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Describe common occupational hazards in industries cheap allopurinol 100 mg line, agriculture purchase allopurinol 100 mg line, and services available to industrial workers purchase allopurinol 100mg free shipping. Plan cheap 300mg allopurinol with mastercard, collect buy 300 mg allopurinol free shipping, analyze, interpret and present data from a hospital/community survey. Describe and analyze the roles of the individuals, family, community and socio-cultural milieu in health and disease. Diagnose and manage maternal and child health problems and advise couples and the community on Community Medicine 65 the family planning methods available. Diagnose and manage common nutritional problems at the individual and community levels. Describe the health information system in India with reference to the Management Information System. Describe the organization and functions of the health care team at Primary Health Centre, Community Health Centre and District levels. Interact with other members of the health care team and participate in the organization of health care services and implementation of National health Programmes. Describe the principles and components of primary Health Care, National Health Policy and its implementation in the country. Diagnose and manage common health problems and emergencies at the individual, family and community levels keeping in mind the existing health care resources, prevailing socio-cultural beliefs and family resources. Plan and implement, using simple audiovisual aids, a health educational programme and carry out its evaluation. Define social & behavioural sciences and discuss their role in Community Medicine. Measure the socio-economic status of a family and describe its importance in health and disease. Construct, pretest and validate a questionnaire / interview schedule to test attitudes of a community. Contents – Definition and principles of health education – Health educational methods – Audiovisual aids – The art of communication – Skills of communication – Methods of overcoming resistance in the individual, family and community. Describe the physical environment inside the home, at the workplace and in the community, and its impact on health and disease. Describe sources of waste and methods of waste control at individual and community levels. Define air pollution, causes of air pollution and describe appropriate measures of control. Contents • Environment: – housing – physical environment inside and outside the home – family environment • Water • Waste • Air pollution, green house effect, ozone layer • Noise and radiation pollution • Vectors of disease • Vector Control and insecticidal resistance. Contents • Need of Bio-statistics in Medicine • Statistical Methods • Frequency Distribution • Measures of Central Thendency. Describe and illustrate natural history of a disease with suitable examples (communicable and non- communicable). Collect relevant clinical, psychosocial information from a patient and family, analyze and present to illustrate the natural history of a common disorder. Advise relevant (psychosocial, cultural and economic context) promotive, preventive, curative and rehabilitative measures for the disorder. Calculate the sensitivity, specificity, positive predictive value of tests given a set of data. Describe the various types of epidemiological study designs, their application, biases, statistical analyses, relative merits and demerits. Contents • Definitions, scope in hospital, community, planning • Measures of Morbidity/Mortality • Rates: Incidence, Prevalence – Death rate – Crude rates/standardized rates – Fertility Rates Years – Person Years – Ratio – Proportions – Risk – Sources of epidemiological data – Causation – Natural history of disease for communicable and non-communicable diseases. Describe the nutrients (carbohydrates, proteins, fats, vitamins and minerals) and their dietary sources. Describe the daily nutritional requirements for different ages, sexes, pregnant and lactating women. Prescribe a balanced diet within the socio-cultural, and economic milieu for • a normal adult male/female • a pregnant/lactating/postpartum woman • an under five child • an adolescent 9. Define food adulteration and describe the methods for detecting and controlling food adulteration. Contents • Role of nutrition in health and disease • Nutritional requirements and sources • Balanced Diet • Deficiency Disorders and Micronutrient Deficiencies • Salt fortification • Protein Energy Malnutrition • Nutritional problems in India • Nutritional programmes • Assessment of nutritional status in community; Growth Charts. Advise a mother on the importance of breast feeding and weaning at appropriate time and addition of weaning foods. Describe the indications, contraindications, side effects and complications of the methods. Contents • Magnitude of the problem • Maternal morbidity and mortality, under five morbidity mortality. Types of impairment, disability, handicap • Assessment of Postpolio Residual Paralysis • Rehabilitation at individual level • Community based rehabilitation – Practical exercise: Post Polio residual paralysis assessment. Plan and investigate an epidemic of a communicable disease in a hospital/ community setting, and institute control measures.

