Tuesday, October 28, 2008

Medical Blogs-in context of a connected world

Sumer's Radiology Site is cited by Joanna Lynn Karpinski, MLIS (karpinsj@mail.nih.gov) is Associate Fellow, National Library of Medicine (NLM), in Medical Reference Services Quarterly, Vol. 27(1), Spring 2008 Available online at http://mrsq.haworthpress.com
According to the article, titled Disconnected in a Connected World: Knowledge and Understanding of Web 2.0 Tools at the University of Pennsylvania Medical Center
"Radiology, a medical field that is highly dependent on image-based examples for teaching, is experiencing a growth of blogs. Sumer Sethi, M.D., uses his blog to post interesting cases from his routine practice and abstracts related to his day-to-day work. The site is visited by more than 30,000 visitors each year and is a focal point for queries from his students and patients. The blog features not only a means of commenting on Dr. Sethi’s posts, but also a small section called a “shoutbox,” where users can post messages or questions on any topic for Dr. Sethi and other readers to see. Dr. Sethi can respond using the shoutbox."

Festival Day

Dear Friends
May god bless you with his choicest blessings this diwali, hope you have a happy and prosperous diwali. Diwali is the festival of lights and prosperity in India.


Dr.Sumer K Sethi, MD
Consultant Radiologist ,VIMHANS
CEO-Teleradiology Providers http://teleradproviders.com
Blog- Sumer's Radiology Site http://sumerdoc.blogspot.com
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences) http://www.damsdelhi.com
Ph- +91-9811181359

Wednesday, October 22, 2008

Maxillary SInus Mucocele-CT




Mucoceles are most commonly frontal or frontoethmoid in origin with maxillary sinus mucoceles accounting for less. Often resulting from trauma or ostial obstruction, mucoceles often expand gradually, but their progression can be much more rapid during episodes of infection. Frequently, the surrounding bone demonstrates either thickening as a result of osteitis from chronic inflammation or remodeling with resorption secondary to the chronic expansile forces and osteolytic enzymes.


Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Tuesday, October 21, 2008

Trigeminal Neuralgia Information

"Trigeminal neuralgia is an idiopathic disorder, but several theories of neuropathological processes attempt to explain the symptoms. One theory is compression of the trigeminal root adjacent to the pons, causing demyelination of the nerve root. This may be caused by tortuous blood vessels in the posterior fossa, tumors, or arteriovenous malformations. However, these structural lesions are not found in all patients with Trigeminal neuralgia. Other theories suggest that Trigeminal neuralgia is a symptom of a central nerve disease or a disease of the trigeminal vascular system involving dysfunctional interplay between a trigeminal sensory plexus and blood vessels located in the pia and dura mater.Trigeminal neuralgia is usually caused by an intracranial artery (eg, anterior inferior cerebellar artery, ectatic basilar artery) or, less often, a venous loop that compresses the 5th cranial (trigeminal) nerve at its root entry zone into the brain stem. Other less common causes include compression by a tumor and occasionally a multiple sclerosis plaque at the root entry zone, but these are distinguished usually by accompanying sensory and other deficits. Other disorders that cause similar symptoms (eg, multiple sclerosis) are sometimes considered to be trigeminal neuralgia and sometimes not. "
References-
Green MW, Selman JE. Review article: the medical management of trigeminal neuralgia. Headache. 1991;31:588-592.
Cheshire WP. Trigeminal neuralgia: a guide to drug choice. CNS Drugs. 1997;7: 98-110.
Turp JC, Gobetti JP. Trigeminal neuralgia versus atypical facial pain: a review of the literature and case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:424-432.
Fromm GH, Terrence CF, Maroon JC. Trigeminal neuralgia: current concepts regarding etiology and pathogenesis. Arch Neurol. 1984;41:1204-1207
Rappaport ZH, Devor M. Trigeminal neuralgia: the role of self-sustaining discharge in the trigeminal ganglion. Pain. 1994;56:128-138.

Accuracy of MRI results

In New York Times article by Gina Kolata raises the question on variability on MRI reports. According to her-"Just as big a problem as the erratic quality of M.R.I. scans is the tendency of doctors and patients to rely on them too much"
Yes i agree there is a variability in results but isnt it true for everyything in medical profession. All depends on the quality of machines and kind of exposure the docotr has to the particular specilaity and also kind of inputs he has recieved with the studies. Very often we radiologiosts recieve requistion forms with no clinical details at all!

