Non-Communicable Diseases: NPCDCS ... - SIHFW Rajasthan

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Referral to a specialist facility Referral is required if there are clinical features suggestive of: • Acute cardiovascular events such as: heart attack, angina, heart failure, arrhythmias, stroke, and transient ischemic attack. • Secondary hypertension, malignant hypertension. • Diabetes mellitus (newly diagnosed or uncontrolled). • Established cardiovascular disease (newly diagnosed or if not assessed in a specialist facility). • Suspected lesions for Cancer • People needing medical therapy to quit smoking. <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 112
Follow up Once the condition of the above categories of people (except with suspected lesion) is assessed and stabilized, they can be followed up in a primary care facility based on the recommendations provided in Manual of MO. They will need periodic reassessment in specialty <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 113
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Non-Communicable Diseases: NPCDCS &
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Risk factors and NCDs largely preve
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Drivers of NCDs SIHFW: an ISO 9001:
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SIHFW: an ISO 9001:2008 certified I
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Epidemiological Transition Communi
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Challenges Many communicable disea
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SIHFW: an ISO 9001:2008 certified I
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Magnitude SEAR-2008: 14.5million t
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50 45 40 35 30 25 Estimated %of pre
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Trends in estimated %of deaths 80%
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Estimated and Projected Deaths due
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Pop.(2010): 1 224 614 327 Age stand
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Metabolic Risk factor Trends 126 Me
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26 Mean BMI 24 22 Male 20 Female 18
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Reported Cases & Deaths due to NCD-
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Total Number of Diabetic Cases - Ra
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Reported Deaths :Type 1 DM- Distric
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District Reported Deaths of Type 2
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Reported Cases of Deaths Due to Can
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District -wise reported Cancer Deat
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SIHFW: An ISO:9001:2008 certified I
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Implications of ↑ burden of NCDs
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MDG-6 NCD burden threatenst the (Co
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2% annual reduction in Chronic Dise
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Answer to the problem: ACT NOW Prev
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Risk factor/disease Tobacco use: Us
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Action at National Level: Two comp
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Strategies Prevention through beha
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Services Preventive, promotive , c
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Facility DH Services Early diagnosi
Page 61 and 62: Institutional Framework Integratio
Page 63 and 64: SIHFW: An ISO:9001:2008 certified I
Page 65 and 66: Screening MO to do: To conduct com
Page 67 and 68: Work closely with other sectors/ de
Page 69 and 70: Surveillance Surveillance is the on
Page 71 and 72: Risk Factor Surveillance: Focus …
Page 73 and 74: Risk factors common to major non-co
Page 75 and 76: Levels of Risk Factor Surveillance
Page 77 and 78: Actions at Hospitals Proper depict
Page 79 and 80: SIHFW: An ISO:9001:2008 certified I
Page 81 and 82: Structure re of presentation Risk
Page 83 and 84: Risk factor in NCD Any attribute,
Page 85 and 86: Risk factors May be truly causativ
Page 87 and 88: NHD of NCD Changes in life style st
Page 89 and 90: The WHO STEP approach to Surveillan
Page 91 and 92: STEPS emphasizes that small amounts
Page 93 and 94: SIHFW: an ISO 9001: 2008 certified
Page 95 and 96: Step1:Questionnaire Based Assessmen
Page 97 and 98: Step 3: Biochemical Measurements D
Page 99 and 100: Core Items Expanded Items Optional
Page 101 and 102: Behavioral Risk Factors “Actions/
Page 103 and 104: Modifiable Risk Factor: 2008 estima
Page 105 and 106: B. Diabetes ‣ Obesity ‣ Sedenta
Page 107 and 108: D. Cancer ‣ Environment ‣ Life
Page 109 and 110: Risk factors and level of NCD preve
Page 111: Goals of implementing these guideli
Page 115 and 116: High risk With established cardiov
Page 117 and 118: If cholestrol can not be measured S
Page 119 and 120: Prevention of CVD (according to ind
Page 121 and 122: NPCDCS Components Prevention throu
Page 123 and 124: Thank you SIHFW: An ISO:9001:2008 c
Page 125 and 126: Problem on the rise : NCDs MI HT CO
Page 127 and 128: Major diet related NCDs Diabetes Ca
Page 129 and 130: Type of cancers Risk factors Diet R
Page 131 and 132: Prominent risk factor Disease Heart
Page 133 and 134: Life Style Modification Primary Pr
Page 135 and 136: Burden of the Bulge In India 1 in
Page 137 and 138: Android : Upper-body obesity--apple
Page 139 and 140: Assessment of central obesity Wais
Page 141 and 142: Why is this happening Drivers of th
Page 143 and 144: Nutrition transitions: Absolute cau
Page 145 and 146: Body Mass Index (BMI ) Quetlet’s
Page 147 and 148: Classification BMI Classification W
Page 149 and 150: Sleep apnea and respiratory problem
Page 151 and 152: Weight management Weight gain Calor
Page 153 and 154: Weight loss goals Realistic Achie
Page 155 and 156: Lifestyle medicine: Need for change
Page 157 and 158: Dietary interventions Managing g /
Page 159 and 160: Life style modification & Diet Bala
Page 161 and 162: SIHFW: an ISO 9001: 2008 certified
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Total energy requirement Total ener
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Diet for NCD: Main focus ‣ Gradua
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Promoting Healthy lifestyle le Tra
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Strategies for Obesity Prevention e
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Tips for weight reduction Slow and
