Transcript for:
Epidemiology in Community Medicine

hello everyone I'm a visible and audible let me confirm if I'm clearly visible audible I will start the class ahead sorry for being late uh let me confirm if you people can see me you can give me a thumbs up for confirmation if you can see me and hear me clearly okay I hope it is working so I welcome you all for today's session a very good morning to all of you I am Dr Priyanka educator on an academy and today I am here to start a fresh series what is the fresh Series today today I'm going to start epidemiology in community medicine so it is a new subject I am starting so in community medicine epidemiology is a very big portion so I am going to cover entire epidemiology in the next four or five days so there will be two hour session every day for epidemiology so today we are having a two hour session of epidemiology now you have to understand this topic is really very very very important right and uh there are many numericals also based on this topic so in epidemiology today I will teach you measurements of mortality and measurements of morbidity I hope you people already understand what is mortality and what is morbidity okay before moving on that you should understand both what is epidemiology if I split the term and see if p means among demos means people and logic means study so epidemiology means it is the study among people so epidemiology is the uh distribution and determine determinants of health related events in specific population that is it just study of people study of people that is epidemiology so uh what is the epidemiological approach so in any epidemiological approach to the disease we call the disease as event we call the disease as event so first you have to describe what is the event that is you have to describe what is the nature of the disease you are describing when did when did the disease occur so first you have described what then you have to describe when then you have to describe where then you have to describe who then you have to describe what is the extent then you have to describe why so there are various questions what is the event that is nature of the disease when the disease occurs that is time distribution where did the disease occur that is Place distribution in entire world where disease occurs most commonly throughout the year in which month on which days the disease is more common time distribution Place distribution who are the persons affected mode that is person distribution so either they are married person so what is the person distribution right what is the extent of the problem magnitude is the magnitude is more or less what is the etiology why the disease is occurring why the answer of Y is the geology want to be done to reduce the problem to reduce the problem what measures we can take that is we will describe the control measures and how it can be prevented in future so in future you want to prevent it that if currently the disease is already there so first you control it first you control it the current episode and in future it doesn't take uh again so you take preventive measures so this is the sequence in which we go for any event what is the event when it occur where it occur who are the persons who are affected what is the extent why it occurs and how we can reduce it how we can prevent in future so any disease any event we will study in this in this manner in epidemiology anyways before moving on all these things I will explain you everything I will explain you what is hypothesis we will create a hypothesis and we will test our hypothesis now there are two possibilities whether our hypothesis is right or whether our hypothesis will be wrong so how to test it what are the tests we perform to test our hypothesis I will come on everything before that you should understand the basics so what I always start with the basics so you should understand that in mathematics in your childhood you have studied these term what is rate what is proportion what is ratio so listen whenever I will teach you now there are multiple formulas in this chapter so whatever I have formula I will teach you that the formula of incidence is this the formula of prevalence is this the formula of case fertility rate is this the MMR formula is this IFR formula is this so looking at any formula you should answer ma'am whether it is a rate whether it is a ratio or whether it is a proportion so for identifying you should understand now most of the students I have seen they don't know the difference between rate ratio and proportion and they just mug up that incidence is the rate prevalence is a proportion no it is not the thing you don't have to mug up you have to understand once you have understood what is the difference between the three so if I give you any any any formula from the entire PSM looking at the formula you can say whether it is a rate Ratio or proportion rate ratio proportion you don't have to mug up so let me come does anyone know what is the difference between rate ratio and proportion it's very easy once you get it now you will never forget let me see if I can see your chat just a second so does anyone know what is the difference between rate ratio and proportion any one RT anyone so okay let me tell you so okay so in in all I will teach you what is rate ratio proportion in all these formula there is a numerator there is a denominator you know in mathematics what is numerator what is denominator so in a fraction the above value is the numerator the below value is the denominator there is a multiplier the multiplier can be 10 can be hundred can be thousand can be ten thousand there is no multiplier right so different multipliers are there in rate ratio proportion and in some formulas we use time specification In Sum we don't use time specification let me start with rate rate ratio proportion I will teach you all three let me start with rate what is rate what is rate so um in rate we have a numerator we have a denominator we have a multiplier the multiplier is not 100 it can be thousand ten thousand one lakh anything but it is not 100 not 100 and a time specifier and a time specifier this is the formula of rate now see the formula of death rate death rate what is death rate you can see now listen one more thing here the numerator is the part of denominator again I am repeating numerator is the part of denominator now look at this example look at this example what is death rate number of death in one year is the numerator medial population is the denominator so whatever so if I am calculating the death rate of India what is the death rate of India so media population of India will be the denominator right total population of India will be the denominator of that particular year I want to calculate death rate of 2021. 