Ordinance Governing

M.Sc. MLT Course

Regulations and Curriculum

2006

Rajiv Gandhi University of Health Sciences, Karnataka

4th 'T' Block, Jayanagar, Bangalore - 560 041

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

The Emblem

The Emblem of the Rajiv Gandhi University of Health Sciences is a symbolic expression of the confluence of both Eastern and Western Health Sciences. A central wand with entwined snakes symbolises Greek and Roman Gods of Health called Hermis and Mercury is adapted as symbol of modern medical science. The pot above depicts Amrutha Kalasham of Dhanvanthri the father of all Health Sciences. The wings above it depicts Human Soul called Hamsa (Swan) in Indian philosophy. The rising Sun at the top symbolises knowledge and enlightenment. The two twigs of leaves in western philosophy symbolises Olive branches, which is an expression of Peace, Love and Harmony. In Hindu Philosophy it depicts the Vanaspathi (also called as Oushadi) held in the hands of Dhanvanthri, which are the source of all Medicines. The lamp at the bottom depicts human energy (kundalini). The script “Devahitham Yadayahu” inside the lamp is taken from Upanishath Shanthi Manthram (Bhadram Karnebhi Shrunuyanadev…), which says “May we live the full span of our lives allotted by God in perfect health” which is the motto of the Rajiv Gandhi University of Health Sciences.

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

Vision Statement

The Rajiv Gandhi University of Health Sciences, Karnataka, aims at bringing about a confluence of both Eastern and Western Health Sciences to enable the humankind “Live the full span of our lives allotted by God in Perfect Health”

It would strive for achievement of academic excellence by Educating and Training

Health Professionals who

· Shall recognize health needs of community,

· Carry out professional obligations Ethically and Equitably and in keeping with National Health Policy,

It would promote development of scientific temper and Health Sciences Research.

It would encourage inculcation of Social Accountability amongst students, teachers and

Institutions.

It would Support Quality Assurance for all its educational programmes.

Motto

Right for Rightful Health Sciences Education

CONTENTS

Table of Contents

Page

Emblem

i

Vision Statement

ii

Notification

iii

Section I

Regulations Governing M.Sc.MLT course

5

Section II

Aims and Objectives

19

Section III

Course Content

20

I Year

20

1. Biochemistry-I

20

2. Microbiology-I

25

3. Hematology and Blood Transfusion -I

33

II Year

44

1.Biochemistry-II

44

2. Microbiology-II

54

3. Hematology and Blood Transfusion –II

63

Section IV

Monitoring Learning Progress

74

Section V

Ethics in M.Sc. MLT

84

Section VI

Minimum requirement

86

Annexure I

Bio-Medical waste management

92

SECTION -I

Regulations Governing M.Sc.MLT course

1. Title of the Courses

Master of Science degree in Medical Laboratory Technology Course, M.Sc. (MLT) is available in the following three branches:

a) M.Sc.MLT in Clinical Biochemistry

b) M.Sc. MLT in Microbiology &Immunology

c) M.Sc. MLT in Haematology & Blood Transfusion

2. Duration of the Course

The duration of the course shall be on full time basis for a period of two years from the commencement of the academic term.

3. Eligibility for Admission

a) A pass in B.Sc. MLT Course from institutions affiliated to RGUHS, or from other Universities considered equivalent by RGUHS.

b) Candidates passing B.Sc. MLT through correspondence course shall not be eligible

4. Selection Criteria

Selection shall be based on merit in the qualifying examination. The candidate has to

choose the branch of his /her choice during the time of seat selection. No change of branch will be Permitted once he /she get admitted.

5. Eligibility certificate

No candidate shall be admitted for the postgraduate degree course unless the candidate has obtained and produced the eligibility certificate issued by the university. The candidate has to make the application to the university with the following documents along with the prescribed fee.

Pass / degree certificate issued by the university.

Marks cards of all the university examinations passed.

Migration certificate.

Certificate of conduct.

Proof of SC/ST or category-I as the case may be.

Candidates should obtain the eligibility certificate before the last date for admission as notified by the university.

A candidate who has been admitted to post-graduate course should register his/her name in the university within a month of admission after paying the registration fee.

6. Medium of instruction

English shall be the medium of instruction for the subjects of study as well as for the

Examination.

7. Course of study

The course shall be pursued on full time basis. There are three branches in M.Sc MLT course. However, both study and examination for main and subsidiary subjects in first year shall be common to all the three branches. In the second year the student shall study subject of his/ her chosen branch. Students shall be posted to RGUHS approved hospitals or clinical laboratories during the practical hours.

Subjects for study and teaching hours for first year and second year M.Sc MLT course are

shown in Table – I and Table-II respectively.

Table - I Distribution of Teaching Hours in First Year M.Sc. MLT Subjects

Sl.No.

Main Subjects

Theory

No. of hours

Practical

No. of hours

Total

1.

Biochemistry-I

a. Clinical Biochemistry

b. Biomedical Techniques

c. Laboratory Management

80

40

40

120

40

--

320

2.

Microbiology -I

a. Clinical Microbiology

b. Immunology

c. Molecular Biology

80

40

40

100

40

20

320

3

Hematology and Blood

Transfusion -I

a. Haematology & Clinical Pathology

b. Immunopathology

c. Medical Genetics

100

40

20

100

40

20

320

Subsidiary subject:

a. Biostatistics

b.Research methodology

30

20

10

--

40

20

Total

530

490

1020

Note: Main and Subsidiary subjects are common in I year for all the three branches.

Table- II Distribution of teaching hours in Second year M.Sc. MLT subjects for the branches.

Sl.NoSl.No.

Branches

Theory

No. of hours

Practical

No. of hours

Total

1.

Biochemistry-II

360

720

1080

2.

Microbiology –II

360

720

1080

3.

Haematology and Blood transfusion -II

360

720

1080

8. Attendance

Every candidate should have attended at least 80% of the total number of classes conducted in an academic year from the date of commencement of the term to the last working day as notified by university in each of the subjects prescribed for that year, separately, in theory and practical. Only such candidates are eligible to appear for the university examinations in their first attempt. A candidate lacking the prescribed percentage of attendance in any subject either in Theory or Practical in the first appearance will not be eligible to appear for the University Examination in that particular subject.

The course shall be pursued on full time basis. No candidate shall be permitted to work in a nursing home or laboratory outside the institution while studying the course. No candidate shall join any other course of study or appear for any other examination conducted by this university or any other university in India or abroad during the period of study.

9. Monitoring Progress of Studies

Work Diary/Record Book Every candidate shall attend symposia, seminars, conferences, journal review meetings & lectures during each semester as prescribed by the department and not absent himself/herself from work without valid reasons. Every candidate shall maintain a work diary and record of his/her participation in the training programme. (Refer section III for model check lists and record book). Special mention may be made of the presentations by the candidate as well as details of laboratory work conducted by the candidate. The work diary and record shall be scrutinized and certified by the concerned faculty members.

Internal Assessment (IA)

Institutions running the course shall conduct three tests each in First and Second year for Internal Assessment. The third test shall be conducted one month prior to the university examination so that it also serves as preparatory examination. The marks obtained in these tests will be considered for internal assessment. Average of the best two marks will be computed for internal assessment and shall be sent to the university as per the notification issued by Registrar (Evaluation) before each university examination. Records and marks obtained in tests will be maintained by the college and made available to the university. Marks of periodic tests shall be displayed on the notice board by the principals without fail.

If a candidate is absent from the test due to genuine and satisfactory reason, such a candidate may be given a re-test within a fortnight.

The distribution of marks for internal assessment for subjects of study in first year and second year are shown in Tables III and IV respectively.

Table III. Distribution of Internal Assessment marks in first year M.Sc.MLT course

Sl No

Subjects

Biochemistry-I

Marks

Microbiology-I

Marks

Haematology &

Blood Transfusion-I

Marks

1.

Theory

20

20

20

2.

Practical

Practicals- 15

20 Record - 5

Practicals-15

20 Record - 5

Practicals-15

20 Record - 5

Table IV. Distribution of Internal Assessment marks in second year M.Sc.MLT course

NOTE: A student must secure at least 50% of total marks fixed for internal assessment for a particular subject in order to be eligible to appear in university examination in that subject. The internal assessment marks will not be added to the marks obtained in the university examination for declaration of pass.

10. Dissertation

Each candidate pursuing M.Sc. MLT Course is required to carry out dissertation work on a selected topic under the guidance of a recognized post graduate teacher for a period of one year after the submission of synopsis. The results of such a work shall be submitted in the form of dissertation.

The dissertation is aimed to train in research methods and techniques. It includes identification of problem, formulation of hypothesis, search and review of literature, getting acquainted with recent advances, collection of data, critical analysis, interpretation of results and drawing conclusions.

Every candidate shall submit to the Registrar (Academic) of the University in the prescribed proforma, two hard copies of synopsis along containing particulars of proposed dissertation work within six months from the date of commencement of the course or on or before the date notified by the University. The synopsis shall be sent through proper channel.

The University shall arrange for review of synopsis and if found suitable shall register the dissertation topic. No change in the dissertation topic shall or guide shall be made without prior approval of the University.

