MBBS Subjects : Fourth Year

Fourth Year - Consist of four subjects

Medicine, Surgery, Obstratics and Gynecology, Pediatrics, Radiology, Orthopedics, Psychiatry, Anaesthesia & Dermatology

Medicine

 GOAL:  The broad goal of the teaching of undergraduate students in Medicine is to have the knowledge, skills and behavioral attributes to function effectively as the first contact physician.

Medicine includes the assessor branches like skin, psychiatry and pulmonology (TB and chest). Thus curricula includes

- Introduction to Medicine

- Infectious Diseases/Tropical diseases Cardiovascular System

- GIT, Liver, Pan. Chest + Miscellaneous

TB

Psychiatry

Skin

- Neurology

Haematology/Haemato-oncology

Tutorials

Skin / STD

- Endo + Misc + Genetics ( 3 Lectures.)

Nephro. +Clinical Nutrition

Tutorial Medicine, Skin, Tb, Psychiatry,

Medicine books recommended

ALAGAPPAN -MANUAL OF PRACTICAL MEDICINE

API - TEXTBOOK OF MEDICINE

CHAMBERLAIN'S- SYMPTOMS & SIGNS IN CLINICAL MEDICINE

CORKE - PRACTICAL INTENSIVE CARE MEDICINE - PROBLEM SOLVING I THE ICU

DAVIDSON'S - PRINCIPLES & PRACTICE OF MEDICINE

GOLWALLA- MEDICINE FOR STUDENTS

HARRISON'S- PRINCIPLES & PRACTICE OF MEDICINE (2 VOL SET)

HUTCHISON'S - CLINICAL METHODS

KUMAR - CLINICAL MEDICINE

KUNDU - BEDSIDE CLINICS IN MEDICINE PART- I

KUNDU - BEDSIDE CLINICS IN MEDICINE PART- II

MEHTA -COMMON MEDICAL SYMPTOMS

MEHTA -PRACTICAL MEDICINE

PATEL -CLINICAL MEDICINE

PATEL- CLINICS IN INTERNAL MEDICINE

WASHINGTON- THE WASHINGTON MANUAL OF MEDICAL THERAPEUTICS

VAIDYA - CASSETTE CLINICS IN MEDICINE (6-VOL SET)

VAIDYA - GENERAL PRACTICE (A PRCTICAL MANUAL)

Surgery

Goal: The broad goal of the teaching of undergraduate students in Surgery is to produce graduates capable of delivering efficient first contact surgical care.

Surgery includes orthopedics, anesthesiology and radiodiagnosis as minor subjects

  1. (A). GENERAL PRINCIPLES
  2. Wound healing and management, scars: Hypertrophic scar and keloid; First aid management of severely injured.
  3. Asepsis, antisepsis, sterilisation.
  4. Surgical sutures, knots, drains, bandages and splints.
  5. Surgical infections and rational use of antibiotics: Causes of infection, prevention of infection, common organisms causing infection.
  6. Boils, cellulitis, abscess, necrotising fascitis.
  7. Tetanus and Gas gangrene: Prevention of Tetanus and Gas Gangrene.
  8. Chronic specific infections: Tuberculosis, Filariasis, and Leprosy.
  9. Antibiotic therapy.
  10. Hospital infection.
  11. AIDS and Hepatitis B; Occupational hazards and prevention.

 (B). 1. Mechanism and management of missile, blast and gunshot injuries.

  1. Surgical aspects of diabetes mellitus.
  2. Bites and stings.
  3. Organ transplantation - Basic principles.
  4. Nutritional support to surgical patients.
  1. RESUSCITATION.
  2. Fluid electrolyte balance.
  3. Shock: Aetiology, pathophysiology and management.
  4. Blood transfusion : Indication and hazards.
  5. Common postoperative complications.

