Abstract Objective Acute viral hepatitis (AVH) caused by virus A and E is one of the many epidemics that plague third world countries like Pakistan. The serological tests required for diagnosis acute may be unavailable or unaffordable to denizens a developing country In such scenario, clinical manifestations ultrasonographic findings are only diagnostic criteria usually present these can used s...

Robert, a nearly 12-year-old boy, traveled an hour to see a new pediatrician. Robert's mom told the pediatrician that Robert had not been seen by a doctor for several years because "no one seems to be able to help him with his problem." Robert had been wetting the bed "ever since he was toilet-trained" at age 2 years. Robert wets the bed about 5 out of 7 nights. He never has daytime accidents. ...

OBJECTIVE To present an updated review of the most common upper respiratory infections (URI) in children seen by the pediatrician in outpatient clinics, for better diagnostic and therapeutic decisions. SOURCES References from Medline database were reviewed. The most relevant articles were selected. SUMMARY OF THE FINDINGS Acute rhinopharyngitis, sinusitis, streptococcal tonsillitis and vira...

A 13-year-old girl follows up with her pediatrician after an episode of syncope while running. She reports feeling more short of breath with activities and more fatigued. The pediatrician notes her to be in no acute distress, with a thin build, clear lung fields with normal saturations, and prominent precordium on exam with mild tachycardia. She has a 2/6 systolic murmur noted at the left lower...

CASE Christine, a 4-month-old infant, is brought to the office for a health-supervision visit by her mother, a 30-year-old emergency department nurse. The mother, who is well known to the pediatrician to be a competent and attentive caregiver, appears uncharacteristically tired. They are accompanied by the 18month-old and 4-year-old siblings because child care was unavailable, and her husband h...

CASE Christine, a 4-month-old infant, is brought to the office for a health-supervision visit by her mother, a 30-year-old emergency department nurse. The mother, who is well known to the pediatrician to be a competent and attentive caregiver, appears uncharacteristically tired. They are accompanied by the 18month-old and 4-year-old siblings because child care was unavailable, and her husband h...