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Cyanoacrylate glue for corneal perforations: a description of a surgical technique and a review of the literature purchase 300mg allopurinol. Symptoms of recurrent corneal erosions (sudden onset of eye pain order 100 mg allopurinol free shipping, usually at night or upon first awakening discount 100 mg allopurinol amex, with redness purchase 300 mg allopurinol visa, photophobia discount 100 mg allopurinol overnight delivery, and tearing) a. History of previous traumatic corneal abrasion, usually secondary to a sudden sharp, shearing injury (fingernail, paper cut, tree branch) a. May have pooling of fluorescein over affected area or negative staining if heaped epithelium 2. Chronic phase: nonpreserved lubricants, hypertonic saline (5% NaCl) ointments; topical corticosteroids combined with systemic tetracyclines B. Procedure is typically performed with patient sitting at slit lamp biomicroscope D. A bent (usually 25 gauge) needle tip (to reduce the risk of full-thickness penetration of the cornea) is used to make numerous superficial puncture wounds into the superficial corneal stroma in the involved area and extending slightly beyond the borders of the previously observed erosions, allowing a firm adhesion to develop as the epithelium heals E. Significant scarring, with increased risk from more aggressive/deeper punctures, may reduce best corrected visual acuity 1. If scarring begins to appear, topical corticosteroids may help to decrease severity B. If microbial keratitis develops, cultures and scrapings should be performed and broad-spectrum topical antibiotic therapy should be initiated pending culture results C. Describe appropriate patient instructions (post-op care, vision rehabilitation) A. Explanation as to likelihood of the procedure to be effective and the possible need for retreatment Additional Resources 1. Elucidating the molecular genetic basis of the corneal dystrophies: are we there yet? Anterior Stromal Puncture for the Treatment of Recurrent Corneal Erosion Syndrome: Patient Clinical Features and Outcomes. Microbial keratitis (to decrease pathogen load in fungal and acanthamoeba keratitis and to enhance corneal penetration of the topical medications) 4. Ocular surface disease (debridement of necrotic epithelium in chemical corneal burns, corneal intraepithelial neoplasia) 5. Irregular or heaped-up traumatic corneal abrasion (See Traumatic corneal abrasion) 6. Corneal topography or keratometry (to detect irregular astigmatism in some cases) D. Pressure patch, bandage contact lens, lubrication, topical antibiotic for recurrent erosion or traumatic corneal abrasion C. Superficial keratectomy with or without the use of diamond burr for recurrent erosions E. Remove the loosely adherent epithelium using a cotton swab, surgical sponge, spatula, blade, or forceps while avoiding trauma to Bowman layer E. Instill antibiotic, nonsteroidal anti-inflammatory drug, and cycloplegic eyedrops. Follow sterile technique and maintain the patient on topical antibiotic until epithelium heals 2. Screen patients for dry eyes and other predisposing conditions such as neurotrophic keratopathy 2. Avoid traumatizing Bowman layer when using a surgical blade to perform debridement 2. Describe appropriate patient instructions (post-op care, vision rehabilitation) A. Describe expectations for postoperative pain and slow, gradual improvement of comfort and visual acuity Additional Resources 1. Sight-threatening or progressive corneal infiltrate exhibiting one or more of the following: i. Infectious crystalline keratopathy if cultures not easily obtained with superficial scraping 2. Corneal infiltrate in a region of the cornea that is very thin, making risk of perforation during biopsy excessively high b. Confocal microscopic examination, if strongly suggestive of the presence or absence of infectious organisms, may obviate the need for a corneal biopsy B. Anterior chamber paracentesis and aspiration of infiltrate on posterior surface of the cornea D. If patient is very cooperative, all techniques except trap door may be performed with patient seated at the slit-lamp biomicroscope 3. If needed, a cotton tip applicator soaked in lidocaine may be held at limbal position where forceps fixation performed C. Supersharp blade may be used to create a vertical or oblique incision to allow sampling using sterile needle or spatula 2. Braided silk suture can be passed through the infiltrate; then cut into pieces for inoculation 3.

