Sums Answers

X ¯x X- X¯ (X-X¯)²
1. The mark obtained by 12 students

at the entrance examination were 24 33 -9 81
as follows
36 33 3 9
24,36,34,35,33,38,38,36,42,23,20,38
34 33 1 1
Calculate the standard deviation
and coefficient of variations 35 33 2 4
• Mean = ∑x / n = 397/12 =33.08

33 33 0 0
• Standard deviation=
38 33 5 25
=
38 33 5 25
=
=6.9 36 33 3 9
 Co efficient of variation 42 33 9 81
= SD/mean x100
23 33 -10 100
=6.9/33.08x100
20 33 -13 169
=20.8 %
38 33 5 25
Total 397 65 529

2.The following table gives the recorded age of onset of diseases for a
group of 20 patients suffering from diabetes mellitus. Recorded age in
years are as follows
39,50,26,45,47,51,33,40,51,53,
66,63,55,57,41,61,47,44,48,54
Find the arithmetic mean ,mode and median
• Mean= ∑x/n
= 971/20
= 48.55 years
• Mode= 47 ,51years
• Median
Arranging the given data in ascending order
26,33,39,40,41,44,45,47,47,48,50,51,51,53,54,55,57,61.63,66
Median = 48+50/2 = 98/2 = 49years
,
3. The duration of illness in days in a group of patients suffering from upper
respiratory infection is given below
Duration of illness in days
9,7,11,9,8,4
6,12,6,8,8,5
Calculate the mean, median ,mode and standard deviation
• Mean = ∑x/n = 93/12 = 7.75 days
• Mode = 8days
• Median = 4,5,6,6,7,8,8,8,9,9,11,12
= 8+8/2
= 8 days
• Standard deviation=
=2.34days
x ¯x X- X¯ (X-X¯)²
4.The weight of 12 students (6 boys
and 6girls) of a particular class were 68 66 2 4
taken and tabulated weight of
students in Kilogram 65 66 1 1
Girls = 68,65,53,61,67,50
53 66 -13 169
Boys = 78,61,74,74,67,74
61 66 -5 25
Find the mean , median, mode,
mean deviation, standard deviation
and coefficient of variation 67 66 -1 1
Mean = ∑x / n = 792/12
50 66 -16 256
= 66 kg
78 66 12 144
Median=50,53,61,61,65,67,67,68,74,
74,74,78 61 66 -5 25
= 67+67/2 = 134/2 76 66 8 64
= 67 kg
74 66 8 64
Mode = 74 Kg
67 66 1 1
= 8.623 kg
74 66 8 64
Standard deviation=
= Total(792) 80 818
=8.623 kg.
Co efficient of variation
= SD/mean x100
= 8.623/66 x100
= 13.065%
Mean deviation = ∑(x-x¯) / n
= 80/12
= 6.67 Kg
5. A group of medical students wished to study the nutritional status of
children under one year in the set of three villages. They were divided into
three teams and Weighed the children using the salter weighing scale.
Given below are the weight of 100 children in kg .
Calculate mean , median ,mode
Class interval No of children(f)
5 -6 8
6-7 25
7-8 20
8-9 22
CI F(Frequency) Mid X F midX Cf(Cumulative
(Class 9-10 19
Frequency)
interval)
10-11 6
5-6 8 5.5 44 8
6-7 25 6.5 162.5 33
7-8 20 7.5 150 53
8-9 22 8.5 187 75
9-10 19 9.5 180.5 94

10-11 6 10.5 63 100
∑FmidX = 787
• Mean = ∑fmidX/n
= 787/100
= 7.87 kg
• Median = L + [n/2- cf] X CI
= 7+ (50-33) X 1
20
= 7 + 17/20 x 1
= 7+0.85
= 7.85 kg
• Mode = L + d1 X CI
d1+d2
=6+ 25-8 X1
(25-8) + (25-20)
= 6 + 17/22
= 6 + 0.77
= 6.77 kg
6.Marks obtained by 50 students in community medicine in final MBBS
Part 1 exam are as follows
calculate measures of central tendency

• Mean=∑fx/n= 3140/50 CI(class F X FX Cf
= 62.8 interval (cumulative
• Median = L + [n/2- cf] X CI Frequency)
F 40-50 5 45 225 5
= 60 + (25-23) X 10
50-60 18 55 990 23
15
60-70 15 65 975 38
= 60+0.132
70-80 7 75 525 45
= 60.132
• Mode = L + d1 X CI 80-90 5 85 425 50
d1+d2
∑FX = 3140
= 50 + 18-5 X 10
(18-5) + (18-15)
= 58.125
7. A prefinal undergraduate student visited IOG & had collected the
following details from a sample of 100 mothers
Calculate mean , median ,mode

