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A Short Book of Public Health

By Muthu V K. New Delhi Jaypee Brothers, 2014 . 627 , Section 1: Introduction 1. Concepts in Health Care ........................................................3 Evolution of Medicine and Public Health 3 Health for All and Primary Health Care 5 Causation of Diseases 7 Concepts in Prevention of Diseases 8 Determinants of Health 9 Dimensions of Health 10 Measurement of Health 12 Global Disease Elimination and Eradication as Public Health Strategies 13 Candidate Diseases for Elimination or Eradication 15 Emerging Infectious Diseases 22 Vaccination for International Travel 29 International Certificate of Vaccination 33 Section 2: Epidemiology of Communicable Diseases Part A: Principles of Control and Prevention 2. Common Terms and Concepts............................................39 Common Terms 39 Modes of Spread of Communicable Diseases 45 Routes of Transmission of Infectious Diseases 46 Immunity 51 Immunizing Agents 53 Prevention and Control of Communicable Diseases 62 Surveillance 69 xiv A Short Book of Public Health Part B: Specific Infections 3. Respiratory Infections..........................................................79 Smallpox 80 Chickenpox 81 Measles (Rubeola) 84 German Measles (Rubella) 89 Mumps 92 Influenza 94 Common Cold 97 Avian Influenza (Bird Flu) in Humans 99 Swine Influenza 104 Severe Acute Respiratory Syndrome 107 Diphtheria 109 Whooping Cough (Pertussis) 112 Tuberculosis 115 Meningococcal Meningitis 123 Acute Respiratory Infections 124 4. Intestinal Infections............................................................129 Poliomyelitis 129 Hepatitis A 133 Hepatitis E 135 Cholera 137 Acute Diarrheal Diseases 140 Typhoid Fever 143 Food Poisoning 147 Escherichia coli (Diarrhea) 151 Amebiasis 152 Ascariasis 154 Hookworm Infestation 156 Guinea Worm Disease (Dracunculiasis) on the Verge of Eradication 158 Contents xv 5. Arthropod-borne Infections..............................................160 Arbovirus Diseases 160 Arbo Parasitic Diseases 163 Lymphatic Filariasis 163 Malaria 167 6. Zoonoses ...............................................................................185 Viral Zoonoses 186 Rabies 186 Japanese Encephalitis 191 Kyasanur Forest Disease 193 Chikungunya Fever 195 Yellow Fever 197 Ebola Hemorrhagic Fever 199 Rickettsial Zoonoses 200 Scrub Typhus (Mite-borne Typhus) 201 Murine Typhus (Endemic Typhus or Flea-borne Typhus) 202 Indian Tick Typhus 202 Q fever 203 Other Rickettsial Infections 204 Bacterial Zoonoses 205 Brucellosis 205 Leptospirosis 207 Plague 209 Anthrax 213 Salmonellosis 213 Parasitic Zoonoses 214 Teniasis (Tapeworm Infestation) 214 Hydatid Disease 215 Leishmaniasis 216 Toxoplasma gondii 219 xvi A Short Book of Public Health 7. Surface Infections................................................................222 Trachoma 222 Tetanus 224 Leprosy 226 Parenterally Transmitted Hepatitis B, C, D and G 231 Hepatitis B 231 Hepatitis C 234 Hepatitis G 236 Sexually Transmitted Infections 236 Acquired Immunodeficiency Syndrome (AIDS) 240 Scabies 245 Pediculosis 245 Section 3: Non-communicable Diseases 8. Coronary Heart Disease .....................................................249 Risk Factors 250 9. Hypertension and Stroke...................................................252 Hypertension 252 Stroke 253 10. Diabetes Mellitus ...............................................................255 Screening, Complication, Prevention 257 11. Obesity ..................................................................................259 Body Mass Index 260 12. Cancer....................................................................................262 Risk Factors, Prevention Strategies 264 13. Rheumatic Heart Disease and Accidents........................266 Rheumatic Heart Disease 266 Accidents 267 14. Mental Health ......................................................................269 Determinants 269 Contents xvii Section 4: Demography and Family Welfare 15. Demography.........................................................................277 World Population Trend 277 16. Family Planning ..................................................................282 Eligible Couples 283 Contraceptive Methods 283 Barrier Methods 284 Terminal Methods 291 17. Maternal and Child Health ...............................................294 Maternal and Child Health Problems 294 Maternal Health Situation in India 295 Reproductive and Child Health Program 296 Birth Weight 299 Infant Feeding 301 Growth and Development 302 Indicators of Maternal and Child Health Care 304 Integrated Management of Neonatal and Childhood Illness (IMNCI) 308 Family and Community Health 310 Section 5: Nutrition 18. Nutrients ...............................................................................315 Classification of Foods 315 Nutrients 316 Macronutrients 316 Micronutrients 321 Energy 334 19. Balanced Diet and Nutritional Contents of Foods .......336 Balanced Diet 336 Nutrient Content of Common Foods 337 xviii A Short Book of Public Health 20. Nutritional Problems in India ..........................................342 Nutritional Profile of India 342 21. Community Nutrition Programs in India.......................346 Community Nutrition Programs 346 Assessment of Nutritional Status 351 22. Food Adulteration...............................................................353 Food Toxicants 353 Prevention of Food Adulteration 354 23. Role of Nutrition .................................................................356 Nutrition, Health and Eugenics 356 Section 6: Health Education and School Health Service 24. Principles of Health Education.........................................365 Some Terms and Concepts 365 Health Promotion 369 Health Education 370 Health Communication 374 School Health Service 378 Health Culture 384 Section 7: Environment and Health 25. Physical Environment and Health ..................................393 Physical Environment 393 Humidity 397 Temperature 400 Ionizing Radiation 405 Non-ionizing Radiation 408 Noise 410 Soil 413 Water 415 Contents xix 26. Control of Biological Environment .................................417 Mosquito Control Measures 417 Fly Control Measures 419 Control of Lice 420 Control of Rat Fleas 421 Control of Ticks and Mites 421 Control of Rodents 422 Disinfection Procedures 422 Recommended Disinfection Procedures 425 Disinfection of Water 425 Water Quality Standards 429 27. Environmental Sanitation..................................................433 Sanitation 433 Disposal of Wastes 434 Wastes from Healthcare Activities (Central Pollution Control Board) 440 E-waste 444 Sanitation in Slaughterhouse 450 Action in Medical Epidemics 454 Global Environmental Problems 455 28. Occupational Health...........................................................457 Occupational Environment 457 Occupational Hazards 458 Other Occupational Hazards 464 Prevention of Occupational Diseases 466 Ergonomics 468 Employees’ State Insurance Scheme 469 Section 8: Healthcare System in India 29. Healthcare Delivery System..............................................473 Health Care in India 473 Primary Health Center 475 xx A Short Book of Public Health Central Bureau of Health Intelligence 476 Voluntary Health Agencies 478 Ford Foundation 486 Rockefeller Foundation 487 Care 488 30. National Health Programs in India .................................490 National Health Programs 490 Guinea Worm Disease Eradication 514 Section 9: Health Care in India: Vision and Mission 31. National Health Policy and Rural Health Mission.......533 National Health Policy 2002 533 National Rural Health Mission (2005–2012) 546 Section 10: Epidemiology and Biostatistics 32. Epidemiological Methods in Health Care......................555 Epidemiological Studies 555 Rate, Ratio and Proportion 559 Descriptive Studies 563 Case-control Studies 566 Cohort Studies 569 Experimental Studies 572 Association and Causation 577 33. Basic Statistics in Health Care ..........................................580 Collection of Statistics 580 Presentation of Statistics 582 Sources of Health Information 589 International Population Statistics 597 Measures of Central Tendency 598 Measures of Variability (Dispersion) 600 Index ..............................................................................................615

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A Short Book of Public Health

By Muthu, V K. New Delhi Jaypee Brothers, 2014 . 627 p. 9789351522287

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A Textbook of practical physiology

By Ghai, C L. New Delhi Jaypee Brothers Medical Publishers (P) Ltd, 2013 . 384 , Section One: Hematology Section Two: Human Experiments Unit I: Respiratory System Unit II: Cardiovascular System Unit III: Special Sensations Unit IV: Nervous System, Nerve And Muscle Unit V: Reproductive System Section Three: Clinical Examination Section Four: Experimental Physiology Section Five: Charts Section Six: Calculations Calculations Appendix Index

Place Hold on A Textbook of practical physiology

A Textbook of practical physiology

By Ghai, C L. Jaypee Brothers 2013 . 384

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A Visual Field Evaluation with automated Devices.

By Reddy G R. Jaypee Brothers, New Delhi 2006 . 211 , ch. 1. Introduction to automated static perimetry ch. 2. Fundamentals of automated perimetry ch. 3. Classification of visual field printouts ch. 4. Interpretation of single field analysis printout ch. 5. Visual field loss in glaucoma ch. 6. Follow-up visual field examination ch. 7. Custom tests ch. 8. Screening tests ch. 9. Short wavelength automated perimetry (blue-yellow perimetry) ch. 10. Visual field testing with frequency doubling technology ch. 11. Visual field defects due to occlusive vascular disorders of the visual pathway, a case of bitemporal hemianopia and coloboma of disc and retina ch. 12. Important clues in operating humphrey field analyzer 9788180616563

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Acute respiratory infection in hospital in developing countries children

By World Health organization. New Delhi Jaypee Brothers 1995 . 69

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All about leprosy

By Prasad, P V S. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi 2005 . 186

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Anatomy and physiology for nurses

By Pearce, Evelyn C. New Delhi Jaypee Brothers Medical Publishers (P) Ltd 1993 . 410

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API Textbook of medicine vol.1

By Munjal Y P. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi . 2872 , Introduction 1. The Practice of Medicine 2 Yash Pal Munjal 2. Disease Profi le and Epidemiology of Communicable and Non-communicable Diseases in India 11 Jugal Kishore Part 2 Clinical Approach to Key Manifestations 1. Pain: Mechanism and Management 22 PN Kakar 2. Headache 24 K Ravishankar 3. Chest Pain 34 Sanjay Tyagi and Amit Mittal 4. Acute Abdomen: Non-surgical Causes 40 Sumeet Singla and AK Agarwal 5. Cough 47 Suman Kirti 6. Haemoptysis 52 Randeep Guleria and Jaya Kumar 7. Jaundice 56 Aparna Agrawal 8. Clinical Approach to Upper Gastrointestinal Bleeding 62 JC Vij 9. Approach to Patient with Lower Gastrointestinal Bleeding 65 Surinder S Rana 10. Fever of Unknown Origin 69 Priscilla Rupali 11. Generalised Lymphadenopathy 76 SK Verma 12. Dizziness and Vertigo 79 M Maiya 13. Syncope 83 Pushpa Yadav 14. Coma 87 B Vengamma 15. Appropriate Ordering of Radiological Investigations 94 Chandan J Das 16. A Clinical Approach to Patients with Ascites 107 Richa Dewan 17. Anasarca: A Clinical Approach 111 Yash Pal Munjal 18. Approach to a Patient with Dyspnoea 115 Praloy Chakraborty 19. Clinical Approach to Exanthematous Fever 120 Bibhuti Saha and Manab Kumar Ghosh CONTENTS Volume 1 API _ Prelims _ Vol-1 for (TRADE).indd xxv PI _ Prelims _ Vol-1 for (TRADE).indd xxv 29-01-2015 14:22:08 9-01-2015 14:22:08 API Textbook of Medicine xxvi Part 3 Diagnostic Imaging 1. Conventional Radiology 126 Ashu Seith Bhalla and Manisha Jana 2. Ultrasound in Medicine 141 BS Rama Murthy 3. Computed Tomography 147 Bhavin Jankharia and Nishigandha Burute 4. Magnetic Resonance Imaging 156 Raju Sharma and Devasenathipathy Kandasamy 5. Nuclear Imaging 173 BR Mittal 6. Positron Emission Computed Tomography and Positron Emission Magnetic Resonance Imaging 186 Rakesh Kumar and Sellam Karunanithi Part 4 Clinical Pharmacology 1. Drug Discovery and Clinical Evaluation of New Drugs 196 SK Gupta and Sushma Srivastava 2. Introduction to Pharmacology 204 CD Tripathi and Sachin Manocha 3. Rational Use of Medicines 210 Sangeeta Sharma 4. Pharmacokinetic and Pharmacodynamic Basis of Pharmacotherapy 213 Rajani Mathur 5. Pharmacovigilance: Safety Monitoring of Medicines 221 V Kalaiselvan 6. Role of National Formulary of India in National Health Care System 227 Jai Prakash and YK Gupta Part 5 Immunology 1. An Overview of the Immune System 232 Sita Naik 2. General Concepts of Immuno-infl ammatory Disorders 242 Ramnath Misra 3. Immunology of Infectious Diseases 246 Sita Naik 4. Approach to a Patient with Suspected Primary Immunodefi ciency Disorder 249 Surjit Singh 5. Laboratory Investigations in Immune-mediated Diseases 256 Amita Aggarwal 6. Pharmacological Manipulation of the Immune System 261 Mitali Chatterjee and Alakendu Ghosh 7. Immunology of Organ and Haematopoietic Stem Cell Transplantation 270 Narinder K Mehra and Neeraj Kumar Part 6 Medical Genetics 1. Introduction to Medical Genetics 278 Late Shyam Swarup Agarwal 2. Mendel and Beyond 282 Ratna Dua Puri 3. Clinical, Conventional and Molecular Cytogenetics 290 Ashutosh Halder API _ Prelims _ Vol-1 for (TRADE).indd xxvi PI _ Prelims _ Vol-1 for (TRADE).indd xxvi 29-01-2015 14:22:08 9-01-2015 14:22:08 xxvii Contents 4. Genetic Tests 301 Ashwin Dalal 5. Inborn Errors of Metabolism 306 Madhulika Kabra 6. Molecular Genetics, Human Genome Project and Genomic Medicine 316 Girisha KM 7. Gene Therapy 322 Rita Mulherkar 8. Genetic Counselling and Prenatal Diagnosis 325 Shubha R Phadke 9. Pharmacogenomics and Personalised Medicine 332 C Adithan 10. Cancer Genetics 335 Rajiv Sarin Part 7 Critical Care Medicine 1. Basic Considerations in Critical Care 342 RK Mani and P Saxena 2. Monitoring of Critically Ill Patients 346 M Hanumantha Rao 3. Fluid and Electrolyte Balance in Health and Disease 352 Sanjay Jain 4. Acid-Base Disorders 360 Alladi Mohan and Surendra K Sharma 5. Enteral and Parenteral Nutrition in Critically Ill Patients 368 Shilpa S Joshi 6. Acute Respiratory Failure 374 Ashit M Bhagwati 7. Sepsis and Acute Respiratory Distress Syndrome 381 Alladi Mohan and Surendra K Sharma 8. Mechanical Ventilation 388 Tamilarasu Kadhiravan 9. Non-invasive Positive Pressure Ventilation 395 Dhruva Chaudhry and Rajesh Chawla 10. Hypotension and Shock 404 Piyush Jain and Rene P Eapen 11. Advanced Cardiac Life Support 407 Sanjeev Bhoi and Sameer Vankar 12. Brain Death and Support of Brain Dead Organ Donor 417 Rajesh Chawla and Prashant Nasa Part 8 Bone Disorders 1. Bone and Mineral Metabolism in Health and Disease 424 Deepak Khandelwal and Ravinder Goswami 2. Investigation and Diagnosis of Bone Disorders 430 Sukumar Mukherjee and Somnath Bhar 3. Rickets and Osteomalacia 437 Bindu Kulshreshtha and Sachin K Jain 4. Osteoporosis 442 SNA Rizvi 5. Developmental Disorders of Bone 448 Rakesh K Sahay 6. Miscellaneous Bone Disorders 451 CV Harinarayan API _ Prelims _ Vol-1 for (TRADE).indd xxvii PI _ Prelims _ Vol-1 for (TRADE).indd xxvii 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxviii Part 9 Diabetes Mellitus 1. Epidemiology and Basic Considerations of Diabetes 457 A Ramachandran and C Snehalatha 2. Pathogenesis of Type 1 Diabetes Mellitus 461 Carani B Sanjeevi and Vijay Viswanathan 3. Pathogenesis of Type 2 Diabetes Mellitus 465 Hemraj B Chandalia 4. Clinical Features and Diagnosis of Diabetes Mellitus 470 Anupam Prakash 5. Life-style Modifi cation in the Management of Diabetes 477 Banshi Saboo 6. Oral Antidiabetic Drugs 480 Anil Bhansali and Viral N Shah 7. Insulins 486 Yash Pal Munjal 8. Newer Modalities of Treatment in Type 2 Diabetes Mellitus 492 Anil Bhansali and G Shanmugasundar 9. In-Hospital Management of Diabetes Mellitus 497 Dukhabandhu Naik and Nihal Thomas 10. Hypoglycaemia 502 Siddharth N Shah 11. Diabetic Ketoacidosis, Hyperosmolar Hyperglycaemic State and Lactic Acidosis 508 Rajesh Rajput 12. Infections in Diabetes Mellitus 514 Samar Banerjee 13. Macrovascular Complications of Diabetes 519 Murlidhar S Rao 14. Microvascular Diseases: Pathogenesis of Chronic Complications 524 Suman Kirti 15. Diabetes and Kidney Disease 528 Raj Kumar Sharma 16. Diabetic Retinopathy 534 Amod Gupta and Reema Bansal 17. Diabetic Neuropathy 539 Manish Modi and Anu Gupta 18. Sexual Dysfunction in Diabetes 542 Shashank R Joshi 19. Management of Diabetic Foot 545 Rumneek Sodhi and Rajiv Parakh 20. Diabetes and Pregnancy 550 V Seshiah and V Balaji 21. Diabetes in the Elderly 554 Jamal Ahmad and Mohammad Asim Siddiqui 22. Prevention of Diabetes Mellitus 557 Yash Pal Munjal Part 10 Endocrinology 1. Basic Considerations of Endocrinology 566 Ashok Kumar Das 2. Endocrine Disorders: A Clinical Approach 571 MS Seshadri 3. Disorders of Hypothalamus and Pineal Gland 576 Abdul Hamid Zargar and Shariq Rashid Masoodi 4. Disorders of Anterior Pituitary 580 RV Jayakumar API _ Prelims _ Vol-1 for (TRADE).indd xxviii PI _ Prelims _ Vol-1 for (TRADE).indd xxviii 29-01-2015 14:22:09 9-01-2015 14:22:09 xxix 5. Disorders of Posterior Pituitary 589 GR Sridhar 6. Disorders of Thyroid Glands 592 Nikhil Tandon and Nishant Raizada 7. Disorders of Parathyroid Glands 606 Ambrish Mithal and Beena Bansal 8. Disorders of Adrenal Glands 610 Eesh Bhatia and Vijayalakshmi Bhatia 9. Disorders of Puberty 621 AC Ammini and Jyotsna VP 10. Disorders of Growth and Development 626 Nalini S Shah 11. Disorders of Gonads 634 Shashank R Joshi 12. Endocrine Disorders of Female Gonads 645 Pikee Saxena and Aruna Nigam Part 11 Dermatology 1. Introduction and Principles of Diagnosis in Dermatology 656 Vibhu Mendiratta 2. Infections and Infestations 665 Surabhi Dayal 3. Allergic and Infl ammatory Disorders 674 Sanjeev Handa 4. Psoriasis and Papulosquamous Disorders 678 Bela Shah 5. Acne and Acneiform Eruptions 685 V Ramesh 6. Bullous Diseases 691 Vibhu Mendiratta 7. Pigmentary Disorders 695 Sandipan Dhar 8. Cutaneous Responses to Environmental Factors 702 DM Thappa and M Malathi 9. Skin Manifestations of Systemic Diseases 708 Sunil Dogra and Rahul Mahajan 10. Pre-malignant Conditions and Malignant Tumours of the Skin 720 Arun C Inamadar and Aparna Palit 11. Sexually Transmitted Infections 724 Yogesh S Marfatia 12. Hair and Nail Disorders 733 S Sacchidanand and AS Savitha 13. Leprosy 741 Hemanta Kumar Kar 14. Dermatology Therapy 747 Asit Mittal Part 12 Cardiology 1. Basic Considerations in Cardiology 757 Upendra Kaul and Aijaz H Mansoor 2. Cardiovascular Diseases: A Clinical Approach 763 GS Sainani 3. Electrocardiology 774 MJ Gandhi Contents API _ Prelims _ Vol-1 for (TRADE).indd xxix PI _ Prelims _ Vol-1 for (TRADE).indd xxix 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxx 4. Exercise Testing 785 Yash Pal Munjal 5. Echocardiography 794 Satish Kumar Parashar 6. Cardiac Imaging 809 Priya Jagia and Sanjiv Sharma 7. Nuclear Cardiology 821 Vikram R Lele and Parag Aland 8. Cardiac Catheterisation and Angiocardiography 827 Lekha Adik Pathak and NO Bansal 9. Heart Failure 834 Donald Kikta and Veronica Franco 10. Treatment of Heart Failure 838 Veronica Franco and Khadijah Breathett 11. Acute Rheumatic Fever 845 R Krishna Kumar 12. Valvular Heart Disease (I) 854 CN Manjunath 13. Valvular Heart Disease (II) 862 VK Bahl and Neeraj Parakh 14. Infective Endocarditis 873 Shyam S Kothari 15. Atherosclerosis 884 KK Sethi and S Lahiri 16. Ischaemic Heart Disease 890 Inder S Anand and Shibba Takkar Chhabra 17. Acute Coronary Syndrome—NSTEMI 898 Ambuj Roy 18. Acute Myocardial Infarction—STEMI 904 Naved Aslam and Abhishek Goyal 19. Hypertension and Its Management 916 Sandhya A Kamath 20. Resistant Hypertension 930 BB Thakur and Smita Thakur 21. Bradyarrhythmias 935 Yash Y Lokhandwala and Gopi Krishna Panicker 22. Tachyarrhythmias 943 Amit Vora 23. Sudden Cardiac Arrest 950 Ashish K Thakur 24. Congenital Heart Disease 959 Sunita Maheshwari 25. Heart in Systemic Diseases 968 Aspi R Billimoria 26. Disorders of the Myocardium 973 KK Talwar and Ajay Bahl 27. Diseases of the Pericardium 985 Sanjay Tyagi and Amit Mittal 28. Surgical Management of Heart Disease 996 Muhammad Abid Geelani 29. Diseases of the Aorta 1005 Manotosh Panja and Soumitra Kumar 30. Vascular Disorders of the Extremities 1015 Gurpreet Singh Wander and Bishav Mohan 31. Pregnancy and Heart Disease 1023 Amal Kumar Banerjee 32. Prevention of Cardiovascular Diseases 1029 SKD Bhardwaj API _ Prelims _ Vol-1 for (TRADE).indd xxx PI _ Prelims _ Vol-1 for (TRADE).indd xxx 29-01-2015 14:22:09 9-01-2015 14:22:09 xxxi Part 13 Gastroenterology 1. Basic Considerations in Gastroenterology 1034 Vineet Ahuja and V Pratap Mouli 2. Clinical Approach to a Patient with Gastrointestinal Disease 1038 AC Anand and Pankaj Puri 3. Investigations: Gastrointestinal Disorders 1042 Ashok Chacko 4. Diagnostic and Therapeutic Utility of Endoscopy 1045 Gourdas Choudhuri 5. Oesophageal Disorders 1051 Shobna Bhatia and Deepak Kumar Gupta 6. Diseases of the Stomach and Duodenum 1061 Pankaj Dhawan and Rajesh Sainani 7. Gastrointestinal Bleeding 1069 Rakesh Kochhar and Jahangeer Basha 8. Acute Pancreatitis 1079 Pramod Kumar Garg 9. Chronic Pancreatitis 1092 V Balakrishnan and Gopalakrishna Rajesh 10. Neoplasms of the Pancreas 1098 V Balakrishnan and Gopalakrishna Rajesh 11. Functional Gastrointestinal Disorders 1103 Philip Abraham 12. Constipation: Diagnosis and Management 1108 Uday Chand Ghoshal 13. Diarrhoea and Malabsorption 1112 BS Ramakrishna 14. Abdominal Tuberculosis 1120 Govind K Makharia 15. Infl ammatory Bowel Disease 1128 Ajit Sood and Vandana Midha 16. Ischaemic Bowel Disorders 1134 Deepak Kumar Bhasin 17. Gastrointestinal Symptoms in Extra-abdominal and Systemic Diseases 1137 Sudeep Khanna and Rakesh Tandon Part 14 Hepatology 1. Basic Considerations of Hepatobiliary Disorders 1144 Vivek Anand Saraswat 2. Hepatobiliary Disorders: Clinical Approach and Investigations 1148 Nagaraja Rao Padaki 3. Hepatobiliary Disorders: Imaging 1158 Shrinivas B Desai 4. Acute Viral Hepatitis 1167 DN Amarapurkar 5. Chronic Viral Hepatitis 1174 Radha K Dhiman 6. Chronic Non-viral Hepatitis 1181 CE Eapen 7. Alcoholic Liver Disease 1184 Rajesh Upadhyay and Nitin Gupta 8. Cirrhosis of the Liver 1190 Philip Abraham 9. Extrahepatic Portal Venous Obstruction 1196 Yogesh K Chawla Contents API _ Prelims _ Vol-1 for (TRADE).indd xxxi PI _ Prelims _ Vol-1 for (TRADE).indd xxxi 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxxii 10. Non-alcoholic Fatty Liver Disease 1199 Ajay Duseja 11. Acute Liver Failure 1204 SK Acharya and Shalimar 12. Inherited Metabolic Disorders of the Liver 1210 P Advaitham and Shanthi Vijayaragavan 13. Parasitic Diseases of the Liver 1216 MP Sharma and Vaibhav Gupta 14. Toxic and Drug-induced Liver Injury 1220 Abraham Koshy 15. Liver Transplantation 1222 Subash Gupta and Ajay Kumar 16. Pregnancy and Liver Diseases 1225 Ashish Goel 17. Liver in Systemic Diseases 1230 Premashis Kar and Rajiv Singla 18. Tumours of the Liver 1234 Kaushal Madan and Pankaj Tyagi 19. Diseases of the Gall Bladder and Biliary Tract 1238 Usha Dutta and Rakesh Tandon Part 15 Haematology 1. Haematopoiesis 1245 Shaji V Ramachandran and Vikram Mathews 2. Anaemia: A Clinical Approach 1253 Renu Saxena and M Mahapatra 3. Splenomegaly: A Clinical Approach 1258 Pankaj Malhotra 4. Iron Defi ciency Anaemia 1262 Subhash Varma 5. Megaloblastic Anaemia 1268 Tarun Kumar Dutta 6. Hereditary Haemolytic Anaemia 1274 MB Agarwal 7. Acquired Haemolytic Anaemia 1285 Farah Jijina 8. Aplastic Anaemia 1291 Dharma R Choudhary and Tuphan Kanti Dolai 9. Acute Leukaemia 1297 SH Advani 10. Chronic Myeloid Leukaemia and Other Myeloproliferative Neoplasms 1306 Tapan Kumar Saikia 11. Myelodysplastic Syndromes 1310 Rajat Kumar and Seema Tyagi 12. Chronic Lymphocytic Leukaemia 1316 M Mahapatra and Renu Saxena 13. Hodgkin’s Lymphoma 1321 Bharath Rangarajan and PM Parikh 14. Non-Hodgkin’s Lymphoma 1327 Auro Viswabandya 15. Plasma Cell Dyscrasias 1331 Pankaj Manubhai Shah 16. Bleeding Disorders 1337 Kanjaksha Ghosh 17. Platelet Disorders 1341 Prantar Chakrabarti API _ Prelims _ Vol-1 for (TRADE).indd xxxii PI _ Prelims _ Vol-1 for (TRADE).indd xxxii 29-01-2015 14:22:09 9-01-2015 14:22:09 xxxiii 18. Idiopathic Thrombocytopenic Purpura 1346 Cecil Ross 19. Disorders of Coagulation 1351 Jina Bhattacharyya and Sangit Dutta 20. Hypercoagulable Disorders 1355 Mammen Chandy 21. Transfusion Medicine 1360 Neelam Marwaha 22. Haematopoietic Stem Cell Transplantation 1365 Velu Nair Part 16 HIV and AIDS 1. Epidemiology of Human Immunodefi ciency Virus Infection 1374 OC Abraham and Susanne A Pulimood 2. HIV Virology and Immunology Including Diagnosis 1376 V Ravi and Anita Desai 3. Pathophysiology and Clinical Features 1380 UL Wagholikar and Alaka Deshpande 4. Antiretroviral Therapy 1386 BB Rewari 5. Drug Resistance 1390 Alaka Deshpande 6. Non-opportunistic Infections 1394 Anil Kumar Tripathi and D Himanshu 7. Opportunistic Infections 1398 Jyoti Wadhwa 8. Non-pharmacologic Interventions and Prevention 1403 R Sajithkumar Contents Part 17 Infectious Diseases A. General Considerations 1. Basic Considerations of Infections 1411 Subhasish Kamal Guha 2. Laboratory Diagnosis of Infections 1414 Camilla Rodrigues and Niyati Desai 3. Syndromic Approach to Infectious Diseases 1422 Rajeev Soman and Neha Gupta 4. Antimicrobial Therapy 1429 Jagriti Bhatia and Dharamvir Singh Arya 5. Infection in the Immunocompromised Host 1437 Ghan Shyam Pangtey and Anupam Prakash 6. Hospital-acquired Infections/Nosocomial Infections 1440 A Shobhana 7. Prevention of Healthcare Associated Infections 1446 BB Rewari and Usha K Baveja 8. Hospital Infection Control 1452 Rohini Kelkar B. Bacterial Infections 9. Staphylococcal Infections 1455 Rita Sood Volume 2 API _ Prelims _ Vol-1 for (TRADE).indd xxxiii PI _ Prelims _ Vol-1 for (TRADE).indd xxxiii 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxxiv 10. Streptococcal Infections 1460 Abhay Narain Rai 11. Pneumococcal Infections 1463 DP Bhadoria and Sanjay Pandit 12. Meningococcal Infections 1467 RK Singal and Vivek Pal Singh 13. Gonococcal Infections 1472 Chander Grover 14. Typhoid Fever (Enteric Fever) 1476 Swapan Kumar Niyogi 15. Bacillary Dysentery 1480 Pankaj Tyagi 16. Cholera 1483 Sujit K Bhattacharya and Sandipan Ganguly 17. Diseases Caused by Gram-negative Enteric Bacilli 1486 Richa Dewan 18. Haemophilus Infl uenzae Infections 1491 M Sabir and Mansoor Ahmed 19. Legionnaires’ Disease 1495 PS Shankar 20. Plague and Other Yersinia Infections 1498 Veena Mittal 21. Clostridial Infections 1502 MK Daga and Arvind Kumar 22. Diphtheria 1508 Sandeep B Bavdekar 23. Pertussis: Whooping Cough 1511 YK Amdekar C. Miscellaneous Bacterial Infections 24. Syphilis 1514 Debabrata Bandyopadhyay 25. Non-syphilitic Treponematoses 1519 Taru Garg 26. Leptospirosis 1522 AP Sugunan 27. Other Spirochaetal Infections: Lyme Disease and Rat Bite Fever 1526 Kamlesh Tewary 28. Anaerobic Infections 1529 R Sajithkumar 29. Atypical Mycobacterial Infection 1531 Surendra Daga 30. Brucellosis 1534 BG Mantur 31. Donovanosis 1537 Dwijendra Nath Gangopadhyay 32. Actinomycosis and Nocardiosis 1539 A Muruganathan 33. Bartonella Infections 1542 Pallavi Bhargava 34. Melioidosis 1544 Kavitha Saravu D. Rickettsial, Chlamydial and Mycoplasma Infections 35. Rickettsial Infections 1547 Mala Chhabra and Veena Mittal 36. Chlamydial Infections 1553 TK Suma API _ Prelims _ Vol-1 for (TRADE).indd xxxiv PI _ Prelims _ Vol-1 for (TRADE).indd xxxiv 29-01-2015 14:22:09 9-01-2015 14:22:09 xxxv 37. Mycoplasma Infections 1556 Dilip Mathai E. Viral Infections 38. Basic Considerations of Viral Diseases 1558 Usha K Baveja 39. Herpes Simplex Virus Infections 1565 Aditya Prakash Misra 40. Human Papillomavirus and Parvovirus Infections 1569 Neerja Bhatla and Biswa B Dash 41. Swine Flu/Avian Flu 1575 Arvind Mathur and Prabhu Prakash 42. Dengue 1580 ME Yeolekar and S Sukumaran 43. Ebola and Marburg Infections 1584 Partha Pratim Chakraborty 44. Japanese Encephalitis 1586 Deepshikha 45. Rabies 1590 Tarun Kumar Dutta 46. Viral Gastroenteritis 1595 Prabhash Chandra Bhattacharyya and Rupjyoti Talukdar 47. Mumps 1597 Falguni S Parikh 48. Measles (Rubeola) 1599 RK Goyal 49. Smallpox 1602 Ramesh Balwant Pandit 50. Lymphocytic Choriomeningitis 1604 Praveen Gupta 51. Prion Disease 1607 PK Maheshwari and Anjana Pandey 52. Human Babesiosis 1609 Yash Pal Munjal and Kusumita Chaudhuri F. Protozoal Diseases 53. Malaria 1611 AK Agarwal and Sarit Chatterjee 54. Amoebiasis and Giardiasis 1620 MP Sharma and Vaibhav Gupta 55. Leishmaniasis 1624 Shyam Sundar 56. Toxoplasmosis 1629 Madhukar Rai 57. Trypanosomiasis 1632 Prashant P Joshi 58. Cryptosporidiosis, Trichomoniasis, Balantidiasis and Isosporiasis 1636 Atul Bhasin G. Helminthic Diseases 59. Ankylostomiasis, Ascariasis and Other Nematodal Infections 1639 Narender Pal Jain 60. Tapeworm and Hydatid Diseases 1650 Anurag Saxena 61. Filariasis and Other Related Infestations 1658 Sanjay Zachariah 62. Schistosomiasis/Bilharziasis 1664 Kirti C Patel Contents API _ Prelims _ Vol-1 for (TRADE).indd xxxv PI _ Prelims _ Vol-1 for (TRADE).indd xxxv 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxxvi H. Fungal Infections 63. Systemic Fungal Infections 1667 Shruti Prem and Rajat Kumar 64. Pneumocystis Jirovecii Pneumonia 1678 V Ramasubramanian Part 18 Disorders of Metabolism 1. Basic Considerations of Metabolism 1682 BK Sahay 2. Inborn Errors of Carbohydrate Metabolism 1684 Siddharth N Shah 3. Lipids and Lipoprotein Metabolism 1687 Soneil Guptha 4. Disorders of Purine and Pyrimidine Metabolism 1698 RV Jayakumar 5. Iron Metabolism and Iron Overload Syndrome 1700 Mukesh Desai 6. Porphyrias 1711 Dhanpat Kumar Kochar 7. Wilson’s Disease 1716 Sanjib Sinha and AB Taly 8. Lysosomal Storage Disorders 1722 Prasanta Kumar Bhattacharya 9. Inherited Disorders of Membrane Transport 1726 SK Singh 10. Amyloidosis 1730 Manisha Sahay 11. Disorders of Adipose Tissue and Obesity 1735 Shashank R Joshi 12. The Metabolic Syndrome 1740 Anoop Misra and Swati Bhardwaj Part 19 Nephrology 1. Structure and Function of the Kidney 1744 Sandeep Mahajan and Yasir S Rizvi 2. Kidney Disease: A Clinical Approach 1750 Vijay Kher and Pranaw Kumar Jha 3. Acute Kidney Injury 1757 Alan F Almeida and Amit Langote 4. Chronic Kidney Disease 1762 Ashok L Kirpalani and Hardik Shah 5. Primary Glomerular Diseases 1772 Vinay Sakhuja and Raja Ramachandran 6. Secondary Glomerular Diseases 1783 OP Kalra and Sandeep Mahajan 7. Urinary Tract Infections 1791 R Kasi Visweswaran and Praveen Namboodiri 8. Nephrolithiasis and Urinary Tract Obstruction 1797 PD Gulati 9. Vascular Injury to Kidney 1802 AK Hooda and AS Narula 10. Polycystic Kidney Disease and Inherited Tubular Disorders 1807 PP Varma and Ranjith Nair API _ Prelims _ Vol-1 for (TRADE).indd xxxvi PI _ Prelims _ Vol-1 for (TRADE).indd xxxvi 29-01-2015 14:22:09 9-01-2015 14:22:09 xxxvii 11. Dialysis and Other Extracorporeal Therapies 1814 NK Hase 12. Renal Transplantation 1827 George T John 13. Tubulointerstitial Diseases of the Kidney 1833 Sree B Raju 14. Drug Nephrotoxicity and Renal Dosage Adjustment 1839 Ankur Gupta and Pritam Gupta Part 20 Neurology 1. Neurological Disorders: Basic Consideration and Clinical Approach 1847 MV Padma Srivastava and RS Wadia 2. Clinical Neurophysiology 1859 J Kalita and UK Misra 3. Neuroimaging 1867 Rakesh K Gupta and Krishan K Jain 4. Epilepsy 1874 Sanjeev V Thomas 5. Disorders of Speech 1890 Apoorva Pauranik 6. Disorders of Cranial Nerves 1900 Sankar Prasad Gorthi and Sundaram Venkatraman 7. Ischaemic Cerebrovascular Diseases 1912 PM Dalal and M Bhattacharjee 8. Haemorrhagic Cerebrovascular Diseases 1926 MV Padma Srivastava and Ajay Garg 9. Cerebrovenous Thrombotic Disorders 1933 D Nagaraja and N Karthik 10. Bacterial Meningitis and Brain Abscess 1937 Ravindra Kumar Garg and Praveen Kumar Sharma 11. Neurotuberculosis 1944 Shyamal Kumar Das and Debal Laha 12. Neurosyphilis 1954 S Prabhakar and Manish Modi 13. Viral Infections of Central Nervous System 1958 Nadir E Bharucha 14. Slow Virus Infections and Prion Diseases 1966 SK Shankar 15. Fungal and Parasitic Diseases of the Nervous System 1971 Ashok Panagariya and Parul Dubey 16. Raised Intracranial Pressure and Hydrocephalus 1977 Daljit Singh 17. Dementia 1981 PS Mathuranath 18. Extrapyramidal Disorders 1987 BS Singhal 19. Cerebellar Disorders 1993 Netravathi M and Pramod Kumar Pal 20. Hyperkinetic Movement Disorders 2013 Mohit Bhatt 21. Amyotrophic Lateral Sclerosis and Other Motor Neuron Diseases 2018 BK Bajaj 22. Demyelinating Diseases of Nervous System 2026 Man Mohan Mehndiratta and Prachi Mehndiratta Contents API _ Prelims _ Vol-1 for (TRADE).indd xxxvii PI _ Prelims _ Vol-1 for (TRADE).indd xxxvii 29-01-2015 14:22:09 9-01-2015 14:22:09 API Textbook of Medicine xxxviii 23. Nutritional and Toxic Disorders of the Nervous System 2034 UK Misra 24. Metabolic Disorders of Nervous System 2041 Vrajesh Udani and Neelu Desai 25. Intracranial Space-occupying Lesions 2055 P Sarat Chandra and PN Tandon 26. Head Injury 2065 AK Singh 27. Peripheral Neuropathy 2073 AK Meena and SA Jabeen 28. Disorders of Autonomic Nervous System 2086 Garima Shukla 29. Myasthenia Gravis 2090 Sumit Singh and Atma Ram Bansal 30. Diseases of Muscles 2094 SV Khadilkar 31. Non-compressive Myelopathies 2107 Mrinal Kanti Roy 32. Compressive Myelopathies 2113 Vibhor Pardasani Part 21 Oncology 1. Developments in Oncology 2120 Lalit Kumar and Prabhat Singh Malik 2. Principles of Cancer Biology and Pathology 2125 Anita M Borges 3. Cancer Screening and Prevention 2131 Atul Sharma and MP Ram Prabhu 4. Principles of Drug Treatment of Cancer 2134 Lalit Kumar and Prabhat Singh Malik 5. Principles of Radiotherapy 2143 GK Rath 6. Head and Neck Cancers 2147 VP Gangadharan 7. Breast Cancer 2150 Vinay H Deshmane 8. Tumours of the Gastrointestinal Tract (Stomach and Oesophagus) 2157 KM Mohandas 9. Colorectal Cancer 2164 K Govind Babu 10. Genitourinary Cancers 2167 Sudeep Gupta 11. Gynaecological Malignancies 2173 PP Bapsy 12. Bone and Soft Tissue Sarcoma 2180 Avinash Deo 13. Cancer of Unknown Primary Site 2184 Hemant Malhotra and Ashwin Mathur 14. Paraneoplastic Syndromes 2191 Senthil Rajappa and D Raghunadharao 15. Cancers in the Predisposed Host 2197 K Pavithran 16. Oncological Emergencies 2202 Avinash Deo 17. Supportive Care in Cancer 2206 Madhuchanda Kar and Rakesh Roy API _ Prelims _ Vol-1 for (TRADE).indd xxxviii PI _ Prelims _ Vol-1 for (TRADE).indd xxxviii 29-01-2015 14:22:09 9-01-2015 14:22:09 xxxix Part 22 Psychiatric Medicine 1. Introduction and Basic Considerations in Psychiatry 2212 Yatan Pal Singh Balhara and Koushik Sinha Deb 2. Organic Mental Disorders 2222 SK Khandelwal 3. Substance Use Disorders 2229 Debasish Basu 4. Psychosis and Schizophrenia 2236 R Thara and Shiva Prakash Srinivasan 5. Mood Disorders 2241 Yatan Pal Singh Balhara 6. Anxiety Disorders 2247 A Shyam Sundar and YC Janardhan Reddy 7. Somatoform Disorders 2254 Rakesh K Chadda 8. Emergency Psychiatry 2260 Dipesh Bhagabati 9. Sexual Disorders 2266 TS Sathyanarayana Rao and Abhinav Tandon 10. Biological and Somatic Treatment of Psychiatric Disorders 2276 E Mohandas and Rajmohan V 11. Psychotherapies in Mental Health 2284 Manoj K Sharma Part 23 Pulmonary Medicine 1. Respiratory System: Basic Anatomy and Physiology 2290 SK Chhabra 2. Pulmonary Disorders: A Clinical Approach 2300 Jyotsna M Joshi 3. Diagnostic Procedures in Pulmonary Disorders 2306 Gautam Ahluwalia and Surendra K Sharma 4. Upper Respiratory Tract Infections 2313 DG Jain 5. Bronchial Asthma 2317 Virendra Singh 6. Chronic Obstructive Pulmonary Disease 2328 Surendra K Sharma 7. Pneumonia 2339 Digambar Behera 8. Suppurative Pleuro-pulmonary Diseases 2352 Sahajal Dhooria and Navneet Singh 9. Pulmonary Tuberculosis 2363 MS Jawahar 10. Fungal Infections of the Lungs 2371 Ashok Shah 11. Diff use Interstitial Lung Diseases 2378 Surinder K Jindal 12. Eosinophilic Lung Diseases and Tropical Pulmonary Eosinophilia 2388 VK Vijayan 13. Sarcoidosis 2395 VK Vijayan 14. Sleep-related Breathing Disorders 2403 R Narasimhan and AR Gayathri 15. Deep Venous Thrombosis and Pulmonary Embolism 2408 Jamshed D Sunavala and Shruti M Tandan Contents API _ Prelims _ Vol-1 for (TRADE).indd xxxix PI _ Prelims _ Vol-1 for (TRADE).indd xxxix 29-01-2015 14:22:10 9-01-2015 14:22:10 API Textbook of Medicine xl 16. Diseases of Pleura, Mediastinum, Diaphragm and Chest Wall 2417 Alladi Mohan 17. Benign and Malignant Tracheobronchial Tumours 2428 Lalit Kumar and MP Ram Prabhu 18. Atelectasis and Pulmonary Fibrosis 2438 Prasanta Raghab Mohapatra 19. Cor Pulmonale 2447 Sandeep Singh 20. Pulmonary Rehabilitation 2454 Sanjeev Sinha and Faraz Ahmed Farooqui Part 24 Rheumatology 1. Basic Considerations of Rheumatology 2458 Rohini Handa 2. Soft Tissue Rheumatism and Regional Rheumatic Pain Syndromes 2463 Ved Chaturvedi 3. Low Back Pain 2469 Ghan Shyam Pangtey and Hemant Gopal 4. Osteoarthritis 2478 Siddharth Kumar Das 5. Gout and Other Crystal Arthritides 2483 URK Rao and Sripurna Deepti 6. Rheumatoid Arthritis 2492 AN Malaviya 7. Spondarthritides 2513 Milind Y Nadkar and Manish W Itolikar 8. Sjögren’s Syndrome 2522 Uma Kumar 9. Systemic Lupus Erythematosus 2525 VR Joshi 10. Antiphospholipid Syndrome 2534 Vikas Agarwal and Anupam Wakhlu 11. Infl ammatory Muscle Diseases 2539 Alakendu Ghosh and Pradyot Sinhamahapatra 12. Systemic Sclerosis 2545 Shefali Khanna Sharma 13. The Vasculitides 2549 Pradeep Bambery 14. Mixed Connective Tissue Disease and Overlap Syndromes 2560 G Narsimulu 15. Rheumatic Manifestations of Systemic Diseases 2564 Debashish Danda 16. Miscellaneous Rheumatic Disorders 2568 Binoy J Paul 17. Emergencies in Rheumatology 2574 Madhumita P Das 18. Tropical Rheumatic Diseases 2579 Aman Sharma Part 25 Nutrition 1. Nutrition: Basic Considerations 2584 SV Madhu 2. Assessment of Nutritional Status 2589 Prema Ramachandran API _ Prelims _ Vol-1 for (TRADE).indd xl PI _ Prelims _ Vol-1 for (TRADE).indd xl 29-01-2015 14:22:10 9-01-2015 14:22:10 xli 3. Protein Energy Malnutrition 2593 Piyush Gupta 4. Water-soluble Vitamins 2598 Milind Y Nadkar 5. Fat-soluble Vitamins 2603 Ghan Shyam Pangtey and Moti Lal 6. Minerals, Trace Elements and Antioxidants 2608 M Raghunath and D Sreeramulu 7. Food Allergy and Food Intolerance 2615 UV Mani 8. Eating Disorders 2618 Anupam Prakash 9. Enteral and Parenteral Nutrition Support 2621 Varsha Part 26 Poisoning and Toxicology 1. Poisoning: Basic Considerations and Epidemiology 2628 Narinder Pal Singh and Gurleen Kaur 2. Aluminium Phosphide Poisoning 2632 Surjit Singh 3. Organophosphorous Poisoning 2634 Surjit Singh 4. Corrosive Poisoning 2637 Rakesh Kochhar 5. Alcohol Poisoning 2640 Pritam Gupta and Ankur Gupta 6. Plant Poisoning 2644 DKS Subrahmanyam and Muktha V 7. Drug Overdose 2649 Narinder Pal Singh 8. Snake Bite Poisoning 2656 HS Bawaskar 9. Scorpion Sting 2662 HS Bawaskar 10. Fluorosis 2670 D Raja Reddy 11. Lathyrism 2677 UK Misra and J Kalita 12. Epidemic Dropsy 2679 Vivek Suman and Shubha Laxmi Margekar 13. Heavy Metal Poisoning 2681 Praveen Aggarwal 14. Miscellaneous Poisonings 2693 Subhash Varma and Vikas Suri Part 27 Environmental Medicine 1. Basic Considerations of Environmental and Occupational Diseases 2704 Randeep Guleria 2. Climate Change: Health and Disease 2707 Anil Gurtoo 3. Air Pollution and Public Health 2713 Anumita R Chowdhury 4. Air-borne Pollutants and Smoke-related Hazards 2719 Rajeev Gupta Contents API _ Prelims _ Vol-1 for (TRADE).indd xli PI _ Prelims _ Vol-1 for (TRADE).indd xli 29-01-2015 14:22:10 9-01-2015 14:22:10 API Textbook of Medicine xlii 5. Drowning, Near Drowning and Submersion Injury 2725 Yudh Dev Singh 6. Electric Shock and Lightning Injury 2728 Naveet Wig and Sourabh Malviya 7. Eff ects of Extremes of Temperature 2731 Rajvir Bhalwar 8. High Altitude Medicine 2738 Anuj Chawla 9. Aerospace Medicine 2746 JS Kulkarni 10. Radiation Hazards 2752 AM Samuel 11. Environmental Disasters 2757 G Immanuel Part 28 Miscellaneous 1. Oral Health and Systemic Diseases 2762 Akshay Munjal and Shilpa Khullar 2. Geriatric Medicine: An Overview 2766 Vinod Kumar 3. Frailty Syndrome 2771 ME Yeolekar and S Sukumaran 4. Polypharmacy in Elderly 2774 Jyotirmoy Pal and Sattik Siddhanta 5. Sexual Medicine 2778 Prakash Kothari 6. Sports Medicine 2783 Jaspal S Sandhu and Shweta Shenoy 7. Life-style Modifi cations to Prevent and Control Diseases 2787 Shridhar Dwivedi and Ramesh Aggarwal 8. Diet in Medical Diseases 2790 Siddharth N Shah 9. Tobacco Smoking-related Diseases and Tobacco Cessation 2800 Raj Kumar 10. Adult Immunisation 2805 AK Agarwal and Sumeet Singla 11. Travel Medicine 2818 Yash Pal Munjal and Aditya Prakash Misra 12. Perioperative Management 2825 Prabha Adhikari 13. Law and Medicine 2829 A Muruganathan and Yash Pal Munjal 14. Care of Terminally Ill 2834 Anil Chaturvedi Part 29 Future of Medicine 1. Futuristic Medicine 2840 Yash Pal Munjal and Anupam Prakash 2. Regenerative Medicine 2846 Velu Nair 3. Introduction to Space Medicine 2854 R Gerzer 4. Nanotechnology and Nanomedicine 2861 RD Lele 5. Robotic Surgery 2868 Roman Dutta Index I–1

