Cell Cycle

Question.

199. The correct sequence of cell cycle is:

1. G0-G1-S-G2-M.

2 .G0-G1-G2-S-M.

3 .G0-M-G2-S-G1.

4 .G0-G1-S-M-G2.

Answer

1. G0-G1-S-G2-M.

Reference

Robbins 6^th Edition Page 50

KDT 4^th Edition Page 836

Quality

Spotter

Status

Repeat

QTDF

Robbins

Discussion

The normal cell cycle proceeds as G1 à S à G2 à M à G1

Some times after M the cels go into a state of rest called G0. Then they come back to G1 ie G0 à G1 à S à G2 à M à G1

And certain drugs act over certain phase

Phase	Drugs
G1	Vinblastine
S	Methotrexate, Cytarabine, 6-TG,6-MP, Hydroxyurea Mitomycin C, Doxorubicin, Daunorubicin
G2	Daunorubicin, Bleomycin, Etoposide
M	Vincristine, Vinblastine, Paclitaxel

Explanation

1. G0-G1-S-G2-M. is the correct sequence

2 .G0-G1-G2-S-M is an incorrect sequence

3 .G0-M-G2-S-G1 is an incorrect sequence

4 .G0-G1-S-M-G2 is an incorrect sequence

Comments

Cell cycle is gaining importance as our understanding of the cyclins and other molecules increase !!

Tips

If you feel that your memory is failing you often remember that the most sensitive phase to Radiotherapy is G2M That means G2 is followed by M. We know that two G won’t come next to each other. Hence only S can come before G2 and…. so on ……

Banding

Question.

200. Which of the following procedures are wsed as routine technique for karyotyping using light microscopy ?

1. C- banding

2. G- banding

3. Q- banding

4. B-rd V- staning

Answer

2. G- banding

Reference

Robbins Pathologic Basis Of Disease 6^th Edition Pg-165

Quality

Spotter

Status

New

QTDF

Robbins

Discussion

Karyotyping (karyo=nut + typing) is the process of arresting the chromosomes in metaphase state , where they are arranged in pairs and take the shape of X connected at the centromere and are arranged in decreasing order of length.

The chromosomes are stained and by this the Structure of the Chromosome is Studied(See another Question on RFLP in this book)

Banding	Name	Remarks
G	Giemsa	Most commonly used
Q	Quinacrine
C	Constitutive Centromere	Shows constitutive heterpchromatin
R	Reverse	Opposite to G Banding

Explanation

1. C- banding is preferential staining of constitutive Hemochromatin

2. G- banding uses Giemsa

3. Q- banding uses Quinacrine and uv light

4. B-rd V- staning uses uv light

Comments

About G Banding

· Purpose:

o To stain metaphase chromosomes with Giemsa or Leishman's stain to elicit a banding pattern throughout the chromosome arms, designated G-Bands. This G-Banding technique requires a chromosomal pretreatment step of trypsin to induce chromosome bands.

· Time required:

o 30-60 minutes

· Special Reagents:

o Leishman stain (Baxter, cat. no. S7710-27)

o Gurr Buffer Tablets (Biomedical Specialties, cat. no.33199)

Tips

· The patterns of G- and Q- bands on a chromosome are sufficiently unique to allow that chromosome's unambiguous identification. Best banding is obtained with prophase chromosomes since these have not yet fully condensed

· An arrayed set of banded chromosomes is called a karyotype and can be used to screen for chromosome rearrangements.

· G-, Q-, and R- bandings are not observed with plant chromosomes.

· Banding patterns appear related to base composition and chromosome loop structure.

· Additional types of banding are also used. For example: N-banding which corresponds to locations of GARn triplet repeats in wheat and barley

Turner's Syndrome

Question.

202. A nineteen year old female with short stature wide spread nipples and primary amenorrhoea most likely has a karyotype of :

1. 47, XX +18

2. 46,XXY

3. 47,XXY

4. 45X.

Answer

4. 45X.

Reference

Robbins 6^th Edition Page 174

Harrison 15^th Edition Chap 66, 338

Quality

High School

Status

Repeat – Seen this is Pre Medical / Pre Dental Q Papers !!!

QTDF

Standard 10^th CBSE Books !!!

