MATCDHAKA – Medical Assistant Training Centre in Dhaka Pharmacy, Veterinary, Dental, Nursing, Pathology, Physiotherapy and Homeopathy Training Institute in Dhaka
Community Medicine-2 Details
HRTR Medical Institute Mobile Number-01797522136.Community Medicine-2 refers to the second part or phase of the subject of Community Medicine, often taught in medical or health-related curricula. It builds upon the foundational knowledge from the first part, delving deeper into specific areas and practical applications of community health.
Key aspects of Community Medicine-2 often include:
- Disease Prevention and Control:Implementing strategies like vaccination programs, screening initiatives, and vector control to prevent and manage diseases within a community.
- Health Education and Promotion:Developing and delivering health education campaigns and programs to empower individuals and communities to make informed health decisions.
- Environmental Health:Addressing environmental factors that affect community health, such as sanitation, water quality, and air pollution.
- Occupational Health:Focusing on the health and safety of workers within various industries and workplaces.
- Primary Health Care (PHC) and Demography:Understanding the principles of PHC and how demographic factors influence community health.
- Maternal and Child Health (MCH) and Family Planning:Addressing the specific health needs of mothers and children, including family planning services.
- Community-Based Research:Conducting research within communities to identify health problems, evaluate interventions, and inform public health practice.
- Health Management and Planning:Developing and implementing strategies for effective health service delivery and management within a community setting.
Specific topics within Community Medicine-2 might cover:
- Epidemiology of Common Health Problems:Studying the patterns and causes of diseases within a population.
- Vector-borne Diseases:Focusing on diseases transmitted by vectors like mosquitoes and ticks, including control measures.
- Public Health Emergencies:Preparing for and responding to public health crises, such as outbreaks or natural disasters.
- Health Systems and Policy:Understanding how health systems function and the role of health policies in shaping community health.
The goals of Community Medicine-2 are to:
- Equip students with the knowledge and skills to address the health needs of communities.
- Enable them to plan, implement, and evaluate community health programs.
- Promote a holistic approach to health that considers the social, environmental, and behavioral factors influencing health outcomes.
# Nutrition
Nutrition is the science of food and its relationship to health. It is concerned primarily with the part played by nutrients in body growths development and maintenance.
# It Deals with:
1-Physiological dietary requirements of man.
2-The capacity of different foods to supply those requirements.
3-Pathological changes that may arise from qualitative or quantitative deficiency of food.
#Food
Is any liquids or solid which when swallowed can provide the human body with materials enabling it to function in one or more of the following-
1-Prodoction of energy
2-Building of the body
3-Participation in mechanism regulate body activities
# Nutrient
Nutrient (food factor) is a term used for specific dietary constituents such as proteins, vitamins, and minerals.
1.Dietetics is the practical application of the principles of nutrition, It includes the planning of meals for the well and the sick.
2.Good nutrition meals maintaining a nutritional status that enables us to grow well and enjoy good health.
-At the beginning public health concerned with sanitation problems of food.
-Then quality and quantity of foods as a protective measure for health has been involved too.
3.Now community aspects of nutrition:
#Dietary constituents
#Nutritional requirements
#Assessment of nutritional status.
#Nutritional problems in public health
#Nutritional programs
4.Relation of nutrition to health:
-It is evident that nutrition is specifically related to both physical and emotional health
-Survival depends on air, water and food. These basic life supporting materials, supply the body with certain essential chemicals that enable it to do its work.
-Essential nutrients supply the fuel and building flocks for carrying on body activities.
5.Signs of good nutrition
-Well developed body with average weight for body size and good muscles with no skeletal malformations.
-Smooths, clears, slightly moisture skin, with no discoloration.
-Shiny hair with healthy scalp and no brittle nor depigmented hair.
-Eyes are clear and bright with no signs of infection or increase vascularity no thickened conjunctives.
-Regarding the general appearance it permits person to be alerts responsive with good attention.
-Good appetites with no digestive problems including regular elimination (no diarrhoea, no constipation)
-Gums are pink, hot swollen no bleeding, straight teeth and well shapes jaw.
