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SYLLABUS
GUIDE FOR YEAR 2009
SYLLABUS
OF FIRST PROFESSIONAL M.B.B.S.
PART-I
SYLLABUS OF FIRST PROFESSIONAL M.B.B.S.
PART-II
SYLLABUS OF SECOND PROFESSIONAL M.B.B.S.
SYLLABUS OF THIRD PROFESSIONAL M.B.B.S.
SYLLABUS OF FOURTH PROFESSIONAL M.B.B.S.
SYLLABUS OF SECOND PROFESSIONAL M.B.B.S.
A)
GENERAL PATHOLOGY
CELL
INJURY
1.
Necrosis, Ischemia, Hypoxia, Infarction and Gangrene
Oncosis
and Autolysis.
2.
Sequence of the ultrastructural and biochemical changes
which
occur in the cell in response to the following:
§ Ischemia
§ Immunological
injury, e.g., Asthma / SLE / Anaphylactic
reaction
§ Physical agents,
e.g., Radiation
§ Genetic defects,
e.g., Thalassemia / Hemophilia
§ Nutritional
deficiency, e.g., Kwashiorkor
§ Infectious agents
§ Viruses, e.g.,
Hepatitis
§ Bacteria, e.g.,
Staphylococcus aureus
§ Fungi, e.g.,
Candida
§ Parasites, e.g.,
Malaria
§ Nutritional
deficiency
3.
Irreversible and reversible injury
4.
Apoptosis and its significance.
5.
Necrosis and its types
6.
Exogenous and endogenous pigmentation.
7.
Dystrophic and metastatic calcification along with clinical
significance.
8.
Metabolic disorders
• Lipid
disorders, Steatosis of liver, Hyperlipidemia
• Protein
disorders
•
Carbohydrate disorders
INFLAMMATION, MEDIATORS OF INFLAMMATION
1. Role of
inflammation in the defense mechanisms of the body.
2.
Vascular changes of acute inflammation and their relation to
morphological and tissue effects.
3. Process
of Chemotaxis, Opsonization and Phagocytosis.
4. Role of
cellular components in inflammatory exudate.
5.
Exudates and transudate.
6.
Important chemical mediators of inflammation.
7. Pathway
of Arachidonic Acid metabolism.
8. Role of
products of Arachidonic acid metabolism in inflammation.
9.
Mechanism for development of fever, with reference to exogenous and
endogenous
pyrogens.
10.
Chronic inflammation including Granulomas.
11.
Granuloma and its types along with causes.
12.
Systemic effects of acute and chronic inflammation and their possible
outcomes.
13.
Significance of ESR.
14.
Induced hypothermia in medicine.
15.
Healing in specialized tissue.
WOUND
HEALING
1. Repair
and regeneration.
2. Wound
healing by first and second intention.
3. Factors
that influence the inflammatory reparative response.
4. Wound
contraction and cicatrisation.
5.
Formation of granulation tissue.
6.
Complications of wound healing.
DISORDERS OF CIRCULATION
a.
Thrombo-embolic disorders and their modalities
1.
Etiology and pathogenesis of thrombosis.
2.
Possible consequences of thrombosis
3.
Difference between thrombi and clots
4.
Classification of emboli according to their composition.
5.
Difference between arterial and venous emboli.
b.
Hemorrhage, Hyperemia and Congestion
1.
Definitions of common types of Hemorrhage
2. Types
of hyperemia
3.
Difference between hyperemia and congestion
c.
Infarction
1. Types
of infarction
2.
Difference between anemic and hemorrhagic infarct
3.
Morphological picture of infraction in different organ systems
d.
Disorders of the circulation and shock
1. Edema,
ascites, hydrothorax and anasarca.
2.
Pathophysiology of edema with special emphasis on CHF.
3.
Pathogenesis of four major types of shock (Hypovolemic,
cardiogenic, vasovagal & septic) and their causes.
4.
Compensatory mechanisms involved in shock.
