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8 Medicine
(A) 0.17
(B) 1.1
(C) 2.1
(D) 3.1
ANSWERS
1. (A) Daily
(Ref: Park: Textbook of Preventive and
Social Medicine, 20th edition, pages 627,
628)
The question is definitely incomplete. The question
should be like this “How frequently should the
well water in a village be chlorinated during
epidemics of cholera?”
Park quotes that: “During epidemics of cholera,
wells should be disinfected every day.” This
clearly implies that while there is no epidemic,
daily chlorination is not recommended. Provided
with “Daily” as answer from VYAPAM, I
suppose, the examiner missed the phrase
“epidemics of cholera” in the question.
Also Know
• Most effective and cheapest method of
chlorination of wells is by bleaching
powder.
• Chlorine demand of well water is estimated
by Horrock’s Apparatus.
• Roughly 2.5 gms of bleaching powder is
required to disinfect 1000 lit of water.
• This will give an approximate dose of 0.7
mg of applied chlorine per liter of water.
• A contact period of 1 hr. is allowed before
the water is drawn for use.
• At the end of 1 hr., the residual chlorine is
tested by “ORTHOTOLIDINE
ARSENITE TEST”.
• If free residual chlorine level is less than
0.5 mg/litre, the chlorination procedure
should be repeated before any water is
drawn.
2. (B) Ahmedabad
(Ref: http://icmr.nic.in/institute.htm#Perma-
nent% 20Institutes/Centres)
Community Medicine 85
4. (C) 2.1
(Ref: Park, Textbook of Preventive and
Social Medicine, 20th edition, page 69)
Relative risk/Risk ratio = Incidence among
exposed/Incidence among non-exposed
= (27/75)/(14/81)
= 2.082 or 2.1
5. (A) Primordial
(Ref: Textbook of Preventive and Social
Medicine, 20th edition, page 39, Encyclopedia of
Primary Prevention and Health Promotion, By
Thomas P. Gullotta, Martin Bloom, page 316, 317
Table 8.1
Community Medicine 87
million units benzathine benzyl benzyl penicillin benzyl penicillin,
benzathine penicillin, IM/3wk IM/3wk IM/3wkLife long
benzyl penicillin For 5 yrs or till For 5 yrs or till
18 yrs, whichever 18 yrs, whichever is
is later later
CHILDREN: CHILDREN: CHILDREN: CHILDREN:
single IM, 600,000 600,000 units 600,000 units 600,000 units
units benzathine benzathine benzyl benzathine benzyl benzathine benzyl
benzyl penicillin penicillin,IM/3wk penicillin, IM/3wk penicillin,
For 5 yrs or till 18 For 5 yrs or till 18 yrs, IM/3wk Life long
yrs, whichever is later whichever is later
88 MP–PPG 2010
6. (C) 270
(Ref: Textbook of Preventive and Social
Medicine, 20th edition, page 488, http://
www.who.int/immunization_delivery/
vaccine_management_logistics/logistics/
expected_wastage/en/index.html)
Community Medicine 89
8. (B) 14
(Ref: Park: Textbook of Preventive and
Social Medicine, 20th edition, page 743)
If you think Park cannot commit mistakes, then I
must tell you that park has not corrected/updated
itself on this point for a very long time. As Pre
Park “The time limit for registering the event of
births is 14 days and for deaths is 7 days” which
in fact was true at the time of framing the act,
but the act has not mentioned any time frame by
itself and has provided the powers to the registrar
general of India to direct state governments and
union territories on this matter. The time frame
Table 8.2
90 MP–PPG 2010
BHORE 1946 Before 1st five year plan Integration of preventive and curative services Primary Health Centre
COMMITTEE (short term plan-1 PHC/40,000 population and long-term plan aka-
3 million plan) Social physician
MUDALIAR 1962 By the end of 2nd five year Also known as “Health survey and planning committee”
COMMITTEE plan (1956-1961) All India health services like Indian administrative services
1 PHC/40,000 population
CHADAH 1963 To study maintenance phase of Basic health workers to work as Multipurpose health workers (1/10,000
COMMITTEE malaria eradication programme population, combine for malaria and family planning)
JUNGALWALLA 1967 Committee on integration of Unified cadre, common seniority, Integrated health services No private
COMMITTEE health services practice. Equal pay for equal work, special pay for special work.
