Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 51 Causes Depression is associated with different causes. These causes are related to physical, mental, personal and family issues and happenings. These can be seen alone or in combination. Brain disorder Change in hormone Unexpected events in life Tragic moments in life Continuous stress and grief in daily life Substance abuse such as alcohol, tobacco, etc. Signs and Symptoms Fatigue and headache Change in appetite Sadness or hopelessness Feeling of worthlessness and negative thought Recall of past failures or self-blame Trouble in concentration and remembering Lack of energy Feeling alone Loss of interest, pleasure in friends, family and favorite activities Trouble sleeping or sleeping too much High blood pressure, fear, restless, nervousness and panic If these signs and symptoms persist for long time in a person, this may lead him / her into depression. Prevention and Control Be happy. Manage the stress and tension. Control negative feelings and thoughts. Build up confidence level and hope. A motivation for good mental health
52 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Accept everything commonly. Practice Yog and meditation regularly. Involve in games and sports. Involve in creative and funny activities. Share the problems with trusted person. Maintain regular exercise and physical training. Receive counseling service from the experts if you have symptoms of depression. Please, observe the adjoining image of a person and imagine his problem. What is your conclusion? Mention as your answer. You can also advise him to treat his problem. ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 1.1 4.4. Anxiety and Management Anxiety (Nepali Translation: lrGtf) is a feeling of unease, such as worry or fear, which can be normal, mild or severe. It includes nervousness, restlessness or being tense, feelings of danger, panic or fear and sometimes strong. In other word, it is a feeling of fear and uneasiness about what is to come. Everyone has feelings of anxiety at some point in their life. For example, you may feel worried and anxious about sitting an exam, or having job interview or a medical test. Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear or terror about everyday situations. Causes Traumatic events Inherited traits Frequent or Repeated grief
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 53 A sufferer of Conversion Disorder Signs and Symptoms Common anxiety signs and symptoms include: Feeling nervous, restless or tense Having a sense of future danger, panic or trouble Faster heart beat Breathing rapidly Sweating Trembling Feeling weak or tired Trouble concentrating Having trouble sleeping Experiencing gastrointestinal problems Having difficulty in controlling worry Prevention and Control Be happy. Manage the stress and tension. Build up strong confidence level. Accept everything commonly. Regular Yog and meditation. Participate in games and sports. Involve in funny activities. Share the problems with trusted person. Maintain regular exercise and physical training. Counseling service, love and affection. 4.5. Conversion Disorder Conversion disorder is a mental condition in which a person has blindness, paralysis, numbness or other nervous system (neurological) symptoms. It was formerly known as hysteria. The disorder can be observed in both sexes, male and
54 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) female of different age groups. The social norms, values, ethics, restrictions, organizational (school, college, etc.) rules and regulations may create and enhance the disorder. Causes for Conversion Disorder Fear Trauma Repressed emotional conflict Living with high stress Forceful activities Financial misery Sexual and domestic violence Symptoms of Conversion Disorder The symptoms of the disorder are similar to that of neurological disorder such as epilepsy, stroke, sclerosis, etc. Loss of physical functions and balance Physical weakness Paralysis of a limb / entire body Hearing /vision impairment Loss / disturbance of sensation Loss /impairment of speech Respiratory infirmity Choking sensation Headache and dizziness Tremor of the body and bodily parts Prevention and Control The counseling (psychopathic counseling) service and psychiatric treatment should be given to the patient. Key Points Health is defined as a stage of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Individual Counseling
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 55 Mental health is a capacity of an invidual to form harmonious relations and behaviours with others. Mental health is essential to live harmoniously with family, friends and society. The sound development of mental health assures good health, behaviors, relationship and long life. Poor mental health is termed as mental illness or disorder. Stress is a crucial factor for the worst mental health and emotional impairment of an individual. We must have stress free environment in personal / family life and must be hopeful. We must have the ability to handle our emotions. Conversion disorder is a mental condition in which a person has blindness, paralysis or other nervous system symptoms that cannot be explained by medical evaluation. Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated or disinterested. Anxiety is a feeling of fear or uneasiness about what is to come. Depression and anxiety both can decrease a person’s ability to function at working places and at home. A. State true or false against the following statements. 1. Poor mental health indicates mental illness or disorder. 2. Emotional trauma causes conversion disorder. 3. Body language and kidding nature matters in the personal relationship. 4. It is difficult to diagnose conversion disorder in youngsters. 5. Depression and anxiety both are curable mental disorders. B. Give short answers to the following questions. 1. What is health? Define. 2. Write the definition of mental health. 3. Why must stressful life be managed? Give a reason. 4. State the definition of depression. 5. Mention any four examples of negative emotions. 6. What is mental health promotion? Define.
56 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 7. Write the importance of positive thinking regarding mental health and its promotion. 8. What is the role of open discussion for the promotion of mental health? 9. What are the possible impacts of stress in our life? 10. Clarify the meaning of conversion disorder. 11. What is anxiety? Write its definition. 12. Suggest the preventive method for the conversion disorder. 13. Why do people not talk on depression and anxiety openly in the family and community although they are having such problems? Give reasons. C. Write long answers to the following questions. 1. State the ways of stress management. 2. Enlist the causes of conversion disorder. 3. What are the symptoms of conversion disorder? Write. 4. “We cannot live happily in stressful condition.” Justify this statement. 5. Mention five symptoms of depression. 6. What are the symptoms of anxiety? Write any five. 7. Discuss on the causes of depression and anxiety. 8. Illustrate any five appropriate methods for the prevention of depression. 9. Point out any five measures to prevent and control anxiety in family as well as community. 10. What are the ways for the promotion of mental health? State and explain any two. Practical Work (a) Split your class into different groups and make a discussion on mental health and mental illness. Please, draft the important points and display them in the classroom. (b) Watch a documentary film “I had a black dog”, a presentation of World Health Organization (WHO), in the class or AV room of your school. Make a short discussion on the story of the film and draft the theme. This film is available in YouTube.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 57 NUTRITION AND FOOD SAFETY 3 Unit COURSE CONTENTS: Lesson Topics 1 Malnutrition and Classification 2 Nutritional Deficiency Disorder 3 Food Safety and Consumer Health Estimated Teaching Hours: 5 Hours (Working Hours)
58 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) LESSON 1 MALNUTRITION AND DISEASE 1.1. Introduction The regular deficiency of various nutrients in our body causes malnutrition. Malnutrition is a condition where body does not get various food nutrients regularly. It means poor supplement of food nutrients to the body. However, in broad sense, it also denotes excessive intake of food and nutrition. The human body needs nutrients to perform its functions. Nutrients include protein, carbohydrate, vitamins, minerals and fat. The supplement of such nutrients depends on our feeding style. The deficiency of nutritious elements create obstacles in many physiological processes. These obstacles invite physical disorder along with malfunctioning of various organs and result the diseases. Disease is not only the result of malnutrition. It also hampers the physical and mental growth and development of our body. Pregnant women, infants, toddlers, children and old people are almost trapped in malnutrition. The wasted and stunted body and low immunity power are the main features of malnutrition. a) Causes of Malnutrition Malnutrition is a serious health problem in the community. There are various causes of malnutrition. a) Consumption of imbalanced diet b) Unhygienic feeding style c) Loss of nutrients from food while cooking d) Regular consumption of junk food Upper arm circumference (UAC) test to monitor the child growth
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 59 e) Regular consumption of low nutrient food f) Prolonged infection of worms g) Famine and starvation h) Lack of knowledge about balanced diet and nutritious food b) Classification of Malnutrition Malnutrition can be classified into two forms. These forms are given below: i. Under nutrition The poor supplement of essential food nutrients and energy to the body is under nutrition. It indicates the lack of food and nutrition in the family and community. The body becomes unable to gain the normal weight, height and both. Bony and weak body is a sign of such malnutrition. ii. Over nutrition Over nutrition indicates the excessive supplement of food nutrients to the body. It may cause obesity, overweight and height. It is an imbalanced nutrition. By measuring arm, weight and height of an individual, we can examine the type of malnutrition. Please, observe the adjoining image and attempt to explain it in few sentences. ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 1.1 1.2. Nutritional Deficiency Diseases Malnutrition leads different diseases and complicated health hazards in human body. Some are kwashiorkor, marasmus, night-blindness, anemia, rickets, goiter and scurvy as well as retardation in physical and mental development.
