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Pg infobook

Postgraduate Resident’s
Information Handbook

DERMATOLOGY,VENEREOLOGY & LEPROSY

Use your five senses. Learn to See The journey of ‘Tanda Sanitarium to Medical College’ is perhaps that of the strong will of the decision makers. The history of ‘Tanda’ dates back to the reign of Rajas Dharam Chand and Langarpal of Kangra during early 16th century. The original inhabitants of the area ‘Lobanas’, a nomadic salt-trading community from surrounding villages of Palampur, Nurpur, Dehra and Kangra, called their settlements and hamlets ‘Tanda’ meaning a ‘traveling body or gang’ in Lobanki dialect. On October 28, 1952, the Governor of Punjab (Kangra was part of then Punjab), Sh. Chandu Lal Trivedi laid the foundation stone of a TB Sanitarium in this rural area located in salubrious lush green valley of Dhauladhar ranges along the river Baner. This 47 acres of land donated by Rai Bahadur Jodhamal Kuthiala, a philanthropist, had also served as tented colony for Italian prisoners during World War II. To begin with the old barracks were converted to house the sanitarium. On completion, ‘Rai Bahadur Jodhamal Kuthiala TB Sanitarium’ was inaugurated by Dr. Rajendra Prasad, the first president of India, on May 19, 1958. It housed 200 indoor patients and a Sarai for their attendants, residences for doctors and paramedics, and an officers’ club. It was rechristened as Dr. Rajendra Prasad Govt. Medical College, Kangra (Tanda) mainly to cater for patients from lower regions of the state who otherwise were traveling all the way to Shimla. The medical college with Dr. V.P. Lakhanpal as the first principal was formally started on February 25, 1997 and the TB Sanitarium integrated with it as “Department of Pulmonary Medicine”. The first batch of 50 students was admitted on January14, 1999 and Zonal Hospital at Dharamshala was attached for teaching. The new air conditioned Pt Deen Dyal Upadhaya hospital complete with its state of the art equipments and other paraphernalia was formally inaugurated on October 17, 2007. Majestic Sardar Sobha Singh auditorium further adds grandeur to otherwise well laid out college campus comprising an air conditioned central library, spacious paraclinical block, lecture theatres complex, faculty residences, and hostels for MBBS/ postgraduate students and residents. Since then it has seen many ups and downs and with the starting of postgraduate courses in dermatology, obstetrics and gynecology, and medicine in the year 2010 a fresh chapter was added to the college’s checkered history. Oncology, Hepatology, Neurology and Cardiovascular surgery departments started functioning with the joining of faculty in 2011. Commissioning of new super specialty block is expected by Nov 2013. The college now admits 100 MBBS students and 49 postgraduate students.
Department information

The department of Dermatology, Venereology & Leprosy is housed in about 438 sq meters (5200 sq feet) floor area. There are three clinic rooms, minor OT, Laboratory, nursing station, record room, counselor room, residents’ room, phototherapy room, and a day care area of about 890 sq. feet, reception area and enough patient waiting area. In addition, there is one teaching room of about 890 sq. feet area. The department has started post graduation (MD) course from the academic year 2010 having three PG students per year. In addition to central library the department has its own well stocked library having more than 150 text and reference books and scientific journals related to the specialty which are available for Equipments and Facilities available
Department of Dermatology, Venereology & Leprosy is providing OPD services on all days. Equipments like PUVA Chambers, Research microscope, Light microscopes, Electrosurgical unit, Liquid N2 Cryosurgical unit, Radiofrequency surgical unit, Co2 LASER unit, Micromotor, Wood’s lamp, Megna vision, etc are available. Special clinics for the diagnosis, management and follow up of reproductive tract infections (RTI/STI), leprosy, contact dermatitis, pigmentary dermatoses, pemphigus and psoriasis are held on different days of the week. Free treatment for STI and leprosy patients and management of lepra reaction cases is also being provided. Department is also providing advanced therapeutic facilities viz. electrocautery, vitiligo surgery like punch grafting and suction blister grafting, hair transplant, tattoo removal, mole surgery and phototherapy, Co2 LASER therapy, radiofrequency surgery, etc. The investigative facilities like patch testing, KOH smears for fungus, various stains, and basic investigations for sexually transmitted infections are available in the departmental clinical side lab. The faculty members have special interest and experience in the diagnosis and management of deep fungal infections (sporotrichosis, chromoblasatomycosis, mycetoma), leishmaniasis, psoriasis and vitiligo. The department caters to about 30000 new and old outdoor patients annually which are likely to increase in coming years. Faculty Members
Resident Doctors
Dr. Abhinav, Dr Gayatri Khatri, Dr Neel Prabha (2011); Dr Sujaya Manvi, Dr Swati Garg, Dr Ravinder Singh (2012); Dr Rajani Sharma, Dr Shiny TN, Dr Isha (2013) Other Staff Members

