COPD in Pakistan: the TB history changes what a bronchodilator test means
Highest prevalence in the region at 13.8%, a fifth of moderate-to-severe disease in people who never smoked, and post-TB COPD where only 27% respond to a bronchodilator against 82% in COPD alone. Plus the household biomass advice and the ceiling-of-care decision the guideline asks you to make on admission.
Asthma in Pakistan: count the canisters, not the inhalers
One salbutamol canister a month raises mortality — and it is sold over the counter here. The national guideline's SABA-free switching table, the exacerbation algorithms, the steroid and nebuliser myths, and the guideline's own admission that its central recommendation is an extrapolation.
Pre-eclampsia in Pakistan: give the magnesium before you send her
The SOGP guideline says to load magnesium sulphate before referral, not on arrival. Here are the dilutions, the toxicity signs, the 80 mL/hour fluid limit, why the target is 140–160 systolic and not lower, and the 40% postnatal eclampsia risk that justifies keeping her three days.
Pneumonia in Pakistan: the national guideline changed in March 2026, and the macrolide is gone
The Pakistan Chest Society replaced the outpatient macrolide with doxycycline and named drug-resistant-pathogen risk as the branch point. Here is the new algorithm, the audit that found 39% of empiric therapy off-guideline, and the breakpoint artefact that makes people abandon a drug that still works.
Hepatitis C in Pakistan: the one condition where we are ahead
The world's largest burden — and generic drugs that cure it 98% of the time. Why you need neither a biopsy nor a hepatologist, the FIB-4 threshold that replaces both, and the TB drug that quietly wrecks a twelve-week course.
Hypertension in Pakistan: half have it, six percent are controlled
The losses are front-loaded — 70% don't know they have it. The three staged national targets including the one for over-80s, the non-validated monitor problem, and the two practices the guideline explicitly tells you to stop.
Diabetes in Pakistan: screen from 30, and there is no glucagon
Why the screening age is 30 not 45, the RAPID score with its South Asian waist cut-offs, why the national guideline won't diagnose on HbA1c, and the one ADA recommendation excluded because the drug doesn't exist here.
UTI in Pakistan: ciprofloxacin is a one-in-four bet
Fluoroquinolones sit at 24% and co-trimoxazole at 27% in Pakistani series. The two oral agents that still work are exactly the two that cannot treat pyelonephritis — and the nitrofurantoin G6PD rule is softer than you were taught.
Anticoagulant rat poison: the vitamin K mistake everyone makes
Giving vitamin K before you have documented a coagulopathy destroys the one test that matters. Why the admission INR is meaningless, who actually needs hospital, and why the child who ate the pellets almost certainly needs nothing.
Copper sulphate (nila thotha): six complications and one dangerous reflex
Blue-green vomit makes the diagnosis. After that it gets hard — six complications in sequence, three reasons methylene blue can fail or harm, and a set of chelation doses nobody has ever proven.
Wheat pill and rat poison: no antidote, and a question to answer first
Chuhay mar dawai covers two completely different poisonings. How to tell them apart, why your staff are at risk from the vomit, why it is not organophosphate — and where two credible sources genuinely disagree.
Harpic and corrosive ingestion: why CT replaced endoscopy
Harpic is 10.5% hydrochloric acid, a normal-looking mouth means nothing, and the emergency investigation is a contrast CT at 3–6 hours — not the endoscopy most of us were taught to book.
Snake bite in Pakistan: the tourniquet, the clotting test, and the dose rule
Why you don't cut off the tourniquet the patient arrives with, the krait bite that leaves nothing to see, how the 20-minute clotting test fails, and the one dose rule that makes children different from every other drug you give.
Fever in Pakistan: dengue, typhoid or malaria — and what to test first
Four days of fever and no focus. Why the first question isn't which of the three, the WHO severe-malaria criteria including the vivax rule most people miss, and the testing order that actually protects the patient.
Dog bite in Pakistan: the rabies PEP decisions that actually matter
Exposure categories, the one-week intradermal course, and the three immunoglobulin rules WHO changed in 2018 that most references still teach the old way — including why the leftover should never go into a buttock.
XDR typhoid in Pakistan: what to give, and what not to trust
Why ceftriaxone fails, what MMIDSP 2022 says to give for each resistance category with doses, and the one test the national guideline says should never be ordered or relied upon.
Dengue warning signs and when to admit: a Pakistan guide
The WHO warning signs, what counts as severe dengue, and who actually needs admission — including the two Group B criteria most people forget and why the platelet count alone should not decide it.
Pakistan EPI vaccination schedule 2026: every dose, age and vaccine
The complete national schedule — all 6 visits from birth to 15 months, including the switch to measles-rubella, typhoid conjugate vaccine at 9 months, and both IPV doses. Plus how to handle the child who turns up late.
Strategy
FCPS Part 1 cut-off score: 2025 vs 2026 (and why it doesn't matter)
What candidates actually scored to pass — sitting by sitting — and why aiming for 75% in mocks beats chasing the rumour-of-the-week pass mark.
Exam tactics
CPSP negative marking on FCPS Part 1: the complete guide
Does CPSP penalise wrong answers? Should you guess? What happens to blank questions? Doctor-verified answers and exam-day strategy.
Resources
Best textbook combination for FCPS Part 1 prep
One book per subject, no exceptions. Our doctor-tested short list — Snell, Guyton, Robbins, Lippincott — with honest tradeoffs and what NOT to use.
Logistics
FCPS Part 1 fee 2026: cost, refund policy, and hidden expenses
What you'll actually pay for the CPSP exam, the no-refund-after-admit-card rule that catches everyone, and the hidden costs (travel, books, Qbanks) nobody mentions until you're 4 weeks out.
Logistics
How to apply for FCPS Part 1 online: step-by-step (2026)
The CPSP portal isn't intuitive. Here's the document checklist, the application flow, the most common rejection reasons, and the gotchas that catch every cycle.
Logistics
Lahore vs Karachi vs Islamabad: which CPSP centre should you pick?
There is no 'easier' centre — the paper is identical. But hall conditions, invigilation strictness, and travel logistics genuinely differ. Honest breakdown to help you decide.
Strategy
How to pass FCPS Part 1 on your first attempt: an honest 8-week plan
Real strategy from candidates who passed first attempt — daily MCQs, mock-exam cadence, recall priorities, and what NOT to do in the final week.
Mnemonics
20 best mnemonics for Anatomy in FCPS Part 1
The mnemonics that actually saved us in the exam — cranial nerves, brachial plexus, abdominal aorta branches, foramen ovale contents, and more. Doctor-tested.
Syllabus
FCPS Part 1 syllabus 2026: complete subject-by-subject guide
Everything covered in the CPSP FCPS Part 1 exam this year — from Anatomy weightage to Behavioural Sciences high-yield areas, with our recommended study order.
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