AK Dutta
Director-Professor and Head of Pediatrics KSCH & LHMC,
New Delhi
Anupam Sachdeva
Incharge of Pediatric Hematology and Oncology Unit and Pediatric Bone Marrow Transplantation Department of Pediatrics Centre of Child Health Sir Ganga Ram Hospital,
Rajinder Nagar, New Delhi
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Advances in Pediatrics
© 2007, AK Dutta, Anupam Sachdeva
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 author and the publisher.
First Edition: 2007
9788180618895
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, Sector 60, Noida
4Contributors
- Aditi Sinha
- Senior Resident
- Kalawati Saran Children's
- Hospital, New Delhi
- AK Dutta
- Director-Professor and Head of Pediatrics
- KSCH and LHMC
- New Delhi
- AK Patwari
- Professor of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran
- Children's Hospital
- New Delhi
- Amit Khosla
- Vitreo-Retina Unit
- Department of Ophthalmology
- Sir Ganga Ram Hospital
- New Delhi
- Amit Luthra
- Consultant Dermatologist
- New Delhi
- Amita Kaul
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Amita Mahajan
- Consultant Pediatric Oncologist
- Indraprastha Apollo Hospital
- New Delhi
- Anil Sachdev dch, md
- Consultant Pediatric Intensivist
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi 110060
- Anju Aggarwal
- Senior Lecturer
- Univeristy College of Medical
- Sciences and Guru Tegh
- Bhadur Hospital
- New Delhi
- Anju Seth
- Professor of Pediatrics
- Kalawati Saran Childrens Hospital
- Lady Harding Medical College
- New Delhi
- Anupam Sachdeva
- Incharge of Pediatric
- Hematology and Oncology
- Unit and Pediatric Bone Marrow
- Transplantation
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Anupam Sehgal
- Senior Resident
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- Anurag Krishna
- Consultant Pediatric Surgeon
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- AP Dubey
- Professor and Head of Pediatrics
- Maulana Azad Medical College
- Delhi
- Archana D Arya
- Consultant Pediatric and Adolescent Endocrinologist and Diabetologist
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Arindam Dutta
- Consultant Dental Surgeon
- New Delhi
- Arun Soni
- Consultant Neonatologist
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Arvind Bagga
- Prof of Pediatric Nephrology
- AIIMS, New Delhi
- Arvind Taneja
- Director Pediatrics
- Max Hospitals
- B R Thapa
- Additional Professor and Head
- Division of Pediatric
- Gastroenterology Hepatology and Nutrition
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh-160012, India
- Bharat R Agarwal
- Consultant Pediatric
- Hematology and Oncology
- B J Wadia Hospital, Mumbai
- Bhavini Acharya
- Department of General Dentistry
- Center for Excellence in Oral and Craniofacial Biology LSUHSC
- New Orleans, USA
- Bhavneet Bharti mbbs md
- Department of Pediatrics
- Advanced Pediatric Centre
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- BR Nammalwar
- Chief Nephrologist
- Dept of Nephrology
- Kanchi Kamakoti CHILDS
- Trust Hospital, Chennai-600034
- Brijesh Arora
- Assistant Professor
- Pediatric Oncology
- Tata Memorial Hospital
- Mumbai
- Deepak Gupta
- md (psychiatry), dnb (psychiatry), dcap (uk), fiicamh (uk)
- Child and Adolescent Psychiatrist
- Sir Ganga Ram Hospital and Indraprastha Apollo Hospital
- Centre for Child and Adolescent Wellbeing
- New Delhi, India
- Deepak Ugra
- Consultant Pediatrician
- Lilavati Hospital
- Mumbai
- Dhiren Gupta
- Consultant Pediatric
- Intensive Care Unit
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- Dinesh Kaul
- Consultant Pediatric
- Infectious Diseases
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110 060
- Gaurav Kharya
- Department of Pediatrics
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- GR Sethi
- Professor
- Department of Pediatrics
- Maulana Azad Medical College
- Delhi
- Gurinder Pal Singh
- Consultant Pediatric
- Intensive Care Unit
- Max Balaji Hospital
- Delhi-110092
- Harish K Pemde
- Associate Professor of Pediatrics
- Lady Hardinge Medical College
- New Delhi
- HPS Sachdeva
- Consultant Pediatrician
- Sita Ram Bhartiya Hospital
- New Delhi
- IC Verma
- Head of the Department of Genetic Medicine
