COMMUNITY

MEDICINE
PRACTICAL
 3
I. Cereals

 Constitutes bulk of the diet

 Main sources of energy (carbohydrates)

 Contribute significant quantities of fibre

 Cereal proteins are poor in nutritive quality being deficient

in the essential amino acid lysine
 4
1. Rice
NUTRITIVE VALUE(per 100g) PUBLIC HEALTH IMPORTANCE

Energy: 345 Kcal • Rice proteins are Good source of B

group vitamins, especially thiamine .
Proteins: 6.8g • Richer in lysine than the other cereal
Fat: 0.5g proteins.
• Poor source of calcium and iron
• Effect of Milling: Causes reduction in-
• Protein - 15%
• Thiamine 75%
• Riboflavin and Niacin 60%
 5
Parboiled Rice:

 An ancient Indian technique

 Preserves the nutritive quality of rice
 The paddy is soaked in hot water at 65 to 70°C for 3-4
hours
 During steaming, much of the vitamins and minerals present
in the aleuronic layer of the grain are driven into the inner
endosperm
 With subsequent milling, the nutrients are not removed
 Drying hardens the rice grain making it more resistant to
insect invasion and more suitable for storage than raw rice.
 6
2. Wheat
NUTRITIVE VALUE(100g) PUBLIC HEALTH IMPORTANCE

Energy: 346Kcal • The limiting amino acids are lysine and

threonine.
Protein: 11.81g
• Maida or white flour which represents
70% extraction of wheat is poorer from the
nutritional stand point.
• The whiter the flour, the greater the loss
of vitamins and minerals
 7
3. Maize
NUTRITIVE VALUE(100g) PUBLIC HEALTH IMPORTANCE

Energy: 342Kcal • Maize is fairly rich in fat.

• Proteins of maize are deficient in
Protein: 11.1g
tryptophan and lysine and some strains
contain an excess of leucine.
• Excess of leucine interferes in the
conversion of tryptophan into niacin,
aggravating the pellagragenic action of
maize.
 8
II. Millets

 The term “millet” is used for small grains which includes jowar (sorghum), bajra (pearl

millet), ragi, kodo, etc.,

 They are ground and eaten without having the outer layer removed.

 The calorie and protein contents of millets are similar to that of the cereals.
 9
1. Ragi
NUTRITIVE VALUE(100g) PUBLIC HEALTH IMPORTANCE

Energy : 328 Kcal • Cheapest among millets

• It is a good source of iron,
Protein:7.3g phosphorus, thiamine and a fair
Rich in calcium : 344 mg source of niacin and riboflavin
 10
2. Jowar / Sorgam

NUTRITIVE VALUE(100g) PUBLIC HEALTH IMPORTANCE

Energy: 349 kcal • The proteins are limiting in lysine

Protein: 10.6g and threonine.
• Certain varieties of jowar have high
leucine content and consumption
of these varieties is associated with
pellagra.
 11
3. Bajra

NUTRITIVE VALUE(100g) PUBLIC HEALTH IMPORTANCE

Energy: 361 Kcal • Deficient in lysine and threonine

Protein: 11.6g • Contains significant amount of Vit
B complex, Calcium and Iron
 12
III. Pulses

 Rich sources of protein (18-25 percent)

 Rich in vitamins-B

 Do not contain any vitamin A or vitamin C

 Germinated legumes contain some vitamin C

 Proteins are of low quality - deficient in methionine (Red gram is deficient in

tryptophan also)

 Rich in lysine so combined with cereals to supplement its protein content

 13

BENGAL GRAM RED GRAM GREEN GRAM

BLACK GRAM SOYABEAN

 Energy Proteins
Pulses 14
(100g) (100g)

Red gram 335 22.3

Black gram 347 24.0

Green gram 348 24.5

Bengal gram 360 17.1

Soya bean 432 43.2

 15
SOYA BEAN

PUBLIC HEALTH IMPORTANCE

• Richest in proteins among pulses.
• It contains about 40% proteins, 20% of fat and 4% of minerals.
• The proteins of soya bean are of relatively high nutritive
value.
• The limiting amino acid is methionine
 16
IV. Green Leafy Vegetables
NUTRITIVE VALUE (100gm)
Carotene------ 1200-7500 µg Iron------------ 0.8-16.0 mg
Calorie-------- 32-96 Kcal Ascorbic acid-----48-220 mg
Calcium------- 30-500 mg
LETTUCE LEAVES SPINACH CORIANDER LEAVES
 17
IV. Green Leafy Vegetables…

 Vegetables are classed as “protective foods”; their value resides in their high
vitamin and mineral content.

 They are rich sources of carotenes, calcium, Iron and vitamin C and fairly
good sources of riboflavin, folic acid and lysine.

 Sulphur containing amino acids are deficient and vitamin B12 is absent.

 Some vegetables like green peas and beans are also good sources of
protein.
 18
Green Leafy Vegetables

 Vegetables usually have a large water content, low energy and protein content and
varying amounts of “dietary fiber”

 Because of their low caloric value and large bulk, they are important
constituents in the diets of obese people and pregnant women

 RDA of is about 40 g for an adult

 19
V. Roots and Tubers

POTATOES PUBLIC HEALTH

NUTRITIVE VALUE
IMPORTANCE
Good sources of Can be used to
carbohydrates supplement diets of
Poor in protein, minerals underrnourished groups
and vitamins. Carrot is a e.g. children
good source of Overintake can lead to
TAPIOCA carotene. weight gain, diabetes;
RDA of roots and tubers hence, to be avoided
is by the obese, diabetic
50-60 g for an adult. or at-risk people
 20
VI. Nuts and Oil Seeds

NUTRITIVE VALUE (per PUBLIC HEALTH IMPORTANCE

100 g)
Calorie: 570 Kcal Contain good amount of fat
Proteins: 26.2 g and good quality protein in a
Contains 22-28 % relatively small bulk.
GROUNDNUT
proteins and 42-50 % oil. Used in the preparation of
Most of the vegetable processed protein food such
oils are rich in essential as Indian multipurpose food,
fatty acids. Baalahar and balanced malt
food.
 21
VIII. Fats and Oils
NUTRITIVE VALUE
Sunflower seed soil is a rich Vegetable oils contain
source of the essential polyunsaturated fatty acids
fatty acid -linoleic acid, like linoleic and linolenic
containing about 73 acids which are needed
percent. to meet the EFA
requirement.
Concentrated sources of Coconut oil is poor in
energy providing unsaturated acids
9 kcal/g. (9 %).
 22
Continued...
PUBLIC HEALTH IMPORTANCE

In coconut oil Saturated fatty acids constitute91 % characterized

by the presence of a high percentage of Lauric and myristic
acids.
COCONUT OIL
High fat intake is harmful leading to cardiovascular
complications.

