A SOCIO-DEMOGRAPHIC

STUDY OF A FAMILY
AND
A CASE STUDY OF
CLINICAL DEPRESSION

By,
Naresh Sirvi
Roll No –168
Batch – 99
Department of Preventive and Social Medicine,
Government Medical College, Surat.
 GOVERNMENT MEDICAL COLLEGE, SURAT

CERTIFICATE

This is to certify that Mr. Naresh Sirvi, Roll no: 168, of Batch: 99:
has satisfactorily carried out “The Socio-Demographic Study of a
Family & The Case Study of “Clinical Depression” allotted to his
group at Ambanagar, Bhatar, Surat; under the guidance and direct
supervision of Department of Preventive & Social Medicine, Government
Medical College, Surat.

Batch No.: 99
Roll No.: 168
Exam No.:

Date:
Place:
……………………………………………………..
Professor and Head,
Department of Community Medicine,
Government Medical College, Surat.
 Acknowledgement

This study is the cumulative result of efforts of many people who

have extended their support to help us complete this project and I take
this opportunity to express my gratitude for their help, guidance and
encouragement.
I am very grateful to Dr.Jayesh Kosambiya, Professor and Head,
Dept. of Community Medicine, Government Medical College Surat, for
providing us an opportunity to get a first-hand experience of conducting
a survey and close interaction with the people of the community.
I would also like to thank Dr Irfan Momin, Dr. Arya, Dr. Vaishali, Dr.
Meera and Dr. Teesta for their untiring guidance throughout the case
study. I would also like to extend my gratitude towards all other
faculties & residents of the Dept. for their support.
I am grateful to the paramedical and non-medical staff of the
Department, especially Ms. Dharmistha for providing all the logistics for
conducting the survey.
Finally, I wish to express my sincere thanks to my colleagues and
family members of the cases studied for their kind and patient
cooperation.

- Mr. Naresh Sirvi

INDEX
Sr. Pg.
Topic
No. No.

1 Introduction 5
2 Part A-Demographic Profile of Study Area. . . . . . . . .. .
a) Aims & Objectives 7
b) Materials and Methods 8
c) Observation and Interpretation 10

3 Part B-Family Study . . . . . . . . . . . . . . . . . . . . . . . . . . ..

a) Aims & objectives 26
b) Materials & Methods 26
c) Introduction 27
d) Diet Survey & Recommendations 33

4 Detailed study of the case in the family. . . . . . . . . . . . . . . 36

-Impact of health problems on family

5 Problems faced during the study and experiences. . . . . .. 40

6 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 42

Introduction
-India is an enormous concoction of diversity, of people, cultures, ethnicities,
topography, socio-economic tiers, languages and beliefs. Of that, Gujarat is a
unique blend of communities from all over India, especially the eastern and
northern states. 

-This survey tackles with a minute part of this very large demographic, and
studies local patterns and lifestyles in a compact study.

-The main focus of the survey is studying lifestyle of an urban slum locality,
since urbanization is the fastest growing national movement. As of 2019, 34% of
India's population resides in urban dwellings, with a lot more unrecorded influx
of immigrants and part-time laborers. 

-Such a situation creates a myriad of socio-economical, biological, pathological,

psychological and environmental issues which need constant surveillance and
management. For a healthy, functional system, various problems in the
community need to be recorded, understood, and acted upon, to fulfill the needs
of an ever-increasing population.

-The demography studies in Preventive and Social Medicine are meant for this
purpose of educating individuals about community requirements and projections
about growth and physical as well as mental well-being of all individuals.

-In this survey, the students of MBBS 3rd 1st year, GMCS, visit Ambanagar, a
congested urban area in Bhatar, Surat, to study the community's population,
family patterns, sanitation, surroundings, housing situation, water supply,
waste management and influence of COVID19 and the pandemic on the people.

-Within this report is data pertaining to the citizens' education, employment,

COVID Testing and disease in the community, child welfare, and economic
conditions. 
-In summary, it was found that the community is majorly composed of families
of a lower socio-economic class, with a high population density, and unfavorable
living standards with poor hygiene in the surroundings, inefficient waste
disposal.

