IAP

Textbook
of Pediatrics
4th Edition
 IAP
Textbook
of Pediatrics Volume

4th Edition
Editor-in-Chief
A Parthasarathy
Professor of Pediatrics, Madras Medical College, and
1
Deputy Superintendent, Institute of Child Health and Hospital for Children, Chennai (Retired)
National President, IAP 1997, Regional Advisor, APPA, 199799
Founding Editor-in-Chief, Indian Journal of Practical Pediatrics
Contributory Editor, ColorAtlas of Tropical Pediatrics, American Academy of Pediatrics 2009

Executive Academic Editor

PSN Menon
Sub-Dean, Professor of Pediatrics, Division of Pediatric Endocrinology and
Officer in-Charge Genetic Unit, All India Institute of Medical Sciences, New Delhi (Retired)
Consultant and Head, Department of Pediatrics
Jaber Al-Ahmed Armed Forces Hospital, Kuwait

Senior Editors
RK Agarwal Panna Choudhury
President, IAP 2008 President, IAP 2009
Senior Consultant Pediatrician and Director Editor-in-Chief, Indian Pediatrics 2005-7
RK Hospital Consultant Pediatrician
Udaipur, Rajasthan, India Lok Nayak Hospital, New Delhi, India

Naveen C Thacker Deepak Ugra

President, IAP 2006 President Elect, IAP 2010
Senior Consultant Pediatrician and Director Consultant Pediatrician
Deep Children Hospital and Research Centre Lilawati Hospital and Research Centre, Mumbai
Gandhidham (Kutch), Gujarat, India Guru Nanak Hospital and Research Centre, Mumbai

Senior Academic Editors

Piyush Gupta MKC Nair
Professor of Pediatrics Professor of Pediatrics and Clinical Epidemiology
University College of Medical Sciences Director, Child Development Centre
New Delhi, India Medical College, Thiruvananthapuram, Kerala, India
Editor-in-Chief, Indian Pediatrics 2008-10 President IAP 2004, President INDIACLEN 2005-7
Executive Editors
Rohit C Agrawal Tanmay Amladi
Honorary Secretary General, IAP 2007-08 Treasurer, IAP 2007-8, Honorary Neonatologist
Director, Chandra-Jyoti Children Hospital Nowrosjee Wadia Maternity Hospital and NICU
Mumbai, Maharashtra, India Parel, Mumbai, Maharashtra, India
Academic Editor
K Nedunchelian
Editor-in-Chief, Indian Journal of Practical Pediatrics
Assistant Professor of Pediatrics, Madras Medical College
Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India

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IAP Textbook of Pediatrics , 4th edition

2009, Indian Academy of Pediatrics, Kailas Darshan, 1st Floor, Kennedy Bridge, Nana Chowk, Mumbai 400 007, India
Tel: (022) 23887906/23887922/23889565 Fax: (022) 23851713
E-mail: iapcoff@bom5.vsnl.net.in; centraloffice@iapindia.org
Websites: www.iapindia.org/www.ijpp.org/www.indianpediatrics.net/www.iapdrugformulary.com
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means:
electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the Indian Academy of Pediatrics and
the publisher.

This book has been published in good faith that the material provided by editors is original. Every effort is made to ensure accuracy of
material, but the publisher, printer and Indian Academy of Pediatrics will not be held responsible for any inadvertent error(s). In case of
any dispute, all legal matters are to be settled under Delhi jurisdiction only.

First Edition: 1999, 2000

Second Edition: 2002, 2003
Third Edition: 2006
Revised Reprint 2007
Fourth Edition: 2009
ISBN 978-81-8448-580-6
Typeset at JPBMP typesetting unit
Printed at Ajanta
 To
The Children of India
Whose Care, Survival and
Development are Our Concern
IAP Textbook of Pediatrics
This textbook has covered all aspects of child health contributed by reputed authors, in addition to
National Health Programs. Thus, it has fulfilled all the criteria of a reader friendly treatise

Dr Uday Bodhankar
President, IAP 1995
President, ISTP 1999-2001
Nagpur

Several luminaries who are past and present teachers have contributed their might which has made the
present textbook a novel production in many aspects

Prof YC Mathur
President, IAP 2001
Hyderabad

Indeed it is a millennium gift to students and practitioners in a well written and well presented
comprehensive format covering A to Z in Pediatric care

Dr Swati Y Bhave
President, IAP 2000
New Delhi

Teachers of Pediatrics will find in this book guidelines for the course contents in undergraduate and
postgraduate medical education. Medical students will find readable and reasonably detailed, yet concise
information in this book, not only to complete the course and pass the final examination, but also to guide
them during their clinical career as intern, house surgeon and medical practitioner

Prof T Jacob John

President, IAP 1999
Vellore

I hope this textbook finds an appropriate place in the students' and practitioners' bookshelf. I sincerely
wish that this book is also suitable for undergraduates and postgraduates

Prof MR Lokeshwar
President, IAP 1998
Mumbai
Contributors
Aditi Sinha Agarwal RK Anand N Pandit
Senior Research Associate Consultant Child Specialist British Council Building
Department of Pediatrics RK Hospital 917/1 Fergusson College Road
All India Institute of Medical 5A Madhuban Pune 411 004, Maharashtra
Sciences, New Delhi 110 029 Opposite RSEB Window Email: kemhrc@vsnl.com
Residence Udaipur 313 001, Rajasthan
5B Srijan Apartments Email: rk_hospital@hotmail.com; Anand RK
B 9/8 Sector 62 presidentiap2008@gmail.com 55 Kavi Apartments, Worli
Noida Mumbai 400 018, Maharashtra
Uttar Pradesh Ajit Kumar
Email: ishanand@rediffmail.com
Email: aditisinha4@rediffmail.com 3/6/69/B/20/4/A
Avanti Colony
Near Skyline Theatre Anandam R
Advani SH
KB Lal Road, Bashirbag Professor of Pediatric Neurology (Retd)
Director
Hyderabad 500 029 Consultant Neurologist
Department of Medical Oncology
Jaslok Hospital, Peddar Road Andhra Pradesh PRS Hospital, Killippalam
Mumbai Thiruvananthapuram, Kerala
Maharashtra Amdekar YK Residence
Residence 151 Tushar 1st Floor RAJCOT
201 Satyam Shivam Sunderam 14th Road Chembur Thycaud
Ghatkopar Mumbai 400 071, Maharashtra Thiruvananthapuram 695 014
Mumbai 400 077 Email: ykasya@gmail.com Kerala
Maharashtra Email: anandam45@yahoo.com
Email: shadvani2000@rediffmail.com Amit Upadhyaya
Consultant Hematologist Anil Mokashi
Agarwal DK Sunflag-Pahuja Center for Ramabai Maternity General
D-115 Sector 36, Noida Blood Disorders and Childrens Hospital
Gautam Budh Nagar 201 301 Sunflag Hospital, Faridabad Baramati, Pune 413 102
Uttar Pradesh Haryana Maharashtra
Email: dramit.upadhyay@yahoo.co.in
Agarwal KN Anil Sachdev
D-115 Sector 36, Noida Amrish Vaidya
63/12
Gautam Budh Nagar 201 301 Consultant Pediatric Surgeon
Old Rajinder Nagar
Uttar Pradesh Kokilaben Dhirubhai Ambani
New Delhi 110 060, Delhi
Email: kna_noida@hotmail.com; Hospital, Andheri West
Email: anilcriticare@hotmail.com
adolcare@hotmail.com Mumbai 400 053
Maharashtra
Agarwal R Residence Anita Khalil
Department of Pediatrics 5E Sundatta Apartments The Heart Centre
BJ Wadia Hospital for Children and 10A Mount Pleasant Road 2 Ring Road
Institute of Child Health Mumbai 400 006 Lajpat Nagar IV
Parel, Mumbai 400 012 Maharashtra New Delhi 110 024, Delhi
Maharashtra Email: amrishvaidya@yahoo.com Email: anitakhalil@yahoo.com
X IAP Textbook of Pediatrics

Anju Aggarwal Archana Sathe Ashish R Bavdekar

Reader in Pediatrics Om Padmalaya 11 Yeshwant Nagar
University College of Medical 1123/A Shukrawar Peth Ganeshkhind Road
Sciences and Guru Tegh Bahadur Opposite Hirabag Pune 411 007
Hospital Pune 411 002 Maharashtra
Delhi Maharashtra Email: bavdekar@vsnl.com
Residence
Flat # 3C Block C2B, Janakpuri Armida Fernandez Ashok Gupta
New Delhi 110 058, Delhi 53 Sea Springs 25 Chetak Marg
Email: aggar_anju@yahoo.com; BJ Road, Band Stand Near JK LON Hospital
aanju67@gmail.com Bandra (West) Jaipur 302 004, Rajasthan
Mumbai 400 050 Email: dr_ashok_05@hotmail.com
Anju Virmani Maharashtra
C 6/6477 Email: drfernandez@snehamumbai.org Ashok K Deorari
Vasant Kanj Professor of Pediatrics
New Delhi 110 070 Arun Gupta Division of Neonatology
Email: virmani.anju@gmail.com BP 33, Pitampura All India Institute of
New Delhi 110 034, Delhi Medical Sciences
Anupam Sachdeva Email: ritarun@vsnl.com New Delhi 110 029
C-107 Neelambar Apartment Residence
Near Sainik Vihar Arun Kumar Gupta D-II/22, Ansari Nagar
Shakurbasti Professor and Head New Delhi 110 029, Delhi
New Delhi 110 034 Department of Radiodiagnosis Email: sdeorari@yahoo.com;
Email: anupamace@yahoo.co.in All India Institute of ashokdeorari_56@hotmail.com
Medical Sciences, New Delhi 110 029
Anupama Borker Email: arun676@hotmail.com; Ashok K Gupta
Consultant Pediatric arunk676@yahoo.com 50 B/D, Gandhinagar
Hemato-Oncologist Jammu 180 004
SL Raheja Hospital Arun Phatak Jammu and Kashmir
Mahim, Mumbai 102 Ambica Apartments Email: doc_ashokg@yahoo.com
Maharashtra Shanker Tekri
Residence Dandia Bazaar Ashok K Patwari
22 Kaustubh Plot # 8 Vadodara 390 001 Readers Flat # 4
Bandra Reclamation Gujarat LHMC Campus
Bandra (West) Email: atphatak@satyam.net.in Bangla Sahib Road
Mumbai 400 050 New Delhi 110 001
Maharashtra Arunmozhi T Email: akpatwari@hotmail.com;
Email: anupamasb@hotmail.com Assistant Professor of akpatwari@gmail.com
Community Medicine
Anurag Tomar Madras Medical College Ashok S Kapse
4 Govind Marg Residence Kapse Children Hospital
Jaipur 302 004 8I Block, 2nd Main Road 1st Floor, Akshar Complex
Rajasthan Chennai 600 102 B/H Rang Upvan, Makkaipool
Email: anurag@nimsr.com Tamil Nadu Surat 395 001, Gujarat
Email: ashokkapse@hotmail.com
Archana S Kher Arvind Bagga
6/A Anand Bhavan Professor of Pediatrics Babu George
36th Road, TPS III Division of Nephrology Medical Superintendent
Bandra (West) All India Institute of Medical Child Development Centre
Mumbai 400 050 Sciences, Ansari Nagar Medical College Campus
Maharashtra New Delhi 110 029 Thiruvananthapuram,
Email: kheras@bom8.vsnl.net Email: arvindbagga@hotmail.com Kerala
 Contributors XI

