Analysis of Keshan Disease - Coursework Example

 Analysis of Keshan Disease Etiology The research that was carried in China between 1960 and 1980s showed that the main cause of the disease was the deficiency of selenium, a mineral found in the soil. Selenium has antioxidant properties that protect cells from damage. This assertion was based on the following findings. Low selenium levels in local foods, as well as low selenium level in rural residents, were linked to geographic allocation of KD as well as Se deficiency. As introduced above, Keshan disease started from hilly places as well as mountains areas. According to the results of the research, the Se concentration in maize as well as rice that was grown in the endemic sites were very low compared to those grown in non-endemic areas (OŠŤÁDalovÁ 2012). The results of the research also showed that the Se concentration was also significantly low in the blood as well as the hair of the individuals that resided in the endemic sites compared to that of individuals living in non-endemic sites. Additionally, the research carried on the level of hair Se in children from farming families as well as children from non-farming families also linked the low level of Se with deficiency of some nutrients in the diet. Family families mainly rely on their food products from their farms, and as a result, do not access other nutrients such as animal proteins. According to the findings, children from farming families had low hair Se levels compared to those from non-farming families. The interpretation for the variation was thought to be as a result of the non-farming families accessing more sources, as well as a variety of foods including animal foods. From the results of all the researches, one can deduce that the main cause of Keshan disease was the deficiency of Se in the blood of an individual as well as the deficiency of Se in the diet of the victims of the disease. Pathology Keshan disease is associated with many complications in the body of a patient. It weakens the heart tissues by resulting to tissue necrosis. The affected person is more susceptible to other opportunistic diseases. KD is the one that results to impairment of cell-mediated immunity, as well as B cell function (Hoffmann 2007). The disease is also associated with the damage of the DNA as well as the alteration of the cell cycles which then result to apoptosis along inhibiting angiogenesis (Whitton 2012). The uncontrolled growth of tissues (tumor) within the body is also as a result of KD. Epidemiology Keshan disease is a prevalent cardiomyopathy that has been common in China for the past 100 years. The disease’s name was derived from a violent outbreak that took place in Keshan County that is located in Northern in early 1935 (Loscalzo 2014). Its effects are significant in both children and young ladies at the age of giving birth because of their low immunity. The disease is regionally spread in the belt running from northeast all the way to southwest China. Often the peasants who reside in rural areas are the ones who are susceptible to the disease. In most occasions, people relate the occurrence of this to rural people with their monotonous as well as limited access to a good diet (Rayman 2000). The incidence of Keshan disease varies with seasons; its occurrence is highest during winter in regions located in the North. It is also highest in the South during the summer season. The incidence of the disease also varies significantly from year to year. For instance, during the peak of the disease that was in 1959, 1964 as well as 1970 the annual occurrence of the disease surpassed 40 per 10,000 of the victimized population. During these years, over 800 cases were reported, and approximately 1400 to 3000 deaths put down each year (Fairweather-Tait et al. 2011). However, the incidence of Keshan disease has dropped significantly currently because of the inclusion of selenium in the diet. Its incidence currently is below 5 per 100,000 of the victimized population. Currently, the reported cases are also approximately 1000 per year. Retrieved from http://pubs.acs.org/cen/80th/print/selenium.html The map shows Keshan disease distribution on the belt running from northeast to the southeast. Keshan disease can be grouped into four distinctive types: acute, sub-acute, chronic as well as latent. Keshan disease has no significant signs and symptoms. However, it can be diagnosed by the aid of the new criteria that have been introduced. Acute cases of the disease are categorized by sudden acute deficiency of the heart functionality (Wang 2009). Chronic cases, on the other hand, are associated with moderate to severe amplification of the heart with unstable of deficient heart function. Latent cases, unlike acute and chronic cases, are associated with the normal functionality of the heart with less incidence of heart enlargement. Sub-acute conditions, on the other hand, combine the chronic and acute clinical features (Patrick 2004). Symptoms and Diagnosis of Keshan disease The main characteristics of KD include acute or sometimes chronic cardiac insufficiency. It is also associated with cardiac enlargement and congestive heart failure. (Watababe, Kubota, Senda & Masaki 2011), other characteristics of the disease include cardiac arrhythmias as well as ECG changes. However, it is evident that there are no specific symptoms for identifying KD clearly. Histopathologically, the disease can be associated with multifocal necrosis as well as fibrous substitute of myocardium. Multifocal myocardial necrosis is regarded as the main characteristic trait of KD (Rayman 2000). This feature however is also shown in other different pathological conditions such as cystic fibrosis. As introduced above, there are four types of KD depending on its severity. As a result of their variation, it is evident that their symptoms will differ significantly. Symptoms of these groups of KD disease can be presented as dizziness, malaise