21 already occurred so 2021 May what was the population of India mid-year population you have to write in denominator how many persons were dead so these are the part of this population only so you have to notice one thing that whosoever is dead that is a part of this population only so numerator is a part of denominator so there is a numerator there is a denominator but the most important thing numerator is a part of denominator these two are not separate thing the one who are dead or the persons from this population only right and the multiplier is 1000 the multiplier is not hundred it can be anything but it is not 100 and there is the time specifier here the time specifier is one year so you can calculate the death rate for one month also one year also it's your wish so time specifier can be anything so this is great everyone give me a thumbs up what is rate so let me summarize in rate there is a numerator there is a denominator numerator is the part of denominator right after that there is a time specifier and there is multiplier multiplier is never 100 it can be anything but it is never 100 because 100 will be the multiplier only in proportion not in rate not in ratio it will be in proportion so please learn the formula of rate everyone you are not giving the thumbs up please give me a thumbs up if you got this formula so what how you will Define rate it is the occurrence of some particular event here the event is death here the event is death so occurrence of some particular event it can be disease it can be death in a population so denominator is the population during a given time so given one time is usually one year so this is the formula of rate right so siddhi rishinika I hope you got it so numerator denominator time specifier and multiplier we have four things here right multiplier is usually thousand ten thousand one lakh whatever but never hundred again and again I am repeating numerator here is the part of denominator so the person who are dying are from the population only they are not aliens they are from this population only right so then the persons who are dying are from this population so numerator is a part of denominator time specifier is a calendar year right it can be 2020 21 whatever I want to calculate and multiplier is never 100 it can be anything else so this is rate we are done now let me come on ratio second thing is ratio what is ratio does anyone know what is ratio so in my class there are many students attending it live how many are boys how many are girls so let me take the ratio of boys upon girls no numerator is not a part of denominator denominator is not a part of numerator both are separate entities both are completely separate entities so how number of boys upon number of girls we can do ratio like this so there is a numerator there is a denominator but numerator and denominator are separate entities numerator and denominator nothing to do with each other numerator is not a part of denominator denominator is not a part of but yeah if I say boys upon total students attending my class right or girls upon total students attending my class so here numerator is the part of denominator from the total students boys are from the total students girls are so here it is not ratio these two are not ratio these two are not ratio but if I say boys upon girls or girls upon boys it is a ratio so in ratio there is a numerator there is a denominator you can see there is a numerator numerator there is a denominator but numerator is not a component of denominator give me a thumbs up there is no multiplier nothing no ten hundred thousand ten thousand nothing and about time specifier there can be present there can be absent time specify as some time present and sometime if time specifier is absent if I say in a month in a day in a year so I'm giving you a guideline tell me in one day how many boys upon girls in one day or one year or one month so there is time specifier if I am not seeing any time specifier it is the instantaneous so opposite of time specifier is instantaneous at that instant how many girls and boys are there so if there is it can be time specification it can be instantaneous anything can happen so this is the thing have you got it have you got it so it is the relationship in size of two random quantities the two random quantities here is boys upon girls boys upon girls or girls upon boys so in the class how many boys are there how many girls are there nothing to do with each other nothing to do how many how many are wearing red color how many are wearing blue color so nothing to do with each other right so numerator and denominator are two random quantities and we are framing a relationship between them right that is known as ratio that is dividing one quantity by another quantity both are quantity quantity you know quantity means new number these are the numbers we are dividing with each other so you know that is ratio that is the ratio have you got it what is ratio have you got it what is ratio so let me summarize so I have already taught you what is rate I have already taught you what is ratio and now I will come on proportion now I will come on proportion so in rate I told you there is a numerator there is a denominator in ratio also I taught you there is a numerator there is a denominator but in rate the numerator is the part of denominator in ratio numerator denominator have nothing to do with each other these are two separate entities number one number two in rate there is the time specifier always present it can be one year one day one month usually one year taken most of the time but here time specifier can be present can be absent it is not fixed it is not compassion that it is always present usually it is absent the third difference here the multiplier is present which can be anything but not 100 usually thousand but not hundred here multiplier is also absent now compare the formula of the two you will yourself get the differences between rate and ratio so rate is numerator upon denominator into time specifier into multiplier multiplier which is not 100 here only numerator and denominator no time specifier no multiplier here in ratio everyone gave me a thumbs up and here the most important difference you didn't told me in rate numerator is a part of denominator in ratio numerator and denominator are two separate entities now I will give you multiple formulas right in the polls you have to identify you have to identify whether rate and ratio are to separate entities or whether uh sorry whether it is a rate or whether it is a ratio looking at numerator and denominator where the numerator and denominator