Ba

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W20
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PREFACE TABLEOFCONTENTS

Communi t
yHeal th studentneeds t he T-
Cont
ent
,Pr
eface&Acknowl
edge.
.1-1
medi cal i nformation besi de t he
depar tment al cour ses t o become a VOLUMEONE
goodCommuni t
yHeal thPr actit
ioneri n
Professi onalEt hics...
..
..
..
...
...
..
..
....
...
..
2-8
thef utur e.Ipr esentmai nlyformedt his
Pri
mar yHeal thCar e(PHC) .
...
..
...
....
.8-15
not efort heCommuni tyHeal thst udent s,
Behav iorChangecomm. ...
..
...
..
...
..15-17
but I t hink t hat Communi t
y Heal th
Communi t
yLinkage&Devel opment.17-18
student smayobt ai
nsomel i
tt
lebenef it
Occupat i
onal Heal th...
..
..
...
..
...
..
...
..19-23
afterr eadingi t.It
scont entsal lskil
lsof
AccidentandEmer gency .
..
...
..
..
....23-26
the di fferentourr espect ivel ecturers
Referral andOut reachSer vi
ces. .
..26-28
whi ch ar e essent i
alf or the gener al
HumanNut ri
tion...
...
..
...
..
..
..
...
..
..
.....
28-35
pract i
tioneraccor ding t ot he moder n
Sympt omat ology ..
...
..
..
..
...
..
...
..
..
....
35-42
medi calknowl edge.Idi d mybestt o
Communi t
yMent al Health..
...
..
...
..43-47
present t his not e as a Communi ty
I
ntroduct i
ont oPhar macol ogy .
...
.47-49
Heal th Pr acti
tioner'
s gui de because I
Essent ialMedi cine....
..
..
..
...
...
..
..
...49-52
thi
nk t
hat Communi ty Heal th
Environment al Heal t
h...
..
...
..
...
..
...
.52-56
Pract i
tionerwi thoutski ll
si snotagood
BBBDBBVOL UMETWO
pract i
tioner.Thanks f ormy Al mi ght y
HIMS. ..
....
..
..
..
.....
..
..
...
..
...
..
..
..
...
..
...
..56-58
Allahf orachi ev i
ngthisnot e.Thanksf or
PHCManagement ...
..
...
..
..
..
...
..
..
...58-60
myf ami l
ywhodoi ngev erythingforme.
UseofSt andingOr der..
..
...
..
...
..
...
.60-62
ACKNOWLEDGEMENT Account i
ngSy stem i nPHC. ...
..
...
63-65
Mater nal Heal th.
...
...
..
...
..
..
..
...
..
..
..65-72
I
n t he name of Al lah, The Most I
mmuni tyandI mmuni zati
on. .
..
..72-78
Benefi
cent,TheMostMer cifulandt he AnatomyandPhy siology .
..
...
..
..
..78-107
Master(Absol ut
eCont roll
eroft heday Cli
nical Skill
s.....
..
..
...
..
...
..
..
..
...
..
..107-123
ofJudgment ).AllThanksandPr aisebe HealthSt ati
stics...
...
..
..
..
...
..
...
..
..
.123-125
toAlmightyAllah(S.W.T)forHi sInfi
nit
e bbcjbc VOL UMETHREE
Mercy,Lov e,Protecti
on and Gui dance
ReproductiveHeal th...
..
....
..
..
..
..
.126-132
thr
ought hisresearchandf ormingt hi
s
SchoolHeal t
hPr ogr ammes. ...
..
132-134
notetogetherandmyst udyaswel l
. Communi t
yEy eCar e..
..
....
..
..
..
..
.134-137
My si ncere appreciation goes t o my Ear,Nose&Thr oatcar e. .
..
..
...
..
..137-140
par ents,Uncl es,Aunt ies,Cousi n my ControlofCommuni eDi
cabl sease.
.140-141
ControlofNon- Com.Di sease. .
.141-142
class mat es f or t heir pr ayers and
Communi t
yNewbor ncar e..
..
..
.143-145
suppor tt
hroughoutmyst udy ,mayAl lah
OralHealth..
..
..
..
..
....
...
..
....
..
..
..
...
.145-146
(S.W. A) gr ant t hem wi th Jannat ul
Care&ManagementofHI V/AIDS..
.146-150
Firdaus ( Amin) .And my appr eci
ation CareofOl derPerson. .
..
....
..
..
..
..
.150-152
alsogoest ot heent i
rel ecturersinmy CareofPersonWi hSpec
t ialNeed.152-152
Depar tment of Communi ty Heal th Chil
dHeal th.
...
..
..
..
.....
..
....
..
..
..
..
..
152-154
Sciencewhot aughtmeal lthecour ses. Familyplanning..
..
.....
..
....
..
..
..
..
..
154-158

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22.

PROFESSI
ONALETHI
CS andrehabil
it
ati
vehealt
hact
ivi
ti
esand
ser
vicestothepeoplewher
etheyl
ive
Ethnic:-Isasy stem (awri
tten andwor k.
documentorr ules)observedwithavery
highstandar dofr espect(
bya Prof
ession:
-Isanoccupati
onwhich
profession)whi chguidesandcontrols demandsahi ghstandar
dofeducat
ion
themor al behaviourandmanifestsin aswellashighcodeofconduct
,and
thechar acterandmi nd. ethi
csandetiquet
te.

Medical
ethi
cs:-Isthecodeofmor al Values: -Areeffect
ivedi
sposi
ti
on
andsoci
albehaviouri
nrelat
ionshi
pto towar dsaper son,anobj
ectorani
dea
medical
prof
essionandt hepati
ent andr epresentawayofl i
fe.
ent
hrust
edtoyourcare.
Theri
ght
softhepract
ici
ngcommuni
ty
Eti
quette:-Meanscodeofmanner s, heal
thpr
act
it
ioner
behavi
ourandact i
onswhi chare
expectedofapr of
essionalundercer
tai
n ThefollowingaretheRi ghtsand
condit
ions/ci
rcumstancesandar e Guidel
ineswhi chshallensurethatther
e
observedbyallintheprofessi
on. i
si mprovedhealthservicebya
communi t
yhealthpractit
ionertothe
Codeofpr ofessi
onalconduct
:-Arethe member softhecommuni tyintheheal
th
coll
ecti
onofRul es,
LawsandSt andards faci
li
tyandi nthecommuni ty:
thatgui
deandcont rolt
hebehaviourof
theprofessi
on. 1.Pract i
cing,inaccor dancewi ththe
scope, whichi sl egall
yper missiblefor
Client:-I
sapersonwhoi shealt
hyand specifi
cpr actice
comesf or
;fur
therhealt
hser v
ices, 2.Properor ient ati
onandgoal -
dir
ected
receiveacommodi ty,healt
heducation, i
nser viceeducat ioninr espectoft he
medi caladvi
ceandcar e. modesandmet hodsoft reatmentand
procedur esrelev antt oherwor king
Patient:
-Isapersonwhoissuff
eri
ng sit
uation
fr
om adi seaseandisundermedi
calor 3.Negot iati
onwi ththeempl oyerfor
surgicalt
reatmentandcar
e. suchcont i
nuingpr ofessional education.
Communi tyhealt
h:-I
sthebranchof 4.Adv ocacyf orpr ot
ectionofpat ients
medicineconcernedwit
hthetotal
healt
h andper sonnel forwhom he/ shehas
oftheindi
vidual
,thef
amili
es,t
hegroup, acceptedr esponsi bi
lit
y.
thecommuni ty,
thenati
onandtheworld 5.Asaf ewor kingenv i
ronment ,whichis
atlar
ge. equippedwi thatl eastmi nimum
physical,mat erialandper sonal
Communi t
yHealt
hPr act
iti
oner:
-Isa requir
ement s.
speci
all
ytr
ainedprof
essionalwho 6.Refusingt oCar ryoutat ask
provi
despromoti
ve,prev
entiv
e,curat
ive reasonabl yregar dedasout sidethe

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scopeofhi s/ herpr acti

ceandf orwhi ch corr
ectlabel
ingofhi
s/her;per
son,
he/shehasi nsuf i
cienttrainingorf or possession,
Specimensforin
whi chhe/ shehasi nsuf f
icient vest
igati
onpurposeli
kebloodsample.
knowl edgeorski l
l.
7.Wi thholdingpar ti
cipationi nunet hical Dut
iesofCommuni
tyHeal
thPr
act
it
ioner
pract i
ce. 1.Car ingforthesickandi nj
uri
es
8.Obt ainingwr it
tenpol i
cygui delines 2.Hel pingtheindi
v i
dualandthef amil
y
andpr escri
pt i
onsconcer ni ngt he totakeposi ti
veact i
on
managementofhi s/herwor king 3.Trainingothers
env ir
onment 4.Adopt i
ngcommuni t
yhealthservi
ces
9.Ref usingt oi mplementapr escr i
pti
on 5.Ev aluati
ngandconduct ingresearch
ortopar ti
cipatei nact i
vi
t i
es, whi ch 6.Shar ingwithothersinthe
accor dingtohi s/herprof essional dissemi nati
onofheal t
hinformation
knowl edgeandj udgment ,arenoti nthe
i
nter estoft hepat i
ent. CodeofConductf
orCommuni
tyHeal
th
10.Di sclosur et ohis/hert hedi agnosi s Pract
it
ioner
ofpat ientsf orwhom he/ sheaccept s
1.Setahi ghst andar
d
responsi bil
ity
2.I
ntra-professi onalObli
gation
11.Awor ki
ngenv i
ronment ,whi chisf ree
3.UseofSt andi ngOrders
oft hreats,intimidationori nter ference.
4.Maintenanceof2wayr eferr
alsy
stem
12.Amedi cal suppor torr eferral system
5.Admi ni
st er
ingofTr eat
ment
tohandl eemer gencysi t
uat ions
6.PromptAt tent i
on
effectively.
7.Givenofev idence
13.Amanageabl ewor kl
oadsot hat
8.Useofuni f
or m
adequat estandai dofheal thcar ecanbe
9.Antiprofessi onalbehaviours
mai ntainedev i
denceasanexper t
10.Absent eeism
witness.
General
worket hni
cofacommuni
ty
Ri
ghtofacl
i
ent
/pat
ient
heal
thpract
it
ioner
1.Ri ghtofconsi derati
onandr espect,
1.Actwi thsenseofmat uri
ty
privacyandconf identi
ali
ty
2.Developt hesenseofselfmot
ivat
ion
2.Uncondi tionedaccept anceasa
3.Beaccur atei nal
lact
ivi
ti
es
humanbei ng
4.Practi
cet horoughness
3.Recei vingheal thcar einaccor dance
5.Practi
cedependabi li
ty
wi t
hhi s/herspeci f
icneeds
6.Beflexibl
e
4.Inf or
med, vol
untarydeci sion-maki
ng,
7.Haveagoodj udgment
regar di
ngconsentandr efusal of
8.Behonest
treatment
9.Havei nti
atives
5.Conf i
rmat ionofi denti
tyf orpurposes
10.Beasser tive
ofdi agnosi s,careandt reat mentand
11.Bepunct ual

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12.Possesstheat
ti
tudeofef
fi
ciency 5.Beactiv
easapr ofessi
onalin
13.Beamemberofat eam devel
opingcar
eofPr ofessi
onal
14.Betactf
ul knowledgeandshouldhav et
heabi
l
ityt
o
i
mpactt hesameintoothers.
Et
iquet
tet
obeobser
vedbya
Communit
yHeal
thPract
it
ioner Thecommunityheal
thpract
it
ionerand
hi
s/hercol
l
eaguesrel
ati
onshi
p
1.Hav egenui nedesi ret ohelppeople
2.Bewar m andat t
entive 1.Behonesti nhis/herprofessional
3.Listeningwi thattention discussionwi thcoll
eaguesl ikeduring
4.Prov i
deappr opr i
atepr ivacytohis/
her reportwr i
ting.
cli
ents/patient 2.Trusthi s/hercoll
eaguest oelicit
5.Hav eempat hy cooper ati
on
6.Addr essal lthecl i
ent /pati
ents 3.Hav erespectf orthecont ri
butionof
formally,suchasMr .
,Mr s.,Alhaj
i
,Dr.Et
c. others.
7.Av oidsmoki nganddr i
nkingalcoholi
n 4.Takeappr opri
ateactiontosaf eguard
theheal t
hf acilityenvironment theclient/pati
entWhenhi s/ hercareis
8.Av oidengagi nginmar keting endanger edbyaco- workerorot hers.
9.Av oidpil
f eri
ngorst ealinghealth
faci
lit
ypr oper tylikedrugs, equipment, Thecommunit
yhealt
hpracti
ti
onerand
etc. hi
s/herempl
oyerr
elat
ionshi
p
10.Don' tfi
ghtwi thcolleaguesor 1.Cooper at ewi thhis/heremploy eri n
cli
ents/patient sort heirrelati
ves carr
youtcar etoot hebestinterestof
11.Consi derj uniorcolleaguesas themanagementoft hehealthfaci li
ty
brothers/sisters andt heclient s.Foll
owt heempl oy er '
s
Thecommuni t
yhealt
hpract
it
ionerand poli
cygui delines.
hi
s/herpr
ofessi
onrel
ati
onshi
p 2.Makesuggest i
onst otheempl oy er
s
onissuest hatillhelpinsoundpol icy
1.Mai ntaincompet encebycont inual for
mul ati
on
l
earningandexecut i
ngr esponsi bil
it
ies 3.Behonesti ncarryingoutalldut ies.
withast rictfocusonheal thethics 4.Hav etrustonhi s/herempl oy ert hat
2.Act i
ngt hroughapr ofessional wages, promi sesmadewi ll
bef ulfill
ed.
organization, par
ti
cipateinest abl i
shing 5.Usedi aloguet oset t
leanygriev ance
andmai nt ainingequitableand againstempl oy er
.
economi cwor ki
ngcondi ti
on.
3.Inaccept i
nganddel egating Ther
elat
ionshi
pbetweenthe
responsibi l
i
ties,putintoconsi deration communityheal
thpr
acti
ti
onerand
theindividual'scompet ence. membersofthecommunity
4.Pl ayamaj orroleindet erminingand 1.Li
sten,lear
nandunderst
andthe
i
mpl ement i
ngdesi r
abl estandardsof member softhecommuni t
y
healthcar e. 2.Tal
k,discussanddeci
dewiththe

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member soft hecommuni t

y. t
hosedelegat
eswhohav
enotpr
e-
3.Encourage,organi
semember softhe r
egi
ster
ed.
communi tytoparti
ci
pate;Encourage
them t
otakeupheal thybehavioursand Rat
ional
eforr
egi
str
ati
on
habi
ts. 1.Registrati
ondi sti
ngui shesthe
4.Beinvolvedandact i
vel
ypartici
patei
n regi
steredar chi t
ect sasqual i
fied
thecommuni tydevelopmentact i
vi
ti
es. professionals.
Cl
assi
fi
cat
ionofet
hics 2.Empl oyersandcl i
ent smayr equir
e
archit
ectst ober egisteredbefor et
hey
1.Descri
ptiv
eethi
cs:-I
sthestudyof canbeengaged.
peopl
e’sviewsaboutmoralbel
ief
s. 3.Beingr egisteredi nt heArchitect
s’
Registermaybeapr econditi
onf or
2.Normati
v eet
hics:
-Ist
hest
udyof
taki
ngpar tin( international)
ethi
calact
ion.
compet iti
onsandt ender s.
3.Appliedethi
cs:-Ref
erst
othe 4.Carryingoutact iviti
esi not
herEU
pract
icalappli
cati
onofmoral MemberSt at es(andof t
enoutsidethe
consi
der at
ions. EU)iseasi erf orper sonswhoar e
regi
stered.
Pr
inci
plesofet
hics
Li
censeorl
icence:-Isanoff
ici
al
1.Proportional
it
y per
missi
onorper mittodo,
use,orown
2.Justi
ce somethi
ng.
3.Respectf orautonomy
4.Effi
ciency Li
censing:-Isdef i
nedasabusiness
5.Healthmaxi misati
on arr
angement ,wher ei
nacompany
6.Benef i
cence author
izesanot hercompanybyissui
ng
7.Non-mal efi
cence ali
censet otempor ari
l
yaccessit
s
i
ntell
ectualpropertyr
ight
s.
Registr
ation:
-Isaprocessbywhicha
pat
ient'snameandi dent
it
yareenrol
l
ed Rat
ional
eofl
i
censi
ng
i
ntot herecordsoft
hehospit
al.
Ensuringy ourcompanyi
sproperl
y
Pr
ocedur
esOFRegi
str
ati
on l
icensedhel pstobri
ngprot
ecti
onto
yourself
,youremployeesandyour
1.Priortot heev ent( pre-r
egistrat
ion) customer s.
whichi sexcl usivelydoneonl inethrough
Focal Pointsdesi gnat edbyeach Pr
ocedur
e/st
epsofl
i
censi
ng
admini st
rationandent i
tyentit
ledto
part
icipatei nt hemeet i
ng. 1.Considert
heamountofwor ky
ou
2.Dur i
ngt heev ent(onsi teregistr
ation) wanttodo
whichr equiresal etterofaccr edit
ation 2.Researchotherpat
ents
fr
om t heDesi gnat edFocal Pointfor 3.Fi
ndasmal l i
mprovement

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4.Don’tfi
letooearly stakeholderstoinf
orm programsand
poli
cies
5.Consideraprov i
sionalpat
ent
11.Prov i
deinfor
mal counseli
ng,heal
th
6.Bey ourownexper t screenings,andreferr
als
7.Fi
ndy ourmar ket 12.Buildcommuni tycapacit
yto
8.Createanadmi nistr
ati
on addressheal t
hissues
9.Usemul ti
medi a 13.Addr esssocialdeter
minantsof
health
10.Reachoutt omul ti
plecompani
es
Rol
esorr
esponsi
bil
it
yandlimitat
ionof Essenti
almoralpr
inci
plesandcodes
aCommunit
yHealthpract
it
ioner thatshoul
dguidetheCHEW' si
nthei
r
working
CHP/CHW' srol
e: -Thisi
sdependson
fact
orssuchtheireducation,trai
ning, 1.Leadershi
pandi t
'sl
imitati
on
l
ivedexperi
ence,andexper ience 2.Ther i
ghttohumandi gnit
y
workingwit
hspeci fi
cpopulations. 3.Lateness/absenteei
sm
CHWsmayper formt hefoll
owi ngroles; 4.Rrightt
opr otecti
onfrom harm
5.Righttoconfidenti
ali
ty&pr i
vacy
1.Cr eateconnect ionsbet ween 6.Properdressing
vulnerabl epopul ationsandheal thcare 7.Respectforleaders/cli
ents
prov i
der s 8.Respectforcol l
eagues
2.Hel ppat ientsnav igateheal thcare 9.Adulter
yorf orni
cati
onwi thcli
ent
s
andsoci alser vi
cesy stems andcl i
ent
srelative
3.Managecar eandcar et r
ansi t
ionsfor
10.Steali
ng/pil
feri
ng
vulnerabl epopul ations
4.Reducesoci al i
sol ati
onamong Moral
it
y:-Refer
st othesetofst
andards
patient s t
hatenablepeopletoli
vecooperat
ivel
y
5.Det ermi neel i
gibilityandenr oll i
ngroups.
i
ndi vi
dual sinheal thi nsur ancepl ans
6.Ensur eculturalcompet enceamong Duty:
-Isacommi t
mentorexpect
ati
on
healthcar eprov i
der sser v
ingv ulnerable toperf
orm someacti
oni
ngeneralori
f
popul ations cer
tai
ncircumst
ancesar
ise.
7.Educat eheal t
hcar eprov i
der sand
stakehol dersaboutcommuni tyhealt
h Liabi
li
ty:
-Ist
hestat
eofbei
ngl
egal
l
y
needs responsi
blef
orsomethi
ng.
8.Pr ov i
decul turall
yappr opriatehealth
Soci
all
yaccept
abl
est
andar
dofpr
act
ice
educat ionont opicsr el
atedt ochr oni
c
diseasepr evention, phy si
cal act i
vi
ty,and
Behavi
or:-Thi
srefer
st oal
lcompanies
nutriti
on
9.Adv ocatef orunder servedi ndivi
duals speci
fywhatisacceptabl
ebehavi
or,and
orcommuni t
iest or eceiveser v i
cesand whatisnot,whenhir
inganemployee.
resour cest oaddr essheal t
hneeds I
ntegr
it
y:-I
sthekeycomponentt
o
10.Col l
ectdat aandr el
ayi nformat i
ont o

6
Ba
sicOfCo
mmu
nit
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hPr
act
it
ion
ers
;Vo
lume1
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:Ba
shi
rAl
iMa
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ri,
CHE
W20
22.

workplaceethi
csandbehavi
oris Si
mil
ari
ti
esbet
weenLaw&Mor
ali
ty
i
ntegri
ty,orbei
nghonestanddoingt
he
r
ightthingatal
lti
mes. Mai nsimil
ari
ty:
-I srefer
stoast hey
bothaimt oregulateli
feinsociety.
Accountabil
ity
: -I
sthetaki
ng Althoughmor al
it
yencompasesmor e
responsibi
li
tyforyouracti
onsisanot
her thanlaw, t
heybot hgreatl
yincaseof
majorfactorwheni tcomesto mor ali
tyorcompl et
lyasforlawlose
workplaceethicsandbehav i
or. theirusewhenal oneonaunknown
i
sland.
Teamwor k:-I
sav i
talaspectofthe
workplacei sworki
ngwel lwi
thothers. Ty
pesofdut
y
Thatincludeseveryonefrom peerst
o
1.AbsoluteDut y
supervi
sor stocust
omer s.
2.Cont r
actualDuty
Commi
tment
:-I
saet
hical
and 3.DelegableandNon- Del
egabl
eDut
y
4.Legal Duty
behav
ior
algui
del
i
nesi
nthewor
kpl
ace
5.Mor alDuty
of
tenpl
aceahi
ghamountof 6.Negat i
veandPosi t
iveDut
y
i
mpor
tanceondedi
cat
ion.
Responsi
bil
i
ty:
-Ist
hest at
eorfactof
Di
ff
erencesbet
weenLaw&Mor
ali
ty havi
ngadutytodealwithsomethi
ngor
ofhavi
ngcontr
oloversomeone.
Law Mor
ali
ty
Breachesofdut
y:-Referstoas
1 Sanctionsare Thereisno (Countabl
eoruncountable)when
i
nvariably offi
cialsanct
ion someonef ai
l
stodosomet hi
ngthati
tis
i
mposedf orthe fori
mmor al thei
rdutytodoaccordingtothel
awor
i
nfri
ngementof behav i
our anagreement.
alegal obl
igat
ion Ty
pesofl
i
abi
l
ity
2 Lawi s Morali
tycannot
del
iberatel
y bedeli
beratel
y 1.Stri
ctl i
abil
ity
changedby changed,r
ather 2.Vicariousliabi
li
ty
Parl
iament i
tevolves 3.Criminal l
iabil
it
y
and/orthe sl
owly 4.Civi
lliabil
ity
courts 5.Derivativeli
abil
ity
3 Legalpri
nci
ples Moral
it
yi s 6.Several l
iabil
it
y
needto i
nvari
ablymuch 7.Jointliabil
it
y
i
ncorporat
ea moreflexibl
e Damage: -Isal
ossorharmresult
ing
degreeof andvariable from i
njuryt
operson,
proper
ty,
or
cert
aint
y reput
ation.

7
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ty
pesofdamage i
ii
.Mor eemphasi swasl aidoncur ati
ve
care
1.Compensat oryDamages i
v.Therewaspoormanagementoft he
2.Inci
dentalDamages healt
hsy stem
3.ConsequentialDamage v.Nopr operco- ordi
nati
on
4.Nomi nalDamages vi
.Poorf inancialall
ocat
ion
5.Liqui
datedDamages vi
i.Nosel f-
rel
iance&sel f-determinat
ion
6.Punit
iveDamages vi
ii
.Ther ewasi nadequat elogisti
c
PRI
MARYHEALTHCARE(
PHC) support

Health:-WorldHealthOrgani
zati
on 3.1975-1985: -I sal soknownast hird
national dev elopmentpl an.Itgav erise
(WHO)1948def i
nedhealthasthestat
e
Niger i
abasi cheal thser v i
cescheme
ofcompl et
ephy si
cal,mental
andsocial
(NBHSS)whi chr ecei vedt heassi stance
well-
beingnotmer el
ytheabsenceof
of(1975-1980) .Isal sot hepr ecursor
diseasesorinfi
rmity
.
forPHC.I thast hef ol lowing
St
agesofthedevel
opmentofheal
th char acteristi
cs;
sy
stem i
nNiger
ia i
.Emphasi swasl aidonpr eventive
serv i
ces
Thedevel
opmentoft heNiger
iaheal
th i
i.Itmadeat tempt st or eacht hegr ass
syst
em i
sdividedint
ofour(4)
;befor
e roots
i
ndependence,1960-1975,1975-1985, i
ii.Gov enmentbui ltheal thcli
nics,heal t
h
and1985topr esent
. cent ers,compr ehensi veheal thcent ers,
1.Bef oreindependent :-Therewasno basi cheal thuni t
sandmobi leclini
cs.
definedsy stem.Heal t
hser v
iceswere i
v .Ther ewasi ncr easedpopul ation
mai nl
ypr ov i
dedbynat i
vedoct or
s, cov erage
herbalist
sandt r adi
tionalbirt
h v.Ther ewassomecommuni t
y
attendant's.Colonialmast ersinNiger
ia mobi l
izati
onandpar ticipat i
onsot he
communi tieshav etheirownDoct ors communi tieswer esomehowi nvolved.
thattreattheirfami l
iesandst aff
. vi.Thesy stem at tempt edt ocorectt he
i
mbal ancesi nt hedi st r
ibutionofheal t
h
2.1960-1975:-Therewasmuch resour ces
emphasisoncurati
vecare.Gov
ernment
bui
ltmanyhealt
hfacil
it
iesbutt
he Ther
easonwhyi
tfai
l
ed
populat
ionwasnotcovered.
1.Therewasf ault
yimplement ati
on
Theplanfai
l
edbecauseoft
hef
oll
owi
ng 2.Noappr opriatetechnol
ogy
reasons; 3.Pri
nciplesofPHCwer enotappl ied
i
.Nocommuni t
yinvol
vement 4.Nosel f
-rel
i
ance&sel f-
determinati
on
i
i.Therewasi
nadequat
epopul
ati
on 5.Nopr operschemef ortr
aining
coverage 6.Communi t
ieswer enotfullyinv
olved

8
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

4.1985-Pr esent:-Thi sst ageoft he devel

opment
Nigeriaheal t
hsy stem ist heer aof 9.Thereshoul
dbeanor gani
zed
pri
mar yHeal thcar e(PHC) .PHCwas monitor
ingandeval
uati
onsy st
em.
foundedi nAl ma-At aRussi a)USSRon 10.Thereshoul
dbedev el
opmentof
12thSept ember1978.I twasf ounded healt
htechnol
ogy,i
nfor
mat i
on
becauseoft heunaccept abl epoorst ate
ofheal t
hi nthedev elopi ngcount riesand Thenat
ional
dev
elopmentpl
an
amongt heunder ser v
edpopul ati
oni n 1.Thef irstnat i
onaldev el opmentpl an
thedev elopedwor ld.Att heAl ma- Ata wasf r
om 1962-1968.Thi swast hefir
st
Wor l
dheal thassembl y, allpar ti
cipation nati
onal dev elopmentpl an.I twas
wereaskedt otakehomeanddev elop desi
gnedf ol l
owingt heNi geria
thepr i
nciplesandphi l
osophyofPHC. i
ndependencei n1960.I tai medatt he
NigerialaunchedPHCi nAugust1987. i
mpr ovingofheal thoft hepopul ace.
TheNi ger i
ahealthpol icyof1988was Trai
ningofmedi calmanpowerand
foundedont hepr i
ncipl esofPHCbased construct i
onofheal thcent er swere
onthephi l
osophyofsoci al justi
ceand emphasi zed;
equitytoachi eveheal t
hf oral lNiger i
aby i
.Theheal thpr ogrammesai medat
they ear2000andbey ond.Heal thf orall i
mpr ovingt heheal thsituat ioninthe
meanst hatthepeopl ewi ll att
ainal ev el country
ofheal t
ht hatwillpermi tt hem t ol eada i
i.Pri
or i
tywasgi vent otr ainingof
sociall
yandeconomi cal lypr oduct ivelif
e. medical per sonnel/manpowerand
PHCplanstoachi
evei
tsobj
ect
ives construct i
onofmedi cal cent ersE.g.
thr
oughthefol
l
owingst
rat
egi
es Materials,Di spensaries,Hospi t
al.
i
ii
.1968, Nicholarhospi tal i
sf oundedin
1.Ther ewil
l bethreeti
ersy stem of Lagos
healthcare
2.Thef ederal,st
ateandl ocal Thenegat
ivepoint
softhef
ir
stnat
ional
gov ernmentshallsuppor tacoor di
nat
ed devel
opmentplanwer
e;
member . i
.Itneglectedthepreventi
vecare
3.Ther eshouldbemul tisectoral i
i.Thepr ogrammehasnoposi t
iveresul
t
appr oach ontheheal thofstat
usoft heNiger
ian
4.Ther eshouldbecommuni ty people
i
nv olvementandpar ti
cipati
on i
ii
.Ther uralcommuni t
ieswere
5.Ther eshouldbepr operdev elopment neglect
edf rom t
heser vi
ces
ofmanager ialprocessatal ll
ev el
.
6.Ther eshouldbeschemef oressent
ial 2.TheSecondNat i
onalDev el
opment
drugs PlanWasFrom 1970-1974.Thi swas
7.Ther eshouldbeanor ganized ai
medatcor r
ecti
ngt hedefici
enciesthat
wor kshopsy st
em wasfoundinthefir
stnational
8.Ther eshouldbemanpower devel
opmentplan.E.g.Correct
ionthat

9
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

neglectofpr eventi
vehealt
hcar eetc. scheme( NBHSS)wasbasedonthe
Thesecondnat i
onaldev
elopmentpl an pri
nci
plesofPHC
wasemphasi zeonthefoll
owing; i
ii
.Healthmanpowerdevel
opment
i
.Reconst ructionofheal
thst r
uctures
fol
lowingt heendofNi geri
anci v
ilwar Thenat ional basi cheal thser v i
ce
i
i.Envir
onment alsani
tat
ionand scheme( NBHSS) :-Isapr ogr ammet hat
developmentofmedi calpersonnelare wasi ntroducedi ntoNi ger i
anheal th
emphasi zed. sy stem i nt hemi d1980' swhi chai med
atcor r
ect i
ngt hedef ectoft heheal th
Thenat
ionalobj
ect
ivesoft
hispl
anwer
e sy stem i nNi gerian.Ther easonf orthe
tomakeNigeri
a; est ablishmentofnat i
onal basi chealth
ser vicescheme( NBHSS)i s:
i
.Af reeanddemogr aphicsoci
ety
i
.Tocor rectt hei mbal ancescr eatedin
i
i.Aj ustandegali
tari
ansociety
thel ocat ionofheal thcent erst hereby
i
ii
.Al imitedandstrongandsel f
-r
eli
ant
i
ncr easingt hecov erageofmedi cal
nati
on
ser vices
i
v.Agr at
eanddy nami ceconomy
i
i.Tocor rectt hei mbal ancesi nthe
v.Al and/ful
lofbri
ghtopportuni
tyforal
l
dist ri
but ionofheal t hser vi
ce
cit
izens.
i
ii.Tot rainanddev elopedmanpowerf or
3.Thet hirdnat i
onal developmentpl an theheal thcar eser v i
cesgi venpr i
orit
yfor
Wasf rom pl an1975-1980.The prev ent i
v eheal t
hmeasur es
national basi cheal thserv icescheme i
v .Tocor recti mbal ancesbet weent he
(NBHSS)wasbasedont hepr inciples prev ent i
v eandcur ativeheal thcar e
primar yheal thcar e( PHC)andwas ser vices
desi gnedatt hi
sper iod.Thescheme v.Topr ov i
dei nf
rast ructuralfacili
tiesfor
wasai medati ncr easingt hecov erage prev ent i
v eheal t
hcar epr ogramme
25%t o60%bypr ov i
dinga vi.Theuseofsi mpl eandr elev ant
compr ehensi veheal thcar et hatwoul d medi cal technol ogyappr opriatetoeach
ensur ecommuni t
ymobi lization, communi ty
i
nv olvementpar ti
cipat i
onanddi sease vii
.Toensur ecommuni typr ov i
ding
prev ention;usingappr opr iate heal thser vi
ces
technol ogyaswel laspl anni ngand
4.Thef ourth4thnat ionaldevelopment
management .Heal thr ef
or m was
planWasFr om 1981-1985.Theheal th
i
ncl udedi nt het hirdnat i
onal
poli
cycont entfort hefourth4thnat ional
dev elopmentpl an1975-1980andt he
developmentpl an1981-1985was
refor m wer e;
retl
ectinthenat ionalhealthpolicy
i
.Thenat i
onal basi cheal thser vice
documentwhi chwasst at
edt hat ,
time
scheme( NBHSS)wasdesi gnedwi ththe
goalofnat i
onal healthpolicyshallbe
assist anceoft hewor l
dheal th
establi
shedacompr ehensiveheal t
h
organi zation( WHO)
caresystem basedonpr i
mar yheal t
h
i
i.Thenat ional basi cheal thser vi
ce

10
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

care, t
hatt hePr omot ive, Protecti
ve, 7.Bonehealer
s
Prev enti
ve, Restorativeand 8.Tradi
ti
onalbi
rt
hat
tendance
Rehabi li
tati
v etoev eryci ti
zenoft he
count rywithintheav ail
abl eresources Healt
ht eam:-Isagroupofheal
th
sot hatthei ndividual andt he workersworkingtoget
hert
owardsa
communi t
iesareassur edofsoci al commongoal .
welfareandeconomi cal l
ypr oducti
v e Composi
ti
onofheal
tht
eam
l
ives.I nthisplanadesi gnofan
i
ntegr atedpr imar yheal thcar esystem 1.Medi calDoct
or
wasmade.Whi chi ncludes; 2.Nurses
i
.1980-Ekohospi tal f
oundedi nLagos 3.CHEWS
i
i.1982-I mot eachi nghospi tali
nower i 4.JCHEW
i
sf ounded 5.EHO
Factor sthataf f
ectheal thcar e 6.Midwi ves
Factor sthataf f
ectheal thcar e 7.Drivers
8.Cleaners
1.Soci
al f
actors 9.TBA
2.Economicf act
ors 10.MLT/ MLS
3.Poli
ti
calfactor
s 11.Medi calr
ecords
4.Envi
ronment alf
actor
s
5.Poorplanning Char
act
eri
sti
csofheal
tht
eam
6.Cult
uralfactor
s
1.Theteam musthavecommongoal or
Vari
ouscul
tur
altheor
iesofdi
seases object
ives
causat
ioni
nNigeri
a 2.Theteam mustbeproperl
yco-
odinat
ed
1.Causeofancestor
s 3.Thereshoul
dbeclearcommuni cation
2.CauseofactofGod amongt hem
3.Causeofeffect 4.Thereshoul
dberegularmeet i
ng
4.Wit
chesandwi zar
dcr
aft 5.Allmembersmustbeliev
et hatthei
r
5.Evi
l ey
etheory wor ki
simport
ant
6.Sorcery 6.Member smusttr
usteachot her
7.Thereshoul
dbedistr
ibuti
oncent erof
Commonsour
cesofheal
thcar
edel
i
ver
y
task
i
nNiger
ia
Funct
ionsofheal
tht
eam
1.Tradit
ional
her
bal
i
st
2.Fait
hbase 1.Healt
heducation
3.Moder n 2.Advocacy
4.Babalawo 3.Communi t
ydiagnosis
5.Self
-care 4.Communi t
ymobi l
izat
ion
6.Pri
vateDoctor 5.Provi
sionofheal
thservi
ces

11
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

6.Refer
ralserv
ices Pol
i
cycoul
dmeant
hef
oll
owi
ng
7.Topromot eheal
thservi
ces
8.Toimprovegoodwat ersupply 1.Setofgoalsi.e.pol
i
cyi
sgoal or
ient
ed
9.Toensuregoodant enat
alcare 2.Senseofdirection(
mappingout)
10.Toidenti
fyheal
thproblem i
nthe 3.Decisi
onorwi shes
cl
ini
candcommuni ty 4.Procedur
ef oraccompl
ishingan
object
iveoracti
on
Qual
i
tiesofheal
tht
eam member
Nat i
onal healthpol i
cy:-Canbedef i
neas
1.Mustbeknowl edgeable thel egalfr
amewor korblueprint
2.Mustbehonest gov ernmentoft hepcopleofNi geri
aas
3.Mustbetrustwor thy amast eractionpl antoenableit'
s
4.Mustbeintell
igence cit
izenst oachi ev eastateofcompl ct
e
5.Mustbeempat heti
c phy sical
,ment al andsocialwel
l bei
ng,
6.Mustberesponsi ble andnotmer elytheabsenceofdi seaes
7.Mustbeinit
iative orinf i
rmity.
8.Mustbechar i
smat ic
9.Mustbeappr oachable Componentofnat
ional
pol
i
cyonheal
th
10.Mustbedependabl e 1.Healtheducat i
on
2.Familyplanning
Fact
orsmi
l
itat
ingagai
nstaheal
tht
eam
3.Housing
1.Lackofco- oper at
ion 4.Watersuppl y
2.Inadequat emat eri
als,equipmentand 5.Wast edi
sposal
drugswi t
hl ogistics 6.Preventi
ve/curati
vemedi
cine
3.Lackofmot i
v ati
onf rom theteam 7.Rehabil
it
ation
l
eader s
Popul
ati
on:-Canbedefinedast he
4.Inadequat esuper vision
5.Communi cat i
ongabamongt he numberofpeopl
einageogr aphicarea.
member soft het eam I
tcanalsotheusedforsubgroupsof
6.lackofclearl ineofcommuni cat
ion peopl
eoranimals.
7.Lackofr egul armeet i
ng Populati
onpoli
cies:-Theseare
8.Favoriti
sm ont hepar tofleader cust
omar il
ydef
inedaspur posetul
9.Lackofgoodor ganizati
on measuresaimedataf f
ecti
ng
management demogr aphi
cprocesses,notabl
yfert
il
it
y,
10.Mal -
distributionoft askand mortali
tyandmigration.
recourseset c.
Gover
nmentpol
icyi
ssuesand
Policy:-I
sast at
ementofintenti
ons manager
ial
tool
sinheal
thdevel
opment
aboutt hefut
ure.Thereal
i
zationof
theseintenti
onswill
dependont he 1.Heal
thi
nfor
mati
on
cont r
olofanumberofv ari
ables. 2.Heal
thmanpowerdev
elopment

12
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Heal
thtechnology i
ncl
udesheal
thdev
elopment
.
4.Heal
thresearch
5.Heal
thcarefinanci
ng Taskshi f
ti
ng:-Thewor l
dhealt
h
organization(WHO)descr i
bestask
1.Healt
hinformation:-I
sTheef f
ect
ive shafti
ngasi nvol
vingt
herati
onal
managementofheal t
hserv
ices redi
stributionoftaskamonghealth
demandst heestabli
shmentofa workfor ceteam.
nat
ionalhealt
hinformati
onsy st
em.
Tasksharing:-Thi
sistheall
owinga
2.Heal thmanpowerdev el
opment : -I
s widerrangeofcadrestooi
lercert
ain
themi nistr
iesofHeal t
hshallensur ethat servi
ces,whent hi
scanbedonesaf el
y
medi cal,nursing,publi
cheal t
handor der andeffectiv
elyasameansofr api
dly
school sofheal thsciencesundert heir expandingtheaccessandimprovingthe
j
urisdicti
oni ncludeintheireducation healt
hcar e.
programmest hephilosophyofHeal t
h
forallthepr inci
plesofpr i
mar yhealth Goalsoftaskshi ft
ing&t askshari
ng:-Is
care,andt heessent i
alsofthe thesimpl
yt ogett heri
ghtwor kerwith
manager i
al processfornationalhealth ri
ghtski
lli
nt her i
ghtplacesdoingthe
development . ri
ghtthi
ngwi thoutnecessar i
l
y
abandoni
ngot hermethodofi ncr
easing
3.Healt
htechnology:-Isthemost thenumberofqual i
fi
edheal t
hwor ker
s.
appr
opriat
ehealthtechnologi
esshal
lhe
sel
ectedforuseatalllevel
softhe Broadpol
icyobj
ect
iveoft
askshi
ft
ing
heal
thcaresystem. andtaskshar
ingi
nNigeri
a

4.Heal t
hr esearch: -Ist heprioriti
esfor 1.Act ualizehumanr esour ceheal t
h
healthser vi
ceandbi omedi cal research wor kforceneedsf orthecount ryint he
shallreviewi ncollabor ati
onwi tht he deliveryofessent ialheal thser v
ices.
MinistryofEducat ion, Scienceand 2.Onl i
net heessent i
al heal t
hcar e
Technol ogy, Mechani smsshal l be servicesr elatedtaskt hatcanbe
devisedt opr omot eSuppor tand performedbydi f
ferentcadr esof
coordinat eresearchi nt hehighpr ior
ity frontli
neheal t
hcar ewor ker sattending
areasandt ost r
engt hent her esearch totheneedsoft heNi ger ianpopul ation
capabi l
i
tiesofnat ional inst
itutionalto 3.Pr ovideaf r
amewor kf orempower ing
enablet hem t ounder takethese awi derr angeofheal t
hcar ewor kerst o
essent i
al t
asks. rapidlyexpandaccesst oessent ial
healthcar eser vi
cest omeett heset
5.Healthcarefi
nancing:-Isthe MDGst arget.
economi candsocialdevelopmentsar
e 4.Pr omot et hebestuseofcompet ency
i
nterr
elated.Acount y
'seconomic andexper tisesofwel l-
trainedmi d-l
ev el
cl
imatehasi mpli
cationsforthe cardert omeett heNi gerianpopul ati
on
countr
y'ssocial
dev elopmentwhich healthneed.

13
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

5.Topr omoteefficiencyand 6.Adequatesuppl yofpor tablewater

eff
ectivenessintheut i
li
zationof andbasicsani tation
fi
nancialandnon-financialresourcesin 7.Promot i
onoff oodsuppl yandpr oper
seali
ngupaaccesst oessent i
alhealt
h nutr
iti
on
careservicedeli
veryinNi geri
a. 8.Communi t
yey ecare
9.Communi t
ydent alcare
Primaryheal thcar e: -Wor l
dHeal t
h 10.School healthpr ogramme
Organizat i
on( WHO)1978def i
ned 11.Communi tycar eoft heaged
PrimaryHeal t
hCar easanessent ialcar
e 12.Careofper sonwi thspecialneeds
basedonpr act ical
,sci enti
fi
call
ysound, 13.Primaryear ,noseandt hroatcare
sociall
yaccept ablemet hodand 14.Careofadol escent
technologymadeuni versall
yaccessible 15.Careofadul t
toindividuals,fami l
iesandcommuni ti
es 16.Controlofnon- communi cable
throught heirfullparticipat
ionatthe di
sease
costthatt hecommuni tyandcount r
y
canaf fordtomai ntainatev erystageof Roleofpri
maryheal
thcar
einnat
ional
theirdev el
opmenti nt hespiri
tofself- healt
hsystem
rel
ianceandsel f-
deter minati
on.
1.PHCshoul dbethefirstcontactof
Pr
inci
plesofpr
imar
yheal
thcar
e famili
esandcommuni ti
es
2.Providespreventi
ve,curati
ve,
1.Communi t
ypar ti
cipat
ion rehabil
i
tativeandpromot ehealth
2.Appropriatetechnology servi
ces
3.I
ntegrationofser vi
ce 3.Toensur edeli
veryofbasi cand
4.I
ntersectoralcoll
aborati
on essenti
al heal
thservi
ces
5.Avai
labili
ty
6.Acceptabili
ty Li
nkagebet
weenthethr
eet
ir
esof
7.Aff
ordabi l
i
ty nat
ional
heal
thsy
stem
8.Sel
f-rel
iance
9.Equi
tabledi st
ributi
on 1.Ther eisat wowayofr eferr
alsy
stem
10.Sel
f-determination 2.Thef ederal gover
nmentmaket he
poli
ciest hatguidethem all
Component
sofpr
imar
yheal
thcar
e 3.Policiesofpl anni
ngdependondat a
fr
om al lthetiers
1.Heal t
heducat i
on 4.Theyoper ateinco-or
dinat
emanner
2.Prov i
sionofessent i
aldrugs
3.Prevent ionandcont roloflocal
ly Pri
maryhealt
hcar
eappr
oacht
oNi
ger
ia
endemi cdi sease heal
thsyst
em
4.Immuni zationagainstvaccines
preventabledi seases 1.Bott
om upapproach
5.Mat ernal andchildhealthincl
uding 2.Emphasisonprevent
ion
familyplanni ng 3.Costrecov
ery

14
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

4.Qual
i
tyassur
ance 5.Gender
6.Educati
on
Chal
l
engesfaci
ngeff
ecti
vedel
i
ver
yof 7.I
ncome
pr
imaryheal
thcar
eserv
ice 8.Healt
hyfood
1.Poorplanning 9.Medicalcar
e
2.Lackoft r
aini
ng Tr
adit
ional
andcult
uresthatf
avour
abl
y
3.Lackofincentiv
e i
nfl
uenceheal
thbehavi
or
4.Inadequatefaci
li
ti
es
5.Lackofcommuni t
ymobi
li
zat
ion 1.Malecir
cumci si
on
6.Poorresearch 2.Respecttoelders
7.Lackofcommuni t
yempower
ment 3.Ext
endedf amily

Thr
eet
ier
sofNi
ger
iaheal
thsy
stem Behaviourchangecommuni cation:-I
s
theprocessofwor ki
ngwi t
hindivi
duals,
1.Pri
maryheal
thcar
e
famil
iesandcommuni cat
ionchannelto
2.Secondar
yheal
thcar
e
promot eposi
ti
veheal t
hbehav i
orand
3.Tert
iar
yheal
thcar
e
supportonenv i
ronmentthatenablesthe
Alt
ernati
vehealthcare:
-I sthetermf or communi tytomai nt
ainposit
ive
medicalproductsandpr act
icethatare behavior.
notpartofstandardcare.E.g.t
radit
ional
Healt
heducati
on:-I
saprocessof
heal
ers.
educati
ngpeopl
eaboutt
heirheal
th.
BEHAVI
ORCHANGECOMMUNI
CATI
ON
Healt
hpromotion:-Istheprocessof
Communi t
y:-Canbedefi
neasasoci
al enabl
ingpeopl
et oincreasecontr
olov
er
unitwhohavesomethi
ngincommon andtoimprovetheirhealt
h.
suchasnorms,val
uesorident
it
y.
Pr
inci
plesofheal
thpr
omot
ion
Or
gani
zat
ional
str
uct
ureofacommuni
ty
1.Empower ment
1.Leadershi
p( modernandt r
adi
ti
onal) 2.Holi
stic
3.Equi
tabl e
2.Househol dstr
ucture(powerdeci
sion)
4.I
ntersectoral
3.Organizat
ionalst
ructur
e(modernand 5.Sust
ai nable
tr
adit
ional) 6.Mult
i-strat
egy
7.Part
icipati
ve
Soci
o-cul
tur
alfact
orsthati
nfl
uence
heal
thbehavi
orinthecommuni cat
ion Basi
cel
ementofcommuni
cat
ion

1.Ethni
cit
y 1.Encoder
2.Language 2.Message
3.Channel
3.Reli
gion
4.Decoder
4.Age 5.Feedback

15
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Healt
hcommuni cat
ion:
-Ist
hestudy Bar
ri
eref
fect
iveheal
thcommuni
cat
ion
andpract
iceofcommunicat
ing
promoti
onalheal
thi
nformat
ion,
suchas 1.Poorli
steni
ng
heal
thcampaigns. 2.Emot i
onal
it
y
3.Poorplanni
ng
I
mpor
tanceofheal
thcommuni
cat
ion 4.Hiddenagenda
5.Language
1.I
thelpstogetkeymessage 6.Dist
rust
2.I
nfl
uenceandmot iv
ate 7.Non-conduct
iveenv
ironment
3.Pr
omot ehealt
hyeati
ng
4.Pr
omot ephysi
calskil
l
s Gui
del
i
nesf
ormessagedev
elopment

Met
hodofcommuni
cat
ion 1.Messageshoul
dprovi
deopti
on
2.Messageshoul
dbeposit
ive
1.Campai gns 3.Messageshoul
dhaveobj
ectiv
es
2.Massmedi a 4.Messageshoul
dbeleadtoacti
on
3.Notes 5.Messageshoul
dbeneedbaseand
4.Source rel
evant
5.Communi cat
ionchannel
6.Li
teracycommuni cati
ongab Communi
tymobi
l
izat
ionf
orheal
th
act
ion
Communicat
iont
echnol
ogyi
nheal
th
educat
ion 1.Poli
ti
calpart
ies
2.Soci
almov ements
1.Visual(
blackboard,
puppets,
visual 3.I
ndivi
dualgroup
sli
de)
2.Audio(tapes,
radi
ocomput er
) Methodofcommuni
tymobi
l
izat
ionf
or
3.Audiovisual(
tel
econfer
ence, heal
thact
ion
tel
evisi
on)
1.Sensi
ti
zation
Fact
oryt
hatfaci
li
tat
eef
fect
iveheal
th 2.Meeti
ngs
communicat
ion 3.Healt
htalk
4.Healt
heducat i
on
1.Empathy
5.Groupdiscussi
on
2.Creat
erappor t
3.Bespecifi
c Var
ioushealt
hdevel
opmentcommi
tt
ee
4.Withholdjudgment i
nprimaryhealt
hcar
e
5.Goodplanning
1.L.
G.APHCimplement
ati
oncommi
tt
ee
6.Conduciveenvironment
2.Heal
thf
acil
it
ies
7.Knowledgeoft herecei
ver
/audi
ence
3.Wardvi
l
lage
8.Speedandsequenceofspeech 4.Community

16
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Heal
theducat
iont
oheal
thpr
omot
ion Rol
esofcommuni
tydi
agnosi
s

1.I
nformati
oneducati
on& 1.Identif
yav ai
l
abl eresour
ces
communicati
on 2.Itsimplif
yev al
uat i
onofhealt
h
2.Behavi
orchangecommuni
cat
ion programmes
3.Soci
albehavi
orchange 3.Ithelpstoaddr essobstacl
e
communicati
on 4.Identif
ytheheal thneedofthe
communi t
y
COMMUNI
TYLI
NKAGE&DEVELOPMENT
Rat
ional
eforcommuni
tydi
agnosi
s
Communi t
y:-Canbedefi
neasasoci
al
unitwhohavesomethi
ngincommon 1.Provi
desspeci
fi
cinfor
mationfora
suchasnorms,val
uesorident
it
y. part
icul
arcommunity
2.I
thelpstodeci
deinint
erv
ention
Ty
pesofcommuni
ty str
ategy
1.Urban 3.I
thelpstoi
denti
fycommuni t
yneed
2.Semiurban Met
hodusei
ncommuni
tydi
agnosi
s
3.Rural
1.Observat
ion
Char
act
eri
sti
cofcommuni
ty 2.I
ntervi
ew
1.Sub-Group 3.Questi
oneer
2.Homogeneous 4.Groupdiscussi
on
3.Heterogeneous 5.Reviewofexist
ingr
ecor
d
4.Si
ze
St
epsi
ncar
ryoutcommuni
tydi
agnosi
s
5.Li
keness
6.Neutral
ity 1.Makeent rythroughL.G.Aint othe
7.Parti
cularname communi t
y
8.Rul
esandr egul
ati
ons 2.Ident i
fyboundariesofthecommuni ty
9.Communi t
ysenti
ment
3.Obt ainsketchmapoft heCommuni ty
Component
sofcommuni
ty 4.Listr esour
cesav ail
ablei
nt he
communi t
y
1.Economy 5.Listofcul t
uralpracti
cesandat tit
ude
2.People
aff
ect i
ngheal th(useful
,harmlessor
3.Cult
ure
healthful)
4.Healt
h
6.Soci alcustomsandi mpor t
antf esti
val
5.Quali
tyofl
i
fe
ofthecommuni t
y
6.Envi
ronmental
7.Listoft heinfr
astruct
ureint he
Communit
ydiagnosi
s:-I
stheprocess communi t
y
off
indi
ngouttheheal
thneedofthe 8.Col l
at i
onofinformationfr
om t he
communit
y. communi t
y

17
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

9.Conductint
erv
iewofsocialgroups Situati
onanalysis: -I
sthepr ocessof
10.Reportusi
ngfeder
alminist
ryof fi
ndi ngoutactual heal
thstatusina
heal
thformat communi t
yanddet ermini
ngt heabil
i
ty
11.Giv
efeedbacktoL.G.
Aorst ateor oft heavail
abl
eheal t
hservicesto
respondt othepr oblemsident i
fi
ed.
FMOH

Communi t
yMobi li
zati
on:-Ist
heprocess Rol
eofsi
tuat
ionanal
ysi
sinPHC
ofinspir
ing,encouragi
ngandar ousi
ng 1.Toknowt herealheal
thstat
usoft he
theinter
estofpeopl etomaket hem people
becomeact ivel
yinvolvedinfi
nding 2.Toknowt hescopeandt y
pesof
soluti
onsfortheirproblems. resour
cesav ai
l
able
Rol
eofcommuni
tymobi
l
izat
ion 3.Toknowwher ei
mmedi at
eattenti
on
i
sneeded
1.Immuni zati
onserv
ices 4.Forproperpl
anning
2.ANCser vi
ces 5.Forpropermonit
oringandevaluat
ion
3.Fosterself-
rel
i
ance
4.Ithel
pst hecommuni t
ytoi
dent
if
y I
nst
rumentusei
nsi
tuat
ionanal
ysi
s
theirpr
oblems 1.Mapofthearea
St
epsi
nvol
vei
ncommuni
tymobi
l
izat
ion 2.Tal
ly
ingsheet
3.For
mH
1.Knowingt hecommuni t
yheads 4.For
mC
2.Pl
anformobi li
zation 5.For
mF
3.I
denti
fytheent r
ypoi nt
4.Makeiniti
alcontactwi t
htheleader
s I
mpor
tanceofsi
tuat
ionanal
ysi
s
5.Arr
angef ormeetingwi thCommunity
1.Helpstodeter
mi nethenat ur
eand
6.Att
endsubsequent( f ol
l
ow- up
scopeofapr obl
em
meeti
ng)
7.Monit
oringandev aluation 2.Helpstounderstandopinionof
pati
entinthehealthfaci
li
ty
Advocacy:-I
stheprocessofcr
eati
ng 3.Helpstoident
ifyactualhealt
hstat
us
awarenessconcer
ninganyhealt
hmatter
amongpol i
cymakersinordert
oget St
epsi
nvol
vei
nsi
tuat
ionanal
ysi
s
thei
rsupport
.
1.Planningf orsituat
ionanal
ysi
s
Fourf
ocusgr
oupf
oradv
ocacy 2.Trainintervi
ewer
3.Testy ourinstrumentsbypract
ici
ng
1.Thechairmanofal ocalgov'
tcounci
l wit
hi nterv
ieweront heuseof
2.Supervi
sorycounselorf
orheal t
h i
nstrument
3.Thelocalgov'
tPHCcoor dinator 4.Conduct ingthesi t
uati
onanal
ysis
4.Dist
ri
cthead/headoft r
adit
ional usi
ngFMOHf ormat
counci
l

18
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

OCCUPATI
ONALHEALTH&SAFETY 2.Chemical di
seaseE.
g.
i
.Ulcerat
ion
Occupat ionalHealt
h:-Canbedef i
nedas
i
i.Burns
thepr omot i
onandmai ntenanceofthe i
ii
.Gaspoi son
highestdegr eeofphysical
,mental
, i
v.Dermat i
ti
sduet oi
rr
it
ati
on
emot ionalandsocialwell-
bei
ngof
wor kersinalloccupat
ion. 3.Psychosoci
aldiseaseE.
g.
i
.Stresscondi
ti
on
Pr
inci
pleofOccupat
ional
Heal
th i
i.Poorworkenvir
onment
1.Mai ntenanceofhi ghestdegr eeof i
ii
.Poormot i
vati
ont owork
physical,ment al
,andsoci alwell-
being
4.Physicaldi
seaseE.
g.
ofwor ker s
i
.Deaf ness
2.Managementofwor ki
ngenv i
ronment
i
i.Cataract
s
toreducehazar d
i
ii
.Glaucoma
3.Protect i
onofwor kersf r
om r i
skofof
i
v.Frozebite
thei
rwor ki
ngenv i
ronment
4.Mot iv
at i
onofwor kersf orincreasei
n 5.MechanicalcausediseaseE.
g.
production i
.Lacerati
on
5.Rehabi li
tat
ionandmai ntenanceof i
i.Fal
lfrom hi
gh
workingenv i
ronment i
ii
.Fal
lfrom sl
oppyf l
oor

Occupat
ionalheal
thdi
sease:-I
sany Commonoccupat
ional
diseases
chr
onicali
mentthatoccursasaresul
t
ofworkoroccupati
onalacti
vi
ti
es. 1.Occupati
onal l
ungdisease:-Are
groupofdiseasewhichresultfr
om the
Commonoccupat
ional
disease effectofv
ariousdustonthelungs.

1.Occupat
ional
lungdisease Exampl
es
2.Occupat
ional
dermatiti
s
1.Asbestosi
s
3.Occupat
ional
inj
uries
2.Sil
i
cosis
4.Occupat
ional
cancer 3.Bargasosi
s
5.Occupat
ional
accident 4.Bysinossi
s
5.Farmer’sl
ungs
Cl
assi
fi
cat
ionofoccupat
ional
disease
Asbest
osi
s: -I
salongterm
1.Bi
ologi
cal di
seaseE.
g.
i
nfl
ammationandscaringofthelungs
i
.Bacteri
alagent
duetoi
nhalati
onofasbestosdust.
i
i.Hel
minthiasi
s
i
ii
.Vir
us Si
gnandsy
mpt
om ofasbest
osi
s
i
v.Fungi
1.Short
nessofbr
eath
v.Pr
otozoa
2.Respi
rat
orybl
ocked

19
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Cough Pr
event
ionofBar
gasosi
s
4.Chestpai
n
5.Wheezing 1.Dustcontr
ol
2.Useoffacemask
Compl
i
cat
ionsofasbest
osi
s 3.Peri
odi
cmedical
exami
nat
ion

1.Lungcancer Bysi
nosis:-Al
socal
ledMondayf everi
n
2.Mesothel
ioma occupat
ionall
ungsdiseasecausedby
3.Pulmonar
yheartdi
sease exposur
et ocot
tondust.

