1.
1.
Incubatio
Incubatio
n
n
Period
Period
o
o
Diseases
Diseases
2.
2.
Important Days o Public
Important Days o Public
Health Importance
Health Importance
3.
3.
Instruments
Instruments
o
o
Importance
Importance
in
in
Public
Public
Health
Health
4.
4.
Mode(s) o Transmi
Mode(s) o Transmi
ssion o
ssion o
Diseases
Diseases
5.
5.
Some Important Health Legislations Passed in India
Some Important Health Legislations Passed in India
6.
6.
Some I
Some I
mportant
mportant
Health
Health
Programmes
Programmes
o
o
India
India
7.
7.
Vectors and Diseases Transmitted
Vectors and Diseases Transmitted
8.
8.
New
New
T
T
uberculosis
uberculosis
Diagnosis (RNTCP)
Diagnosis (RNTCP)
Guidelines
Guidelines
in I
in I
ndia
ndia
(w.e.. 01 April, 2009 onwards)
(w.e.. 01 April, 2009 onwards)
9.9.
National Pop
National Pop
ulation Policy (NPP)
ulation Policy (NPP)
2000
2000
10.
10.
National Health Policy (NHP) 2002
National Health Policy (NHP) 2002
11.
11.
Millennium
Millennium
Development
Development
Goals (MDGs)
Goals (MDGs)
12.
12.
New Malaria Treatment Guidelines in India (2013 onwards)
New Malaria Treatment Guidelines in India (2013 onwards)
13.
13.
Draf
Draf
Guidelines
Guidelines
:
:
Biomedical W
Biomedical W
aste
aste
Management G
Management G
uidelin
uidelin
es
es
2011
2011
14.
14.
Golden
Golden
Poin
Poin
ts
ts
(Sets
(Sets
1–5)
1–5)
15.
15.
Current
Current
Public
Public
Health
Health
Related
Related
Statistics
Statistics
o I
o I
ndia*
ndia*
16.
16.
Newer
Newer
Concepts
Concepts
in P
in P
reventive
reventive
and
and
Social M
Social M
edicine
edicine
17.
17.
Honors
Honors
in
in
Health
Health
and
and
Medicine
Medicine
18.
18.
High Level
High Level
Expert Gro
Expert Gro
up
up
(HLEG) Report
(HLEG) Report
on U
on U
niversal H
niversal H
ealth
ealth
Coverage (UHC)
Coverage (UHC)
SECTION
1.
1.
Incubatio
Incubatio
n
n
Period
Period
o
o
Diseases
Diseases
2.
2.
Important Days o Public
Important Days o Public
Health Importance
Health Importance
3.
3.
Instruments
Instruments
o
o
Importance
Importance
in
in
Public
Public
Health
Health
4.
4.
Mode(s) o Transmi
Mode(s) o Transmi
ssion o
ssion o
Diseases
Diseases
5.
5.
Some Important Health Legislations Passed in India
Some Important Health Legislations Passed in India
6.
6.
Some I
Some I
mportant
mportant
Health
Health
Programmes
Programmes
o
o
India
India
7.
7.
Vectors and Diseases Transmitted
Vectors and Diseases Transmitted
8.
8.
New
New
T
T
uberculosis
uberculosis
Diagnosis (RNTCP)
Diagnosis (RNTCP)
Guidelines
Guidelines
in I
in I
ndia
ndia
(w.e.. 01 April, 2009 onwards)
(w.e.. 01 April, 2009 onwards)
9.9.
National Pop
National Pop
ulation Policy (NPP)
ulation Policy (NPP)
2000
2000
10.
10.
National Health Policy (NHP) 2002
National Health Policy (NHP) 2002
11.
11.
Millennium
Millennium
Development
Development
Goals (MDGs)
Goals (MDGs)
12.
12.
New Malaria Treatment Guidelines in India (2013 onwards)
New Malaria Treatment Guidelines in India (2013 onwards)
13.
13.
Draf
Draf
Guidelines
Guidelines
:
:
Biomedical W
Biomedical W
aste
aste
Management G
Management G
uidelin
uidelin
es
es
2011
2011
14.
14.
Golden
Golden
Poin
Poin
ts
ts
(Sets
(Sets
1–5)
1–5)
15.
15.
Current
Current
Public
Public
Health
Health
Related
Related
Statistics
Statistics
o I
o I
ndia*
ndia*
16.
16.
Newer
Newer
Concepts
Concepts
in P
in P
reventive
reventive
and
and
Social M
Social M
edicine
edicine
17.
17.
Honors
Honors
in
in
Health
Health
and
and
Medicine
Medicine
18.
18.