Balachandran A Bharat Agarwal Brijesh Arora

F/177 Plot # 235 A1101 Jagat Vidya CHS Associate Professor
Anna Nagar, Chennai 600 102 Behind Guru Nanak Hospital Pediatric Oncology
Tamil Nadu Bandra-Kurla Complex Tata Memorial Hospital
Email:dr_abalachandran@hotmail.com; Bandra (East) Ernest Borges Marg
drabalachandran@yahoo.com Mumbai 400 051 Parel, Mumbai 400 012
Maharashtra Maharashtra
Baldev S Prajapati Email: parul@bom5.vsnl.net.in Residence
Aakanksha Children Hospital House No 7 Anand Bhavan
Opposite Tulsishyam Flats Bhula Bhai Desai Road
Bharat Dalvi
Nava Vadaj Road Near Breech Candy Hospital
Division of Pediatric Cardiology
Ahmedabad 380 013 Mumbai 400 026
Gujarat Department of Cardiology Email: brijesharora@rediffmail.com
Email: drbprajapati@yahoo.co.in King Edward VII Memorial Hospital
Mumbai, Maharashtra Chandan J Das
Balvir S Tomar Senior Research Associate
4 Govind Marg Bhaskar Raju B Department of Radiodiagnosis
Jaipur 302 004 # 11 Sringeri Mutt Road All India Institute of Medical
Rajasthan Ramkrishna Nagar Sciences
Chennai 600 028 New Delhi 110 029
Banapurmath CR Tamil Nadu Email: chandanjd@yahoo.com
DOOR # 176 3rd Main Road Email: drbhaskarraju@yahoo.com
PJ Extension Choudhry VP
Devangere 577 002, Karnataka A-26 Shivalik
Bhavuk Garg
Email: crbanapurmath@hotmail. com Malviya Nagar
Senior Research Associate
New Delhi 110 017, Delhi
Banerjee SR Department of Orthopedics Email: vedpchoudhry@yahoo.co.in
8 Jessore Road, Dum Dum All India Institute of
Kolkata 700 028, West Bengal Medical Sciences Dadhich JP
Email: purnima@cal.bsnl.net.in; New Delhi 110 029 23 Canara Apartments
srbanerjee@vsnl.net Residence Sector 13, Rohini
525 Masjid Moth Doctors Hostel New Delhi 110 085, Delhi
Baskar PK Masjid Moth
Director Email: jpdadhich@gmail.com
New Delhi 110 049
Sri Viveka Institute of Dental
Email: drbhavukgarg@gmail.com Dagar KS
Sciences
54, GN Chetty Road, T Nagar Consultant
Bina Ahuja Department of Pediatrics and
Chennai 600 017, Tamil Nadu
Clinical Specialist Congenital Heart Surgery
Bhandari B National Polio Surveillance Project Escorts Heart Institute and
90/L Road, Bhupalpura India-WHO Research Centre, Okhla Road
Udaipur 313 001, Rajasthan RK Khanna Tennis Stadium New Delhi
Bhandari NR Africa Avenue
C-32 Koh-e-Fiza New Delhi 110 029 Dani VS
BDA Colony Residence Gandhi Sagar (East)
Bhopal 462 001 E 285 Narain Vihar Mahal
Madhya Pradesh New Delhi 110 028, Nagpur 440 002
Email: bhandari33@rediffmail.com; Email: ahujabina@rediffmail.com; Maharashtra
nr_bhandari@yahoo.com ahujabi@npsuindia.org Email: visadani@nagpur.dot.net.in
XII IAP Textbook of Pediatrics

Deepak Bansal Dutta AK Guruprasad G

House # 1334, Sector 19 Flat # 8 2164 Veda IV Main X Cross
Faridabad, Haryana Lady Hardinge Medical College MCC A Block
Email: deepakkritu@yahoo.com Campus, New Delhi 110 001, Delhi Devangere 577 004
Email: drdutta@gmail.com Karnataka
Deepak Seth Email: gurug61@hot.com;
Department of Pediatrics Gadadhar Sarangi dr_g_gp@yahoo.com
Himalayan Institute of Professor
Harish Kumar
Medical Sciences Department of Pediatrics
12/406 Sunder Vihar
Post Doiwala, Dehradun 248 140 Hitech Medical College, Pandara, New Delhi 110 041
Uttarakhand Bhubaneswar, Orissa Email: harishalwadhi@hotmail.com;
Email: drdeepakseth@rediffmail.com Residence hkumar@unicef.org
C/o Dr Laxmi Kanta Mohapatro
Indra Shekhar Rao M
Deepak Ugra At Telisahi (Parijat Lane)
Former Medical Superintendent
A-402/403 Sausalito Ranihat, Cuttack 753 001, Orissa Institute of Child Health and
Kia Park Prathamesh Complex Email: gdsarangi@sify.com; Niloufer Hospital, Hyderabad
Veera Desai Road, Andheri (West) gdsarangi@hotmail.com Andhra Pradesh
Mumbai 400 053 Residence
Email: deepakugra@hotmail.com Ganessan KM Indra Prastha
13 Chinna Mudali Street Plot # 106
Desai AB Gudiyattam Abhinav Nagar
1004 Panchtirth Gudiyattam 632 602, Tamil Nadu Secunderabad 500 025
Jodhpur Char Rasta, Satellite Email: dr_kmganessan@ rediffmail. com Andhra Pradesh
Ahmedabad 380 015, Gujarat Email: indramummulla@yahoo.co.in
Email: drabdesai@hotmail.com George Moses L
Iyer KS
Prof of Microbiology (Retd)
Senior Consultant and Head
Digant D Shastri Director
Department of Pediatrics and
Killol Children Hospital Kilpauk Laboratory Services Congenital Heart Surgery
303-304 Takshashila Apartments 27(12) Vasy Street Escorts Heart Institute and
Majuragate, Surat 395 002 Near Ega Theatre Research Centre, Okhla Road
Gujarat Kilpauk, Chennai - 600 010 New Delhi
Email: drdigant@hotmail.com
Jacob John T
Gowrishankar NC
Thekkekara 439 Civil Supplies
Dilip Mukherjee Assistant Professor Godown Lane
9/1 Ramnath Pal Road Department of Pulmonology Kamalakshipuram, Vellore
Kolkata 700 023 Institute of Child Health and North Arcot 632 002
West Bengal Hospital for Children Tamil Nadu
Email: dilipmukherjee@rediffmail.com Chennai 600 008 Email: vlr_tjjohn@sancharnet.in
Residence Jain MK
Divya Prabhat 12/A Balasubramaniam Street Quarters # 2
Ear Nose Throat Specialist and Mylapore Opposite District Hospital
Head and Neck Surgeon Chennai 600 004 Vidisha, Madhya Pradesh
Jeevak Hospital Tamilnadu
Opposite Asiad Bus Stand Jayakar Thomas
Senior Consultant Dermatologist
Dadar (East) Mumbai (East) Gupta BD Kanchi Kamakoti Childs TRUST
Vrandwan 120 Hospital and Mehtas Hospital
Dubey AP Bhagat Ki Kothi Extension Chennai, Tamil Nadu
6E MS Flats Near Asha Hospital Residence
Mint Road Complex Opposite New Campus 2 West Mada Church Road
New Delhi 110 002 Pali Road, Jodhpur 342 001 Royapuram
Email: apdubey52@rediffmail.com; Rajasthan Chennai 600 013, Tamil Nadu
anand_dubey52@hotmail.com Email: Brahmadgupta@Hotmail.com Email: jayakarthomas@gmail.com

Jayashree A Mondkar Kalpana D
22/24 Vaibhav Apartments Assistant Professor
SK Bole Road, Dadar Department of Pediatric Neurology
Mumbai 400 028 SAT Hospital
Maharashtra Medical College
Email: jamond@vsnl.com; Thiruvananthapuram 695 004,
jayashreemondkar@hotmail.com Kerala
Residence
Jayashree Muralidharan KALPANA
127 Type V PGI Flats NSP Nagar
Sector 24-A Kesavadasapuram
Chandigarh 160 023 Thiruvananthapuram 695 004,
Email: mjshree@hotmail.com Kerala
Email: vijaykal@hotmail.com
Jaydeep Choudhury
Assistant Professor Kamath SS
Department of Pediatrics XL/5152 TD Road (North End)
Institute of Child Health Kochi, Ernakulam 682 035
Kolkata, West Bengal Kerala
Residence Email: sskamath@vsnl.net
95/2 Ballygunge Place
Karmarkar DP
Kolkata 700 019
1165 Harbhat Road
West Bengal Karmarkar Wada
Email: drjaydeep_choudhury@ Sangli 416 416, Maharashtra
yahoo.co.in
Ketan Praveen Parikh
Jnanindra Nath Behera
Consultant Pediatric Surgeon and
Associate Professor of Pediatrics Pediatric Laparoscopist
SCB Medical College Kokilaben Dhirubhai Ambani
Cuttack 753 007, Orissa Hospital, Andheri West
Email:jnanindranathb@gmail.com Mumbai 400 053
Maharashtra
Joshi NC Residence
B-404 Kukreja Palace
19-B Kumkum Apartments
Vallabhbaug Lane Extension
SV Road, Vile Parle (West)
Ghatkopar (East)
Mumbai 400 056, Maharashtra Mumbai 400 075
Maharashtra
Jugesh Chhatwal Email: ketan40@hotmail.com
Department of Pediatrics
Keya R Lahiri
CMC Hospital
Professor and Head
Ludhiana 141 008, Punjab
Department of Pediatrics
Email:pediatricscmcl@rediffmail.com
Seth GS Medical College and
KEM Hospital
Kabra SK Parel, Mumbai 400 012
Additional Professor Residence
Department of Pediatrics Vijay Kunj B/10
All India Institute of Medical JN Road, Santacruz (East)
Sciences Mumbai 400 055
New Delhi 110 029 Maharashtra
Email: skkabra@rediffmail.com Email: infopediatrics@gsmc.edu
Contributors XIII
Kochupillai N
Director, Medical Research
MS Ramaiah Medical College and
Hospitals, MSR Nagar, MSRIT PO
Bengaluru 110 029, Karnataka
Email: kochupillai@gmail.com
Kotwal PP
Professor and Head
Department of Orthopedics
All India Institute of
Medical Sciences
New Delhi 110 029
Residence
C 1/19 Ansari Nagar
New Delhi 110 029
Email: prakash_kotwal@hotmail.com
Krishan Chugh
J-5/169
Rajouri Garden
New Delhi 110 027
Email: chughk2000@yahoo.co.in
Kulkarni ML
2373 MCC A Block
Devangere 577 004
Karnataka
Email: rajappanpillai@hotmail.com
Kumud P Mehta
Mother and Child Hospital
Gita 2nd Floor
P Ramabai Road
Gamdevi
Mumbai 400 007
Maharashtra
Email: mehtakumud@hotmail.com
Kundan Kumar Mittal
227-B Medical More
Model Town
Rohtak 124 001, Haryana
Email: kundanmittal@yahoo.co.in
Lokeshwar MR
19/54 Welfare Mansion
Sion, Mumbai 400 022
Maharashtra
Email: mrl123@roltanet.com;
mrlokeshwar@gmail.com
XIV IAP Textbook of Pediatrics

