Podcasts about mbbs

In today's episode, we had the pleasure of speaking with Kanwal P. S. Raghav, MBBS, MD, about the role of fruquintinib (Fruzaqla) in the treatment of adult patients with pretreated, metastatic colorectal cancer (CRC). Dr Raghav is a professor in the Department of Gastrointestinal Medical Oncology in the Division of Cancer Medicine, associate vice president of the Department of Ambulatory Medical Operations, and executive medical director of the Department of Ambulatory Treatment Centers at The University of Texas MD Anderson Cancer Center in Houston. In our exclusive interview, Dr Raghav discussed the mechanism of action of fruquintinib, key efficacy data from the phase 3 FRESCO (NCT02314819) and FRESCO-2 (NCT04322539) trials, the treatment settings where this agent is most frequently administered, and adverse effects to be aware of. He also noted how the role of fruquintinib in earlier lines of therapy has yet to be defined due to a lack of optimal predictive biomarkers. Dr Raghav concluded by emphasizing the importance of clinical trials for improving outcomes for patient with CRC.

Full article: Contrast-Enhanced Voiding Urosonography and Radionuclide Cystography for Diagnosing Vesicoureteral Reflux Using VCUG as the Reference Standard: Systematic Review and Meta-Analysis What is the current role of contrast-enhanced voiding urosonography in the detection of pediatric vesicoureteral reflux (VUR)? Raisa Amiruddin, MBBS, is joined by Hansel Otero, MD, to discuss the recent meta-analysis by Hayatghaibi et al. comparing imaging tests for VUR diagnosis.

Join leading experts Fariha Abbasi-Feinberg, MD, FAASM, Medical Director of Sleep Medicine at Millennium Physician Group and President Elect for the American Academy of Sleep Medicine; Inderpreet K. Madahar, MD, MBBS, Assistant Professor of Endocrinology, Diabetes, and Metabolism at Corewell Health; and Sarah Nadeem, MD, FACE, Assistant Professor, Section of Endocrinology, Diabetes, and Metabolism at Baylor College of Medicine, Houston, TX, as they discuss the complex relationship between obstructive and central sleep apnea and metabolic disorders such as obesity and type 2 diabetes.Key topics include:Who should be screened for sleep apnea and the recommended screening toolsFirst-line and adjunctive therapies for managementThe evolving role of multidisciplinary careHow clinical practice is shifting with the recent FDA label expansion of tirzepatide (Zepbound®)When tirzepatide may be considered alongside or in place of CPAP, APAP, and BiPAP therapiesTune in for practical insights to better identify, manage, and support patients at risk. This episode is made possible through a sponsorship from Lilly.

In this episode, host Shikha Jain, MD, speaks with Shakira Grant, MBBS, about providing patients and physicians with the proper education on AI tools, focusing on marginalized communities and more. •    Welcome to another exciting episode of Oncology Overdrive 0:14 •    About Grant 0:26 •    The interview 2:07 •    How did you get to where you are today? 2:38 •    Tell me about how you got into the AI space […] What aspects interest you specifically? 4:19 •    Can you take me step-by-step through how CROSS works with different health care organizations? 8:05 •    How does CROSS address concerns about AI?  10:33 •    Do you think AI could widen our disparities if it's taking its prompts from biases in humans? 13:31 •    How do we educate people about fixing the challenges presented by AI so that we can use this data more accurately? 16:38 •    Where do you see this going? […] What would you view as success in the next ten years? 18:22 •    How are you managing the current political climate with this type of work? 21:31 •    What do you plan to do next in your own career? 27:42 •    If someone could only listen to the last few minutes of this episode, what would you want listeners to take away? 29:25 •    How to contact Grant 30:23 •    Thanks for listening 31:28 Shakira J. Grant, MBBS, MSCR, is a physician, entrepreneur, and healthcare executive who works at the intersection of clinical medicine, health policy, and artificial intelligence. She is the founder of CROSS Global Research & Strategy, LLC (CROSS), a company dedicated to providing end-to-end solutions that ease the adoption of AI in healthcare. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. Grant can be reached on LinkedIn or via email drgrant@crosscatalyze.com. Disclosures: Jain and Grant report no relevant financial disclosures. 

Welcome to Top of the Morning by Mint.. I'm Nelson John and here are today's top stories. Ladakh Erupts in Violence What began as a hunger strike turned into Ladakh's deadliest unrest in years. Four dead, 60+ injured, and Leh under lockdown after protesters demanding statehood and Sixth Schedule protections clashed with security forces, torching buildings and vehicles. Activist Sonam Wangchuk is accused by the Home Ministry of provoking “Arab Spring-style” protests, though he denies it. Talks with Delhi are set for October 6. Private Sector Enters Stealth Race L&T and BEL are teaming up to bid for India's stealth fighter project, the Advanced Medium Combat Aircraft. With ₹15,000 crore sanctioned for prototypes, the IAF plans to induct 120 jets by 2035. This marks a major shift from HAL's monopoly as private defense firms compete in India's biggest aerospace contract. India-Australia Organic Pact A new deal recognizes each other's organic certifications, unlocking smoother trade. India exports just $9M worth of organics to Australia today, but the pact could boost prices for farmers and open markets in cereals, spices, tea, and wine. Australia leads with 53M hectares of organic farmland; India has the most organic producers worldwide. Trump's “Triple Sabotage” at UN Donald Trump cried foul after his UN speech was marred by an escalator stop, a dead teleprompter, and sound glitches. He called it “sabotage,” but UN officials said the mishaps were linked to his own team and budget cuts triggered by delayed US payments. Big Boost for Medical Seats The cabinet cleared ₹15,034 crore to add 5,023 MBBS and 5,000 PG seats. India has doubled capacity since 2014, yet 20 lakh aspirants still chase limited spots. The rapid expansion faces hurdles: faculty shortages and unaffordable private fees. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Ramji Ram is Nepal's first doctor from the marginalized Chamar community. Overcoming extreme poverty and caste-based discrimination, he earned his MBBS degree through sheer determination and a government scholarship. Despite facing institutional barriers and financial hardships, he succeeded in becoming a Medical Officer at Nepal's Ministry of Education.

Host Dr. Tushar Chopra and guest Dr. Aisha Shaikh discuss the importance of good techniques for connecting and disconnecting HD catheters, review catheter locking solutions and novel caps, and consider new data released since the 2019 KDIGO guidelines.

Host Dr. Tushar Chopra and guest Dr. Aisha Shaikh discuss the importance of good techniques for connecting and disconnecting HD catheters, review catheter locking solutions and novel caps, and consider new data released since the 2019 KDIGO guidelines.

