MRCP, PhD, clinical professor of respiratory infection and immunity at Barts and the London School of Medicine and Dentistry, Queen Mary University of London, told Healio. “Obviously

DM Neurology or Doctorate of Medicine in Neurology also known as DM in Neurology
is a super speciality level course for doctors in India that is done by them
after completion of their postgraduate medical degree course. The duration of
this super speciality course is 3 years, and it deals
with the nervous system and its functional disorders.
Neurologists diagnose and treat diseases of the brain, spinal
cord, and nerves.

The course is a full-time course pursued at various recognized medical
colleges across the country. Some top medical colleges offering this
course include All India Institute of Medical Sciences, New Delhi, Sree Chitra Thirunal Institute for Medical Science
and Technology, Thiruvananthapuram,
Jawaharlal Institute of Postgraduate Medical Education & Research,
Puducherry (JIPMER), and more.

Admission to this course is done through the NEET-SS Entrance exam
conducted by the National Board of Examinations, followed by counseling based
on the scores of the exam that is conducted by DGHS/MCC/State Authorities.

The fee for pursuing DM (Neurology) varies from college to college and
may range from Rs. 5000 to Rs. 30 lakhs per year.

After completion of their respective course, doctors can either join the
job market or can pursue certificate courses and Fellowship programmes
recognized by NMC and NBE. Candidates can take reputed jobs at positions as
Senior residents, Consultants, etc. with an approximate salary range of Rs.30
lakhs to Rs. 60 lakhs per year depending upon their expertise.

What is DM in Neurology?

Doctorate of Medicine in Neurology, also known as DM (Neurology) or DM
in (Neurology) is a three-year super speciality programme that candidates can
pursue after completing a postgraduate medical degree.

Neurology is the branch of medical science dealing with the nervous system and its functional disorders. Neurologists diagnose and treat diseases and disorders of the brain, spinal cord, and nerves.

The postgraduate students must gain ample knowledge and experience in
the diagnosis, and treatment of patients with acute, serious, and life-threatening
medical and surgical diseases.

PG education intends to create specialists who can contribute to
high-quality health care and advances in science through research and training.

The required training done by a postgraduate specialist in the field of Neurology
would help the specialist to recognize the health needs of the community. The
student should be competent to handle medical problems effectively and should
be aware of the recent advances in their specialty.

The candidate is also expected to know the principles of research
methodology and modes of the consulting library. The candidate should regularly
attend conferences, workshops and CMEs to upgrade her/ his knowledge.

Course Highlights

Here are some of the course highlights of DM in Neurology

Name of Course

DM in Neurology

Level

Doctorate

Duration of Course

Three years

Course Mode

Full Time

Minimum Academic
Requirement

Candidates must have a postgraduate medical Degree in MD/DNB
(General Medicine) or MD/DNB (Paediatrics) obtained from any
college/university recognized by the Medical Council of India (Now NMC)/NBE,
this feeder qualification mentioned here is as of 2022. For any further
changes to the prerequisite requirement please refer to the NBE website.

Admission Process /
Entrance Process / Entrance Modalities

Entrance Exam
(NEET-SS)

INI CET for various
AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru

Counselling by DGHS/MCC/State
Authorities

Course Fees

Rs.5000 to
Rs. 20 lakhs per year

Average Salary

Rs.30 lakhs to Rs. 60
lakhs per year

Eligibility Criteria

The eligibility criteria for DM in Neurology are defined as the set of
rules or minimum prerequisites that aspirants must meet to be eligible
for admission, which includes:

Name of DM course

Course Type

Prior Eligibility Requirement

Neurology

DM

MD/DNB (General Medicine)

MD/DNB (Paediatrics)

Note:

· The feeder qualification for DM in Neurology is
defined by the NBE and is subject to changes by the NBE.

· The feeder qualification mentioned here is as of
2022.

· For any changes, please refer to the NBE website.

· The candidate must have obtained permanent
registration with any State Medical Council to be eligible for admission.

· The medical college's recognition cut-off dates for
the Postgraduate Degree courses shall be as prescribed by the Medical Council
of India (now NMC).

Admission Process

• The admission process
  contains a few steps to be followed in order by the candidates for
  admission to DM in Neurology. Candidates can view the complete admission
  process for DM in Neurology mentioned below:

• The NEET-SS or National
  Eligibility Entrance Test for Super speciality courses is a national-level
  master's level examination conducted by the NBE for admission to
  DM/MCh/DrNB Courses.

• Qualifying
  Criteria-Candidates placed at the 50th percentile or above shall be
  declared as qualified in the NEET-SS in their respective speciality.

• The following Medical
  institutions are not covered under centralized admissions for DM/ MCh
  courses through NEET-SS:

1. AIIMS,
   New Delhi and other AIIMS
2. PGIMER,
   Chandigarh
3. JIPMER,
   Puducherry
4. NIMHANS,
   Bengaluru

• Candidates from all eligible
  feeder speciality subjects shall be required to appear in the question
  paper of the respective group if they are willing to opt for a super
  speciality course in any of the super speciality courses covered in that
  group.

• A candidate can opt for
  appearing in the question papers of as many groups for which his/her
  Postgraduate speciality qualification is an eligible feeder qualification.

• By appearing in the question
  paper of a group and on qualifying for the examination, a candidate shall be eligible
  to exercise his/her choices in the counselling only for those super speciality subjects covered in the said group for which his/ her broad
  speciality is an eligible feeder qualification.

Fees Structure

The fee structure for DM in Neurology varies from college to college.
The fee is generally less for Government Institutes and more for private
institutes. The average fee structure for DM in Neurology is around Rs.5000 to Rs. 30 lakhs per year.

Colleges offering DM in Neurology

There are various medical colleges across India that offer courses for
pursuing DM in (Neurology).

As per National Medical Commission (NMC) website, the following medical
colleges are offering DM in (Neurology) courses for the academic year 2022-23.

Sl.No.