High Level
High Level
Expert Gro
Expert Gro
up
up
(HLEG) Report
(HLEG) Report
on U
on U
niversal H
niversal H
ealth
ealth
Coverage (UHC)
Coverage (UHC)
SECTION
D Diisseeaassee CCaauussaattiivve e oorrggaanniissmm IInnccuubbaattiioon n PPeerriiood d ((IIPP)) C Chhiicckkeen n ppooxx HHuummaan n ((aallpphhaa) ) hheerrppees s vviirruus s 33 114 4 – – 116 6 ddaayyss M Meeaassllees s ((RRuubbeeoonneellllaa)) RRNNA A ppaarraammyyxxoovviirruuss 110 0 – – 114 4 ddaayyss R Ruubbeelllla a ((GGeerrmmaan n MMeeaasslleess)) RRNNA A TTooggaavviirruuss 114 4 – – 221 1 ddaayyss M Muummppss RRNNAAMMyyxxoovviirruuss 1144––2211ddaayyss OOrrtthhoommyyxxoovviirruuss 1188––7722hhoouurrss D Diipphhtthheerriiaa CCoorryynneebbaacctteerriiuum m ddiipphhtthheerriiaaee 2 2 – – 6 6 ddaayyss P Peerrttuussssiis s ((WWhhooooppiinng g ccoouugghh)) BBoorrddeetteelllla a ppeerrttuussssiiss 7 7 – – 114 4 ddaayyss M Meenniinnggooccooccccaal l mmeenniinnggiittiiss NNeeiisssseerriia a mmeenniinnggiittiiss 3 3 – – 4 4 ddaayyss S SAARRSS CCoorroonnaavviirruuss 33––55ddaayyss T Tuubbeerrccuulloossiiss MMyyccoobbaacctteerriiuum m ttuubbeerrccuulloossiiss WWeeeekks s – – yyeeaarrss P Poolliioommyyeelliittiiss PPoolliioovviirruuss 77––1144ddaayyss H Heeppaattiittiis s AA EEnntteerroovviirruus s 772 2 ((PPiiccoorrnnaavviirruuss)) 115 5 – – 445 5 ddaayyss H HeeppaattiittiissBB HHeeppaaddnnaavviirruuss 4455––118800ddaayyss H HeeppaattiittiissCC HHeeppaacciivviirruuss 3300––112200ddaayyss C Chhoolleerraa VViibbrriioocchhoolleerraaee 11––22ddaayyss T Tyypphhooiid d ffeevveerr SSaallmmoonneelllla a ttyypphhii 110 0 – – 114 4 ddaayyss S Sttaapphhyyllooccooccccaal l ffooood d ppooiissoonniinngg SSttaapphhyyllooccooccccuus s aauurreeuuss 1 1 – – 6 6 hhoouurrss A Assccaarriiaassiiss AAssccaarriis s lluummbbrriiccooiiddeess 2 2 mmoonntthhss A Annccyylloossttoommiiaassiis s ((HHooookkwwoorrmm)) AA. . dduuooddeennaallee 5 5 wweeeekks s – – 9 9 mmoonntthhss M Maallaarriiaa PPllaassmmooddiiuummvviivvaaxx 88––1177ddaayyss P Pllaassmmooddiiuum m ffaallcciippaarruumm 9 9 – – 114 4 ddaayyss P Pllaassmmooddiiuum m mmaallaarriiaaee 118 8 – – 440 0 ddaayyss P Pllaassmmooddiiuum m oovvaallee 116 6 – – 118 8 ddaayyss WWuucchheerreerriia a bbaannccrrooffttii 8 8 – – 116 6 mmoonntthhss R Raabbiieess LLyyssssaavviirruus s ttyyppe e 1 1 ((RRhhaabbddoovviirruuss)) 3 3 – – 8 8 wweeeekkss Y Yeelllloow w ffeevveerr 2 2 – – 6 6 ddaayyss J Jaappaanneesse e eenncceepphhaalliittiiss GGrroouup p B B aarrbboovviirruus s ((FFllaavviivviirruuss)) 5 5 – – 115 5 ddaayyss K KFFDD AArrbboovviirruuss((FFllaavviivviirruuss)) 33––88ddaayyss C Chhiikkuunngguunnyya a ffeevveerr CChhiikkuunngguunnyyaavviirruus s ((AArrbboovviirruus s AA)) 4 4 – – 7 7 ddaayyss L Leeppttoossppiirroossiiss LLeeppttoossppiirra a iinntteerrrrooggaannss 4 4 – – 220 0 ddaayyss B Buubboonniic c ppllaagguuee YYeerrssiinniia a ppeessttiiss 2 2 – – 7 7 ddaayyss P Pnneeuummoonniic c ppllaagguuee YYeerrssiinniia a ppeessttiiss 1 1 – – 3 3 ddaayyssReview of Preventive and Social Medicine I n c u b a t i o n P e r i o d o f D i s e a s e s
Scrub typhus Rickettsia tsutsugamushi 10 – 12 days
Qfever Coxiellaburnetti 2–3weeks
Taeniasis (Tapeworms) T. solium, T. saginata 8 – 14 weeks
L. donovani 1 – 4 months
Trachoma Chlamydia trachomatis 5 – 12 days
Tetanus Clostridiumtetani 6–10days
Yaws Treponemapertenue 3–5weeks
HIV/ AIDS HIV/ HTLV – III/ LAV Months – 10 years
SwineFlu H1N1 1–4 days
Crimean Congo Fever Nairovirus (Bunyavirus) 1–9 days
H7N9 H7N9 1–10 days (3.3 days)
MERS Betacoronavirus 12days
Eboladisease Ebolavirus 2-21days
Anthrax Bacillusanthracis 1-7days
30th January Anti-Leprosy Day
2nd Wednesday of March No Smoking Day
8th March International Women’s Day
15th March World Disabled Day
24thMarch Anti-TBDay
7thApril WorldHealthDay
25th April World Malaria Day
8th May World Red Cross Day
31stMay NoTobaccoDay
5th June World Environment Day
14th June World Blood Donor Day
26th June
1stJuly DoctorsDay
11th July World Population Day
28th July World Hepatitis Day
8th September World Literacy Day
28th September World Rabies Day
1st October International Day for Older Persons
1st October National Voluntary Blood Donation Day
