PREVENTIVE AND SOCIAL MEDICINE mci screening test and indian medical examz high yield important topics study tips
By Live Dr - Wed Feb 11, 3:19 am
PREVENTIVE AND SOCIAL MEDICINE
|First stage- high stationary||High birth rate and a high death rate which cancel each other and the population remains stationary|
|Second stage early expanding||Death rate begins to decline while birth rate remains unchanged|
|Third stage late expanding||Death rate declines still further and the birth rate tends to fall, population continues to grow, as births exceed deaths|
|Fourth stage- low stationary||This Stage is characterised by low birth and low death rate with the population becomes stationary|
|Stationary population||No growth|
|Slow growth||< 0.5|
|Very rapid growth||1.5-2|
|Pqli-physical quality of life index|
|Infant mortality rate
Life expectancy at 1 year
|Hdi-human developmental index|
|Life expectancy at birth
The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.-Winston Churchill
ELEVENTH HOUR P.S.M. 74
|mosquito type||breeding place||diseases transmitted|
|Anopheles||Clean stagnant water||Malaria|
|Culex||Polluted stagnant water||Bancroftian filariasis, Japanese encephalitis, west-Nile fever, viral arthritis.|
|Aedes||Artificial collections of water||Dengue, yellow fever, Chikungunya|
|Mansonites||Ponds with aquatic plants||Malayan filariasis, Chikungunya.|
National malaria eradication program
|activity||api > 2||API <2|
|Routine spraying||Done||Not done|
|Entomological assessment||Done||Not done|
|Active and passive surveillance||Done||Done|
|Presumptive and radical treatment||Given||Given|
|Follow up smear after 1 year||Not done||Done|
|Diseases subject to international health regulations|
|Diseases under surveillance by WHO|
Louse borne typhus fever
|ILO, WHO, IRC||Geneva|
|UNICEF, UN, UNESCO||New York|
*3 by 5 initiative
Global target by WHO and UNAIDS to provide treatment to 3 million people living with hiv/aids in low income and middle income countries with life prolonging anti-retroviral treatment by the end of 2005.
The only time the human population declined was in the years following 1347, the start of the epidemic of the plague ‘Black Death’ in Europe.
ELEVENTH HOUR P.S.M. 75
*UNICEF’S GOBI – FFF program-
*Slogan of World Health Day 2007
Invest in health, Build a safer future
|An establishment employing.
10 or more workers where power is used
20 or more where power is not used.
A minimum of 500 cubic feet of space has been prescribed for each worker
Prohibits employment of children below 14 years.
Maximum of 48 hours working hours per week, not exceeding 9 hours per day, with rest for atleast ½ hour after 5 hours of continuous work
Total number of hours in a week (including overtime) shall not exceed 60 hours.
*Net protein utilization= Digestibility coefficient x Biological value
= Nitrogen retained X 100
*Protein Energy Ratio = Energy from protein
Total energy in diet
*Protein efficiency ratio = Weight gain per unit protein consumed
*Amino acid score = mg. of amino acid per gram of protein
=mg. of same amino acid per gram egg protein
Whenever you are asked if you can do a job, tell them, “certainly, I can.” Then get busy and find out how to do it.-Theodore Roosevelt.
ELEVENTH HOUR P.S.M. 76
|Neurolathyrism||boaA- Lathyrus sativus (kesari dal)|
|Aflatoxins||Hepatotoxicity- -Aspergillus flavus, Aspergillus parasiticus infection of groundnut, tapioaca, cereals.|
|Ergotism||cereals and millets , infected by field fungus claviceps fusiformis|
|Epidemic dropsy||Mustard oil adulterated with argemone oil. Toxins are benzophenanthridine alkaloids- sanguinarine and dihydrosanguinarine. Leg edema with diarrhea.|
|Endemic ascites||Panicum miliare- (gondhli) contaminated with weed seeds of crotalaria (jhunjhunia) – ascites with jaundice.|
|Fusarium toxin||Rice, sorghum, Fusarium incamatum.|
New ORS formula
|Tri sodium citrate dehydrate||2.9 gm / 10mmol / 30meq|
|Glucose||13.5 gm / 75 mmol|
ELECTROLYTE CONENTRATRION IN ORS
10mmol / 30meq
|2 litres of water
I packet of WHO-ORS
40 ml of mineral solution
Plus zinc supplements-20 mg. for 10-14 days
ELECTROLYTE CONENTRATION IN RESOMAL
7 mmol / 21 meq
|Copper||Menky’s kinky hair disease.|
Beri Beri originates from the Sinhalese language meaning “I cannot, I cannot”.
