Pediatrics

The Pediatric Cardiothoracic Surgery department at Apollo Institute of Pediatrics is a centre of excellence for the surgical treatment of congenital and acquired heart and lung conditions in children. Our team of highly skilled pediatric cardiothoracic surgeons, supported by specialised cardiac anesthesiologists, intensivists, and nurses, provides comprehensive care for the most complex cardiac and thoracic conditions.

Key areas of expertise include:

1. Congenital heart defects

• Problems with the heart's structure that are present at birth, ranging from mild to life-threatening.
• Surgical correction of conditions such as atrial and ventricular septal defects, Tetralogy of Fallot, and transposition of great arteries, etc.

2. Neonatal cardiac surgery

• Specialised surgeries for critically ill newborns with congenital heart defects.

3. Heart valve repair and replacement

• Indicated for a blocked/narrowed valve in your child’s heart or one that isn’t functioning normally.
• Procedures to correct valve dysfunction while preserving heart function.

4. Aortic arch reconstruction

• Coarctation (narrowing) of the aorta (the largest artery in the body) is a congenital heart defect that occurs when a baby's aorta does not form properly during pregnancy, which is corrected by surgery.
• Surgical treatment for narrowing of the aorta and other arch defects.

5. Management of cardiomyopathies

• Rare heart condition that affects the heart muscle in children.
• Surgical options for heart muscle diseases unresponsive to medical therapy.

6. Lung and chest wall abnormalities

• These include structural abnormalities of the chest, conditions affecting the lungs and the chest cavity, etc
• Expertise in lung resections, chest wall corrections, and treatment of thoracic masses.

Pediatric Cardiology expertise  of the Apollo Institute of Pediatrics is well known all over India for  superior patient care and clinical outcomes. From infancy to adulthood, our team of Cardiologists, Cardiac Surgeons, nurses and other specialists collectively are dedicated exclusively to providing a full spectrum of cardiac services for patients with congenital heart disease and other rare heart conditions. Each year, our Cardiologists care for more than 10,000 children and adults with congenital and acquired heart defects, including the rarest and most complex cases in the world. This level of experience translates to better outcomes. Our Cardiologists sub-specialise in different areas of Cardiology including Catheter intervention, Foetal Cardiology, Three Dimensional Echocardiography, Pulmonary hypertension, Heart failure & Pediatric Heart and Lung Transplantation.

ECHOCARDIOGRAPHY AND FOETAL CARDIOLOGY PROGRAMME
We specialise in Echocardiography for Congenital and Structural heart disease. Both Transthoracic and Transesophageal Three Dimensional echocardiographic studies are performed with technically advanced machines. Portable echocardiography facilities are available in the Catheterisations lab, Cardiac Operating room, Cardiothoracic ICU and Pediatric intensive care. We perform foetal echocardiography and offer antenatal counselling services for high risk pregnancies. Our team has expertise in Neonatal emergency cardiac care, Neonatal interventions and gives inputs pre and post cardiac surgeries.

CARDIAC CATHETER INTERVENTIONS
We have a team of Interventional Cardiologists who perform complex structural interventions including neonatal interventions, adult congenital interventions and Hybrid procedures. We perform about 500 catheter interventions per annum, in our state-of-the-art catheterisation laboratory.

HEART FAILURE / PULMONARY HYPERTENSION CLINICS AND TRANSPLANT PROGRAMME
We maintain a database of Heart failure and pulmonary hypertensive patients. Detailed clinical assessments are performed for these patients in the Heart failure and Pulmonary hypertension clinics which are conducted twice a week.

TRAINING PROGRAM
The Department is accredited for the National Board of Examinations (NBE) Fellowship programmes. We support the development of future leaders in Pediatric Cardiac care. We currently host National board fellows, International fellows and fellows on rotation from Pediatrics and Adult Cardiology. Fellows receive hands on training in Echocardiography and Cardiac Catheterisation procedures. We offer an academic programme with regular clinical case discussions, journal clubs, seminars and formative assessments. Papers are presented regularly at  National and International conferences.

Read more

The Department of Paediatric Urology provides comprehensive, multi disciplinary tertiary care for children with a wide spectrum of Urological problems / abnormalities. We offer a highly specially and focused treatment for Urology problems. Our expert Paediatric Urology surgeons perform precise surgeries empowered by the availability of the latest facilitating equipments and back up support of trained staff in the field of Key hole surgeries, Laparoscopic surgeries, Robotic surgeries and Endourology.

