foundation module - phase i - usjpmedical.sjp.ac.lk/downloads/module-books/phase-i/1...

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Foundation Module - Phase I

Faculty of Medical Sciences

University of Sri Jayewardenepura

December 2017 Version 2.0

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Introduction

The Foundation Module occupies part of the first term of the MBBS degree.

During this module we aim to cover some aspects of basic medical science,

primarily in the subject of cell biology, basis of normal and abnormal functions,

integrated in the 3 basic sciences. In addition you will learn the basics of medical

genetics, histology of basic tissue types and general embryology with an

introduction to molecular biology vis-à-vis medicine. The mode of teaching will

centre on lectures, tutorials/small group discussions (SGD), fixed learning modules

(FLM), self learning activities and practicals. In addition, activities will be carried

out at the resource centre which will facilitate the learning process. These include

computer based self learning and curriculum-related language activities in the

Language laboratory. At practical classes you will learn basic laboratory skills,

handling of light microscope and identifying basic tissues under the light

microscope basic statistical analysis and be introduced to human cadaver

dissection. You will have a summative examination at the end of the term. Hope

you enjoy this module.

Module Committee

Prof.L.V.Athiththan (Chairperson, Department of Biochemistry) Dr. Sajith Edirisinghe (Convener , Department of Anatomy)

Prof. D.M.S. Fernando (Department of Physiology)

Prof. S. Suresh (Department of Biochemistry)

Dr. S. Shiyanth ( Department of Anatomy)

Dr. C. Hewage (Department of Physiology)

Dr. U.P.K. Hettiaratchi (Department of Biochemistry)


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General Objectives

At the end of the foundation module, the student should be able to:

1. describe the structures and functions of mammalian cells.

2. describe the structure of sub-cellular organelles and their adaptation to

functions.

3. describe the cell cycle.

4. identify tissues and describe the histology of different cells using light

microscope.

5. describe the methods of transport across cell membrane, explain receptors

and discuss concepts of up-regulation and down regulation.

6. explain the cellular environment and distribution of body fluids

compartments.

7. describe the role of pH and physiological buffers.

8. explain fluid, electrolyte and acid-base balance and the consequences of

imbalance.

9. explain the structure and function of biomolecules; proteins, carbohydrate,

lipids and nucleic acids, with emphasis on medical applications.

10. discuss the structure–function relationship of enzymes, co-factors and

chemical energy in the medical context.

11. describe the structure and function of nerve and muscle.

12. describe the nerve impulse transmission at the synapse including the

neuromuscular junction

13. describe the functions of autonomic nervous system

14. describe development of the human embryo.

15. explain Mendelian genetics and inheritance; and the terms, gene, genome

and linkage. To metabolism


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16. describe the basis of modern molecular biology and list its applications in

medicine.

17. attain skills required for basic biochemical and physiological tests and be

acquainted with standard laboratory procedures.

18. be acquainted with dissection procedures and to adopt precautions in the

dissection room.

19. explain basic descriptive statistics

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Main Content Area

Main Content Area Lectures

(Hours)

Practical/Dissectio

ns No. of (3hrs)

sessions

Tutorials/SGD

No. of (2hrs)

sessions

1. Introduction to Laboratory& Statistics

(Biochemistry, Physiology) 00,01 02,04 -

2. Cell, Cell Membrane and Cellular

Environment(Biochemistry, Anatomy, Physiology) 07,03,07 02,02,00 02,00,01

3. Biomolecules(Biochemistry) 11 04 04

4. Energy, Enzymes and Co-factors(Biochemistry) 08 06 01

5. Histology (Anatomy) 03 06 -

6. Nerve, Muscle and Neurotransmitters (Anatomy,

Physiology)

02,06 03, 00,04

7. General Embryology(Anatomy) 05 - -


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Foundation Module - Phase I

A-Essential to know B- Good to know C- Nice to know

1. INTRODUCTION TO LABORATORY

Intermediate Objectives Broad Content Areas Activity Duration Department

Learn and practice laboratory safety

measures.

