EXPERIMENT BOOKLET The secrets of health
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EXPERIMENT BOOKLET
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EXPERIMENT BOOKLET
The secrets of health
Subject -1
Module - 401
The Foundation for Research in Community Health (FRCH)
Pune
3 and 4, Trimiti B Apartments, 85 Anand Park, Aundh, Pune - 411007
Telephone: 020-25887020, Fax: 020-25881308
Email: frchpune@giaspn01.vsnl.net.in
Preface
National Institute of open schooling - We have published four experiment booklets
based on the four modules of Gramsakhi
While studying the Gramsakhi modules,
only reading or explaining them orally is not sufficient for understanding them. The
procedure will only remain embedded in our minds permanently if we actually implement
it.
Similarly, frequent repetition of the demonstrations enhances our skills.
Since the instructor is present while conducting the procedure, mistakes, if any, are
immediately rectified. All doubts arising during the execution of the procedure can be
clarified on the spot. Moreover, a large part of the syllabus is covered automatically.
This is the reason for publishing these booklets. Experiments have been selected
independently from each module and diagrams have been given as and when required.
All these experiments are of use in our daily life. Implementing these regularly will
help in increasing our self-confidence.
We hope that these booklets will be of use to you
Contact us in case of any queries, difficulties or in case you feel that some other
important information must be included or in case you have any suggestions regarding
the arrangement and layout. This will make these experiment booklets easier and simpler
and in turn, will aid in achieving our goal.
♦
I
1. Drawing a picture of the human body and familiarising
ourselves with the various organs of the body.
Aim :
Familiarising ourselves with the various organs of the body.
Requirement :
Pencil and paper or chalk and a person
Procedure :
Draw a picture of a man and a woman or make a man or a woman lie
down on the ground and draw tt ie outline of his/her body on the ground.
Trace the internal and external organs from the head to the abdomen
on the drawing or the outline on the ground. Illustrate the brain in the
skull, the left and right lungs a-> well as the heart in the chest, food pipe
and windpipe (trachea), chest arid the muscle (diaphragm) that divides
the chest from the abdomen Illustrate the stomach, liver, intestines,
large intestine, bladder, spleen, womb, prostate glands Illustrate the
ears, nose, eyes, forehead, and neck. Draw a picture of a body, face
down, and illustrate the vertebral column, spinal cord etc. Illustrate as
many organs as possible.
Observation :
Identifying the relationship between the external and internal organs
of the body.
❖
When one complains of stomach pain, it could be related to the
internal organs like the intestine or liver. This experiment is useful
in order to understand the mutual relationship between all organs
and for informing yourself about various organs of the body as
well as for familiarising yourself with your body.
For additional information - The body puzzle manufactured by ‘Tathapi’,(Pune).
Website- Inside the body.
An outline of the human body
Heart
Stomach
Liver
Intestine
Urinary
Bladder
Left
Right
2. Giving expression to problems/
How do you identify an illness?
1.
It is possible to sense that a person is not well by his/her expression.
2.
The patient’s complaints can be sensed when he/she enters the room. A patient
with stomach pain cannot walk upright. He/she will always walk bent at the waist.
A patient with a pain in the lumbar area will enter with a hand on the pelvis. A
patient with a sprained neck will be holding his/her neck stiff.
3. An infant touches his/her ear if he/she has ear pain.
3. The mutual dependence of nature and human beings
Aim :
To acknowledge that human beings are a part of nature and are
dependant on it.
Requirement :
One cup rice and one cup jowar
Procedure :
Sprinkle rice and jowar in the courtyard/ on the road or in any open
place.
Observation :
1) Sparrows, pigeons and crows will peck the grains.
2) Cows/buffaloes on the road or even domestic cows will eat these
grains.
3) Even mice will arrive to eat the remaining few grains.
Opinion :
1) We grow grains in fields, this in itself means that various plants
produce grains. Land, water and favourable weather conditions are
required for producing grains.
2) This food produced by nature is eaten by human beings, animals
as well as birds.
3) Chaff, dried leaves of trees as well as animal and human excreta
in the fields turn to manure again.
mixes with the soil and nourishes
the crops leading to a healthier yield.
4) It is the intrinsic character of nature to maintain balance. This
means that all parts of nature (including humans) are mutually
dependant. For example, the number of mice will increase if we
kill the snakes that generally prey on mice. If there is an increase
in the number of mice, they will attack and destroy the crops. We
will not have any food to eat.
Inference :
1) This means that we are dependant on nature for food, water,
air and clothing.
2) We are only a cog in the wheel of nature.
3) Not only is it our responsibility to maintain the balance of nature,
but it is also essential for our happy existence
For more information : Nisarg aam manus (Nature and man)
Dr. Madhav Gadgil
5
4. For explaining the necessity (importance)
of the bone structure/ cavity.
Aim :
To understand why the bone cavity is necessary
Requirement :
Bone structure
Procedure/
Examining the skeleton and explaining the importance of the chest
Observation :
cavity. There are three bone cavities in the body.
1.
Skull: The skull is the bone of the head. The function of the
skull is the complete protection of the delicate and most important
organ of the body, the brain This is the reason that it has a round
shape It also protects the eyes, a very delicate organ.
2.
Thoracic cavity: The thoracic cavity is created with 12 ribs
from the front and 12 vertebral columns from the back. Not only
does the thoracic cavity protect the heart and the lungs, but it also
helps in their expansion. When we breathe in, the ribs are lifted
upwards and outwards due to which the lungs expand and a large
quantity of air is inhaled.
3.
Pelvic cavity: The pelvic cavity is like a vessel, wherein the
upper section is joined with the abdominal cavity. The pelvic cavity
is home to the female reproductive organs, the bladder and has
space for the rectum to expand. Similarly, the uterus grows upwards,
i.e.
towards the abdominal cavity. The main bone of the legs (femur)
is joined with the bone of the pelvic cavity. The various bone joints
in the limbs make movement easy. The body can move easily
owing to the spinal cord and it has been made flexible by the
spine.
Inference :
The different cavities in the body protect the important organs
of the body Movement becomes easy and flexible. The various
bone joints in the limbs make movement easy
Examining the tonsils
1) Infected tonsils
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5. The immune system of the body.
Aim :
Learning to examine the immune system of the body.
Requirement :
A torch.
Procedure :
(1) Request the patient to open his/her mouth and say ‘Aaah’. At
the same time, shine the torch in his/her throat
Observation :
The pair of tissue masses that are visible behind the wisdom teeth
are tonsils. The shape, colour and the white/ yellow spots on these
tissue masses aid us in diagnosing tonsillitis.
1) Diagnose tonsillitis if the tonsils as well as the internal walls
(mucous membrane) of the throat are red.
2) Diagnose chronic tonsillitis if the tonsils are enlarged and
pink and the throat also seems pink.
3) Diagnose bacterial infection of the tonsils if the tonsils are red
and has red or yellow spots on them.
4) Diagnose diphtheria if the tonsils and the throat are encased
in a white film.
Procedure :
(2) Using your palms, examine the lymph nodes in the throat, armpits
and inner thighs gently.
Observation :
We obtain information about enlarged lymph nodes as well as which
part is infected by examining the neck from all sides. Lymph nodes
on both sides of the jaw are enlarged in case of tonsillitis. The
lymph nodes under the ear lobes swell in case of external infection.
Lymph nodes at the back of the neck swell in case of scalp infections
and lice.
Lymph nodes in the armpits swell in case of breast diseases, ingrown
hair in the armpit or in case of some lung diseases.
Lymph nodes in the inner thighs swell in case a wound on the
leg is infected or in case of sexual diseases.
Inference :
Tonsils, lymph nodes and spleen develop the immune system of
the body
8
6. Checking the pulse rate.
1) Stand to the right of the patient for measuring his/her pulse rate.
2) Check the pulse of the right hand of the patient with your right hand.
3) To check the pulse rate, place the index, middle and ring fingers of your hand
on the pulse that is in line with the patient’s right thumb, just below the place
where the palm and the arm are joined as shown in the figure.
4) Press the radial artery to feel the pulse with your index and ring fingers, and
count the pulse with your middle finger.
5) Count for an entire minute.
<♦ The normal pulse rate of an adult is between 60 and 90/minute
♦♦♦ It is often not possible to check the pulse rate of children, in which case
the heart rate can be checked using a stethoscope.
Apart from the hands, we can measure the pulse rate in a few more
places. For example, on the left and right side of the inguinal region,
at the centre of the heel or on the left and right side of the neck at
a high point.
Checking the pulse rate
7. Measuring blood pressure
Aim :
To diagnose a patient’s illness by measuring blood pressure.
Requirement :
Stethoscope, sphygmomanometer (BP apparatus)
Procedure :
Stand to the right of the patient for measuring his/her blood pressure,
since it is convenient to examine the entire body of the patient while
standing to his/her right.
1) Place the sphygmomanometer at level with the patient’s heart.
2) Blood pressure can be measured while the patient is sitting or
lying down.
3) Request the patient lie down and talk to him/her as this will divert
his/her attention. Tie the handcuff of the sphygmomanometer
around the patient’s arm above the elbow joint.
4) Raise the mercury level to 160-170 mm by compressing the balloon.
Simultaneously, check whether you can feel the pulse. The pressure
at which the pulse can be identified is the systolic blood pressure.
