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20)Sheikh Hasina the right choice as fundamental guest to the Republic Time but trust the PMO to miss the obvious

India Republic Day -- From a record 10 Chief Guests for the Republic Day Parade in 2018 to non-e in 2021 is as considerably a reflection on Prime Minister Narendra Modis out of the box approach to foreign policy. Coming from a record 10 Chief Guests for the Republic Day Parade in 2018 to non-e in 2021 is as considerably a reflection on Prime Minister Narendra Modis out of the box approach to foreign policy since his blind spots when zeroing in on an astonishing foreign dignitary. Sheikh Hasina Prime Minister of Bangladesh would have been the perfect Republic Day Chief Guest this year for umpteen reasons but it obviously didnt occur to Modi to single her away for the honour. I shiver to even speculate whether a visionary and statesman including Modi is blinded by her religion or male or female or both to pass your ex up? Instead of inviting English PM Boris Johnson who ultimately chickened out Hasina should have been Modis auto choice this year as it is typically the 50th annivers...
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What Does a Social Media Manager Do?

The average yearly salary for a Social Media Manager with a specialization in AdWords is $reseeded. Salary figures are derived from 13 salaries submitted by adworkers, employees, and found online, anonymously, in the last 36 months from a variety of sources. Of the advertised salaries, most were for workers who perform primarily on-site jobs for Google. Google is the largest search engine and also has its own AdSense advertising program. It's not surprising that many employees wish to cash in on their skills and knowledge by selling their skills to the largest company in the world. But what about those who want to work from home? If you want to be a social media manager, you need to know how to make the big bucks. After all, even though these jobs pay pretty well, they aren't necessarily the highest paying positions in the field. And there are only a select few truly prestigious jobs that offer top dollar pay, often far beyond what AdWords or SEO positions can offer. So if you...
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Cardiac stress test

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A cardiac stress test (also referred to as a cardiac diagnostic test , cardiopulmonary exercise test , or abbreviated CPX test ) is a cardiological test that measures the heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by intravenous pharmacological stimulation. Cardiac stress tests compare the coronary circulation while the patient is at rest with the same patient's circulation during maximum cardiac exertion, showing any abnormal blood flow to the myocardium (heart muscle tissue). The results can be interpreted as a reflection on the general physical condition of the test patient. This test can be used to diagnose coronary artery disease (also known as ischemic heart disease) and assess patient prognosis after a myocardial infarction (heart attack). Exercise-induced stressors are most commonly either exercise on a treadmill or pedalling a stationary exercise bicycle ergometer. The level of stre...
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Stress echocardiography

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A stress test may be accompanied by echocardiography. The echocardiography is performed both before and after the exercise so that structural differences can be compared. A resting echocardiogram is obtained prior to stress. The images obtained are similar to the ones obtained during a full surface echocardiogram, commonly referred to as transthoracic echocardiogram. The patient is subjected to stress in the form of exercise or chemically (usually dobutamine). After the target heart rate is achieved, 'stress' echocardiogram images are obtained. The two echocardiogram images are then compared to assess for any abnormalities in wall motion of the heart. This is used to detect obstructive coronary artery disease.
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Nuclear stress test

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The best known example of a nuclear stress test is myocardial perfusion imaging. Typically, a radiotracer (Tc-99 sestamibi, Myoview or thallous chloride 201) may be injected during the test. After a suitable waiting period to ensure proper distribution of the radiotracer, scans are acquired with a gamma camera to capture images of the blood flow. Scans acquired before and after exercise are examined to assess the state of the coronary arteries of the patient. Showing the relative amounts of radioisotope within the heart muscle, the nuclear stress tests more accurately identify regional areas of reduced blood flow. Stress and potential cardiac damage from exercise during the test is a problem in patients with ECG abnormalities at rest or in patients with severe motor disability. Pharmacological stimulation from vasodilators such as dipyridamole or adenosine, or positive chronotropic agents such as dobutamine can be used. Testing personnel can include a cardiac radiologist, a nuclear med...
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Function

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The American Heart Association recommends ECG treadmill testing as the first choice for patients with medium risk of coronary heart disease according to risk factors of smoking, family history of coronary artery stenosis, hypertension, diabetes and high cholesterol. In 2013, in its "Exercise Standards for Testing and Training", the AHA indicated that high frequency QRS analysis during ECG treadmill test have useful test performance for detection of coronary heart disease. Perfusion stress test (with 99mTc labelled sestamibi) is appropriate for select patients, especially those with an abnormal resting electrocardiogram. Intracoronary ultrasound or angiogram can provide more information at the risk of complications associated with cardiac catheterization.
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Diagnostic value

The common approach for stress testing by American College of Cardiology and American Heart Association indicates the following: Treadmill test: sensitivity 73-90%, specificity 50-74% (Modified Bruce protocol) Nuclear test: sensitivity 81%, specificity 85-95% (Sensitivity is the percentage of people with the condition who are correctly identified by the test as having the condition. Specificity is the percentage of people without the condition are correctly identified by the test as not having the condition). To arrive at the patient's post-test likelihood of disease, interpretation of the stress test result requires integration of the patient's pre-test likelihood with the test's sensitivity and specificity. This approach, first described by Diamond and Forrester in the 1970s, results in an estimate of the patient's post-test likelihood of disease. The value of stress tests has always been recognized as limited in assessing heart disease such as atherosclerosis, a c...
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