Textbook of Biochemistry for Medical Students DM Vasudevan, Sreekumari S, Kannan Vaidyanathan
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fm1Textbook of Biochemistry for Medical Studentsfm2
fm3Textbook of Biochemistry for Medical Students
Eighth Edition DM VASUDEVAN MBBS MD FAMS FRCPath Distinguished Professor of Biochemistry College of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India (Formerly, Principal, Amrita College of Medicine, Kerala) (Formerly, Dean, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim) Email: dmvasudevan@yahoo.co.in SREEKUMARI S MBBS MD Professor and Head Department of Biochemistry Sree Gokulam Medical College and Research Foundation Thiruvananthapuram, Kerala, India Email: sreekumarisudhakaran0@gmail.com KANNAN VAIDYANATHAN MBBS MD Professor and Head Department of Biochemistry Pushpagiri Institute of Medical Sciences and Research Centre Thiruvalla, Kerala, India Email: drkannanvaidyanathan@gmail.com
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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Textbook of Biochemistry for Medical Students
First Edition: 1995
Second Edition: 1998
Third Edition: 2001
Fourth Edition: 2004
Fifth Edition: 2007
Sixth Edition: 2010
Seventh Edition: 2013
Eighth Edition: 2016
9789385999741
Printed at
fm5Dedicationfm6
With humility and reverence, this book is dedicated at the lotus feet of the Holy Mother,
Sri Mata Amritanandamayi Devi
"Today's world needs people who express goodness in their words and deeds. If such noble role models set the example for their fellow beings, the darkness prevailing in today's society will be dispelled, and the light of peace and non-violence will once again illumine this earth. Let us work together towards this goal"
Mata Amritanandamayi Devi
fm7Preface to the Eighth Edition
We are glad to present the Eighth edition of the Textbook of Biochemistry for Medical Students. Now, this Textbook is entering the 22nd year of existence. With humility, we may state that the medical community of India has warmly received the previous editions of this book. The Medical Council of India have accepted it as one of the standard textbooks. We are happy to note that this book has also reached in the hands of medical students of neighboring countries of Nepal, Pakistan, Bangladesh, Sri Lanka, etc., and also to distant countries in Africa and Europe. We are very proud to report that the Textbook has a Spanish edition, with wide circulation in the Central and South America. Slovak edition has also been published. Apart from the medical community, this book has also become popular to other biology group of students in India. In retrospect, it gives immense satisfaction to note that this textbook served the students and faculty for the past more than two decades.
From the first edition onwards, our policy was to provide not only basic essentials, but also some of the advanced knowledge. About 30% contents of the previous editions were not required for an average student aiming for a pass. A lot of students have appreciated this approach, as it helped them to pass the PG entrance examinations at a later stage. However, this asset has paved the way for a general criticism that the extra details are a burden to the average students. Especially when reading for the first time, the students may find it difficult to sort out the essential minimum from the advanced portions. We have accepted the request from the majority of the students, and reduced the content in this edition.
Thus, in consultation with the Publishers, we have decided to make two different books, one for MBBS and another one for postgraduate courses in Biochemistry. Thus, the content has been made lesser in this textbook. We are bringing out the postgraduate textbook in due course.
Yet another regular criticism against the previous edition was that the font size was small, and it was difficult to read the book. This problem is solved in this edition, by changing the font. The readability has thus been markedly improved. While increasing the font size, we were very conscious that the bulk of the book should not be increased. We have reached a compromise in these mutually opposing tasks.
A major attraction of this edition is the incorporation of clinical case studies in almost all chapters. We hope that this feature will help the students to identify the clinical relevance of the biochemistry. Further, clinically relevant points were added in most of the chapters. Rapid progress has been made in the area of molecular biology during past few years, and these advances are to be reflected in this book also.
Essay questions, short notes, multiple choice questions and viva voce type questions are given at the end of almost every chapter. These questions are compiled from the question papers of various universities during the last decade. These questions will be ideal for students for last-minute preparation for examinations.
A textbook will be matured only by successive revisions. In the preface for the first edition, we expressed our desire to revise the textbook every 3 years. We were fortunate to keep that promise. This book has undergone metamorphosis during each edition. Chemical structures with computer technology were introduced in the second edition. Color printing has been launched in the third edition. The fourth edition came out with multicolor printing. In the fifth edition, the facts were presented in small paragraphs, so as to aid memory. In this sixth edition, figures were drastically increased. In the seventh edition, about 100 cases studies were added. In this 8th edition, extra topics have been pruned out. But the figures and boxes have been increased. Thus there are about 1000 figures, 200 tables and 200 boxes, altogether making the book more student-friendly. The quality of paper is also improved during successive editions.
