reetings fellow pediatricians! I will be your
guide in the next phase of the journey down memory lane in Cruiser
Indian Pediatrics 1964-2013. Dr Sisir Bose, the first Captain, was
flagged off on this journey from Calcutta in 1964. The significant
landmarks achieved during subsequent phases under the navigation of Dr
NG Mojumdar, Dr PN Taneja and Dr OP Ghai have been shared with you in
previous issues. Tighten your seat belts and let us proceed onwards!
Organization of the Editorial Board and Office
The steering wheel was handed over to Dr Satya Gupta
in January 1976 till March 1980, which covers Volumes 13-17. Dr Satya
Gupta has been an inspiration for all pediatricians, especially women.
She is a tough gold standard to measure up to, being the lone woman
Editor of IP and second woman President of Indian Academy of Pediatrics
(1980 – 81) after Dr Shanti Ghosh. A description of her career and
contribution to the field of Pediatrics has been described in this
year’s January issue [1].
As Dr Satya Gupta took up the reins of Editor of IP,
3000 issues were being published per month by 1980. The content page of
the first two issues of 1976 displayed Dr G Srivastava and Dr NK Anand
as the Assistant Editors. In the March 1976 a Journal Committee and
Editorial advisory board finds mention for the first time (Fig.
1). In those days the editorial office had to relocate with each new
editor and there had already been 3 changes since 1964. Each time this
would naturally lead to a transitional period in which the new Editor
faced problems of re-establishing an efficient office due to the changes
in space, staff, and facilities in addition to getting accustomed to the
newfound responsibilities. Now the shift was to the Department of
Pediatrics, Maulana Azad Medical College, New Delhi (Fig 1).
Other problems were absence of permanent dedicated secretarial staff and
limited funds. These issues were referred to by Dr Satya Gupta in her
Presidential address in 1980,when she stated, ‘Having being your
editor for the last 4 years, I would fail in my duty if I did not draw
your attention to the difficulties facing your journal….it has no fixed
address….need not only financial assistance but also a permanent
address’[2]. A permanent editorial office with staff finally
materialized much later.
|
Fig. 1 Intimation of change in address
of Editorial office, Office bearers of IAP (1976- 77), Journal
Committee and Editorial Advisory Board.
|
Quality of Content
One of the primary responsibilities of any Editor is
upholding the author’s voice while keeping the reader in mind. The
section ‘Preparation of Manuscripts: Instructions to Authors’ in the
January issue 1976 states ‘Indian Pediatrics, the official journal of
the Indian Academy of Pediatrics publishes original research articles in
Pediatrics and Community Health and authenticated critical reviews of
pediatric subjects. Case reports of only special merit highlighting a
new facet are accepted. A brief letter to the Editor commenting upon
some articles which have appeared in the Indian Pediatrics, a case
report of special interest or brief clinical and laboratory observations
and personal views will be considered for publication’[3]. During this
period the contents were not categorized into separate sections like the
present day journal. However a consistent sequence of articles was
followed; From the Editor’s desk/Editorial, clinical studies, case
reports/ short communication, and miscellaneous (Practitioner’s column,
Letter to the Editor, Notes and News, Messages, Book reviews,
etc).Although Indian Pediatrics had become an indexed journal, the
time-bound process of peer review that is practiced today was yet to be
initiated. Selection and non- acceptance was mostly at the Editor’s
discretion.
This made the Editors’ job extremely challenging. The
contents of submitted articles may have been very good but there was
general lack of knowledge of research methodology, scientific paper
writing skill and publication ethics among authors contributing to the
journal. Study Guidelines (CONSORT,etc) and workshops on research
methodology and scientific paperwriting that are easily accessible today
were still not available. Writing a paper of good content as well as
quality was a tough prospect for the author. Editing a paper of good
content but poor quality to make it suitable for publication was even
tougher. In Dr Satya Gupta’s words, "A journal is dependent on the
quality of articles it receives. The basic tools of research are the
seven ‘C’s which stand for Competence, Confidence, Creativity,
Cooperation, Collaboration and finally Communication. This is where the
journal becomes an active participant. Communication is not only an art
but also a science.While few of us have the skill to write well,
majority may need training in this scientific art of communication.