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Applications of Ultrasound in Anesthesia: A Handbook

By Lalchandani Kavitha S. Jaypee Brothers, New Delhi 2018 . 135 , Chapter-01 Basics of Ultrasound 1-15 Chapter-02 Ultrasound-guided Central Venous Access 16-56 Chapter-03 Complications and their Management 57-65 Chapter-04 Ultrasound-guided Peripheral Venous Access 66-74 Chapter-05 Introduction of Ultrasound-guided Regional Block 75-85 Chapter-06 Upper Extremity Nerve Blocks 86-109 Chapter-07 Lower Extremity Nerve Blocks 110-118 Chapter-08 Transversus Abdominis Plane Block 119-130

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Atlas of Histopathology

By Damjamov Ivan. Jaypee Brothers, New Delhi 2012 . 399 , 1. The Cardiovascular System .................................................................................... 1 Ivan Damjanov Normal Histology 1 Atherosclerosis 2 Coronary Heart Disease 2 Hypertension 3 Rheumatic Heart Disease 3 Infections of the Heart 4 Cardiomyopathy 5 Tumors of the Heart 5 Vasculitis 5 Tumors of Blood Vessels 6 2. The Respiratory System ........................................................................................ 27 Paul St. Romain, Rashna Madan, Ivan Damjanov Upper Respiratory System 27 Sinonasal Inflammations 27 Nasopharyngeal Tumors 27 Lungs 28 Alveolar Disorders Impeding Respiration 28 Bronchopulmonary Infections 29 Immunologic Lung Diseases 31 Interstitial Lung Diseases 31 Pneumoconioses 32 Chronic Obstructive Pulmonary Disease 33 Pulmonary Neoplasms 33 3. Hematopoietic and Lymphoid System ................................................................. 57 Da Zhang Normal Hematopoietic and Lymphoid System 57 Anemia 57 Microcytic Hypochromic Anemia 58 Macrocytic Anemia 58 Anemia Caused by Intrinsic Red Blood Cell Abnormalities 58 Anemia Caused by Bone Marrow Failure 59 Hemolytic Anemia 59 Leukemia 59 Acute Myeloid Leukemia 60 Acute Lymphoblastic Leukemia/Lymphoma 60 Chronic Myeloid Leukemia 60 Chronic Lymphocytic Leukemia 60 Lymphoma 61 Hodgkin Lymphoma 61 4. Digestive System .................................................................................................... 83 Rashna Madan Esophagus 83 Developmental Anomalies 83 Inflammatory and Infectious Conditions 83 Preneoplastic Conditions and Neoplasms 84 Contents xiv / ATLAS OF HISTOPATHOLOGY Stomach 85 Developmental Anomalies 86 Inflammatory and Infectious Conditions (Gastritis) and Gastropathies 86 Polyps and Neoplasms 88 Small Intestine 90 Developmental Anomalies 90 Inflammatory and Infectious Conditions 90 Polyps and Neoplasms 91 Colon 91 Developmental Anomalies 92 Inflammatory and Infectious Conditions 92 Polyps and Neoplasms 94 Appendix 95 Inflammatory and Infectious Conditions 96 Neoplasms 96 5. Hepatobiliary System .......................................................................................... 137 Maura O’ Neil Liver 137 Inflammatory Diseases 137 Metabolic Disorders 139 Cirrhosis 139 Neoplasms 139 Gallbladder 140 Inflammation 140 Neoplasms 141 6. Pancreas ................................................................................................................ 159 Rashna Madan, Ivan Damjanov Congenital and Inherited Conditions 159 Inflammatory Diseases 159 Neoplasms 160 Tumors of the Exocrine Pancreas 160 Tumors of the Endocrine Pancreas 161 7. The Urinary System............................................................................................. 177 Da Zhang, Ivan Damjanov Normal Histology 177 Overview of Pathology 177 Developmental Disorders 177 Glomerular Diseases 178 Vascular Kidney Diseases 180 Infectious Diseases 180 Neoplasms 180 8. The Male Genital System ................................................................................ 199 Ivan Damjanov Testis 199 Developmental Disorders 199 Infections 199 Neoplasms 200 Prostate 201 Benign Prostatic Hyperplasia 201 Neoplasms 201 Penis 201 Neoplasms 202 9. Female Reproductive System .............................................................................. 215 Fang Fan Vulva, Vagina and Cervix 215 Non-Neoplastic Epithelial Vulvar Disorders 215 Non-Neoplastic Lesions of Cervix 216 Human Papillomavirus Related Squamous Intraepithelial Lesions 216 Invasive Squamous Cell Carcinoma 217 Cervical Adenocarcinoma 217 Vulvar Paget Disease 217 Uterine Corpus 217 Endometritis 218 Endometrial Hyperplasia 218 Endometrial Epithelial Tumors 218 Endometrial Stromal Tumors 219 Smooth Muscle Tumors 219 Carcinosarcoma 220 Fallopian Tube 220 Acute and Chronic Salpingitis 220 Tubal Pregnancy 221 Carcinoma 221 Ovary 221 Non-Neoplastic Cysts 221 Endometriosis 221 Surface Epithelial-Stromal Tumors 221 Germ Cell Tumors 222 Sex Cord-Stromal Tumors 222 Metastatic Tumors 223 Pregnancy Related Changes 223 Blighted Ovum 223 Hydatidiform Mole 223 Choriocarcinoma 224 10. Breast .................................................................................................................... 253 Fang Fan Normal Breast 253 Reactive and Inflammatory Lesions 254 Nonproliferative Fibrocystic Change 254 Adenosis 254 Intraductal Proliferative Lesions 254 Lobular Neoplasia 255 Fibroepithelial Lesions 256 Papillary Lesions 256 Invasive Breast Carcinoma 256 Male Breast Lesions 257 11. The Endocrine System......................................................................................... 273 Paul St. Romain, Ivan Damjanov Pituitary 273 Neoplasms 273 Thyroid 274 Goiter 274 Thyroiditis 274 Neoplasms 275 CONTENTS / xv Parathyroid 276 Hyperplasia 276 Adenoma 276 Adrenal 277 Acute Adrenal Insufficiency 277 Chronic Adrenal Insufficiency 277 Adrenal Cortical Hyperplasia 277 Adrenal Cortical Adenoma 278 Adrenal Cortical Carcinoma 278 Pheochromocytoma 278 Neuroblastoma 278 12. The Skin ................................................................................................................ 297 Garth Fraga Genodermatoses 297 Inflammatory Dermatoses 297 Spongiotic Dermatitis 297 Psoriasiform Dermatitis 298 Interface Dermatitis 298 Disorders of the Hair Follicle 298 Perivascular Dermatitis 299 Granulomatous Dermatitis 299 Vesiculobullous/Blistering Dermatitis 299 Infections and Infestations 300 Bacterial Infections 300 Viral Infections 300 Fungal Infections 300 Arthropods 300 Neoplasms 301 Epidermal Neoplasms 301 Melanocytic Neoplasms 301 Mesenchymal Neoplasms 302 Hematolymphoid Neoplasms 303 13. Bones, Joints and Soft Tissues ............................................................................ 331 Katie L Dennis, Fang Fan Bones 331 Developmental Disorders 331 Metabolic Disorders 332 Inflammation 333 Neoplasms and Related Lesions 333 Joints 334 Osteoarthritis 335 Rheumatoid Arthritis 335 Gout 335 Pigmented Villonodular Synovitis 335 Soft Tissue Tumors 335 Tumors of Adipose Tissue 336 Tumors of Fibrous Tissue 336 Tumors of Skeletal Muscle 336 Tumor of Uncertain Histogenesis 336 xvi / ATLAS OF HISTOPATHOLOGY 14. Skeletal Muscles ................................................................................................... 355 Ivan Damjanov Neurogenic Muscle Diseases 355 Genetic Muscle Diseases 356 Rhabdomyolysis 357 15 Central Nervous System ...................................................................................... 367 Paul St. Romain, Ivan Damjanov Normal Central Nervous System 367 Cellular Reactions to Injury 367 Neuronal Injury 367 Glial Reaction to Injury 368 Cerebrovascular Disease 368 Cerebral Ischemia 368 Infections of the Central Nervous System 369 Meningitis 369 Encephalitis 369 Subacute Sclerosing Panencephalitis 369 AIDS Encephalopathy 369 Spongiform Encephalopathies 370 Demyelinating Diseases 370 Multiple Sclerosis 370 Neurodegenerative Diseases 370 Alzheimer Disease 370 Parkinson Disease 370 Amyotrophic Lateral Sclerosis 371 Subacute Combined Degeneration of the Spinal Cord 371 Neoplasms 371 Astrocytic Tumors 371 Oligodendroglioma 371 Ependymoma 372 Medulloblastoma 372 Meningioma 372 Schwannoma 372 Hemangioblastoma 372 Metastatic Tumors 372 Index .............................................................................................................................. 395

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Atlas of electrocardiography

By Wang,K. Jaypee Brothers, New Delhi 2013 . 306

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Atlas of electrocardiography

By Wang,K. Jaypee Brothers, New Delhi 2013 . 306 , 1. Mechanics of Recording ECG 1 2. Vectorial Concept of the QRS 2 3. Orientation of the ECG Leads 3 4. Systematic Approach to the Interpretation of ECG 4 5. ECG Waves, Intervals and Segments 4 6. Guide for Heart Rate Estimation 5 7. Proper Labeling of the Component Waves of the Ventricular Depolarization 6 8. QRS Axis 7 9. Glossary of Cardiac Rhythms 8 10. A Normal ECG 18 11. P Wave Abnormalities 20 12. Ventricular Hypertrophy, Left, Right and Biventricular 21 13. Intraventricular Conduction Defect • Bundle Branch Block 30 • Fascicular Block 33 14. AV Block 37 15. Myocardial Infarction 50 16. Simple Electrophysiologic Characteristics of the Conduction Systems 92 17. P-QRS Relationships in Arrhythmias • Reciprocal Beats 99 • Ventricular Capture Beats 101 • Fusion Beats 101 • AV Dissociation 102 • Ventriculophasic Sinus Arrhythmia 109 • Retrograde Conduction to Atria 111 18. Atrial Premature Beats 112 19. Atrial Tachycardia 116 20. Role of the AV Junction in Supraventricular Arrhythmias 118 21. Effects of Adenosine in Supraventricular Arrhythmias 119 22. Supraventricular Tachycardia (SVT) 120 xii Atlas of Electrocardiography 23. Atrial Fibrillation 123 24. Atrial Flutter 129 25. Multifocal Atrial Tachycardia 146 26. Ventricular Premature Beats 150 27. Usefulness of Ventricular Premature Beats 154 28. Aberrant Conduction 161 29. Ventricular Tachycardia 165 30. Electrolyte Problems 171 31. Sinus Node Dysfunction 186 32. Electronic Pacemaker 190 33. Stress Electrocardiography 196 34. Atrial Repolarization (Ta) Wave 197 35. Ventricular Pre-excitation 200 36. Concealed Conduction 214 37. ST-Segment Elevation in Conditions Other than Myocardial Infarction • Normal 222 • Early Repolarization Pattern as a Normal Variant 225 • "The Other" Normal Variant 226 • Left Ventricular Hypertrophy 23 • Left Bundle Branch Block 81 • Pericarditis 227 • Prinzmetal's Angina 228 • Brugada Syndrome 229 • Pulmonary Embolism 230 • Stress Cardiomyopathy 231 • Cardioversion 232 • Hyperkalemia 177 • ‘Metabolic’ ST Elevation 233 38. Miscellaneous: • Accelerated AV Conduction 234 • Acute Cor Pulmonale 235 • Atrial Septal Defect, Primum and Secundum 237 • Bidirectional Tachycardia 239 • Brugada Syndrome 229 • Cardioinhibitory Response 240 • Dextrocardia 241 • Digitalis Effect on the ST-Segment 242 • Duchenne Muscular Dystrophy 243 Contents xiii • Early Transition 244 • Ebstein's Anomaly 245 • Electrical Alternans 246 • Hypertrophic Cardiomyopathy 250 • Hypothermia 251 • Late Transition 253 • Long QT interval 254 • Low QRS Voltage 255 • Memory T–Wave 256 • Mitral Stenosis 257 • Nonspecific ST-T Changes 258 • Poor R-Wave Progression 259 • Stress Cardiomyopathy 260 • Swan-Ganz Catheterization Causing High Grade AV Block in a Patient with LBBB 261 • T-Wave Alternans 262 • Transplanted Heart 263 • Tricyclic Overdose 264 • U Waves 265 • U Waves Mimicking P Waves 266 39. Artifacts 267 40. Differential Diagnosis of: • Regular Narrow-QRS Tachycardia 273 • Regular Narrow-QRS Bradycardia 282 • Pauses 284 • Tall R Waves in the Right Precordial Lead 285 • Bigeminal Rhythm (Paired QRS Complexes) 292 • Changing QRS Axis or Morphology 294 • ST-Segment Elevation in V1-3 296 41. Addendum • How to Make an Interpretation of Arrhythmia Easy, Correct, Convincing and Clinically Relevant? 298 • A Little Rhythm Strip that Told the Whole Story 300 Index 3

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Atlas Optical Coherence Tomography of Macular Diseases and Glaucoma

By Gupta Vishali , Amod Gupta, M R Dogra. Jaypee Brothers, New Delhi 2012 . 744 , Chapter-01 Introduction to Optical Coherence Tomography 1-6 Chapter-02 OCT Equipment 7-8 Chapter-03 Technique of Acquiring OCT 9-14 Chapter-04 Selection of Scan Protocols 15-26 Chapter-05 Interpretation of OCT Scan 27-46 Chapter-06 Diabetic Macular Edema 47-118 Chapter-07 Idiopathic Central Serous Chorioretinopathy (ICSC) 119-181 Chapter-08 Macular Hole 182-227 Chapter-09 Retinal Vascular Occlusions 228-261 Chapter-10 Retinal Vasculitis 262-265 Chapter-11 Epiretinal Membranes 266-295 Chapter-12 Age-related Macular Degeneration 296-353 Chapter-13 OCT in Choroidal Neovascular Membranes 354-359 Chapter-14 Juxtafoveal Telangiectasia 360-380 Chapter-15 Heredodystrophic Disorders 381-435 Chapter-16 Foveal Hemorrhage 436-439 Chapter-17 Photic Maculopathy 440-447 Chapter-18 Optic Disc Pits 448-457 Chapter-19 Inflammatory Diseases of Retina-choroid 458-540 Chapter-20 Retinal Angiomatosis Proliferation 541-548 Chapter-21 Retinal Trauma 549-566 Chapter-22 Macular Evaluation following Retinal Detachment Surgery 567-575 Chapter-23 Degenerative Myopia 576-584 Chapter-24 Postoperative Endophthalmitis 585-590 Chapter-25 Multimodal Imaging with Spectralis HRA+OCT 591-656 Chapter-26 Introduction 657-660 Chapter-27 OCT in Glaucoma 661-664 Chapter-28 OCT Scans for Glaucoma 665-677 Chapter-29 Stratus OCT in Glaucoma 678-687 Chapter-30 Case Illustrations 688-722 Chapter-31 Limitations of OCT 723-731 Chapter-32 The Spectral Domain OCT for Glaucoma 732-740

