effficacyofwhichofthefollowingvaccinesisgreatest:

a)tetanus
b)measles
ANSB

REF:THEVACCINEHANDBOOKBY
GARYMMARSHAL
efficacyoftetanustoxoidhasneverbeenstudiedinclinicaltrial,butantibodyresponse
wouldsuggestefficacyofvirtually100%
MKhaswronglygivenansasmeasles

catchhere:singleormultipledoses
multipledoses::tetanusattainsbetterthanmeasles
singledose::measles
utthelinesabovethem,ifureadthemcarefullyaroramentions...
"efficacyoftetanustoxoidrangesfrom80100%.butprotectionisincompleteafterfirstdose>>>athirddoseinducesimmunityin
almost100%,,,
thefirsttwodosesdonttoit.

Now 4 to start anti TB treatment ONLY TWO SPUTUM SAMPLES taken.. One stat and second in next morning.
Also duration of cough is FIFTEEN DAYS and not three weeks.
vaccin vial monitering is now available for HBV vaccine.
new wonder drug for kala azar-Miltefosine.
DIAL THERMOMETER USED FOR COLD CHAIN TEMPERATURE MONITERING,BASED ON
THERMOCOUPLE PRINCIPLE
Yaws has been declared eliminated from india in 2007
India eliminated leprosy in dec 2005
vit A is now given upto 5 yr age.. instead 3 yrs.

3rd MAY... WORLD LAUGHTER DAY.

January 30 World Leprosy Eradication Day
February 28 National Science Day
March 8 International Women's Day; International Literacy Day
March 15 World Disabled Day
March 21 World Forestry Day; International Day for the Elimination of Racial Discrimination
March 22 World Day for Water
March 24 World TB Day
April 7 World Health Day
April 17 World Haemophilia Day
April 22 Earth Day
May 3 World Asthma Day
May 8 World Red Cross Day
May 9 World Thalassaemia Day
May 11 National Technology Day
May 12 World Hypertension Day; International Nurses Day
May 31 Anti-tobacco Day

June 5 World Environment Day

June 14 World Blood Donor Day
June 26 International Day against Drug Abuse and Illicit Trafficking
July 1 Doctor's Day
July 6 World Zoonoses Day
July 11 World Population Day
September 8 World Literacy Day (UNESCO)
September 16 World Ozone Day
September 21 Alzheimer's Day
September 22 Rose Day (Welfare of cancer patients)
September 26 Day of the Deaf
October 1 International Day for the Elderly
October 3 World Habitat Day
October 2nd Thursday World Sight Day
October 13 UN International Day for Natural Disaster Reduction
October 15 World White Cane Day (guiding the blind)
October 16 World Food Day
November 14 Diabetes Day
November 17 National Epilepsy Day
December 1 World AIDS Day
December 3 World Day of the Handicapped
December 10 Human Rights Day
November 2, 2009 will mark the first annual World Pneumonia Day
ORS Week from 27th July to 3rd August.
Childrens Day is celebrated on 14th November, every year in India
International Children's Day is celebrated on June 1 and Universal Children's Day is on November 20.
MAY
5 International Midwife day
8 International Red Cross day
12 World Nurses' Day
12 14 Cerebral Palsy Week
15 World Family day
26/5 1/6 Child Protection Week
28 International Day of Action FOR Women
31 World No Tobacco Day
International Multiple Sclerosis Month
World Asthma Day takes place each year on the first Tuesday in May

Decision analysis measure: the relative value a patient places on a particular outcome.
Painless eschar *the tache noire are found in *rickettsia
STEPS Step 1: History
Step 2: Anthropometric measurements
Steps 3: Biochemical tests
Chickenpox Lesions concentrated more on trunk