Despite the fact that there are many agencies which provide guidance on
how to write scientific papers, most submitted papers put a great strain
on the editorial staff of journal, and thus editors have a
responsibility to help authors improve their communication skills" [4].
Keeping these sentiments in mind, it still took another 25 odd years for
the workshop on ‘The Art and Science of writing a paper’ conceived by Dr
Piyush Gupta, the present editor, to materialize.
On comparing the ‘Instructions for Authors’ with the
present day journal guidelines striking differences are evident. Some of
these included an unstructured abstract, absence of word limit and
necessity of masking face and private parts of the patient in the
figures, references according to Index Medicus and a statement
‘The forwarding letter should preferably bear the signatures of all
authors or alternately got forwarded through the head of department."
This was probably the reason why each published article ended with an
acknowledgment to the same for granting permission.
Content of Articles Published during 1976-1980
Editorials and Orations: In accordance with Dr
Satya Gupta’s philosophy, most editorials dealt with the significant
social pediatric problems of those times. In ‘From the Editors Desk’ in
the first issue of 1976 she wrote, ‘For the future to be meaningful to
young people, each one of us will have to strive harder so that millions
of children who have been denied pleasures of childhood may get a better
deal of life, The needs of these children are not new or unreasonable.
All that they ask for is food, shelter, clothing, education love and the
right to live…. We the physicians have a varying degree of sense of
responsibility to the society and we fulfill our obligations both as
individuals and through our medical organizations. She ends with, ‘Hence
a comprehensive approach by a team of Physicians, Pediatricians,
Obstetricians and Family welfare workers is necessary so that a package
program is provided for mothers and children in their entirety’[5].
In addition to the aforementioned topics there were
editorials on special laws related to children, infant mortality, Well
baby clinics, Immunization, and Nutritional supplementary programs. A
few issues were dedicated to special themes like Pediatric problems in
South East Asia (October 1977 which published overviews from Indonesia,
Japan, Philippines, Singapore and Sri Lanka) and ‘The International Year
of the Child (1979).’ Reflecting her keen interest in medical teaching
and academics there were editorials that dealt with ‘Importance of
National Medical Library for medical information retrieval’, ‘Research
in post graduate pediatric education’, ‘Principles of evaluation in post
graduate medical education’ and the SC Sheth Oration by Dr BN Sinha who
discussed medical education and the curriculum extensively [6-9]. The
1978 January editorial commended certain aspects of the Medical Council
of India’s recommendationsfor Pediatric training (published in the
December 1977), while suggesting further improvements [10].
Original research: It was an eye-opener to
realize that health related issues that are taken for granted today were
burning topics of research in the seventies. To recognize their
significance in that nascent stage and publishing shows a remarkable
scientific temper of Editors of that era. Table I displays
some of the important studies that were published related to the ‘New
kids on the block’ of those times!’ Pun intended!