MICROBIOLOGY
1. Defence
mechanisms of the body.
2.
Microbial mechanisms of invasion and virulence.
3.
Difference between sterilization and disinfection.
4. Methods
of disinfection and sterilization of the following:
a.
Facility where the doctor practices,
b.
Examination table ,
c. Any
spillage e.g. sputum, vomitus, stool, urine, blood,
d.
Examination tools , e.g., thermometer, nasal and ear specula and
spatula,
5.
Principles of aseptic techniques such as Venepuncture, urinary
catheterization, bandaging, suturing and lumber puncture.
6.
Universal precautions for infection control.
7. General
principles of the following serological tests:
a. ELISA –
Hepatitis (A,B,C,D,E,G) Rubella, CMV and HIV
b. PCR
c.
Haemagglutination – TPHA
d. Western
Blot –HIV
Malaria.
8.
Interpretation of :
a. Culture
reports
b.
Serological reports and
c.
Microscopic reports of gram stain and ZN stain.
9.
Principles of proper collection and submission of specimens for
laboratory
investigations
9. General
characteristics and taxonomy of Bacteria, Rickettsia,
Chlamydia,
Viruses and Fungi.
11.
Communicable, Endemic, Epidemic, and Pandemic Diseases, Carriers
Pathogens,
Opportunists, Commensals and Colonizers.
12.
Microorganisms responsible for infection of the following organ
systems:
§ Central Nervous
System
§ Respiratory
System
§ Gastrointestinal
System
§ Genital System
§ Urinary System
§ Infections of
Bones and Joints
§ Zoonosis
§ Infection of the
Skin
§ Hepatic
Infections
13
Pathogenesis, Treatment, Epidemiology, Prevention and Control of the
following
organisms:
(i)
Bacteria
Staphylococcus aureus
Streptococcus pneumoniae
Beta
hemolytic streptococcus group a & b
Diphtheria
sp.
Bordetella
sp.
Bacillus
anthracis
Clostridium perfrignes
Clostridium botulinum,
Clostridium difficile
Clostridium tetani
Actinomycies israelli
Nocardia
asteroides
Neisseria
meningitis
Neisseria
gonorrhoeae
Gardenella
vaginalis
Haemophilus influenzae
Mycobacterium tuberculosis
Mycobacterium leprae
E.coli
Klebsiella
Proteus
Salmonella
Shigella
Yersinia
pestis
Pseudomonas
Vibrio
cholera
Vibrio
parahemolyticus
Campylobacter jejuni
Helicobacter pylori
Legionella
Mycoplasma
pneumoniae
Chlamydia
Treponema
pallidium
Leptospira
Rickettsia
sp.
(ii)
Viruses
Mumps
Herpes
Measles
Influenza,
Para
influenza
RSV
Hepatitis
A, B, C, D, E
Rota
CMV
EBV
Rubella
Chicken
Pox
HIV
Rabies
(iii)
Fungus
Cryptococcus neoformans
Candida
albicans
Tinea
species
(iv)
Protozoa
Plasmodium
species
Giardia
lamblia
Entamoeba
histolytica
Cryptosporidium
Leishmania
species
Trichomonas vaginalis
Toxoplasma
gondii
Pneumocyctis carinii
(v)
Helminths
Ascaris
lumbricoides
Ancylostoma duodenale
Trichuris
trichuria
Enterobius
vermicularis
Filaria
species
Strongyloides stercoralis
Schistosoma species
Echinococcus species
Taenia
solium
Taenia
saginata
Hymenolepis nana
PRINCIPLES OF ANTI MICROBIAL ACTION.
1.
Antibiotics, selective toxicity, bacteriostatic and bactericidal.
2. Host
determinants in relation to selection of an antimicrobial drug for
therapy.
3. Minimum
inhibitory concentration (MIC) and minimum bactericidal
concentration (MBC)
4.
Bacterial resistance and the mechanisms involved in acquiring bacterial
resistance
5.
Mechanisms involved in transfer of drug resistance to bacterial
resistance.
