Medical Tests for  UPSC, IAS, IPS, IFS Civil Service Mains Examination 

Medical Tests for  UPSC, IAS, IPS, IFS Civil Service Mains Examination 

Blood pressure

(a) As a general rule any systolic pressure over 140 mmHg. and diastolic over 90 mmHg. should be regarded as suspicious and the candidate should be hospitalized by the Board before giving their final opinion regarding the candidate’s fitness or otherwise. The hospitalization report should indicate whether the rise in blood pressure is of a transient nature due to excitement etc. or whether it is due to any organic disease. In all such cases X-ray Chest, ECG, Echocardiography, Haemogram, Fundoscopy, Lipid Profile, KFT, Serum Electrolytes and urine, should be done for evaluation of micro and macro vascular complications. If the Medical Board feels necessary, further specific tests can be done after admission of the candidate. Candidate will be declared ‘Fit’ only if he/she is free from any complication of Hypertension.

(b) Method of taking Blood Pressure: Standard ISI marked BP instrument should be used as a rule. The measurement should not be taken within fifteen minutes of any exercise or excitement. Provided the patient and particularly his arm is relaxed he may be either lying or sitting. The arm is supported comfortably at the patient’s side in a more or less horizontal position. The arm should be freed from the cloth to the shoulder. The cuff completely deflated should be applied with the middle of the rubber over the inner side of the arm and its lower edge an inch or two above the bend of the elbow. The following returns of cloth bandage should spread evenly over the bag to avoid bulging during inflation.

The brachial artery is located by palpation at the bend of the elbow and the stethoscope is then applied lightly and centrally over it below but not in contact with the cuff. The cuff is inflated to about 200 mm. Hg. and then slowly deflated. The level at which soft successive sounds are heard, represents the Systolic Pressure. When more air is allowed to escape the sound will be heard to increase in intensity. The level at which the well heard clear sound changes to soft muffed fading sounds represents the diastolic pressure. The measurements should be taken in a fairly brief period of time as prolonged pressure of the cuff is irritating to the patient and will vitiate the reading. Rechecking
if necessary should be done only a few minutes after complete deflation of the cuff. Sometimes as the cuff is deflated sounds are heard at a certain level, they may disappear as pressure falls and reappear at a still lower level. This silent Gap may cause error in readings.

14.    Diabetes Mellitus :

All candidates should be subjected to Fasting Blood Sugar and HbA1C after 8-10 hours/overnight fasting to rule out presence of Diabetes Mellitus. If a candidate is found to be having above normal levels of Blood Glucose and/or HbA1C, he/she will be subjected to following biochemical and radiological tests for evaluation of micro and macro vascular complications of Diabetes Mellitus:

(a)   Fasting Blood Sugar with 8-10 hours/overnight Fasting and 2 hours OGTT after 75 gm of Glucose. (b)   Haemogram
(c)   Lipid Profile
(d)   KFT

For Micro Vascular changes:

(a)   Nephropathy- Micro albuminuria.
(b)   Retinopathy-Fundus examination and if required FFA (c)   Neuropathy- On clinical examination.
(d)   Ultra Sound whole abdomen- if required. For Macro Vascular changes:
(a)   ECG
(b)   Doppler for peripheral vascular diseases (Arterial) (c)   TMT- if required
(d)   ECHO- if required

Candidate will be declared ‘Fit’ only if he/she is free from any complication of Diabetes Mellitus.

15.    Candidate’s hearing ability :—

The candidate’s hearing in each ear should be good and there should be no sign of disease of the ear. In case it is defective the candidate should be examined by the ear specialist; provided that if the defect in hearing is remediable by operation or by use of a hearing aid a candidate cannot be declared unfit on that account provided he/she has no progressive disease in the ear. This provision is not applicable in the case of Railway Services.

The following are the guidelines for the medical examining in this regard :—

*Hoarseness of voice can be tested subjectively by Speech Language Pathologist with the help of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) and objectively, if required by Dr. Speech/Vaghmi/Computerised Speech Lab (CSL)/Harmonic to Noise (H/N) ratio/Glottogram etc.

**Stuttering  can  be  tested  subjectively  by  Speech  Language  Pathologist  and  if  required,  objectively  by  Percent dysfluency (syllable, word, phrase repetitions) and duration of dysfluency.
16.    All candidates with pregnancy will be Temporarily ‘Unfit’/‘Fit’ for all types of services which require mandatory physical training. They mandatory will be declared ‘Fit’ after confinement.

17.    The following additional points should be observed:—

(a)  that his/her teeth are in good order and that he/she is provided with dentures where necessary for effective mastication (well filled teeth will be considered as sound);

(b)  that the chest is well formed and his/her chest expansion is sufficient and that the heart and lungs are sound; (c)  that there is no evidence of any abdominal disease;
(d)  that his/her limbs, hands and feet are well formed and developed and that there is free and perfect motion of all joints;

(e)  that there is no congenital malformation or defect;

(f)  that he/she does not bear traces of acute or chronic disease pointing to an impaired constitution; (g)  that he/she bears marks of efficient vaccination;
(h)  that he/she is free from communicable disease. How? (Temporary Unfit?) (i)  Grade-I Haemorrhoids should be declared ‘Fit’.
(j)  absence of one Testis in the scrotum should be declared ‘Fit’. However possibility of undescended testis is to be ruled out.

(k)  candidate with varicose veins would be declared temporarily unfit for technical services

(l)  diseases such as Hernia, Hydrocele, Varicose Veins, Hemorrhoids etc, which can be cured by surgical means should be declared only ‘Temporarily Unfit’ and should be declared ‘Fit’ after successful surgery.

(m)  all candidates with malignancies detected at the time of entry into service should be declared ‘Unfit’. (n)  all candidates having transplanted organs should be declared ‘Unfit’ except corneal Transplant.