Universal precautions taken in

handling biological material (A)

Personal hygiene & protective

clothing (A)

Do’s and Don’ts in the lab (A)

First aid procedures to be

followed in an emergency (A)

Proper way of cleaning and

disposal of spilled chemicals (A)

Practical

6 hrs

Biochemistry


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1. INTRODUCTION TO LABORATORY (continued)


List commonly used laboratory consumables,

instruments and their usage.

Basics of conducting Physiology

experiments in human subjects

(A)

Basics of clinical examination of

human subjects (A)

Basic descriptive statistics and

their presentation in tables,

charts, and graphs (A)

Practical

Lecture

Practical

6 hrs

1hr

6 hrs

Physiology

Physiology

Physiology


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2. CELL, CELL MEMBRANE & CELLULAR ENVIRONMENT


Describe basic structure and functions of an

eukaryotic cell.

Explain the principles of using light &

electron microscope.

Explain the cells under the light microscope

using the above knowledge.

Describe cell cycle and replication

Structure of cell membrane (A)

Nucleus, sub cellular organells

cytoskeleton (A)

Disorders related to abnormal

function of sub cellular

organelles (B)

Functions of the major parts of

the light microscope (A)

Method of making simple

microscopic preparations and

examintion under the

microscope (A)

Examine the main

morphological features of cells

as seen under the light

microscope (A)

Mitosis, meiosis and cell death

(A)

Lecture

Lecture

Practical

Lecture

1 hr

1 hr

6 hrs

1 hr

Biochemistry

Anatomy

Anatomy

(Histology

lab)

Anatomy


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2. CELL, CELL MEMBRANE & CELLULAR ENVIRONMENT (continued)


Describe the basic structure of the cell

membrane and relate these to the function of

a cell.

List the modes of transport across the cell

membrane & describe with examples the

salient features of each

Basic structure of the cell

membrane (A)

Functions of membrane proteins,

carbohydrates and the importance

of the lipid bilayer (A)

Modes of transport across the cell

membrane with examples (A)

Passive

- Simple/Facilitated diffusion.

- Non ionic diffusion.

- Osmosis - Osmotic pressure

- Solvent drag

- Movement of ions across ion

channels.

Active

- Vesicular transport

o Endocytosis &

exocytosis

- Primary active and secondary

active

o Na+/ K+ATPase pump

and its importance

Ionophores

Oral rehydration solution- basis of

Lecture

Lecture

SGD

1 hr

2 hrs

2 hrs

Biochemistry

Biochemistry

Biochemistry


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use (A)



Illustrate the components of the cell (sub

cellular organelles) and describe their

structure in relation to each organelle.

Discuss how the structure is adapted to

perform the function.

Explain the features & functions of receptors

& discuss the concept of up-regulation &

down-regulation.

Describe the methods of intercellular

communication.

Explain the mechanisms of inter /

intracellular communication.

Illustrate the components of a

cell and its histology (A)

Briefly explain the main

functions of each organelle in a

cell (A)

Features & functions of

receptors (A)

Concept of up-regulation &

down-regulation (A)

Define with examples agonist,

partial agonist, antagonist,

inverse agonist (A)

Paracrine, endocrine, autocrine,

neural and communication via

gap junctions with examples for

each type (A)

Mechanisms of inter / intra -

cellular communication (A)

List the 1st and the 2nd

messengers in intracellular

communication. (A)

Lecture/

Discussion

Lecture

Lecture

Lecture

1 hr

1 hr

1 hr

1 hr

Anatomy

Biochemistry

Physiology

Physiology


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Describe the distribution of body fluids in to

compartments.

(extra- cellular and intracellular.)

Describe the composition of each

compartment in terms of distribution of

major anions and cations and explain the

similarities & differences in the composition

of each compartment.