Preventi
on&managementof Si
gnandsy
mpt
om ofby
sinosi
s
asbestosi
s
1.Short
nessofbr
eath
1.Supporti
vecare
2.Respi
rator
ybl
ocked
2.Vaccinat
ion
3.Cough
3.Oxygentheraphy
4.Chestpain
4.Avoidsmoking
5.Wheezing
Sil
i
cosis:
-Isanincur
abl
edisease
Si
gnandsy
mpt
om ofBy
sinosi
s
causedbyinhal
i
ngdustthatcont
ain
si
li
ca. 1.Chestti
ghtness
Si
gnandsy
mpt
om ofsi
l
icosi
s 2.Wheezing
3.Breat
hdiff
icult
y
1.Dyspnea 4.Lungsscaring
2.Persi
stentcough 5.Chestpain
3.Chestpain 6.Short
nessofbr eat
hing
4.Fever
Farmersl
ungsdisease:
-Isadi
sease
Pr
event
ionofsi
l
icosi
s
causebyanall
ergytomoldorcer
tai
n
1.Dustcontrol crop.
2.Properventi
l
ati
on
Si
gn&sy
mpt
omsoff
armer
slung
Bargasosi
s:-I
sadiseaseofthel
ungs
1.Drycough
causebyinhal
ati
onofsugarcanedust
orfi
bers. 2.Rapidbreat
hing
3.Feverandchil
ls
Si
gnandsy
mpt
om ofBar
gasosi
s 4.Suddensickness

1.Breathl
essness Pr
event
ionoff
armer
slungdi
sease
2.Coughingblood
3.Heamopt i
sis 1.Avoi
ddustyworki
ngenvir
onment
4.Sl
ightfever 2.Wearfacemaskorpipe
5.Bronchit
is 3.Useexhaustbl
owers

20
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

2.Occupat
ionalder
mat i
ti
s:-Isa Pr
event
ionofoccupat
ional
inj
uri
es
commondi seasesandmanywor kpl
ace
andcanbequi t
eincapaci
tati
ng. 1.Incorpor at
easaf ety&wel l
nessplan
2.Conductpr e-placementphy sical
s
Ty
peoccupat
ional
der
mat
it
is 3.Educat eempl oyeesandst aff
4.Resear chsaf etyv ul
nerabi
li
ties
1.I
rr
itantder
mati
ti
s 5.Providepr otect i
onequipment
2.Al
lergi
cdermat
it
is 6.Hav eadequat estaffi
nglevels
Causesofoccupat
ional
der
mat
it
is 7.Don'tt akeshor tcuts
8.Inspect&mai ntai
nallcompany
1.Mechanicalfact
or vehicl
es
2.Physi
calfactor 9.Moni torsafet ymeasur es
3.Chemicalfactor 10.Keepanor derlyworkplace
4.Bi
ologi
cal f
actor
Occupati
onalcancer:-Iscausedwhol l
y
Pr
event
ionofoccupat
ional
der
mat
it
is orpart
lybyexposuret oacancer
causi
ngagent( car
cinogen)atwor k,
or
Appropriateuseofglov es,cl
othi
ng,and byaparti
cularsetofcircumstancesat
faceshieldsshouldbewor ntoprevent work.
dir
ectcont actbetweent hesubstance
andtheski n.Goodper sonalhygi
ene Ty
peofoccupat
ional
cancer
pract
iceswi ll
helpreduceonsetof
dermatit
isbywashi ngt hechemical or 1.Lungcancer
substanceof ftheski
nassoonas 2.Bladdercancer
possibl
e. 3.Mesot hel
i
oma
4.Mesot hel
i
omai nwomeni
s23%
Occupat i
onali
njury:-I
saninjur
ythat
takesplaceinthecourseofaper son'
s Causesofoccupat
ional
cancer
empl oymentactiv
iti
es.Itmaybeany 1.Asbest osf i
bers(color
ectal,l
arynx,
kindofinjur
ythatresult
sfrom t
he l
ung,ov ary,pharynx,stomachcancer s,
wor kpl
ace,i
ncludi
ngi l
l
nessordisease. mesothelioma)
Causesofoccupat
ional
inj
uri
es 2.Wooddust s(nasopharynx,Si
nonasal
cancers)
1.Li
fti
ng 3.UVr adiati
onf rom sunl
ight(skin
2.Fati
gue cancers)
3.Dehydrati
on 4.Metal wor ki
ngf l
uidsandmi neraloil
s
4.PoorLighti
ng (bl
adder ,
lung, si
nonasal,skincancers)
5.HazardousMat er
ial
s 5.Sil
i
cadust( lungcancer)
6.ActsofWor kplaceViol
ence
7.Tri
psandf all Occupat
ionalhazard:-I
sdef i
nedasa
8.Str
ess condi
ti
oninthewor kenvironmentwhi
ch
hasthepotenti
alofcausinginj
ury
.

21
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Cl
assi
fi
cat
ionofoccupat
ional
hazar
d poi
soni
ngset
c.

1.Phy sicalhazar
d:-Thosearehazard Causesofhomehazar
d
thatcanbeeasi l
ypercei
vedoffel
t.E.
g.
i
.Noi se 1.Fall
s
i
i.Col d 2.Poisoni
ng
i
ii.Frozebite 3.Fi
resandburns
i
v .Vibrati
on 4.Chokingandsuf
focat
ion
v.Smoke 5.Drowning
vi.Spark Pr
event
ionofhomehazar
d
2.Chemi calhazard:-Thesear e 1.Keept hefloorsdr ytopr eventany
chemical substancesthatcaneitherbe sli
pping,especi
allyintheki t
chenand
i
nhaledorhav econtactwiththeskin, bathrooms.
eyeoranyot herpartofthebodywhi ch 2.Keepst urdystepstoolstousewhen
couldcausei njur
ies.E.
g. reachingforthi
ngsi nclosetsorthetop
i
.Vases kit
chencabi net
s.
i
i.Laud 3.Usesaf etygatestocloseof f
i
ii
.Mer cury stai
rcasesfrom wander ingkids.
i
v.Fames
v.Soli
d Factor
yact:-Isaseri
esofnati
onalor
vi
i.Sol
v ents countr
ylawpassedbyt heparl
iamentor
Senateofthatnati
ontoregul
atethe
3.Psychosocialhazar
d:-Ar
ethose condit
ionofindust
ri
alemployment.
hazardthatareassociat
edwit
hworker
s
mood.E. g. Factor
y:-I
sdefi
nedasanypremises
i
.Stress i
ncludi
ngtherel
evantwher
etenormore
i
i.Poorwor kenvir
onment workersar
eworking.
i
ii
.Poormot ivat
iontowork
Factor
yacti
nrel
ati
ont
oheal
tht
he
4.Biol
ogicalhazard:-Theseareli
vi
ng fact
orymust
;
microscopicorganism thatcan
contaminatewor kersandcause i
.Cleanness
i
nfecti
onori l
lhealth.E.
g. i
i
.Ov ercrowding
i
.Virus i
i
i.Ventil
ation
i
i.Fungi i
v.Drainageofflood'
s
i
ii
.Protozoa v
.Sanitaryconvenience
i
v.Bacteri
a Fact
oryi
nrel
ati
ont
owel
far
e
Homehazard:-I
stheuni
ntent
ional i
.Supplyofdrinki
ngwater
i
njur
iest
hatoccuri
nandaroundthe i
i
.Washi ngfacil
it
y
homecanincl
udeburns,
fal
ls,
drowning, i
i
i.Accommodat i
onsf
orclot
hing

22
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

i
v.Fi
rstai
d Ef
fectofoccupat
ional
acci
dent
v
.Exemption
1.Damageandinjur
y
Industr
ial
acci
dent:-I
sdefi
nedasany 2.Loseofti
meandmoney
accidentt
hathappenstoapersoni
nthe 3.Loseofmater
ial
courseofthei
rworkthatr
esul
tsinan 4.Loseofgoodhealt
h
i
njury. 5.Lossofl
if
e

Causesofi
ndust
ri
alacci
dent
s Pr
event
ionofoccupat
ional
acci
dent

1.I
nher entHazardsorNatur
eofJob 1.Provi
sionofadequat eli
ght
ing
2.Sl
ippingorf al
li
ngonthefl
oor 2.Provi
sionofpr operandventi
l
ati
on
3.Coll
isionandObstruct
ion 3.Carel
essoft hewor ker
s
4.Equipment sandMachines 4.Properelectr
icconnecti
on
5.Fi
rehazar ds 5.Suffi
cienttr
aini
ngofstaff
6.Unsaf eActs
ACCI
DENTANDEMERGENCY(
A&E)
7.MiscellaneousCauses
Acci
dent:
-Isanunforeseen,unpl
anned
Pr
event
ionofi
ndust
ri
alacci
dent
andunpl
easantevent
st hatr
esulti
ng
1.Useofpersonalprotect
iveequi pment i
njur
y,l
ossofpropert
yordeat h.
2.Engi
neeri
ngcont r
ol
Emergency:
-Isanunexpect
ed
3.Conductpre-
placementphy sicals
danger
oussituati
ont
hatcal
lsf
or
4.Educateemployeesandst affs
i
mmedi at
eact i
on.
5.Don'tt
akeshortcuts
6.I
nspectandmai ntai
nallvehicles Fi
rstaid:-I
sthef i
rstori
mmedi ate
tr
eatmentgivent oaninj
uredoril
l
Occupati
onalacci
dent:-I
ssuddenand
personbeforethearri
valofmedical
unexpect
edinjur
ycausebyexternal
personnelortakentothenearestfaci
l
ity
.
fact
orsatworkplace.
Rul
esoff
ir
stai
d
Causesofoccupat
ional
acci
dent
1.Shoutf orhel p!
1.Inadequatel i
ghting
2.Assesst hesi t
uati
onandscoutt he
2.Poorv enti
l
at ion
terr
it
or y
3.Lesscar ef
ul ness
3.Det er
mi nei ftheaccidentwarr
antsa
4.Looseandi llst
ructur
es
visi
ttoahospi t
alorsimplyacleansi
ng
5.Improperel ectri
cconnecti
on
andaBand- Aid.
6.Neglectrulesandr egulat
ions
4.Ifyouar et rai
nedandcer ti
fi
edinCPR
7.Faultymachi ne
andaper soni schokingorcannot
8.Brokenbot tle
breathe,begi nCPRr ightaway.
9.Mov i
ngv ehicle
5.Stopt hebl eeding
10.Toxicchemi cal
s
6.Treatanysy mptomsofshock

23
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

7.LookforaMedicAler
tbracel
et i
mbal
ancei
noxy
gendemandandsuppl
y.
8.Seektrai
nedmedical
assist
ance
9.Nevergiveani
njur
edunconsci
ous Ty
pesofshock
personanythi
ngbymouth. 1.Physi
ologi
cal
shock
10.Wait 2.Psy
chosocial
shock
Reasonsf
orf
ir
stai
d Si
gnandsy
mpt
om ofshock
1.Toaidrecover y 1.Extremelylowbl oodpressur
e
2.Tosavelife 2.Feelingweak
3.Topreventinjuryfr
om wor
seni
ng 3.Chestpai n
4.Torel
ievepain 4.Prov i
desweat i
ng
5.Tr
eatmi norinjury 5.Dizziness
Cont
entoff
ir
stai
dbox 6.Rapidbr eat
hing
7.Bluel i
psandf i
ngersnail
s
1.Razor
2.Sci
ssors Fi
rstai
dtr
eat
mentofshock
3.Aspiri
n 1.Keept hepatientl yi
ngdownwi thl
egs
4.I
odine rai
sed
5.Cottonwool 2.Ifpossibl
emai ntai
nt heblood
6.Spi
rit pressureinthebr ain
7.Bandage 3.Donotgi veany t
hingt odr
ink
8.Paracetamol 4.Donott rytowar mt hepatientbutdo
9.Spl
int l
oseal lt
ightclothingar oundtheneck
Ty
pesofemer
gencycondi
ti
ons chestandwai st.

1.Shock Bur
ns:
-Isadamagetot
hebodycause
2.Burn byt
her
malheat
erchemi
cal
.
3.Wound Ty
pesofbur
n
4.Fracture
5.Bleeding 1.Fi
rstdegr
ee:
-Super
fi
cial
bur
n
6.Epistaxis
2.Seconddegr
ee:
-Ski
nisbl
i
ster
s
7.Snakebi te
8.Dogbi te 3.Thi
rddegree:
-There'
sdeeper
9.Drowni ng dest
ruct
ionunderl
yi
nggrowthcel
ls
10.Acut eabdomen
11.Asphy xia Fi
rstai
dtr
eat
mentofbur
n

Shock:-Refer
stotheor
gansand 1.Placeacleanclothesovert
hebur
n
ti
ssuesofthebodynotr
ecei
ving areatokeepawayai r
suff
ici
entfl
owofbloodasaresul
tof 2.Getthevi
ctim headlyi
ngdownunti
l

24
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

doctorarr
ived ski
nsur
face.
3.Spacev i
cti
m headandchestsl i
ght
ly
l
owert hanotherpart
. 2.Compoundfract
ure:
-Ist
hebony
4.I
ft hevi
ctimisconsciousandcan fragment
scanbeseenprot
rudi
ng
swallowgiveslotofnon-alcohol
i
c throught
heski
n.
beverage. 3.I
ncompletefr
act
ure:-Thesear
e
Fi
rstai
dtr
eat
mentofchemi
cal
bur
n fr
actur
ethatdon'
tdest
roytheconti
nui
ty
ofthebone.
Thef i
rstai
dershoul df l
usht hepartwith
waterspeedi l
yinor dertoreducet he 4.Greensti
ckfractur
e:-Thi
soccur
s
extendedoft heinjury.I
fclothingisover whenonesi deoftheboneisbr
okenand
thebur npartstr
eam ofwat ershouldbe otherbent
.
appendwhi leremov i
ngthecl othi
ng.All 5.Completefract
ure:
-Thi
scause
burns,exceptwhi l
esmal lareai s damagetot heboneandinj
uryt
o
eff
ectedandt r
eatedshoul dbeseenby i
nter
nalorgans.
adoct orornurse.
Si
gnandsy
mpt
omsoff
ract
ure
Epist
axis:-Thisisoccurwhentheblood
vesselsnearthesurfaceofthenasal 1.Ther
e'sapai nont hesideofthe
cavit
yareinjuredordamage. fr
actur
e
2.Ther
ei satenderanddi scomf or
t
Causesofepi
staxi
s 3.I
mmobi li
zedoft hefracturepart
1.Trauma 4.Swell
ingofthef r
actureside
2.Di
r ectblow 5.Bl
eedinginternalorexternal
3.Commoncol d 6.Shockasar esultofhemor r
hage
4.Medi ci
ne Fi
rstai
dtr
eat
mentoff
ract
ure
5.Dryai r
1.Ifinjuryi stospi neorneck, thevi
cti
m
Si
gnandsy
mpt
omsofepi
staxi
s
shouldnotbemov eoral l
owedt omov e
1.Darkorbri
ghtbleedi
ng until
st retcherar eav ai
lable.
2.Troubl
ebreat
hing 2.Keept hepat ientcalm
3.Smelli
ng 3.Wat cht hevictim breathingand
prepar et oadmi nisterarti
fici
al
Fract
ure:-I
sabreakinconti
nui
tyoft
he respiration
bonesasar esul
tofpat
hologi
cal 4.Firstai dt obrokenbonesshoul dnot
weakness. extendbey ondpr eventi
onf urt
her
i
njuri
es.
Ty
pesoff
ract
ure
5.Donotmov et hepat i
entunlessfor
1.Simplef
ract
ure:
-Isafr
actur
ein safety
whichthefr
agmentsar
efiel
dundert
he 7.Not hingshoul dbegi venbymout h

25
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

8.Sendformedi
cal
doct
ort
otr
anspor
t 3.Refer
redpai
n:-I
sapainf
eltinpartof
tohospi
tal thebodyforawayf
rom t
heactualcause
ofthepain.
Bleedi
ng:-Isafl
owofbloodfrom
ruptur
edbloodvessel
sorescapeof Fi
rstai
dtr
eat
mentofacut
eabdomen
bloodfrom bl
oodvessel
s.
1.Forheartburnfrom gast
ro-
osepha
Si
gnandsy
mpt
om ofbl
eedi
ng gealref
luxtakeantacid.
2.Forconstipat
iontakeami l
dstool
1.Pateski n soft
enerorlaxativ
e.
2.Pulser apidandweak 3.Forpaintakeacetaminophen.
3.Thi
r stiness
4.Rest l
essness Prevent
ionacci
dent
sint
hehomeand
5.Gaspi ngf orai
r thecommuni t
y

Fi
rstai
dtr
eat
mentofbl
eedi
ng 1.Envir
onment alsanit
ation
2.Keepmedi cineinlackcupboar
d
Servi
cebl eedingwi t
hbl oodf l
owi ngout 3.Avoidalcohol
mustbest opped, atoncebypr essing 4.Properroadmai ntenance
withfi
nger sdirectt ot hewoundort he 5.Goodf uncti
onal t
raff
ic
edgesoft hewoundt ogetherforatl east 6.Monitori
ngpl aygr
ound
tenmi nutestherewi llbenot i
met o 7.Automat i
on
searchf orasterilebandage, l
ayt he
pati
entdownwhent hebleedinghas REFERALANDOUTREACHSERVI
CES
showeddownpr essapadofmat erial
overthewoundandt i
edfirmlyinpl ace. Referr
alsystem:-Isthet r
ansferof
Ifoozest hrough, applymor emat erialon responsi
bil
ityofcarefrom lowerhealth
topoft heor i
ginal pad. faci
li
tytohigherhealt
hf aci
lit
yorvice-
vasawhichmaybeei thertemporallyor
Acuteabdomen: -I
sapai nt
hataffect permanently.
theareabetweenthechestandhips
thatstar
tssuddenl
y,worsenqui
cklyand Ty
pesofr
efer
ral
syst
em
l
astforshortti
me. 1.Nor
mal pathway
Ty
pesofacut
eabdomen 2.Emergencypat
hway

1.Vi
scer
alpain:-Thisisduetoswoll
en Reasonf
orr
efer
ral
ordamagetointernalorgansi
nthebody, 1.Pati
entrequest
maynotfeelexactpointofpai
n. 2.Lackofhospi t
alequi
pment
2.Pariet
alpai
n:-Thi
sisduetosudden 3.Languagebar r
ierbet
weenhealth
i
njury&y oucanfeel
exact
lywherethe worker
painis. 4.Whent hestandingordersayr
efer
5.Forconti
nuityofcare

26
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

6.Fordi
agnost
icpur
pose Sanitati
on,Pr ophylaxi
s
3.Secondar yE. g.Earl
ydi agnosisand
Condi
ti
onst
ober
efer
red promptt reatment
1.I
ntest i
nal obst ructi
on 4.Ter t
iaryE.g.li
mi t
ationofdi sabi
l
iti
es,
2.Acut eappendi citi
s rehabil
itati
ons.
3.Strangul atedher nia Theyar ealsocl assifi
edasPr imary,
4.Mul tiplef racture Secondar yandTer ti
arylevels
5.Chr oni cdi sease Lev
elsofr
efer
ral
syst
em
6.Obst etri
csemer gency
7.Sev er ebur n( 95°c) 1.Referr
altoPHC:-Thi
sisthet ypeof
8.Ment al disorder ref
erralaPri
maryHealt
hCar e(PHC)
9.Pret erm baby equippedtoprovi
deahigherlevelof
10.Car di ovascul ardisoder
s caretoapatient
.

Constr
aintt
oef
fect
ivet
oref
err
al 2.Refer
ralt
ocompr ehensi
veheal
thcar
e:-Is
syst
em themor eadv ancedappr oachtohealth
careisavailabl
eoft hecenter,more
1.Poorpr eparati
onoft hehigherl
evel sophist
icatedfacili
tyandequipment
2.Breakint hetwoway sof suchasX- ray,laborat
ory,dent
alunit,
communcat ionsyst
em treat
mentr oom andbedf orobserv
ation
3.Poorplanni ng i
spr ovi
ded.
4.Insecuri
ty
5.Confli
ct 3.Refer
raltost
ategeneralhospit
al:-I
sthe
6.Inadequat eknowledge generalhospit
alprovi
desecondar ycare.
7.Favorit
ism andnepot ism Pati
entreferr
edt her
ear ethoseinneed
8.Lackoft ransport ofmor edetail
sexami nati
ont oconfir
m
di
agnosisandt reatment.
Adv
ant
ageoft
wowayofr
efer
ral
syst
em
Outreachservices:-I
sthetaki
ngPHC
1.Provideef f
ectiv
el i
nkageamong fr
om t heurbantoleastremotear
easin
heal
thf acil
iti
es orderfortheruralwhethert
obenefi
tthe
2.Ensurecont inui
tyofcar e servi
ces.
3.Provider el
evantinformati
ontothe
heal
thwor ker Obj
ect
ivesofr
efer
ral
syst
em
4.Assistonupdat ingt heheal
thworker
onthet reatmentpr ovi
ded. 1.All
owpat ient
saccesst oexpert
medicalcare
Lev
elsofheal
thcar
edel
i
ver
yinPHC 2.Preventcomplications
3.Facil
it
atequickr ecover
y
1.Promotiv
eE.g.Goodnut
ri
ti
on, 4.Obtaintheservicesofappropri
ate
Adequatehousi
ng di
agnost i
cfacil
it
ies
2.Prevent
iveE.
g.Immuni
zati
on, 5.Promot eknowledgeoft heheal
th

27
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

staf
f Bar
ri
ersf
orout
reachser
vices
6.Buil
dcontidencei nthepatient
7.Ensureefectiveness 1.Poorpl anning
8.Lesscostasmuchaspossi ble 2.Lackofmoney
9.Ensurecont i
nuityofcare 3.Logisticsproblem
10.Enhancet eam spiri
tamongheal t
h 4.Insurgency
workers 5.Poort ransport
ati
on
11.Reducepat ient'
smor t
ali
tyr at
e 6.Language
7.Conflict
Rat
ional
eforout
reachser
vices 8.Disasters
9.Lackofadv ocacy
1.Tofoll
owuppat ientthatareunder 10.Biasmi ndamongthewor
ker
s
tr
eatment
2.ToextendPHCser v
icest o Ser
vicespr
ovi
deddur
ingout
reach
communi ti
esatthegrassr ootlevelt
hat ser
vice
aregeographi
call
yinaccessible.E.g.
Natur
eoft heroad. 1.Generaloutpat
ientser
vices
3.ToprovidePHCser vicesto 2.Antenatalcar
e
communi ti
esthatneedsspeci alhealt
h 3.I
mmuni zation
att
enti
on.E.g.Epi
demi crefugeset c. 4.Chi
ldwel f
arecli
nic
5.Healtheducati
on
St
epsi
npl
anni
ngout
reachser
vices
Mobileheal
thcl
i
nic:-I
stheoutreach
1.Obj ect i
vesoft heout r
eachser v i
ces andmobi l
eheal
thservi
cesarecarri
ed
2.Pr epar ati
onofschedul eofv i
sitfor outatthesametime,undert
hesame
eachv il
lage room basedont
heheal t
hneedoft he
3.Pr epar edutyr ost erfort hestaf f pati
ent.
basedonav ai
labi l
it
y&cat egor yofst af
f
4.Car ingoutor ientationf orstafffor Heal
thser
vicest
ool
s
them t oabestwi t
ht heirfunctions. 1.St
aff
5.Pr ov i
deandensur ethatequi pment 2.Money
suppl iesandr esour cesneededf ort he 3.Tr
ansport
outreachser vicesar eingoodor derand 4.Mater
ial
ssuchas;Cool box,
Fir
staid
available. box,
Referr
alfor
m, Ar
m circumfer
ence,
6.Liai sewi t
ht hev i
ll
ageheal thwor ker Headcir
cumferenceetc.
andcommuni tyl eaderi nor dertoensur e
thatt heobj ectivesoft hepr ogrammed HUMANNUTRI
TION
areachi eved.
Nutri
ti
on: -Canbedefi
neast hesci
ence
7.Det er mineifv ill
ageheal thwor kerand
thati
nterpret
stheint
eracti
onof
vil
lagedev elopmentcommi tt
eehav e
nutri
entsandothersubstancesi
nfood
beensel ectandt rainot herwisear range
i
nr el
ati
ont omaint
enance, gr
owth,
forthei rselectionandt r
aining.

28
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

reproduct
ion,
heal
thanddi
seaseofan Bal
ancediet:-Canbedefi
neasafood
organism. whi
chcont ai
nsthevar
iousnut
ri
enti
n
cor
rectquanti
tyandqual
it
y.
Food:-Isaanysubstances(sol
idor
l
iqui
d)consumedt oprovidenut
rit
ional Component
sofbal
ancedi
et
supportforanor
gani
sm.
1.Carbohydrat
es
Cl
assesoff
ood 2.Protei
ns
3.Vit
ami ns
1.Bodybuildi
ngf ood:-Thesearefood'
s 4.Fats
thatareri
chproteinsandhelpingivi
ng 5.Minerals
struct
uretothebody .E.
g.Meat ,
Fish, 6.Water
Beans,Liv
eretc.
Carbohy
drat
es:
-Thesear
eorgani
c
2.Energyproduci
ngfood:-Thesear e compoundmadeupofcarbon,
hydrogen
veryri
chincarbohydr
atesandf ats andoxygen.
whichhelpsprovi
dethebodywi th Cl
assesofcar
bohy
drat
es
energy.E.
g.Rice,Yam,Maize,etc.
1.Monosacchar i
des: -Thesear e
3.Protecti
vefood:-Thesearefoods carbohydratesthatar eformedf or
thatcontai
nplentyofvit
aminsand absorptionafterdigestion.E.g.Gl
ucose,
mineralswhichenhanceimmune Fructose,andGal actosewhi chare
system.E.g.Frui
tandvegetabl
es. madeupofsi nglesugar .

Cl
assi
fi
cat
ionofnut
ri
ent
s 2.Disacchar
ides:
-Thesearemadeup
oftwoBondofmonosacchar i
de.E.
g.
1.Essentialnutrient
s:-Thesear e sucrose,mal
toseandlact
ose.
prot
iensobt ainedf r
om foodsour ces
becauset hebodydoesnotpr ovi
de 3.Poly
saccharides:
-Thesearemadeup
them orprov i
det hem inveryli
ttl
e ofmanymol eculesofmonosacchari
de.
E.g.St
arch,
glycogenandcell
ulose.
amount .E.g.Vitamins,Minerals,
Fats,
Prot
ein&Car bohy drat
es. Funct
ionofcar
bohy
drat
es

2.Non-essenti
alnutri
ents:-Theseare
1.Pr
ovi
sionofener
gy
prot
iensmanuf actur
edf rom thebody
2.Sat
isf
act
ionofhunger
anddonotneedt obeobt ainedfrom
foodsources.E.g.Cholesterol 3.Pr
ovi
sionofbodyheat
4.I
ncr
easebodywei
ght
Adequatediet
s/balancediet:-I
sasetof
5.Mai
ntai
nsgl
ucosel
evel
int
hebl
ood
mealthatcontai
nal l
theadequat e
nut
ri
entsintherightproport
ionthat 6.I
ndi
gest
ibl
ecar
bohy
drat
eel
i
minat
e
humanbodyneedsf orproperfuncti
on. wast
e.

29
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Digest i
onofcar bohydr ates:-I
st he Fatandoil
s:-Canbedef ineasa
digest i
ont hatst artfrom t hemout h compoundoff at
tyacidsat t
achedtoa
wher ept yalinbegi nst heconv ersionof compoundcalledglycer
ol consi
sti
ngof
foodst archi ntomal t ose.Thef oodt hen carbonandoxygen,buttheoxy genand
passest ot hest omachwher e hydrogenar
enott hesamewi t
hthatin
hydr ochloricaci dmakespl ent
ypt yali
n water.
native.Whenf oodr eacht heupperpar t
oft hesmal lintesti
net heenzy mes Cl
assi
fi
cat
ionoff
ats
sucr ose,mal toseandl actosefi
nished 1.Sat
uratedfats( har
mf ult
ogreatand
conv ersationofsugari ntoglucoseand bl
oodv essel
s)
thegl ucosei sabsor bedi ntothebl ood 2.Monounsat uratedfats(Decr
easelow
stream thr ought heintest i
nalwall. densi
tyli
poproteins&i ncr
easehigh
Protei
n:-Thesear
eor ganiccompound densi
tyli
poproteins)
madeupofcar bon,hydrogen,oxy
gen, 3.Pol
yunsaturatedf at
s( moreheal
thful
)
ni
trogenandotherelementssuchas Di
ff
erencebet
weenf
atsandoi
l
s
phosphorusandsulphur.
1.Sol
i
datroom temperat
ure
Cl
assi
fi
cat
ionofpr
otei
ns 2.Mel
dtooilathight
emperatur
e
1.Compl eteproteins:-Thesear
e
proteinsfoundinf oodsuchasegg,mil
k, Oi
l
sar
e
fi
sh, snai
l,edi
bleinsectandpoult
ry,
1.Li
qui
datr
oom t
emper
atur
e
thesear esaidtobecompl et
epr
otei
n
becauset heycont ai
ntheessenti
al 2.Sol
i
dif
ier
satl
owt
emper
atur
e
aminoaci dourbodyneed.
Funct
ionsoff
ats
2.Incomplet
eproteins:-Theseare
proti
ensfoundfrom vegetables,
grai
ns 1.Pr
oductofener
gy
andbeans, t
heyarecall
edi ncomplet
e 2.Gener
ati
onofbodyheat
becausetheytakeoneormor eofthe
3.Sur
round&suppor
tsomebody
essenti
alaminoacid.
or
gans
Funct
ionsofpr
otei
ns 4.Lubr
icat
econt
entofi
ntest
ine
1.Growthanddev el
opmentofti
ssues 5.Tr
anspor
tat
ionandst
orageoff
ats
2.Repairwornoutti
ssues sol
ubl
evi
tami
ns(
A,D,
E&K)
3.Formationofhormones&enzymes
4.Formationofanti
-t
oxi
ns Vi
tami
n:-Thesear
echemi
cal
5.Buil
dingofhemoglobin
subst
ancesessent
ial
fornor
mal
6.Produceenergyinabsenceof
carbohydr
ates met
abol
i
sm andheal
th.

30
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Cl
assi
fi
cat
ionofv
itami
ns Str
ategiesthatsuppor
tpr
oper
nutr
it
ionaleducati
on
1.Fatsol
ubl
evit
amins(A,
D,E&K)
2.Watersol
ubl
evit
amin(Bcompl
ex&C) 1.Focusi ngonnut riti
onv ulnerable
group0-5y ears
I
mpor
tantofv
itami
ns 2.Gi vingf oodr eachi nener gyf r
om six
(6)mont hsofagef requent l
yatl east
1.Enhancebody '
suseofcarbohydr
ates
four( 4)timesdai ly
2.Importanti
nbloodformati
on
3.Di scour agi ngt heuseofbr eastmil
k
3.Helpinformati
onofnervoussystem
subst itut
esandcommer cial
chemical
suppl ement ar yfood
4.Preventsonsetofmanydisease
4.Pr omot ingconsumpt ionofadequat e
5.Actasant aoxi
dant(A,C&E)
dietamongschool chil
dren, pregnant&
Miner
als:-Thesearei
norganic l
act atingmot hers
compoundwi thi
nthebodynecessar
y 5.Useofgr owmoni tori
ng
foral
lbodyprocess. 6.Adequat ef oodpr eparati
on
7.Homev isittopr ov i
deSuper vi
sion
Funct
ionsofmi
ner
als food/ dietar yissuesandf oll
owup.
1.Vi
tali
ngrowthofteethandbones Nutrit
ionaldisorders:-Isadisorderthat
2.Helpi
ngcel
lul
aracti
vi
ties ari
seasar esultoftakingnut r
ientsin
Cl
assi
fi
cat
ionofmi
ner
als ei
therexcessorl owqual it
y,quantit
yor
proporti
on.Ar ediseasescausedby
1.Majorel ement(cal
cium,chlori
ne, consumpt i
onofdi etwithinsuffi
cientor
magnesi um, sodi
um,potassi
um, excesssour ceoforl ackingapr oper
phosphor us&Sulphur balancedietofnecessar ynutri
ents.
2.Traceel ement(chr
omi um,copper,
Nut
ri
entdi
sor
der
sincl
ude
zi
nc,fluoride,i
odi
ne,i
ron&sel eni
um).

Water:-I
saliquidcompoundof 1.Protei
nener gymal
nutr
it
ion
hydrogenandoxy genformedbythe (kwashiorkorandmar asmus)
chemicalcombinationofhydr
ogenand 2.Coitr
e
oxygenatarati
oof65%ofhumanbody 3.Anemi a
i
smadeupofwat er. 4.Obesity
Funct
ionsofwat
er 5.Rickets
6.Scurvy
1.Circulatesthrought hebody
7.Xeropthalmi a
2.Transpor tnutri
entst ocel
l
8.Osteopor osis
3.Remov ewast ethroughurine&sweat
4.Par t
icipatei
nal lchemicalreact
ion 9.Desteomal acia
5.Moi steningfood 10.Angularst omati
ti
s

31
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Pr
otei
nener
gymal
nut
ri
ti
on Causeofmar
asmus

Kwashior
kor:-Isafor
m ofsevere 1.Star
vati
on
protei
nenergymalnut
ri
ti
onmostusual
l
y 2.Di
arrhealdi
sease
seeninchil
drenorear
lychi
ldhood 3.I
nfecti
on
betweentheagesof1-2. 4.Povert
y
5.I
gnorance
Causesofkwashi
orkor 7.Cult
ure
8.Poli
cy
1.LowPr oteinintake
2.Abr uptbr east
f eeding Si
gnandsy
mpt
omsofmar
asmus
3.Pov ert
y
1.Stuntedgrowth
4.Ignorance
2.Washi ngofmusclesand
5.Poorper sonal/env i
ronmentalhy
giene
subcutaneousfat
s
6.Negat i
v et r
aditionalpract
ices 3.Oldmanappear ance
7.Infecti
on 4.Hairchange
8.Par ent
al negligence 5.Edema
Si
gn&sy
mpt
om ofkwashi
orkor Chi
l
datr
iskofmal
nut
ri
ti
on
1.Stuntedgrowth 1.Vulnerablechi
ldr
en0-
5year
s
2.Potbelly 2.HIVposi ti
ve
3.Dryskin 3.Parentheseschil
d
4.Loosest ool 4.Homel esschil
d
5.Looseofappetite 5.Abundantchi l
d
6.Moon- face 6.Neglectedchil
d
7.Li
v erenlar
gement 7.Disabi
lit
ies

Managementofkwashi
orkor Nutriti
onalassessment:-Canbe
definedasi ndeptheval
uati
onofbot h
1.Properwearingpr ocess objecti
veandsubj ect
ivedatar
elat
edt o
2.Exclusiv
ebreastfeeding anindividualf
oodandnut ri
ent
sintake,
l
ifestyleandmedi calhi
stor
y.
3.Heal t
heducation
4.Treatmentofinfection Pur
poseofnut
ri
ti
onal
assessment
5.Followupofi snecessary
1.Toi dentifythepopulati
onori ndi
vidual
6.VitaminAsuppl ementt or
est
ore groupatr isk
appetite 2.Identif
yi ndi
v i
dualorgroupthatare
mal nouri
shed
Marasmus:-I
saf or
m ofsever
eprot
ein 3.Todev elophealthcareprogrammed
thatmeett hecommuni t
yneed
ener
gy(cal
ori
es)malnut
ri
ti
onmainly
4.Tomeasur etheeffecti
venessofthe
seenint
hefir
styearoft
ime. nutrit
ionalprogramsandi nt
erventi
on

32
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Met
hodofnut
ri
ti
onal
assessment Comprehensi
venut
ri
ti
onal
ser
vicei
n
cl
ini
candcommunity
1.Di
rectmet
hod
2.I
ndir
ectmethod 1.Nutri
tional assessment
2.Givi
ngf eedbackt ot heCommunity
Di
rectmethod:
-Thi
sdealswi
t h 3.Screeningpr egnantwomanf or
i
ndivi
dual
sandmajorobj
ect
ivescr
it
eri
a. nutr
it
ional problem
4.Encour agingexclusivebr
east
feedi
ng
Di
rectmet
hodi
ncl
udes;
5.Superv i
sionofJCHEW, VVHW, TBAS
1.Anthropomet r
icmet
hod:-Ist
he onnut r
it
ionact ivi
ti
es
measureoft hebodyheight
,wei
ghtand 6.Teachingf oodhy giene&adequate
proport
ion.E.g.MUAC,Head di
et
ci
rcumference.
Descr
ibechi
l
dnut
ri
ti
on
2.Bi
ochemicalmethod:
-Thi
sdealwit
h
thel
evelofthedi
etar
yconst
it
uenti
nthe 1.Infantandy oungchi ldf eedingwhich
bodyfl
uid. i
ncludes;
a.Counsel l
ingtoencour age
3.Cli
nicalmethod:-Isthesi
mplestand
breastfeedingaf terchildbirth
mostpr acti
calmethodwhichneeds
b.Excl usivebreastfeedingf or6mont hs
physi
cal examinat
iontoassessgeneral
c.Ageappr opr i
atecompl ement ar
yfood
appearance.
2.Vi t
ami nAsuppl ement( twiceannuall
y
4.Di r
ectevaluat i
onmet hod: -I
sthe i
nchi ldren6- 59mont hs)
processofassessi ngthenut ri
ti
onal 3.Gr owt hmoni tori
ng
i
nt akeofandi ndi
vidualgroup.E.g.24 4.Communi tymanagementofacut e
hour sdiet
aryr eport,
Foodf requency mal nutri
tionusingf recklyt ouse
quest i
onnaire,Dietar
yhistorysinceearl
y therapeut i
cf oods
l
ife,Fooddi etarytechni
que, Observe
foodconsumpt i
on. Commonhealthpr
obl
emst hataf
fect
nut
ri
ti
oni
ntakebypat
ientl
i
v i
ngwithHIV
Indi
rectmethod:-I
st heuses
communi tyi
ntressthatref
lect
sthe 1.Lackofappetit
e
i
ndividual
stat
usandneed. 2.Nauseaandv omiti
ng
3.Soremout h(t
hrush)
I
ndi
rectmet
hodi
ncl
udes; 4.Digesti
veprobl
ems
1.Ecologicalvar
iableincl
udingagar
ic 5.Skinprobl
em
2.Economi cfactors 6.Cold
3.Cult
ur alandsocialhabit
s 7.Cough
4.Vit
al healt
hstati
stics 8.Inf
luenza

33
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Processoffeedi
ngHIVposi
tiv
emother
s Ty
pesofmi
cronut
ri
ent
mustbef ol
l
owt opr
eventtr
ansmi
ssi
on
1.I
rontabl
ets
tothei
rbabies
2.I
odine
1.Suppor ti
ngt hemot hersdecisionto 3.Zi
nc
breastfeeding 4.Vi
taminA
2.Pr ovi
dingnut r
iti
oncounselli
ng
I
nter
venti
onst
rategi
esinthecont
rol
&
3.Teachi ngherpr operpositi
oningand
pr
eventi
onofmicronut
ri
ent
attachment
4.Put ti
ngbabyt obr eastimmedi at
ely 1.Supplementation
afterbirt
h 2.Ponti
ficat
ion
5.Br eastf
eedingday&ni ghtatleast6 3.Diet
arydiversi
ficati
on
ti
mes 4.Controlofparasiti
cinf
est
ati
on
6.Av oidmixedf ood
7.Counsel l
ingwi thregardto Breast
feedi
ng:-I
stheprocessof
compl ement aryfoodorwhen feedi
ngthebabywithbreastmi
lkf
rom
recommended bir
thtotwoyearsofage.

CMAM: -MeanCommunity Adv

ant
ageofbr
east
feedi
ng
ManagementAcut
eMalnutr
it
ion
1.Breastmi l
kiseasilydigested
Component
sofCMAM 2.I
roni nbreastmilkiseasilyabsorb
3.Cont ai
nallthenutri
entsneededby
1.Communi tyoutreach baby
2.Outpati
entcaref orsev
ereacut
e 4.Breastfeedbabiesdonotsuf f
erfr
om
malnutr
it
ion(SAM) consumpt ion
3.Stabi
li
zati
oncent ercaref
orSAM wi
th 5.Breastfedbabiesarelesspr oneto
medicalcomplicati
ons di
sease
4.Servi
cesorpr ogrammesf or 6.I
tenhanceemot ionalboundbet ween
managementofmoder at
eacute mot herandchi l
d
malnutr
it
ion(MAM) 7.Breastmi l
kscleanandf reefrom
pathogenic
Pr
inci
pleofCMAM
Di
sadv
ant
agesofbr
eastmi
l
k
1.Maximum accessandcov erage
2.Appropri
atemedical&nutri
ti
onalcar
e 1.Br
eastengagement
3.Ti
mel i
ness 2.I
nusual breastshape
4.Careforaslongasitisneeded 3.Tr
ackingoft hebreast
4.Wastemot hertime
Micronutr
ient
s:-Thesearediet
ary
5.Di
rt
ymot her
component soft
enrefer
stoasmi ner
als
andv i
taminsalt
houghonlyrequi
redby Complementar
ydiet
:-Weari
ngi
sthe
thebodyinsmal lamount. gr
aduali
ntr
oducti
onofchi
ldtot
hesemi
-

34
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

sol
i
dfoodoft
hef
ami
l
y. 4.Fi
ndoutnut ri
ti
onalpr
oblemsint
he
Pr
inci
plesofweani
ng communi ty
5.Screenoutnutri
ti
onalabnor
mali
ti
es
1.Gradual
int
roduct
ionoffoodoneata 6.Enablesthegovernmenttopl
anon
ti
me nutr
it
ionalprogr
ammed.
2.Foodshoul
dbehy gieni
call
yprepared
mothershoul
dobserveandf oll
owchild SYMPTOMATOLOGY
patt
erns
Sy
mpt
omat
ology
:-I
sabr
anchof
3.Foodshoul
dbesmoot hintextur
e
medici
newhi chdeal
witht
hestudyand
4.Foodshoul
dbeeasi l
ydigested
cl
assif
icat
ionofsymptomsanddisease.
Commonweani
ngdi
ets
Sign: -Canbedef i
neasobjecti
ve
1.Stapl
esE.g.Cereals,roots,vegetabl
es, evidenceofadi seaseinwhichanot
her
star
chyf r
uit
s(Banana, plantai
n). personot herthantheper
soninfect
ed
2.Peasandbeans cani denti
fy.
3.Foodf r
om animal E.
g.Fi r
st,l
iver,
meat Sy
mpt
oms:
-Canbedef
ineassubj
ect
ive
4.Greenleafyveget
abl esthebet tert
he evi
denceofdiseaset
hatcanonlybe
foodvalueE.g.Carrots,Cassav aleaf exper
iencebytheper
soninf
ected.
5.Fatsandoils
Di
sease:
-Isanycondi
ti
ont
hatr
esul
tsi
n
Nut
ri
ti
onal
educat
ion:
-Thi
sdeal
swi
th di
sor
deroftheorganofthebodywhi
ch
theprocessofenl
ightenf
orming,and i
snotduetoexternal
inj
ury
.
educati
ngpeopleonhowt omakebet t
er
Rat
ional
forsy
mpt
omat
ology
useoftheavail
abl
ef oodresour
ces.

Commonnut
ri
ti
onal
probl
ems 1.Enablet hecommuni tyhealt
hwor ker
s
toknowt hesev eri
tyofthedisease
1.Lowbirt
hr at
eandPEM 2.Helpt heheal thworkerstotake
2.Micr
onut r
ient
sdefi
ci
ency appropriateact i
on
3.Nutr
it
ionalanemi
a 3.Enablet hecommuni tyhealt
hwor ker
s
toidentif
yt hesy mptomsoft hedi sease
Nut
ri
ti
onal
educat
ion
4.Helpt hecommuni tyworkerstoknow
1.Raisestrongandhealt
hyy out
hs whatt hepat ientdoestoreadyto
2.Changepeopl ewayoflif
e soluti
on
3.Enablesev er
ymemberoft he 5.Toi dentifythesympt omsoft he
communi tytoacaretakerofhisorher diseases
heal
th 6.Correctt hediagnosisofthedi seases

35
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Respi
rat
orydi
sor
der 3.Short
nessofbr eat
h
4.Sl
ightFeverandchil
ls
Respir
ator
ydisoder
sincl
udes;Ast
hma, 5.Chestdiscomfort
Bronchi
ti
s,Pneumonia,
Tubercul
osi
set
c. 6.Chestpain
Asthma:-I
sacondi
ti
oni
nwhichy our Causesofbr
onchi
ti
s
air
waysnarr
owandswel
landproduce
extr
amucus. 1.Smokingcigar
ett
es
2.Airpol
lut
ionanddust
Si
gnandsy
mpt
omsofast
hma 3.ToxicGases
1.Short
nessofbreat
h Pr
event
ionofbr
onchi
ti
s
2.Chesttight
ness
3.Chestpain 1.Avoi
dsmoking
4.Wheezingsoundwhenexhal
i
ng 2.I
fyoucatchacold,
getplent
yofr
est
5.Coughing 3.Eataheal
thydi
et
4.Washyourhandsoften
Causesofast
hma
Pneumoni
a:-I
saninf
ect
iont
hat
1.Commoncol d i
nfl
amestheai
rsacsi
noneorboth
2.Phy si
calact
ivi
ty(
Exercise-induced l
ungs.
asthma)
3.Coldair Si
gn&sy
mpt
omsofpneumoni
a
4.Airpoll
utant
s&i r
ri
tantsE. g.Smoke
5.Strongemotionsandst ress 1.Fever,
sweat
ingandshakingchi
ll
s
2.Cough,whi
chmaypr oducephl
egm
Pr
event
ionofast
hma 3.Chestpai
ninbreat
heorcough
4.Short
nessofbreat
h
1.Fol
lowyourasthmaact i
onpl
an 5.Fati
gue
2.Pneumonia 6.Nausea
3.I
denti
fyandav oidasthmatri
ggers 7.Vomiti
ng
4.Monit
oryourbr eathi
ng 8.Diar
rhea
5.Regul
armedical checkup
6.I
denti
fyandtreatat t
acksear
ly Causesofpneumoni
a
7.Takeyourmedi cati
onasprescr
ibed
1.Bacter
iai
ntheai
rwebr
eat
he
Bronchi
ti
s:-Isaninfl
ammat ionoft
he 2.Fungi
l
iningofyourbronchi
altubes,whi
ch
3.Vir
us
carryai
rtoandf r
om yourlungs.
Pr
event
ionofpneumoni
a
Si
gnandsy
mpt
omsofbr
onchi
ti
s

1.Sleepingdi
ff
icul
ty 1.Hygi
ene
2.Fatigue 2.Eatr
ight
,wi
thpl
ent
yoff
rui
tsand

36
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

vegetabl
es 3.Short
nessofbr
eat
h
3.Exerci
se 4.Chestpai
n&Coldhandsandf
eet
4.Getenoughsl
eep 5.Headaches
5.Quitsmoki
ng Causesofanaemi
a
Tubercul
osis(TB):
-Isapotenti
all
y 1.Hemorr
hagic
seri
ousinfect
iousdiseaset
hatmainl
y 2.I
rondef
ici
ency
aff
ectsyourlungs. 3.Hemoly
tic

Si
gn&sy
mpt
omsoft
uber
cul
osi
s Pr
event
ionofanaemi
a

1.Coughingupblood Eati
ngadiett
hatincl
udesavar
iet
yof
2.Weightloss vi
taminsandmineral
s,i
ncl
udi
ng;
3.Fati
gue
1.I
ron
4.Fever 2.Fol
ate
5.Nightsweats 3.Vit
aminB-
12
4.Vit
aminC
Pr
event
ionoft
uber
cul
osi
s
Leukemia:-Iscancerofthebody'
s
1.Alwayscoveryourmout hwitha
bl
ood-for
mi ngti
ssues,i
ncludi
ngthe
ti
ssuewheny oucoughorsneeze
bonemar r
owandt hely
mphaticsyst
em.
2.Washy ourhandsaftercoughingor
sneezi
ng Si
gn&sy
mpt
omsofl
eukemi
a
3.Don'tv
isi
totherpeopleanddon't
1.Headache
i
nvit
ethem tovisi
tyou
2.Easybleedi
ngorbrui
sing
Blooddisorder:-Thesear econditi
on 3.Bonepain
4.Lossofappeti
teandLossofwei
ght
thati
mpactt hebl ood'sabil
it
yto
5.Tir
edorweakness
funct
ionscor r
ectly.Commonbl ood
6.Joinpain
disor
dersinclude: Anemia,Leukemia,
Hemophi l
ia,Eosinophili
aetc. Eosi
nophi
li
a:-Thisref
erstoacondi
ti
on
ofhavi
nganincreasednumbersof
Anaemi a:-I
sar educti
onint
hequanti
ty eosi
nophi
l
’sintheperipher
albl
ood.
of(oxygen-carr
ying)hemogl
obi
nin
bloodand/ orbelownormalquant
it
yof Causeseosi
nophi
l
ia
redbloodcells.
1.All
ergi
esandast
hma
Si
gnandsy
mpt
omsofanaemi
a 2.Drugall
ergy
3.I
nfecti
ons(most
lyf
rom par
asi
tes)
1.Fati
gue&Weakness
4.Skin
2.I
rregul
arhear
tbeat
s

37
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

5.Lungs knownasdi
seasethatpresentint
he
l
umberver
tebr
ateorspineregion.
Si
gn&sy
mpt
omsofeosi
nphi
l
ia
Causesofl
umbago
1.Skinrash
2.I
tching 1.Frequentsi
tt
ing
3.Diarr
hea 2.Stayi
ngbentforward
3.Muscularweakness
4.Asthma
4.Excessiv
ebandaging
5.Runnynose
Si
gnandsy
mpt
omsofl
umbago
Muscul oskeletal disorders: -Isthe
i
njuri
est hataf fectt hehumanbody '
s 1.Swelling/ i
nfl
ammat i
onoftheback
mov ementormuscul oskel etalsystem 2.Lowerbackpai nwheny ousneeze
(i
.e.muscl es,tendons, l
igament s,ner
ves, 3Rest r
ict edmov ementofthespi
ne
di
scs, bloodv essel s,etc.)Common 4.Tingl
ing
muscul oskeletal disodersi ncludes; 5.Compl etelossofsensat
ion
Arthri
ti
s, Myalgia, My el
oma, Lumbago,
Osteomy el
it
is,Ski nwr i
nkl eset c. Pr
event
ionofl
umbago

Arthr
it
is:-I
saseri
ousmedi
calcondit
ion 1.Getregularexerci
set okeepy
ouback
thatcausesswol
l
enandpai
nfultothe musclesfitandflexi
ble
j
oint. 2.Avoidprolongedsitt
ing

Si
gnandsy
mpt
omsofar
thr
it
is Osteomyel
it
is:
-Canbedefi
nedasan
i
nfl
ammat i
onofbonecausedby
1.Joi
ntPainandSwell
ing i
nfecti
ongeneral
l
yint
helegs,
armsor
2.Sti
ff
ness spi
ne.
3.Rednessofski
naroundthejoi
nt
Si
gn&sy
mpt
om ofOst
eomy
eli
ti
s
4.Decreasedr
angeofmotion
1.FeverFati
gue
Pr
event
ionofar
thr
it
is
2.Swell
ingwar mthandrednessovert
he
1.Exerci
se areaoftheinfect
ed
2.Controlyourbodysugarl
evel 3.Pai
ni ntheareaoftheinf
ecti
on
3.Avoidinjur
y&St r
etch
CausesofOst
eomy
eli
ti
s
4.Stayathealthyweight
5.Quitsmoking 1.Thebl oodst
ream Bact
eri
ainthe
6.Stopdrinki
ngalcoholi
c bloodstream
Lumbago:-Iswhent
hef uncti
onofyour 2.Injuri
esseverepunct
urewoundscan
backmusclesisl
imi
ted,usual
lyi
nthe carrygermsdeepi nsi
deyourbody
.
l
umberspineregi
onorlumbagoalso 3.Sur gery

38
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Skinwri
nkl
es:-Isanatural
partofagi
ng, Si
gnandsy
mpt
omsdent
alcar
ies
aremostprominentonexposedskin, 1.Badbr eathandunpleasantt
ast
e
suchastheface,neck,
handsand 2.Painanddi scomfort
for
earms. 3.Swel l
i
ngorbl essi
nggums
4.Toothl oss
Si
gn&sy
mpt
omsofski
nwr
inkl
es
5.Dif
ficultyeat
ing
1.Lumps
Pr
event
iondent
alcar
ies
2.Pai
nandswel
l
ingcanbepr
esent
1.Brushy ourteet
hatleasttwiceaday
Causesofski
nwr
inkl
es wit
haf luori
de-contai
ningtoothpast
e.
1.Age 2.Cl
eanbet weenyourteethdailywi
th
dent
al f
lossori nt
erdental
cleaners.
2.Smoking
3.Dehydrat
ion Stomat i
ti
s:-I
sat erm appli
edt
ot he
4.Exposuretoul
travi
olet(UV)l
i
ght i
nflammat i
onoft hemucousl i
ningof
5.Repeatedfaci
alsexpressi
ons anyoft hestr
ucturesi
nt hemout hwhi
ch
mayi nvol
vethechecks, gums,l
ips,
Pr
event
ionofski
nwr
inkl
es
throatandtherooforf l
ooroft
hemout h.
1.Prot
ecty ourski
nfrom sunl
ight Si
gnandsy
mpt
omsst
omat
it
is
2.Don'tsmoke
1.Painorirr
it
ati
onont heli
ps,
checks,
3.Eataheal t
hydiet
gums, t
ongueorsi desofthemout h
4.Moistur
ize
2.Youmayhav eburningsensati
on
5.Usedproductwi t
hbuil
tinsunscr
een i
nsidethemout h
3.Ulcer
s,soresorblister
sinsi
dethe
Mout
hdi
sor
der
s:-Thesei
ncl
udes;
mout horonthelips
Dent
alcari
es,Or
alcancer
,St
omat
it
is,
4.Redpatchesint hemout h
Gi
ngivi
ti
setc. 5.Painf
ulsoresthatcanmakei t
uncomf or
tabl
e
Dentalcar
ies(
toot
hdecay):-I
sthe
breakdownofteet
h(cavi
ti
es)dueto Pr
event
ionst
omat
it
is
acidsmadebybacteri
a.
Oralcancer
:-Thesear
ecancer sthat
CausesDent
alCar
ies occursontheinsi
deofthemout his
sometimescall
edoralcav
itycancer.
1.Breakdownofthehardti
ssue
Si
gnandsy
mpt
omsor
alcancer
2.Smallholei
ntheteeth
3.Largewhole(cav
iti
es) 1.Looseteet
h
4.Abscess 2.Tonguepain
5.Sorenessandpain 3.Jawpainorsti
ff
ness

39
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

4.Di
ff
icul
torpai
nful
chewing Pepti
culcer
: -Theseareopensor est
hat
5.Di
ff
icul
torpai
nful
swall
owing developontheinsidel
iningofyour
esophagus,stomachandt heupper
Pr
event
ionor
alcancer
port
ionofyoursmal li
ntesti
ne.
1.Stopusingtobaccoordon' tstar
t Si
gn&sy
mpt
omsofpept
icul
cer
2.Avoidexcessi
v esunexposur etoli
ps
3.Seey ourdent
istregularl
y 1.Vomitingofblood,whichmayappear
4.Practi
cinggoodor alhygiene redorblack
5.Avoiddr i
nkal
cohol 2.Darkbloodi nst
oolsorstool
sthatar
e
blackortarry
Gingivi
ti
s:-Isanon-destructiv
edi sease 3.Nauseaorv omit
ing
thatcausesinfl
ammat ionoft hegums. 4.Unexplainedweightloss
Themostcommonf orm ofgi ngivit
is, 5.Appetitechanges
themostcommonf orm periodontal
diseaseoverall
,i
sinresponset o Causesofpept
icul
cer
bacteri
albiofi
l
mst hati
sat tachedt ooth
surface,t
ermedplaquei nduced 1.Bacteri
um
gingivi
ti
s. 2.Regularuseofcer
tai
npai
nrel
i
ever
s

Si
gnandsy
mpt
omsgi
ngi
vi
ti
s Gastr
iti
s:-Thesearedescri
besasa
groupofconditi
onswithonethi
ngin
1.Swoll
engums common; inf
lammationoftheli
ningof
2.Bri
ghtredorpurpl egums thestomach.
3.Pai
nfultotoucht hegums
4.Bl
eedinggums Si
gnandsy
mpt
omsofgast
ri
ti
s
5.Bl
eedingafterbrushingorf
lossi
ng 1.Nausea
6.Badbreath(hali
tosis) 2.Vomiti
ng
3.Afeel
ingofful
lnessi
nyourupper
Pr
event
ionofgi
ngi
vi
ti
s abdomenaftereati
ng

1.Br
usht
hor
oughl
ytwi
ceaday Duodenal
ulcer
:-I
sasor et
hatf
ormsi
n
2.Cont
rol
diabet
esi
fyouhav
eit t
helini
ngoftheduodenum.
3.Don’
tsmokeorot
hert
obaccopr
oduct Si
gn&sy
mpt
omsofduodenal
ulcer
4.Fl
ossev
erydayt
oremov
ebact
eri
a
1.Nausea
bet
weent
het
eet
h
2.Vomiti
ng
5.Li
mitf
ood&dr
inkswi
thl
otsofsugar 3.Bl
oati
ng

St
omachdi
sor
der
s:-Thesei
ncl
udes; Cardiovasculardi
sease:-Thesear
e
Pel
vi
cul
cerdi
sease,
Duodenal
ulcer
, heartdiseasedescribesarangeof
conditi
onst hataf
fectyourhear
t.
Gast
ri
ti
set
c.

