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.

Disclaimer: The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

Dr. Basil Springer

“Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth.” – 3 John 2

When one conjures up a visit to Barbados, thoughts of an idyllic paradise spring to mind. Barbados, at Christmas or other times of the year, certainly delivers on that promise time and time again, visit after visit.

During my current visit “back home”, it hasn’t been all relaxation, since a visit from Trinidad to Barbados for me means lots of business activities, errands as well as doctors’ appointments, along with family and friends’ get-togethers and the various parties and social activities associated with the yuletide season.

As I prepare for my return to Trinidad and Tobago to settle into my weekly activities, which include Rotary service activities, shepherding businesses as well as continuing work on writing projects, I reflect on the rich experience of my visit to Bim.

The highlight for me was, of course, Judy’s Christmas/birthday celebrations, reconnecting with my children, grandchildren, and extended members of the Springer, Cozier and Barrow clans. However, an extra delight was spending time with three generations of long-time friends from Canada, with whom I was blessed to work during my consulting days as the founder and managing director of System Caribbean Limited.

From childhood, I have spent much time walking on the beaches of Barbados, and it was marvellous to continue the tradition, this time while communing with nature as well as with friends strolling through the Rockley golf course community.

As I have written in the past, the benefits of walking have been abundant in boosting my holistic health. There is much to gain business-wise, mentally, physically, socially, and spiritually while engaging in this activity, whether solo or with company.

Whatever the setting — along the beach, across the golf course, within botanical gardens, around a park, through the neighbourhood, in hilly terrain — it is often on these journeys that ideas are fertilised and solutions materialise for challenges and opportunities alike.

As we welcome a new year, let’s not only cherish the memories of time spent with family and friends over the holiday season, but let’s also commit to embarking on, and sustaining, a healthy lifestyle.

A good start for 2023 would be to embrace good nutrition, sleep, hugs, prayer and meditation, and exercise (including walking), as we continue to serve our Creator and fellow human beings on this wonderful journey called life.

Now let’s embrace the blessing of a new year in a sound mind and healthy bodies! 

Dr. Basil Springer GCM is a Change-Engine Consultant. His email address is basilgf@marketplaceexcellence.com. His columns may be found at www.nothingbeatsbusiness.com.

The post #BTColumn – Commit to a healthy lifestyle appeared first on Barbados Today.

Under the new policy, full-time male employees, 18 years and above with at least 12 months of continuous service, whether contracted or in a confirmed post, are eligible to apply for paternity leave. Part-time male employees with at least 12 months of continuous service and who are working at least 18 hours per week are also eligible.

Paternity leave can only be granted within the first six months of delivery and can be granted as one full allotment or in two instalments if requested by the employee, with the minimum period of one instalment being five working days.

There are some men who have openly shared on social media platforms that when they access this privilege they would do it when their spouse's maternity leave is up in order for the baby to be at home with a parent for the first six months of his or her life.

Further, it is recommended that for the first six months of a baby's life he or she be exclusively breastfed. In an arrangement such as the one expressed by several fathers online, it is still possible on the basis that the mother expresses breast milk and stores it properly.

But how does one store breast milk? Below, information from Mayo Clinic highlights things to consider when storing breast milk.

What kind of container should I use to store expressed breast milk?

Before expressing or handling breast milk, wash your hands with soap and water. Then store the expressed milk in a clean, capped food-grade glass container or hard plastic container that's not made with the chemical bisphenol A (BPA). You can also use special plastic bags designed for milk collection and storage.

Don't store breast milk in disposable bottle liners or plastic bags designed for general household use.

What's the best way to store expressed breast milk?

Using waterproof labels and ink, label each container with the date you expressed the breast milk. If you're storing expressed milk at your baby's child-care facility, add your baby's name to the label.

Place the containers in the back of the refrigerator or freezer, where the temperature is the coolest. If you don't have access to a refrigerator or freezer, store the milk temporarily in an insulated cooler with ice packs.

Fill individual containers with the milk your baby will need for one feeding. You might start with 2 to 4 ounces (60 to 120 millilitres), and then adjust as needed. Also consider storing smaller portions — 1 to 2 ounces (30 to 60 millilitres) — for unexpected situations or delays in regular feeding. Breast milk expands as it freezes, so don't fill containers to the brim.

Can I add freshly expressed breast milk to already stored milk?

You can add freshly expressed breast milk to refrigerated or frozen milk. However, thoroughly cool the freshly expressed breast milk in the refrigerator or a cooler with ice packs before adding it to previously chilled or frozen milk. Don't add warm breast milk to frozen breast milk because it will cause the frozen milk to partially thaw.

How long does expressed breast milk keep?