Rate
Ratio

Lesions in different stages of development

Fever usually comes at the time of appearence of rash
Vericella- Reye syndrome
The highest risk of fetal infection with rubella occurs during the first trimester. In seronegative patients the risk of
infection exceeds the 90%. However, before other measures (such as termination of pregnancy)are considered, a
rubella immune status must be performed.
Kata thermometer measures- Air temperature, humidity and air movement
Catch-up, keep up, follow up strategy seen in-->Measles vaccination
MUMPS- Orchitis is the most common menifestation of of mumps among post-pubertal males. Since orchitis is
bilateral in less than 15 percent cases, sterlity after mumps is rare. Mumps pancreatitis which may present as abdominal
pain, is difficult to diagnose because an elevated serum amylase level can be associated with either parotitis or
pancreatitis. Aseptic meningitis may develop.
Numerator is a part of denominator eg. Incidence (P-56)
Numerator and denominator are separate quantities eg. Prevalence, CFR, Relative risk, Coefficient of variation

Recent Statistics:
CBR--> 23.4 (21.76-->2009)
CDR--> 8 (6.23 --2009)
IMR--> 54 (2007)
2009-->
o IMR: 30.15 deaths/1,000 live births
o Male: 34.61 deaths/1,000 live births
o Female: 25.18 deaths/1,000 live births
o Life Expectancy at birth Males - 62.3 (2005); 67.46 (2009)
Females - 65.3 (2005); 72.61 (2009)
Neonatal mortality rate : 37 per 1000 live births (2006); 34 per 1000 live births (2009)
Early neonatal mortality rate : 28 per 1000 live births (2006)
Under 5 mortality rate : 72 per 1000 (2007); 64 per 1000 (2009)
General fertility rate - 93.3 (2006)
General marital fertility rate - 111.7 (2009)
Total feritility rate - 2.72(2009)
GRR--> 1.3 (2006)
NRR--> 1.4
MMR--> 301/lakh Live Birth(2003); 2009 --> 254
CPR--> 58%
Sex ratio--> 933(2001); 927 (2009)
Least- Haryana
Least child sex ratio- Punjab
Favourable:Kerala,Manipur,Sikkim
Population--> Rural(72%): Urban(28%)
Q. Which of d following is an example of DISABILITY limitation1)Reducing occurence of polio by immunisation
2)Arranging for schooling of child suffering from PRPP
3)Resting affected limbs in neutral position------------------------ans
4)Providing calipers for walking
DiscussionIn Tertiary prevention, there are 2 phases: 1. Disability limitation: - It consists mostly MEDICAL/TECHNICAL measures that will limit the progression of further
disability caused by the disease. Like in this example, Resting the limb, may prevent progression of the further
damage to the limb. This this medical advice is Disability limitation.
2. Rehabilitation: - These are more of Social and Vocational measures to let the handicap patient establish in society.
Providing Calipers for walking can't limit the progression of his disease. It can only make him move. So, it is helping
the Handicap.

Epidermoid carcinoma of hard palate found in AP-->a/w reverse smoking

Basic activity of under-five clinics is growth monitoring. In growth monitoring, weight of the child is measured monthly
during infancy, every 2 months during 2nd year and every 3 months there after up to the age of 5 yrs.

Cost benefit analysis

Economic benefit of any programme is compared with the cost of that programme

Cost effectiveness analysis

Benefit instead of being expressed in in terms of results achieved (eg. Number of lives
(better than cost-benefit analysis) saved) is compared with the cost of the programme
Which of the following statements is false regarding Japanese Encephalitis ?
A) Transmitted by Culex mosquitoes
B) Water tanks serve as breeding sites
C) Pigs are amplifiers
D) Two doses of vaccine---------------ns
Discussion- actually three doses of vaxcine given (ans supported by GT-84 Q-256). Japanese encephalitis vaccine can prevent
JE, however, JE vaccine is not 100% effective and is not a substitute for mosquito precautions. Three doses of vaccine are
given, with the 2nd dose given 7 days after the 1st and the 3rd dose given 30 days after the 1st. The third dose should be given
at least 10 days before travel, to be sure the vaccine begins to protect and to allow for medical care if there are delayed side
effects. A booster dose may be needed after 2 years.
New families--> applies to those families which are within 10-yr duration and consists of parents and children
ORS for all ages during first four hours of diarrhoea:
Age
Weight(kg)
ORS solution(ml)
< 4mths

