This document provides an overview of rural health care services in India. It describes the various levels of healthcare available, including primary, secondary and tertiary care. At the primary level, it outlines the roles of Accredited Social Health Activists (ASHAs), Anganwadi workers, local dais, male and female health workers, and the services provided at subcenters and primary health centers. It also discusses the functions of community health centers at the secondary level and the organization of healthcare administration at the district level through rural and urban bodies.
Primary health centers are the corner stone of rural health services .
It act as a referral unit for 6 sub centers and refer out cases to CHCs.
It covers a population of 30,000 in plain area and 20,000 in hilly and tribal area.
There are 4-6 beds for patients and some diagnostic facilities are also available.
National Leprosy Eradication Programme (NLEP)Kavya .
Chronic infectious disease caused by Mycobacterium leprae.
It usually affects the skin and peripheral nerves
Long incubation period generally 5-7 years.
Classified as paucibacillary or multibacillary
permanent disability
Timely diagnosis and treatment of cases
Primary health centers are the corner stone of rural health services .
It act as a referral unit for 6 sub centers and refer out cases to CHCs.
It covers a population of 30,000 in plain area and 20,000 in hilly and tribal area.
There are 4-6 beds for patients and some diagnostic facilities are also available.
National Leprosy Eradication Programme (NLEP)Kavya .
Chronic infectious disease caused by Mycobacterium leprae.
It usually affects the skin and peripheral nerves
Long incubation period generally 5-7 years.
Classified as paucibacillary or multibacillary
permanent disability
Timely diagnosis and treatment of cases
This ppt gives you the details about the NRHM scheme. The SWOT analysis has been done which helps you to know the strength and weakness part of the NRHM program.
BY: Dr.Pavithra R (M.H.A)
Unit:-2. Health and welfare committeesSMVDCoN ,J&K
Various committees of experts have been appointed by the government from time to time to render advice about different health problems. The reports of these committees have formed an important basis of health planning in India. The goal of National Health Planning in India is to attain Health for all by the year 2000.
Levels of health care and health care settingsRajdip Majumder
In this slide explain about Levels of health care and health care settings..
References taken from: 1. Text book of Community Health Nursing-I written by Lt. Col. KK Gill 2. Text book of Community Health Nursing written by Keshav Swarnkar
This ppt gives you the details about the NRHM scheme. The SWOT analysis has been done which helps you to know the strength and weakness part of the NRHM program.
BY: Dr.Pavithra R (M.H.A)
Unit:-2. Health and welfare committeesSMVDCoN ,J&K
Various committees of experts have been appointed by the government from time to time to render advice about different health problems. The reports of these committees have formed an important basis of health planning in India. The goal of National Health Planning in India is to attain Health for all by the year 2000.
Levels of health care and health care settingsRajdip Majumder
In this slide explain about Levels of health care and health care settings..
References taken from: 1. Text book of Community Health Nursing-I written by Lt. Col. KK Gill 2. Text book of Community Health Nursing written by Keshav Swarnkar
INTRODUCTION
The concept of “Primary Health Care” came into existence, following a joint WHO-UNICEF International Conference at Alma-Ata, USSR on 12th September 1978.
The governments of 134 Countries and many voluntary agencies at Alma-Ata Conference called for acceptance of WHO goal of “Health for All by 2000 AD” and proclaimed Primary Health Care as a way to achieving Health for All.
This approach has been described as “Health by the people” and “placing people’s health in people’s hand”.
Primary Health Care is the first level of contact of individuals, the family and community with the national health system, where essential health care is provided.
At this level that health care will be most effective within the context of the area’s need and limitations.
DEFINITION
• Primary Health Care is defined as,
“Essential health care based on practical, scientifically, sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that community and the country can afford to maintain at every stage of their development in the spirit of self-determination.”
• The Alma-Ata Conference defined Primary Health Care as follows: -
“Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford.”
CHARACTERISTICS OF PRIMARY HEALTH CARE
• It is essential health care, which is based on practical, scientifically sound and socially acceptable methods and technology.
• It should be rendered universally acceptable to individuals and the families in the community through their full participations.
