Parimal (@Haywired2) profile picture

MBBS @ Osmania Med Coll - Hyd MD Anaesthesia @ AIIMS - Delhi DM Critical Care @ AIIMS - Delhi Ass Consultant @ Gangaram Hosp - Delhi Here for nerd stats

New Delhi, India
Joined May 2019
Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)Photo by Parimal (@Haywired2)
Very happy and proud to manage this case perioperatively.
World’s Largest rare brain tumour (malignant peripheral nerve sheath tumour) of 2.9 kilos was removed by the Department of Neurosurgery with excellent support from the Department of Anesthesiology and Department of Transfusion Medicine . This 26 years old patient was deferred from several tertiary care centres accross India and was finally treated at AIIMS Kalyani. Intraoperatively patient was transfused a total of 18 PRBC (Ultra massive transfusion) and 8 PRBC perioperatively with other blood products showing exemplary support by the Department of Transfusion Medicine for setting the benchmark level. Kudos and top notch proficiency by the department of Anaesthesiology which ultimately lead to a successful conclusion. Heartfelt Thanks to our Executive Director sir for his encouragement, visionary leadership under whom AIIMS Kalyani has taken new dimensions of patient care.
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ANATOMY PEARL: HOW TO REMEMBER BRONCHOPULMONARY SEGMENTS Struggling to memorize the bronchopulmonary segments? These two mnemonics make it easier. 1. RIGHT LUNG: A PALM Seed Makes Another Little Palm 🟪 Right upper lobe: Apical, Posterior, Anterior (S1-S3) 🟩 Middle lobe: Lateral, Medial (S4-S5) 🟨 Lower lobe: Superior, Medial basal, Anterior basal, Lateral basal, Posterior basal (S6-S10) 2. LEFT LUNG: ASIA ALPS ⭕ Left upper lobe: Apicoposterior, Superior lingular, Inferior lingular, Anterior (S1+2, S3, S4, S5) ⭕ Lower lobe: Anteromedial basal, Lateral basal, Posterior basal, Superior (S7+8, S9, S10, S6) Clinical relevance Bronchopulmonary segments are anatomically and surgically important because each segment has its own segmental bronchus and pulmonary arterial supply. Knowing their locations helps with: - Localizing disease on chest imaging. - Bronchoscopy and segmental navigation. - Planning anatomical segmentectomy. Remember: Right lung = 10 segments. Left lung is commonly described as 8-10, depending on whether combined segments are counted separately. Source: Radiopaedia – Bronchopulmonary segments (mnemonic).
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My daughter turned 18. We wanted to get her PAN card issued. Simple enough? Not in India! 🫩 Her date of birth was incorrect on Aadhaar. To correct it, we were asked to get a birth certificate in the new format introduced after 2019. At the birth certificate office, they didn't even have application forms! Instead, a picture of the form was pasted on the wall. We were told to photograph it, find a stationery shop, print it and fill it out. No stationery shop nearby. Spent 20 minutes finding one. Then another problem: the registration number on her old birth certificate was illegible because of an overlapping stamp. Officials were reluctant to help and asked us to return after a few days. After much insistence, one helpful young man finally traced the number. Application submitted. Relief? Not quite. "It will take 2–3 months, sir." Apparently, the application must travel through multiple government departments before a new birth certificate can be issued. All this just to correct a date of birth, so that an 18-year-old can get her PAN card! We talk about Digital India, but basic government services still require citizens to run from pillar to post. Why must something so simple be so complicated?