Records/File being maintained
Outdoor Register
Psoriasis & Metabolic syndrome record Biopsy Register and Histopathology record Patient Referral Register Ongoing Projects/Thesis

study of Occupational Contact Dermatitis among efficacy of Isotretinoin with that of Methotrexate in Moderate to levels of Homocysteine, Vitamin B12, Folic acid and Prolactin, in psoriasis patients and correlation with disease severity rheumatological manifestations among leprosy patients patients in relation to associated co-morbidities study of vitiligo in relation to other disorders including common autoimmune diseases associated with vitiligo
Paracelsus

Curriculum for Postgraduate Residents

Name of the course
: M.D. (Dermatology, Venereology & Leprosy)
Name of the University: Himachal Pradesh University, Shimla-171005 (H.P.)
Duration of the course: Three years
The principles of postgraduate training in Dermatology, Venereology and Leprosy are
as follows
:
1. Learning in program shall be essentially autonomous and self-directed. The formal teaching shall be aimed at facilitating this effort. 2. The training shall involve learning experiences derived from or targeted to the needs The goal of post-graduate medical education in the subject shall be to produce competent 1. who shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy 2. who shall have mastered most of the competences, pertaining to the specialty, that are required to be practiced at the secondary and the tertiary levels of the health care 3. who shall be aware of the contemporary advances and developments in this specialty 4. who shall have acquired spirit of scientific enquiry and is oriented to the principles of 5. who shall have acquired the basic skills in teaching of the medical and paramedical 2. Strategies to achieve above goals
A. Components of Postgraduate Curriculum

5. Training in Research methodology, Medical ethics and Medico-legal aspects B. Common Teaching Curriculum for Postgraduate Residents
Proper referral for Lab Investigations (Pathology, Microbiology & Medicolegal responsibilities of Residents C. Following Postgraduate Teaching/Training Schedule will be adhered strictly

9:30 am to 1:30 pm
8 am Onwards
General OPD/UG Clinic
PG Seminar,
Mahajan/ Dr K S Clinics*
UG Seminar* Evening
PG Teaching
Clinics*
Clinical Case
Round, All
Meeting for
Residents/ PG
students, UG
Class*

UG Seminar* Evening
Service round, UG
Clinics*
PG Seminar,
Clinics*
Clinics*
Seminar *
UG Class *
PG Journal Club,
Clinics*
pathlogy
teaching
/Thesis
review

