, and sexual
dysfunction.
2. Long-term alcohol misuse can also lead to damage to the central nervous system
and peripheral nervous system, immunologic defects, and a propensity for bone
fractures.
3. Women develop long-term problems of alcohol dependence more quickly than
men, and they have a greater mortality rate from alcoholism, which can raise the
risk of breast cancer. Over time, heavy drinking can impair reproductive function,
resulting in decreased ovarian mass, monthly irregularity, and early menopause.

➔ PSYCHOLOGICAL EFFECT
1. Alcohol misuse can cause severe mental health issues, including cognitive
problems and brain damage, significantly impairing social skills due to the
neurotoxic effects of alcohol on the prefrontal cortex area.
2. AUD patients often experience severe psychiatric issues, including anxiety and
depressive issues, which typically develop during alcohol withdrawal but improve
or vanish during a continuous clean slate.
3. Psychosis, confusion, and organic brain syndrome may be caused by alcohol
misuse, leading to misdiagnoses like schizophrenia. Panic disorder can develop or
worsen as a direct result of long-term alcohol misuse.
4. The co-occurrence of major depressive disorder and alcoholism is well
documented, with comorbid occurrences distinguishing between substance-
induced and independent episodes. Psychiatric problems vary by gender, with
women more likely to have co-occurring diagnoses such as MDD, anxiety, panic
disorder, PTSD, or BPD.

➔ SOCIAL EFFECT
1. Alcohol use disorder leads to serious social problems due to brain pathological
changes and the intoxicating effects of alcohol.
2. Alcoholism increases the risk of criminal offenses like child abuse, domestic
violence, rape, burglary, and assault, leading to employment loss, financial
problems, and legal consequences. Women with AUD are more likely to
experience physical or sexual assault, abuse, and domestic violence, resulting in
higher psychiatric disorders and increased alcohol dependence.
3. The alcoholic's behaviour and mental impairment can lead to isolation from family
and friends, which can result in marital conflict, divorce, or domestic violence.
4. Alcoholism can lead to child neglect, lasting emotional damage, and fear of
parents due to unstable mood behaviours, shame over inadequacy, and self-image
problems, which can result in depression in children.

➔ ALCOHOL WITHDRAWAL
1. Alcohol withdrawal can be fatal if not managed properly, as it increases
stimulation of the GABAA receptor, promoting central nervous system
depression.
2. Abruptly stopping alcohol consumption triggers uncontrolled synapse firing,
causing symptoms like anxiety, seizures, hallucinations, shakes, and heart failure.
3. Common withdrawal symptoms include anxiety, depression, fatigue, and sleep
disturbances in the 3-6 weeks post-cease.
4. Alcohol use problems cause a kindling effect, with each withdrawal crisis
becoming more severe, leading to long-term functional alterations in neuronal
circuitry and gene expression.

● Causes and Risk Factors of Alcoholism

Alcohol misuse can stem from psychological or social factors, such as social withdrawal
or coping with daily stress. Scientists are still exploring the causes of alcohol use disorder
the exact mechanism that causes people to misuse alcohol is unclear,it appears to be a
combination of these factors:
● Genetics
● Early childhood events, Experienced trauma, such as physical or sexual abuse.
● Attempts to relieve emotional pain.
● May also run in families and have a family history of alcohol use disorder.
● Have had stomach bypass surgery (Roux-en-y) for weight issues.
● Have mental health issues such as grief, anxiety, depression, eating disorders, and
PTSD.
● Consume alcohol often, in large amounts, or start early in life.
Other risk factors include: psychiatric disorders like schizophrenia ,mood disorders like
depression or anxiety, personality disorders, impulsivity, loneliness ,stress.

