1 Diagnosis of lifestyle diseases- Priyankesh Mishra

DIAGNOSIS OF LIFE STYLE DISEASES

PRIYANKESH MISHRA

INDIAN SCHOOL OF COMPLEMENTARY THERAPY AND ALLIED SCIENCES

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Manuscript info
Abstract .
Manuscript Number:- SCI-1004 A complete human system is dependent on how he lives in today’s
world. The complete way of living also describes its effect on physical
Received date:- 23rd june, 2019
as well as mental health. The lifestyle we deal with, is unique and
hence the diagnosis should be done very precisely. Today in this
Final accepted:- 26th june, 2019
modern civilized world the lifestyle has changed very much and
Publishing date:- 1st july, 2019 hence the suffering of lifestyle diseases are more than the previous
times. Patients that are suffering must be diagnosed properly in the
bed side and in a manner of actual and laboratory base methods.
This paper hence basically deals with the diagnosis of lifestyle
diseases. What are the lifestyle diseases that affect people today
primarily and how are they diagnosed properly. The way of writing
prescription in both acute and chronic cases and evenly knowing the
symptoms of the particular disease is necessary. Hence let’s start the
discussion.

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INTRODUCTION

Every human being has its own way of living and pursuing to the nature. In this aspect of leading a life develops various
types of disorder and diseases that affects the health of human being. Health as by definition of world health organization
(WHO) is state of complete physical, mental and social well being.A human social well being also administers his health
and also a cause of several diseases that today’s world is facing. Samuel Hahnemann (father of Homoeopathy) in his
organon of medicine at aphorism 5 says “useful to the physician in assisting him to cure are the particulars of the most
probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease,
to enable him to discover its fundamental cause, which is generally due to chronic miasm. In the investigations, the
ascertainable physical constitution of the patient, his moral and intellectual character, his occupation, mode of living and
habits, his social and domestic relations, his age, sexual function, etc. are to be taken into consideration.”

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2 Diagnosis of lifestyle diseases- Priyankesh Mishra

Lifestyle as by definition says a way of living of individuals, families (households), and societies, which they manifest in
coping with their physical, psychological, social, and economic environments on a day-to-day basis. Lifestyle is expressed
in both work and leisure behaviour patterns and (on an individual basis) in activities, attitudes, interests, opinions, values,
and allocation of income. It also reflects people's self-image or self-concept; the way they see themselves and believe they
are seen by the others. Lifestyle is a composite of motivations, needs, and wants and is influenced by factors such as
culture, family, reference groups, and social class.

These lifestyle habits of human beings affect several health factors causing diseases. These diseases should be
diagnosed with other concern in chronic as well as acute diseases, matching all the symptoms and conditions of the
patient.

Lifestyle of today’s is a vast difference with the vedic culture of living. In the great Rig Vedas the lifestyle is depicted with
the works they used to do; as a Brahmin(upper caste people) should live his life peacefully and to be dedicated to god ,
having light foods with no use of alcohol and other tobacco products, and as the king is said to be prosperous and had
several works of both brain and physical so he used to consume meat and other protein foods. Now-a-days these system
is rarely followed in the society rather every part of society including the rich and middle class people have same type of
high speed and fast working day. The Vedas in ancient way has said of how to live life and avoid diseases and, what sort
of food , people, activities one should avoid. In Bhagwad Gita, Shri Krishna Says to Arjun that the human how they live
and how they spent there whole life, the duties they served and all describes his current physical and mental condition. In
short He says about the effect of life style on human being.

Moving from some basics about lifestyle, and introduction to the lifestyle diseases there are several factors that affect the
lifestyle diseases and then the diseases must be diagnosed properly before it kills the patient. Before that we must begin
with health and disease.

HEALTH

As defined by World Health Organization(WHO) it is a "State of complete physical, mental, and social well being, and not
merely the absence of disease or infirmity." Health is a dynamic condition resulting from a body's constant adjustment and
adaptation in response to stresses and changes in the environment for maintaining an inner equilibrium called
homeostasis.

So, health is a combination of various aspect as in mental health, physical health and social wealth.

