Editor-in-Chief
A Parthasarathy
MD DCH DSc (Hon) FIAP
Senior Consultant Pediatrician AP Child Care, Chennai Former Distinguished Professor The Tamil Nadu Dr MGR Medical University, Chennai Retired Senior Clinical Professor Madras Medical College, Chennai Deputy Superintendent Institute of Child Health and Hospital for Children Chennai,
Tamil Nadu, India
Associate Editors
Alok Gupta
MD FIAP
Pediatrician and Counselor Pediatric Specialties Clinic, Jaipur Formerly, Assistant Professor (Pediatric Medicine) Mahatma Gandhi Medical College and Hospital Jaipur,
Rajasthan, India
Anupama S Borker
MD
Consultant Pediatric Hematologist/Oncologist Somaiya Ayurvihar, Asian Institute of Oncology Mumbai, Maharashtra, India
Dhanya Dharmapalan
MD
Consultant Pediatrician Dr Yewale's Multispecialty Hospital for Children Navi Mumbai, Maharashtra, India
Forewords
Pramod Jog
S Sachidananda Kamath
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Partha's Management Protocols in Pediatric and Adolescent Practice
First Edition: 2016
9789385891922
Printed at
5Dedicated to
The authors and their patients (newborns, infants, children and adolescents) who have contributed rich learning material for us and to Late Dr Panna Choudhury, a doyen and legend in pediatrics who has contributed significantly for medical education in pediatrics and the promotive and preventive health of India's future citizens for decades6
7Contributors
- Alok Gupta
- Pediatrician and Counselor
- Pediatric Specialties Clinic, Jaipur
- Formerly, Assistant Professor (Pediatric Medicine)
- Mahatma Gandhi Medical College and Hospital
- Jaipur, Rajasthan, India
- Mobile: 9414062700
- Email: docalok@hotmail.com
- Anand K Shandilya
- Consultant Pediatrician
- Dr Anand's Hospital for Children
- Jogeshwari East
- Mumbai, Maharashtra, India
- Mobile: 9820309947
- Email: shandilya3@gmail.com
- Anupama S Borker
- Consultant Pediatric Hematologist/ Oncologist
- Somaiya Ayurvihar, Asian Institute of Oncology
- Sion, Mumbai, Maharashtra, India
- Mobile: 9869084466
- Email: dranupamasb@gmail.com
- Anup Mohta
- Head Department of Pediatric Surgery Director
- Chacha Nehru Bala Chikitsalaya Delhi, India
- Mobile: 9810478187
- Email: mohtaanup@hotmail.com
- Anuradha Sovani
- Professor and Head
- Department of Psychology
- SNDT Women's University
- Mumbai, Maharashtra, India
- Trustee and Consultant, IPH
- Thane, Maharashtra, India
- Mobile: 9821050528
- Email: anuradhasovani@gmail.com
- A Parthasarathy
- Senior Consultant Pediatrician
- AP Child Care, Chennai
- Former Distinguished Professor
- The Tamil Nadu Dr MGR Medical
- University, Chennai
- Retired Senior Clinical Professor
- Madras Medical College, Chennai
- Deputy Superintendent
- Institute of Child Health and Hospital for Children
- Chennai, Tamil Nadu, India
- Mobile: 9042260053
- Email: apartha2030@gmail.com
- Arbinder Kumar Singal
- Pediatric Urologist
- Stecker Fellow Pediatric Urology
- Consultant Pediatric Urologist and Hypospadialogist
- MTR Hospital and Hypospadia Foundation
- MGM University of Health Sciences
- Navi Mumbai, Maharashtra, India
- Mobile: 9930902944
- Email: arbinders@gmail.com
- Bharat Agarwal
- Head
- Department of Pediatric Hematology and Oncology
- Bai Jerbai Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Mobile: 9820051571
- Email: parulbrat@gmail.com
- B Sumathi
- Pediatric Gastroenterologist
- Institute of Child Health and Hospital for Children
- Chennai, Tamil Nadu, India
- Mobile: 9841371490/9043879235
- C Thangadorai
- Senior Clinical Professor of Pediatrics (Retd.)