Discussion

In Turner, The somatic abnormalities primarily involve the skeleton and connective tissue.

· Lymphedema of the hands and feet,

· webbing of the neck,

· low hairline,

· redundant skin folds on the back of the neck,

· a shieldlike chest with widely spaced nipples, and

· growth retardation are features that suggest the diagnosis in infancy.

· Micrognathia,

· epicanthal folds,

· prominent low-set or deformed ears,

· a fishlike mouth, and

· ptosis may be present.

· Short fourth metacarpals are present in half,

· and 10 to 20% have coarctation of the aorta.

· In adults, the average height rarely exceeds 150 cm.

Associated conditions include

· renal malformations,

· pigmented nevi,

· hypoplastic nails,

· tendency to keloid formation,

· perceptive hearing loss,

· unexplained hypertension,

· glucose intolerance, and

· autoimmune thyroid disease

Explanation

1. 47, XX +18 is Edwards’ Syndrome

2. 46,XXY ??

3. 47,XXY is Klinefelter’s Syndrome

4. 45X. is the Genotype of Turner

Comments

MC Cause of Death in Turner is CVS Disorders

One of the Important Causes of Primary Amenorrhea is Turners Syndrome

Tips

G.O.Ms.No.16 Dated: 4.2.2004 Health and Family Welfare (F1) Department

GOVERNMENT OF TAMIL NADU

ABSTRACT

Medical and Rural Health Services – Upgradation of Krishnagiri Taluk Hospital to that of District Headquarters Hospital for the newly formed Krishnagiri District - Orders issued.

---

Health and Family Welfare (F1) Department

G.O.Ms.No.16 Dated: 4.2.2004

Read:

1. G.O.Ms.No.569, Revenue Department, dated 20.11.2003

2. From the Director of Medical and Rural Health Services, lr No.5567/ P&D II/2/04 dt:23.1.2004 and 27.1.2004.

-------------

Order:

In the Government Order first read above orders were issued for the bifurcation of Dharmapuri District into two Districts namely Dharmapuri District with Headquarters of Dharmapuri and Krishnagiri District with headquarters at Krishnagiri.

2. The Special Officer, Krishnagiri District has proposed for the immediate upgradation of Taluk Head quarters Hospital to District Headquarters Hospital as Honourable Chief Minister has proposed to inaugurate the District on 9.02.2004.

3. The Director of Medical and Rural Health Services has accordingly sent proposals to the Government for the upgradation of existing Taluk Hospital, Krishnagiri to the District Headquarters Hospital. He has stated that the bed strength of Government Hospital, Krishnagiri is now 193. For increasing the bed strength and improving the infrastructure facilities of the said Hospital to be upgraded to that of District Headquarters, necessary action is already under process under Health System and other infrastructure facilities needed for a District Headquarters Hospital will be taken up in the first year itself. Hence no extra funds are requested from Government for upgrading the said Taluk Hospital to that of District Headquarters Hospital in respect of construction of buildings and improving of infrastructure facilities.

4. The Director of Medical and Rural Health Services has also stated that a District Headquarters Hospital should be managed by the Hospital Superintendent in the cadre of Senior Civil Surgeon. The present Medical Officer in-charge of Government Hospital, Krishnagiri is already a Senior Civil Surgeon. Hence it is adequate if the present Senior Civil Surgeon Medical Officer post is redesigned as Hospital Superintendent. Four Civil Surgeon posts are already available at Government Hospital Krishnagiri out of which one post may be designated as Resident Medical Officer(RMO) to make the District Headquarters Hospital a full fledged one.

5. At present the following special Departments are available at Taluk Hospital Krishnagiri.

1. Dental Clinic

2. Eye Clinic

3. S.T.D. Clinic

4. Paediatric Clinic

5. Blood Bank

6. Accident and Emergency Services

7. Post Partum Ward

8. T.B.Clinic

9. Intensive Caronary Care unit

10. Leprosy Ward

11. Burns Ward

12. X-ray Unit

13. Operation Theatre

14. Laboratory

Besides the special Departments for a District Headquarters Hospital the following specialists are essentially required to give improvised medical care to the poor people living in and around the village of Krishnagiri.

