Crac👑KING Community Medicine
with Mentor Dr. Surya B. Parajuli

An initiative of Prof. (Assoc.) Dr. Surya B. Parajuli

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

🙏 Namaste Dear Learners 🎓

This digital book has been developed in accordance with the MBBS curriculum of Kathmandu University for the subject of Community Medicine. The content is structured to support conceptual understanding, practical learning, and self-assessment aligned with the prescribed syllabus. We are committed to continuous improvement and expansion. Curricula of other universities and institutions of Nepal and abroad will be incorporated in future updates. Additionally, postgraduate Community Medicine curricula will be added in the near future. We hope this digital companion supports your learning journey with clarity, confidence, and purpose.

🩺 Community Medicine in MBBS – Overview

📘 Out of the total 4.5 years of the MBBS course, the longest duration is devoted to Community Medicine, highlighting its vital role in shaping holistic, community-oriented physicians.

🏥 During the 1-year Compulsory Rotatory Internship, intern Doctors complete a ½-month posting in Community Medicine, gaining hands-on exposure to epidemiology and screening clinic.

📚 Teaching spans from Semester I to Semester VII, covering 31 modules with multiple lessons under each module, ensuring progressive and comprehensive learning.

📝 University Examinations

⏱️ First University Exam: End of 2nd year [MBBS II]
(Preclinical Community Medicine)

⏱️ Second University Exam: End of 3.5 years [MBBS III]
(Clinical Community Medicine)

Core Pillars of Community Medicine

🌱 Health Promotion
🛡️ Disease Prevention
🔍 Screening
🩺 Primary Clinical Care
♿ Rehabilitation

🎯 Together, these pillars ensure a continuum of care—from prevention to recovery—strengthening healthcare at the individual, family, and community levels.

Navigate Full Curriculum: Click Here

🔵 SEMESTER I

📘 Module 1: Human and Medicine

Lesson 1: Medicine in antiquity (Primitive Medicine, Indian Medicine, Chinese Medicine, Egyptian Medicine, Greek Medicine, Roman Medicine)
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Lesson 2: Dawn of scientific medicine
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Lesson 3: Modern medicine
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Lesson 4: Medical revolution
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Lesson 5: Socio-cultural aspects of health in Nepal
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Lesson 6: Eugenics
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Lesson 7: Alternative medicine
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Lesson 8: Medical ethics
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📘 Module 2: Concept of Health and Disease

Lesson 1: Definition of Health & well-being
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Lesson 2: Dimensions and determinants of health
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Lesson 3: Epidemiological triad
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Lesson 4: Theories of disease causation
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Lesson 5: Natural history of disease
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Lesson 6: Risk factor concept
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Lesson 7: Concept of control of disease
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Lesson 8: Levels of prevention
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Lesson 9: Modes of intervention
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Lesson 10: Primary health care
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Lesson 11: Goals/targets set to achieve "Health for All"
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Lesson 12: Critical review of HFA 2000
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Lesson 13: Revitalizing primary health care
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Lesson 14: MDGs in the context of Nepal
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Lesson 15: SDGs in the context of Nepal [Additional lesson]
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📘 Module 3: Nutrition I

Lesson 1: Basics of Nutrition [Additional lesson]
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Lesson 2: Protein-energy malnutrition
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Lesson 3: Iron deficiency
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Lesson 4: Vitamin A deficiency
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Lesson 5: Determinants of nutritional status of individual/ community
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Lesson 6: Nutritional sources and requirements
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Lesson 7: Balanced diet
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Lesson 8: Nutritional deficiency disorders e.g. PEM, Iron deficiency, Vitamin A deficiency
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Lesson 9: Nutritional problems in Nepal
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Lesson 10: Nutritional status assessment in a community
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📘 Module 4: Nutrition II

Lesson 1: Iodine deficiency disorders (IDD)
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Lesson 2: Magnitude of the problem in Nepal
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Lesson 3: Community assessment of IDD
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Lesson 4: Zinc deficiency
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Lesson 5: Salt fortification
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📘 Module 5: Environment Health I

Lesson 1: Environment-physical environment inside and outside the home
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Lesson 2: Water-safe water, potable water
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Lesson 3: Purification of water at the household and community levels
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Lesson 4: Waste disposal- the necessity of waste disposal and General principles of waste disposal
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Lesson 5: Excreta disposal-necessity of excreta disposal, General principles of excreta disposal
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Lesson 6: Family environment and principles of good housing
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📘 Module 6: Biostatistics I

