Principles and Practice of Community Medicine Asma Rahim
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1Principles and Practice of Community Medicine
2Principles and Practice of Community Medicine
Asma Rahim Asst. Professor Department of Community Medicine Medical College Calicut, Kerala India
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3, EMCA House, 23/23B Ansari Road, Daryaganj
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Principles and Practice of Community Medicine
© 2008, Asma Rahim
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition : 2008
9788184481723
Typeset at JPBMP typesetting unit
Printed at Replica Press
4This book is dedicated to my Students !
5Foreword
It is my proud privilege to write foreword to the textbook entitled Principles and Practice of Community Medicine. Our country has definitely made significant progress in the field of health care delivery system during the past five decades. Yet one cannot deny that apportioning our limited resources amongst sectors providing primary, secondary and tertiary health care has been injudicious. The tertiary health care sector is unduly glorified; whereas the promotive, preventive and rehabilitative aspects of health care have not still been given due consideration. Our syllabus for medical students and training the students received were also in that line. However it is very much gratifying that Medical Council of India has perused the matter in the right perspective and made an attempt to rectify the defects. The objective of medical education spelt out in the “Regulation on Graduate Medical Education 1997” is a reflection of the current thinking of academicians in the field of medical education.
Any textbook on Community Medicine should take into due consideration the new trends in the medical education and should provide sufficient information on health scenario of our country, social and environmental factors influencing health and diseases and intervention programmes. This textbook – Principles and Practice of Community Medicine has succeeded largely in achieving these objectives. The layout of different chapters and the simplicity of the language are also appreciable. I have no hesitation in recommending this textbook as a “quick revision text” for Undergraduate and Postgraduate medical students and as a comprehensive textbook for nursing and paramedical students.
Dr. C. SADASIVANPILLAI
md, dph, pgdim, pgdhrm, fisc. d
Principal
MES Medical College
Perinthalmanna, Kerala
(Former Prof. & HOD of Community Medicine and Former
Director of Medical Education, Kerala)
6Preface
It is being repeatedly stressed that Community Medicine is one of the most important branches of Medicine. Many undergraduates lament that this is a highly conceptual subject too difficult to assimilate and memorise. Most of the books currently available in this subject are too exhaustive and elaborate. A student often memorises the least important facts and leaves out the most important facts in the process. Elaborate concepts, poor application of the principles taught, frequently changing public health scenario, over and above poor teaching methods makes this subject most unpalatable to the Medical student.
As an Undergraduate Student I had yearned for a concise textbook presented in a lucid style in Community Medicine. Least did I know that Lord had kept in store for me a career in this field and would direct me into writing a textbook on this subject. The habit of jotting down important points in any subject I read, has helped me a lot in preparing this manuscript. I admit that a keen and critical reader may not find elaborate concepts in this textbook to rack his brains upon, but he is sure to find what is most required.
I have taken great care not to leave out important topics like General Epidemiology, Environment, Hospital Hygiene, Immunisation etc. which are often poorly dealt with in most of the currently available books. It is my sincere belief that all topics have been treated with equal importance.
The reader may find the presentation a little different as the key points are highlighted for holding readers immediate attention. This book is sure to serve as a quick reference during exams for the Medical students. It is my strong intuition that this book will be handy for allied medical disciplines like Dentistry, Nursing, Pharmacy and even Medical Officers from the Health services. I believe that I have been able to bring out the ‘Essence of Community Medicine’ in this textbook.
Asma Rahim
7Acknowledgements
I wish to place on record my deep gratitude to Dr C Sadasivanpillai, Principal, MES Medical College, Perinthalmanna for the very encouraging foreword he wrote on this book. I am deeply indebted to my teachers, Dr Leelamoni K, Professor and Head of Community Medicine, Medical College, Karakonam. Her unflagging support and learned advice have gone a long way in improving the quality of this publication. I wish to thank Dr Ramla Beegum, Professor and Head of Community Medicine, Medical College, Kolenchery for the encouragement and inspiration she has been to me.
Surely this book would not have seen the light of the day had it not been for the unstinting support of my Professors Dr K Vijayakumar, and Dr Thomas Bina. I am greatly obliged to them for their assistance and kindness.
I would like to thank all my Colleagues and Postgraduates in the Department of Community Medicine for their unconditional support.
My thanks are due to the Personnel at M/s Jaypee Brothers Medical Publishers, New Delhi for their role in bringing out this publication in time.
No words can adequately express my heartfelt appreciation of the meticulous secretarial assistance of Mrs. Shailaja Bhattathiri of Gayatri Graphics, Calicut. Her quality conscious efforts will be evident in every chapter of this book.
I would also like to thank profusely Mr Prasanth CB, Statistician, Department of Community Medicine for his contributions to the topic of Biostatistics.
I am extremely thankful to my father Dr M Mahamood, Retd. Director and Professor of Pediatrics, Medical College, Calicut and my mother Mrs Aysha Mahamood who have been a constant source of inspiration and support for me throughout my life. They were committed in providing a conducive environment for the successful completion of this book.
Finally I thank the Lord for blessing me with my husband Dr Raheem and our daughters Jumana and Raniya who have shared with me both the agony and ecstasy in the preparation of this manuscript.