1. Medicine (General Medicine)

2. Surgery

3. Obstetrics and Gynaecology

4. Paediatrics

5. Ophthalmology

6. Orthopaedic Surgery

7. E.N.T

He has suggested that out of 15 Assistant Surgeons posts now in existence in the Hospital. 7 posts may be redesignated as Assistant Surgeon specialists to manage the above specialities. By implementing the above arrangements, the purpose of upgrading the said Taluk Hospital to that of District Headquarters Hospital will be fully served without any extra expenditure to the Government.

6. The proposal of the Director of Medical and Rural Health Services has been examined in the light of the Developments of the Health System Development Project, In Health System Development Project no major upgradation has been proposed for Krishnagiri because the existing beds strength is sufficient to cater to the population. As per the norms developed for the Hospitals under Health System Development Project. It has been decided to designate Krishnagiri Taluk Hospital as Headquarters Hospital, with the existing beds strength. All other appropriate speciality services as for a District Headquarters Hospital could be provided according to the norms. In the circumstances Government issue the following orders:

i) Krishnagiri Taluk Hospital is upgraded with immediate effect as Krishnagiri District Headquarters Hospital with a bed strength of 200. It will function as District Headquarters Hospital for the Krishnagiri District.

ii) The existing Medical Officer in the Taluk Hospital, Krishnagiri in the cadre of Senior Civil Surgeon be redesignated as Hospital Superintendent.

iii) The one Civil Surgeon post in the Hospital be redesignated as Resident Medical Officer.

iv) Out of 15 Assistant Surgeon posts in the Hospital, 7 Assistant Surgeon post be redesignated as Assistant Surgeon specialits.

7. The Director of Medical and Rural Health Services is requested to take follow up action for the functioning of the District Headquarters Hospital with immediate effect.

8. This order issues with the concurrence of the Finance Department vide its U.O.No.371/FS/P/04 dated 3.2.2004.

(BY ORDER OF THE GOVERNOR)

SHEELA RANI CHUNKATH

SECRETARY TO GOVERNMENT

To

The Director of Medical and Rural Health Services, Chennai-6

The Special officer, Krishnagiri District

The Treasury Officer, Krishnagiri and Dharmapuri

The Accountant General, Chennai-18

The Accountant General (CAS), Chennai-18

The Pay and Accounts Officer(South), Chennai-35

The Revenue Department, Chennai-9

The Senior Personal Assistant to Minister for Health, Chennai-9

The Under Secretary, Chief Minister Office, Chennai-9

Copy to:

All Heads of Department under the control of

Health & Family Welfare Department

All Sections in Health & Family Welfare Department

/Forwarded By Order/

`Defective' question booklets for medical PG entrance exams

From http://www.hindu.com/2004/01/12/stories/2004011202450400.htm

THIRUVANANTHAPURAM. Jan. 11. There has been an allegation that some candidates who appeared for the All India, Entrance Examinations for admission to MD and MS courses, on Sunday, were issued `defective' question booklets.

No examination officials were available, here, for comment.

One of the candidates, S. Chandrasekharan, told The Hindu that after question 278, in the question booklet issued to him, the subsequent questions were numbered 271, 272, and so on. In a complaint given to the All-India Institute of Medical Sciences (AIIMS), New Delhi, which conducted the examination, Dr. Chandrasekharan alleged that the faulty numbering indicated that the `remaining questions in the booklet was of some other series'. He was issued the question booklet numbered 84730.

"As soon as the defect was detected, we had brought it to the notice of the invigilator and requested for replacement, which was not complied with due to lack of replacement material," he said in the complaint.

Dr. Chandrasekharan, who wrote his examination at the Government VHS School for Girls, Mancaud, said when he contacted the centre superintendent, he was able to learn that nearly 40 candidates had faced a similar problem. It is also learnt that several candidates who appeared for the examination at the Cotton Hill Government Girls High School and at the Model High School, faced similar difficulties.

In some cases, the invigilators are reported to have read out the `correct' questions from `non-defective' booklets. In some other instances, the invigilators reportedly told the candidates to answer the questions in the sequence found in the booklets issued to them.

The candidates had to answer 300 questions in three and a half hours.

