SOCIAL AND

PREVENTIVE
MEDICINE
REVIEW NOTES

MEDPGNOTES

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

CONTENTS
INTRODUCTION............................................................................................................................................................. 9
GENERAL FEATURES OF SOCIAL AND PREVENTIVE MEDICINE.................................................................................. 9
TYPES OF MEDICINE .................................................................................................................................................. 9
MEDICAL BOOKS ..................................................................................................................................................... 10
MEDICAL DISCOVERIES ........................................................................................................................................... 10
NOBEL PRIZE ........................................................................................................................................................... 11
CONCEPTS OF HEALTH AND DISEASE.......................................................................................................................... 11
GENERAL FEATURES OF HEALTH AND DISEASE ...................................................................................................... 11
NATURAL HISTORY OF DISEASE .............................................................................................................................. 11
INCUBATION PERIOD .............................................................................................................................................. 12
SECONDARY ATTACK RATE...................................................................................................................................... 13
ICEBERG PHENOMENON......................................................................................................................................... 13
HUMAN DEVELOPMENT INDEX .............................................................................................................................. 13
PHYSICAL QUALITY OF LIFE INDEX .......................................................................................................................... 14
MODIFIED KUPPUSWAMI SCALE............................................................................................................................. 14
MORTALITY INDICATORS ........................................................................................................................................ 14
CASE FATALITY RATE ............................................................................................................................................... 14
MORBIDITY INDICATORS ......................................................................................................................................... 15
STANDARDISATION ................................................................................................................................................. 15
QUARANTINE .......................................................................................................................................................... 16
ISOLATION............................................................................................................................................................... 16
SURVEILLANCE ........................................................................................................................................................ 16
DISEASE CONTROL .................................................................................................................................................. 17
DISEASE ELIMINATION ............................................................................................................................................ 17
DISEASE ERADICATION............................................................................................................................................ 17
PRIMORDIAL PREVENTION...................................................................................................................................... 18
PRIMARY PREVENTION ........................................................................................................................................... 18
SECONDARY PREVENTION ...................................................................................................................................... 18
TERTIARY PREVENTION ........................................................................................................................................... 19
INTERNATIONAL CLASSIFICATION OF DISEASES ..................................................................................................... 19
DEATH CERTIFICATE ................................................................................................................................................ 19
TRENDS OF DISEASE ................................................................................................................................................ 19

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

EPIDEMIC ................................................................................................................................................................ 20
ENDEMIC ................................................................................................................................................................. 20
PANDEMIC .............................................................................................................................................................. 21
SPORADIC................................................................................................................................................................ 21
ZOONOSES AND ANTHROPOZOONOSES................................................................................................................. 21
HOST ....................................................................................................................................................................... 21
RESERVOIR .............................................................................................................................................................. 22
CASE ........................................................................................................................................................................ 22
CARRIER .................................................................................................................................................................. 22
TRANSMISSION OF DISEASES .................................................................................................................................. 22
PERIOD OF COMMUNICABILITY .............................................................................................................................. 23
HERD IMMUNITY..................................................................................................................................................... 23
MILLENIUM DEVELOPMENT GOALS........................................................................................................................ 24
EPIDEMIOLOGY ........................................................................................................................................................... 24
GENERAL FEATURES OF EPIDEMIOLOGY ................................................................................................................ 24
RATE AND RATIO ..................................................................................................................................................... 27
INCIDENCE AND PREVALENCE................................................................................................................................. 27
SURVIVAL ................................................................................................................................................................ 28
CASE CONTROL STUDY ............................................................................................................................................ 28
ODDS RATIO ........................................................................................................................................................... 29
COHORT STUDY....................................................................................................................................................... 29
RELATIVE RISK AND ATTRIBUTABLE RISK ................................................................................................................ 29
ECOLOGICAL STUDY ................................................................................................................................................ 30
CAUSATION AND ASSOCIATION .............................................................................................................................. 30
RANDOMISED CONTROL TRIAL ............................................................................................................................... 31
BIAS ......................................................................................................................................................................... 32
BLINDING ................................................................................................................................................................ 32
NON COMMUNICABLE DISEASES................................................................................................................................ 33
GENERAL FEATURES OF NON COMMUNICABLE DISEASE ....................................................................................... 33
HEART DISEASE ....................................................................................................................................................... 33
DIABETES................................................................................................................................................................. 34
HYPERTENSION ....................................................................................................................................................... 34
CANCER ................................................................................................................................................................... 34
ROAD TRAFFIC ACCIDENT ....................................................................................................................................... 34

