Common Diseases In Humans

Historically, health was often linked to the balance of certain 'humors' (fluids) in the body, as suggested by early Greek and Indian medical systems. However, scientific discoveries like William Harvey's work on blood circulation and the use of tools like thermometers disproved these older theories.

Modern biology understands health as influenced by the complex interplay between the mind, nervous system, endocrine system, and immune system. A healthy mind can positively affect the immune system, which in turn maintains health.

Overall health is affected by three main factors:

1. Genetic disorders: Conditions inherited from parents or present from birth due to genetic defects.
2. Infections: Diseases caused by pathogens.
3. Life style: Factors like diet, water intake, exercise, rest, and personal habits.

Health is more than just the absence of disease or physical fitness; it's defined as a state of complete physical, mental, and social well-being.

Healthy individuals are more productive, contributing to economic prosperity. Health also leads to increased life expectancy and reduced rates of infant and maternal mortality.

Maintaining good health requires:

• Balanced diet.
• Personal hygiene.
• Regular exercise (including practices like Yoga).

Furthermore, for preventing diseases, it's essential to have awareness about common illnesses, get vaccinated against infectious diseases, practice proper waste disposal, control disease vectors (carriers), and maintain hygiene in food and water sources.

A disease occurs when the function of one or more organs or body systems is negatively affected, leading to specific signs and symptoms.

Diseases are broadly classified into:

• Infectious diseases: Easily transmitted from one person to another. These are common and can range in severity (e.g., common cold, typhoid) to fatal (e.g., AIDS).
• Non-infectious diseases: Not transmitted from person to person (e.g., cancer, diabetes). Cancer is a leading cause of death among non-infectious diseases.

Various organisms, including bacteria, viruses, fungi, protozoans, and helminths, can cause diseases in humans. These disease-causing agents are called pathogens. Most parasites are pathogens as they harm their host.

Pathogens enter the body through various routes, multiply, and disrupt normal bodily functions, causing damage. Pathogens adapted to living inside the host must be able to survive the host's defense mechanisms (e.g., surviving low pH in the stomach).

Examples of common infectious diseases and their pathogens:

• Typhoid: Caused by the bacterium Salmonella typhi. Transmitted through contaminated food and water. Symptoms include high fever, weakness, stomach pain, constipation, headache, loss of appetite. Severe cases can lead to intestinal perforation and death. Diagnosed by the Widal test.
• Pneumonia: Caused by bacteria like Streptococcus pneumoniae and Haemophilus influenzae, or certain viruses. Infects the alveoli of the lungs, filling them with fluid, causing breathing difficulty. Symptoms: fever, chills, cough, headache. Severe cases show bluish lips/fingernails. Spread by inhaling droplets/aerosols from infected persons or contact with contaminated objects. Other bacterial diseases include dysentery, plague, diphtheria.
• Common Cold: Caused by Rhino viruses. Infects the nose and respiratory passages, but not the lungs. Symptoms: nasal congestion/discharge, sore throat, cough, headache, fatigue (usually 3-7 days). Highly infectious, spread via droplets from coughs/sneezes or contaminated objects.
• Malaria: Caused by the protozoan Plasmodium (various species like P. vivax, P. malariae, P. falciparum). P. falciparum causes malignant malaria, which can be fatal.
  • Life cycle of Plasmodium requires two hosts: human and female Anopheles mosquito (the vector).
  • Sporozoites (infectious form) enter humans via mosquito bite. They multiply in liver cells, then attack RBCs.
  • Rupture of RBCs releases a toxic substance, haemozoin, causing chills and recurring high fever every 3-4 days.
  • Mosquitoes get infected by biting infected humans, taking up the parasites, which develop into sporozoites in their salivary glands, ready to infect another human.
• Amoebiasis (Amoebic dysentery): Caused by the protozoan parasite Entamoeba histolytica, found in the large intestine. Symptoms: constipation, abdominal pain, cramps, stools with mucus and blood clots. Houseflies are mechanical carriers. Spread by drinking water/food contaminated with fecal matter from infected persons.
• Ascariasis: Caused by the helminth Ascaris (roundworm), an intestinal parasite. Symptoms: internal bleeding, muscular pain, fever, anemia, intestinal blockage. Spread by ingesting eggs from contaminated soil, water, vegetables, or fruits.
• Elephantiasis (Filariasis): Caused by the helminth Wuchereria (filarial worm, e.g., W. bancrofti), living in lymphatic vessels for years. Causes chronic inflammation, typically in lower limbs and genital organs, leading to gross deformities. Transmitted by female mosquito bites.
• Ringworms: Caused by fungi of genera like Microsporum, Trichophyton, Epidermophyton. Symptoms: dry, scaly lesions on skin, nails, scalp, accompanied by intense itching. Fungi thrive in warm, moist areas (skin folds). Spread by contaminated soil, towels, clothes, combs of infected individuals.

