Happy
New Year! January 1 is a time when we sit and set resolutions, many of which we discard before the month ends. However, in life, goals are important and those goals should consist of health-based targets for living a more rewarding life in tip-top shape. Below are seven health goals we should set and work towards achieving this year.

1. Walk more

Ten minutes a day of brisk walking can increase circulation, lift your spirits, and enhance sleep. If you want to increase your walking in 2023, try breaking it up into 10-minute sessions to make it less intimidating. Remember, if while walking you can talk but your breathing is faster than usual, you are walking briskly enough.

2. Spend less time sitting down

The body wasn't designed to sit in front of the TV or at a desk for long periods of time. It raises your chances of developing diabetes; cardiovascular disease; and breast, colon, and colorectal cancer. Why not break up your desk time with the Pomodoro method? Set a timer so that each hour will be divided into two 25-minute blocks and two 5-minute pauses. During the work periods concentrate on your work, and during the breaks move around. Make use of your breaks to stand up, perform a quarter squat, rotate, or simply take a lap around the office. When you're working, this strategy can improve your concentration.

3. Plan meals

Just purchasing what you need reduces calories and waste, while saving you money. Before you go shopping, take the time to plan your meals and make a list.

4. Make sure you're enrolled for 2023 health insurance coverage

Do you have health insurance next year? If you aren't sure, now's the time to double-check. Call your insurance providers and review your existing plans or make an appointment to get some amount of coverage. It's protection you need when you least expect it.

5. Schedule your annual check-ups

Most individuals don't enjoy going to the doctor, especially if everything seems to be in order. However, as the saying goes, "An ounce of prevention is worth a pound of cure." Plan a time for your yearly check-up or well-woman appointment. Remember to schedule a dental cleaning or two while you have your calendar out.

6. Drink more water

Drinking a few more glasses of water each day can significantly improve your general health, particularly in warm weather or when you are exercising hard. The daily recommended intake is eight glasses of water. A glass typically measures eight ounces so a simple way is to invest in a 64 ounce bottle, fill it with water and complete it by the end of the day. If you don't like plain water, flavour it with infused fruit, herbs, or tea bags, but avoid processed sugar, sodas, and other artificially sweetened beverages.

7. Improve your sleep hygiene

Good sleep hygiene is crucial for both physical and mental health. You likely already know some of the simplest advice for getting more rest: consistent pattern, avoid using screens at least 30 minutes before bedtime, and keep phones away and on mute. It's important to get those eight hours in.

Public Health personnel, accompanied by Pan American Health Organization (PAHO) members, direct him to one of the tents set up by the Ministry in this sector of the Dominican capital, on the banks of the Isabela River, where the majority of the country’s ten cases of the disease have been confirmed.

Romer Castro expends his last energy to reach the provisional care center, where they begin the standard protocol for a patient with the symptoms: diarrhea, vomiting, stomach pain, and dehydration picture. He has taken too long to arrive for treatment, according to the health personnel of the mobile hospital, who are used to foreign patients who are afraid to go to the doctor, especially if they have irregular immigration status.

After giving him first aid, they transport him to the Moscoso Puello Hospital, accompanied by a relative and one of the doctors in charge of the case, so that the necessary tests can be performed to confirm if it is cholera, as there are other conditions, such as parasitism, that present with similar symptoms.

 

New Delhi: 19 eminent doctors have been selected as part-time members of the medical advisory council of the National Medical Commission (NMC).

The Union Minister for Health and Family Welfare, Dr Mansukh Mandaviya took part in the appointment process through a draw of lots.

The procedure of appointments is laid down in National Medical Commission (NMC) Act, 2019.

All appointments comprised 10 Part-time Members from State/UT governments, 9 Part-time Members from State Medical Council, fourth Member of each Autonomous Board and One expert for Search Committee.

As per the NMC act 2019, these appointments are being done for two years. Members from various states/UTs have been selected in the following categories:

1. Ten Part-time Members of NMC are selected from the nominee of the State / UT Government in Medical Advisory Council (earlier appointed in 2020): Assam, Arunachal Pradesh, Chhattisgarh, Puducherry, Uttarakhand, Ladakh, Sikkim, Telangana, Karnataka and Kerala.

Smt. Krishna Gohain, retired IAS officer and a Vice Chancellor of Srimanta Sankaradeva University of Health Sciences has been nominated from  Assam. He was earlier appointed as the Secretary to the Education Department, Govt. of Assam. 

Prof. Saket Kushwaha, Vice Chancellor of Rajiv Gandhi University of Health Sciences from Arunachal Pradesh. He is an Indian agricultural scientist and economist and has published more than a dozen books and a look at them indicates the wide range of his scholarly aptitude. Prior to Rajiv Gandhi, he served as a vice-chancellor, department dean or professor-in-charge at several universities including Banaras Hindu University and Lalit Narayan Mithila University.

Prof. Dr. Gurmeet Singh, Vice Chancellor of Puducherry University selected from Puducherry. He is a renowned academic administrator and an internationally reputed expert in the field of corrosion science and smart materials. During 2011-2012, Prof. Singh served as a Chair Professor at Lunghwa University, Taipei, where he was specially invited to start collaborative research. He was a visiting scientist to Hungary and Japan and has been on academic assignments to Germany, Italy, Australia, Singapore, Korea, Thailand and Kenya.

Prof. Hem Chandra, Vice Chancellor of Hemwati Nandan Bahuguna Health University, Dehradun from Uttarakhand. Prof. (Dr.) Hem Chandra, before joining as Vice-Chancellor, HNB Uttarakhand Medical Education University, Dehradun, was Head of Department of Hospital Administration & Medical Superintendent, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) Lucknow, UP.

Prof. S. K. Mehta, Vice Chancellor of University of Ladakh. Dr Mehta is a fellow of the Royal Society of Chemistry and has served as the director of PU's Sophisticated Analytical Instrumentation Facility (SAIF). He has more than 360 publications in international journals of repute to his name, 8,400 citations and is an author of as many as 15 books/chapters. He has been nominated as a member of several national committees.

Lt. Gen. (Dr.) Rajan Singh Grewal, Vice Chancellor of Sikkim Manipal University. He superannuated as Director General Medical Services (Army) in 2020, after 38 years of distinguished meritorious service in various prestigious academic, professional, administrative leadership & staff appointments under Ministry of Defence. He was appointed as Honorary Surgeon to the President of India in 2019. He has received various prestigious honours & awards.