I Started Loving Myself More After Joining Swami's HospitalOn August 15, 1973, a young MBBS graduate from Kasturba Medical College, Bengaluru, began a humble Sunday clinic in the village of Begur. With nothing more than his medical degree, the help of a compounder, and an unshakable determination to serve, he quietly tended to villagers in a corner 33 kilometres from Bengaluru.What started as a small act of service has today blossomed into a movement that provides free healthcare to more than 1,000 patients every week. For over five decades, this dedicated doctor has never missed a single Sunday at his clinic in Begur. In recognition of his lifelong commitment, the Government of India honoured him with the Padma Shri in 2010.Ask him what fuels this unwavering resolve, and he humbly replies:“Baba's message, ‘Hands that serve are holier than lips that pray,' has touched me deeply and given me the strength to carry on and do even more. These hands are not my hands, they are His hands.”Echoing a similar spirit of surrender, Dr Geetanjali Tulapurkar, Head of the Department of Anaesthesia at the Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, shares: “It is not me doing anything for the patients. Every patient who comes to Baba's hospital actually heals me. Day by day, I am realising that I am not the doer, and this fills me with a great sense of peace and joy."Both of these eminent physicians were among the inspiring speakers at the Global Medical Conference held in Prasanthi Nilayam in June 2025.

An inside scoop to pediatric radiology training and beyond. Amy Mehollin-Ray, MD, speaks with host Raisa Amiruddin, MBBS, on the many training pathways available and common misconceptions about the subspecialty. Academics, teleradiology, private or hybrid practice: the opportunities are everywhere! https://www.ajronline.org/doi/10.2214/AJR.25.33866

Interview with David C. Whiteman, MBBS, PhD, author of A Risk Prediction Tool for Invasive Melanoma. Hosted by Adewole S. Adamson, MD. Related Content: A Risk Prediction Tool for Invasive Melanoma

Interview with David C. Whiteman, MBBS, PhD, author of A Risk Prediction Tool for Invasive Melanoma. Hosted by Adewole S. Adamson, MD. Related Content: A Risk Prediction Tool for Invasive Melanoma

In this episode, host Dr. Tushar Chopra and guest Dr. Namrata Krishnan will discuss how to safely connect and disconnect HD catheters, common myths about catheter care in hemodialysis, and showering with a dialysis catheter.

In this episode, host Dr. Tushar Chopra and guest Dr. Namrata Krishnan will discuss how to safely connect and disconnect HD catheters, common myths about catheter care in hemodialysis, and showering with a dialysis catheter.

See the heart of a devout Muslim who converted to Christianity. Asar shares his transformative journey from being raised in conservative Tehran to embracing Christianity. He recounts his early passion for seeking God, his struggles with archaic texts, and how a mysterious blue book pointed him towards Christianity. His amazing story includes moments of prayer, visions, and even a Holy Spirit bath, ultimately leading him to openly declare his faith in Jesus Christ. Despite facing severe persecution and threats, Isar remained steadfast, further deepening his faith through his community and service in various churches.In part 1 you'll see that Isar's zeal for prayer helps turn him toward Christ, with the Blue Book changing him before he even knew what was happening.Be encouraged as you hear a story testifying what is happening all over Persia. Helpful LinksFarsi BibleIslam vs. ChristianityCompare Bible verses in Qu'ran and Bible, side by side, Christian perspective, Dr. Ahmed JoktanOne80 with Mahmoud A, 88 and 89One80 with Naeem Fazal, 81 and 82One80 with Shahe Nahler, 58 and 59One80 with David Sadik, Episode 42One80 with Sara A., Episode 21One80 with Dr. Ahmed Joktan, 11 and 12OneWay Prayercast Love Muslims TestimoniesLet us know what you thought of the show!Follow One80 on Apple Podcasts, Spotify, or our website.Never miss a One80. Join our email list. Follow us on Instagram.Share One80, here's how!OneWay Ministries

On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Tom Cross, MBBS, DCH, to discuss the Cross Bracing Protocol. In this conversation, Dr. Cross discusses the following: Background on the Cross Bracing Protocol (CBP) and its origins The selection criteria and the grading system for the CBP The rehabilitation considerations for the CBP and potential complications Future directions of research for the CBP Dr. Tom Cross has practiced sports medicine for the past 28 years and during that time successfully completed 5 years of specialist post-graduate training in sport & exercise medicine. He has broad sports medicine experience caring for recreational athletes (adults and children), musculoskeletal injuries that occur at work or home, elite/professional athletes and also military personnel. Resources: Healing of Acute Anterior Cruciate Ligament Rupture on MRI and Outcomes Following Non-Surgical Management with the Cross Bracing Protocol https://bjsm.bmj.com/content/57/23/1490 Cross's Website, including additional resources and information about the CBP: https://www.stadiumclinic.com.au/dr-tom-cross-sports-doctor-sydney.html

In today's episode, we passed the mic to Tara E. Seery, MD, who moderated an OncLive Insights discussion on the future of the pancreatic cancer treatment paradigm. Rounding out the discussion with additional expert perspectives were Paul E. Oberstein, MD, and Priyadarshini Pathak, MBBS. Seery is a medical oncologist at the Hoag Family Cancer Institute in Newport Beach, California. Oberstein is an associate professor in the Department of Medicine at the New York University (NYU) Grossman School of Medicine; as well as the director of the Gastrointestinal Medical Oncology Program, the assistant director of the Pancreatic Cancer Center, and the service chief of the Gastrointestinal Medical Oncology Program at NYU Langone's Perlmutter Cancer Center. Pathak is an assistant in medicine at Massachusetts General Hospital and an instructor in medicine at Harvard Medical School in Boston.  In this exclusive conversation, Drs Seery, Oberstein, and Pathak highlighted key data from the phase 3 NAPOLI 3 trial (NCT04083235) of NALIRIFOX (liposomal irinotecan, 5-fluorouracil [5-FU], leucovorin, and oxaliplatin) vs nab-paclitaxel (Abraxane) and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma; the toxicity profiles of NALIRIFOX and FOLFIRINOX (leucovorin, 5-FU, irinotecan, and oxaliplatin); real-world data with these regimens, and more. 

In this episode of Molecule to Market, you'll go inside the outsourcing space of the global drug development sector with Stephen Dilly, Chairman, President and Chief Executive Officer at Codexis. Your host, Raman Sehgal, discusses the pharmaceutical and biotechnology supply chain with Stephen, covering: His journey of almost 40 years in the industry, including 20 years as a CEO. Leading two therapeutic companies to two, successful, $billion+ exits... Not making snap judgements and instant opinions early on in your role as a senior leader. Why he took on the challenge of leading Codexis at this phase of his career. The importance of values as guiding principles, and spending in-person time with your team. As President & CEO of Codexis since August 2022, Stephen brings more than three decades of executive management experience in the biopharmaceutical industry. Most recently, he served as President and CEO of Sierra Oncology (NASDAQ: SRRA) through its recent sale to GlaxoSmithKline for $1.9 billion.  Previously, Dr. Dilly served as CEO of Aimmune Therapeutics, acquired by Nestle Health Science for $2.6 billion. Dr. Dilly has served in executive roles at Genentech, Chiron and SmithKline Beecham and has been associated with the development, approval and launch of more than twenty marketed drugs across multiple therapeutic areas. He holds both an MBBS and a PhD in Cardiac Physiology from the University of London.   Molecule to Market is also sponsored by Bora Pharma (boracdmo.com) and Charles River (www.criver.com), and supported by ramarketing.    Please subscribe, tell your industry colleagues and join us in celebrating and promoting the value and importance of the global life science outsourcing space. We'd also appreciate a positive rating!

