PSM DAMS DVT : 2014

• RAJEEV SHETTY
FAMOUS SCEINTISTS
VACCINATION
HEALTH PROGRAMMES
DEMOGRAPHY
NUTRITION
ENVIRONMENTAL HEALTH
INTERNATIONAL HEALTH
BIOSTATISTICS
FAMOUS SCIENTISTS
HIPPOCRATES
JOHN SNOW
EDWARD JENNER
LOUIS PASTEUR
ROBERT KOCH
JAMES LIND
WALTER REED
RONALD ROSS
HAR GOBIND KHURANA
VACCINATION
BCG VACCINE
COURSE AFTER BCG VACCINATION

• PAPULE(2 WK)-ULCER(4WK)-
SCAR(6WK)
SUPPURATIVE LYMPHADENITIS
MEASLES VACCINE
 VACCINE VIAL MONITOR

• An outer circle-blue
• An inner square-white ( made of heat sensitive
material)
DPT Vaccine
DPT Vaccine :

• D & T are Toxoids, P is killed acellular

bacilli

• Dose : 0.5 ml

• Route : Intramuscular

• Site : Antero-lateral aspect of thigh, middle

1/3.
Aluminium phosphate or aluminium
hydroxide

• Used as adjuvant (A-A) .

• It increases immunogenicity of vaccine

Thiomersal
• Used as preservative.
• DPT Vaccine can result in fever : Antipyretic
is given with DPT.

• PERTUSIS COMPONENT ( side effects)-

• Persistent (> 3 hours) inconsolable crying.
• Hypotonic hypo-responsive episode ( HHE)
COLD CHAIN
Ice-lined Refrigerator (ILR)

• Is ‘most important component of cold chain’ in

India

• Temperature of ILR (Cold Chain) in India: +2 C

to +8 C

• ILRs must be kept on

• Atleast 10 cms away from walls

• ILRs can maintain temperature with even 8 hours

of uninterrupted electricity per day’
VACCINE CARRIER
Dial Thermometer

• To monitor the temperature.

• Is kept in ILR at PHC

• Is ‘based on principle of thermocouple’

• Recommended temperature monitoring at PHC

level is: Twice daily
 JE VACCINE

• Dose: 0.5 ml

• Route: Subcutaneous

• Site:LEFT TRICEPS (SUBCUTANEOUS

FOLD)
PENTAVALENT VACCINE
• 6,10,14 weeks

• Dose : 0.5 ml

• Route : Intramuscular

• Site : Antero-lateral aspect of thigh, middle

1/3.
HEALTH PROGRAMMES
RNTCP
 NEW TARGETS
Detection- 90%.

CURE RATE

• Category I- 90%

• Category II- 85%

 2 DISEASES TO BE SCREENED
HIV

DIABETES MELLITUS
 NEW
• NIKSHAY

• BAN :on Quantiferon TB gold tests

Janani Shishu Suraksha Karyakram
(JSSK)

• pregnant women delivering in public health

institutions.

• sick infants.
SERVICES

• (Mnemonic- D- Diet, drugs, Diagnostics..

T- transport
C- caesarian section)

“ JSSK is implemented by DTC ( Delhi traffic

corporation)”..))
NVBDCP
• World health day- 2014

• SMALL BITE: Big threat

 DIAGNOSIS
• PERIPHERAL SMEAR
• RDKs- BIVALENT.
 FALCIPARUM MALARIA
In North-Eastern States (NE States):

• ARTEMETHER( 20 mg) - LUMEFANTRINE

(120 mg) + PRIMAQUINE (Single dose)
 Other States:

• Artesunate (AS) and Sulfadoxine-

Pyrimethamine (S-P) tablets + PRIMAQUINE
(Single dose)
Treatment of uncomplicated P.falciparum
cases in pregnancy:

• 1st Trimester : Quinine.

• 2nd and 3rd trimester: Area-specific ACT.

P vivax malaria:

• Chloroquine: 25 mg/kg body weight divided

over three days.