Dr. Karunakar Reddy, Vice Chancellor of Kaloji Naryana Rao University of Health Sciences from Telangana. He is a member of the Expert Committee on the COVID-19.

Dr Ashok Chandraker, Vice Chancellor of Pandit Deendayal Upadhyaya Memorial Health Science and Ayush University of Chhattisgarh. 

Dr. M. K. Ramesh, Vice Chancellor of Rajiv Gandhi University of Health Sciences has been selected from Karnataka. He in the past has served the University as Registrar (Evaluation). Previously, Dr. S. Sacchidanand served as the VC of the institute and he retired on 14 June.

Dr. Mohanan Kunnummal, Vice Chancellor of Kerala University of Health and Sciences, Thrissur from Kerala. Dr. Mohanan was a professor at the Department of Radio Diagnosis at Thrissur Medical College for a long time. In 2016, he was appointed as the principal of Manjeri Government Medical College. After retirement, he was working as the head of the Department of Radio Diagnosis in Perinthalmanna MES Medical College.

2. Nine Part-time Members of NMC are selected from the nominee of State Medical Council in Medical Advisory Council (earlier appointed in 2020): Andhra Pradesh, Haryana, Goa, Gujarat, Delhi, Odisha, Himachal Pradesh, Punjab and Rajasthan

Dr. Mahesh Babulal Patel, Vice Chancellor of Gujarat University. He was a Professor of Pathology at B. J. Medical College in Ahmedabad (Gujarat).

Dr. Deepak Sharma from Rajasthan.

Dr. Vijay Kumar from Punjab. 

Dr. Rajiv Sood, Founder and Dean of ABVIMS & Dr RML Hospital's Department of Urology & Renal Transplant from Delhi. A master specialist in the field of Urology, he was instrumental in the creation of the Department at RML Hospital and has been heading its Urological Services since its inception in 1996.

Dr. Vinod Kashyap, registrar at the Himachal Pradesh Medical council.

Prof. Datteswar Hota is an eminent Renal Transplant Surgeon at the S.C.B Medical College, Cuttack in Odisha. He is also the recipient of the BC Roy Lifetime achievement award.

Dr. Padmanabh Vaman Rataboli, who was the president of the Goa Medical Council, is among the five members, who have been reelected to the council.

Dr. R. K. Aneja, President of the Haryana Medical Council.

Dr. Buchipudi Sambasiva Reddy is the president of the Andhra Pradesh Medical Council.

3. Fourth Member of each Autonomous Board (part-time Member) from the nominee of State Medical Council in Medical Advisory Council (earlier appointed in 2020) have been selected.

Dr. Pallavi P. Saple, administrator of the Maharashtra Medical Council and has been nominated for Undergraduate Medical Education Board in Maharashtra. Dr Saple was a former student of JJ Hospitals itself. She also served as the professor and the head of the paediatric department in the institute. Dr Pallavi Saple became one of the youngest deans to take charge of the institute.

Dr. K Senthil has been selected for Post-Graduate Medical Education Board in Tamil Nadu. Dr K Senthil is an MD General Medicine and a Prof of Medicine in Madurai Medical College.He has been Practicing in a village in Madurai district - Checkanurani, since 1990 after completing his MD and serving the poor and rural people around the area for last 32 years. He has also been serving as the President of TN Medical Council for the last 7 years and Also been the State President of TN Govt Doctors Association for last 16 years continuously.

Dr. Urmila Singh has been selected for Medical Assessment and Rating Board from Uttar Pradesh. 

Dr. Sahajanand Prasad Singh is a consultant general surgeon and National President of the Indian Medical Association (IMA). Dr Singh also served as the President of the Bihar Chapter of the Indian Medical Association. He has been nominated for Ethics and Medical Registration Board

4. One expert from Odisha was nominated for the Search Committee.

Prof. Datteswar Hota is an eminent Renal Transplant Surgeon at the S.C.B Medical College, Cuttack and has been nominated for the Search Committee from Odisha. He is also the recipient of the BC Roy Lifetime achievement award.

List of the names of experts can be found below. For maintaining transparency in the draw of lots, media personnel was also present to record the event.

Shri Rajesh Bhushan, Union Health Secretary, Dr. Manohar Agnani, Additional Secretary, Dr. Sachin Mittal, Joint Secretary along with officials from Health Ministry were present during the event.

Selected Members from States/ UTs

S No

Name of State/ UT

Name of the Member

1

Assam

Smt. Krishna Gohain, IAS (Retd.), Vice Chancellor, Srimanta Sankaradeva University of Health Sciences

2

Arunachal Pradesh

Prof. Saket Kushwaha Vice Chancellor Rajiv Gandhi University of Health Sciences

3

Puducherry

Prof. Dr. Gurmeet Singh, Vice Chancellor, Puducherry University

4

Uttarakhand

Prof. Hem Chandra , Vice Chancellor Hemwati Nandan Bahuguna Health University, Dehradun

5

Ladakh

Prof. S. K. Mehta, Vice Chancellor, University of Ladakh

6

Sikkim

Lt. Gen. (Dr.) Rajan Singh Grewal, Vice Chancellor, Sikkim Manipal University

7

Telangana

Dr. Karunakar Reddy, Vice Chancellor, Kaloji Naryana Rao University of Health Sciences

8

Chattisgarh

Dr Ashok Chandraker, Vice Chancellor, Pandit Deendayal Upadhyaya Memorial Health Science and Ayush University of Chhattisgarh

9

Karnataka

Dr. M. K. Ramesh, Vice Chancellor, Rajiv Gandhi University of Health Sciences

10

Kerala

Dr. Mohanan Kunnummal, Vice Chancellor, Kerala University of Health and Sciences, Thrissur, Kerala

Selected Members from Various State Medical Councils

S No

Name of State Medical Council

Name of the Member

1

Gujarat

Dr. Mahesh Babulal Patel

2

Rajasthan

Dr. Deepak Sharma

3

Punjab

Dr. Vijay Kumar

4

Delhi

Dr. Rajiv Sood

5

Himachal Pradesh

Dr. Vinod Kashyap

6

Odisha

Prof. Datteswar Hota

7

Goa

Dr. Padmanabh Vaman Rataboli

8

Haryana

Dr. R. K. Aneja

9

Andhra Pradesh

Dr. Buchipudi Sambasiva Reddy

Selected Members (Part-Time) for Autonomous Boards of NMC

S No

Name of State Medical Council

Name of the Part-time Member

Under-Graduate Medical Education Board

1

Maharashtra

Dr. Pallavi P. Saple

Post-Graduate Medical Education Board

1

Tamil Nadu

Dr. K. Senthil

Medical Assessment & Rating Board

1

Uttar Pradesh

Dr. Urmila Singh

Ethics & Medical Registration Board

1

Bihar

Dr. Sahajanand Prasad Singh

Selected Expert for Search Committee

S No

Name of State/ UT

Name of the Member

1

Odisha

Prof. Datteswar Hota

Also Read:All MD, MS Medicos have to undergo Residency in district hospitals for 3 months: NMC mandates implementation

Preperitoneal pelvic packing is associated with a greater risk of complications and a high overall mortality rate (36%), whereas angioembolization (AE) is associated with a decreased mortality rate (PP).