● Treatment and Management of Alcoholism

Alcohol withdrawal treatment focuses on short-term relief and long-term suppression of
cravings. Treatment often includes detoxification, medication, and therapy. Moderate to
severe AUD patients require medication, while mild AUD patients may benefit from
therapy without medication.
 ➔ Medications: Medications are prescribed to reduce the symptoms of withdrawal.
Other medications can help you quit drinking by suppressing alcohol cravings or
making you feel sick when alcohol enters your body. The most prescribed
medication are naltrexone (Revia, Vivitrol) and acamprosate (Campral)
➔ Behavioural treatments—also known as talk therapy and provided by licensed
therapists—are aimed at changing drinking behaviour. Examples of behavioural
treatments are brief interventions and reinforcement approaches, treatments that
build motivation and teach skills for coping and preventing a return to drinking,
and mindfulness-based therapies. As you recover from AUD, you may find it
helpful to see a psychotherapist who uses cognitive behavioral therapy (CBT)
techniques. CBT helps you modify your thoughts and actions while also learning
alternative coping mechanisms.

● Prevention of Alcoholism
- Adolescents are more likely to develop habits like smoking, drug, or alcohol use,
making it crucial for parents and teachers to prevent and control substance abuse.
High levels of nurturing and consistent discipline can reduce the risk of substance
abuse.
- Parents and teachers should avoid peer pressure, educate children to face
problems, and channel energy into healthy pursuits. Seeking help from parents,
peers, and professionals can help individuals overcome drug and alcohol abuse.
- Alcohol policies implemented by the WHO, national governments, and
parliaments include increasing the age of alcohol purchase, banning alcohol
advertising, and taxing products. Preventing alcoholism may involve reducing
stress and anxiety levels in individuals.

SMOKING
Smoking is the act of inhaling and exhaling the fumes of burning plant material. A
variety of plant materials are smoked, including marijuana and hashish, but the act is
most commonly associated with tobacco, which is smoked in a cigarette, cigar, or pipe.
Tobacco contains nicotine, an addictive alkaloid that can produce both stimulating and
relaxing psychoactive effects.
Smoking is a prevalent recreational drug, causing negative health effects due to
challenges in respiration and physiologic processes. It is a leading cause of diseases like
lung cancer, heart attack, COPD, erectile dysfunction, and birth defects. Long-term
smokers face approximately half the mortality rates of non-smokers, highlighting the
need for improved health care.
 ● Effect of Smoking
➢ PHYSIOLOGICAL EFFECT
Smoking harms body organs, increases inflammation, and negatively affects the immune
system, making individuals more susceptible to infection. It is also linked to various
types of cancer, including bladder, cervical, kidney, uterine, liver, and pancreatic cancer.
Smoking increases the risk of developing these diseases, making it crucial to quit
smoking to maintain overall health.

➔ Central nervous system

Tobacco contains nicotine, a mood-altering drug that is habit-forming and highly
addictive. It reaches the brain quickly and can energise the body, but as the effect wears
off, it can cause fatigue and cravings. Physical withdrawal can impair thinking and lead
to negative emotions like anxiety, irritability, and depression. Withdrawal can also cause
headaches and trouble sleeping.

➔ Vision
Smoking long-term can affect your vision and optic nerve. It may lead you to develop
certain conditions that affect the eyes. These can include:
● cataracts, which cause cloudy vision
● age-related macular degeneration, which causes damage to a spot in the center of
your retina and causes loss of your central vision.

➔ Cardiovascular system
Smoking can damage the cardiovascular system, including your: heart , arteries and
blood vessels. Nicotine causes blood vessels to tighten, which restricts the flow of blood.
Smoking also raises blood pressure, weakens blood vessel walls, and increases your risk
of blood clots. These factors raise your risk for cardiovascular disease, including:
● atherosclerosis
● coronary heart disease, including heart attack and sudden cardiac death
● stroke
● peripheral artery disease

➔ Integumentary system (your body's outer layer like nails, hairs , skin )
Cigarette smoking can cause premature skin damage, wrinkles, delayed wound healing,
and certain skin cancers. It also affects fingernails and toenails, increasing the risk of
fungal nail infections. The digestive system is also affected, with increased cancer risk in
organs like mouth, throat, larynx, oesophagus, stomach, pancreas, colon, and rectum.
Even those who smoke but don't inhale face an increased risk of mouth cancer. Type 2
diabetes develops faster in smokers.

