IAP Clinical Examination in PEDIATRICS
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IAP Clinical Examination in Pediatrics
First Edition: 2021
9789389776379
Printed at:
- Aloka Santosh HedauDNB FICO FPOSPediatric Ophthalmologist and Squint SpecialistDr Aloka's Eye CareHyderabad, Telangana, India
- Anand RaoMD Fellowship Pediatric RheumatologyDirectorPediatric Rheumatology ClinicManipal Hospital, BengaluruIndira Gandhi Institute of Child HealthBengaluru, Karnataka, India
- Archana KadamMD (Ped) DNBDevelopmental PediatricianKEM Hospital and Jehangir HospitalPune, Maharashtra, India
- Bakulesh ChauhanMD PGDAPProfessorDepartment of PediatricsKG Patel Children HospitalVadodara, Gujarat, India
- Baldev PrajapatiMD DPed FIAP MNAMSProfessor and HeadDepartment of PediatricsGCS Medical College, Hospital and Research Center, AhmedabadAakanksha Children Hospital and Postgraduate InstituteAhmedabad, Gujarat, India
- Chandrika S BhatMBBS MD RCPCH Fellowship PediatricRheumatologyConsultant Pediatric and RheumatologistDepartment of RheumatologyRainbow Children's HospitalBengaluru, Karnataka, India
- MMA FaridiMD DCH MAMS FIAP FNNFPrincipal, Dean and ProfessorDepartment of PediatricsEra's Medical CollegeLucknow, Uttar Pradesh, India
- Mukund VaghelaMBBS MS (Otolaryngology)Consultant ENT SurgeonKundan ENT HospitalAhmedabad, Gujarat, India
- R MadhuMD (Dermatologist) DCHAssociate ProfessorDepartment of DermatologyMadras Medical CollegeChennai, Tamil Nadu, India
- Rajal PrajapatiMD DPedFormer ProfessorDepartment of PediatricsAMC MET Medical CollegeVS General HospitalAhmedabad, Gujarat, India
- Rhishikesh ThakreDM (Neo) MD DNB DCH FCPS FIAPDirectorNeo Clinic and HospitalAurangabad, Maharashtra, India
- Satish TiwariMD (Pediatrics) LLB FIAPProfessorDepartment of PediatricsDr PDM Medical CollegeAmravati, Maharashtra, India
- Sudhir MishraMD (Pediatrics)Chief Consultant and HeadTata Main Hospital and Manipal Tata Medical CollegeJamshedpur, Jharkhand, India
- Suktara SharmaMBBS MS (Otolaryngology)Assistant ProfessorDepartment of ENTGCS Medical College, Hospitaland Research CenterAhmedabad, Gujarat, India
- Vijay BhaskarMBBS MD (DERM) DCHAssociate ProfessorDepartment of DermatologyMadras Medical CollegeChennai, Tamil Nadu, India
- Vikram BhaskarMD (Pediatrics)Assistant ProfessorDepartment of PediatricsUniversity College of Medical Sciences and Guru Teg Bahadur HospitalNew Delhi, India
Indeed, it is a proud privilege for me to write “foreword” for IAP Clinical Examination in Pediatrics.
Even though the medical science has expanded by leaps and bounds and there are many diagnostic modalities available, still clinical examination is the key to early and appropriate diagnosis without submitting the patient for a battery of investigations. A detailed history taking and thorough clinical examination can definitely contribute to the accurate early diagnosis and save on time and money both. In an era of consumerism, Google-learned patients, and cut throat competition, it is imperative to have strong clinical knowledge and skill. A strong foundation of the same can be created while the person is in medical training (during undergraduate and postgraduate studies).
With an aim to strengthen the clinical skills of students and young practitioners the Indian Academy of Pediatrics (IAP) envisaged to come out with a book on IAP Clinical Examination in Pediatrics under action plan 2018–19. We feel blessed to have Dr Baldev Prajapati and team as editorial board members who have taken pains and have carefully drafted this book.