Monday, October 20, 2008

Journal Club-Patent Foramen ovale and Migraine

Recent evidence supports that the prevalence of patent foramen ovale is higher in patients with migraine with aura. Tatlidede AD et al conducted a case-control study and searched for intra-atrial right to left shunt in 53 patients with migraine. PFO was detected by means of transthoracic echocardiography with administration of contrast medium during valsalva maneuver and the results were compared with age and sex matched 27 healthy controls. Patent foramen ovale was more frequent in the migraine group.
Reference- Agri 2007 Oct;19(4):39-42
However in Circulation 2008 Sep 30;118(14):1419-24. Epub 2008 Sep 15. Paper titled-Patent foramen ovale and migraine: a cross-sectional study from the Northern Manhattan Study (NOMAS), authors didnot find aassociation significant. According to them, The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.

Friday, October 17, 2008

Entrepreneur MD- The Healthcare Consultancy & Scientific Solutions

Entrepreneur MD are global networks of executives, physicians, scientists,pharma professionals, web developers and other professionals who deliver expertise and decision-making assistance to business, government and investment leaders from around the world. Our Special focus is on Indian Healthcare,hospitals, nursing home, Web 2.0, Medical Imaging, medical informatics, Medical outsourcing industry and computerizaion of hospitals. We also are specialists in medical education sector with more than 10 years of experience in medical eductation business. we with our network of people also provide valuable inputs for various clinical trials. We at times serve as your outsourced HR department and offer quality people for key positions in your healthcare related projects.
We also provide scientific and medical services for pharmaceutical, medical devices, biotechnology, and health care organizations. We prove to be an asset to our clients by our deep understanding of the health care domain, scalable processes and methodologies for conceptualizing integrated scientific solutions, robust project management and delivery processes.

Contact Us
Corporate Address-4B Pusa Road, Near Karol Bagh Metrostation, 3rd Floor New Delhi, India Phone+91-9811181359+91-9711360364
Fax+91-11-25853434

Thursday, October 16, 2008

Neurooncology CME 2008-Invitation to all

Neuro-Oncology CME
This is invitation to all interested in the topic of Brain Tumour.
Schedule is as follows---

VIMHANS
Date : 26.10.2008
Time : 8.30 am
Venue : VIMHANS Auditorium
DMC Accreditation : 4.30hrs.
Registration / Breakfast Time : 8.30am – 9.00am
1. Brain tumors an overview Chairpersons Dr. H.N.Aggarwal (SGRH)
Speaker : Dr. Daljit Singh (GBPH) Dr. A.K.Anand (RGCI)
9.00am-9.20am

2. Early recognition of S/S of brain tumors Dr. L.N.Gupta (RMLH)
Speaker : Dr. Vikas Gupta (Fortis, Noida) Dr. G.K.Jadhav (Apollo)
9.20am-9.40am

3. Radiological protocol for diagnosing Dr. N.K.Arora (JGH)
Brain tumors Dr. Munish Aggarwal (JGH)
Speaker : Dr. Sumer Sethi (VIMHANS)
9.40am-10.00am

4. Newer Radiological techniques Dr. A.K.Chaturvedi (RGCI)
How helpful ? Dr. S. Dua (Fortis, Noida)
Speaker : Dr. H. Mahajan
(Mahajan Imaging Centre)
10.00am-10.20am

5. Surgical management of malignant Dr.A.K.Singh(Fortis,Noida)
Brain tumors Dr. Dinesh Singh(Pushpanjali
Speaker : Dr. V.P.Singh (Apollo)
10.20am-10.40am

6. Management intracranial meningiomas Dr. S. Sinha(GBPH)
Speaker : Dr. H.S.Bhatoe (R&R) Dr. I.P.Goel (JGH)
10.40am-11.00am