< 5*

200-400*

4-11 mths

05/07/09

400-600

1-2 yrs

8-10.9

600-800

2-4 yrs

11-15.09

800-1200

5-14 yrs

16-29.9

1200-2200

>15 yrs

>30

2200-4000

Diseases targeted under IMNCI Neonatal Jaundice

Diarrhoea
Bacterial septicaemia
Pneumonia
Fever(Malaria)
Unconsciousness/Convulsions(tetanus)
Ear problem(Otitis media)
Malnutrition and anaemia
Time-Bound Goals for the Eleventh Five Year Plan(2007-0012)
Reducing Maternal Mortality Ratio (MMR) to 1 per 1000 live births.
Reducing Infant Mortality Rate (IMR) to 28 per 1000 live births
Reducing Total Fertility Rate (TFR) to 2.1.
Providing clean drinking water for all by 2009 and ensuring no slip-backs.
Reducing malnutrition among children of age group 03 to half its present level.
Raising the sex ratio for age group 06 to 935 by 201112 and 950 by 201617.
Reducing anaemia among women and girls by 50%.

NRHM includes- RCH II, NDCP(National Disease Control Programmes), IDSP(Integrated Disease Surveillance Project).
NRHM will also enable main-streaming of AYUSH
Operational duration for various programmes RCH II--> 2005-2010
NACP III--> 2005-2010

 NRHM--> 2005-2012
Millenium development goals--> Upto 2015
Child mortality rate reflects income, nutrition, health care and basic education. UNICEF--> best indicator of social
development and well being
Cows milk is not recommended for children until they are 1yr of age because the high level of protein causes increase in
the solute load to the kidneys. It is this overload that leads to lethargic dehydrated state of the child. Leinoleic, leinolenic,
calcium and vitamin B-Complex not present in high concentrations in cows milk.
Q. A diagnostic test has sensitivity of 64% and specificity of 99%. Such a test would carry the risk of which kind of
problem1. High relative risk
2. Low likelihood ratio
3. False negatives----------------ans
4. False positives
Discussion- Sensitivity is defined as the number of true positives divided by the sum of the number of true positives and false
negatives. It is the proportion of patients with the condition in question that the test can detect. Thus if the sensitivity is only
64% the number of false negative will most likely be unacceptability high.
High false positive are found in:
Low prevalence
Low specificity
Latest recommendations for supplementary nutrition under ICDS scheme, a malnourished child receives the following at
AWC--> 800 KCal
ESI Act(1948): Applicable thouroughout the country(in contrast to factories act which is not applicable to the state of J+K)
o Benefits:
Medical(no cash)
Sickness benefit : 91 days* --> 50%(new park) of daily wages
Extended sickness benefit: 2 yrs* --> 50% of daily wages; applicable for only 34 diseases(not all); only
people of same organisation are eligible for the benefit
Enhanced S.B. :Sterlisation(full wages),Vasectomy(7 days),Tubectomy(14 days)
Maternity benefit :
@ full wages(3 mths for full term delivery/confinement) --> 6 mth recommended in 6th pay
commission for government institutions(still not applicable to ESI Act)
Miscarriage: 6 wks
Complication due to confinement: 30 days
Disablement benefit:
Temporary:@ 70% of daily wages
Permnent: Full time life pension
Dependents benefit
Rehabilitaion benefit: @ Rs 10 per month of premium
Funeral benefit: 2500/ Factorys Act(1948): Applicable in whole country (except J/K)o Hrs of work: 48 hrs/wk --> 9 hr/day (With OT: 60 hrs/wk)
o Age of employment: <14 yrs not allowed; 15-18 yrs (considered adolescent)
o Per capita space requirement for workers *500 cu.ft.(350 before 1945)
o Others:
If >1000 employees present--> Safety officer
If > 500 employees present--> Welfare officer
If > 250 employees present--> Canteen
If > 30 women employees present--> Creche

Peumoconiosis(usually takes 10-12 yrs to develop): 0.5-3 micron dust cause pneumoconiosis. No treatment so prevention
is the only option. Initial stages--> Disease is arrested with stoppage of exposure(not reversed)
o Silicosis: Shortest incubation period(few mth - 6yrs); involves *upper lobe, Intense nodular fibrosis--> hence
snow storm appearance on CXR, crazy paving appearence on HRCT

o Asbestosis: Referred to as fibre of death; *Diffuse peribronchial fibrosis, CXR-Ground glass appearance,affects