Total body water as a percentage

of body weight (A)

Distribution of body fluids in

different compartments (A)

Extra-cellular – (interstitial fluid,

transitional fluid) and intracellular

compartments, their volumes and

proportions (A)

Composition of each body fluid

compartment (A)

Differences in the composition of

ECF and ICF in terms of major

anions and cations (Na+, K+, Cl¯,

HCO3 and proteins) (A)

Lecture

Lecture

1 hr

1 hr

Physiology

Physiology


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Outline the principles of

measuring/calculating different body fluid

compartments.

Explain the mechanism of formation of

interstitial fluid.

Outline the processes that maintain the

volume, pH, composition of different body

fluid compartments.

Measurable body fluid

compartments (A)

Substances that are used to mea-

sure these fluid compartments

(A)

Explain the method of

measuring/calculating the body

fluid compartment (A)

Transport processes involved in

forming body fluids and

maintaining their composition

(A)

The mechanism of formation of

interstitial fluid (starling forces)

(A)

Regulation of ECF volume and

composition (A)

Definitions of osmolality and

osmolarity (A)

Concept of tonicity (A)

Define isotonic, hypotonic,

hypertonic solutions with

examples (A)

Lecture

2 hrs

Physiology


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Homeostatic mechanisms that

operate in electrolyte and acid

base disturbances (A)



Outline the fluid, electrolyte & acid-base

disturbances that occur in different body

compartments and explain the compensatory

mechanisms to maintain homeostasis.

Discuss the changes in the distribution of

body fluids with age. (infants, adults and old

age)

Explain the metabolic changes in volume and

composition that occur in body fluid

compartments in diarrhoea & vomiting.

Dehydration, overhydration,

hypernatremia, hyponatremia

hyperkalaemia, hypokalaemia,

acidosis, alkalosis (A)

Changes in the distribution of

body fluids with age (A)

Volume, electrolyte & acid

base changes that occur in

different fluid compartments in

diarrhoea & vomiting (A)

Importance of rehydration and

the fluids used for rehydration

(A)

Lecture

SGD

1 hr

2 hrs

Physiology

Physiology


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Explain the terms pH and Buffer

List the different physiological buffers and

explain the important biological functions of

these buffers.

Explain the application of Henderson-

Hasselbalch equation.

Define the term ‘pI’ and to state its uses

Definition of pH, pH in relation

to H+ concentration, and how to

inter convert pH & H+ (A)

Methods of measuring pH (B)

Important biological roles of pH

(A)

Definition of the term buffer (A)

Buffering action, buffer range (A)

Buffers of blood, urine, cytosol

and intracellular fluid (A)

Henderson-Hasselbalch equation

and its applications (B)

Definition of ‘pI’ and how it can

be calculated (A)

Lecture

SGD

Practical

2 hrs

2 hrs

6 hrs

Biochemistry

Biochemistry

Biochemistry


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3. BIOMOLECULES (continued)


List the sources, structure and functions of

inanimate molecules that are present in

organisms

Sources of biomolecules e.g.

carbohydrates, proteins, lipids

and nucleic acids (A)

Functions of different

bio-molecules (A)

Carbohydrate. – mono, di,oligo,

and polysaccharides,

glycosaminoglycans,

proteoglycans, glycoprotein (A)

Amino acids and proteins (A)

Lipids - fatty acids, TAG

phospholipids, steroids,

sphingolipids, eicosanoids (A)

Nucleic acids- DNA, RNA,

histones (A)

Lecture

SGD

(Carbohydrates)

Lecture

SGD

(Protiens)

2 hrs

2 hrs

3 hrs

2 hrs

Biochemistry

Biochemistry

Biochemistry

Biochemistry


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Explain the chemical and three-dimensional

structures of biological molecules and

assemblies, how the molecules form these

structures and how the properties vary with

them.

Explain the structural and functional

relationship of macromolecules.

Explain the various forces stabilizing the

macromolecules.

