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Basis of pediatrics PDF

649 Pages·2020·169.708 MB·English
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BASIOSF PEDIATRI€ TENTHE 8 1TION Pervez Akbar Кhan МВBS,FCPS FoпnerP]ryo,f eosfPs eodri atrics Nishtar CMoeLdJiecgael Multan t1;) NISHTAR � "P UBLICAITONS J', ModeТlо wпM,u ltTaenl0 :3 34-6344140 0302 1-2066562 © Nishter Publications (Pvt.) Ltd. BasisofPediatrics by PervezAkbar Khan All rights reserved. No partofthis publication may be reproduced, stored in a retrieval system, ortransmitted in anyform or by anymeans,electronic,mechanical,photocopying,recordingorotherwise,withoutthepriorpermissionoftheCopyrightHolders. Thisbookissoldsubjecttotheconditionthatitshallnot,bywayoftradeorotherwise,belent,resold,hiredoutorotherwisecirculated without the publisher's priorconsent in anyform ofbinding or cover other than that in which it is published and without a similar conditionincludingthisconditionbeingimposedonthesubsequentpurchaser. Medicalknowledgeisconstantlychanging.Asnewinformation becomesavailable,changesintreatment,procedures,equipment and the use ofdrugs become necessary.Theeditors, contributors and the publishers have, as far as it is possible, taken care to ensurethatthe information given in this text is accurate and up-to-date. However, readers are strongly advised to confirm that the information, especiallywith regard to drug usage, complieswiththe latest legislation and standards ofpractice. Neitherthe publishernorthe authorsassume any responsibilityforanyloss orinjuryand/ordamageto person or propertyarising outofor relatedtoanyuseofthematerialcontained inthishandbook. Copyright© 2018 All Rights Reserved First Edition 1985 Sixth Edition 2002 Second Edition 1986 Seventh Edition 2008 Third Edition 1989 Eighth Edition 2011 Fourth Edition 1992 Ninth Edition 2018 Fifth Edition 1997 Tenth Edition 2020 (8 NISHTAR WR PUBLICATIONS Model Town, Multan Tel: 0334-6344400 0321-2066562 | ISBN: 978-969-791-631-3 Printed in Pakistan lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP qapIse}jlou ooY IS popId¥}ap }0 IUA dviaujs* !!!LLAROF EGDELWONK EERF )si.negbil - siseneG yrarbiL - tisiv skoob eerfroF( iz@fRd Thisbookiswritten forundergraduates keeping in view theirspecial requirements and theirdire need ofasmall book onPediatrics.ThemainobjectofthisbookistointroducethestudentswiththeelementaryknowledgeofPediatricsand to enable themto prepare forthe examination. It may also be useful for internee doctors who optto work in Pediatric hospitals. It is not meant to replace the standard textbooks ofPediatrics. Its topics have been carefully selected to include only thoseaspects,whichare eithernottoucheduponordiscussedindetail in Medicine. Thishas greatlyhelpedmetolimit thevolumeofthisbook.Valuable suggestions andcriticism willbe greatlyappreciatedtothisend. Iam greatly indebted to my learned teachers, Prof. Shaukat Raza Khan, Prof. S. M. Haneef, Prof. Tariq Iqbal Bhutta, Prof.AbdulWaheedQureshi,andProf. FehmidaJaleel,whohadgreatinfluenceonmeduringmy formativeyears.This bookreflects the salientfeatures oftheknowledge impartedto meduringtheseyears. MygratitudeisduetoDr.M.M.ZafarullahKundiandDr.ShukarElahiforprovidingmethematerialandencouragement inwritingofthis book. I amthankfulto Dr. MuhammadBakhshMalik,forproofreadingofthismanual. Intheend,thanksareduetoMr. KarimUllahMazhar, fortypingofthismanuscriptandMesser’sCaravan BookCenter forpublishingit. Prof. Dr. PervezAkbarKhan