2. Preventive Healthcare-.pptx Social Pharmacy ER 2020

Social Pharmacy ER 2020

1. Chapter 2. Preventive Healthcare Social Pharmacy (20115) Prof. Vaishali P. Argade Lecturer in PRES, Institute of Pharmacy, Loni Email:[email protected] Mobile:[phone]

2. Points to be cover: Demography and Family Planning (3) Mother and child health, importance of breastfeeding, ill effects of infant milk substitutes and bottle feeding (2) Overview of Vaccines, types of immunity and immunization (4) Effect of Environment on Health – Water pollution, importance of safe drinking water, waterborne diseases, air pollution, noise pollution, sewage and solid waste disposal, occupational illnesses, Environmental pollution due to pharmaceuticals (7) Psychosocial Pharmacy: Drugs of misuse and abuse – psychotropics , narcotics, alcohol, tobacco products. Social Impact of these habits on social health and productivity and suicidal behaviours (2)

3. What is DEMOGRAPHY ?? Demography is the systematic/periodic study of population growth. The term demography is of Greek origin and is composed of the two words, demos (people) and graphein (describe), implying the description of people . In demographic studies we will discussed about the population size, growth(births, deaths, and migration)the demographic studies we will discussed about the population size, growth(births, deaths, and migration)

4. IMPORTANCE OF DEMOGRAPHY : Due to involvement of demographic study we will control the population growth by adding any modus . 1. By the demography we will define the health status of any population or community and provided the regular health services. 2. After demographic study, we can fulfill the nutritional supplement, regular medicine and also fulfill the population needs. 3. Demographic studies, also improve the education level of any nation or state by providing the usable/accessory study materials and equipment's. Demography is a field that is of special importance to sociology – in fact, the emergence of sociology and its successful establishment as an academic discipline owed a lot to demography.

5. COMMON SOURCES & INDICATORS OF DEMOGRAPHY : Birth rate — Birth rate is the statistic or rational expression about the, number of live births in a given area during a given time per 1000 population. Death rate — Death rate is the statistic or rational expression about the, number of deaths in a given area during a given time per 1000 Migration rate —Due to the migration of people, it indicates the demographical changes in the population and affect the rational presentation. It is effect by two ways

6. Fertility rate : The fertility rate refers to the number of live per births per 1000 women in the child bearing age group, usually taken to be 15 to 49 years. It also refers as, The Total number of live births that a hypothetical woman would have if she lived through the reproductive age group and had the average number of babies in each segment of this age group as determined by the age specific fertility rates for that area . Infant mortality rate — Number of death of babies before the age of one year per 1000 live births. Maternal mortality rate — Number of women who die in child birth per 1, 00,000 live birth Sex ratio : Sex ratio refers to the number of females per 1000 males in a given area at a specified time period.

7. DEMOGRAPHIC CYCLE : High stationary (first stage) - This stage is characterized by, high birth rate and high death rate no any change in size of population. Early expanding (second stage) - This stage is characterized by, death rate begins to decline and birth rate no change initial increase in population. Late expanding (third stage) - This stage is characterized by, birth rate begins to decline while the death rate still decrease. Continue increase in population. Low stationary (fourth stage) - This stage is characterized by, low birth rate and low death rate stability in population. Declining (fifth stage ) - This stage is characterized by, birth rate is lower than the death rate. Decrease in population.

8. FAMILY PLANNING : Definition/Introduction : “ Family planning is a practice to controlling the number of children one has and maintain the intervals between their births, particularly by means of contraception or voluntary sterilization. ” According to WHO in 1971 it is defined as ‘ a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country.

9. AIM OF FAMILY PLANNING Control population Improve the health (Physical, mental and social) Reduce hunger and poverty Reduce maternal mortality Reduce infant mortality and morbidity Improve the reproductive health Decrease the STDs Improve the education level Reduce MTPs Provide all the government services and resources. Methods of family planning Natural / Traditional Method Physical barrier Method Chemical/ Hormonal method

10. 1. Natural/Traditional methods : Natural methods work on the principle of avoiding chances of ovum and sperm meeting. It follows many ways— Periodic abstinence — It is one such method in which the couple avoid or abstain from coitus from day 10 to 17 of the menstrual cycle when ovulation could be expected. As chances of fertilization are very high during this period , it is called the fertile period . Withdrawal or coitus interruptus —It is the another method in which the male partner withdraws his penis from the vagina just before ejaculation so as to avoid insemination . Lactational amenorrhea — During the lactational period following parturition ovulation are absence. Completely absence of menstruation only up to a maximum period of six months following parturition.

11. 2. Physical / barriers methods — In barrier methods, ovum and sperms are prevented from physically meeting with the help of barriers. It is available for both — For male — Male condoms are barriers made of thin rubber/latex that are used to cover the penis in the male, just before coitus so that the ejaculated semen would not enter into the female reproductive tract. It also prevented the STDs . For female — Female condom are also a barrier method made of thin rubber/latex sheath that are used to cover the vagina and cervix in female. They prevent conception by blocking the entry of sperm in female reproductive tract. It also prevented the STDs. Diaphragms, cervical caps and vaults are also barrier made of rubber that are inserted into the female reproductive tract to cover the cervix during coitus.

