Partha’s Fundamentals of Pediatrics Swati Y Bhave, A Parthasarathy, MKC Nair, Anupama S Borker
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1Partha's FUNDAMENTALS OF PEDIATRICS2
3Partha's FUNDAMENTALS OF PEDIATRICS
Second Edition
Editor-in-Chief A Parthasarathy Distinguished Professor of Pediatrics The Tamil Nadu Dr MGR Medical University, Guindy, Chennai Senior Clinical Professor of Pediatrics (Retired) Madras Medical College Deputy Superintendent Institute of Child Health and Hospital for Children Chennai, Tamil Nadu, India Chief Academic Editor Anupama S Borker Professor Department of Pediatrics In-charge Pediatric Hematology-Oncology Kasturba Medical College, Manipal University Manipal, Karnataka India Academic Editors MKC Nair Professor of Pediatrics and Epidemiology Director Child Development Center Sree Avittom Thirunal (SAT) Medical College and Hospital Thiruvananthapuram, Kerala,India Swati Y Bhave Senior Consultant Apollo Indraprastha Hospitals, New Delhi, India Former Professor of Pediatrics BJ Medical College, Pune Former Associate Professor of Pediatrics Grant Medical College, Mumbai Former Consultant and Associate Professor Bombay Hospital Institute of Medical Sciences Mumbai, Maharashtra, India Foreword Mayil Vahanan Natarajan
4
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© 2013, A Parthasarathy
All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permission of the publisher.
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Partha's Fundamentals of Pediatrics
First Edition: 2007
Second Edition: 2013
9789350903612
Printed at:
5Dedicated to
The revered memory of my mentor, friend, philosopher and guide, (Late) Professor V Balagopal Raju, Retired Professor and Head, Department of Pediatrics, Madras Medical College, Chennai and Director and Superintendent, Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamil Nadu, India, whose compassion and concern for the health care of children in India, inspired many of his students and colleagues across the country, and to (Late) Dr Tapan Kumar Ghosh, Kolkata, West Bengal, India, for his untiring services in the field of infectious diseases in India6
7Contributors 13
Foreword
It is a great pleasure for me to write foreword for the book, Partha's Fundamentals of Pediatrics. The author of the book is known to me for a long time as a good teacher and academician dedicating most of his time for the betterment of children. As the children of developing countries differ from their counterparts in developed countries, the Indian Academy of Pediatrics plays a vital part in the health needs of children and the participation rendered by Senior Pediatricians like Dr Parthasarathy for the same is very immense in taking the child health to the next level.
The book is thoroughly written keeping in time with the rapidly changing concepts in pediatrics besides being evidence-based in that aspect. Apart from being an excellent textbook for undergraduates and postgraduates, the book has a quantum of knowledge to be cherished by the fellow pediatricians across the globe. I am sure that the book will continue to remain as a prestigious publication and serve the nation by helping the doctors engaged in the care of the children needing latest updates.
I congratulate Dr Parthasarathy on his stupendous efforts, and I wish him and the book all the best.
Mayil Vahanan Natarajan
Vice-Chancellor
The Tamil Nadu Dr MGR Medical University
Chennai, Tamil Nadu, India
Ex-Professor of Orthopedics and Director
Institute of Orthopedics and Traumatology
Madras Medical College and Rajiv Gandhi Government General Hospital
Chennai, Tamil Nadu, India14
15Preface to the Second Edition
With dedication, we have published the second edition of this book in accordance with the revised Medical Council of India (MCI) and All India Institute of Medical Sciences (AIIMS) MBBS syllabus. Respective authors and chapter editors have taken great pains to revise and update the text in tune with the revised syllabus. Attempt has been made to include few additional topics not included in the syllabus but useful for the undergraduate student when he/she embarks practicing medicine after getting his/her degree.
Thus, the book is presented with the day-to-day management guidelines also to benefit the practicing pediatricians and family physicians who need to be updated on fundamentals useful for their practice. The book will, therefore, continue to be a reference volume for the undergraduates, even as they become practitioners of pediatrics, as a desktop-reference volume and ready-reckoner, because today's medical student is tomorrow's practitioner.
