PST NTA Level 4

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Hypertension Disease Control and Prevention • Source Session/Topic 35 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 35: Identification of Patients with Hypertension Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Hypertension • Describe Types of Hypertension • Describe Major Signs and Symptoms of Hypertension • Explain Treatment Of Hypertension • Explain Prevention and Control of Hypertension Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |05 minutes |Presentation |Cause of Hypertension | |3 |20 minutes |Presentation |Types of Hypertension | | | |Buzzing | | |4 |15 minutes |Presentation |Major Signs and Symptoms of | | | | |Hypertension | |5 |20 minutes |Presentation |Treatment of Common Hypertension | |6 |40 minutes |Presentation |Prevention and Control of | | | |Small group |Hypertension | | | |discussion | | |7 |05 minutes |Presentation |Key Points | |8 |05 minutes |Presentation |Evaluation | |9 |05 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Hypertension (5 minutes) • Hypertension or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is persistently raised • Blood pressure is expressed by two measurements: o The systolic pressure occurs when the left ventricle contract o The diastolic pressure occurs when the left ventricle relaxes before the next contraction • Normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. • Hypertension is present if the blood pressure is persistently at or above 140/90 mmHg for most adults STEP 3: Types of Hypertension (20 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the types of hypertension? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Hypertension is classified as either: • Primary (essential) hypertension defined as high blood pressure with no obvious underlying cause. o About 90–95% of cases are categorized as primary hypertension • Secondary hypertension; defined as hypertension due to an identifiable cause o Accounts for remaining 5–10% of cases of hypertension, o Causes of secondary hypertension; ▪ chronic kidney disease, ▪ pregnancy ▪ alcohol ▪ narrowing of the aorta or kidney arteries ▪ Endocrine disorder e.g. excessive aldosterone, cortisol, or catecholamines ▪ Drugs such as corticosteroids, non-steroidal anti-inflammatory drugs [pic] STEP 4: Signs and Symptoms of Hypertension (15 minutes) • Hypertension usually does not cause symptoms initially • Some patients report; o Headaches (particularly at the back of the head and in the morning) o Vertigo, o Tinnitus (buzzing or hissing in the ears) o Altered vision or fainting episodes • Sustained hypertension over time is a major risk factor for: o Heart disease o Coronary artery disease o Stroke o Aortic aneurysm o Peripheral artery disease o Chronic kidney disease STEP 5: Treatment of Hypertension (20 minutes) • Refer patients to the hospital for investigations and initial treatment and follow up may be even done at dispensary or health centre • Antihypertensive medications are available for treating hypertension • First line medications for hypertension include: o Tthiazide – diuretics e.g. hydrochlorothiazide o Calcium channel blockers, e.g. diltiazem o Angiotensin converting enzyme inhibitors e.g. captopril o Angiotensin receptor blockers e.g. losartan ▪ These drugs may be used alone or in combination ▪ The majority of people require more than one medication to control their hypertension. STEP 6: Prevention and Control of Hypertension (40 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are preventive and control measures of hypertension? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Lifestyle changes are recommended to lower blood pressure, before starting drug therapy. o Maintain normal body weight for adults (e.g. Body mass index 20 – 25 kg/m2) o Reduce dietary sodium intake o Engage in regular physical activity e.g. Walking o Limit alcohol consumption • consume a diet rich in fruit and vegetables • Stop smoking and reduce intake of dietary saturated fat and cholesterol • Lifestyle modification may lower blood pressure as much as antihypertensive drug • Patient education o Hypertension is a lifelong disorder ▪ Long-term commitment to lifestyle modifications and pharmacological therapy is required. ▪ Repeated in-depth patient education and counselling improve compliance and reduce cardiovascular risk factors. STEP 7: Key Points (5 minutes) • Hypertension is diagnosed by properly measuring elevated blood pressure at three or more separate occasions based on 2 or more readings. • Treatment approach in hypertension is based upon its severity by classification ranging from non pharmacological to pharmacological. • Patient’s education repeatedly carries a great role for optimal control of hypertension by lifelong commitment to lifestyle modification and drug therapy. STEP 8: Evaluation (5 minutes) • What is hypertension? • How is hypertension classified? •

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Diabetes Disease Control and Prevention • Source Session/Topic 36 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 36: Identification of Patients with Diabetes Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Diabetes • Describe Types of Diabetes • Describe Major Signs and Symptoms of Diabetes • Explain Treatment of Common Diabetes • Explain Prevention and Control of Diabetes Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Causes of Diabetes | | | |Brainstorming | | |3 |10 minutes |Presentation |Types of Diabetes | |4 |30 minutes |Presentation |Major Signs and symptoms of | | | |Buzzing |Diabetes | |5 |20 minutes |Presentation |Treatment of Diabetes | |6 |30 minutes |Presentation |Prevention and Control of Diabetes | | | |Small group | | | | |discussion | | |7 |05 minutes |Presentation |Key Points | |8 |05 minutes |Presentation |Evaluation | |9 |05 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Diabetes (10 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What causes diabetes? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Diabetes mellitus (DM) comprises Hyperglycemia is a cardinal manifestation due to; o Insulin deficiency or o Insulin resistance • Several distinct types of DM exist and are caused by a complex interaction of genetics, environmental factors and life-style choices • Factors contributing to hyperglycemia may include: o Reduced insulin secretion o Decreased glucose usage, and o Increased glucose production STEP 3: Types of Diabetes (10 minutes) There are three main types of diabetes mellitus: • Type 1 DM results from failure of pancreases to produce enough insulin o This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". o The cause is unknown • Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. o As the disease progresses a lack of insulin may develop o This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes" o The primary cause is excessive body weight o Risk Factors for Type 2 Diabetes Mellitus ▪ Family history of diabetes (i.e. parent or sibling with type 2 diabetes) ▪ Obesity i.e. body mass index (BMI) >27kg/m2 ▪ Age >45 years ▪ History of gestational diabetes mellitus ▪ Hypertension ▪ High density lipoprotein (HDL) cholesterol <0.90 mmol/l (35mg/dl) ▪ In HIV patients, the HAART therapy can increase risk of diabetes • Gestational diabetes, is the third main form and occurs when pregnant women without a previous history of diabetes develop a high blood sugar level. STEP 4: Signs and Symptoms of Diabetes (30 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the signs and symptoms of diabetes? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Clinical features of DM depend on the severity of disease and its complications. They include: • Polyuria • Polydipsia • Polyphagia • Hyperglycaemia • Glycosuria • Keto acidosis • Coma • Weight loss • Fatigue • Weakness • Blurred vision • Frequent superficial infections e.g. vaginitis, fungal skin infections • Slow healing of skin lesions after minor trauma [pic] Figure 36.1: Main symptoms of diabetes STEP 5: Treatment of Diabetes (20 minutes) • Treatment of DM should be initiated at hospital after thorough evaluation • Follow up may be done in the health centre when patients are stable Type I Diabetes Mellitus Insulin is required • The commonly used types of insulin are: o Fast-acting: Includes the insulin analogues aspart, lispro, and glulisine. ▪ These begin to work within 5 to 15 minutes and are active for 3 to 4 hours. o Short-acting: Includes regular insulin ▪ Begins working within 30 minutes and is active about 5 to 8 hours. o Intermediate-acting: Includes NPH insulin ▪ Begins working in 1 to 3 hours and is active 16 to 24 hours. o Long acting: Includes the analogues glargine and detemir, o Begins working within 1 to 2 hours and continue to be active, without major peaks or dips, for about 24 hours, although this varies in many individuals. o Ultra-long acting: Currently only includes the analogue degludec, ▪ Begins working within 30–90 minutes, and continues to be active for greater than 24 hours o Combination insulin products – Includes a combination ▪ of either fast-acting or short-acting insulin Type 2 Diabetes Mellitus • There are several classes of anti-diabetic medications available such as: o Biguanides; e.g. Metformin o Sulfonylureas, ▪ First generation e.g. Chlorpropamide, Tolbutamide ▪ Second generation e.g. Glipizide, Gliclazide, Glibenclamide, Glyburide ▪ Third generation e.g. Glimepiride, Gliclazide MR (DIAMICRON MR 60) o Thiazolidinediones e.g Rosiglitazone STEP 6: Prevention of Diabetes (30 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Peptic Ulcers Disease Control and Prevention • Source Session/Topic 37 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 37: Identification of Patients with Peptic Ulcers Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Peptic Ulcers • Describe Types of Peptic Ulcers • Describe Major Signs and Symptoms of Peptic Ulcers • Explain Treatment of Common Peptic Ulcers • Explain Prevention and Control of Peptic Ulcers Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |05 minutes |Presentation |Causes of Peptic Ulcers | |3 |15 minutes |Presentation |Types of Peptic Ulcers | | | |Brainstorming | | |4 |30 minutes |Presentation |Major Signs and Symptoms of Peptic | | | |Buzzing |Ulcers | |5 |20 minutes |Presentation |Treatment of Peptic Ulcers | |6 |30 minutes |Presentation |Prevention and Control of Peptic | | | |Small group |Ulcers | | | |discussion | | |7 |05 minutes |Presentation |Key Points | |8 |05 minutes |Presentation |Evaluation | |9 |05 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Related Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Peptic Ulcers (5 minutes) • Definition : An ulcers is a break in the mucosal surface >5 mm in size, with depth to the submucosa • Common causes include; o The bacteria, helicobacter pylori o non-steroidal anti-inflammatory drugs o tobacco smoking o Alcohol o Psychological stress o Diet: certain foods can cause dyspepsia, but no convincing studies indicate an association between ulcer formation and a specific diet. STEP 3: Types of Peptic Ulcers (15 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What are the types of peptic ulcers? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • PUD encompasses: o Gastric ulcers (GU) which is an ulcer in the stomach o Duodenal ulcers (DU) which is an ulcer in the first part of the small intestines (duodenum) • Duodenal and gastric ulcers share common features in terms of pathogenesis, diagnosis, and treatment, but several factors distinguish them from one another. STEP 4: Signs and Symptoms of Peptic Ulcers (30 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are signs and symptoms of peptic ulcers? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Signs and symptoms of peptic ulcer can include one or more of the following: • Epigastric pains associated with mealtimes o pain appears about three hours after taking a meal in duodenal ulcers • Bloating and abdominal fullness • Hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric ulcer, or from damage to the esophagus from severe/continuing vomiting. • Melena (tarry, foul-smelling feces due to presence of oxidized iron from hemoglobin); • Nausea, and copious vomiting; • Loss of appetite • Weight loss • Dyspepsia that becomes constant not relieved by food or antacids, radiating to the back may indicate a penetrating ulcer STEP 5: Treatment of Peptic Ulcers (20 minutes) • Treatment is initiated at the hospital • The clinician's goal in treating PUD is to: o Provide relief of symptoms (pain or dyspepsia) o Promote ulcer healing o Prevent ulcer recurrence and complications • Therapy for H. Pylori Eradication o H. pylori should be eradicated in patients with documented PUD o The agents used with the greatest frequency include: ▪ Amoxicillin ▪ Metronidazole ▪ Tetracycline ▪ Clarithromycin ▪ Bismuth compounds o Triple Therapy Regimes include: ▪ Amoxicillin, Metronidazole and omeprazole ▪ Lansoprazole, clarithromycin, and amoxicillin ▪ Bismuth subsalicylate, tetracycline, and metronidazole etc. • Antacids e.g. Magnesium Trisilicate – offer symptomatic relief by neutralizing stomach acidity • Acid inhibitory agents – decrease the amount of acid in the stomach helping with healing of ulcers. o Histamine 2 receptors blockers (H2 blockers) e.g. Ranitidine, fomatidine o Proton Pump Inhibitors (PPIs)e.g. Omeprazole, Lansoprazole • Prostaglandin analogue (misoprostol) for prevention of NSAID-induced ulceration STEP 6: Prevention and Control of Peptic Ulcers (30 minutes) |Activity: Group discussion (20 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are preventive and control measures of peptic ulcers? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Personal hygiene – It's not clear how H. pylori spread, but there's some evidence that it could be transmitted from person to person or through food and water. o Wash hands with soap and water before handling o Eat foods properly cooked • Use NSAIDs with caution. o Avoid taking aspirin, ibuprofen, and other non-steroidal anti- inflammatory drugs o Take medication with meals • Avoid drinking or drink alcohol in small amounts o Avoid drinking alcohol when taking medication • Don't smoke. Smokers are much more likely to get

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Asthma Disease Control and Prevention • Source Session/Topic 38 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 38: Identification of Patients with Asthma Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Asthma • Describe Major Signs and Symptoms of Asthma • Explain Treatment of Asthma • Describe Prevention and Control of Asthma Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Handout 38.1: Bronchial Asthma – Precipitating or Aggravating Factors SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |20 minutes |Presentation |Causes of Asthma | | | |Brainstorming | | |3 |10 minutes |Presentation |Major Signs and Symptoms of Asthma | |4 |10 minutes |Presentation |Treatment of Asthma | |5 |50 minutes |Presentation |Prevention and Control of Asthma | | | |Group | | | | |discussion | | |6 |05 minutes |Presentation |Key Points | |7 |10 minutes |Presentation |Evaluation | |8 |10minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Cause(s) of Asthma (20 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What are the causes of asthma? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Asthma is a respiratory tract disorder characterized by chronic inflammatory reversible airways obstruction. • Involves the respiratory system constricting the airway • Bronchial asthma may be either episodic (the patient has no respiratory symptoms between episodes, or signs of asthma. • Paroxysm of wheeze and dyspnoea may occur at any time and can be of sudden onset • May be extrinsic (this occurs to young people due to allergy) or intrinsic (occurs in older people) Causes • The symptoms are caused by constriction of bronchial smooth muscle (bronchospasm), oedema of bronchial mucous membrane and blockage of the smaller bronchi with plug of mucous • It can also be triggered by factors like allergens, infections, exercise, tobacco smoke inhaled chemicals and drugs for example aspirin • High risk jobs such as farming, painting, janitorial work and plastic manufacturing • Generally it can be caused by a complex interaction of environmental and genetic factors [pic][pic]Handout 38.1: Bronchial Asthma – Precipitating or Aggravating Factors STEP 3: Major Signs and Symptoms of Asthma (10 minutes) • Signs and Symptoms of Asthma: o Wheezing o Productive cough o Shortness of breath (dyspnoea) o Chest tightness o Increased respiratory rate o Increased heart rate o Diaphoresis (excessive sweating) o Decreased exercise tolerance Cough and wheeze are common during the night and may disturb sleep STEP 4: Treatment of Asthma (10 minutes) • Acute severe asthma and life threatening asthma in adult o Perform pre-referral treatment: ▪ Nebulized salbutamol or inhaled salbutamol (if available) ▪ Hydrocortisone 200mg i.v slowly (if available) ▪ Aminophylline 250mg i.v slowly or tabs ▪ Monitor vital signs o Refer to hospital immediately • Treatment at the hospital o Oxygen 40-60% via nasal prongs or face mask if available o Nebulized salbutamol or inhaled salbutamol delivered by a spacer o Hydrocortisone 200mg i.v slowly then oral prednisolone 30-60mg for 5-7 days o Aminophylline 250mg i.v slowly or tabs when therapy above fails STEP 5: Prevention and Control of Asthma (50 minutes) |Activity: Small Group Discussion ( 10 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the measures for the prevention and control of asthma? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |CLARIFY and SUMMARIZE by using the contents below | Patient Education • Should begin at the time of diagnosis and be revisited in every subsequent consultation. • Education involves the patient understanding the nature of asthma, the practical skills necessary to manage asthma successfully for example using inhaler devices and monitor the effect of treatment • Patients should appreciate the differences between the reliever medication (bronchodilator) and the controller medication (anti- inflammatory) Prevention of Asthmatic Attack • Avoidance of exposure to allergen to which patients are sensitive to: o Animal dander: Avoid contact with dogs, cats, horses or other animals. o Feathers in pillows or quilts: Substitute latex foam pillows and terylene quilts. o Avoid all preparations of relevant drugs for example beta-blockers, aspirin and other nonsteroidal anti-inflammatory drugs if the patient is sensitive. o Food: Identify and eliminate from diet. o Industrial chemicals e.g. isocyanates, epoxy resins, perfumes: Avoid exposure to chemical or change occupation. o Do not smoke and avoid environmental smoke. o Pollens: Try to avoid exposure to flowering vegetation and keep the bedroom windows closed. o Avoid exertion during high levels of pollution. STEP 6: Key Points (5 minutes) • Asthma can either be caused by a complex interaction of environmental and genetic factors. • Major signs and symptoms includes wheezing, shortness of breath (dyspnoea) and chest tightness • Severe bronchial asthma is an emergency which need urgent attention. • Educating patients with bronchial asthma should start early when diagnosis is established in order to carry out necessary precautions. STEP 7: Evaluation (10minutes) • What are the cause(s) of asthma? • What are the major signs and symptoms of asthma? • What is the treatment of asthma? • What are the

