Mental and Neurological Disorders Quiz

Health Fitness Regulations for Public Employment

• The lecture covers Ministry of Civil Service policy and procedure regarding public employment
• A refreshed policy is possibly needed for future pre-employment assessments in other sectors
• The policy covers conditions that disqualify individuals from meeting health fitness standards
• Health fitness regulations for public employment, including visual acuity levels required at recruitment for positions demanding specific visual requirements
• List of jobs requiring color vision proficiency
• Reinstatement in service, and extension of service duration
• Pre-employment examination form
• Examples of important tests

Surgical Conditions

• Large hernias unless fully healed
• Large hydroceles or hematoceles unless fully healed
• Elephantiasis if the size of the affected part hinders functionality
• Malignant tumors in general
• Amputation of a limb in roles requiring the use of the amputated limb
• Evident, incurable splenomegaly
• Incurable ascites
• Severe liver cirrhosis
• Bone and joint tuberculosis unless fully healed

Respiratory Conditions

• Active pulmonary tuberculosis until it has been dormant for at least one year
• Pleural effusion until it is fully absorbed
• Acute and subacute pneumonia and pulmonary abscesses until they are healed

Cardiovascular Conditions

• Heart failure until cardiac function is stabilized

Urinary System

• Presence of albumin in the urine does not disqualify an individual from health fitness
• Large amounts of albumin in the urine when all casts, except for hyaline casts, or more than five red or white blood cells are found in high-power microscopic field, along with elevated blood pressure, and a blood urea level above 75 mg%
• Persistent blood sugar levels exceeding 120 mg% when fasting, or exceeding 180 mg% at peak, accompanied by ketones, unless treated, with the condition stabilized and ketones cleared

Mental, Neurological, and Epileptic Disorders, and Psychological Conditions

• All incurable mental, neurological, and epileptic disorders
• Curable cases are postponed until it is confirmed that the condition has been stable and symptom-free for at least one continuous year
• Psychological conditions are generally divided into two types:
  • Mild conditions (neurosis) do not prevent functional employment
    • Include hysteria, anxiety, and reactive depression
  • Severe conditions (psychosis), traditionally referred to as mental disorders
    • Include schizophrenia, manic-depressive psychosis, and paranoia
• Cases requiring specialist examination and report on suitability for service

Dermatological and Venereal Diseases

• Chronic and incurable contagious skin and venereal diseases (STDs/STIs) affecting multiple parts of the body and incompatible with work duties
• Active (positive) leprosy until the case is no longer infectious

Communicable Diseases

• All infectious diseases until they are fully cured and no longer contagious

Severe Visual Impairment

• Less than 6/60 vision in both eyes, even with corrective lenses, regardless of type
• Individuals with lower visual acuity or blindness may be considered for positions that do not require vision

Technical Positions in General

• Specialist doctor, general practitioner (resident)
• Pharmacist, pharmacy assistant, nursing supervisor, nurse, midwife
• Science specialists (Chemistry, Physics, Geology, and related)
• Teacher, "Physical Education Teacher or Trainer"
• Agricultural engineer or equivalent
• Technician positions (various specialities)
• Technical worker, physical therapist, laboratory assistant
• Notaries, members of judicial councils, legal and Sharia investigators
• Required Level: 6/36 vision in both eyes with glasses
• Color perception: according to job nature

Engineers and Equivalent Positions

• Engineer, draftsman, photographer (except surveyors)
• Archaeological restorer
• Required Level: 6/18 – 6/18 or 6/12 – 6/24 or 6/9 – 0 (Has vision in only one eye) with glasses
• Color perception: (according to job nature)

Technical Positions in Certain Departments

• Meteorology: weather observer and assistant, meteorology controller, aerial photographer and assistant
• Civil Aviation: air traffic controller and assistant, wireless technician (operations), wireless technician (maintenance)
• Ports: port controller, port officer
• Surveying: engineer, computer operator, typist, photographer, specialized surveyor, surveying controller
• Workers involved in microscopic examinations: laboratory doctors, laboratory technicians, biology teachers
• Required Level: 6/12 – 6/12 or 6/9 – 6/18 with glasses not exceeding 6 diopters
• Color perception: according to job nature; for wireless technicians (operations) and surveying specialists, color perception is not required

