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Indian Academy of Pediatrics, MumbaiIndian Academy of Pediatrics, MumbaiMonthly Newsletter, Vol. 3, March 2013

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Contact : Indian Academy of Pediatrics, 92/4, Geeta Building, 1st Floor, Next to Chhagan Mitra Petrol Pump,Dr. B. Ambedkar Road, Rani Laxmibai Chowk (Sion Circle), Sion (E), Mumbai - 400 022.Email : [email protected] | [email protected] Telefax : +91-22-24045803 Mob. : 9821432788

Not for Sale For Private Circulation only

President

Dr Sharat Menon

Hon. Secretary

Dr Sridhar Ganapathy

Hon. Treasurer

Dr Bela Verma

You have Made Us Proud

INDIAN ACADEMY OF PEDIATRICS, MUMBAI92/4, Geeta Building, 1st Floor, Next to Chhagan Mitra Petrol Pump,

Dr. B. Ambedkar Road, Rani Laxmibai Chowk (Sion Circle), Sion (E), Mumbai - 400 022.Email : [email protected] | [email protected]

Telefax : +91-22-24045803 Mob. : 9821432788

IAP, MUMBAI

IAP Navi Mumbai IAP ThaneDr Upendra Kinjawadekar

Dr. Subhash RaoDr Mahendra Kelkar

Dr Geeta Bhat

IAP Kalyan/Karjat DombivaliDr Gurudutt Bhat

EB Member IAP Central from Mumbai Dr Kamlesh Shrivastava

ADVISORS

Dr Bharat Parekh Dr Bharat Agarwal Dr Bipin Shah Dr Nitin Shah

Dr Sandeep Bavdekar

Dr Sujata Kanhere Dr Sushma Malik

Dr Preetha Joshi Dr Samir Dalwai

TRUSTEES

EX - OFFICIO MEMBERS

EXECUTIVE BOARD MEMBERS

CF KD REGISTRY

Dr Vinit Samdani

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Dr A D Rathod Dr Mukesh Agarwal Dr Murlidhar Mahajan

Dr Uday PaiPresident Elect

Dr Sushma Save

Hon. TreasurerDr Bela Verma

Joint TreasurerDr Sushant Mane

Hon. SecretaryDr Sridhar Ganapathy

Past PresidentDr Kamlesh Shrivastava

PresidentDr Sharat Menon

Dr Raju Khubchandani

OFFICE BEARERS AND MEMBERS OF EXECUTIVE BOARD, 2013

Dr Yashwant Gabhale

Dr Bakul Jayant Parekh Dr Bharat Agarwal Dr Bipin Shah Dr P N Patnekar Dr Vijay Tuteja

Central IAP Dr C.P. Bansal

Dr. Sailash Gupta

Dr Varsha Phadke

1Indian Academy of Pediatrics, Mumbai. Monthly Newsletter, Vol. 1, January 2013

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Editorial

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Taking up the post of the secretary of the MUMBAI IAP or getting admitted to the hospital….my colleagues have the same question for me—serious hai kya?

Now I am deep into IAP giving it the best gift -my time-as this is something i will never get back.

In IAP,it is our endeavour to make it an organisation par excellence, provide a platform where we share knowledge and gel with fellow colleagues and ultimately work towards the betterment of the health of our pediatric population.

From this issue we will introduce a knowledge platform. This will aim to be a platform where needed and relevant do's and don'ts and usefulness of various accessible medical advancements shall be discussed by experts .

The postgraduate teaching series kick starts this month-Members are free to attend the same . The lectures will be in a different format-- where approaches shall be discussed with a blend of advances and tipsters in practice by senior teachers.

The news letter shall continue to carry all the relevant CME details for the month.

thAnd not to forget ,we have the installation ceremony of our new team on the 17 of March (details on pg. No. 8 ). On the same day,we shall also gratefully acknowledge the services of our beloved teachers Dr. Almeida R. Fernandez and Dr. Ramesh D. Potdar by conferring on them the lifetime achievement awards.