2nd Wednesday of October World Disaster Reduction Day
9th October World Sight Day
10th October World Mental Health Day
24thOctober UNDay
10th November Universal Immunization Day
25th November International Day for Elimination of Violence against Women
1st December World AIDS Day
3rd December International Day of Disabled Persons
10th December Human Rights Day
Last Week of April World Immunization Week
1–7th May Anti–Malaria Week
1–30th June Anti–Malaria Month
1–8th August World Breast Feeding Week
25th August–8th September Eye Donation Fortnight
Instrument Use
Ice Lined Refrigerator (ILR) Cold chain temperature maintenance
Dial Thermometer Cold chain temperature monitoring
Horrock’s Apparatus Chlorine demand estimation in water
Chlorinator, Chloronome Mixing/regulating the dose of chlorine in water
Chloroscope Measuring level of residual chlorine in drinking water
Winchester Quart bottle Assess physical and chemical quality of drinking water
Kata Thermometer Assess cooling power of air and air velocity (Latter Currently)
Anemometer Assess air/wind velocity
Hygrometer and Sling Psychrometer Assess air humidity (moisture content of air)
Assman Psychrometer Assess air humidity (moisture content of air)
Mercurial Barometer Atmospheric pressure
Anaeroid Barometer Atmospheric pressure
Wind Vane Assess air/wind direction
Salter’s scale Field Instrument for Low Birth Weight (LBW)
Infantometer Length of infants
Stadiometer Height of adults
Shakir’s Tape Mid-Arm Circumference (MAC)
Sound Level Meter Measures intensity of sound
Band Frequency Analyzer Characteristic of sound (pitch)
Disease Mode(s) of transmission Remarks
Chicken Pox Droplet infection, droplet nuclei. Face to face transmission
Measles Droplet infection, droplet nuclei, through conjunctiva 4 days before rash to 5 days later
Rubella Droplet infection, droplet nuclei, vertical 1 week before rash to 1 week later
Mumps Droplet infection, direct contact
Droplet infection, droplet nuclei
Diphtheria Droplet infection, direct contact, fomite borne 95% transmission from carriers
Whooping Cough Droplet infection, direct contact, fomite
Meningococcal Droplet infection Carriers most important source of infection
TB Droplet infection, droplet nuclei. Not Fomite borne
Poliomyelitis Faeco-oral, droplet infection
Hepatitis A Faeco-oral, parenteral, sexual
Hepatitis B
Hepatitis C Perinatal, parenteral, sexual
Hepatitis D Perinatal, parenteral, sexual Super-infection/co-infection to HBV
Hepatitis E Feco-oral
Cholera Feco-oral, contaminated foods/drinks, direct contact
Typhoid Feco-oral, urine-oral
Amoebiasis Feco-oral
Ascariasis Feco-oral
Ancylostomiasis Direct penetration(skin), oral Transmission may be perennial
Dracunculiasis Consumption of water containing cyclops Water based disease
Dengue Aedes bite Water breeding disease
Leptospirosis Urine, feces, tissues of rats Direct skin contact
Nipah virus Consumption of bats-eaten fruits Person-to-person in India
Ebola virus sweat, saliva)
National Family Planning Programme:
National Malaria Control Programme (NMCP):
Lymphatic Filariasis Control Programme:
National Leprosy Control Programme:
National Malaria Eradication Programme (NMEP):
National Tuberculosis Programme (NTP):
National Goitre Control Programme (NGCP):
National Trachoma Control Programme:
Urban Malaria Scheme (UMS):
Integrated Child Development Services (ICDS) Scheme:
National Cancer Control Programme:
National Programme for Control of Blindness (NPCB):
Kala Azar Control Programme:
National Mental Health Programme:
National Leprosy Eradication Programme (NLEP):
National Guineaworm Eradication Programme:
National AIDS Control Programme (NACP):
Baby Friendly Hospital Initiative (BFHI) :
Revised National Tuberculosis Control Programme (RNTCP):
Child Survival and Safe Motherhood (CSSM) Programme:
National AIDS Control Programme I (NACP I):
Yaws Eradication Programme:
Revised Lymphatic Filariasis Control Programme:
Enhanced Malaria Control Project (EMCP):
Reproductive and Child Health Programme I:
National Anti Malaria Programme (NAMP):
National AIDS Control Programme II (NACP II):
National Vector Borne Disease Control Programme (NVBDCP):
Integrated Disease Surveillance Project (IDSP):
