PSM Probe

PSM PROBE-RECENT PSM UPDATES FOR NEET/ INI-CET 2023
February, 2023
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DAMS PSM 1
Dear friends,
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In your big journey, this is a small contribution. This pdf is a collection of
all the updates that have been added recently and along with that there
are a few topics which most of us face difficulty while reading. A quick look
through this file will be fruitful.
I want to express my special thanks of gratitude to Dr. Sumer Sethi,

Director DAMS for his valuable guidance. Big thanks to Dr. Sidharth Sekhar
Mishra, PSM faculty for his support and guidance in collecting all updates
and compiling.
I wish you all a very good luck. May god bless you all.
DAMS PSM 2
CONTENTS
S.No. Topic
1. India Recent Data

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2. Recent Schemes/ policies by GoI
3. Immunization related updates in India

Section-I
4. Most Common cause of death in India
5. eHealth and Telemedicine
6. Essential Medicine
7. Prophylaxis
8. Leprosy
9. TB and NTEP
10. HIV-AIDS including Management of Infant born to HIV mother
11. Rabies
Section-II
12. IPHS 2022
13. Biomedical waste management including COVID waste
14. Nutrition update NIN-2020
15. Updates in Health Indicator
16. Food Adulterants
Use code KASHMED191 for discount on eMedicoz app
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DAMS PSM 3
1. INDIA RECENT DATA
Current value Source

Birth rate No. of live births × 1000 19.5 SRS-2022
Mid-year Population
Death rate No. of deaths in year × 1000 6.0 SRS-2022 Page | 4
Mid-year Population
Growth rate CBR-CDR/10 1.3% SRS-2022
Sex ratio No. of females per 1000 males 1020 NFHS-5

Sex ratio at birth 907 SRS-2022
TFR Average number of children that 2.0 NFHS-5
would be born to a woman in her
entire lifetime
Unmet need Women sexually active but not 9.4 NFHS-5
using any contraceptive method
Institutional Giving birth to a child in a medical 88.6% NFHS-5
delivery institute under trained medical
personnel
Infant Mortality Infant deaths × 1000 28 SRS-2022
Rate Live birth
Neonatal Mortality Neonatal deaths × 1000 20 SRS-2022
Rate Live birth
Under 5 Mortality Deaths in < 5 years age × 1000 32 SRS-2022
Rate live birth
Child survival index 1000-U5MR
10
Child death rate Death in 1-4 year × 1000 denominator is not live
MYP of children 1-4 year birthPYQ
Maternal Mortality Maternal deaths × 1,00,000 97 SRS MMR
Ratio Live birth Bulletin
Maternal Mortality Maternal deaths × 1,00,000 6.0 SRS MMR
Rate Women in reproductive age group Bulletin
Life time risk of 0.21% SRS MMR
maternal mortality Bulletin
DAMS PSM 4
2. Recent schemes/ policies by Government of India
2.1 UN declared 2023 as “International Year of Millet”

o Millets are smaller grains which are
eaten without removing outer layer
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o Popular millets are Ragi (Finger
millet), Bajra (Pearl Millet), Jowar
(Sorghum)
o Significance of millets:
▪ Gluten free, low glycemic index
▪ Less expensive
▪ Nutritionally superior
▪ Super crop at growing-requires less water, resilient to climate
change
▪ Ragi-Rich in calcium, Jowar may induce pellagra
2.2 World Health Day-2023

• On 7 April 2023-World Health Day ̶ the World Health Organization will
observe its 75th anniversary.
• Theme-Health for all
2.3 National Strategic Plan and Roadmap for Leprosy 2023-2027

• Vision: Leprosy free India with
o zero infection and disease,
o zero disability,
o zero stigma and discrimination.
• Goal: Accelerate towards achieving Interruption of Leprosy Transmission in India.
• Specific objectives:
1) Strengthen leadership, commitment, and partnerships
2) Acceleration of Case Detection
3) Provision of Quality Services
4) Enhanced measures for Prevention of Disease, Disabilities, Stigma,
Discrimination and Violation of Human Rights
5) Digitalization of Surveillance Systems
DAMS PSM 5
2.4 National Suicide prevention strategy: Reduction in suicide mortality by 10% by

2030
• establish effective surveillance mechanisms for suicide
• Establish psychiatric OPD
• Integrate a mental well-being curriculum in all educational institutions
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within the next eight years.
• It envisages developing guidelines for responsible media reporting of
suicides, and restricting access to means of suicide.
2.5 KIRAN: To provide support to people facing anxiety, stress, depression,

suicidal thoughts and other mental health concerns.
2.6 Manodarpan: It is aimed to provide psychosocial support to students,

family members and teachers for their mental health and well-being during
the times of Covid-19.
2.7 Cervavac: India’s first indigenous cervical cancer vaccine

