Isang Makakalimuting Utak

Habang naglalakbay patungong San Pablo at iniisip kung anong paliwanag ang gagawin kay Gerry kung bakit ako naabala sa pagdating, sari-saring bagay ang pumasok sa aking hungkag na pag-iisip.

Naisip kong para akong napilayan ng malaman kong naiwan ko pala ang aking cellphone sa banyo. Hindi lang iilang beses kong nakalimutan ang aking cellphone. Medyo may kadalasan na ang pangyayaring ito at nababahala na ako.

Bilang isang taong propesyunal na nakapagtapos sa unibersidad, mahirap aminin sa sarili na nagiging ulyanin ako pagdating sa mga tribyal na bagay. Hindi lamang cellphone ang madalas kong makalimutan. Marami pang ibang maliliit na bagay.

Tulad na lang ng payong.

Hindi na mabilang ang payong na nawala ko. Yung iba matapos ang tag-ulan nawawala na lang parang bula. Merong naiwan sa Jeep (umuulan kasi nung sumakay ako at lintik namang tumigil pagbaba ko kaya nalimutan ko tuloy na may dala pala akong payong). Merong naiwan sa Jolibee, sa sinehan, at kung saan-saan pang lugar. Ang masaklap pa ay maaalala ko na lang ito kung ako'y nasa bahay na...o kaya ay bigla na namang umulan.(teka ...putsa nakalimutan ko ang payong ko sa sinehan!)

Minsang umuulan ay lumabas ako ng bahay at binitbit ang payong ng aking mahal na kapatid na babae.

"Hoy mama" ang wika ng munting babae, "baka mawala mo na naman yang payong ko!"

"Mahal kong kapatid, " ang sagot ko "kailan ba naman ako nakawala ng payong?"

"Nung isang linggo...iniwan mo ang payong mo kung saan, kaya nag-aalala ako na baka iwala mo rin yang payong ko"

Kungsabagay may katwiran siya. Nakalimutan kong nakalimutan ko nga pala ang payong ko sa dyipning sinakyan ko nung isang linggo. Medyo magulo.

Kung tutuusin medyo nakaka-insulto ang payong ng aking kapatid sa aking pagkalalaki. Ang payong na ito ay kulay pink, at may nililok na ulo ng bibe bilang hawakan.

Ikaw ba, o lalaking nagbabasa nito, ay makapagdadala ng ganitong uri ng payong? Marahil ay kung bumabagyo lamang!

Sa totoo lang may phobia na akong bumili ng payong, kaya tuloy naalala ko ang kahanga-hangang mga Ingles na parati na lang may dalang mahabang itim na payong. Dala dal nila ito sa init o tag-ulan at nakapagtatakang hindi nila ito nakakalimutan kung saan, na para bang ito'y parte na ng kanilang kasuotan. Sa ganitong paraan ay itinatag nila ang kanilang Imperyo at sa ganitong paraan nawala din ito sa kanila.

Ang isa pang bagay na lagi kong nawawala ay ang bolpen.

Kung susumahin ang tinta ng lahat ng nawala kong bolpen ay maaari na siguro akong makapagsulat ng isang Encyclopedia Britannica.Hindi ko mawari kung bakit ang lahat ng bolpeng nagdaraan sa kamay ko ay nawawalang parang bula. Dati niregaluhan ako ng tatlong mamahaling Parker bolpen...Tuwang-tuwa ako sa kagalakan dahil kung ako lang mismo ay di makakabili niyon...Sa ngayon hindi ko matandaan kung saan ko ito naiwan.... o kung sino ang tarantadong nanghiram at hindi na ito isinoli.

Isang leksiyon: huwag magpapahiram ng bolpen, singkwenta porsyento ang tsansa na hindi na ito maisosoli sa iyo. Kung may manghiram ay mabuti pang magsinungaling na wala kang bolpen....E paano kung makita nung nanghihiram yung nakausling bolpen sa bulsa ng iyong polo shirt? Buweno, sabihin na ito ay walang tinta, basta huwag ipahiram.

Ngayon nga ang laging gamit ko na lang ay Panda Bolpen na kahit mawala ay walang problema. Tutal ay limang piso lang naman ang isa nito.

Teka, narito na pala ako sa San Pablo, mabuti na lang at dalawang oras lang ako naabala...teka......

Bakit ba ako nandito sa San Pablo.....ano nga ba ang gagawin ko sa lugar na ito.....

Lintik na utak ito...

Radiology Jobs And Opportunities

Now Sumer's Radiology Site -The Top Radiology Magazine has a Job Section.

Radiology Jobs
An Online Portal for Radiology Jobs. Kindly post Radiology Related Job Vacancies here by emailing me at- sumerdoc@yahoo.com

"Radiology Jobs"

http://radiology-jobs.blogspot.com

Cartoon by Dave Walker. Find more cartoons you can freely re-use on your blog at We Blog Cartoons.

Interesting article Mortality associated with contrast media in AJR

Deaths attributed to X-ray contrast media on U.S. death certificates.