DISEASE

Disease is the external manifestation of internally deranged vital force, which collectively affect a persons physical,
mental and social well being. So, disease is the collection of several symptoms when the three aspects of the well being
like mental, social or physical well being got damaged individually or collectively. A disorder in structure or function in
human, animal and plant especially one that produces specific symptoms or that affects a specific location and is not

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3 Diagnosis of lifestyle diseases- Priyankesh Mishra

simply a direct result of physical injury. The study of disease is called pathology , which includes the study of etiology , or
cause, pathogenesis of pathology. Diseases are often construed as medical conditions that are associated with specific
symptoms and signs. A disease may be caused by external factors such as pathogens or by internal dysfunctions. There
are 5 main types of disease:-

1) Infectious disease and inflammatory :- Infectious disease are diseases that diseases that are caused by the
pathogens as bacteria, viruses, fungi or parasites. Some infectious diseases can be passed from person to person. Some
are transmitted by bites from insects or animals. And others are acquired by ingesting contaminated food or water or
being exposed to organisms in the environment.

2) Nutritional and Deficiency disease:- a disease (such as scurvy) caused by a lack of essential dietary elements
and especially a vitamin or mineral.

3) Genetic and Hereditary disease:- Hereditary disease that is caused by an abnormality in an individual's
genome, the person's entire genetic makeup. The abnormality can range from minuscule to major -- from a discrete
mutation in a single base in the DNA of a single gene to a gross chromosome abnormality involving the addition or
subtraction of an entire chromosome or set of chromosomes. Some genetic disorders are inherited from the parents,
while other genetic diseases are caused by acquired changes or mutations in a preexisting gene or group of genes.
Mutations can occur either randomly or due to some environmental exposure.

4) Psychological disease:- Any collision between sub conscious and conscious mind resulting in mismatch expectation
level, stress, faulty perception, randomised negative thoughts and anxiety which can results into a series of psycho-
somatic compression.

5) Neoplastic Disease:- Any pathological condition which starts as the allergic menfestation and inflammatory reaction
which results into either resolution (i.e. replacement of the pathological cell by the healthy cell) or may undergo through a
series of mechanism of cellular death. Proliferation of the new cells means the initiation of the neoplastic changes, when
it disregualted by several factors neoplastic diseases results.

LIFESTYLE AND RELATED DISEASES

The definition of healthy lifestyle is not working out all the time rather eating fruits and vegetables and performing weight
lifting. A healthy lifestyle is doing whatever is good for your body and for your soul, loving, being happy, laughing with the
ones you love, feeling comfortable with your body and being positive. A way of living of individuals, families, and societies,
which they manifest in coping with their physical, physiological, social, and economic environment on a day-to-day basis.

Lifestyle is expressed in both work and leisure behaviour patterns and(on an individual basis)in activities, attitudes,
interests, opinions, values, and allocation of income. It also reflects people’s self-image or self-concept; the way they see
themselves and believe they are seen by others. It is a composite of motivations, needs, and wants and is influenced by
factors such as culture, family, reference groups, and social class.

Whereas lifestyle diseases are defined as diseases linked with the way the people live their life. These diseases are
ailments that are primarily based on the day to day habits of people. Habits that detract people from activity and push them
towards a sedentary routine can cause a number of health issue that can lead to chronic non-communicable diseases that
can near life threatening consequences. This is the dilemma surrounding lifestyle disease, diseases that are not
transmitted between people, but rather develop over time due to genetics and personal choices.

CAUSES OF LIFESTYLE DISEASES

If we consider with the name of disease as lifestyle thus any faulty way of living life is the major factors of lifestyle diseases.
Not only the way of living rather mode of thinking, postures, gestures, reaction, action all will be included in this category.
Diet, psychological and lifestyle are major factors thought to influence susceptibility to many diseases. On discussion we
get two types of causes of lifestyle diseases that are as one is by choice and the other is by force/pressure. In by choice
type of cause the person chooses the lifestyle as his own choice e.g, drug abuse, tobacco abuse, alcohol consumption and
lethargic way of leading life. On the other hand if the person is supposed to suffer from sinus infections but have to work for
hours in an air-conditioned chamber or glass factory or anything not suited to him, this type lifestyle problem/ diseases is
due to by force/pressure.People in developing countries, whose diets still depend largely on low-sugar starchy diet foods
with little meat or fat have lower rates of colorectal cancer, breast cancer, prostate cancer, endometrial cancer and lung
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4 Diagnosis of lifestyle diseases- Priyankesh Mishra

cancer, whereas in Australia the chances of having these cancers is more due to obese and lethargic lifestyle. Causes are
not just from smoking and alcohol abuse. Adults can develop lifestyle diseases through behavioural factors that impact on
them. These can be unemployment, unsafe life, poor social environment, working conditions, stress and home life can
change a person’s lifestyle to increase their risk of developing one of these diseases.

