“The treatments ranged from filling cavities, restorations, extractions and cleaning to root canals and dentures”

View the full post How Canadian dentists, hygienists are helping locals in the Caribbean on NOW Grenada.

The SERENE trials showed that a higher induction dose of Humira (adalimumab, AbbVie) was no more effective than the standard induction dose for inducing clinical remission in both ulcerative colitis and CD. A higher maintenance dose (40 mg weekly) was slightly more

Our choice today is Jack Daniels (yes, this is a real thing) in honor of our 16th anniversary since Pharmalot debuted. We would like to take a moment to thank you for tuning in all these years and, moreover, lift our cup to recognize those of you who provide feedback, suggestions, criticism, and tips. Now, though, time to get cracking once again. We hope your day is productive and meaningful. And of course, do stay in touch. …

After mobilizing to quickly develop and manufacture a Covid-19 vaccine, Johnson & Johnson has vastly scaled back efforts to produce the shots as it faces slumping demand, The Wall Street Journal reports. In recent months, J&J terminated manufacturing agreements with companies that helped produce the shot, such as Catalent and Sanofi. Meanwhile, a partnership with Merck to help make the shots, forged at the urging of the U.S. government, has not lived up to expectations. The companies are now engaged in arbitration. Merck made J&J vaccines at only one plant, but did not make commercial doses at another plant involved a more complex part of the manufacturing process.

Continue to STAT+ to read the full story…

on Monday due to shock, severe dengue fever with warning signs, leptospirosis, and a urinary tract infection, according to the death certificate issued by the health center.

The young pregnant woman underwent a Kerr-type cesarean section with the consent of her relatives to save the child she carried in her womb. Unfortunately, the baby died as well. The remains of the young woman and her daughter are buried in her home, which is almost directly in front of Padre Granero’s Catholic Church. People come to the site to express their condolences to their relatives and to express their sorrow over this tragic event.

While the Ministry of Health investigates an alleged dengue outbreak in the Padre Granero, Bello Costero, and La Laguna sectors. Several residents of that region have been hospitalized after exhibiting symptoms of these health conditions.

 

Aldosterone causes salt to be retained in the body, driving up the blood pressure. Patients with excessive aldosterone levels in the blood are resistant to treatment with the commonly used drugs for Hypertension, and at increased risk of heart attacks and strokes.

Doctors at Queen Mary University of London and Barts Hospital, and Cambridge University Hospital, have led research using a new type of CT scan to light up tiny nodules in a hormone gland and cure high blood pressure by their removal. The nodules are discovered in one-in-twenty people with high blood pressure.

Published today in Nature Medicine, the research solves a 60-year problem of how to detect the hormone producing nodules without a difficult catheter study that is available in only a handful of hospitals, and often fails. The research also found that, when combined with a urine test, the scan detects a group of patients who come off all their blood pressure medicines after treatment.

128 people participated in the study of a new scan after doctors found that their Hypertension (high blood pressure) was caused by a steroid hormone, aldosterone. The scan found that in two thirds of patients with elevated aldosterone secretion, this is coming from a benign nodule in just one of the adrenal glands, which can then be safely removed. The scan uses a very short-acting dose of metomidate, a radioactive dye that sticks only to the aldosterone-producing nodule. The scan was as accurate as the old catheter test, but quick, painless and technically successful in every patient. Until now, the catheter test was unable to predict which patients would be completely cured of hypertension by surgical removal of the gland. By contrast, the combination of a ‘hot nodule’ on the scan and urine steroid test detected 18 of the 24 patients who achieved a normal blood pressure off all their drugs.

The research, conducted on patients at Barts Hospital, Cambridge University Hospital, and Guy’s and St Thomas’s, and Universities of Glasgow and Birmingham, was funded by the National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC) partnership, Barts Charity, and the British Heart Foundation.

Professor Morris Brown, co-senior author of the study and Professor of Endocrine Hypertension at Queen Mary University of London, said: “These aldosterone-producing nodules are very small and easily overlooked on a regular CT scan. When they glow for a few minutes after our injection, they are revealed as the obvious cause of Hypertension, which can often then be cured. Until now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully this is about to change.”

Professor William Drake, co-senior author of the study and Professor of Clinical Endocrinology at Queen Mary University of London, said: “This study was the result of years of hard work and collaboration between centres across the UK. Much of the ‘on the ground’ energy and drive came from the talented research fellows who, in addition to doing this innovative work, gave selflessly of their time and energy during the national pandemic emergency. The future of research in this area is in very safe hands.”

