8.1 Common Diseases in
Humans
8.2 Immunity
8.3 AIDS
8.4 Cancer
8.5 Drugs and Alcohol Abuse
Health, for a long time, was considered as a state of body
and mind where there was a balance of certain ‘humors’.
This is what early Greeks like Hippocrates as well as
Indian Ayurveda system of medicine asserted. It was
thought that persons with ‘blackbile’ belonged to hot
personality and would have fevers. This idea was arrived
at by pure reflective thought. The discovery of blood
circulation by William Harvey using experimental method
and the demonstration of normal body temperature in
persons with blackbile using thermometer disproved the
‘good humor’ hypothesis of health. In later years, biology
stated that mind influences, through neural system and
endocrine system, our immune system and that our
immune system maintains our health. Hence, mind and
mental state can affect our health. Of course, health is
affected by –
(i) genetic disorders – deficiencies with which a child is
born and deficiencies/defects which the child inherits
from parents from birth;
(ii) infections and
(iii) life style including food and water we take, rest and
exercise we give to our bodies, habits that we have or
lack etc.
The term health is very frequently used by everybody. How do we
define it? Health does not simply mean ‘absence of disease’ or ‘physical
fitness’. It could be defined as a state of complete physical, mental and
social well-being. When people are healthy, they are more efficient at
work. This increases productivity and brings economic prosperity. Health
also increases longevity of people and reduces infant and maternal
mortality.
Balanced diet, personal hygiene and regular exercise are very important
to maintain good health. Yoga has been practised since time immemorial
to achieve physical and mental health. Awareness about diseases and
their effect on different bodily functions, vaccination (immunisation)
against infectious diseases, proper disposal of wastes, control of vectors
and maintenance of hygiene in food and water resources are necessary
for achieving good health.
When the functioning of one or more organs or systems of the body is
adversely affected, characterised by appearance of various signs and
symptoms, we say that we are not healthy, i.e., we have a disease. Diseases
can be broadly grouped into infectious and non-infectious. Diseases
which are easily transmitted from one person to another, are called
infectious diseases. Infectious diseases are very common and every
one of us suffers from these at sometime or other. Some of the infectious
diseases like AIDS are fatal. Among non-infectious diseases, cancer is the
major cause of death. Drug and alcohol abuse also affect our health adversely.
8.1 COMMON DISEASES IN HUMANS
A wide range of organisms belonging to bacteria, viruses, fungi,
protozoans, helminths, etc., could cause diseases in man. Such disease-
causing organisms are called pathogens. Most parasites are therefore
pathogens as they cause harm to the host by living in (or on) them. The
pathogens can enter our body by various means, multiply and interfere
with normal vital activities, resulting in morphological and functional
damage. Pathogens have to adapt to life within the environment of the
host. For example, the pathogens that enter the gut must know a way of
surviving in the stomach at low pH and resisting the various digestive
enzymes. A few representative members from different groups of
pathogenic organisms are discussed here alongwith the diseases caused
by them. Preventive and control measures against these diseases in general,
are also briefly described.
Salmonella typhi is a pathogenic bacterium which causes typhoid
fever in human beings. These pathogens generally enter the small intestine
through food and water contaminated with them and migrate to other
organs through blood. Sustained high fever (39° to 40°C), weakness,
stomach pain, constipation, headache and loss of appetite are some of
the common symptoms of this disease. Intestinal perforation and death
may occur in severe cases. Typhoid fever could be confirmed by
Widal test : A classic case in medicine, that of Mary Mallon nicknamed
Typhoid Mary, is worth mentioning here. She was a cook by profession
and was a typhoid carrier who continued to spread typhoid for several
years through the food she prepared.
Bacteria like Streptococcus pneumoniae and Haemophilus influenzae
are responsible for the disease pneumonia in humans which infects the
alveoli (air filled sacs) of the lungs. As a result of the infection, the alveoli
get filled with fluid leading to severe problems in respiration. The symptoms
of pneumonia include fever, chills, cough and headache. In severe cases,
the lips and finger nails may turn gray to bluish in colour. A healthy
person acquires the infection by inhaling the droplets/aerosols released
by an infected person or even by sharing glasses and utensils with an
infected person. Dysentery, plague, diphtheria, etc., are some of the other
bacterial diseases in man.
Many viruses also cause diseases in human beings. Rhino viruses
represent one such group of viruses which cause one of the most infectious
human ailments – the common cold. They infect the nose and respiratory
passage but not the lungs. The common cold is characterised by nasal
congestion and discharge, sore throat, hoarseness, cough, headache,
tiredness, etc., which usually last for 3-7 days. Droplets resulting from
cough or sneezes of an infected person are either inhaled directly or
transmitted through contaminated objects such as pens, books, cups,
doorknobs, computer keyboard or mouse, etc., and cause infection in a
healthy person.
