Mahajan & Gupta Textbook of Preventive & Social Medicine (4th Ed.)[Ussama Maqbool]

Mahajan & Gupta Textbook of Preventive and Social Medicine In their Esteemed Opinion “ I congratulate you for your bold and strenuous effort in bringing out the Textbook of Preventive and Social Medicine for medical students in India This book would definitely become popular very soon in India.” — Dr M Sudarshan, Professor and Head, Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India “This book is very informative and well written and can be used as reference by community health personnel engaged in health care delivery.” — Dr Deoki Nandan, Professor, Department of Social and Preventive Medicine, SN Medical College, Agra, Uttar Pradesh, India “I congratulate you for writing a good Textbook of Preventive and Social Medicine.” — Dr VN Mishra, Professor and Head, Department of Social and Preventive Medicine, LLRM Medical College, Meerut, Uttar Pradesh, India “It was a pleasure to go through this book The contents have been brought out at the desired standard.” — SD Gaur, Professor and Head, Department of Preventive and Social Medicine, BHU, Varanasi, Uttar Pradesh, India “The Textbook of Preventive and Social Medicine by Dr Mahajan and Dr Gupta is a very good attempt.” — Dr Abdul Rauf, Professor and Head, Department of Social and Preventive Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India Mahajan & Gupta Textbook of Preventive and Social Medicine Fourth Edition Revised by Rabindra Nath Roy MBBS MD (PSM) Associate Professor Department of Community Medicine Burdwan Medical College and Hospital Burdwan, West Bengal, India Indranil Saha MBBS MD (Community Medicine) Assistant Professor Department of Community Medicine Burdwan Medical College and Hospital Burdwan, West Bengal, India Authors of Previous Edition’s MC Gupta MBBS MD (Medicine) MPH LLB Ex-Dean and Professor National Institute of Health and Family Welfare, New Delhi, India Formerly Additional Professor All India Institute of Medical Sciences, New Delhi, India (Late) BK Mahajan MBBS DPH FCCP FIAPSM Deputy Director, Health Services, Bombay State (1958-60) Formerly, Professor of Preventive and Social Medicine at Medical College, Jamnagar (1960-73) Mahatma Gandhi Institute of Medical Sciences, Sevagram (1973-82) Senior Consultant, ICDS Central Technical Cell, AIIMS (1982-87) ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • Panama City London Dhaka Kathmandu đ Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: jaypee@jaypeebrothers.com Overseas Offices J.P Medical Ltd 83, Victoria Street, London SW1H 0HW (UK) Phone: +44-2031708910 Fax: +02-03-0086180 Email: info@jpmedpub.com Jaypee Brothers Medical Publishers (P) Ltd 17/1-B, Babar Road, Block-B, Shaymali Mohammadpur, Dhaka-1207 Bangladesh Mobile: +08801912003485 Email: jaypeedhaka@gmail.com Jaypee-Highlights Medical Publishers Inc City of Knowledge, Bld 237, Clayton Panama City, Panama Phone: + 507-301-0496 Fax: + 507-301-0499 Email: cservice@jphmedical.com Jaypee Brothers Medical Publishers (P) Ltd Shorakhute, Kathmandu Nepal Phone: +00977-9841528578 Email: jaypee.nepal@gmail.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2013, Jaypee Brothers Medical Publishers All rights reserved No part of this book may be reproduced in any form or by any means without the prior permission of the publisher Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com This book has been published in good faith that the contents provided by the authors contained herein are original, and is intended for educational purposes only While every effort is made to ensure accuracy of information, the publisher and the authors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work If not specifically stated, all figures and tables are courtesy of the authors Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device Mahajan & Gupta Textbook of Preventive and Social Medicine First Edition: 1991 Second Edition: 1995 Third Edition: 2003 Fourth Edition: 2013 ISBN 978-93-5090-187-8 978-93-5025-239-0 Typeset at JPBMP typesetting unit Printed at Dedicated to My dear wife (Late) Dr Manju Gupta (27-1-1948—13-6-1996) without whose inspiration and sacrifice this book would not have been possible MC Gupta Preface to the Fourth Edition The last few years have witnessed a rapid progress in the field of Community Medicine There was a felt need for publication of an updated fourth edition of this book after a gap of couple of years Many new concepts have arisen and much more modifications have been incorporated over the past strategies We think this edition will also meet the expectations of the medical and nursing students, as well as the students of Public Health, teachers of Community Medicine and the program implementers of health services Almost all the chapters have been thoroughly revised and updated; notably among those are epidemiology, communicable and noncommunicable diseases, MCH and family planning, management, demography and vital statistics, disaster, biomedical waste management, food and nutrition, immunization, geriatrics, communication, etc National Health Programs have also been thoroughly revised and updated New data have been incorporated, wherever applicable Latest SRS and census data have also been included Various domains that are of importance, both in theory, practical and viva of MBBS examination have been highlighted with examples and justification Many postgraduate study materials have also been incorporated with references for further reading Various flow charts, diagrams and pictures have been introduced for clarity of understanding Students will be benefited for their preparation in answering MCQ for their Postgraduate Entrance Examination It is our earnest hope that fourth edition of this textbook will help the MBBS, Postgraduate aspirants, Postgraduate students and the students of other public health disciplines We will be grateful to the students and the teachers for their valuable feedback, comments and constructive criticism We will acknowledge and will try our best to address those issues in the subsequent editions Rabindra Nath Roy Indranil Saha Preface to the First Edition Preventive and social medicine is one of the most important subjects in the curriculum of a medical student Unlike other subjects, preventive and social medicine, community medicine and community health are the concern not only of those specializing in these fields but of all others in the medical profession, including those engaged in active clinical care as well as the health administrators As a matter of fact, the subject is of serious concern to all interested in human health and welfare, whether in the medical profession or not The present book is patterned on the earlier book Preventive and Social Medicine in India by Professor BK Mahajan, published in 1972 However, the marked developments in the subject during the last 20 years have necessitated extensive changes and additions Hence, this volume is presented as a new book in its first edition The entire approach is epidemiological and the subject matter is presented in a linked and continuous manner The language and style are simple, and attractive with emphasis on practical aspects which may be of utility not only to PHC medical officers and health administrators but even to general practitioners The whole book is divided into four parts The first part deals with the general aspects of preventive and social medicine and its scope The second part, comprising two-thirds of the book, is built around the epidemiological triad The third part deals with demography, vital statistics and biostatistics The fourth part is devoted to health care of different groups, and includes detailed discussion of primary health care, health policy and the relation between health and development The above division is objective and purposeful It makes the reader familiar with the essential course content of community medicine, inculcates in him the epidemiological approach to health and disease, and prepares him to practise family medicine as a family physician A chapter on general practice has been added for this purpose Though the book is primarily written for the undergraduate students, it would be of use to the postgraduate students as well The number of references has been kept to a minimum Only those references have been included which substantiate a controversial or less widely-known