The dissertation shall be written under the following headings:

· Introduction

· Aims or objectives of study

· Review of literature

· Materials and methods

· Results

· Discussion

· Conclusion

· Summary

· References

· Tables

· Annexure

The written text of dissertation shall not be less than 50 pages and shall not exceed 100 pages excluding references, tables, questionnaires and other annexure. It should be neatly typed in double line spacing on one side of paper (A4 size, 8.27” x 11.69”) and bound properly. Spiral binding should not to be done. A declaration by the candidate that the work was done by him/her shall be included. The guide, head of the department and head of the institution shall certify the bonafide of the dissertation.

Four copies of dissertation shall be submitted to the university through proper channel along with a soft copy (CD), three months before the final examinations. It shall be assessed by two examiners appointed by the university, one internal and one external. No marks shall be awarded for dissertation. Acceptance of the dissertation is a pre-requisite for a candidate to be eligible to appear in the final examination.

11. Guide

The eligibility academic qualification and teaching experience required for

recognition as Guides by the RGUHS are:

a) Eligibility to be a guide

Shall be a full time teacher in the college or institution where he or she is working..

b) Academic qualification and teaching/professional experience for each branch

M.Sc. MLT- Clinical Biochemistry

· Ph.D. in Medical Biochemistry / Clinical Biochemistry with minimum of three years of teaching/professional experience after PhD in a teaching institution or in a laboratory approved by RGUHS,

Or

· M.D. in Biochemistry with three years of teaching/professional experience after post graduation in a teaching institution or in a laboratory approved by RGUHS,

or

· M.Phil. in Clinical Biochemistry with a minimum of four years of teaching/professional experience after M.Phil in a teaching institution or in a laboratory approved by RGUHS,

or

· M.Sc in Clinical Biochemistry [Medical], or M.Sc. MLT in Clinical Biochemistry with five years of teaching/professional experience after the postgraduate qualification in a teaching institution or laboratory approved by RGUHS.

M.Sc. MLT - Microbiology & Immunology

· M.D. or Ph.D. in Microbiology and three years of teaching/professional experience after post graduation in a teaching institution or in a laboratory,

or

· M.Sc. MLT in Microbiology and Immunology/M.Sc in Medical Microbiology with five years of teaching/professional experience after the postgraduate qualification in a teaching institution or laboratory approved by RGUHS.

M.Sc. MLT-Haematology & Blood Transfusion

· M.D. or Ph.D. in Pathology and three years teaching/professional experience after post graduation in a teaching institution or in a laboratory approved by RGUHS,

or

· M.Sc. MLT in Haematology & Blood Transfusion with five years of teaching/professional experience after the postgraduate qualification in a teaching institution or laboratory approved by RGUHS.

c) Age:

The age of guide shall not exceed 65 years.

d) Student: Guide ratio - 5:1. A recognized guide shall supervise dissertation work of not more than five students per academic year.

12. Schedule of examination

a. The University conducts two examinations in a year at an interval not less than four

to six months.

b. The number of examiners for practical and viva-voce shall be two, comprising of

one internal and one external examiner appointed by the university.

c. A candidate shall not be admitted to the practical examinations for the first time

unless he/she produces the class record book certified by the Head of the Department.

d. A failed candidate need to appear for both theory and practical examination in the

failed subject/s only in the subsequent examination.

13. Scheme of examination:

University examination:

There shall be two University examinations, one at the end of first year and the other at the

end of second year, respectively.

First year M.Sc MLT

Both the main and subsidiary subjects for M.Sc. MLT course shall be common for all the

three branches in the first year.

Eligibility to appear in university examination

A candidate shall be eligible to appear for first year M.Sc.MLT examination at the end of one year from the commencement of the course. He/She should have satisfactorily completed the prescribed course and fulfilled the prescribed attendance.

.

Written examination: Written examination shall consist of three theory papers each of three hours duration. Each paper shall carry 100 marks.

Practical examination : There shall be one practical examination in each of first year subjects. Each practical examination carries 100 marks.

Viva- voce : - This shall aim at assessing depth of knowledge, logical reasoning, confidence and oral communication skills. Both internal and external examiners shall conduct the viva- voce. Total marks shall be 50.

The particulars of subjects for examination and distribution of marks are shown in the Table –V.

Table-V. Main Subjects for Examination and Distribution of marks for First year

Sl

No

Theory

Practical

Grand

Total

A

Main Subjects

No of

papers

Max

Marks

Practical

Marks

Viva –Voce

Marks

Total

Practical

Marks

Paper I- Biochemistry-I

Section A: Clinical Biochemistry

Section B: Biomedical Techniques and

Laboratory Management

one

100

100

50

150

250

Paper II- Microbiology-I

Section A : Clinical Microbiology

Section B : Immunology and

Molecular Biology

one

100

100

50

150

250

Paper III- Haematology &

Blood Transfusion-I

Section A : Haematology and

Clinical Pathology.

Section B : Immunopathology and

Medical Genetics

one

100

100

50

150

250

B

**Subsidiary subjects

Section A: Biostatatics

Section B :Research methodology

One

100

(60)

(40)

No practical examination

100

**Respective colleges shall conduct examination for subsidiary subjects and send the marks to the University. Prescribed percentage of marks for a pass in subsidiary subject is 35.

Second year M.Sc MLT

Examination in II year shall be held separately for each branch. A candidate will appear only in the branch chosen by him/her at the time of admission.

Eligibility: To be eligible to appear in the II year examination a candidate shall have:

i) completed one year of study in II year, and ii) passed in all the subjects of I year.

Written examination : Written examination shall consists of two theory papers. Each paper shall be of three hours duration. Each paper shall carry 100 marks.

Practical examination : There shall be one practical examination in each of the branches . The marks for each practical examination shall be 100 marks.

The duration of practicals from 9.00 a.m. to 5.00 p.m. with a lunch break of one hour in between for each of the branches is as follows:

M.Sc. MLT Clinical Biochemistry II Practical

2 days

M.Sc. MLT Microbiology & Immunology II Practical

3 days

M.Sc. MLT Hematology & Transfusion II. Practical

2 days

Viva- voce : This shall aim at assessing depth of knowledge, logical reasoning, confidence & oral communication skills. Total marks shall be 50. Presentation of dissertation and discussion on it be done during the viva-voce .No marks shall be awarded to the presentation of dissertation.

Both internal and external examiners shall conduct the practical and viva- voce examination.

The particulars of subjects for examination and distribution of marks are shown in the Table –VI.

Table-VI. Main Subjects for Examination and Distribution of marks for Second year

Sl

No

Main Subjects

Theory

Practical

Grand

Total

No of

papers

Marks

Sub

total

Practical

Marks

Viva –Voce

Marks

Total

Practical

Marks

1

Biochemistry - II

Two

100

200

100

50

150

350

2

Microbiology-II

Two

100

200

100

50

150

350

3

Haematology & Blood Transfusion-II

Two

100

200

100

50

150

350

*Records –To be assessed by the external examiners during University Practical examination.

14. Criteria for Pass.

a. Criteria for pass in a subject:

For declaration of pass in any subject in the University examination, a candidate shall pass both in Theory and Practical examination components separately, as stipulated below:

Theory component consists of marks obtained in University Written paper. For a pass in a theory subject, a candidate shall secure not less than 50% of maximum marks in each paper and an aggregate of 50% marks per subject prescribed for the University examination separately. For pass in practical examination the candidate has to secure 50% marks in aggregate i.e. marks obtained in the practical and viva-voce examination added together provided the candidate has secured 40% marks in practical examination.. A failed candidate is required to appear for both Theory and Practical in the subsequent examination in that subject.

b. Criteria for pass in First and Second year:

To consider as pass in first or second year a candidate has to appear in all the papers prescribed

for each subject and has to pass in all the prescribed subjects of the University examination for

the concerned year.

15.Carry over

A candidate who has appeared in all subjects of first year in the university examination is eligible to go to second year provided he/she has passed in any two subjects. However, failed candidate has to pass the failed subject to become eligible to appear for second year university examination.

16 Declaration of distinction: A candidate securing total aggregate marks of 75% or more in the

first attempt shall be declared as passed with distinction. Distinction will not be awarded

for candidates passing the examination in more than one attempt.

17. Number of attempts

A candidate is permitted not more than three attempts (actual appearance) to pass the first year examination or within two academic years from the year of admission, whichever is earlier. A candidate will not be allowed to continue the course if he/she fails to comply with the above stipulation.

18. Maximum duration for completion of course

A candidate shall complete the course within four years from date of admission

Failing which the candidate will be discharged.

19. Eligibility for award of degree

A candidate shall have passed in all the subjects of first and second year to be eligible for award of degree.

SECTION II

AIMS AND OBJECTIVES

1. Aims and Objectives:

The goals of postgraduate training in various branches of M.Sc MLT are to train graduates who will:

· Practice respective branches efficiently and effectively, backed by scientific

knowledge and skill.

· Exercise empathy and a caring attitude and maintain high ethical standards.

· Continue to evince keen interest in continuing professional development whether

in teaching or practice.

· Willing to share the knowledge and skills with any learner, junior or a colleague.

· To develop faculty for critical analysis and evaluation of various concepts and

views & to adopt most rational approach.

· Demonstrate understanding of basic sciences relevant to respective branches.

· Acquire the detailed knowledge about the fundamentals and advances of the respective branches.

