Essentials of Pediatrics will be an invaluable text for students aspiring to master the competencies in pediatrics. With the new CBME curriculum, the teaching learning methods and pattern of evaluation have changed. Additionally, with NExT, which is designed to judge the conceptual understanding and problem-solving skills of final-year MBBS students, replacing the final MBBS exam and postgraduate entrance exam, the need for an undergraduate textbook that covers the subject of pediatrics under the framework of this new curriculum was acutely felt, to cut through voluminous text and help students acquire the competencies expected.
Essentials of Pediatrics is designed to include the information essential for a doctor to provide health care to children as the “physician of first contact” in the community—the attribute expected of the Indian Medical Graduate (IMG). This book covers the promotive, preventive, and curative aspects of those disease conditions a primary healthcare provider is likely to encounter. It is also designed to help students prepare for the new pattern of evaluation. The learning objectives and competencies to be achieved by the learner have been clearly defined at the beginning of each chapter. Thus, the student is aware of what he/she should be ABLE to do at the end of the session. The problem-based learning approach with typical cases ensures that the clinical relevance is well-understood. There are focus questions at the end of each chapter for self-assessment and to help students face the MCQ-based NExT with confidence.
Many chapters have dealt with the subject differently. Chapter 6 on Adolescent Health and Chapter 20 on Neonatology cover the essential aspects of providing care for the common conditions unique to these age groups. Chapter 27 focusses on emergencies and triaging, which are critical for saving lives. Chapter 34 on Infectious Diseases focuses on those diseases important in our country, while Chapter 35 includes topics like informed consent and ethics in child care, which are so important in current practice. The three annexures at the end of the book present the IAP and WHO growth charts, BMI-for-age charts, and Integrated Management of Neonatal and Childhood Illness (IMNCI) guidelines.
Essentials of Pediatrics is well-organized and comprehensive. The textual material is supported by clinical case studies, illustrations, and photographs. A mix of MCQs and other self-evaluation exercises are included to aid in better preparation for the examinations.
Padmasani Venkat Ramanan, MD, MRCPCH (UK), completed her MBBS and MD (Pediatrics) from Maulana Azad Medical College. She is currently Professor of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai. Her special interests are in infectious diseases, vaccinology, growth, nutrition, and medical education. She has been a teacher and examiner for undergraduate students of medicine, postgraduates in pediatrics, fellows, and doctoral students for over 25 years. An astute clinician, a keen researcher, and a prolific writer, she has over 60 publications in national and international indexed medical journals, two book chapters, and two books to her credit.
Ramachandran P, MD (Pediatrics), DNB (Pediatrics), is currently Professor of Pediatrics and Associate Dean, Postgraduate (PG) Studies at Sri Ramachandra Institute of Higher Education and Research, Chennai. Having taught pediatrics for undergraduates and postgraduates in different institutions in Tamil Nadu for nearly 40 years, he superannuated in the year 2011 as Director & Superintendent I/C, Institute of Child Health, Madras Medical College, Chennai. He has served as the Editor-in-Chief of the Indian Journal of Practical Pediatrics (2014–2016) and as the academic editor of the IAP Textbook of Pediatrics. He was a member of the IAP Task Force on the Implementation and Support of the MCI Competency-based Curriculum for Pediatrics in undergraduate education (2019).