60 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) a) Marasmus -;'s]gf;_ Marasmus is caused by deficiency of protein and carbohydrate. It is protein-energy mal-nutritional (PEM) disease. Mostly children between five months to five years of age suffer from marasmus. It is a deadly disease. It may lead the children to death if not cured on time. Symptoms The muscles are wasted and body becomes skinny and bony. The wasted body is the main feature of marasmus. Loss of appetite, irritation, incessant diarrhea and dehydration are other features of the disease. Prevention The infants must be provided complete breast feeding. The children of weaning period and others must consume both body building and energy giving food i.e., rice, potato, sugar, milk, egg, meat, fish, etc. regularly. Marasmus (Left) and Kwashiorkor (Right) b) Kwashiorkor -k'mj]mgf; ÷ ?Gr]_ The deficiency of protein in the body causes kwashiorkor. The muscles and stomach swell due to retention of water and children attempt to cry or
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 61 weep all the time due to pain. So, Runche, a Nepali name, has been given to the disease. The children under five years normally suffer from this nutritional disorder. Symptoms Swollen body, loss of weight, cracks in skin, fatigue and retardation in physical growth are some features of kwashiorkor to diagnose. Prevention The infants must be provided with sufficient breast feeding. The toddlers and children must be fed bean, egg, milk, meat, fish and their product adequately in weaning and post weaning period. c) Goiter -unuf“8_ Goiter is an iodine deficiency disorder. The thyroid gland produces thyroxin hormone. This hormone requires for physical growth and development. Thyroid gland requires iodine to secret thyroxin hormone. Thyroid gland continues secretion of hormones. The lack of iodine mineral causes swelling of gland. Swelling develops into a muscular bulge and it is known as goiter. Symptoms Deficiency of iodine exposes some features in the body. For example, bulging eyes, faster heartbeat, retarded growth, enlargement of thyroid gland are some to mention. Prevention We must consume plenty of iodine containing food items. The chief source of iodine is Aayo Noon (Iodized Salt) in the context of Nepal. It is prepared by the fortification of iodine. The green vegetables, egg, fish, onion and sea-food are other sources of iodine. Victim of Goiter Aayo Noon
62 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) d) Anemia -/StcNktf_ Anemia is an iron deficiency disease. It is caused by decline of red blood cell (RBC) in the blood. The red blood cell carries food nutrients and oxygen and transport to cells, tissues and organs of the body. The deficiency of iron declines the number of RBC in the blood which is known as anemia. The red blood cell cannot manufacture in deficiency of iron. The main cause of anemia is iron deficiency. The extreme bleeding and worm infestation are other significant causes of the disease. People of all ages might suffer from anemia but pregnant women have the highest risk of this disease. Symptoms Weakness of the body, yellowish skin, lack of blood, inability to work, etc. are some common features of anemia. Prevention We must consume green vegetables, liver, meat, eggs, grams, beans, onion, Gundruk and get supplements of iron tablet for the prevention. e) Night blindness -/tGwf]_ The inability of eye to see in dim light or evening time due to deficiency of vitamin A is called night blindness. The victim can watch everything in sunlight / bright light but loses vision power (vision impairment) at dim light. The children of school age (5 to 7 years), the mothers and lactating mothers are more prone to this disease. Round worm infestation, diarrhea, dysentery, measles, malnutrition, etc. are other some causes of the disease. The prolonged deficiency of vitamin A may lead to permanent blindness. Symptoms The symptoms that occur with night blindness are headache, eye pain, nausea, vomiting, blurry or cloudy vision, sensitivity to light and difficulty seeing into the distance. Onion, A source of iron A bundle of carrots
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 63 Prevention We must consume food that supplies vitamin A adequately to prevent night blindness. Yellow fruits like banana, papaya, mango, guava, yellow and green vegetables, egg and liver are also prime sources of vitamin A. f) Scurvy The deficiency of vitamin C causes scurvy. The defect that occurs due to deficiency of vitamin C is called scurvy. Symptoms The features of scurvy are spongy and bleeding gums, loose teeth, hemorrhages, anemia, weakness, chronic cough and cold, low immunity power, rough skin and delayed recovery from wounds. Prevention The best way to prevent scurvy is regular consumption of vitamin C containing fruits. We must consume green vegetables and citrus fruits such as Amala, lemon, orange, Nibuwa (lime), Bhogate (pomelo), etc. We should be away from smoking and drug addictions because they destroy the vitamin C acquired by our body. g) Rickets The deficiency of vitamin D causes rickets. It is a kind of bone defect. Mostly children suffer from rickets although it may appear in fully grown adults too. It causes inflammation and swelling of the bones. The stored calcium and phosphorous in bones deplete due to deficiency of vitamin D resulting in weak and twisted bones and wrongly oriented teeth. Symptoms Rickets makes bones of chest and legs soft, weak and twist. The body becomes Bimiro (Citron), a good source for Vitamin C Twisted legs in rickets
64 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) unable to bear the body weight. It causes bent legs, barrel shaped chest and wrongly oriented teeth. Children become thin and lean and unable to grow. Prevention The consumption of food stuffs that are rich in vitamin D such as fish, meat, milk and egg is required for prevention of rickets. The regular sunbath is also beneficial for the prevention. h) Obesity Obesity is a nutritional disorder resulted by excessive consumption of carbohydrate. The growing children are getting the unnatural fatness. The fast foods, junk foods, processed foods and other carbohydrate rich foods contribute to obesity. Obesity invites the problems of diabetes, heart disease and over weight in childhood. Key Points Malnutrition is a condition where body does not get various food nutrients regularly. There are two types of malnutrition: under and over nutrition. Marasmus is caused due to long deficiency of protein and carbohydrate. The long deficiency of protein in the body causes kwashiorkor. Goiter is caused by Iodine deficiency. The deficiency of vitamin C causes scurvy. Anemia is an iron deficiency disease. Night blindness is caused due to lack of vitamin A. The deficiency of vitamin D causes rickets. Obesity is a nutritional disorder resulted by excessive consumption of carbohydrate. A. Find the missing words and complete the following statements. 1. Marasmus is caused due to long deficiency of _________ and _________. 2. The long deficiency of protein in the body causes the _____________ . A girl getting obesity
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 65 3. Goiter is caused by _____________ . 4. Aayo Noon is a good source of _____________ . 5. The deficiency of vitamin C causes _____________ . 6. Anemia is an _____________ . 7. Night blindness is caused due to lack of _____________ . 8. The deficiency of vitamin D causes _____________ . 9. The under and over nutrition are just _____________ in nature. B. Complete the following table with the required information. Nutrients Sources Protein Carbohydrate Iodine Vitamin A Vitamin B Vitamin C Vitamin D C. Answer the following short questions. 1. Write the definition of malnutrition. 2. State any two causes of malnutrition. 3. State the main cause of marasmus. 4. What is the meaning of over nutrition? 5. Find the name of disease caused by deficiency of protein. 6. Mention the preventive measures to anemia. 7. Define goiter in your own words. 8. Why does human body need iodine? Write. 9. What causes goiter? Write. 10. Define night blindness. 11. Give the cause of night blindness. 12. Which disease is caused by deficiency of vitamin D? Write.