Madhulika Kabra Manju Mehta Meena R Malkani

Additional Professor Professor of Clinical Psychology F-6 Model House
Genetic Unit Department of Psychiatry 158 Sion (East)
Department of Pediatrics All India Institute of Medical Sciences Mumbai 400 022, Maharashtra
All India Institute of Medical Sciences New Delhi 110 029 Email: mmalkani@hotmail.com
New Delhi 110 029, Delhi Email: drmanju.mehta@gmail.com
Email: mkabra_aims@yahoo.co.in; Meenakshi N Mehta
madhulikakabra@hotmail.com Manorama Verma Shaivali C/3 9, BMC Colony
8 SF HIG Flats Kag Khan Road, Worli
Madhusudhana SN Bhai Randhir Singh (BRS) Nagar Mumbai 400 018, Maharashtra
Department of Virology Ferozepur Road
National Institute of Mental Health Ludhiana, Punjab Meharban Singh
and Neurological Sciences A-47 Sector 31, Noida
Bengaluru, Karnataka Gautam Budh Nagar 201 301
Marwaha RK
Professor of Pediatrics Uttar Pradesh
Mahadeviah M Email: meharbans_singh@gsk.com
Incharge, Division of Pediatric
518 Rajmahal Vilas Extension
Hematology-Oncology
Sadashiv Nagar Menon PSN
Advanced Pediatric Centre
Bengaluru 560 080 Consultant and Head
Postgraduate Institute of Medical
Karnataka Department of Pediatrics
Education and Research
Email: rmv518@yahoo.com Jaber Al-Ahmed Armed Forces
Chandigarh 160 012
Hospital, Kuwait
Maiya PP Email: rammarwaha1@rediffmail.com
Residence
343 25th Cross W1C 055 Wellington Estate
9th Main Road Mathur RC
DLF City Phase V
Banashankari II Stage 4-1-1233/5
Gurgaon 122 002, Haryana
Bengaluru, Karnataka Subhodaya Apartments
Email: psnmenon@hotmail.com
Email: p_maiya@hotmail.com Bogulkunta, ABIDS
Hyderabad 500 001 Milind S Tullu
Major K Nagaraju Andhra Pradesh Associate Professor
Senior Consultant in Email: rcmathur@hotmail.com Department of Pediatrics
Pediatric Allergy Seth GS Medical College
Kanchi Kamakoti Childs TRUST Mayilvahanan Natarajan KEM Hospital
Hospital Professor and Head Parel, Mumbai 400 012
12 A Nageswara Road Department of Orthopedic Surgery Residence
Nungambakkam Madras Medical College and 1 Sankalp Siddhi
Chennai 600 034 Government General Hospital Service Road, Kher Nagar
Email: majorknr@yahoo.co.in Chennai 600 003 Bandra East
Mumbai 400 051
Tamil Nadu
Malathi Sathiyasekaran Residence Nagabhushana S
# 16th Cross Street 4 Lakshmi Street Visiting Consultant
Indira Nagar Kilpauk Columbia Asia Hospital
Chennai 600 020 Chennai 600 010 Hebbal, Bengaluru
Tamil Nadu Tamil Nadu Residence
Email: mal.bwcs@gmail.com Aditya # 37/22/1
Meena P Desai
2nd Cross 1st Main
Mamta V Manglani 307 Samudra Mahal Sundarnagar
A-202 Casuarina, Evershine Greens Dr AB Road, Worli Post Gokula
New Link Road, Andheri (West) Mumbai 400 018 Bengaluru 560 054, Karnataka
Mumbai 400 102, Maharashtra Maharashtra Email: nagabhushana_s@rediffmail.com;
Email: mmanglani@hotmail.com Email: drmeenadesai@gmail.com respicon2005@yahoo.co.in

Nair MKC
TC 24/2049
Near Rose House
Womens College Junction
Thycand
Thiruvananthapuram 695 014,
Kerala
Email: nairmkc@rediffmail.com;
nairkc@rediffmail.com
Nammalwar BR
2 Main Road, Seetha Nagar
Nungambakkam
Chennai 600 034
Tamil Nadu
Email: brn@biosys.net
Nandini Mundkur
Bangalore Children Hospital
City Centre # 6 Chitrapur
Bhavan 8th Main 15th Cross
Malleswaram
Bengaluru 560 055
Karnataka
Email: bchrc@vsnl.com
Naveen Thacker
Past President, IAP
Deep Children Hospital
Plot 208, Sector 1-A
Opposite Hero Honda Showroom
Gandhidham, Kutch 372 201
Residence
D-70 Shaktinagar
Gandhidham
Kutch 370 201, Gujarat
Email: drnaveenthacker@gmail.com
Neeraj Jain
Associate Professor
Department of Pediatrics
Himalayan Institute of Medical
Sciences
Jolly Grant, Dehradun 248 140
Uttarakhand
Residence
A1/2 Maa Ganga Vaatika
Rishikesh, Uttarakhand
Email: neerajjain@vsnl.net
Contributors XV
Niranjan Shendurnikar Pankaj Hari
C/21 Nandigram # 2 Additional Professor
Sindhwai Maata Road Department of Pediatrics
Vadodara 390 004, Gujarat All India Institute of Medical
Email: drnsps@gmail.com Sciences, New Delhi 110 029
Email: pankajhari@hotmail.com
Nitin Chandra Mathur
4-1-1233/5 Subhodaya Panna Choudhury
ABIDS Consultant Pediatrician
Hyderabad 500 001 Department of Pediatrics
Andhra Pradesh Maulana Azad Medical College
Email: nitincmathur@gmail.com and Lok Nayak Hospital
New Delhi 110 002, Delhi
Nitin Shah Email: pannachoudhury@gmail.com;
186-A Vaswani Villa drpchoudhury@gmail.com
1st Floor Block # 3
Jain Society, Near Jain Temple Paramesh H
Sion (West), Mumbai 400 022 Medical and Managing Director
Maharashtra Lakeside Medical Center and
Email: drnitinshah@hotmail.com Hospital
33/4 Meanee Avenue Road
Noel Narayanan S Near Ulsoor Lake
TC 1/1991 9(1) Bengaluru 560 042, Karnataka
Keezhchira, Doctors Lane Email: dr_paramesh1@yahoo.com
Kumarapuram
Thiruvananthapuram 695 001 Parang N Mehta
Kerala 2/C Anjani Towers
Nupur Ganguly Parle Point
Assistant Professor of Pediatrics Athwa Lines
Institute of Child Health, Kolkata Surat 395 007
107 Garfa Pratapgarh Gujarat
Kolkata 700 075 Email: parang@rediffmail.com
Email: nupur_diya@yahoo.com
Parthasarathy A
Omprakash S Shukla Brindavan
33-B Shilalekh Bunglows 166 Park Road
Opposite Nandanvan Society Western Extension
Behind Railway Station, Alkapuri Anna Nagar
Vadodara 390 007, Gujarat Chennai 600 101
Email: opshukla2004@yahoo.co.in Email: apartha2000@yahoo.com
Pandian K Phadke KD
9B Medawakkam Road 707 14th Cross
Adambakkam JP Nagar II Phase
Chennai 600 088, Tamil Nadu Bengaluru 560 078
Email: pandianking@yahoo.com Karnataka
XVI IAP Textbook of Pediatrics

Piyush Gupta Residence Rakesh Lodha

Professor of Pediatrics B 301 Greenfields Assistant Professor of Pediatrics
University College of Medical Sciences Lokhandwala Complex All India Institute of
New Delhi Andheri West Medical Sciences
Editor-in-Chief, Indian Pediatrics Mumbai 400 053 New Delhi 110 029
Email: purna.kurkure@gmail.com Residence
Residence
Block # R-6-A A-5 Type # 5
Purvish M Parikh
Dilshad Garden IARI, Pusa, New Delhi 110 012,
9 Neeta Building
Near Telephone Exchange Above Computer Point Email: rakesh_lodha@hotmail.com,
Delhi 110 095 Opposite Poddar Hospital rlodha1661@gmail.com
Email: prof.piyush.gupta@gmail.com 227 Annie Besant Road
Worli, Mumbai 400 025 Ramachandran P
Potdar RD Maharashtra Institute of Child Health and
Laxmi Gruha
Hospital for Children
69 DV Pradhan Road Raghupathy P
Egmore, Chennai
Dadar (East) # 39 6th Cross 35th Main
KAS Officers Colony Tamil Nadu
Mumbai 400 014
Email: rdpotdar@snehamrc.com BTM Layout IInd Stage
Bengaluru 560 068 Ramakrishnan S
Prahlad N Karnataka Shreyas
Email: p.raghupathy@gmail.com 15/7 Vidya Marg
22/1 Poes Road, II Street
Teynampet Old Fatehpura
Rajeshwar Dayal
Chennai 600 018 Udaipur 313 004
Opposite Kidwai Park
Tamil Nadu Rajamandi Rajasthan
Email: drprahlad@yahoo.com Agra 282 002, Uttar Pradesh
Email: r_dayal123@rediffmail.com Ramaswamy Ganesh
Pratibha D Singhi Registrar in Pediatrics
Chief Pediatric Neurology and Rajniti Prasad Kanchi Kamakoti Childs TRUST
Neurodevelopment Senior Lecturer Hospital
Department of Pediatrics Department of Pediatrics 12-A Nageswara Road
Postgraduate Institute of Institute of Medical Sciences Nungambakkam
Medical Education and Research Banaras Hindu University Chennai 600 033
Varanasi 221 005
Chandigarh 160 012 Tamil Nadu
Residence
Email: pratibhasinghi@yahoo.com Residence
7 FF Kabir Colony
Banaras Hindu University 3-A Raju Street
Prisca Colaco Varanasi 221 005 West Mambalam
D-107 Gasper Enclave Email: rajaniti_prasad@hotmail.com Chennai 600 033
St Johns Road, Bandra
Rajput CS Ramesh S
Mumbai 400 050
C/o Dr Mrs MC Rajpur Consultant Pediatrician
Maharashtra
Department of OBGYN BRS Hospital
Purna A Kurkure Wanless Hospital 28, Cathedral Garden Road
Professor-in-Charge Miraj 416 410, Maharashtra Chennai 600 034
Pediatric Endocrinology Division Residence
Raju C Shah
HOD, Departemnt of Ankur Children Hospital New No 28 Old No 37
Medical Oncology Behind City Gold Cinema Madava Road
Tata Memorial Hospital Ashram Road Navarangpura Mahalingapuram
Dr Ernest Borges Marg Ahmedabad 380 009, Gujarat Chennai 600 034, Tamil Nadu
Parel, Mumbai 400 012 Email: rajucshah@rediffmail.com; Email: rameshsanthanakrishnan
Maharashtra rajucshah@lycos.com @gmail.com
 Contributors XVII