CI(Classinterval) f x Fx Cf(cumulative frequency)
55-60 1 57.5 57.5 1
60-65 8 62.5 500 9
65-70. 5 67.5 337.5 14
70-75 55 72.5 3987.5 69
75-80 16 77.5 1240 85
80-85 14 82.5 1155 99
85-90 1 87.5 87.5 100
∑fx = 7365v
• Mean = ∑fx /n
= 7365\100
= 73.65 gms%
Median = L + [n/2- cf] X CI
= 70 + (50-14) X 5
55
= 70+3.25
= 73.27 gms%
• mode = L + d1 X CI
d1+d2
= 70 + 55-5 X5
(55-5) + (55-16)
=70 + 250/89
=72.81 gms%
8 .In a series of boys the mean systolic blood pressure was 120mm of Hg
and standard deviation was 10mm of Hg .In the same series mean height
and standard deviation was 160cms and 5 cms .Find which character
shows greater variation
• Coefficient of variation(COV) for BP = SD/Mean X100
=10/120 X 100
= 8.33 %
• Coefficient of variation(COV) for Height = SD/Mean X100
= 5/160 X 100
=3.125 %
Therefore, BP shows greater variation

.
9. In a dietary survey conducted as per of nutrional assessment in semi

urban area of tamil nadu the protein in take of 400 families is as given
below
Protien intake(gms per day) No of families
15-25 30
25-35 40
35-45 100
45-55 110
55-65 80
65-75 30
75-85 10
Find mean protein intake and also calculate median and mode
CI(Class f x fx Cf(cumulative
interval) frequency)
15-25 30 20 600 30
25-35 40 30 1200 70
35-45 100 40 4000 170
45-55 110 50 5500 280
55-65 80 60 4800 360
65-75 30 70 2100 390
75-85 10 80 800 400
∑fx = 19,000
• Mean = ∑fx/n
=19000/400
= 47.5 gms/day
• Mode = L + d1 X CI
d1+d2
= 45 + 110-100 X 10
(110-100) + (110-80)
= 45+10/40 X 10
= 45+2.5
= 47.5 gms/day
Median = L + [n/2- cf] X CI
= 45 + (200-170) X 10
110
= 45+30/11
= 45+2.727
= 47.73 gms/day
10. The IQ of 50 boys are given .find out the mean , median, mode of the
given IQ
IQ No of boys
0-20 3
20-40 4
40-60 3
60-80 4
80-100 13
100-120 12
120-140 8
140-160 3
CI(class f x fx Cf(cumulative
interval
Frequency)
0-10 3 10 30 3
20-40 4 30 120 7
40-60- 3 50 150 10
60-80 4 70 280 14
80-100 13 90 1170 27
100-120 12 110 1320 39
120-140 8 130 1040 47
140-160 3 150 450 50
∑fx = 4560
Mean IQ = ∑fx/n
= 4560/50
= 91.2
Median IQ = L + [n/2- cf] X CI
= 80 + (25-14) X 20
13
= 80+11/13 X 20
= 80+220/13
= 96.92
Mode IQ = L + d1 X CI
d1+d2
= 80 + ( 13-4 ) X 20
(13-4) + (13-12)
= 80+9/10 X 20
= 80+18
= 98
11.The midyear population of a town in the year 2008 was 1 lakh. The total
number of deaths was 1200. Deaths due to cholera were 100 out of the
total number of 1000 cases of cholera in that same year. Further deaths in
persons above 60 years were 250 among the 10,000 people of people
above 60 years.
Calculate
a) Crude death rate
b) Cause specific death rate
c) Age specific death rate
d) Case fatality rate
e) Proportional mortality rate
f) How will you investigate the outbreak of cholera? What steps would
you take if you are the health official in charge of the town?
Given Data
1) Mid-year population = 1,00,000

2) No.of deaths = 1200
3) Cholera cases = 1000
4) Death due to cholera = 100
5) Total population of >60 years = 10,000
6) Total deaths among > 60 years = 250
a) Crude death rate
= Number of deaths during the year x 1000
Mid-year population
= 1200 x 1000
1,00,000
= 12 per 1000 population
b) Cause specific death rate
Death rate due to cholera
= Number of deaths from cholera during a calendar year x 1000
Mid-year population in the same year
= 100 X 1000
1,00,000
c) Age specific death rate
Specific death rate in age group above 60 years
= Number of deaths of persons > 60 years during calendar year X 1000
Mid-year population of persons aged> 60 years in the same year

= 250 x 1000
10,000
d) Case fatality rate
= Total number of deaths due to a particular disease x 100
Total number of cases due to the same disease
= 100 x 100 /1000
= 10%
e) Proportional mortality rate for cholera
Number of deaths from the specific disease in a year x 100
Total deaths from all causes in that year
= 100 x 100
1200
= 8.33%
f) Proportional mortality rate for the persons aged >60years
= Number of deaths of persons aged above 60 yrs x 100
Total deaths of all age groups in that year
= 250 x 100
1200
= 20.83%
g) Investigation of cholera outbreak
 Verification of the diagnosis

 Notification
 Early case finding
 Establishment of treatment centres
 Rehydration therapy
 Adjuncts to therapy
 Epidemiological investigations
 Sanitation measures – water control, excreta disposal, food
sanitation, disinfection
 Chemoprophylaxis
 Vaccination
12. A town of population during the year 2006 of 1lakh had in that year,
2300 live births, 1100 deaths of all groups, 5 maternal deaths, 138 infant
deaths.
Calculate the crude death rate, growth rate, maternal mortality rate and
infant mortality rate.
Crude birth rate
= Number of live births during the year x 1000
Mid – year population
= 2300 X 1000
100000
• Crude death rate
= 1100 X 1000
100000