➔ Lung damage
Smoking causes lung damage, tissue loss, and increased susceptibility to pulmonary
infections like tuberculosis and pneumonia. It also leads to chronic cough, worsens
asthma attacks, and increases cancer risk. Lung damage is the leading cause of lung
cancer, making it a significant health concern.People who smoke are at higher risk for
chronic irreversible lung conditions such as:
● chronic bronchitis, permanent inflammation that affects the lining of the breathing
tubes of the lungs
● chronic obstructive pulmonary disease (COPD), a group of lung diseases
● lung cancer and adult-onset asthma
Pregnant women who smoke during pregnancy can have underdeveloped lungs, and
children with smoking parents or caregivers may experience health conditions like
coughing, wheezing, asthma attacks, pneumonia, and reduced lung function. Teens who
smoke may have smaller and weaker lungs than those who don't smoke.

➔ Sexuality and reproductive systems

Nicotine affects blood flow to the genital areas of both men and women.
Smoking may also contribute to fertility issues and lower sex hormone levels in males
and females, leading to decreased sexual desire.
❖ Smoking can lead to sexual dissatisfaction for people with vaginas, affecting their
ability to reach orgasm, lubrication, and menopause earlier. It also affects hormone
production, making it harder to become pregnant and increasing the risk of early
delivery, low birth weight, stillbirth, SIDS (sudden infant death syndrome).
❖ For people with penises, smoking can decrease sexual performance.Smoking can
negatively affect the function of blood vessels, which may restrict the blood flow
needed to achieve an erection in people with penises. This may result in erectile
dysfunction (ED). ED can also lead to fertility problems.It can also damage the
DNA in sperm, making it difficult to conceive and increasing the risk of
miscarriage and certain birth defects.
➢ PSYCHOLOGICAL EFFECT
1. Smoking has significant psychological effects on individuals with mental health
conditions. Individuals with mental health conditions tend to die 10-20 years
earlier than the general population. Smoking is a major contributor to reduced life
expectancy, especially among those with mental health conditions.

2. Depression is associated with smoking, as it can temporarily boost dopamine

levels, but in the long term, it adversely affects dopamine production. Bipolar
disorder has a higher smoking prevalence, with earlier onset, greater severity of
symptoms, and a higher risk of suicide ideation.

3. Attention Deficit Hyperactivity Disorder (ADHD) and PTSD are strongly linked,
with both children and adults more likely to smoke. War veterans with PTSD,
especially from the Vietnam War, have elevated smoking rates, higher nicotine
cravings, and lower quit rates.

● Causes and Risk Factors of Smoking.

- Social influences include peer pressure and social norms, which can lead
individuals to smoke to fit in or be accepted. Family background can also increase
 the likelihood of smoking, as smoking-prone family members can influence
others.
- Genetic predisposition is linked to smoking behaviour, and individuals with a
family history of smoking may be more susceptible to nicotine addiction.
- Psychological factors, such as stress, anxiety, and depression, can lead to
smoking as a coping mechanism.
- Marketing and media influence can create a positive image of smoking, making
it seem more appealing.
- Accessibility, especially for young individuals, can increase the likelihood of
smoking initiation. Lower educational attainment and lack of awareness about
health risks associated with smoking may contribute to higher smoking rates.
- Personality traits, such as sensation-seeking or rebelliousness, can also make
individuals more prone to risky behaviours like smoking.

● Treatment of Smoking
Tobacco cessation can be achieved through a combination of behavioural therapies and
medications, such as nicotine replacement therapy, bupropion, and behavioural
Behavioural Treatments
➔ Behavioural counselling is a crucial tool for smoking cessation, providing four to
eight sessions in-person or via telephone. It includes various approaches such as
Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and
mindfulness-based treatments
➔ CBT helps patients identify triggers and teach them relapse-prevention skills, such
as relaxation techniques, to avoid smoking.
➔ MI helps patients explore their ambivalence about quitting smoking and enhance
their motivation to make healthy changes. MI has been shown to result in higher
quit rates than brief advice or usual care.
➔ Mindfulness-based treatments help patients increase awareness of sensations,
thoughts, and cravings that may lead to relapse. Interest in mindfulness-based
treatments has increased over the past decade, with studies showing it benefits
overall mental health and can prevent relapses to smoking.