Wysowski DK, Nourjah P

"From 1999 through 2001, deaths attributed to the International Classification of Diseases (ICD) code for contrast media occurred at the rate of 1.1-1.2 per million contrast media packages distributed. An analysis of 1999 death certificates indicated that most deaths attributed to contrast media predictably were associated with renal failure or nephropathy and anaphylaxis or allergic reactions. Risk assessment of the comparative safety of classes or agents was limited by lack of specific contrast media names. Names of administered contrast agents should be recorded in patients' medical records and communicated to primary care physicians and certifiers of death in the event of serious sequelae after an identified recent radiologic procedure."

Reference-

AJR Am J Roentgenol 2006 Mar;186(3):613-5.

Radiology Quiz-Musculoskeletal Radiology

Quiz Section
What is the radiological finding in the Xray of the arm and what are the associated conditions? Give your answers in the comments section. The winners and the correct answers will be published here next week. [Real Straight forward one :-)]

WINNERS-
Richa, Mona

CORRECT ANSWER- ABSENT RADIUS

ASSOCIATED SYNDROMES-

MNEMONIC-"THEFT"

TAR Syndrome, Holt Oram, Ectodermal Dysplasia, Fanconi syndrome, Trisomies

Isang Weirdong Karanasan

Binisita ko ang kaibigang si Gerry Alanguilan noong nakaraang linggo sa kanyang bahay sa San Pablo, Laguna.

Napagkasunduan namin na alas nuwebe pa lang ng umaga ng Martes ay nandoon na ako, na ang ibig sabihin ay madaling araw pa lang ay naglalakbay na ako galing Cubao upang makarating sa takdang oras. Ngayon, ako ay isang taong mahigpit sa oras ng usapan. Kapag napagkasunduan natin na magkita tayo ng alas-otso, alas syete pa lang ay nandoon na ako sa tagpuan.

Kaya noong Lunes ng gabi, maaga akong natulog para nga magising ng maaga. Itinakda ko ang aking alarm clock sa alas-singko ng umaga at inisip na tamang tama, alas-otso pa lang ay nakatayo na ako sa Jolibee San Pablo at doon ay susunduin ako ni Gerry. Yun ay sa dahilang hindi ko pa alam ang kanyang bahay.

Kaya kinaumagahan, eksakto, walang kapalya-palya, tumunog nga ang alarm clock sa takdang oras. Nagising ako siyempre dahil sa lakas ng tunog ng alarm.

Iniunat ko ang kamay at inabot ang relo sabay pindot dito upang patigilin ang nakabubwisit na tunog. Tapos natulog uli ako, ang wika pa sa sarili ay "hmmp masyado pa yatang maaga kaya maiidlip muna ako ng mga lima pang minuto tapos gigising na at maliligo na at maglalakbay na".

Kaya naidlip akong muli. Kaya naman ng idilat kong muli ang mga mata ko ay nagulat ako dahil maliwanag na ang kapaligiran. Tiningnan kong muli ang relos. Alas-otso na ng umaga. Teka, di ba ang sabi ko limang minuto lang ako maiidlip? E bakit alas otso na? Kaaaahhh!!! Kailangang magmadali!!!Karipasssss!!!

Hilamos(5 secs.), Mumog(7 secs.), Pagtimpla ng kape (10 secs... sikreto? 3in1 coffee, ang pagpunit lang ng sachet at paglagay ng tubig na mainit ang nakapagpatagal), Paghigop ng kape(mga 3 minutos, sa pagitan ng paliligo at pagpunas ng katawan...o saan ba kayo nakakita ng taong nagkakape at naliligo hehe!), sepilyo(30secs.,saka na ko magsisipilyo ng mas matagal..bukas..hehe) Pagsuot ng damit, pagsusuklay, pagtingin ng konti sa salamin(5 minutos).

Tapos larga! Labas ng bahay! Takbo sa Cubao bus terminal! Sakto, may naghihintay na bus patungong Lucena at daraan sa San Pablo. Sakay sa Bus! Haaaahhh salamat nakasakay na ako. Alas-otso y medya na...Haahh kakapagod mag-rush.

Teka bat di pa pala umaandar ang bus? Tinanong ko ang kundoktor. "Mamang konduktor" ang wika ko, "bakit di pa tayo umaandar?"

"Boss pupunuin pa po natin ang bus e, nasa kalahati pa lang ang pasahero"
Ngwek, ngwek, ngewk, ngwek. Ito yung hilarious sound na maririnig kapag nagpatawa ng korni si Dolphy sa pelikula.

Matapos ang mga labinlimang minuto, napuno din ang bus, at sa nakakainis na kabagalan ay unti-unti na itong umusad patungong kalsada. Nagbayad ako ng siento kinse bilang pamasahe. Tapos ipinaubaya na sa tsuper ang aking kapalaran. Diyos ko, ang wika ko, pakibilisan lang naman sana ang paglalakbay at tiyak na masisira ako sa aking usapan...

Ano bang masisira? E alas nuwebe na! Talagang sira na ko sa usapan. At dahil dalawang oras ang tinatayang biyahe patungo sa San Pablo, tiyak, alas onse na ng umaga ang dating ko doon. Wala akong magagawa. Mabuti pa tawagan ko na lang si Gerry at sabihin sa kanya na ako ay medyo maaabala sa pagdating.