Jan. 1985 lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP lam greatly indebted tostudentsof Medical colleges and doctorsworking in children wardsofdifferenthospi- tals who continue to look for a book which fulfill their partial needs and at time they have to refer to textbook forfurther details. still feel the students complain of studying such a large bookfor preparation oftheirexam | and they require a brief version. The knowledge of pediatrics is ever expanding and have tried to limits its | volume to manageable size. For this have curtailed many detailed explanation of different aspects and | omitted many diagrams to limit its size. In this edition have included the recent national statistics which were available from year 2017. In addition it | was a great pleasure to get help from Dr Athar Abdul Razzaq to review neonatal section and include ail the recent updates available and give it a complete newer look. Similarly Dr Muhammad Imran took immense interest in updating Nephrology section and almostcompletely help us rewritethesection and including ail the recent updates and brief essential new topics. It was a great effort on his part. |am also indebted to Dr Ghazi Khosa who spared his precious time to revise the Gastroenterology and liver diseases section. {t will be pleasure to get his help in future edition also. am extremely thankful to Dr Muhmmad Idrees who worked | meticulously to read the book and brought necessary changes from scrap and added almost more then fifty paragraphs and cancel many diagrams which were unnecessary to limit the size of the book. He was also responsible to bring all the necessary changes in this new edition. It was kind of him to spare his valuable time from family life and medical profession. shall be failing in my duty if don’t mention the name of Dr Talat | | Pervaiz for valuable suggestion and Dr Asif Qamar Rana to taking the responsibility to draw the diagram of growth and development and taking the responsibility to publish the book to international standards. hope | they won't let me down in this endeavor. i shall be looking forward to students and doctors for valuable suggestion and necessary ratifications of our shortfalls. Nobody is perfect except ALLAH almighty. Prof. Dr. PervezAkber Khan lii71VHOS FOGIIMONY fa | (sruebdqi - sisouey Auesgiy - SIA Syood ea4y404) IZOsYpP fn Prof AbdulBari. @ Prof Khawie am Taceba Bolan MedicalCollege, Quetta Lahore Prof Jamal Rave: LahoreGeneral Hospital DeanJPMC, Karachi Prof Iqtadar Kh Dean MotherandChild Health.Aga Khan Hospital, Karachi KingEdwardMedicalCollege Lahore ProfFazal. Gomal MedicalCollege, Dera Ismail Khan PunjabM.C Faisalabad Peshawer MMDC., Multan ProfSalman / ProfQasim |a — ArmyMedical College, Rawalpindi. oe Quaid-i-Azam MedicalCollege, Bahawalpur ProfFouziaZa NMC, Multan DeanChildrenHospital Multan ProfSamiaNat ProfMubarik Rawalpindi Medical College, Rawalpindi ShaikhZayedRahimYarKhanMedical College ProfTahir Maso ProfHuma Arshad Children Hospital & instituteofChild Health, Lahore. Children’sHospital, Lahore ProfTipu Sultan it LahoreGeneral Hospital, Lahore Children’s Hospital, Lahore Prof Ayesha: ProfShazia Mai Dr Muhammad’ ChildrenHospital, Lahore ProfWagarRabb Sahiwal Medical College lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP 3133 History Taking and Physical {es Behavioral and Psychiatric Disorders 70 Examination 1 Pica 70 Nocturnal enuresis 70 History 1 Encopresis 72 Physical examination 3 Attention Deficit Hyperactivity Disorder Neonatal! reflexes 11 (ADHD) 73 (ey, Growth and Development 15 Autism spectrum disorder (pervasive develop- Growth 15 mental disorder) 74 Tic disorder 75 Development 17 Red flags in development 24 Anorexia nervosa and bulimia nervosa........... 