• named qHPV Quadrivalent Human Papillomavirus Vaccine.
• It is a quadrivalent vaccine against HPV 6,11,16, 18
• Type: virus like particle
• Schedule: 2 doses (0 and 6 months), 3 doses for immunocompromised (0, 1, 6
months)
• Dose and route: 0.5 ml IM
• Developed by Serum Institute of India
2.8 HPV vaccine in 9 to 14 years age:

• India is expected to add HPV vaccine for 9 to 14 years age group under UIP
• This will be provided primarily through schools.
2.9 Tele-MANAS: Tele Mental Health Assistance and Networking Across

States
• free tele-mental health services all over the country.
• The programme includes a network of 23 tele-mental health centres
of excellence, with NIMHANS being the nodal centre.
• Toll-free, 24×7 helpline number (14416) has been set up across the
country
DAMS PSM 6
2.10 EYE (Eliminate Yellow Fever Epidemics) Strategy
3 objectives 1. protect at-risk populations;

2. prevent international spread; and
3. contain outbreaks rapidly.
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5 components • affordable vaccines and sustained vaccine
market;
• strong political commitment at global,
regional and country levels;
• high level governance with long-term
partnerships;
• synergies with other health programmes and
sectors; and
• research and development for better tools
and practices
2.11 Pradhan Mantri TB Mukt Bharat Abhiyan: Community support to TB

patients
o The Ni-kshay Mitra shall provide additional
▪ support to all the on-treatment TB patients
▪ who have given consent for support.
o The support includes
▪ Nutritional support
▪ Additional investigations for the diagnosed TB patients
▪ Vocational support
▪ Additional nutritional supplements
o Min 1 year support commitment
o Consent can be physical consent or online OTP based consent.
o Nikshay Mitra id will be generated.
o Ni-kshay Mitra can be an individual Co-operative, Corporate, Elected
representative, Individual, Institution, NGO, Political Party
2.12 iNCOVACC: First Intranasal COVID19 vaccine

• Route: Intranasal covid vaccine
• Dose: 0.5 ml in 8 drops, 4 drops in each nasal
• Developed by: Bharat Biotech
• Type: Adenovirus vector-based vaccine
2.13 AYUSHMAN BHARAT DIGITAL MISSION

• Launched in September 2021
• A health ID for every citizen
• Healthcare professional registry and
health care facility registry of all health
care providers
DAMS PSM 7
• Currently implemented in pilot phase in 6 UTs

2.14 National Action Plan for Dog Mediated Rabies Elimination (NAPRE)
• This action plan was introduced as a roadmap to
eliminate rabies by 2030.
• Inter-ministerial coordination
• Availability of anti-rabies vaccine and Page | 8
immunoglobulins at every health facility
2.15 PM POSHAN:
• Pradhan Mantri POshan SHAkti Nirman
• Scheme launched by GoI to replace Mid day meal scheme
• Launched for 5 years 2021-22 to 2025-26
• Coverage: same as mid-day meal scheme i.e. class I to class VIII.
• Bal Vatikas: includes pre school children also (this was not included in mid
day meal scheme)
• Poshan Vatika: nutritional garden in school premises
• Tithi bhojan: Community participation programme in which people
provide special food to children on special occasion/ festival
• Direct bank transfer
• Nutritional experts in every school
2.16 Malaria vaccine
• WHO recommends RTS,S/AS01 malaria
vaccine be used for the prevention of P.
falciparum malaria in children living in
regions with moderate to high
transmission as defined by WHO.
2.17 WHO Global centre for traditional medicine
• The Union Cabinet, approved the establishment of a World Health Organization

Global Centre for Traditional Medicine (WHO GCTM) at Jamnagar, Gujarat.
• The WHO GCTM, to be established under the Ministry of AYUSH, will be the first
and only global outposted centre (office) for traditional medicines.
DAMS PSM 8
2.18 INSPIRE: Seven strategies for ending violence against children