66 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 13. What is obesity? Define. 14. Which disease is known as PEM disease? Why? 15. In which disease, the bones of human body twist? D. Answer the following long questions. 1. What are the main features of marasmus? 2. Write the preventive measures of marasmus. 3. State the main features of kwashiorkor. 4. List the preventive measures of kwashiorkor. 5. What are the preventive measures against anemia? 6. State the preventive measures of goiter. 7. Discuss the preventive measures of night blindness disease and write them in points. 8. Mention the effective measures for the prevention of scurvy disease. 9. What are the features of rickets? State all. 10. Can we prevent and control rickets? If so, what are the suitable measures for the prevention and control? 11. Write the differences between marasmus and kwashiorkor. 12. What are the symptoms of night blindness? Write. Organize an intra-class oratory on the topic of “An apple a day keeps the doctor away”. Enrich Your Knowledge! Apart from humans, goiter can develop in all domestic mammals as well as birds.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 67 LESSON 2 FOOD SAFETY AND CONSUMER HEALTH 2.1. Food Safety Food is a basic component for health and life. Good, nutritious and safe or hygienic foods can make us healthy and active. These foods can contribute to uplift public health in the community. The use of safe, healthy and nutritious food items controls illness and diseases caused by food contamination. The diseases such as diarrhea, dysentery, infestation, cholera and others are known as common food-borne diseases. Food safety is a method to handle, prepare and store the foods that prevent food-borne illness. The food safety maintains complete hygiene from the field to kitchen and kitchen to ingestion. The cereals, vegetables, fruits, milk, meat, fish, factory and market foods need special care from production to cook. The vegetables, fruits, milk, meat, fish and market foods are prone to rapid contamination. a) Food Safety and Components There are some components for food safety. These components protect and promote the quality and hygiene of the food. a. Separation The fresh, healthy and well ripen foods should be separated from the herd and kept in the basket or container safely. b. Cleaning The food items should be kept clean. The use of safe water to clean the food items makes them free from dirt, insecticide, fungi, bacteria, worms and their eggs. Proper cleaning can also make them fresh and healthy. The hands should be clean and neat for the cleaning. The cleaning of vegetables with clean water Food Safety The cleaning of vegetables with clean water
68 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) c. Storage The washed food items should be stored at right places after they dry up. The dry, cool and open places are appropriate for the storage. We can use room, cabin, drum, can and similar places to store them. The refrigerator can be used to store, if it is available. The temperature and light are the key factors to extend the life and quality of foods. d. Cooking Cooking process should be safe. The utensils, oil, ghee, spices, water and cooking places i.e., kitchen, etc. should be safe for cooking. Over cooking can destroy the food nutrients while less cooking may cause the abdominal problems. So, we should cook our food at the proper temperature. The conservation of nutrients is important for cooking. The following are some tips for the safe cooking: i. Prepare food stuffs at cooking hour only. ii. Do not chop the vegetables into tiny pieces. iii. Do not waste skins and coats of vegetables and fruits if they are edible. Skins and coats protect vitamins and minerals in food. iv. Do not wash rice deeply to cook because external surface of rice grains possesses carbohydrate and vitamins. So, never attempt to throw rice-water (Chaulani). v. Cover the cooking pots while cooking. We must cover the cooked food stuffs. It prevents loss of vitamins and minerals along with vaporization. vi. Use the rice / pressure cooker to cook the food because they cook faster and their lid blocks the damage of nutrients i.e., carbohydrates, vitamins, minerals, etc. along with vaporization. vii. Prepare the pickle and green salad at lunch or Tiffin hour only. It prevents the contamination and loss of nutrients. viii. Wash hands for 20 seconds with soap and water before, during, and after preparing food and before eating. i. What is the safe way for the purification of milk? Please, write in a single word. __________________ ii. What is the Nepalese name of adjoining container? _____________________ 2.1
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 69 2.2. Introduction to Consumer Health We all are consumers. We consume several market goods and services in our daily life. The food products, medicines, cleaning items, cosmetic products and others are being used to make daily life easy and comfortable. All these commercial and essential goods have not the same quality and standard. The cheap, low quality and non-branded items ruin the consumers’ (our) health. We should try to be a clever and wise customer while purchasing the goods from the market to save our health. Some Market Goods We should pay full attention to the following facts of goods. These are essential to protect the consumer (our) health. Maximum retail price (MRP) Production and expiry date Brand name, quality mark, bar/ QR code and label Direction to use and cautions Weight, volume and quantity Name of the producer / manufacturer Detail of ingredients Receive the receipt or bill after purchase. Display of price list at shop / complex. Discard the goods if price and label are overwritten. QR Code
70 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Bar / QR code and Quality Marks Key Points The good, nutritious and safe or hygienic food can make us healthy and active. Food safety is a method to handle, prepare and store the foods that prevent foodborne illness. Cereals, vegetables, fruits, milk, meat, fish, factory and market foods need special care from production to cooking. Over cooking can destroy food nutrients while less cooking may cause abdominal problems. Temperature and light are the key factors to extend the life and quality of food. We consume several market goods and services in our daily life. People consume food products, medicines, cleaning items, cosmetic products and others to make their daily life easy and comfortable. The cheap, low quality and non-branded items ruin the consumers’ (our) health. The use of safe water to clean the food items make them free from dirt, insecticide, fungi, bacteria, worms and their eggs. A. Complete the following sentences with the missing details. 1. We should not _____________ meat, fish and milk or milk products together. The meat and fish do not allow the body to consume nutrients of milk and milk products. 2. Cold stores can be used to ____________ the large quantity of food products. 3. It is not necessary to peel potato, cucumber, apple, mango, radish and carrot because skins and coats protect the _____________ and ______________________ in them.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 71 4. A clever and wise customer is very conscious to _____________ the goods from the market to save his health. B. Write short answers to the following questions. 1. What is food safety? Define it in your words. 2. State four components of food safety. 3. State any four measures to protect the food nutrients while cooking. 4. What is the meaning of separation in food safety? 5. Who is customer? Define. 6. Write a disadvantage of low-quality goods. 7. Name the quality marks of market goods. 8. What is information related to the goods of the market? Write any four. 9. Why is food safety important? Write. 10. Write short notes on: a) Storage of food b) Cleaning of food Practical Work Please observe any food or cleaning items such as soap, toothpaste, toilet cleaner, etc. and note down the following information. 1. Name of product: ............................ 2. Using methods: ............................ 3. Manufacturing date: ...................................................... 4. Name of manufacturer: ..........................……. 5. Ingredients: ............................ 6. Expiry date: ..........................…….. 7. MRP (Maximum Retail Price): …… 8. Bar Code / QR code / ISO / NS mark