Foreword Preface Contributors 1. Normal Growth and Development PE1.1–1.6 Anitha Palani, Sasitharan R, Abhinayaa J Terminologies and Factors Affecting Growth and Development Patterns of Growth Assessment of Physical Growth by Anthropometric Measurements Growth Chart and its Clinical Significance Normal Development Methods of Assessment of Development 2. Common Problems Related to Growth PE2.1–2.6 Shobana S, K. Vidhya Sagar Growth Faltering (Failure to Thrive) Assessment of a Child with Growth Faltering Short Stature in Children Referral Criteria 3. Developmental Delay and Intellectual Disability PE3.1–3.5 Rema Chandramohan Developmental Delay Intellectual Disability (ID) 4. Common Problems Related to Development (Scholastic Backwardness, Learning Disabilities, Autism, ADHD) PE4.1–4.5 P. Sudhakar, Poongodi Bala Scholastic Backwardness, Learning Disabilities Attention Deficit Hyperactivity Disorder Autism Spectrum Disorder Child Guidance Clinic — Role in Children with Developmental and Behavioral Problems 5. Common Problems Related to Behavior PE5.1, 5.3–5.9 Abhinayaa J, RV Dhakshayani Habit Disorders and Behavioral Problems Thumb Sucking Nail Biting Breath-Holding Spells Temper Tantrums Pica Referral to a Specialist Enuresis and Encopresis Fussy Infant 6. Adolescent Health PE6.1–6.4, 6.6, 6.7, 6.10, 6.13 Sarala Premkumar, Poongodi Bala, Ramachandran P Adolescence — Definition, Stages and Changes General Health Problems During Adolescence Adolescent Nutrition and Common Nutritional Problems Adolescent Sexuality and Related Problems Adolescent Eating Disorder Common Mental Health Problems During Adolescence Adolescent-Friendly Health Services (AFHS) Adolescent Health Check-up Drug Abuse and Sexual Abuse in Children and Adolescents 7. Breastfeeding PE7.1–7.7 Srinath MV, Radha Kumar 8. Complementary Feeding PE8.1–8.5 Radha Kumar, Srinath MV 9. Normal Nutrition—Assessment and Monitoring PE9.1–9.5 Subramani P Age-Related Nutritional Needs of Infants, Children and Adolescents, including Micronutrients and Vitamins Eliciting Nutritional History and Calculating Calorie and Protein Intake Age-Related Calorie and Protein Requirement Assessment and Classification of Nutritional Status of Infants, Children, and Adolescents 10. Malnutrition: Etiopathogenesis, WHO Classification, Clinical Features, Complications, and Management PE10.1–10.3, 10.6 Karamath SP Role of Locally Prepared Therapeutic Diets and Ready-to-Use Therapeutic Diets 11. Obesity PE11.1–11.4, 11.6 Dhivyalakshmi J Etiology, Clinical Features, and Management of Obesity in Children Risk Approach for Obesity — Prevention Strategies, and Referral Criteria Assessment of a Child with Obesity 12. Fat and Water-Soluble Vitamins PE12.1, 12.2, 12.5–12.7, 12.10–12.16, 12.19, 12.20 Dinesh Kumar J Vitamin A Vitamin D Vitamin E Vitamin K Water-Soluble Vitamins — B Complex and C 13. Micronutrients in Health and Disease PE13.7–13.14 C. Ravichandran Iodine Calcium Magnesium Zinc 14. Toxic Elements PE14.1, 14.2, 14.5 Shruthi TK, Padmasani Venkat Ramanan, Krithika P Lead Hydrocarbon (Kerosene) Poisoning Oxygen Toxicity 15. Fluid and Electrolyte Balance PE15.1–15.4 Poovazhagi Varadharajan Fluid and Electrolytes in Health and Disease Fluid and Electrolyte Imbalance and its Management 16. Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines PE16.1–16.3 K. Nedunchelian, Shaik Mohammad Shafi Jan Components of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Method of Risk Stratification Assessment of Children Aged <2 months using IMNCI Guidelines and Stratifying Risk Assessment of Children Aged 2 months to 5 years Using IMNCI Guidelines and Stratification of Risk 17. The National Health Programs, National Health Mission PE17.1–17.2 Ramachandran P National Programs Related to Maternal and Child Health, including RMNCH A+, RBSK, RKSK, JSSK, Mission Indradhanush and ICDS, and NHM — Vision, Goals, Strategies, and Plan of Action National Health Mission (NHM): Vision, Goals, Strategies, and Plan of Action 18. Reproductive Child Health (RCH) Program PE18.1–18.2 Ramachandran P Preventive Interventions for Child Survival and Safe Motherhood 19. Immunization PE19.1–19.6, 19.9, 19.14–19.16 Rajesh B, Dhana Rathna Moorthy Vetrichelvan, M. Karthikeyan Universal Immunisation Programme and the National Immunization Schedule Epidemiology of Vaccine-Preventable Diseases Description of Vaccines Cold Chain and Methods of Safe Storage and Handling of Vaccines Immunization in Special Situations Components of Safe Vaccine Practice Implied Consent in Immunization Newer Vaccines 20. Neonatology PE20.1–20.4, 20.6–20.17, 20.19–20.20 Prakash A, Uma Maheshwari B, Mohamed Asiff R, Abhiramilatha T, Usha Devi R, Thambarasi T, Thinesh Kumar J, Ashok C Common Neonatal Nomenclature Care of a Normal Neonate Neonatal Resuscitation Assessment at Birth and Routine Care Resuscitation when Baby is not Crying/Breathing at Birth Assessment of a Neonate Follow-up Care for Neonate Birth Asphyxia Respiratory Distress in Newborn Respiratory Distress Syndrome (RDS) Transient Tachypnea of Newborn (TTN) Meconium Aspiration Syndrome (MAS) Birth Injuries in Neonates Hemorrhagic Disease of the Newborn Low Birthweight Infants Neonatal Hypothermia Neonatal Hypoglycemia Hypocalcemia in Newborns Neonatal Seizures Neonatal Sepsis Congenital and Perinatal Infections Neonatal Hyperbilirubinemia Surgical Conditions in Newborns 21. Genitourinary System 282 PE21.1–21.9, PE21.11–21.14, PE21.17 Sangeetha Perungo Urinary Tract Infection Hematuria in Children Acute Post-Streptococcal Glomerulonephritis (PSGN) Proteinuria Nephrotic Syndrome Acute Kidney Injury Chronic Kidney Disease in Children Wilms’ Tumor History Taking and Physical Examination in a Child with Diseases of the Genitourinary Tract Urine Examination in Children Plain X-ray KUB and USG of KUB Common Surgical Conditions of the Genitourinary System Hypertension in Children and Adolescents 22. Rheumatological Problems in Children PE22.1, 22.3 Mahesh Janarthanan Musculoskeletal Examination Common Vasculitic Disorders — Kawasaki Disease and IGA Vasculitis (Henoch-Schonlein Purpura) Juvenile Idiopathic Arthritis (JIA) Juvenile Systemic Lupus Erythematosus (SLE) 23. Cardiovascular System 324 PE23.1–23.12, 23.16, 23.17 Harapriya B, Ritchie Sharon Solomon Congenital Heart Disease Heart Failure in Children Acute Rheumatic Fever (ARF)—Etiopathogenesis, Clinical Presentation, and Management Infective Endocarditis History-Taking in Cardiac Disease Examination of the Cardiovascular System Drugs in Cardiac Diseases: Antifailure Drugs and Inotropic Agents Cardiac Catheterization —Indications and Limitations Common Pediatric Cardiac Surgeries 24. Diarrheal Diseases in Children PE24.1–24.8, 24.11–24.13 K. Vidhya Sagar, Sumathi Bavanandam Acute Diarrhea Persistent Diarrhea Chronic Diarrhea Dysentery 25. Malabsorption, Including Celiac Disease and Common Surgical Conditions of the Gastrointestinal Tract PE25.1, 21.14 Sumathi Bavanandam Common Surgical Conditions of the Gastrointestinal Tract 26. Acute and Chronic Liver Disorders PE26.1–26.9, 26.11, 26.12 K. Vindhiya Acute Hepatitis Chronic Liver Diseases Portal Hypertension History-Taking and Examination in Liver Disease Investigations in Liver Disease Upper Gastrointestinal (GI) Endoscopy Prevention of Hepatitis B Infection—Universal Precautions and Immunization 27. Pediatric Emergencies PE27.1–27.5, 27.7–27.9, 27.11, 27.13, 27.24–27.26, 27.28, 27.29 Shuba S, Krithika P, Ranjit Kumar Manokaran, Poovazhagi Varadharajan, T. Murali Under-5 Mortality Cardiac Arrest/Cardiopulmonary Arrest Respiratory Distress in Children Shock in Children Approach to an Unconscious