Health – Dominican Today

La Zurza is adapting to living with the danger of contracting cholera

Santo Domingo, DR
The residents of the La Zurza sector, a locality of the National District where four new cases of cholera were confirmed almost a week ago, have had to modify their habits and take extreme hygiene measures to avoid contracting the disease.

Santo Domingo, DR
The residents of the La Zurza sector, a locality of the National District where four new cases of cholera were confirmed almost a week ago, have had to modify their habits and take extreme hygiene measures to avoid contracting the disease.

Housewives, the elderly, and young people said they only use water from the water tanks recently installed by the Santo Domingo Aqueduct and Sewerage Corporation (CAASD) for cooking and doing their chores.

“At every certain point, there are four large water tanks that are filled twice a day and with that water we do everything, because we cannot use water from the well or from the river, due to the weeds,” said Mariela Veras, referring to the degree of contamination of the La Isabela River.

Although the Dominicans said they were aware of the threat posed by cholera, the Haitians residing in the area continue to bathe and even wash their clothes in the pool, which shows how unhealthy it is.

Given this situation and the number of Haitians residing in the area, the health authorities have prepared awareness material in Creole and Spanish so that foreigners can receive in their own language the necessary preventive information to avoid the spread of the dangerous disease.

“We have been educating them house by house, we are taking them educational material in Spanish and Creole because there are some foreign citizens here, but the Dominicans have mostly heeded the call for prevention, which is what we are looking for,” said the director of Area IV of Public Health, Jesús Surdí.

On the other hand, during a tour made by journalists of this newspaper, a brigade of workers of the Mayor’s Office of the National District was observed in the area, which has been cleaning all the places that could be a focus of bacteria since yesterday morning.

Mobile hospital

By order of the Minister of Public Health, Daniel Rivera, a mobile hospital was installed last Monday in La Zurza. A team of doctors assists all citizens who present any symptomatology related to cholera.

Fewer patients

Dr. Máximo Canela, in charge of the unit, explained to journalists of Listín Diario that, although the number of patients has gradually decreased, each patient is evaluated, submitted to treatment, or referred to a hospital center, depending on the case.

He added that they are also doing “an educational work by handing out flyers containing essential information on cholera.”

A week ago, the Ministry of Public Health confirmed four new cases of cholera, for a total of six in the country. All correspond to Dominican citizens residing in the La Zurza sector of the National District.

The health authorities urged the population not to be alarmed, to remain alert to reports, and to follow prevention measures such as frequent hand washing, washing food properly, eating well-cooked food, and drinking only potable water.

They also recommend going to the nearest health center for investigation and timely treatment if you have any diarrheal events.

The Ozama cordon

On Thursday, the proposal of the Listin Diario newspaper in its Wednesday editorial to cordon off and prohibit the access of bathers to the Isabela and Ozama rivers due to their high levels of contamination and the recent incidence of cholera bacteria was positively accepted by the Ministry of Health.

According to Dr. Daniel Rivera, Minister of Health, the analyses to understand whether or not it is necessary to limit the passage to both river sources are already underway.

Rivera added that, as Public Health, they are going to wait until they see the cultural studies in the waters of the two rivers to proceed to accompany the acting institutions as much as they have done in the intervention process developed by the Ministry in the capital sector of La Zurza, where the first cases of cholera have appeared in the country.

KEYS

Cases and tests

The Ministry of Public Health reported that eight cases had been confirmed in the Dominican Republic, and six others are awaiting results. It explains that since the cholera cases appeared in Haiti, more than 3,000 tests have been carried out in the country to detect the disease.

Prevention

To combat the disease, the authorities continue to intensify preventive measures through water chlorination, monitoring in schools where toilets and pipes are being repaired, installing new water tanks, creating wells for drinking water supply, and cleaning rivers.

2 years 3 months ago

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Medical Bulletin 24/December/2022

Here are the top medical news for the day:Unique set of attributes linked to healthy, optimal aging identifiedAging is a complex interplay of biological, behavioral, environmental, and social changes However, some studies have often missed or overlooked the influence of the dynamic roles of individual and environmental factors.

A recent study published in the International Journal of Environmental Research and Public Health challenged prior definitions of healthy or successful aging by adopting a broader perspective. The researchers Mabel Ho et al, observed older adults in Canada and identified unique attributes among people who age optimally. They also assessed how well people age despite any chronic illnesses that may develop as they grow older.

Reference:

Ho, M.; Pullenayegum, E.; Burnes, D.; Fuller-Thomson, E. Successful Aging among Immigrant and Canadian-Born Older Adults: Findings from the Canadian Longitudinal Study on Aging (CLSA). Int. J. Environ. Res. Public Health 2022, 19, 13199. https://doi.org/10.3390/ijerph192013199

Older adults who walked up to 9000 steps had healthier hearts: Study

Findings from the latest study led by Amanda Paluch, assistant professor of kinesiology in the School of Public Health and Health Sciences, show that older adults who walked between 6,000 and 9,000 steps per day had a 40-50% reduced risk of a cardiovascular event, such as a heart attack or stroke, compared to those who walked 2,000 steps per day.

The evidence-based health benefits of walking continue to accumulate, according to ongoing research by a University of Massachusetts Amherst physical activity epidemiologist, who leads an international consortium known as the Steps for Health Collaborative.

Reference:

Amanda Paluch et al, Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis, Circulation, DOI 10.1161/CIRCULATIONAHA.122.061288

Mystery behind a deadly brain cancer cracked by CHSL researchers

Glioblastomas, also known as GBMs, are grade 4 malignant (cancerous) tumours in which a sizable percentage of tumour cells are actively dividing and reproducing at any given time. They are fed by a plentiful and unusual blood supply from tumour vessels.

The brain cancer, glioblastoma, is a fierce and formidable opponent. Its millions of victims include Senator John McCain, President Biden's son, Beau, and famed film critic Gene Siskel, to name just a few. Most patients succumb within two years and few make it past five, a statistic that hasn't improved in decades due to lack of effective treatment options.

Reference:

Alea Mills et al,BRD8 maintains glioblastoma by epigenetic reprogramming of the P53 network,Nature,DOI:10.1038/s41586-022-05551-x

Smoking heightens the likelihood of having mid-life memory loss, confusion, finds study

The self-reported experience of greater or more frequent confusion or memory loss is known as subjective cognitive decline (SCD). One of the first obvious signs of Alzheimer's disease and other dementias is this type of cognitive impairment.

Middle-aged smokers are far more likely to report having memory loss and confusion than nonsmokers, and the likelihood of cognitive decline is lower for those who have quit, even recently, a new study has found.

Reference:

Jenna Rajczyk et al,Journal of Alzheimer s Disease,DOI10.3233/JAD-220501

2 years 3 months ago

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Smoking heightens the likelihood of having mid-life memory loss, confusion, finds study

The self-reported experience of greater or
more frequent confusion or memory loss is known as subjective cognitive decline
(SCD). One of the first obvious signs of
Alzheimer's disease and other dementias is this type of cognitive impairment.

The self-reported experience of greater or
more frequent confusion or memory loss is known as subjective cognitive decline
(SCD). One of the first obvious signs of
Alzheimer's disease and other dementias is this type of cognitive impairment.

Middle-aged smokers are far more likely to
report having memory loss and confusion than nonsmokers, and the likelihood of
cognitive decline is lower for those who have quit, even recently, a new study
has found.

The research from The Ohio State University is
the first to examine the relationship between smoking and cognitive decline
using a one-question self-assessment asking people if they've experienced
worsening or more frequent memory loss and/or confusion.

The findings build on previous research that
established relationships between smoking and Alzheimer's Disease and other
forms of dementia, and could point to an opportunity to identify signs of
trouble earlier in life, said Jenna Rajczyk, lead author of the study, which
appears in the Journal of Alzheimer's Disease.

It's also one more piece of evidence that
quitting smoking is good not just for respiratory and cardiovascular reasons –
but to preserve neurological health, said Rajczyk, a PhD student in Ohio
State's College of Public Health, and senior author Jeffrey Wing, assistant
professor of epidemiology.

"The association we saw was most significant
in the 45-59 age group, suggesting that quitting at that stage of life may have
a benefit for cognitive health," Wing said. A similar difference wasn't found
in the oldest group in the study, which could mean that quitting earlier
affords people greater benefits, he said.

Data for the study came from the national 2019
Behavioral Risk Factor Surveillance System

Survey and allowed the research team to
compare subjective cognitive decline (SCD) measures for current smokers, recent
former smokers, and those who had quit years earlier. The analysis included
136,018 people 45 and older, and about 11% reported SCD.

The prevalence of SCD among smokers in the
study was almost 1.9 times that of nonsmokers. The prevalence among those who
had quit less than 10 years ago was 1.5 times that of nonsmokers. Those who
quit more than a decade before the survey had an SCD prevalence just slightly
above the nonsmoking group.

"These findings could imply that the time
since smoking cessation does matter, and may be linked to cognitive outcomes,"
Rajczyk said.

The simplicity of SCD, a relatively new
measure, could lend itself to wider applications, she said.

"This is a simple assessment that could be
easily done routinely, and at younger ages than we typically start to see
cognitive declines that rise to the level of a diagnosis of Alzheimer's Disease
or dementia," Rajczyk said. "It's not an intensive battery of questions. It's
more a personal reflection of your cognitive status to determine if you're
feeling like you're not as sharp as you once were."

Many people don't have access to more in-depth
screenings, or to specialists – making the potential applications for measuring
SCD even greater, she said.

Wing said it's important to note that these
self-reported experiences don't amount to a diagnosis, nor do they confirm
independently that a person is experiencing decline out of the normal aging
process. But, he said, they could be a low-cost, simple tool to consider
employing more broadly.

Reference:

Jenna
Rajczyk et al,Journal of Alzheimer s Disease,DOI10.3233/JAD-220501

2 years 3 months ago

Neurology and Neurosurgery,Pulmonology,Neurology & Neurosurgery News,Pulmonology News,Top Medical News,MDTV,Neurology and Neurosurgery MDTV,Pulmonology MDTV,MD shorts MDTV,Neurology & Neurosurgery Shorts,Pulmonology Shorts,Channels - Medical Dialogues,Lat

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Patent infringement: Roche loses US appeal in Sandoz lung disease drug case

US: Roche's Genentech Inc failed to prove that a proposed Sandoz Inc generic of its blockbuster lung-disease drug Esbriet would infringe its patents, a U.S. appeals court affirmed Thursday.

The U.S. Court of Appeals for the Federal Circuit upheld a decision rejecting Genentech's bid to block the generic idiopathic pulmonary fibrosis (IPF) drug.

The Federal Circuit said Sandoz's drug would not infringe Genentech patents related to methods for managing side effects while using Esbriet. Other patents Genentech accused Sandoz of infringing were invalid, the appeals court said.

Representatives for both Genentech and Sandoz declined to comment, citing ongoing litigation.

San Francisco-based Genentech's Esbriet is used to treat IPF, a serious chronic lung disease. Roche earned over $1 billion last year from worldwide Esbriet sales.

Genentech sued Switzerland-based Sandoz and several other drugmakers, including Amneal Pharmaceuticals Inc and Teva Pharmaceutical Industries Ltd, for patent infringement in 2019 over their proposed Esbriet generics. Sandoz defeated Genentech's lawsuit against it in Delaware federal court in March and launched its generic in May.

Read also: Roche, Chugai Pharma to transfer Bonviva business in Japan to Taisho Pharma

The Federal Circuit agreed with the district court that Sandoz's generic would not infringe patents covering ways to avoid adverse interactions between Esbriet and another drug. It also upheld the decision that some of Genentech's patents were invalid.

"Varying doses in response to the occurrence of side effects would seem to be a well-established, hence obvious, practice," the appeals court said. "Thus, claiming it as an invention would appear to be at best a long shot."

Read also: Submit Phase IV CT protocol: CDSCO Panel tells Roche over Anti-Cancer drug Pralsetinib

The case is Genentech Inc v. Sandoz Inc, U.S. Court of Appeals for the Federal Circuit, No. 22-1595.

For Genentech: Daralyn Durie of Durie Tangri

For Sandoz: William Jay of Goodwin Procter

Read also: Roche Actemra gets USFDA okay to treat COVID in hospitalised adults

2 years 3 months ago

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Health | NOW Grenada

Top Hill Senior Citizens Home receives much-needed items

Hon. Tevin Andrews handed over donations from the Desk of the Elderly gifted by the Catholic Church to the Top Hill Senior Citizens Home

View the full post Top Hill Senior Citizens Home receives much-needed items on NOW Grenada.

Hon. Tevin Andrews handed over donations from the Desk of the Elderly gifted by the Catholic Church to the Top Hill Senior Citizens Home

View the full post Top Hill Senior Citizens Home receives much-needed items on NOW Grenada.

2 years 3 months ago

Carriacou & Petite Martinique, Health, PRESS RELEASE, catholic church, classique lighting, clavia mclean, desk of the elderly, ministry of carriacou and petite martinique affairs, tevin andrews, top-hill senior citizens home

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DrNB Cardiology: Admissions, Medical Colleges, Fees, Eligibility Criteria details here

DrNB Cardiology or Doctorate of National Board in Cardiology also known as DrNB in 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 superspecialty course is 3 years, and it focuses on the prevention and treatment of heart diseases.

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-Bhubaneshwar, Army Hospital (R and R)-New Delhi, B.M. Birla Heart Research Centre- Kolkata,and more

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

The fee for pursuing DrNB (Cardiology) varies from accredited institutes/hospital to hospital and may range from Rs. 50,000 to Rs. 10,00,000 per year.

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

DNB is equivalent to MD/MS/DM/MCh degrees awarded respectively in medical and surgical super specialities. The list of recognised 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-speciality qualifications and super speciality qualifications when granted in a medical institution with attached hospital or in 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-speciality 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 the purposes of teaching also.

What is DrNB in Cardiology?

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

Cardiology is the branch of medical science dealing with the prevention and treatment of heart diseases.

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

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

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

The 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 Cardiology would help the specialist to recognize the health needs of the community. The students should be competent to handle medical problems effectively and should be aware of the recent advances in their speciality.

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 Cardiology

Name of Course

DrNB in Cardiology

Level

Doctorate

Duration of Course

Three years

Course Mode

Full Time

Minimum Academic Requirement

MD/DNB (General Medicine/Paediatrics/Respiratory Medicine) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE

Admission Process / Entrance Process / Entrance Modalities

Entrance Exam (NEET-SS)

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

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

Course Fees

Rs. 50,000 to Rs. 10,00,000 per year

Average Salary

Rs. 6,00,000 to Rs. 30,00,000 per year

Eligibility Criteria

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

  • Candidates must be in possession of a postgraduate medical Degree (MD/MS/DNB) from any college/university recognized by the MCI (Now NMC)/NBE.

•The eligible feeder specialty qualification for DrNB in Cardiology is mentioned below

Name of Super Specialty course Course Type Prior Eligibility Requirement Cardiology DM/DrNB MD/DNB (General Medicine) MD/DNB (Paediatrics) MD/DNB (Respiratory Medicine)

•The prior entry qualifications shall be strictly in accordance with 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 of 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 tobe followed in order by the candidates for admission to DrNB in Cardiology. Candidates can view the complete admissionprocess for DrNB in Cardiologymentioned below:

  • The NEET-SS orNational Eligibility Entrance Test for Super specialty courses is anational-level master's level examination conducted by the NBE for admission toDM/MCh/DrNB Courses.
  • Qualifying Criteria-Candidates placed at the50th percentile or above shall be declared as qualified in the NEET-SS in theirrespective specialty.
  • The following Medical institutions are notcovered 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 specialtysubjects shall be required to appear in the question paper of respective group,if they are willing to opt for a superspecialty course in any of the superspecialty courses covered in that group.
  • A candidate can opt for appearing in thequestion papers of as many groups for which his/her Postgraduate specialtyqualification is an eligible feeder qualification.
  • By appearing in the question paper of a groupand on qualifying the examination, a candidate shall be eligible to exercisehis/her choices in the counseling only for those superspecialty subjectscovered in said group for which his/ her broad specialty is an eligible feederqualification.

Fees Structure

The fee structure for DrNB in Cardiology varies from accredited institute/hospital to hospital. The fee isgenerally less for Government Institutes and more for private institutes. The average fee structure for DrNB in Cardiology is around Rs.50,000 to Rs. 10,00,000 per year.