72 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) DISEASE, SAFETY AND 4 FIRST AID Unit COURSE CONTENTS: Lesson Topics 1 Non-Communicable Diseases and Prevention 2 Sexually Transmitted Diseases and Prevention 3 First Aid and Exercise 4 Risk Management at School 5 Disaster and Safety Estimated Teaching Hours: 8 Hours (Working Hours)
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 73 LESSON 1 NON-COMMUNICABLE DISEASES 1.1. Introduction Disease is an abnormal condition in which body faces the sickness or infirmity due to internal disorder and infection of germs. Some examples of diseases are diarrhea, common cold, asthma, goiter, cancer, gastritis, etc. These diseases are classified as communicable and non- communicable. Non-communicable diseases cannot transmit from person to person. The examples of noncommunicable diseases are cancer, gastritis, diabetes, heart diseases and kidney infection. The other examples of such diseases are also found. These diseases have a connection with internal and external disorder of human body. Some noncommunicable diseases are chronic and deadly in nature. However, they are easily treated in the early stage of diagnosis. 1.2. Some Non-communicable Diseases i. Cancer (Nepali Name: ca{'b /f]u) An abnormal growth of cells in specific organs or body is called cancer. Cancer is a chronic disease. It can attack the people of any age group. It is a dreadful and deadly disease. Cancer is easily treated in primary stage if it is diagnosed earlier. It may be very difficult to recover in late stage. Causes of Cancer There are several potential causes of cancer. Some causes are given below: Smoking Alcoholism Drug addiction Unhealthy feeding habits Goiter: A NonCommunicable Disease
74 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Heredity Prolonged radiation of electronic appliances and machines Sign and Symptoms Sudden increment of nodes in various body parts Development of new nodes and tumor in the body. These nodes may or may not have pain. Sudden change in warts or moles Growth in moles Growth of nodes in the breasts No improvement of wounds and cuts since long Discharge of blood mixed milk from breasts Movement of nodes in abdomen Discharge from vagina if there is no menstruation Fatigue in normal work Prevention and Control of Cancer Stay away from cigarette, bindi, tobacco, raksi, wine, beer and drug addiction. Avoid the roasted and fried food stuffs. Avoid fungal food. Consume fresh and well-cooked food regularly. Keep the mouth clean. Clean the genital organs regularly. Stay away from the environmental pollution. Do the regular checkup of cervix and uterus. Avoid sex with multiple partners. Perform light exercise regularly. Take vaccine against cervix cancer. Consume green vegetables especially cauliflower, broccoli, etc. because they provide elements against cancer to the body. Include foods rich in vitamin A, E and C regularly in the diet. In case of genetic cancer, consult the doctors or hospitals manually.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 75 Please, study the pamphlet issued by National Health Education, Information and Communication Center and do the tasks that follow. National Health Education, Information and Communication Center is a government body of GON under Ministry of Health. a. What is the name of the disease mentioned? _____________________________________ _____________________________________ b. What is the method to identify the disease? _____________________________________ _____________________________________ 1.1 ii) Asthma (Nepali Name: bd ÷ wDsL Joyf) Asthma (/ˈæzðmə / or /ˈæsθmə /) is a respiratory tract disease. It makes the respiratory tract (trachea) narrow causing an inflammation. The narrowing of trachea can produce wheezing and breathlessness. Asthma attacks bronchus and bronchioles in the lungs. It causes contraction, swelling and inflammation in them and affects breathing. Effect of Asthma
76 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Dust, smoke, extreme cold, lung problems, heart diseases, psychological factors, etc. are some causes of asthma. Sign and Symptoms: Cough Breathlessness Problem in thorax Wheezing Irritation Weakness Increment of pulse rate Prevention and Control: Be safe from cold and cold food items. Stay away from smoking, alcoholism and drug addiction. Take bath with warm water and drink warm water. Stay away from dusty and smoky area. Avoid the goods that promote asthma and allergy. Be free from mental pressure and tension. Follow the doctors’ advices completely and take medicine regularly. Consult the doctors or hospitals regularly. iii) Diabetes (Nepali Name: dw'd]x ÷ lrgL /f]u) Diabetes is also known as sugar disease. The level of sugar increases in blood. The excess amount of sugar or glucose excreted by urine is diabetes. Carbohydrates convert into sugar or glucose in the body when metabolized. The whole portion of glucose must be consumed in the body. The body yields energy from glucose. Our body requires an insulin hormone to consume glucose. This hormone is produced by pancreas. The deficiency of insulin hormone increases the level of glucose in the blood. The excess amount of glucose is excreted through urine. This condition is called diabetes. There are two reasons associated with deficiency of insulin hormone. The first primary reason is less production of hormone due to disorder in pancreas. The excess supplement of glucose in the blood stream due to over consumption of food rich in carbohydrates is another cause of diabetes.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 77 It is a hereditary disease so it is transferred to offspring from parents. The luxurious and passive lifestyle also promotes diabetes because it helps to store glucose in blood. Diabetes is generally diagnosed in late adulthood stage at the age of 40-45 years. However, the trend has changed along with lifestyle of people. So, people of all age groups have equal risk of diabetes. Diabetes affects some organs badly. It damages retina and causes permanent blindness. It also affects heart, kidney and nerves. Sign and Symptoms: Frequent urination Milky white urine Loss of weight Quick tiredness and fatigue Quickly feeling of extreme hunger Laziness Faint and unconsciousness Increase in the level of glucose in blood and urine Slow healing of sores or wound Dry and itchy skin Muscular weakness Prevention and Control: Consume less carbohydrates rich foods in suspicious case. Increase the consumption of green vegetables, beans and fruits. Decrease the consumption of sweets, chocolates, sweet potatoes, etc. Avoid eating fatty and oily food to maintain the body weight. Perform the physical exercise, yog and work daily. Take balanced diet regularly. Visit the doctors or dietitians in case of hereditary diabetes. Follow the dietary menu prescribed by dietitians. Take the insulin hormone as per requirement. There should not birth from diabetic parents. Quit smoking, alcoholism and drug addiction.
