fluorosis_bengali may help all of viewers

1. 4/8/2016
1
gÓ¥−l¡¢pp
S¡a£u gÓ¥−l¡¢pp fË¢a−l¡d J ¢eu¿»Z LjÑpS¡a£u gÓ¥−l¡¢pp fË¢a−l¡d J ¢eu¿»Z LjÑpS¡a£u gÓ¥−l¡¢pp fË¢a−l¡d J ¢eu¿»Z LjÑpS¡a£u gÓ¥−l¡¢pp fË¢a−l¡d J ¢eu¿»Z LjÑp§§§§Q£Q£Q£Q£
−Sm¡ ü¡ÙÛÉ cçl
hy¡L¥s¡
¢c−hɾc¥ cš
−Sm¡ fl¡jnÑ c¡a¡ (S¡a£u gÓ¥−l¡¢pp fË¢a−l¡d J ¢eu¿»Z LjÑp§Q£) hy¡L¥s¡
Hj Hp ¢p (j¡C−œ²¡h¡C−m¡¢S) , Hj Hp ¢p (¢eE¢VÊpe J L¢jE¢e¢V −qmb)
¢lp¡QÑ úm¡l ( g¥X J ¢eE¢VÊpe p¡−u¾p )
Original Articles : Dr. Bhushan Chakraborti , former ADHS Fluorosis Govt. of W.B.
E−ŸnÉ
fª¢bh£l ¢h¢iæ Aw−n gÓ¥−l¡¢pp HL¢V Seü¡ÙÛÉ pjpÉ¡z
gÓ¥−l¡¢p−pl L¡lZ −Lhm −g¡Ól¡CX eu, hlw Hl p¡−b
k¤š² B−R hý¢hd L¡lZ, h¡qL Hhw f¢l−hnNa Ef¡c¡ez
¢Q¢Lvp¡¢h‘¡−el kb¡kb fË−u¡N HC −l¡N¢Vl −r−œ
j¡e¤o−L S£heq¡¢e J jq¡j¡l£l ¢hfc −b−L hy¡Q¡−a f¡−lz
k¢cJ gÓ¥−l¡¢pp HLh¡l q−m a¡−L p¡l¡−e¡ e¡ −N−mJ
¢h¢iæ −g¡Ól¡CX ¢ejѨm£LlZ fÜ¢al j¡dÉ−j fË¢a−l¡d
Ll¡ k¡uz

2. 4/8/2016
2
gÓ¥−l¡¢pp L£ ?
gÓ¥−l¡¢pp HL¢V Seü¡ÙÛÉ pjpÉ¡z
gÓ¥−l¡¢pp −L¡e −Ry¡u¡−Q −l¡N euz
H¢V HL¢V −l¡N k¡ Bj¡−cl nl£−ll nš²
Hhw elj Lm¡l j−dÉ −g¡Ól¡CX p’−ul j¡dÉ−j
pª¢ø quz
H¢V p¡d¡lea cy¡−al lP f¢lhaÑe Hhw
nl£−ll ü¡i¡¢hL A¢ÙÛL¡W¡−j¡l f¢lhaÑ−el à¡l¡
¢Q¢q²a Ll¡ k¡uz
pjÙ¹ fª¢bh£−a 25 ¢V −c−n
fË¡c¤iÑ¡h −hn£z
H¢nu¡ Hhw H¢nu¡l j−dÉ
i¡la J ¢Q−e HC −l¡−Nl
fË¡c¤iÑ¡h −hn£z
HR¡s¡J B−SÑ¢Ve¡,
−j¢„−L¡ Hhw Ešl J
B¢éL¡u Hl fË¡c¤iÑ¡h mrÉ Ll¡ k¡uz
gÓ¥−l¡¢p−pl ¢hÙ¹¡l

3. 4/8/2016
3
i¡lah−oÑ gÓ¥−l¡¢p−pl fË¡c¤iÑ¡h
l¡SÙÛ¡e J …Sl¡V Hhw c¢rZ i¡l−a HC −l¡−Nl fË¡c¤iÑ¡h
j¡l¡aÈLz
f¡”¡h, q¢lu¡e¡, jdÉfË−cn Hhw jq¡l¡−øÊ Hl fË¡c¤iÑ¡h j¡T¡¢l
dl−Zlz
a¡¢jme¡s¥, f¢ÕQjh‰, EšlfË−cn, ¢hq¡l Hhw Bp¡−j
fË¡c¤iÑ¡h a¥me¡j§mL Ljz
−N¡V¡ i¡lah−oÑ gÓ¥−l¡¢pp Smh¡¢qa ¢L¿¹¥ …Sl¡V Hhw
EšlfË−c−nl ¢LR¥ Aw−n gÓ¥−l¡¢pp LmL¡lM¡e¡l à¡l¡J
Rs¡−µRz
70-100 % Districts affected
40-70 % Districts affected
10-40 % Districts affected
<10% Districts affected
Endemicity not known
Andaman
Nicobar
l¡SÙÛ¡el¡SÙÛ¡el¡SÙÛ¡el¡SÙÛ¡e
…Sl¡V…Sl¡V…Sl¡V…Sl¡V
f¡”¡h
q¢lu¡e¡
jdÉfË−cn
jq¡l¡øÊ
a¡¢jme¡s¥
f¢ÕQjhf¢ÕQjhf¢ÕQjhf¢ÕQjh‰‰‰‰
EšlfË−cn
¢hq¡l¢hq¡l¢hq¡l¢hq¡l
Bp¡j
No. of affected State =18
No of affected District
230
people affected, 62
million ( 6 million
children)
Causative factor, excess
consumption of fluoride
through drinking water
(>1.0ppm) and diet.