• Growth rate = Crude birth rate – Crude death rate (in percentage)
= 23 per 1000 – 11 per 1000
=1.2 %
Maternal mortality rate
= No. of maternal deaths during a given year x 1000
Total No. of Live births in the same area & year
= 5 x 1000
2300
= 2.17 per 1000 live births
Infant mortality rate
= No. of deaths of children less than 1 yr of age in a year x 1000
No. of live births in the same year
= 138 x 1000
2300
= 60 per 1000 live births

13. The following data relate to a town for the year 2000
Mid year population – 100000
No. of live births – 2400
No of deaths – 1040
No of late fetal deaths – 40
Deaths under 1 week of age – 40
Deaths in first four weeks – 120
No. of infant deaths - 160
Calculate the crude birth rate, crude death rate, infant mortality rate,
perinatal mortality rate and neonatal mortality rate.
Crude birth rate
= 2400 X 1000
100000

 Crude death rate
= 1040 X 1000
100000
= 10.4 per 1000 population
= 160 x 1000
2400
Perinatal mortality rate
= late fetal deaths ( 28 wks gestation & more) + early neonatal deaths ( 1st
wk ) in 1 year X 1000
Live births in the same year
= 40 + 40 x 1000
2400

Neonatal mortality rate
= No. of deaths of children under 28 days of age in a year X 1000
Total live births in the same year
= 120 x 1000
2400
= 50 PER 1000 live births

14. In an estimated mid year population of 200000 there were 5000 live
births & 1650 deaths in the year 2004. Women of child bearing age group
formed 20% of the population
No. of fetal deaths > 1000 gms – 100
No. of abortions – 600
No. of deaths 0 – 7 days – 100
No. of deaths under 1 year – 300
Calculate the crude birth rate, crude death rate, infant mortality rate,
perinatal mortality rate and general fertility rate.
• Crude birth rate
= 5000 X 1000
20000
= 25 per 1000
• Crude death rate

= 1650 X 1000
200000

= 300 x 1000
5000
Perinatal mortality rate
= late fetal deaths ( 28 wks gestation & more) + early neonatal deaths ( 1st
wk ) in 1 year X 1000
Live births in the same year
= 100 + 100 x 1000
5000
General Fertility Rate
= No. of live births during the year x 1000
Mid year women population age 15-44(or 49) in the same year
= 5000 x 1000
20% of 200000
= 5000 x 1000
40000
= 125 per 1000 women population
15. The following data relate to a municipal town for the year 2007.
Mid-year population – 300000
Birth rate – 18 per 1000 mid year pop
Death rate – 8 per 1000 mid year pop
Deaths under 1 week – 40
Deaths 8 – 28 days – 60
Deaths in 1 month to one year – 80
Women in child bearing age – 22% of the pop
Calculate the infant mortality rate, neonatal mortality rate, post neonatal
mortality rate, general fertility rate and growth rate.
Calculation:
No.of live births = 18 x 3,00,000 = 5400
1000
Total deaths = 8 x 3,00,000 = 2400

1000
Women in reproductive age group = 22% of 3,00,000 = 66,000
. No.of deaths of children less than 1 yr of age in a year x 1000
= 40 + 60 + 80 x 1000
5400
=No. of deaths of children under 28 days of age in a year x 1000

= 40 +60 x 1000
5400
Post neonatal mortality rate
= No. of deaths of children between 28 days & 1 year of age in a given year x 1000
= 80 x 1000
5400

= 5400 x 1000
66000
= 81.82 per 1000 women population(15-44)
Growth rate = Crude birth rate – Crude death rate (in percentage)
= 18 per 1000 – 8 per 1000
=1.0 %
16. In an estimated mid-year population of 1,00,000 there were 3000 live

births. The number of women in the reproductive age group was 15000.
Distribution of women and births in the different age groups are given
below.
Age group (in yrs) No. of women No. of births
15 – 24 4000 1200
25 – 34 6000 1600
35 – 44 5000 200
Total 15000 3000
Calculate:
Crude birth rate
General fertility rate
Age specific fertility rate
Total fertility rate
Crude birth rate
= 3000 X 1000
100000
Mid year women population aged 15-44 (or 49) in the same year
= 3000 x 1000
15000
= 200 per 1000 women population( 15-44)
Age specific fertility rate
= No. of live births in a particular age group x 1000
Mid year women population of same age group
15-24 yr fertility rate
= 1200 x 1000
4000
25 – 34 yr fertility rate
= 1600 x 1000
6000
35 – 44 yr fertility rate
= 200 x 1000
5000
Total fertility rate:
= 10 x ∑ASFR
1000
= 10 X (300 + 266.7 + 40)
1000
= 6
17. In an estimated mid-year population of 100000 there were 2500 births