Reference:

Wu et al. [11C]metomidate PET-CT versus adrenal vein sampling for diagnosing surgically curable primary aldosteronism: a prospective, within-patient trial. https://doi.org/10.1038/s41591-022-02114-5

The Good Hope Medical Station will be closed effective Tuesday, 17 January 2023, until further notice

View the full post Temporary closure of Good Hope Medical Station on NOW Grenada.

DrNB Paediatric
Cardiology or Doctorate of National Board in Paediatric Cardiology also known
as DrNB in Paediatric Cardiology is a super specialty level course for doctors
in India that is done by them after completion of their postgraduate medical
degree course. The
duration of this super specialty course is 3 years, and it focuses on the diagnosis and treatment of congenital heart diseases and coronary artery diseases in
children.

The course
is a full-time course pursued at various accredited institutes/hospitals across
the country. Some of the top accredited institutes/hospitals offering this
course include Apollo Hospital, Chennai, Artemis Health Institute, Gurgaon,
Haryana, Bai Jerbai Wadia Hospital for Children Institute of Child Health and
Research Centre, Mumbai, Maharashtra, 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 DrNB (Paediatric Cardiology) varies from accredited
institutes/hospital to hospital and may range from Rs. 50,000 to
Rs. 1,25,000 per annum.

After completion of their respective course, doctors can either join the
job market or can pursue certificate courses and Fellowship programs recognized by
NMC and NBE. Candidates can take reputed jobs at positions as Senior residents,
Consultants, etc. with an approximate salary range of
Rs.6,00,000 – Rs.30,00,000 per annum.

DNB is equivalent to
MD/MS/DM/MCH degrees awarded respectively in medical and surgical super
specialties. The list of recognized qualifications awarded
by the Board in various broad and super specialties as approved by the
Government of India are included in the first schedule of the Indian Medical
Council Act, 1956.

The Diplomate of National Board in
broad-specialty qualifications and super specialty qualifications when
granted in a medical institution with the attached hospital or a hospital with
the strength of five hundred or more beds, by the National Board of
Examinations, shall be equivalent in all respects to the corresponding
postgraduate qualification and the super-specialty qualification granted under
the Act, but in all other cases, senior residency in a medical college for an
additional period of one year shall be required for such qualification to be
equivalent for teaching also.

What is DrNB in Paediatric Cardiology?

Doctorate of National Board in Paediatric
Cardiology, also known as DrNB (Paediatric Cardiology) or DrNB in (Paediatric
Cardiology) is a three-year super specialty program that candidates can
pursue after completing a postgraduate degree.

Paediatric Cardiology is the branch of medical
science dealing with the diagnosis and treatment of congenital heart diseases and coronary artery diseases in children.

The National
Board of Examinations (NBE) has released a curriculum for DrNB in Paediatric Cardiology.

The curriculum
governs the education and
training of DrNB in Paediatric Cardiology.

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 Paediatric Cardiology
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 DrNB in Paediatric Cardiology

Name of Course

DrNB in Paediatric Cardiology

Level

Doctorate

Duration of Course

Three years

Course Mode

Full Time

Minimum Academic Requirement

Candidates must have a postgraduate medical Degree in MD/DNB (Paediatrics) obtained from any college/university recognized by the MCI (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

Counseling by DGHS/MCC/State Authorities

Course Fees

 Rs. 50,000 to Rs. 1,25,000 per annum

Average Salary

Rs.6,00,000 – Rs.30,00,000 per annum

Eligibility Criteria

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

Name of the super specialty course

Course Type

Prior Eligibility Requirement

Paediatric Cardiology

DrNB

MD/DNB (Paediatrics)

Note:

·
The feeder qualification for DrNB in Paediatric Cardiology 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 prior entry qualifications shall be strictly
  by Post Graduate Medical Education Regulations, 2000, and its
  amendments notified by the NMC and any clarification issued from NMC in this
  regard.
• 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 DrNB in Paediatric Cardiology. Candidates can view the complete
admission process for DrNB in Paediatric
Cardiology mentioned below:

• The NEET-SS or
  National Eligibility Entrance Test for Super specialty 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 specialty.
• 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 specialty
  subjects shall be required to appear in the question paper of the respective group if they are willing to opt for a super specialty course in any of the super
  specialty courses covered in that group.
• A candidate can opt for appearing in the
  question papers of as many groups for which his/her Postgraduate specialty
  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 counseling only for those super specialty subjects
  covered in the said group for which his/ her broad specialty is an eligible feeder
  qualification.