Course Name

State

Name and Address of
Medical College / Medical Institution

Management of College

1

DM - Neurology

Andhra Pradesh

Andhra Medical College, Visakhapatnam

Govt.

2

DM - Neurology

Andhra Pradesh

Sri Venkateswara Institute of Medical Sciences
(SVIMS) , Tirupati

Govt.

3

DM - Neurology

Andhra Pradesh

Guntur Medical College, Guntur

Govt.

4

DM - Neurology

Andhra Pradesh

NRI Medical College, Guntur

Trust

5

DM - Neurology

Andhra Pradesh

Narayana Medical College, Nellore

Trust

6

DM - Neurology

Assam

Gauhati Medical College, Guwahati

Govt.

7

DM - Neurology

Bihar

Indira Gandhi Institute of Medical
Sciences, Sheikhpura, Patna

Govt.

8

DM - Neurology

Chandigarh

Postgraduate Institute of Medical Education &
Research, Chandigarh

Govt.

9

DM - Neurology

Delhi

All India Institute of Medical Sciences, New
Delhi

Govt.

10

DM - Neurology

Delhi

Atal Bihari Vajpayee Institute of Medical
Sciences and Dr RML Hospital, New Delhi

Govt.

11

DM - Neurology

Delhi

G.B. Pant Institute of Postgraduate Medical
Education and Research, New Delhi

Govt.

12

DM - Neurology

Delhi

Vardhman Mahavir Medical College & Safdarjung
Hospital, Delhi

Govt.

13

DM - Neurology

Delhi

Institute of Human Behaviour and Allied Sciences,
Delhi

Govt.

14

DM - Neurology

Gujarat

SBKS Medical Instt. & Research Centre,
Vadodra

Trust

15

DM - Neurology

Gujarat

Smt. N.H.L.Municipal Medical College, Ahmedabad

Govt.

16

DM - Neurology

Jammu & Kashmir

Sher-I-Kashmir Instt. Of Medical Sciences,
Srinagar

Govt.

17

DM - Neurology

Karnataka

National Institute of Mental Health & Neuro
Sciences, Bangalore

Govt.

18

DM - Neurology

Karnataka

Jawaharlal Nehru Medical College, Belgaum

Trust

19

DM - Neurology

Karnataka

S S Institute of Medical Sciences& Research
Centre, Davangere

Trust

20

DM - Neurology

Karnataka

Kasturba Medical College, Manipal

Trust

21

DM - Neurology

Karnataka

Father Mullers Medical College, Mangalore

Trust

22

DM - Neurology

Karnataka

JSS Medical College, Mysore

Trust

23

DM - Neurology

Karnataka

Vydehi Institute Of Medical Sciences &
Research Centre, Bangalore

Trust

24

DM - Neurology

Karnataka

St. Johns Medical College, Bangalore

Trust

25

DM - Neurology

Karnataka

Bangalore Medical College and Research Institute,
Bangalore

Govt.

26

DM - Neurology

Karnataka

M S Ramaiah Medical College, Bangalore

Trust

27

DM - Neurology

Kerala

Government Medical College, Kottayam

Govt.

28

DM - Neurology

Kerala

Sree Chitra Thirunal Institute for Medical
Science and Technology, Thiruvananthapura

Govt.

29

DM - Neurology

Kerala

Government Medical College, Kozhikode, Calicut

Govt.

30

DM - Neurology

Kerala

Medical College, Thiruvananthapuram

Govt.

31

DM - Neurology

Kerala

Pushpagiri Institute Of Medical Sciences and
Research Centre, Tiruvalla

Trust

32

DM - Neurology

Kerala

M E S Medical College , Perintalmanna Malappuram
Distt.Kerala

Trust

33

DM - Neurology

Kerala

Jubilee Mission Medical College & Research
Institute, Thrissur

Trust

34

DM - Neurology

Kerala

T D Medical College, Alleppey (Allappuzha)

Govt.

35

DM - Neurology

Kerala

Amrita School of Medicine, Elamkara, Kochi

Trust

36

DM - Neurology

Madhya Pradesh

All India Institute of Medical Sciences, Bhopal

Govt.

37

DM - Neurology

Madhya Pradesh

Sri Aurobindo Medical College and Post Graduate
Institute, Indore

Trust

38

DM - Neurology

Maharashtra

Seth GS Medical College, and KEM Hospital, Mumbai

Govt.

39

DM - Neurology

Maharashtra

Bombay Hospital Institute of Medical Sciences,
Mumbai

Govt.

40

DM - Neurology

Maharashtra

Topiwala National Medical College, Mumbai

Govt.

41

DM - Neurology

Maharashtra

Grant Medical College, Mumbai

Govt.

42

DM - Neurology

Maharashtra

Jawaharlal Nehru Medical College, Sawangi
(Meghe), Wardha

Trust

43

DM - Neurology

Maharashtra

Bharati Vidyapeeth University Medical College,
Pune

Trust

44

DM - Neurology

Maharashtra

Dr D Y Patil Medical College, Hospital and
Research Centre, Pimpri, Pune

Trust

45

DM - Neurology

Meghalaya

North Eastern Indira Gandhi Regional Instt. of
Health and Medical Sciences, Shillong

Govt.

46

DM - Neurology

Orissa

All India Institute of Medical Sciences,
Bhubaneswar

Govt.

47

DM - Neurology

Orissa

Kalinga Institute of Medical Sciences,
Bhubaneswar

Trust

48

DM - Neurology

Orissa

Instt. Of Medical Sciences & SUM Hospital,
Bhubaneswar

Trust

49

DM - Neurology

Orissa

SCB Medical College, Cuttack

Govt.

50

DM - Neurology

Pondicherry

Jawaharlal Institute of Postgraduate Medical
Education & Research, Pondicherry

Govt.

51

DM - Neurology

Punjab

Christian Medical College, Ludhiana

Trust

52

DM - Neurology

Punjab

Dayanand Medical College & Hospital, Ludhiana

Trust

53

DM - Neurology

Rajasthan

SMS Medical College, Jaipur

Govt.