4. 4/8/2016
4
f¢ÕQjh−‰ gÓ¥−l¡¢p−pl fË¡c¤iÑ¡h
f¢ÕQjh−‰ 43 ¢V hÔ−L gÓ¥−l¡¢pp Bœ²¡¿¹
j¡e¤−ol pwMÉ¡ 2.202.202.202.20 mrzmrzmrzmrz
f¢ÕQjh−‰ Bœ²¡¿¹ −Sm¡…¢m -
Ešl/ c¢rZ ¢ce¡Sf¤l, j¡mc¡, h£lih£lih£lih£li¨¨¨¨jjjj,
hy¡L¥s¡, f¤l¦¢mu¡, c¢re 24 flNZ¡,
Hl j−dÉ i£oZi¡−h Bœ²¡¿¹ −Sm¡…¢m -
f¤l¦¢mu¡, h£lih£lih£lih£li¨¨¨¨jjjj, c¢rZ ¢ce¡Sf¤l Hhw
h¡yL¥s¡zh¡yL¥s¡zh¡yL¥s¡zh¡yL¥s¡z

5. 4/8/2016
5
−gÓ¡l¡C−Xl Evp
i¨-NiÑÙÛ Sm (Ground Water)
A¢dL −gÓ¡l¡CX pjªÜ M¡cÉ âhÉ
LmL¡lM¡e¡ (AÉ¡m¤¢j¢eu¡j, gp−gV
g¡¢VÑm¡CS¡l CaÉ¡¢c Evf¡ceL¡l£ L¡lM¡e¡)
−gÓ¡¢l−e−VX XÊ¡N
Lp−j¢VLpÚ
h¡qL Ef¡c¡e
p¡d¡lei¡−h −gÓ¡l¡CX f¡Z£u S−ml j−dÉ b¡−Lz
kMe −gÓ¡l¡CX fË¢a 1 ¢mV¡l S−m 1.5 ¢j¢mNË¡−jl −h¢n
b¡−L aMe −pV¡ ü¡−ÙÛÉl f−r q¡¢eLlz
S−ml A¢dL r¡lL−šÄl fËi¡−h j¡eh nl£−l −gÓ¡l¡CX −h¢n
−n¡¢oa quz
M¡−cÉl j−dÉ LÉ¡m¢pu¡−jl Ef¢ÙÛ¢a −gÓ¡l¡C−Xl −n¡oZ Lj¡u
J −lQe h¡¢s−u −cuz
MlS−m A¢dL LÉ¡m¢pu¡−jl Ef¢ÙÛ¢a −gÓ¡l¡C−Xl ¢ho¢œ²u¡
eø L−lz
¢iV¡¢je ¢pÚ, LÉ¡m¢pu¡j, pjªÜ M¡cÉ âhÉ gÓ¥−l¡¢p−pl Bœ²je
qÊÊ¡p L−lz

6. 4/8/2016
6
ú¥−ml h¡µQ¡−cl j−dÉ c¿¹ gÓ¥−l¡¢pp (Dental Flurosis)
−cM¡ k¡uz
30-40 hRl huú j¡e¤o−cl −r−œ A¢ÙÛ pwœ²¡¿¹ gÓ¥−l¡¢pp
(Skeletal Fluorosis) −cM¡ k¡uz
a¥me¡j§mLi¡−h f¤l¦−ol¡ j¢qm¡−cl −b−L −h¢n Bœ²¡¿¹ qu HC
−l¡−Nz
A¢n¢ra/c¢lâ pÇfËc¡u HC −l¡−N A¢dL Bœ²¡¿¹ quz
−kM¡−e AÉ¡m¤¢j¢eu¡j BL¢lL Ešme Ll¡ qu Hhw −pC ph
L¡−kÑl p¡−b −k h¡ k¡l¡ S¢sa a¡−cl j−dÉ H¢V −fn¡Na ü¡ÙÛÉ
pjpÉ¡ ¢qp¡−h −cM¡ k¡uz
h¡qL Ef¡c¡e
f¢l−hnNa Ef¡c¡e
h¡vp¢lL A¢dL Ns a¡fj¡œ¡z
Lj hª¢øf¡az
Lj Sm£u h¡×fz
gÓ¥−l¡¢p−pl B¢dLÉS¢ea p¡hp−um lLz
A¢dL −gÓ¡l¡C−Xl pÇfæ Hm¡L¡ ¢i¢šL n¡Lp¢êz
−gÓ¡l¡C−Xl k¤š² cy¡−al j¡Se kMe ¢nöl¡ hÉhq¡l
L−lz
Eo· Smh¡u¤z
Eæuen£m −cnz