I- Implementation and enforcement of laws
N- norms and values
S- safe environment
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P- parent and caregiver support
I- Income and economic strengthening
R- response and support services
E- education and life skill
❑ Abhiyan Indradhanush:
• Change of bedsheets according to VIBGYOR
pattern in ESIC hospitals to give more
emphasize on hygiene and cleanliness in
hospitals.
• Under ministry of labour
❑ MPCDSR
• In September 2021, MoHFW launched Maternal Perinatal Child Death Surveillance
Response Software (MPCDSR).
• It is a one-stop integrated information platform to eliminate preventable maternal
mortality and streamline the maternal and child death audits across the country
❑ MusQan:
• launched to ensure provision of timely, appropriate,
quality and safe services to children in public health
facilities.
DAMS PSM 9
3. Updated Immunization schedule: (from 1st Jan 2023)

a. Third dose of f-IPV added at 9 months.
b. At 6 and 14 weeks: 0.1 ml given Intradermal on right arm
c. At 9 months: 0.1 ml given Intradermal on left arm
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*Please note
In case of Measles
Outbreak, MR vaccine can
be given from 6 months to
9 months.
This is known as Zero Dose
of MR.
❑ U-Win
d. To digitise India’s Universal Immunization Programme
e. The platform will be used to register and vaccinate every
pregnant woman, record her delivery outcome, register
every new born, administer birth doses and all vaccination
events thereafter
DAMS PSM 10
4. Top Causes of deaths in India
All age group Neonatal Infant 1-4 years

MC Prematurity & low birth Prematurity & low Injuries
Cardiovascular weight birth weight
diseases (Pneumonia Page | 11
last year)
2nd MC Birth asphyxia & birth Pneumonia Pneumonia
Respiratory trauma
diseases (Injuries last
*in urban area 2nd year)
MC is malignancy
3rd MC Neonatal pneumonia Birth asphyxia & Other NCDs
Malignancy birth trauma
*in urban area 3rd (Diarrhoeal
MC is respiratory diseases last
disease year)
DAMS PSM 11
5. eHealth and Telemedicine in India
e-Hospital Software for managing hospital in government sector

eRakt kosh Digitise blood banks
eSanjeevani web based telemedicine solution Page | 12
eVin Strengthening vaccine supply
Kilkari Mobile app delivers free reproductive, ,aternal and

neonatal care
National health portal Awareness about health, government programs and

services
Mera aspataal Patient Feedback on service quality
mDiabetes For prevention and care of diabetes
m-cessationPYQ Quit tobacco
TB
PYQ
Nikshay
Nikushth online reporting of leprosy
DAMS PSM 12
6. ESSENTIAL & COUNTERFEIT MEDICINES

ESSENTIAL MEDICINES
• These are those medicines that satisfy the priority health care needs of the
population.
• These are intended to be available at all the times in adequate amounts, appropriate Page | 13
dose, assured quality and affordable price
• Which medicine is essential is National responsibility and may differ in different
situation.
NATIONAL LIST OF ESSENTIAL MEDICINES
• The first list of essential medicine was prepared in 1966 and was subsequently revised
in the year 2003, 2011, 2015 and 2022.
• India adopted concept of essential medicines by WHO but India’s list of essential
medicines is different due to national circumstances.
• The criteriaPYQ used for inclusion of a medicine in national list is as follows:
1. The medicine should be approved/ licensed in India.
2. Medicine should be useful in a disease which is public health problem in India.
3. Stable under storage conditions
4. Cost effective
5. Fixed dose combinations are generally not included unless they have added
benefits like decrease side effects increased efficacy
6. The list is based on level of health care like Primary (P), secondary (S) and
tertiary (T) because treatment facility and trained personnel are different at
these levels.
NATIONAL LIST OF ESSENTIAL MEDICINE 2022
• It comprised 384 drugs across 27 categories including category for Management of
COVID 19. While the list has 34 new drugs, 26 drugs from the 2015 list have been
dropped.
COUNTERFEIT MEDICINESPYQ
• Any medicine which is produced with an Intention to cheat is counterfeit medicine.
• This can include
o Mis-labelling (including expiry date)
o No active ingredient
o Wrong ingredient
o Correct ingredient in insufficient quantity
Identifying a sub-standard or falsified medical product

• Examining the packaging condition, spelling mistake
• Matching details on outer packaging and inner packaging
DAMS PSM 13
• Ensuring the medicine looks correct like colour

• Discussing with your doctor if you suspect the product is not working properly
and reporting your medicines regulatory authority
7. Post Exposure prophylaxis/ Contact management:
Diseases Prevention Page | 14

Chicken pox • Vaccine: Live attenuated vaccine OKA strain Given 0.5 ml Sub-
cutaneous (Contraindicated in pregnancy, infancy and
immunocompromised)
• Immunoglobulins: VZIG 12.5 IU/kg (if vaccine contraindicated)
• Antibiotics: Acyclovir for 7 days if Ig and vaccine not indicated
DiphtheriaPYQ Erythromycin for every contact irrespective of Vaccination status
TB TB preventive therapy (check TB section)
Measles Vaccine: Available as MR/ MMR/ MMRV

