Obesity
Definition: An abnormal growth of the adipose tissue due to an enlargement of fat cell size (hyper-trophic obesity) or an increase in fat cell number (hyper-plastic obesity) or a combination of both.BMI > 30 for males and > 28.6 for females.
Prevalence: 20 -40 percent in adults and 10-20 percent in children in developed countries.Risk factors:
Age: Incidence increase with age, obese child usually → obese adult,1/3 of obese adults were obese Childs.Sex: Optimal age for obesity is 29-35 year in male and 45-49 in female.
Genetic factor: Important.
Physical inactivity: Vicious circle, decrease expenditure of energy more important than overeating.
Socio-economic status: Inverse relation now.
Eating habits: Between meals, more sugar, carbohydrates and fats with low fibers.
Psychological factors: Depression, anxiety, loneliness and frustration (vicious circle). (Secret eaters).
Familial tendency.
Endocrine factor: Cushing's syndrome, hypothyroidism and GH deficiency.
Assessment of Obesity:
Body weight:
> 2 SD from median weight for height as a cut-off point for obesity.BMI = weight in kg / (height in meter)2.
Skin fold thickness: (Harpenden skin calipers) mid triceps, biceps, scapular and supra-iliac skin. The sum of measurement should be < 40 mm in males and < 50 mm in females.
Others.
WHR.
Hazards of Obesity:
An established risk factor in hypertension, IHD, accidents, gallbladder diseases and diabetes. Nonetheless, even in cancers.Varicose veins, abdominal hernias and OA of knee, hips, spine in addition to flat feet.
Psychological abnormalities.
Increased risk from surgery.
Sleep apnea.
Lowered fertility.
Lowered life expectancy.
Establiehed risk factors in breast cancer.
Prevention:
Dietary changes.Physical activity.
Others: surgery plus medicine.
Accidents
Definition:
"An unexpected, unplanned occurrence which may involve injury".WHO definition:
unplanned event resulting in recognizable damage.
Important facts about accidents:
* Accidents represent a major epidemic of non-communicable disease. They are no longer considered accidental and they are part of the price we pay for technological progress.* Accidents have their own natural history and follow the same epidemiological pattern as any other disease (Interaction between host, agent and environment).
* Accidents occur more frequently in certain age groups, at certain times, and at certain localities.
* Certain people are more prone to accidents; alcohol, drugs, physiological and psychological states increase their susceptibility.
* The majority of accidents are preventable.
* Accidents allover the world, they rank the fourth among the ten leading causes of deaths, leading to 7.5 per cent of deaths in both developed and developing countries. About 4 million of deaths allover the world is due to accidents (only one million is due to intentional injuries).Types of accidents:
Road traffic accidents: Accounts for about 1 million of deaths allover the world annually, and for each death, there will be 30-40 minor injuries, and 10-15 serious injuries (disabilities). Mean ages affected are 15-24 years.
Domestic accidents: Affects both extreme of ages and the most common causes are;
Drowning.Burns.
Poisoning.
Falls.
Injuries from sharp and pointed instruments.
Bites and other injuries from animals.
Industrial accidents: Thousands workers are died and many others are injured and crippled.
Passenger's accidents: Railways, airplanes, ships etc.Burns: 10 per cent of all accidental deaths are due to burns.
Wars and Terrorist actions.Causation of accidents: Multiple
Human 90 per cent.
Environmental 10 per cent.
Prevention of accidents:
Data collection.Safety education.
Promotion of safety measures: Such as safety belts, safety helmets, leather clothing and boots, Children protection and others.Alcohol and other drugs.
Primary cares.Elimination of causative agents.
Enforcement of laws.Rehabilitation of services: Such as medical, social and occupational.
9. Accidents researches (accidentology).THE ELDERLY (Geriatrics): Aging is a natural process. Actually, the modern physician cannot heal an old age, but can protect, promote and extend it. Thus, old age should be regarded as a normal, inevitable biological phenomenon.
Size of the problem: Worldwide, the population aged 60 or over is expected to be more than double from 500 million in 1990 to about 1.2 billion by the year 2035 and 72 per cent will be living in developing countries. Most of this growth is expected to be in Africa, Asia
Throughout the world, the "oldest old" (aged 85 or older) are the most rapidly increasing age group among the older population. The oldest elderly require a lot of proper health and social services. The majority will be women, and many are living alone.
CULTURAL VIEWS FOR THE ELDERLY: The Western society, with its emphasis on youth, productivity, individualism, autonomy and self-control, is often quite intolerant of old people. Those societies that have entered the information age of computers, global telecommunications and artificial intelligence give an increased cultural importance to the brain.
In non-Western cultures, the elders are considered the living store of oral history and ancient traditions; of cultural mores, beliefs, myths, and ritual expertise. In addition to that, certain religious guides are seriously intended for the care of elderly and regarded that as one of the priorities of moral and religious values.
HEALTH PROBLEMS OF THE AGED: I- Problems due to the Aging Process: Senile cataract, glaucoma, nerve deafness, bony changes affecting mobility (such osteoarthritis), emphysema, failure of special senses, and changes in mental outlook.
II- Problems Associated with Long-Term Illness: 1. Degenerative diseases of heart and blood vessels. 2. Cancer. 3. Accidents. 4. Diabetes. 5. Diseases of locomotor system: articular and non-articular diseases such as fibrositis, myositis, neuritis, gout, rheumatoid arthritis, osteoarthritis, spondylitis of spine, etc. 6. Respiratory illnesses: such as chronic bronchitis, asthma, and emphysema. 7. Genitourinary problems: Enlargement of prostate, dysuria, nocturia, frequent and urgency of micturition are common complaints among elderly.
III- Psychological Problems: 1. Mental changes: Such as impaired memory, rigidity of outlook, and dislike of changes. 2. Sexual adjustment: 3. Emotional disorders: "bitterness", inner "withdrawal", "depression and even "suicide".
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