D. Sharad Gedam

• Doctor of Medicine
• Professor (Associate) at Government medical college, Vidisha, MP, India

Objective: To improve the rate of first-hour breastfeeding in term and near-term healthy neonates by a quality improvement (QI) study at Secondary Care District Hospital. Design: QI study. Setting: Labor room-operation theatre of a secondary care district hospital. Participants: Stable newborns ≥35 weeks of gestation born by normal vaginal delivery...

The current Covid-19 is the biggest challenge world is facing in the last 100 years. Most of the countries of even developed continents like Europe and North America are facing extreme difÀculty to control the disease. Pre-term newborns are a special population with an immature immune system, placing them at greater risk of severe infections includ...

Coronavirus infections were first reported from Wuhan China. Although there is controversy about numbers of affected patients, it is assumed that millions of population have been affected already in China.

Introduction: ARI has been estimated to be the single largest cause of death in young children. This study will be used to evaluate factors that may predict mortality due to ALRTI in children, thus helping to identify those at risk, so that timely therapeutic measures may be instituted. Material and Methods: A prospective case control study on 200...

Introduction: Current trend in Neonatal mortality rate (NMR) is stagnant for last few decades. Early onset sepsisis one of commonest causes of NMR. As clinical presentation is often nonspecific, a high degree of suspicion is required for early initiation of specific therapy. Choice of empiricalantibiotic is the cornerstone of specific therapy. Depe...

Introduction:Cerebral Palsy is not a disease but a condition affecting health and well being of a child. Reports claim a rising incidence of cerebral palsy. Fifty children with cerebral palsy were studied to find out the etiological factors and the clinical findings. Method: A retrospective, cohort, observational study was done in 50 children with...

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who wer...

Head and neck cancer are prevalent reason for cancer. Compared to CT, MRI has better tissue, spatial and contrast resolution, Non-ionizing radiation, Non-invasiveness, Multiplanar imaging and soft tissue definition.

Background: Acinetobacter baumanii is an increasingly troublesome nosocomial pathogen, often with multidrug and pandrug resistant strains, mainly in intensive care units (ICUs), being responsible for different types of nosocomial infections. Objectives: The objective was to determine prevalence of carriers of Acinetobacter Spp. and predisposing ris...

Trauma is a major cause of mortality worldwide. Majority of trauma deaths occurs within 24 hours of injury. Survival depends on timely resuscitation. Initial evaluation uses primary survey involving Airway maintenance, Breathing, Circulation, Disability and Exposure. In secondary survey, thorough head to toe examination is done. Initial resuscitati...

Vitamin A deficiency is the commonest cause of preventable childhood blindness in developing countries. Severity of xerophthalmia is directly proportional to the severity of malnutrition.

The first investigation ordered on clinical suspicion of dengue is complete blood count. The classical dengue triad includes increased hematocrit, atypical plasmacytoidlymphocytosis and thrombocytopenia [1].Hemoconcentration (hematocrit elevated > 45% or by > 20% from previous value) is diagnostic of Dengue Hemorrhagic Fever. Further confirmation i...

Early markers of motor delay which have been studied include antenatal characteristics of mother and perinatal variables likeheart rate variability, responsiveness to stimulation, motor function, behavioral state and infant size.

Regional anaesthesia is nowadays commonly practised universally. It provides superior pain relief in first & second stages of labour, anesthesia for episiotomy & instrumental delivery.

The global prevalence of childhood blindness is approximately 1.4 million. Nearly 500,000 children become blind every year - nearly one per minute.Worldwide, vitamin A deficiency is the commonest single cause of childhood blindness. Childhood blindness can be categorized as preventable & curable. Preventable causes include corneal scars due to vita...

Alcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol. Alcohol dependence is one of the commonest psychiatric disorders, second only to major depression.

Catheter associated blood stream infections are common entity in ICU setting. Indeed it is having 1-13 % prevalence rate in various studies.

Ascitis is common entity in adults. Increased vascular permeability, decerse plasma oncotic pressure & lymphatic obstructions are common causes.

Lymph node enlargement is common reason for outpatient department visit. A systematic approach is important to reach final diagnosis. It becomes further important because large numbers of patients are suffering from benign conditions.