Medication Treatment:
➔ Nicotine Replacement Therapy (NRT)—NRT improves smoking cessation
outcomes, and behavioural therapies can increase quit rates.
➔ Bupropion, an antidepressant, is equally effective as NRT in inhibiting brain chet
reuptake. Combining NRT with other medications may facilitate cessation, and
 adding bupropion to NRT also improves cessation rates. Other antidepressant
medications, independent of their antidepressant effects, are also effective for
smoking cessation.

● Prevention of Smoking
Preventing smoking involves a multi-faceted approach; key strategies include
implementing comprehensive anti-smoking programs in schools, public campaigns,
tobacco control policies, social support and intervention, peer education, school-based
interventions, age restrictions, and online and social media initiatives.
- Education and awareness are crucial for preventing smoking. Schools should
implement comprehensive anti-smoking programs, public campaigns, and tobacco
control policies to educate students about the health risks associated with smoking.
- Tobacco control policies should include higher taxes on tobacco products,
smoke-free zones, and strict advertising restrictions, especially targeting youth.
- Social support and intervention can be achieved through community programs,
family involvement, peer-to-peer programs, and role modelling.
It's important to note that quitting smoking is a challenging but worthwhile journey. If
you or someone you know is trying to quit, seeking professional help and support can
make a significant difference.
OBESITY ( LIfeStyle Disorder )
Obesity is a long-term (chronic) health condition that progresses over time. Obesity is
defined by excess body fat (adipose tissue) that may impair health. When your body has
too much extra fat, it can change the way it functions. These changes are progressive, can
worsen over time, and can lead to adverse health effects.
The BMI (body mass index) is used to measure average body weight against average
body height. As a generalisation, a BMI of 30 or higher is associated with obesity. If
your BMI is between 25.0 and 29.9 kg/m2, they put you in the overweight category.
There are three general classes of obesity that healthcare providers use to evaluate what
treatments may work best for each person. They include:

● Class I obesity: BMI 30 to <35 kg/m2.

● Class II obesity: BMI 35 to <40 kg/m2.
● Class III obesity: BMI 40+ kg/m2.

BMI is also used to calculate obesity in children, but it is calculated relative to the child’s
age and assigned sex. A child older than 2 years may be diagnosed with obesity if their
BMI is greater than 95% of their peers in the same category. Different growth charts may
present slightly different BMI averages based on the population they are sampling.
 ● Symptoms
➔ Metabolic changes: The process of turning calories into energy to power your
body's operations is known as metabolism. When your body has more calories
than it can use, it converts the extra calories into lipids and stores them in your
adipose tissue (body fat). When you run out of tissue to store lipids, the fat cells
themselves become enlarged fat cells secrete hormones that produce an
inflammatory response.
- Chronic inflammation has many adverse health effects, such as insulin
resistance,which means your body can no longer use insulin to efficiently lower
blood glucose and blood lipid levels (sugars and fats in your blood)., High blood
sugar and blood lipids also contribute to high blood pressure.
These combined risk factors are known as metabolic syndrome, causing further weight
gain and making it harder to lose weight and sustain weight loss. Metabolic syndrome, a
common factor in obesity, contributes to various diseases like Type 2 diabetes, fatty liver
disease, kidney disease, cardiovascular diseases like high blood pressure, heart failure,
and heart attack, and cholesterol gallstones.

➔ Direct effects: excess body fat may clog the organs of your respiratory system,
and stress contributes to asthma, sleep apnea, back pain and gout.

➔ Indirect effect: Obesity is also associated indirectly with:

● Memory and cognition, including a high risk of Alzheimer’s disease and dementia.
● Female infertility and pregnancy complications.
● Depression and mood disorders.
● Certain cancers,including pancreatic, colorectal, breast, uterine and ovarian.
 ● Causes of obesity
Obesity is caused by consuming more calories than your body can use. Many factors
contribute to this. Some factors are individual to you and others are built into the
structure of our society
Factors that may increase calorie consumption include:
● Fast and convenient foods:High-processed fast and convenience foods are
common, often being the only readily available options due to cost and
accessibility. These foods are low in fiber, nutrients, sugar, and fat, making them
easy to consume and increase hunger.