Total calorie from visible fat should not exceed 20%. Also to
meet the minimum needs 5-10% of calories may be derived from
visible fat.
 23
Butter and Ghee
PUBLIC HEALTH
NUTRITIVE VALUE
IMPORTANCE
Butter contains about 82 % fat and 3500 I.U. of Butter and ghee serve
vitamin A per 100 g. mainly as sources of fat
Ghee is 100 % fat and contains about 2000 and Vitamin A
I.U. of vitamin A per 100 g.

GHEE

BUTTER
 24
Dalda (Vanaspati)

 Vanaspati or vegetable ghee is prepared by hydrogenation of

vegetable oils.
 During hydrogenation, the liquid oils become solid because the
monounsaturated and polyunsaturated fatty acids are
converted, both to saturated fatty acids and to trans fatty
acids.
 Essential fatty acid content is drastically reduced.
 Since saturated fats are resistant to oxidation, foods prepared in
vanaspati keep fresh for a longer period.
 Since vanaspati is lacking in fat-soluble vitamins, it is fortified
with vitamins A (2500 IU per 100 grams) and D (175 IU per
100 grams)
 IX. FRUITS

 Fruits are protective foods

 Indian gooseberry (amla), guava and orange are rich sources of vitamin C

 Mango and papaya contain carotene

 Banana and mango contain good amounts of carbohydrates

 Dried fruits (raisins and dates) are good sources of calcium and iron

 Custard apple (sitaphal) is rich in calcium.

 Fruits contain cellulose which assists in bowel movement.

 RDA of 85 grams or more per day

 PAPAYA

NUTRITIVE VALUE
( Per 100 grams ) PUBLIC HEALTH IMPORTANCE
Calories-------- 32 Kcal
Papaya is an inexpensive fruit available

Carotene------ 2740 μg during all seasons

Regular consumption of papaya will

ensure good supply of vitamin A and C
 BANANA

NUTRITIVE VALUE ( Per 100 PUBLIC HEALTH IMPORTANCE

grams )
Used in the diets of children being treated for severe
Calories ----104 Kcal malnutrition
Good source of Potassium
and Iron
Mashed fruit with milk and sugar can be excellent supplementary
or weaning food for children

High glycaemic index and calorie content. Hence, to be avoided

in diabetics, obese and at-risk people

Ripe bananas have a mild laxative property - a remedy for

constipation
X. MILK

CONSTITUENTS / 100 g COW HUMAN

Fat ( g ) 4.1 3.4

Protein ( g ) 3.2 1.1

Lactose ( g ) 4.4 7.4

Calcium ( mg ) 120 28

Iron ( mg ) 0.2 -
MILK
Vitamin C ( mg ) 2 3

Energy ( Kcal ) 67 65
 MILK contd.....

PUBLIC HEATH IMPORTANCE

Good source of proteins (3-4 percent), fats (3-6 percent), sugars (approximately 5
percent), calcium, phosphorus, riboflavin and other B-group vitamins.

Deficient in iron and vitamin C

The principle milk protein is casein. Compared to cow’s milk, human milk has less
protein and higher lactose content
 MILK contd......

PUBLIC HEALTH IMPORTANCE

Pasteurization of milk is to get rid of any disease producing bacteria it may contain

An adult should consume at least 150 ml of milk per day

Children, Pregnant and Lactating women should receive at least 250 ml milk per day
EGG

NUTRITITIVE VALUE ( Per 100 g of

Hen’s egg )
Calorie ----- 173 Kcal
Protein ----- 13.3 g
EGG

Vitamin A ----- 1180 I.U.

Cholesterol ----- 250 mg
Phosphorus ----- 220 mg
Iron ----- 2.1 mg
 PUBLIC HEALTH IMPORTANCE OF EGG

Contains all the nutrients except carbohydrate and vitamin C

Egg proteins have all the essential amino acids in the right
proportions.

Net Protein Utilization (NPU) is 100 for egg.

Known as the reference protein because of its high biological

value.
 PUBLIC HEALTH IMPORTANCE OF EGG …

Boiling destroys ‘avidin’, a substance which prevents the body

from obtaining biotin. Boiled egg is therefore nutritionally
superior to raw egg.

Egg white is rich in proteins, hence, recommended for

malnourished, immuno-compromised patients and children

Egg yolk is rich in cholesterol and lecithin so contraindicated in

people with hypercholesterolemia.
 FISH

NUTRITIVE VALUE PUBLIC HEALTH IMPORTANCE

(Per 100 g) Fish proteins have a good biological value, a satisfactory amino
acid balance and are easily digested
Protein ------ 15-25 g
The fat of fish is rich in unsaturated fatty acids which are cardio-
protective
Fish liver oils are the richest source of vitamins A and D

Fish bones are an excellent source of calcium, phosphorous and

fluoride
Sea fish are good sources of Iodine

Fish do not contain carbohydrates

 POULTRY & MEAT

NUTRITIVE VALUE (Per 100 g)

Protein -------- 15 – 20 g PUBLIC HEALTH IMPORTANCE

Iron -------- 2- 4mg
Meats are a good source of iron and also zinc and B vitamins

Iron contained in meat ( haeme form ) is more easily absorbed

than iron in plants

POULTRY MEAT The energy provided by meat depends upon its fat content which
is more for red meat than poultry

Red meat contains high amounts of cholesterol; its overintake is

associated with carcinoma of the colon

Liver is extremely rich in many nutrients

RED MEAT
 SUGAR AND JAGGERY
NUTRITIVE VALUE ( Per 100 g
PUBLIC HEALTH IMPORTANCE
)
Calories: Cane sugar – 396 Carbohydrate foods produced from sugarcane in India
Kcal, Jaggery – 383 Kcal
Iron (Jaggery) – 11.4 mg Refined or table sugar (sucrose) provides “empty calories”

JAGGERY Jaggery, which is also used in place of refined sugar, contains

useful amounts of carotene and iron derived from cooking pans

Sugars and refined cereals should be used sparingly due to its

high glycemic index
SUGAR
Honey consists of about 75 percent sugars, mostly fructose
and glucose
IDLI

NUTRITIVE VALUE OF IDLI

(2 IDLIS = 1 PLATE)
Calories ( Kcal ) 130.5
Protein ( g ) 4.62
Calcium ( mg ) 27.2
Iron ( mg ) 0.8
Retinol ( μg ) 8.16
 PUBLIC HEALTH IMPORTANCE OF IDLI
Fed to infants as a weaning food and as a main dish in
diets in hospitals

Main ingredients used in the preparation of idli are white

polished rice (cereal) and black gram dhal (pulse).

