PG Textbook of Pediatrics: General Pediatrics and Neonatology (Volume 1) Siddarth Ramji, PSN Menon, Piyush Gupta, Rakesh Lodha
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1PG Textbook of PEDIATRICS2
3PG Textbook of PEDIATRICS
Volume 1
GENERAL PEDIATRICS AND NEONATOLOGY
Piyush Gupta MD FAMS FIAP Professor Department of Pediatrics University College of Medical Sciences and Guru Teg Bahadur Hospital New Delhi,India PSN Menon MD FIAP Consultant and Head Department of Pediatrics Jaber Al-Ahmed Armed Forces Hospital Kuwait Siddarth Ramji MD FNNF Director-Professor Department of Neonatology Maulana Azad Medical College and Associated Lok Nayak Hospital New Delhi,India Rakesh Lodha MD Additional Professor Department of Pediatrics All India Institute of Medical Sciences New Delhi,India
4
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PG Textbook of Pediatrics (Volume 1)
Fifth Edition: 2015
9789351527251
Printed at
5Dedicated to
Children of India
and
Those Who Care for Them6
7Section Editors 9Authors 31preface
In the last decade, many textbooks of pediatrics have been published in India. However, most were targeted towards undergraduates and general practitioners. The number of students opting for postgraduate courses in pediatrics is on the rise. Currently, most postgraduates in pediatrics augment their knowledge by reading and referencing to textbooks published abroad. Many of the Western textbooks are very detailed and provide an important amalgamation of clinical pediatrics with the major advances in genetics, genomics, physiology, diagnosis, imaging, and therapeutics. However, the “state-of-the-art” on the care of the normal and ill neonate, child, or adolescent as presented in these textbooks differ from that practiced in India or South Asia. While these books provide a detailed description of most disorders seen in children, they unfortunately do not provide both evidence-based medicine and astute personal clinical experiences from India. The focus is missing on the core issues relevant in the Indian context, i.e., growth, nutrition, immunization, development, newborn and adolescent health, and programmatic and social issues in child health. The need for a comprehensive postgraduate textbook, which can be adapted to Indian needs, has been recognized and expressed for some time now.
Rapid strides in medicine and technological advances in biological sciences were witnessed in the last decade. Advances in preventive and therapeutic care have opened new prospects for care of children. However, substantial improvements in quality of life have been limited to those with access to healthcare. Poverty, ignorance, war, bioterrorism, misplaced priorities and the lack of political will have prevented many children throughout the world, benefitting from these significant advances. Despite advances in infectious diseases, newer vaccines and preventive neonatal care, mortality and morbidity continue to be unacceptably high. Our priorities for care of children are often different from the developed world. Also, medical advances and good clinical practice must always be coupled with effective advocacy. These aspects need to be addressed in a postgraduate textbook, as current postgraduates are the future decision makers in our country.
It is our earnest wish and hope that the postgraduate textbook will help to fill the long-felt vacuum. It attempts to provide the essential information that postgraduates throughout India need to capture to effectively address the health problems that our children and youth may face in the times to come. Our objective is to be comprehensive yet concise and reader friendly, embracing both the new advances in science as well as the time-honored art of pediatric practice. Both Indian and international experts in respective fields have provided the details that have been further scrutinized for exposition and usefulness to pediatric postgraduates by a chosen team of eminent academicians. We have liberally included tables, line diagrams, images, clinical photographs, illustrative figures, flow charts and algorithms in the main text. The book is divided into 10 major Parts and further arranged into 51 Sections and Annexures to cover all aspects of postgraduate pediatric curriculum. Themes which have major public health relevance for India are extensively covered. It is almost impossible to cover all pediatric problems with the same degree of detail, and hence a careful balance has been made in the details of description of diseases and their management to the needs of the students, and to keep the book to a manageable size. Summary points “In A Nutshell” are provided at the end of each chapter. Selected recent references—mostly leading articles, reviews and position statements—are provided for more detailed information, if desired by the student or the teacher.
Some kind of overlap is unavoidable in a book of this magnitude, with 725 plus minds working on more than 600 chapters simultaneously. We have strived hard to minimize it. We have also tried our best to keep all the chapters on an even keel despite the unavoidable diversity of disciplines, thoughts, experience, and expressive capabilities of the distinguished authors and section editors, from all over the globe. The book would not have been possible but for the support that we received from these erudite contributors. We are indebted to them for their knowledge, introspection, and judgment during the entire process. Together we have worked hard to produce a compilation that will be helpful to those who desire to learn more about child health in India and thus provide better care for children.
Piyush Gupta
PSN Menon
Siddarth Ramji
Rakesh Lodha32
33Acknowlegments  
ACKNOWLEDGMENTS FROM AUTHORS
 