78 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Try to be safe from cuts and wounds. Generate public awareness against diabetes. Make a list of non-communicable diseases. Your list should include the non-communicable diseases that have been hunting the people in your community. You may take the idea from your parents. 1.2 iv) Heart Diseases The heart related diseases are generally termed as heart diseases. We read about three different heart diseases. They are: a. Heart Attack b. Hypertension c. Hypotension a) Heart Attack (Nepali Name: x[bo3ft) Heart attack is a fatal and dangerous disease among the noncommunicable diseases which makes heart failure. It can attack us at any time. There is not any specific provision of treatment of heart attack. However, we can minimize the risk by improving feeding and lifestyle. Causes: The accumulation of fats in heart and blood vessels may cause heart attack. The excessive fats make the blood vessels narrow and stiff that block the regular supplement of blood to the heart. Malfunctioning of cardiac muscles, connective tissues and low volume of blood in the body cause this disease. Exertion on valves and ventricles of heart and irregularity in heart beat are also considered as the causes of heart attack. Frequent mental stress may lead the people to heart attack. The consumption of oily and spicy foods, smoking, drinking habits and drug addiction promote the heart disease. Human Heart
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 79 Sign and Symptoms: Breathing difficulty and lot of sweating Low body temperature Heart stops to pump the blood Blood vomiting due to inability of blood from the lungs to the heart Still vision Fainting at unpredictable time Prevention and Control: Perform regular exercise. Avoid fatty, oily and spicy food stuffs. Avoid smoking and drinking habits. Be free from regular tension or stress. Visit the doctors regularly in suspicious cases. Control obesity. Avoid the sedentary lifestyle. Always consume the fresh foods, green vegetables and fruits. Consume the cholesterol free food stuffs. b) Hypertension (Nepali Name- pRr /Strfk) The pressure created by blood in blood vessels during circulation is called blood pressure (BP). The normal blood pressure in human body is 120/80 mmHg. It represents systolic (blood pumping) and diastolic (blood receiving) value of blood pressure. The numerator belongs to systolic while denominator to diastolic. It is measured by a device called sphygmomanometer. The blood pressure above the normal blood pressure is called high blood pressure or hypertension. It is observed along with ageing after the age of 45 years. The blood vessels become narrower and stiffer in old stage and they obstruct in pumping the blood. The heart exerts more pressure to pump
80 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) the blood and it causes the high blood pressure. The normal range of high blood pressure is more than 130/90 mmHg. Causes: One of the major causes of high blood pressure is ageing. Hereditary is another major cause of hypertension. The passive lifestyle, consumption of fatty, oily, chilly, salty and spicy food stuffs are other causes of high blood pressure. The stress to the brain, hormonal imbalance, obesity, smoking and drinking habits also contribute to the disease. Sign and Symptoms: Regular headache Loss of appetite Laziness and weakness Sleeplessness and dizziness Faintness Irritation and aggression Increment in blood pressure Prevention and Control: Avoid salty, chilly, spicy, fatty and oily food stuffs. Avoid smoking and drinking habits. Consume the fresh food, fruits and green vegetables regularly. Perform the regular exercise and yog. Consult the cardiologist and respect all the advices. c) Hypotension (Nepali Name: Go"g /Strfk) The blood pressure below the normal blood pressure level is called low blood pressure or hypotension. The causes of low blood pressure are deficiency of nutritious food and fasting of long period. The deficiency of water, abnormal leanness and thinness, weakness, engagement in excessive physical and mental activities, excessive bleeding, etc. are other causes of low blood pressure.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 81 190 180 170 160 150 140 130 120 110 100 90 80 70 40 Diastolic (bottem number) Systolic (top number) 50 60 70 80 90 100 High Blood Pressure Pre-high blood pressure Ideal blood pressure Low A diagrammatic representation of blood pressure Sign and Symptoms: Weak and low pulse Slow heart beat Physical weakness and dizziness Physical imbalance Fainting Sleepiness
82 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Prevention and Control: Supplement of balanced diet Maintain the appropriate body weight Consume the salty food regularly Drink plenty of water everyday Avoid smoking and drinking habits Control stress and anxiety Follow the regular health check up What is the name of this device? Please, find and write. _______________________________________________ _______________________________________________ _______________________________________________ mmHg is the measuring unit of blood pressure and it stands for ___________________________________________ . 1.3 Key Points Disease is an abnormal condition in which body faces the sickness or infirmity due to internal disorder and infection of germs. Non-communicable diseases are caused by disorders of human body. Cancer is an abnormal growth of cells in specific organs or body. Consume green vegetables especially cauliflower, broccoli, etc. because they provide elements against cancer to the body. Include food rich in vitamin A, E and C regularly in the diet. The heart related diseases are generally termed as heart diseases. Heart Attack is a fatal disease which causes heart failure. The accumulation of fats in heart and blood vessels may cause heart attack. Asthma is a respiratory tract disease. It makes the respiratory tract (trachea) narrow causing its inflammation. Cancer is an abnormal growth of cells in specific organs or body. The body excretes the excess amount of sugar or glucose through urine in diabetes.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 83 The deficiency of insulin hormone increases the level of glucose in blood. The pressure created by blood in blood vessels is called blood pressure (BP). The normal blood pressure in human body is 120/ 80 mmHg. A. State the following statements whether true or false. 1. Asthma makes the respiratory tract (trachea) narrow causing its inflammation. 2. Cancer is easily treated in primary stage if it is diagnosed earlier. 3. The luxurious and passive lifestyle assists diabetes. 4. Diabetes damages retina and causes blindness. 5. The accumulation of fats in heart and blood vessels may cause heart attack. 6. The range of high blood pressure is more than 130/90 mmHg. 7. The disease which cannot transmit from one person to another is known as non-communicable disease. 8. The diseases include both communicable and non-communicable diseases. B. Write short answers to the following questions. 1. What is a disease? Define. 2. What is asthma? Define. 3. What are the causes of asthma? 4. Define cancer. 5. What happens in diabetes? 6. What are the causes of diabetes? 7. What is heart attack? Define. 8. Define blood pressure. 9. What is the value of normal blood pressure of human body? 10. Define hypertension. 11. Define hypotension. 12. Show the differences between hypotension and hypertension.