7. 4/8/2016
7
gÓ¥−l¡¢pp pwœ²jZ ¢edÑ¡lZL¡l£ mrZ
¢nö−cl c¿¹ gÓ¥−l¡¢pp (Dental Fluorosis)
huú−cl A¢ÙÛ gÓ¥−l¡¢pp (Skeletal Fluorosis)
elj Lm¡ pwœ²¡¿¹ gÓ¥−l¡¢pp (Non Skeletal
Fluorosis)
c¿¹ gÓ¥−l¡¢pp (Dental Fluorosis)
−k pjÙ¹ ¢nöl¡ A¢dL −gÓ¡l¡CX k¤š² Hm¡L¡u b¡−Le a¡−cl cy¡−al
lP f¢lhaÑe AhnÉñ¡h£ Hhw HV¡ p¡d¡leax ÙÛ¡¢u cy¡−aC −cM¡ k¡uz
fË¡b¢jL i¡−h E‹Æm p¡c¡ h−ZÑl cy¡a j¢me q−u k¡u Hhw qm¤c¡i
BÙ¹lZ f−sz
œ²jnx HC qm¤c¡i BÙ¹lZ h¡c¡j£ lP d¡lZ L−l Hhw h¡c¡j£
−cM¡uz
HC f¢lhaÑe p¡d¡leax cy¡−al ANËi¡−N −cM¡ k¡uz
flhaÑ£L¡−m pjNË cy¡a L¡−m¡ q−u k¡u, Hhw cy¡−al j−dÉ −R¡V −R¡V
NaÑ h¡ ¢Râ pª¢ø q−a f¡−l Hhw Ah−n−o Hje¢L cy¡aJ f−s k¡uz
gÓ¥−l¡¢pp pwœ²¡¢ja Hm¡L¡l j¡e¤−ol¡ A¢a AÒf hu−pC c¿¹q£e q−u
f−sz

8. 4/8/2016
8
Mild Dental Fluorosis
A¢ÙÛ gÓ¥−l¡¢pp (Skeletal Fluorosis)
A¢ÙÛ gÓ¥−l¡¢pp h¡µQ¡ Hhw huú Ei−ul j−dÉC −cM¡ k¡uz
A¢ÙÛ gÓ¥−l¡¢p−pl mre…¢m qm - ¢h¢iæ A¢ÙÛ p¢å Hhw ¢f−Wl ¢nl cy¡s¡u
hÉ¡b¡, Le¤C qy¡V¥ J f¡−ul −Q−V¡u hÉ¡b¡, ¢fW J O¡−s hÉ¡b¡, qy¡V¡ Qm¡ Ll−a
Ap¤¤¢hd¡, nl£l œ²jnx p¡j−el ¢c−L Ty¥−L k¡Ju¡z
A¢ÙÛ gÓ¥−l¡¢p−p Bœ²¡¿¹ hÉ¡¢š²l A¢ÙÛl OeaÆ −h−s k¡u Hhw ¢LR¥ ¢LR¥ −r−œ
A¢ÙÛ−a LÉ¡m¢pu¡−jl Ai¡hS¢ea L¡l−e J¢øJjÉ¡−m¢pu¡ dl−el f¢lhaÑe mrÉ
Ll¡ k¡u Hhw HC dl−el f¢lhaÑe A¢ÙÛl H„−l fl£r¡u fËL¡n f¡uz
L−nl¦L¡ e¡m£l pwL£ZÑa¡l g−m pÀ¡u¤ BO¡afË¡ç q−u b¡−L Hhw k¡l
gmül©f f‰¥aÆz

9. 4/8/2016
9
¢h¢iæ fËL¡−ll A¢ÙÛ gÓ¥−l¡¢pp
1) −Se¤ i¡mN¡j
2) −Se¤ −il¡j
3) ¢V¢hu¡l ANËfÕQ¡v i¡−Nl hœ²a¡ (p¡¢hl ¢V¢hu¡)
4) −ú¡¢mJ¢pp
5) fÉ¡l¡fÔÉ¡¢Su¡ (H¢V HL¢V j¡l¡aÈL dl−el A¢ÙÛ gÓ¥−l¡¢pp)
−Se¤ i¡mN¡j (GenuValgum)-
Hl Bl HL e¡j eLÚ ¢ez f¡ …¢m de¤−Ll ja
−hy−L k¡uz qy¡V¥ c¤¢V −S¡s¡ −m−N k¡u J c¤¢V
f¡−ul f¡a¡l j−dÉ c§laÆ A−eL −h−s k¡uz
−Se¤ −il¡j (GenuVarum)-
H−r−œJ f¡…¢m de¤−Ll ja −hy−L k¡u ¢L¿¹¥
HM¡−e hÉ¡¢š²l qy¡V¥ −S¡s¡l j−dÉ c§laÆ A−eL
−h−s k¡u J f¡−ul f¡a¡ c¤¢V flØf−ll L¡−R
Q−m B−pz

10. 4/8/2016
10
L¡C−g¡¢ppL¡C−g¡¢ppL¡C−g¡¢ppL¡C−g¡¢pp (Kyphosis)-
¢nlcy¡s¡l ANËi¡−Nl hœ²a¡, −b¡l¡¢pL −LS
AejZ£u q−u f−s, a¡R¡s¡J Øf¡Ce¡m L−XÑl
pw−L¡Qe O−V b¡−Lz
¢V¢hu¡l ANËfÕQ¡vi¡−Nl hœ²a¡¢V¢hu¡l ANËfÕQ¡vi¡−Nl hœ²a¡¢V¢hu¡l ANËfÕQ¡vi¡−Nl hœ²a¡¢V¢hu¡l ANËfÕQ¡vi¡−Nl hœ²a¡
(Anterioposterior Bowing
ofTibia) -

