What is the newest field of medicine? – Here is all you need to know

Sarah Henry, MD, a doctor at Boston Children’s Hospital, is just beginning her shift while her coworkers are departing for the day. In Henry’s role as a nocturnist, he works 10-midnight shifts a month and avoids traditional workplace stressors like lengthy commutes by sleeping most of the time during the day.

However, the true appeals of the position lie elsewhere. Henry observes that the hospital seems to be a different place at night than it is during the day. Meetings and conferences are not taking place, and no one is going in and out. Patients and their families will benefit from a more simple work environment that allows me to spend a lot of time with them. What you said means a lot to me.” A number of new medical career options have opened up in recent years, some as a result of medical advancements, others as a result of changes in the way health care is provided. Here are 4 new specializations, what they involve, and what training is required to pursue them.

1. Nocturnist

Nocturnists — physicians who practice hospital care largely at night — have a promising future as the percentage of medically difficult patients in hospitals increases. Atashi Mandal, MD, an Orange County nocturnist, thinks it “adds a degree of safety and care to the hospital.” In many ways, nocturnists are similar to hospitalists in that they admit and cover patients, but since they work at night, they are typically working alone and without the assistance of other doctors. Because of this, they typically have more freedom than their daytime colleagues.

Board certification in the internal medicine, family medicine, and pediatrics is required, as it is for regular hospitalists. According to Philip A. Masters, MD, vice president of and international and membership programs at the American College of Physicians, a doctor may also pursue Maintenance of Certification in the Focused Practice in Hospital Medicine or additional training in a specific subspecialty such as cardiology or pulmonary medicine.

Over 70% of hospitalist programs feature nocturnists, and demand is outpacing supply, according to the 2016 State of Hospital Medicine Report. Therefore, they may make 15 to 20 percent more than daytime hospitalists and earn the same compensation with fewer hours while working the same amount of hours. Although “finding it easier to sleep throughout the day is crucial,” Henry explains. This can’t be done by everyone.

2. Clinical informatics 

According to Douglas B. Fridsma, MD, Ph.D., president & CEO of the American Medical Informatics Association, clinical informatics, also known as biomedical or health informatics, entails gathering and analyzing patient health data and putting that knowledge to good use in

What is Diabetes Mellitus – Here is all you need to know

carbohydrate metabolism problem diabetes mellitus, in which the body’s capacity to make or react to insulin is compromised, resulting in abnormally high or low blood sugar levels. Morbidity and death from diabetes are common, however, these results are not directly related to the disease itself. Instead, they’re linked to conditions that arise as a consequence of long-term management of diabetes mellitus. Diseases of the small and large blood vessels and of the nerves are all included in this category.

Causes of Diabetes Mellitus

Beta cells in the pancreas emit insulin, which is produced by the islets of Langerhans, a cluster of cells in the pancreas. It is insulin’s job to make cells take in glucose so they can utilize it as an energy source. Diabetic patients may have insulin-resistant muscle & adipose cells or malfunctioning beta cells, both of which result in reduced insulin output. Hyperglycemia is the result of a rise in blood glucose levels in any of these two scenarios (high blood sugar). 

The extra glucose in the blood is expelled in the urine when the blood sugar levels rise. Urinary volume & frequency increase, as well as thirst, as a result of the increased excretion of glucose in the urine. Its term, diabetes mellitus, is derived from the Greek word diabainein, meaning “to pass through,” and Mellitus, which means “sweetened with honey,” alludes to sugar in the urine. Itching, hunger, loss of weight, and weakness are all signs of diabetes.

Diagnosis of Diabetes Mellitus

Diabetes is a disease that many individuals are unaware they have. There were an estimated 8.1 million undiagnosed cases in the United States in 2012. Increased urination and a markedly high blood sugar level are among the most common signs of type 2 diabetes. Diabetic patients have blood glucose values more than or equal to 126 mg/ 100 ml (7.0 mmol/liter) after such an overnight fast, or higher than 200 mg/ 100 ml (11.1 mmol/liter) in general to make a diagnosis of the disease. A condition known as impaired fasting glucose is identified in people whose fasting blood glucose levels range from 100 to 125 mg/ 100 ml (6.1 – 6.9 mmol per liter) (prediabetes). In a healthy person, blood glucose levels in the fasting state should not exceed 100 mg / 100 ml (6.1 mmol/liter).

Diabetes & impaired fasting glucose are defined by arbitrary blood glucose levels, yet these levels are linked to an increased risk of macrovascular & microvascular illness. Diabetes is more likely to develop later in life in those with impaired fasting glucose. Pregnant women are tested for gestational diabetes using oral glucose tolerance tests, in which blood glucose levels are monitored hourly for many hours after ingesting a significant amount of glucose (often 75 or 100 grams). As a result of the lower blood glucose concentrations seen in healthy pregnant women compared to nonpregnant women and men, gestational diabetes has more strict criteria for diagnosis than other kinds of diabetes.

Measuring levels for advanced glycosylation ending products may help determine the length & severity of hyperglycemia (AGEs). Red blood cells’ hemoglobin molecules undergo glycosylation, resulting in the formation of AGEs, which persist until the red blood cell dies. The bulk of vascular damage in patients with diabetes is thought to be caused by AGEs. HbA1c, a glycosylated form of hemoglobin, is especially helpful for monitoring hyperglycemia as well as the success of diabetic therapy.

Treatment of Diabetes Mellitus

When diabetes first appeared, most people perished within a few months. That changed with the discovery of insulin in the 1920s. Ketoacidosis, the buildup of ketones (byproducts of fat metabolism) and acid in the blood, occurs when diabetes is left untreated. Severe nausea and vomiting are the patient’s last resort when the accumulation of these metabolic waste products from a diabetic metabolic meltdown becomes unmanageable.

Reduced blood glucose levels are the primary goal of treatment for diabetes. Achieving this is critical to improving health and limiting the long-term effects of diabetes. Diabetic patients may utilize HbA1c tests to see if their medication is working. HbA1c readings should be as near to normal as possible as a goal.

Diet & exercise

Diets and regular exercise are recommended for all diabetics in order to help them achieve and maintain a healthy weight and keep their blood sugar levels in check after a carbohydrate-rich meal, which may cause a spike in blood sugar. Diets that are low in fat and high enough in protein are recommended for patients. Protein accounts for 20% of calories, with the remaining 70% coming from carbohydrates, ideally from complex carbs rather than simple sweets. This is how it works in real life.

For obese patients, overall calorie content should be determined by the patient’s nutritional needs for development or weight reduction. Even a few days of calorie restriction may have a significant impact on hyperglycemia in overweight and obese individuals with type 2 diabetes. Increases in insulin sensitivity may also be achieved by weight reduction, especially when it is done in conjunction with regular exercise.

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