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Paediatrics: An Illustrated Colour Text.
  1. NANU GREWAL, Senior house officer, paediatrics

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    Paediatrics: An Illustrated Colour Text. Edited by D J Fields, J Stroobant. (Pp 120; £17.50) Churchill Livingstone, 1997. ISBN 0-443-05254-9.

    When I teach medical undergraduates I pitch at three levels: things that if you do not know, you will fail (for example, what is Kernig’s sign); things to know that will secure you a safe pass (for example, knowing the ABC of basic resuscitation); and things that will get you into the honours class (for example, use of DNAses in cystic fibrosis). I have yet to see a core textbook based on these key desiderata of the student mind set.

    Paediatrics: An Illustrated Colour Text is an enjoyable multiauthor book that offers help to students in a symptom based approach. It wants its photographs and (excellent) illustrations to do the teaching. These and a three column format of text enable it to boast comprehensive cover of paediatrics in a slim 120 pages.

    To the student familiar with browsing the internet this book is a boon for a paediatric attachment—much of the layout has aWindows feel to it. But one student’s path of least resistance is another’s dumbed down soft option and its A4 size and lack of margin space make carrying and annotating “on the hoof” difficult.

    What of the symptom based approach? It is true that much of paediatric diagnosis rests on the history. Plus, history taking is what a student does most of (and is most comfortable with). Unit headings, such as “noisy breathing” and “spots and rashes” deal with common problems and reflect the language of concerned parents. These criteria break down somewhat with “oliguria” and “abdominal lumps” (not classic symptoms) where it seems disease entities have been shoe horned in for completeness.

    What students find difficult is presenting cases, either on consultant ward rounds or eventually at finals’ long cases. Terminology, bandied effortlessly by senior house officers and registrars, can be daunting. The authors are to be applauded therefore for taking the trouble to define and distinguish basic terms such as respiratory noises (snuffles, stridor, wheeze, grunting, etc) and the terminology of rashes.

    The diagrams are well designed to stay in the memory, although the usefulness of this book as a revision aid is thwarted by a lack of depth in all areas. The problem arose when—for example, I wanted to read up, as students are often asked to, on meningitis. There are five references in the index, each to rather meagre entries in the text, while dehydration is not listed at all in the index. The air of superficiality is compounded by the absence of “further reading” sections.

    Overall, Paediatrics: An Illustrated Colour Text would be a useful companion for a first year clinical student. Its format is undoubtedly alluring, even addictive, but may frustrate students with designs on a career in paediatrics. If book budgets are tight, it cannot truly be recommended as a sound investment.