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Supreme Court slams hospitals, government for 1,000% mark-up on cancer drugs; reserves verdict in a plea to cap essential drug prices Read here: barandbench.com/news/can-you…
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STT - Hazam GST - Hazam LTCG - Hazam STCG - Hazam Toll Tax - Hazam Road Tax - Hazam Excise Tax - Hazam Income Tax - Hazam Surcharges - Hazam Property Tax - Hazam Education Cess - Hazam Professional Tax - Hazam 'Aise nai chalta hai, Jo mila sab Hazam'
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At a wedding, and every direction I look in, many women above 40/50 have a penguin walk, knee issues and lack of muscles Almost all men have a big belly, no muscles Sarcopenia is the biggest cause of worry in our population
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Parimal retweeted
Ever wondered why a coronary occlusion gives the ECG it does? Block any part of the coronary circulation on a 3D heart and watch the 12-lead (and the echo!) evolve. Free for learning and teaching. Have fun! cliffreid.com/culprit #FOAMed #ECG #OMI #MedEd #Cardiology
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MATTER OF GREAT PRIDE FOR INDIAN SCIENCE!   Ashoke Sen becomes the first Indian to win the prestigious Oskar Klein Medal (2026), jointly  awarded by Stockholm University and the Nobel Committee for Physics of the Royal Swedish Academy of Sciences for his pioneering work in String theory.   deccanherald.com/science/ben…   String theory gives a unified description of all matter and the forces between them based on the postulate that the elementary constituents of matter are tiny one dimensional (string-like) objects instead of point particles. Sen’s breakthrough work has shown that multiple string theories are all different versions of a single underlying theory.   Incidentally, I met Ashok Sen for the first time, when both of us were elected  as FRS (Fellows of Royal Society) in 1998. Ashoke ( nominated by Stephen Hawking himself) was young 42 yrs and I was an oldie - 55 yrs though!   What struck me was Ashoke’s  incredible simplicity. His wife Sumathi Rao has reportedly said that Ashoke bought his first suit and needed some assistance to wear his first tie for that prestigious 1998 FRS ceremony in London, when one signs in the same book that Sir Isaac Newton has signed.   A film made on the life and work of Ashoke Sen, when we at the H K Firodia Award in Science & Technology honoured him in 2005 in Pune, will inspire all our budding scientists - showing how science & simplicity goes together. youtu.be/CoVc5cM5XlU?si=vQNQ… We all feel so so proud Ashoke! @PMOIndia @NITIAayog @PrinSciAdvOff @IndiaDST @CSIR_IND @ictstifr @PuneIntCentre @kvijayraghavan
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I’m in love with this sentence: “The strongest version of you is buried under the habits you’re afraid to break.”
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Misleading packages are illegal in Japan
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When performing complex lung operations a plan for PA control is critical These bulldog clamps by @ScanlanInc (I have no COI) are a must have available for every robotic lung case. Extrapericardial proximal PA control on the left & distal PA control at interlobar PA:
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1/Do radiologists sound like they are speaking a different language when they talk about MRI? T1 shortening what? T2 prolongation who? Here’s a translation w/an introductory thread to MRI.
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" Indian Reserves are not a war chest. They're a powder keg" " Equity Markets don't owe you anything: a profit; a return of your capital. And definitely not a Return on your capital. They don't you a living. But they have made excellent livings for all the folks involved in selling equity products to small investors. " " Equities aren't for the masses. Returns are sparse for years, volatile , sudden and sporadic, little predictability. Hence, they are meant ONLY for the Classy". " I have always believed and said that stock market isn't for general janata/ awaam. It's a game for pros, and should remain with pros or with people already wealthy through other means" " It's time the Govt. belled the MF equity cat: Govt is disincentivising Gold because it's a drain on FX. Well, we import around $60 billion of gold pa. And through SIPs, we have allowed knife through butter exits to Foreign Capital of around $50 billion last 12 months, around $80 billion last 24 months. Both gold and SIPs are resulting in massive similar dollar outflows so penalise ONLY gold?" " In my recent article in Business Standard, I analysed that in 35 years since 1991, our external resilience percentile rank has moved from 42 to 45. It's a tragedy that we still exhibit every characteristic of a classic Emerging Market: extreme dollar shortage, crashing currency, rising rates, firefighting at any global crisis " My interview to Mint today.