· Update knowledge by self-study and by attending courses, conferences and seminars relevant to branch chosen.

· Undertake audit, use information and carryout research with the aim of publishing or presenting the work at various scientific gatherings.

Acquire adequate skills and competence in performing various tasks as required.

· Adopt ethical principles in all aspects of the professional practice.

· Foster professional honesty and integrity.

· Discharge the duties irrespective of social status, caste, creed or religion of the customer/client.

· Develop oral and written communication skills.

· Provide leadership and get the best out of his or her team in a congenial working atmosphere.

· Apply high moral and ethical standards while carrying out research.

· Be humble and accept the limitations in his or her knowledge and skill and ask for help from colleagues when needed.

Section III

Course Content

First Year M.Sc.MLT

BIOCHEMISTRY-I

THEORY :-

Section-A: - CLINICAL BIOCHEMISTRY

80 Hours

1. CHEMISTRY OF CARBOHYDRATES

· Definition and Function

· Classification

· Isomerism of Monosaccharides

· Properties of Monosaccharides

· Modified Monosaccharides

· Disaccharides

· Polysaccharides

2. CHEMISTRY OF PROTEINS

· Definition, function of Proteins

· Classification of Amino acids

· Properties of Amino acids

· Classification and properties of proteins

· Structural organization of proteins

3. CHEMISTRY OF LIPIDS

· Definition and function of Lipids

· Classification of Lipids

· Properties of Lipids

4. NUCLEIC ACIDS

· Nucleotides and its bases

· DNA in detail

· RNA and its classification

· High energy compounds

5. ENZYMES

· Classification of Enzymes

· Factors affecting enzyme activity

· Inhibitors

· Specificity

· Enzyme Kinetics

· Enzymes in clinical diagnosis

6. Clinical significance, principle of estimation

· Bilirubin General types and jaundice

· Liver Function Test

i) Bilirubin estimation (Mally evlen method, jendrassrk and Gorf method direct spectrometry method)

ii) Alkaline phosphates and acid phosphates estimation by King’s method

iii) SGOT, SGPT Reatam frank method ALP, PT etc.

· Glucose tolerance test (GTT) importance and principle and techniques of GTT

· Insulin tolerance test

· Gastric juice analysis

· Xylose absorption test

· Analysis of calculi

· Cerebrospinal fluid analysis

i) Composition and function of CSF

ii) Clinical significance of CSF analysis

iii) Estimation of sugar and proteins in CSF

7. Urine chemistry

· Automation in Urine chemistry

· Physical and Chemical examination of Urine samples. Qualitative tests for inorganic urinary ingredients

· Common qualitative and quantitative tests of urine

· Clearance test for urine function

8.Electrolytes: sodium, potassium, chloride, CO2 (HCO3 -), total and ionized

calcium, phosphorus (inorg.), magnesium.

9.Blood gases and pH, carboxyhemoglobin, CO, Met Hb, O2saturation

10.Disorders of carbohydrate metabolism

11. Abnormalities of proteins in plasma

12. Disorders of plasma lipids and lipoproteins

13. Blood collection procedures- theory of anticoagulation.

Bio-Medical waste: Types, potential risks and their safe management.

CLINICAL BIOCHEMISTRY PRACTICALS 120 Hours

1. Estimation of blood glucose by Folin method, Ortho toludine method & CHOD – POD method.

2. Estimation of protein by Biuret method, Lowry, UV method

3. Estimation of serum creatinine by Jaffe’s method

4. Estimation of urea in blood sample by urease

5. Estimation of Total cholesterol by CHOD/POD method

6. Estimation of Triglycerides by GOP/PA method

7. Estimation of HDL Cholesterol by precipitation method

8. Estimation of SGOT in blood sample by kinetic method

9. Estimation of SGPT in blood sample by kinetic method

10. Estimation of alkaline phosphatase in blood sample by kinetic method

11. Estimation of acid phosphatase in blood sample by kinetic method

12. Estimation of bilirubin in blood sample by kinetic method

13. Estimation of Na+, K+ & Ca++ by electrode analyzer

14. Estimation of common parameters in urine through use of strips

15. Estimation of T3, T4 and TSH by ELISA method.

Section B: -BIOMEDICAL TECHNIQUES AND LABORATORY

MANAGEMENT.

BIOMEDICAL TECHNIQUES

40 Hours

1. Methods of qualitative analysis of biomolecules:

Principles, experimental procedures and application of chromatography – paper, thin-layer, ion exchange, affinity, gel filtration, gas-liquid and HPLC. Principles, procedures and application of Electrophoresis – paper, polyacrylamide gel, agarose gel, capillary and cellulose acetate.

2. Centrifugation Techniques – Principle and technique of preparative and analytical centrifugation, differential centrifugation, density gradient centrifugation, ultra-centrifuge and its application.

3. Quantitative methods: Principles and applications of Photometry, Spectrophotometry, flurometry, ion selective procedures, flame photometry, atomic absorption spectrometry. Ion selective electrodes and their applications in Medicine.

4.Isotopes: Detection and measurement of radioactive isotopes, application of isotopes in research and clinical bio-cemsitry.

5.Cell Fractionation, Biochemical activities of different fractions, marker enzymes.

6.Bioenergetics and Biological oxidation: Concept of free energy change, high energy compounds, ATP generation, redox potentInternal Assesmentl, Electron transport chain, oxidative phosphorylation, inhibitors, Uncouplers, ionophores.

7.Purification of enzymes from cells, characterization and criterInternal Assesment of purity, purification of proteins.

8. Bio-Medical waste: Types, potential risks and their safe management.

PRACTICALS `

40 Hours

1. Chromatography: paper, thin layer, gel, ion-exchange, demonstration of HPLC and GLC

2. Electrophoresis: slide gel, PAGE, Agarose gel, Native, SDS PAGE of Blood Sample. (Demo only)

3. Photometry, spectrophotometry, atomic absorption spectrophotometry

4. Cell fractionation – methods

LABORATORY MANAGEMENT 40 Hours

1. Preparation of operating budgets; general aspects of financial management of laboratories:

2. Cost-analysis (tests and instruments); justification of providing new services or rejecting existing ones; lease and purchase decision analysis; delegation of budget responsibilities, work load statistics.

3. Laboratory design: Designing laboratories for different types and sizes of institutions: selection of equipment and systems for the laboratory, concepts of workstation consolidation, workflow analysis, concepts in laboratory automation (sample transportation systems, modular systems, robotics).

4. Laboratory safety: Fire, chemical, radiation and infection control

(body substance precautions), hazardous waste and transport of hazardous materials.

5. Training of technical staff: Familiarity is needed with the syllabi of various training programs; knowledge of the teaching requirements and level of knowledge technical staff; understanding of qualifications of technologists trained in other countries.

6. Maintenance of records: Procedure manuals, ward manuals, quality control programs, patient data retrieval.

7. Personnel management: Personnel policy manual; job descriptions; labor, supervision relations; conducting job interviews; motivation, recognizing job distress syndrome; delegation to a laboratory manager.

8. Hospital organization; interactions between the laboratory service and the rest of the hospital.

9. Professional ethics.

10. Quality assurance; total quality management; development and monitoring of performance indicators.

11. Public relations; hospital and community.

12. Basic clinical epidemiology

13. Laboratory Data Processing:

14. General principles of methods for reduction of data into forms suitable for electronic data handling systems (computerized accessioning functions, sample identification and tracking (e.g. bar code systems), result reporting, storage and retrieval, electronic data transfer).

15. Use of computers in quality control and management; use of computers for calculating analytical results (eg. non-linear functions).

16. General aspects of system design; central vs. stand-alone systems, host computers and equipment interfaces.

17. Laboratory information systems LIS), Hospital information systems (HIS).

18. Personal computer use; word processing, spreadsheets, data-base, graphics, statistics, presentations, email, internet. Security of data storage and transmission.

19. Data base structures and data mining.

20. Appropriate access control to patient information.

SCHEME OF EXAMINATION OF BIOCHEMISTRY-I.

Theory: - Their shall be one paper of 3 hrs duration, carrying 100 marks each.

PAPER I:-Biochemistry-I

Sec A: - Clinical Biochemistry

-50 marks

Sec B: - Biomedical Techniques and Laboratory Management -50 marks

Type of questions and distribution of marks for each section carrying 50 marks

Type of questions

No of questions

Marks for each questions

Total

Long Essay

01

20

20

Short Essay

05

06

30

PRACTICAL EXAMINATION

Max Marks: 100

1. Identification of Unknown Carbohydrate,

Protein or NPN

-30 Marks

2. Practicals: A

-40 Marks

Procedures involving Chromatography or Electrophoresis to be given for seperation and identification of aminoacids or carbohydrates.

Practicals: B

-30 Marks

Estimation of Glucose, Total protein, Creatinine, Urea, Cholesterol (any one)

VIVA-VOCE----50 Marks

The Viva Voce exam will carry 50 marks and both the internal and external examiners will conduct the examination

MICROBIOLOGY- I

THEORY:

Section A: - CLINICAL MICROBIOLOGY.

CLINICAL MICROBIOLOGY 80 Hours

1. General aspects.

The investigation of biological samples in infectious diseases is different from the other branches in that it requires general knowledge of pathogenic agents (bacteria or viruses) and of host reaction.