-This survey was conducted as a door-to-door activity on field, aiming to

familiarize the surveyors with knowledge of socio-economical standards, dietary
practices, effect of the COVID19 pandemic, and morbidities and mortality in a
common community for a better understanding of plans, government schemes
and efforts in effect over the entire nation for demographic studies and data
collection.
 PART – A
(Demographic Profile of Study Area)

1. Aims and Objectives

2. Materials and Methods
3. Observations and Interpretations
4. Discussion and Comments
5. Recommendations
 AIMS AND OBJECTIVES
I. To study socio-demographic profile of urban field practice area (Ambanagar)
department of Community Medicine, Government Medical College, Surat.

II. To study an allotted case in detail.

MATERIAL AND METHOD

 Study period: 22nd September and 25th September, 2021
(9.00 am to 11.30 am)

 Study area: Ambanagar, Bhatar, Surat (1 km away from our college)

 Study Population: General Public residing in the area who consented to

participate in the survey.

 Materials used: Pre-designed Questionnaire in form of ODK ONA Questionnaire,

weighing machine, Measuring tape, Sphygmomanometer, Torch and
Stethoscope.

 Urban field practice area of department of Community Medicine is about 1 km

from Government Medical College Surat.
 On Day-1, briefing regarding need of survey, methodology of survey, and
designing of appropriate tool for survey was discussed with all the students.
 All of us have been divided into 10 different teams for understanding
preparation of a questionnaire.
 All of us tried and prepared a questionnaire, which was later on revised and
finalized.
 A final form (ODK App based) was shared in our WhatsApp group and was
used for data collection.

 In field practice area different lanes are allotted to different students for house-
to-house survey.
 The selection and allotment of household for this family study were arbitrary
and not random.
 Each student visited about 10 households and collected information from a
responsible respondent.
  On an average 10 families have been contacted by each student over two days
of a field work in morning hours.
 All the forms had been submitted online in the evening after the data
collection in the morning.
 Total 291 households have been surveyed and analysis was carried out using
SPSS software.

 A few rate, ratio and proportion have been calculated for fulfilling the objectives.
 Charts have been prepared for better understanding.
 Tables have used to compile the information.

 During the survey various aspect of physical, social and biological environment
had been observed.

 Domestic and Para-domestic sanitation was also observed.

 A case of Clinical Depression was also studied in detail and its

sociodemographic corelate have been identified and presented.

OBSERVATION & INTERPRETATION

 Average Family Size:

-The total no. of families surveyed = 322
-Total population under study = 1413

Avg. family size = Total population under study

Total no. of families
= 1413
322
= 4.39
Total Household members
N 322
Mean 4.39
 
 Std. Error of Mean
 
Median
 
Mode
 
Std. Deviation
 
Sum 1413
 

 Type of Family:
Table 1:Distribution of families according to type in the surveyed area
Type of family

   Frequency Percentage
Joint
43 13.35%
Nuclear
171 53.10%
Third
Generation
87 27.02%
Undefined
21 6.52%
Total
322 100.00%
 Distribution of Type of family
180 171
160
140
120
Frequency 100 87
80
60
43
40
21
20
0
joint nuclear three generation undefined
Types of family

Comment:
Around half of the families in study area are nuclear, rest are joint families,
undefined family and third generation family.

 Ownership of House (Owned or Rented)

Table 2: Ownership of House in Ambanagar area

Ownership of house
Frequenc Percentag
  y e
Own 260 81.50
Rent 59 18.50
Tota
l 319 100

 Age and Sex Wise Distribution of Population:

 Table 3: Age wise distribution of population in Ambanagar area
AGE WISE DISTRIBUTION OF
POPULATION
MAL FEMAL
AGE GROUP E E
1-4 YR 36 21
5-14 YR 119 80
15-45 414 360
46-64 147 140
65 AND
ABOVE 52 44
TOTAL 768 645

Age wise distribution of population

AGE Frequen percentag
GROUP cy e
1-4 YR 57 4.03
5-14 YR 199 14.08
15-45 774 54.78
46-64 287 20.31
65 AND
ABOVE 96 6.79
TOTAL 1413 100

Distribution of age according to Age wise

900
800 774

700
600
Frequency

500
400
287
300
199
200
96
100 57
0
1-4 YR 5-14 YR 15-45 46-64 65 AND ABOVE
Age group

Proportion of Male population = Total male population*100/Total population

=768*100/ 1413
=54.35% of the population is male.
Proportion of Female population=Total Female population*100/Totalpopulation
= 645 × 100/1413
= 45.64% of the population is female.

