Approach to a limping child General points Classification Management depends on 4 factors which can be remembered using the mnemonic SCFE. Stability and Severity a. Loder classification: b. Severity: Severity Southwick angle on frog-leg lateral view (Difference of head-shaft angle from normal side) Wilson slip % on AP or frog-leg…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
Clinical Skills and Approaches
Inverted Reflexes
An inverted tendon reflex refers to the elicitation of the movement opposite to that normally seen when the reflex is elicited. Mechanism of Inverted Reflexes A lesion which simultaneously affects: This leads to 2 components: Mechanisms of hyperactive response: Types of Inverted Reflexes 1. Inverted supinator reflex: 2. Paradoxical triceps…
Clinical Skills and Approaches
Hoffmann’s Sign
History Method of Eliciting Hoffmann’s Reflex Mechanism of Positive Hoffmann’s Reflex Sudden stretch of the finger flexors causes involuntary finger flexor contraction due to activation of a monosynaptic stretch reflex. Exaggeration of the reflex is caused by hyperreflexia in the setting of upper motor neuron dysfunction. Upper motor neuron lesions…
Case Reports
Nine Interesting cases in Neonates
1. Sepsis presenting with Diabetic ketoacidosis like feature in Preterm neonate A thriving preterm neonate had new onset sepsis with off color skin and poor feed tolerance. A workup for sepsis was sent and antibiotics were upgraded to 2nd line agents. Inotrope was added for tachycardia with poor perfusion. By…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Lesions of the Umbilical Cord in Newborn
Anatomy of Umbilical Cord Umbilical cord is a connecting link between fetus and placenta through which fetoplacental circulation occurs. It is formed from allantois carrying vessels from Fetus to Chorion and passing abdominal stalk. It is around 50 cm long and contains 2 umbilical arteries and 1 umbilical vein surrounded by…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Apt Test in Newborn: Maternal vs Neonatal Blood
We had few cases of suspected GI bleeding, admitted or referred to our NICU. One was case of Hematochezia and other was case of fresh blood in vomitus. Both babies were born to mother with Antepartum hemorrhage. The general condition of the babies were fine, and the vitals. There was…
Case Reports
A case of child with Mucopolysaccharidosis : Hunter Syndrome
1st Published in Pedchrome in January 1, 2015 Case Summary A 6-year-old patient was found to have course facial features and short stature. Parents have noticed a developmental stasis since 4-5 years of age. The weight was normal. There were no any chronic illness, any significant birth and postnatal history…
Blog
A Case of Gastroschisis : Media’s Irresponsibility
1st Published in Pedchrome in October 19, 2012 National Newspapers of Nepal like Kantipur Daily and Nayapatrika had published some news regarding the Case of Om Hospital where the papers irresponsibly declared that the doctor’s negligence had led to the death of a new-born. According to the Om Hospital Authority,…