DRINKING AND SMOKING

Value of alcohol from the physiological and psychological point of view is not subject to a different opinion.It has some food value in the sense that it makes some calories and hence spares or supplements carbohydrates.In any form it is not at all essential for nutrition.It has a calorific  value of 6 to 7 colories per ml The psychological "stimulant" effect of the alcohol in moderate doses are used in high altitude during cold and inclement weather as a psychological booster than any other reason.On the other hand if consumed in excess it may produce very bad effects on the tissues mainly liver,heart and central nervous system.These effects are mainly in alcoholics lack of food and or improper absorption in "chronic hard boiled alcoholics"  as a result of chronic alcoholic gastritis.
Small amount of alcohol taken occasionally may not be harmful physiologically or physically,but higher regular consumption may lead to diseases of liver,stomach,kidneys,cardiovascular system and nervous system causing alcoholic cirrhosis,nephritic conditions,stomach ulcers, various nervous and psychic ailments,
cancer in mouth,throat,food pipe and stomach.Regular consumption of large quantities sooner or later leads
compulsive drinking and further on to addiction and finally confirmed as "alcoholism" in its classical stage
which is harmful to the body and mind.In fact alcoholism itself takes the form of a disease needing treatment
psychologically.It may in its extreme forms cause sudden or chronic alcoholism dipsomania,delirium tremors
and various types of psychosis such as Korsakoff s syndrome,crippling paralysis, etc.The effects of alcoholism on the central nervous system are 3 causes;it leads to myeline degeneration progressing to
Wallerian degeneration of the nerve tissue;it causes deficiency of nutriments specially the vitamin b group
due to malabsorption,gastric irritation and liver damage;it causes psychological aberration by regular use.
The effect of mental functions are lowering of  rational thinking,increased latent period,reaction time and
decreased cerebration,disturbance of the power of correct judgment,increased mental irritability and lethargy after drinking bouts,decreased power of concentration,decreased balancing power and decreased
capacity for prolonged and sustained intellectual work.Chronic alcoholism may lead to obesity and its effects.
A concentration of as low as 0.4 mg per cc blood will cause disturbance of judgement for quick action as
required while driving a vehicle or for semiliar duties,etc.
Heavy smoking is another harmful habit.Tobacco is not essential for a healthy or happy life.Like drinking this habit also often begins as a social accompaniment for relaxation under tense conditions,as an escape from relatives of life stress or from the false beliefs in their beneficial values.The temporary relief is followed by irritation or lack of concentration and craving for further smoking.Like tobacco chewing or alcohol drinking this lead to compulsive smoking and then to addiction.Excessive smoking, if started in early life,causes increased incidence of lung cancer.It increases to a high incidence of ischaemic heart disease,peptic ulceration,gastric cancer and tremors.Nicotine causes powerful vasospasm,chronic bronchitis and pharyngitis
and dental staining always seen in heavy smokers.Smoking increases chance for frost bite,due to vasospasm
induced by it.Withdrawal symptoms are lack of concentration,restlessness,irritability,etc.smoking is not having any nutritional or health promoting values and heavy smoking has definite unhealthy effects.

pmkutty









  

SNAKE BITE

HABITS OF SNAKES

The snake is a limbless creature with a scaly elongated body, colours and patterns on the body blend with surroundings.the progression of the snake is by gliding,moving faster on rough surface than on smooth surfaces.Head having a pair of eyes and a pair of nostrils but no external ears.The important anatomical parts of the snake is,as far as the human health hazard is concerned,are teeth and venom glands of poisonous snakes."envenomation"is the term called for the snake bite poisoning.Snakes eat insects,frogs,rats and mice.The king cobra type of some lives on small snakes and also its own kind.The Mongoose.dogs,cats, eagle and peacock are its natural enemies.Dogs and cats are alerted by its presence and they catch it.

Most snakes are are usually nervous and shy;therefore,they try to escape and hide if disturbed,and attack only if escape is not possible.Some are,however,vicious and attack unprovoked.They are not disturbed in fields and forests and getting of plenty of prey,are more infested than inhabited areas.But rodents may attract them into build up areas.Jung heaps, garbage.and rubbish collections,close to human habitation,offer them

undisturbed shelter and offer them lot of prey.They also live hollow of trees and abandoned and fallen masonry.

