HUMANHEALTHANDDI

SEASE
I
NTRODUCTI
ON
 Heal
thi
sast
ateofcompl
etephy
sical
,ment
alandsoci
alwel
lbei
ng,
andnotmer
elyanabsenceofdi
sease
ori
nfi
rmi
ty(
W.H.
O-1948)
.
 Anychangef
rom t
henor
mal
stat
ethatcausesdi
scomf
ortordi
sabi
l
ityori
mpai
rst
heheal
thi
scal
l
eddi
sease.
 Timeinter
valbet
weent
heentryofpat
hogenandappear
anceofsy
mpt
omsi
scal
l
edt
hei
ncubat
ionper
iod.
Dur
ingt
hisper
iod,pat
hogensmul
ti
ply
.
 Ant i
bioti
csar ethosesubst anceswhi char esecr etedbymi cro-organism t
hatinhi
bitt
hegrowthordestr
oy
theothermi cro-organism.Thi sterm wasgi venbyWal ksman( st
reptomy cin-
fi
rstbacter
ialant
ibi
oti
cobtai
nedfr
om
bacter
ia-St
rept omy cingriseus) .
E.g.
,Bacteriostati
c-t etr
acy cline,chlorampheni col,
Bacteri
olyt
icorBact eri
cidal-streptomy cin,ci
profloxacin,ampi cil
l
in.
 Ant i
septicsanddi si nfectantsar eagentst hatinhibitorkil
lmicrobesoncont act.Conventi
onal
ly,
agent
sused
onli
v i
ngsur facesar ecalledant i
sept i
cswhi lethoseusedf orinanimateobj ectsarecall
eddisi
nfect
ants.
I
ndisinfecti
on, itkil
lsonlyv eget ati
vef or
msofbact eri
a.
 Steril
izati
oni sthepr ocesst hatkill
sallformsofpat hogens, i
ncludingspores.
 Thedi
seaseagenti
saf
act
or(
subst
anceorf
orce)whi
chcausesadi
seasebyi
tsexcessordef
ici
encyor
absence.
 Ty
pesofdi
seaseagent
sar
ebi
ologi
cal
,nut
ri
ent
,chemi
cal
,phy
sical
,mechani
cal
etc.
 Bi
ologi
cal
agent
s-I
tincl
udesv
iruses,
ricket
tsi
as,
bact
eri
a,f
ungi
,pr
otozoans,
hel
mint
hesandar
thopods.
 
o Thebi
ologi
cal
agent
sar
ecal
l
edpat
hogens(
Gr.Pat
hos 
=di
sease;
genes=pr
oduci
ng)
.
o Pat
hogenspr
oducedi
seasesi
ntwoway
s:t
issuedamageandt
oxi
nsecr
eti
on.
o Tissuedamage:Thebact er
iaresponsi
blefortuber
cul
osis,
damagecell
sandcausel esi
onsinthe
l
ungs.Bloodoozesf r
om t
helesi
onsi
ntot heairsacs,l
eadi
ngt ohaemorr
hages.Thebact
eri
at hatcausemeningi
ti
s
att
acktheprotect
ivemembranescover
ingthebr ai
n.Thevirusofrabi
esdestr
oysbrai
nti
ssue.Thepol i
ovi
rus
damagesmot ornervecel
lsi
nthespi
nal cor
d.
o Toxi
nsecr
eti
on:
Manymi
crobespr
oducepower
ful
poi
sons,
cal
l
edt
oxi
ns,
whi
chcausedi
seases.
 
o Toxi
nsar
eof2t
ypes:
endot
oxi
nandexot
oxi
n.
o Exotoxi
nsar
ereleasedassoonasproduced.Thedi
seasesbr
oughtaboutbyexot
oxi
nsi
ncl
ude
t
etanus,
scar
letf
ever
,dipht
her
ia,
andbot ul
i
sm (f
oodpoisoni
ng).
o Endot
oxinsar
er etai
nedinthebact
eri
alcell
sandr el
easedwhenbacter
iadieanddi
sint
egr
ate.The
di
seasescausedbyendotoxi
nsincludetyphoi
dfever
,chol
era,bubonicpl
agueanddysenter
y.
 Nut
ri
entagent
s 
Thesecompri
sef oodcomponent
ssuchascar
bohy
drat
es,
fat
s,pr
otei
ns,
miner
als,
vit
ami
nsand wat
er.
 Chemicalagent
s
o Thesear
efur
theroft
wot
ypes-endogenousandexogenous.
o Endogenouschemi
cal
agent
sar
efor
medi
nthebodyi
tsel
fandi
ncl
udehor
mones,
enzy
mes,
urea
andur
icaci
d.
o Exogenouschemi
calagent
sent ert
hebodyfr
om outsi
debyinhalat
ion,
ingest
ionori
nocul
ati
on.
Pol
l
utant
s(f
umes,gases,
dusts,
metal
s)andall
ergens(spor
es,
pol
len)areexamples.
 Phy
sical
agent
s
Thesei
ncludeheat,col
d,humi
dit
y,pr
essur
e,r
adi
ati
on,
elect
ri
cit
yandsound.
 Mechanicalagent
s
Thesecomprisechroni
cfri
cti
onorothermechanicalf
orceswhi
chresul
tini
njur
y,spr
ain,
disl
ocat
ion,
fract
ure.
 Def
iciencyandexcessofsubstances:
e.g.,
hormones,
enzymes.
 Somediseasesar
ecausedbygenet
icdi
sordersandlackorunder
devel
opmentoforgans.Theagent
sfor
cer
tai
ndi
seasessuchaspept
icul
cer
s,cor
onaryheartdi
seasesandhypert
ensi
on,ar
enotful
l
yknown.

Tabl
e:Medi
calTer
ms 
SCI
ENTI
STS
 Fat
herofMedi
cine:
Hippocr
ates.Hegav
easci
ent
if
icexpl
anat
ionofdi
seasef
ort
hef
ir
stt
ime.
 Fat
herofSur
ger
y:Susr
uta.Heusednon-
poi
sonousl
eechesasanant
icoagul
antdur
ingsur
ger
y.
 Fat
herofAy
urv
eda:Char
aka(
Ayu→ Li
fe,
Veda→ Knowl
edge)
.Hef
ir
stgav
econceptofdi
gest
ive,
met
abol
i
sm andimmunit
y.
 Fat
herofModer
nPat
hol
ogy:
Rudol
f Vi
rchow.
 Fat
herofI
mmuni
ty:
Edwar
dJenner(
Smal
l
poxv
acci
ne)
.
 Fat
herofBl
oodgr
oupi
ng:
C.Landst
einer
.
 Fat
herofModer
nBact
eri
ology:
Rober
tKoch(
Ant
hrax,
T.B.
,Chol
era)
 Nobel
Pri
zef
orodor
antr
ecept
or(
olf
act
ion)i
sgi
vent
oRi
char
dAxel
andLi
ndaB.
Buck.

TYPESOFDI
SEASES
 Thedi
seasesmaybebr
oadl
ycl
assi
fi
edi
ntot
wot
ypes:
congeni
tal
andacqui
red.
 Congeni
tal
Diseasesar
eanat
omi
cal
orphy
siol
ogi
cal
abnor
mal
i
tiespr
esentf
rom bi
rt
h.Theymaybecaused
by–
o Asi
ngl
egenemut
ati
on(
alkapt
onur
ia,
pheny
lket
onur
ia,
albi
nism,
sickl
e-cel
lanaemi
a,haemophi
l
ia,
col
ourbl
i
ndness)
. 
o Chr
omosomal
aber
rat
ions(
Down’
ssy
ndr
ome,
Kli
nef
elt
er’
ssy
ndr
ome,
Tur
ner
’ssy
ndr
ome)or
 
o Env
ironment
alf
act
ors(
clef
tpal
ate,
har
eli
p).
 
 Unl
i
kethegeneandchr
omosome-
inducedcongeni
tal
def
ect
s,env
ironment
all
ycausedabnor
mal
i
tiesar
enot
t
ransmi
tt
edtot
hechil
dren.
 Acqui
redDi
seasesdev
elopaf
terbi
rt
h.Theyar
efur
theroft
wot
ypes:
communi
cabl
eandnon-
communi
cabl
e.