Rana KS Ritabrata Kundu Sachdev HPS

Senior Advisor Pediatrics and Professor of Pediatrics E 6/12, Vasant Vihar
Pediatric Neurology Institute of Child Health New Delhi 110 057
Army Hospital R & R, Delhi Cantt Kolkata, West Bengal Email: hpssachdev@hotmail.com
New Delhi 110 010 Residence
Email: kamersinghrana@yahoo.com.in 26A Sarat Chatterjee Road Sajid Qureshi
Lake Town Assistant Professor
Rao KS
Kolkata 700 089 Pediatric Surgical Oncology
Ragasudha
Email: rkundu22@gmail.com Tata Memorial Hospital
13/242 Matwada
Warangal 506 002 Dr Ernest Borges Marg
Andhra Pradesh Riyaz A
Parel, Mumbai 400 012
Arakkal
Maharashtra
Rashmi Dalvi Chalappuram
C/o Dr BV Dalvi Residence
Kozhikode 673 002
A-10 Mutual CHS 1/26 Merchant Building
Kerala
Mogul Lane, Mahim 3rd Sankli Street
Email: saif_gem@hotmail.com
Mumbai 400 016, Maharashtra Byculla, Mumbai 400 008
Maharashtra
Rashmi Kumar Rohit C Agrawal
Email: sajidshafique@rediffmail.com
HIG 111 Sector E Director
Aliganj, Lucknow 226 020 Chandra-Jyoti Children Hospital
Sandeep B Bavdekar
Uttar Pradesh Mumbai, Maharashtra
Email: rashmik2005@gmail.com; A-2/9 Worli Seaside CHS
Residence
rashmik06@yahoo.co.in Kag Khan Road, Worli
603/4 Vindyachal
Neelkanth Valley Mumbai 400 018
Ravichander B Maharashtra
Senior Pediatric Consultant 7th Road Raja Wadi
Ghatkopar (East) Email: drsbavdekar@vsnl.com
Military Hospital
Bengaluru, Karnataka Mumbai 400 077
Maharashtra Sankaranarayanan VS
Email: drrohitag@hotmail.com 16 Balaji Avenue
Ravikumar T
New # 31 Old # 14 T Nagar, 1st Street
Jaganathapuram Roshani N Taori Chennai 600 017, Tamil Nadu
3rd Street Chetpet Research Officer Email: drvssankaranarayanan@gmail.com
Chennai 600 031 Department of Pediatrics Santosh K Bhargava
Tamil Nadu Seth GS Medical College D 7 Gulmohar Park
Email: trkoomar@hotmail.com KEM Hospital, Parel New Delhi 110 049
Mumbai 400 012, Maharashtra
Ravikumar VR Email: santoshb@ndf.vsnl.net.in
Email: roshanitaori@hotmail.com
66 Cooperative Colony Saradha Suresh
KK Pudur Roshni Bhagwat Director and Superintendent
Coimbatore 641 038 Consultant Pediatric Oncologist Institute of Child Health and
Tamil Nadu Mahakoshal Hospital Hospital for Children
Email: masr.mar@usa.net
Jabalpur, Madhya Pradesh Egmore, Chennai 600 008
Renu Sexena
Residence Tamil Nadu
Professor and Head Vatika Duplex
Department of Hematology 65 Napier Town Saroj Mehta
All India Institute of Jabalpur 482 001 1159/15C, Chandigarh 160 015
Medical Sciences Madhya Pradesh Chandigarh
New Delhi 110 029 Email: roshni26@yahoo.com Email: ssmehta100@yahoo.com
XVIII IAP Textbook of Pediatrics
Shah MD
51 2nd Floor Jashoda Niwas
Nehru Road
Vile Parle (East)
Mumbai 400 057
Maharashtra
Email: shahmdip@vsnl.net
Shailesh Kanvinde
Consultant Pediatric Hematologist
and Oncologist
Deenanath Mangeshkar Hospital
Pune, Maharashtra
Residence
Prerana Society
Opposite New Abhinav Vidyalaya
37/2 Erandavane
Pune 411 038
Maharashtra
Email: skanvin@vsnl.net;
skanvinde@123inida.com
Shanti Ghosh
5 Sri Aurobindo Marg
New Delhi 110 016, Delhi
Email: sghosh@del13.vsnl.net.in
Shashi N Vani
10 Shamiana
61 Brahmin Mitra Mandal Society
Ahmedabad 380 006, Gujarat
Sheila Bhave
9 Solapur Road
Pune 411 001
Maharashtra
Email: sheilabhave@vsnl.net
Shivananda
Siddhi 608 3rd Stage
3rd Block, 7th Main
Basaveshwaranagar
Bengaluru 560 079
Karnataka
Email: sssidhi@rediffmail.com
Shivbalan SO
Consultant Pediatrician and
Pulmonologist
Sundaram Medical Foundation
Chennai, Tamil Nadu
Email: sivabalan.somu@gmail.com
Shobha Banapurmath Chennai 600 017
390 8th Main Tamil Nadu
PJ Extension Email: dr.srinivas@gmail.com
Devangere 577 002
Karnataka Srinivasan S
Email: sbanapurmath@hotmail.com C II/4 Dhanvanthari Nagar
JIPMER, Puducherry 605 006
Shreekant W Chorghade
Puducherry
Rajeev
Email: srinivasan_jip@yahoo.co.uk
Dharampeth
Nagpur 440 010, Maharashtra
Srivastava RN
Email: chorghade1@hotmail.com
487 Mandakini Enclave
Alaknanda
Shripad Banavali
New Delhi 110 019
Professor of Pediatric Oncology
Email: rnsri@vsnl.net
Department of Medical Oncology
Tata Memorial Hospital
Srivastava SP
Dr Ernest Borges Marg
S-104 Udai Giri Bhavan
Parel, Mumbai 400 012
Budh Marg Road, Patna 800 001
Maharashtra
Bihar
Residence
Email: spsrivastava13@yahoo.com
# 11-A Jyoti Sadan,
Sheetla Devi Temple Road, Mahim
Subhash J Dalal
Mumbai 400 016
Consultant Pediatric Surgeon
Email: banavali_2000@yahoo.com
Former Dean, Wadia Childrens
Hospital
Soumya Swaminathan
Residence
B-8 Sagarika
3 Maheshwar Niketan
15-III Seaward Road
Peddar Road, Mumbai 400 026
Valmiki Nagar
Maharashtra
Chennai 600 041
Tamil Nadu
Email: doctorsoumya@yahoo.com Subramanyam L
9-A Karneeswarar Koil Street
Srikanta Basu Santhome, Chennai 600 004
# 318 Aashirwad Enclave Tamil Nadu
104 IP Extension Email: shivbalam1@rediffmail.com
Patparganj
New Delhi 110 092
Suchitra Ranjit
Email: srikantabasu@hotmail.com;
G/A Ranga Nivas
srikantab@yahoo.com
40 Barnaby Road, Kilpauk
Chennai 600 010, Tamil Nadu
Srinivas S
Email: chitrasona@rediffmail.com
Department of Gastroenterology
Royal Children's Hospital
Melbourne Sudeshna Mitra
Australia Department of Pediatrics
Residence Postgraduate Institute of Medical
14 Balaji Avenue Education and Research
1st Street Chandigarh 160 012
Thiagarajanagar Email: mitrasudeshna@hotmail.com
 Contributors XIX

Sumathi B Surjit Singh Tapan Kumar Ghosh

Assistant Professor Department of Pediatrics Scientific Coordinator
Department of Pediatric PGIMER, Chandigarh 160 012 Institute of Child Health
Gastroenterology Chandigarh Kolkata
Institute of Child Health and Email: surjitsinghpgi@hotmail.com; Residence
Hospital for Children surjitsingh@sify.com 13 Neogi Pukur Bye Lane
Egmore, Chennai 600 008 Kolkata 700 014
Residence Sushil Madan West Bengal
New No 6 (Old 24) 804-2A Brindaban Apartments Email: dr_tkghosh@rediffmail.com,
Kutchery Lane Poonam Nagar, Andheri (East) dr.tkghosh@yahoo.in
Mylapore Mumbai 400 093, Maharashtra
Chennai 600 004
Swati Kanakia Tewari AD
Tamil Nadu
2/10 Shreeji Sadan 1459 Sector 3, Rohtak 124 001
Email: drbsumathi@rediffmail.com
Vrindavan Society Haryana
Sunanda K Reddy Vrindavan Chowk Email: ad_tewari@hotmail.com
Consultant Neurodevelopmental Sion, Chunabhatti
Pediatrician Mumbai 400 022
Thangadorai C
K-118 Ground Floor Maharashtra
18 Taylors Road, Kilpauk
Hauz Khas Enclave Email: drkanakia@vsnl.com
Chennai 600 010
New Delhi 110 016 Tamil Nadu
Email: write2sunanda@gmail.com; Swati Y Bhave
C II/47 Shahjahan Road Email: thangadorai@yahoo.com
carenidhi@gmail.com
Opposite UPSC Office
Sunil Karande New Delhi 110 003, Delhi Thangavelu S
Flat # 24 Joothica, 5th Floor Email: sybhave@yahoo.com;
H-15, G-2 Sea Breeze Apartments
sybhave@gmail.com
22A Naushir Bharucha Road Thiruvalluvar Nagar
Mumbai 400 007 Thiruvanmiyur
Tanmay Amladi
Maharashtra Chennai 600 041, Tamil Nadu
Honorary Neonatologist
Email: karandesunil@yahoo.com Email: thangavelu_s@yahoo.com
Nowrosjee Wadia Maternity
Hospital and NICU Parel, Mumbai
Sunit C Singhi
Residence Thapa BR
Professor and Head
A/50/1368 MIG Division of Pediatric
Department of Pediatrics
Adarsh Nagar CHS Ltd Gastroenterology
Advanced Pediatric Centre
Prabhadevi PGIMER
PGIMER, Chandigarh 160 012
Mumbai 400 025
Email: sunit.singhi@gmail.com; Chandigarh 160 012
Maharashtra
dr_singhi@yahoo.com Chandigarh
Email: tanmayamladi@gmail.com
Email: brthapa1@yahoo.co.in;
Supriyo Ghose Tanu Singhal pgimer@chd.nic.in
Chief, Professor and Head of Consultant Pediatrician
Department of Ophthalmology Kokilaben Dhirubhai Ambani Thirugnanasambandham C
Rajendra Prasad Centre for Hospital and Medical Research Institute 8 I Block
Ophthalmic Sciences Four Bungalows, Andheri West 2nd Main Road
All India Institute of Medical Sciences Mumbai 400 053, Maharashtra Chennai 600 102
New Delhi 110 029 Email: tanusinghal@yahoo.com Tamil Nadu
XX IAP Textbook of Pediatrics

Uday B Nadkarni Vasanthi T Vijay Agarwal

2 Vaibhav, Plot # 12-13 Old # 4/123 New # 4/693 Cottage # 15
Linking Road Extension 7th Main Road, Swaminatha Nagar Oberai Apartments
Santacruz (West) Kottivakkam 2 Sham Nath Marg
Mumbai 400 054 Chennai 600 041 Delhi 110 054
Maharashtra Tamil Nadu Email: vijay@webcottage.com
Email: drvasanthi@hotmail.com
Upadhyay SK Veena Kalra Vijay N Yewle
402 Bhimarathi Building Senior Consultant Pediatrics Yewale Hospital
Road # 3 Daulal Nagar (Pediatric Neurology) Plot 6B Sector 9
Borivali (East) Indraprastha Apollo Hospitals Vashi 400 703
Mumbai 400 066 Sarita Vihar, Delhi Mathura Road Navi Mumbai
Maharashtra New Delhi 110 076 Maharashtra
Residence Email: vnyewale@vsnl.com;
Utpal Kant Singh 101 Jorbagh vntewale@gmail.com
Professor and Head New Delhi 110 003, Delhi
Department of Pediatrics Email: kalra.veena@gmail.com
Vijayakumar M
Nalanda Medical College
Flat # 4 Muktha Vandan
Patna, Bihar Vibha Jain Old # 4 New # 7
Residence Consultant Ramanathan Street
8 Rajendra Nagar Department of Pediatrics Kilpauk
Patna 800 016, Bihar Himalayan Institute of Chennai 600 010
Email: utpalkant.singh@yahoo.co.in Medical Sciences Email: drmvk@vsnl.net
Jolly Grant, Dehradun 248 140
Vaman V Khadilkar
Uttarakhand
B-3 Shashi Kiran Apartment Vijayalakshmi Bhatia
Residence
Ashok Path Professor
77 SBM Complex
Off Law College Road Department of Endocrinology
Haridwar Road
Erandwane Sanjay Gandhi Postgraduate
Rishikesh
Pune 411 004, Maharashtra Institute of Medical Sciences
Email: vkhadilk@vsnl.com; Vibha Mangal Post Box # 375
akhadilkar@vsnl.net Consultant Lucknow 226 001
Department of Pediatrics Uttar Pradesh
Varshney MK Email: vbhatia@sushrut.s.gpgi.ac.in
Himalayan Institute of
Senior Research Associate
Medical Sciences
Department of Orthopedics
Swami Rama Nagar
All India Institute of Medical Sciences Vijayasekaran D
Dehradun 248 140
New Delhi 110 029 # 43rd Cross Street
Uttarakhand
Residence Dr Subbaraya Nagar
521 Masjid Moth Doctors Hostel Vibhu Kwatra Kodambakkam
Masjid Moth Vibhu Nursing Home Chennai 600 024
New Delhi 110 049 11/137 Malviya Nagar Tamil Nadu
Email: drmkvarshney@gmail.com New Delhi Email: vijsekar@hotmail.com
 Contributors XXI

