The Department of Internal Medicine at Sree Balaji Medical College and Hospital is a thread which links with all the departments and specialties in the hospital. It is managed by an excellent and competent group of doctors including consultants, senior residents, medical officers and Post Graduate trainees. WHAT THE DEPARTMENT DEALS WITH:
Internal medicine is the foundation on which all the medical super specialties are built. It is the first point of contact for any patient who seeks a specialist opinion as the internist has a holistic approach towards a patient, analyses various problems and then if required refers to the concerned super specialist whose highly specialised skills are used for the patients’ benefit.
This department provides broad range of services for diagnosis and treatment by doctors skilled in the management of patients who have undifferentiated or multi-system disease processes. It has round the clock back up from allied departments like cardiology, endocrinology, gastroenterology, neurology, nephrology and psychiatry. WHAT’S IN THE SPECIALTY
The services provided under the specialty include:
1. Critical care:
2. Intensive care treatment and management of critically ill/compromised patients, infectious diseases, drug overdose and poisoning and other medical emergencies like Septicaemia, diabetic ketoacidosis, shock of any kind, meningitis, pneumonia etc.
4. Management of chronic diseases: Involves multi-system discussion by senior consultant of department of medicine. Coordination between different specialist and holistic care of patients
5. Infectious diseases like
6. Malaria, Typhoid fever, Tuberculosis, HIV/AIDS, Dengue fever, influenza etc. (Investigated in depth and treated)
7. Management of drug overdoses and poisoning:
8. Active involvement of faculty in providing emergency care
9. Modern and world class standard intensive care unit with step down intensive care wards.
10. Efficient nursing care
11. Environmental disease management:
12. Includes diseases due to Industrial chemical exposure, drowning, electrical injuries, radiation injuries, snake bite, lizard bite, dog bite, insect or scorpion bite are treated in department on Internal medicine.
13. Allergy workup and management:
14. Allergy testing
15. Pre-employment checks
They are designed to diagnose and evaluate fitness for employment by various organizations ACADEMICS COURSES OFFERED:
• Caters to twenty post-graduates each year. Previously the department had six PGs per year which was recently expanded to twenty.
• Also caters to a batch of 250 MBBS students. These undergraduate students over their four and a half years are posted over two months in the department for clinical postings and have many hours of theory sessions for them. CALENDER
• Every day there is a academic session for these post-graduates. These include any one of the following:
• Interesting case of the month
• Journal Club
• ECG of the week
• Image of the week
• Apart from these, there is a twice weekly clinical case presentation for the residents. They are asked to present cases to professors and their art of presentation is fine-tuned. This is to prepare the final year post-graduates to prepare for the exam.
• The department also conducts monthly CME/ Virtual Webinars where speakers from outside the college and come in and give a lecture on their area of expertise.
• The post-graduates have five months of peripheral posting wherein they are posted in super-specialty and other departments and in ICU to provide them with further exposure.
• Once a year the department conducts conferences wherein eminent speakers from all around the country are invited to speak. Some of the recent events that has been conducted are: PYROCON, RHEUMACON, GERONTOCON.
• Both under-graduate and post-graduates are divided into each of the units. These students are under constant mentorship from the unit faculty.
• Theory sessions are conducted as interactive lecture sessions with the aid of Powerpoint, models, etc.
• Clinical postings are conducted by offering the students a case scenario and asked to present the same. They are also shown the schema and way of examination and history taking with help of patients admitted in the ward. This also exposes them to a variety of clinical signs.
• Post-graduate students are encouraged to publish case reports, review articles and original research papers and get it published in reputed journals. They are guided by the faculty to how to go about the same.
• They are also taught the art of imparting medical knowledge by asking them to take clincal classes for undergraduate sessions. This brings out the teacher in them. SYLLABUS APPLIED BASIC SCIENCES ANATOMY INCLUDING HISTOLOGY:
• Embryology - Development of Heart and Great Vessels Development of Brain and Spinal Cord.
• Anatomy of Brain and Spinal Cord with their Blood Supply and Venous Drainage.
• Cranial Nerves and Autonomic Nervous System. Nervous Control of Bladder and Rectum.