*lower 2/3;calcification of diaphragmatic pleura is characteristic;Associated cancers-Bron.Ca., GIT Cancers,

Mesothelioma(M/C with crocidolite variety)--> types: pleural(more common)/peritoneum; Crysolite is safest
variety
Cotton--> Byssinosis; 1st stage called Monday fever

Perinatal period:
o >28 wks of gestation to--> first 7 days of life
o but when age is not known: >1000 gm wt. or >35 cm CRL
National population policy:
o In NPP all targets are to be achieved by 2010 (except population stabilisation--> 2045)
o NRR: current level--> 1.4
Indirect measure- so not included in NPP
NRR= 1 when (Direct measurements included in NPP):
TFR= 2.1(by 2010)
CPR= 60%
Contraceptives:
o POP(Only 3 indications):
Women >35 yrs of age
Lactating women in first six months of lactation
Younger women with risk of neoplasia
o IUD:
Should not be prescribed to a woman who does not have a single living child
Should not be prescribed to woman with multiple sexual partners--> PID--> Infertility
o Condom: Most widely used contraceptive worldwide except INDIA
FR: 4-14--> so not a choice for a newly married couple
o OCPs: Recommended for newly married couple
FR: <1%
Within 3 mths of stoppage ~98% of woman can conceive
Advantages of Nested Case Control Study:
o Temporality of association(i.e. cause must precede the event)
o No recall bias
o Confounding is minimised
Q. Randomisation in a clinical trial is done mainly to:
1. Help ensure the study subjects are representative of general population
2. Reduce selection bias in allocation of treatment
3. Ensure groups are comparable on baseline characteristic
4. Facilitate double blinding
Option 2 is correct.
1=2(same thing.1 defines selection bias)
1,2,3 all are independently correct
Q. False about RCT:
1.Sample size depends on hypothesis
2.Dropouts are excluded from analysis
3.Interviewers bias can be eliminated by double blinding
4.Groups are comparable on baseline characteristics
Option 2 is ans(given wrong in guides)
It is assumed that dropped out people could have behaved in a similar manner like the people who continued the study
About option 1
Factors on which sample size of RCT depends:
Effect size:
o Difference in response rate in 2 groups
o Larger the effect size, smaller the sample size

o Response rate in one of the groups

Level of significance(alpha)
Power of study(1-beta)
Type of hypothesis
o One tailed
o Two tailed
Attrition rate

Herd immunity is not constant but labile

Surveillance: Systematic ongoing process of collection, compilation, analysis and dissemination of health related data for
action
Types:
Active: House to house survey: done for malaria nationwide (for leprosy only in endemic areas)
Passive: AFP(not polio)
Sentinel: Done for missing cases(old concept)/total cases(new concept)
o HIV, Hep B/C,Outdoor air pollution and water supply
Behavioral(NEW): HIV, NCD
Notification for Occupational d/e: ILO/WHO/GOI under factories act- BAANOS:
Byssinosis
Asbestosis
Anthraconiosis
Noise induced hearing loss
Occupational dermatitis
Silicosis
Steps of epidemiological investigation:
Confirmation of diagnosis
Confirmation of epidemic( >2 S.E.---> Epidemic)
Define population at risk
Spot map
Counting population
Rapid search for cases and characteristics
Data anlysis: Time, Place and Person
Formulate hypothesis
Test the hypothesis
Temporary preventive and control measures
Search for etiological factors
More search for cases
Write the report
Q. Association of chronic disease is a/e:
1. Dose response relationship
2. Temporal association
3. Biological plausibility
4. Consistency
Ans..none
Criteria for causal association:
1. Strength of association RR,AR,CC(Correlation coefficient)
2. Temporality of association
3. Dose/Duration response relationship Biological gradient
4. Specificity(One cause disease); in chronic disease there is multifactorial association
5. Consistency
6. Biological plausibility
7. Coherence
Primary case --> Serial interval(~incubation period)---> Secondary case(P=56,90)
Alpha is a test criterion or a cut off at which we decide whether to accept null hypothesis or reject it