COMMUNI
CABLEDI
SEASES 

 Thedi
seaseswhi
charecausedbypat
hogens(
vir
usesandli
vi
ngorgani
sms)andr
eadi
l
yspr
eadf
rom t
he
i
nfect
edt
otheheal
thyper
sonsar
ecalledcommuni
cabl
eorinf
ecti
ousdi
seases.
 AGermanphysi
cian,
Rober
tKoch,
li
stedt
hef
oll
owi
ngf
ourcondi
ti
onst
oest
abl
i
sht
hataspeci
fi
cpat
hogen
causesapar
ti
cul
ardi
sease–
o Thesuspect
edpathogenshoul
dbei
nvar
iabl
ypr
esenti
ntheani
mal
ssuf
fer
ingf
rom t
hedi
seaseand
shoul
dnotbef
oundi
nhealt
hyindi
vi
duals.
o Thepat
hogensi
sol
atedf
rom t
hedi
seasedani
mal
shoul
dbegr
owni
napur
ecul
tur
e. 
o Whenthi
scul
tur
eisi
nocul
atedi
ntoaheal
thyhost
,thel
att
ershoul
ddev
elopt
hedi
seaseandshow
i
tschar
act
eri
sti
csymptoms.
o Thepat
hogenshoul
dber
ecov
erabl
efr
om t
heexper
iment
alhost
,andi
tshoul
dbet
hesameast
he
or
igi
nal
one.
 

TRANSMI SSI
ONOFDI SEASES(PATHOGENS)
 Thediseases(pat
hogens)aretr
ansmitt
edf
rom t
her
eser
voi
rsofi
nfect
iont
otheheal
thyper
sonsi
nthe
fol
l
owingway s:dir
ectandindi
rectt
ransmissi
on.
 Di
rectt
ransmi
ssi
on:Thepat
hogensofsomedi
seasesr
eacht
hehumanbodydi
rect
lywi
thouti
nter
medi
ate
agent
s.Thi
scanoccurasunder:
o Contactwi t
hInfectedPersons: Certai
ndiseasesproducesor esorl
esionsontheskin.Contactwi
th
mat eri
alsdi
schargedf rom thesesoresorlesionsbringsaboutinfecti
on.Ringworm,at
hlete’
sfoot,
barber’
sitch,
chickenpox,small
pox ,syphili
sandgonor r
hoeaar espreadbydi r
ectcont act
.Kissi
ngal
sospr eadsi
nfecti
on.The
diseasesthataretransmittedbydi r
ectcontactarecalledcontagiousdiseases.
o Dr opl
etInfect
ion:Somedi seasesarecaughtbymer el
ybei
nginaconfinedplace(room, t
heatre,
bus)wi
thani nf
ectedperson.Thel att
erthrowsoutti
nydr opl
etsofmucusbycoughi ng,
sneezing,spi
tti
ngorev en
tal
ki
ng.Thesedropletsmaycont ainpathogens(vi
ruses,bacter
ia)di
slodgedf
rom nasalmembr ane,t
hroat,andlungs.
Manyofthesedropletsareinhaled.Dipht
heria,
scarl
etfever,
inf
luenza,commoncold,measles,mumps, tubercul
osis,
pneumonia,andwhoopingcoughar espreadbydroplets.
o ContactwithSoi
l:Thebacter
iar
esponsi
blef
ortet
anusandbl
oodpoi
soni
ngent
ert
hehumanbody
f
rom t
hesoi
lthr
oughinjuri
es.Hence,ski
ninj
uri
esshoul
dnotbenegl
ected.
 
o AnimalBi
tes:
Virusofrabi
es,
orhy
drophobi
a,i
sint
roducedt
hrought
hewoundcausedbyt
hebi
tes
ofr
abi
dani
mal
s,mostcommonlydogs.
o ThroughPlacenta:I
nthelat
erpar
tofpr
egnancy
,duetoageorinj
ury,
theplacent
abecomes
permeabl
etocert
ainpathogenssuchasv i
rusofger
manmeaslesandbacter
iaofsyphi
l
is.Thepathogenst
henpass
fr
om themater
nalbloodint
ot hefoet
albl
ood.
 I
ndir
ectTransmi
ssi
on: Thepat
hogensofcer
tai
ndi
seasesr
eacht
hehumanbodyt
hroughsome
i
nter
medi
ateagent
s.Theseagentsar
e- 
o Vect
ors:
Insect
str
ansmi
tdi
seasesi
ntwodi
ff
erentway
s-
Housef l
ycar r
iesthecausat i
veor ganismsofchol era,ty
phoid,dysenteryandt uberculosisont helegsandmout hparts
from faecesandsput um t of oodanddr inks.Thel att
er,i
ftaken,causei nfection.Ital
socar riesthemi crobes
responsibleforopht halmiaandconj unct i
vit
isfrom eyetoey e.Ants,cockr oachesandhousecr icketsalsocar ry
diseaseger mst oarticlesoff ood.
Cer t
ainblood-suckingi nsectscar rydisease- causingorganismsi ntheirbodyandt r
ansmi tthem wi t
hbites.Human
body -
lousespr eadst yphus, ratfleat ransmi tsbubonicplague, t
setsef l
yspr eadsAf ricansleepingsickness, sandfly
transmitskala-azarandor iental sore, Aedesmosqui tospreadsy el
lowf ever,Cul exmosqui totransmi t
sf i
lar
iasis,and
Anophel esmosqui tospr eadsmal ar
ia, t
icksspreadr ockymount ainspot t
edf ever.
o Vehicle-bor neMet hod: Thecausat i
veorganismsofdy sent ery,choler
aandt yphoidentert he
humandi gesti
vet r
actwi thf oodandwat er.Mostoft hehel mint
heswhi chpr oducedi seasesi nmanal sogeti nt
ot he
bodyi nasi mil
arway .Somedi seasesar etransmittedthroughblood, e.g.
, AIDS.
o Air
-bor
neMethod:Thepathogensmayr
eacht
hehumanswi
thai
randdust
.Theepi
demi
cty
phus
spr
eadsbyi
nhal
ationofdri
edf
aecesofi
nfectedli
ce.

CLASSI
FICATI
ONOFCOMMUNI
CABLEDI
SEASE

Dependi
nguponthetypeofcausat
iveagent
,communi
cabl
ediseasesar
ethef
oll
owi
ngt
ypes-bact
eri
al,
vir
al,
ri
cket
tsi
al,
spi
rochaet
al,
prot
ozoan,f
ungalandhel
mint
heset
c.
BACTERIALDISEASES
Typesofbact
eri
aldi
seasesar
echol
era,
pneumoni
a,t
yphoi
det
c.

Tabl
e:Bact
eri
alDi
seasesi
nHuman
VI
RALDI SEASES
Vi
ral
diseasesar
etr
ansmi
tt
edbycont
actf
omi
teanddr
opl
etmet
hod.Ty
pesofv
iral
diseasear
e-i
nfl
uenza,
smal
lpox,
et
c.

Tabl
e:Vi
ralDi
seasesi
nHumans
PROTOZOANDI SEASE
Thesearecausedbyprot
ist
s.Theyi
ncl
udemal
ari
a,amoebi
asi
s,gi
ardi
asi
s,kal
aazar
,Ci
l
iar
ydy
sent
ery
,
tr
ypanosomiasi
setc.