TABLE I Important Studies Published During 1976-1980
Aspect |
Title |
Immunization |
BCG vaccination |
|
BCG vaccination and post vaccination allergies in babies
vaccinated at birth |
|
Comparison of BCG by conventional intra-dermal and jet methods |
|
Efficacy of oral OPV in infancy |
|
A survey of immunization status and breast feeding practices |
Family Planning |
Study of health status of children whose parents have undergone
Family planning (FP) |
|
A comparative study of Immunization status of children whose
parents had undergone FP |
|
Awareness of unmarried girls regarding population problem, human
reproduction and family planning |
Child care and
|
Care of children under 5 years’ |
Child Health
|
Evaluation of efficiency of delivery of
|
Programs |
different health & nutrition schemes in young children |
|
Viewing the 3 ongoing intervention programs- natural experiments
for pre-school children |
|
Evaluation of knowledge and competence of Anganwadi workers as
agents for health care in rural populations |
Nutrition |
Quick nutritional screening by Mid Arm Circumference or Bangle |
|
Evaluation of different regimes of management in malnourished
children |
|
Effect of supplementary feeding on the nutritional status of
pre-school children |
Diarrhea
|
Oral rehydration in Acute Gastroenteritis in young children |
|
Treatment of small bowel diarrhea with electrolyte-glucose drink |
|
Fluid and electrolyte problems in Acute Gastroenteritis-
correlation with nutritional status |
|
ORT in childhood diarrhea- a comparative study |
|
Epidemiological study of diarrhea amongst children under 5 in a
slum |
|
Sugar intolerance in diarrhea |
In the late seventies the focus of several micro- and
macro studies were an attempt to determine the immunization coverage in
select populations, and to establish norms of nutritional status, status
of health, physical growth and/ or sexual growth pertaining to Indian
children of various age groups, various settings, and States.
Protein-Calorie Malnutrition was another popular topic of research with
various aspects being studied.The term Protein Energy Malnutrition was
used for the first time only in mid-1979. Since reduction in pediatric
morbidity and mortality from communicable diseases was of prime
importance there were numerous studies on infectious diseases. Studies
on tuberculosis (Tuberculin test - its diagnostic significance,
Influence of treatment on size of tuberculin reaction, A review of 150
cases of tuberculosis in children, Evaluation of diagnostic criteria of
Tubercular meningitis), Malaria (in infancy) and Measles (case studies
of 600 children, study of complications) were published frequently and
strange as it may sound in today’s context so did amebiasis and
helminthiasis (drugs, pattern of intestinal obstruction). Research on
micronutrients like Zinc and Magnesium also started to appear.
|
Fig. 2 First page of article entitled
‘Indigenous newborn infant warmer with humidity bottle and
oxygen hood: a new concept on new born care’ with picture of the
apparatus.
|
Interest in neonatology started to flourish.
Fig. 2 displays an interesting article that appeared in 1976
entitled ‘Indigenous Newborn Infant Warmer with Humidity bottle and
Oxygen hood: a new concept on newborn care’ [11]. The same year also saw
the study ‘Comparative trials of phototherapy versus phenobarbitone in
the management of neonatal hyperbilirubinemia’ being published. Other
articles started to appear more frequently by 1978. It was interesting
to see topics like ‘Postnatal weight loss in the first 72
hours’,‘Lecthin-Sphingomyelin ratio in amniotic fluid’, ‘Study of
maternal and neonatal factors in relation to perinatal morbidity’, ‘A
study of incidence of different birth weight babies and related
factors’, ‘Maternal nutrition and low birth weight babies’,
‘Longitudinal study of morbidity and mortality pattern from birth to 6
years of age in infants of very low birth weight’, Impact of
socio-economic status on the development of small for dates at 3- 4
years’ and ‘The incidence and etiology of respiratory distress in
newborn.’ An issue of 1979 was dedicated to the newborn with an
editorial entitled ‘Care of the newborn in the community’.
Topics related to development (Etiological factors in
cerebral palsy in India, Neuromuscular development during infancy,
Clinical evaluation of children with delayed onset of speech), metabolic
disorders (Homocystinuria and response to pyridoxine) and genetics (Dermatoglyphics,
Chromosomal studies) were seen on occasion. There were a large number of
case reports of syndromes being reported from India for the first time
and surprisingly even case reports on Kala Azar and poliomyelitis (in
infancy)!