Episode 125 of The Prakhar Gupta Xperience features Dr. Ravi Sharma, one of India's top neurosurgeons trained entirely at AIIMS, New Delhi. With over 15 years of experience and 120+ research papers, he has handled some of the toughest brain and spine surgeries with exceptional results. Awarded the Institute Medal by the Prime Minister as AIIMS' best MBBS graduate, Dr. Sharma now leads at Paras Health, Gurugram, specializing in brain tumors, skull base surgery, Gamma Knife radiosurgery, and complex head injuries.Recording Date: August 4, 2025This is what we talked about:0:00 - Scrolling Is Destroying Your Sleep01:28 - Vaping Is Making You Dumb05:08 - Dopamine Detox08:34 - New Disorder Discovered09:53 - Awareness Paradox11:50 - Porn Ruining Intimacy14:15 - Cognitive Behavioural Therapy18:47 - How He Topped NEET By Sleeping Well22:18 - Side Effects Of Melatonin23:18 - How To Unlock Super Intelligence28:02 - Can Neuralink Cure Blindness30:12 - What Is Parkinson's Disease33:32 - Humans Becoming Cyborgs35:12 - Do Dreams Have Meaning39:48 - What Is Personality Made Of42:37 - Real Life Aparichit49:48 - Causes Of PTSD54:24 - Trauma Response is Genetic55:55 - Delulu Is 'Not' The Solulu59:05 - The Pink Hippopotamus1:00:58 - Frontal Lobe Depression1:04:12 - Some Fascinating Cases1:08:40 - Most Common Issues1:16:12 - Headaches and Their Types1:17:52 - Migraine and Its Triggers1:23:33 - Left Brain vs. Right Brain Theory1:27:37 - What Does It Mean to Be Brain Dead?1:30:17 - Difference Between Coma and Brain Death1:31:42 - Consciousness and Its Origin1:34:47 - Meditation and Neuroscience1:37:46 - Supplements for the Brain1:40:32 - The Future of Neuroscience in 20 Years

In this World Shared Practice Forum Podcast, Dr. Padmanabhan Ramnarayan discusses the findings of the clinical trial comparing high-flow nasal cannula (HFNC) therapy to continuous positive airway pressure (CPAP) therapy in pediatric critical care. The trial, which was published in JAMA, explores the effectiveness of HFNC as a non-inferior alternative to CPAP for respiratory support in acutely ill children. Dr. Ramnarayan reviews the trial's design, key outcomes, and implications for clinical practice, providing valuable insights for healthcare professionals involved in pediatric respiratory care. LEARNING OBJECTIVES - Understand the design and methodology of the clinical trial comparing HFNC and CPAP in pediatric critical care - Identify the primary and secondary outcomes of the trial and their significance - Discuss the implications of the trial findings for clinical practice and future research in pediatric respiratory care AUTHORS Padmanabhan "Ram" Ramnarayan, MBBS, MD, FRCPCH, FFICM Professor of Paediatric Critical Care Imperial College London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: August 26, 2025. ARTICLES REFERENCED Ramnarayan P, Richards-Belle A, Drikite L, et al. Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA. 2022;328(2):162-172. doi:10.1001/jama.2022.9615 RENOVATE Investigators and the BRICNet Authors, Maia IS, Kawano-Dourado L, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025;333(10):875-890. doi:10.1001/jama.2024.26244 Pelletier JH, Maholtz DE, Hanson CM, et al. Respiratory Support Practices for Bronchiolitis in the Pediatric Intensive Care Unit. JAMA Netw Open. 2024;7(5):e2410746. Published 2024 May 1. doi:10.1001/jamanetworkopen.2024.10746 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/whctgh753rgnhc7rxn7w3mn/20250712_WSP_Ramnarayan_Transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Ramnarayan P, O'Hara JE, Burns JP. High-Flow Nasal Cannula vs CPAP in Acutely Ill Children. 08/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/high-flow-nasal-cannula-vs-cpap-in-acutely-ill-children-by-p-ramnarayan-openpediatrics

Neeru A. Vallabh, MBBS, FRCOphth, PhD, FEBOS-GL, recaps her article, “The Role of Anterior Segment OCT in MIGS,” which was featured in the March/April issue of Glaucoma Today. Dr. Vallabh explores how this mode of advanced imaging can enhance the patient evaluation and surgical results, reviewing its utility for preoperative evaluation and intraoperative adjustments and its ability to provide insights into postoperative outcomes.

On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Tom Cross, MBBS, DCH, FACSEP, to discuss the Cross Bracing Protocol. In this conversation, which was recorded during the 2025 AMSSM Annual Meeting, Dr. Cross discusses the following: Background on the Cross Bracing Protocol (CBP) and its origins The selection criteria and the grading system for the CBP The rehabilitation considerations for the CBP and potential complications Future directions of research for the CBP Dr. Tom Cross has practiced sports medicine for the past 28 years and during that time successfully completed 5 years of specialist post-graduate training in sport & exercise medicine. He has broad sports medicine experience caring for recreational athletes (adults and children), musculoskeletal injuries that occur at work or home, elite/professional athletes and also military personnel. Resources: Healing of Acute Anterior Cruciate Ligament Rupture on MRI and Outcomes Following Non-Surgical Management with the Cross Bracing Protocol https://bjsm.bmj.com/content/57/23/1490 Cross Bracing Protocol Patient Information Booklet: https://www.stadiumclinic.com.au/pdf/cross-bracing-protocol-patient-information-booklet.pdf Dr. Cross's Website, including additional resources and information about the CBP: https://www.stadiumclinic.com.au/dr-tom-cross-sports-doctor-sydney.html

In this episode, Dr Zoe Swithenbank speaks to Dr June Leung, a senior researcher at the SHORE and Whariki Research Centre at Massey University in New Zealand. The interview covers June's systematic review and meta-analysis on the association of parental or caregiver alcohol use with child maltreatment.· An overview of the review and the definition and forms of child maltreatment [01:00]· Why it is important to look at all forms of child maltreatment [03:48]· Quantifying the harms of alcohol and identifying preventable risk factors [05:00]· The take home messages of the study [06:23]· What June's findings do and do not suggest for the wider alcohol literature [07:28]· What the implications of the findings are for policy and practice [08:29]· The challenges in conducting the review [11:02]· The limitations of the study [13:08]· The surprising aspects of conducting this review [15:12]About June Leung: Dr Leung is Senior Research Officer at SHORE & Whariki Research Centre, Massey University, based in Auckland, New Zealand. Her research focuses on global alcohol policy, alcohol industry influence, and the epidemiology of chronic diseases. She is also a public health physician by training and a fellow of the New Zealand College of Public Health Medicine and the Hong Kong College of Community Medicine. She completed her undergraduate medical degree (MBBS), Master of Public Health (MPH) and Doctor of Medicine (MD) at The University of Hong Kong. Dr Leung has no conflicts of interest to declare.About Zoe Swithenbank: Dr Zoe Swithenbank is a senior research associate at Lancaster University, currently working on a National Institute for Health and Care Research (NIHR) funded research project exploring treatment pathways for co-occurring alcohol and mental health problems. She recently completed her SSA funded PhD at Liverpool John Moores University on behavioural interventions for smoking cessation in substance use treatment services. Prior to starting her academic career, Zoe worked in health services including substance use, mental health, and homeless services, and these experiences shaped her research interests, as well as her commitment to the inclusion of people with lived experience in research.Original review: The association of parental or caregiver alcohol use with child maltreatment: A systematic review and meta-analysis of longitudinal studies https://doi.org/10.1111/add.70055The opinions expressed in this podcast reflect the views of the host and interviewees and do not necessarily represent the opinions or official positions of the SSA or Addiction journal.The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information. Hosted on Acast. See acast.com/privacy for more information.