Snakes survive starvation for long time and hibernate during severe winters.In tropics they are seen in the open all year round.In subtropics they come out in  summer and more open during rains in search of dry places.most land snake can climb in the tree and swim.Fresh water snakes are nonpoisonous.A medical person should be able to distinguish the poisonous from non-poisonous snakes and a bite from it is required anti venom treatment or not,because,although the anti venom treatment is life saving,it carries a certain amount of risks.If the bite is certainly that from a non poisonous snake the specific treatment can be withheld.The distribution,local names and important distinguishing features of Indian poisonous snakes should be learned by a first aider and he must know the first aid treatment to give to a snake bite case before the arrival of a doctor or the case is being transported to a hospital.
There are about 1000 species of snakes in the world out of which 300 are Poisonous.Out of 400 species of
Indian land snakes 40 species are poisonous,and out of those only 4 per cent only constitute the total population of snakes.Out of 30 sea snakes species in India one species only poisonous.But due to their narrow gape they can rarely bite effectively.The main poisonous land snakes in India are the cobra,King cobra,vipers and the Krait which is most poisonous of all the snakes but least commonly bites a man.The first 3 species cause most of the deaths.But pit vipers in India do not cause many deaths.There are three main types of viper in India namely, Russell s viper,green pit viper and so scaled viper which all can be distinguished by seeing the marks,scales and a pit on the head of green pit viper.Cobras include the common India cobra and king cobra which is forest dweller.The common Indian cobras are found in thick jungles or in open country with or with out vegetation and in gardens or in cultivated lands under rubbish or in old temples and mosques.It is also found in dark rooms of bungalows, homes,when disturbed it tries to escape.A young cobra is much more alert and irritable and strikes and bites and more dangerous than a full grown cobra.Venom of cobra affects nervous system,depresses brain and makes respiratory failure.
Vipers with pits on heads between nose and eyes called "pit vipers" and not having such  pits are
"pit less vipers".Both types are found all over India.There are about 110 kinds of these viper snakes and all are poisonous.but the venom of some of them is not lethal to man.Their poison fangs are well grown and effective for a bite.A viper has a flat,broad and some what triangular head with angles,normally covered with small scales.and eyes vertically.11 kinds of pit vipers are found in Indian sub continent,and 22 kinds are found in Asia out of 65 kinds pit vipers in the world.Indian pit vipers are mostly found in hilly areas and deaths from their bites are rare.The deaths by bites of pit-less vipers are more in India are the Russell's and the Echis vipers.They are easily distinguished by the broad plates extending right across the belly and the small scales on the head like to those on the body.their back marked with black blotches of inverted V shaped markings.No other land  snake possesses all these features combined.Venom of vipers affect on blood and circulatory system and makes hemorrhage/bleeding internally and externally.
Kraits are found more in eastern India than other parts of country,but are found in patches of all over the country.There are two main varieties, the banded and non branded.Kraits has the most potent venom of all
the land snakes,which affects the central nervous system and paralyses of the brain and collapses of lungs and suffer from respiratory failure.But these snakes are inoffensive and shy which bites human beings very rare.It abounds in cultivated fields and human habitations.They have a small mouth and very fine fangs.
Snake venom is a clear, oduorless and fastless liquid.After drying it and adding water to it,it will again become a powerful poison.It acts only through broken surface of skin,mouth,or mucous remembrances.It is like a digestive juice and digests everything except hair,nails and etc.Venom contains four important enzymes.The systemic effects produced by each type of venom is determined by the presence of particular enzymes.A snake can bite number of times successfully and continue to secrete venom,and the amount of poison discharged one time by each bite from a poisonous snake varies from 2-3 drops as in the case of sea snake,and 30 drops as in the case of king cobra.
 The diagnosis of envenomation and its type is made by the time interval between the bite and starting of symptoms,and progression,type of syndrome and local examination of snake.Snake venom is highly potent poison and absorbed into the body rapidly.As all snakes are not poisonous and all bites are not fatal,all snake bitten persons suffer from psychological shock and few deaths may occur due to it.So all bites are considered as poisonous and requiring proper attention.The victim should not exert and should keep calm and reassure the victim.Absolute rest and warmth should be given,and hot tea or coffee may be given.Alcohol and strychnine are prohibited and morphia is contraindicated.It is better to give first on the spot.The victim may call for help or proceed slowly to the place where assistance can be had.A quick inspection and general examination of bitten part may give indication whether poison has been injected.
Treatment depend on correct diagnosis of envenomation and its type.The venom acts very soon if a large
amount is absorbed into the circulation,and anti snake venom serum,which is the only specific remedy,does not get a fair chance and time to neutralize the venom if its administration is delayed ,First aid,therefore, aimed at preventing and delaying absorption of the poison pending administration of the anti snake venom.
The first aid treatment for snake bite is as follows:Remember RRP(REST,REASSURANCE,POSITION)  
If you see a snake bite case locally,give him complete rest,reassure the victim and keep the bitten part lowered if the bite is one of the extremities.Any action walking,running.etc will increase circulation and poison may absorb rapidly in the whole body.Aim of the first aid is, not to enter snake venom into circulation. Wash the part thoroughly by soap and water or with plain water if soap is not available on the spot,This will remove the poison from the site of bite from further absorption to blood.Suck the bitten part by your mouth if mucous membrane in mouth is intact.Then apply a piece thick string of cloth round the limb,on the single bone,above the site
of bite.Tighten it with a stick just enough to stop venous circulation not for arterial flow.This more beneficial
in case of cobra bite than viper bite.suction may be done by breast pump or cupping glass etc,if incisions are made on the part of bite,There is also a controversy that if incision are made in the bitten part, more poison may absorb in circulation.Any way valuable time may not be wasted over these procedures.
The limb should be immobilized with a splint,broad strips of wood or in sand bags or plaster splints.
Thomas splint should be used when patient has to be moved over a long distance for specific treatment.The
envenomation having been diagnosed,the anti snake venom serum should be given with out delay on arrival
to hospitals.
pmkutty

POPULATION CONTROL

The population growth

The most pressing social problem undermining the social security and development in the world today,mainly in developing countries of Asia,South America and Africa,but specially in our country,is that of growing population.The population has been growing since the birth of civilisation about 6000 years ago,but the rate of growth now is more than ever before.Before the beginning of christian Era,the world population has been
estimated at less than 125 million and the population in India less than 7 million.The natural forces balanced the births by deaths and kept the population growth low.The populations have been growing in the world every  where but has been growing faster in the eastern countries,especially so in the developing countries like India.Our average rate of increase in population is over 2.5 per cent per year which is more than that of any developing country.It took several thousand years,say 5000 years or more,for our population to reach
its present level of more than 500 million.But the present rate of growth it will take only 27 years to reach 1000 million.This is the population explosion.