 Blood bourne pathogens are:HIV,HBV,HCV,HGV,EBV,CMV,Syphilis

Q. Basic reproduction rate of infection best correlates to:
1. Rate of contact with another(infectious) person
2. Frequency of new infectious cases on contact with each(infectious) another person
3. Probability of transmission of infection on contact
4. Incubation(infectious) period of disease
Answer is option 2..
BRR(Ro):
If Ro < 1 --> Minimal chances of epidemic outbreak
If Ro > 1 --> Chances of outbreak
Ro=Transmission probability(SAR,Binomial model) x Period of communication x Rate of contact
Ro(Def.): Expected no. of infectious host(secondary) that will occur on contact with one infectious host or one infective
source(Primary:Case,Vector,Fomite,Animal,Contaminated food or water)
If secondary cases do not become infectious to others it is not counted in Ro.
All those who develop d/e on contact with secondary infectious host are also not included
Transmission probability:Probability of developing d/e after coming in contact with infective host
o Depends on:
Immunity of susceptible host
Virulance of organism
Mode of transmission
Cirrhosis+HCC--> HepB*, (HepB+HepD)**
Universal work precautions applies to:
o Blood
o Body fluid containing visible blood
o Semen and vaginal secretion
o Body fluids like Amniotic fluid, Seminal fluid
o Tissues
Universal work precautions does not applies to (if no visible blood is present):
o Faeces
o Vomitus
o Urine
o Sputum
o Breast milk
o Saliva
o Tears
(But of course common precautions are to be taken here also)
Latest guidelines in RNTCP:
History of 2 wk duration--> TB suspect--> Do sputum microscopy--> 2 samples required
Sputum positivity:
1 or 2 positive--> sputum smear positive TB--> start ATT
2 negative--> Antibiotics(FQ or Aminoglycosides:7-10 days)
Improves--> Non TB
No improvement--> CXR
o Suggestive of TB--> Sputum smear negative TB--> Give ATT
o Not suggestive of TB--> HIV testing--> positive
>200 CD4+ --> Give ATT then ART
<200 CD4+ --> Give ART first
Thioacetazone is C/I as second line drug of ATT with ART
Q. Leprosy affects all except:
1. Nerve
2. Ovary

3. Testes
4. Uterus-------ans(Clarified by AA)
Discussion- Lepra bacilli affects the cooler areas of the body eg. Nerve,Testis,Nasal tip etc. According to WHO leprosy is a
public health problem if prevalence is more than 0.01
Vaccine preservatives:
o Live attenuated bacterial vaccine eg. BCG Preservative esp. antibiotic not added
o Thiomersal:
Used as preservative in DPT,HiB,HepB,Measles,MMR
Contains Hg--> not used as a preservative now
o Measles--> Live viral vaccine--> add antibiotic as preservative to prevent bacterial contamination
o OPV: MgCl2, phenolphthalein
Biological transmission
Propagative*
Cyclo-Propagative(CPM)
Cyclo-developmental

Characteristic change
MultiPlies
Change in form and number
Only development

Example
Plague
Malaria
Filaria

Q fever--> inhalation of dust is more common cause of transmission compared to aerosol

Rubella vaccination:
o Priority group: All females of child bearing age
o Pregnancy is a contraindication
So do pregnancy test before vaccination--> negative--> vaccinate--> then ask for no pregnancy for
next 3 mths(since pregnancy is a contraindication)
Q. Which of the following statements is true about the BCG vaccination:
A. Distilled water is used as diluent for BCG vaccination
B. Site of injection should be cleaned thoroughly with spirit
C. Mantoux test becomes positive after 36 hrs
D. WHO recommends Danish 1331 strain for vaccine production
Answer is D.Distilled water: Measles,MMR
Spirit or other antiseptic not used(for live vaccine) use dry cotton swab
Mantoux Test (P-153)
Lepromin test(P-271):
o Tells about immune status of patient
o Fernandez reaction: 48-72 hrs
o Mitsuda reaction: 21 days
Trachoma:
o Tetracycline 1% ointment for local application
o Oral azithromycin
HIV window period:
o Time period between infection and detection of antibodies against HIV
o p24 antigen detection--> done to diagnose HIV in window period
o Seroconversion after HIV exposure occurs after--> The antibody titre usually becomes positive 6-12 wks after
exposure (the presence of antibody provides no protection against AIDS)
AFP surveillance is done in children aged 0-15 yrs--> 2 stool samples
Polio: Man is the only known reservoir of infection
For vaccinations after a break give whatever he should have received as primary immunisation by now
Age is the most important risk factor for becoming a chronic carrier following an acute episode of hepatitis B.
o Adult: 6-10% chances of chronicity
o Infant: 90% chances of chronicity--> Reason to introduce HepB in UIP
Q. Many professional organisation recommend that all pregnant women be routinely counselled about HIV infection
and should be encouraged to be tested.What is the most important reason for early identification of HIV infection in
pregnant women
A. A caeserian section can be planned to reduce HIV transmission to the new born
B. Breast feeding can be discouraged to reduce transmission to new born