Recognition of extra qualification
KARTAR SINGH 1973 Accepted for 5th five year plan, Single cadre of multipurpose workers, i.e., MPW (Female)-Female health
COMMITTEE committee on multipurpose workers (in place of nurse/midwifes) and MPW (Male) Male health
workers under health and family workers (in place of family planning assistant)1 PHC/50,000
planning population divided into 16 subcentres (one for 3000 to 3500 population)
Contd.
Contd.
SRIVASTAVA 1975 6th five-year plan “Group on “Referral Services Complex” Medical and health education
COMMITTEE Medical Education and Support commission ROME scheme (reorientation of medical education)
Manpower” Acceptance of the recommendations of the Shrivastava Committee led to
“Rural Health Service”
KRISHNAN 1982 To address the problems of Health post run by a doctor, a Public Health Nurse, 4 Auxiliary Nurse
COMMITTEE urban health Midwives, 4 multipurpose workers and 25 Community Health Workers for
a population of 50,000.
Community Medicine 91
COMMITTEE Educational commission for health sciences (ECHS) like
UGC Health science universities, Vocationalization of education health
manpower cells at Centre and states
92 MP–PPG 2010
9. (C) Chennai,
(Ref: Q 2 of PSM)
Births/Deaths/1000 Population
Birth Rate
Death Rate
Total Population
Time
Also Know
• WHO’s measles elimination strategy
comprises a three part vaccination strategy,
i.e., catch-up, keep-up and follow-up.
Table 8.3
94 MP–PPG 2010
High stationary stage Early expanding stage Late expanding stage Low stationary Declining
stage
Birth rate high Birth rate high (remains Birth rate begins to fall Birth rate low Birth rate lower than
unchanged) death rate
Death rate high Death rate falling Death rate falling Death rate low
(declines further)
Population growth slow Population increasing Population increasing, Population stable Population growth
but less rapidly (Total Fertility negative (sub-
Rate <2.5) replacement
fertility<2.1)
India till 1920 Afghanistan, Palestinian, (Developing countries) (Industrialized nations) Germany, Hungary,
(pre-industrial society) Bhutan, Laos, Sub-Saharan India, South Africa, Asia Europe, USA, Russia
Africa (except South Africa) (except China) Canada, China,
Singapore, Australia,
New Zealand, Brazil,
South Korea, Turkey,
Mauritius
Community Medicine 95
13. (D)150-200
However in my opinion it should be (a) 40-50.
Decision of High Court of Madhya Pradesh on
this matter is awaited. Hallelujah!!!!
96 MP–PPG 2010
(Ref: http://www.un.org/ecosocdev/geninfo/
sustdev/waterrep.htm, EARTH SUMMIT
+5, UN Assessment of Freshwater Resources
“High-intensity use in urban and industrial areas
may place severe stress on fresh water resources
in surrounding localities. The Assessment reports
an estimated household consumption in industrial
countries of 150 to 200 litres of water per day,
with an additional 150 to 200 litres per person per
day going for various municipal services.
Additional conservation measures could reduce
the per capita amount of usage. But in the
developing countries, it can be anticipated that
current per capita usage, which is about 50 litres/
person/day in many urban areas, is sure to
increase in the coming years. This will necessitate
additional water-treatment capacity and improved
water management capacity.”
(Ref:http://ddws.nic.in/popups/Rural
DrinkingWater 2ndApril.pdf Rajiv Gandhi
National Drinking Water Mission)
National Rural DrinkingWater Programme;
Annexure 1, A. Norms for Providing Potable
Drinking Water in Rural Areas “40 litres per
capita per day (lpcd) for humans to meet the
following requirements based on basic minimum
need as defined under the ARWSP guideline.”
Purpose Quantity (lpcd)
Drinking 3
Cooking 5
Bathing 15
Washing utensils 7
House ablution 10
Total 40
(Ref: Guidelines for drinking water quality,
2nd edition, volume 3, Surveillance and
control of community supplies, World Health
Organization Geneva, page 74)
“Measurements of the volume of water collected
or supplied for domestic purposes may be used
Community Medicine 97