Colleges offering DrNB in Cardiology

There are various accredited institutes/hospitals across India thatoffer courses for pursuing DrNB in Cardiology.

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

Hospital/Institute

Specialty

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

AIG Hospital Mind Space Road, Gachibowli, Hyderabad Telangana-500032

Cardiology

3

Amandeep Hospital Dalhousie Road, Mamun Cantt, Pathankot Punjab-145001

Cardiology

1

Apex Heart Institute Block: G-L, Mondeal Business Park, Near Gurudwara, S. G. Highway, Ahmedabad Gujarat-380059

Cardiology

2

Apollo BGS Hospital Adichunchanagiri Road, Kuvempunagar, Mysore Karnataka-570023

Cardiology

1

Apollo Hospital 154/11, Opp. I.I.M., Bannerghatta Road, Bangalore Karnataka-560076

Cardiology

3

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

Cardiology

6

Apollo Hospital Health City, Chinagdhili, Visakhapatnam Andhra Pradesh-530040

Cardiology

3

Apollo Hospital Parsik Hill Road, Plot no 13, Sector 23,CBD Belapur, Navi Mumbai Maharashtra-400614

Cardiology

2

Apollo Hospital Plot No. 251 Sainik School Road Unit-15, Bhubaneshwar Orissa-751005

Cardiology

2

Apollo Hospital Room No. 306, Office of the Director of Medical Education Jubilee Hills, Hyderabad Telangana-500033

Cardiology

3

Apollo Hospital Village Lingiadih, Seepat Road, Bilaspur Chhattisgarh-495006

Cardiology

1

Apollo Hospital International Plot No. 1A, GIDC Estate Bhat, District - Gandhi Nagar Gujarat-382428

Cardiology

2

Apollo Multispecialty Hospitals Limited 58, Canal Circular Road, Kolkata West Bengal-700054

Cardiology

5

Apollo Specialty Hospital No. 64, Vanagaram Ambattur Main Road, Off PH Road, Near Srivaru Kalyanamandapan, Ayanambakkam Tamil Nadu-600095

Cardiology

2

Apollomedics Superspeciality Hospital Sector B, Bargawan, LDA Colony , Lucknow Uttar Pradesh Uttar Pradesh-226012

Cardiology

1

Apple Saraswati Multispecialty Hospital (Apple Hospitals and Research Institute Ltd.) 804/2, 805/2, E Ward, Bhosalewadi, Kadamwadi Road, Kolhapur Maharashtra-416003

Cardiology

2

Army Hospital (R and R) Delhi Cantt, New Delhi Delhi-110010

Cardiology

2

Artemis Health Institute Sector 51, Gurgaon Haryana-122001

Cardiology

1

Asian Heart Institute and Research Centre G/N Block, Bandra Kurla Complex, Bandra East, Mumbai Maharashtra-400051

Cardiology

2

Asian Institute of Medical Sciences Sector 21-A, Badhkal Flyover Road, Faridabad Haryana-121001

Cardiology

2

Aster Medcity Kuttisahib Road, Near Kothad Bridge, South Chittoor P. O., Cheranalloor, Kochi Kerala-682027

Cardiology

1

Aster Prime Hospital (A Unit of Sri Sainatha Multi Specialty Hospital) Plot No. 2 and 4, Behind Mitrivanam Building, Ameerpet, Hyderabad Telangana Telangana-500038

Cardiology

2

B.M. Birla Heart Research Centre 1/1 National Library Avenue, KOLKATA West Bengal-27

Cardiology

1

Baderia Metro Prime Multispecialty Hospital (Formerly Metro Hospital and Cancer Research Centre) Kuchaini Parisar, Damoh Naka, Jabalpur Madhya Pradesh-482002

Cardiology

1

Bankers Heart Institute Near Tagore Nagar, Opp. Suryakiran Complex, Old Padra Road, Vadodara Gujarat-390015

Cardiology

2

Bansal Hospital C Sector, Shahpura Bhopal Madhya Pradesh-462016

Cardiology

1

Batra Hospital and Medical Research Centre 1, Tuglakabad Institutional Area, M.B. Road, Delhi-110062

Cardiology

2

Believers Church Medical College Hospital St. Thomas Nagar, Kuttapuzha P O, Thiruvalla Kerala-689103

Cardiology

2

BGS Global Hospital 67, Uttrahalli Road, Kengeri, Bangalore Karnataka-560060

Cardiology

1

Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital Sangli Miraj Road Sangli Maharashtra-416416

Cardiology

1

Capitol Hospital C/O Capitol Hospital Jalandhar Pathankot Road Nh 44 Near Reru Chowk Jal Punjab-144001

Cardiology

1

Care Hospital Exhibition Road, Nampally, Hyderabad Telangana-500001

Cardiology

3

Care Hospital Road No. 1, Banjara Hills, Hyderabad Telangana-500034

Cardiology

4

Care Hospital- Hi Tech City Old Mumbai Highway, Near Cyberbad Police Commisionerate, Gachibowli,Hyderabad, Telangana-500032

Cardiology

1

Caritas Hospital Thellakom P. O Kottayam Kerala-686630

Cardiology

2

CHL Hospital A.B Road, LIG Square, Indore Madhya Pradesh-452008

Cardiology

1

Continental Hospital Plot No. 3, Road No. 2, IT and Financial District, Nanakramguda, Gachibowli, Hyderabad Telangana-500032

Cardiology

2

Deenanath Mangeshkar Hospital and Research Centre. 8+13/2, Erandwane, Near Mhatre Bridge, Pune Maharashtra-411004

Cardiology

2

Delhi Heart and Lung Institute 3 MM, II, Panchkuian Road, Delhi-110055

Cardiology

2

Down Town Hospital G S Road, Dispur GUWAHATI Assam-781006

Cardiology

1

Dr. B L Kapur Memorial Hospital Pusa Road, New Delhi Delhi-110005

Cardiology

1

Dr. B. Nanavati Hospital Vivekanand Rd., Vile Parle West, Mumbai Maharashtra-400056

Cardiology

1

Dr. L H Hiranandani Hospital Hillside Avenue, Hiranandani Gardens, Powai, Mumbai Maharashtra-400076

Cardiology

2

Dr. Rajendra Prasad Govt. Medical College Dist. Kangra At Tanda, Himachal Pradesh-176002

Cardiology

2

Dr. Ramesh Cardiac and Multi Speciality Hospital D. no. 26-14-1, Nagarampalem Collector Office Road. Guntur Andhra Pradesh-522004

Cardiology

1

Dr. Ramesh Cardiac and Multispeciality Hospital (Formerly Citi Cardiac Research Centre Ltd.) Ring Road, Near ITI College, Vijayawada Andhra Pradesh-52008

Cardiology

3

Eternal Heart Care Centre and Research Institute 3-A, jagatpura Road, Near Jawahar Circle, Jaipur Rajasthan-302017

Cardiology

2

Fortis Escorts Heart Institute Okhla Road, New Delhi Delhi-110025

Cardiology

7

Fortis Hospital 14, Cunningham Road, Bangalore Karnataka-0

Cardiology

2

Fortis Hospital 154/9, Opp. IIMB Bannerghatta Road, Bangalore Karnataka-560076

Cardiology

2

Fortis Hospital A- Block, Shalimar Bagh Delhi-110088

Cardiology

2

Fortis Hospital Mulund Goregaon Link Road, Mumbai Maharashtra-400078

Cardiology

1

Fortis Hospital Sector-62, Phase-VIII, Mohali Punjab-160062

Cardiology

3

Fortis Hospital, 730, Anandapur, EM Bypass Road, Kolkata West Bengal-700010

Cardiology

1

Fortis Memorial Research Institute Sector-44, Opposite HUDA CITY centre Metro Station, Gurgaon, Haryana-122002

Cardiology

1

Frontier Lifeline Hospital International Centre for Cardio Thoracic and Vascular Diseases, R-30-C, Ambattur Industrial Estate Road, Mogappair, Chennai Tamil Nadu-600101

Cardiology

2

G Kuppuswamy Naidu Memorial Hospital Post Box No. 6327, Nethaji Road, Pappanaickenpalayam, Coimbatore Tamil Nadu-641037

Cardiology

6

Global Hospital and Health City (A unit of Ravindernath GE Medical Associate Pvt Ltd) No-439, Cheran Nagar, Perumbakkam, Chennai Tamil Nadu-600100

Cardiology

1

Government General Hospital Ernakulam Road, Cochin Kerala-682011

Cardiology

2

Government Medical College Karan- Nagar, Srinagar Jammu and Kashmir-190010

Cardiology

2

Govt. Medical College B-5, Medical Enclave, Jammu Jammu and Kashmir-180001

Cardiology

2

Grecian Super Speciality Hospital (A unit of R.G.S Healthcare Pvt. Ltd), Sector-69, Opp. Village Kumbra, S.A.S Nagar, Mohali Punjab-60062

Cardiology

2

HCG Hospital, 1, Maharastra Society, Mithakhali, Ellisbridge Ahmedabad Gujarat-380006

Cardiology

2

Heart and General Hospital 7, Vivekanand Marg, C- Scheme, Jaipur Rajasthan-302001

Cardiology

1

Holy Family Hospital St. Andrew`s Road, Bandra West, Mumbai Maharashtra-400050

Cardiology

2

Holy Heart Super Speciality and Trauma Centre 330, Vinay Nagar, Delhi Bypass Chowk, Rohtak Haryana-124001

Cardiology

1

Indiana hospital and Heart Institute Near Mahaveer Circle, Pumpwell, Kankanady, Manglore Karnataka-575002

Cardiology

1

Indira Gandhi Institute of Cardiology PMCH Campus, Ashok Raj Path, Patna Bihar-800004

Cardiology

2

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

Cardiology

2

Ivy Health and Life Sciences Sector 71 SAS Nagar Mohali, Punjab-160071

Cardiology

2

Jagjivan Ram Railway Hospital Maratha Mandir Road, Mumbai Central, Mumbai Maharashtra-400008

Cardiology

1

Janakpuri Super Speciality Hospital Society (An Autonomous Institute) Under Govt. of NCT of Delhi C-2B, Janakpuri, West Delhi, Delhi-110058

Cardiology

2

Jaslok Hospital and Research Centre 15, Dr. Gopalrao Deshmukh Marg, Mumbai Maharashtra-400026

Cardiology

1

Jehangir Hospital 32, Sassoon Road, Pune Maharashtra-411001

Cardiology

1

Jupiter Hospital Eastern Express Highway, Thane (West) Maharashtra-400601

Cardiology

1

K.G. Hospital and PG Medical Institute No.5, Arts College Rd, COIMBATORE Tamil Nadu-641018

Cardiology

1

Kamalnayan Bajaj Hospital (Marathwada Medical and Research Institutes) Gut No. 43, Beed Bypass Road, Satara Parisar, Aurangabad Maharashtra-431005

Cardiology

1

Kasturba Medical College Hospital (KMC Hospital) Dr. B R Ambedkar Circle, Jyothi Balmatta Road, Mangalore Karnataka-575001

Cardiology

4

Kauvery Hospital No. 199, Luz Church Road, Mylapore, Chennai Tamil Nadu-600004

Cardiology

1

Kauvery Hospital Heart City Old No. 12, New No.52 Alexandria Road Cantonment Trichy Tamil Nadu-620001

Cardiology

2

Kerala Institute of Medical Sciences P B No.1, Anayara P O, Trivandrum Kerala-695029

Cardiology

2

KIMS Hospital # 1-112/86, Survey No 55/ EE, Kondapur Village, Serilingampally Mandal, Hyderabad Telangana-500084

Cardiology

1

KIMS Icon Hospital (A Unit of Iconkrishi Institute of Medical Sciences Pvt.Ltd) 32-11-02, BHPV Post, Sheelanagar, Visakhapatnam Andhra Pradesh-53001

Cardiology

1

KIMS Saveera Hospital #1-1348,Srinagar Colony Extention,Opp Sakshi Office,Anantapuram Andhra Pradesh-515004

Cardiology

1

Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Achyutrao Patwardhan Marg, 4 Bunglows, Andheri (W), Mumbai Maharashtra-400053

Cardiology

1

Kovai Medical Centre Post Box No. 3209, Avinashi Road, Civil Arodrom Post, COIMBATORE Tamil Nadu-641014

Cardiology

2

Krishna Institute of Medical Sciences 1-8-31/1, Minister Road, Secunderabad Telangana-500003

Cardiology

3

Krishna Institute of Medical Sciences 77-7-7, Seelam Nukaraju Complex Road, Katari Gadens, Rajahmundry Andhra Pradesh-533103

Cardiology

1

Krishna Institute of Medical Sciences Ltd Dargamitta, Nellore Andhra Pradesh-524003

Cardiology

1

Lalitha Super Specialty Hospital Kothapet, Guntur Andhra Pradesh-522001

Cardiology

2

Lilavati Hospital and Research Centre A-791, Bandra Reclaimation, Bandra West, Mumbai Maharashtra-400050

Cardiology

3

Lisie Medical Institution P.O. Box 3053, KOCHI-18 Kerala Kerala-682018

Cardiology

3

M.I.O.T. Hospital 4/112, Mt-Poonamallee Rd, Nanapakkam, CHENNAI Tamil Nadu-600089

Cardiology

1

Madras Medical Mission Hospital 4A Dr Jayalalitha Ngr, Mogappair CHENNAI Tamil Nadu-600037

Cardiology

4

Maharaja Agrasen Hospital Rohtak Road, West Punjabi Bagh New Delhi Delhi-110026

Cardiology

2

Malabar Institute of Medical Sciences Mini Bye Pass, Govindapuram, Calicut Kerala-673016

Cardiology

2

MALABAR INSTITUTE OF MEDICAL SCIENCES Ltd CHALA EAST, KANNUR Kerala-670621

Cardiology

2

Manipal Hospital No. 98, Rustum Bagh, Old Airport Road, Bangalore Karnataka-560017

Cardiology

2

Max Smart Super Specialty Hospital (Formerly Known as Saket City Hospital), Mandir Marg, Press Enclave Marg, Saket, Delhi-110017

Cardiology

1

Max Super Specialty Hospital (A unit of Balaji Medical and Diagnostic Research Centre) 108A, Opp Sanchar Apartments, IP Extension, Patparganj,New Delhi Delhi-110092

Cardiology

2

Max Super Specialty Hospital 1,2, Press Enclave Road, Saket, Delhi-110017

Cardiology

5

Medanta The Medicity Sector-38, Gurgaon Haryana-122001

Cardiology

3

Medica Superspecialty Hospital 127 Mukundapur, E M Bypass, Kolkata West Bengal-700099

Cardiology

2

Medicover Hospitals (Formerly MaxCure Hospital) Behind Cyber Tower, Lane next to McDonald, Hi-tech City, Madhapur, Hyderabad Telangana-500081

Cardiology

2

Medicover Hospitals MVP 1-1-83, NH16, Beside Petrol Bunk, Sector- 6, Venkojipalem, Visakhapatnam Andhra Pradesh-530017

Cardiology

3

Meenakshi Mission Hospital and Research Centre Lake Area, Melur Road, MADURAI Tamil Nadu-625107

Cardiology

1

N M Virani Wockhardt Hospital Kalawad Road, Rajkot Gujarat-360005

Cardiology

1

Narayana Hrudayalaya Monogram Mill Compound Opp. Rakhial Police Station, Rakhial Gujarat-380023

Cardiology

2

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

Cardiology

8

Narayana Hrudayalaya Surgical Hospital CAH 1, 3rd Phase, Devanur, Mysuru Karnataka-570019

Cardiology

2

Narayana Multispecialty Hospital Sec-28, Rana Sanga Marg, Pratap Nagar, Jaipur Rajasthan-302033

Cardiology

2

National Heart Institute 49 Community Centre, East of Kailash, New Delhi Delhi-110065

Cardiology

3

NIMS Medicity Noorul Islam Institute of Medical Sciences and Research Foundation Aralummoodu, Neyyattinkara, Trivandrum Kerala-695123

Cardiology

2

P.D. Hinduja National Hospital and Medical Research Centre Veer Savarkar Marg, Mahim, Mumbai Maharashtra-400016

Cardiology

1

Paras HMRI Hospital NH - 30, Raja Bazar, Bailey Road, Patna Bihar-800014

Cardiology

2

Peerless Hospital and B K Roy Research Centre 360, Panchasayar, KOLKATA West Bengal-700094

