What is the correct first aid for a burn to the forearm?

Cool it under cool running water for a sustained period, then cover with cling film or a clean non-fluffy dressing

Burst the blisters to release the fluid

Spread butter or toothpaste on it

Assertion (A): Exercise combined with moderate dietary restriction is the most effective approach to long-term weight control. Reason (R): Exercise alone always produces faster weight loss than dieting alone. Choose the correct option.

Both A and R are true, and R is the correct explanation of A

Both A and R are true, but R is not the correct explanation of A

A person has collapsed after touching a faulty appliance and is still in contact with it. Which actions are correct? Select all that apply.

Call for help and begin resuscitation if the person is not breathing normally

If the power cannot be switched off, separate the person using a dry non-conducting object

Switch off the power at the mains before touching the person

Call for help and begin resuscitation if the person is not breathing normally

Pull the person away by the hand at once

If the power cannot be switched off, separate the person using a dry non-conducting object

Switch off the power at the mains before touching the person

Which statements about body mass index are correct? Select all that apply.

It does not distinguish fat from muscle, so it can misclassify muscular athletes

Indian consensus guidelines treat a BMI of 25 or above as obese

It does not distinguish fat from muscle, so it can misclassify muscular athletes

Indian consensus guidelines treat a BMI of 25 or above as obese

It is calculated as height divided by weight squared

By the WHO classification a BMI of 22 is overweight

Why are rescue breaths given early in the resuscitation of a drowning casualty?

Because the cause of collapse is lack of oxygen, so restoring oxygen is the priority

Because drowning casualties always have a normal heartbeat

Because chest compressions are never used in drowning

Because water must first be pumped out of the stomach

Because the cause of collapse is lack of oxygen, so restoring oxygen is the priority

Health Education II: Psychosomatic and Sedentary Lifestyle Diseases, Obesity and Body Weight Control with the Roles of Exercise and Diet, First Aid and its Principles for Shock, Poisoning, Burns, Drowning, Bleeding, Electric Shock and Common Sports Injuries, Pollution and its Effects on Health, Nutrition, Deficiencies and Supplements, and the Effects of Smoking, Alcohol and Drugs

The second half of Unit VI covers the health problems of modern life and the teacher's response to emergencies. It explains psychosomatic and lifestyle diseases and how activity prevents them; obesity, body mass index and the energy arithmetic of weight control, and why exercise combined with diet works best; the objectives and principles of first aid and the textbook first-aid steps for shock, poisoning, burns, drowning, bleeding, electric shock and sports injuries; air, water, noise and radiation pollution; the balanced diet, deficiency diseases, malnutrition and supplements; and the effects of tobacco, alcohol and drugs. This is education for teachers and students, not a substitute for trained medical care, and current first-aid guidance should always be followed.

1. Psychosomatic and lifestyle diseases, obesity and weight control

Psychosomatic disorders are physical conditions in which psychological factors, especially chronic stress, anxiety and emotional conflict, play a significant part in onset or course: tension headache and migraine, peptic ulcer and irritable bowel syndrome, some forms of asthma and skin disorders such as eczema, and a contribution to hypertension and heart disease. Sedentary lifestyle diseases, or non-communicable diseases, arise mainly from physical inactivity, unhealthy diet, tobacco, alcohol and stress: obesity, type 2 diabetes, hypertension (conventionally a blood pressure of 140/90 mmHg or above, though some guidelines use lower thresholds), coronary heart disease and stroke, osteoporosis, low back pain and some cancers. Their causes are clustered risk factors and their prevention is regular physical activity, a balanced diet with less salt, sugar and saturated fat, maintaining a healthy weight, avoiding tobacco, limiting alcohol, managing stress, adequate sleep and regular screening.