6. Mode of
action of various antimicrobial drug groups.
7.
Superinfection and cross sensitivity.
LIST OF
COMMON ORGANISMS CAUSING ORGAN SYSTEM EFFECTS
a.
Common organisms causing CNS Infections
(i)
Bacteria
Steptococcus pneumoniae
Beta
hemolyticus srteptococcus group b
Neisseria
meningitidis
Haemophilis influenzae
Mycobacterium tuberculosis.
E.coli
Listeria
monocytogenes
(ii)
viruses
Enterovirus
Mumps
Herpes
Adenovirus
(iii)
fungus
Cryptococcus neoformis
(iv)
protozoa
Malaria
Toxoplasma
B.
Common organisms causing respiratory tract infection
(i)
bacteria:
Steptococcus pneumoniae
Beta
hemolyticus streptococcus group b
Diptheria
sp.
Bordetella
sp.
Hemophilus
influenzae
Mycobacteriurn tuberculosis
Klebsiella
Legionella
Mycoplasma
pneumoniae
(ii)
viruses
Herpes
Adeno
virus
Measles
Influenza
Para
influenza
Rhinovirus
RSV
(iii)
protozoa
Pneumocystic carinii
C.
Organisms causing gastrointestinal tract infection / infestation
(i)
Bacteria
Clostridium difficile
Mycobacterium tuberculosis
Salmonella
Shigella
Vibrio
cholera
Vibrio
parahemolyticus
Campylobacter jejuni
Helicobacter pylori
(ii)
Viruses
Hepatitis
A
Rota
Astro
(iii)
Fungus
Cryptococcus neoformis
(vi)
Protozoa
Giardia
lamblia
Entameba
histolytica
Cryptosporidium
D.
Common organisms causing hepatic infections
(i)
Bacteria
Streptococcus species
Coliforms
Anaerobes
(ii)
Viruses
Herpes
Hepatitis
A, B, C, D, E
CMV
EBV
(iii)
Protozoa
Entameba
histolytica
Tape worms
Echinococcus granulosus
E.
Common organisms causing skin infection
(i)
bacteria
Staphylococcus aureus
Streptococcus pyogenes
Actinomyces israelli
Nocardia
asteroides
Mycobacterium tuberculosis
Mycobacterium leprae
Corynebacterium diphtheriae
(ii)
viruses
Herpes
Measles
Rubella,
Chicken
pox
Moluscum
contagiosum
(iii)
fungus
Candida
albicans
Tinea
species
(iv)
arthropodes
Sarcoptes
scabiei
Pediculus
species
Cinex
lectularius
(v)
helminths
Filaria
species
Strongyloides stercoralis
Schistosoma sp.
(vi)
protozoa:
Leishmania
species.
f.
Common organisms causing bone and joint infection
Bacteria: Staph aureus,
Streptococcus pyogenes, Haemophilus
influenzae,
Neisseria gonorrhoeae, Brucella melitenesis, Salmonella
typhi,
Strep. pneumonae, Pseudomonas sp. and Mycobacterium
tuberculosis.
g.
Common organisms causing genital infection
(i)
Bacteria: Mycoplasma
urealyticum
(ii)
Viruses: Pox, Herpes,
Hepatitis B, HIV
(iii)
Fungus: Candida albicans
(iv)
Arthropodes: Sarcoptes scabiei
(v)
Protozoa: Tricomonas vaginalis
h.
Common organisms causing zoonosis
(i)
Viruses: Rabies,
(ii)
Protozoa: Toxoplasma gondii,
Leishmania sp.
(iii)
Helmenthics: Echinococcus sp.
GENETICS
1. Common
sex linked, autosomal recessive and autosomal dominant
disorders.
2. Common
genetic mutations.
3.
Diseases associated with consanguineous marriages.
4.
Molecular biology techniques.
