BLDE University Courses

M.D. (Physiology)

Course Syllabus

Objectives:

At the end of the course a postgraduate student in Physiology should be able to:

• Demonstrate comprehensive knowledge and understanding of general and systemic Physiology.
• Comprehend and understand physiological basis of health and disease affecting various organ systems.
• Select and use appropriate teaching techniques and resources.
• Critically evaluate published journal literature and to effectively use the library facilities including computer, C.D. Rom and Satelite search.
• Carryout relevant research.
• Function as an effective member of teaching team or research team.
• Carryout professional obligations ethically and keeping in view national health policy.

Outline of course contents

Theory

• History of Medicine with special reference to physiology
• Comparative Physiology
• Systemic Physiology
• General Physiology at Cellular, Sub Cellular and Molecular level.
• Clinical and Applied Physiology.
• Exercise and Sports Physiology.
• Environmental Physiology, including effects of change in altitude temperature, humidity & space travel
• Thermal and humidity changes
• Chrono Physiology – New born, adult and old age Physiology.
• Effects of stress, Behavioral Physiology – Yoga, Meditation.
• Physiology of growth and development
• Laboratory animal ethics – Guidelines for care and use of animals in scientific research. – Breeding of and Experiments on animals (control and Supervision) rules, 1998 under prevention of cruelty to animals Act 1960.

Practical Training

Animal Experiments

• Amphibian experiments(for demonstration only)
  • Freeload and After Load
  • Effect of continuous repeated stimulation (study of phenomena of fatigue)
  • Length tension diagram.
  • Properties of Cardiac Muscle: Long refractory period, All or None Law.
  • Extrasystole and Compensatory Pause, Beneficial effect
  • Regulation of Heart, Vagus dissection and effect of vagal stimulation.
  • Actions of acetylcholine, Adrenaline and Nicotine on Heart (Langley’s)
  • Perfusion of isolated frogs heart – Role of Na+, K+, Ca+
  • Decerebrate and Spinal frog.
• Mammalian - To be performed by students
  • Rat/guinea pig ileum : Intestinal movement recording
  • Rabbit heart: Langend preparation - To be demonstrated if animals are available and have been procured as per CPCSCA guideline
  • General Management of Mammalian experiments.
  • Recording blood pressure and respiration on dog and also the effects of various factors.
  • Recording the effect of stimulation of Vagus nerve on blood pressure and respiration on dog
  • Stimulation of central and distal end of the vagus on arterial pressure after vagotomy
  • Effect of drug – Adrenaline and Acetylcholine on blood pressure and respiration on dog.
  • Adrenal extract on intestinal movement and tone.
  • Effect of Occlusion of the Carotid arteries on blood pressure and respiration.
  • Stimulation of Splanchnic nerve (distal end) on arterial pressure.

Human Physiology

• Clinical Physiology
  • Elementary principles of clinical examination
  • Methods of Inspection/palpation/percussion/auscultation
  • Plan of conduction and scheme of recording
  • General examination
• Cardiovascular system
  • Clinical examination of circulatory system
  • Examination of the pulse, blood vessels and measurements of blood pressure.
• Respiratory system
  • Clinical examination of respiratory system
• Gastro-intestinal system
  • Clinical examination of abdomen.
• Central Nervous System
  • Clinical examination of the central nervous system and autonomic nervous system and its physiological basis.
  • Examination of higher mental functions.
  • Clinical examination of the special senses. Outline of the examination of cranial nerves.
  • Tests of hearing and deafness
  • Motor functions
  • Reflex functions
  • Sensory function
• Ophthalmology
  • Clinical examination of the eye and papillary reflex
  • Visual acuity
  • Perimetry
  • Accommodation
  • Colour vision and colour blindness
  • Fundoscopy

Laboratory Procedures (Normal human subjects)

• Haematology:
  • Haemocytometry
  • Determination of Reticulocyte count, Platelet count, WBC count, RBD count and absolute eosinophil count in normal and diseased states.
  • Differential count of WBC
  • Haemoglobinometry, spectroscopy
  • Blood grouping and cross matching
  • Determination of bleeding time, clotting time
  • Haemolysis & Fragility test
  • Examination of normal bone marrow aspiration smear
• Cardio vascular system:
  • Electrocardiography – ECG & its interpretation.
• Respiratory System:
  • Mechanical spirometry
  • Recording of lung function tests by computerized or electronic spirometer
  • Breath holding and endurance tests
  • Blood gas analysis
  • Stethography
  • Resuscitation and artificial respiration.
• Reproductive System:
  • Methods to determine ovulation time –
    • Basal Body temperature chart,
    • Cervical smear
    • Vaginal smear
  • Pregnancy diagnostic test – Immunogical test
  • Sperm count
• Gastro Intestinal System:
  • Endoscopy
• Nerve Muscle Physiology
  • Ergography
  • Recording of EMG – Nerve conduction, both sensory and motor
• Others:
  • Construction of Dietry chart for –
    • Growing Children
    • Hypertensive patients
    • CAD
    • Diabetes mellitus patients
  • Tests for physical fitness –
    • Field 2 km. walk
    • Lab Harvard step test
    • Bicycle ergometry
    • Treadmill protocols leading to determination of vo2 max.
    • Cardio respiratory response to whole body exercise.

