CAUSES & PREVENTION OF DISABILITIES.

Disability prevention needs awareness…

Dr Saim Ali Soomro. MBBS,MCCM.

*Core Public Health Functions for BC: Evidence ReviewPrevention of Disabilities (Congenital & Genetic) Ministry of Health 2008

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]

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.

Causes …Social /Medical.

Pre Natal Causes:

•The period between conception to birth .

•Germinal period 10-14 days long, Embryonic stage 2-8th week. Fetal stage (8th 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

Peri n

ata

l ca

use

s

•Anoxia and asphyxia•Prematurity- prior to 37 weeks•Low birth weight –under 5 ½ pounds•Hemorrhages•Metabolic problems•Seizures•Birth problems

Multiple birthsAbnormal presentationprolapsed umbilical cord

•Respiratory distress syndromelack of surfactant (coats the alveoli)Can result in collapsed alveoli

•Jaundice•Rhesus incompatibility

Postnatal causes

Thalidomidelegal 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

Psychosocial factorsSocial correlates

Low SESNutrition PovertyFamily sizeLow maternal intelligenceLow maternal educational levelAbsence of parentsLanguage environment

Psychological correlatesChild rearing practicesAbuse and neglectFetal Alcohol Syndrome Head injuries

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.

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.

Down Syndrome

Trisomy 21

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

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 thinkingFacial features:

Long faceHigh arched palateLong ears

In females, less like to have a label of retardation; less severe features

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.

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

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.

Prevention of Disabilities

Folic acid supplements

Maternal ultra sounds. Intra uterine surgeries to

correct deformities. Nutritional support

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.

CORE PUBLIC HEALTH REVIEW OF BC.

Prevention ofDisabilities(Congenital & Genetic)Population Health and WellnessBC Ministry OF HEALTH…2008.

16x9

4x3

*Medscape.com

Thank you………!