Human performance

Minerals are essential for the normal growth and maintenance of the body. Many of the essential minerals are widely distributed in foods, and most people eating a mixed diet are likely to receive adequate intakes. Daily requirement of mineral is more than 100 mg, they are called major elements or macro minerals. If the requirement of minerals is less than 100 mg/day, they are known as minor elements or microminerals or trace elements.

General functions of minerals.  It is very essential components for day-to-day life in organism. These include calcification of bone, blood coagulation, neuromuscular transmission, homeostasis, acid-base equilibrium, fluid balance and osmotic regulation etc.  Certain minerals are integral components of biologically important compounds such as haemoglobin (Fe), thyroxine (I), insulin (Zn) and vitamin B12 (Co). Sulphur is present in thiamine, biotin, lipoic acid and coenzyme A.  Several minerals participate as cofactors for enzymes in metabolism (e.G., Mg, Mn, Cu, Zn, K). Some elements are essential constituents of certain enzymes (e.G., Co, Mo, Se).

Classification of minerals.

A. Classification based on the requirement. 1. Macrominerals. The seven principal elements constitute 60-80% of the body’s inorganic material. These are calcium, phosphorus, magnesium, sodium, potassium, chloride and sulphur. 2. Microminerals.  Essential trace elements. Iron, copper, iodine, manganese, zinc, molybdenum, cobalt, fluorine, selenium and chromium.  Possibly essential trace elements. Nickel, vanadium, cadmium and barium  Non-essential trace elements. Aluminium, lead, mercury, boron, silver, bismuth etc B. Classification of minerals on the basis of the functions as. 1. Structural function— calcium, magnesium, phosphate. 2. Membrane functions— sodium, potassium. 3. Act as prosthetic groups in enzymes— cobalt, copper, iron, molybdenum, selenium, zinc. 4. Regulatory action in hormone— calcium, chromium, iodine, magnesium, manganese, sodium, potassium. 5. Essential, but function unknown— silicon, vanadium, bromine, nickel, tin, lithium. 6. Present in normal diet but may cause the toxic in excess— aluminium, arsenic, antimony, cadmium, caesium, germanium, lead, mercury.

Phosphorus  An adult body contains about 1 kg phosphate and it is an intracellular component of cells. Most of it (about 80%) occurs in combination with Ca2+ in the bones and teeth. About 10% of body phosphorous is found in muscles and blood in association with proteins, carbohydrates and lipids.

Functions of phosphorus.  Phosphorus is essential for the development of bones and teeth.  It plays a central role for the formation and utilization of high-energy phosphate compounds e.G., ATP, GTP, creatine phosphate etc.  Phosphorus is required for the formation of phospholipids, phosphoproteins and nucleic acids (DNA and RNA).

Deficiency diseases of phosphorus.  Serum phosphate level is increased in hypoparathyroidism and decreased in hyperparathyroidism.  In severe renal diseases, serum phosphate content is elevated causing acidosis.

Iron  The total content of iron in an adult body is 3-5 g. About 70% of this occurs in the erythrocytes of blood as a constituent of haemoglobin. At least 5% of body iron is present in myoglobin of muscle. Haem is the most predominant iron-containing substance.

Functions of iron.  Iron mainly exerts its functions through the compounds in which it is present. Haemoglobin and myoglobin are required for the transport of O2 and CO2.  Cytochromes and certain non-haem proteins are necessary for electron transport chain and oxidative phosphorylation.

Deficiency diseases of iron. Iron deficiency anaemia—It is an important problem worldwide, because if iron losses from the body are relatively high (during heavy menstrual blood loss or intestinal parasites), it is difficult to achieve an adequate intake to replace losses. Iron deficiency anaemia mostly occurs in growing children, adolescent girls, pregnant and lactating women. It is characterized by microcytic hypochromic anaemia with reduced blood haemoglobin levels.  Nephrosis— When kidney glomerular mechanism is damaged, proteinuria results. Then haptoglobin, hemopexin and transferrin are lost in urine, with consequent loss of iron. 

