ministry of health chainama college of health sciences ...

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MINISTRY OF HEALTH

CHAINAMA COLLEGE OF HEALTH SCIENCES

DIPLOMA IN CLINICAL MEDICAL SCIENCES GENERAL

DRAFT 1 - NOVEMBER, 2015

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TABLE OF CONTENT 1.0 Introduction

1.1 Diploma in Clinical Medicine 1.2 Licensure ……………………………………………………………… 1.3 Scope of Practice………………………………………………………

2.0 Goals and Objectives of the Curriculum Mission Statement Curriculum Vision Curriculum Model Curriculum Goals Curriculum Objectives Curriculum Competences

3.0 Structure of the Curriculum Entry Requirements Course Coding System Curriculum Road Map Progression Criteria Grading System Coding system

3.1 Year 1 3.1.1 Semester One

ANP 110: Anatomy & Physiology…………………………………

FEM 110: Fundamentals of Emergency Medicine…………………

MSP 110: Medical Socio-Psychology………………………………

CME 115: Communication Skills & Medical Ethics………………

MBC 110: Medical Biochemistry – Nutrition………………………

3.1.2 Semester Two………………………………………………………..

ANP 120-Anatomy & Physiology……………………………

FEM 120-Fundamentals of Emergency Medicine……………

BMS 120-Biomedical Sciences………………………………

MED 125-Internal Medicine (I)………………………………

PHM 125- Pharmacology & Therapeutics……………………

MBC 120: Medical Biochemistry – Nutrition………………...

3.2 Year2 3.2.1 Semester One…………………………………………………………………………

MED 210-Internal Medicine (II)……………………………………

SGY 210 -Surgery………………………………………………

OBG 210 -Obstetrics & Gynecology……………………………

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PED 210 –Paediatrics & Child Health…………………………

MHP 210-Mental Health & Clinical Psychiatry………………

PHC 210 - Public Health (Community Health, Primary Health Care

& Health Promotion)

3.2.2 Semester Two…………………………………………………

MED 220-Internal Medicine (III)……………………………

SGY 220-Surgery (I)……………………………………………

OBG 220 -Obstetrics & Gynaecology……………………………

PED 220 –Paediatrics & Child Health……………………………

MHP 220 -Mental Health & Clinical Psychiatry…………………

PH 220-Public Health (Community Health, PHC & Health

Promotion)

HSM 225- Health Systems & Management………………………

3.3 Year3 Courses 3.3.1 Semester One

Clinical Rotations

MED 310 - Internal Medicine Clerkship SGY 310 - Surgery Clerkship OBG 310 - Obstetrics and Gynaecology Clerkship PED 310 - Paediatrics & Child Health Clerkship MHP 310 – Mental Health & Clinical Psychiatry Attachment

3.3.2 Semester Two

Clinical Rotations

MED 320 - Internal Medicine Clerkship SGY 320 - Surgery Clerkship OBG 320 - Obstetrics and Gynaecology Clerkship PED 320 - Paediatrics & Child Health Clerkship MHP 320 – Mental Health & Clinical Psychiatry Attachment

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1. INTRODUCTION

This curriculum focuses on the essence of providing guidance to lecturers in the preparation of students throughout the course from the beginning to the end of training for Clinical Officers General (COG).In considering the gross shortage of qualified human resource for health in clinical practice, the need for more competent Clinical Officers (COs) in Zambia cannot be over emphasised. Provision of this complete reviewed curriculum is an important achievement for both the Ministry of Health (MOH) and the Chainama College of Health Sciences (CCHS). An up-to-date reviewed curriculum was necessary to address the trends in medicine and the health sector in the last five years. This curriculum illustrates a semester system covering a specified number of courses. In addition, the practicum aspect of the training has been arranged in periodical clinical placements. Varied teaching methods and audio-visual aids have been included to enhance teaching and learning with a methodical periodic evaluation of students to ascertain learning progress. The effective implementation of this curriculum lies in the commitment by the lecturers and students in ensuring that its contents are delivered. The programme

The Diploma in Clinical Medical Sciences General for COG is an affiliated programme of the University of Zambia, School of Medicine (UNZA SOM). The Diploma in Clinical Medical Sciences General is a clinical skills and community-based training programme aiming to producing graduates capable of providing basic essential medical care and management at primary health care level. The COG programme is a three year programme with a focus on common health problems. The programme prepares graduates to bring medical care as close to the family as possible by providing basic health care services to a cross section of the Zambian population. On completion of the programme, graduates are awarded a Diploma in Clinical Medical Sciences General. The graduates are registered with the Health Professions Council of Zambia (HPCZ) as -COGs_. The COG programme is structured in a way that allows infusion of both theory and practical training activities for students. The practical sessions are at the ends of the first semester of year one, second semester of year one and the second semester of year two. Students undertake these practical attachments at appropriate health facilities. The final year of study involves clinical attachment in various speciality fields of clinical practice that includes clerkships in internal medicine, surgery, obstetrics and gynaecology as well as paediatrics and child health. In addition, there are rotations in other specialty areas that include: ophthalmology, ENT, psychiatry, dermatology and dentistry.

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The curriculum is designed to take a competence-based model and was reviewed with consideration of both local and international trends in medicine.

LICENSURE A Clinical Officer General (COG) graduate is a healthcare professional who is trained to practice medicine and licensed by the Health Professions Council of Zambia (HPCZ) to perform basic clinical tasks. Scope of Practice A Clinical Officer General is trained to provide curative and preventive health care services; primary health care services. Furthermore, a COG should be able to refer patients to appropriate level of health care. The roles of a COG in the health care system include: managing needs of clinical care, carrying out administrative roles and responsibilities, and participating in research and teaching.

MISSION STATEMENT

Committed to providing and promoting quality health education in order to produce graduates with adequate knowledge, skills, and attitudes to deliver quality primary health care services in both clinical and community settings in Zambia

VALUES In achieving this mission, the programme upholds the following values:

Excellence Integrity Commitment Cooperation Innovations

VISION

To provide the support and structure that will enable every student to excel in basic essential clinical care delivery at primary health care level.

CURRICULUM MODEL

The curriculum adopts a hybrid model that incorporates both traditional and innovative based competency approaches.

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GOALS AND OBJECTIVES OF THE CURRICULUM

GOALS

The goals of the curriculum are to:

Provide a Clinical Officer General student with medical knowledge, skills and attitudes to engage in clinical practice

Produce Clinical Officer General who will be able to: Provide quality health care services in a wide variety of clinical and

community settings. Appreciate social and cultural effects on the delivery of health

care through exposure to a wide variety of clinical settings reflecting on the diversity of patients and the communities in which they live.

Utilise current information system and technology to enhance their delivery of health care services

Equip students with an understanding of health policies and delivery system as well as their role as health professionals in the health sector.

Objectives By the end of the three year training programme, the graduate should be able to:

1. Apply appropriate clinical biomedical sciences in the care of patients 2. Apply knowledge of behavioral and social sciences in the management

of patients and clients 3. Demonstrate observation of medical ethics, human rights relevant to

medical practice 4. Demonstrate ability to communicate effectively 5. Take history of the patient appropriately 6. Perform physical examination of patients correctly 7. Demonstrate ability to correctly manage patients/clients 8. Demonstrate ability to manage health care facility 9. Function in a multidisciplinary team

10. Demonstrate understanding of health related research processes 11. Apply knowledge and skills for information technology

Competences On completion of the three year programme, the graduate should possess the following requisite skills and attributes:

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Medical knowledge Basic and clinical sciences in the management of patients appropriate to

their level of care. Order and interpret appropriate investigations.

Patient care Obtain a thorough medical history Develop and carry out patient management plans. Counsel and educate patients and their families. Competently perform medical and surgical procedures considered

essential in the area of practice. Demonstrate caring and respectful behaviours when interacting with

patients and their families Provide health care services and education aimed at maintaining health

and preventing health problems. Work effectively with other health care professionals to provide patient-

centred care. Interpersonal and communication skills

Communicate effectively with the patients, family and health care team. Demonstrate emotional resilience and stability, adaptability, flexibility,

and tolerance of ambiguity and anxiety. Accurately and adequately document and record information regarding

the care process for medical, legal, quality and financial purposes Professionalism

Create and sustain a therapeutic and ethically sound relationship with patients.

Exhibit -culturally sensitive and acceptable behavior when interacting with patients, family and other caregivers.

Adhere- to ethical, legal and regulatory requirements of the profession. System based practice

Apply medical information and clinical data systems to provide effective and efficient patient care.

Manage and refer patients to appropriate levels of care Demonstrate understanding of the funding sources and payment

systems that provide coverage for patient care. Practice cost-effective health care and resource allocation that does not

compromise quality of care. Work in a multidisciplinary team of health care professionals. Use information technology to support patient care

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ENTRY REQUIREMENTS Direct Entry To qualify for admission for Diploma in Clinical Medical Sciences General programme, a candidate must be a holder of a full Zambian School Certificate of Education or equivalent with five subjects passed at credit level or better.

Three of the subjects must be English language, Mathematics, and Biology

One or two subject(s) should come from Science, Chemistry, Physics, Human Biology and Nutrition.

One subject from the following list: Literature in English, Religious Education, Geography, History, Agriculture Science, Zambian Languages Civic Education

Minimum age of 17 years

Certificate/diploma holders To be admitted in the Diploma in Clinical Medical Sciences General Programme, the candidate must possess the following:-

Five subjects passed at credit level or better, four of which must be English language, Mathematics, Biology and Science/Chemistry/Physics

Certificate/ diploma in a health related programme(s)

Registration certificate and a valid practicing certificate from the Health Professions Council of Zambia ( HPCZ) or General Nursing Council (GNC) or Zambia Counselling Council (ZCC)

PROGRESSION CRITERIA YEAR ONE : SEMESTER 1 There are six (6) courses in this semester. Continuous Assessment (CA) For each course taken, students shall be evaluated by way of continuous assessment (CA). This assessment shall carry 40% of the total final mark/grade and CA will include tests, assignments or practical work. A minimum of two CA tests must be conducted.

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Final Examinations Final examinations shall be undertaken at the end of each semester. There will be a written paper and an Objective Structured Examination (OSCE) in each course. The written paper and OSCE marks will be 60% of the final mark/grade in each course. A student shall be deemed to have passed the End of Semester Examination if he/she obtains 50% or more of the total available marks in each course (CA plus End of Semester Examination). Eligibility for passing the examination A student is required to pass 50% of the summative examination in each course. A student who fails continuous assessment in three (3) or more courses will not be eligible to sit for end of semester examination. A student who obtains a grade of 1 D+ or 2 D+s will be required to sit for supplementary (re-sit) examinations in the course(s) failed. A student who obtains a grade of 1 D or 2 Ds or 1 D+ & 1 D will be required to sit for supplementary (re-sit) examinations in the course(s) failed, provided that he/she has passed continuous assessment. A student who obtains a grade of 1 D+ or 1 D or 2 D+s or 1 D+ & 1 D in supplementary (re-sit) examinations in the course(s) failed will be required to carry forward (repeat) the course(s) failed in the semester in which the course is being offered, provided that the failed course is not a pre-requisite for the courses to be under taken in the following semester. A student will be required to repeat the semester by the following criteria: 3 Ds with failure in continuous assessment in one or two courses Failure with 2 D and 1 D+ with failure in continuous assessment in one or two courses Failure with 2 Ds with failure in continuous assessment in one or two courses A student who is required to repeat the first semester shall have to undertake the repeat within a subsequent relevant semester in the academic year A student may repeat a semester or a course only two times. Exclusion from the programme: The following criteria shall apply for exclusion (discontinuation) from the programme:

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Failure in more than three courses Failure to pass a repeated semester two times. Failure to pass a repeated course(s) two times.

YEAR ONE : SEMESTER 2 There are six (6) courses in this semester. Continuous Assessment (CA) For each course taken, students shall be evaluated by way of continuous assessment (CA). This assessment shall carry 40% of the total final mark/grade and CA will include tests, assignments or practical work. A minimum of two CA tests must be conducted. Final Examinations Final examinations shall be undertaken at the end of each semester. There will be a written paper and an Objective Structured Examination (OSCE) in each course. The written paper and OSCE marks will be 60% of the final mark/grade in each course. A student shall be deemed to have passed the End of Semester Examination if he/she obtains 50% or more of the total available marks in each course (CA plus End of Semester Examination). Eligibility for passing the examination A student is required to pass 50% of the summative examination in each course. A student who fails continuous assessment in three (3) or more courses will not be eligible to sit for end of semester examination. A student who obtains a grade of 1 D+ or 2 D+s will be required to sit for supplementary (re-sit) examinations in the course(s) failed. A student who obtains a grade of 1 D or 2 Ds or 1 D+ & 1 D will be required to sit for supplementary (re-sit) examinations in the course(s) failed, provided that he/she has passed continuous assessment. A student who obtains a grade of 1 D+ or 1 D or 2 D+s or 1 D+ & 1 D in supplementary (re-sit) examinations in the course(s) failed will be required to carry forward (repeat) the course(s) failed in the semester in which the course is being offered, provided that the failed course is not a pre-requisite for the courses to be under taken in the following semester. A student will be required to repeat the semester by the following criteria: 3 Ds with failure in continuous assessment in one or two courses

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Failure with 2 D and 1 D+ with failure in continuous assessment in one or two courses Failure with 2 Ds with failure in continuous assessment in one or two courses A student who is required to repeat the first semester shall have to undertake the repeat within a subsequent relevant semester in the academic year. A student may repeat a semester or a course only two times. Exclusion from the programme: The following criteria shall apply for exclusion (discontinuation) from the programme:


YEAR TWO : SEMESTER 1 There are Six (6) courses in this semester. Continuous Assessment (CA) For each course taken, students shall be evaluated by way of continuous assessment (CA). This assessment shall carry 40% of the total final mark/grade and CA will include tests, assignments or practical work. A minimum of two CA tests must be conducted. Final Examinations Final examinations shall be undertaken at the end of each semester. There will be a written paper and an Objective Structured Examination (OSCE) in each course where applicable. The written paper and OSCE marks will contribute 60% of the final mark/grade in each course. A student shall be deemed to have passed the End of Semester Examination if he/she obtains 50% or more of the total available marks in each course (CA plus End of Semester Examination). Eligibility for passing the examination A student is required to pass 50% of the summative examination in each course. A student who fails continuous assessment in three (3) or more courses will not be eligible to sit for end of semester examination. A student who obtains a grade of 1 D+ or 2 D+s will be required to sit for supplementary (re-sit) examinations in the course(s) failed. A student who obtains a grade of 1 D or 2 Ds or 1 D+ & 1 D will be required to sit for supplementary (re-sit) examinations in the course(s) failed, provided that he/she has passed continuous assessment.

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A student who obtains a grade of 1 D+ or 1 D or 2 D+s or 1 D+ & 1 D in supplementary (re-sit) examinations in the course(s) failed will be required to carry forward (repeat) the course(s) failed in the semester in which the course is being offered, provided that the failed course is not a pre-requisite for the courses to be under taken in the following semester. A student will be required to repeat the semester by the following criteria: 3 Ds with failure in continuous assessment in one or two courses Failure with 2 D and 1 D+ with failure in continuous assessment in one or two courses Failure with 2 Ds with failure in continuous assessment in one or two courses A student who is required to repeat the first semester shall have to undertake the repeat within a subsequent relevant semester in the academic year. A student may repeat a semester or a course only two times. Exclusion from the programme: The following criteria shall apply for exclusion (discontinuation) from the programme:


YEAR TWO : SEMESTER 2 There are Seven (7) courses in this semester INTERMEDIATE EXAMINATION This is an external examination administered by Examination Council of Health Sciences (ECHOS). Students shall be evaluated as follows: (i)Continuous Assessment (CA) For each course taken, students shall be evaluated by way of continuous assessment (CA). This assessment shall carry 40% of the total final mark/grade and CA will include tests, assignments or practical work. A minimum of two CA tests must be conducted. (ii) Final Examinations Final examinations shall be undertaken at the end of each semester. There will be a written paper and an Objective Structured Examination (OSCE) in each course where applicable. The written paper and OSCE marks will contribute 60% of the final mark/grade in each course.

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A student shall be deemed to have passed the End of Semester Examination if he/she obtains 50% or more of the total available marks in each course (CA plus End of Semester Examination). Eligibility for passing the examination A student is required to pass 50% of the summative examination in each course. A student who fails continuous assessment in three (3) or more courses will not be eligible to sit for end of semester examination. A student who obtains a grade of 1 D+ or 2 D+s will be required to sit for supplementary (re-sit) examinations in the course(s) failed. A student who obtains a grade of 1 D or 2 Ds or 1 D+ & 1 D will be required to sit for supplementary (re-sit) examinations in the course(s) failed, provided that he/she has passed continuous assessment. A student who obtains a grade of 1 D+ or 1 D or 2 D+s or 1 D+ & 1 D in supplementary (re-sit) examinations in the course(s) failed will be required to carry forward (repeat) the course(s) failed in the semester in which the course is being offered, provided that the failed course is not a pre-requisite for the courses to be under taken in the following semester. A student will be required to repeat the semester by the following criteria: 3 Ds with failure in continuous assessment in one or two courses Failure with 2 D and 1 D+ with failure in continuous assessment in one or two courses Failure with 2 Ds with failure in continuous assessment in one or two courses

A student who is required to repeat the first semester shall have to undertake the repeat within a subsequent relevant semester in the academic year. A student may repeat a semester or a course only two times. Exclusion from the programme: The following criteria shall apply for exclusion (discontinuation) from the programme:


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YEAR THREE : SEMESTER 1 & 2 There are five (5) courses in this semester. Continuous assessment Students shall undertake a clinical skills attachment. Students will be evaluated by way of continuous assessments which will include attachment tests (written and practical) and assignments. The continuous assessments will contribute 40% towards the end of year practical examination. End of year examination This examination shall be undertaken at the end of the year. A candidate shall be deemed to have passed the end of year examination if he/she obtains 50% or more of the total marks in each course in both written and practical. The end of year examination shall comprise the following: Written Paper: There will be a written paper in each course. Each written paper will carry a mark of 100%. A candidate shall be deemed to have passed the written examination if he/she obtains 50% or more in each course. A student who obtains a grade of 1 D+ or 1 D or 2 D+s shall be required to sit for supplementary (re-sit) examinations in the course(s) failed provided that he/she has passed continuous assessment. Criteria for repeat practical period (clerkships) The following criteria shall apply for repeat practical period (clerkships):

Failure with 1 D and 1 D+ Failure in supplementary examination

A candidate may repeat the practical period (clerkship) only once. A student who is required to repeat the practical period shall have to undertake the repeat within a subsequent relevant academic year. Practical Results of the practical component of the end of year examination shall comprise the following:

Continuous Assessment - Continuous assessment shall carry 40% of the total mark/grade in each course as follows:

Log book 20%

End of attachment test (written and practical) 20%

Objective Structured Clinical Examination (OSCE) - There shall be an OSCE in Psychiatry. The OSCE will carry 60% in each course.

A candidate shall be deemed to have passed the practical examination if he/she obtains 50% or more of the total available marks in each course (CA + OSCE)

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A candidate who fails the course with a grade of D+ will be required to repeat the appropriate clerkship during the long vacation prior to the next academic year, at the end of which he/she will be reassessed. Clerkship will last 8 weeks. A candidate who fails in a repeat course/clerkship with a grade of D may be required to repeat the year. A candidate who fails in more than twice in the course may be excluded (discontinued) from the programme. Grading of Results

MARKS GRADE POINTS

85 – 100 A+ Distinction 5 75 – 84 A Distinction 4

70 – 74 B+ Merit 3 65 – 69 B Credit 2

55 – 64 C+ Definite pass 1

50 – 54 C Bare pass 0 45 – 49 D+ Bare fail 0

35 – 44 D Clear fail 0 0 – 34 E Ungraded 0

Course Coding

Each course has an alphanumeric coding interpreted as follows:

1. The initial letters designates the course subject. 2. The first digit indicates the year of study. 3. The second digit identifies the semester in which the course is taught. 4. The third digit identifies the course status. The digit 0 denotes a full

course .i.e. a course runs for two semesters while the digit 5 denotes a half course for a course running in one semester.