point, or which relate to recent work or review Inter-relation between health and development, health manpower planning, communicable disease epidemiology in natural disasters, mental health program and the program for control of acute respiratory infections have been discussed in detail The national ICDS program has been given adequate coverage Care has been taken to include practical aspects in relation to diagnosis and management of leprosy, which may have to be tackled by many PHC medical officers and general physicians Special attention has been paid to the chapters on social environment, host factors and health, noncommunicable diseases, food and nutrition, demography and vital statistics, health policy, planning management and administration, primary health care, health education, information and communication, maternity and child health, school health, geriatrics, mental health and health service through general practitioners so as to present the concerned topic in a most up-to-date and easily comprehensible manner Some sections, such as those relating to water supply and disposal of wastes, could have been reduced further by omitting certain details; the latter have been retained in view of the requirement of public health administrators The existing curricula of various universities, as also the suggestions from eminent professors, have been given due consideration while preparing this book We shall feel amply rewarded if this book is found useful for students, teachers, public health administrators and PHC medical officers We are grateful to a large number of colleagues in different parts of India, who spared their valuable time and effort to go through the manuscript, offered constructive suggestions and incorporated appropriate changes wherever necessary These include Professor YL Vasudeva and Professor Sunder Lal (Rohtak), Professor RD Bansal and Professor SC Chawla (LHMC, Delhi), Professor OP Aggarwal (UCMS, Delhi), Professor G Anjaneyulu (Hyderabad), Dr GS Meena (MAMC, Delhi), Professor IC Verma, Dr Bir Singh and Dr Ravi Gupta (AIIMS, Delhi), Dr GVS Murthy and Dr K Madhavani (Wardha), Dr LN Balaji (UNICEF) and Professor KK Wadhera (CMC, Ludhiana) Professor Bansal, Professor Anjaneyulu and Professor Wadhera, in particular, took special pains to Textbook of Preventive and Social Medicine x go through the entire manuscript critically at various stages of preparation We owe special gratitude to Professor G Anjaneyulu, for writing a foreword to the first edition for the book after going through the entire manuscript We are thankful to the American Public Health Association, Washington, and the Institute of Health and Nutrition, Delhi, India for permission to reproduce certain portions of the text from their publications Reference to original source has been made wherever this has been done We must thank to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who have done a marvellous job in record time, in spite of delay from our side We must also acknowledge the contribution of our typists Shri Rameshwar Dayal and Shri Murli Manohar, whose excellent typing skills greatly reduced the drudgery associated with drafting and redrafting of a manuscript Lastly, we must express our heartfelt thanks and indebtedness to our wives who silently, and sometimes not so silently, suffered—their husbands continuously lost in books, papers and proofs in utter disregard of their domestic responsibilities MC Gupta (Late) BK Mahajan Acknowledgments We would like to thank the people without whom this book would not have been possible, they are our colleagues, students and our family We are thankful to the Almighty for the ability, circumstances and health that were needed to write the book Last but not the least both the editors thankful to M/s Jaypee Brothers Medical Publishers (P) Ltd, Kolkata and New Delhi, India to give this special opportunity to update and revise Mahajan & Gupta Textbook of Preventive and Social Medicine Preparedness Plan for Meeting Chemical Disasters The effects produced by a chemical disaster would primarily depend upon the nature of accident and vary from target to target The effects on life systems can be lethal if a toxic gas pollutes the air When the source of drinking water is contaminated, delayed effects will manifest themselves The possible biological effects likely to accrue from chemical depend upon the extent of exposure and the potential of the implicated chemical to interact with diverse anatomical structures and physiological functions Adverse effects could be instantaneous death or the appearance of disease clusters Individual susceptibility, degree and duration of exposures and failure or success to counter immediate effects modify prognosis Risk of cancer and mutagenic changes in the progeny are to be anticipated Contamination of ambient air is presumably the most significant pathway by which the toxic chemical attacks the target organ in major chemical disasters Intake by inhalation or absorption through skin and mucous membrane constitute the main routes of entry In the case of contaminated water or food, the targets will be the digestive and assimilative systems Such a plan should cover different phases before the disaster and after the disaster: Assessment of Risk A large number of chemicals are known to be highly toxic to man Many of them are alien to the human system and the external environment They are capable of disturbing economical equilibrium and hence impair the survival of life-support systems What is the basis on which the risk of exposure to these chemicals is assessed? Risk management of toxic chemicals comprises the following steps: • Identification of the hazard • Estimation of the hazard • Assessment of the risk to the community • Availability of safer alternatives • Assessment of the ability of the community to absorb “acceptable” risk • Safety evaluation of chemicals The safety evaluation of chemicals has two important interlinked components: Exposure assessment making estimates of the chemical in the environment and in the target organisms Toxicity evaluation: This is an area where lot of work needs to be done A study conducted by the prestigious National Academy of Sciences revealed that more than 70 percent of the chemicals in use in commerce in USA are yet to undergo rigorous toxicity evaluation as required under regulatory procedures.11 IDENTIFICATION OF THE HAZARD All existing arid potential hazards in chemical industry must be identified and inventorized After notification, an appropriately constituted inspectorate system should check the hazards periodically RISK ASSESSMENT CHAPTER 41: Disaster Management Health Effects of Massive Chemical Exposures It is essential that the exact location of the hazardous installation is demarcated along with its surrounding ecosystems Assessment of impact on human population, natural vegetation, cultivated lands, cultural property and fragile ecosystems of possible massive leakage of chemicals from the site should be made periodically The risk involved must be balanced against societal benefits ON SITE AND OFF SITE PREPAREDNESS PROGRAM Next to hazard identification and risk assessment the urgent task to be accomplished is the setting up of an effectively orchestrated on site and off site preparedness program An ideal system for chemical disaster management should consist of: • An authority to give directives based on updated information with a back-up of research • An alert system which not only gives the warning but also establishes as effective communication net work • A local authority to carry out the directives for migration of the injured and for instituting measures for relief and rehabilitation • Communication/Alert system: In addition to well known essential components of natural disaster management plan, chemical disaster plans have to include an efficient communication mechanism which triggers the activation of emergency treatment units where the human victims and affected animals are given appropriate chemical antidotes to flush out toxins from their bodies • Off site emergency: Off site emergency plans have to deal with identification of vulnerable Groups; their prompt evacuation if a recurrence of release of toxic material is anticipated; mopping up of water and food sources; and decontamination procedures for exposed land and vegetation Furthermore programs have to be initiated for