Composition, structure &

different classifications and

characteristic features of different

carbohydrates, proteins, lipids

and nucleic acids as mentioned

above. (B)

Differentiate: mono, di &

polysaccharides and list their

functions (A)

Hydrogen, hydrophobic,

electrostatic bonds and van der

Waals forces (in Iry. IIry, IIIryand

IVry structure of proteins and H

bonds in nucleic acids) (A)

Lecture

SGD

(Lipids)

Lecture

SGD

(Nucleic acids)

4 hrs

2 hrs

2 hrs

2 hrs

Biochemistry

Biochemistry

Biochemistry

Biochemistry


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Explain that macromolecules are susceptible

to external factors.

Outline that changes in the structure of

macromolecules can lead to various diseases.

Outline the principle in the

qualitative and quantitative assay of

macromolecules / components in the

laboratory

Denaturation of proteins and

factors responsible (A)

Denaturation and renaturation of

DNA and RNA (A)

Blood group antigens, collagen,

keratin, Mb, Hb, cell membrane

functions (mainly lipids) and

insulin (A)

Qualitative and quantitative

estimation of amino acids and

proteins, & estimation of iso-

electric point, unsaturation of

FA, rancidity components of

phospholipids, structure of DNA (B)

Practicals

CHO & lipids

Proteins

6 hrs

6 hrs

Biochemistry

Biochemistry


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4. ENERGY, ENZYMES AND CO FACTORS


Explain how enzymes are similar and

dissimilar to other catalysts.

Classify enzymes with examples.

Explain the factors affecting rate of enzyme

reactions.

Draw the Michaelis-Menton and

Lineweaver-Burk plots and explain the

significance of constants with examples.

Illustrate activation and inhibition with

examples of medical importance.

Illustrate the diagnostic value of isozymes

Explain the principles of

allosterism and covalent modification and

Labile, efficient, specific, lower

ΔE, activation and no change in

position of equilibrium, activity

can be controlled (A)

Six classes and examples of each

(A)

pH, temperature, activators,

inhibitors and enzyme

concentration (A)

Effect of substrate concentration

(B)

Significance of KM and VM (A)

Examples of competitive,

non-competitive and suicide

inhibition (A)

Lactate dehydrogenase and

Creatine kinase isozymes (A)

Characteristics of allosterism

Lecture

SGD

Practical -1

Practical -2

5 hrs

2 hrs

6 hrs

6 hrs

Biochemistry

Biochemistry

Biochemistry

Biochemistry


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their significance.

with examples (A)

Covalent modification of

glycogen synthase (A)

Effect of hormones (A)

Guided

Learning

Session

6 hrs

Biochemistry

4. ENERGY, ENZYMES AND CO FACTORS (continued)


Classify co-factors

List high energy compounds and explain

their purpose in metabolism.

Prosthetic groups, co-enzyme,

co-substrate and metal ions (A)

ATP, NuTP, NuDP, Acetyl CoA,

PEP, UDP sugars (A)

Driving forward unfavourable

reactions, activation and

participation (A)

Lecture

Lecture

1 hr

1 hr

Biochemistry

Biochemistry


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5. HISTOLOGY


Describe the main morphological features of

epithelial tissues, in particular those which

cover surfaces or line body cavities.

Describe the morphological characteristics of

secretary cells and glandular units.

Describe the ultra-structure of the skin.

Describe the formed elements of the

supporting connective tissues.

Describe the various kinds of connective

tissue proper.

Characteristics of epithelia. (A)

Classification of epithelia (A)

Unilaminar (simple) epithelia (A)

Multilaminar epithelia (A)

Membrane specializations of

epithelia (A)

Glandular epithelium (A)

Exocrine glands (A)

Thick skin and thin skin (A)

Main layers of skin, epidermis,

dermis, hypodermis or subcutis

(A)

Skin appendages (A)

Skin circulation (A)

Cells of connective tissue, extra

cellular matrix, fibres of

connective tissue (A)

Classification of connective

tissue, defence cells of

Lecture

Histology

Practical

Lecture

Practical

Lecture

Practical

1 hr

6 hrs

1 hr

6 hrs

1 hr

6 hrs

Anatomy

Anatomy

Anatomy

Anatomy

Anatomy

Anatomy


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Describe ultra-structural features of

connective tissue cells.

supporting tissue (A)

The reticuloendothelial concept

(A)

6. NERVE, MUSCLE, NEUROTRANSMITTERS, SYNAPTIC TRANSMITTERS &AUTONOMIC

NERVOUS SYSTEM


Describe the structure of neurone, peripheral

and central nervous tissue.

