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Approach to Practical Pediatrics Manish Narang

SECTION-I: BASICS OF PRACTICAL PEDIATRICS
CHAPTER 1:Instruments
- LARYNGOSCOPE (FIG. 1.1)
  - SIZES
  - STERILIZATION
  - COMPLICATIONS
- ENDOTRACHEAL TUBE (FIG. 1.2)
  - DRUGS GIVEN THROUGH ENDOTRACHEAL TUBE
  - COMPLICATIONS
- SELF-INFLATING BAG (FIGS 1.3A AND B)
- FACE MASK (FIG. 1.4)
- OXYGEN MASK (FIG. 1.5)
  - DISADVANTAGES
- NASAL OXYGEN CATHETER (FIGS 1.6A AND B)
  - ADVANTAGES
  - DISADVANTAGES
  - OTHER OXYGEN DELIVERY DEVICES
  - MONITORING OXYGEN THERAPY
- ACRYLIC OXYGEN HOOD (FIG. 1.7)
  - ADVANTAGES
  - DISADVANTAGES
- INFANT FEEDING TUBE (FIG. 1.8)
  - HOW TO INSERT
- SUCTION CATHETER (FIGS 1.9A AND B)
- UMBILICAL CATHETER (FIG. 1.10)
  - COMPLICATIONS
- DILEYS MUCUS EXTRACTOR (FIG. 1.11)
- TONGUE DEPRESSOR (FIG. 1.12)
- TUBERCULIN SYRINGE (FIG. 1.13)
- INHALERS (FIGS 1.14A AND B)
- METERED DOSE INHALER
  - DRUGS DELIVERED THROUGH MDI
  - SIDE EFFECTS
  - ADVANTAGES
  - DISADVANTAGES
  - WHY YOU MUST SHAKE MDI
  - FLOAT TEST (FIG. 1.15)
  - HOW TO PRIME MDIS
  - PARTICLE SIZE
- DRY POWDER INHALER (DPI) (FIG. 1.16)
- NEBULIZER CHAMBER (FIG. 1.17)
  - STEPS TO USE NEBULIZER
- SPACER (FIG. 1.18)
  - ADVANTAGES
  - DISADVANTAGES
  - BONE MARROW ASPIRATION NEEDLE (FIG. 1.19)
  - PARTS
  - USES
  - SITE
  - CONTRAINDICATIONS
  - COMPLICATIONS
- BONE TREPHINE BIOPSY (FIG. 1.20)
- LUMBAR PUNCTURE NEEDLE (FIG. 1.21)
- VIM-SILVERMAN‘S NEEDLE (FIG. 1.22)
  - PARTS
  - ADVANTAGES
  - DISADVANTAGES
- TRUCUT BIOPSY NEEDLE (FIG. 1.23)
  - INDICATIONS OF LIVER BIOPSY
  - INDICATIONS FOR KIDNEY BIOPSY IN NEPHROTIC SYNDROME
  - INDICATION FOR KIDNEY BIOPSY IN ACUTE GLOMERULONEPHRITIS
- THREE WAY (FIG. 1.24)
- MICRODRIP SET (FIG. 1.25)
- BLOOD SET (FIG. 1.26)
- GUEDEL AIRWAY (FIG. 1.27)
- INTRAVENOUS CANNULA (FIG. 1.28)
- SPHYGMOMANOMETER (BP APPARATUS)
  - PULSES CONFIRMED BY SPHYGMOMANOMETER
- CONDOM CATHETER (FIG. 1.29)
- CORD CLAMP (FIG. 1.30)
- RESPIRATORY EXERCISER (FIG. 1.31)
- URINE COLLECTION BAG (FIG. 1.32)
- INFANTOMETER (FIG. 1.33)
- SAHLI‘S HEMOGLOBINOMETER (FIG. 1.34)
  - INSTRUMENT
  - PROCEDURE
  - OTHER METHODS FOR MEASUREMENT OF HEMOGLOBIN
- WINTROBE'S TUBE
  - INSTRUMENT
  - PROCEDURE
  - PCV (HEMATOCRIT)
- WESTERGREN TUBE
  - PROCEDURE
- NEUBAUER‘S CHAMBER
- RBC PIPETTE (FIG. 1.37)
  - INSTRUMENT
  - USES
  - PROCEDURE
  - WBC PIPETTE (FIG. 1.37)
  - USE
  - PROCEDURE
- GROWTH CHART (FIGS 1.38A AND B)
  - REFERENCE CURVES
  - WHO GROWTH CHART
  - GROWTH CHARTS USED IN INDIA
  - IAP CARD
  - INTERPRETATION OF GROWTH CURVES