ELEVENTH HOUR P.S.M. 77
VITAMIN A PROPHYLAXIS
|Newborn||50000 IU at birth|
|Children below 12 months||100000 IU at 9 months with MMR and then every after every 6 months|
|Children more than 12 months||200000 IU till 3 years of age|
|Preganant and lactating women||5000 IU every day|
|Live attenuated vaccines||Killed vaccines|
Yellow fever mmr
Epidemic typhus Chicken pox
EPI schedules as recommended by Govt. of India.
|Birth -15 days||BCG + OPV (ZERO DOSE)|
|6 weeks -8 weeks||OPV1 + DPT1|
|10 weeks – 12 weeks||OPV2 + DPT2|
|14 weeks – 16 weeks||OPV3 + DPT3|
|9 months (completed)||Measles vaccine|
|15 months-18 months||1st booster of OPV + DPT|
|4 years -6 years||OPV+ DT 2nd booster|
|10 years||Tetanus Toxoid|
|16 years||Tetanus Toxoid|
|Vaccines contraindicated in HIV/AIDS patient|
Genius is one percent inspiration, ninety-nine percent perspiration.- Thomas edison
ELEVENTH HOUR P.S.M. 78
*A killed and a live vaccine can be administered simultaneously at different sites.
*2 or more killed vaccines can be given simultaneously or at any interval between doses
Exception- cholera and yellow fever, between these 2 gap of atleast 3-4 weeks is necessary
*2 live vaccines should be given either simultaneously or at a gap of 4 weeks
*Measles, mumps and rubella should not be administered in children who have received immunoglobulin in the previous 3 months
*Live virus vaccines should not be given to patients with congenital immunodeficiencies, immunosuppression.
*Normal siblings of immunocompromised children should not be administered OPV, as it is easily transmitted to the latter
|Pulse polio immunisation||2 doses of OPV are given at an interval of 6-8 weeks, to children less than 5 years of age,on a fixed day, through out the nation, irrespective of their immunisation status|
|Intensified pulse polio immunisation||In the 3 days following ppi ,unimmunised children are visited in their homes and vaccinated|
|Mop-up round||2 extra doses of OPV are given to children below 3 years of age irrespective of their immunisation sttatus , within a period of 7-14 days|
|Ring immunisation||Outbreak response immunisation , carried out around 5 km radius of a case of acute flaccid paralysis.
A minimum of 5000 children under 5 years of age are given 2 doses of OPV at aninterval of 6 weeks.the first dose within 48 hours of notification of a case of AFP
Who’s measles elimination strategy
|Catch up||One time nation wide vaccination campaign targeting usually all children aged 9 months to 14 years regardless of history of vaccination status|
|Keep up||Routine services aimed at vaccinating more than 95 % of each successive birth cohorts|
|Follow up||Subsequent nation wide vaccination campaign conducted every 2-4 years targeting all children born after the catch up campaign|
WHO recommends Danish 1331 strain.
It is reconstituted with normal saline.
The site should not be cleaned with spirit.
Mantoux test becomes positive after 8 weeks.
The mosquito is the most dangerous animal in the world. 3000 people die each day from Malaria. World wide, 515 million people are infected.
ELEVENTH HOUR P.S.M. 79
|Anthropozoonoses||Infection transmitted from vertebrate animal to man||Rabies, plague, anthrax|
|Zooanthroponosis||Infection transmitted from man to vertebrate animals||Human tb in cattle|
|Amphixenosis||Infection maintained in both man and lower vertebrate animals that may be transmitted in either directions||T. cruzi
|Direct||Direct transmission from animal to human with /without mechanical vector / fomite.|
|Cyclozoonoses||More than one vertebrate host present|
|Metazoonoses||Transmitted biologically via invertebrate vector|
|Saprozoonoses||Transmitted via non-animal reservoir|
|Anthropozoonoses||Transmitted via vertebrate vector.|
|category||infected by||preventive measures|
|Category 1||Touching / licking intact skin||No vaccination|
|Category 2||Minor scratches/ abrasion, lick on broken skin||Only vaccine|
|Category 3||Bites, scratches, contamination of mucus with licks||Immunoglobulin and vaccine|
|color coding||waste category|
|Yellow||Human anatomical waste|
|Red||Microbiology and biotechnology waste|
|Blue/ White translucent/ Puncture proof can||Waste sharps|
|Black||Discarded medicines, incineration ash|
|Sullage||Waste water from domestic sources not containing human excreta|
|Sewage||Waste containing human excreta|
|Market refuse||Solid waste matter from markets containing putrid vegetable and animal matters|
Hard work is straight line and luck is a curved line. Follow the straight line and the curved line will follow you.- Author Unknown
ELEVENTH HOUR P.S.M. 80
|Primary centre||1/ 30000 population in general areas
1/ 20000 population in tribal, hilly and backward areas
|Subcentre||1/ 5000 in general areas
1/ 3000 in tribal, hilly and backward areas
|Community centre||1 / 80000 to 1.2 lakhs population|
|Dai||1 per village|
|Anganwadi worker||1 per 1000 population|
|Village health guide||1 / 1000 population or village|
|CAUSES OF Maternal mortality
( IN DESCENDING ORDER )
*Baby friendly hospital
The criteria for designation as Baby-Friendly include:
1 Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 Train all health care staff in skills necessary to implement this policy.