C. Early identification of a new born at risk of HIV infection will improve survival
D. Zidovudine therapy can be offered to reduce the chances of transmission of HIV to the newborn
Answer is DNow DOC is Nevirapin
Q. All are targeted in Target intervention for HIV except:
A. Street children
B. Industrial worker
C. Migrant labourers
D. Sex workers
Answer is B.
Target intervention in high risk group:
Commercial sex workers
MSM(Homo)
IV drug users
Truck drivers
Migrant labourers
Prison inmates
Street children
o Risk of prick injuries
o IV drug use
o Homosexual activity
Q. In HIV maximum risk of transmission is by:
A. Homosexual
B. Blood transfusion
C. Heterosexual
D. Needle prick
Answer is B.
Mode of transmission/Route of transmission
Sexual--> heterosexual--> 85%(max.)
Perinatal,IV drug, Bld. Transfusion--> 2-3%
Others--> 7%

Risk of infection/Efficacy of transmission

BT--> 90-95%
Perinatal--> 20-40%
Sexual--> <1%
Cutaneous--> < 0.03%
Muco-cutaneous--> 0.005%

Q. All stages of rash are observed in:

1. Typhoid
2. Measles
3. Smallpox
4. Chickenpox
Answer.2..
Measles--> Pleomorphism--> maculopapular rash
Typhoid--> Rose spots
Small pox--> Multilocuar, Umblicated,Centrifugal rashes
Chickenpox--> Uilocular,dew drop like,Centripetal rashes
Pnemonic for appearance of rashes after fever in different diseases:
(1)Children (2)Should (3)Play (4)Morning (5)Evening
(1) C--> Chicken pox--> Fever and rash same day
(2) S--> Scarlet Fever--> Rash on second day of fever
(3) P--> Pox(small pox)
(4) M--> Measles
(5) E--> Enteric fever(Typhoid)
Rabies free zone in INDIA-->Lakshwadeep
Maximum: Karnataka esp.Banglore
Rabies free zone declared: When no indigenous(within country)rabies reported for a period of 3 yrs.

Q. Chemoprophyllaxis can be done for the following except:

1. Meningococcal meningitis
2. Typhoid
3. Cholera
4. Plague
Answer.2
MM--> Now ciprofloxacin(Earlier sulphadiazine)
Cholera--> Tetracycline
Plague--> Tetracycline
Rx of plague--> Streptomycin
Q. For operating the blood bank the licence is given by:
1. NACO
2. NABL
3. State health ministry/Ministry of health
4. Drug controller general of INDIA
Answer4..
NACO--> gives recommendations and provides guidelines
State health ministry/Ministry of health--> Regulatory authority
Drug controller general of INDIA--> Licencing authority
Q. A man used to take 20 cigarretes per day & started coughing. Family suggest quitting cigarettes.He is ready to quit
but thinks that quitting will make him irritable.The best health planning model followed here is:
1. Precontemplation & preparation
2. Contemplation and cost involved
3. Benefit and risk
4. Health belief model
Answer4
Health Evaluation models:
1. Health belief model(internal assessment)
i. Perceived susceptibility to ill health
ii.Perceived severity to ill health
iii. Perceived benefits of behaviour change
iv. Perceived barriers to taking action
2. Stages of change(Behaviour change is a process or phenomenon and not a one time event and also it is not a linear
model):
i. Precontemplation
ii.Contemplation
iii. Decision
iv. Action
v. Maintainence
STEPS(full form????):
STEP 1- History taking--> Smoking,Alcohol,Diet,Family,Physical activity
STEP 2- Clinical examination,Anthropometric(ht,wt,waist circumferencemost specific)
STEP 3- Biochemistry--> Blood sugar,Lipid profile, KFT,S.Creatinine
Q. All of the following are included in NPCB in tenth year plan except:
1. >80% IOL implantation surgery
2. 450 million cataract surgery per lakh
3.Vit.A prophylaxis 5 doses starting at 9 month of age till 3 years
4. Development of 50 paediatric ophthalmology unit
Answer..3.
Option 3 is a part of RCH programme(P-367)
NPCB--> Ensure 70% coverage of Vit.A supplementation(P-362)
1995 disability act: Includes:
o Blindness
o Low vision
o Leprosy(cured)

