starvation.pptx community medicine environment

Community medicine _ environmental health_Nutrition_ Starvation

1. STARVATION

2. Starvation Manifestation of starvation occurs when min. req. of calorie is not met Causes; Total deprivation of food Partial deprivation of food

3. Normal calorie requirement; Desk job worker – 30-35 calories per kg per day Or For an ideal wt. of 60kg – 1800-2100calories per day

4. Classification of starvation Acute starvation ; Entombment in pits, mines, landslide, earthquakes Willful withholding Chronic starvation Concentration camps Famines

5. Symptoms Feeling of hunger gradually increased for 2 days Then feeling of hunger subsides but thirst becomes intense Apathy and fatigue Progressive loss of body wt. Emaciation (loss of body subcutaneous fat) Nutritional anemia Skin – dry, wrinkled, pigmented, ulcers

6. Symptoms Lips dry, cheek hollow, eyes sunken, coated dry tongue, thick scanty saliva, feeble voice Abdomen. Concave Hair – dry Nails brittle

7. Symptoms Subnormal temp. Feeble pulse Scanty urine with acetone smell Constipation or terminal non-infective diarrhoea

8. Fatal period; Without food and water – 7-10days With only water – 50-60days Female with stand better Healthy better than sick Obese better than lean Loss of 40% body wt. – fatal

9. Cause of death; Inanition Circulatory failure Inter current infections

10. Postmortem appearance External appearance; Features already told Rigor mortis comes early and lasts for short period Decomposition sets in early

11. Postmortem appearance

12. Internal appearance; Blood – less All organs – wt. and size reduction Heart, liver, liver, kidney and spleen pale and atrophied Omental and mesenteric fat is lost Atrophied GIT Stomach empty, wider, small intestine wall thin, almost transparent

13. Gall bladder is always full and distended There may be gall stones Bones demineralized – areas of rarefaction on X-Rays In children – skeleton shows spinal curvature, rickets and dental defects In adults – progressive osteomalacia and stress fractures

14. Medico-legal issues Whether it was Suicidal, homicidal or accidental To rule out mental illness Rare disease like stricture of esophagus Hunger strike (forceful feeding is lawful) Homicidal starvation – illegitimate children Old and helpless people Accidental cases – ship wreck, entombment in mines