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Indian Journal of Community Medicine

Comments on the Reviews of Foundations of Community Medicine

Author(s): F Ahad

Vol. 32, No. 1 (2007-01 - 2007-03)

I have very carefully gone through your book review on Foundations of Community Medicine1. I do not want to comment on all the deficiencies pointed out in the book review, but what prompted me to write to you are unfair comments passed by the reviewer on following issues. Epidemiology definitions pertaining to all the links in the natural history of communicable diseases are given in chapter 40 and difinitions on mass phenomena of diseases as also on morbidity, mortality and disability are given in chapter 4. Formulate for computing various mortality raes are appropriately given in chapter 31.

The evolution of Public Health has been presented logically and comprehensively comprising of difinition, historical development, and span of Public Health. A summary table also higlights differentiating features between Public Halth and preventive Medicine. The chapter on the evolution of the discipline of Community Medicine presents an elaborate profile of Community Medicine on the same lines as of Public Health, Preventive Medicine, and Social Medicine.

A sub-chapter on the ‘natural history’ of cancer contains a comprehensive table presenting the nature, distribution, and aetiogenesis of 123 cancers of Public Health significance. In view of ‘genome study’, which has attracted the attention of several disciplines, each highliting its own area of interest, this book has naturally concentrated on preventive genetics only, which has been exhaustively covered in chapter 54. Leptospirosis has been discussed along with other biological hazards of zoonotic origin. It is again projected in table 19.1 for further elucidation.

I feel observations about this book that “it fails to act as a source of information”, “it does not seem to fulfill the academic requirements of undergraduates”, “a sense of completeness and comprehensiveness is missing”, “reader fails to get a sense of contentment, satisfaction or enrichment after going through the chapters”, are totally miplaced.


  1. Singh AJ. Book Review: Foundations of Community Medicine by Dhaar and Robbani, New Delhi: Elsevier, 2006. Indian Journal of Community Medicine 2006; 31:5.

F Ahad
Government Medical College,
Srinagar, Jammu & Kashmir

Reviewer’s Reply

In the 21th century focus in epidemiology should be on the latest. Burden of disease. DAILY, DFLE etc. Have been with us for more than a decade but chapter 40 fails to elaborate on these. Chapter 31 realted to MCH mortality, does not address the issues like standardized death rates. The mortality diagram has wrong labeling of D. M. W (P. 465). Moreover, definition of early and late fetal death rates mentions ‘pregnancy among the female population’ (as of now only females get pregnant !). These are several other omissions and errors such as RCT does not figure in the text or in the index, theory of causation has not been described, the forumulae for specificity, positive and negative predictive values are all wrong (P 553), definition of epizootic is missing, the tails of the normal curve appear to touch the baseline (P 880). It fact in can also be used for more than two attributes.

As far as historical developments are concerned, the year of industrial revolution in England is mentioned as 1950, is obviously wrong (P 17). How do authors explain that ‘Profile of Modern Medicine’ includes only Public Health etc. And nothing about fails to enlighten the readers why, when how, and where the term ‘Community Medicine’ evolved (p 27-28).

The table on cancer is more of a theroretical nature. The magnitude in term of age, sex, and time-wise trends of cancer in India are not given. Preventive genetics certainly has a scope of including at least one paragraph each on ‘Human Genome Project’, ‘Cloning’ and related ethical aspects. Leptospirosis is dealt only briefl y, its occurrence in India, incubation period, laboratory diagnosis or treatment is not mentioned (p 332). The chapter 10 on ‘human population and its control’ gives wrong notions about family welfaremore towards coercion (p 148). It needs to be changed (remember excesses in 1975 emergency!). The next chapter titled ‘arthropod population and its control’ also needs to be changed.

Chapter organization, coherence, sequence is also not proper. Section III Biological Environment and Health gives just a table of zoonosis and then next page onwards it is chapter 10 dealing with human population, biological environment zoonoses, human populaiton, arthropods and then a special treatment to ‘rate population’-this does not give a coherent picture.

AJ Singh
Department of Community Medicine, PGIMER, Chandigarh

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