54

DM - Neurology

Rajasthan

All India Institute of Medical Sciences, Jodhpur

Govt.

55

DM - Neurology

Rajasthan

Geetanjali Medical College & Hospital, Udaipur

Trust

56

DM - Neurology

Rajasthan

Mahatma Gandhi Medical College and Hospital,
Sitapur, Jaipur

Trust

57

DM - Neurology

Rajasthan

Government Medical College, Kota

Govt.

58

DM - Neurology

Rajasthan

Dr SN Medical College, Jodhpur

Govt.

59

DM - Neurology

Tamil Nadu

Sri Ramachandra Medical College & Research
Institute, Chennai

Trust

60

DM - Neurology

Tamil Nadu

Tirunelveli Medical College,Tirunelveli

Govt.

61

DM - Neurology

Tamil Nadu

Madurai Medical College, Madurai

Govt.

62

DM - Neurology

Tamil Nadu

Saveetha Medical College and Hospital,
Kanchipuram

Trust

63

DM - Neurology

Tamil Nadu

Stanley Medical College, Chennai

Govt.

64

DM - Neurology

Tamil Nadu

Madras Medical College, Chennai

Govt.

65

DM - Neurology

Tamil Nadu

Christian Medical College, Vellore

Trust

66

DM - Neurology

Tamil Nadu

Dhanalakshmi Srinivasan Medical College and
Hospital,Perambalur

Trust

67

DM - Neurology

Tamil Nadu

KanyaKumari Government Medical College,
Asaripallam

Govt.

68

DM - Neurology

Tamil Nadu

Govt. Mohan Kumaramangalam Medical College,
Salem- 30

Govt.

69

DM - Neurology

Tamil Nadu

K A P Viswanathan Government Medical College,
Trichy

Govt.

70

DM - Neurology

Tamil Nadu

Thoothukudi Medical College, Thoothukudi

Govt.

71

DM - Neurology

Tamil Nadu

Chengalpattu Medical College, Chengalpattu

Govt.

72

DM - Neurology

Tamil Nadu

Coimbatore Medical College, Coimbatore

Govt.

73

DM - Neurology

Tamil Nadu

Thanjavur Medical College,Thanjavur

Govt.

74

DM - Neurology

Tamil Nadu

Chettinad Hospital & Research Institute,
Kanchipuram

Trust

75

DM - Neurology

Tamil Nadu

Sree Balaji Medical College and Hospital, Chennai

Trust

76

DM - Neurology

Tamil Nadu

SRM Medical College Hospital & Research
Centre, Chengalpattu

Trust

77

DM - Neurology

Tamil Nadu

Meenakshi Medical College and Research Institute,
Enathur

Trust

78

DM - Neurology

Tamil Nadu

PSG Institute of Medical Sciences, Coimbatore

Trust

79

DM - Neurology

Telangana

Osmania Medical College, Hyderabad

Govt.

80

DM - Neurology

Telangana

Nizams Institute of Medical Sciences, Hyderabad

Govt.

81

DM - Neurology

Telangana

Gandhi Medical College, Secunderabad

Govt.

82

DM - Neurology

Telangana

Chalmeda Anand Rao Insttitute Of Medical
Sciences, Karimnagar

Trust

83

DM - Neurology

Telangana

Deccan College of Medical Sciences, Hyderabad

Trust

84

DM - Neurology

Uttarakhand

All India Institute of Medical Sciences,
Rishikesh

Govt.

85

DM - Neurology

Uttarakhand

Himalayan Institute of Medical Sciences, Dehradun

Trust

86

DM - Neurology

Uttar Pradesh

Institute of Medical Sciences, BHU, Varansi

Govt.

87

DM - Neurology

Uttar Pradesh

Sanjay Gandhi Postgraduate Institute of Medical
Sciences, Lucknow

Govt.

88

DM - Neurology

Uttar Pradesh

King George Medical University, Lucknow

Govt.

89

DM - Neurology

Uttar Pradesh

Dr. Ram Manohar Lohia Institute of Medical
Sciences,Lucknow

Govt.

90

DM - Neurology

West Bengal

Institute of Postgraduate Medical Education &
Research, Kolkata

Govt.

91

DM - Neurology

West Bengal

Calcutta National Medical College, Kolkata

Govt.

92

DM - Neurology

West Bengal

Burdwan Medical College, Burdwan

Govt.

93

DM - Neurology

West Bengal

Nilratan Sircar Medical College, Kolkata

Govt.

94

DM - Neurology

West Bengal

Govt. Medical College, Kolkata

Govt.

Syllabus

A DM in Neurology is a three years specialization course that provides
training in the stream of Neurology.

The course content for DM in Neurology is given in the Competency-Based Postgraduate Training Programme released by National Medical Commission, which can be assessed through the link mentioned below: 

NMC Guidelines For Competency Based Training Programme For DM Neurology

SYLLABUS

Course contents

AIM:

To produce specialists with necessary skills, judgement and sense of dedication to tackle all major and minor cardiac problems. The candidates will be trained in all aspects of Neurology starting from Basic Sciences to recent advances.

PAPER I: BASIC SCIENCES RELATED TO NEUROLOGY

NEUROANATOMY

The Neuroanatomy with special emphasis on development of:

· Neuroaxis (brain, spinal cord and neurons and glia),

· Autonomic nervous system and their maturation process in the post-natal, childhood and adolescent states;

· Location and significance of stem cells,

· CSF pathways,

· Blood supply and sino venous drainage of brain and spinal cord, the meninges,

· Skull and vertebral column, the cranial nerves, spinal roots, plexuses, and their relation to neighboring structures;

· Anatomy of peripheral nerves,

· Neuromuscular junction and muscles;

· Histology of cerebrum, cerebellum, pituitary gland, brain stem and

spinal cord, nerves and neuromuscular junction and muscle.