Immunoglobulin: 0.25 IU/kg body weight (within 3-4 days of exposure)
(Don’t give Ig and vaccines together, delay vaccine 2-3 months after
giving Ig)
H1N1PYQ Oseltamivir (adults or > 40 kgs: 75 mg OD)

< 3 months-not recommended
Malaria Doxycycline/ Mefloquine/ Primaquine/ Chloroquine/ Proguanil
Filariasis PYQ DEC with (Albendazole or Ivermectin) (D, A or I)

Triple drug: DEC+Albendazole+Ivermectin (DAI)
Mass drug administration is done
Rabies Check rabies section
Yellow fever Live attenuated vaccine 17D for all travellers to endemic areas
Vaccine certificate is mandatory
Valid after 10 days to lifetime
LeprosyPYQ Single dose rifampicin 600 mg (>15 years)
Cholera Tetracycline or Doxycycline
DAMS PSM 14
8. Leprosy:
❑ Recent data:
• Leprosy Prevalence: 0.45/10,000
• Leprosy ANCDR: 5.52/1,00,000
❑ Recent update:
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• Sparsh: leprosy awareness campaign
• Sapna: Leprosy Mascot
• Welfare allowance raised from 8000 to Rs
12,000
❑ TreatmentPYQ:
RDC for 6 months in case of PB and for 12 months in case of MB
PB MB
6 months duration 12-month duration
Day-1 Day-1
Rifampicin Rifampicin
Clofazimine Clofazimine
Dapsone Dapsone
Day 2-28 Day 2-28
Clofazimine Clofazimine
Dapsone Dapsone
DAMS PSM 15
9. TB and NTEP
o 4S Screening: Screening of 4 symptoms: cough, fever, weight loss and night
sweats
o Nikshay poshan: Rs 500 per month for nutritional assistance
o Nikshay samparak: Toll free helpline 1800116666
Page | 16
o TB Arogya saathi: Mobile app for TB information, TB symptoms
o TB travel reimbursement: Rs 750 coming from notifiable tribal area
o TB notification incentives: Rs 500 for notification and Rs 500 for successful
outcome
o Neglecting TB notification: IPC 269 and 270
o TB supporter incentives: Rs 2000 for DS-TB and Rs 5000 for DR-TB
o H-Mono TB: resistance to Isoniazid
o Rifampicin Resistant TB (RR-TB): resistance to rifampicin
o MDR TB: resistance to isoniazid and rifampicin
o Pre XDR TB: resistance to isoniazid and rifampicin with any FQ
o XDR TB: resistance to isoniazid and rifampicin with any FQ and at least any
one Group A
o TB Preventive Therapy: treatment offered to individuals who are at high risk
of developing tuberculosis
TPT Regimen
6H regimen: 6 months daily H (isoniazide) monotherapy
3HP Regimen: 3 months weekly H (isoniazide) and P (rifapentine)
4R Regimen: 4 months daily R (rifampicin)
6Lfx Regimen: 6months daily Lflx
o TB treatment regimen:
Drug sensitive TB 2 months HRZE 4 months HRE
H Mono 6 months Lfx RZE

Shorter oral 6 months 5 months
Bedaquiline containing ❑ Levoflox, ❑ Levoflox,
MDR regimen ❑ Clofazimine ❑ Clofazimine
❑ Pyrazinamide ❑ Pyrazinamide
❑ Ethambutol ❑ Ethambutol
❑ High dose
isoniazide
Ethionamide
❑ Bedaquilline
Oral longer MDR/XDR 18 -20 months
TB Regimen • Bedaquiline
• Linezolid
• Levoflox
• Clofazimine
• cycloserine
DAMS PSM 16
10. HIV/AIDS
❑ Post Exposure prophylaxis
Preferred regimen Alternate regimen

Page | 17
Age > 10 years Tenofovir Tenofovir
Weight > 30 kgs Lamivudine Lamivudine
Dolutegravir Lopinavir/ Ritonavir
Age 6-10 years Zidovudine If HB <9gm/dl replace
Weight 20-30 Lamivudine zidovudine with abacavir
kgs Dolutegravir
Age <6 years Zidovudine
Weight < 20 kgs Lamivudine
Lopinavir/ Ritonavir
❑ When to start ART?
All persons diagnosed with HIV infection should be initiated on ART regardless of the
CD4 count or WHO Clinical Stage or age group or population sub-groups.
❑ What is the preferred regimen for ART?
Tenofovir (TDF 300 mg) + Lamivudine (3TC 300 mg) + DOLUTEGRAVIR (DTG 50 mg)
regimen (TLD) as FDC in a single pill once a day (at a fixed time every day as per
patient’s convenience)
❑ What is Rapid ART initiation

is defined as “ART initiation within seven days from the day of HIV diagnosis”.
❑ What is IRIS
“The worsening of signs and symptoms due to known infections, or the development
of disease due to occult infections within 6 weeks to 6 months after initiating ART,
with an increase in CD4 count.”
This is a condition that can occur shortly after a person starts ART for the first time. It
is a spectrum of clinical signs and symptoms resulting from the body’s ability to
mount an inflammatory response associated with immune recovery
❑ What is Advanced HIV disease