● Sugar is in everything: The food industry is not designed to promote health, but
rather to sell addictive products that consumers crave. High on this list are sweets
and sugary drinks, which lack nutritional value and are high in added calories.

● Marketing and advertising: Advertising heavily promotes processed foods,

sweets, and sugary drinks, which are not necessary but required by the industry. It
makes these products seem normal and necessary, and also heavily promotes
alcohol, adding empty calories to our daily lives.

● Psychological factors: Modern society's common issues like boredom, loneliness,

anxiety, and depression can lead to overeating, particularly consuming high-
calorie foods that activate pleasure centers in our brains. Eating to feel better is a
primal human instinct, but our evolution has not kept up with the abundance of
food that Western societies enjoy.

Factors that may reduce the number of calories we use include:

● Screen culture: Online activities like work, shopping, and social life are causing
increased screen time, enabling sedentary entertainment through streaming media
and binge-watching.
● Workforce changes: The rise of automation and computers in the industry has led
to a shift towards desk work and longer hours.

● Fatigue: Sedentary lifestyles lead to weariness, decreased motivation, stiff body,

aches, pains, and general stress, resulting in fatigue and a snowball effect, as
studies show sitting for longer periods causes weariness and decreased motivation.
 ● Childcare trends: Children are spending less time playing outside due to cultural
trends that don't find it safe to play unattended, inadequate access to public spaces,
and quality childcare. Many childcare environments are replacing free play with
TV, highlighting the need for better outdoor spaces and facilities.

● Management and Treatment

Your healthcare provider will focus on urgent health issues first, followed by a long-term
weight loss plan. Research indicates that team-based programs with frequent
communication are most effective in helping people lose weight and maintain it.

Dietary changes - Individual dietary changes for weight loss may vary, with some
focusing on portion sizes or snacks, while others focus on changing their diet. Most
people can benefit from eating more plants, such as fruits, vegetables, and whole grains,
which are lower in fat and rich in fiber and micronutrients.

Increased activity- Everyone has heard that diet and exercise are both important to
weight loss and weight maintenance. But exercise doesn’t have to mean a gym
membership. Just walking at a moderate pace is one of the most efficient types of
exercise for weight loss. Just 30 minutes is suggested.

Behavioural therapies- Counseling, support groups, and cognitive behavioural therapy

can aid in weight loss by rewiring the brain for positive changes, managing stress, and
addressing emotional and psychological factors. These methods can help individuals
address various levels of weight and weight loss efforts, ensuring both human and
practical support is crucial for successful weight loss.

Medication - Medications aren’t the whole answer to weight loss, but they can help
tackle it from another angle. For example, appetite suppressants can intercept some of the
pathways to your brain that affect your hunger.

Weight loss surgery - If you have been diagnosed with class III obesity, bariatric surgery
may be an option for you. It works by changing your biology instead of just your mind or
your habits. They restrict the number of calories you can consume and absorb. They also
change hormonal factors in your digestive system that affect your metabolism and
hunger.

● Prevention
Preventing obesity is easier than treating it once it has taken hold. If you’ve noticed a
pattern of recent weight gain in yourself or your child, or if you have a family history of
obesity, you might want to take steps to intervene sooner rather than later. Some of the
ways to prevent it are:
 ● Make a small sacrifice: Do you have a daily snack habit or “pick-me-up,” such as
a sugary drink, and consider replacing it? Just 150 extra calories a day can add up
to 10 extra pounds in a year. That’s equal to a snack-size bag of potato chips or
just two double-stuffed Oreos.
● Add a small activity. Alternatively, consider what you might do to burn an extra
150 calories in a day. For example, go for a hike, use an elliptical machine for 25
minutes, or take the dog for a brisk walk for 35 minutes.
● Shop intentionally: Stock your home with healthy foods, and save sweets and
treats for special occasions when you go out. Whole foods are higher in fiber and
lower on the glycemic index, so they don’t cause your blood sugar to spike and
drop the way processed snacks and treats do.
● Cultivate overall wellness: reduce your screen time, go outside, and go for a
walk. Manage your stress and try to get adequate sleep to keep your hormone
levels in check. Focus on positive changes and healthy activities rather than how
your efforts affect your weight.