12. 3. Chemical/hormonal methods— Chemical and hormonal substances also overcome the conception and work as contraceptive. Oral contraceptives —In the oral contraceptive tablets or pills are used which contains either progestogens or progestogen -estrogen combination. Pills have to taken daily for a period of 21days starting preferably within the first five days of menstrual cycle . ‘ Saheli ' the new oral contraceptive for the females contains a non-steroidal preparation . It is ‘once a weak’ pill with very few side effects and high contraceptive value. IUDs— Intra Uterine Device are most effective and popular method are inserted by doctors or experts nurses in the uterus through vagina.

13. Peste & Jellies : They are push into the vagina with the help of applicator. Suffecient time is given for the chemical to spread . Passaries : These are kept into the vagina , five minute before the intercourse. The tablets melt at body tempreature & spread the chemical on mouth of uterus . Aerosoles ( Foam tablet ) : Foam tablet is kept into the vagina five min before intercourse at body temperature , it melts and produce foam which act as barrier for the entry of sperms into uterus.

14. Surgical methods — Surgically method is perform in both male and female. Surgical method is also called sterilization method which blocks gamete transport and thereby prevent conception. It is two types. Tubectomy — It is permanent methods of family planning which is done in females called female sterilization. In tubectomy , a small part of the fallopian tube removed or tied up through a small incision in the abdomen or through vagina . This operation is done using general or spinal anesthesia.. It is considered as major operation . Women will have to stay in hospital for about 7 days.

15. Vasectomy – It is process of male sterilization in which vas are cut and tied, so that sperms can’t enter the urethra . It is simple and easy surgical process . Operation is done under local anesthesia . A Small cut is given on both sides of man’s scrotum i.e. on each of tube which carry seeds from the testes. Cut ends are tied up. This prevents flow of male seeds into semen.

16. Family planning programs : India was amongst the first countries in the world to initiate action plans and programs at a national level to attain total reproductive health as a social goal. These programs called ‘family planning’ With the help of audio-visual and print- media governmental and non-governmental agencies have taken various steps to create awareness among the people about reproduction-related aspects. Introduction of sex education in school, teachers, and friends should be encouraged to provide right information to the young growth Some Important Programs Given below : Reproductive and Child health care (RCH). International conference on population and development (ICPD). National Health Mission (NHM). National Population Policy (NPP). National Health Policy (NHP). Millennium development goals (MDG). Sustainable development goals (SDG).

17. Mother & Child Health : BREAST FEEDING : “ Breastfeeding is the activity by which, the nourishing the new born baby with milk from the breast and complete their nutritional demands stands for proper growth and development up to a certain period . Breast milk contains the water, proteins, carbohydrates, antibodies, fats, hormone, vitamins , minerals and other immune cells etc. IMPORTANCE OF BREASTFEEDING --- To Improve resistance power against disease. To Fulfill nutrients supply to the body. Mother ilk provide immunity power to baby . Due to involvement of supplement, baby get proper growth & development & also provide strength to the body parts. For Mother care : Breastfeeding is simply not responsible for a baby growth apart from this, it is also responsible for mother health. In mother keep it safe from many conditions. Diabetes, ovarian cancer, regulated cholesterol level, breast cancer, high blood pressure etc.

18. ROLE OF PHARMACIST IN MOTHER AND CHILD HEALTH If any problem come regarding to the mother or child health then pharmacists supply various contraceptive options and prescribe initiate emergency contraception. Aware the parents and supply vitamins and nutritional supplements, including folic acid and iron supplements and also promote cessation of alcohol and nicotine use. 2. Pharmacists recommend drug therapy, dosages, and duration of the essential medicine during the pregnancy and also decide the drug for developing embryo. 3. Pharmacists make decisions regarding accessibility of critical medications in labor and delivery and provide required sterile medication products during delivery.

19. 4. Pharmacists, support breastfeeding (when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breast feeding by HIV- infected mother is recommended ). 5. Pharmacists supply the effective treatment to the child and drug therapy (Oral rehydration salts and Zinc therapy) and also insure no deficiencies quality, purity, or potency of medicinal products . 6. Pharmacist also participated in health program and aware the parents to any disease conditions and provide the proper precaution.

20. SUBSTITUTES FOR INFANT MILKS : Some conditions mother are not able to breast feeding due to reasons (low milk production, severe disease condition etc.) then substitute or alternative milk are the one way to fulfill the baby needs other than the mother milk. Substitute Milk : Substitute milk is a synthetic form of liquid/powder nutrition designed to closely mimic the nutrient quality and composition of breast milk. - It provides a similar amount of calories, fat, and proteins as breast milk.