6.Food Constituents:
-Carbohydrates which provide the body with energy and may be converted into fat.
-Fats which provide the body with energy and may also form body fat.
-Proteins which provide materials for growth and repair of body tissues. They can also provide energy and sometimes can also converted to fat.
-Minerals which are substances that provides materials for growth, repair and regulation of body processes.
-Vitamins and other accessary substance that regulate body processes.
7.Calorie:
Calorie is the unit of energy needed to raise one gram of water one degree centigrade.
8.Kilocarorie:
Energy needed to raise one kilogram of water one degree centigrade.
-1gm carbohydrates =4 calories
-1gm fat=9 calories
-1gm protein=4 calories
# Energetic value of nutrients:
Normal chemical composition of man weighing 65 kg
| Name | kg | Percentage % |
| Protein | 11 | 17 |
| Fat | 9 | 13.2 |
| Carbohydrate | 1 | 1.5 |
| Water | 40 | 61.6 |
| Minerals | 4 | 6.1 |
# Function of food in human body
Tissue Building (Proteins, minerals,
Bone builting (Calcium, plos plion & vitamin D)
Vitality and protection protection from disus (vitamins and minerals)
Energy production (Fats, Carbohydrat
Antibodies formation (Proteins)
# Feeding behavior Control:-
The control of feeding behavior in brain is by centers situated in the hypothalamus through:
(1) Nervous stimuli in the stomach.
→ Contraction of stomach when it is e
(2) Chemical stimuli through the role of insulin and its relation to blood glucose level. Also free fatty acids raised during hunger.
(3) Thermic stimuli, in cold weather person feel more hungry.
#Nutritional requirements (calorie requirements a term that indicates the amount
of proteins, fats carbohydrates, minerals – Vitamin and water
Factors affecting nutrional requirements:
age
Sex,
Physiological status, (developmental stage)
Physical activity,
Climate
Body weight.
-Each 10°C rise in Temperature)
-15% reduction in the requirements
-Each 10 years increase in age 30-50 years
-3% reduction in requirement.
-7.5% reduction in requirement
#Special groups:
Pregnancy-400 Calorie daily in requirements. rise
Lactation-1000 calorie daily rise in requirements.
Children (1-3) years old-1300-1500 Calorie rise in-requirement.
#Nutrition & Health:
Proper nutrition is the most important single factor in the maintenance of health and efficiency It encourages-disease prevention and prolongation of Productive life.
The standard of nutrition is on fox for the degree of development any country.
# Nutrition and Disease:
1.The causation of majority of human illness are-
-Hereditary factors
-Environmental factors
-Dietary habits
2.It is impossible to change hereditary and much difficult to change environment but it is a relatively easy to change feeding habits.
3.Great advances have been made during the past 50 years in knowledge of nutrition and in the practical application of that knowledge specific nutritional diseases were identified and technologies developed to control them.
4.While attention was concentrated on nutrition deficiency diseases during the 1st decodes of the century the science of nutrition was extending its influence into other fields (agriculture, animal husbandry, economics and sociology)
5.During the recent years the science of nutrition moved out of laboratory and linked itself to epidemiology.
Chapter 2
Contraceptive Methods
1.Contraception:
Prevention of conception is called contraception.
2.What are the criteria of a good family planning contraceptive?
Criteria of a good family planning contraceptives are-
-Safe
-Effective
-Acceptable to all
-Inexpensive and easy access
-Reversible
-Simple to administer
-Independent of coitus
-Long lasting
-Requiring little or no medical Supervision.
3.Classify contraceptive methods.
Contraceptive methods-
These are the preventive methods which help to avoid unwanted pregnancy.
Classification:
- Spacing / temporary methods
1)Barrier methods
# Physical- Condom (male and female), Diaphragm, Vaginal, Sponge.
# Chemical- Foam (tablet, aerosol), creams and pastes, jelly, suppository, soluble film.
# Combined- Condom + jelly, Condom + creams.
2) Intrauterine devices
# Non medicated IUCD
-1st generation: Lippes loop
# Medicated IUCD
-2nd generation: Cu-T-200, Cu-T-220C, Nova-T, Multifood devices.
