- Ecological triad.

Ecological triad (epidemiological triad)

Ecological triad of disease is composed of:-

1- Causative Agent.

2- Host.

3- Environment.

Return to other triads here.

- Plumbism.

Plumbism is manifested by

" flea crop "

Facial pallor.

Lead line.

Encephalopathy.

Anaemia.


Constipation

Colic

Cardiac manifestations.


Renal manifestations.

Reproductive manifestations.


Optic atrophy.

Paralysis.

Enjoy,,,,

Dr Ibrahim samaha.

- Health needs of adolescent.

They need "DELTA"

Diet ( healthy and good)

Education ( sex and family )

Loving home and good family relationship.

Trust and confidentiality.

Accept autonomy.

Enjoy,,,,

Dr Ibrahim samaha.

- Design of school desk.

- Risks in adolescence period.

" Muster HDL " جمع HDL

Malnutrition and aneamia.

Lot of Unmets regarding nutrition, reproductive and mental health.

School dropouts and child labour.
Sexual maturity and onset of sexual activity.
Social risks - look here -.

Transition from dependence to relative indpendence.
Teenage pregnancy.

Early marriage.

Reqiure safe and supportive environment.

Habits and behaviors picked up in adolescence period have long life impact.

Desire for experimentation.

Lack of formal and informal education.

Enjoy,,,,
Dr Ibrahim samaha.

- Social Risks in adolescence period.

" FILMS "

Social Frustration.

Inadequate school syllabus about adolescent health.
Ignorance of sex and sexuality.

Lack of understanding.
Lack of recreational , reactive and working opportunities.

Misdirected peer pressure in abscence of adequate knowledge.

Suboptimal support at family level.

Enjoy,,,,
Dr Ibrahim samaha.

- Rules for counselling.

Collected in the word " GATHER"

• Great the person and show respect and trust.
• Ask about his problem ,encourage him express himself with his own words.
• Tell him relevant information.
• Help them to make decisions,explore alternatives and ensure that nothing has been emposed.
• Explain any misunderstanding.
• Return to follow up visits.

Source:- Communication and ;health behavior p.g 28, Prof. Doctor,Nadia montaser, Mansoura Uni.

- Components of Antenatal care.

Collected in the word " IRON chase المطاردة الحديدية"

• Immunization.
• Registration and  Record keeping.
• Outrech services (home visits).
• Nutritional care.

• Clinical services.
• Health education.
• At risk approach.
• Social care.
• Examination : 1st visit and periodic visits.

- Factors affecting hazardous effect of noise.

" Fetid "

Frequency of noise.

Exposed person age.

Type of noise.


Individual susceptibility.
Intensity of noise.

Duration of exposure.
Distance from source.

Enjoy...
Dr Ibrahim Samaha

- Nutritional problems in childhood.

" DO in pairs"

Dental caries (Ca,fluorine deficiency).
Obesity

PEM (protein energy malnutrition).
Pellgra.

Aribofilavinosis.
Vit A deficiency.

Iron deficiency anaemia.
Iodine deficiency.

Rickets (Vit D deficiency).

scurvy(Vit c deficiency).

Enjoy...
Dr Ibrahim Samaha

- Manifestations of Vit A toxicity.

" Haem + CL "

Hepatosplenomegaly.
Hair (sprase and coarse).
Hypoplastic anaemia.

Alopecia.
Abnormal bone growth.

Eczema.
Erythema.

Mitosis stop,Mortality of cell ( with dose of 100000 microgram/Kg/day)
+
Clubbing of fingers.
Congenital abnormalities.

Leucopenia.

Enjoy...
Dr Ibrahim Samaha

- Age specific death rates.

N.B:-
-from statistical point of view infant is who 1 year old.
- But from pediatric point of view infant is who 2 years old when early infancy is the first year of life and late infancy is the 2nd year of life.
- (1-4 years) child mortality rate from the end of the 1st year of life till the end of the 4th year of life.

-Henoch-Schonlein purpura.

Allergic purpura
Anaphylactoid purpura
(Henoch-Schonlein purpura)

(Purpura on the right lower leg of a child)

-Def:- is an allergic disorder in which the allergic reaction occur in the
wall of blood vessels in "JARS"

• Joints
• Abdomen(GIT)
• Renal(kidney)
• SKIN

-Aetiology:- (Antigen)
1-Infection.
2-Food or drug allergy.
3-Insect bite.

-Symptoms:-

• Purpura, arthritis and abdominal pain are known as the classic triad of Henoch–Schönlein purpura (1).
• Bluish purple bruises (purpura)— most often on Joints .
• Swollen, achy joints.
  fever.
• Bleeding in the digestive tract may cause abdominal pain.
• Hematuria may develop.
• Bleeding in the kidneys may cause kidney damage.