III. COMMON SKIN AND SUBCUTANEOUS CONDITIONS.

  1. Sebaceous cyst, dermoid cyst, lipoma, haemangioma, neurofibroma, premalignant conditions of the skin, basal cell carcinoma, naevi and malignant melanoma.
  2. Sinus and fistulae. Pressure sores; prevention and management.
  1. ARTERIAL DISORDERS.
  2. Acute arterial obstruction : diagnosis and initial management; types of gangrene ; diagnosis of chronic arterial insufficiency with emphasis on Burger’s disease, athreosclerosis and crush injuries.
  3. Investigations in cases of arterial obstruction. Amputations;
  4. Vascular injuries : basic principles of management.
  1. VENOUS DISORDERS.
  2. Varicose veins: diagnosis and management; deep venous thrombosis: diagnosis, prevention, principles of therapy; thrombophlebitis.
  1. LYMPHATICS AND LYMPH NODES.
  2. Diagnosis and principles of management of lymphangitis, lymphedema, acute and chronic lymphadenitis; cold abscess, lymphomas, surgical manifestations of filariasis.

VII. BURNS.

  1. Causes, prevention and first aid management; pathophysiology; assessment of depth and surface area, fluid resuscitation; skin cover; prevention of contractures.

VIII. SCALP, SKULL AND BRAIN.

  1. Wounds of scalp and its management: recognition, diagnosis and monitoring of patients with head injury including unconsciousness; Glasgow coma scale recognition of acute / chronic cerebral compression.
  2. ORAL CAVITY, JAWS, SALIVARY GLANDS.
  3. Oral cavity: I) Cleft lip and palate; Leukoplakia; retention cyst; ulcers of the tongue.
  4. II) Features, diagnosis and basic principles of management of carcinoma lip, buccal mucosa and tongue, prevention and staging of oral carcinomas.
  5. Salivary glands: I) Acute sialoadenitis, neoplasm: diagnosis and principles of treatment.
  1. B. Epulis, cysts and tumours of jaw: Maxillofacial injuries; salivary fistulae
  1. NECK.
  2. Branchial cyst; cystic hygroma.
  3. Cervical lymphadenitis: Non-specific and specific, tuberculosis of lymphnodes, secondaries of neck.
  1. B. Thoracic outlet syndrome: diagnosis.
  1. THYROID GLAND
  2. Thyroid: Surgical anatomy, physiology, investigations of thyroid disorders; types, clinical features, diagnosis and principles of management of goitre, thyrotoxicosis and malignancy, thyroglossal cyst and fistula.
  1. B. Thyroiditis, Hypothyroidism.

XII. PARATHYROID AND ADRENAL GLANDS.

  1. Clinical features and diagnosis of hyperparathyroidism, adrenal hyperfunction/ hypofunction.

XIII. BREAST.

  1. Surgical anatomy; nipple discharge; acute mastitis, breast abscess; mammary dysplasia; gynaecomastia; fibroadenomas.
  2. Assessment and investigations of a breast lump.
  3. Cancer breast : diagnosis, staging, principles of management.

XIV. THORAX.

  1. Recognition and treatment of pneumothorax, haemothorax, pulmonary embolism: Prevention/ recognition and treatment, flail chest; Stove in chest ; Postoperative pulmonary complications.

XIV. B. Principles of management of pyothorax; cancer lung.

  1. HEART AND PERICARDIUM.
  2. Cardiac tamponade
  3. Scope of cardiac surgery.

XVI. OESOPHAGUS.

  1. Dysphagia: Causes, investigations and principles of management.
  2. Cancer oesophagus : Principles of management.

XVII. STOMACH AND DUODENUM.

  1. Anatomy; Physiology, Congenital hypertrophic pyloric stenosis; aetiopathogenesis, diagnosis and management of peptic ulcer, cancer stomach; upper gastrointestinal haemorrhage with special reference to bleeding varices and duodenal ulcer.

XVIII. LIVER

  1. Clinical features , diagnosis and principles of management of : Amoebic liver abscess, hydatid cyst and portal hypertension. Liver trauma.

