Review of Preventive and Social Medicine (including Biostatistics) (7th Ed.) – Jaypee Brothers Medical

958 Pages·2016·11.64 MB·English

by  V. (2015)

Review of
Preventive and
Social Medicine
(Including Biostatistics)
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(Thoroughly revised and updated edition including latest exam pattern questions)
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Seventh Edition
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Vivek nJain
MBBS (Maulana AzUad Medical College), Delhi
MD Community Medicine (PSM) (Lady Hardinge Medical College), Delhi
Ex Senior Resident UCMS & GTBH, VMMC & SJH, Delhi
Ex Facult-y GFIMSR, Faridabad, Haryana
Ex Consultan t UN Office on Drugs & Crime, South Asia
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The Health Sciences Publisher

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© 2015, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those
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in question. However, readers are advised to check the most current information available on procedures included and check information from
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Inquiries for bulk sales may be solicited at: [email protected]
Review of Preventive and Social Medicine (Including Biostatistics)
Third Edition: 2011
Fourth Edition: 2012
Fifth Edition: 2013
Sixth Edition: 2014
Seventh Edition: 2015
ISBN : 978-93-5152-730-5
Printed at
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Preface
Dear Students,
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Let me first thank you for your overwhelming support to the 6th edition of the book, making it the best-seller book on the subject
in India. It again reiterates my belief that good content by a subject-speciality author is always appreciated by students. It now
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gives me immense pleasure to share with you the NEW (Seventh) edition of the book.
Key features of Sixth edition retained in Seventh edition V
• Theory given at start of each chapter (Theory divided chapter-, topic-, sub-topic wise – Small/one-liner points in each
topic/Important previous MCQs marked as Q) d
• Key REVISION Points given on side of each topic for MUST-KNOW MCQs facts
• New NBE based pattern has been adopted chapter-wise (Focus one wider coverage, concept development, one-liner
approach, value-based MCQs, applied aspect MCQs, image based MCQs, updated golden points)
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In the 7th edition of the book following NEW ADDITIONnS have been done to make a student stay ahead in this
competitive era with changing pattern of Examinations:
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• Additional PICTURE MCQs with Answers (According to Recent Examinations)
• Recent most solved MCQs papers
– AIIMS May/November 2014, PGI May/N ovember 2014, JIPMER PG 2014, Bihar PG 2014, APPG 2014
– ALL Recent Questions 2013, 2014 -
• Recent/New topics and changing conce pts in PSM
– New National Immunisation Sche9dule 2015
– New Health Programmes: RBSK, NSSK, JSSK, RKSK, PMJDY, PMSSY, NUHM
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– New Strategies (RMNCH+A, BeMONC, CeMONC, End-TB, AMMRS)
– New Acts, Policies (NMrHP 2014, FSSA 2006, POCSO 2012)
– Newer/Emerging Diseases (H7N9, Ebola, MERS-CoV)
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– New Changes in RhTI/STI Treatment 2015 (STD color kits, Suraksha clinic)
– New Malaria Treatment Guidelines 2013
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– New PPTCT Guidelines 2015 (Triple ARV Prophylaxis)
– New Rabies Prophylaxis Guidelines 2015 (Essen, Thai Red Cross Regimen)
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– New Protein Quality Assessment Guidelines 2015 (DIAAS)
– New AN visits, PN visits Guidelines
– Changes in Epidemiology of Various Diseases
– Changes in National Health Programmes (NRHM, MDMP, JSSK, HNBC, ICDS)
– New Clinical Trial Guidelines (Phase 0)
– New NACP Guidelines (HIV district classification, LAC, LAC PLUS, ART PLUS)
– Twelfth Five Year Plan 2012–17
– New Establishments (NIDM, NDRF)
• New Annexure: HLEG on UHC (Recent Examinations based)
• An Updated compilation of Public Health Statistics of India
• Rural Health Statistics India 2014
• Other New Inclusions/Upcoming Topics: Triangle of Epidemiology and Advanced Model of Epidemiological
Triangle, Health Promotion, Matrix of Levels of Prevention, Diluents, VVM in Vaccines, NEW DRAFT PROPOSED
Biomedical Waste Management Guidelines, 2011, HDI New Calculation Guidelines, DALY, QALY, YPLL, New
Sterilisation Guidelines 2013, New Cardiovascular Risk Indicators (Waist Height Ratio), New Semen Analysis
(WHO) Guidelines, Newer Visual Impairment Guidelines.
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Review of Preventive and Social Medicine
‘Understanding PSM is difficult, owing to the vastness of the subject, but enjoyable, if you come across a good teacher and a useful book!’