rehabilitation of victims FIRE—DO’S AND DON’TS10 • Switch off gas supply from cylinder and electrical 689 appliances when not in use PART IV: Health Care and Services • Keep clothes, curtains and other potentially combustible items at least feet from room heaters • Keep a fire extinguisher in home or office and learn how to use it • Not to overload electrical extension cords • Call fire brigade urgently when fire is noticed • Do not allow children to play with matchboxes or lighters and electrical appliances like room heater, immersion heater, iron, hair dryers, etc Natural Disaster Management in India India with a wide range of climatic and topographical conditions is subject to various types of natural disasters In contrast, biological and chemical disasters take only a second place The extent and severity of natural disasters in India is briefly indicated below: Floods Flood is a common natural disaster during the later part of the monsoon period Floods are estimated to affect 6.7 million hectares of land annually The statistics of 10 years (1979-89) indicates that on an average in India about 30 million people are affected every year Drought Drought is also perennial feature in India Sixteen percent of the country consists of drought prone areas Statistics of 10 years (1979-89) show that on an average more than 50 million people are affected annually by the drought conditions Cyclones The coastal area of the country experiences about two to three tropical cyclones of different intensity every year with varying degree of destruction and loss of life East coast is more vulnerable than the west coast Statistics of years period indicates that on an average at least cyclones of varying intensity touch the Indian coast every year CYCLONES—DO’S AND DON’TS10 • Keep monitoring the warnings This will help to prepare for cyclone emergency • Switch off electrical mains in the house • Keep some dry nonperishable food and medicines always ready for emergency use • Check the house, secure loose tiles, carry repair works for doors and windows • Fishermen should not go for fishing in high seas after 690 cyclone warning • Have to evacuate the place during emergency Earthquakes The Himalayan region from Kashmir to Arunachal Pradesh is in the seismic Belt Twenty earthquakes of severe magnitude affected India during the last century The recent ear thquake in L atur and Osmanabad districts of Maharashtra indicated that a large number of casualties can take place even in a low seismic zone EARTHQUAKES—DO’S AND DON’TS10 • Follow BIS codes relevant to concerned area for building standards • Repair deep plaster cracks in ceilings and foundations Expert advice should be sought if there are signs of structural defects • Do not stay close to glass, windows, outside doors and walls and anything that could fall such as lighting fixtures or furnitures • Do not use elevators during earthquake • Ascertain the exit plan from the building • Switch off electrical gadgets and power supply • Know emergency telephone numbers (doctors, hospital, police, etc.) Statewise Analysis By and large in India, all States/Union Territories are likely to face a disaster situation like drought, flood, cyclone and earthquake Based on information from the Ministry of Agriculture (Deptt of Natural Disaster Mitigation), there are 21 States/UTs Which are most vulnerable? Out of 21 State/UTs, State faces all types of disasters, States face types of disasters, 11 face two types of disasters and face one type of disasters All States, which are prone to only one type of disaster, face severe drought situation every year.1 National Policy In a federal set-up, as in India, the responsibility to formulate the government’s response to a natural calamity is essentially that of the concerned State Government However, the central government supplements, to the extent possible, the efforts of the state government by way of providing financial and material assistance for effective management of the situation in accordance with the existing scheme of financing the relief expenditure The present scheme of financing the relief expenditure arising out of natural calamities has come into force with effect from April, 1990 consequent upon the acceptance of the recommendations of the Ninth Finance Commission Under this scheme, a calamity relief fund (CRF) has been constituted for Disaster Management Structure in India State Level As mentioned earlier, under the Indian Federal System, disaster management is the responsibility of state government Research, surveys, guidelines and provision of financial assistance to the states are provided by the central government Details of state structure, which varies from state to state, will not be presented here, though general role of the state machinery in disaster management will be touched upon while describing the national aspects National Level At the central level, there is a Crisis Management Group headed by the Cabinet Secretary and consisting of nodal ministries in charge of different types of disasters and support ministries consisting of concerned department/ ministries For Natural Disasters, Ministry of Agriculture is the Nodal Ministry, other Ministries are supportive departments In the event of disaster, a multidisciplinary central govt team, at the initiation of the affected state, conducts a disaster assessment and also makes recommendations for assistance Responsibility of disaster preparedness and response in the state is usually discharged by the Relief and Rehabilitation Department of the department of revenue The Crisis Management Group at the state level is headed by the Chief Secretary of the Government with participation of all the related agencies At district level, a District Level Coordination and Review Committee is constituted and headed by the Collector as Chairman in which all other related agencies and departments participate Role of the Health Sector PUBLIC HEALTH IMPACT FOLLOWING DISASTERS Flood, cyclone and drought are common disasters seen in India Water-borne diseases like diarrhea, dysentery and typhoid are widely prevalent and get exacerbated during these disasters Cases of malaria and filarial also increase after 10 to 15 days of monsoon or after flooding Leptospirosis has been found in a few areas in Tamil Nadu Bacillary dysentery caused by Shigella has been found in West Bengal and Assam adjoining Bangladesh Earthquake impact on water supply and sanitation and make the affected population vulnerable to diseases like diarrhea, dysentery and acute respiratory infections One of the responsibilities of the Health Department during this period is to provide immediate medical care and keep their surveillance mechanisms specifically alert CHAPTER 41: Disaster Management each state with certain amount allocated to them Of this amount, 75 percent is contributed by the central government and given to the state in four equal installments The balance 25 percent is provided by the state government from its own resources Following the constitution of the CRF, it is the responsibility of the concerned state government to meet the expenditure on calamity relief However, in a crisis of a severity, the government of India will examine the case and, if found deserving, give additional funds to the state through a newly created corpus fund called National Fund for Calamity Relief (NFCR) Disaster Management Structure in Health Sector National Level The Emergency Medical Relief Division of Directorate General Health Services in the Ministry of Health and Family Welfare is the technical unit exclusively meant for management of crisis situations The Division is headed by Director, Emergency Medical Services and Relief For the purpose of the crisis situations, he reports/receives instructions directly from the technical chief (Director General of Health Services) and the Administrative Head of the Ministry (Secretary Health and FW) The secretary, Health and FW has empowered Director, EMR to represent the Dept for crisis situation in different Crisis Management Groups Disaster Management requires multisectoral and multidisciplinary approach, which needs coordination at various levels from Central to District Level In the Ministry of Health and Family Welfare (Govt of India) such mechanism of coordination is done through the office of the Director, Emergency Medical Services and Relief (EMR) The objective of the