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Effect on Skin The deficeiency causes dryness and roughness of skin developing keratosis of hair folliciles with concomitant deficiency of Vit-B complex purchase 400mg noroxin otc. Osteoclastic activity is also hampered noroxin 400mg mastercard, causing defective bone formation Effect on general Metabolism Zinc is necessary to maintain normal plasma concentration of Vit A generic noroxin 400mg visa. This vitamin is also necessary for the conversion of trioses to glucose perhaps indirectly through adrenal cortex that synthesizes hormones concerned with Gluconeogenesis. The first pro-vitamin D3 (chloecalciferol) with rupture of the bond between C9 and C10. It is a photolytic process involving no enzyme and slows down with aging because of the decrease of 7- dehydrocholesterol. Hydroxylation at C21 takes place in the endoplasmic reticulum of hepatocytes in a non-regulating process. Disturbance in enetrohepatic circulation can thus lead to deficiency of this vitamin. The main site for further hydroxylation at the 1 position is in the renal tubules. It crosses cell membrane bind to cytoplasmic receptor to form a complex, which is translocated to the nucleus. Bone: It promotes synthesis of osteocalcin which is needed for bone mineralization. Ricketes is characterized by the production of soft pliable bones due to defective mineralization secondary to calcium deficiency. Vit D deficiency is also characterized by low concentration of calcium in blood in association with increased serum alkaline phosphatase. In adults the deficiency produce Osteomalacia due to decreased absorption of calcium and phosphorous, maintains a low plasma level resulting in weak mineralization of bones. D level enhances calcium absorption leading to hypercalcemia and metastatic calcium deposits. There is a tendency to develop kidney stones from the hypercalciuria, secondary to hypercalcemia. It exists in the diet as a mixture of eight closely related compounds called Tocopherols. Functions The main function of Vit E is as an antioxidant, in particular a membrane antioxidant associated with lipid membrane structure. It provides protection from the action of peroxides by converting them to a product that is conjugating with glucuronic acid and excreted in bile. Source: The richest source is vegetable oil, and nuts 180 Deficiency Vit E deficiency is a rare but found in complication of prolonged and severe steatorrhoea, and of prolonged parenteral nutrition. Deficiency of Vit E causes anemia in children with cystic fibrosis of pancreas are found to be tocopherol deficient as a result of stetorrhoea. There are three types, Menaquinone (K2 )present in animals ,Phylloquinone (K1) present in Plants. Like vit E, the absorption of Vitamin k is dependent on appropriate fat absorption. Functions It is the only one acting as co-enzyme from the group of Fat soluble vitamins. It is required for post translational modifications of several proteins required in the coagulation cascade. Activation is carried out by the carboxylation of specific glutamate residues on the prothrombin by Vit K dependent enzyme. The presence of a second carboxyl group on the glutamate (γ- 181 carboxy glutamate) side chain confers phospholipids binding properties on the Prothrombin in 2+ the presence of Ca. Deficiency It is widely distributed in nature and produced by the intestinal micro flora. However, it is found in patients suffering from Liver diseases (obstructive jaundice), in new born infants and in patients with malabsorption. The placenta is inefficient at passing maternal Vit K to the fetus and immediately after birth the circulation concentration drops, but recovers on absorption of foods. In addition the gut of the new born is sterile, so that the intestinal micro flora does not provide a source of vit K for several days after birth. This is the reason why adults who are on prolonged antibiotic treatment require supplementation of Vit. D dependent Carboxylation reactions are used in the treatment of thrombosis related diseases. Warfarin, which inhibit the action of Vit K - probably via the mechanisms involved in the regeneration of the active hydroquinone. Tests to asses Vitamin K status include the prothrombin time-an important test in the investigation and management of jaundiced patients and of those on anticoagulant treatment. Some elements are needed at high concentrations, required more than 100mg per day. Sodium and Potassium: They are important in cell, muscle physiology, transmission of messages and other biological processes. Since both are widely distributed, deficiency of the two elements is rarely found. It is usually seen in patients with dehydration, on steroid therapy or excess sodium intake. Hyponatremia: It is common in patients who are in diuretics or excessive sweating, kidney disease, diarrhea and congestive heart failure. Other causes are decreased excretion by the kidney, diseases like Anuria, tissue damage or Diabetes Mellitus. Hypokalemia: Low potassium is not due to dietary deficiency but due to conditions like vomiting, diarrhea. Calcium and Phosphate: Major parts (90%) of them are found in the form of crystal lattice in the bone.