Cereal and pulse proteins complement each other and

provide a more balanced and “complete” protein intake –
supplementary action of proteins

Fermentation increases the nutritive value of idli by

improving the availability of essential amino acids. Also, rich
in vitamins B complex
 IODIZED SALT
In India daily salt consumption -- 5 g -- 30 g

Salt intake more than 10 g is a risk factor for

Hypertension

Excessive salt intake may also result in atrophic

gastritis, gastric cancer and reduction in bone
density

Salt intake should not be more than 5 g per day

IODIZED SALT…

Salt is fortified with iodine to prevent iodine deficiency disorders

Level of iodization is fixed under the Prevention of Food

Adulteration (PFA) Act and is not less than 30 ppm at the
production point, and not less than 15 ppm of iodine at the
consumer level
Entomology
 Arthropods of
Medical Importance: Points for Identification
CULEX EGGS
Laid in clusters or rafts
Oval shaped
Lateral floats - absent

CULEX LARVAE
Suspended with head downwards at an angle to water surface
Siphon tube present - long and
narrow
No palmate hairs for floatation
CULEX PUPAE
Long and narrow siphon tube
CULEX ADULTS
At rest, body exhibits a hunch back
FEMALE CULEX
Wings usually not spotted
Palpi are shorter than proboscis
Antennae - not bushy
MALE CULEX Wings usually not spotted
Palpi are long, tapering and deflected out
Antennae - bushy
ANOPHELES EGGS
Laid single
Boat shaped
Lateral floats present

ANOPHELES LARVAE
Rests parallel to water surface
No siphon tube
Palmate hairs for floatation are present
ANOPHELES PUPAE Broad and short siphon tube
ANOPHELES ADULTS Rests at an angle to the surface
FEMALE ANOPHELES: Spotted wings
Palpi long and straight
Antennae - not bushy
MALE ANOPHELES Spotted wings
Palpi long and club shaped
Antennae - bushy
AEDES EGGS Laid singly, cigar shaped (20 - 25 in No.)
Do not posses lateral floats

AEDES LARVAE Suspended with head downwards at an angle to water surface

Siphon tube present - short and broad
No palmate hairs for floatation

AEDES PUPAE Long and narrow siphon tube

AEDES ADULT Referred to as "TIGER MOSQUITO"

Easily distinguished by white stripes on black body
Legs have silvery stripes against dark black legs
Wings not spotted

HEAD LOUSE / BODY LOUSE HEAD: Pointed with pair of 5 jointed antennae
(WINGLESS INSECT) THORAX: Fused mass, shape like a square
ABDOMEN: Elongated with 9 segments
Last abdominal segment is pointed in case of males and bilobed in case of

females

53
 HEAD LOUSE / BODY LOUSE Mode of Transmission
contact
(WINGLESS INSECT) DIRECT CONTACT: By close combs or brushes
INDIRECT CONTACT: Infested
cloths, bedding, used
2.

by lousy persons
RAT FLEA HEAD: conical, attached to thorax without neck
(WINGLESS INSECT) THORAX: pairs of strong legs attached
ABDOMEN: 10 segments
In males - penis
In females - spermatheca
Mode of Transmission:
1. BITING BLOCKED FLEAS
2. MECHANICAL TRANSMISSION
3.

ITCH MITE
Just visible to naked eye
(Sarcoptesscabiei) 0.4 mm in size

Tortoise shaped body, body covered with small bristles

No demarcation into cephalothorax and abdomen
4 pairs of legs, with suckers on front legs, hind legs have long bristle
Mode of Transmission
Transmitted by close contact and contaminated clothes
THROMBOCULID MITE 3-4 mm in size
(Leptothrombidiumdeliense and Mouth parts consists of pair of chelicerae and pair of
palps
Has four pair of legs
First pair of legs is the
largest
CYCLOPS
mm size, just visible to naked eye
Pear shaped semi-transparent body
Forked tail and pigmented eye
2
pairs of antennae and 5 pairs of legs
Average life months

FEATURES
HARD TICK
SOFT TICK
Covers entire back in males,
(chitinous shield on dorsal surface) only

2) Head
smallportion in front in females Absent

Situated at anterior end Lies ventrally

3) Eggs Several hundreds or
laid at one sitting thousands Laid in batches of 20-100 over
4) Nymphal stages long period
One
Habits
Five
Always on host
Feeds by day
and night Crevices and cracks during day
Feed on host
at night

54
 Fle - 1 : Head Louse

FEMALE MALE
Adult Hard Ticks

Body Louse

The Adult Soft Tick FEMALE MALE

EGGS

Xenopsyila cheopis, the oriental rat filca: male, left; female, right. Trombiculid Mite

Scabies mite
Cyclops - Female
Length: 0.25 to 0.40 mm

55
 Culex
Anopheles
Eggs Laid in rafts
Laid singly Laid singly

No floats
Has floats No floats

Larvae
Rest at
Rest at
an angle to the
an angle to the
water surface water surface

Rest parallel to
waler surface
Air tube Air tube

Rudimentary breathing tube Long, slender breathing

Short, stout breathing tubo with several
tube with one palr
of hair tufts
pairs of hair tufts

Pupae (differ only slightly)

Adult
Proboscis and
body at an Proboscis and
Proboscis and angle to body at an
body in same one another angle to
straight line one another

Maxillary
Maxillary Maxillary

Maxillary palps Maxillary paips

as long as proboscis
Maxillary palps
shorter than proboscis shorter than proboscis

Wings Wings
spotted generally
uniform

Tip a
Tip of
female abdomen
female abdomen
usually pointed usually blunt

Differentiating features of Anopheles, Aedes and Culex

mosquitoes

56
 Anopheles Mosquito

 Identification points
 Spotted wings
 Maxillary palpi equal to median proboscis in both sexes
 Non – bushy antennae
 Diseases transmited - Malaria
 Breed - Clean water
 Control measures
 Anti adult measures include chemical control, genetic control measures
like sterile male technique, chemosterilants etc. Personal protective
measures like mosquito nets, mosquito repellants are also effective.
 Anopheles Larva