Causes of population growth: The rapid increase in population in India is due to the decreased death rates from over 50 per cent of the population at the starting of this century to about 15 per 1000,while the birth rate has remained almost at about 40.This leaves a surplus of 25 persons per 1000 of population per year.
The decreased mortality due to the control of major endemic diseases and epidemics,better health care of the communities and improved living environments,premature births,still births and infant mortality,all depend upon the care of the pregnant mother,have halved during the last 30 to 40 years.population grows in three stages.The first of this stage is slow population growth.During this stage the high birth rate is accompanied with equally high death rate.This stage is found in the underdeveloped communities with low living standards.
The next stage is that of rapid population growth,this occurs in the communities.which are rapidly developing their living standards.we are at present in this stage.The third stage is that of steady population.This obtained by reducing the birth rate faster than the falling death rate;both balancing each other.This is the ideal stage to be achieved by us.
The growth of human population occurs in progress while the food grows,more over the land on the surface of the earth for growing food,building houses,raising industries,and that required for supporting civilized human existence is limited,while population can grow and has grown unlimitedly. A widening gap is so created mainly affecting the earlier years of life,increases the proportion of the younger generation.It accompanied by a falling birth rate,and the adult proportion of population increase.In developed western countries like U.K these proportions are 70 per cent productive and 30 per cent non-productive,half which are young persons and half old.In India the younger age group is about 49 per cent of the whole population while in the developed countries it is 15 to 20 per cent.

The practicable remedial measures; The population control measures include firstly the migration.Large scale of migrations which occurred in the in ancient and historic periods are no more possible now to any out side countries.Inter-state migrations are possible in India,provided enough industrial enterprises are undertaken in otherwise barren lands to attract and occupy surplus people to other over populated areas.The next measure is to increase the food and commodity production to support the growing population,which is being pursued in our country

National considerations:
The limited available land and arithmetical progression of food grain production can not maintain a population growing in geometrical progression.In spite of about 75 per cent increase in food grain production since 1950,the per capita allowance has not increased of  pre-existing allowance of 12 to 14 ozs. The present yield per acre will not materially increase unless a radical change in agricultural methods on a vast scale is brought about.
Mechanisation of farming is  essential for increased food production,will entail the rapid release of vast labour force from agricultural employment and will have to be absorbed in industry which is not possible with out a planned successful economy.
Initially the community and industrial development plans are based on a certain estimate of population..Full employment,community and administrative services commercial and commodity production will fall short of requirements.
provision of a adequate social services,living and working accommodations,employment have all to be planned according to the size and type of population.Increase in population upsets the plans.
The expectation and experience of a better livings has increased demands of people on food,consumer goods,housing,community services,administrative services,social security and welfare services.
So the improvements in general living standards far achieved is being under minded and general fall will not be at a distance.We have to remain  depend on other countries for all our requirements.The close  relationship of housing,nutrition,social security,with mental health,necessitates a limitation of the family.

Family consideration: Large families are desirable for agrarian civilizations of feudalistic pattern.Industrial
civilization has resulted in disintegration of joint families due to shifting from rural to urban environments.
Economic bonds between "nuclear"families have loosened and between their collective reliance on the parent joint family for social and economic security,which was the most important single asset of the joint family system,has been severed.The income of the nuclear families drifting to urban areas is not always sufficient
and can not be supplemented from the limited joint rural land resources.so family size limitation has become
necessary.A small family is convenient for housing,feeding.clothing,planning education,training and employment.
Individual considerations: This concerns the health of the mother and efficiency and growth of the child.many pregnancies and confinements damage the health of mother and does not permit her to look after the child properly or help his normality of  growth.India has adopted a family welfare programme officially.Prolonging the marriageable ages of young women by affording the facilities for education up to a later age and there fore employment in gainful professions is one of the methods of decreasing the birth rate. Avoidance of polygamy can also help birth control to certain extent and control the growth of population.

pmkutty 

CLIMATE AND HEALTH

Life on earth exists within an envelop of atmosphere which surrounds the earth for about 100 km above it.This atmospheric envelop has 3 zones;the inner most extending up to 11 km is called "troposphere",the middle zone up to 20 km is the stratosphere and the outer most is ionosphere.The narrow belt between first and third zone is called troposphere
 which almost completely separates these two zones having contrasting characteristics as explained below.

The temperature in the troposphere decreases as the height increases,at the rough rate of 0.65 per 100 meters until it goes down to about 55 c beyond the troposphere up to 32 km it is almost constant;there after goes on increasing so that between 50 to 60 km it is more than that at the sea level.The troposphere contains 80% of total bulk of the air and almost all moisture and terrestrial dust of the atmosphere.The troposphere does not permit dispersion of the mass of air from the troposphere into the stratosphere.In the troposphere there are eddies and turbulence which produce vertical air currents causing cloud formations and rain fall.
The stratosphere is very calm,and clouds do not rise above troposphere. .All ultra violet below 0.29u (2900A)
absorbed ozone above the troposphere which also stops the electrical storms which are common in the  stratosphere.The troposphere so acts as an insulating blanket and barrier which keeps the envelope of gaseous, troposphere moving within its bounds with out being disturbed by cosmic events,harmful radiation
and electric storms of outer space,or getting lost in the void of outer space.Life ceases instantaneously above 10000 meres.Atmosphere contains air,water vapor Radiation and dust.