84 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) C. Write long answers to the following questions. 1. What are the symptoms of asthma? 2. Write the methods to prevent asthma. 3. Illustrate the major causes of cancer. 4. What are the symptoms of cancer? 5. Write the preventive measures against cancer. 6. Write the symptoms of diabetes. 7. Suggest the preventive measures to prevent and control diabetes. 8. Enlist the symptoms of heart attack. 9. What are the preventive measures against heart attack? 10. State the causes of hypertension. 11. Write the symptoms of hypertension. 12. Write the preventive measures to hypertension. 13. Point out the causes of hypotension. 14. What are the symptoms of hypotension? 15. Which methods can be effective for the prevention of hypotension? Project Work Visit a nearby health post, hospital or any health institution and collect posters and pamphlets of some communicable and noncommunicable diseases. Display them in your classroom and conduct a discussion program.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 85 LESSON 2 SEXUALLY TRANSMITTED DISEASE 2.1. Introduction Some diseases cause the infections of reproductive tract and are transmitted through sexual intercourse. Such diseases are called sexually transmitted diseases or STD. The genital organs i.e., penis, vagina, testes, cervix, uterus etc. are infected due to STDs. Gonorrhea, syphilis and AIDS are some of the sexually transmitted diseases. These diseases are transmitted by virus, fungi and bacteria mainly through sexual contact. A Social Message Mode of Transmission There are several modes of transmission of these diseases. Unsafe sexual contact Sharing under wears of the infected person New birth from infected mother (vertical transmission) Sharing common bed with infected person Unsafe blood transfusion and transplant of infected organs Sharing needles, syringes, knife, blade and razor used by infected person 2.2. Prevention of STD We can adopt the following measures to control the sexually transmitted diseases:
86 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Limit sexual intercourse between husband and wife only. Make the intercourse safe by using condom. Maintain hygiene of sexual organs. Sterilize the fomites of the infected person. Visit the hospitals or doctors in cases of suspicion. Avoid multiple sex partners. Avoid unsafe blood transfusion and transplant of infected organs. Sterilize the needles, syringes, knife, blade and razor before using. Generate public awareness against STD. 2.3. Some Sexually Transmitted Diseases a) Gonorrhea (Nepali Name: ;'hfs) Gonorrhea is a bacterial infection of human genital organ. Urethra, vagina and uterus are affected by this disease. Its incubation period is 2 to 10 days. The pus starts to discharge from penis and vagina after complete infection of the disease. Mode of Transmission: There are several modes to transmit this` disease. They are: Unsafe sexual contact Sharing of under wears of the infected person New birth from infected mother Sharing common bed with infected person Sign and Symptoms: Burn in urination Whitish discharge along with urine Pus discharge Frequent micturition Swelling of penis and vulva Pain in testes Prevention and control: Limit the sexual intercourse between husband and wife.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 87 Make the intercourse safe by using condom. Maintain the hygiene of sexual organs. Sterilize the fomites of the infected person. Visit the hospitals or doctors in suspicious cases. Generate public awareness against Gonorrhea. b) Syphilis (Nepali Name: lel/ª\uL) Syphilis is a common but more dreadful STD. It is a bacterial infection of human genital organs. The bacteria are found in semen, vaginal secretion and blood of the infected person. Incubation period The incubation period of this disease is 10 to 90 days with an average incubation period of 21 days. Modes of Transmission Unsafe sexual intercourse Prenatal infection Unsafe blood transfusion Lactation and kissing Symptoms: The symptoms are observed through three different stages. Symptoms in the First Stage: Swelling of lymph glands Chancre (wound) around genital organs No pain in chancre If the disease is not diagnosed and treated then it exposes the secondary symptoms. Symptoms in the Second Stage: Headache and fever Sore throat and rashes in mouth, lips and throat Swelling around perineum Swelling of bones and joints
88 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Symptoms in the Third Stage: Tumor in skin, bone, liver and central nerve Trouble in Aorta Syphilitic Meningitis Mental disorder and paralysis Prevention and control: Maintain safe sexual contact with condom. Limit the sexual contact between husband and wife. Avoid multiple sex partners. Immediately visit hospitals or doctors in suspicious events. Public awareness should be generated. iv) AIDS (Acquired Immune Deficiency Syndrome) AIDS is a sexually transmitted infection (STI). It is a highly contagious global health problem which is mainly caused by unsafe sexual behaviors. Causative Agent The causative agent of AIDS is HIV (Human Immuno - Deficiency Virus).The virus is highly contagious that disposes WBC and immune system. The virus can be detected in blood, semen, vaginal secretion and bone marrow of the infected person. The treatment system against this infection is anti-retro viral (ARV) treatment. The system does not recover completely from AIDS but prolongs the life span of the infected person. It is a freely-available treatment. Modes of Transmission: HIV is transmitted through the following modes: Unsafe sex Sex with multiple partners Transfusion of HIV infected blood and organs Sharing of syringe, needles, blade, knife, razor, etc. Drug abusers
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 89 Stages of AIDS: The human body does not expose the sign and symptoms of AIDS instantly after getting the infection. There are certain stages of HIV / AIDS for the diagnosis. a) Window Period: HIV enters in the body but does not infect. HIV is present in the blood but cannot be detected under any test. So, there is high chance to transmit HIV from the host. It is heavily serious stage of HIV / AIDS in term of infection. It exists 6 to 12 weeks (3 months) normally. b) Asymptomatic Stage: This stage is called HIV positive state. HIV can be detected by blood test. However, the infected body does not show any symptom of AIDS. Infected person shows the normal behaviors. This state exists 10 to 15 years or more. c) Symptomatic Stage: This stage is the stage of AIDS. It leads the victim to his/her death. Infected person exposes all the signs and symptoms of AIDS and meets the critical syndrome. The body and mind become extremely weak and loses immunity power. It covers generally 1-2 years. The right treatment system, ARV and high level of confidence vigorously extend the life span and beat the ill thoughts. Signs and Symptoms a) Minor Symptoms: Chronic cough for a month or even longer Swelling of lymph nodes in the neck and other parts Swelling and wound towards the end of tongue Swollen lips and sore in sexual organs Formation of red rashes in the skin Frequent Pneumonia and herpes zoster b) Major Symptoms: More than 10 % loss in the body weight Persistent fever for months