· Functional anatomy of lobes of cerebrum and white matter tracts of brain and spinal cord, craniovertebral junction, conus and epiconus and cauda equina, brachial and lumbosacral plexuses, cavernous and other venous sinuses;

· New developments in understanding of:

o Ultrastructural anatomy of neurons,

o axonal transport,

o neural networks and synapses and nerve cell function at molecular level.

NEUROPHYSIOLOGY

• Neurophysiology will cover all the physiological changes in the nervous system during its normal function with special reference to nerve impulse transmission along myelinated fibers,
• neuromuscular junction and synaptic transmission,

· muscle contraction;

· visual, auditory and somatosensory and cognitive evoked potentials;

· Regulation of secretions by glands, neural control of viscera such as heart, respiration, GI tract, bladder and sexual function; sleep-wake cycles;

· Maintenance of consciousness,

· special senses,

· control of functions of (a) pituitary, (b) autonomic system (c) cerebellum, (d) and extrapyramidal functions,

· reflexes,

· upper and lower motor neuron concepts and sensory system.

MOLECULAR BIOLOGY

Brain is the one structure where maximum genes are expressed in the human

body. The topics include:

· Principles of molecular biology including Gene Structure, Expression and regulation;

· Recombinant DNA Technology;

· PCR Techniques,

· Molecular basis for neuronal and glial function,

· Molecular and cellular biology of the membranes and ion-channels,

· Mitochondrial genome,

· Role of RNA in normal neuronal growth and functional expression,

· Receptors of neurotransmitters,

· Molecular and cellular biology of muscles and neuromuscular junction, etc.

· The Human Genome and its future implications for Neurology including

developmental and neurogenetic disorders,

· bioethical implications and genetic counselling,

· Nerve growth and other trophic factors and neuroprotectors,

· Neural Tissue modification by genetic approaches including Gene Transfer, stem cell therapy etc.

· Molecular Development of neural tissue in peripheral nerve repair

NEUROCHEMISTRY

· All aspects of normal and abnormal patterns of neurochemistry including:

· Neurotransmitters associated with different anatomical and functional areas of brain and spinal cord, especially with respect to dopaminergic, serotoninergic, adrenergic and cholinergic systems,

· Opioids,

· Excitatory and inhibitory amino acids and their role in pathogenesis of Parkinsonism, depression, migraine, dementia, epilepsy,

· Neuromuscular junction and muscle contractions,

· Carbohydrate, amino acid and lipid metabolism,

· Neural expression of disorders of their metabolism,

· Electrolytes and their effect on encephalopathies,

· Muscle membrane function, storage disorders,

· Porphyria.

NEUROPHARMACOLOGY

• Application of neuropharmacology in medical therapy of epilepsy, Parkinsonism, movement disorders, neuropsychiatric syndromes, spasticity, pain syndromes, disorders of sleep and dysautonomia syndromes.
• Antiepileptic drugs, usage during disorders of renal, hepatic function and in dementia.
• Adverse drug reactions of common drugs used in Neurological disorders including antiepileptic drugs, antiplatelets, anticoagulants etc.

NEUROPATHOLOGY

• Pathological changes in various neurological diseases with special reference to vascular, immune-mediated, demyelinating and dysmyelinating, metabolic and nutritional, genetic and developmental, infectious and iatrogenic and neoplastic etiologies and clinical correlation.
• Pathological changes in nerve and muscle in neuropathies and myopathies.
• Ultrastructural pathology such as apoptosis, ubiquitinopathies, mitochondrial diseases, channelopathies, peroxisomal disorders, inclusion bodies, prion diseases, disorders mediated by antibodies against various cell and nuclear components, paraneoplastic disorders etc.

NEUROMICROBIOLOGY

Microbiological aspects of infectious neurologic diseases including:

• Encephalitis, meningitis, brain abscess, granulomas, myelitis, cold abscess, cerebral malaria, parasitic cysts of nervous system, rhino cerebral mycoses, leprous neuritis, neuro leptospirosis, primary and secondary Neuro HIV infections, congenital TORCH infections of brain, slow virus infections such as CJD and SSPE.
• Neurological complications of viral infections such as Polio, EBV, Chickenpox, Rabies, Herpes, Japanese encephalitis and other epidemic viral infections.

NEUROTOXICOLOGY

Diagnosis and effective therapy of:

· Organophosphorus poisoning,

· hydrocarbon poisoning,

· lead, arsenic, botulinum toxin and tetanus toxicity,

· snake, scorpion, spider, wasp and beestings.

NEUROGENETICS AND PROTEOMICS:

· Autosomal dominant and recessive and X-linked inheritance patterns,

· disorders of chromosomal anomalies,

· Gene mutations, trinucleotide repeats, dysregulation of gene expressions,

· Enzyme deficiency syndromes,

· Storage disorders,

· Disorders of polygenic inheritance,

· Proteomics in health and disease.

NEUROEPIDEMIOLOGY:

• Basic methodology in community and hospital based neuro-epidemiological studies such as systematic data collection, analysis, derivation of logical conclusions,

· Concepts of case-control and cohort studies, correlations,

· Regressions and survival analysis,

· Basic principles of clinical trials.

PAPER II: CLINICAL NEUROLOGY INCLUDING PEDIATRIC NEUROLOGY and NEUROPSYCHIATRY.

GENERAL EVALUATION OF THE PATIENT

• The science and art of history taking,
• Physical examination including elements of accurate history taking, symptoms associated with neurological disease,
• Physical examination of adults, children, infants and neonates, syndromes

associated with congenital and acquired neurological disease, cutaneous

markers,

· Examination of unconscious patients,

· Examination of higher mental functions, cranial nerves, the ocular fundus,

· Examination of tone, power of muscles,

· Proper elicitation of superficial and deep reflexes including alternate techniques,

· Neonatal and released reflexes,

• Neurodevelopmental assessment of children, sensory system, peripheral nerves, signs of Meningeal irritation, skull and spine examination including measurement of head circumference, shortness of neck and carotid pulsations .and vertebral bruits.