40
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

DiseasesundertheHeartdisease Si
gn&sy
mpt
omsofcar
diacar
rest
umbr el
lai
ncludebloodvesseldiseases,
suchasAr rhyt
hmias,Cardi
acarrest, 1.Fati
gue
Congestiv
ecar di
acfai
lur
eet c. 2.Rapidori
rr
egularheartbeat
3.Reducedabil
i
tytoexercise
Arrhythmias:
-Thesearedescri
besan
4.Incr
easedneedtourinateatni
ght
i
rregularhear
tbeat.Wi
ththi
scondi t
ion,a
5.Lackofappeti
teandnausea
person'sheartmaybeattooquickly
, t
oo
6.Weakness
slowly,t
ooear l
y,orwi
thanir
regular
rhythm. Causesofcar
diacar
rest
Si
gn&sy
mpt
om ofar
rhy
thmi
as Heartfai
lureoft
endevelopsaft
erother
1.Chestpain condit
ionshavedamagedorweakened
2.Shortnessofbreath yourheart.However
,theheartdoesn'
t
3.Dizzi
ness needtobeweakenedt ocauseHeart
4.Severeheartpalpi
tat
ions fai
lur
e.
5.Anx i
ety
6.Sweat i
ng Endocri
nedisorder:-Thiscanber esult
s
whenagl andproducest oomuchort oo
Causesofar
rhy
thmi
as l
it
tl
eofanendocr i
nehor monewhi ch
1.Coronaryar
terydisease di
seaseincludes;Goiter
s,Diabet
es, and
2.Highbloodpressure Osteomyeli
tisetc.
3.I
njuryfr
om ahear tatt
ack Goit
er:-I
sanabnormal
enl
argementof
Cardi
acar r
est:-I
sthesudden, yourthyr
oidgl
and.
unexpectedlossofhear
tfunct
ion,
Si
gnandsy
mpt
omsofgoi
ter
breat
hingandconsciousness.
1.Ati
ghtf eel
i
nginy ourt
hroat
Si
gn&sy
mpt
omsofcar
diacar
rest
2.Coughing
1.Suddencoll
apse 3.Hoarseness
2.Nopulse 4.Di
ffi
cultyswall
owing
3.Nobreathi
ng
5.Di
ffi
cultybreat
hing
4.Lossofconsci
ousness
Causesofgoi
ter
Causesofcar
diacar
rest
1.I
odinedef i
ciency
Thei mmediatecauseofsuddencar di
ac
arresti
susuall
yanabnor mali
tyinyour 2.Multinodulargoit
er
heartrhyt
hm (arrhy
thmia)
,theresul
tofa 3.Soli
taryThyroidnodul
es
problem wit
hy ourhear
t'
select
rical 4.Thyroidcancer
system. 5.Pregnancy

41
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Diabet
esmelli
tus:
-Theseareref
erstoa Pr
event
ionofmi
ctur
it
ion
groupofdi
seasesthataff
ecthowyour
1.Eat
ingabal anceddi etand
bodyusesbloodsugar(gl
ucose)
. maint
aininganact i
velifesty
lecanhelp
Si
gnandsy
mpt
omsofdi
abet
es moderatetheout putofur i
ne.
2.Eat
ingahi gh-f
iberfoodscanal so
1.I
ncreasedt hir
st hel
ptor educetheconst ipat
ion.
2.Drymout h
3.Frequenturinati
on Uri
naryt
r acti
nfecti
ons:-Theseare
4.Extremehunger morecommoni nwomen.Theyusual ly
5.Unexplai
nedwei ghtl
oss occuri
nt hebladderoruret
hra,butmore
6.Fati
gue seri
ousinfect
ionsinvol
vethekidney.
7.I
rrit
abil
it
y
Si
gn&sy
mpt
omsofUTI
s
8.Visi
onpr oblem

Causesofdi
abet
es 1.Abur ni
ngfeeli
ngwheny oupee
2.Af r
equentorintenseurgetopee,
1.Thepancr eassecretesinsuli
nint
othe eventhoughlit
tl
ecomeoutwheny oudo
bloodstream. 3.Cloudy,dar
k,bloody,orstr
ange
2.Thei nsuli
nci r
culates,enabl
ingsugar
smelli
ngpeeFeel i
ngt i
redorshaky
toentery ourcells.
4.Feverorchil
ls(asignthatthe
3.Insuli
nl owerst heamountofsugari n
i
nfecti
onmayhav ereachedy ourki
dney
s)
yourbloodst ream.
4.Asy ourbl oodsugarl eveldr
ops,so CausesofUTI
s
doest hesecr eti
onofi nsuli
nfr
om your
pancreas. 1.Arti
fi
cialsweet
ener
s
2.Spicyfoods
Genito-uri
narydisorder
: -Thi
sincl
udes;
3.Alcohol
Micturi
tion,Prostat
ehy perpl
asi
a,uri
nar
y
4.Coffee
tr
actinfecti
on, Non-Gonococcal
uret
hr i
ti
set c. Pr
event
ionofUTI
s
Mict
uri
ti
on(uri
nat
ion)
:-Ist
heprocess 1.Empt yyourbladderoftenassoonas
ofur
ineexcr
eti
onfrom t
heuri
nary youfeel theneedt opee;don’trush,and
bl
adder.
besur ey ouempt i
edy ourbladder
Si
gn&sy
mpt
omsofmi
ctur
it
ion compl etely
2.Wipef r
om fronttobackaf teryouuse
1.Strong-smell
inguri
ne thetoilet
2.Bloodi nt
heur i
ne 3.Frankl otsofwat er
3.Fev er
4.Chooseshower soverbaths
4.Chills
5.Drinkpl ent
yofl i
quids,
especi al
ly
5.Lossofbl addercont
rol
water

42
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

COMMUNI
TYMENTALHEALTH 10.Lawst
oensurethataper
son
makingawil
ldoessowhil
emental
l
yil
l
Communi tyment alhealt
h: -Thisref
ers
heal
th
toallt
hosef aci
li
ti
esapar tfrom hospit
al
whichareempl oyedfort hetreati
ngand Ty
pesofment
ali
l
lness
rehabi
li
tat
ingment alil
lnessint he
communi t
y . 1.Psychosis
2.Neurosis
Mentalheal
th:-Istheabil
i
tyofhuman
3.Addicti
vedisorder
tocopewiththestressesofli
vi
ngand
4.Depression
achi
evedrelat
ivel
yeffect
iveadjust
ment
.
5.Anxiety
Mentalil
lness:-I
st hesuccessful 6.Puerperalpsychosi
s
adapt
ationtost r
essorsintheinter
nal 7.Schizophreni
a
andexternalenvir
onment .
8.I
nsomni a
Ment
alheal
thl
aws 9.Epi
lepsy
10.Calyptomania
1.Lawswer ei nsidetoensur et he
11.Nymphomani a
welfareoft hement all
yf illedar etaken
2.Lawst hatar ebeeni ntendedt o I
nsomni
a:-I
sast
ateofl
ackofsl
eepi
ng
protectmember soft hecommuni ty
undernor
mal
condi
ti
ons.
from thement allyi
ll
3.Lawswer emadet opr ot ectt he Epi
l
epsy
:-I
sast
ateofel
ect
ri
cal
ment all
yi llfr
om bei nghar m byt he changesbythemot orneuronsthat
communi ty
causesthefol
l
owing; Sei
zure,
Gr aspi
ng,
4.Lawst hatr equi r
est hement allysick
i
naggitati
onwhent woaxoncol l
oid
tobehospi t
alized
5.Lawswhi chdonotal l
owst hatt he becameaxon-axi
nic.
ment all
ysi ckshoul dbekeptagai nst
Cal
ypt
omsni
a:-I
sast
ateofment
al
thei
rwi llunlessf orsafet y
di
soder
sthatindi
vi
dualst
ealunv
aluabl
e
6.Lawswhi chst at
ethatt hement all
y
sickhasabl er ighttor ecei v etreat ment i
tems.
andsuppor t Nymphomania:-I
sastateofmental
7.Lawst hatpr eventsper sonwhohav e di
sodersinwhicht
heindi
vidual
cannot
hadcer taint ypeofment al lydi sorder s bel
ieveinadaywit
houtasexual
from hol dingsensi ti
veposi tion i
ntercour
sebutmaleandfemaleare
8.Ther ear el awsconcer ni ngmar riage i
nvolved.
whicht ur noutt ohavebeencont r
act ed
whenoneoft hepar tner swasi l
l Psy
chosi
s:-I
sacondi
ti
onofmi
ndt
hat
9.Anot herl awst oprot ecti llper son r
esult
sindi
ff
icul
ti
esdet
ermi
ningwhati
s
propertiesf rom beent emper ed r
ealandwhatisnotr
eal
.

43
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Causesofpsy
chosi
s Si
gns&sy
mpt
omsofdepr
essi
on

1.Headinjuri
es 1.Depr essedmood
2.HIVandAI Ds 2.Changesi nsleep,appeti
te,
&weight
3.Malari
a 3.Lessact ivi
tyormor eagitat
ion
4.Syphil
is 4.Troubl econcentrati
ng
5.Str
oke 5.Lowener gy
6.Parki
nson’sdisease
6.Feelinghopel essorguilt
y
7.Postnataldepressi
on
7.Phy sicalachesandpai ns
8.Lymphdi sease
8.Suicidalthoughts
Si
gnandsy
mpt
omsofpsy
chosi
s
Anxiet
y:-Canbenor
malinst
ressful
1.Halluci
nati
ons&Del usions sit
uati
onssuchaspubl
i
cspeakingor
2.Diff
icul
tyincar r
y i
ngoutdailyact
ivi
ty taki
ngat est
.
3.Suspici
ousness
4.Lackofself-careorhy giene Causesofanxi
ety
5.Socialwit
hdr awal 1.Stressatwor k
6.Lackofmot i
v at
ion 2.Stressfrom school
7.Noemot i
onsatal l 3.Stressinaper sonalrelat
ionshi
psuch
8.Sleepproblem asmar ri
age
4.Fi
nanci alst
ress
Hall
uci
nations:
-Isaf
alseper
cept
ion 5.Stressfrom globaloccurrencesor
char
acter
izedby; poli
ti
calissues
6.Stressfrom unpredictabl
e
1.Tactil
eHal l
ucinat i
ons
7.Stressfrom anemot i
onaltrauma
2.AuditoryHallucinations
suchast hedeat hofal ovedone
3.OlfactoryHallucinations
8.Stressfrom aseriousmedi calil
l
ness
4.Visual Hal
lucinations
9.Sideeffectofmedi cation
Depressi
on:
-Isamooddi sor
dert
hat
Si
gn&sy
mpt
omsofanxi
ety
causesapersi
stentf
eel
i
ngofsadness
andlossofi
nter
est. 1.I
ncreasedhear tr
ate
Causesofdepr
essi
on 2.Rapidbr eathi
ng
3.Restlessness
1.Puberty(MaleandFemal e)
4.Troubleconcent r
at i
ng
2.Premenst r
ualSyndromeand
5.Diff
icult
yf al
li
ngasl eep
Premenst r
ualDysphoricDisorder
3.Pregnancy 6.Feeli
ngf aintordizzy
4.Post-Part
um Depression 7.Shortnessofbr eat
5.Peri
menopauseandMenopause 8.Drymout h
6.Andropauseinmen, l
aterinli
fewhen 9.Sweat i
ng
test
osteronelevel
schange 10.Rest l
essness

44
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Postpartum psychosi
s:-Alsoknownas Schi
zophreni
a:-I
saser
iousmental
PuerperalpsychosisandPostnatal di
sorderi
nwhichpeopl
eint
erpr
etreal
i
ty
psychosis,t
hisconditi
onistheleast abnormal
ly.
commonbutal sothemostsev ereand
Causesofschi
zophr
eni
a
dangerousoft hepostpar
tum mood
di
sorders. 1.Genet i
cs
2.St
r uctur
alchangesinthebrai
n
Sign&sympt
omsofpost
par
tum
3.Chemi calchangesint
hebrain
psychosi
s
4.Pregnancyorbi r
thcompli
cati
ons
1.Del
usions 5.Childhoodtrauma
2.Confusedordi sorgani
zedt
hinki
ng 6.Prev i
ousdruguse
3.Hall
ucinations
Si
gn&sy
mpt
om ofschi
zophr
eni
a
4.Poorjudgment
5.Aggressivene 1.Delusi on
6.Anxiet
y 2.Halluci nati
ons
7.Depressionorextremesadness 3.Disor ganizedthinking
8.Hyperactivi
ty 4.Abnor mal motorbehav ior
9.Severemoodswi ngs 5.Negat i
v esympt omsi ncludes;
10.I
nsomni a 6.Negl ectper sonal hygiene
11.Restl
essness 7.Appeart olackemot ion
12.Paranoia 8.Doesn' tmakeey econt act
9.Doesn' tchangef aci
al expressi
ons
Causesofpost
par
tum psy
chosi
s
10.Loseofi nterestinev eryday
1.Aper sonal healthhist
oryofbipol
ar acti
vit
ies
di
sorderorschi zophreni
a
Posi
ti
vement
alheal
thhabi
ts
2.Aclosef ami l
ymembersuchasa
motherorsi sterwi thahistor
yof
1.Dev
elopi
ngt
heabi
l
ityt
ocopewi
th
postpartum psy chosisoranother
psychiatri
cill
ness st
ress
3.Discontinuedmoodst abi
li
zer
sand/or 2.Capaci
tyt
olov
e
anti
psy choti
cmedi cati
ons 3.Abi
l
ityt
ofaceandacceptr
eal
i
ty
4.Previousexper iencewi t
hpostpar
tum 4.Abi
l
ityt
ounder
standonesel
f
psychosisaf t
erpr egnancy
5.Adequat
erest
Ri
skf
act
orsofpost
par
tum psy
chosi
s 6.Adequat
enut
ri
ti
on

1.Bei
ngayoungteenmother 7.Adequat
esl
eep
2.Havi
ngyourf
ir
stbaby 8.Desi
ret
oinf
luencedeci
sion
3.Havi
ngCompli
cati
onsduri
ngdel
iv
ery 9.Av
oidr
eli
giousphant
asm
4.Havi
ngbabywit
hhealt
hcompli
cati
on 10.Regul
arexer
cise

45
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Causesofment
ali
l
lness 6.Provi
dingprevent
ivecurat
iveand
rehabi
l
itati
vesupportfort
hesick
1.Her edit
ar y
2.Ignorance Sti
gma:-Canbedefi
neasamar
k
3.Pov erty shameorsoci
aldi
sgrace.
4.Stress
5.Lossofj ob Stereotypes:-Tobel
iev
eunfai
rl
ythatal
l
6.Conf l
ict orthingswi t
haparti
cular
7.Divorce characteri
sti
csarethesame.
8.Unempl oyment
Ef
fect
sofst
igma&st
ereot
ype
9.Chr onicill
ness
10.Poornut ri
ti
on 1.Stigmat i
zationbyfri
ends&r el
ati
ves
11.Lossofj ob 2.Av oidi
ngpeopl ewhov ocal
12.OldAge 3.Inti
mi datingpeoplearoundhim
4.Wi thdrawal sy
ndrome
Suppor
tforcl
i
ent
sandfami
lyi
nthe
5.Lackoff ocus
homemanagementofment
all
yil
l
6.Suicidalat t
empt
1.I
dent ifyt
hei ndividualpot enti
alsoas 7.Insomni a
tohelpt odev elop&i mpr ovet hose
Addr
essst
igmahandcor
rectst
ereot
ype
2.Tor emov est igma&mi sconception
i
nthecommunit
y
agai
nstment al l
yill
3.Encour aget heindividualt obeself- 1.Getmentalheal
thtreat
mentneeded
motivatingandsel f-
rel
iant 2.Donotbeli
eveit
4.Encour ageposi tivethinking 3.Donothideaway
5.Enhancet ol eranceandunder standi
ng 4.Connectwit
hothers
amongi ndi
vidual s 5.I
t'
snotpersonal
6.I
mpr ovethenut r
iti
onal statusofthe 6.Youarenotyouril
l
ness
i
ndivi
dual
Pr
inci
plesofr
ehabi
li
tat
ionsofment
all
y
Rol
esoffamilyi
nthei
dent
if
icat
ionof i
ll
inthecommunity
mental
il
lness
1.Fundamentalfreedom &ri
ghts:-Thi
s
1.Identi
ficationofear l
ysigns& i
sconcernal l
personshavetherightto
sympt oms thebestavail
ablementalheal
thcare,
2.Creatingawar enessand whichshallbepartoftheheal
thand
understandi ngamongpeopl e social
caresystem.
3.Risi
ngf undandl ogist
icstoassess
thement al l
ysick 2.Protect
ionofminors:-Isaspecial
4.Organi zingadv ocacyforinf
luenci
ng careshouldbegivenwithinthe
i
nformat ionf orthesick purposesofthesepri
nciplesandwi t
hin
5.Prov i
dingr el
iefmat er
ialf
orthesick thecontextofdomesticlawr el
ati
ngto

46
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

t
hepr ot
ecti
onofmi norst oprot
ectthe restr
icti
veenv i
ronmentandwi ththe
r
ight
sofmi nors,
including,i
fnecessar
y, l
eastr estr
icti
veorintr
usivetr
eatment
t
heappoi nt
mentofaper sonal appropriat
et othepatient'
sheal
thneeds
r
epresentat
iveot
hert hanaf amil
y andt heneedt oprotectthephysi
cal
member . safetyofot her
s.

3.Lif
eint
hecommuni ty:-Everyperson 10.Medi cati
on:-Shallmeetthebest
withamental
ill
nessshallhavetheright heal
thneedsoft hepatient
,shallbe
toli
veandwork,asfaraspossible,
in gi
vent oapat i
entonlyfortherapeuticor
thecommunit
y. di
agnost icpurposesandshall neverbe
administeredasapuni shmentorf orthe
4.Determinati
onofment alil
l
ness:
-Isa convenienceofot her
s.
deter
mi nati
onthataper sonhasa
mental i
ll
nessshallbemadei n I
NTRODUCTI
ONTOPHARMACOLOGY
accordancewithinternati
onall
y
acceptedmedi calstandards. Pharmacology
:-I
sthescient
if
icst
udy
ofint
eract
ionbet
weendrugsandbody
5.Medi calexami nati
on: -Noperson ti
ssues.
shallbecompel l
edt oundergomedi cal
exami nati
onwi thav iewt odet
ermining Def
ini
ti
onst
erms
whetherornotheorshehasament al
Drugs:-Isasubstancesisusedasa
i
ll
nessexcepti naccor dancewit
ha
medication.Al
socandef i
neasa
procedureaut horizedbydomest icl
aw.
substancesthatprol
ongt hel
if
eofa
6.Confidenti
ali
ty:
-Istheri
ghtof pati
entwi t
hincur
abledisease.
confi
dent i
ali
tyofi
nfor
mation
concerningallper
sonstowthese Pharmacokinet i
cs:-Isdefi
nedas
Pri
nciplesapplyshal
lberespect
ed. digesti
on,dist
ribut
ion,
biotr
ansformation,absorpt
ionand
7.Roleofcommuni ty:
-Everypatient excreti
onofdr ugsinthebody .
shallhav
et heri
ghttobetreat
edand
caredfor,asfaraspossi
ble,i
nthe Pharmacodynami
c:-I
sdefi
nedas
communi tyinwhichheorshelives. bi
ologi
calandphy
siol
ogi
calef
fect
sof
dr
ugsinthebody.
8.Standardofcare:-Everypati
entshal
l
havether i
ghttorecei
vesuchheal t
hand Idi
osyncr
asies: -I
sahy pert
ensi
ve
soci
al careasisappropri
atetohisor reacti
onexperiencedbyani ndi
vi
dual
herhealthneeds,andisentit
ledtocare aftert
heuseofdr ugswhichisnot
andtreatmentinaccordancewi t
hthe basedonov erdose.
samest andardsasotherill
persons.
Pharmacovigi
lance:-Istheassessment
,
9.Tr
eatment
:-Ever
ypat
ientshal
lhav
e underst
andingandpr eventi
onof
ther
ightt
obetreat
edi
ntheleast adver
seeffectsreacti
on.

47
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

I
mpor
tanceofphar
macol
ogy sodium,chl
ori
de,
calcium,ironetc.ar
e
producedfr
om mineralssource.
1.ItenablesCHEW' st ohav eadequat e
knowledgeofdr ugsi nt hest anding 4.Micro-organi
smssour ce:-Thesear e
orders drugsproducedf r
om Micro-organisms,
2.Itenablest heCHEW' stoappr eciate suchdrugsar eanti
microbialagents.
drugspr escri
pt i
onusi nggenet i
cnames Penici
l
lin,stapr
omy ci
ntetracycl
ineetc.
3.Iti
mpr ovest hepr act i
ti
oner
knowledgeondr ugsi nteraction 5.Syntheti
csour ce:-Thesear edrugs
4.Itexposesv ari
ousmet hodof producedf r
om simpl ercomponent sof
i
rrati
onal drugsuse naturalsubstancesinphar maceutical
s.
5.Iti
mpr ovesknowl edgeon E.g.paracetamol,l
exot an,
Diazepam etc.
managementofacci dentt hatcanr esult Classi
fi
cat
ionofdr
ugsbasedont
hei
r
fr
om dr uguseE. g.ov erdose. formsandfunct
ion
Expl
ainnamesofdr
ugs 1.Byt hesubst ancef rom whi chtheyare
animals, synt
het i
cet c.
1.Chemical
name:
-Thisexpl
aint
he
2.Byt hewayt heyar edispensedor
exactnameoft
hedrugs
proscribedE.g.bl i
sters,rol
letc.
2.Geneti
cname:-I
stheoff
ici
almedi
cal 3.Byt hef ormt hetakeE. g.tablet
,gas,
nameassignedt
othedrugbythe l
iquid,capsuleset c.
counci
l. 4.Byt hewayt heyar eadmi nist
eredE.g.
Oral,i
njectable,inhalati
on,gener i
cor
3.Brandname:-Thi
sisanamegi vent
o brandnames.
thedrugsbyt
hemanuf act
urert
hatsel
l
s 5.Byt hewayactagai nstdiseaseor
thedrugs. disorders.
Var
ioussour
cesofdr
ugs Anticonv
ulsantE.
g.Diazepam 5mg,
Phenobabit
on30mg, Carbamazepi
ne
1.Vegetablesource: -Istheoldest
200mg.
sourceofdrugs, i
tincludesthepl ant
productli
keleaves,root sseeds,flower
s, Antidot
esE.g.Act
ivatedchar
coal
1mg
fr
uitsandbark.Digoxi n&Qui nineare powder,At
ropinei
njecti
on600mg,
drugsfrom plantsour ce. Loxon.
2.Animalsource:
-Isamanydr ugs Antii
nfect
iveE.g.Amoxicil
l
incap
especi
all
ythoseinform ofvaccines, 250/500mg, Chropheni
colcap250mg,
hormonesandser um ar
ef r
om ani mal Arhemeterl
umef antri
netab40/120mg.
ori
gin.
Antimal
ari
aE.gAmodi
aquine,
3.Miner
alssour
ce:-Thesearedr
ugs Art
esunat
etabs50mg-inj
.60/120,
suchasferr
ousgluconat
e,pot
assi
um, Chl
oroqui
netab100mg

48
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Antibact
eri
alE.g.Gent
amicini
nject
ion St
epsf
oror
der
ing
80mg, Ampi
cloxcaps500mg,
Ery
thromyci
nt abs250/500mg. 1.Knowhowof tentheorder
2.Listthedrugsneeded
Hormones&synthet
icE.g.Condom, 3.Calculatetheamountofdr ugsneeded
Sper
micidal
,Or
alcontr
acepti
vepil
l
s. i
nt hatorderingint
erval
4.Fil
lrequest i
ngform according
Gast
roi
ntest
inal
E.g.Hy osi
netab.10mg,
5.Calculatethecostofdr ugsordered
MMT500mg, Or
s,Bisacodyl5mg.
6.Forwar dmoneyf ordrugsor dered
Cardi
ovasculardrugsE.g.Met
hyl
dopa wit
hr equisit
ionform
tab250mg, Bentr
oflui
zi
detab5mg
St
epofst
orki
ng
Pain:
-Isagener
alter
mt hatdescr
ibes
1.Receivethedrugs
uncomfor
tabl
esensati
onsinthebody.
2.Signar ecei
ptfordrugsreceiv
ed
Ty
pesofpai
n 3.Compl etetheledgerbasi
c
accordingly
1.Acutepain 4.Storedrugsasappr opri
ate
2.Chronicpain 5.Usef ir
stexpir
esandf i
rstsyst
em
3.Neuropathi
cpain
4.Nocicepti
vepain ESSENTI
ALMEDI
CINE
5.Radicul
arpain
Essenti
almedici
ne:
-Aret
hosedrugs
Analgesi
corpainki
ll
er:
-Isanymember thatsati
sfyt
hebasi
cheal
thneedofthe
ofthegroupofdrugsusedtoachi
eve majorit
yofpopul
ati
on.
analgesi
a,r
eli
effr
om pain. Managementofessent ialmedi ci
ne: -I
s
Narcotic: -I
sasubst anceusedtotreat theessentialofdrugst
hatar esafe,
moder atet oseverepain.Narcot
icsare eff
ecti
veandaf f
ordabl
ewhi chsatisfy
l
ikeopiat essuchasmor phi
neand thehealt
hcar eneedofmaj orit
yand
codeine, butarenotmadef rom opium. coverprevalentdi
seaseandcondi tions
Theybi ndt oopioi
dreceptorsinthe ofthepeopl e.
centr
al ner v
oussy st
em.Nar coti
csare Suppl ysystem:-I
st hesuppl
iesof
nowcal ledopioids. medi cineandmedi calsuppl
i
esmustbe
Non-narcoticanalgesi c:-Isa reputabletherear
emanyopt i
ons
av ai
l
abl etheit
emsmaybepar ched
medicationsmaybebenef ici
ali
n
from pr i
vateorev
eni nter
nat
ional
helpi
ngt ocontrol chronicpain.Some
supplies.
examplesofnon- opioidpai n
medicationsincludeov erthecounter Obj
ect
iveof(
NEDF)
medicationssuchasTy l
enol
(acet
ami nophen) ,Mot ri
n( i
buprof
en), 1.Tomakeessent
ialdr
ugseasi
ly
andAleve( naproxen) . avai
l
abl
etotheenti
repopul
ati
onont
he

49
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

condi t
ionbasis vi
i.I
ndomet haci
nCapsul es,25mg;
2.Tousedr ugst hataresafeand suppositor
ies100mg
effecti
v e vi
ii
.Mor phi
neTabl ets,
10mgI nj
ect
ion,
3.Tor educet hecostofdr ugst hrougha 10mgi n1ml
cent r
al bul
kpur chasingsystem using i
x.Paracetamol Tablets,
500mgSyrup
genet i
cnames 125mg/ ml
4.Topur chaseonl ynecessarydr ugsf
or
x.Pethi
dineInj
ection,50mg/ml
thesy stem thusser vi
ngforeign
100mg/ 2ml
exchange
5.Topr ovi
det r
ainingforimpr oved 2.Ant
idot
es
drugsmanagementandski l
lst ohealt
h
wor kers i
.Acet ylcysteineInjection,200mg/ ml i
n
10ml ampoul e
St
epsf
ormanagementof(
EDRF) i
i.AtropineInjecti
on, 1mg( sulphate)in
1.Select
ingfr
om essent
ialdr
ugsli
st 1ml ampoul e
thoseneededatt
hespeci f
icheal
thuni
t i
ii.Calci
um gl uconateI njecti
on,
2.Orderi
ngthedr
ugs 100mg/ ml i
n10- ml ampoul e
3.Receivi
ngandstori
ngthedrugs i
v .Charcoal,activ
atedPowder ,tablet
4.Issui
ngandusingthedrugs v.NaloxoneI njecti
on, 400mcg
(hydrochlori
de)in1ml ampoul e
Nat
ional
essent
ial
medi
cinel
i
st
vi.ObidoxinechlorideI njecti
on,
1.Anal
gesic 250mg/ ml
2.Anti
dotes
3.Ant
iconv
ulsant
s/ant
iepi
l
ept
ics
3.Anti
convulsant
s
4.Anti
infecti
ve i
.Carbamazepi neTabl et ,
scor ed,100mg,
5.Anti
bact er
ial 200mg
6.Anti
mal ari
a
i
i.ChlormethiazoleCapsul e,25mg
7.Anti
mi grai
ne
i
ii
.Chlorpromazi neTabl ets,25mg,
8.Anti
acid
100mg; inj
ection50mg/ 2ml
Nat
ional
essent
ial
medi
cinel
i
stwi
thE.
g i
v.Diazepam I nject
ion, 5mg/ ml i
n2-ml
ampoul e
1.Anal
gesi
c
v.Haloperi
dol Tablet,5mg; injecti
on,
i
.Acetylsali
cyli
cacidTabl et
s,300mg 5mg/ ml
i
i
.Al l
opurinolTabl
et, 100mg vi
.Phenobar bitoneTabl et,15-100mg;
i
i
i.ColchicineTablets, 500mg eli
xi
r,15mg/ 5m
i
v.Diamor phinepl
us
4.Ant
ii
nfect
ive
v
.Di cl
ofenacTablet, 25mg, 50mg;
i
njecti
on75mg/ 3ml i
.Mebendazol
eTabl
et(
chewabl
e),
v
i.IbuprofenTablets, 200mg, 400mg 100mg,500mg

50
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

i
i.Ni
closami
deTabl
et(
chewabl
e), vi
ii
.Pr
opr
anol
olTabl
et,
20mg,
40mg,
500mg 80mg

5.Ant
ibact
eri
a 8.Ant
aci
d

I
.Amoxy cil
li
nCapsul eort ablet, 250mg, i
.Al umi ni um hy droxideTabl
et,
500mg;
500mg oral suspensi on,320mg/ 5ml
i
i.Ampi cil
li
nPowderf orinjection, i
i.Ci met idineTabl et,200mg,400mg,
500mg, 1g(sodium salt)inv ial i
nj ection
i
ii.Benzy l
penici
lli
nPowderf ori njecti
on, i
ii.Magnesi um hy droxi
deOral
600mg( =1mi ll
ionIU),3g(=5mi ll
ionIU) suspensi on, equivalentto550mg
(sodium orpot assium salt
) magnesi um oxi de/10ml
i
v .Cloxacil
li
nCapsul e,250mg; sy rup i
v .Omepr azoleCapsul e,20mg
125mg/ ml;i
njection,
250mg/ ml v.Rani t
idineTabl et,150mg
v.Flucloxaci
ll
inCapsul e,oralsol ution, (hy drochl ori
de)
i
nj ecti
on
Met
hodusei
nquant
if
icat
ion
6.Ant
imal
ari
a
1.Morbidi
tyandst andardtr
eatment
I
.Chl oroquineTabl et
,100mg, 150mg 2.Cal
culatet hequant i
tyofdrugsto
i
i.Doxy cycli
neCapsul eort abl
et,100mg tr
eatanill
ness
(hydrochloride) 3.Addthet otaldrugsuseddur ingt
he
i
ii.Pri
maqui neTabl et,
7.5mg, 15mg( as order
inginterval
4.Epi
demi ology/populati
onbase
diphosphat e)
i
v .Pyrimethami neTablet,
25mg
Drugrevolvi
ngf ound:-I
stheprovi
sion
v.QuinineTabl et,300mg( asbisulphat
e
madebyFMOH, WHOandWBNKt o
orsulphat e);i
nj ecti
on300mg
ensureconstantav ai
l
abil
it
yofessenti
al
vi.Sulphadoxi ne+py r
imethamineTablet,
drugswi t
hinthehealthcar
edeli
very
500mg+25mg( Fansi
dar)
system aswel l
asgenuinedrugs.
7.Ant
imi
grai
ne
St
epf
orset
ti
ngupD.
R.F
i
.Acet ylsali
cyl
icacidTabl et,300mg
1.Discusswi t
hdistri
ctorCDCthe
i
i.Ami tr
iptyli
neTabl et,10mg, 25mg
potent i
alsofDRF
i
ii
.Car bamazepi neTabl et
, scored,
2.Listessent i
aldrugsrequi
redforthe
100mg, 200mg
healthuni t
i
v.Dihy droergotamineI njection,1mg/
ml
3.Det erminehowof t
entoorder
v.Ergotami ne+caf feineTabl et
,
4.Calculatetheamountofeachdr ugs
1mg+100mg
neededi nt heorderi
nginter
val
vi
.Ibupr ofenTabl et
,200mg, 400mg
5.Costoft hedrugstoordered
vi
i.Paracet amol Tablet,500mg

51
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Adv
ant
ageofD.
R.F ENVI
RONMENTALHEALTH

1.Encour agecommuni t
yinvolv
ement Environment
:-I
sreferstothe
andpar t
icipation surroundi
ngorcondit
ionsi
nwhi cha
2.DRFi ssel f-
account
ing person,pl
ant
soranimal sl
i
v esor
3.Discour ageirr
ati
onaldrugsuse operate.
4.Makedr ugsmanagementt obe
accountabl e Cl
assi
fi
cat
ionofenv
ironment
5.Essential dr
ugsareaffordabl
e 1.Physicalenvi
ronment
ReasonwhyD.
R.Ff
ail 2.Bi
ologicalenvir
onment
3.Socialenvi
ronment
1.Underbudgeti
ng
2.I
neffecti
vecostr
ecov
ery Physi
calenvi
ronment :-Referstoallt
he
3.Pri
ceincr
ease non-l
i
vingornaturalresourcesthat
4.Poormanagement provi
desorabioti
cf actor
s.E.g.Land,Ai
r,
5.Poorori
ginat
edDRFstaf
f Water,Bui
l
dingset c.

Essent
ial
medi
cinel
i
stf
oll
owi
ng Biol
ogicalenvir
onment:-Refer
stothe
naturall
i
vingorbioti
cfactor
sinthe
1.Geneti
cname envir
onment .E.
g.Plant
,Humanbeing,
2.Dosage Animals,Insect
setc.
3.I
ndicat
ionandcont
ra-
indi
cat
ion
Socialenvi
ronment:-Referstot
he
1.ParacetamolTAB500m i
mmedi at
esocialsett
inginthepeopl
e
i
.Indi
cat i
on:-Muscleache,f
everet
c. l
iveorinwhi chsomethinghappensor
i
i.Contrai
ndicat
ion:
-Liverdi
seaseetc. develop.E.
g.Cultur
e,Income,Tradi
ti
on
etc.
2.Erythromycin250/500mg
Envir
onmental:-Isabranchofpubl
ic
i
.Indication:
-Dipht
heria,
conj
unct
ivi
ti
s
healt
hthati
sconcer nedwithal
laspect
s
etc.
ofthenatur
al andbuil
denvir
onment
i
i.Cont r
aindi
cati
on:-Hist
oryofal
l
ergi
es, thatmayaffecthumanl i
fe.
pregnancyet c.
Env i
ronmentalheal
th:-I
sdef
inedas
3.Fluconazole50/150/200mg thoseaspectsofhumanhealthand
i
.Indicati
on:-Vaginalcandi
diasi
set
c. diseasethatar
edet er
minebyfact
orsi
n
i
i.Contrai
ndicati
on:-Pregnancy, theenv i
ronment.
hypersensit
ivi
tyreact
ionetc.
Component
soft
heenv
ironment
4.Pharmacovigi
l
ance:-Ist
he
1.Provi
sionofwholesomeand
monitor
ingoftheprocessofdr
ugi
ntake,
adequatewatersupply
metaboli
sm andexcreti
on.
2.Contr
ol ofi
nsect
s,vect
or&otherpest

52
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Foodhy giene manydi

ff
erentchemi
cal
pol
l
utant
s.
4.Contr
ol excessi
veheatandcold
5.Contr
ol ofairpol
lut
ion Airpol
lut
ion:-Canbecausedbygases
6.Contr
ol ofcommuni cabl
edisease orsoli
dparti
culat
es.
7.Medicalwast emanagement& Soi
lpol
lut
ion:
-Isl
i
nkedt
ogr
oundwat
er
di
sposal pol
l
uti
on.
8.Prov
isionofgoodhousi ng
9.Contr
ol ofnoiseandradiat
ion Sour
cesofWat
er,
airandsoi
lpol
l
uti
on
10.Controlofwaterpoll
uti
on
Sourcesofwat erpol l
ution:-Isthe
Envi
ronmentalheal
thhazard:-Istheset sewage( WasteWat er)Sewagei s
ofeventwhichhasthepotenti
al t
o anothernamef orwast ewat erfrom
thr
eatenthesurr
oundingnatural domest i
candindust ri
al processes.
envi
ronmentandaffectpeoplehealth. Agri
cultur
alPolluti
on.Theagr icult
ure
i
ndustrycover
s76%oft helandar eaof
Classi
fi
cat
ionofenv
ironmentheal
th
Engl
andandWal es,whichi ncludes;Oil
hazard
Poll
uti
on,Radioact i
veSubst ances,Riv
er
1.Chemicalhazar
d:-I
sanysubstance dumpingandMar i
neDumpi ng.
thatcanharmtopeopleE.g.Aci
d,
Sourcesofsoi lpoll
ution: -I
scomes
Asbestosi
s,Lead,
Hydrogenetc.
from dif
ferentsourcesi ncludi ng
2.Physi
calhazard:-Arecondit
ionsthat agri
cultureandani mal husbandr y.Some
thr
eatenourphysicalsaf
ety.E.
g.Fir
e, oftheagr i
cultur
alpract i
cesl eadt osoil
Coldandhot,Noise,Radi
ati
onet c. poll
ution.Theyareani mal wast es,use
oflongl i
vedpestici
des, her bicides,
3.Biologicalhazard:-Isabiologi
cal fungi
cides, nematocides, etc.f erti
li
zer
s
substancet hatposesat hr
eattothe andsomeagr i
cul
tural practices.
healthofl i
vi
ngor ganisms,primari
ly
humans.Thi scouldincludeasampl eof Sourcesofai rpoll
ution:-Thisi scause
ami croorganism, vi
rusortoxinthatcan bysolidandl iqui
dpar t
iclesandcer t
ain
adverselyaffecthumanheal t
h. gasest hataresuspendedi nt heair.
Thesepar ti
clesandgasescancome
4.Socio-cult
uralhazard:-Aremost fr
om carandt ruckexhaust ,factor
ies,
rel
evantt oyou;Mostsoci o-cult
ural
risk dust,poll
en,mol dspor es,volcanoesand
fact
orsf all
intooneoft hreecategori
es; wil
dfires.Thesol i
dandl iquidpar t
icl
es
Demogr aphic,Social
/Cultur
al or suspendedi nourai rarecalledaer osol
s.
Beli
efs/Atti
tudes.
Ef
fectofH2O,
Air&Soi
lpol
l
uti
on
Wat erPol
luti
on: -Canbecont aminated
byphy si
calpoll
ut ant
s(soli
dmat eri
al), Eff
ectofwaterpoll
uti
on:-I
sthe
biol
ogicalpol
lutants(suchasbact er
ia contami
natedwatercanharborbacter
ia,
thatcausewat erbornediseases)
,and suchasthoseresponsi
blefordi
arr
hea,

53
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

chol
era,dysentery,
typhoid,hepati
ti
sA, suspendedi
mpurit
iesandsalt
s.I
tis
andpoli
o.Accor di
ngt otheUN, every cl
ear,col
our
lessandodour
less.
year
,approximately297,000childr
en
underfi
vedief r
om diseasesl i
nkedto Met
hodofwat
erpur
if
icat
ion
poorsanit
ation,poorhygiene,orunsafe 1.Coll
ection
dri
nki
ngwat er. 2.ScreeningandSt r
aini
ng
Ef
fectofai
rpol
l
uti
on 3.Chemi caladdit
ion
4.Coagul at
ionandFloccul
ati
on
1.GlobalWarming 5.Sediment at
ionandClari
fi
cati
on
2.Cli
mateChange 6.Fi
ltr
ation
3.AcidRain 7.Disi
nfection
4.Smogef fect 8.Storage
5.Deteri
orati
onoffi
elds 9.Distr
ibuti
on
6.Exti
ncti
onofanimal speci
es
7.Respir
atoryheal
thproblems Adv
ant
ageofwat
erpur
if
icat
ion
8.Deteri
orati
oninbui
ldingmater
ial
s
1.Waterpuri
fi
cati
oncanpr
otectagai
nst
Effectofsoi l
pol l
uti
on:-Ist heof t
en har
mful or
ganisms
causesoi l
barrenness,offensiveodour 2.Waterpuri
fi
cati
onremov
estoxic
etc.Ther esult
antef f
ectcoul dimpacton metal
s
soil,airandwat erquali
tyaswel las Di
sadv
ant
ageofwat
erpur
if
icat
ion
humant hatresideorwor kcl oset othe
pollutedareaov eraperiodoft i
me 1.Wat erpur
if
icat
ionmaynotremove
dependi ngont hephy si
cal natureoft he pesti
cides
pollutantaswel lasit
sconcent rati
on. 2.Wat erpur
if
icat
ionr
equi
reregul
ar
maintenance
Sour
cesofwast
ewat
eri
nacommuni
ty
Wastewat er:
-Isthepoll
utedfor
m of
Communi t
ywat ersy st
emsobt ai
nwat er watergeneratedfr
om rai
nwaterrunof
f
from twosour ces; surf
acewat erand andhumanact i
vi
ti
es.I
tisalsocall
ed
groundwat er.Peopl eusesur faceand sewage.
groundwat erev erydayf orav ari
etyof
purposes,includingdr i
nking,cooking, Ty
pesofwast
ewat
erorsewage
andbasi chygiene, inadditi
ont o
recreati
onal,agricult
ural,
andi ndustri
al 1.Domesticsewage
acti
v i
ti
es. 2.I
ndust
rialsewage
3.St
orm sewage
Portabl
eswat er
:-I
sthewat erwhi
chi
s
Wastewatercomes: -Thesearef rom
fi
tforhumanconsumpt i
onanddri
nki
ng
purposes.Charact
eri
sti
cs:Wateri
sfr
ee ordi
nar
ylivi
ngpr ocesses;bat
hing,toil
et
fr
om harmf ul
bacteri
a,germs, fl
ushi
ng,laundry
, di
shwashing,etc.It
comesfrom resi
dent i
alanddomest ic

54
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

sources.Commer cialwastewat er Methodofsol

i
dwast
edi
sposal
ina
comesf rom non-
domest i
csour ces, communit
y
suchasbeaut ysalon,taxi
dermy ,
furni
tur
er ef
ini
shi
ng, musicalinstrument 1.Burni
ng
cleani
ng,orautobodyr epairshops. 2.Compost i
ng
3.Sanit
arylandfi
l
ls
Effectofwast ewat er:-Thisisont he
4.Controlt
ippi
ng
env i
ronmentiswheni tcont r
ibutes
towar dthecontami nationand 5.I
ncinerat
ion,et
c.
destructionofnaturalhabi t
atsandt he
Techni
quesofexcr
etadi
sposal
inar
ural
wildl
ifethatli
veint hosehabi tatsby
exposi ngthem t
ohar mf ul
chemi cals community
thatwoul dotherwisenotbepr esent
1.Opendef ecati
on
overt henatural
cour seoft hings.
2.Trenchlatri
ne
Way
stopr
eventwat
erpol
l
uti
on 3.Pi
tlatri
nes
4.Ventil
atedImprovedpi
tlat
ri
ne
1.Pi
ckupl
i
tterandt
hrowi
tawayi
na 5.Aquapr iv
y,etc.
gar
bagecan
2.Bl
oworsweepf
ert
il
izerbackont
othe Identi
fi
cat
ionofhouseholdand
communi t
yar t
hropodsandvect
ors
gr
assi
fitget
sont
opav
edar
eas.Don'
t
effectofi
njur
iousart
hropodsonhuman
putf
ert
il
izeront
hegr
assr
ightbef
orei
t
heal
th
r
ains.Thechemi
cal
swi
l
lwashi
nto
st
orm dr
ainsandwat
erway
s 1.Di
rectl
yinj
uri
ousar
thr
opods
3.Mul
chorcompostgr
assory
ard 2.I
ndir
ectl
yinj
uri
ousart
hropods
wast
e.Or
,leav
eiti
nyoury
ardi
fyou
I
nsect
ici
descanbecl
assi
fi
edi
ntot
wo
can'
tcompost
.Don'
tbl
owl
eav
esi
nto
maj
orgr
oups
t
hest
reet
.Thi
scl
ogsanddamages
st
orm dr
ains 1.Systemicinsecti
cides:-Thi
siswhich
4.Washy
ourcaroroutdoorequi
pment haveresidualorlongterm act
ivi
ty.
wher
eitcanf
lowt
oagr
avel
orgr
assy 2.Cont
acti
nsect
ici
des:
-Iswhi
chhav
e
ar
eai
nst
eadofast
reet noresi
dual
acti
vi
ty.
5.Don'
tpoury
ourmot
oroi
ldownt
he
st
orm dr
ain.Takei
ttot
henear
estaut
o Met
hodsofv
ect
orcont
rol

par
tsst
ore.I
t'
sfr
ee! 1.Bi
ologi
cal cont
rol
6.Nev
ercl
eanupaspi
l
lbyhosi
ngi
tint
o 2.Mechanicalcontr
ol
ast
orm dr
ain 3.Chemicalcontr
ol

55
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Basi
cfoodgr
oups 3.Ser
ving
4.Sel
l
ing
1.Breads, cereals,ri
ce,pasta,noodl
es
andot hergr ai
ns Pr
inci
pleoff
oodpr
otect
ion
2.Veget ablesandl egumes
1.Foodtofood
3.Fruit
2.Handstofood
4.Milk,yoghur t
, cheeseand/ or
3.Equi
pmenttofood
al
ternatives
5.Leanmeat ,
fish,poul
try,eggs,nut
s Regulat
oryagenci
es:-Ar
ethemeansby
andlegumes whichimplementsl
awsenactedbyt
he
l
egisl
ature.
Foodsour ces:-Thisisthemostoft he
foodhasi t
sorigininplant
s.Somef ood Funct
ionofr
egul
ator
yagenci
es
i
sobt aineddi r
ectlyfr
om plants;butev en
animalst hatareusedasf oodsour ces 1.Theyi
mplementl
aws
areraisedbyf eedingthem foodder ived 2.Theyenf
orcel
aws
from plants.Cerealgraini
sast aple
HEALTHMANAGEMEMTI
NFORMATI
ON
foodthatpr ovidesmor efoodener gy
worldwidet hananyot hertypeofcr op. HealthInfor
mat onManagementSyst
i em:-Isa
pl
annedsy stem ofcol lect
ing,
Foodbonedi seases: -Thisisill
ness
processing,storing,disseminati
ngand
causedbyconsumi ngcontami nated
usingheal t
hr el
at edinformati
ont ocarr
y
foodsorbev erages.Manydi fferent
outfuntionsmanagement .
disease-causingmi cr
obesorpat hogens
cancont ami natef oods,
sot herear e I
mpor
tanceofHI
MS
manydi f
ferenttypesoff oodbor ne
i
llnesses.Mostf oodbornediseasesar e 1.Itpr ovi
desinformat ionf orassessi ng
i
nf ecti
onscausedbyav ariet
yof thest ateofheal t
hoft hepopul ation
bact er
ia,vi
ruses, andparasit
es. 2.Itpr ovi
deinformat iont omanaget he
healthcar esystem
Foodpoi
soni
ng:-I
stheresul
tof 3.Itpr ovi
deinformat iont oi dent i
fy
chemi
cal
sortoxi
nsfoundinthef
ood. maj orhealthproblem
4.Itpr ovi
deinformat iont omoni t
orthe
Foodsanitat
ion:-Ref
erstopubli
c progr esstowardsst ar tedgoal s
heal
thconditi
onsrel
atedtocl
ean 5.Itpr oduceandv alidat est andor
dri
nki
ngwat erandadequatet
reatment disseddat acollecti
onf orm.
anddisposalofhumanexcret
aand 6.Itpr eparedanddessi minat edpr ot
ocol
sewage. forthecol l
ecti
ngdat a
Pr
inci
plesoff
oodsaf
ety&f
oodhy
giene 7.Pr omot i
ng&mai ntai ningHeal t
h
8.Pr eventi
ngandmanagi ngdi sease
1.Handl
i
ng 9.Reduci ngunnecessar ydi sabili
ty
2.Pr
oducing 10.Reduci ngpr emat uredeat h

56
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Moni t
oring&ev al
uation:-I
stheperi
odi
c Ty
pesofheal
thi
ndi
cat
or
acti
vityduringaprograms
Implement ati
onandateachper iod, 1.Healthpoli
cyi ndi
cator
dif
ferentinformat
ionar ecol
lect
ed, 2.Healthstat
usi ndicat
or
coll
atedandanal ysed. 3.Provisi
onuti
lizati
onofHeal t
hcar
e
i
ndicator
Monit
ori
ng:-I
sar
outi
neassessmentof
ongoi
ngprogr
amssuchasPHCservice. 4.Int
eresteddiseasesur v
eil
l
anceand
responseindi
cat ors
Eval
uati
on:-Istheper
iodi
cassessment
ofover
allachi
evement. Heal
thst
atusi
ndi
cat
ors

Component
sofM &E 1.Lowbirthwei
ght
2.Highbloodpr
essur
e
1.Objecti
ves
2.Goals 3.Diabet
es
3.I
ndicators 4.Asthma
4.Resources 5.Cancer
5.Feedback 6.Obesit
y
6.I
nterventi
on
Usesofheal
thi
ndi
cat
or
I
mpor
tanceofM &E
1.Tomonitort
rends
1.Enhancedeci si
onmaki ng 2.Toassessneeds
2.Itprovidesinformat iononwhat
3.Toassesseff
ectofi
nter
vent
ion
servi
cesar ebeingpr ovided
4.Toassesspoli
cyi
mpact
3.Demonst r
atewhathasbeen
accompl i
shed Typesofrecor
d/dat
acol
l
ect
ion
4.Itserveasaney eopeneraboutt he regi
ster
satall
level
s
i
nterventionsthatwor ked
5.Itassessest hecostef fect
ivenessof Pr
imar
yheal
thcar
elev
els
aninterventi
onst rategy
6.Itshowsi fact i
vi
tiesar edir
ected 1.Chi
l
dheal
thcar
e
towardst hespeci f
iedt argetgroupand 2.Tr
eat
mentcar
d
goal. 3.PHCPer
sonal
heal
thcar
eand

DataManagementCy cl
e:-I
saprocess t
reat
mentcar
d
thathel
psheal
thfaci
li
ti
escoll
ect
,st
ore
Communi
tyl
evel
andpreser
vedatafoundwit
hin
i
nformati
onsystems. 1.VVHW/TBASPictor
ialsrecordofwor
k
Heal
thindi
cator:-CanbeDefi
neasa 2.Communit
ydemogr aphicprofi
le
measureofachievementofpr
imar
y 3.Communit
yfamil
ypl anni
ngpr of
il
e
heal
thcareobjecti
ves. 4.Communit
yPregnancypr ofi
l
e

57
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Heal
thf
aci
l
ity
/wor
dlev
el Ty
pesofsuper
visi
on

1.Cl
ini
cmast
ercard 1.Di
rectsuper
visi
on
2.NHMSRegi
sterandf
ormat 2.I
ndir
ectsupervi
si
on

L.
G.Al
evel
s Qual
i
tiesofgoodsuper
visi
on

1.NHMSRegist
erandformat 1.Ever
yworkersi
scarri
edalong
2.Mont
hlysummaryfor
ms 2.Endur
ingandtr
aini
ngor i
ented
3.Str
esstheneedtoreachthetarget
Dist
ri
ctHIS:-I
sdescri
beasdocument 4.Useofavai
labl
eresources
datathatar
erout
inel
ycol
lect
edinal
l
publi
chealt
hfaci
l
iti
esinacount
ryusi
ng Rat
ional
eofsuper
visi
on
thesystem.
1.Toensureeffect
iveuseofresources
Dat
aent
ryandanal
ysi
susi
ngDHI
S 2.Toident
ifytr
aini
ngneedofst aff
3.Tomot i
vatesthesubordi
nated
Dataentryandanaly
ses: -Canbedone 4.Toensurequalit
ati
ve&quant i
tati
ve
i
ncust omersuserdevelopedtomimic workdeli
very
paperbasedforminor dertoeaset
he
processofdataentr
y. Supervi
sor ycheckli
st:-I
saformatused
toobtai
ni nfor
mat i
onneededfor
PRI
MARYHEALTHCAREMANAGEMENT i
nterv
entionorpl anni
ng.
Management
:-Istheprocessofgett
ing
Delegati
on:-Ist
heactofgi
vi
ng
thi
ngsdonet
hroughtheeffor
tofother
peopl
e. responsi
ble,aut
hor
it
yandsharing
accountabil
i
tyandsti
l
lmaint
aining
Pr
inci
plesofmanagement control
.
1.Mot i
vation El
ementofdel
egat
ion
2.Managementbyobj ecti
ves
3.Divi
sionofl abor 1.Responsibi
l
ity
4.Delegation 2.Author
ity
5.Superv i
sion 3.Resources
6.Unityofcommand 4.Accountabi
li
ty
7.Spanofcont r
ol
8.Learningbyexper i
ence Pr
obl
emsofdel
egat
ion
9.Eff
ectivecent r
ali
zat
ion
1.Inadequateauthor
it
y
Supervi
sion:-Canbedefinedasa 2.Lackofknowl edgeofthework
processofov er
seei
ngtheperfor
mance 3.Inadequateequipment/mater
ial
s
oftaskassignedtoindi
vi
dualorgroup 4.Inter
fer
encebyt hesuperi
oroffi
cer
ofpeople. fr
om t i
met oti
me

58
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Mer
it
sofdel
egat
ion 3.Anar
chi
cstyl
es:-Thi
siswherebyt
he
l
eaderhasnoauthor
it
yorcont
rol.
1.I
tbringgoodrelati
onshipbetween
workers Motivat
ion:
-Isthepr ocessof
2.I
tmakessuper v
isi
oneasier energi
zi
ngani ndi
vidualinordert
o
maintai
nbehav i
or.
3.I
tpromot esenseofbelonging
4.I
tserveasani ncenti
vesforthejuni
or Pr
inci
plesofmot
ivat
ion
workerstodevelopskil
l
s
5.Theleaderhast i
metomanageot her 1.Mot
ivat
ionbyachievement
2.Mot
ivat
ionbywor kenvir
onment
j
obs
3.Mot
ivat
ionbydelegati
on
6.I
ncreasedoutput
4.Mot
ivat
ionbyreward
Demer
it
sofdel
egat
ion 5.Mot
ivat
ionbyrecognit
ionofef
for
t
6.Mot
ivat
ionbypunishment
1.Wr ongdeci si
oncouldbemade
2.Thewor kmaynotbepr oper
lydone Mot
ivat
ionf
act
orsofPHCmanagement
3.I
ncompl etedelegat
ionbysuperior 1.Regularpaymentofsalary
off
icer 2.Regularpromoti
onofst af
f
4.Feart hatthesuperi
ormayl osehis 3.Staf
ftrai
ning
posit
ion 4.Encouragegoodrel
ationshipamong
5.Thej uniorworkersmayov erst
ephis staf
f
boundar y 5.Properatt
enti
ontostaffneeds

Leadershi
p:-I
stheactofbei
ngi
n Managementbyobject
ives:-I
sdefi
ned
contr
ol ov
eragrouppeopl
e. asaprocessbywhichP.H.C.managers
andt
heirsubordi
nat
esantici
patej
oint
ly
Ty
pesofl
eader
shi
p i
nsett
inggoals.