Vimlesh Seth Walia BNS Yuvaraj Chandra Mathur

N-14/D DDA Flats (SFS) 1004 Sector 11-C 4-1-1233 Boggul Kunta
Mandir Marg, Saket Chandigarh 160 011 Subodaya
New Delhi 110 017, Delhi Email: bnswalia@hotmail.com Hyderabad 500 001
Email: drsdseth@yahoo.com
Wilson CG Andhra Pradesh
Vinod K Paul House # 117 Sector A Email: ycmathur@hotmail.com
Professor and Head A WHO Colony
Department of Pediatrics Gautam Enclave Zeenat Currimbhoy
All India Institute of Medical Sciences Secunderabad 500 009
Ansari Nagar Division of Pediatric
Andhra Pradesh Hemato-Oncology
New Delhi 110 029, Delhi
Email: info@kimsmedicalcollege.org Department of Pediatrics
Email: vkpaul@medinst.ernet.in;
vinodkpaul@hotmail.com LTMG Hospital and
Yogesh C Govil
LTM Medical College
Vipin M Vashishtha 4006/1/2, A-2 Balda Colony
Consultant Pediatrician and Sion, Mumbai 400 022
New Hyderabad
Neonatologist, Mangla Hospital Maharashtra
Lucknow 226 007
Shakti Chowk, Station Road Email: currimbhoyzinet@gmail.com
Uttar Pradesh
Bijnor 246 701, Uttar Pradesh Email: yogeshgovil@usa.net
Email: vipin@iappec.com,
vipinipsita@gmail.com Zulfikar Ahamed M
Yogesh Jain
SAJAN, TC 1072/4
Vrajesh P Udani Jan Swasthya Sahyog
Pazhaya Road MCPO
69 Al Jebreya Court I-4 Parijat Colony
Nehru Nagar Thiruvananthapuram 695 011
Marine Drive, Mumbai 400 020
Maharashtra Bilaspur 495 001 Kerala
Email: vrajesh@vsnl.com; Chhattisgarh Email::mzulfikarahamed@rediffmail.com;
vrajeshudani@yahoo.co.in Email: janswasthya@gmail.com zulfikarahamedm@sancharnet
Foreword
Child health needs of developing countries are altogether different. Indian Academy of Pediatrics is dedicated for
total child welfare from zero to eighteen years of age. With this aim, the first edition was published in 1999 and in
ten years it has been so popular, not only in India but in SAARC and many developing countries. It speaks of its
receptivity, utility, affectivity and relevance. And now with much enthusiasm and pleasure, the fourth edition is in
your hands.
I sincerely appreciate Dr A Parthasarathys dedication and commitment to the children and in the professional
front in our country. His untiring efforts will serve as an inspiration for young pediatricians to emulate and encourage
them to contribute to ailing society along their professional path with sincere services.
It is certainly a matter of pride to note that many senior pediatricians have been taking time off their innumerable
social commitments to pool valuable knowledge in the form of this book. I admire all the editors and contributors
for this rich compilation.
The contents of the book have been chosen very carefully for developing as well as developed countries and
have broadly covered the relevant and vital issues of Comprehensive Child Health Care. Considering the caliber
and expertise of contributors and authors, I am convinced that the book will be a treasure of knowledge to be
cherished by the pediatricians across the world.

RK Agarwal
National President, 2008
Indian Academy of Pediatrics
Foreword
Specialty of Pediatrics covers more than 50 percent of the population. Infant and childhood morbidity continue to be
very high and adolescent health problems are still not adequately addressed by medical profession. Thus, it is
imperative that budding doctors need to have sound training to look after the children from birth to 18 years.
Pediatrics is a part of undergraduate curriculum and there is tremendous demand for a textbook on pediatrics. For
credibility it is also necessary that the book is evidence based. IAP Textbook of Pediatrics fulfills an important void
in this direction and has become immensely popular with all its editions. The book has been well received in many
developing countries having similar health scenario.
Contributors of this book are renowned experts in their respective fields. An invariable problem with multi-
authored texts is the diversity of presentations adopted by a multitude of contributors. Dr A Parthasarathy, Editor-
in-Chief of the book since inception and an accomplished academician with tremendous zeal, managed this issue by
carefully crafting a common editorial style. In this venture he has been aptly assisted by Dr PSN Menon and
Dr Piyush Gupta, along with many highly reputed chapter editors. Keeping with time, the text of the book has been
aptly modified and all the chapters have been thoroughly revised.
The book is designed to be relevant to the need of the developing countries. Emphasis has been on common
prevalent conditions though allied subjects seen in children have also received due attention. Section on Community
Pediatrics deserves special mention as most textbooks with western approach hardly provide any information in
this respect. The book is voluminous which is inherent in a textbook trying to cover all aspects related to pediatric
care.
Apart from fulfilling the main function of an excellent undergraduate textbook, this edition would be invaluable
for residents and medical practitioners interested to know in detail various childhood conditions. Even postgraduate
students will find much useful information. The book certainly will continue to remain as a very prestigious
publication of Indian Academy of Pediatrics and serve the nation by helping doctors engaged in the care of children
needing latest updates.

Panna Choudhury
Consultant Pediatrician
Lok Nayak Hospital
New Delhi 110 002 and
National President
Indian Academy of Pediatrics 2009
Preface to the Fourth Edition
The last few years have witnessed a rapid progress in medicine and technological advances in biological sciences.
The specialty of Pediatrics has perceived further advances in preventive and therapeutic care. These have provided
impetus to revise knowledge, harvest new information and thus continue the process of learning. There was a felt
need for publication of an updated fourth edition of this book after a gap of three years. This was also prompted by
the enthusiastic response to the previous editions from practicing pediatricians, postgraduates, undergraduates as
well as faculty of Departments of Pediatrics throughout the country.
It has been our endeavor to present this subject in a simplified, practical manner to provide adequate clinical
guidance to pediatricians so that children derive the benefits of early diagnosis and optimal treatment. The basic
outline of the book is retained. We have tried our best to oversee that the art and science of clinical pediatrics
maintains its central position without being overshadowed by newer technical advances.
This fourth edition of the IAP Textbook represents a substantial revision and reorganization of the text based on
a complete review of the field of Pediatrics. It has 36 chapters and is being published in two volumes for the first
time. The first volume consists of 16 chapters with 195 subchapters contributed by 171 authors and the second
volume contains 20 chapters with 95 subchapters by 89 authors. The first volume features 28 new authors while the
second volume has 14 new authors representing the continuum of the best available talent, both experienced and
young with vast experience and expertise. Almost all the chapters have been thoroughly revised and updated in a
lucid and readable style.
Several new chapters have been added keeping in mind the changing concepts of pediatric care in the global
scenario. Some of these include child and adolescent school health education, vaccine storage and handling adverse
effects following immunization, parent counseling, practical approach to fever in children, pneumococcal infection
and its prevention, chikungunya fever, hemoptysis, gastroesophageal reflux, allergen-specific immunotherapy,
antiphospholipid syndrome, vasculitis, intravenous immunoglobulin, polycystic ovarian syndrome, etc. The chapters
on research methodology and computers serve a long felt need.
In addition, the IAP Infectious Diseases Chapter Protocols on selected infectious diseases viz. malaria, enteric
fever, pyogenic meningitis and rabies have been incorporated in the Miscellaneous Topics. This edition also provides
the most recent IAP recommendations on immunization of children and adolescents. The current IAP and WHO
growth charts have been appended with details on the techniques of measurement and interpretation. Unfortunately
many children, especially from the rural and remote areas have not yet benefited from the significant advances in
the prevention and care of many health problems. In this context the two chapters viz. National Rural Health Mission
and Pediatric Priorities in the 21st Century are rewritten. The chapter on Common Procedures has been updated.
The Academy would like to place on record its appreciation to all the authors for their contributions to the fourth
edition. It also gratefully acknowledges the efforts and time spent by Senior Editors and Chapter Editors who have
devoted great deal of their time reviewing and editing the manuscripts. The support from the office-bearers and
staff of the IAP Central Office Secretariat at all stages is appreciatively accredited. The book would not have seen the
light of the day but for the support and excellent cooperation of M/s Jaypee Brothers Medical Publishers (P) Ltd,
New Delhi.
It is our earnest hope that this new edition of the IAP Textbook will help in early diagnosis and efficient
management leading to optimal outcome and improving the quality of patient care.

A Parthasarathy
PSN Menon
Piyush Gupta
MKC Nair
Preface to the First Edition
Pediatrics has grown and developed with significant milestones in preventive and therapeutic care over the past
few decades. The WHO and UNICEF in their Primary Health Care (PHC) approach, have given due importance for
effective child survival programs. So much so the medical students need to be well oriented towards these approaches
in Pediatrics as the future middle level managers in Primary Health Care.
Several luminaries in the Indian pediatric scenario, have contributed their might in bringing out books for the
undergraduate medical students. However, the rapid advances made in the various pediatric subspecialties have
necessitated the updating of these books from time to time. Nevertheless, the need for a full fledged textbook was
felt for long. The Indian Academy of Pediatrics thought it fit, to shoulder the responsibility of bringing out such a
need based Textbook in Pediatrics for medical students. Our erudite and enthusiastic editors and contributors
made it possible at a record time. The Academy owes its gratitude to all these experts for their worthy contribution.
The book has been divided into several sections. A few chapters included in this book are entirely newer concepts
which are not usually found in the conventional pediatric textbooks. It has also worthy annexures to the main
contents. However, editing the text to suit the needs of medical students was a Himalayan task. The idea is to equip
the medical students with adequate knowledge in Pediatrics in order to make them confident to shoulder the
responsibilities concerned with preventive and curative Pediatrics. Thus, it is hoped that the practitioners of Pediatric
Medicine will benefit from this book.
We are confident that this book will serve the needs of medical students especially at a time when the Medical
Council of India has made Pediatrics as a major examination subject. Thus, the publication of the book is not only
timely but also out of necessity.
The Academy would like to place on record its appreciation to the senior editors, chapter editors, contributors,
and staff members of IAP Central Secretariat for help rendered in the creation of this book and M/s Jaypee Brothers
Medical Publishers (P) Ltd., New Delhi, for their excellent cooperation in bringing out the First Edition at record
time.

A Parthasarathy
PSN Menon
MKC Nair
Acknowledgements
We are indebted to the President and members of the Executive Board 1997 of the Indian Academy of Pediatrics
(IAP) for the initiation and completion of the project of bringing out the first ever Academys textbook for medical
students and practitioners. We are also thankful to the successive Presidents and members of the Executive Boards
1998-2008 for their encouragement in sustaining the project towards the publication of the Fourth Edition.
Our grateful thanks go to the various contributors and senior editors, past and present teachers of Pediatrics who
have made this Himalayan task a reality by their precise and updated text. We are indebted to the faculty and
residents of the All India Institute of Medical Sciences, New Delhi for shaping the contents of the First Edition which
has made the production of the subsequent editions an easy task and to Ms Manju, Ms Chitra and Ms Suman for
their assistance in typing and drafting the text of the book for the first edition.
The secretarial and organizational skills of Mr Joseph A Gonzalves and his supportive staff of IAP Central Office,
Mumbai, so ably and meticulously guided by Dr Rohit Agrawal, Secretary General and Dr Tanmay Amladi, Treasurer
are also gratefully acknowledged. The coordination efforts of Mrs Lokanayaki Ethirajan, Mrs Nirmala Parthasarathy,
Dr (Mrs) Pratibha Janardhanan, Mrs Kavitha Balaji, Mr A Sriramulu and Mr Louis Francis are acknowledged with
thanks.
Mr R Janardhanan, Mr P Balaji, Ms Shruthi Pavana, Ms Swathi Pavana, Ms Kavya Balaji and Ms Mahia Balaji at
Chennai need special mention for their untiring assistance in correspondence and formatting of the book with
updated contents.
Our grateful thanks are due to Mr Shaji Jacob Ninan and Dr Nazeer Ahamed at Kuwait for the assistance rendered
to the senior editor in editing, scrutinizing and proofreading of the individual chapter files.
Our sincere and grateful thanks go to the family of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi,
especially Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Vij (Director-Pharma), Mr Tarun Duneja
(Director-Publishing), Mr KK Raman (Production Manager), Ms Samina Khan (PA to the Director-Publishing),
Mr Ashutosh Srivastava (Assistant Editor), Ms Yashu Kapoor and Ms Kamlesh Bisht (DTP Operators) and
Ms Sonia Mehta (Graphic Designer) for their untiring coordination efforts in the production of the Fourth Edition.
We also place on record our sincere appreciation of the help rendered by the local branch managers of the Jaypee
Brothers Mr Mukherjee, (Chennai), Mr Uday Honnemadi (Mumbai), Mr Jayanandan (Author Co-ordinator,
Chennai), Mr Damodharan (Field Executive, Chennai) and the headquarters staff at New Delhi for the help
rendered to the Editor-in-Chief and Academic/Senior Editors.
All attempts have been made to acknowledge the sources of information and illustrations. Inadvertent omission,
if any, is regretted.

