Institute of Child Health
"Total Care from Birth to 16 Years"
The status of department of pediatrics at Sir Ganga Ram Hospital has been raised to Institute of Child Health. This was done in the year 2010 as a recognition of the expanding stature of this centre that provides comprehensive health care from birth to 16 years. Today, the ICH encompasses all aspects related to children both during illness and health.The ICH has expanded its role from just therapeutic to preventive, social and educational aspects of child health.
This institue provideds best of care to children through a coordinated effort of its three departments i.e. pediatrics, neonatology and pediatric surgrey. The ICH has grown significantly over the years and is today a sought aftercent of excellence in the field of not only cutting edge comprehensive clinical care but also postgraduate education, research and social health.
Education is a major strength of this institute. The ICH has a long standing Diplomate of National Board (DNB) programme in General Pediatrics which has been expanded. Today it boasts of fellowship programmes in several specialties sucha as neonatology, hematology-oncology, critical care, rheumatology and gastroenterology.
"State-of-the-art" care is provided to children with complex clinical conditions. These services are provided by a dedicated team of experienced and trained clinicians and specialists in several fields. Many specialists work together for some children to provide comprehensive care under one roof.
Services available at the ICH are:
Specialized services added in last decade to ICH:
Community outreach program and advocacy on child health:
The ICH has expanded its role from just therapeutics to social pediatrics and advocacy. It conducts regular community outreach programs in various part of the country.
The ICH has been playing an important role on advocating following issues concerning children:
PEDIATRIC HEMATOLOGY ONCOLOGY
BONE MARROW TRANSPLANT UNIT
(24 hr Helpline +91 9717145987)
HAEMATOLOGY AND ONCOLOGY AND BMT SERVICES
Bone Marrow and Stem Cell Transplant Unit
Paediatric Haematology-Oncology Unit: Patient Care
Clinical Programs include
We have key administrative and scientific leadership positions in Paediatric Haematology Oncology (PHO) Chapter of India Academy of Paediatrics (IAP) as well as in the International Society of Paediatric Oncology. The program has a major commitment to participation in National Training Program in Practical Paediatric Oncology (NTP-PPO) and National Training Program in Practical Paediatric Haematology (NTP-PPH) through PHO chapter of IAP. Our division is also involved in Capacity building in Hemophilia services across India (NNHF grant). Cutting edge clinical research in hemophilia/thrombophilia and ITP are also major commitments.
Paediatric Haematology Oncology Fellowship Program
CHILD DEVELOPMENT CLINIC
~Nurturing Young Ones~
Early Development is Fundamental to the Well Being of Your Child
(Post Down Syndrom Parent Support Group meet with Team Members Dr. Praveen Suman, Imran Noorani, Sona Bhawnani, Dolly Malhotra)
REDEFINING LIVES OF CHILDREN
WE VALUE DEVELOPMENTAL AND PSYCHOLOGICAL WELL BEING OF YOUR CHILD.
Ph: +91 9811244200 / +91 9555276476
A Caring Environment That Fosters Development, Creativity, and Learning.
Assessment & Planning By Development Pediatrician and Psychologist:
Psychological Assessments and Interventions:
ALL UNDER ONE ROOF
Leading The Way For Your Child's Development
OUR CORE TEAM OF SPECIALISTS:
DIVISION OF PEDIATRIC NEPHROLOGY
The division of Pediatric Nephrology of Institute of Child Health, Sir Ganga Ram Hospital provides multidisciplinary comprehensive care to pediatric patients with kidney diseases both as in-patients and out-patients. This division is headed by Dr. P.K.Pruthi who is joined by Dr.Kanav Anand to provide dedicated pediatric nephrology services to the needy.
The speciality is supported by a state of art pediatric intensive care unit having all the facilities for round the clock renal replacement therapy (dialysis). Renal replacement therapy is provided to all pediatric patients ranging from low birth neonates to adolescents
pediatric surgery and urology units are well equipped to deal with any pediatric surgical / urological procedures that the pediatric nephrology patients require.
