Sunil Jain

By Sunil Jain

Armed Forces doctors are often required to treat children affected in war, combat, and disasters. Tender care & comprehensive tact is needed for children. Acquisition of these qualities comes with knowledge, its application, and practicing skills. Throughout history, children have been victims of armed conflict. War-related injuries are more severe as compared to the civilian sector injuries. Penetrating injuries are associated with significant damage to local structures, whereas blast injuries are associated with less local injury and more multisystem trauma. Children are not small adults. The differences have important practice implications. Identifying and correcting physiological compromise improves outcomes. The examination and vital sign data can be interpreted only if the caregiver has a thorough understanding of normal values. Identification & treatment of what is killing the patient is done in primary survey. Secondary survey, extremity trauma, fracture biomechanics, & burns peculiarities need attention. Care of the injured patient is a dynamic process. Frequent monitoring required for proper response. Small infants have a narrow margin for error. Combat trauma provides multiple opportunities for improvement. Continuation of research will ensure ongoing progress and further improvement in the outcomes of both military and civilian casualties.

Part of the book: Current Topics on Military Medicine

By Sunil Jain, Arvind Singh Kushwaha and Vishal Marwaha

Complete coverage of all infants, everywhere with wonderful evidence, and covering completely with first six months of exclusive breastfeeding and thereafter proper weaning while continuing breastfeeding up to 2 years of age or beyond is desirable. Reaching all rightly and robustly is required. All this will contribute greatly towards the growth & development of infants and grandly towards the Sustainable Development Goals. We propose the “ABC mothers” plan. Progress for required practices for results possible with making mothers—“Able for practices advantageous, bold with pertinent awareness, and confident with propitious attitude”. Strong efforts on sound footing are necessary for health of all our infants and happiness all around with sustainable development. Scientific infant feeding will contribute to advance the attainment of this. Medical education teaching best beneficial practices is for excellence. One promoting breastfeeding is the best. The US Surgeon General’s Implementation Strategies elaborate “Education content”, “Enabling competency”, & “Education continuing”. Competency-based curriculum for Indian Medical Graduates includes “to promote and support optimal breast feeding”. Need for inclusion in teaching curriculum across US, UK, & internationally has been documented. Given all the evidence for breastfeeding benefits, it should be a consistent essential component of training in all medical schools worldwide.

Part of the book: Selected Topics on Infant Feeding

By Sunil Jain, Bhagya Kamal Jain, Prem Kamal Jain and Arvind Singh Kushwaha

Patient safety is fundamental to high-quality patient care. Hospitalization has its inherent complications. Medical errors can further comprise patient safety. Hospitals provides an opportunity for practicing preventive medicine. Two important areas are (i) making treatment and hospitalization free from side-effects (ii) obviating medical errors. In hospitals these can have serious consequences. Patient safety compromise can occur at the individual or system level. A methodical model for this should include (i) Intervention design (ii) Intervention implementation (iii) Intervention institutionalization. Managerial perspective important for leadership and team work. Leadership can energize excellence in the coordination and mobilization of the large number of inter-dependent processes and resources needed for achievement of patient safety. Three-dimensional strategy for Leadership is suggested (i) Initiatives appealing (ii) Integrating all (iii) Incremental advancements. The ‘Five Es’ for Teamwork, and the ‘Five Cs’ for Organizational Change are elaborated. Artificial Intelligence has the potential to improve healthcare safety. AI enables analysis of data from multiple sources simultaneously using advanced algorithms. This identifies predictors and outcomes. Ensemble learning algorithms, used by advanced practitioners of machine learning, are useful with high final accuracy. Hence in matters of health these should be utilized. All this will make prevention targeted, better, and timely.

Part of the book: Contemporary Topics in Patient Safety