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Autopsy Practices

By Lanjewar Dhaneshwar , Pradeep Vaideswar. Jaypee Brothers, New Delhi 2017 . 180 , 1. Autopsy: Introduction and History 1 Dhaneshwar Lanjewar Types of Autopsies 1; History of Autopsy 2; History of Autopsy in India 5 2. External Examination at Autopsy 10 Arvind Valand, Dhaneshwar Lanjewar 3. Utility and Techniques of Autopsy 15 Jaya Deshpande Preliminary Skin Incisions 17; Opening of the Thoracic and Abdominal Cavities 18; Techniques of Evisceration 19 4. In situ Examination 22 Dhaneshwar Lanjewar Examination of Cranial Cavity 22; Pericardial Cavity 23; Pleural Cavity and Lungs 24; Abdominal Cavity 24 5. Systemic Examination 27 Bishan Radotra, Pradeep Vaideeswar, Gayathri Amonkar, Anjali D Amarapurkar, Ashim Das, Vinaya Shah, Daksha Prabhat, Shubhangi Agale, Subhash Yadav 5A: Central Nervous System 27 Bishan Radotra Brain Removal Procedure 28; Examination of the Brain Before Fixation 31; Fixation of the Brain 32; Removal of the Spinal Cord 32; Examination of brain After Fixation 33; Sampling for Histology 35; Spinal Cord Examination and Sampling 36 5B: Cardiovascular System 38 Pradeep Vaideeswar Separation and Fixation of the Heart 38; External Examination of the Heart 41; Opening the Heart and Heart Weight 47; Internal Examination of the Heart 48; Alterations in Dissection 53; Sampling for Histopathology 53 Contents Prelims.indd 13 12/23/2020 3:42:42 PM xiv Autopsy Practices 5C: Examination of the Respiratory System 55 Gayathri Amonkar Importance of External and In Situ 55; Lung Dissection, Fixation and Cutting 57; Examination of the Lungs 59 5D: Gastrointestinal Tract at Autopsy 62 Anjali D Amarapurkar In Situ Examination 63; Systemic Examination 63 5E: Approach in Autopsy of Patients with Liver-related Problems 69 Ashim Das External Examination 69; Internal Examination 70 5F: Urogenital Tract at Autopsy 76 Vinaya Shah External Examination of the Kidneys 76; Examination of Cut Surface of the Kidneys 79; Examination of the Ureters 83; Examination of the Urinary Bladder 84; Examination of the Testes 85; Examination of the Prostate 86; Examination of the Seminal Vesicles 86 Examination of the Female Genital Tract 86 5G: Examination of the Lymphoreticular System 88 Daksha Prabhat, Shubhangi Agale, Subhash Yadav Spleen 88; Thymus 96 6. Autopsies in Special Situations 99 Bhuvaneshwari Kandalkar, Pragati Sathe, Late Ratnaprabha Ghodke, Kusum Jashnani 6A: Pediatric Autopsies 99 Bhuvaneshwari Kandalkar, Pragati Sathe, Late Ratnaprabha Ghodke External Examination 100; Incisions and In Situ Examination 101; Systemic Examination 102; Postmortem Investigations 105; Sampling for Histopathology 105 6B: Autopsy in Maternal Deaths 107 Kusum Jashnani Role of Autopsy in Maternal Deaths 108; Importance of Clinical Records 108; External Examination 108; In Situ Examination 109; Internal Systemic Examination 110 7. Autopsy and Law 118 Shailesh Mohite Indian Law Related to Medicolegal Postmortem 122 8. Design of Autopsy Room 130 Smita Divate, Dhaneshwar Lanjewar Basic Functional Areas 130 Prelims.indd 14 12/23/2020 3:42:42 PM Contents xv 9. Autopsy Safety Precautions 136 Smita Divate General Rules for Autopsy Biosafety 137; Isolation Room for Specific Types of High-Risk Autopsies 138; Safe Use of Sharp Instruments 138; Limiting the Generation of Aerosols 138; Personal Protective Attire/Equipment for Autopsies 139 Handwashing 139; Cleaning and Decontamination 139; Handling of Cadavers 140; Storage and Transport of Tissues 140; Demonstration of Organs At Meetings 141; Biowaste Disposal 141; Photography 141; Employee Health 141; Appendix 1 143; Appendix 2 144 10. Autopsy Audit 145 Jaya Deshpande Preanalytical Phase 145; Analytical Phase 146; Postanalytical Phase 146; Autopsy Clinical Audit Monitors 147 11. Embalming 148 Deepak S Joshi History 148; Modern Embalming 148; Principle of Embalming 149; Pre-Embalming Steps and Their Legal Aspects 150; Equipment Required for Embalming 150; Methods of Embalming 151; Packing and Transportation 152; Plastination 152 12. Autopsy Guidelines in COVID-2019 154 Dhaneshwar Lanjewar Guidelines and Precautions for Performing Autopsy 154; Recommendations for Gross Contamination and Liquids 156 Appendices 159 Case 1: Central Nervous System 159 Bishan Radotra Case 2: Central Nervous System 162 Bishan Radotra Case 3: Cardiovascular System 163 Pradeep Vaideeswar Case 4: Cardiovascular System 166 Pradeep Vaideeswar Case 5: Gastrointestinal Tract 169 Anjali D Amarapurkar Case 6: Urinary Tract 171 Vinaya Shah Case 7: Autopsy In Infectious Disease 173 Dhaneshwar Lanjewar Prelims.indd 15 12/23/2020 3:42:42 PM xvi Autopsy Practices Case 8: Maternal Mortality 176 Kusum Jashnani Case 9: Pediatric Autopsy 179 Pragati Sathe Case 10: Urinary System and Gastrointestinal Tract 181 Dhaneshwar Lanjewar Case 11: Respiratory System 184 Pradeep Vaideeswar, Saranya Singaravel Case 12: Central Nervous, Cardiovascular and Respiratory Systems 187 Bishan Radotra Case 13: Multi-System Involvement 193 Bishan Radotra Case 14: Gastrointestinal Tract 200 Dhaneshwar Lanjewar, Saroj Bolde Index 207

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Basic concepts in Head & Neck Surgery and oncology

By Krishnakumar Thankappan, Subramania Iyer. Jaypee Brothers, New Delhi 2015 . 264 , SECTION 1: THYROID Chapter 1. Pathology of Thyroid Tumors....................................................................................3 Smitha NV Classification 3 Fine Needle Aspiration Cytology (FNAC) 4 Papillary Carcinoma 5 Follicular Carcinoma 8 Poorly Differentiated Carcinoma 9 Anaplastic (Undifferentiated) Carcinoma 9 Medullary Carcinoma 10 Molecular Genetics 11 Ancillary Testing 13 Chapter 2. Guidelines in the Management of Differentiated Thyroid Cancer...................14 Shreya Bhattacharya, Krishnakumar Thankappan Diagnostic Evaluation 14 Treatment 15 Risk Stratification 20 Role of Radioiodine after Thyroidectomy 20 Distant Metastasis 21 External Beam Radiotherapy (EBRT) 21 Follow-up 21 Recurrent DTC 21 Chapter 3. Guidelines in the Management of Medullary and Anaplastic Thyroid Cancer.......................................................................................23 Shreya Bhattacharya, Krishnakumar Thankappan Medullary Thyroid Cancers 23 Diagnostic Evaluation 23 TNM Staging 24 Treatment 24 Prognosis 26 Anaplastic Carcinoma 26 Staging 26 Management 26 Prelims_Thankappan.indd 19 25-02-2019 16:49:20 xx Basic Concepts in Head and Neck Surgery and Oncology Chapter 4. Principles of Thyroid Surgery..................................................................................28 Shreya Bhattacharya, Krishnakumar Thankappan Surgical Anatomy 28 Surgical Technique 29 Complications of Thyroidectomy 30 Chapter 5. Role of Nuclear Medicine in Adjuvant Therapy and Follow-up of Differentiated Thyroid Cancer.................................................32 P Shanmuga Sundaram Selection of Patients for Radioiodine 131I Ablation 33 Side Effects of 131I High-dose Therapy 36 Long-term Effects of 131I 37 Chapter 6. Medical Management of Differentiated Thyroid Cancer...................................39 Vasantha Nair, Krishnakumar Thankappan General Principles 39 Follow-up after Initial Therapy 39 T4 Suppression Therapy 40 Role of T3 41 Chemotherapy 41 Addressing Comorbidities 41 Chapter 7. Parathyroid Tumors: Evaluation and Management............................................44 Shibu George Anatomy 44 Primary Hyperparathyroidism and Parathyroid Adenoma 44 Asymptomatic Primary Hyperparathyroidism 45 Parathyroid Carcinoma 47 Secondary Parathyroid Malignancy 48 SECTION 2: SALIVARY GLANDS AND PARAPHARYNGEAL TUMORS Chapter 8. Pathology of Salivary Gland Tumors .....................................................................55 Chaya Prasad, Smitha NV WHO Classification 55 Malignant Tumors 55 Benign Tumors 65 Prelims_Thankappan.indd 20 25-02-2019 16:49:20 Contents xxi Chapter 9. Imaging of Salivary Gland Tumors.........................................................................67 Sandya CJ, Akshay Kudpaje, Sivakumar Vidhyadharan, Rajsekar CS Normal Anatomy 67 Neoplasms of Salivary Glands 68 Malignant Neoplasms of Parotid Gland 70 Chapter 10. Guidelines in the Management of Salivary Gland Malignancies .....................72 Mahamaya Prasad Singh, Krishnakumar Thankappan, Subramania Iyer Epidemiology 72 Clinical Presentation 72 Imaging 72 Biopsy 74 Treatment 74 Prognosis 76 Chapter 11. Principles of Salivary Gland Tumor Surgery.........................................................77 Mahamaya Prasad Singh, Krishnakumar Thankappan, Subramania Iyer Surgical Anatomy 77 Parotidectomy: Surgical Technique 78 Submandibular Gland 80 Surgical Technique 80 Chapter 12. Imaging in Parapharyngeal Tumors ......................................................................81 Sandya CJ, Akshay Kudpaje Anatomy 81 Imaging Assessment 81 Pathology 82 Chapter 13. Parapharyngeal Space Tumors ...............................................................................89 Mahamaya Prasad Singh, Krishnakumar Thankappan Anatomy 89 Boundaries 89 Tumors of the Parapharyngeal Space 89 Clinical Presentation 90 Treatment 91 Approaches to the Parapharyngeal Space 91 Prelims_Thankappan.indd 21 25-02-2019 16:49:20 xxii Basic Concepts in Head and Neck Surgery and Oncology Chapter 14. Tumors of Infratemporal Fossa: Approaches and Management......................94 Divya GM Surgical Anatomy 94 Classification of Tumors of Infratemporal Fossa 94 Diagnosis 96 Patient Selection 97 Approaches to Infratemporal Fossa 97 Chapter 15. Malignant Tumors of the Temporal Bone .......................................................... 101 Deepak Balasubramanian Etiology 101 Spectrum of Malignancies in the Temporal Bone 101 Pathways of Tumor Spread in the Temporal Bone 101 Clinical Presentation 102 Clinical Evaluation 102 Staging 102 Treatment 103 Prognosis 103 Chapter 16. Facial Nerve ............................................................................................................. 105 Salima Rema Windsor Anatomy 105 Surgical Landmarks for Facial Nerve 107 Pathophysiology 108 Etiology of Facial Nerve Paralysis 109 Management of Facial Nerve Paralysis 110 Treatment of Facial Paralysis 111 Facial Reanimation 111 SECTION 3: NECK Chapter 17. Neck Nodal Levels and Classification of Neck Dissection............................... 117 Shashikant Vishnubhai Limbachiya, Deepak Balasubramanian Anatomy of the Fascial Spaces of the Neck 117 Neck Lymphatics 117 Classification of Neck Nodal Levels 117 Terminology of Neck Dissection 121 Staging of the Neck 122 Prelims_Thankappan.indd 22 25-02-2019 16:49:20 Contents xxiii Chapter 18. Management of the Node Negative Neck ......................................................... 124 Shashikant Vishnubhai Limbachiya, Deepak Balasubramanian Treatment Options 124 Chapter 19. Management of the Node Positive Neck ........................................................... 127 Shashikant Vishnubhai Limbachiya, Deepak Balasubramanian Treatment for N+ Neck 127 Radical Neck Dissection 127 Modified Radical Neck Dissection 131 Complications of Neck Dissection 132 Chapter 20. Nodal Metastasis from an Unknown Primary Origin....................................... 134 Krishnakumar Thankappan Theories of Occurrence 134 Evaluation 134 AJCC 8th Edition: Changes in Relation to Cervical Metastasis with Unknown Primary 135 Treatment 137 SECTION 4: PARANASAL SINUSES Chapter 21. Pathology of Tumors of the Nose and Paranasal Sinuses............................... 143 Chaya Prasad WHO Histological Classification 143 Chapter 22. Imaging of the Paranasal Sinus Tumors............................................................. 151 Sandya CJ, Akshay Kudpaje, Sivakumar Vidhyadharan, Chinmay Kulkarni Sinonasal Neoplasms 151 Imaging Modalities 151 Lymphatic Spread 151 Perineural Spread 152 Orbital Involvement 153 Brain and Dural Involvement 153 Soft Tissue Involvement 154 Chapter 23. Guidelines in the Management of Malignancies in Maxillo-ethmoid Complex ............................................................................... 156 Adharsh Anand, Deepak Balasubramanian Patterns of Spread 156 Presenting Signs and Symptoms 157 Prelims_Thankappan.indd 23 25-02-2019 16:49:20 xxiv Basic Concepts in Head and Neck Surgery and Oncology Ohngren’s Classification 157 TNM Staging, AJCC 8th Edition 157 Evaluation 157 Treatment Guidelines 158 Management of Neck 161 Management of the Orbit 161 Reconstruction and Rehabilitation 161 Outcome 162 Chapter 24. Principles of Surgery in the Management of Tumors of Maxillo-ethmoid Complex ............................................................................... 163 Adharsh Anand, Deepak Balasubramanian Surgical Anatomy 163 Surgical Treatment 163 SECTION 5: ORAL CAVITY AND OROPHARYNX Chapter 25. Imaging in Oral and Oropharyngeal Tumors .................................................... 171 Sandya CJ, Akshay Kudpaje, Shreya Bhattacharya Oral Cavity 171 Retromolar Trigone 172 Lymphatic Evaluation 179 Metastases 179 Chapter 26. Guidelines in the Management of Oral Cavity Cancers .................................. 181 Sivakumar Vidhyadharan, Anoop R, Krishnakumar Thankappan Epidemiology 181 Clinical Presentation 181 Treatment: General Principles 185 Chapter 27. Guidelines in the Management of Oropharyngeal Cancers........................... 190 Prameela CG Epidemiology 190 Etiology 190 Anatomy 191 Subsites of Oropharynx 191 Pathology 191 Clinical Features 191 Distant Metastasis 192 Prelims_Thankappan.indd 24 25-02-2019 16:49:21 Contents xxv Evaluation 192 Management 193 Subsite-wise Treatment Approaches 196 Transoral Surgical Approaches 200 Adjuvant Treatment 200 Definitive Radiotherapy 201 Altered Fractionation Schedules 202 Treatment Sequelae 204 Chapter 28. Principles of Surgery in Oral Cavity Cancers ..................................................... 205 Sivakumar Vidhyadharan, Subramania Iyer, Krishnakumar Thankappan Surgical Anatomy 205 Retromolar Trigone 207 Surgical Management and Techniques 207 Management of the Mandible 212 Assessment of Bony Invasion 213 Mandibulectomy 214 SECTION 6: LARYNX, HYPOPHARYNX AND NASOPHARYNX Chapter 29. Imaging in Laryngeal and Hypopharyngeal Tumors....................................... 221 Sandya CJ, Akshay Kudpaje Anatomy of Larynx 221 Imaging Techniques 222 Supraglottic Cancers 223 TNM Staging 226 Chapter 30. Guidelines in the Management of Laryngeal Cancers .................................... 231 Akshay Kudpaje, Krishnakumar Thankappan Anatomy 231 Clinical Features 232 Treatment 233 Chapter 31. Guidelines in the Management of Hypopharyngeal Cancers........................ 239 Akshay Kudpaje, Krishnakumar Thankappan Anatomy 239 Clinical Features 240 Treatment 242 Prelims_Thankappan.indd 25 25-02-2019 16:49:21 xxvi Basic Concepts in Head and Neck Surgery and Oncology Chapter 32. Principles of Surgery in Larynx and Hypopharynx Cancers........................... 247 Akshay Kudpaje, Krishnakumar Thankappan, Subramania Iyer Transoral Laser Microsurgery 247 Vertical Partial Laryngectomy 249 Supraglottic Laryngectomy 250 Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy (SCPL-CHEP) 250 Supracricoid Partial Laryngectomy with Cricohyoidopexy (SCPL-CHP) 251 Near Total Laryngectomy 252 Total Laryngectomy 253 Alaryngeal Speech 253 Chapter 33. Tracheostomy and Airway Management........................................................... 255 Salima Rema Windsor Tracheostomy 255 Pediatric Tracheostomy 258 Types of Tracheostomy Tubes 260 Percutaneous Dilatational Tracheostomy 260 Chapter 34. Guidelines in the Management of Carcinoma of the Nasopharynx........................................................................... 263 Pushpaja KU Anatomy 263 Lymphatic Drainage 263 Epidemiology 263 Etiology 264 Pathology 264 Routes of Spread 264 Clinical Presentation 265 Diagnosis 266 General Treatment Principles 268 SECTION 7: GENERAL TOPICS Chapter 35. Melanoma and Nonmelanoma Skin Cancers.................................................... 273 Divya GM Melanoma 273 Nonmelanoma Skin Cancers 279 Basal Cell Carcinoma 281 Squamous Cell Carcinoma 283 Prelims_Thankappan.indd 26 25-02-2019 16:49:21 Contents xxvii Chapter 36. Role of Chemotherapy in Head and Neck Cancer............................................ 285 K Pavithran Induction Chemotherapy 285 Induction Chemotherapy Followed by CRT versus CRT Alone 286 Locally Advanced SCCHN 286 Postoperative Concurrent Chemoradiotherapy 287 Nasopharyngeal Carcinoma 288 Recurrent or Metastatic Disease 288 Metronomic Chemotherapy 288 Immunotherapy 288 Chapter 37. Principles of Radiotherapy in Head and Neck Malignancies ......................... 290 Anoop R General Principles and Radiobiology 290 Four R’s of Radiobiology 290 Fractionation 291 Methods of Radiation Delivery 291 Clinical Applications 292 Radiation Treatment Planning 292 External Beam Radiation Therapy 294 Three-dimensional Conformal Radiation Therapy (3D-CRT) 295 Intensity-modulated Radiation Therapy 295 Brachytherapy 297 Side Effects of Radiation Treatment 298 Chapter 38. Molecular Biology of Head and Neck Cancer.................................................... 300 Mayuri Mohan Rajapurkar Tobacco-related Cancers 301 Human Papillomavirus-related Cancers 301 Genetic Susceptibility 301 Carcinogenesis 302 Field Cancerization 302 Epithelial-to-Mesenchymal Transition 303 Epigenetic Modification 303 Molecular Pathways involved in HNSCC 303 Genetic Expression Profiling and Prognostic Markers 304 Role of Immunotherapy 305 Chapter 39. Recent Advances in Management of Head and Neck Cancer........................ 307 Deepak Balasubramanian Human Papillomavirus and Head and Neck Cancer 307 Transoral Robotic Surgery 307 Prelims_Thankappan.indd 27 25-02-2019 16:49:21 xxviii Basic Concepts in Head and Neck Surgery and Oncology Sentinel Node Biopsy 308 Molecular Diagnostics in Thyroid Cancer 308 Newer Systemic Agents (Epidermal Growth Factor Receptor and Tyrosine Kinase Inhibitor) 309 Advances in Radiation Delivery Techniques 309 Chapter 40. Head and Neck Reconstruction ........................................................................... 310 Mohit Sharma, Abhijeet N Wakure, Sivakumar Vidhyadharan, Subramania Iyer Principles of Reconstruction 310 Goals of Reconstruction 310 Reconstructive Strategies 310 Postreconstruction Rehabilitation 323 Index .......................................................................................

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Basics in occupational therapy and therapeutic activities

By Neelima Punithan. Jaypee Brothers, New Delhi 2008 . 118

Place Hold on Basics in occupational therapy and therapeutic activities

Basics of biostatistics: A manual for medical practitioners

By Bali, Jatinder and Kant, Anil. Jaypee Brothers 2017 . 540 , Section 1: Bioethics, Evidence-based Medicine 1. Bioethics in Clinical Research 13 Major Divisions of Ethics 13; Bioethics 14; Main Branches of Bioethics 14 Etymology, History and the Famous Nonethical Experiments 14 Dachau and Auschwitz Concentration Camp Hypothermia Experiments 15 Animal Ethics 34; Environmental Ethics 35; Anthropocentrism 36 2. Evidence-based Medicine and Levels of Evidence 38 Evidence-based Medicine 38; Fundamental Principles 38 Components of Evidence-based Practices 39 3. Introduction to Statistics 49 Etymology 49; History 49; Notable Contributors 50 India in Modern Context 51; Applications 51; Summing Up 52; Biostatistics 52 Section 2: Research Methodology and ‘Back to School’ 4. Research Methodology 57 Objectives of Research 57; Types of Research 58 Approaches to Research 59; Research Methods 60; Research Methodology 60 5. Inside Research Methodology: The Nuts and Bolts 63 What Constitutes a Research? 63; Research Plan 72 6. Back to School 74 Greek Alphabets 74; Common Mathematical Operators/Symbols 75 Modulus 76; Basics of Set Theory and Venn Diagrams 76; Indices 79 Progressions: Arithmetic and Geometric Progressions 79 Logarithms and Antilogarithms 80; The Exponential Function ‘e’ 81 Ratio 81; Proportion 82; Factorial; 82; Permutations and Combinations 83 Section 3: Describing the Data 7. Frequency Distribution 87 Classification of Data 87; Variables: Discrete and Continuous 89 Frequency Distributions: Discrete and Continuous 89 Relative Frequency Distribution 93 Bivariate or Two Way Frequency Distribution 93; Marginal Distribution 94 8. Measures of Central Tendency 95 Central Value Concept 95; Measures of Central Tendency 95 Types of Measures of Central Tendency 96; Median (Md) 100 Quartiles, Deciles and Percentiles 103; Mode (M0) 105 Harmonic Mean 109; Which Measure to Use? 111 9. Measures of Dispersion (or Variation) 114 Understanding Dispersion 114; Types of Measures of Dispersion 115 Quartile Deviation 116; Percentile Deviation 116; Mean Deviation 116 Standard Deviation 117; Lorenz Curve 119 Coefficient of Dispersion and Its Measures (Also referred as a Relative Measure of Variation) 120; Which Measure of Dispersion to Use? 121 Contents xiv Basics of Biostatistics: A Manual for the Medical Practitioners 10. Skewness, Moments and Kurtosis 122 Skewness 122; Kurtosis 125; Moments 126; Significance 127 Section 4: Probability, Probability Distribution and Sampling 11. Theory of Probability 131 Terminology in Probability Theory 132; Approaches to Probability 133 Conditional Probability 137; Bayes Theorem 139 12. Theoretical Discrete Probability Distributions 142 Underlying Concepts and Terminology 142 Types of Theoretical Discrete Distributions 147 13. Theoretical Continuous Probability Distributions 163 Normal Distribution 163; Rectangular Distribution 174 Lognormal Distribution 176; Exponential Distribution 176 14. Sampling Theory 178 What is a Sample and why it is Required? 179; Types of Sampling Methods 180 Advantages and Disadvantages of Sampling 182 What should be the Sample Size? 183; Sampling Errors 185 Standard Error 186; Underlying Basis of Sampling Theory 186 Section 5: Correlation, Regression, Partial and Multiple Correlation and Regression, Theory of Attributes 15. Correlation 191 What is Correlation? 191; Correlation Measures 192 16. Regression Analysis 205 Components of Regression Analysis 205; Types of Regression 206 Linear Regression Analysis and Line of Best Fit 207; Logistic Regression 212 17. Partial and Multiple Correlation and Regression 216 Partial Correlation; 216; Multiple Correlation 217 Partial and Multiple Regression 218; Multicollinearity 221 18. Theory of Attributes 225 Terminology of Attribute Theory 225; Association of Attributes 228 Section 6: Statistical Testing 19. Hypothesis Testing 235 Basic Concepts 236; Practical Considerations in Framing and Testing Hypothesis 246 20. Tests of Significance (Z and Student’s ‘t’-Test) 248 Large Sample Tests 249; Small Sample Tests (Student’s t-tests) 256 What is P-value? 267 21. F-Test and Analysis of Variance and Covariance 269 Constants and Properties of F-Distribution 269; Applications 270 22. Chi-square Test 286 Degrees of Freedom 286; Salient Points of Chi-square 287 Chi-square Distribution 288; Applications of χ2 Distribution 289 Chi-square Test of Homogeneity of Correlation Co-efficient 298 Remarks on Chi-Square 300 23. Nonparametric Tests 301 Advantages 301; Disadvantages 302 Run Test: Test for Randomness in a Series of Observations 302 The Signed-rank Test for Testing Specified Mean or Median of a Population 303 Wilcoxon Signed Rank Test for Paired data 304 Contents xv Kolmogorov-Smirnov Test for One Sample 307 Kolmogorov-Smirnov Test (For Comparing Two Populations) 308 Mann-Whitney ‘U’ Test for Equality of Two Means 310 Wilcoxon-Wilcox Test for Comparison of Multiple Treatment on a Series 311 Kruskal-Wallis Rank Sum Test (H-Test) 313 Friedman Test (Two-way ANOVA) 314 Test of Significance of Spearman’s and Kendall Rank Correlation 317 McNemar’s Test for Paired Samples 317; Cochran Q Test 318 24. Which Statistical Test to Use? 321 Summary of Statistical Tests 322 25. Special Considerations about Inferential Issues in Biostatistics 327 Cause-Effect Relationship: Is it Really True? 328; Bias 329 Confounding 329; Spurious Relationship 331; Effect Modification 331 Bradford Hill Causality Criteria 332; Exposure-Disease Association 333 Odds Ratio 334; Attributable Risk 335 26. Measurement and Error Analysis 337 Measurement 337; Levels of Measurement 338 Evaluating Measurement 340; Reliability v/s Validity 343 Assessment of Validity: Specificity and Sensitivity 344 Errors in Measurement 350 Section 7: Other Statistical Concepts Frequently Used in Research 27. Vital (Demographic) Statistics and Life Tables 357 Basics of Vital Statistics 357; Life Tables 367 Survival Analysis and Kaplan-Meier Curves 374; Log-Rank Test 378 28. Time Series Analysis 381 Time Series Components 382; Measuring the Components of Time Series 384 29. Interpolation, Extrapolation and Forecasting Methods 398 Terminology 399; Methods of Interpolation 400 Extrapolation and Forecasting 406 Section 8: Statistical Concepts for Medical Administration 30. Index Numbers 411 Key Decisions in Creating Index Number 412; Weighted Index Numbers 417 Quantity and Value Index Numbers 423; Chain Index Numbers 423 Base Shifting and Splicing 426; Index Number Tests 427 31. Statistical Quality Control 429 Control Charts 430; Types of Control Charts 431 Charts based on Actual Measurements 432 ‘C-Control Chart’ for Number of Defects Per Unit 435 P-Control Chart (Fraction Defectives or Proportion of Defects) 436 Acceptance Sampling 437 32. Decision Theory 440 Notation/Terminology 441; Decisions Methods 443 Principles of Decision Making 444; Decision Tree Analysis or Tree Diagram 449 Section 9: Report Writing and Applying for Grants 33. Research Report Writing: How to do? 453 Organization of the Research Report 453 Manuscript Preparation for Journals 460 xvi Basics of Biostatistics: A Manual for the Medical Practitioners 34. Applying for Grants 467 Preparing for Application Process 468 Ground Reality: The Background Check 469 Main Application: Contents and Pitfalls 470 Background and Significance or Introduction 471 Preliminary Studies/Progress Report 471; Research Design and Methods 471 Results 472; Monitoring and Evaluation 472 Protection of Human Subjects and Institutional Review Boards 473 Bibliography 474; Contracts 474; Abstracts 474; Title 474 Biographical Sketches 474; Budget 475 Formatting and Instructions to Applicants 475 Cover Letter 476; Decision Process Explained 476; Pay Lines 477 Outcomes 477; Common Problems Encountered 478; Revision of Application 479; Voila! Manna from Heaven: The Funding 480 Records and Accounting 480 Appendix 481 Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence 482 Random Number Table 484; Binomial Coefficients 485 Binomial Probabilities 486 e–λ Values for Calculating Poisson Probabilities for (0 < λ < 1) 490 Area Under the Standard Normal Curve 491 Area Under the Standard Normal Curve 493 Area Under the Standard Normal Curve 495 Critical Values of ‘t’ 497; Critical Values of Chi Square (χ2) 498 Critical Values of F (0.05 or 5%) 500; Critical Values of F (0.01 or 1%) 503 Factors for Construction of Control Charts (Statistical Quality Control) 506 Studentized Range: Critical Values 508 Studentized Range: Critical Values 510 Pearson’s Correlation Coefficient (r): Critical Values 512 Spearman Rank Correlation Coefficient (ρ): Critical Values 513 Run Test: Acceptance Region for Values of ‘R’ 514 Sign Test: Critical Values of ‘T’ 515 Kolmogorov-Smirnov Test: Critical Values of ‘D’ 517 Wilcoxon-Wilcox Two-Sided Test: Critical Values 518 Mann-Whitney Test (U Test): Critical Values of ‘U’ 521 Critical Values of τ: Kendall Rank Correlation Significance Test 522 Wilcoxon Signed Rank Test ‘W’: Lower and Upper Critical Values 523 Common Logarithms (log10x) 524; Antilogarithms 530 Index 537

Place Hold on Basics of biostatistics: A manual for medical practitioners

Basics of biostatistics: A manual for medical practitioners

By Bali, Jatinder and Kant, Anil. Jaypee Brothers 2017 . 540 , Zero Point: Approach Road to Learning 1 Statistics in a Nutshell 8 Section 1: Bioethics, Evidence-based Medicine 1. Bioethics in Clinical Research 13 Major Divisions of Ethics 13; Bioethics 14; Main Branches of Bioethics 14 Etymology, History and the Famous Nonethical Experiments 14 Dachau and Auschwitz Concentration Camp Hypothermia Experiments 15 Animal Ethics 34; Environmental Ethics 35; Anthropocentrism 36 2. Evidence-based Medicine and Levels of Evidence 38 Evidence-based Medicine 38; Fundamental Principles 38 Components of Evidence-based Practices 39 3. Introduction to Statistics 49 Etymology 49; History 49; Notable Contributors 50 India in Modern Context 51; Applications 51; Summing Up 52; Biostatistics 52 Section 2: Research Methodology and ‘Back to School’ 4. Research Methodology 57 Objectives of Research 57; Types of Research 58 Approaches to Research 59; Research Methods 60; Research Methodology 60 5. Inside Research Methodology: The Nuts and Bolts 63 What Constitutes a Research? 63; Research Plan 72 6. Back to School 74 Greek Alphabets 74; Common Mathematical Operators/Symbols 75 Modulus 76; Basics of Set Theory and Venn Diagrams 76; Indices 79 Progressions: Arithmetic and Geometric Progressions 79 Logarithms and Antilogarithms 80; The Exponential Function ‘e’ 81 Ratio 81; Proportion 82; Factorial; 82; Permutations and Combinations 83 Section 3: Describing the Data 7. Frequency Distribution 87 Classification of Data 87; Variables: Discrete and Continuous 89 Frequency Distributions: Discrete and Continuous 89 Relative Frequency Distribution 93 Bivariate or Two Way Frequency Distribution 93; Marginal Distribution 94 8. Measures of Central Tendency 95 Central Value Concept 95; Measures of Central Tendency 95 Types of Measures of Central Tendency 96; Median (Md) 100 Quartiles, Deciles and Percentiles 103; Mode (M0) 105 Harmonic Mean 109; Which Measure to Use? 111 9. Measures of Dispersion (or Variation) 114 Understanding Dispersion 114; Types of Measures of Dispersion 115 Quartile Deviation 116; Percentile Deviation 116; Mean Deviation 116 Standard Deviation 117; Lorenz Curve 119 Coefficient of Dispersion and Its Measures (Also referred as a Relative Measure of Variation) 120; Which Measure of Dispersion to Use? 121 Contents xiv Basics of Biostatistics: A Manual for the Medical Practitioners 10. Skewness, Moments and Kurtosis 122 Skewness 122; Kurtosis 125; Moments 126; Significance 127 Section 4: Probability, Probability Distribution and Sampling 11. Theory of Probability 131 Terminology in Probability Theory 132; Approaches to Probability 133 Conditional Probability 137; Bayes Theorem 139 12. Theoretical Discrete Probability Distributions 142 Underlying Concepts and Terminology 142 Types of Theoretical Discrete Distributions 147 13. Theoretical Continuous Probability Distributions 163 Normal Distribution 163; Rectangular Distribution 174 Lognormal Distribution 176; Exponential Distribution 176 14. Sampling Theory 178 What is a Sample and why it is Required? 179; Types of Sampling Methods 180 Advantages and Disadvantages of Sampling 182 What should be the Sample Size? 183; Sampling Errors 185 Standard Error 186; Underlying Basis of Sampling Theory 186 Section 5: Correlation, Regression, Partial and Multiple Correlation and Regression, Theory of Attributes 15. Correlation 191 What is Correlation? 191; Correlation Measures 192 16. Regression Analysis 205 Components of Regression Analysis 205; Types of Regression 206 Linear Regression Analysis and Line of Best Fit 207; Logistic Regression 212 17. Partial and Multiple Correlation and Regression 216 Partial Correlation; 216; Multiple Correlation 217 Partial and Multiple Regression 218; Multicollinearity 221 18. Theory of Attributes 225 Terminology of Attribute Theory 225; Association of Attributes 228 Section 6: Statistical Testing 19. Hypothesis Testing 235 Basic Concepts 236; Practical Considerations in Framing and Testing Hypothesis 246 20. Tests of Significance (Z and Student’s ‘t’-Test) 248 Large Sample Tests 249; Small Sample Tests (Student’s t-tests) 256 What is P-value? 267 21. F-Test and Analysis of Variance and Covariance 269 Constants and Properties of F-Distribution 269; Applications 270 22. Chi-square Test 286 Degrees of Freedom 286; Salient Points of Chi-square 287 Chi-square Distribution 288; Applications of χ2 Distribution 289 Chi-square Test of Homogeneity of Correlation Co-efficient 298 Remarks on Chi-Square 300 23. Nonparametric Tests 301 Advantages 301; Disadvantages 302 Run Test: Test for Randomness in a Series of Observations 302 The Signed-rank Test for Testing Specified Mean or Median of a Population 303 Wilcoxon Signed Rank Test for Paired data 304 Contents xv Kolmogorov-Smirnov Test for One Sample 307 Kolmogorov-Smirnov Test (For Comparing Two Populations) 308 Mann-Whitney ‘U’ Test for Equality of Two Means 310 Wilcoxon-Wilcox Test for Comparison of Multiple Treatment on a Series 311 Kruskal-Wallis Rank Sum Test (H-Test) 313 Friedman Test (Two-way ANOVA) 314 Test of Significance of Spearman’s and Kendall Rank Correlation 317 McNemar’s Test for Paired Samples 317; Cochran Q Test 318 24. Which Statistical Test to Use? 321 Summary of Statistical Tests 322 25. Special Considerations about Inferential Issues in Biostatistics 327 Cause-Effect Relationship: Is it Really True? 328; Bias 329 Confounding 329; Spurious Relationship 331; Effect Modification 331 Bradford Hill Causality Criteria 332; Exposure-Disease Association 333 Odds Ratio 334; Attributable Risk 335 26. Measurement and Error Analysis 337 Measurement 337; Levels of Measurement 338 Evaluating Measurement 340; Reliability v/s Validity 343 Assessment of Validity: Specificity and Sensitivity 344 Errors in Measurement 350 Section 7: Other Statistical Concepts Frequently Used in Research 27. Vital (Demographic) Statistics and Life Tables 357 Basics of Vital Statistics 357; Life Tables 367 Survival Analysis and Kaplan-Meier Curves 374; Log-Rank Test 378 28. Time Series Analysis 381 Time Series Components 382; Measuring the Components of Time Series 384 29. Interpolation, Extrapolation and Forecasting Methods 398 Terminology 399; Methods of Interpolation 400 Extrapolation and Forecasting 406 Section 8: Statistical Concepts for Medical Administration 30. Index Numbers 411 Key Decisions in Creating Index Number 412; Weighted Index Numbers 417 Quantity and Value Index Numbers 423; Chain Index Numbers 423 Base Shifting and Splicing 426; Index Number Tests 427 31. Statistical Quality Control 429 Control Charts 430; Types of Control Charts 431 Charts based on Actual Measurements 432 ‘C-Control Chart’ for Number of Defects Per Unit 435 P-Control Chart (Fraction Defectives or Proportion of Defects) 436 Acceptance Sampling 437 32. Decision Theory 440 Notation/Terminology 441; Decisions Methods 443 Principles of Decision Making 444; Decision Tree Analysis or Tree Diagram 449 Section 9: Report Writing and Applying for Grants 33. Research Report Writing: How to do? 453 Organization of the Research Report 453 Manuscript Preparation for Journals 460 xvi Basics of Biostatistics: A Manual for the Medical Practitioners 34. Applying for Grants 467 Preparing for Application Process 468 Ground Reality: The Background Check 469 Main Application: Contents and Pitfalls 470 Background and Significance or Introduction 471 Preliminary Studies/Progress Report 471; Research Design and Methods 471 Results 472; Monitoring and Evaluation 472 Protection of Human Subjects and Institutional Review Boards 473 Bibliography 474; Contracts 474; Abstracts 474; Title 474 Biographical Sketches 474; Budget 475 Formatting and Instructions to Applicants 475 Cover Letter 476; Decision Process Explained 476; Pay Lines 477 Outcomes 477; Common Problems Encountered 478; Revision of Application 479; Voila! Manna from Heaven: The Funding 480 Records and Accounting 480 Appendix 481 Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence 482 Random Number Table 484; Binomial Coefficients 485 Binomial Probabilities 486 e–λ Values for Calculating Poisson Probabilities for (0 < λ < 1) 490 Area Under the Standard Normal Curve 491 Area Under the Standard Normal Curve 493 Area Under the Standard Normal Curve 495 Critical Values of ‘t’ 497; Critical Values of Chi Square (χ2) 498 Critical Values of F (0.05 or 5%) 500; Critical Values of F (0.01 or 1%) 503 Factors for Construction of Control Charts (Statistical Quality Control) 506 Studentized Range: Critical Values 508 Studentized Range: Critical Values 510 Pearson’s Correlation Coefficient (r): Critical Values 512 Spearman Rank Correlation Coefficient (ρ): Critical Values 513 Run Test: Acceptance Region for Values of ‘R’ 514 Sign Test: Critical Values of ‘T’ 515 Kolmogorov-Smirnov Test: Critical Values of ‘D’ 517 Wilcoxon-Wilcox Two-Sided Test: Critical Values 518 Mann-Whitney Test (U Test): Critical Values of ‘U’ 521 Critical Values of τ: Kendall Rank Correlation Significance Test 522 Wilcoxon Signed Rank Test ‘W’: Lower and Upper Critical Values 523 Common Logarithms (log10x) 524; Antilogarithms 530 Index 537