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If not treated with 5 days of antibiotics order noroxin 400mg without prescription, exclusion should be for 21 days after cough onset discount noroxin 400 mg without a prescription. If there is a high index of suspicion that the person has pertussis generic 400 mg noroxin otc, exclude until the individual has been evaluated by a medical provider and deemed no longer infectious by the local health department, 5 days of antibiotics are completed or until the laboratory test comes back negative. Some lab tests (pertussis cultures) are less accurate after antibiotics are given or if significant time has passed since the onset of symptoms. Antibiotics are usually not given to people who have had a cough for more than 21 days because they will no longer be helpful. Adolescents ages 11 through 18: Adolescents aged 11 or 12 should receive a single dose of tetanus, diphtheria, and pertussis (Tdap) in place of tetanus and diphtheria (Td). Adolescents aged 13 through 18 who have not received Tdap should receive a single dose of Tdap instead of Td for booster immunization Adults Ages 19 through 64: One dose of Tdap vaccine is recommended in place of the next booster of Td. Tdap is recommended for adults having close contact with infants less than 12 months of age, providing the interval of the most recent Td was two years or more. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth. If you think your child Symptoms has Pertussis: Your child may first have a runny nose, sneezing, mild cough, and possibly fever. Childcare and School: If your child has been infected, it may take 5 to 21 days (usually 7 to 10 days) for symptoms to start. If staff or children are not Contagious Period treated, they need to stay From the time of the first cold-like symptoms until 21 home until 21 days after days after coughing begin. Call your Healthcare Provider If someone in your home has: ♦ had a cough 7 or more days. Antibiotics will reduce the contagious period, but may do little to relieve your child’s cough. Also, if public health has recommended that antibiotics are needed because of an exposure. Age appropriate pertussis vaccine should be administered in the absence of documented laboratory confirmed disease. Pinworms are most often found in preschool and school-aged children and their parents. These small worms are found in the human intestine and crawl out of the rectum at night to lay eggs on the anal area. Spread can also occur when infected people do not wash their hands well after scratching the anal area and then touch food or other objects, which are then eaten or touched by an uninfected person. Wash hands thoroughly with soap and warm running water after using the toilet, after contact with the anal area, handling bedding or underclothing, and before eating or preparing food. If you think your child Symptoms has Pinworms: Your child may have itching of the anal area, especially Tell your childcare at night. Prevention Wash hands after using the toilet or changing diapers and before preparing food or eating. Pneumococcal disease is an infection caused by a type of bacteria called Streptococcus pneumoniae (pneumococcus). There are different types of pneumococcal disease, such as pneumococcal pneumonia, bacteremia, meningitis, and otitis media. More serious pneumococcal infections include lung infection (pneumonia), bloodstream infection (septicemia), and infection of the brain (meningitis). Spread may occur when a “carrier” of the pneumococcus bacteria coughs or sneezes the bacteria into the air and another person breathes them in. By touching the secretions from the nose and mouth of an infected/colonized person then touching your eyes, nose, or mouth. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth. Infection If you think your child has Symptoms a Pneumococcal Infection: Your child may have fever, ear pain, or pull on their Tell your childcare ear. Call your Healthcare Provider ♦ If your child has a high fever or ear pain that does not stop. Smoke increases the risk for serious respiratory infections and middle ear infections. Pneumonia can be a complication of other illnesses and can occur throughout the year. Infants and young children who experience common respiratory viruses and are exposed to second-hand tobacco smoke are at increased risk of developing bronchiolitis, bronchitis, pneumonia, and middle ear infections. Most of these viruses or bacteria can cause other illnesses, and not all persons exposed to them will develop pneumonia. Spread may also occur by touching the hands, tissues, or other items soiled with nose and mouth secretions from an infected person and then touching your eyes, nose, or mouth. Wash hands thoroughly with soap and warm running water after touching the secretions from the nose or mouth. If you think your child Symptoms has Pneumonia: Your child may have a runny nose, cough, fever, rapid Tell your childcare breathing, and chest pain. Childcare and School: Yes, until fever is gone Contagious Period and your child is healthy enough for routine Shortly before and while your child has symptoms. Antibiotics do not work for illnesses caused by a virus, including colds and certain respiratory infections. Smoke increases the risk for serious respiratory infections and middle ear infections. Infants and young children who experience common respiratory infections and are also exposed to second-hand tobacco smoke are at increased risk of developing bronchiolitis, bronchitis, pneumonia, and middle ear infections. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.