Some of the human diseases are caused by protozoans too. You might
have heard about malaria, a disease man has been fighting since many
years. Plasmodium, a tiny protozoan is responsible for this disease. Different
species of Plasmodium (P. vivax, P. malaria and P. falciparum) are
responsible for different types of malaria. Of these, malignant malaria caused
by Plasmodium falciparum is the most serious one and can even be fatal.
Let us take a glance at the life cycle of Plasmodium (Figure 8.1).
Plasmodium enters the human body as sporozoites (infectious form)
through the bite of infected female Anopheles mosquito. The parasites
initially multiply within the liver cells and then attack the red blood cells
(RBCs) resulting in their rupture. The rupture of RBCs is associated with
release of a toxic substance, haemozoin, which is responsible for the chill
and high fever recurring every three to four days. When a female Anopheles
mosquito bites an infected person, these parasites enter the mosquito’s
body and undergo further development. The parasites multiply within
them to form sporozoites that are stored in their salivary glands. When
these mosquitoes bite a human, the sporozoites are introduced into his/
her body, thereby initiating the events mentioned above. It is interesting
to note that the malarial parasite requires two hosts – human and
mosquitoes – to complete its life cycle (Figure 8.1); the female Anopheles
mosquito is the vector (transmitting agent) too.
Entamoeba histolytica is a protozoan parasite in the large intestine of
human which causes amoebiasis (amoebic dysentery). Symptoms of
this disease include constipation, abdominal pain and cramps, stools
with excess mucous and blood clots. Houseflies act as mechanical carriers
and serve to transmit the parasite from faeces of infected person to food
and food products, thereby contaminating them.
Drinking water and food contaminated by the faecal
matter are the main source of infection.
Ascaris, the common round worm and Wuchereria,
the filarial worm, are some of the helminths which are
known to be pathogenic to man. Ascaris, an intestinal
parasite causes ascariasis. Symptoms of these disease
include internal bleeding, muscular pain, fever, anemia
and blockage of the intestinal passage. The eggs of the
parasite are excreted along with the faeces of infected
persons which contaminate soil, water, plants, etc. A
healthy person acquires this infection through
contaminated water, vegetables, fruits, etc.
Wuchereria (W. bancrofti and W. malayi), the filarial
worms cause a slowly developing chronic inflammation
of the organs in which they live for many years, usually
the lymphatic vessels of the lower limbs and the disease
is called elephantiasis or filariasis (Figure 8.2). The
genital organs are also often affected, resulting in gross
deformities. The pathogens are transmitted to a healthy
person through the bite by the female mosquito vectors.
Many fungi belonging to the genera Microsporum,
Trichophyton and Epidermophyton are
responsible for ringworms which is one of
the most common infectious diseases in man.
Appearance of dry, scaly lesions on various
parts of the body such as skin, nails and
scalp (Figure 8.3) are the main symptoms of
the disease. These lesions are accompanied
by intense itching. Heat and moisture help
these fungi to grow, which makes them thrive
in skin folds such as those in the groin or
between the toes. Ringworms are generally
acquired from soil or by using towels, clothes
or even the comb of infected individuals.
Maintenance of personal and public hygiene is very important for
prevention and control of many infectious diseases. Measures for personal
hygiene include keeping the body clean; consumption of clean drinking
water, food, vegetables, fruits, etc. Public hygiene includes proper disposal
of waste and excreta; periodic cleaning and disinfection of water reservoirs,
pools, cesspools and tanks and observing standard practices of hygiene
in public catering. These measures are particularly essential where the
infectious agents are transmitted through food and water such as typhoid,
amoebiasis and ascariasis. In cases of air-borne diseases such as
pneumonia and common cold, in addition to the above measures, close
contact with the infected persons or their belongings should be avoided.
For diseases such as malaria and filariasis that are transmitted through
insect vectors, the most important measure is to control or eliminate the
vectors and their breeding places. This can be achieved by avoiding
stagnation of water in and around residential areas, regular cleaning of
household coolers, use of mosquito nets, introducing fishes like Gambusia
in ponds that feed on mosquito larvae, spraying of insecticides in ditches,
drainage areas and swamps, etc. In addition, doors and windows should
be provided with wire mesh to prevent the entry of mosquitoes. Such
precautions have become more important especially in the light of recent
widespread incidences of the vector-borne (Aedes mosquitoes) diseases
like dengue and chikungunya in many parts of India.