Prenatal counselling is offered to families where the foetus has been diagnosed to have renal / urological anomalies.
Renal transplant services at Sir Ganga Ram Hospital are one of the best in the country.The members of the renal transplant team include renal transplant surgeon, pediatric nephrologist, transplant coordinator and social worker. Today advances in surgical techniques have made it possible to transplant young children once they attain a weight of 10-15 kg.
Our mission is to help children with kidney disorders, attain the best quality of life possible, and to assist families and primary care physicians in providing the same.
Our services include diagnosis, evaluation and management of:
Pediatric Nephrology general clinic
Pediatric nephrology clinic is a very busy clinic and is held every Saturday from 12 to 1 pm to look after the general patients.
Academic activities: The division is actively involved in academic activities and research work.
A child on Acute Peritoneal Dialysis
Child undergoing Continuous Renal Replacement Therapy (CRRT)in pediatric ICU
Child undergoing Continuous Renal Replacement Therapy (CRRT)in pediatric ICU
The pediatric intensive care unit (PICU) was established in 1993 and was the first such unit in the northern India. It was started as a four bedded unit with 2 nurses, basic monitoring equipment and only one ventilator. Now this is a multi disciplinary unit with 12 beds with 1:1 patient nurse ratio and has 'state-of-the-art' equipments for the real time continuous monitoring of vital signs in critically ill children. Each bed has the facility to continuously monitor ECG, respiratory rate, temperature, noninvasive blood pressure, invasive intra-arterial pressure, central venous pressure, end-tidal carbon dioxide, oxygen saturation, EEG, bispectral index and intracranial pressure. It is the only unit in the city to have point-of-care ultrasonography facility.
Children with serious medical diseases like meningoencephlitis complicated pneumonia,hepatic encephalopathy with multi-organ failure are admitted in this PICU. Patients with serious surgical problems are also provided services in the pre- and post operative period. Advanced airway management and mechanical ventilation with patient friendly, modern machines are the highlighted achievements of this unit. Small babies over a month of age receive non-invasive ventilation by nasal prongs or facemask. Children with complicated pulmonary diseases are ventilated with advanced high frequency oscillator.It is a busy unit with more than 900 admissions per year and with survival rates comparable to the PICUs of developed western countries.
The Department of Pediatrics offers 'state-of-the-art' pediatric critical care transport services, both by road and air, round the clock. The PICU helpline on receiving a requisition organizes an ambulance equipped with transport ventilation, emergency life saving drugs and multi-parameter monitor for continuous monitoring of vital parameters during transportation. A trained pediatric intensive care fellow accompanies the transport team. The department firmly believes that stabilization, care and treatment during transportation of a critically ill child have major impact on the successful outcome in the PICU
Transport helpline numbers(+91-7838003352,09810084075)
This division of pediatric subspecialty was started 15 years back by trained pediatric pulmonologists for the first time in northern part of India. The patients are referred from Delhi and surrounding states. A wide spectrum of cases with airways and pulmonary diseases are seen and followed up on regular basis. Childhood asthma in varying forms and severity constitute the major proportion of cases. These patients are followed up clinically and with spirometry on regular basis in a special clinic with proper record maintainence. Other less common diseases like cystic fibrosis, multi drug resistant tuberculosis, bronchiectasis and interstitial lung disease are diagnosed with the help of excellent diagnostic facilities like CT, MRI scan,ventilation-perfusion scan, sweat chloride test and flexible bronchoscopy.