For adults and adolescents, and children older than 5 years, advanced HIV disease is
defined as CD4 cell count <200 cells/mm3 or WHO stage 3 or 4 event. Includes both
ART-naive individuals and those who interrupt treatment and return to care.
All children younger than 5 years of age (who are not already receiving ART and
clinically stable) with HIV are considered as having advanced HIV disease.
DAMS PSM 17
❑ HIV-TB coinfected Patients

Start ATT first then ART
ART should be started as soon as possible within 2 weeks of initiating TB treatment,

regardless of CD4 cell count, among PLHIV (except when signs and symptoms of
meningitis are present). Page | 18
Among PLHIV with TB meningitis, ART should be delayed at least 4 weeks (and
initiated within 8 weeks) after treatment for TB meningitis is initiated.
❑ ART regimen in pregnant and breastfeeding

Tenofovir + Lamivudine +Dolutegravir
❑ ART regimen in Pregnant women presenting in active labour
Intra-partum Post-partum
Pregnant women Initiate TLD Continue TLD
presenting in active TDF (300 mg) + 3TC (300 TDF (300 mg) + 3TC
labour mg) + DTG (300 mg) +
No ART initiated in (50 mg) DTG (50 mg)
past
❑ Co-trimoxazole prophylaxis in adults:

❑ Initiation Cotrimoxazole prophylaxis must be initiated in PLHIV
with CD4 count <350 cells/mm3 or with WHO clinical
stage 3 and 4
❑ Dosage One double-strength tablet or two single-strength
tablets once daily – total daily dose of 960 mg (800
mg SMZ + 160 mg TMP)
❑ Discontinuation When CD4 count is greater than 350/mm3 on two
different occasions tested 6 months apart, with an
ascending trend and devoid of any WHO clinical stage
3 or 4 conditions
DAMS PSM 18
❑ Co-trimoxazole prophylaxis in adults:
Group When to start When to stop

cotrimoxazole
All HIV-exposed From 6 weeks of age HIV infection has been reliably excluded by a Page | 19
infants/children negative antibody test at 18 months,
regardless of ARV initiation.
All HIV-infected Regardless of WHO At 5 years of age, when clinical or
infants and stage or CD4 counts immunological indicators confirm restoration
children up to 5 or CD4% of the immune system for more than 6
years of age months i.e., in a child >5 years of age with a
WHO T- stage 1 or 2 and CD4 count of >350
cells/
mm3 on two occasions not less than 6
months apart
All HIV-infected WHO Stages 3 and When clinical or immunological indicators
children >5 4 regardless of CD4 confirm restoration of the immune system
years count or for more than 6 months i.e., in a child >5
of age CD4 <350 cells/mm3 years of age with a WHO T stage 1 or 2 and
regardless of WHO CD4 count of >350 cells/mm3 on two
staging occasions not less than 6 months apart
DAMS PSM 19
❑ Infant ARV prophylaxis
Risk status Drug Duration