are two separate entities or whether numerator is a part of denominator based on that you have to answer let me come on the third thing proportion if you got this let me come on proportion this is the example of ratio as I have told you there are seven boys and 12 girls so the ratio of boys to girls is 7 upon 12 and if you say girls upon boys it will be 12 upon seven so both are ratios both are ratios you can say boys upon girl or girls upon boys whatever let me come on the third thing the third thing here is proportion are you people there everyone give me a thumbs up I'm coming on proportion the third thing is the proportion now in proportion again you have a numerator again you have a denominator of course in the Nomine you better denominator but here again numerator is a part of denominator like rate like rate numerator is a part of denominator so you will say mm what is the difference between rate and proportion then in rate also you taught us this thing that numerator is a part of denominator here the multiplier is always 100 here multiplier is no always hundred if you remembered in red multipliers is never 100 it can be thousand ten thousand usually thousand but never hundred here it is always hundred the multiplier is always 100 and in rate there is time specification here there is no time specification it is instantaneous so time specification yeah this is the this is the formula of proportion have you got it so let me tell you example see this example so in this example okay you can see the number of children which came there is a village imagine there is a village in India right in that Village you have visited and you have seen how many children in that Village have scabies at that particular instant when you are visiting when you are visiting at that particular instant how many children have scabies so it is instantaneous at a certain instant I am talking I'm not talking throughout the year throughout two years throughout the month no on that instant so it is instantaneous that is the numerator and total number of children of the village is the denominator so you tell me numerator is a part of denominator yes or no so yes the person the children who are having scabies are the part of this total children only so total children in the village whatever there are 200 tourism children in the village and out of those 15 have scabies so these 15 are a part of this the numerator is the part of denominator but look at the multiplier multiplier is 100 so looking at the multiplier you can identify whether it is a rate or proportion so let me summarize the things everyone give me a thumbs up everyone so listen there is rate there is ratio there is proportion so in rate numerator is a part of denominator in proportion also numerator is a part of denominator but here multiplier is never hundred it can be thousand ten thousand lakh anything here multiplier is always 100 and here always there is time specifier present here no time specifier present here instantaneous is the proportion is and ratio there is numerator there is denominator which are not part of each other these are two random quantities and there is no multiplier no time specifier everyone give me a thumbs up so B will summarize the formula of rate ratio proportion if you people are with me if you help me I can write it out you will help me yes you will help me please tell me the formula for rate first then ratio then proportion who will help me so in rate write down numerator upon denominator numerator upon denominator numerator upon denominator now in rate numerator is the part of denominator in ratio numerator and denominator are two random quantities they are not related to each other in proportion again numerator is a part of denominator right that is about numerator denominator done okay coming on multiplier coming on time specifier so in raid there is always a time specifier always always in proportion it is always instantaneous it is not time specifier and in ratio it can be anything time specifier can be present or absent means it can be instantaneous have you got it coming on the third thing the third thing is the multiplier what is the multiplier in each of the scenario in rate multiplier is usually thousand ten thousand like it is never hundred and here it is always 100 and there is no multiplier no multiplier so you can see the final formula of all these this is the formula for rate ratio is only numerator upon denominator nothing and this is the formula of proportion so everyone means everyone give me a thumbs up if you got this concept you can solve many questions many believe me do you have any doubt RP equals anyone else having any doubt so I will be happy if you ask any doubt to me yes anyone having any doubt no doubt should I proceed yet so okay you tell me the conclusion now you will use your brains and you will tell me the conclusion in the conclusion whether you have to tell me infant mortality rate is this a rate or Ratio or proportion you have three options rate proportion I will ask you one by one maternal mortality rate sex ratio incidence prevalence case fertility rate risk rate so formulas are written in front of you apply your knowledge on these formulas and you tell me whether it is a rate of ratio or proportion no need to mugger students usually who do not have this basic knowledge now they just come on look at the formula you can yourself decide why to mug up let me start with the first one infant mortality rate look at the formula look at the formula of infant mortality rate number of infants who are dead upon number of live birth so you tell me numerator is a part of denominator yes or no whether the numerator is a part of denominator yes or no and multiplier is thousand so number of infant infant any one year right so total number of children who are born the live birth so yes of course numerator is a part of denominator right so if numerator is a part of denominator it is not ratio it can be rate it can be proportion not whether it is rate or proportion look at this time specifier it is thousand very good so of course it is rate it is rate very good it is rate so see apply your knowledge on the second formula MMR mmrc the formula now now see the formula beautiful formula what is the numerator number of maternal death maternal death how many mothers are dead that is the numerator and number of live birth is the denominator live but means the mothers have given birth to the children now so number of live birth is the denominator right the mother can give birth to single child also if she can give birth to twins also triplets also so number of life but total number of live birth is the denominator but number of mothers dead is