coordination is to review crisis situations from time to time and meet those needs, which state government cannot meet For this purpose, continuous dialogue and communication are maintained with the Directors of Health Services, Stores Division under the Federal Government, vaccine producing institutes, National Institute of Communicable Diseases and Director, Malaria unit 691 PART IV: Health Care and Services State Level Usually a Joint Director or a Deputy Director of Health Services under Director of Health Services in the state is responsible for crisis management, coordination, monitoring and implementation He has information about key personnel involved in disaster management at the Center, State and District Level District/PHC Level At district level, the chief medical officer/Civil Surgeon is responsible to implement and coordinate health sector activities He has details of information about officers involved in disaster management at state, district and PHC level Non-governmental Organizations There are a number of NGOs which are functioning in the field of disaster management Most of them are small and work locally However, Indian Red Cross Society and Ramakrishna Mission are the two organizations, which take very active part in disaster management As a matter of fact, these two organizations supplement government efforts They have sufficient infrastructure to provide immediate facilities within shortest possible time Details of the role played by Indian Red Cross in disaster management are given below Indian Red Cross Society Besides its activities related to mother and child welfare, including nutrition program, arrangements of relief to the victims of epidemics, earthquakes, cyclones, droughts, floods and natural and industrial calamities is also a function of the Red Cross They also provide paramedical education in fields like first aid, nursing and blood banking Promotion of voluntary blood donation is an important activity of the society There is a network of 51 blood banks run by Red Cross in 11 states Medical relief is extended to the community through their static and mobile units 692 International Day for Disaster Reduction: 14th October This day is dedicated to strengthening of pre-disaster prevention, preparedness and steps for mitigation measures and prompt and efficient response, National Disaster Management Authority (NDMA) has strived to train the community to face challenges of both natural and man-made disasters References Govt of India, DGHS, Min of H & FW [1995] Health Sector Contingency Plan Also available at http:// www.whoindia.org/SDE/EHA/EHAHome.asp Govt of India, DGHS, Min of H &FW [1995] ] Health Sector Contingency Plan, Part III: Guidelines For Mass Casualty Management Hospital Contingency Plan Also available at http://www.whoindia.org/SDE/EHA/ HealthContingency/Part%20III.pdf] Guidelines on Disaster Management A compilation of expert guidelines on providing Healthcare Dualeh M, Shears P Refugees and other displaced populations In: Detels R, McEwen J, Beaglehole R, Tanaka H (Eds) Oxford Text Book of Public Health, 4th edition Oxford University Press, 2002; pp 1737-53 Shmona K A typical course of disaster, Community Stress Prevention Centre, 2005; Tel Hai College, Israel WHO Myths and realities in disaster situations 2005 Available: http://www.who.int/hac/techguidance/ems/ myths/en/ WHO Handbook on emergency field operations, Geneva, World Health Organization 1999 Govt of India, DGHS, Min of H & FW [1995] Health Sector Contingency Plan, Part II:Planning For Natural Disaster Also available at http://www.whoindia.org/SDE/ EHA/HealthContingency/Part%20II.pdf] Govt of India, DGHS, Min of H & FW [1995] Health Sector Contingency Plan, Part I: Planning for Biological Disaster Also available at http://www.whoindia.org/SDE/ EHA/HealthContingency/Part%20I.pdf 10 National Disaster Management Authority Government of India Available at www.ndma.gov.in 11 Govt of India, DGHS, Min of H &FW [1995] Health Sector Contingency Plan, Part V: Planning For Chemical Disasters Also available at http://www.whoindia.org/SDE/ EHA/HealthContingency/Part%20V.pdf Index A Abdominal pain 228 Abnormal bleeding and DIC 314 Abortion 617 Abortive polio 244 Absence of human carrier stage 176 Accidental falls 374 infection 176 poisoning 374 Accidents 374 Acquired immune deficiency syndrome 144, 279 Active immunization 178, 242, 351 mouse protection test 191 surveillance 20, 385 Acute abdomen 652 adenolymphangitis 319 brain disorders 644 communicable diseases 162 coryza 170 exposure 86 flaccid paralysis 245, 249 hepatitis A 27 B 27 malnutrition 415 respiratory distress syndrome 314 infections 208, 209 seroconversion illness 282 viral hepatitis 27 watery diarrhea 222 Adequacy of breast milk 584 Adequate sample rate 250 stool sample 250 Adhesive fly paper 116 Adolescent health care 540 Adulteration of milk products 399 Advantages of breastfeeding 584 depo-provera 614 intradermal schedule 346 IUD 609 observation techniques 453 Pehchan card 98 segregation 665 syndromic case management 293 Aedes aegypti 328 africanus 327 albopictus 329 simpsoni 327 Age related macular degeneration 379 Agha Khan foundation 661 Agriculture and food security 105 AIDS 284 dementia complex 282 myelopathy 282 neuropathy 282 related complex 282 Air borne infections 166, 168 conditioning 51 motion 46 pollution 99, 209 pressure 84 temperature 46 Albuminoid ammonia 59 Algyotibauses dengu 310 Alimentary canal 162 Allethrin 122 Alternative systems of medicine 513 Amantadine 174 Ambiguous vaccine-derived poliovirus 249 Amebiasis 153, 235 American Diabetes Association 373 Ammonia 59 Anaerobic pond 80 Analysis of vital data 467 Anaphylactic shock 652 Anemia 577 Anganwadi Centers 602 Animal fat and tallow melting 89 foods 390, 398 poxviruses 176 Annual blood examination rate 309 entomological inoculation rate 310 leave with wages 95 parasite incidence 309 Anomalies in health manpower structure 488 regarding job opportunities 489 Anopheles 112 Antecedent viral infection 209 Antenatal advice 583 care 539, 582 counseling for danger signs 583 measurements/tests 582 Anthrax 349, 671 infection 671 Anti-adult measures 113, 325 Antibiotic 235 treatment of acute rheumatic fever 364 Antibody detection 344 tests 283 Antifertility vaccines 619 Antifly measures 219 Antigen detection 343, 344 tests 283 Antilarval measures 112, 324 Antileprosy drugs 266 Antimalarial drugs 312 vaccines 312 Antirabies immunoglobulin 347 vaccine 345 Antiretroviral therapy 286 Antiviral susceptibility assays 283 Applied nutrition program 420 Appropriate health education 84 Arboviruses 326 ARI component of RCH program 210 Arithmetic progression method 468 Artemether 314 Artemisinin-based combination therapy 312 Artesian well 54 Artesunate 314 Arthropod 109 borne diseases 305 infections 167 virus infections 153 transmitted helminths 258 Artificial humidification 94 ventilation 51 Ascaris lumbricoides 257 Ascorbic acid 397 Assessment of air pollution 49 child with diarrhea 222 malnutrition in elderly 639 nutritional status 408 of child 589 occurrence of malaria 309 Atherosclerosis 394 Athlete’s foot 302 Atmospheric pressure 46 Atypical infection 155 Average infection rate 322 Avian influenza 172 B Baby friendly hospital initiative 585 Bacillary dysentery or shigellosis 235 Textbook of Preventive and Social Medicine 694 Bacillus cereus 228 thuringiensis israelensis 113 Bacteria 12, 56, 65 Bacterial disease 678 infections 282 Bacteriological index 266 Bajaj committee 487 Balantidiasis 238 Bar diagram 436 Barber’s tools 303 Basic concepts in community medicine health and nutrition knowledge 429 laboratory services 545 structure of ICD 26 BCG vaccination 197 Beef tapeworm 253 Behavior change communication 317 disorders among children 644 Benign tertian malaria 305 Benzathine henzylpenicillin 365 Benzene hexachloride 122 Benzyl benzoate 124 Bharat Sewashram Sangh 270 Bhore Committee 485 Biological trickling filter method 79 Biomedical waste management 663 rules 668 Biophysical methods 412 Birth and fertility rates 472 control 605 rates 469 Black fever 333 fly 115 water fever 305 Bleaching powder 63, 165 Blindness 353, 376 Blood 162, 245 boiling and drying 89 culture 233 pressure measurement 366 safety 290 surveys 309, 322 transfusion 281 Blurring of vision 583 Body building foods 398 mass index 371, 412 Boiling water 164 Bonded labor system 139 Bone boiling 89 Borax 125 Border