UGC NTA NET/JRF Exam, Social Medicine & Community Health, February-2023

Total Questions: 100

91. (Qs. No. 91-95): Read the given paragraph and answer question:

Chief Medical Officer of a district presents data where proportion of deaths due to Noncommunicable diseases were 70% in current year as compared to 50% for last 5 years.

The data for junk food consumption as well as proportion of people with obesity shows consistent increase over last few years.

Data was collected for fat intake in patients with and without Non-Communicable Diseases (NCDs) as given below.

Fat intakeNCD (Present)NCD (Absent)Total
High6050110
Low405090
Total100100200

Most likely reason for Increase in proportion of deaths due to NCDs in the population:

Correct Answer: D. Deaths due to other causes (non NCDs) might have decreased
Solution:

The increase in the proportion of deaths due to NCDs in the population can be influenced by various factors.

If the number of deaths due to other causes (non-NCDs) decreases, then even if the number of NCD deaths remains constant, their proportion among total deaths will rise.

Given that the data suggests a consistent increase in junk food consumption and obesity (known risk factors for NCDs), the likely scenario is that while NCD-related deaths might have increased, deaths from other causes might have decreased more sharply, leading to an increased proportion of NCD deaths.

92. Population level study design relating increase in NCDs due to junk food consumption in population is best described as:

Correct Answer: A. Ecological study
Solution:

An Ecological study observes data on a population level rather than an individual level. It examines the rates of a particular outcome in relation to exposure levels.

Here, we are looking at the increase in NCDs in correlation with the increase in junk food consumption in the entire population.

The relation between a population-level health outcome (increase in NCDs) and populationlevel exposure (junk food consumption) is best described through ecological studies.

93. The study data presented in tabular form is suggestive of:

Correct Answer: B. Case Control Study
Solution:

The data in tabular form represents a Case Control Study. This is evident because it starts with an outcome (presence or absence of NCD) and looks back in time to find possible causes or associations.

In this table, patients are divided based on whether they have NCDs or not, and then their fat intake is assessed to see if there's an association.

94. From tabulated data, most appropriate estimate that can be calculated is:

Correct Answer: B. Odds ratio approximately 1.5
Solution:

To determine the Odds Ratio (OR), we look at the odds of exposure in the cases versus the odds of exposure in the controls.

Using the table: Odds of high fat intake in NCD cases = 60/40 = 1.5 Odds of high fat intake in controls (no NCD) = 50/50 = 1. The Odds Ratio = 1.5/1 = 1.5.

95. All of the following statements are true for dietary goals regarding total energy intake in diet from dietary fat, EXCEPТ:

Correct Answer: D. 5-10% for trans fatty acids
Solution:

Dietary recommendations for total energy intake from dietary fat have been established to reduce the risk of NCDs. Recommendations include:
(A) < 20% total energy intake from fats
(B) 6-10% from polyunsaturated fatty acids (PUFAS)
(C) 5-8% from omega-6 polyunsaturated fatty acids (n6PUFAs).

However, "5-10% for trans fatty acids" is incorrect. Trans fatty acids are harmful and should be limited to as low as possible within the context of a nutritionally adequate diet.

Global guidelines often recommend keeping trans fat intake to less than 1% of total energy intake.

96. (Qs. No. 96-100): Answer the question from the paragraph given below:

In a village with mid-year population of 25,000, there were 640 women who became pregnant during a year. Of the pregnancies, there were 35 deaths of foetuses weighing less than 1000 grams.

There were 5 foetal deaths weighing over 1000 grams at delivery, during the year. There were 600 live births during the year. Among the newborns, 5 died within first seven days of birth.

Another 15 died before the completion of one year of life. One of the pregnant ladies died due to excessive bleeding during delivery at home, and another lady died in a road traffic accident, two months after delivering a child.

Which among the following indicators can be calculated for the village for the given year, only from the information given?

Correct Answer: A. Early Neonatal Mortality Rate
Solution:

Early Neonatal Mortality Rate (ENMR) refers to the number of newborns who die within the first seven days of life per 1000 live births in the same year.

Given the data, there were 5 deaths within the first seven days from a total of 600 live births.

Therefore, ENMR = (5/600) × 1000 = 8.33, which rounds to 8. This rate gives an indication of both the quality of maternal health and newborn care in the first crucial week of life.

97. From the information given, which one of the following will be the NUMERATOR (in absolute numbers, and without considering multiplier) in the calculation of the Peri Natal Mortality Rate?

Correct Answer: B. 10
Solution:

The Peri Natal Mortality Rate (PNMR) includes fetal deaths (stillbirths) plus early neonatal deaths (within the first week).

Fetal deaths weighing over 1000 grams at delivery were 5, and 5 newborns died within the first seven days. So, the numerator is 5 + 5 = 10.

This rate is significant as it encompasses both late pregnancy losses (stillbirths) and deaths in the first week of life, reflecting the effectiveness of obstetric and neonatal care.

98. Which among the following best represents the calculation of Maternal Mortality Ratio in the village during the given year (with the multiplier as 1,00,000)?

Correct Answer: A. (1/600) × 1,00,000
Solution:

he Maternal Mortality Ratio (MMR) is calculated as:

MMR = (number of maternal deaths / number of live births) x multiplier In this case, we are looking to find out the number of maternal deaths and the number of live births:

Number of maternal deaths = 1 (One of the pregnant ladies died due to excessive bleeding during delivery at home).

The death of a lady in a road traffic accident, two months after delivering a child, is not considered as a maternal death for the purpose of MMR because it's not directly related to the pregnancy or its management.

Number of live births = 600
Using the formula:
MMR = (1/1600) × 1,00,000 = 166.67
This can be rounded off to approximately 167.

99. Which one among the following best represents the calculation of Crude Birth Rate (CBR) in the village during the given year (with the multiplier as 1000)

Correct Answer: B. (600/25,000) × 1000
Solution:

Crude Birth Rate (CBR) is the number of live births in a year per 1000 population. Given 600 live births in a village with a population of 25,000, CBR = (600/25,000) × 1000 = 24.

This is an essential demographic indicator that helps understand population growth and the need for services like maternal and child health care.

100. Which one among the following best represents the Infant Mortality Rate (IMR) in the village during the given year (rounded to nearest whole number)?

Correct Answer: C. 33 deaths per 1000 live births
Solution:

The Infant Mortality Rate (IMR) is the number of deaths of infants under one year old per 1000 live births in the same year.

From the data, 5 infants died within the first seven days and another 15 before completing one year, totaling 20 infant deaths. IMR = (20/600) x 1000 = 33.33, which rounds to 33.

IMR is a key indicator of the overall health of a society and reflects the social, economic, and environmental conditions in which children (and others in society) live, including their health care.