The advancements made in biological science have armed us to
effectively deal with many infectious diseases. The use of vaccines and
immunisation programmes have enabled us to completely eradicate a
deadly disease like smallpox. A large number of other infectious diseases
like polio, diphtheria, pneumonia and tetanus have been controlled to a
large extent by the use of vaccines. Biotechnology (about which you will
read more in Chapter 12) is at the verge of making available newer and
safer vaccines. Discovery of antibiotics and various other drugs has also
enabled us to effectively treat infectious diseases.
8.2 IMMUNITY
Everyday we are exposed to large number of infectious agents. However,
only a few of these exposures result in disease. Why? This is due to the
fact that the body is able to defend itself from most of these foreign agents.
This overall ability of the host to fight the disease-causing organisms,
conferred by the immune system is called immunity.
Immunity is of two types: (i) Innate immunity and (ii) Acquired
immunity.
8.2.1 Innate Immunity
Innate immunity is non-specific type of defence, that is present at the
time of birth. This is accomplished by providing different types of barriers
to the entry of the foreign agents into our body. Innate immunity consist
of four types of barriers. These are —
(i) Physical barriers : Skin on our body is the main barrier which
prevents entry of the micro-organisms. Mucus coating of the
epithelium lining the respiratory, gastrointestinal and urogenital
tracts also help in trapping microbes entering our body.
(ii) Physiological barriers : Acid in the stomach, saliva in the mouth,
tears from eyes–all prevent microbial growth.
(iii) Cellular barriers : Certain types of leukocytes (WBC) of our body
like polymorpho-nuclear leukocytes (PMNL-neutrophils) and
monocytes and natural killer (type of lymphocytes) in the blood as
well as macrophages in tissues can phagocytose and destroy
microbes.
(iv) Cytokine barriers : Virus-infected cells secrete proteins called
interferons which protect non-infected cells from further viral
infection.
8.2.2 Acquired Immunity
Acquired immunity, on the other hand is pathogen specific. It is
characterised by memory. This means when our body encounters a
pathogen for the first time it produces a response called primary
response which is of low intensity. Subsequent encounter with the same
pathogen elicits a highly intensified secondary or anamnestic response.
This is ascribed to the fact that our body appears to have memory of the
first encounter.
The primary and secondary
immune responses are
carried out with the help
of two special types of
lymphocytes present in our
blood, i.e., B-lymphocytes and
T-lymphocytes.
The B-lymphocytes produce an
army of proteins in response to
pathogens into our blood to fight
with them. These proteins are
called antibodies. The
T-cells themselves do not secrete
antibodies but help B cells to
produce them. Each antibody
molecule has four peptide chains,
two small called light chains and
two longer called heavy chains.
Hence, an antibody is represented
as H2
L2
. Different types of antibodies are produced in our body. IgA, IgM,
IgE, IgG are some of them. A cartoon of an antibody is given in Figure
8.4. Because these antibodies are found in the blood, the response is also
called as humoral immune response. This is one of the two types of
our acquired immune response – antibody mediated. The second type is
called cell-mediated immune response or cell-mediated immunity
(CMI). The T-lymphocytes mediate CMI. Very often, when some human
organs like heart, eye, liver, kidney fail to function satisfactorily,
transplantation is the only remedy to enable the patient to live a normal
life. Then a search begins – to find a suitable donor. Why is it that the
organs cannot be taken from just anybody? What is it that the doctors
check? Grafts from just any source – an animal, another primate, or any
human beings cannot be made since the grafts would be rejected sooner
or later. Tissue matching, blood group matching are essential before
undertaking any graft/transplant and even after this the patient has to
take immuno–suppresants all his/her life. The body is able to differentiate
‘self’ and ‘nonself’ and the cell-mediated immune response is responsible
for the graft rejection.
8.2.3 Active and Passive Immunity
When a host is exposed to antigens, which may be in the form of living
or dead microbes or other proteins, antibodies are produced in the host
body. This type of immunity is called active immunity. Active immunity
is slow and takes time to give its full effective response. Injecting the
microbes deliberately during immunisation or infectious organisms
gaining access into body during natural infection induce active
immunity. When ready-made antibodies are directly given to protect
the body against foreign agents, it is called passive immunity. Do you
know why mother’s milk is considered very essential for the new-
born infant? The yellowish fluid colostrum secreted by mother during
the initial days of lactation has abundant antibodies (IgA) to protect the
infant. The foetus also receives some antibodies from their mother,
through the placenta during pregnancy. These are some examples of
passive immunity.
8.2.4 Vaccination and Immunisation
The principle of immunisation or vaccination is based on the property of
‘memory’ of the immune system. In vaccination, a preparation of antigenic
proteins of pathogen or inactivated/weakened pathogen (vaccine) are
introduced into the body. The antibodies produced in the body against
these antigens would neutralise the pathogenic agents during actual
infection. The vaccines also generate memory – B and T-cells that recognise
the pathogen quickly on subsequent exposure and overwhelm the
invaders with a massive production of antibodies. If a person is infected
with some deadly microbes to which quick immune response is required
as in tetanus, we need to directly inject the preformed antibodies, or
antitoxin (a preparation containing antibodies to the toxin). Even in cases
of snakebites, the injection which is given to the patients, contain preformed
antibodies against the snake venom. This type of immunisation is called
passive immunisation.
