Cholera continues its expansive process and reaches the Villa Francisca sector
Residents in the Villa Francisca and Ensanche Luperón sectors, National District, requested greater intervention from the authorities to eliminate improvised landfills and stagnant water in the curbs, after the report of six new cases of cholera, bringing the total to 77 infected in the last months.
S.M.L., who supports himself by selling bottles of water and soft drinks in the vicinity of Parque Enriquillo, assured that since last Friday the 17th he has suffered constant diarrhea, although he has not undergone laboratory tests to identify its origin. His neighbors, a family of three made up of a grandfather, his daughter, and his adolescent grandson were on their way to the Félix María Goico Hospital at the time for the same reason: acute diarrhea for several days.
In Villa Francisca, they receive two types of water in the pipeline, one fresh and the other brackish. “Today fresh water came to the tap,” said the lady. Upon noticing the presence of reporters in the area, Ana, another community member, commented that some people do not have bathrooms in their homes, and they throw fecal matter and garbage out into the open, contaminating the environment. The fetid smell corroborated the affirmations of the young mother, who asserted that she could not open the windows to ventilate her home.
A few meters away was Cirilo, a vendor of yaniqueques and boiled eggs, who assured that he had adopted very hygienic-sanitary measures, although “sales are not very good.” “Very clean hands,” he said as he showed them as a sign that they were clean. “Look at the showcase, not a fly gets in there,” he added.
2 years 1 month ago
Health, Local
California Says It Can No Longer Afford Aid for Covid Testing, Vaccinations for Migrants
All day and sometimes into the night, buses and vans pull up to three state-funded medical screening centers near California’s southern border with Mexico. Federal immigration officers unload migrants predominantly from Brazil, Cuba, Colombia, and Peru, most of whom await asylum hearings in the United States.
Once inside, coordinators say, migrants are given face masks to guard against the spread of infectious diseases, along with water and food. Medical providers test them for the coronavirus, offer them vaccines, and isolate those who test positive for the virus. Asylum-seekers are treated for injuries they may have suffered during their journey and checked for chronic health issues, such as diabetes or high blood pressure.
But now, as the liberal-leaning state confronts a projected $22.5 billion deficit, Gov. Gavin Newsom said the state can no longer afford to contribute to the centers, which also receive federal and local grants. The Democratic governor in January proposed phasing out state aid for some medical services in the next few months, and eventually scaling back the migrant assistance program unless President Joe Biden and Congress step in with help.
California began contributing money for medical services through its migrant assistance program during the deadliest phase of the coronavirus pandemic two years ago. The state helps support three health resource centers — two in San Diego County and one in Imperial County — that conduct covid testing and vaccinations and other health screenings, serving more than 300,000 migrants since April 2021. The migrant assistance program also provides food, lodging, and travel to unite migrants with sponsors, family, or friends in the U.S. while awaiting their immigration hearings, and the state has been covering the humanitarian effort with an appropriation of more than $1 billion since 2019.
Though the White House declined to comment and no federal legislation has advanced, Newsom said he was optimistic that federal funding will come through, citing “some remarkably good conversations” with the Biden administration. The president recently announced that the United States would turn back Cubans, Haitians, and Nicaraguans who cross the border from Mexico illegally — a move intended to slow migration. The U.S. Supreme Court is also now considering whether to end a Trump-era policy known as Title 42 that the U.S. has used to expel asylum-seekers, ostensibly to prevent the spread of the coronavirus.
Already, one potential pot of federal money has been identified. The Federal Emergency Management Agency and the U.S. Department of Homeland Security issued a statement to KHN noting that local governments and nongovernmental providers will soon be able to tap into an additional $800 million in federal funds through a shelter and services grant program. FEMA did not answer KHN’s questions about how much the agency spends serving migrants.
“We’re continuing our operations and again calling on all levels of government to make sure that there is an investment,” said Kate Clark, senior director of immigration services for Jewish Family Services of San Diego, one of two main migrant shelter operators. The other is run by Catholic Charities for the Diocese of San Diego.
While health workers and immigration advocates want the state to continue funding, Newsom appears to have bipartisan support within the state for scaling it back. He promised more details in his revised budget in May, before legislative budget negotiations begin in earnest. And, he noted, conditions have changed such that testing and vaccination services are less urgent.
San Diego County Supervisor Nathan Fletcher, a Democrat, agreed that the burden should be on the federal government, though local officials are contemplating additional assistance. And state Senate Republican leader Brian Jones of San Diego, who represents part of the affected region, said that California is set to end its pandemic state of emergency on Feb. 28, months before the budget takes effect in July.
“The pandemic conditions no longer warrant this large investment from the state, especially since immigration is supposed to be a federal issue,” Jones said in a statement.
California began its migrant assistance support soon after Newsom took office in 2019 and after the Trump administration ended the “safe release” program that helped transport immigrants seeking asylum to be with their family members in the United States. It was part of California’s broad pushback against Trump’s immigration policies; state lawmakers also made it a so-called sanctuary state, an attempt to make it safe from immigration crackdowns.
California, along with local governments and nonprofit organizations, stepped in to fill the void and take pressure off border areas by quickly moving migrants elsewhere in the United States. The state’s involvement ramped up in 2021 as the pandemic surged and the Biden administration tried to unwind the Trump administration’s “remain in Mexico” policy. While some cities in other parts of the country provided aid, state officials said no other state was providing California’s level of support.
In a coordinated effort, migrants are dropped off at the centers by federal immigration officers, then are screened and cared for by state-contracted organizations that provide medical aid, travel assistance, food, and temporary housing while they await their immigration hearings.
Both Catholic Charities for the Diocese of San Diego and Jewish Family Service of San Diego coordinate medical support with the University of California San Diego. The federal government covers most of the university’s costs while the state pays for nurses and other medical contractors to supplement health care, according to Catholic Charities.
It often takes one to three days before migrants can be put on buses or commercial flights, and in the meantime, they are housed in hotels and provided with food, clothing, and other necessities as part of the state’s program.
“Many of them come hungry, starving,” said Vino Pajanor, chief executive of Catholic Charities for the Diocese of San Diego, who described the screening and testing process at the centers. “Most of them don’t have shoes. They get shoes.”
Officials said about 46,000 people have been vaccinated against the coronavirus through the program. They said the figure is significantly lower than the number of migrants who have come through the centers because some were vaccinated before reaching the U.S. and younger migrants were initially ineligible, while others refused the shots.
According to the California Health and Human Services Agency, the state plans to phase out some medical support, but the sheltering operations are expected to continue “for the near term” with their future determined by the availability of federal funding. Of the more than $1 billion spent by the state, $828 million has been allocated through the Department of Public Health, according to the governor’s office.
The agency said that while the state has not adopted specific plans to cut the sites’ capacity, it will put a priority on helping families with young children and “medically fragile individuals” if the shelters are overwhelmed by arrivals.
Some immigration advocates said the state was making the wrong choice.
“Now’s the time for the state of California to double down on supporting those individuals that are seeking relief from immigration detention,” said Pedro Rios, who directs the U.S.-Mexico border program at the American Friends Service Committee, which advocates on behalf of immigrants. “I think it sends an erroneous message that the issues are no longer of concern.”
This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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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This story can be republished for free (details).