Districts Cluster Project 595 Borderline lepromatous 263 tuberculoid 262 Bordetella pertussis 190 Bore hole latrine 74 Borrelia recurrentis 117, 342 Breakthrough varicella 177 Breastfeeding 127, 583 Brominated vegetable oil 356 Bronchial asthma 174, 368, 652 Bronchiectasis 368 Brucella abortus 234 melitensis 234 suis 234 Brudzinski’s sign 192 Brugia malayi 321 filariasis 323 Bubonic plague 335 Burning micturition 318 Butylethyl propanediol 124 C Calcium 394 Calculation of odds ratio 34 vital and health indices 467 Campbell-stoke sunshine recorder 46 Camphechlor 121 Cancer 86, 354, 369, 394 and cardiovascular diseases 353 Carbamates 123 Carbohydrates 393 Carbolic acid 165 Carbon dioxide 105 monoxide 99, 100 Carcinogenic stimuli 355 Cardiovascular disease 362, 368 control program 483 Carditis 364 Cataract 86, 378 blindness 382 Category of bites and management 345 Causes of disease drug-resistant tuberculosis 206 food poisoning 228 maternal mortality 578 pediatric mortality 580 Cell mediated immunity 261 Central nervous system disease 280 HIV disease 282 TB division 283 Cerebral malaria 305 Cerebrospinal fluid 182, 245, 281 meningitis 192 Cerebrovascular stroke 652 Cervical cancer 359 rigidity 192 Chadha Committee 486 Challenge of health education 561 Chancroid 272, 276 Changing nature of virus 171 Chemical carcinogens 355 disasters 688 disinfectants 164 poisoning 228 Chemoprophylaxis 155, 198, 314, 340 Chemotherapy regimens 200 Chickenpox 170, 177 Chikungunya fever 330 Children parasite rate 309 Chi-square test 447 Chlamydia trachomatis 301 Chloramine 62 Chlordane 123 Chlordimeform 121 Chlorhexidine 165 Chlorinated hydrocarbons 122 Chlorination 61, 79 Chlorine dioxide 62 tablets 63, 165 Chlorofluorocarbons 105 Chloroxylenol 165 Chlorpicrin 124 Chlorthion 123 Choice of cooking oils 392 study design 30 population 41 Cholera 153, 214 Chopra Committee 485 Chorea 364 Chromosomal disorders 145 Chronic brain disorders 644 bronchitis 368 exposure 86 illness 16 malaria 306 renal disease 174 respiratory disease 174, 369 viral hepatitis 27 Cimex lectularius 118 Circulatory system 149 Classical smallpox 175 Classification of ARI 208, 210 communicable diseases 166 diabetes mellitus 372 disasters 680 illness 386 insecticides 121 Cleaning of air 69 Clofazimine 266 Clonorchis sinensis 252 Clostridium botulinum 228 perfringens 59, 228 tetani 350 Cluster testing 277 Cocoa 404 Coefficient of variation 440 Coitus interruptus 605, 607 Conduction of FGD 566 Congenital malaria 311 rubella syndrome 184 syphilis 274 varicella syndrome 177 Consequences of iron deficiency anemia 417 Conservation of nutrients 405 Constipation 230 Consumer Protection Act 140 Contact diseases 260 infections 168 isolation 158 poisons 121 survey 263 time 61 tracing 277 transmission 166, 261 Content of primary health care 552 Control of communicable diseases 483, 536 diarrheal diseases 220 disease in dogs 347 infection 417 influenza 173 local endemic diseases 541 maternal morbidity and mortality 579 noncommunicable diseases 483 Controlled fertilization 127 Copper acetoarsenite 113 sulfate 64 T intrauterine device 615 Cor pulmonale 368 Corea 364 Corneal pathology 378 Coronary artery disease 644 disease 147 Corynebacterium diphtheriae 187 Cost benefit analysis 526 effectiveness analysis 527 methods 495 utility analysis 528 Cowie’s sign 182 Crude death rate 471, 475 Cryptic malaria 311 Cryptococcal meningitis 284 Culex 112 fatigans 322 quinquefasciatus 310, 323 tritaeniorhynchus 331 Curative services 540, 635 Curb parking 375 Current contraceptive prevalence 622 estimates of TFR 470 flaccid paralysis 249 Policy of Insecticide Use in India 114 status of poxvirus disease 176 Cutaneous anthrax 349, 671 Cyanocobalamin 397 Cyanosis 210 Cycle in man 306 mosquito 307 Cyclones 690 Cysts of Entamoeba histolytica 56 Index Cold boxes 598 chain equipments 597 monitor 600 sickness rate 599 Collection of sputum 202 vital statistics 463 water samples 59 Colombo plan 660 Color coding scheme 665 Coma 652 Combination of cold cloud duration 331 Combined extraction and propulsion system 51 pill 612 Common cold 170 medical emergencies 652 nutrition problems in India 413 obstetric emergencies 652 pediatric emergencies 652 surgical emergencies 652 Communicability period 187 Communicable disease 153, 155, 161, 168, 507 program 541 period 155 Communications skills 567 Community education 278 level interactions 541 medicine mobilization 431 participation 317, 430 in primary health care 552 surveys 465 Complement system 148 Complicated measles 180 Complications of delivery 577 gonorrhea 275 hypertension 367 Complimentary feeding 584 Components of antenatal checkups 582 dots plus 206 family medicine 651 MCH care 581 primary health care 533 syndromic case management 293 Composition of cow’s milk 398 Comprehensive health care 635 primary health care 552 Compressed natural gas 49 Concentration method 322 Concepts of disease health prevention Concurrent disinfection 156, 162 Condom 608 promotion 290 D Dai training 594, 625 Danish International Development Agency 382 Save Children Fund 270 Dapsone 266 Death rates 471, 472 Deep freezers 598 well 53 Deer fly 115 Definition of disaster 680 epidemiology 11 poliomyelitis 245 surveillance 383 types of cases 203 Degree of sunshine 46 Dehydration 217 Delivery of National Public Health Programs 509, 514 Delphi technique 455 Demographic considerations in family planning 606 gap 460 stages 460 transition 460 Demonstration of viral nucleic acid 283 Dengue 329 hemorrhagic fever 329 Density of infection in mosquito 322 Dental caries 393, 677 Deprofessionalization of medicine Dermacentor andersoni 341 Dermal leishmaniasis 335 Dermatitis 117 Determinants of health 6, 551 Determinate leprosy 262 Developing innovative partnerships 372 Development of brain 127 human resources for health 482 Dharmendra’s scale 266 Dhobie’s itch 303 Diabetes 174, 369, 372, 393, 394 Control Program 483 Diaphragm method 608 Diarrhea 220, 221, 228, 318 Dibutyl phathalate 124 Dichloro diphenyl trichlorethane 122 Dieldrin 122 Dietary fiber 393 improvement 416 sucrose 678 Diethyl stilbesterol 37 695 Textbook of Preventive and Social Medicine Diethylcarbamazine 324 Diethylstilbestrol 615 Different scales of measurement 434 Digestive system 149 Dihydrofolate reductase inhibitors 312 Dilemma of adolescent hypertension 366 Dimethyl carbate 124 phthalate 119, 124 Diphtheria 153, 170, 186, 687 Diphyllobothrium latum 255 Direct chlorination 79, 80 droplet transmission 166 fluorescence assay 178 standardization 473 transmission 154, 160 Disablement benefit 97 Disaster Assessment 680 Management Structure in Health Sector 691 India 691 Disease surveillance 382, 541 under Surveillance Project 383 Disinfected water 59 Disinfection 156, 163, 189, 199, 219 Disposal of biomedical waste 665 general waste 668 wastes and effluents 93 DNA vaccines 288 Dog tapeworm 254 Domestic refrigerators 598 Dose schedule of iron and folic acid 423 Double blinding 40 Doubling time of world population 461 Down’s syndrome 144 Dracunculus medinensis 258 Drinking water 94 Droplet infection 261 nuclei 154, 161 Drug resistance 315 therapy 368 toxicity 200 Dry heat 164 Duck embryo vaccine 346 Duodenal ulcer 644 Duration of prophylaxis 365 Duties of PHC Medical Officer 537 E Ear discharge 318 Early latent syphilis 274 Earthquakes 690 Easy detection of disease 176 Echinococcus granulosus 254 Egg inoculation 172 Electron microscopy 176 696 Elimination of breeding places 112, 115 Emergency contraception 615 immunization 687 Emerging infections 352 diseases 352 Employees State Insurance Act 95 Endemic typhus 340 Energy 406, 523 rich foods 398 Entamoeba histolytica 236 Enteric fever 153, 230 Enterobius vermicularis 256 Environmental health 657 pollution 99 protection 505 sanitation and safe water supply 536 Epidemic measures 162 typhus 117, 339 Equivalent sterilizations 623 Eradicate and eliminate certain diseases 551 Erythromycin 365 Escherichia coli 228 ESIC Pehchan Card 98 Essential fatty acids 392 newborn care 592 Estimates of world population 461 Ethinyl estradiol 615 Ethyl hexanediol 124 parathion 121 Evaluative study 29 Excess of soluble salts 56 Execution of plan 477 Executive board 656 Exposure rate 34 Extended sickness benefit 96 Extending Public Health Services 510, 515 External atmosphere 45 environment 14 Extraintestinal amebiasis 235 Extrapulmonary tuberculosis 202, 284 Extrinsic incubation period 110 F Family