In his first Editorial, Prof. OP Ghai who took over as Editor in January
1973 noted with satisfaction that ‘The Journal ranks as one of
the foremost … in India with high academic standards and regular
publication. The journal is now financially viable in this period of
rising costs and diminishing revenues. Credit for this achievement, to a
large measure, is due to the confidence reposed by the members of the
Academy in the Editor [1]. He asserted that ‘A medical journal is not
only a repository of articles for archives, but is also a living medium
for communication of information of practical use to the readers.
Journal of the professional society reflects the image of the
organization through the quality of scientific contributions by the
members.’
He urged prospective authors to ensure ‘Improved
standards and higher levels of excellence .... and in promoting the
objectives of the Indian Academy of Pediatrics. My challenge is to make
the Journal a piece de resistance for the young pediatric
residents who will be the members of the Academy in a few years and for
practitioners who seek the newest information on pediatric problems,
which comprise two-thirds of their practice’ [1].
While these thoughts were scribed in an era when
there was hardly any talk on impact factor or related indices, it is
satisfying that Indian Pediatrics today consistently ranks
amongst the highest national and regional medical journals with large
readership. This accomplishment has chiefly been possible due to the
commitment of successive Editors who have worked with as much passion,
as their predecessors.
Dr Ghai further suggested that ‘Considering the
social need of the country, the Journal solicits more articles on
applied and operational research on delivery of health care to children.
These will receive high priority in publication’ [1]. The Editor adhered
to this policy and a number of publications during his term focused on
this important domain. He also appealed to ‘contributors to exercise due
care in submitting manuscripts. Typographic mistakes should be checked,
standard abbreviations should be used for names of journals and
illustrations should be of high quality, capable of good reproduction.’
These considerations are valid even today, as members of the Journal
Committee spend tireless hours in their effort to improve the content
and style of manuscripts submitted to the Journal.
One of the first articles in 1973 presents health
statistics of the country, with a then population of almost 547 million
and infant mortality rate of 140 per 1000 [2]. States like Kerala and
Haryana were notable for their lower infant mortality, below 80 per 1000
live births. Our neighbor, Sri Lanka (then Ceylon), already had a rate
of 48 in 1967! The same issue carries recommendations of a ‘Workshop on
Care of Under Five’ and meeting their health needs through special
clinics [3]. An accompanying Editorial, entitled ‘Health planning for
children’ maintains that ‘Progress can be measured only with a clear
concept of goals. When translated in terms of child health and welfare,
these are not measured by the number of hospital beds for children,
outpatient attendance or pediatricians trained, but the health
experiences of the children. We should have aimed at a clear reduction
of morbidity and mortality in children ..... and for improvement in
nutrition and general health’ [4]. The high rates of neonatal, infant
and child mortality in the country, with marked regional disparities
continue to concern pediatricians and health planners even in the 21st
century. The current infant mortality rate in India is similar to what
Sri Lanka had achieved 4 decades ago.
The Presidential Address by Dr. RS Dayal, at the
Annual Conference of the Academy in Trivandrum in 1973, focused on
topics that he felt required immediate attention, chiefly the need for
an adequate and structured undergraduate Pediatrics curriculum, and
enhancing the care of children through School Health Services. He also
emphasized the need for operational and disease oriented research [5],
views that were echoed by the next President, Dr. BD Patel in Kanpur,
who mooted the need for ‘action-orientation based programs’ and
importance of mass health education [6]. The views of the Government of
India regarding health needs for children were addressed in detail by
Sh. VC Shukla, then Minister of State for Planning, in the Shantilal
Sheth oration during the Annual Meeting in Manipal in 1975 [7].
A number of articles, including by Prof. KK Kaul from
Jabalpur, address the importance of imparting quality undergraduate and
postgraduate training in Pediatrics [8-11]. These articles call
attention to the needs of adequate clinical experience in Pediatrics,
case-based learning and the benefits of formative and summative
assessment. Articles from pediatricians from countries in south and
south-east Asia [12] expressed similar views. Later, a special article
by OP Ghai highlighted the pedagogic objectives and specific learning
outcomes for postgraduate training in Pediatrics [13]. These articles
undoubtedly shaped the evolution of current curriculums, and publication
of related resource material, including the IAP Textbook of Pediatrics.
A special January 1975 issue featured the proceedings
on three Workshops organized in 1972 by the Nutrition Sub-committee of
the Indian Academy of Pediatrics, under the stewardship of PM Shah. The
recommendations of the first Workshop on ‘Infant foods industry and
pediatricians’ seem rather anachronistic given the current official
relationship of the Academy with the infant food industry, but
nevertheless worth reading [14]. The second Workshop addressed the
‘Ecology and management of protein calorie malnutrition’ including
extensive discussions on assessment and grading, epidemiology and
management [15]. The final Workshop on ‘Care of the under fives’
emphasized the aims, activities and benefits of focused and
comprehensive care provided by special clinics, a concept pursued in
varying measures by subsequent health planners [16]. A monograph on
proceedings of these Nutrition Workshops was available for Rs. 10!