WATER Water is the most abundant constituent of the human body, accounting for one-half to four-fifths of body weight, depending mainly on body fat content.

Functions of Water: Major functions of water:  Carrier of Food Nutrients: Every nutrient in soluble form in water is carried from intestines to tissues through blood.  Constituent of Liquid: Water is the major constituent of all liquids of body as blood, urine, sweat, lymph.  Regulate body temperature: Water helps to regulate and control body temperature. Heat is produced when food is burnt for energy. Water is evaporated through respiration and sweat and body temperature is maintained normal. Body’s heat is lost through the skin, lungs, urine and faeces.  Safety/Security of Delicate Organs: Water is around lungs, heart, brain which protects them from outer injury. Thus provide security to these organs and thereby to human being.  Water as lubricant: Water acts as lubricant in joints. Water around joints help normal circulation process in cells. It is an essential constituent of all the cells of the body and the internal environment.

Water turnover and balance  Water is an essential component of the human body, making up about 60% of body weight in adults. The balance of water in the body is regulated by several mechanisms to maintain proper hydration levels.  Water turnover refers to the process by which water is continually exchanged between the body and the environment. This turnover can occur through various routes such as the skin, lungs, and gastrointestinal tract.

Mechanisms involved in water turnover and balance: 1. Thirst mechanism: The body's thirst mechanism helps regulate water intake by stimulating the desire to drink water when there is a need to replace fluids lost through sweat, urine, and breathing. 2. Kidneys: The kidneys play a crucial role in water balance by regulating the amount of water excreted in urine. When the body needs to conserve water, the kidneys reduce urine output by reabsorbing more water back into the body. 3. Antidiuretic hormone (ADH): ADH is a hormone produced by the pituitary gland that regulates water balance by controlling the amount of water excreted in urine. When the body needs to conserve water, ADH levels increase, causing the kidneys to reabsorb more water and produce less urine. 

Dehydration: Dehydration refers to a condition where the body lacks adequate fluids to carry out normal physiological functions. It can occur when the body loses more fluids than it takes in, leading to an imbalance in the body's electrolytes and dehydration.

Causes of Dehydration: There are several causes of dehydration, including: 1. Inadequate Fluid Intake: The most common cause of dehydration is not drinking enough fluids. This can occur if a person is not thirsty or if they are unable to access water. 2. Excessive Fluid Loss: Dehydration can also occur if the body loses too much fluid through sweating, urination, or diarrhea. 3. Medical Conditions: Certain medical conditions can also cause dehydration, including diabetes, kidney disease, and fever. 4. Medications: Some medications can cause dehydration as a side effect

Oral Rehydration Therapy: Oral rehydration therapy (ORT) is a simple and effective way to treat dehydration. It involves drinking a solution of water, salt, and sugar to replace fluids and electrolytes lost due to dehydration. ORT is often used to treat dehydration caused by diarrhea, vomiting, and other illnesses that cause fluid loss. ORT is recommended by the World Health Organization (WHO) as the first-line treatment for dehydration. It can be given at home or in a healthcare setting and is suitable for all age groups. ORT solution can be made by dissolving the following in one liter of clean water:  6 level teaspoons of sugar  1/2 level teaspoon of salt The solution should be sipped slowly over a period of four to six hours. If vomiting occurs, the solution should be paused for 10 minutes and then restarted. ORT should be continued until the individual is rehydrated, and fluid losses have been replaced.

Oral rehydration salt (ORS): Oral rehydration therapy is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube.  It is expanded as Oral rehydration salt.  It is composed of 4 constituents, sodium chloride, trisodium citrate, potassium chloride, and glucose.  It helps in preventing dehydration caused by diarrhea.  The combination improves fluid absorption in the intestines, allowing fluids to be restored more quickly.

Introduction to Pathology of Blood and Urine—  The pathology of blood involves the study of the cellular and molecular components of blood and their interactions.  Blood is composed of various cells and plasma, which contains nutrients, hormones, electrolytes, and other vital components that are essential for the body's normal functioning.  Any abnormality in the composition or function of these components can lead to a wide range of medical conditions.