1.Naturall
eadershipE.g.monarchs Managementf
unct
ion
2.Vestedandappoi ntedleader
ship
1.Pl
anni ng
3.Technicall
eadership
2.Organizing
4.El
ectedleadership
3.Controlli
ng
St
yleofl
eader
shi
p 4.Dir
ecting
5.Reporting
1.Democrati
cstyl
es:
-Isal
lowesfor 6.Budget i
ng
expr
essionofmindandconsul
tant
ati
on 7.I
mpl ement at
ion
bysurbodi
nates. 8.Moni t
or i
ng&ev al
uat
ion
2.Autocr
aticst
yles:-Thi
siswhereby Heal
thpl
anni
ng:-I
stheprocessof
thel
eaderdoesnothi sbusi
nesshard usi
nginf
ormati
ongather
edf r
om t
he
handedwithoutcarr
ing. Communityt
oprovi
dewor kabl
e

59
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

solut
ionsfori
dent
if
yHeal
thneedand care
probl
em inthecommuni
ty. 4.Toensureproperuseofr esources
St
epi
nvol
vedi
nheal
thpl
anni
ng 5.Enablesstaf
fenjoytheirwork
6.Encouragespeci
alizat
ion
1.I
dent i
fytheheal
thproblem 7.Remov econfusi
onandst ress
2.Selecti
ngpri
orit
yprobl
ems i
nvolvedinthepati
entmov i
ngupand
3.Setti
ngobjecti
ves down
4.Antici
patepossibl
eobstruct
s
5.Providepossi
blesolut
ion PHCmanagementst
ruct
uresatv
ari
ous
6.Writethehealt
hplan l
evel
s
Thoset
obei
nvol
vedi
npl
anni
ng 1.Vil
lagedevelopmentcommi t
tee
1.Themember sofdistri
ct 2.Thewar ddev elopmentcommi t
tee
2.Thehealt
hwor kers 3.LGAdepar tment /techni
calcommi t
tee
3.Communi t
yleaders 4.StatePHCdev elopmentcommi ttee
4.Non-gov
ernment alor
gani
zati
on 5.NationalPHCdev elopmentagency
operat
ingi
nthear ea
M³ofmanagement
5.PHCmanagementcommi t
teeofLGA

Resour cesall
ocati
on:
-Isthe 1.Money
distr
ibuti
onofimplements,per
sonsor 2.Manpower
forcesneededt oachi
evethegoal
sofa 3.Mater
ial
parti
cularprogram.
USEOFSTANDI
NGORDER
Ty
peofr
esour
ces
Standingorders:-Theseareasetof
1.Humanresources specifi
cguideli
nesarrangedbyage
2.Mater
ial
resources group,diseaseconditi
ons,fi
ndi
ngs,
cl
inicalj
udgmentandact ions,which
Smoot hfl
owofcli
enttocl i
nic:
-Isthe
defi
nehowcl i
entsshouldbecaredf or
partofmanagementwhi chensure
properar
rangementssot hatseri
esof attheprimaryHeal t
hcarefacil
it
ies.
functi
onsareco-
ordi
natedi nspaceand Component
sofst
andi
ngor
der
s
ti
met oavoiddel
ays.
1.Pref
ace
Rat
ional
eforsmoot
hfl
ow 2.Tabl
eofcontent
3.Acknowl
edgement
1.Toreduceunnecessarywasteof
cli
ent
stime Obj
ect
ivesofst
andi
ngor
der
s
2.Togiveroom forpropervent
il
ati
onin
thecl
ini
c 1.Gi
vet
heheal
thwor
ker
slegal
3.Toensurethatcli
entsrecei
vequali
ty pr
otect
ioni
nthei
rpr
imar
yheal
thcar
e

60
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

assi
gnment Sect
ionoft
hest
andi
ngor
der
s
2.Pr
ovi
deasy
stemat
icf
ramewor
kfor 1. Sect
ion1 0-28day
sofl
i
fe
hi
stor
ytaki
ngandphy
sical
exami
nat
ion.
2. Sect
ion2 2mont
hs-5y
ear
s
3.Assi
stt
heheal
thwor
ker
stomanage
l
esscommon,
easi
l
yfor
got
tenandmor
e 3. Sect
ion3 6y
ear
s-12y
ear
s
ser
iouscondi
ti
ons.
4 Sect
ion4 Adol
escence13-
17y
rs
4.Mai
ntai
nhi
ghanduni
for
m st
andar
d
ofheal
thcar
e. 5 Sect
ion5 Adul
theal
th

5.Mi
nimi
zeunnecessar
y,of
tent
ime 6 Sect
ion6 El
der
ly(
65+)
expensi
veandt
imeconsumi
ng
l
abor
ator
yinv
est
igat
ion.
6.Pr
ovi
def
ramewor
kforev
aluat
ionof Howt
ouset
hest
andi
ngor
der
s
car
eandst
affper
for
mance.
1.Lookupt hecl ient’spr oblem or
Lay
outofst
andi
ngor
der
s compl ainti nthesect ionandt urntot he
appr opr iat epage.
1.Describti
on 2.Askal l quest ionsasl istedi nthe
2.Hist
or y histor ybox .
3.Exami nati
on 3.Per form al ltheexami nati
onasl i
sted
4.Fi
nding i
nt heappr opr i
atebox.
v i.Compl ai
nt 4.Assembl eandr ecor dal lsignifi
cant
v i
i.Examination i
nf ormat ion.I ncludingnegat iveones.
5.Cli
nicaljudgement 5.Fr om t hel istoff i
ndi ngs, selectt he
6.Acti
on boxcont ai ningal lsigni f
icantf inding
relatedt ot hepar ti
cul arclient.
7.Healtheducat i
on
6.Locat et heact i
oncor respondi ngt o
Quat
eoft
hest
andi
ngor
der thesel ect edgr oupoff indingsand
managet heCl ient'
scompl aintasst ated.
1.Compl
ainoft
hepat
ientE.
g. 7.Itmaybenecessar ytor efert omor e
Headache thanonesect ionoft heSt andi ngOr ders
2.CHO&CHEW St
andi
ngOr
der2015 i
nor dert ocompl etelymanageal lthe
probl emswi thwhi cht hecl i
entpr esent s.
edi
ti
on
8.Takeappr opr i
ateact i
onbasedon
3.PageNo.E.
g.255-257or257 yourf indi ngsandr ecor dint hehome-
4.ApendsE.
g.Desi
gnat
ion,
signat
ure& basedr ecor d( PHCChi l
dHeal thcar dor
dat
e greencar df orchildrenunder5y earsand
Per sonal Heal t
hRecor dory ell
owcar d

61
 Ba
sicOfCo
mmu
nit
yHe
alt
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act
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ion
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;Vo
lume1
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CHE
W20
22.

for>5y earsol d). appropriateinthecompl aintcolum

9.Whenev eracour seofmedi ci
neor samewi ththeexami nati
oncol um.
i
njectionisduet ofi
nish,revi
ewthe 11.Not ey ourcli
nical j
udgment
12.Locat etheact i
oncor respondingt
o
cli
ent'scondit i
on.Thisisagoodwayto
theselectedgr oupoff i
nding
carefull
yev aluateyourwor k.
13.Giveheal thtal
k/ education
10.Remembert ogivet hehome-based
14.Appendy oursignat ure,
recordcar dbackt othe desi
gnat ion/rankanddat e.
mot her/caregiverorcli
ent
Whysomest
udent
sfai
lst
andi
ngor
der
s
St
epi
ntheuseofst
andi
ngor
der
s
1.Unf ami li
aritywiththest
andingor der
1.Wel comepat ientwi t
hgr eet i
ngsand
2.Tensi on
offerseat
3.Inefficiencyandsl owness
2.Obt ainpat ientsper sonal dat ai fanew
4.Badpr esent ati
on
cardi st obei ssuedandpat ients
5.Forget t
ingofappendsi gnature,
compl ain.Quat et hest andi ngor der
designat ionanddat e
3.El i
city ourpat ientco- oper at i
onby
6.Wr ongf indingandmanagement
tel
linghi m/ hert haty ouar eusi ngt he
7.Wr onghi storytaki
ngandphy sical
standi ngor dert oassi sty oui nfindi ng
exami nat i
on
outt hepr edi sposi ngf act orst ohi s/her
8.Wr ongexpl anationofprocedureand
condi tion/ compl ai n
otherr elatedcomment s
4.Tur nt ot hecont entt of indoutt he
pagei nwhi cht hesect i
oni sl ocat ed Two-wayr efer
ralsystem: -Isan
5.Tur nt ot hepagei nwhi cht hesect ion
organizedtwo-wayr el
ationshipbet ween
i
sl ocat ed, scr oll throught hesy mpt oms
ahealthcareprov i
derorphy sicianina
tolocat edcompl ainofy ourpat ient
6.Mov et ot hepagei nwhi chy our healt
hcar efaci
lit
yatonel ev elofthe
patient scompl aini st reat healt
hcar esystem andanot herheal t
h
7.El i
citf ory ourpat ient sco- oper ation carepr ov
iderorphysicianinaheal th
andt henconducthi story carefacil
it
yatthesameorhi gherlevel
8.El i
citf ory oupat ient sco- oper ation oftheheal t
hcaresy stem.
thatt hest andi ngor derhasf urther
i
nst ruct edy out ocar ryoutan Referr
al:-I
sthetr
ansferof
exami nat i
ononhi m/ herusi ng responsi
bil
it
ytemporall
yorper
manent
ly
exami nat i
oni nstrument toanotherheal
thworkerfol
l
owedbya
9.Washy ourhandsanddr ypr epar e feedback.
yourt r
ayandcar r youtt heexami nat ion
byexpl ainingpur poseandpr ocedur eto Ty
pesofr
efer
ral
syst
em
thepat ientaswel laswr i
tingdowny our
fi
ndi ng/ resul ts. 1.Nor
mal pathway
10.Locat ey ourf i
ndi ngst hat 'smost 2.Emergencypat
hway

62
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

ACCOUNTI
NGSYSTEM I
NPHC Dif
fer
encebet
weencommer
cial
and
gover
nmentaccount
Account
ingsy stem i
nPHC: -I
sthe
syst
ematicprocedureforr
ecordi
ng Commer
cial Gov
ernment
fi
nanci
altransacti
oninPri
maryHealt
h
Careset
ting. 1. Accountare Accounti
snot
publ
ishedaft
er bei
ngpubli
shed
Pr
inci
plesofaccountsy
stem annualaudi
ti
ng

1.Dualconcept 2. Usepart
icul
ar Usesall
sorts
2.Consistency booksof ofbooksof
3.Pri
odicity account
ing account
ing
4.Busi
nessconcept
5.Matchingconcept 3. Maxi
mizat
ionof Nonprof
it
6.Costconcept pr
ofi
t or
ient
ed
7.Real
izationconcept
4. Theyperfor
mto Theperf
ormto
8.Material
ityconv
enti
on
costumers sat
isf
acti
on
9.Moneymanagement
sati
sfact
ion
Money :-Canbedefi
neasamedi um of 5. Exter
nalaudi
tor Accaremostly
exchangeforgoodsandser
vices. examine examineby
account i
nter
nalaudi
tor
Ty
pesofmoney

1.Vi
sibl
emoney
2.I
nvi
sibl
emoney Booksusedi
naccount
ingi
nPHC

Visi
blemoney
:-Isthephysicalcash 1.Bookofor i
ginal
ent
ry
seenorhandl
edfrom whereexpenses 2.Ledger
areonthebal
ancekepthandy . 3.Cashbook
4.Impress
Inv
isi
blemoney:
-Ist
hemoneyst
art
ed 5.Stockaccountbook
i
nwr i
ti
ngeit
heri
nanoteot
heror 6.Balancesheet
cheque. 7.Vouchersheet
8.Invoi
ce
Funct
ionsofmoney
I
nvoi
ce:-Thi
sisdocumentbysel
l
ert
o
1.I
tserv
easamedi um ofexchange t
hebuyer.
2.I
tserv
easmeasur eofvalue
3.I
tserv
easastoreofv al
ue Vouchersheet:-I
sapri
ntedpi
eceof
4.I
tserv
easaunitofaccount paperthatcanbeusedi
nsteadof
5.I
tencour
agei
nstall
mentpay ment moneyt opayforsomet
hing.

63
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
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gume
ri,
CHE
W20
22.

Cashbook:-I
sabasicaccountbooki n 2.Surpl
usbudget:
-Iswhenthetotal
whichar
erecordedal
lreceipt
sandal l proposalrev
enuei
smorethanthe
paymentofmoneyinanor ganizat
ion. expendit
ure.

Imprest
:-Isamethodofcont
rol
l
ing 3.Defici
tbudget
:-Iswhent
het
otal
cashrequi
redforsmal
lpayment
sinan proposedexpendi
turei
smoret
hanthe
organi
zati
on. total
estimatedr
evenue.

Bookofor igi
nalentr
y:-Theseare Budgetcont
rol:
-Isanact
ionofdeci
sion
j
ournalsonsubsi di
arybookswhichall madetoensurethatpl
anedbudgetor
tr
ansactionsarerecordedbefor
ebeing est
imateisachi
eved.
postedintotheledger.
Ef
fect
sofi
mpr
overbudget
Doubleentrybookkeepi ngsyst
em: -I
s
therecordi
ngoft wof ol
daspectof 1.I
mproperpay mentofstaff
businesstransact
ionsofat i
me.These 2.I
nabil
it
ytomai nt
ainequipment
arerecei
v i
ng(debiti
ng)andthegiv
ing 3.I
nadequatemoneyt osupplydrugs
(cr
editi
ng). 4.I
nsecurecli
nical
servi
ces
5.Ext
ernaldebtwil
lnotbesettl
ed
Pet
tycashi mpresssyst
em:-Thiscan 6.CHEW programmewi l
lnotprogress
bedescribeasaf i
xedamountofmoney
I
mpl i
cat
ionsandef
fect
sofi
mpr
oper
madeav ail
abl
ef orsmal
lpur
chaseofan
budgeti
ng
i
nsti
tut
ion.

Ther
earetwobookst
hatcanbeusedt
o 1.Poorori ncompl eteexecuti
onofthe
programmed
oper
atepet
tycash
2.Ov erl
abor i
ngthef ewst af
fand
1.Simpl
epett
ycashE.
g.Date,
det
ail
s, denialsofright
voucher
,amountr
ecei
vedandpai
dout. 3.Lackofsav i
ngs
4.Inabil
it
yt oreacht hetar
getduetolow
2.Columnarpet t
ycashE.g.Date,
coverage
part
icul
ars,
v ouch,amountrecei
ved&
5.Lackpay mentofsal ar
yandother
pai
doutdet ail
s.
i
ncent i
ves
Budget:-I
sapr ocessofest
imat
ingor 6.Inadequat eequipment ’
s
pl
anningapr oj
ectoraprogr
ammedi na 7.Staffmangost rike
monitor
ingterms. 8.LessFi nancialControl

Ty
peofbudget Fi
nanci
alr
epor
t:-Thi
sist
her
epor
t

1.Balancebudget
:-Iswhenthet
otal wr
it
ingbyt
heact
ivi
tyorpr
ogr
amme
esti
mat edrev
enueisequal
tothe manageraf
terspendi
ngmoneyoran
expensive. al
l
ocat
ion.

64
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Howt
orecei
vedst
ock Drugdev ol
vingf
oundaccount:-I
sa
system wherebyacert
ainamountof
1.Checki ncomi ngstockagai nstorders moneyknownasseedmoneyi sset
anddel i
verydocument at
ion. asideforthepur
chaseofdrugs.
2.Identif
y,recordandr epor t
di
scr epancies. Basicbooksusedi
nDRFaccount
ing
3.Inspectitemsf ordamage, quali
tyand procedur
e
use-bydat esandr ecordfindings
accor di
ngt oorganizati
onal procedur
es. 1.Facil
i
typriceli
stfor
m
4.Recor ddetail
sofi ncomi ngstock 2.Stockrequestvoucher
accor di
ngt oorganizati
onal procedur
es. 3.Thebincar d
4.Cashbooks
Howt
oor
derst
ock 5.Ledger
6.Foundstatement
1.Intr
oducti
ont oor deri
ng
2.Calculat
erequi redstockquant i
ty Costrecoveryi
nPHC: -Thi
sfocusedon
3.Calculat
epur chaseor derquant i
ty thepotenti
alofuserfeestoincr
easethe
4.Createapur chaseor der resour
cesav ai
labl
eforprimary
5.Typesofor derav ai
lablefr
om t he healt
hcare.
popupmenu
6.Calculat
eforecast MATERNALHEALTH
7.Othersetti
ngsi nthecr eat
eor der
Mat er
nalhealt
h:-Candef
inedast
he
window
8.Creati
ngabl ankpur chaseor der promotive,pr
event
ive,
cur
ativ
eand
9.Viewingapur chaseor der rehabi
li
tati
vehealt
hcaref
orthemother
s.
10.Buttonsinthepur chaseor derlist Pre-concept
ioncare:
-Isthecar
egiv
en
window toawomanbef oresheconcei
ved
11.Editi
ngapur chaseorder pregnancy.
Howtokeepi
nvent
oryofexpendabl
e Component
sofpr
e-concept
ioncar
e
suppl
i
es
1.Physi
calassessment
1.Knowt hefourcategor i
esofinventory 2.Ri
skscreening
2.Understandtheadv antagesand 3.Vacci
nati
on
di
sadv ant
agesofhol dingont oinventor
y 4.Counsel
ing
3.Understandthecost sofholdi
ng
i
nventory I
mpor
tanceofpr
e-concept
ioncar
e
4.Learnhowt hetypeofst ock
i
nfluenceshowmuchy ouneedt ostore 1.Preventunderwei
ghtandstunt
ing
5.Setami nimum level growth
6.Determineare-orderinglev
el 2.Preventsti
l
lbir
th,
pret
erm andl
ow
7.Setamax i
mum level weight

65
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Preventi
onofcompl icationsduri
ng bepr
egnancybutonitalonedoesnot
pregnancy makecer
tai
nthatther
e'spregnancy
.E.
g.
4.Preventneonatali
nfection
1.Amenor r
hea
5.Preventbir
thdefect 2.Breastchanges
6.Preventvert
icalt
ransmi ssionsuchas 3.Blueishcolorofv agi
na
cancer,HIV,t
ype2di abeteset c. 4.Softeningofisthmus
Ser
vicei
nconst
it
utepr
econcept
ioncar
e 5.Skinchanges
6.Bladderirri
tabi
li
ty
1.Nut riti
onalservices 7.Changei nt heuterus
2.Env ironmental servi
ces 8.Mor ningsickness
3.Ment alhealt
hgenet iccounseli
ng Positi
vepregnancy:
-Isthetestdueto
4.Toensur eopt imalgoodcondi t
ionof presentofHumanChr onicGonadotr
opin
mot herandbaby (HCG)hormonesi nuri
neorblood.
5.Scr eeningofi nfect
iondiseaseE.g.
Syphilis,gonorrheaetc. Positi
vesi gn: -Thesear ethose
6.Medi calassessment evidencet hatoni talonecanmaket here
7.Infect i
onprev enti
onandt reat
ment i
sconf irm pr egnancy .E.g.
1.Themov ementoft hefetusinthe
Rol
eofCHEWSi
npr
e-concept
ioncar
e uteruswi l
lbeexper i
encebymot her.
2.Fetal hear tbeatwi llbeheardwi t
hthe
1.Toensurethesaf etyofbot hmot her useoff etal stethoscopeasf rom 24
andbaby weeksofgest ati
on.
2.Toensureheal t
heducat i
ongi vento 3.Palpat i
onf etalpartsasf r
om 24
motherisproperlypracti
ce weeksonwar d.
3.Provi
dingcultural
lyappropriat
ehealth 4.X-raywi llalsoconf irmt hepresence
educati
on ofaf etust hepar t
swi llbevisi
ble.
4.Advocati
ngt hecommuni t
yt oreceiv
e 5.Ultrasoundwi llal
soconf irmthefetus
heal
theducation partandf et al heardsound.
5.Coll
ati
ngdat a&r ely
inginformationto Ty
peofchangesi
npr
egnancy
poli
cymaker s
1.Physiological change
Pr
egnancy
:-I
sthesuccessf
ul 2.Anatomi cal change
i
mplant
ati
onoft
hezygoteintheut
erus. 3.Socialchange
4.Psychologi cal
Si
gnofpregnancydiv
idedi
ntotwo
pr
obabl
eorpr esumpti
veandposi
ti
ve Changeinpregnancy:-I
sthechange
si
gnofpregnancy duri
ngpregnancyarethealt
erat
ioni
n
thenormalfunct
ioni
ngofthewoman
Probabl
esignofpregnancy
:-Thesear
e causedbypregnancy.Thechangear
e
thoseevi
dencethatonethi
nkther
emay causedbymai nl
ybysomehor mones

66
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

r
eleasedi
nthewomansy
stem. Ski
n

Physiol
ogical
changi
est
hataf
fectal
l
1.Pregnancymaskont hef ace
organsofthewomenbody,i
ncl
udethe
2.Pi
gment edli
nelongit
udi nati
ryon
fol
lowing;
middleabdomen( l
ineanigr a)
Vagi
na 3.Varicosity
1.Reddi
shincolour 4.Dar kerl
inearoundtheni pple
2.Purpl
eincolour 5.Dar kerperi
neum
3.Moresofter 6.Stretchmasks( star
egr av i
darum)
4.Moreacidic
Or
alcav
ity
Ut
erus
1.Mil
dpainfulgum,somebl
eedi
ng
1.Endomet ri
um becomet hi
cker 2.I
ncreasedsali
vat
ion
2.Richeringlycogen
3.ChangeinTaste
3.Muscl esfi
bresgrowi nsize
(hypertr
ophy) St
omachandi
ntest
ine
4.I
ncr easeinnumber( hyperpl
asia)and
becomewel lorgani
zed 1.Nauseaandv omit
ing
5.Sizeandwei ghtofuterusincrease 2.I
ncreasedsmallst
ooli
ngandur
inat
ion
6.Dev el
opmentofnewbl oodv essel
s 3.Sl
owdi gest
ion
andt heref
oremor ebloodsuppl y
4.Heartburn
7.I
st hmussof tenandelongates
5.Consti
pati
on
Cer
vix
Rspi
rat
orysy
stem
1.I
ncreasedfatdeposit
1.I
ncr
easedoxy
geni
ntakedur
ing
2.I
ncreasedbloodsupply
i
nspir
ation
3.Moretissuegrowth
4.For
mat ionofcol
ostrum 2.I
ncreasedcarbondi
oxi
der
eleased
5.Sof
ten dur
ingexpirat
ion

Endocr
inesy
stem Hear
t

1.Corticost
eri
odhormonesi ncreasesd 1.I
ncreaseinsi
ze
2.Plasmai odi
nedecreases 2.Beatsst
rongerandr
egul
ar
3.Prolacti
nhormonesincreases
Bl
ood
4.Foll
idestimul
ati
nghor mone
decreases 1.I
ncr
easei
ncel
lnumberofr
edbl
ood
5.Luctonisi
nghormonesdecr eases cel
l
sduetomoreoxy
gendemand

67
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

2.Increasei npl
asmav ol
ume 4.Albumin
3.Increasei nwhit
ecellsespeci al
ly 5.Sugarinuri
ne
neutrophil
s 6.Jaundice
4.Increasesi nv
olumeofbl oodf l
owto 7.Excessiv
eweight
theuterusandpl acental 8.Malari
a
5.Relaxationanddilat
ionofv essel
s,
Ef
fect
ivecasemanagementofmal
ari
a
whichcanl eadt
ohy pertension
i
npregnancy
Phy
siol
ogyofpr
egnancy&f
ert
il
izat
ion
1.Carryoutmal ar
iatestusingRDT
1.Theov um r el easeddur ingov ulat
ionis 2.Admi ni
sterACTt othosewi t
hRDT
call
edbyt hef i
mbr iaeandpassedi nto posi
tivetestresul
ts
theFal l
opi ant ubet hecil
iaand 3.I
nv esti
gateandtreatothercausesof
peri
stalticmov ementoft het ubepeopl e i
ll
nessaccor dingtonati
onal guidel
i
nes
4.Providecounsell
ingondr ugs
theov um onl y.
compl i
anceandadv ersereaction
2.Meanwhi lemanyhundr edsofmi ll
ions
5.Compl etepharmacovigil
ancef or
m
somear esay ingov er300,000, 000of
andsubmi ttoLGA
spermsadeposi t
edi nvagi nadur ingthe
i
ntercour seal sopeopl ethemsel veswith Labour:-Canbedef i
nedasthe
thei
rtail towar dst hefall
opi ant ube. physiol
ogical
processbywhichthefet
us,
3.Thecer v i
xcont ainmucust heyat t
ract placent
a,membr aneandumbili
calcor
d
thesper m. areexpell
edthroughthebi
rt
hcanal or
4.Themat uredandheal thysper m theproductofconcepti
on.
rel
easesanenzy mesknownas Thr
eephasesofl
abour
hydroniladi zewhi chdissol vest hewal l
oftheov um sot hatonesper m cel l
s 1.Power
entersusual l
y. 2.Passage
3.Perssenger
5.Thenucl eioft het wocel ls(sper m&
ova)fuseandt hemembr aneoft he Gener
alsi
gnsofl
abour
ovum isseat edt oav oident ryofany
1.Spont aneousRupt ur
eofMembr anes
othersper m.
2.Cont racti
ons
Dangersi
gni
npr
egnancy 3.MucusPl ug/'
Bloody'Show
4.InvoluntaryShiver
ing
1.Oedema 5.Lightening
2.Hyper
tensi
on 6.Diarrhoea
3.Anaemia 7.IncreasedBr axt
onHi cksCont
ract
ions

68
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ty
pesofl
abour phaseswhi
chi
ncl
udet
hef
oll
owi
ng;

Tr
uel
abour Fal
sel
abour 1.Latentphase
2.Activephase
Contract
ionf
eel Cont r
acti
onfeel 3.Transit
ionphase
atabout40weeks atabout32weeks 1.Latentphase:-Thisoccuratthe
ofpregnancy ofgestat
ion cerv
ixdilatedfr
om 0-3cm in
pri
migrav i
daand4cm inmul t
i-
gravi
da
Regul
ar&strong Cont
ract
ionpai
n
theaveragedurationi
s9hour sin
cont
ract
ionpain notr
egul
ar pri
migrav i
daand5hour sinmult
i-gr
avi
da.
Thesign&sy mptom ofthi
sphaseis
Contract
ionpai
n Contr
act
ionpai
n
mucuspl ugorbloodyshow.
feel
mor eonthe moreonthe
l
owerback abdomen 2.Act i
vephase: -Thi
si sterm ofcervi
x
dil
atati
onf r
om 4cm t o7cm i n
There'
s There'
sno pri
mi gravidaitlastfr
om f our(4)tofi
ve
eff
acementoft
he eff
acementoft
he (5)hour sandi nmul t
i-gravi
dai tl
ast
cerv
ix cerv
ix aboutt wo( 2)oroneandhal f(1½)hours.
Inthisphaset hewomani ncreasein
Enemastimul
ate Enemadoesnot Pulserat e,Respirat
onr ate,Blood
Uter
ine sti
mulat
eUter
ine PressureandBl oodshow.
cont
racti
on contr
act
ion 3.Transi t
ional phase: -Thisi
saphase
thatlastfrom 8cm -10cm ofcer vical
Ther
e'sshow Ther
e'snoshow
dil
atation,theav eragedurati
oni n1-2
hourf orprimipar aand1hour sformul ti
-
parat hecont ract i
onpat t
ernisregul ar
St
agesofl
abour
strongandl asting60secondi n2-3
1.Fi
rststageoflabour minut es.Thef requentsi gnand
2.Secondst agesoflabour Sympt omsoft hisphasemaybe
3.Thir
dst ageoflabour vomi t
ingvi si
ble,buggingattheperineum
4.Fourt
hst ageoflabour andbear ngadowne
i ff
ortofthewomen.

Si
gnoff
ir
stst
ageofl
abour
Firststageofl abour :
-Thisistheperi
od
fr
om onsetoff i
rstrhythmic 1.Uterinecont r
acti
on
cont r
actionstof ulldi
latat
ionsof 2.Uteriner et
ract
ion
cervicalOSwhi chis10cm.Nor mal fi
rst 3.Effacementofcer v
ix
stageofl abourl astfor12hoursin 4.Format ionofupperandlower
primigravidaand8hour si
nmul ti
grav
ida. segmentoft heuterus
Thef ir
stst ageofl abourhasthree 5.Dil
atationofcer v
icalOS
6.Appear anceofshow

69
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Managementoff
ir
stst
ageofl
abour contraction
5.Cleant hebaby 'seyesinsideoutward
1.Welcomepat i
entandr el
ativ
es withster i
lewaterswab, swabt hemouth
2.Takepat i
enthi storyandphy si
cal andnosewi thdifferentswab
examinati
on 6.Feel forcordar oundthebaby '
sneck
3.Takepat i
entv italsignandf etal 7.Delivertheant eri
orshoulderwith
heart
beatev eryonehour spontaneousr otat i
on
4.Ensurethati tist r
uel abour 8.GiveI M oxyt
oxi norergoment r
into
5.Makesur epat ientbl adderisempt i
ed themot herifbleeding
6.Encouragepat i
entt omov ein 9.Suckmout handnosepr operly
betweencont raction 10.Recor ddeliverytime,weighand
7.Applyenemai fappl icable Apgar '
sscor e
8.Shaveandt horoughl ycleanpat i
enti
f
appli
cable Thir
dstageofl abour
:-Ist
heperiod
9.Encouragef luidintake fr
om thedeliv
er yoft
hebabytothe
10.Recordpr oper lyandexpl ai
nt othe separat
ionandexpulsionofpl
acenta
pati
entclearl
y andmembr ane.Anor malthi
rdstageof
Secondst ageofl abour:-Thisisthe l
abourlastforabout10-15mi nutes.
peri
odf r
om t hefull
ydilati
onofcer vical Si
gn&sympt
omsoft
hir
dst
ageofl
abour
OSt odeli
v er
yofbabyorf etus.No
vi
ginalexami nati
on( VE)inthisstagei t 1.Lengtheningofcordatt hev
ulva
l
astfor1houri nprintand30mi nutesin 2.Placentaseparat
ion
multi
para.
3.Bloodgushoutf resh
Si
gnofsecondst
ageofl
abour 4.Hardandgl obucarfundus
5.Oxytoci
nr el
easeintot hebl
ood
1.Fulldilatat
ionofthecer vi
x
str
eam byt heposteri
orlobeofthe
2.Expulsi v
eut er
inecont racti
on
3.Gapingandpoi ntinganus pi
tui
tar
ygl
and.
4.Bulgingofper ineum Managementoft
hir
dst
ageofl
abour
5.Ruptur eofmembr ane
6.Presenceofpr esent i
ngpar t 1.Immedi atelyafterbaby'
sdel i
ver
ed
7.Stoolingur ge cervixandv aginashouldbei nspect
ed
forlacerati
on.
Managementofsecondst
ageofl
abour
2.Del i
veryofplacentausuallyoccurs
1.Assesmat eri
alandf etal
conditi
on within2-10mi nutes(30mi nutes
fr
equently maxi mum)
2.Encouragingpat i
entt opushduring 3.Giveoxy toxi
norer goment ri
ntothe
contr
actionwhenbear i
ngdownur geon mot herifbleeding
3.Maintainpr operaseptictechni
ques 4.Squeezi ngoft hefundusisnot
4.Deli
vertheheadatt heendofa recommend

70
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Fourthstageoflabour :
-Thisisalast Component
soff
ocusedANC
stage,whenthepl acentaisdeli
ver
ed
unti
l4hour spostpartum provi
de 1.Bi
rt
hpr
epar
ati
onandcompl
i
cat
ion
supporti
vecaredur i
ngl abour
. r
eadi
ness

Compl
i
cat
ionsofl
abour&pauper
ium 2.I
ronandf
oli
caci
dsuppl
ement
sin
ANC
1.Prolongl abour 3.Tet
unust
oxoi
dimmuni
sat
ion
2.Abnor mal presentat
ionoff oet
us 4.De-
wor
mingusi
ngmebendazol
e
3.Swel li
ngoff aceandl egs
5.Tr
eat
menti
npr
egnancy(
IPTp)
,useof
4.Post partum hemor r
hage
I
nsect
ici
det
reat
ednet
s(I
TN)
5.Cordpr ol
apse
6.Pre-eclampsi a(convulsi
on) 6.Phy
sical
exami
nat
ionl
i
kef
oet
alhear
t
7.Hyper tension sound
8.Retainedpr oduct(placenta) 7.Car
eforski
l
ledat
tendant
9.Lessf oet almov ement 8.Counsel
l
ingser
vices
10.Ment al problems
11.Sev erebl eeding Post
par
tum hemor
rhage:
-Isamor
e
bl
eedi
ngt
hannor
mal
aft
ert
hebi
rt
hofa
Pr
event
ivemeasur
esofdangersi
gns
baby
.It
'saser
iousbutr
arecondi
ti
on.
1.Seey ourheal t
hcar epr ovi
derregul
arl
y
Ty
peofpost
par
tum hemor
rhage
2.Makeheal t
hyf oodchoi ces
3.Earl
ydi agnosis&t reatmentofmal ari
a 1.Mi
norpost
par
tum hemor
rhage:
-Is
4.Keepingbl oodpr essureundercont r
ol t
heest
imat
edbl
oodl
ossupt
o1,
000
5.Keepy ourbl oodsugari ncheck MLS.
6.Focusedant enatalcare
7.Tetanust oxoidimmuni zat
ion 2.Majorpost
par
tum hemor
rhage:-I
s
8.Bir
thpr eparednessandcompl icati
ons anyesti
matedbl
oodlossover1,
000
readi
ness MLS.
9.Dewor mi ngusingAl bendazole
10.Provisionofi r
onandFol i
cacid 3.Secondar
yPost
par
tum Hemor
rhage:
-Is
suppl
ementi nant enatalcare def
inedasabnor
mal
bleedi
ngf
rom
geni
alt
ractf
or25hour
saf
terdel
i
ver
yup
Focusedant enatalcare(FANC):-Isthe
t
osi
xweeks.
personal
izedcar eprovidedtoa
pregnantwomanwhi chemphasizeson Ecl
ampsi a:-Thisisanacut econdit
ion
thewomen' sov eral
lhealthst
atus,her character
izedbyconv ul
sionsandcoma
preparat
ionforchi l
dbirthandreadiness whichoccur sbefore,
duri
ngoraf ter
forcompl i
cati
ons.
l
abour .

71
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Si
gnandsy
mpt
omsofecl
ampsi
a Ty
pesofl
ochi
a

1.Vomi ti
ng 1.Lochi
arobar1-3daysbr
ightredin
2.Epigastriapain col
or
3.I
ncr easei nOedema 2.Lochi
aserosae4-10day
spi nki
shin
4.I
ncr easei nprot
einurea col
or
5.Uri
neout putdimini
shed
3.Lochi
aalba11-14dayswhit
ei ncol
or
6.Drowsi ness
I
mmedi
atenewbor
ncar
e
Pre-ecl
ampsia:-I
saconditi
ont hati
s
associat
edwi t
hpregnancywhich 1.Ensur eimmedi at
ewar mth,
dr y
ingand
presentwit
hhighbloodpressure, skintoski ncont act
protei
ninuri
neandOedema. 2.Assessbr eathingorneonatal
Si
gn&sy
mpt
om ofpr
e-ecl
ampsi
a resuscitati
on( helpi
ngbabiesbreathe)
3.Ear l
yinit
iati
onofbr eastf
eedingwithi
n
1.St
r ongheadache 30mi nut e
2.Bl
ur r
edordoublevi
sion 4.Cleancor dcar eusing4%
3.Overacti
verati
ons
chlorhexidi
negel
4.Hi
ghbl oodpressur
e
5.Protei
ninuri
ne Post
-nat
alcar
e
6.Oedema
1.Homev isi
tati
onwi thmot her,i
nfant
Puerper
al:-I
stheperi
odwhichbegi
ns wit
hin2-3day sofbi rth
assoonaspl acent
aisexpel
l
edand 2.Maternal nutri
ti
oncounsel l
ing
l
astsforabout6-8weeks.
3.Postpartum familypl anning
Puerper
al sepsi
s:-Thisi
sani nf
ecti
onof 4.Continuet hermal protecti
on
5.Dail
ycor dcar ewit h4%chl orhexidi
ne
thegenit
alstrackoccurr
ingusuall
y
gel
withi
nthreeweeksaf t
eraborti
onor
6.Excl
usi v
ebr eastfeedingt hroughout
chil
dbir
th.
si
xmont hs
Involut
ion:-Ist
heprocesswherebythe 7.Newbor nImmuni zation
uterusreturnst
oit
snor malsi
zeafter 8.Newbor ney ecare0. 5%er ythr
omy ci
n
chil
dbirth. ortobr
amy cin.
Amenorr
hea:-Thi
smeansabsenceof I
MMUNI
TYANDI
MMUNI
ZATI
ON
menst
ruati
on.
Immunity:
-Istheabili
tyoft
hebodyt o
Lochia:-I
sthedi
schargefr
om the
resi
staparti
culari
nfecti
onortoxi
nby
geni
talstr
ackofawomani mmedi at
ely
theacti
onofsensiti
zedwhiteblood
aft
erlabourandt
hroughoutthe
puerperal
. cell
s.

72
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ty
pesofi
mmuni
ty Anti
body:-Thisisaspecifi
cform of
prot
einproducedinthelymphoidtissue
1.I
nnate/nat
ural
/nonspeci
fi
cimmuni
ty andabletocounteractt
hieffact
sof
2.Acquir
ed/adapt
iveimmunity bact
erial
antigentoxi
ns.
Innatei
mmuni ty:
-lsthenatur
al Fact
orsaf
fect
inghosti
mmuni
ty
i
mmuni t
ythatismor eorl
esspermanent
withanindiv
idual
,innatei
mmuni t
y 1.Age: -Thisisthehostimmuni t
yis
system i
swhatwear ebor
nwi t
handitis hi
ghi n0-59mont hsofaget ofight
non-speci
fi
c. agai
nsti nfect
iousdisease,whil
eoldage
astheyar egrowingoldt hei
rimmunityi
s
Acquiredimmunity:-I
stheimmunity decreasing.
thatanindiv
idualacqui
resaft
ert
hebirt
h
i
scal l
edacquiredoradapti
veorspeci
fi
c 2.Pregnancy
:-Apr egnantwomenal so
i
mmuni t
y. havelowimmuni t
yatt hatpart
icular
ti
mebecauset heli
ttl
ei mmunityleftwi
ll
Char
act
eri
sti
csofacqui
redi
mmuni
ty besharedbetweenmot herandfetus.

1.Specifi
cit
y 3.Nutrit
ion:-Theimmuni tywil
lbelow
2.Diver
sity whent hegoodnut ri
ti
on( bal
ancediet)
3.Discr
iminat
ionbet
weensel
f&non-
sel
f contai
ningamountoft heessenti
al
4.Memor y nutr
iti
onel ementsthatthebodymust
havetof uncti
onnormal l
yisnottaken.
Way
sofacqui
ri
ngi
mmuni
ty
4.Drugs:-Thisisacer tai
ndrugssuch
1.Nat
ural
act
ivei
mmuni
ty asthoseusedt otreatmal i
gnant
2.Nat
ural
passi
vei
mmuni
ty conditi
onsshowt oxicit
ynotjustt
oo
3.Ar
ti
fi
cial
act
ivei
mmuni
ty malignantcell
sbutal sotonormalcel
ls
4.Ar
ti
fi
cial
passi
vei
mmuni
ty i
ncludingthoseinvol
v edinimmunity
.

5.Env i
ronment:
-Istheenvir
onmenthas
Antigen:
-Thisisanysubstancewhich
ar ol
etoplayinthedisposi
ti
onofheal
th
wheni nt
roducedi
ntothebodysystem
statusofanindi
v i
dual.
underfavorabl
econdi
tionssti
mulat
ethe
producti
onofanti
bodies. 6.Traumaandst r
ess:
-Ifyouar
e
undergoi
ngstressort
raumainf
ormsof
Vacci
nes:
-Thesear
eant
igeni
c acci
dentthepersonwil
lhavel
ow
subst
anceswhi
chwhenadmi
nist
eredi
n i
mmuni tythr
oughimmunesuppressi
on.
ani
ndi
vi
dual
,st
imul
atet
hepr
oduct
ion
7.Her
dimmuni t
y:-Meansgrouped
ofspeci
fi
cant
ibodi
esandpr
otect
sthe i
mmuni t
ygiventoagroupofpeopl
eora
i
ndi
vi
dual
agai
nstt
hatpar
ti
cul
ardi
sease. community
.

73
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Vacci
nepr
event
abl
edi
seases Pent
aval
ent

1.Poli
omy eli
tis Rout
eofadmi
nist
rat
ionofv
acci
nes
2.Tubercul osis
3.Pertussis( whoopingcough) 1.I
ntra-der
mal
4.Diphtheria 2.Subcutaneous
5.Tetanus 3.I
ntra-muscular
6.Measl es 4.Orall
y
7.Yell
owf ev er Pr
ocedur
esf
ori
mmuni
zat
ions
8.Mumps
9.Rubella 1.Assembl eallt
hemat eri
al needed
10.Hepat i
tisB 2.Washhandwi thsoapandwat er&dry
11.I
nf l
uenza 3.Reconsti
tutethosevaccinei n
12.Meni ngococcal diseases powderedf or
mf oll
owingst andard
13.Cholera procedure
15.Hepat i
tisA 4.Drawoutt hereconsti
tutedv acci
ne
16.Meumococcal disease 5.Spellai
rbygent l
ypushingoutt he
17.Typhoidf ev er pl
ungerpushi ngallt
he(bubbl es)
18.Hepat i
tisE 6.Remov ethemi ddl
eusedi ndrawing
19.Humanpapi ll
omav irus fr
om thev i
al
20.Rabies
Adv erseev ent sfollowi ngi mmuni zati
on
Ty
pesofv
acci
nes (AEFI) :-Canbedef inedasanyunt oward
medi cal occur r
encewhi chf oll
ows
1.Liveattenuatedv acci
nes: -Li
ve i
mmuni zat i
onandwhi chdoesnot
vaccinesar eli
vingorganismsbut necessar il
yhav ecausal relationship
attenuat
ed, theyaremadet olosetheir wi t
ht heusageoft hev acci ne.Wor ker,
pathogenicity&r et
aintheiranti
genici
ty parent sormember soft hecommuni ty
.
E.g.Measl esvaccine,BCGandYel l
ow AEFIoccur smost lywi t hinamont hof
fevervaccine receivingv accination.AEFIcanr ange
2.Kil
l
edv accines:-Theorgani
sm are from mi l
df ev ers,inject i
onabscesses,
i
nacti
vatedorki l
ledbyheator conv ulsions, par al
y sisandr arelydeath.
chemical
se. g.Poli
ov acci
ne,I
nfl
uenza Adv erseev ent sarei nev i
tablei nany
vacci
neToxoi dvaccine:TT,DT i
mmuni zat i
onpr ogrammedbuti tis
usual l
yi ncr easedbyt hef ollowi ng;
3.Combi nedv accines:
-Thesear e 1.Poori nject i
onsaf etyt echni que
vaccinespr eparationcontai
nsmor e 2.Poorv accinehandl i
ng( storing
thanoneant i
gen, iti
seconomi cal, vaccineswi thot heri njectabl edr ugsin
reducest henumberofv i
sit
stot he thesamest orageequi pment )
hospitalandt henumberoft i
met he 3.Lackofpr operscr eeni ngofcl i
entsfor
chil
dwi l
l beinjected.E.
g.DPT, MMR, i
mmuni zat i
on

74
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

4.Errorinvacci
nemanuf
act
urer
’s hadanaphy l
axis(seri
ousal l
ergic
technique reaction)orothersev erereactiontoa
previousdoseoft hev accineora
Ty
pesofAEFI
S vaccinecomponent .
1.Commonmi norr
eact
ions 2.Don' tgi
veav accinei fthecar egiver
2.Ser
iousr
eacti
ons objectstoimmuni zat
ionf orasi ckinfant
afterexplanati
ont hatmi ldil
lnessisnot
1.Commonmi
norr
eact
ions acont rai
ndicati
on.Askt hecar egi
vert o
comebackwhent heinfantiswel l.
1.Localreacti
ons
a. i .Rednessatinj
ect
ionsi
tes Defaultertracing: -I
st heprocessof
b. ii.Pain fi
ndingchi ldr
enwhomi ssedtheir
c. ii
i.Swell
ing schedul ed.Why , wet r
acingdefaulter
s
2.Feverabov e38°
C wil
l i
mpr ov
ei mmuni zati
onper f
ormance.
3.Ir
ri
tabil
it
y Thiswi l
l mean:
4.Malaise 1.Heal theirchildrenandcommuni ti
es
5.Generalapathy 2.Lowerheal thcar ecostf orf
ami l
ies
3.Increasedj obsat isfacti
on
2.Ser
iousr
eact
ions
Howt
ododef
aul
ter
Thesesy mptomsr esul
tfr
om body
react
iontoav acci
neoritcomponents. 1.Usingt heNPIr egisterorat icklerfi
l
e,
Therare,moreseriousvacci
nereact
ions i
dentifythei nf antswhomi ssedt heirl
ast
i
nclude; appointmenty oushoul d;
1.Convulsi
on a.Reviewt her egistertoi denti
fyi nf
ants
2.Anaphy l
acti
cshock whoar eov erduef orthei rnextdose.
3.Severeall
ergi
creacti
onsE.g.Oedema b.Keepat icklerf i
le.Af tereach
4.Adenopathy i
mmuni zationv i
sit,mov et hecar dtothe
5.Encephalopathy monthwhent henextv isi ti
sdue.
c.Everymont h,rev i
ewt hecar dst hat
Cont
ra-
indi
cat
ionsofi
mmuni
zat
ion
havenotbeenmov ed.Lookf ornames
Foraf i
rstdoseofv accine,assesst he ofinf
ant swhomi ssedt heir
gener alstatusofthechi l
dt or ul
eout i
mmuni zationst hatmont h.
signsofser iousill
ness.Fora 2.Forinf antswhohav enotr eturned,l
ist
subsequentdosei nav acci neser i
es, thei
rname, l
ocat ion,etc.i ntheDef aul
ter
askt hecar egiverwhetheranyadv erse Traci
ngTempl ate
event s,i
ncludinganaphy l
axi s,occurred 3.Givet heJCHEW acopyoft he
foll
owi ngthepr evi
ousdose( s).All DefaulterTr acingTempl ateforthe
i
nf antsshoul dbeimmuni zedexcepti n ward/dist r
ictwher et hei nfantlives.
thef oll
owingsi t
uati
ons; 4.Askt heJCHEW t of i
ndt heinfantand
1.Don' tgivevaccineifthei nfanthas helpensur eshe/ sheget scaughtupas
soonaspossi ble.

75
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Reasonsf
ordef
aul
tngf
i rom i
mmuni
zat
ion Chal
l
engesofi
mmuni
zat
ioncov
erages

1.Inadequat ecounseli
ngofmot hers 1.Distancet otheheal thfaci
l
ity
2.Mi ssedappoi ntment 2.Refusal ofparentst ovacci
natean
3.Lossofv acci
nat i
oncards el
igibl
echi l
d
3.Wai t
ingt i
me
4.Failureonheal thworkerstomake
4.Lackofsuppl i
es
homev isit
5.Poorknowl edgeofpar ents
5.Poorr elati
onshipbetweenheal t
h
6.Fearofsi deef f
ects
wor kersandcl i
ents 7.Lackoft ransportationtooutreach
6.Lackofsuppor tfrom malepartners areas
(duet ohi ghwor kloadonmot her)
. 8.Shor t
ageofst aff
7.Non- av ail
abil
ityofvacci
ne( outof 9.Inadequat elogi
stics
stocksy ndr ome) 10.Unav ai
labili
tyofv acci
nati
on
mat er
ials
I
mmuni
zat
ion:
-TheWor
ldHeal
th
Or
gani
zat
ion(
WHO)def
ined Coldchainsystem:-I
sthesyst
em used
forstor
ingvaccinei
ngoodcondit
ioni
s
i
mmuni
zat
ioni
sthepr
ocesswher
ebya
call
edthecoldchain.
per
soni
smadei
mmuneorr
esi
stantt
o
ani
nfect
iousdi
sease,
typi
cal
l
ybyt
he Mai
ntenanceofcol
dchai
nsy
stem
admi
nist
rat
ionofav
acci
ne. 1.Thereshoul dbegoodel ectr
icit
y
supply
I
mpor
tanceofi
mmuni
zat
ion
2.Thereshoul dbegoodt ransportat
ion
1.Reducemor bi
dit
yandmor t
ali
tyrat
e system
amongchi ldrenage0-5Year s 3.Checkr efr
igeratororfreezerstwice
dail
y
2.Boostt hebodyi mmuni t
y
4.Don’tkeepf oodorwat erwi thvaccine
3.Immuni zati
onssavechild’
slif
e
i
nsidether ef
rigerators
4.Immuni zati
oncansav efamilyti
me
5.Cleananddef rosterrefri
gerators
andmoney
6.Keepv accinesinr ecommended
5.Immuni zati
onprotectsf
uture temperature
generat i
ons
6.Itproducesst rongandhealthychil
d Component
sofcol
dchai
nsy
stem
7.Immuni zati
onimprovessocialand 1.Toensurepr
operv
acci
net
ranspor
t
healthstat usofthecommuni tyandthe 2.St
orage
wor l
datl arge 3.Handl
ing
8.Prev entsagainstkil
l
ersdiseases
9.Prev entsagainstbli
ndness Thr
eef
act
orsar
eimpor
tant
(supplement s) 1.Tr
ainedper
sonnel

76
Ba
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mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

2.Tr
ansport
ati
on&storageequipment Medi
cal
wast
edi
sposal
ini
mmuni
zat
ion
3.Ef
fi
cientmanagementprocedur
es
Procedurefordisposalofusedinj
ect
ion
Col
dchai
nequi
pment equipment.Allusedinjecti
onequi
pment
mustbesaf elydisposedofsyri
ngesand
1.Coldrooms needlesaretubeusedonl yonceand
2.Freezer
s thendestroyed.Foll
owt hesest
epsto
3.Refri
gerat
ors disposeofinject
ionequipmentsafel
y;
4.Coldboxes
1.Al lusedsy r
ingesandneedl esmust
5.Vaccinecarr
ier
s
bedi sposedofi mmedi atel
yaf teruseby
6.I
cepacks
droppi ngt hem i ntot hesaf et ybox.
7.Foam pads
Whi chi ncludes;
Coldboxes: -Isani nsulat
edcontainer a.Af teruse, singl e-usesy r
ingesand
thatcanbel i
nedwi thi
cepackst okeep needl esshoul dbepl aceddi rect l
yi na
vaccinesanddi luentsintherequir
ed safet ybox .
temper at
urer angeduringtransportor b.Toav oidneedl est ickinjur i
es, donot
shortterm storage. attemptt or ecapt heneedl eort o
separ at ethesy ringeandneedl e.
Fol
l
owi
ngpur
pose c.Usedsy ringesandneedl esshoul dnot
bet ransf erredf r om cont ainert o
1.Tot ranspor tvacci
nesanddi luentsto
cont ainer.
outreachsit esandst oret hem during d.Iff oranyr easont hesaf etyboxesr un
healthfacil
ityi mmunizationsessi ons outatapost ,usedi njection.Equi pment
2.Tost orev accinestempor ari
lywhen canbedi sposedofi napunct ure-
theheal t
hf acili
tyref
rigeratorisoutof resistantcont ai nerwi thal id, suchas
orderori sbei ngdefrosted. bucket .Acar dboar dboxi snotpunct ure
3.Tot ranspor tmonthl yvaccines resistant .
e.Fort hesouseofsaf etybox, y ou
suppliesfrom t heLGAst oretosmal l
shoul dnev erdi sposet hefollowi ng
healthfacil
ities.
i
temsi nt hem;
I
cepacks:-Thesear
eflat
,leakproof 1. i
.Empt yordi scar dedv ials
pl
asti
ccontai
nerst
hatcanbef i
ll
edwith 2. i i
.Cot tonpads
water
. 3. i ii
.Dr essi ngmat eri
als
4. i v.Intrav enousbagsot ubes
Cont
ent
sofacol
dbox 5. v .Lat exgl ov esorwast epr oduct
6. v i
.Anypl ast icmat eri
al or bnn
1.I
cepacks(0.3l
i
ter
s,0.
4li
ter
s,0.
6li
t s)
er 2.Whent heboxi sf ull,disposei tof fby
2.Foam pads burni ng.
3.Vacci
nes a.Amanuf actur eddi sposal boxcan
4.Dil
uents holdappr oxi mat ely100sy ringesand

77
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sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

needles. Funct
ionsofepi
thel
i
alt
issue
b.Thissafet
yboxesaredi
sposedofby
i
.Asel ect i
vebarr
ierthatli
mi ttranspor
t
vari
ousmet hodssuchaspitbur
ning,
ofsubst anceinandoutoft hecel l
s.
drum burni
ngorinci
ner
ati
on.
i
i.Protectivesurf
acet hatresist
ANATOMYANDPHYSI
OLOGY i
nfluenceofext ernalenvir
onment .
i
ii
.Asecr etor
ysurfacethatr elease
Anatomy:
-Ist
hescienti
fi
cst
udyhow
substancepr oducedbycel ls.
thehumanbodyst
ructur
es. i
v.Absor ption
Physi
ology
:-I
sthestudyofhowt
he v.Fil
tr
at i
on
humanbodypartsf
uncti
on. vi
.Excr eti
on

Ty
peofanat
omy Cl
assi
fi
cat
ionofepi
thel
i
alt
issued

1.Mi
croscopi
canat
omy 1.Simpleepit
hel
ial
tissue:
-Isconsi
sta
2.Gr
ossanatomy si
nglelayerofi
denti
calcel
ls,
andis
di
videdinto;
Humanbody :-Hasdi f
ferentstr
uctural
l
ev el
sofor gani
zati
on, st
arti
ngwi t
hsub a.Simplesquamousepi thel i
um: -I
s
atoms, at
oms, moleculesand composedofasi nglelayeroff latt
en
compoundsandi ncreasi
ngi nsizeand cell
sandf itcloselytogetherl i
kef l
at
complexitytocell
s,ti
ssues, or
gansand stonesformi ngat hi
nandsmoot h
thesystemst hatmakeupt hecompl et
e membr ane.I tl
inesthef ollowing;
organism. i
.Bloodv esselsendot helium
i
i.Lymphv esselsendot helium
Def
ini
ti
ont
erms i
ii
.Alveolioflung
i
v.Heart(endocar di
um)
Cell
s:-Isthesmall
estindependent
v.Ductsofnephr onsinki dney
funct
ioninguni
tsofli
fe.
b.Si
mpl
ecuboi
dal
epi
thel
i -I
um: sconsi
st
Tissue:-I
smadeupofmanysimilar
ofcubeshapedcel
l
sfit
ti
ngclosel
y
cell
sthatper
for
m aspeci
fi
cfunct
ion.
togetherl
yi
ngonabasementmembr ane.
Ty
pesoft
issue I
tlines;
i
.Ki dneyt
ubul
es
1.Epi
theli
alt
issue i
i.Foundinsomegl
andsE.g.t
hyroi
d
2.Connecti
vetissue
3.Musclesti
ssue c.Simpl ecolumnarepit
heli
al:
-Is
4.Nervousti
ssue formedbyasi nglel
ayerofcel
ls
rectangular
lyinshaponabasement
Epi
thel
ialt
issue:-Foundi
ntheouter membr ane.I
tlines;
l
ayerofskin,l
ini
ngoforgans,bl
oodand i
.Stomach
l
ymphv esselsandbodycavit
ies. i
i.Trachea

78
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mmu
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alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

i
i
i.Smal
lI
ntest
ine Funct
ionsofconnect
ivet
issue

d.Ciliatedsimpleepi
thel
ium:-Also i
.Itbi ndst ogethersupportand
rectangularinshape,wit
hhairl
ike strengt henbodyt issues.
structure(cil
ia)
.Themov ementofthe i
i.Itpr otectsandinsulateint
ernal
cil
iat oadi r
ecti
onpropel
ssubstancesto organs.
thef all
opiantubesandrespi
rat
ory i
ii
.I tcompar tmenlaisestr
ucturesuch
canal s. asSkel etalmuscles.
i
v.I tser veasamaj ortr
ansportsyst
em
2.St
rat
if
iedepi
thel
ium:-Hasmany
withint hebody .
l
ayer
sofunifor
m cell
s.E.
g.
Cel
l
sinconnect
ivet
issue
a.Strati
fi
edsquamousepithel
ium:-Thi
s
i
scomposedofsev eral
layer
sofcell
s. 1.Fi
brobl
asts:
-Thosethatrepai
r
Inthedeepestlay
ersthecell
saremainl
y damagesandcleanstheti
ssue
col
umnarandast heygrowthesur
face envi
ronmentbyphagocyt
osis.
fl
attenedandareshed. 2.Macr ophage:-Thisisir
regul
ar
shapedcel l
swithattachedand
Basementmembr ane:-Itisf
uther
unattachedgrai
ns.Theirmaj or
div
idedintoker
ati
nisedandnon-
functi
onsar ecl
eaningbyengul f
ingand
kerat
ini
niseStr
ati
fi
edepithel
i
um. digesti
on.
i
.Kerat
ini
s:-I
sfoundondr
ysurf
ace 3.Plasmacell
s:-Thi
sisacell
sthat
subj
ect
edt owearandt
ear
.E.
g.Ski
n, produceanti
bodi
eswhenwher eis
hai
rsandnail
s. anti
gen.Mostofthecell
sar
e
responsi
blei
nproduct
ionofhi
stamines.
i
i.Noneker
ati
ninri
se:-Isprotectsmoi st
subj
ectedtowearandt earpr eventor
y 4.Fatscells:-Therearethreediff
erent
them f
rom dr
ying.E.
g.Conj unctiv
a, typesoffatcellsinthebody ;
whi t
e,
phary
nx,osophagus,vaginaet c. brown,andbei ge.Fatcell
scanbe
storedinthreeway s:essenti
al,
b.Transiti
onalepit
hel
ium:-Iscomposed subcutaneous, orvi
sceralfat
.
ofseverallayer
sofpearshapedcells.I
t
5.Leukocyt
es: -I
sawhi tebloodcel
l,
l
inessev eral
partsoftheuri
naryt
ract
vi
talt
ot hedefensesoft hei
mmune
i
ncludingthebladderandall
ows syst
em againstdisease.Theydonot
str
etchingasbladderfil
l
s. usual
lyoccurintheur i
neinsigni
fi
cant
numbers.
Connecti
vetissue:
-Thi
sistheconnects
andsupportsmostpartofthebody. Ty
pesofconnect
ivet
issue
Theyconsti
tutemostpartofski
n,bone
1.Adiposeconnecti
vetissue
andtendons. 2.Areolaconnect
iveti
ssue

79
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iMa
gume
ri,
CHE
W20
22.