(
a)Mal
ari
a
 Lav
eran(
1880)di
scov
eredmal
ari
alpar
asi
tei
nbl
oodofmal
ari
apat
ient
.
 Pf
eif
fer(
1892)pr
oposedt
hatmal
ari
aisspr
eadbybl
oodsucki
ngi
nsect
.
 Di
scov
eryofPl
asmodi
um andi
tst
ransmi
ssi
on byAnophel
es(
femal
e)wasconf
ir
medbyRonal
dRoss
(
1897)
.
 Mal
ari
aiscausedbyt
het
oxi
nspr
oducedi
nthehumanbodybyt
hemal
ari
alpar
asi
tes,
Plasmodi
um.
 Themalar
ial
par asi
tesarecarr
iedfrom theinfect
edtothehealt
hypersonsbyt hef
emaleAnophel
es
mosquit
o.Themosquitopicksupt heparasi
teswi t
htheblood,whenitbi
tesaninfectedper
son.Whenthi
sinf
ected
mosquit
obitesaheal
thyperson,parasi
tesmi gr
ateintohisbl
oodwiththesali
va,whichthemosqui
toinj
ect
sbefore
sucki
ngupbloodtopreventitscl
otti
ng.
Fi
g.:St
agesinthel
i
fecycl
eofPlasmodium
 Ther
earef
ourspeci
esofPlasmodium,
whi
chcausedi
ff
erentki
ndsofhumanmal
ari
a
o P.vi
vax:I
tcausesbeni
gnter
ti
anmalar
ia,
whichatt
acksever
ythi
rdday,i
.e.,
aft
er48hour
s.The
f
everi
smi
l
dandsel
dom fat
al.Thi
sspeci
esi
swide-
spr
eadinthetr
opical
andtemperat
eregions.
o P.ov
ale:
Ital
socausesbeni
gnt
ert
ianmal
ari
a,whi
chr
ecur
sev
ery48hour
s.Thi
sspeci
esi
sfound
onl
yinWestAf
ri
caandSouthAmeri
ca.
o P.malari
ae: I
tcausesquart
anmalari
a,whi
chrecursev
eryf
our
thday
,i.
e.,
aft
er72hour
s.Thi
s
speci
esi
sfoundi
nbot
ht r
opicalandtemperat
eregi
ons,buti
tisnotv
erycommon.
o P.fal
cipar
um : I
talonei
scapabl
eofcausingthr
eety
pesofmalari
a,vi
z.,
quart
anmal
ari
a,whi
ch
at
tacksal
mostdail
y,mal
ignanttert
ianmalar
ia,
whichoccur
sev er
y48hour
s,buti
sverysever
eandoft
enfat
al;
and
i
rr
egularmal
ari
a.Thi
sspeciesisfoundonlyi
nthetropi
calr
egion.
 Mal
ari
aresul
tinanaemi
a,t
oxaemi
aandspl
enomegal
y(enl
argedspl
een)
.
 Ant
imalar
ialdrugsar
equi
nine,
chl
oroqui
neet
c.Dal
apr
im dr
ugki
l
lst
hepar
asi
ti
cst
agespr
esenti
nbot
hli
ver
cel
l
sandRBC'sofblood.

(
b)Amoebi
asis
 I
tiscausedbyi
ntest
inal
endopar
asi
ti
cpr
otozoanEnt
amoebahi
stol
yti
caofman.
 I
nfect
ioni
str
ansmi
tt
edbycont
ami
nat
ion.
 I
tischar
act
eri
zedbyabdomi
nal
pai
nal
ter
nat
ingdi
arr
hoeaandconst
ipat
ionet
c.
 Ent
amoebasecr
etescy
tol
ysi
nthater
odest
hemucousmembr
aneoft
hei
ntest
ine.

(
c)Gi
ardi
asis
 Alsocal
l
edbackpeper
'sdi
sease,
iti
scausedbyGi
ardi
aint
est
inal
i
s.
 I
tinhabi
tsupperpar
tofsmal
li
ntest
ine(
duodenum andj
ejunum)
 I
nfect
ioni
str
ansmi
tt
edbycont
ami
nat
ionofcy
stswi
thf
oodanddr
inks.
 I
tischar
act
eri
zedbymi
l
ddi
arr
hoea.

(
d)Kal
aazar
 Kal
aazarorl
eishmani
asi
siscausedbyLei
shmani
adonov
ani
andspr
eadbysandf
ly(
Phl
ebot
omus)
 I
tischar
act
eri
zedbyf
everandenl
argementofv
iscer
alor
gans.
 I
tisal
soknownasdum-
dum f
ever
. 
 Lei
shmani
abr
azi
l
iensi
scausesespundi
aandor
ient
alsor
eiscausedbyL.
tr
opi
ca.

(
e)Ci
l
iar
ydy sent
ery(
Bal
ant
idi
asi
s)
 I
tiscausedbyBal
ant
idi
um col
i
.Iti
nhabi
tst
hehumanl
argei
ntest
ine(
col
on)
.
 I
nfect
ionoccur
sbyi
ngest
ingcy
stswi
thf
oodanddr
inks.
 Bal
antidi
um col
icausesulcer
sinthecol
onandi
nvadesmucousmembr
anebysecr
eti
nganenzy
me
hy
alur
odi
nase.Thus,
general
lyresul
tsindi
arr
hoea.
 Tet
racy
cli
neorl
odoqui
nol
areef
fect
ivet
reat
ment
.

(
f)Tr
ypanosomi
asis
 Iti
scausedbydi
ff
erentspeci
esofTr
ypanosoma.
 I
tischaracter
izedbyhi
ghf
ever
,swel
l
ingoft
heneckandar
mpi
t,weakness,
anaemi
a,l
ethar
gy,
unconsci
ousnessetc.
 T.gambi
ensecausesGambi
anf
everofWestAf
ri
cansl
eepi
ngsi
ckness,
whi
chi
sspr
eadbybot
hsexesoft
se
-
tsef
ly(
Glossi
napal
pal
is)
.
 RhodesianorEastAfr
icansleepingsi
ckness,
causedbyT.rhodesiensei
sspr
eadbyG.morsi
tans.Chagas
di
seaseorSouthAmer i
cansleepingsicknessi
scausedbyT.cruzi
andspr eadbyPanst
rongi
l
ussp.I
tismore
commoni nchil
drenandyoungadul t
s.
Tabl
e:Sexual
l
yTr
ansmi
tt
edDi
seases(
STD)i
nHuman

HELMINTHICDISEASES
Hel
minthesar
emul t
icel
lul
arpar
asit
esandi ncl
udesroundwormsandf
lat
wor
ms.Hel
mint
hescausesv
ari
ousdi
seases
i
nmanl i
ke,f
il
ari
asi
s,taeni
asi
s,ascar
iasi
s,enter
obiasi
setc.

(a)Fil
ari
asis
 I
tiscausedbyWucher
iabancr
oft
i.I
tisal
soknownasel
ephant
iasi
sduet
oexcessi
veenl
argementofbody
partsli
keleg.

Fig.:Diagr
am showi
nginfl
amati
oninoneofthe l
owerl
imbsduetoel
ephanti
asi
s
 Symptomsincl
udefev
er,pr
oli
fer
ati
onofendot
hel
ial
cel
lsanddeposi
ti
onofmet
abol
i
tesi
nthewal
lofl
ymph
vessels.
 I
tist
ransmi
tt
edbyCul
exorAedesmosqui
toes.

(
b)Taeni
asi
s
 Iti
scausedbyi
ntest
inal
endopar
asi
te,
Taeni
asol
i
um.
 I
tischar
act
eri
zedbyabdomi
nal
pai
n,i
ndi
gest
ion,
lossofappet
it
e,nauseaet
c.
 Cy
sti
cer
cosi
slar
vaofTaeni
acausescy
sti
cer
cosi
swhi
chcausesdamaget
odi
ff
erentbodypar
ts,
bli
ndness
et
c.

(
c)Ascar
iasis
 ItiscausedbyAscar
isl
umbr
icoi
des.
 Vect
orsf
ort
hisdi
seasear
efl
i
esandcockr
oaches.
 I
tischar
act
eri
zedbycol
i
cpai
n,i
ndi
gest
ion,
diar
rhoea,
vomi
ti
ng,
weaknesset
c.
 Scr
atcht
est
,der
mal
testandst
ool
testcanbedonet
odet
ectt
her
oundwor
minf
ect
ion.

