Anurag Bajpai
Senior Resident, Pediatrics AIIMS,
New Delhi
Jyoti Sharma
Consultant, Pediatrics Bhartiya Vidyapeeth,
Pune
PSN Menon
Additional Professor Pediatric AIIMS,
New Delhi
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Practical Pediatric Endocrinology
© 2003, Anurag Bajpai, Jyoti Sharma, PSN Menon
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition : 2003
Publishing Director: RK Yadav
9788180610110
Typeset at JPBMP typesetting unit
Printed at Lordson Publishers (P) Ltd, C-5/19, RP Bagh, Delhi 110 007
to
the children attending
the
Pediatric Endocrinology Clinic
All India Institute of Medical Sciences
New Delhi
5Foreword
It is a great pleasure to write a foreword for, Practical Pediatric Endocrinology. This book is primarily targeted to the trainees and practicing pediatricians of the developing world.
Pediatric endocrinology has emerged as an important pediatric sub-specialty. The management of pediatric endocrinological problems remains enigmatic, complicated and mystified for many a pediatricians. The standard books of pediatric endocrinology are very exhaustive for the clinicians. Most practicing pediatricians are ill at ease at handling children with endocrine problems. Wide array of diagnostic endocrinological tests are now available complicating the matter further. These problems are accentuated in the developing world where economic and technological constraints limit the extent of investigational work-up. This book, characterized by its brevity and clarity, tries to impart practical and systematic approach to pediatric endocrine disorders.
The book provides algorithmic approach to common pediatric endocrinology problems with special emphasis on diagnosis and management to suit the needs of resource-poor countries. The approach differs from practices in the developed world as cost-effective and easily available investigations are performed in the initial phase and more demanding investigations are recommended only when they are essential.
Principles of pediatric endocrinology have been kept in sight while writing this book. It is recommended for wide readership among professionals caring for children with endocrine problems.
Professor Veena Kalra
Head, Department of Pediatrics
AIIMS, New Delhi
6Preface
The last decade has witnessed tremendous expansion in pediatric sub-specialties in the developed countries; the developing countries however lag far behind in these regards. Pediatric endocrinology in particular is in its infancy in most of developing world with inadequate exposure and training in the undergraduate and postgraduate curriculum. Excellent reference books are available for those with keen interest in the subject; these books are however too voluminous for the practicing pediatrician. The pediatric endocrinology texts addressing practical management issues are tailored to the needs of developed countries and not suited to the needs of resource-poor countries.
This book intends to provide practical approach to pediatric endocrine disorders with special emphasis to diagnosis and management within the limitations of developing countries. The book has been divided into the eight sections covering various aspects of pediatric endocrinology. The chapters have been organized into etiology, clinical approach, laboratory evaluation and management.
Postgraduate residents in pediatrics and general pediatricians are most likely to benefit as this book provides quick reference to diagnostic and management approach in the wards and outpatient clinics. The algorithmic approach and succinct presentation should be helpful to those preparing for examinations. The specialists (pediatric as well as adult endocrinologists) may find the approach to endocrine disorders helpful.
The feedback from the readers would be of importance to us and we would eagerly wait for the same.
Anurag Bajpai
Jyoti Sharma
PSN Menon
7Acknowledgements
No effort is possible without contributions from contemporaries and well-wishers and this book is certainly no exception. We owe acknowledgement to all the faculty members and residents of Department of Pediatrics at the All India Institute of Medical Sciences who lend a helping hand to the project at one time or the other. We express our gratitude to Professor Veena Kalra who graciously accepted to write the foreword for the book. Our special thanks are due to Dr Rakesh Lodha and Dr Tanu Singhal whose advice helped us in making this book more presentable and practical. Dr Anurag Tikaria, Dr Shantanu Saha, Dr Himanshu Goel and Dr Yuthika Sharma devoted their precious time in finalizing the manuscript. The experience we gained from the children presenting to our pediatric endocrinology clinic forms the basis of this book. We will forever remain indebted to these lovely children and their parents who in times of their misery provided us with the opportunity of dwelling into the fascinating field of pediatric endocrinology. We owe are thanks to M/s Jaypee Brothers Medical Publishers (P) Limited for their cooperation in bringing out the book. The practical approach and cooperative nature of Mr RK Yadav ensured that the project remained hassle free and extremely enjoyable.