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FIGHT AGAINST NON-COMMUNICABLE DISEASE

 

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Clinical courses

ABOUT AUTHOR
Sadanand Dhananjay Khair
College Government College of pharmacy Karad, Maharashtra, India

ABSTRACT
Non communicable diseases are those diseases which are mostly chronic and rarely acute this are not contagious in nature they are not transfer from one person to another. Referred to as a "lifecycle" sickness, in light of the fact that most of these maladies are preventable ailments, the most widely recognized reasons for non-communicable disease  (NCD) incorporate tobacco use (smoking), liquor misuse, less than stellar eating routines (high utilization of sugar, salt, immersed fats, and trans unsaturated fats) and physical inertia. In India as well as world level although there is food of vehicles, motorbikes, gadgets like mobile phones, cameras ,smart phones computer related materials still at level of human being may he or she be poor or rich educated or non-educated  having a good job or jobless or unmarried or divorced man suffering from disease which are difficult to treat because of pollution at every level at every level of soil, water ,food, agricultural products, air pollution human being are facing no of respiratory disease like C.O.P.D.,emphysema asthma etc. Non communicable disease are those type of disease which do not spread from person to person. They either present since birth or developed during growing stages. Common reasons for this type of disease are infection with various agents, pollution, changing life style, using chemical things rather than herbal things, using high amount of drug of abuse
.

Reference Id: PHARMATUTOR-ART-2676

INTRODUCTION
After the invention of germ theory era of communicable disease come to an end. Since the introduction of sulphonamide in 1935 and penicillin in 1940 we as medical and paramedical professional comes to a long way in antimicrobial therapy. The powerful arsenal of antibiotic appeared to be too good. Antibiotics spread around the world too widely too cheaply and used indiscriminately one result of this wide spread use is change of disease pattern. Once STD i.e. sexually transmitted disease were supposed to affect practically most of the population. But with administration of proper and powerful antimicrobial agent there is no more such a fear among society. But silently creeping out of diabetes., thyroid disorder, thyrotoxicosis,goiter,myxedema,P.C.O.D,polycystic ovarian cancer,obesity,arthritis,renal disorder-glomerulus nephritis to end stage renal failure need of dialysis, hypertension and hypertension related vascular disorder of retina,cardiomyopathies,cerebral haemorrhages,cerebral infracts and many other emerged. Silently after man won the fight partially at least against microbes and related disease like tuberculosis.

We can’t say like that we have suppressed the infection by use of indiscriminant use of antibiotics. There is no any sort of either philosophical, theoretical or practical proof of it. Still after the cessation of infection disease like cholera, plague etc. there is sure an emergence of diseases of metabolic origin especially that is diabetics and its complications acute and chronic complication which impose a heavy load on health care providers as well as it puts a load on economical level as well as its increases morbidity, mortality of human beings. Now its duty of government as well as of policy makers at national level and state level to actual grass root level to patient about giving proper education regarding this issue.

So called lifestyle disease. How they emerge what is impact of diabetes, may be HTN hypertension of final outcome of patient in I.C.U. or ward. How long is the process of disease whatever may be the name of disease it is duty of everyone in chain of education to supply the necessary thought provoking practical knowledge to patients as well as their family members, caretakers, family physicians, lab technicians, super consultants and finally last but not the least pharmacist.it should be clear about the disease process, its coarse, its differential diagnosis and finally its prognosis should be clear to fight with disease.

In India as well as world level although there is food of vehicles, motorbikes, gadgets like mobile phones, cameras ,smart phones computer related materials still at level of human being may he or she be poor or rich educated or non-educated  having a good job or jobless or unmarried or divorced man suffering from disease which are difficult to treat because of pollution at every level at every level of soil, water ,food, agricultural products, air pollution human being are facing no of respiratory disease like C.O.P.D.,emphysema asthma etc.

Definition- Non communicable diseases are those diseases which are mostly chronic and rarely acute this are not contagious in nature they are not transfer from one person to another. Some consist parasite infection but it is indirect in nature. Which not causes direct host to  host transmission. (https://en.wikipedia.org/wiki/Non-communicable_disease)

The NCD Alliance is a worldwide association established in May 2009 by four universal organizations speaking to cardiovascular sickness, diabetes, malignancy, and ceaseless respiratory ailment. The NCD Alliance unites approximately 900 national part relationship to battle non-transferable ailment. Long haul points of the Alliance include
NCD/illness national designs for all
A tobacco free world
Improved ways of life
Fortified wellbeing frameworks
Worldwide access to moderate and great quality prescriptions and advances
Human rights for individuals with NCDs.