Cardiology

1

Polakulath Narayanan Renai Medicity Multi Super Specialty Hospital PB No. 2259, Palarivattom (PO), Cochin Kerala-682025

Cardiology

1

PRS Hospital Tc 21/53 Killippalam Karamana Trivandrum Kerala-695002

Cardiology

1

Pushpawati Singhania Hospital Press Enclave, Sheikh Sarai Ph-II, Delhi-110017

Cardiology

1

Quality Care India Limited (Care Hospital) (Formerly Visakha Hospital and Diagnostics (Care Hospital)) A.S. Raja Complex, Door No: 10-50-11/5, Waltair Main Road, Ramnagar, Visakhapatnam Andhra Pradesh-530002

Cardiology

2

Rabindranath Tagore International Institute of Cardiac Sciences Premises No.1489, 124, Mukundapur, E M Bypass, Near Santhoshpur Connector, KOLKATA West Bengal-700099

Cardiology

4

Rajiv Gandhi Super Speciality Hospital Tahirpur, Delhi-110093

Cardiology

1

Ramkrishna Care Hospital Aurobindo Enclave, Pachpedhi Naka, Dhamtari Road, N. H. 43, Raipur Chhattisgarh-492001

Cardiology

1

Rhythm Heart Institute Near Siddharth Buglows, SAMA-SAVLI Road, Vadodara Gujarat-390022

Cardiology

1

Ruby Hall Clinic 40 Sassoon Road Pune Maharashtra-411001

Cardiology

2

Sahyadri Narayana Multispecialty Hospital Harakere, N T Road, Shimoga Karnataka-577202

Cardiology

2

Saideep Healthcare and Research Pvt Ltd Viraj Estate, Yashwant Colony, Tarakpur Ahmednagar Maharashtra-414003

Cardiology

1

Sakra World Hospital (A Unit of Takshasila Hospitals Operating Private Limited) No. 52/2, 52/3, Devarabeesanahalli, Varthur Hobli, Bangalore Karnataka-560103

Cardiology

1

Santokbha Durlabhji Memorial Hospital Cum Medical Research Institute Bhawani Singh Marg, JAIPUR Rajasthan-302015

Cardiology

1

Sarvodaya Hospital and Research Centre YMCA Road, Sector-08, Faridabad Haryana-121006

Cardiology

2

Shree Mahavir Health and Medical Relief Society Hospital (Smt. R B Shah Mahavir Super Specialty Hospital and Shri B D Mehta Mahavir Heart Institute) Shree Mahavir Health Campus, Athwagate, Ring Road, Surat Gujarat-395001

Cardiology

1

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

Cardiology

4

Sir Hurkisondas Nurrotumdas Hospital and Research Centre Raja Ram Mohan Roy Road, Gordhan Bapa Chowk, Prathana Samaj, Mumbai Maharashtra-40004

Cardiology

1

Sky Hospital and Research Centre RIMS Road District Imphal-west Manipur-795004

Cardiology

1

Southern Railway Head Quarter Hospital Aynavaram, Perumbur, CHENNAI Tamil Nadu-600023

Cardiology

2

Sparsh Super Specialty Hospital #4/1, Tumkur Road, Yeshwanthpur, Bangalore Karnataka-560022

Cardiology

1

Sri Ramakrishna Hospital 395, Sarojini Naidu Road, Sidhapudur, COIMBATORE Tamil Nadu-641044

Cardiology

2

Sri Sathya Sai Institute of Higher Medical Sciences Prasantha Gram, ANANTHPUR Andhra Pradesh-515134

Cardiology

2

Sri Sathya Sai Instt. of Higher Medical Sciences EPIP Area, Whitefield, Bangalore Karnataka-560066

Cardiology

2

Sri Sri Holistic Hospital #1-2-49/13b, Nizampet Road, Hydernagar, Kukatpally, Medchal, Telangana-500072

Cardiology

1

SRM Institutes for Medical Sciences No. 1, Jawaharlal Nehru Salai, 100 ft Road, Vadapalani, Chennai Tamil Nadu-600026

Cardiology

1

Star Hospital 8-2-596/5, RD. NO-10, Banjara Hills, Hyderabad Telangana-500034

Cardiology

3

Star Pinnacle Heart Center 10-11-12,Apiic Health City Chinagadili,Visakhapatnam Andhra Pradesh-530040

Cardiology

2

Sterling Hospital Plot No. 251, 150 ft Ring Road, Near Raiya Circle. Nanavati Chowk, Rajkot Gujarat-360005

Cardiology

1

SunShine Hospital 1-7-201 to 205 PG Road, Beside Paradise Hotel, Secunderabad Telangana-3

Cardiology

2

Tamil Nadu Government Multi Superspeciality Hospital Anna Salai,Chennai Tamil Nadu-600007

Cardiology

2

The Gujarat Research and Medical Institute (Rajasthan Hospitals) Camp Road, Shahibag, Ahmedabad Gujarat-380004

Cardiology

1

Tirumala Hospital Lower Tank Bund Road, Opp. R T C Complex, Vizianagaram Andhra Pradesh-535003

Cardiology

1

Tricolour Hospital Dr.Vikram Sarabhai Road,Near Genda Circle, Wadi Vadi, Vadodara Gujarat-390007

Cardiology

1

Tristar Hospital Nanpura, Athwagate, Surat Gujarat-395001

Cardiology

1

Vijaya Hospital New No. 434, Old No. 180, N S K Salai, Vadapalani, CHENNAI Tamil Nadu-600026

Cardiology

2

Virinchi Hospital Door No. 6-3-2,3 and 3/1 Road No 1, Banjara Hills, Virinchi Circle, Hyderabad Telangana-500034

Cardiology

2

Yashoda Hospital Behind Hari Hara Kala Bhawan, S.P. Road, Secunderabad Telangana-500003

Cardiology

2

Yashoda Super Speciality Hospital Nalgonda X Road, Malakpet, Hyderabad Telangana-500036

Cardiology

1

Yashoda Super Speciality Hospital Raj Bhavan Road, Somajiguda, Hyderabad Telangana-500082

Cardiology

2

Zydus Hospital Near Sola Bridge, S G Highway, Ahmedabad Gujarat-380054

Cardiology

2

Syllabus

A DrNBin Cardiology is a three years specialization course that providestraining in the stream of Cardiology.

The coursecontent for DrNB in Cardiology is given in the NBE Curriculum releasedby the National Board of Examinations, which can be assessed through the linkmentioned below:

DrNB Cardiology In India: Check Out NBE Released Curriculum

1. Fundamentals of Cardiovascular Disease

i. Global Burden of Cardiovascular Disease,

ii. Heart Disease in Varied Populations,

iii. Economics and Cardiovascular Disease,

iv. Clinical Decision-Making in Cardiology,

v. Measurement and Improvement of Quality of Cardiovascular Care,

vi. The Principles of Drug Therapy

2. Molecular Biology

i. The Cardiovascular History and Physical Examination the Electrocardiogram

ii. Choice of imaging technique Cardiac Ultra sound

iii. Cardiovascular Magnetic Resonance Cardiovascular Computed Tomography Nuclear Cardiology

3. Evaluation of the Patient

i. The History and Physical Examination:

ii. An Evidence-Based Approach,

iii. Electrocardiography

iv. Exercise Stress Testing, Echocardiography,

v. Genetics of Myocardial Disease, Genetics of Myocardial Disease,

vi. The Chest Radiograph in Cardiovascular Disease,

vii. Nuclear Cardiology,

viii. Cardiovascular Magnetic Resonance,

ix. Computed Tomography of the Heart,

x. Cardiac Catheterization,

xi. Coronary Angiography and

xii. Intravascular Ultrasound Imaging.

4. Preventive Cardiology

i. The Vascular Biology of Atherosclerosis,

ii. Risk Factors for Atherothrombotic Disease,

iii. Systemic Hypertension: Mechanisms and Diagnosis,

iv. Systemic Hypertension:

v. Therapy

vi. Lipoprotein Disorders and Cardiovascular Disease,

vii. The Metabolic Syndrome, Diabetes Mellitus, and Atherosclerotic Vascular Disease,

viii. Nutrition and Cardiovascular Disease,

ix. Primary and Secondary Prevention of Coronary Heart Disease,

x. Comprehensive Rehabilitation of Patients with Cardiovascular Disease,

xi. Complementary and Alternative Approaches to Management.

5. Basic Sciences related to Cardiology Cardiac Anatomy

i. The cardiac anatomy with special emphasis

ii. Development of heart and blood vessels,

iii. Foetal circulation and its changes in post-natal life;

iv. Coronary circulation

v. Venous drainage of heart; the heart and pericardium and its relation to neighbouring structures; anatomy of cardiac chambers and valves;

vi. Arteries and veins; histology of heart and blood vessels.

vii. Functional anatomy of the heart,

viii. Orientation of the heart within the Thorax,

ix. Methods used to study cardiac anatomy, correlative anatomy,

x. New developments and future challenges,

xi. Quantum computing, Ultrastructure of the heart,

xii. Cardiac Embryology and Histology.

6. Cardiac Physiology

Cardiac Physiology will cover all the physiological changes in the heart during its normal function with special reference to cardiac cycle; myocardial contractility; pressure changes in the cardiac chambers; cardiac output; factors controlling blood flow; regulation of cardiac function; cardiac reflexes; coronary blood flow; exercise physiology; physiology of blood pressure regulation; normal influence on cardiovascular system; preload; after-load; assessment ofventricular function; regulation of cardiac contraction; action potentials; the cellular basis of cardiac contraction, Integration of the cardiovascular system the response to dynamic exercise, etc.

7. Cardiac Molecular Biology

i. Principles of molecular biology including Gene Structure,

ii. Expression and regulation;

iii. Recombinant DNA Technology; PCR Techniques,

iv. Molecular basis for cellular growth,

v. Molecular and cellular bilology of the normal, hypertrohied and failing heart including cardiac growth and hypertrophy

vi. Molecular and Cellular biology of the blood vessels including endothelial cell vascular smooth muscle interactions, atherosclerosis etc,

vii. The Human Genome and its future implications for cardiology including bioethical implications and genetic counselling,

viii. Cardiovascular Tissue modification by genetic approaches including Gene Transfer etc, Molecular Development of the heart including anomalies.

8. Cardiac Biochemistry

All aspects of normal and abnormal patterns of cardiac biochemistry including cardiac enzymes; lipid profile, cardiac metabolism, electrolytes and their effect on cardiac function etc.

9. Cardiac Pharmacology

All the drugs used in the treatment of cardiac disorders inclusive of antianginal agents like

i. Beta-blocking agents,

ii. Nitrates and calcium channel blockers,

iii. Antifailure agents like diuretics,

iv. Angiotensin-Converting Enzyme (ACE) Inhibitors,

v. Angiotensin-II Receptor Blocking Drugs (ARBs) and aldosterone antagonism, Digitalis,

vi. Acute Inotropes and inotropic Dilators

vii. Antihypertensive Drugs,

viii. Antiarrhythmic Drugs

ix. Antithrombotic agents like Platelet Inhibitors, Anticoagulants and Fibrinolytics, Lipid-Lowering and Atherosclerotic Drugs, choice of drugs, which drug for which disease? Adverse Cardiovascular Drug Interactions and Complications.

10. Cardiac Pathology

i. All pathological changes in various cardiac diseases with special reference to clinical correlation included.

ii. Special emphasis on pathological changes in the pulmonary vascular system in various cardiac disorders;

iii. Pathogenesis and pathology of rheumatic fever and rheumatic heart disease;

iv. cardiomyopathies

v. Dilated hypertrophic and obliterative / restrictive; congenital heart diasease -

vi. Cyanotic and acyanotic; atherosclerosis;

vii. Coronary artery disease;

viii. Cardiac involvement in other systemic diseases and storage disorders etc.

11. Cardiac Microbiology

The various microbiological aspects of cardiac diseases including rheumatic fever, infective endocarditis, myocarditis is included. Cardiac Molecular Biology has been included under a separate head.

12. Clinical Cardiology including Pediatric Cardiology

i. General Evaluation of the Patient

The History,

Physical Examination and Cardiac Auscultation including elements of accurate history taking, symptoms associated with cardiovascular disease,

The physical examination of adults, children, infants and neonates,

syndromes associated with congenital heart disease,

measurement of arterial blood pressure, venous pulse,

examination of the retina,

inspection and palpation of the precordium,

Cardiac auscultation.

13. Heart Failure

i. Pathophysiology and diagnosis of Heart Failure,

ii. Diagnosis and management of heart failure,

iii. Cardiac transplantation and mechanical ventricular support.

14. Rhythm aqnd Conduction Disturbances

i. Mechanisms of cardiac arrhythmias and conduction disturbances,

ii. Recognition,

iii. clinical assesment and management of arrhthmias and conduction disturbances, antiarrhythmic drugs, etc

15. Syncope, Sudden Death and Cardio-Pulmonary Resuscitation

i. Diagnosis and management of syncope,

ii. sudden cardiac death,

iii. Cardiopulmonary Resuscitiation and the subsequent management of the patient etc.

16. Coronary Heart Disease

i. Atherogenesis and its determinants,

ii. Pathology of coronary atherosclerosis,

iii. Coronary blood flow and myocardial ischemia,

iv. Dyslipidemia, other risk factors, and the prevention of coronary heart disease

v. Non atherosclerotic coronary heart disease,

vi. Diagnosis and management of patients with chronic ischemic heart disease,

vii. Diagnosis and management of patients with unstable angina,

viii. Diagnosis and management of patients with acute myocardial infarction,

ix. The electrocardiogram in Acute myocardial infarction,

x. Thrombogenesis, antithrombotic and thrombolytic therapy,

xi. rehabilitation of the patient with coronary heart disease etc.

xii. Congenital heart disease and other paediatric cardiac disorders.

17. Systemic Arterial Hypertension

i. Hypertension, epidemiology,

ii. pathophysiology,

iii. diagnosis and treatment.

18. Pulmonary Hypertension and Pulmonary Disease

i. Pulmonary hypertension,

ii. Pulmonary embolism,

iii. Chronic Corpulmonale etc.

19. Valvular Heart Disease

i. Acute rheumatic fever

ii. Aortic valve disease,

iii. Mitral valve disease, Mitral valve prolapse syndrome,

iv. tricuspid valve,

v. pulmonic valve and multivalvulardisaese,

vi. Clinical performance of prosthetic heart valves,

vii. Antitihrombotic therapy for valvular heart disease etc.

20. Congenital Heart Disease

i. Cardiovascular disease due to genetic abnormalities

ii. the pathology,

iii. pathophysiology,

iv. recognition and treatment of congenital heart diseases,

v. Congenital heart disease in adults etc

21. Cardiomyopathy and Specific Heart Muscle Diseases

i. Classification of cardiomyopathies,

ii. Dilated cardiomyopathy,

iii. hypertrophic cardiomyopathy,

iv. Restrictive, obliterative and infiltrative cardiomyopathies,

v. Myocarditis and specific cardiomyopathies

vi. endocrine disease and alcohol,

vii. AIDS and the cardiovascular system,

viii. Effect of noncardiac drugs,

ix. electricity, poisons and radiation and the heart etc.

22. Pericardial Diseases and Endocarditis

i. Diseases of the pericardium,

ii. Infective endocarditis

23. The Heart, Anesthesia and Surgery

i. Perioperative evaluation and management of patients with known or suspected cardiovascular disease who undergo noncardiac surgery

ii. Anesthesia and the patient with cardiovascular disease, etc

24. Miscellaneous Diseases and Conditions

i. The connective tissue diseases and the cardiovascular system,

ii. Neoplastic heart disease,

iii. Diabetes and cardiovascular disease,

iv. traumatic heart disease,

v. effects of mood and anxiety disorders on the cardiovascular system,

vi. Heart disease and pregnancy,

vii. The heart and obesity,

viii. the heart and kidney disease,

ix. exercise and the cardiovascular system,

x. Acute hemodynamics conditioning training the athelete's heart and sudden death,

xi. Cardiovascular aging in health and therapeutic considerations in older patients with cardiovascular diseases, women and coronary artery disease

xii. Cardiac trauma.

xiii. Tumors of hear

xiv. Geriatric heart disease.

xv. General Anaesthesia and non-cardiac surgery in patients with heart disease

xvi. Sports and Heart Disease

xvii. Cardiac rehabilitation

A. Psychological factors in heart disease Occupational and Regulatory Aspects of Heart Disease Non -cardiac Surgery in Cardiac Patients

1. TROPICAL CARDIOLOGY Conditions which are specifically found in the tropics like

i. Rheumatic heart disease,

ii. Endomyocardial Fibrosis

iii. Eosinophilic Heart Disease,

iv. Aortoarteritis etc.