2 years 1 month ago
california, COVID-19, Health Care Costs, Disparities, Immigrants, Latinos
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Venus Remedies bags marketing nod for generic cancer drugs from Uzbekistan, Palestine
Mumbai: Venus Remedies Limited has received marketing authorisations for its generic cancer drugs from Uzbekistan and Palestine. Having over 800 marketing authorisations worldwide, the company is making big strides by now extending its footprint in Central Asia and Middle East with the marketing approval for Carboplatin in Uzbekistan and Docetaxel and Irinotecan in Palestine.
Venus Remedies is expected to launch these drugs in Uzbekistan and Palestine in the next financial year. Venus Remedies Joint Managing Director Dr Manu Chaudhary said, “It is a proud moment for all of us, a significant step towards delivering healthcare solutions that are effective and have a positive impact on patients’ lives. Our mission is to make cancer treatment accessible to everyone and improve outcomes. The approval of these products brings us closer to achieving this goal.”She said the marketing authorisations would help Venus Remedies further strengthen its oncology portfolio and improve its presence in the oncology space. “The two markets offer a great opportunity to us and we are aiming at capturing a sizeable share in these markets through the three cancer drugs in the very first year of their launch. We will continue to invest in our generic drug portfolio and expand to new geographies,” said Chaudhary.
Panchkula-based Venus Remedies Ltd is among the 10 leading fixed-dosage injectable manufacturers in the world. Having presence in 80 countries with a portfolio of 75 products spread over Europe, Australia, Africa, Asia-Pacific, Commonwealth States, Middle East, Latin America and Caribbean region, the company has nine globally benchmarked facilities in Panchkula, Baddi and Werne (Germany), apart from 11 overseas marketing offices. Its manufacturing units are certified for ISO 9001, ISO 14001, ISO 18001 and OHSAS. The company has also been approved by European-GMP, WHO-GMP and Latin American GMP(INVIMA), among others.
Read also: Venus Remedies gets Responsible Export Organisation Certification from CII
2 years 1 month ago
News,Industry,Pharma News,Latest Industry News
The 'Silent Pandemic': Long COVID on and around campus - The Stanford Daily
- The 'Silent Pandemic': Long COVID on and around campus The Stanford Daily
- The People's Pharmacy The People's Pharmacy
- Is the pandemic over? Clark County health officials say COVID likely here to stay The Columbian
- Three Years Into Pandemic, Research Is Starting to Piece Together Long COVID CNET
- FACE TO FACE: Life lessons learned during the battle with long-term COVID Bahamas Tribune
- View Full Coverage on Google News
2 years 1 month ago
Caring for your heart
Although February is celebrated as Heart Month, it is important to be aware of your heart health all year long. During the pandemic, many persons may have neglected to do their heart screenings, which can negatively impact their health. Nearly a...
Although February is celebrated as Heart Month, it is important to be aware of your heart health all year long. During the pandemic, many persons may have neglected to do their heart screenings, which can negatively impact their health. Nearly a...
2 years 1 month ago
Why is heart care important
Embracing a healthy lifestyle at any age can prevent heart disease and lower your risk for a heart attack or stroke. You are never too old, or too young, to begin taking care of your heart. Your heart health is central to overall good health. It...
Embracing a healthy lifestyle at any age can prevent heart disease and lower your risk for a heart attack or stroke. You are never too old, or too young, to begin taking care of your heart. Your heart health is central to overall good health. It...
2 years 1 month ago
$838 million earmarked for National HIV/AIDS response project
THE Government will be spending $838 million on the National HIV/AIDS Response in Jamaica project during the 2023/2024 fiscal year.
The programme is geared at reducing AIDS-related morbidity by providing effective biomedical and supporting services, and reducing new HIV infections among key populations through behavioural and structural interventions.
THE Government will be spending $838 million on the National HIV/AIDS Response in Jamaica project during the 2023/2024 fiscal year.
The programme is geared at reducing AIDS-related morbidity by providing effective biomedical and supporting services, and reducing new HIV infections among key populations through behavioural and structural interventions.
Details of the project are outlined in the 2023/2024 Estimates of Expenditure, which will be considered by the Standing Finance Committee of the House of Representatives shortly.
Targets achieved up to the end of December 2022 include the provision of HIV-prevention programmes and testing and test results for vulnerable groups, including men who have sex with men (MSM) and female sex workers (FSW).
In addition, 91 MSM were placed on oral antiretroviral PrEP, 49 per cent of people living with HIV were placed on antiretroviral therapy (ART), and 78 per cent virological suppression was achieved among all people living with HIV and ART.
For the upcoming fiscal year the programme is expected to reach 7,846 MSM, 8,762 FSW, and 432 transgender (TG) persons through HIV-prevention programmes. Also, 7,886 FSW and 389 TG will get tested and receive the results, and 1,128 MSM will be placed on oral antiretroviral PrEP.
The programme will engage 71 per cent of people living with HIV and ART, achieve 80 per cent virological suppression of people living with HIV and ART, and link 93 per cent of people diagnosed with HIV and are on ART.
2 years 1 month ago
STAT+: Dutch group sues AbbVie for human rights violations stemming from Humira pricing
A Dutch public interest group has filed a lawsuit claiming AbbVie breached a duty to human rights by using unfair and excessive pricing to bolster sales of its Humira drug and dominate the market at the expense of the health care system in the Netherlands.
In making its case, the Pharmaceutical Accountability Foundation argued AbbVie allegedly overcharged the Dutch health care system by up to $1.2 billion by “abusing” its position in the marketplace and keeping prices high. The company sold approximately $2.3 billion worth of Humira in the Netherlands between 2004 and 2018, when its patents provided a monopoly.
2 years 1 month ago
Pharma, Pharmalot, drug pricing, legal, patents, Pharmaceuticals
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
MCh in Gynaecological Oncology: Admissions, Medical Colleges, Fees, Eligibility criteria details
MCh Gynaecological
Oncology or Master of Chirurgiae in Gynaecological Oncology also known as MCh
in Gynaecological Oncology 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
MCh Gynaecological
Oncology or Master of Chirurgiae in Gynaecological Oncology also known as MCh
in Gynaecological Oncology 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 management of cancers of the female reproductive system, including ovarian cancer, uterine
cancer, vaginal cancer, cervical cancer, and vulvar cancer.
The course is a full-time course pursued at various recognized medical
colleges across the country. Some of the top medical colleges offering this
course include Dr. B. Borooah Cancer Institute (Regional Cancer Centre), Guwahati, Assam, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, B J Medical College, Ahmedabad, Gujarat.
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 MCh (Gynaecological
Oncology) varies from college to college and may range from Rs. 6,900 to Rs.3,50,000
in government college per year and from Rs.2,07,000 to Rs.28,00,000 per year in
private medical colleges.
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 26,00,000 to Rs.50,00,000
per annum.
What is MCh in Gynaecological
Oncology?
Master
of Chirurgiae in Gynaecological Oncology, also known as MCh (Gynaecological Oncology) or MCh in (Gynaecological Oncology) is a three-year super specialty
program that candidates can pursue after completing a postgraduate degree.
Gynaecological Oncology is the branch of
medical science dealing with the diagnosis and management of cancers of the female reproductive system,
including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer.
National
Medical Commission (NMC), the apex medical regulator, has released a Guidelines
for Competency-Based Postgraduate Training Programme for MCh in Gynaecological
Oncology.
The Competency-Based
Postgraduate Training Programme governs the education and training of MChs in Gynaecological
Oncology.