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‣ Avoid fried foods and bakery pr
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When to eat Set aside a time for
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Way to eat Eat slowly. Chew prop
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Recommendations in preventing diabe
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Calculating balanced diet Know Rec
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How to calculate balance diet Step
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Key recommendations -Diet • Frui
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Thank you SIHFW: an ISO 9001: 2008
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Structure re of presentation Basic
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What is Cancer SIHFW: an ISO 9001:
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Growth of Cells • Undesirable •
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Common Cancer sites Male- • Mout
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Prefix adeno- chondro- Meaning Nami
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India 0.8 million new cases/year
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Five Common Cancers Rank World Indi
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Issues in Cancer control Burden of
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Cancer patterns Predominance of To
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Prevention ention and screening Se
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Early diagnosis ‣ Individual’s
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Diagnosis Radiological Biochemica
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Cancer Interventions in different E
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350 Age wise distribution of deaths
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Common Cancer in Male 50000 45000 4
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No of Cancer Deaths -India 350 300
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Cancer Deaths -Rajasthan 60 50 40 5
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District wise Reported Cancer Death
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Projected Cases of Oral Cancer in I
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Age - wise distribution of Deaths d
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Symptoms of Cervical Cancer Post-m
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Evaluation and Management after Pap
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VIA Category Negative Positive Crit
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Cryotherapy (ablation) Management
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Age - wise distribution of Deaths d
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Sign and Symptoms A lump or thicke
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Diagnosis Breast awareness & breas
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Health professionals can - Key Mess
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Projected Cases of Lung Cancer in I
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Symptoms Persistent cough or worse
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National Programme SIHFW: An ISO:90
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National Cancer Registry Programme
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Schemes under NCCP Recognition of
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District Services under NCCP Healt
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Medical college Health Promotion &
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Why include Cancer In NPCDCS No u
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Objective e of TCC Scheme Develop
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Thank You For more details log on t
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Definition ‣ Group of brain dysfu
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Burden of Disease 7000000 6000000 5
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Risk Factors ‣ Age and Sex ‣ Hy
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Cerebrovascular Accident Risk Facto
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Cerebrovascular Accident Anatomy of
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Ischemic Cascade Cerebrovascular Ac
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‣ Trouble in walking Symptoms ‣
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Identification of an acute event S
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Diagnosis: CT without contrast Cer
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Cerebrovascular Accident Classifica
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CVA Recognition SIHFW: An ISO:9001:
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Cerebrovascular Accident Thrombotic
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Cerebrovascular Accident Common Sit
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Cerebrovascular Accident Embolic St
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Cerebrovascular Accident Goals for
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Cerebrovascular Accident Hemorrhage
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Cerebrovascular Accident Hemorrhagi
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Delayed Neurological deficit in Re
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Hemorrhagic-Subarachnoid Cerebral A
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Cerebrovascular Accident Clinical i
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Cerebrovascular Accident Clinical M
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Cerebrovascular Accident Treatment
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Cerebrovascular Accident Diagnostic
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CVA - Treatment Goals Surgical Tre
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Drug Therapy Cerebrovascular Accide
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Cerebrovascular Accident Rehabilita
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Cardio-Vascular Diseases SIHFW: An
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Source: WHO Burden of Disease Numb
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Cardiovascular Diseases group of di
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Newly emerging CVD risk factors ‣
