POST GRADUATE FINAL YEAR MS (AYU) SHALYA TANTRA – GENERAL SURGERY
PAPER – I Shalya Tantra Vangmaya – Literature, Research, and Development 100 Marks
1. Thorough study of the Sushruta Samhita including other relevant portions of Brihattrayee and Laghutrayee.
2. Knowledge and importance of Surgical Audit and Research.
3. Medico-legal issues – Understanding the implications of acts of omission and commission in practice. Issues regarding Consumer Protection Act, the medical profession, national health policy – Implications in a medico-legal case like accidents, assaults, etc.
4. Surgical ethics including Informed consent.
5. Yogya Vidhi – Practical and Experimental training on different types of Surgical Models for Research in Surgery.
6. Clinical and diagnostic methods in Shalya Tantra – X-rays, U.S.G., Endoscopies (for diagnostic and treatment purposes), MRI, CAT scanning, and other recent diagnostic tools.
7. Concept of Sandhana Karma – Plastic reconstructive and cosmetic surgery. Fundamentals of Sandhana Karma –
i. Karna Sandhana – Auroplasty
ii. Nasa Sandhana – Rhinoplasty
iii. Ostasandhana – Cheiloplasty
iv. Grafts and Flaps – Techniques and applications.
v. Vascular anastomosis and grafts.
8. Recent development on Sushruta’s surgical principles and practices.
PAPER-II – SHALYA TANTRA VIGYAN 100 Marks
1. Vrana – Wound management
i. Management of Nija Vrana, Dushta Vrana and Nadi Vrana.
ii. Vrana Chikitsa – Shasti upakramas, Pathya-apathya.
iii. Wound and Ulcer.
iv. Dagdha Vrana – Burns, scalds, Dhumopaghata, Ushnavata, Frostbite, electric burns, and their management.
v. Prameha Pidaka – Diabetic carbuncle, Diabetic wound, and its management.
vi. Kotha – Gangrene and Principles of Amputation.
vii. Sadyo Vrana – Traumatic wounds – Nidana, Prakara, Lakshana, Upadrava and Chikitsa, Bites and stings and its management.
2. Pranasta Shalya – Diagnosis and management. 3. Vranashopha-Inflammation, Vidradhi – Abscesses, and Pidika – Boils. 4. Granthi – Cyst and Arbuda – Benign and malignant Neoplasm.
5. Bhagna – Classification, Clinical Features, Complications, and Management.
6. Sandimoksha – Classification, Clinical Features, Complications, and Management.
7. Udara Roga – Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications, and Management.
8. Gulma Roga – Nidana, Prakara, Lakshana, Upadrava and Chikitsa.
9. Shoola vyadhi – Nidana, Prakara, Lakshana, Upadrava and Chikitsa.
10. Diseases of Rectum and Anal Canal – Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications and Management of Arshas, Parikartika, Bhagandara, Guda Vidradi, Gudabhramsa, and Sanniruddaguda.
11. Ashmari – Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications, and Management.
12. Mutraghata and Mutrakrichhra – Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications, and Management.
13. Niruddhaprakasha – Phimosis, Parivartika – Paraphimosis, and Avapatika – Prepuceal ulcer.
14. Vriddhi Roga – Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications, and Management.
PAPER – III – ADHUNIK SHALYA KARMA – MODERN SURGERY 100 Marks
1. Fundamentals of modern surgery and treatment of surgical disorders including surgical anatomy, physiology, and pathology.
2. Diagnosis and Surgical treatment of head and spine injury, thoracic trauma, and abdominal trauma. Blast injuries and Management.
3. Diagnosis and surgical measures for disorders of Artery, Vein, Ligaments, Muscles, and Tendons.
4. Diagnosis and Surgical management of neck disorders e.g. salivary glands, thyroid, Thyroglossal cyst and Fistula, Branchial cyst and fistula, Cystic hygroma, and Lympadenopathies.