as well as loss of appetite. Nausea is also common in acute cases. Unlike acute cases, sub-acute cases results to restlessness in addition to minor dilation of the heart. Sub-acute is the most common type of KD disease; it is a common disease to children. Patients suffering from latent disease often fail to know that they are suffering from the disease. This disease rarely shows up; it is often identified through physical checkups or in an autopsy. However, this disease is the main cause of dizziness, fatigue as well as palpitations after an individual has participated in an activity. Severe KD can affect the heart, and as a result of this, other methods have to be employed in order to diagnose its presence in an individual. Some of the methods employed in its diagnosis include use of the echocardiogram, a machine similar to the ultrasound machine. A special rod in this machine aids in the taking of the photo of the heart showing the atria, ventricle as well as other parts of the heart in order to find out if the disease has resulted to structural complications (Beck &Levander 1998). It also assists in identifying any blockage that may result to arrhythmia. Resting ECG testing also plays a very significant role in the diagnosis of the KD. ECG test is often conducted when a person is relaxing; the test aid in carrying out a fast preliminary test on the functionality of the heart (Tanguy, Grauzam& Boucher 2012). A special ECG test referred to as Holter ECG monitor is also used in the diagnosis of KD. The testing device is worn below clothing for about 24 hours in order to record rhythmical beatings of the heart in order to determine the key cause of arrhythmia. The use of stress ECG is also elemental in diagnosis of the heart’s activity while performing some activities. The machine assists in determining whether there are any problems with the functionality of the heart under strenuous activities. A photo of a child suffering from Keshan disease; the child is thin because of loss of appetite as a result of the disease. The heart pictures shows how KD has resulted to structural complications of the heart. Treatment There are diverse medications currently for the treatment of the symptoms associated with Keshan disease. Among the treatments include use of angiotensin-converting-enzyme inhibitor (ACE inhibitors) in cases associated with the enlargement of the heart also referred to as dilated cardiomyopathy. ACE inhibitors are also used when there is a failure of the heart's functionality. The use of ACE inhibitors is associated with their lowering of the blood pressure of the blood. Use of beta blockers also aids significantly in the treatment of an infected heart. It lowers the heart rate as well as force thus preventing the conditions of the heart from worsening. The use of these types of medication relates to those of ACE inhibitors; they are used in the case of heart enlargement or when there is a case of a heart failure. Additionally, corticosteroids medications are used to reduce inflammation that takes place in the heart muscle as well as reduce symptoms of cardiomyopathy and myocarditis (Levander& Beck 1997). They also reduce symptoms of heart failure. However, these types of medication are also associated with some side effects such as stomach irritation, tachycardia, and nausea that need to be addressed. Management and prevention Management of KD involves treatment of the patients with selenium (Kiefer 2004). KD patients require enough resting time in order to heal properly. It is also advisable for the patient to avoid the consumption of alcohol completely because it results to blood pressure within the heart circulatory system that may worsen the symptoms of the disease. Patients' consumption of foods rich selenium is also advisable because they help the heart heal very fast. Additionally, it is advisable for the sick to consume healthy foods such as unprocessed foods rich in vegetables, minerals, and antioxidants. KD is also believed to be caused by a virus or bacteria (Harthill 2011). As a result of that, it is advisable for people to prevent themselves from coxsackievirus B3 by avoiding contacting mouth fluids of an infected person. It is crucial for the people living in areas with a limited amount of selenium in the soil to seek for supplements so as to enrich their soils with selenium. Current research on Keshan disease As outlined in this essay, majority of the people thought that KD resulted mainly from the deficiency of selenium in the diet as well as in the soil of specific areas in China. This perception has been effective for many years leading to people living without thinking of any other possible cause for the disease. However, recent studies have shown that the mutation of coxsackievirus B3 in a human’s body may contribute significantly to the occurrence of Keshan disease (Beck 1997). The studies also linked abundance of selenium with the prevention of problems such as oxidative destruction of the erythrocytes. From this assertion; therefore, one can deduce that KD also leads to the damage of red blood cells. In conclusion, Keshan disease is a disease associated with inefficiency of selenium in the diet. The occurrence of this disease is common in China. However, it affects mostly young children and ladies who are at the age of giving birth. Its effects are associated with cardiovascular complications. It lowers the activeness of a patient as well as exposes him to other viral diseases because it hampers with the immune system. Symptoms of this disease are very many and diverse. It causes chronic cardiac insufficiency as well as cardiac enlargement. It also leads to congestive heart failure. There are diverse medications such as ACE inhibitors for the treatment of the symptoms associated with Keshan disease. Management of KD involves giving oral supplementation selenium (200 µg each day for a month) to patients. 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