Recombinant DNA technology has allowed the production of antigenic
polypeptides of pathogen in bacteria or yeast. Vaccines produced using
this approach allow large scale production and hence greater availability
for immunisation, e.g., hepatitis B vaccine produced from yeast.
8.2.5 Allergies
When you have gone to a new place and suddenly you started sneezing,
wheezing for no explained reason, and when you went away, your
symptoms dissappeared. Did this happen to you? Some of us are sensitive
to some particles in the environment. The above-mentioned reaction could
be because of allergy to pollen, mites, etc., which are different in different
places.
The exaggerated response of the immune system to certain antigens
present in the environment is called allergy. The substances to which
such an immune response is produced are called allergens. The antibodies
produced to these are of IgE type. Common examples of allergens are
mites in dust, pollens, animal dander, etc. Symptoms of allergic reactions
include sneezing, watery eyes, running nose and difficulty in breathing.
Allergy is due to the release of chemicals like histamine and serotonin
from the mast cells. For determining the cause of allergy, the patient is
exposed to or injected with very small doses of possible allergens, and the
reactions studied. The use of drugs like anti-histamine, adrenalin and
steroids quickly reduce the symptoms of allergy. Somehow, modern-day
life style has resulted in lowering of immunity and more sensitivity to
allergens – more and more children in metro cities of India suffer from
allergies and asthma due to sensitivity to the environment. This could be
because of the protected environment provided early in life.
8.2.6 Auto Immunity
Memory-based acquired immunity evolved in higher vertebrates based
on the ability to differentiate foreign organisms (e.g., pathogens) from self-
cells. While we still do not understand the basis of this, two corollaries of
this ability have to be understood. One, higher vertebrates can distinguish
foreign molecules as well as foreign organisms. Most of the experimental
immunology deals with this aspect. Two, sometimes, due to genetic and
other unknown reasons, the body attacks self-cells. This results in damage
to the body and is called auto-immune disease. Rheumatoid arthritis
which affects many people in our society is an auto-immune disease.
8.2.7 Immune System in the Body
The human immune system consists of lymphoid organs, tissues, cells
and soluble molecules like antibodies. As you have read, immune system
is unique in the sense that it recognises foreign antigens, responds to
these and remembers them. The immune system also plays an important
role in allergic reactions, auto-immune diseases and organ
transplantation.
Lymphoid organs: These are the organs where origin and/or maturation
and proliferation of lymphocytes occur. The primary lymphoid organs
are bone marrow and thymus where immature lymphocytes differentiate
into antigen-sensitive lymphocytes. After maturation the
lymphocytes migrate to secondary lymphoid organs like spleen,
lymph nodes, tonsils, Peyer’s patches of small intestine and
appendix. The secondary lymphoid organs provide the sites for
interaction of lymphocytes with the antigen, which then proliferate
to become effector cells. The location of various lymphoid organs
in the human body is shown in Figure 8.5.
The bone marrow is the main lymphoid organ where all
blood cells including lymphocytes are produced. The thymus
is a lobed organ located near the heart and beneath the
breastbone. The thymus is quite large at the time of birth but
keeps reducing in size with age and by the time puberty is
attained it reduces to a very small size. Both bone-marrow
and thymus provide micro-environments for the development
and maturation of T-lymphocytes. The spleen is a large bean-
shaped organ. It mainly contains lymphocytes and phagocytes.
It acts as a filter of the blood by trapping blood-borne micro-
organisms. Spleen also has a large reservoir of erythrocytes.
The lymph nodes are small solid structures located at different
points along the lymphatic system. Lymph nodes serve to trap the
micro-organisms or other antigens, which happen to get into the lymph
and tissue fluid. Antigens trapped in the lymph nodes are responsible for
the activation of lymphocytes present there and cause the immune
response.
There is lymphoid tissue also located within the lining of the major
tracts (respiratory, digestive and urogenital tracts) called mucosa-
associated lymphoid tissue (MALT). It constitutes about 50 per cent of
the lymphoid tissue in human body.
8.3 AIDS
The word AIDS stands for Acquired Immuno Deficiency Syndrome.
This means deficiency of immune system, acquired during the lifetime of
an individual indicating that it is not a congenital disease. ‘Syndrome’
means a group of symptoms. AIDS was first reported in 1981 and in the
last twenty-five years or so, it has spread all over the world killing more
than 25 million persons.
