‘My work on size of pancreas helping many paediatricians’

At 77, when most retire, and many live a life without any motive or motivation, Dr DS Raut completed his well-documented research on a rare disease ‘acute pancreatitis in children’. The veteran pediatrician from Nagpur, who got a PhD from the Maharashtra University of Health Sciences (MUHS) this August, became the oldest practising doctor in Maharashtra to get the title. His journey to become a ‘doctor of doctors’ is full of twists and turns. Finally, Dr Raut’s research proved one of the finest scientific contributions to the field of paediatrics in contemporary modern medicine. He shared his 25-year-long process of this PhD with TOI which is an extraordinary story of consistency, dedication and resolve.
Excerpts from an interview...
Q. What motivated you to work on acute pancreatitis in children?
A. I have been working on this subject for 25 years. It was September 17, 1994, when I saw my first patient, a schoolboy showing symptoms of acute pancreatitis. In this condition, the pancreas becomes inflamed (swollen) over a short period of time. This disease is still rare in children. In the 1990s, it was even difficult to diagnose it. Doctors used to prescribe medicines for gastro or worm infections. Thankfully, most cases were used to resolve spontaneously. But, ultimately they used to go undiagnosed. This is because we never had a standard formula to know the normal size of the pancreas. As we had no idea about the standard size of the pancreas, it was impossible to know whether the pancreas of a child was really swollen or how much it was swollen unless and until we got a highly oversized pancreas in sonography. So, I decided to find out the objective method to diagnose the enlargement of the pancreas in acute pancreatitis and also to determine the normal size of the pancreas in children.
Q. So, you got the formula right?
A. Of course. It took around two decades of research and 67 well-documented cases. The incidence of this disease is rare. I used to hardly get 4 to 5 cases every year in my small clinic. I used to keep meticulous records of every case profile, ultrasound report, photograph, pre and post-treatment differences in the size of the pancreas, and so on. With this study, I got the sonography-based imaging criteria to ascertain pancreatic enlargement in children. Now, with the help of statisticians and software engineers, I have developed two mobile applications in which you just have to enter the size of the head, body, and tail of the pancreas from the ultrasound report and you get the detailed result about the enlargement of the pancreas. This formula is my scientific contribution to the field of paediatrics. Many doctors are using it and many cases are now getting diagnosed and treated correctly.
Q. How difficult was the PhD journey?
A. I completed my MD in paediatrics in 1975. At that time medical colleges were affiliated to Nagpur University. My research started in 1994. I needed a detailed profile of every case for this research. For this, I categorically decided to work only on the cases I treat in my small clinic in Indora. So, it took 10-12 years for me to get enough data. In 2006, I registered for PhD with NU and filed my thesis. But I was told that medical or health-related PhD research cannot be submitted to NU anymore as Maharashtra had a dedicated health university (MUHS) by then. I was disappointed. My entire hard work was in vain. After a few years, the PhD idea clicked again. I went to MUHS in 2014. They said there is no institute in Nagpur recognized for PhD research from where I could register myself as a research scholar.
Q. Why was there no recognized PhD research institute in Nagpur?
A. Simply because doctors don’t do PhD research. It’s rare for practising doctors to conduct research and submit a thesis and appear for the viva. I was attached to Lata Mangeshkar Hospital at that time. We registered our college as a recognized PhD institute with MUHS. Here, Dr Vitthalrao Dandge, my friend and colleague became my PhD guide. Interestingly, there is an age limit of 70 years to become a PhD guide, but there is no age limit to become a research scholar. So, I got my provisional registration in 2014. It took three more years to get a permanent registration as a PhD scholar. As my research was almost ready, I completed it in the mandatory three years. In 2021, health university experts interviewed me. In the 2022 convocation, I got the much-awaited PhD for my research. It was a long journey but a fruitful one.
Q. Do you think your scientific contribution has finally got recognition now?
A. I worked on this subject because it was my passion to find out a diagnostic formula for this rare disease. It benefited my fellow paediatricians and radiologists and will continue to make a difference in the years to come. The PhD awarded to me will get national recognition and paediatricians from across the country can now follow this formula through my mobile app. It’s free for all.
Q. What kind of changes have you seen in paediatric patients over the years?
A. Children and their problems are the same, but parents are different. They have become overprotective. They come loaded with Google knowledge and literally cross-examine doctors. I’m from an old school where we believe in a physical examination and suggest very few blood tests etc. Nowadays, parents themselves insist on diagnostic tests. It has become challenging for present-day paediatricians to deal with parents.