XVIII. B. Surgical anatomy; primary and secondary neoplasms of liver.

XIX. SPLEEN

  1. Splenomegaly: causes, investigations and indications for splenectomy: splenic injury.
  1. GALL BLADDER AND BILE DUCTS
  2. Anatomy, physiology and investigations of biliary tree; clinical features, diagnosis, complications and principles of management of cholelithiasis and cholecystitis; obstructive jaundice.
  3. B. Carcinoma of gall bladder, choledochal cyst.

XXI. PANCREAS.

  1. Acute pancreatitis : Clinical features, diagnosis, complications and management.
  2. Chronic pancreatitis, pancreatic tumours.

XXII. PERITONEUM, OMENTUM, MESENTERY AND RETROPERITONEAL SPACE.

  1. Peritonitis : Causes, recognition and principles of management; intraperitoneal abscess.

XXII B. Laparoscopy and laparoscopic surgery.

XXIII. SMALL AND LARGE INTESTINES

  1. Diagnosis and principles of treatment of : Intestinal amoebiasis, tuberculosis of intestine, carcinoma colon; lower gastrointestinal haemorrhage; Enteric fever, parasitic infestations.

XXIII. B. Ulcerative colitis, premalignant conditions of large bowel.

XXIV. INTESTINAL OBSTRUCTION.

  1. Types, aetiology, diagnosis and principles of management; paralytic ileus.

XXV. ACUTE ABDOMEN.

  1. Causes, approach, diagnosis and principles of management.

XXVI. APPENDIX

  1. Diagnosis and management of acute appendicitis, appendicular lump and abscess.

XXVII. RECTUM.

  1. Carcinoma rectum: diagnosis, clinical features and principles of management; indications and management of colostomy.

XXVII. B. Management of carcinoma rectum; prolapse of rectum.

XXVIII. ANAL CANAL .

  1. Surgical anatomy. Clinical features and management of: fissure, fistula in ano, perianal and ischiorectal abscess and haemorrhoids; Diagnosis and referral of anorectal anomalies.

XXVIII. B. Anal carcinoma.

XXIX. HERNIAS.

  1. Clinical features, diagnosis, complications and principles of management of : Umbilical, Inguinal, epigastric and femoral hernia.
  2. Omphalitis.

XXIX . B. Umbilical fistulae, Burst abdomen, ventral hernia.

XXX. GENITO- URINARY SYSTEM.

  1. Symptoms and investigations of the urinary tract.

XXXI. KIDNEY AND URETER

  1. Investigations of renal mass; diagnosis and principles of management of urolithiasis, hydronephrosis, pyonephrosis, and perinephric abscess, congenital anomalies of kidney & Ureter and renal tumours.
  2. Renal tuberculosis.

XXXII. URINARY BLADDER.

  1. Causes, diagnosis and principles of management of haematuria, anuria and acute retention of urine.

XXXIII. PROSTATE AND SEMINAL VESICLES.

  1. Benign prostatic hyperplasia: diagnosis and management.

XXXIII. B. Carcinoma prostate.

XXXIII. URETHRA AND PENIS

  1. Diagnosis and principles of management of Phimosis, paraphimosis and carcinoma penis.
  2. Principles of management of urethral injuries.
  3. Urethral strictures.

XXXV. TESTES AND SCROTUM

  1. Diagnosis and principles of treatment of undescended testis; torsion testis; Hydrocoele, hematocoele, pyocoele, varicocele, epididymo-orchitis and testicular tumours.

XXXVI PAEDIATRIC SURGERY

  1. Oesophageal atresia and Intestinal atresia
  2. Anorectal malformations
  3. Constipation in children: Hirschsprung's disease, Acquired megacolon,
  4. Congenital diaphragmatic hernia
  5. Extrophy, Epispadias complex and hypospadias
  6. Spinal diastrophism and Hydrocephalus
  7. Urinary tract infections in children- Vesicoureteral reflux, posterior urethral Valves, Vesico Ureteral Junction obstruction/Duplex ureter, Obstructive uropathy in Children : Hydronephrosis, Hydroureteronephrosis
  8. Testicular Maldescent
  9. Umbilical Hernia, Exompholos: Major/minor
  10. Wilm’s Tumours: Neuroblastoma, Ganglionioneuloblestoma, Ganglioneuroma, Endo-dermal Sinus Tumours.
  11. Hamartomas in Children: Lymphangioma and Cystic hygroma, Haemangioma.