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Appendicitis 540–543 K35–K37 U119 Other digestive diseases 530 order noroxin 400mg without a prescription, 534–537 400mg noroxin fast delivery, 550–553 purchase 400mg noroxin with amex, 555–558, K20–K22, K28–K31, K38, K40–K66, 560–570, 572–579 K71–K73, K75–K92 U120 J. Benign prostatic hypertrophy 600 N40 U123 Other genitourinary system diseases 590–599, 601–611, 617–629 N20–N39, N41–N64, N75–N98 U124 K. Other unintentional injuries E800–E807, E820–E848, E870–E879, Rest of V, W20–W64, W75–W99, E900–E909, E911–E949 X10–X39, X50–X59, Y40–Y86, Y88, Y89 U156 B. War E990–999 Y36 U160 Other intentional injuries E970–E978 Y35 Source: Mathers, Lopez and others 2004. Ischemic heart disease deaths may be miscoded to a number of so-called cardiovascular “garbage” codes. These include heart failure, ventricular dysrhythmias, generalized atherosclerosis, and ill- defined descriptions and complications of heart disease. Proportions of deaths coded to these causes were redistributed to ischemic heart disease as described by Lozano and others (2001). The Burden of Disease and Mortality by Condition: Data, Methods, and Results for 2001 | 99 Table 3A. Fardous, Bulletin of the World Health Organization 77(8)a Kazakhstan 1981–2, 1985–2001 2001 a CodMod 2001 Kenya Ministry of Health, hospital CodMod South Africa 1996 data, 1996, 1998–2000a Kiribati 1999–2002 2000–2 Ministry of Health, Family Vital registration 2000–2 Planning and Social Welfare, Third National Health, Family Planning and Social Welfare Plan 1992–5a Korea, a CodMod Philippines, India Democratic People’s Rep. Thoma, unpublished 1998a Nepal a CodMod Philippines, India Netherlands 1950–2000 2000 b Vital registration Vital registration (Continues on the following page. Kitts and 1961–3, 1965–7, 1993–5 c Vital registration Vital registration Nevis 1969–95 St. Vincent and 1970–2, 1974, 1977, 1979, 1997–9 c Vital registration Vital registration the Grenadines 1982–7, 1995–9 Samoa Department of Health Cook Islands, Marshall Statistics, Demographic Islands, Niue, Samoa, and Health Survey, 1999 Tonga, Tuvalu, Vanuatu, and 2000a Kiribati, Nauru, Fiji San Marino 1995–2000 1998–2000 b Vital registration Vital registration São Tomé and 1984–5, 1987 a CodMod South Africa 1996 Principe Saudi Arabia a CodMod Bahrain, Kuwait, 1997–2001 Senegal Niakhar 1983–90: deaths CodMod South Africa 1996 assessed by verbal autopsy. Gear, “Causes of Death in a Rural Area of South Africa: An International Perspective, Journal of Tropical Pediatrics, 46 (June)c; and Violence and Injury Surveillance Consortium, Rapid Assessment of Trauma Facilities at State Hospitals in South Africa, 2000a Spain 1951–2000 2000 b Vital registration Vital registration Sri Lanka 1950–68, 1977, 1980–9, 1996 a CodMod 1996 1991–2, 1995–6 Sudan a CodMod Arab Rep. Anguilla, Aruba, Bermuda, British Virgin Islands, Caymen Islands, Falkland Islands, French Guiana, Guadeloupe, Martinique, Montserrat, Netherlands Antilles, Puerto Rico, Turks and Caicos Islands, and U. Burden of disease rates for the West Bank and Gaza were estimated using death registra- tion data and separate estimates of war deaths. The Burden of Disease and Mortality by Condition: Data, Methods, and Results for 2001 | 107 Table 3A. Syphilis Acute and chronic infection with Treponema pallidum 2 Congenital syphilis Syphilis in the newborn due to maternal-fetal transmission in utero Low birthweight Birthweight of less than 2,500 g Primary Initial infection in adults resulting in primary chancre at site of inoculation Secondary Disseminated disease, which appears 2–8 weeks after the primary stage and is usually marked by a rash Tertiary—neurologic Late stage of disease with varied neurological manifestations A2b. Chlamydia Bacterial infection transmitted vaginally, anally, or perinatally with Chlamydia 2 trachomatis (excludes ocular trachoma) Cervicitis Inflammation of the cervix uteri due to Chlamydia trachomatis Neonatal pneumonia Pneumonia in infants due to infection with Chlamydia Ophthalmia neonatorum Purulent conjunctivitis in infants less than 30 days, acquired during passage through an infected birth canal Low birthweight Birthweight of less than 2,500 g Pelvic inflammatory disease Inflammation of the adnexa of the uterus (includes endometritis) Ectopic pregnancy Pregnancy located outside the uterus Tubo-ovarian