GROWTH
DISORERS/NEOPLASIA
1. Atrophy
and Hypertrophy, Agenesis, Dysgensis, Aplasia, Hypoplasia,
Hyperplasia, Metaplasia, Dysplasia, Neoplasia, Anaplasia,.
2. Cell
cycle and cell types (stable, labile, permanent)
3.
Mechanisms controlling cell growth
4.
Classification systems of tumors.
5.
Characteristics of benign and malignant tumors
6.
Difference between Carcinoma and Sarcoma.
7. Grading
and staging system of tumors.
8. Biology
of tumor growth
9. Process
of carcinogenesis
10. Host
defense against tumors.
11.
Mechanism of local and distant spread.
12. Local
and systemic effects of tumors.
13. Tumor
markers used in the diagnosis and management of cancers.
14. Common
chemical, physical agents and viruses related to human
cancer.
15.
Epidemiology of common cancers in Pakistan.
16.
Radiation and its effects on tissues.
17. Cancer
screening.
IMMUNOLOGY
1.
Antigen, antibody, epitope, hapten and adhesion molecules.
2.
Difference between innate and acquired immunity.
3.
Structure and function of major histocompatibility complex (MHC).
4.
Cytokines.
5.
Mechanism of humoral and cell medicated immunity.
6.
Hypersensitivity reactions, Type I, Type II, Type III and Type IV.
7.
Autograft, homograft, allograft and xenograft.
8.
Immunotolerance and immunoparalysis.
9.
Mechanism involved in allograft rejection and steps that can be taken
to combat
rejection.
10.
Classification of Immunodeficiency disorders
11. Basis
of autoimmunity.
12. Tissue
transplantation.
13.
Pathology and pathogenesis of AIDS.
14. Lab
diagnosis of immunological diseases.
RECOMMENDED BOOKS
1.
Pathological Basis of Disease by Kumar, Cortan and Robbins, 7th
Ed., W.B.
Saunders.
2.
Medical Microbiology and Immunology
by Levinson and Jawetz,
9th
Ed., Mc Graw-Hill.
3. Medical Genetics
by Jorde, 3rd Ed., Mosby.
4.
Clinical Pathology Interpretations
by A. H. Nagi
B.
PHARMACOLOGY AND THERAPEUTICS
The
course outline is as follows:
1)
General Pharmacology:
1.
Definition of pharmacology, objectives of learning pharmacology,
definition
of drug and drug nomenclature.
2.
Branches/divisions of pharmacology.
3. Sources
of drugs.
4. Active
principles of drugs and pharmacopoeias.
5. Dosage
forms and doses of drugs.
6. Route
of drug administration.
7.
Absorption of drugs and processes involved in drug absorption.
8. Factors
modifying absorption of drugs.
9.
Transport of drugs across cell-membrane.
10.
Bio-availability, its clinical significance and factors affecting
bioavailability.
11. Drug
reservoirs, distribution and redistribution of drugs, plasma protein
binding.
12.
Pro-drug, bio-transformation of drugs, enzyme induction, enzyme
inhibition
and entero-hepatic circulation.
13. Plasma
half-life of drugs, steady state concentration, its clinical
importance
and factors affecting it.
14.
Excretion of drugs.
15.
Mechanism of drug action.
16. Dose
response curves, structure-activity relationship.
17.
Factors modifying action and doses of drugs.
18.
Pharmacokinetics, pharmacodynamics and receptors.
19.
Pharmacogenetics.
2)
Dermatological and topical drugs (Locally Acting Drugs)
§
Demulcents, emollients, irritants, counter irritants, astringents.
Antiseborrhoeics, locally acting enzymes.
§
Antiseptics and disinfectants.
§
Ectoparasiticides.
3)
Drugs Acting on Gastrointestinal Tract:
§ Emetics
and anti emetics.
§ Drugs
affecting motility of GIT.
§ Ulcer
healing drugs.
§
Purgatives/ laxatives.
§
Antidiarrhoeals.
4)
Cardiovascular Drugs
§
Antiarrhythmic drugs.
§
Inotropic drugs.