• Anatomy including Histopathology of Endocrine Glands. Anatomy of Liver, Pancreas and Portal Circulation.
• Anatomy including Histopathology of Kidneys. Anatomy including Histopathology of Spleen.
• Anatomy of Bronchopulmonary Segments, Pleura and Mediastinum. Surface Anatomy of Head and Neck, Thorax and Abdomen. PHYSIOLOGY INCLUDING BIOCHEMISTRY:
• Liver: Laboratory tests of liver Function.
• Kidney: Laboratory Tests of Kidney Function.
• Exocrine and Endocrine function of pancreas.
• eroids - Various tests to study function of Endocrine Glands.
• Pulmonary Function Tests.
• The mechanism of Deglutition.
• Digestion: Gastric and Intestinal secretion and their Hormones-
• Mechanism of absorption of Fat, Proteins and Carbohydrates.
• Heart: Basic principles of condition system and electro-cardiogram - Circulation - Measurement of cardiac output - Factors controlling arterial blood pressure – Mechanism of production of cardiac failure and syndrome of
• Blood, Plasma, proteins - Coagulation of blood RBC and WBC development -
• Platelets - Erythropoiesis and its regulation - Blood groups - Iron Metabolism.
• Physiology of Micturition and Defaecation.
• Fluid and electrolyte balance.
• Calcium and Phosphorous Metabolism.
• Carbohydrate metabolism.
• Fat metabolism
• Protein metabolism and electrophoresis.
• Inborn Errors of metabolism.
• Porphyrins and porphyrias.
• Jaundice - Types and Diagnosis.
• Metabolism of Haemoglobin and circulation of Bile pigments.
• Immunoglobulin and the Mechanism of Immunity.
• Physiology of consciousness.
• Physiology of sleep and disorders of sleep.
• Temperature regulation.
• Physiology of hunger and its disorders. PATHOLOGY INCLUDING MICROBIOLOGY:-
• Central nervous system: Brain and spinal cord Meningitis and Encephalitis, Abscess Tumors, Syphilis .of nervous system, Nutritional and metabolic disorders, epilepsy, vascular diseases.
• Heart: Rheumatic fever and carditis, Coronary artery diseases Hypertension, Atherosclerosis, Cardiomyopathy, Pericarditis, Specific and non specific arteritis, Congenital Heart diseases.
• Kidneys: Nephritis, Nephrosis, Kidney, changes in metabolic and collagen vascular diseases, Acute and chronic renal failure.
• Lungs: Pulmonary tuberculosis, atypical mycobacteria, Tumours of lung.
• Liver: Portal hypertension, Cirrhosis of liver, Tumors of liver.
• Bone: Disorders of Mineral and Bone matrix.
• Endocrine Glands: Myxoedema and Thyrotoxicosis, Hyper and hypoparathyroidism, disease of Pituitary, Adrenal Cortex and Medulla.
• Diabetes Mellitus and its complications – Pathological changes in Viscera.
• Gastro intestinal disorders: Peptic ulcer, Malabsorption syndrome, Ulcerative colitis, Amoebiasis (Intestinal and extraintestinal).
• Lymphomas. Leukemias and other blood dyscariasis. PHARMACOLOGY:
• Chemotherapy, Antibiotics and antimicrobials
• Antiamoebic drugs.
• Antiviral agents.
• Drugs acting on Autonomic nervous system.
• Drugs for Epilepsy.
• Cardiac glycosides.
• Antiarrythmic drugs.
• Coagulants and anticoagulants.
• Histamine and antihistamine drugs.
• Vaccines and Immune Sera.
• Drug abuse, drug tolerance, drug addiction.
• Newer drug TROPICAL MEDICINE:
• Diseases caused by Protozoa: Malaria, African and American Trypanosomiasis, Leishmaniasis, Toxoplasmosis, Coccidiosis and Pneumocystis infection, Ameobiasis, Giardiasis
• Trematode and Cestode infestation.
• Diseases caused by Viruses: Arbovirus diseases Pox diseases, other viruses’ diseases: Measles, Infective Hepatitis, poliomyelitis, Rabies.