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Becker shaffers diagnosis and therapy of the glaucomas

By Hoskins, H Dunbar; Kass, Michael A. Jaypee Brothers, New Delhi 1989 . 678

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Biochemistry

By Naik Pankaja. New Delhi Jaypee Brothers 2016 . 674 , Section I Structure and Function of the Biomolecules Eukaryotic Cell StructureCarbohydratesLipidsAmino Acids, Peptides, and ProteinsEnzymesHemoglobinNucleotides and Nucleic AcidsSection II Energy Metabolism and Metabolism of Biomolecules Biological OxidationCarbohydrate MetabolismLipid MetabolismProtein MetabolismIntegration of Metabolism and Metabolism in StarvationHemoglobin MetabolismPurine and Pyrimidine Nucleotide MetabolismSection III Nutrition Nutrients and their Role in NutritionVitaminsMineralsSection IV Molecular Biology Replication, Repair and RecombinationTranscription and RNA ProcessingGenetic Code, Mutation and TranslationRegulation of Gene ExpressionGenetic EngineeringSection V Clinical Biochemistry Body Water and ElectrolytesAcid-Base BalanceOrgan Function TestsCoronary Heart Disease and Cardiac MarkersPlasma Proteins and ImmunoglobulinsThe Immune SystemRadioisotopes in MedicineCancerAcquired Immunodeficiency SyndromeSection VI Biochemistry of Cellular Communications Mechanism of Hormone ActionNeurotransmittersSection VII Special Topics Metabolism of XenobioticsFree Radicals and AntioxidantsEnvironment and HealthBiomedical Waste ManagementMuscle BiochemistryConnective TissueAnalytical Techniques in BiochemistryGlossary Reference Values for Selected Biochemical Laboratory Tests Index

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Biopharmaceutics and Pharmacokinetics

By Madan, P L. New Delhi Jaypee Brothers, 2014 . 522

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Biostatistics: A manual of stastistical methods for use in health, nutrition and anthropology

By Visweswara Rao, K. New Delhi Jaypee Brothers, 1996

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Biostatistics: A manual of stastistical methods for use in health, nutrition and anthropology

By Visweswara Rao, K. Jaypee Brothers, New Delhi

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Brunnstroms clinical kinesiology

By Smith, Laura K, et al.. Jaypee Brothers, New Delhi 1996 . 468

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Brunnstroms clinical kinesiology

By Smith, Laura K, et al.. Jaypee Brothers, New Delhi 1996 . 468

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Cardiac pacing : A physiological approach

By Das ,Asit. Jaypee Brothers, New Delhi 2016 . 328 , History of Pacemaker Introduction to Physiological PacingManaging AlgorithmSelective Site: Right Ventricular Septal PacingSelective Site: His Bundle PacingSelective Ste: Right Atrial Septal PacingCase DiscussionIntroduction to Cardiac Resynchronization TherapyRole of Pre-Procedure ECG AnalysisAnatomy of Coronary SinusImplantation TechniqueSurface Electrocardiography: CRT Follow UpOptimizing ResponseNewer Advances 9789352501823

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Cataract surgery and its complications

By Jaffe, Norman S. Jaypee Brothers, New Delhi 1989 . 667

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Clinical anatomy: A problem solving approach

By Kulkarni, Neeta V. New Delhi Jaypee Brothers, 2012 . 958

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Clinical anatomy: A problem solving approach Vol.1

By Kulkarni, Neeta V. Jaypee Brothers, New Delhi 2016 . 476 , Section 1: General Anatomy 1. Anatomy—Past, Present and Future 3 2. Basic Tissues of the Body 6 3. Cartilage, Bones and Joints 29 4. Vascular Tissue and Lymphatic Tissue 42 5. Skin, Hypodermis and Deep Fascia 49 6. Descriptive Anatomical Terms 54 7. Clinicoanatomical Problems and Solutions 57 Section 2: General Embryology 8. General Embryology including Basic Genetics and Genetic Causes of Birth Defects 63 9. Clinicoanatomical Problems and Solutions 94 Section 3: Upper Limb 10. Bones of Upper Extremity 101 11. Pectoral Region and Breast 119 12. Axilla and Axillary Lymph Nodes 131 13. Brachial Plexus and Axillary Vessels 136 14. Superficial Muscles of Back and Scapular Region 146 15. Pectoral Girdle and Shoulder Joint 155 16. Upper Limb (Cutaneous Nerves, Dermatomes, Superficial Veins, Lymph Vessels and Lymph Nodes) 162 17. Compartments of Arm 168 18. Cubital Fossa and Elbow Joint 176 19. Compartments of Forearm 183 20. Radioulnar Joints and Wrist Joint 198 Volume 1 xviii Clinical Anatomy (A Problem Solving Approach) 21. Hand 207 22. Long Nerves of Upper Limb 223 23. Clinicoanatomical Problems and Solutions 231 Section 4: Lower Limb 24. Bones of Lower Limb 239 25. Surface Features, Cutaneous Nerves, Venous and Lymphatic Drainage of Lower Limb 258 26. Front of Thigh 268 27. Gluteal Region, Posterior Compartment of Thigh and Sciatic Nerve 281 28. Adductor or Medial Compartment of Thigh and Hip Joint 293 29. Popliteal Fossa and Knee Joint 305 30. Compartments of Leg and Retinacula Around Ankle 321 31. Tibiofibular Joints and the Ankle Joint 335 32. The Foot 340 33. Clinicoanatomical Problems and Solutions 355 Section 5: Thorax 34. Bones of Thoracic Cage 363 35. Thoracic Inlet and Thoracic Wall 371 36. Mediastinum, Pleural Cavities and Organs of Respiratory System 381 37. Thoracic Diaphragm and Phrenic Nerves 403 38. Development of Heart and Congenital Anomalies 411 39. Pharyngeal Arch Arteries and Fetal Circulation 418 40. Pericardium and Heart 424 41. Blood Supply of Heart 439 42. Fibrous Skeleton, Conducting Tissue and Nerve Supply of Heart 445 43. Major Blood Vessels of Thorax 449 44. Lymphatic Organs and Autonomic Nerves of Thorax 459 45. Esophagus 466 46. Clinicoanatomical Problems and Solutions 471 Contents xix Section 6: Abdomen, Pelvis and Perineum 47. Bones of Abdomen and Pelvis 479 48. Anterior Abdominal Wall and Inguinal Canal 485 49. General Disposition of Peritoneum and Viscera in Abdominopelvic Cavity and Development of Gut 504 50. Stomach, Duodenum, Small Intestine and Large Intestine 519 51. Pancreas, Liver, Biliary Apparatus and Spleen 542 52. Blood Supply of Digestive Tract 560 53. Lumbar Fascia and Posterior Abdominal Wall or Retroperitoneum 567 54. Suprarenal Glands, Kidneys and Ureters 579 55. Extraperitoneal Structures in True Pelvis 596 56. Sigmoid Colon, Rectum and Urinary Bladder 603 57. Reproductive Organs 613 58. Perineum in Male and Female 638 59. Clinicoanatomical Problems and Solutions 662 Section 7: Head and Neck 60. Bones of Head and Neck 671 61. Scalp 697 62. Face including Eyelids and Lacrimal Apparatus 701 63. Parotid Gland 717 64. Cervical Fascia and Triangles of Neck 722 65. Submandibular Region and Submandibular Gland 736 66. Pharyngeal or Branchial Arches 744 67. Thyroid Gland and Parathyroid Glands 747 68. Major Blood Vessels, Cervical Plexus, Cervical Sympathetic Chain, Cervical Lymph Nodes and Deep Muscles of Neck 754 69. Infratemporal Fossa, Pterygopalatine Fossa, Maxillary Artery and Temporomandibular Joint 769 70. Orbit and Eyeball 783 71. Oral Cavity, Tongue and Palate 801 72. Nasal Cavity and Paranasal Air Sinuses 811 73. Pharynx 819 74. Larynx 829 75. Ear (External and Middle), Eustachian Tube, Mastoid Antrum and Internal Ear 837 76. Clinicoanatomical Problems and Solutions 850 V 9789351529668

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Clinical anatomy: A problem solving approach, Vol.1

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Clinical anatomy: A problem solving approach, Vol.2

By Kulkarni, Neeta V. Jaypee Brothers, New Delhi 2016 . 1048 , Section 1: General Anatomy 1. Anatomy—Past, Present and Future 3 2. Basic Tissues of the Body 6 3. Cartilage, Bones and Joints 29 4. Vascular Tissue and Lymphatic Tissue 42 5. Skin, Hypodermis and Deep Fascia 49 6. Descriptive Anatomical Terms 54 7. Clinicoanatomical Problems and Solutions 57 Section 2: General Embryology 8. General Embryology including Basic Genetics and Genetic Causes of Birth Defects 63 9. Clinicoanatomical Problems and Solutions 94 Section 3: Upper Limb 10. Bones of Upper Extremity 101 11. Pectoral Region and Breast 119 12. Axilla and Axillary Lymph Nodes 131 13. Brachial Plexus and Axillary Vessels 136 14. Superficial Muscles of Back and Scapular Region 146 15. Pectoral Girdle and Shoulder Joint 155 16. Upper Limb (Cutaneous Nerves, Dermatomes, Superficial Veins, Lymph Vessels and Lymph Nodes) 162 17. Compartments of Arm 168 18. Cubital Fossa and Elbow Joint 176 19. Compartments of Forearm 183 20. Radioulnar Joints and Wrist Joint 198 Volume 1 xviii Clinical Anatomy (A Problem Solving Approach) 21. Hand 207 22. Long Nerves of Upper Limb 223 23. Clinicoanatomical Problems and Solutions 231 Section 4: Lower Limb 24. Bones of Lower Limb 239 25. Surface Features, Cutaneous Nerves, Venous and Lymphatic Drainage of Lower Limb 258 26. Front of Thigh 268 27. Gluteal Region, Posterior Compartment of Thigh and Sciatic Nerve 281 28. Adductor or Medial Compartment of Thigh and Hip Joint 293 29. Popliteal Fossa and Knee Joint 305 30. Compartments of Leg and Retinacula Around Ankle 321 31. Tibiofibular Joints and the Ankle Joint 335 32. The Foot 340 33. Clinicoanatomical Problems and Solutions 355 Section 5: Thorax 34. Bones of Thoracic Cage 363 35. Thoracic Inlet and Thoracic Wall 371 36. Mediastinum, Pleural Cavities and Organs of Respiratory System 381 37. Thoracic Diaphragm and Phrenic Nerves 403 38. Development of Heart and Congenital Anomalies 411 39. Pharyngeal Arch Arteries and Fetal Circulation 418 40. Pericardium and Heart 424 41. Blood Supply of Heart 439 42. Fibrous Skeleton, Conducting Tissue and Nerve Supply of Heart 445 43. Major Blood Vessels of Thorax 449 44. Lymphatic Organs and Autonomic Nerves of Thorax 459 45. Esophagus 466 46. Clinicoanatomical Problems and Solutions 471 Contents xix Section 6: Abdomen, Pelvis and Perineum 47. Bones of Abdomen and Pelvis 479 48. Anterior Abdominal Wall and Inguinal Canal 485 49. General Disposition of Peritoneum and Viscera in Abdominopelvic Cavity and Development of Gut 504 50. Stomach, Duodenum, Small Intestine and Large Intestine 519 51. Pancreas, Liver, Biliary Apparatus and Spleen 542 52. Blood Supply of Digestive Tract 560 53. Lumbar Fascia and Posterior Abdominal Wall or Retroperitoneum 567 54. Suprarenal Glands, Kidneys and Ureters 579 55. Extraperitoneal Structures in True Pelvis 596 56. Sigmoid Colon, Rectum and Urinary Bladder 603 57. Reproductive Organs 613 58. Perineum in Male and Female 638 59. Clinicoanatomical Problems and Solutions 662 Section 7: Head and Neck 60. Bones of Head and Neck 671 61. Scalp 697 62. Face including Eyelids and Lacrimal Apparatus 701 63. Parotid Gland 717 64. Cervical Fascia and Triangles of Neck 722 65. Submandibular Region and Submandibular Gland 736 66. Pharyngeal or Branchial Arches 744 67. Thyroid Gland and Parathyroid Glands 747 68. Major Blood Vessels, Cervical Plexus, Cervical Sympathetic Chain, Cervical Lymph Nodes and Deep Muscles of Neck 754 69. Infratemporal Fossa, Pterygopalatine Fossa, Maxillary Artery and Temporomandibular Joint 769 70. Orbit and Eyeball 783 71. Oral Cavity, Tongue and Palate 801 72. Nasal Cavity and Paranasal Air Sinuses 811 73. Pharynx 819 74. Larynx 829 75. Ear (External and Middle), Eustachian Tube, Mastoid Antrum and Internal Ear 837 76. Clinicoanatomical Problems and Solutions 850 Volume 2 xx Clinical Anatomy (A Problem Solving Approach) Section 8: Vertebral Column and Spinal Cord, Cranial Cavity and Brain 77. Deep Muscles of Back, Suboccipital Triangle and Vertebral Artery 857 78. Vertebral Column 865 79. Spinal Cord 875 80. Cranial Meninges, Dural Venous Sinuses, Middle Menigeal Artery and Pituitary Gland 890 81. Development of Central Nervous System 904 82. Base of Brain and Brainstem 909 83. Cerebellum and Fourth Ventricle 925 84. Diencephalon and Third Ventricle 933 85. Cerebrum 942 86. Blood Supply of Brain 950 87. White Matter of Cerebrum 957 88. Reticular Formation, Lateral Ventricle, Basal Ganglia Limbic System and Csf Circulation 963 89. Overview of Autonomic Nervous System 973 90. Clinicoanatomical Problems and Solutions 977 Section 9: Cranial Nerves 91. Olfactory Nerve and Pathway 983 92. Optic Nerve and Visual (Optic) Pathway 985 93. Oculomotor Nerve, Trochlear Nerve and Abducent Nerve 990 94. Trigeminal Nerve and Sensory Pathway 996 95. Facial Nerve 1001 96. Vestibulocochlear Nerve, Vestibular Pathway and Auditory Pathway 1006 97. Glossopharyngeal Nerve 1010 98. Vagus Nerve 1013 99. Accessory Nerve 1017 100. Hypoglossal Nerve 1019 101. Clinicoanatomical Problems and Solutions 1022 Index 1025

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Clinical anatomy: A problem solving approach. Vol.2

By Kulkarni, Neeta V. Jaypee Brothers, New Delhi 2016 . 1048 , Section 6: Abdomen, Pelvis and Perineum 47. Bones of Abdomen and Pelvis 479 48. Anterior Abdominal Wall and Inguinal Canal 485 49. General Disposition of Peritoneum and Viscera in Abdominopelvic Cavity and Development of Gut 504 50. Stomach, Duodenum, Small Intestine and Large Intestine 519 51. Pancreas, Liver, Biliary Apparatus and Spleen 542 52. Blood Supply of Digestive Tract 560 53. Lumbar Fascia and Posterior Abdominal Wall or Retroperitoneum 567 54. Suprarenal Glands, Kidneys and Ureters 579 55. Extraperitoneal Structures in True Pelvis 596 56. Sigmoid Colon, Rectum and Urinary Bladder 603 57. Reproductive Organs 613 58. Perineum in Male and Female 638 59. Clinicoanatomical Problems and Solutions 662 Section 7: Head and Neck 60. Bones of Head and Neck 671 61. Scalp 697 62. Face including Eyelids and Lacrimal Apparatus 701 63. Parotid Gland 717 64. Cervical Fascia and Triangles of Neck 722 65. Submandibular Region and Submandibular Gland 736 66. Pharyngeal or Branchial Arches 744 67. Thyroid Gland and Parathyroid Glands 747 68. Major Blood Vessels, Cervical Plexus, Cervical Sympathetic Chain, Cervical Lymph Nodes and Deep Muscles of Neck 754 69. Infratemporal Fossa, Pterygopalatine Fossa, Maxillary Artery and Temporomandibular Joint 769 70. Orbit and Eyeball 783 71. Oral Cavity, Tongue and Palate 801 72. Nasal Cavity and Paranasal Air Sinuses 811 73. Pharynx 819 74. Larynx 829 75. Ear (External and Middle), Eustachian Tube, Mastoid Antrum and Internal Ear 837 76. Clinicoanatomical Problems and Solutions 850 Volume 2 xx Clinical Anatomy (A Problem Solving Approach) Section 8: Vertebral Column and Spinal Cord, Cranial Cavity and Brain 77. Deep Muscles of Back, Suboccipital Triangle and Vertebral Artery 857 78. Vertebral Column 865 79. Spinal Cord 875 80. Cranial Meninges, Dural Venous Sinuses, Middle Menigeal Artery and Pituitary Gland 890 81. Development of Central Nervous System 904 82. Base of Brain and Brainstem 909 83. Cerebellum and Fourth Ventricle 925 84. Diencephalon and Third Ventricle 933 85. Cerebrum 942 86. Blood Supply of Brain 950 87. White Matter of Cerebrum 957 88. Reticular Formation, Lateral Ventricle, Basal Ganglia Limbic System and Csf Circulation 963 89. Overview of Autonomic Nervous System 973 90. Clinicoanatomical Problems and Solutions 977 Section 9: Cranial Nerves 91. Olfactory Nerve and Pathway 983 92. Optic Nerve and Visual (Optic) Pathway 985 93. Oculomotor Nerve, Trochlear Nerve and Abducent Nerve 990 94. Trigeminal Nerve and Sensory Pathway 996 95. Facial Nerve 1001 96. Vestibulocochlear Nerve, Vestibular Pathway and Auditory Pathway 1006 97. Glossopharyngeal Nerve 1010 98. Vagus Nerve 1013 99. Accessory Nerve 1017 100. Hypoglossal Nerve 1019 101. Clinicoanatomical Problems and Solutions 1022 Index 1025

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Clinical Anatomy: A problem solving approach, Vol.1

By Kulkarni, Neeta V. New Delhi Jaypee Brothers, 2016 . 476

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Clinical Anatomy: A problem solving approach, Vol.2

By Kulkarni, Neeta V. New Delhi Jaypee Brothers, 2016 . 477-1048

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Clinical methods in pediatrics

By Arvind, R. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi . 342

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Clinical orthopaedic diagnosis

By Pandey, Sureshwar; Pandey, Anil Kumar. Jaypee Brothers, New Delhi 2000 . 501

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Clinical orthopaedic diagnosis

By Pandey, Sureshwar; Pandey, Anil Kumar. Jaypee Brothers, New Delhi 2009 . 729 , 1.Introduction 2.Examination of long bones 3.Joints 4.Shoulder joint 5.Elbow joint 6.Wrist joint 7.Hand 8.Spine 9.Pelvis 10.Low backache 11.Examination of paralytic patients 12.Hip 13.Knee 14.Ankle joints 15.Foot 16.Peripheral nerve injuries 17.Bone tumors 18.Mandible and temporomandibular joint 19.Cross examination of head injury 20.Cross assessment of chest injuries 21.Cross examination of abdomen 22.How to read x-ray plate 23.Advanced diagnostic imaging 24.Syndromes related to orthopedics and traumatology 25.Leg ulcers 9788184484182

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Clinical surgery pearls

By Dayananda Babu, R. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi 2013 . 616 , Section 1: DefinitionsDefinitions Section 2: Long casesToxic GoiterSolitary Thyroid Nodule (STN-Nontoxic)Papillary Carcinoma Thyroid with Lymph Node MetastasesMultinodular GoiterEarly Breast CancerAdvanced Breast CancerEpigastric LumpRight Hypochondrial Lump without JaundiceRight Iliac Fossa Mass (Suspected Ileocecal Tuberculosis)Suspected Carcinoma of the CecumAppendicular MassObstructive JaundiceVaricose VeinsPeripheral Occlusive Vascular DiseaseLymphomaRenal SwellingPseudocyst of PancreasRetroperitoneal TumorTesticular MalignancyPortal HypertensionMesenteric Cyst Section 3: Short casesNon-thyroid Neck SwellingTuberculous Cervical Lymph NodeCervical Metastatic Lymph Node and Neck DissectionsCarcinoma Tongue with Submandibular Lymph NodeCarcinoma of Gingivobuccal Complex (Indian Oral Cancer)Parotid SwellingSubmandibular SialadenitisRanula, Plunging Ranula, Sublingual Dermoid and Mucous CystThyroglossal Cyst, Lingual Thyroid, Ectopic Thyroid, Subhyoid Bursa and Carcinoma Arising in Thyroglossal CystBranchial Cyst, Branchial Fistula, Cystic Hygroma Soft Tissue SarcomaNeurofibroma, von Recklinghausen's DiseaseLipoma (Universal Tumor) Sebaceous Cyst/Epidermoid Cyst/Wen/Dermoid CystUlcerMalignant MelanomaBasal Cell Carcinoma/Rodent UlcerSquamous Cell Carcinoma-SCC (Epithelioma)Carcinoma PenisCongenital Arteriovenous Fistula/Hemangioma/Compressible SwellingUnilateral Lower Limb EdemaHydrocele of Tunica Vaginalis Sac (Epididymal Cyst, Spermatocele, Varicocele, Hematocele, Chylocele, etc.)Inguinal Hernia/Femoral HerniaIncisional Hernia (Ventral hernia, postoperative hernia)Epigastric Hernia (Fatty Hernia of the Linea Alba)Paraumbilical Hernia, Umbilical Hernia in Adults and ChildrenDesmoid Tumor, Interparietal Hernia (Interstitial) and Spigelian HerniaGynecomastia/Male Breast CarcinomaFibroadenoma/Cystosarcoma/Breast Cyst/Fibroadenosis/Fibrocystic Disease/ Mastalgia/Mastopathy/Chronic Mastitis 9789350903964

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Clinical surgery pearls

By Babu,R Dayananda. Jaypee Brothers, New Delhi 2018 . 590 , SECTION 1: DEFINITIONS Definitions....................................................................................................................................................1 SECTION 2: LONG CASES 1. Toxic Goiter ............................................................................................................................................... 16 2. Solitary Thyroid Nodule (Nontoxic).................................................................................................. 38 3. Papillary Carcinoma Thyroid with Lymph Node Metastases................................................... 45 4. Multinodular Goiter ............................................................................................................................... 60 5. Early Breast Cancer................................................................................................................................. 67 6. Advanced Breast Cancer....................................................................................................................... 87 7. Epigastric Lump....................................................................................................................................... 98 8. Right Hypochondrial Lump without Jaundice...........................................................................113 9. Right Iliac Fossa Mass (Suspected Ileocecal Tuberculosis).....................................................121 10. Suspected Carcinoma of the Cecum..............................................................................................127 11. Appendicular Mass...............................................................................................................................139 12. Obstructive Jaundice...........................................................................................................................144 13. Varicose Veins.........................................................................................................................................158 14. Peripheral Occlusive Vascular Disease...........................................................................................176 15. Lymphoma ..............................................................................................................................................194 16. Renal Swelling........................................................................................................................................209 17. Pseudocyst of Pancreas......................................................................................................................220 18. Retroperitoneal Tumor........................................................................................................................226 19. Testicular Malignancy..........................................................................................................................233 20. Portal Hypertension.............................................................................................................................245 21. Mesenteric Cyst .....................................................................................................................................260 SECTION 3: SHORT CASES 22. Nonthyroid Neck Swelling.................................................................................................................265 23. Tuberculous Cervical Lymph Node.................................................................................................268 24. Cervical Metastatic Lymph Node (Carcinoma of Unknown Primary) and Neck Dissections ..........................................................................................................................277 25. Carcinoma Tongue with Submandibular Lymph Node ..........................................................289 26. Carcinoma of Gingivobuccal Complex (Indian Oral Cancer).................................................299 27. Parotid Swelling.....................................................................................................................................304 28. Submandibular Sialadenitis..............................................................................................................316 29. Ranula, Plunging Ranula, Sublingual Dermoid and Mucous Cyst.......................................320 xvi Clinical Surgery Pearls 30. Thyroglossal Cyst, Lingual Thyroid, Ectopic Thyroid, Subhyoid Bursa and Carcinoma Arising in Thyroglossal Cyst...................................................................323 31. Branchial Cyst, Branchial Fistula, Cystic Hygroma and Carotid Body Tumor...................329 32. Soft Tissue Sarcoma of the Extremities.........................................................................................336 33. Neurofibroma, Von Recklinghausen’s Disease ...........................................................................344 34. Lipoma (Universal Tumor)..................................................................................................................350 35. Sebaceous Cyst/Epidermoid Cyst/Wen/Dermoid Cyst............................................................353 36. Ulcer...........................................................................................................................................................358 37. Malignant Melanoma ..........................................................................................................................367 38. Basal Cell Carcinoma/Rodent Ulcer................................................................................................380 39. Squamous Cell Carcinoma (Epithelioma).....................................................................................385 40. Carcinoma Penis....................................................................................................................................392 41. Congenital Arteriovenous Fistula/Hemangioma/Compressible Swelling.......................400 42. Unilateral Lower Limb Edema ..........................................................................................................409 43. Hydrocele of Tunica Vaginalis Sac (Epididymal Cyst, Spermatocele, Varicocele, Hematocele, Chylocele, etc.).............................................................................................................418 44. Inguinal Hernia/Femoral Hernia......................................................................................................426 45. Incisional Hernia (Ventral Hernia, Postoperative Hernia).......................................................444 46. Epigastric Hernia (Fatty Hernia of the Linea Alba)....................................................................450 47. Paraumbilical Hernia, Umbilical Hernia in Adults and Children...........................................452 48. Desmoid Tumor, Interparietal Hernia (Interstitial), Spigelian Hernia .................................457 49. Gynecomastia/Male Breast Carcinoma.........................................................................................460 50. Fibroadenoma/Cystosarcoma/Breast Cyst/Fibroadenosis/Fibrocystic Disease/Mastalgia/Mastopathy/Chronic Mastitis/Nipple Discharge .................................467 SECTION 4: RADIOLOGY AND IMAGING Radiology Questions and Answers ..................................................................................................476 SECTION 5: IMPORTANT TABLES AND CHARTS General .....................................................................................................................................................537 Trauma......................................................................................................................................................543 Burns..........................................................................................................................................................548 Neck ...........................................................................................................................................................551 Breast.........................................................................................................................................................552 Abdomen.................................................................................................................................................555 Vascular.....................................................................................................................................................563 Limbs.........................................................................................................................................................566 Anorectal..................................................................................................................................................570 Index

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Community and social pediatrics