Basic neurone types ultra

structure of neurone (A)

Myelinated and non-myelinated

nerve fibres (A)

Synapses and neuromuscular

junctions (A)

Peripheral nervous tissues (A)

Differences between peripheral

nerves and ganglia (A)

Central nervous tissue (A)

Differences between grey and

white matter (A)

Sensory receptors (A)

Lecture

Practical

1 hr

6 hrs

Anatomy

Anatomy


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NERVOUS SYSTEM (continued)


Define resting membrane potential & explain

its genesis.

Explain the different phases of an action,

potential and describe the basis of generation

& conduction of action potentials.

Define relative and absolute refractory

periods and explain their significance.

Explain the effects of electrolyte imbalances

of ECF on nerve excitability.

Explain response to nerve injury

Ionic movement involved in the

generation of resting membrane

potential (A)

Ionic movement in the generation

of an action potential (A)

Method of nerve conduction (B)

The significance of absolute and

relative refractory periods (A)

Electrolyte imbalances and its

effect on nerve excitability (A)

Denervation hypersensitivity (A)

Nerve degeneration &

regeneration

Lecture

SGD

2 hrs

2 hrs

Physiology

Physiology


23




Describe the light and electron microscopic

features of smooth, cardiac and skeletal

muscle tissue.

Describe the functional characteristics of the

3 types of muscles – skeletal, smooth,

cardiac

.

Describe the physiological basis of

excitation, contraction coupling of skeletal

muscle.

Compare and contrast the electrical and

mechanical events occurring in the

Skeletal muscle – Light

microscopic appearance, basic

ultra structure, sliding filament

mechanism (A)

Cardiac muscle- distinctive

morphological features.(A)

Smooth muscle – distinguishing

features (A)

Comparison of the functions of

skeletal, smooth muscle &cardiac

muscles (A)

Excitation-contraction coupling

(B)

Electrical and mechanical events

in muscles (B)

Lecture

Practical

Lecture

1 hr

3 hrs

1 hr

Anatomy

Anatomy

Physiology


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skeletal/smooth and cardiac muscle.




Explain the structure of the neuromuscular

junction and describe the chemical &

electrical mechanism of synaptic

transmission

Relate the above knowledge

to the events that occur in Myasthenia

Gravis, organophosphate poisoning and use

of neuromuscular blockers.

Neuromuscular junction

- chemical & electrical

mechanism involved in

relation to

1. release of neurotransmitters

2. action on motor end plate

3. termination of action

(A)

Synaptic transmission

Neuromuscular transmission in

Myasthenia Gavis & organo-

phosphate poisoning (B)

SGD

2 hrs

Physiology


25




Outline the functions of the autonomic

nervous system

List the main neurotransmitters in the body

and describe their chemical composition

(type), sites of action, mode of action and

metabolism

Sympathetic and parasympathetic

nervous system in relation to

- Transmission (A)

- Actions (A)

- Stimulation (A)

- Blocking (A)

Neurotransmitters and their

- Composition (A)

- Site of action (A)

- Mode of action (A)

- Metabolism (B)

Lecture

SGD

Lecture

SGD

2 hrs

2 hrs

1 hr

2 hrs

Physiology

Physiology

Physiology

Physiology


26

7. GENERAL EMBRYOLOGY


Understand the normal development of the

human embryo and foetus.

Describe the formation of early embryo and

the umbilical cord, the three-layered concept.