The present team has decided that it's time to stop saying we wish and start saying we will—for all new projects. So let's have more beginnings than endings.

Warm regards,Dr Sridhar Ganapathy.Secretary, IAP, Mumbai.

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Notes

Indian Academy of Pediatrics, Mumbai. Monthly Newsletter, Vol. 3, March 2013

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Monthly Meetings

th 7 March Thursday : North West Mumbai Pediatric Meeting

Venue Borivali Medical Brotherhood, Shri N. B. Chadwa Hall,

TPS Marg, Borivali West, Mumbai

Time 08.30 am to 10.00 am

:

:

Enquiries to Dr. Charu Suraiya 9820357632:

st th th, th1 ,8 ,15 & 29 March Friday : Clinical meetingsth

22

Institute

B J Wadia hospital Dr S Prabhu

J . J . Hospital Dr A D Rathod

K.E.M Hospital Dr Mukesh Agrawal

B.Y. L . Nair hospital Dr Sandeep Bavdekar

LTMG hospital Dr Mamta Manglani

Head of department

th th st th st7 , 14 , 21 , 28 & 31 March 2013 : Postgraduate Grand Rounds

Venue

Time

Pediatric Seminar Hall, Lokmanya Tilak Medical College, Sion

6:00 pm to 8:00 pm

:

:

KD REGISTERY

CYSTIC FIBOSIS REGISTERY AND CONSULTATION

For further information regarding literature update ,parent information , IVIG availability –

Contact : Dr Raju Khubchandani :

Ph 022-2386522, fax 23898362 mob: 9821095552 E mail :[email protected]

For consultation and or swat chloride test refer patient on FRIDAY'S with prior appointment ndto room no 221 OPD floor – 2 floor ,Jaslok hospital , Pedder road . patients refered for

sweat test must carry all their records and reports .

For further information regarding literature updates , parent information , sweat test and

physiotherapy

Contact : Dr Raju khubchandani ph : 022-2386522 Fax : 23898362 Mob : 9821095552

Email : [email protected]

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DID YOU KNOW

Laughter the Best Medicine


DID YOU KNOW

Skipping breakfast over long periods would have detrimental effects on your cardio metabolic health.

An Australian study in the American journal of clinical nutrition [2010;92;1316—1325 by Smith K J et al ]-

-skipping breakfast resulted in larger waist circumference, higher fasting insulin, total cholesterol and

low density lipoprotein levels.

Ultraviolet B light produces 90% of vitamin D in human beings, so the teen population which spends

more time indoors should get out of their sedentary habits, get outdoors to get sensible sun exposure for their

vitamin D.

Tobacco smoke contains very tiny amounts of radioactive polonium-210. in smokers this builds up to the

equivalent radiation dosage of 300 chest x-rays a year for a person who smokes one and a half packs a day.

So it's time to quit smoking.

The latest trigger for asthma—FACE BOOK

The new social networks like face book are a source of psychological stress capable of triggering an

asthmatic exacerbation

Man introduces his family

Yeh meri biwi GOOGLE Rani...

Sawal pucho toh dus jawab deti hai

Ye mera beta FACEBOOK Kumar

Ghar ki baat poore mohalle tak pahuchata hai

Ye meri beti TWITTER...

Poora mohalla follow karta hai

Aur main ORKUT Raja....

Ab muje kohi puchta hi nahi

Finally it may happen

Beer cheaper than petrol!!!

There will be a slogan...

JUST DRINK DONT DRIVE

The art of living.......

Having a wife is a part of living but having girlfriend along with wife is art of living

Parameters beyond CBC

A 13 year old girl presented fever and lymph node enlargement requiring lymph node excision. Her CBC showed Hb 11.6, WCC 8400 and platelet count of 32000. Peripheral smear of this patient showed several large platelets. Patient had no bleeding symptoms and her previous platelet count 2 year back was also 40000. She was told to undergo bone marrow investigations to rule out immune thrombocytopenia, but declined the procedure. She was not on any regular treatment and was not on regular follow up.