CHAPTER 2:Drugs
- ORS (ORAL REHYDRATION SOLUTION)
- SODIUM BICARBONATE
  - AVAILABLE STRENGTHS
- RINGER LACTATE
- 25% GLUCOSE
  - DOSE
    - Side Effects
    - Precaution
- MANNITOL (20% SOLUTION)
  - DOSAGE
    - Contraindications
- CALCIUM GLUCONATE
  - PREPARATIONS
- POTASSIUM CHLORIDE (KCI)
  - PREPARATIONS
- AMINOPHYLLINE
  - PREPARATION
- ADRENALINE
  - PREPARATION
- DOPAMINE
  - PREPARATION
- DOBUTAMINE
- ATROPINE
- FUROSEMIDE
  - PREPARATIONS
    - Dosage
    - Precaution
- DIGOXIN
  - PREPARATIONS
- VITAMIN D
- VITAMIN A
  - PREPARATION
    - Dosage
    - Side Effects
- VITAMIN K
  - PREPARATION
- DIAZEPAM
  - PREPARATION
- PHENOBARBITONE
  - PREPARATIONS
- PHENYTOIN
- PHOSPHENYTOIN
  - PREPARATIONS
- MIDAZOLAM
- PENICILLIN
- ACTH
  - PREPARATION
    - Side Effects
- METHYL PREDNISOLONE
  - AVAILABLE STRENGTHS
    - Dose
    - Side Effects
  - DIFFERENCE BETWEEN PREDNISOLONE AND METHYL PREDNISOLONE
CHAPTER 3:Neonatal Resuscitation
- INTRODUCTION
- BASICS OF ASPHYXIA
- RESPONSE TO BIRTH
- INITIAL STEPS OF RESUSCITATION
- EVALUATION (FIG. 3.2)
- BAG AND MASK VENTILATION
  - VENTILATING PROCEDURE
  - CHECK HR
- CHEST COMPRESSIONS
  - RATIONALE
  - TECHNIQUES
- ENDOTRACHEAL INTUBATION
- MEDICATIONS
- POSTRESUSCITATION CARE
CHAPTER 4:Immunization
- Immunization History
  - History of Immunization
    - IAP Immunization Schedule
    - Types of Vaccines
  - WHAT IS ROUTINE IMMUNIZATION
  - NEWER (ADDITIONAL) VACCINES
  - (NFHS 3) DATA ON IMMUNIZATION
- BCG VACCINE
- ORAL POLIO VACCINE
  - EXISTING COVERAGE
- INJECTABLE POLIO VACCINE (IPV)
- DTWP VACCINE
- DTaP VACCINE (ACELLULAR PERTUSSIS VACCINE)
- DT VACCINE
- TETANUS TOXOID (TABLE 4.2)
- TETANUS IMMUNOGLOBULIN (TIG) (TABLE 4.2)
- TD VACCINE (TETANUS, DIPHTHERIA TOXOID)
  - Tdap VACCINE
- MEASLES VACCINE
- MMR VACCINE
- MUMPS VACCINE
- RUBELLA VACCINE
- HEPATITIS-B VACCINE
- HEPATITIS B IMMUNOGLOBULIN
- MENINGOCOCCAL VACCINE
- PNEUMOCOCCAL VACCINE
- INFLUENZA VACCINE
- RABIES VACCINE
- RABIES IMMUNOGLOBULIN
- H. INFLUENZAE-B CONJUGATE VACCINE
- TYPHOID VACCINE
- CHICKENPOX VACCINE
  - COMPOSITION
    - Recent CDC Guidelines
- HEPATITIS A VACCINE
  - KILLED HAV VACCINE
  - WHO Recommendation
- ROTAVIRUS VACCINE
- HUMAN PAPILLOMA VIRUS (HPV) VACCINE
- COMBINATION VACCINES
- COLD CHAIN
  - ORDER OF SENSITIVITY OF VACCINES TO HEAT
- EDIBLE VACCINES
- IMMUNIZATION IN SPECIAL CIRCUMSTANCES
  - PRETERM INFANTS
CHAPTER 5:Antibiotic Therapy
CHAPTER 6:Differential Diagnosis of Abnormal Signs
CHAPTER 7:Dietary History
CHAPTER 8:Developmental History