1.1 Definition of infection and infectious disease: natural bacteriological ecosystem.

1.2 Pathogenicity of bacteria and viruses.

1.3 General epidemiology of infection and infectious diseases.

1.4 Sterilization & Disinfection

1.5 Culture media and preparation

1.6 Bacteriology of Milk, Water and Air

2. Diagnostic procedures.

2.1 Specimen selection and collection (blood, urine, sputum, faeces, others).

2.2 Specimen processing: smears, staining, cultures including cell cultures, susceptibility testing, antigen detection.

2.3 Preservation of cultures

2.4 Usual techniques for microbe and virus identification (including principal differential characteristics).

2.5 Molecular biology techniques for characterization of microbes and viral agents.

2.6 Bacteriological and viral serology.

3. Bacterial and viruses.

Succinct description of responsible bacterial and viruses in bacteriological and viral syndromes or diseases (including principal differential characteristics).

3.1 Bacterial: Neisseria gonorrhoeae and N. meningitidis, Staphylococcus aureus, Coagulase Negative Staphylococcus, Streptococcus pyogenes (especially S. agalactiae and S. pneumonia), Escherichia coli, Salmonella, Shigella and other Enterobacteriaceae,

Vibrio cholerae, Pseudomonas aeruginosa, Haemophilus influenzae, Clostridium perfringens, C. tetani, Bacteroides spp, Lister monocytogenes, Legionella, Mycobacterium tuberculosis and others, Treponema pallidum, Chlamydia, Mycoplasma, etc.Corynebacterium diphtheriae, Bacillus anthracis, B.cereus, Non sporing Anaerobes, Bordetella, Brucella, Yersinia, Actinomyces, Pasteurella, Franciesella,

3.2 Viruses: herpes (herpes simplex, herpes varicellae, cytomegalovirus, Epstein Barr virus); hepatitis A, B, C, D, E; human immunodeficiency virus; enteroviruses (poliovirus); rubella, mumps, measles, parvovirus B19, RSV, myxovirus, rhinovirus, coronavirus, adenovirus, rotavirus, papillomavirus, rabies, Arboviruses, Poxviruses, Oncogenic Viruses,etc.

4. Antibiotics and antiviral agents

5.1 Basic knowledge of antibiotics and antimicrobial therapy.

5.2 Antibiotic and antiviral sensitivity test.

5.3 Antibiotic and antiviral resistant mechanisms.

Medical Parasitology & Mycology

5. Epidemiology, main clinical signs, basis for biological diagnosis (including a succinct description of parasites and fungi without biochemical characteristics),treatment.

5.1 Amoebiasis: Entamoeba histolytica.

5.2 Giardsis, cryptosporidiosis and uro-genital trichomoniases.

5.3 Malaria.

5.4 Toxoplasmosis.

5.5 Intestinal, hepatic and urinary helminthiasis: strongyloidiasis, ancylostomiasis, enterobiasis, ascariasis, schistosomiasis (Schistosoma mansoni and S haematobium), fascioliasis (Fasciola hepatica) and taeniasis (Taenia saginata).

5.6 Fungal infections (Candida albicans, Cryptococcus neoformans, etc.).

5.7 Aspergillus infections (Aspergillus fumigatus).

5.8 Dermatophyte infections (Microsporum canis, Epidermophyton

floccosum, Trichophyton rubrum, Trichophyton mentagrophytes).

5.9 Leishmaniosis.

5.10 Echinococcosis.

5.11 Pneumocystosis.

5.12 Filariasis.

5.13 Leptospirosis

6. Usual techniques for parasite and fungus identification.

7. Immunological and molecular diagnosis of parasitic and mycological diseases.

8. Bio-Medical waste: Types, potential risks and their safe management.

MICROBIOLOGY PRACTICALS 100 Hours

1. Collection of clinical materials like blood, urine, stool, sputum,

swabs, CSF etc.

2. Parasitology - collection, preservation and transportation of faecal material for examination of parasites. Concentration techniques of stool for ova and cyst. Wet preparation of faecal sample for ova and cyst. Identification of ova and cyst in stool sample.

3. Procedure of techniques of sputum for AFB.

4. Procedure of skin clipping of Leprae Bacilli.

5. Identification of organisms with Biochemical reactions of common organism like - Staphylococus, E.coli - Klebsiella, shigella, Salmonella, Proteus, Pseudomonas.

6. Antibiotic Sensitivity tests

7. Preservation of stock culture

8. Bacteriology of water

9. Collection of specimen for fungal examination like skin scrapings, swabs, CSF.

10. Fungal examination by wet preparation

11. Fungal culture

12. ELISA HIV & HBsAg test (Demonstration only)

13. Western blot test ( Demonstration Only)

14. Incubation of fertile eggs and inoculation by various routes. (Demonstration only)

Section B:-IMMUNOLOGY AND MOLECULAR BIOLOGY

IMMUNOLOGY 40 Hours

Immune System

Basic immunology

A. Characteristics of the Immune System

1. Define CD antigens.

2. Define primary and secondary lymphoid tissues.

3. Define mucosal-associated lymphoid tissues.

3.1 oral

3.2 nasopharyngeal

3.3 gut-associated

3.4 reproductive

4. Describe blood-lymph circulation and lymphatics.

5. Organization of lymph nodes

5.1 Explain hematopoietic cell distribution in lymph nodes.

5.2 Provide examples and locations of lymph nodes in head and neck.

Innate and Adaptive Immunity

1. Define concepts of specificity and memory.

2. Describe basic properties of innate immune cells.

3. Describe basic properties of adaptive immune cells.

Physiochemical properties of innate immunity

1. Physiological barriers

2. Anatomical barriers

3. Phagocytic/endocytic barriers

4. Inflammatory barriers

Adaptive Immunity

1. Define humoral immunity.

2. Define cell-mediated immunity.

3. Define T cells, T cell subsets, B cells, and plasma cells.

Antigens and Immunogens

1. Define antigen and immunogen.

2. Define relative antigenicity of macromolecules.

3. Define and give example of antigenic determinants and epitopes.

4. List types of antigens with examples.

5. Define ‘Hapten’ and explain how they function in the immune system

Immunoglobulins (Igs)/Antibodies (Abs):

1. source from B cells and plasma cells

2. B cell/antibody/specificity relationship

3. Describe structure of immunoglobulins:

3.1. Molecular components of Igs

3.2 heavy and light chains

3.3 variable and constant regions

3.4 Define allotype, isotype, idiotype.

Classification of immunoglobulins

1. Explain differences based on heavy and light chains.

2. Describe functional properties of Ig classes.

3. Describe evidence for number of antigenic determinants recognized by Igs.

T cells

1. Describe classification of T cells (Th1, Th2, αβ and γδ T cells).

2. Compare and contrast molecular and cellular features of T cell receptor (TCR) to B cells receptor (Ig molecule).

3. Describe development of T cells in the thymus.

4. Describe the genes’ rearrangement in TCR development.

5. T cell-associated molecule - the TCR complex

5.1 CD3 molecules

5.2 T cell signaling by CD3

6. Define αβ and γδ T cells, including

6.1 tissue distribution

6.2 differential functions of αβ and γδ T cell.

The Complement System

1. Define the complement system and describe when and how it is used.

2. Provide step-by-step examples of how complement works:

2.1 the classical complement pathway

2.2 the alternate complement pathway

3. List representative infectious agents and products that activate complement.

4. Describe biological effects mediated by complement.

5. Describe the effects of complement on the immune system.

6. Describe the significance of complement at oral mucosal surfaces.

Antigen Processing and Presentation

1. Describe use as a function of T cell activation.

2. Describe cells involved in antigen processing and presentation.

The Major Histocompatibility Complex (MHC)

1. Describe gene nomenclature for MHC antigens.

2. List the numbers of human MHC genes.

3. Explain the tissue distribution of MHC antigens.

4. Describe the structure of MHC Class-I and Class-II molecules.

5. Describe, with examples, how peptide antigens are processed.

Cell-Mediated Immunity (CMI)

1. Describe the cells involved in CMI and the role played in the immune response.

2. Describe the mechanisms of tissue cell destruction by T cells.

3. Describe concept of ‘Memory T Cell’.

4. Define Natural Killer (NK) cell.

5. Define ‘Super Antigen’ and give examples in disease.

Bio-Medical waste: Types, potential risks and their safe management.

IMMUNOLOGY PRACTICALS 40 Hours

1. VDRL Tests

2. Brucella Agglutination test

3. Weil felix test (Demonstration only)

4. Paul Bunnel test (Demonstration only)

5. RA test

6. CRP test

7. TPHA

8. ELISA

9. ASLO

10. WIDAL

MOLECULAR BIOLOGY

MOLECULAR BIOLOGY

40 Hours

1. DNA: the support of hereditary information

Structure, types, coiling and supercoiling, topoisomerases, replication, satellite DNA. Organisation of Prokaryotic and Eukaryotic genome, chromosomes structure, number, sex chromosomes, human karyotype, methods for chromosome analysis, chromosome banding, FISH, CGH, Flow cytometry, Cell cycle, mitosis and meiosis.

2. Transcription and translation factors involved, RNA processing, types of RNA, genetic code, Lac operon, Tryptophan operon, regulation in eukaryotes, gene dosage and gene amplification, generation of antibody diversity.