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2. DIPLOMA IN CLINICAL MEDICAL SCIENCES CURRICULUM ROAD MAP

Semester 1 Semester 2

Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June

Year 1 ANP 110- Anatomy and Physiology ANP 120-Anatomy and Physiology

FEM 110-Fundamentals of Emergency Medicine FEM 120-Fundamentals of Emergency Medicine

BMS 110-BiomedicalSciences

( Immunology/Parasitology/ Microbiology) BMS120-Biomedical Sciences ( Haematology, Pathology)

MBC 110-Medical Biochemistry and Nutrition MBC 120-Medical Biochemistry and Nutrition

MCI 115-Medical Ethics & Communication Skills MED 125-Internal Medicine

MSP 115-Medical Socio-Psychology PHM 125-Pharmacology & Therapeutics

Year 2 MED 210-Internal Medicine MED 220-Internal Medicine

SGY 210-Surgery SGY 220-Surgery

OBG 210-Obstetrics & Gynaecology OBG 220-Obstetrics & Gynaecology

PED 210-Paediatrics & Child Health PED 220-Paediatrics & Child health

MHP 210-Mental Health & Clinical Psychiatry MPH 220-Mental Health & Clinical Psychiatry

PHC 210- Public Health (Community Health, Primary Health Care & Health promotion)

PHC 220-Public Health (Community Health, Primary Health Care & Health promotion)

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HSM 225- Health Systems& Management

Year 3 MED 310-Internal Medicine Clerkship MED 320-Internal Medicine Clerkship

SGY 310-Surgery Clerkship SGY 320-Surgery Clerkship

OBG 310-Obstetrics & Gynaecology Clerkship OBG 320-Obstetrics & Gynaecology Clerkship

PED 310-Paediatrics & Child Health Clerkship

PED 320-Paediatrics & child health clerkship

MHP 310-Mental Health & Clinical Psychiatry MHP 320-Mental Health & Clinical Psychiatry

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MASTER PLAN

JAN

JUL

FEB

AUG

MAR

SEP

APR

OCT

MAY

NOV

JUN

DEC

JUL

JAN

AUG

FEB

SEP

MAR

OCT

APR

NOV

MAY

DEC

JUN

Year 1, Semester 1 - 16wks

FIRST LECTURE BLOCK

Theory Exam & OSCE

2wks

4wks

Clinical Practice I(Clinical Procedures)

Year 1, Semester 2

SECOND LECTURE BLOCK

Theory Exam & OSCE

2wks

4wks

Clinical Practice II

(Screening/Laboratory)

Year 2, Semester 1 Year 2, Semester 2

THIRD LECTURE BLOCK

Theory Exam & OSCE

2wks

4wks

Clinical Practice III

(screening)

FOURTH LECTURE BLOCK

Theory Exam & OSCE

2wks

Holiday

Year 3, Semester 1 + 2

Clinical Practice IV (Hospital Rotations )

No Name of Clinical Area/Experience Course Code No of Weeks

1. Surgery Clerkship

ENT

Dentistry

SGY 320 6Wks

2Wks

2Wks

Study break 1WK

Theory Exam & OSCE

2wks

Graduate

Skills development (skillsLab, Clinic,

Hospital)


Hospital


Hospital)


Hospital)

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Ophthalmology 2Wks

2. Obstetrics & Gynaecology Clerkship OBS 320 6Wks

3. Paediatrics and Child Health Clerkship PED 320 6Wks

4. Medicine Clerkship MED 320 6Wks

5. Mental Health & Psychiatry Clerkship MHP 320 3Wks

TOTAL No. of WEEKS 33 Wks

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3. STRUCTURE OF THE PROGRAMME

YEAR 1: SEMESTER 1 ANP 110-Anatomy and Physiology FEM 110-Fundamentals of Emergency Medicine BMS 110-Biomedical Sciences (Immunology/Parasitology/ Microbiology)

MBC 110-Medical Biochemistry and Nutrition CME 115-Communication Skills & Medical Ethics MSP 115-Medical Socio-Psychology YEAR 1: SEMESTER 2 ANP 120-Anatomy and Physiology FEM 120-Fundamentals of Emergency Medicine BMS120-Biomedical Sciences (Haematology, Pathology) MED 125-Internal Medicine PHM 125-Pharmacology & Therapeutics MBC 120-Medical Biochemistry and Nutrition YEAR 2: SEMESTER 1 MED 210-Internal Medicine SGY 210-Surgery OBG 210-Obstetrics & Gynaecology PED 210-Paediatrics & Child Health MHP 210-Mental Health & Clinical Psychiatry PHC 210- Public Health (Community Health, Primary Health Care & Health promotion) YEAR 2: SEMESTER 2 MED 220-Internal Medicine SGY 220-Surgery OBG 220-Obstetrics & Gynaecology

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PED 220-Paediatrics & Child health MPH 220-Mental Health & Clinical Psychiatry PHC 220-Public Health (Community Health, Primary Health Care & Health promotion) HSM 225- Health Systems& Management YEAR 3: SEMESTER 1 Clinical Rotations

1. MED 310 - Internal Medicine Clerkship 2. SGY 310 - Surgery Clerkship 3. OBG 310 - Obstetrics and Gynaecology Clerkship 4. PED 310 - Paediatrics & Child Health Clerkship 5. MHP 310 - Mental Health & Clinical Psychiatry Attachment

YEAR 3: SEMESTER 2 Clinical Rotations

1. MED 320 - Internal Medicine Clerkship 2. SGY 320 - Surgery Clerkship 3. OBG 320 - Obstetrics and Gynaecology Clerkship 4. PED 320 - Paediatrics & Child Health Clerkship 5. MHP 320 - Mental Health & Psychiatry

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YEAR ONE: SEMESTER 1 COURSES

COURSE TITLE : HUMAN ANATOMY AND PHYSIOLOGY COURSE CODE : ANP 110 AIM Equip students with knowledge, skills and attitudes of anatomy & physiology in correlation to its use in medicine. OBJECTIVES Describe human anatomy and physiology Describe the structure and function of anatomical parts of various system of the human body. Describe the cells and tissues of various systems Describe homeostasis of the human body. Demonstrate knowledge on the maintenance of near normal internal body environment Explain basic embryology and its clinical significance COMPETENCES Identify various organs of the human body Illustrate anatomical parts of the various organs of the human body. Relate major pathological processes to structure of the body systems during clinical practice Relate the optimal functioning of the human body systems to clinical practice Demonstrate the understanding of homeostasis of the human body. Identify common foetal malformations Demonstrates understanding of occurrence of foetal malformations

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CONTENT UNIT 1: INTRODUCTION TO ANATOMY AND PHYSIOLOGY 1.1. Definition of terms 1.2. Organization of the body 1.3. Planes of the body, terms of direction and orientation. UNIT 2: CELLS AND TISSUES 2.1 Structure and function of the cell

2.1.1 Organelles: nucleus, ribosome, mitochondrion, lysosome, Golgi apparatus

2.1.2 Cell membrane: resting membrane potentials, transport across cell membrane, 2.1.3 Celldivision:mitosis, meiosis

2.2 Tissues 2.2.1 Epithelium:mucosa, serosa, synovia membranes 2.2.2 Connective tissue 2.2.3 Muscle tissue

2.2.4 Neuron tissue UNIT 3: GENERAL EMBRYOLOGY

3.1 Gametogenesis Chromosomal Aberrations Down’s syndrome Turner’s syndrome Klinefelter’s syndrome

3.2 Ovulation to implantation Embryonic development of germ layers-gastrulation Derivatives of the ectoderm, mesoderm and endoderm Neurulation Birth defects Fetal period Fetal growth abnormalities Structure and function of the placenta Amniotic fluid

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Fetal membranes UNIT 4: HOMEOSTASIS

4.1 Hormonal control mechanisms (positive and negative feedback) 4.2 Temperature, 4.3 Glucose, 4.4 pH and buffers 4.5 Body fluids compartments 4.6 Body fluid composition

UNIT 5: MUSCULO SKELETAL SYSTEM

5.1 Skeleton 5.1.1 Appendicular Skeleton 5.1.2 Axial Skeleton; 5.1.3 Joints: (movable, slightly movable and immovable 5.2 Principal skeletal Muscles 5.2.1 Head and neck 5.2.2 Shoulder girdle and upper limb 5.2.3 Trunk; Abdominal wall muscles 5.2.4 Pelvic floor and lower limbs

TEACHING METHODS Lectures Group discussions Demonstrations E-Learning Skills Laboratory/ Practical CONTACT HOURS : 64 Lectures – 4 hours/week Skills lab – 1 hour/week ASSESSMENT METHODS: Continuous assessment = 40% 2 written tests = 20% OSCE = 15%

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1 assignment = 5% Final examination = 60%

Written = 40% OSCE = 20%

PRESCRIBED READINGS Tortora,J. & Derrickson B.(2014). Principles of anatomy and physiology (14thed) John Wiley and Sons inc. Wilson K. & Waugh. A (2010) Ross and Wilson Anatomy and Physiology in Health and Illness New York: Churchill Livingstone Guyton A.C. (1993) Text book of Medical Physiology London: W. B. Saunders CO. RECOMMENDED READINGS Langlel. L.L, Telford. I. R.& Christensen. J.B (1980), Dynamic Anatomy and Physiology (5thed) New York: Mcgraw-Hill. Sigrid R, (1994) Physiology and Anatomy London: Churchill Livingstone Peter. C. W. (1995) Gray’s Anatomy New York: Churchill Livingstone Campbell, P.N. & Smith A.D. (1988). Anatomy and Physiology in Health and Disease ELBS Edition. Edinburgh: Churchill Livingstone McMinn R.M.H. Hutchings R.T. Pedington, J. & Abrahams, P.H. (1993). A Colour Atlas of Human Anatomy (3rd Ed). London: Mosby-Wolfe/ELBS Lumley, J.S.P, Craven, J.L & Aitken, J.T. (1987) Essential Anatomy (4th Ed). Edinburgh: Churchill Livingstone ISBN: 0-443-03573-3 Rutishauswer, S. (2002) Anatomy and Physiology Lippincott: Springhouse

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COURSE TITLE: FUNDAMENTALS OF EMERGENCY MEDICINE COURSE CODE: FEM 110 AIM Equip student with knowledge and skills for provision of quality health care to acutely ill and injured persons. OBJECTIVES Define common emergency medical terminologies Describe the significance of emergency medicine Demonstrate understanding of medico-legal issues in emergency medicine Perform common medical emergency procedures Demonstrate ability to use appropriate skills in transporting casualties/patients Manage medical emergency procedures COMPETENCES Adequately manage common medical emergencies Evaluate and refer patients/casualties to appropriate units or institutions Lift and handle casualty/patient using appropriate methods Administer appropriate drugs in various medical emergencies Use appropriate instruments in varied medical emergencies Document patient’s information Apply medico-legal issues in management of medical emergencies COURSE CONTENT UNIT 1:INTRODUCTION 1.1 Definition of Emergency Medicine 1.2Definitions of terms 1.3 History of Emergency Medicine 1.4 Emergency medicine priorities 1.5 Procedures

27

1.5.1 Vital signs 1.5.2 Hand washing UNIT 2: EMERGENCY ROOM ANDPATIENT TRIAGING 2.1 Emergency room/casualty 2.2 Common instruments; application and use 2.3 Emergency tray 2.4 Medical positions 2.5Lifting and transportation of casualty/patient 2.5.1 Human crutch 2.5.2 Blanket drag 2. 5.3 Fireman’s lift 2. 5.4 Hand seat carry 2. 5.5 Transport on stretcher 2.5.6 Improvised Lifter 2.6 Emergency/ triaging UNIT 3 : COMMON EMERGENCY ACUTE PAINS 3.1 Headache 3.2 Chest pain 3.3 Abdominal pain 3.4 Back pain 3.5 Muscular – skeletal pain UNIT 4 : RESPIRATORY EMERGENCIES 4.1 Airway obstruction 4.2 Choking 4.3 Asphyxia (Suffocation) 4.4 Acute severe asthma 4.5 Foreign body in the throat, nose and ear 4.6 Procedures 4.6.1 Helmlich Maneuver (Abdominal Thrust) 4.6.2 Chest Thrust

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UNIT 5: BITES AND STINGS 5.1 Human 5.2 Animal 5.3 Snakes 5.4 Insect UNIT 6: BURNS AND SCALDS 6.1 Definitions and Classifications 6.2 Aetiologies 6.2.1 Thermal 6.2.2 Electrical 6.2.3Chemical 6.2.4 Radiation 6.2.5 Physical UNIT 7: UNIVERSAL MEDICO- LEGAL ISSUES 7.1 Abandonment 7.2 Battery 7.3 Negligence 7.4 Sexual abuse (rape, incest and defilement) 7.5 Consent TEACHING METHODS Lectures Tutorials Demonstration Skills lab Role play E - Learning

29

CONTACT HOURS Lectures 2 Hours per week Practical 2 Hours per ASSESSMENT Continuous Assessment = 40% Written tests (1) = 10% Skills Lab (Practical) = 30% End Semester Examination = 60% Written = 30 OSCE = 30 PRESCRIBED READINGS American Academy of Orthopaedic Surgeons (AAOS) (2013), Emergency Care and Transportation of The Sick and Injured; Orange Book series, USA. American Academy of Orthopaedic Surgeons, Thygerson A.L (edior), (2011), First Aid, CPR and AED Advanced, USA Limmer D.J, O’keefe M, Grant H. T etal, (2011), Emergency Care, 12th Edition, USA. Wachter, R.M (2012), Understanding Patients Safety,2nd Edition, USA

RECOMMENDED READINGS

British Red Cross (2009) First Aid Manual; The Authorised Manual of St. John Ambulance, S. Andrews First Aid and the British Red Cross: London: D.K Publishers

Handbook of Emergency Cardiovascular Care (2008). American Heart Association Standard Guidelines for Medical Rescue Providers;

Hazinski, M.F (editor) (2006), Basic Life Support for Health Care Providers (Student’ts manual), USA: American Heart Association,

Pestana, C. (2013). Dr.Pestana’s Surgery notes: Top 180vignettes of he surgical wards

Kloeck, W.G.J A. (2008) Guide to the Management of Common Medical Emergencies in Adults, RSA.

30

COURSE TITLE : BIOMEDICAL SCIENCES

COURSE CODE : BMS 110

AIM

Equips student with knowledge, skills and attitude to diagnose and manage common human pathogenic infections.

OBJECTIVES

Define terms used in immunology, microbiology and parasitology

Demonstrate understanding of the functions of the immune system in health and disease

Describe the factors that influence infections

Outline the different classifications of microorganisms and the diseases they cause

Describe the pathogenesis of common diseases

Demonstrate ability to diagnose common diseases

Outline basic laboratory diagnostic methods.

Describe geographical distribution, life cycle of common pathogens and prophylaxis of diseases

COMPETENCES

Explain the functions of the immune system in health and disease

Explain the functions of the immune system in health and disease.

Identify factors that influence infections

Order appropriate diagnostic tests

Perform basic tests in microbiology, immunology and parasitology.

Interpret laboratory results

Diagnose common diseases

Outline Concepts in Antimicrobial Therapy

Comply with biomedical safety standards

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Demonstrate understanding of infection surveillance, prevention and epidemic preparedness skills.

CONTENT

UNIT 1:INTRODUCTION TO IMMUNOLOGY

1.1 Innate Immunity and adaptive immunity.

1.2 Cells and tissues of immune system

1.3 Antigen and Antibodies

1.4 Compliment system

1.5 Cell Mediated Immunity

1.6 Immune Disorders

1.7 Immunodeficiencies(HIV and AIDS)

1.8 Immunity and host resistance to infections

1.9 Immunization

UNIT 2 MICROBIOLOGY (Bacteriology, virology, Mycology)

Introduction to Clinical Microbiology

Definition of terms

Factors contributing to infections

Methods of transmission and prophylaxis

Classification of microorganisms

Structure and morphology

Microbial physiology and pathogenicity

1. Bacterial genetics and pathogenecity

2. Clinical manifestations

3. Principles of diagnostic technique

7. Technical methods in microbiology

32

Principles of sterilisation, disinfection and asepsis

Collection, transportation and handling of specimens

Antimicrobial drugs and sensitivity testing

8. Bacteria of medical importance

9. Viruses of medical importance

10. Microbiology in Public Health

11. Antimicrobial agents and resistance

UNIT 3 : MEDICAL PARASITOLOGY

3.0 Introduction to parasitology

Definition of terms

Classification of parasites

Transmission and prevention of parasitic diseases

Parasitic clinical manifestations and diagnostic methods

3.1. Parasites of medical importance

Haemoprotozoa: plasmodium, trypanosomes and leishmania

Amoebae: entamoebahistolytica and others

Flagellates: giardia lamblia, trichomonavaginalis

Intestinal ciliates: balantidium coli

Cocidia& microsporidia: cryptosporidium; isospora, toxoplasma

Trypanosomes: bruceigambiense, bruceirhodesiense, cruzi

UNIT 4 HELMINTHOLOGY

4.1 Intestinal and Tissue Nematodes

Intestinal: ascaris, anterobius, hook worms, strongyloides, trichuris

Tissue: loa loa, trichinella, dracunculus, capillaria, onchocerca,

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Lymphatic filariasis: wuchereria, brugia,

4.2 Cestodes: Tapeworms and Trematodes (Flukes)

Tapeworms

Taeniasolium

Taeniasaginata

Hymenolepis nana

Echinococcusgranulosus

Diphylobothriumlatum

4.3 Trematodes(Flukes)

SchistosomaHaematobium

SchistosomaMansonii

Fasciola hepatica

4.4 LABORATORY PROCEDURES

Macroscopy and Microscopy

Blood ,body fluids, stool and urine

Serological tests (RDT-RPR, HIV, Malaria parasites, sputum, CRAG)

TEACHING METHODS:

Lectures

Tutorials

Practicals

e-Learning

CONTACT HOURS:

Lectures – 2 hours / week

Practicals 2 hours/ week

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ASSESSMENT

Continuous = 40%

Tests (two tests) = 30%

Assignments = 10%

Examinations = 60%

Written Exam = 40%

Practical Exam = 20%

PRESCRIBED READINGS

1. Prescott et al (2011) Microbiology, 7th Edition, McGrawhill, Boston.

2. RamnikSood (2012) Medical Laboratory Technology 5rd edition, Jaypee brothers, New Delhi.

3. Sherris, J.C.(2004).Medical Microbiology.An Introduction to infectious diseases.New York: McGRAW-HILL


Jawetz, E., Melnick, J., Adelberg. (2010). Review of Medical Microbiology (16thEd.) Lange. ISBN: 0-87041-053-9.

JayaranPanika .C. K. (2011).Text Book of medical Parasitology, 4rd edition, Jaypee brothers, New Delhi

Gordon,C. and Zumla, A. (2003). Manson’sTropical Disease, 21stedtion,Elst, Saunders.

Cheesbroogh, M.(2008).District laboratory practice in tropical countries, 2ndedition, Cambridge university press, UK

Richard, G. (2008).Medical microbiology 4thedition, Elsevier Limited, New Dehli

Logeswari, S.(2008).Textbook of Microbiology, 1stedition, Jaypee brothers, New Dehli

35

COURSE TITLE: MEDICAL BIOCHEMISTRY AND MEDICAL NUTRITION

COURSE CODE: MBC 110

AIM:

Equip students with knowledge and skills in managing common nutritional disorders.

OBJECTIVES

Describe the functions of cell organelles

Describe the effects of water on dissolved molecules.

Classify the biomolecules

Describe the functions of biomolecules

Describe the physical and chemical properties of biomolecules

Describe energy production from biomolecules

COMPETENCES

Classify the cell organelles of the human body

Demonstrate the understanding of the functions of the cell organelles

Differentiate the physical properties of biomolecules

Differentiate the chemical properties of biomolecules

Demonstrate an understanding of the functions of biomolecules

Apply the knowledge of biochemistry in disease management

7. Relate water balance to normal physiology

8.Explain the role of water in metabolism

9.Elaborate the metabolism of biomolecules

36

COURSE CONTENT:

UNIT 1 INTRODUCTION TO BIOCHEMISTRY

1.1 Cells

1.1.1 cell organelles and their functions

1.2 Water: (Functions, pH, buffers)

1.3 Biomolecules

1.3.1 Introduction to Biomolecules

UNIT 2 STRUCTURE AND CATALYSIS

2.1 Amino Acids, Peptides and proteins

2.1.1 Amino Acids (Functions, Classification and isomerism)

2.1.2 Formation of Peptides and synthesis of proteins

2.1.3 Hydrolysis (Urea cycle)

2.1.4 Physical and Chemical Properties

2.2 Enzymes;

2.2.1 Nomenclature (EC System)

2.2.2 Functions

2.2.3 Effect of temperature and pH on enzymes

2.2.4 Cofactor and Co-enzymes

2.2.5 Enzyme inhibition

2.3 Carbohydrates

2.3.1 Classification and Functions

2.3.2 Isomerism

2.3.3 Synthesis of disaccharides and polysaccharides

2.3.4 Hydrolysis

2.3.5 Physical and Chemical Properties

2.4 Lipids

2.4.1 Classification and Functions

2.4.2 Structure and Triglyceride Formation

37

2.4.3 Fatty acids and Nomenclature

2.4.4 Isomerism

2.4.5 Hydrolysis (Lipolysis)

2.4.6 Physical and Chemical properties

2.5 Biological Membranes and Transport

2.5.1 Active Transport

2.5.1.1. Primary

2.5.1.2 Secondary

2.5.2 Passive Transport

5.2.2.1 Simple

5.2.2.2 Passive

5.2.2.3 Facilitated Diffusion

2.5.3 Endocytosis

2.5.4 Exocytosis

2.5.5 Pinocytosis

2.6 Nucleotides and nucleic acids

2.6.1 Nucleosides (include Nucleoside analogues)

2.6.2 Nucleotides (Nucleic Acids)

2.6.3 Deoxy-Ribonucleic Acid and Ribonucleic Acid (DNA and RNA)

2.6.4 Synthesis and Degradation of Nucleotides and Nucleic Acids

UNIT 3 BIOENERGETICS AND METABOLISM

3.1Principles of Bioenergetics

3.2 Glycolysis,

3.3 Glycogenesis,

3.4 Gluconeogenesis,

3.5 Lipogenesis

3.3 Tricarboxylic Acid (TCA) Cycle

38

3.4 Electron Transport System

3.5 Pentose phosphate pathway (Nucleic Acid Metabolism)

3.6 EmbdenMayerholf Pathway (EMP)

3.7 Protein Synthesis and the Genetic Code

TEACHING METHODS

Lectures

Group Discussions

Tutorials

Practicals

e-learning

CONTACT HOURS

Lectures 4 hours per week

ASSESSMENT METHODS

Continuous Assessments = 40%

Tests (2) = 30 %

Assignments(2) = 10%

Examination = 60%

Written =40%

Practicals =20%

PRESCRIBED READINGS

39

Murray, K.R., Botham K.M (2012) Harpers illustrated Biochemistry, 29th Edition. New York: McGraw Hill

Nelson D.L., Cox M.M (2013) Lehninger Principles of Biochemistry, 6th Edition.W.HFeeman USA.

Vasudevan, S.S, Kannan V. A (2010) A Text Book of Biochemistry for Medical Students, New Age International (P) Limited, New Delhi

RECOMMENDEDREADINGS

Berg, M.J, Tymoczko, J.L et al (2001) Biochemistry. 5th edition

GAW, A, Murphy, M, J, Cowan, R, A et al (2008) Clinical Biochemistry.4th edition. Churchill Livingstone. Edinburgh. ISBN 978-0-443-06932-1

Horton R.H (2006) Principles of Biochemistry, Pearson Prentice Hall

Menninger, A.L, Nelson D.L. and Cox M.M. (1993).Principles of Biochemistry.Worth Publishers, New York. ISBN: 0-87901-500-4.

Nath R.L. (2007) A Text Book of Medical Biochemistry, New Age International (P) Limited Publishers, New Delhi India

Nelson D.L. and Cox MM (2009) Leninger Principles of Biochemistry, 5th edition. W.H. Freeman New York

Rashi J.A (2002) A Text Book of Practical Biochemistry, B. Jain Publishers, New Delhi India

Tymoczko J.M., Stryer L (2007) Biochemistry 6th edition. W.H. Freeman, New York

Vaudryan, D.M, et al (2008) Text book of Biochemistry for Medical Students. 5thedition.Jaypee. India

COURSE TITLE:COMMUNICATION SKILLS AND MEDICAL ETHICS

COURSE CODE: CME 115

AIM

Equip students with knowledge, skills and attitudes that will enable them to communicate effectively with patients, care givers and the community professionally

OBJECTIVES

Define common terms in communication

Describe the communication process

Explain the professional code of conduct for health professionals

Describe ethical principles governing clinical practice and research

40

Demonstrate understanding of legislation and regulations governing the medical practice in Zambia

Describe management of information system

Describe ethical principles governing clinical practice and research

COMPETENCES

Utilises ethically acceptable communication skills to clients and colleagues in medical practice.

