Paediatrics

Paediatrics

Departmental information

OVERVIEW OF THE DEPARTMENT

Department of Paediatrics, S. Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital, Bagalkot is well established medical faculty, with 4 units having dedicated team of doctors & well trained nursing staffs are managing NICU, PICU, and Casuality. Department is fully equipped with advanced ventilators, Defibrillators, Multipara monitors, ABG machine, mobile X-ray units, Head cooling units, CPAP and HFNC machines etc.    Total bed strength of 130 beds; with 30 beds each in Unit & 10 beds for Thalassemia children. Neonatal Intensive care unit is situated in 2^nd floor of Pediatric building with 35 beds. In the 1^st floor of same building Paediatric Intensive care unit is also situated with 20 bedded strength. Both NICU & PICU are well equipped & well staffed

VISION

• To be a leading healthcare institution, recognised for excellence in patient care, innovation, and community engagement, delivering compassionate, high quality, and accessible medical services to improve the health and well being of all.
• To promote pediatric health through integrated clinical practice, education and research.

MISSION

• To provide exceptional, compassionate holistic pediatric healthcare services that enhance in health and well being of our patients and the communities we serve, with a commitment to innovation, excellence and patient centered care.
• To ensure equitable access to healthcare for all, regardless of socioeconomic status, through comprehensive, affordable and culturally sensitive services.
• To foster a healthier community by providing preventive care, health education and outreach programs tailored to local needs.

INFRASTRUCTURE OF THE DEPARTMENT

OUT PATIENT DEPARTMENT

            Department of Pediatric has Out Patient Department in OPD block. OPD has all the facilities & space as per National Medical council of India norms. Paediatric OPD has 4 consulting rooms with all the adequate facilities. It has sub-speciality OPDs- Asthma clinic, DTTU, Immunization clinic, Adolescent and obesity clinic, Cardiology clinic, Neurology clinic, Nephrology clinic, Endocrinology clinic, Hematology clinic, Neonatology clinic, Child guidance clinic, Child rehabilitation clinic and Nutrition centre. It has demonstration room for teaching students. It has waiting area, growth monitoring / recording area.

PAEDIATRIC IN PATIENTS DEPARTMENT

Pediatric Wards:

There are 4 Pediatric wards situated in First floor of Paediatric block. Each Unit has bed strength of 30 beds & 10 beds for Thalassemia Cass and Gastroenteritis cases. 

In all  the wards there is a teaching/ procedure room, duty doctors room, side laboratory and nurses room. All the procedures are done at procedure room. Routine investigations are done at side lab, wards are having central oxygen and central suction facility.

INTENSIVE CARE UNITS

Department of Paediatrics has level III care NICU and PICU which are well equipped for post graduate teaching.

PICU

 PICU at S.Nijalingappa Medical College & Hanagal Shri Kumareshwar Hospital is situated at first floor. It is a 20 bedded, well equipped, air conditioned with Pediatric Intensivists & well trained nursing staff.

 NICU

NICU is placed in first floor with 35 beds. It has two compartments with provision for level II and level III care. It has facility for feeding room, change and scrub etc. NICU is air conditioned with central suction & central oxygen, compressed air facility and Thermoregulation facility with well trained staff nurses. Well equipped with advanced Mechanical ventilators, CPAP and HFNC machines, and Head cooling units.

FACILITIES AND SERVICES PROVIDED BY THE DEPARTMENT

Subspeciality services

Well baby services

Department of pediatrics and nursing provide comprehensive baby services at pediatric outpatient department from Monday to Saturday between 9am – 5pm. Services include, growth plotting and monitoring, breast feeding counseling, nutritional advice, immunization, and screening for developmental delay. Pediatric resident and a junior consultant will be manning the clinic, which will be supported by senior consultants. Vaccination will be administered by well-trained nursing personnel within the premises of pediatric OPD. Mothers and infants requiring additional help for breast feeding will be referred to lactation clinic which is handled by trained counselors. Same services can be obtained between 4-6 pm in the evenings as a part of special consultations.

Adolescent Clinic
Patient type: Adolescents 12-18 yrs
Venue: OPD no-22
Time: 10 am - 5 pm
Days: Every Tuesday only
Faculty In - Charge: Dr. Sheela M S
M.B.B.S., MD
Assistant Professor of Pediatrics,
Background: Adolescents (10-19 yrs) are transitioning both physically and psychologically to don adult roles. Many teenagers undergo much stress in coping with these changes. They have unique health needs, and the Teen clinic is a one-stop center to address their health concerns. The clinic offers ‘Teen friendly services’ with attention to privacy and confidentiality, to especially address sensitive issues impacting adolescents’ health and well-being

Services offered:
1. Assessment of physical (ex. height) and pubertal changes (ex. delayed changes, menses related) during adolescence.
2. Overweight/obesity /eating disorders.
3. Adolescent behavioral and emotional problems requiring counseling.