Ophthalmologists

• Required Level: 6/9 – 6/9 or 6/6 in both eyes, or 6/6 – 6/12, without obvious real strabismus

Certain Maritime Positions

• Captains, navigators, tugboat captains, chief seafarers, lookouts
• Required Level: 6/9 – 6/9 or 6/6 – 6/12 without glasses
• Color perception: via Ishihara test
• Visual field: normal
• No real strabismus.
• Retina is normal
• Chief seafarers in small vessel guidance
• Seafarers
• Navigators
• permitted to use glasses if 40 or over, correction not exceeding 2 diopters
• Required Level: 6/12 – 6/12 or 6/9 – 6/18 without glasses
• Color perception: via Ishihara test
• Visual field: normal
• No visible real strabismus
• Retina is normal

Positions That Do Not Require Visual Acuity

• Muezzin, Quran teacher, Imam, preacher, Teachers of religious and Arabic sciences in schools or religious institutes, Marriage contract officiants

List of Jobs Requiring Color Vision Proficiency

• Jobs requiring color vision proficiency due to the nature of their work, including General Technical Jobs
  • Meteorology, Meteorologist, Assistant Meteorological Technician, Meteorological Observer
  • Civil Aviation, Air Traffic Controller
  • Ports, Port Controller
  • Microscopic examination and similar machines (Laboratory Doctors, Laboratory Technicians, Biology Teachers)
• Other jobs requiring color vison proficiency
  • Physicians
    • Ophthalmologist, Forensic Doctor
  • Maritime Jobs
    • Captains, Pilots, Chief Mariners, Lookouts, Chief Mariners for guiding small vessels
  • Specialized or General Technical Jobs
    • Pharmacist, Assistant Pharmacist
    • Science Specialists (Chemistry, Physics, Geology)
    • Teachers (Chemistry, Practical Arts Drawing, Embroidery, Arts, Textile, Engraving, Decoration)
    • Electricians, Wiring Works, Decor Specialists, Engraving and Decoration Specialists
  • Engineers
    • Engineer, Decor, Engraving, or Decoration Designer, Chemical Engineer, Electrical, or Wiring Engineer, Restoration Engineer
  • Civil Aviation
    • Wiring Technician, Maintenance, Air Traffic Monitoring
  • Surveying
  • Engineer, Designer, Computer Operator, Map Printer, Photographer, Surveyor, Surveying Supervisor
  • Teachers (industrial institutes, intermediate colleges, science and math centers, education colleges, girls' colleges, Educational Departments (Chemistry Division), Art education, sewing and home economics institutes)
  • Health technicians
    • Radiology Technician, Health Inspector, Medical Registration and Statistics Technician, Nursing technicians (male and female)

Reinstatement in service, extension of service duration

• Medical examinations for reinstatement, extension, or termination of service are under the jurisdiction of the General and Local Medical Committees
• Exemption from health fitness requirements for appointment to service is under the authority of the General Medical Committees
• Occupational medical committees consist of:
  • Occupational Medicine
  • Medicine
  • Surgery
  • Psychiatry and any other subspecialties

Guidelines

• Complete all fields of the form according to the position applied for.
• Familiarity with the Health Fitness Regulations is recommended.
• Medical conditions treatable within 60 days are considered fit, provided a medical examination is taken post recovery.
• Other illnesses mentioned refer to: dermatological and sexually transmitted diseases, and any additional illnesses requiring medical examination.
• Additional tests administered may require a deliverable for results directly to the candidate.
• Positive results do not automatically disqualify the candidate from positions not requiring those respective examinations.

