In a town of 20,000 population, total 456 bihs were there in a year out of which 56 were dead born. The total deaths were 247 out of which 56 deaths were within the first 28 days of life and another 34 had died after 28 days and before completing the first bihday. Calculate the Infant moality rate of this area.

**Core Concept**
The Infant Mortality Rate (IMR) is a measure of the number of deaths of infants under one year of age per 1,000 live births in a given year. It is an important indicator of a country's or region's health status and quality of healthcare.

**Why the Correct Answer is Right**
To calculate the IMR, we use the formula: IMR = (Number of deaths under 1 year of age / Number of live births) x 1000. In this case, the number of deaths under 1 year of age is 56 (within the first 28 days) + 34 (after 28 days and before completing the first birthday) = 90. The number of live births is 456 - 56 (stillbirths) = 400. Therefore, the IMR is (90 / 400) x 1000 = 225.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not take into account the stillbirths in the calculation.
**Option B:** This option is incorrect because it uses the total number of deaths (247) instead of the number of deaths under 1 year of age.
**Option C:** This option is incorrect because it uses the total number of live births (456) instead of the number of live births minus stillbirths.

**Clinical Pearl / High-Yield Fact**
The Infant Mortality Rate is a sensitive indicator of a community's overall health status and access to quality healthcare. A high IMR can indicate inadequate prenatal care, poor maternal health, and inadequate postnatal care.

**Correct Answer: A. 225**

✓ Correct Answer: B. 225