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Our faith is a highly personal one; this is part of And There's More! Practical Techniques for Better Readings. Learn the Language of Tarot. Encyclopedia Home. Encyclopedia Articles. Bat's Wool. Neo-atherosclerosis tends to occur more after injury. The incomplete endothelial re- continues to be a predictor of ISR after PCI generation leads to excessive uptake of circu- whereas others do not.
Of note, however the lating lipids and atherosclerotic development is negative studies were for the earlier generation accelerated with Intimal thickening, intracellular of DES and may reflect the early learning curve lipid deposition with thin cap fibroatheroma and with DES implantation which requires different necrotic tissue. The chronic inflammation is re- techniques as compared to the BMS stents. Some authors have also postulated Bio-degradable polymers in use in the current that fibrotic response is predominantly respon- generation stents may therefore facilitate faster sible for the re-stenotic response in diabetic healing and less chances of DES ISR patients.
Models and Risk Analysis
Paclitaxel has a cytotoxic effect and patients. This is not surprising considering that binds and interferes with micro-tubular function. Ge- and diffuse disease. Previous studies have also netic mutations however can confer resistance indicated that there is a higher risk of target to these drugs and influence the occurrence of vessel revascularisation with higher SYNTAX restenosis. Hypersensitivity to the material of the score. Similarly the same authors noted previ- stent such as nickel can also contribute to ISR.
Rest- mation. Persistence of inflammatory stimuli and enosis in bare metal and drug-eluting stents. Coronary ble plaque was considered to play an important stenosis, imaging, structure and physiology. Therefore Edition. Toulouse, France: Europa Edition; Understanding and managing in-stent rest- Treatment of ISR: In BMS-ISR in the early days enosis: a review of clinical data, from patho- the only option was plain old balloon angioplas- genesis to treatment. Journal of Thoracic Dis- ty with high recurrence rates and this was fol- ease.
Circulation Cardiovascular interventions. Other advan- teries. Ross R Nature. Hetero-stenting ie use of 29; Aronson D. Med Hypotheses. Active products is associated with in-stent restenosis matrix metallo-proteinases 3 and 9 are inde- in patients with type 2 diabetes with drug-eluting pendently associated with coronary artery in- coronary stents.
Park et al, Coronary Artery Dis- stent restenosis. Creager MA Impaired endothe- creased restenosis rate after implantation of lium dependent vasodilation in patients with in- drug-eluting stents in patients with elevated se- sulin- dependent diabetes mellitus. Circulation rum activity of matrix metalloproteinase -2 and ; J Am Coll Cardiol Intv ; 3: 90— Circulation ; Systematic testing of literature reported genet- Suppl V:V PLoS One ; diate endothelial cell dysfunction caused by ele- 7: e vated glucose.
Am J Physiol. MacRury 15 Takahasi K. Diabetologia ; Platelet abnormalities in diabe- nary implantation of sirolimus- or paclitaxel-elut- tes mellitus, Diabetes ;4l SuppI In-stent neoatherosclerosis: a final com- mon pathway of late stent failure. J Am Coll Car- diol. Chitra S. Good presentations can make your talk community or a big conference audience.
We memorable and outstanding from the rest. This like, appreciate and remember few such events article aims to teach simple means of creating an but on the back of our minds, we cannot forget effective presentation. It is To use good accessories and be punctual for estimated that more than 30 million PowerPoint your talk is of utmost importance. It also tells one presentations PPTs are given every day. But how to stay calm; breathe properly; emphasize as PowerPoint conquered the world, critics have a good point and use pauses in your speech piled on, maybe justifiably so.
In , the US for dramatic effect. Having a good assistant for Defence Secretary banned PPTs during a sum- helping you in your presentation is a great asset. The article dwells on TRAPS in your talk such Certain readymade tools are available online as a bored audience; difficult queries and how to by professional organizations like the American tackle them; how to handle random interruptions College of Physicians, for research presenta- and lack of attention from the audience.
Many authors teemed members in the audience is also taught have expressed their own experiences regarding in the article. The advantage of having a backup transmitting information to the audience. Most of them appear to be common sense and are generally well known; therefore, why are Finally, using the KISS principle of keeping flaws so common, even in senior presenters? Planning slides as a memory aid. However, if presenters want their talk to be in- - Common complaints about ineffectual and spiring and practice-changing, they should ad- dull presentations revolve around the appar- here to the agreed advice found in this review.