Obesity is excess body fat that impairs health. It is commonly screened by the body mass index, BMI = weight in kilograms ÷ (height in metres)²: a person of 64 kg and 1.6 m has a BMI of 64 ÷ 2.56 = 25. The WHO classification for adults is below 18.5 underweight, 18.5–24.9 normal, 25–29.9 overweight and 30 or above obese; because Asian Indians carry more body fat and risk at a given BMI, Indian consensus guidelines (2009) use 23–24.9 as overweight and 25 or above as obese. BMI does not distinguish fat from muscle, so a muscular athlete may be classed overweight wrongly; waist circumference (Indian cut-offs about 90 cm for men and 80 cm for women) and the waist-to-hip ratio indicate the more harmful abdominal fat. Obesity raises the risk of type 2 diabetes, hypertension, heart disease, stroke, osteoarthritis, sleep apnoea, some cancers and psychological problems.

Body weight is controlled by energy balance: weight is stable when energy intake equals expenditure, rises with a surplus and falls with a deficit. One kilogram of body fat stores roughly 7,700 kcal, so losing 0.5 kg of fat a week requires a deficit of about 3,850 kcal a week, or 550 kcal a day. Dieting alone can reduce weight quickly, but part of the loss is water and lean tissue, metabolic rate falls and the weight tends to return; exercise alone produces slower loss but preserves or builds lean mass, improves fitness and is strongly linked to keeping weight off; exercise combined with moderate dietary restriction is the most effective and sustainable approach, since it creates the deficit while protecting muscle and metabolic rate. Crash diets, very low-calorie diets without supervision, slimming pills and making weight by dehydration before competition carry real risks.

2. First aid: objectives, principles and common emergencies

First aid is the immediate care given to an injured or suddenly ill person until professional help arrives. Its objectives are often summarised as the three Ps: preserve life, prevent the condition from worsening and promote recovery. Its principles are to check the scene for danger and make it safe; to stay calm and assess the casualty; to call for help and emergency services early; to deal first with life-threatening problems (an open airway, breathing, circulation and severe bleeding); to do no further harm; to reassure the casualty; and to hand over with an account of what happened. For an unresponsive person who is not breathing normally, current resuscitation guidance for lay rescuers puts chest compressions first: hard and fast in the centre of the chest, about 100–120 a minute and at least 5 cm deep in an adult, with 30 compressions to 2 rescue breaths for those trained to give them, and use of an automated external defibrillator as soon as one is available.

Emergency	Recognition	Textbook first aid
Shock	Pale, cold, clammy skin; rapid weak pulse; fast shallow breathing; anxiety	Call for help; lay the person down and raise the legs if no leg or spinal injury; keep warm; give nothing by mouth; monitor breathing
Poisoning	History, container, burns round the mouth, vomiting, drowsiness	Call emergency services or a poison centre; do not induce vomiting unless told to; keep the container; place an unconscious breathing person in the recovery position
Burns	Red, blistered or charred skin	Cool the burn under cool running water for at least 10 to 20 minutes; remove rings and loose clothing not stuck to the burn; cover with cling film or a clean non-fluffy dressing; no ice, butter or ointments; seek care for large or deep burns
Drowning	Person in difficulty or recovered from water, not breathing normally	Rescue without endangering yourself (reach or throw, do not go in unless trained); call for help; if not breathing normally begin resuscitation, giving rescue breaths early because the problem is lack of oxygen
Bleeding	Visible blood loss; signs of shock in severe cases	Apply firm direct pressure with a clean pad; raise the part if possible; add dressings without removing soaked ones; for life-threatening limb bleeding a tourniquet may be applied by a trained person; treat for shock
Electric shock	Contact with a live source; burns; unconsciousness	Do not touch the casualty until the current is switched off or the casualty is separated with a dry non-conducting object; call for help; begin resuscitation if needed; treat burns

Common sports injuries are soft-tissue injuries: a sprain is a stretch or tear of a ligament (commonly the ankle), a strain a stretch or tear of a muscle or tendon (commonly the hamstring), a contusion a bruise from a blow, and an abrasion a scrape; hard-tissue injuries include dislocations, in which bone ends are displaced from a joint, and fractures, which may be simple (closed), compound (open, with a wound), greenstick (an incomplete fracture common in children), comminuted (broken into fragments), impacted or stress fractures from repeated load. Soft-tissue injuries in the first days are managed by protecting the part and relative rest, cold, compression and elevation, the steps summarised as PRICE or, in newer guidance, POLICE and PEACE and LOVE, which add optimal loading and a gradual return to activity. Suspected fractures and dislocations are immobilised as found with splints or slings, never forced back, and referred; head and neck injuries are treated as spinal injuries until ruled out, and any athlete with a suspected concussion is removed from play and not returned the same day.

