B.Sc Physician Assistant

AVINASHILINGAM INSTITUTE FOR HOME SCIENCE

AND HIGHER EDUCATION FOR WOMEN

COIMBATORE – 641043, India

Scheme of Instruction & Examination

(For the students admitted from 2015 -16 & onwards)

Part Subject Code Name of the Hrs. of Scheme of Examination Paper/Component Instruction

T P Duration of CIA CIE Total Credit Exam

T P

First Semester

I 15BLT001/ Tamil : -Ilakkiam I- 5 - 3 - 50 50 100 4 15BLH001/ Ilakkanam, Ilakkia 15BLF001 Varalaru/

Hindi: Prose, Poetry and Technical Terms/

French: Communicative French I

Core Course

15BPAC01 Anatomy – I 3 2 3 - 50 50 100 3

15BPAC02 Physiology – 1 5 - 3 - 50 50 100 3

15BPAC03 Principles of Nutrition 3 2 3 - 50 50 100 3 and Diet Therapy

15BPAC04 Infection Control 4 - 3 - 50 50 100 3

Discipline Specific Elective (DSE)

III Course

15BPAI01 DSE I : Computer 2 3 3 - 50 50 100 3 Application for Paramedics

Games 1 ------

Hospital Posting* ------

IV Medical Camp -

Second Semester

II 15BLE002 English Language Through 5 - 3 - 50 50 100 4 Literature-II

Core Course

15BPAC05 Anatomy – II 3 2 3 - 50 50 100 3

III 15BPAC06 Physiology –II 4 - 3 - 50 50 100 2

15BPAC07 Physiology –III - 3 - 3 50 50 100 2

Practical -I

15BPAC08 Counseling Psychology 3 2 3 - 50 50 100 3

Discipline Specific Elective (DSE) Course

15BPAI02 DSE II: Clinical Bio 4 3 3 - 50 50 100 2 Chemistry – I

Games - 1 ------

15BPAC09 Hospital Posting - - - - 70 30 100 4

IV Medical Camp -

Third Semester

Core Course

15BPAC10 Pharmacology and 4 3 3 - 50 50 100 3 Toxicology - I

15BPAC11 General Pathology -1 4 3 3 - 50 50 100 3

15BPAC12 Bio statistics and 4 - 3 - 50 50 100 2

III Research

15BPAC13 Fundamentals of Health 3 2 3 - 50 50 100 2 sciences

Discipline Specific Elective (DSE) Course

15BPAI03 DSE III: Clinical Bio 4 3 3 - 50 50 100 2 Chemistry – II

Hospital Posting* ------

IV Medical Camp -

Fourth Semester

Core Course

15BPAC14 Pharmacology and 3 - 3 - 50 50 100 3 Toxicology –II

15BPAC15 General Pathology-II 3 - 3 - 50 50 100 3

15BPAC16 Medicine – I 3 2 3 - 50 50 100 2

15BPAC17 Microbiology 3 - 3 - 50 50 100 2

15BPAC18 Obstetrics and 3 2 - 3 50 50 100 2 Gynecology-I III

15BPAC19 Pediatrics and 2 2 - 3 50 50 100 3 Neonatalogy

Discipline Specific Elective (DSE) Course

15BPAI04 DSE IV: Bio medical 4 3 3 - 50 50 100 4 Instrumentation and

Scientific Measurements

15BPAC20 Hospital Posting - - - - 70 30 100 6

IV 15BXMC01 Medical Camp

Internship During Summer Vacation 30 days

Fifth Semester

Core Course

15BPAC21 Community Medicine 4 - 3 11- 50 50 100 3

15BPAC22 Medicine – II 4 - 3 - 50 50 100 3

15BPAC23 Medicine – III - 4 - 3 50 50 100 2

Practical -III

15BPAC24 Surgery – I 3 2 3 - 50 50 100 3

15BPAC25 Geriatrics 3 2 3 - 50 50 100 3

III 15BPAC26 Obstetrics and Gynecology- 3 2 3 - 50 50 100 3 II

15BPAC27 Principles of Management 1 - - - 100 - 100 4

(Self Study Course)

15BPAC28 Physician Assistant - - 1 - 100 100 2 (Computer based test)

Hospital Posting* ------

15BPAC29 Internship 100 - 100 4

Sixth Semester

Core Course

\ 15BPAC30 Surgery – II 4 - 3 - 50 50 100 3

III 15BPAC31 Surgery – III - 3 - 3 50 50 100 3

Practical -IV

Total 108

*Credits given only at the end of even semesters.

Specialization Module -I

Trauma Care

Part Subject Code Name of the Hrs of Hrs of Examination Paper/Component Instruction

T P T P CIA CIE Total Credit

Sixth Semester

Core Course

15BPAT32 Principles of Trauma and 3 2 3 - 50 50 100 4 Disaster Management

15BPAT33 Principles of Life Support 3 2 3 - 50 50 100 4

and Neuro Trauma

15BPAT34 Obstetrics and 3 2 3 - 50 50 100 4 Gynaecological Trauma III 15BPAT35 Orthopedics 5 - 3 - 50 50 100 4

15BPAT36 Hospital Posting - - - - 70 30 100 6

Seventh Semester

In-Service Training I

1) Anesthesiology and Post - 8 - 3 25 25 4 Operative Care

2) Intensive Care - 8 - 3 25 25 4

3) Surgery - 8 - 3 25 25 4 III 15BPAT37 4) Neuro trauma - 6 - 3 25 25 4

Eighth Semester

In-Service Training II

1) Orthopedic - 8 - 3 25 25 4

2) Gynaecology - 6 - 3 25 25 4

3) Trauma and Basic Life - 8 - 3 25 25 4 Support III 15BPAT38 4) Spine - 8 - 3 25 25 4

Total Credits 54

Specialization Module -II

General Medicine

Part Subject Code Name of the Hrs of Hrs of Examination Paper/Component Instruction

T P T P CIA CIE Total Credit

Sixth Semester

Core Course

15BPAM32 Obstetrics and Gynaecology-I 5 - 3 - 50 50 100 4

15BPAM33 Obstetrics and Gynaecology-II - 5 - 3 50 50 100 4

Practical - V

15BPAM34 Principles of Emergency 5 - 3 - 50 50 100 4 Medicine and Disaster III Management

15BPAM35 Hospital Management 5 - 3 - 50 50 100 4

15BPAM36 Hospital Posting - - - - 70 30 100 6

Seventh Semester -

In-Service - Training I

1) Emergency - 8 - 3 25 - 25 4

2) Pediatrics - 8 - 3 25 - 25 4

3) Intensive Care - 8 - 3 25 - 25 4

III 15BPAM37 4) Medicine - 6 - 3 25 - 25 4

Eighth Semester

In-Service Training II

1) Casualty - 8 - 3 25 - 25 4

2) Cardiology - 6 - 3 25 - 25 4

3) Oncology - 8 - 3 25 - 25 4

III 15BPAM38 4) Surgery - 8 - 3 25 - 25 4

Total Credits 54

Specialization Module -III

Obstetrics and Gynecology

Part Subject Code Name of the Hrs of Hrs of Examination Paper/Component Instruction

T P T P CIA CIE Total Credit

Sixth Semester

Core Course

15BPAG32 Clinical Obstetrics 3 2 3 - 50 50 100 4

15BPAG33 Gynecology 3 2 3 - 50 50 100 4

III 15BPAG34 Neonatology 3 2 3 - 50 50 100 4

15BPAG35 Infertility 3 2 3 - 50 50 100 4

15BPAG36 Hospital Posting - - - - 70 30 100 6

Seventh Semester

In-Service Training I

1) Obstetrics - 8 - 3 25 - 25 4

2) Post Op (Ante natal) - 8 - 3 25 - 25 4

3) Ultra Sound - 8 - 3 25 -- 25 4

III 15BPAG37 4) Infertility - 6 - 3 25 - 25 4

Eighth Semester

In-Service Training II

1) Physiotherapy - 8 - 3 25 - 25 4

2) Gynaecology - 6 - 3 25 - 25 4

3) Post Op (Post natal) - 8 - 3 25 - 25 4

4) Oncology - 8 - 3 25 - 25 4

III 15BPAG38

Total Credits 54

Specialization Module -IV

Ophthalmology

Part Subject Name of the Hrs of Hrs of Examination

Code Paper/Component Instruction

T P T P CIA CIE Total Credit

Sixth Semester

Core Course

15BPAO32 Ocular Diseases 5 - 3 - 50 50 100 4

15BPAO33 Contact Lens 3 2 3 - 50 50 100 4

15BPAO34 OT- Refractive Surgery 5 - 3 - 50 50 100 4

15BPAO35 Ophthalmology for 5 - 3 - 50 50 100 4 Vulnerable Group III 15BPAO36 Hospital Posting - - - - 70 30 100 6

Seventh Semester

In-Service Training I

1) Optometry - 8 - 3 25 - 25 4

2) Dilatation - 8 - 3 25 - 25 4

3) Out Patient ward - 8 - 3 25 - 25 4

III 15BPAO37 4) Specialty (UBM,HFA) - 6 - 3 25 - 25 4

Eighth Semester

In-Service Training II

Specialty Clinics - 8 - 3 25 - 25 4

(Cataract, Orbit, Squint)

Operation Theatre - 6 - 3 25 - 25 4

Specialty (Retina, - 8 - 3 25 - 25 4 Glaucoma, Cornea)

Specialty (FFA,BSCAN) - 8 - 3 25 - 25 4 III 15BPAO38

Total Credits 54

Semester Subject Code Name of the Hrs. of Scheme of Examination Paper/Component Instruction T P CIA CIE Total Credit

Part IV COMPONENTS

A.Ability Enhancement courses (AEC)

I. Ability Enhancement course (AECC)

V 15BAES01 Environment Studies 2 1 1

IV 15BSCS01/ Communication Skill-I / 3 - Remarks 2 15BSSS01 Soft Skills-I V 15BSCS02/ Communication Skill-I 3 - Remarks 2 /Soft Skills-II 15BSSS02

II. Skill Enhnacement Course (SEC)

Any Value added Course 40 hrs Remarks 1 semester Duration between II to V

Co-curricular Courses Remarks 1

Add on Certificate

course/ Certificate in By the end Women Studies/ of 4 Certificate in Ambedkar semester Studies

General Awareness- Online/ Quantative Aptitude

I,II,III &IV 15BXMC01 3.Extra –Curricular 10 1 Courses

Medical Camps

Total Credits 8

Total Credits to Earn the Degree

S.no Components Credit

1. Part I, II, &III Components 108

2. Part III Open Core Components 54

3. Part IV Components: 8

Total 170

Other Courses offered by the Department

Value added course- 15BPAV01 –First Aid Practicum

Anatomy – I Semester I Hours of Instruction/week: 3+2 15BPAC01 No of Credits: 3

Objectives:  To understand the general structure and functions of human body.  To develop an ability to apply the principles of anatomy in clinical practice.

Unit I Gross Anatomy 15

Introduction to Anatomy, nomenclature, anatomical position, planes, tissues and movements. Osteology:(a) Names of the bones of the body and their position, classification of the bones with examples,general features of the bone and normal development, Microscopic anatomy of bone: Cells, bone matrix, structural features of compact and cancellous bone, their differentiation and functions, ossification general pattern of blood supply, ossification of the bones of the limbs for age determination. X-rays of bones. (b) Process of repair of bone. Microscopic features ofcell:detailed structure of cell and its components and their functional mechanisms.

Unit II Muscular System and Arthrology 16

Classification and identification of the muscles of the body: main attachments, nerve supply and action(s), Microscopic anatomy of muscles: General features, structure of skeletal muscle, Smooth muscle and Cardiac Muscle, their classification, basis of classification into type I and type II muscle fibers and their significance, structural and functional characteristics of cardiac and smooth muscle (b) Details of attachments of the muscles; ultra structural features of muscle; mechanism of the movement caused by the muscle/muscles and various forces exerted by them and their detailed action(s). Arthrology: (a) Definition and classification of joints, general features of different types of joints; detailed study of core joints of the limbs and movements performed at various joint of the body (b) Microscopic anatomy of articular cartilage; maintenance of articular cartilages; blood supply and nerve supply of the joints. Microscopic features ofepithelium:characteristics, types, functions, distribution, basal lamina, cell junctions, and metaplasia.

Unit IIICardio Vascular and Respiratory System 16

Cardio Vascular System: (a) Normal position, external features and parts of the heart; internal features of the chambers of heart, names of the blood vessels and venous drainage of the organs, structures and body as a whole, conducting system of

heart, fibro skeleton of heart and variation(s), developmental anomalies of heart and blood vessels, valvular defects. Respiratory System:(a) Position, parts, relations, blood supply of upper and lower respiratory tract. Pleura, its reflection,nerve supply, pleural recesses and their significance, broncho pulmonary segments, their importance. (b) Mechanism of respiration. Microscopic features of: Connective tissue: Cells, fibers and their structural features and functions. Intercellular substances, amorphous ground substance, types of connective tissue (loose areolar tissue, dense connective tissue) and their distribution. Specialized connective tissue: different types of cartilages and their functions and distribution.

Unit IV Digestive and Genito Urinary System 13

Digestive System: Parts, position, situation, shape and size, sub division, surface anatomy, relations, blood supply, nerve supply, venous and lymphatic drainage, histology, applied anatomy of Spleen, Stomach, Duodenum, Liver, Gall Bladder, Pancreas, Large and Small Intestine. Genito-Urinary System: Parts, position, relations, blood supply, nerve supply and lymphatic drainage of Uterus, Cervix Vagina, Ovary, Ovarian Duct, Testis, Epididymis, Seminal Vesicle, Ductus Deferens, Prostate, Kidney, Ureter, Urinary Bladder and Urethra.

Unit V Abdominal Wall Viscera and Endocrine Glands 15

Abdominal wall viscera; Anterior abdominal wall; Inguinal canal; Posterior abdominal wall; Peritoneal cavity – Greater and lesser sacs ,Peritoneal ligaments; Sub-diaphagmatic spaced pelvic floor and Ischiorectal fossa Basic knowledge of perineal spaces Name; Position; Important peritoneal and other Relations; Blood supply; Nerve supply; Histology and microstructure portal vein and porta-systemic anastomosis ,Important arteries; Inferior venacava. Endocrine glands: Thyroid, Para thyroid, Pineal gland, Pituitary gland, Thymus Adrenal gland and Hypothalamus- their location, relations, their hormones, control of hormone release, blood supply, nerve supply venous and lymphatic drainage.(b) Clinical manifestations of common endocrine disorders. Total Hours 75

Text Books:

1. Ranganathan Ts, (2013) Textbook of Human Anatomy.6th editionS Chand and Company Pvt Ltd Publisher, New Delhi. 2. Ross and Wilson, Anatomy and Physiology in Health and Illness, Anne Waugh 2010, Publisher ELBS with Churchill Livingstone.

Reference Books: 1. Romanes G.J, Cunningham’s Manual of Practical Anatomy.(1986) 15thedition, Reprint 2008 Oxford Medical Publications. 2. SinghI.B, Text Book of Human Osteology, (2006) Jaypee Brothers, Medical Publishers. 3. Ross M.H, E. and Williams L.J and Wilkins Romell, Kaye G.I,Histology: A Text and Atlas (1995),3rd edition, Anne Waugh 2010, ELBS with Churchill LivingstonePublishers. 4. Inderbir Singh,Textbook of Human Histology.(2002), 4th Edition Jaypee Brother, New Delhi. 5. B.D. Chaurasia, Human Anatomy -Vol. I, II, III, (1979 reprint 2008) CBS Publishers andDistributors, New Delhi.

Physiology - I Semester I Hours of Instruction/week: 5 15BPAC02 No. of Credits: 3

Objectives:  To explore the normal functioning of the living organisms  To learn their principles, mechanisms and control.

Unit I General Physiology 15 Cell: electron microscopic structure of cell and cell membrane.Cell function: morphology of cell components and functions. Body fluids: compartments – volume and composition, membrane potentials of body fluid components, units for measuring concentration of solutes. Transport across:the cell membrane: homeostasis – intra cellular communication and feedback mechanism.Tissue (histophysiology): muscle: structure of skeletal and cardiac muscle – neuro muscular junction. Excitation – contraction coupling – muscle contraction, Types of skeletal muscle fibres changes, Types of smooth muscle – structure and functional properties – innervation. Nerve: neurons and neuroglia – nerve fibre – excitation and conduction – lonic basis - measurements of electrical events. Classification of nerve fibres.

Unit II Blood 16

Composition, volume and general functions of blood, Haematocrit,Composition of plasma, Plasma proteins ,their production and function , Erythropoiesis and red blood cell function , Structure, function, production and different types of haemoglobin, Iron absorption storage and metabolism, anaemia jaundice and its different types. Leucocytes: Classification, functions, formation, fate. Thrombocytes: Structure and function,formation, count; Primary Haemostatis.Blood indices and various disorders ,Clotting mechanism of blood , Blood groups and their role in blood transfusion, Complications of blood transfusion with reference to ABO and RH incompatibility, Physiological anticoagulants, Role of Vit.K,Clotting disorders (Haemophilia etc.), Blood grouping and cross matching, Components of reticuloendothelial system their gross and microscopic structure including (tonsil, lymph node and spleen), Development and function of reticuloendothelial system.

Unit IIIGastrointestinal System 16 Introduction to digestion: General structure of G.I. tract, Innervation. Salivary glands: Structure of salivary glands, composition, regulation of secretion andfunctions of saliva. Stomach: Composition and functions of gastric juice, mechanismand regulation of gastric secretion. Exocrine Pancreas - Structure,

compositionof pancreatic juice, functions of each component, regulation of pancreatic secretion. Liver: structure, composition of bile, functions of bile, regulation of secretion. Gall bladder: structure, functions. Small intestine - Composition, functions and regulation of secretion of intestinal juice. Large intestine - Functions.Mastication,deglutition, gastric filling and emptying, movements of small and large intestine,defecation.

Unit IV Excretory System 13 Structure and functions of kidney, functional unit of kidney and functions ofdifferent parts. Juxta glomerular apparatus, renal blood flow. Formation ofUrine: Glomerular filtration rate - definition, determination, normal values,factors influencing G.F.R. Tubular reabsorption - Reabsorption of sodium, glucose, water and other substances. Tubular secretion - secretion of urea, hydrogen and other substances.Mechanism of concentration and dilution ofurine. Role of kidney in the regulation of pH of the blood. Micturition: anatomy and Innervation of Urinary bladder, Mechanism of micturitionand abnormalities. Body Temperature and Functions of Skin Unit V Endocrinology 15 General endocrinology - Enumeration of endocrine glands and hormones – General functions of endocrine system, chemistry, mechanism of secretion, transport, metabolism, regulation of secretion of hormones. Hormones of anterior pituitary and their actions, hypothamic regulation of anterior pituitary functions Disorders of secretion of anterior pituitary hormones. Posterior pituitary: Functions, regulation and disorders of secretion.Thyroid: Histology, synthesis, secretion and transport of hormones, actions of hormones, regulation of secretion and disorders, Thyroid function tests. Adrenal cortex and Medulla - synthesis, secretion, action, metabolism, regulation of secretion of hormones and disorders. Other hormones – Angiotensin, A.N.P. Total Hours : 75

Text Books 1. Sembulingam.K, Prema Sembulingam Essentials of Medical Physiology, (1999, Reprint 2008)4th edition, Jaypee brothers Medical publishers New Delhi.

Reference Books: 1. Kim E. Barrett, Susan M. Barman, Scott Boitano, and Heddwen Brooks ,Ganong's Review of Medical Physiology,(2009)23 rd Edition (LANGE Basic Science) 2. John E. Hall Guyton and Hall Textbook of Medical Physiology, 2010

Principles of Nutrition and Diet Therapy

Semester I Hours of Instruction/week: 3+2 15BPAC03No. of Credits: 3

Objectives:

 To gain knowledge in the planning and preparation of therapeutic diets.

 To understand the planning, selection and preparation of foods during health and deficiency conditions.

Unit I Energy 8 Definition of energy, units of energy, calorie and joule. Basal metabolism, specific dynamic action of foods. Energy needs of the body measurementsof energy balance. Ideal proportion of calories from protein, carbohydrates and fats. Carbohydrates: Classification, chemistry, digestion and absorption, metabolism, functions, sources and requirements. obesity, underweight.

Unit II Proteins 10

Classification and chemistry, Digestion absorption and metabolism,Functions, source and requirements, Essential amino acids, deficiency state.Lipids:

Classification, chemistry, saturated and unsaturated fatty acids, digestion , absorption and metabolism, functions and sources, requirements and effects of deficiency.Macro minerals: Functions,absorption, metabolism, sources, factors affecting the utilization ofcalcium, phosphorus, magnesium. Micro minerals: Functions, sources,effects of deficiency of copper, iron, cobalt, zinc, iodine.

Unit IIIVitamin 12 Classification on the basis of solubility, chemistry, absorption, metabolism, functions, requirements and deficiency conditions and Hyper vitaminosis:

Vitamin A, D, E, K, ascorbic acid, thiamine, riboflavin, niacin, pyridoxine, folic acid, panthothenic acid and cyanocobalamine. Water: Importance, distribution in the body, functions, water balance, requirements. fibre:

definition,classification. sources and role of fibre in human nutrition

Unit IV Concept Of Diet Therapy 10 Classification, purpose and principles of therapeutic diets, modification of normal diets. Obesity: Etiological factors, assessment of obesity,

complications, reducing diets, importance of exercise. Underweight: Assessment, etiological factors, diet modification: Diet modification for 19

diabetes mellitus, febrile conditions:typhoid, tuberculosis, malaria, pneumonia, influenza. Gastrointestinal disorders: diet modification for peptic ulcer, diarrhoea, dysentery, constipation, gastritis, lactose intolerance, irritable bowel syndrome, flatulence, diverticulitis. Dietary management for liver and kidney diseases: jaundice, hepatitis, cirrhosis, hepatic coma and nephritis, nephritis, acute and chronic renal failure, dialysis : Cardiovascular disease:, diet modification for atherosclerosis, coronary heart disease, congestive heart failure, hypertension Allergy: diet modification- common food allergies. Nutritional deficiencies: diet modification – protein energy malnutrition, anemia and vitamin A deficiency. Unit V Nutrition for Vulnerable Groups 5 Paediatrics: Normal requirements of protein, carbohydrate, fat, minerals, vitamins and trace elements for newborns, children, pregnant and lactating mothers. Exclusive breast feeding, advantages of breast feeding, infant feeding, weaning diets, planning of preterm nutrition, therapeutic diet chart. Recognition and treatment of nutritional deficiency disorders. Protein energy malnutrition: classification, causes, management including that of complications. National Nutrition and other child health and welfare programmes. Management of problems related to lactation failure. Geriatrics:Nutritional requirement, changes in total body mass and body composition, Nutritional assessment, Nutritional deficiency in old age, Osteoporosis, Osteomalacia and Vitamin D, Iron and Vitamins, Recommended intake of nutrients, Prevention of Nutritional deficiency

Total Hours : 45 Practical 30

List of Experiments:

1. Grouping of foods according to food groups. 2. Planning, preparation and evaluation of menu for balanced diet. 3. Preparing the different therapeutic diets. 4. Planning, preparation and evaluation of menu for Febrile conditions, Obesity, Under Nutrition, Ulcer and Diabetes. 5. Planning, preparation and evaluation of menu for liver diseases, Cardio vascular diseases, and deficiency diseases.

TotalHours: 75

Text Book:

1. Davidson S., Passmore R., Brook J.F and Truswell M Human Nutrition and Dietetics. (1993). 9th edition. The English Language Book Society, Livingston.

Reference Books:

1. Robinson C.M and Lawler R.M, Normal and Therapeutic Nutrition. (1986) Mac Millan Pub. Co., New York.

2. Krause M.V., and Hunscher M.A., Food, Nutrition and Diet therapy. (1983) W.B. Saunders company, Philadelphia, London, Toronto.

3. Swaminathan,M., Essential of food and nutrition, Vol . I and II (1984) Ganesh and Co, Madras.

4. HelenA, Guthrie.M Introductory Nutrition, (1989)7th edition, Toronto.

Infection Control

Semester I Hours of Instruction/week: 4 15BPAC04No. of Credits: 3

Objectives:

 Recognize benefits to patients and health-care workers adhering to scientifically accepted principles and practices of infection control.  Student as a professional perform these control practices and to monitor infection control practices.

Unit IIntroduction to Infection Control 10

Definition of infection, infection control, importance of infection control, sources of infection, nosocomial infections, risk factors, purpose of infection prevention, The principles of infection prevention and control. Concept of "The Chain of Infection": Pathogen or infectious agent, Mode of transmission: Contact with pathogen: Direct; Indirect; Droplet; Airborne: Common vehicle

(e.g., food, water); Vector borne, Susceptible host.

Unit IIFactor Influencing The Outcome Of Exposures 15

Causes and spread of infection, Host factors: Natural barriers, Host immunity: pathogen or infectious agent factors:.infectivity, pathogenicity, virulence, size of innoculum, route of exposure, duration of exposure. Environmental factors: contamination of environment, fomites: contamination of equipment, device- related and blood-borne infections.

Unit III Standard Universal Precautions 15

Standard Universal Precautions for Client Care, Hand Washing. Antiseptics and Disinfectants: Definitions and Common use, Protecting Antiseptics and Disinfectants from Contamination, Antiseptics, and Disinfectants. Surgical Hand Scrub and Attire: surgical hand scrubbing, antiseptic hand scrubbing agents, wearing and removing sterile gloves, surgical attire. Control of routes of transmission: Appropriate selection and use of agents, Factors influencing hand hygiene efficacy: Sources of potential contamination or cross-contamination of hand hygiene materials.

Unit IVReducing Risk of Infection During Clinical Procedure 10

Aseptic technique,Maintaining a sterile field, Maintaining a safe environment in a surgical procedure area,use and disposal of needles and other sharps. Processing instruments and other reusable items, Decontamination and cleaning:decontamination,preparing chlorine solution, and steps of decontaminating items.

Unit VUse of Appropriate Barriers 10

Appropriate selection, donning, doffing, and disposal of personal protective equipment (PPE). Appropriate isolation/cohorting of patients infected with communicable diseases, Cleaning, steps of cleaning, Sterilization, HLD and storage: Definition and methods of sterilization, autoclaving (steam sterilization), Chemical sterilization, high level disinfection (hld), pediatric issues in infection control. Total Hours: 60

Text Books:

1. Nizam N. Damani(2003), Manual of Infection Control ProceduresCambridge University Press

Reference Books:

1. Jennie Wilson,(2007) Infection Control in Clinical Practice,3rd edition, Bailliere Tindall.

2. Janet McCulloch(2000) Infection Control, Wiley-Blackwell

Allied: I -Computer Application for Paramedics

Semester I Hours of Instruction/week: 2+3 15BPAI01 No. of Credits: 3

Objectives:  To impart a basic level appreciation programme for the health care students.

Unit I : Introduction to Computer 5

What is Computer, Basic Applications of Computer : Components of Computer System, Central Processing Unit (CPU), VDU, Keyboard and mouse, Otherinput/output devices, computer memory, Concepts of hardware and software; Concept ofcomputing, Data and Information; Applications of IECT; Connecting keyboard, mouse,monitor and printer to CPU and checking power supply.

Unit II : Operating Computer using GUI Based Operating System: 8

What is an OperatingSystem; Basics of Popular Operating Systems; The User Interface, Using mouse; Using right button of the mouse and moving Icons on the screen, Use of common Icons, Status Bar, Using menu and menu-selection, Running an application, Viewing of file, folders anddirectories, Creating and renaming of files and folders, Opening and closing of different Windows; Using help; Creating short cuts, Basics of O.S setup; Common utilities. Understanding Word Processing: Objectives, Word processing basics, Opening word processing package, Menu bar , Using the help, Using the icons below menu bar, Opening and closing documents , Opening documents, Save and save as , Page setup, Print preview, Printing of documents , Text creation and manipulation, Document creation , Editing text , Text selection , Cut, Copy and Paste , Font and Size selection , Alignment of text , Formatting the text , Paragraph indenting , Bullets and numbering , Changing case , Spell check,language setting and thesaurus; Printing of word document., Table manipulation , Draw table , Changing cell width and height , Alignment of text in cell , Delete / insertion of row and column , Border and shading.

