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Hello, good evening and welcome again. I am Dr. Srther and we have with us again very special guest Dr. Praep Suryani. He doesn't need any introduction and he has contributed a lot to your learning through my channel as well. So obviously he is the pioneer in the focus field in India and uh he's in the barty professor of neonatlogy. He trained in India and Australia and he is one of the few who came back to give back to this country. His passion for teaching comes from his father he said and he maintains a very high level of uh engagement with the students the gurugul system. So u uh Dr. Praep I mean welcome and thank you so much for the great effort you're putting in and I should congratulate you and your team. You got the 100th publication that's really amazing.
Thank you. Thank you Shar. I think uh we both are on the same track. you started this uh channel and through channel you are educating the not only the medical student but the parents and um probably the my side is I have concent I'm concentrating on the mainly the newborn focus part and um uh thank you for inviting and have a discussion thank you.
I mean the main reason we thought we'll have this chat I mean I know I have shared your lung ultrasound videos and also the >> hemodynamic mix based I mean uh the approach to shock and things like that on this channel from before and I know you are an amazing teacher. I had the personal experience of attending your lung ultrasound workshop when you came to Dubai >> and above all you are so humble and a genuine human being as well. So uh the publications are obviously a niche area because you are contributing what you're doing and sharing different aspects. So do you want to say something about your >> Yes.
Yes. what what is actually important for all of us as a team members. I believe that we have maximum number of patients in India. Now as a neonatlogist these are the three areas mandatory for all of us naturally the ventilation hemodynamics and research is mandatory. Now why I'm trying to say the research because unless and until we have our own data definitely our situation or our standards only increase.
So this is the reason why another reason why we started thought process about training the people with the same thought process and then making multicentric areas and that's a plan. Now the first plan was naturally the train the team my team and already that team is working in a good shape. Now we are training a lot of medical schools plus the DR&B centers where they are on the same platform so that we can have a link as a multicentric trial. I'll just give a simple example now. Now we all diagnose very easily pneumonia >> by lung ultrasound which is not so common in western people but now how how much time that pneumonia takes to resolve by lung ultrasound no one knows.
So if we combine these 10 centers and if you have around let's say 25 patients per center you get immediately 250 babies in a span of hardly 3 to 6 months. Yes.
So that's a thought process for me is a research ideas. We have plenty of research idea. I'll just give example another example. Now as the BRAT score we all do the six reasons lung scan.
Yes.
Anterior and lateral. But if you don't do the posterior scans in Asia Africa >> you are going to miss posterior basal pneumonia.
Right. What is my observation? That's a paper reason pipeline with Nadia from France that maximum pneumonia are in the basal region and that will be picked up by posterior scans.
So if I don't do the posterior scan, I will miss those pneumonia. Hence that's another multicentric thought process in our mind >> and that's the reason why we are training on the similar platform all the people so that we can go ahead in this direction.
Yeah >> and as a neontologist I feel we all feel that training and research goes hand in hand.
So that's very important. I don't know if you are following some colleagues on Twitter who are debating whether the medical school should separate the academic interest students from the beginning from those who are only going to appraise papers and practice. I mean obviously you do need a basic uh knowledge of review of literature appraisal of journals and so on but the actual research that you and Siniasmi and colleagues similar colleagues are doing is only for I mean it's not the cup of tea for everyone. So I for example never had an interest in actual research. I have interest in learning and disseminating knowledge but not in actual research and you can segregate it but once you have that interest you need a mentor like you to direct and also to practically execute and you're right I mean the case load in India is so high that you can be leaders in uh the world in certain areas of the field which you're choosing. I think because yeah they can >> what I can tell the people now is all of us we know that neuron is our core subject but in neonatlogology we all need to select one area suppose now you have selected area of naturally neuron is a core subject but you have selected teaching training as a one area.
Yeah. Similarly in future students have to select suppose neal per terminology, neal hemodynamics, neonal pus, neal infection diseases, neural neurology, neural hematology. We need to select one of the area >> and excellent >> in that one of the area we need to concentrate our own local research.
Yeah. >> Means our local re we don't require too many very high five okay our cities and all that. We just plot we also need observational studies to document in the world that this is a prevalent in our area this is available in area then it goes forward so lot of good institutes I I think India is doing good in research now in the last 15 years you already mentioned the shinas Dr. Kabra or Som Shaker or the people are doing a good research now. So if we concentrate along with our academic training all the people will not be interested in research and I'm not saying that if 100 DM people pass out and 100 will do the research.
Yeah. >> Out of 100 even five people are gone into that field we are in good shape. That's thought process from my side.