Let us plan to deliver an effective presentation by A simple but effective framework for any pre- understanding Tips, Tricks and Traps. Audience Analysis tation. Most candidates are overambitious about what can be squeezed into just five to ten min- - Medicine is specialized; every scientific audi- utes.
Be realistic about what you can achieve ence has diversity. Think about the range of in- in the time limit and plan accordingly. As a rule tellectual backgrounds from which the audience of thumb, less is almost always more. Also, might hail; will there be scientists from your fo- remember to factor for questions at the end. Can you transmit the core mes- Tip4. Can Tip2. Core Message you articulate it in a sentence or two?
Do the - What atendees will remember after 24hrs ypu talk?
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Does the slide - PPTS can inspire attendees to read your journal ar- content support those key ideas? Have you in- ticle, provide useful feedback, ask important ques- tions or think about collaborations but by themselves, cluded material superfluous to that message? Re- membermuchadaylater;perhapsjustthecoremes- sage and one or two of your most compelling slides.
Are your most im- avoid distracting indiscriminate pictures, portant slides drawn distinctly? A human brain finds diffi- cult to retain 50th word from the screen in front. It may be worthwhile to produce a brief summarising handout of the main points. Aim to distribute this before you begin, for a clear and confident start. Cardio Diabetes Medicine Tip5. Phrasing lights, and turn on the projector especially if the meeting staff does not provide these services.
Most feel ner- your attention eg. Use your structure to help you, eg. Projection Tip9. During the presentation - Presentation skills include aspects of non-ver- - Breathe: If you are particularly nervous before bal communication, such as gestures and facial you start, take a few moments to slow down your expression. Stretching also helps in same way. It also gives - Pause: Using brief pauses to illustrate the time if you want to clear up some administrative structure of your session can also help you to details eg.
Prefer to use mouse as a pointer if out forced or unnatural gestures. Avoiding fid- there are multiple screens. Try out the audiovi- geting and convey your confidence through your sual equipment, pointer and the microphone es- body language. Set up your visuals feel more relaxed and engage the audience. Delivery Skills length and lighting; and troubleshoot according- ly. Designate an assistant - Know your material, do not read it. Cardio Diabetes Medicine - Change your voice pitch and inflection to em- effective and non-aggressive way of acknowl- phasize important points.
Answer concisely and to the point, so that oth- ers can ask too. Many people find the thought restate the question for the audience. Have the question restated if there was a trou- the question and answer session, far more terri- ble in understanding. Treat the presentation as a pro- fessional exercise and move on. This is an Cardio Diabetes Medicine. Cardio Diabetes Medicine Trap5: Too much animation 4. During discussion you need to blank the slide - Dizzy animations really put off the audience. Wearing a lapel mike and walking through Trap6: Complex data the audience also adds to your friendliness and - It is dying for the audience if you need to ex- command on presentation.
Recognizing the organizer or a prominent - Use the text in the animations and you can use personality in audience or the chairman by first the star Tarot to explain the process. If a quiz is answered, a chocolate or a pen or USB drive gift keeps the audience entertained Trap7: Silly phrases 8. Have a backup plan Trap8: Unreadable font style - Anticipate the events that could have a nega- - Using serif fonts which maybe better in print but tive impact on your presentation. Devise a back- different on screen. Have a handout ready. Have a penlight ments, stressing how wonderful you are and in your pocket.
Consider leaving the podium time. Trustworthiness and assume that everyone knows what you are - If the problem is easily correctable, explain to talking about is not appreciated by any audience. When the problem is rectified, continue - Below are the hallmarks of self-goals and the where you left off. Talk about something completely off point.
Just show up and wing it and dignified you will have them on your side. Feature your business logo prominently on ev- Conclusion ery slide 5. Go over time Use the K. Avoid 7. If you promise to do something after you speak, jazzy colours, pictures and transitions. The essence is Purposefully, Plan, Phrase, Pre- 1. We learn from everyone: Perfection.