(
d)Ent
erobi
asi
s(oxyur
is)
 Iti
scausedbyEnter
iobi
usv
ermi
cul
ari
s(pi
norseatwor
m).
 I
tst
ransmi
ssi
oni
sdi
rectbycont
ami
nat
edf
ood.
 I
tcausesanal
itchi
ng,
appendi
cit
is,
ner
vouspr
obl
em.
 

(
e)Ancy
lost
omiasis
 Iti
scausedbyAncy
lost
omaduodenal
e.
 I
tist
ransmi
tt
edbyi
nfect
edl
arv
avi
acont
ami
nat
edf
oodandv
eget
abl
es.
 Sy
mpt
omsi
ncl
udechr
oni
cbl
oodl
oss,
depl
eti
onofbody
'si
ronst
oresl
eadi
ngt
oanaemi
a,i
nfl
ammat
ionof
ski
net
c.

(
f)Schi
stosomiasi
s(Bi
lhar
zia)
 I
tiscausedbySchist
osomahaemat
obi
um.
 I
tist
ransmi
tt
edbysnai
l
.
 I
tisf
oundi
nur
inar
ybl
adder
,bl
oodv
essel
sandcausesi
tchi
ng,
rashes,
aches,
fev
eret
c.

FUNGALDISEASES
Thesear
ecausedbyf
ungi
,thenongr
eenhet
erot
rophi
cor
gani
sms.Theyi
ncl
uder
ingwor
m andat
hlet
e'sf
oot
.

(
a)Ri
ngwor
m 
 Ri
ngwor
miscausedbydi
ff
erentgener
aoff
ungi
-Mi
crospor
um,
Tri
chophy
tonandEpi
der
mophy
ton.
 I
tisani
nfect
ionofski
n,hai
randnai
l
s.
 I
tssy
mpt
omsi
ncl
udesr
edscal
ypat
chorbump.
 Ringwormiscont
agi
ousandi
seasi
l
yspr
eadf
rom oneper
sont
oanot
her
,soav
oidt
ouchi
ngani
nfect
edar
ea
onanot
herperson.
 

(
b)At
hlet
esf
oot
 I
tiscausedbyaf
unguscal
l
edTi
neapedi
s.
 I
tisav
erycommonski
ncondi
ti
ont
hataf
fectt
hesol
eoft
hef
ootandt
heski
nbet
weent
het
oes.
 Commonsy
mpt
omsi
ncl
udev
ari
ousdegr
eesofi
tchi
ngandbur
ning.
NONCOMMUNICABLE(NON-
INFECTIOUS)DI
SEASES
 Thesedi
seasesr
emainconf
inedtot
hepersonwhodev
elopst
hem anddonotspr
eadt
oot
her
s.
 Themainnon-communicabl
edi
seasesar
edi
abet
es,
inf
lammat
orydi
seasesofj
oint
ssuchasar
thr
it
is,
gout
,
car
diov
asculardi
seasesandcancer
.

(
a)Di
abetesMell
it
us 
 Diabet
esischar
act
eri
zedbychr
oni
chy
per
gly
cemi
awhi
chi
sexcessi
veconcent
rat
ionofgl
ucosei
nthebl
ood.
 Di
abetesi
spri
mari
l
yar
esul
tofr
elat
iveorcompl
etel
ackofi
nsul
i
nsecr
eti
onbyt
heβcel
l
sofi
slet
sof
Langer
hansinpancr
eas.
 Di
abet
esi
sest
abl
i
shedbybl
oodandur
inesugarl
evel
s.

(
b)Ar
thr
it
is
 Art
hri
ti
sisanyi
nfl
ammat
orycondi
ti
onoft
hej
oint
schar
act
eri
zedbypai
nandswel
l
ing.
 Ty
pesofar
thr
it
isar
e:r
heumat
oidar
thr
it
is,
ost
eoar
thr
it
isandgout
.
 Ther
eisnocur
eforar
thr
it
is,
drugsar
eav
ail
abl
ewhi
chr
eli
evepai
n.
 Rheumat
oidar
thr
it
is 
o I
tischar
act
eri
zedbyi
nfl
ammat
ionoft
hesy
nov
ial
membr
ane.
o Aki
ndofr
heumat
oidar
thr
it
ist
hatoccur
siny
oungerpeopl
eisSt
il
l’
sdi
sease.
o I
tusual
l
yst
art
sint
hesmal
lj
oint
sint
hehandandpr
ogr
esst
oot
herbodyj
oint
s.
 Ost
eoar
thr
it
is 
o I
tisacommondi
seaseamongt
heel
der
lyper
sonsr
esul
ti
ngf
rom er
osi
onofar
ti
cul
arcar
ti
lage.
o Inost
eoar
thr
it
is,t
hesecret
ionofl
ubri
cat
ingsynovi
alfl
uidbet
weent hebonesatt
hej
ointst
ops.The
j
oint
sbecomei
nfl
ammed,it
smov ementbecomespainf
ulandit
sfuncti
onisdimini
shed.
o I
tiscommoni
nol
dper
son,
mai
nlyaf
fect
ingwei
ghtbear
ingj
oint
s.
 Gout
o Goutr
esul
tsf
rom accumul
ati
onofur
icaci
dcr
yst
alsi
nthesy
nov
ial
joi
nts.
o Goutisadi
seaseassoci
atedwi
thani
nbor
ner
rorofur
icaci
dmet
abol
i
sm t
hati
ncr
easespr
oduct
ion
ori
nter
fer
eswi
thexcr
eti
onofur
icaci
d.
o I
tisv
erypai
nful
,par
ti
cul
arl
yatni
ghtandmakemov
ementdi
ff
icul
t.Goutgener
all
yaf
fect
sthegr
eat
t
oe.

CARDI
OVASCULARDISEASES
 Car
diov
ascul
ardi
seasesr
efert
oanumberofdi
seasesassoci
atedwi
tht
hebl
oodv
ascul
arsy
stem.
 Somemaj
orcar
diov
ascul
ardi
seasesar
erheumat
ichear
tdi
sease,
hyper
tensi
vehear
tdi
seaseandcor
onar
y
hear
tdi
sease.
 Rheumat
ichear
tdi
sease
o Rheumati
cheartdiseasei
sanautoi
mmunedi
sease,
mostcommoni
nchi
l
drenaf
terasev
eret
hroat
i
nfect
ionbycer
tai
nstr
ainofSt
reptococcusbact
eri
a.
o Anant
igenont
hesur
faceoft
hesebact
eri
aisv
erysi
mil
art
oanant
igenont
hesur
faceof
my
ocar
dium.
o Theant
ibodi
esagai
nstSt
rept
ococcusmayr
eactwi
thmy
ocar
dium andcausehear
tdi
ff
icul
ti
es.
 Hy
per
tensi
vehear
tdi
sease
o Hy
per
tensi
vehear
tdi
seasear
ecausedbyhy
per
tensi
on,
i.
e.,
incr
easedbl
oodpr
essur
e.
o Ser
ioushy
per
tensi
oni
sacommoncauseofchr
oni
chear
tfai
l
urepar
ti
cul
arl
yinol
derpeopl
e. 
 Cor
onar
yhear
tdi
seases 
o Cor
onar
yhear
tdi
seasesarechar
act
eri
zedbyimpai
redheartf
unct
ionduet
oinadequat
ebl
oodf
low
t
othehear
t.Angi
napect
ori
sist
hechestpai
ncausedmostoft
enbymy ocar
dial
anoxi
a. 
o At
tacksofangi
napect
ori
sar
eof
tenr
elat
edt
oexer
ti
on,
emot
ional
dist
urbanceandexposur
eto
excesscol
d. 
o My
ocar
dial
inf
arct
ioni
scommonl
ycal
l
edcor
onar
yorhear
tat
tack.
 
o Coronaryheartdi
seasemaybeduet
orai
sedser
um chol
est
erol
,ci
gar
ett
esmoki
ng,
highbl
ood
pr
essur
e,phy
sical
inacti
vi
ty,obesi
tyanddi
abet
es.
o Cy
anosi
sref
erstoablui
shcol
orat
ionoft
heski
nandmucousmembr
anesduet
otoomuch
deox
ygenat
edhaemogl
obi
nintheblood.
 
