Graduate Medicine

Demystifying Thoracic CT: A Clinician's Guide to Precision Imaging in Lung Diseases Dr Neeraj Manikath , deepseek.ai Introduction The computed tomography (CT) scan is the cornerstone of modern pulmonary diagnostics and monitoring. However, the choice between non-contrast low-dose (LDCT), standard high-resolution (HRCT), contrast-enhanced, and volumetric expiratory scans is often a source of confusion. An incorrect selection can lead to missed diagnoses, unnecessary radiation exposure, or non-diagnostic studies. This article provides a definitive guide, complete with clinical pearls and a pragmatic algorithm, to streamline this decision-making process. 1. Decoding the CT Alphabet: Indications and Protocols The key is to match the clinical question to the correct protocol. A. Low-Dose CT (LDCT) Primary Indication: Lung cancer screening in high-risk individuals (e.g., 55-80 years, >30 pack-year history, current smoker or quit <15 years ago) [1]. The Pearl: LDCT is a screening to...

 Day-to-Day Assessment and Management of Decompensated Liver Disease: A Practical Guide for Medical Interns Dr Neeraj Manikath   Abstract Decompensated liver disease, often manifesting as cirrhosis with complications such as ascites, hepatic encephalopathy (HE), variceal bleeding, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS), represents a critical phase of chronic liver injury with high morbidity and mortality. This review provides a comprehensive overview tailored for medical interns on ward duty, emphasizing systematic daily assessment, evidence-based management strategies, and practical tips to optimize patient outcomes. Drawing from major guidelines including those from the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), we highlight key pathophysiology, diagnostic approaches, therapeutic interventions, and prognostic tools. Special sections on "pearls" (valuable in...