Ensure privacy and confidentiality

Demonstrate effective listening skills and attitudes to be able to respond positively.

Identify utilitarian and deontological basis of ethically informed decision making process in medical practice

Utilize both open and closed ended questions to obtain information

Utilize electronic media

Conduct health education

CONTENT

UNIT 1 :COMMUNICATION SKILLS

Definition

Elements of communication

Communication process

Types of communication

Verbal Communication

Non -Verbal Communication

Communication skills

Active listening

Summarising

Exploratory questioning for feelings

41

UNIT 1 :STUDY SKILLS

Planning work

Reflective thinking

Time management

Use of IT for learning

Search engines

e-Granary

Writing skills

Academic writing

Referencing, Bibliography

Examination skills

Preparation for examinations

Understanding examination rubrics

Writing examinations

UNIT 3 : MEDICAL ETHICS AND PROFESSIONAL PRACTICE

3.1Philosophical basis and principles of medical ethics

Ethical theories, Deontology and Utilitarianism

Medical Research and Ethics

Policy, legislation and regulation for COGs – The Practice

Clinical Incompetence

Inter-professional relationships

Relationship With Other Health Workers

Relationship With Unqualified Practitioners and Traditional Healers

42

The Ethical Dimension: Responsibility To Community

TEACHING AIDS:

Audio-visual

Simulated patients

TEACHING METHODS

Lectures

Tutorials

Demonstration

Skills lab

Role play

CONTACT HOURS

Lectures 1 hour per week

Practicals 2 hours fortnightly

ASSESSMENT

Continuous Assessment = 40%

Written tests (1) = 10%

Skills Lab (Practical) = 30%

End Semester Examination = 60%

Written = 30

Practicals = 30

43

PRESCRIBED READINGS

1. Guffey, M. E. (2007) Essentials of Business Communication. 7th edition. Australia. Thomson Southwestern.

2.Hybels, S. & Weaver, R. (2004) Communicating Effectively. 7th Ed. Boston. McGraw Hill

3. Health Professions Council of Zambia Guidelines

4.TrustTraining Manual on Ethical and HumanRightsStandards for Health Care Professionals


1. Banda. S. S, (1999) Medical Ethics for Medical and health Professions. Oxford Press, London

2.Cottrell, S. (2001) Teaching Study Skills and Supporting Learning. Hampshire. Palgrave Publisher

3.Cottrell, S. (1999) The Study Skills Handbook. Hampshire. Palgrave Publisher

4.Epsten, R. L. (2001) Critical Thinking. Australia. Wadsworth Publisher

5.Feldman, R. S. (2000) Power Learning: Strategies for Success in College and Life. Boston. McGraw-hill.

44

COURSE TITLE: MEDICAL SOCIO-PSYCHOLOGY

COURSE CODE: MSP 115

AIM

Equip students with socio-psychological perspectives and their application in the field of clinical practice.

OBJECTIVES:

1. Describe the basic psychological concept in relation to Medicine.

2. Describe the influence of cultural beliefs and practices human behaviour and health

3. Discuss the economic and political systems that might affect the health of individuals in communities.

4. Explain human psychological development

5. Define the concept of counseling

6. Describe the process of counseling

COMPETENCES

45

1. Apply sociological constructs of health and illness in their practice

2. Recognise sociological influences on health and illness when dealing with patients

3. Utilize knowledge acquired to understand human behaviour at all ages of life span

4. Utilize knowledge acquired to identify needs of clients with regard to coping and adjustment to ill health

5. Explainbehaviour in relation to diseases

6. Apply appropriate psychological and sociological knowledge and skills to solve health related problems

7.Apply psychological knowledge, theories and principles to various situations demanding counselling in clinical practice

8.Create positive helping relationship

CONTENT

UNIT 1

INTRODUCTION TO SOCIOLOGY

1.1 Definition of Medical Sociology

1.2 Sociological perspectives and relevance to medicine

1.3 Sociological inquiry

UNIT 2: SOCIOLOGY APPLIED TO MEDICINE

2.1 Health as a social concept

2.2 Social basis of disease

2.3 Social role in medicine

2.4 Social factors in disease aetiology

2.5 Health and Society,

46

2.6 Society and mental health.

2.7 Social epidemiology

UNIT 3 CULTURE

3.1 Definition

3.2 Components of culture

3.3 Factors of cultural change

3.4 Importance/function of culture.

3.5 Subculture

3.6 Deviant behaviour

3.7 Social stigma

UNIT 4 SOCIETY AND SOCIALIZATION

4.1 Definitions

4.2 Types of society and their significance to disease conditions

4.3 Family

4.3.1 Definition

4.3.2 Types of families

4.3.3 Health family

4.3.4 Diseased family

4.4 Marriage

4.3.4.1 Definition

4.3.4.2 Types of marriages

4.3.4.3 Monogamy

4.3.4.4 Polygamy

4.3.4.5. Polyandry

4.3.4.6 Same sex marriage

4.3.4.7. Cohabitation

4.4 SOCIAL STRATIFICATION

47

Definition

Class

Race

Ethnicity

Sex and Gender

4.5 Groups

4.5.1 Definition

4.5.2 Formation of groups

4.5.3 Types of groups and their significance to disease conditions

4.6 Religion

4.6.1 Definition

4.6.2 Types of religion and their significance to health and disease conditions

4.7 Economic systems

4.7.1 Definition

4.7.2 Types and their significance to health and disease conditions

4.8 Political systems

4.8.1 Definition

4.8.2 Types of political systems and their policy implication to health and disease

4.9 Education

4.9.1 Definition

4.9.2 Types of education systems and their relevance to health and disease

UNIT 5 SOCIAL PROBLEMS

5.1 Definitions

5.2 Social problems

5.3 Crime

5.4 AIDS

48

5.5 Malnutrition

5.6 Personality disorganisation

5.7 Poverty

UNIT 6 SOCIAL STRATIFICATION

6.1 Definition

6.2 Class

6.3 Race

6.4 Ethnicity

6.5 Sex and Gender

UNIT 7 SOCIAL CHANGES IN SOCIETY

7.1 Introduction

7.2 Meaning of change

7.3 Theories of social change (modernisation theories)

7.4 Agents of change

7.5 Attitudes

7.6 Persuasion

7.7 Conformity

7.8 Compliance

PSYCHOLOGY

UNIT 1 THE NATURE AND SCOPE OF PSYCHOLOGY

1.1 Definition

1.2 Applications of Psychology

49

1.3 Approaches to studying Psychology

1.3.1.1Neuro biological approach

1.3.2 Humanistic approach

1.3.3. Psychoanalysis

1.3.4 Behaviourism

1.3.5 Cognitive approach

UNIT 2 PSYCHOLOGICAL PROCESSES

2.1 Perception

2.1.1 Sensation

2.1 2 Perceptual groupings

2.1.3 Visual illusion

2. 2 Motivation

2.2.1 Definition of terms

2.2.1.1 Need

2.2.1.2 Drive

2.2.1.3 Motive

2.2.1.4 Incentive

2.3 Physiological and non-physiological basis of motivation

2.4 Hypothalamic control of motivation

2.5 Classification of motives

2.6 Theories of motivation

UNIT 3 HUMAN PSYCHOLOGICAL DEVELOPMENT

3.1 Attachment and bonding

3.2 Gender – role development

50

3.2.1. Gender roles

3.2.2 Gender identity

UNIT 4 INTELLIGENCE

4.1 Definition

4.2 The nature of intelligence

4.3 The role of genetics and environment in determining intelligence

4.4 Psychometric methods of assessing intelligence

4.5.1 Mental Age Scale

4.5.2 Intelligence Quotient (IQ)

UNIT 5 PERSONALITY

5.1 Definition

5.2 Psychodynamic approach

5.3 Behavioural approach

5.4 Humanistic approach

5.6 Personality development

5.7 Determinants of personality

5.7.1 Genetic

5.7.2 Environmental

UNIT 6: COUNSELLING

6.1 Definition

6.1.1Important variables:

6.1.1.1 Helping relationship

51

6.1.1.2 Helping process

6.1.1.3 Problem

6.1.1.4 Repertoire

6.2The process of Counselling

6.2.1 Advice giving, Counselling and Psychotherapy

6.2.2 Benefits of Counselling

6.2.3 Qualities of a Counsellor

6.2.3 Therapeutic environment

TEACHING METHODS

Lectures

Group Discussions

Tutorials

Field visits

CONTACT HOURS

Lectures: 2 hours per week

ASSESSMENT


Tests = 10%

Tutorials = 10%

Case presentations = 10%

52

Assignments = 10%

Examination = 60%

Written = 60%

PRESCRIBED READINGS

1. Fieldman, R.S. (2013) Understanding Psychology. 11th Ed. New York. McGraw Hill

2. Giddens, A. (2002).Sociology Polity, Press Oxford.

3. Kalat,J.W.(2011).Introduction to Psychology.Australia.WardsworthCenage Learning

4.Sutton, P.W and Anthony, G. (2013) Sociology. 7th Ed. NO TOWN Polity Press.

5. McLeod. J, (2013) An Introduction to Counselling. 5th Ed. Berkshire.Open University Press.


1. Amstrong, D. (1980).An Outline of Sociology as Applied to Medicine,Oxford : Oxford Press

2. Anthikad. J. (2007).Psychology for Graduate Nurses, New Delhi.Jaypee Brothers.

3. Burton, W. (1980) Social problems; Little Brown and Company, Boston. Toronto.

4. Gerrig , J.R (2012) Psychology and Life. Pearson Education Inc. Barcelona.

5. John J. Macionis, (1997) Sociology, Prentice-Hall.Inc New Jersey.

6. Nohen-Hoeksema.S., et al (2009) Atkinson and Hilgard’s Introduction to Psychology. Italy: Wadsworth Cengage Learning.

7 Hough, M. (2010) CounsellingSkills and Theory.India. Holder Education, Hachette : UK Company.

53

Year 1: Semester 2 Courses

54

COURSE TITLE: HUMAN ANATOMY AND PHYSIOLOGY

COURSE CODE: ANP 120

AIM

Equip students with knowledge, skills and attitudes of anatomy & physiology in correlation to its use in medicine.

COURSE OBJECTIVES

55

Describe the structure and function of anatomical parts of various system of the human body.

Describe the cells and tissues of various systems

Describe homeostasis of the human body.

Demonstrate knowledge on the structure and function of organs that provide special senses.

Draw and label important anatomical parts of the various organs of the human body.

COMPETENCES

Identify various organs of the human body

Relate the optimal functioning of the human body systems during clinical practice

Relate the optimal functioning of organs for special senses during clinical practice

Demonstrate knowledge on maintenance of near normal internal body environment

Illustrate anatomical parts of the various organs of the human body.

CONTENT

UNIT 1: STRUCTURE AND FUNCTION OF THE RESPIRATORY SYSTEM

1.1 Nasal cavities, pharynx and larynx

1.2 Trachea

1.3 Bronchioles, alveoli

1.4 Pleural cavity

UNIT 2: STRUCTURE AND FUNCTION OF THE CARDIOVASCULAR SYSTEM

56

2.1 Heart: atria, ventricles, valves and pericardium

2.2 Structure of the blood vessels; arteries, arterioles, veins and venules

2.3 Capillaries; types and location, starling’s forces

2.4 Circulatory routes; vessels of head and neck, upper limbs, thorax, Abdomen and lower limbsvenepuncture

2.5 Fetal Circulation and Changes at birth

UNIT 3: STRUCTURE AND FUNCTION OF THE LYMPHATIC SYSTEM

3.1 Lymph fluid

3.2 Lymph vessels

3.3 Lymph nodes

3.4 Spleen

3.5 Thymus

UNIT 4: STRUCTURE AND FUNCTION OF THE DIGESTIVE SYSTEM

Digestive tract; mouth, tongue, oesophagus, stomach duodenum, ileum, Colon, sigmoid, rectum, anus

Accessory organs; saliva glands, liver, biliary system pancreas

4.3 Peritoneum

UNIT 5: STRUCTURE AND FUNCTION OF THE ENDOCRINE SYSTEM

5.1 Pituitary gland

5.2 Thyroid and parathyroid glands

5.3 Islets of langerhans

5.4 Adrenals

5.5 Gonads

5.6 Thymus

5.7 Pineal body

57

UNIT 6: STRUCTURE AND FUNCTION OF THE UROGENITAL SYSTEM

6.1 Kidneys, ureters

6.2 Urinary bladder, urethra

6.3 Male reproductive system

6.3.1 Penis

6.3.2 Scrotum, testes, epididymus, vas deferens

6.3.3 Seminal vesicles, prostate gland

6.4 Female reproductive system

6.4.1 Vulva, vagina, Bartholin glands, cervix

6.4.2 Uterus, Fallopian tubes

6.4.3 Ovaries

6.4.4 Breast

6.4.5 Menstrual Cycle

UNIT 7: STRUCTURE AND FUNCTION OF THE NERVOUS SYSTEM

7.1 Central nervous system; brain and spinal cord

7.2 Peripheral nervous system; cranial and spinal nerves

7.3 Autonomic nervous system;

7.3.1 Sympathetic

7.3.2 Parasympathetic

7.4 Special senses

7.4.1 Nose

7.4.2 Tongue

7.4.3 Eye

7.4.4 Ear

7.4.5 Skin

58

TEACHING METHODS

Lectures

Practicals

Tutorials

Group discussion

Demonstrations

e - Learning

Skills Laboratory

CONTACT HOURS

Lectures – 4 hours per week

Skills lab – 1 hour per week

METHODS OF ASSESSMENT:

Continuous assessment = 40%

2 written tests = 20%

OSCE = 15%

One Assignment = 5%

Final examination = 60%

Written = 40%

OSCE = 20%

PRESCRIBED READINGS

Tortora J and Derrickson B (2014) Principles of anatomy and physiology (14thed) John Wiley and Sons inc.

59

Wilson K. and Waugh. A (2010) Ross and Wilson Anatomy and Physiology in Health and Illness New York: Churchill Livingstone

Guyton A.C. (1993) Text book of Medical Physiology London: W. B. Saunders CO.


Rutishauswer, S. (2002).Anatomy and Physiology. Lippincott: Springhouse

Peter C Williams (1995) Gray’s Anatomy New York: Churchill Livingstone

Campbell, P.N. and Smith A.D. (1988). Anatomy and Physiology in Health and Disease ELBS Edition. Edinburgh: Churchill Livingstone

McMinn R.M.H. Hutchings R.T. Pedington, J. and Abrahams, P.H. (1993). A Colour Atlas of Human Anatomy (3rd Ed). London: Mosby-Wolfe/ELBS

Lumley, J.S.P, Craven, J.L and Aitken, J.T (1987) Essential Anatomy (4th Ed). Edinburgh: Churchill Livingstone ISBN: 0-443-03573-3

Sigrid R, (1994) Physiology and Anatomy London: Churchill Livingstone

COURSE TITLE: FUNDAMENTALS OF EMERGENCY MEDICINE

COURSE CODE FEM 120

AIM

60

Equip student with knowledge and skills for provision of quality health care to acutely ill and injured persons.

OBJECTIVES

1. Demonstrate ability to use appropriate skills in transporting casualties/patients

2. Describe emergency medicine

3. Demonstrate understanding of medico-legal issues in emergency medicine

4. Perform common medical emergency procedures

5. Manage medical emergency procedures

COMPETENCES

Adequately manage common medical emergencies

Evaluate and refer patients/casualties to appropriate units or institutions

Lift and handle casualty/patient using appropriate methods

Administer appropriate drugs in various medical emergencies

Use appropriate instruments in varied medical emergencies

Document patients information

Apply medico-legal issues in management of medical emergencies

CONTENT

UNIT 1 : BLEEDING (HEMORRHAGE)

10.1 BLEEDING

10.1.1 Arterial bleeding

10.1.2 Venous bleeding

61

10.1.3 Other types

PROCEDURES

Application of Tourniquet

Pressure Point Identification and Compression

10.2 SHOCK

10.2.1 Hemorrhagic

10.2.2 Hypovolemic

10.2.3 Neurogenic

10.2.4 Septic

10.2.5 Anaphylactic

PROCEDURES

Cannulation

Application of Tourniquet

UNIT 11

11.0 INJURIES (PENETRATING AND NONE PENETRATING)

11.1 Fractures, dislocation, sprains & strain

11.2 Head and neck injuries

11.3 Chest injuries

11.4 Abdominal injuries

11.5 Soft Tissue injuries

11.6 Spinal injuries

PROCEDURES

Splinting

62

Sling

Application of POP

Reading X rays

Bandaging

Wound dressing

UNIT 12

12.0 BASICS – ADMINISTRATION OF LOCAL ANESTHETIC AGENT

12.1 Pharmacology of Local anesthetic drugs

12.2 Classification of local anesthetic drugs

12.3 Classification of local anesthesia technique

12.4 Calculation of dosage (Lignocaine)

12.5 Side effects of Lignocaine

12.6 Complications of local anesthesia

PROCEDURES

Injection giving

UNIT 13

13.0 POISONS & POISONING

13.1 Alcohol

13.2 Organophosphate

13.3 Hydrocarbon (Kerosene, Petrol)

13.4 Barbiturate

13.5 Analgesic

13.6 Iron

63

13.7 Carbon monoxide

PROCEDURES

Gastric decontamination

Gastric Lavage

UNIT 14

14.0 CONVULSIONS

14.1 Epileptic fits

14.2 Febrile convulsions

14.3 Dissociative disorder

14.4 Substance withdrawal effects

UNIT 15

15.0 UNCONSCIOUSNESS AND COMA

15.1 Definition

15.2 Common causes

15.3 Assessment of coma (Glasgow coma scale score)

15.4 Management of unconscious patient

PROCEDURES

Support ventilation (Ambu bag)

Nebulization

Suctioning

Oral /Nasal pharyngeal airway

64

UNIT 16

16.0 STROKE

16.1 Pre hospital assessment and care

UNIT 17

17.0 CARDIAC ARREST

17.1 Ventricular fibrillation

17.2 Overview - ventricular fibrillation (VF)

17.3 Identification of VF

17.4 Introduction to ECG monitoring

PROCEDURES

Defibrillation (Including use of Automated External Defibrillator (AED))

Cardiac monitoring

Cardio Pulmonary Resuscitation

UNIT 18

18.0AGGRESSIVE PATIENT

18.1 Causes of aggressive behavior

18.2 Management of aggressive patient

UNIT 19

19.0 INTRODUCTION TO RADIOLOGY

19.1 X-ray (skull, chest, pelvic & limbs); Reading/Interpretation

19.2 Ultra Sound (abdominal); Reading/Interpretation

UNIT 20

65

20.0 SUMMARY OF CLINICAL PROCEDURES TO BE DONE

20.1 Vital signs

20.2 Hand washing

20.3 Support ventilation (Ambu bag)

20.4 Nebulization

20.5 Suctioning

20.6 Bandaging

20.7 Wound dressing

20.8 Splinting

20.9 Sling

20.10 Catheterization

20.11 Nasal Gastric Tube (NGT insertion)

20.12 Gastric lavage

20.13 Gastric Decontamination

20.14 Injection

20.15 Cannulation

20.16 Cardio Pulmonary Resuscitation (CPR)

20.17 Helmlic Maneuver (Abdominal Thrust)

20.18 Chest Thrust

20.19 Oral /Nasal pharyngeal airway

20.20 Ear syringing

20.21 Defibrillation (Including use of Automated External Defibrillator (AED))

20.22 Cardiac monitoring

20.23 Application of POP

20.24 X ray reading

TEACHING AIDS:

CD’s,

66

Anatomic models and manikins

TEACHING METHODS

Lectures

Tutorials

Demonstration

Skills lab

e-learning

CONTACT HOURS


Practicals 2 hours per week

ASSESSMENT



Skills Lab (Practical) = 30%

Examination = 60%

Written = 30 %

OSCE = 30 %

PRESCRIBED READINGS

1. American Academy of Orthopaedic Surgeons (AAOS) (2013), Emergency Care and Transportation of The Sick and Injured; Orange Book series, USA.

67

2.American Academy of Orthopaedic Surgeons, Thygerson A.L (edior), (2011), First

Aid, CPR and AED Advanced, USA

3.Kloeck W.G.J A (2007/2008) Guide to the Management of Common Medical Emergencies in Adults, RSA.

4.LimmerD.J,etal, (2011), Emergency Care, 12th Edition, USA.

Wachter R.M (2012), Understanding Patients Safety,2nd Edition, USA


1. British Red Cross (2009) First Aid Manual; The Authorised Manual of St. John Ambulance, S. Andrews First Aid and the British Red Cross; D.K Publishers London

2.Handbook of Emergency Cardiovascular Care (2008). American Heart Association Standard Guidelines for Medical Rescue Providers:Handbook: (2008) RSA.

3.Hazinski M.F. (editor) (2006).Basic Life Support for Health Care Providers (Student’ts manual), USA.

4.Pestana C. (2013). Dr.Pestana’s Surgery notes: Top 180vignettes of he surgical wards

68

COURSE TITLE : BIOMEDICAL SCIENCES

COURSE CODE : BMS 120

AIM

Equips the student with knowledge andskillsto diagnose and manage common human pathogenic infections.

OBJECTIVES

Describe the pathology and haematology

Describe the composition of blood

Describe the functions of blood

Outline the different classifications of haematological conditions

Demonstrate understanding of biomedical safety standards

Describe the pathogenesis of common diseases

Carry out basic laboratory tests

COMPETENCES

Classify various haematological condition

Order appropriate diagnostic tests

Demonstrate understanding of the composition of blood

Explain the functions of the various components of blood

Comply with biomedical safety standards

69

Perform basic tests in haematology

Differentiate various haematological conditions

Interpret laboratory results

Diagnose common diseases

Include pathology competence

CONTENT

UNIT 1:PATHOLOGY

1.1 Introduction to Pathology

1.2 Causes of diseases

1.3 Diagnostic procedures in pathology

1.4 Cell Injury, Cell death and Adaptation

1.5Neoplasia (Tumours)

1.6 Genetics

1.7 Inflammation (acute and chronic inflammation)

1.8 Healing, Regeneration and Repair

1.9 Haemodynamic, Thrombosis and Shock.

UNIT 2 HAEMATOLOGY

Blood Composition And Function

Haemopoesis

Anaemias

Iron deficiency

Haemolytic

2.2.3. Aplastic anaemia

Leukemia

70

2.4.1 Haemoglobinopathies

2.4.2 Sickle cell

2.4.3 Thalassemias

Coagulation Pathways

Blood Transfusion

Blood grouping

Blood products

2.6.3 Safety of blood

TEACHING METHODS

Lectures

Group discussions

Tutorials

e-Learning

CONTACT HOURS


ASSESSMENT METHODS

Continuous = 40%

Tests(2) = 30%

Assignment = 10%

Final Examination- 60%

PRESCRIBED READINGS

Hoffbrand, A.V.,& Petti J.E. (1993) Essential Haematology, 3rd Ed, Blackwell Scientific, Oxford.