- Madras Medical College
- Chennai, Tamil Nadu, India
- Mobile: 9444048384
- Email: dr.thangadorai@yahoo.com
- Deepa Bhaskaran
- Assistant Professor in Developmental Pediatrics
- Child Development Centre, Medical College
- Thiruvananthapuram, Kerala, India
- Mobile: 9895323534
- Email: deepa.children@hotmail.com
- Deep Naveen Thacker
- Hon. Project Director
- Child Health Foundation
- Gandhidham, Gujarat, India
- Mobile: 9440859028
- Email: deepthacker@gmail.com
- Devaraj Raichur
- Consultant Pediatrician
- Sushruta Multispeciality Hospital
- Hubballi, Karnataka, India
- Mobile: 9449864828/7411777495
- Email: drdevaraj@rediffmail.com
- Dhanya Dharmapalan
- Consultant Pediatrician
- Dr Yewale's Multispecialty Hospital for Children
- Navi Mumbai, Maharashtra, India
- Mobile: 9820274280
- Email:drdhanyaroshan@gmail.com
- Dhivya Lakshmi
- Assistant Professor and Consultant Pediatric Endocrinologist
- Department of Pediatrics
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 9841184748
- Email: dhivya8@yahoo.co.in
- Divya Manivannan
- DNB Trainee
- Department of Pediatrics
- Dr Mehta's Children's Hospital
- Chennai Tamil Nadu, India
- Mobile: 9787250191
- Email: drdivi.manivannan@gmail.com
- Hemchand Prasad
- Consultant Endocrinologist
- Dr Mehta's Children's Hospital
- Chennai, Tamil Nadu, India
- Mobile: 9884984280
- Email: hemchan82@gmail.com
- H Paramesh
- Pediatrician-in-Chief
- Pediatric Pulmonologist and Environmentalist
- Chairman
- Medical and Managing Director
- Lakeside Medical Center and Hospital
- Bengaluru, India
- Mobile: 9845022689
- Email: dr_paramesh1@yahoo.com, drhparamesh@gmail.com
- Jayakar Thomas
- Professor and Head
- Department of Dermatology
- Sree Balaji Medical College and Hospital
- Chennai, Tamil Nadu, India
- Mobile: 9841038484
- Email: jayakarthomas@gmail.com
- Jeeson Unni
- Consultant Pediatrician
- Dr Kunhalu's Nursing Home
- Kochi, Kerala, India
- Mobile: 9847245207
- Email: jeeson@asianetindia.com/jeeson1955@gmail.com
- Ketan Parikh
- Pediatric Surgeon, Urologist and Laparoscopist
- Tara Neo-Surg Hospital
- Ghatkopar-E
- Consultant: Jaslok, Nanavati, Seven Hills and Hiranandani Hospitals
- Mumbai, Maharashtra, India
- Mobile: 02221021603/9821010035
- Mahantesh Matti
- Assistant Professor
- Department of Pediatrics
- SDM Medical College
- Dharwad, Karnataka, India
- Mobile: 8123892917
- Email: drmahantesh77@gmail.com
- Malathi Sathiyasekaran
- Consultant Pediatric Gastroenterologist
- Kanchi Kamakoti Childs Trust Hospital
- Sundaram Medical Foundation
- Chennai, Tamil Nadu, India
- Mobile: 9841041991
- Email: mal.bwcs@gmail.com
- Meenakshi Swaminathan
- Senior Consultant
- Department of Pediatric Ophthalmology and Strabismus
- Medical Research Foundation
- Chennai, Tamil Nadu, Maharashtra, India
- Mobile: 9840143813
- Email: meenakshiswaminathan@gmail.com, drms@snmail.org
- M Govindaraj
- Professor and Head
- Dr Ambedkar Medical College
- Bengaluru, Karnataka, India
- Mobile: 9449033243
- Email: drgovindaraj55@gmail.com
- MKC Nair
- Vice Chancellor
- Kerala University of Health Sciences
- Thrissur, Kerala, India
- Ex-Professor of Pediatrics and Founder Director
- Child Development Centre
- Thiruvananthapuram, Kerala, India
- Mobile: 9447121689
- Email: cdcmkc@gmail.com
- MR Lokeshwar
- Consultant Pediatrician and Pediatric Hematologist/Oncologist:
- Shushrusha Citizen's Co-Operative Hospital Ltd.