By Banerjee, S R, Ed.. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi

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Community medicine

By Sarker, Gautham and Das, Palash. New Delhi Jaypee Brothers, 2017 . 547 , 1. Concept of Health and Disease ........................................................................................................................1 Long Essay Questions • Definition of health as per WHO with its limitation 1 • Different determinants of health 1 • Indicators of health 2 • Characteristics of an ideal indicator 2 • List the various indicators of health which directly assess ill health in a community 3 • Other uses of indicators of health 3 • Meaning of disease control, elimination, extinction and eradication with examples 4 • Different disability rates, Sullivan’s index with examples, concept of disability limitations 4 • Primordial prevention and different levels of prevention and mode of interventions 4 • Diagram and application of different modes of interventions in the natural history of disease 5 • Knowledge of natural history of diseases helps us to prevent disease in the community 6 • Multifactorial causation of disease with suitable examples 7 • Role of healthy lifestyle in promotion of health with examples of lifestyle factors 7 • Comparison the health situation in two communities 7 Short Notes and Relevant Questions • Rehabilitation, social rehabilitation and vocational rehabilitation 8, 9 • Measurement of morbidity/morbidity indicators 9 • Medical care and health care not synonymous 9 • Primary health care basically the responsibility of the state 9 • Primary health care, delivery of primary health care 10 • Elements of primary health care 10 • Principles of primary health care 11 – Equitable distribution 11 – Community participation 11 – Intersectoral coordination 11 – Appropriate technology 11 • Determinants of primary health care 11 • Health promotion 11 • Principle of prevention 12 • Primordial prevention 12 • Disability limitation 13 • Dependency ratio 13 • Spectrum of disease 13 • Disease dynamics 13 • Early diagnosis and treatment are the main intervention of disease control 13 • Iceberg phenomenon of a disease 13 • Well-being and Wellness 14 • Quality of life 14 • Physical quality life index (PQLI) 14 • Human development index (HDI) 14 • Global hunger index (GHI) 15 • Human poverty index (HPI) 15 • Healthy lifestyles 15 • Lifestyle and healthy aging 16 • Age-specific indicator of health 16 • Standardized mortality ratio (SMR) 16 • Crude death rate 17 • Life expectancy 17 • Proportional mortality rate 17 xviii Community Medicine Buster • Secondary attack rate 17 • Case fatality rate and its significance 18 • Survival rate 18 • Community diagnosis 18 • Community treatment 19 • Web causation of disease 19 • Concept of positive health 19 • International classification of diseases (ICD) 19 • Dimensions of health 20 • Spiritual dimension of health 20 • Family medicine and family physician 20 • Socialized medicine 21 • Public health and phases of public health 21 • Health for all 21 • Contribution of Edward Jenner, Roland Ross and Louis Pasteur 21 2. Healthcare Delivery System ...........................................................................................................................23 Long Essay Questions • 3-tier system of healthcare delivery in India, its reforms and of private-public partnership in different delivery of health services 23 • Enumerate the principles of primary healthcare delivered in rural areas 24 • Measure health of people of a village near a primary health center 25 • Difference between primary health center and hospital 26 • Organogram of healthcare delivery in India 27 • Various healthcare systems in India 27 • Comprehensive healthcare 27 • Functions of PHC relating various activities of district health society 28 • Health care delivered by a community development block 28 • Functions of Block Primary Health Center 29 • Record Linkage and tracking of beneficiaries under maternal and child healthcare 29 • Indian Public Health Standard (IPHS) 30 Short Notes and Relevant Questions • Function of sub-center 34 • Functions of primary health center (PHC) 35 • Function of community health center (CHC) 35 • Functions of medical officer of a block primary health center 35 • Doctor-patient relationship plays a vital role in care of disease—explain 35 • First referral unit (FRU)/FRU will reduce MMR—explain 35, 36 • Difference between comprehensive healthcare and curative healthcare 36 • Difference between PHC and CHC 36 • ASHA/Eligibility criteria for selection, links healthcare delivery with community 36 • Role of ASHA as depot holder 37 • Average populations catered in relation to health—in a village, Sub-center, PHC, BPHC or CHC 37 • Role of Anganwadi worker, health worker (female), ASHA and their coordination 37 • Preventive services offered by medical colleges and hospitals 38 • Accessibility cannot be equated with acceptability of health services—justify 38 • Three-tier Panchayat Raj Structure 38 • Uses of hospital records 39 • Medical audit 39 • Job description (functions) of multipurpose health worker (female) 39 • De-professionalization of medicine 40 • Indigenous systems of medicine in India/AYUSH in healthcare in community 40 • Central Govt Health Scheme (CGHS) 40 • Poverty line 41 • Five-year plans 41 • Recommendation of Bhore Committee 42 • Recommendation of Mudaliar Committee 42 • Recommendation of Kartar Singh Committee 43 • Shrivastav Committee 43 Contents xix 3. Epidemiology ..................................................................................................................................................45 Long Essay Questions • Define epidemiology, classify the types of epidemiological studies/methods 45 • The aims and objectives of epidemiology and its application in public health practice 45 • Define incidence and prevalence of disease, their relation and uses of epidemiology 46 • Enumerate the steps of procedure in a descriptive epidemiological study 47 • Difference between cross-sectional and longitudinal study 48 • Step-by-step description of a descriptive cross-sectional study to assess overweight and obesity 48 • Steps in conducting a case-control study with an appropriate example 49 • Steps of case-control study to find out the association between smoking and lung cancer 50 • Bias in case-control study including the process of elimination of bias 50 • Important differences between case-control and cohort study 51 • Advantages/merits/strength/weakness of case-control and cohort study designs 51 • Types of cohort study and its steps 52 • Different types of analytical studies and basic steps of randomized control trial 53 • Epidemiological triad, triangle of epidemiology, agent, host and environmental factors 54 • Basic measurements on epidemiology 55 • Difference between epidemiology and clinical medicine 56 • A few cases of jaundice have occurred in boys’ hostel and its investigation 56 • Objectives of investigation of an epidemic and its step 56 • Investigation of an epidemic of fever cases 57 • Steps of investigation of food poisoning in a hostel 57 • Investigation of an outbreak of diphtheria in a sub-center area 58 • Investigation of outbreak of typhoid in a student hostel in an urban area 58 • Discuss different modes of transmission of diseases 58 • Source and reservoir of infection, dynamics and modes of disease transmission 59 • Methods of controlling reservoir 60 • Time, place and person distribution of diseases with suitable examples 61 • Different types of epidemics with suitable examples 61 • Spot map 62 • Define the term endemic and epidemic with suitable examples 63 • Difference between epidemic, endemic, pandemic and sporadic 63 • Hospital-acquired infection (nosocomial infection) and its prevention 64 Short Notes and Relevant Questions • Man today is viewed as an “Agent” of his own disease—justify 64 • What is the confounding in epidemiological study 64 • Importance of cross-product ratio/odds ratio 65 • Indications for cohort studies 65 • Define relative risk and attributable risk 65 • Population attributable risk 66 • Blinding in epidemiological studies (RCT) 66 • Temporal association between a risk factor and disease 67 • Epidemiologically carriers are more dangerous than cases—justify with examples 67 • Difference between primary case and index case 67 • Vector 67 • The terms “source” and” reservoir” are not always synonymous—explain 68 • Death (international) certificate 68 • Droplet infection and airborne infection 69 • Difference between nosocomial infection and opportunistic infection 69 • Pandemic 69 • Zoonosis 69 • Difference between monitoring and surveillance with examples 70 • Monitoring and surveillance are not synonymous—explain 70 • DALY 70 • Disability-free life expectancy 71 • Epidemic curve 71 • Usefulness of knowing incubation period 71 • What is extrinsic incubation period 72 • Median incubation period 72 xx Community Medicine Buster • Generation time 72 • What is serial interval 72 • Standardized death rate 72 • Injection safety is important for the recipient, provider and community—justify 73 • Methods (Types) of disinfection 73 • Sterilization and disinfection are not synonymous 73 4. Screening.........................................................................................................................................................74 Long Essay Questions • Definition of screening for diseases 74 • Type, uses and criteria for screening of diseases 74 • Different measures to evaluate the screening test 74 • Plan for cancer screening in PHC area by MO I/C 75 Short Notes and Relevant Questions • Screening and case finding are not synonymous—explain 76 • Difference screening and diagnostic test 77 • Sentinel surveillance of disease is better than periodic mass screening—explain 77 • Significance of “true positive” value in screening test 77 • Significance of “false positive” in screening test 78 • Interpretation of false-negatives of a screening test 78 • Sensitivity and specificity 78 • Sensitivity and specificity of a screening test are inversely related—justify 78 • Lead time in screening of a disease and its significance 79 5. Immunization and Vaccine-related Issues and Oral Questions...................................................................80 Long Essay Questions • Mission Indradhanus 80 • National Immunization schedule of India 81 • Vitamin A prophylaxis schedule for 9 months to 5 years children 82 • Different types of live vaccines and examples of different types of specific protection 82 • Mother and child protection card (MCPC)—explain 82 • Investigation and steps taken for increasing immunization coverage in a district 85 • Causes of adverse events following immunization (AEFI), important health managerial functions/measures need to be undertaken to overcome the problem in that block 86 • Line listing and an outbreak of measles in one Tribal block and its management 87 • Epidemiology, treatment, major complications and prevention of measles in children 88 • The specific advantages of Edmonston–Zagreb stain vaccine over other measles vaccine 89 • Planning and organizing immunization services in a sub-center area 89 • Appropriate health education plan for vaccination campaign for measles and rubella 89 • Concept of cold chain and its equipment 91 • Meaning of reverse cold chain 91 Short Notes and Relevant Questions • Types of immunity, difference between active and passive immunity 91, 92 • Universal Immunization Programme (UIP) 92 • Herd immunity with examples 92 • Different agents for active immunization 93 • Objective of antenatal immunization of mothers against tetanus 93 • Use of auto-disable syringes in National Immunization Program 93 • Difference between live and killed vaccine 94 • Live vaccines are potent immunizing agents than killed vaccine—explain 94 • Vaccine vial monitor (VVM) 94 • Vaccine preventable diseases and vaccines under UIP 95 • Newer vaccines in National Immunization Schedule 95 • Rotavirus vaccine (RVV) 95 • Pneumoccal congjugate vaccine (PCV) 95 • Japanese encephalitis (JE) vaccine 96 • Inactivated polio vaccine (IPV) 96 • Difference between Salk and Sabin vaccine 97 • Routine Immunization and Integrated Pulse Polio Immunization (IPPI) 97 Contents xxi • Risk of VAPP and VDPP and future plan of polio immunization 97 • Role of IPV in polio eradication—explain 98 • Switch from trivalent to bivalent OPV as a Polio endgame plan 98 • Final push for polio eradication 98 • Shake test 98 • BCG vaccine (Route, dose, when to give) 99 • Mantoux test 99 • Hepatitis B vaccine and its schedule for children 99 • Explain the rationality of giving Hepatitis B vaccine in infants 100 • Pentavalent vaccine 100 • Measles vaccine 100 • Rationale of administration of measles vaccine at the age of 9 months 101 • Clinical feature of measles along with description of rash 101 • Epidemiologically measles is eradicable—explain 101 • MMR vaccine 101 • Difference between chickenpox and smallpox 102 • Chickenpox and its prevention 102 • What is 17D vaccine 103 • Eradication of tetanus is not practicable 103 • Candidate vaccine 104 • Different phases in clinical trial of vaccines 104 • Ring immunization 104 • Influenza vaccine 104 Viva (Oral) Questions • Why conditioning of ice packs are very important issue in case of vaccination 105 • Placement of vaccines on the icepacks and off the icepacks 105 • Vaccines: sensitivity to heat and freezing 105 • Open Vial Policy 105 • Why dose of BCG vaccine is 0.05 mL in case of children below 1 month of age? 106 • Phenomena after BCG vaccination 106 • Why BCG vaccine is given only up to 1 year of age? 106 • If no scar appears after administration of BCG, is revaccination required? 106 • Role of OPV-O at birth 106 • Can OPV and vitamin A is given with DPT booster 106 • Can an infant be breastfed immediately after OPV 106 • Role of second dose of measles vaccine is introduced in the National Immunization Program 106 • When measles vaccine is given at 6 months of age? 106 • Measles catch-up campaign 107 • If a child comes later for 1st dose, then what should be next schedule of vaccines? 107 • If a child received one dose of measles vaccine during an SIA campaign, should it receive the routine dose of measles vaccine? 107 • Why DPT vaccine is given in the anterolateral aspect of mid-thigh and not in the gluteal region? 107 • Why a minimum gap of 4 weeks between the two doses of DPT? 107 • If a child could not receive DPT1, 2, 3 and OPV 1, 2, 3 according to NIS, up to what age can the vaccine be given? 107 • Why DT is replaced by DPT vaccine for children above 2 years of age? 107 • What should be done if a child is found allergic to DPT or develops encephalopathy after DPT? 107 • A child aged 10 months remains unimmunized. Advise immunization of the child till 16 years of age 107 • Which vaccines can be given to a child between 1 and 5 years of age? 107 • Which vaccines can be given to a child between 5 and 7 years of age? 108 • Should one restart with 1st dose of a vaccine if the child brought late for the dose or defaulter or left out? 108 • Why spirit swab not advisable to clean the injection site before vaccination? 108 • If a child above 2 years of age has not received the JE vaccine either routine immunization or SIA should he/she be given the JE vaccine? 108 • Justification of PCV introduced in National Immunization Schedule 108 • Vaccination schedule for Pneumococcal vaccine for adults 108 6. Communicable Diseases...............................................................................................................................109 Long Essay Questions • Diseases of Public Health importance NVBDCP and its principles 109 • Strategies under National Vector-borne Diseases Control Programme (NVBDCP) 109 xxii Community Medicine Buster • General guidelines for treatment of uncomplicated malaria as per National Drug Policy 110 • Diagnosis and treatment strategies of malaria as per National Strategic Plan (2017-22) 111 • Different modes of vector-borne disease transmission with examples 112 • National Malaria Control Programme (NMCP)/Discuss the reasons of persistence of malaria 113 • Importance ABER and API on the context of malaria 113 • Epidemiology of malaria and strategies to prevent malaria in your PHC area 113 • Clinical feature, mode of transmission and chemoprophylaxis of malaria 114 • Instruction to health workers in the urban center for surveillance of fever cases 115 • Short-term control measures to control an outbreak of malignant malaria 116 • Long-term control measures to control an outbreak of malignant malaria 116 • Describe National Antimalaria Programme 117 • Life cycle of malarial parasite 117 • Definite host and intermediate host in malaria and why? 118 • Malariometric measures/Malaria indices in National Antimalarial Program 118 • Slide positivity rate 118 • Active and passive surveillance of malaria 119 • Major epidemiological types of malaria 119 • Radical treatment for vivax malaria 120 • Factors responsible for resurgence of malaria 120 • Approaches of malaria control 120 • Difference between mosquito and sandfly 121 • Enumerate mosquito-borne diseases 121 • Man-made malaria 121 • Comment on malaria week and WMD (antimalaria month campaign) 121 • Epidemiology of lymphatic filariasis and its control in India 121 • Mass drug administration in filariasis 122 • Why filariasis never causes explosive epidemic? 122 • Night blood examination in filariasis 122 • Assessment of filarial control program 123 • List the arboviral diseases 123 • Epidemiology, clinical features and control of Japanese encephalitis 124 • Epidemiology and clinical presentations and classification and diagnosis of dengue fever 124 • Dengue shock syndrome 126 • Clinical feature, diagnosis, treatment, control of chikungunya fever 127 • Epidemiology clinical feature, diagnosis, treatment control of kala-azar 127 • Enumerate the causes of resurgence of kala-azar 128 • Integrated vector management (IVM) 129 • Discuss the epidemiology of AIDS 131 • National AIDS Control Programme along with National AIDS Control Organization 132 • Package of services provided under NACP-IV 132 • Name common STDs 133 • Syndomic approach in management of STDs 134 • Role of (pretest and post-test) counseling in controlling HIV/AIDS in VCTC/ICTC 135 • Sentinel surveillance in prevention of HIV/AIDS 135 • Suraksha clinic 135 • What do you mean by HIV/AIDS? 136 • Clinical manifestations/WHO criteria for diagnosis of AIDS 136 • AIDS related complex (ARC) 136 • Modes of transmission of HIV/AIDS 136 • List vertically transmitted diseases 137 • Role of high-risk group and bridge population in HIV transmission 137 • HIV is behavioral disease—explain 137 • Enumerate the various RTI/STI syndromes 137 • Common complication of STDs 138 • Describe risk factors of HIV/AIDS 138 • ICTC should be supported by ART/Link ART Centre—explain 138 • Opportunistic infections in AIDS 138 • Explain window period 139 • Contact tracing in STIs 139 • Screening for diseases in blood bank 139 • Postexposure prophylaxis in relation to HIV/AIDS 139 Contents xxiii • One pregnant women whose husband was found to be HIV positive, came to OPD on 2nd trimester. How do you manage the case and what advice you give to the couple? 140 • Universal precaution 140 • HIV-TB collaboration are extremely important for control of HIV and TB in India 140 • Problem, epidemiological factors and prevention of rabies 141 • A 10 years old child reported with dog bite on calf muscle in casualty OPD within 2 hours of bite, suggest measures to prevent rabies in this child 141 • WHO categories of exposure in rabies 141 • Postexposure prophylaxis of rabies 142 • Prevention of human rabies 143 • Pre-exposure prophylaxis 143 • Measures for minimizing human rabies in an area 143 • Fixed virus 143 • Essen regimen and rabies immunoglobulin for passive immunization in post-exposure period of animal bite 144 • Confirm the diagnosis of plague and plague control measures 144 • Blocked flea/Partial blocked fleas are more dangerous 145 • Describe the epidemiology of leprosy 145 • Discuss classification, diagnosis (history, physical examination, investigation) and treatment (MDT as per WHO) of leprosy 146 • Outline the control methods with reference to National Leprosy Eradication Programme 147 • The steps for elimination of leprosy 148 • Different modes of intervention under levels of prevention in relation to leprosy 149 • 30-year-old man attends OPD with more than 5 hypopigmented patches, write down the diagnosis of the clinical condition 150 • Different presentation of leprosy to be encountered in outpatient department of hospitals 150 • Leprosy eradication is very difficult to achieve—justify 150 • Enumerate indicators are used to assess the disability of leprosy cases in field level 150 • Epidemiology of tuberculosis 151 • Various components of DOTS strategy 151 • National Program on Control of Tuberculosis in India in the context of RNTCP and NTEP with new initiatives 151 • Revised National Tuberculosis Control Program in Bihar or any state of India 154 • Cardinal symptoms for diagnosis of pulmonary tuberculosis, organize Revised Tuberculosis Control Program in a primary health center area 156 • Diagnostic process for initiation of treatment of TB under RNTCP. What is category I and II treatment for TB? What is MDR and XDR-TB? 156 • Different levels of prevention, mode of interventions as applied to pulmonary tuberculosis 160 • Common side effects of 1st-line anti-tubercular drugs 161 • An initially sputum smear-negative pulmonary TB patient was found smear positive on follow-up sputum examination at the end of initial intensive phase. Classify and categorize the patient according to RNTCP and discuss further management of the patient 161 • A case presenting with cough for more than 4 weeks according to RNTCP guidelines? If it is a sputum positive pulmonary tuberculosis, how will you manage the case? 161 • National Tuberculosis Control Programme gives priority on detection of new smear-positive cases/Sputum smear examination is the method of choice for case finding in TB—explain 162 • Passive surveillance in tuberculosis 162 • Tuberculosis is an old disease but new threat—Justify 162 • Describe in details DOTS-Plus 162 • Epidemiology of poliomyelitis 163 • Polio eradication in the light of epidemiological factors influencing poliomyelitis 163 • Meaning of acute flaccid paralysis, various strategies for eradication of poliomyelitis 164 • AFP surveillance and environmental surveillance 165 • Levels of prevention and modes of intervention as applied to poliomyelitis 165 • Provocative poliomyelitis 166 • Describe the epidemiology, prevention and control of hepatitis B in India 166 • Hepatitis B infection should be considered more dangerous than HIV infection—justify 168 • Australia antigen 168 • Serological marker of hepatitis B 168 • What is Covid-19 infection, its clinical features, different modes of transmission of Covid-19 infection, diagnosis, high-risk groups, discuss its management and prevention 169 • Describe epidemiology, clinical features, diagnosis, managememt and prevention and control of Swine Flu (H1N1) 171 • All influenza pandemics were caused by influenza virus A and not by B or C—explain 172 xxiv Community Medicine Buster • Antigenic shift and antigenic drift 172 • Measures to prevent entry of yellow fever into India 173 • India is yellow fever-receptive area—explain 173 • Aedes aegypti index 173 • Mode of transmission of arthropod-borne diseases 174 • Environmental control—best approach to control of arthropods 174 • Blanket treatment with examples 174 • Cyclops 174 • What is chandler’s index? 175 • Mass drug administration for soil transmitted helminthes 175 • Epidemiology and prevention of Ebola virus disease 175 • SAFE strategy for trachoma 176 • Inappropriate and inadequate use of antibiotics leads to antimicrobial resistance 177 • What is the criteria’s for successful parasitism 177 • Zika virus 177 • Bioterrorism 178 7. Non-Communicable Diseases ......................................................................................................................179 Long Essay Questions • Major “risk factors” responsible for sharing non-communicable disease among adults 179 • Enumerate non-communicable disease of public health importance 179 • Discuss the epidemiology of hypertension with special reference to Indian context 180 • Define hypertension, modifiable and nonmodifiable risk factors and preventive measures 180 • Define essential hypertension, prevalence in India, prevention measures 182 • As 6th semester student, you are required to conduct a research project on “prevalence of hypertension among medical students of your institute” within a period of 3 months. 182 • A 35-year-old sedentary obese man with smoking habit, blood pressure of 126/100 mm of Hg. The management with special emphasis on diet of the person 182 • Rules of halves 183 • Tracking of Blood pressure 183 • DASH diet and its role in prevention of hypertension 183 • Risk factors of coronary heart disease (CHD), levels of prevention of disease 184 • Measure the burden of coronary heart disease (CHD) in the community 186 • Burden and natural history of RHD. What are the criteria for diagnosis of rheumatic fever and rheumatic heart disease? What are the non-therapeutic measures of prevention of rheumatic heart disease? 186 • Major causes of blindness in India. Outline the strategies adopted for control of blindness 188 • Many school students in your block are found suffering from reduced ability to see the board-work by the teacher in class room. As BMOH, how will you manage the situation? 188 • Definition of blindness according to WHO. Discuss in brief the three levels of eye care for prevention of blindness in our country 189 • Delineate the structure of operation for vision 2020: The Right to sight in our country 190 • Preventive blindness 190 • Multifactorial etiology of cancer. Add a note on the basic approach to control of cancer 191 • Cancer registry 191 • Early (danger) signs of cancer, cancer education, epidemiology of oral cancer and methods of its different levels of its prevention in the community 192 • Methods of screening for cancer 193 • Common causes of cancer among males and females in India. Enumerate the cancers more frequently found in India. Write briefly epidemiology, prevention and control of cancer cervix in India 194 • Epidemiology and prevention of breast cancer in India 196 • Micronutrient in cancer 197 • Objectives, components and strategies of National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) 197 • Cancer components under National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) 197 • Epidemiology of road traffic accident (RTA) in India. Common causes of RTA. Describe measures to reduce the problem 198 • Domestic accidents, causes and prevention 200, 201 • Epidemiology of diabetes 201 • Classification of diabetes adopted by WHO/American Diabetic Association 201, 202 Contents xxv • Levels of prevention and modes of intervention in the context of diabetes 203 • Primary preventive measure with family history of diabetes 204 • Multicausation in diabetes/different epidemiological determinants 205 • Measures for prevention and control of type 2 diabetes mellitus 206 • Complications (macrovascular and microvascular) of diabetes mellitus 206 • Self-care in diabetes mellitus 207 • Role of diet in the management of diabetes 207 • Role of diet in various diseases. Add a note on “ Diet and Cancer”. 207 • Snake bite and its epidemiology, risk factors, early clues for patients, first-aids, antivenom 208 • Core strategies of National Programme for Health Care of Elderly (NPHCE) 209 • Health problems of geriatric population 210 • Passive smoking 210 • Warning signs of poor mental health 211 • Drug addiction 211 • Explain de-addiction 211 • Drug dependence 212 • Factors associated with high-risk for drug abuse 212 8. Nutrition and School Health ........................................................................................................................213 Long Essay Questions • Definition of malnutrition, direct and indirect effect of malnutrition, indicators of malnutrition 213 • Epidemiology of malnutrition in under-five 213 • Causes, classification of PEM, different levels of prevention and its interventions 214 • Objectives of school health program, different aspects/components/essentials of school health services 216 • Objectives of ICDS, services provided, components, beneficiaries of ICDS 218 • Objectives of nutritional assessment 219 • Assessment of nutritional status of under-five children in a community 219 • Considering its effect on present and future lives of children, name most important anthropometric indicator of undernutrition with justification 221 • Different methods of diet survey, method applied to assess nutritional status in “Family Program” 221 • Enumerate common nutritional problems in the community 222 • Nutritional assessment schedule 222 • Micronutrients supplemented through national nutrition program 223 • Enlist community nutrition program available in India 223 • Social factors are responsible for PEM 223 • Disorder caused by iodine deficiency, strategies to control iodine deficiency disorders in India 224 • “Consume only iodized salt”—explain the meaning and background of the message 224 • Vitamin A deficiency diagnosis, treatment and its prevention (prophylactic schedule) 225 • Extraocular manifestations of vitamin A deficiency 225 • Enumerate the components of IYCF 226 • Complementary feeding 226 • Supplementary feeding for infants aged 6 months to 1 year 227 • Problems of adolescents, national programs concerning improvement of adolescent health. 227 • Define obesity and overweight, assess obesity and prevention and control 228 • Different types of food toxicants and consequent diseases in India and their prevention 230 Short Notes and Relevant Questions • Growth chart can play multiple roles—explain 232 • Uses of growth monitoring 234 • Difference between marasmus and kwashiorkor 234 • Functions of CDPO 234 • Functions of Anganwadi worker (AWW) 235 • Village Health and Nutrition Day (VHND) 235 • Supplementary nutrition and therapeutic nutrition are different—explain 235 • Balanced diet and prudent diet 235, 236 • Meaning of a reference protein 236 • Assessment quality of protein 236 • Essential amino acids 237 • Limiting amino acids 237 • Combining rice and pulse in diet is a good practice 237 • Name important sources of dietary fiber 237 xxvi Community Medicine Buster • Name of essential fatty acids, its dietary sources and enumerate their functions 237 • Indian reference man and Indian reference women 237, 238 • Body mass index (BMI) 238 • Role of IEC in prevention and control of adolescent obesity 238 • Short term high dose of vitamin A oil supplementation is useful for prevention of xerophthalmia—justify 238 • Vitamin A supplementation is necessary after measles infection - give reasons 239 • Food fortification 239 • Food enrichment 240 • Food additives and food adulteration are not synonymous—explain 240 • Education for food handlers regarding handling of food 241 • Fluorine is often called two edged sword—explain 241 • Endemic fluorosis with its prevention 241 • Parboiled rice is nutritionally superior to milled rice—justify 242 • Nutritional profile of cereals 242 • Pasteurization 242 • Milk borne diseases 242 • Recommended dietary goals 243 • Vitamin deficiency can cause psychosis and why? 244 • Food standards 244 • Food safety 244 • Food security 245 • Nutritional surveillance 245 9. Medicine and Social Sciences.......................................................................................................................246 Long Essay Questions • Understand by of social medicine, effect of social factors in causing disease 246 • Types of family, stages of family cycle; discuss the role of family in health and disease 247 • Function of family 248 • Modified Prasad’s socioeconomic classification 248 • Modified Kuppuswamy’s socioeconomic classification 249 • Cultural factors in health and disease 250 Short Notes and Relevant Questions • Family is considered as an epidemiological unit—explain why? 251 • Family as a unit of health 251 • Social diagnosis 252 • Social pathology 252 • Social stress 252 • Customs do not always have deleterious/negative effect on health—discuss the statement 253 • Culture 253 • Meaning of acculturation 254 • Role of emotions in health and disease 254 • Social marketing 254 • Medical social worker (MSW) 254 • Social mobilization 255 • Social defense 255 • Social therapeutics measures 256 • Social control mechanism 256 10. Reproductive and Child Health....................................................................................................................257 Long Essay Questions • Meaning of RCH its program with respect to component, implementation and goals 257 • RCH services are provided through different levels of health care available in blocks 259 • Target-free approach/community need assessment (CNA) in RCH 260 • RCH package of services for pregnant lady 260 • Component of RCH-II programs with special reference to STD and adolescent health 261 • Different maternal health problems in India 262 • Indications of MCH care, causes and factors related to maternal mortality and its prevention 262 • Organize an immunization session for infant and children and pregnant mother 264 • Definition, objectives and components of antenatal care, prevention of neonatal death 265 Contents xxvii • Antenatal check-up of a pregnant women of 22 weeks gestation, ensuring safe delivery 265 • Antenatal care and antenatal check-ups during pregnancy, high-risk group of mothers during pregnancy, danger signals of pregnancy 265 • Specific health protective measures in ANC 269 • Nutritional requirements during pregnancy and lactation 269 • Different categories of manpower available at block level for delivering the primary health care services 269, 270 • Outline the services a newborn is expected to receive from the sub-center and ASHA from birth up to five years of age 269, 270 • Home-based new born care 269, 270 • Name the five cleans prevention of neonatal tetanus and measure to prevent its further occurrence 271 • Meaning by essential obstetric care, services delivered under RCH-II program 273 • Importance of maternal death review, review at community level 275 • Essential obstetric care for all pregnant women in sub-centre of 6,000 population 275 • Antenatal services at PHC with 30,000 population, co-ordination of ANM, AWW and ASHA 276 • Functions of an under-five clinic in a sub-center area 276 • Definition and classification of Low Birth Weight babies, prevalence of LBW babies in India and target to achieve, measures to reduce low birth weight babies in a block 277 • Baby friendly hospital initiative (BFHI), 10 steps of successful breastfeeding, advantages of exclusive breastfeeding, continue feeding during illness 278 • Define maternal mortality ratio and maternal mortality rate and their difference 280 • Components of EmOC, minimum services to be provided by a fully functional FRU 280 • Important medical causes and factors (social) related to maternal mortality, measures to prevent and control such deaths in rural community 281 • Lot of ladies died due to postpartum hemorrhage in a block, steps to be taken to reduce the condition in a block 282 • Proportion of institutional delivery is very low in a district also coverage of JSY is low, suggest measure for its improvement 283 • Postnatal check-up of a mother having a child aged 2 weeks, probable postnatal complications of mother and child, measures to improve the situation at community level 284 • Definition, factors affecting IMR and suggest measures for its prevention 286 • IMR current scenario in India 286 • Importance of Neonatal Mortality, components of essential newborn care with special reference to breastfeeding 289 • Perinatal mortality, causes, methods of prevention and control of perinatal mortality 289 • Perinatal mortality is an important indicator of MCH care 290 • Intensified National Iron Plus Initiative(I-NIPI)/Anemia Mukt Bharat strategy 292 • Causes and detrimental effects of nutritional anemia, measures under I-NIPI 293 • Etiopathogenesis, prevention and control of anemia in pregnant mother 294 • 12 by 12 initiative for Anaemia Control Programme 294 • Action plan to conduct IEC campaign in a block to reduce anemia among pregnant woman 294 • Epidemiology of diarrheal diseases, preventive measures for control of diarrhea in the community specially children 296 • Description of ORT 297 • 2-year-old child presented with history of frequent passage of loose stool for two days, irritability, excess thirst and skin turgor was going back slowly. Classify the dehydration with proper justification in accordance with national program guidelines. Outline the management of child 300 • Describe the problem of ARI 300 • A 6-month-old infant with ARI had a respiratory rate 56/minute. There was no chest indrawing and no danger sign. Classify the ARI with justification and discuss the management accordingly 300 • Treatment ARI of under-5 children 300 • Congenital rubella syndrome, and its prevention 302 Short Notes and Relevant Questions • Paradigm shift/does RCH program differ from CSSM program? 303 • “Mother and child are one unit”—justify 303 • Crèches 304 • Objectives of early neonatal care 304 • Newborn care 305 • Common home-made oral rehydration solutions 305 • Low osmolarity ORS has many advantages over previously used ORS—justify 306 • Zinc therapy is beneficial in management of diarrhea—explain/Zinc is given with ORS in treatment of diarrhea—justify 307 • Institutional delivery can reduce maternal mortality to a great extent—explain 307 • Growth and development are not synonymous—explain 308 • Kangaroo mother care (KMC) 308 • Rooming-in 308 xxviii Community Medicine Buster • Juvenile delinquency 309 • Child placement 309 • Child trafficking 309 • IMNCI 310 • “At risk” infants 310 • RMNCH-A (Chapter 21, Q.2) 311 • Janani Suraksha Yojana (Chapter 21, Q.4) 311 11. Demography and Family Planning ..............................................................................................................312 Long Essay Questions • Definition of demography, different demographic cycles in details 312 • Couple protection rate (CPR) is persistently low in a block, measures for improvement 313 • Classify contraceptives methods, describe the advantages and disadvantages of them 314 • Conventional contraceptives, name different types with advantages and disadvantages 320 • A women aged 35 years with two children (age of the last child 5 years) likes to adopt a family planning method, advice for her, reasons behind it 320 • GATHER as method of counseling in family planning 321 • Enumerate fertility indicators, concept of NRR=1 323 • Health benefits of family planning 323 • Factors responsible for high fertility in India, strategies for controlling the situation 324 • Characteristics of age and sex composition of population 324 • Define sex ratio, factors behind the declining of it in India, measures improvement 325 • Gender bias and health 325 • Sociodemographic goals for 2015, steps for evaluation of family planning program 326 • Define population explosion, demographic trends in India, measures for control of population explosion 326 Short Notes and Relevant Questions • Population pyramid is important for public health 328 • Demographic gap 328 • Age at marriage and its significance 328 • Scopes of family planning services 328 • Knowledge of contraceptives among adolescent 329 • Unmet need for family planning 329 • Net reproductive rate and its significance 329 • Total fertility rate (TFR) 329 • Traditional Birth Attendants (TBA) 330 • Eligible couple 330 • Target couples 330 • Definition of couple protection rate and contraceptive prevalence rate 330 • Cafeteria approach in family planning 331 • Noncontraceptive benefits of oral contraceptives 331 • Hormonal contraceptives 331 • Injectable contraceptives 331 • Emergency/back-up contraception 332 • Describe no scalpel vasectomy (NSV) 332 • Postoperative advices following vasectomy 333 • Pearl index 333 • Medical Termination of Pregnancy Act (MTP), 1971 333 • PNDT Act 333 • Social marketing of condoms 334 12. Occupational Health .....................................................................................................................................335 Long Essay Questions • Factors influencing pneumoconiosis its control and prevention 335 • List (classify) the occupational diseases (hazards), measures for prevention and control 336 • Define factory under Indian Factories Act, 1948, provision recommended to protect the health of the workers 338 • Eligibility criteria for enrolling in ESI scheme, mention the benefits under ESI scheme, services available under medical benefits 339 • Define social security, scheme for industrial workers 340 Contents xxix • In an accident in a factory, a male worker lost his lower limb below thigh. Enumerate the benefits he is entitled to under ESI Act. In case of death of the worker, what are the benefits his family is entitled to get? What are the steps to be taken from the management to prevent future occurrence 340 • Many cases of silicosis were reported from a pottery and ceramic industry. As an Industry Health Officer, write epidemiology and measures recommend for prevention and control of the problem 341 Short Notes and Relevant Questions • Occupational hazards of agricultural workers 342 • Ergonomics 342 • Respirable dust 343 • Diagnosis and control of inorganic lead poisoning 343 • Noise/Hazards of noise pollution (exposure/effect) 343 • Hazards of radiation and radiation hygiene 344 • Tobacco control legislation in India 344 • Health Insurance Scheme 345 • Thermal indices comfort 345 • Problems of industrialization 345 • Sickness absenteeism 346 • Child labor 346 • Occupational cancer (causes and types) and its prevention 346 13. Water, Housing, Environment, Ventilation, Air, Lighting, Noise, Radiation, and Latrine........................348 Long Essay Questions • Enumerate the water-borne and water-related diseases, measures for ensure safe water (portable water) to an urban area 348 • Different tests for bacteriological surveillance of drinking water, explain why coliform organisms are chosen as indicator of fecal pollution of water 351 • Principles of chlorination of water/the mere addition of chlorine to water is not chlorination 352 • Criteria for healthful housing, overcrowding, diseases transmitted and related to overcrowding 352 • Criteria for a sanitary latrine, types of latrine recommend for a rural area, discuss the principle of septic tank 353 • Break point chlorination of water, water harvesting in urban areas 354 • Important inorganic chemicals of health significance present in ground water of West Bengal, the health effects and control measures 354 • Definition of hardness of water, disadvantages of it, purification water on large scale 355 Short Notes and Relevant Questions • Purification of water at household level/small scale 356 • Superchlorination 357 • Types of ventilation 357 • Sanitary barrier 358 • Sanitary landfil 358 • Biological treatment of sewage/biological oxygen demand 359 • Soakage pit 359 • What is comfort zone, mention the ranges of corrected effective temperature 359 • Heat stress indices (HSI) 360 • Causes of air pollution and health hazards (effect on human health), monitoring of air pollution, parameter and prevention and control 360 • Greenhouse effect 361 • Causes and effects of global warming 362 • High altitude/mountain sickness 362 • Daylight factor 362 14. Health Planning and Management..............................................................................................................363 Long Essay Questions • As a BMOH, you noted that in certain villages people preferred quacks rather than your services and measure to be taken 363 • Community diagnosis of the health situation in order to formulate intervention measures 364 • Definition of planning, management, objectives, target and goals, steps of planning cycle 365 • Qualitative and quantitative methods of health management 366 xxx Community Medicine Buster • Importance of MIS in health planning and management 369 • SWOT analysis 369 • Components of evaluation process 369 • MDG 370 • Health-related millennium development goals 372 • Sustainable development goals (SDGs) 373 Short Notes and Relevant Questions • Management consist of four basic principles—explain 374 • Target and goal 375 • Prioritization is important step in health planning—justify 375 • Feedback is very important in health planning 375 • Budgeting 376 • Zero budget approach 376 • Cost-effective analysis and cost-benefit analysis are not synonymous—explain 377 15. Waste Management......................................................................................................................................378 Long Essay Questions • Different types of biomedical waste generated in hospital, measures suggested for their safe disposal as per National and State rules, different color container for disposing hospital wastes 378 • Guidelines for handling and disposal of waste generate during treatment, diagnosis and quarantine of Covid-19 patients 379 • Importance of waste tracking 383 • Different methods of solid waste disposal with special reference to rural area 383 • A recent public demonstration has occurred in a block primary health center about disposal of biomedical waste containing water body by the side of the hospital. As a BMOH of the hospital, what measure would you like to adopt for proper waste management of your hospital? 383 • Biomedical waste should be segregated at source (hospitals/nursing homes) 383 Short Notes and Relevant Questions • Principles of biomedical waste management 385 • How will you handle contaminated metal instruments 385 • Health hazards of health care (biomedical) waste 385 • What should be the thickness of plastic bags should they be permitted, why? 386 • Disposal of sharp waste in healthcare setting 386 16. Disaster Management...................................................................................................................................387 Long Essay Questions • Common causes of disaster, disaster cycle, different health hazards likely to occur during and after flood/cyclone/ (Amphan in West Bengal) water-borne diseases. As a BMOH, describe your preparedness to mitigate such hazards in future 387 Short Notes and Relevant Questions • Triage 390 • Vaccination in disaster 390 17. Health Information System and Education and Communication .............................................................391 Long Essay Questions • Vital statistics, collection and compilation of vital events in a CHC area 391 • Sources of health information in India 392 • Essentials of a good communication process (components) 392 • Different types of communication 393 • Concept of information, education and communication 393 Short Notes and Relevant Questions • Various sources of health information available in India, their advantages and disadvantages 394 • Sample registration system (SRS) in India 395 • Census 395 • Health education 396 • Kinds of interview 397 • Demonstration 398 Contents xxxi • Telemedicine is now an important field of medical communication 398 • Channels of communication 398 • Group discussion 398 • Common barriers of communication 399 • Attitude 399 • Role-play 399 • Different methods of health education communication 400 • Objective of health education 400 • Health education and counselling 400 • Health education is not a health propaganda—Justify with example 401 • Focus group discussion (FGD) 401 • Panel discussion 401 • Symposium 402 • Role of interpersonal communication in behavior change 402 • Behaviour change communication (BCC) 402 18. International Health Organizations and International Health Regulations ............................................404 • Voluntary Health Agency, function, networking, important role in health care delivery 404 • Nongovernment Organizations and its role in community health 404 • International Health Agencies functioning in India, works of bilateral agencies 404 • WHO 405 • UNICEF/GOBI-FFF 406 • CARE 406 • World Bank 406 • Indian Red Cross 407 • Activities of International Red Cross 407 • Rockefeller foundation 407 • Ford foundation 407 • FAO 408 • ILO 408 • Emporiatrics 408 • Isolation 409 • Quarantine 409 • International quarantine 409 • Quarantine and Isolation are not synonymous 409 • Notification of disease/International Health Regulation (IHR) 409 19. Genetics and Health......................................................................................................................................411 Long Essay Questions • Define preventive genetics, problems of consanguinity, measures available for prevention of diseases having genetic background 411 • Genetic diseases 413 Short Notes and Relevant Questions • Premarital genetic counseling to a young lady whose parents are sickle cell positive 414 • Gene therapy 415 • Role of genetic predisposition in common diseases/genetic factors in cancer 415 20. Basic Statistics ...............................................................................................................................................416 Long Essay Questions • Different types/methods of sampling, their advantages and limitations 416 • Sampling technique 420 Short Notes and Relevant Questions • Uses of biostatistics in public health/Usages of statistics in medical research 420 • Work sampling 420 • Normal curve 421 • Uses of normal curve 421 • Standard normal curve 422 • Terms “normal curve” and “standard normal curve” are not synonymous 422 • Types of data with suitable examples 422 xxxii Community Medicine Buster • Hospital statistics are considered a poor guide for estimation of a disease frequency in a community 423 • Methods of presentation of statistical data 423 • Bar diagram 423 • Pictogram 425 • Pie diagram/chart 425 • Histogram 425 • Frequency polygon 426 • Line diagram 426 • Measurement of central tendency 426 • Statistical average 426 • Measure of dispersion 427 • Mean deviation 428 • Standard deviation 428 • Contingency table 429 • Chi-square test 429 21. National Health Programs ............................................................................................................................431 Long Essay Questions • Integrated Disease Survellance Program (IDSP) 431 • RMNCH +A 432 • Government policies and schemes for women empowerment 433 • Janani Suraksha Yojana (JSY) 433 • List of important national health programs of India 434 • Swachh Bharat Mission/Abhiyan 435 • Ayushman Bharat Programme 436 22. MCQs of Different Universities of India.......................................................................................................438 23. Fill in the Blanks with Appropriate Word(s) ................................................................................................450 24. True/False.......................................................................................................................................................455 Index 45