1. Controllable Risk factors:- your diet and body weight. Your daily levels of physical activity. Your level of sun
exposure. Smoking and alcohol abuse.
2. Uncontrollable Risk Factors:- age, race(status of living), gender and heredity.

Types of Lifestyle Diseases

Lifestyle diseases include atherosclerosis, heart disease, and stroke; obesity and type 2 diabetes; and diseases
associated with smoking and alcohol and drug abuse.

1. Cardiovascular Diseases:-
CVD are diseases or disorder that result from damage to the heart and blood vessels. The cardiovascular
disease mostly shows situations that comprise of narrowed or congested blood vessels that can lead to heart
attack, chest pain or stroke. Further heart illness, such as those that impact your heart’s muscle and valves
also are measured procedures for heart disease.
Symptoms:- heart disease denotes several sorts of circumstances that can affect heart function. Distinctive signs of a
cardiovascular problem consist of :-
o Pains of heaviness in the chest, which may specify angina
o Pain or uneasiness in the arms, the left shoulder, elbows, jaws or back.
o Shortness of inhalation, also known as dyspnea
o Vomiting and fatigue
o Dizzy or faint
o Cold sweat

Types:- Cardiac or heart related, ailments and circumstances include:-

o Angina measured both a cardiac and a vascular disease

o Arrhythmia, where there is an uneven heartbeat or heart rhythm

o Congenital heart disease, when a difficult with heart function or structure from birth.
o Coronary artery disease(CAD), which disturbs the arteries that feed the heart muscle
o Expanded cardiomyopathy
o Mitral regurgitation
o Mitral valve prolapse
o Pulmonary stenosis
o Rheumatic heart disease, which can be a difficulty of strep throat
o Vascular diseases are the ailments that affect the blood vessels: the arteries, veins, or capillaries.
2. Metabolic disorder:- this is mainly of 3 types:- Diabetes Melitus, Hyper tension and Gout
Diabetes:- A disorder in which cells are unable to obtain glucose from the blood such that high blood
pressure levels result.DM is a group of metabolic disorder characterized by high blood sugar levels over a
prolonged period.

Symptoms:- High blood sugar include frequent urination, increased thirst, and increases hunger. The
classical symptoms of untreated diabetes are unintended weight loss, polyuria( increased urination),
polydipsia( increased hunger).

Diabetes is due to either the pancreas not producing enough insulin, or the cells of body not responding properly to the
insulin produced. There are three main types of diabetes mellitus:-

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5 Diagnosis of lifestyle diseases- Priyankesh Mishra

o Type1 diabetes results from the pancreas’s failure to produce enough insulin due to destruction of
beta cells. It is also referred to as “insulin dependent diabetes mellitus (IDDM)”.
o Type2 diabetes begins with insulin resistance , a condition in which cells fail to respond to insulin
properly. As the disease progresses, a lack of insulin may also develop. This is also known as “non
insulin dependent diabetes mellitus. The most common cause is a combination of excessive body
weight and insufficient exercise.
o Gestational Diabetes:- It is the third main form, and occurs when pregnant women without a
previous history of diabetes develop high blood sugar levels.

Prevention and treatment involve maintain a healthy diet, regular physical exercise, a normal body weight, and
avoiding use of tobacco. Control of blood pressure and maintain proper foot care of important for people with
disease.

3. Cerebrovascular accident:- It is the loss of brain function due to a disturbance in the blood supply to the
brain. This disturbance is due to either ischemia(lack of blood flow) or haemorrhage. Risk factors for stroke
include old age, high blood pressure, diabetes, high cholesterol and tobacco smoking. High blood pressure is
the most important modifiable risk factor.

Symptoms:- Symptoms of stroke include trouble walking, speaking and understanding as well paralysis or
numbness of the face, arm or leg.

