Google Cloud Speech-to-Text API (Chirp) + Gemini 2.5 Flash Non-Thinking. Treat it as a searchable index of what was broadcast, not a quotation record.
00:00:00that presence that makes a person stand out, in short,
00:00:03you're farming now is when you do poses that give you style
00:00:07points, presence or charisma, but beware, you can also
00:00:11lose it, for this reason
00:00:14why the power to make a various battles are already being fought among the young people of this new
00:00:17generation and look at this shocking bull
00:00:21that got stuck in a vehicle, all this was recorded by
00:00:24one of the cell phones of a person who was inside this
00:00:28car.
00:00:30An unusual episode occurred during a bull run through the countryside in
00:00:34Guadalajara in Spain. It is a bull that charged a vehicle in full
00:00:38motion. It also broke one of the rear windows. The
00:00:41impact caused one of the animal's horns to remain inside the
00:00:45cabin. The bull remained attached to the vehicle for several
00:00:49seconds while the vehicle continued to move forward. The scene was
00:00:52recorded on video by the occupants of the car who
00:00:56filmed the moment from the interior. In the images, you can see
00:00:59it next to the vehicle after going through the
00:01:02glass with one of its horns. The episode occurred
00:01:06within the framework of the patron saint festivities of Iriepal celebrated
00:01:10in honor of San Roque. During the journey, the Bull focused
00:01:14its attention on this car and the charge occurred. After
00:01:17remaining attached for a few seconds, the animal ended up
00:01:21stumbling and fell to the ground while the car continued its
00:01:24journey.
00:01:30our recommendation of the day arrives at this hour and it comes from
00:01:34Lotto, the Aruba lottery and the accumulated Mini
00:01:37Mega and its Mega Plus, the
00:01:39accumulated continues to rise, Lotto, the Aruba lottery comes with
00:01:43its tremendous accumulated for tomorrow, Tuesday, August
00:01:4625th, where you can win 700,000 florins with the
00:01:50Mini Mega and with the Mega Plus you will have the possibility of
00:01:53winning the super accumulated millionaire of one million
00:01:57florins, this for tomorrow, Tuesday. Buy your
00:02:00Mini Mega and Mega Plus ticket before it's too late. Don't forget that Lotto
00:02:045 for this Wednesday has an accumulated of
00:02:08180,000 florins, Lotto changing
00:02:10lives. And look at these images, a young man
00:02:14bought a washing machine online through social
00:02:17media and realized something digital that prevented him from
00:02:21seeing, well, it was just a
00:02:23sticker.
00:02:25This was the case of a user on Tiktok who shared his experience when
00:02:29buying a...
00:05:51Welcome to another episode of Caribbean Medical
00:05:54TV. Today we're getting to the very core of your
00:05:57physical health, the very essence that guides you through
00:06:00life, the heart. While the
00:06:03Caribbean is unique in many ways, we unite with the
00:06:07rest of the world in the rise of one of the most common chronic health
00:06:10conditions, heart disease.
00:06:13many of our Caribbean people, some unknowingly, are living with
00:06:17heart disease or know someone with this ailment.
00:06:20Unsurprisingly, this condition can influence our
00:06:23peace, our professions, our families, in short, our
00:06:27entire lives. Heart have three arteries and
00:06:31two arteries in the left side, that is what you call left main
00:06:35coronary artery, it divides into two, one is left anterior
00:06:39descending artery, which supplies the blood supplies to the
00:06:42heart muscle 60% of the heart muscle and then the
00:06:46left circumflex artery which supplies to the
00:06:4920% of the left side of the artery and then right side
00:06:53right coronary artery we call it as it supplies to the
00:06:5620% of the heart muscle so in total three arteries
00:06:59supplies 100% of the heart muscle so main one is
00:07:03led that is left anterior descending artery left are complex right
00:07:07coronary artery supplies to 20% each the heart is the main
00:07:11one from the blood and to different parts of the body, so the artery supposed to
00:07:15be healthy and nice. the causes of heart
00:07:18disease are no mystery. unfortunately, the risk
00:07:22factors are very common in our communities.
