The Department is at the forefront among centres that provide comprehensive surgical care to children, including tertiary care.

Overview

Pediatric Surgery deals with the surgical care of newborn babies, infants and children to the age of 18 years. This branch is highly specialized, not only because one has to handle very delicate and miniature tissues, but also because it requires a great deal of patience, compassion and understanding to handle little babies and their very anxious parents. The Department is at the forefront among centers that provide comprehensive surgical care to children, including tertiary care.

PEDIATRICS:

Noble Hospital, Pune provides state-of-the-art care to children with complex clinical conditions. These services are provided by a dedicated team of experienced and trained experts and specialists in several fields of Paediatrics. Many specialists work together for some children to provide comprehensive care under one roof. We provide a full range of inpatient and outpatient clinical services for children and their families to optimize health and well-being.

Services available at the ICH are:

• General Paediatrics
• Pediatric Surgery
• Neonatal intensive care
• Adolescent medicine
• Cardiology
• Comprehensive thalassemia care
• Developmental pediatrics
• Emergency medicine
• Intensive care
• Neonatal care
• Neonatal & pediatric cardiac surgery
• Nephrology
• Neurology
• Orthopedics
• Psychiatry
• Psychology

Treatment:

The Department provides it's services broadly in following domains:

• Pediatric General and Specialities OPDs
• Pediatric Emergency Medical Services
• Pediatric Indoor services- Pediatric General Ward, Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU)

PEDIATRIC OPD SERVICES

Children never stay calm in one place and always are on the tip of their toes to stroll around. The large & beautiful play area allows children to play and move around during their waiting time. The OPD and waiting area have been thoughtfully designed by The Director of Paediatrics, Dr. P.D. Pote, keeping in mind the Emergency patients are given preference.

The appointment system is managed in an effective way to cut down waiting time with equal justice given to walk-in patient treatments.

Noble Hospital is also extending the Paediatric OPD and Immunization services to kids on a daily basis at its Branch, Noble Polyclinic at Destination Centre in Magarpatta City in Pune.

OPD Timings:

Noble Hospital Pune is unique in its class for conducting Paediatric OPD even on Sundays as there is no time-bound for kids to become sick. Sunday OPD also provides convenience to the parents, who are busy on weekdays, immunizing their kids.

The OPD is open every day from 8:00 am to 9:00 pm (Sunday 9:00 am to 3:00 pm) and is attended by qualified, experienced and Senior Consultant Paediatricians. In order to minimize inconvenience and waiting period, OPDs are conducted simultaneously in two different chambers, by two consultant paediatricians at a time providing quick service to sick children.

Speciality Paediatric OPDs:

• Pediatric Surgery
• Pediatric Neurology and Neurosurgery
• Pediatric Ophthalmology
• Pediatric Nephrology
• High-Risk Infant Clinic
• High-Risk Child OPD
• Healthy Baby Clinic
• Immunization Clinic
• Pediatric Nutrition
• Pediatric Psychiatry
• Pediatric ENT
• Pediatric Plastic Surgery

Healthy Baby Clinic

Noble Hospital follows the principle “prevention is better than cure” by conducting a comprehensive preventive Healthy baby clinic. It is conducted daily (except Sunday) for healthy babies who are advised to visit their doctor at a specific scheduled time (starting at 4 weeks, then every month for the first 6 months, then every quarter till 2 years, then every 6 months till 12 years of age) for a comprehensive preventive program which includes:

Periodic assessment of their growth (with the help of growth charts), nutritional status and development. It also helps in scheduling their immunizations and addressing parental concerns (like feeding, bathing, massage, frequency of urine and stools, growth, developmental milestones, teething, nutrition, etc.). This OPD provides sufficient time for educating parents for caring for their babies during a sick period (e.g.: fever control, care of hydration, monitoring for urine output, relieving nasal blockade, etc.) And also educating them for assessing danger signs in their children, advising on Breastfeeding practices, weaning practices, diet and nutrition.

