Preventive and Social Medicine (PSM) - AIM4PG

RADIOLOGY POINTERS PART-1 https://youtu.be/6ibWOenFRAg More Lectures will be uploaded every week Also notes will be provided Currently all notes are posted in @AIM4PGNOTES Group Join Notes Group @aim4pgnotes

BRONCHIECTASIS https://youtu.be/Fmp08De_BcM More Lectures will be uploaded every week Also notes will be provided Currently all notes are posted in @AIM4PGNOTES Group Join Notes Group @aim4pgnotes

THORACOCENTESIS https://youtu.be/Az2cYrvKFCU More Lectures will be uploaded every week Also notes will be provided Currently all notes are posted in @AIM4PGNOTES Group Join Notes Group @aim4pgnotes .

Get ready for the NEET PG 2022 Subject-wise Test Series - 2 : Community Medicine Live Today at 10:00pm. Click Here to Join => https://unacademy.com/test-series/neet-pg-2022-subject-wise-test-series-2/XBGT5WEQ

🔹Difference between the rash of Chickenpox and Smallpox🔹 🔹Chickenpox ▪️Centripetal distribution ▪️Spares palms and soles, rash mostly on flexor surfaces ▪️Superficial ▪️Vesicles are unilocular and give dew drop on rose petal appearance ▪️Rash is pleomorphic and symmetrical ▪️Rapid evolution 🔹Smallpox ▪️Centrifugal ▪️Palms and soles involved, rash predominant on extensor surfaces ▪️Deep seated ▪️Vesicles are multilocular and umbilicated ▪️Rash is monomorphic ▪️Slow evolution Dr Chandrika N aim4pg team

Contraindications to vaccines 1) All vaccines - Anaphylactic reaction to previous dose 2) Live vaccines (MMR, BCG, Varicella, Yellow fever) - Pregnancy, Radiation therapy 3) Yellow fever Egg allergy Immunodeficiency 4) BCG Symptomatic HIV infection 5) Influenza, yellow fever Egg allergy 6)Pertussis containing vaccines Evolving neurological disorders Dr Chandrika N www.aim4pg.com team

Hill's criteria for causal association 1) Temporality Suspected cause precedes observed effect. 2) Strength Larger the relative risk, the more likely it is causal 3) Consistency If the association is observed repeatedly under the same or various conditions, then more likely it is causation. 4) Specificity When exposure is associated with a specific outcome only, then it is more likely to be causal 5) plausibility A biologically plausible mechanism between cause and effect can be support for causation 6) Coherence A causal conclusion should not seriously conflict with the present substantive knowledge of the outcome 7) Analogy Other established cause - effect relationships may be used in analogies to support this causal relationship 8) Gradient It is called dose - response or response curve. It refers to the existence of an exposure - response relationship 9) Experiment To check if the condition can be or has been changed, weakened or prevented by experimental approach Dr Chandrika N aim4pg team

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🔹WHO clinical definition of AIDS ▪️It is used for AIDS surveillance in the clinical setting ▪️Patients > 12 years of age are said to have AIDS if they have at least 2 major and 1 minor signs, provided other clinically similar conditions are be ruled out. 🔹Major signs ▪️Weight loss >/= 10% of body weight ▪️Chronic diarrhoea > 1 month ▪️Prolonged fever for > 1 month (intermittent and constant) 🔹Minor signs ▪️A peristent cough > 1 month ▪️Generalized pruritic dermatitis ▪️History of herpes zoster ▪️ Oropharyngeal candidiasis ▪️Chronic progressive or disseminated herpes simplex infection ▪️ Generalized lymphadenopathy 🔹For surveillance purposes, the presence of either of the following is also considered sufficient to diagnose AIDS ▪️Generalized Kaposi's sarcoma ▪️Cryptococcal meningitis Dr Chandrika N aim4pg team A Persistent cough > 1 month Generalized pruritic dermatitis History of herpes zoster Oropharyngeal candidiasis Chronic progressive or disseminated herpes simplex infection Generalized lymphadenopathy