Reproductive and Child Health Programme II:
National Rural Health Mission (NRHM):
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), 2006
National AIDS Control Programme III (NACP III):
National Tobacco Control Programme (NTCP):
National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS):
National Program for Health Care of the Elderly (NPHCE):
Vector Disease(s) transmitted
Objectives of National Population Policy 2000 –
Immediate objectives:
To meet unmet need of contraception; to strengthen health infrastructure; to strengthen health personnel and to promote integrated service delivery for basic RCH care–
Mid-term objective: ‘
To bring the total fertility rate (TFR) to Replacement Level; i.e. TFR to 2.1’–
Long-term objective:
To stabilize population by 2045National Socio-demographic Goals of NPP 2000 (achieve by 2010)
– Address the unmet needs for basic reproductive and child health services, supplies and infrastructure
– Make school education up to age 14 free and compulsory, and reduce drop outs at primary and secondary school levels to below 20 percent for both boys and girls
– Reduce infant mortality rate to below 30 per 1000 live births
– Reduce maternal mortality ratio to below 100 per 100,000 live births – Achieve universal (100%) immunization of children against all vaccine
preventable diseases
– Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age
– Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons
– Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices
– Achieve 100 percent registration of births, deaths, marriage and pregnancy –
promote greater integration between the management of reproductive tract Control Organisation
– Prevent and control communicable diseases
– Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households
– Promote vigorously the small family norm to achieve replacement levels of TFR – Bring about convergence in implementation of related social sector programs so
Goals for 2005 – Eradicate Polio and Yaws
– Eliminate Leprosy
– Establish integrated system of Surveillance, National Health Accounts and Health Statistics – Increase state sector health spending from 5.5% to 7% of budget
Goals for 2007 – Achieve zero level of growth of HIV/AIDS
Goals for 2010 – Eliminate Kala Azar
– Reduce mortality by 50% due to TB, Malaria, Vector borne diseases and Water borne diseases – Reduce prevalence of blindness to 0.5%
– Reduce IMR to 30/1000 and MMR to 100/Lac
– Increase utilization of public health facilities from <20% to >75% – Increase health expenditure as % of GDP from 0.9% to 2.0%
– Increase share of central grants to constitute >25% of total health spending – Further increase state sector health spending to 8% of budget
Baseline Year for MDGs: 1990 Deadline year for MDGs: 2015
8 MDGs:
Goal 1: Eradicate extreme poverty and hunger Goal 2: Universalize primary education
Goal 3: Gender equality and women empowerment Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other disease (Tuberculosis) Goal 7: Ensure environmental sustainability
Goal 8: Develop global partnerships for development
3 out of 8 goals, 8 out of 18 targets required to achieve them and 18 out of 48 indicators of progress are ‘directly health related’ – Goal 4, 5 and 6 are ‘directly health related’
I. VIVAX MALARIA
II. FALCIPARUM MALARIA
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PLEASE NOTE:
:
Age Colour code for blister pack
0-1year Pink 1-4 years Yellow 5-8 years Green 9-14 years Red 15+ years White
:
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III. MIXED INFECTIONS (P. VIVAX + P. FALCIPARUM)
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IV. PLASMODIUM MALARIAE
V. PLASMODIUM OVALE
VI. MIXED INFECTIONS
Review of Preventive and Social Medicine N e w M a l a r i a T r e a t m e n t G u i d e l i n e s i n I n d i a ( 2 0 1 3 o n w a r d s )
VII. SEVERE & COMPLICATED MALARIA
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– Arteether
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VIII. CHEMOPROPHYLAXIS
Dear students, PLEASE NOTE: These guidelines are ‘draft proposed guidelines’ in Gazette of India. They have NOT YET been implemented in India.
