This document provides an overview of epidemiology and public health planning principles. It defines epidemiology as the study of distribution and determinants of health problems in populations and its application to control such problems. The key objectives of epidemiology are described as understanding disease causation, testing hypotheses, evaluating intervention programs, and informing public health administration. Effective public health planning requires defining goals, objectives, strategies, approaches, and approaches for monitoring and evaluation. Descriptive epidemiology involves observing the basic features of disease distribution by person, place, and time to identify problems and plan services. Developing hypotheses about potential causes involves interrogating usual suspects and looking for clues in patterns of who, where, and when individuals become ill.
Observingthedistributionofdiseaseorhealth related events in human population.
• Identify the characteristics with which the disease is associated.
• Basically 3 questions are asked who, when and where.
• Who means the person affected, where means the place and when is the time distribution.
Observingthedistributionofdiseaseorhealth related events in human population.
• Identify the characteristics with which the disease is associated.
• Basically 3 questions are asked who, when and where.
• Who means the person affected, where means the place and when is the time distribution.
Epidemiology is a basic discipline essential to both clinical and community medicines. It also helps to develop the way of thinking about health and disease.
This an overview of epidemiological study designs with strengths and weaknesses. It also underscores the fact that one does not necessarily need an experimental study to prove causality, as described by the Bradford-Hill criteria for causality. Further, it highlights the hierarchy of study designs
Coronary restenosis refers to the re-narrowing or reoccurrence of blockage in a coronary artery that has previously been treated with a procedure such as angioplasty and stent placement. Angioplasty is a procedure used to open narrowed or blocked arteries by inflating a balloon-like device to widen the artery, and a stent may be placed to help keep the artery open.
Restenosis can occur when the artery becomes narrowed again due to various factors, including the growth of scar tissue inside the artery, inflammation, or the formation of new plaque. Restenosis can lead to recurrent symptoms of chest pain (angina) or other complications.
To help prevent restenosis, doctors may recommend lifestyle changes such as quitting smoking, adopting a heart-healthy diet, exercising regularly, and taking medications to manage risk factors such as high cholesterol, high blood pressure, and diabetes. In some cases, additional treatments or procedures may be necessary to address restenosis, such as repeat angioplasty, stent placement, or bypass surgery. It's essential for individuals who have undergone coronary artery procedures to follow their healthcare provider's recommendations for monitoring and managing their heart health to reduce the risk of restenosis.
Arrhythmias are abnormal heart rhythms that can occur when the electrical impulses that coordinate the heartbeats are disrupted. There are different types of arrhythmias, including:
1. Atrial Fibrillation (AFib): This is the most common type of arrhythmia and occurs when the heart's upper chambers (atria) beat irregularly and out of sync with the lower chambers (ventricles).
2. Supraventricular Tachycardia (SVT): SVT is a fast heart rate originating above the ventricles, often in the atria.
3. Ventricular Tachycardia (VT): VT is a fast heart rate that starts in the heart's lower chambers (ventricles).
4. Ventricular Fibrillation (VFib): VFib is a life-threatening arrhythmia where the ventricles quiver instead of pumping blood effectively.
5. Bradycardia: This is a slow heart rate, usually below 60 beats per minute.
Arrhythmias can be caused by various factors, including heart disease, high blood pressure, diabetes, smoking, excessive alcohol consumption, stress, certain medications, and structural abnormalities in the heart. Some arrhythmias may not cause any symptoms, while others can lead to symptoms such as palpitations, dizziness, chest pain, shortness of breath, and fainting.
Treatment for arrhythmias depends on the type and severity of the condition. It may include lifestyle modifications, medications, medical procedures like cardioversion or ablation, or implantation of devices like pacemakers or implantable cardioverter-defibrillators (ICDs) to help regulate the heart's rhythm.
If you experience symptoms of an arrhythmia or have been diagnosed with one, it's important to work closely with your healthcare provider to determine the best treatment plan and management strategies to help control
What is research, Types of research, Requisites of good research, Concept in epidemiology, Epidemiologic studies , Literature search, Protocol designing, Ethical issues, Dissertation writing , Research paper writing , Reviewing a research paper
Evidence based decision making in periodonticsHardi Gandhi
INTRODUCTION TO EVIDENCE BASED DENTISTRY
EVIDENCE BASED PERIODONTOLOGY
NEED, PRINCIPLES, GOALS AND ADVANTAGES OF EBDM
SKILLS NEEDED FOR EBDM
ASSESING THE EVIDENCE
INCORPORATING INTO THE PRACTICE
The Research Design & Conduct Service recently gave a presentation to staff at the Cardiff School of Medicine to let people know about their services, advice and support, which they offer to health professionals who are in the process of developing research projects. The RDCS was funded in 2010 by the National Institute for Social Care and Health Research (NISCHR), part of the Welsh Assembly Government. Their partner organisations are Cardiff and Vale University HB, Cwm Taf HB, Aneurin Bevan HB and Powys Teaching HB.