CHAPTER 9:Family and Socioeconomic History
CHAPTER 10:General Physical Examination
CHAPTER 11:Anthropometry
CHAPTER 12:Health Indicators
SECTION-II: LONG CASES IN PEDIATRICS
CHAPTER 13:Protein Energy Malnutrition (PEM)
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 14:Renal System
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 15:Cardiovascular System
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
  - GUIDELINES OF WORKING GROUP ON MANAGEMENT OF CONGENITAL HEART DISEASES IN INDIA
- DISCUSSION
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- DISCUSSION
CHAPTER 16:Respiratory System
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
- SYMPTOMS
- GENERAL PHYSICAL EXAMINATION
- SYSTEMIC EXAMINATION
  - RESPIRATORY SYSTEM EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
  - PNEUMOTHORAX IN RELATION TO ATMOSPHERIC PRESSURE
CHAPTER 17:Gastrointestinal System
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- DIFFERENTIAL DIAGNOSIS
- INVESTIGATIONS
CHAPTER 18:Central Nervous System
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
  - PAST HISTORY
  - DIETARY HISTORY
  - FAMILY HISTORY
  - SOCIOECONOMIC HISTORY
  - IMMUNIZATION HISTORY
- SYSTEMIC EXAMINATION
  - NERVOUS SYSTEM
  - RESPIRATORY SYSTEM
  - GI AND GENITOURINARY SYSTEM
  - CARDIOVASCULAR SYSTEM
  - LYMPHORETICULAR SYSTEM
- DIAGNOSIS
- INVESTIGATIONS
  - LUMBAR PUNCTURE (AFTER FUNDUS EXAMINATION TO R/O RAISED ICT)
    - Baseline Tests before Starting Treatment
- TREATMENT
- DISCUSSION
  - DEFINITIONS
  - INCREASED INTRACRANIAL TENSION
  - WHEN TO SUSPECT TBM
  - POOR PROGNOSTIC FACTORS IN TBM
  - POOR PROGNOSTIC FACTORS IN PYOGENIC MENINGITIS
  - COMPLICATIONS IN TBM
  - CAUSES OF SEIZURES IN TBM
  - CAUSES OF HEMIPLEGIA IN TBM
  - STAGES IN TBM
  - PRINCIPLES OF CHEMOTHERAPY
  - MULTIDRUG RESISTANT TUBERCULOSIS
  - CATEGORY IV REGIMEN
  - DRAWBACKS OF RNTCP
  - DIAGNOSTIC CRITERIA OF CONGENITAL TUBERCULOSIS
  - BABY BORN TO MOTHER WITH TB (DIAGNOSED IN THIRD TRIMESTER OR DURING DELIVERY)
  - DIFFERENCE BETWEEN TUBERCULAR AND ATYPICAL MYCOBACTERIAL LYMPHADENITIS
  - CAUSES OF NEGATIVE MANTOUX IN TUBERCULOSIS
  - CRITERIA FOR DIAGNOSIS OF PAPILLEDEMA
  - FUNDUS EXAMINATION IN PAPILLEDEMA AND OPTIC NEURITIS
  - MODIFIED GLASGOW COMA SCALE FOR INFANTS AND CHILDREN
  - DOLL'S EYE MOVEMENT
  - STAGES OF COMA
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
  - ANTENATAL AND PERINATAL HISTORY
  - PAST HISTORY
  - FAMILY HISTORY
  - SOCIAL HISTORY
  - OCCUPATIONAL HISTORY
- SYSTEMIC EXAMINATION
  - NERVOUS SYSTEM EXAMINATION
  - CARDIOVASCULAR EXAMINATION