This was the first unit to start flexible bronchoscopy in preterm and term newborns, infants and older children in the northern region in 1993 and over 7000 bronchoscopies have been done safely since then. This is usually done as a day care procedure. This procedure is done in a designated suite with minimal sedation and local anesthesia and all the special software. With this procedure, the pulmonologist can directly visualize and appreciate the dynamics of the large airways and can take lavage and biopsy from the suspected area
The pediatric neurology service is a heavily attended specialty, caring for patients from india. Childhood epilepsy forms a major proportion of the cases attending clinic. Most of these patients have severe and intractable epilepsies. Patients suffering from headaches and childhood migraine and other pain syndromes form another sizeable group who attend the pediatric neurology services. A lot of children with disorders like autistic spectrum disorders, neuromuscular disorders, demyelinating disorders and neurodegenerative disorders attend pediatric neurology clinic. With the facilities of latest MRI, electro neurophysiology, genetic and metabolic laboratory, many children are diagnosed with rare disorders by the pediatric neurologist.
Pediatric and neonatal neurosurgery is a highly specialized surgical branch. It was started as a separate department in June 2002 and it added new dimension to the existing neurosurgical facility at Sir Ganga Ram Hospital. It was the first subspecialty unit of its kind to be established in northern part of India both in private and government sector.
This specialty is run by a team of dedicated, trained and committed pediatric neurosurgeons Department of pediatric and neonatal neurosurgery adds its invaluable contribution to one stop multidisciplinary facilities available at the Institute of Child Health. All cases after neurosurgical procedures are managed at the state of the art pediatric and neonatal intensive care units. Hence complete and comprehensive care is being provided by a team of pediatric intensivists and neurosurgeons.
Over the past nine and half years, more than 1000 surgeries have been performed with highly successful results which are comparable to western statistics. Major congenital brain and spinal cord anomalies like hydrocephalus, spinal dysraphism(tethered cord) and encephalocoels were treated with highly encouraging results. The department has the lowest ventriculo-peritoneal shunt revision rate. The cosmetic and neurological results of most complicated surgery for severe craniosynostoses were most gratifying. The blood vessels abnormalities like aneurysms and arterio-venous malformations are rare in pediatric population and have been treated successfully in coordination with interventional neurosurgeon. The stereotactic surgery is an established mode of surgery for adult patients to handle space-occupying lesions in vital areas of the brain. This type of high end technology requiring highest level of skills has been performed in Sir Ganga Ram Hospital in pediatric patients.
Pediatric neurosurgery operation theaters are best equipped with dedicated neuro-anesthesiologists, latest Pentero microscope, CUSA, navigation station, stereotactic frame and endoscopes. The department is very active academically and research papers have been presented and awarded in the national and international conference
Pediatric Gastroenterology and Hepatology
The division of pediatric gastroenterology and hepatology is one of the finest in the country
mso-layout-grid-align: none; text-autospace: none;">providing state of the art diagnostic and therapeutic modalities all under one roof. The various facilities available include upper gastrointestinal endoscopy (diagnostic and therapeutic procedures like sclerotherapy,band ligation, foreign body removal, stricture dilatation etc.), sigmoidoscopy, colonoscopy, polypectomy, endoscopic retrograde cholangio-pancreatography (ERCP), endosonography, fibroscan, capsule endoscopy pH monitoring for gastro-oesophageal reflux disease and percutaneous endoscopic gastrostomy (PEG) tube placement for enteral feeding. Various diagnostic and therapeutic procedures such as liver biopsy and cyst/abscess aspirations are routinely performed. Gastrointestinal manometry is also available for complex gastrointestinal motility disorders. Over 400 endoscopic procedures are performed per year,including complex therapeutic interventions.
The unit has a very successful pediatric liver transplantation programme. It has to its credit the successful liver transplantation in a 4.5 kg child, the smallest in India. Several children in end stage liver disease have found a new lease of life in the hands of the experienced and dedicated team of this unit. Facilities such as molecular adsorbent recirculating system (MARS) for children in acute liver failure have helped in providing successful bridge to transplantation in children. The survival rate post transplantation is comparable to the best centres inthe world.