DISTURBANCES OF SENSORIUM

• Pathophysiology and diagnosis of COMA,
• Diagnosis and management of coma, delirium and acute confusional states, reversible and irreversible causes,
• Persistent vegetative states and brain death,
• Neurophysiological evaluation and confirmation of these states,
• Mechanical ventilation and other supportive measures of comatose patient,
• Prevention of complications of prolonged coma,

· The significance of timely brain death in organ donation and ICU resource utilization.

SEIZURES and EPILEPSY and SYNCOPE

· Diagnosis of seizures, epilepsy and epileptic syndromes,

• Recognition, clinical assessment and management of seizures especially their electrodiagnosis, video monitoring with emphasize on phenomenology and their correlation with EEG,
• Structural and functional brain imaging such as CT and MRI and fMRI and SPECT scan, 
• Special situations such as epilepsy in pregnant and nursing mothers, driving, risky occupations, its social stigmas differentiation from pseudo seizures,

• Use of conventional and newer antiepileptic drugs, their drug interactions and adverse effects etc.,
• Modern lines of management of intractable epilepsies, such as ketogenic diet, vagal nerve stimulation, epilepsy surgery,
• Pre-surgical evaluation of patients,
• Management of status epilepticus and refractory status epilepticus,
• Differentiation of seizures from syncope, drop attacks, cataplexy, startles etc.

HEADACHES and OTHER CRANIAL NEURALGIAS

· Acquisition of skills in the analysis of headaches of various causes such as those from raised intracranial pressures, migraines, cranial neuralgias, vascular malformations,

· Meningeal irritation, Psychogenic etc. and their proper pharmacologic management.

CEREBROVASCULAR DISEASES

· Vascular anatomy of the brain and spinal cord,

• Various causes and types of cerebrovascular syndromes, ischemic and hemorrhagic types, arterial and venous types, anterior and posterior circulation strokes,

· OCSP and TOAST classifications,

· Investigation of strokes including neuroimaging using Dopplers,

• CT and MR imaging and angiography, acute stroke therapy including

thrombolytic therapy,

· Interventional therapy of cerebrovascular diseases,

· Principles of management of subarachnoid haemorrhage etc.

• Special situations like strokes in the young, strategies for primary and secondary prevention of stroke.

DEMENTIAS

· Concept of minimal cognitive impairment,

• Reversible and irreversible dementias causes such as Alzheimer’s and other neurodegenerative diseases and vascular and nutritional and infectious dementias, their impact on individuals, families and in society.
• Genetic and familial syndromes.
• Pharmacotherapy of dementias, the potential role of cognitive rehabilitation and special care of the disabled.

PARKINSONISM AND MOVEMENT DISORDERS

· Disorders of the extrapyramidal system such as Parkinsonism, chorea, dystonia, athetosis, tics, their diagnosis and management,

· Pharmacotherapy of Parkinsonism and its complications,

• management of complications of Parkinsonism therapy, including principles of deep brain stimulation and lesion surgeries.

· Use of EMG-guided botulinum toxin therapy,

· Management of spasticity using intrathecal baclofen and TENS.

ATAXIC SYNDROMES:

· Para infectious demyelination, cerebellar tumours, hereditary ataxias, vestibular disorders,

· Diagnosis and management of brainstem disorders,

· Axial and extra-axial differentiation.

CRANIAL NEUROPATHIES:

• Disorders of smell, vision, visual pathways, pupillary pathways and reflexes,
• Internuclear and supranuclear ophthalmoplegia,
• Other oculomotor disorders,
• Trigeminal nerve testing,
• Bell’s palsy,
• Differentiation from UMN facial lesions,
• Brain stem reflexes,
• Investigations of vertigo and dizziness,
• Differentiation between central and peripheral vertigo,

· Differential diagnosis of nystagmus,

· Investigations of deafness, bulbar and pseudobulbar syndromes.

CNS INFECTIONS:

• Diagnosis and management of viral encephalitides, meningitis bacterial, tuberculous, fungal, parasitic infections such as cysticercosis, cerebral malaria, SSPE, Neuro HIV primary and secondary infections with exposure to gram stain and cultures, bac tec, QBC, ELISA and PCR technologies.

NEUROIMMUNOLOGY DISEASES

• Diagnosis and management of CNS conditions such as Multiple Sclerosis, PNS conditions such as GBS, CIDP, Myasthenia gravis, polymyositis.

NEUROGENETIC DISORDERS

· Various chromosomal diseases,

• Single gene mutations such as enzyme deficiencies,
• Autosomal dominant and recessive conditions and X-linked disorders,

trinucleotide repeats,

• Disorders of DNA repair. Genetics of Huntington’s disease, familial dementias, other storage disorders, hereditary ataxias,
• Hereditary spastic paraplegias, HMSN, muscular dystrophies, mitochondrial inheritance disorders.

DEVELOPMENTAL DISORDERS OF NERVOUS SYSTEM

· Neuronal migration disorders,

· Craniovertebral junction diseases,

· Spinal dysraphism,

• Phacomatoses and other neurocutaneous syndromes- their recognition and management.

MYELOPATHIES

• Clinical diagnosis of distinction between compressive and non-compressive myelopathies,

· Spinal syndromes such as anterior cord, subacute combined degeneration,

· Central cord syndrome,

· Brown-Sequard syndrome,

· Tabetic syndrome,

· Ellsberg phenomenon.

· Diagnosis of spinal cord and root compression syndromes,

· CV junction lesions,

· Syringomyelia, conus cauda lesions,

· Spinal AVMs,

· tropical and hereditary spastic paraplegias,

· Fluorosis.

PERIPHERAL NEUROPATHIES

• Immune mediated, hereditary, toxic, nutritional and infectious type peripheral neuropathies; their clinical and electrophysiological diagnosis.