How long you can safely keep expressed breast milk depends on the storage method. Consider these general guidelines:

Room temperature. Freshly expressed breast milk can be kept at room temperature for up to six hours. However, it's optimal to use or properly store the breast milk within four hours, especially if the room is warm.

Insulated cooler. Freshly expressed breast milk can be stored in an insulated cooler with ice packs for up to one day.

Refrigerator. Freshly expressed breast milk can be stored in the back of the refrigerator for up to four days in clean conditions. However, it's optimal to use or freeze the milk within three days.

Deep freezer. Freshly expressed breast milk can be stored in the back of a deep freezer for up to 12 months. However, using the frozen milk within six months is optimal.

Keep in mind that research suggests that the longer you store breast milk — whether in the refrigerator or in the freezer — the greater the loss of vitamin C in the milk.

It's also important to note that your breast milk changes to meet your baby's needs. Breast milk expressed when a baby is a newborn won't as completely meet the same baby's needs when he or she is a few months older. Also, storage guidelines might differ for pre-term, sick or hospitalized infants.

How do I thaw frozen breast milk?

Thaw the oldest milk first. Place the frozen container in the refrigerator the night before you intend to use it. You can also gently warm the milk by placing it under warm running water or in a bowl of warm water.

Don't heat a frozen bottle in the microwave or very quickly on the stove. Some parts of the milk might be too hot, and others cold. Also, some research suggests that rapid heating can affect the milk's antibodies.

More research is needed on whether previously frozen milk that's been thawed can be frozen again and safely used. However, many experts recommend discarding thawed milk that isn't used within 24 hours.

Does thawed breast milk smell or look different from fresh breast milk?

The colour of your breast milk might vary slightly depending on your diet. Also, thawed breast milk might seem to have a different odour or consistency than freshly expressed milk. It's still safe to feed to your baby. If your baby refuses the thawed milk, shortening the storage time might help.

Parts of this story first appeared on Mayo Clinic. Read more: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/i...

The calls were made as Jamaica is among 12 countries set to receive a financial boost to push vaccine efforts through Canada's Global Initiative for Vaccine Equity (CanGIVE) launched on Friday.

Under the project, which will support country-led efforts that enhance COVID-19 vaccine delivery, increase vaccine confidence and generate demand for sustainable health systems, CAD$45 million was donated to Pan American Health Organisation (PAHO) and CAD$70 million donated to United Nations Children's Fund.

Minister of Health and Wellness Dr Christopher Tufton said as Jamaica continues to emphasise the take-up of the COVID-19 vaccines, strengthen routine immunisation programme and primary health care system, the threats of the coronavirus are still present.

"The virus is still a threat and indeed it has to be worrying, that we are seeing an emergence of infection rates, hospitalisation and deaths. Strengthening our routine immunisation programme and the primary health care system or building resilience is a fundamental objective and from that perspective we are very grateful for this programme," said Tufton.

"It is fundamental because COVID has taught us that we are fighting against not just a virus but either ignorance of the importance of immunisation or downright resistance because of a lack of understanding or otherwise of how critical that is to human development report," he said.

Noting that while Jamaica's positivity rate is not as high as other countries, we are still moving in the wrong direction as the COVID-19 positivity, which was 4.5 per cent before the Christmas period, increased to 6.5 per cent at the end of December.

"We are keeping a close eye on it but again it is a challenge which we have to champion. COVID-19 therefore remains a threat and we must take advantage of the tools that helps to utilise that threat and as we all agree, vaccination represents such. We need to continue to renew our message, target specific populations, re-educate health workers and equip them with the knowledge and resources to reach more persons and save more lives," said Tufton.

At the same time, director of health emergencies at PAHO Dr Ciro Ugarte echoed a similar concern, pointing to a surge in cases in the Americas.

"It's not over yet. Everybody wants to get out of COVID, but just last month, in Americas we had a surge of a number of cases and deaths that we haven't seen in previous months. Increase was 28 per cent of new cases and another 46 per cent in new deaths compared to the previous months," said Ugarte.

He said the surge in cases is worrying, as people fail to apply the knowledgeable learned throughout the COVID-19 experiences.

"This is worrisome because we should have learnt many of the lessons that the pandemic showed us and those are the type of challenges we need to look at and probably need to assess with our capacity, the capacity of the countries and the capacity of organisations to deal with these emergencies. Many people are less vaccinated for the seasons that we use to have a higher coverage, so this is also another challenge," he said.

The Barbados Medicinal Cannabis Licensing Authority (BMCLA) will be celebrating its second anniversary on January 18, 2023, with activities that include education and engagement with the public, the health sector and investors. 

The week of events are:

Jan 16, 2023: Launch of BMCLA Cannabis Crash Course Term 2  – partnered with the University of the West Indies (UWI) – Future Learn Courses – Open to the public via registration on https://www.bmcla.bb/blog.