• Its availability should be at a cost, which the community and country can afford to maintain at every stage of their development in a spirit of self-reliance and self-development.
• It requires joint efforts of the health sector and other health related sector like education, food and agriculture, social welfare, animal husbandry, housing, etc.
ELEMENTS OF PRIMARY HEALTH CARE
The Alma-Ata Declaration has outlined 8 essential components of Primary health care,
1. Education concerning prevailing health problems and the methods of preventing and controlling them.
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation.
4. Maternal and child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention and control of locally endemic diseases.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential drugs.
PRINCIPLES OF PRIMARY HEALTH CARE
1) Equitable distribution: -
Health service must be shared equally by all people irrespective to their ability to pay.
Primary health care aims to redress ‘Social injustice’ by shifting the centre of gravity of health care system from c
Health Care delivery system is the skeleton of meeting healthcare needs of enormous population of every country.
In order to have a clear view of community medicine, it is essential to know about different health care systems in order to fulfill learning objectives of students.
MATERNAL & CHILD HEALTH PROGRAMME IN COMMUNITY HEALTH NURSING
According to W.H.O. (1976) Maternal & child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother & child.” Thus maternal & child health services is an important & essential services related to mother & child’s overall development.
6. Reduce maternal, perinatal, infant & child mortality & morbidity rates. Child survival. Promoting reproductive health or safe motherhood. Ensure birth of healthy child.
7. Prevent malnutrition. Prevent communicable disease. Early diagnosis & treatment of the health problems. Health education & family planning services.
8. The MCH service are rendered through the infrastructure of P.H.C. & sub centers. It is proposed to set up one P.H.C. & sub-centers. It is proposed to set up one P.H.C. for every 30,0000 population, & one sub-centers for every 3000 to 5000 population. Each sub-centers are foundation of national health system. Each sub-sub-center is manned by a team of one male & female health worker. In addition there is a team of one trained Dai & one health guidein every village.
A zoonosis is an infectious disease that has jumped from a non-human animal to humans. Zoonotic pathogens may be bacterial, viral or parasitic, or may involve unconventional agents and can spread to humans through direct contact or through food, water or the environment
COMMUNITY HEALTH NURSING-II
HEALTH PLANNING POLICIES AND
PROBLEMS.To address the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery for basic reproductive and child health care.
To bring the TFR to replacement level by 2010, through vigorous implication of inter-sectorial operational strategies.
To bring the TFR to replacement level by 2010, through vigorous implication of inter-sectorial operational strategies.
To achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development and environmental protection
Address the unmet needs for basic reproductive and child health services, supplies and infrastructure.
Make school education up to age 14 free and compulsory, and reduce drop outs at primary and secondary school levels to below 20 percent for both boys and girls.
Reduce infant mortality rate to below 30 per 1000 live births.Reduce maternal mortality ratio to below 100 per 100,000 live births.
Achieve universal immunization of children against all vaccine preventable diseases
Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age.
Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons.
Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices.
Achieve 100 per cent registration of births, deaths, marriage and pregnancyContain the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater integration between the management of reproductive tract infections (RTI) and sexually transmitted infections (STI) and the National AIDS Control Organisation.
Prevent and control communicable diseasesIntegrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households.
Promote vigorously the small family norm to achieve replacement levels of TFR.
Bring about convergence in implementation of related social sector programs so that family welfare becomes a people centered programme.Decentralized planning and programme implementation
Convergence of service delivery at village level
Empowering women for improved health and nutrition
Child health and survival
Meeting the unmet needs for family welfare services
Underserved population groups(urban slums, tribals, hill areas, adolescents)
Diverse health care providers
Collaboration with and commitments from non government organisations and private sector
Mainstreaming Indian systems of medicine and Homeopathy
A National Commission on Population, presided over by the Prime Minister, will have the Chief Ministers of all states and UTs, and the Central Minister in charge of the Department of Family Welfare and other concerned Central Ministries and Departments reputed demographers, public health professionals, and NGOs as members.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
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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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. INTRODUCTION
Health is a state of complete physical Mental
and Social well being and not merely an
absence of disease of infirmity.
