Illustrated Textbook of Pediatrics

975 Pages·2015·36.79 MB·English

by  Md Salim Shakur

Illustrated Textbook of
PedIaTrIcs
Illustrated Textbook of
PedIaTrIcs
SECOND EDITION
Md Salim Shakur
MBBS (DMC, DU) DCH (Glasgow and Dublin) MRCP (UK) PhD (Nutrition, DU)
FRCP (London, Glasgow, Edinburgh) FRCPCH (UK)
Consultant (Visiting)
Department of Pedriatrics
United Hospital Limited
Dhaka, Bangladesh
Formerly
Professor of Pediatric Nutrition and Gastroenterology and Academic Director
Bangladesh Institute of Child Health
Director, Dhaka Shishu (Children) Hospital
Dhaka, Bangladesh
Foreword
MR Khan
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Illustrated Textbook of Pediatrics
First Edition: 2014
Second Edition: 2015
ISBN 978-93-5152-515-8
Printed at
Dedicated to
My Parents
Late Md Abdush Shakur
and
Late Mrs Sayma Khatun
who blessed me with life of peace,
knowledge, dignity, comfort and contentment
CONTRIBUTORS
Ahmed M MBBS DCH (Glasgow) PhD FRCP (Glasgow) Paul SP MBBS (RMC)
Head Senior Registrar
Department of Child Health Rajshahi Shishu Hospital
Gono Bishwabidyalay Rajshahi, Bangladesh
Savar, Bangladesh
Rahman Md A MBBS DCH
Khan M Specialist
MBBS FCPS (Internal Medicine) MSc (Hepatology)
Department of Pediatrics and Neonatology
FRCP (Edin, Glasgow) FACP FCCP
United Hospital Limited
Chairman
Dhaka, Bangladesh
Hepatology Society and Former Professor
Department of Hepatology Rahman S MBBS FCPS (Medicine) FRCP
Bangabandhu Sheikh Mujib Medical University (BSMMU) Professor, Department of Hepatology
Dhaka, Bangladesh Bangabandhu Sheikh Mujib Medical University (BSMMU)
Dhaka, Bangladesh
Md Salim Shakur
MBBS (DMC, DU) DCH (Glasgow and Dublin) MRCP (UK) PhD (Nutrition,
Rima R MBBS FCPS (Pediatrics)
DU) FRCP (London, Glasgow, Edinburgh) FRCPCH (UK)
Assistant Professor
Consultant (Visiting)
Department of Pediatrics Cardiology
Department of Pedriatrics
BICH, Dhaka Shishu Hospital
United Hospital Limited
Dhaka, Bangladesh
Dhaka, Bangladesh
Mohosin F MBBS FCPS (Pediatrics) Saha N MBBS FCPS (Pediatrics)
Associate Professor Associate Professor
Department of Pediatrics Department of Pediatrics Neurology
BIRDEM General Hospital and Ibrahim Medical College Dhaka Medical College
Dhaka, Bangladesh Dhaka, Bangladesh
FOREWORD
It is my great pleasure to congratulate the author and the contributors for accomplishing the stupendous job of composing
an Illustrated Textbook of Pediatrics.
Textbook remains the mainstay of medical education for centuries. However, due to rapid development of acquiring
knowledge effortlessly via the Internet and through handy medical books, gathering knowledge from reading textbooks
in conventional way is currently losing its previous attraction. There are many textbooks on pediatrics, but this colorful
textbook is unique, containing 1,149 colorful illustrations, which has made the book reading-friendly and will provide
a new dimension in the field of textbook of pediatrics. This I believe will also help to bring back the pleasure of reading
textbooks in pediatrics to great extent.
This book while providing update informations in pediatrics, emphasized significantly on spectrum of diseases and
child health problems of public health importance of Bangladesh. The outstanding effort of the author to cover community
pediatric problems of Bangladesh as well as hospital pediatric problems at secondary and tertiary level is praiseworthy.
Unlike many textbooks, the author endeavored to incorporate clinical methodology (neurology, cardiovascular and
neonatology in particular) with eye-catching illustrations to compliment clinical understanding, which I believe will
benefit senior medical undergraduates and postgraduates in pediatrics undertaking clinical examinations. Specialists in
pediatrics, postgraduates in pediatrics, pediatric practitioners, general practitioners and senior undergraduate medical
students will be enormously benefited from this book. This book will also serve as ready reference to busy pediatricians,
trainee doctors and child healthcare providers.