Common blood disorders include anemia, leukemia, and hemophilia.  Anemia is a condition in which the body does not have enough red blood cells, causing fatigue and weakness.  Leukemia is a type of cancer that affects the blood and bone marrow, leading to an overproduction of abnormal white blood cells.  Hemophilia is a genetic disorder that causes the blood to clot abnormally, leading to excessive bleeding.

Lymphocyte’s role in health and diseases.

 Lymphocytes are a type of white blood cell that plays a crucial role in the immune system. They are responsible for identifying and attacking foreign substances such as viruses, bacteria, and cancer cells. There are two main types of lymphocytes: B cells and T cells.  B cells produce antibodies that help identify and neutralize pathogens. When a B cell encounters a foreign substance, it produces a specific antibody that binds to the pathogen and signals other immune cells to destroy it.  T cells play a variety of roles in the immune system, including recognizing and destroying infected cells, regulating the immune response, and helping B cells produce antibodies.

Platelet’s role in health and diseases.  Platelets, also known as thrombocytes, are small fragments of cells that help the blood clot to stop bleeding. They are formed in the bone marrow and circulate in the blood. When a blood vessel is damaged, platelets rush to the site and stick together, forming a plug to stop the bleeding.  Abnormalities in platelet function can lead to bleeding disorders, such as hemophilia and von Willebrand disease, or thrombotic disorders, such as deep vein thrombosis and pulmonary embolism. 

Biotechnology  Biotechnology is multidisciplinary field which has major impact on our lives.  The technology is known since years which involves working with cells or cell-derived molecules for various applications.  It has wide range of uses and is termed “technology of hope” which impact human health, well being of other life forms and our environment.  Biotechnology is the use of living organisms or their products to create useful products, processes, or services. It involves the manipulation of biological materials, including cells, DNA, and proteins, to develop new medicines, foods, and other products. Biotechnology encompasses a wide range of fields, including genetic engineering, molecular biology, biochemistry, microbiology, and cell biology.  The applications of biotechnology are vast and have the potential to benefit many industries and areas of life. In medicine, biotechnology has revolutionized the development of new drugs and therapies, including vaccines, gene therapies, and personalized medicine. In agriculture, biotechnology has improved crop yields, created drought-resistant crops, and enhanced livestock production.  Biotechnology also plays a critical role in environmental conservation, with bioremediation technologies using microorganisms to clean up pollutants and biodegradable plastics and biofuels reducing dependence on fossil fuels.

DNA technology:  DNA technology is the use of various methods to manipulate, analyze, and modify DNA (deoxyribonucleic acid), which is the genetic material that carries the instructions for the development and function of all living organisms.  DNA technology has revolutionized many fields of biology, including genetic engineering, molecular biology, and biotechnology.  One of the most common uses of DNA technology is genetic engineering, which involves the manipulation of an organism's DNA to add, delete, or modify specific genes.  This technology has allowed scientists to create genetically modified organisms (GMOs) with desired traits, such as resistance to pests, increased yield, or improved nutritional content. Examples of DNA technologies:  DNA cloning  Polymerase chain reaction (PCR)  Gel electrophoresis  DNA sequencing

The kidneys have several important functions in the body, including: 1. Regulation of fluid balance: The kidneys help regulate the balance of fluids in the body by filtering waste and excess fluids from the blood and excreting them as urine. 2. Regulation of electrolyte balance: The kidneys help regulate the balance of electrolytes in the body, such as sodium, potassium, and calcium, by filtering and selectively reabsorbing these ions as needed. 3. Regulation of blood pressure: The kidneys help regulate blood pressure by producing hormones that control the diameter of blood vessels and the volume of blood circulating in the body.