Unit III : Excel and Power Point 7

Using Spread Sheet: Basics of Spread Sheet; Manipulation of cells; Formulas and functions; Editing of Spread Sheet, printing of Spread Sheet.

Making Small Presentation: Basics of presentation software: Using power point, Opening a power point presentation, Saving a presentation , Creation of presentation, Creating a presentation using a template, Creating a blank presentation , Entering and editing text, Inserting and deleting slides in a presentation, Preparation of slides 24

,Inserting word table or an excel worksheet, Adding clip art pictures, Inserting other objects ,Providing aesthetics, Enhancing text presentation , Working with colour and line style , Adding movie and sound , Adding headers and footers , Presentation of slides , Viewing a presentation , Choosing a set up for presentation , Printing slides and handouts , Slide show , Running a slide show , Transition and slide timings ,Automating a slide show, Taking printouts of presentation.

Unit IV :Communication Using Internet 6

Communication using the Internet: Basic of Computer networks: Definition of LAN, WAN, Intranet. Concept of internet; Applications of internet; connecting to internet, Knowing the internet; Basics of internet connectivity related troubleshooting.

WWW and Web Browsers: World Wide Web; Web Browsing software, Search Engines, Understanding URL; Domain name; IP Address; Using e-governance website. Web Browsing software: Internet Explorer, Netscape Communicator, Surfing the Internet: Giving the URL address, Search, Moving around in a web-site, Printing or saving portion of web pages, Down loading. Communications and collaboration: Basics of electronic mail: What is an electronic mail?, Email addressing , Configuring email client , Using e-mails , Opening email client ,Mailbox: inbox and outbox ,Creating and sending a new e-mail ,Replying to an e- mail message ,Forwarding an e-mail message ,Sorting and searching emails ,Advance email features ,Sending document by e-mail ,Activating spell checking ,Using address book ,Sending softcopy as attachment ,Handling spam ,Instant messaging and collaboration ,Using smiley ,Internet etiquettes. Getting an email account, Accessing sent emails, Using emails, Document collaboration; Instant Messaging; Netiquettes.

Unit V Health Care Informatics 4

Introduction to the software’s related to the Hospital Management: Hospital Management System, Payroll system, Accounting System, InventoryControl System and other computer applications in Hospitals. What isand Why Medical Informatics? , The Goals of Medical Informatics, The Organization of Health Information: the Paper-based Medical Record, the Electronic Medical Record. E Health: ”Connectivity” Creating a Virtual Healthcare Delivery System: Information for the Physician Information for the Patient

Total Hours: 30

Practical 45 List of exercises 1. Basics of popular operating system –WINDOWS

2. The User ,Interface, Task Bar, Icons, Menu 3. Running an Application, Operating System Simple Setting 4. Changing System Date and Time, Changing Display Properties, To add or remove a Windows component. 5. Changing Mouse Properties, Adding and removing Printers, File and Directory Management, Creating and renaming of files and directories, Common utilities

6. Word Processing Basics, Opening Word Processing Package, Menu Bar, Using The Help, Using the Icons Below Menu Bar 7. Opening and closing Documents, Opening Documents, Save and Save as 8. Page Setup, Print Preview, Printing of Documents 9. Text Creation and manipulation, Document Creation, Editing Text 10. Text Selection, Cut, Copy and Paste, Spell check, Thesaurus 11. Formatting the Text, Font and Size selection, Alignment of Text

12. Paragraph Indenting, Bullets and Numbering, Changing case 13. Table Manipulation, Draw Table, Changing cell width and height 14. Alignment of Text in cell, Delete / Insertion of row and column, Border and shading

15. Elements of Electronic Spread Sheet, Opening of Spread Sheet, Addressing of Cells 16. Printing of Spread Sheet, Saving Workbooks, Manipulation of Cells 17. Entering Text, Numbers and Dates, Creating Text, Number and Date Series

18. Editing Worksheet Data, Inserting and Deleting Rows, Column, Changing Cell Height and Width

19. Formulas and Function, Using Formulas, Function 20. Basic of Computer Networks, Knowing Local Area Network (LAN), Wide Area Network (WAN)

21. Applications of Internet, Connecting to the Internet, Troubleshooting 22. Understanding the World Wide Web (WWW), Web Browsing Software, Popular Web Browsing Software 23. Working on Search Engines, Popular Search Engines / Search for content 24. Accessing Web Browser, Using Favourites Folder, Downloading Web Pages,

Printing Web Pages 25. Understanding URL, Surfing the web, Using e-governance website 26. Email Addressing, Using E-mails, Opening Email account 27. Mailbox: Inbox and Outbox, Creating and Sending a new E-mail, Replying to an E-mail message 28. Forwarding an E-mail message, Sorting and Searching emails, Document collaboration

29. Instant Messaging and Collaboration, Using Instant messaging, Instant messaging providers, Netiquettes 30. Opening A PowerPoint Presentation, Saving a Presentation, Creation of Presentation

31. Creating a Presentation Using a Template, Creating a Blank Presentation, Entering and Editing Text, Inserting And Deleting Slides in a Presentation 32. Preparation of Slides, Inserting Word Table or An Excel Worksheet, Adding Clip Art Pictures

33. Inserting Other Objects, Resizing and Scaling an Object, Presentation of Slides 34. Viewing A Presentation, Choosing a Set Up for Presentation, Printing Slides And Handouts 35. Slide Show, Running a Slide Show, Transition and Slide Timings, Automating a Slide Show Total Hours 75

Text Books: 1. Shortliffe et al., (2006).Biomedical Informatics, Computer Applications in Health Care and Biomedicine, 3rd Edition, Springer-Verlag,

2. Katherine Murray (2003) Faster Smarter Microsoft office XP,Prentic hall of India

Reference Book:

1. Jane Calabria, Dorothy Burke. (2000) MS Windows Professional, Prentice hall of India.

Anatomy- II

Semester II Hours of Instruction/week: 3+2 15BPAC05 No of Credits: 3

Objectives:

 To enable the student comprehend the normal disposition, clinically relevant interrelationships, functional and cross sectional anatomy of the various structures in the body; Unit I : Special Sensory Organs 12

Gross Anatomy of a) Eye-Eyelids, Conjunctiva, Lacrimal gland, Structure of eyeball, relations, extra ocular muscles their nerve supply and actions (s) Orbit, b) Ear- External , Middle and Inner ear -Structure, cartilage, ligaments, Muscles of the auricula,External Acoustic Meatus, relations, blood supply, nerve supply, and lymphatic drainage. c) Tongue: Structure, Muscles – Extrinsic and Intrinsic,Nerve, lymphatic and blood supply, Histology- Papillae. d) Nose –Walls of nasal cavity, Nasal conchae, nasal meatus, segments, Para Nasal Sinuses e) Skin- Epidermis, Dermis, Subcutaneous Tissue. f) Lymphatic System-Development of the lymphatic vessels, Lymphatic capillaries, distribution, Location of the core groups of the lymph nodes of the body and their drainage areas, Lymphatic vessels, its structure, Lymphatic glands, its structure, lymph, thoracic duct and its tributaries

Unit II : Upper and Lower Extremities 20

Upper extremity: Bones, Muscles, Joints of Upper Limb- Shoulder,Arm, Forearm, Hand. Muscles- Origin, insertion, action, essential attachments, relations, blood supply, nerve supply and lymphatics. Fasciae of the Upper Limb, Regional Anatomy-Axillary fossa, Trilateral foramen, Quadrilateral foramen, Cubital fossa, Carpal canal (carpal tunnel syndrome).Jointsits Articulations, muscles, and ligaments, Arthrokinematics, Blood supply and Lymphatics, Cervical and Brachial Plexus-Commencement, Course and termination of nerves, root value, relations and distribution. b) Lower extremity: Bones. Muscles and Joints of Lower Limb-Hip, Thigh, Leg, Foot. Muscles- Origin, insertion, action, essential attachments, relations; blood supply; nerve supply, lymphatics. Joints its articulations, Ligaments. Arthrokinematics, Blood supply and lymphatics, Lumbar and Sacral Plexus- Commencement, Course and termination of nerves, root value, relations and distribution.

Unit III : Thorax 20 Thoracic cage -- Walls of thorax, Types of joints of thorax, Mediastinum – sub divisions, boundaries and Contents, Innervation, Blood supply, Venous and lymphatic drainage. Diaphragm-Structure, Crura and central tendon Opening, Blood supply, Innervation, Variations, Clinical significance, Abdominal muscles .Osteology -Features of vertebra (cervical, thoracic, lumbar, sacral) typical and atypical vertebras, Features of sternum, Ribs and its articulations, muscles associated.

Unit IV : Head and Neck 15 Scalp. Face- Facial bones, Hyoid, Temporo Mandibular Joint, Origin, insertions and actions of facial muscles, Platysma, Facial nerve, Sensory innervation of the face,Arteries of the face- Carotid ,facial, sub mental ,temporal, occipital, supra and infra orbital artery, Applied anatomy of face.Structures of neck, Triangles of neck - Sub-occipital, Anterior and Posterior, Occipital. Origin, insertion, action, applied anatomy of Sternocleidomastoid muscle. Other areas-Parotid region, Temporal and Infra- temporal fossae. Sub-mandibular region. Mouth- boundaries, structures, soft and hard Palate, developmental anomalies. Pharynx. Larynx, blood vessels of neck, Jugular vein, brachiocephalic vein, tributaries, its clinical significance, lymphatic drainage of head and neck.

Unit V : Brain And Spinal Cord 8

Cranial cavity -Cranial fossa (Anterior, Middle, and Posterior) and structures related, Meninges, Duramater and Dural venous sinuses, Spinal cord: Location, extent, spinal segments, external features and internal structure. Brain: Sub- divisions, location external features and internal structure of medulla oblongata, pons, mid-brain, cerebellum and cerebrum and spaces around them. Name and location of ventricles of brain and circulation of cerebrospinal fluid, blood supply of the brain and spinal cord.Cranial Nerves: Name, number, attachment, nuclei, location and general distribution.Spinal nerves: Typical spinal nerve groups and number of spinal nerves, name and location of plexus. Location and general distribution of the branches. Names of sensory and motor nerve endings. Sensory pathways. Pyramidal and extra pyramidal motor systems, upper and lower motor neurons, motor pathways. Autonomic nervous system: Sympathetic and para sympathetic nervous system. Location of preganglionic and post-ganglionic neurons

Total Hours: 75

Text Books

1. Ranganathan Ts, (2013) Textbook of Human Anatomy. 6th editionS Chand and Company Pvt Ltd Publisher, New Delhi. 2. Ross and Wilson, Anatomy and Physiology in Health and Illness, Anne Waugh 2010, Publisher ELBS with Churchill Livingstone.

Reference Books: 1. Romanes G.J, Cunningham’s Manual of Practical Anatomy. (1986) 15thedition, Reprint 2008 Oxford Medical Publications. 2. SinghI.B, Text Book of Human Osteology, (2006) Jaypee Brothers, Medical Publishers. 3. Ross M.H, E. and Williams L.J and Wilkins Romell, Kaye G.I, Histology: A Text and Atlas (1995), 3rd edition, Anne Waugh .ELBS with Churchill Livingstone. 4. Inderbir Singh, Textbook of Human Histology.(2002), 4th Edition Jaypee Brother, New Delhi. 5. Chaurasia.B.D.Human Anatomy(1979 reprint 2008), Vol. I, II, III, CBS Publishers, New Delhi.

Physiology –II

Semester II Hours of Instruction/week: 4 15BPAC06No. of Credits: 2

Objectives  To enable the student explore the normal functioning of the living organisms their Principles, mechanisms and control.  Elucidate the physiological aspects of normal growth and development.

Unit I : Cardiovascular System 10

Heart and circulation, Function of cardiac muscle, Cardiac pacemaker and cardiac muscle contraction, Cardiac cycle-Phases, Pressure changes in atria, ventricles and aorta. Volume changes in ventricles. Jugular venous pulse, arterial pulse, ECG, its recording and interpretation, changes in ECG, Common arrhythmias and its mechanism of development , Types of blood vessels and their function, Hemodynamics of blood flow (local control systemic circulation its regulation and control), Peripheral resistance , its regulation and effect on circulation ,Arterial pulse, Blood pressure and its regulation , Cardiac output and its control- Definition, normal values, one method of determination, variation, measurement of bloodpressure,factors affecting heart rate and stroke volume, Heart rate- Normal value, variation and regulation. Heart sounds and murmurs Importance, circulation, and control of venous return ,Coronary circulation, Splanchnic, pulmonary and cerebral circulation , Triple response and cutaneous circulation , Foetal circulation and circulatory changes at birth Cardio vascular homeostasis - Exercise and posture.

Unit II : Respiratory System 15

Function of respiratory tract, Respiratory and non-respiratory function of the lungs, External and internal respiration. Functional anatomy of respiratory passage and lungs. Respiratory movements: Musclesof respiration, Mechanism of inflation and deflation of lungs. Intra pleural and intra pulmonary pressures and their changes during the phases of respiration, Mechanics of breathing - surfactant, compliance and work of breathing. Spirometry: Lung volumes and capacities definition, normal values, significance, factors affecting vital capacity, variations in vital capacity, Pulmonary ventilation- alveolar ventilation and dead space – ventilation. Composition of inspired air,alveolar air and expired air. Exchange of gases: Diffusing capacity, factors affecting it. Transport of Oxygen and carbon dioxide in the blood. Regulation of respiration – neural and chemical. Hypoxia, cyanosis, dyspnoea, periodicbreathing. Artificial respiration, pulmonary function tests.

Unit III : Reproduction 15

Sex differentiation, Physiological anatomy of male and female sex organs,Female reproductive system : Menstrual cycle, functions of ovary, actions of estrogen and Progesterone, control of secretion of ovarian hormones, testisor ovulation, fertilisation, implantation, maternal changes during pregnancy, pregnancy tests and parturition. Lactation, composition of milk, factors controlling lactation, milk ejection, reflex, male reproductive system: spermatogenesis, semen and contraception

Unit IV: Central Nervous System 10

Organization of central nervous system .Neuronal organisation at spinal cord level Synapse receptors, reflexes, sensations and tracts, Physiology of pain. Brain structure and function- cerebellum, thalamus, hypothalamus and cerebral cortex. Formation and functions of CSF .Autonomic nervoussystem, structure of spinal cord, ascending and descending tracts, spinal shock, hemi section.

Unit V : Special Senses 10

Functional anatomy of eye.Functions of retina: photoreception. Functions of retina: colour vision and electroretinography, Mechanism of vision andvisual perception. Functional anatomy of ear: impedance Organ of Corti: Peripheral auditory mechanism, Auditory pathway, Central auditory mechanism and auditory perception, Olfaction, Physiology of taste. Total Hours: 60

Text Book:

1. Sembulingam.K, Prema Sembulingam Essentials of Medical Physiology(1999, Reprint 2008) 4th edition, Jaypee brothers Medical publishers New Delhi.

Reference Books: 1. Kim E. Barrett, Susan M. Barman, Scott Boitano, and Heddwen Brooks ,Ganong's Review of Medical Physiology,(2009) 23 rd Edition ,LANGE Basic Science. 2. John E. Hall Guyton and Hall Textbook of Medical Physiology, 2010

Physiology -III Practical-I 32

Semester II Hours of Instruction/week: 3 15BPAC07No. of Credits: 2

Objectives

 To enable the students distinguish between normal and abnormal data derived as a result of tests which he/she has performed and observed in the laboratory.

Practical 45 S.no List of Experiments 1 Determination of blood groups 2 Bleeding time and clotting time. 3 Estimation of hemoglobin 4 Estimation of Blood Glucose level. 5 Study of heart sounds by using stethoscope 6 Identification of auscultating areas 7 Recording of blood pressure 8 Effect of posture and exercise on blood pressure 9 Calculation of maximum voluntary ventilation (MVV) and expiratory volume (FEV) by spirometry. 10 Measurement of BMR 11 Demonstration of ECG, EEG, EMG, ophthalmoscope

Text Book:

1. Jain.A.K, Manual Of Practical Physiology For MBBS, (2012), 4 th Edition, Avichal Publishing Company Reference Books: 1. Michael Swash, Michael Glynn, Hutchinson's Clinical Methods (2007). 22 nd Edition, Saunders Ltd 2. Sri Nageswari.K,Rajeev Sharma, Practical Workbook of Human Physiology (2006), Ist Edition, Jaypee Brothers Medical Publishers (P) Ltd.

Counselling Psychology 33

Semester II Hours of Instruction/ Week: 3+ 2

15 BPAC 08 Number of Credits: 3

Objectives

 To help the students gain knowledge about the basic counseling skills

Unit Title Contents Hours of Instructions

1 Introduction to Introduction- Difference between counsellors 15 counseling and helpers- Helpers and clients as diverse persons

Basic 2. counseling Communication and action skills- Mind 15 skills skills- Feelings and physical reactions- Assertiveness skills 3. Dimensions and Core conditions of helping The helping relationships- Communication processes and relationship and patterns- The collaborative working 15 process relationship- Model of helping

Understanding the internal frame of 4 Specific reference- Showing attention and interest- Counselling Paraphrasing and reflecting feelings- Starting,

Skills Structuring and Summarizing- Asking questions- Monitoring- Offering challenges

and feedback- Self- disclosing- Managing resistances and making referrals- Facilitating 15

problem solving- Coaching, demonstrating

and rehearsing- Relaxation 5. 15 Terminating Improving clients’ self talk, rules, help ethically perceptions- Negotiating homework- Terminating helping

References

1. Nelson & Jones (2012). Basic counseling skills- A helper’s manual. Sage publications, New Delhi. 2. Patterson, E & Welfel (2000). The Counselling Process- 5th edition, Wasworth books/ Cole, Thomson Learning.

Allied-II Clinical Biochemistry- I Semester II Hours of Instruction/week: 4+3 15BPAIO2 No. of Credits: 2 Objectives:  To understand the clinical significance of biochemical parameters and the interpretation of their findings in abnormal conditions.

Unit I Specimen Collection 12 Blood, urine, feces, cerebrospinal fluid and amniotic fluid. Preservation of the specimens - anticoagulants and normal values of biochemical parameters.

Unit II Abnormalities of Carbohydrate Metabolism 12

Diabetes mellitus - complications, types and metabolic changes, glucose tolerance test, glycosuria, ketone bodies, ketoacidosis and glycosylated hemoglobin. Fructose and lactose intolerance, galactosemia, lactiacidosis, alcoholism and glycogen storage disease.

Unit IIIAbnormalities of Lipid Metabolism 12

Plasma lipids and lipo proteins, fatty liver, obesity, atherosclerosis, hyper and hypo lipoproteinemia. Hypertension and its complications.

Unit IV Abnormalities of Protein Metabolism 12

Plasma proteins in health and disease, Inborn errors of amino acid metabolism- phenyl ketonuria, albinism, tyrosinosis

Unit V Blood Clotting and Electrolyte Imbalance 12

Identification of defects in blood clotting- bleeding time, clotting time, prothrombin time, hemophilia, Variations of electrolytes in disease - sodium, potassium, calcium, chloride carbonate. Total Hours 60 Practical 45 List of Experiments Collection of random and 24 hours urine samples and use of preservatives Qualitative analysis of urine for the detection of glucose, bilirubin, proteins, ketone bodies and blood Estimation of urea, uric acid in urine Estimation of creatinine and calcium in urine

Visit to a clinical laboratory Total Hours 105 Text Book: 1. Allan Gaw, Michael J. Murphy, Robert A. Cowan, Denis St.J.O Rectly, Michael J. Stewart and James Shepherd, Clinical Biochemistry, (2008), Fourth edition, Churchill Livingstone,

Reference Books:

1. Gaw, A., Murphy, M.J., Cowan, R.A., Rectly, D.S., Stewart, M.J. and Shepherd, J. (2008), Clinical Biochemistry, 4th ed, Churchill Livingstone, New York. 2. Gowenlock, A.H., Murray, J.R. and Lauchlan, D.M. (2006), Practical clinical Biochemistry, 6thed, CBS Butterworth publishers, New Delhi. 3. Nayak, B. (2002), Manipal Manual of Clinical Biochemistry, 1st ed, Jay Pee brothers, New Delhi.

Pharmacology and Toxicology-I

SemesterIII Hours of Instruction/week:3+2 15BPAC10 No. of Credits: 3

Objectives:  To describe details of drugs and chemical agents used in patient care

 Administer them effectively to patients and observe the results

Unit I General Pharmacology 10 Definition of terms in Pharmacology, Drug nomenclature (chemical name, non – proprietary name, brand name) Sources of drugs with examples, Routes of drug administration, Special drug delivery systems: Transdermal, ocusert, implants, osmotic pump, liposome encapsulation, drug targeting and pro-drugs. Pharmacokinetics: Absorption - Structure and function of biological membrane, different processes involved in absorption and factors affecting drug absorption. Bioavailability - factors affecting bioavailability and bioequivalence. Distribution - Volume of distribution, redistribution, plasma protein binding and tissue storage and barriers of distribution (blood brain barrier, placental barrier) Biotransformation - Metabolism of drugs – sites, phases – phase I (non – synthetic), phase II (synthetic) with examples, microsomal enzyme induction, inhibition and their consequences, first pass metabolism and their effects and enterohepatic circulation. Elimination - Renal, rectal, pulmonary , biliary excretion, excretion in breast milk, skin and salivary elimination, kinetics of elimination , clearance, plasma half-life and its clinical significance, loading dose, maintenance dose, steady state concentration, therapeutic drug monitoring and methods of prolonging the duration of action of a drug. Unit II : Drug Action and Adverse Reactions 15 Principles of drug action (stimulation, depression, irritation, replacement, cytotoxic action) Mechanisms of drug action with examples, Competitive antagonism, non – competitive antagonism, Receptor-definition, types, agonist, antagonist, partial agonist, inverse agonist, ligand, affinity, intrinsic activity (efficacy), drug action, drug effect,Transducermechanism, Dose-response relationship- potency, efficacy, selectivity. Therapeutic index, combined effect of drugs – synergism (additive, Supraadditive), antagonism (physical, chemical, physiological, receptor) – definitions with one example. Fixed drug combination, Factors modifying drug action, tolerance (cross tolerance, tachyphylaxis,) drug resistance, cumulation. Adverse drug reactions: Classification, side effects, secondary effects, toxic effects, intolerance, idiosyncrasy, drug allergy, (types, treatment, examples) photosensitivity, drug toxicity – drug dependence, drug withdrawal reactions, teratogenicity, carcinogenicity, mutagenicity, drug induced diseases (Iatrogenic disease) – definitions with examples. Drug – Drug interactions, clinical Significance of drug interactions, drug food interactions and drug and body tissue interaction. Bioassay: Definition, principles of bioassay and types of bioassay.

Unit III Drugs Acting on Nervous System and Autacoids 20 i) Autonomic Nervous System: Introduction, Classification of drugs affecting ANS, Cholinergic (parasympathetic) drugs*- cholinergic agonists, Cholinergic blocking drugs*, Adrenergic drugs* (catecholamines, noncatecholamines), Adrenergic blocking drugs* (Alpha-adrenergic blockers, Beta-adrenergic blockers), Muscarinic receptor* (agonists and antagonists) Adrenergic receptor agonists and antagonists). ii) Skeletal Muscle Relaxants*:- Peripheral neuromuscular blockers*- classification*, Centrally acting muscle relaxants. Directly acting muscle relaxants, Neuromuscular blocking drugs* iii)Local Anaesthetic:Classification, mechanism and actions of local anaesthetics, synergism with vasopressors, adverse effects, indications, contraindications and complications of different routes of administration of local anaesthetics. iv) Autacoids:Various autacoids and their physiological and pathological actions and effects. Histamine actions, releasers, anaphylaxis, clinical significance of histamine, betahistine. Conventional H1 antihistamines* - classification, Second generation H1 antihistamines*, Drug therapy of vertigo and motion sickness. 5 HT(serotonin) – 5HT agonists and antagonists (pharmacological actions, preparations and therapeutic uses). Ergot alkaloids - preparations and uses. Bradykinin and their antagonists. Angiotensin and ACE inhibitors* and angiotensin receptor antagonist. Lipid derived autacoids – eicosanoids (prostaglandins*, leukotrienes) and platelet activating factor, PAF antagonists – clinical significance, preparations and uses.

Unit IV Drugs Acting on Cardiovascular System and NSAID 15 Drugs affecting renin angiotensin system- angiotensin converting enzyme inhibitors*, angiotensin receptor antagonist*, Drugs therapy of heart failure – classification, Cardiac glycosides*, digitalis toxicity. Newer inotropic agents, role of vasodilators, beta blockers*, ACE inhibitors and diuretics in heart failure. Drug therapy of arrhythmias – Classification*, preparations, classes, mechanism of action, indications. Lipid lowering drugs for the treatment of hypercholesterolemia*, Drug therapy of Hypertension- Classification*, angiotensin converting enzyme inhibitors*, angiotensin receptor antagonist*, calcium channel blockers*, diuretics*, beta blockers*, alpha blockers*, vasodilators*, central sympatholytics*. Management of hypertensive emergencies. Drugs for myocardial ischemia – Classification*, rationale of combination therapy in angina pectoris, role of antiplatelet drugs. Drug treatment of myocardial infarction. Drugs used in peripheral vascular diseases.Non steroidal anti – inflammatory drugs –classification, Aspirin* (prototype), non-selective and selective cycloxygenase inhibitors*. Drugs used for rheumatoid arthritis and gout.

Unit V Hematologic and Respiratory Drugs 15 Respiratory: Beta-2-adrenergic agonists*,Anti cholinergic*,Corticosteroids* Leukotriene modifiers*, Mast Cell Stabilizers*, Methylxanthines*, Expectorants*, Antitussives*, Drug Therapy of Bronchial asthma: Classification*, Principles governing the selection of drugs in bronchial asthma, inhaled asthma medication, Precautions to be

taken during their use. Management of acute attacks, prophylaxis and status asthmaticus. Pharmacotherapy of cough: Classification*, Principles of choosing appropriate cough remedies. Antitubercular drugs* –classification, first line drugs*, Second line drugs, newer drugs, anti tubercular drug regimens, Management of adverse drug reaction with anti tubercular drugs, chemoprophylaxis, tuberculosis in AIDS, pregnancy, breast feeding, drugs used in Atypical Mycobacteriae. Hematological:Haematinics*: (Iron, vitamin B12 and folic acid)*, minerals (trace elements) and vitamins and clinical significance, preparations, uses, treatment of iron deficiency anemia, megaloblastic anemia, iron poisoning. Erythropoietin* and other growth factors,Coagulants*,Anticoagulant*, Thrombolytic drugs*, Antithrombotics*, Fibrinolytic, Antiplatelet agents*. Plasma expanders and blood transfusion - Chemistry, pharmacokinetics, preparations, dosage and uses, adverse effects. Drugs induced blood dyscrasias.* * Classification, Mechanism of Action, Pharmacological Actions, Adverse Drug Reactions, Precautions, Contraindications, Preparations, Drug Interactions, Therapeutic Uses/Indications. Total Hours 75

Text Books:

1. Tripathi K.D,Essentials of Medical pharmacology (2001) 4th edition, J.P.Brothers Medical Publishers Ltd. 2. Tripathi K.D. Pharmacology classification of drugs with doses and preparations, (2001). 2nd edition, J.P.Brothers Medical Publishers Ltd.

Reference Books: 1. Richard.D.Howland and Mary.J.Mycek, (2005). Lippincotts Pharmacology Williams and Wilkins Publishers.

2. Satoskar. R.S.(2008),Pharmacology and Pharmacotherapeuticsreprint SD Bhandarkar, SS Ainapure

3. Susan.B. Masters Bertram.G. Katzung Anthony. Trevor,Basic and clinical Pharmacology (2009) 11 th edition..Tata Mc Graw Hill

General Pathology-I

Semester III Hours of Instruction/Week: 3+3 15BPAC11No. of Credits: 3

Objectives:

 Understand the normal homeostatic mechanisms, the derangements of these mechanism and theeffects on human systems.