3.Mutation spontaneous, induced, point mutation and silent mutation, frameshift mutation, physical and chemical mutagents, molecular basis, site directed mutagenesis, significance of mutagenesis, DNA repair, isolating mutants, Ames test.

4. Recombinant DNA technology: necessary elements – enzymes and vectors – plasmids, cosmids, bacteriophages, shuttle vectors, expression vectors, construction of rDNA and cloning strategies – various methods, genomic libraries (e.g. using phage vectors), cDNA libraries, introduction of rDNA into host – methods, restriction maps and sequencing.

5. Genetics in medicine: Hemoglobin and hemoglobinopathies, phenylketonuria, alkaptonuria, homocystinuria, Lesch-Nyhan syndrome, genetics of cancer, Down’s syndrome, Di-George syndrome, Kleinfelters syndrome, Turner’s syndrome, hermaphroditism, cystic Fibrosis, hemophilia, prenatal diagnosis of genetic diseases, application of recombinant DNA Technology in medicine – PCR, RFLP, DNA finger printing, therapeutic proteins, vaccines, antibodies, transgenic organisms, gene therapy, human genome project.

MOLECULAR BIOLOGY PRACTICALS 20 Hours PCR- Side Directed Mutagenesis

DNA Isoltation

DNA Cloning, Bacteriall Transformation and Fusion Protein Purification

(Demonstration only)

Plasmid Analysis by Restriction Digestion and Protein Gel Electrophoresis

DNA Gel Electrophoresis.

SCHEME OF EXAMINATION

Theory: - Their shall be one paper of 3 hrs duration, carrying 100 marks each.

PAPER II:- MICROBIOLOGY-I

Sec A: - Clinical Microbiology

-50 marks

Sec B: - Immunology and Molecular Biology

-50 marks

Type of questions and distribution of marks for each section carrying 50 marks

Type of questions

No of questions

Marks for each questions

Total

Long Essay

1

20

20

Short Essay

5

06

30

PRACTICAL EXAMINATION:

1. Identification of bacterial culture (Pre plated Cultures on Mac Conkey or Blood Agar and if required IMViC tubes to be provided)

- 15 Marks

2. Spotters

- 15 Marks

3. Stool Examination

-10 Marks

4. Acid Fast Stain

- 10 Marks

Or

Albert’s Stain

5. Serology Exercise

- 30 Marks

6. Mycology Exercise

- 20 Marks

Total

- 100 Marks

Viva-Voca Examination

50 Marks

Both internal and external examiners shall conduct the practical and viva- voce examination

HAEMATOLOGY AND BLOOD TRANSFUSION –I

THEORY

Section A: - HAEMATOLOGY AND CLINICAL PATHOLOGY

HAEMATOLOGY 75 Hours

Haemotopoesis – Origin, development, function and fate of blood cells.

Erythropoiesis – Origin, development of RBCs, biosynthesis of Hb, control of Erythropoiesis.

Disorder’s of Red blood cells, Erythrocyte Indices, Red cell inclusion bodies

Anaemia, definition, Pathophysiology, classification -morphologic and Etiologic classification and clinical features. Investigations in a case of anaemia.

Morphologic – Microcytic hypochromic anaemia, macrocytic anaemia.

Haemolytic anaemias – Definition, classifiction, clinical features.

Investigations to establish a case of hemolytic anaemia.

Tests done - i. Peripheral smear – specific morphologic abnormalities

ii. Reticulocyte count

Corrected reticulocyte count

Reticulocyte production index

iii. Osmotic fragility test

iv. Coomb’s test

v Sickling phenomenon

vi. Kleihauer acid Elution test

vii. Alkali denaturation test

viii Ham’s test, Sucrose lysis Test

ix Electrophoresis – HbF & Hb A2 estimation

x. Test for G6PD deficiency

Aplastic anemia. Pancytopenia, Anemia due to abnormal globin synthesis

Polycythaemia.

Disorders of white Blood cells – Leucocytosis, Leukopenia, Leukaemoid reaction,

Myelodysplastic syndrome(MDS) .

Leukaemias -Definition ,Etiology ,Clinical features.

Classification- [ French American British- FAB classification] Lab Investigations

Cytochemistry of Acute leukaemias

Chronic myeloid leukaemia -clinical presentation. Investigations. Philadelphia

chromosome.

Leucocyte Alkaline Phosphatase [LAP score.]

Chronic lymphocytic leukaemia

5. Plasma cell disorders – classification

Plasma cell myeloma – definition ,clinical features, investigations.

6. Myelo Proliferative disorders – general features ,classification – investigations 7. Lympho Proliferative disorders - general features, classification , Investigations

8. Lipid Storage Disorders

9. Haemoparasites 10. Bone marrow examination

11 Haemorrhagic disorders

Definition – Pathogenisis,Clinical fearture ,Classification. - vascular disorders, Platelet disorders, coagulation disorders, Fibrinolysis.

Normal haemostasis .

Investigation of heamorrhagic disorders

Tests of vascular and Platelet function – Bleeding time , Clot retraction, Platelet count

B..M Aspiration , Platelet Aggregation Studies.

Tests for Coagulation Disorders

Screening test – First line tests

Prothrombin time (PT), Activated Partial Thromboplastin Time(APTT), Thrombin

Time (TT)

Second line tests – Mixing experiments. Urea Solubility Test[Test for Factor XIII ]

Coagulation Factor assay. Factor VIII: C Inhibitor Study.

Disseminated Intravascular Coagulation [ DIC ]-Definition ,Pathophysiology, Clinical

Feartures and Laboratory Investigations.

Fibrinogen assay 12. Thrombotic disorders –Classification, Pathogenisis, Clinical Feartures and Laboratory

Investigations. Antiphospholipd Antibody Syndrome.

13. Automation in Haematology 14. Organization & quality control in the laboratory

15. Cleaning of glassware

16. Biomedical waste management

Bio-Medical waste: Types, potential risks and their safe management.

HAEMATOLOGY PRACTICALS 60 Hours

Blood collection. Anticoagulants used in Hematology

Red cell indices

E.S.R., PCV, Platelet count, Absolute Eosinophil count

Reticulocyte count

Stains used in Hematology

Preparation of blood film

Preparation of Leishman’s stain, Giemsa stain and MGG stain

Peripheral smear staining by leishman’s stain. Interpretation of peripheral smear. Differential count.

Microcytic hypochromic anemia –

Investigations including serum Iron & TIBC

Macrocytic anemia - Investigations including B12 & folate assay, schilling test

9. Hemolytic anemia – General Lab investigations

10. Hemolytic anemia - Special Tests.

Osmotic fragility test

Alkali denaturation test

Sickling test

Hb electrophoresis

Investigations of G6PD deficiency

Autoimmune hemolytic anemia investigations

Coomb’s test

11. Blood Parasites

12. Bone marrow – preparation of bone marrow smears , Trephine biopsy smears

Staining of B.M Aspiration Smears. Demonstration of Iron stain

13. Leukemia - Interpretation of Peripheral smear in Leukemia.

Cytochemical stains – Demonstration

14. Haemorrhagic disorders

Collection and anticoagulants used – Demonstration

BT, CT – Demonstration

PT,INR, APTT, TT- Demonstration

Mixing experiments – Demonstration

Test for D-Dimers- Demonstration

Assay of coagulation factors - Demonstration

Factor VIII: C Inhibitor Study – Demonstration

Urea Solubility Test for Factor XIII- Demonstration

Fibrinogen assay - - Demonstration

15. Thrombotic work up - Demonstration

Investigation for Antiphospholipid Antibody- Demonstration

16. Automation in hematology - demonstration

17. Cleaning of glassware

18. Bio-medical waste management – demonstration.

19. Organization and quality control in the laboratory.

20. Preparation of Stains, Reagents, Diluting fluids.

CLINICAL PATHOLOGY 25 Hours

Collection, transport, preservation and processing of various clinical specimens

Urine examination, Physical, chemical and microscopic. Urine analysis by Strip method

Test for haemosiderin pigment.

Renal function tests.

Stool examination – collection of specimen of feaces

Macroscopic (Naked eye) inspection

ii Concentration method ,Flotation method .

iii. Microscopic examination

iv. Chemical examination

Strip method

vi. Test for Occult blood – Benzidine Test

Sputum examination – collection of specimen

i. Physical examination

ii. Microscopic – Gram’s stain, Ziehl Neelsen stain for AFB

iii. Chemical examination

Gastric analysis

Indications ,contra indication. Method of collection. Fasting gastric juice – Macroscopic and microscopic examination.

i Fractional test meal

ii. Augumented Histamin test

iii. Hollander’s test

Cerebrospinal fluid analysis

Method of obtaining CSF, indications, contra indications.

Examination of CSF : i. Physical examination

ii. Biochemical examination

iii. Microscopic examination

a. Cytological examination

b. Bacteriological examination

Body fluids

Microscopic examination of Pleural, Pericardial, synovial, ascitic and peritonial fluid.

Pregnancy Test- Method ,interpretation.

Bio-Medical waste: Types, potential risks and their safe management.