Place Hold on Community medicine

Community medicine with recent advances

By Suryakantha , A S. Jaypee Brothers Medical Publishers (P) Ltd., New Delhi 2014 . 941

Place Hold on Community medicine with recent advances

Community medicine with recent advances

By Suryakantha , A S. Jaypee Brothers Medical Publishers (P) Ltd., New Delhi 2014 . 941

Place Hold on Community medicine with recent advances

Community Mental Health in India

By Chawan B S, Nitin Gupta, Priti Arun. Jaypee Brothers, New Delhi 2012 . 662 , Section I: An Introduction to Community Mental Health 1. The Relevance of Community Psychiatry in India..................................................................................................................3 R Srinivasa Murthy • Challenging Mental Health Situation in India 3 • International Development of Mental Health Services 7 • Development of Mental Health Services in Low and Middle Income Countries 8 • Development of Mental Health Services in India 9 • Community Mental Health Initiatives in India 9 • International Developments 16 • Personal Reflections of Last Six Decades 16 • Future of Community Psychiatry in India 17 Section II: Historical Concepts and Evolution 2. Psychiatry in India: A Historical Perspective.........................................................................................................................25 S Haque Nizamie, Mohammad Zia Ul Haq Katshu, Samir Kumar Praharaj • History of World Psychiatry 25 • Psychiatry in Ancient Vedic India 26 • Psychiatry in Medieval India 27 • Psychiatry in Colonial India 27 • Psychiatry in Postindependence India—The Colonial Hangover and Development of Modern Psychiatry 32 • How Far We Have Come? 36 3. General Hospital Psychiatry.....................................................................................................................................................39 Prakash B Behere, Manik C Bhise • The Concept of General Hospital Psychiatry Units 39 • History 40 • Integrating Psychiatry with General Health Care System in India 40 • Roles of General Hospital Psychiatry Units in India 41 • Inter Relationship between Psychiatry and other Specialties 43 • Future of Ghpus in India 49 4. Towards Community Mental Health Care: Primary Health Care Model..........................................................................53 Sunder Lall, Shanker Prinja • Village Level 53 • System of Sub-Health Centers 53 • System of Primary Health Centers 54 • System of Community Health Centers 54 • Moving Away From Mental Institutions—Towards Community Mental Health Care 55 5. National Mental Health Programme .......................................................................................................................................58 Rajesh Kumar, Dinesh Kumar National Mental Health Programme 58 • Evolution of District Mental Health Programme 59 • National mental health programme in Eleventh Five-Year Plan (2007–12) 61 • District Mental Health Programme and national rural health mission 62 6. District Mental Health Programme.........................................................................................................................................65 BN Gangadhar, KV Kishorekumar • The Magnitude of Mental Health Problems: The Need for Decentralized Mental Health Care 65 • The Burden of Mental Disorders 66 • Current Resources for Mental Health Care 66 • Capacity-Building for Primary Care Personnel to Deliver Mental Health Care 66 • The Advantages of Planning Mental Health Care at the District Level 67 • Aims and Objectives of the Dmhp 67 • The Process of Implementation of the Dmhp in the District 67 • Mid-Course Evaluation of the Dmhps 69 • Findings and the Recommendations of the Evaluation of the Functioning of Dmhp in India: Evaluation by the Ministry of Health and Family Welfare, Govt of India, 2009 69 • Key Issues for Effective Implementation of the Dmhp in India 71 Section III: Dimensions of Community Psychiatry 7. Family and Mental Health in India ........................................................................................................................................77 Vikas Bhatia, Rohit Garg, Abhiruchi Galhotra • Changing Concepts Over the Role of Family in Mental Illness 77 • The Indian Family 78 • Historical Aspects of the Role of the Family in Mental Illness in India 80 • Impact of Mental Illness on the Families 80 • Therapeutic Role of xxviii Community Mental Health in India Family in Management of Psychiatric Illnesses 82 • Changes in Traditional Indian Family and Implications for Mental Health 82 • Role of Family Self-Help Groups and Nongovernmental Organization in Mental Health in India 84 • Early Warning Signs of Psychiatric Illnesses: Can Family Prevent Psychiatric Illness? 85 8. Stigma of Mental Illness ...........................................................................................................................................................89 Santosh Loganathan, R Srinivasa Murthy • Historical Perspectives 89 • Stigma: Concepts and Terminologies 91 • Consequences of Stigma 92 • Stigma Research: Instruments and Methods 94 • Research from India 96 • Research Among Low and Middle-Income Countries 99 • Research Studies From Western Countries 100 • Anti-Stigma Campaigns 102 • An Agenda for Action—What Can be Done by the Following Stakeholders? 103 9. Disability and Functioning .....................................................................................................................................................112 R Thara, Hema Tharoor • Definitions 112 • Areas Affected 112 • Impact of Disability 113 • International Classification of Disabilities 113 • Relevance of Icf to Rehabilitation 114 • Measurement of Disabilities 114 • Indian Disability Evaluation and Assessment Scale 114 • Why Measure Disability? 115 • International Study 115 • Indian Research on Disability 116 • Cross-Cultural Issues and Disability 116 • The Interplay of Disability and its Impact on Practice of Community Psychiatry 117 • Conclusion and The Way Ahead 117 10. Homelessness and Mental Illness...........................................................................................................................................119 RC Jiloha, Lokesh S Shekhawat • Definitions and Concepts 119 • Prevalence 120 • Homelessness and Mental Illness 120 • Pathways to Homelessness for The Mentally Ill 121 • Homelessness and Individual Psychiatric Disorders 123 • Legal Issues Related to Homeless Mentally Ill 123 • Negative Effects of Being Homeless 124 • Community Mental Health Programs and the Homeless Mentally Ill In India 124 • Government and Nongovernment Organizations Working for Homeless Mentally Ill 124 • Management 125 • Principles of Management 127 • Early Intervention 127 • Housing Programs 128 • Outreach Services 128 • Assertive Community Treatment 128 • Service Integration 129 • Motivational Interventions/Stages of Change 129 • Modified Therapeutic Communities 129 • Self-Help Programs 129 • Involvement of Consumers and Recovering Persons 130 • Psychiatric Rehabilitation 130 • Training and Employment 130 • Crisis Care Services 130 • Teaching and Training 130 11. Gender and Community Mental Health: Sharing Experiences from our Service Program ..........................................136 Bhargavi V Davar • Contested Concepts of ‘Mental Illness’ 136 • Mental Health Empowerment as the Basis for (Urban) Community Mental Health Policies 138 • Nuancing Gender in the Context of Development, Urbanization and Mental Health 143 • Designing a Gender Sensitive Urban Community Mental Health Program 144 12. The Role of Non-Governmental Organizations in Community Mental Health Care......................................................148 Vandana Gopikumar, Elizabeth Negi, Mirjam Dijkxhoorn • Case Study 1 148 • Mental Health Sector—An Overview 149 • Ngo Sector in India 150 • Working with Divergent Mental Health and Well-being Needs of People from Lower Socioeconomic and Vulnerable Groups 151 • Case Study 2 152 • Working with Tribal Communities 154 • Working with Self-Help Groups 154 • Focus on a Rights Framework 154 • Caregiver and User Driven Programs 155 • Focus on Research 156 • Working with Traditional Systems of Healing 156 • Community Fostering 156 • Challenges Faced by Ngos in the Mental Health Sector 156 • Positive Trends in Community Mental Health Care in the Ngo Space 157 Section IV: Legislative Aspects 13. Contemporary Debates about Mental Health Legislation: A Summer and a Winter of Discontent ............................ 161 Anirudh kala • United Nations Convention Rights of Persons with Disabilities (UNCRPD) and Mental Health Act 163 • Towards a New Mental Health Act 165 • Concerns about the Proposed New Act 167 14. Persons with Disability Act ....................................................................................................................................................169 Rachna Bhargava, Siva Kumar Thanapal, Abhijit Rozatkar • What is Disability? 169 • Change in Perspective of Viewing Disability 169 • Epidemiology of Disability 169 • Policies for Disability in India 170 • Salient Features of the Pwd Act, 1995 170 • Inclusion of Mental Illness in Pwd Act, 1995 170 • Criticism of Pwd Act 172 • General Policy Issues 172 • Sectoral Policy Issues 173 • Implementation of the Act 173 • Awareness of The Act 174 • Certification of Disability 174 • United Nations Convention on the Rights of Persons with Disabilities 174 • Right to Persons with Disabilities Act, 2010: Working Draft 174 • Notable Advances in the New Act 175 • Disability Rights Authority 175 15. Narcotic Drugs and Psychotropic Substances Act ..............................................................................................................176 Debasish Basu, Munish Aggarwal, Umamaheswari V • Historical Background 176 • The Narcotic Drugs and Psychotropic Substances Act 177 • Amendments 180 • Community and the Narcotic Drugs and Psychotropic Substances Act 180 16. Human Rights and Law .........................................................................................................................................................184 Soumitra Pathare, Kunal Kala, Alok Sarin • Interaction between Human Rights and Mental Health 184 • International Human Rights Systems 185 • The Indian Scenario 188 • Necessity of Mental Health Legislation—Protecting, Promoting and Improving Rights through Legislation 188 • Substantive Content of Mental Health and Related Legislation 189 • Interface between Policy and Legislation 191 Section V: Community Mental Health and Psychiatric Specialties 17. Community Based Addiction Psychiatry .............................................................................................................................195 Anju Dhawan, Raman Deep Pattanayak • Background and Rationale 195 • Concept 195 • Principles and Practices 196 • Range of Community Based Services 196 • Advantages 197 • International Perspectives 197 • Community based Approaches in India 198 • Sector-Based Interventions (Workplace, Schools) 201 • Cost-Effectiveness 202 18. Community Based Geriatric Psychiatry ...............................................................................................................................205 KS Shaji • Care of older People 205 • Disability/Dependence 205 • Caregiver Issues 206 • Geriatric Psychiatric Disorders 206 • Treatment Gap 208 • Integration with other Services 208 • Peoples’ Participation in Mental Health Care for Older People 209 • Lessons from Palliative Care 209 • Development of Community based Dementia Care 210 • Schemes and Policies 210 • Welfare Associations for Elderly 211 • Future Directions 211 19. Community Child and Adolescent Psychiatry ....................................................................................................................213 Savita Malhotra, Navendu Gaur • Historical Account 213 • Introduction 213 • Principles and Goals of Community Child and Adolescent Psychiatry (CCAP) 214 • Therapeutic Foster Care (TFC) Model 215 • Chandigarh’s Child Protection Programme: A Community Initiative 217 • Inter-Sectoral Interface 217 • School Mental Health 218 • Conclusion 221 20. Learning Disabilities: Community Based Approaches and Initiatives .............................................................................222 Chhaya Sambharya Prasad, Samir Dalwai, Hemant Singh Keshwal Background 222 • Diagnosis 224 • Issues to be Addressed 227 Section VI: Emergencies in the Community 21. Farmers’ Suicides in Central Rural India ...........................................................................................................................231 Prakash B Behere, Manik C Bhise • Definition of Various Terms 231 • Magnitude of Problem 231 • Epidemiology 232 • State wise Prevalence in India 233 • Etiology 233 • Survivors of Farmer Suicide 235 • Prevention of Farmer Suicides 236 • Role of Psychiatrists 238 • Role of other Allied Professionals 238 • Role of Community-Based Psychiatry in Prevention 238 22. Suicidal Behaviour and Suicide Prevention..........................................................................................................................241. Roy Abraham Kallivayalil, PG Saji • myths about Suicide 241 • Definition and Terms 242 • Epidemiology 242 • Suicidal Behavior as a Public Health Problem 242 • Associated Factors in Suicide 243 • Causes of Suicidal Behavior 243 • Psychiatric Disorders and Suicide 244 • Survivor Guilt in Suicide 245 • Copycat Suicide and Media 246 • Society and Suicide 246 • Religion, Culture and Suicide 247 • Economic Situation and Suicide 247 • Suicide by Farmers 247 • ‘What’ after Assessment 247 • General Approaches in Suicide Prevention 248 • The Kerala Experience 249 23. Crisis and Violence Intervention............................................................................................................................................251. Rajiv Gupta, Arunima Gupta • Crisis: Concept and Definition 251 • Violence Potential and Crisis Intervention 251 • Management 253 • Crisis Intervention 253 • Violent Behavior 254 Contents xxix xxx Community Mental Health in India 24. Disaster Management: Mental Health Perspective ............................................................................................................257 Nilamadhab Kar • Post-Disaster Mental Health Sequelae 257 • Vulnerability Factors 260 • Post-Disaster Interventions 261 • Types of Psychological Intervention 262 • Psychopharmacological Intervention 263 • Role of Mental Health Professionals in Disaster Management 263 Section VII: Alternatives to Hospitalization 25. Models of Community Mental Health Care .........................................................................................................................269. BS Chavan, Abhijit Rozatkar, Ajeet Sidana • What is Required? 269 • Evolution of Community Mental Health 269 • Component of Community Mental Health Model 270 • Are Western Models Appropriate for Developing Countries? 270 • Various Community Models 271 • Future Models for Community Psychiatry 279 26. Camp Approach.......................................................................................................................................................................281 BS Chavan, Ajeet Sidana, Abhijit Rozatkar • Introduction • Why do We Need the Camp Approach? 281 • Camp Approach in Psychiatry 281 • The Camp Approach in Substance Dependence 282 • History of the Camp Approach for Substance Dependence 282 • Organizing a Camp 283 • The Camp Experience 284 • Current Status of Camp Approach 286 27. Primary Prevention of Psychiatric Disorders .....................................................................................................................288 BS Chavan, Nitin Gupta, Jasmin Arneja • Definition of Prevention 288 • Mental Health Promotion 288 • Risk and Protective Factors 289 • Altering Environmental Settings 289 • Prevention in Relation to Prenatal Period and Infancy 290 • Preventing Specific Disorders 291 • Problems Encountered in Primary Prevention Research 294 28. Alternative/Indigenous Therapies .........................................................................................................................................296 Rakesh K Chadda, Koushik Sinha Deb • Defining Indigenous and Alternative Medicine 296 • Classifying Indigenous and Alternative Therapies 296 • How Many People Actually Seek Alternative Medicine Treatment before Coming to Modern Treatment Centers? 297 • Why do Patients Turn to Indigenous and Alternative Medicine in the Present-Day Context? 298 • A Brief Overview of the Various Types of Alternative Medicine 298 • Efficacy of Alternative Treatment/Indigenous Therapies 304 Section VIII: Models and Strategies for Management 29. Integration of Mental Health Services with General Health Care ....................................................................................311 R Srinivasa Murthy • Historical Aspects 313 • Magnitude of Mental Disorders in Primary Health Care 314 • Integration of Mental Health Care with Primary Health Care 314 • General Practitioners Training 318 • Training Resources for Integration of Mental Health Care 319 • Current Status of Integration of Mental Health With General Health Services 319 • Future Needs 320 30. Public Mental Health Education............................................................................................................................................324 R Srinivasa Murthy • Existing Beliefs and Practices 324 • Mental Health Educational Activities in the Country 326 • Evaluation of the Public Mental Health Education Activities 329 • International Experiences 331 • Guidelines for Preparing Mental Health Education Programs 331 31. Fight Against Stigma...............................................................................................................................................................334 Sudhir Kumar Khandelwal, Raman Deep Pattanayak • Concept and Consequences 334 • Strategies and Interventions to Fight Stigma 334 • Health-Related Stigma: What has Worked Elsewhere? 337 • Action Against Stigma 338 • Global Program Against Stigma: ‘Open the Doors’ 339 • Stigma Reduction: Asian Perspective 339 • Stigma Reduction: Indian Perspective 340 • Addressing the Stigma Associated with Psychiatry 340 • Addressing the Stigma in Media 341 • Need to Address the Stigma in Special Populations 341 • Future Directions 341 32. Social Inclusion and Mental Health: Some Experiences with Intellectual Disability......................................................345 Keerti Menon, Reeta Peshawaria • Initiatives and Their Applicability 345 • Summary and Conclusions 348 33. Role of Self-Help Groups........................................................................................................................................................350 Lok Raj • Definition 350 • Classification 350 • What helps in Self-Help Groups? 351 • How Effective are Self-Help Groups? 352 • Recovery International Experience 353 • Indian Perspective 354 • Challenges and Way Forward 355 34. Voluntary Sector and NGOs.................................................................................................................................................. 357 Priti Arun, Suravi Patra, Nitin Gupta • History and Present Scenario of Ngos in India 357 • Role of Voluntary Sector in Health 358 • Need of Voluntary Sector in Mental Health 358 • Areas addressed by Ngos 358 • Research Evidence 360 • Future Directions 361 35. Role of Psychotherapy and Counseling.................................................................................................................................362 Vijoy K Varma, Nitin Gupta • What is Psychotherapy? 362 • Why Consider Psychotherapy? 362 • Western Model of Psychotherapy 362 • Eastern Traditional Model of Psychotherapy 363 • Types of Psychotherapy 364 • Pragmatics Related to the Process of Psychotherapy 364 • How Psychotherapy Heals? 365 • Adapting Psychotherapy for India 365 • Manpower Constraints 365 • Practical Aspects 366 • Role of Health Professionals in India at the Community Level 366 • Principles and Practice of Psychotherapy at the Community Level 366 • Psychotherapy in Specific Situations 367 36. Psychosocial Rehabilitation in Psychiatry ............................................................................................................................369 Paramleen Kaur, Abhijit Rozatkar • Introducing Disability in Mental Illness 369 • Nosological Status of Disability 369 • Disability, Functioning and Rehabilitation 369 • What is Psychiatric Rehabilitation? 370 • Assessment of Psychiatric Disability and Rehabilitation Needs 370 • Interventions in Rehabilitation 371 • Planning Rehabilitation Needs of Patient 373 • Residential Continuum 374 • Rehabilitation in Mental Retardation 374 • Psychosocial Rehabilitation in Developing World Versus Developed World 375 • Psychosocial Rehabilitation in India 376 Section IX: Administrative, Governance and Research 37. Contributions of Major Professional Bodies ........................................................................................................................383 JK Trivedi, Rahul Saha • Beginning of Ips and Ijp: Aims and Objectives and Postindependence Scenario 384 • Major Contributions and Impact 386 • Other Professional Bodies 387 • How are Professional bodies and Community Psychiatry Interlinked? 389 • Possible Goals for Future 390 38. Community Mental Health Initiatives by the Government: Past, Present and Future ..................................................393 Jagdish Kaur, Suman K Sinha • Burden of Mental Disorders 393 • Role of the Government in Mental Health Care Delivery in India 393 • National Mental Health Programme 394 • Mental Health Act and other Supportive Legislations 395 • National Health Policy Supporting Community Mental Health 396 • District Mental Health Programme 396 • Gaps Identified in Effective Implementation of DMHP during the Ninth Plan Period 396 • Restrategized Nmhp in the Tenth Plan Period 396 • Expansion of District Mental Health Programme 396 • Achievements of Nmhp During the Tenth Plan Period 397 • Revised Strategy of Nmhp in the Eleventh Five Year Plan Period 397 • Revised Implementation Plan for Dmhp 397 • DMHP-Team 397 • Integration of Nmhp with Nrhm 399 • International Cooperation in Community Mental Health 399 39. Community Psychiatry: Cost-Effectiveness and Monitoring .............................................................................................402 Pratap Sharan, A Shyam Sundar • Cost Effectiveness 402 • Who Choice 403 • Monitoring of Community Psychiatric Services 407 40. Models for Research in the Community ...............................................................................................................................413 Ajit Avasthi, Naresh Nebhinani • Research in Community Psychiatry 414 • The Principal Methods used in Community Research 414 • Models of Community Mental Health Care 415 • Indian Research 417 • Ethical Issues in Community Research 417 • Monitoring and Auditing in Community Research 417 • Importance of Community Based Research 418 • Conclusion 418 • Future Directions 418 41. Appropriate Resource Management: Administrative and Political Initiatives ................................................................421 BS Chavan • Availability of Manpower in Mental Health 421 • Human Resources Management 424 • Use of Nonprofessionals for Mental Health Care 426 Contents xxxi xxxii Community Mental Health in India Section X: Community Mental Health: International Perspectives 42. Community Psychiatry in United States of America ........................................................................................................431 Jagannathan Srinivasaraghavan, Sukriti Mittal, Nishant Kumar, Bhagirathy Sahasranaman, Veena Garyali, Swapnil Gupta, Rajeev Panguluri • History of Community Psychiatry 431 • Community Psychiatry in California 434 • Community Psychiatry in Florida 435 • Community Psychiatry in Illinois 437 • Community Psychiatry in New York 438 • Community Psychiatry in Mississippi 439 • Conclusion 440 43. Community Psychiatry in United Kingdom........................................................................................................................442 Niraj Ahuja, Andrew Cole • Historical Aspects and Evolution 443 • Deinstitutionalization, Community Psychiatry and General Hospital Psychiatry 443 •Tiers: Primary, Secondary andTertiaryCare (SteppedCare Model) 445 •Community Mental HealthTeams 445 • National Service Framework for Mental Health 446 • Functional or Specialist Teams 446 • Multidisciplinary Teams: The Evidence 447 • Funding, Tariffs and Payment by Results 447 • New Horizons 447 • Mental Health Act 448 • Relevance and Suggestions towards Adaptation to the Indian Setting 448 44. Community Mental Health Services in Australia and New Zealand................................................................................451 Dinesh K Arya, Brian Kelly • Structure of Services 451 • Community Psychiatry—It is Important to Define its Scope 452 • Community Psychiatry in India, Australia and New Zealand—Similarity in Trends 452 • Growth of Community Psychiatry 456 • Some Myths about Community Psychiatry 457 45. Community Psychiatry in Singapore....................................................................................................................................460 Somnath Sengupta, Leong Jern-Yi, Joseph, Lee Cheng • Factors that Influence the Effectiveness of a Community Mental Health Program 460 • Community Mental Health Program (Cmhp) in Singapore 462 • Summary of Community Psychiatric Services in Singapore 466 • Is Cmhp Singapore Applicable to India? 466 • Community Mental Health Program of Singapore Applied to the Realities of India 468 46. Community Psychiatry in Malaysia ......................................................................................................................................470 Dato’ Suarn Singh, Cheah Yee Chuang • Prevalence of Mental Disorders and an Overview of Mental Health Services 470 • Historical Background 470 • Important Milestones in the Development of Community Psychiatry in Malaysia 471 • Family Support Groups 473 • Strategies to Strengthen and Enhance Community Mental Health Services 474 • Interface between Primary and Secondary Care 475 • Training and Human Resources 475 • In Service Training 475 • Clinical Practice Guidelines 476 • National Mental Health Registry 476 • Clinical Audit Indicators for Quality Management 476 • Future Direction 476 47. Community Psychiatry in Sri Lanka ...................................................................................................................................478 Jayan Mendis • History of Community Psychiatry in Sri Lanka 478 • The Present State of Community Psychiatry in Sri Lanka 479 • The Community Health Care Program of Sri Lanka 479 • Non-Governmental Organizations in the Provision of Community Psychiatry 482 • Community Mental Health Care in the Gampaha District 482 • Strengths of the Existing Community Mental Health Services 483 • Weaknesses of the Existing Community Mental Health Services 483 • The Future of Community Psychiatry in Sri Lanka 483 48. Community Psychiatry in Pakistan......................................................................................................................................485 Late Haroon Rashid Chaudhry, Raumish Masud Khan, Ammara Shabbir • Historical Perspective of Community Psychiatry in Pakistan 485 • Current Mental Health Scenario 485 • Existing Manpower Resources and Infrastructure 486 • Existing Training and Research Facilities and Initiatives 487 • Existing Models of Delivery of Care 488 • Role of Ngos 489 • Mental Health Legislation 489 • Mental Health Policy 489 • Current Scenario 489 • Suggestions and Future Directions 490 Section XI: Community Psychiatry and Clinically Applied Anthropology 49. What is Cultural Validity and why is it Ignored? The Case of Expressed Emotions Research in South Asia.................................................................................................................................................................................493 Sushrut Jadhav • What Is Cultural Validity? 493 • Validity of Expressed Emotions Research in South Asia 493 • Why Is Cultural Validity Ignored? 494 50. A Cultural Critique of Community Psychiatry in India.....................................................................................................496 Sumeet Jain, Sushrut Jadhav • What Ails Community Psychiatry in India? Three Vignettes 496 • Brief Cultural History of Community Psychiatry in India 498 • Critical Issues and Future Directions 504 51. Pills that Swallow Policy: Clinical Ethnography of a Community Mental Health Programme in Northern India .........................................................................................................................................................................509 Sumeet Jain, Sushrut Jadhav • the ‘Policy’ Pill 510 • Compliance With Medication: The Pill As A Boundary Marker 511 • ‘Sarkari Davai’(Government Medicine): Community Reactions To Government Services 515 • Discussion 515 52. Eco-psychiatry: Culture, Mental Health and Ecology with Special Reference to India.................................................522 Arabinda N Chowdhury, Sushrut Jadhav • Concepts Relevant To Ecopsychiatry 522 • Development of the Concept of Ecopsychiatry 523 • Ecopsychiatric Issues—Ecology and Mental Health 523 • Ecosystem Services and Human Health 524 • Social Change and Ecology 524 • Disasters 525 • Urbanization, City Ecology and Mental Health 525 • High-Rise and Metro-Rail 526 • Deforestation 527 • Development-Induced Population Displacement 529 • Climate Change 530 • Environmental Degradation 532 • Eco-Specificity and Mental Health: A Case Study From Sundarban, West Bengal, india 533 • Some Practical Steps in Clinical Community Psychiatry 533 53. Stigmatization of Severe Mental Illness in India: Against the Simple Industrialization Hypothesis............................543 Sushrut Jadhav, Roland Littlewood, Andrew G Ryder, Ajita Chakraborty, Sumeet Jain, Maan Barua • Materials and Methods 543 • Results 544 • Discussion 545 • Appendix: Stigmatization Questionnaire 548 54. Psychiatric Stigma Across Cultures: Local Validation in Bangalore and London ..........................................................550 Mitchell G Weiss, Sushrut Jadhav, R Raguram, Penelope Vounatsou, Roland Littlewood • Methods 551 • Results 552 • Discussion 557 55. Clinical Appeal of Cultural Formulations in Rural Mental Health: A Manual...............................................................560 Sushrut Jadhav, Sumeet Jain • What is Culture? 