Draft BMW Management Guidelines 2011 are NOT valid for:
e Schedule I: Categories of BMWBMW category Type of waste Disposal steps
Category 1 Human anatomical waste Incineration
Category 2 Animal waste Incineration
Category 3 Microbiological and Biotechnology waste 1. Chemical treatment/ Autoclaving/ Microwaving 2. Mutilation/ Shredding
Category 4 Wasted sharps 1. Chemical treatment/ Destruction by needle or tip cutters/
Autoclaving/ Microwaving 2. Mutilation/ Shredding Cat egory 5 Di scarded medicines and cytot oxic drugs
Category 6 Soiled waste Incineration
Category 7 Infectious solid waste 1. Chemical treatment/ Autoclaving/Microwaving
2. Mutilation/ Shredding
Category 8 Chemical waste 1. Chemical treatment
2. Disposal in drains
Schedule II: Types of Containers and Disposal
Color coding Waste categories Treatment options
Yellow 1,2,5,6 Incineration
3, 4, 7 1. Chemical treatment/ Destruction (needle/
tip cutters)/ Autoclaving/ Microwaving 2. Mutilation/ Shredding
Blue 8 1. Chemical treatment
2. Disposal in drains
PSM: GOLDEN POINTS 1
Father of Medicine/First True Epidemiologist Hippocrates
Father of Public Health Cholera
First Country to Socialise Medicine completely Russia
Health as a “State of complete physical, social and mental
WHO
HDI(Human Development Index) comprises Knowledge (Literacy and Mean years of schooling), Income and
Longevity (Life Expectancy at Birth)
Life Expectancy is a Mortality Indicator (Positive Health Indicator)
“Epidemiological Triad” comprises of Agent, Host and Environment
Extermination of organism is Eradication
Action taken prior to onset of disease is Primary Prevention
Early Diagnosis and Treatment are Secondary Prevention
Ivory Towers of Disease Large Hospitals
Diseases
Prevalence is a Proportion (Total=New + Old Cases)
Total no. of deaths/Total no. of cases is Case Fatality Rate
Observed Deaths/Expected Deaths is Standardized Mortality Ratio (SMR)
Prevalence/Duration is Incidence
Both exposure and outcome have occurred before study starts in Case Control Study
Cohort Study is Forward Looking/Prospective Study
Matching Removes confounding, Ensures Comparability
Relative Risk is Incidence among Exposed/ Incidence among non-exposed
Framingham Heart Study is a Cohort Study
Heart of a Control Trial is Randomization
Occurrence of a Disease Clearly in excess of normal expectancy Epidemic Disease imported in a country where it doesn’t occur Exotic
Iatrogenic Disease is Physician-induced
First case to come to notice of investigator Index Case
Pseudo-Carriers are Carriers of avirulent Organisms
Malaria parasite in Mosquito is Cyclo-propagative Transmission
Gap between Primary case and Secondary Case is Serial Interval
Yellow Fever/BCG/Measles are Live Vaccines/ Lyophilised vaccines
Golden Points G o l d en P o i n t s
Advantage gained by screening Lead Time
True Positives
Usefulness of a screening test is given by Sensitivity
Small Pox was declared Eradicated on 8 May, 1980
Rash in Chickenpox is Pleomorphic and Dew-drop like
Koplik Spots are diagnostic of Measles (upper 2nd molar)
Incubation Period for Measles is 10-14 days
Strain for Measles Vaccine is Edmonston Zagreb
Strain for Rubella Vaccine RA 27/3
Type A (H5N1 strain) virus
Hundred Day Cough is Pertussis (Whooping Cough)
DOC for Chemoprophylaxis of Meningococcal Meningitis Rifampicin
Positive Schick Test indicates Susceptible to Diphtheria
Inability to drink is a sign of Very Severe Disease
SARS is caused by Corona Virus
Overall Prevalence of TB infection 30 - 40 %
Sputum Smear +ve at or after 5 months ATT Failure
Only Bacteriostatic drug in Primary ATT Drugs Ethambutol
Category II treatment (RNTCP) duration is 8 Months (3m IP + 5m CP)
WHO has recommended ‘DANISH 1331’ strain for BCG Vaccine
Failure in RNTCP Sputum +ve at/after 5 months treatment
Sputum Smear (ZN Staining)
DOTS is Directly Observed Treatment, Short Course Chemotherapy
Category II (8 Months treatment) For every 1 clinical case of Poliomyelitis, there are 1000 subclinical Cases