Fees Structure

The fee structure for DrNB in Paediatric Cardiology varies from accredited institute/hospital to hospital. The fee is
generally less for Government Institutes and more for private institutes. The average fee structure for DrNB in Paediatric Cardiology ranges from Rs. 50,000 to Rs. 1,25,000 per annum.

Colleges offering DrNB in Paediatric Cardiology

Various accredited institutes/hospitals across India offer courses for pursuing DrNB in Paediatric Cardiology.

As per the National Board of Examinations website, the following accredited
institutes/hospitals are offering DrNB (Paediatric Cardiology)
courses for the academic year 2022-23.

Hospital/Institute

Specialty

No. of Accredited Seat(s)
(Broad/Super/Fellowship)

Apollo Hospital
21, Greams lane, Off Greams Rd, Thousand Lights, Chennai.
Tamil Nadu-600006

Paediatric Cardiology

2

Artemis Health Institute
Sector 51, Gurgaon
Haryana-122001

Paediatric Cardiology

1

Bai Jerbai Wadia Hospital for Children
Institute of Child Health and Research Centre, Acharya Donde Marg, Parel,
Mumbai
Maharashtra-400012

Paediatric Cardiology

2

Indraprastha Apollo Hospital
Delhi-Mathura Road, Sarita Vihar, New Delhi
Delhi-110076

Paediatric Cardiology

1

Kanchi Kamakoti Childs Trust Hospital
12A, Nageswara Road, Nungambakkam, CHENNAI
Tamil Nadu-34

Paediatric Cardiology

3

Mehta Multispecialty Hospital
(Formerly Known as Dr. Mehta`s Hospital) 2, McNichols Road, 3rd Lane,
Chetpet, Chennai
Tamil Nadu-600031

Paediatric Cardiology

1

Narayana Hrudayalaya Hospital
(NH-Narayana Health City, Bangalore) #258/A, Bommasandra Industrial Area,
Anekal Taluk, Bangalore
Karnataka-560099

Paediatric Cardiology

2

Rainbow Children's Hospital
Sy. No. 8/5, Marathahalli K R Puram Outer ring road, Doddanekundi,
Marathahalli, Bengaluru
Karnataka-560037

Paediatric Cardiology

1

Rainbow Children`s Hospital
22, Rd#10, Banjara Hills, Hyderabad-500034
Telangana-500034

Paediatric Cardiology

3

Sir Ganga Ram Hospital
Rajinder Nagar, New Delhi
Delhi-110060

Paediatric Cardiology

3

St. Johns Medical College Hospital
Sarjapur Road, Koramangala Bangalore
Karnataka-560034

Paediatric Cardiology

2

Surya Children`s Medicare
(Formerly Surya Children`s Hospital) Junction Of S. V. Road and Dattatray
Road Santacruz (West), Mumbai
Maharashtra-400054

Paediatric Cardiology

2

Syllabus

A DrNB
in Paediatric Cardiology is a three years specialization
course that provides training in the stream of Paediatric Cardiology.

The course
content for DrNB in Paediatric Cardiology is given in the NBE Curriculum released by the National
Board of Examinations, which can be assessed through the link mentioned below:

DrNB Paediatric Cardiology In India: Check Out NBE Released Curriculum

COURSE CONTENT

1. Training Courses

Each student would have to undergo the following courses:

 Pediatric Basic life support (BLS)

 Advanced Trauma Life Support (ATLS)

 Pediatric Advanced Life Support (ALS)

The suggested areas and topics which should form the core subject content are:

a. Cardiovascular Physiology, Pathology, Pathophysiology, and Therapy

 Shock (hypovolemic, neurogenic, septic, cardiogenic) and its complications

 Cardiac rhythm and conduction Disturbances

 Pulmonary edema—cardiogenic, non-cardiogenic

 Cardiac Tamponade and other acute pericardial diseases

 Acute and chronic life-threatening valvular disorders

 Acute complications of cardiomyopathies and myocarditis

 Vasoactive and inotropic therapy

 Pulmonary hypertension and cor-pulmonale

 Principles of oxygen transport and utilization

 Perioperative management of patients undergoing cardiovascular surgery

 Recognition, evaluation, and management of hypertensive emergencies and urgencies

 Congenital heart disease and the physiologic alterations with surgical repair

 Noninvasive methods of cardiac output assessment (i.e., aortic Doppler, etc.)