Biliary Atresia and Surgical jaundice

Surgery Books

1 . Charles V. Mann, R.C.G. Russel, Norman S., Williams, Bailey and Love’s Short Practice of Surgery, 23rd Edition, 2000 Chapman and Hall.

  1. K.Das: Clinical Methods in Surgery, 8th Edition, 1968, Suhas Kumar Dhar, Calcutta.
  2. JSP Lumley : Hamilton Bailey’s Physical Signs 18th Edn Butterworth/Heinemann. 1997,
  3. Somen Das ; A Practical Guide to Operative Surgery, 4th Edition, 1999, s. Das, Calcutta
  4. SHORT CASES IN SURGERY – BHATTACHARYA
  5. MANIPAL - MANUAL OF SURGERY
  6. NAN - UNDERGRADUATE SURGRY
  7. PARULEKAR - PRACTICAL SURGERY
  8. PATEL - HANBOOK OF SURGICAL INSTRUMENTS FOR UNDERGRADUATES
  9. R.D.B'S - ART OF CLINICAL PRESENTATION IN SURGERY
  10. R.D.B'S - ART OF STUDYING SURGICAL PATHOLOGY
  11. VAIDYA- CASSETTE CLINICS IN GENERAL SURGERY (5-VOL SET)
REFERENCE TEXT BOOKS
  1. .James Kyle : Pye’s Surgical handicraft, Indian edition, k.m. Varghese Company David C.
  2. Sabiston ; Text Book of surgery : The Biological basis of Modern Surgical Practice, 15th Edition, 1971, W.B. Saunders.
  3. Seymour I. Schwartz, G. Tom Shines, Frank C. Spencer, Wendy Cowles Husser: Principles of Surgery, Vol. 1 & 2, 7th Edition, 1999, Mc Graw Hill
  4. R.F. Rintoul : Farqharson’s Text Book of Operative Surgery, 8th Edition, 1995, Churchill Livingstone.
  5. Sir Charles Illingworth, Bruce m. Dick: A Text Book of Surgical Pathology,12th Edition, 2979, Churchill Livingstone.
  6. R.W.H. McMinn : Last’s Anatomy: Regional and Applied; 10th Edition, 1999, Churchill Livingstone
Obstratics and Gynecology

Goal: The broad goal of the teaching of undergraduate students in Obstetrics and Gynaecology is that he/she shall acquire understanding of anatomy, physiology and pathophysiology of the reproductive system & gain the ability to optimally manage common conditions affecting it.

  1. Applied anatomy of female genital tract.
  2. Development of genital tract
  3. Physiology of menstruation
  4. Puberty and menopause
  5. Physiology of ovulation / conception / implantation.
  6. Early development of human embryo.
  7. Structure, function and anomalies of placenta.
  8. Physiological changes during pregnancy / diagnosis of pregnancy.
  9. Antenatal care, nutrition in pregnancy, detection of high-risk pregnancy.
  10. Normal labour - Physiology, mechanism, clinical course and management, pain relief in labour.
  11. Normal puerperium and breast-feeding.
  12. Examination and care of newborn.
  13. Contraception - Introduction and basic principles
  14. Maternal mortality and morbidity, perinatal mortality and morbidity. National health programme - safe-motherhood, reproductive and child health, social obstetrics.

