(Questions for the Long Case, OSCE, Short Cases shall be on the basis of 60% 'must know',
30% 'good to know' and 10% 'nice to know'
Viva voce: 4 stations, 5 marks each (Total 20 marks)
PAEDIATRICS&NEONATOLOGY
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DETAILS OF THE COURSEDuration of course
: 10 weeks in 3
VI ,VIII &IX
semesters
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Total number of hours theory:100
Lectures
:34 (including pediatric surgery)
Clinical
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8-9 AM Tutorials9 AM 1 PM Case discussions &
Innovative sessions
Exposure of students to newborns and emergency management is inadequate during
ten weeks of under graduate postings. During evening hours they should be posted in
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causality, ICU and new born nursery.General guidelines
Apart from bedside discussion there should be 66 hours of Innovative sessions during clinical
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sessions in the forenoon session. This comprises of project work, seminars, structureddiscussion, and integrated teaching.
Simple day to day problems should be given more importance.
Sessions which will improve communication skills and attitude should be given more
importance.
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Pediatric casualty posting is compulsory during the final year posting. They should be posted inIntensive care unit and new born nurseries during evening hours with due care to prevent
infections in nurseries .
There should be enough pediatric surgery case exposure during clinical sessions
The training in pediatrics should prepare the student to deliver preventive, promotive, curative
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and rehabilitative services for care of children both in the community and rehabilitative services158
and at hospital as part of a team in an integrated form with other subjects.
For integrated teaching the topics should be planned in advance by discussion with different
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specialties.GOALS
Students should have knowledge and skill to diagnose common problems in newborn and
child, identify life threatening situations and to decide when to refer to higher centers.
OBJECTIVES
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1. KnowledgeAt the end of the course, the student should be able to:
a) Describe the normal growth and development during fetal life, neonatal period, childhood
and adolescence and outline deviations thereof.
b) Know age related requirements of calories, nutrients, fluids, in health and disease.
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.c) Know the common pediatric disorders and emergencies in terms of epidemiology, etiology
pathogenesis, clinical manifestations, diagnosis, rational therapy and rehabilitation.
d) Know preventive strategies for common infectious diseases, malnutrition, genetic and
metabolic disorders, poisonings, accidents and child abuse.
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e) Know national programs relating to child health including immunization.f) Basic knowledge about special situations like newborn and adolescents
.
2. Skills
At the end of the course, the student shall be able to:
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a) Take a detailed pediatric history; conduct an appropriate physical examination of childrenincluding neonates. Make clinical diagnosis, do common bedside investigative procedures,
interpret common lab results and plan and institute therapy.
b) Take anthropometric measurements, Casualty posting may be utilized to train or
procedures like resuscitation of newborn infants at birth, prepare Oral Rehydration Solution
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performs tuberculin test, administer vaccines available under current nationalimmunization program, IV canulation, start an intravenous saline and provide naso-gastric
feeding. Learning from residents should be encouraged. Evening hours apart they may get
familiar with common drugs and equipment from casualty and intensive care units
c) Observing or video demonstration of diagnostic procedures such as lumbar puncture, liver
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and kidney biopsy, bone marrow aspirations, pleural tap and ascitis tap is desirabled) Distinguish between normal newborn babies and those requiring special care and institute
early care to all new born babies. Provide correct guidance and counseling in breast
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feeding.e) Provide ambulatory care to all sick children, identify indications for specialized inpatient
care and ensure timely referral of those who require hospitalization
f) Know how to write a proper prescription & referral letter. How to interpret investigations to
be stressed. They may be assigned specific tasks which will improve skills in the
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management, communication and attitude towards patients.g) To develop basic communication skill s to communicate with pediatric patents and parents.
h) Sensitive to the ethical issues while dealing with children and adolescents.
i) To take consent for procedures
j) Learn to address Common ethical issues in pediatrics ward and OPD.
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k) Application of child rights in the back ground of medical practiceMethods
Seminars
Videos and simulation
Bedside clinics
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Hands own proceduresIntegrated sessions
Participation in procedures.
DETAILS OF LECTURES
INFECTIOUS DISEASES
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Poliomyelitis, measles, diphtheria, tetanus, Childhood tuberculosis, typhoid fever, HIVinfection, Dengue and chikungunya, viral haemorrhagic fevers and malaria. Pertussis, Mumps,
Rubella, Influenza, H1N1, seasonal epidemics.
GIT AND LIVER
Diarrhoeal diseases, hepatitis and hepatic failure, Cirrhosis liver and portal hypertension.
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helminthic infestations.CARDIO VASCULAR SYSTEM
Congenital heart diseases, Rheumatic fever and RHD , C C F , Hypertension , Infective
endocarditis
RESPIRATORY SYSTEM
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160Childhood asthma, Acute Bronchiolitis, Pneumonias in children, Suppurative Lung disease,
smoking and environmental pollution, Croup syndromes
C.N.S
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Cerebral palsy, Mental retardation, Meningitis and Encephalitis, Seizure disorders & FebrileSeizures.
Haemo poetic system
Anemia in children, bleeding disorders
Nephrology
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Disorders of kidney acute nephritis, Nephrotic syndrome, Renal failure, Urinary tractinfection
Endocrine disorders
Diabetes mellitus, Thyroid disorders, short stature
Connective Tissue disorders
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JRA & vasculitis (SLE and HSP, Kawasaki disease)Malignancies in children
Leukemia, Lymphomas, Neuroblastoma, Solid tumors, CNS tumors
National programs
Others
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Rational use of antibiotics
Common poisonings
Pediatric Palliative Care
New Born
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Respiratory distress in new born161
Neonatal seizures
Congenital malformations
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Antenatal diagnosis and treatmentSepsis in new born.
