THE NOSE & IT'S COMMON DISORDER

The Nose is a special sense organ for smell and respiration. This smell is supplied by the olfactory nerve. The olfactory nerve fibres originate from the special olfactory cell on the roof of nose. The olfactory nerves carry impulses of the smell to the olfactory area of the temporal lobes of the brain where sensation and impulses are interpreted and give smell.

Common Functions:

• Air is cooled down and is made moist
• The odor of the inspired air can be easily taken
• The dust particles and bacteria are caught up and removed

Common disease of the Nose

Rhinitis: It is an inflammation of the mucous membranes of the nose with symptoms of sneezing, itching, nasal discharge and congestion. It can be allergic, non-allergic, or both.

Seasonal allergic rhinitis: It is caused by substances that trigger allergies, called allergens.

Perennial allergic rhinitis: It is an IgE-mediated reaction to allergens that show little or now seasonal variation. It is persistent, chronic and generally less severe than seasonal allergic rhinitis.

Ref: PMD,OSL,Bangladesh

Common disorders of the Endocrine System
are-
1) Hyperthyroidism
2) Hypothyroidism
3) Hyperparathyroidism
4) Hypoparathyroidism
5) Diabetes mellitus
6) Acromegaly
7) Diabetes insipidus

Hyperthyroidism is a condition caused by an overactive thyroid gland. The gland makes too much T4 and T3 hormones. Hormones are substances that affect and control many important functions in the body. Weight loss, Increased appetite, Restlessness, Heat intolerance, Fatgue & Nervousness are the common symptoms of Hyperthyroidism.

Hypothyroidism is a condition in which the thyroid gland fails to produce enough thyroid hormone. Weakness Fatigue Cold intolerance Constipation Weight gain Depression Joint or muscle pain Thin and brittle hair are the common symptoms of Hypothyroidism.

Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or when cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. Diabetes mellitus is a chronic disease that causes serious health complications including renal failure, heart disease, stroke, and blindness. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin.

Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone. Most commonly it is a benign GH producing tumor derived from a distinct type of cells and called pituitary adenoma. Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious pathogenesis and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years.

Diabetes insipidus (DI) is caused by the inability of the kidneys to conserve water, which leads to frequent urination and pronounced thirst. The amount of water conserved is controlled by antidiuretic hormone, also called Vasopressin.

Ref: PMD, OSL, Bangladesh

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Some disorders of the Urinary System

Urinary tract infections: UTIs are caused by the bacteria. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria. There are three main types of UTI.


Cystitis: Inflammation of the urinary bladder.


Urethritis: Inflammation of the urethra.


Pyelonephritis: inflammation of the kidney tissue and the renal pelvis. The most common type of renal disorder, pyelonephritis may be chronic or acute.


Common symptoms associated with UTIs are-
a) Frequent urination
b) Burning or pain during urination
c) The feeling of having to pee even though little or no urine actually comes out
d) Pain in the lower abdomen
e) Pain above the pubic bone (in women)
f) A full feeling in the rectum (in men)
g) Bloody or foul-smelling urine
h) Fever
i) A general feeling of shakiness and fatigue

Kidney stones: It is the term commonly used to refer to stones in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system.

Prostatitis: It is an inflammation of the prostate gland. It is characterized by frequency urination with urgency, painful urination. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics.

Proteinuria: Presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that kidneys are not working properly.

Renal failure: Results when the kidneys are not able to remove waste products from the blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This condition can be caused by an accident that injures the kidneys loss of a lot of blood or some drugs or poisons. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD).

Causes of urinary system disease: Problems in the urinary system can be caused by aging, infections or injury (blood loss). As get older, changes in the kidneys’ structure cause them to lose some of their ability to remove wastes from the blood.

Ref: PMD, OSL, Bangladesh

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Peptic Ulcer


Peptic Ulcer : An ulcer is a sore or painful wound. The term “peptic ulcer” refers an ulcer in the lower oesophagus, stomach or duodenum. Ulcers in the stomach or duodenum may be acute or chronic; both penetrate the muscular tissue and mucosa. Depending on their location, peptic ulcers have different names.

Gastric ulcer: This is a peptic ulcer that occurs in your stomach.

Duodenal ulcer: This type of peptic ulcer develops in the first part of the small intestine

Esophageal ulcer: An esophageal ulcer is usually located in the lower section of your esophagus. It's often associated with chronic gastroesophageal reflux disease.

Both a gastric ulcer and a duodenal ulcer result when H. pylori or a drug (NSAIDS) weakens the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. Both the acid and the bacteria can irritate the lining and cause an ulcer to form.

Ref: PMD, OSL, Bangladesh

Common Otic Disorder


External Otitis: The most common disorder of the outer ear. The process develops due to loss of the protective cerumen and excessive moistures in the ear canal. This leads to maceration of the canal skin allowing bacterial growth and invasion. Symptoms include otalgia, mild hearing loss, and scant otorrhea.

Otitis Media: Inflammation of the middle ear. It may be acute, chronic, suppurative or secretory.