00:07:25there has been a decline in mortality, but that
00:07:28decline plateaued around
00:07:302019-2020 and in fact has started to increase
00:07:34again. some of that was due to the excess mortality due
00:07:37to the COVID pandemic, but top of that there's been
00:07:41the epidemic. of obesity and
00:07:43diabetes that is added risk factor and thus
00:07:47cardiovascular disease has trended up over the last few years
00:07:51and cardiovascular disease mortality, so we still have lot of
00:07:54work to do here in the Caribbean and around the
00:07:57world. heart failure and cardiovascular disease are
00:08:01related. this is like a journey in the
00:08:04illness of the patient. the patient is
00:08:07starting point to have something that we call
00:08:11risk factors. for example, elevated high
00:08:14blood pressure that we call hypertension or
00:08:18high cholesterol or diabetes, that
00:08:21leads to changes in the heart and the
00:08:24arteries, a concept for example that our arteries
00:08:28getting older, stiffy and
00:08:32good ateroesclerosis,
00:08:35finally complications are rise, for example
00:08:39cerebrovascular disease, stroke,
00:08:42failure or kidney
00:08:45problems, if they are not address in the
00:08:49right manner, the patient can lead to very
00:08:53limited quality of life or unfortunately son
00:08:56ordain law the life. every person is an
00:09:00individual, but definitely
00:09:03having risk factors, high blood pressure, high
00:09:07cholesterol, smoking and
00:09:09diabetes are the person that can lead to... heart
00:09:12failure in the heart failure is not addressed or
00:09:16treated, the person, 50% of the
00:09:19persons die in the in the five years
00:09:23after the diagnosis, because there
00:09:26are sometimes no warning symptoms, many people are
00:09:29unaware they are at risk for heart problems, the key to
00:09:33prevention is being prepared, we had a 25
00:09:36year old young man recently who
00:09:39had no clue that he had anything and when i listened, heard the
00:09:43murmur of mitral stenosis, meaning that his mitral valve, the one on the left side
00:09:47between the top and bottom, wasn't opening, and when we did the echo, it
00:09:50showed that he had severe stenosis and he's 25 and never had a clue that
00:09:54he had this disease, so we can go on forever with these stories, but what we saying
00:09:58is if you identify, if you keep doing well person checks, something
00:10:02will tip somebody off that something is
00:10:04wrong,
00:10:07children have to be seen by pediatrician or a
00:10:11gp or somebody who's listening for
00:10:13abnormalities, not just you getting vaccines and done, but
00:10:17listening for a murmur,
00:10:19alert to the fact that rash could mean be more than rash,
00:10:23right? just thinking of the diagnosis. because we say what you don't think of you will miss
00:10:26in terms of diagnosing, so if
00:10:29you do that then there's a possibility.
00:10:32unfortunately, I am seeing the the
00:10:35incidence going up and I'm seeing it in younger patients.
00:10:39for example, I trained in the university of Calgary in
00:10:42Canada, and in my training when I did these
00:10:46procedures, did it in patients who were in 60 days 7
00:10:49days, but in gayana I am doing
00:10:52procedures or restance on patients. as young as
00:10:5630s and in the 40s and we did a study in
00:10:59between 2022 to 2023 where we look at
00:11:03about 230 patients who present with this type of heart
00:11:07attack, we found that the average age was in the
00:11:1050s, we found that they were predominantly male
00:11:13patients and a significant portion, almost
00:11:1670% were South Asians or
00:11:19East Indians, lot of patients had diabetes,
00:11:22hypertension and 80% of the...
00:11:25presented late and did not receive the therapy within the 12
00:11:29hour period. the good news is that detection and
00:11:32treatment have been increasing in the caribbean. the heart
00:11:36patient of today has more options than the heart patient of
00:11:39decades ago. I think as a whole that the Caribbean is actually quite
00:11:43good at healthcare, so certain territories may be better certain
00:11:47things, but we haven't had to send patients away for a long time,
00:11:51actually. in terms of cardiovascular care specifically, we probably...