560 • Discussion 563 • Summary 565 56. Cultural Dimensions of Health-Seeking Behaviour for Psychiatric Disorders in North India: An Exploration of Medical Pluralism ...................................................................................................................................566 Antti Pakaslahti • Orientation to the Temples and the Healing Tradition 567 • The Network of Healers in Balaji 568 • Background and Help-Seeking Pathways of Patients 569 • on Symptoms and Diagnoses of Patients From Two Perspectives 571 • Three Accounts of Help-Seeking 572 • Summing Up For Future Research 574 Section XII: Personal and Popular Narratives of Suffering 57. Experiences and Reflections from the Parent of a Schizophrenic Daughter ...................................................................581 Dr Sood • Onset of the Problem 581 • Handling of A Schizophrenic At Home 582 • Society and Stigma 582 • Great Relief to the Patient and the Parents 583 58. Gopalan ....................................................................................................................................................................................584 Sneha Rajaram 59. Mind Snare...............................................................................................................................................................................591 Divya Gupta 591 • Millions of Families are Struggling with Psychiatric Illnesses with Almost No Support: Divya Gupta Surveys A Landscape of Intense Despair—and Hope 591 Section XIII: Appendix (Reprints of Historical Papers) 60. A Model for Rural Psychiatric Services—Raipur Rani Experience..................................................................................605 NN Wig, R Srinivasa Murthy, TW Harding • Mental Illness At the Village Level 605 • Issues 606 • the Study Area 606 • Progress and Observation 607 • Health Staff Interview 607 • Screening of the General Health Clinic Population (Adults) 608 • Screening of the General Health Clinic Population (Children) 608 • Community Attitude to Mental Disorders 609 • Priority Selection 609 • Rural Psychiatric Contents xxxiii xxxiv Community Mental Health in India Clinics 609 • Training of the Health Personnel 610 • Training Manual 611 • Training Programs 611 • Supervision and Support of the Health Personnel 611 • Decentralization of Services 611 • Observation During Supervision of Health Personnel 613 • Administrative 613 • Community Involvement and Health Education Activity 615 • Implications 616 61. Mental Health Delivery Through Rural Primary Care—Development and Evaluation of a Training Programme ...............................................................................................................................................................617 Mohan K Isaac, RL Kapur, CR Chandrashekar, Malavika Kapur, R Pathasarathy • Context 618 • Objectives 618 • Trainee Characteristics 618 • Resources 619 • Process 619 • Effects 619 • Discussion 619 • Appendix 621 62. ICMR-DST: Collaborative Study on Severe Mental Morbidity ........................................................................................623 Indian Council of Medical Research and Department of Science and Technology • Introduction 623 • Review of Literature 623 • The Present Study 628 • Phase I: Development, Modification and Translation of Research Instruments 635 • Phase II: Training of Centre Personnel and Intervention by Trained Personnel 637 • Phase Ii: Field Survey 645 • Discussion 646 • Issues Emerging Out of the Study 649 • Epilogue 651 Index....................................................................................................................................................................................................655 Introduction Mohan Isaac Wow! A book on Community Mental Health in India! That too authored and edited by mostly Indian mental health professionals based on their experiences in attempting to provide meaningful mental health services to over a billion populations. When the editors invited me to contribute an introduction to this book, I was indeed delighted. I was naturally reminded of my own entry to the field of community mental health in India almost 35 years ago, during the second half of 1976. The first and only specially designated community mental health unit in the country was set up at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru and the late Professor Ravi Kapur was appointed to the first Chair of Community Psychiatry in India at NIMHANS. The main goal of this unit was to develop methods of taking mental health care out of the psychiatric institutions to the large sections of unserved and underserved populations, particularly in the rural areas. Those were the days when Milton Greenblat had famously termed ‘psychiatry’ the ‘cinderella of medicine’ in the New England Journal of Medicine and Fuller Torrey had predicted the “death of psychiatry”. Specialization in psychiatry by young medical graduates was not considered very commendable. After my initial years of postgraduate training in psychiatry, my decision to join the newly formed community mental health unit at NIMHANS as one of its few earliest staff members (against the possibility of working as a junior consultant in the hospital setting) and carry out my doctoral thesis related work in the villages around the Sakalawara Rural Community Mental Health Center was frowned upon by many around me. However, the quick acceptance with minimal changes and publication of my thesis related work on detection of psychosis and epilepsy in the community by multipurpose health workers of rural primary health centers in journals such as The Lancet and the British Journal of Psychiatry convinced me that we were in the right direction. I was also convinced that the only way mental health care could be delivered to the unreached populations in the country was by big development of community mental health. I continued to be attached to the community mental health unit at NIMHANS for nearly the next 30 years. During this period, I also had the privilege of personally knowing the work in the field of community mental health of most of the authors of this textbook. Subsequently, after I moved to the University of Western Australia where I continue to be attached to a community, culture and mental health unit, I learned on the first hand basis how very different is the delivery of community based mental health services in a resource rich developed setting and a developing country. What follows in this introduction is my personal perception of issues in community mental health in western and nonwestern settings such as India. Community mental health Community mental health, in very broad and simple terms, refers to care of and services provided to persons with mental health problems and their families in community settings. In developing countries such as India, community settings would include a person’s home, large joint family setting, a general practitioner’s clinic, a government run primary health center (PHC), community health centre (CHC) or a district hospital, a non-hospital residential facility such as a half-way home or hostel run by non-governmental organizations, a private psychiatrist’s office/clinic, a counseling center or a rehabilitation center in a community location running day programs and providing a range of other community based services. Such care or services may be provided by; besides trained mental health professionals (psychiatrists, clinical psychologists, psychiatric social workers, and psychiatric nurses), trained general practitioners, primary health center doctors and multipurpose health workers, counselors, rehabilitation workers and family members and other carers under the overall supervision of mental health professionals. The broad range of services can include early identification xxxvi Community Mental Health in India and prompt treatment of both common and severe mental disorders, management of persons with chronic mental disorders in the community, referral to secondary and tertiary mental health services as well as other social welfare services, attention to the mental health needs of persons with various physical health problems, and interventions aimed at mental health promotion and mental health prevention in community organizations such as schools, anganwadis (pre-school institution), industries and in the larger community itself. The goals and principles of community mental health ideally are decentralization, comprehensiveness of care, accessibility of appropriate, affordable and equitable basic mental health care to all, multidisciplinary and multisector (including private sector) involvement, community participation and inter-sectoral collaboration. Community mental health in the West In the rich and developed countries of Western Europe, Scandinavia, and North America and in Australia and New Zealand, community mental health care really began only during the second half of the twentieth century. Up until the 1950s, care for persons with severe mental disorders in these countries was provided only in large stand-alone institutions called asylums (mental hospitals). Such institutions steadily grew in number, size and occupancy in most of these countries during the previous two centuries. However, beginning in the early part of twentieth century, due to a variety of factors such as overcrowding, poor living conditions, declining financial resources, unmotivated staff, growing public and professional discontent, etc. The mental hospitals progressively started declining in their therapeutic role and functions. The serendipitous discovery of the first effective antipsychotic medication, chlorpromazine in 1952 and its subsequent widespread use triggered a process which was later referred to as deinstitutionalization. Deinstitutionalization was not preconceived and has been variously defined. Mental health historians are divided about whether to call it a ‘policy’, ‘concept’, ‘movement’, ‘protest movement’ or just an ‘era’. Some critics of deinstitutionalization have referred to the phenomenon as a ‘factoid’. Deinstitutionalization essentially meant moving severely mentally ill people out of large institutions—mental hospitals and shifting their care and support to community based settings and later closing part or all of the institution. For example, the total number of severely mentally ill inpatients in all mental hospitals in the United Sates of America which was 558,329 in 1955 came down to 71, 619 in 1994 (US population in 1955 was 164 million and in 1994, 260 million). In USA, the growth of community mental health was accelerated by numerous factors including the final report of the Joint Commission on Mental Illness and Health (appointed by President Eisenhower in 1955) titled “Action for Mental Health” submitted in 1961. President John Kennedy called for the closure of large stand alone psychiatric institutions and their replacement by home and community care services. The enactment of the Community Mental Health Centres Act (signed by President Kennedy in 1963, three weeks prior to his assassination) paved the way for the creation of community mental health centers in USA. During the succeeding years, similar events occurred in most rich and developed countries. Care of persons with severe mental disorders moved out of the mental hospitals and into the community. The process of deinstitutionalization and the creation of various alternatives to mental hospitals occurred at varying pace in different countries. Factors which determined the pace of reforms included changes to mental health legislation, financial resources and funding arrangements, availability of trained human resources, social acceptance, political will and administrative commitment. For example, in Italy a new mental health law, called the “Law 180” was enacted in 1978. The law aimed to change mental health services radically. It had four main components namely: (1) Phase out mental hospitals and cease all new admissions, (2) Establish general hospital psychiatry wards (maximum 15 beds), (3) Restrict compulsory admissions and (4) Set up community mental health centers. The mental health care scenario changed dramatically following the enactment of the legislation. The development of the type of community based services varied internationally. Non-hospital residential facilities such as half way houses and hostels and different forms of supported accommodation in the community were established. Catchment area teams and multidisciplinary community mental health teams were created to deliver different types of services for the persons discharged from mental hospitals. A form of intervention consisting of initial engagement with patients, assessment of their needs, individualized care planning, environmental interventions, regular monitoring and review and patient advocacy referred to as ‘case management’ was developed. Different forms of case management including a particular form of intensive care called ‘assertive community treatment’ (ACT) became the predominant mode of community based care in all resource rich settings. The current form of mental health services in the West is a pragmatic balance of community and hospital based care, referred to as “balanced care” wherein treatment and a variety of community based services are provided either at home or close to home, coordinated by mental health professionals and agencies. Such care also includes short-term hospitalization when needed, invariably in a general hospital based psychiatry unit. In many western countries, mental health reform is still an ongoing process (Burns, 2007; Fagin, 1985; Fakhoury and Priebe, 2002; Isaac, 2007; Thornicroft and Tansella, 2004). Community mental health in developing countries such as India In most Asian and Latin American countries with very modest financial and trained human resources mental health services continue to be provided largely through mental hospitals or stand alone psychiatric institution. The mental health reform process has barely begun only during the past decade in most countries. In Japan, the number of institutionalized mentally ill increased over the years. In many countries of Africa, formal mental health services are rudimentary. The story of community mental health in India is very different from the West. Persons with mental disorders traditionally have always been treated within the community. Such persons were generally taken care of by the family, the larger community and traditional healers. Asylums which later became mental hospitals were opened in India, initially by the British East India Company and later by the country’s colonial rulers, primarily for British soldiers and British nationals who suffered from mental disorders. For a large country with a huge and growing population, the total number of mental hospital beds available was always very small. At the time of India’s independence in 1947, the country had just 17 psychiatric institutions and about ten thousand mental hospital beds. Since the mental health care facilities were so inadequate, some more mental hospitals were built in the country during the first two decades after independence. However, more than fifty years later, when the country’s National Human Rights Commission (NHRC) surveyed all the then existing mental hospitals (total of 37, most of them funded by various state governments), and other mental health care institutions in the country, the total number of hospital/institutional beds for persons with mental disorders was still less than twenty thousand. Bold reforms involving the family members of those admitted to the hospital were initiated as early as the mid 1950s and 60s in the mental hospitals at Amritsar and Agra and certain centers such as Vellore. Strength of institutions such as the joint family, marriage, the close knit community, greater tolerance of deviant behaviour not only within families but also in the larger community, lower expectations from persons with mental disorders, religion and faith based coping as well as healing strategies, all contributed to large numbers of persons with various mental disorders being taken care of in the community. Many years later, the 2 years, 5 years and 25 years follow-up of persons with schizophrenia studied on a long-term basis by the World Health Organization’s Division of Mental Health at Agra, Chandigarh and Chennai centers showed that such patients, in general had relatively a much better outcome in India than in many other developed countries in the world. Around this time, a steadily increasing number of mental health units in the general hospital and medical college based teaching hospital settings were set up in the bigger cities in the country. General hospital psychiatric care meant shorter periods of hospitalization and greater involvement of family members in the care of person with mental disorder. More and more persons with various less severe forms of mental disorders too sought help in general hospital psychiatry units. All over the country, almost every person with any mental disorder was initially treated/managed primarily by traditional healers of various types including healers and priests who worked from within religious institutions such as temples. One of the consequences of the grossly limited modern facilities for care of mental disorders was that many mentally ill persons became “wandering and homeless mentally ill” across the country. Widespread misconceptions about causation of mental disorders, all pervasive stigma, and lack of community demand for modern mental health care services, grossly inadequate budgetary inputs for mental health in the midst of competing needs for infectious and communicable disorders and nutritional disorders, severe shortage of trained mental health professionals, all contributed to neglect of mental health care. Health planners, administrators and even other medical specialists and general practitioners were unaware of the wide prevalence and suffering caused by mental disorders. Unlike most other newly independent developing countries of Asia, Africa and Latin America and despite the above mentioned problems, psychiatry grew in India slowly and steadily, but definitely. Amongst several developments which took place in the country during the initial post-independence decades which contributed to not only the growth of psychiatry but also the starting of pilot community mental health projects, three are worth mentioning. These three important developments were: (i) Starting of the Indian Psychiatric Society (IPS) – the professional body of psychiatrists in India, with a membership of 42 in 1947. First annual conference of the Indian Psychiatric Society was held in Patna in January 1948. Not many years later, in 1958, the IPS began publishing its academic journal – Indian Journal of Psychiatry (or the IJP, as it is popularly referred to in India), currently in its 53rd Volume. (ii) Conduct of some very good epidemiological surveys of mental disorders in the community during the late fifties and early sixties, in places such as Bengaluru and Agra. Introduction xxxvii xxxviii Community Mental Health in India Agra later was chosen as one of the nine centers in the World Health Organization International Pilot Study of Schizophrenia (IPSS) – one of the only two centers in the developing world, the other was Ibadan, Nigeria. (iii) Perhaps the most important development was the starting of an institution for training and research in the field of mental health – the All India Institute of Mental Health (AIIMH) in Bengaluru in 1954. It is interesting to note that such an institute for training mental health professionals (psychiatrists, clinical psychologists, psychiatric nurses and psychiatric social workers) was opened even before the starting of other major training and research institutions in the overall field of medicine such as the All India Institute of Medical Sciences (AIIMS) in New Delhi and the Post Graduate Institute of Medical Education and research (PGIMER) in Chandigarh. It is also interesting that the All India Institute of Mental Health in Bengaluru had full fledged departments of Neurology, Neurosurgery and allied basic sciences departments such as Neurophysiology, Neuropathology and Biophysics right from its early days – the realization of the close links between mental health and neurosciences, “brain and mind”, the concept of clinical neurosciences in action, well ahead of such developments taking place much later in developed countries of the West. To convey the true nature of the institution more appropriately, AIIMH became the National Institute of Mental Health and Neurosciences (NIMHANS) in 1974, now arguably one of the most productive and prestigious research and training institutions in the fields of mental health and neurosciences in the whole of the developing world. Realizing the need to develop and evaluate meaningful and feasible alternate approaches/strategies to mental health care delivery in the country, NIMHANS created a Chair of Community Psychiatry and started a specially designated Community Psychiatry unit in 1975, much before positions and units for developing community psychiatry became fashionable elsewhere in the world. During the late 1970s and 80s, the Community Mental Health unit at NIMHANS developed an approach and a strategy for integrating basic mental health care with the existing general health care services in India. This approach involved decentralized training in basic mental health care for primary health center doctors and multipurpose health workers, making essential psychotropic medications easily available at all peripheral primary health care institutions and providing continued on-the-job training, support and supervision for the trained primary health center staff to carry out simple mental health care services under the overall supervision of a mental health professional at the district head quarters level. This approach was initially tried in various primary health centers (PHCs) in Karnataka State which those days covered a population of hundred thousand. Later, it was expanded to a whole district (i.e. all the peripheral health care institution in a district), in Bellary district of Karnataka State. The overall strategy which evolved after 5 years of trial in Bellary came to be known as the “Bellary model” of District Mental Health Programme (DMHP) and was adopted by the Ministry of Health and Family Welfare, Government of India for staggered country wide implementation as a fully centrally (federally) funded programme (Isaac, 2011; Srinivasa Murthy, 2011). It is interesting to note that nearly three decades later, an international consortium of 422 researchers, advocates and clinicians working in more than 60 countries have identified “integration of screening and core packages of services into routine primary health care”, “reducing the cost and improving the supply of effective medications”, “providing effective and affordable community based care and rehabilitation” and “strengthening the mental health training of all health care personnel” as some of the top “grand challenges in global mental health” (Collins et al., 2011). In 1982, India was one of the first countries in the developing world to formulate a National Mental Health Programme (NMHP). But budgetary allocation for the implementation of the NMHP was made only since 1996- 97, during the ninth (1997-02), tenth (2002-07) and the eleventh (2007-12) Five Year Plans by the Government of India. Recently, several authors have critically looked at the successes and failures in the implementation of the NMHP and its main component namely the District Mental Health Programme (DMHP) and have offered numerous corrective suggestions (Goel, 2011; Isaac, 2011; Jacob, 2011; Patel, 2011; Srinivasa Murthy, 2011). Most experts believe that the DMHP has failed to “integrate mental health care delivery into primary care” due to a wide variety of administrative, managerial and technical reasons. However, experts observe “… the programme has ensured wider availability of essential psychotropic medication…” (Jacob, 2010), the DMHP is “essentially a psychiatrist led out-patient clinic in district hospitals” (Patel, 2011) and “major gains have been made…. The NMHP is now accepted as a relative low-cost, high-yield public health intervention which is doable, as shown in states such as Kerala and Gujarat” (Goel, 2011). The country can soon expect a “radical revision and re-haul of the dysfunctional NMHP” and a “re-written” DMHP for the 12th Five year plan (2012-2017) in independent India’s first mental health policy as in early 2011 the Ministry of Health and Family Welfare, Government of India constituted a Mental health policy group comprising diverse stakeholders (Patel, 2011). The country is also on the threshold of seeing a new National Mental Health Care Plan with specific reference to the NMHP and DMHP, with specific strategies and activities to implement the priority areas of action identified in the National Mental Health Care Policy and an estimate of financial resources required to implement the Plan by April 2012, according to the ‘Terms of Reference’ of the Policy Group (GOI-MOHFW, 2011). A Book of Community Mental Health for Non-Western Settings This multiauthored book of Community Mental Health largely follows a ‘mental health systems’ approach to deal with various topics. The term mental health system includes (i) mental health policies, plans, programmes (ii) legislations and regulations governing mental health service organization and practice (iii) organization of service programes for detection and treatment of mental disorders including reliable supply of psychotropic medicines and rehabilitation services (iv) programmes that are devoted to mental health promotion (v) social arrangements that promote social participation including work and income support for persons with mental illness and (vi) the political, socio cultural and economic environment in which all the above occurs, besides other topics (Minas and Cohen, 2007). The book begins with an introductory chapter on the needs, relevance, growth and current status of community mental health in India (Section I). The historical evolution of mental hospitals as an institution in India, growth of general hospital psychiatry units and the genesis of the national mental health programme and its flagship programme, the district mental health programme are described in Section II. Integrating mental health into primary care in developing countries is different from such integration in developed countries because the primary care network itself is very differently organized due to a variety of factors such as limited trained personnel and poor financial resources. Chapter 29 describes the challenges in the integration of mental health into general health services. Innovative approaches such as mental health camps and extension clinics in smaller towns and big villages have been developed to reach the vast unreached populations in rural areas. Various such models of community mental health care are described in Chapters 25 and 26. It is well known that almost all people who need mental health care in developing countries often seek such care and help from traditional and indigenous healers. Chapter 28 reviews the role and significance of alternative therapies in mental health care. When support for research is limited, the area which is often forgotten is community mental health. There is a need to build research capacity in community mental health in developing countries. Models of research in community mental health are explained in Chapter 40. There are comprehensive chapters on community based services for special populations such as the elderly, children and adolescents, children with learning disabilities and those suffering from substance use related problems (Section V). Issues of specific relevance to developing countries such as India including steadily increasing suicides in the country and farmer’s suicides (Chapters 21 and 22), continuing difficulties related to stigma (Chapters 8, 31, 53 and 54), homelessness of the mentally ill with special problems relevant to developing country settings (Chapter 10), mental health aspects of manmade and natural disasters which are endemic in India (Chapter 24), and the role of gender in community mental health (Chapter 11) are included. Contributions to the development of community mental health by professional organizations such as the Indian Psychiatric Society are reviewed in Chapter 37.The section on legislation (Section IV) also includes a chapter on the Narcotics and Psychotropic Substances Act of India. The authors who are predominantly Indian and who come from multiple backgrounds – well known academicians, researchers and teachers, clinicians from the governmental as well as private sectors, health administrators from the government in charge of mental health program, practitioners and activists from the non-governmental sector, care providers and a media person who writes about mental health issues in the popular print media (Chapter 59) – add to the richness and variety of the contents and coverage in this text book. The continuing role of the federal government in supporting community mental health is discussed in Chapter 38 by senior officers who were in charge of the mental health program at the time when the chapter was commissioned (and subsequently submitted for the book). The role of non-governmental sector in various mental health programs is being increasingly recognized in India. There are a growing number of such organizations carrying out different types of community based activities all over the country. The relevance of the voluntary non-governmental sector is well described in Chapters 12 and 34. Carer and consumer participation in mental health programs have only begun in a small way in India. Carer and consumer advocacy organizations are very few unlike western settings. Chapters 57 and 58 provide caregiver perspectives from the caregivers as well as the professionals points of view. A fairly large section on community mental health in some South and East Asian countries such as Sri Lanka, Pakistan, Malaysia and Singapore and developed countries such as the USA, UK, Australia and New Zealand (Section X) will give the reader an opportunity to compare and contrast issues across the world. The fact that the authors Introduction xxxix xl Community Mental Health in India of chapters about community mental health in developed countries have had training and first hand experience of situation in non-western settings adds value to their chapters. The community mental health professionals’ understanding of the relevance of clinically applied anthropology in their work is very limited. An entire section (Section XI) is devoted to cultural critique of community mental health in India and related issues including what cultural validity is and why it is often ignored. Editors have chosen to include few papers not very easily accessible such as the ICMR-DST Collaborative Study on Severe Mental Morbidity and some of the initial papers describing work done in Raipur Rani near Chandigarh and Sakalawara near Bangalore which describe the early phase of developments in community mental health in India as appendices (Section XIII). Most psychiatry postgraduate training centers in India do not provide any organized and structured training or exposure to community mental health related topics. This book can immensely contribute to filling up the lacunae in community mental health training of not only psychiatrists but other mental health professionals as well. Although, the issues are largely based on the authors work and expertise in India, the book will be valuable to any mental health professional working in non-western settings. Published literature in peer reviewed journals on issues related to community mental health in developing countries including India is very limited. The authors have reviewed the grey literature consisting of various documents, papers in non peer-reviewed and non-academic publications and the lay print media. There are numerous contradictions and puzzles yet to be clarified and answered as far as mental disorders in developing countries such as India are concerned. One such puzzle is raised by Sartorius (2011), an internationally recognized leader in mental health, a distinguished past President of the World Psychiatric association and for over 25 years the Head of the World Health Organization’s mental health division and under whom I had the privilege to work for a number of years. He has visited all the mental hospitals and a variety of other institutions in India. He raises a question “simple to ask” but “without a satisfactory answer”. “How was it possible that India had in all approximately 20,000 beds in mental hospitals and psychiatry departments in general hospitals when by conservative estimates in India there were at least 10 million seriously mentally ill people who need in-patient care for at least 2 weeks a year?” He goes on to observe that “Some patients were probably living as vagrants or beggars and others were undoubtedly in prisons. Still, with all these calculations – and taking into account that the incidence of severe mental illness such as schizophrenia in India did not differ from that in other countries and that there must have been more people with various forms of brain damage due, for example to poor perinatal care, infectious diseases and malnutrition in childhood than in Europe – it was not clear what was happening with the millions of people who were acutely ill and who needed help and more millions whom mental illness left impaired and unable to look after themselves”. “The extended family system might explain part of the puzzle – but not all of it: in surveys families did not have as many mentally ill people in their midst as could be expected if most of the mentally ill were cared for in this way”. The various chapters in this book on Community Mental Health describing largely the current situation in India may provide at least part of the answer to this puzzle. Conclusion During the past 35 years, after the starting of the community mental health unit at NIMHANS, many things have changed in the field of mental health care all over the world. Significant developments have occurred in community based mental health care in India too, most of which are well described in this book. However, as a series of comprehensive and authoritative reviews of the situation of mental health in low and middle income countries, including India published recently in journals such as The Lancet have shown, the treatment gap in mental health continues to be quite wide and much needs to be done to fill this gap. It is interesting to note that the broad principles of community mental health in developing countries have changed very little over the years as indicated by the recent mental health gap action programme of the World Health Organization (mhGAP) and similar programmes elsewhere (Jacob, 2011) and some of the top “grand challenges in global mental health” (Collins et al., 2011) as identified by more than 400 experts in the field of mental health from all over the world. Meaningful partnerships and collaboration between diverse stakeholders are urgently required for progress in community mental health in India. True innovation and leadership are needed, more than ever before. Bibliography 1. Burns T. Community Mental Health Teams. Psychiatry 2007;6:325- 328. 2. Collins PY, Patel V, Joestl SS. Grand challenges in global mental health. Nature 2011;475:27-30. 3. Fagin L. Deinstitutionalisation in the USA. Psychiatric Bulletin 1985;9:112-114. 4. Fakhoury W, Priebe S. The process of deinstitutionalisation: an international overview. Current Opinion in Psychiatry 2002;15:187-192. 5. Goel DS. Why mental health services in low and middle income countries are under-resourced, under-performing: An Indian perspective. The National Medical Journal of India 2011;24:94-97. 6. Government of India Ministry of Health and Family Welfare (GOI-MOHFW). Constitution of a policy Group to frame a Mental Health policy for India, No. V.15016/49/2009-PH-I dated 15th April 2011. 7. Isaac M. Provision for the long term discharged patient. Psychiatry 2007;6:317-320. 8. Isaac M. The National Mental Health programme: Time for reappraisal. in Themes and Issues in Contemporary Indian Psychiatry. Edited by Kulhara P et al. New Delhi, Indian Psychiatric Society, 2011. 9. Jacob KS. Repackaging mental health programmes. The Hindu, 2010, Opinion, 4th November 2010. 10. Jacob KS. Repackaging mental health programmes in low and middle income countries, Indian Journal of Psychiatry 2011;53:195- 198. 11. Minas H, Cohen A. Why focus on mental health systems? International Journal of Mental Health Systems 2007;1:1-4. 12. Patel V. The great push for mental health: why it matters for India. Indian Journal of Medical Research 2011;134:407-409. 13. Sartorius N. Notes of a traveller. Acta Psychiatrica Scandinavica 2011;123:239-246. 14. Srinivasa Murthy R. Mental health initiatives in India (1947 – 2010) The National Medical Journal of India 2011;24:26-35. 15. Thornicroft G, Tansella M. Components of a modern mental health service: a pragmatic balance of community and hospital care: Overview of systematic evidence. British Journal of Psychiatry 2004;185:289-290