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The fndings also treatment because of the fear of knowing their illnesses showed that women play a major role in the health and the masculinity factor in men buy allopurinol 100mg low cost. Sex was important for men and erectile dysfunction impetus for men to initiate preventive healthcare 300 mg allopurinol for sale. Women wanted more Further order 300mg allopurinol with amex, the study also showed that the women are effort in dissemination of men’s health information through more receptive and better equipped with health multiple routes of media and more compulsory medical information and public awareness on men’s health purchase 300mg allopurinol otc. Women were generally better Therefore buy allopurinol 100 mg with visa, public campaigns to improve men’s health informed about health matters and hence could potentially should also be targetting at women, who will in turn help their spouses in improving their health status. The response of the Malaysian government In Malaysia, there is currently no concerted effort to Subsequently, it concentrated on improving health tackle the problem of men’s health. Between 2005 and 2007, the campaign had focused its activities on workplace where the main workforce In 2005, there was an attempt by the Ministry of was men. The Minister campaigns touched on many issues related to men’s of Health in his opening address at the First Na- health; however, important factors underpinning tional Men’s Health and Aging Conference 2005 af- men’s poor health such as unwillingness of men to firmed the importance of promoting men’s health in engage in healthy lifestyle, appropriate health seek- Malaysia11. However, for various reasons, the pol- ing behaviour, accessibility to men’s health services, icy has yet to materialise. An example is the Healthy Lifestyle Campaign had prioritised women and child health due to high ma- started by the Division of Health Education in 199112. Such programmes are not avail- of cardiovascular diseases, prevention and con- able for men. The promotion of men’s health, therefore, ics; however, these are, again, targeting at the general focuses on family development. Recently, men wellness screening pack- conditions by using self-administered questionnaires age has been included as part of its service. These serv- and several obstacles exist in the implementation of the ices require men to attend their outpatient centres and screening programmes. It is still very much munity Development is also partly responsible for men’s disease-oriented rather than men-focussed. The future for male health in Malaysia Currently, the health status of Malaysia men is rather adult and older males. The prevalence of chronic diseases and health check and healthy lifestyle should be stressed health concerns like diabetes, cardiovascular diseases, to all men and their spouses and families. There is also smoking, obesity and overall metabolic syndrome is a urgent need to develop an effective service delivery rising rapidly. Findings from the local and global research of awareness among the general public and healthcare work on men’s health should be disseminated to and professionals alike. There is also an absence of close utilized by the public, healthcare professionals and collaboration across disciplines as well as governmen- policy makers to inform healthcare decision making. It will also help to create awareness of be spearheaded by governmental and non-governmen- the concept of men’s health to the healthcare profes- tal bodies. The members of this group are from various backgrounds with the same interest in improving men’s health in Malaysia. He is also the Adjunct Profes- sor and consultant urologist in the University of Malaya. Seng Fah Tong is a consultant family physician and senior lecturer in the Department of Family Medicine, Faculty of Medicine, University Kebangsaan Malaysia. His research is on the topic of how to improve men’s health screening by Malaysian primary care physicians. Her main areas of research work and interest revolve around psychological aspects of health and illness, reproductive and sexual health, aging male and men’s health. Chirk Jenn Ng is an Associate Professor in the Department of Primary Care Medicine, University of Ma- laya. Lancet 2001; 357: 1685-1697 ences in knowledge, attitudes and practices related to erectile dys- 2. The frst national men’s urinary tract symptoms, erectile dysfunction and incontinence in health & aging conference in conjunction with Universiti Ma- men from a multiethnic Asian population: Results of a regional laya’s 100th anniversary [document on the internet] Minis- population-based survey and comparison with industrialised na- try of Health 2007; [updated 2009 Jan 22; cited 2009 Jan 29]. Erectile Dysfunction and Comor- bidities in Aging Men: An Urban Cross-Sectional Study in Malay- 12. General lems and its association with social, psychological and physical Objective [homepage on internet] Ministry of Women, Family and factors among men in a Malaysian population: A cross-sectional Community Development; 2008 [updated 10 Dec 2008; cited 2009 study. For example local ideologies and practices mean work or strategic approach from central government that achieving the ideals of conventional masculinity that provides guidance or consistency for decision requires an unwillingness to admit weakness or to ac- making about issues that have particular implications cept help and a propensity towards risk-taking behav- for men’s health. The process of male socialisation and the socio- development of men’s health policy and interventions cultural norms that underpin this process result in an has been somewhat ad hoc, resulting in a disjointed set adverse risk profle for men and subsequent poor health of strategies and policies that has failed to comprehen- outcomes. Consequently, despite a more favourable dis- sively address the broad range of issues facing men in tribution of the socioeconomic determinants of health, relation to health. Since the mid-1980s, gains in life expectancy have been greater for males (an in- crease of 7.