The hepatology wing is managing both chronic and acute liver diseases in children including hereditary diseases of liver. It is complimented well in the area of metabolic liver disease by an excellent unit of Genetics within the hospital, making it possible to diagnose and treat children with these life threatening diseases. Intervention radiological procedures are also performed in various vascular diseases of the liver. The unit has a dedicated wing providing nutritional inputs and classes for the caregivers and parents. These include nutritional counseling for simple and complex gastrointestinal disorders. Disorders such as chronic liver diseases, chronic diarrhea, persistent diarrhea, and chronic constipation requiring nutritional as well as medical inputs are managed comprehensively by the team of experts on a regular basis.Besides widespread clinical and research work being done by the unit, training and fellowship programme has been undertaken to impart clinical knowledge to upcoming doctors in the field of gastroenterology.
The division of pediatric & adolescent endocrinology/diabetes provides diagnostic, consultative, and long-term management of patients known or suspected of having endocrine disorders. These include children with diabetes mellitus, growth disorders (short or tall stature), hypopituitarism, abnormal pubertal development (early or delayed puberty), obesity, menstrual abnormalities, hirsutism, gynecomastia (breast enlargement in boys), thyroid and adrenal disorders, disorders of sexual differentiation (abnormalities of genitalia such as undescended testes, micropenis etc) and problems of bone calcium metabolism. Comprehensive care is provided in both inpatient and out patient settings.
There is a special clinic dedicated to growth & pubertal disorders, obesity & diabetes and a thalassemic endocrine clinic for thalassemic children at our centre. Facilities for investigating children with endocrine disorders are available in the hospital. These include all stimulation tests, a genetics laboratory, radiological facilities, expertise in interpretation of bone age and skeletal dysplasias and a department of nuclear medicine.
There is a newborn screening program for congenital hypothyroidism and congenital adrenal hyperplasia. Every baby delivered in our hospital is screened for these disorders before discharge so that an early diagnosis can be made. Our diabetes service provides diagnosis, education, and initial and ongoing management of children with diabetes from infancy through late adolescence. The goal is to keep children healthy and out of the hospital by teaching them and their families as to how to meet the challenges imposed by diabetes. We also have the expertise in insulin pump use and continuous glucose monitoring systems for diabetic children.&
Pediatric Cardiac Sciences
Pediatric cardiology and cardiac surgery services provide a full spectrum of evaluation, diagnosis and management of congenital and acquired heart diseases including cutting edge interventional therapy from fetus to adulthood. Services are provided by a team of pediatric cardiologists specialized in the care of neonates, infants and children who require cardiac care. The pediatric cardiology faculty perform both diagnostic and therapeutic interventional procedures in infants and children including balloon septostomy balloon valvuloplasties, device closure of ASD, VSD and PDA and stenting of critical lesions
Pediatric cardiac surgery services are provided by highly trained and dedicated pediatric cardiac surgeons specialized in neonatal and pediatric cardiac surgeries and ably supported by trained pediatric cardiac anesthesiologist. Pediatric cardiac surgery is available for a whole range of disorders, from repair of ventricular septal defect, atrial septal defect and tetrology of Fallots to highly complex neonatal cardiac surgery including arterial switch operation total anomalous pulmonary venous connection and double outlet right ventricle. The pediatric cardiac operation rooms are equipped with all the modern gadgets and monitoring systems required for the complicated surgery. The post operative care is provided round the clock by an in-house designated team including cardiologist, anesthesiologists and intensivists.
Pediatric Emergency and Acute Care Services
Institute of child health centre is one of few hospitals which has a dedicated pediatric emergency room. The specialty provides round the clock (24x7) emergency care to all the pediatric patients (birth to 16 years) coming to emergency room. Over 8000 patients attend emergency per year. The pediatric emergency services are supervised by senior pediatric consultant who is trained in pediatric emergency, acute care and toxicology. In addition to emergency services, pediatric procedural sedation and analgesia is also provided.