Conditions treated and Services offered:

• We specialise in procedures for:
  • Hydronephrosis- a condition involving swelling of the kidney due to build up of urine
  • Pelvic ureteric junction obstruction- a blockage of the junction where the kidney meets the ureter
  • VUR / Duplex System

Vesicoureteral reflux [VUR] occurs when urine flows backward from the bladder to the kidneys, increasing the risk of kidney infections and damage.  Duplex system is a congenital condition where the kidney has two separate collecting systems instead of a normal single system . We provide a full spectrum of treatment options, from conservative management with antibiotics to minimally invasive surgical correction, such as ureteral reimplantation or endoscopic injections.

• Antenatal counseling for foetal urological conditions.
• Neonatal emergencies, prenatally detected anomalies, abdominal mass, urosepsis, urinary retention, scrotal masses, abnormal external genitalia, etc.
• Neonatal conditions: Renal anomalies, tumours, exstrophy complex, ambiguous genitalia, posterior urethral valve, scrotal anomalies, etc.
• Multidisciplinary care for kids with bladder and spine anomalies, which combines the expert collective care of Paediatricians, Nephrologists, Paediatric Urologists, Neurosurgeons, Endocrinologists and Developmental Physicians.
• Various Endourological procedures like:
  • PUV fulgration: a minimally invasive procedure to treat Posterior urethral valve , a condition causing blockage in the male urethra
  • Ureterocele deroofing: a procedure to treat ureterocele , a swelling at the end of the ureter
  • Sub ureteric injection of Deux for Vesicoureteral reflux, using injection of a bulking agent called Deux  near the point of entry of the ureter.
  • Endoscopic injection of ‘Botox’ for Neurogenic bladder, where the bladder is affected by nerve damage.
  • Bladder and ureteric stones managed by Laser Lithotripsy, where the stones are broken by laser energy.
  • PCNL (Percutaneous Nephrolithotripsy)  for Kidney stones using small incisions .Apollo is one of the few centers in India doing this procedure in the paediatric age group
• Reconstructive urology

This includes procedures like Bladder Augmentation.

• Management Paediatric Penile abnormalities: penile torsion, chordee, concealed penis, intersex surgeries, and Hypospadias. Hypospadias is a congenital condition in males where the urethral opening is located in the underside of the penis instead of at the tip. We are one of the major centres in India where all varieties of Hypospadias are corrected as a one stage procedure with results comparable to the best in the world.
• Treatment of bladder functional abnormalities, urinary urgency, urge incontinence, dysfunctional voiding, neurogenic bladder, nocturnal enuresis etc with add on availability of paediatric urometry/ Urodynamic studies  to assist in treatment.

The Pediatric Neurology department at Apollo Institute of Pediatrics is dedicated to diagnosing and treating a wide spectrum of neurological disorders in children, from infancy through adolescence. Our team of experienced pediatric neurologists works in collaboration with other specialists to provide comprehensive care for complex neurological conditions.

We have a fully equipped Neurophysiology lab for all the tests needed.

Facilities for laboratory investigations and radiology (including MRI) are available. Inpatient video-EEG telemetry and other neurophysiological testing facilities are also available in a child-friendly environment.

Key areas of focus include:

1. Epilepsy Management

• Long-term medical management of epilepsy, a brain disorder that causes people to have brief episodes of involuntary movement called seizures.
• Advanced diagnostics, including video EEG monitoring and neuroimaging.
• Evaluation for epilepsy surgery and ketogenic diet therapy for medication-resistant cases.

2. Neurodevelopmental disorders

• Neurodevelopmental disorders are a group of conditions that affect the brain and nervous system during development, and can cause impairments in cognition, communication, behaviour, and/or motor skills.
• Early diagnosis and intervention for disorders like autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), etc.
• Multidisciplinary therapy plans, including behavioural, speech, and occupational therapy.
• Medical management of neurodevelopmental disorders along with child psychiatric specialists

3. Neuromuscular disorders

• These are a set of conditions where the  neuromuscular system is affected, including the nerves that control muscles and the muscles themselves.
• Expertise in managing conditions like muscular dystrophy (progressive muscle weakness and degeneration), myopathies (skeletal muscle issues), and Guillain-Barré syndrome (neurological disorder that occurs when the body's immune system attacks the peripheral nervous system).
• Advanced genetic testing and rehabilitation therapies.

4. Headache and migraine management

• Various headaches including migraines, tension headaches, sinus headaches, etc.
• Individualised treatment plans involving medication, lifestyle adjustments, and counselling.

5. Movement disorders

• Neurological conditions that affect your child's ability to move typically and with control.
• Diagnosis and management of conditions like cerebral palsy, dystonia, and tics.
• Botulinum toxin therapy and physical rehabilitation services.