CLINICAL PATHOLOGY PRACTICALS 40 Hours

1.Urine examination, Physical, chemical and microscopic. Urine examination by Strip method

Urine Test for haemosiderin pigment. [Demonstration ]

2. Stool examination –

i. Macroscopic examination

ii. Concentration method ,Flotation method .

iii. Microscopic examination

iv. Benzidine Test- for occult blood

3. Sputum examination - Macroscopic, Microscopic and AFB Staining

4. Examination of Cerebrospinal fluid [CSF ] and body fluids.

5. Pregnancy Test

6. Examination of Semen.

Section B: - IMMUNOPATHOLOGY AND MEDICAL GENETICS

IMMUNOPATHOLOGY 40 Hours

1. Mechanism of Ab-mediated inactivation : direct and indirect

Eg. Diabetes mellitus, thyroid diseases, pernicious anemia, polyendocrinopathy, infertility, haemophilia, myasthenia gravis, anti-idiotypes and diseases.

2. Immune deficeincy disorders

3. Immunohaematologic diseases : transfusion reactions, erythroblastosis foetails, warm-antibody disesases, cold antibody diseases, drug and hemolytic diseases, agranulocytosis, thrombocytopenic purpura, immune suppression cytotoxic antibodies in vitro.

4. Immune comples reactions : arthus reaction, serum sickness, evaluation of circulating immune complexes.

5. Connective tissue diseases : Pl;arteritis, SLE, dermatomyosis, rheumatic fever, rhematoid arthritis, prograssive systemic sclerosis.

6. Atopic anaphyllactic reactions : reaginic antibody, anaphylaxis, atopic allery – factors involved, asthma, hay fever, food allergy, insect allergy, atopic eczma, delayed hypersensitivity reactions, contact dematitis, viral infectionss, graft-host relationship in pregnancy.

7. Autoallergiiic diseases: encephalomyelitis, multiple sclerosis, oorchitis, thyroiditis, sjogren’s syndrome.

8. Granulomatous reactions : Infectious diseases like tuberculosis, leprosy.

9. Autoimmune diseases-organ specific and systemic.

10. Immunomodulators

11. Clinical transplantation-Kidney ,Bone marrow ,Heart.

12. Immunology of AIDS ,Tumour and Tumour markers.

13. Immunohaematology- Campatibility testing.

Bio-Medical waste: Types, potential risks and their safe management.

IMMUNOPATHOLOGY PRACTICALS 40 Hours

1. Serological tests [Screening &diagnostic] used in different pathological conditions.

2. Delayed type hypersensitivity testing.

3. Detection of tumor markers.

4. Histocompatibility testing.

5. Blood grouping &cross matching.

6. Coomb’s Test - Direct & Indirect.

7. Setting up of Immuno histochemistry lab.

MEDICAL GENETICS

20 Hours

1. The history and impact of Genetics in Medicine

Gregor Mendel and the laws of inheritance.

The chromosome basis of inheritance

Origin of Medical Genetics

Classification of Genetic disease

The impact of Genetic disease

Major new developments

2. The Chromosome varInternal Assesmenttion and sex determination

An overview of chromosome number, chromosome composition and sex determination in humans.

Methods of chromosome analysis.

Molecular cytogenetics.

Chromosome abnormalities.

3. Human genetic diseases

Genetic disorders with classical MendelInternal Assesmentn inheritance.

Autosomal recessive inheritance.

Patterns of autosomal dominant inheritance.

X-linked inheritance.

Patterns of pseudo-autosomal inheritance.

A typical pattern of inheritance.

4. Biochemical genetics

The inborn errors of metabolism.

Disorders of amino acid metabolism.

Urea cycle disorders.

Disorders of carbohydrate metabolisms.

Disorders of steroid metabolism.

Disorders of lipid metabolism.

Lysosomal storage disorders.

Disorders of purine/pyrimidine metabolism.

Organic acid disorders.

Disorders of copper metabolism.

Peroxidase disorders.

5. Human Genome project, treatment of genetic disease and gene therapy.

Human genome project

Treatment of genetic disease

Gene therapy.

6. Genetics & society.

GENETICS PRACTICALS

20 Hours

1. Study of Karyotypes I

Normal karyotyping in Humans – male (46, XY) and female (46, XX), G banded metaphase plates.

2. Study of Karyotypes II

Abnormal karyptypes – Down syndrome (Autosomal), Turner syndrome and Klinefelter syndrome (Sex chromosome)

3. Sex chromatin

Buccal semear study and staining methods for Barr bodies

Blood smear study of drumsticks in neutrophils

SCHEME OF EXAMINATION

Theory: - Their shall be one paper of 3 hrs duration, carrying 100 marks each.

PAPER III:- Haematology and Blood Transfusion -I

Sec A: - Haematology and Clinical Pathology

-50 marks

Sec B: - Immunopathology and Medical Genetics

-50 marks

Type of questions and distribution of marks for each section carrying 50 marks

Type of questions

No of questions

Marks for each questions

Total

Long Essay

1

20

20

Short Essay

5

06

30

Practicals Examination - Total –100 marks

1. Spotters

- 20 marks

2. Staining and reporting the Peripheral smear - 20 marks

3. Special test - ( Any two to be performed ) - 10marks

a. RBC / WBC Count

b. Reticulocyte count

c. Absolute Eosinophil Count

d. ESR or PCV

e. Osmotic Fragility Test

f. Sickling test

4. Blood Transfusion preliminary tests

a. Blood grouping and typing including Dn test

(Compulsory )

- 10 Marks

Any one of the following

- 10 Marks

b. Cross – Matching –

c. Coomb’s Test - Direct & Indirect

5. Clinical Pathologya. Urine Examination (Compulsory) – 10 Marks

i. Physical

ii. Microscopic

iii. Chemical

Any two of the following

- 10 Marks

1.Sugar & Ketone Bodies

2.Protein & Blood

3. Bilirubin / Bile salt / Bile pigment

Stool Examination

- 10 Marks

i. Microscopic

ii. Macroscopic

iii. Special Tests

Viva-Voce Examination

-50 Marks

1. Haematology –15

2. Clinical Pathology – 10

3. Immunology – 15

Both internal and external examiners shall conduct the practical and viva- voce examination

**SUBSIDARY SUBJECTS I YEAR

1. BIOSTATISTICS

30 Hours

1. Introduction to Biostatistics

Definition, role of statistics in health science and health care delivery system

2 . Sampling Population, sample, sampling, reasons for sampling, probability and non-probability sampling

Methods of probability sampling-simple random, stratified, systematic-procedure, merits and demeritsUse of random number table.

3. Organization of data

Frequency table, histogram, frequency polygon, frequency curve, bar diagram, pie chart

4. Measures of location Arithmetic mean, median, mode, quartiles and percentiles – definition, computation (for raw data ), merits, demerits and applications.

5. Measures of variation

Range, inter –quartile range, variance, standard deviation, coefficient of variation- definition, computation (for raw data), merits, demerits and applications

6 : Basic probability distributions and sampling distributions:

Concept of probability distribution. Normal, Poisson and Binomial distributions, parameters and application. Concept of sampling distributions. Standard error and confidence intervals. [Skewness and kurtosis ]

7 : Tests of significance :

Basic of testing of hypothesis – Null and alternate hypothesis, type I and type II errors, level of significance and power of the test , p value.

Tests of significance (parametric) – t – test (paired and unpaired), Chi square test and test of proportion, one way analysis of variance.

8 . Correlation and Regression :

Scatter diagram, concept and properties of correlation coefficient, examples (No computation Simple correlation ) Pearson’s and spearman’s, testing the significance of correlation coefficient. Linear and multiple regression.

Suggested books :

1. Lwanga SK Cho-Yook Tye (Editors). Teaching Health Statistics, Twenty lessons and seminar outlines, World Health Organization, Geneva

2. Mahajan BK, Methods in Biostatistics for medical students and research workers. 6th Edition, Jaypee Brothers medical Publishers, New Delhi, 1997.

3. Sundr Rao PSS and Richard J. Introduction of Biostatistics; A Manual for students in Health sciences. Prentic-Hall of India Pvt. Ltd, New Delhi.

4. N.S.M. Rao : Elements of Health statistics

STATISTICS PRACTICALS 10 Hours

1. Collection and tabulation of data

2. Graphical representation of data

3. Correlation and regression analysis

4. Student’s ‘t’ test

5. Chi-square test

6. ANOVA

2. RESEARCH METHODOLOGY 20 Hours

Aim

The aim of this Module is to provide the student with experience of research

methods and techniques while working alongside research laboratory staff on a designated research project.

Objectives

By the end of this Study Module students should be able to:

(i) design, carry out, write up and critically appraise a selected research topic;

(ii) demonstrate knowledge of skills in appropriate research laboratory practices;

(iii) carry out a range of laboratory techniques using appropriate methodologies.

Constituency

These module are intended for students who wish to learn research methods and techniques and perhaps do a PhD in the future. Some experience of laboratory practice would help the student to take full advantage of this module, although in most instances students will be fully trained in all necessary techniques.

Conceptual outline

This is a purely practical module designed to introduce students to a variety of research techniques and to give them the opportunity of using these techniques in conducting a novel a research project. Each student will choose an individual research project and will be directly supervised by an expert in the field. This Module will necessitate long working hours in some cases and may involve some students studying at institutions other than the parent Institution.