Patients with significant injuries to parts of the body other than the pelvis were also included in the study.

The authors performed a sensitivity analysis, excluding the subset of patients with an Abbreviated Injury Severity score of 2 or greater for head or chest, and confirmed their findings. The inclusion of these patients with a median Injury Severity Score of 24 may explain the high mortality rate and the median of 9 units of blood transfused. An independent risk of death has been linked to pelvic fractures in the context of other serious injuries, as shown by previous research. Perhaps most importantly, the authors show that there is substantial variation in the management of these critically ill patients across the United States, particularly in the choice and combination of interventions used, such as aortic endovascular balloon angioplasty (AE), preperitoneal PP, and resuscitative endovascular balloon angioplasty (REBOA).

This population-based research may have residual confounding, and patients who receive preperitoneal PP are physiologically different from those who can wait for the interventional radiology team, but the obvious issue from these findings is: what can we do to better rescue these patients and lower their high fatality rate?

The most noteworthy discovery of this research is the wide range of hospital management approaches. This variant warrants more investigation. Literature demonstrates that variance in procedures of care typically reflects variation in the quality of care offered, even if some variation is always necessary to provide patient-centered, tailored care.

Although the Ministry of Health and Wellness was unable to provide data on the economic impact of men suffering from noncommunicable diseases (NCDs), it revealed that 24 per cent of men suffer from elevated blood pressure in comparison to 19 per cent of women.

"We find that men generally don't come to us, sometimes, until it is too late to do much about their illnesses. As to the reason for this, I am not sure. It could be cultural, or it could be the fact that many men believe they should always show that they are strong even when the occasion doesn't call for it," explained Dr Dwayne Hall, consultant general surgeon at Cornwall Regional Hospital.

Dr Hall noted that NCDs are those diseases not transferable by contact but rather developed through family genetics, degenerative changes, or unhealthy lifestyle habits, and argued that more men need to adopt better health-seeking behaviours because male life expectancy in Jamaica is 72 years while for women it is 76 years.

Health professionals have underscored that although more women in Jamaica suffer from NCDs than men, more males may actually be affected than the figures suggest.

"Generally, because females have better health-seeking behaviours it would appear as though females have a higher prevalence of noncommunicable diseases than men but this may not necessarily be the case — and this is why we are encouraging men to take monitoring their health seriously, especially as it relates to illnesses such as hypertension and diabetes," Dr Hall added.

The consultant general surgeon added that there are also misconceptions about medication and treatment for NCDs.

"Some Jamaicans have the false understanding that one month's supply of medication for hypertension and diabetes mellitus will cure the disease. They will additionally say, 'I'm not claiming this disease, doc. And, if I start medications I know I won't ever come off them, and this is not the life I want'," noted Dr Hall.

"Then, you have some Jamaican men who stay away from medications for hypertension as they say it affects their nature and make them ineffective. So, the hypertension will go unchecked for months, resulting in complications such as kidney failure, stroke and heart attacks.

Whole foods nutritionist Dr Elloreen Pryce explained that when it comes to NCDs and taking their health seriously, some men are often unwilling to seek, or follow medical advice.

"From my experience, many men do not take their health seriously," said Dr Pryce.

"When you tell them to check their prostate, especially if they're over 40, some will ask why it is important or make some excuse as to why they won't do it.

"They can be very difficult to work with when it comes to things that may impact their health positively. If you say to them, 'Eat more vegetables,' they may say they aren't rabbits or other animals. If you say to them, 'Cut down on the alcohol,' they will raise objections. In fact, in preparing their meal plans, if you say, 'Cut down on the meat,' they'll ask what you expect them to eat," added Dr Pryce, who also wants men to be more proactive when it comes to their health.

"There's an adage that says when you see men at the doctor, it's because they are extremely ill or were taken there by a woman. We want men to dispel this notion of not visiting the doctors until it is too late. We want them to take care of themselves so they can be around us for a long time," said Dr Pryce.

In the meantime, Hugh Reid, general manager of JN Life Insurance, pointed out that even when it comes to acquiring life insurance for protection against critical illnesses, men are less likely to purchase a policy than women.

"When we look at our data here at JN Life Insurance, women outnumber men two to one when it comes to our client base. We need men to take their health seriously because of the impact it has on our economy and families who lose their male breadwinners in the most productive years of their lives," said Reid.

Data from the Ministry of Health and Wellness have revealed that NCDs and injuries are a major public health burden in Jamaica, and are the leading cause of death.

In 2015 an estimated seven out of 10 Jamaicans died from the four major NCDs — cancer, cardiovascular disease, diabetes, and chronic lower respiratory disease.

The ministry adds that an individual suffering from NCDs spends approximately one third of the household per capita expenditure on health-care services and the purchase of pharmaceutical drugs.

Institutions from Latin America and the Caribbean to receive grants to support the elimination of communicable diseases

Cristina Mitchell

27 Dec 2022

The duration of this super specialty course is 3 years, and it focuses on the study of the cause, prognosis, treatment, and prevention of blood-related 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-Gandhi Nagar, Army Hospital (R and R)-New Delhi, Dr. B L Kapur Memorial Hospital Pusa Road, New Delhi 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 (Clinical Haematology) varies from accredited institutes/hospital to hospital and may range from Rs. 80,000 to Rs. 4,00,000 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. 5,50,000 toRs.19,00,000 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 the 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 Clinical Haematology?

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

Clinical Haematology is the branch of medical science dealing with the study of the cause, prognosis, treatment, and prevention of blood-related diseases.

National Board of Examinations (NBE) has released a curriculum for DrNB in Clinical Haematology.

The curriculum governs the education and training of DrNB in Clinical Haematology.

