Community Medicine

By
DR. Zulfiqar Ali

Contents
Chapter No.1
Basic Definition & Introduction
Definitions
1
Health and its dimensions
3
Spectrum of disease
4
Iceberg of disease
4
Natural history of disease
5
Levels of prevention
7
Apply 5-levels of prevention on T.B & hypertension
9
WHO (World Health Organization) 10
UNICEF
10
Important days of the year
11
Viva Questions
11

Chapter No.2
PHC & Rural Health
Definition & Elements of PHC
13
Principles of PCH
13
Health for all by year 2000
15
Health planning cycle
15
5-Star Doctor
16
Levels of prevention & health care 16
Major diseases
16
FLCF (First level care facilities)
17
BHU & RHC
18
Duties of LHV
21
Rural health problems
22
Viva questions
23
MCQS
23

Chapter No.3
Demography
Demography
25
Population Dynamics
25
Population growth rate
26
Reason for population change
26
Calculation of population in b/w
census years
Components of population growth 27
Causes of highest mortality
28
Causes of decrease mortality
28
Causes of high fertility
29
Basic fertility measures
29
Population pyramid
30
Dependency & Sex ratio
31
Demographic transition
31
Demographic Cycle
31
Demographic trap
32
Population momentum
33
Implications of high population
growth
33
Demographic features of Pakistan 34
Vital index & population density
35
Viva questions
35
MCQS
35

27

Chapter No.4
Biostatistics
Introduction & functions
Important terms
Data & its type
Sources of data
Presentation of data
Types of measurements applied on data
Measurement of central tendency

37
37
38
38
39
43
43

Arithmetic mean
Median
Mode

Measures of dispersion

44

Range
Mean deviation
Standard deviation

Hypothesis
Probability or p value
Chi-Square test
Life Table
Viva questions
MCQS

45
45
46
46
47
47

Chapter No.5
Environment
Water
Air & ventilation
Soil
Housing
Noise
Climate & health
Viva questions
MCQS

Chapter No.6
Nuclear Medicine
Radiation, sources & its types
Units of radiation
Maximum permissible dose
Penetration ability
Effects of radiation
Uses of radiation
Protection from radiation
ALARA principle & Bays rule
Viva Questions
MCQS

49
67
73
75
77
79
83
83

85
85
86
86
86
87
87
87
88
88

Chapter No.7
Hospital & Biomedical Wastes management &
Sold waste disposal
Introduction & Types of wastes
89
Waste management team & plan
90
Steps in hospital wastes
Management
91
solid wastes disposal
92
Methods of disposal of wastes
93
Health Hazards of Human excreta 93
Methods of human excreta disposal 94
Septic tank
94
Definitions
95
Strength of sewage (BOD& COD) 95
Activated sludge process
95
Viva Questions
96
MCQS
96

Chapter No.8
Epidemiology
Definition, aim & uses
97
Epidemiological approach
97
Basic measurements in
Epidemiology
98
Tool of measurement
98
Rates
Ratio
Proportion

Numerator & denominator

99
Mortality rates & ratios
100
Measurement in morbidity
101
Incidence
Prevalence

Epidemiological methods
102
Descriptive Epidemiology
Analytical
Experimental

Blinding

111
Association & causation
111
Web of causation & Wheel
112
Investigation of an
epidemic
113
KAP studies
114
Uses of Epidemiology
114
Viva questions
115
MCQS
115

Chapter No.9
School Health Services
Introductions & aims
117
Situation of school health service 117
School health team
118
Duties of school medical officer
118
Duties of school nurse & an
attendant
118
Drugs & equipment of school clinic119
Role of school teacher
119
Profiles of School health program 119
School health problems
121
Functions of school health
Services
121
Advantages and disadvantages of school health
services
121
Viva questions
122
MCQS
122

Chapter No.10
Health Education
Definitions & aim
123
Stages of health education
123
Strategies, communication
124
Methods of health education
125
Methods of maintaining behavioral change
126
Models
126
Principals of health education
127
Programme plan
127
Evaluation
127
Viva questions
128
MCQS
128

Chapter No.11
Immunization
Immunology and its uses
Immunity & its types
Important terms
Herd immunity
Immunizing agents

129
129
130
131
131

Vaccines
Immunoglobulins
Antisera/antitoxin

Cold chain
134
Shake test & thawing
135
EPI schedule
135
Vaccination schedule of 9
months & 2 years child
135
Contraindication of vaccines
135
Abnormal reactions &
Complications of vaccines
137
Tetanus toxoid
137
Polio
137
Causes of failure of vaccine
138
Vaccines descriptions
138
Pre- exposure prophylaxis
139
Immunization recommends for travelers to endemic area
Optional & compulsory vaccines 140
Important terms
140
Vaccine schedule for rabies
141
Viva questions
142
MCQS
142

140

Chapter No.12
Disaster Management
& Control
Definition & types of
disaster
143
Steps of disaster
management
143
Organization model for
disaster
145
Social reaction following
a
Disaster
145
Duties of health team
145
Viva questions
145
Surveillance cycle