- Dadar, Mumbai
- Lilavati Hospital and Research Centre
- Bandra Reclamation
- Bandra (W), Mumbai, Maharashtra, India
- Mobile: 9821031496
- Email: mrlokeshwar@gmail.com
- M Zulfikar Ahamed
- Professor and Head
- Department of Pediatric Cardiology
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Mobile: 9447797979
- Email: zulfikarahamed@gmail.com
- Narendra Chaudhary
- Assistant Professor
- Pediatric Hematology-Oncology
- Department of Child Health
- Christian Medical College
- Vellore, North Arcot, Tamil Nadu, India
- Mobile: 8973182286
- Email: drnarendrapgi@rocketmail.com
- Naveen Jain
- Associate Professor
- Department of Neonatology
- Kerala Institute of Medical Sciences
- Thiruvananthapuram, Kerala, India
- Mobile: 9387814568
- Email: naveen_19572@hotmail.com
- Naveen Thacker
- Director
- Deep Children Hospital and Research Centre
- Kutch, Gujarat, India
- Mobile: 90426217314
- Email: drnaveenthacker@gmail.com/thackernaveen@gmail.com
- Nazrin Md Ismail
- Department of ENT
- Head and Neck Surgery
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 9500154687
- Email: nazams@gmail.com
- NC Gowrishankar
- Deputy Head, Pediatrics
- Pediatric Pulmonologist and Bronchoscopist
- Chennai, Tami Nadu, India
- Mobile: 9444047740
- Email: cugowri@yahoo.com
- PA Mohammed Kunju
- Professor and Head
- Department of Pediatric Neurology
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Mobile: 9447246333
- Email: drpamkunju@gmail.com
- Pandiarajan Vignesh
- Senior Resident (DM 1st year) in
- Pediatric Clinical Immunology and Rheumatology
- Advanced Pediatrics Centre
- Post Graduate Institute of Medical Education and Research (PGIMER)
- Chandigarh, India
- Mobile: 9592047009, 9944547009
- Email: vigimmc@gmail.com
- (Late) Panna Choudhury
- Consultant Pediatrician (Retd.)
- Lok Nayak Hospital
- New Delhi, India
- Mobile: 9810806979
- Email: pannachoudhury@gmail.com
- Parimalam Kumar
- Professor and Head
- Department of Dermatology
- Government Villupuram Medical College
- Villupuram, Tamil Nadu, India
- Mobile: 9841159279
- Email: drparimalam@gmail.com
- P Ramachandran
- Professor and Head
- Department of Pediatrics
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 9840471901
- Email: ramachandran_dr@rediffmail.com
- PS Rajakumar
- Associate Professor
- Department of Pediatrics
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 9941821207
- Email: rajakumarps@gmail.com
- Rhishikesh Thakre
- Consultant Neonatologist
- Director, NICU,
- Neo Clinic and Hospital
- Aurangabad, Maharashtra, India
- Mobile: 9325212131
- Email: rptdoc@gmail.com
- RN Srivastava
- Consultant Pediatric Nephrologist
- Apollo Indraprastha Hospitals
- New Delhi, India
- Mobile: 9313460046
- Email: drrnsri@gmail.com
- Sankar VH
- Additional Professor
- Genetic Clinic
- Associate Professor
- Department of Pediatrics, SAT Hospital
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Mobile: 9349930828
- Email: sankarvh@gmail.com
- Shina Menon
- Consultant Pediatric Nephrologist
- Apollo Indraprastha Hospitals
- New Delhi, India
- Mobile: 9654855257
- Email: menonshina@gmail.com
- Somu Lakshmanan
- Professor
- Department of ENT
- Head and Neck Surgery
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 9840041597
- Email: somu_l1496@yahoo.com
- S Ramesh
- Consultant Pediatrician and Neonatologist
- BRS Hospital
- Chennai, Tamil Nadu, India
- Mobile: 9940676999
- Srikanth R
- Associate Consultant
- Department of Pediatric Ophthalmology and Strabismus
- Medical Research Foundation
- Chennai, Tamil Nadu, India
- Mobile: 9677046201