Sex ratio (overall): = Total no. of female × 1000 / Total no. of males
= 645×1000/768
= 840 females per 1000 males.

Sex ratio of India2016-18= 899 females/1000 males

Sex ratio of Gujarat2016-18= 866 females/1000 males
Sex ratio of Surat2011 = 787 females/1000 males --(1)

Comments:
The sex ratio of surveyed population of Ambanagar is higher than the Surat’s Sex ratio
as per census 2011. However, it is smaller than the India’s and Gujarat’s sex ratio.
Possible cause for this may be sample was too small.

Proportion of Children less than 5years of age:

= No. of children under 5 years * 1000

Total population
= 57*1000
1413
= 40 children per 1000 population

Proportion of people above 65 years age

= Total no. of male + female >65 year age *100

Total population
= 96*100
1413
= 6.79 percent

Proportion of Female in Reproductive age Group:

= No. of females in 15-45 years* 1000

 Total Population of Females

= 360* 1000
645

= 558 per 1000 female.

Dependency Ratio:

= (Population of 0-15 yrs. + population of >65 yrs.) * 100

Population between 15-65 yrs.

= 352 X 100
1061
= 33.17%
Comment: In India, this ratio is 48.73% (2). Here it is quite less than the national ratio

Child dependency ratio = Population of 0-15 years *100

Population between 15-65 yrs.

= 256* 100
1061

= 24.13%
Comment: In India, this ratio is 26.2%(3) Here it is 24.13% which is more than the
national and the state ratio.

Old age dependency ratio = 96* 100/1061

= 9.04%

 Total income of the family

Monthly Income
Frequenc
Class y Percent
1 >7770 237 81.4
2 3808- 22 7.6
 7769
3 2253- 3 1.0
3808
4 1166- 4 1.4
2253
5 <1166 5 1.7
  Total 271 93.1
Missin 20 6.9
  g
Tota   291 100.0
l
Table 5:Total income of families in Ambanagar area

Total Monthly Income of Family

250

200
Frequency

150

100

50

0
>7770 3808-7769 2253-3808 1166-2253 <1166
Monthly Income of family

 Literacy Rate:

Table 6: Distribution of surveyed population according to their education

 Education Status of individual
Frequenc Percentag
  y e
ILLITERATE 106 7.50
PRIMARY 579 40.98
SECONDARY 339 23.99
HIGHER
SECONDARY 174 12.31
GRADUATE 110 7.78
POST-
GRADUATE 12 0.85
NA 93 6.58
Total 1413 100

Educational Status
1% 7% 8%
8%

12%

41%

24%

ILLITERATE PRIMARY SECONDARY

HIGHER SECONDARY GRADUATE POST-GRADUATE
NA

Total Literacy rate (overall):

= Total no. of literate population (>7years) *100
Total no. of population (>7 years)
= 1214 *100
1320
=91.97%

Literacy rate (male):

= Total no. of literate male (>7 years) 100
Total no. of male (>7 years)

= 566 *100
673
= 84.10%

Literacy rate (female):

= Total no. of literate female (>7years) 100
 Total no. of female (>7years)
= 399 * 100
569
= 70.123%
Illiteracy rate (overall):
= Total no. of Illiterate person (>7 years) *100
Total no. of person (>7 years)

= 106 x 100
1320
= 8.03%
Comments:
Literacy rate of India is 74.04%; male 82.14% and female 68%.NFHS-4
Literacy rate of Gujarat is 80%; male 89% and female 72%.NFHS-4
Literacy rate of Surat is 87%; male 92.5% and female 81%.NFHS-4 ------- (5)

Overall Male & Female Literacy rate of the surveyed population of surveyed area at
Ambanagar, Bhatar, Surat is higher than national average, comparable to state average but less than
Surat rates. The reasons for this could be purposive sampling and the population has achieved
minimum primary education that is considered as literate.