11. 4/8/2016
11
fÉ¡l¡fÔÉ¡¢Su¡ (fÉ¡l¡fÔÉ¡¢Su¡ (fÉ¡l¡fÔÉ¡¢Su¡ (fÉ¡l¡fÔÉ¡¢Su¡ (Paraplagia) -
A¢ØVJ−ú−m−l¡¢pp Hl SeÉ Øf¡Ce¡m
L−XÑl pw−L¡Qe O−V b¡−L HC −r−œz
−ú¡¢mJ¢pp (Scoliosis) -
HC −r−œ hÉ¡¢š²l ¢nl cy¡s¡ −hy−L k¡u,
HC pLm hÉ¡¢š²l ¢nlcy¡s¡ Cwl¡¢S hZÑj¡m¡l
""S'' Abh¡ ""C'' Ar−ll ja −cM¡uz

12. 4/8/2016
12
H„ −l −a ¢h¢iæ f¢lhaÑeH„ −l −a ¢h¢iæ f¢lhaÑeH„ −l −a ¢h¢iæ f¢lhaÑeH„ −l −a ¢h¢iæ f¢lhaÑe

13. 4/8/2016
13

14. 4/8/2016
14
1)1)1)1) L−ueL−ueL−ueL−ue −VØV−VØV−VØV−VØV - HC −V−ØV hÉ¡¢š²−L qy¡V¥ iy¡S e¡ L−l −j−T −b−L
HL¢V L−ue a¥m−a hm¡ q−hz A¢ÙÛ gÓ¥−l¡¢p−p Bœ²¡¿¹ hÉ¡¢š² HC
−V−ØV hÉ¡bÑ q−hz
2) ¢QeÚ −VØV¢QeÚ −VØV¢QeÚ −VØV¢QeÚ −VØV ---- HC −V−ØV hÉ¡¢š²−L ¢e−cÑn −cJu¡ q−h ay¡l b¤a¢e
hrÙÛ−m ØfnÑ Ll¡l SeÉz k¢c HC fl£r¡u hÉ¡¢š² ay¡l O¡−s
hÉ¡b¡ Ae¤ih L−l Hhw hÉ¡bÑ qu a¡q−m h¤T−a q−h hÉ¡¢š² A¢ÙÛ
gÓ¥−l¡¢p−p Bœ²¡¿¹z
3) −ØVÊQ −VØV−ØVÊQ −VØV−ØVÊQ −VØV−ØVÊQ −VØV ---- HC −V−ØV hÉ¡¢š²−L ¢e−cÑn −cJu¡ q−h ay¡l h¡ý c¤¢V
f¡−nl ¢cL fËp¡¢la Ll¡l SeÉ Hhw Le¤C c¤¢V iy¡S L−l j¡b¡l
fÕQ¡vi¡N ØfnÑ Ll¡l SeÉz k¢c HC fl£r¡u hÉ¡¢š² hÉ¡bÑ qu
a¡q−m h¤T−a q−h hÉ¡¢š² A¢ÙÛ gÓ¥−l¡¢p−p Bœ²¡¿¹z
A¢ÙÛ gÓ¥−l¡¢pp ¢e¢lrZ

15. 4/8/2016
15
L−ue −VØV
¢QeÚ −VØV

16. 4/8/2016
16
−ØVÊQ −VØV
k¢c −L¡e S¡uN¡ f¢lcnÑe L−l −cM¡ k¡u −k
−pM¡−e 20 na¡wn j¡e¤o gÓ¥−l¡¢pp −l¡−N
Bœ²¡¿¹ a¡q−m −pC ¢h−no S¡uN¡ h¡ A’m¢V
gÓ¥−l¡¢pp fË¡c¤iÑ¡h h−m ¢Q¢q²a qC−hz
(Fluorosis Endemic Area)
gÓ¥−l¡¢p−pl fË¡c¤iÑ¡−hl fËL¡n

17. 4/8/2016
17
1)q¡−al J f¡−ul B‰¥−m Ry¥Q h¡ ým g¥¢Vh¡l Ae¤i¨¢az
2)A¢dL a«o·¡aÑ
3)hýj§œ
4)j¡e¢pL Ahp¡c
5)j¡b¡ hÉ¡b¡
6)−L¡ù L¡¢WeÉ
7)Øj«¢a n¢š² qÊÊ¡p
8)pÀ¡u¤ S¢ea Ap¤¤¢hd¡
HR¡s¡J A¢dL −gÓ¡l¡CX j¡wp −fn£, A¿», öœ²¡Z¤, −m¡¢qa
lš² L¢ZL¡ fËi«¢alJ A¢dL j¡œ¡u r¢a L−l b¡−Lz
elj Lm¡ pwœ²¡¿¹ gÓ¥−l¡¢pp
gÓ¥l¡C−Xl f¢lj¡Z gm¡gm (WHO - 1975)
1 ppm −X¾V¡m LÉ¡¢lp Lj¡u
2 ppm c¿¹ gÓ¥−l¡¢pp
5 ppm A¢ØVJ−ú−m−l¡¢pp
8 ppm 10% A¢ØVJ−ú−m−l¡¢pp
20-80 ppm/°c¢eL S−m J M¡h¡−l œ²f¢mw A¢ÙÛ gÓ¥−l¡¢pp
50 ppm/°c¢eL S−m J M¡h¡−l b¡Cl−uX NË¢¿Ûl f¢lhaÑe
100 ppm/°c¢eL S−m J M¡h¡−l −c−ql ü¡i¡¢hL hª¢Ü qÊÊ¡p
125 ppm/¢°c¢eL S−m J M¡h¡−l hª−‚l f¢lhaÑe
2.5 - 5 NË¡j jªa¥É

