Why is criticism of newer scientific technologies always frowned upon or rather considered indecent ?
In science you don’t require politeness , we only require correctness.This is especially true in medical sciences. But this is easier said than practiced in the scientific community . In any scientific conferences the only a couple of minutes or few lines [...]
Archive for October, 2008
Should we be polite in our criticism of science ?
Posted in Uncategorized on October 31, 2008 | Leave a Comment »
Herd behavior in medical profession
Posted in cardiology-ethics, tagged annals of internal medicine, bmj, cardiology, drsvenkatesan, ethics in medicine, herd behavior, lancet, medicine, nejm on October 31, 2008 | Leave a Comment »
What is herd behavior ?
It is a behavioral pattern where in animals and humans in large numbers , tend to behave in the same way at the same time without application of mind .
Herd behavior in human societies
Herd behaviour describes how individuals in a group can act together without planned direction. The term pertains [...]
Normal qrs cardiac failure says goodbye to CRT and CRT says good bye to echocardiography !
Posted in Cardiology - Electrophysiology -Pacemaker, Cardiology -Interventional -PCI, cardiology -Therapeutics, tagged bmj, cardiac failure, cardiac resynchronisation therapy, care hf, circulation, combo device, CORONARY SINUS, coronary veins, cpmanion, CRT, desynchronisation, echocardiography, electrophysiology, ICD, jama, lancet, lv epicardial pacing, madras medical college, medtronic, miracle, nejm, prospect, resynchronisation, rethinq, st jude, tissue tracking on October 27, 2008 | Leave a Comment »
CRT , cardiac resynchronisation therapy is being projected as a revolutionary treatment for cardiac failure , where a failing heart is rewired electrically through multiple leads and make it contract more effectively.The success rate of CRT was highly variable.The basic question here is, there should be a significant documentation of desynchronisation prior to CRT [...]
Unroofed coronary sinus (URCS) an interesting congenital heart disese
Posted in cardiology -congenital heart disease, cardiology congenital heart disese, tagged ATRIAL SEPTAL DEFECT, cardiology, congenital heart disese, contrast echocardiography, CORONARY SINUS, coronary sinus asd, cyanosis in asd, dilated coronary sinus, drsvenklatesan, madras medical college, PERSISTENT LEFT SVC, ucla, unroofed coronary sinus on October 20, 2008 | Leave a Comment »
The superior aspect of coronary sinus and a portion of the left atrium share a common wall .Embryological defects in this area result in a communication between left atrium and coronary sinus. This defect descriptively called as unroofed coronary sinus .This entity is most commonly associated with persistent left SVC. Extreme form of unroofing [...]
Is the terminology of “Non q MI” obsolete or still relevent ?
Posted in Cardiology -Interventional -PCI, Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged acc.aha, acute coronary syndrome, angina, cardiology- coronary care, circulation, drsvenkatesan, ECG, jacc, madras medical college, nejm, nstemi, st depression, st segment, stemi, unstable angina on October 19, 2008 | 2 Comments »
Acute coronary syndrome (ACS) is currently classified as STEMI and NSTEMI.This classification came into vogue primarily to triage patients for thrombolysis eligibility , as ST elevation is the only criteria for thrombolysis.The earlier term non q MI is largely used to denote the present day NSTEMI. In the past q MI was referring to transmural MI non q MI [...]
Why commerce always prevail over common sense in medicine ?
Posted in Infrequently asked questions in cardiology (iFAQs), cardiology-ethics, tagged annals of internal medicine, bmj, common sense based medicine, drsvenkatesan, ethics, evidence based medicine, fda, hippocrates, jama, lancet, nejm on October 19, 2008 | Leave a Comment »
Human civilisation has met so many challenges.Man kind has enjoyed the benefits of modern medicine for over a century.Now comes the new threat.Threat from within.The onslaught of marketing force has contaminated the medical science .
It is widely recognised commerce is masquereading as science , from stem cell research to futile and costly drugs, [...]
What are the ECG features of NSTEMI ?
Posted in cardiology- coronary care, tagged acs, stemi, nstemi, T WAVE INVERSION on October 17, 2008 | Leave a Comment »
Non ST elevation Myocardial infarction (NSTEMI) is a major mode of presentation of acute coronary syndrome.
Patients present with clinical unstable angina and elevated cardiac enzymes or troponin.
ECG features can be any of the following.
1.ST depression (70-80%)
2.T wave inversion(10-20%)
3.Both ST depression and T wave inversion
4Post MI NSTEMI -ECG changes variable ( Ironically ,even a residual ST elevation may be [...]
Rescue thrombolysis in acute myocardial infarction: Are we closing our mind to this important therapeutic concept in acute coronary syndrome ?
Posted in Cardiology -Interventional -PCI, My presentations, cardiology -Therapeutics, tagged acute coronary, cardiogenic shock, cardiologist, drsvenkatesn, europcr, failed thrombolysis, lancet, nejm, nstemi, primary angioplasty, rescue angioplasty, rescue thrombolysis, scai, stemi, streptokinase, tctmd, thrombolysis, tnk tpa, tpa on October 15, 2008 | 1 Comment »
Rescue thrombolysis in acute myocardial Infarction
*Venkatesan sangareddi ,Madras medical college,Chennai.India
Back ground Failed thrombolysisin acute myocardial infarction occurs in 30-40% of patients. The incidence of progressive pathological remodelling and cardiac failure is high in these patients. The approach to the patient with failed thrombolysis is generally considered to be catheter based and the outcome is not clear. Bleeding [...]
What is the greatest medical breakthrough since 1840?
Posted in cardiology-ethics, tagged Add new tag, bmj, COMMON SENSE, ethics, INTERHEART on October 14, 2008 | Leave a Comment »
The greatest discovery in medicine is “ common sense” and
”democracy”.
The greatest medical discovery is the realization that medicine is an constantly evolving science. It needs lot of knowledge to know our ignorance . Common sense has probably saved more lives and reduced suffering in this world than any other single discovery. Note [...]
What is the simplest possible guideline for doing coronary angiogram following acute myocardial infarction ?
Posted in Cardiology -Interventional -PCI, Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged acc.aha, acc/aha guidelines for stemi, acute myocardial infarction, cath lab, conservative approach, coronary angiogram, drsvenkatesan, ethics, evidence based cardiology, excercise stress test, guidelines, interventional cardiologist, jacc, jama, lancet, nejm, nstemi, nuclear imaging, pci, pre discharge stress testing, pre discharge tmt, ptca, sestamibi, stemi, stent, streptokinase, sub maximal, thallium, thrombolysis on October 11, 2008 | Leave a Comment »
Answer: Do coronary angiogram for all patients who had suffered from an acute myocardial infarction* ( Forget about all those mulitpage ACC/AHA guidelines !).
For an interventional cardiologist , it is often considered a crime to follow a conservative approach !
*Caution : This one line guideline is not based on scientific fact but reality based . Ideally one should identify high risk subsets [...]
Archives
Pages
Meta
-