 Understand the etiopathogenesis, the pathological effects and the clinico-pathological correlation ofcommon infectious and non-infectious diseases.

Unit ICell Injury 18 Necrosis, Types of Necrosis, Ischemia, Hypoxia, Infarction and Gangrene, Oncosis and Autolysis.Sequence of the ultra structural and biochemical changes which occur in the cell in response to the following: Ischemia, Immunological injury, e.g., Asthma / SLE / Anaphylactic reaction, Toxic. Reversible cell injury: Types, Morphology: Swelling, vacuolation, and hyaline, fatty change. Irreversible cell injury: Calcification, Dystrophic and metastatic calcification along with clinicalsignificance.Amyloidosis: Classification, Pathogenesis, and Morphology.Exogenous and endogenous pigmentation.

Unit II Inflammation and Repair 18 Role of inflammation in the defense mechanisms of the body, Vascular changes of acute inflammation and their relation to morphological and tissue effects, Process of Chemotaxis, Opsonization and Phagocytosis, Role of cellular components in inflammatory exudate. Exudates and transudate, Important chemical mediators of inflammation, Pathway of Arachidonic acid metabolism. a) Acute inflammation: Features, causes, vascular and cellular events. Morphologic variants of acute inflammation. Inflammatory cells and mediators .b) Chronic inflammation: Causes, types, nonspecific and granulomatous with examples.Systemic effects of acute and chronic inflammation and their possible outcomes, Significance of ESR. c) Wound healing by primary and secondary union, factors promoting and delaying the process, Healing at specific sites including bone healing.Repair and regeneration, Wound healing by first and second intention, Factors that influence the inflammatory reparative response, Wound contraction and cicatrisation, Formation of granulation tissue, Complications of wound healing.

Unit III Growth Disturbances and Neoplasia 18

Elucidation of Growth Disturbances:Atrophy, Hypertrophy, Hyperplasia, Hypoplasia, Metaplasia, Malformation, Agenesis, Dysplasia. Neoplasia: Classification, histogenesis. Biologic behavior: Benign and Malignant; Carcinoma and Sarcoma. Malignant Neoplasia: Grades and stages, Local and distant spread. Carcinogenesis: Environmental carcinogens, chemical, viral, occupational, Heredity and cellular oncogenes. Tumor and host interactions: Systemic effects including paraneoplastic syndromes, Tumor immunology, Laboratory diagnosis: Cytology, Biopsy, Tumor markers.

Unit IV Immunopathology and Circulatory Disturbances 18

Immune system: Organization of cells, antibodies and regulation of immune responses. Hypersensitivity: Types and examples, Antibody and cell mediated tissue injury with examples. Primary immunodeficiency. Secondary Immunodeficiency including HIV infection. Auto-immune disorders like systemic lupus erythematosis; organ specific and non-organ specific such as polyarteritis nodosa, Hashimoto’s disease. Tumor immunity. Organ transplantation: Immunologic basis of Rejection and Graft versus host reaction.

Circulatory Disturbances: Thrombo-embolic disorders and their modalities: Etiology and pathogenesis of thrombosis, Possible consequences of thrombosis, Difference between thrombi and clots, Classification of emboli according to their composition, Difference between arterial and venous emboli. Hemorrhage, Hyperemia and Congestion: Definitions of common types of Hemorrhage, Types of hyperaemia, Difference between hyperemia and congestion. Infarction: Types of infarction, Difference between anemic and hemorrhagic infarct, Morphological picture of infraction in different organ systems, Gangrene. Disorders of the circulation and shock: Edema - Pathogenesis and types, ascites, hydrothorax and anasarca, Pathophysiology of edema with special emphasis on CHF, Pathogenesis of four major types of shock (hypovolemic,cardiogenic, vasovagal and septic) and their causes, Compensatory mechanisms involved in shock, Chronic venous congestion: Pathogenesis and changes in lung, liver, and spleen. Derangements of fluid and electrolyte imbalance

Unit V Infectious Diseases* and Miscellaneous Disorders 18

Mycobacterial Diseases:Tuberculosis and Leprosy. Bacterial Diseases: Pyogenic, Typhoid, Diphtheria, Gram negative infection, Bacillary dysentery, Syphilis.Viral Diseases: Polio, Herpes, Rabies, Measles; Rickettsial, Chlamydial infection. Fungal diseases and opportunistic infections. Parasitic infections: Malaria, Filaria, Amebiasis, Kala-azar, Cysticercosis, Hydatid.

AIDS: Aetiology, modes of transmission, diagnostic procedures and handling of infected material and health education.

(*General Features, Causative Organism, Patterns of Infection, Transmission, Clinical Manifestations, Microscopic Findings, Pathophysiology, Clinical Features, and Diagnosis).

Miscellaneous disorders:Autosomal and sex-linked disorders with examples, Metabolic disorders:Lipid disorders, Steatosis of liver, Hyperlipidemia, Protein disorders, Carbohydrate disorders. Pathophysiology of Metabolic Syndrome - Insulin resistance,Dyslipidaemia,Glucose intolerance, Hypertension.Protein energy malnutrition:Kwashiorkor,Marasmus,Marasmic- Kwashiorkor,Pathophysiology of vitamin deficiency disorders, Radiation Injury: Epithelial changes after Radiation Exposure, Atrophy, Necrosis and Ulceration, Metaplasia, Epithelial Atypia, Dysplasia, Stromal Changes, Fibrosis, Atypical Fibroblasts, Stromal,, Necrosis, Vascular Changes, Capillaries, Arterioles, Small and Medium-Sized Arteries, Large Arteries and Veins, Pathologic findings in specific organs. Disorders of pigment and mineral metabolism such as bilirubin, melanin, hemosiderin.

Total Hours : 90

Text Books:

1. Ramnik Sood, Illustrated Pathology(2001), J.P.Brothers Medical Publishers Ltd. 2. Ramnik Sood, Haematology for Students (2001). 4th edition,J.P.BrothersMedical Publishers Ltd.

Reference Books:

1. Cotran Robbins, Pathologic Basis of Disease (2007).6th edition, Elsevier Publications

2. Vinay Kumar, Ramzi’S Cotran, Stanley L.Robbins, Robbins Basic Pathology, (2004).updated edition,Elsevier Publications

3. Frank Firkin, Colin ChestermanDavid Penington, Brayan Rush, De Gruchy’s Clinical Haematology in Medical Practice.(2002) ,5 edition, Oxford University

Medicine – I

Semester III Hours of Instruction/Week: 3+3 15BPAC12No. of Credits: 2

Objectives:  To acquire knowledge on the art of history taking, physical examination and about investigations.  To enable the student recognize the illness and start early treatment

Unit I Specific Infections 18

Clinical Features, Signs and Symptoms, Laboratory Diagnosis, Treatment And Prevention of: Protozoal infections, Amobiasis, Malaria, Leishmaniasis, Toxoplasmosis, Giardiasis, Trichomoniasis, Trypanosomiasis. Bacterial infections: Streptococcal infections, Pneumococcal infections, Staphylococcal infections, Meningococcal infections, Gonococcal infections, Legionella infections, Pertussis and Diphtheria, Tetanus, Botulism, Gas gangrene, other clostridial infections. Cholera, Salmonellosis - Typhoid and paratyphoid fevers, Shigellosis and bacillary dysentery, Brucellosis, Plague, Donovanosis (Granuloma inguinale), Helicobacter Pylori. Infections due to pseudomonas and other gram negative bacteria: Anaerobic infection, Mycobacterial diseases, Tuberculosis, Leprosy.

Unit II Cardiovascular system 18 Clinical Examination of the Cardiovascular System. Functional anatomy, Physiology and Clinical symptomatolgy, Cardiac investigations and therapeutic procedures: E.C.G, X-ray chest and ECHO with reference to common cardiovascular diseases. Chest pain, Breathlessness, Palpitation, Acute circulatory failure (cardiogenic shock),Acute and chronic heart failure, Hypertension and hypertensive heart disease, Presyncope and syncope, Cardiac arrest and sudden cardiac death, Abnormal heart sounds and murmurs, Atrial fibrillation, Disorders of heart rate, rhythm and conduction, Congestive cardiac failure, Rheumatic fever and rheumatic heart disease, Valvular heart disease, Ischaemic heart disease, Congenital heart disease in the adult, Peripheral vascular disease, Atherosclerosis, Pericardial disease, Myocarditis and cardiomyopathy, Cardiac arrhythmias, Infective Endocarditis, Congenital heart disease, Atrial myxoma pulmonary heart disease,Myocardial and pericardial disease. Coronary artery disease. Common congenital heart diseases in adolescents and adults: ASD, VSD, PDA, TOF and Coarctation of Aorta.Acute and chronic pericarditis, pericardial effusion and cardiac tamponade. Common aortic diseases; peripheral vascular disease: arterial and venous.

Unit III Respiratory Disease*

Clinical Examination of the Respiratory System. Functional anatomy, 18 Physiology and diagnostic methods: Sputum examination, X-ray chest, pulmonary function tests and bronchoscopy. Cough, Dyspnoea, Chest pain, Haemoptysis. The solitary radiographic pulmonary lesion: Respiratory failure, Upper and lower respiratory infections, Bronchial asthma, Chronic obstructive pulmonary disease, Pneumonias, Pulmonary tuberculosis, Bronchial asthma and tropical eosinophilia, Chronic obstructive airway disease and cor pulmonale, Acute and chronic respiratory failure,Suppurative lung diseases, Bronchiectasis, Lung abscess, Interstitial and infiltrative lung diseases. Occupational lung diseases. Tumors of the bronchus and lung. Pulmonary vascular diseases. Pulmonary hypertension. Pulmonary thromboembolism. Acute respiratory distress syndrome. Obstructive sleep apnoea. Diseases of the nasopharynx, larynx and trachea. Diseases of the mediastinum, diaphragm and chest wall.Diseases of pleura: Plural effusion, empyema.,pneumothorax.

Unit IV Kidney and Genitourinary System* 18

Clinical Examination of the Kidney and Genitourinary System. Functional anatomy, physiology and investigations. Dysuria, pyuria, urethral symptoms. Disorders of urine volume: Hamaturia, Proteinuria, Oedema. Obstruction of the urinary tract: Incontinence, Acute and chronic renal failure, Infections of the kidney and urinary tract. Congenital abnormalities of the kidneys and urinary system: Glomerulonephritides, nephrotic syndromeTubulo-interstitial diseases, pyelonephritis. Tubulointerstitial diseases and toxic nephropathies, renal involvement in systemic disorders.Drugs and the kidney. Renal vascular diseases. Urinary tract calculi and nephrocalcinosis. Tumors of the kidney and genitourinary tract. Renal replacement therapy.

Unit V Hematological Disorders* 18

Clinical Examination In Blood Disorders: Anaemia: Iron deficiency, megaloblastic and common haemolytic anaemias (thalassemia, sickle cell and acquired haemolytic). Common bleeding disorders (thrombocytopenia and haemophilia). Agranulocytosis and aplastic anaemia. Leukaemias. Lymphomas. Polycythemia, Leucopenia, Leucocytosis, Thrombocytopenia, Thrombocytosis, Pancytopenia, Lymphadenopathy, Splenomegaly, Venous thrombosis, abnormal coagulation screen, Infections, Myeloproliferative disorders, Haematological malignancies. Blood group and transfusion: Major blood group systems and histocompatibility complex, concepts of transfusion and component therapy; indications for transfusion therapy, precautions to be taken during blood transfusion, hazards of transfusion and safe handling of

blood and blood products. Disorders of coagulation and venous thrombosis, Bone marrow transplantation.

*Definition, Aetiological Factors, Pathophysiology, Signs and Symptoms, Investigations and Diagnosis, Differential Diagnosis, Principles of Treatment.

Total Hours : 90

Text Books:

1. Christopher Haslett, Sir Stanley Davidson, Davidsion’s Principles and Practice of Medicine,(2009).18th edition, Livingstone publications. 2. Parveen Kumar, Michael L Clark, Kumar and Clark’ Clinical Medicine(2012).12th edition, Saunders Ltd Imprint.

Reference Books;

1. Vasnaik, Essentials of Emergency Medicine, (2001) 2nd edition, J.P.Brothers Medical Publishers Ltd. 2. Dennis. L.Casper, Eugene Braunwald AntonyFauci, Harrison’sPrinciple of Internal Medicine, (2004).16th edition, Mcgraw Hill Medical Publishing Division. 3. Michael Swarsh, Michael Glynn, Hutchison Clinical Methods –An Integrated Approach to Clinical Practice, (2007). 22 nd edition, Elsevier Saunders. 4. Mark Kinirons andHarold Ellis, French’s Index of differential diagnosis-An A-Z, (2005). 14th edition, Hodder Arnold -An Hachette UK Company

Microbiology-I

Semester III Hours of Instruction/Week: 3+3 15BPAC13 No. of Credits: 2

Objectives:

 Acquire knowledge on suitable antimicrobial agents for treatment of infection and scope of immunotherapy and different vaccine available for prevention of communicable diseases  Apply methods of disinfection and sterilization to control and prevent hospital and community acquired infections.

Unit IIntroduction to Microbiology and Bacteriology 18

(i) Natural history of microbial diseases. (ii) Unique differentiating features of eukaryotes and prokaryotes (iii) Source and spread of microbes (iv) Rationale for classifying microbes into bacteria, fungi viruses, parasites. Bacteriology: The nature of bacteria, Morphological differences, Growth requirement, Nomenclature and classification, Enumeration of bacteria responsible for certain primary diseases. Bacterial Staining: principles, Media for growth / bacterial colony, Familiarization with materials used. Common tests for bacterial identification, Staining principle, Motility testing, common sugar fermentation and other biochemical tests such as catalase / coagulase/ citrate utilization/ nitrate reduction / urease/ PPA/ OF/ indole etc. Sensitivity testing

Unit IIMicroscope and Staining: 18

Principle and structure of Light Microscope, Numerical Aperture, Resolving Power. Magnification. Principle and structure of electron microscope (SEM and TEM). Comparison between light and electron microscope. Preparation and staining of specimens for light microscopy: Fixation, dyes and simple staining, differential staining- gram staining, acid-fast staining, staining specific structures-negative staining, endospore staining, flagella staining.

Unit IIIMicrobial Nutrition and Culture Media

Microbial Nutrition: Common nutrient requirements, Nutritional types of 18 microorganisms, growth factors. Uptake of nutrients by cells. Culture Media: Synthetic or defined media. Commonly used media. Types of Media- Selective, differential and enrichment media. Cultivation of organism: Cultivation of bacteria, fungi and viruses. Pure culture: Concept of pure culture. Methods of pure culture of microorganisms – Spread plate, streak plate and pour plate

Unit IVCollection of Samples and Host-Parasite Relationship 18

Collection of clinical samples, Transport of various appropriate clinical samples. Transport media, Description of container with contents or no contents, Preliminary processing of clinical samples. Host-Parasite relationship: Presence of normal flora, Enumeration and explanation of various host-parasite interaction, Mechanism of pathogenesis adhesion/ colonisation/ virulence and toxigenicity, Host response, Koch’s postulates.

Unit VMicro – organisms and Source of Contamination 18

Classification; characteristics, size, method and rate of reproduction; factors influencing growth; pathogenic and non-pathogenic organisms; common disease caused by different types of organisms. Sources of contamination and Controlling measures:Ingestion, inhalation, through skin and mucous membranes and congenital; transfer of infection via throat, nose, urine and faeces, wounds and discharges, methods of collecting specimens; direct and indirect infection and cross infection. Principles and methods of microbial control: Sterilization – dry heat, moist heat and chemicals, Disinfections – physical, natural gases, chemicals used and preparation of lotions. Medical and surgical asepsis, cross – infection; control of spread of infection, Pasteurisation.

Total Hours : 135

Text Book:

1. Rajesh Bhatia ,Essentialsof Medical Microbiology,(2001). 2nd edition, J.P.Brothers Medical Publishers P. Ltd.

Reference Books:

1. Connie R. Mahon, Donald C. Lehmanand George Manuselis,Textbook of Diagnostic Microbiology, 2010.Lippincott

2. Pamela.C.Champ, Richard.A.Harvey, Bruce.D.Fisher,Lippincott’s Illustrated Review Microbiology, (2007). 2nd edition, Lippincott

Allied-III Clinical Biochemistry- II

Semester III Hours of Instruction/week: 4+3 15BPAIO3 No. of Credits: 2

Objectives:  To learn the clinical significance of biochemical parameters and the interpretation of their findings in abnormal conditions

Unit I Respiratory System 12 Functions of the lungs -Diseases of the respiratory system (lung infection, asthma and allergy). Respiratory function tests – lung volumes, measurement by spirometer, helium dilution technique, and nitrogen washout method. Unit II Cardiovascular System 12 Functions of the heart- Diseases of the cardiovascular system (thrombosis, acute myocardial infarction) Cardiovascular function tests – maker enzymes (creatinine kinase and lactate dehydrogenases).

Unit III Alimentary Tract 12

Functions of the stomach, intestine and pancreas - alimentary tract and pancreatic abnormalities (gastritis, peptic ulcer and pancreatitis) - pancreatic function tests – invasive and non invasive test, gastric function test – fractional test meal, stimulation test. Unit IV Liver Function Tests 12

Metabolism of bile pigment, test based upon excretory, abnormalities of bile pigment. Detoxifying function. Types of jaundice. Liver marker enzymes (alkaline phosphatase, acid phosphatase, alanine tranaminase, aspartate transaminase and lactate dehydrogenases)

Unit V Kidney Function Tests 12

Diagnosis and screening for renal diseases. Types of renal failure, glomerular diseases – nephritis and nephrosis..Test which measure GFR – urea clearance test based on secretion and tubular function.Urinary calculi – analysis of stone

Total hours 60 Practical 45

List of Experiments 1. Collection of blood and use of anticoagulants

2. Separation of serum and plasma 3. Estimation analysis of blood glucose, urea, iron and hemoglobin 4. Analysis of serum uric acid, creatinine and phosphorus

5. Estimation of SGOT, SGPT by kit method

6. Estimation of total cholesterol, HDL, LDL, VLDL cholesterol and triglycerides by kit method

Total Hours: 105

Text Books: 1. Gaw, A., Murphy, M.J., Cowan, R.A., Rectly, D.S., Stewart, M.J. and Shepherd, J. (2008), Clinical Biochemistry, 4th edition, Churchill Livingstone, New York. 2. Nayak, B.Manipal Manual of Clinical Biochemistry, (2002), 1st edition, JayPee brothers, New Delhi.

Reference book:

1. Gowenlock, A.H., Murray, J.R. and Lauchlan, D.M. (2006), Practical clinical Biochemistry, 6th edition, CBS Butterworth publishers, New Delhi.

Pharmacology and Toxicology-II

Semester IV Hours of Instruction/Week: 3+2 50

15BPAC14No. of Credits: 3

Objectives

Enable the student to describe details of drugs and chemical agents used in patient care situations, store and administer them effectively to patients and observe the results

Unit I Gastrointestinal and Dermatological Pharmacology 10

Gastrointestinal: Drugs used for the control of gastric acidity, digestants, antiflatulents.,Drug treatment of peptic ulcer*- classification (H2 blockers*, proton pump inhibitors*, prostaglandin analogues, antacids, ulcer protective). Treatment of helicobactor pylori infection. Emetics, antiemetics*, prokinetic drugs – Classification*, mechanism of action, actions, adverse drug reaction, uses and drug interactions. Treatment of gastroesophageal reflux disease. Drug treatment of gallstones. Agents used for constipation – classification, laxatives, purgatives and hazards of purgatives. Drugs used in diarrhoea – indications for the use of antimotility agents*, antimicrobial agents and antisecretory agents and oral rehydration powder. Drugs used in therapy of inflammatory bowel disorders. Dermatological: Systemic Treatment- Corticosteroids, antibiotics, antihistamines, Immuno suppressants indications. Topical treatment: Calamine lotion, creams, emollients, antifungal agents, Sunscreens - reflectors, absorbents – indication, advantages, disadvantages, Pharmacotherapy of scabies and pediculosis. * Mechanism of Action, Pharmacological Actions, Adverse Drug Reactions, Precautions, Contraindications, Preparations, Drug Interactions, Therapeutic Uses/Indications.

Unit II : Hormones 10

Definition, different types and their mechanism of action. Thyroid hormones – Levo thyroxine*, antithyroid drugs*- classification,preparations and uses. Antidiabetic drugs – Insulin, Actions conventional preparations, highly purified preparations, reactions, uses, newer insulin delivery devices. Oral hypoglycemic drugs*- classification, management of hypoglycemia, diabetic ketoacidosis. Glucagon – actions, uses. Corticosteroids – regulation of secretion, preparations*, Glucocorticoid antagonists. Gonadal hormones – Androgens*, anabolic steroids – preparations, side effects, uses, antiantrogens – side effects, uses. Estrogens – preparations*, hormonal replacement therapy, antiestrogens*, selective estrogen receptor modulators. Progestins – Preparations*, antiprogestins – (Mifepristone) hormonal contraceptives – types of methods, (oral, injectable), preparations*, male contraceptive. Drugs acting on uterus – uterine stimulants- classification, (Oxytocin*, Ergometrine*, Prostaglandins). Uterine relaxants – Preparations*. Drugs affecting calcium balance: Calcium parathyroid hormone, calcitonin, vitamin D, preparations, uses. Bisphosphonates – actions, uses, Pharmacotherapy of

osteoporosis. *Mechanism of Action, Pharmacological Actions, Adverse Drug Reactions, Precautions, Contraindications, Preparations, Drug Interactions, Therapeutic Uses/Indications.

Unit III : Chemotherapyof Microbial Diseases 7

General principles of chemotherapy, antibiotics – definition, sources, chemical nature, mechanism of action, (spectrum of activity, type of action, problems. Toxicity, hypersensitivity reactions, drugs resistance – types, mechanisms, prevention of super infection. Factors determining the choice of an antibiotic, minimum inhibitory concentration (MIC), post antibiotic effect (PAE), minimum bactericidal concentration (MBC). Combinations of Antimicrobials – Advantages, disadvantages, indications. Prophylactic use of Antimicrobials – indications with examples, causes for the failure of chemotherapy.Sulfonamides* - preparations, cotrimoxazole*. Quinolones* – classification- first generation, Second generation. Drugs used in typhoid fever. Beta lactum antibiotics: classification, Penicillins* (including semisynthetic, Acid resistant, penicillinase resistant, Extented spectrum), Beta lactamase inhibitors, Cephalosporins*,monobactams*, carbapenems*. Tetracyclines* and chloramphenicol*. Aminoglycosides*- classification. Macrolide*

Unit IV Miscellaneous Antibiotics 8 classification, newer macrolides*, clindamycin, Lincomycin, vancomycin, Teicoplanin, Linezolid, Fusidic acid, Polymyxin B, Bacitracin, Tyrothricin – Spectrum and uses Pharmacotherapy of urinary tract infection, urinary antiseptics, Pharmacotherapy of sexually transmitted diseases: Antileprotic drugs* - Classification, Pharmacotherapy, drug regimen (MDT), Alternative regimens, management of lepra reactions, newer drugs. Antifungal drugs: Classification*, local, systemic mycoses management. Antiviral drugs: classification, Anti–herpes virus drugs*, Anti–retrovirus drugs*, WHO guidelines for the treatment of HIV infection, anti influenza virus drugs*, nonselective antiviral drugs*. Anti malarial drugs*: Classification, different forms of anti malarial therapy, management of cerebral malaria, radical cure, malaria prophylaxis, resistant malaria. Antiamoebic drugs: Classification*, Anthelmintics: classification*, choice of drugs for various worm infestation. *Chemistry, Spectrum of activity, Mechanism of action, Pharmacokinetics, Preparations, Adverse effects, Interactions, Precautions, Uses

Unit V Central Nervous System 10 General anaesthetics*– Definition, mechanism of action, stages of anesthesia, classification, advantages and disadvantages. Intravenous anaesthetics* – (inducing

agents, slower acting drugs) Dissociative anesthesia (ketamine),neuroleptanalgesia. Preanaesthetic medication. Aliphatic alcohol – Pharmacological actions, interactions, toxicity, clinical uses. Disulfiram, treatment of alcoholism and treatment of methyl alcohol poisoning. Sedative - hypnotics. Definition, classification – barbiturates*, benzodiazepines*, Non- Benzodiazepine hypnotics*, benzodiazepine antagonist. Treatment of barbiturates poisoning. Antiepileptic drugs – Classification of drugs* Pharmacotherapy of epilepsy, Management of status epilepticus. Drugs for CNS degenerative disorders. : Parkinsonism – classification of drugs*, pharmacotherapy of alzheimer’s disease, motor neuron disease. Antipsychotic drugs – Classification* (chlorpromazine* prototype) Atypical Antipsychotics* Pharmacotherapy of Schizophrenia. Antianxiety drugs - Classification* Sedating, non sedating antianxiety drugs, Pharmacotherapy of anxiety. Antidepressant drugs – Classification* (Imipramine* prototype) MAO inhibitors Selective serotonin reuptake inhibitors (SSRI’s), Opioid Analgesics – Classification* (Morphine* prototype) Management of acute morphine poisoning, Other opioids, partial agonists, agonist Antagonists, Pure antagonists, Management of opium dependence. Drug addiction and drug abuse. CNS stimulants - Classification*, Cognition enhancers (Nootropics) – uses with examples. Therapeutic Gases – Oxygen, Nitrous oxide, carbon dioxide and their use.

* Mechanism of Action, Pharmacological Actions, Adverse Drug Reactions, Precautions, Contraindications, Preparations, Drug Interactions, Therapeutic Uses/Indications.

Total Hours : 45

Practical 30  Principles of Prescribing Writing: Prescribing drugs, Collecting drug history from patients, p-drug concept, Cost – containment, Repeat prescriptions, Warnings and consent, Self – medication, Prescription of common disorders, Clinical uses of drugs in hepatic and renal failure  Spotting Exercise: Identify the commonly used drugs, dose and dosage calculations, formulations and its route of administration

Total Hours 75

Text Books:

1. Tripathi K.D, Essentials of Medical pharmacology (2001) 4th edition, J.P.Brothers Medical Publishers Ltd.

2. Tripathi K.D. Pharmacology classification of drugs with doses and preparations, (2001). 2nd edition, J.P.Brothers Medical Publishers Ltd.

Reference Books:

1. Satoskar. R.S ,Pharmacology and Pharmacotherapeutics.(2008) reprint SD Bhandarkar, SS Ainapure

2. Susan.B. Masters Bertram.G. Katzung Anthony. Trevor,Basic and clinical Pharmacology (2009). 11 th edition..Tata Mc Graw Hill.

General Pathology-II

Semester IV Hours of Instruction/Week: 3 15BPAC15 No. of Credits: 3

Objectives:

• Understand the normal homeostatic mechanisms, the derangements of these mechanism and the effects on human systems. • Understand the etiopathogenesis, the pathological effects and the clinico-pathological correlation of common infectious and non-infectious diseases

Unit I Cardiovascular and Respiratory Pathology * 8 Cardiology- Rheumatic fever and Rheumatic Heart Disease : Pathogenesis, Morphology and effects, Infective Endocarditis : Causes, Pathogenesis and Morphology, Atherosclerosis and Ischemic Heart Disease; Myocardial Infarction, Diseases of blood vessels other than atherosclerosis, Hypertension and Hypertensive Heart Disease, Congenital Heart Disease : ASD, VSD, Fallot’s Bicuspid aortic valve, PDA, Pericarditis and other pericardial diseases, Cardiomyopathy. Respiratory-Concept of obstructive and restrictive lung disorders, Inflammatory diseases of bronchi: chronic bronchitis, bronchial asthma, bronchiectasis, chronic obstructive lung disease. Pneumonias: Lobar, Broncho, Interstitial, Pulmonary suppuration including lung abscess: Etiopathogenesis and morphology, Pulmonary Tuberculosis: Primary and Secondary, Morphologic types including pleuritis. Emphysema: Types, pathogenesis, Atelectasis and Hyaline Membrane Disease, Tumors: Benign; Carcinoid, Malignant:Squamous cell, Oat cell, Adeno, etiopathogenesis, Occupational lung disorders :anthracosis, silicosis, asbestosis, mesothelioma.

