Activities of the Faculty of Paediatrics:

The activities of the faculty of paediatrics are keeping in with the objectives of the Institute like patient care service, training and research.

The work load of the Faculty:

The Faculty of Paediatrics acts as a primary referral centre for the local community and a secondary referral centre for the rest of the country. This pattern of referral gives us a unique case mix of important common diseases and specialised problems. In the Jalkuri branch we have seen about 64,000 children since July 1994 when we started the paediatric out patient services (Table-1). The month wise attendance of the last four years at paediatric OPD is shown in Fig-1. The disease profile of out patients is shown Fig-2. We opened a Diarrhoea Treatment Centre (DTC) on 18th September '98 in response to the diarrhoea epidemic following the devastating flood of '98 and treated 393 children as inpatients and about 800 at the ORT corner. The inpatient care and out patient services at Matuail have just started since 10th February and 15th February, 1999 respectively (Table-2). We hope that in the coming days we will be able to offer specialised services in the field of gastro-enterology, nutrition, respiratory medicine and cardiology and neonatology.

The inpatient workload will comprise the full range of ward work and level-II care for neonates. There will be full facilities for investigations and an active research program, which includes collaborative projects with other clinical and epidemiology department in our Institution. The physical infrastructure and other logistics will provide a unique centre for training in the field of paediatrics.

Staffing of the Faculty:

The faculty comprises one unit having major interests in the field of nutrition, gastroenterology, respiratory medicine, cardiology and neonatology. Current staffing in the faculty of Paediatrics includes :

• Associate Professor (3)
• Assistant Professor (2)
• Registrar (1)
• Assistant Registrar (7)
• Nursing staff (10)
• Computer operator (1)
• Audiometrician (1)
• Physiotherapist (1)
• MLSS (4)

Clinical facilities:

There are close links with OBGYN department with whom the facilities are shared. Our clinical facilities is custom designed to the specifications made by the clinical staff. We have a purpose built Paediatric out-patient department with eight consultation chambers and a waiting area for 200 patients. The OPD also includes a child asthma centre, a centre for detection of heart disease, audiometry unit for hearing impairment, physiotherapy unit for physically handicapped, growth and development unit for assessment of developmentally delayed, nutritional rehabilitation unit for malnourished children, lactation management unit for lactational failure cases, and the traditional EPI and ORT corner. The children ward has 28 general beds. In addition there are 4 cabins, 9 special care baby unit (SCABU) beds, 2 neonatal intensive care beds (NICU), 4 diarrhoea cots, 2 for asthma/ARI beds and 2 lactation beds. A triage nurse remains alert during OPD service to pick up very sick children for providing immediate attention thus avoiding long waiting time. Investigation facilities include all routine and biochemical and bacteriological examinations, x-rays, ultrasound as well as doppler echocardiography.

Medical record keeping is a unique feature of this Institute unlike any other government hospital of the country. Every patient attending the hospital is given a number (Medical Record Number, MRN) in the registration desk at the first appearance through a computer facilitated data entry program. With this recording the patients are linked to this Institute and the MRN is used for recording the chronology of one's medical events to be utilised for future reference whenever required.

Clinical programmes:

OPD coverage by the consultants : Registrars and Assistant Registrars are the first line doctors to see out patients at OPD which is open from 9.00 AM to 3.00 PM. A separate card is maintained for each patient to document the salient features. This card is retrieved when the patient revisits ICMH next time. The hospital is trying to minimise the patients' waiting time. The patients requiring investigations are sent to the respective laboratory and they are again requested to report with the investigation results after 1.00 PM to avoid clash with the new patients. A consultant is always available at the OPD to provide opinion to the referred cases.

Ward round : There is one major teaching ward round per week, supervised and led by all the consultants of the paediatric faculty. Consultants of other departments including Laboratory Medicine and Imaging are also invited to join the academic ward round. All ward rounds and consultations have a strong teaching and service commitment. There are daily ward rounds conducted by the Registrars and the consultant of the day.

Paediatric asthma: A child asthma centre will be organised soon at the OPD for giving care to asthmatic children. Asthma education to parents and older children by a trained nursing stuff will be an integral part of asthma management in this centre. Peak flow meter use will be encouraged by the patients and spirometry will be done on the older children whenever necessary. Records of all patients will be maintained in the asthma centre. Different research protocols will be developed to find out better management in the context of our country.

Centre for detection of heart disease : This centre will put effort for early diagnosis of congenital heart disease, rheumatic fever and rheumatic heart disease by taking history, doing physical examination, ECG and color doppler echocardiography. A trained paediatric cardiologist will be on overall supervision of the unit.

Audiometry unit : The children who will be suspected to have impaired hearing will be subjected to screening test for hearing assessment. A qualified audiometrician will be in charge of the unit.

Physiotherapy unit : This unit is providing physiotherapy to the physically handicapped children and children with pulmonary conditions where it is necessary. Mothers who delivered recently will also benefit from this physiotherapy.

Growth and development clinic : This clinic will monitor the growth and development of all children who will be brought to the clinic. Even normal children will be assessed at this clinic.

Nutritional rehabilitation centre : The children who are malnourished will be given nutritional care in this unit. The parents of the children will be taught about the food, their preparation and feeding of their children.