National Programme for

Prevention and Control of

Cancer,Diabetes,Cardiovascular Diseases and Stroke
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National Program for Prevention and Control of

Cancer, Diabetes, Cardio-Vascular Disease & Stroke

A Guide for
Health Workers
 National Programme for
Prevention and Control of
Cancer,Diabetes,Cardiovascular Diseases and Stroke
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rH
ou
Y
n
hI
Healt

National Program for Prevention and Control of

Cancer, Diabetes, Cardio-Vascular Disease & Stroke
Acknowledgements

This guide for health workers has been prepared by NCD unit of
Ministry of Health and Family Welfare under the guidance of Dr.
R.K. Srivastava, Director General of Health Services and Dr.
Deoki Nandan, Director, National Institute of Health and Family
Welfare. The team gratefully acknowledges the thoughtful
comments and inputs received from Dr. P.L Joshi, Ex-Faculty,
NIHFW Dr. LalitKant, Prof. Department of Medical Oncology,
AIIMS, Dr. Mithila Dayanidhi, Consultant Cancer, MoHFW, Dr.
Sitanshu Kar, Ex-NMH –National Consultant, WHO India.
Praface
9.
10. Geriatric Care
11. Stroke
12. Conclusion
Method of Screening of Diabetes by Strip method
Things Needed:
? A glucometer
? Test strips
? A lancet
? A notebook & pen
Figure 4: Diabetic Check up.

Step 1 : Take out the glucometer and place on a flat surface

Step 2 : Remove a test strip from the container and place in the glucometer. One
end will need to face the top of the glucometer; usually it has a darker
colored line on it. This is where the blood will be placed for testing.
Step 3 : Turn on your glucometer.
Step 4 : Use a lancet to pierce the skin and obtain blood from the tip of a finger.
Step 5 : Place the blood sample on the test strip. The test strip package will have
exact instructions, including blood sample size. Usually, this is
accomplished by placing the blood drop against the edge or top of the
strip.
Step 6 : Watch the glucometer screen. It should show a "waiting" or
"processing" symbol, and will emit a beep when the sample has been
tested. The results will be displayed as a number on the screen.

Record your test results in your notebook and pass this information to Medical
officer.

Fasting Glucose 2-hour Post-Glucose Load

Diagnosis
(mg/dl) (mg/dl)
Diabetes Mellitus >=126 >=200

Impaired Glucose Tolerance < 110 >140 to <200

Impaired Fasting Glucose >=110 to <126 >140 to <200

When to do the Breast Self-Exam?
? Do breast examination once a month
? If you are still having menstrual periods, the best time to do BSE is
2 or 3 days after your period ends. These are the days when your
breasts are least likely to be tender or swollen. It is common for
your breasts to be swollen and tender right before or during your
menstrual period.
? If you no longer menstruate, pick a certain day-such as the first
day of each month for this purpose.
? If you are taking hormones-a day after withdrawal bleeding stops.

The five Steps of a Breast Self-Exam.

Step 1:
? Begin by looking at your breasts (Gap) in the
mirror with your shoulders straight and your arms
on your hips.
? Here's what you should look for (Check the
different places where bulletes are there ):
? Brasts that are their usual size, shape and
color.
? Breasts that are evenly shaped without
visible distortion or swelling.
? If you see any of the following changes,
bring them to your doctor's attention:
Ø Dimpleing, puckering, or bulging of the
skin
Ø A nipple that has changed position or an
inverted nipple (pushed inward instead
of sticking out)

Step 2:
? Now, raise your arms and look for the same
changes especially look for any dimpling of skin or
in drawing nipple.

Step 3:
? While you're at the mirror, gently squeeze each
nipple between your finger and thumb and check
for nipple discharge (this could be a milky or yellow
fluid or blood).
Step 4:
? Next, feel your breasts while lying down, using
your right hand to feel your left breast and then
your left hand to feel your right breast. Use a firm,
smooth touch with the first few fingers of your
hand, keeping the fingers flat and together.
? Cover the entire breast from top to bottom, side
to side from your collar bone to the top of your
abdomen, and your armpit to your cleavage.
Begin examining each area just beneath your skin
with a very soft touch, and then increase pressure
so that you can feel the deeper tissue. Down to
your ribcage using fingers only. Follow a pattern
to be sure that you cover the whole breast. You
can begin at the nipple, moving in larger and
larger circles until you reach the outer edge of the
breast. You can also move your fingers up and
down vertically, in rows.

Step 5:
? Finally, feel your breasts while you are standing or
sitting. Many women find that the easiest way to
feel their breasts is when their skin is wet and
slippery, so they like to do this step while bathing.
Cover your entire breast, using the same hand
movements (Space) described in Step 4.
 Developed by
National Institute of Health and Family Welfare
and
Directorate General of Health Services
Ministry of Health and Family Selfare
Government of India
under the
Government of India
World Health Organization Collaborative Programme

April 2011