Unit II Urinary Tract and Gastro-Intestinal Tract Pathology* 8 Uninary Tract- Renal structure, basis of impaired function, urine analysis, Glomerulonephritis: Classification, Primary Proliferative and Non Proliferative, Secondary Glomerulonephritis : SLE, Purpura, Polyarteritis, Amyloidosis, Diabetes, Nephrotic Syndrome, Acute Renal Failure : Acute tubular and cortical necrosis, Progressive renal failure and end stage renal disease, Pyelonephritis, Reflux Nephropathy, Interstitial Nephritis, Renal tumors : Renal cell carcinoma, Nephroblastoma, Renal vascular disorders, kidney changes in Hypertension, Urinary bladder : cystitis, carcinoma, Urinary tract Tuberculosis, Urolithiasis and Obstructive Uropathy, Renal Malformations : Polycystic kidneys.

Gastro Intestinal- Leukoplakia, Carcinoma oral Cavity and Esophagus, Salivary gland tumours: Mixed, Adenoid cystic, warthin’s, Peptic ulcer: etiopathogenesis and complications; gastritis: types. Tumors of stomach: Benign; Polyp, Leiomyoma, Malignant; Adenocarcinoma, Lymphoma, Inflammatory diseases of small intestine: Typhoid, Tuberculosis, Crohn’s, Appendictis, Inflammatory diseases of appendix and large intestine: Amoebic colitis, Bacillary dysentery, Ulcerative Colitis, Ischemic and Pseudomembranous enterocolitis, diverticulosis. Malabsorption : Celiac disease, Trophical sprue and other causes Tumours and Tumor like condition of the large and small intestine : Polyps, Carcinoid, Carcinoma, Lymphoma, Pancreatitis, Pancreatic tumors : Endocrine, Exocrine and periampullary.

Unit IIIHematopathology, Liver and Biliary Tract Pathology* 12

Hematopathology: Anaemia- classification, Nutritional anaemia’s -Iron deficiency anaemia, Folic acid/Vit B 12 deficiency anaemia including pernicious anaemia, Haemolytic anaemia : Classification and investigation, Autoimmune, Alloimmune ,Hereditary hemolytic anaemias : Thalassemia, sickle cell anaemia, Hereditary hemolytic anaemias : hereditary spherocytosis, G-6-PD deficiency, Acquired hemolytic anaemias, Drug induced microangiopathic, Aplastic anaemia, PNH and Myelodysplastic syndrome, Hemostatic disorders : Platelet deficiency; ITP, Drug induced, Coagulopathies : Coagulation factor deficiency; hemophilia, DIC and anticoagulant control, Leukocytic disorders : Leukocytosis, leukopenia, leukemoid reaction, Acute and chronic Leukemia : Classification, Diagnosis, Myeloproliferative disorders : Polycythemia, Myelofibrosis, Multiple myeloma and dysproteinemias, Blood transfusion : grouping and cross matching, untoward reactions, transmissible infections including HIV and hepatitis.

Liver and Biliary Tract: Jaundice-Types, pathogenesis and differentiation, Hepatitis-Acute and chronic, Etiology, Pathogenesis and Pathology, Cirrhosis: Etiology, Post necrotic, Alcoholic, Metabolic, Pathology, Morphology (Macronodular, Micronodular, Mixed), complications, Portal Hypertension-Types including non-cirrhotic portal fibrosis and Manifestations, Tumors of Liver- hepatocellular and metastatic carcinoma, tumor markers, Concept of hepatocellular failure, Diseases of the gall bladder : Cholecystitis, Cholelithiasis, Carcinoma

Unit IV Reproductive, Osteopathology andLymphoreticular Pathology* 9

Reproductive System: Diseases of cervix: cervicitis, cervical carcinoma, aetiology, types and cytologic diagnosis, histological appearances of different phases of menstrual cycle and the abnormalities associated with it. Diseases of uterus: endometritis, endometrial hyperplasia and carcinoma, adenomyosis, smooth muscle tumors. Diseases of the breast: Mastitis, abscess, Fibrocystic disease, Neoplastic lesions: Fibroadenoma, Carcinoma, Phyllodes tumor. Prostate: Nodular

Hyperplasia and Carcinoma, Ovarian and testicular tumors, Pelvic inflammatory diseases including salpingitis, Genital Tuberculosis. Osteomyelitis-Acute, Chronic, Tuberculous, Mycetoma. Metabolic diseases- Rickets/Osteomalacia,Osteoporosis, Hyperparathyroidisism. Tumors: Primary, Osteosarcoma, Osteoclastoma, Ewing’s Sarcoma, Chondrosarcoma, Metastatic Arthritis: Rheumatoid, Osteo and tuberculous arthritis. Lymphoreticular System: Lymphadenitis: nonspecific, Granulomatous, Hodgkin’s and Non-Hodgkin’s Lymphomas: Classification, Morphology, Diseases of the spleen: Splenomegaly causes and effect, Thymus: Dysgenesis, Atrophy, Hyperplasia, and Neoplasia.

Unit V Endocrine and Neuropathology* 8 Endocrine Pathology- Diabetes Mellitus: Types, Pathogenesis, pathology, Non neoplastic lesions of thyroid: Iodine deficiency goiter, autoimmune thyroiditis, thyrotoxicosis, ,myxedema. Tumors of thyroid – adenoma, carcinoma: Papillary, Follicular, Medullary, Anaplastic. Adrenal diseases : Cortical hyperplasia, atrophy, tuberculosis, tumors of cortex and medulla, Parathyroid hyperplasia and tumors and Hyperparathyroidism, Pituitary tumors, Multiple endocrine Neoplasia.

Neuropathology- Inflammatory disorders: Pyogenic and tuberculous meningitis, brain abscess, tuberculoma, and CNS tumors – primary: glioma and meningioma, and metastatic CSF and its disturbances: cerebral edema, raised intracranial pressure. Cerebrovascular diseases: Atherosclerosis, thrombosis, embolism, aneurysm, Hypoxia, Infarction and Hemorrhage.

*Clinical features, course of the disease and relevant laboratory investigations, followed by demonstration of the gross and microscopic features of the disease and clinico-pathologic correlation Total Hours 45 Text Books:

1. Ramnik Sood, Illustrated Pathology(2001), J.P.Brothers Medical Publishers Ltd.

2. Ramnik Sood, Haematology for Students (2001). 4th edition,J.P.Brothers Medical Publishers Ltd.

Reference Books:

1. Cotran , Robbins Pathologic Basis of Disease (2007).6th edition, Elsevier Publications

2. Vinay Kumar, Ramzi’S Cotran, Stanley L.Robbins, Robbins Basic Pathology, (2004).updated edition, Elsevier Publications

Medicine – II

Semester IV Hours of Instruction/Week: 4 15BPAC16 No. of Credits: 2

Objectives  Elicit a detailed history; perform a thorough physical examination including mental status, examination and examination of an unconscious patient.  Correlate the clinical symptoms and physical signs to make a provisional anatomical, physiological, etiopathological diagnosis along with the functional disability and suggest relevant investigation.Interpret reasonably the relevant investigations.

Unit I Gastrointestinal Tract* 10

Clinical Examination of the Abdomen: Abdominal pain (acute and chronic), Dysphagia, Dyspepsia, Vomiting, Constipation, Diarrhoea, Abdominal lump, Weight loss, Gastrointestinal bleeding - upper and lower, Approach to the patient with gastrointestinal disease, Diseases of the mouth and salivary glands - oral ulcers, candidiasis, parotitis, Diseases of the oesophagus - GERD, other motility disorders, oesophagitis, carcinoma oesophagus, Diseases of the stomach and duodenum - gastritis, peptic ulcer disease, tumors of stomach, Diseases of the small intestine- Acute gastroenteritis and food poisoning, Intestinal tuberculosis, Inflammatory bowel disease, Malabsorption syndrome, Tumors of small intestine, Acute, sub-acute and chronic intestinal obstruction,.

Unit II Gastroinstestinal Tract and Accessory Organs* 15

Disorders of the colon and rectum, Bacillary dysentery, Amoebic colitis, Ulcerative colitis, Tumors of the colon and rectum, Irritable bowel disease, Abdominal tuberculosis- Peritoneal, Nodal, Gastrointestinal- Ischaemic gut injury, Anorectal disorders. Diseases of the peritoneal cavity- Acute and chronic peritonitis, Ascites, Peritoneal carcinomatotis.

Liver and Biliary tract disease: Clinical Examination of the Abdomen for Liver and Biliary Disease. Functional anatomy, physiology and investigations of hepatobiliary disease. ‘Asymptomatic’ abnormal liver function tests, Jaundice, Acute (fulminant) hepatic failure,

Unit III Diseases of Accessory Organs* of Digestive System 15

Portal hypertension and ascites, Hepatic (portosystemic) encephalopathy, Hepatorenal failure, Liver abscess - amoebic and pyogenic, Viral hepatitis - acute and chronic, Acute and chronic hepatitis Alcoholic liver disease. Cirrhosis of liver and chronic liver disease. Drugs, toxins and liver, Fatty liver and non alcoholic steatohepatitis, Infiltrative diseases of liver, Wilson’s disease, Hemachromatosis, Tumors of the liver, Gallbladder and biliary tract diseases, Functional anatomy- Acute and chronic ‘cholecystitis’, Cholelithiasis- Tumors of gall bladder and bile ducts.. Pancreas, Liver and Biliary tract disease: Acute and chronic pancreatitis, Tumors of pancreas.

Unit IV Disorders of the Immune System and Connective Tissue* 10

Introduction to the immune system and autoimmunity, Primary immune deficiency diseases, HIV, AIDS and related disorders.Systemic connective tissue diseases - SLE, RA, PSS, Vasculitides, Ankylosing spondylitis, reactive arthritis and undifferentiated spondyloarthropathy, Sarcoidosis, Amyloidosis. Musculo skeletal manifestations of disease in other systems: Fibromyalgia, Diseases of bone.

Unit V Rheumatology and Bone Disease* 10 Clinical Examination of Bone Disease :Anatomy of Joints, Joint pains, Bone pain, Muscle pain and weakness, Regional periarticular pain, Back and neck pain, Approach to articular and musculoskeletal disorders, Inflammatory joint disease, Infectious arthritis, Inflammatory muscle disease, Osteoarthritis, Rheumatoid arthritis. Spondylo arthopathies. Infective arthritis. Differential diagnosis of arthritis in the elderly. Arthritis in children. Back pain, soft tissue rheumatism. Bone disease: Physiology, structure and formation of bone. Metabolic bone disease, calcium disorders. Infections of the bone, neoplastic bone disease. Total Hours : 60

*Major manifestations of disease. *Definition, Aetiological Factor, Pathophysiology, Signs and Symptoms, Investigations And Diagnosis, Differential Diagnosis, Principles of Treatment.

Text Books: 1. Christopher Haslett, Sir Stanley Davidson, Davidsion’s Principles and Practice of Medicine,(2009).18th edition, Livingstone publications.

2. Parveen Kumar, Michael L Clark ,Kumarand Clark’ Clinical Medicine(2012).12th edition, Saunders Ltd Imprint.

Reference Books:

1. Vasnaik, Essentials of Emergency Medicine, (2001) 2nd edition, J.P.Brothers Medical Publishers Ltd. 2. Dennis. L.Casper, Eugene Braunwald Antony Fauci, Harrison’s Principle of Internal Medicine, (2004). 16th edition, Mcgraw Hill Medical Publishing Division. 3. Michael Swarsh, Michael Glynn, Hutchison Clinical Methods –An Integrated Approach to Clinical Practice, (2007). 22 nd edition, Elsevier Saunders. 4. Mark Kinirons andHarold Ellis, French’s Index of differential diagnosis-An A-Z, (2005). 14th edition, Hodder Arnold -An Hachette UK Company

Microbiology-II

Semester IV Hours of Instruction/Week: 3 15BPAC17 No. of Credits: 2

Objectives

 Acquire knowledge on suitable antimicrobial agents for treatment of infection and scope ofimmunotherapy and different vaccine available for prevention of communicable diseases  Apply methods of disinfection and sterilization to control and prevent hospital and community acquiredinfections.

Unit I Introduction to Parasitology and Virology 8

Parasites: Biology of protozoa, Protozoan parasites causing human infection, Medically important helminths– Ectoparasites

Virology: The nature and properties of viruses, Classification of viruses, Morphology, Laboratory Diagnosis of Viral Infection: Brief appraisal of pathogenicity of viruses, Culture methods, Cytopathic effects, Inclusion bodies, Serological test (CFT, HAI, neutralisation),Bacteriophages, Retro viruses - HIV, Hepatitis virus , Pox virus Picrona virus – Polio, Orthomyxo virus - Influenza., Arbo virus - chikungunya, Dengue. Herpies and Adeno viru,Mumps , Measles and Rubella Virus Bacteriophage - structure and significance

Unit-II Systematic Bacteriology* 8 Study of Staphylococcus, Streptococcus, Pneumococcus, Neisseira gonorrhoea, Neisseira,Meningitis, Cornybacterium diptheriae, Mycobaterium, Clostridium, E.coli, H. pylori, Klebsiella, Salmonella, Proteus, Pseudomonas, Vibrio and Spirochaetes - Treponema pallidum Borrelia vincentii., Actinomycetes. Cariogenic streptococci.

*Morphology,Cultural Characteristics, Biochemical Reaction, Pathogenesis/Disease Caused and Lab Diagnosis

Unit-III Introduction To Mycology 12

Nature of fungi : basic structures and classification, Morphology and structure of fungi, Classification of fungi, Nutrition and cultivation of fungus, Superficial mycoses, Cutaneous andSubcutaneous mycosis, Systemic fungal infections with opportunistic mycosis. Common laboratory methods for diagnosis of fungal infections: KOH preparation with principles, Lactophenal cotton blue preparation, Negative staining and procedures, Special staining and procedures, Culture of fungi, Serodiagnosis.

Unit-IV Gastrointestinal Infections and Genetics 9

Microorganisms associated: Bacteria, parasites, viruses and fungi.Parasitic infection: Amoebiasis, Entamoeba spp, Naegleria spp, Acanthamoeba spp, other intestinal protozoal infections Bacterial and viral genetics:Structure and replication of bacterial DNA, Plasmids, Transfer of genetic materials, Mutations, Viral replication, Interactions among viruses (recombination, genetic reactivation, complementation etc). of viral infection, Recombinant DNA technology

Unit-V Immunology 8

Immunity: Definition and classification - General principles of innate and acquired immunity. Immune Response - Humoral immunity and cell mediated immunity. Antigen - Definition, classes, properties. Antibodies/Immunoglobulins - Definition, Properties, Sub types of Immunoglublines , Antigen/Antibody Reaction/Serological Refractions, Features of antigen/antibody reaction, Precipitation, Agglutination , Complement fixation test, Neutralization, Opsonization, Immune adherence, Immuno fluorescence, Immuno electron microscopic test, Structure and functions of immune system - Parts of immune system - T/B cells, other cells and their functions Hyper sensitivity reactions - General principles of different types of hypersensitive reactions i.e., type 1, 2, 3, 4. Auto immune disorders, ELISA Total Hours 45

Text Book:

1. Rajesh Bhatia ,Essentials of Medical Microbiology,(2001). 2nd edition, J.P.Brothers Medical Publishers P. Ltd.

Reference Books:

1. Connie R. Mahon, Donald C. Lehmanand George Manuselis, Textbook of Diagnostic Microbiology, 2010. Lippincott

2. Pamela.C.Champ, Richard.A.Harvey, Bruce.D.Fisher,Lippincott’s Illustrated Review Microbiology, (2007). 2nd edition, Lippincott

Microbiology–III Practical-II

Semester IV Hours of Instruction/week: 3 15BPAC18No. of Credits: 2

Objectives

1. Plan and interpret laboratory investigations for the diagnosis of infectious diseases and to correlate the clinical manifestations with the etiological agents 2. Identify the common infectious agents with the help of laboratory procedures and use antimicrobial sensitivity tests to select suitable antimicrobial agents 3. Use the correct method of collection, storage and transport of clinical material for microbiological investigations

Practical 45 List of Experiments 1. Microscopy and micrometry Introduction to microscopes, Focussing slides under low/ high power and oil immersion, Principles and demonstration of various types of microscopes 2. Direct demonstration of bacteria by staining Gram staining, Albert’s staining, Acid fast staining 3. Motility tests and biochemical tests for bacterial identification Hanging drop method for motility testing, Important biochemical tests : principles and interpretation 4. Laboratory diagnosis of viral infections Collection and transport of samples, Demonstration of egg inoculation techniques, cell culture, cytopathic effect, plaque assay, serological tests (complement fixation, haemagglutination inhibition, neutralization, ELISA) 5. Laboratory diagnosis of fungal infections a. Collection and transport of specimens, Gram stain, KOH preparation, India ink preparation for direct demonstration, Sabouraud’s dextrose agar/media, Lactophenol cotton blue for identification b. Latex agglutination test 6. Sterilization and disinfection Visit to media and sterilization room (demonstration of autoclave and hot air oven) and CSSD

7. Stool examination for cysts a. Collection and transport of stool sample for parasites b. Direct examination (saline and iodine preparations) c. Concentration of stool for parasites d. Identification of cysts 8. Laboratory diagnosis a. Superficial, Subcutaneous,Deep Mycoses ,Malaria Leishmaniasis, Enteric Fever, Meningitis.

b. E.coli infection , cholera, food poisoning

c. Upper and lower respiratory tract infections,tuberculosis, UTI , anaerobic infections

d. Serological test (CFT, HAI, neutralization)

Total Hours 45

Text Book:

1. Rajesh Bhatia ,Essentialsof Medical Microbiology,(2001). 2nd edition, J.P.Brothers Medical Publishers P. Ltd.

Reference Books:

1. Connie R. Mahon, Donald C. Lehmanand George Manuselis,Textbook of Diagnostic Microbiology, 2010.Lippincott

2. Pamela.C.Champ, Richard.A.Harvey, Bruce.D.Fisher,Lippincott’s Illustrated Review Microbiology, (2007). 2nd edition, Lippincott

Bio statistics and Research

Semester IV Hours of Instruction/week: 5 15BPAC19 No. of Credits: 3

Objectives

 To apply and practice the skills needed for scientific research.  To understand the benefits of qualitative and quantitative research designs

Unit I Research Methodology 15

Defining research problems, Selection of problems, technique involved defining problem, Research design: Meaning of research design, need for research design, features of good design, different research designs, basic principles of experimental design. Steps on the research process, Selection and statement of problem, Formulation of hypothesis, Basic principles and methods of research designs. Research Ethics , review of literature, Research design, data collection, Pilot studies, Projects

Unit II Sampling and Data Collection 16

Definition of Population, Sampling: Definition, Types- simple, random, stratified, cluster, double sampling systematic sampling, Quota sampling, judgement sampling, accidental sampling- sampling and non- sampling errors..Sampling design, census and sample survey, Implication of a sample design, steps of sample.Need for sampling - Criteria for good samples, Application of sampling in community, Procedures of sampling and sampling designs errors. Data- why, what, from whom, when and where to collect. Data collection methods and instruments: Methods of data collection, Questioning, interviewing observations, record analysis and measurement. Types of instruments Validity and Reliability of the instrument Pilot study data collection procedure

Unit III Introduction to Statistics 16

Meaning, definition, characteristics of statistics. Importance of the study of statistics, Branches of statistics, Statistics and health science, Parameters and estimates, Variables and their types, Measurement scales. Tabulation of Data: Basic principles of graphical representation, Types of diagrams – histograms, frequency polygons, smooth frequency polygon, cumulative frequency curve, Normal probability curve. Measures of central tendency: Need for measures of central Tendency, Definition and calculation of Mean – ungrouped and grouped,

interpretation and calculation of Median-ungrouped and grouped, Meaning and calculation of Mode, Geometric mean and Hormonic mean, Guidelines for the use of various measures of central tendency.

Unit IV Measures of Dispersion 13

Range, mean deviation, standard deviation and variance. Probability and Standard Distributions: Meaning of probability of standard distribution, the binominal distribution, the normal distribution, Divergence from normality – skewness, kurtosis. Correlation and regression: Significance, correlation coefficient, linear regression and regression equation. Testing of hypotheses, Level of significance, Degrees of freedom. Chi-square test, test of Goodness of fit and student t-test.

Unit VDissemination of Report andHospital Statistics 15

Communication of research findings, Verbal report, Writing research report, Writing scientific article/ paper Critical review of published research and Utilization of research findings.

Hospital Statistics: Definition and scope – Birth and Death Registration – Functions and uses - record keeping, Methodologies: efficiency, barriers – essential health data with special reference to demography of population dynamic outpatient statistics - daily average outpatient attendance, average outpatient attendance etc. Inpatient statistics – Bed occupancy rate, bed turnover rate. Hospital morbidity mortality - gross and net death rate, Institutional death rate, anesthesia death rate, post operative death rate

Total Hours 75

Text Books:

1. Gupta, S.P, Statistical Methods, (1999).3rd edition, Educational publication, New Delhi.

2. Mangal, S.K, Statistics In Psychology and Education,(2002), 2nd edition, Prentice Hall. New Delhi.

Reference Book:

1. Gravetter, F.J. and Wallant, L.B,Statistics for Behavioral sciences,(2000). 5th edition, Wadaworth-Thomson learning, Singapore:

Allied-IV Bio medical Instrumentation and Scientific Measurements

Semester IV Hours of Instruction/week: 4+3 15BPAI04No. of Credits: 4

Objective  To gain knowledge about the functioning and operation of biomedical equipments in the hospital.

Unit I Basic Concept of Medical Instrumentationand Basic Sensors and 10 Principles

Terminology of medicine and medical devices, classifications of biomedical instruments, static and dynamic characteristics, different types of sensors and its principles, amplifiers and signal processing.

Unit II Origin of Bio Potentials and Electro Physiologic Equipments 10

Electrical activity of excitable cells, ENG, EMG, ECG, ERG, Audiometer, Phonocardiograph. Types of bio potential electrodes, Biotelemetry MRI., X-Ray, CT Scan.

Unit III Blood Pressure, Flow and Volume and Respiratory System 10

Measurements of blood pressure, indicator –dilution method, continuous and rapid injection. Electromagnetic blood flow meters, ultrasonic flow meters, thermal convection velocity sensors, chamber Plethysmography. Measurement of gas flow rate, lung volume, respiratory Plethysmography

Unit IV Clinical Equipments and Scientific Measurements 15

Electrochemical sensors, measurement of blood gas concentration, Spectrophotometers, electrophoresis, immunological methods, centrifugation techniques, chromatographic techniques, electrochemical techniques ventilators. Infusion and syringe pump medical gases (compressor, dryer, o2 and n2, cylinder).

Unit V Diagnostic and Therapeutic Equipment, Medical Imaging, Electrical 15

Safety cardiac pacemaker, defibrillator, hemodialysis, lithotripsy, ventilators, infant incubators, drug delivery devices, surgical diathermy. Computed radiography, 67

computed tomography, magnetic resonance imaging, nuclear medicine, SPECT, PET, ultrasonography .electrical safety, physiological effects of electricity, safety codes and standards, basic approaches to protection against shock. Ambulance and its power supply. General power supply, ups, convertor, invertor distribution.

Total Hours 60

Practical 45

List of Experiments

1. Study of electrodes. ECG

2. Study of Page writer, Phonocardiograph

3. Study of Defibrillator, Larynscope

4. Study of Ambu bag, Suction m/c

5. Vitals signs monitoring –BP andNIBP Monitoring

6. Study of Spirometer , Pulse oximeter. Temperature monitoring.

7. Study of X-Rays, MRI, CT Scan

8. Study of Vascular Doppler. TENS

Total Hours 105

Text Book:

1. John G.Webster, Medical Instrumentation - Application and Design (2007), 3 rd edition,

Reference Books:

1. Keith Wilson and John Walker, TB- principles and techniques of practical biochemistry, (2007). 4 thedition, Cambridge University press.

2. Cromwell Leslie ET AL, Biomedical Instrumentation and Measurement (2008).2nd edition.

Community Medicine

Semester V Hours of Instruction/week: 4 15BPAC21No. of Credits: 3

Objectives  Understand the concepts of community health and measures of levels of health.

 Learn the epidemiological methods.

Unit I Concepts in Health 10

Definition of health. Determinants of health. Characteristics of agent, host and environmental factors in health and disease and the multi factorial aetiology of disease. Modes of transmission of disease. Various levels of prevention and modes of intervention with appropriate examples. Hospital infections, disinfection, disinfestations and Sterilization. Disposal of hospital wastes. Indices used in measurement of health.

Unit II Community Health 15

Difference between community health and institutional health, Principles of community health, Qualities and functions of a community health worker. Aspects of community health: a) Family health services-maternal and child care and family planning services. b) School health services. Definition and Importance of community medicine and various terms.

Unit III Epidemiology 15

Definition, concept and role in health and disease. Definition of the terms used in describing disease, transmission and control. Natural history of a disease and its application in planning intervention. Modes of transmission and measures for prevention and control of communicable and non-communicable diseases. Definition, calculation and interpretation of the measures of frequency of diseases and mortality. Common sampling techniques, simple statistical methods for the analysis, interpretation and presentation of data, frequency distribution, measures of central tendency, measures of variability. Need and uses of screening tests. Accuracy and clinical value of diagnostic and screening tests (sensitivity, specificity, predictive values). Planning and investigation of an epidemic of a communicable disease in a community setting. Principle sources of epidemiological data. Various types of epidemiological study designs.

Unit IV Epidemiology of Specific Diseases and Occupational Health 10

Extent of the problem, epidemiology and natural history of the disease. Relative public health importance of a particular disease in a given area. Influence of social, cultural and ecological factors on the epidemiology of the disease. Control of communicable and non-communicable diseases: Case definition, Diagnosing and management (laboratory and treatment). , Principles of planning, implementing and evaluating control measures for the diseases at the community level bearing in mind the relative importance of the disease. Discuss prevention issues with regards to 5 levels of prevention. Occupational Health : Employees State Insurance Scheme. Identification of the physical, chemical and biological hazards to which workers are exposed while working in a specific occupational environment. Preventive measures against these diseases including accident prevention. Various legislations in relation to occupational health. Diagnostic criteria of various occupational diseases

Unit V Health Situation in India 10

Demography, mortality and morbidity profile and the existing facilities in health services. Causes of poor health. National plans to meet the needs-Control and eradication of various diseases-Nutritional programmes-Family Welfare programmes- Water and sanitation programme-Special programmes. Home visits:- Principle-Planning-Technique and evaluation- Equipment and their care.

Total Hours 60

Text Book:

1. Vidya Ratan, Preventive Social Medicine.(2001). 9th edition, J.P.Brothers Medical Publishers P. Ltd.

Reference Books: 1. MahajanB.K.,Text Book of Preventive and Social Medicine. (2003), J.P.Brothers Medical Publishers P. Ltd. 2. Jain.B , Preventive and Social Medicine.(2004) J.P.Brothers Medical Publishers P. Ltd 3. Park.K , Park’s Text Book of Preventive and Social Medicine(2009).20th edition, Banarsidas Bhanot

Medicine -III Semester V Hours of Instruction/week: 4 15BPAC22No. of Credits: 2

Objectives  Enable the students to evaluate each patient as a person in society and not merely as a collection of organ systems.  To develop an interest in and care for all types of patients.

Unit I Skin Diseases* 10

Clinical examination of skin diseases.Major manifestations of skin disease: various types of rash, Pruritis, Erythroderma, Urticaria, Photosensitivity, Blisters, Leg ulcer, Alopecia, Acne, Approach to patient with skin disease, Some common skin infections and infestations - scabies, fungal infections, pyoderma, Eczema, psoriasis and other erythematous scaly eruptions, Cutaneous drug reactions, Disorders of pigmentation, Disorders of the nails, Skin manifestations of systemic diseases

Unit II Neurological Diseases* 15

Clinical Examination Of Nervous System. Functional anatomy, physiology and investigations. Major manifestations of nervous system disease: Headache and facial pain, Raised intracranial tension Faintness, dizziness, syncope and vertigo, Sleep disorders, Disorders of movement, Ataxia, Sensory disturbances (numbness, tingling and sensory loss), Acute confusional states, Coma and brain death, Aphasias and other focal cerebral disorders, Speech, swallowing and brain-stem disturbance, Visual disturbances, Sphincter disturbances, Migraine and cluster headaches, Seizures and epilepsy, Cerebrovascular disease, Dementias, Acute and chronic meningitis, Viral encephalitis.