2. Diseases of The Great Vessels and Peripheral Vessels

i. Diagnosis and treatment of diseases of the aorta,

ii. Cerebrovascular disease and neurologic manifestations of heart disease,

iii. diagnosis and management of diseases of the peripheral arteries and veins,

iv. surgical treatment of peripheral vascular diseases, etc.

3. Cardiovascular Disease and Disorders of Other Organs

i. Endocrine Disorders and Cardiovascular Disease,

ii. Hemostasis,

iii. Thrombosis,

iv. Fibrinolysis, and Cardiovascular Disease,

v. Rheumatic Fever, Rheumatic Diseases and the Cardiovascular System,

vi. The Patient with Cardiovascular Disease and Cancer,

vii. Psychiatric Behavioral Aspects of Cardiovascular Disease,

viii. Neurological Disorders and Cardiovascular Disease,

ix. Interface Between Renal Disease and Cardiovascular Illness, Cardiovascular

x. Manifestations of Autonomic Disorders.

B. Diagnostic and Interventional Cardiology Including Cardiac Instrumentation

1. Diagnostic Cardiology

i. The resting Electrocardiogram,

ii. The Chest roentgenogram and cardiac fluoroscopy,

iii. The Echocardiogram,

iv. ECG Exercise Testing

v. , Cardiac Catheterization,

vi. Coronary Arteriography,

vii. Coronary Blood Flow and Pressure Measurements,

viii. Cardiac Ventriculography

ix. Pulmonary Angiography, Angiography of the Aorta and Peripheral Vessels,

x. Nuclear Cardiology, Computed tomography of the Heart,

xi. Magnetic resonance Imaging of the heart,

xii. Magnetic Resonance imaging of the Vascular System,

xiii. Positron Emission Tomography for the noninvasive study and quantification of blood flow and metabolism in human cardiac disease,

xiv. long-term continuous electrocardiographic recordings

xv. Signal Averaging techniques and measurement of Late Potentials,

xvi. Techniques of Electrophysiologic evaluation of Brady and tachyarrhythmias,

xvii. Coronary Intravascular

xviii. Ultrasound Imaging endomyocardial biopsy etc.

2. Interventional Cardiology

i. Percutaneous Coronary Interventions,

ii. Coronary Angioplasty,

iii. Atherectomy, Atheroablation and Thrombectomy,

iv. Coronary Stenting, Balloon Valvuloplasty,

v. Peripheral Intervention, Pediatric interventions,

vi. Intraaortic Balloon

vii. Counterpulsation and other Circulatory Assist Devices

viii. ,Interventional Electrophysiology

ix. ,Cardiac pacemakers,

x. Implantable devices for heart failure and for the treatment of cardiac arrhythmias etc.

3. Cardiac Instrumentation

i. Principles of cardiac instrumentation,

ii. pressure recording, ECG Machines

iii. Cardiac Monitors,

iv. Defibrillators

v. Cath-Lab Equipment,

vi. EP Lab Equipment,

vii. Gamma Camera,

viii. CT Scan, MRI Equipment, PET Scans,

ix. Echocardiography including Stress Echo, Colour Doppler and TEE, Pacemakers temporary and Permanent, ICDs,

x. Triple Chamber Devices

xi. radiofrequency ablation equipment,

xii. programmed stimulators

xiii. IABP, Holter and Signal Averaging and ABP machines,

xiv. Treadmill equipments,

xv. Hemodynamic recorders

xvi. oximeters,

xvii. Computers and image processing in Cardiology etc.

C. Recent Advances in Cardiology, Cardiac Epidemiology, Preventive Cardiology Including Related Cardiac Surgery

1. Atherosclerosis and Prevention Epidemiology of Cardiovascular Diseases, Risk Factors for Atherosclerotic Diseases & Assessment Of Cardiac Risk Special Problems in the prevention of cardiovascular disease

i. Diabetes mellitus type 2

ii. Menopausal women;

iii. Non-traditional risk factors for coronary disease

Special problems in hyperlipidemia therapy

i. Child with hypercholesterolemia;

ii. Transplant patient;

iii. Hypercholesterolemia in the elderly;

iv. Elevated lipoprotein.

2. Cardiac Vascular Disease

Special problems in Vascular Disease;

i. Compromise of an internal thoracic artery to coronary artery graft by subclavian artery disease; localized lymph edema

3. Ischemic Heart Disease

Special Diagnostic issues in Ischemic Heart Disease:

i. The patient with chest pain, a positive stress test and normal coronary arteries;

ii. The patient with coronary artery disease and acute and chronic heart failure

4. Stable Coronary Syndromes

Special problems in myocardial ischemia;

i. Management of variant angina breakthrough;

ii. Management of the non-revascularization patient with severe angina;

iii. Treatment of silent ischemia;

iv. Treatment of microvascular angina;

v. Viagra, sexual activity and the cardiac patient.

5. Acute Coronary Syndromes

Special problems in Acute Myocardial Infarction;

i. Right ventricular infarction

ii. Acute myocardial infarction and normal coronary arteries;

iii. Non perfused acute myocardial infarction after thrombolytic therapy.

6. Non Pharmacological treatment of Ischemic Heart Disease: Special problems in non-pharmacologic therapy:

i. unprotected left main coronary angioplasty;

ii. chronic total occlusion;

iii. saphenous vein graft interventions;

iv. percutaneous intervention of cardiac allograft vasculopathy;

v. In-stent restenosis.

7. Hypertension: Management issues in difficult hypertension like

i. Hypertension and ethnicity;

ii. hypertension in pregnancy preeclampsia;

iii. perioperative hypertension;

iv. ambulatory blood pressure monitoring;

v. diabetes and hypertension;

vi. resistant hypertension;

vii. hypertension in the context of acute myocardial infarction or coronary interventions;

viii. concomitant therapy in hypertension.

8. Cardiac Arrhythmias Special problems in cardiac pacing like

i. pacemaker syndrome;

ii. temporary cardiac pacing;

iii. diagnostic and surgical procedures in pacemaker patients;

iv. pacemaker lead extraction;

v. biventricular pacing for congestive heart failure.

Special problems in supraventricular arrhythmias like

i. Syncope in PSVT;

ii. paroxysmal and perioperative atrial fibrillation;

iii. cycle length alternantion in supraventricular tachycardia;

iv. atrial flutter;

v. atrial fibrillation and anticoagulants.

Special problems in ventricular arrhthmias like;

i. problems of implanted defibrillators;

ii. syncope in a patient;

iii. palpitations and VT in a young woman.

9. Heart Failure and Cardiomyopathy:

Special problems in chronic heart failure like;

i. mechanisms of exercise intolerance and exercise testing;

ii. cardiac cachexia;

iii. anemia, renal dysfunction and depression inn heart failure;

iv. disease management programs.

Special problems in myocarditis and cardiomyopathy like

i. peripartum cardiomyopathy

ii. HIV myocarditis and cardiomyopathy;

iii. Adriamycin induced cardiomyopathy;

iv. Tachcardiomyopathy;

v. Diabetic Cardiomyopathy

10. Valvular Heart Disease

Special problems in valvular heart diseases like;

i. new onset atrial fibrillation in asymptomatic mitral stenosis;

ii. mitral stenosis and pregnancy;

iii. low gradient, low ouput aortic stenosis;

iv. mild to moderate aortic stenosis in patients undergoing bypass surgery;

Special problems in surgical treatment of valvular diseases:

i. perivalvular leaks;

ii. pregnancy and anticoagulation;

iii. postoperative management of valvular dysfunction in valvular surgical treatment.

11. Congenital Heart Disease:

Special problems in Adult Congenital heart diseases:

i. pregnancy in a woman with eisenmenger syndrome;

ii. thromboembolism after fontan procedure;

iii. late systemic RV failure in patients with TGA.

12. Special problems for the Cardiology Consultant

Community Cardiology: The training of PG students will involve learning experience "Derived from" or "Targeted to" the needs of the community. It shall therefore be necessary to expose the students to community based activities. Throughout the course of training the emphasis shall be on acquiring knowledge, skill and attitudes through first hand experiences as far as possible. The emphasis will be on self learning rather than on didactic lectures

13. Schedule of posting Ward & ICCU's Duties: 12 months

i. Duties should include diagnostic case workup and day to day management of common cases (angina, myocardial infarction, rheumatic heart disease, hypertension, congestive heart failure, congenital heart disease,).

ii. The resident should acquire the expertise / knowledge to diagnose and manage the cardiac emergencies (acute myocardial infarction and its complications, LVF, common arrhythmias, cardiogenic shock, pericardial tamponade etc)

14. Cardiac Emergency posting: 6 months

i. The resident should learn prompt diagnosis and management of cardiac emergencies.

ii. The trainee should fortify the skills of hemodynamic monitoring in emergency situations and should learn procedures like arterial line insertion, temporary venous pacing, central line insertion, pericardiocentesis, intra aortic balloon pump insertion, swan ganz catheter insertion etc.

15. Cath Lab posting: 8 months

i. The resident should acquaint himself with the pre, peri and post procedural management of patients to be taken up for intervention in a cath lab.

ii. The trainee should assist and perform procedures like coronary angiography, percutaneous coronary angioplasty, balloon valvoloplasty, cardiac catheterization of congenital heart disease patients, temporary pacemaker, permanent pacemaker,

iii. Electrophysiological diagnosis and management of arrhythmias,

iv. AICD, Bi-ventricular pacemaker, IABP insertion etc.

16. Non-invasive lab posting: 8 months

i. The resident should learn the principles and fundamentals of echocardiography.

ii. The trainee should be able to perform echo-cardiograms of adults, adolescents and infants under direct supervision. The trainee should observe transesophageal echo's and should also master the skills of performing and interpreting stress tests and holter monitoring.

17. Cardiac surgery posting: 2 months

i. Mandatory Posting with certificate of satisfactory attendance from the CTVS Dept Head.

ii. The resident should learnedpre operative preparation and management of post operative recovery patients.

iii. The trainee should have seen CABG, valve replacement, congenital heart disease surgery and aortic surgery.

18. Practical:

i. History, examination and writing of records:

ii. History taking should include the background information, presenting complaints and the history of present illness, history of previous illness, family history, social and occupational history and treatment history.

iii. Detailed physical examination should include general physical and CVS examination

iv. Skills in writing up notes, maintaining problem-oriented medical records (POMR), progress notes, and presentation of cases during ward rounds, planning investigation and making a treatment plan should be taught.

v. The resident should fortify the skills of hemodynamic monitoring in emergency situations and should learn procedures like arterial line insertion, temporary venous pacing, central line insertion, pericardiocentesis, intra aortic balloon pump insertion, swan ganz catheter insertion etc.

vi. The resident should assist and perform procedures like coronary angiography, percutaneous coronary angioplasty, balloon valvoloplasty, cardiac catheterization of congenital heart disease patients, temporary pacemaker, permanent pacemaker, Electrophysiological diagnosis and management of arrhythmias, AICD, Bi-ventricular pacemaker, IABP insertion etc.

vii. Ability to perform echo-cardiograms of adults, adolescents and infants under direct supervision. He should observe transesophageal echo's and should also should also master the skills of performing and interpreting stress tests and holter monitoring.

viii. Simulation based training should be given particularly in Transesophageal Echocardiography, Some Complex Structural Interventions and Coronary Interventions, CRTs, and TAVRs. Biostatistics, Research Methodology and Clinical Epidemiology Ethics Medico legal aspects relevant to the discipline Health Policy issues as may be applicable to the discipline

19. Job Responsibilities - Outdoor Patient (OPD) Responsibilities:

i. The working of the residents in the OPD should be fully supervised.

ii. They should evaluate each patient and write the observations on the OPD card with date and signature.

iii. Investigations should be ordered as and when necessary using prescribed forms

iv. Residents should discuss all the cases with the consultant and formulate a management plan.

v. Patient requiring admission according to resident's assessment should be shown to the consultant on duty.

vi. Patient requiring immediate medical attention should be sent to the casualty services with details of the clinical problem clearly written on the card.

vii. Patient should be clearly explained as to the nature of the illness, the treatment advice and the investigations to be done.

viii. Resident should specify the date and time when the patient has to return for follow up. In-Patient Responsibilities Each resident should be responsible and accountable for all the patients admitted under his care.

20. In-Patient Responsibilities

The following are the general guidelines for the functioning of the residents in the ward:

i. Detailed work up of the case and case sheet maintenance:

ii. The trainee should record a proper history and document the various symptoms.

iii. Perform a proper patient examination using standard methodology.

iv. The trainee should develop skills to ensure patient comfort/consent for examination.

v. Based on the above evaluation The trainee should be able to formulate a differential diagnosis and prepare a management plan.

vi. Should develop skills for recording of medical notes, investigations and be able to properly document the consultant round notes.

vii. To organize his/her investigations and ensure collection of reports.

viii. Bedside procedures for therapeutic or diagnostic purpose. • Presentation of a precise and comprehensive overview of the patient in clinical rounds to facilitate discussion with senior residents and consultants ix. To evaluate the patient twice daily (and more frequently if necessary) and maintain a progress report in the case file.

x. To establish rapport with the patient for communication regarding the nature of illness and further plan management.)

xi. To write instructions about patient's treatment clearly in the instruction book along with time, date and the bed number with legible signature of the resident.

xii. All treatment alterations should be done by the residents with the advice of the concerned consultants and senior residents of the unit.

21. Admission day

Following guidelines should be observed by the resident during admission day.

i. Resident should work up the patient in detail and be ready with the preliminary necessary investigations reports for the evening discussion with the consultant on duty

ii. After the evening round the resident should make changes in the treatment and plan out the investigations for the next day in advance. Doctor on Duty

iii. Duty days for each Resident should be allotted according to the duty roster.

iv. The resident on duty for the day should know about all sick patients in the wards and relevant problems of all other patients, so that the trainee could face an emergency situation effectively

v. In the morning, detailed over (written and verbal) should be given to the next resident on duty. This practice should be rigidly observed.

vi. If a patient is critically ill, discussion about management should be done with the consultant at any time.

vii. The doctor on duty should be available in the ward throughout the duty hours. Care of Sick Patients • Care of sick patients in the ward should have precedence over all other routine work for the doctor on duty.

viii. Patients in critical condition should be meticulously monitored and records maintained

ix. If patient merits ICU care, then it must be discussed with the senior residents and consultants for transfer to ICU.

22. Discharge of the Patient

i. Patient should be informed about his/her discharge one day in advance and discharge cards should be prepared 1 day prior to the planned discharge.

ii. The discharge card should include the salient points in history and examination, complete diagnosis, important management decisions, hospital course and procedures done during hospital stay and the final advice to the patient.

iii. Consultants and DNB Residents should check the particulars of the discharge card and counter sign it.

iv. Patient should be briefed regarding the date, time and location of OPD for the follow up visit

23. In Case of Death

i. In case it is anticipated that a particular patient is in a serious condition, relatives should be informed about the critical condition of the patient beforehand.

ii. Residents should be expected to develop appropriate skills for breaking bad news and bereavements.

iii. Follow up death summary should be written in the file and face sheet notes must be filled up and the sister in charge should be requested to send the body to the mortuary with respect and dignity from where the patient's relatives can be handed over the body.

iv. In case of a medico legal case, death certificate has to be prepared in triplicate and the body handed over to the mortuary and the local police authorities should be informed.

v. Autopsy should be attempted for all patients who have died in the hospital especially if the patient died of an undiagnosed illness. Bedside Procedures The following guidelines should be observed strictly

vi. Be aware of the indications and contraindications for the procedure and record it in the case sheet. Rule out contraindications like low platelet count, prolonged prothrombin time, etc.

vii. Plan the procedure during routine working hours, unless it is an emergency.

viii. Explain the procedure with its complications to the patient and his/her relative and obtain written informed consent on a proper form. Perform the procedure under strict aseptic precautions using standard techniques. Emergency tray should be ready during the procedure.

ix. Make a brief note on the case sheet with the date, time, nature of the procedureand immediate complications, if any.

x. Monitor the patient and watch for complications(s). Medico-Legal Responsibilities of the Residents • All the residents are given education regarding medico-legal responsibilities at the time of admission in a short workshop.

xi. They must be aware of the formalities and steps involved in making the correct death certificates, mortuary slips, medico-legal entries, requisition for autopsy etc

xii. They should be fully aware of the ethical angle of their responsibilities and should learn how to take legally valid consent for different hospital procedures & therapies.

xiii. They should ensure confidentiality at every stage.