Medicos against privatisation

Medicos against privatisation

T.S. SUBRAMANIAN

Medical students in Tamil Nadu, backed by their seniors in the profession, resist bitterly what they see as moves that would dilute the quality of medical education and produce a surfeit of doctors as a result of the setting up of more medical colleges in the private sector.

S.R. RAGHUNATHAN

A demonstration by agitating medical students in Chennai on April 28.

A LARGE section of the medical fraternity in Tamil Nadu, including principally about 12,000 medical students, is pitted against the State government over the issue of the virtual privatisation of medical education. The students, who initiated the struggle, have made another important demand: the scrapping of a quota of seats for non-resident Indians (NRIs) in government medical colleges, to which admissions are made on the basis of a higher payment structure. The students' agitation, which entered the 27th day on May 19, has the backing of the Tamil Nadu Government Doctors' Association. Doctors in government service pursuing their postgraduate education have joined the protest.

According to a Government Order dated August 13, 2001 issued by the State Health and Family Welfare Department, since "it would be prohibitively expensive to open more number of colleges in the state sector", it has been "decided to consider the request of the private organisations for the request of NOC (no-objection certificate) to start medical and dental colleges in backward areas". The government directed the Director of Medical Education (DME) "to consider the requests of private organisations for issue of essentiality certificate to start medical/dental colleges in the backward/rural areas of the state... "

The students termed the G.O. "an invitation to open private medical and dental colleges" and expressed the fear that such institutions would proliferate, in the process bringing down the quality of medical education. The vice-president of the Tamil Nadu Medical and Dental Students' CRRIs', Senior House-Surgeons' and Postgraduate Doctors' Association, D. Karal, said: "Seats will be sold for Rs.25 lakhs to Rs.35 lakhs. People with money will buy them... " After private organisations were allowed to start engineering colleges, more than 230 such colleges had sprung up in the State leading to dilution of standards in education. "This should not happen in medical education because it is tantamount to playing with the life of patients," said Karal. This Association is spearheading the agitation. (CRRI stands for Compulsory, Rotatory Residential Internship).

One of their key demands relates to barring new private medical and dental colleges by law. The essentiality certificate given by the government to the Meenakshi Ammal Trust, Chennai, to start a medical college near Kancheepuram, triggered the trouble.

State Health Minister S. Semmalai said that the power to clear private medical colleges lay with the Centre, not the States. "Despite the existence of the G.O., no essentiality certificate has been issued to any private medical or dental college by this government. The Meenakshi Ammal Trust received the essentiality certificate on the orders of the Supreme Court." The Madras High Court had directed that the Trust be given the certificate. The State government appealed against this in the Supreme Court, but the court upheld the High Court's order, Semmalai added.

The Minister said separately that in the matter of granting permission to set up private medical colleges, the State government's powers were limited compared to those of the Centre. The Supreme Court had specified these powers in a case filed by the Kirubananda Variar Medical Trust, he said. In another case, he said, the apex court had ruled that even when a State government refused to give permission for a dental college being started, the Dental Council of India could take a decision. He contended: "As per the Supreme Court ruling, only the Centre had the powers to permit private medical colleges to come up. It is meaningless for the students to agitate against the State government when they should be protesting against the Centre, which has the power to sanction private medical colleges... "

But the students insist that the State government has the power to block new colleges, for the power to grant no-objection and essentiality certificates were its. They point out that the Supreme Court had said a mere policy decision by a State government not to allow private medical colleges would not do; there should be a law to back such a decision.

There are 11 government-run medical colleges and one government dental college in Tamil Nadu. These 12 colleges offer about 1,120 seats. Besides, there are six private medical colleges and 11 private dental colleges. The government recently announced that it will set up medical colleges at Theni, Vellore and Nagercoil.

After two rounds of talks between Semmalai and the students' leaders failed on May 17, the government acted tough. About 5,000 medicos were suspended. Of them more than 1,200 would not be allowed to sit for their examinations beginning in the first week of June, he said. Undaunted, the students asserted that their agitation would continue.

When the medicos launched a token strike on April 9, their demands, other than that relating to privatisation, were that the State government should get Medical Council of India (MCI) recognition for the MBBS course offered by the K.A.P. Viswanatham Government Medical College in Tiruchi and the Thoothukudi Government Medical College, and postgraduate courses offered by the government medical colleges, and provide more facilities in the Government Dental College, Chennai. The government was also requested to withdraw the increase in fees for postgraduate medical courses and restore the 10 per cent increase in stipend for MBBS and BDS students during their one-year period of internship.