5. Diagnosis and Surgical management of breast diseases, Benign and Malignant breast tumors.
6. Diagnosis and Surgical measures of diseases of the Gastrointestinal system –
i. Oral cavity – Oral ulcers, Oral cancer, Precancerous conditions, Submucosal fibrosis, Leukoplakia, Cleft lip and palate, Lip tumors, Mucosal cyst, Nasopharyngeal cancer, Tongue ulcer, and cancer.
ii. Oesophagus – Oesophageal varices, Dysphagia, Neoplasm, Strictures, and Gastro-oesophageal reflux.
iii. Stomach and duodenum – Congenital anomalies, Injuries, Inflammation, Ulcer, Neoplasm, Pyloric stenosis, Acute dilatation, Hiatus hernia, and Foreign bodies.
iv. Pancreas – Congenital anomalies, Acute and Chronic pancreatitis, Calculi Neoplasm, and Cysts of the pancreas.
v. Peritoneum, Omentum, Mesentery, Retroperitoneal Space – Peritonitis, Abscess, Neoplasm, Mesenteric cyst, Torsion of the mesentery, Vascular thrombosis, Retroperitoneal cyst, and Fibrosis.
vi. Abdominal mass – Diagnosis and Management.
vii. Small intestine – Congenital anomalies, Inflammation, Ulcer, Neoplasm, Stenosis, Injuries, Foreign bodies, Diverticuli, Peutz-jeghers syndrome, Chron’s disease, Carcinoid tumors, Enteric perforation, and Intestinal fistula.
viii. Large intestine – Congenital anomalies, Inflammation, Ulcer, Neoplasm, Stenosis, Injuries, Foreign bodies, Diverticuli, Faecal fistula, Amoebiasis, and Familial polyposis coli.
ix. Caecum and Vermiform appendix- Appendicitis, Appendicular abscess, Appendicular mass, Perforation, Carcinoid Tumor, and other Neoplasm.
x. Gastrointestinal bleeding – Haemetemesis, Malena, Haemobilia, Bleeding per anum – Causes, Diagnosis, and Management.
xi. Rectum and anal canal – Diagnosis and Surgical Management of Congenital Anomalies, Inflammation, Ulcer, Neoplasm, Stenosis, Prolapse, Hemorrhoids, Fistula-in-ano, Fissure-in-ano, Anorectal Abscess, Incontinence, Injuries, Foreign bodies, and Pilonidal sinus.
7. Umbilicus and abdominal wall – Congenital anomalies, Umbilical infections, Sinus, Neoplasm, and Desmoid tumor.
8. Diagnosis and surgical measures of diseases of Hepatobiliary system –
i. Liver – Abscess, Cyst – Hydatid cyst, Primary and Secondary malignant tumors, Portal Hypertension and Budd-Chiari Syndrome.
ii. Gall bladder and Bile duct – Congenital anomalies, Acute and Chronic Cholecystitis, Cholelithiasis, Neoplasm, Cholangitis, Stenosis, Choledocholithiasis, Choledochal cyst, and Cholangiocarcinoma.
iii. Spleen – Splenomegaly and Splenic Injury.
9. Diagnosis and surgical management of Hernias – Inguinal, Femoral, Umbilical, Incisional, Abdominal wall, and other hernias.
10. Endoscopic procedures – Oesophagogastroduodenoscopy, Sigmoidoscopy, and Colonoscopy.
11. Principles of laparoscopic surgery – Diagnostic and therapeutic laparoscopy.
PAPER –IV VISHISHTA SHALYA VIGYAN – SPECIALITY
The Scholar has to choose any one of the Specialities amongst the following based on research area PAPER – IV –
Specialty No – 01 Anushastra Vigyan – Parasurgical Therapeutics 100 Marks
1. Kshara Karma and Prayoga – Caustic therapy
i. Introduction of different types of Kshara, Method of preparation, Standardization, pH value, Application, complications, and management.
ii. Surgical Anatomy and Physiology of Anus and Rectum.
iii. Arshas – Nidana, Purvaroopa, Roopa, Samprapti, Prakara and Chikitsa.
iv. Haemorrhoids – Aetio-pathogenesis, types, and its surgical management. Knowledge of different methods of treating Haemorrhoids – Rubber band ligation, D.G.H.A.L, Radiofrequency, Ablation, Cryo-surgery, Cautery, Laser, Infrared coagulation, and other advanced techniques.
v. Bhagandara – Nidana, Purvaroopa, Roopa, Samprapti, Prakara, Chikitsa and application of Kshara Sutra.
vi. Fistula-in-ano – Definition, Aetio-Pathogenesis, Types, Diagnostic methods and its Surgical and para surgical management including knowledge of Fibrin Glue, Advanced Flap Therapies, and other recent techniques.
vii. Parikartika – Nidana, Samprapti and its Chikitsa.
viii. Fissure-in-ano – Aetio-pathogenesis, types, and its management.
ix. Sannirudhaguda and its Chikitsa.
x. Anal Stenosis – Aetio-pathogenesis and its management.
xi. Gudavidradhi – Nidana, Purvaroopa, Roopa, Samprapti, Prakara and its Chikitsa.
xii. Anorectal abscesses – Aetio- pathogenesis, types, complications, and its management.
xiii. Foreign body in the rectum and anal canal – Method of diagnosis and its management.
xiv. Congenital Anorectal disorders and their management.
xv. Anorectal tumor – Types and its management.