Apart from chapters on History Taking and Clinical Examination the book has sections on some of the overlooked skills—Anthropometry and Assessment of Growth and Assessment of Diet and Feeding Practices. It has also included some non-medical sections like: Communication with Child and Parents and Ethical and Legal Issues in Pediatric Practice.
I am sure reading this comprehensive book on clinical skills will be a big boon as they do not need to refer several books and it will contribute to capacity/skill building for the PG students.
My heartiest congratulations to editorial team as well as contributors for coming out with this compact but comprehensive book on clinical skills. I am sure it will be popular amongst readers.
Digant D Shastri
President, 2019
Indian Academy of Pediatrics
Foreword
In the field of modern as well as ancient medicine, clinical examination has played a pivotal role and has been taught the students to be good clinicians. Though there are many books available on this subject, we have never had a comprehensive book from Indian Academy of Pediatrics. This made us to initiate this project.
As we thread into the early part of the 21st century with newer technologies changing the way of diagnosis, sometimes we wonder whether the period of clinical examination with inspection-palpation-percussion is over. But I am sure a proper history and clinical examination will give you a diagnosis in almost 80% of the cases. As teachers it is our duty to make sure that our future students are trained well in clinical examination.
The IAP Clinical Examination in Pediatrics will be an excellent trestle for students of pediatrics, be it undergraduate, postgraduate, or fellowship student with depth and clarity.
First and foremost I wish to congratulate Dr Baldev Prajapati who took on this project almost single-handedly. He has been able to bring out the book within the time limit, which is highly appreciable. I also thank other team members for taking up the onerous task of compiling this book and enthusiastically pursuing this project to fruition. They have envisioned a comprehensive coverage of clinical examination in this book with Indian focus and perspective in mind. I am also glad to see that a large number of experts in this field have contributed chapters and made this into a genuine team effort.
IAP is a professional organization whose mission statement is improvement of child health and it is committed to the mental and physical wellbeing of all children with various academic and social activities. IAP fulfills this mission by updating the knowledge, attitude, and skills of her members by various academic events and publications. Over the last many years, IAP publications, being very popular, are well read, accepted, and appreciated.
Any organization can thrive only when it is focused on its core purpose. IAP has a long-standing track record of outstanding academic activity. It can be reinvigorated only when we continue to produce an academic output of excellent quality. This book is a step forward in that direction. I wish to convey the academy's gratitude to all those who have been involved in this effort, chiefly the editors and contributors for giving life to the IAP's vision for emerging as a professional organization of repute.
Santosh T Soans
President, 2018
Indian Academy of Pediatrics
Foreword
In this modern era of sophisticated technology for laboratory and radio imaging diagnosis and their easy availability, the art of clinical diagnosis is gradually vanishing. With reference to it, several members of IAP including office bearers and executive board members felt a need of a book on clinical examination, helping the students to understand the importance of bedside clinical examination and diagnosis. To impart thorough clinical knowledge and skill to the students, the book should be small in volume, in simple language, and easy to understand. With this thought, IAP decided to bring out this publication, IAP Clinical Examination in Pediatrics.
It is our great pleasure and privilege to have Dr Baldev Prajapati, Professor and Head, Department of Pediatrics, GCS Medical College, Hospital and Research Center and Aakanksha Children Hospital and Postgraduate Institute, Ahmedabad, Gujarat, India as the Editor and other eminent teachers as contributors. Baldev Prajapati is very well-known as an eminent teacher across the country. He is known for his bedside teaching, clinical acumen, and analytic approach based on detail history and thorough clinical examination to any given case.
This book contains unique chapters on communication skill, ethical and legal issues in practice, and diagnosis of death which are hardly found in other books. The special aspects of child health like Developmental assessment, Diet in young children, Anthropometry, and Growth assessment are covered very nicely. Besides all the systems, it also includes Newborn, Eye, ENT, Skin, and Musculoskeletal system examination. A chapter on Common procedures is relevant to daily practice. The book has been made self-explanatory by many original clinical pictures and tables.
