Friday, October 24, 2014

Too much to do, too little time-problem or paradox

People keep complaining about lack of time and they keep saying they are busy. At times I have seen people who say they are too busy even to talk on phone.
Well my dear friends it is never about time, it is always about priorities.
If you really want to do something you will somehow manage time. We all have ‘less and more time’ with us all the time, and we keep swinging between the two sides depending on our priorities. Why is this so important to know, because you might be spending your precious “time” on valueless things and if you don’t prioritize, you end up being busy with very little net output. This is what happens in exams, relationships, family and work.
Many people ask me how I manage my time, simple, I always work towards my broad instinct, gut feeling and keep checking myself about what I am doing, is it coherent to broad philosophy of my work. It is so easy to be attracted to more things, new ventures, I check them out but choose only those which fit in my priority and once I want to do something, I don’t procrastinate, I just do it.
Every once in while I meet people who blame lack of time for their failure and that makes me think, they are missing out on the most important asset management skill in the world-time management. Mantra for time management is simple- Understand what you want to do, prioritize, make decisions, and don’t procrastinate.
Procrastination makes easy things appear harder and impossible.
Learn the value of moment and seize your opportunity. Just go ahead and build your careers, your dreams. All of us have one thing in common: 24 hrs/day and each day, each moment has infinite potential provided you prioritize and do what you really want to do, need to do; that is the reason why some people are able to take out more out of their "24 hours"

Variance between MDCT manufacturers in Hounsefield Measurement

In an article by Ramit Lamba et al published in AJR , found  low consistency in the Hounsfield unit measurements  obtained by the two scanners one by GE and other by siemens. They have concluded Hounsfield unit measurements for unenhanced abdominal soft tissues of the same patient vary between scanners of two common MDCT manufacturers.

Reference and further reading
CT Hounsfield Numbers of Soft Tissues on Unenhanced Abdominal CT Scans: Variability Between Two Different Manufacturers’ MDCT Scanners. Ramit Lamba, John P. McGahan, Michael T. Corwin, Chin-Shang Li, Tien Tran, J. Anthony Seibert, and John M. Boone
American Journal of Roentgenology 2014 203:5 , 1013-1020 

Role of CT in Pancreatitis-AJR Review

In a structured review published in AJR by Murphy et al, authors have compiled updated imaging nomenclature for pancreatitis.  These points include when to call pseudocyt or when to call walled of necrosis on CT. Very useful for all residents. 

Key points from the review include

  • CT is used to confirm the diagnosis of acute pancreatitis when the diagnosis is in doubt and to differentiate acute interstitial pancreatitis from necrotizing pancreatitis, which is a key element of the updated Atlanta nomenclature. 
  • The acute interstitial variety accounts for 90–95% of cases, with acute necrotizing pancreatitis accounting for the remaining cases.
  • Necrosis due to acute pancreatitis is best assessed on IV contrast-enhanced CT performed 40 seconds after injection.
  • Simple fluid collections associated with acute interstitial pancreatitis are subdivided chronologically. A collection observed within approximately 4 weeks of acute pancreatitis onset is termed an “acute peripancreatic fluid collection (APFC).” A collection older than 4 weeks should have a thin wall and is termed a “pseudocyst.” Both APFCs and pseudocysts can be infected or sterile.
  • Fluid collections associated with necrotizing pancreatitis are labeled on the basis of age and the presence of a capsule. Within 4 weeks of acute pancreatitis onset, a fluid collection associated with necrotizing pancreatitis is termed an “acute necrotic collection (ANC)” whereas an older collection is termed an area of “walled-off necrosis (WON)” if it has a perceptible wall on CT. The term “pseudocyst” is not used in the setting of necrotizing pancreatitis collections. 
Reference and further reading: 

Updated Imaging Nomenclature for Acute Pancreatitis
Kevin P. Murphy, Owen J. O'Connor, and Michael M. Maher

Friday, October 17, 2014

Interview in DD News-Dr Sumer Sethi

My interview on DD, Baatein Career Ki about PG medical preparation and career options for medical students.

Thursday, October 16, 2014

Why is Tc99m prefered for nuclear scan?

Technetium- 99m  (metastable isomer) is the most frequently used radionuclide in nuclear medicine today. Its parent nuclide, molybdenum-99 (99Mo), can be produced in either a reactor or a cyclotron. 99Mo has a half-life of 66 h and therefore 99Mo/99mTc generators can conveniently be supplied weekly to nuclear medicine departments, providing a fresh daily supply of the radionuclide. The 6-h half-life of 99mTc is sufficiently long for most imaging applications and its 140-keV gamma radiation has reasonable tissue penetration but can still be easily collimated

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