  - RESPIRATORY SYSTEM EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
  - DEFINITIONS
  - LOCALIZATION OF LESION IN HEMIPLEGIA
  - VIITH NERVE PALSY (UMN TYPE)
    - Site of Lesion
  - DIFFERENCE BETWEEN 9TH AND 10TH CRANIAL NERVE PALSY
  - SUPERFICIAL REFLEXES
  - ALTERNATING HEMIPLEGIA OF CHILDHOOD
  - CAUSES OF RECURRENT HEMIPLEGIA
  - BLOOD SUPPLY OF BRAIN
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
  - FAMILY HISTORY
  - SOCIAL HISTORY
  - OCCUPATIONAL HISTORY
- SYSTEMIC EXAMINATION
  - NERVOUS SYSTEM EXAMINATION
  - RESPIRATORY SYSTEM
  - GI TRACT AND GENITOURINARY SYSTEM
  - CARDIOVASCULAR SYSTEM
  - LYMPHORETICULAR SYSTEM
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
  - RELATIONSHIP OF BLADDER, HAND AND LEG FIBERS IN THE SPINAL CORD
  - DETERMINATION OF SPINAL SEGMENTS IN RELATION TO VERTEBRA
  - UPPER MOTOR VS LOWER MOTOR NEURON LESIONS
  - LOCALIZATION OF THE LEVEL OF COMPRESSION
  - SENSORY IMPAIRMENT
  - DEEP TENDON REFLEXES
  - RULE OF 3 (SENSORY DERMATOMES)
  - CAUSES OF XANTHOCHROMIA IN CSF
  - CAUSES OF ALBUMINO CYTOLOGICAL DISSOCIATION IN CSF
  - CAUSES OF PARAPLEGIA IN SPINAL TUBERCULOSIS
  - PARAPLEGIA DUE TO CEREBRAL CAUSE
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
    - History of Disease
    - History of Risk Factors
  - DEVELOPMENTAL HISTORY
    - In detail.
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
  - DEFINITION
  - CIRCULATION OF CSF
  - FACTORS CAUSING HYDROCEPHALUS
    - Diagnosis of Hydrocephalus
  - FEATURES OF LATE ONSET HYDROCEPHALUS
  - PHYSIOLOGICAL BUFFERS IN RESPONSE TO HYDROCEPHALUS
  - COMPLICATIONS OF CSF SHUNT SURGERY
  - PROGNOSIS
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
    - History of Disease
  - CNS History
  - IMMUNIZATION HISTORY
- SYSTEMIC EXAMINATION
  - CENTRAL NERVOUS EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
  - TREATMENT
- DISCUSSION
  - DEFINITION OF ACUTE FLACCID PARALYSIS
  - MONOVALENT, BIVALENT AND TRIVALENT ORAL POLIO VACCINE
  - WHY MOPV1 IS USED IN SOME AREAS AND NOT OTHERS
  - CAUSES FOR POLIO IN FULLY IMMUNIZED CHILD
  - EMG-NCV CHANGES IN POLIO AND GBS
  - TOTAL NO OF CONFIRMED POLIO CASES
  - PSEUDOPARALYSIS
  - VIRUS ISOLATION AND SPECIMEN COLLECTION
  - SURVEILLANCE
  - BACKGROUND RATE
  - INDICATORS OF SURVEILLANCE PROGRAM
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
  - FAMILY HISTORY
- SYSTEMIC EXAMINATION
  - CNS EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
  - GOALS
    - Line of Management
- DISCUSSION
  - DEFINITION
  - WHAT IS NOT CEREBRAL PALSY?
