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Epidemiology of Acute Diarrheal Diseases

• Major killer of under 5 children, even though the toll has reduced considerably
– 10% of under-5 deaths in India
– Reduction of mortality mainly due to rehydration tech including ORS
• Under 5 children are estimated to have 3 episodes per year
– Incidence hasn’t changed much but mortality is reduced considerably
– Loss of considerable number of DALYs
• Leading cause of death during disasters and emergencies

W.H.O guidelines on When and how to use masks for coronavirus disease prevention

As on 23rd March 2020
When to use a mask
• If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
• Wear a mask if you are coughing or sneezing.
• Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
• If you wear a mask, then you must know how to use it and dispose of it properly.

Mission Indradhanush (as in Jan 2020)

Mission Indradhanush
The percentage of children, who are fully immunized (FIC), was found to be only 65% in 2013-14. This was despite the Universal Immunization Program (UIP) running since 1985 and Expanded Program on immunization (EPI) since 1978.
Mission Indradhanush was launched in December 2014 to:
• Actively achieve full immunization of 90 percent by 2020 and
• Simultaneously to boost the Routine Immunization (RI) infrastructure in the country

Taking a Meaningful Clinical History

A student is often tempted to quickly move on to examination after listening to the presenting complaints.
Clinical history taking should not be taken lightly.
A logically taken history will give rise to a list of probable diagnoses in your mind by identifying patterns of symptoms even before you proceed on to the examination.
Systematically taken history will guide you to:
• Look especially for signs for confirming or ruling out certain disorders upon physical examination and

Mechanism (in brief) of transmission of vectors borne disease

1. Mechanical: infectious agent is mechanically transported through soiling of vector’s feet or proboscis or by passage through its gastrointestinal tract. for example spread of e coli by housefly
2. Biological:
a. Propogative: infectious agent merely multiplies inside the vector e.g. plague in rat flea
b. Cyclo-propogative: agent changes in number and also in form e.g. malaria parasites in mosquito
c. Cyclo-developmental : the disease agent undergoes only development but no multiplication e.g. microfilaria in mosquito


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