Normally with platelet count of <50000 performing surgical procedures can be risky because of high chance of bleeding. Several of such patients will have their procedures cancelled or physician will choose to transfuse them platelets before and after the procedures to avoid bleeding. In this case, because of large platelets in the blood, machine is not able to give the accurate platelet count. Also even though older machines will provide the MPV (mean platelet volume), where higher MPV will suggest large platelets in the peripheral blood, it still will not be able to accurately include those large platelets in the platelet count and anxiety about the low platelet count will still remain.

With availability of the new machines where the platelet count is done by optical method (platelet-O), now there is a luxury of getting an accurate count even if there are large platelets in the peripheral blood. By this technology machine counts the platelets not only by their size (like old machines) but also by the fluorescence. Because of this way of counting platelets, it counts all the cells with similar fluorescence together. Hence if platelets are as

big as red cells for example, will still have similar platelet like fluorescence and hence will be

counted as platelets. Platelet-O will also avoid need for manual platelet count. More importantly we can now get a parameter

called IPF (Immature Platelet Fraction) which

informs about the immature platelets as percentage on the CBC. Higher IPF percentage suggests that the bone marrow is producing adequate number of platelets and the destruction is occurring in the blood and hence more and more immature platelets ate coming from the marrow in the blood. IPF is also useful in cases where transient infection like dengue fever is the cause for low platelet count. Higher IPF here would suggest that the platelet count will recover soon and platelet transfusions can be avoided.

Thus, in patients with thrombocytopenia with high IPF, platelet transfusions can be avoided because of likelihood of platelet recovery and minimal risk of bleeding in such patients. On the contrary, if low platelet count is associated with low IPF, it suggests that the bone marrow dysfunction/hypofunction is the cause for thrombocytopenia needing bone marrow examination as well as need for platelet transfusion. Other new parameters now available to us on a five channel CBC machines are IRF (Immature Reticulocyte Fraction) & IGF (Immature Granulocyte Fraction) which are used to predict the bone marrow function and Retic He & RBC He which are useful for diagnosis of functional iron deficiency and anaemia of chronic disease.

Our patient here had IPF of 20.4% suggesting lot of large platelets and good marrow function. Even though her standard machine platelet count was only 32000, her optical platelet count (platelet-O) was 81000. She underwent the lymph node excision without any need for platelet transfusions.

Reference: C. Briggs, Int. Jnl. lab. Haematology. 2009;31.277-9 7

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Dr. Balkrishna Padate.MD (Med) MRCP(UK) FRCPath(UK) CCST (UK)Consultant Haematology, Haemato-Oncology and BMTP D Hinduja National Hospital and Research Centre, MumbaiHonorary Senior Lecturer, University of London

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Growth Symposia schedule on 14th April.

Venue: “Regus”, Trade Centre, In front of Telephone Exchange, Bandra Kurla Complex, Mumbai

Govind Jethwani

Product Specialist, Eli Lilly & co. India Pvt. Ltd.Mb: +919823252287

Indian Academy of Pediatrics, Mumbai. Monthly Newsletter, Vol. 3, March 2013 10

ICU AVALIABILITY IN MUMBAI-DIRECTORY/WEBSITE FACILITY

In a city of Mumbai even though we boast of the best management for our sick children, availing of a bed for our lower socio economic class in the time of a crises when the child is critical is a nightmare. Invariably they run from pillar to post often with a note from the local political leader or a social worker to end up dismayed due to refusal by most BMC/charitable institutes. The woeful shortage of ICU beds, compounded with the apathetic attitude of some management authorities prompted me to initiate this project.

We are planning to compile a directory and website for availability, facilities provided

and rates (in case of private sector or trust) of all ICUs (neonatal and pediatric) in Mumbai. For

this I solicit the cooperation of each and every one of you who is catering to intensive care.

Kindly inform via email or phone-your details

NamePhone no.Name of your hospital/visiting hospital(private or trust )No. of bedsLevel of careNo. of ventilators availableICU rates

Our email [email protected]/You can inform MrNilesh or MrVinod at our IAP office Ph – 022-24045803

Friends, I implore upon you to be proactive and furnish the details at the earliest .If other states can clamp down other NMRs and Under 5 MRs why should we lag behind?