Acute otitis media occurs commonly in children. It's incidence rises during the winter months. It is a result from disruption of Eustachian tube patency.

Suppurative otitis media occurs due to respiratory tract infection, allergic reaction, or positional changes during feeding. Allow reflux of nasopharyngeal flora through the eustachian tube and colonization in the middle ear. Pathogens involve Pneumococci, beta hemolytic streptococci, Hemophilus influenza and other gram- negative bacteria.

Secretory otitis media occurs due to obstruction of the eustachian tube results in negative pressure in the middle ear that promotes transudation of sterile serous fluid from blood vessels in the membrane of the middle ear that promotes transudation of sterile serous fluid from blood vessels in the membrane of the middle ear.

Chronic secretory otitis media is cause by an adenoidal tissue overgrowth that obstructs the eustachian tube that obstructs the eustachian tube, edema resulting from allergic rhinitis or chronic sinus infection, and inadequate treatment of acute suppurative otitis media.

Chronic suppurative otitis media: It is in most cases the result of inappropriate treatment of acute suppurative otitis media. It is a chronic inflammation of the mucous membrane, periost and even osseous tissue of the middle ear. Symptoms: A long period of recurrent otopyorrea which is very difficult to get cured, hypoacusis and perforation of the tympanic membrane


Ref: PMD, OSL, Bangladesh

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FIVE DIGESTIVE JUICE

Saliva: This is the combined secretion from the salivary glands and the small mucus secreting glands of the lining of the oral cavity. Saliva consists of water, mineral salts & enzyme ptyalin. Ptyalin split cooked starch to maltose. Maltose further breaks down into glucose with the help of the enzyme maltase in the small intestine.

Gastric Juice: It is a strong acidic liquid secreted into the stomach by gastric glands. Its main components are digestive enzymes pepsinogen and rennin, hydrochloric acid and mucus. Pepsinogen with hydrochloric acid converted in to active Pepsin, which digests proteins up to the stage of peptone. Rennin coagulates caseinogens of milk. Gastric lipase digests fat to some degree. Hydrochloric acid helps to hydrolyze foodstuffs.

Pancreatic juice: Produced by the pancrease and enter into the duodenum. It contains a variety of enzymes. They include trypsinogen, chymotrypsinogen, elastase, carboxypeptidase, pancreatic lipase and pancreatic amilase. Pancreatic juice is alkaline in nature due to the high concentration of bicarbonate ions. This is useful in neutralizing the acidity, allowing for effective enzymic action. Trypsinogen and chymotrypsinogen with enteropeptidase converts peptones in to peptides and polypeptides. pancreatic amilase converts all digestible polysaccharides not affected by ptyalin to disaccharides.Lipase converts fats to faty acid and glycerol.

Bile: A digestive chemical that is produced in the liver, stored in the gall bladder, and secreted into the duodenum. The main components of bile are water, bile salts, bile pigments, and cholesterol. Bile salts act as emulsifying agents in the digestion and absorption of fats. Cholesterol and bile pigments from the breakdown of hemoglobin are excreted from the body in the bile.

Intestinal juice : Secrets from the glands of small intestine . It consists of water, mucus & enzyme enteropeptidase. Its function is to complete the process begun by pancreatic juice; the enzyme trypsin exists in pancreatic juice in the inactive form trypsinogen, it is activated by the intestinal enteropeptidase. Trypsin can then activate other protease enzymes and catalyze the reaction.

Ref: PMD, OSL, Bangladesh.

HISTAMINE AND ITS RECEPTORS


Histamine: It is an amino acid derivative, usually secreted from the mucosal mast cells of the stomach. Histamine is produced primarily by mast cells and basophils, which are abundant in the skin, GI tract, and respiratory tract. Histamine is stored in granules in mast cells and basophils until it is released. It is found that histamine serves as the stimulator of the parietal cells to secret hydrochloric acid.

Histamine Receptors: Histamine, whether formed in the body or come from the out side, cannot perform its action until it can reaches at their specific receptors. Histamine receptors have been classified as H1, and H2, and H3

a) H1 receptor: receptors are present mainly in the smooth muscles of intestine, bronchi and blood vessels. H1 receptors are involved in allergic reactions that cause dermatitis, rhinitis, conjunctivitis, and other forms of allergy.

b) H2 receptor: receptors are mainly present in the gastric parietal cells and the smooth muscles of some blood vessels. H2 receptors are primarily concerned with gastric acid secretion but they are also involved in allergic reactions.

c) H3 receptor: These are presynaptic receptors located on nerve terminals. Activation of these receptors inhibits the release of histamine and other neurotransmitters.


Ref : PMD, OSL, Bangladesh

Accessory Organs of Human Body

Liver - a large organ located above and in front of the stomach. It filters toxins from the blood, and makes bile and some blood proteins.
Pancreas - an enzyme-producing gland located below the stomach and above the intestines. Enzymes from the pancreas help in the digestion of carbohydrates, fats and proteins in the small intestine.