-3rd generation (Hormone containing devices): Progestasert
3) Hormonal methods
# Oral pill
-Combined pill: Oestrogen and progesterone
-Once a month pill: Long acting oestrogen + Short acting progesterone
-Progesterone only pill (POP): Mini pill/ Micro pill
-Post coital: Morning after pill
-Male pill: Gossy pol (Cotton seed oil)
-Triphasic pill
# Slow release (depot) formulation
-Progesterone only:
i) Injectable- DMPA (Depot medroxy progesterone acetate) IM 150mg every 3 months and NET-EN (Norethisterone enantate) IM 200 mg every 2 months.
ii) Subcutaneous / Implant: Norplant (5years)
iii) Vaginal ring: Levonorgestrol
#Combined injectable contraceptives
i)Cycloem / Cycloprovre (Monthly)
4.Post conceptional methods- (Termination of pregnancy)
#Menstrual regulation (MR)
#Menstrual induction
#Abortion
5.Miscellaneous:
#Abstinence of sex
#Coitus interruptus
#Safe period (rhythm method)
#Natural family planning methods-
i)Basal body temperature method
ii)Cervical mucus method
iii)Symptothermic method
#Breast feeding
#Birth control vaccine
B)Permanent methods
i)Meal Sterilization: Vascetomy
ii)Female Sterilization: Tubectomy, Tubal ligation
4)Write down the advantages and disadvantages of condom.
Advantages-
i)Easily available
ii)Safe and inexpensive
iii)Easy to use do not require medical supervision
iv)No side effects
v)Light, compact and disposable
vi)Protect from not only pregnancy but also STDs/ HIV/ AIDS
vii)Advised in treatment of premature ejaculation as this reduces sensitivity of the glans penis.
Disadvantages-
i)It may slip off or tear during coitus due to incorrect use.
ii)Interferes with sex sensation.
5.What are the indications of oral pill?
#Indications of oral pills-
A) Contraceptive use
B) Non-contraceptive use-
-To reduce premenstrual tension
-Dysmenorrhora
-Abnormal uterine bleeding
-Dyfunctional uterine bleeding
-Functional ovarian cyst
-Benign breast disease
-Sterility
-Endometriosis
-Menopause
6)Ideal contraceptive of pill:
i) Sexually active young and adult woman
ii) Nulliparous woman
iii) Woman with endometriosis who are not really to get pregnant
iv) Non lactating postpartum woman
7)What are the complications / side effects of oral pill?
i) Cardiovascular effect:
-Myocardial infection, cerebral thrombosis, venous embolism with or without pulmonary embolism.
ii) Carcinogenesis:
-Cervical carcinoma (mainly)
iii) Metabolic effect:
-The elevation blood pressure, alteration of serum lipid (i.e increase LDL, VLDL and decrease HDL)
iv) Other adverse effect:
-Liver disorder
-Premature cessation of lactation
-Subsequent fertility
-Ectopic pregnancy
-Increase the incidence of birth defect of factors
v)Common unwanted effect:
-Breast tenderness
-Weight gain
-Headache and migraine
-Bleeding disturbance
8)What are the contra indications of oral contraceptive pills?
i)Absolute:
-Cancer of the breast and genitals
-Liver disease
-Previous or present history of thromboembolism.
-Cardiac abnormalities
-Congenital hyperlipidaemia
-Undisgnosed abnormal uterine bleeding
ii)Special problems requiring medical surveillance.
-Age over 40 years
-Mild hypertension
-Chronic renal disease
-Epilepsy
-Migraine
-Nursing mothers in the first 6 months
-Gall bladder disease
-Diabetes mellitus
-Amenorrhra
9)What are the selection criteria of candidates of IUCD?
i)Who has born at least one child
ii)Has no history of pelvic disease
iii)Has normal menstrual period
iv)Is in a managemous relationship
v)Has access to follow up and treatment of potential problems.
Chapter-3
Maternal and child health (MCH)
1)Define maternal and child health. What is MCH?