Mabuti na lang at naisulat ko ang kanyang telephone number sa aking cellphone. Hehe maiintindihan ni Gerry kung na-late man ako. Tatawagan ko siya ngayon din...sa pamamagitan ng aking cellphone! Sa ganitong pagkakataon ay maasahan mo talaga ang teknolohiya! Biruin mo kung walang cellphone e tiyak na mamumuti ang mata ni Gerry sa San Pablo sa kahihintay sa akin, di ba?

Kinapa ko ang aking bulsa para kunin ang cellphone.Wala.....kabilang bulsa...wala din....sa loob ng bag...wala din..medyo kinakabahan na ako sa puntong ito...Tiningnan ko ang gilid ng aking upuan...wala din...ilalim ng upuan...wala din! Sa kamamadali ko naiwan ko nga pala sa banyo ang cellphone ko! Hindi!

Tapos pumasok sa isip ko..itetext ko ang kapatid ko sa bahay para isend niya sa akin ang number ni Gerry, para pagdating ko ng San Pablo ay tatawagan ko si Gerry sa landline (dahil di ko rin alam kung saan ang Jolibee san Pablo. E kaso, paano ko nga matetext ang kapatid ko e wala nga akong cellphone! Weird na pag-iisip! @+#@#$@*%

GRRRRR!!! nararamdaman kong tumataas ang aking stress level.....At napakahirap pa namang pababain nito..May isang lalaking katabi ko ang gumagamit ng analog cellphone...dati ko itong pinagtatawanan dahil laos na ito at mukhang kudkuran ng yelo. Ang uso ngayon ay digital na, subalit ngayon, kahit analog na cellphone na kasinglaki ng kudkuran ng yelo ay kailangan ko!

Hmmmmp...Isang leksiyon ang talagang natutunan ko sa eksperyensyang ito.....Isang dakila at banal na leksiyon.....

Dapat ay dalawa ang cellphone ko!

Diagnostic Imaging in Pulmonary Embolism

Imaging of pulmonary embolism

"If a diagnosis of pulmonary embolism (PE) has not been excluded after the initial clinical assessment and chest X-ray, the options for further evaluation include V/Q scintigraphy and CT. CT pulmonary angiography allows the pulmonary arterial system to be visualised and inter-observer agreement is generally very good for a diagnosis of PE. The advantage of CT over other imaging techniques is that it also demonstrates other aspects of the thoracic anatomy and facilitates alternative diagnoses. This is important since up to two-thirds of patients with suspected PE may eventually receive a different diagnosis. The advent of spiral MDCT provides a powerful tool for diagnosis of PE that is currently being compared with various combinations of tests in the PIOPED II study. CT is undoubtedly very valuable for the diagnosis of PE, but in order to reduce radiation exposure, it should be the last step in a sequential clinical evaluation."

From article by Simon PG Padley, Kapila Jain. Imaging of pulmonary embolism. in Controversies and Consensus in Imaging and Intervention.

Mr Tom Cruise-Doing Ultrasound yourself is irresponsible

Experts Warn of Dangers of Do-It-yourself Ultrasounds

Reference- Tom Cruise's Use of Fetal Keepsake Ultrasound Called Irresponsible on http://www.wbkansas.com

"Experts argue that actor Tom Cruise's claim to be qualified to perform unsupervised ultrasound exams on his fiancé, Katie Holmes, because he "read the manual" that came with the machine was irresponsible.Experts also called the move potentially dangerous, and that due to Cruise’s celebrity status, may have incorrectly influenced others to place their unborn children at risk by performing such exams with no medical supervision."

Well, ultrasound is a safe examination and is routinely done in pregnancy but still it is not to be done everyday like the way Tom Cruise is advocating. Laboratory studies have shown that ultrasound can produce physical effects in tissue, such as mechanical vibrations and rise in temperature, particularly when used for a prolonged period of time. It is strongly advocated that ultrasound images should be interpreted by properly trained physicians and the results discussed with the parents and treating physicians in order to plan for the best care of the baby and mother.

Radiation Humour

Just discovered this while net surfing here- More X-Ray Humour , Check out the site for such Funny X-ray stuff :-)

"XRAY TECHS LOVE LETTER

To My Dearest,

My colleague, we are like Beatrice and Dante;Dido and Aeneas. As sure as angular momentum is conserved, our professional love will endure the entropy of the universe. Your Barium Enema Films are as moving as Bach's ascending canon. Please meet me wearing only your Thyroid Shield at the Dark Room. We will study your TeleRAD and analyze the composition of barium and gastrograffin.

Yours Radiatingly,

Secret Xray Tech"

Impact of Obesity on Medical Imaging

OBESITY AND RADIOLOGY

Reference-Advance Imaging Magazine

"Americans are getting larger—much larger, which is no secret to radiologists or radiologic technologists. Very obese patients often exceed imaging table weight maximums and bore/gantry limitations, and frequently their body fat impedes rendering of quality diagnostic images. While patients must take responsibility for their own health, equipment vendors and the clinical community are equally invested in solving the weighty matter of obesity in medical imaging. Everything from plain X-ray to ultrasound, MRI and CT can be affected by obesity to the extent that the images can be very difficult to interpret."

All Radiologists have written sometime or the other in the reports of the patient-poor visualization due to obesity. This is common knowledge the size of the patient affects the quality of imaging study. Sometimes the issue is not poor visualization, it is inability to fit in to the machine, so vendors are now realising this fact and producing bigger machines. Common man understands that obesity leads to heart disease etc but is unaware that his/her diagnsotic studies may be hampered by his size. Approach to this problem has to be two prong-one on the part of the vendors to make bigger machines and other on the part of the people to realise the perils of obesity.