Let the mercury drop to the minimum level.
5) Then, approximate the place on the centre of the inner elbow where
you feel a pulse and place the diaphragm of the stethoscope exactly
there.
6) Raise the mercury level to 160-170 mm by compressing the balloon
and turn the key located near the balloon and lower the mercury
slowly. Listen to the pulse by placing the stethoscope at the centre
of the inner elbow at the same time. The time when you can here
the pulse is the systolic blood pressure. When the pulse becomes
indistinct and then stops altogether is the diastolic blood pressure.
Observation :
The blood pressure of an average adult human is from 90/60 mm /
mercury to 140/90 mm /mercury. The average blood pressure of an
individual depends on his/her constitution.
Inference :
There is a difference of 10 mm in the blood pressure taken while a
person is sitting and lying down. This is normal.
11
8. Counting heartbeats
Aim :
To count the heartbeats using a stethoscope
The heart is located on the left side of the rib cage. The pulse rate
is the heart rate We can measure the heart rate or beat using a
stethoscope It is possible to hear the heartbeat four fingers below our
left nipple slightly to the left.
Place the ends of the rigid part of the stethoscope tubes in the ears
and listen to the heartbeats and the sounds of the respiratory system
by placing the diaphragm of the stethoscope on the chest.
Heartbeats :
The heartbeat sounds like lub-dub. You can hear the first sound ‘lub’
during the contraction of the atrium and ‘dub’ during the contraction
of the ventricle. The two sounds of lub and dub are not separated by
a large time interval. This interval is less than that between the sounds
of dub and lub. Lub-dub, lub-dub, lub-dub.
We can listen to the other sounds of the internal organs of the
respiratory system using the diaphragm of the stethoscope. The
sound of regular breathing is like the sound of air being passed in
and out of a large pipe. We can hear a whistle-like or flute-like
sound through the stethoscope when a patient is afflicted with
asthma. When the stethoscope is placed on the lung area of the
abdomen of a patient afflicted with pneumonia, noises
like a paper being crumpled can be heard.
1
9. Examination related with the respiratory system.
A list of questions that are to be asked to the patient.
A) 1. Personal details about the patient
What is your name?
What is the name of your village?
Address?
Age?
Gender?
Education?
Marital status.
A) Unmarried
B) Married
C) Widow/Widower
D) Divorced
Financial condition:
About the house
What kind of roof does the house have?
Does the house have a chimney?
Is there a toilet/bathroom?
Fuel used:
1. Wood 2. Dried cow dung cakes
3. Kerosene
4. Gas
Type of work.
’I
Where do you work?
1. On the farm?. In the house
3. Salaried employee
What type of work is it?
B) History of illness
Vaccination (for children)
Are you allergic to any food/medicine?
Addiction - cigarette/bidi/alcohol
C) Present examination - Description
A patient afflicted with an illness of the respiratory system has the following symptoms
1. Phlegm/cough
2. Difficulty in breathing.
3. Acute pain in the chest
In case the patient states any of the above complaints, then regard them
as the main symptoms and first obtain additional information about the same and
then about the remaining symptoms.
13
D) Examining for phlegm/cough
Ask the following questions first if a patient complains about phlegm-cough
•
Since when do you have this problem?
•
How do you exactly cough? What type of cough is it?
•
When is the cough acute?
•
In case of cough with expectoration -
•
What colour is the phlegm?
•
Is the phlegm thick or thin?
•
Since when do you have this problem?
•
It is imperative to find out for how long the bouts of cough last
•
Cough occurs due to germs/pollution/allergy.
•
Cough that occurs due to virus is cured within 8-10 days on its own. If the
cough occurs due to bacteria and does not stop even with antibiotics, then
following five diseases must be taken into consideration - TB, cough due to
the cancer virus, smoker’s cough, farmer’s cough.
•
How do you exactly cough? What type of cough is it?
Observation
Dry cough
This type of cough occurs due to allergies
, worms in the abdomen or it occurs
in farmers due to the mould in the farm.
Cough with expectoration
The phlegm produced in the iupper
------- respiratory system (nose, pharynx) is thin and
that produced in the lower respiratory tract (lungs, bronchi,
, and bronchioles) is thick,
Watery phlegm is formed due to virus. Thick,
greenish-yellow phlegm is formed due
to bacteria. One can suspect TB, pneumonia or lung cancer if the phlegm is reddish
brown in colour
At what time of the day to you experience severe bouts of coughing?
The person afflicted with long-term illness of the respiratory system will complain
of severe bouts of coughing in the mornings. The phlegm discharged during a single
bout of coughing can vary from a spoonful to a cupful.
2. Ask the following questions first if the patient complains about difficulty in
breathing —
1
What do you mean when you say that you are experiencing difficulty in breathing1?
If the patient complains about chest pain, then ask him/her the questions mentioned
m point three In case of breathlessness ask the following questions
Do you feel breathless while working? It is normal for everybody to become
breathless while exercising, but it should come under control within a short period.
Difficulty while inhaling or exhaling indicates a disorder of the respiratory system
Difficulty in breathing while lying down or constantly is a serious symptom Many
a times, difficulty in breathing indicates heart diseases In such cases the patient
must be sent to the doctor.
3
What makes you feel better?
In case of an illness of the respiratory system the patient is constantly breathless.
Nothing eases the patient’s difficulty. A patient with a heart disease will feel
worse when lying down and better when sitting.
4
Since when do you have the problem of breathlessness? Is it increasing or has
it decreased?
If breathlessness is caused due to an illness of the respiratory system, it gradually
increases. The patient can tackle this problem by making lifestyle changes.
5. For this reason, ask him/her whether he/she can still perform all the activities
that he/she performed last year?
3. Ask this question first to the patient if he/she complains about acute pain
in the chest, let the patient describe the type of pain in his/her own words.
Extreme cutting pain is caused due to the inflammation of the lung covering. A
pressing pain or pain like a stone kept on the chest js caused due to heart diseases.
Where does it pain? In case of pneumonia, the pain is acute and the patient
can easily pinpoint this spot. In case of pneumonia, the site and the pain are mutually
associated.
If the patient has chest pain related with heart diseases, then the pain is diffusing
which spreads to the left side of the chest, shoulders and sometimes, down to
the left hand.
The patient does not have fever in case of heart diseases, whereas the patient
has fever along with chest pain in case of pneumonia and TB. The windpipe (trachea)
is located in the centre of the chest, so an inflammation of the windpipe (trachea)
causes pain in the middle of the chest.
Swelling or inflammation of tonsils and larynx causes throat pain. If the pain increases
on pressing the larynx externally, it is suggestive of tonsillitis.
1. Tonsils
2. Inflammation of the larynx
3 Inflammation of the trachea -
Difficulty in swallowing.
Pain increases on pressing externally.
Pain in the centre of the chest.
15
4
Pneumonia, TB
Acute cutting pain in specific areas and fever
5
Heart diseases
Pressing pain, radiating to the shoulder, chest till the
hands
Turn to the other two sets of questions only after asking the sets of questions corresponding
to the patient’s complaints about the mam symptoms Obtain the following information
apart from that above.
1. Do you have fever with chills? Fevers
with chills are caused due to germs.
2. Are you taking any medicines'?
3. Are you allergic to any medicines? Even
allergy causes breathlessness
4. Do you suffer from constant exhaustion?
5. Are you loosing weight? If the answer to the above two questions are 'yes’, the
illness has not arisen suddenly; you could diagnose that they possibly indicate heart
disease, TB, anaemia or emphysema. Send the patient to a doctor in this case
6. Do you smoke bidi or cigarette?
The inflammation of the respiratory system may increase due to the house. Collect
information regarding pollution in the house. Ask which type of fuel is used in the
house.
7. What is your occupation?
Carrying out a few specific jobs exposes r
a person to the risk of dust and micro
organisms entering the body along ,with the ai
air. This may cause a burning sensation
in the respiratory system or fibrosis.
Occupations that pose a risk to the respiratory system.
1.
Quarry work
2.
Stone-splitting
3.
Factories manufacturing slates - chalks
4.
Carding cotton.
5.
Traffic police
8. Does anyone else from your family suffer from the same problems?
In case someone in the family has TB, other members of the family are at a risk
of contracting the same, Asthma may occur in children whose parents are afflicted
with it.
10. Examining the organs of the respiratory system
Aim :
To examine the organs related to the respiratory system and diagnosing
ailments if any.
Requirement :
Torch, tongue depressor, stethoscope
Procedure :
1) The respiratory system begins with the nose: Examine the nose
with a torch. The mucous membrane of our nose appears red and wet.
The mucous membrane appears swollen in case of a stuffy nose. A
grape-like, soft and swollen knot can also be observed in the nose.
2) The next organ is the throat: Request the patient to open his/her
mouth and say ‘Aaah’. Now, the mucous membrane can be viewed at
the back wall of the throat. The mucous membrane of a healthy person
will appear pink. This mucous membrane appears red in case of
pharyngitis. Even white/yellow/ash-coloured spots may be observed in
our throat in case of bacterial infection. The tongue depressor can be
used for a clearer view of the throat. The tonsils, throat and larynx as
well as the trachea can be viewed by pressing the tongue depressor
down on the back of the tongue.
The mucous membrane in all of these parts of a healthy person will
appear pink, whereas it will appear red in case of an inflammation of
any of these organs.