⚠️ No ice, butter or toothpaste on a burn

Cool running water for a sustained period is the first aid for a burn. Ice can deepen the tissue damage, and butter, oil, toothpaste and ointments trap heat and raise the risk of infection. Blisters are not to be burst.

3. Pollution: air, water, sound and radiation

Air pollution comes from vehicle exhaust, industry, power plants, construction dust, burning of crop residue and waste, and indoor burning of solid fuels; its main pollutants are particulate matter (PM10 and the finer, more dangerous PM2.5), sulphur dioxide, nitrogen dioxide, carbon monoxide, ozone and lead. It causes and worsens asthma, bronchitis, chronic obstructive pulmonary disease, lung cancer and heart disease; India's National Air Quality Index, launched in 2014, reports air quality in bands from good to severe. Water pollution from sewage, industrial effluents, agricultural runoff of fertilisers and pesticides, and natural contaminants such as fluoride and arsenic causes water-borne diseases, fluorosis and arsenic poisoning. Noise (sound) pollution from traffic, industry, loudspeakers and construction causes hearing loss with prolonged exposure above about 85 decibels, sleep disturbance, stress and raised blood pressure. Radiation pollution may be ionising (X-rays, nuclear radiation, radon), which damages cells and DNA and raises cancer risk, or non-ionising (ultraviolet, which causes sunburn and skin cancer).

Preventive and safety measures include, for individuals, checking the Air Quality Index and avoiding outdoor exercise on bad days and near traffic, using well-fitted masks where appropriate, drinking safe (boiled, filtered or treated) water, limiting exposure to loud noise and using ear protection, and protecting the skin from strong sun; and for society, cleaner fuels and vehicles, public transport, emission and effluent standards, treatment of sewage and industrial waste, ending open burning, planting trees, noise limits, and the laws that give them force, such as the Water Act 1974, the Air Act 1981 and the Environment (Protection) Act 1986.

4. Nutrition, deficiencies, malnutrition and supplements

A balanced diet provides all the nutrients in the right proportions for health, growth and activity: carbohydrates (the main energy source, about 4 kcal per gram; preferably complex, from cereals, millets, pulses and vegetables), proteins (for growth and repair, about 4 kcal per gram; from pulses, milk, eggs, fish, meat and nuts), fats (concentrated energy, about 9 kcal per gram, and fat-soluble vitamins; with limits on saturated and trans fats), vitamins and minerals (regulators, from fruits, vegetables, milk and whole grains), dietary fibre and water. Deficiency diseases include protein–energy malnutrition (kwashiorkor, from a diet especially short of protein, with oedema; marasmus, from severe shortage of energy, with extreme wasting), night blindness and xerophthalmia (vitamin A), beriberi (vitamin B1, thiamine), pellagra (niacin, with the three Ds of dermatitis, diarrhoea and dementia), scurvy (vitamin C, with bleeding gums), rickets in children and osteomalacia in adults (vitamin D), anaemia (iron, folic acid or vitamin B12) and goitre (iodine).

Malnutrition means both undernutrition and overnutrition, and India carries the "double burden" of both. Undernutrition in children is assessed by stunting (low height for age, a sign of chronic undernutrition), wasting (low weight for height, a sign of acute undernutrition) and underweight (low weight for age); micronutrient deficiencies are called hidden hunger. Overnutrition leads to overweight and obesity. Nutritional supplements (vitamin and mineral tablets, protein powders, iron and folic acid for adolescent girls and pregnant women, vitamin A for children, iodised salt) correct genuine deficiencies or meet special needs, but a balanced diet should come first; unnecessary high doses of fat-soluble vitamins can be toxic, and sports supplements carry the risk of contamination with prohibited substances.

