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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Treatment Options in Oncology This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Treatment Options in Oncology This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Pneumonectomy 70192c01 chest lung heart ribs fx acquired levocardia s/p left pneumonectomy elevated diaphragm CTscan Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Pneumonectomy 70192c01 chest lung heart ribs fx acquired levocardia s/p left pneumonectomy elevated diaphragm CTscan Davidoff MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Colloid Cyst of Third Ventricle – Indication for Surgery of Benign Tumor 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Colloid Cyst of Third Ventricle – Indication for Surgery of Benign Tumor 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => table [nodeValue] => Imaging Treatment The Common Vein copyright 2007 Pharmaceuticals Chemotherapy – Before and 6 weeks After – Metastatic Small Cell Lung Carcinoma 70248c01 liver metastattic small lung carcinoma with diffuse metatstattic disease to the liver )hepatic metastases metastasis before and after treatment 6weeks post chemotherapy successful result size change character change CTscan Davidoff MD 5star Resolving Splenomegaly Post Treatment for Lymphoma 47632c01 spleen adrenal a pretreatment b 6 weeks post treatment size decreasing size of splenomegaly dx lymphoma stable adrenal mass CTscan Davidoff MD Before and After Antibiotic Therapy 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution Surgery Glioblastoma of the Corpus Callosum S/P Debulking 72420c01 46 male brain cerebrum genu of the corpus callosum crosses midline enhancing tumor in periphery surrounding edema dilated right hor mass effect on the lateral ventricles tumor arises from the corpus callosum post operative resection of the left side of the tumor methemoglobin effects in the left side a = T1 post gadolinium b= T1 weighted post contrast c= T2 weighted d = GRE blood products T2* effects dx glioblastoma s/p debulking Davidoff MD Reconstruction of the Skull with Methacrylate 72744c01 bone brain skull temporal bone parietal bone methacrylate surgery methacrylate craniotomy protection surgery treatment CTscan Davidoff MD Courtesy Ashley Davidoff MD AAA 7.4cms – Indications for Surgical Intervention 2055BH~1.c01 abdomen aorta abdominal aorta AAA aneurysm thrombus 7.5cms surgical size Courtesy Philips Medical Systems Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Aortic Stent Graft wih Leak 72717 abdomen abdominal aorta AAA s/p stent graft with aortic stent leak leak type 1 CTscan Courtesy Ashley Davidoff MD Hearing Aid Left Ear 72459c01 skull bone ear listening hearing device hearing aid auditory mastoid air cells temporal bone maxillary sinus Davidof MD CTscan Colloid Cyst of Third Ventricle – Indication for Surgery of Benign Tumor 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD Pneumonectomy 70192c01 chest lung heart ribs fx acquired levocardia s/p left pneumonectomy elevated diaphragm CTscan Davidoff MD Mastectomy 49707c01 49707 breast mastectomy surgery treatment carcinoma 3D volume rendering Davidoff MD 49707c01 49707 49706 Mass No Surgery Bilateral Meningiomas _ too small for clinical concern – No Surgery 72038c01 brain meninges frontal lobe bilateral small fx calcified mass with soft tissue cap size character position benign space CTscan Davidoff Radiation Therapy Treatment Options in Oncology This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment XRT Courtesy Ashley Davidoff MD. 31432_02e Surgical Replacement Healing 49464 bone femur fx healed fracture compensation total knee replacement plain X-Ray Davidoff MD 49465 Prosthetic Porcine Valve 06712b01.400 prosthesis prosthetic valve porcine valve heart aorta mitral valve therapy Popcorn Calcification 73656.800 pelvis lymph nodes popcorn calcification right total hip replacement X-ray plain film of the pelvis Courtesy Ashley Davidoff MD Minimally Invasive Therapy Potential for Disaster Treated 49586c01 bone thoracic spine compression fracture trauma cement reenforcement wek link units to unity units to dysunity joints treatment CTscan Davidoff MD Yin Yang Sign of Flow Reversal 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign aka ying yang turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue Davidoff MD Pseudoaneurysm (Yin Yang) Before and After Treatment with Thrombin 60447c01 