Behavioral problems in children
Common poisoning and accidents in children
Nutrition
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BFHI, IYCF, Nutritional assessment, SAM, Specific Vitamin deficiency disordersOther National programs
Genetics
Common chromosomal disorders like Down's syndrome, Turner syndrome.
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Avoid repetitions of topics already covered in morning sessions. Newer teaching methodsmay be utilized which will improve the student participation and interest
TUTORIALS
Stress should be given on the clinical approach of common problems
1. Introduction to pediatrics, History taking and general Examination
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2. Examination of all the major systems3. Growth and development, demonstrate how to do. Common disorders of growth and
development may be demonstrated. Charting and Interpretation of growth charts
4. Nutrition, including the assessment. Common disorders of nutrition may be demonstrated
Avoid detailed theory of nutritional disorders in morning session
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5. Immunization ?National immunization schedule & Newer vaccines(The above topics may be covered during the initial clinical posting)
New born:
Resuscitation newborn
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Assessment of gestation162
Low birth weight babies
Convulsions in newborn
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Jaundice in newborn(Videos may be used here)
(Approach to common problems)
a) Dyspnea ,wheezing and strider
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b)Edemac) Jaundice
d)Pallor
e)Bleeding
f)Loose stools
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g)Vomitingh) Convulsions
i)Coma
i) j)Shock
k) Weakness, limping, Excessive
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cry l)Child with rashm) Prolonged fever (demonstrate how to take, record temperature, how to
interpret temperature chart
ADOLESENCE
Adequate coverage of common problems for adolescents to be included
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Pediatric surgery classes. They should report to the parent department after pediatric surgeryclinical sessions
Chronic conditions in Pediatrics
Instruments and procedures,
X-rays
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Vaccines, Growth charts, drugs, IV fluids should be shown .Common equipments should beshown during initial postings. In final year they should get chance to use and practice them. Eg
nebulizers
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They should be involved in simple procedures like nasogastric tube insertion, rectal drugadministration etc
Students should be involved in the social activities of department eg ORS day, Immunization
week; Breast feeding week .They should be given specific tasks in the conduction of the
programs. If possible they may be given specific task to address a community problem .eg low
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vaccine coverage, how to solve?Case Record
Separate clinical record book should be kept and at least 5pediatric cases one
newborn and one pediatric surgery cases to be written.Better to have a uniform
format for case record .
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Log BookIn addition to record book, a separate log book should be maintained by students to record
daily activities, supervised by concerned Unit chief or Assistants.
Bothe case record and Log book should be compulsory.
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Formativeassessment.End posting examination should be conducted at the end of clinical postings.
Three theory examinations should be conducted.
University model clinical examinations should be conducted apart from the end posting
examinations and is compulsory.
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Text Books RecommendedPrescribed Books
1. Essentials of Pediatrics by O.P.Ghai
2. Clinical Examination in Pediatrics by Meharban Singh
3. Hutchison`s Clinical Methods
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4. Clinical evaluation of new-born, infants and children by Dr. Sushama Bai5. Care of Newborn by Meharban Singh
6. Nutrition & Child development by Dr. K. E. Elizabeth
Reference Books
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Nelson Text Book of PediatricsIAP Text Book of Pediatrics
Social and Preventive Medicine by Park
EVALUATION
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164Theory examination
? Total marks
: 100
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? TheoryUniversity
: 40
Viva
: 10
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Int. Asst
: 10
Total
: 60
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? PracticalsUniversity exam : 30
Int. Asst. : 10
Total : 40
Theory question papers (see model question paper)
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1. Structured essay should be based on a clinical scenario. The question should bestructured in such a way there should not be any ambiguity.
2. This section short notes mainly on management (From Major systems and Pediatric
surgery
3. This section short notes (2 marks each, 5 questions Mainly on growth, development,
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nutrition, social pediatrics ,National programs4. This section short notes (2 marks, 4 questions)
Neonatology, breast
feeding, immunization.
Clinical examination
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Two cases 20 minutes eachFirst case
12.5 Marks
165
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(System case. Common problems should be given importance)Assessment to view child along with family, care giver concerns as a whole in discussing
management
Second case -
12.5 Marks
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(Assessment of nutrition, Growth, Development and Immunization.Children without illness may also be kept for assessment).
OSCE
5 Marks
There should be three stations. Clinical scenario analysis or skill assessment stations are
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desirable. Out of three stations one newborn scenario is compulsory. Better avoid newbornbabies as cases.
Marks
2 mark for newborn scenario
1.5 marks each for other 2 stations making total 5
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Time3 minutes for each station.
New born session may be made performance station e.g. demonstration of use of AMBU bag
on a manikin or performance of initial stage of resuscitation.
SURGERY AND I T S ALLIED SPECIALITIES
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(SURGERY including Paediatric Surgery)A. GOAL
The broad goal of teaching the undergraduate medical students in Surgery is to
produce graduates capable of delivering efficient first contact surgical care.
B. OBJECTIVES
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1. KnowledgeAt the end of the course, the student shall be able to:
a. Describe aetiology, Pathophysiology, principles of diagnosis and management of common
surgical problems including emergencies, in adult and children
b. Define indications and methods for fluid and replacement therapy including blood
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transfusion c. Define asepsis, disinfection and sterilization and recommended judicious use of166