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New on pulmonarypocus.com: 🔊 Doppler Lab: pulmonarypocus.com/new-page-… 🫀 Echo Sim (TTE & TEE): pulmonarypocus.com/tte-tee-s… 📈 Hemodynamic Lab: pulmonarypocus.com/hemodynam… Free to use. Feedback welcome reply here otr email [email protected] #POCUS #MedEd #FOAMed @NephroP @PulmCrit
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Apple is taking its sweet time reviewing EchoSuite, so rather than keep waiting, I’ve decided to launch it on the web! The upside is that It is available to everyone. 🌐 echosuite.app EchoSuite brings together a real-time, anatomically labeled TTE simulator with interactive coaching and a fully adjustable 3D scene to make things more intuitive. It also includes echo calculators, and illustrations to guide you through image acquisition and measurements.
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これめっちゃスゴい! さっきカテ室で技師さんに教えてもらったけど、 角度自分で調整して冠動脈造影どんなふうな見えるかわかる カテ室にくる前に全研修医は確認必須! 今度からもうこのURL教えたらCAGの授業は完了 #循環器内科 #研修医 learncoronary.com
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The website is live at intro2echo.com and the github is at github.com/douyang/echodemo It was really fun to make the free movement - the video doesn't do it justice, but you can free move both the TTE and TEE probe and it'll generate the 2D image in according to the 3D model. There's a couple of chapters on common echo concepts and common diseases. Would love feedback!
I'm almost ready to share it, but Claude Code is very good at keeping consistency across views and chapters. For example, I can specify a heart phenotype, and will make all the images consistent and physiologically plausible. Even with unlimited time, I don't think I could create such a nice tutorial!
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Incredible work by @stefano_garzon to enrich coronary pullback data. I never thought IVUS could be so beautiful, I’m mesmerized!
Corelab annotations are a lot of work. Frame after frame, contour after contour, and the software we had made it hard. So I built our own with @claudeai. It’s called Coronaut. It was made entirely with Claude Code, to solve a problem we lived with every day. It takes an IVUS pullback and segments the lumen, EEM and stent struts automatically. I think it does a much better job than the software we had available. It also does 3D reconstructions and calculates FFR from the lumen. Was it fast or easy? No. It’s been more than a year in the making. But it allowed us to overcome a barrier that would otherwise have blocked us forever. I know how to code, but how long would it take me to do this by myself? Years? When I say AI will revolutionize medicine, this is what I mean. This is where doctors and chips meet, and I think it’s beautiful. Is it perfect? No. It is not finished or validated yet, and it is for research purposes only at this time. But we are working on it constantly, and it’s coming along. #CardiologyX #IVUS #AI
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I used @claudeai to build an interactive tool called AngioView (angioview.com) to help you understand coronary angiograms. One of the most challenging parts of being a first-year cardiology fellow is learning how to interpret cath lab imaging. It can take a lot of repetition before you're able to create a mental 3D map of coronary anatomy, which is so important because you need to understand how changes in cranial/caudal and LAO/RAO angulation affect the overall coronary perspective. I never found a high-quality tool out there to help visualize all this (at least not for free) so hopefully this site helps speed up that learning process!
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I built NavRad Anatomy, a free tool with an AI Guide that makes it simpler to learn clinically important imaging anatomy. To read scans, you need to know the anatomy. But there’s a lot to learn, and it’s hard to know what matters. With this app, you can scroll through real scans with labels and colour-coded overlays, filter the structures you want to see, learn essential anatomy with key clinical pointers, or ask the AI Guide: “Walk me through the liver segments” (see video) “Teach me the segments of the internal carotid artery” Or even: “Just show me the basics” Then test yourself by asking it to quiz you. Works on your phone or computer, so you can learn on the go. See it in action 👇 Try it at anatomy.navigatingradiology.…, or click "Anatomy" in Navigating Radiology.
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