A Parthasarathy
PSN Menon
Piyush Gupta
MKC Nair
Contents
Volume 1
1. PEDIATRIC CARE IN DEVELOPING COUNTRIES
Chapter Editor: Piyush Gupta
1.1 Importance of Pediatrics ............................................................................................................................ 2
RD Potdar
1.2 Attaining Proficiency in Pediatrics .......................................................................................................... 3
BNS Walia
1.3 Pediatric Care in Developing Countries ................................................................................................. 5
BNS Walia
1.4 Primary Health Care ................................................................................................................................... 7
Yuvraj Chandra Mathur, Nitin Chandra Mathur
1.5 Primary Neonatal Care .............................................................................................................................. 9
Santosh K Bhargava
1.6 Management of Primary Health Center ............................................................................................... 12
Piyush Gupta
1.7 Training of Medical Graduate as Middle Level Manager ................................................................ 16
C Thirugnanasambandham, T Arunmozhi

2. HISTORY ELICITATION AND PHYSICAL EXAMINATION

Chapter Editors: PSN Menon, Piyush Gupta
2.1 History Elicitation ..................................................................................................................................... 24
T Ravikumar, C Thangadorai
2.2 Physical Examination and Clinical Skill Development .................................................................... 30
C Thangadorai, T Ravikumar
2.3 Parent Counseling .................................................................................................................................... 40
Parang N Mehta

3. NEWBORN CARE
Chapter Editor: Ashok K Deorari
3.1 Neonatal Nomenclature and Definitions ............................................................................................. 46
Meharban Singh, Vinod K Paul
3.2 Resuscitation of an Asphyxiated Newborn Baby ............................................................................... 50
Meharban Singh, Ashok K Deorari
3.3 Care of a Normal Newborn Baby .......................................................................................................... 56
Meharban Singh, Ashok K Deorari
XXXIV IAP Textbook of Pediatrics

3.4 Common Developmental and Physiological Problems in Newborn Babies ................................. 61

Meharban Singh, Vinod K Paul
3.5 Management of Low Birth Weight Babies ........................................................................................... 65
Vinod K Paul, Ashok K Deorari, Meharban Singh
3.6 Common Diseases of Newborn Babies ................................................................................................ 71
Meharban Singh, Vinod K Paul, Ashok K Deorari

4. GROWTH AND DEVELOPMENT

Chapter Editor: KN Agarwal
4.1 Growth and Development: Basic Concepts ......................................................................................... 80
AB Desai, Dilip Mukherjee
4.2 GrowthBirth to Puberty ....................................................................................................................... 83
KN Agarwal, DK Agarwal, SK Upadhyay
4.3 Physical Growth and Sexual Development in Adolescence ............................................................. 96
KN Agarwal, DK Agarwal, SK Upadhyay
4.4 Development ........................................................................................................................................... 105
KN Agarwal, DK Agarwal, SK Upadhyay
4.5 Failure to Thrive ...................................................................................................................................... 111
Madhulika Kabra, PSN Menon

5. INFANT FEEDING
Chapter Editor: RK Anand
5.1 Infant and Young Child Feeding ......................................................................................................... 116
RK Anand, SP Srivastava
5.2 Breastfeeding and Weaning .................................................................................................................. 122
RK Anand, SP Srivastava, Arun Gupta, JP Dadhich

6. NUTRITION
Chapter Editor: Meenakshi N Mehta
6.1 Protein Energy Malnutrition ............................................................................................................... 136
Meenakshi N Mehta
6.2 Water Soluble Vitamins: B Complex Vitamins ................................................................................ 163
Shashi N Vani
6.3 Fat Soluble Vitamins ............................................................................................................................. 166
Panna Choudhury
6.4 Trace Elements ....................................................................................................................................... 171
B Bhandari
6.5 Child and Adolescent School Health Education .............................................................................. 176
Sushil Madan
 Contents XXXV

7. COMMUNITY PEDIATRICS
Chapter Editor: Piyush Gupta
7.1 Community Pediatrics .......................................................................................................................... 188
Shashi N Vani
7.2 National Health Programs .................................................................................................................... 190
Shashi N Vani, Piyush Gupta
7.2.1 National Rural Health Mission (NRHM) 2005-2012 ........................................................... 191
Piyush Gupta
7.2.2 Maternal and Child Health (MCH) Programs ...................................................................... 193
Shashi N Vani
7.2.3 Integrated Child Development Services (ICDS) Program ................................................. 194
BNS Walia
7.2.4 Child Survival and Safe Motherhood (CSSM) Program .................................................... 196
BNS Walia
7.2.5 Reproductive and Child Health (RCH) Program ................................................................. 197
BNS Walia, Shashi N Vani
7.2.6 Integrated Management of Neonatal and Childhood Illness (IMNCI) Strategy .......... 200
BNS Walia
7.2.7 National Programs on Immunization .................................................................................... 200
A Parthasarathy, Shashi N Vani, BNS Walia
7.2.7.1 Universal Immunization Program (UIP) .................................................................. 200
KM Ganessan
7.2.8 Acute Respiratory Infections (ARI) Control Program ........................................................ 202
Keya R Lahiri, BNS Walia, Shashi N Vani
7.2.9 Control of Diarrheal Disease (CDD) Program ..................................................................... 203
BNS Walia, Shashi N Vani
7.2.10 National Leprosy Eradication Program ................................................................................. 204
BNS Walia
7.2.11 National Vector Borne Disease Control Program (NVBDCP) .......................................... 206
Piyush Gupta
7.2.11.1 National Malaria Control Program ................................................................... 206
BNS Walia
7.2.11.2 National Filaria Control Program ...................................................................... 207
BNS Walia
7.2.12 National AIDS and STD Control Program ........................................................................... 207
BNS Walia
7.2.13 Nutrition Programs ................................................................................................................... 208
Shashi N Vani
7.2.14 Mid-day Meal Program ............................................................................................................ 209
HPS Sachdev
7.2.15 Anemia Control Program ......................................................................................................... 209
Shashi N Vani
7.2.16 Control of Vitamin A Deficiency ........................................................................................... 210
BNS Walia
7.2.17 National Iodine Deficiency Disorders Control Program ................................................... 210
N Kochupillai
XXXVI IAP Textbook of Pediatrics

7.2.18 National School Health Program .......................................................................................... 211

BNS Walia
7.2.19 National Cancer Control Program ......................................................................................... 211
BNS Walia
7.2.20 National Mental Health Program (NMHP) ......................................................................... 211
BNS Walia
7.2.21 National Program for Control of Blindness ........................................................................ 211
BNS Walia
7.3 Community Newborn Care .................................................................................................................. 212
Shashi N Vani
7.4 Under Five Clinics ................................................................................................................................. 215
Ajit Kumar
7.5 The Girl Child ........................................................................................................................................ 218
Shanti Ghosh
7.6 Customs and Beliefs in Child Rearing .............................................................................................. 220
Anil Mokashi
7.7 International Agencies and Child Health ......................................................................................... 225
Shashi N Vani
7.8 Adoption and Care of Orphans ........................................................................................................... 226
RD Potdar

8. CHILD ABUSE, NEGLECT AND CHILD LABOR

Chapter Editors: Meenakshi N Mehta, SR Banerjee
8.1 Child Abuse and Neglect ...................................................................................................................... 230
Meenakshi N Mehta
8.2 Child Labor .............................................................................................................................................. 244
Meenakshi N Mehta, SR Banerjee

9. IMMUNIZATION AND INFECTIOUS DISEASES

Chapter Editors: A Parthasarathy, Tapan Kumar Ghosh
9.1 The Principles and Practice of Immunization ................................................................................... 258
T Jacob John
9.2 Vaccines and Vaccine Preventable Diseases: Today and Tomorrow ............................................ 262
AB Desai
9.3 Newer Vaccines ....................................................................................................................................... 265
AK Dutta, Anju Aggarwal
9.4 Vaccine Storage and Handling ............................................................................................................. 271
RK Agarwal, Digant D Shastri
9.5 Management of Adverse Effects Following Immunization (AEFI) ............................................... 277
M Indra Shekhar Rao, Tanmay Amladi
9.6 Approach to Management of Fever in Newborns, Children and Adolescents
in Office Practice ..................................................................................................................................... 285
Digant D Shastri
 Contents XXXVII

9.7 Fever and Fever of Unknown Origin .................................................................................................. 295

PP Maiya
9.8 An Approach to a Child with Fever and Skin Rash ......................................................................... 302
Jayakar Thomas
9.9 Tuberculosis in Children....................................................................................................................... 315
Vimlesh Seth
9.10 Abdominal Tuberculosis ....................................................................................................................... 332
Saroj Mehta, Vimlesh Seth
9.11 Neurotuberculosis .................................................................................................................................. 336
Vimlesh Seth
9.11.1 Revised National Tuberculosis Control Program (RNTCP) including
Directly Observed Treatment .................................................................................................. 342
Vimlesh Seth
9.12 Poliomyelitis ............................................................................................................................................ 350
Ashok K Gupta
9.12.1 Differential Diagnosis of Acute Flaccid Paralysis ............................................................... 354
AD Tewari
9.12.2 National Immunization Days (NIDs) as a Vital Component of Polio Eradication
Strategy ......................................................................................................................................... 359
Vipin M Vashishtha, Naveen Thacker
9.13 Diphtheria ................................................................................................................................................ 362
AP Dubey, Jaydeep Choudhury
9.14 Pertussis (Whooping Cough) ................................................................................................................ 364
YK Amdekar
9.15 Tetanus ..................................................................................................................................................... 366
AP Dubey, Jaydeep Choudhury
9.16 Measles ..................................................................................................................................................... 368
AP Dubey, Jaydeep Choudhury
9.17 Mumps: Epidemic Parotitis ................................................................................................................... 370
Ashok Gupta
9.18 Rubella ...................................................................................................................................................... 372
AP Dubey, Jaydeep Choudhury
9.19 Staphylococcal Infections ...................................................................................................................... 374
AK Dutta, Anju Aggarwal
9.20 Pneumococcal Disease and its Prevention ......................................................................................... 376
Rohit C Agrawal
9.21 Hemophilus Influenzae b Disease ...................................................................................................... 383
RK Agarwal, Anju Aggarwal
9.22 Typhoid Fever ......................................................................................................................................... 383
YK Amdekar
9.23 Leprosy ..................................................................................................................................................... 387
Rajeshwar Dayal
9.24 Leptospirosis in Children ...................................................................................................................... 392
S Ramesh
9.25 Chickenpox (Varicella) .......................................................................................................................... 394
AP Dubey, Jaydeep Choudhury
XXXVIII IAP Textbook of Pediatrics

9.26 Dengue Illnesses ..................................................................................................................................... 396

Ashok S Kapse
9.27 Infectious Mononucleosis ..................................................................................................................... 404
S Ramesh
9.28 Respiratory Syncytial Virus Infection ................................................................................................ 405
A Balachandran, SO Shivbalan
9.29 Rotavirus Disease ................................................................................................................................... 408
Raju C Shah
9.30 Rabies ........................................................................................................................................................ 409
Tapan Kumar Ghosh, A Parthasarathy
9.31 Pediatric HIV Disease ............................................................................................................................ 414
Meena Malkani
9.32 Chikungunya Fever ................................................................................................................................ 419
Utpal Kant Singh, Rajniti Prasad
9.33 Malaria in Children ................................................................................................................................ 423
Ashok S Kapse
9.34 Kala-azar (Visceral Leishmaniasis) ..................................................................................................... 440
Yogesh Jain, Rakesh Lodha