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 Clinical Haematologywould help the specialist to recognize the health needs of the community. The student should be competent to handle medical problems effectively and should be aware of the recent advances in their 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 Clinical Haematology

Name of Course

DrNB in Clinical Haematology

Level

Doctorate

Duration of Course

Three years

Course Mode

Full Time

Minimum Academic Requirement

MD/DNB (General Medicine/ Paediatrics/ Biochemistry/ Pathology) 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

Counselling by DGHS/MCC/State Authorities

Course Fees

Rs. 80,000 to Rs. 4,00,000 per year

Average Salary

Rs. 5,50,000 to Rs.19,00,000 per year

Eligibility Criteria

The eligibility criteria for DrNB in Clinical Haematology 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 Clinical Haematology is mentioned below:

Name of Super Specialty course Course Type Prior Eligibility Requirement Clinical Haematology DM/DrNB MD/DNB (General Medicine) MD/DNB (Paediatrics) MD/DNB (Biochemistry) MD/DNB (Pathology)

•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 to be followed in order by the candidates for admission to DrNB in Clinical Haematology. Candidates can view the complete admission process for DrNB in ClinicalHaematology mentioned below:

• The NEET-SS or National Eligibility Entrance Test for Super specialty courses is a national-level master's level examination conducted by the NBE for admission to/MCh/DrNB Courses.
• Qualifying Criteria-Candidates placed at the 50th percentile or above shall be declared as qualified in the NEET-SS in their respective specialty.
• The following Medical institutions are not covered under centralized admissions for DM/MCh courses through NEET-SS:

1.AIIMS, New Delhi and other AIIMS

2.PGIMER, Chandigarh

3.JIPMER, Puducherry

4.NIMHANS, Bengaluru

• Candidates from all eligible feeder specialty subjects shall be required to appear in the question paper of the respective group, if they are willing to opt for a superspecialty course in any of the superspecialty courses covered in that group.
• A candidate can opt for appearing in the question papers of as many groups for which his/her Postgraduate specialty qualification is an eligible feeder qualification.
• By appearing in the question paper of a group and on qualifying the examination, a candidate shall be eligible to exercise his/her choices in the counseling only for those superspecialty subjects covered in said group for which his/ her broad specialty is an eligible feeder qualification.

Fees Structure

The fee structure for DrNB in Clinical Haematology varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for DrNB in Clinical Haematology is around Rs. 80,000 to Rs. 4,00,000 per year.

Colleges offering DrNB in Clinical Haematology

There are various accredited institutes/hospitals across India that offer courses for pursuing DrNB in Clinical Haematology.

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

Hospital/Institute

Specialty

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

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

Clinical Haematology

2

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

Clinical Haematology

1

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

Clinical Haematology

2

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

Clinical Haematology

1

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

Clinical Haematology

2

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

Clinical Haematology

1

HealthCare Global Specialty Hospital (Formerly Bangalore Institute of Oncology) Deans Office #8, P. Kalinga Rao Road, Sampangiram Nagar, Bangalore Karnataka-560027

Clinical Haematology

1

Malabar Cancer Centre Moozhikkara P O, Kodiyeri, Thalassery, Kannur Kerala-670103

Clinical Haematology

2

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

Clinical Haematology

1

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

Clinical Haematology

4

Rajiv Gandhi Cancer Institute and Research Centre Sec-5, Rohini, New Delhi Delhi-110085

Clinical Haematology

3

Sahyadri Super Specialty Hospital Plot No. 30C, Erandawane, Karve Road, Pune. Maharashtra-411004

Clinical Haematology

2

SCB Medical College and Hospital Mangalabag, Cuttack, Odisha Orissa Orissa-753010

Clinical Haematology

2

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

Clinical Haematology

2

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

Clinical Haematology

2

Tata Medical Center 14 Major Arterial Road (E-W), Newtown, Rajarhat, Kolkata West Bengal-700160

Clinical Haematology

2

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

Clinical Haematology

1

Syllabus

A DrNBin Clinical Haematology is a three years specialization course that provides training in the stream of ClinicalHaematology.

The course content for DrNB in Clinical Haematology is given in the NBE Curriculumreleased by the National Board of Examinations, which can be assessed through the link mentioned below:

DrNB Clinical Haematology In India: Check Out NBE Released Curriculum

1. THEORY SYLLABUS: Departments involved in the training programme:

i. Clinical Haematology (Adult and Pediatric) and HSCT

ii. Laboratory Haematology including Haematopathology, Cytogenetics and Molecular genetics

iii. Transfusion Medicine

iv. Microbiology

v. Biochemistry

vi. Pathology

vii. Nuclear Medicine

viii. Radiotherapy

ix. HLA/transplant immunology

2. CLINICAL HAEMATOLOGY TRAINING:

Under the faculty's guidance and supervision, the postdoctoral student will be responsible for the acquisition of knowledge in all areas of Haematology (clinical and laboratory) and Transfusion Medicine. Such knowledge will be acquired through bedside teaching, seminars, case presentations, journal clubs, tutorials, proper use of the library, and formal reviews of selected major topics. Faculty should be present at various exercises to provide appropriate input. The trainee will acquire clinical experience by day-today management of all patients admitted to the Haematology service under the faculty's supervision.

i. Basic Haematology:

a. Cell Cycle and haematopoiesis, iron, vitamin B12 and folate metabolism, concepts of coagulation and natural anticoagulant, structure, and functions of all types of blood cells.

b. Principles of chemotherapy, concepts of combination chemotherapy, their toxicities.

c. Monoclonal antibodies, immunotherapy and small molecules in Haematology, their use and toxicities.

d. Immunology: principles of innate and adaptive immunity and transplant immunology.

ii. Disorders of Red Cell: Clinical evaluation of a patient with anemia, adequate history taking, clinical examination, appropriate laboratory investigations, and management.

a. Iron deficiency anemia: Iron metabolism and its regulation, pathophysiology of iron deficiency, epidemiology, iron deficiency as a community health program, causes in the population, control strategies in the population. Interpretation of serum iron, TIBC, transferrin, ferritin to diagnose iron deficiency. Relevant test to establish the cause of the iron deficiency. Management, including iron replacement and treatment of the underlying cause. Epidemiological significance of iron deficiency anemia in the population and preventive strategies.

b. Vitamin B12 and folate deficiency: Understanding the role of Vitamin B12 and folate in cellular metabolism and the interaction of disease and drugs with B12 and folate metabolism. Clinical and laboratory evaluation of the deficiency and management of vitamin B12 and folate deficiency.