MYOPATHIES AND NEUROMUSCULAR JUNCTION DISORDERS

· Clinical evaluation of patients with known or suspected muscle diseases aided by EMG,

• Muscle pathology, histochemistry, immunopathology and genetic studies,
• Dystrophies, polymyositis, channnelopathies, congenital and mitochondrial myopathies,

· Neuromuscular junction disorders such as myasthenia, botulism, Eaton-lambert syndrome,

• Snake and organophosphorus poisoning, their electrophysiological diagnosis and management.

· Myotonia, stiff person syndrome.

PAEDITRIC NEUROLOGY:

· Normal development of motor and mental milestones in a child, Cerebral palsy,

· Attention deficit disorder,

· Autism,

· Developmental dyslexia,

· Intrauterine TORCH infections,

· Storage disorders,

· Inborn errors of metabolism affecting nervous system,

· Developmental malformations,

· Child hood seizures and epilepsies,

· Neurodegenerative diseases.

COGNITIVE NEUROLOGY AND NEUROPSYCHIATRY:

· Detailed techniques of higher mental functions evaluation,

• Basics of primary and secondary neuropsychiatric conditions such as anxiety, depression, schizophrenia, acute psychosis, acute confusional reactions (delirium), organic brain syndrome,

· Primary and secondary dementias, differentiation from pseudodementia.

TROPICAL NEUROLOGY

Conditions which are specifically found in the tropics like to be taught in detail;

· Neuro-cysticercosis,

· Cerebral malaria,

· Tropical spastic paraplegia,

· Snake/scorpion/ Chandipura

· Encephalitis,

· Madras Motor Neuron disease etc.

PAPER III: DIAGNOSTIC and INTERVENTIONAL NEUROLOGY INCLUDING NEUROLOGICAL INSTRUMENTATION, DIAGNOSTIC

NEUROLOGY

· Performing and interpreting Digital Electroneurogram, Electromyogram,

· Evoked potentials, Electroencephalography,

· Interpretation of skull and spine X-rays,

· Computerized tomography of brain and spine,

• Magnetic resonance images of brain including correct identification of various sequences, angiograms, MR spectroscopy,

· Basics of functional MRI,

• Interpretation of digital subtraction imaging, SPECT scans of brain, subdural EEG recording, transphenoidal electrode EEG techniques for temporal lobe seizures,
• video EEG interpretation of phenomenology and EEG-phenomenology correlations,
• EEG telemetry,
• Transcranial Doppler diagnosis and monitoring of acute ischemic stroke,
• Subarachnoid haemorrhage,
• Detection of right-to-left shunts etc;
• Colour duplex scanning in Carotid and vertebral extracranial segment screening.

NEUROINSTRUMENTATIONS

Acquire skills in procedures like:

· Intrathecal administration of antispasticity drugs, beta interferons in demyelination, opiates in intractable pain etc.,

· EMG-guided Botox therapy for dystonia,

· Subcutaneous administration of antimigraine and antiparkinsonian drugs,

• Intraarterial thrombolysis in extended windows of thrombolysis in ischemic strokes,
• Transcranial Ultrasound clot-bust intervention in a registry in acute stroke care unit,
• Planning in deep brain stimulation therapy in uncontrolled dyskinesias and on-off phenomena in long standing Parkinsonism,

· Planning in vagal nerve stimulation in intractable epilepsy.

PAPER IV:

RECENT ADVANCES IN NEUROLOGY:

ADVANCES IN NEUROIMAGING TECHNIQUES, BIONICS IN NEURAL PROSTHESIS and REHABILITATION, NEUROPROTEOMICS and NEUROGENETICS, STEM CELL and GENE THERAPY

ADVANCES IN NEUROIMAGING TECHNIQUES:

· Integration of CT, MR, SPECT, and PET images with each other and with EEG.

• EVOKED potentials-based brain maps in structural and functional localization in neurological phenomena and diseases.
• DSA interpretation and diagnosis.

BIONICS IN NEURAL PROSTHESIS AND REHABILITATION:

· Advanced techniques in neuro-rehabilitation such as TENS, principles of man-machine interphase devices in cord, nerve and plexus injuries, cochlear implants, artificial vision.

NEUROPROTEOMICS AND NEUROGENETICS:

Brain functions are regulated by proteomics and genomics linked to various proteins and genes relevant to the brain, the body’s maximum number of proteins and genes being expressed in brain as neurotransmitters or channel proteins and predisposing the brain to a number of disorders of abnormal functioning of these proteins.

STEM CELL AND GENE THERAPY:

· Principles of ongoing experiments on stem cell therapy for nervous system disorders such as foetal brain tissue transplants in parkinsonism; intrathecal marrow transplants in MND,MS, and Spinal trauma; myoblasts infusion therapy in dystrophies.

NEUROEPIDEMIOLOGICAL STUDIES AND CLINICAL TRIALS:

The students of the DM course will be trained in conducting sound Neuro-epidemiology studies on regionally and nationally important neurological conditions as well as on diseases of scientific and research interest to the department. They will also be trained in the principles of clinical trials.

Essential Practical Knowledge

1. Online certification in Research Methodology Course

• 2. Certification of NIHSS, MRS, mBI, EDSS
• 3. Interpretation of acute stroke imaging
• 4. Performance of cerebral angiography and interpretation of DSA
• 5. Performance of TCD
• 6. Performance and interpretation of electrophysiological tests

Career Options

After completing a DM in Neurology, candidates will get employment
opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from
which include Registrar, Senior Resident, Demonstrator, Tutor, etc.

While in the Private sector, the options include Resident Doctor,
Consultant, Visiting Consultant (Neurology), Junior Consultant, Senior
Consultant (Neurology), and Neurology Specialist.

Courses After DM in Neurology Course

DM in Neurology is a specialization course that can be pursued after
finishing a Postgraduate medical course. After pursuing a specialization in DM in
Neurology, a candidate could also pursue certificate courses and Fellowship
programmes recognized by NMC and NBE, where DM in Neurology is a feeder
qualification.

