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

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o o o o ACE inhibitors Decrease production of angiotensin i II, thus causing efferent arteriolar vasodilatation o Enalapril 5-40mg/day(1-2) o Captopril 25-200mg/day(2) 200mg/da o Lisinopril10-40mg/day (1) o Ramipril 2.5-20mg/day(1-2) Can be combined with diuretics and CCB Side effects-Dry cough, Angioedema, Hyperkalemia ARB’s o Losartan 25-100mg/day (1-2) o Valsartan 80-320mg/day(1) o Candesartan 2-32mg/day (1) o Telmisartan 20-80mg/day(1) o Olmisartan 20-40mg/day(1) C/I of ACEI’s and ARB’s are renal failure, bilateral renal artery stenosis, pregnancy <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 362
Beta blockers Act by decreasing cardiac output, due to reduction of heart rate and contractility Selective (ß1) Acebutolol-200-600mg/day(2) Atenolol-50-100mg/day(1) Metoprolol-12.5-100mg/day(2) Bisoprolol-10mg/day(1) Esmolol-50-300µg/kg/min IV <strong>Non</strong>selective Propranolol-40-160mg/day(2) Combined alpha/beta Labetalol-200-800mg/day(2) Carvedilol-12.5-50mg/day(2) Contraindications are asthma, COPD, PR-
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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 &
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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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Page 311 and 312: Hemorrhagic-Subarachnoid Cerebral A
Page 313 and 314: Cerebrovascular Accident Clinical i
Page 315 and 316: Cerebrovascular Accident Clinical M
Page 317 and 318: SIHFW: An ISO:9001:2008 certified 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: Diuretics Thiazide Inhibit Na + /C
Page 365 and 366: α adrenergic blockers Lower BP by
Page 367 and 368: Medicines are tailored depending on
Page 369 and 370: ‣ Start with calcium channel bloc
Page 371 and 372: Compelling Indications for Compelli
Page 373 and 374: Management of Hypertension at diffe
Page 375 and 376: Follow-up and Monitoring Patients
Page 377 and 378: Ischemic Heart Disease Myocardial i
Page 379 and 380: Burden of IH Disease 10000000 22367
Page 381 and 382: Symptoms ‣ Abrupt, unexpected car
Page 383 and 384: Treatment of IHD ‣ Medical treatm
Page 385 and 386: Management & Prevention: Modifying
Page 387 and 388: ‣ Weakness in sternocleidomastoid
Page 389 and 390: Prevention ention ‣ Strokes are p
Page 391 and 392: ‣ Physical therapy to improve str
Page 393 and 394: Rheumatic heart diseases ‣ Compli
Page 395 and 396: ‣ Breathlessness ‣ Fatigue ‣
Page 397 and 398: Prevention ‣ Seek immediate medic
Page 399 and 400: SIHFW: An ISO:9001:2008 certified I
Page 401 and 402: Conceptualization ation of NPHCE U
Page 403 and 404: Objectives es Provide Preventive,
Page 405 and 406: Ageing Ageing is a progressive biol
Page 407 and 408: Ageing means….. Demographers: A
Page 409 and 410: Ageing Progressive and generalized
Page 411 and 412: 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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