Stress hyperglycemia is common in pediatric critical illness. It is associated with poor outcome in large number of patients.

IUGR is pathologic inhibition of intrauterine fetal growth. Risk factors for IUGR comprise maternal factors, fetal factors, adnexal factors & Placental or umbilical cord factors. For predicting IUGR a combined approach using clinical data, serum markers, biophysical parameters has higher predictive value.

Asphyxia results from compromised gas exchange. Pathogenesis of neonatal asphyxia involves energy crisis, lactic acidosis, excitotoxicity& free radical injury. Initial poor oxygenation leads to hypoxemia with intact organ function.Later hypoxia develops with anaerobic metabolism followed by asphyxia with involvement of major organs. The changes dur...

Zika Virus is emerging as global emergency. We are presenting here a brief epidemiological profile, brief clinical features and preventive aspects of Zika virus fever globally.

ECMO is a technique of providing cardiac & respiratory support to sustain life. Nowadays it is being increasingly used in newborns. Respiratory ECMO is used for severe respiratory distress syndrome, pneumonia & meconium aspiration syndrome. Cardiac ECMO is used after open heart surgery, myocarditis or myopathy. There are two types of ECMO, Veno-Ven...

Suicide has become one of the leading cause of death in adolecesnt age group. In this abstract we are trying to find out causes of increasing trends and preventive stratigies.

Obesity in adolescents is increasing rapidly. Biological, genetic, cultural & behavioral factors cause obesity. Risk of becoming obese is 50% when either of the parent is obese & it increases to 80% when both of them are obese.

Obesity in adolescents is increasing rapidly. Biological, genetic, cultural & behavioral factors cause obesity. Risk of becoming obese is 50% when either of the parent is obese & it increases to 80% when both of them are obese.

Therapeutic hypothermia for infants with perinatal asphyxia has been studied in several randomised controlled trials. There is convincing evidence that moderate therapeutic hypothermia (33-34°C for 72 h), when initiated within 6 h after birth among term & near-term infants (≥35 weeks) with moderate to severe HIE reduces the risk of death or major d...

PICU stay is largely associated with hospital acquired infection. Preventive stratigies are important to decrease morbidity and mortality associated with nosocomial infections.

Zika Virus is emerging as global emergency. We are presenting here a brief epidemiological profile, brief clinical features and preventive aspects of Zika virus fever globally.

IVIG is being used off-label in newborns for sepsis prophylaxis, treatment of neonatal alloimmune diseases such as HDN & NAIT.Though earlier studies supported IVIG prophylaxis in neonatal sepsis prevention, latest INIS Trial showed that IVIG is not recommended to prevent neonatal sepsis. Use in treatment of sepsis remains controversial. Cochrane sy...

Lactate is the most commonly used predictor in septic shock. High lactate levels are associated with increased mortality. Septic shock is the most common type of shock with around 50% mortality. Mortality increases by nearly 40% with every hour of delayed treatment.

Although influenza is recognized as an important cause of acute respiratory illness, little is known about the prevalence and burden of influenza in India.

Occupational stress is increasingly faced by doctors. Upto some extent, stress improves performance but when excessive, it becomes harmful. Doctors have more stress related mental health problems than general population. Burnout is inability to cope with emotional stress at work. It consists of 3 domains; emotional exhaustion, depersonalization & l...

Self-medication is rapidly evolving major public health concern. Pharmacists or pharmacy attendants play an important role in fostering self-medication among the public and this is supported with the increasing consultation cost.

Vancomycin-resistant organisms are significant nosocomial pathogens worldwide. Vancomycin resistant is a growing problem in the ICU setting. Treatment is difficult because of limited options (antibiotics) available.

Sexually transmitted infections are recognized as major public health problem. This is not only a medical problem but also a social and behavioral problem. This requires preventive strategies to be more focused and consolidated.

Today dengue ranks as the most important mosquito-borne viral disease in the world & its incidence has increased 30-fold over the last 50 years. In India there is recent increase in cases of Dengue in last few years.

Hypothyroidism is most common preventable cause of Mental retardation. Most of developed countries have been adopted neonatal thyroid screening programme three decades back. In India still congenital hypothyroism is important preventable cause of mental retardation. Universal Neonatal thyroid screening looks a distant dream in Indian scenario.