Frequently Asked Questions (FAQs) –DM in Neurology Course

• Question: What is the
  full form of DM?

Answer: The full form
of DM is a Doctorate of Medicine.

• Question: What is a DM
  in Neurology?

Answer: DM Neurology
or Doctorate of Medicine in Neurology also known as DM in Neurology is a super
specialty level course for doctors in India that they do after
completion of their postgraduate medical
degree course.

• Question: What is the
  duration of a DM in Neurology?

Answer: DM in Neurology
is a super speciality programme of three years.

• Question: What is the
  eligibility of a DM in Neurology?

Answer:
The candidate must have a postgraduate medical Degree in MD/DNB (General Medicine) or MD/DNB
(Paediatrics) obtained from any college/university recognized
by the Medical Council of India (Now NMC)/NBE, this feeder qualification
mentioned here is as of 2022. For any further changes to the prerequisite
requirement please refer to the NBE website.

• Question: What is the
  scope of a DM in Neurology?

Answer: DM in Neurology
offers candidates various employment opportunities and career prospects.

• Question: What is the
  average salary for a DM in Neurology candidate?

Answer: The DM in Neurology
candidate's average salary is between Rs. 30 lakhs to Rs. 60 lakhs per year
depending on the experience.

• Question: Can you
  teach after completing DM Course?

Answer: Yes, the candidate
can teach in a medical college/hospital after completing the DM course.

14, 2021) – Doctor Alejandro Cambiaso, president of the Dominican Association of Health Tourism (ADTS), and Amelia Reyes Mora, president of AF Comunicación Estratégica, announced the celebration of the most important medical tourism event in Central America and the Caribbean, the “VI International Health and Wellness Tourism Congress,” which will be held on November 1 and 2 of this year, at the JW Marriott Hotel, in Santo Domingo.

“The activity features important conferences and panels with renowned national and international speakers, aimed at the top players of the sector, such as health centers, dentistry, clinical and pharmaceutical laboratories, hotels, insurers, banks, investment funds, investment, airlines, medical facilitators, government, transportation, legal advisors, accreditors, among others,” said Dr. Alejandro Cambiaso.

Medical tourism annually mobilizes more than 21 million people worldwide, presenting an annual growth rate of approximately 20%, constituting a market that oscillates between 74 and 92 billion dollars, according to Patients Beyond Borders.

“This international congress constitutes a platform for multi-sector integration, innovation, networking, business development, and investment opportunities, and public-private synergies at a local and international level,” expressed Amelia Reyes Mora.

The 2020-2021 Medical Tourism Index, the top ranking of the sector, included nine Latin American nations among the 46 most attractive countries for Americans to receive health services: Costa Rica, Dominican Republic, Argentina, Colombia, Brazil, Panama, Jamaica, Mexico, and Guatemala, which motivates us to draw up joint strategies to strengthen our regional positioning.

This prominent event, which was organized by the ADTS and the Communication and Public Relations firm, AF Comunicación Estratégica, has brought together in its last two recent editions more than 800 participants and around 70 local exhibitors, Canada, Costa Rica, the United States, India, Mexico, Puerto Rico, Panama, Spain, Colombia and Caribbean islands and more than 110 sponsors.

For more information about the event, registrations, and sponsorships, access the web portal: https://congresoadts.com/  (809) 567-2663.

About the Dominican Health Tourism Association (ADTS, for its acronym in Spanish): The Dominican Health Tourism Association is a non-profit organization that promotes the Dominican Republic as an ideal place for health tourism, because of its high-quality, cost-effective medical, dental, and wellness services, hospitality conditions, attractive geographical position, and climate.

PAHO provides guidance to countries in response to increased chikungunya cases

Cristina Mitchell

15 Feb 2023

USA: Long-term achievement of lower LDL-C levels, down to <20 mg/dL, is associated with a reduced risk of cardiovascular (CV) outcomes and no safety concerns in patients with atherosclerotic cardiovascular disease, according to an analysis of FOURIER-OLE. The study appeared in the journal Circulation on Feb 13 2023.

LDL-C (low-density lipoprotein cholesterol) is a well-known risk factor for atherosclerotic cardiovascular disease. However, there is no information on the optimal achieved LDL-C level concerning safety and efficacy in the long term.

FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk) comprised 27 564 patients with stable atherosclerotic cardiovascular disease. They were randomized to evolocumab or placebo and followed for a median of 2.2 years. In FOURIER-OLE, the open-label extension, 6635 patients transitioned to open-label evolocumab irrespective of initial treatment allocation in the parent trial and were followed for an additional five years.

Prakriti Gaba from Brigham and Women's Hospital and Harvard Medical School in Boston, MA, and colleagues examined the relationship between achieved LDL-C levels, defined as an average of the first two measured LDL-C levels, in FOURIER-OLE (in 6559 patients) and the incidence of subsequent CV and safety outcomes. Sensitivity analyses were also performed to evaluate cardiovascular and safety effects in the whole FOURIER-OLE and FOURIER patient population.

The study led to the following findings:

· In FOURIER-OLE, 40%, 24%, 16%, 12%, and 7% patients achieved LDL-cholesterol levels of 20 to <40, <20, 40 to <55, ≥70, and 55 to <70 mg/dL, respectively.

· The team observed a monotonic relationship between lower achieved LDL-C levels—down to very low levels <20 mg/dL—and a lower risk of the primary efficacy endpoint (composite of myocardial infarction, cardiovascular death, stroke, or hospitalization for unstable angina or coronary revascularization) and the key secondary efficacy endpoint (composite of myocardial infarction, cardiovascular death, or stroke) that persisted after multivariable adjustment.

· No statistically significant associations were found between lower achieved levels of LDL-C and increased risk of the safety outcomes (new or recurrent cancer, serious adverse events, hemorrhagic stroke, cataract-related adverse events, neurocognitive adverse events, new-onset diabetes, muscle-related events, or noncardiovascular death) in the primary analyses.