Low risk Syrup Nevirapine (NVP) From birth till 6 weeks
Infants born to mothers with or
suppressed viral load (<1000 Syrup Zidovudine (in Page | 20
copies/ml) done any time after 32 situations where NVP will
weeks of pregnancy up to delivery not be effective):
High risk
❑ Infants born to HIV-positive
mother not on ART
❑ Maternal viral load not done In case of Exclusive
after 32 weeks of pregnancy Replacement Feeding
till delivery (ERF):
❑ Maternal viral load not Syrup NVP + Syrup From birth till 6 weeks
suppressed between 32 Zidovudine of age
weeks of pregnancy till In case of Exclusive
delivery Breastfeeding (EBF):
❑ Mother newly identified HIV From birth till 12
positive within 6 weeks of weeks of age
delivery
SERVICE DELIVERY MODEL FOR HIV Care, support and treatment
Functions
Link ART centre • Monitor PLHIV on ART
• Drug refill to patients on ART
• Treatment of minor opportunistic infection
• Management of minor ADR
Link ART plus centre • ART initiation after written approval from NACO/SACS
ART centre • ART Initiation
ART Plus centre • Conduct SACEP to review PLHIV for second line ART
Centre of excellence • Conduct SACEP to review PLHIV for second line ART
• Management of complex Opportunistic infection
• ADR of ART
• Training
• Research
DAMS PSM 20
Management of Infant born to HIV positive mother
“HIV-exposed infant/child”
❑ Defined as infants and children born to mothers infected with HIV, until HIV infection
can be reliably excluded or confirmed in them.
Page | 21
❑ DIAGNOSIS
 The diagnosis of HIV infection in infants younger than 18 months is different
from that in adults.
 The standard diagnostic tool for HIV infection in adults is antibody testing but
it has limited utility in new-borns and infants because of maternal antibodies
which are present in an infant’s blood for up to 18 months after birth making
it difficult to differentiate maternal from infant antibody.
 Therefore, use of qualitative nucleic acid testing (NAT) is recommended in
infants for diagnosing HIV.
❑ BREASTFEEDING
 Exclusive breastfeeding up to 6 months as it maximizes the chances of survival
of the infant.
 Mixed feeding increases the risk of transmission of HIV and should be
avoided
❑ ARV prophylaxis
 All HIV exposed infants should be initiated on ARV prophylaxis soon after
birth for a duration of 6 to 12 weeks.
❑ IMMUNIZATION
 Asymptomatic HIV exposed babies should be given all the vaccines in the
National Immunization Programme
 BCG should be given to all HIV exposed infants at birth but if delayed avoid
BCG in symptomatic CLHIV
 Live vaccines should be avoided in severely immune compromised
(CD4<15%) and/or symptomatic infants and children
 Rotavirus vaccine and pneumococcal vaccine should be given in HIV exposed
infants due to their risk for diarrhoea and pneumonia
 Inactivated Japanese Encephalitis (JE) vaccine is safe for use in CLHIV
 Vitamin A supplementation as per the national immunization schedule
❑ Co-trimoxazole prophylaxis:
 All HIV exposed infants should get co-trimoxazole prophylaxis from the age
of 6 weeks
 Continue CPT until child is proven HIV negative on all three serological tests
at 18 months of age or later if still being breastfed
DAMS PSM 21
Page | 22
DAMS PSM 22
11. Rabies
❑ Animal bite wound management:

1. Wound washing under running water with antiseptic soap
2. Avoid suturing. If can’t delay suturing
Page | 23
3. TT prophylaxis
❑ Passive immunization with immunoglobulinsPYQ
Indications:
❑ All category III

❑ All immunocompromised Category II and III patient
Types and dosages
Type Dose
Human 20 IU/ kg
Equine 40 IU/ kg
Administration:
❑ As much as possible immunoglobulins dose should be infiltrated carefully to

wounds
❑ No need to give 7 days after bite
DAMS PSM 23
❑ Rabies vaccine
• All animal bite victims of category II and category III
• Two regimens are used commonly in India. Any one of them can be used
Post exposure Pre exposure Re-exposure Page | 24

prophylaxis prophylaxis prophylaxis
Updated Essen Updated Essen Updated Essen
Thai red Thai red Thai red
cross cross cross
Route ID IM ID IM ID IM
Dose 0.1 ml 0.5 ml 0r 1 0.1 ml 0.5 ml 0r 1 0.1 ml 0.5 ml 0r 1
ml ml ml
Site 2 site 1 site 1 site on 1 site 1 site on 1 site
right and Deltoid or shoulder Deltoid or shoulder Deltoid or
left anterolateral anterolateral anterolateral
shoulder aspect of aspect of aspect of
thigh in thigh in thigh in
children children children
No. of 2 1 1 1 1 1
injection
per visit
Days 0,3,7,28 0,3,7,14,28 0,7 0,7 0,3 0,3
Booster Booster on
on day day 21 or 28
21 or 28
Total no. 4 5 3 3 2 2
of visits
Give immunoglobulins High risk group should In case of
in category III and if have their neutralizing documented proof
immunocompromised antibody titre checked of vaccine within 3
give in category II and III every 6 months for months nothing to
initial 2 years after be given just wound
primary vaccine washing
If less than 0.5 IU/ml a If immunoglobulins

booster is given in last episode
recommended no need to repeat
immunoglobulin
even if it’s a
category III bite
DAMS PSM 24
12. IPHS 2022
Health and Wellness Centre- Sub Health Centre
Population norms for Health and Wellness Centre- Sub Health Centre
Plains Hilly
HWC-SHC 5000 3000 Page | 25
UHWC 15,000-20,000 -
Oxygen delivery system in HWC-SHC & UHWC
B type 1500 l oxygen Oxygen