Teaching strategy

This module is entirely laboratory based, with no formal teaching or lectures. Teaching is on a one-to-one basis with a designated supervisor. Students must be highly motivated and be prepared to work long hours in order to make a success of this module.

Reviewing the literature

Aim

This Study Module aims to describe and illustrate the methods available for identifying and reviewing quantitative and qualitative literature.

Objectives

By the end of the Study Module students should be able to:

(i) carry out an appropriate, rigorous review of the literature; and

(ii) understand the strengths and weaknesses of different methods of identifying, assessing and synthesizing literature.

Conceptual outline

This module will cover all stages in carrying out an appropriate and rigorous review.

1. Planning the review: the role of the literature review and specification of the task

2. Identification of relevant literature, both published and unpublished: developing a search strategy and using bibliographic databases.

3. Appraising the literature: methods for assessing the quality of quantitative and

qualitative research.

4. Synthesising the evidence: integration of the evidence using both quantitative and qualitative methods; principles of meta-analysis.

5. Formulating recommendations and writing the review.

Teaching strategy

The technical aspects of literature reviewing will be presented in lectures and computer practicals, using some of the databases available through the RGUHS’s HELINET network. The format of the seminars will encourage both a practical application and critical appraisal of methods. Each student can choose his or her own topic and question for their assessed literature review. Students should consider possible topics and questions in preparation for the Study Module. There will be three sessions during the Study Module for general advice on the assessment.

Course Content

Second Year M.Sc.MLT

BIOCHEMISTRY-II

PAPER I

SECTION A

1. LIVER AND BILIARY TRACT STATUS

· The dynamics and mechanisms of liver enzyme release and the clinical utility of measuring hepatic enzymes (e.g., aspartate aminotransferase, alanine aminotransferase, -glutamyltransferase, alkaline phosphatase, and lactate dehydrogenase).

· The biochemical assessment of liver function by nonenzyme analytes such as albumin, ammonia, bile acids, bilirubin, urea nitrogen, cholesterol, total protein, and triglycerides.

· Bilirubin metabolism, fractionation of bilirubin (conjugated, unconjugated, -bilirubin, direct vs indirect) and unique aspects of neonatal bilirubin. Understand the conditions and genetic defects that affect bilirubin metabolism, transport and clearance (e.g., Gilbert disease and Dubin-Johnson syndrome).

· Jaundice

2. RENAL FUNCTION

· The basic physiology of renal function. The basic categories of renal diseases (e.g., pre renal azotemia, obstructive azotemia, glomerulonephritis, acute vs chronic renal failure, uremic syndrome) and be familiar with the National kidney Foundation practice guidelines for these conditions. The laboratory analytical methods (e.g., Jaffe vs creatinase) for the assessment of renal function (creatinine, urea nitrogen, glomerular filtration rate) and proteinuira. The concept of creatinine clearance, how it can be used to estimate glomerular filtration rate, and the various methods employed to measure it. Renal handling of electrolytes and key metabolites and the interpretation of urinary electrolyte measurements.

· The definition of osmolality, molecules in serum that contribute to osmolality, and calculation of osmolal gap as well as the principle of the osmometer. The common pitfalls and sources of error during estimation of the osmolal gap (e.g., hyperproteinemia, hyperlipidemia, hypermagnesemia). The differential diagnosis of an unexplained, increased osmolal gap, including alcohol or glycol ingestion, alcoholic or diabetic ketosis or ketoacidosis, and osmotherapy (e.g., mannitol or glycerol administration), among others. The principles of fluid balance.

3. GASTRIC & PANCREATIC FUNCTION

· The clinical manifestations of gastric, pancreatic, and intestinal disease and diagnostic methodologies such as the breath tests for Helicobacter pylori, fecal occult blood, lipase and amylase (e.g., fractionation of amylase; pancreatic vs salivary and amylase/creatinine clearance ratio).

· The role of gastrointestinal hormones and enzymes in digestion and the evaluation of malabsorption and diarrheal sydromes.

4. ASSESSMENT OF THYROID FUNCTION

· The structure, biosynthesis, secretion, and metabolism of thyroid hormones (thyroxine (T4), triiodothyronine(T3), and reverse T3 (rT3). Thyroid physiology and control of thyroid function (thyrotropin-releasing hormone (TRH) and thyrotropin (TSH).

· The common causes of hypothyroidism and hyperthyroidism

· The laboratory tests for evaluation of thyroid disorders and be able to interpret these analytes in their clinical context with an apprecitation for the euthyroid sick state.

· Current analytical methodologies for thyroid testing (TSH methods : 1st-, 2nd-, and 3rd-generation assays; isotopic and nonisotopic methods; T4; free T3 methods; T-uptake methods; TSH suppression and stimulation tests).

5. ACID-BASE CHEMISTRY WATER AND ELECTROYLTES BALANCE.

· Define the Henderson-Hasselbach equation. Physiologic buffers systems and the role of respiratory and renal compensation. Categories of clinical disorders of acid-base balance (metabolic and respiratory acidosis, metabolic and respiratory alkalosis, mixed disorders).

· The differential diagnosis of common electrolyte disorders

6. ISOENZYMES AND CLINICAL ENZYMOLOGY

7. TUMOR BIOMARKERS :

· The definition, classification, biochemistry, and distribution of tumor markers, both protein and carbohydrate, including, but not limited to, prostate-specific antigen, calcitonin, human chorionic gonadotropin, -fetoprotein, carcinoembryonic antigen CA 15-3, CA 125, and CA 19-9.

· The limitations of laboratory assessment of various tumor markers and the factors affecting the results of different analytical procedures.

· The conceptual basis of assays used to screen for malignancy, including Bayes theorem.

. Recent developments in identifing proteomic patterns for cancer detection.

8. PEDIATRIC CLINICAL BIOCHEMISTRY

Problems of specimen collection; capillary specimens.

Reference range differences in infants and children: Those that vary significantly with age and sex (inorganic phosphorus, creatinine, alkaline phosphatase, aspartate aminotransferase, creatine kinase).

Special problems in pediatrics: Respiratory distress syndrome , gastrointestinal disease (fat absorption, disaccharide intolerance, protein-losing neonatal

hyperbilirubinemia; cystic fibrosis; neuroblastoma (VMA ,HVA); enteropathy), , Heavy metal poisoning in children.

9. AUTOMATION AND POINT OF CARE TESTING (POCT)

10. COLORI METER AND SPECTROPHOTO METER

11. FLAME PHOTO METER AND ION SELECTIVE ELECTRODES (ISE)

12. BLOOD GAS ANALYSIS

13. PH METER

14. ELECTROPHORESIS AND CHROMATOGRAPHIC TECHNIQUES

15. Therapeutic Drug Monitoring and Toxicology

SECTION B

1. PHARMACOKINETICS

· The concepts of drug absorption, bioavailability, volume of distribution, and distribution phases (multicompartment models) and be able to predict peak drug levels.

· The differences between fist-and zero- order kinetics of drug metabolism / elimination.

· The concepts of drug clearance, halt-life, and the exponential rate constant. Be able to calculate steady-state drug levels and estimate peak and trough drug levels throughout a dosing cycle

· The origin and consequences of nonlinear or zero-order pharmacokinetics on drug pharmacokinetics

· The differences between measurement of total, free, and protein-bound drug levels and be able to assess the consequences of altered protein binding on pharmacokinetics and therapeutic drug monitoring.

2. DRUG METABOLISM

· The differences between phase I and phase II drug metabolism reactions

· Various consequences of competing metabolic pathways to

modulate both the efficacy and toxicity of administered medications

· Frequent interindividual variability drug-metabolizing enzymes and its impact on the variability of drug response

3. PHARMACODYNAMICS

· The general mechanisms of drug action, including drug-receptor interactions, modulation of metabolic pathways, and nucleic acid biochemistry.

· Rreference ranges for therapeutic drug monitoring, methods of establishing the same and understand the varying utility of trough , peak, or steady-state drug levels for monitoring both drug efficacy and toxicity. The therapeutic index.

4. THERAPEUTIC DRUG MONITORING OF SPECIFIC DRUG CLASSES

· The principles and practice of therapeutic drug monitoring of antidepressants, mood stabilizers, and antipsychotics; anticonvulsants; cardioactive drugs; bronchodilators; antibiotics; and immunosuppressants.

· The relative significance of peak and trough levels for monitoring of these drug classes

5. TOXICOLOGIC SYNDROMES

· The pathophysiological basis and be able to recognize the five major toxicologic syndromes (cholinergic, anticholinergic, sympathomimetic, opiate, and sedative-hypnotic).

· formulation of toxicologic differential diagnosis and designing a clinical laboratory testing protocol for each of the syndromes

· The basic therapeutic approach to each syndrome

6. LABORATORY EVALUATION AND MANAGEMENT OF OVERDOSED OR POISONED PATIENTS

· The National Academy of Clinical Biochemistry guidelines for Emergency Toxicology.

· The important differences between urine and blood (including serum and plasma) for monitoring and detection of drugs / xenobiotics.

· Designing and implementing standardized STAT panels of laboratory tests for evaluation of overdosed/poisoned patients.

· The limitations of drug "screening" protocols and be able to consult on the design of more extensive drug-testing protocols to supplement the standard STAT panels.