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 Gynaecological
Oncology 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 MCh in Gynaecological Oncology
Name of Course
MCh in Gynaecological Oncology
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic
Requirement
Candidates must have a postgraduate medical Degree in MD/MS/DNB (Obst. & Gynae) 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
Counseling by DGHS/MCC/State
Authorities
Course Fees
Rs. 6,900 to Rs.3,50,000 per year in Government medical colleges
Rs.2,07,000 to Rs.28,00,000 per year in Private
medical colleges
Average Salary
Rs.26,00,000 to
Rs.50,00,000 per annum
Eligibility Criteria
The eligibility criteria for MCh in Gynaecological Oncology are defined as
the set of rules or minimum prerequisites that aspirants must meet to
be eligible for admission, which includes:
Name of
Super Specialty course
Course
Type
Prior Eligibility
Requirement
Gynaecological
Oncology
MCh
MD/MS/DNB
(Obst. & Gynae)
Note:
·
The feeder qualification for MCh Gynaecological Oncology is MD/MS/DNB (Obst. & Gynae) 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 MCh in Gynaecological
Oncology. Candidates can view the complete
admission process for MCh in Gynaecological Oncology 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 MCh in Gynaecological Oncology varies from college to college. The fee is generally
less for Government Institutes and more for private institutes. The average fee structure for MCh in Gynaecological Oncology is around Rs. 6,900 to Rs.3,50,000 per year in government colleges and from
Rs.2,07,000 to Rs.28,00,000 per year in private medical colleges.
Colleges offering MCh in Gynaecological Oncology
Various medical colleges across India offer courses for
pursuing MCh in (Gynaecological
Oncology).
As per National Medical Commission (NMC) website, the following medical
colleges are offering MCh in (Gynaecological Oncology) courses
for the academic year 2022-23.
Sl.No.
Course Name
State
Name and Address of
Medical College / Medical Institution
Annual Intake (Seats)
1
M.Ch - Gynaecological Oncology
Assam
Dr. B. Borooah Cancer Institute (Regional Cancer
Centre), Guwahati
2
2
M.Ch - Gynaecological Oncology
Bihar
Indira Gandhi Institute of Medical
Sciences, Sheikhpura, Patna
1
3
M.Ch - Gynaecological Oncology
Gujarat
B J Medical College, Ahmedabad
4
4
M.Ch - Gynaecological Oncology
Karnataka
Kidwai Memorial Institute of Oncology, Bangalore
3
5
M.Ch - Gynaecological Oncology
Karnataka
St. Johns Medical College, Bangalore
1
6
M.Ch - Gynaecological Oncology
Kerala
Regional Cancer Centre, Thiruvanthapuram
2
7
M.Ch - Gynaecological Oncology
Kerala
Amrita School of Medicine, Elamkara, Kochi
2
8
M.Ch - Gynaecological Oncology
Maharashtra
Tata Memorial Centre, Mumbai
2
9
M.Ch - Gynaecological Oncology
Orissa
Acharya Harihar Regional Cancer Centre, Cuttack
2
10
M.Ch - Gynaecological Oncology
Tamil Nadu
Christian Medical College, Vellore
2
11
M.Ch - Gynaecological Oncology
Uttarakhand
All India Institute of Medical Sciences,
Rishikesh
21
Syllabus
An MCh in Gynaecological Oncology
is a three years specialization course that provides training in the stream of
Gynaecology and Oncology.
NMC Guidelines Competency-Based Training Programme For MCh Gynaecological Oncology
Syllabus
Course contents:
At the end of a three-year course in Gynaecological Oncology, the post-graduate student should have acquired the following theoretical, clinical skills and research knowledge.
• Diagnostic techniques and staging of gynecological cancers
• Surgery for gynecological cancers
• Principles of radiation therapy for gynecological malignancies
• Chemotherapy, targeted therapy, and Immuno-therapy for gynecological cancers
• Palliative care for advanced and recurrent cancers
• Pathology of common gynecological cancers
• Research methodology for clinical trials and statistics
• Writing original papers in reputed national & International scientific journals
• Knowledge related to epidemiology and preventive oncology as applied to Gynaecological Oncology
1. Diagnostic techniques and staging
Objectives :
• The trainee should be able to:-
Identify the appropriate diagnostic techniques needed to:-
- establish the diagnosis
- establish the extent of the disease
- evaluate co-existing diseases which may have an important bearing on the selection of and response to treatment
- evaluate the response of cancer to treatment
- Stage cancer according to the current F.I.G.O. classification for gynecological cancers and the corresponding TNM classification.
- have sufficient knowledge in colposcopy and have expert knowledge of the colposcopic evaluation of abnormal cervical or vaginal cytology and vulval neoplasia and identify abnormal epithelial and vascular patterns involving the cervix, vagina, and vulva with the colposcope
- perform cystoscopy
- perform proctosigmoidoscopy
- perform hysteroscopy
- understand the indications for gastrointestinal endoscopy
- he expert in directed cervical biopsies, cone biopsy, LEEP biopsy of the cervix, endocervical curettage, endometrial biopsy and curettage, vulval and nodal biopsies of pelvic, abdominal, and other nodal sites
- understand the indications and techniques for open and percutaneous biopsies
- of possible metastatic sites such as lung, liver, and spine
- understand the indications for and be able to carry out trans-vaginal and trans-abdominal needle biopsy for the diagnosis or evaluation of the extent of pelvic cancers understand the use and limitations of cytology in the detection of cancer and know how to obtain the necessary samples
• The trainee should know the indications for the relative value and interpretation of values and limitations of the techniques such as:-
- Radiographic diagnosis:
- Standard plain film evaluation of heart, abdomen, and skeletal system
- CT Scan and MRI
- Angiography, pulmonary, renal, pelvic
- Intravenous and retrograde urography
- Gastrointestinal and colonic radiography
- Mammography
- Radioisotope scanning:
- PET/CT scanning
-liver-spleen
- bone
- brain
- kidneys
- lungs
- peripheral vascular system
- Ultrasonography
- Measurement of tumor markers and other humoral markers of cancer and benign tumors
- serum HCG and beta-HCG
- serum Alpha fetoprotein
- Carcinoembryonic antigen
- Serum CA125
- Ectopic hormone production (for example-growth hormone, HCG, parathormone)
- Steroid hormones (estrogen/androgens/corticosteroids)
- Biochemistry
- liver function tests
- renal function tests
- carbohydrate tolerance tests
- inappropriate ADH secretion
Blood coagulation
- tests for coagulopathies
- monitoring of anticoagulant therapy
- the prophylactic and therapeutic use of anticoagulants
Pulmonary function tests (PFT)
Perioperative monitoring
- central venous pressure and CVP lines
- pulmonary wedge pressure and Swann Ganz catheters
- arterial lines
- ECG
- the role of HDU/ITU
2. Surgery for gynecological cancers
• Objectives
• The trainee should gain expertise in:-
preoperative evaluation
pre-operative preparation
- bowel
- position of ostomy sites
- fluid restriction
- pulmonary – when indicated
- thromboprophylaxis
- counseling the patient and the family
- obtaining informed consent
- choice of treatment – surgical and non-surgical treatment
- surgical anatomy comprising detailed knowledge of the abdominal pelvic anatomy, including genital, urinary, and G.I tracts and other areas of relevance, e.g., thigh and neck
- management of complications- To be familiar with common complications associated with commonly performed surgical procedures for gynecological cancers.