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The need for more cheap 300 mg allopurinol free shipping, systematic evaluation was repeatedly identified during this research project in relation to formative discount 300mg allopurinol overnight delivery, process allopurinol 100 mg free shipping, impact purchase allopurinol 300 mg online, outcome and cost-effectiveness evaluation [4 purchase allopurinol 300 mg on-line, 5, 8]. Evaluations can identify the significant and appropriate expectations of an initiative, the most effective strategies, and may support the development of best practices [32], serving to keep an initiative on track or, alternatively, indicate when it is advisable to adjust or adapt the advocacy strategies. The importance of an inclusive approach to meaningful evaluation [33] was also highlighted [5] in order to identify whether the intended beneficiaries of the advocacy intervention perceived a benefit from the initiative [32]. An initiative which brings about a change of policy or legislation will be of little real value if those for whom the change was intended to benefit do not know that this change has come about or if they are unable to access the legal services to vindicate their rights [33]. Recent developments have strengthened the knowledge base for health advocacy evaluations, and strong recommendations exist about the importance of the use of a theory of change during the development of campaigns and initiatives to make explicit the intended relationship between actions and outcomes [5]. The emerging knowledge and resource base might be profitably utilised in the wider development of evaluation of health communication interventions for the prevention and control of communicable diseases in the future. A number of issues were highlighted as priorities, including developing an evidence base for the use of new and social media channels, profiling and targeting audiences, and retrospective evaluation on the use of health communication in recent crises in order to inform proactive planning for future crisis events. Evaluation is particularly underdeveloped in the broader context of health communication, and scant in relation to health communication for the prevention and control of communicable diseases. Integral to the development of more formal evaluation is progress in identifying the indicators of success for health communication activities. Promisingly, the evidence base is increasing and, for example, there are a number of guides and toolkits about theory-based evaluation of health advocacy interventions that can guide further advances in this sphere [34, 35]. A platform to support the development and sharing of evidence, tools, experiences and outcomes would greatly facilitate the development of the field of health communication. Interventions and activities can be accessed from such a database and tailored to suit the needs of the topic, country and target group. Such an approach would also strengthen the consistency of health communication for prevention and control of communicable diseases in Europe. A particular value of such a platform may be the sharing of evidence and experience in relation to poorly reached groups. For example, a number of European countries have a significant Roma population, and the learning achieved in one country from a campaign to target the Roma population may provide an invaluable basis to inform a campaign with similar objectives in another country. Likewise, religious influences on the uptake of particular health services or health interventions may impact consistently on communities of that faith in whichever European country they live, and therefore, evidence gathered in one jurisdiction might usefully inform development and practice in other jurisdictions. The current status of health communication campaign evaluation demonstrates the need for capacity building within and across European countries. Such capacity building can be enhanced and/or promoted through the identification of the skills and knowledge of researchers and health professionals who have worked in this area. Encouraging and facilitating open dialogue to exploit the lessons that may have been learned but not documented may also contribute to capacity. More extensive and detailed publication of process and impact evaluations would usefully contribute to the ongoing development of policy and practice [6]. The consultations identified a desire among the stakeholders for the development of a more reciprocal relationship between those working in the area of health communication and transnational agencies. Workforce The availability of qualified human resources with sufficient skills and knowledge and the availability of training options. The challenges and opportunities offered by the diversity of the workforce involved in health communication for communicable diseases in Europe were highlighted earlier. Health communication competencies may be defined as the combination of the essential knowledge, abilities, skills and values necessary for the practice of health communication (adapted from [36]). Overall, stakeholders considered that education and training for health communication in the prevention and control of communicable diseases is currently underdeveloped across Member States [1-3]. It is important that, in consultation with Member States, research is conducted to establish the core competencies required for health communication so as to clarify the focus of the education and training provision. A number of key skills deficits were identified in the stakeholders consultations. One was around evaluation research, which was perceived to require specific skills and resources. The types of evaluation reported in the data collection suggest that participants are at least familiar with outcome, impact and cost- effectiveness evaluations. A second area of concern to the stakeholders was in the use of media in general, and specifically new media and new technologies. Because of the variability between countries in their capacity to develop and effectively use health communication activities, any strategic development at a European level must be cognisant of this discrepancy in capacity and experience. Effective guidelines and tools to support health communication in a consistent way will be of significant value. During the consultation, the stakeholders identified a number of specific training needs, including in the area of social media, evaluation, and public relations in order to be prepared to deal with the media, particularly in crisis situations. A particular challenge of social media was identified as its speed, requiring health communicators to respond immediately to issues in order to pre-empt the dissemination of misinformation and also to react immediately to counter any misinformation that has already been disseminated [3].