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue treated with thrombin injection Davidoff MD Coil Embolisation 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency coil embolisation MIT Feeding Gastrostomy 49762 49761 stomach gastrostomy pigtail catheter T tacks antrum N-G tube nasogastric tube food feeding aspiration fluoroscopy X-ray Tracheostomy 72333 airway tracheostomy tubes treatment airways trachea ventilation Davidoff MD Surgical repair of 12cms AAA 72460c01 aorta AAA abdomen abdominal aortic aneurysm 12 cms aneurysm surgical exposure retractors surgical exposure 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Davidoff MD 5star Resolving Splenomegaly Post Treatment for Lymphoma 47632c01 spleen adrenal a pretreatment b 6 weeks post treatment size decreasing size of splenomegaly dx lymphoma stable adrenal mass CTscan Davidoff MD Before and After Antibiotic Therapy 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution Surgery Glioblastoma of the Corpus Callosum S/P Debulking 72420c01 46 male brain cerebrum genu of the corpus callosum crosses midline enhancing tumor in periphery surrounding edema dilated right hor mass effect on the lateral ventricles tumor arises from the corpus callosum post operative resection of the left side of the tumor methemoglobin effects in the left side a = T1 post gadolinium b= T1 weighted post contrast c= T2 weighted d = GRE blood products T2* effects dx glioblastoma s/p debulking Davidoff MD Reconstruction of the Skull with Methacrylate 72744c01 bone brain skull temporal bone parietal bone methacrylate surgery methacrylate craniotomy protection surgery treatment CTscan Davidoff MD Courtesy Ashley Davidoff MD AAA 7.4cms – Indications for Surgical Intervention 2055BH~1.c01 abdomen aorta abdominal aorta AAA aneurysm thrombus 7.5cms surgical size Courtesy Philips Medical Systems Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Aortic Stent Graft wih Leak 72717 abdomen abdominal aorta AAA s/p stent graft with aortic stent leak leak type 1 CTscan Courtesy Ashley Davidoff MD Hearing Aid Left Ear 72459c01 skull bone ear listening hearing device hearing aid auditory mastoid air cells temporal bone maxillary sinus Davidof MD CTscan Colloid Cyst of Third Ventricle – Indication for Surgery of Benign Tumor 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD Pneumonectomy 70192c01 chest lung heart ribs fx acquired levocardia s/p left pneumonectomy elevated diaphragm CTscan Davidoff MD Mastectomy 49707c01 49707 breast mastectomy surgery treatment carcinoma 3D volume rendering Davidoff MD 49707c01 49707 49706 Mass No Surgery Bilateral Meningiomas _ too small for clinical concern – No Surgery 72038c01 brain meninges frontal lobe bilateral small fx calcified mass with soft tissue cap size character position benign space CTscan Davidoff Radiation Therapy Treatment Options in Oncology This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment XRT Courtesy Ashley Davidoff MD. 31432_02e Surgical Replacement Healing 49464 bone femur fx healed fracture compensation total knee replacement plain X-Ray Davidoff MD 49465 Prosthetic Porcine Valve 06712b01.400 prosthesis prosthetic valve porcine valve heart aorta mitral valve therapy Popcorn Calcification 73656.800 pelvis lymph nodes popcorn calcification right total hip replacement X-ray plain film of the pelvis Courtesy Ashley Davidoff MD Minimally Invasive Therapy Potential for Disaster Treated 49586c01 bone thoracic spine compression fracture trauma cement reenforcement wek link units to unity units to dysunity joints treatment CTscan Davidoff MD Yin Yang Sign of Flow Reversal 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign aka ying yang turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue Davidoff MD Pseudoaneurysm (Yin Yang) Before and After Treatment with Thrombin 60447c01 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue treated with thrombin injection Davidoff MD Coil Embolisation 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency coil embolisation MIT Feeding Gastrostomy 49762 49761 stomach gastrostomy pigtail catheter T tacks antrum N-G tube nasogastric tube food feeding aspiration fluoroscopy X-ray Tracheostomy 72333 airway tracheostomy tubes treatment airways trachea ventilation Davidoff MD Surgical repair of 12cms AAA 72460c01 aorta AAA abdomen abdominal aortic aneurysm 12 cms aneurysm surgical exposure retractors surgical exposure control upper inflow with cross clamp control of outflow opening the aoric wall exposing the lumen filled with thrombus operating room treatment delivery of 12cmss thrombus and leaving eptyaortic sac Courtesy Syed Razvi MD )