Pediatric Infectious Diseases and Immunology
Dedicated pediatric infectious disease services are being provided since 1998 in the department. Children admitted in the wards and those seen on ambulatory basis as outpatients and in the specialty clinics are referred with various complicated bacterial, viral and fungal infections. Services are being provided for children with HIV infection and AIDS. These children are referred from various cities of northern India. A compassionate treatment is provided to all the in-patient and out patient without any discrimination. Mothers and infants are managed for prevention of perinatal transmission. All the laboratory facilities (hematological, biochemical and immunological) and other ancillary amenities are available for diagnosis of congenital immunodeficiency disorders including T and B cell disorders. Children are managed for hypogammaglobinemia and are given IVIG therapy on routine basis. Children with drug resistant TB are evaluated and managed according to standard protocols. Routine immunization services are provided in the immunization clinic. Travel immunization and prophylaxis is also offered to various patients.
Pediatric rheumatology is a sub-specialty of pediatrics that embraces the study of inflammatory and non-inflammatory conditions involving the connective tissues in children less than 16 years of age. This service was set up in 2001 and over the last decade has grown from a small fledging to a well established unit. We have the distinction of being the first centre in the private medical arena in India to start this pediatric subspecialtyand today are the only centre in the country to have a post doctoral fellowship programme.
The common problems seen and addressed by the team include: childhood arthritis, juvenile lupus erythematosus, juvenile dermatomyositis, and vasculitis including Kawasaki disease and pain syndromes. The unit has frequent references for children with Pyrexia of Unknown where we commonly diagnose Stills Disease or SLE. The children with rheumatic diseases may have joint pains, fever, rashes,muscle weakness, breathing difficulty, seizures, nephritis and indeed problems in virtually any body system. The division of pediatric rheumatology at the hospital provides comprehensive care to children with these diseases and is equipped to look after patients with complex and multisystem disorders. We aim to provide world-class multidisciplinary care under one roof and prefer to do this in an ambulatory setting so as to minimize disruption of normal family life for the child
The Division of Pediatric Rheumatology has registries on several rheumatic diseases and provides state of the art care with modern therapeutic agents including Biologic response modifiers. Each patient is assessed objectively and periodically reviewed with the aim of early remission and excellent quality of life in all children
Clinical Child Psychology
Central to this specialty is psychological assessment and psychotherapy. This service specializes in the assessment of development delays and associated disabilities, assessment and therapies for autism, assessment of poor school performance and learning disabilities, IQ assessments, personality testing, aptitude testing, neuro-developmental evaluations, remedial tutoring, behavioural assessments and their structuring, attention deficit disorders and hyperactive children. There are special sessions on counseling children, parents and families of chronic medical diseases and victims of child abuse, rape and dysfunctional families.
Child and adolescent psychiatric services provide specialist care for children, adolescents, and young people, parents and families with emotional, behavioural, psychosomatic, neuro-developmental and educational problems through a holistic team approach.
Department of Pediatric Surgery
Pediatric surgery deals with the surgical care of newborn babies, infants, children and adolescents up to the age of 16 years. This department has been providing comprehensive, state-of-the-art surgical care to children, including tertiary care, for more than three decades. Besides the commonly performed surgeries for hernia, hydrocele, and undescended testis on day-care basis we are routinely dealing with complex surgical problems in children, including major congenital malformations in newborns like esophageal atresia with or without trachea-esophageal fistula, congenital diaphragmatic hernia, neonatal bowel obstruction,
abdominal wall defects, etc. Pediatric urologic surgeries for pelvi-ureteric junction obstruction, vesico-ureteric reflux, megaureters, bladder exstrophy, and endo-urological procedures such as cystoscopic fulguration of posterior urethral valve inneonates, endoscopic management of reflux are regularly performed. Hepatobiliary lesions like biliary atresia, choledochal cyst, liver mass, etc. and gastro-intestinal anomalies such as anorectal malformations, Hirschsprung's disease, intestinal atresia, malrotation etc. are commonly done. Pediatric thoracic surgery for lung cysts, lobar emphysema, cystic adenomatoid malformation and other mediastinal masses are also conducted. Video-assisted thoracoscopic surgery (VATS) in children with empyema and other thoracoscopic procedures are also performed. Reconstructive surgery in children with cleft lip, cleft palate and hypospadias / epispadias is undertaken. Pediatric tumors like Wilm's, neuroblastoma, sarcomas, teratomas, etc. are managed successfully with the support of pediatric medical-oncology and intensive-care teams. Minimal access abdominal surgeries are routinely done for both diagnostic and therapeutic reasons (laparoscopic appendicectomy, cholecystectomy, lap-assisted pull-through procedures etc.) in our department. Pediatric trauma is managed with multidisciplinary approach.