The healthy baby clinic also allows screening children for early signs of disease (like anemia, heart murmur, etc.) to conduct their behavioral assessment and counsel them on child psychology and child behavior-related problems.

Immunization Clinic

Immunization, being one of the most precious inventions in human life to date, is an important aspect of Paediatrics, for the prevention of diseases in your child. Emphasizing the importance of prevention of communicable diseases in your kids, Noble Hospital conducts a separate Immunization clinic, conducted daily including Sundays. Sunday OPD also provides convenience to the parents who are busy on weekdays for immunizing their kids.

In Immunization clinic, thorough information is given to parents regarding:

• Vaccination schedule for both mandatory and optional vaccines.
• Options of combination vaccines
• Post vaccination care & monitoring
• Possible side effects after vaccines & its management
• Vaccine recommendations in Special situations etc.

Growth & Nutrition

Department of pediatrics Noble hospital in collaboration with the Department of Diet and Nutrition conducts comprehensive programs and counseling sessions towards parental education for assessment of growth of their kids and for providing proper and balanced nutrition to them.

High Risk Child OPD

Children visiting the OPD who are very sick (eg. All emergency clinical conditions, High-grade fever, continuous vomiting, or loose motions) are given first priority and are immediately attended to by a Resident doctor and managed accordingly in the procedure room and immediately seen by consultant pediatrician also.

High Risk Infant Clinic

Noble Hospital provides a separate consultation facility dedicated to the high-risk newborns discharged from NICU: for their regular follow-up, monitoring, assessment of growth, development, hearing, and vision as well as for their vaccinations. This avoids delay in waiting for the delicate infants avoiding their contact with other children presenting to general OPD.

Follow Up OPD

During hospitalization admitted children as well as their parents suffer from mental and physical stress. Keeping this in mind, We provide separate follow up consultation facilities for ease & convenience of pediatric patients discharged from PICU or Paediatric General Ward, ensuring their compliance to the post-discharge medicines and instructions as well as ensuring complete recovery from the disease process, its prevention in the future with special emphasis on their nutritional rehabilitation.

PEDIATRIC EMERGENCY SERVICES

Though every medical emergency is EMERGENCY but in a Paediatric emergency each second counts. Noble Hospital understands this and is open (365 days, 24×7) for all pediatric emergencies providing: Emergency medical Services to all pediatric patients presenting to the Emergency/Casualty Department, all attended by educated and trained pediatricians and guided by senior consultants.

HOSPITAL ADMISSION FOR CHILDREN

Noble Hospital is equipped with a state of the art 20 bedded Paediatric general ward for hospitalized children. It also has a facility for admitting sick children in semi-private, private, deluxe and super-deluxe rooms.

Hospitalization of a child causes mental trauma to the parents but it is needed for the betterment of your sick child. To make you and your child comfortable our caring nursing & medical staff is always there. Parents are informed at the time of admission about provisional diagnosis, plan of care, investigations, and management. Keeping in mind parental anxiety, they are briefed and counselled twice a day regarding the progress and development, by senior pediatricians. The ward is attended to and taken care of 24×7 by pediatric resident doctors. The Unit gets around 900-1000 admissions in a year. The unit gets about 2,000 admissions in a year. All the consultants manage these babies as per their admission days. Pediatric services are kept at an affordable level.

Dr. P.D. Pote has designed the Paediatric General Ward keeping every important aspect of hospitalized children in mind, making it very spacious, with a child-friendly environment having brightly painted walls with colourful charts, cartoon cut-outs and posters adorning the walls. The ward is equipped with toys and games to keep the child patient entertained, happy and stress-free… The ward is Resident Doctor friendly as well, providing an excellent working environment and monitoring facilities for them.