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Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment XRT Courtesy Ashley Davidoff MD. 31432_02e Surgical Replacement Healing 49464 bone femur fx healed fracture compensation total knee replacement plain X-Ray Davidoff MD 49465 Prosthetic Porcine Valve 06712b01.400 prosthesis prosthetic valve porcine valve heart aorta mitral valve therapy Popcorn Calcification 73656.800 pelvis lymph nodes popcorn calcification right total hip replacement X-ray plain film of the pelvis Courtesy Ashley Davidoff MD Minimally Invasive Therapy Potential for Disaster Treated 49586c01 bone thoracic spine compression fracture trauma cement reenforcement wek link units to unity units to dysunity joints treatment CTscan Davidoff MD Yin Yang Sign of Flow Reversal 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign aka ying yang turbulent flow dx pseudoameurysm 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mastoid air cells temporal bone maxillary sinus Davidof MD CTscan Colloid Cyst of Third Ventricle – Indication for Surgery of Benign Tumor 70045.800 brain third ventricle foramen of Munro third ventricle headaches, vertigo, memory deficits, diplopia, and behavioral disturbances. smooth, round hyperdense endodermal origin, typically located at the foramen of Munro in the anterior aspect of the third ventricle. T benign filled with gelatinous material and cholesterol crystals cause hyperdensity potential complication can cause hydrocephalus by obstructing third ventricle usual Rx is surgery CTscan Davidoff MD Pneumonectomy 70192c01 chest lung heart ribs fx acquired levocardia s/p left pneumonectomy elevated diaphragm CTscan Davidoff MD Mastectomy 49707c01 49707 breast mastectomy surgery treatment carcinoma 3D volume rendering Davidoff MD 49707c01 49707 49706 Mass No Surgery Bilateral Meningiomas _ too small for clinical concern – No Surgery 72038c01 brain meninges frontal lobe bilateral small fx calcified mass with soft tissue cap size character position benign space CTscan Davidoff Radiation Therapy Treatment Options in Oncology This is a collage of the usual treatments available for lung cancer. Top left depicts the XRT option while the Caravaggio of the sacrifice of Isaac is the surgical option and bottom left the chemotherapeutic option. Courtesy Ashley Davidoff MD. 31432c code lung pulmonary mass neoplasm malignant primary malignancy carcinoma imaging radiology CTscan treatment XRT Courtesy Ashley Davidoff MD. 31432_02e Surgical Replacement Healing 49464 bone femur fx healed fracture compensation total knee replacement plain X-Ray Davidoff MD 49465 Prosthetic Porcine Valve 06712b01.400 prosthesis prosthetic valve porcine valve heart aorta mitral valve therapy Popcorn Calcification 73656.800 pelvis lymph nodes popcorn calcification right total hip replacement X-ray plain film of the pelvis Courtesy Ashley Davidoff MD Minimally Invasive Therapy Potential for Disaster Treated 49586c01 bone thoracic spine compression fracture trauma cement reenforcement wek link units to unity units to dysunity joints treatment CTscan Davidoff MD Yin Yang Sign of Flow Reversal 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign aka ying yang turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue Davidoff MD Pseudoaneurysm (Yin Yang) Before and After Treatment with Thrombin 60447c01 60438.800 s/p catheterization with painful pu;satile hematoma with new bruit artery femoral artery fx yin yang sign turbulent flow dx pseudoameurysm false aneurysm USscan color flow doppler red blue treated with thrombin injection Davidoff MD Coil Embolisation 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency coil embolisation MIT Feeding Gastrostomy 49762 49761 stomach gastrostomy pigtail catheter T tacks antrum N-G tube nasogastric tube food feeding aspiration fluoroscopy X-ray Tracheostomy 72333 airway tracheostomy tubes treatment airways trachea ventilation Davidoff MD Surgical repair of 12cms AAA 72460c01 aorta AAA abdomen abdominal aortic aneurysm 12 cms aneurysm surgical exposure retractors surgical exposure control upper inflow with cross clamp control of outflow opening the aoric wall exposing the lumen filled with thrombus operating room treatment delivery of 12cmss thrombus and leaving eptyaortic sac Courtesy Syed Razvi MD )