Scenario Concerned parents appear in the Out patient Department, with a newborn who has bilateral breast engorged and obviously secreting milk. Parents had tried to squeeze the milk out but instead the breast got further engorged. Few months before a neonate was admitted for Intravenous antibiotics for similar problem, after…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Stress, Strain, Viscoelastic behavior
Stress or load: Force over area (has units of Newton per square metre) Strain or deformation: Change in length over original length caused by applied stress or load (unitless and expressed as ratio or percentage) Mnemonic: If your boss is under a lot of stress, his personality changes (strain) A….
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Where, When, How and Now What? Congenitally missing teeth
1st published in Pedchrome on February 5, 2015. The perfect smile on a parent’s face rotates to a frown when they are informed that their child may have a smaller number of teeth than normal. The total number of teeth in the primary dentition is 20 and that in the…
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Cooperation for Improvement of Oral Health in Children in Nepal
1st Published in Pedchrome on November 8, 2014. Childhood is considered the golden period of life, but it is also a phase when diseases are lurking in every nook and corner to attack these tiny buds. Like systemic diseases there are a number of oral health problems that affect children…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pressure Sores and Bed Sores
A pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. Normal capillary refill is 16-33 mmHg. Ischemia occurs with prolonged pressure >33 mmHg: Ischial tuberosity: >100 mmHg during sitting Sacral region: 40-60 mmHg in…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Motor March Phenomenon
Motor march phenomenon is a sign of reinnervation like Hoffman-Tinel’s sign which has been discussed earlier. Observed in: Axonotmesis Repaired Neurotmesis Not observed in: Neuropraxia Motor march phenomenon: As the re-innervation of injured nerve proceeds, the muscles nearest to the site of injury recovers first followed by distal ones sequentially…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Friedreich’s Ataxia : Mnemonic
Friedreich’s ataxia is a hereditary spinocerebellar degenerative disorder named after German neurologist, Professor Nicholaus Friedreich. Mnemonic: FRIEDREICH’S Ataxia 1. Foot deformity (progressive cavo-varus), Frataxin expression reduced 2. Recessive (autosomal), Repeat of trinucleotide GAA (chromosome 9) 3. Iron accumulation in mitochondria 4. Extensor plantar response 5. Dysarthria (within 5 years of…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Perkin’s Timetable for Fracture Healing
One needs to understand the difference between bone union and consolidation first Union Consolidation Definition Partial/Incomplete repair Full/Complete repair Callus Calcified Ossified Attempted angulation Painful Painless Fracture line in X-ray Still visible Obliterated and crossed by bony trabeculae Full weight bearing Cannot be undertaken Can be undertaken Reference: Physiotherapy in…