The contents include a wide range of pediatric topics starting from Pediatric Care in Developing Countries, National Rural Health Mission, History Elicitation and Physical Examination, Newborn Care, Growth and Development, Infant and Young Child Feeding, Community Pediatrics, Immunity, Immunization and Infectious Diseases, Systemic Diseases of Neurology, Cardiology, Pulmonology, Gastroenterology, Hepatology and Pancreatology, Nephrology, Hematology, Oncology, Endocrinology, Genetics, Allergy and Rheumatology, and chapters related to allied subspecialties in Pediatrics like Ophthalmology, Otorhinolaryngology, Dentistry, Orthopedics, Learning Disabilities, Child Labor and Neglect, Adolescent Health, Poisoning and Toxic Ingestion, Essentials of Pediatric and Neonatal Intensive Care, Surgery, Rational Drug Therapy, Medical Research, Pediatric Procedures, Radiology and Imaging in 33 Chapters including 9 Miscellaneous Topics, viz. Vital Statistics, IMNCI Strategy, Rights of Children, Drugs and Drug Dosages, Interpretation of Laboratory Values and Allergy Tests, Safe injection Practices and the MCI/AIIMS-MBBS syllabi for ready reference.
It is our fervent hope that the readers of the book will appreciate the fluency and readability of the text and will find the topics covered useful for undergraduate examination and day-to-day pediatric practice. Your valuable suggestions are earnestly welcomed to improve the contents and quality of future editions of the book.
A Parthasarathy
Anupama S Borker
MKC Nair
Swati Y Bhave16
17Preface to the First Edition
The long-pending recommendation of the Indian Academy of Pediatrics (IAP) and the dream of many senior teachers in Pediatrics, became a reality when the Medical Council of India (MCI) announced the inclusion of Pediatrics as a separate examination subject in the year 1997. The IAP Education Center and the MCI, based on the recommendations of the IAP experts, executed a very concise and need-based syllabus.
The need for a concise textbook to impart fundamental knowledge of pediatrics to the graduate medical students was felt and the Indian Academy of Pediatrics brought out a comprehensive textbook for the first time titled IAP Textbook of Pediatrics. The academy's venture was warmly welcomed by students, teachers and practitioners alike. However, due to its comprehensive nature, the contributors could not restrict the text and hence it became voluminous. Several topics which were not the part of MCI syllabus were also included. Soon the IAP Textbook of Pediatrics became a true desktop companion of postgraduates and practitioners. Several reprints were brought out and the third edition has been published in 2006.
A much smaller version became the need of the hour and hence this book at the request of undergraduates. Though we cannot claim a state-of-the-art presentation, we have strived our best to include all the topics as delineated by the Medical Council of India and the IAP Education Center in their syllabus and also a few selected topics of practical importance.
It is our fervent hope that this textbook will fulfill the fundamental needs of the undergraduates. Your suggestions are most welcome to improve the quality of the contents for future editions.
A Parthasarathy
PSN Menon
MKC Nair
Swati Y Bhave18
19Acknowledgments
The Editor-in-Chief is indebted to the following, for timely assistance in accomplishing this project on schedule:
  1. All learned contributors, chapter editors and members of the editorial board.
  2. Dr Anupama S Borker for her dedication and hard work, and the “eagle's eye” scrutiny and editing of the whole book.
  3. Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr Tarun Duneja (Director-Publishing), Ms Samina Khan (PA to Director-Publishing), Dr Richa Saxena (Chief Editor), Dr Anchal Kaushik and Ms Jagriti Kundu (Medical Editors), Mr KK Raman (Production Manager) and his production team of graphic designers, proofreaders and typesetters, M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, and Mr Pradeep Ratan Mukherjee (Branch Manager), Mr Jayanandan (Author Coordinator) and their dedicated team of Chennai Branch Office, Mr CS Gawde (Branch Manager), Mr Ramesh (Author Coordinator) and their dedicated team of Mumbai Branch Office, and Mr Venugopal (Branch Manager) Bengaluru, Karnataka, India, for their coordination and assistance from time to time.
  4. Mrs Nirmala, Mr R Janardhanan, Dr (Mrs) Prathibha, Ms Shruthi Pavana, Ms Swathi Pavana, Mr P Balaji, Mrs Kavitha, Ms Kavya, Ms Mahiya, for their valuable suggestions and coordination and to Mr D Prakash, Mr Ajay Kumar, Mr Shukla, Mrs Uma Devi Sathish and Mr Sathiyathasan of Chennai, Tamil Nadu, India, for their secretarial assistance.