Lesson 1: Need of biostatistics in medicine
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Lesson 2: Statistical method
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Lesson 3: Frequency distribution
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Lesson 4: Measure of central tendency
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🔵 SEMESTER II

📘 Module 7: Epidemiology I

Lesson 1: Definition of epidemiology
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Lesson 2: Uses of epidemiology in hospital, community and health planning
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Lesson 3: Basic measure in epidemiology e.g. rate, ratio and proportion
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Lesson 4: Mortality: concepts of crude, specific and standard prevalence of disease
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Lesson 5: Significance of time place and person distribution in epidemiology
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Lesson 6: Sources of epidemiological data
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📘 Module 8: Information Education Communication (IEC)

Lesson 1: Health educational methods including A-V aids for individual, group & mass
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Lesson 2: Significance, advantages and disadvantage of the methods
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Lesson 3: Planning a health education program
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Lesson 4: Information, education and communication strategies
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Lesson 5: Evaluation of health education activities
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📘 Module 9: Environmental Health II

Lesson 1: Air pollution source, effects, control , greenhouse effect, ozone layer
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Lesson 2: Energy conservation: alternate source of energy
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Lesson 3: Noise pollution: sources, effects and control
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Lesson 4: Ventilation
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Lesson 5: Lighting
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Lesson 6: Radiation hazards
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Lesson 7: Hospital waste management
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Lesson 8: Urban health
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Lesson 9: Global warming
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Lesson 10: Meteorology of medical relevance
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Lesson 11: Entomology: Mosquito, Housefly, Lice, Ticks, Fleas, Sand-fly, Reduviid bugs, Rodents and their control
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📘 Module 10: Demography

Lesson 1: Importance of demography
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Lesson 2: Demography cycle
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Lesson 3: World population trend: regional difference, birth and death rate
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Lesson 4: Growth Rate
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Lesson 5: Transmigration
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Lesson 6: Demographic trends of the country: age and sex composition, age pyramids
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Lesson 7: Sex ratio, density of population, family size, urbanization, literacy, life expectancy
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Lesson 8: Fertility- determinants of fertility: biological and behavioral determinants
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Lesson 9: Fertility related statistics
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Lesson 10: Effect on population of changes in birth, death and growth rates
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Lesson 11: Vital statistics and method of collection: census, registration of vital events
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Lesson 12: Hospital records, population surveys
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🔵 SEMESTER III

📘 Module 11: Sociology

Lesson 1: Types of family
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Lesson 2: Function of family
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Lesson 3: Role of family in health and disease
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Lesson 4: Culture factors influencing health and disease
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Lesson 5: Social organization and community participation
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Lesson 6: Measurement of the socio-economic status of a family and its importance in health and disease
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📘 Module 12: Community Diagnosis Orientation

Lesson 1: Community Diagnosis Orientation (Collect demographic data and study)
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Lesson 2: The Community environment
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Lesson 3: Family environment
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Lesson 4: Family support system
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Lesson 5: Water collection/storage
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Lesson 6: Refuse/waste disposal
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Lesson 7: Customs/beliefs during pregnancy, lactation, postpartum
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Lesson 8: Customs/practices towards elderly/ disabled
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Lesson 9: Illness behavior
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Lesson 10: Food practices/customs/ beliefs
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Lesson 11: Beliefs about family size/ son (male) preference
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Lesson 12: Child rearing practices
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Lesson 13: Acute morbidity in the family
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Lesson 14: Follow up a pregnant woman, neonate, under five year child to record growth and development
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Lesson 15: Diet pattern of a pregnant, lactating and postpartum woman
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Lesson 16: Follow up an adolescent
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Lesson 17: Follow up elderly/disabled persons
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Lesson 18: Follow up eligible couples and provide family planning advice
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📘 Module 13: Family Medicine

Lesson 1: Identify and diagnose illness in the family
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Lesson 2: Follow up and study response(s) of the individual /family/community to the specific illness
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Lesson 3: Acute respiratory infections
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Lesson 4: Rubella
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Lesson 5: Mumps
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Lesson 6: Diphtheria
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Lesson 7: Pertussis
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Lesson 8: Chickenpox
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Lesson 9: Pneumonia
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Lesson 10: Tuberculosis
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Lesson 11: Measles
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Lesson 12: Diarrhea
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Lesson 13: Fever
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Lesson 14: HIV and AIDS
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Lesson 15: Bronchial asthma
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Lesson 16: COPD
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🔵 SEMESTER IV