and 850 deaths. Of those who died 600 were women, of whom 8 died
between 1st and 42nd day following delivery, 2 between 43rd and 56th day
following delivery. The rest of the deaths were unrelated to delivery.
Women in the child bearing age group constituted 20 percent of the
population. Number of infant deaths was 125 and deaths within the first 28
days was 75.
Calculate the crude birth rate, infant mortality rate, neonatal mortality rate,
maternal mortality rate and general fertility rate.
Crude birth rate
= 2500 X 1000
100000
=No. of deaths of children less than 1 year of age in a year x 1000
= 125 x 1000
2500
= No. of deaths of children under 28 days of age in a given year x 1000
= 75 x 1000
2500
Maternal mortality rate
= No. of maternal deaths within 42 days of delivery in a given year X 1000
Total No. of Live births in the same area & year
= 8 x 1000
2500
= No. of live births during the year x1000
= 2500 x 1000
20% of 100000
= 2500 x 1000
20000 = 125 per 1000 population
18. A slum area with a population of 20000 experienced an epidemic of

hepatitis in the year 2005. 400 cases were recorded and 95% of them
occurred among those aged less than 40 years. There were 8 deaths due
to hepatitis. There were totally 200 deaths due to all causes during that
year.
a. What is the death rate due to hepatitis?
b. What is the case fatality rate?
c. What is the proportional mortality rate due to hepatitis?
d. What is the crude death rate for the year 2005?
Specific death rate due to hepatitis
= Number of deaths from hepatitis during a calendar year x 1000
Mid-year population
= 8 x 1000
20000
Case fatality rate
= Total number of deaths due to a particular disease x 100

Total number of cases due to the same disease
= 8 x 100
400
= 2%
Proportional mortality rate due to hepatitis
Number of deaths from hepatitis in a year x 100
Total deaths from all causes in that year
= 8 x 100
200
= 4%
Crude death rate
= 200 X 1000
20000

19. In a PHC of 50000 population, 6000 blood smears were taken under
active surveillance in 2003. on examination, 60 blood smears were found to
be positive for P.vivax, 5 for P.falciparum and 4 for P.vivax and
P.falciparum.
Calculate annual blood examination rate, annual parasite incidence,

annual falciparum incidence, slide positivity rate and slide falciparum rate.
Annual blood examination rate
= No. of slides examined x 100
population under surveillance
= 6000 x 100
50000
= 12%
Annual parasite incidence
= Confirmed malaria cases during one year x 1000
Population under surveillance
= 60+5+4 x 1000
50000

Annual falciparum incidence
= Confirmed cases positive for P.falciparum x 1000
Population under surveillance
= 9 x 1000
50000
Slide positivity rate
= Slides found positive for malaria parasites x 100
Total slides examined
= 69 x 100
6000
= 1.15%
Slide falciparum rate
= Slides found positive for P.falciparum x 100
Total slides examined
= 9 x 100
6000
= 0.15%
20. In a town of 50,000 population all were examined for microfilaria in
peripheral blood and for clinical manifestation of filariasis. Of this 50
persons showed microfilaria in peripheral blood. 100 persons showed
clinical manifestation for filariasis.
Calculate
a. Microfilaria rate
b. Filaria disease rate
c. Filaria endemicity rate
Microfilaria rate
= No.of Persons showing microfilaria in peripheral blood x 100
Sample population
= 50 x 100
50000
= 0.1%
Filaria disease rate
= No.of Persons showing clinical manifestation for filariasis x 100
Sample population
= 100 x 100
50000
= 0.2%
Filaria endemicity rate
No.of Person showing Mf in peripheral blood + persons having clinical manifestation x100
Sample population
= 150 x 100
50000
= 0.3%
21. In a study to find association of blindness with diabetes ,diabetes

status was taken as the risk factor and the distribution of blindness with
respect to presence or absence of diabetes is given below :
Exposure Blindness present Blindness absent
DM present 180 120
DM absent 140 200
1) What s the type of study design.

2) Calculate the exposure rates.
3) Calculate the odds ratio.
4) Comment on the odds ratio
Answers
1) This is case control study

2) Exposure rate for cases
= a/a+c X100 = 180/320 X100 = 56.25%
Exposure rate for controls
= b/b+d X 100 = 120/320 X 100 = 37.5%
3) Odds ratio = ad/bc = 180*200/140*120 = 2.14

4) Comment: Pts with diabetes are 2.14 times at greater risk of
getting blindness
22. Thalidomide was first marketed as a safe non-barbiturate hypnotic in

Britain in 1958.In 1961,there were a large number of babies born with
abnormalities which was previously rare.A study was conducted in one
hospital in Britain showed that among 46 mothers delivered of deformed
babies,41 were found to have had Thalidomide during their early
pregnancy.This was compared with a control of 300 mothers who have
deliverd norml babies among whom 2 mothers have taken Thalidomide.
1) What s the type of study design.
2) Calculate the exposure rates.
3) Calculate the odds ratio.
4) Comment on the odds ratio.
Deformation Deformation
+
-
1) This is a Case control

Thalidomide 41 2 43
study
+
2) Exposure rate for cases 5 298 303

-
= a/a+c x100
46 300 346
= 41/46 x100
= 89.13%
Exposure rate for controls
= b/b+d x 100
= 2/300 x 100
= 0.67%
3)Odds ratio
= ad/bc
= 41x 298 / 5 x 2
=1221.8
Comment:
Pregnant women exposed to thalidomide during early pregnancy are