3.Fi
brousconnecti
vet i
ssue i
i
i.Responsi
bleformemories
4.El
asti
cconnecti
vet i
ssue i
v.I
nit
iat
esallvolunt
arymovement
5.Fl
uidconnect
iveti
ssue Cel
l
sofner
voust
issue
6.Lymphoidconnectiv
et i
ssue
7.Boneconnecti
vetissue 1.Neur
ons
8.Cart
il
agi
nousconnect i
vetissue 2.Neur
ogl
i
a

Musclet
issue:-Thi
sisproduces Organ: -I
sanintegr
atedcollectionof
movementthroughit
sabili
tytocont
ract
. twoormor eki
ndsoftissuet hatworks
Thi
sconstit
utesskel
etal
,smoothand togethertoper
form specif
icf unct
ion.
car
diacmuscles. E.g.Stomachismadeofal lt
y peof
ti
ssues.
Funct
ionsofmuscl
est
issue
System: -I
sagr oupoforgansthatwork
i
.Mait
ainspostur
e togethertoperf
orm majorfunct
ion.E.
g.
i
i
.Generatesheat Respirat
orysystem cont
ainsseveral
i
i
i.Pr
oducebodymovement organs.
Cl
assi
fi
cat
ionofmuscl
est
issue Organi
sm l
evel
:-Thev
ari
ousor
gansof
t
hebodyformtheenti
reor
gani
sm.
1.Skelet
almuscles:-I
sdescr
ibedso
becauseitf
ormst hosemuscl
esthat Mucousmembr ane:-I
sthemoistli
ning
mov esthebones.
oftheali
mentary,r
espi
rator
yand
2.Smoot hmuscl es:-Islocatedinthe genit
ouri
narytr
actsandsomet i
mes
wallsofhallowinter
nal str
ucturessuch ref
eredtoasthemucosa.The
asbloodv essel
sai r
way s,andmost membr anesurf
aceconsistofepit
heli
al
organsoft heabdomi no-pelv
iccavity
. cel
lswhichproducessecret
ioncall
ed
mucosa.
3.Cardi
acmuscl es:-Thismuscl
esonly
foundintheheartwhichf or
m mostof Funct
ionsofmucousmembr
ane
theheartwall
.Thecar di
acmuscles
acti
onisinvol
untary
. 1.Protectsli
ningmembr anef rom dryi
ng
2.Protectsli
ningmembr anef rom
Ner vousti
ssue:-Thi
sisfoundinthe mechani calandchemi calinjury
brain,spi
nalcordandnerves.I
t 3.Ithelpsinhaledpart
iclespr eventi
ng
respondstov ari
oustypesofsti
muliand them from enteri
ngtheal veoliofthe
transmitsnerveimpul
s. l
ungs

Funct
ionsofner
voust
issue Serousmembr ane:-I
ssecreteaserous
wateryfl
uid.Theyconsistdoublel
ayer
i
.Responsi
blef
orpercept
ion
i
i
.Responsi
bleforbehavi
or ofareol
arconnect i
veti
ssuelinedby
si
mpl eepi
t hel
i
um.

80
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ser
ousmembr
anef
oundi
n; Si
mpl
egl
ands
1.Thepleur ali
ningthethoraciccavi
ty
1.Si
mpl
etubul
ar
andsur r
oundingt helungs.
2.Theper icar
dium li
ningthe 2.Si
mpl
ebr
anchedt
ubul
ar
peri
cardicalcavit
yandsur roundi
ngthe 3.Si
mpl
ecoi
l
edt
ubul
ar
heart. 4.Si
mpl
eaci
nart
ubul
ar
3.Theper icar
dium li
ningtheabdomi nal
cavit
yandsur roundingtheabdomi nal Compoundgl
and
organs.
1.Compoundt
ubul
argl
and
Gl
and:-Ar
egr
oupsofepithel
i
al cell
s
2.Compoundt
ubul
araci
nargl
and
t
hatpr
oduceaspeci
ali
sedsecretion.
3.Compoundaci
nargl
and
Cat
egor
iesofgl
ands
Cl
assi
fi
cat
ionofendocr
inegl
and
1.Endocri
negl
ands
2.Exocr
inegl
ands 1.Mer
ocr
inegl
and
2.Apocr
inegl
and
Endocr
inegl
and:
-Itsecr
eti
onent
erst
he
4.Hol
ocr
inegl
and
i
nter
sti
ti
alf
lui
dandt
hendi
ff
usedi
rect
ly
i
ntobl
oodst
ream wi
thoutf
oll
owi
ng Bodycav
iti
es:
-Ist
hesecav
iti
esoft
he
t
hroughduct
s;Pi
tui
tar
y,Pi
neal
,Thy
roi
d, bodyhouset
hei
nter
nal
organs,
whi
ch
Par
athy
roi
d,Adr
enal
,Pancr
east
ici
slet
, commonl
yref
err
edt
oast
hev
iscer
a.
Ov
eri
esandTest
es. Thet
womai
nbodycav
iti
esar
ethe
l
argerv
ent
ral
(ant
eri
or)andt
hesmal
l
er,
Exocr
inegl
ands:
-Secr
etest
hei
r
dor
sal
(post
eri
or)bodycav
ity
.
pr
oduct
sint
oductt
hatempt
yont
othe
sur
faceofacov
eri
ngandl
i
ning Thoraciccav i
ty:
-Houseslungandhear
t.
epi
thel
i
um. Iti
sprotectedbyt heri
bcage&
associatedmuscul at
ureandthe
St
ruct
ural
classi
fi
cat
ionofexocr
ine ster
num ant eri
orl
y.
gl
ands
Abdomi
nal
&pel
vi
ccav
ity
:-Thesear
e
1.Uni
cel
l
ulargl
and:
-Thi
sis ext
endsf
rom t
hedi
aphr
agm i
nfer
iort
o
suder
if
erous(
sweat
)sebaceous(
oil
) t
hef
looroft
hepel
vi
s.I
tisdi
vi
dedi
nto
andsal
i
var
ygl
and. super
iorabdomi
nal
andi
nfer
iorpel
vi
c
2.Mul
ti
cel
l
ulargl
and:
-Isdi
vi
dedi
nto cav
itybyi
magi
nar
yli
nepassi
ngatupper

si
mpl
eandcompound. pel
vi
s.

81
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act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Abdomi
nal
cav
ity
:-Cont
ainst
he Organel
les:-Theseareper manent
st
ructur
eswi thcharact
erist
ic
st
omach,
int
est
ine,
li
ver
,spl
eenand
morphologythatarehighlyspeci
ali
zed
gal
l
bladder
. i
nspecificcel
lul
aractivi
ty.
Pelvi
ccav i
ty:
-Contai
nsur
inar
ybladder,
rect
um, andport
ionsoft
hereproduct
ive 1.Nucleus:-Isaov ali
nshapeandisthe
organs. l
argeststructurei
nt hecel
l
.Cont
ainthe
heredi
taryfactori
nt hecel
l
.
Dorsalbodycav i
ty:
-Itconsti
tutesthe
cephal
iccav i
tycontai
ningbrainandthe Funct
ionsofnucl
eus
vert
ebralcanalcontai
ningthespinal
i
.Housesmostoft hecell
DNA
cord.
i
i.I
tcont
rolmostaspectofcel
l
ular
Cytol
ogy :-Isabranchofscience str
uct
ureandfuncti
on
concernedwi thastudyofcell
s,Cell i
ii
.Vit
ali
nthecelldiv
isi
on
theoryexplainsaboutal
ll
ivi
ng
organismsar ecomposedofcel landcel
l 2.Ri
bosomes:-Isati
nygranul
es,
products. composedofRibosomalRNA( r
RNA)
.
Theyar
esit
eofpr ot
einsynt
hesi
s.
Plasma( cel
ls)membr ane:-Ist
heouter
l
ining,li
miti
ngmembr anesepar
ati
ngt he Funct
ionsofr
ibosomes
cellint
ernalpar
tsfrom extr
acell
ular
Wherepr
oti
enar
emadef
rom ami
no
mat eri
als&externalenvi
ronment.
aci
ds.
Funct
ionsofpl
asmamembr
ane
3.Endoplasmi
creti
culum: -I
sadouble
i
.Separatethecy toplasm insi
deacel l membr anechannel
.Itisconti
nuouswit
h
f
rom extracell
ularflui
d. thenuclearmembrane.
i
i.Separ
at ecellfr
om oneanot her
i
ii
.Provi
deanabundantsur faceon Funct
ionsofendopl
asmi
cret
icul
um
whichchemi calreactioncanoccur .
i
v.Regulatethepassageofmat eri
alsi
n i
.RERpr oducessecretor
ymembr ane
t
oandoutofcel ls. andorganell
esproti
en
v.I
tencloseandpr otectanytypeofcell i
i.SERsy nt
hesi
sfattyacidsandst er
oid
i
ii
.SERhel ptorel
easeglucoseinto
Int
ernal
envir
onment
:-I
stheint
ernal
bloodst
ream inli
vercell
s
surr
oundingofamul
ti
cel
lul
aror
ganisms.
i
v.SERisusedf ordetoxi
ficat
ion
Cyt
oplasm:-Isthesubstancethat
sur
roundsorganell
esandislocated 4.Mi
tochondr
ia:
-Isasmal
l
,spher
ical
,
bet
weent henucleusandplasma rodshapedorf
il
ament
ousst
ruct
ure.I
t
membr ane. gener
atesener
gy.

82
Ba
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act
it
ion
ers
;Vo
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Funct
ionsofmi
tochondr
ia 9.Ci
l
ia/
flagel
l
a:-Thr
eadl
i
ke
1.Mi
crofi
lamentsandmi cr
otubules, appendages,whi
char
emadeof
movementofot herorganell
es, microt
ubules.
2.Or
ganizingproti
enwithincell
wal l
Divisionofcel ls:-Ther ear etwot y
pesof
3.Mai
ntainingofcell
sshape.
cellsdi v
isionmi tosisandmei osis.
5.Ly
sosome: -Appearasmembrane 1.Inmi t
osi s,cel l
sdi vi
deonl yonce.
encl
osedspheres.Theyar
eformed Divisionmai tainsdi pl
oidnumberof
fr
om Golgi
compl exes&havesi
ngl
e chr omosomes.I tundergoesanucl ear
membrane. divisionandcy toplasm di vi
sion.
Thet wochr omosomest hatmadeup
Funct
ionsofLy
sosome eachpai rinknownashomol ogous
chr omosomes.I nfemal et he
i
.Lysosomal enzymeshel
precycl
ewor
n
homol ogouschr omosomesconsi stof2
outcel
lsstr
uctures
l
ar gexchr omosomeswhi leinmal et he
i
i.Cl
eaningofcellsbydi
gest
ingand
pairconsi stofal argexandamuch
removi
ngwast es
smal l
ery .Somat iccellsar ecalled
diploid.
6.Golgicomplex:-Thi
sisneartothe
2.Inmi t
osi s,cel l
sdi vi
det wiceandsuch,
nucleus.I
tconsist4-8membr anous
fourdaught er scal l
sorhamat esar e
sacs.Itpr
ocess,sort
,pack&deliv
er produced.Di vi
sionmai tainshapl oid
prot
eintov ar
iouspart
softhecell
. numberofchr omosomes.Occur sdur i
ng
hamat esf or mat ionandt herei s
Funct
ionsofGol
gicompl
ex.
crossi ngov erorexchangeofgenet ic
i
.Sortandpackageprot
ienintovesi
cle mat eri
als.
i
i.Tr
ansportofpr
otei
ntov ar
ious Cel
lscycl
e:-I
tconsi
stsoftwomajor
dest
inat
ion per
iods,mi
tot
icandint
erphase.

7.Cy
to-
skel
eton:
-Ist
hecy
topl
asm has Interphase: -Duringint
erphasethe
acomplexinternalstr
uctur
econsisti
ng replicatesit'sDNA.Italsoproduces
ofaseri
esofexceedi ngl
ysmal l addi ti
onal organell
esandcy t
osoli
c
componet sinantici
pat
ionofcells
micr
ofil
aments, mi
crotubul
e&
division.Interphaseconsistt
hree
i
nter
medi at
efilamentstogetherr
efer
red phases; G1, SandG2phases.
toasthecyto-skel
eton.
G1phases:-I
st heint
ervalbetweenthe
8.Cent
rosome:
-Isadensear
eaof mitot
icphaseandSphase.Dur ingG1
cyt
oplasm gener
all
yspheri
caland phasethecel
lsi sact
ive,i
trepli
cate
l
ocatednearthenucleusi
tcontai
n mostofitsorganell
esandcy tosoli
c
cent
riol
es. componets.(
8-10hr s).

83
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Sphases: -Theint
erv
al bet
weenG1 3.Anaphase:-Dur
inganaphase, t
he
phaseandG2phasel astabout8hrs. cent
romeresspli
t,seper
ati
ngthet wo
Duri
ngtheSphaseDNAr epl
icat
ion member sofeachchromatidpairwhi
ch
occur
s.Asr esul
toft
het woidenti
cal movetowardopposi t
epoleofthecell
s
cel
lswil
l havethesamegenet i
c byacti
onofspindl
ef i
bersfr
om each
materi
als. si
de.

G-2phases:-Ist
hei nt
ervalbetweenthe 4.Telephase: -Duringthi
sphasethe
Sphaseandt hemi t
oti
cphase.Dur ing chromat iduncoiledateachendofthe
G2phaseitlast(4-
6hrs)duringthecells cel
l nuclearmembr aneandnucl
eusl
us
growthcont
inues,enzymesandpr oti
en ref
or m andgetr eadytodivi
de.
aresynt
hesizedinthepreparati
onf or
cell
sdiv
isi
on. 5.Cytopl asmic(Cytokinesis):-I
st he
divi
sionofacal l
scy toplasm and
G-Ophases: -Thesearecell
sthat organellesintotwoi dent i
calcel
ls.This
remainsinG1phasef orav er
yl ongt
ime processbegi nsinlateanaphasewi t
h
i
sdest i
nednev ertodi
videagain.Most formationofcl eavagef urrow.The
nerv
escel l
sareinGophase. divi
sionhappensbyact ionofact i
ng
microfi
lament swhi chconst ractthe
Mitoticphase:-Isacel lscycl
ewhi ch
centeroft hecells.
resultint
hef ormationoft woidentical
cell
sconsi stsofanucl eardivi
sionand Reproducti
vecel
lsdivi
sion: -This
cytoplasmicdivisi
onf ormt woidentical processcall
edsexualreproduct i
on,
cell
s.Mi t
oticphasei nclude; eachnewor gani
sm isther esultoft
he
unionoftwodiff
erentgamat es
1.Pr
ophase:
-Dur
ingear
lypr
ophaset
he (f
arti
li
zati
on)oneproducedbyeach
chromati
d,t
hechromosomesfi
bre parent.
condensedandshor
tenedi
nto
Mei osis:
-Isther epresentativecells
chr
omosomes,
eachpr
ophase
divi
sionthatoccur sinthegonads
chromosomesconsi stoftwostr
andcall
(ovariesandt estes).Gamat econt ai
nsa
chromatids,andthechromatidarehol
d singlesetofchr omosomeandt husar e
toget
herbycent r
omer eandeach haploid(n)cells.Not ef er
til
izati
on
centr
omer eissorroundingby restoresthedi ploidnumberof
kinat
ichore. chromosomes.Unl i
kemi tosiswhi chis
ompl eteafterasi ngleround, mei osis
2.Met
aphase:
-Inmet
aphase,
the occuri ntwosuccessi vest ages.Mei osis
mitot
icspindlesali
gnthecentromeres landmei osi
sI I.
ofchromatidpairsattheextr
actcenter
Mei
osisI:-Thi
sisthebegins
ofthemitoti
cspindle.Themidpoint
i
mmediatelyaf
terchr
omosomal
regi
oniscalledmet aphasepl
ate. r
epl
icat
ioniscompleteconsi
stoff
our

84
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alt
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it
ion
ers
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

phase; r
egi
oni
scal
l
edmet
aphasepl
ate.

1.Pr ophaseI : -Isanext endedphasei n 7.AnaphaseII:-Duri

nganaphase,the
whi cht hechromosomesshor tenand cent
romeressplit
,seper
ati
ngthet wo
thickeens, thenucl ei envelopand member sofeachchromatidpairwhich
nucl eolusdisappear .Twoev entthatdid movetowardopposi t
epoleofthecells
notoccuri nthemi tosisoccur s; t
wo byacti
onofspindlefi
bersfr
om each
sisterchr omat idofeachpai rof si
de.
homol ogouschr omosomespai roffan
8.TelephaseI I
:-Duri
ngthi
sphasethe
eventcal l
edsy napsi sandt her esulti
ng
chromat iduncoil
edateachendofthe
fourchr omatidsf orm ast ruct urecalled
cel
l nuclearmembr aneandnucl
eusl
us
tetrad.Secondpar t
soft hechr omat i
ds
ref
or m andgetreadytodivi
de.
oft wohomol ogouschr omosomesmay
beexchangedwi thoneanot heri na 9.Cytopl asmic(Cytokenesi s)I
I:-Isthe
processcr ossingov er(itallows divi
sionofacal l
scyt oplasm and
exchangeofgenesbet weenchr omat id organellesintotwoi dent i
calcel
ls.This
ofhomol ogouschr omosomes) . processbegi nsinlateanaphasewi t
h
formationofcl eavagef urrow.
2.MetaphaseI:
-Iswhentetr
adsl i
ne-up
al
ongtheequatorofthespi
ndle.Spindle Mutat i
on:-OccurswhenaDNAgenei s
fi
bersatt
achedtothecent
romer eregion damagei nsuchawayastoal t
erthe
ofeachhomologouschromosomespai r
. geneticmessagecarri
edbythatgene.A
mut agenisanagentorsubstancethat
3.AnaphaseI:-Iswhentetr
ads
canbr ingaboutaper
manental t
erat
ion
seperat
eandar edrawntoopposi
te
tothephy si
calcomposi
ti
onofaDNA
polesbythespindl
efiber
s.The
sucht hatgeneti
cmessageischanged.
centr
omer esi
nAnaphaseIr emai
nint
act
.
Tr
ansportofsubst
anceacr
osscel
l
4.TelephaseI:-I
ssimilartotel
ophase
membrane
ofmitosisuntessthatonlyonesetof
repl
i
cat edchr
omosomesi sincell
s 1.Activ
et r
ansport:
-Isthetransportof
nucl
earenv el
opmayormaynotf or
m. substancesupt hei
rconcentrat
ion
gradi
enti.efrom al
owert oahigher
5.ProphaseII
:-Nucl
earenvel
op(i
ffor
m concentrat
ion.Chemicalenergydri
vesin
i
nt el
ophaseI)di
ssolv
eandspindl
e theform ofATP.
fi
bersrefor
m.Indeedmeiosi
sIIi
svery
si
mi l
artomitosi
s. 2.Passi
v etransport
ati
on: -Thisoccur
s
whensubst ancescancr ossthe
6.MetaphaseII:
-Inmet aphase,t
he semipermeabl emembr aneand
mitot
icspindl
esalignthecentr
omer es organel
lesmembr anetomov edownthe
ofchromatidpai
rsatt heext
ractcenter concent
r at
iongradient
s( osmosisand
ofthemitoti
cspindle.Themidpoint dif
fusi
on) .

85
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iMa
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ri,
CHE
W20
22.

3.Bulktransport:-Transferofparti
cles (22L)andext racellularf l
uid(18L).
The
tolargetocrosst hecellsmembr ane extracellul
arf luidi smadeofup;
occursbypi nocytosis(cell
seati
ng).The 1.Interstit
ial fl
uidandl ymph( 20%)
parti
cleegulfbyext ensionofcytopl
asm 2.Plasma( blood)( 7. 5%)
whenencl osethem byf or
mi nga 3.Fluidi nbones( 7.5%)
vacoule,pi
nocy t
osisallowst hecell
st o 4.Fluidi ndenseconnect i
vetissuel
ike
bri
ngi nfl
uid. carti
lage( 7.5%)
5.Tr ans-cellularfluid; Consistof
Homeost asis:-Thisisanysel f
- a a.Cer ebr ospi nal fl
uid
regulat
ingpr ocessbywhi chbiologi
cal a b.Intraocul arf luid
system tendt omaintainstabi
lit
ywhi l
e a C.Di gest iv
ej ui ces
adjusti
ngt ocondi ti
onst hatareoptimal a d.Ser ousf l
uid
forsurvival
.I fhomeost ati
cis a e.Sy nov ialfluidi njoi
nts
Successf ull
ifecontinues; i
f a f.Fluidi nur i
nar ytr
act
unsuccessf ul di
sasterordeathensues.
Thecont rolofbodyt emperaturein Cerebrospinalfluid(CFS):-Isaclear,
humani sanexampl eofhomeost asi
sin col
orlessbodyf luidfoundinthebr ai
n
abiologicalsy stem. andspinal cord.TheCFSi sderiv
edf rom
abloodpl asmaandi sproducedbyt he
I
mpor
tanceofHomeost
ati
c
ependymal cel
lsi nthenchoroidplexus
1.Themai ntenanceofbody ofthenv entri
cleoft hebrain.
temperatureiscontroll
edbyt hebrai
n.
Anat
omi
cal
posi
ti
onoft
hebodysy
stem
2.Glucoseisthemostbasi cf
orm of
sugar,andtheonlyt ypethebodycan
1.Cardiovascularsystem
usedirectl
y.
2.Respiratorysystem
3.Controlofbil
eacidbyt heli
ver
4.Controlofwaterinki dney 3.Digestivesystem
5.Regulati
onofbl oodoxy gen 4.Endocr i
nesy stem
6.Concentrati
onofATPi nthecel
ls 5.Reproduct i
vesy st
em
7.Maitananceofwat ermi ner
all
eveli
n 6.Muscul ar&skel et
alsyst
em
thebody 7.Excretorysystem
Bodyf l
uid: -Consi stsofintracell
ularand 8.Nervoussy stem
extracellularflui
d.I sanyofv ar
iousf l
uid 9.Lymphat icsystem
foundi nt hebody( suchasbl ood, Bodyf
lui
dschemi
str
y
cerebr ospinal fl
uid, pl
asma, semen,
uri
ne) .Thehumanbodycont ai
nconsi st Osmosis:-I
sthemov ementofwat er
ofsolidandf l
uids.Thesef l
uidsmakeup moleculest
hroughasemi per
meabl e
about2/ 3oft hebodywei ghtandmost l
y membr anefr
om alessconcentr
ated
arewat erwhi chisabout40L.Thebody sol
uti
ont oamor econcent
rat
ed
wateri smadeupofi nt
racellul
arflui
d sol
uti
on.

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iMa
gume
ri,
CHE
W20
22.

Dif
fusi
ons:-Ist
hemovementof Car
diov
ascul
arsy
stem
molecul
estromparegi
onofhigher
Cir
culat
orysy stem: -Canbedef i
nedas
concent
rat
iontoar
egionofl
ower
thepart
soft hebodyandmet hods
concent
rat
ion.
i
nv ol
veswitht hedistr
ibut
ionofblood
Si
mil
ari
ti
es andlymphr oundt hebody .The
cir
culat
orysyst em divi
dedintotwo;
1.Theybot
hgodownt heconcent
rat
ion
gradi
ent Bloodci rculatorysystem: -Whi chfurt
her
2.Theydonotneedener
gy divi
dedi ntohear tandbl oodv essels.
Thebl oodv esselscompr isesoft he
Di
ff
erences veinsandar teri
eswhi chbr anchesi nt
o
Osmosis:-I
sthemovementofwat
er venulesandar t
eri
olesrespi r
atory,and
molecul
esonly.Whi
l
e eachar teriolesandv enulesendi na
networ kofcapi ll
ari
es.
Dif
fusi
on:
-Isthemovementofany
part
icl
es(
atom,mol
ecules,
water
,et
c.)
. Lymphcircul
atorysystem:-Thisist
he
whichisfut
herdivi
dedi nt
olymphnodes
Osmosi
s:-Happensacr
ossa andthelymphv essel
s.Thelymph
semi
per
meablemembr ane,
whi
l
e vessel
scompr i
sesoft heaff
erentwhich
bri
ngslymphtot henodesandt he
Dif
fusi
ons:-Thosenotneeda
aff
erentl
ymphv esselswhichtakes
membr ane,
ithappensdi
rect
lyi
nthe l
ymphawayf r
om thenode.
fl
uid.
I
mpor
tanceofbl
oodci
rcul
arl
ysy
stem
Movement
sofbodyfl
uidbet
weenand
wi
thi
nbodycompart
ment 1.Mov ementofmat eri
alst oacross
wheret heyar esupposetobe, the
Thr
eemaj orfl
uidcompar
tment
s; materi
al sinmov ementar e;nutr
ient
s,
1.I
ntravascularfl
uid oxygen, carbondioxi
de,urea,homones,
2.I
ntersti
tialf
lui
d ant
ibodi esandant i
gen.
3.I
ntracell
ularfl
uid 2.Maint enanceofhemost asi
s
Fl
uidmov
ement
:-Fr
om t
he I
mpor
tanceofl
ymphci
rcul
ator
ysy
stem
i
nt r
avasculart oint
erst
iti
aland
1.Cleanthebloodimpurit
ies
i
nt r
acell
ularcompar tmentsoccursi
nt he
2.Returnsfl
uidtotheblood
capil
lari
es,thecapi l
lar
ymembr aneis
3.Form acti
veanti
bodies
fr
eelypermeabl etosmallmolecul
ar 4.Lymphnodescl earcell
sdebr
isand
weightpar ti
clessuchasel ect
ri
cal
yte, microbes(phagocytosi
s)
glucose,lactate,gl
uconateand
Blood:
-Isclassi
fi
edasaconnect
ive
bicorbonate.
ti
ssue,si
ncenearl
yhal
fofi
tismadeup

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iMa
gume
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CHE
W20
22.

ofcel
l
s. Serum:-Isthepl asmathatcontainsno
Funct
ionsoft
hebl
ood fi
bri
nogen,whi chcleanstheareaof
woundandal soprevententr
yofdi r
t'
s/
1.Transpor tat
ion micro-
organism intothebodyv i
athe
2.Regulationoft emperature wound.
3.Protecti
onagai nsti
nv i
sionofant i
gen
4.Distr
ibutionofhomones Ar
teri
es,veinsandcapi
l
lar
iesarethe
5.Cleansingt hebodywast epr oducts bl
oodv esselsoft
hecardi
ovascul
ar
6.Hemost asis sy
stem
7.Transpor tat
ionofoxygenf rom lungto
Art
ery:-I
sanel
ast
icbl
oodvessel
that
ti
ssue
tr
ansport
sbl
oodawayf
rom t
heheart.
8.Transpor tat
ionofcarbondi oxidefrom
ti
ssuet olung Two(
2)mai
nty
pesofar
ter
ies
9.Transpor tat
ionofdigestedf oodfrom
smallintestinetoti
ssue. 1.Pulmonar
yarteri
es
2.Systemi
cart
eries
Composi
ti
onofbl
ood
Pulmonar
yarter
ies:-Thiscar
rybl
ood
Redbloodcells(Erythrocyt
es):-Fr
om fr
om thehear
ttothel ungswher
ethe
ery
thri
sm, meaning“ red”,
arethered bl
oodpicksupoxy gen.
bl
oodcells,containsredpigmentrichi
n
Veins:-Areclasticbl
oodv essel
sthat
i
ron(haemogl obin),
whi chtr
ansport
bri
ngbl oodfrom otherpartsofthebody
oxygen. tothehear t
.Thel owpressurevenous
Whitebl oodcell
s(Leukocyt
e):-Thi
sis system needst hecontr
actionof
musclest oreturnthebloodtotheheart
.
fr
om l euko,meaning“whit
e”,ar
ethe
severaltypesofwhitebloodcell
s,whi
ch Ther
ear
efourt
ypesofv
eins
protectagainsti
nfect
ion,Cl
eanthebody
deathcel l
sandSpeedupwoundheal i
ng. 1.Pulmonar yvei
n
2Sy stemicv ei
ns
Plat
elet(
Thrombocyte)
:-Arecel
l 3.Superfi
cialvei
n
fr
agmentsthatparti
ci
pateinbl
ood 4.Deepv ei
ns
cl
otti
ngtopreventbl
eedingandal
so
Capil
lar
ies:-Areti
nybl oodv essels
guardsofft
heentryoforgani
sm i
ntoa
connecti
ngar t
eri
est ov ei
ns.These
wound. bloodvesselscarr
yoxy genand
Plasma:-I
sthel
i
quidpartofbloodit nutri
ent
st oindi
vi
dual cell
st hroughout
thebody.Mechani sm bywhi ch
makesupabout55%oft otal
blood
exchangeoccurbet weenbl oodand
volume,
whichmait
ainanceof
ti
ssuesisincapil
lari
es.
hemoestasi
s.

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gume
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CHE
W20
22.

Ar
ter
ial
bloodsuppl
ytot
hemaj
or apexofthehear t
.
or
gansofthebody 8.Post
eriorti
bialpulselocatedatthe
backofankle.
Brain: -I ssuppl ybyt hecar oti
dand 9.Thetemporal pulseislocatedatthe
vertebr al artery tempor
al boneoft heskull.
Hear t: -Issuppl ybyt hecor onar yartery
Lungs: -Issuppl ybyt hebr onchialarter
y Di
sor
der
soft
heci
rcul
ator
ysy
stem
Liver: -Issuppl ybyt hehepat icartery
Atheroscler
osis: -Isagar deningoft he
Kidney s: -Ar esuppl ybyt her enalartery
arteri
es,i
tistypicallycausedbyadi et
Stomach: -I
ssuppl ybyt hegast ri
cand highinfat,whichl eavesf attydeposits
gast roepi ploicartery ont heli
ningoft hebl oodv essels.These
Skin: -Issuppl ybyt hecut aneousar t
ery fattydeposit
sst icktogetherandmake
Test es: -Ar esuppl ybyt heCst i
cular thearteri
eshar dandl essflexi
ble.
artery
Uterus: -I ssuppl ybyt heut erinear t
ery My ocar di
alinf
arcti
on(MI):-Isthe
Ov aries: -Issuppl ybyt heov ar i
anar t
ery technicaltermf orahear
tat tack.Aheart
Pancr ease: -IsSuppl ybyt hespl enic attackcanoccurwhent hebl oodsupply
artery i
scutof ffrom t
heheart,oftenbya
Bloodpr essur e: -Canbedef ineast he bloodcl ot.Someheartattacksar e
pressur eofci rculat
ingbl oodont he mi nor
, butotherscanbelife-thr
eateni
ng.
wal l
soft hebl oodv essel s.
Cardiacischemia:-Meanst heheart
Pulse:-I
stheregul
arbeatingofbl
ood muscl eisnotgetti
ngenoughoxy gent o
thr
oughy ourbody'
sarter
y,wihi
chyou functi
onpr operl
y.Apersonwi t
hcar di
ac
canf eel
wheny outouchparti
cul
arpar
ts i
schemi awi l
lusual
lyexperi
enceangi na-
ofyourbody. l
ikepai nandmayf eelasthought hey
arehav i
ngahear tatt
ack.Cardiac
Somesi
tei
nbodywher
ecanf
eel
pul
se
i
schemi amaycausesi mil
arpaintoa
1.Thecar oti
dpul sei slocatedont he heartattack.
sideofy ourneck( thecar oti
darter y)
Heartfailure:-Isnotpumpi ngblood
2.Thebr achi alpul sei sfoundint he
aroundthebodyasef ficientl
yasi t
i
nnerelbow
should.Itcanl eadtof atigue,short
ness
3.Thef emor alpul seisi nthegroinar ea
ofbreath, andcoughi ng.Somepeopl e
4.Thepopl it
eal pul seislocatedatt he
withhear tfai
lurefi
ndi tdi f
fi
culttodo
backoft heknee
thi
ngssuchaswal king, cli
mbingst ai
rs,
5.Thedor salispedi spulseisfel
tont he
orcarryi
nggr oceries.
topofthef ootandsl i
ghtlytothesi deor
nexttot hemi dline. Hy pert
ension:-I
sahighbloodpressur
e
6.Radial pulselocat edatt hewrist . orhy per
tensionmeanstheforceor
7.Theapi calpulsei sfoundneart he pressureoft hebl
oodfl
owingthrough

89
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CHE
W20
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thev esselsi
sconsistent
lytoohigh. 3.Tur
mours
Highbl oodpressur
ecanl eadtostroke, 4.Embol
i
sm
l
ossofv isi
on,hear
tfail
ure,
heartattack,
kidneydisease,andreducedsexual Anaemi a:
-Isthecondi t
ionofhav i
nga
function. l
owert hannormal redbloodcellcount
.
Peoplewithanemi ahaveaLownumber
Blooddisor
derscanaff
ectbl
oodcel
ls ofredbloodcells.Mil
danemi aof t
en
andalsotheli
quidpor
ti
onofthebl
ood causesnosy mpt oms.Mor esevere
i
nclude; anemiacancausef at
igue,pal
eskin,and
short
nessofbr eathwithexert
ion.
Hear
tdi
seases
Malari
a:-Isamosquito'
sbi
tet
ransmi
ts
1.Heartfail
ure
aparasi
teint
oaper son'
sbl
ood,wher
eit
2.Val
v esfail
ure
i
nfectsredbloodcel
ls.
3.Deformity
4.Physioldamage Thalassemi c:-Isagr oupofi nherited
blooddisor der
s.Thesedi sor dersar e
Bl
oodv
essel
sdi
seases
causedbygenet icmut at
ionst hat
1.Emboli
sm preventthenor nmal product i
onof
hemogl obin.Whenr edbl oodcel lsdo
2.Vari
cosit
y
nothav eenoughhemogl obin,Oxy gen
3.Madages
doesn'tgett oallpar
tsoft hebody .
4.Tumour
Organst hendonotf unct ionpr operly.
5.Micr
obialdi
seaes
Thesedi sorderscanr esultin:
6.Art
eri
oscler
osi
s
Lymphoma: -Isabloodcancerthat
Bl
ooddi
seases occursinthebody '
slymphaticsyst
em.
Yourwhitebl oodcell
schangeandgr ow
1.Hypert
ensi
on
outofcontrol.Hodgkin'
sly
mphomaand
2.Vari
ousaneami
a
non-Hodgkin'sly
mphomaar ethetwo
3.I
nfecti
on
majortypesofl ymphona.
4.Cancer
Leukemi a:-I
sabloodcancerinwhich
Ly
mphnodesdi
seases
malignantwhitebl
oodcellsmult
ipl
y
1.Lymphadenopat
hy i
nsidey ourbody'
sbonemar r
ow.
Leukemi amaybeei t
heracut
eorchr oni
c.
2.Inf
ect
ionandabscess
Chronicleukemiaadvancesmoreslowly.
3.Tumours
Notenoughplatelet
s:-Thisisahavi
ng
Ly
mphv
essel
sdi
sease
toofewplatel
etsisquitedanger
ous
1.I
nfect
ion(
lymphangi
ti
s) becauseevenasmal linjur
ycancause
2.Damages seri
ousbloodloss.

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ri,
CHE
W20
22.

Toomanypl at
elets: -I
sdealwi
thi
fyou atr
ium andlef
tvent
ri
cl
e.Thebi
cuspi
d
havetoomanypl ateletsi
nyourbl
ood, val
v ehastwoCusps.
bl
oodcl ott
scanf orm andblockamajor
Hear tmuscl ecomponent s:-Isthenear t
art
ery
, causi
ngast rokeorhear
tatt
ack.
wall ismadeupoft hreelay er
s; t
hei nner
Plat
eletsthatdon'tclotcor
rectl
y:-Thi
s endocar dium, middl emy ocardium and
i
sSomet i
mes, deformedplatel
etscan't outerepi cardium.Thosear esur rounded
sti
cktoot herbloodcellsorthewallsof byadoubl emembr anessaccal l
edt he
yourbloodv essels,
andsocan' tcl
ot pericardi
um.Thei nner mostl ayeroft he
properl
y.Thiscanal soleadtoa hear tcal
ledt heendocar dium.l tismade
dangerouslossofbl ood. upofal i
ningofsi mpl esquamous
epitheli
um andcov ershear tchamber s
Heart:-Isamuscul aror gan,which andv al
ves.Itiscont i
nuouswi ththe
pumpsbl oodthrought hebloodv essel
s endot hel
ium oft hev einsandar t
eriesof
ofthecirculat
or ysy stems.Bl ood thehear t,andi sjoinedt ot he
providesthebodywi thoxygenand my ocardium wi that hinlayerof
nutr
ients,aswel lasassi sti
ngi nthe conncct i
v etissue.
remov alofmet abol i
cwast es.In
humanst hehear tislocatedbet ween Respiratorysy stem: -Isthenet workof
thelungs, i
nthemi ddlecompar t
mentof organsandt issuest hathelpy ou
thechest.Thehear tisappr oximatel
y breathe.Thi ssyst em helpsy ourbody
thesizeofaman' sfist(230-350grams) absorboxy genf rom theairsoy our
andisshapedl ikeani nvertedcone. organscanwor k.Italsocleanswast e
gases, suchascar bondioxide,fr
om
Chamber sofheart:-Ist
hehearthas yourbl ood.Commonpr oblemsi ncl
ude
fourchamber s,
twoupperatria(
the all
ergies,diseasesori nf
ect i
ons.
recci
vingchamber s)andtwolower
ventri
cles(t
hedischargi
ngchamber s)
. Respirat
ory:-Ist
hechiefrespi
ratory
Theat r
iaopenintotheventr
icl
esviathe organisthelung.Thelungswor kwith
atri
oventri
cul
arvalves. thecir
culatorysy
stem topumpOxy gen
ri
chbloodcel l
sinthebody.Shortnotein
Valvesoft hehear t
:-Ist hehear thas therespir
atorysyst
em organsinclude;
fourvalves,whichsepar at
eits
chamber s.Onev alveliesbet weeneach Mout handnose: -I
stheopeni
ngsthat
atri
um andv entri
cle,andonev alv
er est
s pullai
rfrom outsi
deyourbodyi
ntoyour
attheexitofcachv entricl
es.Thev al
ves respir
atorysyst
em.
betweent heatriaandv entr
iclesare Funct
ionsofnose
call
edtheat ri
ovent r
icularvalves.
Betweent herightatrium andt heri
ght 1.I
ntr
oducesai ri
ntot
hebody
ventri
cleisthetricuspidv al
ve.The 2.Warmst heatmospheri
cai
ritcool
tri
cuspidv al
vehast iir
eecusps.The 3.Fi
lt
ersair
bicuspi
dv alveli
esbet weent heleft 4.Fur
thercleani
ngofair

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:Ba
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iMa
gume
ri,
CHE
W20
22.

5.Expelunwant
edmucus Ribs:
-Thesearebonest
hatsur
round
6.Detect
ionbyrecei
vi
ng andprot
ectyourl
ungsandhear
t.

Sinuses:-I
sthehol l
owareasbetween Alv
eoli:
-Istheti
nyairsacsinthel
ungs
thebonesiny ourheadthathel
p wheretheexchangeofoxy genand
regulat
ethetemper at
ureandhumidit
y carbondioxi
detakesplace.
oftheairyouinhale.
Br
onchi
oles:-I
sasmal l
branchesoft
he
Pharynx(Throat):
-Isthet
ubethat br
onchi
altubesthatl
eadtothealv
eol
i.
deli
versairf
rom yourmouthandnoset
o
thetrachea(windpipe)
. Funct
ionsofbr
onchi
oles

Funct
ionsofphar
ynx 1.Makestheairwarms
2.Makestheairhumid
1.Dualpassageforfoodandair 2.Phagocyt
iaFunct
ion
2.Bri
ngst heai
rtoapproximat
ebody
temperature Capil
lari
es:-Thesearebl
oodv
essel
sin
3.Producesanti
bodi
est hatpr
otectt
he thealveol
iwal l
sthatmov
eoxy
genand
body carbondioxide.

Trachea:-Isthepassageconnect
ing Lunglobes:-Thesearesect
ionsofthe
yourthroatandlungs. l
ungs-thr
eelobesintheri
ghtlungand
twointheleftl
ung.
Funct
ionsoft
rachea
Pleur
al:-I
sthethi
nsacsthatsur
round
1.Regul
atethetemper at
ureofair eachlunglobeandsepar
ateyourlungs
2.Pl
aysasignif
icantrolei
ncoughi ng fr
om thechestwall
.
3.Mait
ainunint
errupt
edai rpassage
Ci
li
a:-I
stheti
nyhairsthatmovei
na
Bronchi
alt
ubes:-Isthetubesatthe wave-
li
kemotiontofi
lt
erdustandot
her
bott
om ofyourwindpipethatconnect i
rr
it
antsoutofyourai
rways.
i
ntoeachlung.
Epiglot
t i
s:-Thisi
satissueflapatthe
Funct
ionsofbr
onchi
al entrancet othetr
acheathatcloses
wheny ouswallowtokeepf oodand
1.Makestheairsui
tabl
yhumid l
iquidsoutofy ourair
way .
2.Makestheairsui
tabl
ywarm
3.Expel
sfor
eignsubstance Larynx(voi
cebox)
:-I
sthehol
l
oworgan
thatal
lowsyoutotal
kandmakesounds
Lungs:-I
sthetwoorganst
hatr
emove whenai rmovesi
nandout.
oxygenfr
om theai
randpassi
tint
oyour
bl
ood. Funct
ionsofl
ary
nx

Diaphragm:-I
sthemusclethathel
ps 1.Warmsandmoisteni
nspi
redair
yourlungspul
linai
randpushitout 2.I
ttakespar
tinv
oicepr
oducti
on

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iMa
gume
ri,
CHE
W20
22.

3.I
tpart
ici
pat
esi
nthemechani
sm of off
oodwi
thsal
i
va)
swal
lowi
ng
Esophagus:
-Thisislocat
edinyour
Di
sor
deri
sofr
espi
rat
orysy
stem thr
oatnearyourtr
achea(windpi
pe)
,the
esophagusrecei
vesfoodfrom y
our
1.Asthma mouthwheny ouswallow.
2.Pneumoni a
3.Tubeecul osi
s Pharynx(Throat):
-Isthet
ubethat
4.Cancer deli
versairf
rom yourmouthandnoset
o
5.Lar
y ngiti
s thetrachea(windpipe)
.
6.Phary ngi
tis
7.Tonsilli
ti
s Stomach: -Isahol l
owor gan,
or
8.Epi
st axis "container
,"thathol
dsf oodwhil
eitis
9.Pneumoconi osi
s beingmi xedwi thst
omachenzy mes.
10.Turmous Theseenzy mescontinuetheprocessof
breakingdownf oodint
oausabl efor
m.
Digest
ivesy
stem:-Thisisconsi
stofal
l
theorganswhichareconcer
nedin Funct
ionsofst
omach
chewingandabsorpti
onoffoodand 1.Contai
nsthefoodeaten
eli
minati
on. 2.Itpr
oducesgastr
icjui
ce
Digest ive:-Isthedi gest i
vest ruct ures 3.Limitt
heabsorbt
ionofsomeliqui
d
consi stoft hegast rointestinaltractpl us 4.Helpsinabsor
bti
onofv i
tami
nB12
theaccessor yorgansofdi gestion.The Smal l
intest
ine:-Thisismadeupof
gast r
oi ntesti
nal organsf ordi gest ion threesegment s-theduodenum,
i
ncl udet hemout h, esophagus, phar ynx, j
ejunum, andileum -thesmalli
ntestine
stomach, smallint estine,andl ar ge i
sa22-f ootlongmuscul art
ubet hat
i
nt estine.Whi letheaccessor yor gans breaksdownf oodusi ngenzymes
i
ncl udet het ongue, salivarygland, rel
easedbyt hepancr easandbil
ef rom
pancr eas, li
ver,andgal l
bladder .These theli
ver.
digest i
v eorgansar elocat edint he
abdomi nal cavit
y .Shor tnot eoft he Funct
ionsofsmal
li
ntest
ine
digest i
v eorgansi nclude;
1.Complet
ionofDigest
ion
Mouth:-I
st hebeginni
ngofthe 2.Mostofnutr
ient
sareabsor
bed
di
gesti
vetract.I
nfact,
digest
ionst
art
s 3.Somesecret
ionhasantimi
crobi
al
bef
oreyouev entakeabite. acti
on

Funct
ionsofmout
h Lar
gei
ntest
ine,
orcol
on:
-Thi
sis
1.Contai
nsthefoodasmachanical r
esponsi
blef
orpr
ocessi
ngwast
eso
breakdown(masti
cat
ion) t
hatempt
yingt
hebowel
siseasyand
2.Formati
onofbluebytongue(
mi xt
ure conv
eni
ent
.

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iMa
gume
ri,
CHE
W20
22.

Funct
ionsofl
argei
ntest
ine Funct
ionsofl
i
ver

1.Secr
etionofmuci n 1.Thesecr eti
onofbi le
2.AbsorbtionofH2O, gl
ucoseandsal
t 2.Deami nat i
onofami noacid
3.Movef eacesdownt or ect
um 3.Conv ersionofgl ycoge-
glucose
4.Bact
erial decomposit
ion
4.Conv ersionofgl ucose-glycogen
5.Excr
etionofcal ci
um andiron
5.Desat urati
onoff ats
6.Formf eaces
6.Format ionofpl asmapr otei
nsfrom
Tongue: -I
st hef l
exibl
emuscularorgan aminoaci d
i
nt hemout ht hatisusedt omovefood 7.Synthesi sofv i
taminA
around, fortastingandt hati
smov ed 8.Storageofv i
tami nB12
i
ntov ariousposi t
ionstomodifyt
hef l
ow 9.Detoxificati
onofdr ugsandt oxins
ofairfrom thel ungsi nordert
oproduce 10.Gener ationofheat
di
fferentsoundsi nspeech.
Gallbl
adder :
-Thesearestor
esand
Salivar
ygl ands:-Thesear ehavethree
concentratesbil
efrom t
heli
ver,and
pairsofmaj orsali
varyglandsunderand
thenreleasesiti
ntotheduodenum in
behindy ourjaw-paroti
d,subli
ngualand
thesmal lint
esti
netohelpabsor
band
submandi bular.Manyot herti
nysali
v ar
y
glandsar einyourlips,i
nsideyour digestfats.
cheeks,andt hroughouty ourmouthand Funct
ionsofgal
l
bladder
throat.
1.Storageofbi
l
e
Pancreas:-Thesear esecr
etesdi gest i
ve
2.Releaseofbi
le
enzymesi ntot heduodenum t hatbr eak
downpr otein,fatsandcarbohy drates. Bi
l
educt
Thepancr easal somakesi nsulin,
passi
ngi tdirectlyi
ntothebloodst r
eam. 1.Pat
hwayofbi l
e
Insul
i
ni sthechi efhormonei ny ourbody 2.Emulsi
fi
cat
ionoffat
s
formetabolizingsugar.
3.Aci
dsabsorbt
ionofVit
ami
nk
Funct
ionsofpancr
ease
Rectum: -I
sastrai
ght,
8inchchamber
1.Secretesjui
cefordi
gest
ionof thatconnectst
hecolontotheanus.
carbohydrat
es,fat
sandprotei
ns
2.Regulati
onofglucose(t
hrough Anus:-Issurr
oundedbysphincter
secret
ionofglucagon. musclesthatareimport
antinallowing
contr
olofstool.I
tisa2inchlongcanal
Li
v er:
-Istheli
verhasmanyf uncti
ons,
consi
sti
ngoft hepelv
icfl
oormuscl es
butitsmainjobwi t
hinthedigestiv
e
system i
st opr
ocesst henutrient
s andthetwoanal sphi
ncter
s(internal
absorbedfrom thesmal l
int
est i
ne. andexternal
).

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iMa
gume
ri,
CHE
W20
22.

Di
seasesofdi
gest
iveor
gans Pancr
easdi
seases

Mout
hs,
tongue&t
eet
hdi
seases 1.Diabetesmell
i
tus
2.Cancer
1.St
aphy l
ococcusaureus( bact
eri
al) 3.Tumour s
2.Oralcandidi
asi
s(fungal) 4.Pancreati
ti
s
3.Herpessimplex(vi
ral
) 5.I
nf ect
ion
4.Mout hrumours(nutr
it
ional)
Li
verdi
seases
Sal
i
var
ygl
andsdi
sease
1.Hepati
ti
s
1.I
njury 2.Li
verabseess
2.Mumps 3.Li
verfai
lure
3.Tumoursandcancer
s 4.Li
vercurhosis
4.Stonesf
ormat
ion 5.Li
vertumour
Phar
ynxdi
seases Gal
l
bladderdi
seases
1.Tonsi
lit
is 1.I
njury
2.Pharyngi
ti
s 2.I
nflammat
orycondi
ti
ons
3.Dipht
heria
Bi
l
eductdi
seases
Oesophagusdi
seases
1.Gallst
one
1.Ossophagi
ti
s 2.Tumour s
2.Detor
mity 3.Jaundice
3.I
nfect
ion
Endocr inesy stem: -Istheendocr ine
4.Tumour
structureconsi stofgl andswhi char e
Smal
l&l
argei
ntest
inesdi
seases responsi blef ort heproduct i
onand
secrctionofhor mones, t hehor mones
1.Obstr
uct
edint
est
ines arechemi cal subst ancest hatregulate
2.Appendi
ci
ti
s theact ivit
yofot hercel l
s.Themaj or
3.Tumours glandoft heendocr i
nesy stem arethe
4.I
njur
y hypothal amus, pi t
uit
ary,t hyroi
d.
5.I
nfest
ati
onbypar
asit
es parathy toi
d, adr enals,pineal body,
pancreas, andt her eproduct i
veorgans.
St
omachdi
seases
Funct
ionsofendocr
inesy
stem
1.Ulcer
2.Gast r
it
is 1.Theysecretechemical
messengers
3.Tumour s i
ntothebloodstream
4.I
nf ect
ation 2.Theyinf
luencegrowthandcel
lul
ar
acti
vi
ti
es

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iMa
gume
ri,
CHE
W20
22.

3.Theyhelpmaintainasuitabl
eint
ernal gl
andsal
somakehor
monescal
l
ed
envir
onment cor
ti
cost
eroi
ds.
4.Theyensuresl
owr el
easeof
secreti
onsfr
om glandst opromote Pancreas:-Thisisaorganthatispar
tof
properbodycoordi
nat i
on bothyourdigesti
veandendocr i
ne
5.Theycomplementt heactivi
ti
esofthe systems.Itmakesdigesti
veenzy mes
nervoussyst
em thatbreakdownf ood.I
talsomakesthe
hormonesi nsul
inandglucagon.
Endocr
inesy
stem or
gans
Ov ari
es:-Isthewomenr eproducti
ve
Hypothal
amus:-Thisorganconnects organs, t
heseor gansmakeest rogen
yourendocri
nesystem wit
hyour andpr ogesterone.Thesehor moneshel
p
nervoussyst
em.Itsmainjobist
ot el
l dev el
opbr eastsatpuberty,
regulat
ethe
yourpit
uit
arygl
andt ostar
torst
op menst rualcycle,andsupporta
makinghormones. pregnancy .

Pi
tui
tar
ygland: -Thisisy
ourendocr
ine Testes:-I
sthemenr eproduct
iveor gans,
sy
stem’smast ergland.I
tuses thetest
esmaket est
osterone.Ithelps
i
nfor
mat i
onitget sfr
om yourbr
aint
otell them growfaci
alandbodyhai rat
ot
herglandsiny ourbodywhattodo. puberty
.Ital
sotel
lsthepenistogr ow
l
argerandplaysaroleinmakingsper m.
Pinealgl
and:-I
tmakesachemical
call
edmelatoni
nthathel
psyourbody Uri
nar
ysyst
em: -Canbedefi
nedast he
getreadytogotosleep. par
tsoft
hebodyandmet hodsinv
olved
i
nthefor
mationandremovalofur
ine.
Thyroi
dgland:-Thisisaglandt
hat
Ur
inar
yor
gans
makest hy
roi
dhor mone,whichcont
rol
s
yourgrowthandmet abol
ism. Twokidneys:-Thi
sorganext
ract
s
wastesfr
om theblood,
bal
ancebody
Parathy
roi
d:-Thi
sisasetoffoursmall fl
uidsandfor
m uri
ne.
glandsbehi
ndyourthy
roi
d.Theyplaya
rolei
nbonehealt
h.Theglandscontr
ol Twoureter
s:-Thisisthet
ubeconduct
s
yourlev
elsofcal
ci
um andphosphorus. ur
inefr
om thekidneystot
heuri
nary
bl
adder.
Thymus:-Thisisagl
andmakeswhi t
e
bloodcel
lscal
ledT-
lymphocyt
esthat Urinarybl
adder
:-Thisi
sthereserv
oir
receiv
esandstorestheur
inebroughtt
o
fi
ghtinf
ecti
onandarecruci
alasa
i
tbyt hetwoureter
s.
chil
d'
simmunesy st
em devel
ops.
Adrenals:-I
sthebestknownf ormaking Uret
hra:-Thisi
sthetubeconduct
suri
ne
the"f
ightorfli
ght"hormoneadrenal
i
ne fr
om thebladdert
otheoutsi
deofthe
(al
socal l
edepinephri
ne)
,thesetwo bodyforeli
minati
on.

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iMa
gume
ri,
CHE
W20
22.

Uret
er:-I
saductthatt r
ansmit
suri
ne i
nhandwi t
htheendocr inesy stem in
fr
om thebladdert
ot heext
eri
oroft
he regulatingbodyf uncti
onsand
bodyduri
ngur i
nat
ion. maint ainingconst antinternal
environment( homeost asis)itusually
Di
aphragm:-I
sthepr
imarymuscleused provides, aquickerr esponsewhen
i
nrespir
ati
on,
whichi
stheprocessof compar edt otheendocr ineresponse
br
eathi
ng. thatissl owerandmor epr olonged,
Funct
ionsofur
inar
ysy
stem thereforet hener voussy stem ismai nly
concer nedwi thel ectr
ical i
mpul sesas
1.Excret
ionofwastes i
tsmeansofcommuni cat i
ont hrough
2.Hormonapr oduct
ion thewhol ebody .Theseel ectri
cal
3.Acidbasebalanci
ng i
mpul sesar etransmi t
tedt hr
oughbasi c
4.Helpsinregul
ati
onofbloodvolume unit
scal l
edner vecel l
soft heneur ons.
5.Producti
onofredbloodcell
s Thener vesaret hebasi cf unctionalunit
s
6.Helpsinmaintai
ningel
ectr
olyt
es ofthener voussy stem.
bal
anceint hebody
Nervoussy st
ems: -Thisi
sdeal swi
th
Di
sor
der
soft
heur
inar
ysy
stem therapidcommuncat ionbetween
dif
ferentpart
soft hebodyinresponse
1.Diabetes
tochargesintheinternal
andr egul
ati
an
2.Ki
dneyst one
ofinvolunt
aryfuncti
onswithi
nt hebody.
3.Hy per
tensi
on
4.Nephriti
s Funct
ionsofner
voussy
stem
5.Renalfail
ure
6.Renalcalcul
i 1.Cont rolofbody '
sinternal envir
onment
7.Urinar
yinconti
nence tomai ntain"homeost asis".Anexampl e
ofthi
si st heregulati
onofbody
Urine:-Isthemadeupof96%wat erand temper ature.
4%ur ea,uricaci
dchr
lori
des,
sulphates, 2.Progr ammi ngofspi nalcor drefl
exes.
creati
nine,ammonia,sodi
um,potassium, Anexampl eofthi
sist hest retchref
lex.
phosphat eandoxal
ates. 3.Memor yandlearning
4.Volunt arycontrolofmov ement
Normaluri
ne:-Isaamberi
ncolor.PHof
6.Gener atingresponsest ot hat
uri
neisacidi
c,nor
malur
inehasgravi
ty
i
nformat i
on(mot orresponses) .
ofbetween1020and1030upt o1200ml
ofuri
necanbev oi
dedbyheal
thy Component
sofner
voussy
stem
i
ndivi
dual.
1.Brain
Ner
voussy
stem 2.Spinalcord
3.Peripher
alner
voussy
stem
I
ntr
oduct
ion
Neuroneornerv
ecell
:-Thi
siseach
Thener
voussy
stem usual
l
ywor
kshand
neur
oneconsistsofacel
lbodyandi
ts

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iMa
gume
ri,
CHE
W20
22.

prodeds,oneaxonandmanydendr it
es. car
diacandsmoothmusclecont
ract
ion
Neuronescannotdi vi
de,andforsurv
ival andalsogl
andul
arsecr
eti
on.
theyneedacont inuoussupplyof
oxygenandgl ucose.Neuronesgenerate 3.Associ
ati
on/
int
erneur
ones
andtransmi tel
ectr
icali
mpulsecall
ed Theseareneuronesthattransmit
acti
onpot enti
al. i
mpulsesfrom sensoryneuronesto
Pr
oper
ti
esofaneur
ones motorneur
onesandar eentir
elyl
ocat
ed
i
nthecentralner
voussy st
em.
1.Tr ansmissionofimpulsesi nbot h
electri
calandchemi cal Nev rogli
a: -Ist
heneur onesofthe
2.Theyar ethephy siol
ogical uni
tsofthe ocent r
al nervoussystem aresupported
nerv oussystem byf ourtypesofnon- excitabl
egli
alcell
s
3.Theycar ryelectr
icali
mpul sest o thatgr eatl
youtnumbert heheurones
variouspartsoft hebody( conductivi
ty) Uhlikener vecell
s,whichcannotdi v
ided,
4.Theycanpr oducechemi calenergy gli
al cell
scont i
nuetodi vi
dethroughout
(ATP) l
ife.Theyar e;
5.Theycani nit
iat
eimpulsesi n 1.Astr
ocytes
responset ost i
muili(
ir
ri
tabili
ty) 2.Oli
godendrocyt
es
Ty
pesofneur
ones 3.Microgl
i
a
4.Ependymal Cel
l
s
1.Sensor
yoraf
fer
entneur
ones
Funct
ionsofneur
ologl
i
a
Theseareneuroneswhi chtransmi
t
i
mpulsesfrom receptorsintheski
n, 1.Provi
dedev el
opmental ,
physiol
ogical
,
senseorgans,andvisceratothebrai
n andmet abolicsupportforneurons.
andspinalcor
d. 2.Theyar eresponsibl
ef ormaintai
ning
homeost ati
ccont r
ol
2.Mot
ororef
fer
entneur
ones 3.Immunesur vei
ll
anceint henervous
system.
Thesearenervethatori
ginateinthe
brai
nandspinalcordtheytransmit Di
vi
sionsofner
voussy
stem
i
mpul sest
otherecectororgans:
Musclesandgiands.Therearet wo Thenervoussysterm maybedi vi
ded
ty
pes. i
ntotwopr i
nci
pal di
vi
sions,t
hecentral
ner
voussy st
em andt heperi
pheral
i
.Somaticef
fer
entNerves:
-Isinv
olv
ed ner
voussy st
em,andsev eralsub-
i
nv ol
unt
aryandref
lexSkel
etal
muscle di
vi
sions.
contr
act
ion.
Peripheral
nervoussyst
em:-This
i
i.Autonomiceffer
entNerves:-
These consistsofthenerv
esandgangli
a
couldeit
herbesy mpathet
icor outsidethebrai
nandspinal
cord.The
parasympathet
ic.Theyareinv
olvedi
n mainf unct
ionofthePNSistoconnect

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22.

theCNSt otheli
mbsandorgans, Funct
ionsofcer
ebr
um
essenti
all
yserv
ingasarel
aybetween
thebrai
nandspi nal
cor
dandtherestof 1.Itcontrol
sment alact
ivi
ti
esi nvol
ved
thebody. i
nmemor yint
ell
i
gence,senseof
responsibil
i
ty,t
hinki
ng,r
easoni ngmoral
Funct
ionsofper
ipher
alner
voussy
stem senseandl earni
ng
2.Iti
niti
ateandcontrolskeletalmuscl
e
1.Mostner vesoft heper iptteralnervous contract
ionandt her
eforevoluntary
sy stem conv eysensor yimpul sesf rom mov ement .
ther ecept orst othecent ralner vous
sy stem fori ntegrati
oncoor dinationand Cerebell
um: -I
ssit
uatedbehindthe
Interpretation. ponsv ar
ollandimmediat
elybelowthe
2.ThePNSal soconv eymot or-
impul ses poster
iorporti
onofthecerebrum.
from theCNSt otheef fectoror gans
whi chincludeskel etalmuscl es, smoot h Funct
ionsofcer
ebel
l
um
muscl es, car diacmuscl es,andgl and. 1.Coordi
nati
onofv ol
untar
ymuscular
Ref lexact i
on:-Canbedef i
nedasf ast mov ementpost
ureandbalance
i
nv ol untaryandusual l
yprotecti
vemot or 2.I
tcontrol
sandcoordinatest
he
responsest ospecifi
cstimuli
.E.g. mov ementsofvar
iousgroupsof
Wit hdr awal ofaf i
ngerf
rom everyhot musclesensuri
ngsmoot handpreci
se
surf aceonst r
ict
ionpupili
ntespenseto act
ion.
brightl ightControlofbloodpressure. Brianst em: -Thisisthepar toft hebr
ain
thati ssi t
uat edbel owt hecer ebrum,i
n
Refl
exARC:-Thisisthepathani
mpul se
frontoft hecer ebell
um andabov eme
fol
l
owf r
om it
'sori
ginint
hedendri
tesor spinal cor d.I tismadeupoft hreepai
rs
cel
lsbodyofaneuroninonepartofthe mi dbr ain, t
hemi dbr aini
st hear eaof
bodytoit
'st
erminati
onelsewher
eint he thebr ai nst eam si t
uatedbet weent he
body. cer ebrum abov eandt heponsbel ow;
1.Itcont ainsner v efi
breswhi chconnect
Component
sofr
efl
exARC
thecer ebrum wi thlowerpar tsofthe
brai nandwi ththespi nalcord.
1.Recept
or
2.Ital socont ai
nsnucl ei
t hatactsas
2.Sensor
yneur
one
relayst ationsf ortheascendi ngand
3.Cent
er descendi ngner vef i
bres.
4.Mot
orneur
ane
Funct
ionsofbr
ainst
em
5.Ef
fect
or
1.Regulat
ionofhear
trat
e
Cer
ebr
um:
-Thi
sist
hel
argestpar
tof 2.Breat
hing
t
hebr
ainandi
toccupi
est
heant
eri
or 3.Sl
eeping
andt
hemi
ddl
ecr
ani
alt
ossae. 4.Eati
ng

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CHE
W20
22.