Polio stool samples are transported in Reverse Cold Chain (+ 2° to + 8° C)
HBeAg is Marker of Infectivity/Viral Replication
ORS Solution should be used within 24 Hours
Enteric Fever includes Typhoid and Para-typhoid Fevers
Chandler’s Index for Hookworms is Av. No. of Eggs/gm of stool
MC arboviral disease is Dengue
Presumptive Treatment in Malaria Chloroquine
Only communicable disease of man that is always fatal Rabies
Main Vector for Yellow Fever is Aedes aegypti
Pigs in Japanese Encephalitis are
KFD is transmitted in India by Haemaphysalis (Hard tick)
Main reservoir of Plague in India Tatera indica (Wild Rodent)
Scrub typhus is caused by Rickettsia tsustsugamushi
Leishmaniasis (Kala Azar)
Elimination Level for leprosy <1/10,000
MDT for PBL is given for 6 months
Yaws is caused by Treponema pertenue
Slims’Diseaseis AIDS
Review of Preventive and Social Medicine G o l d e n P o i n t s
MC cause of heart disease in 5-30 yr old is Rheumatic fever
WHO Criteria for diagnosis of RF/RHD are based on Revised Jones Criteria
MC Cancer in India is Lung Cancer (Males); Cervico-uterine cancer (Females)
Pap Smear should be done At beginning of sexual activity and then every 3 yrs
BMIis Weight(Kgs)/Height2 (m2)
Waist Hip Ratio indicates Obesity in Women when > 0.85
WHO Blindness is <3/60 in better eye
MCCofBlindness Cataract
API
I n Malaria program, MPW does Act ive Surveill ance every 14 days (Fort nightly)
NHP 2002 envisages Kala Azar Elimination by 2010
Elimination Level of Leprosy <1/10,000
Passive
Prevalence of Blindness in India 1.05%
Under RCH Program, Kit A, B are kept at Subcentre Level
Feb 2001
Annual growth rate for India 1.64%
Sex ratio No. of females/1000 males (940 in 2011)
Completed family Size represents TFR (Total Fertility Rate)
2childnormmeans NRR=1
No. of Eligible Couples in India 150–180 ECs/1000 population
Conventional Contraceptives Condoms/Spermicides
Progestasert (3rd gen IUD) releases 65 mcg/day Progesterone
MC complaint of IUD insertion is Bleeding
Only Non-steroidal OCP Centchroman (Saheli)
MTP Act, 1971 was passed in April 1972
For sterilization, age of Husband should be < 60 years
Pearl index (____/HWY)
3 most important MCH problems Malnutrition, Infection and Unregulated fertility
MC disorder to be screened in neonates Neonatal Hypothyroidism
Low Birth Weight is Birth Weight <2.5 Kg
Most sensitive indicator of growth among children Weight
World’s greatest Public Health Tool is Immunization
Denominator for MMR Live Births
MCCofMMRis Hemorrhage
Juvenile is age < 18 yrs (Boys), <18 yrs (Girls)
Alcohol yields energy of 7 Kcal/gram
Protein requirement 0.83 gm/kg/day
Most important Essential fatty Acid is Linoleic Acid
Richest Source of Vitamin-A/D is Halibut Liver oil
Golden Points G o l d en P o i n t s
Adult Pregnant females are Anemic if Hb < 11 gm%
Optimum Level of Fluorine intake 0.5–0.8 ppm (mg/L)
Soyabean contains 43.2% proteins
Best among food proteins Egg
An Indian Reference Man weighs 60 kg
Best indicator of Protein Quality NPU
First Indicator of PEM Under-Weight for Age
Two-in-One salt contains Iron+Iodine
ToxininLathyrism BOAA
Phosphatase Test is done for
Acculturation is Cultural Contact
IQ MentalAge/ChronologicalAge×100
Disinfecting Action of chlorine is due to Hypochlorous Acid
Residual Level of Chlorine in Water 0.5 mg × Contact period 1 Hr
Temporary Hardness of Water is due to Ca++ and Mg++ Bicarbonates
Anemometer measures Air Velocity
Most satisfactory method of Refuse disposal
Water Seal in Sanitary latrine is 2 cms
Best approach for arthropod control Environmental Control
TigerMosquito Aedes
Parisgreenisa StomachPoison
Pyrethrumisa SpaceSpray
Yellow bag is used for disposal of BMW Cat. 1,2,3 and 6 (Cat. 1, 2, 5, 6 in New Guidlines)
Plumbismis Leadpoisoning
MC Occupational Cancer Skin Cancer
Preplacement Examination is a part of Ergonomics
Indian Factories Act, 1948 recommends per capita space Min.500 cu.ft.