AIDS is caused by the Human Immuno deficiency Virus (HIV), a
member of a group of viruses called retrovirus, which have an envelope
enclosing the RNA genome (Figure 8.6). Transmission of HIV-infection
generally occurs by (a) sexual contact with infected person, (b) by
transfusion of contaminated blood and blood products, (c) by sharing
infected needles as in the case of intravenous drug abusers and (d) from
infected mother to her child through placenta. So, people who are at high
risk of getting this infection includes – individuals who have multiple
sexual partners, drug addicts who take drugs intravenously, individuals
who require repeated blood transfusions and children born to an HIV
infected mother. Do you know–when do people need repeated blood
transfusion? Find out and make a list of such conditions. It is important
to note that HIV/AIDS is not spread by mere touch or physical contact; it
spreads only through body fluids. It is, hence, imperative, for the physical
and psychological well-being, that the HIV/AIDS infected persons are
not isolated from family and society. There is always a time-lag between
the infection and appearance of AIDS symptoms. This period may vary
from a few months to many years (usually 5-10 years).
After getting into the body of the person, the virus enters into macrophages
where RNA genome of the virus replicates to form viral DNA with the help of
the enzyme reverse transcriptase. This viral DNA gets incorporated into host
cell’s DNA and directs the infected cells to produce virus particles (Figure 8.6).
The macrophages continue to produce virus and in this way acts like a HIV
factory. Simultaneously, HIV enters into helper
T-lymphocytes (TH
), replicates and produce progeny viruses. The progeny
viruses released in the blood attack other helper T-lymphocytes. This is
repeated leading to a progressive decrease in the number of helper T-
lymphocytes in the body of the infected person. During this period, the person
suffers from bouts of fever, diarrhoea and weight loss. Due to decrease in
the number of helper T lymphocytes, the person starts suffering from infections
that could have been otherwise overcome such as those due to bacteria
especially Mycobacterium, viruses, fungi and even parasites like Toxoplasma.
The patient becomes so immuno-deficient that he/she is unable to protect
himself/herself against these infections. A widely used diagnostic test for
AIDS is enzyme linked immuno-sorbent assay (ELISA). Treatment of AIDS
with anti-retroviral drugs is only partially effective. They can only prolong
the life of the patient but cannot prevent death, which is inevitable.
Prevention of AIDS : As AIDS has no cure, prevention is the best option.
Moreover, HIV infection, more often, spreads due to conscious behaviour
patterns and is not something that happens inadvertently, like pneumonia
or typhoid. Of course, infection in blood transfusion patients, new-borns
(from mother) etc., may take place due to poor monitoring. The only excuse
may be ignorance and it has been rightly said – “don’t die of ignorance”.
In our country the National AIDS Control Organisation (NACO) and other
non-governmental organisation (NGOs) are doing a lot to educate people
about AIDS. WHO has started a number of programmes to prevent the
spreading of HIV infection. Making blood (from blood banks) safe from
HIV, ensuring the use of only disposable needles and syringes in public
and private hospitals and clinics, free distribution of condoms, controlling
drug abuse, advocating safe sex and promoting regular check-ups for
HIV in susceptible populations, are some such steps taken up.
Infection with HIV or having AIDS is something that should not be
hidden – since then, the infection may spread to many more people.
HIV/AIDS-infected people need help and sympathy instead of being
shunned by society. Unless society recognises it as a problem to be dealt
with in a collective manner – the chances of wider spread of the disease
increase manifold. It is a malady that can only be tackled, by the society
and medical fraternity acting together, to prevent the spread of the disease.
8.4 CANCER
Cancer is one of the most dreaded diseases of human beings and is a major
cause of death all over the globe. More than a million Indians suffer from
cancer and a large number of them die from it annually. The mechanisms
that underlie development of cancer or oncogenic transformation of cells,
its treatment and control have been some of the most intense areas of
research in biology and medicine.
In our body, cell growth and differentiation is highly controlled and
regulated. In cancer cells, there is breakdown of these regulatory
mechanisms. Normal cells show a property called contact inhibition by
virtue of which contact with other cells inhibits their uncontrolled growth.
Cancer cells appears to have lost this property. As a result of this, cancerous
cells just continue to divide giving rise to masses of cells called tumors.
Tumors are of two types: benign and malignant. Benign tumors normally
remain confined to their original location and do not spread to other parts
of the body and cause little damage. The malignant tumors, on the
other hand are a mass of proliferating cells called neoplastic or tumor
cells. These cells grow very rapidly, invading and damaging the
surrounding normal tissues. As these cells actively divide and grow they
also starve the normal cells by competing for vital nutrients. Cells sloughed
from such tumors reach distant sites through blood, and wherever they
get lodged in the body, they start a new tumor there. This property called
metastasis is the most feared property of malignant tumors.