All these are regarded as external organs as they can be viewed with
the help of a torch. But, we have to use the stethoscope and listen to
the sounds of the internal organs of the respiratory system, which cannot
be viewed with the eyes, in order td diagnose illnesses related with
them.
A whistle-like, suuuui-suuuui, sound would be heard when the
stethoscope is placed on either side of the chest in case of asthma.
When the stethoscope is placed on the chest of a pulmonary oedema
patient, it sounds like a paper crumpling.
Inference :
The reasons behind hearing both these sounds are,
1. In case of asthma, there is a hindrance in the bronchioles while
exhaling. Pressure is created while exhaling, as more air has to be
exhaled out of a narrow passage and a noise like the one created
while blowing air through a flute is produced.
2. In case of pulmonary oedema, water fills in the air sac. That is why
a sound like a paper being crumpled is emitted when the air flows into
it It is also known as rales
Apart from this examination, we can obtain knowledge about chronic
illness of the respiratory system by examining the nails. Risen nails
indicate previous bronchitis and long term asthma. The ribs are drawn
in in case of asthma and pneumonia in children. The nostrils flare and
the neck muscles are stretched
Throat examination
6,
11. Examining for previous illness
Aim :
1)
Discerning the previous illnesses of the patient and ascertaining
if it has any effect on the present illness.
2)
We can discern the patient’s past history of illness before
examining the patient by taking his/her history, e g we can
be informed about past pneumonia, TB, blood pressure, diabetes,
heart diseases, heart disorders, asthma.
3)
We can also discern about any surgeries that the patient has
undergone by inquiring about the same with the patient.
For example:
1.
The scar of a gallbladder surgery can be seen on the right
side of the abdomen, below the ribs.
2.
A diagonal scar on the seventh quadrant of the abdomen may
indicate an appendix surgery.
3.
A scar on the second quadrant of the abdomen, above the
navel, usually indicates a surgery of the duodenum of the small
intestine or a surgery for ulcers.
4.
A vertical or horizontal scar below the navel in women
usually indicates a caesarean section.
y
I
A. Surgical scars on the thorax & Abdomn
Surgery of
gall bladder
Renal
Surgery
L Pephe ulcer or
ulcer of the
« small intestine
Umbticus
Renal
Surgery
Caeserean/
Hystecectomy
Appendicectomy,
Surgery of the
appendix •
!0
Examining the eyes for anaemia
_________________ and jaundice
1. Conjunctiva as it appears in
anaemic patient
1. Conjunctiva as it appears in
patient suffering from
jaundice
2. Conjunctiva as it appears in
normal person
2. Conjunctiva as it appears in
normal person
t
21
12. Examining present illness
Aim :
Diagnosing the patient’s illness and prescribing medicines accordingly
as well as advising the patient about health.
Requirement :
Torch, tongue depressor, stethoscope, soap for washing hands, water
Procedure :
Listen to all the complaints of the patient, start examining the patient
only after obtaining all information about his/her illness. The
examination can be conducted in the following steps.
Pulse :
Check the pulse rate for one minute using a watch.
Describe it as given below.
For example, 80 per minute.
Rate of
Check the patient s rate of breathing for one minute by placing your
breathing ;
hand on the patient’s abdomen/chest.
Describe it as given below.
For example, 20/minute
Blood pressure : Request the patient lie down and measure the blood pressure.
For example, 120/80 mm mercury
General examination
Observation
of the hair:
Sparse hair in infants may indicate malnourishment. Information
regarding hair hygiene as well as dandruff in the hair can be obtained
through this examination.
Eyes:
Check whether the eyes are kept clean. Whether the patient is
anaemic or not, as well as the approximate severity of anaemia
can be ascertained by examining the mucous membrane of the
lower eye lids The mucous membrane of an average healthy person
is reddish in colour. It is pinkish in persons with low or moderate
anaemia and whitish in case of severe anaemia
Whether the patient has jaundice can be ascertained by examining
the colour of the conjunctiva under the upper eye lids.
In the same manner, information as regards eye infections can be
obtained by the redness of the eyes and the accumulation of dirt
at the corners of the eyes.
2
Nine-parts / segments of the abdomen
Some part of liver &
stomach
o
Nipple
o
Liver & gall
bladder
Stomach &
spleen
Rt. Kidney,
large
intestine
Appendix
Rt. Ovary
(in Women)
Small
Intestine
(Pancreas)
•
Lt. Kidney,
large intestine
!
A Z- .
Urinary bladder, Uterus
(in women), Rectum y
V
Some part of
sigmoid colon
• Lt. Ovary
* (in Women)
Nipple
Rt. ribs
Lt. ribs
■
«!
S
o
Uhttcus
/Navel)
Pelvic
Nose :
Information as regards the mucous membrane in the nose and the
cleanliness of the nose can be obtained through examination
Ears :
Information as regards the cleanliness of the ears as well as any
ear infections can be diagnosed after viewing the ears using a torch.
Mouth :
Request the patient to open his/her mouth and say 'Aaah’ for
examining the patient’s throat We have been informed about the
same in the chapter regarding the examination of respiratory illnesses
Along with the throat, we can obtain information as regards the
diseases of the different parts of the mouth We can first ascertain
the patient’s oral hygiene by looking at his/her teeth. Then, the state
of the mucous membrane of the tongue and its dryness gives
information regarding dehydration. We can estimate the haemoglobin
content of the patient through the colour of his/her tongue.
Boils and wounds inside the mouth indicate malnourishment and
vitamin B deficiency.
We can obtain information regarding the patient’s addictions by
examining the mouth, e g. a blackish layer is formed on a part of
the gums between the teeth of persons addicted to mishri (roasted
and powdered tobacco).
The lips of persons addicted to cigarettes and bidi turn black at
the centre and their front teeth are stained yellow. A white patch
may be observed at the spot where a person always places tobacco.
Neck :
The lymph nodes on the neck should be examined gently and slowly.
This helps in diagnosing any infection of the throat, mouth or ears.
Nails :
Examine nails for cleanliness, shape and colour.
Raised nails indicate long term asthma in 90% of the patients. The
colour of the nails provides information about the haemoglobin content
in the blood
Chest :
The chest is shaped like a drum in case of emphysema
Abdomen :
Examine the abdomen gently using the entire palm of your hand.
But since the finger tips are more sensitive we receive more
information through them. Press the lower abdomen gently and with
proper pressure for ruling out the possibility of lumps Pain at specific
spots on the abdomen while examining with a gentle pressure
signals specific illnesses, e g
The possibility of appendicitis cannot be ruled out in case there
is a pain in the lower right side of the abdomen on pressing gently.
In that case the patient will also have the symptoms of fever and
vomiting. In the initial stages of appendicitis, the pain is just below
the navel and it then shifts to the seventh quadrant of the abdomen.
In case of parasitic infections like Giardiasis, Amoebiasis : Pain in the lower left
side of the abdomen. In that case the patient will also complain
about ordinary fever, diarrhoea with mucous and blood discharge,
nausea, vomiting.
In case of inflammation in the stomach : The patient may experience pain in the
upper left side of the abdomen that may sometimes spread up to
the navel, but does not have fever. The patient will also complain
about burning sensation in the heart and abdomen, nausea as well
as vomiting. The patient may experience pain in the upper right
side of the abdomen in case of liver diseases.
In case of kidney diseases : The patient will experience acute pain in the back when
the areas on both sides of the spine just under the ribs are pressed.
Abdominal
examination
13. McBurney’s sign
Aim :
Diagnosing appendicitis
Procedure :
Request the padent to lie down on his/her back and examine the
abdomen gently. Examine from just below the right ribs up to the
right thigh
In case of appendicitis, if the centre point of an imaginary line
imaginary line
from the navel to the pelvic bone is pressed with the hand and
then suddenly released, the patient will writhe in pain.
i
I
Inference :
In case of appendicitis, the peritoneum is inflamed. The patient
experiences pain when the abdomen is pressed, as in doing so
the peritoneum is pressed.
The patient has fever and vomiting in case of appendicitis.
14. Murphy’s sign
Aim :
Diagnosing the diseases of the gallbladder.
Procedure :
Request the patient to sleep on his/her back. Press the area above
the lower abdomen gently to examine the stomach. Request the
patient to breathe deeply during this examination.
Observation :
The patient with an inflammation of the gallbladder writhes in pain
during examination.
Inference :
When the patient breathes deeply, the lungs expand and diaphragm
shifts downwards and as the liver is under the diaphragm it shifts
downwards as well. The gallbladder is situated directly below the
liver. While examining, the hand presses the gallbladder when the
liver shifts downwards. The patient experiences pain in case of an
inflamed gallbladder and he/she writhes in pain.
t
15. Examining a patient’s liver and spleen
Procedure :
1) Liver examination
Request the patient to lie down on his/her back with the legs straight
or with the legs bent from the knees. For examining the liver inspect
from the right thigh up to the upper abdomen just under the nght
ribs by pressing the abdomen gently with your right hand Request
the patient to breathe deeply during this examination.
Observation :
When the patient breathes deeply, your right index finger will feel
the lower section of the liver if it is enlarged.
The liver is enlarged in case of jaundice. Amoebiasis also leads
to the enlargement of the liver as small lumps are formed in the
liver.