🔹MCQ🔹 🔸Sentinel surveillance aims at identifying all of the following cases except? a) Old cases b) New cases c) Cured cases d) Missed cases Answer : c) Cured cases 🔸Explanation : 🔹Sentinel surveillance ▪️It is used to augment the notification system used in surveillance of diseases ▪️It detects the total case load and is used to identify the missing cases that are not notified among the old and new cases ▪️Sentinel data from the same is extrapolated to the entire population and the prevalence can be commented on 🔹Advantages : ▪️Bias in reporting is minimized ▪️Feedback is simplified Dr Chandrika N aim4pg team

🔹Control, elimination and eradication 🔸Control ▪️It aims at decreasing the incidence, duration and transmits the disease. ▪️It also aims at decreasing the physical and psychological complications of a disease. 🔸Elimination ▪️It is a reduction in the number of new cases of an infectious disease to a zero ( or a very low defined target rate) in a defined geographical area as a result of deliberate efforts. 🔸Eradication ▪️Complete and permanent worldwide reduction to zero new cases of an infectious disease through deliberate efforts. ▪️No further control measures are required. Dr Chandrika N aim4pg team

🔹Types of screening🔹 1) Multiphasic screening It is the application of 2 or more screening tests in combination with a large number of people at one time. Example - Annual health check ups 2) High risk or Selective Screening It is done on high risk groups Example - MRI Screening of breast is done anually in 25 year old women with BRCA 1, BRCA 2 mutations in a first degree relative. 3) Mass screening It is the screening of a whole or large population. Example - Using a chest x ray for TB screening in a large populations. It is done for diseases with high prevalence. Dr Chandrika N aim4pg team

🔹Antara program🔹 ▪️Injectable contraceptive ▪️MPA (medroxyprogesterone acetate) ▪️Dose - 150mg IM, every 3 months ▪️First dose can be taken : 🔸Anytime after regular menstruation 🔸After 6 weeks of delivery 🔸Immediately after abortion ▪️Mechanism of action 🔸Inhibition of ovulation 🔸Cervical mucus thickening 🔸Endometrial atrophy preventing Implantation ▪️Contraindications 🔸Unexplained vaginal bleeding 🔸Stroke or severe diabetes 🔸Breast cancer (past or present) 🔸Active hepatitis or liver tumor 🔸A desire for rapid return of fertility ▪️Disadvantages 🔸Menstrual irregularities (light / heavy bleeding /amenorrhea) 🔸Slight weight gain 🔸No protection against sexually transmitted diseases 🔸A slight loss in bone mineral density during the first two years of use. Dr Chandrika N aim4pg team

🔹MCQ ❓Which of the following is not a prescriptive screening? a) Pap smear testing in 40 years old woman b) Screening of blood donors c) Neonatal screening for hypothyroidism d) Urine sugar testing Answer : b) Screening of blood donors 🔹Explanation : 🔸Screening of diseases is done to detect unrecognized disease or defect, in apparently healthy individuals, by means of rapidly applied tests, examinations or other procedures. 🔸Screening tests are divided into two types : Prospective screening and prescriptive screening 🔹Prospective screening ▪️People are screened for others benefit ▪️Purpose is to control the disease ▪️Request is from the authority ▪️Example Screening of blood donors Screening of immigrants for infectious diseases HIV screening during antenatal visits, sex workers 🔹Prescriptive screening ▪️People screened for their own benefit ▪️Purpose is case detection ▪️Request is from the physician ▪️Example Pap smear testing in 40 years old woman for detection of cervical cancer Testing of urine sugar for diabetes mellitus Neonatal screening for hypothyroidism Dr Chandrika N aim4pg team