3 Inform all pregnant women about the benefits and management of breastfeeding.
4 Help mothers initiate breastfeeding within one half-hour of birth.
5 Show mothers how to breastfeed and maintain lactation, even if they should be separated from their infants.
6 Give newborn infants no food or drink other than breast milk, unless medically indicated.
7 Practice rooming in – that is, allow mothers and infants to remain together 24 hours a day.
8 Encourage breastfeeding on demand.
9 Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
10 Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic
Failure rate of contraceptives = Total accidental pregnancies X 1200
Total months of exposure
If the normal one hundred thousand hairs on a head were woven into a rope, it could support a weight of more than twelve tons.
ELEVENTH HOUR P.S.M. 81
*Five clean practices for safe delivery
Clean delivery surface
No application on cord stump
*1 ml IM injection of iodized oil (poppy seed oil)
Provides protection for 4 years against goiter
*Recommended level of fluoride in drinking water is-0.5-0.8 mg/litre
*SAFE strategy for trachoma
s– Trichiasis Surgery
a– Antibiotic treatment
f– Facial cleanliness
*Variance = SD2 = sum of squares
*Coefficient of variation = sd x 100
*Standard error of mean = SD
*Standard error of difference between two means = √ (SD1) 2 + (SD2)2
*Standard error of proportion = √ PQ
Always remember that your own resolution to succeed is more important than any one thing. – Abrahm Lincoln.
ELEVENTH HOUR P.S.M. 82
*Standard error of difference of proportions = √ P1Q1 + P2Q2
*Relative risk = incidence in exposed
incidence in not exposed
*Attributable risk = Incidence in exposed – Incidence in not exposed
Incidence in exposed
*Sensitivity = True positive ______________
True positive + false negative
*Specificity = True negative_____________
True negative + false positive
*Positive predictive value = True positive______
True positive + false positive
*Screening time- Time interval between, first possible point and final critical diagnosis
*Lead time- Time interval between first possible time and usual time of diagnosis
|Nominal||Cannot be quantified, but divided into qualitative categories, e.g. male-female|
|Ordinal||Data can be arranged in a meaningful order, but difference between the 2 values is not constant, e.g. ranking in a class|
|Discrete||Variables which can take place only certain values but not between them, e.g. number of children immunized in a village|
|Interval||Data can be arrange din meaningful order and the difference between them is meaningful|
|Continuous||Variables can take any value e.g. weight|
|Median||Middle observation when the data is arranged in an ascending or descending order|
|Mean||Average value of an observation|
|Mode||Most commonly occurring value|
While living in Memphis, Tennessee, in 1866-67, Thomas Edison developed a device to electrocute cockroaches.
ELEVENTH HOUR P.S.M. 83
|Mean +/- 1 sd||68.3 %|
|Mean +/- 2 sd||95.4%|
|Mean +/- 3 sd||99.7%|
Mean > median
Median > mode
|Single blind||Participant is not aware whether he belongs to study group or the control group|
|Double blind||Neither the doctor nor the participant is aware|
|Triple blind||Participant, investigator and the person analyzing are unaware.|
*Pre-post clinical trial / before -after studies / self-controlled trials
A single set of patients is used and they are studied before and after studies, thus, the patient is his own control
Due to different rates of admission to the hospital for people with different diseases
*Type I error- the probability of detecting a significant difference when the parameters or treatments are really the same, i.e. the risk of a false positive result.
*Type II error- the probability of not detecting a significant difference when there really is a difference, i.e. the risk of a false negative result.
|Primary case||First case of communicable disease introduced into the population|
|Index case||First case to come to the attention of the investigators|
|Secondary case||Cases developing from contact with primary case|
Concentrate all your thoughts upon the work at hand. The sun’s rays do not burn until brought to a focus.- Alexander Graham Bell
ELEVENTH HOUR P.S.M. 84