This book would become a most practical and useful tool to the students in their training in clinical medicine. I hope this book will find its place on shelf of each library.
Bakul Jayant Parekh
President, 2020
Indian Academy of Pediatrics
Preface
Over the last few decades, the science of medicine has progressed very rapidly not only in the field of therapeutics, but also in the field of diagnostic technology. But, it is a sad reality that there is a gradual rusting of clinical medicine and lack of interest for bedside diagnosis among us. Detail history, thorough physical examination, and good communication skill are major pillars of clinical medicine. Medicine is not only science, but it is also an art. It is learnt only by methodological and well-organized clinical examination which requires continuous practice and special efforts. During bedside teaching in my daily round and conducting undergraduate as well as postgraduate examinations, I felt the need of a handbook on clinical examination in pediatrics which is simple, easy to understand, and can be practiced daily. Meanwhile, I received a request from the office of our central Indian Academy of Pediatrics to prepare a book, IAP Clinical Examination in Pediatrics under my Editorship with the help of eminent teachers, I accepted it immediately with a great pleasure.
The book has been written to provide a simplified clinical approach to children with various medical disorders. The focus is mainly on clinical methods to elicit physical symptoms and signs. The book is phased into 18 chapters, beginning with a chapter on communication with child and parents. It has been observed that communication skill is lacking with many of us as it was not taught to us during our training period. It provides knowledge, skills, and philosophy to handle the children and their parents with concern and compassion. Breastfeeding and feeding practices in young children, anthropometry and assessment of growth, and developmental assessment have unique place in pediatrics. Breastfeeding and related practical issues, diet in young children, interpretation of anthropometric parameters and assessment of growth, body index mass (BMI), use of growth charts, and importance of developmental screening and assessment have been covered in view of its importance in health and disease of children. Besides all the major systems, it also includes examination of newborn, eye, ENT, skin, and its appendages and musculoskeletal system. There are plenty of tables and our own original clinical photographs for good visual impression and easy retrieval of information. With availability of most advanced life-supporting systems for the management of critically ill patients, many a times it is a dilemma for a treating physician to diagnose death with reference to modern medicine and law. For this reason, a separate chapter on Diagnosis of Death is devoted. In this modern era, it is essential for every clinician to be well versed regarding ethical and legal issues in our daily practice. The expert in the field has made it simple for us. A chapter on Common Procedure in Pediatrics is relevant to this book.
Baldev Prajapati
Acknowledgments
I would like to thank Dr Bakul Jayant Parekh, President IAP–2020, Dr Digant D Shastri, President IAP–2019, Dr Santosh T Soans, President IAP–2018, Dr Remesh Kumar R, Honorable Secretary, IAP 2018–19 and all the members of the executive board, IAP for giving me the opportunity to prepare this book. I remain grateful to all the authors for their contributions, without whose help it would not have been possible. I am thankful to all my colleagues from Department of Pediatrics, GCS Medical College, Hospital and Research Center, Ahmedabad, Gujarat, India; Aakanksha Children Hospital and Postgraduate Institute, Ahmedabad, Gujarat, India for their help in preparing this book. No amount of words can express my gratitude to my wife, Dr Rajal Prajapati, my daughters, Dr Aakanksha and Dr Aalapi, and my son-in-law, Dr Mukund, who allowed me ample time for completing this book.
I thank the faculties Drs Ami Patel, Hetal Jiyani, Bhanu Desai, Pinakin Trivedi, Harsh Mod, Prarthana Kharod-Patel, Rutvik Parikh, and Sheena Sivanandan and all the Resident Doctors, Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad for their contribution for clinical photographs and other helps.
I like to thank Nisarg Shah for type setting and composing.
I also like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Prerna Bajaj (Development Editor), and the staff of M/S Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us in every way possible to bring out this book.
I welcome comments for omissions and errors as well as suggestions for future editions.