RESUMO
Background: The World Health Organization (WHO) recommends promotion of nurturing care for early childhood development (NCECD) by focusing on five essential components viz., good health, adequate nutrition, promotion of early childhood learning, responsive caregiving, and safety and security. Indian medical graduates and pediatricians are the keys to successful delivery and propagation of NC-ECD in the community. Their training therefore needs to include skills and knowledge needed to promote and practice ECD. Objective: To evaluate the existing undergraduate (UG) and postgraduate (PG) curricula of pediatrics for components related to early childhood development, assess gaps in the training essential to practice and promote ECD, and suggest recommendations to incorporate NC-ECD in the UG and PG curricula. Process: Indian Academy of Pediatrics created a task force to review the UG/PG medical curricula, consisting of experts from pediatrics and medical education. The task force deliberated on 20 March, 2021 and identified the gaps in current curricula and provided suggestions to strengthen it. The recommendations of the task force are presented here. Recommendations: Taskforce identified that the UG/PG medical curricula are lacking training for propagating early childhood learning, responsive caregiving, caregiver support, and ensuring safety and security of children. The taskforce provided a list of competencies related to ECD that need to be included in both UG and PG curriculum. NC-ECD should also be included in topics for integrated teaching. Postgraduates also need to be exposed to hands-on-training at anganwadis, creches, and in domestic setting.
RESUMO
Even though the prevalence of tuberculosis is very high in the developing world, skeletal tuberculosis of extremities rarely occurs. Here we report an uncommon form of bone tuberculosis in a 16 year old female presenting as tubercular dactylitis of proximal phalanx of right middle finger confirmed by Histopathology.
RESUMO
Adolescents among the urban and rural poor have a high incidence of chronic energy deficiency (CED) and anemia, more so in girls than in boys. Adolescent pregnancies (15-19 years) contribute to 19% of total fertility in India and record the highest maternal mortality rates. Besides maternal age, lack of education, low socio-economic status, maternal undernutrition and limited access to maternal health services are important determinants of poor pregnancy outcomes. Low birth weight is the major adverse outcome for the infant and an important determinant of increased child mortality. There is a lack of data for long term follow up of infants of adolescent mothers versus mothers 20 years and above, and more specifically, in the urban poor setting, an emerging concern.