 Identification points - Elongated multi segmented body with

palmate hairs present on the abdominal segments
 Siphon tube is absent.
 It floats horizontally in water (surface feeder)
 There are four stages of growth and it is called asinstars with
moulting between each stage.
 Control measures:
 Antilarval measures – Environmental control measures : land
filling and drainage, chemical control measures like mineral oils,
Paris green and Biological control measures by use of gambusia
and guppy fish.
 Culex Mosquito

 Identification points - Non spotted wings, Short palpi, Non – bushy antennae
 Diseases transmited - Bancroftian filariasis, Japanese encephalitis, West Nile fever, Viral
arthritis
 Breed - Dirty water, cess pools, drainage
 Control measures
 Anti adult measures like space spraying
 Personal protective measures like mosquito nets, repellants
 Genetic control measures like sterile male technique
 Culex Larva

 Identification points - Elongated multisegmented body with

a siphon tube on the 8th abdominal segment.
 Palmate hairs are absent
 Found suspended in water with their head downwards
(bottom feeders)
 Control measures:
 Drainage of wastewater collection, larvicides like mineral
oils/Paris green in the form of pellets are effective.
 49
Aedes mosquito

Public health importance

-Only female transmits

1. Dengue

2. Yellow fever (not in India)

3. Chikungunya

4. Rift valley fever

5. Filaria (Not in India)

 Hard Tick

 It is a wingless with four pairs of legs. Its head is situated at

the anterior end.
 Its body is dorso-ventrally compressed. The scutum covers
the entire back in males and only a small portion in front in
females.
 It breads in cracks and crevices of the wall, cattle shed
and stables, shrubs and vegetation.
 Diseases - KFD, Viral Encephalitis, Tick Typhus, Tick
Paralysis and Babesiosis.
 52
Hard tick

1. Tick typhus
2. Viral encephalitis
3. Hemorrhagic fever
4. Tularaemia
5. Tick paralysis

SOFT TICK –

1. Q fever

2. Relapsing fever

3. KFD
 53
Control of ticks

 a) Insecticidal control
 Dusting or spray formulations of DDT, Lindane, Malathion

 b) Environmental control
 Filling up of cracks and crevices
 Reduction of animal hosts (Rodents & dogs)

 c) Protection of workers
 Protective clothing with benzyl benzoate/diethyl toluamide impregnated clothing
 Manual removal of ticks from body
 Rat Flea

 Its body is bilaterally compressed. It is a wingless ectoparasite with

three pairs of legs.
 It has backwardly directed bristles present over the body.
 In male fleas there is a coiled penis in the abdomen.
 In female fleas there is a dark short stumpy structure called
spermatheca present in the posterior part of the abdomen.
 Diseases transmitted - Bubonic Plague, Endemic or Murine Typhus
and Chiggerosis.
 Insecticidal control measures like 10% DDT dust, and or Gamma /
HCH, repellants like DEET followed by rodent control measures can
be used.
Insecticides
Insecticides

Contact poisons
Stomach poisons Fumigants
a) Natural – pyrethrum,
Eg: Paris green, sodium • Eg: HCN, SO2
mineral oils
flouride
b) Synthetic
Contact poisons:

Organo phosphorus
Organo chlorine
compounds: Carbamates:
compounds:
Fenthion, Propoxur
DDT,HCH(BHC)
Abate,Diazinon
 DDT-Dichloro diphenyl trichloroethane

 White amorphous powder

 Contains 70-80% of para-para isomer
 Contact poison-nervous system paralysis
 Residual action-18 months

➢ Application as
✓ Residual spray(100-200mg/sq foot)
✓ As a dust 5-10% strength for control of lice, fleas, ticks and bugs
✓ As aerosol or space sprays
DDT…

➢ Disadvantages:

✓ Persistence in living organisms like plants and some

wild animals leading to ecosystem damage

✓ Insecticide resistance
 BHC-Benzene hexa chloride

 Also called hexachlorocyclo-hexane(HCH)

 White chocolate coloured powder with musty smell

 Technical HCH- 13-16% Gamma isomer

 Pure HCH – 99% Gamma isomer (lindane)

 Residual action – 3 months

 Kills insects by direct contact and its vapour

 25-50 mg/sq feet gamma HCH – residual treatment.

Fenthion (Baytex)

 Organophosphorus compound

 Brown liquid with garlic smell

 Usual dosage for residual spray-100 mg/sq foot

 Very powerful larvicide

 Abate (Temephos)

 An organophosphorus compound

 Brown viscous liquid, soluble in petroleum

solvents

 Low toxicity

 Extensively used in India for control of

An.Stephensi in wells and in water containers

 Dosage : 1 ppm

 Less effective as adulticide.

Diazinon

 Organo phosphorus compound

 Volatile liquid

 Kills by direct contact and fumigant action

 Used in DDT resistance

 Dosage: 60 – 100 mg/sq. foot

 Mosquito larvicidal oil

 It’s a natural contact poison

 Kerosene, crude oil, malariol

 Mosquito larvae and pupae

 Oils suffocate and poison the aquatic stages of mosquito

 Injurious to aquatic vegetation and fish if not properly used

 Pyrethrum

 Vegetable origin
 Flowers of chrysanthemum cinerariafolium
 Active principles: pyrethrum 1 and 2,cinerins 1 and 2- nerve
poisons
 Ready to spray solution contains 0.1 % pyrethrins
 Sprayed at rate of 1 oz per 1000 cu. feet of space. windows
and doors closed for half an hour
 No residual action
Disinfectants
 Phenol

 Commonly used “crude phenol”- mixture of phenol+cresol

 Dark oily liquid

 Effective against gram positive, gram negative bacteria and

certain viruses

 Slowly effective against spores and acid fast bacteria

 10% strength - disinfection of faeces

 5% strength – mopping floors and cleansing drains

 0.2-1% aqueous solution – bacteriostatic

 Cresol

 An excellent coal-tar disinfectant

 3-10 times as powerful as phenol

 5-10% cresol – disinfection of feces and urine.

 Cresol emulsified with soap – saponified cresol

 Lysol, izal , cyllin – cresol emulsions

 Lysol contains 50-60% cresol

 2% solution of lysol used for disinfection of faeces

 Dettol (chloroxylenol)

 Non toxic antiseptic

 Active agaianst streptococci and other gram positive

bacteria

 5% dettol is used for disinfection of instruments and

plastic equipments; a contact of atleast 15 min required

for disinfection.
Savlon

 Combination of cetrimide (cetavlon) and hibitane

 Plastic appliances- disinfected in normal strength savlon for

20 min

 Clinical thermometers are best disinfected in savlon 1 in 6

spirit in just under 3 minutes

 Bleaching powder

 White amorphous powder with pungent smell of

chlorine

 33% available chlorine

 A 5% solution- disinfection of faeces and urine, with one

hour contact period.