Procedure :
2) Spleen examination
For examining the spleen, inspect from the left thigh up to just under
r
Observation :
the left nbs by pressing the abdomen gently with your right hand
Ask the patient to breathe deeply during this exammation as well
The spleen is enlarged in case of sickle cell anaemia and frequent
bouts of malaria.
EXPERIMENT BOOKLET
Health and environment
Subject - 2
Module - 402
The Foundation for Research in Community Health (FRCH)
Pune
3 and 4, Trimiti B Apartments, 85 Anand Park, Aundh, Pune - 411007
Telephone: 020-25887020, Fax: 020-25881308
Email: frchpune@giaspn01 .vsnl.net.in
Preface
National Institute of open schooling - We nave published four experiment booklets
based on the four modules of ‘Gramsakhi’. While studying the Gramsakhi modules,
only reading or explaining them orally is not sufficient for understanding them. The
procedure will only remain embedded in our minds permanently if we actually implement
it.
Similarly, frequent repetition of the demonstrations enhances our skills.
Since the instructor is present while conducting the procedure, mistakes, if any, are
immediately rectified. All doubts arising during the execution of the procedure can be
clarified on the spot. Moreover, a large part of the syllabus is covered automatically.
This is the reason for publishing these booklets. Experiments have been selected
independently from each module and diagrams have been given as and when required.
All these experiments are of use in our daily life. Implementing these regularly will
help in increasing our self-confidence.
We hope that these booklets will be of use to you.
Contact us in case of any queries, difficulties or in case you feel that some other
important information must be included or in case you have any suggestions regarding
the arrangement and layout. This will make these experiment booklets easier and simpler
and in turn, will aid in achieving our goal.
Contents
1. The requirement of oxygen for combustion
A Diag.Oxygen is required for combustion
2
2. What is your rate of breathing?
3
3. What is your lung capacity?
4» Diag. What is the lung capacity
4
5
4. Getting acquainted with the income of the Gram Panchayat
6
5. Using bleaching powder to purify water
8
6. Mother solution
10
7. A-frame -a useful device for digging continuous channels at the same level 11
+ Diag. A-frame device
12
8. Preparing a drainage pit and maintaining it.
♦ Diag. Drainage pit
13
14
9. Purifying water using solar energy
15
10. Using solar energy
16
•fr Diag. Solar cooker
17
11. Report writing
18
19
Diag. Sample
I
1. The requirement of oxygen for combustion
Aim:
Proving that the oxygen in air is required for combustion.
Requirement:
Two small candles, 2 glasses, 1 saucer, matchbox
Procedure:
1) Place 2 glasses next to one another.
2) Light the 2 candles using the matchbox. Fix one candle each
in the two glasses using a drop of hot wax. Ensure that the
candles are not taller than the glasses.
3) Now, place a steel saucer over one glass.
4) Observe both glasses for 15 to 20 minutes.
Observation:
1) The candle in the uncovered glass will keep burning even after
15-20 minutes.
2) The candle in the covered glass will extinguish within a short
time.
Inference:
1) Since one glass was uncovered, the candle was supplied with ;
air. The oxygen in air was used for combustion and the candle
continued burning.
2) Since the other candle was covered, the air supply to the candle
ceased. The candle kept burning till oxygen in the air trapped
inside the glass existed. As soon as it was used up, the candle
extinguished.
From this it can be inferred that the oxygen in air is required
for combustion.
Oxygen is required for combustion
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2. What is your rate of breathing?
Aim:
Counting your breath rate
Requirement:
A second clock, paper, pen and a friend for assistance
Procedure:
1) With the help of your friend, count the number of breaths per
minute while sitting calmly Use this method to count the number
of breaths per minute four times and calculate the average.
2) Now, take a brisk walk and immediately record the number of
breaths per minute.
3) Now, run the distance that you walked and record the number
of breaths per minute.
4) Record the number of breaths per minute after jumping up and
down on the spot 25 to 30 times.
5) Accordingly, draw a graph of the records to find out when your
rate of breathing was the fastest and it was the slowest?
Further uses:
Repeat the same experiment on your friend and record the
observations. Take age and physique into consideration while
comparing.
3. What is your lung capacity?
Aim:
To observe the capacity of the lungs to inhale air
Requirement:
Rubber tubes, one large glass bottle (2 litre capacity), a rubber
stopper for a glass tube, potassium permanganate, a scale with
centimetre reading, etc.
Procedure:
1) Prepare the rubber stopper for the glass bottle by fitting two
glass tubes as shown in the diagram.
2) Mark the cm or ml indications on the glass bottle, in case it
does not already exist. Fill this bottle with 2 litres of water to which
potassium permanganate has been added.
3) Now, take a deep breath and hold it and then blow forcefully
into one rubber tube, water will start spilling out from the other tube.
Pour this water into an empty vessel.
4) The more the air in your lungs the more the water that spills
out from the bottle. Now, either, calculate the difference between
the water level before and after the experiment or measure the
water that spilled out from the bottle.
5) (Clean the tube with a disinfectant each time after blowing air
through it.)
6) What is your lung capacity? , Instead of taking a deep breath,
take a normal breath. Observe the difference in the result of a deep
breath as against a normal breath.
Further uses:
Check the lung capacity of different persons using this apparatus.
I
What is the lung capacity?
Rubber Tube
II
Blow in air from
here
Rubber' \\
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Water level (at the
beginning)
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Water with Potassium
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4. Getting acquainted with the income
of the Gram Panchayat
Aim:
1)
Getting acquainted with the different means of income of the
Gram Panchayat.
2)
Classifying the different means of income
Requirement:
Register, pen, Xerox copies, etc.
Procedure:
1)
It is necessary to consider the availability of money before
undertaking any development work in the village. Obtain
information about the different means through which the Gram
Panchayat collects funds. Consult with the village worker,
Sarpanch, members and former members for the same. As
residents of the village, you have the right to obtain detailed
information about the income of your Gram Panchayat.
2)
Obtain detailed information about grants to the Gram Panchayat,
taxes levied by the Gram Panchayat, charged fees, auctions,
rent on immoveable property, special grants, and donations to
the Gram Panchayat, contribution from the people, etc.
Income of the Gram Panchayat from the aforementioned as
well as other sources is calfed Panchayat funds. It can be
classified as follows.
1. Grants to the Gram Panchayat
2. Different taxes levied by the Gram Panchayat
3. Rent received by the Gram Panchayat
4. Loans taken by the Gram Panchayat
5. Donations and contributions accepted by the Gram Panchayat
6. Fees charged by the Gram Panchayat
Example 2 Income from the different taxes levied by the Gram
Panchayat
a) House-tax on buildings and open space
b) Water tax
c) Entertainment tax, fair and festival tax
d) Vehicle tax (Parking lot)
e) Market tax
f) Cattle shed fee
g)
Different records/registration fees
h)
Tax on cattle (cattle trading)
i)
Lighting tax
j)
Health tax, etc.
Classify as mentioned above and stay informed about the income
gained from them.
Further uses:
After obtaining information about the income of the Gram Panchayat,
as a vigilant resident, take active part in the planning of work and
expenditure in future.
Income from the taxes levied
Funds of the Gram Panchayat
by the Gram Panchayat
1. Different taxes levied by the Gram
a) House-tax on buildings and
open space
Panchayat
2. Grants to the Gram Panchayat
b) Water tax
3. Rent received by the Gram Panchayat
c) Entertainment tax, fair and
festival tax
4. Loans taken by the Gram Panchayat
d) Vehicle tax (Parking lot)
5. Donations and contributions accepted
e) Market tax
by the Gram Panchayat
6. Fees charged by the Gram Panchayat
f)
Tax on cattle (cattle trading)
g) Lighting tax
h) Health tax, etc.
❖
In this manner, we can classify the income of the Gram Panchayat
obtained from fees, donations, rent and loan, from which we can estimate
the total income of the Gram Panchayat.
5. Using bleaching powder to purify water
Aim:
Deciding and administering the dosage of bleaching powder for
purifying water
Objective:
Calculating the capacity of the water storage tank.
1)
2) Deciding the dosage of bleaching powder for purifying water.
Requirement:
A cloth tape (5 meters); string; weighing scale, blank paper; pen,
etc.
Procedure:
1) Measure the interior of the village water supply tank with the
help of a tape in meters in the following manner.
For a square or rectangle tank -
Length, breadth and the water depth
For a round tank The diameter of the tank and the depth of water
(Use the string for measuring the water depth)
Enter the above measurements in the following formula to calculate
the total water capacity in litrefc.
The total of a square or rectangle tank
Water (litre) =
length (meter) x breadth (meter)
X water depth (meter) x1000
The total of a round tank
Water (litre) =
diameter (meter) x diameter (meter)
X water depth (meter) x 785
(The resultant answer indicates the total water capacity of the
tank in litres.)
Use 5 gm of bleaching powder having 35% active chlorine for
purifying every 1000 litres of water (Use bleaching powder with
an ISI mark)
2) Depending on the water capacity weigh the bleaching powder
with the help of a weighing scale. Add enough water to the powder
in the bucket to make a paste. Then, add enough water to make
to
bucketful of water Stir this mixture well with a stick.
Cover and keep aside till it settles.
3) Pour this settled mixture into another bucket and add this mixture
to the water by dipping the bucket deep in and out of the water
till it is well mixed The water is ready for use after half an hour.