1221.8 times at greater risk of delivering malformed babies.
23. 1000 workers working in a ceramic factory were followed up for a

period of 10 years. Among whom 125 of them developed chronic
respiratory illness. A comparison group of 2000 workers who were
working in a non dusty environment were also followed up for the same
period among whom 25 of them developed chronic respiratory illness
a) What s the type of study design.
b) Calculate the incidence rate.
c) Calculate the relative risk and comment.
d) Calculate the attributable risk and comment .
a) This is a Cohort study

Chronic respiratory illness
Exposure to Present Absent

ceramic dust
Present 125 (a) 875 (b)
Absent 25 (c) 1975 (d)
B) Incidence among Exposed
= a/a+b x100
= 125/1000 x100
=12.5%
Incidence among non-exposed
=c/c+d x100
=25/2000x100
=1.25%
C)Relative risk
= Incidence among Exposed / Incidence among non exposed
=12.5/1.25
= 10
Comment on relative risk
Those exposed to ceramic dust are at 10 times greater risk of

developing chronic respiratory illness.
d)Attributable risk
= Incidence among Exposed - Incidence among non exposed X 100
Incidence among Exposed
= 12.5-1.25 X 100
12.5
= 90%
Comment:
90% of chronic respiratory illness among those working in ceramic

factory is attributed to their work in dusty environment
24. A group of 63 women in reproductive age group of a village were

followed up for a period of 2 years. There were 4 offsprings who developed
neonatal tetanus. Similarly matched 82 women were followed up in a
neighbouring city. One offspring developed neonatal tetanus. Can u
consider rural environment as pre-disposing factor for development of
neonataltetanus.
Calculate the relative risk and attributable risk.
n.Tetanus + - Total
Village 4 59 63
City 1 81 82
5 140
= a/a+b x100
= 4/ 63 x100
Incidence among non-exposed
= c/c+d x100
= 1/82 x 100
C)Relative risk
= 4/63
1/82
= 5.206
Attributable risk
= Incidence among Exposed -Incidence among non exposed X 100
= (4/63-1/82) X 100
(4/63)
= 80.79%
25.A group of male adults 20 to 60 years of age using pan masala under
various trade names were followed up for one year.50 of them were
selected from a HSC area.A control group of 100 men comparable in other
aspects were followed up for the same period.The outcome of the study
was development of leukoplakia.19 of the pan chewers developed
leukoplakia.while 4 of the control developed leukoplakia.The reported
prevalence of leukoplakia in population is 10%.
a) What s the type of study design.
b) Calculate the relative risk and comment.
c) Calculate the attributable risk and comment .
d) Calculate the population attributable risk and comment.
Leukoplkia + -
Pan masala + 19 31 50
- 4 96 100
23 127
a) This is a cohort study
b) Relative risk
= (19/50 x100)
(4/100 x 100)
= 38/4
= 9.5
Comment:
Those persons using pan masala are at 9.5 times greater risk of
developing leukoplakia
Attributable risk
= Incidence among Exposed -Incidence among non exposed X 100
= (19/50 x 100 ) - (4/100 x 100) X 100
(19/50 x 100)
= 38-4 X 100
38
= 89.47%
Comment:
89.47% of leukoplakia is attributed to the use of pan masala
Population attributable risk
= Incidence in the population -Incidence among non exposed X 100
Incidence in the population
= (10/100 x 100 ) - (4/100 x 100) X 100
(10/100 x 100)
= 10 – 4 X 100
10
= 60%
Comment
If the pan masala usage is eliminated, the incidence of leukoplakia will
decrease by 60%
26.A study was conducted to measure the protective effect of BCG against
tuberculous meningitis.60 cases of tuberculous meningitis were diagnosed
in 5 hospitals. An equal number of controls matched for age, sex and
neighbourhood were selected. Trained workers assessed BCG vaccination
status of the cases and controls by looking for a typical scar over the left
deltoid region.25% of the cases and 50% of the controls had BCG scar.
a.what is the type of study.
b.what is the exposure factor being studied.
c.calculate the odds ratio.
d.calculate the protective effect of BCG against tuberculous
meningitis
TB meningitis + - Total
BCG scar + 15 30 45
- 45 30 75
60 60
a) This is a case control study
b) Exposure being studied here is BCG vaccination ( Assesed by

presence of scar in left deltoid region
c) Odds ratio
= ad/bc
= 15x 30 / 30 x 45
= 0.33
d) Protective factor = (1- odds ratio ) X 100
= 1-0.33 X 100
= 67%
27. A new screening test for disease X was found to be positive in
20% of 600 people among whom the prevalence of disease was
known to be 16%. There were 12 false negatives.
Calculate the specificity, sensitivity and positive predictive value.
Data given:
1) No.of people = 600
2) Total test positive = 20% of 600 = 120
3) Prevalence of disease = 16% of 600 = 96
4) False negative = 12
Disease present Disease absent Total
Test+ 84 (a) 36 (b) 120
test - 12 (c) 468 (d) 480
96 504
a) sensitivity= a x 100
a+c
= 84/96 X 100
= 87.5%
b) specificity = d x 100
b+d
= 468/504 X 100
= 92.86%
c) Positive predictive value = a x 100
a+b
= 84/120 X100
= 70%
28. The results obtained after screening 10,000 people for diabetes with
random blood sugar is given in the table.The screening level of
120mg/dl.The prevalence of diabetes in that population was known to be
1.5%.
Data given
Total population = 10,000
Prevalence of diabetes = 1.5% of 10,000 = 150
DIABETIC NON-DIABETIC
RBS PRESENT 70 (a) 100 (b)
RBS ABSENT 80 (c) 9750 (d)
TOTAL 150 9850
Calculate the specificity, sensitivity and positive predictive value
 sensitivity= a/a+c x 100
= 70/150 x 100 = 46.7%
 specificity = d/b+d x 100
= 9750/9850 x 100 = 98.98%
 Positive predictive value = a/a+b x 100
= 70/170 x100 = 41.12%
29.FNAC studies on 114 women were compared with gold standard of