- intraoperative
1. transfusion reaction
2. cardiac arrest
3. injury to the bladder, bowel, ureters, and major blood vessels
- postoperative
a. atelectasis, other pulmonary complications
b. intra-abdominal bleeding
c. DVT and pulmonary embolus
d. vesicovaginal fistula
e. ureterovaginal fistula
f. rectovaginal fistula
g. renal failure
h. congestive heart failure
i. jaundice
j. pyrexia and sepsis
k. respiratory insufficiency
l. wound problems – infection, dehiscence, evisceration
m. paralytic ileus
n. bowel obstruction
• The trainee should have sufficient training and experience so that the following procedures may be independently and competently performed and their aftercare managed by the completion of the training period.
Primary procedures
- hysterectomy – (a) radical, (b) total abdominal, (c) vaginal
- pelvic lymphadenectomy
- para-aortic lymphadenectomy
- radical vulvectomy
- inguinal and femoral lymphadenectomy
- debulking surgery for stage III and IV ovarian cancer, fertility-sparing surgery for early-stage ovarian cancer
- conservative surgery for early-stage ovarian and cervical carcinoma in young patients
- laparoscopic surgery for carcinoma endometrium, carcinoma cervix
- Exenteration procedures
Gastrointestinal procedures related to gynecological malignancy in collaboration with colorectal surgeons where necessary :
- small intestine : (a) resection and reanastamosis
(b) bypass procedures
(c) ileostomy
- large intestine : (a) resection
(b) colostomies
Urinary tract procedures related to gynecological malignancy in collaboration with urological surgeons where necessary :
- bladder : (a) partial cystectomy
(b) cystotomy
- ureter : (a) ureteroneocystostomy
(b) end-to-end ureteral reanastomosis
(c) ileal conduit
Evaluation procedures
- cystoscopy
- laparoscopy
- colposcopy
- Upper GI endoscopy
- sigmoidoscopy/colonoscopy
• The trainee should at least understand the place of:-
- pelvic exenteration
- primary colonic anastomosis
- continent urinary conduits
- vaginal reconstruction
- plastic reconstruction of the vulva
- laparoscopic lymph node dissection
- laparoscopic surgical staging
- laparoscopic prophylactic salpingo-oophorectomy
- radical vaginal surgery for cervical cancer
- insertion of intracavitary radiation applicators
- feeding jejeunostomy/gastrostomy
- repair of vesicovaginal fistulae
- primary closure
- bulbocavernosus interposition
• Over 30 months it is expected that a candidate enrolled for an MCh course in Gynaecological Oncology will perform the following number of procedures:-
Complete pelvic and para-aortic node dissection - 15
Complete ureteric dissections - 12
Radical abdominal hysterectomy - 12
-Radical excisions of vulval cancer including
Groin dissection - 05
-Laparotomies for stage III and IV ovarian cancer - 25
-Fertility-sparing surgery for early gynecological - 05
cancers
-Type I hysterectomies for carcinoma endometrium - 10
-Exposure to newer surgical techniques such as
HIPEC, robotic surgery
• To allow assessment of training, the trainee should keep a logbook of cases for discussion at assessment. Suggested minimum data comprises
- Patient Id (WITHOUT NAME)
- Date
- Main, Co-Surgeon or assistant surgeon
- Tumour and stage
- Procedure
- Complications
- Special features
3. Principles of radiation therapy for gynecological malignancies
Objectives
The trainee should have sufficient familiarity with the principles and practice of Radiation Oncology in treatment planning, in the execution of intracavitary applications, and the management of irradiation-induced complications.
• Radiobiology and Cell biology
General principles of Radiobiology
- The cell cycle, basic cell kinetics, tumor vasculature, and angiogenesis.
- Cellular systems and their response to radiation
- Radiation biology models radiation damage at the cellular level.
Techniques in molecular biology
- Nucleic acid analysis including electrophoresis, hybridization, blotting, PCR, sequencing, transfection
- Microarray techniques
- Transgenic models
The genetics of normal and malignant cells
- Normal chromosomal structure and function, normal gene transcription
- Normal DNA repair mechanisms
- Polymorphisms, mini and microsatellites
- Chromosomal and genetic changes in malignancy, point mutations, translocations, deletions, gene amplification, and over-expression
- Oncogenes, proto-oncogenes, tumor suppressor genes.
Normal tissue radiobiology
- Normal tissue damage & concepts of normal tissue tolerance
- The concept of damage (lethal, sub-lethal, potentially lethal) & Repair
- The cell survival curve as a basis for fractionation
- Hyper fractionation, accelerated fractionation, and hypo fractionation
- Hypoxic cell sensitizers and protectors
• Radiotherapy treatment planning
Alpha, beta, and gamma rays
Inverse square law
Immobilization (techniques and accuracy)
Tumor localization: direct visual, simulator, CT, MRI, USG, PET
Principles of conformal therapy and intensity modulated radiation therapy (IMRT)
• Radiotherapy Treatment
External Beam Therapy & equipment
- Principles of superficial, orthovoltage, and megavoltage
- Principles of the Linear Accelerator & Telecobalt machines
- Radiation Doses; Radical & Palliative
- Radiotherapy Techniques: Conventional, 3D-CRT, IMRT & IGRT
Brachytherapy
- Types of sources & their construction
- Principles of clinical use
- Gynaecological intracavitary brachytherapy systems, source, and dose distributions and dose specification, dose to point A & B
- Principles of after-loading (manual, remote, low, medium, and high dose rate)
- Image-guided Brachytherapy
Radiotherapy at gynecological sites
- Uterine Cervix
- Corpus Uteri
- Vagina
- Vulva
- Ovaries
- Fallopian Tube
- Radiotherapy at uncommon sites
Radiation protection
- Radiation risk & Radiation limits
- Protection mechanisms: time, distance, shielding
- Monitoring of personnel
- Dose reporting mechanisms and dose level
Early radiation reactions
- Bowel, Bladder, Vaginal & Skin reactions
• Late Complications
- Factors affecting late complications
- A complication to GI Tract, Urinary tract, Skin, Bone Marrow, etc.
- Managing complications
- Late radiation-induced malignancies
• Combination of chemotherapy and radiation therapy (neoadjuvant, concurrent, and adjuvant)
• To allow assessment of training, the trainee should keep a logbook of cases for discussion at assessment. Suggested minimum data comprises
Patient id (WITHOUT NAME)
- Date
- Tumour and stage
- Procedure (e.g. radiotherapy planning or insertion)
- Complications
- Special features
4. Chemotherapy for gynecological cancers
1. Objectives
The trainee should understand the pharmacology of the major drugs used in cancer chemotherapy and be able to use them.
• Cell biology including:
cell cycle kinetics
log kill hypothesis
cycle and phase specificity
• Classes of chemotherapeutic agents :
Taxanes
alkylating agents
antimetabolites
antibiotics
vinca alkaloids
hormones
miscellaneous agents
• Targeted therapy
• Immunotherapy
• Mechanism of action
• Pharmacology of specific agents
- routes of administration and absorption
- distribution
- biotransformation
- excretion
- drug interactions
- pharmacokinetics
- Benefits and limitations of combination chemotherapy
- Intraperitoneal chemotherapy
- High dose chemotherapy
- General guidelines for clinical evaluation include the definitions of complete or partial responses, the concept of phase I, II, and III drug trials, and adjuvant therapy.
- Toxicity including :
- general effects on rapidly proliferating epithelium such as bone marrow, G.I.