18. 4/8/2016
18
gÓ¥−l¡¢p−pl ¢eu¿»−Zl SeÉ e£¢a J ¢e−cÑngÓ¥−l¡¢p−pl ¢eu¿»−Zl SeÉ e£¢a J ¢e−cÑngÓ¥−l¡¢p−pl ¢eu¿»−Zl SeÉ e£¢a J ¢e−cÑngÓ¥−l¡¢p−pl ¢eu¿»−Zl SeÉ e£¢a J ¢e−cÑn
n£OË −l¡N ¢eZÑu
Hhw
A¢hm−ð qÙ¹−rf Ll¡
n£OË gÓ¥−l¡¢pp −l¡N ¢eZÑu
Cq¡ A¿¹iѨš² L−l - hÉ¡¢š²l n¡l£¢lL fl£r¡ Hhw −l¢XJm¢SLÉ¡m
fl£r¡z
−k mrZ …¢m g¥Ó−l¡¢pp −l¡N ¢eZÑ−ul −r−œ p¡q¡kÉ L−l -
cy¡−al f¢lhaÑe - Q−Ll ja p¡c¡ cy¡az
A¢ÙÛ p¢å−a hÉ¡b¡ J Aej¢eua¡z
f¡−ul hœ²a¡z (−Se¤ −il¡j Hhw −Se¤ i¡mN¡j)
q¡a J f¡−ul H„−l à¡l¡J S¡e¡ k¡uz
HR¡s¡J gÓ¥−l¡¢pp −l¡N ¢eZÑ−ul SeÉ ¢LR¥ mÉ¡h−lV¢l −VØV Ll¡ q−u
b¡−L :-
hÉ¡¢š²l j§−œ −gÓ¡l¡C−Xl j¡œ¡ ¢eZÑ−ul à¡l¡z
hÉ¡¢š²l l−š² −gÓ¡l¡C−Xl j¡œ¡ ¢eZÑ−ul à¡l¡ Hhw
f¡Z£u S−m −gÓ¡l¡C−Xl j¡œ¡ ¢eZÑ−ul à¡l¡z

19. 4/8/2016
19
A¢hm−ð qÙ¹−rf Ll¡
A¢hm−ð qÙ¹−rf Ll¡l HL¢V f¢lLÒfe¡ Bj¡−cl
¢ejÀ¢m¢Ma Ef¡−u Ll−a q−h -
ü¡ÙÛÉ pÇfLÑ£u ¢nr¡z
¢eh¡l−el Ef¡uz
¢Q¢Lvp¡z
f¤ZhÑ¡pe(l£qÉ¡¢h¢m−Vne)z
−gÓ¡l¡CX NËq−el ¢el¡fc j¡œ¡
WHO Hl fl¡jnÑ Ae¤p¡−l f¡Z£u S−m
−gÓ¡l¡C−Xl ¢el¡fc j¡œ¡ qm 1.5 ¢j¢mNË¡j/¢mV¡lz
i¡la£u ¢e¢cÑø j¡œ¡ qm 1 ¢j¢mNË¡j/¢mV¡lz

20. 4/8/2016
20
gÓ¥−l¡¢p−pl ¢eh¡lZ
−g¡Ól¡CX Afp¡lZ fÜ¢az
f¤¢øNa Ef¡uz
−gÓ¡l¡CX Afp¡le
−k−qa¥ −gÓ¡l¡C−Xl fËd¡e Evp f¡Z£u Sm −p−qa¥
−gÓ¡l¡CX Afp¡leC gÓ¥−l¡¢pp ¢eh¡l−el ph−Q−u
i¡m Ef¡u Hhw HC Afp¡le fÜ¢a pÇfæ q−a
f¡−l −X¡−j¢ØVL Hhw L¢jE¢e¢V Eiu fkÑ¡−uC

21. 4/8/2016
21
−gÓ¡l¡CX Afp¡le fÜ¢a
¢ba¡−e¡ fÜ¢a p¡d¡lei¡−h −gÓ¡l¡CX Afp¡l−el −r−œ hÉhq¡l q−u b¡−Lz
Q¥e −kje S−ml Mla¡ Lj¡−a p¡q¡kÉ L−l b¡−L ¢WL −pCi¡−h S−ml
−gÓ¡l¡CXJ Afp¡le L−l. b¡−Lz
−h¢n j¡œ¡u gV¢L¢l hÉhq¡l L−lJ f¡Z£u Sm −b−L −gÓ¡l¡CX Afp¡le
Ll¡ −k−a f¡−lz
Bj¡−cl −c−nl °h‘¡¢eLl¡ HL¢V −gÓ¡l¡CX Afp¡le fÜ¢al ¢hL¡n
O¢V−u−Re k¡q¡l e¡j qm e¡m−N¡ä¡ fÜ¢az HC fÜ¢a−a f¡Z£u S−ml
−gÓ¡l¡C−Xl j¡œ¡ Hhw S−ml r¡lL−aÆl Efl ¢i¢š L−l ¢L f¢lj¡Z
gVÚ¢L¢l J Q¥e S−m −jn¡−e¡ k¡−h a¡ ¢qp¡h Ll¡ k¡u
−l¢Se Hhw AeÉ¡eÉ f¢lpË¡hZ fÜ¢al à¡l¡J f¡Z£u Sm −b−L −gÓ¡l¡CX
Afp¡le Ll¡ −k−a f¡−lz