Miscellaneous: Some of the Review articles of
note were ‘Nutritional programs in India’, ‘Zinc in pediatric nutrition
and therapy’, ‘Exchange Transfusion in newborns’ and a somewhat
futuristic ‘Genetic counseling services in teaching hospitals.’ The
Practitioner’s column was a new feature started from 1977. One may
possibly visualize these as pre-historic ancestors of the current IAP
recommendations by expert groups. These included articles written by a
single expert who discussed common pediatric issues and problems that
are still relevant to office practice today (Immunization, Diarrhea and
dehydration, Nutritional requirements of infants and children, How to
wean the baby, Shock, Congestive heart Failure, Convulsions, Comatose
child, Meningitis, Acute Renal failure, Urinary Tract Infection,
Hypertension, Respiratory distress in infants and children, and
Cyanosis). There were also topics of a more advanced tone like ‘Current
trends in use of antibiotics in pediatric practice’, ‘Role of fetal
physician in medicine’, and ‘Care of neonates with surgical disorders.’
One such article entitled ‘Healthy baby competition: crowning a baby
with a prize’ must be mentioned due to its uniqueness [12]. In this the
authors had devised certain health criteria based on various aspects of
development and child care with a scoring system (Fig. 3).
These kinds of competitions were a commonly used strategy then as an
incentive for parents to promote better child health.
|
Fig. 3 Table showing health criteria
used for judging each participant.
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Letters to the Editor: These comprised of the
usual comment (in agreement or disagreement) on a previously published
article with a rebuttal when indicated. There were some noteworthy
letters on educational underachievement, a study of different brands of
triple vaccines with discrepancies in products by different
manufacturers, and a significant suggestion by Dr Meharban Singh
proposing a change over in IP to the Vancouver method of citing
references [13,14]. An extremely indignant letter was published
regarding an advertisement of a certain baby feeder which the author
felt that ‘The advertisement is in gross violation of the very basic
concept of breast feeding that we wish to encourage and which in fact
was the theme of the last International Congress held at New Delhi in
1977’[15].
Ethical Issues
Corrections appeared from time to time.The practice
of declaring ‘Conflict of interest’and ‘source of funding’ had still not
been started. I wonder whether present day editors would consider it a
conflict of interest to publish an advertisement of a certain anti-helminth
suspension on the page immediately preceding a research paper on the
same drug in Ascariasis and Oxyuriasis in children’ (Fig. 4).
The manufacturing company was acknowledged for providing drug supplies
for the study in that article [16]!
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Fig. 4 Conflict of Interest or No
conflict of Interest: that is the question!
|
|
|
Fig. 5 (a) Table showing gradual
increase in Annual subscription rates during Dr Satya Gupta’s
Editorship (b) Notice for Subscription Renewal (c) Polite note
of caution to defaulters.
|
Subscription and Printing Press Issues
During this period there was a rapid increase in the
costs of paper, printing and postal charges. This was reflected in the
dramatic increase in price of the journal (Figs. 5a, b).
These rates may appear paltry nowadays but mathematically it was a 2.5
fold hike in price in just 4 years. During Dr Satya Gupta’s tenure the
Printing press was changed thrice. Annexure 1 mentions reasons of
‘labor troubles and strikes’ as well as ‘many other difficulties’, which
might have been a mismatch between escalating costs and available budget
[17]. To add to the esteemed Editor’s woes it seems that there were
quite a few IAP members who did not pay their subscription on time.
Figure 5b gives one a fair idea of how this issue was tackled!There
were some additional problems that resulted in the Editor tendering the
following apology in January 1978, ‘Regret inconvenience caused to
readers by delay in November and December issues due to unavoidable
circumstances at the press and post office. We hope your future issues
would be regular.’
Journal Finances
Since Indian Pediatrics has always been a
non-profit academic journal, the funds that covered the process of
printing and dispatch were generated by a combination of IAP
contribution and advertisements. The former was probably not enough for
the Editors liking as reflected in a snippet of her Presidential address
mentioned earlier [2]. The products that were advertised in the journal
comprised mainly of drugs; antibiotics, cough syrups, Whoopil-a
concoction used for whooping cough (Fig. 6), Kaolin Pectin
Preparations for diarrhea, anti-helminths, and Liv 52. Since the weaning
recommendation was at 3 months then and in the absence of the present
day IMS Act, there were many advertisements pertaining to infant feeding
formulas and weaning foods. In contrast to the sophisticated vaccines
that are advertised nowadays one could see advertisements of the ‘now
humble then rocking ‘Triple Antigen DPT’, Immunoglobulins (anti-tetanus)
as well as SPAN PPD for Mantoux test. There were even a few non medical
related advertisements; AMCO batteries, DAVP Nation on the Move (Customs
and central excise, Manifold rise in power, Record output of steel) and
National Savings Organization. These four years saw most advertisements
in black and white still although the first single-colored advertisement
had appeared in January 1976 and multi-colored in the October 1976
issue.