Apart from articles on basic health care in the
community, there is equal emphasis on the need for ensuring models of
high quality hospital care for children with serious illnesses. An
editorial underscores that ‘academic excellence and optimal care are not
exclusive. On the contrary, they are interlinked and interdependent’
[17]. The need and requirements for pediatric intensive care units and
strategies for neonatal resuscitation [18] was highlighted.
Indian Pediatrics featured a number of excellent,
state-of-the art reviews written by eminent physicians and researchers.
Of note are reviews on ‘Tuberculin test’ [19] and ‘Mortality due to
tuberculosis’ [20] by Raj Narain, ‘Challenges in diagnosis of rheumatic
activity’ by Subimal B Roy [21], ‘Central nervous system tuberculosis’
by PM Udani [22, 23] and ‘Nutritional anemia’ by Tripathi [24]. A series
of articles, by AK Bhattacharya from the School of Tropical Medicine in
Calcutta, on ‘Kwashiorkor and marasmus’ discuss issues pertaining to
etiology and assessment [25], pathological, biochemical and metabolic
studies [26], and its management and outcome [27]. Two important
articles describe the utility of the abridged Bayley Scale of Infant
Development in Indian children [28] and their application to patients
with neurological disorders [29]. While these articles were published 4
decades ago, they still are an important educational resource for
postgraduate students and researchers.
Reflecting an increasing realization to reduce
neonatal morbidity and mortality, a large number of articles address
various facets related to care of sick neonates. Research papers on
birth weight, intrauterine growth curves of singletons and nomenclature
of newborns [30-32] and physical and neurological criteria for gestation
assessment [33] continue to be cited even today. Important causes of
neonatal morbidity and mortality in the country [34], incidence and
etiology of hyperbilirubinemia [35-37], profile of hypoglycemia [38] and
infantile obstructive cholangiopathy are discussed with considerable
clarity. The Journal cites the often referred to poem by Prof. ON
Bhakoo on ‘Cry of a premature baby’ [39] that is reproduced in its
entirety below.
Cry of a Premature Baby
I came too early, I came too light
From the warm womb, to the cold room
Struggling for breath, dying to
survive
Hungry for food, to keep the brain
alive
The invisible enemy, threatens
through you
And the yellow pigment, ever ready to
cripple
Lungs too stiff, to get oxygen to
blood
If only you care, I need special care
Brain bleeds with strain, blood
channels too fragile
Be gentle, be kind, be warm for a
while
By your thoughtful care, given this
start
I may be Winston Churchill, I may be
Bonaparte!
The content of research papers published in journals
of academic societies usually reflects contemporary issues that are of
relevance to its membership. Invited reviews, on focused topics, have an
educational purpose and are directed towards the general readership.
Journals also provide a forum for discussion among its readers. During
1973-75, the Journal fulfilled its mandate on issues that were
significant at that time. The number of submitted manuscripts had
increased, inevitably resulting in rejection rates close to 50%. In his
farewell Editorial, Dr. Ghai while expressing satisfaction at the growth
of the Journal, thanked members of the Academy for reposing
confidence in him, the reviewers for their time in evaluating and
revising manuscripts ‘for the sheer love of science’ and welcomed his
successor, Dr. Satya Gupta [40].
Indian Pediatrics had done well in its childhood
and adolescence was round the corner!
References
1. Ghai OP. Perspective. Indian Pediatr. 1973;10:5.
2. Sinclair S. Vital statistics-India:
Population-growth rate-infant mortality-age specific mortality. Indian
Pediatr. 1973;10:51-3.
3. Workshop on care of under fives. Indian Pediatr.
1973;10:47-50.
4. Ghai OP. Health planning for children. Indian
Pediatr. 1973;10:1-4.
5. Dayal RS. Presidential Address. Indian Pediatr.
1973;10:61-4.
6. Patel BD. Presidential address. Perspectives in
Pediatrics in India for the seventies. Indian Pediatr. 1974;11:1-5.
7. Shukla VC. Dr. Shantilal C. Sheth Guest Oration.
Indian Pediatr. 1975;12:285-9.
8. Kumar RC, Kaul KK. The pediatric component of
general practice in Jabalpur. Indian Pediatr. 1973;10:103-10.
9. Rao MN, Chandra H. Present status of pediatric
undergraduate education in India. Indian Pediatr. 1973;10:121-4
10. Ghai OP. Instructional objectives for training In
Pediatr. Indian Pediatr. 1973;10:199-201.