24. Bedside Procedures

The following guidelines should be observed strictly:

i. Be aware of the indications and contraindications for the procedure and record it in the case sheet. Rule out contraindications like low platelet count, prolonged prothrombin time, etc.

ii. Plan the procedure during routine working hours, unless it is an emergency. Explain the procedure with its complications to the patient and his/her relative and obtain written informed consent on a proper form. Perform the procedure under strict aseptic precautions using standard techniques. Emergency tray should be ready during the procedure.

iii. Make a brief note on the case sheet with the date, time, nature of the procedure and immediate complications, if any.

iv. Monitor the patient and watch for complications(s).

25. Medico-Legal Responsibilities

i. All the residents are given education regarding medico-legal responsibilities at the time of admission in a short workshop.

ii. They must be aware of the formalities and steps involved in making the correct death certificates, mortuary slips, medico-legal entries, requisition for autopsy etc.

iii. They should be fully aware of the ethical angle of their responsibilities and should learn how to take legally valid consent for different hospital procedures & therapies.

iv. They should ensure confidentiality at every stage.

v. The Candidate should be trained in some Medico-Legal Aspects regarding patient management like how to obtain informed consent, how to approach litigations and what problems can occr on the unexpected death of patients.

vi. They should also be trained in laws especially with regards to Medico-Legal Cases and Transplantation laws. The student would be given adequate training during the course so that the trainee will be able to perform and interpret various non-invasive and invasive techniques as outlined below:

26. Non - invasive

i. Electrocardiography

ii. Stress ECG

iii. Ambulatory ECG

iv. Echocardiography – M-mode, Two dimensional, Doppler, Colour flow imaging, Transoesophageal echocardiography and stress echocardiography.

v. Ambulatory BP monitoring.

27. Invasive

i. To perform temporary pacemaker insertion and pericardiocentesis.

ii. To perform left and right heart catheterization, to calculate and interpret various hemodynamic parameters.

iii. To assist in various interventions including Valvuloplasty, coronary and congenital interventions.

iv. To interpret electrophysiological data and assist in electrophysiology procedures, permanent pacemaker implantation and AICD implantation

28. Minimum No. of Procedures for competency

i. Trans thoracic Echocardiography………………………400

ii. Transoesophageal Echocardiography………………….25

iii. Stress ECG………………….………………….…………100

iv. Temporary Pacemaker………………….…………………20

v. Ambulatory ECG's analysed………………….…………..50

vi. Permanent pacemaker Implantation's assisted………….5

vii. Cardiovascular Catheterization………………….………100

viii. Percutaneous Cardiovascular Intervention's assisted…10

29. Affective Domain

i. To adopt ethicalpractices in dealing with patients, colleagues, subordinates superiors and health care workers.

ii. To promote cordial interpersonal relation

iii. To perform as a team

iv. To learn to be a leader when the need arises.

v. To learn to order investigations and prescribe drugs rationally.

vi. To be aware of ethical issues in human and animal research.

vii. Take rationale decision in the face of ethical dilemmas in cardiac diseases.

viii. Demonstrate sympathy & Humane approach towards patients & their families & exhibit interpersonal behaviour in accordance with social norms & expectations.

30. Attitude & Values

Demonstrate empathy and humane approach towards patients and their families and exhibit interpersonal behaviour in accordance with the societal norms and expectation.

Career Options

After completing a DrNB in Cardiology, candidates will getemployment opportunities in Government as well as in the Private sector.

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

While in the Private sector theoptions include Resident Doctor, Consultant, Visiting Consultant (Cardiology),Junior Consultant, Senior Consultant (Cardiology), Critical Care Specialist,etc.

Courses After DrNBin Cardiology Course

DrNB in Cardiology is a specialisation course whichcan be pursued after finishing a Postgraduate medical course. After pursuingspecialisation in DrNB in Cardiology,a candidate could also pursue certificate courses and Fellowship programmesrecognised by NMC and NBE, where DrNB inCardiology is a feeder qualification.

Frequently Asked Question (FAQs) – DrNBin Cardiology Course

Question: What is the full form of DrNB?

Answer: The full form of DrNB is Doctorate ofNational Board.

Question: What is a DrNB in Cardiology?

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

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

Answer: DrNB in Cardiology is asuper specialty programme of three years.

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

Answer: Candidates must be in possession of a MD/DNB (General Medicine/Paediatrics/Respiratory Medicine) from any college/university recognized by theMedical Council of India (now NMC)/NBE.

Question:What is the scope of a DrNB in Cardiology?

Answer:DrNB in Cardiology offers candidatesvarious employment opportunities and career prospects.

Question:What is the average salary for a DrNB inCardiology candidate?

Answer:The DrNB in Cardiology candidate'saverage salary is between Rs. 6,00,000to Rs. 30,00,000 per annum depending on the experience.

Question: Can you teach after completing DrNB Course?

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

2 years 3 months ago

News,Health news,NBE News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses

Health – Dominican Today

Dominican Republic does not have immediate access to a cholera vaccine

The Dominican Republic has not had immediate access to cholera vaccines, even though the diarrheal disease has been detected in eight patients nationwide. Haiti has 18,000 suspected cases, more than 1,300 confirmed cases, and at least 320 dead, according to official figures released earlier this week.

The worldwide shortage of the vaccine that helps prevent the disease, as well as the low incidence of cases on the Dominican side of the island, make accessing the biological difficult for Dominican health authorities.

Eladio Pérez, Vice Minister of Collective Health, emphasizes the Dominican Republic’s interest in being able to administer the vaccines, at least in vulnerable areas. They have approached the Pan American Health Organization (PAHO) and manufacturers with this interest. “We asked for support and PAHO informed us that we did not qualify, because the situation in the country does not meet the emergency criteria to access the vaccine. They inform us that there is also a global vaccine shortage, which, if true, would allow them to assist us. “We also spoke with the vaccine manufacturer, and the response was the same,” the official said.

Even though only eight cholera positives have been reported in the country to date since the first case was discovered last October, the vice minister emphasizes how beneficial it would be to be able to apply it to the vulnerable population. He uses the Isabela River in the National District as an example, a tributary where the bacterium that causes cholera has already been detected and on whose margin, specifically in the La Zurza sector, six of the eight registered positives are present. 

 

2 years 3 months ago

Health

Healio News

Top in rheumatology: Adalimumab biosimilar approval; the immunopathophysiology of PsA

The FDA approved Idacio as a biosimilar to Humira, a TNF inhibitor with indications for rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis and plaque psoriasis.According to the manufacturer, Idacio (adalimumab-aacf, Fresenius Kabi) is a citrate-free formulation of Humira (adalimumab, AbbVie).

It was the top story in rheumatology last week.The second top story explored the mechanism of action by which psoriatic arthritis treatment works.Read these and more top stories in rheumatology below:FDA approves

2 years 3 months ago

BBC News - Health

Molnupiravir Covid antiviral treatment hastens recovery - trial

But molnupiravir showed no obvious benefit at reducing hospital cases and deaths, a study found.

But molnupiravir showed no obvious benefit at reducing hospital cases and deaths, a study found.

2 years 3 months ago

Health | NOW Grenada

Canada supports Grenada Planned Parenthood Association’s SRHR clinics

“The project in Grenada advances critical foreign policy priorities for Canada in the Caribbean, including gender equality and human dignity — including health and education”

2 years 3 months ago

Health, PRESS RELEASE, canada fund for local initiatives, grenada planned parenthood association, grenchap, lilian chatterjee

Health – Dominican Today

Authorities evaluate the possibility of cordoning off the Isabela and Ozama rivers due to the incidence of cholera

Daniel Rivera, the Minister of Public Health, announced on Thursday that an assessment of the situation is already underway to determine whether or not the Isabela and Ozama rivers should be closed due to cholera.

According to Rivera, due to the high levels of contamination in its waters, which are possibly sponsors of the country’s current cases of cholera, located in the La Zurza sector that maintains a spring that flows into the Isabela River, studies are already being conducted pertinent to determine fence their surroundings and definitively evade the insistent bathers.

Similarly, the doctor stated that, while the interpretations agreed with the Ministry of the Environment and the Santo Domingo Aqueduct and Sewerage Corporation (CAASD), Public Health would benefit from greater control over the bacteria’s prevalence. “Other State entities are already required to use this strategy, which will benefit Public Health by controlling the emergence of new cases in the area,” he assured.

This proposal to surround and prohibit access to both river sources stems from an editorial published today in the newspaper Listin Diario, which identifies this and other measures as possible channels of cholera retention.

 

2 years 3 months ago

Health, Local

Kaiser Health News

Inmigrantes detenidos en centros enfrentan riesgo de covid como al inicio de la pandemia

LUMPKIN, Ga. — En octubre, Yibran Ramirez-Cecena no le dijo al personal del Centro de Detención de Stewart que tenía tos y secreción nasal. Está detenido en la instalación del suroeste de Georgia desde mayo, y ocultó sus síntomas por temor a que lo pusieran en confinamiento solitario si daba positivo para covid-19.

“Honestamente, no quería pasar 10 días solo en una habitación, lo llaman el agujero”, dijo Ramírez-Cecena, quien espera que decidan si es deportado a México o puede permanecer en los Estados Unidos, en donde ha vivido por más de dos décadas.

Poco antes de que Ramírez-Cecena se enfermara, los funcionarios del Servicio de Inmigración y Control de Aduanas (ICE) de la instalación le negaron su solicitud de alta médica. Es VIH positivo, que según la lista de los Centros para el Control y la Prevención de Enfermedades es una afección que puede aumentar el riesgo de enfermar gravemente por covid.

Ahora, frente al tercer invierno pandémico, reza para no contraer covid mientras está detenido. “Todavía da miedo”, dijo.

En todo el país, la posibilidad de desarrollar una enfermedad grave o morir por covid ha bajado, por las vacunas de refuerzo actualizadas, las pruebas en el hogar y las terapias. La mayoría de las personas pueden sopesar los riesgos de asistir a reuniones o viajar.

Pero para las aproximadamente 30,000 personas que viven en espacios cerrados en la red de instalaciones de inmigración del país, covid sigue siendo una amenaza constante.

El ICE actualizó su guía de pandemia en noviembre. Pero las instalaciones han ignorado las recomendaciones anteriores de usar máscaras y equipo de protección, tener pruebas y vacunas disponibles, y evitar el uso del confinamiento solitario como cuarentena, según detenidos, grupos de defensa e informes internos del gobierno federal.

Según los protocolos de ICE, el aislamiento por covid, utilizado para evitar que otros detenidos se enfermen, debe estar separado de la segregación disciplinaria.

La agencia no abordó este punto, pero dijo en un comunicado a KHN que a los detenidos se los coloca en una “sala de alojamiento médico individual” o en un “una habitación de aislamiento médico de infecciones transmitidas por el aire”, cuando esté disponible.

La atención médica en los centros de detención de inmigrantes ya era deficiente antes de la pandemia. Y en septiembre, las personas médicamente vulnerables en los centros de detención de ICE perdieron una protección, con la expiración de una orden judicial que requería que los funcionarios federales de inmigración consideraran la liberación de los detenidos con riesgo de covid.

La agencia “ha renunciado por completo a proteger a las personas detenidas de covid”, dijo Zoe Bowman, abogada supervisora ​​de Las Américas Immigrant Advocacy Center en El Paso, Texas.

El uso de la detención de inmigrantes en el país se disparó a fines de la década de 1990 y creció después de la creación de ICE en 2003. Los centros de detención —unos 200 complejos privados, instalaciones administradas por ICE, cárceles locales y prisiones repartidas por todo el país— retienen a adultos que no son ciudadanos estadounidenses mientras disputan o esperan la deportación.

La duración promedio de la estadía en el año fiscal federal 2022 fue de aproximadamente 22 días, según la agencia. Los defensores de los inmigrantes han argumentado durante mucho tiempo que las personas no deberían ser detenidas y, en cambio, se les debería permitir vivir en comunidades.

El Centro de Detención de Stewart, un vasto complejo rodeado de cercas con alambre de púas en los bosques de Lumpkin, tiene una de las poblaciones de detenidos más grande del país. Cuatro personas bajo la custodia del centro han muerto por covid desde el comienzo de la pandemia, el mayor número de muertes por covid registradas en estos centros.

Cuando funcionarios de inmigración transfirieron a Cipriano Álvarez-Chávez al centro de Stewart en agosto de 2020, todavía confiaba en la máscara que tenía después de ser liberado de la prisión federal en julio, según su hija, Martha Chavez.

Diez días después, el sobreviviente de linfoma de 63 años fue llevado a un hospital en Columbus, a 40 millas de distancia donde dio positivo para covid, según su informe de defunción. Murió después de pasar más de un mes conectado a un ventilador.

“Fue pura negligencia”, dijo su hija.

Dos años después de la muerte de Álvarez-Chávez, grupos de defensa y detenidos dijeron que el ICE no ha hecho lo suficiente para proteger de covid a los detenidos, una situación consistente con el historial de atención médica deficiente y falta de higiene de las instalaciones.

“Es desalentador ver que no importa cuánto empeoran las cosas, nada cambia”, dijo la doctora Amy Zeidan, profesora asistente en la Facultad de Medicina de la Universidad de Emory, quien revisa los registros de salud de los detenidos y realiza evaluaciones médicas para las personas que buscan asilo.

Una investigación bipartidista del Senado reveló en noviembre que las mujeres en el Centro de Detención del Condado de Irwin en Georgia “parecen haber sido sometidas a procedimientos ginecológicos excesivos, invasivos y, a menudo, innecesarios”.

En el Centro de Procesamiento de Folkston, también en Georgia, el ICE no respondió a las solicitudes médicas de manera oportuna, tuvo una atención de salud mental inadecuada y no cumplió con los estándares básicos de higiene, incluidos baños funcionales, según un informe de junio de la Oficina del Inspector General de Seguridad del Departamento de Asuntos Internos. Y una denuncia presentada en julio por un grupo de organizaciones de defensa alegó que una enfermera del centro Stewart agredió sexualmente a cuatro mujeres.

El ICE defendió su atención médica en un comunicado enviado por correo electrónico, diciendo que gasta más de $315 millones anualmente en atención médica, y que garantiza la prestación de los servicios médicos necesarios e integrales.

Aún así, muchas instalaciones carecen de personal y están mal equipadas para manejar las necesidades médicas a largo plazo de la gran población de detenidos, dijo Zeidan. La atención tardía es común, la atención especializada es casi inexistente y el acceso a la terapia es limitado, dijo. El cuidado de covid no es diferente.

En sus protocolos para covid, el ICE recomienda el uso de anticuerpos monoclonales, que ayudan al sistema inmunológico a responder de manera más efectiva a covid, para el tratamiento. Pero no reconoce ninguno de los otros tratamientos recomendados por los CDC, incluidos los antivirales como Paxlovid, que pueden reducir las hospitalizaciones y las muertes entre los pacientes con covid.

“Durante décadas, el ICE ha demostrado ser incapaz y no estar dispuesto a garantizar la salud y la seguridad de las personas bajo su custodia”, dijo Sofia Casini, directora de monitoreo y defensa comunitaria de Freedom for Immigrants, un grupo de defensa. “Covid-19 solo ha empeorado esta horrible realidad”.

Once personas han muerto por covid bajo custodia de ICE. Pero ese número puede ser una subestimación; defensores de los detenidos han acusado a la agencia de liberar a las personas o deportarlas cuando están gravemente enfermas como una forma de evadir las estadísticas de muertes.

Antes de la pandemia, Johana Medina León fue liberada de la custodia de ICE cuatro días antes de su muerte, según un artículo de mayo en Los Angeles Times. Vio a un médico unas seis semanas después de su primera solicitud, decía el artículo, pero ICE aceleró su liberación solo unas horas después de que su condición empeorara.

Este otoño, los detenidos recluidos en instalaciones de todo el país llamaron a la línea directa de detención de Freedom for Immigrants para quejarse de las condiciones de covid, que varían de una instalación a otra, dijo Casini. “Incluso en la misma instalación, puede cambiar de semana a semana”, dijo.