Chapter No.13
Screening & Sampling
Definition, aims, objectives &
uses of screening
147
Type of screening
148
Dif. b/w screening &
diagnostic test
148
Criteria for screening
148
Sensitivity, specificity & predictive value
150
Yield
151
Definition & methods of sampling 151
Probability & non-probability
Sampling
152
Sampling errors
153
Viva questions
153
MCQS
154

Chapter No.14
IMCI & Child survival
IMCI strategy & its aims
155
Components of IMCI
155
Advantages of IMCI study
155
Situation of children in Pakistan 156
women conditions in Pakistan
156
Major killers of children
157
Composition of ORS
158
Indigenous ORS
158
Viva questions
158
MCQS
158

Chapter No.15
CH NO. 15 chdfdf
Reproductive Health (MCHC)
Definition & components
159
Maternal Mortality and morbidity 159
Health problems of females
160
High risk cases
161
MCHC & its components
161

Antenatal care
Intra-natal care
Postnatal care
Infant care

Training programmes
165
Birth weight and low birth wt.
166
Growth monitoring and promotion 166
Growth chart
167
Under five clinics
168
Brest feeding
169
Artificial milk.
169
Humanization of milk
170
Weaning
170
Maternity & child Welfare center 170
Social obstetrician
171
Mother and child on units
171
Indications of MCH care
172
Infant mortality rate
172
NMR
173
PNMR
174
Safe motherhood
175
Viva Questions
176
MCQS
176

Chapter No.16
Family Planning
Definition, aims & objectives
179
Family limitation
179
Cafeteria choice
180
Classification of fertility regulation 180
Barrier methods
180
Intrauterine contraceptive devices (IUCD)
Hormonal methods
183
Oral pills
183
Non-contraceptive uses of oral pills184
Deport-formulation
185
Post conceptional methods
186
Miscellaneous methods
187
Absentinence
Coitus interrupts

Birth control vaccines

187
Safe period
187
Breast feeding
187
Terminal methods.
188
Family planning and health
scope of family planning services 188
Viva questions
189
MCQS
190

181

Chapter No.17
Occupational Health
Occupation
191
Occupational health
192
Occupational diseases
193
Pneumoconiosis
193
Prevention & control of pneumoconiosis
196
Occupational hazards
196
Viva Questions
200
MCQS
200

Chapter No.18
Social & behavioral science
Definition
201
Sociology
201
Family, joint family society,
Culture, community Class & association
201
Cast system in Islam & Pakistan 202
Social mobility & its types
203
Social evils
203
Health problems and diseases & prevention
203
Psychology & social psychology 204
Personality and its components
205
Medical anthropology & its components
Genetics
205
Ecology
206
Political science
206
Social pathology
206
Viva questions
207

205

Chapter No.19
Food, Nutrition & Health
Definition & classification of food 209
Nutrients & its types
Balanced diet
Caloric requirements of male, female & infants
Food caloric values
Factors affecting caloric needs
211
Macronutrients
Micronutrients
Vitamins
Minerals
Diet
Adult male & female
Infants, children & old age
Pregnancy & lactation
Food fortification
Food adulteration
Food poisoning, infection
& toxemia
Preservation of foods
219
Animal foods & inspection of meat 219
Characteristics of Good meat, Fresh fish & egg
Meat born diseases
Composition of milk
Humanization of milk
221
Advantages of Breast-feeding
222
Adulteration of milk
Common preparation from milk
222
Methods for rendering milk safe
223
Pasteurization & boiling
223
Dangerous food & control
223
Assessment of nutritional status
224
Malnutrition
Protein energy malnutrition
226
Kwashiorkor & marasmus
227
Obesity & its complications
228
Via questions
229
MCQS

210
210
211
211
212
213

217

217
218
218

220
220
221

222

225

229

Chapter No.20
Mental Health
Definition & introduction
231
Etiology of mental illness
232
Mental health service
232
Prevention of common mental health
problems in Pakistan
232
Team in C.M.H. center
233
Intelligence & I.Q.
233
Diff. b/w mental illness and mental
Deficiency
234
Viva questions
235
IMCQS
235

Chapter No.21
Communicable diseases
Introduction and Communicable diseases
Incubation period &
Infective Period.
239
Dynamics of diseases
240
Control of c. diseases
242
Sterilization & disinfection and their procedures
243
Malaria
245
Small pox & chick pox
247
Polio
248
SARS.
249
Anthrax
249
Yellow fever
250
Rabies
251
T.B
252
Typhoid fever
254
Sexually transmitted disease
255
AIDS
Hepatitis B

Viva questions

259

237

Chapter No.22
Non-Communicable Diseases
Introduction
Hypertension
261
Coronary heart disease
262
Diabetes mellitus
263
Blindness
Accidents
Obesity
265
Rheumatic heart disease
266
Smoking
267
Snake-bite
Cancer
269
Viva Question
270
MCQS
271

Chapter No.23
Miscellaneous
Alcohol & addiction
Drug dependence
273
Research
274
Health management information System
Medical entomology
277
Parasitology
282
Insecticides (DDT)
282
Viva Questions
283
MCQS
283

261

263
264

268

272
275

Chapter No.24
Tables of Differences
286- 294

Chapter No.25
Professional Evaluation
295-297
Models
Tray
Visits
Slides
Note-book
Viva