76 Puberty and the tanner stages 24 Pediatric Nutrition and Nutritional Growth charts 26 Disorders 77 Immunization 35 Nutritional requirements 77 Definition 35 Infant feeding 78 Vaccine 35 Breastfeeding 79 Immunglobulins 35 Artificial feeding 82 Vaccination schedule 35 Weaning 83 Precautions and recommendations 36 Micro-nutrients and Macro-nutrients 84 Conditionswhich arenotcontraindicated to Vitamin A 84 immunization 36 Vitamin D 86 BCG vaccine 36 Vitamin E 87 Poliomyelitis vaccine 37 Vitamin K 87 Diphtheria, Tetnus, and Pertussis(DTaP) Vitamin Br 88 vaccine 37 Folic acid 88 Measles, Mumps, Rubella (MMR) vaccine 38 Vitamin C 88 Measles immunization 38 lron 89 Hepatitis B vaccine 38 Zinc 90 Meningococcal vaccine 39 lodine 90 Haemophilus influenza type B vaccine 39 Malnutrition 90 Pneumococcal vaccine 40 Classifications 92 Typhoid vaccine 40 Marasmus 94 Cholera vaccine 40 Kwashiorkor 95 Hepatitis A vaccine 41 Obesity and overweight 101 Rotavirus vaccine 41 Influenza vaccine 4) Fluid and Electrolyte Disorder 103 Varicella vaccine 41 Maintenance fluid therapy 103 Rabies immunization 42 Dehydration and replacement therapy 103 Social and Preventive Pediatrics 44 Sodium disorders 104 4) Pakistan statistical data 44 Potassium disorders 106 Acid-base disorders 107 Child rights 45 Child abuse 45 Acutely ill Child 111 Child neglect 47 Child labor 47 Anaphylaxis 1m Shock N2 IMCI (Integrated Management of Childhood 48 Burn injuries N13 lllness) IMCI_ tables 51 Foreign body inhalation and choking 115 lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP Drowning (submersion injury) 117 4 Infecti.ous Diseases 180 Head trauma (injury) 117 he+ Acute diarrhea 180 Cholera 186 Bal Neonatology 119 Shigellosis (bacillary dysentery) 188 Definitions nig Presistent diarrhea 189 History and examination of newborn infant... 119 Giardiasis 190 Neonatal resuscitation 121 Amebiasis 190 Care of the normal newborn infant 125 Typhoid (enteric) fever 191 Temperature regulation in newborn infant 125 Poliomyelitis 195 Hypothermia 126 Diphtheria 198 Hyperthermia 126 Pertussis (whooping cough) 202 Nutritional management ofthe newborn Tetanus 205 infant 127 Botulism 208 Total parenteral nutrition (TPN) 129 Measles 208 Birth asphyxia/Perinatal asphyxia 130 Mumps 212 Prematurity 133 Chickenpox (Varicella) 213 Causes of respiratory distress in the newborn infectious mononucleosis 216 infant 137 Malaria 217 Respiratory distress Syndrome (RDS) 138 Tuberculosis 221 Necrotizing Enterocolitis (NEC) 140 Rheumatic fever 229 Intraventricular Hemorrhage (IVH) 142 Dengue fever 234 Apnea 144 Leishmaniasis 236 Neonatal sepsis 145 Rabies 237 TORCH infections 148 Primary amebic meningoencephalitis Toxoplasmosis 148 (Naegleria) 239 Rube a 149 Worm infestation (Helminthiasis) 240 Cytomegalovirus (CMV) 150 wi Herpes Simplex Virus (HSV) 150 Respiratory Disorders 243 Tuberculosis 151 Choanal atresia 243 Hepatitis B virus 151 Acute Respiratory Infections (ARI) 243 Jaundice neonatorum 152 Acute pharyngitis 244 Unconjugated (indirect) Tonsils and adenoids 245 Hyperbilirubinemia 152 Acute epiglottitis 246 Conjugated (direct) Croup 247 Hyperbilirubinemia 159 Laryngomalacia 248 Post-term infant 160 Otitis media 248 Large for Gestational Age (LGA) infant 160 Bronchiolitis 250 Small for Gestational age infant (SGA) 161 Pneumonia 252 Meconium aspiration syndrome 162 Pleural effusion 256 Transient Tachypnea ofthe Newborn Bronchiecatasis 257 (TTN) 164 Pulmonary abscess 259 Hypoglycemia 165 Pneumothorax 259 Hypocalcemia 166 Asthma 260 Infant of Diabetic Mother (IDM) 167 Cystic fibrosis 266 Neonatal seizures 169 pea Hemorrhagic disease of the newborn infant.. 