NURSING TRAINING COURSE

It is a fact that good competent nurses contribute the backbone or the major component of management of indoor patients particularly the ICUs. Sadly this aspect has not been given enough priority especially in private setups. Moreover because of gross shortage of nurses often we tend to resort to appoint untrained trainees. A good efficient intelligent trained nurse goes a long way in giving you peace of mind when you are away from the hospital. With this in mind Mumbai IAP has initiated a training course comprising of 8-10 lecture series with hands on practical training in paediatric and ICU skills to be held on Sundays in the MBIAP office. You can register the names of your hospital; nurse (irrespective of their qualification).The training or lectures are arranged to be given by nursing tutors and trained doctors. Skills in identifying sick babies, practical management, short background theory behind management, ICU monitoring will be dealt upon.

stWe will be registering the 1 60 students on first come first serve basis. The course will start in May (further details will be in the next news letter).So please hurry!

A small charge of Rs 500 per student will be charged for working lunch and handouts notes


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REGISTRATIONSCONSULTANT : Rs. 750RESIDENTS : Rs. 500

Cheque/DD : B.J.Wadia Hospital for Children.Outstation cheques : Add Rs. 100

For Details : Contact Prof. S.N. BhatnagarDr. S. Reddy Dr. Pinakin PujariDr. Kalpesh Patil

9869013797982051407786550253009920147567

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MEDICO-SURGICAL MEETth7 April 2013

Auditorium, B.J.Wadia Hospital for Children Organized by

Prof. Sushmita N. Bhatnagar and IAP Mumbai Branch

This event focuses on pediatric conditions which need both medical and surgical care. Surprisingly, there are more and more conditions which require joint care and unity between the medical and surgical fraternity in providing a comprehensive care for the child. The purpose of organizing this medico-surgical event is to highlight how the medical and surgical counterparts are important and what role each has to play for a complete and optimum care of a child with surgical condition. What should be the ideal time of surgical intervention, when and how the surgical patient looked after by the pediatrician be transferred, what should be

the pre-operative workup, what should be the post-operative management while the child is still hospitalized and what is the protocol for follow-up. Not just these issues, but how long to follow-up a child who has un dergone surgery, what investigations are needed in the follow-up period and understanding and explaining the prognosis to the parents without any discrepancy between the medical and surgical counterparts are an integral part of successful outcome.

With the best of faculty, both medical and st

surgical, we welcome you all to join us on 31

of March for a formulative event.

TENTATIVE PROGRAM FOR THE MEDICO-SURGICAL MEET

Sushmita BhatnagarProf. & HOD, Pediatric Surgery,Wadia Childrens Hospital,Consultant - Bombay Hospital,Mumbaiwww.pedsurg-bhatnagar.orgphone – 9869013797

Symposium in Medical Genetics

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Theme — Neuro Genetics

Forth Coming CME’s

Monday 4th March 2013, 9 am onwards

VENUE : Seminar Hall, National Institute for Research in Reproductive Health (NIRRH), Opposite KEM hospital, Parel, Mumbai 12

HOSTS AND SPONSOR

ICMR Genetic Research Center, NIRRH

ACADEMIC PARTNER - Indian Academy of Pediatrics, Mumbai


8:30 am to 9:00 am - Registration and breakfast 9:00 am to 9:15 am Inaugural address Dr Sanjiva Kholkute, Director, GRC, NIRRH

Scientific Program (9:15 am onwards) Topic: Immune– Brain Connect Speaker– Dr Rashid Merchant Eminent Pediatrician, Teacher and Researcher. Cur-rently, Consultant Pediatrician and Head, Pediatrics, BJ Wadia Hospital, Ex-Dean Wadia Hospital

Topic– Tandem Mass Spectrometry in screening of Neuro-Metabolic Conditions Speaker– Dr Rita Christopher Prof and Head, Department of Neurochemistry, NIM-HANS, Bangalore