LIFESTYLE DISORDER
Lifestyle disorders, also known as non-communicable diseases (NCDs), are health
problems that result from an individual's everyday habits and practices. NCDs are chronic
in nature and cannot be communicated from one person to another.
Lifestyle disorders are often caused by unhealthy habits and environmental factors. Key
reasons include poor diet, lack of physical activity, smoking, excessive alcohol
consumption, chronic stress, lack of sleep, genetic predisposition, environmental factors,
workplace factors, urbanisation, technological advancements, and socioeconomic status.
According to the WHO, low- and middle-income countries and the poorest people in all
countries are the worst affected by deaths due to NCDs.

● Characteristics of NCDs
Complex etiology (causes): Noncommunicable illnesses are caused by unrelated factors
such as unplanned urbanisation, globalisation of unhealthy lifestyles, and an ageing
population. Apparent reasons such as high blood pressure, high blood glucose, high blood
lipids, and obesity may be manifestations of underlying lifestyle choices

Long latency time: The latency period of NCDs is often long, ranging from many years
to several decades. Non-contagious origin (non-communicable): Because NCDs are not
transmitted from person to person, it is a foregone conclusion that these illnesses arise in
a person from non-contagious origins.

The long-term effects of the disease: Because NCDs are chronic, the course of sickness
is frequently prolonged and takes years before a patient is obliged to seek medical
treatment or intervention. NCDs frequently cause functional impairment or disability,
making it difficult for patients to live normally. Patients suffering from chronic NCDs
may be unable to engage in regular physical activity, go to work, or eat normally.

Multiple risk factors: Various risk factors contribute to the beginning and progression of
NCDs. The many hazards may be classified into three groups: modifiable behavioural
risk factors, non-modifiable risk factors, and metabolic risk factors, many of which are
shared by various illnesses.

● Risk factors
➔ Modifiable behavioural risk factors: behavioural risk factors such as excessive
use of alcohol, bad food habits, eating and smoking tobacco, physical inactivity,
wrong body posture, and disturbed biological clock increase the likelihood of
NCDs. The modern occupational setting (desk jobs) and the stress related to work
are also being seen as potent risk factors for NCDs.
➔ Metabolic risk factors: Metabolic risk factors contribute to four key metabolic
changes that increase the risk of NCDs: raised blood pressure, overweight or
obesity, hyperglycemia (high blood glucose levels), and hyperlipidemia (high
levels of fat in the blood).
➔ Non-modifiable risk factors: risk factors that cannot be controlled or modified by
the application of an intervention can be called non-modifiable risk factors and
include age, race, gender, and genetics.
➔ Environmental risk factors: Several environmental risk factors contribute to
NCDs. Air pollution is the largest of these, leading to millions of deaths globally
due to NCDs, including stroke, ischaemic heart disease, chronic obstructive
pulmonary disease, and lung cancer.

● Type of Lifestyle Disorder

NCDs such as cardiovascular diseases (CVD), stroke, diabetes, and certain forms of
cancer like cholesterol cancer, mental health disorders (anxiety, depression, and stress-
related disorders), liver disease, obesity, and kidney disease are heavily linked to lifestyle
choices and, hence, are often known as lifestyle diseases.
*NOTE*: WE CAN USE ABOVE EXPLAINED INFORMATION ABOUT OBESITY
AND CANCER AS WELL IN THIS SECTION AS WELL CAUSE THEY ARE
LIFESTYLE DISORDER AS WELL
There are some major lifestyle or non-communicable diseases that are more prevalent
than other diseases. These diseases are
➔ Cardiovascular Diseases: Coronary heart disease, cerebrovascular disease,
rheumatic heart disease, and other illnesses are among the categories of heart and
blood vessel disorders known as CVDs. Heart attacks and strokes account for
more than four of every five CVD deaths.
- Unhealthy eating, inactivity, usage of tobacco products, and abuse of
alcohol are the main behavioural risk factors for heart disease and stroke.
- Individuals may experience elevated blood pressure, elevated blood
glucose, elevated blood lipids, and even become overweight or obese
because of behavioural risk factors.