5. Smoking, alcohol and drugs: effects, prevention and rehabilitation

Tobacco, smoked or chewed, is the leading preventable cause of death. Nicotine is addictive and raises heart rate and blood pressure; tar contains carcinogens; carbon monoxide binds haemoglobin and reduces the oxygen the blood carries, which lowers endurance. Tobacco causes cancers of the lung, mouth, throat and other organs, chronic obstructive pulmonary disease, heart disease and stroke, and passive smoking harms others; in India the Cigarettes and Other Tobacco Products Act 2003 (COTPA) bans smoking in public places, advertising, sale to minors and sale near educational institutions. Alcohol is a central nervous system depressant that impairs judgement, coordination and reaction time, dehydrates the body, disturbs sleep and recovery, and in the long term damages the liver (fatty liver, hepatitis, cirrhosis), heart, brain and pancreas and raises cancer risk; it also contributes to accidents, violence and dependence. Drugs of abuse, such as cannabis, opioids, stimulants, inhalants and misused prescription medicines, cause dependence, mental illness, infections from shared needles and overdose; the Narcotic Drugs and Psychotropic Substances Act 1985 governs them in India.

Prevention works at three levels: primary prevention stops use from starting, through health education in schools that builds knowledge, life skills and the confidence to refuse, positive alternatives such as sport and recreation, family and community involvement and enforcement of laws on sale; secondary prevention detects early use and intervenes through counselling; and tertiary prevention treats dependence and prevents relapse. Rehabilitation includes medically supervised detoxification, counselling and psychotherapy, support groups such as Alcoholics Anonymous and Narcotics Anonymous, family therapy, vocational training and social reintegration, and nicotine-replacement and other medicines for quitting tobacco. Physical activity and sport are used in rehabilitation because they rebuild fitness, structure time, provide healthy social networks and improve mood.

Key takeaways

Psychosomatic disorders have a strong psychological component; lifestyle diseases such as obesity, type 2 diabetes, hypertension and heart disease are prevented by activity, diet and avoiding tobacco.
BMI = kg ÷ m²; the WHO calls 25–29.9 overweight and 30 or more obese, and Indian guidelines use 23 and 25; a kilogram of fat is about 7,700 kcal, and exercise with moderate diet is the best route to weight control.
First aid preserves life, prevents worsening and promotes recovery; cool burns with running water, apply direct pressure to bleeding, switch off the current before touching an electric-shock casualty and give compressions first in resuscitation.
Air, water, noise and radiation pollution harm health; the AQI, safe water and noise limits, and the Water, Air and Environment Protection Acts are the main defences.
A balanced diet prevents deficiency diseases such as kwashiorkor, marasmus, scurvy, rickets, beriberi and anaemia; tobacco, alcohol and drugs are prevented by education and life skills and treated by rehabilitation.

Practice questions (10)

Attempt each one before opening the answer. Every explanation names the tempting wrong option as well as the right one, because that is where marks are lost.