MRI in Rheumatoid Arthitis

Magnetic resonance imaging of the hand in rheumatoid arthritis : New scientific insights and practical application.

"Magnetic resonance imaging (MRI) is a sensitive diagnostic modality for the detection of inflammatory changes in peripheral joints. Nevertheless, the widespread clinical use of MRI in assessing patients with early rheumatoid arthritis is still hampered by the technical complexity and higher cost of MRI compared with conventional radiography. The MRI changes associated with rheumatoid arthritis are synovitis, tenosynovitis, erosions, and bone marrow edema."

Reference

Radiologe 2006 Apr 13; [Epub ahead of print]

Leasing of CT Scanners

GE, Physician Partnerships International to Offer Leasing of CT Scanners

"Physician Partnerships International, through its subsidiary Cardiology Imaging Associates, has entered into an agreement with GE Healthcare Financial to offer leasing services for the use of 64 slice CT (Computerized Axial Tomography) scanners. Tibitts states: "This is exciting for us. It presents us with a unique business opportunity to put both cardiologist and radiologists, and possibly other physicians, together to provide an excellent quality of patient care for 64 slice CT, with probable cost savings to the patients." "And by the way no significant up front capital from the physicians. It is just a typical lease, first and last month up front," Tibitts added. "

Source- Monitor Daily

How much is "Sumer's Radiology Site" worth?

My SiteSumer's Radiology Site is worth $24,275.22.
How much is your blog worth?

Inspired by Tristan Louis's research into the value of each link to Weblogs Inc, this little applet uses Technorati's API which computes and displays your blog's worth using the same link to dollar ratio as the AOL-Weblogs Inc deal.

Limitations of MRI in Multiple Sclerosis

Caution needed over role of MRI in diagnosing multiple sclerosis

"Magnetic resonance imaging (MRI) on its own has limited ability to rule out or confirm a diagnosis of multiple sclerosis in patients with a single attack of neurological dysfunction. Whiting and colleagues conducted a systematic review of 29 studies that evaluated the diagnostic accuracy of MRI for multiple sclerosis. Most studies were of poor quality and had short term follow-up. Even when MRI showed many lesions, it could not accurately confirm multiple sclerosis. Similarly, the absence of lesions could not accurately rule out the diagnosis."

Reference-
BMJ 2006;332 (15 April), doi:10.1136/bmj.332.7546.0

Good Friday Isn't so Good for me

Well, Holy Week is over and its time to go back to work. The week had been most boring, especially Good Friday, which I consider the laziest and most boring day in the Philippine calendar. All the establishments are closed: theaters, malls, and, hell, even the gym where I work out every morning.

GOOD FRIDAY
I woke up at about 10 this morning with a little headache. Thank God the incantations that had been blaring all-night long because of the Pasyon reading in our neighborhood had already ended early this morning. Now the silence only added gloom to the general stillness of the day.

What to do at this boring day? Watching TV doesn't help either. All the TV channels seem to be showing nothing except the story of Christ, or Cecille B. De Mille's Ten Commandments, which I have watched for the nth time since I was a kid.

I turned on the radio, just in time to hear an announcer say a few passages of the Bible in almost monotonic voice.

I decided to take a walk outside to strech my legs. There are very few people outside. Only some small kids quietly playing with their toys are all that I can see. A soft breeze of wind blew, making the leaves of the nearby trees grisle with their familiar sounds. I felt like Charlton Heston in the 1970s movie Omega Man where he played the last man on earth.

I walked towards Edsa.. With the exception of few cars passing by from time to time, the thoroughfare seemed desolated. The familiar shops are closed, and only a few people are within sight. Everyone seemd to be on a holiday.

The streets are almost empty, the shops are closed. Only a few people are within sight. This is the familiar sight of a normal Good Friday. Normal?

Going back to my apartment, I decided that the best thing to do at this time is to eat. I resolved not to eat meat this day, wether fish or pork. Fortunately there are plenty of fruits stocked in my fridge: ripe mangoes, guyabanos, pinya and, singkamas.

I peeled off the skin of two ripe mangoes, only leaving a small part unpeeld at the edge so I can hold it while gulping the sweet flesh. Hmmm. Very sweet, the juice is dripping down my arms and into my shirt. I didn't care. I went to shower, felt the fresh water all over my body. Changed my clothes, went to my workstation to check my emails. There was nothing...my goodness, even my emails-so numerous on other days-stopped coming at Good Friday. No one, not even spam emails reached my computer. It seemed that even the internet had stopped this day.

I checked the blogs I usually visit but not one of my friends had updated theirs. It seemed that everyone is on vacation. Well, this is enough. Bored with the internet, I turned off my computer and began playing some of my favorite music cd's.

First, a piano selection of Chopin's sonatas played by Edwin Fischer. The poignant and melancholic sound of Chopin's Nocturnes, so wonderful to listen to on other times, now added sadness to my whole being. I turned it off, and played an aria by Verdi, but no, this doesn't work either. The sopranos enchanting incantations reminded me of the Pasyon.