Learn more about the RDCS by viewing the presentation below and by visiting their website: http://medicine.cf.ac.uk/rdcs/
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. Principles of Epidemiology
Dr. Akhilesh Bhargava
MD, DHA, PGDHRM
Prof. Community Medicine
&
Director-SIHFW, Jaipur
2. Epidemiology
The study of distribution and
determinants of health problems in
specified populations and the application
of this study to the control of these
problems. It is the scientific method of
problem solving used by "disease
detectives"--epidemiologists, laboratory
scientists, statisticians, physicians and
other health care providers, and public
health professionals--to get to the root of
health problems in a community.
2
Akhilesh Bhargava
3. Epidemiology
Define ?
vA study of all diseases/health events
Øinfectious/non-infectious
Øacute/chronic
Øcommunicable/non-communicable.
vScience of rates expressed as
probability
v“ Anything that happens to people”
3
Akhilesh Bhargava
4. Epidemiology:
Gen. Objectives
• Explaining the Causal mechanism of
disease and process of deviation in
Health.
• Explaining the reason for Local disease
occurrence.
• Effective planning and administration of
Health Care Services.
4
Akhilesh Bhargava
5. Specific Objectives
1. Understanding causation of disease
with specific purpose of--
ØFormulation and selection/rejection
of hypothesis.
ØTesting hypothesis through
*Survey
*Observation studies
5
Akhilesh Bhargava
6. Specific Objectives…
2. Testing validity of rationale of
control /intervention programs
3. Classify disease/disability based
on :
Distribution
Causal factors, and
Natural history of disease
6
Akhilesh Bhargava
7. Specific Objectives
4. Explaining local disease pattern
5. Administrative Guidance
– In assessing Need, Utilization &
Effectiveness
– In monitoring & evaluation of control
programs (cost effectiveness & cost benefit
analysis)
– In Logical Planning of
• Services
• Resources
• Programs
• Reach &
• Risk Approach
7
Akhilesh Bhargava
8. Planning: Terms
• Planning-“an act or process of
choosing between alternatives to
accomplish preset goals”.
• Plan denotes a blue print of action
• Program is a strategy with defined
Objectives.
8
Akhilesh Bhargava
9. Goal:
• The proposed long-range benefits of
the program for a specified area,
defined in general terms. A goal is the
ultimate objective; for example,
“reducing the incidence of HIV in (a
country).”
9
Akhilesh Bhargava
10. Purpose:
• The overall objective (also called
strategic objective) of the program, for
example, “to increase the accessibility
to and use of palliative care facilities in
(a particular geographic area).”
• ultimate measure of the program’s
effectiveness.
10
Akhilesh Bhargava
11. Objectives:
• The anticipated outcomes or benefits that
are the expected results of implementing
a strategy. They are described in
measurable terms and indicate a specific
period of time during which these results
will be achieved.
• Should be SMART
• specific,
• measurable,
• appropriate,
• realistic, and
• time-bound
11
Akhilesh Bhargava
12. Strategy
• A strategy is a plan (to choose) to
achieve a particular goal or result;
and reveals the logic of your
choices.
12
Akhilesh Bhargava
13. Approach:
A statement that describes how the
program will achieve its objective. That
is, activities that will help the program
achieve its objectives most effectively
and feasibly.
13
Akhilesh Bhargava
14. Monitoring
• A methodological arm of evaluation that
tracks the program’s incremental steps to
its effect and informs the final evaluation
report.
• A continual, routine effort requiring data
gathering, analysis, and reporting on
results at periodic intervals
• Periodic, regular
• Focuses on inputs, outputs, process
outcomes, work plans
• Basic purpose is improve efficiency
and adjust work plan
14
Akhilesh Bhargava
15. Evaluation
• A technical activity that measures the
program’s impact and effectiveness
as a whole.
• Is not about assigning a “grade” of
success or failure at the end of a
project.
• Episodic
• Focuses on effectiveness, relevance,
impact, cost-effectiveness
• Basic purpose - improve
effectiveness, impact, and future
programming
15
Akhilesh Bhargava
17. Epidemiology?
“Study of distribution and
determinants of health related
state or events & disease in human
population”
“Science of rates expressed as
probability”
17
Akhilesh Bhargava
18. Uses of Epidemiology
• Describe Health events
• Identify the cause of disease
• Identify the Risk factors
• Describe clinical pattern of disease and
identify syndromes
• Identify effective control and/or
preventive measures
• Risk Approach
18
Akhilesh Bhargava
19. Uses of Epidemiology
• Take suitable administrative measures in-
• Assessing Need, Utilization &
Effectiveness
• Monitoring & evaluation of control
programs (cost effectiveness & cost
benefit analysis)
• Logical Planning of
» Services
» Resources
» Programs
» Reach &
19
Akhilesh Bhargava
21. Epi. Studies- Types
Study Alternative Name Unit of Study
Observational
Descriptive
Analytical
Ecological Correlation Population
Cross sectional Prevalence Individuals
case control Case reference individuals
cohort follow-up individuals
Experimental Intervention
Randomized Clinical trial Patients
field trials Healthy people
Community trials Community intervention community
21
Akhilesh Bhargava
22. Descriptive Epidemiology?
Study of distribution of a disease in a
population, and observing the basic
features of its distribution in terms of
time, place, and person.