00:11:55only selled pediatric cases for surgery, lot of the
00:11:58pediatric cases are done by something you call interventional procedures as well and those
00:12:02patients do not have to go away, adult cardiology patients do not go away
00:12:06for anything, so angioplasty,
00:12:08stens, surgical procedures including val replacement about procedures
00:12:12and this is within the caribian as a whole, and trinidad specifically
00:12:16quite in a good way has a highest percapita
00:12:19of cardiologists in caribbean, so we have essentially all the
00:12:22cardiology specialities locally,
00:12:25"a lot of people in the 30's and the 40's and the 50's don't think of health care as being part
00:12:29of a proactive thing, so waiting for something to happen, then go to the
00:12:32doctor, so we see both in men and women that you know the
00:12:36suddenness of cardiovascular disease, and it's one of those weird things that you
00:12:39have to look for, you can't just say i'm waiting for a symptom then to do a test,
00:12:43so it does mean going to your doctor having a frank discussion,
00:12:46again it makes the difference what we looking for, so if somebody has heart is in
00:12:50the family we might look a certain way, if it's a general checkup it might be just a different
00:12:54way of test." but we have the technology, this is not that is
00:12:58unique to some parts of the world, we have different ways of evaluation, we have
00:13:02CT scans, MRI machines, echo machines, so technology is
00:13:05available in the Caribion it is not unique to some other part of the world, we can do
00:13:09it, people just need to access it and again have that discussion with the health
00:13:13provided wherever you are and see what is the best tool for you to come up with that
00:13:16information. in the caribbean we do
00:13:19have different levels of of equipment, availability and access
00:13:23into different territories. Right, so part of what the Caribbean cardiac society
00:13:27does is brings together the
00:13:29um, you know, that network, kind of strengthen that
00:13:33network, establish that network. There are some areas
00:13:36that they may not require setting
00:13:40up of a special area each country, so by
00:13:44meeting together, the PMI say, listen, we are setting
00:13:47up this center for maybe pet scanning, and we would
00:13:51encourage from all the other islands that you could come here.
00:13:54Another... center might decide, well look, we are going to do lot of
00:13:57coronary intervention, and you difficult cases, you could bring
00:14:01them here, so you could have centers of excellence in different
00:14:05fields around the Caribbean. relatively recently in
00:14:08St. Lucia, St. Lucia established his cardiac catheterization laboratory, and what
00:14:12we did is that we had, persons coming from Martini, persons coming
00:14:16from Jamaica, and it would have been cardiologists, cardiovascular
00:14:20nurses, cardiovascular technicians travelling to help
00:14:22establish that cardiac. ization center in St.
00:14:26Lucia and that's what we like to do, we like to build capacity in the different regions
00:14:30and yes there is human resource capacity, but that the equipment and the
00:14:34availability of disposals and so on also very important. In the
00:14:37last years we have faced the appearance of
00:14:41diverse drugs for treating common diseases,
00:14:44diabetes, hypertension, obesity. When we take a look at
00:14:47those patients, patients with obesity, hypertension, diabetes
00:14:51usually suffers not only for that condition but also affects heart.
00:14:55kidneys, liver and other organs, and that's
00:14:59the point when we, the different specialists get together to
00:15:03treat the same patients and in the last year all of these
00:15:07medications usually
00:15:09works not in only one organ. let
00:15:13me give you an example, we have some molecules that can
00:15:17protect the heart at the same time that they protect the
00:15:20kidney and at the same time that they protect the liver, so it is
00:15:23important to have the different specialist
00:15:27perspective of using these medication and the management of these
00:15:30problem. beyond those traditional
00:15:33drugs that have been the cornerstone, the are
00:15:37new... technologies that have to do with
00:15:40genetically manufactured or genetic
00:15:43alterations or new medicines that are
00:15:47based on gene technology and the fact
00:15:50that the human genome has been identified and we
00:15:54can now have the technology to know the genes responsible.
00:15:58scientists are now making gene therapies,
00:16:00antibodies
00:16:03that can target certain molecules in a body
00:16:06to bring the... on the cholesterol, it's quite
00:16:09amazing and it resembles in many ways some of the advanced drug
00:16:13technologies that are used in cancer therapy where you can
00:16:16target the focus. this is now being applied in
00:16:20cardiology. what i presented
00:16:22was the work that we are doing in managing heart
00:16:26attacks and there is one particular heart attack called a
00:16:29stemi st elevation my carl infarction.