The air in its dry state has 78 percent nitrogen,21 percent oxygen and the remaining 1 percent is hydrogen,
carbon dioxide,ozone,and a mixture of other gases,such as org on,neon,radon,etc.Oxygen is the vital constituent of atmosphere as with out it no life could exist on earth,but pure oxygen would oxidase and eradicate all living matter and nitrogen dilutes it correctly.

WEATHER,CLIMATE AND SEASONS:The result of the dynamic meteorological events like high or low barometric pressure waves,gales,storms,rain falls,clouds,hail stones ,snow falls typify the weather of a place.The fundamentals which determine these events at a place are due to the meteorological factors are due to the duration of solar radiation,temperature,the air movement,and the humidity of the atmosphere,altitude and latitude,and also the difference from oceans and presence and direction of ocean currents.Each of the factors modifies others and all influenced by the topographical factors/features.The combination of all of these factors over a definite period is called weather.Its effect on human beings,not upon each individual factor but upon the resultant combination of all of them and the final effect on the human sensation is produced by the most dominant of the meteorological factors,so,weather is proscribed as warm,cold,chilly,rainy,or just fine,lousy or miserable.These adjectives describe the human sensation create by  the particular weather conditions rather than the weathers themselves or  the meteorological events.  
RAIN,HAIL STONES,FOG AND MIST AND SNOW FORMATIONS.
Water has a higher specific heat than the earths crust.It is ,therefore,oceans absorb more  from solar radiation,retain it for longer period and give it out more slowly than the earth.There fore,the
temperature during the day is always higher on land  than on the oceans.This keeps a difference in  temperature on land and sea and produces air movements from the see towards the earth and viz versa.
The moister laden winds from oceans blowing towards land raises up and form clouds with condense as
rain,Rotation round of the earth with its axis gives winds their horizontal directions ,clouds,rain,hail stones,snow,fog,mist and etc,all are different graduations of the condemnation of atmosphere moisture when the moisture laden is cooled.Its contact with the surface of earth produces mist,when air cools about  to 1digree centigrade become water.Snow is formed when went like low or high water vapour  freezes directly into solid flakes with out going through the intermediate state of water drops.
GENERAL INFLUENCE OF CLIMATE ON HUMAN HEALTH AND WELL BEING.
Climate determines the energy level of of man in a given environment.In a tropical climate,to counteract the difficulty in heat loss ,man has adopted to a lower level of of heat production.The vital capacity in healthy young adults living near the equator only a little more than half of the vital capacity in similar individuals in a living in a temperate climate.An inverse relationship between tissue combustion and external temperature
exists.Subtropical and temperate climate are best suited to man s fullest efficiency as  moderate variations to maintain the vigour to improve progress. In the tropics the lowered general tissue vitality from the sluggish cellular combustion keeps human development motionless.Climate effects are well manifested during adaptation in contrast to completely adapted persons.In the same persons the physiological and metabolic
differences can also be the result of seasonal variations where such are marked.
THE ADVERSE EFFECTS OF CLIMATE ON HEALTH.
Climate adversely influences human health directly by the effects of vagaries and extremes;indirectly by influencing mans metabolism or defensive mechanisms;and remotely by modifying his total environs.when direct adverse effects are caused when exposed to climatic extremes when the homeostatic mechanism fail
due to severity of or prolonged exposure or non-adaptability to the extremes,or physiological dysfunction.
Cold injuries like frost bite,heat injuries like heat stroke heat exhaustion sun burns and high altitude hypoxia,etc are the main adverse effects of cold and heat.Incidence of infection and illness,functional deficiency or inefficiency due to them are much commoner than due to direct influences.
FORECASTING OF WEATHER :weather forecasting helps us in planning for agricultural,navigational,aviational and other such activities which are influenced by weather conditions.It is also desirable to know the usual weather and climate conditions for planning of prevention and control of diseases,predict the levels of human efficiency,foresee the dangers of climatic extremes and vagaries on men
and plan for the prevention of their effects.
pmkutty

HISTORICAL BACKGROUND OF HYGIENE AND HEALTH ON WINNING WAR.

Health is wealth.

                         The story of hygiene is the story of man striving to overcome the adverse environment created by himself,either in waging war or preparing for war.It was released in the past,as it is universally agreed today,that losses of man due to diseases from sickness far exceed the losses due to battle field wounds.Frederick of Prussia said"fevers cost me as many men as seven battles.saying that is as true when Frederick cried it 120 years ago.As a matter of hygiene,Moses was the first leader/commander who laid down the laws
of hygiene in the book of Deuteronomy,and much of what he then wrote holds good even today.He dealt with water and food supplies,burial of dead,general sanitation,infectious diseases,bathing,sex hygiene and even selection of people. He also emphasized that certain intestinal diseases could be controlled if the people
could be taught not to pollute the top of ground with their body wastes.To him belongs the honour of of having the shallow trench latrine.