Thank you for that. I mean coming to your teaching I mean you have uh different components and I mean obviously uh it's hard work you mentioned that you have a lesson from like 8:00 to 10:00 almost every night and you also bring students you are bringing a training institute in addition to their coming you're planning to uh separately construct a training center I don't know if you have finished that process but do you want to have a slideshow of to explain what exactly >> yeah just just let me share >> yeah please I'll make >> Can you just make Yeah. Can you make um >> Yeah. >> Yeah. Please go ahead. >> Yeah. >> Okay. >> My slides are visible. >> Yes, please. Yeah. Yeah. So what what I just want to highlight I think I think we all know about the COVID times and the COVID times basically 23rd of the March the lockdown started and on the 1st April I have taken a first session on the brain USG for all over India and then we realized we can teach online and that's the moto we started as a six months course which was the first sort of course in the world as a new focus. So this this was the course uh which we started and we actually we actually have uh basically the the theme was sharing is caring. So if you see this thought process that we need to reach this knowledge of pocus to the all the parts I started my journey in 1996 with the knee cartilage ultrasound after giving cyproloxiseline in sepsis that's where I started the journey of focus in Sydney I learned the eco and brain then we continued the process of learning when I come back to India we learned lung ultrasound we continued learning gut ultrasound lines now ultrasound. So this this is the area what we are saying that we do conduct we do conduct this 6 months course and in this 6 months we cover basically first two months brain and lung. Now you will say that what are their brain and lung. We actually complete 20 sessions of a brain and lung and the sessions are 2our sessions twice a week. The sessions are designed in that the first hour we actually do the peer review. What is the meaning of mentorship or peer review? >> We are still on slide is it? Uh >> pardon >> that you planning to display the second slide or it's still on the first slide. >> Oh slides are not moving. Okay. >> No it moved but uh moved back. >> No no this this is sharing is caring is a slide. >> Yeah. No now it's duration. Now it's a >> yes yes that's fine. So what what we have decided that we usually conduct actually these sessions which are the 2our session these are 9 to 11 and the first hour I called as the mentorship means whatever you have learned in the previous class you go back home you practice you prepare your powerpoint and then you show those presentation to me and I comment what mistakes you are doing, what are the correct things are there and the second session is the second hour where we learn only six points. The most important aspect of the learning is that we should not learn too many things in one day. We should learn five to six points and those five to six points in the next session there are 10 times revision. The theme of the training or the focus is multiple revisions then ultimately it has multiple aspects of the people who share the knowledge. If you see what we do here, we have almost 20 sessions of the brain and lung, almost 20 sessions of the eco cardiography, 10 sessions of hemodynamics and I must proudly say that we have introduced the new concepts of kidney focus, liver focus and the hip focus. These are the three focus which we are going to give the thought process to the world. The brain focus is there since 1990. Eco is there since 2000. Lung came in the picture in 2010. the gut 2015 lines again 2010 onwards but now we are introducing li and that's the article accepted and just uh I told you that that's 100th article by my team once it is published I'll share all of you so this is the program which is a designed over the last 25 years 6 months program every Tuesday and Thursday Indian time 9 to 11 we are religiously doing that starting 9:00 is fixed end point 11 11:30 it happens and we have Indian gurugal system what is the meaning of Indian gural system it is coordination communication it is not one way it is a lot of discussion and we believe that attendance and homework or assignment is important Every person has to do assignment. Then and then this is helpful. Lot of people are saying how we are learning ultrasound online. This is the only course in the world which has changed the thought process that we can learn online and this is the this is the chair I'm sitting for last 5 years every night 9 to 11 as this process and it's a proud moment for me and for my team or for my uh members what I usually want to tell you I would like to show you few important things that we have now reached to the 30 countries of the world. This focus we started way back in 2020 and you will see that yes naturally Indians are the more in my course but the consultant from US, UK, Canada, Australia they also join and they are learning Middle East, Asia, African countries, Southeast Asia and proud to say that now you can see this have these are the countries which are involved in the caucus spreading. This is this is my India where we have reached almost all almost all state except Ladak. This is my state where almost all districts except Girioli. So our aim is to reach tier two cities of Asia and Africa where facilities of immediate bedside ultrasounds are not there. Immediate radiologists are not available. Immediate cardist are not available. Our aim is not to become radiologist. Our aim is not to become radiologist. Our aim is focused bedside immediate thought process to diagnose and to improve the outcome of these babies and by this now we have reached 750 members. So this is the largest cohort in the world where we have trained a 750 members. This is the first batch merely started with the members of 30 which has now next batch 40, next batch 50, next batch 75 reaching to the fifth batch around 100, sixth batch around 100, seventh batch around 100 and eighth batch around 110 and that's how this new focus has spread. So these neopus members they requested me to concentrate on general basic neotology also and that's where we also concentrate mainly the areas of Asia and Africa where basic munal facilities are not there. We have concentrated on the basic course which is called neopulse and we also trained lot of pediatrician for very basic stuffs. What is the basic stuff? Theme is less is more because if we do less things we get more outcome in unit and we concentrate on the 10 areas less ventilation more non-unasive ventilation early