Kidney Function Test: 1. Blood tests: Blood tests that measure levels of creatinine and blood urea nitrogen (BUN) are commonly used to assess kidney function. Creatinine is a waste product that is produced by muscle metabolism and excreted by the kidneys, while BUN is a waste product of protein metabolism. Elevated levels of creatinine and BUN in the blood can indicate decreased kidney function or kidney damage. 2. Urine tests: Urine tests that measure levels of protein and albumin are commonly used to assess kidney function. Albumin is a protein that is normally present in the blood, but not in the urine, while proteinuria is the presence of excessive amounts of protein in the urine. Elevated levels of protein and albumin in the urine can indicate decreased kidney function or kidney damage. 3. Glomerular filtration rate (GFR): GFR is a measure of the rate at which blood is filtered by the kidneys. It is calculated based on a person's age, sex, and blood creatinine levels. A GFR of less than 60 mL/min/1.73m2 for more than 3 months indicates chronic kidney disease. 

Clinical Significances: Problems with starting to pee: This is a measure of how much urine is produced over a certain period of time. Low urine output can indicate poor kidney function.  Glomerular Filtration Rate (GFR): This is considered the most accurate measure of kidney function. It is a measure of how well the kidneys are filtering waste from the blood. GFR can be estimated through blood tests that measure levels of creatinine, a waste product produced by muscles.

4. Sweating: Sweating is a mechanism by which the body cools itself down and removes excess heat. However, excessive sweating can lead to dehydration, which can be dangerous. 5. Breathing: Water is lost through breathing as water vapor in the air we exhale. This loss is more significant in dry environments and during physical exertion. 6. Gastrointestinal tract: Water is lost through the gastrointestinal tract through feces. The body can reabsorb some of this water in the large intestine to maintain water balance.

Factors affecting water balance: 1. Temperature: Hot environments or physical exertion can increase water loss through sweating and breathing, leading to dehydration. 2. Dietary intake: Drinking fluids and eating foods with high water content, such as fruits and vegetables, can help maintain water balance. 3. Medications: Some medications can affect water balance by increasing or decreasing urine output.4. Medical conditions: Certain medical conditions, such as diabetes insipidus, can affect the body's ability to regulate water balance.

Dietary intake of electrolyte:  Electrolytes are minerals that carry an electric charge in the body and include sodium, potassium, calcium, magnesium, chloride, and phosphate.  Electrolytes play a crucial role in various bodily functions such as maintaining fluid balance, regulating blood pressure, and facilitating muscle contractions and nerve impulses.  Dietary sources of electrolytes include foods such as fruits, vegetables, dairy products, and meats.  Sodium is commonly found in table salt, processed foods, and condiments, while potassium is abundant in fruits and vegetables.  Calcium and magnesium can be obtained from dairy products, leafy greens, nuts, and seeds.  Electrolyte balance:  Electrolyte balance refers to the proper distribution of electrolytes in the body's fluid compartments, including the blood, cells, and extracellular spaces.  Electrolyte balance is maintained by various mechanisms, including the kidneys, hormones such as aldosterone and antidiuretic hormone (ADH), and the thirst mechanism.  Electrolyte imbalances can occur due to a variety of reasons, including excessive fluid loss through sweating, vomiting, or diarrhea, or due to certain medical conditions such as kidney disease. 

Sodium Sodium is the chief cation of the extracellular fluid. About 50% of body sodium is present in the bones, 40% in the extracellular fluid and the remaining (10%) in the soft tissues. Sodium is readily absorbed in the gastro intestinal tract.

Functions of sodium.  In association with chloride and bicarbonate, sodium regulates the body’s acid base balance or homeostatic.  It is necessary for the normal muscle irritability and cell permeability.  Sodium is involved in the intestinal absorption of glucose, galactose and amino acids.

Deficiency diseases of sodium.  Hyponatremia— This is a condition in which the serum sodium level falls below the normal. Hyponatremia may occur due to diarrhoea, vomiting, chronic renal diseases, adrenocortical insufficiency (Addison’s disease).  Hypernatremia— This condition is characterized by an elevation in the serum sodium level. The symptoms include increase in blood volume and blood pressure. It may occur due to hyperactivity of adrenal cortex (Cushing’s syndrome), prolonged administration of cortisone, ACTH and/or sex hormones.

Chloride Chlorine is a constituent of sodium chloride. Hence, the metabolism of chlorine and sodium are intimately related and in normal circumstances it is almost totally absorbed in the gastrointestinal tract.