➔ Diabetes: Diabetes is a chronic condition brought on by either insufficient insulin

production by the pancreas or inefficient insulin utilisation by the body. A
hormone called insulin controls blood sugar levels.
- Type 1 diabetes, also known as juvenile diabetes, occurs when the body
does not produce insulin. Insulin is a hormone responsible for breaking
down the sugar in the blood for use throughout the body.
- The body's inefficient use of insulin causes type 2 diabetes, also known as
non-insulin-dependent or adult-onset diabetes. This type of diabetes is
primarily brought on by increased body weight and inactivity.A person
living with type 2 diabetes may or may not need insulin. In many cases,
medication along with changes in exercise and diet can help manage the
condition.
- Uncontrolled diabetes frequently causes hyperglycemia, also known as high
blood glucose or raised blood sugar. Over time, it can seriously harm many
different bodily systems, including neurons and blood vessels.

➔ Chronic Respiratory Diseases (CRDs): CRDs impact the lungs' airways and
other pulmonary structures. The most prevalent ones include pulmonary
hypertension, asthma, occupational lung disorders, and chronic obstructive
pulmonary disease (COPD).
 - Air pollution, exposure to chemicals and dust at work, and recurrent lower
respiratory infections in children are other risk factors besides tobacco
smoke.
- Although CRDs cannot be cured, several treatments can help expand the
airways and reduce shortness of breath, which can help regulate symptoms
and enhance everyday life for those with these conditions.

➔ Hypertension, or high blood pressure, refers to the tension or high pressure in

the vessels responsible for taking blood from the heart to the rest of the body.
- Hypertension is a sustained increase of systemic arterial blood pressure,
typically more than 150/90 mm Hg.
- It often develops gradually over time. Sedentary habits, such as a lack of
regular exercise, coupled with poor dietary choices high in salt and
saturated fats, contribute to the development of hypertension.
- Stress, another element of modern living, also plays a crucial role in
elevating blood pressure levels.
- Addressing lifestyle factors through healthy eating habits, regular exercise,
stress management techniques, limiting alcohol intake, and maintaining a
healthy weight can play a crucial role in preventing and managing
hypertension.

● Prevent Lifestyle Diseases

1. Having a Wholesome Diet - A wholesome diet is crucial for health and
wellbeing, incorporating fresh fruits, green vegetables, and fibre-rich foods. To
prevent lifestyle diseases, individuals should replace junk food with healthy
snacks, drink enough water, limit oily consumption, switch to multigrain or whole-
grain flour, and reduce portion sizes.

2. Maintaining a Balance Between Physical Activity and Food Consumption - A

healthy immune system relies on a balance between physical activity and food.
Adults should engage in 30 minutes of walking five days a week, which aids in
calorie burning and improves stamina, endurance, and strength. Other ways
include daily chores and stairs.

3. Monitoring the Body Weight - Maintaining a healthy body weight is crucial, as

excess weight, particularly near the tummy, can lead to cardiovascular death,
 diabetes, sleep apnea, and cancer. To manage weight, a low-calorie diet and
regular exercise are recommended.

4. Abstaining from Nicotine, Alcohol or Any Other Form of Drug - Avoiding

alcohol and nicotine can prevent one-third of heart disease deaths by damaging
blood vessels, increasing blood clotting, and increasing the risk of atherosclerosis.
Maintaining these habits can lead to improved energy levels, lung capacity, and
younger-looking skin.

5. Avoiding Consumption of Salt, Oil and Sugar in Excess - Anything in excess

turns out to be unhealthy for the body. Consuming a high amount of salt, sugar,
and oil can lead to high blood pressure, heart problems (because of high