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Take home messages 2. Use the rehearse time button to see the stop clock on the screen. Cardio Diabetes Medicine ticle and ppt and 8. Know more sentation-tips. How to prepare and deliver an effective oral presentation. Accept- ed standards on how to give a Medical Research Presentation: a systematic review of expert opin- ion papers. GMS journal for medical education. The widespread use of electronic medical re- cords and the Internet have altered the way doc- This has founded the basis of AI Artificial Intel- tors practice medicine and exchange informa- ligence and Internet of Medical Things IOT or tion.
Leveraging the information contained copious amounts of scientific knowledge into therein and combining it with other sources via everyday practice, it is important to remember big data has the potential to transform medi- that the ultimate goal of medicine is to prevent cal practice by using information generated ev- disease and treat sick patients. The most import- ery day to improve the quality and efficiency of ant action in clinical medicine is judgement di- care.
This is a descriptive analytical review of agnostic and therapeutic , from which all other long techno journey made compact, helpful for a aspects of medical care flow. Despite the great technolog- cords and the Internet have altered the way doc- ical advances in medicine over the last century tors practice medicine and exchange informa- including the information technology revolution tion.
Compounding that the ultimate goal of medicine is to prevent this challenge is the massive information over- disease and treat sick patients. The most import- load that characterizes modern medicine. The computer can help the care of patients. Despite the great technolog- by making accurate predictions of outcome, sim- ical advances in medicine over the last century Cardio Diabetes Medicine.
Cardio Diabetes Medicine including the information technology revolution stored repertoire of diagnostic patterns, must use in medicine of digitization of the medical record, a more laborious analytic approach along with uncertainty remains a key challenge in all as- much more intensive data collection to reach the pects of medical decision-making.
Compounding diagnosis. The primary mistake that can result this challenge is the massive information over- from relying on the free use of pattern recogni- load that characterizes modern medicine.
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In the last 5 decades, many attempts have been Cognitive shortcuts or rules of thumb, sometimes made to develop computer systems to aid clin- referred to as heuristics, are another type of in- ical decision-making and patient management. The computer can help with great efficiency.
Examples of heuristics are: by making accurate predictions of outcome, sim- representativeness, availability, anchoring and ulating the whole decision process, or providing simplicity. EBM updates this construct by placing much This has founded the basis of Artificial Intelli- greater emphasis on the processes by which gence and Information of Things in Medicine. Le- clinicians gain knowledge of the most upto-date veraging the information contained therein and and relevant clinical research to determine for combining it with other sources via big data has themselves whether medical interventions al- the potential to transform medical practice by us- ter the disease course and improve the length ing information generated every day to improve or quality of life.
The meaning of practicing EBM the quality and efficiency of care. Searching the literature and online databases for applicable research data term used to describe the integration of the best 3. Appraising the evidence gathered with regard available research evidence with clinical judg- to its validity and relevance ment and experience as applied to the care of 4.
Integrating this appraisal with knowledge individual patients. Analysis System 2 , is slow, methodical, and effortful. These are, of In a world of computers, data have to be stored course, idealized extremes of the cognitive con- somewhere. In the stone age of computers, tinuum. Nowadays, computers have enormous memory capacity measured in gigabytes or tera- nitive process that appears largely intuitive. An bytes, and files can be transferred to portable experienced clinician often can recognize the devices such as memory sticks, which now also pattern of a diagnosis she or he is very famil- have memories of many gigabytes.
CC is gener- iar with after a very short amount of time with ally understood as a new approach for delivering the patient. The student, who does not have that computing resources. Cardio Diabetes Medicine The cloud was initially driven by IT business data must be processed. In recent years, the and even exabytes of data captured over time.
Communication Technology in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research. It is often characterized by 3Vs: the extreme volume of data, the wide vices. Cardio Diabetes Medicine IOT Physicians and nurses can easily access this re- cord on a tablet or desktop computer.
It sounds The IOT technology refers to connect all objects pretty basic, but the adoption of Electronic Health by using the information sensing devices to the Records EHRs is a game changer. Engineering Internet for information exchange, which is ex- simulation solutions are making medicine partic- changing of physical objects, in order to achieve ipatory, personalized, predictive and preventive intelligent identification and management.
Device connectivity will be key areas for manu- Currently, most hospital information systems still facturers in the coming years. Continua Health Alliance, a global industry alliance that creates cannot achieve it. Figure 1 illustrates how this revolution in medi- These wearable devices and mobile apps now cine will look in a typical IoT hospital, in practice. Figure 2: Adapted from Dimitrov DV.