National Professor MR Khan
Dhaka, Bangladesh
Professor Md Salim Shakur
ABOUT ThE AUThOR
Professor Md Salim Shakur MBBS (DMC, DU) DCH (Glasgow and Dublin) MRCP (UK) PhD (Nutrition, DU) FRCP (London, Glasgow, Edinburgh)
FRCPCH (UK) was born on April 1, 1954 in Dhaka. He passed SSC from Rajshahi Collegiate School in 1970 and HSC from
Dhaka College, Dhaka, in 1972. He obtained MBBS from Dhaka Medical College, in 1979. He obtained diploma in child
health (DCH) from University College Dublin, Ireland, in 1983 and DCH from Royal College of Physicians and Surgeons
of Glasgow, UK, in 1989. He passed MRCP (UK) in Pediatrics from Royal College of Physicians of UK in 1989. Professor
Shakur was conferred PhD by University of Dhaka in 2000 as recognition of his work on role of zinc in severely malnourished
children suffering from pneumonia.
Professor Shakur obtained higher postgraduate training in Pediatrics and Neonatology in Our Lady’s Children’s
Hospital for Sick Children, Dublin, Ireland, in 1983 and in Royal Hospital for Sick Children, Edinburgh, UK, Western
General Hospital, Edinburgh and in Queen Elizabeth Hospital for Sick Children, London, UK, during the years, 1987 to
1989. He was also a postgraduate student at Department of Child Life and Health, University of Edinburgh, UK from April
1987 to September 1989.
He started his academic career as Assistant Professor of Pediatrics (Nutrition and Gastroenterology) at Bangladesh
Institute of Child Health (BICH), Dhaka Shishu (Children) Hospital in 1989. He became Associate Professor in 1993 and
Professor of Pediatric Nutrition and Gastroenterology in 1999. He held the post of Academic Director of BICH from year
2002 to 2004 and Director of Dhaka Shishu (Children) Hospital during the period of 2004 to 2008. He joined as Consultant
and Head, Department of Pediatrics, United Hospital Ltd, Dhaka, in 2009, and currently continuing as Visiting Consultant
of Pediatrics in same hospital.
Professor Shakur is involved in activities in many professional bodies. He is founder Chairman of Bangladesh Paediatric
Gastroenterology and Nutrition Society (BAPGANS) since 2005. He was member of technical committee of action plan of
infant and young child feeding from 2008–2010, Member of Technical Committee for Formulation of National Guidelines
for Management of Severely Malnourished Children (2007–2008), Member of Core Committee, Strategy for Neonatal
Survival, Ministry of Health in 2007. Professor Shakur was Chairman, Scientific Subcommittee of Bangladesh Paediatric
Association (BPA) from 2003 to 2008 and held the post of Vice-President and Executive Member of BPA.
Commencing career as Assistant Professor of BICH in 1990, Professor Shakur engaged himself in research activities in
addition to teaching postgraduates and providing clinical service to hospital. He published more than 40 research papers
in reputed medical journals of home and abroad. He performed extensive research works on micronutrients, particularly
on zinc and notable research papers were published in reputed international medical journals including Indian Journal
of Pediatrics (Indian J Pediatr. 2009;76:609-12), American Journal of Clinical Nutrition (Am J Clin Nutr. 1998;68:742-8),
Indian Pediatrics (Indian Pediatr. 2004;41:478-81). In addition to articles based on original research works, Professor
Shakur published many interesting case reports, including case report of cystic fibrosis, first published case report of
cystic fibrosis [Bangladesh J Child Health. 1995;19(1):23-8] from Bangladesh. He was one of the pioneers in bringing use
of zinc in clinical pediatric practice, particularly in diarrhea in Bangladesh.
Professor Shakur is honorable Fellow of a number of prestigious learned international medical societies. He was
elected Fellow of Royal College of Physicians of Edinburgh (FRCPE) in 1998, Royal College of Physicians and Surgeons of
Glasgow (FRCPG) in 2000 and Royal College of Physicians of London (FRCPL) in 2002. He became Fellow of Royal College
of Paediatricians and Child Health of UK (FRCPCH) in 2000, the first Pediatrician in Bangladesh to obtain Fellowship of
RCPCH (UK) and in the process became prestigious Fellow of all the Royal Colleges of Physicians as well as Royal College
of Paediatrics of UK.
PREFACE TO ThE SECOND EDITION
It is indeed a matter of great pleasure and pride to present Illustrated Textbook of Pediatrics the first ever appearance of
Illustrated Textbook of Pediatrics in color, published by well-recognized internationally reputed medical book publisher
in India. I am extremely delighted by wide acceptance of the book only within few months of its first publication in
February 2014. I am very much thankful to readers particularly to my fellow colleagues who showed keen interest in the
book and patronized the book. Not only the book earned admiration in Bangladesh but also it created interest among
stakeholders of neighboring countries like India, Pakistan and in overseas countries including UK, Canada and North
America. Reputed book publisher based in India “Jaypee Brothers Medical Publishers (P) Ltd.” was prompt to show
interest to take the responsibility of editing, printing and publishing the second edition of the book only couple of months
after the book was first published from Dhaka, which is outstanding. Medical knowledge with learning experience is a
global life-saving solution and medical textbooks served as the mainstay of medical education for centuries. However,
with rapid development of information technology highway via the Internet, gathering knowledge through reading
textbook in conventional way is currently becoming a tedious job and gradually losing its previous glamor. Therefore,
efforts were given to revive the pleasure of reading textbook so that it becomes more absorbing and reading-friendly.