71

Ramniksood (2003) Haematology for students and practitioners, 5thedition. New Dehli: Jaypee brothers

Robins (2007). Basic pathology, 8th edition, Saunders Elsevier USA

PUT INITIALS


Macsween,R. (1996). Muirs Textbook of Pathology. Edward Arnold.London

3. Anderson R M (1979). Textbook of Pathology, 10th Ed. ELBS. London

David etal,. (2008).Muirs text book of Pathology. 14thedition.power book: London

Bain B.J. (1996), A Beginner’s Guide to Blood Cells, 1st Ed, Blackwell Scientific, Oxford.

Amanharan, S,S.(2003) Essential clinical haematology,5thedition, jaypee brothers, New Dehli

72

COURSE TITLE: MEDICAL BIOCHEMISTRY AND MEDICAL NUTRITION

COURSE CODE: MBC 120

AIM:

Equip students with knowledge, skills and attitude to manage common nutrition related conditions in the community.

OBJECTIVES

Describe principles of nutrition in relation to health

Describe nutrition guidelines for different age groups

Identify signs and symptoms of malnutrition

Manage nutritional disorders appropriately

Identify stakeholders for nutritional interventions

COMPETENCES

Identify the macro nutrients important for health

Provide nutrition guidelines on mixed diet in health for different age groups, using locally produced foods

Provide nutrition guidelines in disease for different age groups, using common locally produced foods

Identify causal factors for nutritional disorders

Perform nutritional assessments

Diagnose various nutritional disorders using appropriate tools and techniques.

Network with key stakeholders for nutritional interventions

CONTENT

Unit 1 Principle of Nutrition

CARBOHYDRATES

73

Sources and classification

Functions

Dietary allowances

Conditions associated with carbohydrates

PROTEINS

Sources and classification

Functions

Amino Acids

Dietary allowances

Conditions associated with proteins

LIPIDS

Sources and classifications

Dietary Allowances

Conditions associated with lipids

VITAMINS

Sources and Classification

Properties and functions

Dietary allowances

Conditions associated with vitamins (deficiency and excess)

MINERALS

Sources and Classification

Functions

Dietary Allowances

Conditions associated with minerals (deficiency and excess)

74

UNIT 2

MIXED DIET

2.1 Food Groups

2.2 Food Pyramid

2.3 Food Exchange lists

UNIT 3

NUTRITION IN LIFE CYCLE

3.1.1000 critical days

3.2 Nutrition in Pregnancy

3.3 Nutrition in Lactation

3.4 Infant and Young Child Feeding (IYCF) (Breast and Complementary feeding)

3.5 School going child (2-12 years)

3.6 Adolescence (13-19 years)

3.7 Geriatrics (Old people)

UNIT 4

NUTRITION IN CLINICAL CARE

4.1 Diabetes Mellitus

4.2 Cardiac conditions

4.3 Renal conditions

4.4 Liver conditions

4.5 Peptic Ulcers and gastritis

4.6 Nutrition in HIV/AIDS and Cancer

4.7 Nutrition in Tuberculosis

4.8 Nutrition in Inpatient Care (enteral and parental)

UNIT 5

DISORDERS OF METABOLISM (Carbohydrates and Protein)


75

5.2 Lactose Intolerance

5.3 Gouty arthritis

UNIT 6

MALNUTRITION (CAUSES AND MANAGEMENT)

6.1 Protein Energy Malnutrition

6.2 Iodine Deficiencies

6.3 Vitamin A Deficiency

6.4 Vitamin D deficiency

6.5 Nutritional Anaemias (Iron, Folic, Vitamin B12,)

6.6 Obesity

UNIT 7

COMMUNITY NUTRITION

7.1 Introduction

7.2 Food Security

7.3 Nutrition Assessment.

7.4 Anthropometric Measurements

7.4.1 Growth Monitoring (Weight for Age)

7.4.2Mid Upper Arm Circumference

7.4.3Head Circumference

Weight for Height and Body Mass Index

7.5 Biochemical Tests

7.6 Clinical Signs and Symptoms (oedema, skin rash, pallor, hair, dentition etc.)

7.7 Dietary Assessments

7.8 Evaluation

7.9 Stakeholder involvement in nutrition interventions

UNIT 8

8.1 PROCEDURES

8.2 Diagnosing nutrition deficiencies and relating them to nutrients by doing nutrition

76

assessments

8.3 Nutrition Counselling

TEACHING METHODS

Lectures

Group discussions

Case studies

Skills Lab

CONTACT HOURS

Lectures: 4 hours/week

ASSESSMENT METHODS:

Continuous Assessments = 40%

Written Tests (2) = 10 %

Assignment (2) = 10 %

OSCE = 20 %

Examination = 60%

Written = 40%

OSCE = 20 %

PRESCRIBED READINGS

Gropper S. S and Smith L. J (2012) Advanced Nutrition and Human Metabolism.

Instrument number 48 of 2006 of the Laws of Zambia

77

Ross A. Catherine and Caballero Benjamin M.D. (2013) Modern Nutrition in Health and Disease, 11th edition Lippincott Williams and Wilkins, Wolterskluwer health Philadelphia.

Wardlaw. G.M (2011) Contemporary Nutrition. 8th Edition. New York: McGraw Hill


Central Statistics Office Zambia (2003) the Food Security, Health Promotion and Information System, Lusaka.

Central Statistics Office Zambia (2007) Zambia Demographic Health Survey.

Deryff L.R (2006) The American Dietetic Association’s complete Food and Nutrition Guide

Escott S and Stump MA (2011) Nutrition and Diagnosis Related Care, Amazon

Mahan M.S Kathleen (2011) Krause’s Food and Nutrition Care Process, Amazon

Marie B.A and Hollen H. D (2013) Community Nutrition in Action, 6th edition Amazon

Truswell. S, Wall.P, O’Reilly. C, et al (2003) ABC of Nutrition (4th edition) BMJ. London

Tull. A (1996) Food Nutrition (3rd edition) Oxford University Press. Oxford

Whitney N.E (2012) Student Course Guide, Nutrition Pathways 8th edition, Cengage Learning Publishing Company, Dallas.

Whitney N.E and Rolfes R.S (2012) Understanding Nutrition, 13th edition, Wardsworth Publishing, Dallas.

WHO 2013 PMTCT guidelines (Option B+)

78

COURSE TITLE : MEDICINE

COURSE CODE : MED 125

AIM

Equip the students with the knowledge, skills and attitudes that will enable them to competently manage patients with various medical conditions.

OBJECTIVES:

Take detailed medical history

Perform physical examination 3. Order and interpret investigations

4. Demonstrate ability to diagnose common medical conditions

5. Demonstrate capability to manage medical conditions appropriately.

6. Demonstrate ability to refer conditions beyond their scope of practice

7. Describe the different common medical conditions

COMPETENCES

Take comprehensive medical history

Conduct physical examination in a professional manner

Order and interpret laboratory and radiological investigations

Diagnose various common conditions

Prescribe drugs correctly

Provide information, education and communication at personal and community level

Refer conditions beyond the scope of practice

Classify common communicable conditions

CONTENT

79

UNIT 1

1.0 HISTORY TAKING AND PHYSICAL EXAMINATION

1.1 HISTORY TAKING/ CLIENT INTERVIEW

Pre-requisite of history taking

1.1.1 Creation of a conducive environment for interview

1.1.2. Establishing relationship / rapport

1.1.3. Open-ended and closed questions

1.1.4 Medical history taking.

1.1. 4.1Particulars of patient / client

1.1. 4.2.Main complaints (presenting complaints) and duration

1.1.4.3 History of present illness

1.1.4.4 Past medical and surgical history

1.1.4.5 Family history

1.1.4.6Personal and socio- economic history

1.1.4. 7 For females ask about gynaecologic and obstetric histories

1.1.4.8Drug history 1.1.4.9 Allerg-y history

1.1.4.10 Systemic review

General

Respiratory system

Cardiovascular system

Gastrointestinal tract

Genitourinary system

Musculoskeletal system

Integumentary system

1.2 PHYSICAL EXAMINATION

80

1.2.1 Inspection

1.2.2 Palpation

1.2.3 Percussion

1.2.4 Auscultation

UNIT 2 COMMUNICABLE DISEASES

2.1. BACTERIAL INFECTIONS

Applied anatomy of the affected organ/ system

History taking and clinical examination

2.1.1Cholera

2.1.2 Typhoid Fever

2.1.3 Plague

2.1.4 Brucellosis

2.1.5 Tuberculosis

2.1.6 Leprosy

2.1.7 Typhus

2.1.8 Tetanus

2.2 VIRAL INFECTIONS

2.2.1 Applied anatomy of the affected organ/system

2.2.2 History and Clinical Examination

2.2.3Heamorrhagic Fever (Ebola)

2.2.4 Measles

2.2.5 Rubella

2.2.6 Rabies

2.2.7 Yellow Fever

2.2.8 Severe Acute Respiratory Syndrome (SARS)

2.2.9 Influenza

81

2.2.10 Bird Flu

2.3 PARASITIC INFESTATIONS

History taking and clinical examination

2.3.1 Malaria

2.3.2 Trypanosomiasis

2.3.3 Filariasis due to Wucheleriabancrofti

2.3.4 Toxoplasmosis

UNIT 3.SEXUALLY TRANSMITTED INFECTIONS

3.1 Applied anatomy

3.2 History taking and clinical examination

3.3 Common conditions

3.3.1 Syphilis and neurosyphilis

3.3.2 Gonorrhoea

3.3.3 Chlamydia

3.3.4 Non- specific urethritis, bacterial vaginosis

3.3.5 Acute epididymo-orchitis

3.3.6 Chancroid

3.3.7 Granuloma inguinale

3.3.8 Lymphogranuloma venereum

3.3.9 Herpes genitalis

3.3.10 Trichomoniasis

3.3.11 Candidiasis

3.3.12 Condylomataaccuminata

3.3.13 Syndromic case management

Procedures

82

Historytaking

Physicalexamination

Pleural tap

Gastriclavage

Suprapubicpuncture

Catheterisation

Removal of catheter

Venulepuncture

Nasogastrictubeinsertion

Paracentesis

CPR

Referral

TEACHING METHODS

Lectures

Case studies

Tutorials

Skills Lab

Clinical teaching

e-Learning

CONTACT HOURS: 64 hours


Practice: 1 hour/ week

ASSESSMENTS

83

Continuous = 40%

OSCE = 10%

Assignments = 10%

Tests = 20%

Summative

End of semester examinations = 60%

Written test = 40 %

OSCE = 20 %

PRESCRIBED READINGS

Edwards. C,Munro. J.F&Broucher.I. (2010). Davidsons Principles and Practice of Medicine .21st ed. . Edinburgh : Churchill Livingstone

Cook. C.C&Zumla A (eds), (2003). Manson’s Tropical Medicine. London : Elservier Saunders

Epstein. O., Perkin. G. D, Cookson. J& Bono P (2003). Clinical Examination. 3rd ed. London : Mosby ( Take to main medicine)

Klaussner. J. (2007). Current Diagnosis & Treatment of Sexually Transmitted Diseases: McGraw-Hill Professional Publishing

Handsfield. H. (2011). Colour Atlas & Synopsis of Sexually Transmitted Diseases, 3rd Edition: McGraw-Hill Professional Publishing


Baliga.R. R. (2004).250 Cases in Clinical Medicine . 3rd ed . London1997: Elsevier Saunders.

Collier J, Longmore M, Scally P (2003) Oxford Handbook of Clinical specialties. 6th ed. Oxford: Oxford Press.

Cook C C, Zumla A (eds), (2003). Manson’s Tropical Medicine. London : Elservier Saunders

Kumar. P& Clark. M. (2005).Kumar and Clark’s Clinical Medicine.6th ed. London :Elsevier Saunders

http://www.barnesandnoble.com/c/jeffrey-klausner

http://www.barnesandnoble.com/w/current-diagnosis-amp-treatment-of-sexually-transmitted-diseases-jeffrey-klausner/1109129376?ean=9780071456067&itm=3&usri=sexually+transmitted+diseases

http://www.barnesandnoble.com/c/hunter-handsfield

http://www.barnesandnoble.com/w/color-atlas-amp-synopsis-of-sexually-transmitted-diseases-third-edition-hunter-handsfield/1104151200?ean=9780071624374&itm=2&usri=sexually+transmitted+diseases

84

Longmore. M. Wilkinson. I, &Torok E, (2001). Handbook of Clinical Medicine.5th ed. Oxford:Oxford Press

Lucas. A. O& Gilles. H. M. (2003).Short Text Book of Public Health Medicine for the Tropics. 4thed. London: Hodder Headline Group

Monro,J.F.& Campbell, I.W.( 2000). MacLeod’s Clinical Examination: Edinburgh. Churchill

COURSE TITLE: PHARMACOLOGY& THERAPUTICS

COURSE CODE: PHM 125

AIM: To equip students with basic principles of pharmacology for appropriate clinical use of medicines.

OBJECTIVES

Define terminologies used in pharmacology

Explain the metabolism and excretion of drugs

Describe principles of drug use

Describe adverse drug reactions

Describe mechanisms of action of drugs on various body systems

Explain the mechanisms of action of antimicrobial agents

Describe mechanisms of action of drugs acting on various body systems

Describe drugs used in obstetrics and gynaecology

Describe the pharmacological management of anaemia, skin and eye conditions

Carry out pharmacological calculations

Describe standard prescription guidelines

COMPETENCIES

Describe drug metabolism and excretion

85

Demonstrate understanding of principles of drug use

Recognize and manage adverse effects of drugs

Prescribe drugs according to standard guidelines

Administer drugs in correct dosages, dosage forms and appropriate routes of administration

Appropriate use of antimicrobial agents

Describe therapeutic uses of drugs according to their indications

Administer appropriate drugs in obstetrics and gynaecology

Use pharmacological agents to manage anaemia, skin and eye conditions

Make accurate pharmacological calculations

Utilize the Essential Drugs List and the Zambia National Formulary

COURSE CONTENT

UNIT 1: BASIC PHARMACOLOGY

Pharmacokinetics

Absorption, Distribution, Metabolism and Excretion of drugs

1.2 Pharmacodynamics

Dose – response relationship

Drug receptors

Specificity of drug action

Drug interactions

Pharmacokinetic interactions

Pharmacodynamics interactions

Adverse drug reactions

Individual variation

Classification of Adverse Drug Reactions

86

Drug Formulations and Preparations

Routes of Administration of Drugs

Principles of Drug Administration

UNIT 2: AUTONOMIC NERVOUS SYSTEM PHARMACOLOGY

2.1 Drugs acting on adrenoceptors

2.2 Drugs acting on cholinoceptors

UNIT 3: CARDIOVASCULAR AND RENAL SYSTEMS

3.1 Diuretics3.2 Anti – angina drugs

3.2Anti – lipidemic drugs

3.4 Anticoagulants

3.5 Pharmacological management of heart failure

UNIT 4: ANTIMICROBIALS 4.1 Antibacterial drugs

4.2 Antifungal drugs

4.3 Antiviral drugs

4.4 Antiprotozoal drug

4.5Antihelminthics

UNIT 5: CENTRAL NERVOUS SYSTEM

5.1 Analgesics and Corticosteroids

NSAIDs

Opioids

Pharmacological management of neuropathic pain

Corticosteroids

5.2 Pharmacological Management of Arthritis and Gout

5.3 Anaesthetics

87

5.3.1 Local anaesthetics

5.3.2 General anaesthetics

Antiepileptics

UNIT 6: RESPIRATORY SYSTEM 6.1 Bronchodilators

6.2 Antihistamines

6.3 Expectorants and antitussives

6.4 Oxygen

UNIT 7: GASTROINTESTINAL TRACT

7.1 DRUGS FOR PEPTIC ULCER

7.2 H2 Receptor blockers

7.3 Proton pump inhibitors

7.4 Antacids

Laxatives

7.6 Anti-emetics

7.7 Antispasmodics

UNIT 8: ENDOCRINE SYSTEM

8.1Drugs used in Diabetes Mellitus

8.2 Antithyroid drugs

UNIT 9: DRUGS USED IN OBSTETRICS AND GYNAECOLOGY

9.1 Uterine Stimulants

9.2 Tocolytics

9.3 Induction of Labour

9.4 Termination of Pregnancy

9.5 Suppression of Lactation

88

9.6 Management of Pre-eclampsia and Eclampsia

UNIT 10: PHARMACOLOGICAL MANAGEMENT OF ANEMIA

10.1 Sickle cell anemia

10.2 Iron deficiency anemia

10.3 Aplastic anemia

UNIT 11: DRUGS ACTING ON THE SKIN

11.1 Acne

11.2 Psoriasis

11.3 Eczema

11.4 Antipruritics, Scabicides and Pediculicides

UNIT 12 DRUGS ACTING ON THE EYE

12.1 Anti – infective Agents

Ointments

Eye drops

12.2 Anti – inflammatory Agents

Corticosteroids

NSAIDs Preparations

Anti – histamines

12.3 Anti – Glaucoma Agents

12.4 Mydriatics

12.5 Local Anaesthetics

UNIT 13: PRESCRIBING

13.1 Rational Drug Use and Standard Treatment Guidelines

13.2 Guidelines on Prescription Writing

89

13.3 Basic Pharmaceutical Calculations

13.4 Essential Drugs List and the Zambia National Formulary

TEACHING METHODS AND CONTACT HOURS:

Lectures

Tutorials

Case Study

E Learning

CONTACT HOURS


ASSESSMENTS



Assignment (2) = 20%

EXAMINATIONS = 60 %

PRESCRIBED READINGS

Rang H. P et al (2011) Pharmacology 7th Edition, Churchill Livingstone, London.

Bennett P.N, Brown M.J, Sharma P. (2012). Clinical Pharmacology 11th Edition, Churchill Livingstone, London

Katzung B.G, Trevor A.J, Masters S.B. (2011) Basic and Clinical Pharmacology 12th Edition. Los Altos. Lange Medical Publications.

Woodrow R, Colbert D. J, Smith D.M (2011). Essential Pharmacology for Health Professionals, 6th Edition; New York: Delmar,


90

Brunton L.L, Chabner B.A, Knollmann B.C (2010) Goodman and Gilman’s Pharmacological Basis of Therapeutics, 12th Edition, McGraw – Hill

Boarder M, Navti P, Newby D (2010) Pharmacology for Pharmacy and the Health Sciences: A Patient – centred Approach, Oxford University Press, USA

Wells B, DiPiro J, Schwinghammer T, DiPiro C (2011) Pharmacotherapy Handbook, 8th Edition, McGraw – Hill

Rees A.J, Smith I, Smith B (2010) Introduction to Pharmaceutical Calculations, 3rd Edition, Pharmaceutical Press

British National Formulary. Regular updates

Kalant H, Grant D, Mitchell J. (2007): Principles of Medical Pharmacology

Zambia National Formulary (2013)

Ministry of Health Standard Treatment Guidelines (2013)

91

YEAR 2: Semester 1 Courses

92

COURSE TITLE: MEDICINE

COURSE CODE: MED 210

AIM

To equip students with knowledge, skills and attitude to manage common medical conditions

OBJECTIVES


2. Take detailed medical history

3. Perform physical examination

4. Order and interpret investigations

5. Demonstrate ability to manage medical conditions appropriately.

6. Demonstrate ability to identify and refer conditions beyond scope of practice a clinical officer appropriately

COMPETENCES

Describe different medical conditions

Classify communicable and non-communicable conditions


Performing physical examination in a professional manner.