the numerator not numerator and denominator are not part of each other they are not at all part of each other right numerator May mothers and denominator with children so they are not part of each other have you got it here all the multiplier is given but neglect that multiplier so numerator and denominator are not part of of each other that's why it is ratio that's why it is ratio give me a thumbs up so you can see it is a very commonly asked question in your exams that IMR is the rate but MMR is ratio so IMR infant mortality rate is rate but maternal mortality rate it is a misnomer we say it is a rate but it is not a rate it is a ratio so better to say maternal mortality ratio it is not rate so sometimes we get confused give me a thumbs up if you got it everyone give me a thumbs up so you can apply your knowledge like this right you can see sex ratio the third sex ratio what is sex ratio Formula number of females is the numerator number of males is the denominator is numerator and denominator are part of each other no females are separate males so they are not related to each other so of course again it is a ratio they are not related to each other so again it is a ratio yes so sex ratio is the ratio see the answer see the answers here in the slide I have covered dancers have you got it so next incidence and prevalence yeah so my next topic today in the next lecture I will teach you incidence and prevalence to look at the Formula First incidence they go for prevalence they go you will get you will learn a lot right so see what is incidence number of new case of any disease upon total population so however just suppose the disease is TB so how would the new cases of TB is the numerator and population is the denominator so the number of total TB cases are part of this population only so numerator is a part of denominator and multiplier is thousand so of course it is it is rate now look at the prevalence so here a little bit differences there denominator is total population only but numerator will be new and old both cases will be there so tbk new cases as well as old cases so of course you will see numerator is a part of denominator I agree in both of them numerator here only new cases are there here new plus all both cases are there so in both of them numerator is a part of denominator but look at the multiplier here multiplier is 100 that's why it is a proportion again a most commonly asked multiple time repeat and secure your exam that incidence is the rate prevalence is a proportion prevalence is a proportion so I will come on all these one by one don't worry I will explain you all these terms one by one let me start my topic today so in epidemiology in today's lecture I am going to cover a very important topics what are the measurement of mortality what are the measurements of morbidity does anyone know the difference between mortality and morbidity does anyone knows the difference between mortality and morbidity does anyone know mortality means no if anyone any no there are there are all healthy human beings on the earth we want the human beings to be healthy only if the human being is not healthy if the human being is not healthy there are two weights there are two options either the human being have some disease either or the human being is dead human being so death and disease are the two options death and disease so death death is known as mortality and disease is known as morbidity it's known as morbidity so what what are the measures of death that is measurement of mortality and what are the measurements of the diseases any disease you talk about you take TB you take diabetes you take any any disease of your choice so that is morbidity everyone give me a thumbs up the mortality disease right so I will explain you the measurements of each of them you got the meaning so morbidity meaning any departure from well-being from well-being well-being Muslim Health you know well-being well-being means health so any departure from the well-being the departure can be subjective can be objective have you got it subjective means actual uh objective means actual departure and subjective means psychological disease so patient is feeling I am not well but if you test if you do all the medical tests they are absolutely normal still patients say no I'm not feeling well so it is also considered as morbidity he has some psychological problem or some subjective problem so it is not documented we cannot find the lesion we cannot find anything abnormal in the blood test so it is not objective but yet the subjective so any departure from subjective or objective from state of well-being is known as morbidity it can be sickness it can be disease now there is a difference between sickness and disease I will explain you all when I will take the detail of Mobility sickness is something different disease is something different so it is approximate sickness or disease give me a thumbs up everyone give me a thumbs up right so I will tell you let me come on mortality first what is mortality it is the death we call death as the event at a given time frame given time frame so death we are taking death as a event have you got it so I will teach you measurements of both mortality also morbidity also let me start the measurements of mortality now the lecture is going to be super super interesting super excited right so let me start with modality let me start with measurements of mortality how many measurements of mortality do you people know okay let me ask a question let me take example of India right let me take I am an Indian so I am taking an example of India easy to understand so let me take an example of India let me take the just previous year it is 2022 right so 2021 we are talking about 2000 which is already passed from January to December 1st January to 31st December was the year the complete year 2021 I'm talking about so tell me the in the mortality of India in 2021 so how you will measure I am giving you task go and tell me the mortality of India in the year 2021 so that is your task how you will do this task how you will do what measures you will take how you will do it how you will calculate it so do you have any knowledge about it how many measurements of mortality how we will measure the mortality of any particular location here our location is India right in a particular time here our time frame is 2021 I can make it 2020 19 anything or particular month how you will measure it how you will measure it that is my question to you so there are six indicators by which you can measure the modality six indicators so the most important and easy one to calculate a screw death rate second is specific death rate then proportional mortality rate