Maternal and child health (MCH):
The term maternal and child health refers to the promotive, preventive, curative and rehabilitative, health care for mothers and children (up to 5 years)
2)What are the objectives of MCH?
i)Reduction of maternal, perinatal, infant and childhood mortality and morbidity.
ii)Promotion of reproductive health
iii)Promotion of the physical and psychological development of the child within the family
The ultimate objective of MCH services is life-long health.
3) List the MCH indications.
Indicators of MCH care-
i) Maternal mortality rate
ii) Mortality in infancy and childhood
(a) Perinatal mortality suite
(b) Neonatal mortality rate.
(c)Post – neonatal mortality rate
(d) Infant mortality rate
(e) 1-4 years mortality suite
(f) Under 5 mortality rate.
(g) Child Survival rate
④ What should be the criteria for MCH service of a country”:
(a) Improvement of maternal health.
(b) Improvement of child health.
(e) Family Planning
(d) School health maintenance
(e) Reduction of maternal, Perinatal, infant and-Child food mortality
f) Promotion of reproductive health
(g) Promotion of physical and Psychological-developments
⑤What are the stages of maternal cycle?
(i) fertilization
(ii) Antenatal or prenatal Period
(iii) Intranasal Period.
(iv) Post-natal period.
(V) Inter-conceptional period:
6)What are the MCH problems in your country?
MCH problems in Bangladesh:
(In developing countries).
(1) Malnutrition.
(2) Infection.
(3) Uncontrolled reproduction.
i) Malnutrition:
a) maternal depletion.
b) Anemia of mother.
c) Toxemias of Pregnancy.
d) Post-Partum hemorrhage.
e) Low birth weight of child
ii) Infections
a) Respiratory Tract Infection.
b) EPI 6 diseases
c) Diarrhoea
(d) Abortion
(e) Puerperal sepsis.
iii) Uncontrolled reproduction:
a) Increased prevalence of revere anemia
b) Abortion
c) Ante Partum hemorrhage,
d) Lowe birth weight babies.
e) Maternal mortality
Chapter-4
Antenatal Care (ANC)
1)Define antenatal care
Antenatal care is the care of the woman during pregnancy.
2)List the objectives of antenatal care.
i)To promote protect and maintain the health of the mother during pregnancy
ii)To detect high milk cases and gine them special altention
iii)To prevent the complications
iv)To remove anxiety associated with delivery.
v)To reduce maternal and infant mortality and morbility.
vi)To teach the mother elements of child care, nutrition, personal hygienic and environmental sanitation.
vii)To sensitize the mother to the need for family planning advice to cases seeking medical termination of pregnancy.
3)Discuss the important element of antenatal care.
Components of antenatal clinic:
i)Antenatal visits
ii)Prenatal advice
iii)Specific health protection
iv)Mental preparation
v)Family planning
vi)Pediatric component
- Antenatal visits-
Antenatal visits means antenatal contacts.
i.e-Contacts between the patient and doctor when the first report of the mother is sent to the clinic her name should be registered ideally, the mother should attend the antenatal clinic once a month during the first 7 months twice a months, during the next month and thereafter, once a week if every thin is normally.
b) Prenatal advice:
A major component of ante natal care is antenatal or prenatal advice. The mother is more receptive to advice to concerning herself and her baby at this time than at other times. At this time the mother is advised about her diet, personal hygiene, radiation, warning signs and childcare.
c)Specific health protection.
The mother should be protected against the following diseases or disorders- anemia other nutritional deficiencies, toxemias of pregnancy, tetanus, syphilis, germanmeasler, HIV infection, Rh status.
d) Mental Preparations-
It is as important as physical or material preparation. Sufficient time and opportunity must be giver to the expectant mothers to home a free and front delivery.
e) Family planning
The mother psychologically more respective of advice on family planning than at other times. Educational and motivational efforts must be initiated during the antenatal period.
f) Pediatric components
It is suggest that a pediatrician should be in attendance at all antenatal clinics.