25 hundred years ago,wise men of Indus Valley civilizations knew that drainage maintained health of the people.In the Vedic period Hippocrafts,the important of sanitation was much emphasized.The celebrated
philosopher and physician Charaka and the skilled surgeon Susuta  in B.C 1000 laid emphasis on hygiene.
References in respect of camp sanitation  are also found in Susrutas works where it was enjoined on medical men that they should be aware of the possible harm effects to the health of men and animals through shelters,food,fuel and etc,by taking all possible preventive measures against any harm of their health.In Chapter 7 of the Mahabharatha (B.C 600) Karna,the commander in chief of the Kauravas warned that the prevalence fly nuisance,appearance of swarms of crows and vultures and epidemic intestinal diseases were the sure precursors of defeat.It is also stated in "Artha Shasta of Kautilya"political strategist to Chandra Gupta (B.C 350) Chapter 129,section 10,that the camps should be sited by a survey party comprising of a surveyor,a combatant officer,an engineer and a meteorologist.The duties of the survey party consisted in the selection of site with due consideration to or the nature of the terrain,character of soil,meteorological conditions such as the temperature,humidity variations,shelter from strong wind and sun,to ensure its suitability appropriate to human beings whether at rest or action.In the Mahabharatha in Chapter 7 orders were issued on the mobilization troops,in respect of selection and establishment of water points and siting of water points at such places not liable to contamination,.Kautilya warned that in the field,where likely water is to be scarce,important of pure water carried in water cart or by each man on his person was not to be forgotten.
The reduction of incidence of communicable diseases through general improvement in environs by exogenous methods may reach its limit in the near future.Further improvement in the morbidity due to the communicable disease and non communicable diseases will need conscious efforts on the part of the people themselves.
Health education of persons and their families is,therefore,of utmost importance in addition to the continuance
of efforts to further improve their environment conditions.Specific control and preventive measures against individual ailments or a rational group of ailments should be adopted.In order to evolve such control/preventive measures etiology and epidemiology of such ailments of both groups needs exhaustive and
intensive study.Non communicable diseases have been  less sensitive than the communicable diseases to the socio-environmental diseases .The overall morbidity rate per 1000 of strength decreased from 1322 to 223 during the past 85 years.Incidence of communicable came down to 78 from 989 per 1000 strength and made a contribution of over 70 percent towards the improvement of overall morbidity  incidence;non -communicable disease also decreased but as compared with the spectacular fall of 92 percent in the incidence of communicable diseases,this group showed a fall of 56 percent during the same period 1950.



Caesar paid utmost attention to physical fitness of  of the men,particularly to their bathing and to their  sanitation.Marlborough concentrated on clothing and feeding,and his troops were best fed and clothed of its day in Europe.In Mahabharatha reference exists in respects of large stocks provisions e.g honey,ghee,made available for sale to troops at controlled rates in order to maintain the nutrition of soldier..Parkes,professor of  at the British army medical school,later R.A.M ,College,was the first scientific military hygienist.He lived from 1819 to 1876,and his efforts to improve the living conditions of men as such remarkable and world wide effect that, when he died,Von Molke said :"Every regiment in Europe ought to parade on the day of
Dr. Parkes funeral and present arms in honour of one of the greatest friends a soldier ever end"                

And so the story goes on -each doing what he could with imperfect knowledge.But it was until wold war one 1914-1918 that rational and scientific study of hygiene was made.Then and since a worthwhile result has been achieved,and many of the diseases like malaria,decentery,jaundice/ineffective hepatitis are reduced.
The health is a battle winning actor is well established truth.During the talk on strategy Admiral Mount batten said; "more serious than monsoon ,however,was the incidence of tropical diseases.The jungles of Burma are infested with malaria mosquitoes,scrub typhus mites,and the bacteria and amoeba of dysentery,Between them these presented a more redoubtable enemy than the Japanese themselves.Then therefore,I set  up
at once, an inter services,inter allied medical advisory division to help with research and to organise an offensive drive against disease to be waged by the medical services.The enemy had no medical advisory division and appears to have made NO advance in medical research.As our own troops became more immune to circumstances against which the Japanese had no remedy,I was determined to enlist disease an additional weapon on our side and deliberately chose unhealthy areas in which to fight" .and thus war won.

Reference in respect of naval hygiene also exists.Cap cook the commander of ships scanning the Pacific found the effects citrus fruits,specialy lemon,on the health of sailors.In fact the first vitamin to be described
Vitamin C and the the first alphabet of his name.Nelson interested himself in the prevention of scurvy,and introduced the issue of lemon in the Royal Navy which caused the Royal Merener(later all British sailors) to be nick named as "LIMY".James Lind ,a naval surgeon who lived from 1716 to 1765, had ideas a century and half ahead on his time.He recommended the delousing sailors and backing or their infested clothing as a means of preventing typhus;he knew as much about scurvy as we do today and his recommendation for the introduction of lemon juice in the navy as a daily issue contributed materially to naval victories at the time of Nelson.He introduced the sand filtration of water and the production of drinking water by distillation from sea water.  

