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Taking a Meaningful Clinical History

A student is often tempted to quickly move on to examination after listening to the presenting complaints.
Clinical history taking should not be taken lightly.
A logically taken history will give rise to a list of probable diagnoses in your mind by identifying patterns of symptoms even before you proceed on to the examination.
Systematically taken history will guide you to:
• Look especially for signs for confirming or ruling out certain disorders upon physical examination and

Mechanism (in brief) of transmission of vectors borne disease

1. Mechanical: infectious agent is mechanically transported through soiling of vector’s feet or proboscis or by passage through its gastrointestinal tract. for example spread of e coli by housefly
2. Biological:
a. Propogative: infectious agent merely multiplies inside the vector e.g. plague in rat flea
b. Cyclo-propogative: agent changes in number and also in form e.g. malaria parasites in mosquito
c. Cyclo-developmental : the disease agent undergoes only development but no multiplication e.g. microfilaria in mosquito

Epidemiology: Differences between Case – control and cohort study

Case – control study
  1. Proceeds from the outcome to cause
  2. Starts with cases of disease
  3. Tests if the suspected risk factor occurs more often in the cases than that in the controls
  4. Usually the first study for testing a hypothesis
  5. Requires fewer number of participants
  6. Yields the results relatively earlier
  7. Suitable for rare diseases
  8. Cannot directly estimate the relative risk hence calculates the ‘Odd’s ratio’ (OR)
  9. Only one outcome (disease) can be studied
  10. Inexpensive

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