22. 4/8/2016
22
N¡qÑÙÛÉ Sm −n¡de k¿» ---
H¢V −gÓ¡l¡CX Afp¡l−el M¤hC p¡d¡le
J pÙ¹¡ HL¢V fÜ¢az 3.8 ¢j¢mNË¡j/¢mV¡l
−gÓ¡l¡CX k¤š² Sm HC Sm −n¡de k−¿»l
jdÉ ¢c−u Q¡me¡ Ll−m S−ml −gÓ¡l¡C−Xl
j¡œ¡ 0.18 ¢j¢mNË¡j/¢mV¡l fkÑ¿¹ qÊÊ¡p −f−u
b¡−Lz
HC Sm −n¡de k−¿»l ¢ia−l HL¢V 75 −p¢j
mð¡ Hhw 90 −p¢j hÉ¡p ¢h¢nø HL¢V em b¡−L
Hhw HC em¢Vl ¢ia−l 1 −L¢S −h¡eQ¡l b¡−L
−k¢V f¢lpË¡h−el L¡S L−l b¡−Lz

23. 4/8/2016
23
f¡Z£u Sm −b−L −gÓ¡l¡CX Afp¡l−e Af¡lL
−g¡V¡−e¡ Sm - −g¡V¡−e¡ S−m −gÓ¡l¡C−Xl OeaÆ L−j e¡
hlw BlJ −h−s k¡uz
¢qjÚ n£am Sm - ¢qjÚ n£am Sm −gÓ¡l¡C−Xl Oe−aÆl Efl
−L¡−e¡ fËi¡h ¢hÙ¹¡l Ll−a f¡−l e¡z

24. 4/8/2016
24
f¤¢øNa Ef¡u
−k ph M¡cÉ â−hÉ −gÓ¡l¡C−Xl j¡œ¡ A¢dL B−R
−p…¢m A¢hm−ð hSÑe Ll¡ E¢Qaz
f¤¢øNa Ef¡u, −kje :- A¢dLj¡œ¡u ¢iV¡¢je ¢pÚ
¢iV¡¢je CÚ ,AÉ¡¢¾V A¢„−X¾V
J LÉ¡m¢pu¡j pjªÜ M¡cÉ
gÓ¥−l¡¢p−pl HC pjpÉ¡
A−eLV¡C Lj¡−a p¡q¡kÉ L−lz
f¤¢øNa Ef¡u
1. p¢WL f¤¢ø Hhw fbÉ
2. ¢eaÉ Bq¡−l A¢dL f¢lj¡−e ph¤S n¡L p¢ê NËqe
3. ¢eaÉ Bq¡−l AÉ¡¢¾V A¢„−X¾V pjªÜ M¡cÉâhÉ l¡M−a
q−hz −kje :- N¡Sl, V−j−V¡ −fu¡l¡, hy¡d¡L¢f, ¢hV CaÉ¡¢cz
4. LÉ¡m¢pu¡j pjªÜ M¡h¡l NËqe Ll−a q−hz −kje :- c¤d,
c¤‡ S¡a£u M¡cÉ, −R¡V j¡R CaÉ¡¢c
5. ¢iV¡¢je ¢pÚ pjªÜ M¡h¡l NËqe Ll−a q−hz −kje :- VLÚ S¡a£u
gm, −fu¡l¡, V−j−V¡, Lm¡C X¡m, −jn¡−e¡ X¡m CaÉ¡¢cz
6. −gÓ¡l¡CX k¤š² M¡h¡l −kje :- ¢hVÚ mhZ, p¤¤f¡¢l, m¡m Q¡, a¡j¡L
Hhw −gÓ¡l¡CX k¤š² cy¡−al j¡Se J j¤M −d¡Ju¡l alm CaÉ¡¢c
hSÑe Ll−a q−hz

25. 4/8/2016
25
f¤¢øNa Ef¡−u gÓ¥−l¡¢pp ¢eh¡l−Z L£ Ll−he Bl L£ Ll−he e¡z
Ll−he Ll−he e¡
•¢hV mhZ hSÑe Ll¦e−kje :- c¤d, c¤‡S¡a âhÉ, ph¤S
n¡L p¢ê ¢eaÉ Bq¡−l l¡M¤ez
•¢iV¡¢je CÚ pjªÜ M¡cÉ ¢eaÉ Bq¡−l l¡M¤ez
•¢iV¡¢je ¢pÚ pjªÜ M¡cÉ ¢eaÉ
Bq¡−l l¡M¤e, −kje :- VLÚ S¡a£u gm,
ph¤S n¡L p¢ê
•BulZ pjªÜ M¡cÉ ¢eaÉ Bq¡−l l¡M¤e
−kje :- ph¤S n¡L p¢ê, −fu¡l¡, Lm¡,
−h…e CaÉ¡¢cz
•Nlj jnm¡, Q¡V jnm¡,
qSjm¡, Q¥lZ, a¡j¡L
CaÉ¡¢c hSÑe Ll¦ez
•p¤¤f¡¢l hSÑe Ll¦ez
•−gÓ¡l¡CX k¤š² cy¡−al
j¡Se J −gÓ¡l¡CX k¤š²
j¤M −d¡Ju¡l alm
hÉhq¡l Ll¡ hå Ll¦ez
•m¡m Q¡ hSÑe Ll¦e•LÉ¡m¢pu¡j pjªÜ M¡h¡l NËqe Ll−he
−i¢S−Vhm J−um, ph¤Sn¡L pê£,
hÉhq¡l Ll¡ hå Ll¦ez hSÑe Ll¦e hSÑe Ll¦e
¢eaÉ Bq¡−l l¡M¤ez