Thus morbidity and mortality depend upon the health of personnel.
pmkutty

DENTAL HEALTH

Dental health

Oral and dental health has a profound influence on the general health of a person.Efficient mastication is essential for digestion of food is of course solely dependent on healthy gums.Besides infections of teeth and gums provide primary septic foci for a variety of systemic diseases.A foul mouth is not only a healthy liability but also a social and psychological barrier,.from all these point of view the dental health is importance for preservation of general health.The process of digestion of food starts from mouth and teeth make it easy.
Thus all must be conversant with its essentials.No methods of absolute control of or achieving complete immunity against any of the dental disorders exists as no specific drug or vaccine which will exert a definite protective action against dental diseases has been discovered.However,our present knowledge has a wide
scope for prevention of many dental diseases/conditions and partial or relative control of certain diseases by employment of certain procedures such as oral hygiene and prophylaxis and prosthesis and physiotherapy.
Dental diseases can be permanently arrested if corrective measures are taken early in their course,where by
the extent of the lesions is limited and serious destruction of tissue is prevented
Practice of oral hygiene is the most important means of prevention of dental diseases.Oral hygiene may be
defined as the science of achieving oral health and its preservation by employment of all measures which tent to decrease the incidence of oral diseases and,by the early application of operative procedures,to arrest the
progress of lesions which have already occurred.The greatest success in the prevention of dental diseases lies in the use of those specific measures which tent to inhibit progress of the disease process.
The structure of the teeth: There are two sets of teeth,namely milky tooth and permanent set.normal tooth for an adult is 30 to 32 if wisdom tooth has come.normal dental point for an adult is 20 to 22.Names of the teeth are molar-3,premolar-2,canine-1,and incisor-2,and molar has got 2 points for each and rest are one point for each.Minimum 16 dental points are required for normal mastication of food for digestion.if a molar is extracted 2 points are vanished and other tooth one is extracted one point is lost.thus you can count your dental points..Minimum 16 dental points are required for fitness for medical examination of recruits.The teeth are hard,calcified structures set firmly in bone sockets in the upper and lower jaws by means of a root or roots.The part visible in the mouth is the crown.The hard shiny substance that covers the crown is enamel.The bone like substance covering covering the root is cementum.A substance that forms the body of the teeth is dentin
Functions of teeth: The primary functions of the teeth is firmly to bite and cut the large and hard pieces of food and grinding to reduce to a pulpy mass so as to thoroughly mix it with saliva which changes the starches of food into sugar.For efficient performance of this function the upper and lower teeth should meet in a good bite and normal occlusion. Occlusion means.the relation of upper and lower teeth which each other when the jaws come together in biting or chewing which is hampered when occlusion is faulty.Chewing ability depend upon the soundness of teeth,firmness and hardness of enamel and uniformity of occlusion and strength of jaws.chewing the fibrous foods such as meat,apple,carrots,radish celery and etc, so on endows these properties,benefits the gum by stimulating blood circulation through them and also develops the jaws.Children should be taught to chew their foods thoroughly for many times,and not to crack nuts and very hard bones pieces as it may damage enamel,so that the teeth and its supporting structures develop properly as well- function of organ.Missing teeth cause the cheeks to sink and develop wrinkles.The unpleasing expression due to irregular or missing teeth may cause self-consciousness and inferiority complex and hence social maladjustment.Teeth and their supporting structures thus considerably affect the personality of such individuals concerned
Loss of teeth has always been considered to be the normal phenomenon of aging,but now it is now recognized as a direct result of a pathological process. Periodontal disease known as "Pyorrhea" and dental caries(black cavity occurring in teeth) are the most prevalent of the pathological process causing teeth loss.
Before about 30 years of age the dental caries and after that age, periodontal diseases  are responsible for loss of more teeth  than other causes combined ;the latter causing 3 to 7 times more teeth loss than the former,However,significant difference is taking.place owing to the emergence of the concept of Prevention rather than repair and replacement in dentistry.Periodontal diseases and its etiological  causes and dental caries and causes are not explained herewith and preventive measures are given below,since" prevention is better than cure".