Unit III Diseases of Central Nervous System* and Oncology* 15

Diseases of cranial nerves. Intracranial tumours. Diseases of spinal cord. Multiple sclerosis and other demyelinating diseases, Parkinson’s disease and other extrapyramidal disorders. Cerebellar disorders. Motor neuron disease, Peripheral neuropathy, Neurological manifestations of system diseases, Nutritional and metabolic diseases of the nervous system, Myasthenia gravis and other diseases of neuromuscular junction, Diseases of muscle. Oncology: Cancer genetics. The diagnosis of malignancy. Response to treatment. Principles of chemotherapy. Principles of endocrine therapy. Principles of biological therapy. Haematological malignancy. The lymphomas bone marrow

transplantation. Myeloblative therapy. Paraproteinaemias, solid tumour. Pallative medicine and symptom control.

Unit IV Endocrinology and Metabolism* 10

Diabetes mellitus*-Clinical Examination of the Patient with Diabetes. Physiology, Pathophysiology and investigations, Etiology and pathogenesis, Hyperglycemia, Acute metabolic complications-Diabetic ketoacidosis, Hyperglycemic non-ketotic coma, Hypoglycemia, End organ damage, Management of diabetes, Long-term complications (micro and macrovascular), Long-term supervision, Special problems in management, Prospects in diabetes mellitus. Thyroid gland*- Clinical Examination of Thyroid Disease. Functional anatomy, physiology and investigations. Hyperthyroidism, Hypothyroidism, Thyroid enlargement, abnormal thyroid function test results. The reproductive system*-Male hypogonadism, Gynaecomastia, Impotence, Short stature and delayed puberty, Cryptorchidsm, Hirsutism, Secondary amenorrhoea, Infertility. The parathyroid glands*-Hypocalcaemia, Hypocalcemia. The adrenal glands*- The ‘Cushingoid’ patient, Adrenal insufficiency, Pheochromocytoma. The endocrine pancreas and gastrointestinal tract*-Spontaneous hypoglycemia, Disorders affecting multiple endocrine system. The hypothalamus and the pituitary gland. Hypopituitarism, Visual field defects, Galactorrhea.

Unit V Emergency Medicine 10

Cardiopulmonary resuscitation, Acute pulmonary oedema, Hypertensive emergencies, Diabetic ketoacidosis and hypoglycaemia, Status epilepticus, Acute severe bronchial asthma, Shock, Acute myocardial infarction, Upper GI bleed and hepatic coma, Diagnosis and management of comatose patient, Management of poisoning.

*Definition, Aetiological Factor, Pathophysiology, Signs and Symptoms, Investigations And Diagnosis, Differential Diagnosis, Principles of Treatment Total Hours 60

Text Books 1. Christopher Haslett, Sir Stanley Davidson, Davidsion’s Principles and Practice of Medicine,(2009).18th edition, Livingstone publications.

2. Parveen Kumar, Michael L Clark ,Kumarand Clark’ Clinical Medicine(2012).12th edition, Saunders Ltd Imprint.

Reference Books

1. Vasnaik, Essentials of Emergency Medicine, (2001) 2nd edition, J.P.Brothers Medical Publishers Ltd. 2. Dennis. L.Casper, Eugene Braunwald Antony Fauci, Harrison’s Principle of Internal Medicine, (2004). 16th edition, Mcgraw Hill Medical Publishing Division. 3. Michael Swarsh, Michael Glynn, Hutchison Clinical Methods –An Integrated Approach to Clinical Practice, (2007). 22 nd edition, Elsevier Saunders. 4. Mark Kinirons andHarold Ellis, French’s Index of differential diagnosis-An A-Z, (2005). 14th edition, Hodder Arnold -An Hachette UK Company

Medicine -IV Practical-III Semester V Hours of Instruction/week: 4 15BPAC23No. of Credits: 2

Objectives  Enable the students to evaluate each patient as a person in society and not merely as a collection of organ systems.  Develop an interest in and care for all types of patients

Practical 60

Under Physician Guidance

List of Procedures

1. Obtain a proper relevant history and perform a humane and thorough clinical examination including internal examinations and examinations of all organs / systems in adults. 2. Arrive at a logical working diagnosis after clinical examination.

3. Order appropriate investigations keeping in mind their need, relevance and cost effectiveness 4. Plan and institute a line of treatment which is need based, cost effective and appropriate for common ailments taking into consideration :- Patient, disease, Socio-economic status. 5. Recognize situations which call for urgent or early treatment at secondary and tertiary centers and make a prompt referral of such patients after giving first aid or emergency treatment. 6. Assess and manage fluid / electrolyte and acid-base imbalance.

7. Interpret abnormal biochemical laboratory values of common diseases.

8. Interpret serological tests such as VDRL, ASLO, Widal, HIV, Rheumatoid factor, Hepatitis and TORCH infections. 9. Demonstrate empathy and humane approach towards patients, relatives and attendants. 10. Demonstrate interpersonal and communication skills befitting a physician in order to discuss the illness and its outcome with patient and family. 11. Write a complete case record with all necessary details.

12. Write a proper discharge summary with all relevant information.

13. Write a proper referral note to secondary or tertiary centres or to other physicians with all necessary details. 14. Adopt universal precautions for self protection against HIV and hepatitis and counsel patients. 15. Skin sensitivity tests for drugs and serum.

16. Record and interpret an ECG and be able to identify common abnormalities like myocardial infarction and arrhythmias. 17. Start I.V line and infusion, Give intradermal / SC / IM / IV injections.

18. Insert and manage a C.V.P. line.

19. Conduct CPR (Cardiopulmonary resuscitation ) and first aid in newborns, children and adults including endotracheal intubation. 20. Pass a nasogastric tube, stomach tube and do stomach wash.

21. Catheterise bladder in both males and females.

22. Administer O by mask, catheter and O tent and be able to handle O 2 2 2 cylinder. 23. Provide first aid to patients.

24. Manage diarrhoeas / dysenteries; Assess dehydration; prepare and administer oral rehydration therapy (ORT). 25. Manage emergencies of drowning, common poisoning.

Total hours 60

Text Books:

1. Michael Swarsh, Michael Glynn, Hutchison Clinical Methods –An Integrated Approach to Clinical Practice, (2007). 22 nd edition, Elsevier Saunders. 2. Mark Kinirons andHarold Ellis, French’s Index of differential diagnosis-An A- Z, (2005). 14th edition, Hodder Arnold -An Hachette UK Company.

Reference Books:

Surgery-I Semester V Hours of Instruction/week: 3+2 15BPAC24No. of Credits: 3

Objectives  Diagnose and appropriately treat common surgical ailments.  Identify situations calling for urgent or early surgical intervention and refer at the optimum time to the appropriate centers.  Requisition and interpret basic relevant investigations

Unit I General Principles 10

Wound Healing and Management: Wound healing, classification, wound closure, types,physiology and types of wound infections. Scars: Hypertrophic scar and keloid; First aid management of severely injured, Asepsis, antisepsis, sterilization. Surgical sutures, knots, drains, bandages and splints, surgical infections and rational use of antibiotics: Causes of infection, prevention of infection, common organisms causing infection, Boils, cellulitis, abscess, and necrotising fasciitis. Tetanus and Gas gangrene: Prevention and treatment. Chronic specific infections: Tuberculosis, Filariasis, Leprosy. Antibiotic therapy. AIDS and Hepatitis B. Surgical aspects of diabetes mellitus. Bites and stings. Universal Precautions.Hospital infection. Mechanisms and management of missile, blast and gunshot injuries and RTA. Organ transplantation: Basic Principles. Nutritional support to surgical patients.

Unit II Skin and Blood Disorders* 15

Skin: Sebaceous cyst, dermoid cyst, lipoma, Haemangioma, Neurofibroma, pre-malignant conditions of the skin, Basal cell carcinoma, squamous cell carcinoma, Naevi and malignant melanoma. Sinuses and fistulae. Pressure sores: Prevention and management. Burns: Causes, prevention and first aid management; Pathophysiology; assessment of depth and surface area, fluid resuscitation. Skin cover; prevention of contractures Arterial Disorders: Features of limb Ischaemia, noninvasive vascular diagnostic tests, obliterative atheromatous disease, aneurysms, Raynaud’s syndrome, arterial emboli. Acute arterial obstruction: diagnosis and initial management; types of gangrene; diagnosis of chronic arterial insufficiency with emphasis on Buerger’s disease, atherosclerosis; Investigation in case of arterial obstruction. Amputations. Vascular injuries : Basic principles of management

Venous Disorders: Anatomy of venous system of lower limbs. Venouspathophysiology. Venous incompetence, Varicose veins: diagnosis and management; deep venous thrombosis; diagnosis, prevention, principles of therapy; thrombophlebitis pulmonary embolism. Lymph Nodes: Diagnosis and principles of management of lymphangitis, lymphedema, acute and chronic lymphadenitis; cold abscess; lymphomas; surgical manifestations of filariasis.

20 Unit IIIOphthalmology and Otorhinolaryngology*

Eye Lid, adnexa. orbital disorders: Stye, chalazion, Blepharitis, Dacryocystitis, proptosis, ptosis. Conjunctiva and cornea: Conjunctivitis, keratitis (corneal ulcer), Keratopathy, keratoplasty (eye donation) refractory surgery and contact lens. Uvea: Iridocyclitis, choroiditis. Lens: Cataract, Cataract surgery. Glaucoma and Glaucoma surgery: Retina and optic nerve: diabetic and hypertensive retinopathy. Inflammatory retinitis. Retinitis pigmentosa. Optic neuritis. Papill oedema. Retinal detachment. Vitreous haemorrhage. Squint, ocular nerve palsies. Vision assessment and refraction. Ocular instrumentation and equipment. Ocular pharmacology.

ENT Diseases: Nose and Sinuses: Surgical anatomy of the nose, investigation, trauma to the nose, epistaxis, nasal polyps. Nasal septum, rhinitis, external nasal deformity. Tumous of the nose, oparanasal sinus infection. Maxillary sinusitis. Ear: Surgical anatomy of the ear. Conditions of the external ear, middle and inner ear. Oral and Oropharyngeal cancer, premalignant lesions. Pharynx, Larynx and Neck: Clinical anatomy and physiology, investigation, examination. Diseases of the pharynx, tumours of the pharynx, larynx, Hoarseness of voice and Stridor, Dysphagia ( diagnosis and management). Neck: Trauma to the neck, inflammatory conditions of the neck.

Unit IVAnesthesiology 15

General Anesthesia: Indications, Balanced anesthesia, Amnesia, Analgesia, Need for paralysis, Mask ventilation, Intubation cart, Endotracheal tubes. Regional Anesthesia: Neuraxial anesthesia, Peripheral nerve blocks, Infiltration anesthesia. Drugs: Induction agents, Neuromuscular blocking agents, Opioids, Local anesthetics, Inhalational anesthetics, Reversal agents, Adjuvants. Monitoring: Oxygen saturation, Pulse rate, Electrocardiogram, Blood pressure, Endtidal carbon dioxide, Temperature, Urine output. Equipments Used : Anaesthesia machine, Pipeline source and cylinders, Laryngoscope, Face mask, Endotracheal tube, Airway and circuits, Suction catheter, Spinal and epidural needle, Epidural set, Block tray, Nerve 77

stimulator. Fundamentals of Anesthesia: Introduction neuronal basis of the anesthetic state, neuromuscular block and its antagonism. Effect of anesthesia on respiration. Oxygen therapy. Process of Anesthesia: Anesthetic machine and breathing apparatus, ventilators for anesthetic purpose. Tracheal intubation fluid therapy.Induced hypothermia. Regional Anesthesia: Pharmacology of local anestheticagents. The common nerve blocks. Spinal and extradural analgesia. Complicationsof regional anesthesia: epidural spinal and caudal anesthesia. Anesthesia of Pain Relief: General principles, local anesthesia.Peri op pain relief, post op pain relief, chronic pain relief.

Unit VHead and Neck Region* 15

Head: Congenital anomalies (cleft lip, cleft palate, branchial cyst and fistula,thyroglossal cyst) swellings of parotid and submandibular glands, oral ulcers, leukoplakia, submucous fibrosis, lichen planus, common jaw tumors, squamous carcinoma of oral cavity, pharynx and larynx.Thyroid swellings (adenomatous goitre, Graves’ Disease, papillary and follicular thyroidcancer).Swellings of lymph nodes (tuberculosis, lymphoma, metastatic carcinoma)Leukoplakia; retention cysts; ulcers of the tongue. Features, diagnosis and basic principles of management of carcinoma lip, buccal mucosa and tongue, prevention and staging of oral carcinomas. Salivary Glands: Acute sialoadenitis, neoplasms: diagnosis and principles of management. Epulis, maxillofacial injuries; salivary fistulae. Neck: Branchial cyst; cystic hygroma, Cervical lymphadenitis: Non specific and specific, tuberculosis of lymph nodes, secondaries in neck.Thoracic outlet syndrome: diagnosis.Thyroid: surgical Anatomy, Physiology, investigations of thyroid disorders; types, clinical features, diagnosis and principles of management of goitre, thyrotoxicosis and malignancies; thyroglossal cyst and fistula, Thyroiditis, Hypothyroidism.Parathyroid And Adrenal Glands: Clinical features and diagnosis of hyperparathyroidism, adrenal hyperfunction / hypofunction. Total Hours 75

*Pathogenesis, Causes, Clinical Presentation, Investigations, and Management of the Diseases

Text Books:

1. Bailey and Love – Textbook of Surgery for Medical Students. ELBS and H.K.Lewis andCompany Limited.

2. Norman S. Williams, Christopher J.K. Bulstrode, and P Ronan O’Connell, Bailey and Love's Short Practice of Surgery, (2008) 25 th edition Oxford University Press, USA

Reference Books:

1. Wilma Philipps, Barbara C Long,,Nancy Fugate Woods,Shaffer’s Medical and Surgical Nursing, 7th edition, B.I. Publications Pvt. Ltd.

2. Kochar.S.K,Common Surgical Emergencies, (2001), J.P.Brothers Medical PublishersP.Ltd.

Geriatrics

Semester V Hours of Instruction/week: 5 15BPAC25No. of Credits: 3

Objectives

 Enable the students to provide necessary care to older people in both hospital

sand home settings

 to organize and implement different health care programs for the oldest person

Unit IGerontology: 10

Definition and meaning of geriatrics, Physiological changes of aging: Age related physiological changes. Normal and abnormal aging, theories of aging. Metabolic and structural aspects of aging, biochemical changes in the normal aging brain, Aging in tissues and cells, Atherosclerosis and aging, Ecology of human senses, The mileau interior and aging.

Unit IIGeriatric Medicine 15

How are elderly patients different?, Common patterns of disease in old age, Alteration in pain and temperature responses, Atypical presentation, Complications of Illness, Non specific presentations, Masking by known disease, History taking in the elderly, Physical Examination of the old patient. Investigations in the Elderly*: Interpretation of radiological, hematological and biochemical investigations: ECG, Urinalysis, Radio isotope tests, Bone Scan, Imaging – Ultrasound, CT Scan, MRI.Pharmacological Aspects: Pharmacokinetics in the elderly, Pharmacodynamics, Drug Selection and Dosage, Drug Interactions, Adverse Drug Reactions, Drug Compliance, Drug Misuse.

*How much to investigate?, Concept of Normal Range

Unit IIICNS, Genito Urinary and Metabolic Disorders: 20

Metabolic Disorders: Changes with aging, Diabetes mellitus, Diseases of the Pituitary, Parathyroid and Thyroid, Obesity, Sexual dysfunction, Disorders of Sodium, Potassium, Calcium, Magnesium and Zinc, Disturbances of Fluid metabolism, Hyperpyrexia / Heat Stroke

Central Nervous System: The aging brain, Vascular lesions of the Central

Nervous System, Dementia, Degenerative disorders including Parkinsonism, Head Trauma, Infections of the nervous system, Epilepsy, Peripheral Neuropathy, Disorders of Spinal cord and Nerve Roots, Neoplasia

Genitourinary System: Structural changes with aging, Acute and chronic renal failure, Infections of the genito urinary tract, Diseases of the bladder and prostate, Urinary incontinence, Aging changes in the genital tract, Post menopausal bleeding, Gynaecological disorders in the elderly.

Unit IV Infections and Disorders of Elderly 15

Special Senses: Disorders of the Eye, Disturbance of Hearing,Taste and Smell.

Infections in the Elderly: Host Defences – Natural Barriers, White Cell response, Immune mechanism, Diagnosis of fevers, Urinary infection – Diagnosis and Treatment.Pneumonias – Cause, Diagnosis and Treatment, Septicemia, Bacterial Endocarditis, Antibiotic treatment, Rational use of antibiotics

Gastro Intestinal System: Changes with age, Investigations of the gastro intestinal tract, Disorders of the mouth, GERD / Hiatus Hernia, Acid Peptic Disease. Diseases of the Pancreas, Small Intestine, Large intestine. Fecal incontinence, GI Malignancy, Disease of the liver and Biliary System. Constipation – Prevention and Management

Unit V Systemic Changes in Elderly 15

Respiratory System: Changes with age, Infections of the respiratory system, Chronic Obstructive Airway Disease, Bronchial Asthma, Bronchogenic carcinoma, Respiratory Abnormalities in extra-pulmonary conditions, Respiratory Failure

Musculoskeletal System:The aging joints, Degenerative Joint Disease, Gout, Pseudogout, Rheumatoid Arthritis, Infective Arthritis, Myopathy, Myositis, Polymyalgia Rheumatica, Temporal artiritis, Osteoporosis, Osteomalacia

Hematopoietic System: Changes with aging, Anaemia in the elderly, Leukaemias and Lymphomas, Paraproteinaemia, Myelodysplastic syndromes, Disorders of Haemostasis

Dermatology:The Aging Skin, Pruritus, Cancers / Benign Lesions, Pemphigus and Pemphigoid, Senile Purpura, Herpes Zoster, Intertrigo, Leg Ulcer, Hansen’s Disease

Total Hours 75

Text Books: 1. Lesley Bowker, James Price, andSarah Smith, Oxford Handbook of Geriatric Medicine (2012).Oxford University Press

2. Fillit HM, Rockwood K and Woodhouse K. Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. (2010),7thedition, SaundersPublishers

Reference Books:

1. Kane R, Ouslander J, Abrass I, Resnick B., Essentials of Clinical Geriatrics: (2008), 6 thedition, McGraw-Hill Professional.

2. Koch S, Gloth FM, Nay R, Medication Management in Older Adults: A Concise Guide for Clinicians, (2010). 1st edition

Pediatrics

Semester V Hours of Instruction/week: 3+2 15BPAC26 No. of Credits: 3

Objectives  Diagnose and appropriately treat common paediatric and neonatal illnesses.

 Identify paediatric and neonatal illnesses and problems that require secondary and tertiary care.

Unit IHistory Taking and Physical Examination 10

Introduction: Clinical history, physical examination, examination of individual systems. Growth and Development:Anthropometric and developmental assessment, normal and abnormal growth and development patterns, interpretation of growth curves and road to health chart, detecting and assessing, developmental problems, behavioural problems.Psychological and behavioural problems. Approach to a child with growth retardation and short stature. Preventive Paediatrics: Principles of prevention. Immunization:Vaccines for preventable diseases, Principles of immunisation, Vaccine preservation and cold chain, Indications, contra-indications, adverse reaction and complications, Investigations and reporting of vaccine preventable diseases. Other newer vaccines– Haemophilus Influenza type b, pneumococcal, meningococcal, Varicella vaccine, Hepatitis A and B., Rubella vaccine, Influenza virus vaccine.

Unit II Common Childhood Diseases* 15

Infectious Diseases: Tuberculosis, mumps, rubella, Typhoid, chicken pox and parasitic infestations like Malaria, Mumps, and Common Childhood exanthematous fevers like measles. Amoebiasis Leptospirosis - Rubella, Paediatric HIV, Dengue viral Fever. Kala Azar.Cardiovascular System:Acute rheumatic fever, Rheumatic heart disease and complications, Recognition of congenital acyanotic and cyanotic heart diseases and management of cyanotic spells, Diagnosis and management of congestive cardiac failure.RespiratorySystem:Diagnosis and management of acute bronchial asthma, status asthmaticus, chronic suppurative lung diseases, Bronchiectasis, Bronchopnea, Pneumonitis. Diagnosis and appropriate management of foreign body aspiration.Endocrine System: Hypothyroidism (cretinism), Juvenile diabetes mellitus, CAH (Congenital Adrenal Hyperplasia).Haematological System: Newborn and older children, Leukaemia, Lymphomas. *Recognition of Clinical Features, Signs, Symptoms, Diagnosis, Laboratory

Investigations, Management and Prevention

Unit III Common Systemic Diseases* 20

Central Nervous System:Acute CNS infections, Meningitis including tuberculosis, Encephalitis, Seizure disorders, febrile convulsions, infantile hemiplegia. Cerebral palsy, Mental retardation, Hydrocephalus, Degenerative diseases. Gastrointestinal System:Gastro – oesophageal reflux, GI bleeding. Common hepatic disorders: Acute and chronic Hepatitis, Acute and Chronic diarrhoea and their complications. Hepato splenomegaly, Obstructive Jaundice, Portal Hypertension, Abdominal tuberculosis, chronic constipation and rectal bleeding.Genitourinary System: Acute glomerulonephritis; nephrotic syndrome, Urinary tract infection – acute and recurrent Acute and chronic renal failure. ENT:Otitis media, Allergic rhinitis, Acute and Chronic tonsillitis, Stridor. *Recognition of Clinical Features, Signs, Symptoms, Diagnosis, Laboratory Investigations, Management and Prevention

Unit IVNeonatology 15

Foetal physiology of normal pregnancy. Identification of antenatal, intrapartum and immediate postnatal risk factors, Definition, Identification and classification of high risk neonate, Neonatal resuscitation, Gestational age assessment and care of the normal newborn, Infection, Haemorrhagic Disease of Newborn, Respiratory distress syndrome, Breast feeding, Baby friendly initiative and Feeding difficulties, Birth injuries, Anaemia and Jaundice, CHD (Congenital Heart Diseases), Neonatal seizures.Care of the preterm and low birth weight infant: temperature maintenance, feeding, prevention of complications, appropriate method of transfer to tertiary centre. Identification and referral of neonates with congenital malformations like cleft lip, cleft palate, tracheo-oesophagal fistula, diaphragmatic hernia, anorectal anomalies

Unit VEmergency Paediatrics * 15

Status asthmaticus, Status epilepticus, Acute pulmonary oedema, Hypertensive emergencies, Peripheral circulatory failure due to dehydration, Haemorrhage and shock, Cardiac failure, Cyanotic spells, Scorpion and snake envenomation, and Common poisoning including neem oil, castor oil and accidental kerosene ingestion and RTA in Children.

*Clinical Features, Aetiology, Laboratory Diagnosis, Prevention and Management Total Hours 75

Text Book:

1. Nelson, Text Book of Pediatrics and Nelson Essentials of Pediatrics, (2008) Prism Books (p) ltd, 15th Edition

Reference Books:

1. Ghai O.P, Vinod.K.Paul, Aravind Bagga, Ghai Essential Pediatrics(2009), 7th edition,CBS Publishers 2. Ediz, Current Pediatric Diagnosis and Treatment12th Edition, Lange Medical Book.

Principles of Management (Self Study) Semester V Hours of Instruction/week: 1 15BPAC27No. of Credits: 4

Objective :  To give a proper understanding of the management concepts and techniques as a first step towards developing executives.

Unit I Principles of Management 3

Introduction: Definition, Organizational development, Types of organizations, Human Resource Development including HR Management Motivation in hospitals: Meaning, Types ,Motivational theories: Their impact on Hospital management, Motivating the employees hospitals Financial Management: Basic concepts and application of Operation Research Techniques

Unit II Evolution Of Management Science 3

Definition, nature, principle and process of management -management as science or art ,management as profession, professionalization of management in India, Integration of clinical practice and management Skills,Functions of Management: Planning, Organizing, Staffing, Directing, (Motivation – Communication – Leadership) ,Controlling - All basic theories and styles.

Unit III Leadership: 3

Definition of leadership, leadership style, Continuum of leadership behavior, Managerial grid style, Life-Cycle or situational approach-Four systems of management leadership, leadership skills , Leadership activities in a hospital, Functions of a leader like Communication, Human resource management, Net working.

Unit IV Individual Behavior: 3

Personality,Learning, Attitudes, Perception, Motivation, Ability, their relevance to organizational behaviors in hospital management , Group Behavior, Group dynamics ,Group norms , Group cohesiveness, their relevance to organizational behavior.

Unit V Organization 3

Fundamental concepts and principles, formal vs. informal organization, 86

classification of health care organization, design of organization structure for hospitals, authority and responsibility, line and staff relationship, Staffing and directing ,fundamentals of staffing, recruitment and selection, training and development, fundamentals of directing, motivation , leadership,supervision, Communication.

Total Hours 15

Text Book:

1. Tripathi.P.C , Reddy.P.N , Principles of Management, (2012). 5th edition, McGraw Hill Education India Pvt Ltd.

Reference Books:

1. Mukherjee, Principles of Management,Mcgraw-Hill Education (India) Ltd

2. Joan Liebler, Charles McConnell, Management Principles for Health Professionals, (2011). Jones and Bartlett Publishers.

Surgery –II

Semester VI Hours of Instruction/week: 4 87

15BPAC30 No. of Credits: 3

Objectives

 Provide adequate pre and post operative and follow up care of surgical patients.

 Counsel and guide patients and relatives regarding need, implications and problems of surgery in the individual patient.

Unit I Airway Management andHead Injury* 10

Intubation, Extubation, emergency airway management – indications, rapid sequence intubation, cricoid pressure, burp manouveure, cricothyroidotomy. Airway devices for paramedical personnel :cuffed oropharyngeal airway, laryngeal mask airway, combitube. Sedation – indications, conscious sedation, drugs. Pain management - drugs -neuraxial analgesia. Peripheral nerve blocks. Recovery -recovery from anaesthesia. Postoperative care - oxygen supplementation, monitoring, assessment of pain, discharge criteria.

Head Injury: Wounds of scalp and their management. Recognition, diagnosis and monitoring of patients with head injury including unconsciousness; Glasgow coma scale; recognition of acute cerebal compression. Thorax: Recognition and treatment of pneumothorax, haemothorax; pulmonary embolism; prevention / recognition and treatment; flail chest; stove in chest; postoperative pulmonary complications. Principles of management of pyothorax; cancer lung. Oesophagus: Dysphagia: Causes, investigations and principles of management. Cancer Oesophagus: Principles of management

Unit II Surgical Management of Gastro Intestinal System* 15

Stomach and Duodenum:Anatomy, Physiology; Congenital hypertrophic pyloric stenosis; peptic ulcer, upper gastrointestinal haemorrhage with special reference to bleeding varices and duodenal ulcer.Hemetemesis/ malena, gastric cancer.Liver:Amoebic liver abscess, hydatid cyst and portal hypertension, Liver injuries,Surgical anatomy: primary and secondary neoplasms of liver.Spleen: Splenomegaly: causes, investigations and indications for splenectomy, splenic injury.Gall Bladder And Bile Ducts:Anatomy, Physiology and investigations of biliary tree, cholelithiasis and cholecystitis; obstructive jaundice. Carcinoma gall bladder, choledochal cyst. Acute pancreatitis Chronic pancreatitis, cancer pancreas. Peritonitis: causes, recognition and principles of management intraperitoneal abscesses.Intestinal amoebiasis, tuberculosis of intestine, carcinoma colon; lower gastrointestinal haemorrhage, Ulcerative colitis, Premalignant conditions of large bowel. Intestinal Obstruction, Acute Abdomen, acute appendicitis, appendicular lump and abscess. Unit IIIGenito urinaryDisorders* 15

Investigation of urinary tract: Kidneys and ureters : Congenital abnormalities of

the kidney, ureter, renal pelvis. Injuries to kidney and ureter. Hydronephrosis renal calculi, ureteric calculus. Acute and pyelonephritis. Pyonephrosis. Perinephric abscess. Renal tuberculosis. Neoplasms. Urology : Symptoms and signs investigation. Hematuria and retention of urine. Prostrate, stricture of urethra. Scrotal swellings. Torsion of testis. Acute epididymo orchitis, penis. Tumours of kidney, bladder cancer, prostate cancer. Carcinoma of penis and testicular cancer. Rectum and anal canal : Surgical anatomy of rectum, prolapse carcinoma of rectum. Fissure in ANO, hemorrhoids. External Genitalia : Penis – Phimosis / Paraphimosis Carcinoma of penis, Carcinoma of rectum: indications and management of colostomy. Fissure, fistula in ano, perianal and ischiorectal abscess and haemorrhoids; Diagnosis and referral of anorectal anomalies. umbilical, inguinal and femoral hernia, urolithiasis, hydronephrosis, pyonephrosis, perinephric abscess and renal tumours. Renal tuberculosis. haematuria, anuria and acute retention of urine. Principles of management of urethral injuries.

