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

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Cerebrovascular Accident Clinical Manifestations Anterior Cerebral Artery Involvement Brain stem occlusion Contralateral weakness of proximal upper extremity sensory & motor deficits of lower extremities Urinary incontinence Sensory loss (discrimination, proprioception) Contralateral grasp & sucking reflexes may be present Apraxia – loss of ability to carry out familiar purposeful movements in the absence of sensory or motor impairment Personality change: flat affect, loss of spontaneity, loss of interest in surroundings Cognitive impairment <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 314
Cerebrovascular Accident Clinical Manifestations Posterior Cerebral Artery & Vertebrobasilar Involvement Alert to comatose Unilateral or bilateral sensory loss Contralateral or bilateral weakness Dysarthria – impaired speech articulation Dysphagia – difficulty in swallowing Hoarseness Ataxia, Vertigo Unilateral hearing loss Visual disturbances (blindness, homonymous hemianopsia, nystagmus, diplopia) <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 315
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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
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Institutional Framework Integratio
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Screening MO to do: To conduct com
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Work closely with other sectors/ de
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Surveillance Surveillance is the on
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Risk Factor Surveillance: Focus …
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Risk factors common to major non-co
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Levels of Risk Factor Surveillance
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Actions at Hospitals Proper depict
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Structure re of presentation Risk
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Risk factor in NCD Any attribute,
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Risk factors May be truly causativ
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NHD of NCD Changes in life style st
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The WHO STEP approach to Surveillan
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STEPS emphasizes that small amounts
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SIHFW: an ISO 9001: 2008 certified
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Step1:Questionnaire Based Assessmen
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Step 3: Biochemical Measurements D
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Core Items Expanded Items Optional
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Behavioral Risk Factors “Actions/
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Modifiable Risk Factor: 2008 estima
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B. Diabetes ‣ Obesity ‣ Sedenta
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D. Cancer ‣ Environment ‣ Life
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Risk factors and level of NCD preve
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Goals of implementing these guideli
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Follow up Once the condition of th
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High risk With established cardiov
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If cholestrol can not be measured S
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Prevention of CVD (according to ind
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NPCDCS Components Prevention throu
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Thank you SIHFW: An ISO:9001:2008 c
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Problem on the rise : NCDs MI HT CO
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Major diet related NCDs Diabetes Ca
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Type of cancers Risk factors Diet R
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Prominent risk factor Disease Heart
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Life Style Modification Primary Pr
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Burden of the Bulge In India 1 in
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Android : Upper-body obesity--apple
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Assessment of central obesity Wais
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Why is this happening Drivers of th
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Nutrition transitions: Absolute cau
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Body Mass Index (BMI ) Quetlet’s
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Classification BMI Classification W
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Sleep apnea and respiratory problem
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Weight management Weight gain Calor
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Weight loss goals Realistic Achie
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Lifestyle medicine: Need for change
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Dietary interventions Managing g /
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Life style modification & Diet Bala
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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 &
Page 263 and 264: Why include Cancer In NPCDCS No u
Page 265 and 266: Objective e of TCC Scheme Develop
Page 267 and 268: Thank You For more details log on t
Page 269 and 270: Definition ‣ Group of brain dysfu
Page 271 and 272: Burden of Disease 7000000 6000000 5
Page 273 and 274: Risk Factors ‣ Age and Sex ‣ Hy
Page 275 and 276: Cerebrovascular Accident Risk Facto
Page 277 and 278: Cerebrovascular Accident Anatomy of
Page 279 and 280: Ischemic Cascade Cerebrovascular Ac
Page 281 and 282: ‣ Trouble in walking Symptoms ‣
Page 283 and 284: Identification of an acute event S
Page 285 and 286: Diagnosis: CT without contrast Cer
Page 287 and 288: Cerebrovascular Accident Classifica
Page 289 and 290: CVA Recognition SIHFW: An ISO:9001:
Page 291 and 292: Cerebrovascular Accident Thrombotic
Page 293 and 294: Cerebrovascular Accident Common Sit
Page 295 and 296: SIHFW: An ISO:9001:2008 certified I
Page 297 and 298: Cerebrovascular Accident Embolic St
Page 299 and 300: Cerebrovascular Accident Goals for
Page 301 and 302: Cerebrovascular Accident Hemorrhage
Page 305 and 306: Cerebrovascular Accident Hemorrhagi
Page 307 and 308: Delayed Neurological deficit in Re
Page 311 and 312: Hemorrhagic-Subarachnoid Cerebral A
Page 313: Cerebrovascular Accident Clinical i
Page 319 and 320: Cerebrovascular Accident Treatment
Page 321 and 322: Cerebrovascular Accident Diagnostic
Page 323 and 324: CVA - Treatment Goals Surgical Tre
Page 325 and 326: Drug Therapy Cerebrovascular Accide
Page 327 and 328: Cerebrovascular Accident Rehabilita
Page 329 and 330: Cardio-Vascular Diseases SIHFW: An
Page 331 and 332: Source: WHO Burden of Disease Numb
Page 333 and 334: Cardiovascular Diseases group of di
Page 335 and 336: Newly emerging CVD risk factors ‣
Page 337 and 338: Resource Scenario-1 Scenario-2 Scen
Page 339 and 340: Prevention of CVD Heart disease and
Page 341 and 342: Hypertension “ high blood pressur
Page 343 and 344: Classification Primary / Essential
Page 345 and 346: Epidemiological Determinants Risk/
Page 347 and 348: Symptoms ‣ Headache ‣ Drowsines
Page 349 and 350: Criteria for diagnosing high blood
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Page 353 and 354: Physical examination should include
Page 355 and 356: Desirable: (at CHC/sub-district/dis
Page 357 and 358: Life style advice is advocated for
Page 359 and 360: Treatment Goals The aim should be
Page 361 and 362: Diuretics Thiazide Inhibit Na + /C
Page 363 and 364: 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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For more details log on to www. sih
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