We were pleasantly surprised to receive many letters giving constructive criticisms and positive suggestions to improve the textbook. These responses were from all parts of the country (we got a few such letters from African and European students also). Such contributors include Heads of Departments, very senior professors, middle level teachers and mostly postgraduate students. We have tried to incorporate most of those suggestions within the constraints of page limitations. In a way, this book thus became multiauthored, and truly fm8national in character. This is to place on record, our deep gratitude for all those “pen-friends” who have helped us to improve this book. The first author desires more interaction with faculty and students who are using this textbook. All are welcome to communicate at his e-mail address <dmvasudevan@yahoo.co.in>
As indicated in the last edition, the first author is in the process of retirement and would like to reduce the burden in due course. A successful textbook is something like a growing institution; individuals may come and go, but the institution will march ahead. The third author has been co-opted in the sixth edition. In the seventh edition, the third author took about 10% of the editing work. In this eighth edition, he was responsible to do almost 50% of the editorial work. Accordingly, the first and second authors have taken less pain in editing the book. Thus gradually, the torch is being handed over smoothly to the next generation; and that process will continue in the next editions.
The help and assistance rendered by our postgraduate students in preparing this book are enormous. The official website of Nobel Academy has been used for pictures and biographies of Nobel laureates. Web pictures without copyright protection were also used in some figures. The remarkable success of the book was due to the active support of the publishers. This is to record our appreciation for the co-operation extended by Mr JP Vij, and his associates.
We hope that this eighth edition will be friendlier to the students and be more attractive to the teachers. Now this is in your hands to judge.
“End of all knowledge must be building up of character”.
Mahatma Gandhi
May 2016
DM Vasudevan MBBS MD FAMS FRCPath
Sreekumari S MBBS MD
Kannan Vaidyanathan MBBS MD
fm9Preface to the First Edition
There are many textbooks of biochemistry written by Western and Indian authors. Then what is the need for yet another textbook? Putting this question to ourselves, we have waited for many years before embarking on this project. Most Western textbooks do not emphasize nutrition and such other topics, which are very vital to an Indian student. While Indian authors do cover these portions, they sometimes neglect the expanding fields, such as molecular biology and immunochemistry. Thus, during our experience of more than 25 years in teaching, the students have been seen compelled to depend on different textbooks during their study of biochemistry. We have tried to keep a balance between the basic essentials and the advanced knowledge.
This book is mainly based on the MBBS curriculum. However, some advanced portions have also been given in almost all chapters. These areas will be very beneficial to the readers preparing for their postgraduate entrance examinations.
Chapters on diabetes, cancer and AIDS are included in this book. During their clinical years, the students are going to see such cases quite more often, hence knowledge of applied biochemistry of these diseases will be very helpful. The authors, themselves medical graduates, have tried to emphasize medical applications of the theoretical knowledge in biochemistry in almost all the chapters.
A few questions have been given at the end of most of the chapters. These are not comprehensive to cover all the topics, but have been included only to give emphasis to certain points, which may otherwise be left unnoticed by some students.
We are indebted to many persons in compiling this textbook. We are highly obliged to Dr ANP Ummerkutty, Vice-Chancellor, University of Calicut, for his kind gesture of providing an introduction. Dr M Krishnan Nair, Research Director, Veterinary College, Trichur, has provided his unpublished electron micrographs for this book. Dr MV Muraleedharan, Professor of Medicine, and Dr TS Hariharan, Professor of Pharmacology, Medical College, Thrissur, have gone through the contents of this book. Their valuable suggestions on the applied aspects of biochemistry have been incorporated. Two of our respected teachers in biochemistry, Professor R Raghunandana Rao and Professor GYN lyer (both retired) have encouraged this venture. Professor PNK Menon, Dr S Gopinathan Nair, Assistant Professor, Dr Shyam Sundar, Dr PS Vasudevan and Mr K Ramesh Kumar, postgraduate students of this department, have helped in collecting the literature and compiling the materials. Mr Joby Abraham, student of this college has contributed the sketch for some of the figures. Professor CPK Tharakan, retired Professor of English, has taken great pains to go through the entire text and correct the usage of English. The secretarial work has been excellently performed by Mrs Lizy Joseph. Many of our innumerable graduate and postgraduate students have indirectly contributed by compelling us to read more widely and thoroughly.
Our expectation is to bring out the new edition every 3 years. Suggestions to improve the contents are welcome from the teachers.
“A lamp that does not glow itself cannot light another lamp”
Rabindranath Tagore
DM Vasudevan MBBS MD FAMS FRCPath
Sreekumari S MBBS MD