fascioloidae 252 health 657 Planning 536, 585, 605, 622 and contraception 540 and Population Policy 605 schistosomidae 252 Fasciola hepatica 252 Fasciolopsis buski 252 Fatality rate 155 Father of Indian medicine surgery medicine public health surgery Fats soluble vitamins 395 Fecal streptococci 59 Female condom 615 Fenthion 123 Fertility rates 469 Fertilizer 103 Filariasis 153, 319 Final treatment of disinfection of sewage 79 Financial allocation 325 First aid appliances 94 line drugs 334 stage larva 321 vaccine developed Fish tapeworm 255 Fixed-dose combinations 287 Flat type of smallpox 175 Fluorine 57 Flush cistern 77 Fly control measures 115 Focus group discussion 454, 565 Folic acid 397 Food and nutrition 388, 389 animal transmitted 251, 253 fortification 416 hygiene 423 poisoning 228, 353 preservation 404 production data 413 security 428 Ford foundation 661 Foreign bodies 652 Formal presentation methods 565 Formalin 124, 165 Formative influence 132 Formulation of hypothesis 39 research hypothesis 456 Fortification of essential foods 428 Francisella tularensis 338 Frequency curve 436 distribution table 435 measures 24 polygon 436 table of qualitative data 435 Fumes 87, 100 Fumigation 109, 156 Functions of family 132 PHC 535 under-fives clinic 590 WHO 657 Fungal infections 282 G Gambusia affinis 113 Gandhi Memorial Leprosy Foundation 269 Gaseous pollutants 99, 100 Gastrointestinal anthrax 671 tract 88 Gender development index 523 Genetic configuration constitution 145 Genital molluscum contagiosum 272 pediculosis 272 scabies 272 ulcer 293 Genital warts 272 Geographic information system 21 Geometric progression method 468 Germ theory of disease German measles 170, 184 Gestational hypertension 367 Giardia lamblia 228 Giardiasis 237 Glaucoma 378, 379 Global advisory committee on vaccine safety 193 health targets 551 magnitude 377 warming 105 Glossina morsitans 114 palpalis 114 Glucose 218 Glycated hemoglobin 373 Gonorrhea 272, 275 Government Health Organization 498 Granuloma inguinale 272, 277 Great sanitary awakening Group allocation design 39 Growth chart 3, 586 monitoring 586 rate 461 Guillain-Barré syndrome 193 Guinea worm 258 H H1N1 influenza 174 in humans 174 in pigs 174 Haddons matrix 375 Haemophilus influenzae 193 Handflush water seal latrine 75 Hard ticks 119 Hardness of water 57 Health administration and management 476, 489 care 532 of community 531 wastes 663 economics 524 education 92, 116, 156, 163, 199, 268, 278, 302, 506, 536, 556, 561, 563 equity 551 financing 528 infrastructure insurance 506 legislation 506 manpower planning 487 production 482 map 27 organization in rural areas 499 urban areas 499 planning 476 in India 477 Policies and Sustainable Health Systems 552 Policy 476 Problems in India 532 promotion 9, 92, 146, 197, 358, 556, 586, 635 protection 589, 635 service development 657 planning statistics 512, 517, 657 status of school children 633 Teaching and Health Education 634 team leadership workers 539 Heart diseases 174, 369 Heat cramps 47 exhaustion 46 stroke 46 Helminthic infections 282 Hemoglobinuria 314 Hemorrhagic smallpox 175 Hepatitis A 238 with hepatic coma 27 without hepatic coma 27 B 240 vaccination 243 C 243 D 243 E 244 G 244 Hepatocellular toxicity 200 Heptachlor 121 Herd immunity 156 Herpes progenitalis 272 Hexachlorocyclohexan 122 High atmospheric pressure 47 prevalence of communicable diseases 532 Hind Kushth Nivaran Sangh 269 History of caries epidemic 677 HIV and kala-azar coinfection 334 testing 283 vaccine 287 viral load 283 Hodgkin’s disease 144, 357 Hookworm 257 Hormonal methods 611 Horrock’s test 63 House drainage 77 Housefly 115 HPV testing 360 Human development index 523 health 106 immunodeficiency virus 280 monkeypox 177 nutrition 388 poverty index 523 resource development 494 Hydatid cyst 254 Hydrogen sulfide 99 Hymenolepsis nana 256 Hyperparasitemia 314 Hypertension 174, 365, 644 Hyperthermia 314 Hypochlorites 165 Hypoglycemia 314 Index Fungi 12 Fungus infections 302 I Ice lined refrigerator 598 Identification of cases of disease 161 IEC training scheme 573 Immunization 163, 189, 197, 219, 232, 328, 339, 602 of contacts 162, 286 program 505 schedule 596 Impaired consciousness/coma 314 Implementation of National Nutrition Policy 430 Inactivated vaccine 288 whole cell vaccine 232 Incubation period 18, 157, 172, 180, 196, 216, 234-236, 241-244, 274-277, 302304, 327, 330-334, 339-344, 348-350 Indalone 124 Indeterminate leprosy 262 Indian Council of Medical Research 43 Red Cross Society 692 Systems of Medicine and Homeopathy 484 Indications for Passive Immunization in Emergencies 687 697 Textbook of Preventive and Social Medicine 698 Indicators of provision of health care Indirect air-borne 166 hemagglutination 236 standardization 473 transmission 154, 160 Induced malaria 311 Infant mortality rate 577 parasite rate 309 Infectious disease 157 morbidity 18 Infective hepatitis 153 Infectivity rate 322 Influenza 153, 170 Infrared radiation 85 Inguinal swelling 293 Inhalational anthrax 671 Injectable killed whole cell vaccine 219 Innate defense mechanisms 147 Insect growth regulators 113 Insecticide 56, 120, 158 resistance 125 spray 116 Inspiratory whooping 190 Integrated Child Development Services 420, 600 Counseling and Testing Center 290 Disease Surveillance Project 382 financial envelop 594 Management of Childhood Illness 385 Noncommunicable Disease Control Program 483 Rural Development Program 429 Vector Management 112, 317 Internal atmosphere 45 International Aircraft Regulations 328 Classification of Diseases 26 Day for Disaster Reduction 692 Death Certificate 467 Diabetes Federation 373 Sanitary Conference 654 Vaccination Certificate 328 Interval scale 435 Intestinal amebiasis 235 anthrax 349 malaria 305 Intestines 196 Intradermal schedule 346 test 234 Intramuscular schedule 346 Intrauterine devices 608 Intravenous drug users 281 rehydration 218 Introduction of new pathogen 168 semisolids 585 Invasive cervical cancer 284 Investigation of contacts 162, 286 and source of infection 163 Iodine 63, 165, 394 deficiency 418 disorders 426 Iodization of salt 421 Ionizing radiation 86, 164, 405 Iron absorption 417 deficiency 415 anemia 416 nutritional anemia 426 supplementation 417 Ischemic heart disease 362 Isolation 158, 163, 192, 199, 264, 274, 286 of Bordetella pertussis 190 of virus 185 Itch mite 119 Ivermectin 324 J Janani Suraksha Yojana 583 Japanese encephalitis 330 virus 331 Jaundice 314 John Snow’s Classic Study on Cholera Epidemic 36 Jungalwalla Committee 486 Juvenile delinquency 644 K Kala-azar 333 Kaposi’s sarcoma 284 Kartar Singh committee 486 Kashi Kushth Seva Sangh 270 Kernig’s sign 192 Kyasanur Forest disease 338, 343 L Lactobacillus acidophilus 147 Larvicidals 112 Leishmaniasis 332 Lepromatous 263 Lepromin test 261 Leprosy 153, 260 Mission 269 Organizations in India 269 vaccine 268 Leptospira interrogans 349 Leptospirosis 348 Leptotrombidium akamushi 120 Levels of health education 568 noise 106 planning 476 Levonorgestrel 615 IUD 611 Line Chart or Graph 436 Live attenuated vaccine 288 Louse borne typhus 339 Low activity wastes 104 atmospheric pressure 47 birth weight 209, 577, 581 Lower abdominal pain in females 293 chest wall indrawing 210 Lymphogranuloma venereum 272, 276 M MacConkey’s broth 58 fluid medium 58 Madrid Classification 262 Magnitude in India 377 Main causes of iodine deficiency in India 419 Mainstreaming of AYUSH 547 Major blinding disorders 378 causes of maternal mortality in India 578 Malaria 153, 305 Malignant hypertension 367 pustule 349 tertian malaria 305 Malnutrition 209, 532 Management of child with acute diarrhea 223 dysentery 226 persistent diarrhea 226 measles 180 sick child 387 sterility and low fertility 606 STI/RTI 290 Mansonia 112 annulifera 323 Mass Blood Survey 318 Maternal and child health 505, 539, 576, 581 deaths 467 health 539 morbidity 577 and mortality 577 mortality 577, 578 ratio 577, 623 Maturation pond 80 Measles 153, 170, 179, 380 Measures of central tendency 439 dispersion 439 prevention and control 217, 235 Medical rehabilitation 483 Termination of Pregnancy Act 617 Mefloquine 312 Meningococcal meningitis 170, 191 Meningococcemia 191 Menstrual induction 616 regulation 616 Mental disease 644 health 511, 516, 642 care 646 Methane 105 Methods of family planning 607 sewage disposal 79 surveillance 384 Methoxychlor 122 Methyl bromide 124 N Nasal swab test 672 Nasopharyngitis 191 National AIDS Control