Prevention and control of infectious diseases involve:

• Personal hygiene: Keeping body clean, consuming clean food and water.
• Public hygiene: Proper waste/excreta disposal, disinfection of water sources, hygiene in public catering. These are crucial for water-borne and food-borne diseases (typhoid, amoebiasis, ascariasis).
• Avoiding close contact with infected persons or their belongings for air-borne diseases (pneumonia, common cold).
• Controlling/eliminating insect vectors and their breeding places for vector-borne diseases (malaria, filariasis, dengue, chikungunya): avoid water stagnation, clean coolers, use mosquito nets, introduce larvivorous fish (Gambusia), spray insecticides, use wire mesh on doors/windows.

Advances in biology have led to effective strategies against infectious diseases:

• Vaccines and immunisation: Led to the eradication of smallpox and significant control of polio, diphtheria, pneumonia, tetanus. Biotechnology is enabling safer and newer vaccines.
• Antibiotics and drugs: Effective treatment of many infectious diseases.

Immunity

The body's ability to defend itself against disease-causing organisms is called immunity, conferred by the immune system. Exposure to infectious agents is frequent, but disease only occurs sometimes due to this defense system.

Immunity is broadly classified into two types:

1. Innate immunity: Non-specific defense present from birth.
2. Acquired immunity: Pathogen-specific defense developed during a lifetime.

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Innate Immunity

This is a non-specific type of defense mechanism present at the time of birth. It provides various barriers to prevent the entry of foreign agents into the body. Innate immunity includes four types of barriers:

1. Physical barriers: Skin is the primary physical barrier. Mucus coating the lining of respiratory, gastrointestinal, and urogenital tracts traps microbes.
2. Physiological barriers: Acid in the stomach, saliva in the mouth, and tears in the eyes create conditions that inhibit microbial growth.
3. Cellular barriers: Certain white blood cells (leukocytes) like Polymorphonuclear leukocytes (PMNL-neutrophils), monocytes, Natural Killer (NK) cells (a type of lymphocyte) in the blood, and macrophages in tissues can engulf and destroy microbes through phagocytosis.
4. Cytokine barriers: Virus-infected cells secrete proteins called interferons. Interferons protect neighboring non-infected cells from further viral infection by making them resistant.

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Acquired Immunity

This type of immunity is pathogen-specific and is characterised by memory. It develops after encountering a pathogen or its components.

• Primary response: The first time the body encounters a pathogen, it produces a response of low intensity.
• Secondary response (Anamnestic response): Subsequent encounters with the same pathogen elicit a much stronger and more rapid response. This intensified response is due to the immune system 'remembering' the initial exposure.

Primary and secondary immune responses are mediated by two types of lymphocytes: B-lymphocytes (B cells) and T-lymphocytes (T cells).

• B-lymphocytes: Produce proteins called antibodies in the blood to fight pathogens. This is the basis of humoral immune response (antibody-mediated immunity).
• T-lymphocytes: Do not secrete antibodies themselves but help B cells produce them. They also directly kill infected cells and mediate cell-mediated immune response (CMI).

Antibody structure: Each antibody molecule is composed of four peptide chains: two identical small light (L) chains and two identical longer heavy (H) chains. An antibody is represented as $\textsf{H}_2\textsf{L}_2$. There are different types of antibodies (isotypes) in the body, such as IgA, IgM, IgE, IgG.

Cell-mediated immunity (CMI), mediated by T-lymphocytes, is responsible for differentiating 'self' from 'non-self'. This is crucial in organ transplantation. Grafts from unrelated individuals are often rejected because the recipient's CMI recognises the graft as foreign. Therefore, tissue matching and blood group matching are essential before transplantation, and patients require immunosuppressant drugs lifelong to prevent graft rejection.