Risk factors
A risk factor that can't be decreased or controlled
By intercession; for instance:
• Age,
• Gender,
• Race, and
• Family history (hereditary qualities)
Metabolic factors:
• Raised pulse
• Raised cholesterol
• Elevated glucose
• Overweight and obesity

(https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/new-8/overview-of-ncds_ppt_qa-revcom_09112013.pdf)

Diabetes - Diabetes is a severe form of disorder. It happens when the body does not make enough insulin or can't utilize it well. This causes elevated amounts of glucose (glucose) to develop in the blood. Subsequently, the body does not work like it should.
There are two kinds of diabetes:
• Type 1 diabetes happens when the body stop making insulin. This type may present from birth and required lifelong insulin treatment
• Type 2 diabetes happens when some insulin is made, however the body can't utilize it well. Drugs which helps in insulin release prove useful

Cause behind this situation
The sustenance we eat is processed in our stomach. Here it is turned into glucose, or glucose.  Blood takes glucose to our cells. As a fuel. Glucose must go into our cells with the goal that we can have vitality. Glucose needs the assistance of insulin to do this. Glucose can’t go into our cells if our body does not make enough insulin or if our cells can't utilize the insulin well. This implies the glucose will develop in the blood. People who have elevated amounts of glucose in their blood have prediabetes or diabetes.
(https://www.nhlbi.nih.gov/health/educational/healthdisp/pdf/tipsheets/What-Is-Diabetes.pdf)

Management
Insulin substitution treatment is the pillar for patients with type 1 DM while diet and way of life changes are considered the foundation for the treatment and the executives of type 2 DM. Insulin is additionally significant in type 2 DM when blood glucose levels can't be constrained by eating regimen, weight reduction, exercise and oral meds. Oral hypoglycemic are additionally valuable in the treatment of type 2 DM.
Insulin treatment which consist artificial insulin preparation which is strikingly effective both in constraining postprandial hyperglycemia and avoiding hypoglycemia between meals. This type of preparations can be given by intramuscular and intravenous route. The most significant antagonistic impact are weight gain and hypoglycemia. . Sulphonyl ureas such as glibenclamide, glipizide and biguanides such as metformin, phenformin are oral hypoglycemic drugs. They are responsible for low sugar or hypoglycemia by releasing insulin release from pancreatic ß-cells. Biguanides, for example, metformin is antihyperglycaemic, not hypoglycemic. It doesn't cause insulin discharge from the pancreas and does not cause hypoglycemia, even in huge dosages. Main advantage is they prevent weight gain in type 2 diabetes patients
(http://www.ijpab.com/form/2015%20Volume%203,%20issue%203/IJPAB-2015-3-3-224-230.pdf)

Cancer
It considered as most harmful disease in today’s era comprises abnormal growth of cell which may or may not spread to surrounding cells. Benign and malignant are 2 types of tumors former one is less harmful because it not spreads or invade while latter one is a true cancer. Tobacco use is the reason for about 22% of cancer deaths. Another 10% are because of obesity, less than stellar eating routine, and absence of physical movement or extreme drinking of alcohol. Other variables are certain diseases, exposure to ionizing radiation and natural contaminations.

Types
Carcinoma – it starts in the skin or in tissues that line or spread inward organs. There are distinctive subtypes, including adenocarcinoma, basal cell carcinoma, squamous cell carcinoma and transitional cell carcinoma
Sarcoma – disease that starts in the connective tissues, for example, bone, ligament, fat, muscle or veins
leukemia – cancer that starts in blood forming tissue such as the bone marrow and causes abnormal blood cells to be produced and go into the blood
Lymphoma and myeloma – cancers that begin in the cells of the immune system
Brain and spinal cord cancers – these are known as central nervous system cancers
(https://www.cancerresearchuk.org/what-is-cancer/how-cancer-starts/types-of-cancer)

Treatment
Chemotherapy
Chemotherapy is the treatment of disease with at least one cytotoxic agent of antineoplastic medications. The term incorporates an assortment of medications, which are partitioned into general classifications, for example, alkylating agents and antimetabolites. Medical procedure and radiation treatment evacuate, kill, or harm disease cells in a specific region, yet chemo can work all through the entire body. This implies chemo can kill malignant growth cells that have spread (metastasized) to parts of the body far from the first (essential) tumor. ALKYLATING AGENTS ANTIMETABOLITES ANTI-TUMOR ANTIBIOTICS TOPOISOMERASE INHIBITORS MITOTIC INHIBITORS
(American Cancer Society website. Chemotherapy drugs: how chemotherapy drugs work.www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/how-chemotherapy-drugs-work.html)

Radiation it has cytotoxic effect. It act by damaging DNA of cancerous cell by using ionizing radiation. Low energy rays like x ray are used to treat skin cancer while high energy are used to prevent the cancer present inside the body.

Palliative consideration
Palliative consideration is treatment that endeavors to enable the patient to feel better and might be joined with an endeavor to treat the malignant growth. Palliative consideration incorporates activity to diminish physical, enthusiastic, otherworldly and psycho-social pain. Dissimilar to treatment that is gone for straightforwardly killing disease cells, the essential objective of palliative consideration is to improve personal satisfaction. Individuals at all phases of malignant growth treatment commonly get some sort of palliative consideration.