2. Agnikarma – Thermo therapy
i. Introduction, definition, and importance of Agnikarma.
ii. Agnikarma – Poorva, Pradhana, and Paschal karma, various substances and Shalakas used for Agnikarma and their indications, contraindications, and complications.
iii. Knowledge of modern thermal equipment – Diathermy, Laser therapy, Microwave, Ultracission technique, Cryo Technique, and its uses.
iv. Effect of Agnikarma on the skin, muscle tissue, nerves, metabolism, blood circulation, and infective lesions.
3. Raktamokshana – Bloodletting Procedures
i. Indications, contraindications, and importance of Raktamokshana.
ii. Justification of usage of different types of Raktamokshana in various therapeutic applications.
iii. Different types of Raktamokshana – Sastrakritha – Siravyadhana, Prachana and Asastrakritha – Shringa, Jaluka, Alabu and Ghati.
iv. Jalauka – Nirukti, Paryaya, Bhedha, Sangrahana, Samrakshana, Jalaukavacharana Vidhi – Poorva, Pradhana and Paschat karma.
v. Knowledge of Leeches – Morphology, Anatomy, Physiology, Bio-chemical effects of its various constituents present in its saliva.
PAPER – IV – SPECIALITY NO–02 ASTHI SANDHI EVAM MARMA VIGYAN – ORTHOPAEDICS 100 marks 100 Hours
1 Asthi Sharira – Etymology, Embryology, Applied Anatomy, and Physiology of Asthi. Its Panchbhautik constitution, Poshan (Nutrition), Asthivaha Srotas, Upadhatu, and Mala. Total Number and classification of Asthi. Concept of Dhatwagni in Ayurveda. Asthi Dhatu Kshaya and Vriddhi Lakshana. Knowledge about Tarunasthi. Embryology, Ossification, Histology, Metabolism, Blood Supply, Types, and Biomechanics of Bone and cartilage.
2. Healing mechanism of bone and factors influencing bone healing according to Ayurvedic and Modern concept. Biological and Biophysical technologies for thE Enhancement of Fracture Repair. Knowledge of Sandhaniya and Ropaniya drugs.
3. Sandhi Sharira – Classification, Applied Anatomy and Physiology of Asthi Sandhi. Classification, Applied Anatomy, and Physiology of Joints and Healing Mechanism of a joint.
4. Knowledge of Splints, Orthotics & Prosthetics.
5. Knowledge of Orthopedic implants (e.g. wires, screws, plates, nails) and Instruments. Knowledge of equipment (e.g. C-arm image intensifier and drill machines etc).
6. Concept of Pain according to Ayurved and Modern Medical science.
7. Principles of Reconstruction, Transplantation, Bone grafting, Bone Banking, Bone transportation, and Amputation.
8. Vata Vikara – Asthi, Sandhi and Marma related Vata Vikara like Gridhrasi, Bisvachi, Avabahuka, Manyastambha, Khalvi, Dhatugata vata, Snayugata vata, Katishoola, Katigraha.
9. Diseases about Muscles, Tendons, Ligaments, Fascia, and Bursae.
10. Diseases and Congenital anomalies of Spine e.g. Ankylosing spondylitis, Infective conditions, Tuberculosis, Spondylolisthesis, Inter-vertebral Disc Prolapse, Spondylosis, Scoliosis, Kyphosis, spina bifida, Hemivertebra, Block vertebra, Sacralisation, and Lumbraisation.
11. Diseases and Congenital anomalies of Cervical Spine
12. Diseases and Congenital anomalies Sacroiliac Joint and Bony Pelvis.
13. Diseases and Congenital anomalies of Hand.
14. Diseases and Congenital anomalies of Foot.
15. Diseases and Congenital anomalies of Limbs.
16. Orthopedic Neurological Disorders. Post-Polio Paralysis & Cerebral Palsy.
17. Snehana, Swedana and Panchakarma in Marma, Asthi and Sandhi Vyadhi.
18. Yogic Practices in Orthopedics.
19. Principles of Arthroplasty- Joint Replacement.
20. Introduction of Peripheral Vascular Diseases.
21. Bhagna – Etiology, classification, and General Management principles and Prognosis.
22. The modern concept of Bone and Joint injuries – Etiology, Epidemiology, Classification, and General management principles.