Topic– Epilepsy Genetics Speaker– Dr Anaita Hegde Eminent Pediatric Neurologist, Jaslok Hospital and BJ Wadia Hospital for Children, Mumbai

Topic—Clinical Approach to Pediatric Neuromuscular Disorders Speaker—Dr Viraj Sanghi Eminent Pediatric Neurologist, Bombay Hospital and Research center, Mumbai Lunch—1:30 pm to 2 pm Topic—Role of Imaging in NeuroGenetic conditions Speaker– Dr Deepak Patkar Eminent Radiologist, HOD, Dr. Balabhai Nanavati Hospital, MRI and PET, CT centre

Topic—Application of Basic Cytogenetics and Molecular Genetics to Diagnosis of NeuroGenetic conditions Speaker– Dr Parag M Tamhankar Pediatrician and Medical geneticist, Scientist C and In-charge, Genetic Research center, NIRRH, Mumbai

Topic—Application of Microarray and Next-Generation Se-quencing to Diagnosis of NeuroGenetic conditions Speaker—Dr Ratna Dua Puri Consultant Geneticist, Centre of Medical Genetics at Sir Ganga Ram Hospi tal, New Delhi

Program

Final year students of Government Grant Medical College, Mumbai. Represented ‘Western zone’ in the “50th Golden Jubilee PEDICON, 2013” at Kolkata;in the National round of UG pediatric quiz. There were four other teams from the north (Delhi), south (Chennai), east and central (Lucknow) zones respectively. Central zone’s KGMC, Lucknow, was strongest competitor. There was 'tie' with them till the last round and eventually after a tie- breaker they won the much coveted title of “national champions”.

Kavisha Chaudhari, Kuntal Sen

UG PEDIATRIC QUIZ WINNER AT NATIONAL LEVEL (COVER PAGE PHOTO)

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Division of Pediatric Endocrinology, Department of Pediatrics

B.J.Wadia Hospital for Children, Mumbai Organizes a CME on “Diabetes in Children”

“ Diabetes in Children”

stDay and Date: Sunday, 31 March 2013

Venue :Dr.S.M.Merchant Auditorium, B.J.Wadia Hospital for Children

Conveners:Dr. Rajesh Joshi, Dr Sudha Rao

Registration: -Rs 500/- (Registration is limited . There will be no spot registration.)

Incidence of type 1 diabetes is increasing(3-5% annual rate of increase). T1DM is a special situation and requires special training of medical fraternity across all levels of healthcare,on a large scale. The direct impact of the disease on the patient is debilitating due to the nature of the disease.A person with T1DM needs to follow a structured self-management plan including proper insulin use coupled with blood glucose monitoring, physical activity, and a healthy diet. One has to be aware of novel options in insulin therapy with better features and technologies.This CME is aimed at training health care professionals in the management of type 1 diabetes in children and adolescents. Attending delegates will be given a manual on “Diabetes in children and adolescents”.

TOPICS:- (Speakers: Dr Aparna Limaye, Dr Aspi Irani, Dr Rajesh Joshi, Dr Sudha Rao)

· Type – 1 Diabetes in Children - Pathogenesis & Diagnosis . What we know and what is new?

· Management of Type 1 Diabetes- All you should know about Insulin and various regimens.

· Dietary management in type 1 diabetes –is there a paradigm shift?

· Home management of Type 1 Diabetes- Empowering the child andparents.

· Emergency management - a Pediatrician's perspective.

· Chronic morbidities- Prevention and treatment

· Current perspectives in management – Where are we heading to?

For registration and further details please contact:-

Ms. Asha ( 9869647860 )/ Dr Poonam Singh( 9076127185 ) / Dr Ruchi Parikh (9819108077).

Accredition for MMC credit points has been applied for.