Según Casini, muchas personas que habían dado positivo para covid estaban recluidas en las mismas celdas que las personas que habían dado negativo, incluidas las personas médicamente vulnerables. Este verano, el grupo encuestó a 89 personas a través de su línea directa y descubrió que alrededor del 30% de los encuestados tuvieron problemas para acceder a las vacunas mientras estuvieron detenidos.

Ramírez-Cecena dijo que le dijeron que es elegible para una segunda vacuna de refuerzo de covid, pero que, a diciembre, aún no la había recibido. Un detenido en el Centro de Procesamiento de Moshannon Valley en Pennsylvania dijo que a un guardia se le permitió interactuar con los detenidos mientras estaba visiblemente enfermo, dijo Brittney Bringuez, coordinadora del programa de asilo de Physicians for Human Rights, quien visitó las instalaciones este otoño.

La orden judicial que requería que ICE considerara la liberación de personas con alto riesgo de covid ha ayudado a los detenidos con afecciones médicas graves, dijeron los defensores. Según la orden, ICE liberó a unos 60,000 detenidos médicamente vulnerables en dos años, dijo Susan Meyers, abogada sénior del Southern Poverty Law Center, uno de los grupos de defensa que ayudó a presentar la demanda que resultó en la orden judicial.

El ICE dijo en un comunicado que aún considerará los factores de riesgo de covid como una razón para la liberación. Pero los abogados dijeron que las instalaciones de ICE a menudo no cumplían con la orden judicial cuando estaba vigente.

El año pasado, el ICE negó la solicitud de liberación de Ricardo Chambers del Centro de Detención de Stewart. Chambers, de 40 años, tiene enfermedades psiquiátricas graves, consideradas un factor de riesgo según la orden judicial. También tiene problemas para respirar y se ahoga mientras duerme, como resultado de una lesión nasal que sufrió en un ataque antes de ser detenido. A dos años de estar detenido, todavía no recibió atención para esa lesión.

Ha presentado quejas sobre los protocolos para covid de Stewart, incluidas las condiciones de hacinamiento y la falta de uso de máscaras u otro equipo de protección por parte del personal.

Al negar su liberación, el ICE dijo que Chambers era una amenaza para la seguridad pública debido a sus antecedentes penales, según su abogada Erin Argueta, abogada principal de la oficina de la Iniciativa de Libertad de Inmigrantes del Sureste del Southern Poverty Law Center en Lumpkin. Chambers ya cumplió sus condenas, dijo, y hay una familia en Nueva York que lo acogería.

A principios de este año, fue enviado a confinamiento solitario durante unos 10 días después de dar positivo para covid, dijo. Pero Chambers, quien está luchando contra una orden de deportación a Jamaica, dijo que su experiencia con covid no fue diferente de las otras veces que estuvo en aislamiento.

“Serás tratado como un animal, enjaulado y sin tener culpa de nada”, dijo Chambers.

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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2 years 3 months ago

COVID-19, Noticias En Español, Public Health, States, Georgia, Immigrants, Latinos, Prison Health Care

Medical News, Health News Latest, Medical News Today - Medical Dialogues |

Mouthwash use associated with increased risk of developing prediabetes

Mouthwash use is associated with an increased risk for prediabetes/diabetes suggests a recent study published in the British Dental Journal.

Many people in the UK use mouthwash on a regular basis. Recently, a longitudinal study conducted in Puerto Rico that monitored overweight and obese adults over a three-year period (which included periodontal and oral hygiene assessments) concluded that those using mouthwash twice daily or more at baseline had an approximately 50% increased risk of developing prediabetes/diabetes combined, compared to those who used mouthwash less than twice daily or not at all. The proposed mechanism to explain this is that mouthwash has antibacterial effects in the oral cavity, yet oral bacteria play an important role in the salivary nitrate-nitrite-nitric oxide pathway, and reduced levels of nitric oxide are associated with insulin resistance as well as adverse cardiovascular effects such as hypertension and impaired vascular function. However, methodological limitations in the study bring into question the generalisability of the findings. In this article, the important role of oral bacteria in the production of nitric oxide is discussed, and the findings of the Puerto Rican study are considered in detail. It is important that dental professionals are aware of emerging research on this topic as patients frequently ask for advice on use of mouthwash as part of their oral hygiene regime.

The lack of data on type of mouthwash is an important limitation of the study, as mouthwashes may contain antibacterial agents (for example, designed for treatment of gingivitis), or may be more simply considered as breath fresheners. Indeed, it has been shown that different mouthwashes have differential effects on plasma and salivary nitrite concentrations and impact on blood pressure.

Potentially, future research may lead to recommendations that mouthwash be used no more than, for example, once per day (depending on the rationale for use, and the type of mouthwash being used), and clearly more research (ideally in the form of prospective studies and randomised controlled trials) is required.

Reference:

Preshaw, P. Mouthwash use and risk of diabetes. Br Dent J 225, 923–926 (2018). https://doi.org/10.1038/sj.bdj.2018.1020

2 years 3 months ago

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DrNB Plastic Surgery (Direct 6 Year) In India: Check Out NBE Released Curriculum

The National Board of Examinations (NBE) has released the Curriculum for DrNB Plastic Surgery (Direct 6 Year) course.

I. PROGRAMME GOAL & OBJECTIVES

A. Programme Goal

The goal of DNB in Plastic Surgery (Direct 6 years course) course is to produce a competent

surgeon who:

The National Board of Examinations (NBE) has released the Curriculum for DrNB Plastic Surgery (Direct 6 Year) course.

I. PROGRAMME GOAL & OBJECTIVES

A. Programme Goal

The goal of DNB in Plastic Surgery (Direct 6 years course) course is to produce a competent

surgeon who:

• Recognizes the health needs of adults and carries out professional obligations in keeping with principles of National Health Policy and professional ethics;

• Has acquired the competencies pertaining to Plastic Surgery (Direct 6 years course) that are required to be practiced in the community and at all levels of health care system;

• Has acquired skills in effectively communicating with the patients, family and the

• community;

• Is aware of the contemporary advances and developments in medical sciences.

• Acquires a spirit of scientific enquiry and is oriented to principles of research

• methodology; and

• Has acquired skills in educating medical and paramedical professionals.

B. Programme Objectives

At the end of the DNB Plastic Surgery (Direct 6 years course), the student should be able to:

• Recognize the key importance of medical problems in the context of the health priority of the country

• Practice the specialty of Plastic Surgery in keeping with the principles of professional ethics;

• Identify social, economic, environmental, biological and emotional determinants of Plastic Surgery and know the therapeutic, rehabilitative, preventive and promotion

• Measures to provide holistic care to all patients;

• Take detailed history, perform full physical examination and make a clinical diagnosis;

• Perform and interpret relevant investigations (Imaging and Laboratory); Perform and interpret important diagnostic procedures;

• Diagnose illnesses in adults based on the analysis of history, physical examination and investigative work up;

• Plan and deliver comprehensive treatment for illness in adults using principles of rational drug therapy;

• Plan and advise measures for the prevention of diseases;

• Plan rehabilitation of adults suffering from chronic illness, and those with special needs;

• Manage emergencies efficiently;

• Demonstrate skills in documentation of case details, and of morbidity and mortality data

• Relevant to the assigned situation;

• Demonstrate empathy and humane approach towards patients and their families and respect their sensibilities;

• Demonstrate communication skills of a high order in explaining management and prognosis, providing counseling and giving health education messages to patients, families and communities.

• Develop skills as a self-directed learner, recognize continuing educational needs; use appropriate learning resources, and critically analyze relevant published literature in order to practice evidence-based medicine;

• Demonstrate competence in basic concepts of research methodology and epidemiology;

• Facilitate learning of medical/nursing students, practicing surgeons , paramedical health workers and other providers as a teacher-trainer;

• Play the assigned role in the implementation of national health programs, effectively and responsibly;

• Organize and supervise the desired managerial and leadership skills;

• Function as a productive member of a team engaged in health care, research and education.

II. TEACHING AND TRAINING ACTIVITIES

The fundamental components of the teaching programme should include:

• Case presentations & discussion- once a week

• Seminar – Once a week

• Journal club- Once a week

• Grand round presentation (by rotation departments and subspecialties)- once a week

• Faculty lecture teaching- once a month

• Clinical Audit-Once a Month

• A poster and have one oral presentation at least once during their training period in a recognized conference.

• Attendance of one National conference of Association of Plastic Surgeons of India and one speciality conference / regional conference is a must (specialty conference means Cleft lip and palate conference, Hand, Microsurgery, Burns or Aesthetic surgery. Regional means State or Zonal meetings)

• One paper publication – preferably peer reviewed.

Microsurgery Lab Course: All trainees must undergo a week long microsurgery lab course. Trainees must become proficient in using loupes and microscope. This is mandatory as trainees who are not proficient in microsurgery when they pass out are at a disadvantage.

Fracture Fixation Course: Recommended to attend the AO course on fracture fixation for Cranio Maxilla Facial and Hand. The rounds should include bedside sessions, file rounds & documentation of case history and examination, progress notes, round discussions, investigations and management plan) interesting and difficult case unit discussions.

The training program would focus on knowledge, skills and attitudes (behavior), all essential components of education. It is being divided into theoretical, clinical and practical in all aspects of the delivery of the rehabilitative care, including methodology of research and teaching.

Theoretical: The theoretical knowledge would be imparted to the candidates through discussions, journal clubs, symposia and seminars. The students are exposed to recent advances through discussions in journal clubs. These are considered necessary in view of an inadequate exposure to the subject in the undergraduate curriculum.

Symposia: Trainees would be required to present a minimum of 30 topics based on the curriculum in a period of six years to the combined class of teachers and students. A free discussion would be encouraged in these symposia. The topics of the symposia would begiven to the trainees with the dates for presentation.

Clinical: The trainee would be attached to a faculty member to be able to pick up methods of history taking, examination, prescription writing and management in rehabilitation practice.

Bedside: The trainee would work up cases, learn management of cases by discussion with faculty of the department.

Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals is given towards the end of this document. The candidate would summarize and discuss the scientific article critically. A faculty member will suggest the article and moderate the discussion, with participation by other faculty members and resident doctors. The contributions made by the article in furtherance of the scientific knowledge and limitations, if any, will be highlighted.

Research: The student would carry out the research project and write a thesis/ dissertation in accordance with NBE guidelines. The trainee would also be given exposure to partake in the research projects going on in the departments to learn their planning, methodology and execution so as to learn various aspects of research.

III. SYLLABUS

Theory

Principles, Techniques, and Basic Sciences

• Techniques and principles in Plastic Surgery

• Wound Healing: Normal and Abnormal

• Wound care

• The Blood Supply of the Skin

• Muscle flaps and their Blood supply

• Transplant Biology and Applications to Plastic Surgery (Direct 6 years course)

• Implant Materials and biomaterials

• Principles of Microsurgery

• Microsurgical Repair of Peripheral Nerves and Nerve Grafts

• Tissue Expansion

Plastic Surgery and innovation in medicine

• History of reconstructive and aesthetic surgery

• Psychological aspects of Plastic Surgery

• The role of ethics in Plastic Surgery

• Business principles for plastic surgeons

• Medico-legal issues in Plastic Surgery

• Photography in Plastic Surgery

• Patient safety in Plastic Surgery

• Local anesthetics in Plastic Surgery

• Evidence-based medicine and health services research in Plastic Surgery

• Genetics and prenatal diagnosis

• Principles of cancer management

• Stem cells and regenerative medicine

Aesthetic

• Managing the cosmetic patient

• Aesthetic Surgery of the Face

• Nonsurgical skin care and rejuvenation

• Botulinum toxin (BoNT-A)

• Soft-tissue fillers

• Facial skin resurfacing

• Anatomy of the aging face

• Forehead rejuvenation

• Blepharoplasty

• Secondary blepharoplasty:

• Asian facial cosmetic surgery

• Cutaneous Resurfacing: Chemical Peeling, Dermabrasion and laser resurfacing

• Filler Materials

• Botulinum Toxin

• Structural Fat grafting

• Blepharoplasty

• Rhinoplasty

• Liposuction

• Abdominoplasty and Lower Truncal Circumferential Body Contouring

• Facial Skeletal Augmentation with Implants

• Osseous Genioplasty

• Hair Transplantation

• Facelift

• Neck rejuvenation

• Structural fat grafting

• Skeletal augmentation

• Anthropometry, cephalometry, and orthognathic surgery

• Medico-legal issues in Plastic Surgery

• Photography in Plastic Surgery

• Patient safety in Plastic Surgery

• Local anesthetics in Plastic Surgery

• Evidence-based medicine and health services research in Plastic Surgery

• Genetics and prenatal diagnosis

• Principles of cancer management

• Stem cells and regenerative medicine

Aesthetic

• Managing the cosmetic patient

• Aesthetic Surgery of the Face

• Nonsurgical skin care and rejuvenation

• Botulinum toxin (BoNT-A)

• Soft-tissue fillers

• Facial skin resurfacing

• Anatomy of the aging face

• Forehead rejuvenation

• Blepharoplasty

• Secondary blepharoplasty:

• Asian facial cosmetic surgery

• Cutaneous Resurfacing: Chemical Peeling, Dermabrasion and laser resurfacing

• Filler Materials

• Botulinum Toxin

• Structural Fat grafting

• Blepharoplasty

• Rhinoplasty

• Liposuction

• Abdominoplasty and Lower Truncal Circumferential Body Contouring

• Facial Skeletal Augmentation with Implants

• Osseous Genioplasty

• Hair Transplantation

• Facelift

• Neck rejuvenation

• Structural fat grafting

• Skeletal augmentation

• Anthropometry, cephalometry, and orthognathic surgery

• Hair restoration: A comprehensive review of techniques and safety

• Abdominoplasty procedures

• Lipoabdominoplasty

• Lower bodylifts

• Buttock augmentation

• Upper limb contouring

• Post-bariatric reconstruction

• Aesthetic genital surgery

Breast

• Anatomy of the breast

• Breast augmentation

• Current concepts in revisionary breast surgery

• Mastopexy

• Breast Reduction

• Gynecomastia

• Breast Reconstruction: Prosthetic Techniques

• Latissimus Dorsi Flap Breast Reconstruction

• Breast Reconstruction: Tram Flap Techiniques

• Breast Reconstruction- Free Flap Techniques

• Nipple Reconstruction

• Breast cancer: Diagnosis therapy and oncoplastic techniques The oncoplastic approach to partial breast reconstruction

• Patient-centered health communication

• Imaging in reconstructive breast surgery

• Congenital anomalies of the breast

• Poland syndrome

• Fat grafting to the breast

Principles of Craniofacial distraction

Skin and Soft Tissue

• Dermatology for Plastic Surgeons

• Mohs Micrographic Surgery

• Congenital Melanocytic Nevi

• Malignant Melanoma

• Thermal, Chemical and Electric Injuries

• Principles of Burn Reconstruction

• Radiation and Radiation Injuries

• Lasers in Plastic Surgery (Direct 6 years course)

Congenital Anomalies and Pediatric Plastic Surgery

• Embryology of the Head and Neck

• Vascular Anomalies

• Cleft Lip and Palate

• Non syndromic Craniosynostosis and Deformational Plagiocephaly

• Craniosynostosis syndrome

• Craniofacial Microsomia

• Orthognathic Surgery

• Craniofacial Clefts and Hypertelorbitism

• Miscellaneous Craniofacial Conditions

• Otoplasty and Ear Reconstruction

Head and Neck

• Soft tissue and Skeletal injuries of the Face

• Head and Neck Cancer and Salivary Gland Tumors

• Skull Base Surgery

• Craniofacial and Maxillofacial Prosthetics

• Reconstruction of the Scalp, Calvarium and Forehead

• Reconstruction of the Lips

• Reconstruction of the Cheeks

• Nasal Reconstruction

• Reconstruction of the Eyelids, Correction of Ptosis and Canthoplasty

• Facial Paralysis Reconstruction

• Mandible Reconstruction

• Reconstruction of Defects of the Maxilla and Skull Base

• Reconstruction of the Oral Cavity, Pharynx and Esophagus

• Tumors of Head & Neck

Cleft Lip and Palate and Craniofacial Anomalies

• Embryology of head and neck (excluding central nervous system).

• Regional anatomy of head and neck.

• Embryogenesis of cleft lip and palate.

• Cleft lip and palate, alveolar clefts.

• Velopharyngeal incompetence.

• Orthodontics, speech therapy in cleft lip and palate.

• Principles of craniofacial surgery.

• Rare craniofacial clefts, Tessier's clefts.