Pons: -Issi
tuatedi
nfrontofthei
s Funct
ionsofDi
encephal
on
cerebell
um belowthemi dbrai
nand
abovet hemedul aobl
ongata. 1.Thedi encephalonactsasapr i
mary
relayandpr ocessi
ngcenterforsensory
Funct
ionsoft
hePONS i
nf ormati
onandaut onomiccontr
ol.
2.Thepl ethoraofcommuni cat
ing
1.Ifformsabr i
dgebeweent hetwo pat hway
sbet weent hesestr
uctur
esand
cerebell
arhemi spher e otherpartsoft hebodymakest he
2.Itcontainsnucl eit
hatactasr eay diencephalonaf uncti
onal
lydiv
ersearea.
stati
on'sandsomet heseareassoclat
withcranial ner
ves Hy pothalamus: -Isasmal lbut
3.Isalsopl ayar olei
ncontroll
ing i
mpor tantpont i
onoft hediencephal on.
respir
aton l
tissi tuatedbelowandi nf
rontoft he
thalamus, immedi atelyabovet he
Medul l
aobl ongat
a:-Extendsfr
om the pitui
tarygl and,thehypothalamusi s
ponsabov eandi sconti
nuouswi t
htte l
inkedt othepost eri
orlobethepi t
uitary
spinalcordbelow.lt
sabout2. 5cm l
ong glandbyner vefibresandt ot heanteri
or
andi tl
iesjustwit
hinthecrani
um above l
obebyapor tal
sy st
em ofbl oodvessels.
theforamenmagnum.
Funct
ionsofhy
pot
hal
amus
Funct
ionsofmedul
l
aobl
ongat
a
1.Itcont
rol
stheoutputofhormones
1.I
tactasr
elayst
ati
ons,
forsensor
y fr
om bothlobesofthepit
uit
arygland
ner
vepassi
ngf
rom t
hespi
nal
cor
dto 2.ltcont
rol
stheautonomicnervous
t
hecer
ebr
um. system
3.Itcont
rol
sappeti
teandsatiet
y
2.I
tconsi
stsoff
ourv
ital
cent
res
4.Itcont
rol
sthir
standwaterbalance
i
.Car
diaccent
erwhi
chcont
rol
rat
eand 5.Itcont
rol
sbodytemperature
f
orceofcar
diaccont
ract
ion 6.Itcont
rol
semot i
onalr
eacti
ons
i
i
.Respi
rat
orycent
erwhi
chcont
rol
srat
e 7.Itcont
rol
ssexualbehavi
our
anddept
hoft
her
espi
rat
ion 8.Itcont
rol
ssleepi
ng

i
i
i.Vasomot
orcent
re,
whi
chcont
rol
sthe 12Cr
ani
alNer
ves
si
zeoft
hebl
oodv
essel
s
1.Olfactor
ynerve
i
v.Ref
lexcent
rewhi
chcont
rol
sref
lex 2.Opt i
cnerve
act
ions.Suchasv
omi
ti
ng,
coughi
ng, 3.Oculomot ornerve
sneezi
ngandswal
l
owi
ng. 4.Trochlearnerve
5.Tri
gemi nalnerve
Diencephal
on:-Thisispartofthebr
ain
6.Abducensner ve
connectsthecerebr
um andt hemid
7.Facialnerve
brai
n.Itconsi
stofthalamusand
8.Vestibul
ocochlearner
ve
hypothal
amus.
9.Glossopharyngeal

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10.Vagus Ty
pesofmuscl
esi
nthebody
11.Accessory
12.Hypoglossal 1.Skeletal
muscl
es
2.Smoot hmuscl
es
Di
sor
der
soft
hener
voussy
stem 3.Cardiacmuscl
es

1.I
nfect
ionsdisor
ders:-Suchas 1.Skel etalmuscles:-Thesear etheonly
muscl est hatcanbeconsci ously
meningi
tis,
encephal
i
tis,pol
io,
and
controlled.Theyar eatt
achedt obones,
epi
duralabscess.
andcont ract
ingthemuscl escauses
2.Str
uct
uraldi
sorders:
-Suchasbrai
n mov ementoft hosebones.Anyact i
on
thataper sonconsciouslyundertakes
orspi
nalcor
dinjury
,Bell
'spal
sy,
cerv
ical
i
nv ol
v est heuseofskeletalmuscl es.
spondylosi
s,car
palt
unnel syndr
ome,
Exampl esofsuchact i
vit
iesinclude
brai
norspinalcordt
umor s,peri
pher
al running, chewing,andwr i
ti
ng.
neuropathy
,andGuil
lai
n-Barrésyndr
ome.
2.Smoot hmuscl e:-I
slinestheinsideof
Muscularsy st
em: -I
st heconsistof bloodv essel sandor gans,suchast he
vari
oust y
pesofmuscl ethateachplaya stomach, andisal soknownasv isceral
cruci
alroleinthef unctionofthebody . muscl e.Itistheweakestt ypeofmuscl e
Musclesal l
owaper sont omov e,speak, buthasanessent i
alrol
einmov ingf ood
alongt hedi gest
iv etr
actand
andchew.Theycont rolheart
beat,
mai ntaini
ngbl oodci r
culati
onthrough
breat
hing,anddi gestion.Other
thebl oodv essels.Smoot hmuscl eact s
seeminglyunrelatedf uncti
ons,incl
uding i
nv oluntaril
yandcannotbeconsci ously
temperatureregulationandv isi
on,also cont r
olled.
rel
yont hemuscul arsystem.Keep
3.Car di
acmuscl e:-Thisislocatedonl
y
readi
ngt odiscovermuchmor eabout
i
nt heheart,cardi
acmuscl epumps
themuscul
arsyst
em andhowi
t
bloodaroundt hebody .Cardiacmuscle
cont
rol
sthebody. stimulat
esi t
sowncont r
actionsthat
form ourheartbeat
.Signalsf rom t
he
Howt
hemuscul
arsy
stem wor
ks
nervoussy st
em controlther ateof
Themuscl esaccountforar ound40 contracti
on.Thistypeofmuscl eis
per centofaper son’swei ghtwi ththe strongandact sinvol
untaril
y.
l
ar gestmuscl eint hebodybei ngthe Funct
ionsofmuscul
arsy
stem
gluteusmax imusint hebut tocks.The
1.Mobil
it
y:-Isthemuscularsystem’s
muscul arsystem containsmor ethan
mainfunct
ionistoal
lowmov ement.
600Tr ustedSourcemuscl est hatwork Whenmuscl escont
ract
,theycont r
ibut
e
toget hertoenablet hefullfunctioni
ngof togr
ossandf inemovement .Gross
thebody .

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CHE
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22.

mov ementref er
stolarge,coordinated 5.Respir
ati
on: -Thi
si sbreathing
motionsandi ncludes:wal
king,running, i
nvolvestheuseoft hediaphr agm
swimmi ng.Finemov ementi nv
olv es muscle.Thediaphragm isadome-
smallermov ement s,
suchas; writi
ng, shapedmuscl elocatedbelowt helungs.
speaking,f
acialexpressi
ons. Whent hediaphragm contracts, i
t
pushesdownwar d,
causingt hechest
2.Stabilit
y: -I
sthemuscl etendons cavi
tytogetbigger.Thelungst henfil
l
stret
chov erjoi
ntsandcont ri
butetojoint wit
hai r
.
stabil
ity.Muscl etendonsintheknee
j
ointandt heshoul derj
ointarecruci
al i
n 6.Di gest i
on:-Isthemuscul arsy st
em
stabil
izati
on.Thecor emusclesar e all
owsf ormov ementwithint hebody,
thosei ntheabdomen, back,andpelvis, forexampl e,duri
ngdigest i
onor
andt heyal sostabili
zethebodyand urination.Smoot hmusclesi nthe
assistintasks, suchasl i
ft
ingweights. gastr ointest
inalorGItr
actcont r
ol
digest i
on.TheGIt r
actstretchesf r
om
3.Posture:-Isaskeletalmuscl eshelp themout htotheanus.
keepthebodyi nthecor rectpositi
on
whensomeonei ssit
tingorst anding. 7.Ur ination: -I
st heur inar
ysy stem
Thisisknownaspost ure.Goodpost ure compr isesbot hsmoot handskel etal
rel
iesonst r
ong,fl
exiblemuscl es.Sti
ff
, muscl es,including; bladder,kidneys,
weak,ortightmusclescont ri
but eto peni sorv agina,prost ate,
uret ersand
poorpostureandmi salignmentoft he urethr a.Themuscl esandner v esmust
body.Long-term,badpost ureleadsto wor kt oget hertohol dandr eleaseur i
ne
j
ointandmuscl epaini ntheshoul der
s, from t hebl adder .Urinaryprobl ems,
back,neck,andelsewher e. suchaspoorbl addercont r
ol or
retent i
onofur ine,arecausedby
4.Ci
rcul
ati
on:
-Ist
hehear
tisamuscl
e damaget ot hener vest hatcar rysignals
t
hatpumpsbl
oodt
hroughoutt
hebody
. tot hemuscl es.
Themov ementoft hehear tisoutsideof
8.Chil
dbirt
h: -I
sasmoot hmuscl esin
consci ouscont rol,anditcont racts theuterusexpandandcont ractduri
ng
automat i
call
ywhenst imulat edby chil
dbir
th.Thesemov ement spushthe
electrical si
gnal s.Smoot hmuscl einthe babythrought hevagi
na.Also,thepelv
ic
arteriesandv ei
nspl aysaf urtherrolein fl
oormuscl eshelptoguidethebaby ’
s
theci rculati
onofbl oodar oundt hebody . headdownt hebir
thcanal.
Thesemuscl esmai ntainbloodpr essur e 9.Visi
on:-Isthesixskeletalmuscl
es
andci rculat
ioni ntheev entofbl oodl oss aroundtheey econtrolit
smov ements.
ordehy drat
ion.Theyexpandt oincrease Thesemuscl eswor kquicklyand
bloodf lowdur i
ngt i
mesofi ntense preci
sely,
andal l
owt heey eto;
exer cisewhent hebodyr equi r
esmor e 1.Maintai
nast ableimage
2.Scanthesur r
oundi ngarea
oxy gen.

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CHE
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3.Tr ackmovi
ngobj
ects associ
atedwi
thi
t.I
tconsi
stsof
:
4.Ifsomeoneexperi
encesdamageto
theireyemuscl
es,i
tcanimpai
rthei
r 1.Lymphaticcapi
ll
ari
es:-I
smadeof
visi
on. endothel
ium (
simplesquamous
epi
theli
um)
10.Or ganpr otect
ion:-Isthemuscl esin
thetorsopr otecttheinternal or
gansat 2.Lymphat
icvessels:
-Thisismadeof
thefront, si
des,andbackoft hebody . thr
eelay
ersli
keveins;al
sotheyhav
e
Thebonesoft hespineandt heribs val
ves.
provi
def urt
herprotection.Muscl esalso
3.Lymphati
cducts:-Thesear
educt
s
prot
ectt hebonesandor gansby
thatdr
ainsdi
ff
erentpart
softhebody
absorbingshockandr educingfrict
ionin
andincl
udes:
thej
oi nts.

11.Temper atureregulat
ion:-Isto 1.Rightl
ymphat i
cduct:-Isadr ai
ns
maintainingnor mal bodytemper at urei
s upperri
ghtpartofthebodyandempt ies
animpor tantf uncti
onoft hemuscul ar i
nt ori
ghtsubclavi
anveinthoracicduct
system.Al most85per centTr usted drai
nsremainderpartofthebodyand
Sourceoft heheataper songener atesi
n emptiesi
ntoleftsubcl
avianvein.
thei
rbodycomesf r
om cont r
act i
ng
muscles.Whenbodyheatf all
sbel ow 2.Lymph: -Istheflui
dwithinthe
opti
mal l
evels, t
heskeletalmuscl es l
y mphaticcapill
ari
esandv essel
s;whi
ch
i
ncreaset heiract i
vi
tytomakeheat . i
sder i
vedf rom
Shiver
ingi soneexampl eoft his ti
ssuefluid.Tissuefl
uidi
sder i
vedfr
om
mechani sm.Muscl esinthebl ood thebloodpl asma.
vesselsalsocont r
acttomai ntainbody
3.Lymphoi
dti
ssues:
-Thesear
e
heat.
di
stri
but
edthr
oughoutt
hebody.These
Di
seaseoft
hemuscul
arsy
stem are;

Thei
nfl
ammat
orymy
opat
hies,
suchas; 1.Ly
mphnodes:
-Hel
pforf
il
tr
ati
onof
l
ymph
1.Pol
y my osit
is
2.Dermat omy ositis 2.Tonsi
ls:-Al
sohel
pforf
il
tr
ati
onof
3.Muscul ardystr ophy ti
ssuefl
uids
4.Myast heniagr av i
s
3.Thymus:-Thisi
sforpr
ocessi
ngT-
5.Amy otrophiclat eral
scl
erosi
s
T-l
ymphocytesandhormone(t
hymosi
n)
6.Rhabdomy olysis
secret
iont
ostimulat
eT-l
ymphoid
7.Cardiomy opathy
ti
ssues.
Lymphati
cSyst
em: -Thi
sis
4.Spl
een:-Hel
psforfi
l
trat
ionofbl
ood,
communicat
eswit
ht heblood
anddestr
ucti
onofoldredcel
ls
ci
rcul
ator
ysyst
em andisclosel
y

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Int
egument arysystem: -Consi stt he 9.Aesthet
icsandcommuncat
ion
skinandi tsderi
vatives.Thesei ncl ude 10.Sensorypercept
ion
hair,
nails,andsev eraltypesofgl ands.
Thesy stem functionsi nprotection, in 1.Protecti
on:-Thi
sisagainstharmf ul
theregul at
ionofbodyt emper ature, in microorganisms,f
orei
gnmat eri
alandi t
theexcr eti
onofwast emat erial
s, int he prev
ent sexcessi
velossofbodyf l
uid.
synthesisofv it
ami nD3wi t
ht hehel pof 2.Heatregul
ati
on:-Thi
siswit
hthe
sunrays, andinther ecepti
onofv arious sweat,
heatleavesthebody
sti
mul iperceivedaspai n,pressur eand
temperat ure. 3.Excret
ion:
-Isasmallamountof
wasteproductsf
rom t
hebodysuchas
Skin:
-Isthelargestorganinthebody urea.
occupyi
ngal most2m 2ofsur facearea
thi
ckensof2mm.Ski nhas3mai npart
s. 4.Synt
hesi
s:-Thisi
sbytheact
ionofUV.
Thesearet heepider
mi s,
dermisand Vit
aminDissynthesi
zedi
ntheskin.
hypodermis.
5.Sensoryrecepti
on:
-Itcontai
ns
Hy poderms:-Iti
sfoundbeneatht
he sensoryreceptor
sofheat,col
d,touch,
dermis.Iti
sasubcut aneousl
ayer pressur
e,andpain.
(undertheskin).
Hair:
-ThisiscomposedofKer ati
nized
Hy poder mis:-Iscomposedofl oose, thr
eadsofcel ls,whi
chdevelopsfrom
fi
br ousconnect iveti
ssue,whichi sri
chly theepidermis.Becausei
tar i
sesfrom
suppl i
edwi thlymphaticandbl ood theskin,i
tisconsider
edanappendage
vesselsandner ves.Hypodermi sis oftheskin.Itcoverst
heentirebody
mucht hickerthandermis.Withi nit exceptthepal ms,sol
es,
li
ps, t
ipofpenis,
coilsofduct sofsudor i
fer
ous( sweat ) i
nnerlipsofv ulv
aandnipples.
glands, andthebaseofhai rfollicl
es.
Funct
ionofhai
r
Epidermis:
-Ist
heouterl
ayeroft
heski
n
1.Insulati
onagainstcoldinscalp
thatismadeofstr
ati
fi
edsquamous
2.Agai nstgl
areineyebrows
epithel
i
um.
3.Screenagainstforeignpart
icles(eye
Funct
ionsofSki
n l
ashes)
4.Inthenost r
il
strapdustparticlesi
n
1.Prot
ection theinhaledair
2.Sensation 5.Protectopeningsfrom for
eign
3.Heatregulation parti
cles
4.Controlofev aporat
ion
5.Stor
ageandsy nt
hesis Nai
ls:-Thisisl
ikehai
raremodif
icati
ons
6.Excreti
on oft
heepi dermi
s.Theyaremadeofhar d
7.Absorption ker
ati
n.Nai l
sarecomposedoffl
at ,
8.Waterresistance cor
nif
iedplatesonthedorsal
surfaceof

104
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hPr
act
it
ion
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

thedist alsegmentoft hefingersandt oe. boneandcar

ti
lage.
Thepr oxi mal partofnaili
sl unul
ar,
whichi swhi tei nit
scolorbecauseoft he Funct
ionsofskel
etal
syst
em
capil
lariesunderneat harecov eredby 1.Support
:-Itfor
mst heint
ernal
thi
ckepi t
heli
um.Nai lhasbodyandr oot. fr
amewor kthatsupport
sandanchor
s
Thebodyi stheexposedpar tandt he al
lsoft
organs.
rooti
shi ddenundert heskin.Thenai l
endswi thaf reeedget hatov er
hangs 2.Pr
otect
ion:
-Bonespr
otectsof
t
theti
poft hef ingers.Epit
heliall
ayer body
organs.
coveringunderneat hofthef or
e-hang
3.Movement:-I
sskelet
almuscles
naili
shy pony chyem.Thenai lr
estson
att
achedtotheskel
etal
sy st
em uset
he
anepi theli
allay erofskincallednailbed.
bonetolev
erstomov ethebodyandit
s
Di
seaseski
n part
.

1.Str
ess 4.Storage:-Fati
sstoredintheinter
nal
2.Eczema cavi
tiesofbones.Bonei tsel
f-
servesas
3.Psoriasis astorehouseofmi neral
s.Themost
4.Sebor r
heicder
mat
it
is i
mpor tantbeingcal
cium andphosphors.
5.Rosaceae
5.Bl
oodcell
for
mation:
-It
'
soccur swit
h
6.I
chthy osi
s
i
nthemarrowcavi
ti
esofcert
ainbones.
7.Vit
il
igo
8.Hives Bone(osseous):
-Isaspeci
ali
zed
connect
iveti
ssuethathast
hestr
engt
h
Skel
etonssy
stem
ofcasti
ronandlight
nessofpi
newood.
Skeletal
:-Istheskel
etalst
ruct
ures
Ty
pesofbone
consistofbonesandcar ti
l
agesthatgiv
e
thebodyi tshape,(
framework)
.Which 1.Longbone:-Arecall
edlongasi ts
functi
onofbodypr otect
ionandmot i
on. l
engthisgreat
erthanit
swi dth.The
mostobv i
ouslongbonesar einthearm
Component
sofskel
etal
andleg.Theyactaslev
erst hatpul
ledby
1.Bones contr
acti
onofmuscles.
2.Joi
nts
2.Shortbones:-Areaboutequal i
n
3.Cart
il
ages
l
ength,widthandthickness,
whi char
e
4.Li
gament
shapedwi t
hregularori
entat
ion.They
Joint:
-Thisisgi v
et hebodyflexi
bil
i
ty occuri
nt hewristandankle.
andallowmov ement stooccur.But
fr
om st r
ucturalpointofvi
ew,thehuman 3.Fl
atbones:
-Ar
ethi
norcur
vedmor
e
skelet
alsystem consistsoftwomai n of
tent
heyar
efl
at.Thi
sincl
udesr
ibs,
typesofsuppor ti
veconnectiveti
ssue, scapul
ae,
ster
num andboneofcr
ani
um.

105
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:Ba
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iMa
gume
ri,
CHE
W20
22.

4.Ir
regul
arbones:-Theydonotfit 3.Crani um ( 8)
neatl
yintoanyothercat
egor
y.E.g.Ar
e 4.Pect or al (shoul der )girdle(
4)
thevert
ebral
,faci
al,
andhipbone. 5.Pariet al (2)
6.Clavicl e( 2)
5.Sesamoi
dbones:-Aresmal lbones 7.Tempor al (2)
embeddedwithi
ncertaintendons,t
he 8.Scapul a( 2)
fi
brouscor
dthatconnectsmuscleto 9.Front al (1)
bones. 10.Ethmoi d( 1)
11.Humer us( 2)
6.Accessor
ybones: -Aremost 12.Sphenoi d( 1)
commonl yfoundinthefeet.They 13.For ear m Occi pi
tal (1)
usual
lyoccurinthedevelopingboneand 14.Ulna( 2)
donotfusecompl et
ely. 15.Face( 14)
16.Radi us( 2)
Funct
ionsofbone 17.Maxi llary( 2)
18.Wr ist( 16)
1.Support
iveandprot
ectionofi
nter
nal 19.Zygomat ic( mol ar)( 2)
organs. 20.Car pal s( 16)
2.Thestorehouseandmai nsuppl
yof 21.Lacr imal (2)
reser
vecalci
um andphosphate. 22.Handandf ingers( 38)
3.Themanuf act
ureofredandwhite 23.Nasal (2)
bloodcel
l. 24.Met acar pal s( 10)
25.Infer i
ornasal conchi i
(2)
Skull:
-ItContain29bones.Theskull 26.Phal anges( 28)
restsont hesuperi
orofver
tebral 27.Palat ine( 2)
column.I ti
scomposedofcr anial
and 28.Lowerext remi t
ies( 62bones)
facialbones. 29.Mandi bl e( 1)
30.Pelv icgi rdle( 2)
Di
vi
sionoft
heskel
etal
syst
em 31.Vomer( 1)
32.Ster num ( 1)
TheAdul thumanskel et
onshav e206 33.Thigh( 4)
namedbonest hataregroupedint otwo 34.Mal leus( hammer )( 2)
pri
ncipal parts.Thesear etheaxialand 35.Femur( 2)
appendi cularskeleton.TheAxial 36.Incus( anv i
l)( 2)
skeletonconsi stbonest hatli
earound 37.Pat ella( 2)
theaxis.Andt heappendi cul
arskeleton 38.Stapes( st i
rrup)( 2)
consistbonesoft hebodyoutoft he 39.Leg( 4)
axialgroup. 40.Hy oid( 1)
41.Tibia( 2)
Di
vi
sionsofAdul
tSkel
eton 42.Ver tebr al col umn( 26bones)
43.Fibul a( 2)
1.Axi
alskel
eton(
80bones) 44.Cer vical v er t
ebr ae( 7)
2.Appendi
cul
arskel
eton(
126bones) 45.Ankl e( 14)
46.Thor aci cv ertebr ae( 12)
1.Skul
l(29bones) 47.Tar sal s( 14)
2.Upperext
remiti
es(
64bones) 48.Lumbarv er tebrae( 5)

106
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it
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;Vo
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

49.Footandt oes(38) heal

thwor kermust :
50.Sacrum (5fusedbones)(
1) b i .Useappr opriatelanguage
51.Metatarsal
s(10) 2. ii
.Li
stenat tenti
v el
y
52.Coccyx( 3-
5fusedbones)(
1) 3 iii
.Notev erbalandnon- verbalclause
53.Phalanges(28)
5.Makethecl i
ent /
pat i
entcomf ortabl
e
54.Thorax(25bones)
55.Ribs(24) 6.Avoi
dtechni cal&pr ofessional
56.Ossicl
esofear( 6) j
argons
7.Lear
ntowar dpat ientandmai nt
ain
CLI
NICALSKI
LLS eyescontact
Cli
nicalski
ll
s:-Canbedefi
nedast he 8.Non-j
udgment alatti
tudes
basicdiagnosti
candther
apeuti
c 9.Noleadingquest ions
procedurethatmaybeperfor
medon 10.Document ationofal li
nformation
pati
entorclientwhi
l
einthecli
nic. Typesofhi
stor
yrequi
reddur
inghi
stor
y
Cli
ni calprocedur e:-Canbedef ineas taki
ng
anyact iviti
esdirectedorper formedon 1.Demogr aphichi story
ani ndividualwiththeobj ecti
veof 2.Medi cal hi
story
i
mpr ovingheal t
h, t
reatingdiseaseor 3.Development al hist
ory
i
njur yormaki ngadi agnosis,orany 4.Bir
thhi story
pract i
ceofaheal thpr act
it
ionert hat 5.Antenat alhistory
i
nv olvesacombi nat i
onofspeci alski
ll
s 6.Obstetricandgy necol
ogi
caHi
stor
y
orabi li
ti
esandmayr equi
redr ugs, 7.Nutri
t i
onal history
dev i
cesorbot h. 8.Fami l
yhi story
Histor
yt akingorintervi
ew: -I
samet hod 9.Socialhistory
bywhi chheal thcareprov idersgat her 10.Occupat i
onal history
i
nformat ionaboutapat ient spastand Adv
ant
agesofi
nter
view/
hist
oryt
aki
ng
presentmedi calcondi t
ioni nor derto
i
nformedcl i
nicaldecisi
on, anditisan 1.Fi
rscl assinformat i
oni sensur edasit
aspectofdi agnosesi nwhi chthe i
sadi rectinteraction.
cl
ient/patienttel
lsstori
esorsi mpl y 2.I
tallowsf ort hecollecti
onofi n-dept
h
compl ainsaboutt heill
nesst otheheal t
h i
nformat ionfrom t herespondent
worker . 3.Therei soppor tunit
ytof or
cl
arif
icationofi ssuesand
Pr
ocedur
es/
met
hodf
orhi
stor
ytaki
ng misconcept i
onsbyt heclient
.
4.Itreducesbi asofi nformation.
1.Greatthepati
ent/cl
ient&cr
eat
e
rapport Di
sadv
ant
agesofhi
stor
ytaki
ng
2.Infor
m consentofthecli
ent
3.Ensureconfi
dential
i
t y 1.I
tisti
meconsumi ng
4.Whi l
eyouarereceivi
ngthe 2.I
nter
viewi
ngdemandal l
otofskil
l
s
I
nf or
mat i
ononpatientcondi
ti
on,
the 3.I
tinv
olvealotofdocumentat
ion.

107
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;Vo
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Physicalexaminati
on:-I
st hethor
ough Pr
ocedur
esf
orphy
sical
exami
nat
ion
andsy st
emat i
cexaminationofthebody
i
nor dertoidenti
fyanyproblem. 1.Explai
nt hepur poseandpr ocedures
2.Youobser vegener alappearancefor
Sensesusei
nphy
sical
exami
nat
ion 3.Stateofal er t
ness
4.Palpation,y ell
ownessorbl uenessof
1.SenseofSi
ght( Visi
on)
theli
pst ongueandf i
ngers
2.SenseofOlf
act or
y( smell
ing)
5.Signsofpoornut ri
ent;si
ze&ot her
3.SenseofGustatory( t
asti
ng)
signs
4.SenseofAuditory(heari
ng)
6.Signsofchr onicill
ness
5.SenseofPerception(feel
ing)
7.Cleanli
ness
Met
hodofphy
sical
exami
nat
ion 8.Placehi m/ heronacouch/ bet
9.Washhandpr operlyanddry
Palpat
ion:-I
stheprocessofusingone's 10.Instr
uctt hepat i
enttoexposesthe
handorf i
nger
stoidenti
fyadiseaseor partthaty ouwant edtoexami ne
i
njuryofthebodyorthelocat
ionofpain.
Areastobeexami
nedur
ingphy
sical
Auscul
tati
on:-I
sli
steningtotheint
ernal examinat
ion
soundsofthebody,usuall
yusinga
stet
hoscope. Head: -Size, shape, tensi on, anddept h
font anel s( i
nbabi es)t ext ure, col ourand
Percussi
on:-I
samethodoftapping cleannessofhai r, condi t
ionofscal p
bodypartswit
hfi
nger
s,hands,orsmal
l (dry ness, l
icer ingwor m et c.)
i
nstrumentsaspar
tofaphysical Ey es: -Redness, dischar ge, pal enesset c.
examinat
ion. Nose: -Visibl eswel li
ngorabnor mal
shape, wat ery ,bloodyormucous
I
nspection:
-Isthet
horoughand
dischar gef lar i
ngofnost rilset c.
unhurri
edvisual
i
zat
ionofapati
ent,t
his
Ear s: -Earl obesf ornor mal shape, sign
requi
restheuseofthenakedeye.
oft ender ness, dischar ge, swel ling
Rat
ional
eofphy
sical
exami
nat
ion behi ndear , hear i
ngl oss, earcanal for
wax, sor esanddi schar ge, eardr umsf or
1.Ithelpstheheal t
hwor kertoi denti
fy col or,per for ationet c.
si
gnofi l
l
nesswhi chhel pinselecting Neck: -Swel l
ing, nodes, stiffnesset c.
ri
ghttreatment Liningofmout h: -Col or ,spot sand
2.Whendoneatbi rt
horf i
rstvisiti
n rashest hrush, bleedi ng, swel li
ngt hroat ,
chil
dren,ithelpstheheal t
hwor kert o redness, enlar gementoft onsi l
spuset c.
knowt hest ateofhealththeper sonat Teet h: -Formi ssi ngt eet h, car r
ies, stai
ns,
fi
rstcontactsot hedev i
ationfrom odourgum bl eedi ngandi nfectionet c.
normal atsubsequentv isi
tcanbe Limb: -Def or mi t
ies, Oedemaorl ossof
detected.Ithelpsindetectingcongeni t
al funct i
onet c.
abnormal i
tiesorinj
uriesinnewbor n. Back: -Nor mal cur vat ure, bul gi
ng

108
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:Ba
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rAl
iMa
gume
ri,
CHE
W20
22.

Abdomen: -Swelli
ngt endernessorany Temper atur
e: -Canbedefinesasthe
enlargement,spleen,orliver. degreeofhot nessorcoldnessofa
Genitali
a:-Normal st
ructure,swell
ing, substances,env i
ronmentorbodyas
discharge(colorandsmel l
) measur edwithat hermometeror
Anus: -Redness,fissures,presentsof againstastandar dscal
e.Thenormal
wor mset c. humanbodyt emper at
ureisbet
ween
Equipment s/materialusedi nphysical 36.4℃ to37.2℃.
exami nati
on
Bodytemperature:-I
st hedegr
eeof
1.Thermomet er hot
nessorcol destofthebodywhichi
s
2.Sphy gmomanomet er measuredusingast andardscal
e.
3.Stethoscope
Causesofpy
rexi
a
4.MUACt ape
5.Diagnost i
cset
1.Invasionofmi croor
ganism int
othe
6.Snellingchart
7.Weighi ngscalebot hadul
tandchi
ld body
8.Pent ouch 2.Infl
ammat ionduet oanycause
9.Couchorbedf orexaminat
ion 3.Cont i
nuespai n
10.Uriner eagentE.g.combi2,combi9, 4.Diseasecausedbypar asit
e
cl
adistics,albust
ics,etc. 5.Directint
erferencewit
ht heheat
Vitalsign:-Theaearethosefi
ndings regul
ationcent er
whi chmani f
esttheworkingconditi
onof
Ty
pesoft
her
momet
er
thev i
talorgansinthehumansy stem,
theseor gansare; 1.Baththermometer
1.Thehear t 2.Wallther
mometer
2.Thelungs 3.Cl
inicalt
hermometer
3.Thebloodv essel
s
Equi
pmentneededf
ort
emper
atur
e
4.Thebrain
5.Vit
alsigns t
aki
ng

Vit
al si
gn:-Isalsodefineashealt
h 1.At r
aycontaini
ngthefol
lowi
ng;
i
ndicatorswhi chenabletheheal
th 2.Thermomet er
workertodet erminethestat
eofhealt
h 3.Gali
potforwetanddr yswap
ofindiv
idual pat
ientandtheyareas 4.Kidneydi
shf orusedswap
fol
lows; 5.Temperaturechart
1.Temper ature 6.AjarofVasel i
ne
2.Pulse 7.Wr i
stwatchwi t
hsecondhandti
mer
3.Respirat
ion 8.Wr i
ti
ngmat eri
alE.
g.penandpaper
4.Bloodpr essure 9.Washinghandset

109
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iMa
gume
ri,
CHE
W20
22.

Si
tesf
ort
aki
ngt
emper
atur
e Conv
ersi
onof°
Cand°F

1.Themouth 1.Toconver
tFahr
enhei
ttocent
igr
ade=
2.TheAxil
l
a °f-32x5/
9
3.Thegroi
n 2.Toconver
tcent
igr
adetoFahr
enhei
t=
4.Therect
um °cx9/5

Pr
ocedur
efort
emper
atur
etaki
ng Themout
h/or
alr
out
e

1.Expl aint hepur poseandpr ocedur e 1.Eachpatientshoul

dhav ea
2.Washhandt hor oughl ywi thsoap, ther
momet erintesttubeofantiseptic
wat eranddr yi tpr operly 2.Pati
ent’
scooper at
ionmustbegai ned
3.Sel ectt hemet hod( oral ,rect al or toensurethathe/shedoesnotchewi t
axill
ary )asappr opr iatef ort heage, ortr
ytospeakwhi lecarryi
ngthet ool.
condi ti
onoft hepat ient, andav ai l
abl e 3.Thebulbisputundert hetongueand
equi pment youmayber equi
redtoholditinplace.
4.Shakedownt het hermomet er
Cont
ra-
indi
cat
ionst
oor
alr
out
e
mer cur yunt i
litr eadsbel ow35℃ or95℉
5.Expl aint hepr ocedur eagai nandwhat 1.Chil
drenunder7y ear
s
youwantt hepat ient( mot heri fchi ld)t o 2.Deli
ri
ouspat i
ent
do. 3.Mouthdef or
mi t
y
6.Cl eant het her momet erwi t
hwetswap 4.Nosepackedwi thgaugeorbreat
hing
anddr yitwi thdr yswapt hendi scar dt he thr
ought hemout h
ent i
re 5.Soonaf terhotorcolddri
nk
7.Usedswapi nt her ecei ver( theki dney 6.Stomat i
tisoranyoraldi
seases
dish) 7.Unconsci ousnesspati
ent
8.Inser tthet her momet ersaf ely( af ter
l
ubr icationi fr ect all
y)anddonotl eav e Axi
l
laandgr
oin
thepat i
ental onewi t hthet hermomet er.
1.Thesi t
emustbedr iedbefore
9.Remov et het her momet eraf t ert wo
i
nser ti
ngthet hermomet er(carefull
yuse
mi nutes( ifr ectal ly
)andt hreemi nut e( if
dryswapt ocleanawaymoi stnott or ob
orallyorot her s).
dry)
10.Remov et het hermomet er,cl eani t
2.Skinsur facemustcompl etely
withwetswap, r
eadandr ecor dont he
surroundt hebulbt oensureaccur ate
temper aturechar t.Shakei tdownt he
reading
mer cur yandr eplacedi tint oits
3.Pat i
entmustbeaskedt ositstil
l t
o
cont ainer.
avoiddislodgeandpossi bl
ebr eakingof
11.I nterpret st hef indingt ot hecl ient
thetool
(mot heri fchi ld)
4.Thet hermomet ershouldstayinpl ace
12.Managecondi t
ionaccor dingt ot he
foratleast3mi nutes.
standi ngor der s
5.Themet hodshoul dbeusedwhen

110
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

manyadultpati
entareshari
ngone 2.Sexofthepat i
ent
:-I
sthepulset
ends
ther
momet erandwhenanadul tpat
ient tobesli
ghtlymorerapi
dinwoment han
cannothavethetemperat
uretaken i
nmenabout5beat /mi
nutes.
oral
ly
. 1.Exer
cise
2.Emotionalupset
Rect
al 3.Heat
1.Aspeci althermomet erisusedwhi ch 4.Star
vati
on
hasashor t
erandt hickerbulb,usuall
y
Agev ari
ati
on:-Pul
seininf
antand
col
or ed
youngchildismorerapi
dthani nadul
t.
2.Aj arofpetroleum jel
lyisrequir
edt o
I
nage, theremaybeconsiderable
l
ubricatethet oolbeforeinserti
on.
vari
ati
oni npul
serat
einhealth.
3.Themet hodiscommonl yusedfor
Vari
ationcanbecausedby :
babi
esandchi l
drenunder6y ear
s.
4.Alsoinspeci alcasesf oeadultE.g.i
n 1.Newborninfant--130-140Beat/
min
unconsciousst ate 2.12mouthold----110-120Beat/ mi
n
3.2-5years------100Beat/ min
Rect
alcont
rai
ndi
cat
ion
4.5-10years-----90Beat /min
1.Diarr
hea 5.Adul
t-----------60-80Beat /
min
2.Rectalprol
apseandoper
ati
on 6.Ol
dage---------t endtobelower
3.Pil
e(hemor r
hoid)
Char
act
eri
sti
csofanor
mal
pul
se
4.Surgery
5.Deformit
y 1.Rat e(speed) :-Atwhi cht hehear ti s
beat i
ng.
Conv
ersi
onofcent
igr
adet
ofahr
enhei
t
2.Rhy thm: -Isther egular i
tyatwhi cht he
1.Fahr
enhei
ttocent
igrade℉-
32×5/9 hear tbeatthati sthel engt hoft i
me
2.Cent
igr
adetoFahrenhei
t℃×9/5+32 betweeneachbeatshoul dbet hesame.
3.Vol ume/ strength:-Ist hemoder ate
Pul se:
-Ist hewav eofdistensionand pleasureisr equi r
edt oobl iteratethe
elongationf eltonanarterywal l
dueto bloodv essel s.
thecont ractionoftheleftventri
cle 4.Tensi on:-I sthev esselsshoul df eel
forcingabout100ml ofbloodi ntothe safeundert hef i
nger s,i
tshoul dnotbe
alreadyfullaor t
a.Pul
ser ateisthe hard.
speedatwhi chtheheartbeat. Abnor mal pul se
Fact
orst
hatcausei
ncr
easei
npul
ser
ate 1.Tachy car dia:-Thisist hei ncrease
actionoft hehear twher et hepul ser ate
1.Positi
onoft hepati
ent:
-Thisi
swhen abov e100beatpermi nut es
apatientisstandingupandmoving 2.Br adycardia:-Istheabnor mal slow
around,therateinmorerapi
dthanwhen actionoft hehear twher et hepul ser ate
heislayingdown. maybesl owas40beatpermi nutes.

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iMa
gume
ri,
CHE
W20
22.

3.Si nusar rhy t

hmia:-Isthepulserateis 4.Washhandset
rapiddur ingi nspir
ati
onandsl owdur i
ng
expi r
ation Pr
ocedur
eforpul
set
aki
ng
4.Ext rasy stole:-I
stheextrabeat s
followedbyl ongpause. 1.Explainthepr ocedur et ot hepat ient
Irr
egul arpul se 2.Washdr yhand
Intermi t
tentpul se:-Pulsei
nbei ng 3.Ifthereisnocont r
aindi cationf orar m
mi ssedandi tmayoccuratr egularor fl
ex edattheelbowwi t
ht hehandr esti
ng
i
r r
egul arinter v
al ont hechest,att heabdomenort he
knee
Ar
eas/
sit
esf
ort
aki
ngpul
se 4.Makesur eti
memeasur einstrument
i
si nagoodwor kingor der
Tempor al
: -Thi siswher ethet empor al 5.Hol dthepatientwr istpl acingt he
arter ypassesov erthet empor alboneof i
ndexandt hemi ddlef ingerov erthe
theheadt hati sinf r
ontoft heear s. radialart
eryandcountt henumberof
Car ot id:-Thi si sthesi teoft heneck pulsationwithi
nt he1st60second
wher et hecar otidarter yrunsbet ween 6.Recor dappropr iatelyonpat i
entchar t
thet r achea. ortreatmentcar di fitisnotpossi bl e
Api cal :-Att heapexoft hehear t,i
nadul t countt hepulseatt her adial artery.Then
i
ti sl ocat edonl eftsiteoft hechest i
tcanbecount edatt het empor al or
about8cm i nt heleftoft hest ernum facialart
ery
breast boneandatt hef our thandf i
fthor 7.Explainpendingt opat i
ent
sixthi ntercost alspacear eabet weent he 8.Washanddr yhand
ri
bs. 9.Manageaccor dingt ost andingor ders
Brachi al:-Att hei nneraspectoft he Respir
ati
on:
-Istheprocessoft
aki
ngin
bicepsmuscl eoft hear m oratt he oxygenandgiv
ingoutcarbondi
oxi
de.
medi al sideoft heel bow
Radi al :-Thi sisl ocatedwher et heradi al Respi
rat
oryr
ate:-I
t'sthenumberof
arter yr unsal ongt her adial boneont he ti
mesanindi
vidualbreat
hinandout
thumbsi t
eoft heout ersideoft hewr i
st. wit
hinoneminute.
Popl iteal :-Thi scanbef oundwher et he
Nor
mal
respi
rat
oryr
ate
popl iteal arterypassesbehi ndt heknee
Post er i
ort i
bial:-It'
sont hemedi al Thisvari
esaccor
dingtoageand
surf aceoft heankl eFemor al etc. sit
uati
onsofthepati
entswhi
chincl
udes
Requi rementf orpul sest aking fol
lowing;
1.AsecondhandWr istWat chorpul se
met er 1.Newborn------30-35beat
/mi
nut
e
2.Wr itingmat er i
al (
penandpaper ) 2.Oneyearol
d---25-30beat/mi
nut
e
3.Homebasedr ecor d/patientt reatment 3.2-5years-----20-25beat
/mi
nut
e
card 4.Adul
t----------
12-18beat
/mi
nut
e

112
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iMa
gume
ri,
CHE
W20
22.

Causesofi
ncr
easei
nrespi
rat
oryr
ate minut eandr ecord, makesur eyoudid
noti nfor mthepat ientt hatyouwi l
lcount
1.Exerci
se hisrespi r
ati
onbecausehemaychange
2.Excit
ement thepat ternofhisr espirati
on.
3.Pyrexi
a 6.Remov eandcl eant hethermomet er
4.Femalehi ghert
hanmale withwetswap
5.Haemor rhage 7.Readandr ecordt het emperatur
eona
6.Heartdisease patientcar d
7.Suddenchi l
li
ngofthebodyet
c. 8.Shakedownt het her momet erand
Causesofdecr
easeofr
espi
rat
oryr
ate replacei ncontainer
9.Int erpretsthef indi ngstothepat i
ent
1.Restingandsl eeping 10.Gi vef ol
lowupi nstructi
on
2.Fati
gue
3.Coma Bloodpr essur e:-Isthef orceexer tedin
4.Toxaemi a thear t
eriesbybl oodasi tcircul
at es.
5.Drugst herapyE.g.morphine Alsoist hef orceofci r
cul at
ingbl oodon
depressesr espi
ratorycent
er thewal lofthear teri
es.Thepr essur e
shouldbeei therhighorl ow
Requi
rement
sforr
espi
rat
oryt
aki
ng (hypertensionandhy pot ension).Blood
Pressur eismeasur edinuni tsof
1.AsecondhandWr i
stWat ch
mill
imet ersofmer cury( mmHg) .The
2.Chair,
bedorcouch
readingsar eal waysgiv eninpai rs,with
3.Writ
ingmater
ial(penandpaper )
theupper( sy stol
ic)valuef ir
stand
4.Homebasedr ecord/pat
ienttr
eatment
foll
owedbyt helower( diastoli
c)v alue.
card
5.Washhandset
Highbl
oodpressure/
hypertension:
-Isa
Procedur
ef ortaki
ngtemperat
ure,pul
se condi
ti
oninwhichtheforceoft heblood
andrespir
ation(TPR)int
hree(3) agai
nstthear
terywalli
stoohi gh.
minutes Usuallyhypert
ensi
onisdef
ineasblood
1.Handwashi ngwi t
hsoapandwat er pressureabove140/90mmHg, andis
andpr operdrying consideredsever
eifthepr
essurei
s
2.Explainthepur poseandpr ocedureto above180/ 120mmHg.
thepat i
ent/cl
i
ent
3.Preparati
onoft het hermomet erand Lowbl
oodpr
essur
e/hy
pot
ensi
on:
-Isa
i
nsertion condi
ti
oni
nwhi
cht
hef
orceofbl
oodon
4.Immedi atel
yaf terinser ti
onoft he t
hewal
lofar
ter
ybel
ownor
mal
,the
ther
momet er,startcount ingthepul se
bl
oodpr
essur
elowenought
hatt
hef
low
foronemi nuteandr ecor d.
ofbl
oodt
otheor
gansoft
hebodyand
5.Aftercountingt hepul sest art
countingtherespi rati
onal sof orone i
nadequat
eandi
tispr
esent
edwi
th

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iMa
gume
ri,
CHE
W20
22.

Si
gnandsy
mpt
omsbl
oodpr
essur
e St
epsi
nest
imat
ingbl
oodpr
essur
e

1.Fainting 1.Expl ainpur poseandpr ocedur et o

2.Dizziness pat i
ent
3.Chestpai n 2.Checkt hatt heappar atusi si ngood
4.Blurredvision wor kingcondi tion
3.Putpat ientincomf ortabl eposi t
ion:
5.I
ncr easedt hi
rst
sitti
ngorl y i
ngdown
6.Nauseaet c.
4.Askt hepat ientexposeandf reet he
Ty
pesofbl
oodpr
essur
e upperar mf rom al l rightcl ot hing
5.Wr apt hecuf far oundt hepat ienti s
Systoli
cbloodpressure:-Thisist
he upperar m nott oot ightort ool oose
forcenoti
cewhent hehear tmuscleisat 6.Connectt het ubef rom t hemeasur e
maxi mum contr
actionandi sthef
irstt
o par toft heappar atust ubet obemer cury
ber ecor
ded.Thenor malrangeof column
systoli
cbloodpressurei
s100- 7.Ti ght ent hescr ew
130mmHg. 8.Whi lepal patingt her adi al pul sei nf l
ate
thecuf ftoapr essur eof30nnHgabov e
Di
ast
oli
cbl
oodpr
essur
e:-Thi
sist
he thel evel atwhi chr adi al pul sat i
oncanno
f
orceobt
ainedwhent
hel
eftv
ent
ri
clei
s l
ongerbef elt
9.Gr adual l
ydef l
at et hecuf fcompl et e
i
nast
ateofr
elaxat
ion.Ther
angei
s60-
10.Ti ght enscr ewagai nandr e-infl
at e
90mmHg.Theav
eragebl
oodpr
essur
e thecuf ftot hebr ewi ngl ev el without
ofaheal
thyadul
tis120/
70mmHg. fell
ingt hepul se
11.Pl acet hedi agr am oft he
Fact
orst
hatcauser
isebl
oodpr
essur
e
stethoscopeov ert hebr onchi alar t
er yin
1.Diabet
esmelli
tus thecubi cal fosse, andt heearpi ecesi n
theear .
2.Exerci
seandemot ionalst
ress
12.Gr adual lydef latet hecuf fby
3.SmokingandAl cohol
releasi ngt hescr ew
4.Excessi
veint
akeofsal tandfat 13.Whent hepr essur eint hecuf fi
s
5.Heredit
ary l
ev eringl istencar ef ull
yandobser ved
6.Kidneycondi
ti
on wher et hef i
rstsoundi shear t.Itist he
7.Obesit
y syst oli
cpr essur ecent imet odef late
pressur eunt ilthel astsound
Typesofbl
oodpr
essur
eest
imat
ion disappear edi ssy stol i
cpr essur e.
appar
atus 14.Def latecompl et elydi sconnectt he
tubeandunwr apf rom t hepat ient
1.Mercury Assumet hepat ient .
2.Aneroi
d 15.Makepat i
entcomf ortabl e
3.Di
gital 16.Recor dr esultonpat i
entt reatmentcar d

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iMa
gume
ri,
CHE
W20
22.

17.Giveappr
opr i
atefeedbacktothe 10.Keepthechildexposedf orsome
pati
ent ti
met oall
owev aporati
on
18.Putawayappar at
usappr opr
iat
ely 11.Reassurethemot her
19.Treatpat
ientaccordi
ngt ost
anding 12.Cleanandreplacetheequipmentin
order
. thei
rproperpl
ace
13.Observeandt r
eatfeveraccordi
ngto
Tepidsponging:
-Thisi
saprocessof standi
ngorders
bri
ngingdownhightemper
atureby
applyi
ngluckwarm wat
ert
ot hebody
. Malnutri
tion:-I
sacondi tionthatresul
ts
fr
om eatingadi etinwhichoneormor e
Reasonf
ort
epi
dspongi
ng nutr
ientsar eei
thernotenoughort oo
1.Tobringdownahighbody much.Ori sagroupofcondi ti
oni n
temperature chi
ldrenandadul tgenerallyr
elatedto
2.Toprev entt
hepat
ientf
rom hav
ing poorquant it
yorinsuff
icientquali
tyof
fi
tsorconv ul
si
on nutr
ientintake,
absorptionorut i
li
zati
on.

Equi
pmentneed Twomaj
ort
ypesofmal
nut
ri
ti
on

1.Lukewarm wat
eri
nabowl Protei
nenergymalnutr
it
ion:
-Isthe
2.Towel result
ingfr
om def
ici
encyinanyorall
3.Mackint
osh nutri
ent.
4.Clot
hSponge Micr
o-nut
ri
entdef
ici
ency:-I
sthe
Pr
ocedur
efort
api
dpongi
ng r
esult
ingfr
om adefi
ciencyofspeci
fi
c
micr
o-nut
ri
ent.
1.Assembl eal lrequir
edequi pmentf or
rapidsspongi ng Causesofmal
nut
ri
ti
on
2.Exampl ethepr oceduret ot hecar e 1.Lowi ntakeoff ood
giverort hemot her 2.Lackofbr eastf eedinginchil
dren
3.Spr eadamacki ntoshont hebedt o 3.Digesti
v edi
sor ders
prev entthebedf rom get t
ingwet 4.Stomachcondi tion
4.Spr eadat owel overthemacki ntosh 5.Socialandmobi lit
yproblem
5.Posi ti
ont hepat i
entcomf or tablyon 6.Ment alhealthproblem
thebedi .
e.lay i
ngdown 7.Alcoholism etc.
6.Soakt hecl oth/spongei nt hebowl of
l
uckwar m wat er Si
gn&sy
mpt
omsofmal
nut
ri
ti
on
7.Appl ythewett owel/sponget othe
1.Lackofappet i
teori
nteresti
nfoodor
child’sbodyf rom t heheadt ot oe
dri
nk
8.Cont inuet hepr ocessunt ilthechi ld’s
2.Tirednessorir
ri
tabi
l
ity
temper aturegoesdown
3.Inabil
it
ytoconcentr
ate
9.Donotmopt hechild’sbodywi th
4.Alway sfeel
i
ngcold
towel

115
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alt
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:Ba
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iMa
gume
ri,
CHE
W20
22.

5.Lossoffat
,musclesmassandbody 5.Bodymassi
ndex
ti
ssue
6.Highri
skofget
ti
ngsi ckandtaki
ng (
b)Bi
ochemi
cal
anal
yses
l
ongertoheal 1.Complet
eorfullbloodcount
7.Highri
skofcomplicati
onaft
er 2.El
ect
roly
techecking/i
nvest
igat
ionet
c.
surger
y
8.Reducedsexdr
iveandi nf
ert
il
it
y (
c)Cl
i
nical
eval
uat
ion

I
nmor
esev
erecasest
her
eis; 1.Phy
sicalexaminat
ion
2.Cur
renthealt
hstatuset
c.
1.Breathi
ngbecomedif
ficul
t
2.Skinbecomethi
n,dry
,inel
ast
ic,
pal
e (
d)Di
etar
yHi
stor
y
andcold
1.Foodpr ef
erenceandfoodhabit&
3.Hairsbecomedryandfall
i
ngout
rel
igioushabit
easi
ly
2.Meal frequency
Assessmentofnut
ri
ti
onal
stat
us 3.Lackofcont r
oloverf
oodselecti
on
andchoi ce
Nutr i
ti
onal assessment :-Isdef i
neas 4.Fluidintake
theinterpretationofant hropomet ri
c, 5.Special di
etetc.
biochemi cal(laboratory),cli
nicaland
dietarydatat odet er
mi newhet hera Weighting:-Isananthr
opometri
c
personoragr oupofpeopl ear ewell methodusedt oassessthenutr
it
ional
nour i
shedormal nour i
shed.Andi tcan stat
usofani ndi
vi
dual(adul
tand
bedoneusi ngA, B,CandD. chil
dren)usingascale.

(
a)Anthropometri
cmeasurement Ty
pesofscal
e
(
b)Bi
ochemi calanal
yses
1.Fl
oorscale
(
c)Cl
inicaleval
uati
on
2.Tablescale
(
d)Di
etaryhistor
y
3.Standi
ngscale(chi
l
drenandadul
t)
(a)Anthropomet r
icmeasurement:-This 4.Hangingscale
methodusedt oassessei
thergrowt hor 5.Digi
talscal
e
changei nthebodycomposi ti
onoft he
Pr
ocedur
eforwei
ght
ing
people,Anthropometri
cmet hodtakento
assessgr owthandbodycomposi t
ion 1.Prepar ewei ght
ingarea
areasf ol
lows: 2.Selecttheappr opriat
escale
1.Weight 3.Explainthepur poseandpr ocedureto
2.High thepatient,t
hemot herorthecaregiver
.
3.Length 4.Testt hescal ewit
ht oensurethatthe
4.Arm ci
rcumf
erencemeasur
ement scal
ei swor king
(MUAC) 5.Askt heclient/pati
enttoremov eal
l

116
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alt
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act
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shi
rAl
iMa
gume
ri,
CHE
W20
22.

themat er i
al i
nhi sbodyt hatwi l
l add I
nter
pret
ati
onofshaki
r'
sst
ri
p
mor ewei ghE. g.handbag, phone
bangles, andshoes.I fchil
d, askt he 1.7.5cm -12cm (r
ed)sev er
elyacut
e
mot hert oundr esst hechild. malnouri
shed( SAM)
6.Bal ancet hescal et o0lev el 2.12.5cm -13.5cm (
yell
ow)mi l
dacute
7.Al l
owt hemot hertoputt hechi ldon malnouri
shed( MAM)
thescal e,andi fadul taskhi m/hert o 3.13.5cm -17.5cm (
green)normal
calm ont hescal e
whichindicat
ewellnourished
8.Readt hewei ghtaccurately
9.Remov et hechi ldfrom thewei ghtand St
epsi
nvol
vesi
nshaki
r'
sst
ri
p
handov ert othemot heroraskt he
measur
ement
patientt ost epdownf rom thescal eif
adult 1.Expl ai nt hepur poseandt he
10.Recor dthewei ghtont hetreat ment procedur etot hemot herort hecar e
card
giver
11.Pl ott hewei ghtongr owt hcur ve
2.Askt hemot hert or emov ecl othing
12.Int erpretthef i
ndingstopat ientor
thecar egi ver thatmaycov ert hechi l
d’slef tupperar m
13.Takeappr opr i
ateacti
onusi ng 3.Pal pat eandl ocat et het i
poft he
standi ngor der s. child’sshoul derwi t hy ourfinger tips
4.Pl acet hezer opoi ntoft heShaker s
I
fthechi
l
disnotcooper
ati
ng
Stripont het i
poft heshoul derand
1.Weightt
hemot herf
ir
standrecor
dit stretcht hest ri
pdownt otheel bowj oint
2.Thenweightt
hemot herandchi
ld 5.Readt hemeasur ementanddi videit
toget
her
byt wot ogett hemi dpoi ntoft hechi ld’
s
3.Subtr
actandgetchi
ld’
sweight
upperar m
MUACmeasur ement :-Mid-upperarm 6.Lett hechi l
d’sar m hangdownl oosely
circumference( MUAC)measur ementis byhi ssi de
thecircumferenceoft heleftupperarm, 7.Pl acet heShaker sSt r
ipar oundt he
measur edatt hemi d-
pointbetweent he i
dent i
fiedpoi ntwi thoutsqueezi ng
ti
poft heshoul derandt hetipoft he muscl esort heski n
elbow.MUACi susef ortheassessment 8.Wher et he0cm mar kmeet swi t
ht he
ofnutrit
ionalst atusofunder5y ear’
s variouscol ourist hecor r
ect
childr
enusi ngt apeorshaker sstrip. measur ementoft hechi ld’smi d- upper
Shakir'
sstr
ip:-Isaninstr
umentusein arm ci rcumf erence.
assessingthenutri
ti
onalstatusof 9.Not et hecol ourandr ecor d
chi
ldrenunder5y ears,i
tistheaccur
ate 10.I nter pretst hef indi ngtot he
waytomeasur efatf
reemass. mot her / caregi ver

117
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ers
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,2&3By
:Ba
shi
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iMa
gume
ri,
CHE
W20
22.