• Primaquine*: 0.25 mg/kg body weight daily

for 14 days.
LLIN( long lasting insecticidal nets)
• DELTAMETHRIN
• 3 YEARS
 KALA AZAR
• RDK-rk39 has been introduced

• Oral drug- Miltefosine

 FILARIASIS
Annual Mass drug administration(MDA).

• DEC + ALBENDAZOLE

• 4-6 years

• IVERMECTIN: used in Africa.

 NATIONAL LEPROSY
ELIMINATION PROGRAMME
PAUCIBACILLARY LEPROSY

• Nerves: only one

• Skin lesions- upto 5

• Treatment duration- 6 months

• Regimen- Rifampicin+dapsone (once a month)

Dapsone- daily

• Follow up- upto 2 years after finishing therapy

MULTIBACILLARY LEPROSY

• Nerves: more than one

• Skin lesions- more than 5

• Treatment duration- 12 months

• Regimen- Rifampicin+dapsone+clofazamine
(once a month)
Dapsone+clofazamine- daily

• Follow up- upto 5 years after finishing therapy

 VISION 2020
WORLD

– Cataract
– Refractive Error and Low Vision
– Trachoma
– Childhood Blindness
– Onchocerciasis/River Blindness

INDIA

– Glaucoma
– Diabetic Retinopathy
– Corneal blindness
ICDS
 BENEFICIARIES
•Children 0-6 Years

•ADOLESCENTS (10-19 YEARS)

•Women 15-45 yrs. Age Group

•Pregnant & Nursing Mothers

ADOLESCENT GIRLS-

• Kishori Shakti Yojana

• SABLA ( Rajiv Gandhi scheme for

empowerment of adolescent girls- RSEAG)

PREGNANT MOTHERS-

• IGMSY ( Indira Gandhi Matritva Sahayog

Yojana)
 SUPPLIMENTARY NUTRITION
BENEFICIARIES CALORIES (Kcal) PROTEIN (gm)

Children: 6-72 months 500 12-15

Severely malnourished 800 20-25

Children (6-72 months)

Pregnant and Lactating 600 18-20

Mothers
DEMOGRAPHY
• POPULATION PYRAMID
NUTRITION
CEREALS

Wheat

Rice
PULSES
Pellagra-

• 4ds: diarrhea,dermatitis,dementia,death..

• Casals necklace

• Maize,jowar,corn..
MUSTARD SEEDS
Epidemic DroPSy

• Argemone oil

• Added to mustard oil,

• Paper chromatography test- most sensitive,

• Nitric acid test- most commonly used test.

• Proteinuria - pedal edema

• Sanguinarine toxin,..
KHESAR DAL
LATHYRISM-

• khesar dal

• MP

• BOAA

• Vit C prophylaxis

• Ban the crop

ENVIRONMENT HEALTH
 HORROCKS APPARATUS,

• DOSE/ DEMAND
HORROCK’S APPARATUS
Free residual chlorine-

• Instrument-chloroscope..

• TESTS-

• Ortho toluidine test,

• Ortho toluidine arsenite test..

• FREE RESIDUAL CHLORINE-

• Contact period- 60 minutes..

Concentration:

• Normal conditions : 0.5 ppm,

• Swimming pool: 1 ppm,
INSECTICIDES
DDT
 DDT (Dichloro-diphenyl
trichloroethane)
• By Zeidler

• White amorphous powder with mild smell.

• Contact poison
• 18 months. of residual action.

• 100-200 mg. per square foot area.

• Either 5% suspension or 5-10% dust form.

 BHC/HCH( Hexachlorocyclo-hexane)

• Lindane is pure BHC (99% GAMMA

ISOMER)

• Contact poison
• 3 mo. Residual effect

• More powerful than DDT.

• 25-50 mg per square foot

 Abate (Temephos)

• Larvicidal.

• Brown viscous liquid/Granules.

USES

• Anopheles stephensi at 1.00 ppm.

• Aedes .
 Pyrethrum
• Vegetable origin(chrysanthemum
cinerariafolium)

• Spray contains: 0.1% of pyrethrum ( SPACE

SPRAY)
• Doors and windows should be kept closed for
½ hours after spray.