Place Hold on Community Mental Health in India

Copeland and Afshari's principles and practice of cornea Vol.01

By Copeland, Robert A, Ed.; Afshari, Natalie A, Ed.. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi 2013 , Section 1: Basic Science 1. Basic Structure and Function of the Human Cornea and Adnexal Structures 3 Sina John Sabet, Chrysavgi Adamopoulou Gross Anatomy of the Cornea 3 Epithelium 4 The Tear Film 6 Bowman’s Membrane 7 Stroma 7 Descemet’s Membrane 8 Endothelium 8 Limbus 9 Sclera 10 Conjunctiva 10 Eyelids 12 2. Corneal Embryology 16 Hon-Vu Q Duong Histology 16 Embryology 18 3. The Human Cornea: Basic Structure and Function 26 Hon-Vu Q Duong Corneal Epithelium 26 Bowman’s Membrane 30 Corneal Stroma 31 Descemet’s Membrane 33 Corneal Pharmacology 40 Volume 1 xxvi Copeland and Afshari's Principles and Practice of Cornea 4. Basic Immunology 43 Behrad Y Milani, Mercede Majdi, Majid A Moarefi, Ali R Djalilian Overview of Immune Response 43 Cellular Components of the Immune Response 43 Soluble Mediators/Receptors of Inflammation 46 Cell-Mediated Immune Response 48 Humoral Immune Response 50 Hypersensitivity Reactions 51 The Ocular Immune Response 52 Immunology of Corneal Graft Rejection 54 5. Morphology and Pathologic Response of Corneal and Conjunctival Disease 59 Emily Baum, Andrew Doan Epithelium 59 Stroma and Keratocytes 61 Endothelium 64 Corneal Limbus 65 Stem Cell Deficiency 65 Conjunctiva 66 6. Corneal Angiogenesis 70 Felix Bock, Claus Cursiefen Angiogenic Privilege of the Cornea 70 Endogenous Inhibitors of Angiogenesis in the Cornea and Aqueous Humor 71 Angiogenesis and Lymphangiogenesis in the Cornea 73 Clinical Consequences of Loss of Corneal Angiogenic Privilege 75 Exogenous Inhibitors of Angiogenesis 76 7. Limbal Stem Cells of the Corneal Epithelium 80 Harminder Singh Dua, Ammar Miri, Dalia Galal Said Stem Cells 80 Limbal Epithelial Stem Cells 81 Section 2: Examination and Evaluation Techniques 8. The Fine Art of Slit-Lamp Biomicroscopy with Applications to Anterior Segment Photography 89 Alan N Carlson Historical Background 89 Elements that Contribute to a Successful Examination 90 Optical Considerations 90 Contents xxvi9. Corneal Pachymetry 98 Matthew V Brumm, Shahzad I Mian Applications 99 Demographics 100 Diagnostic Methods 100 10. Corneal Keratometry 112 Takeshi Ide, Kazuo Tsubota History of Keratometry 112 Eye Optical System 112 Keratometry 113 Keratometric Refractive Index 113 Assumptions and Limitations 114 11. Corneal Topography: Topography Overview 116 Ryan S Vida, Ming Wang PART 1 Topography Overview 116 PART 2 Topography Images for Review and Clinical Applications 121 12. Corneal Imaging 134 Peter Kim, Sonia N Yeung, Charles J Pavlin, David S Rootman Anterior Segment Optical Coherence Tomography 134 Ultrasound Biomicroscopy 137 13. Confocal Microscopy 143 William D Mathers, Michael Page History 143 Principles of Confocal Microscopy 143 Confocal Microscopy Systems in Clinical Use 144 Confocal Microscopy Through Focusing 145 Clinical Applications 145 Research Applications 149 Limitations 150 14. Specular Microscopy 153 Gawain Dyer, George OD Rosenwasser Optical Principles of Specular Microscopy 153 Improvements in Instrumentation and Methods 154 Practical Use of Specular Microscopy 156 Clinical Findings of Specular Microscopy 161 xviii Copeland and Afshari's Principles and Practice of Cornea 15. Corneal Biomechanics 171 David A Taylor, Natalie A Afshari, Robert A Copeland Jr A Brief Physics Overview 171 Operation of the Ocular Response Analyzer 172 Section 3: Epidemiology of Cornea and External Diseases 16. Epidemiology of the Major Cornea and External Diseases 183 Donald Tiang-Hwee Tan, Wei-Boon Khor Epidemiology of Blinding Cornea and External Diseases in the Developing World 183 Trachoma 184 Onchocerciasis 184 Childhood Blindness 185 Ocular Trauma and Corneal Ulceration 186 Epidemiology of Blinding Cornea and External Diseases in the Developed World 188 Part 2: Clinical Topics Section 4: Infectious Diseases 17. Corneal Microbiology 195 Onsiri Thanathanee, Terrence P O’Brien Reaction of the Cornea to Infectious Process 195 Associated Factors 196 Laboratory Diagnosis 197 Bacteriology 202 Virology 206 Mycology 208 Parasitology 209 18. Ophthalmia Neonatorum 214 Janine Smith-Marshall Differential Diagnosis of Ophthalmia Neonatorum 214 Diagnostic Techniques 216 Prophylaxis and Prevention 217 Contents xxix 19. Bacterial Conjunctivitis 219 Brad H Feldman Epidemiology 219 Host Defenses 220 Acute Conjunctivitis 220 Hyperacute Conjunctivitis 224 Chronic Conjunctivitis 225 20. Bacterial Keratitis 229 Francis Mah Clinical Features 230 Diagnostic Techniques 231 Treatment 232 21. Ocular Antibiotics 238 Yannis M Paulus,Christopher N Ta Brief History of Antibiotics 238 Indications for Ocular Antibiotics 240 Classes of Ocular Antibiotics 243 Antibiotic Resistance 246 Antibacterial Concepts 247 22. Viral Conjunctivitis 251 Stephanie Jones Marioneaux Adenoviruses 252 Epstein Barr Virus 259 Cytomegalovirus 259 Poxviridae 259 Molluscum Contagiosum 260 Rna Viruses 260 23. Viral Keratitis 265 Bilal Faiz Khan Viral Keratitis 265 Herpes Virus 265 Congenital and Neonatal Ocular Herpes Simplex 266 Primary Ocular Herpes Simplex Infections 266 Recurrent Ocular Herpes Infection 269 Blepharoconjunctivitis 269 Episcleritis and Scleritis 269 xxx Copeland and Afshari's Principles and Practice of Cornea Epithelial Keratitis: Dendritic and Geographical 270 Epithelial Trophic (Metaherpetic) Ulceration 271 Stromal Keratitis 272 Herpes Simplex Virus Iridocyclitis 274 Varicella-Zoster Virus 275 Iridocyclitis 277 Postherpetic Neuralgia (Phn) 277 Adenoviral Keratoconjunctivitis 278 Molluscum Contagiosum 279 Enterovirus and Coxsackievirus Conjunctivitis 280 Paramyxovirus 280 Togavirus 280 24. Antiviral Medications in the Treatment of Corneal Disease 284 Lisa M Nijm Viral Replication 284 Antiviral Medications in the Treatment of Corneal Disease 286 Other Antiviral Medications 292 25. Fungal Keratitis 295 Bozorgmehr Pouyeh, Anat Galor, Darlene Miller, Eduardo C Alfonso Classification 295 Pathogenesis 295 Epidemiology 297 Clinical Features and Diagnosis 297 Medical Treatment 301 26. Parasitic Keratitis and Conjunctivitis 309 Fahd Anzaar, Joseph Tauber Infections Caused by Protozoa 309 Infections Caused by Nematodes 318 Infections Caused by Cestodes 327 Infections Caused by Trematodes 329 Infections Associated with Arthropods 330 27. Chlamydial Keratitis and Conjunctivitis 346 Marie-Claude Robert, Mona Harissi-Dagher, Mounir Bashour Microbiology 346 Clinical Syndromes 349 Contents xxxi 28. Interstitial Keratitis 365 Robert S Weinberg Clinical Findings 365 Causes of Interstitial Keratitis 366 Bacterial Interstitial Keratitis 366 Section 5: Immunologic Disease 29. Ocular Allergy 377 Mitchell H Friedlaender Immunologic Mechanisms 377 30. Cicatrizing Conjunctivitis 387 Benyamin Y Ebrahim, Mohit Mehtani, Salim Butrus Mucous Membrane Pemphigoid Overview 387 Ocular Cicatricial Pemphigoid 387 Immunopathogenesis 387 Stevens Johnson Syndrome and Toxic Epidermal Necrolysis Overview 394 Immunopathogenesis 395 Paraneoplastic Conjunctival Cicatrization 399 Pseudopemphigoid 399 31. Phlyctenular Keratoconjunctivitis 404 Mona A Kaleem, Robert A Copeland Jr Etiology 404 Clinical Presentation 405 Differential Diagnosis 406 Histology 406 Management 406 32. Peripheral Ulcerative Keratitis 409 Jocelyn A Rowe, Neal P Barney Epidemiology 409 Pathogenesis 409 Clinical Signs and Symptoms 410 Differential Diagnosis 411 Evaluation 412 Treatment 413 xxii Copeland and Afshari's Principles and Practice of Cornea 33. Scleritis and Episcleritis 417 Daniel V Vasconcelos-Santos, Carlos E Pavesio Anatomic Background 417 Classification of Scleral Inflammatory Disorders 418 Epidemiology 418 Clinical Presentation 418 Diagnosis 421 Differential Diagnosis 422 Immunopathology 422 Treatment 424 Prognosis 426 Section 6: Ocular Surface Disease 34. Limbal Stem Cells, Biology and Pathogenesis in Ocular Surface Disease 433 Siamak Zarei-Ghanavati, Sophie X Deng Limbal Stem Cells 433 Limbal Stem Cell Markers 434 Limbal Stem Cell Regulation 435 Limbal Stem Cell Deficiency 435 35. Dry Eye 440 John D Sheppard, Kevin M Bowman Epidemiology 440 Risk Factors 440 Symptoms 443 Diagnosis 443 Classification 445 Pathophysiology 446 Treatment 447 Complications 451 36. Nutritional Factors and the Ocular Surface 456 Deval R Paranjpe Vitamin A and Global Consequences of Vitamin A Deficiency 456 Dietary Intake and Storage of Vitamin A 456 Sources of Vitamin A 457 Causes and Epidemiology of Vitamin A Deficiency in Low Income Versus High Income Populations 457 Contents xxxiThe Role of Other Vitamins in Dry Eye 459 Lipids and Ocular Surface Health 460 Meibomian Gland Dysfunction and Evaporative Dry Eye 460 Role of Lipids in Dry Eye, Ocular Surface Injury, Corneal Nerve Injury and Repair 461 Classification of Fatty Acids—A Brief Review 462 Omega-3 Fatty Acid Supplementation 463 Other Fatty Acid Supplements 465 37. Sjögren’s Syndrome 469 Salman J Yousuf, Janine A Clayton Epidemiology 469 Pathogenesis 469 Diagnosis 470 Ocular Manifestations 470 Extraocular Manifestations 471 Management 472 38. Ocular Surface Disease in Glaucoma 475 Ruben Kuruvilla, Penny Asbell Ocular Surface Disease in Glaucoma Patients 475 Use Of Preservatives in Ocular Medications 476 Bimolecular Changes Associated with Preservatives 477 Cellular Changes Associated with Preservatives 477 Adverse Events from Active Agents themselves 479 Impact of Ocular Surface Disease on Treatment and Compliance 479 Preserved Versus Preservative-Free Therapy 479 39. Blepharitis and Meibomian Gland Dysfunction 482 Hugo Y Hsu, Ronald E Smith Classification 482 Anterior Blepharitis: Staphylococcal Disease 484 Posterior Blepharitis: Meibomian Gland Dysfunction 487 40. Recurrent Corneal Erosion Syndrome 497 Roy Scott Rubinfeld, Animesh Petkar Pathophysiology 497 Diagnosis 498 Medical Treatment 498 Surgical Treatment 500 xxiv Copeland and Afshari's Principles and Practice of Cornea 41. Superior Limbic Keratoconjunctivitis 509 David J Harris Jr History 509 Epidemiology 510 Clinical Findings 510 Diagnosis 511 Pathogenesis 512 Treatment 512 42. Ligneous Conjunctivitis 515 Naima Jacobs-El, Robert A Copeland Jr Etiology, Pathogenesis and Histopathology 515 Epidemiology 515 Clinical Findings 515 Differential Diagnosis 516 Treatment 516 43. Eye Disorders Associated with Dermatological Diseases 519 Omar N Qutub, Rebat M Halder Bullous Dermatoses 519 Hypersensitivity Disorders 523 Eczematous Dermatoses 526 Histiocytic and Granulomatous Disorders 527 Neoplastic Cutaneous Diseases and Proliferations 528 Errors in Metabolism 530 Connective Tissue Disorders 532 Pigmentary/Melanocytic Disorders 533 Genodermatoses 535 44. Thygeson’s Superficial Punctate Keratitis 545 Daniel N Skorich History 545 Clinical Features 545 Differential Diagnosis 546 Pathogenesis and Laboratory 547 Treatment 547 Appendix A 548 Contents xxxv 45. Filamentary Keratitis 551 Saima M Qureshi, Robert A Copeland Jr Histopathology/Pathogenesis 552 Management 554 Recent Management Research 556 46. Climatic Droplet Keratopathy 559 Khalid F Tabbara, Hind M Alkatan Clinical Findings 559 Histopathology and Electron Microscopy 561 Proteomic Analysis and Pathogenesis 562 Prevention and Management 565 47. Neurotrophic Keratitis 567 Kavita Rao Pathophysiology 568 Clinical Presentation 568 Differential Diagnosis 570 Treatment 571 48. Dacryoadenitis 574 Claude L Cowan Jr 49. Immunotherapy for Ocular Surface Diseases and Graft Rejection 580 Takefumi Yamaguchi, Pedram Hamrah Ocular Surface Disease 580 Allergic Conjunctivitis 583 Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis 585 Ocular Cicatricial Pemphigoid 587 Corneal Graft Rejection 589 Section 7: Metabolic and Congenital Disease 50. Metabolic Diseases and Congenital Abnormalities Affecting the Ocular Surface 601 Wadih M Zein, Maryam Mokhtarzadeh Cystinosis 601 Tyrosinemia 602 Alkaptonuria 603 Amyloidosis 603 Gout 604 xxvi Copeland and Afshari's Principles and Practice of Cornea Xeroderma Pigmentosum 605 Systemic Mucopolysaccharidoses 605 Mucolipidoses 606 51. Metabolic Disorders of the Cornea 622 Stephen G Odaibo, Nikisha Q Richards, Robert A Copeland Jr Diabetes Mellitus 622 Mucopolysaccharidoses 626 Lipidoses 630 Dyslipoproteinemia 636 Porphyria 638 Cystinosis 639 Alkaptonuria 641 Amyloidoses 642 Serum Copper Abnormalities 643 Calcium 644 Gold 646 52. Corneal Conditions Associated with Glaucoma 654 Leslie S Jones, Bashira A Charles Congenital Conditions Affecting Corneal Dimensions 654 Section 8: Conjunctival Corneal Dysplasia and Malignancy 53. Conjunctival and Corneal Neoplasms 671 Harmeet S Gill, Devron H Char, Tia B Cole Preliminary 671 Section 1 Premalignant and Malignant Tumors of Epithelium 672 Risk Factors 673 Conjunctival Intraepithelial Neoplasia 675 Squamous Cell Carcinoma 676 Other Conjunctival Epithelial Tumors 676 Corneal Epithelial Tumors 677 Pigmented Conjunctival Epithelial Tumors 677 Section 2 Melanocytic Tumors of Conjunctival Epithelium 677 Conjunctival Melanocytic Nevus 678 Primary Acquired Melanosis 678 Malignant Melanoma 679 Contents xxxvMasquerading Lesions 680 Section 3 Lymphoproliferative Conjunctival Lesions 681 Reactive Lymphoid Hyperplasia 682 Mucosa-Associated Lymphoid Tissue Lymphoma 682 Other Types of Lymphoma 682 Evaluation of Conjunctival Lymphoproliferative Lesions 682 Classification of Lymphoproliferative Lesions 682 Management of Conjunctival Lymphoma 683 Section 4 Other Lymphoid, Leukemic and Histiocytic Conjunctival Lesions 684 Leukemia 684 Histiocytic Tumors 684 Section 5 Secondary and Metastatic Lesions 685 Sebaceous Cell Carcinoma 685 Metastatic Tumors 685 Section 6 Adnexal Lesions 686 Section 7 Management of Conjunctival Tumors 686 Surgical Treatment of Conjunctival Tumors 687 Map Biopsy Technique 689 Nonsurgical Treatment of Conjunctival Tumors 689 Section 9: Trauma 54. Chemical Trauma 699 Roswell R Pfister Epidemiology 699 Classification of Injuries 700 Major Chemical Differences Between Alkali, Acid and Toxic Injury of the Eye 700 55. Trauma of the Anterior Segment 714 Toby YB Chan, Iqbal Ike K Ahmed Clinical Evaluation 714 General Precautions 715 Anesthesia 715 Iris Repair and Reconstruction 715 Iridodialysis Repair 718 Iris or Pupil Repair (Pupilloplasty) 721 Iris Prosthesis 728 xviii Copeland and Afshari's Principles and Practice of Cornea Ciliary Body Trauma and Reconstruction 730 Lens and Zonule Trauma and Surgical Approaches 732 Approach for Traumatic Cataracts 735 Approach for Subluxed Crystalline Lens 738 Approach for Iol Subluxation 739 56. Physical Trauma of the Cornea 749 Mikelson MomPremier, Robert A Copeland Jr Pathophysiology and Microscopy 749 Management 750 Prognosis 755 Section 10: Corneal Dystrophies and Degenerations 57. Anterior Corneal Dystrophies: Dystrophies of the Epithelium, Epithelial Basement Membrane and Bowman’s Layer 761 Mark D Sherman Epithelial Basement Membrane Dystrophy 761 Epithelial Recurrent Erosion Dystrophy 762 Subepithelial Mucinous Corneal Dystrophy (Smcd) 763 Meesmann Corneal Dystrophy 763 Lisch Epithelial Corneal Dystrophy 764 Gelatinous Drop-Like Corneal Dystrophy 765 Reis-Buckler’s Corneal Dystrophy 766 Thiel-Behnke Corneal Dystrophy 766 Grayson-Wilbrandt Corneal Dystrophy 767 58. Stromal Corneal Dystrophies 769 Jayne S Weiss, Michael Mequio, Michael Coleman The Ic3d and Tgfbi Corneal Dystrophies 769 Granular Corneal Dystrophy 773 59. Posterior Corneal Dystrophies 792 Jessica Chow, Natalie A Afshari Fuchs Endothelial Corneal Dystrophy 792 Posterior Polymorphous Corneal Dystrophy 796 Congenital Hereditary Endothelial Dystrophy 799 X-Linked Endothelial Corneal Dystrophy 801 Contents xxxi60. Corneal and Conjunctival Degenerations 805 Ninita Helen Brown, Robert A Copeland Jr Conjunctiva 805 Epithelium and Subepithelium 806 Central Stroma 807 Peripheral Stroma 808 Postinflammation 810 Endothelial 813 Iron Lines 813 61. Ectatic Diseases of the Cornea: Keratoconus, Pellucid Marginal Degeneration and Keratoglobus 819 Stephen S Khachikian, Michael W Belin Keratoconus 819 Pellucid Marginal Degeneration 826 Keratoglobus 828 Section 11: Corneal and Conjunctival Manifestations of Dietary Deficiencies 62. Nutritional Deficiencies Affecting the Cornea and Conjunctiva 835 Mohit Mehtani, Benyamin Y Ebrahim, Salim I Butrus Prevalence, Mortality and Morbidity 835 Physiology and Metabolism of Vitamin A 835 Pathogenesis of Conjunctival and Corneal Disease 837 Night Blindness (Xn) 837 Conjunctival Xerosis (X1A) 837 Bitot’s Spots (X1b) 838 Corneal Xerosis (X2) 838 Keratomalacia (X3) 838 Corneal Scar (Xs) 839 Prevention and Treatment of Vad 839 Other Nutrient Deficiencies 840 xl Copeland and Afshari's Principles and Practice of Cornea Section 12: Contact Lenses 63. Contact Lenses in the Treatment of Corneal Disease 845 Peter C Donshik, William H Ehlers Indications 845 Corneal Epithelial Disorders 846 Corneal Ulcerations/ Perforations/Lacerations 849 Corneal Edema 849 Surgical Indications 850 Disorders of the Ocular Surface 850 Irregular Corneal Surface 852 Prosthetic Soft Contact Lenses 852 Drug Delivery 853 New Developments 853 Complications of Therapeutic Contact Lenses 853 64. PROSE Treatment for Ocular Surface Disease 856 Deborah S Jacobs, James A Bradley, Hong-Gam Le History of Scleral Lenses and Principles of Design for Physiological Tolerance 856 Definition of a Scleral Lens 856 Prose Treatment 857 Section 13: Emerging Innovation 65. Gene Therapy in the Cornea: Principles and Promise 865 Rajiv R Mohan, Jason T Rodier 865 History of Gene Therapy 865 Advantages of Gene Therapy over Conventional Drug Therapy 866 The Cornea: An Ideal Tissue for Gene Therapy 866 Gene Therapy Vectors 866 Cell and Tissue Targeting 878 An Overview of Corneal Gene Therapy Studies 878 66. Biosynthetic Alternatives to Human Donor Tissue 887 May Griffith, Lucia Kuffova, John Forrester, Neil Lagali, Per Fagerholm, Nerea Garagorri Gantxegui, Thomas Fuchsluger The Case for Regenerative Medicine Approaches for Corneal Transplantation 887 The Cornea as a Research Model 888 Keratoprostheses with Regenerative Capacity 888 Cell-Free Scaffolds for Promoting Corneal Regeneration 889 Contents xli Section 14: Cornea Surgery 67. History of Cornea Surgery 901 Daoud S Fahd, Norma Allemann, Wallace Chamon, Dimitri T Azar History of Keratoplasty 901 History of Refractive Surgery 908 Corneal Collagen Crosslinking 911 Appendix 911 Section 15: Corneal, Scleral and Conjunctival Surgery: Supportive and Protective 68. Ophthalmic Applications of Tissue Adhesives in Anterior Segment Surgery 919 Brian Alder, Terry Kim Cyanoacrylate- and Fibrin-based Adhesives 919 Ophthalmic Uses of Cyanoacrylate- and Fibrin-based Tissue Adhesives 920 Novel Tissue Adhesives 923 69. Conjunctival Flaps 927 Anne S Steiner, Ira J Udell Indications 927 Peripheral Corneal Disease 928 Disadvantages 928 Technique 929 Postoperative Care 930 Complications 930 70. Scleral Transplantation: Supportive and Protective 932 Frank W Bowden III Scleral Graft 932 Anesthesia Options 933 Scleral Graft Techniques 934 Amniotic Membrane 939 Fascia Lata 939 Periosteum 939 Volume 2 xlii Copeland and Afshari's Principles and Practice of Cornea Pericardium 940 Dura Mater 940 Split Thickness Dermal Graft 940 Other Materials 940 Section 16: Ocular Surface Rehabilitation 71. Corneal and Conjunctival Foreign Bodies 945 Larry Ferdinand, Vanessa Ngakeng Clinical Findings and Evaluation 945 Pathogenesis 946 Management 946 Rust Rings 947 Removal of Corneal Foreign Bodies in Lasik Patients 947 Removal of Corneal Foreign Body through a Lamellar Corneal Pocket 947 Treatment 947 Follow-Up 948 Complications 948 Prognosis 948 72. Superficial Keratectomy and Epithelial Debridement 949 Julian A Procope History 949 Indications 949 Technique 951 Complications 953 73 Limbal Dermoid 954 Charles S Bouchard, Samir Vira Epidemiology 954 Clinical Features 954 Histopathology 956 Etiology/Pathogenesis 956 Differential Diagnosis 956 Management 956 74. Evaluation and Management of Eyelid and Eyelash Malposition for the Anterior Segment Surgeon 959 Salman J Yousuf, Earl D Kidwell Keratopathy due to Eyelid Malposition 959 Keratopathy due to Eyelash Malposition 962 Contents xliii 75. Pterygium Surgery 965 Alfred L Anduze Pathogenesis 965 Pathology 966 Prevention 966 Surgery 967 Complications 972 Adjuvant Therapies 975 76. Amniotic Membrane Transplantation 979 Soosan Jacob, Amar Agarwal Embryology 979 Anatomy of the Amniotic Membrane 979 Physiology of Amniotic Membrane 979 Preparation of Amniotic Membrane 979 Role of Amniotic Membrane in Ophthalmology 980 Corneal Uses 980 Conjunctival Uses 984 Tissue Cultured Human Amniotic Epithelial Cells 989 Amniotic Membrane Substrate for Ex Vivo Expansion of Limbal Stem Cells 989 77. Limbal Stem Cell Transplantation 991 Justin D Aaker, Andrew J W Huang Removal of Abnormal Tissue by Superficial Keratectomy 991 Other Surgical Techniques for Ocular Surface Reconstruction 997 Management of Limbal Stem Cell Transplants 998 78. Autologous Ex Vivo Cultivated Limbal Epithelial Transplantation 1001 Sayan Basu, Virender S Sangwan Ocular Burns, Limbus, Stem Cells and Therapy 1001 Indications for Autologous Limbal Transplantation 1002 Preoperative Clinical Assessment and Counseling 1003 Technique of Limbal Biopsy 1003 Technique of Limbal Culture 1003 Technique of Limbal Transplantation 1004 Postoperative Management 1004 Clinical Outcomes of Cultivated Limbal Transplantation 1004 xliv Copeland and Afshari's Principles and Practice of Cornea 79. Modern Eye Banking: Advances and Challenges 1011 Jon A Konti, Prashant Garg, John J Requard, Jonathan H Lass History of Eye Banking 1011 Growth and Trends in Tissue Utilization 1012 Donor Tissue Selection 1012 Tissue Retrieval 1015 Tissue Evaluation 1016 Tissue Preparation for Descemet Stripping Endothelial Keratoplasty 1018 Storage Media 1019 Other Tissue Preparations 1023 International Eye Banking 1026 Financial and Legal Considerations in Eye Banking 1028 Future Threats in Eye Banking 1033 80. Penetrating Keratoplasty: Surgical Techniques and Pre- and Postoperative Care 1037 John W Cowden Indications for Penetrating Keratoplasty 1037 Donor Tissue 1037 Discussing Penetrating Keratoplasty with the Patient 1039 The Operative Procedure 1039 Recipient Procedure 1040 Postoperative Care 1044 Combined Procedures with Penetrating Keratoplasty 1045 Intraoperative Complications 1046 Early Postoperative Complications 1047 Late Complications 1047 Making the Decision to Perform Repeat Penetrating Keratoplasty 1048 81. Management of Postkeratoplasty Astigmatism 1050 Lorenzo J Cervantes, Alex Mammen, Wan Xiao, Deepinder K Dhaliwal Preoperative Factors 1050 Intraoperative Factors 1050 Postoperative Considerations 1053 82. Glaucoma Surgery in Penetrating and Nonpenetrating Keratoplasty Patients 1063 Oluwatosin Smith, Davinder Grover Penetrating Keratoplasty 1063 Descemet’s Stripping Endothelial Keratoplasty 1064 Keratoprosthesis 1065 Refractive Surgery 1066 Surgical Approach 1066 Contents xlv 83 Pediatric Corneal Transplant Surgery 1072 Gerald W Zaidman Indications 1072 Surgery 1073 Surgical Technique 1075 Postoperative Management 1076 Results 1077 84. DLEK, DSAEK, DSEK, DMEK 1079 Marianne O Price, Francis W Price, Arundhati Anshu Indications and Contraindications 1080 Descemet’s Stripping Automated Endothelial Keratoplasty/Descemet’s Stripping Endothelial Keratoplasty 1082 Descemet’s Membrane Endothelial Keratoplasty 1086 Descemet’s Membrane Automated Endothelial Keratoplasty 1086 85. Descemet’s Membrane Endothelial Keratoplasty (DMEK) 1091 Isabel Dapena, Vasilios S Liarakos, Martin Dirisamer, Miguel Naveiras, Ru-Yin Yeh, Ruth Quilendrino, Konstantinos Droutsas, Kyros Moutsouris, Marieke Bruinsma, Gerrit RJ Melles Preoperative Preparation of the Dmek Graft 1092 Descemet’s Membrane Endothelial Keratoplasty Surgical Technique 1092 Visual Rehabilitation Rate and Refractive Outcome 1097 Endothelial Cell Density and Graft Survival 1097 Complications 1097 Descemet Membrane Endothelial Keratoplasty and Cataract 1102 Future Perspectives 1102 86. Deep Anterior Lamellar Keratoplasty 1107 David D Verdier History 1107 Patient and Procedure Selection 1107 Establish Realistic Expectations 1108 Donor Tissue Selection 1109 Surgical Venue and Anesthesia 1109 Surgical Steps in Dalk: Big-Bubble Technique 1109 Alternative Technique to Big-Bubble Dalk: Manual Dissection 1114 Postoperative Care 1115 Long-Term Prognosis 1116 xlvi Copeland and Afshari's Principles and Practice of Cornea 87. Intacs Intracorneal Ring Segments and Keratoconus 1118 Adel Barbara, Lamis Abdel Aziz, Ramez Barbara Intacs in Corneas with Suspected Keratoconus 1120 Intacs and Keratoconus 1120 Operation Techniques 1123 Complications 1132 Histology and Deposits 1136 Additional Procedures to Enhance Intacs’ Effects 1138 Intacs Compared with other Surgical Procedures 1141 New Design of Intacs: Intacs Sk 1143 Intacs and other Ectatic Diseases of the Cornea 1145 88. UVA-light and Riboflavin Mediated Corneal Collagen Crosslinking 1155 Erik Letko, William B Trattler, Roy S Rubinfeld Uva-light and Riboflavin 1156 89. Phototherapeutic Keratectomy 1165 John W Josephson, Jay M Lustbader Candidacy 1165 Clinical Uses 1165 Results 1167 Contraindications and Complications 1167 Surgical Technique 1167 Future Trends 1168 90. Keratoprosthesis Surgery 1170 Gina M Rogers, Kenneth M Goins Preoperative Evaluation 1170 Types of Keratoprosthesis 1172 Outcomes of Keratoprostheses 1177 Complications and Considerations 1177 91. Infant Keratoprosthesis 1183 James V Aquavella, Garrick Chak Historical Perspective 1185 Our Team 1186 Surgical Procedure 1186 Device Assembly 1187 Postoperative Care 1190 Complications 1191 Results 1192 Contents xlvii 92. Boston Keratoprosthesis in the Management of Limbal Stem Cell Failure 1194 Christina R Prescott, James Chodosh Limbal Stem Cell Failure and Ocular Surface Disease 1194 Keratoprosthesis Implantation for Severe Limbal Stem Cell Deficiency 1197 Postoperative Care following Boston Keratoprosthesis in Limbal Stem Cell Deficiency 1198 Complications 1198 Visual Outcomes after Boston Keratoprosthesis in Limbal Stem Cell Deficiency 1199 93. Preoperative Considerations: Patient Selection and Evaluation 1202 Naazli M Shaikh, Stephen C Kaufman, Jamal M Mohsin Selecting the Right Keratorefractive Procedure 1203 Systemic Considerations 1203 Ocular Considerations 1205 Refractive Intraocular Lenses 1210 94. Preoperative Considerations: Corneal Topography 1213 Stephen D Klyce, Edgar M Espana, George O Waring IV Development of the Corneal Topographer 1213 Corneal Topography Displays and Scales 1214 Corneal Topographer Displays 1215 Quantitative Descriptors of Corneal Topography 1216 Corneal Topography and Tear Film 1219 Normal Corneal Topographic Parameters and Deviation from the Normal 1219 Adjunct Screening Tools 1225 Corneal Topographers and Corneal Tomographers 1228 Tomography Elevation Maps 1229 95. Radial Keratotomy 1231 John B Cason, Kerry Assil History 1231 Technique 1232 Results 1233 Predictability 1233 PERK Study 1234 Other RK Studies 1235 Retreatments 1235 96. Conductive Keratoplasty 1238 George O Waring IV, Carolyn A Bates, Jason E Stahl Conductive Keratoplasty 1238 Histology 1238 lviii Copeland and Afshari's Principles and Practice of Cornea Conductive Keratoplasty Treatment 1239 Surgically-Induced Astigmatism 1243 97. Incisional Surgery for Natural and Surgically-Induced Astigmatism 1246 Matthew D Council Patient Selection 1246 Preoperative Measurements 1246 Nomograms 1247 Technique 1248 Complications 1250 Future Directions 1250 98. Shaping the Future and Reshaping the Past: The Art of Vision Surgery 1252 Arun C Gulani History of Lamellar Refractive Surgery (Keratomileusis and Automated Lamellar Keratoplasty) 1252 Gulani Cardinal Rules for Refractive Surgeons 1253 Gulani Classification for Previous Refractive Surgery 1254 99. Intrastromal Corneal Implants for the Treatment of Presbyopia 1274 George O Waring, Stephen D Klyce Kamratm Small Aperture Inlay 1276 Vue+ Space Occupying Inlay 1277 Flexivue Microlens Annular Add Lenticule 1277 Implanting Corneal Inlays 1278 Potential Complications and Management 1279 100. Excimer Laser Surface Ablation: Photorefractive Keratectomy and Laser Subepithelial Keratomileusis 1280 Gitane Patel History 1280 Excimer Laser 1280 Prk, Lasik and Lasek 1280 Preoperative Management 1281 Technique 1281 Postoperative Management 1281 Outcomes 1282 Mitomycin C 1282 Monovision 1282 Photorefractive Keratectomy after Previous Corneal Surgery 1282 Complications 1282 Contents xlix 101. LASIK Instrumentation: Microkeratomes, Excimer Lasers and Wavefront Analyzers 1286 Fasika Woreta, Yassine J Daoud, Kraig S Bower Microkeratomes 1286 Excimer Laser 1294 102. LASIK Techniques and Outcomes 1299 Andrea Cruzat, Roberto Pineda Techniques: Mechanical Microkeratome Versus Laser Keratome 1300 Outcomes 1305 103. LASIK Outcomes in Astigmatism 1313 John J DeStafeno, John P Berdahl Definitions 1313 History 1313 Lasik Treatment of Astigmatism 1315 Astigmatic Axis of Correction 1316 Lasik in Irregular Astigmatism 1317 Lasik after Penetrating Keratoplasty 1317 Lasik Compared to Phakic Toric Implanted Collamer Lens 1317 Excimer Laser Outcomes in Correction of Astigmatism 1318 104. Lasik Combined with Other Procedures 1321 John B Cason On-Flap Photorefractive Keratectomy 1321 Phakic Intraocular Lenses 1322 Posterior Chamber Intraocular Lens 1322 Penetrating Keratoplasty 1323 105. Wavefront-Guided Custom LASIK and LASEK: Techniques and Outcomes 1326 John P Berdahl Optical Considerations 1326 Wavefront Basics 1327 Interpreting Wavefronts 1329 106. LASIK Complications 1334 Mark E Whitten Lasik Preoperative Complications 1334 Lasik Operative Complications 1337 Lasik Postoperative Complications 1340 l Copeland and Afshari's Principles and Practice of Cornea 107. Corneal Applications of Ultrashort Pulse Laser 1346 Mohamed Abou Shousha, Sonia H Yoo Ultrashort Pulse Laser Technology and Laser-Tissue Interaction 1346 Femtosecond Laser Lasik Flap Creation 1347 Penetrating Keratoplasty 1349 Anterior Lamellar Keratoplasty 1350 Endothelial Keratoplasty 1351 Astigmatic Keratectomy 1352 Femtosecond Laser-Assisted Placement of Intrastromal Corneal Ring Segment 1352 Femtosecond Lenticule Extraction and Small Incision Lenticule Extraction 1352 Other Novel Femtosecond Laser Applications in Corneal Surgeries 1353 108. Lens Power Calculations in the Postkeratorefractive Eye 1356 R Duncan Johnson, Uday Devgan Sources of Error in Calculations 1356 Methods for Estimating Effective Central Corneal Power 1358 Aphakic Calculation Methods 1362 Intraocular Lens Choice Considerations 1363 109. Light-Adjustable Lenses Postcorneal Refractive Surgery 1365 Guillermo Rocha, Zale D Mednick Basic Concepts in Iol Calculation 1365 Iol Calculation after Corneal Refractive Surgery 1366 Light-Adjustable Lens Technology 1368 Light-Adjustable Lens Postrefractive Surgery 1370 Section 17: Femtosecond Laser Applications in Anterior Segment Surgery 110. Femtosecond Continuous Curvilinear Capsulorhexis 1377 John P Berdahl History of Continuous Curvilinear Capsulorhexis 1377 Femtosecond Continuous Curvilinear Capsulorhexis 1377 Advanced Iols 1380 Advantages to Surgeons 1380 Postoperative Outcomes 1380 Future of Femtosecond Continuous Curvilinear Capsulorhexis 1381 Contents li 111. Femtosecond Laser Lens Fragmentation 1382 David Smadja, Ronald R Krueger Introduction and Concept of Lens Fragmentation 1382 History and Techniques of Phacoemulsification Ultrasound Fragmentation 1382 Current Limitations of Ultrasound Fragmentation 1383 Introduction of Laser Lens Fragmentation 1383 Technical Considerations for Laser-Assisted Fragmentation 1384 Early Clinical Results 1387 112. Femtosecond Laser Presbyopia Correction 1389 Mike P Holzer The Intracor Procedure 1389 Evaluation of the Intracor Procedure—2-Year Follow-Up Data 1390 Steps for Performing the Intracor Procedure 1390 Results 1392 Working Principle 1393 Patient Selection and Managing Expectations 1393 113. Wound Creation 1395 Brett P Bielory, Terrence J Doherty, James C Loden, George O Waring IV, Richard M Awdeh The Science of the Femtosecond Laser 1395 Application of Femtosecond Technology in Ophthalmology 1395 Laser Settings and Techniques 1397 Top-Hat-Shaped Grafts 1398 Zigzag-Shaped Grafts 1399 Mushroom-Shaped Grafts 1399 Historical Corneal Incisions for Cataract Surgery 1400 Benefit of Using The Fs Laser for Wound Creation 1401 114. Femtosecond Refractive Lenticule Extraction and Small Incision Lenticule Extraction 1405 Karim Mohamed-Noriega, Jodhbir S Mehta Femtosecond Laser 1405 Indications 1406 Preoperative Assessment and Follow-Up 1406 Surgical Procedure 1407 Basic Science 1410 Clinical Outcomes 1412 Refractive Lenticule Extraction (Flex and Smile) 1414 lii Copeland and Afshari's Principles and Practice of Cornea Side Effects 1417 Advantages and Disadvantages of Relex Over Lasik 1417 Future Prospects and Developments 1418 115. Femtosecond Laser Keratoplasty 1421 Marjan Farid, Sumit (Sam) Garg, Roger F Steinert Patient Selection and Preoperative Evaluation 1422 Graft Cutting and Surgery 1422 Review of Recent Outcomes 1423 Femtosecond Laser Assisted Lamellar Keratoplasty 1425 116. Femtosecond Laser Enabled Correction of Postkeratoplasty Astigmatism 1427 Nikhil L Kumar, David S Rootman The Principles of Astigmatic Keratotomy Postkeratoplasty 1427 Femtosecond Enabled Astigmatic Keratotomy (Feak) Post Keratoplasty 1428 Results 1429 Complications 1430 117. Complications of Femtosecond Laser Procedures 1437 George D Kymionis, Vardhaman P Kankariya Complications 1437 Section 18: Corneal Instrumentation 118. Corneal Instrumentation 1447 Ying Qian, Bennie H Jeng Penetrating Keratoplasty 1447 Deep Anterior Lamellar Keratoplasty 1452 Descemet’s Stripping Endothelial Keratoplasty 1454 Descemet’s Membrane Endothelial Keratoplasty 1458 Femtosecond Laser Assisted Corneal Surgery 1458 Section 19: Appendix 119. Surgical Procedure Guidelines Physical Trauma of the Cornea 1463 Mikelson MomPremier, Robert A Copeland Jr Procedural Steps for the Repair of Corneal Lacerations 1463 Contents liii Conjunctival Flaps 1464 Anne S Steiner, Ira J Udell Scleral Transplantation: Supportive and Protective 1465 Frank W Bowden III Sutureless Repair of Conjunctival Erosion Associated with Scleral Resorption following Tube Shunt Surgery 1465 Superficial Keratectomy and Epithelial Debridement 1466 Julian A Procope Instrumentation 1466 Procedure Technique 1466 Evaluation and Management of Eyelid and Eyelash Malposition for the Anterior Segment Surgeon 1467 Salman J Yousuf, Earl D Kidwell Pterygium Surgery 1469 Alfred L Anduze Conjunctival Flaps Procedure for Pterygium Surgery 1469 Amniotic Membrane Transplantation 1470 Soosan Jacob, Amar Agarwal Autologous Ex Vivo Cultivated Limbal Epithelial Transplantation 1471 Sayan Basu, Virender S Sangwan Technique of Limbal Biopsy 1471 Technique of Limbal Culture 1471 Technique of Limbal Transplantation 1471 Postoperative Management 1471 Penetrating Keratoplasty: Surgical Techniques and Pre- and Postoperative Care 1473 John W Cowden Penetrating Keratoplasty: Summary of Operation 1473 Glaucoma Surgery in Penetrating and Nonpenetrating Keratoplasty Patients 1475 Oluwatosin Smith, Davinder Grover Trabeculectomy (Fornix-Based Approach) 1475 Trabeculectomy (Limbus-Based Approach) 1475 Glaucoma Drainage Devices 1476 liv Copeland and Afshari's Principles and Practice of Cornea Pediatric Corneal Transplant Surgery 1477 Gerald W Zaidman Surgical Technique 1477 DLEK, DSAEK, DSEK, DMEK 1478 Marianne O Price, Francis W Price, Arundhati Anshu Descemet’s Membrane Endothelial Keratoplasty 1480 Isabel Dapena, Vasilios S Liarakos, Martin Dirisamer, Miguel Naveiras, Ru-Yin Yeh, Ruth Quilendrino, Konstantinos Droutsas, Kyros Moutsouris, Marieke Bruinsma, Gerrit RJ Melles Descemet’s Membrane Endothelial Keratoplasty Surgical Steps 1480 Deep Anterior Lamellar Keratoplasty 1481 David D Verdier UVA-light and Riboflavin Mediated Corneal Collagen Crosslinking 1482 Erik Letko, William B Trattler, Roy S Rubinfeld Phototherapeutic Keratectomy 1483 John W Josephson, Jay M Lustbader Phototherapeutic Keratectomy Procedure 1483 Boston Keratoprosthesis in the Management of Limbal Stem Cell Failure 1484 Kenneth M Goins Boston Keratoprosthesis Type I Surgery: Step by Step Surgical Preparation 1484 Radial Keratotomy 1486 John B Cason, Kerry K Assil Incisional Surgery for Natural and Surgically-Induced Astigmatism 1487 Matthew D Council Excimer Laser Surface Ablation: Photorefractive Keratectomy and Laser Subepithelial Keratomileusis 1488 Noel Rosado-Adames LASIK Technique with the Mechanical Microkeratome Hansatome 1489 Roberto Pineda, Andrea Cruzat Light Adjustable Lenses Post Corneal Refractive Surgery 1491 Guillermo Rocha, Zale D Mednick Light Adjustable Lens Technology 1491 Contents lv Femtosecond Refractive Lenticule Extraction and Small Incision Lenticule Extraction 1496 Karim Mohamed-Noriega, Jodhbir S Mehta Common ReLEx, FLEx and SMILE Steps (First-half Shared Steps) 1496 FLEx Specific Steps (Second-half Steps) 1496 SMILE Specific Steps (Second-half Steps) 1496 Femtosecond Laser Keratoplasty 1497 Marjan Farid, Sumit (Sam) Garg, Roger F Steinert Graft Cutting and Surgery 1497 Femtosecond Laser Enabled Correction of Postkeratoplasty Astigmatism 1498 Nikhil L Kumar, David S Rootman Corneal Instrumentation for Femtosecond Laser Enabled Penetrating Keratoplasty 1499 Ying Qian, Bennie H Jeng Donor Cornea Laser Resection with Femtosecond Laser 1499 Recipient Cornea Laser Resection with Femtosecond Laser 1499 Index I-i -xxiv 9789350901724

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