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Active And Passive Immunity

• Active immunity: Developed when a host is exposed to antigens (from pathogens or vaccines) and produces its own antibodies in response. This immunity is slow to develop but long-lasting and involves memory. It occurs during natural infection or deliberate immunisation (vaccination).
• Passive immunity: Developed when pre-formed antibodies are directly given to the host to protect against foreign agents. This provides immediate protection but does not involve memory and is usually short-lived.
  • Examples: Antibodies (IgA) received by an infant from mother's colostrum (first milk). Antibodies (IgG) transferred from mother to fetus across the placenta during pregnancy. Injections of antitoxins or antivenom contain pre-formed antibodies for quick response against toxins or venoms.

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Vaccination And Immunisation

The principle behind vaccination and immunisation is the memory property of the immune system. A vaccine is a preparation containing antigenic proteins of a pathogen, or weakened/inactivated pathogens.

When a vaccine is introduced into the body:

• The body's immune system recognises the antigens and produces antibodies against them.
• The vaccine also generates memory B and T cells specific to that pathogen.

Upon subsequent exposure to the actual pathogen, the memory cells quickly recognise it and mount a rapid, massive secondary immune response, producing large amounts of antibodies that neutralise the pathogen, thus preventing the disease (immunity).

For immediate protection against severe infections (like tetanus) or toxins (like snake venom), pre-formed antibodies (antitoxin, antivenom) are directly injected. This is called passive immunisation.

Recombinant DNA technology allows mass production of safe and effective vaccines, such as the hepatitis B vaccine produced from yeast.

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Allergies

An allergy is an exaggerated or hypersensitive response of the immune system to certain environmental antigens called allergens. The antibodies produced during allergic reactions are primarily of the IgE type.

Common allergens include pollen, dust mites, animal dander, certain foods, and drugs. Symptoms of allergic reactions often involve the respiratory tract and skin: sneezing, watery eyes, runny nose, difficulty breathing, skin rashes.

Allergic symptoms are caused by the release of chemicals like histamine and serotonin from mast cells in response to allergen exposure.

Allergy diagnosis involves exposing the patient to small doses of potential allergens to identify the specific allergen causing the reaction. Treatment typically involves drugs like antihistamines, adrenaline, and steroids, which reduce symptoms.

Modern lifestyle may contribute to increased allergies and asthma, possibly due to reduced exposure to microbes and allergens early in life ("hygiene hypothesis"), leading to a less developed immune tolerance.

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Auto Immunity

Higher vertebrates have evolved the ability to distinguish between 'self' cells/molecules and 'non-self' (foreign) entities. Sometimes, this recognition system malfunctions.

Auto-immune disease occurs when the immune system mistakenly attacks the body's own cells or tissues. The reasons for this are not fully understood but may involve genetic factors and environmental triggers.

This auto-attack causes damage to the body. Rheumatoid arthritis is a common example of an auto-immune disease.

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Immune System In The Body

The human immune system is a complex network comprising lymphoid organs, tissues, cells, and soluble molecules (like antibodies). Its key features are its ability to recognise foreign antigens, respond to them, and retain memory of past encounters.

The immune system is involved in defense against pathogens, allergic reactions, auto-immune diseases, and graft rejection in transplants.

Lymphoid Organs: These are sites where lymphocytes (key immune cells) originate, mature, and proliferate.

• Primary Lymphoid Organs: Where immature lymphocytes differentiate into antigen-sensitive cells.
  • Bone Marrow: Main lymphoid organ; all blood cells, including lymphocytes, are produced here. B lymphocytes mature in the bone marrow.
  • Thymus: A lobed organ near the heart, large at birth but shrinks with age. Provides the microenvironment for T lymphocytes to mature.
• Secondary Lymphoid Organs: Where lymphocytes encounter antigens and proliferate to become effector cells.
  • Spleen: Large, bean-shaped organ filtering blood, trapping blood-borne microbes, and storing erythrocytes. Contains lymphocytes and phagocytes.
  • Lymph Nodes: Small solid structures along the lymphatic system. Trap microbes and antigens from lymph and tissue fluid, activating lymphocytes and initiating immune responses.
  • Other secondary lymphoid tissues include tonsils, Peyer's patches (in the small intestine), and appendix.

Mucosa-Associated Lymphoid Tissue (MALT): Lymphoid tissue located within the lining of major tracts (respiratory, digestive, urogenital). It constitutes about $50\%$ of the lymphoid tissue in the human body.

Aids

AIDS stands for Acquired Immuno Deficiency Syndrome. It is a condition characterised by a deficiency of the immune system, acquired during a person's lifetime (not congenital). 'Syndrome' refers to a group of symptoms.