Refer conditions beyond the scope of practice of a Clinical Officer General

CONTENT

UNIT 1.0 RESPIRATORY SYSTEM

1.1Applied anatomy

93

1.2 History taking and physical examination

1.3 Diseases of upper respiratory system

1.3.1 Upper respiratory tract infection

Coryza

Sinusitis

Pharyngitis

Tonsilitis

Epiglotitis

1.4Lower respiratory tract infections

Pneumonia

Bronchitis: acute and chronic

Bronchial asthma including status asthmaticus

Suppurative lung diseases

Empyema

Lung abscess

1.5 Emphysema

1.6Pneumoconiosis

1.7Pulmonary tumours

UNIT 2.0 GASTROINTESTINAL SYSTEM

2.1Applied anatomy

2.2History taking and physical examination

2.2.1 Oral conditions

2.2.1.1Candidiasis

2.2.1.2Hairyluekoplakia

2.2.1.3Opthous ulcers

2.3 Stomach:

2.3.1 Gastritis

94

2.3.2 Peptic ulcers

2.4 IIeum:

2.4.1Dysentery (amoebic and bacillary, schistosomamansoni, tape worm)

2.4.2 Intestinal candidiasis

2.4.3 Malabsorption syndrome

2.4.4Helminthic infestations (Hook worm, ascarislumbricoides, strongiloides, trichuritrichiura)

2.4.5Ileitis

2.5 Liver and Gallbladder:

2.5.1 Viral hepatitis (hepatitis A, B & C)

2.5.2 Liver cirrhosis and portal hypertension

2.5.3 Cholecystitis

2.5.4 Cholangitis

2.5.5 Liver tumours – primary and secondary

2.6 Pancreas

2.6.1 Pancreatitis: acute and chronic

2.7 Colon

2.7.1 Ulcerative colitis

2.7.2 Diverticulitis

UNIT 3 HIV and AIDS

3.1 Management of ARVS

3.1 Immunology and HIV Management

3.2 Goals and General Principles of Combined Antiretroviral Therapy (cART)

Antiretroviral information

ARV Counselling and Education

HIV Prevention

Patient Assessment

Initiating ARV Therapy

95

3.8 Management of HIV infected Populations

3.8.1 Adults

Pregnant and Breast feeding Women

3.8.3 Adolescents

3.8.4 Children

3.8.5 Co infection

3.8.5.1 Tuberculosis

3.8.5.2 Hepatitis (B & C)

Monitoring of patients on cART

3.10 Management of Opportunistic Infections

3.10.1 Guiding principles for the management of OIS

3.10.2 Introduction to Opportunistic Infections

3.10.2.1 Opportunistic infections caused by Bacteria

3.10.2.2 Opportunistic infections caused by Parasites

3.10.2.3 Opportunistic infections caused by fungi

3.10.2.4 Opportunistic infections caused by viruses

3.11 Prophylaxis

3.11.1 Post-Exposure Prophylaxis

3.11.2 Pre-Exposure Prophylaxis

3.11.3 Cotrimoxazole Prophylaxis

3.11.4 Malaria Prophylaxis

3.11.5 Tuberculosis Prophylaxis (3 Is)

3.12 HIV –associated neoplasm

3.13 Syndromic Management of Opportunistic Infections and HIV-related

conditions

Infection prevention for Health Care Providers

Record Keeping, monitoring and evaluation

96

UNIT 4 SKIN CONDITIONS

4.1 Applied anatomy


4.3 Definitions and identification of various skin lesions

4.4. Common bacterial infections

4.4.1 Impetigo

4.4.2 Folliculitis

4.5Common fungal infection

4.5.1 Pityriasisversicolor

4.5.2 Tinea corporis

4.5.3 Tinea cruris

4.5.4Tinea pedis

4.5.5Tinea capitis

4.5.6Tineaunguium

4.5.7Tineabarbae

4.5.8Candidisis

4.6 Common viral infection

4.6.1 Warts (condylomaacuminata)

4.6.2 Herpes Simplex

4.6.3 Herpes Zoster

4.6.4 Molluscum Contagious

4.7 Common parasitic infections

4.7.1 Scabies

4.7.2 Pediculosis

4.7.3 Jiggers

4.7.4 Vitiligo and albinism

4.8Bulous conditions

4.8.1 Pemphigus

97

4.9 Acne vulgaris

4.10 Dermatitis

4.10.1 Eczema

4.10.2 Exfoliative

4.10.3 Seborrhoic

4.10.4 Contact

4.10.5 Atopic Dermatitis

4.11Papulo-squamous conditions

4.11.1 psoriasis

4.12 Melanoma

4.13 Dermatological preparations

4.14Drug eruptions

TEACHING METHODS

Lectures

Case studies

Tutorials

Skills Lab

Clinical teaching

e-learning

CONTACT HOURS

Lecturers : 2 hours/ week

Practicals

ASSESSMENTS

Continuous = 40%

OSCE = 20%

98

Assignments = 5%

Tests = 15%

Examinations = 60%

Written paper = 30%

OSCE = 30%

PRESCRIBED READINGS

Edwards, C,.MunroJ, F&Broucher,I.(2010). Davidsons Principles and Practice of Medicine .17th ed. . Edinburgh : Churchill Livingstone

Lookingbill, D.P. and Marks, J.G. (1993) Principles of Dermatology .2nd ed. Philadelphia: WB Saunders Company.

MOH (2004) Antiretroviral Therapy: Reference manual for Health Workers in Zambia

MOH (2013) Management of Opportunistic infections and Neoplsams: Reference manual for Health Workers in Zambia


Baliga, R. R. (2004).250 Cases in Clinical Medicine . 3rd ed . London: Elsevier Saunders.

Cook, C. C&Zumla, A. (eds), (2003). Manson’s Tropical Medicine. London : Elservier Saunders

Kumar, P& Clark M. (2005).Kumar and Clark’s Clinical Medicine.6th ed. London :Elsevier Saunders

Longmore,M.,Wilkinson, I. &Torok, E.(2001). Handbook of Clinical Medicine.5th ed. Oxford:Oxford University Press.

Beaglehole, R., Bonita R. &Kjellstrom T. (1997).Basic Epidemiology. Geneva: WHO

Buxton,P.R. (2002). ABC of Dermatology .London: BMJ; Publishing co.

99

Collier,J., Longmore, M. &Scally,P.(2003).Oxford Handbook of Clinical specialties. 6th ed. Oxford: OxfordUnversity Press.

Lucas, A. O& Gilles, H. M,(2003).Short Text book of Public Health Medicine for the Tropics. 4thed. London: Hodder Headline Group

Munro,J.F&Campbell, I.W.(2000). Macleod’s Clinical Examination. 10th ed. Edinburgh : Churchill Livingstone

COURSE TITLE: SURGERY

COURSE CODE: SGY 210

AIM:

To equip students with knowledge, skills and attitude to manage common surgical conditions.

OBJECTIVES

Describe the overview of surgery

Demonstrates ability to take comprehensive surgical history

Describe common surgical conditions

Demonstrate ability to diagnose common surgical condition

Manage common surgical conditions in trauma

Discuss foreign bodies in surgery in the body

Describe common surgical infections

Describe infection prevention techniques

Identify common surgical complications

Refer surgical conditions beyond their scope to a higher level of care

COMPETENCES

100

Explain the overview of surgery

Take comprehensive surgical history

Performs appropriate physical examination

Orders specific laboratory and appropriate radiologic investigations

Diagnose common surgical conditions

Interprets common laboratory and specific radiological findings

Applies medico-legal aspects and medical ethics in the management of patients.

Provide or prescribe appropriate surgical treatment

Identify common surgical infections

Applyinfection prevention techniques

Performs specific minor surgical procedures, including Male Circumcision

Refer surgical conditions that cannot be managed at their level

Document and keeppatients’ records

CONTENT

UNIT 1INTRODUCTION TO SURGERY

General overview of surgery

The importance of history-taking, physical examination in surgery

The role of endoscopy, laboratory tests and radiology in the practice of surgery

1.4 Preparing a patient for surgery / management of a patient requiring surgery

1.5 Anaesthesia used in general surgery

1.6 Surgical Incisions

1.7 Sutures and suturing techniques

UNIT 2 INTRODUCTION TO TRAUMATOLOGY

101

Clinical presentation, investigations and management

Priorities of trauma management

Airway and cervical control / collar

Breathing / ventilation

Circulation and haemorrhagic shock

Disability

Exposure

Tourniquets

Intravenous fluids, blood and blood substitutes

UNIT 3 FRACTURES / DISLOCATIONS

Applied anatomy and physiology of bones

Terminology, classification, clinical presentation,investigations and management

Skull and the neck fractures

Upper limbs fractures

Chest fractures

Lower limbs fractures

Healing of fractures

UNIT 4 DERMATOLOGIC WOUNDS

Applied anatomy and physiology of the skin

4.2 Closed and open wounds

Clinical presentation and management of bruises, hematomas, abrasions, avulsions, incisions, excisions, lacerations, punctures, penetrations, amputations

Burns and grafts

Clinical presentation, classification and management of burns

Human and animal bites

Clinical presentation and management

102

Wound healing

UNIT 5 BRAIN, SPINAL CORD AND PERIPHERAL NERVE INJURIES AND INTRACRANIAL HEMATOMAS

Brain injuries

Intracranial hematomas

Clinical presentation, classification and management

Spinal injuries


Spinal shock


Nerve healing

Raised intracranial pressure

Glasgow coma scale

UNIT 6 CHEST INJURIES

Thoracic and intrathoracic injuries

Clinical presentation and management of flail chest, pneumothorax, massive haemothorax, cardiac tamponade, myocardial contusion, oesophageal perforation, aortic rupture

UNIT 7 ABDOMINAL AND PELVIC INJURIES

Abdominal and Intra-abdominal injuries

Pelvic injuries

Clinical presentation and management of injuries to hollow and solid organs

UNIT 8 SURGICAL INFECTIONS OF THE SKIN AND SUBCUTANEOUS TISSUES


Inflammation and its natural history

Abscess, furuncle, carbuncle, cellulitis, erysipelas, pyomyositis, gasgangrene, necrotizing fasciitis and septicaemia

103


Hand infections


UNIT 9 ULCERS


Decubitus ulcer

Diabetic ulcer

4.2.1 Clinical presentation and management

UNIT 10 FOREIGN BODIES

Foreign bodies: in the oesophagus, stomach, bowels, foot and hand


UNIT 11 MUSCULO-SKELETAL DISORDERS

11.2 Backache, septic arthritis, osteoarthritis, osteomyelitis, osteoporosis, sciatica, pathological fractures

11.3.1 Clinical presentation and management

UNIT 12NEOPLASMS OF THE SKIN & SUBCUTANEOUS TISSUES

Applied anatomy and physiology

General principles of tumours

Squamous cell carcinoma, basal cell and malignant melanoma


UNIT 13 COMMON GENERAL SURGICAL PROCEDURES

Diagnostic peritoneal lavage

Insertion of under-water seal drainage

104

Thoracocentesis / pleuricentesis

Pericardiocentesis

Tracheostomy

Thoracotomy

Needle and surgical cricothyroidotomy

Endoscopy: thoracoscopy, laparoscopy, esophagogastro-duodenoscopy (EGD)

Barium meal, barium swallow, barium follow through, barium enema

Endotracheal intubation

Cystoscopy

Laparotomy

UNIT 11 COMMON PROCEDURES

History-taking and physical examination

Intermittent suturing

Removal of sutures

Incision and drainage

Ear examination

Anterior nasal packing

Ear toileting and syringing

Examination of the nose

Removal of foreign body from the nose / ear

Needle cricothyroidectomy

Glasgow coma scale

History taking and oral dental examination

Tooth extraction

History taking and ophthalmic examination

Eye irrigation

Removal of foreign body from the eye

105

Application of eye drops

Visual acuity

Eye bandaging

Male circumcision

UNIT 14 INTRODUCTION TO DENTISTRY

Applied anatomy and physiology in dentistry

Clinical oro-dental history, examination and investigations

Common oro-dental clinical features

Oro-dental examination techniques and diagnostic tests

UNIT 15 ORO-DENTAL DISEASES

Stomatitis, dental caries, candidiasis, oral hairy leukoplakia, dental abscess, gingivitis and periodontitis, periodontal abscess, coronitis, pericoronitis, pulpitis, Vincent ulcerative gingivitis, stomatitis, herpetic ulcers, alphthous ulcers

UNIT 16 ORAL DENTAL ANAESTHESIA

Oral dental anaesthesia

UNIT 17 TOOTH EXTRACTIONS

Indications and contraindications

Complications of tooth extractions

Techniques of tooth extractions

Home care instructions

UNIT 18 DENTAL INSTRUMENTS

Dental instruments

106

UNIT 19 ORAL HYGIENE

Methods of tooth brushing

Fluoridation

UNIT 20 CONSERVATIVE DENTAL CARE (TREATMENT)

Dental fillings and prostheses

Extraction of impacted molar tooth

UNIT 21 FACIAL INJURIES

Fracture of the mandible and maxilla


Other facial injuries

UNIT 22 OSTEOMYELITIS OF THE MAXILLO-FACIAL BONES

Osteomyelitis of maxilla and mandible



Tooth extraction

Tooth-brushing

Tooth-filling

Glossing

TEACHING METHODS

Lectures

Tutorials

Skills lab

107

Case studies

Clinical teaching

e-Learning

CONTACT HOURS:


Skills lab: 4 hours/week

ASSESSMENT:



Assignment (1) = 5%

Skills Lab = 20%

Final Examination = 60%

Written = 30%

OSCE = 30%

PRESCRIBED READINGS

Rains, H., and Richie, D. (2003) Bailey, Hamilton, Bailey & Love's Short practice of surgery, London: H. K. (26th Ed.) Boca Raton, FLa.

Hamblen, D. L., Hamish, A., Simpson, R. W., Adams, C. J. (2007).Outline of Fractures, (12th Ed.), Churchill Livingstone Elsevier

Bhat, S. R.(2012). SRB’s Manual of Surgery (4th Ed.), Jaypee Brothers Medical Publishers, Inc.

Pedlar, J., Frame, J. W., (2003) Oral and maxilla-facial surgery/radiology (3rd Ed.), British Library Cataloguing. Tottenham, London


108

Clain, A. (2012) Hamilton’s Bailey’sDemonstration of Physical signs in Clinical Surgery (15th Ed.) Butterworth-Heinemann, Oxford

King, C., Bewes A.O., Cairns, J. (1984). Primary Surgery, Vol. 1 Non Trauma, Vol. 2 Trauma, , AMREF

Townsend,M.S, (2012), Sabiston’s Textbook of Surgery (19th Ed.) Saunders.

MoH Male Circumcision Guidelines, 2008

Malamed, F. (2003) Local anaesthesia (4th Ed.), USA

109

COURSE TITLE: OBSTETRICS AND GYNAECOLOGY

COURSE CODE: OBG 210

Course Aim

To equip students with the knowledge, skills and attitudes in management of common conditions in gynaecology.

Objectives

Take a comprehensive gynaecological history

Examine a patient with gynaecological pathologies

Describe common gynaecological conditions

Interpret gynaecological clinical findings precisely

Order appropriate investigations

Demonstrate ability to manage appropriately common obstetric and gynaecological conditions

Competencies

Relates relevant principles of basic sciences to gynaecological conditions.

Demonstrates essential skills in gynaecological history taking and clinical examinations.

Identifies common gynaecological conditions

Orders and interprets laboratory and radiological investigations

Performs basic emergency obstetric neonatal care (Bemonc) procedures

Treats common gynaecological conditions

Demonstrates appropriate professionalism and ethical conduct towards care of gynaecology patients.

Refers timely all gynaecological conditions outside the scope of practice

Course Content

UNIT 1 Gynaecological history taking and physical examination

UNIT 2 Fertility problems

110

Endocrine disorders

Amenorrhoea

Primary

Secondary

UNIT 3.Disorders of the menstrual cycle

Dysmenorrhoea

3.2.1 Primary

3.2. 2 Secondary

Menorrhagia

Metrorrhagia

Menopausal problems

UNIT 4 Menstrual disorders

Endocrine disorders

Anatomical disorders

Functional disorders

UNIT 5 Infections

Vulvo-vaginal

Cervical, endometrial

Pelvic Inflammatory Disease

Acute PID

Chronic PID`

STIs in Gynaecology and Obstetrics

Vaginal candidadiasis,

Human Papiloma Virus

Trichomoniasis,

Bacterial Vagnosis

111

UNIT 6 Tumors (benign and malignant)

Tumors of the vulva

Tumors of the vagina

Tumors of the cervix

Tumors of the uterus

Tumors of the ovaries and fallopian tubes

UNIT 6 Genital prolapse

Cystocele

Rectocele

Descensus of the uterus

UNIT 7 Incontinence

Stress-incontinence

Urge-incontinence

Vesico-vaginal fistula

Recto-vaginal fistula

UNIT 9 Gynaecological operations/procedures

Anaesthesia (Local, Cervical block)

Vaginal Speculum Examination

Pelvic Examination

Manual vacuum aspiration

Manual removal of the products of conception

Bartholin Cyst incision and drainage

Visual inspection with acetic acid

Pap smear collection

112

Cervix biopsy/cauterisation

TEACHING METHODS

Lectures Discussions

Clinical skill training (Skills lab, Maternal Units)

Assignments

Group discussions

CONTACT HOURS

4hours/week

Practical

ASSESSMENT METHODS

Continuous assessment: 40%

Written tests (2) 20%

Assignments 10%

Skills lab 10%

Final examination: 60%

Written examination 30%

OSCE 30%

Prescribed Books

Malcolm, S.,Ian M. Symonds (2006) Essential Obstetrics and Gynaecology 4th edition. Edinburgh: Churchill Livingstone

Stanley G. Clayton , Ash Monga. (2006) Gynaecology by Ten Teachers. 18 Edition. London: Hodder Arnold

World Health Organization (2003) Managing Complications in Pregnancy and Childbirth. Geneva: World Health Organization

World Health Organization (2010) Family Planning. Geneva: World Health Organization

Recommended Books

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Stanley%20G.%20Clayton

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Ash%20Monga

113

Neville Hacker, J.George Moore, Joseph Gambone. (2004) Essentials of Obstetrics and Gynaecology.4th Edition. India:Elsevier.

Robert W., Shaw, W., Patrick Soutter and Stuart L Stanton (2000)Gynaecology. Edinburgh:Churchill Livingstone.

Arulkumaran, S., I. Symonds, A. Fowlie (2003) Oxford Handbook of Obstetrics and Gynaecology. Oxford: Oxford University Press.

Arulkumaran, S. (2006) Emergencies in Obstetrics and Gynaecology. Oxford:Oxford University Press.

Jeremy Oats, Suzanne Abraham (2005) Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology.8thEdition.Oxford: Elsevier Mosby.

Govan ADT (2000); Gynaecology Illustrated, 4th edition, Churchill Livingstone

Brandon J, Bankowski at el (2013) John Hopkins manual of Obstetrics and Gynaecology. Lippincott: Williams and Wilkins Publishers.


114

COURSE TITLE: PAEDIATRICS

COURSE CODE: PED 210

AIM

To equip students with the knowledge and skills of management of common conditions in paediatrics

OBJECTIVES

Take a detailed history and perform physical examination.

Order and interpret investigations appropriately

Manage patients with paediatric conditions correctly

Give health education and promotion

List activities of components of child health services

State causes of common paediatric conditions

Demonstrate ability to manage child health services

Identify abnormalities concerning growth and development in children.

COMPETENCES:

Take a comprehensive paediatric history

Perform a physical examination in paediatrics.

Diagnose paediatric conditions

Order and interpret investigations

Manage paediatric conditions

Collect and utilize health information in order to provide preventive, promotive, and rehabilitative services

Referpaediatric conditions to appropriate levels

Interpret under five children’s clinic card

Identify abnormalities concerning growth and development of children

115

Provide preventive, promotive, and rehabilitative services for paediatric conditions with professionalism.

CONTENT

INTRODUCTION TO GENERAL PAEDIATRICS

UNIT1.Overview of paediatrics

Definitions

Scope and history of paediatrics

UNIT2.History taking and physical examination

UNIT3. Growth and development

Physical growth:

3.1.1 Height

3.1.2 Weight

3.1.3 Head circumference

3.1.4 Mid upper arm circumference

3.1.5 Dentition

Failure to thrive

Developmental milestones:

3.3.1 Motor

3.3.2 Social and cognitive

Sexual development

3.4.1 Puberty

3.4.2 Praecox

3.4.3 Delayed

116

UNIT4. Nutritional Disorders

History Taking And Physical Examination

Malnutrition

Classification of malnutrition

Kwashiorkor

Marasmus

Marasmickwashiorkor

Vitamin deficiencies:

Vitamin D

Vitamin A

Vitamin C

INTRODUCTION TO NEONATOLOGY

UNIT1.Examination of the new born

Assessment of the new born

Congenital abnormalities

UNIT2. Emergencies of the new-born:

Birth asphyxia

2.2 Respiratory distress syndrome

Hypoglycaemia

Hypothermia

UNIT3. Abnormalities of birth weight

Low birth weight

117

Prematurity

Small for dates/very small for dates

Large for dates

UNIT4. Haemorrhagic conditions of the newborn

Vitamin K deficiency

Thrombocytopenia

UNIT5.Neonatal jaundice

5.1 Physiological

5.2 Pathological

5.3 Biliary atresia

5.4 Kernicterus

UNIT6. Birth injuries:

Cephalo- haematoma

Peripheral nerve injuries

Fractures

Calputsuccedenum

UNIT7. Congenital malformations

7.1. Cleft palate/lip

7.2. Imperforate anumicrocephaly-hydrocephalus

7.3 Meningocele-menigomyelocele

7.4 Spinal bifida

7.5 Polydactyl

7.6Talipes

7.7 Cystic fibrosis

118

7.8 Hypo/epispadius

UNIT8. Infections in the new-born

Amniotic infection syndrome

Septicaemia

Meningitis

Neonatal tetanus

Umbilical infection

STIs: ophthalmianeonatorum,

Syphilis

Skin infections

Thrush

8.9 Hepatitis

CHILD HEALTH SERVICES

UNIT 9. Child health services

9.1 Growth monitoring

9.2 Immunization schedule

9.3 Nutrition rehabilitation

UNIT 10.Immunisable conditions in children

10.1 Measles

10. 2 Poliomyelitis

10.3 Whooping cough

10.4 Diphtheria

10.5 Tetanus

10.6 Tuberculosis

10.7 Hepatitis B

119

10.8 Rota virus diarrhoea

10.9 Pneumococcal pneumonia

10.10Haemophilusinfluenzae

Procedures

History taking

Physical examination

Nasogastric tube insertion

Nebulisation

Cannulation

Scalp vein cannulation

CPR

Oxygen administration

Suprapubic puncture

Catheterisation

Referral

TEACHING METHODS

Lectures/discussion/demonstration

Tutorials

Skills lab

Case studies

Role plays

e-Learning

CONTACT HOURS

120

Lectures : 4 hours / week

practical

ASSESSMENT




Skills Lab = 10%


Written = 40%

OSCE = 20

PRESCRIBED READINGS

Behrman R. E., Kliegman R. M., Jenson H. B. (2013).Nelson’s Textbook of Paediatrics, Ed. sanders publishers, USA.

Jelife D.B. and Stanfield J.P (1990).Diseases of Children in Subtropicsand Tropics 3rd Edition. London: The English Language Book Society and Edward Arnold Publishers..

Marcdante, K and others (2011),Nelson Essentials of Paediatrics. 6th Edition. Philadelphia: Saunders Elsevier.


Hendricke R.G., Barr D.G.&Mattews T.(1991).Paediatrics in the Tropics.1stEdition,Blackwell Scientific Publications

Sidewell, U. (2011).Easypaediatrics. London: Holdder

Stanfied, P. &Bwibo, N. (2005).Child health: A manual for medical and health workers in healthcentrer and rural hospitals.3rd ed. Nairobi: AMREF.

Wardlaw. G.M. (2011).Contemporary Nutrition. 8thed. New York: McGraw Hill

Anillenmar A.C. (2012). Paediatrics E-mcq: Sauparnika

Tortora G, J, Derrickson V.B (2011).Principles of anatomy and physiology. Vol. 2. 13th ed. John Wiley and sons

121

Crocetti, M..&Barone, M. (2004) Oski’s Essential Paediatrics. London: Lippincott Williams & Wilkins

Rudolph, A. Kamei, R.&Oveby, K. (2002) Rudolph’s Fundamentals of Paediatric. 3rd Edition. New York: McGraw-Hill ( No initials)

IMCI manuals

122

COURSE TITLE : MENTAL HEALTH AND CLINICAL PSYCHIATRY

COURSE CODE : MHP 210

AIM :

To equip students with the knowledge, skills and attitudes to manage mental disorders

OBJECTIVES

Describe the historical background of psychiatry

Discuss the concepts of normality and abnormality

Explain the common terminologies used in psychiatry

Describecommon mental disorders

Explain theories of aetiology of mental disorders

Demonstrate the ability to assess a patient with a mental disorder

Diagnose a patient with mental disorder

Identify medical-legal issues in mental health practice

Discuss management of mental disorders using the bio-psychosocial model of care.

