MBBS Subjects : Second Year

Pathology

Goal: The goal of teaching pathology is to provide undergraduate students comprehensive knowledge of the causes and mechanisms of disease, in order to enable them to achieve complete understanding of the natural history and clinical manifestations of the disease.

Syllabus

  1. General Pathology
  2. Hematology
  3. Systemic Pathology
  4. Clinical Pathology
  5. Autopsy

The Broad area of study shall be:-

  1. A) General Pathology
  2. Microscopy and tissue processing
  3. Identify the common types of cells by light microscopy
  4. Intracellular accumulation
  5. Acute inflammation
  6. Chronic inflammation and Repair
  7. Thrombosis, embolism, infarction and gangrene
  8. Oedema and congestion
  9. Disturbances of pigment metabolism
  10. Tuberculosis
  11. Leprosy
  12. Amyloidosis
  13. Disturbances of growth (Atrophy, hypertrophy, hyperplasia, metaplasia, Dysplasia, hypoplasia)
  1. B) Haematology:
  2. Collection of specimen, anticoagulants and common haematological tests (Hb)
  3. Common Haematological Counts (TLC, DLC) & Interpretation of ESR
  4. Haemopoiesis
  5. Investigations in Anaemia
  6. Investigations in Leukaemia
  7. Investigations in haemorrhagic disorders
  8. Blood Banking
  1. C) Systemic Pathology:
  2. Diseases of blood vessels (Atherosclerosis, syphilitic aortitis)
  3. Diseases of Heart (IHD & RHD)
  4. Pneumonias
  5. Tumours of lung
  6. Diseases of kidney
  7. Gross and Microscopic features of peptic ulcer and duodenal ulcer
  8. Gross and Microscopic features of other intestinal ulcers
  9. Tumours of GIT
  10. Diseases of Liver
  11. Lymphomas
  12. Diseases of male and female genital system

12 &13. Tumours of breast

  1. Tumours of skin (Pigmented)
  2. Tumours of skin (non-pigmented)
  3. Soft tissue tumours
  4. Tumours of bone
  5. Diseases of thyroid
  1. D) Clinical Pathology:
  2. Urine RE - Carryout a bedside routine urine examination and interpret the results.
  3. Pregnancy test and Semen Analysis - (Practical demonstration).
  4. Common cytological preparations (lecture demonstration).
  5. CSF examination.
  6. Serous effusion examination.
  1. E) Autopsy:

Pathology books Recommended:

  1. a) Text book of Pathology by Robbins
  2. b) Text book of General Pathology Part I & II by Bhende and Deodhare
  3. c) Clinical Pathology by Talib
  4. d) Text book of Pathology by Harsh Mohan
  5. e) Text book of Pathology by Muir
  6. f) Haematology De Gruchi
  7. g) IAPM text book of Pathology

Reference books:

  1. a) Anderson's text book of Pathology Vol I & II
  2. b) Oxford text book of Pathology Vol. I, II & III
  3. c) Pathology by Rubin and Farber
  4. d) Pathologic basis of Disease Robbins
Microbiology

Goal: The goal of teaching Microbiology is to provide understanding of the natural history of infectious diseases in order to deal with the etiology, pathogenesis, pathogenicity, laboratory diagnosis, treatment, control and prevention of these infections and infectious diseases.

Curriculum

  1. A) General Microbiology:
  2. Introduction and Historical background
  3. Morphology of bacteria and Classification
  4. Physiology of bacteria including growth requirements & metabolism
  5. Sterilization
  6. Disinfectants
  7. Waste disposal
  8. Bacterial genetics and drug resistance to antimicrobial agents.
  9. Host parasite relationship and bacterial infections
  10. Normal flora
  11. Methods of identification of bacteria. Diagnosis of infectious diseases (direct and indirect)
  1. B) Immunology:
  2. Introduction
  3. Antigens, HLA
  4. Antibodies
  5. Serological reactions
  6. Immune response
  7. Complement
  8. Hypersensitivity
  9. Autoimmunity
  10. Transplantation & tumour immunology
  11. Immuno-Deficiency
  1. C) Systemic Bacteriology:

Pathogenesis includes:

  1. Infectious agent
  2. Habitat
  3. Source / reservoir
  4. Mode
  5. Infective dose
  6. Multiplication, spread
  7. Clinical features, pathology
  8. Complications
  9. Virulence factors
  10. Immunological response

Laboratory diagnosis:

  1. Specimen selection
  2. Collection
  3. Transport
  4. Primary smear, hanging drop
  5. Selection of media
  6. Pathogenicity testing
  7. Anti microbial drug susceptibility testing
  8. Serological interpretation
  1. D) Mycology:
  2. Introduction to Mycology
  3. Agents of Superficial mycosis
  4. Subcutaneous mycosis
  5. Systemic mycosis & Opportunistic fungal infections
  1. E) Virology:

Morphology, pathogenesis, laboratory diagnosis, prevention and control for all viruses.

  • General Virology
  • Laboratory diagnosis of viral infections
  • Viral immunity
  • Pox viruses
  • DNA viruses
  • Respiratory viruses
  • Picornaviruses
  • Hepatitis viruses
  • Arboviruses
  • Rhabdoviruses
  • Slow and Oncogenic viruses
  • Retroviruses
  1. F) Parasitology:
  • Geographical distribution
  • Habitat
  • Morphology (Different Stages) found in human beings
  • Life cycle
  • Pathogenesis
  • Laboratory diagnosis
  • Treatment
  • Control
  • Immunoprophylaxis

Of E. histolytica, Free living amoebae and flagellates, Hemoflagellates, Malaria, Toxoplasma, Taenia saginata & solium, Echinococcus granulosus, Schistosomiasis, A. duodenale, A. lumbricoides, E. vermicularis, T. tritura, W. bancrofti, D. medinensis, T. spiralis

Microbiology books recommended

  1. Textbook of Microbiology - R. Ananthanarayan

- C. K. Jayaram Panikar

  1. A Textbook of Microbiology - P. Chakraborty
  2. Textbook of Medical Microbiology - Rajesh Bhatia & Itchpujani
  3. Textbook of Medical Microbiology - Arora and Arora
  4. Textbook of Medical Parasitology - C. K. Jayaram Panikar
  5. Textbook of Medical Parasitology - Arora and Arora
  6. Textbook of Medical Parasitology - S.C.Parija
  7. Microbiology in clinical practice - D. C. Shanson

Reference books:

  1. Mackie McCartney practical Medical Microbiology - Colle JG , Fraser AG
  2. Principles of Bacteriology, Virology & Immunology vol. 1,2,3,4,5 - Topley Wilsons
  3. Medical Mycology (Emmons)- Kwon – Chung
  4. Review of Medical Microbiology (Lange)- Jawetz
  5. Immunology - Weir DM
  6. Medical Microbiology - David Greenwood, Richard Stack, John Pentherer
  7. Parasitology - KD Chatterjee
  8. Medical virology - Timbury MC
  9. Mackie McCartney Medical, Microbiology vol.1 - Duguid JP

10.Microbial infections - Marmion BP, Swain RHA

Pharmacology

Goal: The broad goal of teaching pharmacology to undergraduate students is to inculcate in them a rational and scientific basis of therapeutics.

  1. A) INTRODUCTION: Pharmacology - a foundation to clinical practice

Development of the branch of pharmacology; Scope of the subject; role of drugs as one of the modalities to treat diseases, definition of drug; nature and sources of drugs; subdivisions of pharmacology rational pharmacotherapy

  1. B) GENERAL PHARMACOLOGY:
  2. C) AUTONOMIC PHARMACOLOGY:
  3. D) CARDIOVASCULAR SYSEM INCLUDING DRUGS AFFECTING
  • Pharmacokinetics
  • Application to pharmacotherapeutics
  • Adverse Drug Reactions 

COAGULATION AND THOSE ACTING ON KIDNEYS:

General Considerations and Overview of antihypertensive therapy;

Diuretics

Angiotensin Converting Enzyme (ACE) inhibitors

Sympatholytics & vasodilators

Management of hypertension

Antianginal: Nitrates & others

Calcium channel blockers

Pharmacotherapy of chest pain

Anticoagulants & Coagulants

Thrombolytics & Antiplatelet Agents

Drugs for CCF: Digitalis glycosides, Others agents

Management of CCF

Antiarrhythmic Agents

Agents used for the management of shock

Hypolipidaemic drugs

Role of Nitric oxide and endothelin to be covered in CVS

  1. E) HAEMATINICS AND HAEMATOPOIETIC FACTORS:

Agents used in therapy of iron deficiency anaemia and megaloblastic anaemia; Erythropoietin,