Paediatric ICU

Children presenting with critical illnesses need intensive monitoring, care, and treatment, which is provided in PICU. Noble Hospital proudly has the only Paediatric Intensive Care Set-Up (including ventilators and equipment’s) in this densely populated part of the city, providing intensive care (includes medical, specialty medical, surgical and specialty surgical intensive care also) to critically ill kids in and around this part of the city with a radius of 200 Km. This also caters to emergency retrieval and intensive care to children with Road Traffic Accidents on Pune-Solapur, Pune-Baramati, and Pune-Nagar Highways. We also have a facility for providing post-operative care to children undergoing major surgeries. Every critically ill child’s initial time period is very vital, which is very well taken care of by our intensivists.

During the stay of children in PICU, their parents face a lot of stress. Noble Hospital respects their concern and hence it has ensured a well-equipped state–of–the–art Paediatric intensive care unit providing care to both pediatric medical as well as surgical patients.

The number of PICU inpatients, 40-50 per month, has a variegated profile. The more frequent indications for PICU admissions are Polytrauma with road traffic accidents, traumatic and non-traumatic coma, respiratory failures from cases of pneumonia, asthma, congenital heart diseases, myocarditis, septic shock, diabetic ketoacidosis, liver diseases, renal failure, foreign body aspiration, accidental poisoning, and animal bites. Children undergoing major pediatric surgeries are monitored in the PICU peri-operatively. The PICU has trained staff, sophisticated equipment like infusion pumps, syringe pumps, Multipara, NIBP, Pulsox monitors and ventilators, and extensive backup facilities like blood gas, micro lab assays, ultrasound machines, bedside X-ray, bedside 2D-Echo, advanced hematological, serological, biochemical and advanced microbiological testing. We have a 4 bedded PICU with the following facilities:-

• 24-hours trained paediatric intensivists caring for critically ill children.
• 3 Latest generation ventilators and equipment (Multipara, Pulsoximeters, Infusion pumps, syringe pumps, etc.)
• Facilities for pediatric critical care subspecialties e.g. Pediatric Surgery, Intensive care, Nephrology, Neurology, Neurosurgery, Cardiology, Gastroenterology, Infectious disease specialist.
• Facilities for procedures during critical care (e.g. Endotracheal intubation, Central line insertion, Lumbar puncture, Thoracocentesis and Intercostal drain insertion, Ventricular tap, Arterial line insertion, Defibrillation, etc.)
• Management (Diagnostic, Therapeutic interventions and Monitoring) is standardized and protocol-based.
• Standard and Prompt diagnostic modality support like urgent bedside X-rays, bedside USG and 2D-Echo, bedside Arterial Blood Gas Analyser, and other laboratory support. Major radio diagnostic support (CT, MRI, Reflux Studies), Endoscopies, colonoscopies under one roof
• Well-trained and experienced, age-specific nursing staff
• Facilities for children with trauma and burns.
• Facilities for peritoneal dialysis

State of art Neonatal Intensive Care Unit (NICU):

In Every Human life, the Neonatal period is the most critical and susceptible period which needs maximum care. Noble Hospital has great pride to have the only NICU set up in this part of the city catering to a large population.

The Neonatal Intensive Care Unit has trained staff, sophisticated equipment like warmers, incubators, pumps, and ventilators, and extensive backup facilities like blood gas, micro lab assays, ultrasound machines, bedside X-ray, bedside 2D-Echo, advanced haematological, serological, biochemical and advanced microbiological testing. It is a 12 bedded State-of-the-art NICU with 4 bedded step down unit. NICU is looked after by qualified neonatologists, paediatricians and well trained, age-specific nursing staff. Our NICU provides the following services and facilities (both medical and surgical) to suffering new-borns.