b. Respiratory Physiology, Pathology, Pathophysiology, and Therapy

 Acute respiratory failure

 Hypoxemic respiratory failure including acute respiratory distress syndrome

 Hypercapnic respiratory failure

 Acute chronic respiratory failure

 Status asthmaticus

 Aspiration pneumonia

 Chest trauma (e.g., flail chest, pulmonary contusion, rib fractures)

 Broncho-pulmonary infections including bronchiolitis/pneumonia etc

 Upper airway obstruction

 Near drowning

 Pulmonary mechanics and gas exchange

 Oxygen therapy

 Mechanical ventilation

 Pressure and volume modes of mechanical ventilators

 Positive end-expiratory pressure, intermittent mandatory ventilation, continuous positive airway pressure, high-frequency ventilation, inverse ratio ventilation, pressure support ventilation, volume support (airway pressure release

 Ventilation, pressure-regulated volume control ventilation), negative pressure ventilation, differential lung ventilation, pressure control, noninvasive ventilation, spilled lung ventilation, one-lung ventilation

 Indications for and hazards of mechanical ventilation (VILI)

 Criteria for extubation and weaning techniques

 Permissive hypercapnia

 High-frequency oscillatory ventilation

 Airway Maintenance

 Airway Emergency airway management

 Endotracheal intubation/rapid sequence intubation

 Tracheostomy, open and percutaneous

 Long-term intubation vs. tracheostomy

 Ventilatory muscle physiology, pathophysiology, and therapy, including polyneuropathy of the critically ill and prolonged effect of neuromuscular blockers

 Pleural diseases: empyema, various effusions, and pneumothorax

 Pulmonary chylothorax, hemorrhage, and hemoptysis

 Noninvasive ventilation

 Chest Physiotherapy /Postural drainage

c. Renal Physiology, Pathology, Pathophysiology, and Therapy

 Renal regulation of fluid balance and electrolytes

 Renal failure: Prerenal, renal, and postrenal

 Hyperosmolar states

 Electrolyte disturbances

 Acid-base disorders and their management

 Principles of renal replacement therapy and associated methodologies (peritoneal dialysis, hemodialysis, peritoneal dialysis, CRRT, SLED), etc

 Ultrafiltration, continuous arteriovenous hemofiltration, and continuous veno- venous hemofiltration) Drug modification in renal failure, calculating eGFR

 Rhabdomyolysis

 Systemic diseases that involve the kidney (hemolytic uremic syndrome)

d. Central Nervous System Physiology, Pathology, Pathophysiology, and Therapy

 Approach to a child presenting with Coma

 Hydrocephalus and shunt function and dysfunction

 Perioperative management of patients undergoing neurologic surgery

 Brain death evaluation and certification

 Diagnosis and management of persistent vegetative states

 Management of increased intracranial pressure, including intracranial pressure monitors Status epilepticus

 Neuromuscular disease causing respiratory failure e.g.

 Guillain-Barré syndrome

 Myasthenia gravis

 Myopathies (Duchenne's, etc.)

 Neuropathy of critical illness

 Traumatic and non-traumatic intracranial bleed

 Traumatic brain injury – mild, moderate, and severe

 Sedation & analgesia: principles and titration

 Neuromuscular blockade: Use, monitoring, and complications

 Invasive ICP monitoring procedure & Ventricular tap / Extra ventricular drain placement

e. Metabolic and Endocrine Effects of Critical Illness

 Nutritional support

 Enteral and parenteral

 Evaluation of nutritional needs including indirect calorimetry

 Immunonutrition and specialty formulas

 Endocrine

 Adrenal crisis and insufficiency (primary and secondary)

 Disorders of antidiuretic hormone metabolism

 Diabetes mellitus

 Ketotic and nonketotic hyperosmolar coma

 Hypoglycemia

 Pheochromocytoma

 Insulinoma

 Disorders of calcium, magnesium, and phosphate balance

 Inborn errors of metabolism

 Electrolyte disorders including Na, K, Mg, Ca, PO4, etc.

f. Infectious Disease Physiology, Pathology, Pathophysiology, and Therapy

 Antibiotics: Pharmacodynamics and pharmacokinetics

 Various antibacterial agents and newer emerging classes of antibiotics

 Antifungal agents

 Ant tuberculosis agents

 Antiviral agents

 Agents for parasitic infections

 Infection control for special care units

 AMR

 Universal precautions

 Isolation and reverse isolation

 Sepsis definitions (sepsis, severe sepsis, septic shock)