21. BOTTLE FEEDING : Bottle feeding is a system, which provide the identical condition/ environment that is similar to breast feeding and nourish the baby by providing the nutrient full supplements . Some precautions/activities required for bottle feeding : Proper cleaning and hygiene required for the bottle feeding. To ensure the feeding supplement, which are healthy for baby or not. To ensure the feeding bottle (plastic, stainless steel) are compatible with the feeding supplement. Try that as much as the feeding is made , give the baby drink immediately and do not leave it for later because supplement are easily deteriorate by the environment. Proper condition and proper position are required for the best feeding.

22. Immunity— Immunity is defined as the ability of immune system to produce the immune response against the disease causing organisms like bacteria, virus, fungus, and other foreign agent. OR Immunity is defined as the resistance power of the body to fight against the infectious disease.  

23. a) Innate Immunity -  The immunity, which is present in an organism by birth is called innate Immunity. Innate immunity refers to the body’s defense system.  Responses are rapid. b) Acquired /Adaptive/ Artificial Immunity.  An individual acquires immunity after birth, hence is called adaptive or acquired immunity. Adaptive immunity develops throughout our lives.  We acquire adaptive immunity when we are exposed to infectious diseases and allergies or when we are immunized against them with vaccines .

24. 1.Active Immunity: It is developed after clinical or subclinical infection or following immunization and it is humoral or cellular type.   Here antibodies i.e. immunoglobulin of 5 types are produced as IgG , IgM , IgE , IgDand IgA ( Ig i.e. immunoglobulin ). The antibodies work to destroy antigens. This is called humoral immunity.   It is long lasting, less expensive, with least side effects and characterized by memory mechanism; as compared to passive immunity. 2 . Passive Immunity:   i) When antibodies produced in one body (human or animal) are transferred to another to induce protection against disease, it is called as passive immunity.   ii) Passive immunity is effective immediately as ready-made antibodies are given to human . iii) It is rapidly established, it is of very short duration

25. Sr. No. Active Immunity Sr. No. Passive Immunity 1 Produced due to contact with pathogens 1 Produced due to Antibodies obtained from outside 2 Immunity is slowly produced 2 Immunity quickly produced   3 Last for long period, may be life long   3 Last for few days 4 Antibodies are produced in the body   4 Antibodies are taken from out side 5 Naturally acquired after infection   5 Naturally acquired from mother through placenta 6 Very few side effects 6 May produce serum sickness

26. Vaccination / Immunization : A process by which  a person becomes protected against a disease  through vaccination.    Immunizing Agents: These are the substances which produce immunity when introduce into the body . Antigen— Antigen are those substances that stimulate the immune system to produce antibodies (protective body). It behaves like foreign particles (bacteria, virus) for recipient body and cause undesirable changes, then recipient body protects itself by producing the antibodies. Antibody —Antibody is the protective protein produced by the immune system in response to the presence of the foreign substances like bacteria, viruses etc and neutralize their activities. It is also called immunoglobulin.

27. Ideal characteristics of vaccine Not cause any allergic reaction Easily administrable without any harm. Easy to store not shows any incompatibility with storage materials. Easily available and low economic value. Not cause any disease condition and rapidly produces antibody effects.  

28.   History of Vaccine Discovery of Immune system- Edward Jenner (1749-1823). Edward was creating the concept of vaccines and formulated the small pox vaccine.   After that Louis Pasteur (1878) discovered the rabies and anthrax vaccine.   Vaccine is the chemical substances or biological preparation which provides the active acquired immunity against any disease. Generally vaccine contains the resemble microorganism or chemical substances (toxins, surface protein etc.) in inactive/killed form.   During the vaccination, vaccine are injected in the body, after that it behaves as a antigen or foreign substance to the body, so our body work against this substances and produced the antibodies create a immunity. It is called that primary response against disease. After that immunity are developed and stored in the memory cells of the brain regarding to the previous infections. In future any similar infections are cause then our immune system give rapid response and fight against disease this is called secondary response by producing antibodies.

29. Types of vaccine— There are four types of vaccines, categorized by the antigen (inactive microbes, toxins, surface protein) used in their preparation. 1. Live attenuated vaccine (LAV)- Live attenuated vaccines (LAV) is prepared by pathogens (virus or bacteria) which causes the infections or disease, that have been weakened under laboratory condition. (These are prepared from live organism) It shows strong immune response Cold chain storage required It is less cost   Example-- – Tuberculosis (BCG), Oral polio vaccine (OPV), Measles, Rotavirus, Yellow fever.  

30. 2. Inactivated vaccine (Killed vaccine ) These are prepared from killed organism. These are more stable than LAV vaccines. It shows relatively poor immune response Cold chain storage is not required It is more costly   Example-- pertussis, Inactivated polio virus (IPV), Clolera vaccine   3. Subunit vaccine (Purified antigen ) Subunit vaccines contains the antigenic parts (disease causing portion) of antigen. Like inactivated vaccine it also not contains the live components of antigen, it is only contains the antigenic parts like surface protein, conjugated chemicals, polysaccharide etc.   Example-- Acellular pertussis, Haemophilus influenza type b Pneumococcal, Hepatitis B.