Unit IV Principles of Cardiothoracic Surgery* 10

Thoracic trauma. Airway obstruction. Pulmonary neoplasms. The mediastinum. Pleural conditions. Chestwall and other thoracic disorders. Heart and pericardium: Cardiac surgery and cardiopulmonary bypass valvular, congenital and ischaemic heart disease. The thoracic aorta. The pericardium cardiac transplantation. Neuro surgery: Cerebral palsy. Polio and other flaccid paralysis inherited disorders. Spine, vertebral column and spinal cord : Anatomy of the spine and spinal cord. Assessment of spine. Spinal tumours, Spinal infection. Nerves : Principles of peripheral nerve surgery. Specific nerve injuries, Cranial nerves. Intracranial infection and tumours. Subarachnoid hemorrhage and aneurysm. Epilepsy and movement disorders.

Unit V Pediatric Surgery* 10

Neck swellings. Intestinal obstruction. Pyloric stenosis. Oesophageal atresia. Aspiration and ingestion of foreign bodies. Gastrointestinal bleeding. Intussuception. Malrotation and volvulus. Jaundice; surgical aspects. Abdominal Mass / Malignancy. Acute appendicitis. Constipation. Anorectal anomalies. Umbilical abnormalities. Inguinal hernia. Scrotal swellings. Hematuria and trauma. Prepuce and circumcision. Undescended testis and torsion. Hypospadias and urinary tract anomalies. Spina bifida. Hydrocephalus and neural tube defects.

*Etiopathogenesis, Clinical Features, Diagnosis and Principles Of Management

Total hours 60

Text Books:

1. Bailey and Love – Textbook of Surgery for Medical Students. ELBS and H.K.Lewis andCompany Limited.

2. Norman S. Williams, Christopher J.K. Bulstrode, and P Ronan O’Connell, Bailey and Love's Short Practice of Surgery, (2008) 25 th edition Oxford University Press, USA

Reference Books:

1. Wilma Philipps, Barbara C Long,,Nancy Fugate Woods,Shaffer’s Medical and Surgical Nursing, 7th edition, B.I. Publications Pvt. Ltd.

2. Kochar.S.K,Common Surgical Emergencies, (2001), J.P.Brothers Medical Publishers P.Ltd.

Surgery –III Practical-IV

Semester VI Hours of Instruction/week: 3

15BPAC31No. of Credits: 3

Objectives

 Provide adequate pre and post operative and follow up care of surgical patients.

 Counsel and guide patients and relatives regarding need, implications and problems of surgery in the individual patient.

Practical 45

Under Physician Guidance

List of Procedures

1. Obtain a proper relevant history and perform a humane and thorough clinical examination including internal examinations ( per-rectal and per- vaginal ) and examinations of all organs / systems in adults and children.

2. Arrive at a logical working diagnosis after clinical examination.

3. Order appropriate investigations keeping in mind their relevance (need based) and cost effectiveness.

4. Write a complete case record with all necessary details.

5. Write a proper discharge summary with all relevant information.

6. Obtain informed consent for any examination / procedure.

7. Be able to do surface marking of common superficial arteries, veins, nerves and viscera.

8. Access and manage fluid / electrolyte and acid base imbalance.

9. Adopt universal precautions for self protection against HIV and hepatitis and counsel patients.

10. Start intra venous line and infusion in adults, children and neonates.

11. Give intradermal / S.C. / I.M. / I.V. injection.

12. Insert and manage a C.V.P. line.

13. Conduct C.P.R. (Cardiopulmonary resuscitation) and first aid in newborns,

children and adults including Endotracheal intubation.

14. Pass a nasogastric tube.

15. Pass a stomach tube and do stomach wash.

16. Incise and drain superficial abscesses; do dressing.

17. Manage superficial wounds and do suturing of superficial wounds and wound toilet.

18. Remove small cutaneous / subcutaneous swellings.

19. Control external haemorrhage.

20. Catheterise bladder in both males and females.

21. Perform nerve blocks like infiltration, digital, pudendal, paracervical and field block.

22. Provide first aid to patients with peripheral vascular failure and shock.

23. Assess degree of burns and administer emergency management.

Text Books:

1. Bailey and Love – Textbook of Surgery for Medical Students. ELBS and H.K.Lewis andCompany Limited.

2. Norman S. Williams, Christopher J.K. Bulstrode, and P Ronan O’Connell, Bailey and Love's Short Practice of Surgery, (2008) 25 th edition Oxford University Press, USA

Reference Books:

1. Wilma Philipps, Barbara C Long,,Nancy Fugate Woods,Shaffer’s Medical and Surgical Nursing, 7th edition, B.I. Publications Pvt. Ltd.

2. Kochar.S.K,Common Surgical Emergencies, (2001), J.P.Brothers Medical Publishers P.Ltd

Trauma Care

Principles of Trauma and Disaster Management

Semester VI Hours of Instruction/week: 3+2

15BPAT32 No. of Credits: 4

Objectives

 Understand the roles and responsibilities of a Paramedic within an EMS System.  Be able to apply the advanced concepts of development, pathophysiology, cardiology, medical emergencies, traumatic emergencies, and special populations in the assessment and management of emergency patients.

Unit I Principles of Trauma Management 8

Definition of Trauma, General principles, Trauma as a disease, Trauma system planning, Pre-hospital triage, Pre-hospital treatment and transport decisions, Categorisation of hospitals, Trauma response and trauma teams, Special circumstances. Mechanisms of Trauma: Mechanism of injury. Principles of Kinetic Energy: Velocity, acceleration, deceleration, kinetic energy and gravity. Blunt and penetrating mechanisms of injury.

Pathophysiology of Trauma: Shock and cardiovascular physiology , Metabolic response to injury , Adult Respiratory Distress Syndrome (ARDS)

Goals of assessment and resuscitation: Specific goals, Deaths, Disability. Initial Assessment of the Trauma Patient: Principles of pre-hospital care, Major incident triage, Clinical assessment and scoring systems, Resuscitation after trauma, Management of the Unconscious Patient. Identify and prioritize patient treatment. Perform primary survey, Priorities of treatment and identification of life/limb- threatening injuries and resuscitation. X-rays for Traumatic patients, Shock, Cardiac arrest, Nasogastric tube, Urinary catheter. Perform a secondary survey as appropriate. Perform continual reassessment. Secondary survey (including revised trauma score), Principles of triage (sieve and sort). Understand the need for specialist assistance.Monitoring. Definitive care. Tertiary survey

Unit II Regional Trauma 8

Thoracic Trauma: Mechanisms of injury and causative effects to include specific blunt and penetrating trauma. Pathophysiology of injury. Importance and types of oxygen therapy (100% oxygen therapy). Recognition and management of tension pneumothorax, open pneumothorax, flail chest, haemothorax, Pericardial and cardiac tamponade. Pulmonary and Myocardial contusion, Thoracic great vessel injuries, Rupture of trachea or major bronchi, Trauma to oesophagus, Diaphragmatic injuries, Thoracic aorta rupture.Pericardiocentesis.

Abdominal / Pelvic Trauma: Mechanisms of injury- penetrating trauma and non- penetrating trauma, causative effects, Pathophysiology of injury, Importance of oxygenation. The Diagnostic Peritoneal Lavage (DPL). Pelvic fractures.

Head Trauma: Acute extra dural, Acute subdural haematoma, Base-of-skull fractures, Cerebral concussion, Depressed skull fracture, Intracerebral haematoma. Management of Head Trauma: ABC Management, Glasgow Coma Score (GCS) .Basic medical management for severe head injuries.

Spinal Trauma: Examination of spine-injured patient, Clinical findings indicating injury of the cervical spine, C-Spine. Neurological assessment: Assessment of the level of injury: Motor response, Sensory response.

Unit III Extremities Trauma and Environmental Emergencies 12

Extremities Trauma: Clinical Examination, Mechanisms of injury and causative effects, Diagnosis and Management: Operative Fracture management (closed, open and pathological), Compartment syndrome, Soft tissue management, Amputation. Non-operative management of fractures: Rehabilitation of the injured patient, The rehabilitation team, Pain management, Complications, Reconstructive surgery in non- unions/mal-unions. Soft Tissues Injuries : Nature and mechanism of soft tissue injury, Management of soft tissue injuries Assessment and Management of Environmental and Special Emergencies: Paediatrics: Paediatric Assessment Triangle (PAT), Using the PAT to evaluate severity and illness or injury category, pediatric primary survey, Interpretation of Breath Sounds , AVPU Neurological Assessment, Comparison between pediatric and adult cardiopulmonary assessment.

Burns: Clinical Examination,Diagnosis of Burns: Rule of Nines for Establishing Extent of Body Surface Burned, Burn Unit Referral Criteria. Management. Special burns: Electrical and Chemical Burns- Diagnosis and Management. RTA's and Whiplash Injuries. Hypothermia, Heat exhaustion, Management of radiation incident. Miscellaneous: Acute loss of vision, Red eye, Hepatitis B and HIV/Aids., Management and preparation for battlefield casualties, Principles of organ donation.

Unit IV Sports Injuries and Management 9

Emergency Situations, Primary and secondary emergency assessment, emergency plan, moving the injured participant. Cardio Pulmonary Resuscitation; Shock management, Internal and External bleeding, Splinting, Stretcher use-Handling and transfer, Management of Cardiac arrest, Acute asthma, Epilepsy, Drowning, Burn, Medical management of mass participation. Heat stroke and Heat illness. Sports specific injuries, with special emphasis on the specific risk factor, nature of sports, kind of medical intervention anticipated and prevention with respect to individual

sports : a. Individual events: Field and Track, b. Team events: Hockey, Cricket, Football, c. Contact and Non-contact sports, d. Water sports. Protective Equipments: Principles of protective equipment, Protective Equipment for: Head and Face, Upper and Lower Extremity.

Unit V Disaster Management 8

Meaning, Concept- Natural Disaster- Floods, Famine, Earthquake, Draught, Forest Fires, Coastal Hazards And Landslides. Manmade Disaster- Chemical and Industrial Accidents, Accidental Explosions, Bomb Blast, Nuclear Disasters, Pollutions. Factors Influencing Natural And Manmade Disaster-Political, Economic, Social, Cultural, Ideological, Ecological Institutional, Scientific And Technological. Disasters and Development- Causes and Consequences. Planning for Disasters-Disaster management- Control plan Emergency preparedness, Disaster management cycle – Post disaster review, results of exercises, prevention, mitigation, preparedness. Intervention of State in Disaster. Organization and Implementation of the Disaster Response. Promoting Mental Health: Pre disaster and Post disaster. Preparing Nursing Administrators, Faculty and Students for Disasters. Preparing Staff and inactive registered people to manage casualties. Role of Voluntary organization in Disaster management, Social Work Intervention in Disaster resource mobilization, working with other professionals. Considerations for vulnerable populations, Preparing to plan and care for children during disaster situations, Role of the infection control in disaster preparedness

Total Hours 45

Practical 30

List of Demonstrations:

1. Appropriate drug therapy in Emergency, CPR. 2. Care for unconscious patient, dying patient: signs of clinical death and signs of approaching death 3. Shifting of patient with various injuries 4. Hospital notification / patient handover / documentation 5. Demonstrate: a. Airway management b. Oxygen therapy c. I.V.cannulation d. Appropriate immobilization e. Patient monitory, appropriate equipments like collars, spinal board, 95

splintage f. Management of haemorrhage, Circulatory support, use and limitations of intravenous therapy g. Insertion of chest tube and care of patients with chest tube, closed chest drainage , gastro intestinal decompression Total Hours 75

Text Book:

1. Kochar. S.K. (2001), Principles and Practice of Trauma Care, J.P.Brothers Medical Publishers P. Ltd.

Reference Books:

1. Pons (2001), Pre hospital Emergency Care Secrets 1st edition J.P.Brothers Medical Publishers P. Ltd. 2. Sr.Nancy (2005), Stephanie’s Principles and Practice of Nursing – Senior Nursing Procedures,Volume-I and II .4th edition, NR Publishing House.

General Medicine

Obstetrics and Gynaecology-I

Semester VI Hours of Instruction/week: 5 96

15BPAM32 No. of Credits: 4

Objectives

 Provide quality maternal care in the diagnosis and management of Antenatal, Intra- natal and Post natal period of normal and abnormal pregnancy.  Provide effective and adequate care to the obstetrical and early neonatal emergencies

Unit I Anatomy and Physiology : 10

Pelvis, pelvic floor, anterior abdominal wall, abdomen, Uterus, supports of uterus, developmental anomalies of uterus, breast, and fetus. Fundamentals of reproduction: Gametogenesis, Ovulation, Menstruation fertilization, implantation and early development of human embryo. Placenta: development, structure, functions. Amniotic fluid: formation and function. Physiology of pregnancy: - maternal changes due to pregnancy, diagnosis of pregnancy-the fetus in normal pregnancy-prenatal care-drugs in pregnancy, antepartum fetal surveillance.

Physiology of labor and puerperium: causation and stages of labor the mechanism of labor-conduct of normal labor. -Intrapartum surveillance -normal puerperium- complications of pregnancy: - early pregnancy complications-anemia in pregnancy-hypertensive disorders of pregnancy-antepartum hemorrhage - abruptioplacentae and placenta previa-perterm labor-intrauterine growth restriction-prolonged pregnancy-multiple pregnancy-rhesus ISO immunization.

Unit II Abnormal Presentations and New Born 15

Abnormal Presentations and Contracted Pelvis: Causes, salient features; principles of management of occipito-posterior, face and brow presentation, Obstructed labour: definition, clinical features, prevention; mechanism of breech delivery. Multiple Pregnancies, Clinical features; diagnosis and complications; principles of management; investigations. Abnormal labor: abnormal fetal presentation- transverse / oblique lie -breech / compound presentations-dystocia-abnormalities of the reproductive tract-complications of the 3rd stage of labor-injuries to the parturient canal -puerperal infections. Obstetric operations:-forceps-versions and destructive operations-caesarean section-induction of labor.

The new born and neonatal problems:-examination and resuscitation of newborn- feeding and immunization of newborn-respiratory distress and neonatal sepsis- neonatal jaundice-neonatal problems and their management.

Unit III Disease and Infection during Pregnancy 20

Disease*: cardiovascular system, liver diseases, tuberculosis, maternal infections during pregnancy, diabetes, urinary system-tumors of the uterus and surgical emergencies during pregnancy, Definition; early detection; investigations; principles of management of pregnancy – induced hypertension and Eclampsia. Aetiopathology; differential diagnosis of convulsions in pregnancy; complications of eclampsia. Anaemia In Pregnancy: during pregnancy and labour.

Infections* in gynaecology: Pelvic inflammatory disease, Sexually transmitted disease, HIV in obstetrics and gynaecology, Benign disorders of female genital tract , Endometriosis and Adenomyosis, Benign lesions of the genital tract. Pelvic organ prolapse-Urinary and fecal incontinence (including fistulae).

(*Aetiology; Classification; Diagnosis; Investigations; Adverse Effects On The Mother and Foetus; Management)

Unit IV Pregnancy 15

Preparation of a patient for vaginal delivery, Preparation of a patient for abdominal delivery, Preparation of delivery room and setting up the table, Positioning the patient, Preparations for receiving the baby and arranging for the baby table, Post delivery care of the mother and baby, Perineal hygiene, breast feeding, care of the breasts. Management of Third Stage of Labor: Complications- predisposing factors; prevention; management of atonic post partum hemorrhage

Unit V Reproductive Endocrinology 15

Coagulation disorders in obstetrics, Imaging Techniques, Prenatal diagnosis.- 98

Contraception., Medical termination of pregnancy. Disorders of the development of mullerian system, Ovulation and menstruation. Gynecological history and examination-Pediatric Gynaecology.-Adolescent Gynaecology. Dysmenorrhea- Abnormal uterine bleeding-Amenorrhea and oligomenorrhea. Reproductive endocrinology: Puberty, Disorders or ovulation, Polycystic ovarian disease, Hirsutism. Infertility. Menopause and Hormone replacement therapy, Gynaecological oncology, Cancer screening, Pre invasive and invasive Cancer of the cervix - Ovarian Cancer, Uterine malignancy, Vulvar cancer, Gestational trophoblastic Neoplasia., Radiotherapy and chemotherapy in gynecological malignancies. Palliative care Total Hours 75

Text Books:

1. ArulkumaranSabaratnam, Sivanessaralnan V, Essentials of Gynaecology. J P Brothers Medical Publisher. 2. Bobak and Jenson, Maternity and Gynecologic Care. Mosby year book, INC.

3. Dutta. D.C, Text book of Gynaecology. New central book agency, Culcutta

Reference Books:

1. Swati Y Bhave , Ashwini Bhaleroa Gandhi (2007) Handbook of Adolescent Gynaecology and ARSH, Ist edition, Jain

2. Gautam N Allahbadia , Rubina Merchant , Hugo C Verhoeven , Rudy Leon De Wilde (2006) ,Gynecological Endoscopy and Infertility , Ist edition, Jain

Obstetrics and Gynaecology-II Practical-V

Semester VI Hours of Instruction/week: 5 99

15BPAM33 No. of Credits: 4

Objectives

Practical 75

Assist in the following procedures under the Physician Supervision.

1. Take history and examination of pelvic organs cases under the supervision

2. History taking and examination of a pregnancy woman

3. Watching progress of labour and conduct of a normal labour

4. Assist in the management of third stage of labour, prevention and treatment of post partum haemorrhage 5. Witness caesarean section, breech delivery, forceps and vacuum delivery

6. Essential care of a newborn

7. Non stress testing of fetus; biophysical scoring of fetus

8. Assist in the performance of minor surgical procedures

9. Perform IUCD insertion and removal

10. Determine gestational age

11. Obtain informed consent for any examination / procedure.

12. Write a complete case record with all necessary details

13. Write a proper discharge summary with all relevant information

14. Organise antenatal, postnatal, well-baby and other clinics

15. Plan and manage health camps such as family welfare camp

16. Do and examine a wet film of vaginal smear for Trichomonas and fungus

100

17. Assist in taking a pap smear.

18. Taking punch biopsy or cervix.

19. Conduct normal vaginal delivery

20. Do artificial rupture of membranes

21. Perform and suture episiotomies

22. Doing post partum tubectomy

23. Perform MTP in the first trimester and be able to do evacuation in incomplete abortion

24. Be able to diagnose and provide emergency management of antepartum and Postpartum haemorrhage

Text Books:

1. Arul kumaran Sabaratnam, Sivanessaralnan V, Essentials of Gynaecology. J P Brothers Medical Publisher. 2. Bobak and Jenson, Maternity and Gynecologic Care. Mosby year book, INC.

3. Dutta. D.C, Text book of Gynaecology. New central book agency, Culcutta

Reference Books:

1. Swati Y Bhave , Ashwini Bhaleroa Gandhi (2007) Handbook of Adolescent Gynaecology and ARSH, Ist edition, Jain

2. Gautam N Allahbadia , Rubina Merchant , Hugo C Verhoeven , Rudy Leon De Wilde (2006) ,Gynecological Endoscopy and Infertility , Ist edition, Principles of Emergency Medicine and Disaster Management

Semester VI Hours of Instruction/week: 5

15BPAM34 No. of Credits: 4

101

Objectives

Enables the student to

 understand the theoretical basis of organ dysfunction and critical illness  apply these principles to treat critically ill patients

Unit I Emergency conditions* 10

Acute myocardial infarction, tachyarrhythmias and bradyarrhythmias, Cardiac arrest, acute pulmonary oedema, endocarditis, myocarditis, pericarditis, Ischaemic heart disease, acute coronary syndromes, stable angina, Cardiac tamponade, hypertensive emergencies, pneumothorax, massive pleural effusion, pulmonary thromboembolism, perforation peritonitis, intestinal obstruction, diabetic ketoacidosis, Non-ketotic hyperosmolar diabetic coma Hypoglycemia, myxedema coma, Thyrotoxic crisis, acute renal failure, metabolic acidosis, cerebrovascular accident, epilepsy, meningitis, cerebral, Trauma and burns, Adrenal and thyroid emergencies, Allergic reactions, malaria, coma, dehydration, diarrhea, septicemia, common poisonings, drowning, electrical injury.

(*Definition, Etiological Factor, Pathophysiology, Signs and Symptoms, Investigations And Diagnosis, Differential Diagnosis, Principles of Treatment.)

Unit II Inflammatory and Renal disorders * 15

Inflammatory and Infectious disorders: appendicitis, cholecystitis, cholangitis, diverticulitis, exacerbations and complications of inflammatory bowel diseases, gastritis, gastroenteritis, and gastro-oesophageal reflux disease, hepatitis, pancreatitis, peptic ulcer, peritonitis. Metabolic disorders: hepatic disorders, hepatic failure. Traumatic and mechanical problems: foreign bodies, hernia strangulation, intestinal obstruction and occlusion

Renal: Olguria/ anuria, Acute renal failure, Renal Replacement Therapy (RRT), Continuous RRT Hematological: Disseminated intravascular coagulation and other coagulation disorders, Thrombocytopenia, Hypercoagulable states and anticoagulation - Hemolytic syndromes, Acute blood loss and anemia, Neutropenia , Blood component therapy. Toxicology: Acute intoxications, Drug overdose, Serious adverse reactions to drugs, Anaphylaxis, Envenomation.

102

(*Definition, Aetiological Factor, Pathophysiology, Signs and Symptoms, Investigations And Diagnosis, Differential Diagnosis, Principles of Treatment.)

Unit III Neurology * and Airway Management 20

Neurology: Coma, Status epilepticus , Head trauma, Intracranial hypertension, Cerebrovascular accidents and cerebral vasospasm, Meningo-encephalitis, Acute neuromuscular disease (including myasthenia and Guillain Barre syndrome), Post anoxic brain damage, Acute confusional states , Spinal cord injury, Neurosurgery – post-operative care, Brain death.

(*Definition, Aetiological Factor, Pathophysiology, Signs and Symptoms, Investigations And Diagnosis, Differential Diagnosis, Principles of Treatment.)

Emergency airway management: Introduction, Structure and function of the upper airways, Evaluation of the airway, Ventilation via mask ,Equipment and Technique, Laryngeal mask airway, Endotreacheal Intubation, Paediatric airway management, Complications of short-term Intubation, Extubation of the trachea, BCLS, ACLS, Indications, Defibrillation Methods, Complications, Difference between defibrillation and Cardio version.

Unit IV Introduction to Disaster 15

Disaster- meaning, concept- natural Disaster- floods, famine, earthquake, draught, forest fires, coastal hazards and landslides. Manmade Disaster: Chemical and Industrial Accidents, Accidental explosions, Bomb Blast, nuclear disasters, pollutions. Factors influencing natural and manmade disaster-political, economic, social, cultural, ideological, Ecological institutional, scientific and technological. Disasters and Development- causes and consequences, Planning for Disasters, Disaster management, Control plan Emergency preparedness, Disaster management cycle, Post disaster review, results of exercises, prevention, mitigation, preparedness..

Unit V Management of Disaster 15

Intervention of State in Disaster. Organization and Implementation of the Disaster 103

Response. Promoting Mental Health: Predisaster and Post disaster. Preparing Nursing Administrators, Faculty and Students for Disasters. Preparing Staff and inactive registered people to manage casualties. Management and preparation for battlefield casualties, Role of Voluntary organization in Disaster management, Social Work Intervention in Disaster resource mobilization, working with other professionals. Preparing Community health nurses and nurses in ambulatory health centers, Considerations for vulnerable populations. Preparing to plan and care for children during disaster situations

Total Hours 75

Text Books:

1. Dr. Narayan Reddy K.A, (2007) The Essentials of Forensic Medicine and Toxicology. 26th Edition. 2. Sha Chibber Chanclara , Mary Fvan Hazinski, Textbook of Basic Life support for Health Care Providers, Publisher American Heart Association.

Reference Books:

1. Kochar S.K. (2001), Principles and Practice Of Trauma Care by J.P.Brothers Medical Publishers P.Ltd.

2. Pons (2001),Pre Hospital Emergency Care Secrets 1st edition, J.P.Brothers Medical Publishers P.Ltd

Hospital Management

Semester VI Hours of Instruction/week: 5

104

15BPAM35 No. of Credits: 4

Objective:

 To familiarize the learner with the basic and advanced concepts of Hospital Management

Unit I Principles of Management 10

Definition, Organizational Development, Types of Organizations, Human Resource Development including HR Management, Motivation in Hospitals: Meaning, Types, Motivational theories, their impact on Hospital Management, Motivating the employee’s hospitals, Financial Management: Basic Concepts and application of Operation Research Techniques.

Unit II Patient Care And Behaviour 15

Introduction: Patient rights, Patient behaviour, Models of patient behaviour, Patient motivation, Patient perception, Attitudes, Attitude change, Personality, Patient involvement and Decision making, Reference group influence , Opinion leadership, Family decision making. Patient care: Introduction, Importance of improving the quality care of patients, role of natural and human resources in patient care management, patient counseling: for surgical procedures, for treatment, grief counseling; protocols, medicare standards. Hospital Administration: Role of Medical Superintendent, Hospital Administrator, Resident Medical Officer, Night Duty Executive; Public and guest relation; importance in patient care, information regarding patients, code of press relations, medical information, patient information booklets, attendants’ management.

Unit III Management of Out-Patient Department: 20

Planning of Out Patient Department: Objectives, Functions of Out Patient Department: Organization Structures, Day Care Centres, Community Health Care Centres, Physical Medicine and Rehabilitation Centre, Performance 105

Emergency Services: Managerial Issues in Emergency Department, Staffing of Emergency Department, Checklist Management. Patient Care in Out Patient Department: Emergency Operation Theatre Management: Planning and Organization of Minor Operation Theatre. Diagnostic Services of Out Patient Department: Referrals and Cross Referrals – Treatment

Unit IV Hospital Hazards 15

Fire Hazards- Elements of fire, Fire hazard triangle: Causes of hospital fires, Fire protection: Structure planning and design considerations, Buildings: Electric installations, Water supply, Fire points and Escape routes, Fuel store, Manual call points, Means of escape and evacuation, Risk evaluation.

Radiation- Biological effects of radiation, Radiation protection and safety, Principles in the layout of a diagnostic x-ray room, Contrast media, Magnetic resonance imaging, Planning constraints, Preventive measures against magnetic field hazards, Nuclear medicine department, Radiation protection aspects, Radioactive waste collection and Disposal procedure for obtaining clearance.

Unit V Bio Medical Waste Management 15

Biomedical Waste Management- Meaning, Categories of biomedical wastes, Disposal of biomedical waste products – Incineration and its importance, Standards for waste, Autoclaving, Micro waving and deep burial segregation, packaging. Transportation-Storage. Human waste disposal and sewage disposal- Diseases carried from excreta, Sanitation barrier, Methods of excreta disposal. Sewage wastes: Meaning, Composition, Aims of sewage disposal, Decomposition of organic matter, Modern sewage treatment, Drawbacks of improper disposal of wastes- Solid and liquid.