📘 Module 14: Epidemiology II

Lesson 1: Epidemiology studies; descriptive, analytical and experimental
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Lesson 2: Basic concepts about transmission of infectious agents
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Lesson 3: Principles of control about communicable disease
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Lesson 4: Principles of control of non-communicable disease
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Lesson 5: Investigation and control of an epidemic
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Lesson 6: Epidemiological principles underlying screening
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Lesson 7: Distinction between screening and diagnostic test
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Lesson 8: Calculate: sensitivity, specificity, positive predictive value etc. for screening test
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Lesson 9: Collect and interpret clinical, psycho-social information from patient/ family to understand the natural history of a disease
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📘 Module 15: Behavioral Science

Lesson 1: Factors affecting behavior attitude
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Lesson 2: Attitudes, nature, development
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Lesson 3: Cognitive development
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Lesson 4: Puberty and adolescence
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Lesson 5: Behavior problem
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Lesson 6: Sexual behavior
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Lesson 7: Normal and abnormal behaviors
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Lesson 8: Implications of behavior in illness
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Lesson 9: Methods to change attitude behavior
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Lesson 10: Measurement of attitudes
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Lesson 11: Questionnaire/pre-testing and validation of a questionnaire/ interview schedule
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Lesson 12: The need for counseling in various situations (e.g. HIV/AIDS affected person)
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Lesson 13: Proper approach and attitude of counselor
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Lesson 14: Communication skills required of a counselor
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📘 Module 16: Community based integrated management of childhood illness (CBIMNCI)

Lesson 1: Introduction to CB IMNCI and orientation to the global problem
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Lesson 2: Importance of CB IMNCI in family medicine
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🔵 SEMESTER VI

📘 Module 17: Communicable Diseases

Lesson 1: Tuberculosis
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Lesson 2: Influenza
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Lesson 3: SARS
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Lesson 4: Malaria
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Lesson 5: Filaria
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Lesson 6: Dengue
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Lesson 7: Leishmaniasis
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Lesson 8: Acute Diarrheal Diseases
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Lesson 9: Viral Hepatitis
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Lesson 10: Typhoid fever
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Lesson 11: Cholera
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Lesson 12: Rabies
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Lesson 13: Japanese Encephalitis
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Lesson 14: Chikungunya
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Lesson 15: Yellow Fever
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Lesson 16: Plague
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Lesson 17: Leptospirosis
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Lesson 18: STDs
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Lesson 19: HIV/AIDS
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Lesson 20: Leprosy
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Lesson 21: Emerging and re-emerging diseases
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Lesson 22: Hospital acquired infections
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📘 Module 18: National Plans for Communicable Diseases

Lesson 1: Malaria
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Lesson 2: STD / AIDS
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Lesson 3: Pulmonary tuberculosis
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Lesson 4: Leprosy
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Lesson 5: Kala-azar
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Lesson 6: Vaccine preventable diseases (VPDs) included in the Expanded Program of Immunization: cold chain and surveillance of VPDs
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Lesson 7: Diarrheal diseases
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📘 Module 19: Occupational Health

Lesson 1: Working environment: health hazards of industrial and agricultural workers
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Lesson 2: Common occupational diseases
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Lesson 3: Industrial toxic substances, health hazards & international safety limits
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Lesson 4: Principles of control of occupational diseases
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Lesson 5: Legal aspects
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📘 Module 20: Mental Health

Lesson 1: Problem of mental health
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Lesson 2: Assessment of mental health
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Lesson 3: Causes of mental ill health
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Lesson 4: Types of mental illness
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Lesson 5: Mental development in children
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Lesson 6: Mental retardation
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Lesson 7: Conversion reaction
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Lesson 8: Schizophrenia
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Lesson 9: Depression
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Lesson 10: Alcoholism & drug abuse/addiction
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Lesson 11: Suicide a deliberate self-harm
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Lesson 12: Problem of sexuality & gender disorders
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Lesson 13: Prevention of mental ill health
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Lesson 14: Mental health services in Nepal
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Lesson 15: Epilepsy
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📘 Module 21: Non-communicable Diseases