 Distribution of Population according to Occupation

Table 7:Distribution according to occupation in Ambanagar area

OCCUPATION OF THE POPULATION

Frequenc Percentag
  y e
UNSKILLED
LABOURER 55 3.892427
HOMEMAKER 302 21.37297
SKILLED
LABOURER 415 29.37013
FARMER 1 0.070771
BUSSINESS
OWNER 61 4.317056
GOVERNMENT
EMPLOYEE 11 0.778485
PRIVATE
EMPLOYEE 121 8.56334
NA 162 11.46497
STUDENT 263 18.61288
OTHER 22 1.556971
TOTAL 1413 100
 Occupation of the population
415
400
302
300 263
200 162
121
100 55 61
11 22
Frequency

1
0
ER ER R ER R E E T
RE NE YE YE NA EN HE
R
UR AK U R M O O D T
BO EM BO FA OW MP
L PL TU O
LA M LA S S E E M S
O
ED H ED NE EN
T TE
LL ILL S SI VA
KI K M I
S S BU ER
N PR
UN V
GO

different type of ocupation

Employment ratio:
= No. of employed persons
No. of Unemployed persons
=686/727
= 0.94:1

Skilled/ Unskilled ratio:

= 415/55
= 7.54:1

 Primary language spoken in house

Table 8:Distribution as per Primary language spoken in Ambanagar area

LANGAUAGE used in family

Frequenc percenta
  y ge
Englis
h 1 0.31
Gujara
ti 271 84.16
Hindi 39 12.11
other 11 3.42
Total 322 100
 Different language Spoken in house hold
300
271
250

200
Frequency

150

100

50 39
1 11
0
english Gujarati hindi other
Language Spoken in Household

 Marital Status of population

Table 9: Marital Status of population in Ambanagar area

MARITAL STATUS
Frequen Percent
  cy age
MARRIED 845 59.80
UNMARRI
ED 206 14.58
DIVORCE
D 4 0.28
SEPARAT
ED 1 0.07
WIDOW 63 4.46
NA 294 20.81
TOTAL 1413 100

 COVID 19 testing and results:

Table 10:Covid 19 testing of population in Ambanagar area

COVID TEST
  Frequenc percentag
 y e
Yes 491 34.75
No 922 65.25
Tota
l 1413 100

Table 11:Result of COVID19 testing in Ambanagar area

COVID TEST RESULT

Frequen Percenta
  cy ge
NEGATI
VE 451 31.92
POSITIV
E 39 2.76
NOT
DONE 923 65.32
Total 1413 100

 BMI Report

Table 12 :Distribution of population according to BMI in Ambanagar area

BMI
Frequenc Percentag
  y e
Underweight (total following
three)    
Severe thinness 57 4.73
Moderate thinness 24 1.9
Mild thinness 42 3.48
Normal range 371 30.81
Overweight 240 19.93
Obese 470 39.03
Total 1204 100

 Addiction status :

Table 13: Addiction status of population in Ambanagar area

ADDICTION
Frequenc percentag
  y e
YES 84 6.42
NO 1225 93.58
Tota
l 1309 100
 Pregnancy status:

Table 14: pregnancy status of female population in Ambanagar area

Pregnancy status of female
population
Frequenc percentag
  y e
Yes 12 3.59
No 322 96.41
Tota
l 334 100

 Prevelant diseases in study population

Table 15:Prevelant diseases in study population of Ambanagar area

Illness
Frequenc Percen
Illness y t
Asthma 2 0.2
Blood pressure+ 1 0.1
Thyroid
Diabetes 8 0.7
Diabetes+Hypertensi 1 0.1
on
Glaucoma 1 0.1
Hypertension 10 0.9

Mental retardation 1 0.1

Missing 212 18.0

No Illness 294 25.0
Schizophrenia 1 0.1

Total 1176 100.0

 PART: B

Family Study

Aim and Objectives:

To identify prevalent health problems in the
family.
To identify the possible Risk factors.
To study the environment and its impact on the family.

Method:
For the detailed case study students of Batch, no 99, Roll No 37 to 72 were
 divided into 12 groups. Each group was allotted one family from which they had
to collect information regarding:

Dietary Intake.
Environment and Sanitation.
Detailed History about a case.

Information was obtained in the following way:

Direct Observation.
Questioning to the members of the Family.
Record Based Information.

I was allotted the family of Shyam Raj Gupta for a detailed study of his family and the
case of his wife, who is suffering from Clinical Depression.