iii. Haemolyticanaemia:

a. Thalassemia and Haemoglobinopathies: Genetic basis and pathophysiology of the disorder, clinical and laboratory evaluation of the patient, with their management, and long-term follow-up. Adequate knowledge on transfusion regimes, chelation, thalassemia complications, the role of splenectomy, and HSCT. Principles of control of the thalassemia syndromes in the population, screening strategies, antenatal diagnosis, genetic counseling and monitoring of complications due to iron overload.

b. Sickle cell disease: Pathophysiology, evaluation, management of the steady-state as well as various sickle cell crises and management of chronic complications. Clinical and haematological features of the various sickle cell diseases. Therapeutic role of HSCT.

c. Inherited enzymopathies (Red cell G6PD deficiency & others) and membrane opathies: evaluation, planning and interpretation of investigations (like Osmotic Fragility Test and Eosin-5'-Maleimide dye binding test) to ascertain the diagnosis, and management. The precise role of splenectomy in the present era and emphasis on genetic counseling.

d. Acquired Haemolytic disorders: evaluation and management of acquired haemolytic anemia, the role of immunosuppression, intravenous immunoglobulin, plasmapheresis and role of splenectomy.

e. Management of rare congenital and acquired red cell disorders like porphyria, congenital dyserythropoietic anemia, pure red cell aplasia (inherited and acquired), side roblastic anemias, and nonspherocytichaemolytic anemia etc.

iv. Disorder of White Cell:

a. Neutropaenia: Clinical evaluation of the neutropenic patient, role of surveillance microbiology, antimicrobial therapy in neutropenia with emphasis on the multidrug-resistant organism, role of growth factors, barrier nursing, and principles of providing a sterile environment for the neutropenic patient. Evaluation and management of inherited neutrophil disorders.

b. Functional disorders of neutrophils: laboratory tests for evaluating neutrophil dysfunction, and the role of growth factors, antimicrobial prophylaxis, and HSCT in its management.

c. Leukemia (acute and chronic): Clinical evaluation, diagnostic confirmation by morphology, immunopheno typing, special stains, cytogenetics, and molecular genetics. They should know the algorithmic approach in immunopheno typing for diagnosis of leukemia's. The trainee must be familiar with the principles of leukemia management and standard protocols available. They should understand the pharmacology of chemotherapeutic drugs, their mode of administration, toxicity and complications such as extravasation. They should have knowledge of supportive care, including transfusion support in managing patients with all types of leukemia. The trainee should be familiar with the management of complications like hyper leukocytosis, tumor lysis syndrome and drug toxicities.

d. Myeloproliferative neoplasms (MPN): Classification, systematic diagnostic evaluation of MPNs, risk stratification, and current management strategies, including the role of HSCT.

e. Myelodysplastic syndrome (MDS): Clinical evaluation, diagnosis, risk stratification, and management, including the role of supportive care and HSCT.

f. Lymphoma: WHO classification of lymphomas, clinical evaluation, principles of diagnosis, and staging. Immunophenotypic (flow cytometry and immunohistochemistry) approach to diagnosis of lymphoproliferative disorders, role of cytogenetic and molecular tests in diagnosis and prognostication of lymphomas. Management of the different types of lymphomas including chemotherapy, HSCT, maintenance therapy and follow-up.

g. Multiple Myeloma and other Para protein disorders: Clinical, laboratory and radiological evaluation of a patient with plasma cell disorders. Interpretation of electrophoresis and imaging reports, assessment of endorgan damage, role of flow cytometry, cytogenetics and risk stratification in diagnosis and management. Treatment algorithm of plasma cell dyscrasia and response assessment. Role of HSCT, post-transplant consolidation, maintenance therapy, and follow-up. Management of complications like anaemia, renal failure, hypercalcemia, infections, bone disease and hyper viscosity. Concepts of monoclonal gammopathy of undetermined/renal/clinical significance. Evaluation and treatment of Waldenstrom'smacroglobulinemia and other rare para proteinemias.

h. Immunodeficiency disorders: Trainees must be able to investigate and manage primary immunodeficiency disorder systematically. They should have adequate knowledge of immunoglobulin replacement principles, interferons, growth factors, antibiotic prophylaxis, and role HSCT. They should have adequate knowledge on the haematological manifestations of acquired immunodeficiency disorders and its management.

i. Disorders of histiocytic: Evaluation and management of Haemophagocyticlymphohistiocytosis and histiocytic malignancies, Langerhans cell history to is and storage disorders.

v. Pancytopenia:

a. Aplasticanaemia: Etiology, pathophysiology, evaluation, and management, including immune suppression (anti-thymocyte globulin, cyclosporine), eltrombopag, and supportive therapy. Role of HSCT including the role of haploidentical transplant. Management of a relapsed case of aplastic anaemia.

b. Bone marrow failure syndrome (BMFS): Etiology, classification, pathophysiology, clinical features of various bone marrow failure syndromes. Clinical evaluation and investigations including the role of cytogenetics, stress cytogenetics and relevant molecular workup for confirmation of the diagnosis. Knowledge of telomeropathies and ribosomopathies and their management. Therapeutic strategies for various BMFS with curative treatment options of HSCT and role of supportive care

c. Evaluation and management of pancytopenia due to other systemic disorders, drugs, autoimmune disorders and sepsis.

vi. Haemostasis and thrombosis:

a. Trainees should be thorough with the clinical and laboratory approach to a patient with a bleeding tendency.

b. Thrombocytopaenia: Evaluation and investigation of the cause of thrombocytopaenia and its management.

c. Inherited platelet function disorders: Clinical evaluation, laboratory diagnostic strategies, and management. Interpretation of platelet aggregation studies, flow cytometry and viscoelastic tests for platelet defects.

d. Inherited coagulation factor deficiencies: Clinical evaluation and laboratory diagnosis of haemophilia, principles of factor replacement, prophylaxis strategies and on-demand therapy, replacement schedule in a person with haemophilia who needs surgery, in the event of major bleed or trauma, and management of complications of haemophilia including arthropathies. Concepts of development of inhibitor and interpretation of inhibitor assay. Principles of managing patients with inhibitors including management of breakthrough bleeds.

e. Acquired bleeding disorders: Evaluation and management of DIC, haemorrhagic complications of liver disease, renal failure, acquired coagulation factor deficiency and drug related platelet disorder. Management of thrombocytopenia in pregnancy.

f. Thrombotic disorders: Classification and laboratory diagnosis of inherited thrombotic disorders, evaluation of acquired thrombotic disorders with emphasis on cancer related thrombosis, the clinical use of anticoagulants, duration of therapy, and monitoring emphasizing the upcoming role of DOACs.