Lesson 1: Epidemiology of non-communicable diseases
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Lesson 2: Nutritional disorders
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Lesson 3: Rheumatic heart diseases
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Lesson 4: Coronary heart diseases
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Lesson 5: Hypertension
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Lesson 6: Cancers
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Lesson 7: Blindness
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Lesson 8: Diabetes
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Lesson 9: Obesity
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Lesson 10: Accidents
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📘 Module 22: National Plans for Non-communicable Diseases

Lesson 1: National plan on non-communicable diseases
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Lesson 2: Program for control of Iodine Deficiency Disorders, Blindness control programs
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Lesson 3: Program for control of other Nutritional Disorders e.g. nutritional anemia, Night Blindness etc.
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Lesson 4: Impairment / Disability / Handicap: Definitions and concepts
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Lesson 5: Assessment of Impairment / Disability / Handicap: e.g. Post-Polio residual paralysis
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Lesson 6: Programs for rehabilitation at the individual and community levels
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Lesson 7: Community based rehabilitation
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🔵 SEMESTER VII

📘 Module 23: Reproductive Health

Lesson 1: Maternal and child health
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Lesson 2: Safe motherhood
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Lesson 3: Magnitude of the problem
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Lesson 4: Maternal morbidity and mortality
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Lesson 5: Under 5 year child morbidity and mortality
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Lesson 6: Breast feeding and weaning
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Lesson 7: Family planning methods
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📘 Module 24: National Health Programs for Specific Age Group

Lesson 1: National Health programs for specific age group
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Lesson 2: School health program
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Lesson 3: Problems for the elderly
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Lesson 4: Social organizations to assist the elderly
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📘 Module 25: EPI – Info

Lesson 1: How to design a computer compatible questionnaire in “EPED”
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Lesson 2: How to “ENTER” data in the questionnaire
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Lesson 3: Simple forms of “CHECK” programs while entering data e.g. range checks, legal values etc
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Lesson 4: “ANALYSIS” of data set
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Lesson 5: Cleaning of data set
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Lesson 6: Frequencies and other tables
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Lesson 7: Graphical output
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Lesson 8: Cross-tabulations
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📘 Module 26: Health Planning and Management

Lesson 1: Primary health care
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Lesson 2: Management of health resources
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Lesson 3: Planning and organization of health services in Nepal
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Lesson 4: Health team at district hospital, health post etc.
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Lesson 5: Voluntary agencies in health care
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Lesson 6: Evaluation of a health program: epidemiology and management principles
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Lesson 7: Need of health economics
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Lesson 8: Concepts of cost benefit and cost effectiveness
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📘 Module 27: Health Delivery System in Nepal

Lesson 1: Evolution of health services
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Lesson 2: Organization of health delivery system in Nepal from center (MoH) to Sub Health Post functions of different category health personnel
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📘 Module 28: Inferential Statistics

Lesson 1: Probability
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Lesson 2: Normal distribution, Poison distribution, Binomial distribution
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Lesson 3: Estimation of standard error
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Lesson 4: Confidence interval
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Lesson 5: Tests of significance
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Lesson 6: Concepts of alpha and beta error
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Lesson 7: Bias and random error
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Lesson 8: Sample size calculation
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Lesson 9: Sampling
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Lesson 10: Correlation and regression
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📘 Module 29: Disaster Management

Lesson 1: Definitions of Calamity, Disaster- natural and man-made
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Lesson 2: Concepts of Hazard and Vulnerability
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Lesson 3: Disaster Cycle
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Lesson 4: Planning for Disaster management
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Lesson 5: Disaster management committee: constituents, line of command etc.
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Lesson 6: Relief measures: when and what to ask for?
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Lesson 7: Concept of Triage
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Lesson 8: Practical play in a disaster situation
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Lesson 9: Simulated exercise on patient triage
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📘 Module 30: International Health

Lesson 1: Need of International Health Organization
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Lesson 2: Structure and functions of WHO
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Lesson 3: Other UN agencies and their role in Health care
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Lesson 4: Bilateral Health Agencies
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Lesson 5: Non-government International Health Agencies
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📘 Module 31: Research Methodology

Lesson 1: Introduction
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Lesson 2: Types of research: Descriptive/Experimental/Non-experimental
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Lesson 3: Systematic Review and Meta-analysis
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Lesson 4: Writing a research Proposal/Conduct Research Project/ Writing a research report
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