(alternate
week)
D. Postgraduate Residents will be participating in following activities of learning:
1. The postgraduate resident will be given independent charge of indoor patients and will plan all the relevant investigations and treatment under the guidance of consultants 2. The postgraduate resident will be joining the OPD’s immediately after the ward work and will be posted in different consultant OPDs for wider learning. 3. The postgraduate resident will be posted in clinical side lab and learn to perform and interpret special tests in relation to the specialty. 4. The postgraduate resident will perform dermatosurgery procedures under supervision 5. The postgraduate resident will prepare and present seminars, journal clubs, clinical 6. The postgraduate resident will keep updated all records/ registers maintained in the dept as a part of learning ‘good record keeping’ practice. 7. The postgraduate resident will submit their plan of thesis to the university after due approval from Institutional Scientific Advisory-cum-Protocol Review Committee and Institutional Ethics Committee before the end of 1st semester. 8. The postgraduate resident will teach the undergraduate students from 4th semester 9. The postgraduate resident will submit thesis before the end of 5th semester. 10. The postgraduate resident will be posted by rotation in the dept of rheumatology/medicine, psychiatry, pathology and microbiology in the 5th semester. 11. The postgraduate residents will participate in NRHM’s/ other multispecialty health camps as a service to the rural community. 12. To be eligible to appear for final examination the postgraduate resident will participate and present scientific papers and posters in Scientific Conferences, CMEs and Workshops. He/she will also publish scientific papers preferably in indexed journals. 13. The postgraduate residents will maintain a logbook of their work performed during three years of residency for overall assessment. They must get it signed by the
3. Postgraduate evaluation schedule

The overall performance of postgraduate residents will be evaluated on day to day basis and
A. Theory: The following term examinations for internal evaluation are scheduled for
Postgraduate Residents during their tenure of training: Part- I Rook’s Textbook of Dermatology Part-II Rook’s Textbook of Dermatology 3rd Term (Dec) Part-III Rook’s Textbook of Dermatology Part-IV Rook’s Textbook of Dermatology
B. Practical: By clinical case presentations and along with term examinations as above.
C. Internal assessment by PG training in-charge based on the performance in the internal
examinations and overall assessment of the work done (as per logbook) by the resident during 4. Scheme of Final Examination
Written papers (4 numbers each carrying 100 marks; Duration 3hours) Principle and Practice of Venereology and Leprosy Recent advances and MCQs covering all of the above Details of syllabus with some variation as per university requirements Paper 1 will contain questions from basic sciences as applied to the specialty covering Dermatology, Venereology & Leprosy. The component of Dermatology will be roughly 80% while that of Venereology & Leprosy will be 20 %. Paper will be in the form of short notes, covering maximum number of topics Paper 2 will contain all aspects of principles and practice in clinical Dermatology. This paper will contain on long question/short notes which will be clinical problem oriented. Paper 3 will contain Venereology & Leprosy. This paper will contain on long question/short notes which will be clinical Paper 4 will contain recent advances with 80% Dermatology and 20 % Venereology & Leprosy component and at least 30 MCQ type questions covering all of above with single response type of one mark each and no negative marking and 7 Short 5. End Objectives

At the end of training in the specialty of Dermatology, Venereology and Leprosy a 1. recognize the importance of this specialty in the context of the health needs of the community and the national priorities in the health sector 2. establish effective communication and rapport with the patients, demonstrate clinical skill, and practice the specialty ethically and in steps with the principles of primary 3. demonstrate sufficient understanding of the basic sciences relevant to this specialty 4. identify social, economic, environmental, biological, and emotional determinants of health in a given case and take then into account while planning therapeutic, rehabilitative, preventive and health promotion measures / strategies 5. diagnose and manage majority of the conditions in the specialty on the basis of clinical assessment, and appropriately selected and conducted investigations 6. plan and advise measures for the prevention and rehabilitation of patients suffering from diseases and disabilities related to the specialty 7. demonstrate skills in documentation of individual case details as well as morbidity and mortality data relevant to the assigned situation 8. demonstrate humane approach towards patients and their families and exhibit inter- personal behavior in accordance with the societal norms and expectations 9. play the assigned role in the implementation of national health programs effectively 10. organize and supervise the chosen and assigned health care services demonstrating adequate managerial skills in the clinic / hospital or the field situation 11. develop skills as a self directed learner, recognize continuing educational needs, select and use appropriate learning resources, plan and formulate learning objectives, 12. demonstrate competence in basic concepts of research methodology, and epidemiology and be able to critically analyze relevant, published research literature, identify gaps in knowledge, and able to formulate research questions 13. develop skills in using educational methods and techniques as applicable to the teaching of medical / nursing students, general physicians, and para-medical health 14. function as an effective leader of a health team engaged in health care, research, or 15. interact, communicate, educate and impart scientific information to public, decision 16. nurture team spirit, harmonize and facilitate intersectional coordination and promote 6. Recommended Textbooks