 Systemic inflammatory response syndrome

 Tropical Infections, Emerging viral diseases (COVID-19 and its complications)

 Healthcare-associated and opportunistic infections in the critically ill

 Adverse reactions to antimicrobial agents

 ICU support of the immune-suppressed patient

 Acquired immunodeficiency syndrome

 Transplant

 Pediatric malignancies

 Occupational hazards to healthcare workers

 Evaluation of fever in the ICU patient

g. Physiology, Pathology, Pathophysiology, and Therapy of Acute Hematologic and Oncologic Disorders

 Acute defects in hemostasis: Thrombocytopenia/ DIC

 Anticoagulation; fibrinolytic therapy

 Principles of blood component therapy

 Packed red blood cell transfusions

 Fresh frozen plasma transfusions

 Platelet transfusions

 Specific coagulation factor concentrates

 Albumin

 Pharmacologic agents that modify the need for transfusion (i.e., aminocaproic acid, aprotinin)

 Erythropoietin

 Acute hemolytic disorders including thrombotic microangiopathies

 Acute syndromes associated with neoplastic disease and antineoplastic therapy

 Sickle cell crisis and acute chest syndrome

 Plasmapheresis

 ICU-acquired anemia

 Oncologic emergencies

h. Physiology, Pathology, Pathophysiology, and Therapy of Acute Gastrointestinal, Genitourinary Disorders

 Upper gastrointestinal bleeding, including variceal bleeding

 Lower gastrointestinal bleeding

 Acute and fulminant hepatic failure

 Acute perforations of the gastrointestinal tract

 Perioperative management of surgical patients

 Stress ulcer prophylaxis

 Obstructive uropathy and its complications

i. Environmental Hazards

 Poisoning: Organophosphate poisoning, Hydrocarbon, etc.

 Envenomation: Snake envenomation, Scorpion sting, etc.

 Drug overdose and withdrawal: Paracetamol, iron, TCA, etc.

 Temperature-Related Injuries: Hyperthermia, heat shock, Hypothermia, frostbite

 Altitude sickness

 Decompression sickness

 Biological and chemical terrorism

 Radiation exposure

j. Immunology and Transplantation

 Principles of transplantation (organ donation, procurement, preservation, transportation, allocation, implantation, maintenance of organ donors, national organization of transplantation activities)

 Immunosuppression

 Organ transplantation: Indications of preoperative and postoperative care

 Transplant-related infectious disease

k. Monitoring, Bioengineering, Biostatistics

 Prognostic indexes, severity, and therapeutic intervention scores

 Principles of electrocardiographic monitoring, and transcutaneous measurements

 Invasive hemodynamic monitoring

 Principles of strain gauge transducers

 Principles of arterial, and central venous catheterization and monitoring

 Echo-based evaluation of cardiac function and derived hemodynamic variables

 Noninvasive hemodynamic monitoring

 Thermoregulation

 Central nervous system brain monitoring (intracranial pressure, NIRS,

cerebral metabolic rate, electroencephalogram, transcranial Doppler)

 Respiratory monitoring (airway pressure, intrathoracic pressure, tidal volume, pulse oximetry, dead space / tidal volume ratio, compliance, resistance, capnography, pneumotachograph)

 Metabolic monitoring (oxygen consumption, carbon dioxide production, respiratory quotient, indirect calorimetry)

 Use of Biostatistics and various tests of significance (SPSS or other soft wares)

l. Ethics

 Consent

 Study enrollment

 End-of-life decision-making and care

 Organ procurement

 Outcome and futility

 Quality of end of life

m. Administration

 Team building, Patient safety

 Organization of patient care

 Physician, nurse, and ancillary staff staffing models

 Documentation and compliance

 Mass casualty or disaster

n. Genetic

 Congenital disease (polysomy, monosomy, trisomy, etc.)

 Storage diseases

 Polymorphisms

 Fundamentals of Genetic testing

 Genetic counseling

o. Pharmacology

 Pharmacokinetics

 Pharmacodynamics

 Safe medication practice

 Drug dosing adjustments in hepatic disease

 Drug dosing adjustments in renal disease

Career Options

After completing a DrNB in Paediatric Cardiology,
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 (Paediatric
Cardiology), Junior Consultant, Senior Consultant (Paediatric Cardiology),
Critical Care Specialist, etc.