vii. Haematopoietic stem cell transplantation (HSCT):

a. Indication sand outcome of HSCT in various diseases. Role of autologous and allogenic transplant in different diseases. Indications and outcome of HLA matched sibling donor, matched unrelated donor, cord blood and haploidentical transplant in different diseases.

b. Thorough knowledge on donor selection.

c. Conditioning regimens used for different disease. Strategies for GvHD prevention.

d. Peripheral blood and bone marrow harvest of stem cell and its manipulation, cryopreservation.

e. Supportive care and management of complications in the post-transplant period.

f. Monitoring and management of the long-term complications in posttransplant patients.

g. Post-transplant vaccination.

h. Post-transplant immune reconstitution and interpretation of chimerism studies.

viii. Consultation Haematology:

a. Haematological complications of pregnancy.

b. Haematological complications of systemic disease.

c. Haematological problems of the intensive care patient.

d. Drugs-related haematological issues.

e. Haematological problems in the newborn.

f. Consults in rheumatology – APS/ HLH/ MAS/ CAPS

g. Haematological consults in geriatric medicine

h. Haematological manifestations in solid malignancies e.g. myelopthisic anemia, cancer related thrombosis.

ix. Supportive care:

a. Management of nausea, vomiting, diarrhoea.

b. Pain management.

c. Management of cytopaenia and its complications like infections, bleeding, and anaemia.

d. Gonad preservation.

e. Parenteral and enteral nutritional support, diet.

f. Infection control, environmental measures, hygiene.

x. Recent Advances in Haematology:

a. Recent concepts on iron metabolism, coagulation, and other basic aspects of Haematology.

b. Recent advances in molecular biology in Haematology.

c. Modern diagnostic tools in Haematology.

d. Recent advances in the understanding of haematological diseases.

e. New drugs in Haematology, including monoclonal antibodies, targeted therapy, and small molecules

f. Management of multidrug resistant organisms and newer antimicrobials.

g. New developments and upcoming role of imaging in Haematology

h. Advances in HSCT, CAR-T cell therapy, and gene therapy.

i. New developments in Haematology as discussed in yearly international conferences and webinars.

xi. Transfusion Medicine:

a. Blood component preparation and clinical use: Blood collection, knowledge on anticoagulants used in storage and their effect on storage. Component preparation and storage. Quality assurance in transfusion medicine.

b. A thorough understanding of the clinical indications for the proper use of specific blood components.

c. Diagnosis and management of transfusion associated complications.

d. Concepts and indication of leucodepletion and irradiation of blood components. Knowledge on the performance of the same.

e. Screening and management of allo-immunisation concerning transfusion.

f. Principles of the plasmapheresis. Principles of the machine, continuous versus intermittent flow techniques, replacement fluids for plasmapheresis, current status, and indication in various diseases should also be known and understood.

xii. Bioethics:

a. Respect human life and the dignity of every individual.

b. Refrain from supporting or committing crimes against humanity and condemn all such acts.

c. Treat the sick and injured with competence and compassion and without prejudice and apply the knowledge and skills when needed.

d. Protect the privacy and confidentiality of those for whom we care and breach that confidence only when keeping it would seriously threaten their health and safety or that of others.

e. Work freely with colleagues to discover, develop, and promote advances in medicine and public health that ameliorate suffering and contribute to human well being

f. Educate the public about the present and future threats to the health of humanity.

g. Advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human wellbeing.

h. Teach and mentor those who follow us, for they are the future of our caring profession.

xiii. Research and biostatistics: Clinical trial protocol designing, Clinical epidemiology, Biostatistics, Bioethics, and Medico-legal issues pertaining to study patients.

3. LABORATORY HAEMATOLOGY:

i. Laboratory Equipment's and organization:

a. Proper use and care of common laboratory instruments such as the light microscope, centrifuge, water baths, freezers, etc.

b. Trainee must have adequate knowledge of all laboratory equipment's essential maintenance, including their calibration procedure and frequency.

c. Knowledge on setting up a Haematology laboratory, its workflow procedures, handling, storage, and sample disposal.

d. Technical and non-technical personnel requirements, their periodic training, and safety.

e. Maintenance of record, data preservation, and generation of laboratory statistics.

f. Quality assurance (Internal and External) measures and assessment of preanalytical, analytical, and post-analytical variables. Period audits to ensure precision and accuracy of lab results.

ii. Basics of Laboratory Haematology

a. Blood collection of samples by venipuncture and finger prick methods.

b. Knowledge about the types of vacutainers and anticoagulants used for sample collection, the ratio of sample to the anticoagulant, the effects of delay in sample processing, and proper temperature of sample storage.

c. Determination of blood counts (haemoglobin, haematocrit and other red cell indices, total and differential WBC counts andplatelet count) manually.

d. Use of automated electronic blood cell counters, including principles and practice. Interpretation of the parameters of advanced cell counters.

e. Preparation, staining, and interpretation of peripheral blood smears.

f. Review of normal and abnormal blood smears with emphasis on:

Morphology of red cells, white cells, and platelets.

Performance of WBC differential count.

Subjective assessment of platelet count.

Interpretation of abnormal smear to ascertain approach to diagnosis.

g. Supravitally staining of reticulocytes: manual and automated techniques and interpretation of the results.

h. Performance of bone marrow aspiration and trephine needle biopsy.

i. Preparation of smears of bone marrow aspirates and biopsy imprints (touch preparations) and their staining by Romano sky stain as well as special stains like Perl's stain, PAS, Sudan Black B, Myeloperoxidase, Specific, on-specific and Dual esterase.

j. Performance and interpretation of HbS (sickle hemoglobin) solubility test, screening for red cell G6PD activity and its interpretation.

iii. Laboratory Investigation of HaemolyticAnaemias:Red cell membrane disorders and Immune Haemolyticanaemias:

a. Quantitation of normal HbA, HbF, HbA2 and abnormal HbS,HbD,HbE,HbC, etc., by electrophoresis and chromatography.

b. Screening for unstable haemoglobin (heat instability and Isopropanol tests).

c. Supravital staining for HbH inclusions.

d. Standard hypotonic saline osmotic fragility test, incubated osmotic fragility test and Eosin-5'-Maleimide binding test by flow cytometry.

e. Heinz body preparation.

f. Screening for red cell G6PD deficiency and quantitative estimation of red cellG6PD activity.

g. Screening for red cell pyruvate kinase (PK) deficiency and assay of red cell pyruvate kinase activity.

h. Screening for other red cell enzymopathies.

i. PNH flow cytometry and FLAER for PNH, Urine haemosiderin.

j. Direct and indirect anti-globulin (Coombs) tests, warm and cold autoantibody (Cold agglutinin) titre, determination of thermal amplitude of cold agglutinin.

k. Role of flow cytometry in the evaluation of Haemolyticanaemia.

l. Role of molecular techniques including NGS in the diagnosis of Haemolyticanaemia.

m. Sickling test.