abscess Abscess located in the fallopian tubes or ovaries Chronic pelvic pain Chronic pelvic pain following reproductive tract infection with Chlamydia Infertility Total infertility due to Chlamydia-related pelvic inflammatory disease and ectopic pregnancy in women and epididymitis in men. Symptomatic urethritis Inflammation of the urethra causing symptoms including dysuria and/or hematuria Epididymitis Inflammation of the sperm ducts A2c. Gonorrhea Bacterial infection transmitted vaginally, anally, or perinatally with Neisseria 2 gonorrhea Ophthalmia neonatorum Purulent conjunctivitis in infants less than 30 days, acquired during passage through an infected birth canal Low birthweight Birthweight of less than 2,500 g Corneal scar—blindness Permanent corneal scar resulting from corneal ulceration due to infection with Neisseria gonorrhea and leading to blindness Corneal scar—low vision Permanent corneal scar resulting from corneal ulceration due to infection with Neisseria gonorrhea and leading to low vision Cervicitis Inflammation of the cervix uteri due to Neisseria gonorrhea Pelvic inflammatory disease Includes both acute and recurrent pelvic inflammatory disease due to gonorrhea Ectopic pregnancy Pregnancy located outside the uterus Tubo-ovarian abscess Abscess located in the fallopian tubes or ovaries Chronic pelvic pain Chronic pelvic pain following reproductive tract infection with Neisseria gonorrhea Infertility Total infertility due to gonorrhea-related pelvic inflammatory disease and ectopic pregnancy in women and epididymitis in men Symptomatic urethritis Inflammation of the urethra causing symptoms including dysuria and/or hematuria Epididymitis Inflammation of the sperm ducts Stricture Narrowing of the urethra due to urethritis 108 | Global Burden of Disease and Risk Factors | Colin D. Diarrheal diseases—episodes Episodes of diarrhea including acute watery diarrhea, persistent diarrhea, and 2 dysentery; deaths of children with both measles and diarrhea or both lower respi- ratory infection and diarrhea are not included in estimates of diarrhea mortality A5a. Pertussis Acute bacterial infection of the respiratory tract with Bordetella pertussis or 2 parapertussis Episodes Acute bacterial infection of the respiratory tract with Bordetella pertussis or parapertussis, characterized by paroxysmal, violent coughs followed by high- pitched inspiratory whoop Encephalopathy Degenerative disease of the brain, which in pertussis is usually a result of hypoxia, leading to mental retardation A5b. Poliomyelitis—lameness Viral infection characterized by acute flaccid paralysis and proven by isolation of 2 polio virus from stool A5c. Diphtheria Acute disease caused by toxin-producing Corynebacterium diphtheriae 2 Episodes Acute bacterial disease involving primarily tonsils, pharynx, larynx, nose, and other sites, characterized by grayish plaques or membranes with surrounding tissue inflammation Neurological complications Polyneuritis involving both cranial and peripheral nerve palsies, which are largely reversible Myocarditis Inflammation of the heart muscle leading to electrocardiographic aberrations and sometimes permanent damage with congestive heart failure, which may be fatal A5d. Measles—episodes Acute and highly contagious infection with measles virus characterized by red, 2 blotchy rash, fever, cough, coryza, and conjunctivitis A5e. Tetanus—episodes Neonatal: infection with Clostridium tetani in infants less than 30 days with pro- 2 gressive difficulty and inability to feed because of trismus, generalized stiffness, spasms, and opisthotonus Non-neonatal: infection with Clostridium tetani in non-neonates with initial localized spasms lead to general rigidity, opisthotonus, and risus sardonicus A6. Meningitis Acute bacterial disease with sudden onset and fever, intense headache, nausea, 2 vomiting, neck stiffness, and—in meningococcal disease—petechial rash with pink macules; must be accompanied by laboratory evidence (in cerebrospinal fluid or blood) of Neisseria meningitidis, Strep pneumoniae, or Haemophilus influenzae type B Streptococcus pneumoniae—episodes Acute bacterial disease with sudden onset and fever, intense headache, nausea, vomiting, and neck stiffness; must be accompanied by laboratory evidence (in cerebrospinal fluid or blood) of Strep pneumoniae Haemophilus influenzae—episodes Acute bacterial