cylinder concentrator
HWC-SHC/UHWC 3 1
Staff in HWC-SHC
Required number
Community Health Officer 1
(CHO)
MPHW (F) 1
MPHW (M) 1
• 1 ASHA for 1000 population in rural
Staff in UHWC
Staff in UHWC
Required number
Medical officer 1
Staff nurse 1
MPHW (M) 1
• 1 ASHA for 2000 population in urban
Roles and responsibilities of CHO
• Clinical care
• Coordinate tele-health
• Coordinate with MPHW M and MPHW F
• Coordinate with community platforms like VHSNC, MAS, SHG
• Chronic condition screening
DAMS PSM 25
Health and Wellness Centre- Primary Health Centre
Population norms:
Population norms for Health and Wellness Centre- Primary Health Centre
Plains Hilly
Rural PHC 30,000 20,000 Page | 26
Urban PHC 50,000 -
Polyclinic 2.5 lakh-3 lakh -
Oxygen delivery system for Health and Wellness Centre- Primary Health Centre
Oxygen delivery system for Health and Wellness Centre- Primary Health Centre
B type 1500 l oxygen Oxygen concentrator
cylinder
Rural PHC 4 1
Urban PHC 4 1
24×7 PHC/UPHC 5 1
DAMS PSM 26
13. Biomedical Waste Management and COVID Waste Management
Category Type of waste Type of bag or container
YellowPYQ ❑ Human anatomical waste Yellow coloured non-chlorinated Page | 27

❑ Animal anatomical waste plastic bags
❑ Soiled waste
❑ Microbiological and
biotechnological waste
❑ Expired or discarded
medicines
❑ Chemical waste
❑ Chemical liquid waste
RedPYQ Contaminated Waste (Recyclable) red coloured

(a) Wastes generated from non-
disposable items such as tubing, chlorinated
bottles, intravenous tubes and sets, plastic bags
catheters, urine bags, syringes
(without needles and fixed needle
syringes) and vaccutainers with their
needles cut) and gloves.
WhitePYQ Sharp metallic waste Puncture proof, Leak proof, tamper
Needles, syringes with fixed needles, proof containers
needles from needle tip cutter or
burner, scalpels, blades, or any other
contaminated sharp object that may
cause puncture and cuts.
BluePYQ Broken glass Cardboard boxes with blue colored

Metallic body implants marking
DAMS PSM 27
COVID Waste
Waste Disposal
yellow ❑ Mask triple layer or N95
❑ Head cover
❑ Shoe cover Page | 28
❑ Disposable linen gown
Red ❑ Googles
❑ face shield
❑ Splash proof apron
❑ Plastic coverall
❑ Hazmat suits
❑ Nitrile gloves
❑ used masks, gloves and tissues or swabs
yellow contaminated with blood / body fluids of COVID-19
patients
❑ PPEs doffed by healthcare workers accompanying
diseased body of COVID-19 patient to crematorium /
graveyards
Keep for 72 hours ❑ Used masks from visitors to crematorium/ graveyards

in a paper bag and including crematorium staff
then dispose like ❑ Used masks of caregivers at home isolation
general waste
❑ Keep separate color-coded bins (with foot operated lids)

❑ double layered bags (using 2 bags) should be used for collection of waste.
❑ Use a dedicated collection bin labelled as “COVID-19” to store COVID-19
❑ The (inner and outer) surface of containers/bins/trolleys used for storage of
COVID-19 waste should be disinfected with 1% sodium hypochlorite
solution daily
❑ Feces from COVID-19 confirmed patient, who is unable to use toilets and
excreta is collected in diaper, must be treated as biomedical waste and
should be placed in yellow bag/container
DAMS PSM 28
14. Nutrition update NIN-2020

Energy requirement
Male Female Pregnant lactating
Sedentary 2110 1660 +350 0 to 6 month- +600 kcal

>6 months- +520 kcal Page | 29
Moderate 2710 2130
heavy 3470 2720
Micronutrient requirementPYQ
Male Female Pregnant lactating Elderly Elderly

male female
Protein 54 46 2nd trimester: 0 to 6m: 54 46

(g/d) +9.5 gm +17
3rd trimester: 7-12m:

+22 gm +13
Calcium 1000 1000 1000 1200 1200 1200
(mg/d)
Zinc 17 13 14.5 14 17 13
(mg/d)
Iodine 150 150 250 280 150 150
(mcg/d)
Iron 19 29 40 23 19 19
(mg/d)
Folate 300 220 570 330 300 200
(mcg/d)
Vitamin A 1000 840 900 950 1000 840
(mcg/d)
Vitamin C 80 65 +15 +50 80 65
(mg/d)
Vitamin D 600 600 600 600 800 1200
(IU/d)
Reference Indian man and woman
Reference Indian Man Reference Indian Woman

