The teeth are the hardest substance which is used to eat and to bite. Each and every normal person will see milk teeth during his childhood and permanent teeth in his later stage.
Primary dentition
The milk teeth will erupt between the age of about 6 months to 36 months. It has no significant differences between the sexes for the age of primary tooth eruption. The first teeth to erupt is the incisors, being more vertical than the permanent incisors, with a deeper incisal overbite. It is used for tearing the flesh. The next teeth to erupt is the first primary molar, the lower molar is slightly forward in relation to the upper molar. Following the molar, the canine teeth are the next milk teeth to erupt. The spaces exist between upper and lower teeth into which the opposing canine tooth interdigitates. It is the normal features of permanent dentition in the higher apes and in the human primary dentition are referred to as the anthropoid spaces. The last teeth to erupt in primary dentition is the second molars.
Development of the occlusion of the permanent dentition
In the permanent dentition, there are three stages. During this development, the lower canine tooth erupting at about 9 years of age and it comes between the first and second stage. In the first stage, the replacement of primary incisor teeth and the addition of four (first permanent molars to the dentition). The age ranges between 6 to 8 years. At the age of about 6 years the second primary molars will loss and the lower first permanent molar will move forward more than the upper first permanent molar. The first stage is completed by the end of 9th year and soon after this the permanent lower canine teeth erupt, replacing the corresponding primary teeth. In the second stage, the replacement of the primary molars and upper canine teeth by the premolars and the permanent upper canines and the addition of second molar teeth will take place in age range of 10 to 14 years. In stage three, the eruption of the third molars in early adult life completes the development of the occlusion of the permanent dentition. The age range for 3rd molar eruption is 18 to 25 years.
Advantages of knowing the development of teeth
- It is important to realize that the permanent dentition does not erupt into a static unchanging environment. During the 6 to 7 years over which most of the permanent occlusion develops, growth is continuing and maturation of function is occurring.
- The potential for change makes it desirable to have a knowledge of any changes which have occurred and are occurring during the development of a child's occlusion, so that any orthodontic treatment can be planned in the light of such knowledge.
The changes during development caused by growth, maturation of muscle function, alteration in habits or eruption of teeth, may cause changes in occlusal relationships.
The human body temperature is measured in three regions, they were mouth, axilla and the rectum region. The normal oral temperature is 98.6 F ( 37 C). The temperature in axilla is 98 F (36.5 C) and the temperature in the rectum is 99.2 F (37.3 C) to 99.8 F.
What is fever?
In human beings, the range of body temperature in different parts is in the range 97 F (36 C) to 99F (37 C). If any rise above normal range is labeled as fever or pyrexia. The term pyrexia is used when the cause of the fever is unknown after investigation and diagnosis is not achieved. If the body temperature arises to 106 F, then it is known as hyperpyrexia. This condition is very dangerous and even can knock out the vital centers in the brain.
Types of fever
The fever is classified into three types, they were continuous, remittent and intermittent.
In continuous fever, the fluctuation of the body temperature within the day is less than 1.5 F. Example; typhoid fever. During the remittent fever, the fluctuation will be more than 1.5 F. Evening temperature is higher than morning. For example; pulmonary tuberculosis.
In intermittent fever, the fever will be only for a few hours during the day. Example; in septic conditions. If the fever occurs daily called Quotidian. If the fever occurs alternate days called Tertian. If after two days interval, then called Quartan.
The patient should consult the physician, when these types of fever exists.
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AMOEBIASIS
It is caused by potentially pathogenic strains of E. histolytica . It is closely related to poor sanitation and socioeconomic status than to climate.
Mode of transmission
- Intake of contaminated water or food
- By oral-rectum contact
- Vectors such as flies, cockroaches and rodents are also capable of carrying cysts and contaminating food and drink.
Prevention
Primarily - aimed to prevent contamination of water, food, vegetables and fruits with human feces.
Secondary - early diagnosis and treatment.
TYPHOID FEVER
It is the systemic infection mainly by S. typhi found only in man. It is clinically characterized by a typical continuous fever for 3 to 4 weeks. More cases are reported among males than females.