 St
roke
o I
tist
hemostcommondegener
ati
vedi
seasei
nman.
o I
tisabr
aindamageduet
ost
oppageofbl
oodsuppl
yresul
ti
ngf
rom cer
ebr
alt
hrombosi
s,cer
ebr
al
haemor
rhageet
c.
o I
tischar
acter
izedbydegenerat
ionofmotorner
vesofbr
ainduetoreducedsuppl
yofoxy
gen
r
esul
ti
ngi
npar
aly
ticat
tackofsomebodypar t
sespecial
l
yli
mb, l
ossofmemory,speechandevendeat
h.

I
MMUNESYSTEM
 Sy
stem whi
chpr
otect
sthebodyf
rom di
seasesi
scal
l
edi
mmunesy
stem.
 Thei
mmunesy st
em consi
sti
ngofsev
eral
organsaswellasWBCi
nbl
oodandl
ymphhast
hej
oboff
ight
ing
of
finv
adi
ngpat
hogensandprevent
inggr
owthandspr
eadofcancers.
 Ly
mphoi
dor
gansar
ethoseor
ganswher
eor
igi
nandmat
urat
ionandpr
oli
fer
ati
onofl
ymphocy
teoccur
s.
 Thepr
imar
yly
mphoi
dor
gansar
ebonemar
rowandt
hymus.
 Bonemarr
owmanufact
uresbi
ll
i
onsofWBCneededbythebodyever
yday.Somenewl
yproducedWBC
r
emai
ninthebonemar
rowtomatureandspeci
ali
zewhi
l
eother
str
avelt
othethymustomatur
e.
 Secondaryl
ymphoi
dor
gansi
ncl
udesl
ymphnode,
adenoi
dst
onsi
l
s,spl
een,
pey
er'
spat
ches(
wit
hini
ntest
ine)
andt
heappendix.
 Ly
mphnodesf
il
terpat
hogensf
rom t
hel
ymphandexposest
hem t
oWBC.
 Spl
eenf
il
ter
spat
hogensf
rom bl
ood.I
tisst
ockedwi
thWBCt
hatr
espondt
othet
rappedpat
hogen.
 Lymphoidti
ssuelocat
edwithi
nt hel
ini
ngofthemajortr
act
s(respi
rat
ory
,di
gest
iveandurogeni
tal
tract
s)i
s
cal
l
edmucosal
associ
atedlymphoi
dt i
ssue(MALT).I
tconst
itut
esabout50%ofthel
ymphoidti
ssueinhumanbody.
 I
mmunol
ogyi
sthesci
enceofdev
elopmentofi
mmuni
tyagai
nstpar
ti
cul
arpat
hogen.
 Thefoundat
ionsofsci
enceofimmunol
ogywer
edi
scov
eredbywor
ker
s-Edwar
dJenner(
1796)
,Loui
s
Past
eur(
1879)andVonBehring(1841)
. 
 Somet
ermsr
elat
edt
oimmunesy
stem ar
e–
o I
mmuni
ty:
Resi
stanceoft
hebodyagai
nstapat
hogenordi
sease.
o Ant
igenorAggl
uti
nogen:
Prot
einoussubst
ancewhi
chst
imul
atest
hepr
oduct
ionofant
ibodi
es.
o Anti
body:
Iti
sacomplexglycopr
oteinsecr
etedby
B-
ly
mphocy
tesi
nresponset
oanant
igen.I
tisalsocal
ledaggluti
nin.
 
o Ant
iser
um:
Ser
um ofanyani
mal
whi
chcont
ainst
heant
ibodyf
oraspeci
fi
cant
igen.
o Venom (
poi
son):
Toxi
csubst
ancessecr
etedbysnakeandsomei
nsect
. 
o Toxoid:
Abact er
ial
exot
oxi
nwhi
chi
sdet
oxi
cat
edbyspeci
alpr
ocedur
est
oal
l
owi
tssaf
eusei
n
i
mmuni
zat
ionagai
nstthedisease.
 I
mmuni
tywasdef
inedbySi
rMacFar
laneBur
net
.
 I
mmuni
tydev
elopedi
n3way
s-byv
acci
nat
ion,
ant
it
oxi
nandt
hroughdi
sease.
 I
mmuni
tyar
eoft
wot
ypes-
o Congeni
tal
immuni
tyori
nnat
eimmuni
tyorNon-
speci
fi
cimmuni
ty.
 
o Acqui
redi
mmuni
tyorAdapt
iveorspeci
fi
cimmuni
ty
 
 

I
NNATEORNONSPECI
FICI
MMUNI
TY

 Innat
eimmunity,pr
esentf
rom bi
rt
h,ar
especi
fi
c(act
sonmanyor
gani
sm)anddoesnotbecomemor
e
ef
fi
cientonsubsequentexposur
etothesameorgani
sm.
 Thenon-
specif
icdef
encemechani
smsi
sfur
theroft
wot
ypes-
ext
ernal
def
ence(
fi
rstl
i
neofdef
ence)and
i
nter
nal
defence(
secondli
neofdef
ence)
 
 Fi
rstl
i
neofdef
encecompr
isephy
sical
andchemi
cal
bar
ri
erst
otheent
ryofpat
hogensi
ntot
hebl
ood.
 Phy
sical
bar
ri
erincl
udesskinandmucousmembr aneandchemical
barri
ersi
ncl
udeschemi
cal
ssecret
edby
ski
nandmucousmembr aneli
keskinsecret
ionandbact
eri
a,nasal
secr
eti
on,cer
umen(earwax),
sal
i
va,t
ear
,vaginal
bact
eri
a.
 Aci
dinst
omach,
sal
i
vai
nmout
h,t
ear
sfr
om ey
es,
all
prev
entmi
crobi
algr
owt
h.
 Secondl
i
neofdefence/
inter
nal
def
encei
scar
ri
edoutbyWBC,
macr
ophages,
inf
lammat
oryr
eact
ions,
fev
er,
i
nter
fer
onsandcomplementsystem.
 I
nfl
ammat
oryr
esponsei
sar
eact
iont
hatcausesr
edness,
heat
,swel
l
ingandpai
nint
hear
eaofi
nfect
ion.
 Bodytemper
atur
eri
secausesf
ever
,fev
eri
scausedbyt
her
eleaseofchemi
cal
cal
l
edpy
rogenf
rom
damagedt
issues.
 I
nter
fer
ons(
discov
eredbyI
ssacsandLi
nder
mann)ar
epr
oducedagai
nstv
iral
inf
ect
ion.
 Thecomplementsy
stem pl
aysani
mpor
tantr
olei
nhostdef
enceagai
nsti
nfect
iousagent
sandi
nthe
i
nfl
ammator
yresponse.

ACQUI
REDI
MMUNI
TY

 Iti
stheresi
stancet
hatani
ndi
vi
dual
acqui
resdur
ingl
i
fe.Thi
sisgener
atedi
nresponset
oanexposur
etot
he
mi
croor
ganism i
nquesti
on.
 Thi
sty
peofi
mmuni
tyi
sfoundonl
yinv
ert
ebr
ates.
 I
tisal
socal
l
edadapt
iveorspeci
fi
cimmuni
ty.
 Thi
simmuni
tyi
sacqui
redaf
terbi
rt
hbyexper
ience.
 Thi
simmuni
tyr
ecogni
seandsel
ect
ivel
yel
i
minat
ethepat
hogen.

FEATURESOFACQUI REDIMMUNITY
 Speci
fi
cit
y:Acqui
redi
mmunit
yisspeci
fi
cforspeci
fi
cmi
croor
gani
sms.
 Di
ver
sit
y:Thi
ssy
stem r
ecogni
sest
hev
astv
ari
etyofmi
croor
gani
sms.
 Discr
imi
nati
onbet
weensel
fandnon-
sel
f:I
tcanr
ecogni
sesel
f(bodyort
issue)andnon-
sel
f(f
orei
gnt
issue)
andr
espondaccor
dingt
othem.
 Memor y:Whenapat hogenenteri
nsidet
hebody,bodytakeslongerti
met orecogniseandrespondt
oi t
.Thi
s
i
scalledpri
maryimmuner esponsebutthememor yoft
hisencounterremaininimmunesy st
em.
Whent hi
spathogenenter
ssecondt i
mei nsi
dethebody
,thebody '
simmunesy stem r
apidlyrecogni
sesthi
spathogen
andrespondsquickl
ytoit
.Thisiscal
ledsecondaryi
mmuner esponse.Thisisbasedonmemor yoftheimmune
syst
em.

