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Chandigarh 20th February:- The Department of Pediatrics, PGI, Chandigarh organizes an annual continuing medical education (CME) and an oration every year in a weekend in the month of February. The inaugural oration was held in 2013 on the occasion of PGI's Golden Jubilee celebrations. The Prof BNS Walia Oration is awarded to an outstanding Pediatrician-whether from India or from overseas- for his or her lifetime contribution to child health care and for his or her lasting impact on the practice of Pediatrics in India. Each year, the oration is followed by a 1½-day CME. The chairperson of the Organizing Committee is Prof Pratibha Singhi, Head of the Department of Pediatrics at PGIMER. The organizing secretary is Dr Deepak Bansal.
This year, the oration, which was the 4th in the series, was delivered by Dr.Soumya Swaminathan, Secretary, Dept. of Health Research & Director General Indian Council of Medical Research (ICMR). The Oration was entitled "Pediatric TB: How to get to zero".
Dr Swaminathan said that childhood TB is grossly under diagnosed because of difficulty in getting proper samples for detecting the TB germ. She said that mathematical modeling has shown that children with TB are as likely as adult patients to have multidrug resistant TB. Gene Xpert, a new technology, has been recommended by WHO as the preferred test in children because the pickup rate of TB more than doubles. Her own research work has shown that young infants require a higher dose of anti tubercular medication per kilo bodyweight compared to older individuals and the under dosing may be one of the reasons behind treatment failure. She mentioned that many novel anti tubercular drugs are now in the pipeline and hopefully some of these will become available for the treatment of patients with multidrug resistant TB. She lamented about the lack of research data regarding anti tubercular drugs in children and data regarding optimum dosing. She mentioned that all countries of the world have pledged to eliminate TB by the year 2050, but it is going to be a very difficult and daunting task unless newer and more potent vaccines and drugs become available.
The inaugural lecture on an approach to Global Developmental Delay was delivered by Prof Pratibha Singhi, who is also the chief of the Pediatric Neurology Unit. She said that global developmental delay is an umbrella term used to describe young children with delayed development. It is conventionally reserved for children below 5 years of age; and intellectual disability or mental retardation is the term used for older children. She said that children have several areas of developmental performance: gross and fine motor, speech and language, cognition, social and personal, and activities of daily living. A child has to be delayed in at least 2 or more areas to be labeled as global developmental delay. When a child with suspected global developmental delay presents to the paediatrician, he/she must take a detailed history including construction of a pedigree of 3 generations, a detailed physical and neurological examination, psychometric evaluation to objectify the functional level and laboratory tests that include genetic testing, metabolic tests, MRI scans and so on. She cautioned the audience that a mere history of delayed crying at birth is not sufficient to conclude that developmental delay was because of birth asphyxia.
Dr Prahbhjot Malhi, head of the Child Psychology Unit, spoke about attention deficit hyperactivity disorder (ADHD) which is the most common neuro developmental disorder affecting 5-10% of children. She said it is characterised by hyperactivity, impulsivity and inattention and that boys are more likely to be diagnosed with ADHD. The cause of ADHD is still not fully understood, with various genetic, environmental and structural and functional changes in the brain being implicated. The treatment of ADHD includes a variety of stimulant medications. Non-stimulant medications are used in children who cannot tolerate the stimulant medications. Doctors have to remain careful for potential abuse and misuse of stimulant medication in adolescents with ADHD.
The next talk was delivered by Dr Naveen Sankhyan, a faculty member in the Paediatric Neurology Unit. He spoke about the clinical recognition of seizures (fits) in office practice. He said that a practical definition of epilepsy is a condition in which there have been 2 or more seizure episodes without any obvious preceding provocation like low blood glucose, head injury, meningitis et cetera. Dr Sankhyan said that many conditions which are not epileptic may apparently resemble epileptic seizures. He said that some children have an aura, which is a subjective feeling before an observable seizure. Seizures in children are broadly divided into 2 types- generalised seizures that involve the whole body and focal seizures that involve only a part of the body.
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