ORS/ SSS:-Theseareoralrehydrat
ion Assessmentofdehy
drat
ion
therapyisthegivi
ngoffl
uidbymout has
1.Nor
mal
dehy
drat
ion
atreatmenttoapat i
enthav i
ngdiarr
hea
i
nor dertopreventorcorr
ect i
.Eyes-Nor mal
dehy dr
ati
on.Duringdehydrati
onchlori
de, i
i
.Skin-Returnimmediat
elyaf
terpi
nch
potassium chl
ori
deandbi carbonat
eare i
i
i.Fontanel-Normal
l
ostandber epl
acedwiththis i
v.Tongue-Nor mal
homemadepr eparat
iontoav oi
d v
.Respirati
on-Normal
dehy dr
ati
on. 2.Mi
l
ddehy
drat
ion
Dehy
drat
ion:
-Isasi
gni
fi
cantl
ossof i
.Eyes-Sunken
f
lui
dthati
mpai
rsnor
mal
bodyf
unct
ion. i
i
.Skin-Ret ur
nslowlyafterpi
nch
i
i
i.Fontanel-Depressed
Causesofdehy
drat
ion
i
v.Tongue-Dr y
1.Theclimateandt heamountof v
.Respiraton-Rapid
physicalexer
cise
3.Sev
eredehy
drat
ion
2.Diseaseconditi
onsuchasdiar
rhea
andmal nutri
ti
onetc. i
.Eyes-Deeplysunken
i
i
.Skin-Ret ur
nv er
yslowl
yafterpi
nch
Si
gnandsy
mpt
oms i
i
i.Fontanel-Deeplydepr
essed
I
nchi
l
dren i
v.Tongue-Ver ydry
v
.Respiraton-Deepandr api
d
1.Thir
standdr ymout h
Ty
pesoff
lui
ds
2.Notearswhencr y
ing
3.Nowetdi aperforthr
eehours Homebasedf l
uidwhichismadeupof
4.Sunkeney esandchecks drinki
ngwater,coconutwater
,fresh
5.Sunkensof tspotontheskul
l j
uiceandr i
cewat eret
c.
(f
ontanel
) ORS: -Whichisinsachetf
orm and
6.Restl
essnessandi rr
it
abi
li
ty recommendedbyWHO
SSS: -Sal
tsugarsolut
ioni
sa
I
nadul
ts homemadef orm ofORScontainingsal
t,
sugarandwat er.
1.Extremet hir
st
2.Lessf requentur
inat
ion UsesofORSORSSS
3.Darkcol oreduri
nati
on
1.Tocorrectel
ect
rol
ytei
mbal
ance
4.Dizziness
causedbydiarr
heainbot
hadul
tand
5.Conf usion
chi
ldren

118
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

2.Topreventandcurr
entdehydr
ati
on Adv
icet
othemot
her
bothinadul
tandchil
dren
1.Storeinacool dr
yplacewithcover
3.Reduceshighbodytemperat
ure
2.After24hour sdiscardandprepare
4.Provi
deenergy
anothersolut
ion
Mat
eri
alf
orORS/
SSS 3.Ensuretowashhandsbef orethe
preparati
on
1.At r
aycont aini
ngt hef ol
lowi
ng; 4.Givethechildasmanyt i
mesas
2.Cubesorgr anulatedSugar possibleandaftereachpassageof
3.Salt waterystool
4.Cleanbowl wit
hcov erformi
xing 5.Cont i
nuetobr eastthechi
ld
5.3ml teaspoon
Visualacui
ty(VA):-Isapr ocessof
6.Deser tspoonf orsti
r r
ing
assessingapatienthowf arcansee
7.Ajugofwat er
fr
om apar t
icul
ardistancewi thoutusi
ng
8.Twobi gmineral bottl
e
anyaid.
9.Acleancupf ordr i
nking
10.Washhandset Rat
ional
sforv
isual
acui
ty

Pr
ocedur
eofORS/
SSSpr
epar
ati
on 1.Todetectanyfuncti
onal
eyedef ect
2.Todeterminethestat
eofthevisionin
1.Ensur eallt
hemat eri
alsareunder theeyesofapat i
entaft
ert
reat
ment
sanitarycondi t
ion 3.Toassess/evaluat
ethevi
sualstatus
2.Expl ainpurposeandpr oceduretot he ofthecli
ent
mot her 4.forpr
e-employmentmedical
3.Washhandwi t
hsoapandwat er&dr y examinati
on
4.Add5cubesor10l evelsgranul
ated
Ty
pesofv
isual
acui
tychar
t
sugarandonel evel(
3ml)saltintoa
bowl . 1.Snellen’schar t(alphabetchart
)used
5.Fillthebeerbot tl
eor2cokebot t
le forl
iteratepatient
withcl eanwat erandpouri ti
ntothe 2.Snellen’schar t(Echar t)usedf
or
bowl chil
drenandi l
li
teratepat i
ent
6.Stirt hesoluti
onproperlyusinga 3.Pictori
al chart(pictures)usedfor
deser tspoon chil
dren
7.Tast esol ut
ionwhichissupposedt o Mat
eri
alf
orv
isual
acui
ty
tastelikecoconutwat erorhumant ears
8.Giv et othechil
dusingcupandspoon 1.Snellen’
schart(
alphabet,Echar
tand
asmanyt i
mesast hechil
dpassesst ool Pict
orialchar
t)
2.Rulerormeasurementt ape

119
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Chai
r 12.Giveappr
opriat
efeedbackt
opati
ent
4.Poi
nter wherenecessarymanageaccordi
ngt
o
standi
ngorders
Pr
ocedur
eformeasur
ingv
isi
on
I
nter
pret
ati
onofv
isual
acui
ty
1.Hangt heSnel l
en’ schar tont hewal l
andensur et hati tisnott oohi ghort oo A. 6/
6 Nor
mal
down. B. 6/
9 Sat
isf
act
ory
2.Ensur et hatt hechar tiff i
rml ysecur ed
anddoesnotswi ng 6/
12
3.Ensur et hatt hei llumi nat i
oni nt he C. 6/
24
placewher et het esti st obeconduct ed
6/
36 Poorv
isi
on
i
smoder ate
4.Expl aint hepur poseandt he 6/
60
procedur et ot hepat ient
D. C.
F5
5.St andorsi tpat ient6met erf rom t he
testchar t(user ulerort apemeasur ethe C.
F4 Ver
ypoorv
isi
on
distance) C.
F3
6.Thent estoneey e, cov ert heot hereye
withpal m oft hehandoracar dboar d(if C.
F2
thepat ientusedpal m oft hehandask E. H.
M
him/ herdonotpr essedt heey e)
L.
P Bl
i
nd
7.Ifpat ientwear sgl assest estwi ththe
glasseson N.
L.P
8.St artf rom t het opl ineoft het est
char tcar efullypoi ntt ot heal phabetE
tell
thepat i
entt oindi cat ewi thhi shand Toil
eti
ng:-Thisisassistorsuperv
ise
theposi ti
oni nwhi cht hear msoft he (someone,especial
lyaninfantori
nvali
d)
chil
dar epoi nt ing i
nusingat oi
let.
9.Thel astl i
net hati sseencor rectlyis Hemogl obintest:-Thisi
smayr elyon
thev isual acui tyoft hepar t
icul arey e dif
ferenttechni
ques, i
ncl
udingreagent
10.Recor dthel astl inet hepat ientsees basedand“ r
eagent-l
ess”methods,ora
correct ly vari
etyofnon- i
nvasivemethods.
11.Recor dv i
sual acui tyasaf ract i
onE.g.
1.Hemoglobincyani
de( HI
CN)Method
6/24wher et henumer ator6i ndi catethe
2.Vanzett
i'
sAzideMet hemogl
obi
n
distanceoft hepat ientf rom t hechar t
3.ReagentLessMet hods
anddenomi nat oras24ast hedi stance
4.Non-I
nvasiveMethods
atwhi chanor mal ey ecanr eadt hechar t 5.Sahl
ísMethod

120
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

6.Hemat
ologyAnalyzer i
ndivi
duali
nownheal
thmanagement
7.Bl
oodGasAnalyzer(BGA) 5.Saveti
meandmoney
6.Hel
pinearl
ydet
ect
ionand
Rout
eofdr
ugsadmi
nist
rat
ion managementofai
l
ment
1.Or alrout e:Manydr ugscanbe Pr
ocedur
eofbr
eastexami
nat
ion
admi nisteredor al
lyasliquids,capsul
es,
tablets,orchewabl etablets 1.Ensur ether ei sprivacy
2.Injectionr outes 2.Undr essappr opr i
atel y
3.Subl i
ngual andbuccal routes 3.Washanddr yhand
4.Rect al r
out e 4.Whi lest andi ngst raightbet or eand
5.Vagi nal route wor ki
ngi ntoami rr
ori nspectt hebr east
6.Ocul arr oute forr ashes, i
nv er si
on, swel l
ingandsi ze.
7.Ot i
cr out e Alsoi nspectpl acingpal m onhi p;
8.Nasal route spr eadi nghandswi deapar tandr isi
ng
9.Inhalat i
onr oute handsupabov ehead.
10.Nebul i
zat i
onroute 5.Gent l
ysqueezeni pplest ocheckf or
11.Cut aneousr oute dischar ge
12.Tr ansder mal rout
e 6.Whi lel yi
ngsupi nedi videthebr east
i
nt of ourwi thpal m ofy ourf i
ngerpr ess
I
nject
ionr
out
es gent l
ydownandt owar dont het our
1.Subcutaneous(undertheskin) par ts,checki ngf orlumps, nodesor
2.I
ntramuscular(i
namuscl e) tender nessr ighthandf orl
eftbr eastand
3.I
ntravenous(i
nav ein) vicev ersa
4.I
ntrat
hecal(aroundthespinalcor
d) 7.St i
l
l onsupi neposi tionusesmoot n
rotat i
onmov ementandcov eral l t
he
Breastselfexaminati
on:-Ist
he tourpar stodet ectanyl umps, nodul ar
examinationoftheindiv
idual
'
sbreastby masst enderar ea
theindi
vidual. 8.Pal pat etheaxi l
laear easforl umpsor
enl argednodes
Rat
ional
forbr
eastsel
fexami
nat
ion
9.Educat epat ient stodoi tatt heendof
1.I
tservesasanexer cisef
ortheorgan ev erymenst rual period
ofthebreast.
Episiot
omy :-Thisisani
ncisi
onthrough
2.Todetectdiseasesoft hebreastsuch
theperinealti
ssuewhichisdeli
berat
ely
ascancer,mastit
islumpse. t.
c
designedorenl ar
gethevulvaoutl
et
3.Todetectdetormat i
onand
duringdeli
very.
abnormalit
iesoftheor gansuchas
absentbreastdevelopmentout si
dethe I
ndi
cat
ionf
orepi
siot
omy
usualpl
aceposi t
ion,doublebreast,
ni
pple,i
nvertednipple 1.Tospeeddel
i
ver
yift
her
eisf
etal
4.Encouragepartici
pationofthe di
str
ess

121
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

2.Goeswi t
hassi steddeliverysuch causedbyashar ppointedobjectsuch
forcevenousext racti
on asneedle.
3.Tor educether iskofintracranial 4.Blur
itwound:-Isatypewoundt hati
s
damagei npr eterm ofbr eechdel iv
er causedbyunedgedobj ectsuchas
4.Topr eventov erstret
chingoft he hammer .
perenealmuscleandpossi ble 5.Avulsi
onwound: -I
sapar ti
alor
unorganizedteart owarddanger ous completetear
ingalwaysoftheski nand
areas ti
ssuebeneath.
5.Toav oidprolapseandst retch
i
nconv enience Cl
assi
fi
cat
ionofwound

Pr
ocedur
eforepi
siot
omy 1.Superf
ici
alwound
2.Part
ialwound
1.Mai ntainsteri
lepr oceduret helabour 3.Ful
lthi
ckness
room
2.Infil
tratewith10ml 0.5%lignocai ne Causesofwound
met hod: (
anaest hesia)cleant hev agina 1.Accident
alongt helineoft hepr oposedi ncisionin 2.Fallf
rom height
ordert oprotectthef atalhead 3.Hotsubst ances
3.Gui dedbyt wof i
ngersasbef ore,a 4.Surgicaloperat
ion
singledeliberatecutofabout4- 5cm 6.I
njectionabscess
alongi smadeatcor ectangle, best
dur i
ngacont r
act i
on Wounddressing:
-Ist
heprocessof
4.Ifdeliveryofheaddoesnotf oll
ow maki
ngsust ai
nedwoundcleanandf
ree
i
mmedi at
elypressur eshouldbeappl i
ed f
rom i
nfect
ion.
ont hesi t
ebet weencont r
actiont o
Mat
eri
alf
orwounddr
essi
ng
mi ni
mi zebleeding
1.Ster
il
escissors,f
orcepandglass
Wound:-Isabreaki
nthecont
inuit
yof
2.Gali
potwithanant i
cept
ic
anybodil
yti
ssueduetoanext
ernal
3.Ki
dneydishf orusedfor
cep
act
ion,t
ypif
iedbyacut
,abrui
se,ora
4.Pl
aster
hematoma.
5.Ki
dneydishf orusedsoi
ledswab
Ty
pesofwound 6.Washhandset
7.Bandageandcot tonwoolforcl
eani
ng
1.Abrasion:-Thisi
soccurswhent he
ski
nr ubsagainstaroughorhard Pr
ocedur
eforwounddr
essi
ng
surf
ace.
1.Assembl et
heneedmaterialf
or
2.Lacerati
on:-Isatypeofwoundt hati
s
wounddr essi
ng
usual
lycausedbyashar pobjectsuch
2.Expl
aintheprocedur
etotheclient
asknife,gl
assorblade.
3.Exposetheareatobeclear
3.Puncturedwound: -I
sawound
4.Washhandwi thsoap&wat eranddry

122
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

5.Putonst eril
egl oves 4.Sampl eRegistr
at i
onSy st
em (SRS)
6.Pickaf or cepwi thdrycott
onchipthe 5.HealthSurvey
cott
onoft hef or cep 6.Stati
sti
csdat aallowust ocoll
ectthe
7.Putdirect lyont hewoundt ocontr
ol i
nformat i
onaroundt heworld
bl
eeding 7.Uset odeterminingt heheal
thstat
us
8.Examinet hewoundf orfor
eignbodies ofthecommuni ty
andgr av
ityoft i
ssuedamage, removeif 8.Itusedinmoni toringspecif
icheal
th
anynon-v iablet issue. program
9.Clearthewoundusi ngtheright
anti
ceptic Rate:-I
sthenumberofevent
sone
10.Applyt her ightant i
cepti
c thousandal
loverpopul
ati
onatr
isk.
11.Askt hepat ientt ocomeaf t
er3to5 Component
soft
her
ates
daysforf ollowup.
1.Numberofev ent s
HEALTHSTATI
STI
CS 2.Peri
odofoccur rence
Healthstat
ist
ics:-Canbedef i
nedas 3.Convi
nientf
act ors
actandscienceofcollecti
on,
organi
zing, 4.Populat
ionaf
f ected
summar izi
ng,present
ati
onand Crudebi
rt
hrate:
-Thisi
sthenati
onof
i
nterpret
ati
onofdat arelat
edtoheal
th. total
numberofl
ivebi
rt
hinaperiodof
Vital
stat
ist
ic:
-Canbedefi
nedasthose ti
meperonethousandpopul
ati
oninthe
recordofvi
talev
entt
hatoccur
sor area.
happensinthecommunit
y. CRB=No.Ofl
i
vebirt
hx1000
Sour
cesofheal
thst
ati
sti
c m Midyearpopul
ati
on

1.Hospitalr
ecord I
nfantmortal
i
tyrat
e:-Thisist
he
2.Census numberofdeathI'
mi nf
antunderone
3.Populati
onSurv eys yearofageperonethousandpopulat
ion
4.Diseaesregi
ster I
MR=deat
hsi
ninfantunderonex1000
5.Envir
onment alhealthdata N Numberofbir
thduri
ngtheyear
6.Epidemiol
ogical surv
eil
lance
7.Otherhealt
hser vices Mat
ernalmortal
i
tyrat
e:-Thisi
st he
r
adi
ooft ot
alnumberofdeathsrelat
ed
I
mpor
tantofv
ital
stat
ist
ics t
opregnancyrel
atedcondi
ti
on.
1.Itusedinplanningandmaking MMR=No.Ofdeat
hduetopregnancyx
process 1000
2.Usefulforpresenti
onofannual
heal
th a. Tot
alnumberofl
i
veandstil
lbi
rth
report
3.Itusetocompr iseheal
thst
ate Sampli
ng:-I
saporti
onorsub-
group
betweenonecount yandanot
her drawnbyanyappr
opri
atest
ati
sti
cal

123
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sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

met
hodf
rom apopul
ati
on. 3.Medi
an

Ty
pessampl
i
ng Ari
thmeti
cmean: -I
sthesum ofser
ies
orfi
guresdiv
idedbythenooftermsof
1.Pr
obabil
it
ysampling fi
gureappear
.
2.Non-
probabi
l
itysampli
ng
X=Ex
Ty
pespr
obabi
l
itysampl
i
ng - n
1.Samplerandom sampling:
-Isthe Median:-Isanumberthatappearsi
n
methodofdr awi
ngthesampl ewhereby themiddleofser
ieswhenarrangedi
n
all
etementsmusthav ethesame descendi
ngorascendi
ngor der.
chancetobechosen.E.g.
i
.Useofr andom number Mode:-I
sthemostfr
equent
lyr
ecur
ri
ng
i
i.Tossofcoins i
nthesetofnumber
sordata
i
ii
.Useofcomput er
i
v.Ball
ingoruseofsli
pofpaper Comput
ati
onmean,
medi
an&mode

2.Systemati
csampli
ng:-Thisi
sa 1.Stepi-Addthenumber
supt
ogeta
proceduresbywhi
chtheselect
ingoft
he tot
al.Exampl
e:2+19+44+44+44+51
fi
rstsamplenumberdet
erminesthe +56+78+86+99+99=622.
enti
resample. 2.Stepii
-Countt
heamountofnumber
s
3.St
rat
ifi
edsampli
ng:-Isamethodof i
nt heseri
es.
sampli
ngfrom apopul
ati
onwhichcan
3.Stepi
i-Di
vi
dethenumberyoufound
bepart
it
ionedi
ntosubpopul
ati
ons.
i
nst ep2byt
henumberyoufoundin
4.Multil
i
stagesampli
ng:-Thi
sisa step3.
processwhichsamplingi
sdoneinstage
Advant
ageanddisadvant
ageof
i
nwhi cheachstageinvol
vedi
ffer
ent
measurecent
eralt
endency
samplingtechni
que.
Adv
ant
agesofmean
Non-
probabi
l
itysampl
i
ngt
echni
ques
1.Onemakesuseofalltheavai
labl
e
1.Convini
ence
datasoiti
sthemostpowerfulmeasure
2.Purposi
ve
touse
Measureofcentral
tendency:
-I sthe 2.I
tisgoodforor
dinal
orint
ervalset
sof
measurethatenabl
esonet ol
ocat ethe data
cent
ral
v al
ueofsetofnumber /scores.
1.Di
sadv
ant
agesmean
Measur
eofcent
ral
tendency
Sometimest heendf
igur
eisadecimal
1.Mean fi
gur
e, whichmakesthedat
aless
2.Mode meaningful.

124
Ba
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yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Adv
ant
ageofmodel
s 2.Cl
assli
mit
:-Inacl
assint
erv
alsay10
to14,
then10issai
daslowercl
assli
mit
1.Thef igureproducedwil
lbeonet hatis and14uppercl
assli
mit
actuall
yi nthesetofnumberswhi chis
notalway st r
ueforothermeasuresof 3.Classmark:-I
sthemidpointofthe
centraltendency. classint
erv
alandisobt
ainedbyadding
2.Iti
st heonl ymeasureofcentr
al theloweranduppercl
assinter
valand
tendencywhi chisusefulf
ornomi nal divi
dingbytwoi.
e10+14=12al lover2
data.
4.Cumul ati
vefr
equency:-Isaddi
ngof
Di
sadv
ant
ageofmode thefrequencyofaparti
cularcl
asstobe
frequencyofthecl
assesbef or
eit
.
Theremaybemor ethanonemodal
val
ue(knownasbimodal)whi
chmakes 5.Classboundar y:-Iswhen0. 5is
thedat
alessr
eli
able. subtractedfrom lowercl assl imitand
addedt ouppercl assl i
mi t.E.g.
Adv
ant
agesofmedi
an
Thedat abel owar escor esoft hetwent
y
Goodtousewithordi
naldat
a. (20)studentsinhumannut ri
tion
I
tisgener
all
yunaff
ectedbyanomal
i
es achievementt ests.60, 70, 72,61,70,50,
andsosafert
ousewi t
hextr
emevalues. 47,60, 71,57,44,62, 69, 60,48, 65,55,
53,73, 74.Usingacl asssi zeof5
Di
sadv
ant
ageofmedi
an groupsandcal cul
at ethef oll
owi ng;
1.Themean
Doesnotwor
kwel
lwi
thsmal
lset
sof
2.Themedi an
dat
a.
3.Themode
Var
iabl
e:-Isanyent
it
ythatcant
akeon
Mean=Ef xalloverEx
di
ff
erentval
ues.
Median=Li +( n/2-cfb)xcall
ov erf
Ty
pesofv
ari
abl
e Wher e;
Li
=Lowercl assbounderofmedi an
1.I
ndependent&dependentv ari
abl
es cl
ass
2.Acti
veandattr
ibutevari
abl
es N=Tot alf
requencyscor e
3.Conti
nuous,di
screteandcategor
ical Cfb=Cumul ativefrequencybefore
vari
abl
e F=frequencyoft hemedi anclass
4.Extr
aneousvari
ables C=classi nt
erval
5.Demographi
cv ari
ables Made=Li +( f
a)xcal l
overfa+fb
Wher e;
Cal
cul
ati
onofagr
oupdat
a
Li
=Lowercl assboundar yofmodel s
1.Classint
erv
al:
-Isthenumberof cl
ass
groupsthatapart
icul
ardat
ais Fa=Fr equencyabov emodel class
cl
assifi
ed Fb=Pr equencybel owmodel class

125
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

REPRODUCTI
VEHEALTH Publ
ichai
r:-Isamount
ainofhai
rwhi
ch
pr
otectt
hepenisandscr
otum f
rom
Reproducti
vehealth:
-Canbedef ineas Micr
o-or
ganisms.
thecompletestateofphysi
calmental
andsocialwell
-bei
ngnotmer el
ythe Mal
eRepr
oduct
iveI
nter
nal
Par
tsI
ncl
ude;
absenceofdiseasesorinfi
rmit
y,
concerni
ngreproducti
veorgansandit'
s Testis:-Theseareorganswhi
ch
funct
ionandprocess. producesspermat ozoa(mal
e
reproducti
vecell
s).
Reproducti
vehealthr
ight
:-Theseare
theri
ghtofindi
vidual
stodecidewhether Functi
onoftest
is
toreproduceandhavereproduct
ive i
.Theyproduce&storethemal
eseed
healt
h. i
i.Theypr
ovidetest
ost
erone

Fact
orst
hati
nfl
uencer
epr
oduct
iveand Pr
ost
ategl
and:
-Isasi
ngl
edoughnut
ri
ght
s shapedt
hatsecr
etef
lui
dthatl
ubr
icat
e
I
.Housing t
hesper
m.
i
i
.Economy
Cowper'
sgland:-Theyarel
ocated
i
i
i.Reli
gion
i
nfer
iort
otheprostateatei
thersi
det
hat
i
v.Occupati
on
openint
otheurethra.
v
.Insecuri
ty
v
i.Poli
cy Funct
ionsofcowper
sgl
and
v
ii
.Epidemic
v
ii
i.Poorwatersuppl
y Theyproducethickcl
earmucuspri
orto
ej
aculat
ionthatdrai
nsint
othespongy
Mal
eRepr
oduct
iveExt
ernal
Par
tsI ude;
ncl uret
hra.

Penis:-I
sasof tandrodli
kestructur
e Processofspermformation:-I
sthe
whichbecomest if
fanderectwhen formati
onofsperm st
artsatpuberty
,
sexualarousedandbloodishighsupply. spermi sfor
medinthetestes.The
Penisgland:-I
sashapedl i
keacor n formati
onofspermiscont r
olby
coveri
ngglandandt hemostsensitiv
e hypothalamus.
partofthepeniswhichsomepar tsare
removeddur i
ngcircumci
sion. Primaryspermatocyt
e:-It
'sundergo
fi
rstmeioticdi
vi
sionreduci
ngthe
Functi
onsofpeni
s numberofchr omosomest ohaploidand
i
.Itser
veasanurineoutl
et form secondar
yspermatocyte.
i
i.I
tserveasanoutl
etofthemal
eseed.
Secondaryspermatocyt
e:-It
'sundergo
Scrotum:
-Isaoneoft hesensit
ive secondmeioticdi
visi
ongivi
ngriseto
organswhichpr
otectthet
estis& foursper
mat i
ds(22+x),
(22+x),
(22+y),
regul
atet
emperature. (22+y)
.

126
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yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Epidi
dymiti
s:-Isacommashapeor gans 8.Urethraopeni
ng:-Istheti
nyholethat
thatl
iesal
ongt hepost
eri
orborderof youpeeoutof ,l
ocatedjustbel
owy our
eachtesti
s.(Epi
didy
miti
sistheplur
al)
. cli
tor
is.Thevaginalopeni
ngisri
ght
belowy ourur
ethral
opening.
Basdeferens:-I
stheendpoi ntofthe
epidi
dymiswhichconv eysperm duri
ng 9.Anusopening:-I
stheopeningwher
e
sexualarousalf
rom epidi
dymistoward thegast
roi
ntesti
nalt
ractendsandexi
ts
theurethra. thebody.

Uret
hra:-I
stheshar
edterminalductof Femal
eRepr
oduct
iveI
nt nalPar
er tsI ude;
ncl
ther
eproducti
veandur
inar
ysy stem.
Vagina:
-Isamuscul artubeext
endi
ng
Seminalvesi
cle:
-ispar
edgl
andslyi
ng fr
om theexter
nal
v aginalwal
ltothe
post
eriortot
hebaseofuri
nar
ybladder
. i
nternal
betweenthecer vi
xandthe
uter
us.
Femal
eRepr
oduct
iveExt
ernalPar
tsI ude;
ncl
Funct
ionsofv
agi
na
1.Monspubi c:-Ref
erstoHairMountai
n
thatprotectt
hefemaleext
ernalor
gans 1.I
taccommodat esmalepenis
from microbes. 2.I
tserveasoutl
etformenstr
ual
cont
ent
2.Labiamajor
a:-Thesearet
wothi
ck 3.I
tchangesincolori
ndi
catespresent
outerl
ipsi
mmedi at
elybel
owtheMons ofpr
egnancy
pubic.
Cervi
x:-I
stheneckofthelowerpar tof
3.Labi
aminora:-I
sasof tt
hini
nnerl
i
ps theuter
usandprotr
udeint
ot hevagi na.
pi
nkishandverysensi
ti
ve. Wehav eint
ernal
andexter
nal cer
vix,
4.Cli
tor
is:-Isaverysensi
ti
veand suchas;
erect
il
etissuecorr
espondentt
othe I
nter
nal
cer
vical
:-I
sopeni
ntot
heut
erus.
malepenis.
External
cer
vical
:-I
sopeni
ntot
he
5.Bart
hol
ingland:-Ref
erstoast
he vagina.
ext
ernalv
aginalubri
cat
or.
Funct
ionsoft
hecer
vix
6.Vaginaopeni
ng:-It
'sthemouth
openi
ngoft hecerv
ixlocat
edbetween 1.I
tall
owst hepassageoffeot
alhead
theanusandurethraopening. orthepresent
ingpartdur
ingpr
egnancy.
2.I
tbecamet ightcl
oseimmediat
ely
6.Hymen:-I
sathi
nmembranewhich aft
erpregnancy.
part
ial
l
ycovert
heopeni
ngoft
hevagi
na.
Fall
opi
antube:-Thesearetwotube
7.Per
ineum:-I
sadiamondshapedarea eit
hersi
deoftheuteruscloset
othe
ext
endingvagi
nal
openi
ngtotheanus. fundusandneartheovari
es.

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:Ba
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rAl
iMa
gume
ri,
CHE
W20
22.

Funct
ionsoff
oll
api
ant
ube Di
seasesofr
epr
oduct
iveheal
th

1.Itcommuni cat
ewi t
htheovari
es 1.Menstrualdi
sor
der
s
2.Pickupov um r
eleasedur
ingovulat
ion 2.Sexualdisor
der
s
forferti
l
izati
on 3.I
nfert
il
ity
3.Itusef orf
amil
yplanni
ng(tubal
l
igation) Menstrualdisor
ders:
-Thisisref
ersto
asoccurrenceinamenst r
ualcir
clet
hat
Over
ies:
-Thesear
ethefemalesex arenotnormal andareconsi
deredI'
l
l
gl
andeit
hersi
deoftheuter
us. heal
th.

Funct
ionsofov
ari
es Menst
ural
disor
der
sincl
ude:

1.Pr
oducti
onoff
emal
eeggdur
ing 1.Amenor
rhea:-I
stheabsenceof
ovul
ati
on menst
ruat
ionorcessat
ionofmenstr
ual
2.Pr
oducti
onoff
emal
esexhor
mones fl
ow.

Uterus:-Isanimpor
tantreproduct
ive 2.Oli
gomenorrhea:-Isthescar
ingor
organt hatserv
easareceiverfor i
nfrequentmenstruat
iondueto
fert
il
izedov um. psychologi
cal
ornat i
onaldi
stur
bance.

Funct
ionsofut
erus 3.Menorr
hagia:
-Ist
heexcessi
ve
menstr
ualfl
owduetoabnormalgrowt
h
1.Itaccommodat esandnourished
oft
heuterus.
fer
til
izedovum
2.Theendomet ri
um undergoesmonthl
y 4.Menarche:-I
sthesignand
cir
cle symptomaticbodychangesfol
lowi
ng
3.Usef orf
amilyplanni
ng commencementofmenst r
uati
on.

Menst rualcycle:-I
st heshadingupof 5.Met
rorr
hagi
a:-I
rregul
arv
agi
nal
theendomet r
ium layeroftheut erusdue bl
eedi
ngwhichisnotdueto
fert
il
izati
onnotoccur ,ori
sthef emal e menst
ruati
on
hormonal act
ivit
iesthatregularl
yt ake Sexualdy
sf unct
ion: -Canber ef
erstoas
placeint hebodyoff emal eofchild I'
l
lacti
onorexper ienceduringsexual
beari
ngage, withaveragecircleof28 i
ntercour
sewhi chi srelat
edto
days. abnormalfuncti
oni ngoftheconcern
organanditspsy chology.
Phasesofmenst
ruat
ion

1.Prol
i
ferati
alphase Exampl
esofsexual
dysf
unct
ion
2.Secr
etoryphase 1.Fr
igi
dit
y:-I
sthel
ackofnor
mal
sexual
3.Menstrualphase
desi
re

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iMa
gume
ri,
CHE
W20
22.

2.Lowli
bidy
:-Thi
sisinabi
l
ityt
oobtai
n 3.Pregnancywastage:-I
sasit
uati
on
normal
sexualsat
isf
acti
onduri
ngsex. wherebyt hewomani sabl
etoconcei
ve
butunabletoproduceali
vechi
ld.
3.Quickejacul
ati
on:-Thi
sisrel
easeof
sperm beforeorshor
tl
yafter Causesofi
nfer
ti
li
tyi
nmal
e
penetrat
ion.
1.I
mpot ence
4.Painf
ulcoit
us:-Thisi
sexper
ienceof 2.Absenceofsemi nalduct
s
painduri
nginter
coursemai
nlybythe 3.Obstr
uctedsemi nalduct
s
female. 4.Absenceoftesticl
es
5.Undescendedtestes
5.Poorer
ecti
on:-I
sthei
nabil
i
tyofthe 6.Hormonalproblems
peni
stoattai
nful
landst
rongerect
ion.
Causesofi
nfer
ti
li
tyi
nfemal
e
6.Ext
raor gani
sm: -I
stheother
behavi
orswor r
yingsexual
inter
cour
se 1.Cerv
icalt
rauma
embarrassingsuchaspassur i
ne 2.PI
D
3.Ovari
ancyst
7.I
mpot ent
:-I
stheinabil
it
yto 4.Obesit
y
par
ti
cipatei
nsexualint
ercour
sebymal
e 5.Ovari
anendometr
iosi
s
duetopoorerect
ion.
Causesi
nbot
hmal
eandf
emal
e
8.Vaginismus:-Isthepart
ialcl
osur
eof
thevagina,pai
nfulpenet
rati
onand 1.UntreatedSTDs
i
ntercoursethetosperm ofthepelv
ic 2.Hypothalamusdisorders
fl
oormuscl es. 3.Geneticimpairment
4.Congeni t
alabnor
mal i
ti
es
I
nfer
til
i
ty:
-Istheinabil
i
tyofcouples
havi
ngunprot
ectedsexualint
ercourse 5.Otherinfect
ion
upto12monthwi thoutanypregnancy. Aborti
on:-I
saspontaneousor
Ty
pesofi
nfer
ti
li
ty del
iberat
edeter
minati
onofpregnancy
bef
ore24weeksofgest at
ion.
1.Pri
maryinfert
il
it
y:-Thisi
st hecoupl
es
haveneverconceiveddespit
e Postabor t
ioncar e:-I
sthet reatment
unprot
ectedsexual i
nter
courseforat andcounsel i
ngf orpost-aborti
onwomen.
l
eastoney ear. Itincl
udescurativecare,suchas
treati
ngabortioncompl i
cat i
ons, aswel l
2.Secondaryinf
erti
l
ity:-Isthewhereby
aspr event
ativ
ecar e,suchaspr ov i
ding
thecoupleshaspreviouslyconceiv
ed birthcontr
oltopr eventfutur
eunwant ed
butsubsequentl
yunabl etoconceived pregnancies.Post -
abort
ioncar er educes
withi
noney eardespit
eexposur eto mor bidi
tyandmor t
ali
tyassoci atedwi th
unprotect
edsexualintercourse. abor t
ion.

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act
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;Vo
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,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Causeofabor
ti
on 8.Tubalabort
ion:-I
saconditi
onof
pregnancyinwhichanembr y
o
1.Lowl evelofplacentahormones i
mpl ant
edoutsidetheuter
usisfor
ced
2.Lowl evelofmat er
nal hor
mones outoftheuter
inetubeleadi
ngtorupt
ure
3.Abnor malit
iesofchromosomes oftheuteri
netube.
4.Unhealthyov um
5.Poorimpl ementati
onofbl ast
ocy
st Compl
i
cat
ionsofabor
ti
on
6.Trauma
7.Abnor malit
iesofuterus 1.Hemor r
hage
8.Anxiety 2.Anaemi a
9.Malnutrit
ion 3.I
nfect i
on
10.Inf
ect i
on 4.Sept i
cemi a
5.Depr essi
on
Ty
pesofabor
ti
on 6.Ment alI'
llheal
th
7.Damageut er
us
1.I
nfectedaborti
on:-Thi
sisthe 8.Shock
i
nfectedproductofconcepti
onl
eadt
o 9.Pyrexia
ter
minationofpregnancy. 10.Tubal damage
2.Therapeuti
cabort
ion:
-Istheending 11.I
nf erti
li
ty
pregnancythr
oughnecessar
yby Menopause:-I
sdef
inedasthestateof
physici
analsoknownaslegalabort
ion. anabsenceofmenstr
ualper
iodsfor12
3.Cri
minalaborti
on:-I
stheintent
ional months.
endi
ngofpr egnancyunderanyconditi
on Andropause: -Isdefi
nedasasy ndrome
notal
lowedbyl ow. associat
edwi thadecr easei
nsexual
4.Embr yoni
cabort
ion:
-Ist
heendingof sati
sfact
ionoradecl i
neinafeel
ingof
pregnancybefor
ethetwent
iet
h(20) generalwell
-beingwi t
hlowlevel
sof
weeks. test
osteronei nolderman.

5.Habi
tualabor
tion:
-It
'sasar
esul
tof Pre-
menopausalsy
ndrome:-I
salossof
l
ongtimeinfect
ion. normal
oftheoveri
esbefor
etheage40
year
s.
6.Cer
vical
abort
ion:-I
sthe
spont
aneousexpulsi
onoffet
us Postmenopausal syndrome:
-Isrefer
s
i
mplantedonornearthecerv
ix. totheyearaft
ermenopause, al
thoughit
canbediffi
cul
tt oknowwhen
7.Mi ssedabort
ion:
-Isacondi t
ionin menopausef i
nishedand
whi chtwo(2)deadimmat ureembr yoor postmenopausest art
s.
fetusisnotrel
easedfrom theuterusfor
two( 2)ormoremont hstheuterus Femalegineti
almuti
l
ati
on:-Canbe
becomesmal l
andsignoft hepregnancy def
inedast hetot
alr
emovalofthe
slowsdown. ext
ernalf
emal egeni
tal
i
afornon-

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alt
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act
it
ion
ers
;Vo
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:Ba
shi
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iMa
gume
ri,
CHE
W20
22.

medi
cal
reason. Longt
erm compl
i
cat
ionsofF.
G.M

Fal
ser
easonsofF.
G.M/
C 1.Recurr
entbleedi
ng
2.I
nfert
il
it
y
1.Somebel i
evet hatthecl itor
aland 3.Dif
fi
cultyi
npassingur
ine
l
abium par
taref emal epr eface 4.Dif
fi
cultyi
nmenst r
uat
ion
2.Becausemal ear ecircumci sed 5.Sexualdysf
uncti
on
3.Theybeli
evet hatthecl itori
swil
l gr
ow
Medicali
zati
on:-Isthemedi cal
i
zat
ionof
andequalthepeni s
FGM/ Ccontinuestorisei
nmany
4.Somebel i
eveasar eligiousobligat
ion
countr
iesdespiteincr
easingnumbersof
5.Wil
lcontrolsexual desire countr
ieslegisl
ati
ngagainstthepr
acti
ce.
6.I
ncreasewomen' sfertil
ity
7.Enhancechildsur v
ival Pr
event
ionofF.
G.M/
C

Ty
pesofF.
G.M/
C 1.Training&retr
aini
ngofheal
thwor
ker
s
2.I
ntroductionofFGM bannedby
1.Ty
pe1:
-Exci
si
onoft
hecl
i
tor
isonl
y. l
egislators
3.Adv ocacy
2.Type2:-Exci
sionoft
hecl
i
tor
isas
4.I
EC
well
aslabiamajora.
Legislati
on: -Ist hel
egisl
ati
onon
3.Type3: -Compl eter
emovalofthe Femal eGeni tal Mutil
ati
onintheUnited
cl
it
oris,l
abiamaj oraaswel
lasinner Stat
esFemal egeni t
almutil
ati
on( FGM),
surf
aceoft helabiaminor
aandst i
tchi
ng hasincr easinglybeent hesubjectof
ofvaginalopening. l
egislativeact i
vitybothinAfr
ican
countriesinwhi chithastr
aditi
onall
y
4.Type4: -Unclassif
ied, t
hisincorpor
ate beenpr acticedandi nnati
onswher e
allot
herassaul tedori njurytothe Afri
cani mmi grantshavesettl
ed.
femaleginet i
al.E.g.Piecing,Pricki
ngof
thecli
tori
s, burningoft heclit
oris, Repr
oduct
ivecancer
:-Canbedef
ined
i
ntroductionofcor r
osivesubst anceand ast
heabnor
mal
prol
i
fer
ati
onof
herbalpreparationintot hevaginawi t
h cel
l
s/t
issueconcer
ningt
her
epr
oduct
ive
theaim att i
ghtening.
or
gans.
I
mmedi
atecompl
i
cat
ionsofF.
G.M
Ty
pesofr
epr
oduct
ivecancer
1.Sever
epain
2.Shock 1.Pr
ost
atecancer
3.Haemorrhage 2.Ov
ari
ancancer
4.I
nfect
ion 3.Br
eastcancer
5.Uri
neret
ention 4.Cer
vical
cancer

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iMa
gume
ri,
CHE
W20
22.

Ri
skf
act
orsofr
epr
oduct
ivecancer 4.Safeschool
envi
ronment
5.Schoolmeal
sservi
ces
1.Papi
ll
omav i
rus
2.I
mmunesy stem def
ici
ency 1.School healt
hserv i
ces:-Thisinclude
3.Soci
o-economic all
thepr ocedureempl oyedinor derto
4.Oral
contracepti
ves knowt heheal t
hstatusoft heschool
5.Smoking chil
dren.Thepr oceduresinclude;
6.OldAge i
.Historytaking
i
i.Physicalexaminat i
on
Genderconceptandv
iol
ence i
ii
.Managementofi dent
ifi
edcases
1.Gender:
-Isasoci al
lyconstr
ucted i
v.Ref er
ralservi
ces
i
denti
fi
cati
onofmenandwomen. v.I
mmuni zati
on
2.Gendermainst
reami ng:-I
sast rat
egy 2.School healtheducat i
on:-Thesear
e
toachi
eveequali
tybet weenmenand allknowl edge,attitude,pr
acti
cesand
women. skil
lst oensur eheal thf
ull
ivi
ngofschool
3.Genderbasedviolence:-I
sa children.Theyi nclude;
phenomenondeepl yrootedingender i
.Heal t
heducat i
ononper sonal&
i
nequali
ty. env i
ronment al hygiene
Exampl
esgenderbasedv
iol
ence i
i.Firstaid
i
ii
.Bal ancedi et
1.Rape i
v.Nut r
it
ion&sexeducat i
on
2.Abuse
3.Assaul
t 3.School
,Home&Communi ty
4.Femalegi
net
ial
mut
il
ati
on(
FGM) rel
ati
onshi
p: -Thisi
saembr acev ar
ious
campaign,advocacyandmobi l
izati
ons
SCHOOLHEALTHPROGRAMME aimedatbringingaboutcor
dial
rel
ati
onshi
pbet weenhome, school&
SchoolHealt
hProgramme: -Canbe
Communi t
y .
defi
neastheservi
cesembar kedupon
bytheheal
thteam i
ncollaborati
onwit
h 4.Safeschoolenvi
ronment:-Isthe
theschoolaut
hori
ty,t
eachersand provi
sionofwholesomesur roundi
ngf
or
parent
sinordert
oensureaheal thf
ul schoolchi
ldr
en&t hei
rteachers.
l
ivi
ngoftheschoolchil
drenwi t
hinand
outsi
detheschoolpremises. 5.Schoolmealservi
ces:-Theseare
serv
icesconcer
nedwi t
ht headequate
Component
sofschool
heal
th nutr
it
ionoftheschoolchil
drenduri
ng
pr
ogr
amme schoolhour
s.

1.Schoolheal
thserv
ices Rat
ional
eforschool
meal
ser
vices
2.Schoolheal
theducati
on
3.School
,home&communi t
y 1.Thechil
dhasr
ightt
oadequat
e
rel
ati
onship nutr
it
ion

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rAl
iMa
gume
ri,
CHE
W20
22.

2.Toensur
eadequategrowthand 2.Toeffectivel
ypasshealt
heducati
on
devel
opmentofschoolchi
l
dren toparents
3.Toavoi
dirr
it
abil
i
tyandpooratt
ent
ion 3.Tobridgeandexi sti
nggapbetween
i
nclass. parent
sandt eachers
4.I
tencour aget ot
ali
nvol
vement
Obj
ect
ivesofschool
meal
ser
vices 5.Avail
ableresourcescanbeident
if
ied
1.Toidentif
ychild'
slearningneeds duri
ngsuchmeet i
ng.
2.Chil
drenarepr ov
idedt aughtt
able St
epsi
nor
gani
zi
ngsemi
nar
manners
3.Chil
drenarepr ov
idedwi thbal
anced 1.Selectt opicst obecov ered.E. g.
diet Balancedi et&pr opernut ri
tion,
4.Toprov i
dethechildrenwi t
hvari
etyof Immuni zat i
on, personal &env i
ronment al
diet hygiene,acci dentpr evention,sex
5.Tointroducethecour seofnutri
ti
onto educationet c.
thestaf
f&chi l
drenofschool . 2.Identi
fyt hepar tici
pant sandi nvi
te
them.
Schoolfoodv endors:-Thesear
et hose 3.Identi
fyt her esour cesper sonand
peoplewhoar eallowedtosellf
oodt o assigntopi cstot hem.
schoolchil
drenatav eryminimalprofi
t. 4.Drawupt hesemi nar/wor kshop
Organizingseminar&wor kshopsto programmeandmaket hebudget .
school chi
ldr
en:-Thi si
st hebringi
ng 6.Hav eabr i
efmeet ingwi thresour ces
togetherofparentsandt eacherswithi
n persont oensur ethateachoft hem is
aper i
odoft i
me, sensit
izi
ngt hem ready.
througheducation,inst
ructi
onsand 7.Ensur et hatmat erialsarer eadyand
l
ect ur
eonheal t
hneedofschool chi
ldr
en. theprogr ammei sper f
ormedwel l.

Seminar:-Isamethodofeducat i
on Chil
dt ochil
dcare:-I
sthehealthand
whereseriesofpaper
sar epresented generalcaregiv
ingtoyoungersibl
i
ngs
anddiscussedondiff
erenttopicsunder bytheiryoungerones.
thesamet ime. Obj
ect
ivesofchi
l
dtochi
l
dcar
e
Wor
kshop:-I samethodofimprov
ing
1.Toprovideassistanttoparents
t
heknowledgeofexperi
encepeopl
ein
t
hei
rownf i
eld. 2.Tomakepr operuseofav ai
labl
e
resour
ces.
Rati
onalef
ororgani
zingseminar& 3.Tospreadheal t
hmessagesf ast
workshopforpar
entsandteacher
sin withi
nthecommuni ti
es
thecommuni t
y 4.Forfastandef f
ectiv
eeducat i
on
1.Togatherdat
afr
om par
ent
sand 5.Toactiveinvol
vechi l
drenasfamily
teacher
s member sinPHCact i
vit
ies.

133
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ty
pesofchi
l
dtochi
l
dcar
e forwardt omai ntainopenai rway .
3.Givet wobr eathbymout hormask.
1.Changewetclot
hes 4.Ifnopul seisdet ectedi nt hecarotid
2.Regul
arbat
hingasandwhendue artery
, t
hef ir
staiderkneel snextt ot he
3.Adequat
enutri
ti
on/
bal
ancedi
et victi
m.
4.Goodlat
ri
nemanners 5.Placingt heheel ofthest ernum
6.Thepr ov i
derdepr essedt hechest
Howt
oev
aluat
eschool
heal
thser
vices about5cm, (
2inches)f orcingbl ood
from thehear tthrought hev i
ctims
1.Teachersintervi
ew
arteri
es
2.Directobser
v ati
on
7.Whent hepr essureisr eleasedbl ood
3.Useofexi st
ingrecords
fl
owsi ntot hehear t
4.Studentquest i
onnai
re
Fi
rstai
dmanagementoff
ract
ure
Fi
rstaid:-Isanemergencycar
efora
vi
cti
m ofsuddenill
nessorinj
uryunt
il 1.I
mmobi li
zedtheaff
ectedpar
t
moreski l
l
fulmedi
caltreat
mentis 2.I
fit
'scompoundf r
acturet
ryt
oar
rest
avai
lable. bl
eeding
3.Applybandage
Component
soff
ir
stai
d 4.Gi
veanalgesic
1.Bandage Notbr
eat
hingpat
ient
2.Spi
rit
3.Sci
ssors 1.Cheekpulse
4.Penli
ght 3.Cheekbreathing
5.Safet
ypins 3.Shoutforhelp
6.I
odine 4.Acti
vateambul ance
7.Acti
vatedcharcoal 5.Applyair
way sbreat
hingci
rcul
ati
on
8.Razor (ABC)oftheressusteti
on.
9.Thermometer
COMMUNI
TYEYECARE
10.Ster
il
eeyewash
11.Ster
il
ecottonwool Eye:-Istheor ganofsi ghtorseeing, i
t'
s
secondi ntheintercranial
nerve, t
heey e
Howt ocar ryoutCPR: -CPRcombi nes
l
ocat edont hehead, it
'ssit
uatedi nthe
thetechni quesofar ti
fi
cialr
espir
ation
orbit
alcavitytheey eissphericalin
withappl icati
onofext er
nal hear
ts
shape, i
thasopt icnervesithast hree(3)
messaget okeepbl oodflowingthr
ough
l
ay er
sandsi x(6)muscl esforfree
thev i
ctim'sbody .
mov ement, i
tmeasur eabout2.5cm i n
Thisfirstaidpr ovi
ders;
diameter.
1.Posi ti
ont hev i
cti
mf aceuponaf irm
surfaceandcl eartheair
way s. Opht
hal
mology
:-I
sthestudyofdi
seaes
2.Tittl
et heheadbackandchi nl
ift
ed oft
heeyeandi
t'
str
eatment.

134
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ophthal
mologi
st:
-Isapersonwho v.Bet
hametasoneey edr
op
speci
ali
zeontr
eatmentofdiseaesof vi
.Sofr
adoxey edrop
theeye. vi
i.Maxit
roley
edrop
vi
ii
.Teracor
toley
edrop
Opht
hal
micphar
macol
ogy x.Bet
hadrone-Neyedrop
1.Ant
ibi
oti
csey
edr
ops/
oint
ment Thr
eel
ayer
sofey
e
i
.Chlorophenol eyedr op 1.Scl
era(fi
rst)
i
i
.Gent amy ci
ney edr op 2.Choroi
d( second)
i
i
i.Garamy ciney edrop 3.Ret
ina(third)
i
v.Neomy ciney edrop
v
.Sulphatramy cineyedr op Somepar
tofey
e
v
i.Sotramy ci
ney edrop
1.Cil
l
iar
ybody:-I
stopr
oduceaf
lui
d
v
ii
.Ciprofl
oxaciney edr op
cal
ledaqueousfl
uid
2.My
dray
sis-f
ordi
l
atat
ionofpupi
l
s
2.Ir
is:
-Ist
oregul
ateamountofl
i
ghti
n
i
.Atr
opine-21days. theeye
i
i
.Homat r
opine-3days
3.Rods:-I
sfordar
knessadapt
ati
oni
t'
s
i
i
i.Neospori
n-8hours
about120m
i
v.Mydraycl
e-6hours
4.Cons:-Thi
sisf
orl
i
ghtadapt
ati
oni
t'
s
3.Mi
oti
c-f
orconst
ri
cti
onofpupi
l
s
about78m
i
.Pil
ocarpine
Commoncommuni
tyey
epr
obl
ems
i
i
.Timopt ol
i
i
i.Zolamine
1.Cataracts
i
v.Eseri
ne
2.Glaucoma
4.Anest
hesi
adr
op-f
orpai
nrel
i
ef 3.Pterygi
um
4.Corneal ulcer
i
.Zy locaine(I
M 3mldi
stl
ewaterf
or
5.Chalazion
zylocaine)
6.Ophthalmi cneot
atr
um
i
i.Tet r
acaine(E.
gpepper
,paf
ume,pet
rol
7.Trachoma
etc.)
8.Styl
e
5.Ster
oidey
edrops/oi
ntment-usedf
or 9.Conjunct i
viti
s
chroni
cimpl
amatorycondi
ti
onofaeye.
Cat
aract
:-I
sal
ensopaci
tyoft
heey
e.
i
.Ster
dexeyedrop
i
i
.Mar i
dexeyedrop Glaucoma:-Iswhenthepr
essur eoft
he
i
i
i.Opticr
om ey
edrop eyeisabovenormaloranincreasei
n
i
v.Bethasol
-Neyedr
op theint
raocul
arpr
essurei
nt heeye.

135
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Chal
azi
on:
-Isapainl
essswell
ingoft
he 3.Pain
l
idduet
oblockageoft
hegland. 4.Poorv i
sion
5.It
ching
Trachoma:-I
sachr oni
cinf
lammati
on 6.Headache
causedbyvir
us.It'
saveryi
nfect
ed 7.Sandyfeeli
ng
diseaesi
ttr
ansfereasi
l
y. 8.Lacerati
on
St
yle:
-Ist
heinfl
ammati
onoftheey e Tr
eat
mentofconj
unct
ivi
ti
s
l
ashesduetoinf
ect
ion(
odi
ulum edema)
.
1.Historytaki ng-findoutt hecause
Corneal
ulcer:-I
sacondit
ioni
nwhi ch 2.Physical exami nationoft heey e
i
nflammationoftheout
ermostlay
erof 3.Remov et hecausei fpossible
theeyeresul
tsinpai
n. 4.Washy ourhandwi thsali
newat er
5.Int
ensiv epeni cil
l
ineey edr op12-24hrs
Opht
halmicneot
atr
um:-Isanewborn
6.Giveant i
bi oti
cE.g.Chl orophenol
conj
unct
ivi
ti
swhichaf
fectthel
i
febaby
,
7.Insevercasesuseey eoint mentinthe
who'
sbetween0-28day s.
ni
ghtandr inseitint hemor ni ngand
Pt
ery
gium:-I
sapiv
eofConj
uncti
va conti
nueusi ngt heey edrop
gr
owinghy
gient
owardst
heconea. 8.Giveanal gesticE. g.PCM, Panadol,
l
etanol t
ds3/ 7
Conjuncti
vi
ti
s:-I
sani
npl
ammat
ionof 9.Giveor alant i
bioti
csorSy stematic
theConjunct
iva. process

Causesofconj
unct
ivi
ti
s Compl
i
cat
ionofconj
unct
ivi
ti
s

1.I
nfecti
on 1.Cornealulcer
2.Forei
gnbody 2.Cornealperfor
ati
on
3.All
ergi
c 3.Cornealopacit
y
4.Trauma 4.PanOpt halmit
is
5.Chemical 5.Bl
indness

Ty
pesofconj
uct
ivi
ti
s Commontropi
caldi
seasewi
they
e
compl
i
cat
ioninthecommunit
y
1.Chemi calconjuncti
vit
is
2.Traumaconj unctivi
ti
s 1.Measles
3.Vi
r al
conjunctivi
ti
s 2.Onchocerciasi
s
4.Bacterial
conjunctivi
ti
s 3.Leishmaniasis
5.Al
lergicconjunctiv
iti
s 4.Sleepi
ngsickness
Si
gn&sy
mpt
om ofconj
unct
ivi
ti
s Met
hodofpr
event
ingey
edi
seases
1.Dischar
ge 1.Heal
theducat
ion
2.Redness 2.Ear
lydi
agnosi
sandt
reat
mentofey
e

136
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sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

di
seases thei
raccommodat i
onandf ood
3.Trai
ningofmedi calpersonnel 5.Transportofpati
entswhoneed
4.Buil
dingofmor eey ecli
nics surgery
5.Provi
sionofincentives 6.Foodf oradmit
tedpatientsdur
ing
6.Provi
sionofadequat eeyedrugs post-operat
ivest
ay
7.Communi tymobi l
izati
onandpract
ice 7.Costofaphasicglasses
8.Refer
ralserv
ices
EAR,
NOSE&THROATCARE(
ENT)
Harmful
pract
icet
hati
ncr
easeey
e
EAR: -I
sanor ganofhear i
ngand
pr
oblems
balanci
ng.Itissuppliedbyt he(vii
i)
1.Inadequatediet cranial
nervethat'sthecochl earnerves,
2.Decreaseexer ci
se whi chi
sstimulatedbyv ibrati
oncaused
3.Poorenv i
ronment alandper
sonal bysoundwav es.Theeari sdi vi
dedinto
hygiene threepart
s,theout erthemi ddleandt he
4.Putti
ngoni onint
ot heeyes i
nnerear .

Reducethei
nci
denceofeyeproblem i
n Ext
ernal
ear
;isf
orm byt
wopar
t
thecommunit
y,howtopreventcommon
eyeprobl
ems Auri
cleorpi
nna:-Thisconsi
stofout
er
cart
il
agi
nousplatecover
edby
1.Practi
cegoodey edropcompliance connect
ivet
issueandskin.
andtechnique
2.Reduceal cohol consumpt i
on Exter
nal
audi
tor
ymeat
usconsi
stof
3.Quitsmoki ng thr
eepart
4.Protecteyesf rom thesun
1.Outercart
il
aginouspart
:-I
stheini
ti
al
5.Reducescr eent ime
partoftheexter
nalaudi
torymeat
usand
6.Hav eregularsighttest
s
7.Followcont actlenshygieneadvice i
smadeupofcar t
il
age.
8.Attendscreening 2.I
nnerbonypart
:-Isal
socover
edby
Stepinmobili
zi
ngt
hecommuni
tyt
o ski
nwhichsupportcl
osel
yto
parti
cipat
ecommunit
yey
ecar
e per
iost
eum.
programme
3.Middleear :-I
sasmal l
,narr
ow,
1.Identif
icat
ionoflocati
ont oconduct i
rregularlat
erall
ycompr essedchamber
eyecamps si
tuatedwi t
hinthet emporalbone,
2.Pr ovi
sionofsupportfacili
ti
eslike consisti
ngofaudi toryassi
cles,muscl
es
water ,
electr
ici
ty,
furni
ture,vol
unteers, andEust achiantube.
etc.
3.Planandi mplementv ariouspublici
ty Auditor
yossi
cles:
-Arethr
eeti
nybones,
met hodst omobili
zeneedypeopl e whicharearr
angedinthef
orm ofa
4.Takecar eofmedi calteam intermsof chain.