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

SCREENING.................................................................................................................................................................. 34
GENERAL FEATURES OF SCREENING ....................................................................................................................... 34
SENSITIVITY ............................................................................................................................................................. 36
SPECIFICITY.............................................................................................................................................................. 37
POSITIVE PREDICTIVE VALUE .................................................................................................................................. 37
NEGATIVE PREDICTIVE VALUE................................................................................................................................. 37
COMBINED SENSITIVITY AND SPECIFICITY .............................................................................................................. 37
PREVENTIVE OBSTETRICS AND PEDIATRICS ................................................................................................................ 38
PREVENTIVE OBSTETRICS ........................................................................................................................................ 38
MATERNAL MORTALITY .......................................................................................................................................... 38
PREVENTIVE PEDIATRICS......................................................................................................................................... 39
PERINATAL MORTALITY........................................................................................................................................... 39
NEONATAL MORTALITY........................................................................................................................................... 40
POST NEONATAL MORTALITY ................................................................................................................................. 40
INFANT MORTALITY ................................................................................................................................................ 40
Infant Mortality Rate ................................................................................................................................................. 40
UNDER 5 MORTALITY .............................................................................................................................................. 41
ICDS ......................................................................................................................................................................... 41
FAMILY PLANNING AND CONTRACEPTION ................................................................................................................. 41
GENERAL FEATURES OF FAMILY PLANNING AND CONTRACEPTION ...................................................................... 41
NATURAL CONTRACEPTIVE METHODS ................................................................................................................... 43
BARRIER METHODS ................................................................................................................................................. 43
FEATURES OF ORAL CONTRACEPTIVE PILLS ............................................................................................................ 43
COMPOSITION OF ORAL CONTRACEPTIVE PILLS..................................................................................................... 45
BENEFITS OF ORAL CONTRACEPTIVE PILLS ............................................................................................................. 45
CONTRAINDICATIONS OF ORAL CONTRACEPTIVE PILLS ......................................................................................... 45
SIDE EFFECTS OF OCP.............................................................................................................................................. 46
MINI PILLS ............................................................................................................................................................... 46
EMERGENCY CONTRACEPTION ............................................................................................................................... 46
TYPES OF IUCD ........................................................................................................................................................ 47
FEATURES OF IUCD ................................................................................................................................................. 48
LIFE SPAN OF IUCD .................................................................................................................................................. 49
COMPLICATIONS OF IUCD....................................................................................................................................... 49
CONTRAINDICATIONS OF IUCD ............................................................................................................................... 49

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

SUBDERMAL IMPLANTS .......................................................................................................................................... 49

VASECTOMY ............................................................................................................................................................ 50
TUBECTOMY............................................................................................................................................................ 50
DEMOGRAPHY ............................................................................................................................................................ 51
GENERAL FEATURES OF DEMOGRAPHY .................................................................................................................. 51
DEMOGRAPHIC CYCLE............................................................................................................................................. 52
BIRTH RATE, DEATH RATE AND GROWTH RATE...................................................................................................... 52
Crude birth rate .......................................................................................................................................................... 52
GRR/NRR is.................................................................................................................................................................. 53
POPULATION GROWTH ........................................................................................................................................... 53
SEX RATIO................................................................................................................................................................ 53
LITERACY RATIO ...................................................................................................................................................... 53
DEPENDENCY RATIO ............................................................................................................................................... 54
SAMPLE REGISTRATION SYSTEM............................................................................................................................. 54
NATIONAL FAMILY HEALTH SURVEY ....................................................................................................................... 54
CENSUS ................................................................................................................................................................... 54
GENERAL FERTILITY RATE........................................................................................................................................ 54
TOTAL FERTILITY RATE ............................................................................................................................................ 55
NET REPRODUCTION RATE...................................................................................................................................... 55
BIOMEDICAL WASTE MANAGEMENT ......................................................................................................................... 55
TRIAGE AND DISASTER MANAGEMENT ...................................................................................................................... 56
OCCUPATIONAL DISEASES .......................................................................................................................................... 57
FACTORIES ACT ........................................................................................................................................................... 58
ESI ACT ........................................................................................................................................................................ 58
POPULATION GENETICS .............................................................................................................................................. 59
ENVIRONMENT AND HEALTH ..................................................................................................................................... 60
GENERAL FEATURES OF ENVIRONMENT AND HEALTH ........................................................................................... 60
HARDNESS OF WATER............................................................................................................................................. 60
CONTAMINATION OF WATER ................................................................................................................................. 60
PURIFICATION OF WATER ....................................................................................................................................... 61
CHLORINATION OF WATER ..................................................................................................................................... 62
AIR POLLUTION, TEMPERATURE AND HUMIDITY ................................................................................................... 63
NOISE ...................................................................................................................................................................... 64
FLOOR SPACE .......................................................................................................................................................... 64