Medical internet of things and big data in healthcare. Healthcare informatics research. Cardio Diabetes Medicine One of the most important elements essential in affords exploration of a broad range of hypoth- data collection is the sensor. During recent years eses and their associated evidence, as well as with improvement in semiconductor technology, uncovers missing information that can be used sensors have made investigation of a full range in mixed-initiative dialog.
Gyroscopes and magnetometers are auxiliary sensors that For each evidence— hypothesis pair, DeepQA can be separately be combined with accelerom- applies hundreds of algorithms that dissect and eters to compensate the lack of accuracy in ob- analyze the evidence along different dimen- tained data for motion tracking. Due to the high sions of evidence such as type classification, risk of falling in the elderly, motion trackers as time, geography, popularity, passage support, wearable devices are used in medical health source reliability, and semantic relatedness.
Many wearable de- This analysis produces hundreds of features. The use of abduction for medical diag- The majority of these devices are in one lead nosis has a long history in the field of artificial in- such as electrocardiogram ECG and electro- telligence. People proposed applying abduction encephalogram EEG measurement, skin tem- to medical diagnosis and provided algorithms perature, etc. There have been recent efforts for computing explanations of data like symp- in wearable devices to provide multi-task vital toms in the context of a collection of axioms signs measurement.
To complete the procedure medical knowledge of data collection, transmission, and analysis, This led to development of decision sup- cloud computing is essential. In fact, according port tool that will help the physician over- to some pre-defined algorithms, data are sent come the cognitive challenges by providing to a medical center, appropriate decisions are 1 the automatic extraction and presen- taken by medical doctors, physicians, or other tation of relevant information from EMR healthcare professionals.
DeepQA defines a power- In , IBM Research took on the grand chal- ful new architecture for structuring and reason- lenge of building a computer system that can per- ing over unstructured natural language content form well enough on open-domain question an- and provides a foundation for developing deci- swering to compete with champions at the game sion support systems that can address many of of Jeopardy!
In , the open-domain question the cognitive challenges clinicians face, as well answering system dubbed Watson beat the two as address some of the weaknesses of prior highest ranked players in a two-game Jeopardy! We discuss our vision for applying Match. IBM has elaborated upon a vision for an it to extract, structure, and reason over natural language content found in medical textbooks, encyclopedias, guidelines, electronic medical records, and many other sources.
We suggest that Cardio Diabetes Medicine. Cardio Diabetes Medicine evidence-based clinical decision support sys- current neural networks RNN , convolutional, tem, based on the DeepQA technology, that this and deep neural networks. Google developed technology provides the basis for a novel clinical a deep neural network known as Google Deep- decision support tool affording valuable assis- Mind AlphaGo that defeated human champions tance in differential diagnosis, exploration of ev- in the Go game in March DL can perform idence that can justify or refute diagnoses, and tasks without human assistance in industry e.
Latest version of Watson includes med- ical literature, patents, genomics, and chemi- Implementation of DL in CV medicine cal and pharmacological data that researchers includes the following: would typically use in their work. Watson has also been developed with specific comprehension of 1 may facilitate exploration of novel factors in scientific terminology so it can make novel con- score systems or add to existing models nections in millions of pages of text.
Watson has 2 can be used to classify novel genotypes and been applied o a few pilot studies in the areas of phenotypes from heterogeneous CVDs drug target identification and drug repurposing. Current pilot projects are beginning to 4 may also help to identify additional stroke yield insight into whether Watson has the poten- risk factors and into new models tial to improve both the accuracy and speed of 5 left ventricular ejection fraction may be pre- adverse-event detection and coding. The challenges of personalized medicine via data Deep Learning DL and analytics have raised many concerns wheth- er it is going to replace medicine .
Privacy Deep learning mimics the operation of the hu- and security concerns in a potential unregulated man brain using multiple layers of artificial neu- sector ought to be raised and clear guidelines ronal networks that can generate automated need to be formulated by the authorities. These predictions from input training datasets. DL has fears have not been unfounded in the near past. Deep learning can Despite the obvious risks with any new technol- be very powerful in image recognition e. It can also be trained in an tologists on biopsy-proven clinical images .