survival rate case fertility rate and standardized mortality rate now these topics are really difficult to understand but I will try my best right listen uh learn their short forms root death rate is known as TDR it is not CDR I will write in all the books in park also it is written as CDR so if CDR is asked to you you should know CDR means crude death rate specific death rate is known as SDR right proportional mortality rate is known as PMR survival rate Sr case fertility rate CFR CFR and standardized standardized mortality rate like SMR standardized mortality rate is ASMR so what I am talking about these are the short forms of that so you should be aware about these short forms right along with the full forms let me start one by one beautifully I am going to explain you no one will explain you with such a Clarity between the difference between the sex let me start with the first one so make a table with me in this table uh in the First Column you will write the uh formula of that that particular so CDR write the formula here SDR write the formula here formula you write the formula then you decide whether the formula is rate or Ratio or proportion you have to decide don't learn based on the formula you have to tell me and some important points regarding that so once you complete this portion now you will see more than 100 mcqs on this topic I will help you in solving all of them don't worry don't shall I start so let me start with the first one CDR crew death rate CDR crude death rate so what is Syria what is CDR so C the numerator and see the denominator see the formula we will learn from the formula then we will come on the definition don't learn the definition will be difficult for you to understand see the formula the denominator is mid-year population you tell me what do you mean by mid-year population media population of India what do you mean by that middle population so what is what is the one year what is the definition of one year so any one year you take just suppose it is already passed I cannot take 2022 because it's running so any one year which is already passed you can take so 2021 just suppose I am talking about so first January to 31st December December 12 12 a.m midnight to 12 a.m midnight right so this is the time frame of one year do you have any doubt so I am talking about the mid-year population so during the entire year some persons are born added in India's population India's population and some people are dead some people are dead so they are gone so some people are eliminated from India's population yes so during the entire year it will happen so if you measure the population at any instant the answer will be different here some are born some are dead here some are born some so the answer will be different at all the instances so you have to do a standardization right so mid-year we have calculated mid mid-year population what is the middle of the year the middle of the year is first July takes six months here take six months here total 12 month so first July is the day it is just at the center of the Year first July so the date is for July so measure the population at first July 12 a.m midnight 12 a.m midnight so at that instant it is a snapshot it is a snapshot of population at that instant snapshot you know the meaning of snapshot so we have taken a snapshot of India's population at first July 12 am so whatever because at every second the population is different you have to decide the time exact time also so it is 12 a.m midnight first July what is the answer is coming that is known as mid-year population of India so it is giving a reflection of the entire year so some are dead some are born some are plus some are minus so we see it at the mid at the mid so it is giving a reflection of throughout the year that is known as medial population of 2021. in a similar way we can calculate for 2020 also in the similar way we can calculate for 2019 also so in July first July of this particular date uh particular years uh at 12 am whatever the population is there it is known as media population everyone give me a thumbs up that is Media population of India so in denominator most of the time we take media population right so medial population of India and what is your task you forget your task what is your task I'm asking what is India's morality in 2021 that is your task so you will say Okay Imam you tell me what is the media population of India in 2021 that will be my denominator and how many deaths occurred from 1st January till 31st December in 2021 how many people were dead number of death number of death number of death in India that is my numerator so what is your numerator here number of death in that particular area my area is India right it can be some particular City also it can be a particular Village also depending on what you want to calculate the mortality in India or in Mumbai or in Delhi on particular Village right so that area you have to see how many deaths are there or that area only you have to tell the media population right there is a numerator there is a denominator there the multiplier here is thousand multiplier is thousand and in one year always you calculate so there is always a time specifier now look at the formula look at the formula you tell me whether it's a rate or ratio proportion the numerator is a part of denominator the person who are dead are the part of this population only now they are not aliens they are part of this population only so numerator is a part of denominator number one thing there is a time specifier right this is one year 2021 19 20 any year you can calculate and multiplier is thousand so what is it is it a rate or ratio proportionika yes anyone whether it is a rate or Ratio or proportion you tell me now so crude death rate so you write the formula like this number of death is the numerator mid-year population is the denominator multiplier 1000 and in one year we have to calculate any year but one year any year 2017 1890 whatever you wish you can think so this is the formula of Syria please understand now the second question why it is known as crude crude means we are not taking any specification this number of death include all males all females I'm not separating male separately females it includes old person also it includes children also right it includes deaths from all diseases I am not calculating it separately that for TBS tell me separate deaths so diabetes tell me separated for cancer tell me separate death no so I'm considering all together number of death of death is of child or death of old it is considered death of male death of female it is considered death of any disease that is considered natural death it is considered road traffic