4. Coping Skills to handle chronic illnesses (requiring prolonged medication and multiple hospital visits with any other department)
5. Sexuality related issues
6. Drug use and abuse issues
7. ‘Risky behaviors’ related counseling.
8. Guidance to parents on adolescent parenting
9. Adolescent immunizations
10. Medico-social support to vulnerable adolescents
11. Group sessions for ‘Life skills’ training (ex. Problem solving, handling emotions, coping with stress, effective communication etc) with assistance of MSW
12. Opportunity for teens to volunteer as Peer leaders.
13. Linkages with Child guidance clinic

Pediatric Cardiology

Venue-Pediatric Opd. RoomNo:22
Time–9 am -5 pm
Day– Saturday
Incharge–Dr Vinaykumar

MBBS,MD, Fellowship in pediatric cardiology

Pediatric Endocrinology Services:

Venue-Pediatric Opd. RoomNo:01
Time–9 am -5 pm
Day– First Tuesday of every month
Incharge–Dr Naveen Charanthimath

MBBS,MD,DM(ENDOCRINOLOGY)

Primary Objectives
1.Clinical and holistic care for endocrine patients
2. Diabetes clinic
3. Medical social work Team support grp creation for diabetic children
4. Nutrition consult for chronic endocrine patients with a Point person in nutrition dept
5. Cross consults across the depts for the chronic patients
6. Diabetes day celebration
Secondary Objectives
1. To Teach Post graduates and Senior residents in the clinic
2. Data storage

3. Research,Thesis topic in endocrine subspeciality
4. Interesting cases to be presented in dept/CME/Conferences
5. Posters/oral papers in Pediatric endocrine subspeciality for Post graduates
6. Difficult cases to be discussed within the dept in association with Adult Endocrine dept
7. To share the activities of the Clinic within the dept periodically.
8. Self update of knowledge and recent aspects of management with online courses/attending Conferences and CME
9. To represent as faculty in conferences and CME
10.To conduct CME in the campus for undergraduates/Post graduates/ practicing Pediatricians

Materials in OPD/IP ward
1.Growth Charts
2. Obesity Panel
3.Diabetes Care – Target GRBS Range; Insulin dosing adjustments. Tips of Ambulatory care at home information Sheet
4. Stress dosing of steroid in adrenal crisis information sheet

Pediatric Asthma Clinic
Venue: Pediatric OPD Room No: 22
Timings: Wednesday 9am to 5pm
Faculty in Charge: Dr Raghavendra Vanaki & Dr. Ramesh Neelannavar

Patient related
1. Registration of all children with uncontrolled or poorly controlled asthma across all units in the asthma clinic. A detailed file is maintained for each patient in the form of hard copy as well as an excel document.
2. To recognize asthma and provide optimum long-term care to all patients
3. To address all other coexisting allergies and comorbidities in children with asthma
4. To maintain long term, follow up both remotely by tele consults and in person at the clinic.
5. To educate and counsel caregivers and patients on asthma and asthma control with the help of audiovisual aids, information booklets and airway models.
6. To emphasize on importance of compliance and adhering to treatment, to check all aspects related to drug, delivery and device.
7. To have a written asthma action plan (short term and long term) for every patient.
8. Interdepartmental discussion and referral: Pediatric Pulmonology, Pediatric surgery etc.

Secondary Objectives: Training and Research Related
1. To organize and conduct asthma training modules and workshops for training of undergraduate students, interns, postgraduate students and faculty.
2. Data Entry and storage
3. Conduct research in asthma including publications, conference presentations and dissertations.
4. To discuss difficult cases with other faculty in the department as well as experts in the field of asthma outside the institute as well.
5. To report the activities of the clinic every quarter to the HOD and other faculty.
Materials Available
● Asthma patient Information Booklet, self-monitoring asthma symptom sheet
● Asthma patient file
● Various drug delivery devices, medications, peak flowmeters to use for demonstration along with placebo medications which can be used for teaching and training purpose as well.
 

Pediatric Neurology

Venue: OPD no - 22
Timings: Thursday 9am to 5pm
Faculty in Charge: Dr. Keludeppa Talawar
MBBS,MD Fellowship in pediatric neurology
● Pediatric neurology  services was initiated in the Paediatric department since 2018 and outpatient clinic was started on 2018 by Dr Keludeppa Talawar

 Aim:
● To evaluate children with suspected genetic diseases or rare diseases and to provide clinicians with guidance for diagnosis and management of genetic conditions. Scope of the services:
● Children with metabolic disorders, dysmorphism, developmental delay or autism, skeletal dysplasia, any congenital abnormalities.
● Patients are referred from Paediatrics department and various others departments like NICU, Developmental Paediatrics, PICU, Neurology, Paediatric nephrology, Paediatric hemato-oncology, endocrinology, pulmonology or Paediatric orthopedics.
● Coordinate with genetic diagnostic laboratories – Cytogenetics or molecular diagnostics.