23. Individual Bone and Joint injuries – Etiology, Epidemiology, Classification, and management principles.
24. External immobilization techniques – Classical and traditional Kusha -splints, Plaster of Paris Technique, Knowledge of different splints and Plasters.
25. Pathological Fractures including Fragility fractures, Stress Fractures, and Peri-prosthetic Fractures.
26. Fractures in Children – Etiology, Epidemiology, Diagnosis, management, and complications.
27. Prognosis of skeletal injuries, Complications of Fractures and Joint Injuries e.g. Myositis ossificans, Volkman’s ischemic contracture, Compartment syndrome, Crush Syndrome, DVT, Thromboembolism, Fat Embolism.
28. Rehabilitation of trauma patient and Principles of Sukhchestaprachara – Physiotherapy and its use in skeletal injuries.
29. Treatment Principles of Asahanta Bhagna – Non-unions, Vishmolvana Sahanta – Malunions, and Ignored or un-reduced dislocations.
30. Diagnosis and management principles of injuries of Vessels, Nerves, Tendons, and Ligaments.
31. Head, Chest, and Abdominal Injuries and management principles.
32. Pelvis and Spine injuries and their management principles.
33. Sports medicine and sports injure – Sports medicine and sports-related Shoulder injuries, Elbow injuries, Knee injuries, Ankle Injuries, Recurrent Dislocations, and other sports-related injuries.
34. Knowledge of Conventional and advanced procedures being done for Different Bone and Joint Injuries e.g. Open Reduction and Internal Fixation, Closed Reduction and Internal Fixation, External fixators, and other operative techniques.
35. Knowledge of Plastic Surgery in orthopedics and bone grafting techniques.
36. Knowledge of various surgical procedures being done for Different Bone and Joint Diseases.
37. Hand Surgery for Diseases, Deformities, and Injuries.
38. Foot Surgery for Diseases, Deformities, and Injuries.
39. Amputations and Arthrodesis – General Principles of Amputations /Arthrodesis and regional Amputations.
40. Knowledge of Diagnostic and Therapeutic Arthroscopy.
PAPER – IV – SPECIALITY NO–03 SANGYAHARAN VIGYAN – ANAESTHESIOLOGY 100 MARKS
1. Knowledge of disorders like Unmada, Apasmara, Mada, Murrcha, Sanyasa, and Stabdhata, etc.
2. Madataya, Stages of Madataya and its management.
3. Pharmacology of Medhya, Vednasthapak, Madkari, Sangyasthapak, Nidrajanan, Akshepjanan and shaman, Svedjanan, Hridyae, Hridyotejak, Raktbharshamak, Shoolprashaman, Vaman and hrillashar (Antiemetic) dravya as mentioned in Ayurvedic Samhita and their application in Sangyaharan.
4. Aromatherapy as a complementary and alternative therapy in pain management and Palliative care.
5. Sangyaharan Bheshaja Vigyan (Pharmacology related to Anesthesia)
- Drugs acting on the Autonomic nervous system:
a . Cholinergic system and drugs- Agonist and antagonist b.Adrenergic system and drugs- Agonist and antagonist
- Autocoids and related drugs:
a. Histamine and Antihistaminic b. 5HT and antagonist c. NSAID’S d. Prostaglandins and leukotrienes
- Drugs acting on the Respiratory system
- Drugs acting on the Somatic nervous system
a. Skeletal muscle relaxants – Depolarizer and Non-Depolarizer. b. Local anesthetics
- Drugs acting on the central nervous system
a. General Anesthetics- Fixed and Volatile anesthetic agents. b. Sedative and hypnotics c. Anti epileptics d. Antipsychotic and anti-maniacs e. Opioids Analgesics and antagonists
Drugs acting on the cardiovascular system
a. Cardiac glycosides b. Antiarrhythmic drugs c. Anti anginal and other anti-ischemic drugs d. Antihypertensive drugs
- Drugs acting on Kidneys
a. Diuretics b. Anti diuretics
- Coagulants and anticoagulants
6. Airway management- Intubation, failed intubation drill, LMA, Bag, and mask ventilation.
7. Anesthesia For General Surgery, Obstetrics, and Gynecology, E.N.T. and Ophthalmic, Orthopedic, Dental, Pediatric, Urology, Plastic, and Outpatient / Daycare surgery.
8. Anesthesia for patients with Diabetes mellitus, Thyroid diseases, inherited metabolic diseases, Obesity, Respiratory diseases, Cardiac diseases, Renal diseases, Geriatric problems, and neuromuscular diseases.