4)Write about the antenatal visits.
i)Antenatal visits mean antenatal contacts.
i.e. Between the patent and doctor.
ii)When the first report of the mother is sent to the clinic, for name should be registered.
iii)Antenatal visits may be categorized in following ways-
-Every 4 weeks up to 32 weeks
-Every 2 weeks from 32 to 36 weeks
-Once a week from 36 to 40 weeks
-Total= 14 visits.
iv)During the visits all the mothers, should be given tetanus toxoid. It is given in 2 doses.
v)It should not be administered in 1st trimester of pregnancy because rarely there is possibility of abortion. So it is given after 3 months.
vi)Sometimes only one dose is given when the woman had taken tetanus within 1 year previously due to any trauma or due to previous pregnancy.
5)Who are the high risk mothers?
Criteria of high risk mother:
-Elderly primary (over 35 years)
-Short stature primary (140 cm and below)
-Malpresentations, breech, transverse lie etc.
-Anteportum hemorrhage, threatened abortion.
-Pre eclampsia and eclampsia
-Anaemia
-Twins, hydramnions
-Previous still- brith, intra ulterine death, manual removal of placenta
-Elderly grant multiporus
-Prolonged pregnancy (14 days after expected date of delivery)
-History of previous association or instrumental delivery.
-Pregnancy associated with general diseases e.g cardiovascular disease, kidney disease, diabetes, tuberculosis, liver disease etc.
6)Who are the high risk babies?
Criteria of high risk babies-
i)Birth weight loss than 2.5 kg
ii)Twins
-Birth order 5 and more
-Artificial feeding
-Weight before 70% of the expected weight (i.e: 2nd and 3rd degree of malnutrition)
-Failure of gain weight during three successive months
-Children with PEM, diarrhoea
-Working mother / one parent.
Chapter-5
Care of New Born
1)Childhood may be divided into the following age periods:
i) Infancy: Up to 1 year of age
ii) Per school age: 1-4 years
iii) School age: 5-14 years
2)What are the common child health problems?
i)Low birth weight (LBW)
ii)Malnutrition
iii)Infections and parasitosis
iv)Accidents and poisoning
v)Behavioural problems
3)How can you take care of a new born?
Care of new born:
a)Immediate care-(Just after birth)
i)Clearing the air way/ resuscitation
ii)Evaluation of the baby by APGAR serving.
iii)Care of the cord –cut aseptically.
iv)Care of the eyes-wash a drop of 1% AgNO3
v)Care of skin-bath is given with soap and warm water to remove vermix, meconium, and blood clot after few hour of birth.
vi)Maintenance of body temperature
vii)Breast feeding (as soon as possible)
viii)Through examination of baby for any congenital abnormalities
ix)Identification of the baby by mother name and sex of the baby
x)Rooming in (keeping the baby with his mother)
b)Late care (within 24 hours)
i)Daily bath of the baby
ii)Inspection of the eyes, mouth and nose for any abnormalities
iii)Maintenance of temperature
iv)Regular monitoring of the weight
v)Baby should be kept in well ventilated and warm room
vi)Early detection of any complication and treatment if any
4)What are the causes of low birth weight baby?
Causes of low birth weight:
a)Maternal factors:
i)Age of the mother- Lower the age, higher the risk
ii)Nutrition- Severe malnutrition, Iron and folic acid deficiency
iii)Infections-UTI, syphilis, hepatitis
iv)Chronic disease- Cardiac, renal, pulmonary disease, DM, HTN.
v)Tumors- Ovarian
vi)Trauma- Physical, psychological
viii)Drugs- Phenobartitone, methyldopa, steroids
b)Obstetric factors:
i)Toxaemia of pregnancy
ii)Antepartum haemorrhage
iii)Premature rupture of membrane
iv)Placental insufficiency
v)Cephalo pelvic disproportion
c)Uterine factors:
i)Uterine malformation
ii)Cervical incompetence
i)Multiple pregnancy
ii)Twins
iii)Hydramrios[p2]
iv)Intrauterine infections
v)Congenital anomalies
vi)Rh incompatibility
e)Social factors:
i)Physical labour
ii)Smoking
iii)Repeated birth
iv)Shorter inter pregnancy intervals
5)What is exclusive breast feeding?
