General description Rule of 2s 1. Occurs in 2% population 2. Symptomatic cases are 2 times more common in males 3. Located within 2 feet proximal to ileocecal valve 4. 2 inches long and 2 cm diameter 5. 2 types of ectopic mucosa: gastric and pancreatic 6. Symptomatic only in…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ABG Interpretation Made Easy
Normal values Step 1: pH Step 2: pCO2 Step 3: HCO3- Step 4: Determine compensation If there is metabolic acidosis or alkalosis, determine if there is appropriate respiratory compensation: No respiratory compensation: Expected pCO2 = Measured pCO2 Respiratory compensation: Expected pCO2 ≠ Measure pCO2 Step 5: Delta ratio ΔAG /…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
How to check an Error in ABG ? ABG analysis
Sometimes, clinicians might find ABG result not matching with the patient condition. These results might arise from technical errors in machine and there are certain points which can be used to check the error. How to Check whether ABG result is Right or has Error? X= 24X PaCO2/HCO3 Y= 80-…
Clinical Skills and Approaches 
Eliciting Primitive Neonatal Reflexes
Neonatal reflexes are the reflexes which are present at birth and have a predictable course of appearance and disappearance. A normally developing newborn should respond to certain stimuli with these reflexes, which eventually become inhibited as the child matures. The list of reflexes that can be elicited in normal newborn…
Clinical Skills and Approaches 
Diet Assessment in Pediatrics: History taking skill
As a part of history taking, Dietary assessment becomes an important part of pediatric history. As childhood is the age of rapid growth and development, any lag in diet and nutrition will manifest with long-term effects if not addressed in time. One of the common nutritional manifestations is Stunting, which…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
SCFE : Mnemonic Approach
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…
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…