The diagnosis is based on the symptoms.

Prognosis:- Most people recover completely within a month, but symptoms may recur several times.

Return to other triads here.

-References:-
(1) Kraft DM, Mckee D, Scott C (1998)"Henoch-Schönlein purpura: a review" Am Fam Physician 58 (2): 405–8, 411. PMID 9713395.

-High risk groups for HBV,HIV,HCV.

"HIP"

H

• Health care workers.
• Heterosexual with multiple parteners.
• Homosexual men.

I

• I.v drug users.
• Infants to +ve mothers(congenital).

P

• Patient receiving repeated blood transfusion.
• Patient undergoing renal dialysis.
• Patient undergoing organ transplantaion.

With my best wishes

- Frose Bite.

*Def:- It is a state of angiospastic with agglutination of blood in the vesseles.

*Cause:-
exposure to low Temperture ( -5 and -10 C) (i.e freezing of the tissues).

*Stages:-

"SING"

• Spastic: spasm of blood vessels.
• Ischemic :- decrease blood supply to the tissues due to spasm of blood vessels.
• Necrotic ulceration:- chronic ulcers due to decrease blood supply to the tissues.
• Gangrenous stage:- either wet or dry.

Enjoy...
Dr Ibrahim

- Heat related illnesses.

Heat related illnesses
(Thermal stress)

"Sect MRI"

Heat Sroke.
Heat Exhaustion.
Heat Cramp,Circulatory instability,Conjunctivitis
Thermogenic anhydrosis.

Miliaria rubra.
Respiratory distress,Retinitis
Ischemic heart diseases.

Dr Ibrahim 

- Disability in geriatrics.

-Morbidities and injures in old age interfere with physical activities , mental and psychologic behavior.

- And associated with variable degrees of disabilities from so mild and hardly noticed to sever and complete disabilities.

- Causes of (disabilities) handicapping in old age = 10 I :-

• Intellectual Impairment (dementia,...etc)
• Impairment of vision & hearing.
• Immobility.
• Instability causing repeated falling.
• Inanition(loss of teeth)causing malnutrition.
• Infection.
• Incontinence.
• Impotence.
• Iatrogensis.
• Isolation causing psychological disorders.

- Important Points in Nutrition.

- Animal milk is poor in:-

*Vitamins:-

Vit D

Vit C

Thiamine (Vit B1).

*Minerals:-

Zinc

Iron


*Essential fatty acids

--------------------------------

- Vitamins syenthesized by Intestinal flora:-

Vit K2

Vit B6

Folic acid

Niacin

--------------------------------

- Nutritional Bone diseases:-

Rickets (Vit D deficiency)

Osteomalacia (Ca deficiency)

Osteoprosis

Dental Caries (Ca,fluorine deficiency)

--------------------------------

- Nutritional Anaemia:-

Iron ( hypochromic microcytic anaemia)

Vit B12 (megaloblastic anaemia)

Folic acid (megaloblastic anaemia)

Enjoy...

Dr Ibrahim Samaha

-Ten ways to reduce risk of cancer.

1- Balanced diet ( which supply the body with sufficient food stuffs,satisfy body requirement,free of toxins or infection,selected in proper portion 50-60% cHO,15-20% proteins,20-30% fat).

2-choose diet rich in fibers.

3-Increase vegetables and fruits for more than 2 servings /day.

4-Control weight,avoid obesity.

5-Excercise regularly.

6-limit highly salted food.

7-limit smoky and  pickled food.

8-Decrease fat intake.

9-Stop alcohol.

10-Stop smoking with its different forms (cigarettes,Bidi,Cigar,Goza ,Hook-ah,Hubble-bubble,Tobacco chewing,Snuff,pipe).

Dr Ibrahim samaha

-Seven basic types of smokers (By Russell).

Seven basic types of smokers  (By Russell)

-If you understand why you smoke, you will have a better chance to adopt appropriate strategies to stop your smoking behavior.

-According to motives for smoking smokers are:

1-sedative smokers:
As comfort in the face of unpleasant feelings or to relieve tension ....

2-Stimulative smokers:
To help thinking, increase concentration and overcome monotony .

3-psychsocial smokers:
As crutch to increase their confidence.

4-Sensory smokers:
Just satisfaction of feeling of a cigarette in mouth or fingers.

5-Indulgent smokers:
Use it for actual pleasure of smoking or to heighten enjoyment of an already pleasurable moment .

6-Addictive smokers:
To avoid the severe withdrawal symptoms of stopping .

7-Automatic smokers:
They Light cigarettes automatically whenever they face any situation.

Plz, kill yourself away from us...........