Materials:
Pre-designed
Questionnaire Weighing
Machine Measure Tape
Mercury Sphygmomanometer
Stethoscope

GENERAL INFORMATION
Head of family: Shyam Raj Gupta
Religion: Hindu

Family Size:6

Family type: Third Generation

Total monthly income: Rs. 10000/-

Per capita income: Rs.1666/-

Family profile:

Name Age/Se Occupation Education Health

x (if more Complains
than 7 years
of age)
FAMILY COMPOSITION DETAILS:
Numbers of adolescents: 2
Numbers of women in reproductive age group: 2
Numbers of women above 45 yrs. of age: 1
Numbers of person above 65 yrs. of age: 1
Numbers of literate: 4
Numbers of illiterate: 2

SOCIO-ECONOMIC STATUS:
Salary (income of the family): 10,000
Income from other sources: NO
Total income of family: 10,000-12000
Per Capita income: 1833/-
Family belongs to socio-economy class: III (Lower Middle)

ENVIRONMENT:
PSYCHOLOGICAL ENVIRONMENT:
Relation with each other in family: good

Peace in the family: good

Relationship with relatives: good

Relationship with neighbors: good

psychological overcrowding: yes

HOUSING AND SANITATION:

Building:Rented

Duration of Stay: 5 years

Type of wall: Concrete

Type of floor: Concrete

Type of roof: RCC

Height of roof :> 6 ft.

Total no. of rooms: 1

Total members living: 6 (male-3 female-3)

Overcrowding: yes

(Floor space, Number of persons per room, sex separation present)

Open space surrounding the house: Absent.

Total floor Area: 420 sq. feet

Kitchen: Standing

Fuel used: LPG cylinder.

Ventilation: Inadequate

Cross ventilation: Absent

Natural light: Inadequate

Refuge: Community Dustbin

Sewage water: Drain

Latrine: Personal

ENTOMOLOGICAL SURVEY:

Name of vector Y/N Breeding Places: Intra Vector control

domestic/Extra domestic measures
adapted
Mosquito Yes Extra domestic Using mosquito
coil
Housefly Yes Extra domestic -
Rodents No - -

Comment: Though there are breeding places, they use mosquito

coil for self-protection.

MCH AND FAMILY PLANNING

1.Eligible couple in family: 1

2.Target couple in family: 1

3.Married life: 22 years

4.Number of children: 3

5.Practice of family planning (Contraceptive): yes

6.Choice of method of family planning: appropriate

7.No of births during last year: no

8.No of deaths during last year: 0

NUTRITIONAL HISTORY:

Diet history:
1. Taken by stock inventory.
2. Diet: Vegetarian

Lifestyle of family members for C.U.:

 Workstyle Male (C.U.) Female (C.U.) Total (C.U.)
Sedentary 0.8+0.8 1.6
Moderate 1.2 1.2
Heavy
Children 1.0+1.0 1.0 3.0
Total 5.8

Diet table according to food items and raw materials:

No. Food item Sub items Amount per Per NIN +/-
year day recommen
dations
gap
/Per
g/CU
C.U.
Wheat 780 kg
CEREALS Jowar 52 kg
1. Bajra - 492.6 460 +32.6
Rice 208 kg
Tur Dal 130 kg
Mung Dal 13 kg
2. PULSES Mung 52 kg 117 40 +77.0
Moth -
Others 52 kg
Potato 130kg
ROOTS Onion 104kg
3. AND Carrots 13 kg 178.5 50 +128.5
Sweet -
TUBERS
potatoes
4. Meat and Fish - - 30 -30.0
5. Green leafy vegetables 52kg 24.62 40 -15.4
6. Other Vegetables 156kg 73.89 60 +13.89
7. Eggs - - 30 -30.0
8. Milk 365L 172.4 150 +22.4
9. Edible oil/Ghee 104 kg 49.26 40 +9.26
10. Sugar/ Jaggary 104 kg 49.26 30 +19.26
11. Others -

Nutrient Intake

Details Actual Expected/recommended/CU Gap (+/-) CU

intake/CU
Calories 2781.15 2400 Kcals +381.15
Proteins 98.87 60 g +38.87
Fats 108.1 20 g +88.1
Carbohydrates 413.9 400 g +13.9

Analysis

Calorie intake is excess than required.

This is because of excess of oil and ghee intake as well
as excess of sugar intake.
They are advised to reduce the intake of oil ghee
and sugar to maintain the diet and instead can
increase the intake of vegetables or eggs.
 PART-C
(Case-Study)

INTRODUCTION 
Mental and behavioral disorders are understood as clinically  significant
conditions characterized by alteration in  thinking,mood or behavior
associated with personal distress  and/or impaired functioning. Individuals
may suffer from one ormore disorders during one or more periods of their
life. One  incidence of abnormal behavior or a short period of abnormal 
mood does not of itself,signify the presence of a mental or  behavioral
disorder.