No, music won't let me out of this gloomy feeling now. I still feel guilty of not doing any worthwhile thing. I turned off the cd player and asked myself what to do next. Well, I have been very busy all year long, almost to the point of burning out myself, all with this business things, and sleeping very late at night because of the internet.

Can't I give myself this day, as a bonus, and take time to rest (as all others are resting), and stop from worrying about future work? Why not? I turned on the airconditoner, dropped myself onto the bed, and began to sleep.

Indeed, sleeping the whole day is an activity I haven't done for so many years. And Good Friday is just the perfect day for it. Ho-hum.

Neuroradiology Teaching Link

Just came across this excellent Neuroradiology Teaching Link. Check out-

Neuroradiology Tutor

Here is the geographic location of my Blog visitors

Well this just goes to show my concept of Radiology Magazine is going places!!

Ebay Philippines

Nagising ako ng tanghali kanina dahil nagbabad na naman ako sa internet hanggang alas-kwatro ng madaling araw. Hindi naman ako napuyat sa pakiki-pag-chat o paghahanap ng libreng porno, ang pagbababad ko kagabi ay may kaugnayan sa eBay.

Sa website na ito ay naglagay ako ng isang online store kung saan maaari akong magbenta ng mga gamit. Sa palagay ko, panahon na rin upang bawasan ko ang dami ng aking koleksyon. Sa totoo lang, masikip na ang aking bahay dahil sa dami ng mga nabili kong gamit noong mga nagdaang taon. Kaya heto magbebenta ako sa internet ng ilang gamit na hindi ko na kailangan. Bukod dito, makakadagdag sa aking ipon ang mga mapagbebentahan ko.

Dati sa Ebay International ako nagbebenta kaya lang ang laki ng bayad na kinakaltas sa aking credit card, kaya naisip kong sa Ebay Philippines na lang magbenta, dahil walang bayad dito.

Ang sinuman ay maaaring magkaroon dito ng account dahil libre lang. Ang hinihingi lang ng Ebay Philippines ay ilang personal na impormasyon at email address. Palagay ko ay isa itong pa-bonus ng Ebay dahil milyon-milyong dolyar naman ang kinikita nila sa kanilang international auctions araw-araw.

Sa Ebay philippines ay maaari kang magbenta ng kahit ano: lote, kotse, aklat, mga kagamitan sa bahay, komiks, magazines, at kung anu ano pa.

Kaya ayun, last week ay nagsimula akong magbenta ng ilang gamit. At swerte naman kahit paano ay nakabenta din ako. Kaya lang may problema. Dahil maraming nagtitinda, naengganyo din akong bumili. Nakabenta nga ako ng isang aklat na may halagang dos sientos singkwenta pesos, bumili naman ako ng mga aklat na ang halaga ay pitong libong piso.

Mahirap nga lang magbenta sa ngayon sa eBay Philippines dahil wala pang gaanong nakakaalam nito. Sa mahigit na limampung items na nilista ko para ipagbili, dalawa lang ang nabili. Kailangan ko pa sigurong pag-aralan ang tamang pagpe-presyo at baka naman overprice. Yun nga lang kahit di ka makabenta magandang paraan ito para magkaroon ng exposure ang iyong mga gamit na gusto ng ibenta.

Ang gagawin mo lang ay kunan ng larawan ang bagay na ibinebenta mo, tapos lagyan mo ito ng deskripsyon, at lagyan ng presyo kung magkano mo nais ibenta.

Maganda ding maging venue ito ng mga gumagawa ng mga independent mini-comics, kasi maaari nila ditong ma-idescribe ng husto ang kanilang komiks. Kahit hindi maibenta, at least kahit paano na-expose siya.

Sa palagay ko sa mga susunod na taon, habang ang karamihan ng mga Pilipino ay magkakaroon ng internet sa bahay, mas sisgla ang kalakalan sa Ebay Philippines. Ngayon pa lang talaga mahina dahil kaunti pa ang nakakaalam. Pero ako, nagsimula na akong magbenta at bumili para makaipon ng feedback score.

Okay ding mamili sa Ebay Philippines ng mga gamit dahil mas mura. Halimbawa yung nabili kong aklat ay pitong libong piso nga pero ang presyo naman nito sa bookstore ay labimpitong libong piso, kaya nakatipid ako ng sampung libo! Pinuntahan ko na lang yung seller sa bahay nila para i-pick-up ang gamit kaya di na ako gumastos sa parsela. Sa ngayon nga ay may iniispatan akong isang kotse na napakamura, at maaari kong bilhin kung sakali.


Yun nga lang kailangan din ang ingat sa pagbili baka mamaya manloloko lang ang nagbebenta. Dapat ay lagi nating isaisip na sa lahat ng bagay, kahit maganda, ay may pumapasok na mga huwad. Tingnan lagi ang "feedback" score ng nagbebenta o bumibili. O kaya naman kung wala pa siyang feedback score, e kontakin siya upang magkaroon ng pag-uusap.


Para sa di pa nakakaalam, punta lang kayo sa Ebay.com, tapos tingnan ninyo dun sa pinakailalim ng webpage ang katagang "Philippines" at eksakto, nasa Ebay Philippines na kayo. O kaya para mas madali punta kayo sa http://www.ebay.ph Kung gusto ninyong magkaroon ng seller's account o buyer's account (para magbenta at makabili), klik nyo lang ang "register"na buton at napakadali na ng susunod. Presto sa ilang minuto ay miyembro na kayo ng Ebay.