9. Regional anesthesia:
- Sub-arachnoid and epidural anesthesia, analgesia
- Plexus and nerve blocks for upper and lower limb
- Regional anesthesia for thorax and abdomen
- Surface anesthesia, infiltration, and field blocks
10. Complications of Regional and general anesthesia, morbidity, mortality, and medico-legal aspects.
11. Anesthesia for Endoscopic, laparoscopic Surgery, and Laser Surgery
12. a. Monitoring in anesthesia:
- Cardiovascular, Respiratory, Renal function, Neurologic and neuromuscular monitoring.
- Perioperative Thermoregulation and monitoring
- Perioperative awareness and monitoring depth of anesthesia with BIS.
- Peri-operative acid-base balance
- Pt’s positioning in anesthesia, its hazards, and management
- Perioperative Fluid management and Blood transfusion.
- Risks and hazards of anesthesia
b. Anesthesia equipment –
- Medical gas systems
- Breathing systems
- Anesthesia machine
c. Postoperative management-
- Postanesthesia care
- Postoperative nausea and vomiting
- Postoperative Intra-Venous fluid therapy
- Acute postoperative pain
- HDU, ICU, CCPR- BLS & ACLS.
- Parenteral nutrition.
- Environmental factor and electrical safety
e. Management of Acute / Chronic Pain-
- Assessment of pain
- Peri-operative pain
- Chronic pain syndrome-detection and prevention
- WHO regime for Cancer pain
- TENS, Behavioral therapy
f. Anesthesia in remote locations
g. Clinical care in extreme environments (At high and low pressure and space).
h. Relevance of Sammohana (Hypnosis), Acupressure, and Acupuncture in Sangyaharan.
i. Recent advances in research in Sangyahrana, Pain Management, and Palliative Care. Scope and Application of principles of Ayurveda in Sangyahrana Research.
PAPER – IV – SPECIALITY NO – 04 MUTRA ROGA – UROLOGY 100 MARKS
1. Anatomical and physiological knowledge of kidney, ureter, urinary bladder, prostate, seminal vesicles, urethra, and penis.
2. Investigations of Mutravaha Srotas – Urinary tract.
3. Aetiopathogenesis, Classification, Clinical Features, Diagnosis, Complications and management of Ashmari – Urinary stone diseases.
4. Kidney and ureter – Clinical presentation, Investigations, and Management of Congenital anomalies, Trauma, Infection, Neoplasm, Hydronephrosis, Hydroureter, and Haematuria.
5. Urinary bladder – Clinical presentation, Investigations, and Management of Congenital anomalies, Trauma, Infection, Neoplasm, Diverticulum, Vesicovaginal fistula, Atony, Schistosomiasis, Urinary diversions, Retention of urine – Mutraghata and Mutrakruccha.
6. Urethra – Clinical presentation, Investigations, and Management of Congenital anomalies – Hypospadias, Epispadias, Posterior urethral valve, Trauma, Infection, and Neoplasm.
7. Prostate and seminal vesicles – Benign and malignant enlargement of the prostate, Prostatitis, Prostatic abscess, and Calculi.
8. Penis – Clinical presentation, Investigations, Management of Congenital anomalies, Trauma, Infection, Phimosis, Paraphimosis, Peyronie’s disease, and Neoplasm.
9. Testis and scrotum-Clinical presentation, Investigations and Management of Congenital anomalies, Ectopic testis, Trauma, Neoplasm, Testicular torsion, Hydrocele, Varicocele, Spematocele, Chylocele, Pyocele, Haematocele, Epididymal cyst, and Fournier’s gangrene.
10. Renal failure – Causes, Diagnosis, Investigations, and Management.
1. Identification, uses demonstration of surgical instruments and methods of sterilization.
2. Training of case taking, bedside clinical, and case presentation.
3. Training of Surgery related Diagnostic imaging techniques.
4. Training of Surgery-related Pre-operative, Operative, and Post-operative procedures.
5. Demonstration and Practical training in Anaesthesia.
6. P.G. Scholars shall develop the skills by observing, assisting, and performing independently all surgical and para surgical procedures.
7. P.G. Scholars shall develop the skills by observing, assisting, and performing independently concerned specialties like Anushastra Vigyan – Parasurgical therapeutics, Asthi Sandhi Evam Marma Vigyan – Orthopaedics, Sangyaharan Vigyan – Anaesthesiology, Mutra Roga – Urology, etc.
8. Training of Surgical Emergencies and Trauma Management.