Child Poisoning in Children Oxygen Therapy and Modes of Administration Triage of Sick Children Brought to a Health Facility Assessment of an Emergency — Sequential Approach Hypothermia Basic Life Support (BLS) Child Abuse or Child Maltreatment 28. Respiratory Disorders in Children PE28.1–9, 28.17, 28.18 Elayaraja Sivaprakasam, B Sarath Balaji Upper Respiratory Infections Stridor in Children Infections of the Larynx and Trachea History-Taking and Examination in a Child with a Respiratory Problem X-ray Chest, Paranasal Sinuses Lower Respiratory Infections (Bronchiolitis, Wheeze-Associated Lower Respiratory Tract Infection, Pneumonia, and Empyema) 29. Hematology PE29.1, PE13.1, PE13.2, PE29.2–29.4, PE29.6–29.13, 29.15–29.17, 29.20 Shobana S, Priyatharshini Parameswaran, Dhaarani Jayaram, S. Shanthi Approach to Anemia Iron Deficiency Anemia Megaloblastic Anemia Hemolytic Anemias — Thalassemia Major, Sickle Cell Anemia, Hereditary Spherocytosis, Autoimmune Hemolytic Anemia, and Hemolytic Uremic Syndrome Thrombocytopenia in Children Hemophilia — Etiology, Classification, Pathogenesis, and Clinical Features Acute Lymphoblastic Leukemia Lymphomas Approach to a Hematological Disorder—History, Examination and Diagnosis Complete Hemogram, Peripheral Smear—Interpretation of Report Peripheral Smear Hemoglobin Electrophoresis and High-Performance Liquid Chromatography (HPLC)—Interpretation of Reports Bone Marrow Aspiration and Biopsy—Indications, Procedure, and Interpretation of Report Splenectomy—Indications and Precautions 30. Nervous System 529 PE30.1–30.21, 30.23, 3.8, 27.6 Saji James, Ranjit Kumar Manokaran, RV Dhakshayani, Shruthi TK, Bhaskar Naidu Meningitis Hydrocephalus Microcephaly Neural Tube Defects Infantile Hemiplegia Febrile Seizures Childhood Epilepsy Status Epilepticus Intellectual Disabilities—Mental Retardation Cerebral Palsy Floppy Infant Poliomyelitis in Children Duchenne Muscular Dystrophy (DMD) Ataxia in Children History-Taking, Examination, and Differential Diagnosis in Central Nervous System (CNS) Disorders Lumbar Puncture: Indications and Contraindications Diagnostic Neuroradiological Procedures in Children Electroencephalography (EEG) Approach to Headache in Children 31. Allergic Disorders (Allergic Rhinitis, Atopic Dermatitis, Bronchial Asthma, Urticaria, Angioedema), Pulmonary Function Tests, Inhalational Therapy PE31.1–31.8, 31.10, 31.12, PE28.19 K. Vindhiya, Padmasani Venkat Ramanan Allergic Rhinitis Atopic Dermatitis Childhood Asthma Pulmonary Function Tests Urticaria and Angioedema 32. Chromosomal Abnormalities PE32.1, 32.4, 32.6, 32.9, 32.11 T.S. Arun Prasath Down Syndrome Turner Syndrome Klinefelter Syndrome 33. Endocrine System PE33.1–33.8 J. Dhivyalakshmi Hypothyroidism Diabetes Mellitus Blood Sugar Testing and Urine Dipstick for Sugar Ambiguous Genitalia Precocious and Delayed Puberty — Definitions 34. Infectious Diseases PE34.1–34.4, 34.7, 34.10, 34.12–34.20 K. Vidhya Sagar, Priyatharshini Parameswaran, Vidya Krishna, Shalini Sharma, Dhana Rathna Moorthy Vetrichelvan, Sugha Priya C.V, Ramachandran P, Padmasani Venkat Ramanan Tuberculosis in Children Tuberculosis—Diagnostics Management of Tuberculosis National Tuberculosis Control Program Fever in Children Measles, Mumps, and Rubella Diphtheria, Pertussis and Tetanus Enteric Fever Vector-Borne Diseases Malaria Common Parasitic Infections—Amoebiasis and Giardiasis Rickettsial Infections COVID-19—Coronavirus Disease 2019 in Children Multi-System Inflammatory Syndrome in Children (MISC) — Associated with COVID-19 35. Medicolegal, Socio-Cultural, and Ethical Issues PE35.1 Ramachandran P Medicolegal Issues Medical Ethics Annexure I IAP/WHO Growth Charts Annexure II WHO BMI-for-Age Chart for Boys and Girls Annexure III Integrated Management of Neonatal and Childhood Illness (IMNCI) Bibliography Index