- Email: drrsk@snmail.org/dr_sri1981@yahoo.com
- S Thangavelu
- Pediatric Consultant and Head
- Department of Pediatrics
- Dr Mehta's Children's Hospital
- Chennai, Tamil Nadu, India
- Mobile: 9790970772
- Email: thangavelu.dr@gmail.com
- Surjit Singh
- Professor
- Department of Pediatrics
- Advanced Pediatrics Centre
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Mobile: 9872283832
- Email: surjitsinghpgi@hotmail.com
- Surpreet Nagi
- Consultant
- Dr Anand's Hospital for Children
- Jogeshwari East
- Mumbai, Maharashtra, India
- Mobile: 9819421667
- Email: nagi.surpreet23@gmail.com
- Swati Y Bhave
- Adolescent Pediatrician
- Head and Incharge Adolescent Wellness Clinic
- Jehangir Hospital
- Former Professor of Pediatrics
- BJ Medical College and Sassoon Hospital
- Pune, Maharashtra, India
- Mobile: 02222854860
- Email: sybhave@gmail.com
- T Ravikumar
- Consultant Pediatrician
- Kanchi Kamakoti Childs Trust Hospital
- Chennai, Tamil Nadu, India
- Mobile: 9841081382
- Email: trkoomar@hotmail.com
- Urvashi Singh
- Junior Resident
- Department of ENT, Head and Neck Surgery
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Mobile: 8939251517
- Email: urvashii.s@gmail.com
- Vaman Khadilkar
- Consultant Pediatric Endocrinologist, Jehangir Hospital
- Pune and Bombay Hospital
- Mumbai, Maharashtra, India
- Assistant Professor
- Pediatric Endocrinology
- Bharati Vidyapeeth Medical College
- Pune, Maharashtra, India
- Mobile: 9850244305
- Email: vamankhadilkar@gmail.com
- Vishesh Jain
- Assistant Professor
- Department of Pediatric Surgery
- All India Institute of Medical Sciences
- Ansari Nagar, New Delhi, India
- Mobile: 9540951519
- Email: dr.vishesh79@gmail.com
- YK Amdekar
- Medical Director
- BJ Wadia Hospital for Children Mumbai and Consultant Pediatrician
- Jaslok Hospital and Research Center
- Mumbai, Maharashtra, India
- Mobile: 9820502368
Partha's Management Protocols in Pediatric and Adolescent Practice (MPPAP) is an exclusive book to assist the students, house officers and clinicians in the evaluation of common pediatric signs and symptoms in clinical practice.
With the help of questions, focused examination and minimum investigations, pediatricians in office practice can reach a working diagnosis and lay down immediate priorities in management.
There is rarely a single acceptable approach to any given problem, and not all diagnoses can fit neatly into an algorithm. Even though the Protocols cannot be considered all-inclusive, the goal is to facilitate a logical and efficient step-wise approach to reasonable differential diagnoses for the common clinical problems. The algorithmic format provides a rapid and concise step-wise approach to a diagnosis. Moreover, it trains the brain to approach a problem.
To put it in the words of Henry David Thoreau, “Our lives are frittered away by detail; simplify, simplify.”
I am sure MPPAP — Meticulously Planned, Practical, Algorithmically Precise—will enhance the capabilities of pediatricians, guiding them towards optimal utilization of available investigative and therapeutic resources.
Pramod Jog
President
15Foreword
It is both a pleasure and a privilege to write a foreword for the book Partha's Management Protocols in Pediatric and Adolescent Practice. The emphasis on evidence-based medicine as well as standardization warrants policies, protocols and guidelines directed at numerous aspects of pediatric problems. This contribution by a formidable team of national and international experts covering all the common pediatric problems assures the user of a broad and collective expertise.