A team of doctors including senior pediatric surgeon, post-graduate senior resident and the trainee resident doctors provide comprehensive surgical care to the children round the clock. The department is accredited by the National Board of Examinations for the super-speciality training in pediatric surgery.
Department of Neonatology
Care of newborn babies has vastly improved in India over last two decades. The department of neonatology takes pride in undergoing this transformation. This unit came into existence in 70's. With improving technological and medical expertise this unit has established as one of the best, not only in Delhi but also in India. It was the first unit in private setup to start mechanical ventilation in newborns. It is comparable to any good international new born unit. Strength of the unit comes from the 'State-of-the-Art' obstetrical and perinatal services rendered in the hospital, which attracts large number of highrisk deliveries. We have one of the largest units with 1000-1200 admissions per annum. The unit has 32 beds and is equipped with modern ventilators, including high frequency ventilator, incubators and multi-parameten monitors and a step-down intermediate care unit.
All procedures related to the neonate like exchange transfusion (both central and peripheral), peritoneal dialysis, surfactant delivery, central line insertion, arterial line insertion and intercostal tube drainage are carried out with precision. The unit now offers a special lactation room where mothers can catch a nap as well as express their milk through latest pumps available. We are proud to be able to have a dedicated lactation counselor who takes sessions on advantages and techniques of breast-feeding and helps mother with expression of breast milk. Apart from lactational counseling she is also a qualified stress counselor and spends valuable time helping relieving & counseling parents of sick neonates in NICU.
Excellent neonatal transport facilities are available round the clock. The resident doctor on duty carries cellular helpline (9810484848) and on receiving the requisition for transport, the transport team comprising of a doctor and a technician goes with the transport incubator fitted with ventilator and monitoring equipment. Over the last 8 years, we have transported (both road and air) nearly 1000 babies from Delhi and surrounding states. We are fortunate to have two transport incubators, one for intramural (with in the hospital) and other one for extramural (from outside) transport. The extramural is latest 'state-of-the-art' transport incubator with attached ventilator.
The unit is first in country to be accredited with DNB neonatology program where fellows are trained in art of neonatal sciences
The problems of long standing cough, wheezing, breathlessness, recurrent pneumonia, asthma, sore eyes, skin rash or eczema and food allergies are on the rising trend. Children are most vulnerable for these problems as body is still developing. Both indoor and outdoor pollution along with other factors are responsible for allergic disorders in children. Once these conditions are not adequately taken care of, these persist in adulthood affecting the quality of life. Allergic disorders are problematic for whole family rather than for an individual. If they are appropriately managed early, allergy can be controlled and people could be free of symptoms for life. Division of Pediatric Pulmonology, Sir Ganga Ram Hospital has started Pediatric allergy clinic for children and adolescents, who are suffering from allergic disorders. A general OPD will be conducted, under supervision of allergy specialist, on every Thursday from 12 noon to 01:00 PM in R. No. G 10 at ward 6, ground floor. Specialized techniques for early diagnosis like skin prick testing and definite immunotherapy are also available.