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

SCHOOL STANDARDS .............................................................................................................................................. 64

SEWAGE DISPOSAL AND SEPTIC TANK .................................................................................................................... 64
VECTORS ................................................................................................................................................................. 65
VECTOR CONTROL................................................................................................................................................... 67
HEALTH CARE IN INDIA ............................................................................................................................................... 68
GENERAL FEATURES OF HEALTH CARE IN INDIA..................................................................................................... 68
PRIMARY HEALTH CARE .......................................................................................................................................... 69
HEALTH WORKERS .................................................................................................................................................. 70
PLANNING COMMITTEE .......................................................................................................................................... 70
POPULATION NORMS ............................................................................................................................................. 71
PLANNING CYCLE .................................................................................................................................................... 71
NETWORK ANALYSIS ............................................................................................................................................... 72
COMMUNICATION AND HEALTH EDUCATION ............................................................................................................ 73
COMMUNICATION .................................................................................................................................................. 73
HEALTH EDUCATION ............................................................................................................................................... 74
FAMILY, SOCIAL AND MENTAL SCIENCES.................................................................................................................... 74
FAMILY .................................................................................................................................................................... 74
SOCIAL SCIENCES..................................................................................................................................................... 75
MENTAL SCIENCES .................................................................................................................................................. 76
INTERNATIONAL HEALTH ............................................................................................................................................ 76
NATIONAL HEALTH PROGRAMMES ............................................................................................................................ 77
GENERAL FEATURES OF NATIONAL HEALTH PROGRAMMES .................................................................................. 77
TUBERCULOSIS ........................................................................................................................................................ 78
LEPROSY .................................................................................................................................................................. 79
AIDS......................................................................................................................................................................... 80
MALARIA ................................................................................................................................................................. 80
FILARIASIS ............................................................................................................................................................... 81
BLINDNESS .............................................................................................................................................................. 81
DEAFNESS................................................................................................................................................................ 82
GOITRE .................................................................................................................................................................... 82
ANEMIA................................................................................................................................................................... 82
POLIO ...................................................................................................................................................................... 82
NATIONAL RURAL HEALTH MISSION....................................................................................................................... 82
NATIONAL HEALTH POLICY ..................................................................................................................................... 83

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

NATIONAL POPULATION POLICY ............................................................................................................................. 83

RCH AND IMNCI ...................................................................................................................................................... 84
MID DAY MEAL PROGRAMME ................................................................................................................................ 84
TRANSPLANTATION OF ORGANS ACT ..................................................................................................................... 85
BIOSTATISTICS............................................................................................................................................................. 85
DATA AND SCALE .................................................................................................................................................... 85
CENTRE OF DISPERSION .......................................................................................................................................... 86
CENTILE AND QUARTILE .......................................................................................................................................... 87
MEASURES OF VARIABILITY .................................................................................................................................... 87
DISTRIBUTION ......................................................................................................................................................... 88
SAMPLING ............................................................................................................................................................... 89
PROBABILITY ........................................................................................................................................................... 90
ERROR ..................................................................................................................................................................... 91
PAIRED T TEST ......................................................................................................................................................... 91
UNPAIRED T TEST .................................................................................................................................................... 91
STUDENT T TEST...................................................................................................................................................... 92
CHI SQUARE TEST.................................................................................................................................................... 92
ANOVA TEST............................................................................................................................................................ 93
REGRESSION............................................................................................................................................................ 93
CORRELATION ......................................................................................................................................................... 93
DEGREE OF FREEDOM............................................................................................................................................. 94

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

KEY TO THIS DOCUMENT

Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
text book of internal medicine 18th
edition
Text in italic font Can be read if
you are thorough with above two

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

INTRODUCTION

INTRODUCTION
GENERAL FEATURES OF SOCIAL AND PREVENTIVE MEDICINE
Cradle of civilization
Origin of SPM dates back to
Great sanitary awakening took place in
Sanitary awakening
Last case of small pox in India
WHO declared small pox eradicated in
Global eradication of small pox
World health day
Anti tobacco day
Red cross was founded by
Red cross emblem
Maximum damage to Napoleons army during his march
to Moscow was done by
GOARN
Central labour institute is located in
Snow and avalanche study establishment
is located at
National environmental engineering
research institute
Headquarters of FAO
Headquarters of UNESCO
Country of WHO but NOT of United
Nations

Mesopotamia
th
18 century
England
Edwin Chadwick
1975
May 1980
1980
th
7 April
st
31 May
Jean Henry Dunant
Size of bars of cross equal horizontally and vertically,
convened in Geneva
Typhus
Global outbreak alert rapid response
Mumbai
Manali
Nagpur
Rome
Paris
Switzerland

