Community MedicineBy

DR. Zulfiqar Ali

ContentsChapter No.1

Basic Definition & IntroductionDefinitions 1Health and its dimensions 3

Spectrum of disease 4Iceberg of disease 4Natural history of disease 5Levels of prevention 7

Apply 5-levels of prevention on T.B & hypertension 9WHO (World Health Organization) 10

UNICEF 10Important days of the year 11

Viva Questions 11 MCQ’S 12

Chapter No.2PHC & Rural Health

Definition & Elements of PHC 13Principles of PCH 13

Health for all by year 2000 15Health planning cycle 15 5-Star Doctor 16

Levels of prevention & health care 16Major diseases 16

FLCF (First level care facilities) 17BHU & RHC 18

Duties of LHV 21Rural health problems 22Viva questions 23MCQ’S 23

Chapter No.3Demography

Demography 25Population Dynamics 25Population growth rate 26Reason for population change 26

Calculation of population in b/w census years 27Components of population growth 27Causes of highest mortality 28

Causes of decrease mortality 28 Causes of high fertility 29Basic fertility measures 29

Population pyramid 30Dependency & Sex ratio 31Demographic transition 31Demographic Cycle 31Demographic trap 32Population momentum 33

Implications of high population growth 33Demographic features of Pakistan 34Vital index & population density 35Viva questions 35MCQ’S 35

Chapter No.4Biostatistics

Introduction & functions 37Important terms 37Data & its type 38Sources of data 38

Presentation of data 39Types of measurements applied on data 43

Measurement of central tendency 43Arithmetic mean

MedianMode

Measures of dispersion 44Range

Mean deviationStandard deviation

Hypothesis 45Probability or “p” value 45Chi-Square test 46

Life Table 46Viva questions 47MCQ’S 47

Chapter No.5Environment

Water 49Air & ventilation 67

Soil 73Housing 75Noise 77Climate & health 79Viva questions 83MCQ’S 83

Chapter No.6

Nuclear MedicineRadiation, sources & its types 85

Units of radiation 85Maximum permissible dose 86Penetration ability 86Effects of radiation 86Uses of radiation 87Protection from radiation 87

ALARA principle & Bays rule 87Viva Questions 88MCQ’S 88

Chapter No.7Hospital & Biomedical Wastes management & Sold waste disposal

Introduction & Types of wastes 89Waste management team & plan 90

Steps in hospital wastes Management 91solid wastes disposal 92

Methods of disposal of wastes 93Health Hazards of Human excreta 93

Methods of human excreta disposal 94Septic tank 94Definitions 95Strength of sewage (BOD& COD) 95Activated sludge process 95Viva Questions 96

MCQ’S 96

Chapter No.8Epidemiology

Definition, aim & uses 97Epidemiological approach

97Basic measurements in

Epidemiology 98Tool of measurement 98

RatesRatio

ProportionNumerator & denominator

99Mortality rates & ratios

100Measurement in morbidity

101Incidence

Prevalence

Epidemiological methods 102

Descriptive EpidemiologyAnalytical

Experimental Blinding

111Association & causation

111Web of causation & Wheel

112Investigation of an epidemic

113KAP studies

114Uses of Epidemiology

114Viva questions

115MCQ’S

115

Chapter No.9School Health Services

Introductions & aims 117Situation of school health service 117School health team 118Duties of school medical officer 118

Duties of school nurse & an attendant 118

Drugs & equipment of school clinic119Role of school teacher 119Profiles of School health program 119School health problems 121

Functions of school health Services 121

Advantages and disadvantages of school health services 121Viva questions 122

MCQ’S 122

Chapter No.10Health Education

Definitions & aim 123Stages of health education 123Strategies, communication 124Methods of health education 125

Methods of maintaining behavioral change 126

Models 126Principals of health education 127Programme plan 127

Evaluation 127Viva questions 128MCQ’S 128

Chapter No.11Immunization

Immunology and its uses 129Immunity & its types 129Important terms 130Herd immunity 131Immunizing agents 131

VaccinesImmunoglobulinsAntisera/antitoxin

Cold chain 134Shake test & thawing 135

EPI schedule 135Vaccination schedule of 9

months & 2 years child 135Contraindication of vaccines 135

Abnormal reactions & Complications of vaccines 137Tetanus toxoid 137Polio 137

Causes of failure of vaccine 138 Vaccines descriptions 138

Pre- exposure prophylaxis 139Immunization recommends for travelers to endemic area 140

Optional & compulsory vaccines 140Important terms 140Vaccine schedule for rabies 141Viva questions 142MCQ’S 142

