Causes & prevention of disabilities

Its a General , Genetic, Medical ,Psychological and Social causes & Prevention of Disabilities.

1. Causes & Prevention of disabilities. Disability prevention needs awareness… Dr Saim Ali Soomro. MBBS,MCCM. * Core Public Health Functions for BC: Evidence Review Prevention of Disabilities (Congenital & Genetic) Ministry of Health 2008

2. What is Disability ? Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An  impairment  is a problem in body function or structure; an  activity limitation  is a difficulty encountered by an individual in executing a task or action; while a  participation restriction  is a problem experienced by an individual in involvement in life situations. Thus, disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives. [1]

3. Causes of Disabilities Disability can happen to Any one…at any age ..and due to any Circumstances. We can divide etiology into many type of Classification models.

4. Causes …Social /Medical. Pre Natal Causes: The period between conception to birth   . Germinal period 10-14 days long, Embryonic stage 2-8 th week. Fetal stage (8 th week to termination of pregnancy). over 3,000 different genetic causes of disability Teratogens: agents causing a defect in a developing embryo or fetus Infections Radiation Maternal nutrition Maternal stress Low birth weight Chromosomal disorders Developmental disorders of brain formation Environmental influences

5. Peri natal causes Anoxia and asphyxia Prematurity- prior to 37 weeks Low birth weight –under 5 ½ pounds Hemorrhages Metabolic problems Seizures Birth problems Multiple births Abnormal presentation prolapsed umbilical cord Respiratory distress syndrome lack of surfactant (coats the alveoli)Can result in collapsed alveoli Jaundice Rhesus incompatibility

6. Postnatal causes Thalidomide legal drugs (alcohol, nicotine, caffeine), prescription drugs (some  antibiotics, hormones, steroids, anticoagulants, anticonvulsants, tranquilizers, methadone),  illegal drugs (cocaine, heroin, marijuana), and environmental pollutants (including lead,  Arsenic, methyl mercury , and polychlorinated biphenyls, or PCBs).  Quality of attachment Illnesses/ Medicines Encephalitis Meningitis Poisoning Malnutrition Injuries

7. Psychosocial factors Social correlates Low SES Nutrition Poverty Family size Low maternal intelligence Low maternal educational level Absence of parents Language environment Psychological correlates Child rearing practices Abuse and neglect Fetal Alcohol Syndrome Head injuries

8. Genetic disorders A normal female genetic map . Down syndrome. Edwards syndrome. Patau syndrome. Albert’s, Alports , Morquo’s & many many more. ADHD, Albinos, Night blindness, hearing loss in families.. Hemophilias , Sickle cell disease, Thallesemias .

9. Genetic Disorders Some prime examples of Mental retardations as a result of Genetic disorders are……. Ct to next page.. Genetic Disorders can cause : Blindness. Hearing impairments. Physical disabilities. Mental impairments . Chronic & familial diseases like dementias, Diabetes Mellitus, CVDs, etc which can lead to various disabilities.

10. Down Syndrome Trisomy 21

11. Turner’s syndrome Affects females Incomplete x chromosome Short stature Webbed neck Low hairline in back Skeletal deformities

12. Fragile X Syndrome Mental retardation   Hyperactivity  Short attention span  *Tactilely defensive  Hand-flapping  Hand-biting  Poor eye contact  * Perseverative speech   * Hyperextensible MP joints  Large or prominent ears   Large testicles  *Simian crease or Sydney line  Family history of mental retardation In males, generally see a decrease in IQs over time Concrete thinking Facial features: Long face High arched palate Long ears In females, less like to have a label of retardation; less severe features

13. Diagnosis, Prevention & Treatment Pre-conception programs α Pre-conception programs can prevent birth defects and low birth weight through targeting smoking cessation, pregnancy intervals, folic acid supplementation and interventions with women with diabetes to improve control of blood sugar levels. Maternal serum screening (MSS) and ultrasound can detect some congenital anomalies. α A large proportion of women are choosing termination following positive screening tests. α Disparities may exist in accessing MSS and termination with respect to education and culture.

14. Exposure to Environmental Risk factors Better diabetic management . MMR vaccination. Tetanus vaccination. There is evidence of increased risk of congenital anomalies and low birth weight for babies born to women exposed to higher than normal levels of some environmental contaminants. Attention to the level of contaminants by monitoring water, air, industrial and waste sites, and occupational exposure is warranted . Pesticide exposure in agricultural communities, and in agricultural workers and their families, merits monitoring

15. Prevention of Disabilities A strong system of perinatal assessments, serial ultra sounds, biochemical & Blood tests. Starts from genetic assessment of aspiring couples. Maternal Serum Assessment . Amniotic fluid examination. Prevention of infection (MMR) Folate & Iron Supplemets .

16. Prevention of Disabilities Folic acid supplements Maternal ultra sounds. Intra uterine surgeries to correct deformities. Nutritional support

17. Prevention……. New born Screening is most important. New Born Screening, Diagnosis and treatment or earliest possible rehabilitation. Earliest possible enrolment in family, community rehab systems.

18. CORE PUBLIC HEALTH REVIEW OF BC. Prevention of Disabilities (Congenital & Genetic) Population Health and Wellness BC Ministry OF HEALTH…2008. 16x9 4x3 * Medscape.com Thank you………!