Source of infection
Primary source - feces and urine of a patient by carriers like insect, flies ,etc.,
Secondary source - contaminated water and food.
Mode of transmission
- Faecal-oral route
- Urine-oral route
Prevention
Control of reservoir - identification, isolation, treatment and disinfection.
Control of sanitation - protection and purification of drinking water supplies, improvement of basic sanitation and promotion of food hygiene.
Immunization - anti-typhoid vaccines such as monovalent anti-typhoid vaccine, Bivalent anti-typhoid vaccine and TAB vaccine.
ASCARIASIS
It is an infection of the intestinal tract caused by the Ascaris lumbricoides which lives in the lumen of the small intestine.
Clinical symptoms
- Nausea
- Abdominal pain
- Cough
Prevention
Primary prevention
Sanitary disposal of human excreta, provision of safe drinking water, food hygiene habits, health education of the community and personal hygiene.
Secondary prevention
Early diagnosis and effective treatment by appropriate drugs.
MALARIA
It is a disease caused by infection of certain species of infected female Anopheline mosquito such as Plasmodium vivax, P. falciparum, P. malariae and P. ovale.
Mode of transmission
Vector transmission - Malaria is transmitted by the bite of certain species of infected female Anopheline mosquito.
Direct transmission - by blood transfusion
Congenital transmission - infection of a newborn from an infected mother.
Clinical features
- Cold stage - lassitude, headache, nausea, chilly sensation, rigors etc.,
- Hot stage - Patient feels burning hot and casts off his clothes, skin is hot and dry to touch, intense headache, etc.,
- Sweating stage - fever comes down with profuse sweating.
Prevention/control
- Management of malaria patient in the community
- Active intervention to control or interruption of malaria transmission with community participation.
TUBERCULOSIS
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POLIOMYELITIS
It is an acute viral infection caused by the poliovirus which has three serotypes 1, 2 and 3. It is mainly an infection of the human alimentary tract but the virus may infect the central nervous system. The most vulnerable age is between 6 months and 3 years.
Mode of transmission
The virus is found in the faeces and oro-pharyngeal secretions of an infected person.
Clinical features
Non-paralytic polio
- Stiffness and pain in the neck and back
- The disease lasts 2 to 10 days
Paralytic polio
- The virus invades the CNS and causes varying degrees of paralysis. A history of fever at the time of onset of paralysis is suggestive of polio.
Prevention
- Immunization is the only effective means of preventing poliomyelitis.
- It is necessary to immunize all infants by 6 months of age to protect them against polio.
- Two types of vaccines are used throughout the world. They are
- Inactivated polio vaccine (IPV)
- Oral polio vaccine(OPV)
VIRAL HEPATITIS
It is the infection of the liver caused by HEPATITIS A, B, C, D, E and G.
HEPATITIS A
It is an acute infectious disease caused by Hepatitis A virus. Infection more frequent among children than adults.
Clinical features
Fever, chills, headache, fatigue, generalized weakness, anorexia, nausea, vomiting, dark urine and jaundice.
Mode of transmission
- Faecal-oral route - It is the major route of transmission.
- Parenteral route - This route rarely transmits it.
Prevention
- Hand washing before eating and after toilet
- Sanitary disposal of excreta which will prevent contamination of water, food and milk and purification of community water supplies by flocculation, filtration and chlorination.
- Several inactivated or live attenuated vaccines are available.
HEPATITIS B
It is an acute systemic infection with major pathology in the liver, caused by Hepatitis B virus. It attacks mainly the age group of 20-40 years.
Mode of transmission
- Parenteral route - It is essentially a blood-borne infection. Infected blood and blood products through transfusions, dialysis, contaminated syringes and needles, etc. transmit it.
- Perinatal transmission - Spread of infection from Hepatitis B virus carrier mothers to their babies.
- Transmission from child-to-child.