 Drawback: Unstable compound, loses its chlorine

content on storage.
 Potassium permanganate

 An oxidising agent

 Occurs as purplish black crystals, highly water soluble, liberates

oxygen which oxidises bacterial protoplasm

 It is used to disinfect aquariums and community swimming pools to

disinfect ones feet before entering the pool

 It is also used to disinfect fruits and vegetables

 Formalin

 Effective against vegetative bacteria, fungi and many viruses

 Slowly effective against bacterial spore and acid fast

bacteria

 Does not injure fabrics and metals

 Used as 2-3 % solution (20-30ml of 40% formalin in 1L of water)

for spraying rooms, walls and furniture

 Formaldehyde gas - most commonly used for disinfection of

rooms.
 Denatured Spirit

 Most commonly used for skin disinfection and hand

washing

 Pure alcohol has no powers of disinfection

 Dilution with water to 60-90%, it is potent bactericidal,

fungicidal, virucidal and tuberculocidal.

 70% alcohol is lethal to all types of non-sporing bacteria in

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Poverty Line, APL, BPL, Pan Card,
Aadhar Card, Health Schemes

1
 • Family income less than Rs 1,20,000/-

• House less than 1000 square feet

Below Poverty Line • Should not work in any institution
Card
• Should not be a government employee

• Less than 10 acres of land holding

2
 • Permanent Account Number (PAN) system of identification
assigns unique identification 10-digit number to every
Indian tax paying entity.
• All tax-related information for a person is recorded against a
single PAN number which acts as the primary key for
storage of information.
Benefits:
• Valid identity proof throughout the country
PAN CARD • Best possible way to keep track of your tax payment.

• News Update: If Aadhaar Card and PAN are not linked

before 31st March 2021, PAN would be rendered
inoperative from 1st April, 2021.
 • 12 digit individual identification number issued by the Unique
Identification Authority of India on behalf of the Government
of India.
• The number serves as a proof of identity and address for
residents of India.
Benefits:
• Income tax: You can verify your filed returns through some
AADHAAR simple steps online Poor and marginalized residents will have
CARD the identification documents they need to receive State
benefits
• Open bank accounts in a flash: There is no need to collect
multiple identity proofs or run around for documentation.
• Get pension money on time
• LPG and other subsidies: You can get the LPG subsidy in your
bank account.
Indira Gandhi Objectives:
National • Assure a respectful life financial assistance are
provided to the widows living BPL.
Widow
Pension Eligibility:
Scheme • Widows of age group 40 to 79 years.

Benefits:
• Rs. 500 per month to the beneficiaries

5
 Objectives of Scheme:
• Provide financial assistance to the senior citizens
of the state

Sandhya Eligibility :
Suraksha • Applicant must a permanent resident of the
State; age >65y
Yojana
Benefits:
• Monthly pension Rs. 500 provided to penniless
elderly
• Concessional Bus Pass to senior citizens in KSRTC

6
 Objectives:

• Assure a respectful life financial assistance are provided to

severe & multi-disabled persons BPL

Eligibility:
Disability
• Family income < Rs 11,500/- pa & Rs 24000 pa in Rural as
Pension
well as in urban area respectively.
Scheme
• Resident of Karnataka at least since last 10 years

• Above 16 years

Benefits:

• Upto Rs 1200 per month, based on amount of disability

the person has 7
 Objective:
• To protect poor unmarried, separated & divorced
women who suffer from social taboo

Eligibility:
Manasvini • Unmarried & Divorced women who having BPL card
Scheme • Age should be between 40 to 64 years.

Benefit:
• Monthly pension amount of Rs.500 through their
bank account.

8
 Objectives

• Reduction of maternal & neonatal mortality by

promoting institutional delivery among the poor

Janani pregnant women

Suraksha Eligibility:
Yojana • Low performing states: All pregnant women, All
deliveries

• High performing states: >19y old, BPL pregnant, Upto 2

deliveries

• All SC & ST women delivering in the associated centers

9
 Objectives:
Pradhan • Providing cash incentive for partial compensation of
Mantri wage loss so that woman can take adequate rest before
Mathru & after delivery
Vandana • Cash incentives would lead to improved health seeking
Scheme behavior

Eligibility:

• All pregnant & lactating women ONLY for first pregnancy

10
 Objective:

• Provide at least one nutritious meal to pregnant & lactating

woman

Mathru Eligibility:
Poorna • All pregnant & lactating women in rural & underprivileged
Scheme areas

Benefit:

• Free meal for 15 m (from the start of pregnancy till 6m after

delivery), 40-45% of the daily calorie, protein & calcium
requirement per day via meal prepared at Anganwadi 11
 Objective:
• To promote the birth & improve status of girl children among
BPL families
• Financial assistance to the girl child through her
mother/father/guardian
Eligibility:
Bhagyalaxmi • BPL, Up to 2 girl child can be benefitted
Scheme • To obtain maturity amount, compulsory education of girl upto
8th standard, & should not be married until 18y of age.
Benefit:
• Health insurance cover up to Rs 25,000
• On attainment of 18 years, beneficiary is paid Rs 34,751
• Annual scholarships

12
Service Beneficiary
Objective:

Supplementary Nutrition • Improve nutritional

• Children <6y & health status of children (0-6 y)
Pregnant
• the
• Lay & lactating
foundation for child’smothers
development: psychological,
Integrated
Immunization • Children
physical & social<6y
Child • Pregnant & lactating mothers
• Reduce mortality, morbidity, malnutrition & school dropout
Development
Health Check-up • Children <6y
• Enhance mother’s capability mothers
to look after the child’s health &
Service (ICDS) • Pregnant & lactating
Referral services nutritional
• Children needs
<6yby proper education
• Pregnant & lactating mothers
Eligibility:
Pre-school education • Children
• Children <6y
3-6y

Nutritional & Health Education• Pregnant

• Women (15-45y)
& lactating women
13
• Women in age group of 15-45y
 Objective:BENEFITS:
1. Medical Benefit to employee & family
• Benefits to employees of factories ( 10 person with power OR
2. Old
20 agewithout
persons medical care
power)

Employee
3. Sickness Benefit (60% of wages payable for 91d)
Eligibility:
state • All4.employees
Maternity
of Benefit
any factory
insurance 5. Disablement Benefit
• Govt will give 2/3rd of administrative benefit; state govt will
6. Dependent
share Benefit
1/8th of medical expenditure & ESI Corporation will
7. Physical
bear&7/8
Vocational rehabilitation
th medical expenditure

8. Unemployment
• Employer allowance (50%
will contribute for 12m)
to 3.25% of employee wage,
Employee
9. Funeral will contribute
Benefit 0.75% of wage
(Rs 10,000)
14
 • Nearly 55 crore people to be covered

• Beneficiaries : Poor, deprived rural families and identified

occupational category of urban workers’ families
Ayushman • Rs 5 Lakh coverage per family per year
Bharat
• No cap on family size or age

• Funded by centre and state 60:40

• To be merged with other schemes

17
 So far..

• 45 lakh hospital admissions

• In more than 18,000 empanelled hospitals

• Cumulative savings of over Rs 13,000 crore for family beneficiaries

• Every 3 seconds a beneficiary is being treated!