When a baby is given only breast milk, not ever a drop of water, up to 6 months of age, it is called on exclusive breast feeding.
6)What is milk injury?
If a baby is fed only with milk over a long period of time, 2 years without giving any supplementary food, the baby becomes flabby and edematous due to deficiency of protein and anaemic due to iron deficiency. This is called milk injury.
7)What is weaning foods?
Weaning is a gradual process of withdrawing of a baby from breast feeding starting around the age of 4-5 months and adding supplementary foods rich in protein and other nutrients
Weaning foods:
Cows milk, fruit juice, soft cooked rice, cereals and smashed khichuri’s, soup, cereals.
8)Why proper weaning is important for child health?
Weaning period is important in child development and if adequate importance is not given the child may suffer from malnutrition and infection.
Chapter-6
Infant and maternal mortality
1)What is IMR? Mention current IMR.
Infant mortality rate (IMR):
Infant mortality rate (IMR) is defined as the ratio of infant deaths registered in a given year to the total number of live births registered in the same year; usually expressed as a rate per 1000 live births.
Calculation:
IMR= No. of deaths of children less than 1 year of age in year
No. of live birth in same year x 1000
2)What are the causes of high IMR of our country?
Important causes of high IMR in Bangladesh:
i)Diarrhoea (30%)
ii)Prematurity and low birth weight (11%)
iii)Whooping cough (2%)
iv)ARI (18%0
v)Neonatal tetanus (7%)
vi)Other causes (24%)- congenital anomalies, malnutrition etc.
3)What is maternal mortality rate (MMR)?
Maternal mortality rate (MMR)
It is the number of death of mother from pregnancy, delivery and puerperal (after delivery for 6 weeks) causes during a calendar year per thousand pf child birth.
Calculation:
MMR=Total no. of female deaths due to complications of pregnancy, child birth or within 6 weeks of delivery from puerperal cause in an area during a given year
Total no. of live birth in the same area in that year x 1000
4)What are the causes of maternal mortality?
Causes of maternal mortality-
i)Pre-eclampsia and eclampsia
ii)Haemorrhage (PPH)
iii)Infection (Puerperal sepsis)
iv)Obstructed labour
v)Severe anaemia
vi)Septic abortion
vii)Associated disease: Cardiac, renal, hepatic, metabolic etc.
5)How maternal mortality can be prevented?
i)Early registration of pregnancy
ii)At least 3 antenatal check-ups
iii)Dietary supplementation including correction of anaemia
iv)Prevention of infection and haemorrhage during puerperium
v)Prevention of complications. E.g: eclampsia, malpresentation, ruptured uterus.
vi)Treatment of medical conditions. E.g: hypertension, diabetes, tuberculosis etc.
vii)Anti malaria and tetanus prophyloxis.
viii)Clean delivery practice
ix)Provision of local trained dais and female health workers
x)Instrumental deliveries for woman with bad obstetric history and risk factors
xi)Promotion of family planning
xii)Identification of every maternal deaths and searching for its cause.
6)Define reproductive health.
Reproductive health-
WHO defines reproductive health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and its functions and processes.
Chapter-7
Immunity
1)Define immunity.
Immunity: Immunity is the ability of body to recognize, destroy and eliminate anti genic material to its own.
2)Classify immunity with examples.
Classification:
a)Innate (non-specific) immunity:
-Genetic/ Constitutional
-Mechanical:
i)Keratin layer of skin
ii)Intact mucous membrane
iii)Mucocilliary movement
iv)Reflexes, e.g: Coughing reflex, sneezing reflex etc.
-Humorol:
i)Normal bacterial flora
ii)Aciol in gastric juice
iii)Complement system
iv)Interferons etc
-Cellular:
i)Macrophage
ii)Eosinophil
iii)Natural killer cells etc
b)Acquired (specific) immunity:
-Active: Where antigens are exposed to the body.
i)Natural: After clinical and sub clinical infections. E.g: Hepatitis A virus infection
ii)Artificial: Different types of vaccines. E.g: Bacterial vaccines, Viral vaccines, Toxoids, Live attenuated vaccines etc
-Passive: Where antigens are not exposed to the body.
i)Natural: #Transfer of material antibody to factus through placenta.