Tea and Inauguration 11.00am-11.30am

7. Skull base tumors – Role Dr.S.Sachdeva (Fortis,Noida)
of ENT surgeon Dr.P.K.Sachdeva(VIMHANS)
Speaker : Dr. Yogesh Jain (VIMHANS)
11.30am-11.50am
8. Spinal tumors – Overall prognosis Dr.A.K.Srivastav (GBPH)
Speaker : Dr. S.S. Kale (AIIMS) Dr. Ashish Goel (SGRH)
11.50am-12.10pm
9. Intra-operative MRI & low grade gliomas Dr.A.K.Singh (Fortis, Noida)
Speaker : Dr. A.N. Jha (Max H.) Dr. P. Gulati
12.10pm-12.30pm

10. Different radiation modalities for malignant Dr. Rath (AIIMS)
Brain tumors Dr. S.Tyagi (Apollo)
Speaker : Dr. S. Hukku (Apollo)
12.30pm-12.50pm
11. Recent management trends in GBM Dr. K.T. Bhowmick (SJH)
Speaker : Dr. P.K. Julka Dr. R. Dua (GTBH)
12.50pm-1.10pm
12. Role of PET-CT in reccurent brain tumors Dr. A.K.Anand (RGCI)
Speaker : Dr. Ishita Sen (SGRH) Dr. Munish (SMH)
1.10pm-1.30pm
13. Genetics and high grade brain tumors Dr.R.Vijaylakshmi(NBRC)
Speaker : Dr. Chitra Sarkar Dr. P.Khurana (VIMHANS)
1.30pm-1.50pm
14. Vote of thanks



Evening Programme
Venue : India Habitat Centre
Mapple Hall
Timings : 7.30 pm onwards

Launching of Delhi Chapter of NOSI

· Introduction : Dr. A.K.Anand
· Recent surgical trends in GBM : Dr. A.K.Singh
· Beyond Surgery : Dr. Rakesh Jalali
· Cocktail & Dinner

Wednesday, October 15, 2008

Medical Search Engine

Just came to know about a new medical search engine. Physicians including radiologists can now conduct highly focused searches of journal abstracts in the U.S. National Library of Medicine plus other useful online resources through SearchMedica.com

Tuesday, October 07, 2008

Tubercular Meningitis with Trapped Ventricle-MRI




This is a case of tubercular meningitis with choroid plexitis and trapped temporal horn of lateral ventricle seen on MRI. Note the abnormal enhancment of choroid plexus.
Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Colloid Cyst-MRI




The term colloid cyst refers to only neuroepithelial cysts that arise in the anterosuperior third ventricle, near the foramina of Monro. The cysts are lined by a single layer of epithelial cells and are typically filled with a thick, viscous mucus that has an array of ingredients, including blood products, macrophages, cholesterol crystals, and numerous metallic ions, such as copper, iron, magnesium, aluminum, and phosphorus. This is a 18 year old female who presented with complaints of headache. Note the cyst is hyperintense on T1 weighted image.

Monday, October 06, 2008

Supraspinatus Calcific Tendonitis-CT


"Painter described calcification in the shoulder in 1907. Codman established that the calcification was within the tendons of the rotator cuff. Calcifying tendinitis of the shoulder is characterized by the presence of macroscopic deposits of hydroxyapatite (a crystalline calcium phosphate) in any tendon of the rotator cuffEven supraspinatus tendons that are macroscopically normal contain minute amounts of calcium deposits. Degenerative tendons that have ruptured contain more calcium deposits, but it is not always in the form of calcium phosphate. The increase in calcium deposits is due to degenerative calcification.In contrast, the calcium in tendons with radiographically visible calcification is in the form of crystalline hydroxyapatite. Calcifying tendinitis is a different condition from that of degenerative tendons in which there is a small increase in calcium content. genral asymptomatic population in 30 to 50 yrs display calccificatin in about 3 to 20%The supraspinatus tendon is affected most often. Calcification is observed with decreasing frequency in the infraspinatus, teres minor, and subscapularis tendons. More than one tendon may be involved. Women are affected slightly more frequently than are men (housewives and clerical workers account for most cases), and the right shoulder is affected slightly more often than the left is. Both shoulders can have or develop calcific deposits in 13-47% of subjects, and the calcific deposit usually is described as being approximately 1-2 cm proximal to the tendon insertion on the greater tuberosity. Computed tomography (CT) scanning may be used to accurately localize the calcific deposit."

Case by Dr MGK Murthy, Sr Consultant Radiologist
&
Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

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