AIDS was first reported in 1981 and has become a global pandemic, causing millions of deaths.

AIDS is caused by the Human Immunodeficiency Virus (HIV). HIV is a type of retrovirus, meaning its genetic material is RNA, and it uses the enzyme reverse transcriptase to convert its RNA genome into DNA after entering a host cell.

Transmission of HIV infection primarily occurs through:

1. Sexual contact with an infected person (vaginal, anal, or oral sex).
2. Transfusion of contaminated blood or blood products.
3. Sharing infected needles, especially among intravenous drug users.
4. From an infected mother to her child during pregnancy (across the placenta), childbirth, or breastfeeding.

Individuals at high risk include those with multiple sexual partners, intravenous drug users, people requiring frequent blood transfusions, and children born to HIV-infected mothers. HIV is transmitted through body fluids (blood, semen, vaginal fluids, breast milk) and not through casual contact like touching or sharing utensils.

There is a variable time lag (from months to many years, typically 5-10) between HIV infection and the appearance of AIDS symptoms.

Mechanism of HIV infection and progression to AIDS:

• After entering the body, HIV initially infects macrophages. Inside macrophages, the viral RNA genome is transcribed into viral DNA by reverse transcriptase. This viral DNA integrates into the host cell's DNA.
• Infected macrophages act as an 'HIV factory', continuously producing new virus particles.
• HIV also infects helper T-lymphocytes ($\textsf{T}_{\textsf{H}}$ cells), replicating and producing new viruses that are released into the blood.
• These progeny viruses then infect other $\textsf{T}_{\textsf{H}}$ cells, leading to a progressive decline in the number of $\textsf{T}_{\textsf{H}}$ cells in the infected person's body.
• $\textsf{T}_{\textsf{H}}$ cells are crucial regulators of the immune response (both humoral and CMI). Their depletion severely weakens the immune system.
• As the number of $\textsf{T}_{\textsf{H}}$ cells decreases, the person becomes immuno-deficient. Symptoms like fever, diarrhoea, and weight loss appear.
• The weakened immune system makes the person susceptible to various opportunistic infections and certain cancers that a healthy person could easily fight off (e.g., infections by Mycobacterium, viruses, fungi, parasites like Toxoplasma). AIDS is characterised by the onset of these opportunistic infections.

Diagnosis of AIDS is commonly done using the ELISA (Enzyme-Linked Immunosorbent Assay) test. Confirmation tests like Western Blot are also used.

Treatment with anti-retroviral drugs can help manage HIV infection and prolong the patient's life by suppressing viral replication, but it does not cure AIDS, which is ultimately fatal.

Prevention of AIDS: Since there is no cure, prevention is crucial. Education and awareness programs by organisations like NACO (National AIDS Control Organisation in India) and WHO are essential. Preventive measures include:

• Promoting safe sexual practices (e.g., using condoms).
• Avoiding sharing needles and syringes, especially among drug users.
• Ensuring blood safety by screening blood donations for HIV.
• Providing disposable needles and syringes in healthcare settings.
• Preventing transmission from mother to child (e.g., through antiretroviral treatment during pregnancy).
• Controlling drug abuse.
• Regular check-ups for HIV in susceptible populations.

There is a need for social support and understanding for people living with HIV/AIDS, rather than isolation and stigma, to help prevent further spread and ensure their well-being. Tackling AIDS requires collective efforts from society and the medical community.

Cancer

Cancer is a major non-infectious disease and a leading cause of death globally. It is characterised by uncontrolled and unregulated cell growth and division.

Normally, cell growth and differentiation are tightly controlled. Cancer cells lose this regulatory control. Normal cells exhibit contact inhibition, where contact with neighboring cells inhibits their further growth. Cancer cells lose this property and continue to divide, forming masses called tumors.

Tumors are of two types:

• Benign tumors: Generally remain confined to their original location and do not spread to other parts of the body. They usually cause less damage but can be problematic if they grow large or press on vital organs.
• Malignant tumors: Masses of rapidly proliferating cells called neoplastic or tumor cells. These cells grow aggressively, invading and damaging surrounding normal tissues. They compete with normal cells for vital nutrients, starving them. The most dangerous property of malignant tumors is metastasis: cells sloughed from the primary tumor can travel through blood or lymph to distant sites in the body and form new tumors there.