The International Classification of Disease (ICD-11) 

classifies the mental and behavioral disorders as:

 Organic, including symptomatic, mental

disorders eg.dementia, in Alzheimer’s
disease, delirium. 
 Mental and behavioral disorders due to psychoactive  substance
use- eg. harmful use of alcohol, opioid dependence  syndrome. 
 Mood(affective disorders)- eg. bipolar
affective  disorder, depressive episode. 
 Schizophrenia, schizotypical and delusional disorders eg.
paranoid schizophrenia, Acute and transient psychotic
disorders. 
 Neurotic and stress related disorder- eg. generalized 
personality disorders, obsessive compulsive disorders.
-Disorders of adult personality and behavior- eg. paranoid 
personality disorder, trans-sexualism.
 Mental retardation. 
 Unspecified mental disorders. 
 SYMPTOMS OF DEPRESSION

Person with depressive episode may experience symptoms related  to: 

 Mood, such as irritability  
 Emotional well being, such as feeling sad or empty, hopeless or 
anxious  
 Cognitive abilities, such as thinking or talking more slowly
-behavioral such as loss of interest in activities, withdrawing  from
social engagements  
 Sleep patterns, such as difficulty sleeping at night, waking  early
or too much sleeping.
 Physical well being, such as fatigue, changes in  appetite, weight
changes, headaches, increased cramps.

CAUSES OF DEPRESSION
Common causes include: 
 Family history 
 Early childhood trauma 
 Medical conditions like insomnia,chronic illness,attention  deficit
hyperkinetic disorder 
 Drug or alcohol use 

RISK FACTORS OF DEPRESSION

 Low self esteem  
 Personal history of mental illness 
 Certain medications.
 Stressful events such as loss of loved one, economic or  family
problems.
 DIAGNOSIS OF DEPRESSION

There isn't a single test the  doctor can make a diagnosis based on symptoms
and a  psychological evaluation. 
In most cases,a series of questions are asked based on:
 moods 
 appetite 
 sleep pattern 
 level of activity
 Thoughts

COMPLICATIONS OF DEPRESSION
 Panic attacks 
 Thoughts of self harm or suicide  
 Social isolation 
 Physical pain
 Relationship problems

TREATMENT OF DEPRESSION  
It’s common to combine medical treatments and lifestyle 
therapies,including the following: 

-MEDICATIONS:-
•Antidepressants like escitalopram, sertraline, paroxetine
•Anti-anxiety like diazepam, lorazepam, buspirone, alprazolam
•Antipsychotics like risperidone, olanzapine, clozapine.

-PSYCHOTHERAPY:-
Speaking with a therapist can help in learning how to cope  negative
feelings. Group therapy sessions are also advised.

-LIFESTYLE MODIFICATION 
Regular exercise of 30 mins,avoidance of drugs or alcohol is  generally
advised.
 CASE-PRESENTATION

Presenting a case of a 36 years old married Hindu female named Sarita

Shyam Gupta residing at Ambanagar, Surat, Gujarat, a homemaker.

 Chief Complaints:
The patient has recent complaint of Indigestion, Constipation and Burning
Sensation in chest along with dizziness and weakness since 4 days.

 Origin, Duration & Progress:

The patient was relatively asymptomatic 1 year back. She started
experiencing episodic illness and loss of interest in regular activities since
then. She had abdominal pain and dysmenorrhea since 6 months. Recently
she developed gradual and progressive fatigue throughout the day along with
burning sensation in chest and constipation. She also had symptoms of
dizziness throughout the day.
She consulted her doctor and she was diagnosed with Major Depressive
Disorder. She was started on medications (Escitalopram, Lorazepam,
Sertraline, Omeprazole) and she is taking the same for 1 year regularly.
At present she has been prescribed Pantoprazole, Domeperidone and
Quetiapine for her recent complaints. Her mood disorder is under control
now.

 Past history:
History of Escitalopram, Lorazepam, Sertraline and Omeprazole use since 1
year for Major Depressive Disorder.
H/o 1 major OT for Renal Stone.
H/o frequent admission at multiple hospital for multiple complaints but
documents not available.
No h/o Diabetes Mellitus /Hypertension /Tuberculosis/Jaundice/Typhoid.