surgical excision biopsy in women without palpable breast masses.
Breast Carcinoma+ Breast Carcinoma -
FNAC Carcinoma + 14 (a) 8 (b)

FNAC Carcinoma - 1 (c) 91 (d)
15 99
Calculate the sensitivity, specificity, positive and negative predictive

value
Sensitivity = a/a+c x 100
= 14/15 x100 = 93.3%
 specificity = d/b+d x 100
= 91/99 x 100 = 91.92%
 Positive predictive value= a/a+b x 100
=14/22 x100 = 63.64%
 Negative predictive value= d/c+d x 100
= 91/92 x 100 = 98.9%
30. A sample survey of 250 children revealed that 72% had nutritional
deficiency.
Calculate the 95% and 99% confidence interval.
Prevalence(p) = 72 , q= 1-P = 28, n= 250

Standard error of propotion= square root of (pq/n)
= square root of 72 X 28
250
= 2.84
95% CI = Mean +/- 1.96 S.E
= 72 +/- 1.96 X 2.84
= 72 +/- 5.57
= 66.43% to 77.57%
99% CI = MEAN +/- 2.58 S.E
= 72 +/- 2.58 X 2.84
= 72 +/- 7.33
= 64.67% to 79.33%
31) Calculate the quantity of bleaching powder containing 23% available

chlorine needed to disinfect a 20m deep well, 6m in diameter having 6m of
water. The Horrock’s test done on the water sample indicates definite blue
colour in 4th 5th and 6th cups respectively. Explain the practical procedure to
chlorinate the well.
Solution:
Data:
Diameter of the well = 6m
Depth of water in the well = 6m
The cup number which shows blue colour first (n) =4
The horrock’s test kit provides the quantity of bleaching powder

required to disinfect 100 Gallons i,e; 445 litres of water. The cup number
indicates the number of spoons of bleaching powder added to the sample.
(And also dosage of chlorine in ppm). Each spoon weighs 2 gm of
bleaching powder. As such 2n is the quantity of bleaching powder required
to chlorinate readily 445 litres of water.
Calculations
1) Volume of water to be disinfected in litres

In cubic meters = II/4D² d
In litres (V) = 0.7885*6*6*1000
=1,69,600 litres.
2) Quantity of bleaching powder required in gm = 2n*V/445

= 2*4*169600/445
= 2982gm
Ans: The quantity of bleaching powder required to chlorinate the well is

2982gm(3kg).
Practical Method of well disinfection:
Quantity of bleaching powder = 3kg

Quantity of hexa – meta phosphate (5%) = 0.05*3000 =150 gm
Quantity of coarse sand ( Twice) = 2*3 = 6kg
Mix up the content and either by immersing the contents in gunny

bag or by pot method of chlorination or by dissolving the bleaching
powder, the well disinfection can be effectively carried out.
Mix up the content evenly and two specially designed single/double

pot with appropriate holes is to be used to dose the chlorine into the
well; Each set contains half the above contents (1.5 kg + 75 gm +
3kg) for better dispersal of chlorine solution. Immerse the pot inside
the well upto 1m below the water level so that it is not affected during
normal water drawal.
32) Calculate the quantity of bleaching powder needed to disinfect a

rectangular well measuring 3m length, 3m breadth and 8m depth having
6m of water to be disinfected. The Horrock’s test done on the water sample
indicates definite blue colour in 5th cup. Explain the practical procedure to
chlorinate the well.
Solution:
Data:
Length of the well (L) =3m
Breadth of the well (B) =3m
Depth of the water = 6m

required to disinfect 100 Gallons i.e.; 445 litres of water. The cup number
Calculations

In cubic meters = L*B*d* 1000
In litres (V) = 3*3*6*1000.
= 54,000 litres.
2) Quantity of bleaching powder required in gm=2n*V/445

=2*5*54,000/445
=1187gm
.
1187gm.
Quantity of bleaching powder = 1187 gm.
Quantity of hexa – meta phosphate (5%) =0.05*1187=60 gm.
Quantity of coarse sand (Twice) = 2*1187=2374gm.

bag or by pot method of chlorination or by dissolving the bleaching powder,
the well disinfection can be effectively carried out.