§
Antihypertensive drugs.
§
Thrombolytics/ anticoagulants/ antiplatelets.
§
Antihyperlipidemic drugs.
§ Anti-anginal
drugs.
§ Drug
management of CCF.
5)
Diuretics
6)
Autocoids
7)
Drugs Acting on Autonomic Nervous System
Cholinergic Drugs.
§ Choline
esters.
§
Anticholine -esterases cholinomimetic alkaloids.
Anti-cholinergic drugs
- Anti
muscarinic
- Anti
nicotinic
Sympathomimetics / adrenergic drugs:
-
Catecholamine
- Non
catecholamine
Sympatholytics/antiadrenergics
- Alpha
adrenergic receptor blockers.
- Beta
adrenergic receptor blockers
Adrenergic neuron blockers
Autonomic ganglionic blockers
Skeletal muscle relaxants
A)
neuromuscular blocking agents - d-tubocurarine, suxamethonium, etc.
B) central
muscle relaxants , meprobamate, mephenesin, diazepam, etc.
8)
Central Nervous System
a.
Sedative-hypnotics.
b.
Anti-epileptics.
c. Anti-parkinson
drugs.
d. General
anaesthetics.
e. Local
anesthetics.
f. Drugs
for movement disorder/ muscle relaxant.
g.
Alcohol.
h. Drugs
for migraine.
i.
Stimulants of the central nervous system:
-
Caffeine, theophyline, theobromine
- Brain
stem stimulants: picrotoxin, nikethamide.
-
Ethamivan, doxapram.
- Spinal
cord stimulants: strychnine.
i.
Psychopharmacology:
-
Anti-psychotics.
-
Anxiolytics.
-
Anti-depressant / anti mania drugs.
- Alcohol
and drugs of abuse.
9)
Analgesics
a. Opioids
and narcotics analgesics.
b.
Nonsteroidal anti inflamatory drugs (NSAID).
c.
Antigout drugs.
10)
Drugs Acting on Respiratory System
a. Drugs
used in treatment of bronchial asthma.
b.
Expectorants.
c.
Mucolytics.
d.
Antitussives.
11)
Drugs Acting on Endocrine System
a.
Pituitary-hypothalamic drugs.
b.
Adrenocorticoids.
c. Sex
hormones
d.
Thyroid/ parathyroid drugs.
e.
Pancreatic hormones and oral anti diabetic drugs.
f. Oral
contraceptives and anabolic steroids.
12)
Drugs Acting on Uterus
a.
Ergometrine.
b.
Terbutaline .
c.
Dinoprostone.
d.
Carboprost.
e.
Ritodrine .
f.
Oxytocin.
Antimicrobial Drugs
a.
Sulfonamides.
b.
Penicillins .
c.
Cephalosporins.
d.
Aminoglycosides.
e.
Tetracyclines.
f.
Macrolides:
Chloramphenicol.
g.
Quinolones.
h. Anti-
tuberculous drugs.
i.
Antileprosy drugs.
j. Anti
fungal drugs.
k.
Antiviral drugs.
l. Anti-protozoal
drugs:
- Anti-
malarial drugs.
-
Anti-amoebic drugs.
m. Urinary
tract antiseptics.
n. Anti
cancer drugs.
o.
Immunosuppressive agents.
p.
Miscellaneous.
q.
Vaccines and immunoglobulin drug interaction.
CLINICAL PHARMACOLOGY & THERAPEUTICS:
The
teaching of clinical Pharmacology should be designed to meet the daily
needs of
medical graduates. It should consist of lectures and demonstrations.
