Psm PPT slides for fmge neetpg .dams lecture

Psm

1. DEMOGRAPHY

2. DEMOGRAPHIC CYCLE

3. TERMS Demographic transition: high birth rate to low birth rate.. Demographic Window: working age group is more.. Demographic Trap - high birth rate and low death rate..

4. Crude birth rate-  21.6 per 1000 , Crude death rate -7.1 per 1000 Growth rate : B-D.. Annual growth rate: 1.64 Decadal growth rate -17.64..

5. POPULATION PYRAMID

6. SEX RATIO: no of females per 1000 males 940 States- Kerala(1084),Haryana(876).. Union territory- Pondicherry/Diu daman.. Child sex ratio (1-4 years) : 914

7. TFR( Total fertility rate) Average number of children born to a woman during her reproductive span.. Complete family size Target- 2.1 ( recent-2.5)..

8. GROSS REPRODUCTIVE RATE Average number of girls a woman has during her reproductive span.. Assumes only fertility pattern..

9. NET REPRODUCTIVE RATE : Number of girls a newborn female will have in the future. Both fertility and mortality pattern.. Target- NRR=1 ..

10. FAMILY PLANNING: Eligible couples- A couple with wife in reproductive age group(15-45).. Couple protection rate- Couples using atleast one of four contraceptives( OCP,IUD,barrier,sterilization ) / total couples..

11. CPR= 60% To acheive NRR=1.. CPR in India is 56% according to NFHS-3.

12. IUD

13. 1 ST GENERATION IUD

14. 2 nd GENERATION IUD Copper-bearing IUDs: Made of plastic with copper sleeves and/or copper wire on the plastic, such as TCu-380A, MLCu-375.

15. Effectiveness : Pregnancy rates for all major IUDs are less than one per 100 women per year.

16. MOST COMMON COMPLICATION- BLEEDING MOST COMMON COMPLICATION OF REMOVAL OF Cu-T: PAIN

17. Hormone-releasing IUDs: LNG-20 (MIRENA)

18. LEVONORGESTREL-20 IUD (LNG-20) It contains 52 mg of levonorgestrel released at the rate of 20 micrograms per day and lasts for at least 5 years. For the LNG-20 a pregnancy rate of 0.3 has been reported after 5 years.

19. BARRIER CONTRACEPTIVES

20. Male Condoms Most condoms are made of latex rubber With correct and consistent use every time, there are 3 pregnancies per 100 women in the first year of use.

21. Female condom Is a thin, soft, loose-fitting polyurethane plastic pouch-like device that lines the vagina. Pregnancies per 100 women in the first year of use as commonly used is 21 . If used correctly and consistently there are 5 pregnancies per 100 women.

22. NORPLANT

23. RISUG Reversible Inhibition of Sperm Under Guidance Invented by an Indian S K Guha . RISUG is an injectable compound that partially blocks the vasa deferentia (tubes that carry sperm).

24. Vaginal rings- Nuvaring Etonogestrel/ethinyl estradiol containing vaginal ring.

25. MOTHER AND CHILD

26. HIGH RISK CHILD: LBW- <2.5 Kg.. Twins .. Birth order >5 .. Grade 2/3 malnutrution .. Failure to gain ( 3 successive months ).. working mother/ single parent..

27. HIGH RISK MOTHER: <140 cm, > 30 year, Malpresentations , APH, PE, History of caeserian section, >5: grand multipara , Twins, Prolonged pregnancy( crossed EDD > 2 Weeks)..

28. MMR: Upto 6 weeks LIVE BIRTHS PER 1 LAKH MDG-5 178

29. INFANT MORTALITY RATE NEONATAL MORTALITY RATE PERINATAL MORTALITY RATE (ONLY CHANGE IN NUMERATOR)

30. GROWTH CHARTS- Weight for age charts, David morley , Road to health chart..

31. ENVIRONMENT HEALTH

32. WATER: CHLORINATION: HOCL ions.. FREE RESIDUAL CHLORINE- Contact period- 60 minutes.. Concentration: 0.5 ppm , Post disaster: 0.7 ppm , Swimming pool: 1 ppm ,

33. INSTRUMENTS DOSE/ DEMAND - Horrocks apparatus,

34. Free residual chlorine- Instrument- chloroscope .. TESTS- Ortho toluidine test, Ortho toluidine arsenite test..

35. BIOLOGICAL INDICATORS OF WATER CONTAMINATION Presumptive coliform count- MPN per 100 ml, Mc ardey table, Membrane filter concentration method.. Fecal streptococci - recent contamination , Clostridium pirefringes - remote..

36. AIR POLLUTION Best index- sulphur dioxide Best biological indicator- lichens..

37. GLOBAL WARMING..

38. KYOTO PROTOCOL - For all green house gases.. MONTREAL PROTOCOL - only for CFC s ..

39. RADIATION: Coulumbs , Gray Seivert - best unit. 5 rads / year.. I 131: So pottassium iodide tablets to be given..

40. NOISE POLLUTION 20 th century- of noise.. >160 db: rupture of tympanic membrane..

41. ENTOMOLOGY

42. Anopheles mosquito

43. Culex mosquito

44. Aedes mosquito

45. Anopheles larva

46. Culex larva

47. Aedes larva

48. Sand fly

49. RAT FLEA

50. Itch mite, Sarcoptes scabiei

51. Hard ticks ( Ixodidae )

52. Soft ticks ( Argasidae )

53. Reduvid bug

54. INSECTICIDES

55. Three groups (Based on mode of action) Contact - through the skin Eg : Pyrethrum, DDT, BHC, Dieldrin . Stomach - oral – through the mouth. Eg : Paris Green & Sodium fluoride. Fumigants . Eg : Sulphur Dioxide

56. DDT

57. DDT ( Dichloro-diphenyl trichloroethane ) 1874,By Zeidler White amorphous powder with mild smell. Contact poison: Acts on nervous system to cause paralysis of wings & legs.