4. Cancer:- A disease caused by uncontrolled cell growth. Benign tumors are not cancerous and usually do not
spread. Malignant tumors are cancerous and do spread.
Causes:- Some common causes of cancers are:-
o Certain virus(HPV)
o Radiation(UV Rays, X-Rays)
o Chemicals in tobacco smoke
o Asbestos(material used in fireproofing)
5. Chronic obstructive pulmonary disease:- COPD , also known as chronic obstructive lung disease(COLD)
characterized by chronically poor airflow. It typically worsens over time. The main symptoms include
shortness of breath, cough and sputum production.
Tobacco smoking is the most common cause of COPD, with a number of other factors such as air pollution
and genetics playing a smaller role.
Intense and prolonged exposure to workplace dusts, chemicals and fumes increase the risk factors of COPD
in both smokers and nonsmokers.
Malnutrition and low birth weight is also a reason for respiratory disease.
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6 Diagnosis of lifestyle diseases- Priyankesh Mishra

6. Depression:- It is a state of low mood and aversion to activity that can affect a person’s thoughts,
behaviour, feelings and sense of well-being. Depressed people can feel sad, anxious, helpless, worthless,
guilty, irritable, hurt, or restless.
Life events and life style that may precipitate depressed mood include childbirth, menopause financial
difficulties, job problems, a medical diagnosis, loss of loved one, natural disasters, social isolation,
relationship troubles, jealousy, separation.
7. Musculoskeletal disorder:- Healthy diet with physical activity in childhood and adolescence builds strong
and healthy bones.
High peak bone density in this age reduces the risk of osteoporosis in later life.
With no exercise ligaments become shorter with less elasticity, muscle tone will be lost thus reduce the
stability, synovial fluid will be reduced, making the joint more prone to injuries.

Diagnosis

Diagnosis is the identification of the nature of an illness or other problem by examination of the symptoms. The word
diagnosis comes directly from the Greek, but the meaning has been changed. To the Greeks a diagnosis meant
specifically a “discrimination, a distinguishing, or a discerning between two possibilities.” Today in medicine that
corresponds more closely to a differential diagnosis. Differential diagnosis is the process of weighing the probability of
one disease versus that of other diseases possibly accounting for patient’s illness. The differential diagnosis of rhinitis
includes allergic rhinitis, the abuse of nasal decongestants and, of course, the common cold.

Diagnostic Criteria:- The term diagnostic criteria designates the specific combination of signs, symptoms, on
examinatory findings and test results that the clinical uses to attempt to determine the correct diagnosis. They are
standards, normally published by the international committees, and they are designed to offer the best sensitivity and
specificity possible, respect the presence of a condition, with the state-of-the-art technology.

There are two major steps to making a diagnosis:-

1. To establish the clinical features by history and examination- this represents the clinical database.
2. To interpret the clinical database in terms of disordered function and potential causative pathologies, whether
physical, mental, social or a combination of these.

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7 Diagnosis of lifestyle diseases- Priyankesh Mishra

History taking and clinical examination are initial but crucial steps to achieving this understanding, even in an era in which
the availability of sophisticated investigations might suggest to a lay person that a blood test or scan will give the
answers. In addition, even though many diseases are now curable, the relief of symptoms is usually what the patient
expects from the medical purposes.
Clinical Diagnosis:- A diagnosis made on the basis of medical signs and patient reported symptoms, rather than
diagnostic tests.
Laboratory Diagnosis:- A diagnosis based significantly on laboratory reports or test results, rather than the physical
examination of the patient. For instance, a proper signs and symptoms; as well as laboratory characteristics of the
pathogen involved.

The phrase “clinical methods” is used less than it used to be. It can be defined as the set as the skills doctors use to
diagnose and treat disease and the manner in which doctors use to diagnose and treat disease and the manner in which
doctors approach clinical problems and relate to patients.

While meeting the patient in the clinic the doctor must make an early assessment of his demeanour, hearing, walking and
any accompanying persons. It is good to offer a greeting and careful introduction and to observe the response
unobtrusively but with care. All of the following questions should be quickly assessed.:-

1. Does the patient appear relaxed and smiling or furtive and anxious?
2. Does the patient make good eye contact?
3. Is he frightened or depressed?
4. Are posture and stance normal?
5. Is he short of breath or wheezing?

In some conditions (e.g, congestive heart failure, asthma, stroke, hypertension),the general nature of the problem is
immediately obvious.

In case of lifestyle diseases several special characters should be checked properly as suppose in case of COPD ( chronic
obstructive pulmonary disease) the nature of sputum and cough of the patient should be checked and demonstrated by
direct and indirect questioning or even by laboratory diagnosis of the sputum. The question that can be asked to the
patient in clinical diagnosis are:-

1. Is sputum produced?
2. What does it look like? Children and some adults swallow sputum, but it is always worth asking for description of
its colour and consistency. Yellow/green sputum is usually purulent. People with asthma may produce small
amounts of very thick or jelly-like sputum, sometimes in the shape of a cast of the airways. Eosinophils may
accumulate in the sputum in COPD.
3. How much is produced? When severe lung damage in infancy and childhood was common, bronchiectasis was
often found in adults.