Drug
treatment of Peptic Ulcer
Drug
treatment of Bronchial Asthma
Drug
treatment of Epilepsy
Treatment
of Parkinsonism Syndrome
Drug
treatment of Rheumatic diseases
Drug
treatment of Ischaemic Heart Disease
Drug
treatment of Hypertension
Treatment
of congestive Heart Failure
Drug
treatment of Hyperlipidemia
Drug
treatment of Edemas
Drug
treatment of different types of shock
Drug
treatment of psychiatric disorders
Drug
treatment of tuberculosis
Drug
treatment of Malaria
Drug
treatment of Typhoid fever
Drug
treatment of Amoebiasis
Drug
treatment of Glaucoma
P R A C
T I C A L S
A -
EXPERIMENTAL PHARMACOLOGY
Experiments designed to observe the action of drugs on animals and
isolated
tissue.
Experiments on the actions of selected drugs to be demonstrated to the
students.
1. Effects
of drugs on reflex time.
2. Effects
of drugs on frog's heart in situ.
3. Effects
of drugs on rabbit's eye.
4. Effects
of Acetylcholine and Atropine on isolated rabbit's ileum.
5. Effects
of histamine and antihistamines on isolated rabbit's ileum.
6. Schemes
to find out unknown drug having stimulatory or inhibitory
effect on
isolated rabbit's ileum .
7. Effects
of neuromuscular blocking agents on frog’s rectus abdominus
muscle.
8.
Methodology of clinical trials .
9.
Introduction to Biostatistics.
B.
PRESCRIPTION WRITING
General
principles
§ General
principles
§
Guideline for rational use of drugs
§
Prescription writing for common ailments
Ø Acute
watery diarrhea
Ø
Bacillary dysentery
Ø Amoebic
dysentery
Ø
Ascariasis
Ø
Tape-worm infestation
Ø Acute
streptococcal pharyngitis
Ø Iron
deficiency anemia
Ø Allergic
rhinitis
Ø Scabies
Ø Acute
malarial fever
Ø Cerebral
malaira
Ø Typhoid
fever
Ø
Bronchial asthma
Ø
Hypertension
Ø Migraine
Ø Cardiac
failure
Ø Shock
Clinico-Pharmacological
Seminars on Rational Drug Therapy and
Drug
Interaction should be conducted
Antibiotics:
Frequency
distribution of antibiotic prescribed in different clinical settings/units.
Rational
prescribing pattern of antibiotics.
Parameters: provisional diagnosis, investigation, empirical therapy.
Prescribing
after
culture and sensitivity.
Vitamins:
Parameters
Groups of
vitamin prescribed.
Vitamins
prescribed on basis of therapeutic indication or empirical.
Single /
multiple vitamins
Frequency
of prescribing and rational use of vitamins/ otherwise.
Analgesics
Parameters
a.
Frequency distribution of various groups of analgesic prescribed.
b. Single
/ multiple drug prescription.
c. Non
specific indications of analgesic prescription.
Adverse
Drug Reactions
a. Anti-microbials,
Cytotoxic drugs , Steroids etc.
RECOMMENDED BOOKS
1. Basic and Clinical Pharmacology
by Katzung, 10th Ed., Mc
Graw-Hill.
2. Pharmacology
by Champe and Harvey, 2nd Ed., Lippincott Williams &
Wilkins.
C.
FORENSIC MEDICINE & TOXICOLOGY
The
course outline is as follows:
1.
FORENSIC MEDICINE
a)
Pakistan’s Legal System:
The powers
and jurisdiction of courts, procedures for inquest, and
legal
procedures. Important legal terms. Application of relevant
Legal
Sections of the Penal Code. The role of a medical doctor in
the
medico-legal system. To give Medical evidence in courts.
Document
information to be prepared by a medical doctor for legal
procedures. Procedure of court attendance and recording of
evidence.
b)
Forensic Sciences:
Role of
Forensic Sciences in crime detection.
c) Law
in relation to medical men:
Privileges
and obligations of Registered medical practitioner.
Doctor-patient relationship in the context of the highest ethical
standards.
Temptations to professional misconduct. Guarding
professional secrets and privileged communication. Maintaining
highest
ethical principles in medical examination and when
obtaining
consent. Medical negligence. Declaring Brain death,
using the
highest ethical and biological principles for the decision.
The pros
and cons of organ transplantation in each individual
case.