Functions of chloride.  Chloride is involved in the regulation of acid-base equilibrium, fluid balance and osmotic pressure. These functions are carried out by the interaction of chloride with Na+ and K+ .  Chloride is necessary for the formation of HCl in the gastric juice.

Deficiency diseases of chloride.  Hypochloraemia— A reduction in the serum chlorine level may occur due to vomiting, diarrhoea, respiratory alkalosis, Addison’s disease and excessive sweating.  Hyperchloremia— An increase in serum chlorine concentration may be due to dehydration, respiratory acidosis and Cushing’s syndrome.

Calcium.  Calcium is the most abundant among the minerals in the body. The total content of calcium in an adult man is about 1 to 1.5 kg. As much as 99% of it is present in the bones and teeth. A small fraction (1%) of the calcium, found outside the skeletal tissue.

Sources.  Milk and milk products are the good source of calcium (cow’s milk, yogurt, cheese).  Egg, fish and green vegetables, fruits (Papaya, orange, kiwifruit) are also medium sources for calcium.

Functions of calcium.  Development of bones and teeth— Calcium, along with phosphate, is required for the formation (of hydroxyapatite) and physical strength of skeletal tissue. Bone is regarded as a mineralized connective tissue. Bones which are in a dynamic state serve as reservoir of Ca. Osteoblasts are responsible for bone formation while osteoclasts result in demineralization.  Muscle contraction— Ca2+ interacts with troponin C to trigger muscle contraction. Calcium also activates ATPase, increases the interaction between actin and myosin.  Nerve transmission—It is necessary for the nerve transmission by activating the axonal vesicle in the neuron.

Deficiency diseases of calcium.  Hypercalcaemia— Elevation in serum Ca2+ level (normal 9–11 mg/dl) is hypercalcemia. Hypercalcemia is associated with hyperparathyroidism caused by increased activity of parathyroid glands.  Hypocalcaemia— Hypocalcaemia is a more serious and life-threatening condition. It is characterized by a fall in the serum Ca2+ to below 7 mg/dl, causing tetany. The symptoms of tetany include neuromuscular irritability, and convulsions.  Rickets— Rickets is a disorder of defective calcification of bones. This may be due to a low levels of vitamin D in the body or due to a dietary deficiency of Ca2+ .

 Hemophilia and von Willebrand disease are inherited disorders that impair the blood's ability to clot, while deep vein thrombosis and pulmonary embolism occur when blood clots form in the veins and travel to other parts of the body, leading to serious complications

Erythrocytes - Abnormal cells and their significance. Red blood cells (RBCs) or erythrocytes are the most abundant type of blood cells in the human body, and their main function is to transport oxygen from the lungs to the body tissues and to carry carbon dioxide from the tissues back to the lungs. The shape of RBCs is an important characteristic that can provide information about a person's health status. A medical professional can evaluatethe shape and size of RBCs as part of a complete blood count (CBC) test to diagnose and monitor blood disorders. Some abnormal shape of RBCs.

1. Normal RBCs— Normal RBCs have a biconcave shape with a flattened centre, which increases their surface area for efficient gas exchange. Normal RBCs are essential for oxygen transport and carbon dioxide removal.

2. Sickle cell-shaped RBCs— Sickle cell-shaped RBCs have a crescent or sickle shape and are characteristic of sickle cell anaemia, a genetic disorder that affects the production of haemoglobin. These abnormal RBCs can cause blockages in the blood vessels, leading to pain, organ damage, and other complications. 3. Schistocyte-shaped RBCs— Schistocyte-shaped RBCs have an irregular shape and are fragmented due to physical damage, such as from trauma or mechanical heart valves. These abnormal RBCs can cause haemolysis, anaemia, and other blood disorders. 4. Target-shaped RBCs— Target-shaped RBCs have a central dark spot surrounded by a lighter ring and an outer dark ring. Target-shaped RBCs can be caused by iron deficiency anaemia, liver disease, thalassemia, and other conditions. 5. Ovalocyte-shaped RBCs— Ovalocyte-shaped RBCs have an oval or elliptical shape and can be seen in various blood disorders, including hereditary elliptocytosis, thalassemia, and myelofibrosis. 6. Tear-drop-shaped RBCs— Tear-drop-shaped RBCs have a teardrop or pear-shaped appearance and can be seen in various blood disorders, including thalassemia, myelofibrosis, and other conditions.