Further uses:
1) Apply the O.T test to verify whether the water in your village
has been processed If not, then teach the above mentioned
process to the waterman of your village.
2) Test the appropriateness of the process with the help of the O.T
test. Make appropriate changes in case of any errors.
6. Mother solution
Aim:
To sterilize water at the household level
Objective:
1) Preparing the mother solution and using it to purify water at
the household level.
2) Using mother solution to purify water in each and every household
Requirement:
200 g bleaching powder, cotton cloth for straining water, a thick
plastic bucket (high), a dry wooden stick one foot in length, a cover
for the bucket, one litre water, rust coloured thick glass bottle.
Procedure:
1) First, measure one litre of water and strain it using a cotton
cloth into a tall bucket.
2) Weigh 200 g fresh bleaching powder having 35% active chlorine
(The bleaching powder (T.C.L) should be of good quality Ensure
that the packet of bleaching powder is sealed airtight.)
3) Pour the entire 200 g of bleaching powder into the plastic
bucket (in which one litre of water is taken) and stir well to
dissolve using a clean and dry wooden stick. Cover and set
this mixture aside for a half an hour to one hour.
4) On removing the cover you will see that the limestone residue
has settled at the bottom. Pour the upper layer i.e. the light
coloured solution containing chlorine carefully into the rust coloured
bottle. This solution containing chlorine is the mother solution.
(Use this solution for purifying water at a ratio of one drop for
four litres of water)
5) Supply this solution in a clean glass bottle for use in every
household in the village and inform the people about its use
and encourage them to use it for water purification.
Further uses:
1)
While getting informed, also inform the people of the village,
especially anganwadi teachers, primary school staff, social workers
about the same.
2) Prepare this mother solution in the primary school and taking
adequate precautions send it home with the children This
procedure must be followed diligently.
7. “A”-frame - a useful device for digging continuous
channels at the same level
Aim:
To construct an "A” frame and to draw contour lines on a mountain
slope
Objective:
1) Building a contour marker using the equipment available at the
local level and which can be used by everybody
2) Drawing level contour lines (level lines) with the help of the frame
(contour marker)
Requirement:
Three 10 feet long bamboos of identical thickness, cotton string for
tying, tailoring tape, sketch pen, lime powder, etc.
Procedure:
1) First, take three 10 feet long bamboos that are of the same
shape, light-weight and straight
2) Mark at points that are one and a half feet away from both ends
of these bamboos using a sketch pen or lime powder. Use the
tailoring tape for measuring. Place the bamboos on these marks
and tie them up to form a triangle as shown in the figure. You
will now have points 'A ‘B’ and ‘C’ and the distance between
these points, i.e. ‘A to ‘B’, ‘B’ to ‘C’ and ‘C’ to ‘A, will be identical
i.e. seven feet. With the tailoring tape, determine the mid point
of the base bamboo ‘C’, 'B'. Name this point ‘D’.
3) Tie one end of a cotton string to the apex ‘A and tie a small
stone to the other end of the string and leave this end hanging
as shown in the figure.
4) This frame will be an equilateral triangle. Likewise, the hanging
end of the plumb bob will be perpendicular with the base ‘C’, ‘B’.
As per the formula of this triangle, when the plumb bob is over
point ‘D’, both legs, ‘B’ and ’C’, will show the even ground level.
In short, these two points are on the same contour level
5) Now, mark points B and ‘C’ on the ground with lime powder and
select one of these points and place one leg of the frame on this
point and then select the other point It is necessary for the plumb
bob to be steady on point 'D’ before marking another point. Draw
the entire continuous contour lines in this manner.
Further uses:
1) Channels can be dug or bunds can be constructed by drawing
continuous contour lines
2) The damages to the farm and expenses caused due to the frequent
bursting of bunds can be avoided by constructing flood-vent at the
same level with the help of the 'A' frame
“A” A-frame device
A
A-B - 7.5 Ft
B -C-7 5 Ft
A-C-7.5 Ft.
i
I
I
B
C
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Ct
8. Preparing a drainage pit and maintaining it.
Aim:
1) To drain sewage water
2) To let the sewage water seep into the soil
Requirement:
A foot ruler, a pickaxe, a hoe, an iron container, a crowbar, medium
sized earthen pot, coconut husks or coir, jute bag, screw, etc.
Procedure:
Select a location to dig a drainage pit. It should preferably be away
from walls and in a place where the combined water from the
bathroom and kitchen emerges. Do not dig a drainage pit in a rocky
or damp place.
1) The dimensions of the drainage pit are decided depending on
the number of people in a family. A pit that is 3 feet long, 3
feet wide and 3 feet deep must be dug for a family of 5 to 6
persons.
2) Fill the bottom 1/3rd layer of the pit with stones and bricks of
approximately 4 to 6 inch diameter. (In this case, 1/3rd is 1 foot.)
3) Then, fill the middle 1 foot layer with pieces of bricks, tiles or
round stones of 2 to 4 inch diameter. (Middle layer - 1 foot)
4) Fill the topmost 1 foot layer with stones, pebbles (with thickness
less than 2 inches) or with coarse sand. The earthen pot has
to be positioned in this layer.
5) Make 10-12 holes at the bottom of a medium sized earthen
pot with the help of a screw (by twisting the screw around). Fill
the pot with coir (fill with shredded coconut husks). Make place
for the pot in the drainage pit and place it such that the mouth
of the pot is at the level of the ground.
6) Now, spread the jute bag over the area surrounding the pot. Plaster
it to the ground using cow dung and mud.
7) Replace the coir/coconut husks in order to maintain the cleanliness
of the pot. After 3 to 4 years or in case you realize that the
water is not seeping in through the pit any longer, dig out the
entire drainage pit and prepare a new drainage pit by filling
it with new stones and bricks or by using the same ones after
drying them well.
Further uses:
In case space is available near or around your house, refilling water
ditches, pits can be can be prepared by digging large pits and filling
it in with the same items as for the drainage pit. Due to this, the
water collected in the rainy season will seep through the soil leading
to the refilling of water and will help in increasing the ground water
level.
Drainage pit
f
% *
1
15
9. Purifying water using solar energy
Aim:
To purify impure water using solar energy
Requirement:
A wide vessel, a concave transparent glass lid that fits over the
vessel, salt, drinking water, even a polythene film will do as a lid
Procedure:
Take water in a wide vessel and dissolve enough salt in it to make
it saline. Cover it with the concave transparent glass lid and expose
it to sunlight. In case of bright sunlight, keep checking, after 30
- 40 minutes small water droplets would have started accumulating
on the inner side of the concave glass lid. When enough water
has accumulated on the lid, lift the lid and taste the water droplets.
Then, taste the water in the main wide vessel.
Evaluation:
Evaporation and condensation are the two actions that take place
in this demonstration. Since the wide vessel was exposed to sunlight,
the water turned to vapour and rose upwards to the lid and
accumulated on the concave transparent glass lid or the polythene
cover in the form of water droplets.
Further uses;
1) Cloud formation.
2) Checking whether it is possible to obtain drinking water
from sea water.
10. Using solar energy
Aim:
Proving that solar energy can be used in daily life.
Requirement.
1 small cup split kesari (Tur dal), 1 small cup rice, solar cooker,
water
Procedure:
1) Wash the split kesari and rice thoroughly.
2) Put the rice and gram separately in the two containers of the
solar cooker and add water in the usual proportion.
3) Taking the position of the sun into consideration, place the solar
cooker in the courtyard/terrace in the morning (between 9:30 a.m.
and 10.00 a.m ). Keep the containers of rice and split kesari in
the cooker and cover v/ith the glass lid
4) Move the solar cooker according to the movement of the sun.
Ensure that the solar cooker is always exposed to the sun.
V
Observation :
1) After approximately two to two and a half hours open the containers
in the cooker. (Use a dry cloth to open the containers to avoid
burning your hands).
2) You will observe that the rice and split kesari ?re well cooked,
piping hot and ready to serve.
/
Inference:
With equipment like the solar cooker we can use solar
energy in our daily life as well.
Note:
Maharashtra Energy Development Agency (MEDA) provides these
solar cookers at a subsidised rate. Solar cookers of different
manufacturers are also available in the market.)
For more information:
Publications of the Maharashtra Energy Development Agency
Solar cooker
Reflector
Glass
coating
11. Report writing
Aim:
Keeping a record of the monthly savings group meetings
Requirement:
Register, pen. clipboard, etc
Procedure:
First of all, record the date, time, group name, village name, place
of the meeting and the meeting attendance in detail. If possible,
mention the meeting number as well.
Background:
Here, a brief account of the important qualitative and quantitative
topics and decisions taken in the previous meeting should be
discussed briefly and documented so as to associate it with the
present meeting.
The main topics of the meeting - meeting objectives:
1) Follow-up for the decisions and the main topics (In short, recording
the decisions taken or the actions taken on the decisions.)
2)
Mention the details regarding the quantitative topics of the meeting
- monetary transactions - savings receipts, savings returns, loan
instalments, interest, fees, new loans, total receipts and
disbursements.
3)
Even the qualitative topics like - the important decision-issues
of the meeting, e g. who was given a loan? how and why was
a person elected? opinions of the members regarding the same,
reaction participation as well as report, new information and discussion
about this information, votes, decisions, etc. must be noted. It is
necessary to record the reactions, questions, discussions, etc. of
the members regarding the new information. Even the situational
context must be given while recording the opinions of the members.