31. 4. Toxoid vaccine (Inactivated Toxoid ) Toxoid vaccines are based on the toxin produced by certain bacteria (e.g. tetanus or diphtheria). Released toxin is used to prepare the vaccine and these parts are necessary to elicit a protective immune response and produce antibody. Example-- Tetanus Toxoid (TT), Diphtheria Toxoid.  

32. Cold chain storage of vaccines .   Vaccines are biological products and can lose their potency if not stored appropriately. The vaccines should be stored at low temperature starting from the manufacturer to the point of use. The maintenance of temperature throughout the transportation, storage and up to administration is called the cold chain . The cold chains maintenances are necessary because on exposure to high temperature vaccines lose potency and their life is shortened. All the vaccines have different heat sensitivities. Oral polio vaccines is most sensitive to heat, next in order are measles, BCG, DPT, DT and TT. If polio and measles vaccines are to be stored for a longer period as in the state or district storage center it can be kept at a temperature below 0 ° Celsius or in the freezer compartment of the refrigerator, but it should not be repeatedly frozen and melted. DPT, DT, TT and BCG should not be frozen. No vaccine should be exposed to direct sunlight. Devices used to maintain cold chain: Refrigerators, Walk in coolers, ice bags, Thermocol Boxes, Freezers etc.

33. Immunization Schedule in India   Full form: DPT : Diphtheria Pertussis Tetanus DT : Diphtheria Toxoid BCG: bacille Calmette -Guerin TT ; Tetanus Toxoid OPV : Oral poliovirus vaccines

34. Beneficiaries     Age     Vaccine     No. of doses and Route of administration.       Infants           6 weeks DPT 3 intramuscular   6 to 9 months Polio (OPV) BCG   3 oral 1 intradermal     9 to 12 months Measles Subcutaneous   Children                                     16 to 24 months       DPT (I booster) 1 intramuscular   Polio (I booster )   1 oral       5-6 years             DT (II booster) 1 intramuscular , (2 doses if not immunized previously)   Typhoid 2 subcutaneous.   10 years       Tetanus toxoid 1 intramuscular         Typhoid 1 subcutaneous         16 years       Tetanus toxoid 1 intramuscular         Typhoid 1 subcutaneous         Pregnant women 16 to 36 weeks of pregnancy Tetanus toxoid 2 intramuscular.        

35. Effect of Environment on health

36. U ses of water W hole body contain about two third of water to its total weight, out of which blood contain 79 %, brain 80 % and bone about 10% of water hence water is integral part of body It help in digestion of food I t help in secretion of digestive juices It maintain electrolyte balance in the body It maintain the fluidity of blood It maintain body temperature It helps in the excretion of waste products from the body   Apart from body function it required for following purpose Ex. for cleaning, gardening, swimming, firefighting.   Domestic purpose for drinking, cooking, bathing, washing Industrial purpose like agriculture, iron and steel industry.

37. sources of water Main source of water are: R ain or snow water S urface water: Ex. River, Canal, tank, pond G round water: Ex. well, springs, Lakes S ea water

38. Rain or snow water:   Rain is primary source of all water. R ain water is pure initially but after coming into atmosphere it become impure. ( E xample dust, suspended matter, microbes, gases) A s it is soft it contains no mineral salt in it. It is suitable for cooking, washing, bathing I t is non pathogenic

39. 2. Surface water: R ainwater after reaching the ground comes to river, Canal, lake or pond called as surface water. Surface water may contain suspended particles and disease causing agent and thus it is dangerous to drink. A fter filtration, sterilization, by chlorination it is suitable for drinking.

40. 3. Ground water T he part of rain water which sink into the ground and reach in subsoil to the varying depth is known as ground water.   The groundwater is considered as superior surface water because the ground itself act as a effective filtration medium. so chances of contamination are less. 4. sea water A fter distillation sea water is used for drinking purpose.

41. Wells   Wells are the main source of water supply in the most Indian villages and towns. T hey are artificial hole and pits into the earth. water collected from this pits manually or mechanically. T ypes of wells: Shallow well : It may be less than 10 feet deep Deep well : it may be several Hundred feet deep Tubewell (bore well): it is simply Shallow  well but metallic or plastic pipe is introduced up to 20 to 25 feet deep. Artesian well: T hese are kind of deep well in which water come out under great pressure and rise above the ground level.

42. Pollution Any environmental/natural disturbances create by the Physical, chemical, and biological resources are called as pollutions . Pollution is any undesirable change in physical, chemical or biological characteristics of air, land, water or soil. Agents that bring about such an undesirable change are called as pollutants . In order to control environmental pollution, the Government of India has passed the Environment (Protection) Act, 1986 to protect and improve the quality of our environment (air, water and soil). Types of pollution —On the basis of sources many types of pollution given below—  Water pollution.  Noise pollution.  Air pollution.  Plastic pollution.  Radioactive pollution.  Soil pollution.