26. 4/8/2016
26
XÊ¡N −k…¢m gÓ¥−l¡¢p−pl L¡lZ
¢LR¥ ¢LR¥ −gÓ¡¢l−e−VX XÊ¡N −k…¢m c£OÑ ¢ce k¡hv hÉhq¡−ll L¡l−e
gÓ¥−l¡¢pp q−a f¡−l, −kje :-
−p¡¢Xu¡j −gÓ¡l¡CX (Osteoporosis) Hl ¢Q¢Lvp¡u hÉhq©a q−u b¡−L
¢e-gÓ¥¢jL AÉ¡¢pX (Rheumatoid Arthritis) Hl ¢Q¢Lvp¡u hÉhq©a
q−u b¡−L
qÉ¡−m¡¢S−e−VXÚ −Se¡−lm AÉ¡e¡−ÙÛ¢VLÚ
O¤−jl h¢s (Valium, Halcion, Restorial etc.)
hÉ¡b¡ e¡nL XÊ¡N (Prednisone, Cortisone)

27. 4/8/2016
27
gÓ¥−l¡¢pp ¢eh¡l−Z ¢f.HCQÚ.C.¢X Hl i¨¢jL¡
p¡l−gp Ju¡V¡l−L f¡e£−ul Ef−k¡N£ L−l −a¡m¡
AÉ¡m¤¢j¢eu¡j p¡m−gV ¢gÒV¡l ¢halZ
p¡l−gp Ju¡V¡−ll Efl ¢i¢š L−l c£OÑÙÛ¡u£ Ju¡V¡l
fÔÉ¡¾VÚ ÙÛ¡fe Ll¡z
hª¢øl Sm pwNË−ql fÜ¢a ÙÛ¡fe Ll¡ Hhw −pC Sm−L
f¡−el Ef−k¡N£ L−l −a¡m¡z
HR¡s¡J −gÓ¡l¡CX j¤š² ¢höÜ f¡Z£u Sm plhl¡q Ll¡z
1.Roof catchment
2.Gutters
3.Downpipe and first flush pipe
4.Storage tank
5.Filter unit

28. 4/8/2016
28
gÓ¥−l¡¢ppgÓ¥−l¡¢ppgÓ¥−l¡¢ppgÓ¥−l¡¢pp cccc§l£Ll−Zl£Ll−Zl£Ll−Zl£Ll−Z −Sm¡ ü¡ÙÛÉ J f¢lh¡l−Sm¡ ü¡ÙÛÉ J f¢lh¡l−Sm¡ ü¡ÙÛÉ J f¢lh¡l−Sm¡ ü¡ÙÛÉ J f¢lh¡l
LmÉ¡ZLmÉ¡ZLmÉ¡ZLmÉ¡Z cç−−−−lllll iiii¨¢jL¡¢jL¡¢jL¡¢jL¡
p¡l−i (¢el£rZ)
1. Skeletal Hhw Non-Skeletal Fluorosis pe¡š²Ll−Zl SeÉ
−Sm¡l k−bµQi¡−h ¢ehÑ¡¢Qa fË−aÉL NË¡−jl Ljf−r 20 ¢V
h¡¢s−a p¡l−i Ll¡ fË−u¡Sez
2. gÓ¥−l¡¢pp Bœ²¡¿¹ NË¡j…¢ml fË¡b¢jL ¢hcÉ¡mu…¢m−a p¡l−i Ll−a
q−h Dental Fluorosis pe¡š²Ll−Zl SeÉz
−l¡−Nl mr−Zl à¡l¡ p¡eš²LlZz