- tract and hair follicles
- drug-specific toxicity
- management
• Trophoblastic disease
• Palliative Chemotherapy
To allow assessment of training, the trainee should keep a personal logbook of cases for discussion at assessment. Suggested minimum data comprises
- Patient Id (without a name)
- Date
- Tumour and stage
- Procedure (e.g. chemotherapy planning or prescription)
- Complications
- Special features
5. Palliative care for advanced and recurrent cancers
1. Objectives:
The trainee should be able to contribute to palliative care including:-
• Pain relief:
- non-narcotic analgesics
- narcotic analgesics
- co-analgesics
- WHO ladder
- understanding the role of anesthetist – (a) pain clinics, (b) neural blocks
• Anxiety relief :
Sedatives and tranquilizers
counseling (patient and family)
Home care
• nausea and vomiting relief:
- antiemetics
- dietary measures
• Community support roles:
- General Practitioner
- district nurse
- family
- religion
- community services, e.g., laundry, social services
- cancer help groups
• The trainee should have received practical exposure to hospice care.
• The trainee should have been taught and have experience in breaking bad news to patients and relatives.
6. Pathology of common gynecological cancers
1. Objectives:
• The trainee should be able to identify, based on direct visual and microscopic evaluation, lesions that are pre-malignant or malignant and distinguish them from benign disorders. She/he should know what histopathological features are important in disease progression i.e. tumor margins, depth of invasion, lymphovascular space involvement, grade, and node metastases. The candidate should be familiar with immunohistochemistry stains and immunophenotyping, receptor studies as applied to gynecological tumors
Vulva including:
- neoplastic and non-neoplastic disorders
- warts
- intraepithelial neoplasia
- carcinoma
- sarcoma
Vagina including:
- adenosis
- warts
- intraepithelial neoplasia
- carcinoma
- sarcoma
Cervix including:
- intraepithelial neoplasia
- microinvasion
- carcinoma
- sarcoma
- neuroendocrine tumors
Uterine body including:
- cystic hyperplasia
- adenomatous hyperplasia
- carcinoma
- sarcoma
- trophoblastic hyperplasia
- carcinosarcoma
Fallopian tube:
- carcinoma
Ovary including:
- functional cysts
- serous cystadenoma and carcinoma
- mucinous cystadenoma and carcinoma
- Brenner tumor
- granulosa-theca cell tumor
- Sertoli-Leydig cell tumor
- gynandroblastoma
- cystic teratoma
- mixed germ cell and gonadal stromal tumors
- embryonal carcinoma
- choriocarcinoma
- endometrioid carcinoma
- metastatic carcinoma
- gonadoblastoma
- mesonephros
SUBJECT-SPECIFIC THEORETICAL COMPETENCIES
Cognitive domain (Knowledge Domain)
At the end of the course, the student should have acquired the following skills and knowledge in the following:
1. Female pelvic anatomy.
2. Vascular supply of pelvis
3. Anatomy of female ureter and bladder.
4. Lymphatic drainage of the female pelvis including the vulva.
5. Pathology of premalignant and malignant lesions of the female genital tract.
6. FIGO and other international staging systems for various gynecological cancers.
7. Surgical principles in the management of various gynecological cancers.
8. Postoperative care, including fluid and electrolyte management.
9. Surgical management in case of the small intestine or large bowel involvement by gynae cancer.
10. Surgical management in case of ureter or bladder involvement or injury during surgery.
11. Prophylaxis against venous thromboembolism.
12. Management of suspected and established cases of venous thromboembolism.
13. Concept of Medical and Radiation Oncology management of these cases.
The affective domain (Attitudes including Communication and Professionalism)
At the end of three years course in Gynaecological Oncology, a candidate should be able to -
1. Effectively communicate to the patient and her relatives the nature of the disease, the extent of the disease, the treatment options available, and the expected outcome following management of the disease.
2. execute the planned treatment with the help of other colleagues in the specialty of Gynaecological Oncology.
3. maintain the highest degree of professionalism in executing treatment of the disease and communication with the patient and relatives.
SUBJECT-SPECIFIC PRACTICAL COMPETENCIES
Diagnostic techniques and staging
1. Objectives :
• The trainee should be able to:-
Identify the appropriate diagnostic techniques needed to:-
- establish the diagnosis
- establish the extent of the disease
- evaluate co-existing diseases which may have an important bearing on the selection of and response to treatment
- evaluate the response of cancer to treatment
• stage cancer according to the current F.I.G.O. classification for gynecological cancers and the corresponding TNM classification.
• have sufficient knowledge in colposcopy and have expert knowledge of the colposcopic evaluation of abnormal cervical or vaginal cytology and vulval neoplasia and identify abnormal epithelial and vascular patterns involving the cervix, vagina, and vulva with the colposcope
• perform cystoscopy
• perform proctosigmoidoscopy
• perform hysteroscopy
• understand the indications for gastrointestinal endoscopy
• be an expert in directed cervical biopsies, cone biopsy, LEEP biopsy of the cervix, endocervical curettage, endometrial biopsy and curettage, vulval and nodal biopsies of pelvic, abdominal, and other nodal sites
• understand the indications and techniques for open and percutaneous biopsies of possible metastatic sites such as lung, liver, and spine, and lymph nodes.
• understand the indications for and be able to carry out transvaginal and transabdominal needle biopsies for the diagnosis or evaluation of the extent of pelvic cancers
• understand the use and limitations of cytology in the detection of cancer, and know how to obtain the necessary samples
• The trainee should know the indications for the relative value and interpretation of values and limitations of the techniques such as:-
Radiographic diagnosis:
- Standard plain film evaluation of heart, abdomen, and skeletal system
- CT Scan and MRI
- Angiography, pulmonary, renal, pelvic
- Intravenous and retrograde urography
- Gastrointestinal and colonic radiography
- Mammography
Radioisotope scanning:
- PET-CT scanning
- liver-spleen
- bone
- brain
- kidneys
- lungs
- peripheral vascular system
Ultrasonography
Measurement of tumor markers and other humoral markers of cancer and benign tumors
- serum HCG and beta-HCG
- serum Alpha fetoprotein
- Carcinoembryonic antigen
- Serum CA125
- Ectopic hormone production (for example-growth hormone, HCG, parathormone)
- Steroid hormones (estrogen/androgens/corticosteroids)
Biochemistry
- liver function tests
- renal function tests - including, creatinine clearance, GFR, urine electrolytes, osmolality, serum electrolytes, osmolality and pH
- carbohydrate tolerance tests
- inappropriate ADH secretion
Blood coagulation
- tests for coagulopathies
- monitoring of anticoagulant therapy
- the prophylactic and therapeutic use of anticoagulants
-Pulmonary function tests (PFT)
-Perioperative monitoring
- central venous pressure and CVP lines
- pulmonary wedge pressure and Swann Ganz catheters
- arterial lines
- ECG
- the role of HDU/ITU
2. Surgery for gynecological cancers
1. Objectives
• The trainee should gain expertise in:-
- Preoperative evaluation
- Pre-operative preparation
- bowel
- position of ostomy sites
- fluid restriction
- pulmonary – when indicated
- thromboprophylaxis
- counseling the patient and the family
- obtaining informed consent
- Choice of treatment – surgical and non-surgical treatment
- Surgical anatomy comprising detailed knowledge of the abdominal pelvic anatomy, including genital, urinary, and G.I tracts and other areas of relevance, e.g., thigh and neck
- Management of complications-To To be familiar with common complications associated with commonly performed surgical procedures for gynecological cancers.