Total Hours 75

Text Books:

106

1. Sharma, (2006), Holistic approach to Hospital Waste Management published by Dept. of Hospital Administration AIIMS, New Delhi.

2. Shailendra K. Singh, (2006).Safety and Risk Management, Mittal Publishers.

Reference Books:

1. Diwan J.H, (2005) Safety, Security and Risk Management, APH .

2. Stephen Ayers and Garmvik, ( 2006) Text Book of Critical Care, Holbook and Shoemaker.

Obstetrics and Gynaecology

Clinical Obstetrics

Semester VI Hours of Instruction/week: 3+2 107

15BPAG32 No. of Credits: 4

Objectives

Enables the student

 Make diagnosis and organize management of antenatal, intranatal and postnatal period of normal and abnormal pregnancy.

 Apply knowledge of vital statistics in obstetrics and RCH programme.

Unit I Obstetrics in Broad Perspective 5

Aims of Obstetrics, Definition: Vital statistics, Birth rate, Maternal mortality, Perinatal, Neonatal mortality and Morbidity, Live birth, Still birth, Abortion, Period of viability. Obstetrics and other branches of medicine. Basic Anatomy: Normal pelvis- review attitude, lie, presentation and position, Relationship to other pelvic organs. Applied Anatomy as related to Obstetric and Gynecological surgery. Definition: Gametogenesis, Ovulation, menstruation, fertilization and implantation. Basic embryology, factors influencing foetal growth and development; anatomy of the embryo and placenta, placenta at term, functions, abnormalities, the foetal sac, amniotic fluid, the umbilical cord, Foetal circulation, foetal skull, bones, Sutures and measurements, Teratogenesis, placental barrier. Diagnosis: Clinical features; differential diagnosis; principles underlying the pregnancy tests.Immunological tests and their interpretation; ultrasonogram: Ultrasound evaluation in Ist trimester – including 11-14 weeks, Ultrasound evaluation in II nd trimester – Target Scan and ultrasound evaluation of Cervix, Ultrasound evaluation in III rd trimester – Growth Scan, Biochemical screening

Unit II Antenatal Care 10

Objectives of antenatal care, assessment of period of gestation, detect abnormality with the help of gravidogram, clinical monitoring of maternal and Antenatal Foetal Surveillance,fetal well-being, detect normal fetal pelvic relation (obstetrical palpation), advice regarding nutrition, drugs in pregnancy, immunization against tetanus, basic

108

investigations.Foetal well-being, biophysical monitoring; pelvic assessment.

Complications of Early Pregnancy: a) Abortions: Definition, Types, Causes, Management of incomplete, inevitable abortion. b) Ectopic Pregnancy: Clinical features; differential diagnosis of acute abdomen, principles of surgical management, causes and conservative management of ectopic pregnancy. c) Hyper emesis Gravidarum: Aetiopathology, Impact on maternal and foetal health; principles of management. d) Gestational Trophoblastic Tumours: Clinical features, differential diagnosis, principles of management, follow up, Laboratory investigations and ultrasonography.

Antepartum Haemorrhage: Classification, Aetiopathology, Clinical features, ultrasonography, differential diagnosis, complications and principles of management. e) Abnormal Presentations and Contracted Pelvis: Causes, salient features, principles of management of occipito-posterior, face and brow presentation. Obstructed labour: definition, clinical features, prevention, and mechanism of breech delivery. Intrauterine Growth Restriction (IUGR), Rhesus Negative Pregnancy.

Unit III Medical And Surgical Disorders Complicating Pregnancy 12

Multiple Pregnancies: Clinical Features, Causes, Investigation, Diagnosis, Complications, Principles of Management. Pregnancy Induced Hypertension: Definition, Aetiopathology, Early Detection, Investigations, Principles of Management. Eclampsia: Aetiopathology, Differential Diagnosis of Convulsions in Pregnancy, Complications of Eclampsia. Anaemia In Pregnancy: Aetiology, Classification, Diagnosis, Investigations, Adverse Effects on the mother and foetus, Management during Pregnancy and Labour. Other Medical Disorders like Heart Disease, Diabetes Mellitus and Urinary Tract Infection, Thyroid disorders, Bleeding disorders, Acute respiratory disorders, Bronchial asthma, Acute diarrheal disorders, Acute abdomen in Pregnancy, Urological problems in pregnancy, Infectious diseases, Trauma and Surgery in pregnancy, Immunizations during pregnancy, Travel during pregnancy: Clinical features, early detection, Complications, effect of pregnancy on the disease and impact of the disease on pregnancy. Abnormality of reproductive tract, Pre Term and post Term pregnancy, Obstetric Hemorrhage,PROM, Poly Hydramnios, Oligo Hydramnios. Diseases* and infections of fetus, abnormalities of placenta, Membranes and umbilical cord.

(*Etiology, Clinical Presentation, Investigation, And Management Of Common Diseases) . Unit IV Normal Pregnancy 10

109

Anatomical and Physiological changes in female genital tract during pregnancy. Management of Normal pregnancy: Prenatal care, Antepartum assessment of fetal well being, Antepartum diagnosis of Fetal Anomalie, Assessment of fetal lung maturity. Normal Labor: Physiology; mechanism in occipito-anterior presentation. Monitoring – Partogram, Mechanism of normal labour, Spontaneous labour and delivery:Induction of labourConduct of normal labour and delivery, Analgesia and anesthesia, Genetic counseling. Preparation of a patient for vaginal delivery, Preparation of a patient for abdominal delivery, Preparation of delivery room and setting up the table, Positioning the patient, Preparations for receiving the baby and arranging for the baby table, Post delivery care of the mother and baby, Perineal hygiene, breast feeding, care of the breasts. Management of Third Stage of Labor: Complications- predisposing factors; prevention; management of atonic post partum hemorrhage.

Abnormalities of Labour and delivery: Abnormalities of bony pelvis, presentation, position and development of Fetus. Abnormalities of expulsive forces. Abnormalities of soft tissue-reproductive tract, Parturition -Bio molecular process, Dystocia, Breach delivery-techniques, Abnormality of third stage, Puerperium, Puerperal Infections, Deep vein thrombosis and pulmonary embolism, Postpartum depression

Unit V Injuries and New Born care 8

Management of injuries to the lower genital tract. Uterine Dysfunction: Classification; recognition of uterine dysfunction; principles of induction and acceleration of labor. Development of placenta, Amniotic fluid, Anatomy of fetus, fetal growth and development, fetal physiology and circulation.Fetal Distress and Fetal Death: Clinical features; causes; diagnosis; principles of management; prevention. Hemolytic Disease Including Rh ISO Immunization Mechanism; Prophylaxis; fetal complications

Puerperium: Physiology; clinical features; complications: recognition and principles of management; prevention of puerperal sepsis.

Care of Newborn: Assessment of maturity; detect asphyxia; principles of resuscitation; common problems. Medical Termination of Pregnancy: Legal aspects; indications; methods; complications. Management of complications. Contraception: Various methods and devices; selection of patients; counseling of couples; side effects; failures and complications. Breast Feeding: Physiology of lactation; care of breasts; counseling regarding breast feeding; mastitis and breast abscess.

Operative Obstetrics: Indications and steps of operation: Caesarean section; assisted breech delivery. Indications, technique and complications for episiotomy, vacuum 110

extraction; low forceps, instrumental evacuation; menstrual regulation. External cephalic version; cervical cerclage; intra-amniotic instillation. Post-Caesarean Pregnancy: Risks; identification of scar dehiscence.

Total Hours 45

Practical 30

List of Demonstrations

1. Take history and examination of pelvic organs cases under the supervision

2. History taking and examination of a pregnancy woman

3. Watching progress of labour and conduct of a normal labour

4. Assist in the management of third stage of labour, prevention and treatment of post partum haemorrhage 5. Witness caesarean section, breech delivery, forceps and vacuum delivery

6. Essential care of a newborn

7. Non stress testing of fetus; biophysical scoring of fetus

8. Assist in the performance of minor surgical procedures

9. Perform IUCD insertion and removal

Total Hours 75

Text Books:

1. Bhargava V.L.(2009) Text book of Obstetrics for Undergraduates, ANE Books.

2. Shirish N. Daftary. (2011), Manual of Obstetrics, 3rd Edition, Elsevier.

111

Reference Books:

1. Sakala, (2001), Broad Review Series of Obstetrics and Gynaecology 2nd edition. J.P.Brothers Medical Publishers P.Ltd.

2. MudaliarA.L,.Krishna Menon M.K, (2005)Mudaliar and Menon’s Clinical Obstetrics, 10th edition, , Reprint 2009 Universities Press

Gynaecology

Semester VI Hours of Instruction/week: 3+2

15BPAG33 No. of Credits: 4

Objectives: 112

Enables the student

 Manage common gynaecological problems and emergencies  Provide adequate care of common gynaec problems and emergencies.

Unit I Anatomy and Physiology of Female Reproductive System 10

Anatomy and physiology of the female reproductive system: Abdomen, Pelvis, Pelvic Floor, Anterior Abdominal Wall, Breast, Uterus, Supports of uterus, Cervix Vagina, Ovary, Ovarian Duct, Congenital abnormalities of female reproductive system,.Physiology of menstruation and ovulation, Physiology of spermatogenesis, Endocrinology - hypothalamus pituitary, thyroid and adrenal glands Neurotransmitters, Applied Physiology. Normal and abnormal microbiology of genital tract and bacterial, viral and parasitic infections responsible for maternal fetal and Gynaecological disorders.

Puberty: Normal and Precocious, Physiology of Menstruation, Abnormal and Excessive Menstrual Bleeding: Definitions; classification of causes; clinical features; principles of investigation; diagnosis and management. Abnormal vaginal discharge: Physiological and Pathological Etiology; characteristics; clinical recognition; investigation; treatment of common causes; genital hygiene.

Unit IIMenstrual Dysfunction 5

Concept of Pre-menarche, menstruation, Menopause and Post-menopausal stages of life. Etiology, Pathophysiology clinical manifestation, diagnosis and treatment modalities of disorder of female reproductive system: Dysmenorrhea, Amenorrhea, Premenstrual syndrome, Abnormal Uterine Bleeding-DUB, Menorrhagia, Metrorrhagia., Oligomenorrhoea, Hyperprolactinemia,, abnormal sexual development, delayed puberty, hirsuitism, infertility, recurrent pregnancy loss Hirsutism, chronic anovulation and PCOD,. Thyroid dysfunction. Menopause: physiologic changes, symptoms, complications, its management, premature menopause, peri menopause concepts and Hormonal replacement Therapy.

Unit IIIInflammatory Diseases* and Neoplasm* 12

Pelvic inflammatory Disease, Ovarian and fallopian tube disorders, cysts, tumors, Uterine and cervical disorders. Endometriosis: normal appearances of the endometrium and uterine corpus at varying stages of life. Recognizing early

113

intrauterine pregnancy, Endometrial polyps, Hyperplasia, fibroids: Recognize fibroids (position and size) , Degeneration of fibroids , Possible central degeneration in setting of pain over fibroid uterus , Adenomyosis

Tumors of Pelvic Organs: Precancerous lesions of female genital tract (cervix, vagina, vulva), Benign and Malignant tumor of cervical ,ovarian, uterine cancer or endometrial , vulval and, vaginal - Aetiopathology; clinical features; differential diagnosis screening procedures; investigations; diagnosis; prevention, principles of management. Prevention of complications, .Breast diseases: Types; Aetiopathology; clinical features, principles of management

Unit IVInjuries to Female Genital Tract and Physiotherapy 10

Mechanical Disturbances: Retroversion, uterine displacement, Cystocele/ Urethrocele/ Rectocele. Injuries and Trauma to pelvic floor: ureteric and bladder injuries. Urological Problems: Incontinence, Stress incontinence Common urological problems in gynaecology - SUI, voiding difficulties, VVF, urodynamics, genital fistulae: Genital Injuries including fistula, Gential Displacements and Genital Prolapse: Aetiology; clinical features; differential diagnosis; principles of management; preventive aspects. Sexual violence.

Physiotherapy in obstetrics and gynaecology: Importance of exercise in health, Exercise in Pregnancy, Antenatal exercise, Postnatal exercise, Breathing exercises, Relaxation methods

Family planning: -Temporary and permanent methods of contraception, Legal issues. Male contraception-importance, methods.Female contraception-importance, methods. MTP Act and procedures of MTP in first and second trimester.( Recent Amendments, Legal/ethical issues), Emergency contraception. Recent advances.

Newer Diagnostic Aids – USG: Ultrasound Anatomy of Pelvis and USG related pathology of pelvis, Uterine and ovarian sonography, Transvaginal ultrasound and follicular monitoring, An understanding of the menstrual cycle, Pelvic inflammatory disease, Poly cystic ovarian syndrome, Endometriosis, Uterine fibroids, Adenomyosis and polyps, Endometrial pathology, Adnexal lesions . interventional sonography, endoscopy, Hysteroscopy, colposcopy, and vaginal and cervical cytology, other imaging techniques

114

Unit VInfections of the Female Genital Tract 8

Venereal and non venereal infections and discharges, Vaginal and vulval disorders

Toxic shock syndrome

Operative Gynaecology: Selection of case, technique and management of complications of minor and major gynaecology procedures: Abdominal and vaginal hysterectomy, Surgical procedures for genital prolapsed, Surgical management of benign and malignant genital neoplasm. Repair of genital fistulae, SUI, Operative endoscopy – Laparosocpic, diagnostic, simple surgical procedures, including laparoscopic tubal occlusion, endometrial ablative technique, Hysteroscopic: Indications, technique and complications: Dilatation and Curettage (D and C); Fractional curettage; cervical biopsy. Indications and steps of abdominal hysterectomy; surgery for ovarian tumours; vaginal surgery for utero-vaginal prolapse. Management of postoperative complications.

Total Hours 45

Practical 30

Assist in the following procedures under the Physician Supervision.

1. Obtain a proper relevant history and perform a humane and thorough clinical examination including internal examinations in adults and children

2. Arrive at a logical working diagnosis after examination

3. Order appropriate investigations

4. Determine gestational age

5. Obtain informed consent for any examination / procedure

6. Write a complete case record with all necessary details

7. Write a proper discharge summary with all relevant information

8. Organise antenatal, postnatal, well-baby and other clinics

115

9. Plan and manage health camps such as family welfare camp

10. Do and examine a wet film of vaginal smear for Trichomonas and fungus

11. Assist in taking a pap smear

12. Taking punch biopsy or cervix

13. Conduct normal vaginal delivery

14. Do artificial rupture of membranes

15. Perform and suture episiotomies

16. Doing post partum tubectomy

17. Perform MTP in the first trimester and be able to do evacuation in incomplete abortion

18. Insert and remove IUCD

19. Be able to diagnose and provide emergency management of antepartum and Postpartum haemorrhage

Total Hours 75

Text Books:

1. ArulkumaranSabaratnam, Sivanessaralnan V, Essentials of Gynaecology. J P Brothers Medical Publisher. 2.Bobak and Jenson, Maternity and Gynecologic Care. Mosby year book, INC. 3. Dutta. D.C, Text book of Gynaecology.New central book agency, Culcutta

Reference Books:

1. Swati Y Bhave , Ashwini Bhaleroa Gandhi (2007) Handbook of Adolescent Gynaecology and ARSH,Ist edition, Jain

116

2. Gautam N Allahbadia , Rubina Merchant , Hugo C Verhoeven , Rudy Leon De Wilde (2006) ,Gynecological Endoscopy and Infertility , Ist edition, Jain

Neonatology

Semester VI Hours of Instruction/week: 3+2

15BPAG34 No. of Credits: 4

117

Objectives

 Provide primary, secondary, and tertiary care to all newborn infants including intensive care of the highest standard to the critically sick neonates and very low birth weight infants using advanced therapeutic and supportive modalities and skills.  Effectively plan therapeutic, rehabilitative, preventive and promotive measures or strategies

Unit I Basic Science of Neonates 5

Definition: of Neonatology, Basic genetics, Fetal and neonatal immunology, Applied anatomy and embryology, Feto-placental physiology, Fetal growth, Neonatal adaptation, Physiology and Development of Respiratory system, Cardiovascular system, developmentaldefects, physiology and hemodynamics of congenital heart disease., Physiology and Development Nervous system, gastrointestinal system, Renal system, Hematopoietic system, Endocrinal system, Metabolic pathways pertaining to glucose, calcium and magnesium, Biochemical basis of inborn errors of metabolism, Electrolyte balance, Development pharmacology, Mechanism of diseases.

Unit II Perinatology 10

High Risk Pregnancy: detection, monitoring and management, impact on the fetus. Perinatal outreach services, Perinatal and neonatal mortality, morbidity, epidemiology (Perinatal Audit), Fetal monitoring: clinical, electronic; invasive, and non-invasive. Intrapartum monitoring and procedures, Assessment of foetal risk, and decision for termination of pregnancy. Diagnosis and management of fetal diseases Fetal monitoring, Fetal intervention Medical diseases affecting pregnancy and foetus, psychological and ethical considerations, Foetal interventions. Foetal origin of adult disease, Diagnosis and management of fetal diseases.

Newborn infant: Problems of prematurity, Immature development, Instability of the control systems in the premature infant, Dangers of oxygen therapy in prematurity. Care of the premature infant. Immunization, Injuries of the fetus and the newborn, Hydrops fetalis.

118

Unit III Neonatology 12

Neonatal resuscitation, Management of normal newborn, Management of LBW, VLBW, ELBW infants, Management of sick neonate, Emergency neonatal care, Thermoregulation, Neonatal transport, Fluid and electrolyte management, Neonatal ventilation, Blood gas and acid base disorders. Neonatal assessment: Assessment of gestation, neonatal behavior, neonatal reflexes, Developmental assessment, detection of neuromotor delay, stimulation Techniques.

Neonatal infections*: Intrauterine infections, Superficial infections, Diarrhea, Septicemia, Meningitis, Osteomyelitis and arthritis, Pneumonias, Perinatal HIV, Miscellaneous infective disorders and fungal infections.

*Etiology, clinical findings, and management.

Unit IV Respiratory and Cardiovascular System of Neonates 10

Neonatal airways: physiology, pathology; management, Pulmonary diseases: hyaline membrane disease, transient tachypnea, aspiration, Pneumonia, pulmonary air leak syndromes, pulmonary haemorrhage, developmental defects, Oxygen therapy and its monitoring, Pulmonary infections, Respiratory distress syndrome and meconium aspiration syndrome, Miscellaneous pulmonary disorders.

Cardiovascular system: Foetal circulation, transition from fetal to neonatal physiology, Examination and interpretation of cardiovascular signs and symptoms, Special tests and procedure (Echocardiography,angiography), Diagnosis and management of congenital heart diseases, Rhythm disturbances, Hypertension in neonates, Shock: Pathophysiology, monitoring, management.

Gastrointestinal system: Disorders of liver and biliary system, Bilirubin metabolism, Neonatal jaundice, Prolonged hyperbilirubinemia, Kernicterus, Congenital malformations, Necrotising enterocolitis.

Unit V Neurology 8

Clinical neurological assessment: EEG, ultrasonography, CT scan, Neonatal 119

seizures, Intracranial hemorrhage, Brain imaging, Hypoxic ischemic encephalopathy, Neuro-muscular disorder, Degenerative diseases, CNS malformation

Renal system: Development disorders, Renal functions, Fluid and electrolyte management, Acute renal failure (diagnosis, monitoring, management).

Endocrine and metabolism: Glucose metabolism, hypoglycemia, hyperglycemia, Calcium disorders, Magnesium disorders, Thyroid disorders, Adernal disorders, Ambiguous genitalia, Inborn errors of metabolism

Hematology: Physiology, Anemia, Polycythemia, Bleeding and coagulation disorders, Rh hemolytic disease, Blood Component therapy

Total Hours 45

Practical 30

Assistance in the following procedures under the Physician Supervision

1. Neonatal examination and anthropometry

2. Developmental assessment

3. Neonatal resuscitation

4. Neonatal ventilation: CPAP, Mechanical ventilation

5. Blood sampling: Capillary, venous, arterial

6. Insertion of peripheral venous, umbilical venous and arterial catheters

7. Monitoring: invasive, non-invasive

8. Enteral feeding (katori-spoon, gavage, breastfeeding)

9. Lactation management

10. Parenteral nutrition

11. Endotracheal Intubation

12. Lumbar puncture and ventricular tap

13. Placing of “chest tube”, Exchange transfusion

120

14. Bed side tests: shake test, sepsis screen, hematocrit, glucose estimation, urine examination, CSF examination, Kleihauer technique, Apt test etc.

15. Neonatal drug therapy

16. Nursery housekeeping routines

17. Infection control and Universal precautions

18. Handling, effective utilization and trouble shooting of neonatal equipment.

19. Decision making, clinical diagnosis, and investigations Management of Neonatal problems

Total Hours 75

Text Books:

1. Avroy A Fanaroff, Richard J Martin, (2010),Neonatal –Perinatal Medicine Diseases of the Fetus and Infant, 9th edition, Mosby.

2. Gordon Avery, Mary Ann Fletcher, MacDonald M.G. (2009) Neonatology Pathophysiology and Management of the Newborn , 5th edition, Mosby

Reference Book

1. William Taeusch H, Roberta A. Ballard, and Christine A. Gleason (2005). Avery's Diseases of the Newborn, 8 thedition, Elsevier.

2. Janet M Rennie, Roberton N.R.C (2012) .Rennie and Roberton’s Textbook of Neonatology, 5 th edition, Elsevier Limited

Infertility

Semester VI Hours of Instruction/week: 3+2

15BPAG35 No. of Credits: 4

121

Objectives

Enables the student to

1. do methodical investigation of problems leading to infertility in individual couples.

2. categorize them according to clinical condition.

Unit I Concept of Infertility 5

Infertility -Meaning, Physiology of Ovulation cycle, Ovulation, Fertilisation, implantation, Endocrinology related to reproduction , Methods of contraception

Embryology: the various stages of oocyte and sperm maturation and of fertilisation, the pre-implantation development of the human embryo in vitro and in vivo.

Genetics: normal genetics (e.g. Mendelian inheritance, the structure and identification of chromosomes and gametogenesis), inherited causes of infertility and early pregnancy loss, genetic aspects of artificial insemination and assisted fertilization, techniques, methods and implications of preimplantation genetic diagnosis. Anatomy, Physiology and pathophysiology:neuroendocrine regulation of the menstrual cycle, neuroendocrine function of the fetus and placenta, hypothalamic and pituitary hypopituitarism and disorders of over secretion of pituitary hormones.

Ovarian Function and Disease: ovarian activity during gestation, age-related changes in ovarian structure and function, clinical and pathophysiological correlates of disorders of the human ovary.

Menstruation: the pathophysiology of disorders of menstruation; anovulation and the resultant hormonal changes indicating any effect on the endometrium, including endometrial hyperplasia.Management of non-gynecological causes of abnormal bleeding (e.g., hypothyroidism, blood dyscrasias and anti-coagulants).

Unit II Female Infertility

Causes: Anovulation: basal body temperature, plasma progesterone and endometrial biopsy; diagnosis of causes of anovulation: Polycystic ovary syndrome (PCOS), Hypothalamic dysfunction, CNS-hypothalamic- pituitary syndromes, Premature

122

ovarian insufficiency, hyperprolactinemia and other causes, selection of ovulation induction utilising anti-oestrogens, gonadotrophins, dopamine agonists, GNRH, GNRH analogues and other agents; Damage to fallopian tubes:including correct use of and interpretation of studies of tubal function (e.g., ultrasound, hysterosalpingography and laparoscopy), indications for tubal reparative procedures including micro-surgery/ or laparoscopic surgery, versus assisted conception, endometriosis and other peritoneal disorders: including diagnosis and staging of endometriosis and other peritoneal causes of infertility, knowledge of the medical management of endometriosis. Abnormal uterus, Congenital abnormalities, Behavioural problems, Environmental and Occupational Factors, Hormonal, Uterine, cervical causes: including tests for sperm/cervical mucus interaction and possible therapy, Unexplained infertility, Risk factors of infertility. Fertility tests: Ovulation testing, Ovarian reserve testing. Other hormone testing. Levels of ovulatory hormones thyroid and pituitary hormones. Imaging tests. Other imaging tests: hysteroscopy, Laparoscopy, Genetic testing.

Unit III Fertility Restoration 12

Restoration: a) Stimulating ovulation with fertility drugs: Clomiphene citrate, Gonadotropins, Metformin, Letrozole.,Bromocriptine.. Risks of fertility drugs: Pregnancy with multiples. Ovarian hyper stimulation syndrome (OHSS). Long-term risks of ovarian tumours. .b) Surgery: Laparoscopic or hysteroscopic surgery, Tubal ligation reversal surgery (microscopic), Tubal surgeries. Other Methods: artificial insemination including the indications and contra-indications; selection of donors and sperm banking, ovum donation: indications, recruitment, counselling and methods for preparation of donors and recipients, adoption: including the indications for adoption; knowledge of appropriate counselling methods; familiarity with various local agencies and legal implications dealing with adoption. Surrogacy: indications, knowledge of appropriate counselling methods.

Unit IV Male infertility 10

Anatomy of Male Reproductive system: Testes,epididymis,vas deferens,ejaculatory duct,urethra,prostate gland, seminal vesicles, Cowper’s glands, scrotum. Physiology of reproductive system: spermatogenesis. Causes of infertility: Smoking, Hormonal disturbances-testosterone , lutenizing hormone (LH) and follicle stimulating hormone, seminal fluid formation and content ,the cycle of spermatogenesis, including endocrinological control mechanisms, its abnormalities and the effects of drugs, the physiology and pathophysiology of sexual function, causes of azoospermia and aspermia, the biosynthesis of oestrogens, androgens and progestogens by the human testis and the biological action of testosterone in man, investigation, diagnosis 123

and therapy of infection of the male reproductive system, cryobiology of semen, counselling of donors and recipients of DI, sperm banking, in vitro and laboratory tests of sperm function e.g., mucus penetration, zona free hamster egg penetration, biochemistry etc, the value and limitations of testicular biopsy and endocrine assessment such as plasma FSH, vasography, the physiology of endocrine and gametogenic function of the testes and accessory glands. Sperm Abnormalities: Defining Sperm Abnormalities, Oligospermia, Azoospermia, Dysspermia, Aspermia, Sperm: Sperm motility, Sperm morphology, Low Sperm Count, Sperm Motility, Sperm Morphology, Genetic Fragmentation, Sperm Abnormalities: A very large round head, An extremely small pinpoint head, A tapered head, A crooked head, Two heads, A tail with kinks and curls., Causes, Diagnosis, Treatment.

Unit V Management of Infertility 8

Common Infertility Tests:Hysterosonogram, Hysterosalpingogram, Clomid Challenge Test, Progesterone – Day 21, Semen Analysis, Endometrial biopsy.

Management: Induction of Ovulation, Ovarian Hyperstimulation Sydrome , Management of Endometriosis with Infertility ,Management of Fibroids with Infertility ,Endoscopic Surgery in Infertility

Assisted Reproductive Technology:Indications and methods of assisted fertilisation, methods of surgical sperm retrieval. IUI (intrauterine insemination), IVF (in vitro fertilization): Factors to Consider with In Vitro Fertilization, Prior to the IVF Procedure, Egg Retrieval and Fertilization, Embryo Transfer, After Embryo Transfer, Risks of In Vitro Fertilization. GIFT (gamete intra fallopian transfer) ,ZIFT (zygote intrafallopian transfer) other assisted reproductive technologies Donor egg IVF, Embryo cryopreservation -frozen fertilized Sperms, Oocytes, Embryos, Ovarian tissue. intracytoplasmic Sperm Injection (ICSI): Post Oocyte collection, Fertization check, Embryo grading. Artificial: Intrauterine insemination (IUI): Selection and steps , IUI Lab set-up and Semen preparation Techniques , Stimulation Protocols for IUI . Ultrasound in infertility. Treating Recurrent pregnancy loss, Third Party Reproduction. Motherhood beyond reproductive age group. Complications of ART.

