Ophthal examination was done normal.Patient was discharged on pediatric OPD follow up Metabolic follow up genetic follow up Ophthal AL bahar hearing assessment EMG NCV at Ibn sina hospital physiotherapy follow up At the age of 8months patient was admitted with right upper Iobe pneumonia following chocking .Patient was seen in pediartic OPD on 2/8/2015 were advised to follow up with gastro OPD follow up along with neuro physiotherapy genetic dietitian and pediatric OPD follow up and was started on Losec 10mg OD and asked to CBC ,RFT ,LFT serum Iactate ,barium Swallow skeIetal survey