Post traumatic stress disorder is common psychiatric illness. Large number of trauma patients suffers from it. In most patient it remain unrecognized and surgeon don’t give much respect to these symptoms associated with PTSD.

Vesical calculi occur due to increased urinary concentration & are commonly seen in children belonging to low socio-economic status. They are usually formed of ammonium acid urate, calcium oxalate or calcium phosphate. Vesical calculi constitute about 70% to 85% of paediatric urolithiasis & boys are affected more than girls. Primary vesical calculi...

In India, various surveys showed that over 70 % of preschool children, pregnant women and adolescent girls were anaemic.

Recently more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.

Vitamin D Deficiency has become prevalent entity know. It is associated with various morbidities like osteoporosis, hip fracture, femur fracture. Early manifestation include pain in weight-bearing joints, back, thighs and/or calves, difficulty in walking and/or climbing stairs, or running and muscle cramps.

HIV is associated with malignancies. AIDS defining malignancies are Kaposi’s Sarcoma, B cell non- Hodgkin’s lymphoma, Primary CNS lymphoma & cervical cancer

Cervical cancer is the second most common cancer among women worldwide. First priority to reduce deaths from cervical cancers is to implement high quality, fully organised screening programmes without delay. Knowledge about cervical cancer and Pap testing influences uptake of cervical cancer screening services. Screening and treatment for precancer...

Primary and secondary Amenorrhea is most common complaint in Obstetrics and Gynaecology. Evaluation of these patients for cause and treatment is essential.

Hypoxic ischaemic brain damage is a major cause of neonatal mortality and morbidity. Similar degrees of insult may completely spare one child and devastate another, so very sensitive prognostic parameters are needed. Conventional predictors like fetal heart rate patterns, Apgar scores, need for resuscitation and umbilical arterial blood gas analysi...

Thrombocytopenia is common problem in sick newborn. It is an early marker of neonatal septicemia. Mortality is high when septicemia is associated with severe thrombocytopenia. During platelet transfusion baby's gestational age, post natal age and underlying and associated clinical conditions must be kept in mind.

Developing countries are facing dual nutritional disorder. Under nutrition still affects more than half of under five children. Nutritional anemia is important component of Malnutrition which affects Obese as well as undernourished children.

Infantile hemangioma is most common benign tumour of infancy. Propranolol has become treatment of choice once approved by FDA recently. We are presenting a brief discussion regarding available options for treatment.

Tuberculosis caused by Mycobacterium group of organism, is one of the ancient disease known to mankind. Despite the long known history of TB, treatment modalities are still not well understood and fully developed. Govt of India declared Tuberculosis a notifiable disease on 7th May 2012. India has introduced PMDT (Programmatic Management of Drug-res...

Various risk factors play a role in triggering allergic diseases among low-income households in developing countries. Indoor smoking, pets, overcrowding are some of the known factors for asthma.

Ebola hemorrhagic fever is a severe and often deadly illness that can occur in humans and primates (e.g. monkeys, gorillas). It is some of most virulent pathogens of humans, causing severe hemorrhagic fever that resembles fulminant septic shock. Recent outbreak of Ebola in West Africa has threatened the whole world, because of the high mortality (8...

In most of developing world Infectious diseases like acute gastroenteritis & Pneumonia are leading causes of Infant & Under five mortality. Malnutrition when present further increases morbidity & mortality of both diseases.

After successful eradication of Polio; India is now moving forward for Measles control and elimination. The vision of “a world without measles” is supported by WHO, UNICEF and other partners in newly released Global Measles and Rubella Strategic Plan 2012-2020.

Exclusive breast feeding in most easily available, affordable and acceptable way to reduce infant mortality rate specially in middle and low income group countries.

Peptic esophageal stricture is a common complication of gastroesophageal reflux disease (GERD). Though thought to be common in childhood but often go undetected in developing country like India due to lack of awareness and limited resources. We are presenting this case because radiologically it was looking like a case of Achalasia cardia but after...

Background: Clinical spectrum of cerebral palsy (CP) is different in developing and developed countries. We evaluated the clinical profile, etiological factors and co-morbidities of children with CP in central India. Methods: 50 children with CP came to the hospital in our rehabilitation center were compared with our previous study done in India an...