Management of anaemia

  1. F) NEUROPSYCHIATRIC PHARMACOLOGY INCLUDING INFLAMMATON, PAIN & SUBSTANCE ABUSE
  • General Considerations
  • Sedative-Hypnotics
  • Psychopharmacology: Antianxiety; Antipsychotics; Antidepressants
  • Antiepileptics
  • Therapy of neurodegenerative disorders:
  • Anti-Parkinsonian agents; cerebral vasodilators/nootropics
  • Local anaesthetics
  • Analgesics: Opioids; NSAIDs
  • Pharmacotherapy of pain including migraine
  • Pharmacotherapy of rheumatoid arthritis and gout
  • Substance abuse: Management of opioid, alcohol and tobacco addictions
  1. G) MISCELLANEOUS TOPICS - I:
  • Autocoids (to be covered before pain lectures)
  • Antiallergics: Antihistaminics
  • Drugs used for bronchial asthma
  • Pharmacotherapy of cough
  • Drugs acting on immune system:
  • Immunostimulants, immunosuppressants; pharmacology of vaccines & sera
  • Drugs acting on the uterus
  1. H) CHEMOTHERAPY INCLUDING CANCER CHEMOTHERAPY:

General considerations

Antimicrobial agents:

  • Sulphonamides & Cotrimoxazole
  • Quinoline derivatives
  • Penicillins, Cephalosporins & Other ? Lactams
  • Aminoglycosides
  • Macrolides
  • Tetracyclines & Chloramphenicol

Pharmacotherapy of UTI

General principles of Antimicrobial use

Antimycobacterial therapy: Anti-Kochs agents; Anti-leprotic agents

Pharmacotherapy of tuberculosis

Antiprotozoal agents:

Antiamoebic, Antimalarials and Anti Kala azar

Pharmacotherapy of malaria

Antihelminthics

(against intestinal Nematodes and Cestodes; extra intestinal Nematodes and Trematodes)

Antifungal agents

Antiviral agents including antiretroviral agents

Pharmacotherapy of STDs

Principles of cancer chemotherapy and their adverse drug reactions

(individual agents and regimes need not be taught)

  1. I) ENDOCRINOLOGY:

Introduction to endocrinology

(including Hypothalamic and Anterior Pituitary hormones)

Steroids

Glucocorticoids: Use and Misuse

Oestrogens & antagonists

Progestins & antagonists

Oral contraceptives & profertility agents

Testosterone & anabolic steroids

Fertility control

Thyroxine and antithyroid agents

Agents affecting calcification

Antidiabetic agents: Insulin; Oral antidiabetic drugs

Pharmacotherapy of Diabetes Mellitus

  1. J) AGENTS USED IN GASTROINTESTINAL DISORDERS:

Pharmacotherapy of nausea & vomiting

Pharmacotherapy of peptic ulcer

Management of dyspepsia

Management of diarrhoea and constipation

  1. K) PERIOPERATIVE MANAGEMENT: to be covered as a case study

Preanaesthetic medication

Preparation of surgical site: antiseptics etc.

Local Anaesthetics

Skeletal muscle relaxants

Drugs used in post-operative period: analgesics, antiemetics etc.

  1. L) MISCELLANEOUS TOPICS – II

Drug-Drug Interactions

Drug use at extremes of age, in pregnancy & in organ dysfunction 

Use of chelating agents in heavy metal poisonings; Environmental & occupational

toxicants and principles of management (particularly cyanide and CO) 

Ocular pharmacology

Dermatopharmacology

General Anaesthetics

Pharmacotherapy of glaucoma and conjunctivitis

  1. M) RATIONAL PHARMACOTHERAPY:

Prescription writing and P-drug concept

Rational Drug Use; Essential Drug List (EDL)

Criticism with reference to Fixed Drug Combinations (FDCs)

Use and misuse of commonly used preparations: vitamins, antioxidants, enzymes etc.