- Sir Ganga Ram Hospital
- New Delhi
- Jagdish Chandra
- Professor of Pediatrics
- Lady Hardinge Medical College and Kalawati Saran Children's Hospital,
- New Delhi
- Jasmeet Aneja
- Department of Pediatrics
- Kalawati Saran Children's Hospital, Lady Harding
- Medical College, New Delhi
- K Shreedhara Avabratha
- Asst. Professor
- Pediatric Hemato-Oncology Unit
- Department of Pediatrics
- Kasturba Medical College
- Mangalore
- Kapil Vidyarthi
- Consultant Pediatric Surgeon
- Department of Pediatric Surgery
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Karen E Gerlach
- University of Texas in Houston
- Department of Obstetrics
- Gynecology and Reproductive Sciences, Houston
- USA
- Karthik Nagesh
- Senior Consultant in Neonatology Former President
- NNF-Karnataka and HOD
- Pediatrics
- Director - Pediatric Research
- Manipal Hospital Airport Road,
- Kishore Shetty
- Asst. Professor of Pediatric
- Dentistry
- Director, Medically Complex
- Patient Clinic, University of Texas
- Health Sciences, Houston
- LSUHSC, New Orleans, USA
- Krishan Chugh
- Head of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Kulkarni A
- Consultant Neonatologist
- Academic Coordinator Apollo
- Centre for Advanced Pediatrics
- New Delhi
- Kush Jhunjhunwala
- Senior Resident
- Kalawati Saran Children's Hospital,
- New Delhi
- Lokesh Guglani
- Senior Resident
- Department of Paediatrics
- AIIMS, New Delhi-110 029
- Lt Col ATK Rau
- Prof and Unit Head
- Pediatric Hemato-Oncology Unit
- Department of Pediatrics
- Kasturba Medical College
- Mangalore
- Lt Col RG Holla dm (neonatology)
- Consultant Neonatologist
- Army Hospital (Research and Referral),
- Delhi, India
- M Vijayakumar
- Consultant Pediatric
- Nephrologist Chennai Pediatric
- Kidney Foundation
- Dr Mehta's Hospitals Pvt. Ltd
- Chennai-600031
- Madhuri Kanitkar
- Associate Professor
- Armed Forces Medical College
- Pune
- Maheshwari A
- Registrar NICU, Apollo Centre for Advanced Pediatrics,
- New Delhi
- Manju Mehta
- Department of Psychiatry
- AIIMS, New Delhi
- Maurice G Sholas
- Asst. Professor Physical Medicine and Rehabilitation
- Director of Rehabilitation Centre
- Children's Hospital of New Orleans,
- Lousiana, USA
- Michael Higgins
- Department of Education of Services, LSUHSC
- New Orleans, USA
- MR Lokeshwar
- Sr. Consultant Hemato-Oncologist
- Lilavati Hospital,
- Mumbai
- Nandan Yardi
- Member Commission on Treatment
- Strategies International League Against Epilepsy
- Consultant Epileptologist and Pediatric Neurologist,
- Jehangir Hospital and KEM Hospital,
- Pune, India
- Neelam Kler
- Head of Neonatology
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Neelam Mohan
- Consultant Pediatric
- Gastroenterologist
- Hepatologist and Liver
- Transplant Physician
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Neeraj Manchanda
- Vitreo-Retina Unit
- Department of Ophthalmology
- Sir Ganga Ram Hospital
- New Delhi
- Nidhi Chopra
- Senior Resident
- Kalawati Saran Hospital
- Lady Hardinge Medical College,
- New Delhi
- Nitin Kapur
- Senior Resident
- Department of Pediatrics
- Maulana Azad Medical College,
- New Delhi
- Noor Ullah Zargar
- Department of Pediatric Surgery
- Center for Child Health Sir Ganga Ram Hospital, Delhi
- PA Kurkure
- Professor/In-Charge
- Pediatric Oncology,
- Tata Memorial Hospital,
- Mumbai
- Pankaj Garg
- Consultant
- Department of Neonatology
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- Panna Choudhury dch, md
- Consultant Pediatrician
- Department of Pediatrics
- Maulana Azad Medical College and Lok Nayak Hospital
- New Delhi-110 002
- Parvesh M Garg
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- Patanjali Dev Nayar
- Consultant Adolescent Health
- Hindu Rao Hospital
- New Delhi
- Pawan Kumar
- Kalawati Saran Children's
- Hospital and Lady Hardinge
- Medical College
- New Delhi-110029
- Piyush Gupta
- Reader
- Department of Paediatrics
- University College of Medical
- Sciences, Delhi-110 095
- PK Pruthi
- Senior Consultant Pediatric
- Nephrology
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Pradeep Sharma
- Professor Strabismus and Neuro-ophthalmology Section