COMPETENCES

Take comprehensive psychiatric history

Distinguish normal and abnormal behaviour

Apply theories of aetiology of mental disorders

Classify common mentaldisorders

Identify symptoms of mental disorders

Diagnose psychiatry conditions

Communicate effectively with patients and caregiversManage cases appropriately using the bio-psychosocial model

COURSE CONTENT:

123

UNIT 1: INTRODUCTION

1.1 History of psychiatry

1.2 Concepts of normality versus abnormality

1.3 Bio psychosocial theory of aetiology and management of mental disorders

1.4 Classification and diagnostic criteria of mental disorders

1.5 Mental illness and the law in Zambia

UNIT 2: COMMON TERMS USED IN PSYCHIATRY

Psychiatric signs and symptoms

Disorder of perception

Disorder of emotion

Disorder of Thought

Disorder of speech

Disorder of Memory

Motor disorder

Disorder of Consciousness

UNIT 3: PSYCHIATRIC (DIAGNOSTIC) INTERVIEW

Psychiatric case History

Mental State Examination

UNIT 4: ORGANIC MENTAL DISORDERS

Dementia

Dysmnesic syndrome

Delirium

UNIT 5: DISORDERS DUE TO PSYCHOACTIVE SUBSTANCES

124

Disorders due to use of alcohol

Disorders due to use to opioids, cannabis, cocaine, sedatives (hypnotics)

UNIT 6: SCHIZOPHRENIA, SCHIZO TYPE AND DELUSIONAL DISORDERS

Schizophrenia and types

Schizo-affective disorders

Delusional disorder

UNIT 7: MOOD (AFFECTIVE) DISORDERS

Manic episode

Bipolar affective disorders

Depressive episode

UNIT 8: PROCEDURES

8.1 History Taking

8.2 Diagnostic interview

8.3 Mental State Examination

8.4 Mini Mental State Examination

8.5 Clinical Presentation

8.6 Psycho-education

8.7 Physical restraint of an acute psychotic patient

8.8 Admission

8.9 Review

8.10 Referral

TEACHING METHODS

Lecture

Group Discussions

125

Tutorial

Skills Lab

Case study

e-Learning

CONTACT HOURS

Lectures : 2 hours /week

Practical

ASSESSMENTS

Continuous Assessment 40%

Written Test (2) = 15%

OSCE = 15%


Examination 60%

Written 40%

OSCE 20%

PRESCRIBED READINGS

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed). Washington, DC: American Psychiatric Association Press.

Gelder, M., Mayou, R., Harrison, P. & Cowen, P. (2005). Oxford Textbook of Psychiatry. Oxford: Oxford University

Saddock, B. J. & Saddock, V. A. (2009). Kaplan and Saddock’s Comprehensive Textbook of Psychiatry (2 volumes). London: Lippincott Williams & Wilkins.

126

World Health Organization (2010). ICD 10 Classification of Mental and Behavioural Disorders. Oxford: Oxford University Press


Ahuja, N. (2006).A Short Textbook of Psychiatry.7th Edition. New Delhi: Jaypee Brothers Publishers.

Andreasen N. C. & Black, D. W. Eds. (2010) Introductory Textbook of Psychiatry. New York: American Psychiatric Publication.

Birnkrant, J. &Carlsen, A. (2007). Crash Course: Psychiatry. Philadephia: Mosby Elsevier.

Oakley, C. (2010). Rapid Psychiatry, 2nd Ed. London: Wiley-Blackwell

Robertson, B. Allwood, C., &Gagiano C. (Eds) (2001). Textbook of Psychiatry for Southern Africa. Cape Town: Oxford University Press.

Sadock, B. J. & Sadock, V. A. (2001). Kaplan &Sadock’s Pocket handbook of Clinical Psychiatry, 3rd Ed. Baltimore: Lippincott Williams & Wilkins.

127

COURSE TITLE : PRIMARY HEALTH CARE

COURSE CODE : PHC 210

AIM

To equip students with knowledge, attitudes and skills on basic concepts and principles of community health

OBJECTIVES

Describe common health problems in the community.

Identify Health priorities in the community by carrying out research

Demonstrate skills on Planning Community Health Services

Apply control interventions for community health problems

Discuss concepts and principles of Primary Health Care.

Demonstrate skills to collaborate with stakeholders in carrying out community health activities

COMPETENCIES

Carry out simple research inthecommunity

Calculate epidemiological rates

Mobilise the community members

Plan for community health programmes

Carry out community health services

Conduct community sensitisation activities

Participate in School Health programmes

Facilitate provision of safe water and sanitation.

Carry out Expanded immunisation programme

Treat common health problems

Document all community health activities

Coordinate with other stakeholders in community health programmes

Conduct research

Analyse research findings

128

Writeresearch report.

CONTENT

UNIT1. EPIDEMIOLOGY

1.0 INTRODUCTION TO EPIDEMIOLOGY

1.1 Concept of Epidemiology

1.2 Definitions

1.3 Terminologies

1.4 Objectives

UNIT2. NATURAL HISTORY OF DISEASE

2.1 Epidemics

2.1.1 Definition 2.1.2 Speed of spread 2.1.3. Prevalence 2.1.4 Mode of transmission 2.1.5 Management and control of epidemics

2.2 Levels of disease prevention 2.2.1 Primary Prevention 2.2.2 Secondary Prevention 2.2.3 Tertiary Prevention

UNIT 3. SCREENING TESTS 3.1 Validity 3.2 Reliability 3.3 Sensitivity 3.4 Predictive Value

UNIT 4. EPIDEMIOLOGICAL STUDIES 4.1 Research designs 4.2 Qualitative and quantitative approaches

129

UNIT 5. EPIDEMIOLOGICAL CALCULATIONS

5.1 Measures of central tendency i Mean

iiMode

iiiMedian

5.2 Morbidity rates/ratios

5.3 Mortality rates

5.4 Incidence rate

5.5 Prevalence

5.6 Case fatality rate

5.7 Crude birth rate

5.8 Crude death rate

5.9 Infant mortality rate

5.10 Fertility rate

5.11 Child mortality rate

5.12 Maternal mortality rate

UNIT 6. INTEGRATED DISEASE SURVEILLANCE6.1 Epidemiology of infectious and 6.2 non-infectious diseases

UNIT 7. DEMOGRAPHY

7.0 INTRODUCTION TO DEMOGRAPHY 7.1 Definition 7.2 Objectives

7.3 Population distribution 7.4 Population pyramid 7.5 Census 7.5.1 Population growth

UNIT 8. APPLIED RESEARCH

130

8.0 Introduction to Applied Research8.1 Definition of Research8.2 Selecting research topic8.3 Problem Statement and Justification 8.4 Literature review8.5 Hypothesis and objectives8.6 Identification of variables 8.9 Methodology 8.9.1 Sampling and sample size determination 8.9.2 Data collection tools /techniques 8.9.3 Pilot study8.10 Data collection 8.11 Data Processing8.12 Analysis8.13 Interpretation8.14 Reporting8.15 Dissemination

UNIT 9.PRIMARY HEALTH CARE

9.0 Introduction To Primary Health Care 9.1 Definition

9.2 Concept of PHC

9.3 Types of PHC 9.4 Principles of PHC

9.5 Elements of PHC

9.6 Ethical issues in community health9.7 Primary Health Care in Zambia

Organisation of Health services in Zambia

PHC Programmes

School Health Services

Expanded Programme of Immunisation

Water and Sanitation

UNIT 10. Community participation and Health

10.1 Definition

10.2 Types of participation

10.3 Principles of participation

UNIT 11. Strategies in Primary Health Care

11.1 Community participation

11.2 Self-reliance

11.3 Social mobilisation

11.4 Intersectoral collaboration

UNIT 12. Community Health workers

131

12.1 Definition

12.2 Types of Community Health Workers

12.3 Selection of Community Health Workers

12.4 Training of Community Health Workers

UNIT13 Community Diagnosis

13.1 Definition

13.2 Purpose of Community Diagnosis

13.3 Tools used in Community Diagnosis

13.4 Steps for conducting Community Diagnosis.

TEACHING METHODS

Lecture discussion

Group Discussion

Tutorials

Field visits

CONTACT HOURS

Lectures: 2 hours /week

ASSESSMENTS 40%

Test 20%

Practical 20%

Examination 60%

132

Research project 20%

Written exam 40%

PRESCRIBED BOOKS

Naidoo, Initial (2010). Developing Public Health and Health Promotion. London: Elsevier

Cowley ,Initial (2008)(2nd edition). Community Public Health in Policy and Practice. London: Elsevier Ltd.

James, M, Robert P. &Jerome, E. (2008). Introduction to Community Health. (sixth edition). Jones and Barlett Learning. Amazon

Kothari,C. R. (2004). Research methodology methods and Techniques. New Delhi: New Age International (P) Limited Publishers

RECOMMENDED BOOKS

J. Mcdonald (1994). Primary Health Care Medicine in its place.

Naidoo. J and Wills. J (2005). Public Health and Health Promotion Developing Practice. London: Bailliere

Wood. C (2008). Community Health. The African Medical and Research Foundation. Nairobi.

Allender.Judith,Rector.Cherie and Warner. Kristine (2013). Community and Public Health Nursing: Promoting Public’s Health. Amazon.

133

YEAR2: Semester 2 Courses

134

COURSE TITLE: MEDICINE

COURSE CODE: MED 220

AIM

The course aims to consolidate clinical skills and ability for basic medical knowledge to elicit and interpret disease signs and symptoms at a level appropriate for a GCO

OBJECTIVES


2. Take detailed medical history

3. Perform physical examination

4. Order and interpret investigations

5. Manage medical conditions appropriately.

6. Refer conditions beyond scope of a clinical officer appropriately

COMPETENCIES

Describe different medical conditions

Classify communicable and non-communicable conditions


135

Performing physical examination in a professional manner.




Refer conditions beyond the scope of practice of a Clinical Officer General

UNIT 1 : CARDIO VASCULAR SYSTEM

1.1. Applied Anatomy

1.2 History and physical examination

1.3 Congestive Cardiac Failure and Pulmonary Oedema

1.4 Ischaemic Heart disease

1.4.1.Angina

1.4.2.Myocardial infarction

1.5 Hypertension

1.6 Rheumatic fever and Rheumatic Cardiac Disease

1.7 Infective Cardiac Diseases

1.7.1. Endocardits

1.7.2 Myocarditis

1.7.3.Pericarditis

1.7.4.Cardiomyopathy

1.8 Arrhythmias.

UNIT 2.0 GENITO-URINARY SYSTEM

2.1 Applied Anatomy


136

2.3 Common conditions

2.4 Kidney

2.4. 1. Nephrotic Syndrome

2.4.2Glomerulo nephritis,

2.3. 3 Renal Failure: Acute and Chronic

2.3. 4 Pyelonephritis

2.3.5 Ureter and Bladder

2.3.5.1 Cystitis

Unit 3. ENDOCRINE SYSTEM

3.1 Applied Anatomy


3.3 Cushing’s syndrome

3.4 Parathyroid


3.5 Diabetis insipidius

3.6 Hyper- and hypothyroidism

UNIT 4. HAEMATOPOETIC AND LYMPHATIC SYSTEM

4.1Applied Anatomy


4.3 Anaemia

4.4 Leukemia

4.5 Lymphomas

4.5.1 Hodgkin

4.5.2 Non-Hodgkin’s

4.6 Haemorrhagic disorders

4.6.1 Hypovitaminosis K.

137

4.6.2 Haemophilia

4.6.3 Thrombocytopenia

UNIT 5. CENTRAL NERVOUS SYSTEM

5.1 Applied anatomy

5.2 History and physical Examination

5.3 Meningitis

5.4 Encephalitis

5.5 Epilepsy

5.6 Cerebro -vascular accidents

5.7 Motor neuron diseases

UNIT 6 .0 MUSCULOSKELETAL SYSTEM

6.1 Applied anatomy


6.3 Arthritis, Rheumatoid

6.4 Arthrosis,

6.5 Gout

6.6 Lumbago and sciatica

TEACHING METHODS

Lectures

Case studies

Tutorials

Skills Lab

Clinical practice

e-Learning

CONTACT HOURS

Lectures: 2 hours /week

Practice

138

ASSESSMENTS

Continuous = 40%

OSCE = 20%

Assignments = 5%

Tests = 15%

Examinations = 60%

Written paper = 30%

OSCE = 30%

PRESCRIBED READINGS

1.Edwards,C.,Munro, B & ,Broucher.I.(2010).Davidsons Principles and Practice of Medicine .21st ed. . Edinburgh : Churchill Livingstone

2. Cook,C.C,&Zumla.A (eds), (2003). Manson’s Tropical Medicine. London :Elservier Saunders

3.Kumar, P& Clark, M.(2005).Kumar and Clark’s Clinical Medicine.6th ed. London :Elsevier Saunders


1.Baliga R R (2004).250 Cases in Clinical Medicine . 3rd ed . London: Elsevier Saunders.

2.Longmore M. Wilkinson I, Torok E, (2001). Handbook of Clinical Medicine.5th ed. Oxford:Oxford Press.

3.Beaglehole R., Bonita R. and Kjellstrom T. (1997) Basic Epidemiology, WHO, Geneva 1993.

4.Lookingbill, D.P. and Marks, J.G. (1993) Principles of Dermatology .2nd ed. Philadelphia: WB Saunders Company.

5.Buxton PR (2002) ABC of Dermatology .London: BMJ; Publishing co.

6.Collier J, Longmore M, Scally P (2003) Oxford Handbook of Clinical specialties. 6th ed. Oxford: Oxford Press.

139

7.Lucas A O, Gilles H M,(2003) Short Text book of Public Health Medicine for the Tropics. 4thed. London: Hodder Headline Group

8.Epstein O , Perkin G D , Cookson J, Bono P (2003) Clinical Examination. 3rd ed. London : Mosby ( Take to main medicine)

9.Hira, B et al. (1997) Sexually Transmitted Diseases: A training manual for health workers.

140



UNIT 1

1.0 Introduction

Applied anatomy & physiology of the peritoneum and abdominal viscera

Surgical history-taking & physical examination

Appropriate laboratory & radiological investigations

UNIT 2

2.0 Clinical presentation and management of: 2.1 Surgical complications of peptic ulcer disease (PUD) 2.2Acute appendicitis, cholecystitis, cholangitis and pancreatitis; pancreatic

carcinoma and cholelithiasis; choledocholithiasis

2.3 Surgical jaundice 2.4 Peritonitis

2.5 Mechanical intestinal obstruction and paralytic ilSigmoid volvulus,

intussusception and Ascariasis2.6 Intra-abdominal abscesses: liver abscess; splenic abscess; subphrenicabscess

UNIT 3

3.0 Description, classification, clinical presentation and management of 3.1 Pyloric stenosis and liver abscess 3.2 Abdominal hernias: inguinal, incisional and femoral 3.4 Haemorrhoids, ano-rectal abscesses; ano-rectal fistulae; fissure-in-ano 3.5 Tumours of the thyroid, oesophagus, stomach, small bowel, colon and ano-

rectal area 3.6 Sinus and fistula

UNIT 4 4.0 Urological conditions 4.1 Kidney: Stones (nephrolithiasis); hydro-nephrosis; tumours

4.2 Ureteric stones: hydro-ureters

4.3 Urinary bladder: stones; schistosomiasis; tumours

141

UNIT 5

5.0 Prostate gland 5.1 Prostatitis

5.1.1 Benign Prostatic Hyperplasia 5.1.2 Carcinoma prostate

5.2 Scrotal swellings

5.2.1 Hydrocoele

5.2.2 Varicocoele; sebacious cysts, tumours5.3Urethra

5.3.1 Urethral strictur5.3.2 Epispadias; hypospadias

5.3.3 Urinary incontinence 5.3.4 Urinary retention: acute and chronic

5.4 Testis and epididymis

5.4.1 Epididymo-orchitis

5.4.2 Cryptorchidism / retractile

5.4.3 Testicular torsion

5.4.4 Tumours

5.5 Penis:

5.5.1penile fracture

5.5.2 priapism

5.5.3 phimosis

5.5.4 Paraphimosis

5.5.5 Tumours

UNIT 6

6.0 Conditions of the breast

6.1 Applied anatomy and physiology of the breast6.2 Comprehensive history of breast conditions

6.3 Physical examination of the breast

6.4 Breast investigations: needle biopsy, mammography

6.5 Mastitis; abscesses

6.6 Tumours: fibroadenomas, cysts, breast carcinoma

142

6.7 Special investigations / procedures

UNIT 7

7.0 Common procedures 7.1 Naso or oro-gastric tube (NGT) insertion, aspiration, feeding

7.2 Colostomy care

7.3 Colostomy / iliostomy / Gastrostomy care

7.4 Gastric / rectal lavage

7.5 Diagnostic peritoneal lavage – DPL

7.6 Enema

7.7Abdominal and chest X-rays

7.8 Ultrasonography scan (USS)

7.9 Endoscopy: laparoscopy, esophagogastroduodenoscopy (EGD),

proctoscopy, sigmoidoscopy, cystoscopy

7.10 Barium swallow, barium meal, barium meal & follow-through, barium

enema

7.11 Male circumcision (MC)

7.12 Urethral and prepucial dilatation

7.13 Cystoscopy

7.14 Catheterization

7.15 Suprapubiccystostomy and aspiration

7.16 Vasectomy

7.17 Sperm count, prostatic specific antigen (PSA)7.18Plain abdominal X-ray (KUB)

7.19Ultra Sound Scan

7.20 Mammography

7.21 Biopsies

UNIT 8EAR, NOSE AND THROAT

8.0 Introduction to conditions of the ear, nose, sinuses and throat

143

8.1 Applied anatomy and physiology of the ear, nose, sinuses and throat

8.2 Clinical ENT history, examination and investigations

8.3 Common ENT clinical features

UNIT 9

9.0 CONDITIONS OF THE EAR 9.1 Otitis Externa 9.2 Auricular hematoma 9.3 Furunculosis 9.4 Otitis media: acute and chronic otitis media 9.5 Mastoiditis 9.6 Wax impaction9.7 Foreign body in the external auditory meatus9.8 Deafness and impaired hearing and hearing devices

9.9 Basal skull (anterior and middle cranial fossa) fractures: diagnosis and management

UNIT 10

10.1 CONDITIONS OF THE NOSE & SINUSES

10.2 Rhinitis

10.3 Sinusitis

10.4 Nasal polyps

10.5 Foreign bodies in the nostrils

10.6 Epistaxis

10.7 Injuries to the nose: perforation of nasal septum, nasal bone fracture, alae

wounds

10.8 Maxillary and mandibular fractures: diagnosis and management

UNIT 11

11.1 CONDITIONS OF THE THROAT

11.2 Acute epiglottitis

11.3 Croup (laryngotracheo-bronchitis - LTB)

11.4 Ludwig’s angina, laryngitis, pharyngitis, tracheitis, tonsillitis and tonsillectomy, peri-tonsillar abscess (Quinsy)

11.5 Foreign body in the throat

11.6 Retropharyngeal abscess

11.7 Trauma to the throat trauma

11.8Tracheostomy

144

11.9 Tumours

UNIT 12

12.0 Common procedures:

12.1 Cricothyroidotomy, needle

12.2 Endotracheal intubation

12.3 Insertion of oro-airway and NGT

12.4 Tracheostomy

12.5 Tracheostomy care

UNIT 13: OPHTHALMOLOGY

Introduction to conditions of the eye

Applied anatomy and physiology of the eye

Common eye clinical symptoms and signs, clinical examination and investigations of the eye

UNIT 14

Conditions of the conjunctiva: conjunctivitis: bacterial, chlamydial, viral, allergic, toxic; pterygium, trachoma, tumours

UNIT 15

Conditions of the eyelids: hordeolum, chalazion, entropion and ectropion, ptosis

UNIT 16

Conditions of the cornea: corneal foreign body, keratitis, corneal ulcers, acute red eye, xerophthalmia

UNIT 17

Conditions of the posterior segment:uveitis, glaucoma, cataract, diabetes retinopathy

145

UNIT 18

Refractive errors: myopia, hypermetropia, presbyopia, astigmatism, aphakia, ophthalmic optics

UNIT 19

HIV/AIDS and the eye: herpes simplex, herpes zoster ophthalmicus, Kaposi’s sarcoma, cytomegalovirus retinitis, retinal toxoplasmosis

UNIT 20

20.1 Ocular trauma: 20.2 Blunt and penetrating

20.3 Orbital fractures: diagnosis and their management

UNIT 21

21.0 Common procedures:

21.1 Cricothyroidotomy, needle

21.2 Endotracheal intubation21.3 Insertion of oro-airway and NGT

21.4 Tracheostomy


TEACHING METHODS

Lectures

Skills lab

Case studies

e-Learning

Discussions

Clinical presentations

Bed side teaching

Role plays

CONTACT HOURS

146

Lectures: 8 hours/ week

Practice 4 hours/week

ASSESSMENT:



Assignment (1) = 5%

Skills Lab = 20%


WRITTEN = 40%

OSCE = 20%

147

PRESCRIBED READINGS

Bailey, Hamilton, Bailey & Love's( 2013).Short practice of surgery. London: Publisher ?

Allan Clain, Hamilton’s Bailey’s Demonstration of Physical signs in Clinical Surgery, 2012, 17th Edition, ButterWorth-Heinemann, Oxford

Muhammad Magbool, SuhailMagbool and Suresh C. Sharma, Textbook of Ear Nose and Throat Diseases, 2013, 12th Edition, Jaypee Medical Publishers, Inc.