- Intraoperative
* transfusion reaction
*cardiac arrest
*injury to bladder, bowel, ureters, major blood vessels
- Postoperative
a. atelectasis, other pulmonary complications
b. *intra-abdominal bleeding
c. *DVT and pulmonary embolus
d. *vesicovaginal fistula
e. *ureterovaginal fistula
f. *rectovaginal fistula
g. *renal failure
h. *congestive heart failure
i. *jaundice
j. *pyrexia and sepsis
k. *respiratory insufficiency
l. *wound problems – infection, dehiscence, evisceration
m. *paralytic ileus
n. *bowel obstruction
• The trainee should have sufficient training and experience so that the following procedures may be independently and competently performed and their aftercare managed by the completion of the training period
Primary procedures
- hysterectomy – (a) radical, (b) total abdominal, (c) vaginal
- pelvic lymphadenectomy
- para-aortic lymphadenectomy
- radical vulvectomy
- inguinal and femoral lymphadenectomy
- debulking surgery for stage III and IV ovarian cancer, fertility-sparing surgery for early-stage ovarian cancer
- conservative surgery for early-stage ovarian carcinoma in young patients
- laparoscopic surgery for carcinoma endometrium, carcinoma cervix
- Exenteration procedures
Gastrointestinal procedures related to gynecological malignancy in collaboration with colorectal surgeons where necessary :
- small intestine : (a) resection and re-anastomosis.
(b) bypass procedures
(c) ileostomy
- large intestine : (a) resection
(b) colostomies
Urinary tract procedures related to gynecological malignancy in collaboration with urological surgeons where necessary :
- bladder (a) partial cystectomy
(b) cystotomy
- ureter (a) ureteroneocystostomy
(b) end-to-end ureteral reanastomosis
(c) ileal conduit
Evaluation procedures
- cystoscopy
- laparoscopy
- colposcopy
-Upper GI endoscopy
- sigmoidoscopy/colonoscopy
• The trainee should understand the place of:-
- Pelvic exenteration
- Primary colonic anastomosis
- Continent urinary conduits
- Vaginal reconstruction
- Plastic reconstruction of the vulva
- Laparoscopic lymph node dissection
- Laparoscopic surgical staging
- Laparoscopic prophylactic salpingo-oophorectomy
- Radical vaginal surgery for cervical cancer
- Insertion of intracavitary radiation applicators
- Feeding jejeunostomy/gastrostomy
- Repair of vesicovaginal fistulae
- primary closure
- bulbocavernosus interposition
Career Options
After completing an MCh in Gynaecological Oncology, candidates will get employment opportunities
in Government as well as in 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 (Gynae oncology), Junior
Consultant, and Senior Consultant (Gynae oncology).
Courses After MCh in Gynaecological Oncology Course
MCh in Gynaecological
Oncology is a specialization
course that can be pursued after finishing a Postgraduate medical course.
After pursuing a specialization in MCh in Gynaecological
Oncology, a candidate could also
pursue certificate courses and Fellowship programs recognized by NMC and NBE,
where MCh in Gynaecological
Oncology is a feeder
qualification.
Frequently Asked Questions (FAQs) –MCh in Gynaecological Oncology Course
- Question: What is the full
form of an MCh?
Answer: The full form of an MCh is Master of
Chirurgiae.
- Question: What is an MCh in Gynaecological
Oncology?
Answer: MCh Gynaecological
Oncology or Master of
Chirurgiae in Gynaecological Oncology also known as MCh in Gynaecological
Oncology 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 an MCh in Gynaecological Oncology?
Answer: MCh in Gynaecological Oncology is a super specialty program of three years.
- Question: What
is the eligibility of an MCh in Gynaecological
Oncology?
Answer: Candidates must have a postgraduate medical Degree in MD/MS/DNB (Obst. & Gynae) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE., this feeder qualification is mentioned here as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
- Question: What
is the scope of an MCh in Gynaecological
Oncology?
Answer:
MCh in Gynaecological Oncology
offers candidates various employment opportunities and career prospects.
- Question: What
is the average salary for an MCh in Gynaecological Oncology candidate?
Answer:
The MCh in Gynaecological Oncology candidate's average salary is between Rs. 26 lakhs to Rs. 50 lakh per annum depending on the experience.
- Question: Can you teach after
completing an MCh Course?
Answer: Yes, the candidate can teach in
a medical college/hospital after completing an MCh course.
2 years 1 month ago
News,Health news,NMC News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses
Tufton: Unhealthy lifestyle a bigger threat to life than COVID-19
HEALTH and Wellness Minister Dr Christopher Tufton told more than 300 members of the Jamaican Diaspora in New York on Saturday that the COVID-19 pandemic was the catalyst, but not the only cause of most of the approximately seven million deaths linked to COVID-19 over the past two and a half years.
Rather, he said, most of these deaths resulted from compromised immune systems due to lifestyle-related illnesses like diabetes, lung diseases, cancers, and cardiovascular complications.
"This should cause us all to see lifestyle diseases as an even bigger threat to life than the COVID virus. We must do more to change lifestyle practices to address high mortality rates this now causes," Tufton said.
Dr Tufton, who was guest speaker at the LJDR Davis Foundation fund-raising charity gala, said approximately 40 million people die each year from these type of ailments, and many more live with severe pain. More effort, he added, is needed to support healthy lifestyle practices like proper nutrition, exercise and rest.
The health minister told the audience that partnership in providing a holistic solution to healthy living is the way forward. He said that apart from proper nutrition, exercise and rest, there is evidence to indicate that volunteerism is both a source of support for those in need as well as a source of therapy for those who give.
Jamaica's Ministry of Health and Wellness, he said, was ready to welcome partnerships in public health as "we believe and support the one world, one health philosophy".
The LJDR Foundation, which is celebrating its 10th anniversary, has had several missions to Jamaica supporting a number of health-related projects, including the renovation of the Chapleton Hospital and the provision of health-care outreach for residents of Brandon Hill in northern Clarendon.
2 years 1 month ago
Health – Demerara Waves Online News- Guyana
US Southern Command begins free surgery, knowledge sharing at GPHC, West Demerara Regional Hospital
Doctors from the United States (US) Southern Command on Monday began performing surgeries, providing dental services and conducting professional knowledge exchanges at the Georgetown Public Hospital Corporation (GPHC) and the West Demerara Regional Hospital, the American embassy here said. The doctors are drawn from the US’ Lesser Antilles Medical Assistance Team (LAMAT) and are part ...
Doctors from the United States (US) Southern Command on Monday began performing surgeries, providing dental services and conducting professional knowledge exchanges at the Georgetown Public Hospital Corporation (GPHC) and the West Demerara Regional Hospital, the American embassy here said. The doctors are drawn from the US’ Lesser Antilles Medical Assistance Team (LAMAT) and are part ...
2 years 1 month ago
Health, News
Bursaries for 2023 European Drugs Summer School, Portugal
7 March 2023 is the deadline to apply for a registration fee bursary for the 2023 European Drugs Summer School (EDSS) in Lisbon, Portugal
View the full post Bursaries for 2023 European Drugs Summer School, Portugal on NOW Grenada.
2 years 1 month ago
Education, External Link, Health, edss, european drugs summer school, portugal, university institute of lisbon
Daniel Rivera: more than RD$20 billion has been invested in the health sector
The Government has invested more than 20 billion pesos in the health sector in its two years in office, Health Minister Daniel Rivera said this Sunday when giving a conference in Santiago. The figure indicated by the official was distributed in expenses corresponding to the lines of infrastructure, equipment, high-cost medicines, and Promese/Cal.
Rivera indicated that only through the Directorate of Access to High-Cost Medications, some RD$9 billion have been made available annually to benefit around 15,000 patients with chronic diseases, which in two years adds up to more than 18 billion in that area. While an amount of RD $5,126,266,797 have been invested in infrastructure (construction, reconstruction, and equipment of 179 health centers).