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Resource Scenario-1 Scenario-2 Scen
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Prevention of CVD Heart disease and
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Hypertension “ high blood pressur
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Classification Primary / Essential
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Epidemiological Determinants Risk/
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Symptoms ‣ Headache ‣ Drowsines
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Criteria for diagnosing high blood
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Headache (severe hypertension) < mo
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Physical examination should include
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Desirable: (at CHC/sub-district/dis
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Life style advice is advocated for
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Treatment Goals The aim should be
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Diuretics Thiazide Inhibit Na + /C
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Beta blockers Act by decreasing ca
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α adrenergic blockers Lower BP by
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Medicines are tailored depending on
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‣ Start with calcium channel bloc
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Compelling Indications for Compelli
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Management of Hypertension at diffe
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Follow-up and Monitoring Patients
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Ischemic Heart Disease Myocardial i
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Burden of IH Disease 10000000 22367
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Symptoms ‣ Abrupt, unexpected car
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Treatment of IHD ‣ Medical treatm
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Management & Prevention: Modifying
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‣ Weakness in sternocleidomastoid
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Prevention ention ‣ Strokes are p
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‣ Physical therapy to improve str
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Rheumatic heart diseases ‣ Compli
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‣ Breathlessness ‣ Fatigue ‣
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Prevention ‣ Seek immediate medic
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Conceptualization ation of NPHCE U
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Objectives es Provide Preventive,
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Ageing Ageing is a progressive biol
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Ageing means….. Demographers: A
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Ageing Progressive and generalized
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Some Facts! World population of 6.
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Projections 60+ 24 million in 1961
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India: Some Facts! Life expectancy
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Household population p + 60 Age By
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Ageing: Common Myths Most elderly
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Integumentary System Production of
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Circulatory System Heart muscle be
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Nervous System Progressive loss of
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Urinary System Decreased circulati
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Reproductive e System Female: vagi
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Psychosocial Changes of Aging Lone
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Psychosocial changes can be a major
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Dementia Term used to describe a l
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Alzheimer’s Disease (continued)
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Meeting the Needs of the Elderly G
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Gender and Ageing g in India Discr
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Care - Services for Elderly l in In
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Primary Health Center Training of
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How to achieve it Ati Active advoc
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Mental Health : Problem, Strategies
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Health "Health is a state of compl
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Mental Health Problems in India 1%
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Extent of the problem… Mental He
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Mental Health Resources In India Ma
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Mental Health Resources In India…
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Mental Health Resources in India 2
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Objectives National Mental Health P
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Essentials of DMHP 1. A decentraliz
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Restrategised NMHP 2003 Components
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Integration of NMHP in NRHM Nation
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DMHP Evaluation Independent evalua
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NMHP Achievement Scheme Financial S
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Failures It is top down approach
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Urban Mental Health Meta analysis b
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NGO Work In INDIA SCARF (Schizophr
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Mental Health NGO Activities Treat
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Community Awareness Role of media
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Tobacco As per Global Adult tobacc
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Stepped Care Approach in Substance
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Future Direction Vision i 2020: Roa
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