A student
While preparing for PG entrance examination, I myself realised that most of the PSM MCQs, related text and even the
referenced answers given in books were invariably unable to satisfy me as a student. Most of the times, there were questions
from ‘topics not given in standard textbooks’ (for example, nested case control study, case series report, statistical errors, probability,
odds and likelihood ratios, health legislations, water washed diseases, golden rice, COPRA, Punnett square, Dixon’s Q-test,
Evidence based medicine, etc.—all together are just the tip of an iceberg of such MCQs). Every year there were ‘new unheard
questions from unexplored fields’, overlapping choices of MCQs from other fields of medicine accompanied with futile search for
‘recent most data of Public Health Statistics’, etc. This all made me realise that PSM is a vast and varied subject to conceptualise and
memorise. Elaborate books also confused me regarding the relative importance of each topic in the subject. I also realised that
students face maximum difficulty in understanding the concepts of ‘Biostatistics’ and in obtaining precise, concise and useful
data from ‘National Health Programmes of India’.
Also, PG entrance examinations have a sizeable chunk of direct MCQs from PSM subject (Just 1 subject out of 19 total
subjects), ranging from 10 to 14% of total (20–25% in CMS-UPSC). Moreover, PSM helps in solving several allied questions
(partly or totally) of Paediatrics, Obstetrics, Pharmacology, Medicine, Microbiology, Ophthalmology, etc.
So, there is no denying the fact that ‘PSM is of paramount importance’ to successfully tackle any PG Entrance Examination.
Thus, I have written this book keeping a student’s, a teacher’s and an examiner’s perspective in mind.
Each chapter has been divided into topics and sub-topics, Theory and MCQs have been arranged section-wise for more
comprehensive understanding of topics. In Theory, Important previous years MCQs have been highlighted (asQ) and MUST-
KNOW facts have been given separately. Book includes PG Entrance Examination MCQs of AIIMS (1991–2014) and AIPGME
(1991–2012 + ‘Recent MCQs’) with referenced, authenticated, full explanatory answers. Solved explanatory MCQs from DPG,
PGI, JIPMER PG Entrance Examinations (2000–2011) have been added to help students grasp subject better. Over 2500 solved
MCQs from UPSC CMS and Several State Medical PG Entrance Examinations (Rajasthan, MP, Andhra Pradesh, Tamil Nadu,
Maharashtra, Bihar, DNB, JIPMER, Kolkata, Karnataka PGMEE) have been added for wider coverage. Recent most changes in
National Health Programmes with updates in Communicable and Noncommunicable diseases provided for competitive edge.
Many answers have been followed by a section on ‘Also Remember’—A compilation of various important noteworthy
points based on previous questions from several fields. Golden Points (Five sets) have been included for a quick revision just
before the examination. Several Annexures (Incubation period and modes of transmission of diseases, important days of public
health, instruments of importance in public health, important health legislations and programmes in India, Vectors, NHP 2002
and NPP 2000, proposed BMW guidelines and public health related statistics of India) have been included towards the end of
the book to give the student an edge over others.
Please remember there is no substitute to theory books, but hopefully you will find all relevant theory in this user-friendly
book.
Despite every possible effort been undertaken to ensure no technical or typographical errors in the book, such are bound to
be present in any book. If you come across another such error or if you have any comment, suggestions, queries or views, you are
most welcome to e-mail to me for a prompt response. All contributions will be duly acknowledged. Do share your experiences
while reading this book and the subject.
Hope you have a successful career ahead.
Wish you Success, not just in PSM but in Life!
Dr Vivek Jain
MBBS MD (Community Medicine)
Email: [email protected]
[email protected]
Visit website: www.docvivekjain.hpage.com
Join me on Facebook: type ‘Dr Vivek Jain’ in search box
For updates: Like ‘Dr Vivek Jain’ page on Facebook
New Delhi 2015–16
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Acknowledgements
I am sincerely thankful to Late Mr RD Jain, my maternal grandfather and my wife Dr Rashmi Naudiyal for being a constant
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source of inspiration for completion of this book. Without support of Dr Rashmi and Baby Mischka, this book would not
have seen light of the day. Without the blessing of my Parents, Parents-in-law and God, this endeavour would not have been
successful. R
Firstly I thank Padmashree Dr Jagdish Prasad, DGHS for organising a grand launch of first edition of the book at New Delhi.
I am grateful to Dr Saudan Singh, former DG (Medical Education), Government of Uttar Pradesh, Director Professor and
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Head, Department of Community Medicine, Vardhman Mahavir Medical College (VMMC), New Delhi for being a source of
support, guidance and motivation for myself.
I am thankful to Dr SK Pradhan, former Director Professor, Department of Cdommunity Medicine, VMMC, New Delhi for
providing me with academic opportunities to help me understand the finer nuances of the subject throughout my PGship and
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SRship.