Illness is a State which
emotional , intellectual,
a person ‘s physical
social or spiritual
functioning is diminished or impaired..
3. Cont….
Health care is...
Promoting
Restoring and
Maintaining health
Embraces all the goods and services designed
for "prevention, promotion and rehabilitation
interventions” includes Medical Care
5. LEVELS OF HEALTHCARE
Primary Healthcare
Provided at the community level
Secondary health care
Provided at PHC, CHC, DH etc.
Tertiary health care
Provided at hospitals
6. DEFINITION
• Primary health care is essential health care made
universally accessible to individuals and acceptable
to them through their full participation and at a cost
the community and country can afford.
7. WHATIS THEREIN PRIMARYHEALTH CARE..
Primary Health Care includes:
– Primary Care (physicians, midwives & nurses);
– Health promotion, illness prevention;
– Health maintenance & home support;
– Community rehabilitation;
– Pre-hospital emergency medical services… and…
– Coordination and referral to other areas of health care.
8. ELEMENTSOF PRIMARYHEALTHCARE
1. Education about prevailing health conditions and methods
to prevent and control them
2. Promotion of food supply and proper nutrition
3. Adequate water supply and basic sanitation
4. Maternal and child health care with family planning
5. Immunization against major infectious diseases
6. Prevention and control of locally endemic diseases
7. Appropriate treatment of common diseases and injuries
8. Provision of essential drugs.
11. I
(2)LOCALDAIS
Most deliveries in rural areas by untrained dais.
Training given for 30 working days. Stipend of Rs
300 during the training period.
The training is at PHC, Sub centers or MCH
centers for two days in a week and on the
remaining four days of the week accompany the
health worker female to the village.
conduct at least two deliveries under the
supervision
12. Functionsof dais
1. MCH care
2. Family planning
3. Immunization
4. Education about health
5. Referral services
6. safe water basic sanitation
7. Nutrition.
13. (3)ANGANWADIWORKER:
Under the ICDS scheme there is an
Anganwadi worker for a population of 1000. There
are about 100 such workers in each ICDS project.
The Anganwadi worker is selected from the
community and she undergoes training in various
aspect of health, nutrition and child development
for 4 months. She is a part time worker and paid
an honorarium of Rs. 200 to 250 per month for the
services.
14. Function of anganwadi worker
1. MCH
2. Family Planning
3. Immunization
4. Education About Health
5. Referral Services
6. Safe Water And Basic Sanitation
7. Supplementary Nutrition
8. Non Formal Education Of Children.
15. ASHA SCHEME:
• One of the key components of the National Rural
Health Mission is to provide every village in the
country with a trained ASHA or Accredited
Social Health Activist. Selected from the village
itself and accountable to it .
• ASHA must primarily be a women resident of the
village- Married / Widowed /Divorced preferably
in the age group of 25 to 45 years.
• she should be a literate woman with formal
education upto class 8.
16. Cont…..
• ASHA will be chosen through a rigorous process
of selection involving various community groups,
self- help groups, Anganwadi institution, The
black Nodal Officer, District Nodal Officer, The
village health committee and the Gram sabha.
• ASHA will have to undergo services of training
episodes to acquire the necessary knowledge.
• The ASHAs will receive performance-based
incentives.
• ASHAs empowered with drug-kit
• ASHA will create awareness in health and
Nutrition.
17. SUBCENTRE
The most peripheral and first contact point
between the primary health care system and the
community.
The Ministry
Welfare
of Health &
is providing
Family
100%
Central assistance
They are established on the basis of
One SC for every 5,000 pop in general and…
One SC for every 3,000 pop in hilly, tribal and
backward areas
Each Sub-Centre is manned by one Male and
one female Health.
19. STAFFFORSUB CENTRE
S.N
O
STAFF FOR SUB
CENTRE
NUMBER
OF POSTS
1 Health Worker (Female)
/ANM
1
2 Health worker (Male) /
MPW
1
3 Voluntary Worker 1
TOTAL 3
20.