6. Neuroimmunological conditions

• Conditions that occur when the body's immune system attacks itself, damaging the brain, nerves, and other tissues.
• Expertise in managing pediatric multiple sclerosis, acute disseminated encephalomyelitis (ADEM), and autoimmune encephalitis.

The Pediatric Orthopedics department at Apollo Institute of Pediatrics specialises in the diagnosis, treatment, and management of musculoskeletal conditions in children and adolescents. Our team of experienced pediatric orthopedic surgeons and specialists provides comprehensive care for a wide range of orthopedic issues, from common injuries to complex congenital deformities.

Key areas of expertise include:

1. Fractures and sports injuries

• Simple or complex injuries to your child’s bones, muscles, ligaments and tendons either due to a fall or a sports-related incident.
• Immediate care for bone fractures and sprains, emphasising growth-plate preservation.
• Rehabilitation for sports injuries to restore strength and mobility.

2. Developmental hip dysplasia

• A condition where the hip joint does not develop properly in babies and young children.
• Early diagnosis using advanced imaging techniques.
• Non-surgical (harness, bracing) and surgical (osteotomies) treatments tailored to your child’s age.

3. Limb deformities and length discrepancies

• Abnormalities in the growth and development of their arms or legs.
• Correction of bow legs, knock knees, and limb length inequalities using minimally invasive or advanced surgical techniques.

4. Scoliosis and other spinal deformities

• Abnormalities in the length and curvature of your child’s spine.
• Comprehensive care for scoliosis (sideways curve in the spine), kyphosis (backward curve in the spine), and other spinal issues, including bracing and spinal fusion surgery when needed.

5. Clubfoot and other foot deformities

• Congenital deformities like clubfoot, flat foot, tarsal coalition, etc.
• Expertise in the Ponseti method of using casts to manipulate better positioning and surgical corrections for resistant cases.

6. Management of bone and joint infections

• Prompt diagnosis and treatment to prevent long-term complications.

The Developmental Pediatrics department at Apollo Institute of Pediatrics specialises in the evaluation, diagnosis, and management of children with developmental delays and disorders. Our team of developmental pediatricians, psychologists, speech therapists, occupational therapists, and other specialists work together to provide comprehensive care for children with a wide range of developmental concerns.

Key areas of focus include:

1. Developmental Delays and Disorders

• Comprehensive evaluation and tailored interventions for autism spectrum disorders, ADHD, learning disabilities, and motor delays.
• Behavioural interventions
• Speech and language therapy
• Occupational therapy
• Physical therapy
• Educational interventions
• Medical management when appropriate

2. Speech and Language Disorders

• Diagnosis and therapy for children with delayed speech, stuttering or articulation issues.

3. Behavioural Problems

• Addressing concerns such as aggression, anxiety, and attention issues through counselling and behaviour therapy.
• Medical management if needed.

The Pediatric Endocrinology department at Apollo Institute of Pediatrics specialises in the diagnosis and treatment of hormonal disorders in children and adolescents. The endocrine system is a complex network of glands and organs, which uses hormones to control and coordinate your child’s metabolism, energy level, reproduction, growth and development. Our team of experienced pediatric endocrinologists provides comprehensive care for a wide range of endocrine conditions that affect growth, development, metabolism, and reproductive health.

Key areas of expertise include:

1. Growth disorders

• Disorders caused by a deficiency or excess in growth hormones in your child.
• Management of short stature and growth hormone deficiencies or excesses.

2. Thyroid disorders

• A common endocrine disorder affecting the production of thyroid hormone produced in the thyroid gland.
• Treatment for hypothyroidism, hyperthyroidism, and congenital thyroid disorders in children.

3. Diabetes (Type 1 and Type 2)

• A chronic disease that occurs when your child’s body does not produce enough insulin or can't use it properly, thus causing an excess of glucose in the body.
• Type 1 diabetes s an autoimmune disorder where your child’s immune system attacks pancreatic cells that produce insulin, while type 2 diabetes  is a lifestyle-related disorder often coupled with obesity and poor lifestyle.
• Comprehensive care, including insulin therapy and glucose monitoring for Type 1 and Type 2 diabetes, and lifestyle counselling for type 2 diabetes.

4. Puberty disorders

• Hormonal imbalances in your child, resulting in overproduction or underproduction of reproductive hormones.
• Overproduction of reproductive hormones can lead to precocious puberty (early puberty), while underproduction or delayed production of reproductive hormones can lead to delayed puberty.
• Management of precocious or delayed puberty.

5. Calcium and bone disorders

• Bone disorders can be caused by many factors, including genetic conditions and nutritional deficiencies.
• Treatment for rickets, osteogenesis imperfecta, osteoporosis, and other metabolic bone conditions in your child.

