Dr. Ahmad Wali Stanikzai - Child Specialist

Dr. Ahmad Wali Stanikzai - Child Specialist د ماشومانو د روغتیا، تعلیم او تربیې په هکله کره، جالب او په زړه پورې معلومات

People call Pakistan a “Muslim country,” but for many of us from Afghanistan, those words feel hollow when we think abou...
17/03/2026

People call Pakistan a “Muslim country,” but for many of us from Afghanistan, those words feel hollow when we think about what we have lived through.

For as long as I can remember, peace has never truly stayed with us. No matter who was in power in Kabul, war always seemed to find its way back into our lives. It is not governments who suffer the most, it is ordinary people. It is children waking up in fear, families losing their sense of safety, and generations growing up knowing more about conflict than calm.

I was born and raised in a refugee camp in Pakistan. This is not politics for me, it is personal. It is the memory of growing up far from home, of feeling like we did not belong, of carrying the quiet pain of being seen as less, as unwanted.

What makes it even harder to accept is the feeling that our suffering has been shaped by decisions far beyond us. Powerful countries play their games, and Pakistan stands in that space, balancing its own needs. But the cost of those choices is carried by Afghan families, again and again.

We are not asking for anything extraordinary. Just a chance to live without fear. To let our children sleep through the night without nightmares. To belong to our own land with dignity and peace.

29/01/2026

د ماشوم سترګې مو وخت ناوخته اوبه کوي یا نښلي؟ مه وېرېږئ!

که ستاسو ماشوم یوه یا دواړه سترګې اوبه کوي یا نښلي، ډېر وخت یې علت د اوښکو د نل تنګوالی (Lacrimal Duct Stenosis) وي. دا عادي ستونزه ده او شاوخوا ۵٪ ماشومانو کې لیدل کېږي.

نښې یې دادي چې، د سترګې دننه اوښکې جمع کېږي، اوښکې په مخ لاندې خوا ته بهېږي، او د ویښېدو په وخت کې سترګې څخه لکه مخاط مواد موجود وی او سترګې یې نښتې وي.

کله ډاکټر ته ورشئ؟
- سترګې پړسوب پیداکړي،
- د رڼا سره حساسیت
- د سترګو زیات خارښت یا درد
- د سترګې یا شاوخوا پوستکي سوروالی/پړسوب

کورني اقدامات: اکثره ماشومان تر ۱ کال پورې پخپله ښه کېږي

۱) پاک لاسونه یا cotton swab وکاروئ
۲) د سترګې دننه کونج څخه پوزې خوا ته ښکته فشار ورکړئ 👁
۳) هر ځل ۵ لنډ فشارونه، ورځ کې ۳–۴ ځله
۴) که لږ اضافي مواد سترګې ته راشي، نرم ټوکر یا کاټن بال وکاروئ

یادونه: که ستونزه ډېره وي، ډاکټر ممکن د انټي بیوټیک څاڅکي ورکړي. که تر ۱ کال وروسته ستونزه پاتې شي، جراحي درملنه لکه probing یا stent placement ممکنه ده

🌟 ډاډه اوسئ! ډېری وخت، ستونزه پخپله حل کېږي او پورتنی نرم مساژ ډېره مرسته کوي.

Management of Refractory Thrombocytopenia: Always Consider Congenital CMV Infection1. When should we suspect CMV?Any cas...
07/12/2025

Management of Refractory Thrombocytopenia: Always Consider Congenital CMV Infection

1. When should we suspect CMV?

Any case of unexplained, refractory thrombocytopenia should raise suspicion for congenital or postnatal cytomegalovirus (CMV) infection.

2. Epidemiology and Prognosis

A. Asymptomatic cases

Approximately 90% of congenital CMV infections are asymptomatic at birth.

However, 15% of these infants may later develop sequelae, including:

Sensorineural hearing loss
Cerebral palsy
Developmental delay
Epilepsy

B. Symptomatic cases

About 15% of congenital infections are symptomatic at birth.

Up to 90% of these infants develop long-term neurodevelopmental sequelae.

3. Diagnosis

Primary diagnostic test

Urine PCR for CMV

If urine collection using a urine bag is difficult, a piece of gauze can be placed in the diaper and then squeezed into a laboratory tube.

Positive PCR within the first 3 weeks of life is consistent with congenital infection.

After 3 weeks, distinguishing congenital from postnatal infection becomes challenging; therefore, clinicians may rely on:

Newborn metabolic screening samples (NBTS) for retrospective CMV PCR testing.

4. Required evaluations after confirming CMV infection

Following diagnosis, the evaluation should include:

Cranial ultrasound (via fontanelle)
Abdominal ultrasound
Ophthalmologic examination (for retinitis/chorioretinitis)
Hearing assessment (ABR/BERA)
Laboratory testing to assess:
Hemolysis
Liver function tests

5. When should we treat?

Treatment with Ganciclovir or Valganciclovir is indicated in the following situations:

A. Evidence of central nervous system involvement, such as:

Intracranial calcifications
Brain malformations
Ventricular dilatation
Brain cysts
Chorioretinitis
Sensorineural hearing loss

B. Severe systemic involvement

Although previously debated, recent practice trends consider most symptomatic congenital CMV cases to be near indications for therapy, especially when there is:

Severe hepatitis
Severe or persistent thrombocytopenia

6. Treatment requirements

Therapy should begin within the first 30 days of life.

Either route may be used:

Oral Valganciclovir/Intravenous Ganciclovir

Both are equally effective, and the choice depends on gastrointestinal tolerance and clinical status.

7. Postnatal (acquired) CMV infection

Acquired CMV infection in healthy term infants usually does not require treatment.

Exception: Preterm infants, who may experience more severe disease.

Treatment decisions are individualized based on clinical severity.

8. Treatment goals and follow-up

Primary treatment goal

Prevention or reduction of long-term neurodevelopmental complications, especially sensorineural hearing loss.

Follow-up during treatment

Regular monitoring for neutropenia, one of the most important adverse effects of Ganciclovir/Valganciclovir.

21/07/2024

0002

Because they absorb moisture, dried foods such as beans and peas, may cause progressive airway obstruction.

21/07/2024

#0001

Any child with an altered mental status is at risk of an upper airway obstruction secondary to a loss of muscle tone affecting the tongue.

Forcing left-handed children to write with their right hands is not in any way harmless or helpful. It is actually harmf...
16/06/2024

Forcing left-handed children to write with their right hands is not in any way harmless or helpful. It is actually harmful to their developing brains and can result in dyslexia, stuttering, and other learning or speech disorders.

Probably the most difficult thing to gets to grips with as a left-handed child is learning to write.

Left-handedness is now accepted as a completely normal aspect of a child's development. Your child’s left-handedness is no barrier to their development, achievements or success. It is just a natural part of who they are.

01/05/2024

Don't handicap your children by making their lives easy. The greatest handicap you can give your kids is the experience of not being loved.

17/04/2024

"Our job is improving the quality of life, not just delaying death."

- Robin Williams

15/04/2024

005 🩺

✍️ Different types of wheeze:

✅ Recurrent wheezing: More than three episodes of wheezing in the past year that lasted for >1 day and affected sleep.
✅ Transient wheeze: Wheezing before 3 years but not at 6 years of age.
✅ Persistent wheeze: Wheezing both before and at 6 year of age also.
✅ Late onset wheeze: No wheeze at 3 years but wheezing at 6 years.
✅ Episodic viral wheeze
✅ Multitriggered wheeze

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+93799625962

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