Develop
and defend a personal moral view on Artificial
insemination, Therapeutic abortions, Euthanasia, Biomedical
research
etc. in keeping with the norms of society and highest
ethical
principles.
d)
Personal Identity
Parameters
of personal identity, methods of identifying living,
dead,
decomposed, mutilated and burnt bodies, and skeletal and
fragmentary remains, using special techniques (Dentistry
Radiology,
Neutron Activation Analysis etc.), and objective
methods of
identification (Osteomtery, Dactyloscopy, D.N.A.
Technique,
Super imposition photography, etc.) Describe the role
of various
blood groups in resolving paternity and maternity
disputes.
Methods to determine time since death.
Methods of
determination of age, sex and race by various
methods
with their medico-legal aspects.
Methods to
trace evidence, Locard’s Principle of exchange and its
medico-legal significance.
e)
Thanatology
Scientific
concepts regarding death, medico-legal aspect of brain
death,
indicators of death, medico-legal aspects of sudden and
unexpected
deaths, causes, manner, mode and mechanisms of
death.
Physicochemical changes subsequent to death occurring in
various
body tissues and organs under various environmental
conditions.
To write a
certification of death according to W.H.O guidelines.
f)
Traumatology
i)
Mechanical Injuries: Mechanisms of wound production,
classification of wounds, wounds produced by conventional
weapons
and their medico-legal aspects. Firearms,
ammunition, classification, nomenclature, wound ballistics and
medico-legal aspects.
Ii)
Mechanical injuries medicolegal considerations: Laws in
relation
to causing bodily harm, wounding and homicide.
-
Examination of an injured person, certify nature, manner of
injury,
causative agent and dating of wounds.
- Link
Sequelae of trauma to its original cause and search
for the
relationship of sequelae to pre-existing disease.
- Causes
of death from wounds.
-
Difference between ante-mortem and post-mortem
wounds.
- To
diagnose whether death is suicidal, homicidal or
accidental.
Iii) The
student should also have knowledge of and be able to
describe
methods of treatment and possible etiologies of
regional
injuries, and should be able to suture simple
superficial wounds of:
Head
(scalp, skull, brain) and face, vertebral column and its
contents,
neck, chest, abdomen, limbs, bones and joints.
and
Special
trauma such as transportation injuries, police torture,
and
Death in
custody
and
Should be
able to determine the medico-legal aspects of heat,
cold,
electrical injuries.
g)
Violent deaths due to asphyxia
Anatomical, physiological, biochemical and pathological signs of
violent
death and of mechanical, chemical and environmental as
physical
death and their medico-legal implications. Death due to
drowning.
h)
Autopsy:
- Types,
objectives, rules, and techniques and describe
procedure
for postmortem.
- Methods
for assessment of fatal period and postmortem
interval.
Post-mortem artifacts. Risks and hazards of autopsy,
and
autopsy protocol.
-
Procedure for selection and preservation, labeling and
dispatch
of biological and non-biological materials for
laboratory
examination; and collection of relevant samples.
-
Exhumation procedures, and their value and limitations.
i)
Forensic Sexology.
Virginity,
pregnancy and criminal processes during delivery, their
medico-legal aspects, examination procedure and reporting.
j)
Sexual offences and relevant sections of law (Zina and
Hudood
Ordinance)
- Natural
and unnatural sexual offences. Medical examination
of victim
and assailant, collection of specific specimens and
writing a
required certification.
- Common
sexual perversions and their cause.
k)
Miscarriage
Medico-legal aspects applicable to miscarriage examining mother
and
aborted material.
Sending
aborted material in proper preservative for examination.
l)
Crime against new born, infants and child:
Infanticide, and criminal and non-accidental violence or abuse to a
newborn,
infant or child.
m)
Forensic Psychiatry
- To
diagnose mental illness.
- To
distinguish between true and feigned insanity.