Causes of cancer : Transformation of normal cells into cancerous
neoplastic cells may be induced by physical, chemical or biological agents.
These agents are called carcinogens. Ionising radiations like X-rays and
gamma rays and non-ionizing radiations like UV cause DNA damage
leading to neoplastic transformation. The chemical carcinogens present
in tobacco smoke have been identified as a major cause of lung cancer.
Cancer causing viruses called oncogenic viruses have genes called viral
oncogenes. Furthermore, several genes called cellular oncogenes
(c-onc) or proto oncogenes have been identified in normal cells which,
when activated under certain conditions, could lead to oncogenic
transformation of the cells.
Cancer detection and diagnosis : Early detection of cancers is essential
as it allows the disease to be treated successfully in many cases. Cancer
detection is based on biopsy and histopathological studies of the tissue
and blood and bone marrow tests for increased cell counts in the case of
leukemias. In biopsy, a piece of the suspected tissue cut into thin sections
is stained and examined under microscope (histopathological studies) by
a pathologist. Techniques like radiography (use of X-rays), CT (computed
tomography) and MRI (magnetic resonance imaging) are very useful to
detect cancers of the internal organs. Computed tomography uses X-rays
to generate a three-dimensional image of the internals of an object. MRI
uses strong magnetic fields and non-ionising radiations to accurately detect
pathological and physiological changes in the living tissue.
Antibodies against cancer -specific antigens are also used for
detection of certain cancers. Techniques of molecular biology can be
8.5 DRUGS AND 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
behaviour patterns and follow healthy lifestyles.
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.
Opioids are the drugs, which bind to specific opioid receptors present
in our central nervous system and gastrointestinal tract. Heroin
(Figure 8.7), commonly called smack is chemically diacetylmorphine which
is a white, odourless, bitter crystalline compound. This is obtained by
acetylation of morphine (Figure 8.7), which is extracted from the latex of
poppy plant Papaver somniferum (Figure 8.8). Generally taken by snorting
and injection, heroin is a depressant and slows down body functions.
Cannabinoids are a group of chemicals (Figure 8.9), which interact
with cannabinoid receptors present principally in the brain. Natural
cannabinoids are obtained from the inflorescences of the plant Cannabis
sativa (Figure 8.10). The flower tops, leaves and the resin of cannabis
plant are used in various combinations to produce marijuana, hashish,
charas and ganja. Generally taken by inhalation and oral ingestion, these
are known for their effects on cardiovascular system of the body.
Coca alkaloid or cocaine is obtained from coca
plant Erythroxylum coca, native to South America. It
interferes with the transport of the neuro-transmitter
dopamine. Cocaine, commonly called coke or crack is
usually snorted. It has a potent stimulating action on
central nervous system, producing a sense of euphoria
and increased energy. Excessive dosage of cocaine
causes hallucinations. Other well-known plants with
hallucinogenic properties are Atropa belladona and
Datura (Figure 8.11). These days cannabinoids are also
being abused by some sportspersons.
Drugs like barbiturates, amphetamines,
benzodiazepines, and other similar drugs, that are
normally used as medicines to help patients cope with
mental illnesses like depression and insomnia, are often
abused. Morphine is a very effective sedative and painkiller, and is very useful
in patients who have undergone surgery. Several plants, fruits and seeds
having hallucinogenic properties have been used for hundreds of years in
folk-medicine, religious ceremonies and rituals all over the globe. When these
are taken for a purpose other than medicinal use or in amounts/frequency
that impairs one’s physical, physiological or psychological functions, it
constitutes drug abuse.
Smoking also paves the way to hard drugs. Tobacco has been used
by human beings for more than 400 years. It is smoked, chewed or used
as a snuff. 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.
When one buys packets of cigarettes one cannot miss the statutory
warning that is present on the packing which warns against smoking
and says how it is injurious to health. Yet, smoking is very prevalent in
society, both among young and old. Knowing the dangers of smoking
and chewing tobacco, and its addictive nature, the youth and old need to
avoid these habits. Any addict requires counselling and medical help to
get rid of the habit.
8.5.1 Adolescence and Drug/Alcohol Abuse
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 behavioural changes. Adolescence, thus is a
very vulnerable phase of mental and psychological development of an
individual.
Curiosity, need for adventure and excitement, and experimentation,
constitute common causes, which motivate youngsters towards drug
and alcohol use. A child’s natural curiosity motivates him/her to
experiment. This is complicated further by effects that might be perceived
as benefits, of alcohol or drug use. Thus, the first use of drugs or alcohol
may be out of curiosity or experimentation, but later the child starts
using these to escape facing problems. Of late, stress, from pressures to
excel in academics or examinations, has played a significant role in
persuading the youngsters to try alcohol and drugs. The perception
among youth that it is ‘cool’ or progressive to smoke, use drugs or
alcohol, is also in a way a major cause for youth to start these habits.