I also appreciate the support and encouragement by Dr DK Raut, former Director Professor, VMMC & SJH,
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Dr AT Kannan, Director Professor and Head, Department of Community Medicine, UCMS, Dr GK Ingle, Director Professor
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and Head, Department of Community Medicine, MAMC, Dr Vibhna, former Professor and Head, Department of Community
Medicine, LHMC and respected Faculty of Department of Community Medicine of these colleges respectively. Dr Rajesh Kumar,
Faculty, MAMC has always inspired me to excel academicallyU.
I am sincerely thankful to Dr P Sai Kumar, MPH (UK), for motivating me to write this book, and for his unparallel support
as my mentor. I am ever thankful to Dr Surabhi, Dr Shagun, Dr Isha and Dr Nidhi, former undergraduates and other students

of LHMC and VMMC, for helping me develop my teaching capabilities.
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Mr Rajesh Sharma, Director, PG-DIAMS and Dr Deepak Marwah, MD (Medicine) have been quite instrumental in helping

me realise my potential as an academician, and I am immensely pleased to share this book with them and thank them for their
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wholehearted support. Words of thanks to Dr Sethi and Dr Bhatia for helping me gain entry into the competitive world of
academics. 9
I am highly grateful to Shri Jitendar P Vij, Group Chairman, M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi,
India for his wholehearted support rin publication of this book. I thank Ms Chetna Malhotra Vohra (Associate Director),
Ms Saima Rashid (Project Manageri) and their Team at Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for work
on the current edition. h
Acknowledgement is also due to Mr Anurag, M/s Medical Book Store, MAMC and LHMC for his suggestions.
I also take this opportunaity to thank the following students/doctors for sharing their invaluable constructive criticisms for
the improvement of the book:
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• Dr Aarav Kumar
• Dr Abhishek Prasad Dash, Bhubaneshwar, Odisha
• Dr Afeefa Hanif, MES Medical College, Kerala
• Dr Ajeet Singh, Patna Medical College
• Dr Akanksha Jain, MVPs Dr Vasantrao Pawar Medical College
• Dr Amit Kumar Gupta, DNB Family Medicine, Maharaja Agrasen Hospital, Delhi
• Dr Amit Kumar Yadav, PTJNM Medical College, Raipur
• Dr Amit Polara, Civil Hospital, Surat
• Dr Ananta Narayan Panda
• Dr Animesh Agrawal
• Dr Ankit Madan
• Dr Ankit Thukral, SGRRIHMS, Dehradun
• Dr Anubhav Srivastava, SNMC, Agra
• Dr Ankush Koul, Darbhanga Medical College, Bihar
• Dr Anupriya Thadani, Era’s Medical College and Hospital, Lucknow
• Dr Arpan Ray, Birbhum, West Bengal
• Dr Ashutosh Sahu
• Dr Ashwini Gupta, Darbhanga Medical College and Hospital
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Review of Preventive and Social Medicine
• Dr Avi Singh
• Dr Bharat Vantekunta, Kaktiya Medical College, Warangal
• Dr Deepa Grover, GMC, Miraj, Maharashtra
• Dr Eftekhar Mohd.
• Dr Gopal Singh Bhati, SMS Jaipur
• Dr Indraneel Sharma, Guwahati
• Dr Jeyakumar Meyyappan
• Dr Jujhar Singh Mann, Rajshahi University, Bangladesh
• Dr Kumar Rohit, SKMCH, Muzaffarpur
• Dr Kunal Tatte
• Dr Lucky Singh, Kanpur
• Dr Mahanthesh Gidaveer
• Dr Mahendra, SIMS, Karnataka
• Dr Mahender Kumar
• Dr Manish Sahu, JNMC, Raipur
• Dr Manosij Maity
• Dr Mareddy Mahesh, Dali University
• Dr (Md) Matin Khan, MGM Medical College, Jamshedpur
• Dr Narendra HR
• Dr Neel Choksi, BJ Medical College, Ahmedabad
• Dr Nilesh Sonawane, Civil hospital, Sangli
• Dr Nissy Motupalli
• Dr Om Shrivastava, CIMS, Bilaspur
• Dr Opalina Roy, Burdwan Medical College
• Dr Piyush Gadegone
• Dr Preeti Chopra
• Dr Prerna Upadhyay
• Dr Rachit Kapoor, Regional Advisor The Lancet Student
• Dr Rajesh Kumar, Faculty, Department of Community Medicine, MAMC, New Delhi
• Dr Ravi Kumar Gupta, RUHS and RNT Medical College, Udaipur
• Dr Sagar Gandhi, NKP Institute of Medical Sciences
• Dr Saikat Mitra, Kolkata
• Dr Sakil Ahmed
• Dr Samcy Arora
• Dr Sanket Agrawal
• Dr Saraswata Mitra, Grodno State Medical University, Belarus
• Dr Sarweshwar Sripada
• Dr Sharaff Dileep, Dalian University, China
• Dr Shashank Saurabh
• Dr Sherinsha Sharafudeen
• Dr Siva Vicky
• Dr Surendra Chaudhary, China Medical University
• Dr Tapaprakash Behera, VSS Medical College, Burla
• Dr Vishnu M Satheesan, Thiruvananthapuram, Kerala
• Dr Vismay Deshani, Smolensk State Medical Academy, Russia
• Dr Vitrag N Shah, New Civil Hospital, Surat
A special vote of thanks to Dr Praveen K, Calicut Medical College, who took out his valuable time to mark out spelling
errors in such a voluminous book.