4)
Giving information as regards the date, time, place and topic
as well as the action plan of the next meeting.
Further uses;
As a health worker, it is necessary to prepare a report of the daily
or monthly work. Through this, you can estimate as well as ascertain
the progress of work. It would be possible to pinpoint the problems
as well as rectify them in time. It also aids in recording the collective
work of the institution
Sample
We can use the following sample to record the monetary transactions of the savings group
monthly meeting
Date:
Place:
Time:
Group name:
Meeting number
No.
Name
Savings receipt
Savings returns
Loan instalments Interest
EXPERIMENT BOOKLET
Health Education
Subject - 3
Module - 403
The Foundation for Research in Community Health (FRCH)
Pune
3 and 4, Trimiti B Apartments, 85 Anand Park, Aundh, Pune - 411007
Telephone: 020-25887020, Fax: 020-25881308
Email: frchpune@giaspn01 .vsnl.netin
Preface
National Institute of open schooling - We have published four experiment booklets
based on the four modules of Gramsakhi’. While studying the Gramsakhi modules,
only reading or explaining them orally is not sufficient for understanding them. The
procedure will only remain embedded in our minds permanently if we actually implement
it.
Similarly, frequent repetition of the demonstrations enhances our skills.
Since the instructor is present while conducting the procedure, mistakes, if any, are
immediately rectified. All doubts arising during the execution of the procedure can be
clarified on the spot. Moreover, a large part of the syllabus is covered automatically.
This is the reason for publishing these booklets. Experiments have been selected
independently from each module and diagrams have been given as and when required.
All these experiments are of use in our daily life. Implementing these regularly will
help in increasing our self-confidence.
We hope that these booklets will be of use to you.
Contact us in case of any queries, difficulties or in case you feel that some other
important information must be included or in case you have any suggestions regarding
the arrangement and layout. This will make these experiment booklets easier and simpler
and in turn, will aid in achieving our goal.
Contents
1 Recognising the signs and symptoms of the respiratory system diseases.
1
* Diag Inflammation of the respiratory system
2
2. Acute symptoms of the respiratory system diseases.
3
3. Household remedies for illnesses of the respiratory system like the common cold
4. Oral Rehydration Solution
* Diag. Preparing ORS/household saline
5. Recognising the symptoms of dehydration
* Diag. Examining for dehydration
6. Checking for fever
* Diag. Thermometer
7. Recognising different types of fever
+ Diag. Various types of fever
8. Symptoms of diseases
* Diag. Symptoms of diseases
5
7
8
9
10
11
12
13
15
16
17
i
1. Recognising the signs and symptoms of the
respiratory system diseases.
Physical
1
examination :
On examining with a stethoscope, you will hear a sound
like the waves
2. In case of acute infection, you will hear a whistle-like sound
There are four stages of the chronic inflammation of the respiratory tract
First stage -
More bouts of coughing in the morning
Second stage -
Breathlessness while climbing, picking up heavy objects and
after walking for a longer distance.
Third stage -
The patient is so weak that he/she cannot even walk up to
the main door of the house and complains about cough with
phlegm in the morning.
Fourth stage ❖
The patient experiences pain even while talking.
You can treat the patients in the first and second stages, but send the patients
in the third and fourth stages to a doctor or a hospital.
Examining the patient :
1.
A ronchi or whistle-like sound would be heard while examining with a
stethoscope.
2.
The patient’s chest would have a sunken appearance.
3.
If the patient is exhaling slowly, it means that the patient is using his/her strength
to exhale.
Symptoms :
1.
2.
A whistle-like sound.
3.
Cold, cough, phlegm
Difficulty in breathing
Signs : 1. The patient requires more time than usual to exhale.
The signs and symptoms of infants between the ages of 2 months and
one year
1
The infant cannot suckle.
2
Epileptic fits
2
3
The infant sleeps longer and it is difficult to wake the infant
4
When the child is sleeping peacefully, you can hear a wheezing sound
5
The infant remains malnourished.
Pneumonia
1. It is pneumonia, in case the ribs do not get drawn in while breathing.
2. It is pneumonia if breathing speed has increased.
For 2 - 12 month old infants - More than 50 breaths per minute is a high
rate of breathing.
For 1- 5 year old children - More than 40 breaths per minute is a high
rate of breathing.
Respiratory Tract Infection
J
*
*
■
.
*
■
«1
*
>
■
:
A
LL
2. Acute symptoms of the respiratory system diseases
In case parents come to you with complaints regarding the child's respiratory mechanism,
you can determine the seventy of the case in the following manner -
1
The child does not consume any thing
2
3.
The child cannot suckle the mother’s milk
4
The child sleeps longer than usual
Experiences epileptic fits.
It is difficult to wake the child
5. A loud noise is emitted while breathing.
6. A whistle-like sound is emitted while the child is quiet.
7.
High fever or the body temperature drops below normal.
8. The child becomes extremely malnourished.
In case of serious illness, send the child to a hospital or doctor immediately.
Acute pneumonia :
Infant below 2 months of age
1.
The breath rate increases to more than 60 breaths per minute.
2.
The ribs are drawn in
Pneumonia in adults :
Signs and symptoms
A)
A person troubled by pneumonia has a high fever with chills, has a cough, experiences
difficulty in breathing (increase in the rate of breathing) and complains of chest pain.
B)
1.
2.
3.
4.
5.
6.
7.
The nostrils flare.
Very high temperature
Increase in the rate of breathing.
The chest does not expand uniformly
No sound is heard when you tap on the chest.
A sound like that of the waves is heard when examined using a stethoscope.
Examine the patient’s nails and lips. In case oxygen supply is less than that required,
the nails and lips turn blue.
I 4 I
Send the patient to the doctor if there is no improvement even after 24 hours Send
to the doctor in the following cases
If the child stops drinking milk and water.
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If the child stops crying
If the rate of breathing increases.
In case of cough even after treatment.
Our responsibility as a health worker
•
Explaining the symptoms of pneumonia to the parents or the guardian of the
child.
•
Informing about the preventive measures against pneumonia.
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| 5
3. Household remedies for illnesses of the respiratory
system like the common cold
Aim :
Acquainting yourself with the household remedies for common cold
Requirement :
Basil, peppercorns, ginger, cinnamon, oil, camphor, long pepper,
lemon, sugar, salt, water, dry ginger powder, turmeric, jaggery, pure
ghee, lemon grass, linseed, white onion.
Procedure :
1) Wash 10-12 basil leaves. Boil 2 peppercorns, 1 small piece
of ginger and basil leaves in 2 cups of boiling water. Simmer
this decoction till it boils down to 1 cup. Administer this hot
decoction to the person having the common cold 2-3 times
a day.
2) Heat two spoons of oil in a small bowl. Add 1 spoon of ground
camphor to the oil and mix. Keep this mixture in a bottle. Rub
this mixture on the nose, forehead and chest in case of common
cold and cough.
3) Prepare tea using lemon grass and cinnamon. Serve this tea
to the person suffering from cough and cold.
4) For common cold, drink lemonade (juice made with water, sugar
and lemon juice).
5) Add 2-3 seeds of long pepper to 1 cup milk and boil. Serve
this to the person suffering from common cold.
6) Take 2 spoons of dry ginger powder in a bowl. Add 1 spoon
pure ghee, 1 spoon turmeric and 1 spoon jaggery to it and
mix till well blended
Prepare 4-6 tablets of this mixture. In
case of common cold take 4-5 tablets a day, one at a time.
7) Take 1 spoon of linseed in a pan and heat. When the linseeds
start to crackle add one cup of water. Then add one chopped
white onion. Simmer this decoction till it boils down to 1/2 cup.
Drink this warm decoction at night just before sleeping.
Observation :
1) A decoction of basil, ginger and peppercorns reduces common
cold with a runny nose and eliminates feverishness.
2) Rubbing oil, to which camphor has been added, on the nose
and chest relieves a running nose
| 6 |
3) Lemon grass and cinnamon tea soothes aching throat and helps
clear the nostrils
4) Dry ginger powder and jaggery tablets as well as long pepper
aids in reducing phlegm.
5) Linseed and white onion helps in thinning coagulated phlegm,
which is discharged via the nose and is excreted via the faeces.
Inference :
1) Illnesses of the respiratory system like the common cold are
caused due to germs, pollutants and allergens. You can try
curing this illness with the above mentioned household remedies
before visiting the doctor.
2) The patient will feel the difference within 3-4 days.
!
7
4. Oral Rehydration Solution
Aim :
Compensating the water deficiency in a person dehydrated due to
diarrhoea.
Requirement :
One litre water, salt, a fistful of sugar, vessel, fireplace/gas, a clean
four-ply cotton cloth, (lemon, baking soda if easily available)
Procedure :
Strain the water through a clean four-ply cotton cloth. Boil this water
for 5 minutes. When cool add one large pinch (three-fingered) of
salt and one pinch (two-fingered) baking soda (if easily available)
and then taste it. It should taste like our tears. Then add a fistful
of sugar and if required, lemon to taste.
Precautions :
1) Use this mixture only for four to six hours after preparation as
there is a possibility of the mixture getting contaminated with
germs.
2) Take the patient to a doctor in case the patient’s condition does
not improve satisfactorily even after administering Oral Rehydration
Solution (ORS).