Accordingly the book has been enriched with more than 1,000 attractive colored illustrations which include clinical
photographs, drawings, sketches to complement clinical understanding, believing illustrations which include clinical
images worth hundred words.
The book is expected to provide update information of pediatrics with special emphasis attached on pediatric illness
of Indian subcontinent particularly child health problems of public health importance of this part of the world. Critical
informations were highlighted with bullet points, in boxes and bolding of words and sentences. Colorful flow diagrams
and algorithms will guide you through the more complex areas. Where applicable more in depth informations were
provided highlighting areas of controversy and stimulating further reading. All are based on best available evidences
or on accepted best practices.
A so called traffic light system flow sheet diagram, table or algorithm is used according to severity of clinical
condition. In this system, features in green zone indicate low risk or safe zone, amber color indicate intermediate risk
and high risk is indicated by red zone which is unique of this textbook. The contents are divided into broad content
and more detailed content which will provide readers quick access to reach desired topic. A detailed index is given at
the rear to provide easy access to information.
In this second edition, the book has been presented with superior print and in more flawless condition. This edition
features more distinct and much higher quality illustrations with better resolution and precision of images.
I would like to acknowledge the contribution of Shri Jitendar P Vij, Group Chairman of internationally reputed
medical publication house, based in India M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India who spent
no time to spot the book and kindly accepted to publish this unique book from his famous publishing house. I would
like to thank Mrs Ritu Sharma, Head of Undergraduate Textbook Division, Ms Samina Khan (Executive Assistant to
Director–Publishing), Mr Sanjoy Chakraborty (Branch Manager, Kolkata) and Mr Sarod Ghosh (Regional Manager,
Bangladesh), for their cooperation and coordination in publishing second edition of the book.
We welcome feedback and constructive criticism from all readers and stakeholders which will motivate us to deliver
the best in future.
We dedicate this second edition to parents and their pediatric patients whose sufferings provided us with learning
experience and helped enormously to publish this wonderful book.
Md Salim Shakur
PREFACE TO ThE FIRST EDITION
No book can provide wise head and warm heart that comes only from clinical experience. However, knowledge is
generally preferable to ignorance and despite the development of information super highway via the Internet, appropriate
knowledge gathering in rational way is still found most easy between the covers of a book. The great physician and
teacher Sir William Osler put it more neatly, “He who studies medicine without books sails an uncharted sea, but he who
studies medicine without patients does not go to sea at all.”
Textbooks have been the mainstay of medical education for centuries. What does yet another pediatric textbook to
current long list of titles? All medical writings are particularly rewriting with addition of recent advances but they are
presented in different styles and formats suitable for specific class of readers or users. This book is neither intended
to replace the existing textbooks nor it can provide the much details contained in scientific journals. Instead I expects
that the book will serve for update review of relevant medical informations and it will be helpful from the start of ones
education in pediatrics all the way through higher general and to some extent to subspecialist training in pediatric field.
This book is intended to be used in whatever one chooses to practice—hospital, generalist or community and family
practice. This book is also expected to be used as a reference book by postgraduate students and pediatricians.
Most of the pediatric textbooks available in Bangladesh are edited by authors of Western countries and definitely of
high quality but most of them fall well short of addressing pediatric problems of public health concern of our country.
Although this book covering the global pediatric problem considering the fact that a doctor may has to work in different
parts of the world, significant effort and emphasis have been attached to clinical and public health problems of developing
countries like Bangladesh.
With advances of information technology, textbook reading in conventional way is threatened to lose its appeal.
Therefore, efforts have been taken to enrich the book with several colorful illustrations, which include clinical
photographs, sketches, drawings, algorithms which have been selected not only to make the book more fascinating to
read but also to enhance clinical understanding believing illustration, particularly clinical photographs, worth hundred
words.
Each chapter, where appropriate, opens with a brief review of some applied basic science relevant to clinical practice
and closes with bibliography. The book also dedicated chapters on basic science required for clinical practice like clinical
genetics, fluid and electrolyte balance, blood gas analysis in a simplified way. Clinical methodology particularly clinical
examination of central and peripheral nervous system, cardiovascular system and neonatal examination methodology
have been elaborately described with illustrations to compliment clinical understanding, which I believe will enormously
benefit postgraduates and senior undergraduates undertaking clinical examinations.
I hope the readers through studying the book will increase the knowledge, skill and confidence to manage pediatric
clinical problems effectively and safely.
Md Salim Shakur