TYPESOFACQUIREDIMMUNITY
 Act
iveacqui
redi
mmuni
ty:
Resi
stancedev
elopedbyani
ndi
vi
dual
asar
esul
tofanant
igeni
cst
imul
us.
Natur al:Resultsfrom acl i
nical orinappar entinfectionbyami cr
oorganism.
Arti
ficial:Resistancesinducedbyv accine.
Vacci nesar epreparedbyl iveorki ll
edmi croor
gani smsort hei
rproductsandisusedf ori
mmuni sati
on.
 Passiveimmuni ty: Itisreceivedpassi v
elybyhostwi thoutpart
ici
pationorcontr
ibuti
onfrom host
'si
mmune
system.I mmunol ogi
cal memor yisabsenther eandt her eadymadeantibodiesaregiveni
ni mmunosuppressi
ve
i
ndividual .
 
Natur al:Resistancepassi velytransferredf rom mot hertobaby .Mothermi l
kgi v
espassiveimmuni t
ytothenewbor
n
chil
dbycol ostrum (fi
rstmot hermi l
k).
Arti
ficial:
 Resistancepassi velytransferredt oar ecipientbyadmi ni
str
ationofant i
bodi
es.
E.g.:Humani mmunol ogicaladmi ni
strati
on.
Anti-Tet anusser um (ATS)
Anti-r abiesserum (ARS)
Anti-di ptheri
aser um (ADS)

Tabl
e:Di
ff
erencebet
weenAct
iveandPassi
vei
mmuni
ty

TYPESOFACTI
VEI
MMUNESYSTEM

CELLMEDI
ATEDIMMUNESYSTEM (CMIS)ORCELLULARIMMUNI TY 
Thi
simmunesy
stem i
sbasedonT-
cel
l
s( 60-
70%)wi
thant
igenspeci
fi
crecept
orsont
hei
rsur
faces.
Tabl
e:Cel
l
sofI
mmuneSy
stem

ANTI
BODYMEDI ATEDIMMUNESYSTEM (
A.M.
I.
S.)ORHUMORALIMMUNITY
 Ant
ibodyorimmunogl
obul
i
nar
ecomplexgly
copr
otei
nmol
ecul
emadeupof4pol
ypept
idechai
ns-
twol
i
ght
andt
woheavychains.
 Theset
wochai
nhel
dtoget
herbydi
sul
phi
debondi
nshapeofYmol
ecul
e.
Twotipsoft
hismol
ecul
ebindwit
hanti
gen(lar
geandcomplexfor
eignmoleculesmai
nlypr
otei
nst
hatact
ivat
ethe
speci
fi
cimmunit
y)l
i
kelockandkeyf
ashionandmakeanti
gen-ant
ibodycomplex.
 
Fig.:St
ruct
ureofanant
ibodymol
ecul
e

 Preci
pit
ati
on:Anti
bodi
escombi newi
tht
heant
igenst
ofor
m pr
eci
pit
atest
hatar
eear
lyi
ngest
edbyt
he
phagocy
tes.Theyareknownaspreci
pit
ins.
 Complementact
ivati
on:Anti
bodyant
igencomplexesactivat
ecomplementpr
otei
nswhichmayopsoni
se
ant
igen,
lysecel
lwal
lofbacteri
acausi
ngthei
rdisi
ntegr
ati
on,at
tractphagocy
test
otheareaofi
nfect
ion.

Tabl
e:Ty
peofant
ibodi
es
ALLERGY

 Al
l
ergyorhyper
sensi
tiv
ityi
stheexcessiv
eimmuner esponset
ocommonanti
gens.Theseant
igensare
pr
esenton/incer
tai
nsubstancescall
edal
lergens(e.
g.,
dust
,poll
en,moul
ds,
cer
tai
nfoods,somemedicines)
 Al
l
ergyi
nvol
vesmai
nlyI
gEant
ibodi
esandhi
stami
ne
 Ant
ihi
stami
nei
samedi
cinet
hatgi
vesr
eli
eff
rom al
l
ergy
. 
 Ty
pesofhy
per
sensi
ti
ver
eact
ionsar
e- 
o TypeIr
eact
ion(i
mmediatehypersensi
ti
vi
tyr
eact
ions)i
nvol
veI
gEmedi
atedr
eleaseofhi
stami
ne
andot
hermedi
atorsfr
om mastcel
lsandbasophi
ls.
o TypeIIr
eacti
ons(cyt
otoxi
chypersensi
ti
ver
eact
ion)i
nvol
veI
gGorI
gM ant
ibodi
esboundt
ocel
l
sur
faceant
igenswi
thsubsequentcomplementf
ixati
on.
o TypeII
Ireact
ions(i
mmunecompl
exreacti
on)inv
olv
ecircul
ati
nganti
genant
ibodyi
mmune
compl
exest
hatdepositi
npostcapil
l
aryv
enul
eswi
thsubsequentcomplementfi
xat
ion.
o TypeIVreact
ion(
del
ayedhy
per
sensi
ti
ver
eact
ionsorcel
lmedi
atedi
mmuni
ty)ar
emedi
atedbyT
cel
l
srat
hert
hanbyanti
body.

VACCI
NATI
ONANDI
MMUNI
SATI
ON

 Vacci
neisthesuspensi
onofinacti
vat
edpat
hogensorant
igeni
cpr
otei
nofpat
hogenwhi
chi
stakenor
all
yor
i
nject
edt
oprovi
deimmunityfort
hatpathogen.
 Pri
nci
pleofvaccinat
ionisbasedonmemor yoftheimmunesy stem.Whenanant igeni
cmat er
ial
isinj
ect
ed
i
naheal thyperson,i
tgenerat
esant i
bodi
esandmemor ycell
sasapr i
mar yi
mmuner esponse.Whent hi
sactive
pathogenenterssecondtimeinsidethi
sbodyofvacci
natedper son,memor ycel
lsrapidl
yrecogniseandrespondwit
h
massiveproductionofl
ymphocy tesandanti
bodi
es.Soitdest
r oyspathogensrapidl
yandt hediseasedoesnot
appear.Personbecomesr esi
stantfort
hatdi
seaseaft
ervaccination.
 Ty
pesofv
acci
nes
o Fi
rstgenerat
ionvacci
nes:Thesevacci
nesar
epr
epar
edbyi
nact
ivat
ingt
hewhol
epat
hogenbutt
hey
hav
esi
deef
fect
s,e.
g.,Oralpol
i
ov acci
ne(OPV),DPT.
o Secondgener ati
onv accines:Ant
igeni
cpol
ypepti
desofpat hogensarepr
oducedwit
hrecombinant
DNAt echnol
ogyintransgenicorganisms.
Thesearemadebymul t
ipli
cati
onofsur faceanti
genbygenet
icengi
neering.Theyhavenosideeff
ect
s.E.
g.,Hepati
ti
s
Bv acci
neproducedfrom t r
ansgenicyeast.
o Thirdgenerati
onv acci
ne: Thesearehi
ghl
ypotent,sy
ntheti
ci nnat
ure&prepar
edbygenes.They
arealsocall
edDNAv accine.
 Passi
vei
mmunisat
ionmaybeinducedbyadmini
str
ati
onofananti
bodycontai
ningpr
eparat
ion,
transf
erof
mat
ernal
anti
bodi
esacr
ossthepl
acent
aandbyt r
ansf
erofly
mphocytest
oinducepassi
vecell
ulari
mmuni t
y.
 Passi
vei
mmuni
sat
ionmaybenat
ural
orar
ti
fi
cial
.
 Natural
passi
veimmuni
sati
onincludesthepassageofmater
nal
IgGacr
osst
hemammal
i
anpl
acent
a.I
n
humans,
IgAistr
ansmit
tedt
othebabys'gutviacol
ostr
um andmil
k.
 Arti
fi
cial
passi
vei
mmuni
sat
ioni
saf
fect
edwheni
mmunodef
ici
entpat
ient
sar
egi
vendosesofant
ibodi
es
f
rom adonor
.