• Pyrethrum + DDT = synergistic effect.

PARIS GREEN
 Paris green
• Copper Aceto-arsenite

• A stomach poison

• Contains 50% of arsenious oxide

INTERNATIONAL HEALTH
WHO
• 7th April- world health day.

• HQ- Geneva

• 6 WHO regions

• India- SEAR

• HQ of SEAR- New Delhi

• Governing body- World health assembly

(WHA).
• HQ- New york

• GOBI-FFF campaign
 PSM DAMS DVT : 2015

• RAJEEV SHETTY
INSTRUMENTS
ENTOMOLOGY
ORGANISATION
PROGRAMMES
GRAPHS
BMW
INSTRUMENTS
KATA THERMOMETER
• Originally devised for – ‘cooling power’ of
air.

• THERMAL COMFORT
• Dry kata- 6 and above.
• Wet kata- 20 and above.

• NOW USED TO : LOW AIR VELOCITIES.

BAROMETER
• Atmospheric pressure

• ‘KEW PATTERN’ station barometer.

• Barograph : instrument for continuos

measurement.
WIND WANE
• Direction of wind.
GLOBE THERMOMETER
• Records a higher temperature than ordinary
air thermometer temperature.

• Difference is : RADIANT HEAT.

RAIN GAUGE
• Measure precipitation-rain,snow,hail..

• Symons rain gauge

• Funnel with a diameter of 5 inches.

• Millimeters/day..
ANEMOMETER
• Air velocity

• 0.5 m/sec- calm

• 30-50 m/sec – hurricane

• Kata thermometer-more sensitive, 10

feet/min.
HYGROMETER
HUMIDITY OF AIR

• Absolute humidity

• Relative humidity = water vapour content

water vapour capacity
SLING PSYCHROMETER
• 2 mercury thermometers.

• Relative humidity
HORROCK’S APPARATUS
• 6 cups

• Starch iodide : indicator

• 1st cup showing blue colour : N

• N x 2gms: of bleaching powder will disinfect

455 liters of water.
SALTER SCALE
INFANTOMETER
STADIOMETER
SHAKIR’S TAPE
ENTOMOLOGY
Anopheles mosquito
ANOPHELES
• Fresh water breeding.

• Spotted wings.

• Sits at 45 degree
 MALARIA
Vector:

• ANOPHELES-
• Types

• Culicifacies: Rural malaria,

• Stephensi: Urban malaria,
• Fluvitalis: forest and foothills

• Dirus : foothills of northeast

• Sundicus : brackish water.
Culex mosquito
CULEX
• Nuisance mosquito
• Hunch back appearance.
• Sewage breeders.

• Diseases-
• JE- culex tritaenirrhycus
• Filariasis- c. quinquefasciatus( culex fatigans)
• West nile fever
Aedes mosquito
AEDES
• Tiger mosquito
• Day time biter
• Artificial breeding places.
• Transovarian transmission.

• Diseases-
• Dengue
• Chikungunya
• Yellow fever
Anopheles larva
Culex larva
Aedes larva
Sand fly
SAND FLY
• Colour- Light-dark brown

• Smaller than mosquito.

• Wings : lanceolate in shape.

• Legs : longer compared to size of body.

• Kala Azar :(phlebotomus argentipes)

• Oriental sore: (phlebotomus sergenti)

• Sand fly fever: (phlebotomus papatassi)

RAT FLEA
RAT FLEA
Flea index

Diseases
• Plague
• Endemic typhus,
• Chiggerosis
Itch mite, Sarcoptes scabiei
Hard ticks
• CHITIN : Exoskeleton

• Diseases:
• KFD
• Crimean congo haemorrhagic fever
• Tularemia
SOFT TICKS
REDUVID BUG
Tse tse fly
Louse
ORGANISATION
UNITED NATION’S POPULATION FUND
• UN agency

For delivering a world

• Every pregnancy is wanted.