10. DISEASES OF CENTRAL NERVOUS SYSTEM

Chapter Editors: Veena Kalra, PSN Menon
10.1 Anatomical Localization of Neurological Problems ....................................................................... 444
CS Rajput, DP Karmarker
10.2 Normal Development and Malformations of Central Nervous System ..................................... 448
Veena Kalra, Rashmi Kumar
10.3 Degenerative Disorders of the Central Nervous System ............................................................... 453
Veena Kalra
10.4 Seizure Disorders in Children ............................................................................................................ 455
Veena Kalra
10.5 Infections of the Central Nervous System ........................................................................................ 462
Veena Kalra
10.6 Coma in Children .................................................................................................................................. 470
CR Banapurmath, Shobha Banapurmath, G Guruprasad
10.7 Brain Tumors in Children .................................................................................................................... 477
KS Rana
10.8 Raised Intracranial Pressure ................................................................................................................ 486
AD Tewari, Kundan Kumar Mittal
10.9 Benign Intracranial Hypertension ...................................................................................................... 489
AD Tewari, Kundan Kumar Mittal
10.10 Motor Weakness in Infancy and ChildhoodClinical Approach ............................................... 491
Vrajesh Udani
10.11 Floppy Infant Syndrome ...................................................................................................................... 495
R Anandam, D Kalpana
10.12 Muscular Disorders in Children ......................................................................................................... 499
K Pandian
 Contents XXXIX

11. DISEASES OF CARDIOVASCULAR SYSTEM

Chapter Editors: Anita Khalil, Srikanta Basu
11.1 Congenital Heart Disease: General Aspects ..................................................................................... 504
NC Joshi
11.2 Common Congenital Heart Diseases in Children ........................................................................... 509
Anita Khalil, M Zulfikar Ahamed
11.3 Medical Management of Congenital Heart Diseases ..................................................................... 518
Anita Khalil, Bharat Dalvi
11.4 Surgery for Congenital Heart Diseases ............................................................................................. 521
KS Dagar, KS Iyer, Srikanta Basu
11.5 Rheumatic Fever and Rheumatic Heart Disease .............................................................................. 526
Anita Khalil
11.6 Congestive Heart Failure in Children ................................................................................................ 534
Anita Khalil
11.7 Systemic Arterial Hypertension in Children .................................................................................... 538
Srikanta Basu, S Srinivasan
11.8 Pericardial Diseases and Disorders .................................................................................................... 548
S Srinivasan, Srikanta Basu
11.9 Cardiac Arrhythmias in Children ....................................................................................................... 551
S Srinivasan, Srikanta Basu

12. DISEASES OF RESPIRATORY SYSTEM

Chapter Editor: A Balachandran
12.1 Examination of the Respiratory System ............................................................................................ 558
YK Amdekar
12.2 Diagnostic Procedures and Investigations in Respiratory Diseases ............................................ 560
Archana S Kher, Soumya Swaminathan, Milind S Tullu
12.3 Flexible Fiberoptic Bronchoscopy (FFBS) ......................................................................................... 564
D Vijayasekaran
12.4 Respiratory Distress .............................................................................................................................. 567
MD Shah
12.5 Upper Respiratory Tract Infection ..................................................................................................... 573
SK Kabra
12.6 Infections of Larynx, Trachea and Bronchi ....................................................................................... 576
Keya R Lahiri, Roshani N Taori
12.7 Pneumonia in Children ........................................................................................................................ 578
A Balachandran, SO Shivbalan
12.8 Acute Bronchiolitis ................................................................................................................................ 583
Uday B Nadkarni
12.9 Empyema ................................................................................................................................................. 586
A Balachandran, Swati Y Bhave, S Thangavelu
12.10 Bronchiectasis ......................................................................................................................................... 588
A Balachandran, Swati Y Bhave, NC Gowrishankar
XL IAP Textbook of Pediatrics

12.11 Lung Abscess .......................................................................................................................................... 589

A Balachandran, Swati Y Bhave, S Thangavelu
12.12 Hemoptysis ............................................................................................................................................. 591
Vibha Mangal, Neeraj Jain, Vibhu Kwatra
12.13 Bronchial Asthma .................................................................................................................................. 593
H Paramesh, L Subramanyam, SO Shivbalan

13. DISEASES OF GASTROINTESTINAL SYSTEM AND LIVER

Chapter Editor: VS Sankaranarayanan
13.1 Diarrheal Diseases ................................................................................................................................ 602
Ashok K Patwari
13.2 Persistent and Chronic Diarrhea in Children ................................................................................... 609
Gadadhar Sarangi, Jnanindra Nath Behera
13.3 Parenteral Nutrition in Children ........................................................................................................ 613
Anand N Pandit, Ashish R Bavdekar
13.4 Parasitic Bowel Diseases ...................................................................................................................... 616
BD Gupta
13.5 Vomiting in Infants and Children ...................................................................................................... 620
S Nagabhushana
13.6 Gastroesophageal Reflux in Infants and Children .......................................................................... 622
Neeraj Jain, Vibha Jain, Deepak Seth
13.7 Gastrointestinal Bleeding in Infants and Children ......................................................................... 624
Saroj Mehta, RC Mathur
13.8 Constipation ........................................................................................................................................... 627
VR Ravikumar
13.9 Abdominal Pain ..................................................................................................................................... 629
S Srinivas
13.9.1 Acute Abdominal Pain in Children ...................................................................................... 629
13.9.2 Chronic Abdominal Pain in Children .................................................................................. 632
13.10 Helicobacter Pylori Infection in Children ........................................................................................ 637
Neeraj K Jain, Vibha Mangal
13.11 Cystic Fibrosis ........................................................................................................................................ 639
Sushil K Kabra, Madhulika Kabra
13.12 Juvenile Tropical Pancreatitis ............................................................................................................. 644
A Riyaz
13.13 Liver and Biliary System ...................................................................................................................... 646
B Bhaskar Raju, B Sumathi
13.14 Hepatosplenomegaly: A Practical Diagnostic Approach ............................................................... 650
Sheila Bhave, Ashish Bavdekar
13.15 Differential Diagnosis of Jaundice in Infancy ................................................................................. 653
MK Jain, Sunil Karande
13.16 Viral Hepatitis ........................................................................................................................................ 655
Malathi Sathiyasekaran, Ramaswamy Ganesh
 Contents XLI

13.17 Chronic Hepatitis in Children ............................................................................................................. 667

BR Thapa
13.18 Chronic Liver Disorders in Children ................................................................................................. 672
VS Sankaranarayanan, S Srinivas
13.19 Cirrhosis of Liver ................................................................................................................................... 675
VS Sankaranarayanan, S Srinivas
13.20 Neonatal Cholestasis Syndrome ......................................................................................................... 682
BR Thapa
13.21 Fulminant Hepatic Failure ................................................................................................................... 692
Rajiv Chandra Mathur
13.22 Ascites ...................................................................................................................................................... 695
Balvir S Tomar, Anurag Tomar

14. DISEASES OF KIDNEY AND URINARY TRACT

Chapter Editors: Arvind Bagga, RN Srivastava
14.1 Renal Anatomy and Physiology ......................................................................................................... 714
Arvind Bagga
14.2 Diagnostic Evaluation ........................................................................................................................... 715
RN Srivastava, Aditi Sinha
14.3 Imaging of the Urinary Tract ............................................................................................................... 719
Arvind Bagga, Aditi Sinha
14.4 Developmental Anomalies .................................................................................................................. 722
M Vijayakumar
14.5 Acute Proliferative Glomerulonephritis ........................................................................................... 724
BR Nammalwar, T Vasanthi, M Vijayakumar
14.6 Renal Vasculitis ..................................................................................................................................... 729
BR Nammalwar, N Prahlad
14.7 Acute Renal Failure ............................................................................................................................... 737
Arvind Bagga, Aditi Sinha
14.8 Nephrotic Syndrome ............................................................................................................................. 743
RN Srivastava, Arvind Bagga
14.9 Urinary Tract Infection, Vesicoureteric Reflux and Reflux Nephropathy .................................. 750
M Vijayakumar, RN Srivastava
14.10 Obstructive Uropathy ........................................................................................................................... 754
Kumud P Mehta
14.11 Disorders of Micturition ...................................................................................................................... 755
Kumud P Mehta
14.12 Chronic Kidney Disease ....................................................................................................................... 757
KD Phadke, Pankaj Hari
14.13 Hypertension .......................................................................................................................................... 761
Kumud P Mehta
14.14 Renal Tubular Disorders ...................................................................................................................... 763
Aditi Sinha, Arvind Bagga
XLII IAP Textbook of Pediatrics

15. PEDIATRIC HEMATOLOGY

Chapter Editor: MR Lokeshwar
15.1 Anemia in Children ............................................................................................................................... 768
MR Lokeshwar, VP Choudhry
15.2 The Value of a Complete Blood Count in Children ........................................................................ 771
Zeenat Currimbhoy
15.3 Anemia in the Newborn ....................................................................................................................... 775
Jayashree A Mondkar, Mamta Manglani, Armida Fernandez
15.4 Nutritional Anemias in Infancy and Childhood ............................................................................. 780
Niranjan Shendurnikar, Omprakash Shukla, Sushil Madan
15.5 Nutritional Anemias in Adolescence ................................................................................................. 785
Sushil Madan
15.6 Thalassemia ............................................................................................................................................ 794
MR Lokeshwar, Nitin Shah, Swati Kanakia, Mamta Manglani
15.7 Sickle Cell Disease ................................................................................................................................ 816
VS Dani
15.8 Red Cell Membrane Disorders ........................................................................................................... 820
Rashmi Dalvi, Bharat Agarwal, R Agarwal
15.9 Autoimmune Hemolytic Anemia ....................................................................................................... 822
Bharat Agarwal, Rashmi Dalvi
15.10 Bone Marrow Failure Syndrome ........................................................................................................ 824
Nitin Shah, MR Lokeshwar
15.11 Physiology of Hemostasis: Approach to a Bleeding Disorder ...................................................... 828
Renu Saxena
15.12 Platelet and Bleeding Disorders ......................................................................................................... 831
VP Choudhry, Amit Upadhyay
15.13 Disseminated Intravascular Coagulation (DIC) .............................................................................. 843
Anupam Sachdeva, VP Choudhry
15.14 Bleeding Disorders in the Newborn .................................................................................................. 854
Jayashree A Mondkar, Mamta Manglani, Armida Fernandez
15.15 Hematopoietic Growth Factors ........................................................................................................... 858
Purvish M Parikh, MR Lokeshwar
15.16 Transfusion Medicine and Component Therapy in Pediatrics ..................................................... 861
RK Marwaha, Sudeshna Mitra, Deepak Bansal

16. PEDIATRIC ONCOLOGY

Chapter Editor: Purna A Kurkure
16.1 Malignancies in Children .................................................................................................................... 874
Purna A Kurkure
16.2 Acute Leukemia ..................................................................................................................................... 874
Anupama Borker, SH Advani
16.3 Hodgkins Disease ................................................................................................................................. 880
Purna A Kurkure, Brijesh Arora, Roshni Bhagwat
 Contents XLIII

16.4 Non-Hodgkins Lymphoma ................................................................................................................. 883

Purna A Kurkure, Brijesh Arora, Roshni Bhagwat
16.5 Wilms Tumor ......................................................................................................................................... 887
Purna A Kurkure, Brijesh Arora, Shailesh Kanvinde
16.6 Neuroblastoma ....................................................................................................................................... 890
Purna A Kurkure, Brijesh Arora, Shailesh Kanvinde
16.7 Soft Tissue Sarcoma .............................................................................................................................. 895
Sajid Qureshi, Purna A Kurkure
16.8 Retinoblastoma ...................................................................................................................................... 901
Sripad Banavali
16.9 Bone Marrow Transplantation ............................................................................................................ 903
Brijesh Arora, Purvish M Parikh, MR Lokeshwar