Gallbladder - a small, sac-like organ located underside of the liver. It stores and releases bile into the small intestine through common bile duct.

Salivary glands - glands located in the mouth that produce saliva. Saliva contains enzymes that break down carbohydrates (starch) into smaller molecules. There are three pairs of salivary glands. They are:

a) 2 Parotid glands
b) 2 Sub-mandibular glands
c) 2 Sublingual glands

Spore: These are highly resistant structures formed in response to adverse conditions. They has a thick keratin like coat, that is responsible for the remarkable resistance to heat, dehydration radiation and chemicals, spore has no metabolic activity and can remain dormant for many years, when they come contact of available water & food they comes to life. All bacteria cannot form spore. Mainly gram positive Bacillus and clostridium can form spore.

Classification of Bacteria

Bacteria are three types based on shape. They are –
Cocci: Round shaped Bacteria; i.e.-Gonococci, Diplococcus Pneumonia, Streptococci etc.
Bacillus: Rod shaped or stick shaped bacteria; Streptobacilli
Spirochetes: Spiral shaped, flexible, Coiled Bacteria.

Bacteria are two types based on gram staining
Lipid bilayer (Lipopolysaccharide) is found in Gram-negative bacteria but not in Gram-positive bacteria.
Gram-positive bacteria: Staphylococcus aureus, Streptococcus pneumonia, Clostridium botulinum, Clostridium titani, Streptococcus pyrogens etc.

Gram-negative bacteria : Eschericia coli , Salmonella spp, Shigella species, Vibrio spp., Neisseria gonorrhoea, Neisseria meningitides, Klepsiella spp etc.

Bacteria are four types based on Gaseous requirements. They are-
a) Aerobic bacteria: Require O2 for growth, (21% O2)
b) Anaerobic bacteria: Don’t use O2 to obtained energy. Some can tolerate low level of O2 but other cannot tolerate even low level of O2 and may die upon brief exposure to air.
c) Facultatively anaerobic bacteria: Don’t require O2 for growth, although they may use O2 for energy production.
d) Microaerophilic bacteria: Require low level of O2 for growth but cannot tolerate the level of O2 present in air (21% O2).

VIRUS

Virus: Non-cellular organisms. They are innate, but alive within the host. Diameter is 0.02 – 0.2mm. They have no Nucleus, Ribosome and Mitochondria.

Characteristics of Virus
Viruses depend upon living host for Replication.
Contain DNA or RNA but not both.
Use the living cell’s energy stores, substrates and Synthetic machinery.
Can have a benign or very destructive relationship with the host.

FUNGI

Fungi: Eukaryotic microorganisms. Most fungi are obligate aerobes some are facultatively aerobes. Diameter 3 – 10 mm. Size of ribosome is 80s. It comprises Mold and Yeast. Molds are filamentous and multi-cellular. Yeasts are unicellular. Example: Aspergillus, Candida, Trychophyton, etc.
Characteristics of Fungi
Fungi lack pigments to manufacture their own food and therefore depend upon other
organisms for life
Includes Yeast & Mushrooms
Suffix – mycosis refer to fungus
PROTOZOA

Protozoa: Eukaryotic microorganisms that have the following features.
More Complex Organism
Unicellular, Mobile, lacking cell wall
Examples: Trichomaniasis, Malaria, Entamoeba histolytica, Giardia lamblia etc.

Antiseptic: Agent that kills or inhibits the growth of microorganisms on the external surface of the body. Toxicity is very low for the host cells. It can be used directly on skin, mucous membrane and wounds.
Example: Alcohol, Iodine, Hydrogen peroxide, Boric Acid, etc.

Antibiotic: Agent, which kills or inhibits the growth of microorganisms internally, is called antibiotic. It is sufficiently nontoxic to the host. It is used in the treatment of infectious disease of man, animals and plants. Example: Tetracycline, Ciprofloxacin, Gentamicin, Mertonidazole, Penicillin etc.

Disinfectant: A chemical, which kills bacteria, virus and other microorganisms on a non-living surface. A complete disinfectant is able to kills spore of microorganisms.Infectious disease in human being is caused by Bacteria, Virus, Fungi, Protozoa and Helminths. Infectious pathogen may spread via water and food. Diarrhoea, Typhoid, Giardiasis, Amebiasis etc. are the common public health problem till today which are the consequence of contaminated water and food

DNS

Hypovolaemia is the consequence of water and electrolyte Loss. Body fluid may be reduced by-
ž Haemorrhage or other medical conditions (Surgery, Diarrhea etc)
ž Reduced fluid intake (Dysphagia, coma)

Sign & Symptons of Hypovolaemia
ž Decrease Bloood Pressure, Increase Heart rate, Decrease urine output, Dry mucous membrane & Flattened neck vein
ž Thirst, Skin Turgor

In Hypovolaemic condition the body try its level best to restore body fluid by means of Reabsorption (through water Balance of the body). If failure, Multi system of the body is collapsed

So, if a patient losses water & electrolyte (Hypovolaemia), it will have to consider DNS to overcome from the Hypovolaemic condition.