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| 8
Preparation of ORS (Oral Rehydration Solution)
Household Saline
Fistful sugar or
jaggery
OnejThree fingered)
pinch of salt
9
5. Recognising the symptoms of dehydration
Minor
Child irritable
Major
Extremely irritable
Critical
Listless for unexplainable
reasons
Normal pulse
Average urination
Pulse rate lowers
Pulse rate extremely low,
hands and feet are cold
to the touch
Slightly less urination
Not urinated for more
than 12 hours.
Fontanel slightly depressed
Fontanel deeply depressed
Sunken eyes
Deeply sunken eyes
Dry and drawn face
Extremely dry and drawn face
Dryness of the mouth
Feeling of thirst
Skin on the lips starts
Flakiness of the lips due
peeling
to dryness
The elasticity of the skin
The elasticity of the skin is
reduces
destroyed
The child may faint
Weight reduces
Weight reduces by 5-10%
Weight reduces by more than
by 5% 10-20%
♦♦♦
We can determine the type of dehydration the child is suffering from by observing
the child’s condition (minor, major or critical).
10
Examining of dehydration
After releasing if the skin
does not get back to normal
instantaneously, it is
dehydrated.
1
f
The elasticity of the skin
reduces.
To Examine - Pinch & pull the
skin between the thumb &
index finger.
f
6. Checking for fever
Aim :
Using a thermometer to check temperature
Requirement :
Thermometer
Procedure :
Wash the thermometer thoroughly and place it in the right or left
armpit of the patient Instruct the patient to hold it in place firmly
Take a thermometer reading after two minutes.
The thermometer can be placed under the tongue for a time period
of two minutes to check the temperature in adults. It is possible
to check the temperature in children by inserting the thermometer
into the rectum. This thermometer is different from regular
thermometers and is known as the rectal thermometer.
Note :
Before checking the temperature, shake the thermometer briskly
and lower the mercury level to 35 °C.
Observation:
The fever can be classified into approximately three types depending
on the temperature reading.
Ordinary fever - 99° to 100 °F
Moderate fever - 101° to 103 °F
High fever - more than 103 °F
Inference:
The basic property of mercury is that it remains in the solid state
at normal temperatures and expands correspondingly with increasing
temperature. We can hence measure fever.
Thermometer
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13
7. Recognising different types of fever
Types of fever
Signs and symptoms
1. Malaria :
Fever with chills The fever is above 104 F and it subsides
after 2-3 hours with sweating. Fever appears on alternate
days or after every 2 days. The patient is fresh when he/
she does not have fever. In some cases, the spleen could
be enlarged when examined. This illness can be diagnosed
from the above symptoms and this diagnosis can be
ascertained by a blood test done during the fever with chills.
Critical condition - incoherent movement, condition veering
towards restlessness. Sometimes, even jaundice can occur
along with malarial fever. This jaundice is not caused due
to viral infection but due to the extensive destruction of red
blood corpuscles.
2. Flu (viral fever) :
Body ache, headache, fever, running nose, moderate fever
when examined.
3. Rheumatic fever :
There is a possibility that the patient has suffered form an
inflamed throat a few days previously. Swelling and pain in
the knee, ankle and elbow joints, breathlessness and fatigue.
This illness occurs in children aged between 5 and 15 years.
4. Sunstroke :
High fever, acute headache, nausea, vomiting...when
examined, the face is red, fever above 104 °F and we are
informed that the patient was exposed to extreme sunlight.
5. Urinary tract
Moderate fever with chills, burning sensation and soreness
infection :
while urinating. Sometimes, blood is discharged along with
urine. Pain in the lower abdomen.
While examined, patient has moderate fever, the patient
complains of pain when the lower abdomen is pressed.
6. Jaundice :
Ordinary fever, appetite loss, weight loss, yellowish urine, the
(inflammation
eyes and nails turn yellow
of the liver)
While examining: The liver swells and hence its size increases.
Pain when the area just below the right ribs is pressed. The
nails and eyes are yellow, even the skin seems yellow in
some cases.
| 14 |
7. Puerperal fever :
Fever occurs within ten days of delivery or miscarriage Along
with fever, the patient also has chills Fatigue, acute pain
in the genitals and lower abdomen, face turns red due to
fever, pulse rate increases, foul smelling dark red blood clots
pass through the vaginal discharge
8. Wound infections :
All areas surrounding the wound turn red A whitish-yellowish
layer forms on the wound due to viral infection, the wound
is painful, movement slows down, moderate fever and pulse
rate is fast
9. Amoebiasis /
Giardiasis :
Pain on the left side of the lower abdomen.
Bowel movements are not very loose. Cramps in the abdomen,
mucus and blood passes through the stool, vomiting, nausea,
low or moderate fever, lassitude, exhaustion, loss of appetite.
When examined, acute pain on the left side of the lower
abdomen in particular. There are no symptoms of dehydration.
10. Cholera :
Watery stools, vomiting, moderate fever, signs of dehydration
are observed early.
11. Pneumonia :
Sometimes, there is possibility of the child contracting
pneumonia if the child is malnourished and is just recuperating
form chicken-pox or measlefe, since the resistance power of
the child, which is already low due to malnourishment,
decreases significantly due to these two diseases. Infections
can occur quickly under these circumstances and the child
is afflicted with pneumonia.
We can identify the type of fever depending on each observation given
above.
I
15
Various types of fever
Rheumatic fever
Urinary tract infection
/
Jaundice
(inflammation
of gall
bladder)
8. Symptoms of diseases
Migraine :
Unbearable headache, nausea, dizziness.
There is a possibility of an increase in blood pressure
Diphtheria :
Inflammation of the throat, pricking sensation and a white film
over the throat, difficulty in swallowing.
Bronchitis :
Pain in the centre of the chest, cough and phlegm, moderate
fever, whistle-like sound while breathing.
Heart attack :
Squeezing pain on the left side of the chest. Pain radiating
towards the left hand, dizziness, profuse sweating, difficulty in
breathing, nausea, vomiting.
Gastritis :
Pain in the abdomen, on the left side under the ribs, pain
reduces after eating, nausea, vomiting, heaviness of the
stomach, loss of appetite. But, in case pain decreases after
eating assume that it is the inflammation of the duodenum of
the small intestine.
Kidney stone :
Pain in the abdomen on the left of the navel, which radiates
forward from the spine. Nausea and vomiting. Burning
sensation while urinating.
/
Gallstones :
Pain on the right side of the abdomen under the ribs.
Pressing with hands causes Pain which increases after eating
fried food, nausea, vomiting.
Inflammation
Pain on the right side of the lower abdomen, Murphy sign
of the
positive, vomiting and nausea, fever, either diarrhoea or
appendix :
constipation
Blood clots
and infection
in the veins
Pain in the calf, swelling and redness
of the calf :
(Varicose veins)
Fracture :
Unbearable pain on the spot on the hand or leg that was hurt
after falling, swelling and redness.
We can identify the illness depending on the types of pain
described above
17
Symptoms of diseases
1 )Appendicitis (Inflammation/ Infection of appendix)
2) Blood clots & in infection in the veins of the calf.(Varicose veins)
EXPERIMENT BOOKLET
Means of Health Promotion
Subject - 4
Module -404
The Foundation for Research in Community Health (FRCH)
Pune
3 and 4, Trimiti B Apartments, 85 Anand Park, Aundh, Pune - 411007
Telephone: 020-25887020, Fax: 020-25881308
Email: frchpune@giaspn01.vsnl.netin
Preface
National Institute of open schooling - We have published four experiment booklets
based on the four modules of Gramsakhi’. While studying the Gramsakhi modules,
only reading or explaining them orally is not sufficient for understanding them The
procedure will only remain embedded in our minds permanently if we actually implement
it
Similarly, frequent repetition of the demonstrations enhances our skills.
Since the instructor is present while conducting the procedure, mistakes, if any, are
immediately rectified. All doubts arising during the execution of the procedure can be
clarified on the spot. Moreover, a large part of the syllabus is covered automatically.
This is the reason for publishing these booklets. Experiments have been selected
independently from each module and diagrams have been given as and when required.
All these experiments are of use in our daily life. Implementing these regularly will
help in increasing our self-confidence.
We hope that these booklets will be of use to you.
Contact us in case of any queries, difficulties or in case you feel that some other
important information must be included or in case you have any suggestions regarding
the arrangement and layout. This will make these experiment booklets easier and simpler
and in turn, will aid in achieving our goal.
Contents
1
Malnourishment
I
* Diag. A graph for the growth from birth till 5 years
2
2. The ‘Sahli’s method’ of testing haemoglobin.
4
* Diag. The 'Sahli’s method’ of testing haemoglobin
3
3. Recognising the nutrition quotient of foodstuff
5
4.
Notice writing
6
5. Our tradition of well being and resource wealth.
7
6. Enriching village life
9
1. Malnourishment
Aim:
Assessing the nutritional status of 0 to 5 year old children and
identifying the stages of malnourishment.
Requirement:
Weighing machine, tape, growth chart graph
Procedure - 1
Depending on the weight and age
A) First, ensure that weighing machine is set to zero
B) Weigh the infant.
C) Record the infant’s weight in front of the age on the growth
chart.
D) Ask the infant’s age and record it on the horizontal line of the
growth chart.
E) Remove the infant’s clothes and weigh him/her and record the
same in the vertical line.