disease with sudden onset and fever, intense headache, nausea, vomiting, and neck stiffness; must be accompanied by laboratory evidence (in cerebrospinal fluid or blood) of Haemophilus influenza type B Neisseria meningitidis—episodes Acute bacterial disease with sudden onset and fever, intense headache, nausea, vomiting, and neck stiffness; must be accompanied by laboratory evidence (in cerebrospinal fluid or blood) of Neisseria meningitidis Meningococcaemia without Invasion of the bloodstream with Neisseria meningitidis. Trypanosomiasis—episodes Infection with protozoa of the genus Trypanosoma, excluding T. Chagas’ disease Infection with Trypanosoma cruzi 2 Infection Episode of infection with Trypanosoma cruzi Cardiomyopathy without congestive Disorder of the heart muscle resulting from infection with T. Schistosomiasis—infection Infection and associated direct mortality from schistosomiasis; does not include 1 estimates of mortality from bladder cancer, cirrhosis, or colon cancer that may be related to schistosomiasis A9d. Leishmaniasis Infection with flagellate protozoa of the genus Leishmania 1 Visceral Generalized involvement of the reticulo-endothelial system due to infection with Leishmania Cutaneous Presence of skin lesions (which may ulcerate) due to infection with Leishmania A9e. Lymphatic filariasis Infection with filariae (Wucheria bancrofti and Brugia malayi) 1 Hydrocele > 15cm Circumscribed collection of fluid in testicle or along the spermatic cord due to filariasis Bancroftian lymphoedema Swelling of subcutaneous tissues due to the presence of excessive lymph fluid as a result of infection with Wucheria bancrofti Brugian lymphedema Swelling of subcutaneous tissues due to the presence of excessive lymph fluid as a result of infection with Brugia malaye A9f. Onchocerciasis Infection with worms of the genus Onchocerca 2 Blindness Inability to distinguish the fingers of a hand at a distance of 3 meters, or less than 5 percent of remaining vision as compared to a normally sighted individual, as a result of infection with Onchocerca volvulus Itching Itchy dermatitis as a result of infection with Onchocerca volvulus Low vision Corrected visual acuity in the better eye of less than 6/18 but better than or equal to 3/60 due to infection with Onchocerca volvulus A10. Dengue Mosquito-born disease caused by viruses of the family Flaviviridae 0 Dengue hemorrhagic fever Severe manifestation of dengue infection characterized by multiple hemorrhages and potentially followed by circulatory failure, neurological manifestations, and shock 110 | Global Burden of Disease and Risk Factors | Colin D. Japanese encephalitis Mosquito-born encephalitis caused by Japanese encephalitis virus 0 Episodes Episode of Japanese encephalitis infection Cognitive impairment Reduced cognitive function resulting from encephalitis due to Japanese encephalitis virus Neurological sequelae Neurological deficits resulting from encephalitis due to Japanese encephalitis virus A13. Trachoma Cases of follicular or inflammatory trachoma 2 Blindness Corrected visual acuity in the better eye of less than 3/60 Low vision Corrected visual acuity in the better eye of less than 6/18 but better than or equal to 3/60 A14a. Lower respiratory infections 2 Episodes Episode of lower respiratory infection Chronic sequelae Includes bronchiectasis and impaired lung function as measured by a decrease in forced expiratory volume B2. Upper respiratory infections 2 Episodes Episode of upper respiratory infection Pharyngitis Inflammation of the pharynx B3. Otitis media Inflammation of the middle ear 0 Episodes Episodes of acute otitis media Deafness At least moderate impairment, where person is able to hear and repeat words using raised voice at 1 meter, resulting from otitis media C1. Maternal hemorrhage 2 Episodes All episodes of antepartum and postpartum hemorrhage Severe anemia Blood hemoglobin level 10 mg/dl following postpartum hemorrhage (Continues on the following page. Maternal sepsis 2 Episodes Major puerperal infection, excluding infection following abortion, minor genital tract infection following delivery, and urinary tract infections following delivery Infertility Failure to conceive again after a previous conception (secondary infertility), caused by maternal sepsis C3. Hypertensive disorders of pregnancy— Includes pre-eclampsia and eclampsia 2 episodes C4.