pot with appropriate holes is to be used to dose the chlorine into the well;
Immerse the pot inside the well upto 1m below the water level so that it is
not affected during normal course of water drawal.
33) Calculate the quantity of bleaching powder containing 23% available

chlorine needed to disinfect a well measuring 4m in length, 3m breadth
having 6m of water in it. The Horrock’s test done on the water sample
indicates definite blue colour in 3rd 4th cups respectively. Explain the
practical procedure to chlorinate the well
Solution:
Data:
Length of the well (L) =4m
Breadth of the well (B) =3m
Depth of the water = 6m
The horrock’s test kit provides the quantity of bleaching

powder required to disinfect 100 Gallons I,e; 445 litres of water. The cup
number indicates the number of spoons of bleaching powder added to the
sample. (And also dosage of chlorine in ppm). Each spoon weighs 2 gm of
Calculations
In cubic meters = L*B*d
In litres (V) = 4*3*6*1000.
=72,000 litres.
2) Quantity of bleaching powder required in gm =2n*V/445

= 2*3*72000/445
= 950gm.
.
950gm.


ba or by pot method of chlorination or by dissolving the bleaching powder,
Mix up the content evenly and two specially designed

single/double pot with appropriate holes is to be used to dose the chlorine
into the well; Immerse the pot inside the well upto 1m below the water level
so that it is not affected during normal course of water drawal.
34) Calculate the quantity of bleaching powder needed to disinfect a well

4.5m in diameter having 5m of water. The Horrock’s test done on the water
sample indicates definite blue colour in 4th cup. Explain the practical
procedure to chlorinate the well.
Solution:
Data:
Diameter of the well =4.5m.
Depth of water in the well =5m.
The cup number which shows blue colour first (n) =4.
Calculations:

In cubic meters = II/4D² d.
In litres (V) = 0.785*4.5*5*1000.
= 79,481 litres.

=2*4*179481/445
=1398 gm say 1400 gm.

1400gm.

Quantity of bleaching powder = 1.4 kg
Quantity of hexa – meta phosphate (5%) =0.05*1400=70 gm
Quantity of coarse sand (Twice) = 2*1.4= 2.8kg

into the well; Immerse the pot inside the well upto 1m below the water level
so that it is not affected during normal course.
35) The 2nd cup in the horrocks test gives a definite blue colour when starch
cadmium iodide indicator solution is added to the water sample. Calculate
the quantity of bleaching powder needed to disinfect a open well of 3m in
diameter having 5m of water. Calculate the quantity of bleaching powder
required to disinfect the well.Explain the practical procedure to chlorinate
the well.
Solution:
Data:
Diameter of the well =3m.
Depth of water in the well =5m.
required to disinfect 100 Gallons I,e; 445 litres of water. The cup number
Calculations:

In cubic meters = II/4D² d
In litres (V) = 0.785*3*5*1000
=35,325 litres

=2*2*35325/445
=311gm.

311gm.

Quantity of bleaching powder = 311gm 311=16gm
Quantity of coarse sand (Twice) = 2*311=622gms

pot with appropriate holes is to be used to dose the chlorine into the well;
Immerse the pot inside the well upto 1m below the water level so that it is
not affected during normal course.
36) A rectangular well measuring 5m in length 4m breadth having 6m water

is disinfected. The Horrock’s test done on the water sample indicates
definite blue colour in 4th 5th and 6th cups respectively. Calculate the
quantity of bleaching powder required to disinfect the well and Explain the
practical procedure to chlorinate the well.
Solution:
Data:
Length of the well (L) =5m.
Breadth of the well (B) =4m.
Depth of the water = 6m.

Calculations:

In cubic meters = L*B*d
In litres (V) = 5*4*6*1000
=120,000 litres.

=2*3*120000/445
=4220gm

4220gm.

Mix up the content and either by immersing the contents in

gunny bag or by pot method of chlorination or by dissolving the bleaching
powder, the well disinfection can be effectively carried out.
into the well; Each set contains half the above contents (2110 gm _ 106
gm+ 4220 gm) for better dispersal of chlorine solution. Immerse the pot
inside the well upto 1m below the water level so that it is not affected during
normal course of water drawal.
37) Water quality test report of a sample drawn from a drinking water
source shows coliform count of 20 per 100ml, nitrites in traces, flouride
value of 2mg per litre and chloride of 750mg per litre. Comment on the
various water quality parameters and evaluate the potability of water with
reasons there for.
No Parameter Test Desired Permissible Remark
result limit limit
1 Coliforms 20/100 0 0 Infected with bacteria,
ml needs chlorination for
disinfection
2 Nitrite Traces Traces Traces Not objectionable
3 Fluoride 2 mg/l 1 mg/l 1.5 Exceeds limits, can cause
flourosis
4 chloride 750 mg/l 250 mg/l 1000 mg/l Not objectionable in the
absence of other source
Evaluation of water potability:
The potability of water could be certified only if the entire range of
water quality parameters for which standards prescribed by
WHO/CPHEED/BIS10500-1992. Under the physical, chemical,
microbiological and radiological aspects are satisfied. In the present case
the coliform count and fluoride values exceed the limiting values and hence
these parameters are the cause for rejection of the water sample. Hence
the water is not fit for drinking and thus not potable
source shows coliform count of 15 per 100ml, 90 mg/l of nitrates,1.2mg per
ltre of iron, 550mg/l of total hardness and turbidity value of 10. Comment on
the various water quality parameters and evaluate the potability of water
with reasons there for.
result limit limit
1 Coliforms 15/100 ml 0 0 Infected with bacteria,
needs chlorination
2 Nitrate 90 mg/l 45 100 Not objectionable in the
absence of other source.