171 te Gastrointestinal and Liver Disorders . 270 Anemia in newborn infant 172 Evaluation of a child with vomiting 270 Polycythemia in newborn infant 174 Gastroesophageal reflux disease 271 Neonatal thrombocytopenic purpura 175 Chronic diarrhea 272 Birth (trauma) injuries 177 Constipation 276 Neonatal conjunctivitis 178 Approach to abdominal pain 277 Peptic ulcer disease 278 Celiac disease 280 lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP inflammatory Bowel Disease (IBD) 282 Generalized Seizures 347 Hepatomegaly 284 Partial Seizures 349 Acute hepatitis 285 Epileptic Syndromes 351 Acute viral hepatitis 285 Management of Epilepsy 351 Hepatitis A 285 Status epilepticus 354 Hepatitis B 286 Headaches 356 Hepatitis C 288 Migraine 356 Hepatitis D 290 Tension headache 356 Hepatitis 290 Headacheswith increased intracranial Hepatitis G 290 pressure 356 Fulminant hepatic failure 290 coma 356 Hepatic encephalopathy 291 Hydrocephalus 359 Autoimmune hepatitis 294 Dandy-Walkersyndrome Cirrhosis 295 (malformation) 362 Portal hypertension and varices 296 Intracranial SpaceOccupying Lesion Liver abscess 297 (SOL) 362 Ascites 298 Intracranial tumors 362 Wilson’s disease 299 Brain abscess 363 Cholecystitis 301 Pediatric stroke 365 Acute pancreatitis 301 Cerebral Palsy (CP) 366 Acute peritonitis 302 Mental retardation 370 it Microcephaly 372 Cardiovascular Disorders 305 Ataxia 373 Fetal and neonatal circulation 305 Neurofibromatosis (NF) 374 Congenital heart disease 305 Tuberous Sclerosis 375 Cyanotic heart disease 307 Sturge-Weber Syndrome (SWS) 375 Tetralogy of Fallot (TOF) 307 Multiple sclerosis 377 Transposition ofGreatArteries (TGA) 309 Ebstein anomaly 3i Neuro-Muscular Disorders 378 Total Anomalous Pulmonary Venous Duchenne muscular dystrophy 378 Drainage or Connections (TAPVC) 312 Myasthenia gravis 379 Truncus arteriosus 313 Fioppy infant 382 Tricuspid atresia 313 Spinal Muscular Atrophy (SMA) 383 Hypoplastic left heart syndrome 314 Degenerative disorders of CNS 383 Acyanotic heart disease 314 Sphingolipidoses 384 Ventricular Septal Defect (VSD) 314 Adreno-leukodystrophy 386 Patent Ductus Arteriosus (PDA) 316 Guillain-Barre Syndrome (GBS) 387 Atrial Septal Defect (ASD) 318 Bell's palsy 391 Aortic stenosis 319 Myotonic muscular dystrophy 392 Coarctation of aorta 319 Syringomyelia 393 Supraventriculartachycardia 320 Transverse myelitis 394 Congestive Cardiac Failure (CCF) 322 Hematologic Disorders 396 Infective endocarditis 325 Anemia 396 Cardiomyopathy 327 Myocarditis 328 Congenital Hypoplastic anemia 397 Diamond-Blackfan anemia 397 Neurologic Disorders 330 Transient erythroblastopenia of childhood 398 Pyogenic meningitis 330 Microcytic anemia 398 Tuberculous meningitis 336 (ron deficiency anemia 398 Beta-thalassemia 400 Encephaiitis 339 Cerebral malaria 342 Hereditary spherocytosis 403 Sickle cell anemia 404 Febrile convulsions 344 Epilepsy 346 Macrocytic megaloblastic anemia 405 lii71VHOS FOGIIMONY (sruebqi - sisouey Avesgi] - WSIA Syood 404) IZOsYpP

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