• Diseases caused by Bacteria: Leprosy,Tuberculosis, Plague, Meliodosis, Brucellosis Tularaemia, Cholera, Shigelloses and Diarrhoea, Salmonelloses, Tetanus, Anthrax, Tropical Pyomyositis, Rhinoscleroma,Meningitis.
• Diseases caused by Spirochetes: Relapsing fevers, Rat bite fever, Leptospirosis.
• Diseases caused by Rickettsiae and Bartonella
• Tropical Veneral Diseases: Lymphogranuloma Venereum, Granuloma
• Diseases caused by Fungi: Superficial Mycoses – Systemic Mycoses.
• Neurological Diseases, Neurasthenia in Tropics, Kuru
• Heart Disorders: Heat stroke and heat hyperpyrexia.
• Nutritional Diseases: Nutritional deficiency syndromes, Malabsorption in the
• Tropics, Vitamin deficiencies, Nutritional.
• Poisons: Chiggers, Mites and Animal poisons – plant poisons, leeches and Leech Infestation.
• Ophthalmology in the Tropics.
• Introduction to Clinical Medicine: Headache – Pain in the chest, Abdominal pain, Pain in the back and neck, Pain in the extremities, Disturbances of heat regulation, Chills and fever, Nervousness, Anxiety and Depression, Lassitude and Asthenia, Faintness, Syncope and Episodic weakness, Motor paralysis, Tremor, Chorea, Athetosis, Ataxia and other abnormalities of Movement and Posture, Dizziness – Vertigo and Disorders of Gait, Common disturbances of Vision, Ocular movement and hearing, Disorders of sensation, Coma and related disturbances of consciousness – Sleep and its abnormalities, The Convulsive state, Affections of Speech, Delirium and other acute confusions states, Derangement of intellect and behaviour due to diffuse and focal cerebral disease, Dyspnoea, Cyanosis, Hypoxia and Polycythemia, Oedema, Palpitation, Hypotension and the Shock Syndrome, Elevation of Arterial Pressure – Sudden Cardiovascular Collapse and Death, Cough and hemoptysis, Oral manifestations of disease, Dysphagia – indigestion, Anorexia, Nausea and vomiting, Constipation, Diarrhoea and disturbances of Anorectal function, Hemetemesis and Melena, Jaundice and Hepatomegaly, Abdominal swelling and Ascites, Loss of weight, Obesity, Dysuria, Incontinence and Enuresis, Oliguria, Polyuria and Nocturia, Hematuria, Disturbances of Menstruation – Disturbances of sexual function, Infertility, Pallor and Anemia, Bleeding, Enlargement of Lymph Nodes and Spleen, Alteration in Leukocytes.
• Genetic Factors in Disease: Cell divison and reproduction, The nature of genetic material, The pattern of familial disorders, Visible abnormalities of Chromosomes – Genetic advice.
• Immunological factors in disease: Components of the Immune System, Mechanism of the Immune Response, Immune deficiency and Lymphoproliferative disorders, Types of Immune reaction and their relation to human disease, Suppression of immune reactions and their effects.
• Infections and diseases: Nature of Microorganism, Epidemiology and spread and infection, Defence of the human host, Diagnosis of infectious, disease, Pyrexia of unknown origin.
• Infectious Diseases: Streptococcal infection, Staphyloccal Infection, Diphtheria, Typhoid, Bacterial food poisoning, Tetanus, Brucellosis, Gonorrhoe, Syphilis, Measles, Rubella.
• Chemotherapy of infections:
• Immunisations: Active and passive.
• Nutritional disorders: Protein - Calorie Malnutrition, Kwashiorkar, Marasmus, Nutritional dwarfing, mineral deficiencies, Vitamin deficiencies, Obesity, Anorexia Nervosa, Bulimia.
• Disturbances in water and electrolyte balance: Sodium depletion – Primary water depletion, Potassium excess and deficiency, Magnesium deficiency, Sodium and water accumulation, Disturbances in Hydrogen ion concentration.
• DISEASES OF CARDIOVASCULAR SYSTEM: Principles of clinical electrocardiogram, Cardiac dysarrhythmias, Cardiac failure, Rheumatic fever, Valvular diseases, Congential heart diseases, Ichaemic heart disease, Pericardial diseases, Cardiomyopathies and Myocarditis, Cardiac tumours, Atherosclerosis, Hypertension, Diseases of Aorta, Peripheral vascular diseases, Cardiovascular syphilis.