- To
advise on procedure of restraint of the mentally ill,
Limitations to civil and criminal responsibilities of mentally ill.
n)
Examination of biological specimens
- Forensic
importance of biological specimens (blood, semen,
salvia,
vomitus, breath, urine, hair),
- The
method of their collection, preservation, dispatch and the
common
laboratory tests performed.
2.
TOXICOLOGY
a)
General principles of Toxicology
- The
scope of Toxicology.
- To
access the laws regulating drugs and noxious products.
- Common
Toxicants in our environments and their abuse.
- Cause of
drug dependence, the fate and detoxification of
poisons in
the biological tissues.
- To
diagnose toxicological cases in acute and chronic
exposure
in living and dead. Utilize general principles of
treatment
with antidotal therapy and management.
- To
handle specimens, work within the framework of duties of
Doctor in
cases of poisoning to prepare and interpret chemical
examiners
reports.
b)
Autopsy techniques with
collection, preservation and dispatch of
biological
material to analytical laboratory.
c)
Specific Poisons
Poisons/drugs of abuse prevailing in our society along with
medico-legal aspects:
i) Alcohol
ii)
Opiates, opioids and other narcotics
iii)
Salicylates and paracetamol
iv)
Hypnotics and sedatives
v)
Stimulants (cocaine), cannabis
vi)
Poisonous plants (aconite, belladonna, hyoscyamus,
stramonium,
digitalis, ergot, mushrooms, nux vomica,
oleander,
tobacco)
vii)
Venomous insects (snakes)
viii)
Inorganic elements, antimony, arsenic, lead, mercury,
phosphorus
ix)
Volatile poisons and corrosives (carbon monoxide, hydro
carbons,
cyanides, sulfuric acid, oxalic acid, carbolic acid
and
alkalis)
x)
Pesticides, herbicides and insecticides
Forensic Medicine
a) Oral
b)
Practical
c) Note
book
Toxicology
a) Oral
b)
Practical
c) Note
book
Learning Methodology:
Recommendations are as under:-
A) Theory
in the form of tutorials, seminars, videos and lectures
B)
Practical in the form of :
§
Demonstrations
§ Posting
in autopsy rooms
§ Postings
such as in medico-legal clinics / casualty departments /
poison
centers.
§
Experiments in biological laboratory.
C) Visits.
D)
Periodical tests will provide feedback to the teachers and assess
adequacy
of learning.
Practical
work will include
1. In
Forensic Medicine
Ø
Autopsies
Ø
Medico-legal examination of injured
Ø
Estimation of age and forensic radiology
Ø Sexual
assaults and sex related cases (impotence, pregnancy etc.).
Ø
Procedure of preservation, dispatch of biological and other
evidentiary material.
Ø
Practical in biological laboratory (identification of blood, semen,
saliva,
etc.).
Ø
Procedure of consent taking and medical certification.
2. In
Toxicology, students should have an understanding of and be able to
describe :
Ø
Diagnostic and management process (alcohol, narcotics and
insecticide poisons).
Ø
Collection, preservation and dispatch of biological materials.
Ø Visual,
olfactory and tactile identification of common poisons found
in
communities and country.
3. Visits
For proper
orientation and practical demonstration, visits are also
suggested
to a:
Ø Court.
Ø Forensic
science laboratory.
Ø
Psychiatric unit or jail
Ø Site
during conduction of exhumation.
RECOMMENDED BOOKS
1. Simpson’s Forensic Medicine
by Barnard Knight, 11th
Ed.,
Edward
Arnold, London.
2.
Parikh’s Text book of Medical Jurisprudence, Forensic
Medicine and Toxicology
by C.K. Parikh 6th Ed.,
CBS Publisher.
3.
Buchanan’s Text book of Forensic Medicine and Toxicology
by
Buchanan, 9th Ed., Livingstone.
4. G.
Principles and Practice of Forensic Medicine
by Prof. Nasib
R. Awan.
5.
Medical Jurisprudence and Toxicology
by Dr. Siddique Hussain.
|
Punjab
Medical College Faisalabad, Pakistan.