Last but definitely not the least, no words can describe the role of all medical students, with whom I ever have had interacted,
in helping me give this book, its final shape.
From the Publisher’s Desk
We request all the readers to provide us their valuable suggestions/errors (if any) at:
[email protected]
so as to help us in further improvement of this book in the subsequent edition.
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Contents
SECTION 1 : ANNEXURES
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Annexure 1: Incubation Period of Diseases 3
Annexure 2: Important Days of Public Health Importance 5
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Annexure 3: Instruments of Importance in Public Health 6
Annexure 4: Mode(s) of Transmission of Diseases 7
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Annexure 5: Some Important Health Legislations Passed in India 8
Annexure 6: Some Important Health Programmes of India 9
Annexure 7: Vectors and Diseases Transmitted d 10
Annexure 8: New Tuberculosis Diagnosis (RNTCP) Guidelines in India (w.e.f. 01 April, 2009 onwards) 11
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Annexure 9: National Population Policy (NPP) 2000 12
Annexure 10: National Health Policy (NHP) 2002 13
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Annexure 11: Millennium Development Goals (MDGs) 14
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Annexure 12: New Malaria Treatment Guidelines in India (2013n onwards) 15
Annexure 13: Draft Guidelines: Biomedical Waste Management Guidelines 2011 17
Annexure 14: Golden Points (Sets 1–5) U 18
Annexure 15: Current Public Health Related Statistics of India 31
Annexure 16: Newer Concepts in Preventive and So cial Medicine 34
Annexure 17: Honors in Health and Medicine - 40
Annexure 18: High Level Expert Group (HLEG ) Report on Universal Health Coverage (UHC) 41
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SECTION 2 : TOP9IC-WISE THEORY MCQs AND EXPLANATIONS
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Chapter 1: History of Medicinie 45
Theory h 45
Multiple Choice Questions 50
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Explanations 53
Chapter 2: Conceptts of Health and Disease 57
Theory 57
Multiple Choice Questions 66
Explanations 77
Chapter 3: Epidemiology and Vaccines 91
Theory 91
Multiple Choice Questions 125
Explanations 156
Chapter 4: Screening of Disease 217
Theory 217
Multiple Choice Questions 223
Explanations 230
Chapter 5: Communicable and Non-communicable Diseases 245
Theory 245
Multiple Choice Questions 306
Explanations 344
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Review of Preventive and Social Medicine
Chapter 6: National Health Programmes, Policies and Legislations in India 405
Theory 405
Multiple Choice Questions 443
Explanations 460
Chapter 7: Demography, Family Planning and Contraception 493
Theory 493
Multiple Choice Questions 519
Explanations 533
Chapter 8: Preventive Obstetrics, Paediatrics and Geriatrics 558
Theory 558
Multiple Choice Questions 575
Explanations 587
Chapter 9: Nutrition and Health 608
Theory 608
Multiple Choice Questions 626
Explanations 643
Chapter 10: Social Sciences and Health 668
Theory 668
Multiple Choice Questions 676
Explanations 681
Chapter 11: Environment and Health 693
Theory 693
Multiple Choice Questions 712
Explanations 729
Chapter 12: Biomedical Waste Management, Disaster Management, Occupational Health,
Genetics and Health, Mental Health 755
Theory 755
Multiple Choice Questions 769
Explanations 780
Chapter 13: Health Education and Communication 798
Theory 798
Multiple Choice Questions 804
Explanations 807
Chapter 14: Health Care in India, Health Planning and Management 813
Theory 813
Multiple Choice Questions 822
Explanations 831
Chapter 15: International Health 842
Theory 842
Multiple Choice Questions 846
Explanations 849
Chapter 16: Biostatistics 855
Theory 855
Multiple Choice Questions 874
Explanations 890
SECTION 3 : IMAGE BASED QUESTIONS
Image Based Questions 939
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