Further- lacks of vital organ functions and look for specif- more, there is no limitation on working memory. Apollo Hospitals has part- References nered with IBM to deploy its cognitive comput- ing platform Watson for oncology and genomics 1. Decision-Making in Clin- in 10 of its cancer care centres . The Indian ical Medicine. The inevitable appli- eses, perform big data analytics, and optimize cation of big data to health care. However, ignorance 4. Hao A, Wang L.
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Medical device integration of the challenges mainly privacy and security model based on the internet of things. The open may overshadow their impact. Machine learn- biomedical engineering journal. Healthcare White Paper by Infosys. Take home messages Healthcare medicine; will increase the speed, data pro- informatics research. Mueller ET. Watson: beyond jeopardy!. Artificial Intelligence. Artificial intelligence in precision cardio- treatment, as well as outcome prediction and vascular medicine.
Journal of the American Col- prognosis evaluation. Powles J, Hodson H. Google DeepMind and care data structured and unstructured and healthcare in an age of algorithms. Health and aims to mimic human cognitive functions to technology. Dermatologist-level classification of skin cancer with deep neural networks. Medical education is undergoing a revolution. The internet and social Our new curriculum will draw from best practice media influence every aspect of our lives and around the world and implement educational and digital technologies and Artificial Intelligence AI technological innovations in learning, teaching provide huge opportunities for transforming un- and assessment approaches to prepare doc- dergraduate medical education.
However, many tors who are equipped with the clinical, research medical schools around the world still use tradi- and leadership skills to allow them be the global tional methods of teaching and learning based practitioners and leaders of tomorrow. As global gradu- Health professionals for a new century: trans- ates, they will be prepared to work across and forming education to strengthen health sys- within health systems, with an equal focus on tems in an interdependent world.
The Lancet, secondary care, public health and primary care. It will incorporate a team- based educational approach. Mumbai, India Abstract: Introduction: 2. Depen- dency on concomitant medicines was reduced Hypertension is a health hazard commonly seen from Despite the presence of mul- tiple pharmacological options, the problem per- Conclusion: sists. This retrospective weight patients suffering from hypertension. Materials: Patients suffering from hypertension, overweight by Asian body mass index BMI chart, who attended the out-patient departments OPDs at Madhavbaug clinics and received minimum 6 sittings of the BP management pro- gram over a day period was considered.
The information about prescribed concomitant med- icines was also noted down. Data were pooled and coded in Microsoft Excel spreadsheet. R Version 3. The mean SBP im- proved significantly at 90 days from The mean DBP also decreased significantly from The mean BMI also decreased significantly at day 90 from Thyroid function test freeT3,freeT4,TSH anal- abolic disorder mainly considered by hypergly- ysis was done by minividas method.
Sub-clinical hypo- another common endocrine gland function that thyroidism was more common than other con- is thyroid gland. Nephropathy Present study found betic subjects. Sub clinical hypothyroidism was most common thyroid disorder, which was more com- Study has been included patients who were ad- mon in female. Diabetic complica- eral Medicine Department at Sundaram Arulrhaj tion were more common in sub clinical hypothy- Hospital,Tuticorin.
A total of patients with roidism. Regular screening of thyroid function in type 2diabetes mellitus diagnosed on the basis all type 2 diabetic patients should be done es- of ADA criteria or who were taking treatment for pecially with uncontrolled diabetes to reduce the diabetes were included in study.
Diabetic state morbidity and mortality.
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Those who develop End stage renal disease ease. It is im- roalbuminuria, and it indicates more advanced portant to detect the Diabetic kidney disease at kidney disease. Microalbuminuria is also with high total cholesterol and LDL. Hence studies on microalbu- minuria in Diabetes are essential to assess the Implementing effective intervention for better burden of Diabetes and its future complications. Results from this test are measured as milligrams mg of pro- tein leakage in urine over 24 hours.
Results gen- erally indicate the following: Cardio Diabetes Medicine. Variables were compared be- tween day 1 and day 90 of CDC. Observations: Out of 48 enrolled elderly male patients, 34 were included for analysis. CDC showed significant improvement in HbA1c from 8. Abdominal girth from Dependency on concomitant medicines was reduced, with num- Cardio Diabetes Medicine.