P. L. Dhingra and ShrutiDhingra, Diseases of The Ear Nose and Throat, 5th Edition, 2013, Elsevier

Jack J. Kanski, Brad Bowling, Kanski, Clinical Ophthalmology, 2011, 7th Edition, Elsevier Saunders

H. V. Nema, NitinNema, Textbook of ophthalmology, 2012, 6th Edition, Jaypee Medical Publishers, Inc.

RECOMENDED READINGS

Townsend. S. ( 2012).Sabiton’s Textbook of Surgery. 19th Edition. Town and publisher

O. J. Gardens, A. W. Bradbury, J. L. R. Forsythe, R. W. Parks, 2014, Principles and Practice of Surgery

King, Bewes A.O., J. Cairns (1984), Primary Surgery, Vol. 1 Non Trauma, Vol. 2 Trauma, 1984, AMREF

Jack McAninch, Tom F. Lue, Smith and Tanagho’s General Urology, 2012, 18th Edition, McGraw-Hill Professional

David A. Macfarlane, Lewis P. Thomas, Textbook of Surgery, 1985, 5th Edition, Churchill Livingstone

Hall and Colman, Diseases of the Ear, Nose and Throat, 2007, 14th Edition edited by B. H. Colman, Churchill Livingstone

Sandford-Smith J., Eye Diseases in Hot Climate, 2003, 4th Edition, Low-cost, Elsevier Saunders

M. yanoff, J. Duker, Ophthalmology, 2014, 4th Edition, Elsevier Saunders

Gerard M. O’Donoghue, Anthony A. Narula, Grant J. Bates, Clinical ENT Illustrated Textbook, 2008, 2nd Edition, Singular Publishing Group, 2000

Bailey, Hamilton, Bailey & Love's short practice of surgery, 2013 revised by A.J.

Harding Rains and H. David Ritchie. London : H. K. 26th ed. Boca Raton, FLa.

12.SriramBhat, SRB’s Manual of Surgery, 2012, 4th Edition, Jaypee Brothers Medical Publishers (P) Ltd

Please include townand publisher Also follow Harvard reference; Start with the surname followed by initials, the year must come after the author/s, then title in bold, town and publisher

148

COURSE TITLE: OBSTETRICS AND GYNAECOLOGY

COURSE CODE: 220

Course Aim

To equip students with the knowledge and skills of management of common conditions in obstetrics and gynaecology.

Objectives

To explain and integrate relevant principles of basic human sciences in obstetric and gynaecological conditions.

To demonstrate advanced skills in history taking and clinical examination of the obstetric and gynaecological patient.

To identify, initiate, and interpret laboratory and bedside investigations required to make a diagnosis and manage the obstetric and gynaecological conditions.

To apply evidence-based clinical obstetrics and gynaecology practice and basic technical skills.

To demonstrate basic surgical skills in obstetrics and gynaecology, including performing surgery independently and managing common obstetric and gynaecological emergencies.

To demonstrate appropriate professionalism and ethical conduct towards care of obstetrics and gynaecology patients.

Competencies

Integrate relevant principles of basic human sciences in obstetric conditions.

Obtain comprehensive obstetric history

Perform clinical examination of the obstetric patient.

Order and interpret laboratory investigations

Manage the obstetric conditions.

Apply evidence based clinical obstetrics practice and basic technical skills.

Perform basic emergency obstetric neonatal care (Bemonc) and manage common obstetric emergencies.

Manage appropriately obstetric and gynaecological conditions

Ethically provide care towards obstetrics patients.

Refer complex cases of obstetrics on time

COURSE CONTENT

149

UNIT 1

1.0 Obstetrics history taking and physical examination

1.1 Normal Pregnancy and Focused antenatal care

1.2 Antenatal cardUNIT 2

2.1 Early Pregnancy

2.2 Hyperemesis gravidarum

2.3 Abortions (include application of manual vacuum aspiration)

Hydatiform mole

UNIT 3

3.1 Late Pregnancy

3.2 Pregnancy induced hypertension

3.3 Pre Eclampsia

3.4 Eclampsia (include administration of parentral magnesium sulphate)3.5 Ante-partum-haemorrhage (placenta previa, abruption placenta, vasa

previa)

3.6 Post-Partum Haemorrhage (causes, initial assessment and

management, specific management)3.7 Premature labour

3.7.1 Multiple Pregnancies

3.8 Medical conditions in Pregnancy (Diabetis, Malaria, HIV and PMTCT,

Anaemia, Heart Diseases)

3.9 Post maturity

UNIT 4 Normal labour and delivery

4.1 Partograph

4.2 Normal mechanism of labour and duration

4.3 Normal delivery

4.3.1 Assessment of the new born

4.3.2 Helping Baby Breath (HBB)

Delivery of the placenta (active management with use of urotonics)

150

4.4.1 Examination of the placenta

4.5 Augmentation of labour (indications and medical use of urotonics)4.6 Induction of Labour (indications and contra indications)Indications for episiotomy and contra indications

4.8 Dysfunctional labour

4.9 Premature rupture of membranes (include administration of parentral antibiotics) 4.9.1 First stage of labour 4.9.2 Arrest of labour4.9.3 Second stage of labour (include use of urotonics, Kiwi vacuum

extractor)

4.9.4 Cord prolapse

UNIT 5 Malpresentations and malposition5.1 Occipital posterior position 5.2 Brow presentation 5.3 Shoulder Dystocia 5.4 Transverse lie

5.5 Obstructed Labour

5.6 Foetal Distress

5.7 Third Stage 5.7.1 Active management with use of oxytocin 5. 7.2 Retention of Placenta (include manual removal of

5.7.3 placenta

5.7.5 Postpartum haemorrhage

5.7.7 Trauma of birth canal (cervical tears)

5.7.8 Uterine rupture

5.8 Puerperium

5.8.1 Postpartum care

5.8.2 Pyrexia

5.8.3 Sepsis (include administration of parentral antibiotics)

5.8.4 Breast condition and breast feeding

5.8.5 Psychosis

5.9 Complications of Pregnanacy

6.0 Obstetric Operations/procedures

6.1 Booking for Antenatal Care and Abdominal Examination

151

6.2 Administer Local and cervical block Anaesthesia

6.3 Cervix Assessment during labour

6.4 Partograph plotting

6.5 Administer Magnesium Sulphate

6.6 Episitomy and Repair

6.7 Repair of trauma of birth canal

6.8 Forceps delivery

6.9 Vacuum Extraction

6.10 Conduct Normal Vaginal Delivery

6.11 Assisted Breech Delivery

6.12 Manual Removal of retained placenta

6.13 Reposition of inverted uterus

7.0 Helping Babies Breath

7.1 Bimanual compression of abdominal aorta

8.0 Smart Care in Obstetrics

9.0 ANC information10.0 Intrapartum information10.0 Postpartum information

TEACHING METHODS

Lectures Discussions

Clinical skill training (Skills lab, Maternity Units)

Assignments

Group discussions

CONTACT HOURS

Lectures: 4 Hours/ week

Practice: 2 hours/week

Assessment Methods

152



Assignments 10%

Skills lab 10%



OSCE 20%

Prescribed Reading

Hanretty, Kevin, P. (2010) Obstetrics Illustrated. 7th Edition. London: Churchill Livingstone.

Malcolm, S.,Ian M. Symonds (2006) Essential Obstetrics and Gynaecology 4th edition. Edinburgh: Churchill Livingstone.

World Health Organization (2003) Managing Complications in Pregnancy and Childbirth. Geneva: WHO, Department of Reproductive Health and Research.

Recommended Reading

Neville Hacker, J.George Moore, Joseph Gambone. (2004) Essentials of Obstetrics and Gynaecology.4th Edition.India:Elsevier.


Arulkumaran, S., I. Symonds, A. Fowlie (2003) Oxford Handbook of Obstetrics and Gynaecology. Oxford: Oxford University Press.

Stanley G. Clayton , Ash Monga. (2006) Gynaecology by Ten Teachers. 18 Edition. London: Hodder Arnold.

Stuart, Campbell.,Christopher, Lees. (2000) Obstetrics by Ten Teachers. 17th Edition. London: Hodder Arnold.



http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Stanley%20G.%20Clayton

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Ash%20Monga

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Stuart%20Campbell

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Christoph%20Lees

153

COURSE TITLE: PAEDIATRICS

COURSE CODE: 220

Course Aim

To equip students with the knowledge and skills of management of common conditions in paediatrics.

OBJECTIVES

Take a detailed history and perform physical examination.

Order and interpret investigations appropriately

State causes of common paediatric conditions

Manage patients with paediatric conditions correctly

Give health education and promotion

Refer paediatric patients to the next level ofcare appropriately

COMPETENCES:

Take a comprehensive paediatric history

Perform a physical examination in paediatrics

Identify signs and symptoms of common paediatric conditions

Order and interpret investigations

Diagnose paediatric conditions

Manage paediatric conditions

Referpaediatric conditions to appropriate levels timely

UNIT 1. Gastro-intestinal system

154

1.1Applied anatomy

1.2 History taking and examination

1.3Diarrhoealdiseases

13.1 Viral

1.3.2 Bacterial

1.3.3 Protozoal

1.3.4 Fungal

1.3.5 Non infective

1.4Dehydration

1.4.1 Assessment

1.4.2 Classification

1.4.3 Management

1.5 Oral Conditions

1.5.1 Oral candidiasis

1.5.2 Cancrumoris

1.5.3 Aphthous ulcers

1. 6Parasitic infestations:

1.6.1Ancylostomiasis

1.6.2 Strongyloidiasis

1.6.3 Ascariasis

1.6.4 Trichuriasis

UNIT2. Genital-urinary system

155

Applied anatomy

History taking and examination

Glomerulonephritis: acute and chronic

Nephroticsyndrome

Urinary tract infections

Pyelonephritis

Ureteritis

Cystis

Urethritis

Epididymorchitis

Schistosomiasis

Renal Failure

UNIT3. Cardiovascular system

Applied anatomy

3.2 History taking and examination

3.3 Congenital heart diseases

3.3.1 Cyanotic: tetralogy of fallot, transposition of greater vessels

Acyanotic: patent ductusarteriosus, ventricular septal defect and Atrial septal defects

Rheumatic fever and Rheumatic Heart Diseases

Bacterial Endocarditis

Congestive Cardiac Failure (CCF)

Pericarditis

UNIT4.Respiratory System

Applied anatomy

History taking and Examination

Upper Respiratory Tract Infections

156

Coryza

Tonsillitis

Otitis Media

Sinusitis

Epiglotitis

Laryngo-tracheo-bronchitis (Croup)

Lower Respiratory Tract Infections

Bronchiolitis

Pneumonias

Asthma

UNIT5. Diseases Of Blood And Lymphatics

Historytaking and Examination

Anaemias

SickleCellAnaemia

IronDeficiencyAnaemia

AplasticAnaemia

Bleeding Disorders

Haemophilia

Epistaxis

Thrombocytopenia

Leukemias

UNIT 6. Lymphomas

Applied anatomy


Hodgkin’s and non-Hodgkin’s

Burkitt’s Lymphoma

157

UNIT7. Central Nervous System

7.1 Applied anatomy


Encephalitis

Meningitis

Cerebral Palsy

Mental Retardation

Convulsions

Epilepsy

The Unconscious Child

158

UNIT 8. Childhood Neoplasms

Applied Anatomy

History taking and examination

Wilm’sTumour

Retinoblastoma

Neuroblastoma

UNIT 9.Endocrine Disorders

Applied anatomy


Diabetes Mellitus

19.2.2 Disorders of the Thyroid Gland

UNIT10. Dermatology

Applied anatomy


Bacterial Infections

Fungal Infections

Parasitic Infections

Viral Infections

UNIT11. HIV and AIDS

Definition

Modes of Transmission

Prevention

WHO Staging

Opportunistic Infections

Management

UNIT12. Intoxication /Poisoning

159


Organophosphates

Acetylsalycylic acid

Paracetamol

Iron tablets

Carbon monoxide

Hydrocarbons

Paraffin

Petrol

UNIT13. Integrated Management Of Childhood Illnesses (IMCI)

Module 1 – Introduction to integrated management of childhood illnesses

Module 2 – Assess And Classify The Sick Child Aged 2 Months To 5 Years

Module 3 - Identify Treatment

Module 4 – Treat the Child

Module 5 - Counsel the Caretaker

Module 5 – Follow Up

Module 6 - Management of the Sick Young Infant Aged 1 Week To two Months

TEACHING METHODS

Lectures/discussion/demonstration

Tutorials

Skills lab

Case studies

Role plays

e-Learning

CONTACT HOURS

160

Lectures : 4 hours / week

practical

ASSESSMENT




Skills Lab = 10%


Written = 40%

OSCE = 20

PRESCRIBED READINGS

Behrman R. E., Kliegman R. M., Jenson H. B. (2013).Nelson’s Textbook of Paediatrics, Ed. sanders publishers, USA.

Jelife D.B. and Stanfield J.P (1990).Diseases of Children in Subtropics and Tropics 3rd Edition. The English Language Book Society and Edward Arnold Publishers. London.

Marcdante, K and others (2011),Nelson Essentials of Paediatrics. 6th Edition. Philadelphia: Saunders Elsevier.


Hendricke R.G., Barr D.G., Mattews T.(1991).Paediatrics in the Tropics.1stEdition,Blackwell Scientific Publications

Sidewell, U. (2011). Easy pediatrics. London: Holdder

Stanfied. ?andBwibo?. (2005). child health manual for medical workers in health in centers and rural hosptitals.3rd ed. Nairobi: AMREF.

Savage,P (1992)help mothers to breastfeed, Nairobi: AMREF

Wardlaw. G.M (2011) Contemporary Nutrition. 8thed. New York: McGraw Hill

Anillenmar A.C (2012) pediatrics E-mcq: Sauparnika

161

Tortora G, J, Derrickson V.B (2011) principles of anatomy and physiology. Vol. 2. 13th ed. John Wiley and sons

Crocetti, Michael & Michael Barone. (2004) Oski’s Essential Pediatrics. London: Lippincott Williams & Wilkins

Rudolp, Abraham, Robert Kamei & Kim Oveby. (2002) Rudolph’s Fundamentals of Pediatric. 3rd Edition. New York: McGraw-Hill ( No initials)

IMCI manuals

162

COURSE TITLE : MENTAL HEALTH AND PSYCHIATRY

COURSE CODE : MHP 220

AIM

To equip students with the knowledge; skills and attitudes to manage clients with mental disorders

OBJECTIVES

Describe anxiety disorders

Distinguish the different forms of anxiety disorders

Demonstrate ability to apply the various treatment approaches for anxiety disorders

Describe behavioural syndromes associated with physiological disturbances

Describe the different forms of behavioural syndromes

Define mental retardation and the subtypes

Describe the psychiatric aspects of epilepsy

Discuss management of mental disorders using the bio-psychosocial model of care

Explain community diagnosis

Describe the preventive, promotive and rehabilitative models in community mental health

Identify the role of non-governmental organization in the delivery of mental health care

COMPETENCES

Assess the presence of Anxiety disorder

Describe the core features and various forms of Anxiety cluster of syndromes

Apply various treatment approaches for Anxiety disorders

Identity behavioural syndromes, epilepsy and mental retardation

Classify drugs used in the management of mental disorders

Manage conditions appropriately using the bio-psychosocial model

Conduct community diagnosis

163

Write a report on the findings of community diagnosis

Disseminate the findings to the community

Plan and implement interventions

Document interventions and progress of client’s health status to facilitate continuity of care

Provide high quality comprehensive mental health care

Implement appropriate interventions in preventive, promotive and rehabilitative activities in a culturally sensitive context

Collaborate with Non Governmental Organizations in delivery of community mental health services

COURSE CONTENT:

UNIT 1: ANXIETY DISORDERS

Generalised anxiety disorder

Panic disorder

Obsessive compulsive disorder

Phobic anxiety

Adjustment disorder

Dissociative disorders

Somatoform disorder

Posttraumatic stress disorder

UNIT 2: BEHAVIOURAL SYNDROMES ASSOCIATED WITH PHYSIOLOGY DISTURBANCES AND PHYSICAL FACTORS

Eating disorders

Non organic sleep disorders

164

Sexual dysfunction

Mental and behavioural disorders in the puerperium

UNIT 3: MENTAL RETARDATION

3.1 Mild mental retardation

3.2 Moderate mental retardation

3.3 Severe mental retardation

3.4 Profound mental retardation

UNIT 4: EPILEPSY

Review of types and classification of epilepsy

Psychiatric aspects of epilepsy

UNIT 5: PERSONALITY DISORDERS

5.1 Definition of personality disorders

5.1.1 Paranoid

5.1.2 Obsessive compulsive (Anankastic)

5.1.3 Dissocial

5.1.4 Emotionally unstable personality

5.1.5 Histrionic

5.1.6 Anxious (avoidant)

5.1.7 Dependent personality

5.2 Habit and Impulse disorders

UNIT 6: COMMUNITY MENTAL HEALTH

Description of community mental health

Common mental disorders in the community

Prevention models

165

Role of community mental health in primary health care

The role of non-governmental organizations (NGOs) in the delivery of mental health care

UNIT 7: PROCEDURES

7.1 History Taking

7.2 Diagnostic interview

7.3 Mental State Examination

7.4 Physical Examination

7.5 Clinical Presentation

7.6 Psycho-education

7.7 Admission of patients

7.8 Discharge of patients

7.9 Reviewing of Patients

7.10 Community Diagnosis

7.11 Sensitization (Health Talks)

7.12 Home Visit

TEACHING METHODS

Lecture

Group Discussions

Tutorial

Skills Lab

Case studies

e-Learning

CONTACT HOURS

Lectures : 2 hours /week

166

practice

ASSESSMENTS

Continuous assessment 40%

Written Tests (1) = 10%

OSCE = 10%


Log book = 10%

Examination 60%

Written Test = 40%

MCQs = 20%

Essays = 20%

OSCE =20%

PRESCRIBED READINGS

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed). Washington, DC: American Psychiatric Association Press.

Gelder, M., Mayou, R., Harrison, P. & Cowen, P. (2005). Oxford Textbook of Psychiatry. Oxford: Oxford University

Saddock, B. J. & Saddock, V. A. (2009). Kaplan and Saddock’s Comprehensive Textbook of Psychiatry (2 volumes). London: Lippincott Williams & Wilkins.

167

World Health Organization (2010). ICD 10 Classification of Mental and Behavioural Disorders. Oxford: Oxford University Press


Ahuja, N. (2006) A Short Textbook of Psychiatry. 7th Edition. New Delhi: Jaypee Brothers Publishers.

Andreasen N. C. & Black, D. W. Eds. (2010) Introductory Textbook of Psychiatry. New York: American Psychiatric Publication.

Birnkrant, J. &Carlsen, A. (2007). Crash Course: Psychiatry. Philadephia: Mosby Elsevier.

Oakley, C. (2010). Rapid Psychiatry, 2nd Ed. London: Wiley-Blackwell

Robertson, B. Allwood, C., &Gagiano C. (Eds) (2001) Textbook of Psychiatry for Southern Africa. Cape Town: Oxford University Press.

Sadock, B. J. & Sadock, V. A. (2001). Kaplan &Sadock’s Pocket handbook of Clinical Psychiatry, 3rd Ed. Baltimore: Lippincott Williams & Wilkins.

168

COURSE TITLE: PUBLIC HEALTH CARE

COURSE CODE: PHC 225

AIM

To acquire knowledge, skills and attitude in health promotion practice.

OBJECTIVES

At the end of this course, the student will be able to:

Describe health promotion.

Demonstrate ability to apply ethical issues in carrying out Health promotion in carrying out community activities.

Demonstrate ability to utilise strategies of health promotion in carrying out community health activities

Demonstrate ability to provide health education in the community.

Differentiate between Health Promotion And Health Education.

Demonstrate ability to apply group dynamic skills in working with the community.

Discuss project planning and management.

Demonstrate ability to plan health promotion programmes in collaboration with stakeholders.

Demonstrate ability to implement health promotion activities.

COMPETENCES

Identify, plan and implement health promotion activities.

Network with stakeholders in promoting health.

Use health education principles in communicating with the community.

Write project proposals to enhance health promotion activities.

Apply health promotion ethics when carrying out health activities.

Identify and address gender health related problems.

Carry out health promotion activities with a gender perspective.

169

HEALTH PROMOTION

CONTENT

UNIT 1. Health as A Concept

Definition of Health

Dimension of Health

Determinants of Health

Description of a healthy (person, family, community, nation)

1.1: Health Promotion As A Concept

Definition of Health promotion

Strategies of Health Promotion

Principles (Core Values) of Health Promotion

Classic examples of Health Promotion

UNIT 2.The Historical Perspective of Health Promotion

Marc Lalonde

Health promotion conferences

UNIT 3.Differentiate Between Health Promotion And Health Education

Common Terms Used In Health Promotion

Social class

Equity

Lifestyle

Stigma and Discrimination

170

UNIT4.Communication In Health Promotion

Defining communication

Types of communication

Barriers to communication

Channels of communication

UNIT5. Working with Groups

Definition of Group

Group dynamics

Leadership

Qualities of a leader

Types of leadership

UNIT6.Basics of Project planning and management

Definition of project

Characteristics of project

Common terms used in the project

Project life cycle

Project proposal writing

UNIT7. Theories and Practice Of Health Education

Define Health Education

Specialized terms of Health Education

Paulo Freire and John Dewey ‘s theories of learning

Lesson planning

UNIT 8.Ethical Issues in Health Promotion

Selflessness

Integrity

171

Beneficence

Respect to life

Confidentiality and privacy

Professional Competence

UNIT9.Gender and Health

Gender as a concept

Difference between Gender and Sex

Roles and Responsibilities

Common gender health problems

UNIT 10.Emerging Health Related Issues

Stress at work

HIV and AIDS

Women violence

Alcohol and health

Children’s Rights

Prostitution

Streetism

Road Traffic Accidents

Early Marriages

UNIT 11.The role of Civil Society and NGOs in promoting health

Defining of NGOs

Classification of NGOs

Advantages and Disadvantages of NGOs

NGO Act

Health activities of NGOs

TEACHING METHODS AND CONTACT HOYRS

172

Lecture discussions

Group discussions

Brainstorming

Role play

CONTACT HOYRS

ASSESSMENTS 40%

Practical 10%

Assignments 10%

Tests 20%

EXAMINATION 60%

Written 40%

Practical 20%

PRESCRIBED READINGS

Edelman C.L; Mandle C.L and Kudzma E.C (2013).Health Promotion throughout the lifespan. Elsevier.

Hubley J (2008) Communicating Health, Oxford, Macmillan Publisher

173

Laverack G (2004) Health Promotion Practice (Power and Empowerment), London, SAGE Publication

Naidoo J and Wills J (2009) Health Promotion Foundations for Practice, London, BaillierTindall

SeedHouse D (1997) Health Promotion, Philosophy, Prejudice and Practice, Chichester, Willy


AMREF (1996) Communicable Diseases, 2nd edition, A Manual for Primary Health Workers, Rural Series 7, AMREF, Nairobi 1993.