- Dr RP Centre for Ophthalmic Sciences
- AIIMS, New Delhi
- Praveen Khilnani
- Senior Consultant, Pediatric
- Pulmonology and Intensivist
- Max Hospital, New Delhi
- Praveen Kumar
- Associate Prof. of Pediatrics
- Division of Pediatric
- Gastroenterology,
- Hepatology and Nutrition
- Kalawati Saran Children's
- Hospital, Lady Hardinge
- Medical College,
- New Delhi
- Praveen Suman
- Consultant Developmental
- Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Radha Krishna Baliga
- Professor of Pediatrics and Nephrology
- University of Mississippi
- School of Medicine Jackson MS
- USA
- Rahul Naithani
- Department of Hematology
- AIIMS, New Delhi-110029
- Raj Kubba
- Consultant Dermatologist
- New Delhi
- Raj Warrier
- Chief of Hematology and Oncology
- Lousiana State University Children's Hospital
- New Orleans, USA
- Rajeev Kulshreshtha
- Consultant Pediatric Surgery
- Head of the Department of Pediatric Surgery
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Rajesh Mehta md, dip. fle, fiap
- Senior Pediatrician and Coordinator SHAHN
- (Safdarjung Hospital Adolescent Healthcare Network)
- Safdarjung Hospital and Vardhaman Mahavir
- Medical College, New Delhi
- Rajesh Sagar
- Department of Psychiatry
- AIIMS, New Delhi
- Raju C Shah
- Consultant Pediatrician President IAP 2005
- Ahmedabad
- Raman Garg
- Department of Psychiatry
- AIIMS, New Delhi
- Ratna D Puri dm
- (Medical Genetics) Consultant
- Department of Genetic Medicine
- Sir Ganga Ram Hospital
- New Delhi
- Rekha Luthra
- Senior Resident
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar,
- New Delhi-110060
- Renu Dutta
- Professor and Head
- Dept of Microbiology
- BPKIHS, Dharan, Nepal
- RK Sabharwal
- Sr. Consultant
- Child Neurology and Epilepsy
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- RN Srivastava
- Consultant Pediatric
- Nephrologist, IP Apollo Hospital
- New Delhi
- Roma Kumar
- Clinical Psychologist
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Ruchira Misra
- Senior Resident
- Department of Pediatrics
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- S Aneja
- Professor of Pediatrics
- Kalawati Saran Children's Hospital,
- Lady Harding Medical College,
- New Delhi
- S Srinivasan
- Director-Professor and Head
- Dept of Pediatrics, JIPMER
- Pondicherry-605006
- Samridh Nagar
- Consultant Neonatology
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Sandip Tripathi
- Senior Resident
- Kalawati Saran Children's Hospital,
- Lady Hardinge Medical College,
- New Delhi
- Sangeeta Sharma
- Paediatrician and Head
- Department of Paediatrics
- LRS Institute of Tuberculosis and Respiratory Diseases
- New Delhi
- Sangeeta Yadav
- Professor
- Department of Pediatrics
- Maulana Azad Medical College
- New Delhi
- Sanjeev Gupta
- Siri Fort Laser Eye Centre
- 8 Siri Fort Road
- New Delhi
- Sanjiv Dhawan
- Consultant Cardiologist
- Sir Ganga Ram Hospital
- New Delhi-110060
- Satish Saluja
- Senior Consultant Neonatology
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- Satya Prakash Yadav
- Consultant Pediatric
- Hematologist and Oncologist
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Satyendra Katewa
- Department of Pediatrics
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110060
- SC Arya
- Director Center for Child Health
- Department of Pediatrics
- Sir Ganga Ram Hospital
- New Delhi-110060
- Shina Menon
- Research Associate
- Department of Pediatric
- Nephrology, AIIMS
- Shyam Kukreja
- Consultant Pediatrician
- Max Balaji Hospital
- Patparganj, Delhi
- Sibal A
- Consultant Pediatric
- Gastroenterologist and Hepatologist
- Medical Director Apollo Hospital Group
- New Delhi
- Siddhartha Gogia md
- Senior Resident
- Department of Pediatrics
- Maulana Azad Medical College and Lok Nayak Hospital
- New Delhi-110 002
- Sujata Sawhney md (Pediatrics), mrcp (uk), ccst (Medical Royal Colleges, uk)
- Consultant Pediatric and Adolescent Rheumatologist
- Center for Child Health
- Sir Ganga Ram Hospital
- New Delhi, India
- Sunil Dutt
- Senior Resident
- Department of Pediatrics Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi-110 060
- Sunit Singhi
- Professor of Pediatrics
- Advanced Pediatric Centre