• DISEASES OF THE RESPIRATORY SYSTEM: Disturbances of respiratory functions, diseases of upper respiratory tract, Obstructive Airway Diseases, Bronchiectasis –Lung Abscess, Broncholithiasis, Diffuse, infiltrative diseases of Lung, Pulmonary thromboembolism, Hypersensitivity reactions of Lung, Environmental Lung Diseases – Primary Pulmonary Hypertension, Neoplasms of Lung, Diseases of Pleura, Mediastinum and Diaphragm, Corpulmonale, Acute Respiratory Failure.
• DISEASES OF THE DIGESTIVE SYSTEM: Diseases of Oesophagus, Peptic Ulcer,Gastritis and other diseases of Stomach including Carcinoma, Diseases of small intestine, Diseases of Colon and Rectum – Diseases of Peritoneum and Mesentery.
• DISEASES OF LIVER AND BILIARY TRACT: Diagnostic Procedures in Liver Diseases, Derangement of Hepatic Metabolism, Disturbance of Biliary Metabolism, Acute Hepatitis, Chronic Active Hepatitis, Cirrhosis of Liver, Tumours of Liver, Suppurative Diseases of Liver,Infiltrative and Metabolic Diseases affecting the Liver, Diseases of Gall bladder and Bile ducts.
• DISEASES OF PANCREAS: Acute and chronic pancreatitis, prognostic indicators, tumors of pancreas
• DISEASES OF KIDNEY AND URINARY SYSTEM: Acute and Chronic Renal Failure, Giomerulonephritis, Nephrotic Syndrome: Vascular Diseases of Kidney, Toxaemia of Pregnancy, Infections of the Urinary Tract, Obstructive Uropathy – Nephrolithiasis, Cystic Diseases of the Kidneys, Other Congential and Hereditary Disorders of the Kidney and Urinary Tract, Tumours of the UrinaryTract.
• DISEASES OF THE ENDOCRINE SYSTEM: The Hypothalamus and Pituitary Gland, Diseases of Anterior Lobe of Pituitary Diseases of Adrenal Cortex and Medulla,Diseases of Testis and Ovaries, Pineal Gland , Diabetes Mellitus, HyperInsulinism,Hypoglycemia, Glucogan Secretion. Diseases of Neurohypophysis, Diseases of Thyroid.
• DISEASES OF THE BLOOD AND BLOOD FORMING ORGANS ORGANS: Blood Formation Blood Destruction, Anemia,Bone Marrow failure, Blood Groups and Transfusions Polycythemia Rubra Vera, Abnormal Haemoglobin ,Disorders of platelets, Haemorrhagic Disorder,Leukemia, Lymphomas, Diseases of spleen and Reticulo Endothelial system.
• DISEASES OF CONNECTIVE TISSUES, JOINT AND BONES: Rheumatoid Arthritis, Ankylosing Spondylitis, Systemic Lupus Erythematosis, Scleroderma, Polymyalgia Rheumatica, Gout, Pseudo Gout, Osteoarthritis, Diseases of Bone, Metabolic and Endocrine Diseases, Tumors of Bone, Metabolic and Endocrine Diseases of Bone, Paget's Diseases.
• DISEASES OF THE NERVOUS SYSTEM: Diagnostic Methods in Neurology, Coma, Headache, Epilepsy,Diseases of Peripheral Nervous System, Diseases of Cranial Nerves, Diseases of Spinal Cord, Cerebro vascular Diseases,Traumatic Diseases of brain, Neoplasms, Pyogenic Infection of Central Nervous System –Tuberculosis and Viral Infections, Multiple Sclerosis, Demyelinating diseases, Metabolic and Nutritional Diseases of Brain, Degenerative Diseases of Nervous system, Developmental and other Congential Anomalies of Nervous Systems, Narcolepsy, Migraine, Disease of Extrapyramidal System, Muscle Disorders, Disorders of Myoneural Junction.