Pathology of Urine.

The pathology of urine involves the analysis of the chemical and physical properties of urine and their relationship to disease. Urine is a waste product that is produced by the kidneys and excreted from the body through the urinary system. 

Examination of urine. The investigation of urine, also known as urinalysis, is a medical test that evaluates the composition and properties of urine to diagnose various medical conditions. Here are some common investigations of urine:

1. Physical examination— This includes the colour, odour, and appearance of the urine. Normal urine is pale yellow in colour, clear, and has a mild odour. Abnormal urine may be cloudy, have a strong odour, or be a different colour, which can indicate various medical conditions.

2. Chemical analysis: A dipstick test is used to check for the presence of different chemicals in the urine, such as glucose, protein, ketones, blood, and bilirubin. Abnormal results can indicate conditions such as diabetes, kidney disease, or liver disease.

3. Microscopic examination: The urine sample is examined under a microscope to detect the presence of abnormal cells, bacteria, crystals, or other particles. This can help diagnose conditions such as urinary tract infections, kidney stones, or cancer.

4. Culture and sensitivity testing: If there is evidence of infection in the urine, a culture and sensitivity test may be performed to identify the type of bacteria causing the infection and determine the most effective antibiotic to treat it.

5. Urine cytology: This is a microscopic examination of the urine to detect abnormal cells that may indicate bladder cancer or other urinary tract cancers. 6. 24-hour urine collection: This test involves collecting all urine produced in a 24-hour period and measuring the volume, composition, and excretion of certain substances in the urine. It can be used to diagnose kidney disorders and other conditions. 7. Stone analysis: If a person has kidney stones, the stones can be analysed to determine their composition, which can help determine the cause and treatment of the stones.

Functions of liver: 1. Bile production: The liver produces bile, which helps in the digestion of fats. 2. Protein synthesis: The liver produces various proteins, such as albumin, that are essential for maintaining proper fluid balance in the body. 3. Detoxification: The liver detoxifies harmful substances, such as drugs, alcohol, and toxins, from the blood. 

Routine liver function tests are performed to assess the liver's health and function. These tests include: 1. Alanine transaminase (ALT) and Aspartate transaminase (AST): These tests measure the levels of liver enzymes in the blood. High levels of ALT and AST are indicative of liver damage. 2. Alkaline phosphatase (ALP): This test measures the levels of ALP in the blood. Elevated levels of ALP may indicate liver or bone disease. 3. Bilirubin: This test measures the levels of bilirubin in the blood. High levels of bilirubin may indicate liver disease or hemolytic anemia

Clinical significance of liver function tests include: 1. Detection of liver disease: Liver function tests can help detect liver disease in its early stages, before symptoms appear. 2. Monitoring of liver function: Liver function tests are used to monitor the progress of liver disease and assess the effectiveness of treatment. 3. Diagnosis of liver injury: Liver function tests can help diagnose liver injury caused by drugs, toxins, or infections.

Lipid profile tests and its clinical significances: A lipid profile test is a blood test that measures the amount of different types of lipids, or fats, in your blood. The lipids measured in a lipid profile test include: 1. Total cholesterol: This measures the total amount of cholesterol in your blood, including both high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol. 2. HDL cholesterol: This is often called the "good" cholesterol because it helps remove other types of cholesterol from your blood. 3. LDL cholesterol: This is often called the "bad" cholesterol because it can build up in your arteries and lead to heart disease. 4. Triglycerides: These are another type of fat that can build up in your blood and contribute to heart disease. Clinical significances: The clinical significance of a lipid profile test is that it can help your doctor assess your risk of developing heart disease.  High levels of LDL cholesterol and triglycerides, and low levels of HDL cholesterol, are all risk factors for heart disease.