Prevention of dental caries..Dental caries is decaying of teeth.It is most wide spread disease and cause much suffering and teeth loss.Excessive conception of sugar and other carbohydrates especially in childhood is a major factor in causing tooth decay,An acid formed by the action of  LactoBacillus acidophilus on sugar deminerilises tooth structure,the enamel and the destine,The severity of action depend upon the the concentration of acid and length of its contact with the tooth.Most vulnerable parts are the pits and fissures and primal surfaces then, will proceed into destine and pulp unless treatment is given. The oral hygiene achieved by regular brushing of teeth after every meal thorough rinsing of the mouth.It should be implemented more strictly in childhood.Restriction of sugar intake in childhood specially in the form of sweets and candies as these are sucked for a long time.This is a very important measure and it is contrary/corollary to oral hygiene.Fluoridation of water supply,The benefits last for life.The quantity of fluoride required for the purposes is one part per million parts of water.Topical application of 20 percent sodium fluoride four applications at the age of 3,7,10 and 13 years suffice.A frequent dental examination is important because it enables the dental surgeon to discover small or hidden cavity while they may be filled early and.with little discomfort,,.Diet.during the years of deciduous teeth are erupting and permanent teeth are being formed in the jaws,an adequate supply of calcium is especially important in the diet,since once the teeth are formed and calcified,they can not absorb any more calcium .A balanced diet  throughout life is very important.Foods selected not only for their nutritional requirements but also for there physical character,Raw fruits and vegetables and other foods that require hard chewing help keep the teeth clean and to exercise the jaws.   .
Prevention and control of periodontist is..
Severe periodontal disease is found  less commonly in children ,and a large number of this disease is found in adults may be due to poor care of teeth during younger age and neglect of gingivitis when it develops.Dental health education must be given its proper way to motivate the individual to practice oral hygiene.Dental hygienist imparting dental health education,securing effective motivation of the individual to follow a prescribed routine in oral hygiene,prophylaxis and physiotherapy regularly to clear the teeth of all calculi.Since it is mostly chronic,destructive,painless and with out any major discomfort in its early stages,it is likely to escape the attention of the patient till it reaches to its advanced stages.Check up with a dental surgeon reaches to its advanced stages.The correction of malocclusion is necessary in preventing and arresting periodontal disease.A missing tooth is to be replaced by an artificial one,No Powders or mouth washes can prevent,dissolve or remove deposits of calculus or prevent or cure periodontists and can not,so,substitute for careful dental hygiene,by self and periodical oral prophylaxis by dental surgeon."Cures for Pyorrhea"advertised in news papers and magazines are of no value may even be harmful.  
Malocclusion.A abnormal tooth arrangement and defects in fitting together of the teeth on closing the jaws are called malocclusion.The specialist field in dentistry which deals with detection,study,prevention and correction of these irregularities is called orthodontists. Malocclusion may be harmful to health for the following reasons..
Irregularities of teeth may impair mastication efficiency.They also may prevent the individual from choosing the proper foods for required nutrition.In later life severe crowding of teeth can be a factor in periodontal diseases.The child may develop psychological handicap due to facial disharmony produced by malocclusion.It may contribute also to certain types of speech defects.If the teeth are not in correct position
may have a an opportunity for retention of food participles and debris.so,maintenance oral hygiene becomes
difficult.more over it may also be responsible for greater dental caries attack.
Important causes of malocclusion are,hereditary,over retention of milky tooth,premature eruption of permanent teeth,premature loss of milky tooth due to caries,and abnormal sucking and biting habits and abnormal sleeping postures and mouth breathing and systemic disease-endocrine disorders,nutritional deficiencies.To prevent and remedy these conditions measures can be taken.Irregularities of tooth position and abnormalities of the jaws can be prevented.The dental decay may be controlled so that no premature loss of teeth;over retained teeth can be removed to avoid over crowding.Habits giving rise to abnormal pressure on the dentofacial structure can be either prevented or broken.
Replacement of missing teeth.Complete loss of natural teeth causes mental disturbance,there fore a period of  emotional adjustment is needed to condition the individual to live with artificial teeth.A new denture wearer may experience difficulty in speech and feeling of a presence a foreign material in the mouth.All these types of difficulties disappear in course of time with  the progressive use of the dentures.Facial expressions may be altered at first slightly,but with the use of artificial dentures the muscles of expression in the cheeks and lips become adjusted to function normally and the natural facial expression returns.The maintenance and care of dentures are;,must be kept clean and free from deposits,whenever kept out side from mouth,be kept in cold water,cleaned with cleaning agent with proper brush and washed in running water before and after use,and periodical check for mastication efficiency also be observed.Care of dentures bearing tissues should be taken The dentures should be kept out of mouth at night unless otherwise advised.The mouth should be thoroughly rinsed in the morning and oral tissue should be cleaned with finger after each meal before going to bed at night.Any abnormal feeling and changes in the tissues under the dentures should be shown to dental surgeon.There being no other points in my memory this article on dental health has come to an end.