Services:

• Surfactant administration
• Total Parenteral Nutrition
• Functional Echocardiography
• Bedside Neurosonography
• Ventilator Management
• Phototherapy – Conventional / LED / Bili blanket
• Bubble CPAP system
• Care of Micropremies (elbws, vlbws and lbws)
• Post-operative care to new-borns undergoing major surgeries.
• Facilities for procedures during critical care (e.g. Endotracheal intubation, Surfactant administration, Partial Exchange Transfusion, Double Volume Exchange Transfusion, Umbillical Vein and Artery Catheter insertion, Lumbar puncture, Thoracocentesis and Intercostal drain insertion, Ventricular tap, Arterial line insertion, etc.)
• ROP screening (Retinopathy of Prematurity) for sick, premature neonates ensuring normal vision for them.
• Neonatal Database Management
• Neonatal Clinical Research
• Training opportunities in the NICU
• New-born Transport
• Retrieval of new-borns from nearby and surrounding nursing homes and hospitals
• New-born Good Health Packages
• Twice daily counselling sessions for parents and relatives

PEDIATRIC SURGERY:

Pediatric surgery is a super specialty branch, which involves operations performed on babies, from fetal age to adolescent age (up to 18 years) by neonatal and pediatric surgeons, who have completed their super specialization (M.Ch) in neonatal & pediatric surgery including Paediatric urology and are extensively trained in managing surgical problems in children.

All the facilities to care for babies undergoing surgery are available under one roof in Noble hospital.

We have well-equipped operation theatres with the state-of-the-art infrastructure, a renowned team of pediatric surgeons well trained in operating on hardly a kilogram baby, anesthetists trained in administering pediatric anesthesia, and excellent postoperative medical and supportive care for the children undergoing surgeries.

The surgeries performed by Pediatric surgeons in our hospital include:

• NEONATAL SURGERY- all congenital anomalies requiring surgery like Tracheoesophageal fistula (TEF, or TOF), diaphragmatic hernias (CDH), omphalocele, gastroschisis, neonatal intestinal obstructions, Jejunal atresia, anorectal malformations, etc. are operated successfully.
• PEDIATRIC GENERAL SURGERY- Inguinal hernia, hydrocele, phimosis, umbilical hernia, hamartomas, thyroglossal cysts, branchial fistulas, appendicitis, intestinal obstructions, Hirschsprung’s (HIRSH-sproongz) disease, hepatobiliary surgery including choledochal cysts, biliary atresia, pancreatic cysts , pediatric thoracic surgery, etc.
• PEDIATRIC UROLOGY- pediatric surgeons are trained in performing all pediatric urological surgeries including complex urogenital reconstructions in children. E.g.: undescended testis, hypospadias, genitoplasties for intersex (DSD), hydronephrosis, vesico ureteric reflux, PUV fulguration, bladder exstrophy repairs, bladder augmentation, etc.
• PEDIATRIC NEUROSURGERY- Meningomyeloceles, encephaloceles, VP shunts for hydrocephalous, etc. are done by pediatric surgeons.
• PEDIATRIC TRAUMA- cosmetic suturing of clws, burns wound care, RTA patients including blunt trauma, stab injuries, hemoperitoneum, etc. are managed by an experienced team of pediatric surgeons
• PEDIATRIC MINIMAL ACCESS SURGERY/ ENDOSCOPIC SURGERY- our pediatric surgeons are trained in performing keyhole surgery (laparoscopic surgery ) even in new-born babies. Laparoscopic appendectomy, laporchipexy, laparoscopic repair of diaphragmatic hernias, lap abdo cysts excisions, and even VATS- video-assisted thoracoscopic surgery for empyemas, lung cysts ,biopsies, etc. Are performed routinely in Noble hospital.
• Endoscopic surgery like bronchoscopy for foreign body extraction, esophagoscopy, sigmoidoscopy, colonoscopy, etc. are done by trained pediatric surgeons.
• PEDIATRIC ONCOSURGERY- all pediatric tumours – nephroblastomas (wilms), neuroblastomas, hepatic tumours, ovarian tumours, rhambdomyoscarcomas etc. are successfully operated by our team of paediatric surgeons.
• ANTENATAL COUNSELLING AND FETAL SURGERY- would-be parents are counseled from the antenatal period itself if any congenital surgical anomaly is detected in fetus so that parents are prepared postnatally to handle the situation well.