Organization 283 Program 288 anti-malarial program 312, 317 Cancer Control Program 361, 483 Diabetes Control Program 374 Disease Surveillance Network 512, 517 Drinking Water Mission 65 Family Health Survey 627 Welfare Program 620 Filaria Control Program 325 Health Committees 485 Planning 478 Policy 502, 507 Programs 537, 541, 549 Immunization Day 249 Program 596 legal Services Day 142 leprosy Eradication Program 270 malaria Control Program 313 mental Health Program 483, 647 NGOs 631 Nutrition Policy 424 Programs 419 Nutritional Anemia Prophylaxis Program 423 Population Policy 629 Program for Control of Blindness 381, 550 Maternal and Child Health 591 Rural Health Mission 595 Sample Survey 465 STD Control Program 278 Vector Born Disease Control Program 313 Water Supply and Sanitation Program 550 Natural Disaster 690, 684 Management in India 690 ventilation 51 Nature of disease immunity 198 soil 46 Neisseria gonorrhoeae 275 meningitides 192, 193 Neonatal deaths 467 mortality rate 577 tetanus 351 Nerve tissue vaccines 345, 347 Nervous system 150 Neurotic disorders 644 New drug development process 41 Niacin 396 Nicotinic acid 396 Nitrates 57, 59 Nitrous oxide 105 Noise pollution 99, 106 Nominal scale 434 Non-agglutinating vibrios 215 Non-bacterial food poisoning 228 Noncholera vibrios 215 Noncommunicable disease 542 Nongonococcal urethritis 272 Non-governmental organizations 692 Nonparalytic aseptic meningitis 245 Nonscalpel vasectomy 618, 626 Nonspecific bacterial infections 170, 186 viral infections 170 Normal curve 441 Nosocomial infection 159, 674 Nosopsyllus fasciatus 116 Notification of diseases 465 Null hypothesis 443 Nutrition 388, 481 policy instruments 427 Status of India 425 Nutritional anthropometry 411 blindness 379 deficiency states 413 status 13, 148, 210, 639 Index Microfilaria density 322 rate 322 Mid-upper arm circumference 412 Mid-day Meal Program 421 Mifepristone 615 Mild protein-energy malnutrition 415 Milk and milk products 398 borne diseases 399 Mineral oils 113 Mini nutritional assessment 639 Minimum needs program 479, 549 wage administration 430 Minipill 613 Mites 119 Mode of spread 232, 235, 275 transmission 161, 172, 188, 195, 216, 239, 241, 244, 247, 256, 274, 311, 323, 329, 334, 339-341, 344, 350 Model registration system 466 Moderate protein-energy malnutrition 415 Modified District Cancer Control Program 361 Moist heat 164 Moniliasis 272 Monitoring of nutrition programs 429 situation 431 Monounsaturated fatty acids 391 Monovalent vaccines 250 Mop up immunization 249 Morphological index 266 Mortality indicators rate 159 Motivation of eligible couples 622 Motor accidents 374 vehicle accidents 374 emission control 102 Movement of air 47 Mudaliar committee 485 Mukherjee committee 486 Multi-drug resistant tuberculosis 206 therapy 265 Multi-factorial causation of disease Multifactorial disorders 145 Multiple tube technique 58 Mumps 170, 182 Mushroom poisoning 228 Mycobacterium leprae 260, 561 tuberculosis 195 Mycoplasma pneumoniae 186 Myocardial infarction 652 O Obesity 370, 393 Occult filariasis 320 Occupational Hazards 91 Health 513, 518 Legislation 93 Services 506 O-Chlor-diethylbenzamide 124 Ocular leprosy 380 Odor elimination 75 Onchocerca volvulus 321 Onchocerciasis 379, 382 Oral cancer 675 candidiasis 676 cholera vaccine 219 contraceptive 367 pills 206 diseases 675 glucose tolerance test 373 Health Programme 483 hygiene 149 mucosal diseases 676 polio vaccine 249 rehydration salt solution 217 solution 223 therapy 217, 218 Ordinal scale 435 Organic sulfides 99 Organizational structure 383, 656 Organochlorines 122 Organophosphorus toxicity 123 Oropharyngeal candidiasis 284 Orthotolidine arsenite test 62 test 62 Oseltamivir 174 Oxidation ditch 79, 80 pond 79 699 Textbook of Preventive and Social Medicine 700 Oxides of nitrogen 99 Ozone 62, 99, 105 P Painful swelling of joints 318 Pan American Sanitary Bureau 654 Panchayati Raj 500 Pantothenic acid 397 Pap smear 360 Pappataci fever 332 Paragonimus westermani 252 Paralytic poliomyelitis 245 Parasite demonstration 333 Paratyphoid fevers 233 Paroxysmal stage 190 Pasteurella tularensis 102 Pediatric morbidity 579 and mortality 579 mortality 579 Pediculus capitis 117 corporis 117 Pelvic infection 610 inflammatory disease 610 Pentachlorophenol 121 Perforation of uterus 610 Performance of Family Welfare Program 483 Perinatal deaths 467 mortality rate 471 transmission 281 vaccine 287 Period of communicability 162, 215, 241, 247, 274, 311, 323, 327, 330, 334, 342, 344, 350 infectivity 231 Periodic abstinence 607 fluctuations 19 health check-up 92 Periodontal disease 676 Peritoneum 196 Permanent carriers 231 disease 645 Permucosal spread 241 Persistent diarrhea 222 generalized lymphadenopathy syndrome 282 Personality disorders 644 Pertussis 687 Pesticides 103 Phases in management of disasters 681 Phenoxymethylpenicillin 365 Phthirus pubis 117 Phylum arthropoda 109 Place distribution 30 Plague in India 337 Plan Health Services 24 Planning of health education 568 methods 31 Plasma glucose 314 Plasmodium vivax 305 Pneumococcal polysaccharide vaccine 186 Pneumoconiosis 90 Pneumocystis carinii 282 Pneumonia 170, 210, 211 Pneumonic plague 335 Poecilia reticulata 113 Poison baiting 109 Polio 153 eradication 248, 249 Poliomyelitis 244 Poly unsaturated fatty acids 391 Polyarthralgia 364 Polyarthritis 364 Polygamy 133 Polynuclear aromatic hydrocarbons 57 Population pyramid 468 stabilization 503 Pork tapeworm 253 Post kala-azar dermal leishmaniasis 333 Postconceptional methods 616 Postexposure prophylaxis 291 Postpartum Program 623, 626 Post-tussive Vomiting 190 Potassium chloride 218 permanganate 64, 165 Prenatal period 577 Presumptive coliform count 58 Prevalence of mental illness 642 tuberculosis infection 194 Prevention of adulteration 424 blindness team 382 deafness and hearing impairment 483 disease in man 345 fly entry 75 fly escape 75 food adulteration 429, 505 infection 118 LBW 581 mosquito bites 114 occupational diseases 92 radiation hazards 86 vitamin A deficiency 422 Preventive vaccine 287 Primary chemoprophylaxis 199 disease 645 health care 532, 533 center level 543 facilities 480 hypertension 366 syphilis 274 Principles of chemotherapy 199 communication 563 compliance 459 health education 561 promotion 557 immunization 148 public domain 459 rehydration 217 totality of responsibility 459 Production of vaccines 600 Progestasert IUD 611 Progestin-only pill 613 Prognostic tests 283 Program Against Micronutrient Malnutrition 483 Progressive disease 645 varicella 177 Promoting consumption of vitamin A rich food 422 Promotion of mental health 92 Protein 389 energy malnutrition 414, 426 Protozoal infections 282 Pseudomonas mallei 349 pseudomallei 338 Psychological stress 363 Psychosomatic diseases 353 disorders 644 Psychotic disorders 644 Pubic louse 117 Public Distribution System 429 health implications 54 nutrition 388 package 529 software 27 interest litigation 143 private mix 207 Pulmonary anthrax 349 edema 314 hypertension 367 tuberculosis 202, 368 Pulse polio immunization 248 Purification of pond 63 tube well 63 water 59 Pyrethrum 121 Pyridoxine 397 Q Q fever 343 Qualitative research methods 451 Qualities of good contraceptive 606 Quantitative research methods 451 Quartan malaria 305 Quasi-experimental design 37 studies 457 R Rabies 153, 343, 687 in dog 343 in man 343 Radioactive pollution 99, 104 Rain water pipes system 78 Rajiv Gandhi Gramin LPG Vitarak Yojana 70 Shramik Kalyan Yojana 97 Rapid Diagnostic Test 306, 313 Household Survey 627 Plasma Reagin Test 273 sand filter 60 Rat bite fever 348 destruction 109 elimination 108 Ratio scale 435 Rattus norvegicus 107 rattus 107, 336 Raw sewage disposal 78 Recombinant vector vaccines 288 Recommended protein intakes for Indians 390 treatment regimens 266 Recycling of wastes 71 Red cross 661 Reducing mosquito-man contact 328 vector population 327 Reduction of individual exposure 105 noise production 84 transmission 84 Refuse disposal 72 Registration of Births and Deaths Act 142 Rehabilitation 10, 93, 147, 269, 590 Relapsing fever 117, 341 Relative bradycardia 230 Removal of fluorides, iron and arsenic 65 hardness 64 Renal malaria 305 Repeat bites 347 Reproductive tract infections 292, 594 Research methodology 450, 457 Resistant hypertension 367 Respiratory allergy 353 isolation 158 passages 162 rate 210 system 88, 149 Restriction of conception in women 146 Retinopathy of prematurity 