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Causes Of Cancer

The transformation of normal cells into cancerous cells can be induced by various agents called carcinogens. Carcinogens can be:

• Physical agents: Ionising radiations (X-rays, gamma rays) and non-ionising radiations (UV rays) cause DNA damage that can lead to cancerous transformation.
• Chemical agents: Certain chemicals present in substances like tobacco smoke (a major cause of lung cancer) can act as carcinogens.
• Biological agents: Certain viruses, called oncogenic viruses, contain genes known as viral oncogenes that can induce cancer. Also, normal cells contain genes called cellular oncogenes (c-onc) or proto-oncogenes. These genes are normally involved in cell growth and division, but if activated under certain conditions, they can be transformed into oncogenes and lead to cancer.

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Cancer Detection And Diagnosis

Early detection is critical for successful cancer treatment. Methods for cancer detection and diagnosis include:

• Biopsy and Histopathological studies: A piece of suspected tissue is surgically removed (biopsy), cut into thin sections, stained, and examined under a microscope by a pathologist to identify abnormal (cancerous) cells.
• Blood and Bone Marrow tests: Used for specific cancers like leukemias (blood cancers) to detect increased numbers of specific cell types.
• Imaging techniques:
  • Radiography (X-rays): Useful for detecting cancers in some internal organs.
  • CT (Computed Tomography): Uses X-rays and computers to create detailed cross-sectional or 3D images of internal structures.
  • MRI (Magnetic Resonance Imaging): Uses strong magnetic fields and non-ionising radiation to produce detailed images of tissues, often superior for detecting soft tissue cancers and identifying pathological changes.
• Antibodies against cancer-specific antigens: Used to detect certain types of cancers that express unique surface proteins.
• Molecular Biology techniques: Can identify genetic mutations or specific genes (like proto-oncogenes) that predispose an individual to certain types of cancer. This can help in risk assessment and preventive measures (e.g., advising individuals with genetic susceptibility to lung cancer to avoid smoking).

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Treatment Of Cancer

Common approaches for treating cancer include:

• Surgery: Surgical removal of the tumor mass. Effective for solid tumors that have not metastasised.
• Radiation Therapy (Radiotherapy): Tumor cells are selectively irradiated with lethal doses of radiation, while taking care to protect surrounding normal tissues.
• Chemotherapy: Using specific chemical drugs (chemotherapeutic agents) to kill rapidly dividing cancer cells. Different drugs are used for different types of cancer. Chemotherapy often has side effects like hair loss, anemia, nausea, etc., due to its impact on other rapidly dividing cells in the body.
• Immunotherapy: Cancer cells can sometimes evade detection and destruction by the immune system. Immunotherapy involves administering substances called biological response modifiers (e.g., alpha-interferon) that activate the patient's immune system to help destroy the tumor cells.

Most cancers are treated with a combination of these approaches (e.g., surgery followed by chemotherapy or radiotherapy).

Drugs And Alcohol Abuse

The abuse of drugs and alcohol, particularly among youth, is a growing public health concern with numerous harmful effects. Education and guidance are crucial for prevention.

Commonly abused drugs include opioids, cannabinoids, and coca alkaloids. Many are derived from flowering plants or fungi.

• Opioids: Bind to specific opioid receptors in the central nervous system (CNS) and gastrointestinal tract. Examples:
  • Heroin (smack): Chemically diacetylmorphine, derived from the latex of the poppy plant (Papaver somniferum). A depressant, slowing body functions. Often taken by snorting or injection.
  • Morphine is an effective painkiller and sedative, used medically, but also subject to abuse.
• Cannabinoids: Interact with cannabinoid receptors, mainly in the brain. Natural cannabinoids are obtained from the inflorescences of the plant Cannabis sativa.
  • Used to produce marijuana, hashish, charas, and ganja.
  • Generally inhaled or orally ingested. Known to affect the cardiovascular system.
  • Some sportspersons abuse cannabinoids for perceived performance enhancement.
• Coca alkaloids (Cocaine): Obtained from the coca plant (Erythroxylum coca), native to South America.
  • Interferes with the transport of the neurotransmitter dopamine.
  • Commonly called coke or crack, usually snorted.
  • Potent stimulant of the CNS, causing euphoria and increased energy. Excessive doses can cause hallucinations.

Other plants like Atropa belladona and Datura (which has characteristic trumpet-shaped flowers) have hallucinogenic properties and are sometimes abused.