6. Obesity and metabolic syndrome

• Associated with insulin resistance, systemic inflammation, and cellular dysfunction.
• Lifestyle interventions and medical management to prevent complications.

The Pediatric Gastroenterology & Hepatology department at Apollo Institute of Pediatrics specialises in the diagnosis and treatment of disorders of the digestive system, liver, and pancreas in infants, children, and adolescents. Our team of experienced pediatric gastroenterologists and hepatologists provides comprehensive care for a wide range of gastrointestinal and liver conditions.

Key areas of expertise include:

1. Inflammatory Bowel Disease

• Chronic inflammatory condition of the gastrointestinal tract, including Crohn’s disease and ulcerative colitis, often causing abdominal pain, diarrhoea, and weight loss.
• Comprehensive management includes dietary counselling and medication.

2. Gastroesophageal reflux disease (GERD)

• Condition where stomach acid frequently flows back into the esophagus, leading to symptoms like heartburn, vomiting, or feeding difficulties.
• Lifestyle modifications, dietary adjustments, medications to reduce acid production, and in rare cases, surgical intervention.

3. Celiac disease

• An autoimmune disorder triggered by gluten, resulting in damage to the small intestine.
• Counselling and nutritional support to address deficiencies.

4. Motility disorders

• Disorders affecting the movement of food through your child’s digestive tract, including chronic constipation or delayed gastric emptying.
• Tailored treatment plans including dietary changes, medications to improve motility, and biofeedback therapy when needed.

5. Liver diseases

• Conditions like hepatitis, fatty liver, or metabolic liver disorders that can impair your child’s liver function and overall health.
• Early diagnosis through advanced imaging and blood tests, medication to manage liver inflammation, and specialised care for complex conditions including transplants.

6. Pancreatic disorders

• Diseases like pancreatitis or enzyme deficiencies affecting your child’s digestive process and nutrient absorption.
• Enzyme replacement therapy and dietary modifications to support digestion.

7. Nutritional disorders

• Issues like malnutrition, failure to thrive, or obesity that impact your child’s growth and development.
• Comprehensive nutritional assessments, personalised diet plans, and ongoing monitoring to ensure healthy growth.

Our Services include: 

• Comprehensive consultations, evaluation and diagnosis, clear management plans including nutritional support
• Diagnostic and Therapeutic endoscopic procedures, such as:
  • Upper GI endoscopy
  • Lower GI endoscopy (Colonoscopy)
  • Capsule endoscopy
  • Manometry (Esophageal & Anorectal)
  • Impedance / pH studies
• Liver procedures, such as:
  • Liver biopsy
  • Polypectomy
  • Variceal ligation
  • Sclerotherapy
  • Esophageal stricture dilatation
• Foreign bodies removal, Percutaneous Endoscopic Gastrostomy (PEG), ERCP.
• Liver transplant care:  Pre transplant assessment and perioperative care in coordination with liver surgical transplant team

The Pediatric Oncology department at the Apollo Institute of Pediatrics is committed to providing compassionate and cutting-edge care for children diagnosed with cancer. 

Treatment of children with blood disorders like anaemia and bleeding problems like haemophilia. Lead areas of service includes therapy of children with thalassemia major, sickle cell anaemia and children with recurrent infections suspected to have primary immune deficiency disorders. These children are seen in our speciality clinic and are offered diagnostic services including molecular work up and complete treatment including curative bone marrow transplantation all under one roof.

We work as a team with diagnostic services and have access to PET CT and specialist Histopathologists, Haematopathologists, Paediatric Intensivists, Paediatric Oncosurgeons and radiation oncologists to provide optimal care for children with cancer.

Bone marrow transplantation offers the only chance of cure for patients with difficult blood cancers, primary immunodeficiency and thalassemia major. The HOPE team performs about 80 paediatric transplants each year and is the largest paediatric bone marrow transplant centre in the country.

Key Areas of Expertise:

1. Leukemia and Lymphomas

• Cancers of the blood and lymphatic system, such as acute lymphoblastic leukemia (ALL) and Hodgkin’s lymphoma, which are among the most common childhood cancers.
• Comprehensive care includes chemotherapy, targetted therapies, and stem cell transplantation for high-risk cases.

2. Brain and Central Nervous System Tumours

• Tumours in the brain or spinal cord, such as medulloblastomas and gliomas, which can impact neurological function and development.
• Advanced surgical interventions, radiation therapy using precision techniques, and chemotherapy tailored to the tumour type.