• In Karnataka 11 separate health schemes were merged into 1

18
 BALANCED DIET
A variety of foods in quantities and proportions that
the need for :
a. Energy
b. Carbohydrates
c. Fats
d. Amino Acids
e. Vitamins & minerals
is adequately met to maintain health, vitality,
general well-being and small provision for short
duration of leanness is adequately met .
 Its Construction
Principles :

1. Protein : 10-15% of energy intake

2. Fat : 15-30% of energy intake

3. Carbohydrates : Approxiamately, 65% of energy intake

4. Also meets requirements of micronutrients

 Indian reference man
19-39 years
Weighs 65 kg
Height 1.77 m
BMI 20.76
Free from disease
Physically fit for active work
8 hrs of moderate activity in his occupation
8 hrs of sleep
4-6hrs in sitting and moving around
2 hrs in household activity , recreation etc.
 Group Consumption Units

Adult male (Sedentary worker) 1.0

Adult male (Moderate worker) 1.2

Adult male (Heavy worker) 1.6

Adult female (Sedentary 0.8

worker)

Adult female (Moderate 0.9

worker)

Adult female (Heavy worker) 1.2

 Group Consumption Units

Adolescents 12-21 years 1.0

Children 9 to 12 years 0.8

Children 7 to 9 Years 0.7

Children 5 to 7 Years 0.6

Children 3 to 5 Years 0.5

Children 1 to 3 Years 0.4

Example: A family consisting of father doing sedentary work and mother
and 3 children aged 10,8,6 years

Family member Consumption units

Father 1.0

Mother 0.8

10 yrs 0.8

8 yrs 0.7

6 yrs 0.6

Total 3.9
¨ One unit of coefficient corresponds to energy

requirement of 2400 Kcal/day

¨ So, 3.9 units = 2,400 x 3.9 = 9360 Kcal is the daily

energy requirement of the family

WATER TREATMENT PLANT
 Purification of Water on a Large Scale
¨ Components of water purification System:
¤ Storage
¤ Filtration

¤ Disinfection
Storage
¨ Natural Purification
¨ Reserve water from which further pollution is
excluded.
Physical Chemical Biological

Settling of Oxidising of Drop in

90% of organic Bacterial
Suspended matter by count
Particles aerobic
bacteria
• Optimum period : 10-14 days
 Filtration : Second Stage

¨ Removal of 98 – 99 % bacteria is achieved.

¨ Types of filters:
¤ Slow Sand Filters (Biological)
¤ Rapid Sand Filters (Mechanical)
 Filtration : Slow Sand Filter

¨ First used in 1804 in Scotland

¨ Elements:
¤ Supernatant (raw) water
¤ A bed of graded sand

¤ An under-drainage system

¤ A system of filter control valves

 Slow sand filter Filtration Rate:
0.4cu.m/hour/square metre
Source

Filter Box
1. Supernatant Water: 1-1.5m
2. sand Bed 1.2m
3. Gravel Support: 0.30m
4. Filter Bottom: 0.60m
Slow Sand Filters: Supernatant Water

¨ Depth:1-1.5 m
¨ Kept at constant level
¨ Provides the constant head of water to overcome
resistance
¨ Provides ‘waiting period’ (3-12 hours) – Purification
¤ Sedimentation
¤ Oxidation

¤ Particle agglomeration
Slow Sand Filters: Sand Bed
¨ 1 m thickness
¨ Properties of Sand particles:
¤ Rounded, diameter: 0.2 to 0.3 mm
¤ Free from clay and organic matter
¨ Provides a vast surface area
¨ Water percolates slowly and undergoes:
¤ Mechanical Straining
¤ Sedimentation
¤ Adsorption
¤ Oxidation
¤ Bacterial Action
Sand Bed: Vital layer
¨ Schmutzdecke: German for “dirt cover”
¨ Slimy and gelatinous growth extending upto 2 to 3 cm
¨ Takes several days to form
¨ Consists of: Algae, Plankton, Diatoms, Bacteria
¨ Removes organic matter
¨ Holds back bacteria
¨ Oxidizes ammonical nitrogen to nitrates
 Slow Sand Filter: Under-drainage
system and Filter control
¨ Perforated pipes
¤ Provide outlet for filtered water
¤ Support the above filter medium

¨ Filter control valve: To maintain constant rate

¨ “Venturi meter”: measures the sand bed resistance
¨ Resistance >1.3metres open regulating valve
¨ indication to clean: fully open regulating valve
¨ Filter cleaning by scraping off the top layer of sand
Source Schmutzdecke
Advantages of Slow Sand Filters
¨ Simple to construct and operate
¨ Cost of construction less
¨ Quality of water very high
¨ Bacterial count (including E.coli) reduced up to
99.99%

Disadvantage: Large area needed

Rapid Sand Filter
¨ First installed in the USA (1885)
¨ Two types:
¤ Gravity type: Paterson’s filter
¤ Pressure type: Candy’s filter

¨ Mechanical process
¨ Filtering medium: Sand particle: 0.4 to 0.7 mm
¨ 1 m depth
¨ Gravel layer below provides support
¨ Under-drains to collect water
Rapid Sand Filter
 Rapid Sand Filters

¨ Steps of Purification:

¤ Coagulation: Alum / Lime (5-40mg per litre)

¤ Rapid Mixing: in a Mixing Chamber

¤ Flocculation:
n Slow stirring using paddles (2-4 rpm)
n Flocculant precipitate of aluminum hydroxide

¤ Sedimentation: in a Sedimentation Tank (2-6 hrs)

¤ Filtration: Rapid sand filtration
River Flocculation
Mixing Sedimentation
chamber chamber tank
Alum

