Monday, October 31, 2016

Cereals, Flours and Seeds Allowed in a Gluten Free Diet

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Cereals and Flours to Avoid in Celiac Disease

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Naturally Gluten Free Foods

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Capillary Hemangioma in a child

Capillary hemangioma on lower limb and face in an 11 months old infant ....

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Vital Signs at Various Ages

Normal Reference Ranges of Vital Signs at Various Pediatric Age Groupa

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Pain Assessment Tool for Kids Under 3 Years (in Urdu)

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High Dose Methotrexate Flowsheet For 4 hour MTX Infusion

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High Dose Methotrexate Flowsheet for 24 hour MTX Infusion

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Visual Infusion Phlebitia Score

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Thursday, October 27, 2016

Management of Fever in a Pediatric Oncology Patient

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Wednesday, October 26, 2016

NEW QUESTION DISTRIBUTION FOR MRCPCH THEORY EXAM

MRCPCH PART 1A (FOUNDATION OF PRACTICE)

61 BEST OF FIVE
14 EXTENDED MATCHING QUESTIONS
NO MORE TRUE FALSE

MRCPCH PART 1B (THEORY AND SCIENCE)

61 BEST OF FIVE
14 EXTENDED MATCHING QUESTIONS
NO MORE TRUE FALSE

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The Science of Pediatrics

New book for MRCPCH part 1b (now known as Theory and Science Paper)..........

THE SCIENCE OF PEDIATRICS - MRCPCH MASTERCOURSE

By Tom Lissauer and Will Carrol

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Sunday, October 23, 2016

Guidelines for the management of Retinoblastoma

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Friday, September 16, 2016

MRCPCH 2009 Website - for all those who are preparing for MRCPCH Exam

MRCPCH 2009 Website ..... a site where you can get almost all sufficient study material for MRCPCH exam. Short cases, long cases, mcqs, clinical exam scheme and videos, exam tips, and notes ... everything.

Here's the Link .... MRCPCH 2009 Website

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Can We Start Weaning (Complimentary Feeding) before 6 months?

This is also one of the common question or problem i would say, that is faced by almost all Physicians. People from different cultures have different views, but what we have to follow is Current Guidelines, that are purely based on Scientific Research.

Yes, we can start weaning before 6 months, but we should not. It's safe to introduce semi solids to your little one at or around 6 months of age.

Like people from different cultures have different views, same ways researchers from different countries have come out with different research ... but all the scientists are united on one thing i.e., weaning should not be started before 17 weeks of age (4 months).

American Academy of Pediatrics says that weaning before 6 months may lead to gastrointestinal infections.

Scientific Point of view to weaning at 6 months is: Digestive system is matured, baby can sit with support and have good head and neck control that makes chewing and swallowing easier, and baby has learned tongue skills (all are signs of readiness for weaning). Research also describes that until 6 months of age, all the nutritional requirements of baby can be fulfilled by milk alone, so why to hurry for weaning.

Mothers think that when baby cries even after feed, or chews fist or fingers, and wakes up in the night, are all signs of starting weaning foods, but that is totally wrong. These all are normal infant behaviors and all are considered as false signs of readiness for weaning.


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Thursday, September 15, 2016

Drugs to avoid in G6PD Deficient Patients

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2 yYear Old Child with Speech Delay - Take Relevant History

Commonly Tested in OSCE / TOACS


  1. Introduction
  2. Establish Rapport
  3. Detail Speech Development History
  4. Other history of developmental delay - gross motor, fine motor, adaptive, social
  5. Birth History - preterm, NICU admission, Congenital anomalies
  6. Family history - global delay, deafness
  7. history of hearing defect - neonatal meningitis
  8. Socio economic and social opportunity given or not
  9. facial / local anomalies - tongue tie?
  10. Autism - mixing with friends / social contact
  11. Thanks
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Baby of Mother with Tuberculosis

Can a Mother with TB, breast feed her child? Will it be transmitted from mother to child?

These are commonly asked Exam Questions, and commonly asked by affected parents also ...

If Mother is Having active TB Lung and Taken treatment for less than 2 months before delivery or diagnosed with TB after Delivery..... then

  • Reassure Mother - its safe to breastfeed her child
  • Dont give BCG at birth
  • Give prophylactic Isoniazid for 6 weeks
  • re evaluate after 6 weeks ... gaining weight? xray?
  • if any finding suggestive of active TB, then start full ATT
  • if baby is doing well and tests are negative, then continue isoniazid for total 6 months
  • 2 weeks after completion of treatment, give BCG.
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Functional Consequences of Iron Deficiency

Iron Deficiency Anemia is the most common condition that is encountered in clinical practice, almost every physician has witnessed this in his/her practice. While Counselling the parents, we must tell them about the Functional Consequences of Iron Deficiency.


  1. Reduced IQ
  2. Reduced Attention Span
  3. Poor Learning
  4. Impaired Scholastic performance
  5. Decreased Exercise stamina
  6. Reduced Muscular Force and Strength
  7. Impaired body temperature regulation
  8. Immune Deficiencies 
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Good and Bad for Children with Celiac Disease

Oral counselling regarding strict diet plan for children with Celiac Disease fails in many of cases .... we must provide a simple and easy to understand chart to the parents, in order to avoid Gluten from childrens diet. I made this simple hand written chart in English plus Urdu for may patients who are diagnosed Celiac Disease. This works and help parents to get this satisfaction that there are many other options to eat while avoiding Wheat.



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Friday, June 10, 2016

Suspicion - KF Ring

This child came to my OPD for GI complaints .... but examination and previous family history was leading me to Wilsons disease .... is this KF ring ??



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