Registration form: (Please submit the details given below to obtain your Credit points)

Name-Address-Mobile no-E-mail-MMC no-

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DEAR IAP MEMBERS

You are cordially invited to grace the occasion of presidential installation ceremony 2013.

thDate-17 March 2013 at MCA(Mumbai Cricket Association)

RG-2,G block,Bandra Kurla Complex,

Bandra (east), Mumbai 400051

6-6.30 PM-Special Executive board meeting to discuss and finalize the introduction of a

certificate course in pediatrics in BMC hospitals as an IAP-MCGB initiative.

Selection of administrative and working committee for the same

PROGRAMME

6.30-7.45 pm-

a) secretarys report for 2012

b) outgoing presidents address

c) felicitation of 2012 office bearers

d) introduction of incoming president and change of medallion

e) incoming presidents address and vision for 2013

7.45-9.15- LIFETIME ACHIEVEMENT AWARD – Dr Ramesh D. Potdar & Dr. Armida R. Fernandez

REGISTRATION FREE BUT COMPULSORY

7.45-8.30- ‘Life Skills for Paediatricians’ by Dr. Ramesh D. Potdar

8.30-9.15 ‘Every Child Counts’ by Dr. Armida R. Fernandez

9.15 Onwards- Dinner


Registration Details There are no registration fees for the CME.. However prior registration is necessary. Final date — 1st March 2013 Spot registrations will be allowed if seats are available MMC points—In process..

Contact Details Mrs Shiny Babu / Mrs Aruna D'Souza Phone—022-24192154, 022-24192037 Mobile—Dr Parag M Tamhankar– 7738116089 Email—[email protected] [email protected]

Life Time Achievement Awards & President Installation

Topic– Gene Therapy—Recent Success Speaker—Dr Lakshmi Vasudevan Eminent Pediatrician, Senior Genetic Consultant, Genetic Research Center (GRC), NIRRH

Topic– Molecular Genetics of Rett syndrome

Topic—Molecular Diagnosis of Hereditary Ataxias Speaker– Dr Ashwin Dalal Pediatrician and Medical Geneticist, Scientist Grade IV and HOD, Diagnostic Division, Center for DNA Fingerprinting and Diagnostics, Hyderabad Speaker—Dr Dhanjit Das Molecular Biologist and Scientist B at GRC, NIRRH

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Dr Neelu Desai

Child Neurologist

Program:

9.30 am– 9.55 am: Approach to unconscious child- Dr Shilpa Kulkarni

10- 10.25 am: CNS infections- Dr Shekhar Patil

PRACTICAL NEUROLOGY CME

We are happy to announce the forthcoming CME on Practical aspects in Pediatric Neurology. thThe theme for the first half a day CME which would be held on 17 March, 2013 is

“Neurological Emergencies “. Experts in the field of Pediatric Neurology across Mumbai would deliver case based approach of common emergencies which perturb the practicing pediatrician. I trust this to be of utmost use to all practitioners who want to remain abreast with the recent advances in the field.

CME on Neurological emergencies- Date: 17th March 2013

Venue: IAP office, Sion, Mumbai

Co organized by MBIAP and CNS (Child Neurology Society)

CME Co-ordinator: Dr Neelu Desai

10.30 am- 10.55am: Approach to Acute ataxia- Dr Neelu Desai

11-11.15am: Tea Break

11.15-11.40 am: Stroke in children- Dr Viraj Sanghi

11.45- 12.10 pm: Acute flaccid paralysis- Dr Mahesh Sambhare

12.15pm-1pm: Panel Discussion (Cases)

LUNCH

1 MMC Credit point

Registration free but compulsory (limited seats-60)

Contact: IAP office: 24045803 for Registration


THANE ACADEMY OF PEDIATRICS .

THANE ACADEMY OF PEDIATRICS is organising a 1/2 day CME ON NEONATOLOGY

on 24 March 2013 at Jupiter Hospital

This would include

1 Case based discussion of common problems in neonatology ,

2 parental counselling of High Risk Newborn,

3 Advances in Neonatology and IEM Screening.

4 Rapid Fire Q and A,

Registration charges Rs 200.

Please contact Dr Bhavesh 932257378, Dr Geeta 9821776407, Dr Mahendra 9821604247.

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