Learn the ABCDEs of the cervical spine. Judy Gadde, DO, MBA, speaks with host Raisa Amiruddin, MBBS, on understanding the delicate bones and ligaments of the pediatric cervical spine, identifying elusive soft tissue injuries and developmental mimics, and effectively communicating essential information while reporting.  https://www.ajronline.org/doi/10.2214/AJR.25.33718

Join hosts Nidhi Madan, MD; Prashant Nagpal, MD, FSCCT; Jill Jacobs, MD, MS-HQSM, FSCCT and Cristina Fuss, MD, PhD, FSCCT as they take a deep dive into featured articles in the May – June2025 issue of the Journal of Cardiovascular Computed Tomography (JCCT). Our hosts chat with Borek Foldyna, MD, FSCCT; Ming-Yen Ng, MBBS, FRCR, FSCCT; Daisuke Kinoshita, MD; Muhammad Taha Hagar, MD and Philipp Arnold, MD. This episode will explore:Air pollution, coronary artery disease, and cardiovascular events:  Insights from the PROMISE trialUsing Cardiac CT to Clarify the Relationship between Air Pollution and AtherosclerosisPerformance of Large Language Models for CAD-RADS 2.0 classification derived from Cardiac CT reportsHigh-risk Plaque Features and Perivascular InflammationSupport the show

Deep Chandh Raja, MBBS, MD, PhD, Australian National University, Kauvery Hospital is joined by Andreas Pflaumer, MD, FHRS, CEPS-P, Royal Children's Hospital Melbourne and Maully J. Shah, MBBS, FHRS, CCDS, CEPS-P Children's Hospital of Philadelphia, to discuss the unmet clinical need for a smaller pacemaker suitable for neonates and infants, researchers developed a specially modified implantable pulse generator incorporating a Medtronic Micra subassembly within a polymer header, connected to a bipolar epicardial lead. This study aimed to evaluate the safety, feasibility, and midterm outcomes of this novel device, reporting follow-up data from multiple centers on patients who underwent implantation. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCEP.124.013436?doi=10.1161/CIRCEP.124.013436 Host Disclosure(s): D. Raja:  Nothing to disclose. Contributor Disclosure(s): M. Shah: Honoraria/Speaking/Consulting: Medtronic, IBHRE Abbott, BioTelemetry, Boston Scientific, Kardium Other Financial Relationships: American College of Cardiology A. Pflaumer: Stock Options - Privately Held: Navi Medical Systems Officer, Trustee, Director, Committee Chair: PACES, Asia Pacific Heart Rhythm Society (APHRS)

What Is Virg*nity? | Dr. Gorakh Mandrupkar & Mukta Chaitanya | Khuspus with Omkar #amuktamukअमुकतमुक ला subscribe करण्यासाठी click करा: https://youtube.com/@amuktamuk?si=LCVcdLVB9KMPVHrkVirg*nity म्हणजे काय? Hymen Break होणं म्हणजे काय? Menstrual cups वापरल्या नंतर Virg*nity Break होते का? पुरुषांना Virg*nity विचारली जात नाही का? Virg*nity ला स्त्रीच्या पावित्र्याशी जोडणं योग्य आहे का? अजूनही लग्न करतांना या गोष्टीचा विचार केला जातो का? पालक म्हणून मुलांना याबाबत कश्या पद्धतीने शिक्षण दिलं पाहिजे?या विषयावर आपण डॉ.गोरख मंद्रुपकर (MBBS, DGO, FCPS,FICOG,स्त्री रोग आणि IVF तज्ञ,मंद्रूपकर क्लिनिक, इस्लामपूर) आणि मुक्ता चैतन्य (Writer, Journalist) यांच्यासोबत खुसपुस केली आहे पूर्ण एपिसोड नक्की बघा.What is virg*nity? What does the breaking of the hymen mean? Does using a menstrual cup result in the loss of virg*nity? Why is virg*nity not questioned for men? Is it appropriate to associate a woman's virg*nity with her purity? Is this still considered when getting married? As parents, how should we educate our children about this topic?We had an insightful conversation on this subject with Dr. Gorakh Mandrupkar (MBBS, DGO, FCPS, FICOG, Obstetrician & IVF Specialist, Mandrupkar Clinic, Islampur) and Mukti Chaitanya (Writer & Journalist). Watch the full episode for the complete discussion.आणि मित्रांनो आपलं Merch घेण्यासाठी लगेच click करा! Amuktamuk.swiftindi.comDisclaimer: व्हिडिओमध्ये किंवा आमच्या कोणत्याही चॅनेलवर पॅनलिस्ट/अतिथी/होस्टद्वारे सांगण्यात आलेली कोणतीही माहिती केवळ general information साठी आहे. पॉडकास्ट दरम्यान किंवा त्यासंबंधात व्यक्त केलेली कोणतीही मते निर्माते/कंपनी/चॅनल किंवा त्यांच्या कोणत्याही कर्मचाऱ्यांची मते/अभिव्यक्ती/विचार दर्शवत नाहीत.अतिथींनी केलेली विधाने सद्भावनेने आणि चांगल्या हेतूने केलेली आहेत ती विश्वास ठेवण्याजोगी आहेत किंवा ती सत्य आणि वस्तुस्थितीनुसार सत्य मानण्याचे कारण आहे. चॅनलने सादर केलेला सध्याचा व्हिडिओ केवळ माहिती आणि मनोरंजनाच्या उद्देशाने आहे आणि चॅनल त्याची अचूकता आणि वैधता यासाठी कोणतीही जबाबदारी घेत नाही.अतिथींनी किंवा पॉडकास्ट दरम्यान व्यक्त केलेली कोणतीही माहिती किंवा विचार व्यक्ती/कास्ट/समुदाय/वंश/धर्म यांच्या भावना दुखावण्याचा किंवा कोणत्याही संस्था/राजकीय पक्ष/राजकारणी/नेत्याचा, जिवंत किंवा मृत यांचा अपमान करण्याचा हेतू नाही.. Guests: Dr. Gorakh Mandrupkar (MBBS, DGO, FCPS, FICOG, Obstetrician & IVF Specialist, Mandrupkar Clinic, Islampur), Mukta Chaitanya, Writer and Journalist.Host: Omkar Jadhav.Creative Producer: Shardul Kadam.Editor: Rohit Landge.Edit Assistant: Rameshwar Garkal.Content Manager: Sohan Mane.Social Media Manager: Sonali Gokhale.Legal Advisor: Savani Vaze.Business Development Executive: Sai Kher.Intern: Mrunal Arve.About The Host Omkar Jadhav.Co-founder – Amuk Tamuk Podcast NetworkPodcast Host | Writer | Director | Actor | YouTube & Podcast ConsultantWith 8+ years in digital content, former Content & Programming Head at BhaDiPa & Vishay Khol.Directed 100+ sketches, 3 web series & non-fiction shows including Aai & Me, Jhoom, 9 to 5, Oddvata.Creative Producer – BErojgaar | Asst. Director – The Kerala StoryHost of Khuspus – a podcast on taboo and uncomfortable topics.Visiting Faculty – Ranade Institute, Pune University.Connect with us: Twitter: https://twitter.com/amuk_tamukInstagram: https://www.instagram.com/amuktamuk/Facebook: https://www.facebook.com/amuktamukpodcastsSpotify: Khuspus #AmukTamuk #marathipodcasts

Building on their first discussion Neda Shamie, MD, revisits the topic with Tanya Trinh, MBBS, FRANZCO, FWCRS, shifting from recognition to implementation. The conversation covers building inclusive programs (diversifying panels and thoughtfully limiting repeat speakers to create space), engaging male allies and role models, applying blinded selection where feasible, and auditing outcomes.