· Similar findings were seen in the whole FOURIER-OLE and FOURIER cohort up to a maximum follow-up of 8.6 years.

To conclude, long-term achievement of lower LDL-cholesterol levels down to <20 mg/dL was linked with a lower risk of CV outcomes and no notable safety concerns in patients with cardiovascular disease.

Reference:

Gaba P, O'Donoghue ML, Park JG, Wiviott SD, Atar D, Kuder JF, Im K, Murphy SA, De Ferrari GM, Gaciong ZA, Toth K, Gouni-Berthold I, Lopez-Miranda J, Schiele F, Mach F, Flores-Arredondo JH, López JAG, Elliott-Davey M, Wang B, Monsalvo ML, Abbasi S, Giugliano RP, Sabatine MS. Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE. Circulation. 2023 Feb 13. doi: 10.1161/CIRCULATIONAHA.122.063399. Epub ahead of print. PMID: 36779348.

The neighborhood’s afflictions date to the early 1970s, when industry left and the drug trade took hold. With each new wave of drugs, the situation grows grimmer. Now, with the arrival of xylazine, a veterinary tranquilizer, new complications are burdening an already overtaxed system.

“It’s all hands on deck,” said Dave Malloy, a longtime Philadelphia social worker who does mobile outreach in Kensington and around the city.

Dealers are using xylazine, which is uncontrolled by the federal government and cheap, to cut fentanyl, a synthetic opioid up to 50 times stronger than heroin. The street name for xylazine is “tranq,” and fentanyl cut with xylazine is “tranq dope.” Mixed with the narcotic, xylazine amplifies and extends the high of fentanyl or heroin.

But it also has dire health effects: It leaves users with unhealing necrotic ulcers, because xylazine restricts blood flow through skin tissue. Also, since xylazine is a sedative rather than a narcotic, overdoses of tranq dope do not respond as well to the usual antidote — naloxone — which reverses the effects of only the latter.

Xylazine has been spreading across the country for at least a decade, according to the Drug Enforcement Administration, starting in the Northeast and then moving south and west. Plus, it has proven to be easy for offshore bad actors to manufacture, sell, and ship in large quantities, eventually getting it into the U.S., where it often circulates by express delivery.

First detected in Philadelphia in 2006, xylazine was found in 90% of street opioid samples in the city by 2021. That year, 44% of all unintentional fentanyl-related overdose deaths involved xylazine, city statistics show. Since testing procedures during postmortems vary widely from state to state, no comprehensive data for xylazine-positive overdose deaths nationally exists, according to the DEA.

Here in Kensington, the results are on display. Emaciated users walk the streets with necrotic wounds on their legs, arms, and hands, sometimes reaching the bone.

Efforts to treat these ulcers are complicated by the narrowing of blood vessels that xylazine causes as well as dehydration and the unhygienic living conditions that many users experience while living homeless, said Silvana Mazzella, associate executive officer of the public health nonprofit Prevention Point Philadelphia, a group that provides services known as harm reduction.

Stephanie Klipp, a nurse who does wound care and is active in harm reduction efforts in Kensington, said she has seen people “literally living with what’s left of their limbs — with what obviously should be amputated.”

Fatal overdoses are rising because of xylazine’s resistance to naloxone. When breathing is suppressed by a sedative, the treatment is CPR and transfer to a hospital to be put on a ventilator. “We have to keep people alive long enough to treat them, and that looks different every day here,” Klipp said.

If a patient reaches the hospital, the focus becomes managing acute withdrawal from tranq dope, which is dicey. Little to no research exists on how xylazine acts in humans.

Melanie Beddis lived with her addiction on and off the streets in Kensington for about five years. She remembers the cycle of detoxing from heroin cold turkey. It was awful, but usually, after about three days of aches, chills, and vomiting, she could “hold down food and possibly sleep.” Tranq dope upped that ante, said Beddis, now director of programs for Savage Sisters Recovery, which offers housing, outreach, and harm reduction in Kensington.

She recalled that when she tried to kick this mix in jail, she couldn’t eat or sleep for about three weeks.

There is no clear formula for what works to aid detoxing from opiates mixed with xylazine.

“We do need a recipe that’s effective,” said Dr. Jeanmarie Perrone, founding director of the Penn Medicine Center for Addiction Medicine and Policy.

Perrone said she treats opioid withdrawal first, and then, if a patient is still uncomfortable, she often uses clonidine, a blood pressure medication that also lessens anxiety. Other doctors have tried gabapentin, an anticonvulsant medication sometimes used for anxiety.

Methadone, a medication for opioid use disorder, which blunts the effects of opioids and can be used for pain management, seems to help people in tranq dope withdrawal, too.

In the hospital, after stabilizing a patient, caring for xylazine wounds may take priority. This can range from cleaning, or debridement, to antibiotic treatment — sometimes intravenously for periods as long as weeks — to amputation.

Philadelphia recently announced it is launching mobile wound care as part of its spending plan for opioid settlement funds, hopeful that this will help the xylazine problem.

The best wound care that specialists on the street can do is clean and bandage ulcers, provide supplies, advise people not to inject into wounds, and recommend treatment in medical settings, said Klipp. But many people are lost in the cycle of addiction and don’t follow through.

While heroin has a six- to eight-hour window before the user needs another hit, tranq dope wanes in just three or four, Malloy estimated. “It’s the main driver why people don’t get the proper medical care,” he said. “They can’t sit long enough in the ER.”

Also, while the resulting ulcers are typically severely painful, doctors are reluctant to give users strong pain meds. “A lot of docs see that as med-seeking rather than what people are going through,” Beddis said.

In the meantime, Jerry Daley, executive director of the local chapter of a grant program run by the Office of National Drug Control Policy, said health officials and law enforcement need to start cracking down on the xylazine supply chain and driving home the message that rogue companies that make xylazine are “literally profiting off of people’s life and limb.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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PAHO launches campaign to raise awareness of childhood cancer in Latin America and the Caribbean

Cristina Mitchell

14 Feb 2023