21. PRIMARYHEALTHCENTRE
PHC is the first contact point between village
community and the Medical Officer.
The PHCs were envisaged to provide an
integrated curative and preventive health care to
the rural population
The PHCs are established and maintained by the
State Governments.
At present, a PHC is manned by a Medical Officer
supported by 14 paramedical and other staff.
22. CONT….
It acts as a referral unit for 6 SubCentres.
It has 4 - 6 beds for patients.
The activities of PHC involve curative, preventive,
promotive and Family Welfare Services.
National Health Plan (1983) proposed
One PHC for every…..30,000 pop in Rural areas
One PHC for every…..50,000 pop in Urban areas
One PHC for every…..20,000 pop in hilly and
tribal areas..
24. FUNCTIONSOFPHCS
Health programmes
MCH care and family planning
Medical care
Health education and training
Referral services
Safe water supply and basic sanitation
Prevention and control of locally endemic diseases
Collection and reporting of vital events
Basic laboratory services..
25. Staffing Pattern of PHC:
1. Medical officer : 1
2. Community health officer : 1
3. Pharmacist : 1
4. Nurse Midwife : 1
5. ANM : 1
6. Health educator :1
7. Health assistant (Male) : 1
8. Health assistant(Female) : 1
1. UDC : 1
2. LDC : 1
3. Lab Technician: 1
4. Driver : 1
5. Class 4: 1
28. General
• He is responsible for all curative and preventive
health work in his area …. Clinical duty… OPD
• Organization of the Indoor services .
• Attending medico-legal cases .
• Attending to emergency cases .
• Organizing The laboratory service at the PHC
• Referring cases to hospital.
29. Supervisory
• He supervisors and Guides the work of
other members of the staff .
• He visits sub centers and other villages
for this purpose.
30. Administrative
• Co-ordinate and co-operate with other health
agencies
• He entwists co-operation of other department
Such as revenue, agriculture, education, Public
Health engineering, etc..
• preparation of tour programs of staff .
• all matters relating to Indents, receipts and
maintenance of supplies.
• Reporting the progress of activities under all
program to the Chief Medical Officer .
31. FUNCTIONS OF FEMALE HEALTHWORKER
1. Registration
2. Care At Home
3. Care Of Community
4. Care At The Clinic
5. Others
32. Registration
• Pregnant woman from 3 month of pregnancy
onwards
• Married women in reproductive period
• Children
• Maintain Maternity card..
33. Careat home
She will provide care to all pregnant women
Distribute Folic acid
Immunization
Initiation family planning
Record and report birth and death..
34. Care at the clinic
• Arrange and help HO and health assistant in
conducting MCH and family planning clinics at
the sub centre
• Conduct Urine Examination and estimate Hb%
35. Care of community
• She will identify women leaders and participate in
the training of women leaders
• Set up women depot holder for condom
distributions
• Participate in meetings
• Utilize satisfied customers, village leaders, dais and
the others for promoting Family Welfare programme
37. MALE HEALTHWORKERS
• Record keeping
• Malaria
• Communicable disease
• Leprosy
• Tuberculosis
• Environmental
• Sanitation
• Expanded programme on immunization
• Family planning
38. HEALTHASSISTANT ( MALE &FEMALE)
• Supervise the health workers
• Supervise the health care services..
• Strengthen the knowledge and skills of health
workers in the different areas
• Help the health workers in the human relation
• Help and guide health workers in planning and
organizing their program
• Promote learning of the health worker
42. The WHO Study Group (1985)
Identified Main self Explanatory Roles
In Primary Health Care
• Nurses as Direct care provider
• Nurse as a Teacher and Educator
• Nurse as a Supervisor and
Manager
• Nurse as Researcher and Evaluator
43. ROLE OF NURSES IN PHC
• Maintaining records and reports
• Conducting camp
• Area visit
• Food supply and proper nutrition
• Maternal and child health including FP
• water supply and basic sanitation
• Prevention and control of locally endemic disease
• Treatment of minor ailments
• Provision of essential drugs drugs
• Immunization
• Conducting school health programmes
• Health education
44. COMMUNITY HEALTH CENTRE :
• Health care delivery in india has 3 levels- primary,
secondary and tertiary.