Prevention
- Hepatitis B vaccine
- Hepatitis B Immunoglobulin (HBIG)
- Passive-active immunization - It is the simultaneous administration of HBIG and Hepatitis B vaccine.
AIDS
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CONTROL OF COMMUNICABLE DISEASES
Isolate the infected patient
Disinfect all the articles used by the patient for instance his bedding, clothing, utensils, etc. and fumigation of the room after the patient recovers.
If a vaccine is available for that disease, all the contacts of the infected person should be immunized.
Be aware of all communicable diseases and make your life happy.
The disease which is capable of being directly or indirectly transmitted from man to man or from the environment (through air, dust, soil, water, food, etc.,) to man is known as communicable disease. Some communicable diseases are chicken pox, measles, rubella, influenza, diphtheria, whooping cough, meningococcal meningitis, Tuberculosis, poliomyelitis, viral hepatitis, malaria, rabies, AIDS, leprosy, etc. The causes, transmission, clinical features, control and the prevention of each communicable disease are given below;
CHICKEN POX (Varicella)
It is an acute highly infectious disease caused by Varicella Zoster Virus. It is also called Human (alpha) herpes virus 3. It is characterized by a vesicular rash which is associated with fever and malaise. The distribution of this disease is worldwide. This disease affects primarily children under 10 years of age. One attack will give durable immunity and second attacks are rare. Infection during Pregnancy presents a risk for the fetus and neonate. It is transmitted from person to person by droplet infection and most patients are infected by face to face contact. The portal of entry of the virus is the respiratory tract.
Clinical features
Pre-eruptive stage
- Onset is sudden with mild or moderate fever
- Pain in the back, shivering and malaise
- Lasts about 24 hours
Eruptive stage
- In children rash is often the first sign and it comes on the day the fever starts.
Control
No specific treatment for chicken pox is there. The control measures are notifications, isolation of patients for about 6 days after onset of rash and disinfections of articles soiled with nose and throat discharges.
Prevention
Varicella Zoster immunoglobulin (VZIG) given within 72 hours of exposure has been recommended for prevention.
MEASLES (Rubeola)
It is caused by an RNA paramyxovirus of the group Myxovirus. It is common among the age between 6 months and 3 years of age in developing countries where environmental conditions are generally poor. It tends to be very severe in malnourished child. It is characterized clinically by fever and cough followed by a typical rash.
Clinical features
Prodromal stage
It is characterized by fever, coryza with sneezing and nasal discharge, cough, redness of the eyes, lacrimation and often photophobia. There may be vomiting or diarrhoea.
Eruptive phase
It is characterized by a dusky-red, macular or maculo-papular rash which begins behind the ears and spreads rapidly in a few hours over the face and neck and extends down the body taking 2 to 3 days to progress to the lower extremities.
Post-measles stage
The child will have lost weight and will remain weak for a number of days.
Control
- Isolation for 7 days after onset of rash.
- Immunization of contacts within 2 days of exposure
- Prompt immunization at the beginning of an epidemic is essential to limit the spread.
Prevention
Measles Vaccination
It is prevented by active immunization. Only live attenuated vaccines are recommended for use because they are both safe and effective.
RUBELLA (German measles)
It is an acute childhood infection caused by a virus of the Togavirus family. It is usually mild (approximately 3 days) and accompanied by low-grade fever. Infection in early pregnancy may result in serious congenital defects, including the death of the foetus. It is worldwide in distribution. It attacks mainly in the age group of 3 to 10 years. One attack results in lifelong immunity.
Transmission
The virus is transmitted directly from person to person by droplets from the nose and throat.
Clinical features
Prodromal symptoms
- Sore throat and low-grade fever
Lymphadenopathy
- Enlargement of the post-auricular and posterior cervical lymph nodes
Rash
- Appears first on the face, usually within 24 hours of the onset of prodromal symptoms. It spreads rapidly to the trunk and extremities.
Complications
- In rare, arthralgia may occur in several joints in adults, especially in young women.