· The toxicologic profiles of specific agents, including acetaminophen, salicylates, alcohols and glycols, barbiturates, tricyclic antidepressants, carbonmonoxide, organophosphates and carbamate, digoxin lead, iron, and cyanide.

· The general supportive measures, the role of alkalinization, the importance of specific antidotes, and the variable efficacy of exchange transfusion hemodialysis, plasmapheresis, and charcoal hemoperfusion of blood in the management of specific agents.

7. LABORATORY EVALUATION OF DRUGS OF ABUSE

· The generic methodology of the routine immunoassays for drugs-of-abuse testing.

· Major drugs of abuse and their clinical manifestations

· Common methods for adulteration of urine and the techniques available in the laboratory to detect them.

· Specific reactivates of each immunoassay, the standard cutoffs for detection, and whether the assay is capable of detecting the parent drug, its metabolites, or both. Identify members of a drug class which are poorly or well detected by a generic immunoassay (e.g., oxycodone detection by the opiate immunoassay) and the common causes of false positives due to cross-reactivities.

8. PHARMACOGENOMICS

ADDITIONAL COMPETENCIES SPECIFIC TO CHEMISTRY

Patient Care

· "Chain of custody" and other legal requirements for forensic chemical pathology.

Professionalism

· The social consequences of testing for drugs of abuse.

PAPER II

1. CARBOHYDRATE METABOLISM AND ITS DISORDERS.

Chemistry and Metabolism of carbohydrates:

Clinical features and laboratory findings in insulin resistance, Type 1, Type 2 and

gestational diabetes mellitus; diagnostic and monitoring criteria for diabetes; investigation of hypoglycemic syndromes (A).

Glucose tolerance test procedures and interpretation (A); in pregnancy (A).

Ketosis and lactic acidosis (A).

Differential diagnosis of coma; hyperosmolar coma (A).

Hemoglobin A1c (A); fructosamines (A); C-peptide (B).

Insulin tolerance test (C); glucagon and somatostatin (C).

Use and dangers of provocative tests, e.g. tolbutamide and glucagon (B).

Assay of insulin, proinsulin and insulin antibodies (B).

Albuminuria (A).

Antibodies (anti-GAD, Anti-insulin, ect.).

2. PROTEINS, DISORDERS OF PROTEIN METABOLISM.

Chemistry and Metabolism of Proteins and Ammaino acids.

Clinical features and laboratory findings in disorders of the plasma proteins (A); acute phase proteins (A).

Serum protein and albumin, serum and urine protein electrophoresis (A).

Causes of hypoalbuminemia; hypo- and hyperglobulinemias (A).

Alpha-1-antitrypsin deficiency (B).

Ammaino aciduras, screening test for ammaino acid disorders.

Methods for protein detection in body fluids.

3. LIPID METABOLISM AND LIPOPROTEIN DISORDERS.

Complete Chemistry and metabolism of lipids

Clinical features and laboratory findings in disorders of triglycerides, lipoproteins and cholesterol metabolism (A).

Lipid, lipoproteins and apolipoproteins metabolism; HDL, LDL, VLDL, apoA, apoB, apoC, apoE and their receptors (A).

Fat absorption, transport, storage and metabolism (A).

Investigation and principles of treatment of hyperlipidemias (A).

Assessment of risk factors for atherosclerosis (A).

Lipoprotein(a), lecithin:cholesterol acyltransferase (LCAT) (B).

Lipid profile, Separation of lipoproteins

4. Chemistry and Metabolism of Nuclic Acids

Nucleotides and their bases,DNA, RNA, Hiegh energy compounds.

Major roles of purines and pyrimidines,synthesis of pyrimidines,pyrimidine salvage,catabolism of pyrimidines,synthesis of purines,purine salvage, catabolism of purines, GOUT.

5. VITAMINS

Water soluble vitamins

Fat soluble vitamins

6. ENERGY METABOLISM AND NUTRITION

Food calories, RQ, BMR, calorie requirements,proteins in nutrition, fats in nutrition,carbohydrates in nutrition, fibers in nutrition,protein –energy malnutrition,starvation,diet for normal adults, pregnant women,children, etc

7. MINERAL METABOLISM AND ITS DISORDERS.

Sodium and potassium,chlorine,calcium and phosphorus,magnesium,sulfur metabolism,Iron,copper,Zinc, Manganese, Molybdenum, Cobalt, Selenium, Iodine, Fluroine, chromium, Water Balance.

8. HORMONES AND ITS DISORDERS

Horomone Families, Neurotransmitter families, Hormone receptors, Regulation of hormone secretion, Signal transductions, Gastrointestinal hormones, Hypothalamic hormones, Posterior pituitary hormony, anterior pituitary hormones, Melanocyte stimulating hormones, placental hormones, Calcitonin, parathyroid hormone, pancreatic hormones, diabetes mellitus, Insulin like growth factors, Adrenal medullary hormones, adrenal cortex hormones, Testosterone, Ovarian Hormones, Thyroid hormones, Regulation of blood sugar, Neurotransmitters.

9. RADIOISOTOPES, ITS APPLICATION AND ITS DETECTION

Radioactive emissions, Radiation – matter interaction, Radiation dose, Radiation

measurement, Effects on human body, Radioisotopes in research, Radioisotopes in diagnosis, Radiotherapy

10. BIOLOGICAL OXIDATION AND ELECTRON TRANSPORT CHAIN (ETC.)

Oxidoreductases, Redox potential, Mitochondrial respiratory chain, electron shuttles, oxidative Phosphorylation, Uncouplers of oxidative Phosphorylation.

11. FREE RADICALS AND ANTIOXIDANTS

M.Sc. MLT Biochemistry - II

General Biochemistry Practicals:

Buffers & Buffering capacity.

Colorimetry.

Spectrophotometry.

Molar Extinction Co-efficient.

Color reactions of Carbohydrates.

Paper chromatography of Carbohydrates.

Thin layer Chromatography of Carbohydrates.

Color reaction of amino acids.

Paper Chromatography of amino acids.

Thin layer chromatography of amino acids.

Ion exchange chromatography of amino acids.

Serum Electrophoresis

Enzymes

Effect of temperature on Enzyme activity.

Effect of substrate concentration on Enzyme activity.

Effect of pH on the rate of reaction.

Effect of enzyme concentration on the rate of reaction.

Clinical Biochemistry Practicals

Anti Coagulants.

Blood Specimen Collection.

Protein precipitants.

Estimation of blood sugar by Folin wu method & Glucose Oxidase Method

Estimation of blood urea by DAM method.

Estimation of blood uricacid by Caraway’s method.

Estimation of serum creatine & creatinine Jaffe’s method.

Estimation of total serum protein by Biuret method.

Estimation of Inorganic phosphorous by method of gomorri.

Estimation of Cholesterol/HDL Cholesterol by enzymatic method.

Estimation of Serum Calcium

Estimation of Serum Bilirubin

Estimation of Alkaline & Acid Phosphatase

Estimation of SGOT, SGPT, UV Kinetic Method and Gamma GT

Estimation of LDH

Estimation of Creatinine Kinase

Estimation of Serum Amylase – Somogyi Amylolytic method

Estimation of Fe binding Capacity ( For Demonstration only )

Estimation of 17-Ketosteroids in urine ( For Demonstration only )

Estimation of Serum C1, HCO3, pH, PO2, PCO2 blood gas analysis ( For

Demonstration only )

CSF Analysis for Biochemical examination ( For Demonstration only )

Analysis of Urine for abnormal constituents

Analysis of Body Fluids: Plural, Peritoneal, Ascitic and Pericardial ( For

Demonstration only )

Estimation of Therapeutic drugs like Digoxin, phenotoin, carbamazapine,

phenobarbitone, cyclosporine, Lithium ( For Demonstration only )

Estimation of Hormones - Thyroid hormones

SCHEME OF EXAMINATION

Theory: - There shall be two papers of 3 hrs duration, carrying 100 marks each.

M.Sc. MLT II Year – Paper I (Theory)

Biochemistry-II

THEORY EXAMINATION

Duration : 3 Hrs

Max Marks:100

Distribution of Marks

SECTION – A

Max Marks: 50

SECTION – B

Max Marks: 50

SECTION A – CLINICAL BIOCHEMISTRY

Type of questions

No of questions for each subject

No. of questions and marks for each question

Total Marks

Long Essay

1

1x20

20

Short Essay

3

03x10

30

SECTION B – PHARMACOLOGICAL BIOCHEMISTRY

Type of questions

No of questions for each subject

No. of questions and marks for each question

Total Marks

Long Essay

1

1x20

20

Short Essay

3

03x10

30

M.Sc. MLT II Year – Paper II (Theory)

Biochemistry-II

THEORY EXAMINATION

Duration : 3 Hrs

Max Marks:100

Distribution of Marks

Type of questions

No of questions for each subject

No. of questions and marks for each question

Total Marks

Long Essay

1 +1

2x20

40

Short Essay

6

06x10

60

PRACTICAL EXAMINATION:

Day 1

1. Identification along with techniques in Chromatography or Electrophoresis – 30

2. Charts reporting

- 10

3. Identification of abnormal constituents in any of biological fluids

(urine / CSF / Ascetic fluid / Pleural fluid) any one

- 15

Day 2

1. Estimation of Blood Sugar / Blood Urea / Uric Ac