I congratulate the Editor-in-Chief A Parthasarathy, Associate Editors Alok Gupta, Anupama S Borker and Dhanya Dharmapalan, and the dedicated contributors for their magnanimous effort in bringing out this remarkable treatise.
This book ensures that we (pediatricians) are well equipped to handle common problems, so that proper care can be instituted from the very beginning.
I am confident that this book will contribute to improving the care of children.
S Sachidananda Kamath
President
17Preface
Partha's Management Protocols in Pediatric and Adolescent Practice is really a challenging task for practising pediatricians. The innumerable doubts and clarifications asked by the parents and adolescent patients are an educating experience by itself. What the pediatricians have not learnt in medical colleges during their undergraduate and postgraduate days, learn new information and gain their own experience through interaction with their parent clients. Attending several Continuing Medical Education (CME) programs, seminars and conferences, no doubt, enriches the practising pediatricians’ learning skills. At the same time, after attending the CME lectures and discussions, the doctors develop further curiosity to gain more knowledge through interaction with experts.
It is with this objective in mind, I conceived the idea of coming out with a series of three books, viz. “ Case Scenarios”, “Frequently Asked Questions”, and “Management Protocols in Pediatric and Adolescent Practice”. The third title is now in your hands. A formidable team of national and international experts joined hands with me with the sole objective of educating the upcoming country's practising pediatricians by sharing the rich experience, they gained from their own archives. Being luminaries in their own field, they share their practical knowledge to benefit the readers purely out of academic interest without expecting any remuneration whatsoever.
The book is presented with 29 chapters covering, newborn to adolescent care, including several subspecialty disciplines in over 500 pages. The protocols which have come out of the experts’ own rich experience over decades, I am sure, will be of great use to the practising pediatricians in managing common and uncommon selected cases in their day-to-day practice. I am confident this book will serve as a desk-top reference volume.
We will strive our best to improve the standard of the title in its subsequent editions. Your suggestions are most welcomed.
19Acknowledgments
We acknowledge with gratitude the painstaking efforts of all our contributors for so meticulously presenting the protocols from their own archives. Our grateful thanks go to all of them who have toiled to send their respective files by burning midnight oil.
My special gratitude and thanks go to Associate Editors Alok Gupta, Anupama S Borker and Dhanya Dharmapalan, who rendered devoted and dedicated hard work in reviewing, editing and preparing the ‘Print Ready Files’, despite their busy academic and professional commitments. This publication would not have seen the light of the day on schedule without their timely help. Chapter-wise reviewers of this book are Alok Gupta: Chapters 1–8, 12, 13 and 26; Anupama S Borker: Chapters 9–11, 14–19; and Dhanya Dharmapalan: Chapters 20–25, 27–29.
For secretarial assistance, I am grateful to Mrs Nirmala Parthasarathy (PRO),
AP Child Care; Dr (Mrs) Prathiba Janardhnan; Mrs Kavitha Balaji; Ms Shruthi Pavana; Ms Swathi Pavana; Ms Kavya Balaji; Ms Mahiya Balaji; Mr R Janardhanan; Mr P Balaji; Mr A Sriramulu (Chennai), Dr Shweta Gupta, and Dr Anant Gupta (Jaipur).
As in the past, our gratitude to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director-Publishing), Mr KK Raman (Production Manager), Mrs Samina Khan (Executive Assistant to Director-Publishing), Mr Mohit Bhargava (Production Coordinator), Mr DC Gupta (Sr Editor), Rohan (Graphic Designer), Gurpreet Kaur (Editor), and Sarvjeet Kaur (Typesetter) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India. Special mention must be made of Ms Heena Gogia (Project Coordinator) who voluntarily coordinated with the contributors and editors untiringly with devotion and dedication. All of them had taken personal interest and painstaking efforts to produce this state-of-the-art book to whom we are extremely indebted.20