A student weighs 64 kg and is 1.6 m tall. What is the body mass index? Type the number.
Numerical answer — type the value.
Show answer
Answer: 25
BMI = weight ÷ height² = 64 ÷ (1.6 × 1.6) = 64 ÷ 2.56 = 25. Dividing by the height once (64 ÷ 1.6 = 40) forgets to square it; 25 is overweight by WHO bands and obese by the Indian cut-off.
Taking one kilogram of body fat as 7,700 kcal, what daily energy deficit in kcal is needed to lose 0.5 kg of fat in a week? Type the number.
Numerical answer — type the value.
Show answer
Answer: 550
0.5 kg × 7,700 kcal = 3,850 kcal a week; 3,850 ÷ 7 = 550 kcal a day. Stopping at 3,850 gives the weekly deficit, not the daily one asked for.
Scurvy is caused by a deficiency of
1. vitamin D
2. iodine
3. vitamin B1
4. vitamin C
Show answer
Answer: D — vitamin C
Scurvy, with bleeding gums and poor wound healing, results from lack of vitamin C. Vitamin D deficiency causes rickets, vitamin B1 deficiency beriberi and iodine deficiency goitre.
What is the correct first aid for a burn to the forearm?
1. Cool it under cool running water for a sustained period, then cover with cling film or a clean non-fluffy dressing
2. Burst the blisters to release the fluid
3. Spread butter or toothpaste on it
4. Apply ice directly to the burn
Show answer
Answer: A — Cool it under cool running water for a sustained period, then cover with cling film or a clean non-fluffy dressing
Sustained cooling with running water limits the damage, and a clean, non-stick covering protects the burn. Ice deepens injury, butter and toothpaste trap heat and cause infection, and bursting blisters opens the wound.
A stretch or tear of a ligament, commonly at the ankle, is called a
1. strain
2. sprain
3. greenstick fracture
4. contusion
Show answer
Answer: B — sprain
A sprain is a ligament injury; a strain injures a muscle or tendon, a contusion is a bruise from a blow and a greenstick fracture is an incomplete break of a child's bone. Sprain and strain are the pair most often confused.
Assertion (A): Exercise combined with moderate dietary restriction is the most effective approach to long-term weight control. Reason (R): Exercise alone always produces faster weight loss than dieting alone. Choose the correct option.
1. Both A and R are true, and R is the correct explanation of A
2. Both A and R are true, but R is not the correct explanation of A
3. A is true, but R is false
4. A is false, but R is true
Show answer
Answer: C — A is true, but R is false
A is true: combining the two creates an energy deficit while protecting muscle and metabolic rate. R is false: exercise alone usually produces slower weight loss than dieting alone; its advantage is preserving lean mass and keeping weight off, not speed.
A person has collapsed after touching a faulty appliance and is still in contact with it. Which actions are correct? Select all that apply.
1. Call for help and begin resuscitation if the person is not breathing normally
2. Pull the person away by the hand at once
3. If the power cannot be switched off, separate the person using a dry non-conducting object
4. Switch off the power at the mains before touching the person
Show answer
Answer: A — Call for help and begin resuscitation if the person is not breathing normally; C — If the power cannot be switched off, separate the person using a dry non-conducting object; D — Switch off the power at the mains before touching the person
The rescuer must not become a second casualty: break the current first, by switching off or with a dry non-conducting object, then call for help and resuscitate if needed. Grabbing the person while the current flows can electrocute the rescuer.
In child nutrition, low height for age, a sign of chronic undernutrition, is called
1. wasting
2. stunting
3. underweight
4. hidden hunger
Show answer
Answer: B — stunting
Stunting is low height for age and reflects long-term undernutrition. Wasting is low weight for height (acute), underweight is low weight for age, and hidden hunger refers to micronutrient deficiencies.
Which statements about body mass index are correct? Select all that apply.
1. It does not distinguish fat from muscle, so it can misclassify muscular athletes
2. Indian consensus guidelines treat a BMI of 25 or above as obese
3. It is calculated as height divided by weight squared
4. By the WHO classification a BMI of 22 is overweight
Show answer
Answer: A — It does not distinguish fat from muscle, so it can misclassify muscular athletes; B — Indian consensus guidelines treat a BMI of 25 or above as obese
BMI ignores body composition and Indian guidelines use 25 as the obesity cut-off. It is weight in kg divided by height in metres squared, and 22 falls in the WHO normal range of 18.5–24.9.
Why are rescue breaths given early in the resuscitation of a drowning casualty?
1. Because drowning casualties always have a normal heartbeat
2. Because chest compressions are never used in drowning
3. Because water must first be pumped out of the stomach
4. Because the cause of collapse is lack of oxygen, so restoring oxygen is the priority
Show answer
Answer: D — Because the cause of collapse is lack of oxygen, so restoring oxygen is the priority
Drowning causes cardiac arrest through lack of oxygen, so guidance emphasises early rescue breaths along with compressions. Compressions are still used, attempts to drain water waste time, and the heart has often stopped.