CT and Radiation Concerns

"Helical (aka slip ring or multidetector) computed tomography (CT) has revolutionized diagnostic cross-sectional imaging by enabling the scanning of a volume of tissue instead of scanning the patient one slice at a time. This technology, combined with further advances in data handling, has allowed radiologists an unprecedented ability to image the body and reconstruct data in multiple planes with little loss of resolution in ever shorter times. It is important for us to recognize that, as in anything in medicine or life, this incredible technology comes with a price. That price is increased radiation exposure.

A recent study from Sweden reviewed the cognitive ability of young men applying for the Swedish military who had been exposed to low-dose irradiation in infancy for cutaneous cranial hemangiomas. Brain dosage was estimated and correlated significantly with subsequent poor school performance, attendance, and cognitive ability. "

From an interesting article in Medscape-CT Scans and Cancer: How One Radiologist Is Safeguarding His Patients by Robert Chevrier .

What we should all realise particularly in kids we should be careful about ordering repeated CT scans say for minor Head Injury or ordering a CT scan when it has been repeatedly normal. One Head CT is equivalent to 150 CXRs and Risk versus benefit analysis should be done before ordering a CT scan.

Sleep Deprivation leads to Medical Errors by Doctors

Effect of reducing interns' work hours on serious medical errors in intensive care units.By Landrigan CP et al in N Engl J Med 2004 Oct 28;351(18):1838-48.

"Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors. Authors conducted a prospective, randomized study comparing the rates of serious medical errors made by interns while they were working according to a traditional schedule with extended (24 hours or more) work shifts every other shift (an "every third night" call schedule) and while they were working according to an intervention schedule that eliminated extended work shifts and reduced the number of hours worked per week. Interns made substantially more serious medical errors when they worked frequent shifts of 24 hours or more than when they worked shorter shifts. Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit. "

LITHOPEDION

Abdominal pregnancy is extremely rare, but even more unusual is the prolonged retention of an advanced abdominal pregnancy with lithopedion formation. Lithopedion is a rare obstetrical outcome of an undiagnosed and untreated advanced abdominal pregnancy, mostly found incidentally.

Just came across this case on www.mypacs.net , an amazing Radiograph...

Here is a link to case of-

"75 year old female with hematuria. Scout of IVP reveals a calcified fetus overlying the right iliac wing. On further questioning the patient claims that she "lost" a baby when she was younger, but did not seek medical care at the time."

LINK TO CASE IMAGE-
http://www.mypacs.net/cases/LITHOPEDION-72398.html

Using Radiology Residents to make up for Labor Shortage-Long Term Implications

Hospitals ponder residents’ role in night call sonography

"Using residents to make up for the shortage of qualified sonographers could undermine medical education and compromise patient care. Clinical demand for ultrasound studies after hours is increasing, and hospitals must juggle staffing to meet that demand. Sometimes sonographers work an in-house shift and perform the scans. Finding sonographers willing to work night shift has become a challenge. But using residents to fill in the gap could undermine their education and, ultimately, affect patient care. Resident on-call duties must always be a balance between educational experience and provision of clinical service. Training programs must be certain that the scanning done by the resident is of educational value and not just an expedient solution to a labor shortage or other business factor."

Reference-Diagnostic Imaging Online

Link to a Good post about principles of X-Rays

An excellent post aimed at laypersons about how X-rays were discovered and how they are produced with some details about the physics involved, interesting read for the curious mind.

An X-ray Tech Student in Phoenix: How It Works - X-ray Machines

Indian Radiology and Imaging Association (IRIA) Website

Here is the link to the new official website of Indian Radiology and Imaging Association with interactive quizzes, all about IRIA and memebership information. Must check for Indian Radiologists.

http://www.iria.in

Summer Memories and Dreams

Okay I've not ben updating my blog as often as I had wanted to but I have been quite busy the past few days spending more time in the library for my research works, and also to find a job so I could survive the hard summer expenditures. A lot of people just don't have much money these days. And that includes me.

The heat is really sweltering, everyone I meet on the streets frowns like mad. Good thing my old airconditioning unit still works fine and even though I see people outside my house sweating it out with the afternoon sun, I still managed to sleep with the covers on top of me.

Yet, Summer in the Philippines is not as hot as in other tropical countries. Perhaps this is because the Philippines is an archipelago and the waters around it helps to make things cool up a bit. This is especially so in the provinces near the beaches like Laguna, Batangas, and most especially the Visiyan provinces.

I still remember the time I spent summer in Malajog beach (Calbayog) in Samar last year. The heat was terrible inland (but not as sweltering as in Manila), but when you get to the beach, the cool wind just makes you think it wasn't summer after all.

When I took a dip into the sea, it felt really cold like taking a bath in early December mornings. The funny thing is if my upper half body is submerged in the sea, it felt really cold down there, but the other upper half exposed to the sun felt the damning heat especially on my shoulders.

Good thing about Malajog Beach and other Samar beaches is that they are not too crowded by people, especially by foreigners, just like what is happening in Boracay where you would see foreigners just everywhere.