Total Hours 45

Practical 30

Trained to be competent in interpretation and ultrasound skills

124

1. Appearance of normal and abnormal uterus including fibroids

2. Endometrial assessment including normal cyclical changes, changes associated with hormone replacement, hyperplasia and malignancy

3. Assessment of ovarian, parovarian and tubal masses

4. Tracking of folliculo genesis and formation and disappearance of corpus luteum

5. Use of ultrasound for assessment of tubal patency using contrast media

6. Confirmation of intrauterine gestational sac with embryo, yolk sac, cardiac pulsation

7. Diagnosis of ectopic pregnancy

8. Assessment of gestational age

9. Assessment of cervical length and dilation.

10. Interpret hysterosalpingography

11. Endocrinological measurement of hormonal substances in biological fluids including the hypothalamus, pituitary, parathyroid, thyroid, adrenal gonadal systems and pregnancy.

Total Hours 75

Text Books:

1. Fritz, Marc A. and Leon Speroff, (2005). Clinical Gynecologic Endocrinology and Infertility8th edition. Lippincott Williams and Wilkins

2. Gautam N Allahbadia , Rubina Merchant , Hugo C Verhoeven , Rudy Leon De Wilde (2006) ,Gynecological Endoscopy and Infertility , Ist edition, Jain

Reference Books:

125

1. Dan I. Lebovic, John David Gordon, Robert N. Taylor (2005) Reproductive endocrinology and infertility: Handbook for clinicians, Scrub Hill Press

2. John David Gordon, Leon Speroff, (2001) Handbook for Clinical Gynaecologic Endocrinology and Infertility, Lippincott Williams and Wilkins

3. David B. Seifer, Leon Speroff (1999). Clinical Gynecologic Endocrinology And Infertility: Self Assessment And Study Guide, Lippincott Williams and Wilkins.

Ophthalmology

Ocular Diseases

Semester VI Hours of Instruction/week: 5 126

15BPAO32 No. of Credits: 4

Objective

 Understand the indications, contraindications, and side effects of medications used in Ocular treatment

Unit I Anatomy of Eye 10

Surface anatomy of the orbit, Nerve supply and blood supply of Extra-ocular muscles, Neural basis of eye movements – 3rd, 4th, 5th and 6th Cranial nerves. Sclera: Anatomy, Anterior and Posterior scleral foramen, Emisaria, Cornea – Structure, transparency, nerves, limbal transition zone, Iris – Structure, Sphincter pupillae, Dilator Pupillae, blood vessels movement of fluid across iris. Ciliary body – Pars plana, pars plicata, blood supply and Nerve supply, Blood supply, accommodation, presbyopia, Aqueous secretion. Retina – anatomy, photoreceptors, general architecture. Refractive media: Anterior chamber relation, Anterior chamber outflow apparatus, Lens structure, Vitreous gross and microscopic anatomy. Eyelids: Orbicularis oculli and levator palpebrae superioris, Anatomy blood supply, nerve supply. Adnexa: Lacrimal apparatus, Embryology and development of eye.

Unit II Diseases of Eyelid and Related Structures 15

Eyelids: Eyelid anatomy, Congenital and developmental anomalies of the eyelids, Blepharospasm, Ectropion, Entropion, Trichiasis and symblepharon, Eyelid inflammations, Eyelid tumours, Ptosis, Eyelid retraction, Eyelid trauma. Lacrimal system: Lacrimal system, Lacrimal pump, Methods of lacrimal evaluation, Congenitial and development anomalies of the lacrimal system, Lacrimal obstruction, Lacrimal sac tumors, Lacrimal trauma. Sclera, Episclera: Ectasia and staphyloma, Scleritis, episcleritis .Orbit: Orbital anatomy, Incidence of orbital abnormalities, Methods of orbital examination, Congenital and developmental anomalies of the orbit, Orbital tumours, Orbital inflammations, Sinus disorders affecting the orbit, Orbital trauma. Conjunctiva and Cornea: Inflammation, Therapeutic principles, Specific inflammatory diseases. Other disease: orbit cellulites, belpharitis, ulcerative, Squamous, hordeclum excretunum, hordeolum internum chalazion, trichiasis Entropion, ectropion, chronic dacryocystitis, acute dacryocystitis, dacryocystectomy, dacryocystorhinostomy, squint, paralytic squint, convergent squint, divergent squint, investigation, treatment, management 127

of ocular emergencies.

Unit III Diseases of Eye 20

Vitreous: Developmental abnormalities, Hereditary hyaloidoretinopathies, Juvenile, retinoschisis, Asteroid hyalosis, Cholesterolosis, Vitreous haemorrhage, Blunt trauma and the vitreous, Inflammation and the vitreous, Parasitic infestations, Pigment granules in the vitreous, Vitreous complications in cataract surgery. Retina: Retinal vascular diseases, Diseases of the choroidal vasculature, Bruch’s membrane and retinal pigment epithelium (RPE), Retinal tumors, Retinoblastoma, Phakomatoses, Retinal vascular anomalies, Retinal and optic nerve head, astocytomas, Lymphoid tumors, Tumors of the retinal pigment epithelium, Other retinal disorders, Retinal inflammations, Metabolic diseases affecting the retina, Miscellaneous disorders, Electromagnetic radiation effects on the retina, Retinal physiology and psychophysics, Hereditary macular disorders (including albinism), Peripheral retinal degenerations, Retinal holes and detachments, Intraocular foreign bodies, Photocoagulation. Other disesases: Acute catarrhal or mucopurulent conjunctivitis Purulent conjunctivitis; opthalmia neonatorum, membranous conjunctivitis, Trachoma, phlectenular -conjunctivitis, Spring catarrh ,Vernal -conjunctivitis, pingnecula, pterygium,xerosis, purulent keratitis, corneal ulcer, hypopyon ulcer, bacterial fungal and viral, marginal ulcer, phlectenular keratitis, viral keratitis, episcleritis, scleritis- iridocyclitis, purulent uvetitis, panaphthalmitis Endophthalmitis, extra ocular -foreign body, intra ocular foreign body, burns, chemical injuries, contusion –injuries, perforating injuries, sympathetic opthalmitis.

Unit IV Disorders of Eye 15

Neuro-ophthalmology: Neuro-ophthalmic examination, History, Visual function testing, Technique of papillary examination, Ocular motility, Checklist for testing, Visual sensory system, The retina, The optic disc, The optic nerve, The optic chiasm, The optic tracts, The lateral geneculate body, The optic radiations, The visual cortex, The visual field, The blood supply of the anterior and posterior visual systems, Disorders of visual integration, Ocular motor system, Supranuclear control of eye movements, Saccadic system, Clinical disorders of the saccadic system, Gaze palsies, Progressive supranuclear palsy, Parkinson’s disease, Ocular motor apraxia, Ocular oscillation, Smooth pursuit system and disorders, Vergence system, Cerebella system, Non-visual reflex system, Position 128

maintenance system, Nystagmus, Ocular motor nerves and medial longitudinal fascicules, the facial nerve, Pain and sensation from the eye, Autonomic nervous system, Selected systemic disorders with neuro-ophthalmologic signs. Lens: Anatomy and Pathophysiology, Normal anatomy and aging process, Developmental defects, Acquired lenticular defects. Trauma: Anterior segment trauma, Posterior segment trauma. Blindness: Blindness – definitions, Causes, Social implications, Rationale in therapy, Drug induced ocular diseases. Glaucoma: Congenital Glaucoma, Buphthalmos, Primary open angle Glaucoma, Closed Glaucoma, Secondary Glaucoma, Investigations, Provocative tests, Diurnal variation treatment, Field defect ,Medical and surgical treatment, Hypertensive retinopathy; Diabetic retinopathy, Retinitis pigmentosa, Optic Neuritis, Optic Atrophy consecutive -optic, Atrophy Glaucomatous optic atrophy.

Unit V Tumors of Eye 15

Tumors of epithelial origina, Glandular and adnexal tumours, Tumours of, neuroectodermal origin, Vascular tumours, Xanthomatuos lesions, Inflammatory lesions, Metastatic tumours, Degenerations and dystrophies: Definitions Degenerations, Dynstrophies, Miscellaneous conditions, Keratoconjuctivitis Sicca (K Sicca), Tear function tests, Stevens – Johnson syndrome, Ocular Rosacea, Atopic eye disorders, Benign mucosal pemphigoid (BMP) – ocular pemphigoid, Vitamin A deficiency, Metabolic diseases associated with corneal charges. Iris, Ciliary body and Pupil: Congenital anomalies, Primary and secondary disease of iris and ciliary body, Tumors, Anomalies of papillary reactions. Choroid: Congenital anomalies of the choroids, Diseases of the choroid and Tumors.

Total Hours 75

Text Book: 129

1. Jack J. Kanski, (2007) Clinical Ophthalmology: A Systematic Approach 6thedition, Butterworth-Heinemann

Reference Books:

1. Khurana A. K, (2007). Comprehensive Ophthalmology,4 thEditionAnshan Publishers.

2. Ramanjit Sihota and Radhika Tandon Parsons (2011), Diseases of the Eye, Elsevier India

Contact Lens

Semester VI Hours of Instruction/week: 3+2

130

15BPAO33 No. of Credits: 4

Objectives

 Designing and fitting of contact lenses, aniseikonic lenses and low vision aids.

Unit I Basics of Lens 8

Corneal anatomy and physiology, Corneal physiology and contact lens, Microbiology and Immunology in relation to Contact Lens wear, Vision and Optics with Contact Lenses. Indications and Contraindications of Contact lens. Preliminary measurements and investigations, Optics of Contact Lens, Appearance of Contact Lenses, Pre and Post Contact lenseaning. Contact lens history and development. Benefits of contact lens over spectacle. Manufacturing methods-spin cast, Lethe cut, Cast modelling. Slit lamp Examination technique: Direct, focal, retro, sclerotic scatter and corneal endothelium specular reflection, illumination techniques, Estimation of anterior chamber depth and angle configuration, Illumination filters, Diagnostic lenses, including 90 or 78 dioptre fundus lenses (or equivalent), Slit-lamp fault finding

Unit II Contact lens Optics 8

Corneal topography; Keratometry and Extended Keratometry, Placido’s disc. Contact lens optics-Contact lens and spectacle lens. Back vertex calculation. Contact lens and Tear lens system, Classification of contact lens and its material (soft and RGP), Material property, Contact lens terminology. RGP and soft lens design. FDA classification of contact lens material, Patient selection and prescreening. Soft spherical contact lens fitting and Assessment, Soft contact lens case and maintenance. Spherical RGP contact lens fitting and assessment, RGP contact lens care and maintenance.Calculation of DK/L, EOP and oedema , Measurements of corneal swelling with the Phachometer

Unit III Soft Lens and Lens Solutions 12

Soft Contact Lens:Soft Contact Lens EW complication, Causes and management, Rigid vs permeable, EW complications: Clinical management, Keratoconus;

131

Overview and contact lens fitting, Soft wearing schedules DW Vs EW, Bifocal Contact Lens fitting and assessment, Toric SCL Lenses, Toric RGP Lenses.

Correlation of illumination with conditioning observed, Pharmacology of contact lens solutions, Review of contact lens solution contents, Effects of wear on contact lenses, Contact lens wear in dry eye, Measurement of the oxygen needs of the eye or needs and contact lens transmissibility, Effect of materials and deposits of DK/L, Identification of lens deposits, Effect of hypoxia on corneal structure.

Unit IV Contact lens fitting 9

Handling of contact Lens, Fitting of spherical soft contact Lens and effects of parameter changes, Astigmatism: Correction options, Fitting spherical RGP contact Lens , low DK and high DK, Effects of RGP contact Lens parameter changes on lens fitting, Fitting in astigmatism, Fitting in keratoconus, Fitting in aphakia , pseudophakia, Lens care and hygiene instructions compliance, Follow op post fitting examination, Follow up slit lamp examination, Cosmetic contact Lens, Fitting contact Lens in children

IC Contact Lens : Bifocal Contact lens, Continuous wear and extended wear Contact lens , Therapeutic Contact lens /Bandage lenses, Contact lens following ocular surgeries, Disposable Contact lens , Frequent replacement lenses, Use of secular microscopy and pachymetry in Contact lens, Care of Contact lens , Contact lens solutions, Contact lens modification of finished lenses, Instrumentation in Contact lens practice, Checking finished lens parameters, Recent developments in Contact lens, Review of lenses available in India.

Unit V Lens for Vulnerable Group 8

Contact lens for children, Contact Lenses for aphakics, Contact Lenses for Pseudo Aphakics, Contact Lenses in post refractive surgery/PRK, Contact lens fitting in astigmatism, Contact lens fitting in keratokonus, RGP lenses – low D.K. and high D.K. lenses, Instructions regarding handling and care of lenses, Cosmetic and prosthetic contact lenses, Extended wear lenses versus Daily wear, Disposable lenses, Contact lens – Toric, Bifocal, Multifocal, Therapeutic lenses / Bandage lenses. , Contact lens solutions – principle of action, compositions, Ordering contact lenses – writing prescription to the lab, Contact lens – modifications of finished lenses (RGP), Advancements in Contact Lens instrumentation and techniques Visual recognition of conditions and problem solving, Fitting

132

consideration for sports vision,Corneal prosthesis, Special applications of Contact Lens in Research and Industry.Checking the parameters, Follow up examinations, Contact lens complications and their management.

Total Hours 45

Practical 30

List of Exercises

1. Write Case sheet and History taking

2. Perform Lensometry

3. Perform External examination

4. Test for phorias and tropias

5. Do Visual acuity

6. Do Objective Refraction

7. Take Subjective Refraction

8. Perform Keratometry

9. Slit lamp examination [Applanation tonometry]

10. Drugs and method of application

11. Do’s and Don’ts – papillary dilatation

12. Use Direct ophthalmoscopes

13. Use Indirect ophthalmoscopes

For Contact Lens Patients

14. Do Patient selection [Type of Contact lens]

15. Perform the procedures up to 10[avoiding applanation tonometry]

Procedures For Soft Lens

16. Fitting of trial based on the refractive correction and keratiometry

17. Slit lamp examination to assess the fitting of CL

133

18. Perform over refraction

19. Prescribe the final base curve and power of CL

Procedures For RGP Lens

20. Fitting of trial lens based on the refractive correction and Keratometry

Total Hours 75

Text Book:

1. Jalie M, (1980) Principles of Ophthalmic Lenses, 3rd Edition

Reference Books:

1. Fannin T. E and Grosvenor .T (1996) Clinical Optics.

2. Andrew Keirl , Caroline Christie (2007) Clinical Optics and Refraction: A Guide for Optometrists, Contact Lens Opticians and Dispensing Opticians, 1st edition, Butterworth-Heinemann.

OT- Refractive Surgery

Semester VI Hours of Instruction/week: 5

15BPAO34 No. of Credits: 4

Objective

134

 Enables the student to understand about different refractive surgeries involved in the ophthalmic field

Unit I Corneal Layers and Shape to the Optics of Eye 10

Computerized cornea l topography: Axial Power and Curvature, Instantaneous Power and Curvature, Mean Curvature, Indications For Corneal Topography In Refractive Surgery, Corneal Topography and Irregular Astigmatism, Limitations of Corneal Topography, Clinical situation illustrating the role of corneal topography in refractive surgery. Wave Front Analysis: Wave front analysis and irregular astigmatism, Fermat’s principle and wave front analysis, Measurement of wave front aberrations and graphical representations, Lower-order aberrations, Higher order aberrations. Biomechanics of the cornea, Effects of kerato refractive surgery, Corneal wound healing. Laser biophysics, Laser-tissue interactions, Types of photo ablating lasers, Wave front-guided laser ablation.

Unit II Patient Evaluation 15

Preoperative Evaluation, Patient Expectations, Social History, Medical History, Pertinent Ocular History, Patient Age, Presbyopia, Monovision Examination, Uncorrected Visual Acuity and Manifest and Cycloplegic, Refraction Acuity, Pupillary Examination, Ocular Motility, Confrontation Fields and Ocular Anatomy, Intra Ocular Pressure, Slit Lamp Examination, Dilated Fundus Examination, Ancillary Test, Corneal Topography, Pachymetry.

Unit III Specific Procedures in Refractive Surgery 20

Radial Keratotomy, Patient Selection, Complications, Hexagonal Keratotomy, Incisional Correction of Astigmatism, Transverse Keratotomy, Arcuate keratotomy and Limbal Relaxing incisions, Complication Keratophakia, Homoplastic corneal inlays, Alloplastic Corneal Inlays Epi keratoplasty, Patient Selection, Complication, Alloplastic Corneal Onlays Intrastromal Corneal ring segment, Patient Selection, Complication, Other Potential uses For Intrastromal 135

Corneal Ring Segments, Orthokeratology.

Unit IV PRK and LASEK 15

Photorefractive keratectomy (PRK) and Laser Sub epithelial Keratomileusis (LASEK): Complication, Patient selection. Laser in Situ Kertomileusis (Lasik), Complication, Patient Selection. Wave front-Guided PRK and LASIK, Pre operative preparation. Thermokeratoplasty, History, Laser Thermokeratoplasty, Conductive Keratoplasty, Patient Selection, Phakic IOL, Advantages, Disadvantages, Patient Selection, Complication, bioptics. Clear lens Extraction (Refractive Lens Exchange): Patient Selection, Surgical Planning, IOL calculation in Refractive Lensectomy, Complications, Advantages, Disadvantages. Toric IOL, Instrumentation, Patient Selection, Planning and Surgical technique, Complications. Multifocal IOL, Patient Selection, Side Effects and Complications. Accommodative IOL, Light-Adjustable IOL Accommodative and Non-Accommodative treatment of Presbyopia, Theories of Accommodation. Non Accommodative Treatment of Presbyopia: Monovision, Conductive Keratoplasty, IOL Implants, Custom or Multifocal Ablation, Corneal Inlays. Accommodative Treatment of Presbyopia, Scleral Surgery, Other IOL Innovations on the Horizon.

Unit V Refractive Surgery in Ocular and Systemic Disease 15

Ocular Conditions: Dry eye, Herpesvirus, Keratoconus, Post-Penetrating Keratoplasty, Ocular Hypertension and Glaucoma, Retinal disease, Amblyopia and Strabismus in the Adult and Child Systemic Condition, Humen Immunodeficiency Virus, Diabetes Mellitus, Connective Tissue Disease. IOL calculation after Refractive Surgery, With Pre-Refractive Surgery Refraction and Keratometry and Post-Refractive Surgery Refraction, With pre-Refractive Surgery Refraction and Keratometry, With Pre-refractive surgery Refraction and Post-Refractive Surgery refraction, With Pre-refractive surgery Refraction only , With no pre-operative Information. Retinal Detachment repair after LASIK, Corneal Transplantation after Refractive Surgery, Contact Lens Use after Refractive Surgery: Indications, General Principles, Contact Lenses After RK, Contact lens Fitting after PRk, Contact Lens Fitting After LASIK, contact Lens assisted Pharmacologically induced Keratosteepening(CLAPIKS) Glaucoma after refractive Surgery .

136

Total Hours 75

Text Book:

1. Collin J. R. O. (2006), A Manual of Systematic Eyelid Surgery, 3rd edition, Elsevier Publications

Reference Books:

1. Schweinit G. E. De (2006). Diseases of the Eye. A Hand-Book of Ophthalmic Practice, For Students And Practioner,3rd edition, W.B. Saunders, Philadelphia,

2. Nathaniel L. Macbrid (2006), Diseases of the Eye, University of Michigan Library

137

Ophthalmology for Vulnerable Group

Semester VI Hours of Instruction/week: 5

15BPAO35 No. of Credits: 4

Objectives

 Enables the students to competently care for patients commonly managed by general Pediatricians/Geriatricians and also handle systemic complications in the area of Ophthalmology

Unit I Paediatric-Geriatric Basics 10

Genetic factor, Prenatal factors, Perinatal factors, Postnatal factors, Measurement of visual acuity: Normal Appearance, pathology and structural anomalies of Orbit, Eyelids, Lacrimal system, Conjunctiva, Cornea, Sclera, Anterior chamber, uveal tract, pupils, Lens, Vitreous, Funds, Oculomotor system, Measurement of refractive status, Determining binocular status, Determining sensory motor adaptability.

Unit II Gerontologic Ophthalmology

Biology of aging, Genetic theories of aging, Physiology of aging, Principles of Geriatric Medicine. Structural changes in the eye, Physiological changes in the eye, Optical and refractive changes in the eye, Aphakia, psuedophakia, Ocular diseases common in old eye, cataract disorders: Pathophysiology of age related cataract, Cataract associated with systemic disease, Cataract associated with ocular disease, Development cataract, zonular cataract acquired cataract, Senile cataract, cortical cataract, nuclear cataract, complicated cataract, diabetic cataract, traumatic cataract after the secondary cataract, vascular diseases of the eye. Management: biometry and planning of refractive outcome; intraocular lens implant technology, recognition and management implications of surgical risk factors, Surgical and anaesthetic techniques, Complications of surgery and anaesthesia. Special considerations in ophthalmic dispensing to the elderly,

138

Management of visual problems of aging.

Unit III Paediatric Ophthalmology 20

Paediatric refractive errors: epidemiology, underlying causes, management. Amblyopia: Clinical features and management of: Infantile esotropia, Acquired esotropia, Intermittent exotropia, Congenital superior oblique weakness, Duane’s syndrome, Brown’s syndrome- Pathophysiology, assessment and management, Retinopathy of prematurity: Pathophysiology, natural history, screening technique, treatment of acute disease, Retinopathy of prematurity, Assessment of the apparently blind baby, Visual loss secondary to neurological disease in infants and children, Differential diagnosis of the white pupil, including retinoblastoma, Clinical features of common genetic syndromes: albinism, neurofibromatosis, Tuberous sclerosis, von Hippel-Lindau disease, aniridia. Presenting ophthalmic features and ongoing assessment of children with brain. Tumours. Ocular assessment in children with dysmorphic syndromes, Differential diagnosis of the white pupil, Retinoblastoma: clinical assessment, genetics, management, Clinical features, genetics, investigations and management of Leber’s congenital. Myopia, Pseudo myopia, Hyperopia, Astigmatism, Anisometropia, vergence and accommodation.

Unit IV Remedial Therapy For Congenital and Childhood Disorder 15

Cataract: Structure (including embryology) and function of the lens, Pathophysiology of cataract development, Congenital cataract: Aetiology, including genetic causes, Cataract associated with systemic disease, Cataract associated with ocular disease, Management: surgical techniques. Glaucoma: Structure and function of the Ciliary body and anterior chamber drainage angle , Aqueous production and drainage; mechanisms of intraocular pressure control , Congenital and childhood Glaucoma: Epidemiology, genetics, and pathophysiology , Diagnosis and management. Open angle glaucoma, ocular hypertension, and normal tension glaucoma: Epidemiology, genetics, pathophysiology , Clinical features: visual field changes and visual field examination techniques, Measurement and significance of intraocular pressure ,Optic disc changes and their assessment, Medical, laser and surgical treatments , Systemic toxicity of topical ocular medications, Angle closure glaucoma : Epidemiology, genetics, and Pathophysiology, Medical, laser and surgical treatments .Glaucoma syndromes : Clinical features and management of: 139

Pseudoexfoliation syndrome, Pigment dispersion syndrome ,Secondary glaucomas, Amaurosis Albinism Neurofibromatosis Tuberous sclerosis von Hippel-Lindau disease Aniridia Coats’ disease Stargardt’s disease Colour vision anomalies . Strabismus: Structure and function of the extraocular muscles, Physiology of eye movement control, Binocular function: physiology and assessment, Accommodation anomalies, assessment and management.

Unit V Ophthalmology in Relation to Medicine* 15

Common systemic diseases with ocular features: Diabetes mellitus, Systemic hypertension, Acquired Heart Disease: Embolism, Subacute bacterial endocarditis,

Thyroid, pituitary and other endocrine disease, Multiple sclerosis, Myasthenia gravis, Sarcoidosis, Infectious diseases: Preseptal and orbital cellulitis, Toxoplasma and toxocara, Tuberculosis, AIDS-related opportunistic infections, Syphilis. Inflammatory diseases: Rheumatoid arthritis and Sjogren’s syndrome, Juvenile idiopathic arthritis, Ankylosing spondylitis, Behcet’s disease, Reiter’s syndrome, Wegener’s granulomatosis, Malaria, Tropical diseases and the eye – leprosy, toxoplasmosis, syphillis trachoma, SLE, Miscellaneous Systemic diseases with ocular features: Anaemia, leukaemia, myeloma and other blood disorders. Ocular toxicity of systemic medications and systemic toxicity of topical ocularmedications.Skin diseases including rosacea, eczema, pseudoxanthoma elasticum, Stevens-Johnson syndrome. Cancer: Benign and malignant neoplasmgrading of staging of cancer, diagnosis, principles of treatment of neoplasia and the eye. Helminthiasis: Its effects on eye and the principles of diagnosis and management. Malnutrition: protein energy malnutrition, water electrolytes, minerals, vitamins, nutritionaldisorders and the eye. Immunology: Introduction, components of the Immune system, principle of Immunity in health, Immunologyin disease, Immunology and the eye. Neurological disorders – Stroke/CVA: Disseminated sclerosis and sub acute combined degeneration. Anatomy with Pathophysiology of Disseminated sclerosis and sub acute combined degeneration, Eye and connective tissue disease. General Medical Emergencies – first aid ocular/general

(*Pathophysiology, Classification, Clinical Examination, Diagnosis, Complications, Management of the disease and the Eye)

Total Hours 75

140

Text Books:

1. Ashok Garg, Emanuel Rosen (2009) Detail for Instant Clinical Diagnosis in Ophthalmology: Pediatric Ophthalmology. Ist edition, Jaypee Brothers

2. Kenneth W. Wright MD, Yi Ning J. Strube, (2012) Pediatric Ophthalmology and Strabismus 3rd edition, OUP USA.

3. Andrew G. Lee, Hilary Beaver, (2009) Geriatric Ophthalmology, 1st Edition, Springer.

Reference Books:

1. Robison D. Harley, Leonard B. Nelson, Scott E. Olitsky (2005), Harley's Pediatric Ophthalmology, Lippincott Williams and Wilkins.

2. Marvin L. Kwitko (2008), Geriatric Ophthalmology, Grune and Stratton, 1985

141

First Aid Practicum (Value Added Course)

Semester II-V Hours of Instruction:40 15BPAV01 No of Credits: 2

Objectives:  To enable the students describe the rules of first aid and demonstrate skill in

rendering first aid during emergencies.

Unit I Introduction 2

Importance of first aid and rules of first aid, Concept of emergency and assessment, Immediate actions and the priorities within first aid, Principles and practice of first aid, Structure and function of the human body. First aid kits- equipment and content.

Unit II External Injuries 3

First aid infire, burns, scalds, fractures, accidents, poisoning, drowning, haemorrhages, insect bites, foreign bodies, unconsciousness, injuries to muscles and joints, immersion, cold shock exposure, hypothermia/hyperthermia and dehydration.

Unit III Emergency Conditions 2

Failure of the circulation : shock, blood loss and the control of bleeding, recognition of internal bleeding, angina and heart attack, diabetic emergency, seizures and miscellaneous condition.

Unit IV Cardio Pulmonary Resuscitation 1

CPR including an awareness of AEDs. Transportation of the injured, Triage, Bandaging and splinting, Unit V First Aid In Community Emergencies 2

Bomb explosions, floods, earthquakes, famines, need for rehabilitation. Community

142

resources- police assistance, ambulance services and their functions in relation to emergencies. Total Hours 10

Practical 30

List of Experiments

1. First Aid, good samaritan laws, EMS system, standards of care, recognizing and responding to emergencies, avoiding infectious diseases

2. Bleeding & wound care, shock, burns, head, spinal, chest, & abdominal injuries, bone, joint & muscle injuries, sudden illness.

3. Cardiac, stroke, respiratory, seizures, diabetes ,poisonings, bites & stings

4. Basic life support: rescue breathing, choking, CPR, AED

5. Heat, cold, & environmental emergencies, rescuing & moving victims, hands-on exercises.

Total Hours 40

143