GYNAECOLOGY

  1. Development of genital tract, congenital anomalies and clinical significance, Chromosomal abnormalities and intersex.
  2. Physiology of Menstruation, Menstrual abnormalities -Amenorrhoea,Dysmenorrhea, Abnormal Uterine Bleeding, DUB.
  3. Puberty and its disorders, Adolescent Gynaecological problems.
  4. Menopause & H R T.
  5. Infections of genital tract, Leucorrhoea, Pruritus vulvae, Vaginitis, Cervicitis, PID, Genital TB, Sexually transmitted infections including HIV infection.
  6. Benign & Malignant tumours of the genital tract. Leiomyoma, carcinoma cervix, carcinoma endometrium,chorio carcinoma, ovarian tumors. Benign & Malignant Lesions of Vulva
  7. Radiotherapy & Chemotherapy in Gynaecology.
  8. Other gynaecological disorders - Adenomyosis, Endometriosis
  9. Genital Prolapse, Genital Tract displacement,
  10. Urinary disorders in Gynaecology, Perineal tears, Genital Fistulae, RVF & VVF.

FAMILY PLANNING:

-------------------------------

  1. Demography and population Dynamics.
  2. Contraception - Temporary methods /Permanent methods.
  3. MTP Act and procedures of MTP in first & second trimester.
  4. Emergency contraception. :
  5. Complications in early pregnancy.
  6. Hyperemesis gravidarum / abortion / ectopic pregnancy / gestational trophoblastic disease.
  7. Obstetrical complications during pregnancy -APH - Accidental hemorrhage. Placenta praevia / Poly hydramnios / oligohydramnios, multifetal pregnancy/ Medical disorders in pregnancy.
  8. Anemia, Heart disease. Hypertensive disorder, PIH and Eclampsia, Diabetes, jaundice, pulmonary disease in pregnancy, Infections in pregnancy
  9. Urinary tract diseases, sexually transmitted infections including HIV, malaria, TORCH etc.
  10. Gynaecological and surgical conditions in pregnancy, Fibroid with pregnancy, ovarian tumours, acute abdomen, genital prolapse.
  11. High risk pregnancy, pre-term labour, post term pregnancy, IUGR, IUFD, pregnancy wastages, Rh incompatibility, post caesarean pregnancy.
  12. Induction of labour.
  13. Abnormal position & presentation : Occipito posterior, Breech, Transverse, Face & Brow, Compound, Cord Presentation and prolapse.
  14. Abnormal labour - abnormal uterine action, CPD.
  15. Obstructed labour, uterine rupture.
  16. Third stage complications - Retained placenta, PPH, Shock, Uterine inversion, Fluid Embolism.
  17. Puerperial Sepsis and Other Complications in puerperium.
  18. Evaluation of Foetal Health during pregnancy and labour.
  19. Drugs used in obstetric practice.
  20. Operative procedures in Obstetrics : Caesarean Section, Instrumental Vaginal Delivery. Forceps, Vacuum,
  21. Maternal Mortality and morbidity, Perinatal mortality and morbidity. National program - safe motherhood, reproductive and child health , Social Obstetrics.

NEW BORN :

------------------

  1. Examination and care of new born & low birth weight babies.
  2. Asphyxia and neonatal resuscitation.
  3. Diagnosis of early neonatal problems.
  4. Birth injuries, jaundice, infection.
  5. Anencephaly & Hydrocephalus and other Congenital Anomalies of fetus.

Preventive Oncology

 Principles of gynaecological surgical procedures

Pre and post operative care in Gynaecology

Ultrasongraphy and Radiology, in Gynaecology

Endoscopy in in Gynaecology

Drugs and hormones in Gynaecology

Surgical procedures in obstetrics

Maternal mortality

Perinatal mortality

Recurrent pregnancy wastages

High risk pregnancy

Rural obstetrics

Drugs in Pregnancy

Drugs in obstetric practice

In addition, integrated teaching with other departments like anatomy, physiology, biochemistry, pathology, microbiology, Forensic Medicine and Preventive and Social medicine to be organized for selected topics.

