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Evolution of Community Medicine (History of Medicine)

History of Medicine (Evolution of Community Medicine) Dr. Farooq Ahmad Assistant Professor Community Medicine Department Rawalpindi Medical College Rawalpindi. Evolution of Community Medicine (History of Medicine). Stages seen in the history of medicine: Stone age 5000 BC: Indian medicine

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Evolution of Community Medicine (History of Medicine)

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  1. History of Medicine (Evolution of Community Medicine)Dr. Farooq AhmadAssistant Professor Community Medicine DepartmentRawalpindi Medical CollegeRawalpindi

  2. Evolution of Community Medicine(History of Medicine) Stages seen in the history of medicine: Stone age 5000 BC: Indian medicine 2700 BC: Chinese medicine (system of barefoot doctor, System of acupuncture) 2000 BC: Egyptian medicine (manuscript of papyrus) Continued…..

  3. Stages seen in the history of medicine: 2000 BC: Mesopotamian medicine (Babylonian code of hammurabi) 460 BC: Greek medicine (Hygiea daughter of Aescuapius, Hippocrates oath) 130 AD: Roman medicine (Galen) Up to 800 AD: Dark ages of medicine Evolution of Community Medicine(History of Medicine) Continued…..

  4. Stages seen in the history of medicine: 900 AD: Arabic medicine (Rhazes, Avicenna) 1500 AD: Revival period (theory of contagion blood circulation by Harvey, vaccination by Jenner) 1800: Sanitary awakening 1850: Rise of public health (epidemic of cholera by John Snow, typhoid by William, Chadwick’s sanitary reforms) Evolution of Community Medicine(History of Medicine) Continued…..

  5. Stages seen in the history of medicine: 1860: Germ theory (anthrax by Robert Koch) 1880: Typhoid & pneumonia 1882 TB 1883: Birth of preventive medicine (ARV) 1883: Cholera vaccine, 1892 dipth antitoxin 1898: Malaria transmission by Ross Evolution of Community Medicine(History of Medicine) Continued…..

  6. Stages seen in the history of medicine: 1900: Multifactorial causation of disease 1911: Social medicine 1920: Disease control 1960: Health promotion 1981: HFA Evolution of Community Medicine(History of Medicine)

  7. Concept of Health

  8. Biomedical concept Ecological concept Psychological concept Holistic concept Concept of Health

  9. WHO Definition of Health Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity and ability to lead socially and economically productive life Operational definition: A condition or quality of human organism expressing the adequate functioning of the organism in giving condition, genetic or environmental

  10. Dimensions of health Physical Mental Social Spiritual Emotional Vocational Others: Cultural Socioeconomic Environmental Educational Nutritional Curative Preventive

  11. Concept of Wellbeing Objective component Standard of living Level of living Subjective component Quality of Life (PQLI) (IM, Life expt. @ 1, Literacy.) Human development Index (Life expt. @ 0, Knowledge, Income)

  12. Concept of Wellbeing • Subjective component • Quality of Life (PQLI) (IM, Life expt. @ 1, Literacy.) The condition of life resulting from combination of the factors such as those determining health happiness education social and intellectual attainments freedom of action, justice and freedom of expression • Human development Index (Life expt. @ 0, Knowledge, Income)

  13. Determinants of health Biological / Hereditary Behavioral & Socio-cultural Lifestyle Environmental Socioeconomic conditions Health and family welfare services Aging of the population Gender Others…..

  14. Determinants of health • Biological • Behavioral • Environmental • Socioeconomic • Health system • Socio-cultural • Aging of the population • Science and technology • Information and communication • Gender • Equality and social justice • Human rights

  15. Responsibility of Health Individual responsibility Community responsibility State responsibility International responsibility

  16. Indicators of health(Valid Reliable Sensitive Specific) Mortality indicators Morbidity indicators Disability indicators Nutritional Status indicators Health care delivery indicators Utilization rate Indicators of social and mental health Environmental indicators Socioeconomic indicators Health policy indicators Indicators of quality of life Others……….

  17. Health Indicators Valid, reliable, sensitive and relevant indicators which determine health development are called health indicators: Mortality Indicators: Death rate, Life span, IMR, Child mortality rate, MMR, Case fatality rate, proportion mortality rate. Morbidity Indicators: Disease rate (incidence, prevalence) Disability Indicators: Hospitalization, loss of work, sullivan index DALYs Nutritional Indicators: Anthropometric values, LBW Utilization Indicators: Fully immunized, bed turn out… Socioeconomic Indicators: Per capita income. Family size.

  18. Mortality indicators Crude death rate Expectancy of life Infant mortality rate Child Mortality rate Under 5 proportionate mortality rate Maternal mortality Disease specific mortality Proportionate mortality rate

  19. Concept of diseaseIt is departure from state of health interrupting in normal function of the body

  20. Concept of disease Theories of causation of disease (Germ theory, Epidemiological Triad, Multifactorial causation, web of causation) Natural History of disease (Prepathogenesis – pathogenesis) (Agent Host Environment) Risk Factors Iceberg Phenomena Monitoring the performance & analysis of routine measurements aimed at detecting changes in the environment or health status of population Surveillance The continuous scrutiny of the factors that determines the occurrence and distribution of disease and other conditions of ill health Sentinel Surveillance Prevention and Control

  21. Difference between Control & Eradication

  22. Examples of Risk Factors

  23. Level of prevention Primordial Prevention Primary Prevention Secondary Prevention Tertiary Prevention

  24. Modes of Intervention Intervention is an attempt to intervene or interrupt the usual sequence in the development of disease in a man. 1. Health Promotion: It is a process of enabling people to increase control over & to improve health Health education Environmental health Nutritional intervention Lifestyle changes Behavior changes

  25. 2. Specific Protection: It is a process to totally avoid disease or illness Immunization Nutritional supplement Chemoprophylaxis Immunoprophylaxis Protective device in industry Protective device against carcinogen Protective device against allergens Modes of Intervention

  26. 3. Early diagnosis and prompt treatment It is a process of early detection of transformation from physiological to pathological state Early diagnosis and prompt treatment of: Ca breast Ca cervix TB Leprosy Modes of Intervention

  27. 4. Disability Limitation It is a process involving interaction to prevent disability e.g. Disability limitation in nerve damage in leprosy Physiotherapy in polio lameness. Impairment Disability Handicap Modes of Intervention

  28. 5. Rehabilitation It is a combine & co-ordinate use of medical, social, economical, vocational and psychological measure to make an individual or community function normally Medical rehabilitation Social rehabilitation Economic rehabilitation Vocational rehabilitation Psychological rehabilitation Modes of Intervention

  29. Thanks

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