Divaka Perera, MD and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the SERIAL study, the first randomized comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in serial coronary artery disease.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

Mehdi H. Shishehbor, DO, MPH, PhD, FACC and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the analysis of 1-Year Outcomes of Transcatheter Arterialization of Deep Veins: PROMISE II and Pooled PROMISE Studies.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

Mehdi H. Shishehbor, DO, MPH, PhD, FACC and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the analysis of 1-Year Outcomes of Transcatheter Arterialization of Deep Veins: PROMISE II and Pooled PROMISE Studies.

Divaka Perera, MD and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the SERIAL study, the first randomized comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in serial coronary artery disease.

During a session at The HemOnc Pulse Live! moderated by Naval Daver, MD, Eunice Wang, MD presents new insights in acute myeloid leukemia care, joined by Aditi Shastri, MBBS, Tapan Kadiya, MD, and Kelly Chien, MD for a rich panel on mutation loss, minimal residual disease, and transplant timing.

Year in Review: Clinical Investigator Perspectives on the Most Relevant New Datasets and Advances in Gynecologic Cancers | Faculty Presentation 2: Endometrial Cancer and Cervical Cancer — Susana Banerjee, MBBS, MA, PhD CME information and select publications

At the 2025 Kidney Cancer Research Summit hosted by KidneyCAN, CancerNetwork® spoke with a variety of leading experts about key developments in the research and management of kidney cancer. Throughout the meeting, presenters shared their findings related to updated clinical trial results, personalized cancer vaccines, potential biomarkers of interest, and other advancements in the field. Thomas Powles, MBBS, MCRP, MD, discussed outcomes from a quality-adjusted survival time without symptoms or toxicity (Q-TWiST) analysis of the phase 3 LITESPARK-005 trial (NCT04195750), in which investigators evaluated treatment with belzutifan (Welireg) vs everolimus (Afinitor) among patients with advanced renal cell carcinoma (RCC). Powles, a professor of genitourinary oncology, lead for Solid Tumor Research, and director of Barts Cancer Institute at St. Bartholomew's Hospital, Queen Mary University of London, stated that these data demonstrate how belzutifan is more active and better tolerated than everolimus in this patient population. David A. Braun, MD, PhD, assistant professor at Yale School of Medicine and member of the Center of Molecular and Cellular Oncology within the Yale Cancer Center, detailed his presentation on a personalized neoantigen cancer vaccine as a treatment for those with RCC. Based on his presentation, Braun highlighted how neoantigen vaccines may effectively yield T-cell responses in patients, illustrating a need for additional, larger studies to elucidate the clinical activity of this modality in an adjuvant setting. Additionally, Wenxin (Vincent) Xu, MD, a medical oncologist at Dana-Farber Cancer Institute and an assistant professor of medicine at Harvard Medical School, spoke about his presentation on how kidney injury molecule-1 (KIM-1) may serve as a prognostic biomarker of response to therapy in patients with RCC. His research posed questions on how KIM-1 can inform the use of adjuvant therapy or specific therapeutic combinations like nivolumab (Opdivo) plus ipilimumab (Yervoy) for this patient population. Eric Jonasch, MD, gave an overview of his presentation focused on the Kidney Cancer Research Consortium, a research partnership spanning 7 institutions dedicated to facilitating mechanistic, hypothesis-testing clinical trials in RCC. Jonasch, a professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, described how this collaboration aims to link identifiable biological characteristics of RCC subtypes to specific treatment strategies while developing predictive biomarkers. KidneyCAN is a nonprofit organization with a mission to accelerate cures for kidney cancer through education, advocacy, and research funding. You can learn more about KidneyCAN's work here: https://kidneycan.org/ References 1. Powles T, de Velasco G, Choueiri TK, et al. Quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis of belzutifan versus everolimus in previously treated advanced renal cell carcinoma (RCC): LITESPARK-005 (LS-005). Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA. Abstract 13. 2. Braun DA. Personalized vaccines in kidney cancer: a journey from concept to clinic. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA. 3. Xu W. From bench to bedside: advancing KIM-1 as a tool for clinical decision-making. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA. 4. Jonasch E. Building the infrastructure for discovery: a clinical trial consortium to accelerate kidney cancer research. Presented at the 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA.

In episode eighteen, PeDRA Pub Club host Hannah Chang and guest panelists, Bella Plumptre, MBBS, and Cheryl Bayart, MD, discuss the article How issues of autonomy and consent differ between children and adults: Kids are not just little people, published in Clinical Dermatology in 2017.PeDRA and the greater pediatric dermatology community are deeply saddened by the sudden passing of Dr. Robert Sidbury. To donate in his honor, please visit the SPD Foundation.

Sign up to Easy Ayurveda Video Classes by clicking the link belowhttps://www.easyayurveda.com/video-classes/Video Course: “Ayurvedic food and Nutrition”https://www.easyayurveda.com/nutrition/Buy Tridosha Made Easy Bookhttps://www.easyayurveda.com/tridosha-made-easy-3/Buy Tridosha Made Easy Book in Spanish LanguageEl corazón de los doshas: Nuevo librohttps://www.easyayurveda.com/el-corazon-de-los-doshas/Click to know more about Easy Ayurveda Hospitalhttps://www.easyayurveda.com/hospital/Buy our new course on Marma Therapy Part 1https://www.easyayurveda.com/marma1Buy our new course on Marma Therapy Part 1Subscribe to Easy Ayurveda Video Classes https://www.easyayurveda.com/video-classes/Subscribe to our free Easy Ayurveda newsletter here (you can unsubscribe and stop them anytime) -  https://forms.aweber.com/form/58/2129766958.htm Buy our course on diabetes reversal, powered by Madhavbaug https://www.easyayurveda.com/diabetes Buy our online video course on Treatment of cardiac disorders with Ayurveda https://www.easyayurveda.com/heartMaster ECG in one week. Sign up for video course https://www.easyayurveda.com/ecgContact Dr. MB Gururaja BAMS MD (Ayu)https://www.easyayurveda.com/gururaja  Contact Dr. Raghuram YS BAMS MD (Ayu)https://www.easyayurveda.com/raghuram Buy Easy Ayurveda Ebooks https://www.easyayurveda.com/my-book Buy Easy Ayurveda Printed Books https://www.easyayurveda.com/books/