Books for Ob/Gy

AFTARY - MANUAL OF OBSTETRICS (HOLAND & BREWS)

DAWN- TEXTBOOK OF OBSTETRICS & NEONATOLOGY

DAWN- TEXTBOOK OF GYNECOLOGY, CONTRACEPTION & DEMOGRAPHY

DUTTA- TEXTBOOK OF GYNECOLOGY

DUTTA-TEXTBOOK OF OBSTETRICS

KERKAR-TEXTBOOK OF OBSTETRICS

KHAN-FIVE TEACHERS GYNECOLOGY

MUDALIAR-CLINICAL OBSTETRICS

OXORN-FOOTE - HUMAN LABOR & BIRTH

PARULEKAR-PRACTICAL GYNECOLOGY & OBSTERICS

PARULEKAR - HANDBOOK OF PRACTICAL GYNECOLOGY & OBSTERICS

SHAW'S-TEXTBOOK OF GYNECOLOGY

VAIDYA-CASSETTE CLINICS IN GYNECOLOGY-OBSTERICS (4 VOL SET)

VIRKUD (D.K.) - MANUAL OF PRACTICAL OBSTETRICS AND GYNECOLOGY

WANI -ESSENTIAL OBSTERICS

Pediatrics

Goal: The broad goal of the teaching of undergraduate students in Pediatrics is to acquire adequate knowledge and appropriate skills for optimally dealing with major health problems of children to ensure their optimal growth and development.

Curriculum

Introduction of Paediatrics.

History taking in children.

Examination of Children.

Normal Growth

Normal Development.

Introduction to newborn and normal newborn baby.

Temperature regulation in newborn.

Breast feeding and lactation management.

Infant and child feeding ( include complimentary feeding)

Normal fluid and electrolyte balance in children.

Immunization.

Birth Asphyxia

Low Birth Weight Babies.

Neonatal Respiratory Distress.

Jaundice in newborn.

Neonatal Infections.

Neonatal convulsions.

PEM and its management.

Vitamin and micronutrient deficiencies.

Nutritional anaemia in infancy and childhood.

Acute diarrhoea.

Hypothyroidism in children.

Congestive heart failure - diagnosis and management.

Congenital heart disease.

Rheumatic heart disease.

Hypertension in children.

Acute respiratory infections.

Bronchial asthma.

Nephrotic syndrome

Acute glomerulonephritis and hematuria

Abdominal pain in children.

Chronic liver disease including ICC.

Haemolytic anaemia including thalassemia.

Leukaemias.

Bleeding and coagulation disorders.

Seizure disorders.

Cerebral Palsy.

Common exanthematous illness.

Childhood tuberculosis

Other topics:

Fluid and electrolyte balance -pathophysiology and principles of Management.

Acid-base disturbances - pathophysiology and principles of management.

Adolescent growth and disorders of puberty.

Congenital heart disease.

Acute respiratory infections, Measles, Mumps, Chicken pox

Other childhood malignancies.

Coagulation disorders - Haemophilia

Mental retardation.

Approach to a handicapped child.

Acute flaccid paralysis.

Behaviour disorders.

Meningitis.

Diphtheria, Pertussis and Tetanus.

Childhood tuberculosis.

HIV infection.

Malaria.

Neurocysticercosis.

Enteric fever.

Immunization.

Paediatric prescribing.

Common childhood poisonings.

Integrated Seminar Topics :

Convulsions

Coma

PUO

Jaundice

Portal hypertension

Respiratory failure

Shock

Rheumatic Heart Disease

Hypertension

Diabetes mellitus

Hypothyroidism

Anemia

Bleeding

Renal failure

Tuberculosis

Malaria

HIV infection

Neurocysticercosis

Perinatal asphyxia ( with obstetrics )

Intrauterine growth retardation ( with obstetrics)

Books for Pediatrics

D.K. - PEDIATRICS

GHAI-ESSENTIAL PEDIATRICS

GUPTE -THE SHORT TEXTBOOK OF PEDIATRICS

MAYOOR CHHEDA-PRATICALS ASPECTS OF PEDIATRICS

SHEJWAL-CLINICAL PEDIATRICS FOR GENERAL PRACTITIONERS