• Every birth is safe.
• Every young person's potential is fulfilled.
WORLD BANK
• “Working for a World Free of Poverty”

• 1944

• HQ : Washington

Comprises two institutions:

• International Bank for Reconstruction and
Development (IBRD)
• International Development Association (IDA).
NDMA
• December 2005 : The Disaster Management Act

• Led to the creation of NDMA.

• Headed by the Prime Minister

• NIDM :New Delhi

• Ministry of Home affairs

• Nodal unit- District

The Food Safety and Standards
Authority of India
• Established under Food Safety and
Standards Act, 2006 .

• Ministry of Health & Family Welfare

 FOOD STANDARDS

CODEX ALIMENTARIUS

• Joint FAO/WHO standards

• International markets,
• Indian standards are based on this.

INDIAN STANDARDS

• PFA STANDARDS- minimum level, mandatory.

• Beaureau of Indian Standards- ISI mark.
• AGMARK
PROGRAMMES
MISSION INDRADHANUSH
• 25th December 2014

• Immunization coverage to all children by

2020.

• Diphtheria, Pertussis, Tetanus, Childhood

Tuberculosis, Polio, Hepatitis B and Measles.

• ( In addition to this: JE and Hib in selected

states.)

• “catch-up” campaign mode

MNREGA
• September 2005.

• Unskilled manual work--- Gram Panchayat ---

Job Card (within 15 days )

• Employment: within 15 days of application

for work.

• Wage Rate: not be less than Rs. 60/ per day.

• Equal wages : to both men and women.

• 5 km radius of the village. ( beyond 5 km,

extra wages of 10%)

• At least one-third beneficiaries : women

SOUND 2030
• Hearing impairment.

• WHO SEARO and Christian Blind Mission

(CBM), Society for Sound Hearing (SSH)

Goal: To reduce avoidable hearing

impairment to 50% by 2015 and 90% by
2030.
SURAKSHA CLINICS
 STI/RTI Clinics : by National AIDS Control
Organisation

 1 : Grey
• (UD) , (CD) , (ARD), Painful scrotal swelling (PSS)

 2: Green
• Vaginal discharge (VD)

 3 : White

• Genital Ulcer Disease- Non herpetic

• Inj. Benzathine penicillin and
• Tab. Azithromycin
 4 : BLUE

• Genital Ulcer Disease- Non-Herpetic

• for patients allergic to penicillin.

• Tab. Doxycycline
• Tab. Azithromycin

 5 : RED
• Genital Ulcer Disease- Herpetic

 6 : YELLOW
• Lower abdominal pain (LAP/PID)

 7 : BLACK

• Inguinal bubo (IB)

RSBY
• Ministry of Labour and Employment. Now
under MOHFW.

• Health insurance for BPL families.

• Entitled to hospitalization coverage up to Rs.

30,000/-

• Five members of the family .

• Need to pay only Rs. 30/- as registration fee.

NHM
REDUCE

• MMR to 1/1000 live births

• IMR to 25/1000 live births
• TFR to 2.1

• Incidence and mortality of TB : by half

• Annual Malaria Incidence : <1/1000

• < 1% microfilaria prevalence in all districts

• Kala-azar Elimination by 2015: <1 case per

10000 population in all blocks.
INAP
• Achieve “Single Digit NMR” by 2030,with all
the states to individually achieve this target by
2035 .
• 1 January 2015

• “National Institution for Transforming

India”Aayog .

• ( niti aayog: Policy Commission)

• Prime Minister : chairperson.

MWCD
Schemes for Adolescent girls
• Kishori shakti Yojana (KSY) –
• Rajiv Gandhi Scheme for empowerment of
adolescent girls (SABLA) –

For pregnants
• Indira Gandhi Matrutva Sahyog Yojana
(IGMSY)
UJJAWALA

• “Prevent trafficking of Women and Children”

 COMPONENTS

• Prevention
• Rescue
• Rehabilitation
• Re-integration
• Repatriation
CHARTS
FOREST PLOT
BOX WHISKER PLOT
KAPLAN MEIER CURVE
LJ CHART
FUNNEL PLOT