Prevention
Active immunization against rubella with live attenuated vaccines
MUMPS
It is caused by Myxovirus parotiditis. It attacks the age group 5-15 years and one attack induces lifelong immunity. It spreads mainly by droplet infection and direct contact with an infected person.
Clinical features
- Pain and swelling in either one or both the parotid glands.
- Earache on the affected side prior to the onset of swelling.
- Pain and stiffness on opening the mouth.
- Fever
- Headache
Prevention
Vaccination - a live attenuated vaccine is given.
Control
- The patient should be isolated till the clinical features subside.
- Disinfect the articles used by the patient.
- Contacts should be kept under surveillance.
INFLUENZA
It is an acute respiratory tract infection caused by a virus belongs to orthomyxoviridae family and there are three sub types: Type A, Type B & Type C. It spreads from person to person by droplet infection created by sneezing, coughing or talking. The route of entry of virus is the respiratory tract.
Clinical features
- Fever (last 1 to 5 days)
- Chills, aches, pains, coughing and generalized weakness.
Complication
Pneumonia to be suspected if fever persists beyond 4 or 5 days.
Prevention
- Good ventilation of public buildings
- Avoidance of crowded places during epidemics
- Encouraging sufferers to cover their faces with a handkerchief when coughing and sneezing and to stay at home at the first sign of the disease.
- The vaccine is not recommended to control spread in the general population.
- Vaccine recommended only in selected groups - for instance in industry to reduce absenteeism and in public servants to prevent disruption of critical public services.
ACUTE DIARRHOEAL DISEASES
Diarrhoea
- Passage of loose, liquid or watery stools for more than three times a day
- Diarrhoea lasting 3 weeks or more may be called chronic diarrhoea.
- Acute diarrhoeas usually lasts 3 to 7 days and it is caused by an acute infection of the bowel. The term gastroenteritis is used to describe acute diarrhoea.
- It is common in children between 6 months and 2 years.
- It is caused by Viruses - Rotavirus, Astroviruses, Adenoviruses, Calciviruses, etc., Bacteria - Campylobacter jejuni, Escherichia coli, Shigella, salmonella, etc.,
- The mode of transmission is through Faecal-oral route by water borne, food borne or direct transmission.
Prevention
The measures recommended by WHO are
Short term
- Appropriate clinical management - oral rehydration therapy
- Appropriate feeding
- Chemotherapy
Long term
- Improving maternal nutrition and child nutrition (promotion of breastfeeding, appropriate weaning practices, supplementary feeding).
Preventive strategies
- Proper sanitation, health education, immunization and fly control.
Beware of all communicable diseases and live a healthy life.
Flexibility is an important part of physical fitness, but it is often overlooked during workouts. It is achieved by stretching. Stress causes muscles to contract and tighten. Stretching helps muscles relax, relieving pain from muscular stress.
Benefits of flexibility
- Increases joint movement (mobility)
- Reduces the risk of low-back problems.
- Improves circulation, bringing nutrients to keep tissues healthy and transporting wastes out of the tissues.
- Improve posture and personal appearance.
- Improve coordination and balance, which helps maintain an independent and active lifestyle in the elderly.
- Helps reduce excess stress by lowering anxiety and boosting feelings of self-confidence.
Maintain your flexibility
- The adage "use it or lose it" applies especially to flexibility.
- Stretch all the major muscle groups in the body and do not stretch swollen joints.
- Stretch the muscle group slowly, until slight discomfort is felt and continue to breathe normally.
- Hold the stretch for at least 10 to 30 seconds and repeat the stretch four times.
- Stretch at least 2 to 3 days per week; every day is okay.
Points to consider
Warm muscles stretch more easily than cold muscles.
Injury can limit range of motion, but a good rehabilitation program can help regain all or part of a joint's flexibility.
As a person ages, flexibility declines due more to inactivity than to the aging process itself. Flexibility can be maintained by doing stretching activities regularly.
Diseases such as arthritis can make it uncomfortable or even painful to more joints. But they can improve their joint mobility through exercise.
You cannot determine flexibility with one test because the flexibility of one joint does not affect flexibility in other joints.