43. water pollution When natural taste and color of water can be changed and bad smell come out from water due to any kind of contamination is known as water pollution . W ater is said to be polluted when it is contaminated with: D issolved gases like H2S, CO2, NH3 D issolved minerals like sodium, calcium & magnesium salt S uspended impurities like clay and mud Microorganisms and organic matter

44. sources of water pollution Sewage : it contain waste water which is having a decomposable organic matter and pathogenic microorganisms. Industrial and trade waste : which contain toxic Chemicals. A gricultural pollutant which contain pesticides and fertilizers. P hysical pollutants like radioactive substances. U sage by human beings example animal washing & washing of clothes. Acidic rain is also a one of the source which caused the water pollution

45. methods of water purification 1. Small scale purification method B oiling Distillation F iltration through cloth C hemical filtration D omestic filters 2. Large scale purification of water Slow sand filtration (SSF, biological filtration) Rapid sand filtration (RSF, mechanical filtration) The waste water can be make usable by using purification methods which removed the contamination present in water.

46. 1 . small scale filtration 1. Boiling: B oiling of water for 5 to 10 minutes kill all the living microorganism and produce sterilized water. 2. Distillation: it also good method during this method all kinds of dissolved impurities can be removed  even volatile also. 3. Filtration through clothes: in this method muslin cloth act as a course filter which can remove suspended material. B ut water filter through muslin cloth is not safe for drinking because it contain dissolved impurities.

47. 4. Chemical filtration: there are various types of chemical agent used for disinfection of water. a) bleaching powder : it contain 33% chlorine. it act as disinfectant by liberating chlorine in water. b) chlorine tablets : one tablet contain 4.5 gram of chlorine that is sufficient for 20 litres of water. c) Iodine: it is used only in emergency but it is costly. d)   P otassium permanganate: it is strong oxidizing agent which kill the Cholera bacteria but it alter the taste smell and colour of water. e) Domestic filter : filtration is done through ceramic filter such as pasteur chamber land filter, berkefeld filter, katadyn filter . T his filter used to remove the bacteria found in drinking water

48. 2. Large scale purification of water  slow sand filtration It is a type of water purification system which effectively remove turbidity and pathogenic microorganisms. a) supernatant water : It is supernatant water present above the sand with its depth vary from 1 to 1.5 m. T he raw water is passed over sand bed and by gravitational force it will flow downward to carry out filtration.

49. b) Graded sand bed   The sand bed is most important component and this is filtering the water. T his consists of sand of different particle size and thickness. T he finest sand is on the top and comparatively coarse sand present below that, water is percolated through the bed very slowly. T his filter is called as biological filter because the surface of sand gets covered with slimy growth which consists of threade like algae. W ater percolates through this bed very slowly this adsorbed the contaminants present in water and produce good quality water.

50. c) Gravel support: Below the sand bed there is a layer of gravel which support the sand bed. The upper part consists of fine gravel and in the lower part there is coarse gravel d) Under drainage system: J ust below the gravel there is network of corous perforated box is present. This box called as filter box. The walls of box made up of stones, brick or cement through that filter water is removed

51. rapid sand filtration Advantages T he rate of filtration is very fast with rapid sand filter T hey occupy less space as compared to slow sand filter T hey can be used for raw water directly, it reduces the bacterial count up 98 to 99 %.

52. W ater is chemically treated with alum .   The treated water then subjected to Rapid agitation with alum due to this impurities gates precipitated. this is done in mixing chamber . T hen water is stirred slowly to form big floccules of aluminum Hydroxide in the flocculation chamber. This flocculated water is then transfer to sedimentation tank and is allowed to  stand for 1 to 6 hours. when floccules settle down the supernatant water is ready for filtration and floccules from the bottom are removed.

53. The partially clarified water is then subjected to rapid sand filtration in the filter beds.   The filtering medium is sand and this is supported by course gravel . Chlorination is most effective method in water purification that is the addition of chlorine to filter water for further purification. Chlorine kills bacteria, oxidized iron, magnesium, hydrogen sulfide and organic matter. C hlorine also control algae, slim organisms and help in the process of coagulation.

54. water borne disease   Consumption of contaminated water with pathogenic microorganisms leads to so many disease known as water borne  disease.   Water harms the many organs and causes the serious problem. Kidney disease, heart disease, lungs disease, etc. Classification of water borne disease 1. Bacterial disease: Ex . Diarrhoea , dysentery, typhoid, cholera. 2 . Viral disease: Ex. Poliomyelitis, Viral hepatitis. 3 .   Protozoal disease : Ex. Amoebiasis , Giardiasis 4. W orm infection : Ex Roundworm, Tapeworm 5 . D isease due to toxic substances: Ex. Lead, Arsenic, Copper, Mercury, Cadmium.

55. hardness of water T he soap destroying power of water known as hardness of water. W ater is said to be hard when it contains calcium and magnesium ions. Two types of hardness of water; Temporary hardness: I t is due to the presence of dissolved calcium, bicarbonate and Magnesium Bicarbonate in water. Permanent hardness: I t is type of hardness that cannot be removed by boiling. I t is caused due to the presence of sulphate , chloride, nitrate in the water. R emoval of hardness of water: H ardness of water is removed by boiling and by addition of lime water. I t also remove by addition of sodium carbonate.