extation maximum CPAP early feeding less TPN or minimal TPN single antibiotics less antibiotics avoiding broadspectctrum antibiotics less lines or removing early lines on this less is more theme. We trained the people and that also reached that has also reached to the various parts of India and that also we have trained almost 13 basically now these are the five 550 members and total training component in the last last five years it has reached to 1,500 members. One of the important aspect in my own life I always wanted to guide lot of NUS always wanted to train lot of people hence I concentrated India now we are training the people from Nepal and Myanmar for upgrading the NICUs and these are the NICUs where I have mentored in India you can see the members from various parts of the India where we have mentored Those who are interested this is my journey of the incubator post or about mentorship about the focus and about the various thought processes which we work out in day-to-day practice. So those members what I what is my theme is that we all have to learn new habits. We all have to accept newer technologies and definitely clinical part is going to remain there. Clinical neurontologology is always there. So along with clinical neurology as inspection, palpation, percussion, escultation, insation is mandatory especially brain, lung, liver lines. Very easy, very simple. Please learn. Don't hesitate to learn new things. Eco takes more time. Eco ecography takes more learning, more patience, more uh practice. But brain and lung and the and the lines and the liver very easy, very simple. And as a pediatrician, we all can contribute more. So friends this is this is what we have done in the last five years of the covid times about the what I called Indian digital neonetal guru system and lot of people have helped us a lot of people have given a lot of suggestions if you also any suggestions please send email or WhatsApp to me always happy to revise the plan always happy to improve the plan. Um that's what has happened. So u um >> maybe you can stop sharing the slides. >> Yeah. Yeah. SA that's that's why I thought uh these are the points I wanted to cover.
Yeah. It's uh very helpful and the neopulse obviously is a very good uh concept as well. So you're covering less is more and I think you have covered all the topics in neonatlogy. So most of the students in Neopole are those from the Neopocus as well the pocus group or >> No actually what happens um 10% people of pocus or pulse jump here and there >> but >> your pulse has to take pulse pulse is mainly designed for practicing pediatrician >> yes >> very simple thoughts very simple protocol based please do this please do that please do that >> nothing related to research in the pulse It's just very simple and no diversion there. While the focus is mainly designed for high-end high-end level where lot of teachers, DM neurology teachers, DM people uh people who have big NICUs >> they are attending. So this is what happening at present moment. cover how they cope in resource limited settings because most of these practitioners now not the focus ones the neopulse ones are probably practicing in resource limited settings >> you are able to give them tips on how to cope with the situations >> yeah yeah um basically what I realized I must say that the African people they need lot of help >> so actually I have members from Ghana, Zambia, Tanzania, uh Kenya, Zimbabwe um South Africa and they they are very good people. >> They are such knowledgeable people. >> Yeah. Have you been there physically? >> Um no no physical. They all is everything is online. >> No, not at you have not been them there to explore how it works there and stuff. >> No, I not been to there at all. Means actually um what happened uh um I'm enjoying and they're also enjoying. So the travel component is uh part has reduced but in future recently I went to Philippines >> and uh in the Philippines I have taken a a session for 100 neontologist and they said that okay this is sensitization session but we need more learning. So those sessions one day two days workshops are sensitization. What I realized or you all know that workshops actually don't you learn that day and after seven days you say oh it's not it's not happening well >> in the focus workshops hence it is continuous learning. >> So similarly what I have done in the Myanmar or I have done the Philippines that I have sensitized them and I told them that those who really wants to learn those who really wants to take forward please join. Yeah, >> then we'll take you forward. >> For the ninth batch, I have member from all these all these Philippines members. So that's how it is happening. Now I'm going to the Vietnam. So I I'll spread the sensitization part there. I'm also going to the Muskat, Oman in November. That's what I do visit one day today for just sensitization situations. >> Very good. And you said you have cut down on your clinical work in the evenings mainly to focus on this. >> Yes. Yes. I I I think you all know that clinical work and this doesn't go hand in hand. We have to sacrifice somewhere. We have to accept that part. >> Uh we also see the feedback you get from your students and it's often amazing feedback always. So congratulations on all the great work you're doing and I think uh I mean this session will help sensitize people to keep learning and uh I mean the neopls or the less is more option is going to help many. I think it's not costly isn't it? I think you're charging. >> No, it's not customer. >> Basically what happens um the developing country people we have kept minimal fees because they are the one who are getting beneficiary for that. While the uh while the Indian consultants I said okay you guys are in the better shape you you bear the cost that other members the cost has kept purposefully low because I think we need to take them upwards. That's what thought process and the new opals also >> that's how it's yeah so those who are interested I think my email and mobiles are with the sharing yeah with the previous with the previous videos also and here also there you can we can always contact and Dr. Sridar is basically he's been very kind. He has he has been always with last four five years we are discussing quite a lot on these uh online teaching online learning and now Sridar has reached to 50,000 people that's that's very wonderful thing recently last week I saw that >> yeah thank you >> and my target is reaching 2,000 focus member his target is 100,000 people reaching so that's what is that's what is our time hopefully thank you for the very nice discussion I will share this soon. Appreciate your