|
Fig. 6 Advertisement for medicated
concoction to be used in Whooping Cough.
|
Conclusion
In the 4 years that Dr Satya Gupta was the Editor she
remained ‘true’ to upholding and improving the quality of IP in both
spirit and name. The ups and downs that she faced during her editorship
are given in Table II. Some of these have already been
mentioned in Annexure 1, ‘From the Editors Desk’ in December 1979 [17].
TABLE II: Innovations And Challenges During Dr Satya Gupta’s Tenure
Innovations |
• |
Formation of a Journal Committee and Editorial advisory Board
(March, 1976) |
• |
Introduction of Clinico-pathological conference (December, 1976) |
• |
Introduction of Practitioner’s column (January, 1977) |
• |
Commemorative volume ‘The child in India’ on occasion of the
XVth International Congress of Pediatrics 1978 (Rs 20) |
• |
Special issues on social pediatrics and drug therapy in children
( Rs 15 each) |
Challenges faced |
Solution |
• |
Rising costs/ inflation |
• |
Increase in subscription rates |
• |
Press problems |
• |
Printing press changed thrice in 4 years |
• |
Non- payment of subscription |
• |
Polite reminders followed by warnings of cancellation of
|
|
|
|
subscription with deadline |
• |
Non-receipt of journal due to postal problems |
• |
Offer of choice of registered post with extra charge
|
|
|
|
(Rs. 40 per year) |
We will have to end our journey here. I hope you
enjoyed your tour with me. Remember there is still a long way to travel.
Another guide will be taking over in the next issue. Farewell.
References
1. A Dedication to Past Editors – We Salute These
Academicians. Indian Pediatr. 2013;50:21-4.
2. Gupta S. Presidential address. Indian Pediatr.
1980;17:211-7.
3. Preparation of manuscript-Instruction to authors.
Indian Pediatr. 1976;13:iii-iv.
4. Gupta S. Early days. Indian Pediatr. 2013;50:49.
5. Gupta S. From the editors desk. Indian Pediatr.
1976;13:1.
6. Dutta Banik ND. Importance of National Medical
Library for medical information retrieval. Indian Pediatr.
1976;13:165-8.
7. Kaul KK. Research in postgraduate pediatric
education. Indian Pediatr. 1977;14:503-4.
8. Gupta S. Principles of evaluation in post graduate
medical education. Indian Pediatr. 1978;15:105-6.
9. Sinha BN. Dr S. S Sheth Oration.Indian Pediatr.
1977;14 11-7.
10. Gupta S. Priorities for child health. Indian
Pediatr. 1978;15:1-2.
11. Guha AK, Guha AR. Indigenous newborn infant
warmer with humidity bottle and oxygen hood (a new concept on new born
care). Indian Pediatr. 1976;13:155-6.
12. Jhala DR, Shah AR. Healthy baby competition:
crowning a baby with a prize. Indian Pediatr. 1980;17:289-291.
13. Nair KPB. Letter to Editor. Indian Pediatr.
1978;15: 99-100.
14. Singh M. Letter to Editor. Indian Pediatr.
1980;17:206.
15. Kaul KK. Letter to Editor. Indian Pediatr.
1978;15:1061.
16. Chaturvedi P. Vanpar suspension in ascariasis and
oxyuriasis in children. Indian Pediatr. 1977;14: 479-80.
17. Gupta S. From the Editors Desk. Indian Pediatr. 1979;16:1069.