Chapter No.12Disaster Management &

Control Definition & types of disaster

143Steps of disaster management

143Organization model for

disaster 145Social reaction following a

Disaster 145

Duties of health team 145

Viva questions 145

Surveillance cycle 146

Chapter No.13Screening & Sampling

Definition, aims, objectives & uses of screening 147Type of screening 148

Dif. b/w screening & diagnostic test 148

Criteria for screening 148Sensitivity, specificity & predictive value 150

Yield 151Definition & methods of sampling 151

Probability & non-probability Sampling 152Sampling errors 153Viva questions 153

MCQ’S 154

Chapter No.14IMCI & Child survival

IMCI strategy & its aims 155Components of IMCI 155

Advantages of IMCI study 155Situation of children in Pakistan 156women conditions in Pakistan 156Major killers of children 157

Composition of ORS 158 Indigenous ORS 158Viva questions 158MCQ’S 158

Chapter No.15CH NO. 15 chdfdf

Reproductive Health (MCHC)Definition & components 159

Maternal Mortality and morbidity 159Health problems of females 160High risk cases 161

MCHC & its components 161

Antenatal careIntra-natal carePostnatal care

Infant careTraining programmes 165

Birth weight and low birth wt. 166Growth monitoring and promotion 166

Growth chart 167Under five clinics 168

Brest feeding 169Artificial milk. 169

Humanization of milk 170Weaning 170

Maternity & child Welfare center 170Social obstetrician 171

Mother and child on units 171Indications of MCH care 172

Infant mortality rate 172NMR 173 PNMR 174Safe motherhood 175Viva Questions 176MCQ’S 176

Chapter No.16Family Planning

Definition, aims & objectives 179Family limitation 179Cafeteria choice 180Classification of fertility regulation 180Barrier methods 180

Intrauterine contraceptive devices (IUCD) 181Hormonal methods 183

Oral pills 183Non-contraceptive uses of oral pills184Deport-formulation 185Post conceptional methods 186Miscellaneous methods 187

AbsentinenceCoitus interrupts

Birth control vaccines 187Safe period 187

Breast feeding 187Terminal methods. 188

Family planning and health scope of family planning services 188Viva questions 189MCQ’S 190

Chapter No.17Occupational Health

Occupation 191Occupational health 192

Occupational diseases 193Pneumoconiosis 193

Prevention & control of pneumoconiosis 196

Occupational hazards 196Viva Questions 200MCQ’S 200

Chapter No.18Social & behavioral science

Definition 201Sociology 201

Family, joint family society, Culture, community Class & association 201

Cast system in Islam & Pakistan 202Social mobility & its types 203Social evils 203

Health problems and diseases & prevention 203Psychology & social psychology 204Personality and its components 205

Medical anthropology & its components 205Genetics 205

Ecology 206Political science 206

Social pathology 206Viva questions 207MCQ’S 207

Chapter No.19Food, Nutrition & Health

Definition & classification of food 209Nutrients & its types 210

Balanced diet 210Caloric requirements of male, female & infants 211

Food caloric values 211Factors affecting caloric needs 211

Macronutrients 212Micronutrients 213

Vitamins Minerals

Diet 217Adult male & female

Infants, children & old agePregnancy & lactation

Food fortification 217 Food adulteration 218

Food poisoning, infection & toxemia 218

Preservation of foods 219Animal foods & inspection of meat 219

Characteristics of Good meat, Fresh fish & egg 220Meat born diseases 220Composition of milk 221

Humanization of milk 221Advantages of Breast-feeding 222

Adulteration of milk 222Common preparation from milk 222Methods for rendering milk safe 223

Pasteurization & boiling 223Dangerous food & control 223

Assessment of nutritional status 224Malnutrition 225

Protein energy malnutrition 226Kwashiorkor & marasmus 227Obesity & its complications 228Via questions 229

MCQ’S 229

Chapter No.20Mental Health

Definition & introduction 231Etiology of mental illness 232

Mental health service 232Prevention of common mental health problems in

Pakistan 232Team in C.M.H. center 233

Intelligence & I.Q. 233Diff. b/w mental illness and mental

Deficiency 234Viva questions 235IMCQ’S 235

Chapter No.21Communicable diseases

Introduction and Communicable diseases 237Incubation period &

Infective Period. 239Dynamics of diseases 240Control of c. diseases 242

Sterilization & disinfection and their procedures 243Malaria 245Small pox & chick pox 247Polio 248SARS. 249Anthrax 249Yellow fever 250Rabies 251T.B 252Typhoid fever 254

Sexually transmitted disease 255AIDS

Hepatitis BViva questions 259MCQ’S 259

Chapter No.22Non-Communicable Diseases

Introduction 261Hypertension 261

Coronary heart disease 262Diabetes mellitus 263Blindness 263Accidents 264Obesity 265Rheumatic heart disease 266Smoking 267Snake-bite 268Cancer 269Viva Question 270MCQ’S 271

Chapter No.23 Miscellaneous

Alcohol & addiction 272Drug dependence 273Research 274

Health management information System 275Medical entomology 277

Parasitology 282Insecticides (DDT) 282Viva Questions 283MCQ’S 283

Chapter No.24Tables of Differences

286- 294

Chapter No.25 Professional Evaluation

295-297Models

TrayVisitsSlides

Note-bookViva