• Craniosynostosis, hypertelorism, craniofacial microsomia

Trunk and Lower Extremity

• Thoracic Reconstruction

• Abdominal Wall Reconstruction

• Lower- Extremity Reconstruction

• Foot and Ankle Reconstruction

• Reconstruction of the Perineum

• Lymphedema

• Pressure Sores

• Reconstruction of the Penis

• Diabetic Foot Care

Hand

• Development of Hand Surgery

• Principles of Upper Limb Surgery

• Radiologic Imaging of the Hand and Wrist

• Soft- tissue Reconstruction of the Hand

• Fractures and Ligamentous Injuries of the Wrist

• Fractures, Dislocations, and Ligamentous Injuries of the Hand

• Tendon Healing and Flexor Tendon Injury

• Repair of the Extensor Tendon System

• Infections of the Upper Limb

• Tenosynovitis

• Compression Neuropathies in the Upper Limb and Electrophysiologic Studies

• Thumb Reconstruction

• Tendon Transfers

• Congenital Hand Anomalies

• Duputyren's Disease

• Replantation in the Upper Extremity

• Upper Limb Arthritis

• Upper Limb Amputation and Prosthesis

• Management of Spastic Hands

• Basic principles of Wrist Surgery

Burns

• Thermal burns.

• Electrical burns.

• Chemical burns.

• Radiation burn.

• Pathophysiology of burn shock.

• Nutrition in burns.

• Facial burns.

• Tangenital excision and sequential excision.

• Reconstruction of burn hand and upper extremity.

• Post burn contractures –treatment of sequelae.

• Burn wound infection, sepsis.

• Principles of planning in event of burn disaster.

• Organization of Burns Unit

• Principles of Skin Banking

General Principles

• History of Plastic Surgery (Direct 6 years course) and its broad scope at the present time.

• Anatomy and functions of skin.

• Split skin grafts and full thickness skin grafts, their take and

• Subsequent behaviour.

• Local skin flaps.

• Pedicled skin flaps and tubs.

• Unstable scar and scar contracture.

• Care of wounds, dressing, techniques and splints.

• Wound healing.

• Grafts – fat, fascia, tendon, nerve, cartilage, bone.

• Infective skin gangrene.

• Hospital infections.

• Suture instruments.

• Surgical instruments.

• Implant materials used in Plastic Surgery (Direct 6 years course).

• Principles of genetics and general approach to the management of congenital malformations.

• Flaps-Fasciocutaneous muscle, musculocutaneous, congenital malformations.

• Local anaesthesia, nerve blocks, regional anaesthesia.

• Principles of anaesthesia for infants, adults, hypothermia, hypotensive anaesthesia.

• Tissue expansion.

• Keloid, hypertrophic scans.

• Endoscopy in Plastic Surgery

Management of and relationships with the Plastic Surgery (Direct 6 years course)

outpatient and inpatient

• Principles of Reconstructive Surgery

• Principles of Aesthetic Surgery

• Management of Acute Trauma

• Malignant Skin Tumours

• Benign Skin Conditions

• Administration

• Basic sub-specialty training in:

i. Burns

ii. Paediatric Plastic Surgery

iii. Head & Neck Tumours

iv. Hand Surgery

v. Burn

vi. Head and Neck Tumours

vii. Cleft Lip and Palate

viii. Reconstruction of Genitalia

ix. Oculoplastic Surgery

x. Limb Trauma

xi. Aesthetic Surgery

xii. Acute and Chronic Wound care with special emphasis on Diabetic Foot Care

xiii. Oncoplastic Breast Surgery

• Biostatistics, Research Methodology and Clinical Epidemiology

• Ethics

• Medico legal aspects relevant to the discipline

• Health Policy issues as may be applicable to the discipline

IV. COMPETENCIES

• Acquisition of basic surgical skills in instrument and tissue handling.

• Incision of skin and subcutaneous tissue: Ability to incise superficial tissues accurately with suitable instruments.

• Closure of skin and subcutaneous tissue: Ability to close superficial tissues accurately.

• Knot tying: Ability to tie secure knots.

• Haemostasis: Ability to achieve haemostasis of superficial vessels.

• Tissue retraction: Use of suitable methods of retraction.

• Use of drains: Knowledge of when to use a drain and which to choose.

• Tissue handling: Ability to handle tissues gently with appropriate instruments.

• Skill as assistant: Ability to assist helpfully, even when the operation is not familiar

• The DNB resident should do the dressings of the patient that have been operated/assisted by them and of patients in Burns ICU.

• The DNB resident should note down the History and examination of admitted patients and should daily put progress notes in files.

• The normal working hours will be from 8.00 AM to 8.00 PM. When on emergency duty, the resident is supposed to stay overnight in the resident room.

• The DNB resident is to get one day off every week

Knowledge & Clinical Skills

1. Incision of skin and subcutaneous tissue:

• Langer's lines

• Healing mechanism

• Choice of instrument

• Safe practice

• Basic Surgical Skills course

• Closure of skin and subcutaneous tissue:

• Options for closure

• Suture and needle choice

• Safe practice

• Ability to use scalpel, diathermy and scissors

• Closure of skin and subcutaneous tissue:

• Accurate and tension free apposition of wound edges

2. Knot tying

• Single handed

• Double handed

• Superficial

• Deep

• Instrument

3. Choice of material

4. Haemostasis:

• Techniques

• Tissue retraction:

• Choice of instruments

• Use of drains:

• Indications

• Types

• Management/removal

• Tissue handling

• Choice of instruments

• Control of bleeding vessel (superficial)

• Diathermy

• Suture ligation

• Tie ligation

• Clip application

• Tissue retraction:

• Tissue forceps

• Placement of wound retractors

• Use of drains:

• Insertion

• Fixation

• Removal

Clinical Skills

• An understanding of burns assessment and resuscitation

• An understanding of burn wound excision and grafting

• An understanding of burn wound dressings

• An awareness of the roles of nursing staff, physiotherapists and occupational therapists in rehabilitation

• Wound care – both acute and chronic and techniques for cover.

• Basics of Skeletal fixation of fractures. (needed for both facial fractures and hand fractures)

• Ability to assess major trauma

• Ability to debride an infected wound or a dirty wound

• Ability to plan and execute soft tissue cover for defects got due to trauma, infection and cancer

Practical

History, examination and writing of records:

• History taking should include the back ground information, presenting complaints and history of present illness, history of previous illness, family history, social and occupational history and treatment history.

• Detailed physical examination should include general examination and systemic examination (Chest, Cardio-vascular system, Abdomen, Central nervous system, locomotor system and joints), with detailed examination of the abdomen.

• Skills in writing up notes, maintaining problem oriented records, progress notes, and presentation of cases during ward rounds, planning investigations and making a treatment plan should be taught.

Bedside procedures & Investigations

• Therapeutic skills: Venepuncture and establishment of vascular access,

• Administration of fluids, blood, blood components and parenteral nutrition,

• Nasogastric feeding, Urethral catheterization, Administration of oxygen,

• Cardiopulmonary resuscitation, Endotracheal intubation.

Clinical Teaching

• General, Physical and specific examinations of Maxillofacial & Hand Injuries should be mastered. The resident should able to analyse history and correlate it with clinical     findings. He should be well versed with all radiological procedures like CT Angio, CT Face with 3D Reconstruction and X-Ray of face. He should present his daily admissions in morning report and try to improve management skills, fluid balance, and choice of drugs. He should clinically analyse the patient & decide for pertinent Investigations required for specific patient.

Teaching Programme

• General Principles

• Acquisition of practical competencies being the keystone of postgraduate medical education, postgraduate training is skills oriented.

• Learning in postgraduate program is essentially self-directed and primarily emanating from clinical and academic work. The formal sessions are merely meant to supplement this core effort.

Teaching Sessions

• The teaching methodology consists of bedside discussions, ward rounds, case presentations, clinical grand rounds, statistical meetings, journal club, lectures and seminars. Along with these activities, trainees should take part in interdepartmental meetings i.e clinico-pathological and clinico-radiological meetings that are organized regularly.

• Trainees are expected to be fully conversant with the use of computers and be able to use databases like the Medline, Pubmed etc.

• They should be familiar with concept of evidence based medicine and the use of guidelines available for managing various diseases.

Teaching Schedule

• Following is the suggested weekly teaching programme in the Department of Plastic Surgery (Direct 6 years course):

1. Seminar once a week

2. Journal club once a week

3. Case Presentation once a week

4. File Audit/Stat Meet once month

5. Grand Round/Interdepartmental Meet once a month

• Each unit should have regular teaching rounds for residents posted in that unit.

• Then rounds should include bedside case discussions, file rounds (documentation of case history and examination, progress notes, round discussions, investigations and management plan), interesting and difficult case unit discussions.

• Central hospital teaching sessions will be conducted regularly and MCh residents would present interesting cases, seminars and take part in clinicL- pathological case discussions.

Conferences and Papers

• A resident must attend at least one conference per year.

• One paper must be presented in at least 3 years.

POSTING

1st year (12 + 3 months)

• First 3 months to be spent in the parent Plastic surgical unit to know the basics of plastic surgery

• Next 12 months to be spent in General Surgery to learn the basics of surgery

2nd year (9 months)

• To undergo Peripheral superspeciality postings

• 1 month in Surgical oncology

• 1 month in Paediatric surgery

• 1 month in Neurosurgery

• 1 month in Gastro Intestinal Surgery

• 1 month in Vascular Surgery

• 1 month in Cardiothoracic Surgery

• 1 month in Anaesthesiology & Intensive Care

• 1 month in Orthopaedics

• 1 month in Dermatology

3rd year (Back to parent plastic surgical unit)

• Basics / Basic Plastic Surgery theory, assisting in major plastic surgery procedures with assistants

4th Year

• To do Basic Plastic Surgery Procedures independently and assist major Plastic surgical procedures

5th Year

• To go to peripheral postings (To other plastic Surgical units in India or abroad. Two or 3 months as agreed by the parent unit academic supervisor)

• To assist major plastic surgical procedures and do basic procedures

6th year

• To do major Plastic Surgical procedures under supervision

Schedule of Posting

• OPD: Twice a week

• OT: Twice a week

• Emergency: Twice a week

Rotation of DNB Candidates in Other institutions

No single unit in the country can boast to be good in all aspects of the wide gamut of Plastic Surgery (Direct 6 years course) as the branch of Plastic Surgery is very wide. In addition it is beneficial to observe the working patterns and learn different techniques used by various stalwarts of this speciality. Hence DNB candidates must be rotated in other units in the country/abroad. The DNB candidate should get a letter from his/her DNB supervisor permitting them to visit the institutions of their choice. The DNB candidates must maintain a log book regarding what they learnt and observed in the institutions that they visit. At the end of the visit to each centre, they should get their logbooks attested by the head of the plastic surgical programme that they visit.

Period: 2 months mandatory, and 3 months upper limit. Location:

• It can be to institutions having an approved DNB/MCh Plastic surgical

• programme in India.

• Under exceptional circumstances a non teaching institution in India can be accepted provided the DNB supervisor agrees and vouches for the quality of work of the chosen institution.

• DNB candidates can observe and train under surgeons/institutions abroad provided the DNB supervisor agrees and vouches for the quality of work of the chosen institution

Job Responsibilities

Outdoor Patient (OPD) Responsibilities

• The working of the residents in the OPD should be fully supervised.

• They should evaluate each patient and write the observations on the OPD card with date and signature.

• Investigations should be ordered as and when necessary using prescribed forms.

• Residents should discuss all the cases with the consultant and formulate a management plan.

• Patient requiring admission according to resident's assessment should be shown to the consultant on duty.

• Patient requiring immediate medical attention should be sent to the casualty services with details of the clinical problem clearly written on the card.

• Patient should be clearly explained as to the nature of the illness, the treatment advice and the investigations to be done.

• Resident should specify the date and time when the patient has to return for follow up.

In-Patient Responsibilities

• Each resident should be responsible and accountable for all the patients admitted under his care. The following are the general guidelines for the functioning of the residents in the ward:

• Detailed work up of the case and case sheet maintenance:

• The trainee should record a proper history and document the various symptoms.

• Perform a proper patient examination using standard methodology.

• He should develop skills to ensure patient comfort/consent for examination. Based on the above evaluation the trainee should be able to formulate a differential diagnosis and prepare a management plan

• Should develop skills for recording of medical notes, investigations and be able to properly document the consultant round notes.

• To organize his/her investigations and ensure collection of reports.

• Bedside procedures for therapeutic or diagnostic purpose.

• Presentation of a precise and comprehensive overview of the patient in clinical rounds to facilitate discussion with senior residents and consultants.

• To evaluate the patient twice daily (and more frequently if necessary) and maintain a progress report in the case file.

• To establish rapport with the patient for communication regarding the nature of illness and further plan management.

• To write instructions about patient's treatment clearly in the instruction book along with time, date and the bed number with legible signature of the resident.

• All treatment alterations should be done by the residents with the advice of the concerned consultants and senior residents of the unit.

Admission day

• Following guidelines should be observed by the resident during admission day.

• Resident should work up the patient in detail and be ready with the preliminary necessary investigations reports for the evening discussion with the consultant on duty.

• After the evening round the resident should make changes in the treatment and plan out the investigations for the next day in advance.

Doctor on Duty

• Duty days for each Resident should be allotted according to the duty roster.

• The resident on duty for the day should know about all sick patients in the wards and relevant problems of all other patients, so that he could face an emergency situation effectively.

• In the morning, detailed over (written and verbal) should be given to the next resident on duty. This practice should be rigidly observed.

• If a patient is critically ill, discussion about management should be done with the consultant at any time.

• The doctor on duty should be available in the ward throughout the duty hours.

Care of Sick Patients

• Care of sick patients in the ward should have precedence over all other routine work for the doctor on duty.

• Patients in critical condition should be meticulously monitored and records maintained. If patient merits ICU care then it must be discussed with the senior residents and consultants for transfer to ICU.

• Resuscitation skills

• At the time of joining the residency programme, the resuscitation skills should be demonstrated to the residents and practical training provided at various work stations.

• Residents should be fully competent in providing basic and advanced cardiac life support.

• They should be fully aware of all advanced cardiac support algorithms and be aware of the use of common resuscitative drugs and equipment like defibrillators and external cardiac pacemakers.

• The resident should be able to lead a cardiac arrest management team.

• Discharge of the Patient

• Patient should be informed about his/her discharge one day in advance and discharge cards should be prepared 1 day prior to the planned discharge.

• The discharge card should include the salient points in history and examination, complete diagnosis, important management decisions, hospital course and procedures done during hospital stay and the final advice to the patient.

• Consultants and DM Residents should check the particulars of the discharge card and counter sign it.

• Patient should be briefed regarding the date, time and location of OPD for the follow up visit.

In Case of Death

• In case it is anticipated that a particular patient is in a serious condition, relatives should be informed about the critical condition of the patient beforehand.

• Residents should be expected to develop appropriate skills for breaking bad news and bereavements.

• Follow up death summary should be written in the file and face sheet notes must be filled up and the sister in charge should be requested to send the body to the mortuary with respect and dignity from where the patient's relatives can handed over the body

• In case of a medico legal case, death certificate has to be prepared in triplicate and the body handed over to the mortuary and the local police authorities should be informed.

• Autopsy should be attempted for all patients who have died in the hospital especially if the patient died of an undiagnosed illness.

Bedside Procedures

• The following guidelines should be observed strictly:

• Be aware of the indications and contraindications for the procedure and record it in the case sheet. Rule out contraindications like low platelet count, prolonged prothrombin time, etc.

• Plan the procedure during routine working hours, unless it is an emergency.

• Explain the procedure with its complications to the patient and his/her relative and obtain written informed consent on a proper form. Perform the procedure under strict aseptic precautions using standard techniques. Emergency tray should be ready during the procedure.

• Make a brief note on the case sheet with the date, time, nature of the procedure and immediate complications, if any.

• Monitor the patient and watch for complications(s).

OT responsibilities

• The 1st year resident observes the general layout and working of the OT, understands the importance of maintaining sanctity of the OT, scrubbing, working and sterilization of all the OT Instruments. The trainee is to assist seniors while operating as well as work as a junior surgical trainee in general surgery.

• The 2nd year DNB resident is posted in various super specialities and he should observe their work and assist the senior surgeons. The trainee should also actively take part in the academic activities of the respective departments

• The 3rd year DNB resident is to assist his/ her seniors for plastic surgical procedures

• The 4th year DNB resident should be able to do minor plastic surgical procedures independently and assist seniors for major surgeries.

