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The sound of Silence

A short story by Hamdan Ali Khan, 1st Year MBBS

The old man sat on the beach, barefooted and alone. Silence reigned everywhere except the occasional thrashing of waves which disturbed the acoustic equilibrium. Night it was, the sky filled with a million lanterns, the birds dozing off quietly and the sea like an old pirate sang a silent shanty. Oh! He missed his youth, when he could swim to the Black Rock without drowning, when he could shout at the vast ocean, his resonant voice fading upon the edges of horizon. But all good things come to an end, the voice that once resonated; now a husky whisper. The man who was the fastest swimmer; now an ancient remainder of time and its echoes. The doctors said he had terminal cancer that he would die in a week. He didn’t fear death, he had no family, nothing to lose except maybe the sight when someone would break his 50 years old record. The silence of the calm sea nurtured in him a desire to swim to the Black Rock once again, one last time. He …

Paeds Unit 2 Ward Test Guide

(Courtesy Ammara Tariq,Ainne Muzaffar,Rabia Jameel,Nimrah Siddique,Aneeqa Nasir and moi-meme =D )

There will be a short case and a table viva.Table viva consists of instruments,Xrays (that are shown to each batch on their last day in ward) and miscellaneous viva questions.In the last ward test,three cases were included in short case
1.Nephrotic syndrome
2.Facial palsy
3.Pleural Effusion

Test was conducted by Dr.Laiq and Dr Khuwaja
Table Viva :
Dr Akmal showed a photo and  asked what can you see in it?
(Malnourished child, loss of subcutaneous fat,muscle wasting,no pad of fat on buttock and thigh,nappy rash,bottle feeding.)
Which degree of malnourishment when age is 2 and weight is 7kg.
How do we classify malnourishment?
Then he asked me to resuscitate a newborn.
(start from dry ,warm, wrap,and do say ABCD and before going to next step, say,'I'll reassess the child'
Then he showed the shakir's tape and asked about use,benefit,,values on red,yellow and green part?(It is a plastic tape with coloured zones ,used for Mid Upper Arm Circumfrence.
Green (>13.5 cms), corresponding to the MAC for normal Yellow (12.5 to 13.5 cms) borderline
Red (<12.5 cms)wasted arms.)

Spacer device ka benefit?
(for small children who don't cooperate in using inhaler)
ETT la benefit ? without assisstance

If asked which drug to use to control fit, always say diazdepam,if still not controlled ,repeat dose, if after three injections, fit not controlled,go for another drug.

In measles go for vitaminA.Deaths in measles is due to common complication of pneumonia.
 A child comes with dirrhoea,what will you do?
What is the treatment of severe dehydration,some dehydration nd no dehydration? ( give answer with accurate doses)
What if the child is in shock?what if there is persistent diarhoea ? Dysentry treatment?Which antibiotic is preferred? (ciprofloxacin)
Instruments : quac tape for MUAC,how to assess?
What is the difference between LP needle and normal syringe?
Drugs used in asthma? Name Beta Agonists
Diarhoea management,dehydration clasification,Epi schedule of measles,measles complications.Neonatal resuscitation me how many breaths given and with what pressure?
Short cases:

(Take a round of ward before the ward test to see the positive findings in the cases likely to come in test.)
Examine Resp System (Do auscultate the back.Tell everything + positive findings)
Mera pleural effusoin ka case tha, usme investigations am PCR and Gram Staining bhi batana
My short case was of pleural effusion.Dr Khuwaja asked every single detail given in book.
My short case was of nephrotic syndrome.The pt. had C/O generalized edema.
Sir asked everything from D/D ,investigations and treatment.he asked the doses of steroids specifically
My short case was of facial palsy. I took a round of the ward on the morning of the ward test so I knew the pt. has signs of facial palsy.Sir simple asked me to start the GPE. Positive findings were loss of naso-labial fold,inability to close eyes completely, and to wrinkle the forehead  and cervical swelling ( likely to be cervical Lymph nodes,matted so the diagnosis was T.B).He asked for causes of facial palsy.I said he probably has tuberculous meningitis that caused facial palsy.

2 imp clincl syn??
1.nasal flaring
2.chest recesion

Child wid sunkn eyes,iritable,skin pinch goes slwly

Hw wil u mange??
Fst tel clasify dirhea. .most imp is to gv ORS

Ors cmposition?its dosage for 10kg child? Methd of gvng??

Picture of child wid los of s/c fat,muscl wastng,nappy rash,los of bucl pad of fat,promnt bons

Hw wil u takle curent measls situation??

Gv vaccination to evry child frm 6 month to 10yr no matr previously vaccinatd or nt(b4 ths period ,usually matrnl antibdy protct)
Mesls home treatmnt??
Isolation. .specly mention vit A 2 lac unt nd its furthr shedule??
Boy wid cnvlsions,hw wil u mange??
Gv diazepam. .if nt cntrld gv for 2nd even for 3rd tym. .stil nt cntrold then gv pheno brbiton ,phenytoin
Boy 5days old wid yelw eyes??Neonatal jaundce
Causes??fst of al phsiolgcl
treatmnt of physiolgcl junadce?
Do Neonate resuscitation..
Rate of ambu bag?40/min
Rate of crdiac 3cmpresns,1 bag or 90/min
Wat z betr mthd 4 crdiac cmpresn?thumbs wala
Xray of boot shapd heart
Cause?teratolgy of fellot
Hw patient wil presnt?cyanosis


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USMLE Step 1 Experience by Ayaz Mehmood (Score : 99/266)

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Let me introduce some myths surrounding USMLE Step 1 which are especially prevalent within Pakistan; I am not too sure about India because I heard their students typically appear in their final years.

 Myth number 1:Do not appear for USMLE Step 1 within your graduation

 Verdict: Baseless, illogical reasoning

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Getting yourself educated in the desi manner i.e. through the Board of Intermediate and Secondary Education is one of the top most challenges of today’s society. Matriculation seems difficult at that time, but when you enter FSc, you realize that matric was the easiest job in the world.  Those obese books of intermediate part I and part II are the worst enemies one can ever have.  People say Medical is tougher, but I find one basic difference in both. When you enter a medical college, y…


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