#Transfer of antibody from mother to infants by breast milk.
ii)Artificial: #Antisera and antitoxins.
E.g: TIG (Tetanus immunoglobulins)
ATS (Anti tetanus serum)
ADS (Anti diphtheria serum)
Chapter-8
Immunization and Vaccination
1)What is immunization? Classify immunization.
Immunaization: It is defined as a technique by which immunizing agents are introduced into the body for the production of Ab to prevent disease.
Classification;
i)Active immunization: Vaccine.
ii)Passive immunization: Immunoglobulin antisera
2)Define vaccine. What are the types of vaccine?
Vaccine: Vaccine is an immune-biological substance designed to produce specific protection against a giver disease.
Types of vaccine:
i)Live attenuated vaccine:
a)Bacterial:
-BCG vaccine; Tuberculosis
-Typhoid oral
-Plague
b)Viral:
-Oral polio vaccine; Poliomyelitis
-Rubella
-Mumps
-Influenza
c)Rickettsial:
-Epidemic typhus.
ii)Inactivated or killed vaccine:
a)Bacterial:
-Pertussis vaccine: Whooping cough
-Cholera vaccine: Cholera
-Typhoid
-Plague
b)Viral
-Salk vaccine (polio)
-Rabies
-Influenza
-Hepatitis B
iii)Toxoids:
a)Bacterial:
-Tetanus toxoid: Tetanus
-Diphtheria toxoid: Diphtheria
iv)Extracted cellular fractions
-Meningococcol vaccine
-Pneumococcol vaccine
v)Combination
-DPT: Diphtheria, Pertussis, Tetanus
-MMR: Meascles, Mumps, Rubelle
-DT
-DP
DPT with typhoid vaccine
-DPTP (DPT + inactivated polio)
3)Write EPI schedule in Bangladesh.
| Disease | vaccine | dose | Age | Site of Vaccination | Routes of administration | ||||||||
| Birth | 6w | 10w | 14w | 9m | |||||||||
| Tuberculosis | BCG | 0.05ml | Yes | – | – | – | – | Upper and outer part of left arm | Internal | ||||
| Diptheria pertussis, Tetanus, Hepatitis-B, Hameophilus.Influenza-B | Pentavalent vacine | 0.5ml | – | yes | yes | yes | – | Upper & outer part of mid thigh | Intermuscular | ||||
| Poliomyectis | OPV | 2.3drops | – | yes | yes | yes | yes | oral | oral | ||||
| Measles | Measles vaccine | 0.5ml | – | – | – | – | yes | Anterolateral part of mid thigh | Sub cutaneous | ||||
4)What is the TT vaccination schedule for woman of reproductive age?
| TT dose | Minimum internal between doses | Years protected |
| TT-1 | O | 0 |
| TT-2 | 4 weeks after TT-1 | 3 Years (from 15 days after administration of TT-2 |
| TT-3 | 6 months after TT-2 | 5 Years (from 15 days after administration of TT-2 |
| TT-4 | 1 Year after TT-3 | 10 Years (from 15 days after administration of TT-2 |
| TT-5 | 1 Year after TT-4 | For life |
Chapter-9
Disinfection
1)Define disinfection. Classify disinfection with examples.
Disinfection: It is the killing of infectious agents outside the body by direct exposure to chemical or physical agents. It can well as disinfectants.
Types-
a)Concurrent disinfection:
It is the application of disinfection measures as soon as possible after the discharge of infectious material from the body of an infected person, or after the soiling of articles with such infectious discharge, concurrent disinfection consists of usually disinfection of urine, faces, vomit, contaminated lines, clothes, hands, dressing, aprons, gloves etc. It prevents spread of disease.
b)Terminal disinfection:
It is the application of disinfective measures after the patients have been moved by death.
c)Precurrent disinfection:
Disinfection of water by chlorination, pasteurization of milk and hand washing.