3. Textbook of STIs & AIDS by Dr V K Sharma 5. Handbook of Leprosy by Ridley & Jopling 7. Critical care in Dermatology by Inamdar A & Palit A 8. Principles of Thesis Writing by Tejinder Singh, et al
7. Diagnosis in Dermatology

“Doctors record patient’s medical history without paying much attention to the patient. But we must never forget that the look on the patient’s face, the tremble in his hands, the falter in his speech, the dreams he has, the drawings he makes, are all potential signs (windows) of what really troubles him” Sir William Osler

1. Develop communication skill to extract history, study primary and secondary lesions, their distribution, configuration, color and must examine all lesions. 2. Know common habits of people and practices in the society. Remember, contact dermatitis is more common due to topically applied home remedies/beauty products, and cosmetics. Adverse drug eruptions can mimic any dermatosis. 3. There are no shortcuts to physical diagnosis and it is learnt by practice. Keep a good atlas of dermatological diseases. Look at pictures, as many as possible, in books, in atlases or journals (these are of better quality than those on the internet). 4. You can always have the treatment if you have the diagnosis. Remember, there is only one correct diagnosis. Know each differential and by exclusion look for the most likely one. Unsure of the diagnosis use brighter/day light, and higher magnification. Remember, rare diseases may be rare but these patients are not. 8. General instructions
1. A stethoscope, a good hand lens, a measuring tape, a torch, microscope slides, few paper pins and cotton wisps, and gloves are essential paraphernalia. If possible have a knee hammer and tuning fork; you may need them sometimes. 2. Must observe universal precautions and avoid needle-stick injuries while sampling for lab tests irrespective of the HIV status of the patient. 3. Must observe due diligence while collecting lab samples and follow instructions issued by the labs for sampling. Always provide relevant information about the patient, treatment and required investigation while filling out lab requisition forms. Make use of the emergency lab facility for patients hospitalized after the hospital 4. Must keep discipline in the department / institute and comply with office orders/policies. Do not get involved in gossip. Must remember your primary priority should always be learning/patient care only. 5. Maintain a congenial environment in the department / institute. Respect your seniors and maintain good relations with your colleagues and other staff members. Work like a team. Remember, your seniors and faculty members are there to guide you through 6. Devote maximum time to your academic work. Remember ‘the eyes can not see what the mind doesn’t know’; develop a knowledge based keen sense of observation. Try to learn all aspects of medical science for an integrated knowledge. 7. Patients care must make your top priority; empathize with them and always be ready to help them. A white coat, well groomed turnout and good communication avoiding technicalities give confidence to the patient and placate their fears making your work easy. Always observe principles of pharmacovigilance and pharmacoeconomics. 8. As per MCI guidelines a PG resident must submit plan of thesis to the university within 6months (before Nov 30) after due approval from ‘Institutional Scientific and Protocol Review Committee’ and ‘Institutional Ethics Committee’. In addition to thesis, presentation of scientific papers / posters in Conferences, Workshops and CPCs and their publications in scientific journals has become mandatory to be eligible for final exams. Plan your field of work accordingly. Follow 'instruction for authors' for writing manuscript (protocol, scientific papers, etc) provided in any of the standard 9. It is highly desirable to make use of computers and internet. Learn it if not already 10. Always keep your LogBook updated.

Source: http://rpgmc.ac.in/dermatology/pg_infobook.pdf

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