TYPES OF MEDICINE
Samuel Hahneman is referred as founding father of
Code of Hammurabi
Yoga is a part of
Evidence based medicine

Useful in evidence based medicine

Alfred Grotjahn is famous for his work in
Socialized medicine

Homeopathy
Mesopotomian medicine
Preventive medicine
Aims to apply best available evidence gained from
scientific method to clinical decision making, Research
paper is investigated by tools quoted in research paper
itself to check validity, Opinions of medical
professionals and researchers have been given least
preference, Evidence is generated from strong studies
RCT, Meta analysis, Systematic review
Social medicine
Free medical care at government expense, regulated by
professional groups, Ensures social equity universal
coverage, Reduces competition among practitioners,
Use state funds for free medicine

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

Socialization of medicine

Socialization does NOT lead to

Free medical service at government expenditure
Provision of medical care to people at
government expense
Primum succurrere means
Heuristics
P-SPIKES for
Alexande technique
Ecology of health

Provision of medical services and professional

education by the state but operated and regulated by
professional groups rather than by the government,
Eliminated competition among physician in search of
clients, Ensure social equity and universal coverage
Ensures complete utilization of services by all people
Socialization medicine
State medicine
First hasten to provide help
Rule of thumb to diagnose rapidly by tricks
Conveying bad news
Complementary medicine
Science of mutual relationship between
living organisms and their environment

MEDICAL BOOKS
Canon of medicine written by
Airs, waters and places written by
Book Sushruta Samhita was translated by

Avicenna
Hippocrates
Hessler

MEDICAL DISCOVERIES
Dhanvantri
Father of medicine
Father of Indian surgery
Father of modern surgery
Father of public health
Father of epidemiology
Father of epidemiology
Associated with epidemiology
First true epidemiologist
First true epidemiologist/evidence based
Multifactorial causation of disease
Spontaneous generation theory
Germ theory of disease
The term vaccine is coined by
Vaccine for Rabies and Anthrax
Introduction of complex media by
Disapproved spontaneous regression theory
Vaccination against small pox
Prevention of scurvy
Transmission of yellow fever
Transmission of malaria by anopheles by
Theory of web of causation
Insect transmission of disease

INTRODUCTION

Hindu god of medicine

Hippocrates
Sushrutha
Ambroise pare
Cholera
John snow
Fracastorius
James lind
Hippocrates
Sacckett
Pattenkoffer
Aristotle
Louis Pasteur
Louis Pasteur
Louis Pasteur
Pasteur
Pasteur
Edward Jenner
James Lind
Walter Reed
Ronald Ross
McMohan and Pugh
Smith

10

SOCIAL AND PREVENTIVE MEDICINE REVIEW NOTES

Mosaic disease of tobacco is due to ultramicroscopic
organisms
Microscope

CONCEPTS OF HEALTH AND DISEASE

Iwanowsky
Leeuwenhoek

NOBEL PRIZE
For studying the complete aminoacid sequence of two
polypeptide chains of insulin, Nobel prize was awarded
to
Nobel prize in 2006 was given for
Nobel prize 2007
2011 Nobel prize for

Banting and Macleod

RNAi
Principles for introducing specific gene modification in
mice by use of embryonic stem cells
Discovery of dendritic cell

CONCEPTS OF HEALTH AND DISEASE

GENERAL FEATURES OF HEALTH AND DISEASE
Definition of health by WHO includes
Latest concept of public health
Speciality dealing with population
Intraspecies competition is among
Living standard of people best assessed by
Standard living by WHO does NOT include
Human poverty index 2 differs from
human poverty index 1 by
Poverty index does NOT include
Regular reporting of health statistics is done for
Emporiatrics describe
Entomology
World health report 2008
NOT proposed in world health report 2008
Concurrent list that do not encompass
Geriatric age group
Community diagnosis is based on

Social, physical, mental, economic

Participation of community from national to
international level
Community medicine
Individuals of population
Physical quality of life index
Human rights
HPI 2 measures social exclusion also
Income
To evaluate trends of disease, To appreciate health
personnels efforts, For epidemiological approach
Health of travelers
Arthropods
Service delivery reforms, Leadership reforms, Public
policy reforms
Economic reforms
Regulation and development of medical profession
75 years
Age and sex distribution, vital statistics, incidence and
prevalence

NATURAL HISTORY OF DISEASE

Components of epidemiological triad
Natural history of disease best studied by
First case coming to notice of physician

Agent, host, environment

Cohort study
Index case

11