• PSYCHIATRY: Neuroses, Antisocial Personality, Grief, Reactive Depression, Manic depressive Psychosis, Involutional Melancholia and Hypochondriacs, Schizopherinic Syndromes and related Psychoses.
• ERRORS OF METABOLISM:Genetic Disorders of Amino acid Metabolism, Cystinuria, Renal Glycosuria Renal Tubular Acidosis, Carcinoid, Syndrome, Gout, Haemochromatosis, Disorders of Porphyrin Metabolism, Hepatolenticular Degeneration, Disorders of Glycogen Synthesis and Mobilization, Galactosemia, Disorders of Lipid Metabolism, Amyloidosis.
• DISORDERS DUE TO CHEMICAL AND PHYSICAL AGENTS INCLUDING NUCLEAR MEDICINE: Common Poisons, Heavy Metals, Alcohol, Opiates and other Synthetic Analgesic Drugs, Barbiturates, Depressants, Stimulants and Psychogenic Drugs, Disorders Caused by Venoms, Bites and Stings, Disorders due to Environment, temperature. Electric Shock, Lightning, Hanging, Disorders due to Alternations in Barometric Pressure Problems of Air and SpaceTravel –Radioactive Isotopes and Radiation injury Electrical Injuries, Immersion Injury and Drowning.
• GERIATRIC MEDICINE: Problem of old age and disease, condition peculiar to the aged.
• COMMUNITY MEDICINE: Problem of over population, Family Planning Programme, National health programmes
• IATROGENIC DISORDERS: Induced by Drug and Other forms of Therapy.
• DISEASES OF THE SKIN: Interpretation of alterations in the Skin, Lesions of General Medical significance, Generalized Pruritus, Pigmentatin of the Skin and Disorders of Melanin Metabolism, Photo sensitivity and other Reactions to Light, Hirsutism and Alopecia, Cutaneous Manifestations of Internal Malignancy, Psoriasis, Pemphigus, Scabies and fungal infections of the Skin.
• OTHERS: History of Medicine, Occupational hazards, Space medicine including high altitude Problems in industrial medicine, Organ transplantation, Imaging technique including CT scan and MRI
• PRACTICAL: History and examination, History taking including psychosocial history, environmental history, physical examination including fundus examination and system examination. Awareness towards current trends in tropical infectious disease and needs of investigative procedures and current treatment trends. Bedside procedures.Monitoring skills: Temperature recording, capillary blood sampling, arterial blood sampling, basic life support skills, advanced life support skills and ventilator settings and monitoring.Therapeutic skills: Nasogastric feeding, endotracheal intubation, cardiopulmonary resuscitation, administration of oxygen, venepuncture and establishment of vascular access, administration of fluids, blood, blood components, parenteral nutrition, common dressings, abscess drainage and basic priniciples of rehabilitation. Investigative skills: Lumbar puncture, bone marrow aspiration and biopsy, pleural, peritoneal, pericardial tap, ascitic fluid therapeutic and diagnostic tapping, biopsy of liver and kidney, collection of urine for culture, urethral catheterization, suprapubic aspiration. Beside investigations: Hemoglobin, TLC, ESR, peripheral smear staining and examination, urine routine and microscopic examination, stool microscopy including hanging drop preparation, examination of CSF and other body fluids, Gram stain and ZN stain.
• Interpretation-X-rays of chest, abdomen, bone and head; ECG; ABG findings; CT/ MRI scan Understanding of 5Common EEG patterns, audiograms, ultrasonographic abnormalities and isotope studies.
CLASS ROOMS AND AV HALL:
Class rooms are spacious well lit and equipped with modern furniture. Class room is fitted with power point projector and enabled with modern audio visual presentation facility. Class rooms are also designed to facilitate the conduct of students seminar and group discussions.
Side lab is present in our department where basic investigation are taken and sent to central laboratory for further processing and reporting. It helps to collect blood sample for the In-patient by bed side.
A Library plays a vital role in the search of knowledge. It serves as the workshop for the all faculties, both post graduate and under graduate students alike. Our Department of General medicine library aims to support the teaching learning activity in the college and also provide the students updated knowledge and to ensure the optimum utilization of the available resources. Our library consists of wide range of books for both UG and PG students which is useful for their references and studies.