Samar is a place where foreigners are still thinking twice to go to. The Warays seemd to get bad publicity allegedly because of their bad tempers. I think this misconcepton is due to the attack by the Warays on the Americans in what is now known as the Balangiga Massacre of 1901. But we must remember that there was a war going on then and that the Americans were even more ruthless in their conduct of war, especially when they get to revenge for the massacre as ordered by General Jacob "Howling Widerness" Smith. He got the epithet because he ordered the U.S. Army to kill all male populations of Samar able to carry a jungle bolo, and to transform the whole island into a "howling wilderness".

When I first went to Samar a few years back, my Nanay even plead that I must not go because something might happen to me on such a faraway place. It's like I'm going to another country? hehe. Being the independent person that I am, I respectfully told her that I know what I'm doing, that I'm only going to Samar, and not Iraq or Afghanistan, and that I'm happy doing it. She just said to me to be careful always in my Samar adventure.

I'm still planning to go back to Samar in the next few months because I have been planning to buy a small waterfront lot there at a very cheap price. The real estate value of land in Samar is still very cheap compared to other island provinces of the Philippines.

Well, I could build a small nipa hut there, sorround it with a garden of wildflowers, and then, as the heat of Summer rolls ahead, I'd be taking a cool dip in the ocean a few feet away from me.

On summer evenings, I would just lie on a couch in front of the beach and gaze at the maligering twilight that gives way to the the enchanting views of a moonlit and starlit night..... Well, everyone has his own little dreams and this one from me isn't too big too.

CT in Aortic Injury

Critical evaluation of chest computed tomography scans for blunt descending thoracic aortic injury.

"Although aortography has been the long-held "gold standard" for diagnosis of traumatic blunt aortic injury, advances in imaging technology offer less-invasive, more-rapid, and potentially more cost-effective evaluation. Chest CT is an acceptable screening tool based on prerequisite high sensitivity and ease of performance in the trauma patient suspected of having a descending thoracic aortic injury. Three-dimensional software reconstruction of the aorta can aid in diagnosing blunt aortic injury when findings are equivocal, but there will continue to be artifacts and limitations that require aortography for clarification."

Reference- Ann Thorac Surg 2006 Apr;81(4):1339-46.

Changing Trends in Radiology

Interesting Interview entitled-

A Conversation with … Frank Seidelmann, DOSubspecialty radiology – meeting the demand for improved healthcare and medical outcomes, Full interview is available here. It talks about the need for Subspecialization in Radiology. Select Extract here-

"Radiology reading strategies are changing. What is evolving is a three-legged approach, in order to offer the most effective reading strategy tailored to the imaging providers' needs. It is a combination of radiology interpretation providers. The first leg is the on-site general radiologist to handle injections, X-rays, ultrasound, CT and some subspecialty reports that will amount to 70 percent of the cases. The next leg is made up of "hyper-subspecialty" experts (by modality/body part) needed to support specific clinicians who will typically operate virtually and will make up about 20 percent of the report volume. The third leg is the traditional teleradiology or nighthawk providers to handle the night time/emergency reads for about 10 percent of the volume."

Radiology Quiz Section-Musculoskeletal System

Radiological Quiz-Musculoskeletal System
Look at the Radiograph and tell the likely diagnosis, please leave your answers in the comments section. Correct answers and the winners will be published here next week.

ANSWER-BRODIES ABSCESS

D/D Osteoid Osteoma

WINNER-Textor50

Medical Blogs And Disease Management

Personal blogs help fight diseases
Divya Ramamurthi (From The Hindu)http://www.hindu.com/2006/04/03/stories/2006040303550200.htm

Many blogs are run by doctors and scientists
Several patients turning to blogs for information
Some details on blogs may not be accurate

"When 42-year-old T. Sumithra's son was diagnosed with Duchenne muscular dystrophy, she wanted to learn more about the condition. She turned to the Internet for information. But instead of pouring through medical sites and trying to understand what they said, Ms. Sumithra turned to personal blogs. "I wanted to find out as much as I could about the condition - recent medical interventions, what happens and why it happens - but I did not want to be put away by the jargon that appeared on medical sites or be scared by what they had to say. So, I turned to blogs," Ms. Sumithra says. She says that she has been able to locate more than 150 blogs on muscular dystrophy. Some with medical information, some on personal stories on how to cope with it, and others with stories of courage and commitment to fight the situation."

Upcoming Conference on Computers in Radiology at Mumbai

RADBIZ - THE BUSINESS & PRACTICE OF RADIOLOGY incorporationg RADBYTES - II (Computers in Radiology)
A new conference will be be held in the first week of May on "The Business of Radiology". Topics will include lectures on "How to buy equipment...", "Finance", "Loan", "Insurance", "Methods of Practice", "Medico-legal Issues", "Marketing", etc. More details are here.

In brief, RADBYTES (Computers in Radiology) will be held on Friday afternoon at KEM Hospital (05 May 2006). RADBIZ (Business and Practice of Radiology) will be held on 06 & 07 May 2006 at Mumbai's ITC Grand Central Sheraton & Towers from 9.00AM - 6.00PM on both days.