3 Iron 1.2 mg/l 0.3 mg/l 0.3 Not in limits. Affects taste,
colour, piping, utensils
4 Hardness 550 mg/l 300 mg/l 600 mg/l Not objectionable in the
absence of other source
5 Turbidity 10 5 10 Beyond permissible limits,
interferes disinfection,
unaesthetic
Conclusions on the potability of water sample
water quality parameter for which standards prescribed by
microbiological and radiological aspects are satisfied. In the present case
the coliform count and iron values exceed the limiting values and hence
these parameters are the cause for rejection of the water sample. Hence
the water is not fit for drinking and thus not potable
39. Water quality test report of a sample drawn from a drinking water
source shows coliform count of 10 per 100ml, Total dissolved solids of
1800 mg/l alkalinity value of 650mg/l, flouride value of 1.4mg per litre and
colour in the platinum pt/co scale of 20 units. Comment on the various
water quality parameters.
No Parameter Test result Desired Permissible Remark
limit limit
needs chlorination
2 TDS 1800 mg/l 500 2000 Not objectionable in
the absence of other
source.
3 Fluoride 1.4 mg/l 1 mg/l 1.5 Not objectionable in

the absence of other
source.
4 Colour 20 5 25 Exceeds limits,
displeasing
5 Alkalinity 650 mg/l 200 600 Beyond permissible
limits, unpleasent
taste
Discussions on the potability of water sample:
water quality parameter for which standards prescribed by
microbiological and radiological aspects are satisfied. The water sample
satisfied all parameters other than coliform count of 10 which makes it
difficult to certify the potability. However the water source could be utilized
by proper chlorination for effective disinfection to nullify the coliform count
as all other parameters just satisfy the requirements in the absence of any
other better sources.

source shows coliform count of 3 per 100ml, Sulphate 350mg/l, arsenic
0.07mg/l, chloride 1200mg/l and turbidity unit of 7. Comment on the various
water quality parameters and evaluate the potability of water with reasons
there for.
result limit limit

needs chlorination
2 Sulphate 350 mg/l 200 400 Not objectionable in the

absence of other source.
3 Arsenic 0.07mg/l 0.01 mg/l 0.05 Exceeds limits, toxic
4 Chloride 1200 mg/l 250 mg/l 1000 mg/l Exceeds limits,

unpalatable
5 Turbidity 7 1 5 Beyond permissible limits,

interferes disinfection,
unaesthetic
Conclusions on the potability of water sample:

The water sample is not potable as such, in so for as if fails to satisfy
the standards prescribed for coliform count and arsenic.
THE TAMIL NADU DR. M.G. R. MEDICAL UNIVERSITY
PRACTICAL & ORAL EXAMINATIONS
INSTITUTE OF COMMUNITY MEDICINE

MADRAS MEDICAL COLLEGE
CHENNAI – 600 003.
EPIDEMIOLOGICAL EXERCISES & BIO STATISTICS

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X ¯x X- X¯ (X-X¯)²

1. The mark obtained by 12 students

• Mean = ∑x / n = 397/12 =33.08

Total 397 65 529

Find the arithmetic mean ,mode and median

Arranging the given data in ascending order

Median = 48+50/2 = 98/2 = 49years

Duration of illness in days

Calculate the mean, median ,mode and standard deviation

• Mean = ∑x/n = 93/12 = 7.75 days

Mean deviation = ∑(x-x¯) / n

Calculate mean , median ,mode

Class interval No of children(f)

6-7 25 6.5 162.5 33

7-8 20 7.5 150 53

8-9 22 8.5 187 75

9-10 19 9.5 180.5 94

• Median = L + [n/2- cf] X CI

Part 1 exam are as follows

calculate measures of central tendency

= 62.8 interval (cumulative

• Median = L + [n/2- cf] X CI Frequency)

• Mode = L + d1 X CI 80-90 5 85 425 50

Calculate mean , median ,mode

55-60 1 57.5 57.5 1

60-65 8 62.5 500 9

65-70. 5 67.5 337.5 14

70-75 55 72.5 3987.5 69

75-80 16 77.5 1240 85

80-85 14 82.5 1155 99

85-90 1 87.5 87.5 100

Median = L + [n/2- cf] X CI

• Coefficient of variation(COV) for BP = SD/Mean X100

• Coefficient of variation(COV) for Height = SD/Mean X100

Therefore, BP shows greater variation

9. In a dietary survey conducted as per of nutrional assessment in semi

Protien intake(gms per day) No of families

35-45 100 40 4000 170

45-55 110 50 5500 280

55-65 80 60 4800 360

65-75 30 70 2100 390

75-85 10 80 800 400

Median = L + [n/2- cf] X CI

100-120 12 110 1320 39

120-140 8 130 1040 47

140-160 3 150 450 50

Median IQ = L + [n/2- cf] X CI

a) Crude death rate

b) Cause specific death rate

c) Age specific death rate

d) Case fatality rate

e) Proportional mortality rate

1) Mid-year population = 1,00,000

= Number of deaths during the year x 1000

= 12 per 1000 population

b) Cause specific death rate

Death rate due to cholera

= Number of deaths from cholera during a calendar year x 1000

Mid-year population in the same year