90 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) High sweating Chronic diarrhea Preventive Measures: Avoid unsafe sexual behaviors and use the condom in case of unsafe sex. Avoid sex with multiple partners. Avoid unsafe blood transfusion and transplant of the infected organs. Sterilize the needles, syringes, knife, blade and razor before using. Public awareness generation Regular counseling to infected person Provision of ARV treatment system Consult the medical person to get PMTCT service in the case of pregnancy. Visit a nearby health post, hospital or any health institution and collect posters and pamphlets of some communicable and non-communicable diseases. Display them in your classroom and make a discussion. 2.1 Key Points Sexually transmitted diseases cause the infections of reproductive tract and are transmitted through sexual intercourse. The genital organs i.e., penis, vagina, testes, cervix, uterus etc. are infected due to sexually transmitted diseases. Syphilis is a common but more dreadful STD with a quick transmission. Gonorrhea is a bacterial infection of human genital organ. Syphilis is a bacterial infection of human genital organ. AIDS is a highly contagious global health problem. Anti-Retro viral (ARV) treatment is used against the AIDS. The right treatment system, ARV and high confidence level vigorously extend the life span of HIV patients. The prevention of mother to child transmission service blocks the transmission of HIV from mother to her baby.
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 91 A. Complete the following sentences with correct words. 1. The example of a sexually transmitted infection is _____________ 2. The incubation period of Gonorrhea is _____________________ days. 3. The first case of HIV infection was examined in _____________. 4. HIV attacks our _____________ and destroys the WBC. 5. The PMCT service stands for _____________________________. B. Answer the following short questions. 1. What is sexually transmitted disease? Define. 2. Write the examples of STDS. 3. What are the causes of STDs? Write. 4. What is the window period of HIV / AIDS? C. Answer the following long questions. 1. What are the modes of transmission to gonorrhea? 2. Enlist the symptoms of gonorrhea. 3. What are the preventive measures of gonorrhea? 4. State the modes of transmission of syphilis. 5. What are the symptoms of syphilis? Write. 6. Write the preventive measures against syphilis. 7. Prepare a list of preventive measures to adopt against STDS. 8. What are the modes of transmission of HIV / AIDS? Write. 9. What are the major symptoms of AIDS? Practical Work Prepare suitable slogans against sexually transmitted disease to generate public awareness in the community.
92 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) LESSON 3 FIRST AID AND EXERCISE 3.1. Introduction First aid is an immediate aid or treatment given to the victim on the spot after the accident. It is provided to an injured person before the arrival of a doctor or health worker and taking to the treatment center such as health post, health center, and hospital. Sometimes, it may be required to a patient and a normal person. The person who is capable for first aid service is known as first aider. 3.2. First Aid Box and Kit The first aid box is a box that is used to store the first aid kits. There are various lifesaving kits which are used in a first aid box. A manual or guide is essential for the proper handling of the first aid kits. A First Aid Kit (Box) includes the following supporting devices for emergency use. Table 2: The kits for first aid box SN First Aid Kit Quantity 1 Triangular Bandage (White) 5 2 Roller Bandage (Different size) 3x3x3 (roll) 3 Gauge Pad 5 4 Forceps 1 5 Scissors 1pair 6 Dettol / Savlon 1 bottle (medium size) 7 Soap 1 piece 8 Surgical Mask 2 9 Hand Glove 1 Pair First Aid Kit (Box)
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 93 10 Cotton Towel (sporty size) 1 11 Handy Plast 12 12 Adhesive Tape 1 roll 13 Crepe Bandage 2 rolls 14 Thermometer 1 15 Oral Rehydration Powder (Jeewan Jal) 4 packets 16 Torch Light 1 17 Hook Pin 12 pieces 18 Diary + Pen / Pencil 1/1 Source: Prathamik Upachar Swayam Sebak Nirdeshika, Nepal Red Cross Society If the First Aid Kit is not available at the accidents spot, we must use locally available materials because our motto is to save the life of an injured person. 3.3. Methods of the first aid i. DR-ABC Method This method is used to examine the serious casualty. This is an initial or primary checkup of the casualty. This method (DR-ABC) co-operates to initiate the appropriate first aid service and examines whether the casualty is alive or dead. A first aider should remember that first aid service should not be a cause of the death of any casualty. The method of DR-ABC is described in short below. D -Danger: The accident spot should be safe to commence the first aid service. The first aider should examine the spot himself to find the danger and to be safe. For example: the accident of electric shock. R -Response:
94 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) This is the way to detect the sense of the injured person. We can call or clap near the ear to get the response of the injured person. The injured person shows the reaction if s/he is conscious. A -Open or clear Air way: The foreign body may be present at respiratory tract. It should be cleared carefully for the breathing purpose. B – Adequate Breathing: The respiration process should be observed and if not, assured it by keeping the casualty at appropriate posture. C – Sufficient Blood Circulation: The blood circulation should be checked by observing test of pulse of wrist. Drill of DR-ABC method during a training session of the first aid: The trainer testing response What are the ways to check the breathing process of a seriously injured person in an accident? Discuss in the class and write the possible and safe techniques. 1.1
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 95 ii. Expired Air Resuscitation (EAR) This method is also known as artificial respiration. The provision of artificial breath to restore the respiration process in emergency state is called artificial respiration. The respiration process of casualty may be interrupted after electric shock, drowning and other cases. Artificial respiration is a rescue operation to save the life of the casualty. There are various methods for the artificial respiration. Mouth to Mouth Respiration and mechanical respiration (ventilator) are most common methods to restore the respiration. a) Mouth to Mouth Respiration This technique can be applied anywhere in emergency period as a part of cardio pulmonary resuscitation (CPR). The following are the techniques for mouth-to-mouth respiration: 1. Place the patient on his/her back firmly. 2. Keep the respiratory tract, mouth and throat straight forward of the injured person. Pillow or the thigh of the first aider can be used for this purpose. 3. Check the airway, if any foreign body is present; swipe it with the help of fingers. 4. Close the nostril of the injured with index finger and thumb and open the mouth. 5. Put the mouth of the first aider over the mouth of the injured person and start to blow until the chest rises. 6. Blow air into the lungs in every 3-4 seconds and take a short recess to extract the air from the body. 7. Respiration may restore after some moments, if not take the injured to the hospital. Mouth to Mouth Respiration