  - MAJOR EVENTS IN HUMAN BRAIN DEVELOPMENT
    - Clinicopathologic Correlation of Cerebral Palsy
  - EARLY DIAGNOSIS OF CP
  - CT SCAN/MRI CHANGES IN CEREBRAL PALSY
  - COMPLICATIONS OF CEREBRAL PALSY
  - VISUAL ASSESSMENT
  - HEARING ASSESSMENT
  - MENTAL ASSESSMENT
  - ATTENTION DEFICIT HYPERACTIVITY DISORDER
  - AUTISM
  - PROGNOSIS
- HISTORY
  - CHIEF COMPLAINT
  - HISTORY OF PRESENT ILLNESS
  - FAMILY HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
  - DEFINITION
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
  - ANTENATAL AND PERINATAL HISTORY
  - FAMILY HISTORY
- SYSTEMIC EXAMINATION
  - CNS EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- DISCUSSION
  - WHEN TO SUSPECT A FLOPPY INFANT
  - INDICATIONS FOR HOSPITALIZATION
  - CAUSES OF PSEUDOPARALYSIS
  - NEUROMUSCULAR DISEASE IN FLOPPY BABY
SECTION-III: SHORT CASES IN PEDIATRICS
CHAPTER 19:Short Stature
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 20:Down's Syndrome
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 21:Rickets
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT ILLNESS
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 22:Normal Neonate
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- DISCUSSION
CHAPTER 23:High-Risk Neonate
CHAPTER 24:Kala-azar
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 25:Thalassemia
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 26:Lymphoma
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
  - HODGKIN'S DISEASE
  - NON-HODGKIN'S LYMPHOMA
- DISCUSSION
CHAPTER 27:Leukemia
- HISTORY
  - CHIEF COMPLAINTS
  - HISTORY OF PRESENT COMPLAINT
    - History of Disease
    - History of Complications
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 28:Hypothyroidism
- HISTORY
- SYSTEMIC EXAMINATION
  - CARDIOVASCULAR SYSTEM
  - CENTRAL NERVOUS SYSTEM
- DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 29:Duchenne Muscular Dystrophy (DMD)
- HISTORY
- SYSTEMIC EXAMINATION
- DIAGNOSIS
- DIFFERENTIAL DIAGNOSIS
- INVESTIGATIONS
- MANAGEMENT
- DISCUSSION
CHAPTER 30:Ataxia
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
CHAPTER 31:Meningomyelocele
- HISTORY
- SYSTEMIC EXAMINATION
- INVESTIGATIONS
- TREATMENT
- DISCUSSION
SECTION-IV: MISCELLANEOUS STUDIES
CHAPTER 32:Invasive Procedures
- LUMBAR PUNCTURE (LP)
- INTRAOSSEOUS CANNULATIONS
- HEEL PUNCTURE
  - PROCEDURE
- SUBDURAL TAP
  - PROCEDURE
- BONE MARROW ASPIRATION
  - SITE
  - PROCEDURE
- BONE TREPHINE BIOPSY
  - PROCEDURE
  - PROCESSING OF SPECIMENS
- LIVER BIOPSY
- KIDNEY BIOPSY
- INSERTION OF NASOGASTRIC TUBE
  - REMOVING THE TUBE
  - COMPLICATION
- ABDOMINAL PARACENTESIS
  - PROCEDURE
  - PRECAUTIONS
- PERICARDIOCENTESIS
  - PROCEDURE
  - COMPLICATIONS
- SUPRAPUBIC TAP
  - PROCEDURE
  - COMPLICATIONS
CHAPTER 33:Legal Acts
- THE JUVENILE JUSTICE (CARE AND PROTECTION OF CHILDREN) ACT, 2000
  - COMMENTS
- THE PRENATAL DIAGNOSTIC TECHNIQUES (REGULATION AND PREVENTION OF MISUSE) ACT, 1994
- ADOPTION ACT
- THE INFANT MILK SUBSTITUTES, FEEDING BOTTLES AND INFANT FOODS ACT, 1992 (IMS ACT)
  - THE LAW TO PROTECT AND PROMOTE BREASTFEEDING
  - THE KEY PROVISIONS OF THE IMS ACT
    - Penalties for violations under the Act
    - What You Can Do?
- MEDICAL/LEGAL PITFALLS
CHAPTER 34:Timing of Surgery for Common Pediatric Conditions
CHAPTER 35:X-rays
- RESPIRATORY SYSTEM
- CARDIOVASCULAR SYSTEM
- X-RAY SKULL
- X-RAY BONES
- GASTROINTESTINAL SYSTEM
- RETROGRADE PYELOGRAPHY
  - VESICOURETERAL REFLUX (VUR)
- CT SCAN
- MRI
  - INDICATIONS FOR MRI CRANIUM
  - IDENTIFICATION OF IMAGES IN MRI
- ROLE OF RADIATION
- CHOICE OF INVESTIGATION
CHAPTER 36:ABG Analysis
CHAPTER 37:Social Programs
- NUTRITIONAL SUPPLEMENTATION PROGRAMS IN INDIA
- OTHER NATIONAL PROGRAMS
Appendix
- Neonatal Resuscitation: 2010 American Heart Association Guidelines

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