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The aim of the training is to train the candidates to diagnose and manage common skin diseases buy noroxin 400mg low price. Diagnose and manage common skin diseases buy cheap noroxin 400mg online, sexually transmitted diseases and leprosy buy noroxin 400 mg low price. To diagnose and manage common medical emergencies related to skin diseases, leprosy and sexually transmitted diseases. To familiarize them with the common laboratory diagnostic skills which help in the confirmation of diagnosis. To train them for preventive measures at individual and community levels against communicable skin diseases including sexually transmitted diseases and leprosy. Clinical examination and description of cutaneous findings in a systematic way in dermatology, sexually transmitted diseases and leprosy. To have a broad idea and approach to manage common skin diseases, sexually transmitted diseases and leprosy. To develop skills to do day-to- day common laboratory tests and their interpretation which help in the diagnosis. Ineffective dermatoses: Pyoderma, tuberculosis and leishmaniasis- Etiology, Clinical features, Diagnosis and Treatment. Infective dermatoses: Viral and fungal infections- Etiology, Clinical features, Diagnosis and Treatment. Infestations: Scabies and pediculosis – Etiology, Clinical features, Diagnosis and Treatment. Melanin synthesis: Disorders of pigmentation (Vitiligo, Chloasma / Melasma)- Etiology, Clinical features, Diagnosis and Treatment. Allergic disorders: Atopic dermatitis and contact dermatitis – Etiology, Clinical features, Diagnosis and Treatment. Drug eruptions, urticaria, erythema multiforme, Steven’s johnson syndrome and toxic epidermal necrolysis – Etiology, Clinical features, Diagnosis and Treatment. Vesiculo-bullous diseases: Pemphigus, Pemphigoid, Dermatitis herpetiformis – Etiology, Clinical features, Diagnosis and Treatment. Epidermopoisis, Psoriasis, Lichen planus and Pityriasis rosea – Etiology, Clinical features, Diagnosis and Treatment. Pathogenesis, Classification and clinical features of leprosy, Reactions in leprosy. Gonococcal and Non-gonococcal infections – Etiology, Clinical features, Diagnosis and Treatment. Syndromic approach to the diagnosis and management of sexually transmitted diseases. Hereditary disorders: Ichthyosis, Albimism, Epidermolysis bullosa, Melanocytic naevi, Freckles and other naevi – Etiology, Clinical features, Diagnosis and Treatment. They have the clinical teaching and demonstrations of all the common skin diseases sexually transmitted diseases, leprosy and common skin emergencies during this period. They also have about a week’s orientation clinical posting during their 3rd semester training period to familiarize them with the history taking, clinical examination and cutaneous lesions. Clinical Assessment: The students go through an assessment at the end of their clinical postings. Elicit a detailed history, perform a thorough physical examination including mental status 4. Correlate the clinical symptoms and physical signs to make a provisional anatomical, physiological, etiopathological diagnosis along with the functional disability and suggest relevant investigation. Professionally present and discuss the principles involved in the management of the patient, initiate first line management and outline short-term and long term management. Manage acute medical emergencies like acute myocardial infarction, acute pulmonary oedema, acute anaphylactic and hypovolumic shock, status asthmaticus, tension pneumothorax, status epilepticus, hyperpyrexia, haemoptysis, gastro-intestinal bleeding, diabetic coma, electric shock, drowning, snake bites, common poisoning etc. Didactic lectures: discussion a particular topic at length in an one hour lecture 2. Seminars: conducted by a combined team of clinician, pathologist and microbiologist discussing a particular topic for two hours 3. Clinical training: The clinical training of undergraduate medical students occurs in four phages: a. During medical posting undergraduates will also be asked to attend specialised department like cardiology, neurology. Medical students are supposed to complete the logbook and signed by faculty after every clinical case discussion. Harrison’s Principles of Internal Medicine, McGraw Hill publications (Reference book) 4. Practical & clinical training - Students should be trained about proper history taking, clinical examination. Observe normal deliveries, forceps and ventouse assisted deliveries, cesrean section. Normal & abnormal development, structure and function of female & male urogenital systems and the female breast. Applied anatomy of the genito-urinary system, abdomen, pelvis, pelvic floor, anterior abdominal wall, upper thigh (inguinal ligament, inguinal canal, vulva, rectum and anal canal). Anatomical & physiological changes in female genital tract during pregnancy fistulae. Anatomy of fetus, fetal growth & development, fetal physiology & fetal circulation. Physiological & neuro-endocrinal changes during puberty disorders, adolescence, menstruation, ovulation, fertilization, climacteric & menopause.

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