• The 5th year DNB resident should be able to do minor plastic surgical procedures and some major surgical procedures with the assistance of his/her seniors

• The final year resident should be able to perform minor/medium/major surgeries independently and assist in medium/major/extra major surgeries. The trainee

• should be able to handle all emergencies and post op complications independently and is responsible for supervision and guidance of his/her juniors.

Medico-Legal Responsibilities of the Residents

• All the residents are given education regarding medico-legal responsibilities at the time of admission in a short workshop.

• They must be aware of the formalities and steps involved in making the correct death certificates, mortuary slips, medico-legal entries, requisition for autopsy

• They should be fully aware of the ethical angle of their responsibilities and should learn how to take legally valid consent for different hospital procedures & therapies.

• They should ensure confidentiality at every stage

V. LOG BOOK

A candidate shall maintain a log book of operations (assisted / performed) during the training period, certified by the concerned post graduate teacher / Head of the department / senior consultant.

This log book shall be made available to the board of examiners for their perusal at the time of the final examination.     

The log book should show evidence that the before mentioned subjects were covered (with dates and the name of teacher(s) The candidate will maintain the record of all academic activities undertaken by him/her in log book.

1. Personal profile of the candidate

2. Educational qualification/Professional data

3. Record of case histories

4. Procedures learnt

5. Record of case Demonstration/Presentations

6. Every candidate, at the time of practical examination, will be required to produce performance record (log book) containing details of the work done by him/her during the entire period of training as per requirements of the log book. It should be duly certified by the supervisor as work done by the candidate and countersigned by the administrative Head of the Institution.

7. In the absence of production of log book, the result will not be declared.

VI. RECOMMENDED TEXT BOOKS AND JOURNALS

Suggested Books

• Grabb & Smith: Plastic Surgery – 7th Edition

• Neligan P. Ed Plastic Surgery – 6 Volume set 4th Edition, 2017.

• Mc Gregor: Fundamental techniques of Plastic Surgery

• Diego Marre. Fundamental Topics in Plastic Surgery

• Plastic and Reconstructive Surgery Ed. Karoon Agrawal

• Green's: Operative Hand surgery

• Grab's: Encyclopedia of flaps

• Flaps and Reconstructive Surgery – Wei and Mardini. 2nd ed

• Paediatric Burns-Total Management of the Burned Child by Marella L     Hanumadass and K Mathangi Ramakrishnan

• Total Burn Care – David Herndon. 4th Ed.

• Mc Carthy: Current therapy in Plastic Surgery

• Practice Manual of Microvascular Surgery – Acland RD and Sabapathy SR

• Maxillofacial Surgery – Peter Ward Booth, 2 vol set. 2nd ed.

Suggested Journals

• Indian Journal of Plastic Surgery

• Plastic and Reconstructive Surgery

• Journal of Plastic Reconstructive and Aesthetic Surgery

• Burns

• Clinics in Plastic Surgery

• Hand Clinics

• Journal of Hand Surgery (am)

• Aesthetic Surgery Journal

2 years 3 months ago

State News,News,Health news,Delhi,NBE News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses,Medical Courses Curriculum

Kaiser Health News

‘Caged … For No Fault of Your Own’: Detainees Dread Covid While Awaiting Immigration Hearings

LUMPKIN, Ga. — In October, Yibran Ramirez-Cecena didn’t alert the staff at Stewart Detention Center to his cough and runny nose. Ramirez-Cecena, who had been detained at the immigration detention facility in southwestern Georgia since May, hid his symptoms, afraid he would be put in solitary confinement if he tested positive for covid-19.

“Honestly, I didn’t want to go spend 10 days by myself in a room — they call it the hole,” Ramirez-Cecena said. He is being held at the center as he waits to learn whether he will be deported to Mexico or can remain in the United States, where he has lived for more than two decades.

Shortly before Ramirez-Cecena got sick, officials from U.S. Immigration and Customs Enforcement at the facility denied his request for a medical release. He is HIV-positive, which is on the Centers for Disease Control and Prevention’s list of conditions that make a person more likely to get seriously ill from covid.

Now, heading into the third pandemic winter, he’s praying he doesn’t get covid while detained. “It is still scary,” he said.

Across the country, the chance of developing severe illness or dying from covid has fallen, a result of updated booster shots, at-home tests, and therapeutics. Most people can weigh the risks of attending gatherings or traveling. But for the roughly 30,000 people living in close quarters in the country’s network of immigration facilities, covid remains an ever-present threat.

ICE updated its pandemic guidance in November. But facilities have flouted past recommendations to use masks and protective equipment, to make testing and vaccines available, and to avoid the use of solitary confinement for quarantining, according to detainees, advocacy groups, and internal federal government reports.

Under ICE’s pandemic protocols, covid isolation, used to keep other detainees from falling ill, must be separate from disciplinary segregation. The agency didn’t address claims that facilities have used solitary confinement areas to isolate detainees who have tested positive for covid but said in a statement to KHN that detainees are placed in a “single, medical housing room” or a “medical airborne infection isolation room” when available.

Medical care in immigration detention facilities was deficient even before the pandemic. Then, in September, medically vulnerable people in ICE detention facilities lost a source of protection, with the expiration of a court order that had required federal immigration officials to consider releasing detainees with covid risks.

The agency has “completely given up on protecting people in detention from covid,” said Zoe Bowman, supervising attorney at Las Americas Immigrant Advocacy Center in El Paso, Texas.

The country’s use of immigration detention exploded in the late 1990s and rose even more after the creation of ICE in 2003. Detention facilities — made up of about 200 privately run complexes, ICE-run facilities, local jails, and prisons scattered across the country — hold adults who are not U.S. citizens while they contest or await deportation. The average length of stay in the 2022 federal fiscal year was about 22 days, according to the agency. Advocates for immigrants have long argued that people shouldn’t be detained and instead should be allowed to live in communities.

Stewart Detention Center, a vast complex surrounded by rows of barbed wire in Lumpkin’s forests, has one of the largest populations of detainees in the country. Four people in the center’s custody have died from covid since the start of the pandemic — the highest number of recorded covid deaths among detention centers.

When immigration officials transferred Cipriano Alvarez-Chavez to the Stewart center in August 2020, he was still relying on the mask he had after being released from federal prison in July, according to his daughter, Martha Chavez.

Ten days later, the 63-year-old lymphoma survivor was taken to a hospital in Columbus, 40 miles away, where he tested positive for covid, according to his death report. He died after spending more than a month on a ventilator.

“It was pure neglect,” his daughter said. His death “shattered our world.”

Two years after Alvarez-Chavez’s death, advocacy groups and detainees said ICE has not done enough to protect detainees from covid, a situation consistent with the facilities’ history of poor medical care and lack of hygiene. “It’s disheartening to see that no matter how bad things get, they don’t change,” said Dr. Amy Zeidan, an assistant professor at Emory University School of Medicine, who reviews detainee health records and performs medical evaluations for people seeking asylum.

A bipartisan Senate investigation revealed in November that women at Georgia’s Irwin County Detention Center “appear to have been subjected to excessive, invasive, and often unnecessary gynecological procedures.” At the Folkston Processing Center, also in Georgia, ICE did not respond to medical requests in a timely manner, had inadequate mental health care, and failed to meet basic hygiene standards, including working toilets, according to a June report from the Department of Homeland Security’s Office of Inspector General. And a July complaint filed by a group of advocacy organizations alleged that a nurse at the Stewart center sexually assaulted four women.

ICE defended its medical care in an emailed statement, saying that it spends more than $315 million on health care annually and ensures the provision of necessary and comprehensive medical services.

Still, many facilities are understaffed and ill-equipped to handle the long-term medical needs of the large detainee population, Zeidan said. Delayed care is common, specialty care is almost nonexistent, and access to therapeutics is limited, she said. Covid care is no different.

In its covid protocols, ICE recommends the use of monoclonal antibodies, which help the immune system respond more effectively to covid, for treatment. But it recognizes none of the other CDC-recommended treatments, including antivirals such as Paxlovid, which can reduce hospitalizations and deaths among covid patients.

“For decades, ICE has proven itself incapable and unwilling to ensure the health and safety of people in its custody,” said Sofia Casini, director of monitoring and community advocacy at Freedom for Immigrants, an advocacy group. “Covid-19 has only worsened this horrifying reality.”

Eleven people have died from covid in ICE custody. But that number may be an underestimate; advocates for detainees have accused the agency of releasing people or deporting them when they are seriously ill as a way to suppress the death statistics.

Before the pandemic, Johana Medina Leon was released from ICE custody four days before her death, according to a May article in the Los Angeles Times. She saw a doctor about six weeks after her first request, the article said, but ICE expedited her release only hours after her condition grew dire.

This fall, detainees being held at facilities across the country called Freedom for Immigrants’ detention hotline to complain about covid conditions, which vary facility to facility, Casini said. “Even in the same facility, it can change week to week,” she said.

Many people who had tested positive for covid were being held in the same cells as people who had tested negative, including people who were medically vulnerable, according to Casini. The group surveyed 89 people through its hotline this summer and found that about 30% of respondents had trouble accessing vaccines in detention.

Ramirez-Cecena said he was told that he’s eligible for a second covid booster shot but had yet to receive it as of December. A detainee at Moshannon Valley Processing Center in Pennsylvania said a guard was allowed to interact with detainees while visibly sick, said Brittney Bringuez, asylum program coordinator at Physicians for Human Rights, who visited the facility this fall.

The court order that required ICE to consider releasing people with covid risks has helped detainees with serious medical conditions, advocates said. Under the order, ICE released about 60,000 medically vulnerable detainees in two years, said Susan Meyers, senior staff attorney at the Southern Poverty Law Center, one of the advocacy groups that helped bring the lawsuit that resulted in the court order.

ICE said in a statement it will still consider covid risk factors as a reason for release. But lawyers said ICE facilities often failed to comply with the court order when it was in place.

Last year, ICE denied Ricardo Chambers’ request for release from Stewart Detention Center. Chambers, who is 40, has serious psychiatric illnesses, considered a risk factor under the court order. He also has trouble breathing and chokes in his sleep — the result of a nasal injury he sustained in an attack before he was detained. It has yet to be repaired during the two years he has been at the detention facility.

He has filed complaints about Stewart’s covid protocols, including crowded conditions and failures by staffers to wear masks or other protective equipment. In its denial of his release, ICE said Chambers was a threat to public safety because of his criminal history, according to his lawyer Erin Argueta, lead attorney for the Southern Poverty Law Center’s Southeast Immigrant Freedom Initiative office in Lumpkin. Chambers has served prison time for his criminal convictions, she said, and there’s a family in New York that would take him in.

Earlier this year, he was sent to solitary confinement for about 10 days after testing positive for covid, he said. But Chambers, who is fighting a deportation order to Jamaica, said his covid experience was no different from the other times he had been in solitary.

“You’ll be treated like an animal, caged, and for no fault of your own,” Chambers said.

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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2 years 3 months ago

COVID-19, Public Health, States, Georgia, Immigrants, Prison Health Care

STAT

STAT+: Former MIT professor tried to influence investigation of harassment at lab, report states

Former Massachusetts Institute of Technology professor David Sabatini attempted to influence a legal investigation into complaints of gender bias and sexual harassment at his lab, according to what appears to be a copy of the investigation report, leaked online Wednesday.

Former Massachusetts Institute of Technology professor David Sabatini attempted to influence a legal investigation into complaints of gender bias and sexual harassment at his lab, according to what appears to be a copy of the investigation report, leaked online Wednesday. The report further found his denials were not credible. Portions of the report had been leaked earlier.

A spokesperson for MIT’s Whitehead Institute, which commissioned the investigation by a law firm, declined to comment on the leaked document.

Continue to STAT+ to read the full story…

2 years 3 months ago

In the Lab, legal, scientists, STAT+

MedCity News

Why Providers Need to Stop Overlooking Burnout Among Clinical Support Staff

While levels have gone down from their pandemic peak, burnout remains high among clinical support staff, according to a new report. It found that 70% of clinical support staff experience moderate to severe burnout, with 32% categorizing their burnout as high to severe. Along with the obvious effect it has on support staff’s wellbeing, burnout also negatively impacts patient care.

2 years 3 months ago

Daily, Health Tech, SYN, Top Story, Artera, burnout, clinical support staff, Nurses, patient communication, physician assistants

Health Archives - Barbados Today

Reporters receive inaugural Journalism Fellowship


Two senior reporters made history by being awarded the first Journalism Fellowships for Childhood Obesity and NCD Prevention on December 15.


Two senior reporters made history by being awarded the first Journalism Fellowships for Childhood Obesity and NCD Prevention on December 15.

Marlon Madden of Barbados TODAY and Regina Selman Moore of The Barbados Advocate were selected to receive the Fellowship, which was launched in May 2021 through a partnership between the Barbados Association of Journalists and Media Workers (BARJAM) and the Heart and Stroke Foundation of Barbados (HSFB).

Pre-COVID research shows that an alarming 31 per cent of children in Barbados are obese or overweight. It is especially critical that young people, parents and policymakers be informed on how to tackle this health crisis that is inextricably linked to the extremely high prevalence of Non-Communicable Diseases (NCDs). Current statistics indicate that eight out of every ten deaths in Barbados is due to an NCD.

An analysis of media coverage in Barbados between June 2021 and March 2022 revealed that articles by Madden and Selman-Moore highlighted childhood obesity, the increasing challenge of NCDs, and its impact on the social, economic and financial sectors.

General Secretary of BARJAM Emmanuel Joseph congratulated the journalists and applauded the initiative. 

“The Association is delighted and celebrates with Regina and Marlon on being chosen for the fellowship. I thank you both for your good work against all the odds, because journalism can be a thankless job as a lot is demanded of us, with very little returns,” said Joseph.

He also thanked the HSFB for the collaboration and urged the two journalists to capitalise on the fellowship and to continue drawing attention to the issue of childhood obesity, as it is a matter of life and death. He noted that the fellowships are key to bringing this concern into public discourse and raising awareness about the issue. “We look forward to the transformation that reporting on childhood obesity (and NCDs) will bring to the local landscape,” he said.

The journalists will each be awarded Bds$1, 200 to support their six-month fellowship, which began on December 1, 2022. During this period, the journalists are challenged to produce evidence-based in-depth articles and stories that further explore the various aspects related to childhood obesity and NCDs at the national and global level, and continue to sensitise Barbadians to the issues. 

 Offering her congratulations, Chief Executive Officer of HSFB Michelle Daniel stressed that the media continues to be an important partner in advocacy efforts for childhood obesity.

“We have noted some very dedicated journalists who understand the metrics of a situation as alarming as childhood obesity and are able to present this information in easily comprehensible ways. Our public cannot be informed about the factors influencing childhood obesity without the support and input of the media. We are heartened to award professional and dedicated journalists to be on the right side for our children as we continue this battle,” she said. 

The presentation to the winning journalists took place at the Heart and Stroke Foundation of Barbados. 

(PR)

The post Reporters receive inaugural Journalism Fellowship appeared first on Barbados Today.

2 years 3 months ago

Feature, Health

Health – Dominican Today

Mental health, the new purpose of brands

Mental health is currently one of the biggest concerns in society, affected by destabilizing events such as economic crises, COVID-19, or war. According to the Ipsos Global Health Service Monitor report, mental health is in second place among global health problems (five points higher than in 2021) and has surpassed cancer in the ranking of the most serious health issues that nations face.

According to the same Global Health report, 58% of the global population says they think “often” about their mental well-being.

According to the World Health Organization (WHO), 15% of adults of working age have a mental disorder, resulting in global economic losses of more than $1 trillion. As a result, this issue is presented as a priority for the international community’s socioeconomic mobility. With these statistics, it is clear that mental health is a topic that is extremely important today and will become even more so in the future. As a result, in a society where consumers expect brands to be agents of change and contribute to people’s well-being, communication strategies that focus on their attention have begun to gain prominence, and many brands have made it their purpose.

The global Communication, Public Affairs, and Marketing consultancy, LLYC, presents the Report “Mental health as a brand purpose” to provide communication strategies that allow brands to relate to their communities of interest. Considering the context in which the definition of a brand’s purpose is critical, mental health presents a great opportunity for companies to play an active, legitimate role in raising awareness and having a positive impact on people.

 

2 years 3 months ago

Health, Local

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