2.1 Gene, Genome and Genetic Basis of Diseases
I have written similar chapters on basics of genetics and molecular medicine for three editions (8th, 9th and 10th) of the API Textbook of Medicine published by the Association of Physicians of India, Mumbai. I am grateful to Ms Smrithi for drawing the figures in this chapter.
Girisha KM
 
3.1.1 Inborn Errors of Metabolism
We are grateful to our patients, their families, students, residents and colleagues for their help. We thank Dr Charushree Prasad for critically reviewing the chapter and providing suggestions.
Chitra Prasad, CA Rupar
 
9.1 Poisoning
I wish to acknowledge the help and support given to me by Dr Paul Nixon.
P Ramesh Menon
 
12.2 Assessment of the Newborn
We acknowledge the efforts of Dr Aliza Mittal in taking clinical photographs for the chapter.
Harish Chellani, Sugandha Arya
 
18.5 CNS Malformations
We gratefully acknowledge the help of Professors Sandeep Agarwal and M Srinivas by contributing the photographs for this chapter.
Nidhi Sugandhi, Veereshwar Bhatnagar
 
23.1 Basic Concepts of Vaccination
I have immensely benefitted from the interactions with many eminent vaccine experts, epidemiologists, academicians and public health program managers. A few of the concepts presented in this chapter could have been (knowingly and unknowingly) borrowed, developed and influenced by my interactions with national and international experts in these areas. I would like to acknowledge their teaching and influence. The opinions expressed in the chapter are solely of mine and should not be attributed to any institution/organization; I have been affiliated in the past or at present.
Chandrakant Lahariya
 
23.5 Adverse Events Following Immunization
I have borrowed heavily from my earlier publication (Vashishtha VM, Kalra A. Adverse Events following Immunization (AEFI), Vaccine Safety and Misinformation against Vaccination. Mumbai: Tree Life Media; 2014.) after due permission from the authors.
Ajay Kalra
 
23.13 Typhoid Fever Vaccines
We would like to thank Dr Leon Ochiai for the continuous guidance and encouragement and Dr Vittal Mogasale for constructive suggestions during the review process.
Sushant Sahastrabuddhe, Mohammad Imran Khan
 
31.19 HIV and Acquired Immunodeficiency Sydnrome
We thank Dr Shubhangi Parkar, Dean (Incharge) of Seth GS Medical College and KEM Hospital, for granting permission to publish this manuscript.
Milind S Tullu, Chhaya Divecha
 
37.1 Applied Anatomy and Physiology of Liver and Biliary Tract
Special thanks to Dr Vijayshri Bhide, GI and Liver Pathologist, Department of Pathology, Deenanath Mangeshkar Hospital, Pune for sharing liver histology pictures.
Vishnu Biradar
 
40.39 Surgical Considerations in Congenital Heart Diseases
Acknowledgement and thanks to my teachers for their contribution and help me in gaining appropriate knowledge and skills to choose, offer and perform the correct operative procedure to scores of unfortunate children born with simple and complex congenital heart defects.
R Benedict Raj
 
40.40 Preventive Cardiology in the Young
34This publication was made possible by grant number 1 D43 HD065249 from the Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.
S Sivasankaran
 
42.11 Status Epilepticus
We wish to acknowledge the help and support provided by Lisa Garrity, Pharm D.
Ravindra Arya, Katrina Peariso
 
42.24 Childhood Ataxia
I wish to acknowledge that a significant part of the discussion on genetic and inherited metabolic disorders associated with ataxia was included in a prior work on the same subject published for e-medicine. The material has been modified considerably to fit into a pertinent discussion on childhood ataxia. I also wish to acknowledge and thank contributors to the prior work; Professor Cheryl Greenberg (MD FRCPC), Division of Genetics and Metabolism, University of Manitoba; Dr Chitra Prasad (MD FRCPC FCCMG), Genetics and Metabolic Disorders, Program of South-Western Ontario; Professor M Jog (MD FRCPC), Division of Clinical Neurosciences, University of Western Ontario.
Asuri N Prasad
 
47.1 Common Visual Problems
I wish to acknowledge the contribution of Dr Ankush Mutreja in preparation of Flow charts 1 to 5 included in this chapter.
Kirti Singh
 
48.11 Cutaneous Manifestations of Collagen Vascular Diseases
I acknowledge Dr Ipsa Niyant Pandya, postgraduate student, Department of Skin and Veneral Diseases, Baroda Medical College, Vadodara, Gujarat for her invaluable contribution.
Yogesh S Marfatia
 
FROM THE EDITORIAL DESK
Ms Anju Kumari:Secretarial assistance.
Dr Sakshi Sachdeva:Editorial assistance.
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