3. Bone and Soft Tissue Sarcomas

• Cancers like osteosarcoma and Ewing sarcoma that affect bones or surrounding tissues, often presenting with localised pain or swelling.
• A combination of surgery, chemotherapy, and radiotherapy, with limb-sparing surgical techniques whenever possible.

4. Neuroblastoma

• Cancer originating in immature nerve cells, commonly found in the adrenal glands, affecting infants and young children.
• Multidisciplinary approach involving surgery, chemotherapy, radiotherapy, and, in advanced cases, immunotherapy or stem cell transplantation.

5. Wilms’ Tumour

• Kidney cancer primarily affecting children under 5, often presenting as a painless abdominal mass.
• Surgical removal of the tumour, followed by chemotherapy and, in some cases, radiotherapy to ensure complete eradication.

6. Retinoblastoma

• Rare eye cancer affecting young children, often detected through abnormal eye reflections or vision issues.
• Treatments include chemotherapy, laser therapy, cryotherapy, and, in advanced cases, enucleation (removal of the eye) to preserve life.

The Department of Paediatric Robotic Surgery is a part of both Paediatric Urology and Paediatric Surgery. This pioneering Department has been instrumental in exploring the use of robotics for surgery in children. The youngest child who has undergone surgery using the robot was just 2 months old and 4 kgs in weight.

Robotic Surgery is modified laparoscopic surgery. Through three or four holes, instruments are introduced into the body and are manipulated to cut and stitch.The instruments in Robotic Surgery have tiny tips which move, twist and turn like the human hand. Along with this, the robotic camera gives a three dimensional view of the internal organs in incredible detail. The depth of vision provided by the robot enables very delicate and precise surgery to be carried out with minimal morbidity. This means that only the diseased organ is dealt with and no disturbance is caused to the adjacent structures.

Unlike laparoscopic surgery, robotic movements are precise, ensuring that the procedure is completed in a very short time. The duration of anaesthesia is reduced and post-operative recovery is very quick. In most cases, oral feeding can be started within a few hours and the child is discharged within a day or two. Short hospitalisation ensures that working parents are not unduly affected.

The Paediatric Intensive Care Unit (PICU) of Apollo Institute of Pediatrics is the most advanced treatment facility of its kind, providing the highest level of care for critically ill and injured children. Many critically ill children with complex conditions are referred from all over India, and also internationally . 

The PICU team provides treatment that is current, evidence-based and closely adheres to global best practices. The unit is staffed by internationally trained and highly committed Paediatric Intensive Care physicians and provides critical care for 24 hours a day, 7 days a week. They liaise regularly with paediatric medical and surgical subspecialists regarding coordination of care, discharge and follow-up. In addition, specially trained Critical Care nurses complement PICU care.

Apollo offers Paediatric Intensive Care Fellowship training and has spearheaded important research that has been published in prominent national and international journals of the speciality.

SPECIALISED CARE

• Multi-system trauma care
• Infectious Disease support that contributes to the targeted therapy of resistant and complicated infections
• Stringent Infection Control department that strictly monitors infection prevention and minimises hospital acquired infections.
• Specialised Burn Intensive Care
• Cardiac Intensive Care after surgery for congenital heart disease
• PICU care after complex abdominal and thoracic surgery, neurosurgical and craniofacial and spinal surgery
• Oncological / Haematological Care
• Procedural Sedation
• Bedside invasive / non-invasive diagnostic procedures (e.g. Bronchoscopy, bedside EEG, ECG and echocardiography)
• Rapid retuning of therapy for complicated forms of circulatory shock using focused “Point of care” Cardiac, Lung and Abdomen Ultrasound
• Intracranial pressure monitoring (ICP)
• Multimodal Monitoring for Cardiac output monitoring – USCOM, PiCCO
• Ultrasound guided placement of central vascular access which improves precision
• Blood gas measurement machines
• Centralized monitoring system
• Difficult airway algorithms and equipment
• Respiratory therapy
• High low oxygen therapy
• Non-invasive ventilation-BiPAP/CPAP
• Nitric oxide therapy
• High frequency ventilator
• End-tidal CO2 monitors
• Hemofiltration  / dialysis/SLED/ Peritoneal dialysis
• Extra-corporeal membrane oxygenation (ECMO)

The specialised and unique state-of-the-art ECMO area is located within the PICU complex. With positive pressure controlled air and anti-microbial surfaces, the ECMO unit has stringent infection-control standards that match those in the Operation Theatre. Experienced multi-disciplinary team can set up ECMO under an hour for severe respiratory or cardio-respiratory failure that has failed conventional therapy. Many critically ill children who have failed conventional therapies have successfully undergone VV-ECMO (for refractory respiratory failure) and VA-ECMO (for refractory shock).