Clinical Biochemistry:

• Examination of normal and abnormal constituents of urine
• Other kidney function tests
• Estimation of blood sugar
• Liver function tests
• Glucose tolerance test

Time Schedule and Rotation postings

The candidates shall attend all the undergraduate theory and practical classes regularly (for one batch of students). During the second year of the course postings may be made to attend other clinical and paraclinical subjects in co-ordination with concerned departments, only in the forenoon sessions as follows:

• Cardiology Dept.- 15 daysLearn to operate ECG apparatus, Echo, Doppler, Cardiac monitor, Learn the methodology of cardiac catheterization. Resuscitation technique, interpretation of ECG & other records.
• Neurology – 15 daysObserve and understand Neuro – Physiological Techniques (clinical Physiology).
  • Clinical Examination of patient.
  • Use of EEG, EMG and Interpretation of EEG, EMG & other investigation data.
• Medical Gastroenterology – 15 days.Clinical examination of patients. To observe Endoscopic techniques.
• Clinical Biochemistry – 15 days.To understand the principles of clinical biochemical tests and interpretation of data.
  • Liver function tests.
  • Renal function tests.
• Haematology Department – 15 daysTo learn investigations
• Blood Bank – 15 days To learn Blood grouping and cross matching collection, storage and transfusion of blood.
• Department of Anatomy – 15 days (Histology Laboratory) Staining techniques, moulding of specimens, slide identification characteristics.
• Biostatics and Research Methodology – To attend workshop on research methodology – 3 days
• Postings in Institute of Aerospace Medicine, Bangalore for Applied Physiology – 1 week Training would include:
  • Applied Cardio-Respiratory Physiology
  • Thermal Physiology
  • Space Physiology
  • High altitude physiology and Hyperbaric medicine
  • Acceleration Physiology

Note : The above topics would include hands-on training in spirometry, orthostatic stress test and evaluation of heat stress and heat strain. The students would be evaluated by means of presentation/symposium at the end of posting.

• Obstetrics and Gynaecology postings – 15 days.
  • Methods of determine ovulation time
    • Basal Body Temperature chard.
    • Cervical smear.
    • Vaginal smear.
  • Clinical examination during pregnancy including antenatal checkup and investigation.
• Chest Medicine – 15 days To learn in laboratory – Lung function tests and interpretation of results.
• General Medicine – 1 month.
  • Clinical examination of patients
  • Investigation procedures
  • Drawing of blood and storage
  • Lumbar puncture.
  • Interpretation of: X-Ray, ECG, Biopsy report, Biochemical results.
  • Endocrinology Postings: Clinical Examination of patient, Radio Immuno Assay techniques.
  • Ophthalmology for fundoscopy and measurement of Intraocular pressure, Refractometry & Perimetry.

Note : Total six months of clinical postings. At the end of these postings, a certificate has to be obtained from the concerned Heads of the Department about satisfactory learning or otherwise.

Seminars & Journal reviews.

The postgraduate students should actively participate in departmental seminars and journal clubs. A record showing the involvement of the student shall be maintained. A diary should be maintained. Seminars and journal clubs are suggested to the conducted alternately once in every 15 days. See chapter for model check lists. During three years of the course, Postgraduate students shall participate in teaching undergraduate students in practicals, tutorials and group discussions.

Dissertation Work

During the course of study every candidate has to prepare a dissertation individually on a selected topic under the direct guidance and supervision of a recognized post graduate teacher as per MCI and BLDE University regulations.

The suggested time schedule for dissertation work is:Identification and selection of topic for dissertation – in first 4 weeks. Preparatory work of dissertation / synopsis including pilot study if necessary and submission of the synopsis to the University within first 6 months from the beginning of course or as per the dates notified by the University. Data collection for dissertation. Writing the dissertation in the following 11/2 years. Submission of thedissertation six months prior to the final examination or as per the dates notified by the University.

Submission of dissertation

The dissertation shall be submitted to the Registrar (Evaluation) of the University six months before final examination or as per the dates notified by the University. Approval of the dissertation by the panel of examiners is a pre-requisite for a candidate to appear in the University examination.

Maintenance of Record of Work Done, Periodical assessment and progress report.

• A diary showing each day’s work has to be maintained by the candidate, which shall be scrutinized by the Head of the Department once in every three months.
• A practical record has to be maintained by the candidate and duly scrutinized and certified by the HOD and to be submitted to the external examiner during the final examination.
• A list of the seminars and journal reviews that have been attended and participated by the student has to be maintained which should be scrutinized by the Head of the Department.
• A practical record has to be maintained by every candidate and duly scrutinized and certified by the head of the department and to be submitted to the external examiner during the final examination.

Note : Syllabus presented on this page is Indicative and for General Information only. Visitors are advised to contact the respective Institutes for any query regarding the Syllabus.