137
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Mal l
eus:-Ot
herwi
secal
ledt
hehammer 5.I
rr
it
ati
on
that'
sahandle,
headandneck,
iti
s 6.Swel
li
ng
attachedtot
helymphat
icmembrane.
Compl
i
cat
ionsofear
li
erdi
sor
der
I
ncus:
-Al
soknownasanv
ill
ooksl
i
kea
premolart
eeth,i
thasabodyonel ong 1.Troublehear i
ng
processandoneshor tprocess.Ant
eri
or 2.Ruptureoft heeardrum
bodyoftheincusart
iculatewiththe 3.Tissuegrowt hbehindtheear
drum
headofmal l
eus. (chl
olesteatoma)
4.Damaget otheti
nybonesi nt
he
St
apes:
-knownasst
ir
rup,
iti
sthe
middleear
smallestboneinthebody.Ithasahead, 5.Mast oidi
ti
s
neck,anter
iorcrusandfootplat
eleadto
art
iculat
ewi t
hincus. Unsaf
epr
act
icei
nthi
scommuni
tyt
he
eardi
sor
der
Eust
achai
ntube:
-Ist
hef
lat
tenedcanal
ext
endingf
rom t
heanteri
orwal
lof 1.Useofshapeobj ectintheear
middl
eeartonasophar
ynx. 2.Useofher bs
3.Drapi
ngofgr i
nnedoni onint
heear
I
nnerear
:-I
sconsi
stoft
hecochl
ea,
4.Useofbr oom tocleanear
ovalwi
ndowandv
est
ibul
achol
ear 5.Matchsti
ckstocl eanear
nerv
es. 6.Usefingernai
l
st ocleanthenose
Di
seases/
disor
der
soft
heear Nose: -Thisi sactasabot hwayf or
1.Oti
ti
smedia respiratorysy stem andcont ainthe
2.Oti
ti
sext
ernal olfactoryor gan, t
hev isibleporti
oni s
3.Eczemaoftheear calledt henost ri
ls(ant eri
ornares) .The
4.Fruncul
osis nost r
ilisvidedbyt hesept um whichar e
5.Aspergi
ll
osis(
otomy
coses) chamber sfr om whi chai rentersintothe
6.Earwax( cr
ewmenori
s) nose.
7.Forei
gnbody Di
seasesoft
henose
Si
gn&sy
mpt
omsofeardi
sor
der
1.Epi
staxi
s
1.Pain 2.Nasal
pol
yp
2.I
tching 3.Si
nusi
ti
s
3.Dischar
ge 4.I
nfl
uenza
4.Fever 5.Fr
uncul
osi
s

138
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nit
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alt
hPr
act
it
ion
ers
;Vo
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,2&3By
:Ba
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iMa
gume
ri,
CHE
W20
22.

6.Nasal
all
ergy l
yry
nxi
scy
lyndr
ical
andsof
tti
ssuet
hat
7.For
eignbody cont
ainv
ocal
wor
ds.

Si
gnandsy
mpt
omsofnosedi
sor
der
s 4.Epi
glot
ti
ti
s:-I
saf
lapofsof
tti
ssue
andcar
ti
lagel
ocat
edj
ustabov
ethe
1.Runnynose
v
ocal
scor
ds.
2.Fat
igue
3.Snor
ing Commondi
seasesoft
het
hroat
4.Nasal
obst
ruct
ion
1.Tonsi
l
li
ti
s
5.Absentsenseofsmel
l
2.Phar
yngi
ti
s
6.Achi
ngmuscl
es
3.Lar
yngi
ti
s
7.Bl
eedi
ng
4.Di
pht
her
ia
Compl
i
cat
ionsofnosedi
sor
der
s 5.Sal
i
var
ygl
anddi
sease
6.Sor
ethr
oat
1.Pneumoni
a
7.Voi
cedi
sor
der
s
2.Br
onchi
ti
s
3.Ast
hma Si
gn&sy
mpt
omsoft
hroatdi
sease
4.Eari
nfect
ion
1.Fev
er
Thr
oat
:-I
samuscul
art
ubesi
tuat
edi
n 2.Cough
t
heneck,
li
nedwi
thmucusmembr
ane, 3.Runnynose
whi
chconnectt
hemout
handnosewi
th 4.Sneezi
ng
t
het
racheaandesophagusandser
veas 5.Headache
passagewayf
orbot
hai
randf
ood. 6.Nauseaandv
omi
ti
ng
7.Bodyaches
Thet
hroatcont
ains;
Compl
i
cat
ionsoft
hroat
sdi
sor
der
s
1.Tonsi
l
sandadenoi
ds:
-Tonsi
l
sar
e
l
ocat
edatt
hebackandsi
deoft
he 1.Bl
ockageofai
rway
s
mout
handadenoi
dsar
elocat
edbehi
nd 2.Sepsi
s(l
i
fet
hreat
eni
ngbact
eri
al
t
henose. bl
oodi
nfect
ion)
3.Rheumat
icf
ever
2.Phar
ynx:
-Ist
hemuscl
eli
nedspace
t
hatconnect
sthenoseandmout
hto Equi
pmentusei
nENT
t
hel
yry
nxandesophagus.
1.Ot
oscopeorAur
oscope
3.Lar
ynx:
-Al
soknownasv
oicebox,
the 2.Lar
ynscope

139
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Ry
noscope ofdi
seasei
nci
dence,
prev
alence,
4.Headl
amp mor
bidi
tyort
oal
ocal
l
yaccept
abl
elev
el
5.Touchandspat
ula asar
esul
tofdel
i
ber
ateef
for
t;
6.Opht
hal
moscope cont
inuedi
nter
vent
ionmeasur
ear
e
7.Nasal
specul
ums r
equi
redt
omai
ntai
nther
educt
ion.

CONTROLOFCOMMUNI
CABLEDI
SEAE 7.Epi
demi
c:-I
sachar
act
eri
sti
cofa
par
ti
cul
arpopul
ati
on,
env
ironmentor
Communi
cabl
edi
sease:
-Thesear
e
r
egi
on.E.
g.Chi
ckenpoxt
hatOccur
sat
t
hosedi
seaset
hatt
hatcaneasi
l
y
pr
edi
ctabl
erat
eamongy
oungschool
t
ransmi
tt
edf
rom oneper
sont
oanot
her
chi
l
dreni
ntheUni
tedSt
atesandmal
ari
a
orf
rom ani
mal
toper
son.
i
nsomear
easofAf
ri
ca.
Def
ini
ti
onoft
ermsf
orkeyepi
demi
ology
Cl
assi
fi
cat
ionofcommuni
cabl
edi
sease
1.I
nci
dence:
-Canbedef
inedast
he
1.Vi
ral
disease:
-Thesear
eref
erst
o
numberofnewcasesoccur
ri
ngi
na
t
hosedi
seaset
hatcanbecausedby
popul
ati
onwi
thi
naspeci
fi
cper
iodof
v
irus.E.
g.Measl
es,
Hepat
it
is,
HIV/
AIDs,
t
ime.
Pol
i
omy
eli
ti
set
c.
2.Pr
eval
ence:
-Thi
sisr
efer
stoasal
l
2.Bact
eri
aldi
sease:
-Thesear
eref
ers
cur
rentcasesoccur
ri
ngi
napopul
ati
on
t
odi
seasecausedbybact
eri
a.Eg.
dur
ingaspeci
fi
edper
iodoft
ime.
Tuber
cul
osi
s,Chol
era,
Dipht
her
ia,
3.Endemi
c:-I
stheunusual
occur
rence Pneumoni
a,Per
tussi
set
c.
i
nacommuni
tyofdi
seasesorspeci
fi
c
3.Fungal
disease:
-Thesear
edi
seases
heal
thr
elat
edbehav
ior
.
causebyv
ersi
onff
ungi
int
hebody
.Eg.
4.Resi
stance:
-Ist
heabi
l
ityofan Candi
diasi
s,Scabi
es,
Tri
chomoni
asi
s,
or
gani
sm t
owi
thst
andt
heat
tackof Ri
ngwor
m,Hi
stopl
asmosi
s,Ti
nea
pat
hogensandr
emai
nedv
irt
ual
l
y capt
is.
unaf
fect
ed.
4.Pr
otozoa:
-Eg.Mal
ari
a,Ameobi
sis,
5.Pr
event
ion:
-Ist
heact
ionsor Tr
ichomoni
asi
s,Tr
yponosomi
asi
s,
st
oppi
ngsomet
hingf
rom happeni
ngor Lei
shmani
asi
s.
r
aisi
ng.
5.Hel
mint
hs:
-Eg.Ascar
iasi
s(r
ound
6.Cont
rol
ofdi
sease:
-Ist
her
educt
ion wor
m),
Tri
chur
iasi
s(r
oundwor
m),

140
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Ent
erobi
asi
s(pi
nwor
m),
Dracuncul
i
asi
s
(
gui
neawor
m),
Hookwor
m. Pr
eventi
vemeasur
eofcommuni
cabl
e
di
seases
6.Ect
opar
asi
te:
-E.
g.Ri
ngwor
m,Ti
nea,
Scabi
es,
Lepr
osy 1.Adequatesanit
ati
on
2.Massv acci
nati
onagai nstspeci
fi
c
Cli
nical
signandsymptomsof di
sease
communi cabl
edi
seases 3.Vectorcontr
ol
Di
seases Si
gn&sy
mpt
oms 4.Communi tymobil
izationand
i
nvolvement
1. I
nfl
uenza i
.Fever 5.Earl
yidenti
fi
cat
ionandmanagement
i
i
.Coughing
ofcausesofcommuni cabledi
sease.
i
i
i.Sneezing
i
v.Sorethroat Cont
rolmeasur
eofcommuni
cabl
e
v
.Runnynose
di
sease
v
i.Fati
gue

2. Conj
unct
ivi
ti
s i
.Redness 1.Ear
lydiagnosisofdi
sease
i
i
.Itches 2.El
iminatethereser
voi
rofinf
ect
ions
i
i
i.Lacri
mati
on 3.I
mmuni zation
i
v.Pain. 4.Heal
theducat i
on.
v
.Sandysensat
ion
Nati
onalpol
i
ciesandi
nter
vent
ionon
3. Hepat
it
is i
.Fever di
seasecontr
ol
i
i
.Headache
i
i
i.Nausea 1.Nati
onalmalar i
aeliminati
onprogr
am
i
v.Weakness 2.Nati
onaltuberculosiscontr
ol
v
.Lossofappet
it
e progr
amme
4. Hl
V/AI
Ds i
.Recurrentfever 3.HIVandAI DSpr ogramme
i
i
.Recurrentcough 4.Neglectt
ropicaldiseasecontr
ol
i
i
i.Di
arrhea progr
amme.
i
v.Oral
thr ustetc.
CONTROLOFNON-
COMM.DI
SEASE
5. Mal
ari
a i
.Fever
i
i
.Lossofappet
it
e Non-communi cabl
edisease:-This
i
i
i.Headache refer
stoasmedi calcondi
tionor
i
v.Bodyache diseasethatcan'
ttr
ansmittedfr
om one
v
.Vomi t
ing
persontoanotherorinf
ectedpersonto
v
i.Nausea
another.
6. Mumps i
.Fever
i
i
.Twi l
l
ing Commonnon-
communi
cabl
edi
sease
i
i
i.Tendernessof
t
hesalivar
ygland 1.Hypert
ensi
on
2.Coronar
ydisease

141
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Di
abetes Si
gnandsy
mpt
omsofcancer
4.Si
cklecell
disease
5.Str
oke 1.Fati
gue
6.Cancers 3.Persi
stentcough
7.Asthma 4.Darknessorsor eski
n.
5.Changeinbowel /bl
adderhabi
ts
Sickl
ecellanemia:
-Isablooddi
sease 6.Weightchanges
thatshor
tensli
feexpect
ancy. 7.Troubl
ebr eat
hing
8.Nightsweate.t.
c.
Sy
mpt
omssi
ckl
ecel
lanemi
a
Ri
skf
act
orsofcancer
1.Fever;Peopl ewi thsicklecellanemi a
haveani ncreasedr i
skofser ious 1.Aging
2.Tobacco
i
nfecti
on, andf ev ercanbet hef ir
stsign
3.Familyhist
oryofcancer
ofaninfection.
4.Radiati
onexposure
2.Unexplainedepi sodesofsev erepai n,
5.Lackofphy si
calact
ivi
ty
suchaspai ni nt heabdomen, chest,
bonesorj oints Cardiovasculardiseases:-Thisrefersto
3.Swelli
ngi nt hehandsorf eet. asthedi seaseoft heheartandbl ood
4.Frequenti nfections vesselsE.g.Hy pert
ension,heartattack,
5.Delayedgr owt horpuber t
y str
oke
6.Visi
onpr oblems Causesofhear
tdi
sease
7.Abdomi nal swel li
ng,especiall
yifthe
areaistendert ot het ouch. 1.Highbloodpr essur
e
8.Paleskinornai lbeds. 2.Smoking
9.Yell
owt inttot heski norwhi tesoft he 3.Highchol est
erol
4.I
nactivit
y
eyes.
5.Familyhistor
y
Cancer
:-Canbedefi
neasanabnor
mal 6.Diabetes
pr
oli
fer
ati
onofcel
lsi
nthebody. 7.Ethni
cbackgr ound

Causesofcancer Si
gn&sy
mpt
omsofhear
tdi
sease

1.Chestpai
n
1.Smoki
ngandt
aboo
2.Headache
2.Di
etofphy
sical
act
ivi
ty
3.Chestdi
scomf ort
3.Radi
ati
on 4.Weaknessinlegs
4.I
nfect
ions 5.Abdominalpai
n
5.Obesi
ty 6.Short
nessbreathi
ng
6.Hor
mones Di
abetes:-I
samedi cal
condit
ional
7.Chr
oni
cinf
lammat
ion di
seasethatoccur
swhent hebodycan'
t

142
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

pr
oduceinsul
i
noref
fect
ivel
yuset
he 4.Psy
chol
ogi
cal
fact
ors
i
nsul
in.
COMMUNI
TYBASEDNEW BORNCARE
Si
gnandsy
mpt
omsofdi
abet
es
Newbor
n:-Usual
l
yrefer
stoababyf
rom
1.Polyurea(excessiveur
inat
ion) bi
rt
htoabout2monthsofage.
2.Polydi
psia(excessivet
hir
st)
3.Polyphagi
a( excessi
vehunger) Inf
ants:
-Canbeconsi
der
edchil
dren
4.Fati
gue anywheref
rom bi
rt
hto1yearol
d.
5.Weightloss Baby: -Canbeusedt oref
ertoanychi
ld
6.Blur
redv i
si
on from birt
htoage4y earsol
d,thus
Ri
skf
act
orsofdi
abet
es encompassi ngnewborns,i
nfants,
and
toddl
er s.
1.Overwei
ght
Phy
siol
ogi
cal
needsofanewbor
n
2.Famil
yhistor
y
3.Raceorethni
city 1.Respir
ator
yadaptat
ion
4.Age 2.Cardi
ovascul
aradaptat
ion
5.Highbl
oodpr essur
e 3.Thermaladapt
ati
on
Respi
rat
orydi
sease:-Theseal
i
ment Basi
cphy
siol
ogyoft
henewbor
n
aff
ect
ingtheai
rwaysandlungs
st
ruct
ure. Atbirt
h,thebaby'sl
ungsar efi
l
ledwit
h
fl
uid.Theyarenotinfl
ated.Thebaby
Causesofr
espi
rat
orydi
sease takesthefi
rstbreat
hwi thi
nabout10
secondsafterdeli
ver
y.
1.I
nfecti
on
2.Smoking Basi
cneedsofnewbor
n
3.Asbestos
4.Si
li
ca 1.Breathi
ng
2.War mth
Si
gn&sy
mpt
omsofr
espi
rat
orydi
sease 3.Asepsis
4.Feeding
1.Di
fficul
tyi
nbreathi
ng
5.Protect
ion
2.Cough
3.Chestpain I
mmedi
atenewbor
ncar
e
5.Chronicmucus
6.Coughingupblood 1.Ensureimmedi atewar
mt h(dr
ying,
ski
nt oskincont act)
Predi
sposi
ngfact
orsofnon- 2.Assessbr eathingorNeonatal
communicabl
edisease Resuscit
ation(Hel pi
ngbabiesbr
eat he)
1.Geneti
cfact
or s 3.Earlyi
nit
iati
onofbr eat
hingwithin30
2.Envi
ronmentalfact
ors minutes
3.Li
festyl
efactors 4.Cleancor dcareusing4%

143
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

chl
orhexi
dinegel ofl
i
fe.

Essent
ial
car
eforev
erybaby Causesofneonat
almor
tal
i
ty

1.Mai nt
ainwar mth(continueskinto 1.Prematuri
ty(37weeks)2.
8%
skincare,del
aybat hingfor24hours) 2.Bir
thasphyxi
a23%
2.Eyecar ewith0.5%er yt
hromy ci
neye 3.Inf
ect
ion37%
ointment. 4.Lowwei ght
3.Cont i
nueexclusivebreastf
eeding 5.Lackofadequatecare
4.VitaminKinjecti
on
Speci
alcar
eforsmal
lbabi
es
5.Immuni zat
ion
1.Lessthan1.
5kg=verysmal
lbaby
Commonnewbor
npr
obl
ems
2.1.5kg-2.
5kg=small
baby
1.Asphyxia
2.I
nfecti
on KangarooMot herCare:-TheWor ld
3.Premat ur
ity healt
hor gani
zati
on(WHO)def i
nedas
4.Jaundice thekeepingpre-t
erm baby/underweight
5.Bir
thinjuri
es chil
dtodi r
ectski
ntoki ncontactwit
h
6.Congeni t
alabnor
mal
i
ty themot herorcaregi
v erpl
usexclusive
7.Malformat i
on breast
feeding.
Speci
alneedf
orsmal
lbabi
es Ty
pesofKMC
1.Prol
ongedskintoski
ncare(KMC) 1.I
nter
mittedKMC
2.Conti
nuousandinter
mit
tentKMC
2.Cont
inuesKMC
3.ArtofKMC; Maki
ngKMCwr aps
4.Monitor
ingbabyinKMCandf ol
l
owup Component
sofKMC
ti
l
ldischar
gefrom KMC
1.Kangar
oonut r
it
ion
Compet
encei
nusi
ng3act
ionpl
ant
s 2.Kangar
ooposition
andmodel
s 3.Kangar
oosuppor t
1.Hel
pbabiesbreat
he(HBB) 4.Kangar
oodischarge
2.Pr
ovideessent
ial
car
eforever
ybaby 5.Kangar
oowr aps
3.Pr
ovideessent
ial
car
eforsmall
Homev
isi
tdur
ingr
egnancy
babi
es
1.Fir
stvisi
t:Asear
lyaspossi
bledur
ing
Peri
natalmor
tal
it
y:-Canbedef
inedas
feot
aldeadaft
er24weeksofgestat
ion pregnancy
andbefore6complet
edaysofbir
th. 2.Secondv i
sit:
Duri
ng7,8,
9mont
hof
Neonat
almortal
it
y:-Ref
erst
ot hedead pregnancy
ofnewbornchil
dwithi
nthef
irst28days 3.Helporganizedel
iv
ery

144
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

I
nter
vent
ionspackagei
nnewbor
ncar
e ofteethandnormal
l
yconsi
stof32t
eet
h.
i
nthecommuni t
y i
.8-I nci
sors
1.Homev isit i
i.4-Canines
2.Birt
hpr epar ednessandemer gency i
ii
.8-Pr emolar
s
readness i
v.12-Mol ars
3.Counsel i
ngandpr eparati
on Teething: -I
sreferstoErupti
oni swhen
4.Thermal care(skintoskincontact) aninfant'sfir
stteeth(pri
maryt eeth,
5.Simpleear lynewbor ncar e babyt eeth,deci
duoust eeth,ormilk
6.Exclusivebr eastf
eedingpromot i
on teet
h)appearbyer uptingthr
ought he
7.Cordcar ewi t
h4%chl orhexi
dinegel gums.Thi soccursstarti
ngar ound3
8.Caref orsmal lbabies(KMC) mont hst oseveralyears.Ataboutt he
9.Chil
dspaci ng ageof6y ears,t
hef i
rstpermanent
10.Mat ernal nutr
it
ion molart eetherupt.
Post
nat
alv
isi
tathospi
tal
/home St
agesoft
eet
her
upt
ion
1.Fi
rstvi
sitafterbir
th( day1) 1.Stage1:(0-6mont hs)Babi
esare
2.Secondv i
si
taf t
erbi rt
h(day3) bornwithaful
l setoftwentyt
eet
h
3.Subsequentv i
sitafterbir
th(day7) beneaththegums.
4.Fol
lowupv isitforthesmal l
babypost
ref
err
al(day2, 10and14) 2.Stage2:(
6mont hs)Thef
ir
stteet
ht o
eruptar
etheupperandlowerfr
ontteet
h,
ORALHEALTH theinci
sor
s.
Oral
healt
h: -Canbetheasstat
e 3.Stage3:(10-14mont
hs)Pr
imar
y
complet
est at
eofphysi
cal
,ment al
,and Molarserupt.
soci
alwell
-beingoft
hebuccalcavi
ty.
4.Stage4:(
16-
22mont hs)Cani
neteet
h
Ty
pesoft
eet
h (bet
weeninci
sorsandmolarsontop
andbottom)wil
ler
upt.
1.Primar yteet
h:-Areal soknownas
deciduous, mil
kteeth,babyt eethor St
age5:
(25-
33mont
hs)Lar
gemol
ars
er
upt
.
tempor aryteet
h.Itstarttoform duri
ng
embr yophaseander uptduringinfancy
. Er
upt
ionofper
manentt
eet
h
(6mont hs-3years).Therear e20
1.Fi
r stmol ar
s-bet ween6and7year s.
primaryt eet
h;
2.Cent rali
ncisors-between6&8y ears.
i
.4-I ncissors(2central&2l ateral
)
3.Lat eral
inci
sors-between7&8y ear s.
i
i.4-Mol ars
4.Cani neteeth-between9&13y ears.
i
ii.2-Cani nes
5.Premol ars-between9&13y ears.
2.Per
manentt
eet
h:-Ar
ethesecondset 6.Secondmol ar
s-between11&13
years.

145
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Si
gnsandsy
mpt
omsoft
eet
hing Pr
ev ent
iveandcont
rol
measur
eofor
al
i
nfecti
ons
1.Irri
tabil
i
ty
2.Achi ldplacingobj ectsorf i
nger si
n 1.Brushingproperl
yonr egul
arbasis
theirmout handbi t
ingont hem 2.Fl
ossing&useofi nter
dent
albrush
3.Increaseddr ibbli
ng 3.Regulardentalcheckup
4.Achi ldbeingchoosyaboutf oodsor 4.Regularexerci
se
refusingfoodsal together
Br
ushi
ngt
eet
hst
epsi
nvol
vet
het
eet
h
5.Rednessofcheeks
6.Swel li
ngofgums 1.St
epi–GettheRi
ghtTools
7.Rest l
essnessday&sl eeplessness 2.Stepi
i–Brushi
nCircl
es
night 3.St
epii
i–Cl
eanInnerSurf
aces
8.Rashesonf aceorbut t
ocks 4.St
epiv–Cl
eanYourTongue
9.Gumsappear i
ngr edandswol len,
and 5.St
epv–Rinse
i
fpr essed,mayf eelhar dandpoi nted. 6.St
epvi–Repeat
10.Nott eethingcausesanyadv erse
effectssuchasf ever ,
diarrhea,ear CAREANDMANAGEMENTOFHI
V/AI
DS
i
nf ect
ionsorot hersuchi l
lnesses. Humani mmunodef
ici
encyvi
rus:-Can
bedefi
neashumani mmunev i
rusthat
Di
seasesassoci
ati
onwi
thor
alcav
ity
at
tackimmunecell
scall
edCD4cel l
s.
1.Gingi
v i
tis HIVdiv
idedi
ntotwotype1andt y
pe2
2.Peri
odont it
is HIV.
3.Dentalplague Type1:-Isthepredominantty
pedueto
4.Dentalcalculus i
tshighrateofrepl
icat
ionitmutat
es
5.Dentalcaries rapi
dlyt
osubt y
pe.
6.Oralthrush
Type2: -Itl
esseasilyt
ransmit
tabl
eand
7.Angularstomat i
ti
s peri
odbet weenini
tiali
nfect
ionand
8.Exophthalmia manifestati
onofsignandsy mptomsis
Cul
tur
alf
act
orst
hati
ncr
easet
her
isk al
way slargert
hant ype1.

Si
gnandsy
mpt
omsofHI
V
1.Inadequat efl
uori
deexposur
e
2.Livi
ngi napoorordisadvant
aged 1.Fati
gue
country 2.Swollenl ymphnodes
3.Insuff
icientaccesst
oproperdental 3.Fever
care 4.Nightsweat s
4.Unhealthydiets 5.Weightl oss
5.Pooror alhygiene 6.Oralthrush
6.Tobaccouseandexcessi vealcohol 7.Diar
rhea
use 8.Vomit i
ng

146
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Acquir
edimmunodefici
encysyndrome Ri
sk/
vul
ner
abl
egr
oupofHI
V/AI
D
(AIDS)
:-I
sadiseasethatcandev el
ops
i
npeoplewit
hHI V,i
tsmostadv ance 1.Commer cialsexwor ker
s(CSW)
stageofHI
V. 2.Malesexwi t
hmal e
3.Multi
plesexpar tners
Si
gnandsy
mpt
omsofai
ds 4.Longdiseasedr i
v es
5.Meninunif orm
1.Recurr
entfever 6.Displ
acedpopul ation
2.Recurr
entdiarrhea
3.Drycough Pr
ogr
essi
vest
agesofHI
V/AI
DS
4.Memor yl
oss
5.Fati
gue 1.St
agei
:-Symptomaticstage
6.Rapidweightloss 2.St
agei
i
:-Mi l
dstage
8.Procur
ednightsweats 3.St
agei
i
i:-Advancedstage
9.Pneumonia 4.St
agei
v:-Sever
estage( AI
Ds)

Modeoft
ransmi
ssi
onofHI
V/AI
DS Pat
hophy
siol
ogyofHI
V/AI
DS

1.Sexual i
nt er
cour se Humani mmunodef ici
encyvir
us:-Is
2.Bloodt r
ansmi ssi on commonl ytr
ansmi t
tedviaunprotected
3.Duringbr eastfeeding sexualact
ivi
ty,
bloodt r
ansf
usions,
4.Verticaltr
ansmi ssion hypodermicneedles,andfr
om mot her
5.Sharingneedl es, syr
inges/
otheri
tems tochil
d.
6.Vaginal fl
uids Acqui
redimmunedef ici
encysyndr
ome
7.Rectal f
luids (AI
DS):
-IscausedbytheHI Vorhuman
i
mmunodef i
ciencyv
irus.
Fact
orsaff
ect
ingt
hepr
ogr
essi
onofHI
V
andaids Factorsthataf
fect
ingHI
V/AI
Ddi
seases
progressi
ng
1.Biol
ogical
factor
2.Personalf
actors 1.Vi
ral
2.Hostcell
ularf
actors
3.Socio-
economi cfact
ors
3.Geneti
cfactor
s
4.Envir
onmental f
actor
s
4.Hostimmunef actor
s
5.Agefactor
s
Predi
sposedf
act
orst
hatt
ransmi
ssi
on
ofHIV/AI
DS Commonsexual
transmi
ssi
oni
nfect
ion

1.Exposuretobl
oodofi nf
ect edper
son 1.HIVandSyphil
is
2.Unprotect
edsexwi t
hinfectedperson 2.Gonorr
hea
3.Mothertochil
dtransmission 3.Tri
chomoniasi
s
4.Hepati
ti
sB
4.Shari
ngcontaminatedequipment.
5.Chlamydi
a

147
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

6.Geni
tal
har
per Ski
ll
suseincar
ryoutdur
ingHI
V
counsel
i
ng
HIVlaborator
yinv
esti
gation:-I
sthe
processofdetect
inganti
bodiesof 1.Attendi ng
anti
gensassociat
edwi t
hHI Vinwhole 2.Listeningski ll
s
3.Basi cempat hyskil
ls
bl
ood, sal
iv
aorurine.
4.Quest ioningski l
l
s
Diagnosti
cstest
:-Sev
eralr
api
dtestki
t 5.Summar izi
ngski l
ls
detectedHIVanti
bodi
esexampl
esare; 6.Integratingcommuni cat
ionski
l
ls
1.Determine Qual
i
tiesofgoodcounsel
or
2.Statpack
1.Abil
i
tyt
olistenhis/herpatient
s
3.Unigold
2.Promot
eclientscent eredapproach
4.Oraquick
3.Abil
i
tyt
oear nthet rustofthecli
ent’
s
Met
hodofHI
Vlabor
ator
yinv
est
igat
ion 4.Doesnotsti
gmat izedHI Vpati
ents
5.Compassi
onandempat hy
1.Diagnostictest
Benef
it
sofHI
Vcounsel
i
ngandt
est
ing
2.CD4count
3.Tot al
lymphocy tecount(TLC) 1.Giveoppor t
unit
ytoknowy ourHI V
4.Virall
oad( VL) status
2.Giveoppor t
unit
ytoassessservices
5.Li
v erfuncti
ont est(LFT)
3.Oppor t
unit
ymai nt
ainyourstat
us
counselingHIVr esist
ancetest(
gene
4.Givegeneralknowledgetotheclient
ty
pes&phenot ype) 5.Ithelpthepubli
ctoknowabout
regularHIVtesti
ng.
HIVcounseli
ngandt esting:-I
sa
processbywhichani ndivi
dualrecei
ves ComponentofHI
Vcounsel
i
ng&t
est
ing
counseli
ngwhichenabl eshim/herto
1.Result
snot i
fi
cation
makei nf
ormeddecisionmaki ngand
2.Giveaccurateinformat i
on
HIVtest. 3.Referr
alasappr opriate
4.Demonst r
ati
ngappr opri
atecondom
Pre-t
estcounsel
ing:-Ist
hecounseli
ng
use
donet oanindi
vidualbef
orer
unningout
5.Provi
dingpsy chologicaland
thetestforhi
m/heradherewit
hthe emotionalsupport
resul
tsofthetest. 6.Assessingcopingabi li
ty

Post-
testcounsel
i
ng:-I
st hecounsel
i
ng Roleofcul
tur
eontheeff
ecti
venessof
donet oanindi
vi
dual
afterrunni
ngthe HIV/AIDScounsel
i
ngandtesti
ng
testi
nor derf
orhi
m/hertoacceptthe 1.Uset
hel
anguaget
hatr
espectcul
tur
e
resul
ts.

148
Ba
sicOfCo
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nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

promotesef fecti
veHI VandAI DS i
nter
venti
on.E.
g.HIVposi
ti
vepeopl
e
counseli
ngandt esting. pr
ogresstoAIDs.
2.Passt hemassagei nawayt hatithas
cult
uralsigni
ficantfort hepeopl e. Sy ndrome:-Canbedef i
nedasa
3.Thepeopl ebel i
efofdi seases collecti
onorsetofsignandsymptoms
causati
onmustnoti gnored thatcharacter
izedsuggestapar
ti
cul
ar
4.Approachesi nHCTshoul dbe diseases.
cult
ural
lyaccept able. Rati
onal
eforsyndromi
cmanagementof
5.Connect i
ngt hepeopl e'sexper i
encein HIVandsexual
t r
ansmi
ttedi
nfect
ions
l
ifepromot eef f
ecti
v eHI VandAI DS
counseli
ngandt esting 1.Counseli
ng
2.Compl i
ance
Concor dantcoupl
es:-Apai
roflong- 3.Condoms
term sexualpart
nersi
nwhichonehasa 4.Contacttr
eatment
sexuallytr
ansmitt
edinf
ecti
onandt he 5.Connecttothemanagementof
otherdoesnot . syndr
omeSTI s.
Di
scor
dantcoupl
es:-I
swhenbot hof Cl
assesofARV
t
hepart
nerarenegat
iveorposi
ti
ve.
1.Neclocidereverset
rancr
ipt
ace
Couplecounsel
ingandtest
ing:
-Canbe i
nhibit
ors( NRTI)
.E.g.
def
inedasauni tcol
l
ecti
veoftwo 1.Zidovudine(AZT)
i
ndivi
dualsfor
mt hebackboneofthe 2.Lamuv udine(37c)
communi t
y. 3.Abacav i
r(ABC)
4.Stavudine(D4T)
Ty
pesofcoupl
es
2.Necloci
derever
setranscr
ipt
ant
1.Pre-
sexualcouples
i
nhibi
tors(NERYI)
.E.
gTenof ov
ir
2.Engagedcouples
di
soprosil
fumarate(
TDF) .
3.Marri
ed/cohabi
t i
ngcoupl
es
4.Poly
gamouscoupl es 3.Non-
necloci
detranscr
ipt
asei
nhi
bit
ors
5.Reunit
ingcouples (NOTRI)
.E.g
i
.Navir
aplne(NVP).
Dif
ferencesbetweenpri
maryand
i
i.El
avi
reng(EFU).
secondaryprev
entionofHI
V/AIDs
4.Proteaseinhibi
tors(
PL)
.E.
g.
Pri
mar yprev
ention:
-Reducethe
i
.Squinavir(SQV)
i
ncidenceoftransmissi
on(E.
g.f
ever
i
i.Rotanavir(RTV)immuneboost
er
peoplebecomeHI VInfect
ed)
.
i
ii
.Lopinavir(LPV).
Secondar yprev
ention:-Reducethe
Opport
unit
ici
nfect
ion:-Arei
nfect
ions
prevalenceandsev eri
tyofthedisease
t
hatoccursmoreofteninpeoplewith
throughearlydetecti
onandpr ompt
weaknessimmunesy stem.(
People

149
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

l
i
vingwi
thHI
V). St
rat
egi
est
hatenhanceadher
ence

Commonoppor
tuni
ti
cinf
ect
ions 1.Pati
entrel
atedstr
ategy
2.Cli
nici
an&healthrelatedstr
ategi
es
1.Meningiti
s 3.Regimenrelat
edstrategies
2.Tuberculosi
s
3.Pneumoni a El
ementofcar
eandsuppor
tneedof
4.Herpes HI
V/AI
DS
5.Pulmonar ydi
seases
6.Respir
atoryinfecti
on 1.Medicalsupport
7.Hepatit
isB 2.Psy
chol ogi
calsupport
8.Sexuall
yt r
ansmi t
tedi
nfect
ions 3.Homel evelsupport
9.Kidneydiseases 4.Communi tylevel
support

Pr
event
ionandcont
rol
ofHI
V CAREOFOLDERPERSON

1.Healtheducat
ion Olderper son:
-It'
sthelastst
ageinli
fe
2.Useofcondoms ofani ndivi
dualandit
'sgenerat
ion
3.Premarit
alHIVcounseli
ng&t esti
ng compr isi
ngofoldermember sofa
4.Li
mitati
onofsexualpartners population.
5.Bl
oodscr eeni
ngbeforetransfusi
ons Careoftheolderperson:
-Thesearethe
6.Avoidshari
ngofsharpobj ect
s serv
icesgiventooldagepeoplei
norder
AdherencetoART:-I
sthesticki
ngfir
mly tomaintai
nandpr omotethei
rhappy
tot
reat mentr
egi
menbytakingHI V heal
thfull
i
ving.
medicineever
ydayandexactlyas Cl
assi
fi
cat
ionofol
dage
agr
eedbet weent
hehealt
hCar eprovi
der
andclient
. 1.Chr
onol
ogi
calage
2.Phy
siol
ogi
cal
age
Fact
orst
hati
nfl
uenceadher
ence
Processofagi ng:-Isaper iodi nl i
fethat
1.Pat
ientabi
l
ityt
ofi
tmedi
cat
ioni
nto whent hebodi l
yfunctioningbegi nsto
decli
ne, usual
lyfr
om t heage30y ear
s
dai
l
yli
fe
andbey ond.I
t'
sbiologicall
yr ootedi n
2.Pat
ientunder
standi
ngt
hatpoor genetics,ti
mer el
atedandi nev itable
adher
encel
eadt
oresi
stance regardlessofhealtheducat ionanddai ly
3.Recogni
ti
ont
hatt
aki
ngal
lthedr
ug routi
ne.
l
osesi
simpor
tant
Si
gnandsy
mpt
om ofagi
ng
4.Av
ail
abi
l
ityofcl
i
niccapabl
eof
1.Decreasei
nbonemass
moni
tor
ingt
reat
ment
2.Changeinbonest r
uctur
e
5.Keepi
ngcl
i
nicsappoi
ntment
3.Decreaseoxygenuptake
6.Tol
erabi
l
ityofARVS 4.Lossofnon-produci
ngcell
s

150
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nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

5.Poorv
isi
onandhear
ing 4.Cul
tur
alpract
ices
5.Communicati
on
Commonpr
obl
em af
fect
ingol
der
per
son Resour
cesandfaci
li
ti
esavai
labl
eint
he
communit
yforcareofaged
1.Physicalproblems
2.Ment alproblems 1.Pensionser vices
3.Psychological probl
ems 2.Modificati
onofl iving
4.Socialproblems accommodat ions
5.Economi cpr oblems 3.Dental ser
vices
4.Assessmentofment alst
atustorul
e
Phy
sical
probl
emsoft
heaged outdement i
a
1.Fai
lingsi ght 5.Healtheducat ionandcounsel l
ing
2.Hear ingloss 6.Regularmedi cal servi
ces
3.Poordent i
tion 7.Provi
sionofai dsforhearingandsight
4.Gener ali
zedbodyweakness Strat
egiestogui
dehowf aci
li
ti
esand
5.Alt
er edpost ure resourcescanbeut
il
izedthecareof
6.Lossofappet it
e aged
7.Painful j
oint
8.Ski
nwr inkled 1.Developmentalcommit
tees
2.Groups
Ment
alpr
obl
emsofaged 3.Fri
ends
1.Dementi
a 4.Socialassoci
ati
ons
2.Anxi
ety 5.Fami l
ymeet i
ng
3.Depr
ession 6.Useofol derpeopl
e'
shome
4.Sel
f-
neglect Typesofser
vicesf
ort
heagedbyt
he
5.Negl
ectofother
s famil
ymember s
Soci
alpr
obl
emsofaged 1.Medicalser
vices
1.Loneli
ness 2.Soci
alservi
ces
2.Idl
eness 3.Famil
ysuppor tser
vice
3.Lackoftranspor
tat
ion Soci
alser
vicesoft
heaged
4.Poorhousing
5.Povert
y 1.Homeheal t
h
Fact
orsi
nfl
uenci
ngt
heheal
thoft
he 2.Goodneighbors
ol
derper
sons 3.Mealsonchair/wheel
s
4.Homecar eprogramme
1.Li
festyl
es
5.Daycarecenter
2.Fi
nancialst
atus
3.Social
support 6.Outi
ngandhol i
days

151
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

Obj
ect
ivesofcar
eofaged Causesofdi
sabi
l
ity

1.Toi nvol
vef amilyandcommuni t
yin 1.Arthr
it
is
thecar eofage 2.Backpai n
2.Tomanagenegat iveper ceptionabout 3.Heartdisease
theaged 4.Cancer
3.Toi dent
ifythepr obl emsaf f
ectingthe 5.Depression
ageandmanaget hem 6.Diabet
es
4.Tor ecognizeav ailablef acil
i
tiesand 7.Nervoussy st
em di
sor
der
s
resourcesforcar eofaged 8.Trauma
5.Toensur epr operut ili
zat i
onoft he
Cl
assi
fi
cat
ionofdi
sabi
l
ity
facil
i
ties
6.Tomakeagedat hingofj oy 1.Phy
sical
disabi
l
ity
7.Togi veasenseofbel ongi ng i
.Paral
ysis
8.Toencour ageourcust omsand i
i
.Lossl i
mb
tradi
ti
onst hataref ullofr especttot he i
i
i.Bl
indness
aged i
v.Deafness
v
.Spinalbif
ida
CAREOFPERSONWI
THSPECI
ALNEED
2.Ment
aldi
sabi
l
ity
Handi
cap: -I
sament alorphysi
cal
i
.Singleparent
hood
di
sadvantage,suchasbli
ndnessora
i
i.Orphans
missi
ngleg.
i
ii
.Mot herl
esschi
ldr
encar
edf
orby
Per
sonwit
hsoci
alneed:-Thesear
e granni
res
i
v.Lowi ncomeearners
per
sonwhoneedspeci
alhealt
hcare.
v.Learni
ngdisabi
li
ty
Commonhandi
cappedcondi
ti
ons
CHI
LDHEALTH
1.Deafness Chil
dhealth:-I
sast ateofcomplete
2.Epil
epsy physi
cal,mental,i
ntel
l
ectual,
social
and
3.Asthma emotionalwell
-bei
ngandnotmer el
ythe
4.Diabeti
c absenceofdiseaseori nf
ir
mity.
5.Bli
ndness Chil
d:-Canbedefi
neashumanbeing
6.Ment al
subnor
mal
i
ty fr
om bir
thbef
ore18yearofage,
whois
undercar
eofparent
s.
Disabi
li
ty:
-IsanylossofPhysi
ological
,
Psychol
ogicalorAnatomi
calstr
ucture Chil
dri
ghtasdecl
aredbyUN: -I
n1959
orfunct
ionasar esul
tofacci
dent theuni
tednat
iongener
alassembly

152
Ba
sicOfCo
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nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

adoptedt hedeclar
ationofr
ight
soft
he di
fferentpr
ogrammeappr oachesintoa
chi
ld.Itmar kedthefir
stmajor str
ategyaimedatreduci
ngmor tal
it
yand
consensusont hefundamental mor bi
dit
yinunderfi
vechil
dren,whil
e
pri
nciplesofchildri
ghts. contri
buti
ngtothei
rimprovedgrowth
anddev el
opment.
Decl
arat
ionl
aychi
l
dri
ght
Component
sofI
MCI
1.Theri
ghttoli
fe
2.Theri
ghttoli
ve 1.Improvi
ngheal
thsy
stem
3.Theri
ghttohaveaname&nat ional
i
ty 2.Improvi
ngheal
thworker
sski
l
ls
4.Theri
ghttofr
eedom ofassoci
ati
on 3.Improvi
ngkeyf
amily&communit
y
5.Theri
ghttocommuni cat
e pract
ice
6.Theri
ghttobasiceducat
ion
Rat
ional
eforI
MCI
7.Theri
ghttogoodhealth
8.Theri
ghttofr
eedom from 1.IMCIasakeyst r
ategyfori
mpr ov
ing
di
scri
minati
on chil
dhealt
h
9.Theri
ghttopri
vacy 2.WHOandUNI CEFdevelopedIMCIin
10.Theri
ghttobebroughtupinaspir
it 1995inresponsetothechall
engesof
ofunder
standi
ngamongpeopl e provi
dingqual
it
yhealthcareforchi
ldr
en

Risk:-Isacondi
ti
ont
hatexposeda Assessmentandcl
assi
fi
cat
ionoft
he
chil
dt odanger
. si
ckchil
d

Fact
orst
hatcanexposedchi
l
dtor
isk 1.Gener aldangersi
gn
2.Tr eat
mentofpr i
ori
ti
es
1.Homel ess
3.Identi
ficat
ionofchil
d'
simmuni
zat
ion
2.Racism
status
3.Disabilit
ies
4.Subst ancesabuse Assessmentofchi
l
dstatus:
-Isa
5.Pov erty processwher
ebyamet hodorcondi
ti
on
6.Divorce ofhealt
hstat
usofchi
l
drencanbe
7.Negl ect determi
ned.
8.Si
ngl epar ent
Thesecanbedonei
ntwomet
hod
9.Teenagerpar ents
10.Abundantchi ld 1.Gener
alassessment
2.Speci
fi
cassessment
I
ntegr
atedManagementofChil
dhood
I
ll
ness(IMCI
):-I
sani
ntegrat
edof 1.Gener
alassessment
:-I
sdonewhen

153
Ba
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nit
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alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

thechi
ldisnotshowinganypar t
icul
ari
ll Condit
ionsthatmayexposedchi
l
dthe
heal
th.I
t'
sdonegr ouphealthser
v i
ces. togravedanger
E.g.
1.Cough, dif
f i
cul
tyi
nbreat
hing
1.Communi tymobil
izati
on
2.Convulsions
2.Schoolhealt
hservices
3.Vomitev eryday
3.Healt
hassessmenti nthecommuni t
y
4.I
nabili
tytobr east
feed
Cr
it
eri
aingener
alassessment 5.Fever
6.Diar
rhea
1.Historytaki
ng
7.Measles
2.Physicalexami nat
ion
8.Malari
a
3.Checkf orgener al
dangersign
9.Malnutrit
ion
4.Classif
ycondi ti
on.
10.Earprobl em
5.Checkf ormal nutr
it
ion
6.Checki mmuni zati
onstatus Sev
erecl
assi
fi
cat
ion
7.Assessmot herownchi l
d
1.Severepneumoni a
8.Managecaseaccor di
ngtostandi
ng
2.Severefebri
leill
ness
order
3.Severedehy drati
on
2.Specif
icassessment:-Isat
ypeof 4.Dysentery
assessmentcarryoutbyahealt
hworker 5.Severepersistentdiar
rhea
whent hechi
ldispresent
ingwi
th 6.Severecompl i
cat edmalnutr
it
ion
speci
ficheal
thproblem. 7.Severeanemi a.
Othersi
nclude:
Import
antofassessmentofhealth
1.Hemogl obi
nbel ow7gm%orneonat e
stat
usofchil
dtothehealt
hwor ker
withbel
ow15gm%
1.Toknowt hety
pesofi llhealt
h 2.Sti
ffneck
aff
ectingthechil
d 3.Abdomi nalpainwi t
hrabidi
ty
2.Toknowsev er
ityofthei l
lhealt
h 4.Oedema
3.Toknowt hestepstakent oremedy 5.Jaundice
thesit
uation
Int
ervent
ioncur
rent
lyi
ncl
udei
nIMCI
4.Todet erminet
heappr opriate
str
ategy
management
5.Determinewhoar eatri
sk 1.Casemanagement
6.Todet erminewhenandwhot osuf
fer 2.I
mpr
ovi
ngt
heheal
thsy
stem
7.Toknowt hemot herspercepti
onover 3.I
mpr
ovi
ngf
ami
l
yandcommuni
ty
theil
l
ness. pr
act
ice

154
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

FAMI
LYPLANNI
NG Hormonal method: -Hor monalmet hods
ofbi r
thcont r
ol preventeggsf rom being
Fami l
yplanning:
-Isthepl
anningof
rel
easedf rom t heov ariesthi
cken
whent ohav echi
ldren,
andtheuseof
cervicalmucust opr eventspermf r
om
healt
hychi l
dSpacingandother
enteringtheut erus,andt hinthelini
ngof
techniquesofimplementsuchplans.
theut er
ust opr eventimpl ant
ation.
Tr
adi
ti
onal
met
hodsoff
ami
l
ypl
anni
ng Whi chincludesf i
v etypes:

Nonpr escri
pti
vemethods:-Theseare 1.I
njectable
met hodswhichcanbeusedwi t
hout 2.Pi
lls
recommendat ionorpr
escri
ptionbya 3.I
mpl ants
healthworkeroranyprof
essional. 4.Ri
ngs
Whi chincl
udes; 5.Thepat ch

1.WithdrawalMethod Met
hodoff
ami
l
ypl
anni
ng
2.MaleCondom
3.Femal eCondom Or
alpi
l
ls
4.Spermi ci
de
1.Microgynon: -0.
15mgt abandthir
ty
5.Ferti
li
tyAwarenessmethod
doseint heserchet,i
tworki
ngwithtime,
6.Lactati
onAmenor heaMethod
7.Emer gencyContr
acept
ionPil
l
s exampl esofthepat i
entst
artt
akingitby
7pm itmustbeuset hesamet i
medai l
y
Moder
nmet
hodsoff
ami
l
ypl
anni
ng i
fnoti twil
lnotwor k.

1.Coit
usintermuptusorwithdrawal 2.Exluton/micr
olut:-Thismet hodis
method about0. 15mgit'
susebyt he
2.Natural
familyplanni
ngmet hod(saf
e breastfeedi
ngmot hers,afterthebabyis
peri
odorabst i
nence) 5mont hsandabov e.OnlyMi nipi
llscan
3.Hormonal method abletouseev enthebabyi slessthan5
4.I
UCD mont hs.
5.Barr
iermethod
6.Permanentmet hod/sur
gical 3.Posti
nor1/ 2(emer gency
7.Emergencycont r
acepti
ve contr
acepti
vespi ll
s):-Thesepil
l
sar e
1.5mgthisdistr
oyemer gencyor
Nat
uralf
amilyplanni
ngmet
hod(
saf
e unwantedpregnancyl ikerapepati
ent
per
iodorabsti
nence) withi
n7day sofr aping.

1.Ferti
li
tyawarenessbasedmethod I
mpl
ant
s
2.Lactati
ngAmenor rheamethod
3.Standarddaysmet hod 1.Janell
e:-Thesear
emet hodthatl
ast
4.Ovulati
onPredicti
ontest atleastf
or5yrs75mginserti
ontypei
t'
s

155
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

al
esst
han<shapei
t'
ssi
dei
slef
tupper 3.LessseveremenstrualsymptomsE.
g.
ar
m. Headache,Fati
gue,I
ri
tabil
it
yetc.
4.Noactionrequi
redpriort
osexual
2.I
mplanon:-Thesearemet hodl
astat
i
ntercour
se
l
eastfor3yr
s68mgi nser
tiontype
5.Permit
ssexualspontaneit
y
var
ti
call
yinlef
tupperarm
Di
sadv
ant
ageoft
hepi
l
l(or
all
y)
3.int
raut
eruscontr
acept
ivedevi
ce:-I
s
themethodthatl
astatl
eastfor12y
ears. 1.Noteff
ecti
veagainsttr
ansmissi
onof
STs.
Bar
ri
ersmet
hods
2.Rarebutdanger
ouscompl i
cati
ons
1.Malecondom suchasbloodclot
ti
ng, Hi
ghBP,
2.Femalecondom especi
all
yinwomenabov e35y ear
s
whosmoke.
I
nject
abl
e 3.Mustbetakendaily
1.Sayanapress: -Thi
sisamet hodt
hat Adv
ant
agesoft
hecer
vical
cap
has104mgf or13weeksi t
'ssi
deis
subcutaneoust olef
tbackofthearmit 1.Reusabl
e
comewi thmi ddleandsyr
inge. 2.Canlastf
oroneort
woy
ear
s

2.Depoprovera:
-Thi
sisamethodthat Di
sadv
ant
ageoft
hecer
vical
cap
has150mgf or12weeksandi
t'
ssideis
1.Noteff
ecti
veagainstSTIs
i
ntramuscul
ar.
2.Needstobefit
tedbyaheal t
hworker
3.Nori
ster
ant:-Thi
sisamet
hodt
hat 3.Maynotfitwomenwi thanunusual
has200mgf or8weeksandi
t'
ssi
dei
s cer
vical
size
i
ntramuscul
ar.
Adv
ant
agesofi
nject
abl
econt
racept
ive
Commonsideef
fect
sofor
all
y,
1.Noact ionrequi
redpr
iort
osexual
i
nject
abl
e&impl
antsmet
hodsincl
udes;
i
ntercourse
1.Bleedi
ng 2.Effect
iveforabout3months
2.Nausea dependingont ypeused
3.Lowerabdomi
nal
pai
n 3.Permitssexualspont
aneit
y
4.Headache
Disadvantageofi
nject
abl
e
5.Vomi t
ing
contracepti
ve
Adv
ant
agesoft
hepi
l
l(or
all
y)
1.Noteffect
iveagai
nstSTI
s
1.Moreregularper
iods 2.Requir
esr egul
arv
isi
ttoheal
thwor
ker
2.Pr
eventcramping fori
nject
ions.

156
Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

3.Maycauseir
regul
arbl
eedi
ng,
wei
ght 4.Mustbeinser
tedbet
for
eeachactof
gai
n,sor
ebreastandnausea Scxual
int
ercour
se.

Adv
ant
agesoft
hecont
racept
ivepat
ch Di
sadv
ant
ageoft
hedi
aphr
agm

1.Noact ionr
equi
redpr i
ortosexual 1.Womenwhoareal
ler
gictot
he
i
ntercourse mater
ial
2.Regularusemayr esul
tinshotermor
e 2.Womenwhohaveabnormalcer
vix
regul
armenst r
ualperi
ods.
Advantagesoft
heemer
gency
3.Reducespremenst r
ualrel
atedir
on
contr
acepti
ve
defi
ciencyandacne
1.Prev
entspr egnancywhenprimary
Di
sadv
ant
ageoft
hecont
racept
ivepat
ch
bi
rthcontr
ol fai
lsduri
ngsex(E.
g.if
1.Dangerouscomplicationsuchas condom breaks)
bl
oodclotti
ng,highBP, especial
l
yto 2.Prev
entpr egnancywhenoneormor e
womensmoker sover35y ear
s. bi
rthcontr
ol pil
l
sareskippedora
2.Contr
aindi
catedagainstsome womani sforcedtohav eunpr
otect
ed
medicati
onssuchasant ibi
oti
cs,
Disadvantageoft
heemer
gency
anti
sei
zures,t
uberculosisandmi gr
aine
contracepti
ve
drugs.
1.Noteff
ecti
veagainstSTI
s
Adv
ant
agesoft
hecont
racept
iver
ing
tr
ansmissi
on
1.Noteff
ect
iveagai
nstSTI
s 2.Needstobeprescri
bedbyaheal
th
2.Thosewhoarereact
ingt
othe worker
.
materi
al
Adv
ant
agesoft
hef
emal
escondoms
3.I
ll
nesstot
hepar t
1.ReducestherisksofmanySTI
s
Di
sadv
ant
ageofcont
racept
iver
ing
2.Avai
labl
eov erthecount
er
1.Transmi ssi
onmaycausev agi
nal 3.I
nexpensive
i
rri
tati
onanddi schar
ge
Di
sadv
ant
ageoft
hef
emal
econdoms
2.Maycausei r
regul
arbleeding,
weight
gai
n, orloss,br
easttenderness,
nausea, 1.LessonsSensati
on
vomitingheadacheandmodechange. 2.Maybr eakdur
ingint
ercour
se

Adv
ant
agesoft
hedi
aphr
agm Encouraget
heaccept
anceoff
ami
l
y
pl
anningint
hecommunity
1.Noteff
ecti
veagainstSTl
s
2.Tr
ansmissi
on Thi
smeanstheact
ivi
ti
escarri
edoutso
3.Needstobefi
ttedbyahealt
hwor
ker
. ast
oimprov
etherateofacceptanceof

157
 Ba
sicOfCo
mmu
nit
yHe
alt
hPr
act
it
ion
ers
;Vo
lume1
,2&3By
:Ba
shi
rAl
iMa
gume
ri,
CHE
W20
22.

famil
yplanni
ngint
hecommuni
ty.Such Standar
dequipmentforset
ti
ngup
acti
vi
ti
esincl
ude; famil
yplanni
ngserv
ices

1.Pr opert raini ngofst aff

st hatwill Procuri
ngstandar dequi pmentisbased
embar kont hischal lenge onthefoll
owi ng;
2.Adequat est udyoft hecustomsand 1.Thepopulat i
ont hatwi l
lrecei
vethe
tr
adit i
onoft hepeopl e servi
ces
3.Inv olv i
ngt hepeopl ethrough 2.Theleveloftrainingoft heservi
ce
sensi ti
zat ionandadequat eor i
entat
ion provi
der
ofcommuni tyl eader s 3.Capacit
yoft hef acil
it
y
4.Pr operadol escentheal t
handsex 4.Avail
ableresour ces
educat i
on 5.Appropri
atet echnology
5.Campai gnpr ogr ams
Managementoff
ami
l
ypl
anni
ngcl
i
nics
6.Or ient ationofr eli
giousl eaders
7.Pr operexpl anat i
onoft hev arious Fami l
ypl anni
ngcl i
nicsaremanagedby
met hodsoff ami l
ypl anning healthwor kerstrai
nedinr eproduct
ive
8.Inter sect or al collaborati
on healthandf amilyplanning.Inanycase
9.Sol icitinggov ernmentsuppor t theheal t
hwor kerprovidingfamily
10.Usi ngcul tur ai
lyaccept abl
e planningser v
ices,shouldtrytonotethe
str
at egi es foll
owi ngkeypoints;

Serv
iceav
ail
abl
einf
ami
l
ypl
anni
ng 1.Theheal thwor ker'
set hi
csar ev er
y
cl
ini
cs muchappl icabl ei
npr ovisi
onoff ami l
y
planni ngser vices.
1.Cont
racept
ion(
bir
thcont
rol
ser
vice) 2.Pr operuseoft heSt andingOr dersis
2.Counsel
i
ng essent i
al butt heSt andingOr dersmust
notr epl acet hecl ini
cal j
udgmentoft he
3.Sexual
l
yTr
ansmi
tt
edI
ntect
ions
staff.
Management
3.Right sandf eel
ingoft hepat ientmust
4.Sexual
i
tyeducat
ion ber espect ed.
5.I
nfer
ti
li
tymanagement 4.Pr operi nfect i
onprocedur eis
6.Ref
err
alser
vices i
mpor t
ant .
7.Not
if
icat
ions 5.Manypeopl ecanusemostf ami ly
planni ngmet hodst herearef ew
8.Dat
acol
l
ect
ionandmanagement
cont raindicat ions.
9.I
dent
if
icat
ionoft
rai
ningandl
ear
ning
6.Foref f
ect iveness,mostf ami l
y
needs planni ngmet hodsdependsmor eont he
10.Resour
cesmanagement usert hant heot hers

158