Jan 17, 2023: BMCLA Health Forum, Island Inn, Aquatic Gap, Bay Street, 6 p.m. – 8 p.m. For the health sector only via registration.

Jan 18, 2023: BMCLA Open House, Hero’s Square, Bridgetown, 9 a.m. to 3 p.m. Open to the public – walk-in or appointment via https://www.bmcla.bb/blog. 

Jan 19, 2023: BMCLA Mix & Mingle, Island Inn, Aquatic Gap, Bay Street, 6 p.m. to 8 p.m. Invitation only via registration.

Communications and Public Education Specialist with the BMCLA, Tracy Moore, said, “These forums are the BMCLA’s continued initiatives to educate and engage stakeholders while ensuring transparency and equity within this developing local industry. We hope that persons come out and be informed and involved in the medicinal cannabis industry.” 

“The BMCLA Health Forum on Jan 17, 2023 will engage the health sector to provide real scope about the medicinal cannabis industry while looking at the important role the sector plays in the industry. It will also be an opportunity to hear feedback and address any lingering concerns. The BMCLA Mix and Mingle on January 19, 2023 will allow for licensees and potential licensees (applicants in the last steps of the application process) to be in a room with potential investors, industry partners and select members of the industry support sector to meet and discuss industry opportunities,” she explained.

Moore noted that two of the four events are for specific audiences. The Health Forum is specifically for doctors, nurses, and pharmacists and the Mix & Mingle is specifically for industry participants. The educational campaign and the Open House are open to the public. 

The BMCLA Cannabis Crash Course Term 2 will have online classes available free to all, while the BMCLA Open House on January 18, 2023 will see the officers of the BMCLA go into the public space to provide important industry information.

“We did the Open House last year, and we had an overwhelming response, so we decided to make it bigger this year by engaging the public in Bridgetown. We can assist anyone who wants to know more about the medicinal cannabis industry or needs help to get into the industry, on a one-on-one basis,” she said.

Moore explained that these forums were very important because the industry grew steadily from last year to this year.

“Last year, we announced that two licensees with a combined nine licences had been approved. This year, we have an additional three licensees with a combined six licences approved by the Board. We also have two applicants at the pre-approval stage with one licence each, and there are currently a few more before the Board for review. So, as the industry grows we need to ensure that the persons who are applying and receiving their licences, those who are our valued partners and stakeholders as well as industry investors, are all growing together under the regulatory framework,” she added.

Moore urged all service providers to get in touch with the BMCLA during this week of activities via socialmedia@bmcla.bb so that they can grow within the medicinal cannabis industry through the BMCLA Classifieds. 

The BMCLA Classifieds allow applicants and licensees to contact service providers like security firms, fencing and lighting companies, accountants, lawyers, administrative workers, real estate agents and anyone else who can benefit from the industry with their products and services via all BMCLA public platforms. (PR)

The post The medicinal cannabis industry in the spotlight appeared first on Barbados Today.

Santo Domingo, DR
A low incidence of viruses that weeks ago created pressures on the health system, among them influenza, Covid-19, and dengue, while the authorities put more emphasis on the control of cholera, produced by bacteria, to prevent its further spread.

Yesterday, the Ministry of Public Health kept under surveillance two hospitalized patients suspected of cholera, but with stable evolution, and assured that the case of a patient coming from Boca Chica with a diarrhea condition is not cholera, but that in any case, for preventive purposes, they proceeded to intervene in the community where he resides.

The details were given to Listín Diario by Dr. Gina Estrella, in charge of Emergencies and Disasters of the Ministry of Public Health, who assured that the country maintains up to now the figure of 17 confirmed cases of cholera and that in Zurza, where an outbreak was registered, control of the cases was achieved and that the dredging of the Isabela river was started to guarantee its fluidity.

He recalled that in addition to Zurza, cases were initially detected in Capotillo and two imported cases in San Carlos. However, prevention interventions are extended to all health areas of Greater Santo Domingo, as well as active surveillance at the national level. He said that out of 90 random cholera tests taken over the weekend in La Zurza and Capotillo, only four were positive, of which two were asymptomatic persons.

Regarding the cases of the influenza virus, Covid-19, and dengue, which maintained high levels of circulation during the last months of last year, the director of Emergencies and Disasters pointed out that they currently maintain a low incidence at the national level.

PAHO and Canada step up efforts to bring COVID-19 vaccines to populations in situations of vulnerability in Latin America and the Caribbean

Oscar Reyes

13 Jan 2023

ent and potential adverse events led Genentech to voluntarily recall Susvimo (ranibizumab injection).However, progress and innovation never come without challenges, and the landscape for wet AMD today