36 Revised Draft National Policy 507 National Tuberculosis Control Programme 200 Rheumatic fever 363 heart disease 363 recurrence 364 Rheumatoid arthritis 243, 644 Riboflavin 396 Rickettsia orientalis 120 prowazekii 117 typhi 340 Ridley’s Jopling Classification 262 scale 266 Rifampicin 266 Rimantadine 174 Ringworm 302 Rockefeller foundation 661 Rodenticide 160 Role of Civil Society 511, 517 disposable and autodisabled syringes 664 emergency contraceptive pills 616 Local Self-government Institutions 510, 515 Routes of transmission 281 Rubella 170, 184 Rural Health Scheme 538 Training Centers 537 Primary Health Care 480, 534 S Safe abortion services 540 motherhood consultant 625 period method 607 Safety of mumps vaccine 183 smallpox vaccination 176 yellow fever vaccine 328 Salmonella gastroenteritis 228 infection 228 typhi 231 Sample registration system 465 Sandfly fever 332 Sanitary latrine 69, 74 well 54 Sarcoptes scabiei 119 Saturated fatty acids 391 Scabies 153, 304 Schemes under NCCP 361 Schick test 188 School Health Program 505, 634 Service 536, 540, 633 Screening Programme 382 Scope of Family Planning Services 605 Scorpions 118 Screening methods 359 Scrotal swelling 293 Scrub typhus 340 Second stage larva 321 Secondary attack rate and attack rate 25 chemoprophylaxis 199 health care 482, 533 hypertension 366 syphilis 274 Secular fluctuations 19 Sensitivity of tuberculin test 198 Septic tank 75, 79 Septicemic plague 336 Serum alkaline phosphatase 239 bilirubin 238 transaminases 238 Severe acute respiratory syndrome 238 anemia 314 dehydration 224 malaria 314 malnutrition 415 pneumonia 210 Sewage disinfection 79 farming 79, 80 Sewerage system 77 Sexual intercourse 281 Sexually transmitted diseases 272, 292 infections 292 Shake test 599 Shallow pit latrine 74 Shrivastav Committee 486 Simple random sampling 442 Single gene disorders 145 Skill development initiative scheme 98 Skin and mucous membranes 162 infections 318 Slaughtering of animals 89 Slow sand filter 60 Smallpox 170, 175 eradication 176 Snail transmitted helminths 251 Social causes of disease 134 medicine 2, Socioeconomic status 133, 378 Sodium bicarbonate 218 chloride 218 fluoride 124 Soft sore 276 ticks 119 Soil transmitted helminths 256 Solid waste 71 disposal 100 Source of infection 160, 187, 191, 192, 195, 215, 231, 260, 273, 301 and period of infectivity 275 pollution 47, 100 protein in diet 390 water pollution 102 Index Quaternary ammonium compounds 165 Quinine 314 701 Textbook of Preventive and Social Medicine 702 Special Nutrition Program 420 Specific bacterial infections 170, 186 viral infections 170, 175 Spectrum of disease 19 iodine deficiency disorders 419 Spermicidal methods 608 Spot test 421 Spread of infection 184 Sputum smear examination for AFB 202 Stabilization pond 79 Stage of collapse 216 disease in man 16 invasion 343, 348 paralysis 343 Staphylococcus aureus 178, 228 Starch iodide test 62 Starchy vegetables 402 State Health Directorate 499 Ministry of Health 499 of Public Health Infrastructure 509, 514 Status epilepticus 652 of AIDS vaccine 288 STD 153 control on large scale 277 syndromes 293 Steps of growth monitoring 588 Sterilization 618 bed scheme 626 Stomach poisons 124 Stop global epidemic of chronic disease 382 Storage and discharge of radioactive waste 104 Strategies for Immunization 687 Measles Mortality Reduction 181 Polio Eradication 249 Streptococcal sore throat 170, 186 Streptococcus pneumoniae 186 Strongyloides stercoralis 258 Subcutaneous nodules 364 Subjective global assessment 639 Sub-national immunization day 249 Subunit vaccine 288 Sulfonamides 312 Sulfones 312 Sulfur dioxide 49, 99, 100, 124 Sullage disposal 81 Sulphonamides 235 Supply of laparoscopes and tubal rings 626 Surface infections 167 water 52 Surveillance of disease 160 fever 384 Swimming pool hygiene 65 Swine flu 174 Syndromes under surveillance 384 Synthetic insecticides 113 peptide vaccine 288 Syphilis 272, 273 T T test 445 Taenia saginata 253 solium 253 Tarapox 176 Tatera indica 336 Teaching methods 565 Terminal disinfection 156 Tertiary Health Care 482 Tests of free chlorine 62 Tetanus 153, 350, 687 immune globulin 351 Thermal pollution 99, 105 Thiamine 396 Third National Family Health Survey 627 stage larva 321 Three types of diarrhea 222 Thyrotoxicosis 644 Tick typhus 341 Tinea barbae 303 capitis 303 circinata 303 corporis 303 cruris 303 pedis 302 unguium 303 Tissue culture vaccines 346 Total fertility rate 470, 623 Totally drug resistant tuberculosis 207 Toxaphene 121, 123 Toxic substances 57 Trachoma 153, 301, 379 Trained dais 538 Training infrastructure 603 need assessment 564 of eye care team 381 of PHC staff 648 Transmission of diseases 110 infectious agents 153, 160 influenza viruses 172 Transovarian transmission 154 Treatment of hypertension 368 malaria 312, 318 MDR-TB 207 paralytic poliomyelitis 245 severe malaria cases 314 vitamin A deficient child 422 Trench fever 117, 340 Trichinella spiralis 255 Trichomonal vaginitis and urethritis 276 Trichomoniasis 272 Trichuris trichiura 257 Trombicula akamushi 341 Trombiculid mite 120 True experimental design 37 Trypanosoma cruzi 118 gambien 114 Tsetse flies 114 Tsutsugamushi fever 340 Tubectomy 618 Tuberculin test 198, 202 Tuberculoid 262 Tuberculosis 170, 193 isolation 158 Tunga penetrans 116 Types of Cohort Study 34 Descriptive Study 31 Drug abuse 645 Emergency Contraception 615 Epidemiological Study 28 Evaluative Study 29 Experimental Studies 37 Family 132 HIV vaccines 288 hypertension 366 influenza vaccines 173 Mental Disorders 643 radiation 86 soil pollution 103 Surveillance 20, 383 water pollutants 102 Typhoid 230 Typical infection 155 U UIP plus 600 Ulipristal acetate 615 Ultraviolet light 62 radiation 85 Uncorrect refractive error 378 Under five clinic 590 mortality rate 471, 577 Undisinfected water 59 Units of energy 406 Universalization of Primary Education 481 Unspecified viral hepatitis 27 Upper respiratory tract 365 Urban Family Welfare Centres 549 Malaria Scheme 318 Primary Health Care 480, 548 Revamping Scheme 549, 626 Urethral discharge 293 Urinary tract infections 577 Uses of catalytic converters 48 chemoprophylaxis 315 epidemiology 36 low beam headlights 375 proper glass in wind screen 375 repellents 114 V Vaccination 176, 339 technique 197 Vaccine 175, 186, 193, 240, 332, 360 derived polioviruses 249 for cholera 219 reaction 596 vial monitor 599 Vacuum System 51 Vaginal bleeding 583 carcinoma 37 discharge 293 ring 614 sponge 608 Varicella 170, 177 zoster immunoglobulin 178 Variola 170, 175 sine eruption 175 Vasectomy 618 VDRL test 273 Vectors of Mlaria in India 306 Vegetable foods 390, 398 Venereal diseases 272 Venous plasma glucose 373 Ventilation 50 Vibrio cholerae 59, 102, 215 parahaemolyticus 228 Village Health Guide Schemes 626 Viral hepatitis 238 A 687 B 687 Virus 12, 56 B hepatitis 272 isolation 172, 283, 344 Visceral leishmaniasis 333, 334 Vision 2020 382 Vitamin 395 A 395 deficiency 417, 426 B complex 396 B1 396 B12 397 B2 396 B5 397 B6 397 C 397 D 395 E 395 K 396 Vomiting 228 W Waist and hip circumference 412 Warm chain 600 Water and food-borne infections 167, 168 closet 77 hardness 363 pollution 99, 102 soluble vitamins 396 supply 69, 635 Weil’s disease 348 Wheat Based Nutrition Program 604 White coat syndrome 367 Whooping cough 153, 170, 190 Wool-Sorter’s disease 349 World bank assistance 382 Food Day 432 Health Assembly 656 Organization 655 Mental Health Day 648 Population Day 463 Worm infections 251 Wuchereria bancrofti 321 Index standard deviation 440 Surveys 452 Syringe Hub Cutter 668 ventilation 50 X XDR-TB 208 Xenopsylla cheopis 116 X-ray chest 202 Yang and Yin principle Y Yates’ correction 448 Yaws Eradication Program 304 Yellow fever 326 in India 327 Yuzpe regimen 615 Z Zanamivir 174 Zidovudine 291 Zila Saksharta Samitis 626 Zinc phosphide 109 Zoonosis 161, 343 703 ... revise Mahajan & Gupta Textbook of Preventive and Social Medicine Contents PART I: GENERAL Evolution of Preventive and Social Medicine • Historical Background 1; • Public Health, Preventive Medicine, ... Rauf, Professor and Head, Department of Social and Preventive Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India Mahajan & Gupta Textbook of Preventive and Social Medicine. . .Mahajan & Gupta Textbook of Preventive and Social Medicine In their Esteemed Opinion “ I congratulate you for your bold and strenuous effort in bringing out the Textbook of Preventive and Social