Tabl
e:SomeI
mpor
tantVacci
nes
NOTES
 EdwardJenner(1796)not i
cedt
hatmil
kmaidsdidnotsuff
erfrom smallpoxbuttheyhadscabsofcowpox.
Hetransportedthemateri
al f
rom thesor
eofmilkmaidwhowassuf fer
ingfrom cowpoxtot heyoungbodyof8year
ol
d.Af t
ersomet i
me,heinjectedli
vesmall
poxmaterial
int
othatboy.Butsymptomsofdi seasesdidnotappear
.He
tr
iedthi
spr ocedur
eonot herpersonandgotsuccess.Hegavethetermv acci
nati
onforthisprocess.
 LouisPast
eur
:Hedi
scov
eredt
hepr
ocessofi
nact
ivat
ingt
hepat
hogen&pr
epar
edv
acci
nesf
orant
hrax,
chol
era,
rabies.
 VonBehr i
ng:Hediscoveredthepr
ocessofpassi
vei
mmuni
zat
ionandpr
epar
edt
heant
idi
pht
her
ial
ser
um by
i
nject
ingdipht
heri
aanti
genintosheep. 
VonBehringisknownas'Fatherofpassi
veimmunizat
ion'
.

CANCER
 Cancerisanabnor
mal
anduncont
rol
l
eddi
vi
sionofcel
l
s,knownascancercel
l
s,t
hati
nvadeanddest
royt
he
sur
roundi
ngtissues.
 
 Gener
all
ycanceri
sdef
inedasuncont
rol
l
edpr
oli
fer
ati
onofcel
l
swi
thoutanydi
ff
erent
iat
ion.
 Cancercel
l
sar
edi
ff
erentf
rom nor
mal
cel
l
sinsomeaspect
s.Theydonotr
emai
nconf
inedt
oonepar
toft
he
body
. 
 Neopl
asm (
cal
l
edt
umor
)isanewabnor
mal
tissuewhi
chi
scapabl
eofcont
inuedgr
owt
h.
 Tumor
smaybebeni
gnandmal
i
gnant
.
 Benignt
umori sal
argel
ocal
i
zedmassofabnor
mal
tissueencl
osedi
nconnect
ivet
issuewhi
chdoesnot
i
nvadeadjacentt
issue.
 Mal
i
gnantt
umori
snotencapsul
atedandi
scapabl
eofi
nvadi
ngadj
acentt
issuesanddi
stantsi
tes.
 Theypenetrateandinf
il
tr
atei
nt otheadjoi
ningti
ssuesanddisl
ocat
ethei
rfuncti
ons.Someofthecancer
cel
lsgetdetachedfrom t
hemainsiteofor i
ginandtr
av el
bybloodandlymphtosi
tesdist
antfrom t
heori
ginal
tumour
andformfreshcolonies,
cal
ledmetastasisorsecondarygrowth.

SYMPTOMSOFCANCER
 Thi
ckeni
ngorl
umpi
nthebr
eastoranyot
herpar
toft
hebody
.
 Changesi
nbowel
orbl
adderhabi
ts.
 I
ndi
gest
ionordi
ff
icul
tyi
nswal
l
owi
ng.
 Unexpl
ainedchangesi
nwei
ght
.

TYPESOFCANCER

 Ty
pesofcancerar
ecar
cinoma,
sar
coma,
leukemi
aandl
ymphoma.
 Car
cinomai
sacancerofepi
thel
i
alt
issueandt
hei
rder
ivat
ivesl
i
kemucousmembr
ane,
ski
n,l
ungs,
breast
et
c.
 Sar
comai
sacancerofpr
imi
ti
vemesoder
mal
tissuel
i
keconnect
ivet
issue,
bone,
muscl
e,l
ymphnodeset
c.
 Leukemiai
sabloodcancer.I
tinvol
vesi
ncr
easedWBCcountofbl
oodduet
oincr
easedf
ormat
ioni
nthe
bl
oodmarrowresul
ti
ngi
ndecreasederythr
opoi
esi
sandRBCcount
.
 Bonemar
rowgr
aft
ingi
susedf
ort
het
reat
mentofl
eukemi
a.
 Ly
mphomasaf
fectt
hel
ymphat
icsy
stem.

CAUSESOFCANCER

 Chemi
cal
orphy
sical
agent
sthatcancausecancerar
eknownascar
cinogen.
 
Dependi
ngonthei
rmodeofaction,
carci
nogensfal
li
ntothef
oll
owingmaincat
egor
ies:
o Agent
sthatcancausealt
erat
ionsint
hegeneti
cmater
ial(
DNA),r
esul
tingi
noncogeni
c
tr
ansfor
mati
on.
o Agentsthatpr
omotetheprol
if
erat
ionofcel
l
s,whi
chhav
ealr
eadyunder
gonegeneti
cal
ter
ati
ons
responsi
blef
oroncogenictr
ansf
ormati
on.Theseagentsar
ecall
edt
umourpr
omoter
,e.g.
,somegrowthf
act
orsand
hormones.
o Cancercausi
ngDNAandRNAv
iruses(
tumourv
iruses)hav
ebeenshownt
obeassoci
atedwi
th
oncogeni
ctr
ansf
ormati
on. 
 Tr
ansf
ormat
ionofanor
mal
cel
li
ntoacancercel
l
,ift
her
egul
ati
oni
supset
.

TREATMENT

 Sur
ger
y:Byr
emov
ingt
heent
ir
ecancer
oust
issueandi
nfect
edl
ymphnodes.
 Radi
ati
on:
Cobal
tther
apy(
Co-
60)
,X-
ray
sradi
ati
onsar
egi
ven.Theser
adi
ati
onsdest
royt
her
api
dlydi
vi
ding
cel
l
s.
 Chemotherapy: Anti
-cancerousdrugs(
li
ke: Vi
ncri
sti
ne(weed-Cathar
ant
husroseus=Vi
ncarosea)
,
Vinbl
asti
ne(weed-Cat harant
husr oseus=Vincarosea)
, (
Cyclophosphami
de)i
nhi
bitt
heDNAsynthesi
sincel
lcy
cle
ofcancerouscel
lbutthishassideef fect
s.
 Mostoft
hecancer
sar
etr
eat
edbycombi
nat
iont
her
apyofsur
ger
y,r
adi
ati
onandant
i-
cancer
ousdr
ug.

AI
DS
 AIDS(Acqui
redI
mmunoDef
ici
encySy
ndr
ome)i
sachr
oni
cli
fe t
hreat
eni
ngdi
sor
derwhi
chdamagest
he
humanbody'
simmunesystem.
 AI
DSi
scausedbyHI
V(humani
mmuno-
def
ici
encyv
irus)whi
chbel
ongst
oret
rov
irus(
groupofRNAv
irus)
 TheHI
Vcanonl
ysur
viv
einbodyf
lui
dsl
i
kebl
ood,
semen,
vagi
nal
secr
eti
onet
c.
 HI
Vist
ransmi
tt
edt
hroughbodyf
lui
dsby
-
o Sexual
cont
act(
mostcommonmodeoft
ransmi
ssi
on)(
Probabi
l
ity<1%)
o Bl
oodcont
act(
100%)
, 
o Bymot
hert
ochi
l
dbypl
acent
a(33%)
,bymot
hermi
l
k
 HI
Visnott
ransmi
tt
edt
hroughor
dinar
ycont
act(
huggi
ng,
danci
ng,
tal
ki
ng,
touchi
nget
c.)wi
thsomeonewho
hasHI
VorAI
DS;
sweat
,tear
sorsal
i
vaet
c.
 Themaj
orcel
laf
fect
edbyHI
Vist
hehel
per
-T-
ly
mphocy
te.
 TheHI
Vvi
rusmul
ti
pli
esandsl
owl
ybegi
nst
odest
royt
heCD4l
ymphocy
te(
Tcel
l
sorhel
perT-
cel
l
s)
 AI
DSwasf i
rstrecogni
sedi
nHat
ai(
USA)i
n1981amongagr
oupofy
ounghomosexual
swhower
eaddi
ctsof
her
oinandothernar
coti
cs.