Age 19-39 years
Weight 65 kgs 55 kgs
Height 1.77 m 1.62 m
BMI 20.75 20.95
DAMS PSM 29
15. Health Indicator
MDPI HDIPYQ PQLIPYQ GHIPYQ

Health: Knowledge Literacy Undernourishment
1) Nutrition in population
2) Child mortality Page | 30
Education: Income IMR Child stunting
3) Year of schooling Child wasting
4) School attendance
Standard of living: Life expectancy at Life Child mortality
5) Cooking fuel birth expectancy at
6) Sanitation 1 year
7) Drinking water
8) Electricity
9) Housing
10) Assets
India’s rank is 66 out of 109 India’s score: 0.633 65 India’s score: 29.1
countries
Rank: 132 India’s
rank:107/121
countries
India falls under

serious hunger.
DAMS PSM 30
16. Food Adulterants

Disease Toxin: Food item Special points
BOAA Khesari dal Prevention is

(Lathyrus sativus) a) Banning crop
Beta Oxalyl b) Vitamin c prophylaxis Page | 31
Amino c) removal of toxin (steeping
Lathyrism Alanine method and parboiling)
d) genetic modification
Epidemic dropsy Sanguinarine Contamination of Test done for detection are:

mustard oil with Nitric acid test and paper
argemone mexicana chromatography test
oil
Endemic ascites Pyrrolizidine Millets are adulterated De-weeding of Jhunjhunia plants

with crotalaria seeds
(locally known as
Jhunjhunia)
Ergotism Ergot fungus Jowar, rye bajra Ergot infested grains can be easily
removed by floating them in 20%
(Claviceps salt water.
purpurea)
Aflatoxicosis Aflatoxin Mainly groundnut also Keep moisture content below 10%
maize, parboiled rice Food grains should be stored after
drying only
DAMS PSM 31

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PSM PROBE-RECENT PSM UPDATES FOR NEET/ INI-CET 2023

I want to express my special thanks of gratitude to Dr. Sumer Sethi,

1. India Recent Data

3. Immunization related updates in India

4. Most Common cause of death in India

5. eHealth and Telemedicine

10. HIV-AIDS including Management of Infant born to HIV mother

12. IPHS 2022

13. Biomedical waste management including COVID waste

14. Nutrition update NIN-2020

15. Updates in Health Indicator

16. Food Adulterants

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1. INDIA RECENT DATA

Current value Source

Sex ratio No. of females per 1000 males 1020 NFHS-5

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2. Recent schemes/ policies by Government of India

2.1 UN declared 2023 as “International Year of Millet”

2.2 World Health Day-2023

2.3 National Strategic Plan and Roadmap for Leprosy 2023-2027

2.4 National Suicide prevention strategy: Reduction in suicide mortality by 10% by

2.5 KIRAN: To provide support to people facing anxiety, stress, depression,

2.6 Manodarpan: It is aimed to provide psychosocial support to students,

2.7 Cervavac: India’s first indigenous cervical cancer vaccine

2.8 HPV vaccine in 9 to 14 years age:

2.9 Tele-MANAS: Tele Mental Health Assistance and Networking Across

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2.10 EYE (Eliminate Yellow Fever Epidemics) Strategy

3 objectives 1. protect at-risk populations;

2.11 Pradhan Mantri TB Mukt Bharat Abhiyan: Community support to TB

2.12 iNCOVACC: First Intranasal COVID19 vaccine

2.13 AYUSHMAN BHARAT DIGITAL MISSION

• Currently implemented in pilot phase in 6 UTs

2.17 WHO Global centre for traditional medicine

• The Union Cabinet, approved the establishment of a World Health Organization

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2.18 INSPIRE: Seven strategies for ending violence against children

N- norms and values

I- Income and economic strengthening

R- response and support services

E- education and life skill

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3. Updated Immunization schedule: (from 1st Jan 2023)

4. Top Causes of deaths in India

All age group Neonatal Infant 1-4 years

5. eHealth and Telemedicine in India

e-Hospital Software for managing hospital in government sector

eSanjeevani web based telemedicine solution Page | 12

eVin Strengthening vaccine supply

Kilkari Mobile app delivers free reproductive, ,aternal and

National health portal Awareness about health, government programs and

mDiabetes For prevention and care of diabetes

m-cessationPYQ Quit tobacco

Nikushth online reporting of leprosy

6. ESSENTIAL & COUNTERFEIT MEDICINES

Identifying a sub-standard or falsified medical product

• Ensuring the medicine looks correct like colour