56. Importance of safe drinking water Water which is suitable for drinking is called potable water. Due to use of clean and safe water we always will be safe from disease. Due to the safe water drinking, metabolism activity perform properly, Then you will always be healthy. We always away from infectious disease and water borne diseases.

57. air pollution When air is contaminated by unwanted substances which have a harmful effect on both the living and the non-living, it is referred to as air pollution. Air consists of a mixture of gases. By volume, about 78% of this mixture is nitrogen and about 21% is oxygen. Carbon dioxide, argon, methane, ozone and water vapors are also present in very small quantities. According to Central Pollution Control Board (CPCB), particulate size 2.5 micrometers or less in diameter (PM 2.5) are responsible for causing the greatest harm to human health. The substances which contaminate the air are called air pollutants.

58. Sources or causes of air pollution Industry like Chemicals, textile, Fertilizer and oil refinery. Combustion of coal, oil and other fuel produces Sulphur dioxide, carbon dioxide, carbon monoxide, hydrogen sulphide and fluorine etc. Motor vehicles emits harmful organic and inorganic compounds. Used of insecticide ,radioactive substances also contribute to air pollution. Respiration of men and animal causes air pollution . By bad habits like smoking. Natural Sources like dust, pollen, fungi, bacteria also causes air pollution. Chlorofluorocarbons (CFCs) which are used in refrigerators, air conditioners and aerosol sprays. CFCs damage the ozone layer of the atmosphere.

59. effect of air pollution on health C ontaminated air may causes respiratory tract disorders  such as asthma, bronchitis, lungs cancer, cough, wheezes, sore throat, eye irritation. A ir pollution also causes retardation of growth in plants, spotting and burning of leaves. A ir pollution also affect respiratory system of animal. Depletion of the Ozone Layer - CFCs are major cause of Ozone layer depletion. It causes contamination of upper atmosphere and the alteration of weather and climate. Acid Rain — Acidic rain is damages the monuments like ‘ Taj Mahal ’. Pollutant like sulphur dioxide and nitrogen dioxide gases react with the water vapors present in the atmosphere to form sulphuric acid and nitric acid. The acids drop down with rain, making the rain acidic. This is called acid rain.

60. airborne disease A disease due to contaminated air is called airborne disease. Example: Asthma, Tuberculosis, Chickenpox, Diphtheria, Measles, pneumonia, wooping cough

61. methods to control air pollution   Contentment : This is prevention of escape of toxic substances in the air. Replacement: It is replacing process in which we use energy resources which will not causes pollution. Ex. Using natural gas instead of oil and coal or used electricity   Dilution : The contaminants present in the air are diluted by plantation. Legislation : Many country have adopted legislation to control air pollution. In India there is ‘Smoke N uisance Act’ which is effective in big cities against pollution.   International Laboratories : by establishing International network of Laboratories for the study of air pollution.

62. noise pollution N oise it can be defined as an unwanted sound that is wrong sound in the wrong place at the wrong time. The unit of sound is decibel (dB) A brief exposure to extremely high sound level, 150 dB or more generated by takeoff of a jet plane or rocket, may damage ear drums thus permanently impairing hearing ability.   Source   of noise Various sources are automobile, factories, Industries, aircrafts ,domestic noise, from radio and television.

63. effect of noise on human health N oise pollution may produces fatigue, Vertigo, headache, decreasing hearing ability, feeling of tiredness. I t produces temporary or permanent deafness. I t leads to irritability and anger. I t also leads to lack of mental concentration. P hysiological changes like rise in blood pressure, heart rate, headache occurs in body.

64. Control/ preventive measures T o avoid this, control the source of noise. Sound producing machine should be enclosed in a soundproof room. It should be oil, grease, repaired or replaced periodically.   The use of loudspeaker should be banned from 10 p.m. to 11 p.m . Building can be design with suitable noise absorbing material for wall, window and ceilings. For people working in noisy area, ear protection aids like ear plugs, muffs, noise, helmet etc. should be provided. Social awareness program should be taken up to educate the public about the causes and effect of noise pollution. P lanting bushes or trees to avoid noise pollution.

65. solid waste   S olid waste are unwanted or discarded material. They may contain dust, ash, paper, fruits, vegetables, Industrial and agricultural matter. It also be denoted by the term refuse . Health hazards of solid waste T hey attract flies and rats. T hey produce bad flavor. They may produced air pollution. There is a possibility of water pollution if rain water passes through refuse on fermentation.