Miscellaneous biochemical tests on Red cells, Plasma, and Urine:

a. Examination of urine red cells, haemosiderin, haemoglobin, urobilinogen, and bilirubin.

b. Principles of estimation and significance of serum ferritin, iron, TIBC, serum cobalamin, red cell folate, serum folate, cry globulin.

iv. Laboratory Investigation of Bleeding Disorders:

Investigation of platelets disorders:

a. Performance of platelet count and morphology, ivy bleeding time, and template bleeding time. Interpretation of MPV and IPF in patients with low platelet counts.

b. Principles, practice, and interpretation of platelet aggregation study and thromboelastographic.

c. Understand the technique and use of flow cytometry in the diagnosis of platelet disorders.

d. Laboratory evaluation of suspected heparin-induced thrombocytopenia (HIT).

Screening and diagnosis of coagulation factor abnormalities:

a. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT).

b. Plasma fibrinogen assay, differentiation of afibrinogenaemia, and dysfibrinogenemia.

c. FDP and D- Dimers

d. Correction studies (Mixing studies) with normal plasma, and factor deficient plasma. APTT based inhibitor screen assay for both immediate acting inhibitor and time dependent inhibitors.

e. Assays of clotting factors with particular emphasis on factors VIII and IX.

f. Urea solubility test and an assay of factor XIII

g. Screening for inhibitors against coagulation factor, especially factor VIII and IX, titration of inhibitor by Bethesda assay.

Relevant tests of fibrinolytic activity:

a. Laboratory Investigation of Thrombotic disorders:

Assays of plasma Antithrombin, protein C, protein Sand Activated Protein C resistance for factor V Leiden.

Principles of screening tests and interpretation of results for lupus anticoagulant by dRVVT as well as anticardiolipin and antiβ2glycoprotein-1 antibodies.

Laboratory monitoring of anticoagulant (heparin and direct oral anticoagulant) therapy: Anti-Xa activity diluted Thrombin Time, and Ecarin clotting time. Diagnosis of Heparin induced thrombocytopenia.

Molecular tests for diagnosis of thrombophilia like Factor V Leiden,

Prothrombin P20210A, MTHFR mutation etc.

b. Flow Cytometry: The trainee should be well versed with the principle of flow cytometry and- flow cytometer's functioning. They must be thorough with the procedure's sample requirements, processing, and analysis of the results. They should be well-versed in the interpretation of flow cytometry results for the diagnosis of haematological malignancies. They must also understand the role of a flow cytometer in evaluating red cell and platelet disorders.

c. Cytogenetics: Understanding the principle and technique of cytogenetics (particularly conventional karyotype and fluorescence in-situ hybridization), relevance, and significance of chromosomal studies in the context of various diseases.

d. Molecular Biology: Understanding the principle involved in the molecular diagnosis of hematological disorders:

DNA and RNA extraction.

RT-PCR and RQ-PCR.

RFLP and other techniques to evaluate polymorphisms.

Difference methods of mutation detection, their principle, and technique.

DNA Sequencing and fragment length analysis for monitoring response to therapy.

e. Transfusion Medicine:

Basic laboratory aspect of transfusion medicine:

ABO blood grouping (forward and reverse), Rh typing Wof donors and recipient's indirect ant globulin test), antibody identification following elution by various techniques.

Blood group compatibility (cross-matching).

Investigation of ABO, Rh, and another immune-Haemolytic disease of the newborn.

Investigations of platelet refractoriness and heparin-induced thrombocytopenia.

Donor recruitment, their clinical and laboratory evaluation before phlebotomy.

Principles of phlebotomy.

Blood component preparation and storage.

Practical and documentation procedures involved in issuing and transfusing blood and cellular components.

Principles and mechanics of blood component preparation.

Principles of apheresis and performance of the procedure concerning the collection of platelets, granulocyte, and stem cells.

Principle and performance of plasmapheresis.

Practical steps in the laboratory investigation of transfusion reactions.

f. Histopathology: Practical laboratory training and related theory should cover the following areas:

Tissue processing (particularly trephine biopsy and lymph nodes)

Techniques of cytology, including cytosine concerning body fluid, CSF in particular.

g. Knowledge in anatomic pathology and immunohistochemistry relevant to the diagnosis of the hematological disorder.

h. Biochemistry: Knowledge of the principle, technique, and interpretation of immunoassays, electrophoresis, nephelometry, etc. The role of proper and adequate sample collection and transport for the tests.

i. HLA module: understanding the principles of:

• Separation of lymphocytes using density gradient centrifugation.

• The micro-lymph cytotoxicity test and its application in HLA typing, cross-matching, and antibody screening.

• DNA-based HLA typing, including high-resolution HLA typing using next-generation sequencing.

• HLA antibody identification.

j. Nuclear Medicine: Principle of PET scan and its role in diagnosis, response assessment, and monitoring of haematological disorders

k. Radiation Oncology: The students should be encouraged to learn about radiotherapy basics and have hands-on training on linear accelerator, IGRT, IMRT, TBI, CRRT in haemato-oncological practice and blood components radiation.

Career Options

After completing a DrNB in Clinical Haematology, candidates will get employment opportunities in Government as well as in the Private sector.

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

While in the Private sector the options include Resident Doctor, Consultant, Visiting Consultant (ClinicalHaematology), Junior Consultant, Senior Consultant (Clinical Haematology),Critical Care Specialist, etc.

Courses After DrNBin Clinical Haematology Course

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

Frequently Asked Question (FAQs) – DrNBin Clinical Haematology Course

Question: What is the full form of DrNB?

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

Question: What is a DrNB in Clinical Haematology?

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

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

Answer: DrNB in Clinical Haematology is a super specialty programme of three years.

Question: What is the eligibility of a DrNB in Clinical Haematology?

Answer: Candidates must be in possession of an MD/DNB (General Medicine/ Paediatrics/ Biochemistry/ Pathology) from any college/university recognized by the Medical Council of India (now NMC)/NBE.

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

Answer: DrNB in Clinical Haematology offers candidates various employment opportunities and career prospects.