Please join host Jason T. Jacobson, MD, FHRS at HRS 2025 in San Diego as he discusses this article with Marmar Vaseghi, MD, MS, PhD, FHRS and Maynak Sardana, MBBS, MS. The prospective, multicenter, randomized BRAVE trial evaluated epicardial catheter ablation targeting the arrhythmogenic substrate in Brugada syndrome patients with implantable cardioverter-defibrillators (ICDs) to prevent ventricular fibrillation (VF). After a planned interim analysis of 52 patients, ablation significantly reduced VF episodes compared with controls (hazard ratio 0.29; P = .018), prompting early trial termination—approximately 83% remained VF-free after one procedure and 90% after a repeat, with a low complication rate (one hemopericardium). https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02381-1/fulltext?uuid=uuid%3A6285a37b-899f-4fcb-bab8-f79564e1bd57 Host Disclosure(s): J. Jacobson: Honoraria/Speaking/Consulting: Zoll Medical, Abbott Medical, Vektor Medical Stocks, Privately Held: Atlas 5D Research: CardioFocus, Inc. Contributor Disclosure(s): M. Vaseghi: Honoraria/Speaking/Consulting: Medtronic Inc., Zoll Inc. Stock Options, Privately Held: NeuCures, Anumana M. Sardana: Nothing to disclose.

Uncover the diverse scope of practice available in pediatric radiology. Shannon Farmakis, MD, speaks with host Raisa Amiruddin, MBBS, on the often unseen professional opportunities in pediatric imaging, including insights into the routines and realities of private practice and approaches for navigating a fulfilling career in the specialty. https://www.ajronline.org/doi/10.2214/AJR.25.33521

Sign up to Easy Ayurveda Video Classes by clicking the link belowhttps://www.easyayurveda.com/video-classes/Video Course: “Ayurvedic food and Nutrition”https://www.easyayurveda.com/nutrition/Buy Tridosha Made Easy Bookhttps://www.easyayurveda.com/tridosha-made-easy-3/Buy Tridosha Made Easy Book in Spanish LanguageEl corazón de los doshas: Nuevo librohttps://www.easyayurveda.com/el-corazon-de-los-doshas/Click to know more about Easy Ayurveda Hospitalhttps://www.easyayurveda.com/hospital/Buy our new course on Marma Therapy Part 1https://www.easyayurveda.com/marma1Buy our new course on Marma Therapy Part 1Subscribe to Easy Ayurveda Video Classes https://www.easyayurveda.com/video-classes/Subscribe to our free Easy Ayurveda newsletter here (you can unsubscribe and stop them anytime) -  https://forms.aweber.com/form/58/2129766958.htm Buy our course on diabetes reversal, powered by Madhavbaug https://www.easyayurveda.com/diabetes Buy our online video course on Treatment of cardiac disorders with Ayurveda https://www.easyayurveda.com/heartMaster ECG in one week. Sign up for video course https://www.easyayurveda.com/ecgContact Dr. MB Gururaja BAMS MD (Ayu)https://www.easyayurveda.com/gururaja  Contact Dr. Raghuram YS BAMS MD (Ayu)https://www.easyayurveda.com/raghuram Buy Easy Ayurveda Ebooks https://www.easyayurveda.com/my-book Buy Easy Ayurveda Printed Books https://www.easyayurveda.com/books/

In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/44ySoL3Follow along with the slides: https://bit.ly/3IvwQrjGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/4lKaO2HFollow along with the slides: https://bit.ly/44PPBysGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. 

Liz Lightstone, MBBS (Hons), PhD, FRCP - Preventing Flare and Protecting Function: What Progress Is Being Made in Active Lupus Nephritis?

Please visit answersincme.com/WHF860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in oncology discuss how the latest therapeutic advances in frontline management of urothelial carcinoma can be integrated into practice to optimize patient care. Upon completion of this activity, participants should be better able to: Review guideline recommendations for the first-line treatment of advanced UC; Identify multidisciplinary strategies to optimize first-line treatment of patients with advanced UC; and Outline current and evolving multidisciplinary approaches to enhance outcomes for patients with UC.

Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by the triad of gait apraxia, cognitive impairment, and bladder dysfunction in the radiographic context of ventriculomegaly and normal intracranial pressure. Accurate diagnosis requires consideration of clinical and imaging signs, complemented by tests to exclude common mimics. In this episode, Lyell Jones, MD, FAAN speaks with Abhay R. Moghekar, MBBS, author of the article “Clinical Features and Diagnosis of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Moghekar is an associate professor of neurology at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Clinical Features and Diagnosis of Normal Pressure Hydrocephalus Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Abhay Moghekar, who recently authored an article on the clinical features and diagnosis of normal pressure hydrocephalus for our first-ever issue of Continuum dedicated to disorders of CSF dynamics. Dr Moghekar is an associate professor of neurology and the research director of the Cerebrospinal Fluid Center at Johns Hopkins University in Baltimore, Maryland. Dr Moghekar, welcome, and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Moghekar: Thank you, Dr Jones. I'm Abhay Moghekar. I'm a neurologist at Hopkins, and I specialize in seeing patients with CSF disorders, of which normal pressure hydrocephalus happens to be the most common. Dr Jones: And let's get right to it. I think most of our listeners who are neurologists in practice have encountered normal pressure hydrocephalus, or NPH; and it's a challenging disorder for all the reasons that you outline in your really outstanding article. If you were going to think of one single most important message to our listeners about recognizing patients with NPH, what would that be? Dr Moghekar: I think I would say there are two important messages. One is that the triad is not sufficient to make the diagnosis, and the triad is not necessary to make the diagnosis. You know these three elements of the triad: cognitive problems, gait problems, bladder control problems are so common in the elderly that if you pick 10 people out in the community that have this triad, it's unlikely that even one of them has true NPH. On the other hand, you don't need all three elements of the triad to make the diagnosis because the order of symptoms matters. Often patients develop gait dysfunction first, then cognitive dysfunction, and then urinary incontinence. If you wait for all three elements of the triad to be present, it may be too late to offer them any clear benefit. And hence, you know, it's neither sufficient nor necessary to make the diagnosis. Dr Jones: That's a really great point. I think most of our listeners are familiar with the fact that, you know, we're taught these classic triads or pentads or whatever, and they're rarely all present. In a way, it's maybe a useful prompt, but it could be distracting or misleading, even in a way, in terms of recognizing the patient. So what clues do you use, Dr Moghekar, to really think that a patient may have NPH? Dr Moghekar: So, there are two important aspects about gait dysfunction. Say somebody comes in with all three elements of the triad. You want to know two things. Which came first? If gate impairment precedes cognitive impairment, it's still very likely that NPH is in the differential. And of the two, which are more- relatively more affected? So, if somebody has very severe dementia and they have a little bit of gait problems, NPH is not as likely. So, is gait affected earlier than cognitive dysfunction, and is it affected to a more severe degree than cognitive dysfunction? And those two things clue me in to the possibility of NPH. You still obviously need to get imaging to make sure that they have large ventricles. One of the problems with imaging is large ventricles are present in so many different patients. Normal aging causes large ventricles. Obviously, many neurodegenerative disorders because of cerebral atrophy will cause large ventricles. And there's an often-used metric called as the events index, which is the ratio of the bitemporal horns- of the frontal horns of the lateral ventricles compared to the maximum diameter of the skull at that level. And if that ratio is more than 0.3, it's often used as a de facto measure of ventriculomegaly. What we've increasingly realized is that this ratio changes with age. And there's an excellent study that used the ADNI database that looked at how this ratio changes by age and sex. So, in fact, we now know that an 85-year-old woman who has an events index of 0.37 which would be considered ventriculomegaly is actually normal for age and sex. So, we need to start adopting these more modern age- and sex-appropriate age cutoffs of ventriculomegaly so as not to overcall everybody with big ventricles as having possible NPH. Dr Jones: That's very helpful. And I do want to come back to this challenge that we've seen in our field of overdiagnosis and underdiagnosis. But I think most of us are familiar with the concept of how hydrocephalus could cause neurologic deficits. But what's the latest on the mechanism of NPH? Why do some patients get this and others don't? Dr Moghekar: Very good question. I don't think we know for sure. And it for a long time we thought it was a plumbing issue. Right? And that's why shunts work. People thought it was impaired CSF absorption, but multiple studies have shown that not to be true. It's likely a combination of impaired cerebral blood flow, biomechanical factors like compliance, and even congenital factors that play a role in the pathogenesis of NPH. And yes, while putting in shunts likely drains CSF, putting in a shunt also definitely changes the compliance of the brain and affects blood flow to the subcortical regions of the brain. So, there are likely multiple mechanisms by which shunts benefit, and hence it's very likely that there's no single explanation for the pathogenesis of NPH. Dr Jones: We explored this in a recent Continuum issue on dementia. Many patients who have cognitive impairment have co-pathologies, multiple different causes. I was interested to read in your article about the genetic risk profile for NPH. It's not something I'd ever really considered in a disorder that is predominantly seen in older patients. Tell us a little more about those genetic risks. Dr Moghekar: Yeah, everyone is aware of the role genetics plays in congenital hydrocephalus, but until recently we were not aware that certain genetic factors may also be relevant to adult-onset normal pressure hydrocephalus. We've suspected this for a long time because nearly half of our patients who come to us to see us in clinic with NPH have head circumferences that are more than 90th percentile for height. And you know, that clearly indicates that this started shortly at the time after birth or soon afterwards. So, we've suspected for a long time that genetic factors play a role, but for a long time there were not enough large studies or well-conducted studies. But recently studies out of Japan and the US have shown mutations in genes like CF43 and CWH43 are disproportionately increased in patients with NPH. So, we are discovering increasingly that there are genetic factors that underlie even adult onset in patients. There are many more waiting to be discovered. Dr Jones: Really fascinating. And obviously getting more insight into the risk and mechanisms would be helpful in identifying these patients potentially earlier. And another thing that I learned in your article that I thought was really interesting, and maybe you can tell us more about it, is the association between normal pressure hydrocephalus and the observation of cervical spinal stenosis, many of whom require decompression. What's behind that association, do you think? Dr Moghekar: That's a very interesting study that was actually done at your institution, at Mayo Clinic, that showed this association. You know, as we all get older, you know, the incidence of cervical stenosis due to osteoarthritis goes up, but the incidence of significant, clinically significant cervical stenosis in the NPH population was much higher than what we would have expected. Whether this is merely an association in a vulnerable population or is it actually causal is not known and will need further study. Dr Jones: It's interesting to speculate, does that stenosis affect the flow of CSF and somehow predispose to a- again, maybe a partial degree for some patients? Dr Moghekar: Yeah, which goes back to the possible hydrodynamic theory of normal pressure hydrocephalus; you know, if it's obstructing normal CSF flow, you know, are the hydrodynamics affected in the brain that in turn could lead to the development of hydrocephalus. Dr Jones: One of the things I really enjoyed about your article, Abhay, was the very strong clinical focus, right? We can't just take an isolated biomarker or radiographic feature and rely on that, right? We really do need to have clinical suspicion, clinical judgment. And I think most of our listeners who've been in practice are familiar with the use and the importance of the large-volume lumbar puncture to determine who may have, and by exclusion not have, NPH, and then who might respond to CSF diversion. And I think those of us who have been in this situation are also familiar with the scenario where you think someone may have NPH and you do a large-volume lumbar puncture and they feel better, but you can't objectively see a difference. How do you make that test useful and objective in your practice? What do you do? Dr Moghekar: Yeah, it's a huge challenge in getting this objective assessment done carefully because you have to remember, you know, subconsciously you're telling the patients, I think you have NPH. I'm going to do this spinal tap, and if you walk better afterwards, you're going to get a shunt and you're going to be cured. And you can imagine the huge placebo response that can elicit in our subjects. So, we always like to see, definitely, did the patient subjectively feel better? Because yes, that's an important metric to consider because we want them to feel better. But we also wanted to be grounded in objective truths. And for that, we need to do different tests of speed, balance and endurance. Not everyone has the resources to do this, but I think it's important to test different domains. Just like for cognition, you know, we just don't test memory, right? We test executive function, language, visuospatial function. Similarly, walking is not just walking, right? It's gait speed, it's balance, and it's endurance. So, you need to ideally test at least most of these different domains for gait and you need to have some kind of clear criteria as to how are you going to define improvement. You know, is a 5% improvement, is a 10% improvement in gait, enough? Is 20%? Where is that cutoff? And as a field, we've not done a great job of coming up with standardized criteria for this. And it varies currently, the practice varies quite significantly from center to center at the current time. Dr Jones: So, one of the nice things you had in your article was helpful tips to be objective if you're in a lower-resource setting. For you, this isn't a common scenario that someone encounters in their practice as opposed to a center that maybe does a large volume of these. What are some relatively straightforward objective measures that a neurologist or someone else might use to determine if someone is improving after a large-volume LP? Dr Moghekar: Yeah, excellent question, Dr Jones, and very practically relevant too. So, you need to at least assess two of the domains that are most affected. One is speed and one is balance. You know, these patients fall ultimately, right, if you don't treat them correctly. In terms of speed, there are two very simple tests that anybody can do within a couple of minutes. One is the timed “up-and-go” test. It's a test that's even recommended by the CDC. It correlates very well with faults and disability and it can be done in any clinic. You just need about ten feet of space and a chair and a stopwatch, and it takes about a minute or slightly more to do that test. And there are objective age-associated norms for the timed up-and-go test, so it's easy to know if your patient is normal or not. The same thing goes for the 10-meter walk test. You do need a slightly longer walkway, but it's a fairly easy and well-standardized test. So, you can do one of those two; you don't need to do both of them. And for balance, you can do the 30-second “sit-to-stand”; and it's literally, again, 30 seconds. You need a chair, and you need somebody to watch the patient and see how many times they can sit up and stand up from a seated position. Then again, good normative data for that. If you want to be a little more sophisticated, you can do the 4-stage balance test. So, I think these are tests that don't add too much time to your daily assessment and can be done with even trained medical assistants in any clinic. And you don't need a trained physical therapist to do these assessments. Dr Jones: Very practical. And again, something that is pretty easily deployed, something we do before and then after the LP. I did see you mentioned in your article the dual timed up-and-go test where it's a simultaneous gait and executive function test. And I've got to be honest with you, Dr Moghekar, I was a little worried if I would pass that test, but that may be beyond the scope of our time today. Actually, how do you do that? How do you do the simultaneous cognitive assessment? Dr Moghekar: So, we asked them to count back from 100, subtracting 3. And we do it particularly in patients who are mildly impaired right? So, if they're already walking really good, but then you give them a cognitive stressor, you know, that will slow them down. So, we reserve it for patients who are high-performing. Dr Jones: That's fantastic. I'm probably aging myself a little here. I have noticed in my career, a little bit of a pendulum swing in terms of the recognition or acceptance of the prevalence of normal pressure hydrocephalus. I recall when I was a resident, many, many people that we saw in clinic had normal pressure hydrocephalus. Then it seemed for a while that it really faded into the background and was much less discussed and much less recognized and diagnosed, and less treated. And now that pendulum seems to have swung back the other way. What's behind that from your perspective? Dr Moghekar: It's an interesting backstory to all of this. When the first article about NPH was published in the Newman Journal of Medicine, it was actually a combined article with both neurologists and neurosurgeons on it. They did describe it as a treatable dementia. And what that did is it opened up the floodgates so that everybody with any kind of dementia started getting shunts left, right, and center. And back then, shunts were not programmable. There were no antibiotic impregnated catheters. So, the incidence of subdural hematomas and shunt-related infections was very high. In fact, one of our esteemed neurologists back then, Houston Merritt, wrote a scathing editorial that Victor and Adam should lose their professorships for writing such an article because the outcomes of these patients were so bad. So, for a very long period of time, neurologists stopped seeing these patients and stopped believing in NPH as a separate entity. And it became the domain of neurosurgeons for over two or three decades, until more recently when randomized trials started being done early on out of Europe. And now there's a big NIH study going on in the US, and these studies showed, in fact, that NPH exists as a true, distinct entity. And finally, neurologists have started getting more interested in the science and understanding the pathophysiology and taking care of these patients compared to the past. Dr Jones: That's really helpful context. And I guess that maybe isn't rare when you have a disorder that doesn't have a simple, straightforward biomarker and is complex in terms of the tests you need to do to support the diagnosis, and the treatment itself is somewhat invasive. So, when you talk to your patients, Dr Moghekar, and you've established the diagnosis and have recommended them for CSF diversion, what do you tell them? And the reason I ask is that you mentioned before we started recording, you had a patient who had a shunt placed and responded well, but continued to respond over time. Tell us a little bit more about what our patients can expect if they do have CSF diversion? Dr Moghekar: When we do the spinal tap and they meet our criteria for improvement and they go on to have a shunt, we tell them that we expect gait improvement definitely, but cognitive improvement may not happen in everyone depending on what time, you know, they showed up for their assessment and intervention. But we definitely expect gait improvement. And we tell them that the minimum gait improvement we can expect is the same degree of improvement they had after their large-volume lumbar puncture, but it can be even more. And as the brain remodels, as the hydrodynamics adapt to these shunts… so, we have patients who continue to improve one year, two years, and even three years into the course of the intervention. So, we're, you know, hopeful. At the same time, we want to be realistic. This is the same population that's at risk for developing neurodegenerative disorders related to aging. So not a small fraction of our patients will also have Alzheimer's disease, for example, or go on to develop Lewy body dementia. And it's the role of the neurologist to pick up on these comorbid conditions. And that's why it's important for us to keep following these patients and not leave them just to the neurosurgeon to follow up. Dr Jones: And what a great note to end on, Dr Moghekar. And again, I want to thank you for joining us, and thank you for such a wonderful discussion and such a fantastic article on the clinical diagnosis of normal pressure hydrocephalus. I learned a lot reading the article, and I learned a lot more today just in the conversation with you. So, thank you for being with us. Dr Moghekar: Happy to do that, Dr Jones. It was a pleasure. Dr Jones: Again, we've been speaking with Dr Abhay Moghekar, author of a wonderful article on the clinical features and diagnosis of NPH in Continuum's first-ever issue dedicated to disorders of CSF dynamics. Please check it out. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