 Family history:
No h/o Diabetes Mellitus /Hypertension /Tuberculosis/Jaundice/Typhoid
No h/o of any genetic/hereditary disease in family
  Personal history:

1. Diet: Vegetarian
2. Appetite: Adequate
3. Sleep: Adequate
4. Bowel & bladder: Normal
5. Habit: No History of Alcohol intake /Smoking /tobacco chewing.

 Negative History:
No h/o Fever
No h/o Cough
No h/o vomiting
No h/o Diarrhoea

 GENERAL PHYSICAL EXAMINATION:

Patient is conscious, co-operative and well oriented to time, place and
person.
VITALS:
-Temperature: Normal (by palpatory method)
-Pulse: 89/min in Right Radial artery in sitting position.
-BP: 130/80 mm of Hg in Rt. Brachial artery in sitting position.
-Respiratory Rate: 15/min

No Pallor,
No cyanosis,
No Icterus,
No Lymphadenopathy,
No clubbing,
No venous engorgement
Head to toe examination: Normal

 SYSTEMIC EXAMINATION

A)Respiratory:
-Inspection: Normal shape of chest and respiratory movements
(Thoraco-abdominal), No audible breath sounds
-Palpation: Trachea In Center
-Percussion: Borders of Lung – Normal
-Auscultation: No Rales and Rhonchi heard
B) CVS:
-Inspection: Pericardium - Normal
: No Bulging / retraction
: No Abnormal Dilated veins
-Palpation: Temperature – Normal
: No Tenderness
: No palpable apex beat
-Percussion: Borders of heart normal
-Auscultation: S1, S2, Normal
C) Abdominal:
-Inspection: No visible Scar on Skin
-Palpation: Soft, No Guarding / Rigidity, Spleen and liver not palpable
-Percussion: No sign of free fluid in abdomen
-Auscultation: Peristaltic sound heard
D) CNS:
-Higher function, Sensation, Reflex, Tone normal(6)

 REGULAR DIET OF THE CASE:

ITEM QUANTITY Kcal PROTEIN
Tea 2 cups 79 1.6
Biscuits 2 40 0.8
Chhapati 5 1400 15
Cooked 2 katori 140 12
vegetable
Dal 1 katori 350 20
Rice 2 katori 700 24
Dry Fruits 2 cashews, 2 73.4 1.4
alomonds, 2
dates
Milk 1 cup 122 8.1
Total 2904.4 82.9

-The patient consumes 2904.4 calories and 82.9 grams of protein in

a day.
-Daily requirement: 2400 kcal (For female- moderate)
-Daily protein requirement: 46g (female of 50 kg weight)
-Comment: Thus, the daily calorie intake is more required amounts.
The protein intake of the female is way more as compared to the
required value.

 RECOMMENDATIONS TO THE PAITENT:

 -Continue taking regular medications as prescribed by the

doctor.
 -Do mild physical activities daily like brisk walking.
 -Make sure you are regularly connected with friends and family.
 -Prefer taking plenty of sleep.
 -Avoidance and management of stress is must.
 -Have maintenance visits with your therapist every so often
when in remission.
 - Consistently practice the strategies and coping mechanisms
your therapist taught you.

PROBLEMS FACED DURING THE STUDY

-Overall study was without any major problem but visits to the same
house in the morning made people little uncooperative.
-Some people refused to provide data.
-In some houses working people were not at home, so we could not
collect the data
-Also, Information regarding diet, people could not tell us the exact
figures how much they consume.
- In the absence of the head of family, some were not able to give
the monthly income exactly
-Sample size is very small so it cannot be correlate to the data of the
whole country.
 LEARNING EXPERIENCE

Following this case study we examined the field exposure for the
very first time.
We practically realised the importance of epidemiological factors in
relation to
the diseases. The study broadens our horizon of knowledge. It was
really worth
experiencing task and it gives the true satisfactory result. The family
we visited
gave us full support and provide all the information we need for our
study
procedure.
 REFERENCES

(1) Park’s Textbook of Preventive and Social Medicine

26th edition
(2) Textbook Of Psychiatry by Niraj Ahuja 7th Edition
(3) National Family Health Survey (NHFS)