Volume 2
17. ENDOCRINOLOGY
Chapter Editor: PSN Menon
17.1 Disorders of Growth ............................................................................................................................. 912
PSN Menon
17.2 Disorders of Pituitary ........................................................................................................................... 919
PSN Menon
17.3 Obesity ..................................................................................................................................................... 925
Anju Virmani
17.4 Disorders of the Thyroid Gland ......................................................................................................... 931
Meena P Desai
17.5 Disorders of Bone and Mineral Homeostasis .................................................................................. 935
Vijayalakshmi Bhatia
17.6 Disorders of Puberty ............................................................................................................................. 941
Prisca Colaco
17.7 Disorders of Sexual Differentiation .................................................................................................. 947
P Raghupathi
17.8 Disorders of Adrenocortical Biosynthesis ........................................................................................ 951
P Raghupathy
17.9 Disorders of Adrenal Glands .............................................................................................................. 955
PSN Menon
17.10 Diabetes Mellitus .................................................................................................................................. 962
Vijayalakshmi Bhatia

18. GENETICS
Chapter Editor: ML Kulkarni
18.1 Basic Genetics for Genetic Counseling ............................................................................................. 972
ML Kulkarni
XLIV IAP Textbook of Pediatrics

18.2 Common Genetic Disorders ................................................................................................................ 989

ML Kulkarni
18.3 New Genetics and Advances in Genetics ....................................................................................... 1013
ML Kulkarni
18.4 Inborn Errors of Metabolism ............................................................................................................. 1029
ML Kulkarni

19. CHILDHOOD DISABILITIES

Chapter Editor: MS Mahadeviah
19.1 Developmental Disabilities in Children ......................................................................................... 1044
MS Mahadeviah
19.2 Cerebral Palsy ...................................................................................................................................... 1045
Pratibha D Singhi
19.3 Attention Deficit Hyperactivity Disorders ..................................................................................... 1049
Nandini Mundkur
19.4 Learning Disability ............................................................................................................................. 1051
MS Mahadeviah
19.5 Childhood Autism ............................................................................................................................... 1053
MS Mahadeviah
19.6 Early Detection and Early Intervention Therapy for Developmental Delay ........................... 1055
MKC Nair, Babu George
19.7 Mental Retardation ............................................................................................................................. 1072
Sunanda K Reddy

20. PEDIATRIC IMMUNOLOGY, ALLERGY AND RHEUMATOLOGY

Chapter Editor: Surjit Singh
20.1 Basics of Immune System in Children ............................................................................................ 1080
Keya R Lahiri, Roshani N Taori
20.2 Immunodeficiency Disorders ............................................................................................................ 1085
Surjit Singh, H Paramesh
20.3 Allergic Rhinitis ................................................................................................................................... 1087
H Paramesh
20.4 Food Allergy and Related Gastrointestinal Tract Diseases ......................................................... 1091
VS Sankaranarayanan
20.5 Value of Allergy Tests in Pediatrics ................................................................................................. 1095
L George Moses, A Parthasarathy
20.6 Allergen Specific Immunotherapy ................................................................................................... 1099
K Nagaraju
20.7 Rheumatological Disorders in Children ......................................................................................... 1101
S Ramakrishnan, A Parthasarathy
20.8 Antiphospholipid Syndrome ............................................................................................................ 1112
Surjit Singh
20.9 Approach to Vasculitis in Children ................................................................................................. 1113
Surjit Singh
 Contents XLV

20.10 Kawasaki Disease ................................................................................................................................ 1115

Noel Narayanan
20.11 Intravenous Immunoglobulin ........................................................................................................... 1118
Surjit Singh

21. THERAPEUTICS
Chapter Editor: Sandeep B Bavdekar
21.1 Basics of Pediatric Therapeutics ....................................................................................................... 1122
Sandeep B Bavdekar, S Ramesh
21.2 Adverse Drug Reactions, Drug Interactions and Therapeutic Drug Monitoring .................... 1126
Archana Kher, Milind S Tullu
21.3 Rational Drug Therapy in Children ................................................................................................. 1130
Arun Phatak

22. PEDIATRIC INTENSIVE CARE

Chapter Editor: Sunit C Singhi
22.1 The Need and Scope of Intensive Care in Pediatrics .................................................................... 1136
Krishan Chugh
22.2 Organization of a Pediatric Intensive Care Unit ........................................................................... 1138
Sunit C Singhi
22.3 Cardiopulmonary Resuscitation ....................................................................................................... 1141
Yogesh C Govil
22.4 Shock ...................................................................................................................................................... 1148
Jayashree Muralidharan
22.5 Acute Respiratory Failure .................................................................................................................. 1153
Uday B Nadkarni
22.6 Assisted Ventilation in Children ...................................................................................................... 1156
Suchitra Ranjit
22.7 Monitoring a Child on Intensive Care ............................................................................................. 1160
Archana Sathe
22.8 Interpretation of Laboratory Findings in a PICU .......................................................................... 1168
Anil Sachdev

23. ADOLESCENT CARE

Chapter Editor: MKC Nair
23.1 Introduction: Why Adolescent Care? ............................................................................................... 1176
MKC Nair, SS Kamath
23.2 Adolescent Care and Family Life Education .................................................................................. 1178
Manorama Verma
23.3 Adolescent Nutrition .......................................................................................................................... 1180
Jugesh Chhatwal
23.4 Adolescent Psychology ....................................................................................................................... 1183
Jugesh Chhatwal
XLVI IAP Textbook of Pediatrics

23.5 Identity Crisis and Adolescents ........................................................................................................ 1186

Shrikant W Chorghade
23.6 Adolescent Sexuality ........................................................................................................................... 1189
Jugesh Chhatwal
23.7 Common Health Problems in Adolescents ..................................................................................... 1192
Manorama Verma, Jugesh Chhatwal
23.8 Polycystic Ovarian Syndrome ........................................................................................................... 1200
MKC Nair

24. ACCIDENTS AND POISONINGS

Chapter Editor: CG Wilson
24.1 Injuries in Children and Injury Control ......................................................................................... 1204
CG Wilson
24.2 Poisoning in Children ......................................................................................................................... 1207
KS Rao, B Ravichander

25. CHILD PSYCHIATRY

Chapter Editor: Manju Mehta
25.1 Child Psychiatry ................................................................................................................................... 1216
Manju Mehta
25.2 Child Guidance Clinic (CGC) ........................................................................................................... 1229
T Ravikumar

26. PEDIATRIC SURGERY

Chapter Editor: Ketan Praveen Parikh
26.1 Common Pediatric Surgical Problems ............................................................................................. 1232
Subhash J Dalal, Ketan Praveen Parikh, Amrish Vaidya

27. PEDIATRIC ORTHOPEDICS

Chapter Editor: Mayilvahanan Natarajan
27.1 Congenital Anomalies ........................................................................................................................ 1264
PP Kotwal, Bhavuk Garg
27.2 Infections of Bones and Joints .......................................................................................................... 1268
PP Kotwal, Bhavuk Garg
27.3 Neuromuscular Disorders .................................................................................................................. 1278
Mayilvahanan Natarajan
27.4 Osteochondritis .................................................................................................................................... 1282
Mayilvahanan Natarajan
27.5 Inequality of Limb Length ................................................................................................................. 1285
Mayilvahanan Natarajan, PP Kotwal, MK Varshney
27.6 Pediatric Bone Tumors ....................................................................................................................... 1288
Mayilvahanan Natarajan, PP Kotwal, MK Varshney
27.7 Miscellaneous Orthopedic Conditions ............................................................................................ 1296
PP Kotwal, MK Varshney
 Contents XLVII

28. PEDIATRIC RADIOLOGY

Chapter Editor: Arun Kumar Gupta
28.1 Pediatric Radiology ............................................................................................................................. 1300
Arun Kumar Gupta, Chandan B Das

29. PEDIATRIC OPHTHALMOLOGY

Chapter Editor: Supriyo Ghose
29.1 Common Eye Problems in Children ................................................................................................ 1316
Supriyo Ghose

30. PEDIATRIC OTORHINOLARYNGOLOGY

Chapter Editor: Divya Prabhat
30.1 Common Problems of Ear, Nose and Throat in Children ............................................................ 1334
Divya Prabhat

31. PEDIATRIC DERMATOLOGY

Chapter Editor: Jayakar Thomas
31.1 Skin Diseases in Children ................................................................................................................. 1336
Jayakar Thomas

32. PEDIATRIC DENTISTRY

Chapter Editor: PK Baskar
32.1 Common Dental Problems ................................................................................................................. 1372
PK Baskar

33. PEDIATRIC PRIORITIES IN THE 21ST CENTURY

Chapter Editor: Piyush Gupta
33.1 Pediatric Priorities in the 21st Century ............................................................................................ 1384
RK Agarwal, Piyush Gupta
33.2 Pollution and Child Health in the 21st Century ............................................................................ 1389
NR Bhandari
33.3 Pediatric Environment Health-Hazards .......................................................................................... 1392
Anupam Sachdeva, MKC Nair, Swati Y Bhave
33.4 Research Methodology in Pediatric Practice .................................................................................. 1410
Saradha Suresh, P Ramachandran
33.5 Computers in Pediatric Medicine ..................................................................................................... 1414
Neeraj Jain, Vibha Jain
XLVIII IAP Textbook of Pediatrics

34. PEDIATRIC PROCEDURES

Chapter Editors: Piyush Gupta, PSN Menon
34.1 Common Procedures in Pediatric Practice ...................................................................................... 1420
Baldev S Prajapati, A Parthasarathy

35. PHYSICAL MEDICINE AND REHABILITATION

Chapter Editors: A K Dutta, Piyush Gupta
35.1 Physical Medicine and Rehabilitation in Pediatric Practice ........................................................ 1446
Bina Ahuja, AK Dutta
35.2 Chest Physiotherapy in Children ..................................................................................................... 1452
D Vijayasekaran

36. Miscellaneous Topics

Chapter Editors: Piyush Gupta, PSN Menon
36.1 Vital Statistics in India ....................................................................................................................... 1458
Piyush Gupta, HPS Sachdev
36.2 The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of
Production, Supply and Distribution) Act, 1992 ............................................................................ 1459
SP Srivastava
36.3 Normal Laboratory Values ................................................................................................................ 1465
Piyush Gupta, HPS Sachdev
36.4 Principles of Fluids and Electrolytes in Diarrheal Dehydration ................................................ 1474
S Ramesh
36.5 Drugs and Drug Dosage ..................................................................................................................... 1480
S Ramesh
36.6 Essential Drugs in Pediatrics ............................................................................................................. 1488
Arun P Phatak
36.7 Growth Charts: ..................................................................................................................................... 1490
Vaman V Khadilkar, Dilip Mukherjee, MKC Nair
36.7.1 IAP Growth Charts ................................................................................................................... 1490
Vaman V Khadilkar
36.7.2 Appendix .................................................................................................................................... 1498
Vaman V Khadilkar
36.7.3 WHO Growth Charts ............................................................................................................... 1502
Dilip Mukherjee, MKC Nair
36.8 Safe Injection Practices ....................................................................................................................... 1507
Baldev S Prajapati, Swati Y Bhave, SS Kamath
36.9 Searching and Researching Online .................................................................................................. 1516
Vijay Agarwal
36.10 The IMNCI Case Management Process ........................................................................................... 1522
Harish Kumar, Raju C Shah, Naveen Thacker, Deepak Ugra
 Contents XLIX

36.11 IAP Infectious Diseases Chapter Protocols: ................................................................................... 1525

Ritabrata Kundu, Nupur Ganguly, Tapan Kumar Ghosh
36.11.1 Malaria .................................................................................................................................... 1525
Raju C Shah, Tapan Kumar Ghosh, Ritabrata Kundu, Nupur Ganguly
36.11.2 Enteric Fever .......................................................................................................................... 1528
Nitin K Shah, Raju C Shah, Tapan Kumar Ghosh, Ritabrata Kundu, Nupur Ganguly
36.11.3 Pyogenic Meningitis ............................................................................................................. 1531
Veena Kalra, Tapan Kumar Ghosh, Ritabrata Kundu, Nupur Ganguly, Vijay N Yewle
36.11.4 Rabies ...................................................................................................................................... 1534
Tapan Kumar Ghosh, SN Madhusudhana, Shivananda
36.12 IAP Consensus Recommendations on Immunization, 2008 ........................................................ 1538
Tanu Singhal, YK Amdekar, Piyush Gupta

Index ...................................................................................................................................................... 1545