Pharmacology books recommended

  1. Basic & Clinical Pharmacology. Katzung BG (Ed), Publisher: Prentice Hall International Ltd., London.
  2. Pharmacology & Pharmacotherapeutics. Satoskar RS, Bhandarkar SD (Ed), Publisher: Popular Prakashan, Bombay.
  3. Essentials of Medical Pharmacology. Tripathi KD (Ed), Jaypee Brothers, publisher: Medical Publishers (P) Ltd.
  4. Clinical Pharmacology. Laurence DR, Bennet PN, Brown MJ (Ed). Publisher: Churchill Livingstone

Reference books:

  1. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. Hardman JG & Limbird LE (Ed), Publisher: McGraw-Hill, New York.
  2. A Textbook of Clinical Pharmacology. Roger HJ, Spector RG, Trounce JR (Ed), Publisher: Hodder and Stoughton Publishers.
Forensic Medicine and Medical Jurisprudence and Toxicology

Goal: The broad goal of teaching undergraduate students Forensic Medicine is to produce a physician who is well informed about Medico-legal responsibility during his/her practice of Medicine. He/She will also be capable of making observations and inferring conclusions by logical deductions to set enquiries on the right track in criminal matters and associated medico-legal problems. He/She acquires knowledge of law in relation to Medical practice, Medical negligence and respect for codes of Medical ethics.

  1. A) DEFINITION, SCOPE RELEVANT TO SUBJECT
  2. History of Forensic Medicine
  3. Need, Scope, Importance and probative value of Medical evidence in Crime Investigation
  1. B) PERSONAL IDENTITY NEED AND ITS IMPORTANCE.
  2. Data useful for Identification of Living and Dead
  3. Age estimation and its medico-legal Importance
  4. Sex determination and it’s medico-legal importance
  5. Other methods of establishing identity: Corpus Delicti, Dactylography, Tattoo marks, Deformities, Scars and other relevant factors
  6. Identification of decomposed, Mutilated bodies and skeletal remains
  7. Medico legal aspect of *DNA fingerprinting - a brief introduction
  8. Medico - legal aspect of blood and blood stains

Collection, Preservation and Dispatch of Specimen for Blood and other ancillary material for identification and Medico-legal examination

  1. C) MECHANICAL INJURIES AND BURNS
  2. Definition and classification of injuries: Abrasions, Contusions, Lacerations, Incised and Stab injury, Firearm and Explosion injury, Fabricated and Defence injury
  3. Medico-legal aspect of injury/hurt, simple and grievous hurts, murder, Ante -mortem, Postmortem Wounds, Age of the injury, cause of death and relevant sections of I.P.C., Cr.P.C.
  4. Causative Weapon and appearance of Suicidal, Accidental and Homicidal injuries
  5. Physical methods of Torture and their identification
  6. Reporting on Medico-legal cases of Hurts
  7. Regional injuries: Head injury, cut throat injuries and Road traffic accident injuries
  8. Thermal injuries: Injuries due to heat and cold, Frostbite, Burns, Scalds and Bride burning
  9. Injuries due to Electricity, Lightening

Collection, Preservation and Dispatch of Specimen for Blood and other ancillary material for Medico-legal examination

  1. D) MEDICO-LEGAL ASPECTS OF SEX, MARRIAGE AND INFANT DEATH
  2. Sexual Offences and perversions: Natural (Rape, Adultery, and Incest), Unnatural (Sodomy, Bestiality and Buccal coitus) Lesbianism, perversions and relevant sections of I.P.C. and Cr.P.C.
  3. Fertility, Impotence, Sterility, Virginity, and Nullity of marriage and divorce on Medical ground
  4. Pregnancy, Delivery, Paternity, Legitimacy, Artificial Insemination, *Fertilisation in Vitro, *Sterilization (Family Planning Measures)
  5. Abortions, Medical Termination of pregnancy, criminal abortions, Battered Baby Syndrome, Cot deaths and relevant sections of I.P.C. and Cr.P.C., M.T.P. Act of 1971 and foetal sex determination Act
  6. Infant death (Infanticide)
  7. Definition Causes, Manners and Autopsy features
  8. Determination of age of Foetus and Infant

iii. Signs of live-born, stillborn and dead born child

Collection, Preservation and Dispatch of Specimen: Hair, seminal fluid/ stains and other ancillary material for medico-legal examination, examination of seminal stains and vaginal swabs