Use of disinfection: Disinfection of urine, faces, vomit, contaminated cloths, hands, dressing, aprons, gloves etc throught out the course of illness.
2)Define disinfectant. Classify disinfectant.
It is a substance which destroys the harmful microbes (not usually spares) with the object of preventing transmission of disease.
Types-
i)Natural –
-Sunlight
-Air
ii)Physical
-Burning
-Hot air
-Auto claving
-Radiation
iii)Chemical
a)Phenol and related compound
-Phenol
-Cresol
-Chlorhexidine
-Crystal violet
b)Quaternary ammonia compound
-Bleaching powder
-Halazone tab
-Iodine
c)Alcohol
-Ethyl alcohol
d)Formaldehyde
e)Miscellaneous
-Lime
-Ethylene oxide
f)Gaseous disinfectant
-Formaldehyde gas: fumigation
-Sulphar dioxide gas
3)What are the qualities of ideal disinfected?
i)It should be cheap and not very poisonous.
ii)It should not act on metals and should not spoid fabrics
iii)It should have good germicidal effect and rapid in action
iv)It should act powerfully in presense of organic matter
v)It should not have any injurious effect on human body
4)Define sterilization. What are the methods of sterilization?
Sterilization is the absolute freeing of an article from any microbial burelen including spores
Methods of sterilization:
i)Physical methods-
a)Heat –
-Dry heat
-Red heat
-Flaming
-Hot air oven
-Incineration
#Moist heat
Below 100
-Pasteurization
-Vaccine bath
-Water bath
At 100
-boiling
-Steaming
-Tyndalization
Above 100
-Autoclave (121)
b)Radiation
-α ray
-x ray
UV ray
c)Filtration
-Berkefeld type
-Chamferland type
d)Ultrasonication
-Ultra sound
ii)Chemical method
a)agents that disrupt membrane
-Surface active agent- e.g: detergents, soap
-Phenol and phenolic compounds. E.g: Phenol, cresol, Lysol
-Alcohol
b)Agents that denature protein
-Acids and alkalis
c)Agents that inactive group of protein or nucleic acid
-Heavy metal e.g: Silver nitration, Silver sulfacliazine
-Oxidizing agents e.g: Halagen, (iodine, chlonic)
-Dyes e.g: crystal violet
-Alkyloting agents e.g: Formaldehyde
Chapter-10
Food
1)Define food. What are the functions of food?
Food: Food is a composite mixture of substance Which consumed performs certain functions in the body.
These functions are-
i)Yielding energy
ii)Building and maintaining the body
iii)Protecting the body and regulating the tissue function.
2)Classify food.
Classification of food-
a)Classification of origin
i)Foods of animal origin-e.g: Meat, fish etc
ii)Foods od vegetable origin. E.g: Vegetables, fruits etc
b)Classification of chemical compositions
i)Protein
ii)Fats
iii)Carbohydrate
iv)Vitamins
v)Mineral
3)Classification of predominant function:
a)Body building foods:
e.g: meat, milk, liver, pulses etc
b)Energy giving foods:
e.g: cereals, sugar, roots, fats, oils
c)Protective foods:
e.g: Vegetables, fruits, milk
4)Classification by nutritive value
i)Cereals and millets
ii)Pulses
iii)Vegetables
iv)Nuts and oilseeds
v)Fruits
vi)Animal foods
vii)Fats and oils
viii)Sugar
ix)Spices
5)What is nutrient? Classify nutrients.
Nutrients: Nutrients are organic and inorganic complexes contained in food. These are about 50 different nutrients which are normally supplies through the food.
Classification of nutrients
a)Macronutrients: These are proteins, fats, carbohydrates,. These are called proximate principles because they form the main bulk of food.
-Protein: 7-15%
-Fats: 10-30%
Carbohydrates: 65-80%
b)They are called micronutrients because they are required in small a mounts which may vary from a fraction of a mg to severe grams.
They are- Vitamins and Minerals