96 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) Please, organize a drill for the mouth-to-mouth respiration under the supervision of the first aider. You can use a dummy. If it is not available, you can involve your classmates by adopting safety measures. 3.2 iii. Cardio Pulmonary Resuscitation (CPR) This method is also known as external cardiac compression (ECC). This technique is induced to recover the expired respiration, blood circulation and heart functions. The stopped blood circulation and heart situation can damage the brain and vital organs within a minute causing death. To avoid such situation, an immediate first aid attention, cardio pulmonary resuscitation (CPR) is required to save the life. A trained first aider and health worker can perform this operation to save the casualty. This life saving operation can be induced in the following conditions: No blood circulation Heart stops to function Stop breathing Lose consciousness Procedures of CPR The following procedures can be followed to commence the cardio pulmonary resuscitation / cardiac massage (ECC): 1. Keep the casualty on the back on a firm place. 2. Press the chest at the center by placing the palms putting one on another and interlock the fingers. Stop the chest compression after four attempts for a short moment. 3. Assure the respiration, if absent, provide one rescue breath (i.e., mouthto-mouth respiration) Performing cardiopulmonary resuscitation, CPR
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 97 4. Assure the heartbeat, if absent, continue chest compression and provide one rescue breath. If no heartbeat and circulation start, take the casualty to the hospital or health post. 1. Please, invite a first aider in your school as the resource person and organize a session to learn cardio pulmonary resuscitation (CPR). 2. Please, collect the video on cardio pulmonary resuscitation (CPR) and display it in the classroom. You can also discuss. 3.3 3.4. First Aid and Accidents a) Foreign Body in the Eyes A speck of dust, leaves, cotton, bricks, food grains and germs can float on the white part of the eyes. Usually, such objects can easily be rinsed off. However, we must not touch anything that sticks to the eyes and penetrates to the eyeball because it may damage the eye. Instead, we have to make sure that the victim gets medical attention (care) quickly. However, we can make the following aids for miner casualty. i. Advise the victim to sit down facing the light. ii. Stand in front of him / her. Gently, open the eyelids with the fingers and thumb to examine every part of the eye. iii. Wash the foreign body by pouring clean water from a glass to the location of foreign body. We can use eye-wash if available. iv. If this attempt is unsuccessful, lift the foreign body by a tip of a clean and neat handkerchief. If a foreign body sticks the inner wall of upper eyelid, dip the eyes in the tub of clean and neat water and blink frequently. If we cannot still remove the body, must get medical help. Caution Do not rub the eyes after penetration of foreign body into the eyes because it brings further complications and causalities. A light foreign body in eye
98 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) b) Foreign Body in the Ear If a foreign body is trapped in the ear, it may cause temporary deafness by blocking the auditory canal. Sometimes it may damage eardrum. Mainly an insect may be trapped inside the ear. First Aid Reassure the victim and let him / her to sit down facing the light. Gently, pour the clean and neat water over the ear so that insect or bodies float out from the ear. If this pouring does not remove the insect or body, take or send the victim to the nearby hospital or health post. c) Foreign Body in the Nose Young children may push small body up their nose. Foreign objects can block the nose and airways. They may cause the infection also. The sharp objects damage the tissues and cause burning and bleeding. So, do not try to remove a foreign object because you may injure yourself or push it further. First Aid Reassure the victim and advise him / her to be calm and quiet. Tell him / her to breathe through mouth at a normal rate. Advise him not to poke inside nose to remove the object himself / herself and take or send the victim to the nearby hospital or health post. d) Foreign Body in the Throat (Choking) - Child (1-7 years) Choking may appear to the people of all ages. Infants, child, adult and aged may face choking. Mostly infants and children can suffer by choking. They can choke food items and small playing materials in the throat (windpipe). Choking is a blockage of the airway (windpipe) by food or other foreign objects. It prevents a person from breathing effectively. In some cases, the An observation of foreign body in ear An observation of foreign body in nose
Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) 99 air flow is completely blocked, in other cases some amount of air can pass to the lungs. Insufficient oxygen being delivered to the body will result in oxygen deprivation. Sign of Choking Choking can cause difficulty in speaking, coughing and breathing. Sometimes, it may cause complete inability to speak, breathe and cough and eventual loss of consciousness. First Aid i. Encourage the child to cough if she /he is beginning to struggle. ii. Give up to five sharp slaps between the shoulder blades using the palm of hand and check the mouth also. If foreign body still exists, proceed to the following actions. iii. Give up to five thrusts / back blows: Stand behind the child. Make a fist with two hands and place it against the lower half his / her breastbone. Drive the fist and pull sharply inwards and upwards up to five times, at a rate of about one chest thrust every three seconds. Also check the mouth and if foreign body still exists, proceed to the following actions. Back Blows and Abdominal Thrust A child is facing choking
100 Health, Physical Education & Creative Arts - Book 8 (Approved by CDC) iv. Give up to five abdominal thrusts: Stand behind the victim with both arms around his / her upper abdomen. Make a fist with both hands and place it between the child’s navel and the bottom of his / her breast bone. Drive the fist with hands and pull sharply inwards and upwards up to five times. If foreign body still exists, repeat the entire procedures until the foreign body is cleared. If it is not cleared, quickly take or send him/her to the hospital or health post. Caution Do not do a finger sweep of the mouth to remove the foreign body. Please, call one of your class mates in the front and show the whole class a demo of back blows and abdominal thrust respectively. You can invite the first aider of your school or Red Cross unit of local area as a resource person. 3.4 e) Heat Stroke (Nepali Name: n' nfUg') The unconsciousness, fainting and casualty due to extreme heat of the sun are known as heatstroke. Normally, it occurs in summer season in the Tarai region of Nepal. The atmospheric temperature increases above 40ºc and causes hot wave of air in the surroundings. The general temperature of human body suddenly rises during heatstroke. The body temperature rises above 40ºc (104ºF). As a result, casualty may become unconscious or faint. In case of delayed medical attention, casualty may lose his/her life. Sign and Symptoms Body temperature crosses 40ºc (104ºF) Headache, dizziness and discomfort Hot, flushed and dry skin Restlessness and confusion A victim of Heat Stroke