Female gamete, male gamete (A)

Union of the gametes (A)

Pre implantation development

(A)

Post implantation development

(A)

Bilaminar germ disc (A)

Trilaminar germ disc, derivatives

of different germ layers –

ectoderm, mesoderm and

endoderm (A)

Lecture

IT self

learning

Lecture

IT self

learning

CD ROM

Lecture

1 hr

1 hr

2 hrs

Anatomy

IT laboratory

Anatomy

IT laboratory


27

7. GENERAL EMBRYOLOGY (continued)


Understand the morphological changes

which arise at the interface of embryonic and

maternal and then foetal and maternal

tissues.

Structure of the placenta.

Describe the formation of the axial

(notochordal) process and the formation of

somites.

Describe briefly the external appearance

during development.

Organogenesis

Embyology demonstration

Cytotrophoblast,

syncytiotrophoblast (A)

Formation and fate of

notochordal process (A)

Somitomeres, dermatome,

myotome, sclerotome (A)

Cephalocaudal folding, lateral

folding, crown-rump length (A)

Morphogenesis and

organogenesis (A)

Embryology (A)

Lecture

IT self

learning

Lecture

IT self

learning

Lecture

IT self

learning

1 hr

1 hr

1 hr

3 hrs

Anatomy

IT laboratory

Anatomy

IT laboratory

Anatomy


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Recommended readings Note: Students are expected to read the latest edition

Anatomy

Gross anatomy

Cunningham’s Manual of Practical Anatomy by G. J. Romanes

Clinical Anatomy; Applied anatomy for medical students and junior doctors by

Harold Ellis.

A Colour Atlas of Human Anatomy by P. H. Abrahams et al.

Clinically oriented Anatomy by Keith L. Moore.

Human Anatomy by B. D. Chaurasia

Clinical Anatomy by regions by Richard S. Snell

Regional and Applied Anatomy

by R. J. Last

Grants Atlas of Anatomy by M. R. Agur

Gray’s Anatomy by Williams et al

Histology

Wheater’s Functional Histology by B. Young and J. W. Herath

Basic Histology by Luis C. Junqueira and Jose Carneiro

Neuroanatomy

Clinical Neuroanatomy by Richard S. Snell

Manter and Gatzs Essentials of Clinical Neuroanatomy

Embryology

Medical Embryology by T.W. Sadler

Human Embryology by Inderbir Singh and G.P. Pal


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Genetics

Basic Medical Genetics by Prof. Rohan Jayasekera

Genetics, a molecular approach by T. A. Brown

Emery’s Elements of Medical Genetics by Robert Muellar and Ian Young

Biochemistry

Lippincott’s Illustrated Reviews of Biochemistry by Denise R. Ferrier

Clinical biochemistry by William Marshall, Marta Lapsley, Andrew Day

Harper’s Illustrated Biochemistry by Robert K. Murray, David A. Bender, Peter J.

Kenelly, Kathleen M. Botham, P. Anthony Weil and Victor W. Rodwell,

Essentials of Medical Biochemistry by R.C. Gupta

Medical Biochemistry and Biotechnology by Mohammed Amanullah,

Practical Clinical Biochemistry by Harold Varley

Physiology

Review of Medical Physiology by William F. Ganong, McGraw-Hill.

Guyton and Hall Textbook of Medical Physiology by John E. Hall

Statistics at Square One by Michael J. Campbell and T. D. V. Swinscow

Compact Disks

Human Anatomy Dissector

Surface Anatomy

The Interactive skeleton

The Interactive Human Anatomy

https://www.amazon.com/s/ref=dp_byline_sr_book_1?ie=UTF8&text=John+E.+Hall+PhD&search-alias=books&field-author=John+E.+Hall+PhD&sort=relevancerank

https://www.amazon.com/Michael-J.-Campbell/e/B001IR1OHM/ref=dp_byline_cont_book_1

https://www.amazon.com/s/ref=dp_byline_sr_book_2?ie=UTF8&text=T.+D.+V.+Swinscow&search-alias=books&field-author=T.+D.+V.+Swinscow&sort=relevancerank

foundation module - phase i - usjpmedical.sjp.ac.lk/downloads/module-books/phase-i/1...

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