accident it is also considered so it is crude it is not specific the opposite of specific is crude so close later of mortality right among the sex indicators it is the worst right it is crude it includes everything everything whosoever is dead count and keep it here so don't see the reason for death whatever if the death is there again it can be male it can be female it can be child it can be young it can be old it can be any disease take all deaths in the numerator denominator is the cost medial population right multiplier is 1000 and time specifier is one year so that's why it is known as crude so in crude death rate crude is crude because it does not specify any particular age group any particular gender or any particular cause of death it is not specifying whether male happy female whether child or whether the cause of death is TB diabetes cancer road traffic accident what is the cause of death so no cause of death it is specified that's where it is known as crude give me a thumbs up it is the simplest measure of mortality most simplest among the sixth right here denominator is mid-year population media population is calculated on first July first July 12 a.m midnight of every year so if you want to calculate media population of 2001. in 2001 in July what is the population and this is known as medial population of that particular year right it is reflects the health status of that area just suppose I am comparing two areas this is Delhi this is Mumbai calculate CDR for both so delicious CDR you will calculate Mumbai klb serial you will calculate the two metros of India you can say so here media population you will take of both respective so Mumbai media population and Delhi medial population of that particular year I'm talking about 2021 so 2021 of Delhi or 2021 Mumbai media population you are writing here now number of death in Delhi you will write a numerator and number of death in Mumbai you will write here in 2000 in 2000 now you will compare the answers of both compare the answers of both here and here just suppose here the answer is 20 uh 200 and here the answer is uh maybe 170. so it is giving the health status now so health status is better in Mumbai as compared to Delhi because in Delhi people are dying more in Mumbai they are lying death less they are dying so less they are dying means health status is good in Mumbai maybe good hospitalization good doctors good health facilities available that's why people are less dying but in Delhi they are dying it is an example all the values are rough right it is not actual scenario just for the sake of understanding I am giving these examples give me a thumbs up if you are getting so lesser the value of CDR better is the health condition of that particular area more is the value of CDR uh poorer is the condition of health status of that particular area you got it you got it so looking at the answer you can decide the health status of that particular area if CDR is much higher in that area means health status is not good in that area maybe Doctors Hospitals and if CDR is less means best doctors are available so that's why people are lying dying less so this is the simplest measure broad broad right other factors may also be responsible for this variation so you can see for India PC these are the real graphs for India these are the real graphs for India you can see now CDR is calculated every 10 years every 10 years we calculate so the latest one we are having in 2011 for 2021 I have to see for the answer till now it is 7.4 7.4 per thousand so if you take the Thousand mid-year population the answer is 7.4 it means in every Thousand Seven point four people are dying every year every year every year 7.4 people are dead among the Thousand so what is the total population of India you know the total popular so in every Thousand Seven point four in every another Thousand Seven point four in every other Thousand Seven so you have to calculate the total death have you got it have you got it no compare the CDR from 2 1981 1991 2001 so every 10 year please compare the CDR so CDR was initially 12.5 and now it is 7.47 so CDR is constantly declining declining declining and from many years it is constant now almost constant so initially health status of India was not good better facilities of the health were not available and especially in the periphery in The Villages uh health status was not very good but gradually we have improved and still we are improving it so we are decreasing the CDR so we want to decrease the CDR right that is our motto being doctors being the health care providers we are the healthcare providers we have to decrease the CDR of our country or of all the not only nation but of the world of the globe we have to decrease the Syria where that is our job to decrease the Syria so we want to decrease the Syria give me a thumbs up everyone give me a thumbs up if you are getting it so what is the formula of CDR the first indicator is done see C CDR is crude debt rate see the formula always look first at the denominator make a rule so denominator is medial population what's the numerator number of death the number of death occurring from this population only so numerator is a part of denominator from the population only people are dying now it is always in one year whatever year 2020 21 22 one year and multiplayer is thousand that's why it is a rate because numerator is a part of denominator and multiplier is hundred no uh multiplier is thousand not hundred right important points are that it is crude so it includes everything it includes death of male death of female Death of old death of child death of young death of all diseases or all causes all causes we are not looking at the cause that's why crude it is the simplest measure and media population is taken on first July the denominator media population is taken so these are the important points regarding it on which McQ will come let me come on the second second um measure for mortality so instead of root it becomes specific the opposite of crude is specific now so specific death rate have you got it so the second the first one was crude the second is specific both are opposite to each other crude non-specific including everything and specific means not not everything it is specific so my choice is specific specific means I have a peculiar mindset about something that is my choice is specific for that name right but my choice is crude crude means I can like anything whatever you will give me it I don't have any specification me screwed so crude and specific are two opposite words in the dictionary so first we have calculated crude death rate now we are calculating specific death rate so first we have calculated CDR now we