- PGIMER Chandigarh-160 012, India
- Sunita Bijarnia
- Consultant
- Department of Genetic Medicine
- Sir Ganga Ram Hospital
- Suresh Gupta
- Consultant Emergency Medicine
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- Rajinder Nagar
- New Delhi-110060
- Tapan Kr Ghosh
- Scientific Coordinator
- Institute of Child Health
- 11, Dr Biresh Guha Street
- Kolkata-700 017
- Tarun Gera
- Consultant Pediatrician
- Sunder Lal Jain Hospital
- New Delhi
- Tinku Bali
- Vitreo-Retina Unit
- Department of Ophthalmology
- Sir Ganga Ram Hospital
- New Delhi
- Tripti Pensi
- Consultant Pediatrician
- Ram Manohar Lohia Hospital
- New Delhi
- UA Kaul
- Consultant Pediatric
- Cardiologist GB Pant Hospital
- New Delhi
- Vandana Chatrath
- Consultant Dermatologist
- New Delhi
- Veda V Vedanarayanan
- Professor of Pediatrics and Neurology
- University of Mississippi Medical Center, Jackson
- MS 39211, USA
- Vikas Kohli md, faap, facc
- Senior Pediatric Cardiologist
- Indraprastha Apollo Hospitals
- New Delhi
- Vikas Taneja dnb (Pediatrics)
- Fellow Pediatric Critical
- Care Council
- Pediatric Cardiac Intensivist
- Indraprastha Apollo Hospitals
- New Delhi
- Vikram Datta
- Consultant Pediatrician
- Kalawati Saran Children's Hospital, Lady Harding Medical College, New Delhi
- Vinita Jain
- Consultant Pediatrician
- Aastha Medical Centre
- Delhi-110034
- Vipin Talwar
- Senior Resident
- Department of Cardiology
- Sir Ganga Ram Hospital
- New Delhi
- Vishal Dublish
- Department of Pediatrics
- Centre for Child Health
- Sir Ganga Ram Hospital
- New Delhi
- VP Choudhry
- Head Department of Hematology
- All India Institute of Medical Sciences
- New Delhi-110029
- Y K Amdekar
- Consultant Pediatrician
- Jaslok Hospital
- Mumbai
A plethora of literature has been published in the field of Pediatrics during the past few decades. With each passing moment our knowledge base has expanded dramatically, with the resultant emergence of various super and sub specialties. The very notion that a practicing pediatrician, and for that matter even a post graduate student, must be competent to deliver holistic care for the child patient at every juncture and in each of these ramifications of pediatrics, is a challenging prospect and highlights the need for continuing education and enhancement of one's skills. To meet these needs, we considered tracking the current trends of pediatric practice in the form of a concise book. The labors of the past few months have resulted in a unique collation of expertise, clinical application and incisive opinions on the latest in our fields. It has been our pleasure to have a host of eminent academicians and practitioners, both international and national, as a part of this endeavor, each lending their imprint into the development of a thorough and comprehensive compendium. The issues that we have addressed through “Advances in Pediatrics” reflect the health afflictions of the Indian child specifically, both urban as well as rural. Our nation suffers from perhaps one of the highest infant - and under five - mortality rates across the globe, reflecting the non availability and delivery of the neonatal health care system. In such a scenario, the importance of neonatal care assumes principal significance. In the same breath, infectious diseases are perhaps a major cause for mortality too and their management and prevention with appropriate vaccination have been the focus of attention. Our purview extends to include gastroenterology, hemato-oncology, nephrology, pediatric cardiology, emergency and respiratory diseases and neurology amongst others. The need of the hour is to be well prepared to meet the adversities that come our way as professionals. Whether we are good, better or the best, we should never let it rest, until our good is better, and our better, the best. That has been the philosophy of our book, and that is the spirit that we would encourage to inculcate in all our readers. A beginning has been made and to see a generation benefit from this vast resource would be most gratifying for us.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less travelled by,
And that has made all the difference.
AK Dutta
Anupam Sachdeva