Likewise, he highlighted the investment of more than RD$3 billion in the budget increase of the Essential Medicines and Central Logistics Support program (Promese/Cal), which went from RD$1,568 million in 2022 to RD$3 billion in 2023.
2 years 1 month ago
Health, Local
9-1-1 staff and ambulances on the brink of collapse
The main facilities of the Directorate of Medical Emergencies are in deplorable conditions. It is the building where the so-called “Caja del Seguro” previously operated. One look at the front, and the impression is that it will soon be demolished. A source revealed to Diario Libre that the internal state of the structure is just as bad as the outside.
Deep leaks in the walls, areas infested with humidity, and meeting rooms without tables or chairs. Bathrooms with pipes about to collapse, among other problems that the building presents.
It is thought that a building of more than 50 years of construction drags the absence of maintenance as governments usually do. If that is true, so is the lack of funds that would be affecting the Directorate of Medical Emergencies, where, despite the fact that retired General Juan Manuel Méndez was appointed in June 2022, the administration does not start because the funds destined for the management are not arriving, nor has the general’s work team been approved: administration, human resources the spinal cord of the control and the employees who were appointed to it have still not been paid in seven months.
The teams of doctors and paramedics that provide emergency medical care services, which are reported through 9-1-1, are even worse off.
2 years 1 month ago
Health, Local
How new medicine can help infertility
INFERTILITY is defined as the failure to conceive after one year of regular intercourse without contraception, or the inability of a woman to carry a pregnancy to a live birth. Statistics show that infertility is estimated to affect 20 per cent of couples of reproductive age.
Dr Kamali Carroll, lab director at the Hugh Wynter Fertility Management Unit, lecturer and embryologist, recently broke down the topic at the Medical Disposables Continuing Education Seminar 'MPowered', at which she addressed the causes of infertility. She also explored solutions and shares how new medicine and technology can help.
Causes
Statistics show that 33 per cent of cases are female factor infertility, 20 per cent are male factor infertility, 39 per cent are a combination of male and female factor infertility, and eight per cent are unexplained infertility factors.
Female infertility is caused by a number of factors ranging from ovulation disorder cases, ageing, having diminished ovarian reserve, premature ovarian failure, and disorders like polycystic ovary syndrome (PCOS). There are also tubal causes and causes such as fibroids and endometriosis.
Male factor infertility is caused by several conditions. These include local, systemic or lifestyle conditions. Local conditions include varicocele (swollen vessels in the testicles), genitourinary infection, epididymo-orchitis (swelling of the testicle), or testicular trauma (injury to testicle). Systemic conditions include diabetes, cancer, and medications, while lifestyle factors include excessive smoking, exposure to pesticides, radiation, and excessive use of mobile devices close to the testicles (using a laptop on your lap for long periods, for example).
Treating infertility
Assisted conception is one of the main ways to treat infertility. This is when a patient uses medical intervention to become pregnant. There are two main types of assisted conception: artificial insemination and assisted reproductive technology (ART).
The most common type of artificial insemination is intrauterine insemination (IUI). With this technique sperm cells are inserted directly into the womb at the time of ovulation. An IUI is ideal for men with borderline sperm parameters, women with hostile cervical conditions, women with at least one patent (open) tube, men with ejaculatory dysfunctions, or for couples with unexplained infertility reasons.
Unlike IUI, ART involves treating infertility with both the eggs and sperm being outside of the body. The most common type of ART is in vitro fertilisation (IVF). In this process the woman is given drugs to stimulate the ovaries to produce multiple eggs. The eggs are then removed from the ovaries and inseminated in the lab, where they are grown and observed, after which the best quality embryos are taken and transferred to the uterus. IVF is suitable for individuals with previous failed IUIs, poor sperm count, blocked tubes, diminished ovarian reserve, recurrent miscarriages, endometriosis, and PCOS.
Innovations to treat infertility
Over the past decade, drugs, technology, and new research have become available to treat infertility and assist with conception.
Laboratory techniques include preimplantation genetic testing, which is a technique used to identify genetic abnormalities in embryos with IVF before putting the embryo back into the uterus.
Assisted hatching is when a laser is used to create a hole in the zona pellucida (layer of the egg), which forces the embryo to hatch and leads to higher pregnancy rates.
Vitrification is a complete dehydration process to freeze eggs that can be stored for later use.
Embryoscope is when eggs are grown in a womb-like incubator in the lab.
Third party reproduction options include donor eggs that have been preserved at an egg bank, which usually comes from a younger female donor. Additionally, there is gestational surrogacy; this is a process in which the child will have no genetic link to the surrogate.
Dr Carroll explained that, contrary to popular belief, many assisted conception services are available right here in Jamaica for couples experiencing infertility.
2 years 1 month ago
Minister of Health: “25% of cholera cases are asymptomatic”
The Minister of Public Health, Daniel Rivera, said Friday that 25% of cholera-positive patients do not have symptoms.
“People think that whenever they get cholera, they will get diarrhea, no. There are 25% who do not feel anything, who can walk without any problem. There is a 25 % that does not feel anything, that can walk without any problem. This is a disease that can be largely asymptomatic,” said the Health Minister.
Rivera assured that there is reasonable disease control in the border area and recalled that the bulk of active cases in Haiti is in Port-au-Prince.
“The control is day by day. If there is a good vaccination there (in Haiti), we believe it will help us in this care,” said the minister.
The head of the Health Cabinet assured that out of 1.2 million cholera vaccines sent to Haiti, 800 thousand people have already been immunized.
“It will help us less. The more of their population is vaccinated, the less risk for us,” he said.
Market visit
The minister made a tour of the Santo Domingo East Municipal Market, located in the El Almirante sector, to verify the sanitary conditions and the handling of the products offered there and to ensure the maintenance of hygiene measures and good food handling to prevent cholera.
The official indicated that most of the food consumed in this area, which is currently the focus of attention for cholera, is dispatched from this market.
La Zurza declares itself free of cholera after a month without infected persons.
“With the cases of cholera that have been registered we have called attention to the care and handling of food and mainly the consumption of safe drinking water, where there is drinking water and good hygiene with vegetables and other products, there will be no contamination by cholera,” said Dr. Rivera.
He said that as of today, there were only four cholera inpatients and that surveillance is being maintained in the hospitals and the tents set up for the detection and attention of suspected cases in the different sectors of the country.
At the end of the visit, he congratulated the workers and administrative personnel of the market for the favorable conditions in which it is located. At the same time, he asked not to neglect and maintain these levels to avoid the spread of the bacteria.
2 years 2 months ago
Health, Local
Health – Demerara Waves Online News- Guyana
Fmr US President Jimmy Carter, who spearheaded Guyana’s electoral reforms, in hospice care
Former U.S. President Jimmy Carter, who convinced Guyana’s then People’s National Congress (PNC)-led administration to agree to major electoral reforms, has entered hospice care, instead of seeking more medical treatment. After a series of short hospital stays, the statement said, Carter “decided to spend his remaining time at home with his family and receive hospice ...
Former U.S. President Jimmy Carter, who convinced Guyana’s then People’s National Congress (PNC)-led administration to agree to major electoral reforms, has entered hospice care, instead of seeking more medical treatment. After a series of short hospital stays, the statement said, Carter “decided to spend his remaining time at home with his family and receive hospice ...