Drugs like barbiturates, amphetamines, and benzodiazepines, prescribed for conditions like depression and insomnia, are also frequently abused.

Drug abuse is defined as taking drugs for purposes other than medicinal use, or in amounts/frequency that impair physical, physiological, or psychological functions.

Tobacco (smoked, chewed, or used as snuff) contains nicotine, an alkaloid. Nicotine stimulates the adrenal gland to release adrenaline and nor-adrenaline, increasing blood pressure and heart rate.

Smoking is linked to increased risk of lung cancer, urinary bladder and throat cancer, bronchitis, emphysema, coronary heart disease, gastric ulcers, etc. Tobacco chewing increases the risk of oral cavity cancer. Smoking reduces the oxygen-carrying capacity of blood by increasing carbon monoxide levels.

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Adolescence And Drug/Alcohol Abuse

Adolescence (roughly 12-18 years) is a critical period of physical, mental, and psychological development, bridging childhood and adulthood. It is a vulnerable phase for initiating drug and alcohol use.

Factors that motivate young people towards substance abuse include:

• Curiosity, need for adventure, and experimentation: Natural tendencies in adolescence.
• Perceived benefits: Belief that drugs/alcohol help escape problems or provide temporary euphoria.
• Stress: Pressure to perform well academically or in competitive environments.
• Societal influence: Perception promoted by media and peers that substance use is 'cool' or modern.
• Unstable family structures or lack of support.
• Peer pressure: Influence from friends or peers to try substances.

Initial use might stem from curiosity, but it can quickly lead to addiction.

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Addiction And Dependence

Addiction is a psychological attachment to the rewarding effects of drugs or alcohol (like euphoria). This psychological craving drives repeated use, even when it becomes self-destructive and harmful.

Repeated use increases the tolerance of body receptors, requiring higher doses for the same effect, leading to increased intake and addiction. Even a single use can be a gateway to addiction for some individuals.

Addiction can trap users in a vicious cycle. Without support, they become dependent on the substance.

Dependence is a physical need for the substance. Abrupt discontinuation leads to unpleasant withdrawal symptoms (anxiety, shakiness, nausea, sweating). Withdrawal can be severe and life-threatening, requiring medical intervention.

Dependence can cause individuals to disregard social norms and resort to illegal activities to obtain money for the substance, leading to significant social adjustment problems.

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Effects Of Drug/Alcohol Abuse

Immediate adverse effects include reckless behavior, vandalism, and violence. High doses can cause coma or death from respiratory failure, heart failure, or cerebral hemorrhage. Combining different substances or taking them with alcohol significantly increases the risk of overdose and death.

Warning signs in youth include declining academic performance, absenteeism, neglect of personal hygiene, social withdrawal, fatigue, aggressive behavior, deteriorating relationships, loss of interest in hobbies, changes in sleep/eating, and weight fluctuations.

Long-term consequences:

• Financial and emotional distress for the individual's family and friends.
• Increased risk of contracting serious infections like AIDS and Hepatitis B, especially among intravenous drug users who share needles. These infections are often chronic and fatal, transmitted through blood or sexual contact.
• Chronic use damages the nervous system and liver (cirrhosis).
• Substance abuse during pregnancy can severely affect the fetus.
• Misuse by sportspersons (narcotic analgesics, anabolic steroids, diuretics, hormones) to enhance performance has severe side effects, including masculinization/feminization, aggressiveness, mood swings, health risks to organs, and in adolescents, stunted growth.

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Prevention And Control

Prevention is key, especially among adolescents who are most vulnerable to starting substance abuse. Identifying risk factors and taking early measures is important. Parents and teachers have crucial roles.

Preventive measures:

• Avoid undue peer pressure: Encourage children's individuality and avoid pushing them beyond their limits.
• Education and counselling: Teach coping skills for stress, disappointments, and failures. Encourage healthy pursuits like sports, reading, music, and yoga.
• Seeking help from parents and peers: Encourage open communication with trusted adults or friends to discuss problems, anxiety, and guilt, and get appropriate guidance.
• Looking for danger signs: Parents and teachers should be aware of the warning signs of substance abuse and intervene early. Friends should also alert adults if they suspect a peer is using drugs/alcohol.
• Seeking professional and medical help: Utilise the services of qualified psychologists, psychiatrists, and de-addiction/rehabilitation centers for individuals struggling with abuse. With professional support, willpower, and effort, recovery is possible.

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