58. 18 mo. of residual action. Application: 100-200 mg. per square foot area. Either 5% suspension or 5-10% dust form.

59. BHC/HCH( Hexachlorocyclo -hexane) 1825 ,by Michael Faraday White or chocolate colored with musty smell. Lindane is pure BHC (99% GAMMA ISOMER) DIRECT CONTACT AS WELL AS VAPOUR

60. 3 mo. Residual effect More powerful than DDT. Dose: 25-50 mg per square foot for residual effect.

61. Abate ( Temephos ) Larvicidal . Brown viscous liquid/Granules. For anopheles stephensi at 1.00 ppm . For dengue .

62. Fenthion ( Baytex ) Brown garlicky liquid. Used in filaria control.

63. Pyrethrum Vegetable origin(chrysanthemum cinerariafolium ) Nerve poison, kills on contact Spray contains: 0.1% of pyrethrum

64. Doors and windows should be kept closed for ½ hours after spray. Pyrethrum + DDT = synergistic effect.

65. Paris green Copper Aceto-arsenite A stomach poison Contains 50% of arsenious oxide

66. BIOTERRORISM

67. Category A Agents/Diseases Anthrax  ( Bacillus anthracis ) Botulism  ( Clostridium botulinum  toxin) Plague  ( Yersinia pestis ) Smallpox  ( variola major) Tularemia  ( Francisella tularensis ) Viral hemorrhagic fevers   [e.g., Ebola ]

68. Category B Agents/Diseases Brucellosis  ( Brucella  species) Glanders  ( Burkholderia mallei ) Q fever  ( Coxiella burnetii )

69. Category C Agents Emerging infectious diseases such as- Nipah virus Hantavirus SARS H1N1

70. NUTRITION

71. QUALITY OF PROTEIN- PDCAAS -Protein Digestability Corrected Amino acid score NPU( Net protein utilization) Biological value of x Digestibilty co efficient/ 100.. Egg- 96

72. LIMITING AMINO ACIDS: Cereals- lysine,threonine .. Pulses- methionine,cystine .. Maize- Lysine, tryptophan..

73. FAT: Essential fatty acids, Deficiency: phrenoderma , Safflower oil- linoleic acid, Arachidonic acid- animal foods, Eicosa pentanoic acid- fish..  

74. VITAMIN B Thiamine: Beri beri , wernickes encephalopathy.. Riboflavin - chelietis ..

75. Pellagra- 4ds: diarrhea,dermatitis,dementia,death .. Casals necklace.. maize,jowar,corn ..

76. B5: Pantothenic acid Burning feet syndrome.. B7: biotin Avidin in raw egg  B9 Folic acid vitamin M, Megaloblastic anemia ..

77. E: Hemolytic anemia of newborn.. K: Hemorrhagic disease of newborn..  

78. URINARY IODINE EXCRETION- 1. Used as a impact indicator after implementing d programme 2. Indicator preferred for Surveillance NEONATAL HYPOTHYROIDISM- sensitive indicator of environmental iodine deficiency.

79. FLUOROSIS: Normal levels- 0.5-0.8 <0.5: dental caries >1.5= mottling of teeth, >3= skeletal >10= crippling food

80. ADULTERANTS- Epidemic dropsy Argemone oil Added to mustard oil, Paper chromatography test- most sensitive, Nitric acid test, Proteinuria - pedal edema Sanguinarine toxin,..

81. Ergotism - Field fungus Claviceps purpura , Bajra seeds, Float in salt water..

82. Endemic ascites - Crotolaria seeds Added to Junjhunia seeds.

83. LATHYRISM- khesar dal MP BOAA Vit C prophylaxis Ban the crop

84. OCCUPATIONAL HEALTH

85. ERGONOMICS: Mutual adjustment between man and his working environment..

86. Miners nystagmus : chronic exposure to darkness.. Welders flash - UV rays.. White fingers - vibration..

87. PNEUMOCONIOSIS - 0.5-3microns.. Silicosis- Mica mines Dense nodular fibrosis Snow storm appearance of lung Risk factor for tuberculosis..

88. Asbestosis- Amphibole- crocidolite type( blue) Mesothelioma ..

89. Anthracosis - coal.. Byssinosis : cotton, Bagassosis : thermoactinomyces sacchari .. Farmers lung- micropolyspora faeni ..

90. LEAD POISONING- A mino levulinic acid- absorption, A nemia : first sign, B urtonian lines-blue lead sulphide lines on gums.. B asophilic stippling of RBC..

91. C oproporphyrin in urine: screening test.. C onstipation.. D rops- wrist/foot.. E DTA- chelating agent.. E ncephalopathy: organic lead.. >70 microgram/ml..

92. B asophilic stippling of RBC..

93. B urtonian lines

94. Cancers: Most common occupational cancer- skin cancer.. Bladder: dye,benzidine,rubber,aniline .. Leukemia - benzol ..

95. Village- 1000 Dai ASHA..

96. SUBCENTRE- ANM / health worker female 3000-HILLY areas 5000: PLAINS.

97. PHC- 20000/30000 MO, LHV- LADY HEALTH VISITOR..

98. CHC- 80000-1,20000.. Specialists: Physician, pediatrician , surgeon, gynaecologist Anaesthetist,public health manager..

99. WHO