Television, movies, newspapers, internet also help to promote this
perception. Other factors that have been seen to be associated with drug
and alcohol abuse among adolescents are unstable or unsupportive
family structures and peer pressure.
8.5.2 Addiction and Dependence
Because of the perceived benefits, drugs are frequently used repeatedly.
The most important thing, which one fails to realise, is the inherent
addictive nature of alcohol and drugs. Addiction is a psychological
attachment to certain effects –such as euphoria and a temporary feeling
of well-being – associated with drugs and alcohol. These drive people to
take them even when these are not needed, or even when their use becomes
self-destructive. With repeated use of drugs, the tolerance level of the
receptors present in our body increases. Consequently the receptors
respond only to higher doses of drugs or alcohol leading to greater intake
and addiction. However, it should be clearly borne in mind that use of
these drugs even once, can be a fore-runner to addiction. Thus, the
addictive potential of drugs and alcohol, pull the user into a vicious circle
leading to their regular use (abuse) from which he/she may not be able
to get out. In the absence of any guidance or counselling, the person gets
addicted and becomes dependent on their use.
Dependence is the tendency of the body to manifest a characteristic
and unpleasant withdrawal syndrome if regular dose of drugs/alcohol
is abruptly discontinued. This is characterised by anxiety, shakiness,
nausea and sweating, which may be relieved when use is resumed again.
In some cases, withdrawal symptoms can be severe and even life
threatening and the person may need medical supervision.
Dependence leads the patient to ignore all social norms in order to
get sufficient funds to satiate his/her needs. These result in many social
adjustment problems.
8.5.3 Effects of Drug/Alcohol Abuse
The immediate adverse effects of drugs and alcohol abuse are manifested
in the form of reckless behaviour, vandalism and violence. Excessive
doses of drugs may lead to coma and death due to respiratory failure,
heart failure or cerebral hemorrhage. A combination of drugs or their
intake along with alcohol generally results in overdosing and even
deaths. The most common warning signs of drug and alcohol abuse
among youth include drop in academic performance, unexplained
absence from school/college, lack of interest in personal hygiene,
withdrawal, isolation, depression, fatigue, aggressive and rebellious
behaviour, deteriorating relationships with family and friends, loss of
interest in hobbies, change in sleeping and eating habits, fluctuations
in weight, appetite, etc.
There may even be some far-reaching implications of drug/alcohol
abuse. If an abuser is unable to get money to buy drugs/alcohol he/she
may turn to stealing. The adverse effects are just not restricted to the
person who is using drugs or alcohol. At times, a drug/alcohol addict
becomes the cause of mental and financial distress to his/her entire family
and friends.
Those who take drugs intravenously (direct injection into the vein
using a needle and syringe), are much more likely to acquire serious
infections like AIDS and Hepatitis B. The viruses, which are responsible
for these diseases, are transferred from one person to another by sharing
of infected needles and syringes. Both AIDS and Hepatitis B infections
are chronic infections and ultimately fatal. Both can be transmitted
through sexual contact or infected blood.
The use of alcohol during adolescence may also have long-term effects.
It could lead to heavy drinking in adulthood. The chronic use of drugs and
alcohol damages nervous system and liver (cirrhosis). The use of drugs
and alcohol during pregnancy is also known to adversely affect the foetus.
Another misuse of drugs is what certain sportspersons do to enhance
their performance. They (mis)use narcotic analgesics, anabolic steroids,
diuretics and certain hormones in sports to increase muscle strength and
bulk and to promote aggressiveness and as a result increase athletic
performance. The side-effects of the use of anabolic steroids in females
include masculinisation (features like males), increased aggressiveness,
mood swings, depression, abnormal menstrual cycles, excessive hair
growth on the face and body, enlargement of clitoris, deepening of voice.
In males it includes acne, increased aggressiveness, mood swings,
depression, reduction of size of the testicles, decreased sperm production,
potential for kidney and liver dysfunction, breast enlargement, premature
baldness, enlargement of the prostate gland. These effects may be
permanent with prolonged use. In the adolescent male or female, severe
facial and body acne, and premature closure of the growth centres of the
long bones may result in stunted growth.
8.5.4 Prevention and Control
The age-old adage of ‘prevention is better than cure’ holds true here also.
It is also true that habits such as smoking, taking drug or alcohol are
more likely to be taken up at a young age, more during adolescence.