Courses After DrNB
in Paediatric Cardiology Course

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

Frequently Asked Questions (FAQs) – DrNB
in Paediatric Cardiology Course

Question: What is the complete full form of DrNB?

Answer: The full form of DrNB is a Doctorate of
National Board.

Question: What is a DrNB in Paediatric Cardiology?

Answer: DrNB Paediatric
Cardiology or Doctorate
of National Board in Paediatric Cardiology also known as
DrNB in Paediatric Cardiology is
a super specialty level course for doctors in India that is done by them after
completion of their postgraduate medical degree course.

Question: What is the duration of a DrNB in Paediatric
Cardiology?

Answer: DrNB in Paediatric Cardiology is a super specialty program of three years.

Question: What is the eligibility of a DrNB in Paediatric Cardiology?

Answer: Candidates must have a postgraduate medical Degree in MD/DNB (Paediatrics) obtained from any college/university recognized by the MCI (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 DrNB in Paediatric
Cardiology?

Answer:
DrNB in Paediatric Cardiology offers
candidates various employment opportunities and career prospects.

Question:
What is the average salary for a DrNB in
Paediatric Cardiology candidate?

Answer:
The DrNB in Paediatric Cardiology
candidate's average salary is Rs.6,00,000 – Rs.30,00,000 per annum depending on
the experience.

Question: Can you teach after completing DrNB Course?

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

IN 2018, Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), issued a call to action for the elimination of cervical cancer. In addition to vaccination and treatment goals, this initiative aims to screen at least seventy per cent of our women with a high-performance test by age 35 and again by age 45 years. The recommended screening test currently is the test for high-risk human papillomavirus (HPV). Achieving these targets by 2030 will place us on the global track toward the elimination of cervical cancer. Furthermore, the WHO equally recommends HPV testing done by a health-care worker or on a self-collected specimen. This recommendation is based on strong research evidence showing that both methods are equally effective.

HPV is responsible for 99.7 per cent of cervical cancers and testing directly for HPV has advantages over Pap smears which indirectly detect HPV by looking for changes in the cells of the cervix caused by HPV. Advantages include higher detection rates for pre-cancerous changes, less false negative results, faster results, and the ability to do self-testing, which is uniquely advantageous. HPV self-testing is one of the health-care modalities highly recommended in the WHO self-care interventions. One justification for this, according to the WHO, is an estimated shortage of 18 million health workers by 2030 and as it is now, at least 400 million people worldwide lack access to the most essential health services. This unmet need is further exaggerated in emergencies, including pandemics like COVID-19 which disrupt routine health services and put a strain on existing health systems.

Several countries, including Denmark, the Netherlands and Australia, have included a self-collection option for routine testing as part of their national screening programmes to reach at-risk patients who decline clinician-collected samples or are remote from access. Research shows that patients participating in self-sampling consistently reported improved convenience, less discomfort, positive attitudes, and overall acceptance compared with clinic-based sampling. Endorsement of self-collection by health-care workers is less certain. Available studies suggests that most clinicians would support a self-collected HPV test if it were highly sensitive and cost-effective.

A recent publication highlighted areas of concern among health-care workers in the United States and one major concern is over women not attending in person and missing opportunities for other important issues to be addressed at the well-woman visit like breast cancer screening. Another was, in which women would self-collection be recommended? Would this test be suitable for all women, including those who have never done a Pap smear or only those who are regularly screened?

The pandemic catapulted us into a virtual age and for health care, it was no different where we saw an expansion of telemedicine services. Some health-care workers are uncomfortable with telemedicine as they are of the view that it lacks some tenets of traditional medical practice — inspect, palpate, percuss, auscultate. Cervical cancer self-screening, they believe, is another modality which may prevent women from being properly managed.

Another concern is access to HPV test kits and infrastructure for testing. Self-testing is attractive as it should be able to reach women in areas remote from health-care facilities. But how exactly will the kits be distributed and collected and how will the samples be processed? Do we have enough laboratory facilities to process these samples?

New initiatives are often met with resistance, but the evidence is clear, with almost 400 new cases of cervical cancer each year and a large unscreened population, there is room for improvement. The start of this new year takes us one year closer to 2030. Jamaica should not be left behind!

Dr Natalie Medley is a consultant obstetrician and gynaecologist and gynaecologic oncologist at the Mona Institute of Medical Sciences, UHWI. She can be contacted at (876) 977-1512, (876) 618- 6048 or nmedsingh@gmail.com.