Clear Filters
Consumption Water
storage

Chlorine

Filtration Rate:
5-15cu.m/hour/square metre
Filtration

¨ “Alum–floc” not removed by sedimentation held

back
¨ Oxidation of ammonia
¨ Impurities clog the filter
¨ Loses the efficiency
¨ “Back-washing”
“Back-washing”

Impurities

Water & Air

Advantages of Rapid Sand Filter

¨ Can deal with raw water directly – without storage

¨ Occupy less space
¨ Filtration is rapid ( 40-50 times of slow sand filter)
¨ Washing is easy
¨ More flexibility in operation

Disadvantage: Highly skilled operation

THANK YOU
Maternal and Child Health
Preventive Promotive

Curative Rehabilitative
 Obstetric score

• Gravida – number of times a female has got

pregnant irrespective of the duration of pregnancy &
outcome

• Para – number of pregnancies which have crossed

the period of viability (28 weeks)
 Obstetric score
• Abortion – expulsion or extraction from its mother of
an embryo or fetus weighing 1000g or less when it is
not capable of independent survival (< 28 weeks)

• Still birth – birth of a newborn after 28 completed

weeks (weighing 1000g or more) when the baby
doesn’t breathe or show any signs of life after
delivery
 Example

• Case 1: A 27 yr old pregnant lady comes for

ANC ,the period of gestation is 6months.She
has two live children from her past 2
pregnancies . No h/o abortions

The obstetric score is G3 P2 L2 A0

 Example

• Case 2: A 30yr old lady comes for check up.

She has two live children from her past 2
pregnancies. No h/o abortions.

Her obstetric score is P2 L2 A0

 Example

• Case 3: A 30 yr old pregnant woman comes for

ANC at 25 weeks POG .She has two live
children from a twin pregnancy and she had
one abortion at 12 weeks.

Her obstetric score is G3 P1 L2 A1

 Antenatal care
• The care of the woman during pregnancy

Antenatal visits
Ideally the mother should attend the clinic :
• Once a month for first 7 months
• Twice a month during the next month
• Once a week thereafter
 Antenatal care
• At least 4 antenatal visits
• 1st visit: Within 12 weeks—preferably as soon
as pregnancy is suspected—for registration of
pregnancy and first antenatal check-up.
• 2nd visit: Between 14-26 weeks.
• 3rd visit: Between 28-34 weeks.
• 4th visit: Between 36 weeks and term.
 Preventive services for the mothers
Prenatal services
At first visit
• History
• Physical examination including weight &
height
• Lab. Examinations – routine blood
(Hb, HIV, HBSAg, VDRL, Blood glucose, Blood
group and Rh) and urine examinations
 Preventive services for the mothers
Prenatal services
On subsequent visits
• Physical examination including weight
• Appropriate weight gain: total 9-11kg; ideally
2kg every month after first trimester
• Hemoglobin estimation, urine examination
• Prenatal services: Iron tablets, TT injection,
Nutrition, Delivery and parenthood, self care,
referral services, family planning, visit by
female health worker
 Preventive services for the mothers
Prenatal services
Diet
• 350 kcal over and above normal requirement
per day

Lactation
• 0-6 months : Extra of 600 kcal/day
• 6-12 months : Extra of 520 kcal/day
 Preventive services for the mothers
Prenatal services
Prenatal advice
• Personal cleanliness
• Child care
• Dental care
• Drugs
• Warning signs:
– Swelling of feet
– Fits
– Headache
– Blurring of vision
– Bleeding/ discharge per vaginum
 Preventive services for the mothers
Prenatal services
Specific protection
• Anemia
• HIV
• Tetanus
• Syphilis
• Rh status
• Prenatal genetic screening
• Mental preparation
• Family planning
• Paediatric component
Intranatal care
• Care of mother and baby during delivery

Postnatal care
• Care of mother and newborn after delivery
 High Risk pregnancy

1. Elderly Primi (> 30 y) 9. Short statured primi

2. Antepartum haemorrhage (Height < 140 cm)
3. Pre-eclampsia, Eclampsia 10.Elderly grand multipara
4. Anaemia 11.Prolonged pregnancy
5. Twins, Hydramnios 12.With medical disorders
6. H/o previous LSCS/ 13.Treatment for Infertility
Instrumental delivery 14. Three or more
7. Malpresentation spontaneous consecutive
8. Previous still birth, IUD abortions

16
 Breast feeding
Advantages of breast milk
• Safe, hygienic
• Fully meets nutritional needs of the baby
• Easily digested by both normal and premature babies
• Immunoglobulin A (IgA)
• Prevents malnutrition
• Helps in spacing of births
 Breast feeding
Exclusive breast feeding
• For first 6 months with no other external food
• Supplementary food only after 6 months

Colostrum
• The first milk
• High concentration of proteins
• Rich in anti infective factors
• Prevents diarrhoeal diseases
 Immunization Schedule
Age Vaccines
Birth BCG, OPV-0, Hep B Birth dose
6 weeks LPV -1 , OPV-1, IPV-1,RVV-1
10 weeks LPV -2 , OPV-2, RVV-2
14 weeks LPV -3 , OPV-3, IPV-2, RVV-3
9 months MR- 1, Vitamin A
16-24 months DPT booster-1, MR- 2, OPV-4, Vitamin A
5-6 years DPT booster-2
10 years TT booster
15 years TT booster
Pregnant Women TT -2 doses, 4 weeks apart
Vaccine Dose Route Site
BCG 0.05 ml Intradermal Insertion of deltoid-
left arm
OPV 2 drops Oral
Hepatitis B 0.5 ml Intramuscular Antero-lateral side of
mid-thigh
DPT 0.5 ml Intramuscular Antero-lateral side of
mid thigh
MR 0.5 ml Subcutaneous Right upper arm
Vitamin A 2 ml Oral
(1 or 2 lakh)
TT 0.5 ml Intramuscular Upper arm (Insertion
of deltoid)
IPV 0.1ml Intradermal Right upper arm
 Optional vaccines
• Other optional vaccines: Chicken pox, Typhoid
vaccine, HPV vaccine
Vaccine When to give Dose & route Site
MMR 13-15m, booster 0.5ml S/c Right upper
at 5y arm
Japanese 1st dose:9-12m 0.5ml Left upper
Encephalitis 2nd dose:16-24m Subcutaneous arm
PCV 6,10,14w 0.5 ml
OR Intramuscular
6,14w with
Booster: 9-15m
 Examination
Mid arm circumference
• Measured using Shakir’s Tape
>13.5 = Normal
12.5 – 13.5 = Moderate
<12.5 = Severe
Thank you
Water borne diseases and
Sanitation barrier

15-Apr-21 1
 Introduction
— “CONTAMINANT” can be defined as
chemical, biological, physical or
radiological substance in water.