Fi
g.:Repl
i
cat
ionofr
etr
ovi
rus

 AI
DSi
ncl
udes3phases-
o Asymptomaticphase-Init
ial
l
ywi thi
n2-12weeks,t
hereisnoanti
bodyproducti
onsoinfect
ivi
tyof
pati
entsoract
ivenessofvir
usismaxi mum inthis per
iod.Thi
speri
odiscall
edthewindowperiod(Nospecif
ic
symptomsappeari nthi
sphase soELISAt esti
snegat i
veinwindowperi
od.)
Lowgradefever,bodyaches,sorethr
oat.
o AIDSrel
atedcomplex(A.R.C.
)-3t o6weeks
I
tischar
act
eri
zedby-
 Di
arr
hoea
 Wei
ghtl
oss(
>10%)
 Cough
 Gener
ali
sedl
ymphadenopat
hy
 Fev
er.
o Ful
l bl
ownAIDS–I
nthi
s,pat
ientbecomesf
ull
yimmunedef
ici
entand T-
Iymphocy
tesorCD4count
6
i
slesst
han200×10 /li
tre.

I
NVESTI
GATI
ON

 Scr
eeni
ngt
esti
sEnzy
meLi
nkedI
mmunoSor
bentAssay(
E.L.
I.
S.A.
).
 Conf
ir
mat
oryt
est
s:West
ernbl
ott
est:
Det
ect
sant
ibodi
es(
prot
eins)i
npat
ient
'sser
um.
 ELI
SAisatechni
quewhichcandet
ectandevenquant
it
ateext
remel
ysmal lamountofapr
otei
n,antibodi
es
orant
igenswit
hthehelpofenz
ymes.Thecommonlyusedenzymesareper
oxidasesandalkal
i
nephosphatase.
 West
ernbl
ott
esti
sthecul
tur
ingofbl
oodandt
est
ingpl
asmaf
orv
irus.
 Vi
ral
loadtestmeasur
est
heamountofv
irusi
nthebl
oodwhi
chwi
l
lhel
pindet
ermi
ningt
hepr
obabl
e
pr
ogr
essi
onofthedisease.
 

TREATMENT

 Dr
ugsusedar
e-
o AZT(
Azi
dot
hymi
dine)orZi
dowdi
ne
o DDI(
Dideoxy
inosi
ne)
o Foscar
net
Thesedrugsinhibi
ttheenzy meof  HIV.
 
 Highlyacti
veanti
r et
rov
iralther
apy(HAART)i
sacombinati
onofthr
eeormoreant
ir
etrovi
ral
agents(cal
led
tr
ipl
etherapyorHAART) ,whichhasbeenhi ghl
yeff
ect
ivei
nreduci
ngthenumberofHI
Vparti
clesi
nthebloodstr
eam
andasar esul
tincreasestheCD4count .

DRUGSANDALCOHOLABUSE
 Dr
ugabuseisdefi
nedassel
fadmini
str
ati
onofadr
ugf
ornon-
medi
cal
reasons.Abuseddr
ugi
ncl
ude
anabol
i
csteroi
ds,
analgesi
csandant
ibi
oti
cs.
 Dr
ugsar
ecl
assi
fi
edont
hebasi
soft
hei
rmodeofact
iononbr
aini
ntot
wocat
egor
ies-
o Psy
choact
iveorpsy
chot
ropi
cdr
ugs
o Psy
chedel
i
corhal
l
uci
nogeni
cdr
ugs.
 Psy
choact
ivedr
ugsar
eal
socal
l
edasmoodal
ter
ingorneur
ologi
cal
drugs.
 Psy
chedel
i
cdr
ugspr
oducepsy
chol
ogi
cal
eff
ect
sli
kei
l
lusi
onsandhal
l
uci
nat
ions.
 Fourcat
egor
iesofpsy
choact
ivedr
ugsar
e-sedat
iveandt
ranqui
l
izer
s,opi
atenar
cot
ics,
sti
mul
ant
sand
hal
l
uci
nogens.
 Al
coholi
sm i
stheconsumpt
ionoforpr
eoccupat
ionwit
hal cohol
icbev
eragest
otheext
entt
hatt
his
behav
iouri
nter
fer
eswiththeal
cohol
i
csnormalper
sonal,
famil
y,sociall
if
e.
 Al
cohol
decr
easest
heact
ivi
tyofCNSt
her
eby
,reduci
nganxi
ety
,tensi
onsandi
nhi
bit
ions.
 Al
cohol
decr
easest
hesecr
eti
onofADHf
rom t
hepost
eri
orpi
tui
tar
ygl
andcausi
ngi
ncr
easedur
ineout
put
.
 I
nthel
i
ver
,al
cohol
isconv
ert
edi
ntoamor
etoxi
csubst
anceacet
aldehy
dewhi
chi
susedf
orener
gybyt
he
cel
l
s.
 Liv
ersy
nthesi
zesf
atf
rom t
heal
cohol
,theext
raf
atdecr
easest
hepr
oduct
ionofenz
ymesandst
ruct
ural
pr
otei
ns.
 Theaccumul
ati
onoff
atsr
esul
tsi
nfat
tyl
i
versy
ndr
ome,
leadi
ngt
oci
rr
hosi
s(r
epl
acementofl
i
vercel
l
sby
f
ibr
oust
issue)
 Al
cohol
addi
cti
onl
ower
sbl
oodsugarl
evel
s,adv
ersel
yaf
fect
ingt
hebr
ain.
 Tobaccoi
sthedr
iedl
eav
esoft
hepl
antNi
cot
ianat
abacum andN.r
ust
ica.
 
 Ni
cot
inei
sthesubst
ancet
hatcausesaddi
cti
ont
otobacco.
 Ni
cot
inei
shi
ghl
ypoi
sonous,
nicot
inepr
esenti
naci
gar
ett
eissuf
fi
cientt
oki
l
laper
soni
ftakeni
ntr
avenousl
y.
 Ni
cot
ine-st
imul
atespassageofner
vei
mpul
se,
causesmuscl
est
orel
axandcausesi
ncr
easedhear
trat
e.
 Tobaccosmokecont
ainscar
bonmonoxi
de,
pol
ycy
cli
car
omat
ichy
drocar
bonsandt
ar.
 Themai
nhar
mful
eff
ect
sofsmoki
ngar
erespi
rat
orydi
seasesandcar
diov
ascul
ardi
sease.
 Oneoft
hecommoncancerat
tri
but
edt
oci
gar
ett
esmoki
ngi
slungcancer
.
 Thewithdr
awal
symptomsincl
udei
rri
tabi
l
ity
,anxi
ety
,cr
avi
ng,
sleeppr
obl
ems,
headacheandl
ethar
gy.I
tmay
cont
inuefor4-
6weeksandcr
av i
ngmaycont
inueformanymonths.
 Someofthei
mpor
tantmeasur
esf
ort
hepr
event
ionandcont
rol
ofal
cohol
anddr
ugabuseamong
adol
escentsar
easfol
l
ows-
o Dr
ugeducat
ionandcounsel
l
ingpr
ogr
am.
o Looki
ngf
ordangersi
gns.
o Av
oidunduepeerpr
essur
e.
o Seeki
nghel
pfr
om par
ent
sandpeer
s.
o Seeki
ngpr
ofessi
onal
andmedi
cal
hel
p.
o Enf
orci
ngst
rongerl
awsandpenal
ti
es.

Tabl
e:Cat
egor
iesofPsy
chot
ropi
cDr
ugs,
thei
rEf
fect
sandCl
i
nicaluses.