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Allergic Rhinitis Disease Control and Prevention • Source Session/Topic 39 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 39: Identification of Patients with Allergic Rhinitis Total Session Time: 60 minutes + 1 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Allergic Rhinitis • Describe Mode of Transmission of Allergic Rhinitis • Describe Major Signs and Symptoms of Allergic Rhinitis • Explain Treatment Allergic Rhinitis • Explain Prevention and Control Allergic Rhinitis Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |05 minutes |Presentation |Causes of Allergic Reactions | |3 |15 minutes |Presentation |Major Signs and Symptoms Allergic | | | |Brainstorming |Reactions | |4 |10 minutes |Presentation |Treatment of Allergic Reactions | |5 |10 minutes |Presentation |Prevention and Control of Allergic | | | | |Reactions | |6 |05 minutes |Presentation |Key Points | |7 |05 minutes |Presentation |Evaluation | |8 |05 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Allergic Rhinitis (5 minutes) Definition • Allergic rhinitis is inflammation of the nasal membranes characterized by a combination of the following symptoms: o Sneezing o Nasal congestion o Conjunctival irritation o Nasal and pharyngeal itching o Lacrimation (rhinorrhea) • Rhinitis is present if sneezing attacks, nasal discharge or blockage occur for more than an hour on most days for: o A limited period of the year (seasonal rhinitis-often called hay fever) o Throughout the whole year (perennial rhinitis) Causes of Allergic Rhinitis • Allergic rhinitis is caused by things that trigger allergies (allergens) • These allergens can be found both outdoors and indoors • When allergic rhinitis is caused by common outdoor allergens such as mold or trees, grass and weed pollens • Allergic rhinitis may also be triggered by allergens that are in your house, such as animal dander (tiny skin flakes and saliva), indoor mold, or the droppings of cockroaches or house dust mites. STEP 3: Signs and Symptoms of Allergic Rhinitis (15 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What are the major signs and symptoms of allergic rhinitis? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Symptoms of Allergic Rhinitis o Sneezing o Itching (of nose, eyes, ears, and Palate) o Rhinorrhea o Postnasal drip o Congestion o Anosmia o Headache o Ear ache o Tearing o Red eyes o Eye swelling o Fatigue o Drowsiness o Malaise STEP 4: Treatment of Allergic Rhinitis (10 minutes) Antihistamines • Antihistamines work well for treating allergy symptoms, especially when symptoms do not happen very often or do not last very long. • Antihistamines taken by mouth can relieve mild to moderate symptoms, but can cause sleepiness e.g. Citerizine • Azelastine is a nasal spray used to treat allergic rhinitis Corticosteroids • Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis. • They work best when used for long term, but they can also be helpful when used for shorter periods Decongestants • Decongestants may also be helpful in reducing symptoms such as nasal congestion. • Nasal spray decongestants should not be used for more than 3 days. STEP 5: Prevention and Control of Allergic Rhinitis (10 minutes) Identify and avoid all triggers of allergic symptoms STEP 6: Key Points (5 minutes) • Allergic rhinitis is inflammation of the nasal membranes • Allergic rhinitis is caused by allergens common in childhood, adolescence and early adult hood • Treatment depends on the type and severity of symptoms, age, and whether there are other medical conditions (such as asthma) • Prevention involves avoiding all triggering factors of your symptoms STEP 7: Evaluation (5minutes) • What is allergic rhinitis? • What are signs and symptoms of allergic rhinitis? • What is the treatment of allergic rhinitis? • What is preventive and control measures of allergic rhinitis? STEP 8: Assignment (5 minutes) |Activity: Take Home Assignment (5 minutes) | | | |DIVIDE students in groups or individuals | | | |ASK the students to work on the following Assignment | |Prepare a presentation to be delivered to the class indicating | |prevention and control of allergic rhinitis | | | |ALLOCATE time for students to do the assignments and submit | | | |REFER students to recommended references | References Braunwald, E. & Fauci, A.N. (2008).Harrison’s Principles of Internal Medicine (17thed) Oxford: McGraw Hill. Davidson, S. (2006). Principles and Practice of Medicine (20thed.). Churchill: Livingstone. Kumar, P.J. & Clark, M. (2006).Textbook of Clinical Medicine (6th ed.). Churchill: Livingstone Swash, M. & Glynn, M. (2007). Hutchison’s Clinical Methods (22nded.). London: Harcourt Publishers Ltd. ← Previous TopicNext Topic →View all Disease Control and Prevention topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 4 • Semester 1 • PST04102 Prevention and Control of Contamination in Pharmaceutical Disease Control and Prevention • Source Session/Topic 40 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 40: Prevention and Control of Contamination in Pharmaceutical Settings Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain Sources of Contamination in Pharmaceutical Settings • Explain The Consequences of Contamination on Pharmaceutical Products • Describe Measures for Preventing and Controlling Contamination in Pharmaceutical Settings Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |20 minutes |Presentation |Sources of Contamination in | | | |Brainstorm |Pharmaceutical Settings | |3 |20 minutes |Presentation |Consequences of Contamination on | | | |Buzzing |Pharmaceutical Products | |4 |50 minutes |Presentation |Measures for Preventing and | | | |Small group |Controlling Contamination in | | | |discussion |Pharmaceutical Settings | |5 |05 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | |7 |10 minutes |Presentation |Assignment | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Sources of Contamination in Pharmaceutical Settings (20 minutes) |Activity: Brainstorming (10 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are sources of contamination in pharmaceutical setting? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | Microbiological contamination Refers to non- intended or accidental introduction of infectious material like bacteria, yeast, mould, fungi, virus, prions, protozoa or their toxins and by-products Sources of contamination in pharmaceutical settings In manufacture/ compounding • Regardless of whether manufacture takes place in industry or on a smaller scale in the hospital pharmacy, the microbiological quality of the finished product will be determined by: o Formulation components used o Environment in which they are manufactured o Manufacturing process itself. • Quality must be built into the product at all stages of the process and not inspected at the end of manufacture or compounding. The following are sources of contamination: o Raw materials: particularly water and ingredients o Processing equipment o Cleaning equipment: Premises/environment o Staff o Packaging In use • Pharmaceutical manufacturers may argue that their responsibility ends with the supply of a well- preserved product of high microbiological standard in a suitable pack and that the subsequent use, or abuse, of the product is of little concern to them. • Products such as multi-dose may acquire contamination on their continued use or if subjected in a contaminated state, particularly in hospitals where it could result in the spread of cross – infection. • Human sources: o During normal usage, patients may contaminate their medicine with their own microbial flora; subsequent use of such products may or may not result in self – infection. o Topical products are considered to be most at risk, as the product will probably be applied by hand, thus introducing contaminants from the resident skin flora of staphylococci, o Micrococcus species and diphtheroids but also perhaps transient contaminants, such as pseudomonas or coliforms, which would normally be removed with effective hand- washing. o A further potential source of contamination in hospitals is the nursing staff responsible for medicament administration. • Environmental sources: o Small numbers of airborne contaminants may settle in products left open to the atmosphere. • Equipment sources: o Patients and nursing staff may use a range of applicators (pads, sponges, brushes and spatulas) during medicament administration, particularly for topical products o If reused, these easily become contaminated and may be responsible for perpetuating contamination between fresh stocks of product, as has indeed been shown in studies of cosmetic products. STEP 3: Consequences of Contamination on Pharmaceutical Products (20 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the consequences of contamination on pharmaceutical products? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Initiating infections o Cross-contamination of medicines contributes to most of the nosocomial infections occurring in hospitals o It also accounts for most of the postsurgical infections and deaths occurring in hospitals. o Cross-contaminated medicines weaken the relationship between patients and healthcare givers. o This occurs mostly in the event of drug resistance and treatment failure, but also infections due to contaminated medicines make patients lose trust in their health care givers. • Medicines spoilage o This occurs by microorganisms chemically decomposing the active ingredient or the excipients. This may lead to: ▪ The product being under- strength, ▪ Physically or chemically unstable, or possibly ▪ Contaminated with toxic materials. • Financial loss o Contaminated products have financial implications in terms of: ▪ additional treatment costs ▪ product recalls ▪ possible litigation/ legal action ▪ damage to the reputation of the manufacturer or compounder STEP 4: Measures for Preventing and Controlling Contamination in Pharmaceutical Settings (50 minutes) |Activity: Small Group Discussion (10 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the measures for preventing and controlling contamination in | |pharmaceutical settings? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW

NTA Level 4 • Semester 1 • PST04102 Methods for Disposing Pharmaceutical Wastes Disease Control and Prevention • Source Session/Topic 41 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 41: Methods for Disposing Pharmaceutical Wastes Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Terminologies Applied in Disposal of Pharmaceutical Wastes • Describe Categories of Healthcare Wastes • Describe Principles of Waste Management • Describe Methods for Disposal of Pharmaceutical Wastes • Explain Consequences of Improper Disposal of Pharmaceutical Wastes • Describe Procedure for Safe Disposal of Unfit Medicines as per Tanzania Foods, Drugs and Cosmetics Act, 2003 Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD • Handout 41.1: Categories of Health Care Wastes • Handout 41.2: Category of products and their recommended disposal methods SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |05 minutes |Presentation |Terminologies Applied in Disposal of| | | | |Pharmaceutical Wastes | |3 |20 minutes |Presentation |Categories of Healthcare Wastes | | | |Brainstorming | | |4 |10 minutes | |Principles of Waste Management | | | |Presentation | | |5 |30 minutes |Presentation |Methods for Disposal of | | | |Buzzing |Pharmaceutical Wastes | |6 |15 minutes |Presentation |Consequences of Improper Disposal of| | | |buzzing |Pharmaceutical Wastes | |7 | 10 |Presentation |Procedure for Safe Disposal of Unfit| | |minutes | |Medicines as Per Tanzania Foods, | | | | |Drugs and Cosmetics Act, 2003 | |8 |05 minutes |Presentation |Key Point | |9 |10 minutes |Presentation |Evaluation | |10 |10 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Terminologies Applied in Disposal of Pharmaceutical Wastes (5 minutes) • Pharmaceutical waste includes expired, unused, spilt, and contaminated pharmaceutical products, drugs, vaccines, and sera that are no longer required and need to be disposed of appropriately. • The category also includes discarded items used in the handling of pharmaceuticals, such as bottles or boxes with residues, gloves, masks, connecting tubing, and drug vials. • Also medicines and cosmetic products are considered as unfit when they are: o Improperly sealed o Damaged o Unexpired and improperly stored o Improperly labelled o Counterfeit o Substandard and adulterated o Prohibited and unauthorized STEP 3: Categories of Health Care Wastes (20 minutes) |Activity: Brainstorming (10 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are the categories of healthcare wastes? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | Classification of HCW [pic] Source: WHO. National Health-Care Waste Management Plans in Sub-Saharan Countries. Guidance Manual (1999). [pic][pic]Refer students to Handout 41.1: Categories of Health Care Wastes for further reading STEP 4: Principles of Waste Management (10 minutes) Pharmaceutical waste • Pharmacy department stores in each health care facility should be rigorously managed to reduce the generation of pharmaceutical waste. Especially, stocks of pharmaceuticals should be inspected periodically and checked for their durability (expiration date). Stock positions should be recorded on a regular basis. Pharmaceutical waste • Pharmacy department stores in each health care facility should be rigorously managed to reduce the generation of pharmaceutical waste. Especially, stocks of pharmaceuticals should be inspected periodically and checked for their durability (expiration date). Stock positions should be recorded on a regular basis. • These wastes usually arise at central locations, i.e. in pharmacies and laboratories and they are also often found at places where the ready-to-use cytotoxic solutions are prepared. • The precautions taken during the use of cytotoxic pharmaceuticals must also be applied on their journey outside the respective establishment, as releases of these products can have adverse environmental impacts. The management of these wastes, in covered and impermeable containers, must be strictly controlled. Solid containers must be used for collection. The use of coded containers is recommended. For reasons of occupational safety, cytotoxic pharmaceutical wastes must be collected separately from pharmaceutical waste and disposed in a hazardous waste incineration plant. STEP 5: Methods for Disposal of Pharmaceutical Wastes (30 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the methods for disposal of pharmaceutical wastes? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Disposal Methods • Landfill o Involves placing unfit medicines and cosmetic products directly into a land disposal site without prior treatment. o The method is used in disposing off solid waste. o Small quantities of unfit medicines and cosmetic products produced on a daily basis may be land filled provided that they are dispersed in large quantities of general waste. o Cytotoxic, narcotic drugs and cosmetic products containing heavy metals such as mercury should not be land filled, even in small quantities. Types of landfill methods • There are three types recognized as outlined below: o Landfill for untreated unfit medicines and cosmetic products o The method is applicable to small quantities of unfit medicine and cosmetic products. It involves placing untreated waste medicine and cosmetic into an uncontrolled, non-engineered open dump. The unfit medicine and cosmetic products should be covered immediately with large quantities of other type of waste or soil/sand to prevent scavenging by unscrupulous people. ▪

NTA Level 4 • Semester 1 • PST04102 Introduction to Human Nutrition Disease Control and Prevention • Source Session/Topic 42 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 42: Introduction to Human Nutrition Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Sources of Different Food Substances • Describe the Composition of each Class of Food (Carbohydrates, Proteins, Fats And Oils, Vitamins And Minerals) • Define Balanced Diet and Explain its Importance to Human Health • Differentiate Between Fat Soluble and Water Soluble Vitamins Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |15 minutes |Presentation |Sources 0f Different Food Substances| | | |Brainstorming | | |3 |30 minutes |Presentation |The Composition of each Class 0f | | | |Buzzing |Food (Carbohydrates, Proteins, Fats | | | | |and Oils, Vitamins and Minerals) | |4 |40 minutes |Presentation |Balanced Diet and its Importance to | | | |Group |Human Health | | | |discussion | | |5 |10 minutes |Presentation |Fat Soluble and Water Soluble | | | | |Vitamins | |6 |05 minutes |Presentation |Key Points | | 7 |05 minutes |Presentation |Evaluation | | 8 |10 minutes |Presentation |Assignment | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Sources of Different Food Substances (15 minutes) |Activity: Brainstorming (5 minutes) | |Ask students to brainstorm on the following question: | |What are sources and classes of different food substances? | |ALLOW few students to respond | |WRITE their responses on the flip chart/ board | |CLARIFY and SUMMARISE by using the content below | Important terms • Food: is what is eaten or taken into the body by parenteral routes for the purpose of nourishing the body. o Foods contain elements called nutrients. • Nutrients: are a variety of chemical substances that, in nature, form part of food. Nutrients are not the same, they can be quite be different from one another. • Nutrition: is the term standing for the sum of all processes involved in food intake, assimilation and utilization by the body. o Food must be available and accessible for consumption o Body ingests, rearranges, assimilates and utilizes the nutrients consumed in food, for the purpose of: ▪ Production of energy ▪ Growth ▪ Functioning of organs and systems ▪ Maintenance of life. • Nutritional status: is the result of the body’s nutrient intake and utilization, which may be good or bad. • Malnutrition: literally means ‘bad nutrition’. o It means any deviation from normal nutrition. o Can be either under-nutrition or over-nutrition Sources of different food substances The main sources of different food substances are: • Cereals: For example maize, rice, millet, wheat and sorghum • Pulses: For example lentils, beans, soya beans and peas • Nuts: groundnuts and cashew nuts • Vegetables: o Green leafy vegetables: cabbage, cauliflower, spinach and lettuce o Roots and tubers: yams, cassava, potatoes, sweet potatoes, carrots and beetroots o Other vegetables: ladiesfingers, brinjals, pumpkins, green peas • Fruits: pawpaws, mangoes, oranges, banana, tangerines, pineapples as well as wild fruits such as baobab fruits and tamarind • Foods of animal origin: meat, fish, eggs, milk and milk products • Sugar, Honey, Fats and Oils o Examples of fats and oils are: ▪ Ghee ▪ Butter ▪ Coconut oil ▪ Margarine ▪ Sunflower ▪ Palm oil STEP 3: The Composition of each Class of Food (30 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What is the composition of classes of food? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Carbohydrates • These are organic compounds composed of the elements carbon, hydrogen and oxygen. • Carbohydrates provide the main source of energy for the body. • Carbohydrates are classified as: o Monosaccharide (glucose, fructose, galactose and mannose) are the simplest carbohydrates. o For their absorption they can pass through the wall of the alimentary tract without being changed by digestive enzymes. o Disaccharides (sucrose, maltose and lactose) and oligosaccharides are also simple carbohydrates. ▪ These have to be converted by the body into monosaccharides before they can be absorbed from the alimentary tract. o Polysaccharides, also called complex carbohydrates, are chemically the most complicated carbohydrates. Examples are starch, cellulose and glycogen. ▪ These are long chain molecules in which a large number of monosaccharides are combined. Lipids • These are organic compounds made of the elements carbon, hydrogen and oxygen but in different proportions and different structural arrangements • Fats and oils provide the body with fuel with very high efficiency • Dietary lipids transport the fat-soluble vitamins (vitamin A, D, E and K) • Absorption of these vitamins does not take place very efficiently in the absence of fat • Lipids that are solid at room temperature (butter, beef fat) are referred to as ‘fats’ • Lipids that are in liquid at room temperature are referred to as ‘Oils’ Proteins • Proteins are organic molecules that contain the elements carbon, hydrogen, oxygen and nitrogen. • Frequently proteins contain sulphur and phosphorus and less frequently, other elements such as iron, copper and iodine • Nitrogen is the element characteristic of all amino acids and therefore of proteins • Amino acids

NTA Level 4 • Semester 1 • PST04102 Managing Patients with Nutritional Deficiency Diseases Disease Control and Prevention • Source Session/Topic 43 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 43: Managing Patients with Nutritional Deficiency Diseases Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Common Nutritional Deficiency Diseases • Describe Management of Nutritional Deficiency Diseases Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD projector • Handout 43.1 SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |50 minutes |Presentation |Common Nutritional Deficiency | | | |Buzzing |Diseases | |3 |40minutes |Presentation |Management of Common Nutritional | | | |Group |Deficiency Diseases | | | |discussion | | |4 |05 minutes |Presentation |Key Points | | 5 |10 minutes |Presentation |Evaluation | | 6 |10 minutes |Presentation |Assignment | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Common Nutritional Deficiency Diseases (50 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the common nutritional deficiency diseases? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Malnutrition • Can occur at any time in the life cycle • When it occurs early in life, irreversible damages can be done to the body and brain • Affects a significant proportion of populations, presenting as macro and or micronutrient deficiency disorders • Nutrition disorder means any kind of disorder caused by eating too little or too much of one or more different nutrients Classification of Malnutrition • Can be classified in different ways but most commonly as under nutrition or over nutrition o Under Nutrition occurs when nutrients intake does not meet nutrients needs o Many nutrients are in high demand due to the constant state of cell lose and later regeneration in the body o Over nutrition is prolonged consumption of more nutrients than the body needs Protein Energy Malnutrition (PEM) • A deficiency of energy and protein which results in body wasting, • Occurs more frequently in infants and young children but is also observed in adolescents and adults • Severe forms of PEM are Kwashiorkor and Marasmus Kwashiorkor • Caused by failure to provide an adequate dietary sources of protein to substitute for the protein • Signs and symptoms includes: o failure of growth but the child is not severely wasted, o swollen abdomen, o hair changes (hair becomes brown, straight and soft) o skin rashes, o child becomes inactive, apathetic, irritable and is difficult to feed, o oedema of lower limbs Marasmus • Causes: severe loss or chronic waste of fat, muscles and other tissues of the body. The disease occurs due to shortage of basic nutrition, proteins, vitamins and calories to the body. It is inadequate energy intake in all forms, including protein. • Signs and Symptoms of Marasmus: remarkable failure of growth, severe muscle wasting with flaccid, wrinkled skin and bony prominence, the child looks awake and hungry and displays what is referred to as ‘old person’s face and oedema is absent Prevention of PEM • The different strategies may include: o Incorporating nutrition objectives into development of policies and programmes o Improving household food security o Protection and promotion of good health o Improving the quality and safety of foods o Protect and promote breastfeeding and complementary feeding o Early treatment of common diseases o Immunization o Growth monitoring o Promoting appropriate diets and healthy lifestyles Vitamins and Minerals Nutritional Deficiencies Vitamin A Deficiency • It plays important roles in the body including vision, maintenance of epithelial tissue, and synthesis of mucous secretion, growth, reproduction and immunity. • The organ that is most readily affected is the eye Symptoms and Signs: • Night blindness (Reduced ability to see in dim light) • Conjunctival xerosis/ drying • Corneal xerosis/drying, • Xerophthalmic fundus (retina has white dots). • Keratomalacia: Perforation of the cornea prolapsed of the iris, loss of ocular contents and perhaps destruction of the eye. Vitamin B1 Deficiency (Beriberi): • Occurs when people consume highly milled polished rice or maize, and starchy roots such as cassava, which are deprived of thiamine content Signs and Symptoms: • Heart palpitation, chest pain. • Dyspnoea (breathlessness), a rapid, sometimes irregular pulse and distended neck veins with visible pulsations • The heart is found to be enlarged • Cyanosis • Increased oedema • Severe dyspnoea • Acute circulatory failure and death • The patient is thin with weak, wasted muscles Anaesthesia and ‘pins-and- needles’ feelings in the feet and arms may increase, eventually causing difficulty in walking • Foot drop and wrist drop commonly occur Vitamin B2 (Riboflavin) Deficiency (Beriberi) Sign and symptoms: • Angular stomatitis • Glossitis • Skin changes • Seborrheic dermatitis • Vascularization of the cornea Vitamin B3 (Niacin) Deficiency (Pellagra): • It is generally associated with maize diet • Early Symptoms of Pellagra: A person appears poorly malnourished, often weak and underweight. A person may also have diminished sensitivity to gentle touch and sometimes some muscular weakness and tremor. Untreated cases of pellagra may die of the disease • The disease is later characterized by the three ‘Ds’: o Dermatitis: deepening of the pigmentation, dry skin, scaly and eventual cracked, desquamation, occasionally the skin may blister, the tongue and other parts of

NTA Level 4 • Semester 1 • PST04102 Specialised Food Therapy Disease Control and Prevention • Source Session/Topic 44 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 44: Specialised Food Therapy Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Specialised Food Therapy • Explain Nutrients Required for Different Groups • Explain Entry and Exist Criteria for Specialised Food Products • Describe Different Types of Specialised Food Products • Describe the Importance of Nutritional Therapy for Acute Malnourished Clients Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD projector • Handout 44.1 SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |50 minutes |Presentation |Common Nutritional Deficiency | | | |Buzzing |Diseases | |3 |40minutes |Presentation |Management of Common Nutritional | | | |Group |Deficiency Diseases | | | |discussion | | |4 |05 minutes |Presentation |Key Points | |5 |10 minutes |Presentation |Evaluation | |6 |10 minutes |Presentation |Assignment | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Common Nutritional Deficiency Diseases (50 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the common nutritional deficiency diseases? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Malnutrition • Can occur at any time in the life cycle. • When it occurs early in life, irreversible damages can be done to the body and brain • Affects a significant proportion of populations, presenting as macro and or micronutrient deficiency disorders. • Nutrition disorder means any kind of disorder caused by eating too little or too much of one or more different nutrients. Classification of Malnutrition • Can be classified in different ways but most commonly as under nutrition or over nutrition. o Under Nutrition occurs when nutrients intake does not meet nutrients needs. o Many nutrients are in high demand due to the constant state of cell lose and later regeneration in the body. o Over nutrition is prolonged consumption of more nutrients than the body needs Protein Energy Malnutrition (PEM) • A deficiency of energy and protein which results in body wasting, • Occurs more frequently in infants and young children but is also observed in adolescents and adults • Severe forms of PEM are Kwashiorkor and Marasmus Kwashiorkor • Caused by failure to provide an adequate dietary sources of protein to substitute for the protein • Signs and symptoms includes: o failure of growth but the child is not severely wasted, o swollen abdomen, o hair changes (hair becomes brown, straight and soft) o skin rashes, o child becomes inactive, apathetic, irritable and is difficult to feed, o oedema of lower limbs Marasmus • Causes: severe loss or chronic waste of fat, muscles and other tissues of the body. The disease occurs due to shortage of basic nutrition, proteins, vitamins and calories to the body. It is inadequate energy intake in all forms, including protein. • Signs and Symptoms of Marasmus: remarkable failure of growth, severe muscle wasting with flaccid, wrinkled skin and bony prominence, the child looks awake and hungry and displays what is referred to as ‘old person’s face and Oedema is absent Prevention of PEM • The different strategies may include: • Incorporating nutrition objectives into development of policies and programmes • Improving household food security • Protection and promotion of good health • Improving the quality and safety of foods • Protect and promote breastfeeding and complementary feeding • Early treatment of common diseases • Immunization • Growth monitoring • Promoting appropriate diets and healthy lifestyles Vitamins and Minerals Nutritional Deficiencies Vitamin A Deficiency • It plays important roles in the body including vision, maintenance of epithelial tissue, and synthesis of mucous secretion, growth, reproduction and immunity. • The organ that is most readily affected is the eye. Symptoms and Signs: • Night blindness (Reduced ability to see in dim light) • Conjunctival xerosis/ drying • Corneal xerosis/drying, • Xerophthalmic fundus (retina has white dots) • Keratomalacia: Perforation of the cornea prolapsed of the iris, loss of ocular contents and perhaps destruction of the eye o All of these may lead to complete blindness Vitamin B1 Deficiency (Beriberi): • It occurs when people consume highly milled polished rice or maize, and starchy roots such as cassava, which are deprived of thiamine content. • Signs and Symptoms: o Heart palpitation, chest pain. o Dyspnoea (breathlessness), a rapid, sometimes irregular pulse and distended neck veins with visible pulsations o The heart is found to be enlarged o Cyanosis o Increased oedema o Severe dyspnoea o Acute circulatory failure and death o The patient is thin with weak, wasted muscles Anaesthesia and ‘pins- and-needles’ feelings in the feet and arms may increase, eventually causing difficulty in walking o Foot drop and wrist drop commonly occur Vitamin B2 (Riboflavin) Deficiency (Beriberi) Sign and symptoms: • Angular stomatitis • Glossitis • Skin changes • Seborrheic dermatitis • Vascularization of the cornea Vitamin B3 (Niacin) Deficiency (Pellagra): • It is generally associated with maize diet. • Early Symptoms of Pellagra: A person appears poorly malnourished, often weak and underweight. A person may also have diminished sensitivity to gentle touch and sometimes some muscular weakness and tremor. Untreated cases of pellagra may die of the disease • The