are calculating SDR everyone give me a thumbs up everyone so specific death rate see the formula see the formula again in the formula the denominator is medial population the denominator is medial population numerator will change Neo numerator number of death not all death so just suppose we are talking again for India we will take the example of India so medial population of India in 2021 so that is the denominator right number of death from the specific cost not all death you take either specific cause or you take specific age or you take specific sex whatever you wish you can take specificity right specificity of that just a second let me see the three specificities I will teach you right and it is also a rate it is also right here multiplier is wrongly written it is not 100 it is thousand make the correction it is thousand so it is also a rate so numerator is a part of denominator only multiplier is thousand only only difference from crude it is specific we are not considering all the deaths right so specification can be at three levels what's the cause of death particular group you are taking or the what is the specification in a particular period let me tell you the example of all three three types of specification can be take we are not taking all if we take all it will be crude we are not taking crude we are taking particular specific group so let me come on the pause look at this formula look at this formula what is the denominator of course denominator is medial population consider always India so media population of India is the denominator number of debt due to diabetes so I am taking one particular positive diabetes I'm not considering uh road traffic accidents say cancer say so don't consider all death I am considering one particular diabetes in 2021. so India May 2021 May diabetes into 1000 right so it is the specific death rate for that particular disease that is diabetes in a similar way you can calculate for TB also in a similar way you can calculate for lung cancer renal cancer any disease we have millions of disease we can calculate specific death rate of all the diseases give me a thumbs up give me a thumbs up if you got it so we can do the comparison now just suppose I am calculating specific death rate for TB I'm calculating specific death rate for diabetes and I am calculating specific death rate for cardiovascular diseases right so answers are coming the various answers in India I am calculating all are for India all are 2021 rates right so various answers will come x y z so I will compare the values the values and I will see who is the biggest burden in the community which is causing most of the debt so in India most of the death is due to TB or diabetes or cardiovascular disease or road traffic accident or suicide so I can compare it so it is easy for comparison for various diseases so I can see key success of the burden who is the most common cause of death in India what is the most common cause of death in India and I can take the measures for that give me a thumbs up so it is better than crude in this way have you got it this is specific pause yes specific pause I am taking different so it can be diabetes can be TB can be cancer the cause of the death is different right now particular group I can take particular different growth so in different group age can be different sex can be different race can be different occupation can be different social class high social class rich and poor can be difference let me tell you example see the two examples are in front of you see the first example infant mortality rate what is the formula you tell me the denominator is number of life but during that year 2021 in India and numerator is number of death of children one year children so I'm taking particular group not all that only of one year children so this is particular group I am taking particular group in 2000 right here I am taking particular group is my female I am not taking all that only women so I'm taking some particular group either the group is eight specific gender specific write some particular group right and third is period specific so ah medial population upon number of death in March so I have concised it only particular month or particular day so period specific so special three can be anything so number of dead due to TB here TB is specific number of death you of males only not females number of death of the person who are the teenage teenager 15 to adolescent 15 to 20 years not all death number of death in January number of death in one week so this is period specific right this is uh age specific this is gender specific this is disease specific so specificity can be of anything so you can put multiple specificity again the denominator is medial population here also and it is also a rate so I am done what are the advantages it is good for comparison so you compare specific death rate you calculate specific death rate for males in India you calculate specific death rate for females in India and compare them so you will come to Nokia who are dying more males or females you compare children old age young age teenagers adolescent you can compare it age-wise also you can compare it gender wise also you can compare it disease-wise also so comparison there is it is good for comparison everyone give me a thumbs up everyone give me a thumbs up so see see now C CDR and SDR compare the denominator of both of them is meteor population but see the new numerator in Syria you are including all death all death here you are including specific death not all death now specific tea can be disease can be age can be gender can be period specificity can be anything give me a thumbs up here also one year here also one year multiplier is 1000 multiplier is thousand so numerator is the part of denominator here also here also the only difference here we are including all here we are not including all and here we are including specific so both of them are rate here it is the simplest one that is the best thing and it is better for comparison it is the best thing give me a thumbs up so you will get all the numericals based on these two now the things will become difficult when I will come on the third one when I will come on the third one first give me a thumbs up if you got this so what aarti is asking in IMR well why there is number of birth in one year we don't take media population infant mortality rate then denominator is always total number of live birth so how many live birth are there in India live birth I'm not taking in consideration the abortions so how many you know the definition of Life specific definition that is infant mortality rate so most uh you know most crucial period in the entire life of any