91 days
Census takes place every 10 years
1,3,6,7,8, 9,11 Median is 7
Normal Distribution Curve is Bell Shaped Symmetric
Chi-Square test
Focus group Discussion should have 6-12 members
NHP 2002 says, Eliminate Lymphatic Filariasis by 2015
Bhore committee was established in 1943
MPW was given by Kartar Singh Committee
1 PHC is for a population of 30,000
International Conference at Alma-Ata (1978) gave concept of Primary Health Care
MDGs have to be achieved by 2015
MPW is located at Subcentre level
Greatest risk of Cold Chain failure is at Subcentre and village level
WorldHealthDay 7April
‘O’ in GOBI Campaign (UNICEF) stands for Oral Rehydration therapy
Review of Preventive and Social Medicine G o l d e n P o i n t s PSM: GOLDEN POINTS 2
Father of Medicine/ First True Epidemiologist Hippocrates
Search for cases in epidemic is done till Twice the Incubation period since last case
Point source epidemic Sharp rise/fall, all cases in 1 Incubation period
Exotic Disease
Phase I clinical trial of drugs done on Healthy volunteers
MMRisa Ratio
Case fatality rate Killing power of a disease
Marc Koska developed Disposable K1-syringe (auto-disabled)
Measles vaccine stored at + 2° to + 8° C
Rubella is Live vaccine and C/I in pregnancy
Period of infectivity of measles 4 days before to 5 days after rash appearance
Yellow fever Vaccine (17 D) Live Vaccine
Lyophilized (freeze dried) Vaccines BCG, Yellow Fever, Measles, MMR
Cold Chain Temperature + 2° to + 8° C
Sensitivity
PPV is directly proportional to Prevalence
Dysphagia, dysarthria and diplopia seen in Clostridium botulinum food poisoning
Leishmaniasis (Kala Azar) is transmitted by Sand Fly (Phlebotamus)
DOC for Kala Azar (Black si ckness) in I ndian program Sodium Stibo-gluconate (Ant imonials)
DOC for Lympho granuloma venerum Doxycycline
Malaria exhibits Cyclo-propogative transmission
Vector of urban malaria Anopheles stephensi
Vector of KFD in India Hemophysalis (Hard Tick)
Japanese Encephalitis, Pigs are
Tourniquet test (dengue) is +ve >20 petechial spots/ sq. inch in cubital fossa
Reservoir in Chikungunya fever Primates (monkeys)
ReservoirofPolio Man(only)
HEV transmission Feco-oral route
Hydatid disease cysts in Postero-superior lobe of liver
Typhoid diagnosed in 1st week by Blood Culture
Yersinia pseudotuberculosis resembles Typhoid/Appendicitis (in humans)
8th Day Disease Tetanus neonatorum
DOC Cholera (Pregnancy) Furazolidone
Diagnosis in RNTCP 2 sputum smear examination (ZN Staining)
RNTCP Objectives >85% cure rate and >70% case detection rate
Treatment duration of MBL 12 months (Surveillance 5 years)
Elimination Level of Neonatal tetanus <0.1 per 1,000
IPofyellowfever 2–6days
10 days - 10 years
Golden Points G o l d en P o i n t s
Best marker of HIV progression
MC Opportunistic Infection in HIV Pneumocystis carinii Pneumonia (TB–India)
Blood screening before transfusion HIV/ HBV/ HCV/ Malaria/ Syphilis
Epidemic typhus main mammalian reservoir Human beings
Soft Tick is vector of Q fever, Relapsing Fever, KFD (not India)
Oseltamivir 150 mg BD × 5 days
Last outbreak of Plague Dangud, Uttrakashi (2004)
ABER (Annual Blood Examination Rate)
Body Mass Index (BMI) Weight (kg)/ Height (metre2)
Highest Growth Rate in India (Census 2001)
India is in Demographic cycle Stage 3 (Declining BR and declining DR)
Highest Life Expectancy
Life expectancy India
NPP 2000, Bring ‘TFR to replacement level’ by 2010
% Geriatric population in India 8.1 %
Infant Mortality rate No. of infant deaths per 1000 Live births
IMR of Japan
Normal respiratory rate in a newborn 40–60 breaths per minute
Pearl Index (Failure rate per HWY)
Failure rate of condoms 2–14 per HWY
WHO Oligospermia Sperm Count <20 million/HPF
WorldHealthDay 07April
Short stature in High Risk Pregnancy < 140 cms
Mental retardation if IQ Level < 70
Golden Rice is rich in ß-carotene (and Iron)
Milkispoorin VitaminCandIron
Pulse with highest protein content Soyabean (43%)
Reference protein Egg (NPU 96)
ToxininLathyrism BOAA
Pellagra
No plant source for vitamins B12 and D
Tests of pasteurization Phosphatase test (MC), Coliform Count, Std plate count
Horrocks Apparatus (Starch Iodide indicator) Chlorine demand estimation