Similarly in case of the other lifestyle diseases the patients complete symptoms should be diagnosed properly as
suppose for cardiovascular disease the diagnosis should be in given ways as:-

1. Electrocardiogram
2. Blood pressure(peripheral if required then central also)
3. Arterial pulse
4. Auscultation of the heart, etc.

And hence this is the way of the diagnosis of the lifestyle diseases, but to write a prescription and case taking skills we
should be more appropriate.

Prescription and case taking of life style disease

Prescription is an art of an instruction written by a medical practitioner that authorizes a patient to be issued with a
medicine or treatment. The diagnosis is first preferred properly and then the whole documentation showed be done
properly so that the person with lifestyle disease can be cured easily. It should be taken in mind the current symptoms

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8 Diagnosis of lifestyle diseases- Priyankesh Mishra

and signs of the patient should be tallied and compared with the lifestyle he/she follows, so that we can easily
demonstrate the difference and cause of the disease.

Present lifestyle and history of lifestyle also plays a major role in the diagnosis as in case of drug history and alcohol
history it would be as:-

Drug history:- The drug history, almost more than any other, benefits from being repeated at another time and in slightly
different way. For example, in trying to define a possible drug reaction as a cause of liver dysfunction, it is not unusual to
find that the patient has taken a few relevant tablets just before the onset of the problem and only remembered or
realized it was important to say so when asked repeatedly and in great detail.

Alcohol history:- The detrimental effects of alcohol on health cause a variety of problems, and the frequency of excess
alcohol use means that up to 10% of adult hospital impatients have a problem related to alcohol.

While observing this two history it must also be noted down that the patient is still consuming alcohol or taking drug or
not. As this daily consumption of alcohol also give a direct signs to how to handle these patients.

In case of chronic cases, the case study should be more precise than acute cases. A proforma that is followed by us can
also be used for diagnosis of the patient. In this a serial wise habits and patients way of living, occupation, desire, food ,
appetite, thirst and all are to be written in a sequence with the patient present complain. The format used by us is given
below:-

st
The 1 page of the case taking sheet is to be very precisely written. Each and every small details of the patient complaint
must be written in this page. Any history of diagnosis related or not related should also be mentioned here. The present
blood pressure, heart sounds and pulse should be recorded at a specific time in a correct way of measurement.
nd
The 2 page is of the genarlities that patient is seeking or his current lifestyle form with the general character. The given
points as thermal regulation, appetite ,thirst, desire, aversion, stool, urine, dream, sleep, mind and intolerance should be
noted down in a correct way of interpretation.

The genarlities character says:-

Thermal regulation:- It defines in what type of climatic condition does the patient feels comfortable as the patient is
chilly, hot or ambothermic, etc.

Appetite:- The patient’s appetite is his hunger and digestion capacity. How much he can tolerate hunger or is there any
problem after tolerating hunger.

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9 Diagnosis of lifestyle diseases- Priyankesh Mishra

Thirst:- it explains the how is the thirst of the patient and how much the water the patient consumes in a day as well
what type of drinking habit he has as less water at more interval, less water at frequent interval or more water at long
interval.

Desire:- desire or what the patient is willing to have as food, what is his favourite food, is there anything he hates , extra
salt requirement etc.

Aversion:- aversion shows what food, environment or anything as dust, milk etc. that is allergic or gives sudden aversed
reaction to patient.

Stool:- colour of stool, any pain/ burning sensation, or any type of problem or no problem also should be described here.

Urine:- urine conditions is also same as for the stool, it is needed to be described.

Like this way each and every small to small information should be collected and described in the case taking sheet and
then a prescription should be made with required medication.

Conclusion

The lifestyle diseases are very concerning in today’s society, so very precisely we must take care of the concerning
disease. Each and every details form a complete set of disease so they must be diagnosed properly.

Reference

Hutchison’s Clinical methods

https://www.medicinenet.com/script/main/art.asp?articlekey=2991

https://www.google.com/search?q=CVD&oq=CVD&aqs=chrome..69i57j0l3.1275j0j7&client=ms-android-
xiaomi&sourceid=chrome-mobile&ie=UTF-8

https://en.m.wikipedia.org/wiki/Diabetes

https://www.webmd.com/diabetes/guide/types-of-diabetes-mellitus

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