person is the first year of life if the first year of life is survived by the children there is less chance he or she will die now so first year is very crucial most of the children are dead in the first year only so I am taking total number of birth which are taking place in India out of that how many survived till one year so that is infant mortality rate you got my point it is not necessary that in PSM all the formula in denominator always have media population no different formulas have different denominators most of the formulas View use media population but it is not always the case should I proceed ahead you're not giving the thumbs up should I proceed to the third PMR pmr's proportional mortality rate proportional mortality rate give me a thumbs up so I am moving on the third one proportional mortality rate PMR we are done with CDR we are done with SDR now I am moving on PMR proportional motility rate nosy Nasi what is the numerator what is the denominator it is debt upon death debt upon death okay what is death upon death here in the denominator you don't take media population here you take all death in India in 2021 in India total death in the denominator total death total death it is not media population total death in the denominator and in the numerator death due to a particular cause so that due to TB that due to diabetes due to cancer in males in females any particular specific age or cause give me a thumbs up so it is proportion multiplier is 100 here here the multiplier is 100 100 so you tell me it is a proportion it is a proportion numerator is a part of denominator numerator is death denominator is total death just suppose in India total persons are dying are one lakh one lakh and due to DB they are one thousand one thousand so out of this total one lakh one thousand are due to TB so rest of the the the people are due to other courses right apart from TB TB have you got it so new so who's the one who are this are part of this only right so total depth so numerator is a part of denominator so of course uh and the multiplier is 100 right so it is a proportion so that's why it is not rate it is not ratio it's proportion give me a thumbs up to see number of debt due to a particular cause upon total death in 200 this is the formula so you can see the two examples I have framed here it is proportional mortality rate of particular disease I have given you the example of TB or particular age group the number of total death in the denominator denominated that due to particular disease or particular age group whatever you wish give me a thumbs up denominator is always total depth and disproportion not for it have you got it have you got what is the advantage it is giving the burden of the disease take this word burden of the disease okay so let me tell you about TB about diabetes about cancer about cardiovascular diseases right let me calculate this for all so denominator for all of them denominator for all of them is total death total death in India total death total death total death and total death but numerator is out of this total death how many are dying due to TB how many are dying due to diabetes how many are dying due to cancer how many are dying due to cardiovascular disease now you will compare the answers of all these so just answers that is the biggest burden in our society biggest burden in our community which is causing most of the death so by comparing this we can decide what is the burden which is which of the following is creating the burden of the disease give me a thumbs up give me a thumbs up now this is most useful sometime when we don't have media population available with us if I ask what is the media population of 2021 USM I don't know still you calculate mortality I don't know the answer what is medial population I don't have any data on it still you please calculate the mortality so this is the best um uh criteria or best I can take to calculate the modernity give me a thumbs up so in India in the world if I talk about this is a report given by the you know who in the world in 2019 16 out of the hundred sixteen percent are dead due to stomach heart disease that is the biggest burden biggest burden second is throw ten percent of the death is due to stroke five percent are due to copds 5.2 percent are due to lra lower respiratory tract infections than dementias right so this is the sequence you can compare it give me a thumbs up give me a thumbs up so again it is good for comparison and uh okay so that is the thing give me a thumbs up now compare the three things please everyone compare the three things everyone so what is TDR what is SDR what is PMR true death rate specific death rate proportional mortality rate right so in the first two the denominator is Media population so the numerator is total depth or numerator is dead due to a particular reason particular specific reason so that is through death written specific death rate both are red one is the simplest one true death rate and SDR is good for comparison but what is PMR in PMR this is death upon death see the denominator here denominator is total death not medial population out of the total death what are uh what is the number of that particular depth like out of the total death how many deaths are due to TV out of the total death how many deaths are due to Schmick heart disease so that is particular pause particular pause into 100 it is not thousand now see the comparison do the comparison of multiplier of all three in the first two it is thousand that's where the first two are read the third one is 100 that's why it's proportion give me a thumbs up in all of them numerator is the part of denominator so in rate also in proportion also numerator is a part of denominator everyone give me a thumbs up so for burden of disease this is the best indicator so three mcqs will come which is the simplest answer is TDR which is best for comparison answer is SDR and which is giving the burden of disease the answer is PMR everyone give me a thumbs up here come on I'm trying hard still things will get more complicated when I will teach you these three also and we will do a comparison and many numericals based on these formulas so please learn these formulas write down all in one notebook and we will do many numericals based on it if you have any dot please ask it otherwise I will end this link and after 10 minutes join another link do you have any doubt anyone have any doubt till now it is difficult this is the most difficult topic of the PSR we will solve numericals also right okay so if you don't have any doubt give me a break for 10 minutes we have completed one hour lecture one or more still 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