This applies to patients who
• Show low execution status, showing restricted capacity to think about themselves
• gotten no advantage from earlier proof based treatment
• are not qualified to take part in any suitable clinical trial
.facts about cancer
Cancer affects everyone – the young and old, the rich and poor, men, women and children – and represents a tremendous burden on patients, families and societies. Cancer is one of the leading
Cancer is a gathering of sicknesses accompanied by uncontrolled development and spread of anomalous cells. There are more than 100 kinds of cancerous growth.
Tobacco use is the single biggest preventable reason for cancer on the planet causing 22% of disease deaths. The American Cancer Society gauges that in 2013 174,100 malignant growth deaths will be brought about by tobacco use.
The most widely recognized malignant growths among men are: prostate, lung, and colorectal (colon) disease. For ladies it's: breast, lung, and colorectal cancer
.

Cardiovascular disease
Major modifiable hazard factors
- High circulatory strain - Abnormal blood lipids - Tobacco use - Physical latency - Obesity - Unhealthy eating regimen (salt) - Diabetes
Non-modifiable hazard factors - Age - Heredity or family ancestry - Gender - Ethnicity or race

Classification
Coronary heart disease it is disease of the vessels providing the heart muscle. Risk factors include High circulatory strain, high blood cholesterol, tobacco use, undesirable eating routine, physical idleness, diabetes, propelling age, acquired (hereditary) mien. Other hazard factors Poverty, low instructive status, poor emotional well-being (discouragement), aggravation and blood coagulating issue.

Congenital heart disease this problems are present in heart since birth due to exposure of hazardous things during gestation which may include hole to the heart, abnormal heart chamber and heart valves etc. risk factors include consumption of alcohol during pregnancy, use of drugs like warfarin thalidomide which considered as teratogenicity infection to mother etc.

Stroke it consist poor supply of blood to the brain which may be caused due blockage or rapture of blood vessels risk factors may include poor diet, atrial fibrillation, tobacco use, diabetes, high blood pressure

Deep venous thrombosis (DVT) and pulmonary embolism Blood get clots in the veins of legs, which can move to the heart and lungs. Risk factors include, cancer, previous episode of DVT, recent childbirth, use of oral contraceptive and hormone replacement therapy, long periods of immobility (https://www.who.int/cardiovascular_diseases/en/cvd_atlas_01_types.pdf)

Management
Managing blood pressure- Reduce salt intake, DASH (Dietary Approaches to Stop Hypertension), Limit alcohol intake

Managing cholesterol- Eat less saturated fat, Include small amounts of monounsaturated and polyunsaturated fats, include fiber-rich foods, Include plant-sterols, exercise weight management, stop smoking managing your alcohol intake
(https://jeanhailes.org.au/health-a-z/cardiovascular-health/management-treatment)
Stress management -Adapt better approaches to deal with your time. You may accomplish all the more less pressure on the off chance that you make a calendar. Consider which things are most significant, and do those first.

Discover better approaches to adapt. Take a gander at how you have been managing pressure. Speak the truth about what works and what does not. Consider different things that may work better.

Take great consideration of yourself. Get a lot of rest. Eat well. Try not to smoke. Point of confinement how much liquor you drink.

Evaluate better approaches for considering. When you end up beginning to stress, attempt to stop the considerations. Work on relinquishing things you can't change. Figure out how to state "no."

Talk up. Not having the option to discuss your needs and concerns makes pressure and can exacerbate negative sentiments. Confident correspondence can enable you to express how you feel in an attentive, thoughtful manner.

Request help. Individuals who have a solid system of family and companions oversee pressure better.

CONCLUSION
Non communicable disease are those type of disease which do not spread from person to person. They either present since birth or developed during growing stages. Common reasons for this type of disease are infection with various agents, pollution, changing life style, using chemical things rather than herbal things, using high amount of drug of abuse. Some changes in life style like stress management, reducing consumption of alcohol and tobacco, using herbal and organic products , exercise and drinking lots of water may improve life style and can increase the life expectancy.

REFERENCES
1. https://en.wikipedia.org/wiki/Non-communicable_disease)
2. (https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/new-8/overview-of-ncds_ppt_qa-revcom_09112013.pdf)
3. (https://www.nhlbi.nih.gov/health/educational/healthdisp/pdf/tipsheets/What-Is-Diabetes.pdf
4. (http://www.ijpab.com/form/2015%20Volume%203,%20issue%203/IJPAB-2015-3-3-224-230.pdf)
5. (https://www.cancerresearchuk.org/what-is-cancer/how-cancer-starts/types-of-cancer)
6. (https://www.who.int/cardiovascular_diseases/en/cvd_atlas_01_types.pdf)
7. https://jeanhailes.org.au/health-a-z/cardiovascular-health/management-treatment)
8. www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/how-chemotherapy-drugs-work.html)

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