Almost one third of Indian population is having tubercular infection. Children always get infection from open cases of Tuberculosis. Associated malnutrition further increases intensity of tuberculosis. In this editorial we have discussed about current scenario of tuberculosis in India with special emphasis on children.

Background: Despite a dramatic reduction in disease burden of vaccine-preventable diseases through childhood immunization, vaccine coverage is not satisfactory even in urban slums. We need considerable efforts to ensure adequate vaccine coverage to control morbidity and mortality. Objective: To assess the immunization coverage in an urban slum area...

Improving access to healthcare is a major challenge for patients, doctors and community. Globally many traditional services which used to be delivered face to face (e.g. banking and shopping) are delivered now telephonically and electronically. Currently, telephonic consultation appears to be used for many different purposes despite scanty informat...

Blindness & visual impairment are important preventable morbidities. It is more important in developing countries like India. Two important aspects are lack of medical care available in peripheral part of country & lack of awareness of general population for medical care. Almost 80-90 % of population is suffering from preventable cause of blindne...

Cervical cancer is the leading cancer in women in India and worldwide. It is unique in providing long window period amenable for early detection in precancerous state through suitable screening tools. Pap smear remain important screening modality. Proper selection of screening method in community setting is a matter of debate.

Blindness & visual impairment are important preventable morbidities. It is more important in developing countries like India.Two important aspects are lack of medical care available in peripheral part of country & lack of awareness of generalpopulation for medical care. Almost 80-90 % of population is suffering from preventable cause of blindness....

Perinatal Asphyxia is leading cause of Neonatal Mortality. Neurological manifestations are predominant in form of abnormal movement and seizures. It involves almost all body system but cardiac functions are not commonly studied.

Blindness & visual impairment are important preventable morbidities. It is more important in developing countries like India. Two important aspects are lack of medical care available in peripheral part of country & lack of awareness of general population for medical care. Almost 80-90 % of population is suffering from preventable cause of blindness...

Role of zinc in human health including growth, development, immune status and acute diarrhea is indisputable. Zinc deficiency is well known because of poor dietary habits, increased secretion and poor absorption of zinc during diarrhea. Present review will demonstrate role of zinc in various pediatric disorders and newer update. We have tried to in...

A child in the hospital encounters with new experiences. He feels strange and forlorn. Different hospital routine and traumatic painful procedure add to increase anxiety and stress level in hospitalized children. Therapeutic play assists children in developing the capacity to external reality, in providing a bridge between the hospital and the outs...

Thromboangitis obliterens (TAO) also known as Buergers disease is occlusive inflammatory disease of medium and small sized arteries. In India prevelance is very high up to 45-63%. Treatment options are limited. Omental transplantation may be considered as a safe and effective treatment modality with smoking cessation.

Introduction: Distraction techniques are important non pharmacological tools to reduce pain in infants and children. Few data are available regarding their effectiveness in toddlers. We have assessed effectiveness of audio-visual distraction techniques in toddlers during and after vaccination. Materials and Methods: The study used a quasi experimen...

Introduction: Lactation is affected by a large number of factors. Equally important as spreading the message of exclusive breast feeding is enabling mothers to sustain it adequately. Considering the ease of implementation and obvious lack of adverse effects, non pharmacologic measures are an attractive option over pharmacologic measures for improvi...

Children are more vulnerable to various adverse events related to drugs and poor understanding of instructions on prescription by the patient or caretakers were likely to cause medication error and less effective treatment. Drug prescribing is a skill that needs to be refined on a continuing basis. It reflects physician's skills and attitude toward...

Introduction: The present study is an attempt to evaluate the incidence of malnutrition as well as obesity. We have evaluated physical growth and sexual maturity rating of 10-18 years adolescent boys-overweight Vs Normal Vs Underweight. Material and Methods: A random sample of 530 adolescent boys (one private English Medium and one Govt. Hindi Medi...

Plummer-Vinson also known as sideropenic dysphagia is a disease that is characterized by classical triad of iron deficiency anemia, dysphagia and esophageal web. It is known to mostly affect white female mainly, but cases have been reported from other ethnic group in the literature. Treatment is very promising especially when it is not associated w...