TB Screening

• All new healthcare workers (HCW), need screening for latent tuberculosis infection (LTBI) by Interferon Gamma Release Assay (IGRA) or Two-Step Tuberculosis Skin Testing (TST)
• If TST or PPD documentation is positive, a Interferon Gamma Release Assay (IGRA) will be required
• If results are negative, nothing further is required
• If results are positive, a chest x-ray is required
• If chest x-ray is negative, nothing further is required.
• If results of chest x-ray are positive, further testing is required

Exclude persons who have had the following from testing:

• Live vaccine administered within past 3 weeks due to possiblity of false negative reaction
• Febrile illness
• Documented positive PPD

Tuberculin Skin Test (TST)

• Detects individuals infected with Mycobacterium tuberculosis
• Administered intradermally using the Mantoux technique (injecting 1.0 mL containing 5 TU of purified protein derivative (PPD) solution)
• Delayed-type hypersensitivity reaction is detectable 2-8 weeks after infection.
• Reaction read and interpreted by trained professionals within 48-72 hours after administration
• Patient given written appointment card and importance of returning for reading within 2-3 days
• Providing a written pamphlet or brochure

Measurement

• Measure the induration (hard bump) rather than the erythema (redness)
• Palpate the area with fingertips and measure diameter of induration perpendicular to the long axis of the arm
• Use a ballpoint pen to mark the edges of the induration
• Use a tuberculin test ruler (or ruler with mm marks) to measure distance between points
• Record following data:
  • Date TST administered
  • Name of PPD solution, lot number, manufacturer, expiry date
  • Results in mm (0 mm if no induration)
  • Date and time of reading plus name of person performing the reading
  • Information to the patient and ordering physician

Chest Radiograph

• Used to differentiate between latent TB and pulmonary TB in those with positive TST results
• Clinical evaluation needed to rule out active TB
  • Chest radiography
  • Baseline CBC and liver function test (LFT)
• Referral to infectious disease consultant, evaluation and possible prophylaxis.
• Periodic retesting recommended for those with abnormal initial results or high risk for hepatic disease

Healthcare workers

• Healthcare workers must undergo the following serological tests:
  • Viral hepatitis (B) "HBs Ag"
  • Viral hepatitis (C) "HCV Ab"
  • HIV test

Ishihara Color Blindness Test

• Identifies red-green color blindness.
• Quick and effective screening tool
• Used worldwide to diagnose inherited color vision deficiencies
• Not for acquired deficiencies
• Plates contain colored dots forming numbers or patterns. People with color blindness will see different patterns.

How the Ishihara Test Works: Plate Examples

• Hidden Number: numbers are only visible to those with normal vision.
• Different Number plates: Those with color blindness see a different number.
• Winding Path plates: use winding paths instead of numbers.

Normal Color Vision vs. Color Deficiency

• Normal: Individuals perceive the full spectrum of colors, distinguishing between shades and hues effectively.
• Color Deficiency: Difficulty differentiating between colors, often red and green, or blue and yellow.
  • Congenital: Present from birth, usually genetic
  • Acquired: Develops later, due to disease or injury

Types of Color Vision Deficiencies

• Protanopia: Reduced sensitivity to red light, reds appear darker, almost brownish.
• Deuteranopia: Reduced sensitivity to green light, impacts red-green distinction.
• Tritanopia: Rare, reduced sensitivity to blue light, confuses blue with green.

Conducting the Ishihara Test: Step-by-Step

• Controlled Lighting: Ensure sufficient proper lighting (ideally natural daylight).
• Standard Distance: Hold plates at a standard distance (typically 75cm).
• Time Limit: Allow a time limit (typically 3 seconds per plate).

Test Administration

• Present plates one by one, asking the patient to identify the number or pattern.
• Patient should not wear color-enhancing glasses.
• Record responses carefully after each plate.
• Test on each eye separately to assess for unilateral color deficiency.
• Avoid prompting or giving clues during the test.

Interpreting the Ishihara Test Results

• Correct Responses: Indicate normal color vision.
• Errors on Specific Plates: Indicates a particular type of deficiency.
• Multiple Errors: Suggests greater severity of deficiency.

Case Studies: Ishihara Test Interpretation

• Case 1: Patient sees '2' instead of '74' indicating red-green deficiency
• Case 2: Patient sees no number, suggesting more severe color blindness

Test your knowledge on various mental, neurological, and epileptic disorders. This quiz covers the nature, categorization, and characteristics of these disorders, as well as the necessary referrals and assessments related to them. Challenge yourself by answering questions about common conditions and their implications.