  1. E) MEDICO-LEGAL ASPECTS OF DEATH
  2. Definition and concept of death, stages, modes, Signs of death and its importance
  3. Changes after death, Cooling, Hypostasis, Changes in eye, Muscle changes, Putrefaction, Saponification, Mummification, Estimation of time since death
  4. Death Certification, Proximate causes of death, causes of sudden deaths, Natural deaths. Presumption of death and survivorship, disposal and preservation of dead
  5. Introduction to *The Anatomy Act, *The Human organ transplantation Act. 1994
  6. Medico-legal aspects and findings of post-mortem examination in cases of death due to common unnatural conditions
  7. Sudden unexpected death, deaths from starvation, cold and heat and their medico-legal importance
  8. Medico-legal aspects of death from Asphyxia, Hanging, Strangulation, Suffocation and Drowning
  1. F) MEDICO-LEGAL AUTOPSY
  2. Autopsy: Objectives, Facilities, Rules and Basic techniques, Proforma for reporting medico-legal autopsy
  3. Exhumation, examination of mutilated remains, Obscure autopsy and post-mortem artifacts

Collection, preservation and despatch of material for various investigations to Forensic Science Laboratory

  1. G) FORENSIC PSYCHIATRY
  2. Definition, General terminology and * Basic concept of normality and abnormality of human behaviour, Civil and Criminal responsibility
  3. Examination, Certification, restraint and admission to Mental Hospital
  4. Mental Health Act – Principles and Objectives

Part – 2. Toxicology:

  1. A) POISONS AND THEIR MEDICO-LEGAL ASPECTS
  2. Definition of poison, General consideration and Laws in relation to poisons\Narcotic drugs and psychotropic substances Act, *Schedules H and L drugs, *Pharmacy Act, Duties and responsibilities of attending physician
  3. Common poisons and their classification, Identification of common poisons, Routes of administration, Actions of poisons and factors modifying them, Diagnosis of poisoning (Clinical and Confirmatory) , Treatment/ Management of cases of acute and chronic poisonings
  4. Addiction and Habit forming drugs, drug dependence
  5. Occupational and environmental poisoning, prevention and Epidemiology of common poisoning and their legal aspects particularly pertaining to Workmen’s Compensation Act
  6. Medico-Legal aspects and findings of postmortem examination in cases of death due to poisonings
  1. B) POISONS TO BE STUDIED
  2. Corrosive: Euphoric Acid, Nitric Acid, Hydrochloric Acid, Carbolic Acid and Oxalic Acid, Sodium and Potassium and Ammonium Hydro-Oxide
  3. Non-metallic, Metallic Poisons and Industrial hazards: Phosphorus and compounds of Lead, Arsenic, Mercury, Copper, and Glass powder
  4. Plant Poisons: Castor, Croton, Capsicum, Semicarpus Anacardium (Bhilawa), Calatropis Gigantea, Abrus Precatorius (Ratti), Dhatura, Cannabis Indica, Cocaine, Opium, Aconite, Yellow Oleander, Strychnine
  5. Animal and Bacterial Poisons: Snakes, Scorpion and Food poisoning
  6. Alcohol (Drunkenness) Ethyl Alcohol, Methyl Alcohol, Kerosene, Barbiturates
  7. Asphyxiant & Gaseous Poisons: Carbon Monoxide, War gases, Hydrocyanic acid, and Cyanides
  8. Insecticides, pesticides and Miscellaneous poisons: Organo-Phosphorus Compounds, Organo-Chloro Compounds, Carbamates (Carbaryl) and Rodenticides (Phosphides)

Collection, Preservation and forwarding of evidence, remains of poison, body discharges and viscera etc. to Forensic Science Laboratory in cases of poisoning

  1. C) FORENSIC SCIENCE LABORATORY: (BRIEF)
  2. Aims, objects, general knowledge about Forensic Science Laboratory
  3. General principles of analytical toxicology

Part – 3 Medical Jurisprudence:

  1. A) LEGAL AND ETHICAL ASPECTS OF PRACTICE OF MEDICINE
  2. The Indian Medical Council, the Act, Formation and Functions; State Medical Council: Formation, Functions, and Registration
  3. Rights and obligations of Registered Medical Practitioners and patient, Duties of physicians and patients, Euthanasia
  4. Infamous conduct, Professional secrecy and privileged communications
  5. Codes of Medical Ethics, medical etiquette, Medical Negligence and contributory negligence, Precautionary measures and defences for Medical Practitioners against legal actions, Medical/Doctors indemnity insurance, Consumer Protection Act relevant to medical practice
  6. Medical Ethics and prohibition of Torture & care of Torture Victims
  1. B) DEFINITION OF HEALTH AND ITEMS TO CERTIFY ABOUT HEALTH
  2. Common medico-legal problems in Hospital practice, Consent in Medical Examination and treatment, under treatment/ Sickness and Fitness certificate, maintenance of medical records
  3. Social, Medical, Legal and Ethical problems in relation to AIDS
  1. C) ACTS AND SCHEMES RELATED TO MEDICAL PROFESSION IN BRIEF:

Workmen’s compensation Act, * Mental Health Act, Medical Practitioner Act, Protection of human rights Act, 1993, * National Human Rights Commission, * Human Organ Transplantation Act and other relevant sections of I.P.C., Cr.P.C. and I.E. Act. Maharashtra civil medical code, Hospital administration manual

Part – 4 Legal procedures in medico-legal cases: (N=8)

  1. Medico-Legal Investigations of death in suspicious circumstances, different Inquest, type of offences
  2. Types of Criminal courts and their powers, punishments prescribed by law, kinds of witnesses, Evidence, Documentary Medical evidence, Dying declaration and Dying deposition
  3. The Trial of criminal cases, Rules and Conventions to be followed by Medical Witness at Medical evidence, subpoena, conduct money
  4. Relevant Sections from the Indian Evidence Act, Indian Penal code and Criminal Procedure code

Forensic medicine books recommended

  1. Modi’s Textbook of Medical Jurisprudence and Toxicology Ed. 22, 1999, by B.V. Subramanyam, Butterworth
  2. The Essentials of Forensic Medicine & Toxicology by K.S. Narayan Reddy
  3. Parikh’s Textbook of Medical Jurisprudence and Toxicology.
  4. Text Book of Forensic Medicine – J.B. Mukherjii VOL 1 & 2
  5. Principles of Forensic Medicine - A. Nandy
  6. Toxicology at a Glance by Dr S.K. Singhal
  7. Bernard Knight et. All: Cox’s Medical Jurisprudence & Toxicology
Reference books
  1. Russell S. Fisher & Charles S.Petty: Forensic Pathology
  2. Keith Simpson: Forensic Medicine
  3. Jurgen Ludwig: Current Methods of autopsy practice.
  4. Gradwohl – Legal Medicine
  5. A Doctors Guide to Court – Simpson
  6. Polson C.J. : The essentials of Forensic Medicine
  7. Adelson, L.: The Pathology of Homicide.
  8. Atlas of Legal Medicine (Tomro Watonbe)
  9. Sptiz, W.U. & Fisher, R.S.: Medico-legal Investigation of Death.
  10. A Hand Book of Legal Pathology (Director of Publicity)
  11. Taylor’s Principles & Practice of Medical Jurisprudence. Edited by A.Keith Mant, Churchill Livingstone.
  12. Ratanlal & Dhirajlal, The Indian Penal Code; Justice Hidayatullah & V.R. Manohar
  13. Ratanlal & Dhirajlal, The Code of Criminal procedure; Justice Hidayatullah & S.P. Sathe
  14. Ratanlal & Dhirajlal, The Law of Evidence; Justice Hidayatullah & V.R. Manohar
  15. Medical Law & Ethic in India – H.S. Mehta
  16. Bernard Knight : Forensic Pathology
  17. Code of medical ethics : Medical Council of India, approved by Central Government, U/S 33 (m) of IMC Act, 1956 (Oct 1970)
  18. Krogman, W.M.: The human skeleton in legal medicine.
  19. FE Camps, JM Cameren, David Lanham : Practical Forensic Medicine
  20. V.V. Pillay : Modern Medical Toxicology.

In second year, students are also learning some part of Community Medicine. But they will appear for exam on above subject only.