🔹Horrock's apparatus 🔸It is used to estimate the chlorine demand of water 🔹Contents ▪️6 white cups of 200 ml each and one black cup with a circular mark ▪️2 metal spoons (each holds 2g of bleaching powder) ▪️7 glass stirring rods and 1 special pipette ▪️Two droppers ▪️Starch iodide indicator solution 🔹Procedure ▪️Use 2g of bleaching powder to create a thin paste in the black cup It is now called the chlorine stock solution ▪️The six white cups are filled with the water to be tested ▪️Add one drop of the stock solution to the 1st cup, two drops to the 2nd cup, three drops to the 3rd cup, and so on till adding six drops to the 6th cup ▪️Stir the cups and wait for half an hour ▪️Add 3 drops of starch iodide indicator to each cup ▪️Development of blue color in the apparatus indicates free residual chlorine ▪️The first cup which develops this color gives an estimate of the amount of bleaching powder needed to disinfect 455 litres of sample water Amount of bleaching powder required = (n x 2)g for 455 litres of water n --> Position of the cup that was first to show a distinct blue color Dr Chandrika N aim4pg team

🔹Population statistics and Viral statistics🔹 🔸Demographic indicators have been divided into 2 parts - Population statistics and Vital statistics 🔸Population statistics ▪️Population size ▪️Sex ratio ▪️Density ▪️Dependency ratio 🔸Vital statistics ▪️Birth rate ▪️Death rate ▪️Natural growth rate ▪️Life expectancy at birth ▪️Mortality rate ▪️Fertility rate Dr Chandrika N aim4pg team

MCQ 🔹Match the following A) Panchayat samithi B) Zilla parishad C) Panchayat 1) District level 2) Block level 3) Village level a) A - 1, B - 2, C - 3 b) A - 2, B - 1, C - 3 c) A - 3, B - 1, C - 2 d) A - 3, B - 2, C - 1 Answer : b) A - 2, B - 1, C - 3 Panchayat samithi - Block level Zilla parishad - District level Panchayat - Village level 🔸Panchayat Raj is a three tier structure of rural self government in India. It operates at the following levels : 🔹Panchayat - Village level (includes Gram sabha, Gram panchayat and Nyaya Panchayat) 🔹Panchayat samiti or janapada panchayat - Block level 🔹Zilla parishad - District level Dr Chandrika N aim4pg team

🔹Community health center (CHC) 🔸Covers 80,000 to 1,20,000 population 🔹Services provided by CHC🔹 🔸Care of routine and emergency cases in medicine and surgery 🔸Maternal, newborn and child health 🔸Family planning 🔸All the functions of national health programmes 🔸Physical medicine and rehabilitation 🔸Oral health 🔸School and adolescent health services 🔸Blood storage facility 🔸Diagnostic services 🔸Referral services 🔸Maternal death review (MDR) Dr Chandrika N aim4pg team

MCQ Anganwani worker should cover what population? a) 5000 b) 1000 c) 4000 d) 400 Answer : d) 400 Explanation : Suggested norms for health workforce 1) Doctor - 1 per 1000 population 2) Health worker (male and female) - 1 per 5000 (plains) 1 per 3000 (remote or hilly areas) 3) Health assistant (male and female) - 1 per 30000 (plains) 1 per 20000 (remote or hilly areas) 4) Pharmacist - 1 per 10000 5) Lab technician - 1 per 10000 6) Auxiliary nurse midwife (ANM) - 1 per 10000 7) Urban social health activist (USHA) - 1 per 1000 to 2500 8) Accredited social health activist (ASHA) - 1 per 1000 (a village, 200 - 500 households) 1 per habitation in remote or hilly areas 9) Trained dais or Trained birth attendants - 1 per 1000 (a village) 10) Village health guide - 1 per 1000 (a village) 11) Anganwadi worker (AWW) - 1 per 400 - 800 in plains 1 per 300 - 800 in remote or hilly areas 12) Nurse - 1 per 5000 13) Mahila arogya samithi - 1 per 250 - 500 (50 - 100 households) Dr Chandrika N aim4pg team