Types of patients seen.

● Global developmental delay,
● Autism Spectrum disorder,
● ADHD and other behavioural disorders
● Intellectual disability
● Cerebral palsy and associated comorbidities
● Cerebral visual impairment
● Speech and language delays
● Metabolic disorders
● Genetic disorders
● Neuromuscular disorders
● Seizure disorder
Services offered
● Screening, assessment, detailed evaluation and comprehensive health care focusing both on optimizing the developmental potential and management of all associated medical co- morbidities in children with developmental concern or disability
● Care of the child in emergencies and during admissions for intermittent medical problems
● Co-ordination of multidisciplinary intervention services and case conferences.
● Counselling parents and family on status and progress
● Teaching and training of medical students and health care staff regarding developmental concerns
● Liaison with professional services as required among experts, clinical assessments, developmental assessments, treatment of patients and planning diagnostic services.

THALASSEMIA AND HEMOPHILIA SOCIETY

Thalassemia is a major health problem, placing an immeasurable emotional, psychological and economic burden on millions of people around the world.

Thalassemias are a group of genetically inherited blood disorder in which the body makes an abnormal form of hemoglobin, the protein in red blood cells that carries oxygen. It results in excessive destruction of red blood cells, which leads to anemia. Without treatment affected children have server failure to thrive and shortened life expectancy. Treatment with a regular blood transfusion, chelation therapy, bone marrow transplantation and medication aimed at reducing transfusion iron overload, allows for normal growth and development and extends life expectancy into the third to fifth decade. These modes of treatment are very costly causing economic burden of families.

Hemophilia is a inherited genetic disorder that impairs the body’s ability to make blood clots, a process needed to stop to stop bleeding. This results in people bleeding longer after an injury, easy bruising, an increased risk of bleeding inside joints or the brain.

Treatment is by replacing the deficient blood clotting factors. This may be done on a regular basis or during bleeding episodes. To lead a normal life and to survive child needs to be given factor replacement regularly which is a burden on the family.

 This has become very essential that organization engaged in providing health care to give treatment and medicines at highly subsidized costs. Keeping in view of above two diseases to reduce the burden on families affected, we formed a society “The Thalassemia and Hemophilia Society”. Established on 04.01.2017, with 14 members headed by Dr. V.C. Charantimath. NGO, registered with Govt of Karnataka.  The main aim of our society is to give free blood transfusion, free chelating drugs, free investigation and treatment for Thalassemia children and supplying and treating Hemophilia with factor transfusion at subsidized rates.

We have 134 registered Thalassemia children who are receiving free treatment since 3 month. We are doing this through generous donations given by kind donors who are concerned with over all well being of these children. 87 donors donated so far. We thrive to give better treatment to these children for better future. We run hemato oncology clinic first Wednesday of every month at OPD no-22.

ACADEMIC ACTIVITIES

UG teaching

Theory classes- As per RGUHS CBME curriculum

Clinicals- 12 weeks of clinical postings

Seminars- Every Tuesday for the final year batch

PG teaching

Case presentations: On every  Wednesday

Journal club: On every Friday

Seminar: On every Thursday

Bedside teaching – Daily

Grand rounds- post OPD days

Mortality meet- First Monday of every month.

Pediatric department is a recognized BLS and ALS regional training centre.

Department of Pediatrics is involved in many projects.

1.   ACTION I and II trial: A multi-country, multicentre, two-arm, parallel, double blind, placebo-controlled, randomized trial of antenatal corticosteroids for women at risk of imminent birth in the early preterm period in health facilities in low resource settings to improve newborn outcomes.
2. A PLUS study: Prevention of Maternal and Neonatal death/ infections with a single oral dose of Azithromycin in women in labor (in low and middle income countries): a randomized controlled trial.
3. Aspirin supplementation for Pregnancy Indicated Risk Reduction in Nulliparous (ASPIRIN): Neurodevelopmental Follow-up Trial.
4. RAPIDIRON Kids trial
5. Repurposing intrapartum azithromycin as a Neuroprotector in Birth Asphyxia.
6. Skills and Drills Intervention at first referral units to improve emergency Obstetric and Newborn care in North Karnataka.
7. Integrated  Management of Neonatal and Childhood Illness (IMNCI) – Baseline assessment of of childhood morbidity and mortality in select districts in India.

IndiaCLEN Program Evaluation Network (IPEN).

8. Therapeutic hypothermia for birth asphyxia using a new servo- controlled devce-Arandomized controlled trial

Department has hosted 3 state conferences, and once in 2 months conducting workshops and CMEs

Total publications of department:

            Original articles: 65

            Case reports: 45

            Text books: 07