Hay naku...panahon na naman ng tag-init sa Pilipinas!
Habang ang mga espalto ng kalsada ay nagbibitak-bitak sa init, ang mga tao naman ay kung saan saang dako tumutungo upang matakasan ang alinsangan at alikabok ng lungsod. Naroong may tumutungo sa mga dalampasigan upang magpalamig, sa mga malls upang makalanghap ng air-con, at siyempre sa mga lalawigan upang doon palipasin ang tag-init.
Dahil dito naisipan kong dalawin ang aking tiyuhin sa Bulakan upang doon magpalipas ng ilang araw at mabisita tuloy ang ilang mga pinsan.

Sakay ng Baliwag Transit, binaybay ko ang mga aplaya at bukirin na siyang karaniwang matatanaw sa kahabaan ng kalsada patungong Bulakan. Dito'y wala kang makikita kundi mga malalawak na taniman ng bukid, at dahil panahon ng tag-init, ang mga bungkos ng tanim na palay ay kapwa mga hinog na ang kulay, animoy mga milyong butil ng ginto na sabay-sabay na umiindayog sa lambing ng hampas ng hanging amihan.

Sa ilang bahagi naman ay ang mga dayami na siyang natira sa mga inaning palay, at sa ilang bahagi pa ay makikita naman ang mga magsasaka na pawang mga nakasuot ng mga malalapad na balangot habang itinataas ang kanilang mga bilao upang ipahiwalay sa hangin ang bigas sa ipa.
Sa bawat bayang aming daanan ay mayroong ilang mga nagtitinda ang umaakyat sa bus upang mag-alok ng mga mamiminindal tulad ng suman, sitsaron, o espasol. Bumili ako ng sitsaron upang ngatngatin habang naglalakbay subalit ang salbaheng tindero ay nakalimutan itong lagyan ng suka(vinegar), kaya hindi ko ito nangatngat (dahil ang sitsaron ay masarap kainin ng may suka di ba?).

Makalipas ang ilang oras na paglalakbay ay narating na rin namin ang bayan ng Baliwag. Matagal tagal na rin akong di nakapunta sa bayang ito subalit sa tingin ko ngayon ay halos walang pinagbago ang Baliwag. Ganito yata ang mga lalawigan, ilang dekada man ang makalipas ay nananatili pa rin sa kanyang matandang anyo.

Kumpara sa lungsod, ang buhay lalawigan ay napakasimple. Ang karaniwang mga tanawin dito ay yaong mga batang galing sa bukid na sakay ng kalabaw, o kaya ng ilang mga manang na galing sa simbahan..o kaya naman ay ng ilang mga kalalakihan na nag-uumpukan at nagkukwentuhan sa tapat ng isang tindahan habang hinihintay ang oras ng muling pagbabalik sa bukid. Ang buhay dito ay simple, walang gaanong pagmamadali, at walang tensyon.

Ang alinsangan ay di gaanong mararamdaman dahil na rin sa dami ng mga punongkahoy. Sumakay ako ng pedikab upang lakbayin naman ang baryo ng aking tiyuhin.Ang kanilang bahay ay isang matandang kolonyal na bahay sa Baliwag Bulakan, sa maliit na baryo ng Sto. Kristo. Pagkababa ko ng pedikab ay kinailangan ko munang mamilapil ng kaunti sapagkat ang kannilang tahanan ay nasa kabilang bahagi pa ng kalsada.

Nakita ko ang aking tiyuhing si Siahong Beloy na nagtatambak ng pilapil sa isang gilid ng puno. Medyo maasim ang pagtanggap niya sa akin. "Dinaramdam ko" ang wika niya "marami pa akong ginagawa. Kung gusto mo'y maghintay ka muna o magpasyal-pasyal. Pwede mong sakyan itong aking kalabaw". Hahah, ang wika ko sa sarili ko. Ako? Sasakay sa kalabaw? Ako na taga-Maynila?
Ibang usapan na ito. Bilang isang propesyonal na tao na nakapagtapos sa unibersidad, inakala kong ang pagsakay sa kalabaw ay isa lamang simple at napakapayak na gawain. Kahit sinong musmos ay makagagawa nito.

Parang nabasa ni Siahong Beloy ang iniisip ko kaya sinabi sa akin na "O baka naman kalabaw lang e hindi ka pa marunong sumakay? Madali lang naman pasunurin itong mga kalabaw. Tulad nitong si Vladimir, napakaamong hayop, sa isang tawag lang ay susunod agad"

Pagkatapos ay tinawag niya ang kalabaw na si Vladimir, "Hoy Vladimir, halika dito...hoy! Sumunod ka! Hoy! Rok-rok-rok". Ni hindi man lang lumingon si Vladimir, at patuloy lang sa pagnguya ng dayami.

Tinanong ko si Siahong Beloy kung ano ang ibig sabihin ng "Rok-rok-rok".

"A iyon ba?" ang sagot niya, "Yan ang paboritong tawag na gustong-gusto marinig ng mga kalabaw. Pag narinig nila iyon ay sumusunod agad. Tingnan mo"
At muli niyang tinawag si Vladimir, "Hoy Rok-rok-rok, Vladimir! Sumunod ka animal!"
Subalit tulad ng dati ay parang walang narinig ang halimaw, at patuloy lang sa panginginain ng dayami.
"O sige" ang baling naman niya sa akin" bahala ka na muna diyan, madali namang sakyan ang kalabaw. Basta sabihin mo lang ang Rok-rok-rok, susunod agad yan".