— Drinking water is reasonably expected to

contain small amounts of some
contaminants.

— Natural impurities are not essentially

dangerous (gases, minerals, impurities).

15-Apr-21 2
Sources of water contamination

15-Apr-21 3
 Water Contamination
Man’s health is affected by contaminated
water
— Ingesting directly or through food
— Lack of Personal hygiene
— Recreation Activities

— Developing countries have heavy burden of

water-related diseases

— The heaviest burden being ADD

15-Apr-21 4
Groups Diseases
Water-borne diseases Cholera; Typhoid; Bacillary
Classification
(diseases transmitted by water) dysentery; Infectious hepatitis;
Giardiasis

Water-washed diseases Scabies; Skin sepsis and ulcers;

(caused by lack of water) Yaws; Leprosy; Lice and Typhus;
Trachoma; Dysenteries; Ascariasis;
Paratyphoid

Water based diseases Schistomiasis; Dracunuliasis;

Filariasis; Threadworm

Water-related insect vector Yellow fever; Dengue fever;

diseases Bancroftian filariasis; Malaria;
Onchocerciasis
15-Apr-21 5
Disease Transmission

15-Apr-21 6
Chemical Contamination of water
— Chemical pollutants: Industry, Agriculture
— Detergents, solvents, cyanides, heavy metals,
bleaching agents, dyes etc.,
— Affect man’s health directly and indirectly
— Not removed by purification processes

15-Apr-21 7
 Dental health
— Fluoride of 1 mg/ litre in drinking water-
protection against dental caries

— High level – Mottling of dental enamel

15-Apr-21 8
 Cyanosis in Infant
— High Nitrate content- Methemoglobinemia

— Rare occurrence

— Surface water from farmland, treated with

fertilizer, gain access to the water supply

15-Apr-21 9
 Cardiovascular diseases

— Hardness of water- protective

— The evaluation of the health effects of

environmental pollutants - as a part of
WHO Environmental Health Criteria
Programme

15-Apr-21 10
 Water Pollution Law
— To protect water from being contaminated,
the Indian Parliament in 1974 passed the
Water (Prevention and control of
Pollution) Law

— Legal deterrent against the spread of water

pollution

— Provides for the Constitution of central,

state and Joint water boards- controlling
pollution
15-Apr-21 11
Sanitation barrier

15-Apr-21 12
 Introduction
Breaking the disease cycle at vulnerable
points:
— Segregation of faeces Primary Barrier
— Protection of water supply
— Protection of foods Secondary
— Personal hygiene Barrier
— Control of flies

15-Apr-21 13
15-Apr-21 14
 Sanitation barrier
— Segregation of excreta by imposing a
barrier – sanitation barrier

— It can be provided by a sanitary latrine

and a disposal pit

— Installation of sewerage system and

sewage treatment plants

15-Apr-21 15
15-Apr-21 16
Water Disinfection

15-Apr-21 17
 Sources of water
— Rain
— Surface water
a. Impounding reservoir
b. Rivers and stream
c. Tanks, ponds and lakes
— Ground water
a. Shallow wells
b. Deep wells
c. Springs
 Safe and wholesome water

— Free from pathogenic agents

— Free from harmful chemical substances

— Pleasant to the taste i.e free from color and

odour

— Usable for domestic purposes

Purification of water at large scale
— Storage
— Filtration –
a. Slow sand or biological filters
b. Rapid sand or mechanical filters
— Disinfection
Purification of water on small scale
1. Boiling

2. Chemical disinfection

a) Bleaching powder
b) Chlorine solution
c) High test hypochlorite / perchloron
d) Chlorine tablets
e) Iodine
f) Potassium permanganate

3. Filtration
Chlorination

15-Apr-21 22
 BLEACHING POWDER
1. It contains about 33% of available chlorine

2. Storage:
• On exposure to air, light, & moisture, rapidly looses
its chlorine content.
• Therefore, stored in dark, cool, dry place in a closed
container that is resistant to corrosion.

3. On mixing bleaching powder with water, the available

chorine reacts with water to form hypochlorous acid
– H2O + CL2 HCL + HOCl
– HOCl H+ + OCL-
 Action of Chlorine
— Disinfection mainly due to hypochlorous acid
(bests action at pH 7).

— Oxidizes all organic matter, ammoniacal

substances & destroys all bacteria present in the
water.

— Chlorine demand:
Amount of chlorine needed to oxidize all organic
matter & ammoniacal substances, to destroy all
bacteria present in the water.
 Action of chlorine contd.
— The point at which this chlorine demand is met
is called as Break-Point Chlorination.

— Further chlorine added beyond the break-point,

free chlorine (HOCl & OCL) begins to appear
in the water ‘free residual chlorine’.

— Minimum recommended concentration

of free chlorine is 0.5 mg/L for one hour
Horrock’s Apparatus
 Contents of Horrock’s Apparatus
1. 6 white cups (200 ml capacity each)
2. One black cup with a circular mark on the
inside
3. 2 spoons (each holding 2g of bleaching
powder)
4. 7 glass stirring rods
5. One special pipette
6. Two droppers
7. Starch-iodine indicator solution
8. Instruction folder
Procedure
1. Take one level spoonful (2g) of bleaching powder
in the black cup make it into a thin paste with a
little water.
2. Add more water to the paste and make up the
volume up to the circular mark with vigorous
stirring. Allow to settle. This is the stock
solution
3. Fill the 6 white cups with water to be tested, up
to about a cm below the brim (“bleaching
powder estimation”)
4. With special pipette provided add one drop of
the stock solution to the 1st cup, 2 drops to the
2nd cup, 3 drops to the 3rd cup, and so on.
 4. Stir the water in each cup using a separate rod
5.Wait for half an hour for action of chlorine
6. Add 3 drops of starch-iodide indicator to each
of the white cups and stir again, development of
blue color indicates the presence of free residual
chlorine.
7. Blue color intensity directly proportional to the
quantity of free residual chlorine in the water.
8. Note the first cup which shows distinct blue
color. Eg: 3rd cup shows blue color, then 3
level spoonfuls or 6g of bleaching powder
would be required to disinfect 455 litre of
water.
“All people, whatever their stage of
development and social and economic
condition, have the right to have access to
drinking water in quantities and of a
quality equal to their basic needs.”

(UN Conference at Mar del Plata, 1977)

15-Apr-21 31
15-Apr-21 32