Subsequently, the agitators discovered the existence of the G.O. of August 13, 2001, which they felt smacked of a privatisation drive. According to the G.O., the government had reviewed the guidelines and constituted a committee to suggest norms for the issue of essentiality certificates to private organisations to start medical and dental colleges in backward areas.

V. GANESAN

State Education Minister S. Semmalai in discussion with the representatives of medical students at the Secretariat in Chennai.

The G.O. said: "The starting of new institutions would go a long way in improving the medical facilities in these areas. A large number of students from the State are going to neighbouring States to pursue medical studies and the students will be able to pursue their studies nearer to their homes." The G.O. mentioned that while the Ninth Plan target was a doctor-patient ratio of 1:1000, the present doctor-patient ratio in Tamil Nadu was 1:2000. "Due to the present ratio, shortage of doctors in the rural areas is felt," it stated.

However, according to Dr. R.M. Krishnan, chairman of the ethics committee of the Indian Medical Association, Tamil Nadu unit, the doctor-patient ratio in Tamil Nadu has reached saturation point. He said that there were 6,000 unemployed or underemployed doctors in the State. According to Karal, the WHO-stipulated doctor-patient ratio is 1:3,500 while in Tamil Nadu it is 1:1000. There were 67,000 registered doctors in Tamil Nadu for its population of 6.2 crores, Karal said.

The students insisted on the withdrawal of the August 13 G.O. When the government failed to provide any assurance on the matter, they launched the strike on April 23. They demonstrated before the office of the Director of Medical Education. They squatted on the road and blocked traffic. They observed a silent protest. They wore masks. They donated blood and ran makeshift outpatient centres.

Dr. K. Prakasam, president, Tamil Nadu Government Doctors' Association, announced the association's support to the students. Its members struck work on May 9. The doctors are planning to start an indefinite strike from May 21.

The government warned the doctors that the Essential Services Maintenance Act (ESMA) would be invoked against them. It transferred Dr. Prakasam and several other doctors. Yet the doctors struck work on May 9 and then on May 14. As they intensified their agitation, patient care was hit in government hospitals. Wards remained empty, and many poor patients were affected.

Medical students in Tamil Nadu have had an extended record of opposing the setting up of private medical and dental colleges. "We started our agitation against privatisation in 1989. In February 2000, we struck work for more than two weeks, expressing our protest against privatisation," Karal recalled.

The fate of their agitation this time around remains uncertain in the face of the seemingly inflexible stand taken by the All India Anna Dravida Munnetra Kazhagam government in the State.

From http://www.hinduonnet.com/fline/fl2011/stories/20030606006713300.htm

As per GO (Ms) No.214 dt 31/10/2002

NEWS

As per GO (Ms) No.214 dt 31/10/2002

The Govt has sanctioned a sum of Rs. 4,01,000/- to the Director of Medical Education to Deposit the same in the District consumer Disputes Redressal forum, Thanjavur.

The Dean, Thanjavur medical college Hospital, Thanjavur is authorized to draw and deposit the same in the District consumer Disputes Redressal forum, Thanjavur.

The District consumer Disputes Redressal forum in its judgement dated 5.4.2002 has ordered the Dean, Thanjavur medical College Hospital, Thanjuvur to pay compensation of Rs.4,01,000/- to Tmt. Rajeswari wife of the Deceased, in the cases O.P. No 22/2002 and 23/2002 filed by Tmt Rajeswari w/o Thiru Kumaresan and Aruna D/o Thiru. Kumaresan in the District consumer Disputes Redressal forum Thanjavur. Thiru Kumaresan died due to Myelogram Test at Thanjavur Medical College.

The Director medical education has also reported than as appeal was preferred in the state consumer Disputes Redressal commission Chennai on 10.7.2002. The state consumer Disputes Redressal commission, Mylapore, Chennai has given interim stay and ordered the Dean to Deposit the sum of Rs. 4,01,000/- in the District consumer Disputes Redressal Forum Thanjavur within six weeks.