• The secondary level of health care essentially includes
community health centres(CHCs) with First referral
units(FRUs).
• CHCs designed to provide referral health care for cases
from the primary health centres.
• 4 PHC are included under each CHCs
• One CHC – 80000 population in hilly/ tribal areas
1,20,000 population in plain areas.
45. • CHC is a 30 bedded hospitals providing specialist
care in medicine, obstetrics and gynecology ,
surgery, paediatrics, dental and AYUSH.
• In 2022 total CHCs = 15,363
46. OBJECTIVES:
• To provide optimal , expert care to the community .
• To achieve and maintain an acceptable standards of
quality of care.
• To make the services more responsive and sensitive
to the need of the community.
47. SERVICES PROVIDED AT CHC:
• Care of routine and emergency cases in surgery :
• A) This includes incision and drainage , and surgery
for hernia , hydrocele, appendicitis, haemorrhoids,
fistula , etc.
• Handling of emergencies like intestinal
obstruction, haemorrhage etc.
48. • Care of routine and emergency cases in medicine:
• Handling of all emergencies in relation to the
national health programmes as per guidelines like
dengue / DHF , cerebral malaria etc,
• 24 – hours delivery services , including normal and
assisted deliveries.
• Essential and emergency obstetric care including
surgical intervention like caesarean sections and
other medical interventions.
• Full range of family planning services including
laprascopic services.
49. • Other management , including nasal packing, tracheostomy,
foreign body removal etc.
• All the national health programmes(NHP) should be
delivered through the CHCs.
• Safe abortion services.
• Newborn care
• Routine and emergency care of sick children
• Others,
• A. blood storage facility
• B. essential laboratory services.
• C. Referral transport services.
50. MANPOWER AT CHC:
PERSONNEL EXISTING
Medical officers, pediatic , gynaecologist, physician
and surgeon
4
Nurse mid wives 7
Dresser 1
Pharmacist/ compounder 1
Lab technician 1
Radiographer 1
Ward boys 2
Sweepers 3
Dhobi 1
Aya 1
Peon 1
Security 1
51. AT DISTRICT LEVEL:
• The principal unit of administarion in india is the district under a
collector.
• There are 967 ( year 2020) districts in india .
• Within each district again there are 6 types of administrative
areas.
• Sub-divcisions
• Talukas
• Community development blocks
• Villages
• Panchayat.
52. • Most districts in india are divided into 2 or more sub
divisions, each in charge of an assistant collector or sub
collector .
• Each division is again divided into talukas , in charge of a
tahsildar.
• A talukas usually comprises between 200 to 600 villages.
• The rural areas of the district have been organized into
blocks, known as community development blocks.
• The block is a unit of rural planning and development , and
comprises approximately 100 villages and about 80,000 to
1,20, 000 population , in charge of a block development
officer.
• Finally there are the village panchayats , which are
institutions of a local self government.
53. HEALTH ORGANIZATION AT
DISTRICT LEVEL:
• URBAN ADMINISTRATION
• Municipal corporation
• Town area committee
• RURAL
ADMINISTRATION
• Panchayat at village level
• Gram sabha
• Gram panchayat
• Naya panchayat
• Panchayat samiti ( at block
level)
• Zilla parishad (at district
level)
54. RURALADMINISTRATION
• PANCHAYATI RAJ INSTITUTION:
• The panchayati raj is a 3 – tier structure of rural local self government in
india , linking the village to the district.
• The three institutions are:
• Panchayat – at the village level.
• Panchayat samiti – at the block level.
• Zila parishad – at the district level .
• Panchayat ( at village level) :
• The gram sabha
• The gram panchayat
• The Nyay panchayat
55. • GRAM SABHA :
• The assembly of all the adults of the village , which meets atleast twice
a year.
• It condsiders proposals for taxation, discuss the annual programme and
elects members of itself.
• GRAM PANCHAYAT :
• An Agency for planning and development at the village level.