66. sources of solid waste or refuse  Street refuse collected by cleaning street Market Refuse Industrial Refuse Domestic R efuse

67. solid waste disposal methods T hey may be disposed by following methods; Dumping method : It is smallest, simplest, easiest method of disposal of refuse. In this method refuse is dump in low lying area. Due to bacterial growth it reduces its volume and converted into humus. Disadvantages: It is exposed to flies and rodents. It emits foul smell. It may lead to water pollution. It is dispersed by wind 2. Burning/ incineration method : it is not an useful method except for the disposal of hospital refuse. In this method refuse is exposed by burning. Disadvantages: It is expensive. Dust and ash must be separated after incineration. It produces air pollution.

68. 3. Compositing method: It is a method of combine disposal of refuse and sludge. It is a natural process where organic matter break down under bacterial action, resulting in formation of humus like material called the compost, which is used as manure. 4.   Burial method: I n this method the refuse is dumped in stench of 20 to 30 cm and cover with soil. After one strength is full another strange is filled in the same way. The content of the strange may be taken out after 4 to 6 month and they can be used as a manure.

69. sewage I t contain waste water, excreta, Industrial waste and wastewater from public places. It look like very dirty water with a bad smell. It contain inorganic and organic matter and also form disease producing organism.   Sewage contain 99.9% water and 0.1% solids. The solids include organic and inorganic substances, microorganisms, dust, fibers. The organic matter decomposes naturally due to action of bacteria present in it and that's why foul smell produces.

70. aim of sewage treatment Sewage treatment include physical, biological and chemical process to remove pollutants. I ts aim is to produce and environmentally safe water called effluent and a solid waste called sludge safe for disposal. S ewage treatment generally involve three stages: 1.   Primary treatment : primary treatment remove material that can be easily collected from the raw sewage. Example: Trash, tree, leaves, branches etc. T he settled and floating material are removed and remaining liquid may be subjected to secondary treatment 2. S econdary treatment: it removes dissolved and suspended biological matter and microorganisms. 3. T ertiary treatment: the purpose of tertiary treatment is to produce a final treatment to raise the effluent quality before discharge into environment . I n this disinfection is the final process.

71. Septic tank S eptic tank is a underground waste water treatment system usually made of concrete or polyethylene with an inlet and outlet pipe.  the wastewater flows from the home comes into the septic tank through an inlet pipe it work by holding the waste water in the tank and separate the solids and liquid material.

72. T he waste water forms 3 layer inside the tank slight lighter layer than water (such as oil and grease) float at the top forming a layer of scum . S olid are heavier than water which settle at the bottom and forming a layer of sludge which is  then subjected to degradation by anaerobic bacteria. M iddle layer is of partially clarified wastewater. The sludge & scum remain in the septic tank. T he layer of clarified liquid flow from septic tank to drain field or outlet.

73. Occupational illness Occupational illnesses are the serious problem for the working person due to workplace specific hazards. It occurs as a result of exposure to physical, chemical, biological and physiological factors in the workplace. Generally harmful chemical are present in the workplace area and cause the adverse health conditions and damage the people. Example- Lead, Arsenic, Pesticides, mercury, silica.

74. Sources of Occupational illness Paint industries Cement industries. Coal industries. Pesticides industries Pharmaceutical industries. Radioactive manufacturing industries.

75. Occupational disease— Skin disorders — Allergic reactions, dermatitis, skin rashes, itching, skin cancer. Respiratory disorders — Shortness of breath, Chest pain, Chest tightness, Abnormal breathing pattern, asthma etc Neurological disorders — headache, memory disturbance, and peripheral neuropathy, multiple sclerosis, Alzheimer's disease, Parkinson's disease, epilepsy, and stroke. Hematological disorders — Leukemia, blood disorders etc. Musculoskeletal disorders — Muscular spasm, Tendinitis, Carpal tunnel syndrome, Osteoarthritis, Rheumatoid arthritis, Fibromyalgia, Ligament Sprain. Hepatic disorders — Hepatitis A, B, and C, cirrhosis. Cardiovascular disorders —— Ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD, Coronary Artery Disease (CAD),Heart Arrhythmia, Dilated Cardiomyopathy , Pulmonary Stenosis . Renal and Urinary disorder — urinary defects, prostate cancer, kidney failure. Reproductive and development disorder— Reproductive tract infections, congenital abnormalities, cancers of the reproductive system and sexual dysfunction.

76. Precaution against occupational disease— Regular replacement of the non-hazardous substance for hazardous one. Job redesign, work organization, work practices regular necessary condition and alternative. Installation of engineering control and devices and provide the educational knowledge and advice For the worker, provide high quality of personal protective equipment

77. Environmental pollution due to pharmaceuticals Pharmaceutical companies’ release the harmful gaseous like carbon dioxide, nitrous oxide, methane, sulphur compounds etc. which effects the air and cause the air pollution. Due to air we face many problem like- respiratory disease ( Emphysema, breathing in comfort, suffocation, etc), ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD),brain disease. It also a causative agent of green house effects. When the pharmaceutical wastes are thrown in the soil then its chemical directly involved in soil and causes the soil pollution and affects the productivity.