11. Kaul KK. Undergraduate teaching and general
practice. Indian Pediatr. 1973;10:203-6.
12. Alam B, Tuchinda P, Pudjiadi SH. Pediatric
education in south Asia. Indian Pediatr. 1973;10:625-8.
13. Ghai OP. Learning objectives, specific learning
outcomes and learning experiences for postgraduate training in child
health. Indian Pediatr. 1975;12:945-50.
14. Nutrition Sub-committee, Indian Academy of
Pediatrics. The Workshop on ‘Infant Foods Industry and Pediatricians’.
Indian Pediatr. 1975;12:54-55
15. Proceedings of the Workshop on Protein Calorie
Malnutrition. Suggestions and recommendations. Indian Pediatr.
1975;12:116-7.
16. Shah PM. Proceedings of the Workshop on Care of
the Under fives. Indian Pediatr. 1975;12:119-39.
17. Ghai OP, Srivastava RN. Hospital care of
children: Need to widen our horizon. Indian Pediatr. 1973;10: 631-2.
18. Ghosh S, Kumari S. Resuscitation of the newborn.
Indian Pediatr. 1973;10:351-5.
19. Narain R. Shantilal C Sheth Guest oration.
Tuberculin test in pediatric practice. Indian Pediatr. 1973;10:131-40.
20. Narain R, Dinakara AM. Mortality due to
tuberculosis in children in India. Indian Pediatr. 1975;12:529-37.
21. Roy SB. Challenge in the diagnosis of rheumatic
activity. Indian Pediatr. 1973;10:571-6.
22. Udani PM, Bhat US, Dastur DK. Tuberculosis of
central nervous system. Indian Pediatr. 1973;10:647-56.
23. Udani PM, Bhat US. Tuberculosis of central
nervous system. Indian Pediatr. 1974;11:7-17.
24. Tripathi AM, Bhatia BD, Agarwal KN. Nutrition
anemias in childhood: A decade of progress in India. Indian Pediatr.
1975;12:343-49.
25. Bhattacharyya AK. Studies on kwashiorkor and
marasmus in Calcutta (1957-74): I. Aetiological and clinical studies.
Indian Pediatr. 1975;12:1103-13.
26. Bhattacharyya AK. Studies on kwashiorkor and
marasmus in Calcutta (1957-74). II. Pathological, biochemical and
metabolic studies. Indian Pediatr. 1975;12:1115-23.
27. Bhattacharyya AK. Studies on kwashiorkor and
marasmus in Calcutta (1957-74). III. Therapeutic and follow-up studies.
Indian Pediatr. 1975;12:1125-33.
28. Phatak P, Gopalan V, Kumar N. Application of
abridged Bayley Scales of Infant Development. I. Compilation and
evaluation of the scales. Indian Pediatr. 1974;11: 545-9.
29. Phatak P, Phatak AT. Application of abridged
Bayley Scales of Infant Development. II. Application to neurologic
cases. Indian Pediatr. 1974;11:551-5.
30. Lakshminarayana P, Nagasamy S, Raju VB. Fetal
growth as assessed by anthropometric measurements. Indian Pediatr.
1974;11:803-10.
31. Singh M, Giri SK, Ramachandran K. Intrauterine
growth curves of live born single babies. Indian Pediatr.
1974;11:475-79.
32. Bhargava SK, Ghosh S. Nomenclature for the
newborns. Indian Pediatr. 1974;11:443-7.
33. Singh M, Razdan K, Ghai OP. Modified scoring
system for clinical assessment of gestational age in the newborn. Indian
Pediatr. 1975;12:311-6.
34. Bhakoo ON, Narang A, Kulkarni KN, Patil AS,
Banerjee CK, Walia BNS. Neonatal morbidity and mortality in hospital
born babies. Indian Pediatr. 1975;12:443-50.
35. Ghosal S.P., Dutta N., Chatterjee D. Incidence of
hyperbilirubinemia in the newborn. Indian Pediatr. 1975;12:317-24.
36. Gupta SC, Kothari J, Bhatia HM. Influence of
birth weight on the severity of hemolytic disease of the newborn due to
ABO incompatibility. Indian Pediatr. 1975;12:477-83.
37. Merchant RH, Merchant SM, Babar ST. A study of 75
cases of neonatal jaundice. Indian Pediatr. 1975;12:889-93.
38. Karan S, Devi PS, Laxman S. Hypoglycemia in the
newborn with special reference to starvation and feeding on blood
glucose levels in low birth weight and full sized infant during the
first 24-hours of life. Indian Pediatr. 1975;12:469-76.
39. Bhakoo ON. Cry of a premature baby. Indian
Pediatr. 1974; 10:365.
40. Ghai OP. From Editor’s Desk. Indian Pediatr. 1975;12:1195.