22
Akhilesh Bhargava
23. Descriptive Epidemiology:
Objectives
• To evaluate trends and allow comparison
among different population groups
• To provide basis for planning, provision
and evaluation of services
• To identify problems to be studied by
analytical methods
23
Akhilesh Bhargava
24. Descriptive Epidemiology
describes-
• Who gets sick and who does not
• Where Rates are highest and lowest
• Temporal pattern of Disease
• Seasonality
• Secular trends decided by changes in-
• Diagnostic techniques
• Denominator data
• Age distribution of population
• Survival
• Actual incidence
24
Akhilesh Bhargava
25. Reasons for changes in Trends:
Real
• Changes in Age distribution of
population
• Changes in Survival pattern
• Changes in Actual incidence for
• Genetic
• Environmental factors
25
Akhilesh Bhargava
26. Reasons for changes in Trends:
Artifactual
• Errors in Numerator due to-
• Changes in disease recognition
• Change in classification of cause
• Change in classification codes of cause of
death
• Changes in accuracy of reporting age at
death
• Errors in denominator due to errors of
enumeration
• ICD-10 has 8000 categories as
compared to 4000 in ICD-9
26
Akhilesh Bhargava
27. Descriptive Epidemiology
Descriptive epidemiological approach
attempts to describe the disease in
terms of its attributes & variables and
answers the questions like-
• Who (Person)
• Where (Place)
• When (Time)
27
Akhilesh Bhargava
29. Who (Person) ?
Is getting the disease
Attributes & Variables
• Age
• Sex
• Ethnicity
• Marital status
• Occupation
• Education
• Income group…………
29
Akhilesh Bhargava
30. Age
Malnutrition
Measles
STI
Arthritis/ Cancer
30
Akhilesh Bhargava
31. Sex
Deaths per 100000 population from CAD
800
Deaths per 100000
700
600
500 Men
400
300 Women
200
100
0
Age groups 5-14 15-24 25-34 35-44 45-54 55-64
<1 1-4
Gap starts narrowing after 54
(menopause), suggests protective effect of estrogen
31
Akhilesh Bhargava
32. Where (Place) ?
Where Rates are highest and
lowest
• Residence
• Occupation/ Work place
• At specific events
• Geographic sites
32
Akhilesh Bhargava
33. Time (When) ?
Reflects on trend
• Year
• Season
• Day
• Date of Onset
• Duration
33
Akhilesh Bhargava
34. Time trends
• Secular (Changes that occur over
long periods of time)
• Periodic (short term)
• Cyclic (Seasonal)
• Epidemic
34
Akhilesh Bhargava
35. Secular trend is influenced by:
• Changes in completeness of source of data
• Changes in diagnostic ability
• Experience
• Techniques
• Changes in data classification approach
(ICD-9 to ICD-10)
• Demographic changes in population
• Changes in environment other than that
which is related to disease
• Changes in clinical
concepts, Diagnosis, Terminology
35
Akhilesh Bhargava
36. Cyclic (Seasonal) trends
Changes in frequency over: Days, Weeks, Months, Years
Seasonal trend-Malaria & Pf cases, 1994 Rajasthan
80
Jan
70 Feb
60 Mar
Apr
50
May
% 40 Jun
30 July
August
20
Sep.
10 Oct.
0 Nov.
Pf cases Malaria Cases Dec.
Months
36
Akhilesh Bhargava
37. Periodic (short term)
• Changes that occur in hours/
days / weeks
• Simultaneous exposure to
single source (Point source)
12
• John Snow- Cholera
10
No. of cases
8
Cases
6
4
2
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Time 37
Akhilesh Bhargava
39. Let us make an educated guess:
Hypotheses
• Why some people get the disease and
others do not
• Why disease occurs in some places
and not others
• Why disease occurs at some time and
not at others
39
Akhilesh Bhargava
40. Developing Hypotheses
• Interrogate usual suspects!
• Source of agent
• Mode of transmission
• Usual reservoirs
• Known risk factors
• Exposures that caused disease
• Look at person, place and time for
clues
40
Akhilesh Bhargava
41. Developing a hypotheses
• Requires familiarity with disease
• Hypothesis should be testable
• Still clueless?
• Talk with cases again
• Visit cases in their own situation
• Don’t forget outliers
41
Akhilesh Bhargava