78. Pharmaceutical drainage directly affects the water and causes the water pollution. Due to pollution many disease borne like diarrhoea , cholera, dysentery, typhoid and poliomyelitis etc. In pharmaceutical companies, machinery work performs which produced loud noise and cause the noise pollution. Many radioactive materials are released by the pharmaceutical company like X-Ray, Gamma-Ray, heavy metal ions etc. which directly affects the health and causes the chronic disorders.

79. Psychosocial Pharmacy Definition— The term psychosocial refers to the psychological and social factors that influence mental health. Social influences such as peer pressure, parental support, cultural and religious background, socioeconomic status, and interpersonal relationships all help to shape personality and influence psychological makeup. Drugs and their Misuses 1 . Psychotropics products. Psychotropic drugs are those drugs which affect the mood, thoughts, and behaviours . It is directly belongs to the mental activity. Psychotropic are generally used to maintain brain chemicals, or neurotransmitters, like dopamine, GABA (gamma amino butyric acid), nor epinephrine, and serotonin.

80. There are five major classes of legal psychotropic medications: Antipsychotics. Antidepressants. Anti-anxiety agents. Mood stabilizers. Stimulants. Misuse of the drugs- many people are used to psychotropic drug to release the stress and anxiety but long terms use it causes the addictive effects on the brain and causes the dependency. Some people are also use to increase working efficiency.

81. 2. Narcotics product— Narcotics products are those substances, which is directly binds to the brain opioids receptors and relieves the moderate to severe pain. The drugs, which are commonly abused, are opioids, cannabinoids and coca alkaloids. Majority of these are obtained from flowering plants. Some are obtained from fungi. Misuse of the drugs: T hese types of drugs is a prescribed type of drugs, without any prescription it is not use because it causes the dependency . Many people are used this substances as a stimulants it is one of the major misuse of this products.

82. 3. Alcohol . Alcohol generally used alcohol used by the person is known as ethyl alcohol. It is also used as medication in limited amount for releases the stress, depressions etc. Misuse of the drugs — It is one which are also cause the addictive effect. High dose of alcohol causes the dangerous effects and causes the severe effects. Due to high dose person loss their mental alertness and behaves as wild types (bad habits).

83. 4. Tobacco Tobacco contains a large number of chemical substances including nicotine, an alkaloid. Nicotine stimulates adrenal gland to release adrenaline and nor-adrenaline into blood circulation, both of which raise blood pressure and increase heart rate. Smoking is associated with increased incidence of cancers of lung, urinary bladder and throat, bronchitis, emphysema, coronary heart disease, gastric ulcer, etc. Tobacco chewing is associated with increased risk of cancer of the oral cavity . Smoking increases carbon monoxide (CO) content in blood and reduces the concentration of haembound oxygen. This causes oxygen deficiency in the body . Smoked tobacco products include cigarettes, cigars, bidis , etc. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip. Misuse of the drugs—Tobacco addiction is caused by a dependency on nicotine and habits formed by smoking or using chewing tobacco. Some people are used as stimulant but high amount causes the severe problems.

84. 5. Adolescence and Drug/Alcohol Abuse. Surveys and statistics show that use of drugs and alcohol has been on the rise especially among the youth. This is really a cause of concern as it could result in many harmful effects. Proper education and guidance would enable youth to safeguard themselves against these dangerous behavior patterns and follow healthy lifestyles. Adolescence means both ‘a period’ and ‘a process’ during which a child becomes mature in terms of his/her attitudes and beliefs for effective participation in society. The period between 12-18 years of age may be thought of as adolescence period. In other words, adolescence is a bridge linking childhood and adulthood. Adolescence is accompanied by several biological and behavioral changes. Adolescence thus is a very vulnerable phase of mental and psychological development of an individual.

85. Suicidal behaviours Suicide is not a mental illness but a serious potential consequence of treatable mental disorders that include major depression, bipolar disorder , post traumatic stress disorder, borderline personality disorder, schizophrenia, substance use disorders, anxiety disorders, and eating disorders like bulimia. Social Impact of these habits on social health and productivity . Suicidal behaviours is not a solution of any problems. Its leave a negative impression in the social community.  Alcohol abuse among adolescents are unstable or unsupportive family structures and peer pressure.

86. Prevention and control of these habits.  Teacher and educational, play a major role to control this activity.  Parenting that combines with high levels of nurturance and consistent discipline, has been associated with lowered risk of substance (alcohol/drugs/tobacco) abuse. Some of the measures mentioned here would be particularly useful for prevention and control of alcohol and drugs abuse among adolescents. 1. Avoid undue peer pressure. 2. Education and counseling. 3. Seeking help from parents and peers. 4. Looking for danger signs. 5. Seeking professional and medical help.

87. REFERENCE: 1.Social Pharmacy, By Jagtap D.B., Gaikwad V.S. S,V. Bhise , Brilliant publication 2.SOCIAL PHARMACY (First Year FY Diploma Pharmacy - PCI's ER 2020), By Dr. S.B. Bhise , Mrs. M S Bhise , Nirali Prakashan . 3.Social Pharmacy, By Dr. Virendra Kumar , Thakur Publication.

88. Thank you…………