o Locomotor disability
o Hearing impairment
o Mental retardation
o Mental illness
At least 40% disablementrequired to qualify for the benefits under disability act
Carrying or issuing false disability certificate both persons are liable for fine upto Rs. 20,000/- or imprisonment
upto 2 yrs

Belief: Psychological state in which a person holds a preposition or premise to be true

Value: Ideas or values which are important to us
Knowledge: When belief is backed by experience or experimentation
Belief/Value/Attitude Once formed are very difficult to change

Q. Regarding purification of water all are true except:

1.Multiple tube method is used for sampling
2.E.Coli can be tested by indole test
3.Clostridial infection indicate recent infection
4.Level of residual chlorine should be 0.5mg/L
Answer.3Recent fecal contamination: E.coli,Steptococci
Q. All of the following are correct about disinfectants except:
1.Glutaraldehyde-Virus killing
2.Ethylene Oxide is 3rd generation disinfecting agent
3.Phenols are ineffective against organic matter
4.Autoclaving is not suitable for sterlization of plastics & sharp instruments
Answer.3....Phenols are effective
Phenol is very weak disinfectantused as a reference
Q. What is not true about DDT:
1.It is a contact poison
2.Causes immediate death
3.Residues can be found upto 18 mths
4.Synergistic action with permethrin
Answer2
2 rounds per year recommended
1-2 gm dosages
Q.Test for efficacy of pasteurisation of milk is:
1.Methylene blue test
2.Phosphatase test
3.OTA test
4.Nitric Acid test
Answer.2
1.. done prior to pasteurisation
Q.True statement about RDA:
1.Average daily requirement of all nutients
2.Average daily requirements of all nutrients except calories + 2 SD
3.Indicates adequacy of dietary intake
4.Applies even to sick people
Answer.3
In option 2 there is no minus
Applies to 97% persons
Not applied to sick individuals(2-3%)
Calorie calculation is not based on RDA
RDA=Mean of minimum(not average) requirement+2SD
Baby friendly hospital initiative--> now obsolete
o Now under IMNCI we have IYCF:

Initiate BF within 1 hr of birth even in C/S(mother is fit with spinal/epidural anesthesia to BF within
1 hr)
Under National Cancer Control Programme,oncology wings are sanctioned to Medical colleges
Janani surakha yojna:100% centrally sponsered programme
o Coverage:
All women in low performing state
All women below poverty line in a high performing state
o Eligibility:
Women age > 19 yrs of age
Only for first 2 living children
Also for third child if she undergoes sterlization(only in low performing states)
o Benefits: Cash incentive + Intranatal + Postnatal + Neonatal care(Antenatal care is not a part of janani
suraksha yojana)
Anganwadi workero is for population of 1000 and not 1 for 1000 children
o is ICDS worker
o training for 4 months, honorarium of Rs. 200-250 per month
o about 100 such workers in each ICDS project
o Services rendered-health check up, immunisation, supplementary nutrition, health education, non-formal preschool education & referral services
Shake test- can be used to determine if vaccine has been frozen at anytime--> useful for DPT/DT/TT/Typhoid(T-Series
vaccine) and HB vaccines which should never be frozen
Socratic method of teaching--> Panel discussion(ck-p-718)