Hence, it is best to identify the situations that may push an adolescent
towards use of drugs or alcohol, and to take remedial measures well in
time. In this regard, the parents and the teachers have a special
responsibility. 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
(i) Avoid undue peer pressure – Every child has his/her own choice
and personality, which should be respected and nurtured. A child
should not be pushed unduly to perform beyond his/her threshold
limits; be it studies, sports or other activities.
(ii) Education and counselling – Educating and counselling him/
her to face problems and stresses, and to accept disappointments
and failures as a part of life. It would also be worthwhile to channelise
the child’s energy into healthy pursuits like sports, reading, music,
yoga and other extracurricular activities.
(iii) Seeking help from parents and peers – Help from parents and
peers should be sought immediately so that they can guide
appropriately. Help may even be sought from close and trusted
friends. Besides getting proper advise to sort out their problems,
this would help young to vent their feelings of anxiety and guilt.
(iv) Looking for danger signs – Alert parents and teachers need to
look for and identify the danger signs discussed above. Even friends,
if they find someone using drugs or alcohol, should not hesitate to
bring this to the notice of parents or teacher in the best interests of
the person concerned. Appropriate measures would then be required
to diagnose the malady and the underlying causes. This would help
in initiating proper remedial steps or treatment.
(v) Seeking professional and medical help – A lot of help is available
in the form of highly qualified psychologists, psychiatrists, and de-
addiction and rehabilitation programmes to help individuals who
have unfortunately got in the quagmire of drug/alcohol abuse. With
such help, the affected individual with sufficient efforts and will power,
can get rid of the problem completely and lead a perfectly normal
and healthy life.
SUMMARY
Health is not just the absence of disease. It is a state of complete physical,
mental, social and psychological well-being. Diseases like typhoid,
cholera, pneumonia, fungal infections of skin, malaria and many others
are a major cause of distress to human beings. Vector-borne diseases
like malaria especially one caused by Plasmodium falciparum, if not
treated, may prove fatal. Besides personal cleanliness and hygiene,
public health measures like proper disposal of waste, decontamination
of drinking water, control of vectors like mosquitoes and immunisation
are very helpful in preventing these diseases. Our immune system plays
the major role in preventing these diseases when we are exposed to
disease-causing agents. The innate defences of our body like skin,
mucous membranes, antimicrobial substances present in our tears,
saliva and the phagocytic cells help to block the entry of pathogens
into our body. If the pathogens succeed in gaining entry to our body,
specific antibodies (humoral immune response) and cells (cell mediated
immune response) serve to kill these pathogens. Immune system has
memory. On subsequent exposure to same pathogen, the immune
response is rapid and more intense. This forms the basis of protection
afforded by vaccination and immunisation. Among other diseases, AIDS
and cancer kill a large number of individuals worldwide. AIDS caused
by the human immuno-deficiency virus (HIV) is fatal but can be
prevented if certain precautions are taken. Many cancers are curable if
detected early and appropriate therapeutic measures are taken. Of late,
drug and alcohol abuse among youth and adolescents is becoming
another cause of concern. Because of the addictive nature of alcohol
and drugs, and their perceived benefits like relief from stress, a person
may try taking these in the face of peer pressure, examinations-related
and competition-related stresses. In doing so, he/she may get addicted
to them. Education about their harmful effects, counselling and seeking
immediate professional and medical help would totally relieve the
individual from these evils.
EXERCISES
- What are the various public health measures, which you would suggest
as safeguard against infectious diseases? - In which way has the study of biology helped us to control infectious
diseases? - How does the transmission of each of the following diseases take place?
(a) Amoebiasis (b) Malaria (c) Ascariasis (d) Pneumonia - What measure would you take to prevent water-borne diseases?
- Discuss with your teacher what does ‘a suitable gene’ means, in the
context of DNA vaccines. - Name the primary and secondary lymphoid organs.
- The following are some well-known abbreviations, which have been
used in this chapter. Expand each one to its full form:
(a) MALT (b) CMI (c) AIDS (d) NACO
(e) HIV - Differentiate the following and give examples of each:
(a) Innate and acquired immunity (b) Active and passive immunity - Draw a well-labelled diagram of an antibody molecule.
- What are the various routes by which transmission of human immuno-
deficiency virus takes place? - What is the mechanism by which the AIDS virus causes deficiency of
immune system of the infected person? - How is a cancerous cell different from a normal cell?
- Explain what is meant by metastasis.
- List the harmful effects caused by alcohol/drug abuse.
- Do you think that friends can influence one to take alcohol/drugs? If
yes, how may one protect himself/herself from such an influence? - Why is that once a person starts taking alcohol or drugs, it is difficult
to get rid of this habit? Discuss it with your teacher. - In your view what motivates youngsters to take to alcohol or drugs and
how can this be avoided?