• Its strength varies from 15 to 30 and population covered varies widely
from 5000 to 15000 0r more
• The members hold office for a period of 3 to 4 years.
• Every panchayat has an elected president ,a vice president and a
panchayat secretary.
56. THE FUNCTIONS
• They cover the entire field of civic administration , including sanitation and public
health and social and economic development of the village.
PANCHAYAT SAMITI :
• It consist of about 100 villages and a population of about 80,000
to 1,20,000.
• The panchayat raj agency at the block level is the panchayat
samiti / janpada panchayat.
• It consists of all sarpanchas of the village panchayat in tha block
MLA, MPs residing in the block area ; representatives of women
scheduled castes, scheduled tribes and cooperative societies.
• The block development officer is the ex – officio secretary of it
and his staff give assistant to the village panchayats engaged in
development programmes.
FUNCTION
• Execution of the community development programme in the block
57. FUNCTIONS OF PRs
• Agriculture
• Supply of safe and clean drinking water
• Women and child development
• Adult and formal education
• Poverty alleviation programme
• Rural electrification
• Health and sanitation
• Water management
• Rural housing
• Roads and other means of communication
58. HEALTHORGANIZATION AT STATE LEVEL
• STATE HEALTH ADMINISTRATION:
• At present there was 29 states in india, with each state
having its own health administration.
• In all states , the management sector comprises the state
ministry of health and a directorate of health or state health
directorate
59. STATE MINISTRY OF HEALTH
• The state ministry of health is headed by a minister of health
and family welfare and a deputy minister of health and
family welfare .
• The healh secretariast is the official organ of the state
ministry of health and is headed by a secretary who is
assisted by deputy secretaries. Under secretaries, a large
administrative staff.
60. STATE MINISTRY OF HEALTH
(ORGANIZATIONSTRUCTURE)
Ministry of health and family welfare
state health minister
Deputy minister of health and family welfare
Health secretariat, Health secretary
Deputy secretaries
Administrative staff members
61. STATE HEALTHDIRECTORATE
• For a long time two departments medical and public health , were
functioning in the states.
• The heads of these departments were known as,
• surgeon general and inspector general of civil hospitals.
• Director of public health respectively.
• The director of health services is the chief medical adviser to the
state government on all matters related to medicine and public
health.
• He is also responsible for the organization and direction of all health
activities.
• The director of health and family welfare is assisted by a suitable
number of deputies and assistants.
• The deputies and assistants director of health may be two types;
Regional and functional.
62. • The director of health and family welfare is assisted by a
suitable number of deputies and assistants.
• The deputies and assistants director of health may be two
types;
Regional and functional.
The regional directors inspect all the branches of public
health.
The functional directors are usually specialist in a particular
branch of public health such MCH, family planning, nutrition,
TB, leprosy and health education.
63. HEALTH ORGANIZATION AT
CENTRAL LEVEL
• AT THE CENTRAL:
• The official ‘organs’ of the health system at the central
level consists of;
• The union ministry of health and family welfare
• The directorate general of health services (DGHS).
• The central council of health and family welfare.
64. UNION MINISTRY OF HEALTH AND
FAMILY WELFARE
• 1) ORGANIZATION:
• the union ministry of health and family welfare is headed by
cabinet minister, a minister of state and a deputy health
minister.
• These are political appoinments.
• Department of health
• Department of welfare
• The secretary to the government of india in the ministry of
health and family welfare is in over all in charge of the
department of family welfare.
65. ORGANIZATION STRUCTURE
Directorate general of health services
Director general of health services
Additional director general of health services
Deputy director general of health services
Administrative staff
66. FUNCTIONS
• UNION LIST ( central govt only)
• International health relation and administration
• Administration of central institutes
• Promotion of research
• Regulation and development of medical, pharmaceutical , dental
and nursing professions.
• Collecting census and publication of statistical data.
67. CONCURRENT LIST ( both central and
state govt)
• prevention of communicable disease.
• Prevention of food adulteration
• Control of drug and poison
• Vital statistics
• Labour welfare
• Economic and social planning