We're joined by Dr Atif Magbool at Sidra Medicine who talks to us about the immense challenges and efforts in providing mental healthcare to children and women in crisis-affected areas. Dr Magbool shares his journey into pediatric psychiatry – primarily influenced by early experiences in Sudan – and discusses the significant differences between child and adult psychiatry. The conversation explores the Gaza Patient Program initiated by Sidra Medicine, which offers comprehensive medical, surgical, and psychological care to children affected by the ongoing genocide in Gaza. Dr Magbool also touches upon the remarkable resilience observed in children survivors, the continuous trauma faced by Palestinian children, and the critical need for mental health support during and after war. The dialogue sheds light on the importance of providing a safe and supportive environment for affected children and the broader impact of war on the mental health sector in crisis zones.This episode is in collaboration with Qatar Foundation. 00:00 Introduction01:29 Dr Magbool's Journey into Psychiatry04:32 Understanding Pediatric Psychiatry06:47 The Gaza Patient Program18:42 Challenges in Palestinian Healthcare20:49 Personal Reflections and Emotional Impact30:39 Support for Women in Crisis35:36 Call to Action Dr Atif Magbool is the Lead Consultant for the Inpatient Pediatrics Beds Under Psychiatric Coverage (PBUPC) team and a member of the CAMHS outpatient services at Sidra Medicine. He earned his MBBS from Omdurman University in Sudan and completed his psychiatric training in Ireland, obtaining his MRCPsych in 2012. He later specialized in Child and Adolescent Psychiatry in Scotland, receiving his CCT before working as a consultant there. He also holds diplomas in Clinical Psychiatry and Health Services Management and has extensive experience in managing a wide range of psychiatric and behavioral disorders in children and adolescents across inpatient, outpatient, and day hospital settings. He is also active in medical education and is fluent in Arabic and English, with proficiency in Serbo-Croatian. Hosted by: Mikey Muhanna

The vital role of the humanities in shaping empathetic communication skills and critical-minded healthcare professionals is explored today with our guest, P. Ravi Shankar, MBBS, MD. Dr. Shankar, MBBS, MD, currently serves as faculty and program coordinator at the IMU Centre for Education in Kuala Lumpur, Malaysia. He is a Foundation for Advancement of International Medical Education and Research (FAIMER) Institutes Scholar and a prolific researcher. Read more: http://facultyfactory.org/ravi-shankar 

Send us a textIn this episode, Dr. Sciarretta speaks with Dr. Muhammad Mohiuddin, a surgeon who specializes in cardiac xenotransplantation (replacing failing human hearts with pig hearts). Listen to hear more about Dr. Mohiuddin's journey, the ethical and structural issues his work presents, and the moments in which his decades of revolutionary work have come to fruition. Support the showIf you enjoyed this episode please give us a five-star rating and consider donating. Your generosity helps our shoe-string budget and allows us to continue producing high-quality content. Click here to donate.