29. 4/8/2016
29
−l¡N ¢eZÑ−ul fl£r¡ (Diagnostic Test)
1. f¡Z£u S−m −gÓ¡l¡C−Xl j¡œ¡ fl£r¡ Ll¡z
2. j§−œ −gÓ¡l¡C−Xl j¡œ¡ fl£r¡ Ll¡z
3. l−š² −gÓ¡l¡C−Xl j¡œ¡ fl£r¡ Ll¡z
AÙ»fËQ¡l J Ko−dl à¡l¡ ¢Q¢Lvp¡z
ü¡ÙÛÉ pÇfLÑ£u ¢nr¡l (I.E.C.) à¡l¡ BQleNa f¢lhaÑez
HC −l¡N ¢eZÑu J p¢WL ¢Q¢Lvp¡l SeÉ ¢eLVhaÑ£ B.P.H.C.
HhwHhwHhwHhw P.H.C. −a −l¡N£−L Bp¡l SeÉ p−Qae L−l −a¡m¡z
gÓ¥−l¡¢pp ¢eu¿»Z J ¢eh¡l−Zl SeÉ fËQ¡l LjÑpgÓ¥−l¡¢pp ¢eu¿»Z J ¢eh¡l−Zl SeÉ fËQ¡l LjÑpgÓ¥−l¡¢pp ¢eu¿»Z J ¢eh¡l−Zl SeÉ fËQ¡l LjÑpgÓ¥−l¡¢pp ¢eu¿»Z J ¢eh¡l−Zl SeÉ fËQ¡l LjÑp§§§§Q£Q£Q£Q£
gÓ¥−l¡¢pp ¢eu¿»Z J ¢eh¡l−Zl SeÉ ¢LR¥ −nÔ¡N¡e :-
• −gÓ¡l¡CX j¤š² Sm Ll¦e f¡e
gÓ¥−l¡¢p−pl Bœ²je −b−L ¢e−S−L hy¡Q¡ez
• p¤¤f¡¢s, a¡j¡L hSÑe Ll¦e
gÓ¥−l¡¢p−pl fË−L¡f −b−L j¤š² qEez
• gmj§m ph¤S n¡Lp¢ê M¡e
gÓ¥−l¡¢pp −b−L j¤¢š² f¡ez
• S−m k¢c b¡−L −gÓ¡l¡CX c§oZ
¢ejÑm ¢gÒV¡−l qu a¡ −n¡dez
• gÓ¥−l¡¢pp −b−L j¤¢š² −f−a
c¤d ¢O q−h −M−az

30. 4/8/2016
30
p¡l−i −fË¡gjÑ¡
fË¡b¢jL ¢hcÉ¡m−ul h¡µR¡−cl p¡l−i −fË¡gjÑ¡
L¢jE¢e¢V p¡l−i −fË¡gjÑ¡
Annexure - I
Dental Fluorosis Survey in School ChildrenProforma For Dental Fluorosis Survey In School Children
Date of Survey :
Name of the School : Name of the BlockName of Block :
Name of the Village : Name of the PHC :
Name of GP : No. of Students enrolled :
Source of Drinking Water : Water Fluoride Concentration (mg/L) :
Number of Children present on survey day :
Food items Consumed as per the list :
Sl.
No.
Name of The Student Age Sex
Blood
Sample
Code
Blood F-
Content
(mg /L )
Restricted Movement
Dental Fluorosis of Students (Y/
N)
Shoulder
Pelvic
Jt.
Knee
Jt.
Name
Head of the Family
Name
Crippled/
Fixed Joint
Urine
Sample
Code No.
Urine F-
Content
(mg/L)Lumber
Spine
Mild Moderate Severe Neck

31. 4/8/2016
31
Annexure - II
Date of Survey :
House Hold No.: Name of the Block :
Name of the Villege /Habitat: Name of the PHC :
Name of GP :
Source of Drinking Water : Water Fluoride Concentration ( mg/ L ) :
Food items Consumed as per the list :
Restricted Movement
Community Survey
Blood
Sample
Code No.
Blood
Fluoride
content
(mg/L)
Sl.No. Name Age Sex
Name -
Head of the
family
Dental
fluorosis
(P/A)
H/O
Joint
Pain
(Y/N)
Knee
Jt.
Crippled
Or
Fixed
Jt.(Y/N)
Urine
Sample
Code
No.
Urine
Fluoride
Content
(mg/L)
Neck Shoulder
Lumber
Spine
Pelvic
Jt.
ANNEX : II
House hold number : Date of survey:
Name of The Block : Village :
Name of The Habitation : Name of the PHC :
Source of drinking water : Water fluoride conc. :
Food items consumed as per list of food items enclosed :
Proforma For CommunitySurveyand Medicine Distribution in Community
SYMPTOMS
Dental
Fluorosis
P/A
Types of
Skeletal
Fluorosis
J.Varum
Yes/No
J.Valgum
Yes/No
OtherManifestation
Joint pain
and
back pain
Yes/No
Tinkling
sensation
in feet and
finger
(yes/No)
Swelling
of
knee
(Yes/No)
Sample Collection
Ifnot collected mark
=X
Urine
sample
coad
Urine
Fluori
de
mg/L
Blood
Sampl
e
Coad
Blood
fluorid
e
mg/L
Head of the
family
Name & Age/Sex
Sl.
No
.
Crippled/
fixd joint
(Yes/No)
Restricted Movement (Yes/No)
Neck Shoulder
Lumber
spine
Pelvic
joint
Knee
joint

32. 4/8/2016
32
gÓ¥−l¡¢pp c§l£Ll−Z ü¡ÙÛÉ cçl J ¢f.HCQ.C.¢X
(P.H.E.D.) Hl j−dÉ pq−k¡N£a¡
gÓ¥−l¡¢pp Bœ²¡¿¹ j¡e¤o−cl pe¡š²LlZ J a¡−cl kb¡ka ¢Q¢Lvp¡l
hÉ¡hÙÛ¡ Ll¡z
¢höÜ −gÓ¡l¡CX j¤š² f¡Z£u Sm plhl¡q Ll¡z
Af¤¢øl ¢Q¢Lvp¡z
AÙ» ¢Q¢Lvp¡z
Ešj ü¡−ÙÛÉl ANËN¢a Hhw ¢höÜ f¡e£u Smz
c£OÑÙÛ¡u£i¡−h ¢höÜ −gÓ¡l¡CX j¤š² Sm plhl¡q Ll¡z
deÉh¡c