F) Identifying the stage of nourishment of the infant.
Procedure - 2 -
In case the age of the infant is not known
Using the tape:
The infant is surely aged between 0 and 5 years, but the exact
age is not known. Use the following procedure and check only in
centimeters.
First, hold the tape at the infants shoulder and bring it down till
the inner elbow and check the measurement, then calculate the
mid-point. Place the tape around this point of the arm and check
the measurement.
Inference:
In case the mid-arm circumference measurement is as given below
then the infant falls in the malnourished category
1.
If the mid-arm circumference measurement is less than 12.5
cm the infant is severely malnourished.
2.
If the mid-arm circumference measurement is between 12.5
and 13.5 cm, the infant is moderately malnourished.
3.
If the mid-arm circumference measurement is more than 13.5,
the infant is normal.
* [O. P Ghai
Essential Paedatrics Shakir’s tape]
!■
A graph for the growth from birth till 5 years
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The ‘Sahli’s method’ of testing haemoglobin
71
2. The ‘Sahli’s method’ of testing haemoglobin.
Aim:
To check the haemoglobin level in the blood
Requirement:
Haemoglobinometer, test tube, rubber pipette, injection needle, rod,
spirit, distilled water, hydrochloric acid, brush, etc
Procedure:
D
Wash hands thoroughly and wear gloves.
2)
Place the haemoglobinometer in front of you.
3)
Take 20 ml hydrochloric acid in a test tube.
4)
Place this test tube in the haemoglobinometer.
5)
Clean the finger of the person whose haemoglobin is
to be checked with a spirit swab.
6)
7)
8)
9)
Prick the finger with a needle.
Press and extract one drop of blood.
Suck this blood through the pipette up to the blue line.
Release this blood into the test tube in which hydrochloric
acid has been poured.
10) Immediately clean the rubber pipette using water.
11) Stir the hydrochloric acid (HCL) and the blood that is
inside the test tube with a rod. Set this mixture aside for 5
minutes. Then, pour distilled water into this tube little by little,
till the colour matches the colour on both the side tubes of
the haemoglobinometer. View the number at the top of the test
tube once all three colours look alike. The number till which
the solution rises is the haemoglobin level of the person. Then,
clean the test tube thoroughly with water and a brush.
Precautions:
1)
Hold the haemoglobinometer in front of your eyes and in ample
light while matching the colours.
2)
Note:
Shake the mixture well.
We can determine the blood haemoglobin level of a person as well
as decide whether the person has anaemia or not using this test.
3. Recognising the nutrition quotient of foodstuff
Aim:
Studying the nutrient quotient of the various types of food constituents
Requirements:
Thick blank papers, chalk, blackboard, pencil, colour sketch pen, etc.
Procedure:
First, make enough chits from the blank paper Write the names of all
foodstuffs in your diet. Prepare approximately 50 to 60 chits.
Then, make all participants (Tais) sit in a circle in front of the blackboard.
Put all chits in a box and pass this box around the circle. Let every
participant remove one chit from the box each time. Pass the box around
till empty.
Make four columns A, B, C and D on the blackboard A) Carbohydrates
(energy giving substance) B) Proteins (for growth and development)
C) Oily food D) Vitamins and minerals (body defence).
Now, let everyone read out their chits and enter them in one of the
above columns. After entering the item, discuss with the whole group
as to whether the entry is correct or incorrect. Then, take the necessary
decision.
Example:
A
B
Carbohydrates
(energy giving
Proteins
(for growth
substance)
Wheat, jowar, rice,
potato, etc.
Further uses:
C
D
Oily substances
Vitamins
and minerals
and development)
Split Bengal gram
Groundnut oil, ghee,
(harbara dal), Kesari
etc.
dal (tur), fish, eggs, etc.
Lemon,
papayas,
Make note of lack of a certain foodstuff in our diet with the help of the
table and see if any solution can be planned or any alternative
measures can be taken.
Like in the above procedure, make chits of the illness caused due to a
lack of certain foodstuff in our diet (Rickets, night blindness,
malnourishment, anaemia, etc.) and write the symptoms, causes, and
preventive measures on it Make a diseases column; fill in this column
with the information obtained after a discussion.
<>
4. Notice writing
Aim:
For providing information to the public.
Requirement:
Board/blackboard, white chalk, coloured chalk
Thought:
1) Select the topic as per the needs of the public e g. new
plans, regarding agriculture, etc.
2)
Provide information as regards local questions/problems.
3) Inform about the remedies for illnesses if you know them. Give
information regarding preventive measures.
4) Awaken consciousness about social issues (e g. superstition,
dowry deaths, female foetus tests and foeticide, alcohol pro
hibition)
5)
Inform about the village programmes.
(Date, time and place of the village meeting)
Precautions:
1) The language should be simple.
2) The sentences should be short.
3) The writing should be visible and legible.
4) The chosen, meaningful information should be a maximum of
5-6 lines.
5) The priority of the information should be determined de
pending on the conditions.
5. Our tradition of well being and resource wealth.
Aim:
Mapping of the resources locally available and required for traditional
remedies
Objectives:
1) As a health worker, staying informed about availability of the natural
resources in our region that are required for traditional remedies.
2) Promoting the knowledge and traditional remedies about the tra
dition of well being appropriately and effectively.
Requirement:
The available outline map of our region (copy prepared by Xerox or
tracing paper), coloured pen, paper, record of the person practicing
traditional medicine and of the place, record of the available natural
resources, rangoli - if the map is to be drawn on the ground, coloured
rangoli, etc.
Procedure:
1) Make a complete detailed list of the manpower and the well being
tradition as well as the remedies available at the local level in our
region (Maintain a register. Record all mid-wives/wet-nurses, masseurs,
fomentation experts, bone setters, physicians, persons anointing with
herbs (traditional practitioners), health workers, nurse, doctor, etc ), and
also the medicines prepared using medicinal plants, minerals, animal
ingredients, etc. and the place where it is available.
2) At the local level, through experience and traditional treatment
methods, the order of treatment is decided depending on the illness.
First, household remedies, then, seek advice from a more knowledgeable
and experienced woman/man, a physician (vaidya/hakim) (one who
prescribes Ayurvedic medicines), a health worker, nurse, doctor and
hospital sequentially. Discuss the sequence of seeking health care with
respect to illnesses.
3) As a health worker, consciously note down the importance of the
health related knowledge of women in the map so as to encourage
and give them respect in society.
4) Show each other the entries in the map. After all workers have
drawn the drawing/map, prepare a large map after a combined
discussion and mount in a public place if possible.
Discuss the advantages-disadvantages and limitations of
traditional treatments.
Advantages:
Easily available service, affordable, quick help, sharing of experience,
gives a boost to self sufficiency
Limitations:
Limitations arise in case of serious illness and in emergency situations.
Further uses:
1) Sowing and growing of medicinal plants - sowing in pots, kitchen
gardens, Dhanvantan garden, etc.
2) Giving detailed information to the wet-nurses/mid-wives about the
prevention of infections as well as identifying dangerous symptoms.
3) Experience should be shared with the physicians (Vaidya/hakim).
4) Ensure that the contractor does not harvest the medicinal plants
excessively for commercial purposes.
Tradition of well being and resource wealth
(Household remedies) - Coffee, lemon
(Knowledgeable person) - Decoction of guava leaves
▼
(Physician (Vaidya/hakim)) -
Nutmeg
(Health worker) - Oral Rehydration Solution
(Nurse/doctor/hospital) - Treatment depending on the
type of diarrhoea e g.
Amoebiasis - Metronidazol.
6. Enriching village life
Aim:
1) To identify the vulnerable section of the society and understand
ing the solutions that can be planned for their needs/problems.
Requirement:
2) Three different groups, register, pen, pencil, rubber, blank paper,
a list of all the heads of the house along with their house numbers.
Procedure:
1) Make a list of different development works of the village, e g.
hand pump, toilets, etc that are carried out for our hygiene facility
(with the assistance of the Gram Panchayat records, village worker,
the Sarpanch, and former Sarpanch).
2) Prepare a map of the village (Draw the outline map on a blank
paper. In case the village is very big, draw the map as per the
ward arrangement or by dividing it into sections. Join them if possible.)
3) Display the list of all the village service and facilities (development
work) e.g. public bathrooms, anganwadi, primary school, coopera
tive society, Gram Panchayat, library, Nirantar Education Programme,
notice board, constructed gutters, community hall, market, etc. on
the map in detail.
4) Display the maps of all three groups on a wall and discuss the
following topics with the participating village institution: Does ev
erybody in the village gain from the service-facilities available in
the village? Who faces what kind of problems to obtain the service
facilities? Which are the other facilities that are additionally nec
essary?
5) The needs of various groups of the society like the poor, schedule
caste-tribe, women, children, disabled, the aged and the abandoned
are different. It is imperative that their needs be given top priority.
Keeping this in mind, make a list of their needs by speaking with
them separately.
6) The vulnerable sections face with injustice even today. Create
awareness about this prevailing condition in the groups and focus
their attention towards creating an action plan for 2 or 3 of their
needs and start working towards meeting the same.
Further uses:
Creating awareness in the groups as well as the members of the
Gram Panchayat about the prevailing condition of the vulnerable
sections facing with injustice even today and focusing their attention
towards creating an action plan
- Media
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