Barrachough S (2007). Analysing Health Policy: A problem oriented Approach. Elsevier

Beaglehole R., Bonita R. and Kjellstrom T. (1997) Basic Epidemiology, WHO, Geneva 1993.

Vaughan J.P. and Morrow R.H. (19989) Manual of Epidemiology for District Health Management, WHO, Geneva.

Wearner D. and Brown B. (2000) Helping health workers learn, Hesperion Foundation, Berkely.

WHO (1983) Education for health , A manual for Primary Health Care Workers, WHO, Geneva.

Wood C. H and Vaughan J. P, de Glanville H. (1995), Community Health, Rural Health Series 12, Nairobi AMREF.

174

COURSE TITLE : HEALTH SYSTEMS MANAGEMENT

COURSE CODE : HSM 225

AIM

To equip students with knowledge, attitude, and skills in management and administration of health facilities.

OBJECTIVE

1. Describe Management.

2. Explain management functions

3. Identify the importance and functions of meetings.

4. Explain Team building.

5. Describe the main leadership approaches, functions and leadership styles.

6. Describe change management.

7. Describe health Management Information in Zambia

7. Demonstrate knowledge in HMIS and Smart Care Software for Health Management

COMPETENCES

1 Define concept of leadership/management

2 Apply key management functions

3 Conducts meetings

4 Work in a multidisciplinary work

5 Applies theories of motivation

6 Perform leadership/supervision functions

7 Initiate change

8 Conduct performance appraisal

9. Utilise HMIS and Smart Care Software for Health Management

175

CONTENT

UNIT 1: MANAGEMENT SKILLS

1.0 DEFINITION OF MANAGEMENT

MANAGEMENT AND LEADERSHIP FUNCTIONS

1.1.1 Planning

1.1.2 Organising

1.1.3 Command

1.1. 4 Coordinating

1.1. 5 Control

1.1. 6 Delegation

11. 7 Decision making

1.1.8 Budgeting

1.1.9 Communication

1.1.10 Implementing

1.1.11 Evaluation

1.1.12 Supervision

1.1.13 Motivation

2.0 MANAGING MEETINGS

2.1 Types of meeting

2.2 Benefits of meetings

2.3 Functions of Meetings

2.4 Elements of Effective Meetings

2.5 Chairman Authority

176

2.6 Common Problems of Meetings

3.0 TEAM MANAGEMENT

3.1 Definition.

3.2 Characteristics of a team/group

4.0 THEORIES OF MOTIVATON

4.1 Abraham Maslow’s Hierarchy of needs

4.2 Douglas McGregor Theory “X” Theory “Y”

5.0 THEORIES OF MANAGEMENT/LEADERSHIP

5.1 Fredrick Taylor – Scientific Management

5.2 Elton Mayo

6.0 LEADERSHIP

6.1 Definition

6.2 Major theories

6.3 Overview of Leadership approaches

6.4 Conventional Traits and styles.

7.0 RESOURCE MANAGEMENT

7.1 Human

7.2 Material

177

7.3 Financial

7.4 Time Management

8.0 CHANGE MANAGEMENT

8.1 Definition

8.2 Factors contributing to accepting change

8.3 Resistance to change

9.0 PERFOMANCE APPRAISAL

9.1 Definition

9.2 What performance appraisal is

9.3 Types of appraisals

9.4 Benefits of appraisals

9.5 Tools used in appraising

11.0 CONFLICT MANAGEMENT

11.1 Introduction

11.2 Exploring organisation culture

11.3 Types of organisation culture

11.4 Evaluation concept of culture

11.5 Conclusion

12.0 DISCIPLINE

12.1 Definition

12.2 Grievance procedure

178

12.3 Disciplinary procedure`

12.4 Disciplinary code and procedure for handling offenses

UNIT 2: MANAGEMENT INFORMATION SYSTEMS

INFORMATION SYSTEMS

Definition

Types

Zambian HMIS

SmartCare

Data and information

Qualities/characteristics of data

Levels of Management Information

Operational

Tactical

Strategic

TEACHING METHODS

Lectures-Discussion

Demonstrations

Group Discussion

Role plays

Skills Lab (HMIS and SmartCare)

CONTACT HOURS

179

Lectures : 2 hour/week

ASSESSEMENT

Continuous Assessment 40%

HMIS/SmartCare Lab 20%

Written Test 1 15%

Assignments 1 5%

End semester Exam 60%

Written 20%

Practical 30%

OSPE 10%

PRESCRIBED READINGS

HoH D.H. (2000).Management Principles and Practice. New Jersey, Prentice Hall Inc. P.465-489

Cole A. (2002).Personnel and Human Resource Management. London: Book Power

Handy. C. B.(2000).Understanding Organisations. Oxford : Oxford

University Press

4. Armstrong M,.(2008).A Handbook of Human Resource Management

Practice(9th Edition). London : Kogan Page


Ivancevich J.M. (2000), Human Resource Management. Boston Irwin McGraw-Hill (7th Edition)

180

GRZ (2003), Disciplinary Code and Procedures for Handling Offenses in the Public Service. Lusaka Printing Service Support Unit

Lucey T. (2001), Management Information Systems”. DPP

MoH Zambia (2008), HMIS Procedure Manual. MoH

MoH Zambia ( 2011), SmartCare Essentials. MoH

MoH Zambia ( 2011), SmartCare Job Aids. MoH

MoH Zambia ( 2011), SmartCare Videos. MoH



AIM:

To equip students with knowledge, skills and attitude to manage common surgical conditions.

OBJECTIVES

Describe the overview of surgery

Describe common surgical conditions

Make specific surgical diagnosis in different systems

Manage specific surgical conditions in trauma

Discuss foreign bodies in surgery in the body

Describe specific surgical infections

Manage specific surgical complications in different systems

181

Refer specific surgical conditions to a higher level

COMPETENCES

Describes various surgical fields or areas

Describes specific surgical conditions

Demonstrates ability to take comprehensive surgical history

Performsappropriate physical examination

Diagnoses common surgical conditions

Orders specific laboratory and appropriate radiologic investigations

Interprets common laboratory and specific radiological findings

Applies medico-legal aspects and medical ethics in the management of patients.

Performs specific biopsies

Provides or prescribes appropriate surgical treatment

Applies infection prevention skills

Performs specific minor surgical procedures, including Male Circumcision

Carries-out appropriate rehabilitation of / follow-up patients

Refers surgical conditions that cannot be managed at his/her level

Documents and keeps record of findings and procedures

CONTENT

UNIT 1 INTRODUCTION TO SURGERY

Applied anatomy & physiology of the peritoneum and abdominal viscera

Surgical history-taking & physical examination

182

1.3 Appropriate laboratory & radiological investigations

UNIT 2 COMMON CONDITIONS OF THE ABDOMINAL WALL, PERITONUEM

Applied anatomy

Clinical presentation and management of:

Hernias

Surgical complications of peptic ulcer disease, acute appendicitis, cholecystitis, cholangitis and pancreatitis; and biliary cholic, acute bowel obstruction, bowel perforation

Peritonitis

UNIT 3 COMMON CONDITIONS OF THE BILIARY SYSTEM

Applied anatomy

Clinical presentation and management of:

Choledocholithiasis

Acute cholecystitis, cholangitis and pancreatitis; and biliary cholic, gallstone ileus

Surgical jaundice

UNIT 4CONDITIONS OF THE ESOPHAGUS, STOMACH, PYLORUS, SMALL AND LARGE INTESTINES

Surgical complications of peptic ulcer disease

4.3 Pyloric stenosis

4.4 Intussusception

4.5 Appendicitis

Sigmoid volvulus

Ileus due to ascariasis

4.8 Mechanical intestinal obstruction and paralytic

UNIT 5 CONDITIONS OF THE RECTUM, ANUS AND PERI-ANAL AREA

Haemorrhoids

183

Ano-rectal abscesses

Ano-rectal fistulae; fissure-in-ano

Intestinal atresia, imperforate anus and aganglionic disease

UNIT 6 CONDITIONS OF THE KIDNEYS, URETERS AND URINARY BLADDER

Applied anatomy and physiology

Clinical methods

Haematuria

6.4 Kidney: nephrolithiasis, hydro-nephrosis and tumours

6.5 Ureteric stones: hydro-ureters

6.6 Urinary bladder: stones, schistosomiasis and tumours

UNIT 7 CONDITIONS OF THE PROSTATE GLAND

Prostatitis

Benign prostatic hyperplasia

Carcinoma of the prostate

UNIT 8 CONDITIONS OF THE URETHRA 8.1 Urethral stricture 8.2 Epispadias 8.3 Hypospadias 8.4 Urinary incontinence 8.5 Urinary retention

UNIT 9 CONDITIONS OF THE TESTIS, EPIDIDYMIS, AND SCROTUM

Epididymo-orchitis

9.2 Cryptorchidism

9.3 Testicular torsion

9.4 Hydrocele 9.5 Varicocele 9.6 Testicular torsion 9.7 Infertility 9.8 Tumours

184

UNIT 10 CONDITIONS OF THE PENIS AND PREPUCE

Penile trauma

Priapism

Phimosis

Paraphimosis

Tumours

UNIT 11 CONDITIONS OF THE BREAST

Applied anatomy and physiology of the breast

Comprehensive history of breast conditions

Physical examination of the breast

Breast investigations: needle biopsy, mammography

Mastitis; abscesses

Tumours: fibroadenomas, cysts, breast carcinoma

Special investigations / procedures


History-taking and physical examination

Intermittent suturing

Removal of sutures

Incision and drainage

Ear examination

Anterior nasal packing

Ear toileting and syringing

Examination of the nose

Removal of foreign body from the nose / ear

Needle cricothyroidectomy

Glasgow coma scale

185

History taking and oral dental examination

Tooth extraction

History taking and ophthalmic examination

Eye irrigation

Removal of foreign body from the eye

Application of eye drops

Visual acuity

Eye bandaging

Male circumcision

UNIT 12 OTHER COMMON PROCEDURES DONE IN SURGERY

Naso or oro-gastric tube (NGT) insertion, aspiration, feeding

Colostomy care

Colostomy / iliostomy / Gastrostomy care

Gastric / rectal lavage

Diagnostic peritoneal lavage (DPL)

Enema

Abdominal and chest X-rays

Ultrasonography scan (USS)

Endoscopy: laparoscopy, esophagogastroduodenoscopy (EGD), proctoscopy, sigmoidoscopy, cystoscopy

Barium swallow, barium meal, barium meal & follow-through, barium enema

Cystoscopy

Vasectomy

Sperm count, prostatic specific antigen (PSA)11.18 Plain abdominal X-ray (KUB)

Ultra Sound Scan

Mammography

Biopsies

UNIT 13 INTRODUCTION TO CONDITIONS OF THE EAR, NOSE, SINUSES AND THROAT

186

13.1 Applied anatomy and physiology of the ear, nose, sinuses and throat

13.2 Clinical ENT history, examination and investigations

13.3 Common ENT clinical features

UNIT 14 CONDITIONS OF THE EAR

Perichondritis, otitis externa, furunculosis

Auricular trauma: hematoma, open wounds Wax impaction

Foreign body in the external auditory meatus

Basal skull fractures: diagnosis and management

Otitis media: acute and chronic

Mastoiditis

Deafness and impaired hearing and hearing devices

UNIT 15 CONDITIONS OF THE NOSE & SINUSES

Rhinitis

Sinusitis

Nasal polyps

Foreign bodies in the nostrils

Epistaxis

Injuries to the nose: perforation of nasal septum, nasal bone fracture, alae wounds

Maxillary and mandibular fractures: diagnosis and management

UNIT 16 CONDITIONS OF THE THROAT

16.1 Acute epiglottitis

16.2 Laryngotracheo-bronchitis

16.3 Ludwig’s angina, laryngitis, pharyngitis, tracheitis, tonsillitis and tonsillectomy, peri-tonsillar abscess (Quinsy)

16.4 Foreign body in the throat

187

16.5 Retropharyngeal abscess

16.6 Trauma to the throat trauma

16.7 Tracheostomy


17.1 Surgical cricothyroidotomy

17.2 Endotracheal intubation

17.3 Insertion of oro-airway and NGT

17.4 Tracheostomy


UNIT 18 INTRODUCTION TO OPHTHALMOLOGY

18.1 Applied anatomy and physiology of the eye

18.2 Common eye clinical symptoms and signs, clinical examination and investigations of the eye

UNIT 19 CONDITIONS OF THE CONJUNCTIVA

Conjunctivitis: bacterial, chlamydial, viral, allergic, toxic; pterygium, trachoma

UNIT 20 CONDITIONS OF THE EYELIDS

Hordeolum, chalazion, entropion and ectropion, ptosis

UNIT 21 CONDITIONS OF THE CORNEA

Corneal foreign body, keratitis, corneal ulcers, acute red eye, xerophthalmia

UNIT 22 CONDITIONS OF THE POSTERIOR SEGMENT

Uveitis, glaucoma, cataract, diabetes retinopathy

UNIT 23 REFRACTIVE ERRORS

188

Myopia, hypermetropia, presbyopia, astigmatism, aphakia, ophthalmic optics

UNIT 24 HIV/AIDS AND THE EYE

Herpes simplex, herpes zoster ophthalmicus, Kaposi’s sarcoma, cytomegalovirus retinitis, retinal toxoplasmosis

UNIT 25 OCULAR TRAUMA

25.1 Blunt and penetrating

25.2 Orbital fractures:

25.2.1 Diagnosis and their management

TEACHING METHODS

Lectures

Skills lab

Case studies

E-Learning

Discussions

Clinical presentations

Bed side teaching

Role plays

CONTACT HOURS


Practical: 4 hours/week

ASSESSMENT:



189

Assignment (1) = 5%

Skills Lab = 20%


WRITTEN = 30%

OSCE = 30%

PRESCRIBED READINGS

Williams, N S, Bulstrode, C J K,O’ Connell, P R (2013) Bailey & Love'sShort Practice of Surgery. (26th Ed)London: Hodder Arnold

Lumley,J S, D’ Cruz (2012) Hamilton Bailey’s Demonstration of Physical signs in Clinical Surgery, (19th Ed). Butterworth-Heinemann, Oxford

Magbool, M., Magbool, S., and Sharma,S C, (2013) Textbook of Ear Nose and Throat Diseases, (12th Ed), Jaypee Medical Publishers, Inc.

Kanski,J J, Bowling, B., (2011) Clinical Ophthalmology (7th Ed.), Elsevier Saunders

RECOMENDED READINGS

Townsend. S. ( 2012) Sabiston’s Textbook of Surgery (19th Ed.), Town and publisher

Gardens,O. J.,Bradbury, A,Forsythe, W. J., Parks, R. W. (2014) Principles and Practice of Surgery

King, M, Bewes, A.O, Cairns J. (1984), Primary Surgery, Vol. 1 Non Trauma, Vol. 2 Trauma, AMREF

McAninch, J W,Lue,T.F. (2012) Smith and Tanagho’s,General Urology (18th Ed.), McGraw-Hill Professional – North America

Colman B. H. (2007) Hall and Colman, Diseases of the Ear, Nose and Throat (14th Ed.) Churchill Livingstone

Bhat, S R (2012) SRB’s Manual of Surgery (4th Ed.), Jaypee Brothers Medical Publishers (P) Ltd

Nema, H V, Nema, N. (2012) Textbook of ophthalmology (6th Ed.) Jaypee Medical Publishers, Inc.

COURSE TITLE: OBSTETRICS

COURSE CODE: 220

Course Aim

190

To equip students with the knowledge,skills and attitudes that will enable them to manage common conditions in obstetrics.

Objectives

Explain and integrate relevant principles of basic human sciences in obstetric conditions.

Demonstrate ability to to take obstetric history


To identify, initiate, and interpret laboratory and bedside investigations required to make a diagnosis and manage the obstetric conditions.

To apply evidence-based clinical obstetrics practice and basic technical skills.

Demonstrate basic surgical skills in obstetrics including performing basic surgery independently

Manage common obstetric emergencies.

Demonstrate appropriate professionalism and ethical conduct towards care of obstetrics patients.

Competences

Integrate relevant principles of basic human sciences in obstetric conditions.

Obtain comprehensive obstetric history


Order and interpret laboratory investigations

Manage the obstetric conditions.

Apply evidence based clinical obstetrics practice and basic technical skills.

Perform basic emergency obstetric neonatal care (Bemonc) and manage common obstetric emergencies.

Manage appropriately obstetric and gynaecological conditions

Ethically provides care towards obstetric patients.

Refer complicated cases of obstetrics on time

191

COURSE CONTENT

UNIT 1 Focused ANC Booking

1.0 Obstetrics history taking and physical examination

1.1 Normal Pregnancy and Focused antenatal care

1.1.1 Option B+

1.3 Antenatal card

UNIT 2 Early Pregnancy Complications

2.1 Hyperemesis gravidarum

Abortions

Hydatiform mole

UNIT 3 Complications of Late Pregnancy

3.1 Pregnancy induced hypertension

3.2Pre-eclampsia

3.3 Eclampsia

3.4 Ante-partum-haemorrhage

3.5Premature labour

3.5.1 Multiple Pregnancies

3.6Medical conditions in Pregnancy

3.6.1 Diabetes mellitus

3.6.2 Malaria

3.6.3 HIV/AIDS

3.6.3.1 EPMTCT

3.6.3.2 Option B+

3.6.4 Anaemia

3.6.5 Heart Diseases

3.9 Post maturity

192

UNIT 4 Normal labour and delivery

4.1 Partograph

4.2 Normal mechanism of labour and duration

4.3 Normal delivery

4.3.1 Assessment of the new born

4.3.2 Helping Baby Breath (HBB)

Delivery of the placenta

Active management with use of urotonics

Examination of the placenta

Augmentation of labour

Induction of Labour

Episiotomy

Dysfunctional labour

Cord prolapse

Premature rupture of membranes

Featal distress

Stages of labour

First stage of labour

Arrest of labour

Obstructed labour

Second stage of labour

Third stage of labour

Active management with use of oxytocin

Retention of Placenta (include manual removal of

UNIT 5 Malpresentations and malposition

5.1 Occipital posterior position

193

5.2 Brow presentation

5.3 Shoulder dystocia

5.4 Transverse lie

UNIT 6 Postpartum haemorrhage

Uterine inertia

Trauma of birth canal

cervical tears

perineal tears

Uterine rupture

UNIT 7 Puerperium

Postpartum care

Pyrexia

Sepsis

Breast condition and breast feeding

Psychosis

Deep vein thrombosis

UNIT 8 Obstetric Operations/procedures

8.1 Booking for Antenatal Care

8.2 Abdominal Examination

8.3Administer Local and cervical block Anaesthesia

8.4Cervix Assessment during labour

8.5Partograph plotting

8.6Administer Magnesium Sulphate

8.7Episiotomy and Repair

8.8Repair of trauma of birth canal

8.9Forceps delivery

194

8.10Vacuum Extraction

8.11Conduct Normal Vaginal Delivery

8.12Assisted Breech Delivery

8.13Manual Removal of retained placenta

8.14Reposition of inverted uterus

8.15 Helping Babies Breath

8.16 Bimanual compression of abdominal aorta

8.17 Caesarean section

8.18 Administration of urotonics,anticonvulsants and antibiotics

8.19 Smart Care in Obstetrics

18.19.1 ANC information

8.19.2 Intrapartum information

8.19.3 Postpartum information

TEACHING METHODS

Lecture Discussions

Clinical skills training (Skills lab, Maternity Units)

Assignments

Group discussions

CONTACT HOURS

Lectures: 4 Hours/ week

Practice: 2 hours/week

Assessment Methods



Assignments 10%

195

Skills lab 10%



OSCE 20%

Prescribed Reading

Hanretty, Kevin, P. (2010) Obstetrics Illustrated. 7th Edition. London: Churchill Livingstone.

Malcolm, S.,Ian M. Symonds (2006) Essential Obstetrics and Gynaecology 4th edition. Edinburgh: Churchill Livingstone.

World Health Organization (2003) Managing Complications in Pregnancy and Childbirth. Geneva: WHO, Department of Reproductive Health and Research.

Recommended Reading

Neville Hacker, J.George Moore, Joseph Gambone. (2004) Essentials of Obstetrics and Gynaecology.4th Edition.India:Elsevier.

Arulkumaran, S., I. Symonds, A. Fowlie (2003) Oxford Handbook of Obstetrics and Gynaecology. Oxford: Oxford University

Stuart, Campbell.,Christopher, Lees. (2000) Obstetrics by Ten Teachers. 17th Edition. London: Hodder Arnold.



http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Stuart%20Campbell

http://www.amazon.co.uk/exec/obidos/search-handle-url?_encoding=UTF8&search-type=ss&index=books-uk&field-author=Christoph%20Lees

196

YEAR 3: Semester 1& 2 Courses

197

CLINICAL ROTATIONAL PRACTICALS (CLINICAL SKILLS TRAINING):

MED 310: INTERNAL MEDICINE CLERKSHIP

Laboratory

Dermatology and Sexually Transmitted Infections

HAARTClinic

SGY 310: SURGERY CLERKSHIP

Dentistry

Ophthalmology

ENT clinic

Circumcision clinics

OBG 310: OBSTETRICS AND GYNAECOLOGY CLERKSHIP

Antenatal clinic

Labour ward

Gynae clinic

PED 310: PAEDIATRICS AND CHILDHEALTH CLERKSHIP

Children’s clinic

Paediatric ward

Out patients clinic

MHP 310: MENTAL HEALTH AND CLINICAL PSYCHIATRY CLERKSHIP

Psychiatric units

Out patients clinic

198

MANAGEMENT AND LEADERSHIP PRACTICALS

CLINICAL ROTATIONAL PRACTICALS (CLINICAL SKILLS TRAINING):

MED 320: INTERNAL MEDICINE CLERKSHIP

Medical ward/ outpatients

SGY 320: SURGERY CLERKSHIP

Surgical wards / outpatients

OBG 320: OBSTETRICS AND GYNAECOLOGY CLERKSHIP

Antenatal clinic

Labour ward

Postnatal clinic

Gynae clinic

PED 320: PAEDIATRICS AND CHILD HEALTH CLERKSHIP

Children’s clinic

Paediatric ward

Out patients clinic

199

MHP 320: MENTAL HEALTH AND CLINICAL PSYCHIATRY CLERKSHIP

Psychiatric ward

Out patients clinic

MANAGEMENT AND LEADERSHIP PRACTICALS

Two weeks theory revision

200

One week study break

Summative Examinations