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MENTAL ILLNESS

Mental health

Mental health is an important component of the total positive health.Health is  the complete state of mental,physical,social well being and free from diseases and disabilities.From that, it is clear that, if one is not mentally clear,he is not an healthy person.Every physical ailment has a mental component and every mental illness has a physical component,social health of the community depends to a large extent on its physical and mental positive health,as anti social elements may develop due to mental and physical handicaps.
Mental health care up to the very recent past concerned itself only with the diagnosis and therapy of the psychiatric cases.The recognition of mental abnormalities as an "illness" took many centuries.The concept has been recently broadened to include early detection of mental break down.Only during the last four decades or so the concept has been further widened to embrace the positive aspect of mental health.now it has come to know that the mental health care of the community is to be strengthen the social integrity by influencing the behavioral pattern of the individuals,and groups so that psycho social situations are controlled by them rationally and logically,and solutions are arrived at with out disrupting the physical,mental or social well being of the community.
The WHO defines mental health as "the capacity in an individual to form harmonious relations with others and to participate in or contribute constructively to changes in the social environment"The different constituent parts of one s personality should work in harmony so that an individual faces life situations rationally,successfully and happily.The comprehensive concept of mental health has a four fold goal before it;to understand and cure the different types of mental disorders and defects;to find out the cases mental break down early;to prevent,or at least to minimize the occurrence of these disorders and defects;and improve the mental health of the community.
Mental health comprises the well being of the intellectual and the emotional components of the mind.The intellectual break down of the individual deprives him of logical and rational thinking and the decisions taken may be faulty affecting the individual s
 well being.Even the community or nation may suffer due to such faulty thinking if such an individual happens to be a leader.But these type of emotional break down is rare and is not very harmful for the mental health of the community or even the individual as when it is accompanied emotional break down,.Emotional imbalance affects individual s reactions,ability to withstand the strains and stress of the life situations affecting the general health,and ability to conform to the conventional social moral.
It may affect the intellectual capacity of logical and rational thinking and power of judgement,lead him to become unsocial,unsociable and even antisocial.At the least the individuals may show their inability to cope life situations.
Resistance against mental,and specially emotional break down is built up by the autonomic process of "integration of personality".It is the normal process of the growth of personality with in the group environs. Infant is suddenly exposed to strange physical and biological environs by birth,and the important part of biological environs is human contact which makes impacts upon the new born not only through the infective process but also  the individual grows within his group, the sphere of these influences widens with physical and neural,somatic and functional,growth of the child,from initial circumscribed family sphere enlarging in stages to include neighbors,school,community,vocational and social contacts.As the biological invasions act as a stimuli to include resistance against the ineffective process,similarly the psycho-social contacts bring about an "integration of personality"which acquires high resistance against difficult situations,aggressive personalities and so on,enabling an individual to react healthily while confronting unwholesome life situations.
Integration of the personality proceeds concomitantly with the neural growth of the individual.The functional attributes the neural growth are intellectual development and emotional mounding.A healthy mind and ability to be molded in an integrated personality depend on healthy genetic endowments,heritage of cultural patterns handed down from generation to generation and physical endowments derived  from healthy intrauterine life.and the physical,social and psychological environs of the individual while growing with in his group.So development of an integrated,matured personality depends to some extent on hereditary but to a greater extent it is the final result of the influence of environments and society.
The ability of the individual to healthily to various situations develops,a characteristic behavioral pattern is established and the pattern of reactions to a particular situation become predictable in conformity with the established pattern of the conventional social behavior.A healthy genetic base can,to some extent,be ensured by marriage counselling,organised on voluntary basis,offers a good via media to eliminate undesirable physical or mental traits or defects from the forthcoming progeny.While advice can be usefully offered by experts in the subject,no dogmatic judgement can be passed by or expected to to be accepted from them by  the couples.
Types of mental break down syndromes; Hysteria,Exhaustion,Anxiety,Confusion,Psychosomatic disorders.Depression,psychosis,Schizophrenia,Paranoid escape and etc are the commonest psychiatric break down and ADD/AH DD(attention deficit disorder) contact disorder and separation disorders are common in childhood and adolescence.Those cases noticed is to be referred to psychiatric/parapsychologist/neurologist/pediatric neurologist,etc.for early detection and treatment.

The commonest signs and symptoms are as follows.
1.Deviation from normal habits.behavior noticed by parents,friends,other members of family/relatives.
2.Sleep disturbances and nightmares,
3.Changes in drinking and eating habits.Increased smoking and consumption of alcohol in case of smokers and drinkers.
4 Alteration in personality and temperament.
5.Emotional instability.This is manifested by sudden out bursts of weeping for no reason or sudden displays of aggressiveness or violence.
6.General feeling of tenseness.The individual may be restless,jumpy.anxious,irritable,apprehensiveness, suspicious.There may be repeated quarrels with friends and neighbors.Head ache and insomnia/sleeplessness and etc.These are the major sign and symptoms of mental illness.

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Obesity

Obesity

Obesity means an excess deposit of fat in the body with an increase in body weight,more than 10% above normal or average for the sex,age,height and stock or clan.The average for each of these variables differ.An extraordinary well developed muscular individual may have weight above the average for his age,sex,height and stock but he is not obese.Fat in the body is deposited in the fat deposits i.e.over the

the abdominal wall,buttocks,thighs and over the shoulders and the back.This is accompanied by by deposition of extra fat in intestinal tissues in the body,borne marrow,around the heart,liver,spleen and kidneys and also higher lipids circulating in blood.Obesity is more common in well-to-do individuals of the higher economic group of population of all countries including in India also.it is estimated to be 25 to 30%.Apart from an ungainly and unseemly appearance,obesity is associated with serious disease processes.A premature death rate is more in the obese persons.It is one of the major risk factors for ischemic heat disease.Obesity increases the death rate in diabetics 5 times,who get cardie vascular accidents(cva) about 2 times
Besides some organic pathological causes like pituitary tumor complaints and menopausal imbalance and deficiency and some anxiety states,or genetic pituitary adipose,the most important and the most universal cause of obesity among otherwise normal people is over eating and lack of exercise.A

A person of normal of normal weight and activity eats more if he is more active and less,if a person is less active,activity abolishes all carbohydrate and most of the fat,obesity develops if activity becomes very low and one is not able to reduce the food intake,Obesity decreases exercise tolerance,to environmental heat and also cold ,sanitation,diseases and injuries.All persons should be known against over weight and obesity-the only 2 ways are controlling it are regular exercise and a restricted dietary,specially the fat producing items such as ghee,oil and carbohydrate,particularly sugar.

The health persons should always be on look out for such tendencies in such persons and educate them  accordingly.The only effective method we have dealing with obesity is by restricting food, The standard method is to reduce total calories in diet.If a secondary worker is requires 2000 calories per day and is told to take 1500 calories he will lose weight.Such diets can be worked out to suit individual concerned requirements and to include a modicum of almost any food the person has been accustomed to eating.
Diet therapy requires as much enthusiasm and perseverance from the subject as a doctor.In practice is  it means persuading the subject to continue to go short of food.The most important single item of food the avoidance of which can be expected to contribute to weight loss is sugar in any form including sweet dishes

The desirable weights for various ages and heights for men can be calculated by them and they can come to know whether they are obese,over weight,normal or subnormal
It is very simple,you see your weight and height and divide your weight in meter squares.If it is in between 18 to 25 your weight is normal.If you are healthy you can save life,prevention is better than cure.

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