2 years 2 months ago
Elections, Health, News, Politics
Government invests RD$9 billion a year in high-cost medicines
The Minister of Public Health and Social Assistance, Daniel Rivera, gave a master conference entitled “Health Impact Strategy of the government of Luis Abinader,” in which he presented the achievements made during this period in the health field.
During the dissertation, the official highlighted that during the two years of administration (2020-2022), some RD 5,126,266,797.59 had been invested in infrastructure and equipment in 179 health centers, saving the State some 5 billion pesos.
He said that in the Directorate of Access to High-Cost Medicines, the government currently invests some 9,000 million pesos annually to benefit about 15,000 patients with chronic diseases.
He stated that the current authorities found the country in a state of emergency, as a result of the COVID-19 pandemic, without an efficient protocol, so they sought a rapid and strategic response to implement, given the challenges and needs faced by the nation at that time.
In that sense, he explained the strategies implemented that resulted in the current development of the health sector.
“The health system did not have an emergency plan, and the regulatory and training framework was made more efficient to respond to any pandemic; the first level of care is being renovated, we increased the diagnostic capacity, implementation of mobile hospitals, relations with international organizations and public-private partnership and high training in human resources in health. Through all these initiatives developed by order of our President Luis Abinader, we have achieved what we are today in terms of health,” indicated Dr. Rivera.
In this context, Dr. Rivera said that the government responded quickly to any epidemiological situation that could arise after the passage of natural phenomena, such as the passage through the country of storm Fiona, as well as with preventive actions for smallpox, cholera, and other viruses.
He also detailed the investments made in remodeling, emergencies, new constructions, first-level centers, and specialties such as hemodialysis, oncology units, and diabetic foot, among others.
During his presentation, the official pointed out that President Luis Abinader has a great strategic vision to continue strengthening the health system in the Dominican Republic, such as the healthy municipalities programs with the implementation of the “Change your Lifestyle” Health Routes and the creation of healthy cities in the provinces of San Francisco de Macorís, San Pedro and San Cristóbal.
“From our Ministry of Health we have impacted more than 100,000 people with the Health Route journey in 17 provinces, with some 35 services such as: evaluations, general consultation, pediatric, blood typing, diagnostics, treatments and prevention oriented to non-communicable diseases, psychosocial support, delivery of medicines, National Health Insurance (SeNaSa) affiliation among other services.”
The also president of the Health Cabinet highlighted the achievements made in the face of the COVID-19 pandemic, with which the country guaranteed vaccination for all citizens and was the third country to apply the third dose. Likewise, the government decided to use the drugs Tocilizumab and REGEN-COV in severe patients and was one of the first in the world with the lowest lethality of the disease.
He also highlighted that the country was one of the five nations with the best vaccination rate, the sixth in Latin America in implementing immunization in children, and the third in the region in carrying out Genomic Sequencing, being recognized by the World Health Organization (WHO/PAHO), for the strategies implemented during the pandemic.
The Minister of Health highlighted the different social programs implemented in the area of health, in which he highlighted the budget increase made in the Essential Medicines Program and Central Logistical Support (PROMESE/CAL), which went from RD 1,568 million in 2022 to RD 3,176 million in 2023 for essential medicines, benefiting around 17,000 low-income patients.
He also mentioned the work carried out by entities such as the National Health Service (SNS), SeNaSa, Uniendo Voluntades, the National Institute of Drinking Water and Sewerage (INAPA), the Ministry of Housing and Buildings, among others.
The Minister of Health held the conference at the UTESA University Convention Center at the invitation of the New Democrats External Sector movement, which officials attended, collaborators of the Ministry of Health, members of Congress, and special guests, among other personalities.
2 years 2 months ago
Health, Local
Opinion: In Turkey, Ukraine, and beyond, the necessity of trauma care
Watching news reports of the heroic relief efforts underway in Turkey and Syria following the devastating earthquake there, I can imagine the terrible weight of emotional trauma that so many people are experiencing right now because I’ve experienced it myself.
A dozen years ago, as a young doctor with a background in emergency medicine, I felt prepared to handle disaster response situations. But I was totally unprepared for the constant exposure to widespread suffering and death that I experienced while providing emergency medical relief after the 2010 earthquake that killed 220,000 people in Haiti.
2 years 2 months ago
First Opinion, Advocacy, health care workers, Mental Health
Telemedicine as safe haven for sexual health
FEBRUARY is STD Awareness Month, and while our sexual health is incredibly personal and private, this doesn't mean we shouldn't take action to ensure that it is prioritised for ourselves and our sexual partners.
The sensitive nature of our sexual lives may cause us to attach shame and embarrassment to our sexual health, causing us to avoid doing checks and even having conversations with our health-care providers about concerns we may have.
Physical, mental, emotional, and social health all contribute to our sexual health. Being in good sexual health means being well-informed, careful, and respectful to yourself and others during your sexual encounters. On your path to improved sexual health your greatest tools will be communication, education, and safety, and with telemedicine you gain remote access to specialists to discuss any concerns, follow-ups, or assessments you may require — all specific to your personal history and health.
• Private, encrypted platforms: Telemedicine services, such as MDLink, operate on encrypted platforms. What this means is, any data shared via this platform will only be available to your doctor and selected authorised personnel within the office. You will not have to worry about the safety of your personal information being shared outside of this platform, whether that be via text, photo, video, or audio.
• No waiting rooms or in-person visits: The anxiety of sitting in a waiting room, knowing you're going to discuss something personal with your doctor, may cause you to feel some level of unease. To avoid this awkwardness you may skip the waiting room altogether. Telemedicine allows you to access your doctor from any location, as long as you have access to the Internet. This may be your office, bedroom, or even your car.
• Convenient testing: After meeting with your doctor online, if they do recommend that you do an STD screening they can send you all the lab forms virtually. To get your tests done you will not need to go into an office either. MDLink's Drive Thru Medical Centre on Old Hope Road in Kingston provides on-site testing which will allow you to remain in your vehicle and get your tests done.
• Your choice of communication method: Do you find face-to-face conversations uncomfortable when talking about sexual health? Would you rather talk on the phone or text? Telemedicine platforms such as MDLink allow you to choose what method of communication you want to use before you begin speaking with your doctor. Allowing you to make a personal choice will encourage you to feel more in control of the situation and more comfortable.
• Diagnosis and assessment of many STIs and STDs: While an STI/STD cannot be 100 per cent diagnosed without a lab test, your doctor may do preliminary assessments toward a diagnosis for STIs such as herpes, chlamydia, HPV, and gonorrhoea by using a telemedicine platform. You will be required to answer questions about your symptoms, and if you are comfortable they may request a video or photograph of any abnormal rashes or bumps you may be concerned about. After these conversations your doctor may suggest a prescription or recommend that you do a lab test for confirmation. Common symptoms of STIs may include pain when urinating, coloured discharge, or specific bumps or rashes. A description of this may lead your doctor closer to a diagnosis without actually seeing you in person.
Telemedicine is a modern, digital tool that aids in the accessibility and quality of health care. Understanding the sensitivity of sexual health care and the variety of needs associated with it, telemedicine provides a unique facility for the awareness, care, and treatment of sexual health. The more people who take their sexual health seriously, the easier it will be to tackle the transmission of STDs and the stigma associated with sexuality. MDLink offers full-service care for sexual health, ensuring you feel safe and taken care of.
Dr Ché Bowen, a digital health entrepreneur and family physician, is the CEO & founder of MDLink, a digital health company that provides telemedicine options. Check out the company's website at www.theMDLink.com. You can also contact him at drchebowen@themdlink.com.
2 years 2 months ago