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• Noncommunicable Diseases


  Also known as chronic diseases, are not passed from person to person. They are of long duration and generally have slow progression
• Chronic conditions


  • Do not result from an (acute) infectious process
  • Are "not communicable"
  • Cause premature morbidity, dysfunction, and reduced quality of life
  • Usually develop and progress over long periods
  • Often initially insidious
  • Once manifested there is usually a protracted period of impaired health
• Noncommunicable Disease (NCD) Characteristics


  • Complex etiology (causes)
  • Multiple risk factors
  • Long latency period
  • Non-contagious origin (non-communicable)
  • Prolonged course of illness
  • Functional impairment or disability
  • Incurability
  • Insidious onset
• Noncommunicable Diseases Risk Factors


  • Any aspect of personal behavior or lifestyle
  • An environmental exposure
  • A hereditary characteristic
• Modifiable Risk Factors (prioritized by WHO)

  • Physical inactivity
  • Tobacco use
  • Alcohol use
  • Unhealthy diets
• Non-Modifiable Risk Factors


  • Age
  • Gender
  • Race
  • Family history (genetics)
• Types of Noncommunicable Diseases


  • Chronic mental illness
  • Injuries, which have an acute onset, but may be followed by prolonged convalescence and impaired function
  • Cardiovascular disease (Coronary heart disease, Stroke)
  • Cancer
  • Chronic lung disease
  • Diabetes
  • Chronic neurologic disorders (Alzheimer's, Dementias)
  • Arthritis/Musculoskeletal diseases
• Cardiovascular Diseases


  Diseases of the heart, vascular diseases of the brain and diseases of blood vessels
• Cardiovascular Diseases are responsible for over 17.3 million deaths per year and are the leading causes of death in the world
• Benign Tumors


  • Do not penetrate (invade) adjacent tissue borders, nor do they spread (metastasize) to distant sites
  • Remain localized overgrowths in the area in which they arise
  • Are more differentiated than malignant tumors, that is, they closely resemble their tissue of origin
• Malignant Tumors


  Are capable of invasion (spread of the neoplasms into adjacent structures) and metastasis (implantation of the neoplasms into non-contiguous sites)
• Chronic Obstructive Pulmonary Disease (COPD)


  A life-threatening lung disease that interferes with normal breathing
• Almost 90% of COPD deaths occur in low- and middle-income countries
• Primary cause of COPD

  Tobacco smoke (through tobacco use or second-hand smoke)
• COPD is not curable, but treatment can slow the progress of the disease
• Total deaths from COPD are projected to increase by more than 30% in the next 10 years without interventions to cut risks, particularly exposure to tobacco smoke
• COPD


  • Characterized by persistent respiratory symptoms and airflow limitation that is not fully reversible
  • Requires the presence of chronic airflow obstruction, determined by spirometry
  • Persistent reduction in forced expiratory flow rates is the most typical finding
  • Increases in the residual volume and the residual volume/total lung capacity ratio, non-uniform distribution of ventilation, and ventilation-perfusion mismatching
• COPD Risk Factors


  • Cigarette smoking (packs/year is the most highly significant predictor)
  • Respiratory infections (important causes of COPD exacerbation)
  • Occupational exposures (coal mining, gold mining, and cotton textile dust)
  • Ambient air pollution (prolonged exposure to smoke produced by biomass combustion)
• COPD Clinical Presentation


  • The three most common symptoms are cough, sputum production, and exertional dyspnea
  • Development of airflow obstruction is a gradual process, many patients date the onset of their disease to an acute illness or exacerbation
  • Development of exertional dyspnea (increased effort to breathe, heaviness, air hunger, or gasping, can be insidious)
  • As COPD advances, the principal feature is worsening dyspnea on exertion
• COPD Physical Examination


  • In patients with more severe disease, the physical examination of the lungs is notable for a prolonged expiratory phase and may include expiratory wheezing
  • Patients with severe airflow obstruction may also exhibit use of accessory muscles of respiration, sitting in the characteristic "tripod" position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles
  • Patients may develop cyanosis, visible in the lips and nail beds
• Diseases Caused by Tobacco Use

  • Coronary heart disease
  • Atherosclerotic peripheral vascular disease
  • Cerebrovascular disease
  • Cancers of the lung, larynx, mouth, esophagus, bladder, pancreas, kidney, and cervix
  • Chronic
• COPD


  • Gradual development of airflow obstruction
  • Many patients date onset to acute illness or exacerbation
  • Principal feature is worsening dyspnea on exertion
• Exertional dyspnea

  Increased effort to breathe, heaviness, air hunger, or gasping
• In patients with more severe disease, the physical examination of the lungs is notable for a prolonged expiratory phase and may include expiratory wheezing
• Patients with severe airflow obstruction may also exhibit use of accessory muscles of respiration, sitting in the characteristic "tripod" position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles
• Patients may develop cyanosis, visible in the lips and nail beds
• Diseases caused by tobacco use

  • Coronary heart disease
  • Atherosclerotic peripheral vascular disease
  • Cerebrovascular disease
  • Cancers of the lung, larynx, mouth, esophagus, bladder, pancreas, kidney, and cervix
  • Chronic obstructive pulmonary disease
  • Intrauterine growth retardation, premature rupture of membranes
  • Low-birth weight babies, perinatal mortality
  • Cataract, macular degeneration
  • Peptic ulcer disease
  • Possibly liver, stomach, and colorectal cancers and acute myelocytic leukemia
• Involuntary smoking (environmental tobacco smoke) is a cause of lung cancer and coronary heart disease in nonsmokers, and respiratory infections and symptoms in the children of parents who smoke
• Diseases caused by smokeless tobacco

  • Oral Cancer
  • Oral leukoplakia
  • Dental caries (possibly)
• Diabetes

  More than 346 million people worldwide have diabetes, there is an emerging global epidemic of diabetes that can be traced back to rapid increases in overweight, obesity and physical inactivity
• Diabetes is predicted to become the seventh leading cause of death in the world by the year 2030, total deaths from diabetes are projected to rise by more than 50% in the next 10 years
• Diabetes

  • Cardiovascular disease is responsible for between 50% and 80% of deaths in people with diabetes
  • Diabetes has become one of the major causes of premature illness and death in most countries, mainly through the increased risk of cardiovascular disease (CVD)
  • Diabetes is a leading cause of blindness, amputation and kidney failure
  • Lack of awareness about diabetes, combined with insufficient access to health services and essential medicines, can lead to complications such as blindness, amputation and kidney failure
• Type 1 Diabetes Mellitus

  Due to autoimmune B-cell destruction, usually leading to absolute insulin deficiency, characterized by a lack of insulin production
• Type 1 diabetes is much more common than type 1 diabetes, accounts for around 90% of all diabetes worldwide
• Type 2 Diabetes Mellitus

  Due to progressive loss of B-cell insulin secretion, frequently on the background of insulin resistance, results from the body's ineffective use of insulin
• Type 2 diabetes can be prevented - 30 minutes of moderate-intensity physical activity on most days and a healthy diet can drastically reduce the risk of developing type 2 diabetes
• Diabetes diagnosis

  • Plasma glucose 126 mg/dL (7.0 mmol/L) after an overnight fast
  • Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during a 75-gram Oral Glucose Tolerance Test
  • Random plasma glucose > 200 mg/dl (11.1 mmol/l) in a patient with classic symptoms of hyperglycemia (weight loss, polyuria, polyphagia, polydipsia) or with signs and symptoms of hyperglycemic crisis
• Gestational Diabetes

  Characterized by hyperglycemia, or raised blood sugar, which has first appeared or been recognized during pregnancy