Question: What is the average salary for a DrNB in Clinical Haematology candidate?

Answer: The DrNB in Clinical Haematology candidate's average salary is between Rs.5,50,000 to Rs. 19,00,000 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 a DrNB course.

According to general, laparoscopic and bariatric surgeon Dr Alfred Dawes, localised, intermittent discomfort in the bladder or abdomen is the primary sign of colic.

Dr Dawes said colic happens when a hollow internal body organ, such as the intestines, gall bladder, rectum, kidneys, or ureters, becomes blocked. He said, the muscles around the impediment contract vigorously in an effort to remove it, which results in painful spasms and gallstones and kidney stones are two of the blockages that cause colic most frequently. In addition, he said sometimes it is actual faeces that casues what is termed as a pseudo or false obstrcution and when trying to pass hard faeces (from overeating or not drinking enough water) the cramping pain starts and comes in waves.

"An acute discomfort that progressively lessens might continue for up to five hours during a colic episode. A lingering discomfort may last for up to 24 hours. A person is more likely to experience further episodes of colic after one," he said.

Moreover, during the Christmastime, it is customary for individuals to experience colic often caused from overeating and gas from foods eaten, for example, dairy if lactose intolerant and flour for those with gluten intolerance.

So while we enjoy the likes of our hams, variety of meats, savouries, sweets, and delicious treats we don't have year-round, be mindful not to overdo it or take risks and end up with an uncomfortable ending to what should be a day of festivities.

Below Dr Dawes shares ways to prevent colic and in the event it happens, several treatments and home remedies.

Prevention

The key is to take action to maintain the health of your digestive system. Among the actions to take are:

Eating a diet high in fibre (that means plenty of fruits, vegetables, and whole grains)

Maintaining hydration

Avoiding foods high in fat

Losing weight if necessary

At-home remedies for colic episodes include:

Keeping hydrated by drinking lots of water

Taking ibuprofen or paracetamol to ease pain

Applying a hot water bottle to the sore spot to relieve pain

Rub or lightly massage the afflicted region

Following a colic diagnosis, a doctor might suggest one of the following treatments:

Pharmaceuticals to treat illnesses, anti-inflammatory treatments, and painkillers to alleviate symptoms

Surgery to explore intestinal obstructions, remove kidney stones, or remove the gallbladder

Stone-melting medications shock-wave therapy, which can shatter stones into small pieces

When to seek medical help

The majority of colic episodes end within a few hours, but if they persist frequently, it is preferable to see a doctor for a diagnosis.

Anyone exhibiting any of the following signs and symptoms ought to consult a doctor immediately:

Jaundice (yellowing of the skin and whites of the eyes) (yellowing of the skin and whites of the eyes)

Long-lasting abdominal discomfort or abdominal pain that is so severe that it is impossible to find relief from it in any position

Cold and a high temperature

A quick heartbeat

Being unable to drink without throwing up

Continual vomiting

Moreover, Dr Dawes said colic comes in waves of pain that comes and goes, therefore any pain that is constant and unremitting can be a sign of something serious and should never be attributed to colic.

Christmas Day has the potential to drastically increase our salt intake! With pre-lunch snacks, canapés, eggnog, home-made chocolate, peppermint, maple-glazed ham, and a Christmas dinner that includes a starter, main dish, and dessert, food plays a prominent role in the celebrations. There are endless opportunities for us to satisfy our cravings. But could all these treats harm our long-term health?

These items can all have up to 15.7 grams of salt in them, which is more than twice the daily recommended limit of six grams.

But with a few quick tricks and time-saving techniques, you can cut the salt on your Christmas menu by up to 10 grams (5.7 grams of salt). The American Heart Association advises consuming no more than two-thirds teaspoons of salt each day. In fact, today, American adults consume nearly 50 more sodium than the limit recommended by federal guidelines, putting us at risk of high blood pressure. Left unaddressed, consultant urologist Dr Jeremy Thomas says this can increase our likelihood of experiencing kidney disease, stroke and heart disease – the country's leading cause of death.

So, does this mean we need to forget our upcoming feasts? Fortunately, no. Dr Thomas shares tips on how to reduce our salt intakes this Christmas and why it is necessary to do so.

1. Do away with the salt shaker: If it's not there, we can't use it. By taking the salt shaker off the table and out of the kitchen cupboard, you can lessen the temptation to over salt.

2. Avoid items high in sodium: Avoid the high-sodium bottled sauces and marinades, soy sauce, broth, garlic salt, onion salt, and other seasoning. Instead, add flavour to food with ingredients like fresh herbs, spices, vinegar, lemon, garlic, and onions.

3. Steer clear of ultra-processed foods and fast food: The FDA estimates that eating packaged, commercially produced, or restaurant items accounts for more than 70 per cent of Americans' dietary sodium intake. Whenever possible, opt for fresh foods or ingredients with no added salt.

4. Examine the packaging: Choose foods with no more than the recommended nutritional value, check brand websites or package labels. Be sure to check labels when purchasing the ingredients for your meals.The salt content of similar foods can vary greatly, so it's a good idea to check the label, especially on snacks like crisps, olives, and nuts. By selecting the lesser salt options that are offered, you can also save over a gram in a starting of smoked salmon, cream cheese, and bread.

5. Cook at home: Making a roast from scratch at home will significantly reduce the salt content. Although ready-made vegetables seem like a time-saving option, they can include excessive amounts of salt. In contrast, home-cooked veggies without salt added contain only a trace. Another way to reduce salt consumption is to buy a fresh or frozen turkey or ham and cook it at home; pre-prepared portions frequently contain a lot of salt. Use herbs like rosemary, cinnamon, and cloves in place of salt or butter to add flavour. Make sure to rinse the food before cooking and serving if you're using canned goods. Remember to include fruits and veggies on half of your plate.

6. Time-savers: There are a number of foods which are low in salt or don't typically vary between brands so you can save your time and buy these foods. By selecting smaller-sized holiday goodies, you can also cut back on your sodium intake. When dining out, request sauces and gravies on the side rather than putting them on top of your food.

Dr Thomas added: "About one in three Jamaicans or 33 per cent live with hypertension or some form of cardiovascular disease. It is endemic and the number one killer in Jamaica, worse than crime. However, it is not something that happens overnight, it takes time to develop and so lifestyle changes can prevent, slow the progression or help maintain control. So while we might let go our diets for the Christmas season, we need to be aware not to overdo it and to mind how much we veer to indulge. Reduce the salt and sugar and still try to get some exercise in."