Level of residual level of chlorine in water 0.5 ppm (mg/litre) for contact period 1hr
Maximum tolerable level of nitrates in water 50 mg/litre
Anopheles larvae rest Parallel to under surface water
Aedes larvae breed in
Kata thermometer measures Cooling power of air
Maximum allowable sweat rate 4.5 litres per 4 hours
Vit-D resistant rickets inheritance Sex-linked dominant
Burtonian Line (Blue Line on Gums) Lead poisoning (Plumbism)
Symposium
Review of Preventive and Social Medicine G o l d e n P o i n t s No.ofPHCsinIndia 24,049
Bhore committee (1946) recommended ‘3 Million Plan’ and ‘Social Physicians’
‘Multi-purpose Workers’ introduced by Kartar Singh Committee
‘Inventory’ (of materials) means Stock on hand at anytime
Scatter/Dot Diagram represents Correlation
Histogram is Continuous quantitative data presentation
Mean (µ) + 2 SD (s) 95 % of total values
Use of Cluster Random Sampling Evaluation of Immunization Coverage
Chi-square Test Sig. of association b/w 2 qualitative characteristics
PSM: GOLDEN POINTS 3
Total osmolarity of WHO Reduced Osmolarity ORS 245 mmol/L
Routine surveillance is supplemented by Sentinel surveillance
Traditional lifestyles for CHD prevention. Primordial level
Softening of water is recommended above hardness >150 mg/litre
Degrees of freedom for 3X6 table (Chi-square) is 10
Word ‘Random’ means Equal and known chance
DOTS Plus refers to MDR TB treatment (Cat IV)
Low birth weight incidence in India is 28%
One Urban-PHC is for population 50,000
Panel discussion
Ambulatory patients in triage Cat III (GREEN)
Mite transmits rickettsial diseases Scrub typhus, R. pox
Drug of choice for scabies 5% Permethrin
Statistical test to compare means between 2 groups Unpaired students t-test
Exposure period required for Anthracosis 12 years
1 PHC in tribal area for a population of 20,000
Dose of ORS for a child with weight 12 kg 900 ml
10 years
Main disinfection in chlorination of water is by Hypochlorous acid
3 divisions of Planning Commission General secretariat, Technical divisions,
Program advisors
ROME scheme recommended by Srivastava committee
Q-fever is caused by Coxiella burnetti
Q-fever is transmitted by Inhalation of infected dust
Midday meal programme provides 1/3 calories and 1/2 proteins
Unmet need for Family planning in India is highest for Adolescents
Number of holes per sq. inch in mosquito net 150
MCC of neonatal mortality in India LBW and prematurity
MC side effect of Depot contraceptives Irregular menstrual bleeding
Golden Points G o l d en P o i n t s
1 Community Development Block population 100,000
Exclusive breast feeding till 6 months age
Older name of Janani Suraksha Yojana
Lime + Alum
Numerator of Pearl Index No. of accidental gestations
Richest source of Vitamin D Halibut liver oil
Average incubation period for HIV 10 years
Incubation period for Measles 10 days
First outbreak of Hepatitis E in Delhi 1955
MCfoodpoisoning Staphylococcus
True positive indicate Sensitivity
Best method to prevent Nosocomial infection Hand washing
Hardy Weinberg law failure in Mutations, Linkage disequilibrium
Hepatitis B vaccine is a type of Killed vaccine
Prophylactic treatment of Rheumatic heart disease Benzathaine penicillin
Vector of Yellow fever Aedes aegypti
1994 epidemic in India was. Plague
DOC for Crimean Congo Fever Ribavirin
Effectiveness of MCH services is given by IMR
KitBiskeptat. Subcentres
Richest source of Iron among nuts. Pistachio
A7/California/2009
Web of causation proposed by McMohan and Pugh
Father of Modern Toxicology
Condom failure occurs due to Incorrect use
BMI of Normal Asian Men 18.5-22.99
Infective stage of Plasmodium to man Sporozoite
Spot map was used for study of Cholera
NormalIQis 90–109
Koplikspotsareseenin Measles
Zinc
HIV mainly affects cell type Helper T-cells (CD4)
ESIActcameinyear 1948
Pigs
Sodium ion content in ORS 75 mmol/ L
HydatidcystisseenMCin Liver
Main aim of Vision 2020 Eliminate avoidable blindness
ShelflifeofCuT380A 10years
Recommended frequency of school health examination Once every 6 months
Human DNA consist of 3 billion base pairs
Doors + windows area in a school class
NormalIQlevel 90–109IQpoints
Highest case fatality rate Rabies