00:16:32what what happens in in that case is that the artery
00:16:36becomes blocked 100% percent so
00:16:39when that happens, patients will obviously get significant
00:16:42chest pains is that you have to open that
00:16:45artery as soon as possible and the early you
00:16:49open that artery the better the outcomes, so if you open that artery
00:16:53within the hours you have better
00:16:56chance, but there are certain therapies that you can give that would
00:17:00have to be given within 12 hours, in addition to
00:17:04that they goal standards actually taking the patient to the... cat
00:17:07lap and trying to open that artery with balloon, that is called
00:17:11PCI. so my presentation
00:17:15was based on the work we're doing in trying to
00:17:19have this therapy available in all the 10 regions of
00:17:22Giana. my area of focus is minimal invasive
00:17:26heart procedures, really percutaneous heart procedures, meaning doing heart
00:17:30valves or closing holes in the heart by just going through either an artery or the
00:17:33vein in the leg. these procedures are much safer than open. heart
00:17:37surgery, they require lower hospital time, lower
00:17:41hospital stay, they don't require ICU admission, so they of course
00:17:45save money and they save lives. my area of
00:17:48expertise is cornaries and blocked coronary order, so the real this is
00:17:52without question, the most cutting edge thing you can do for cornerers right now, the
00:17:56other thing that's is been around and is emerging and evolving is
00:17:59stenting, we still stent, more than half the
00:18:03patients are eligible for stent, those that are not
00:18:06eligible for stents are.
00:18:37apply that technology to almost 100% of my
00:18:40patients, we now on the cusp of
00:18:43learning how AI is
00:18:46interacting with the tools that we have been
00:18:48using, so now increasingly we're using
00:18:52AI to find
00:18:55tune both the treatments that we're giving
00:18:58and also to help us with the complex decision making,
00:19:02we can now also ask AI, AI, what do you
00:19:05think and and AI?
00:19:08will promote a well, that's what will suggest and will
00:19:11suggest a strategy. now it's not that he's committed to doing
00:19:15that, but it's like having an experienced partner that
00:19:18can give you some advice and you can think about it, and so that that's
00:19:22fantastic, especially for areas
00:19:25like in most Caribbean islands where you
00:19:28have few specialists or few super
00:19:31specialists who don't have even yoke
00:19:35colleague always to bounce idea. off of now you can talk to
00:19:39AI and collaborate and
00:19:41disagree and and at the end of the day the doctor
00:19:45remains the one who makes the decision, but he always
00:19:48feels as if he's surrounded by colleagues who can give him
00:19:52another opinion. as with many chronic non-communicable
00:19:55diseases, healthy changes in lifestyle can go a
00:19:59long way toward keeping your heart healthy. it is all about
00:20:02prevention and the risk factors. we've gotten very good at treating heart
00:20:06attacks, at treating... heart failure at treating the
00:20:09end stages of the disease, but we're
00:20:12still behind in terms of preventing disease. the number
00:20:16one risk factor in the Caribbean and around the world remains
00:20:19and will remain up to the year 2050 is
00:20:22hypertension. the problem with hypertension is that people
00:20:26either don't get it measured, don't know they have it, even if they have it,
00:20:29they feel okay, they don't feel it, and so they don't get it
00:20:33treated, so that's the number one modificable risk factor
00:20:36right now. "We're doing pretty well with cholesterol, people know their
00:20:40cholesterol, the statin drugs are ubiquitous to
00:20:43use, and almost free of side effects, and so lot more
00:20:47people getting their cholesterol lowered, but..." I mentioned, there's this
00:20:51rise in obesity and diabetes as the third risk
00:20:54factor by 2050, so we have to get our
00:20:58handle on that, and uh, so hypertension,
00:21:01obesity, diabetes are the areas that really need a lot of work over
00:21:05the next 20 years. The only way you know or you
00:21:08have information as to what your blood pressure is is if you are
00:21:12if you are checking it, so you must know your numbers, you must check your
00:21:16blood pressure, okay, and for those who have
00:21:19got high blood pressure, then whatever is between yourself and your
00:21:22physician, your doctor, whatever decision has been
00:21:26made, then you want to adhere to those principles, because they
00:21:29are very good treatment methods that would
00:21:33control the blood pressure and therefore remove that risk or
00:21:36decrease that risk of complications such as aotic
00:21:40disease, aotic anerism, aotic dissection, sometime you see it in
00:21:44young pregnant women as well during pregnancy, the person because you
00:21:47know the blood pressure changes during pregnancy, Sometimes you have
00:21:51women experiencing complications during their pregnancy where they've got to
00:21:55high blood pressure, high blood pressure sometimes can occur in pregnancy,
00:21:58and if it's not well managed, you can also develop aotic dissections and
00:22:02complications of aotic rupture. Exercise
00:22:06is really the best medicine, it's better than any medication that I can
00:22:09prescribe, or any cardiologist can prescribe,
00:22:13getting just simple walking, 7 or 8,00
00:22:16steps a day should be the goal. There are very good studies.
00:22:20now showing that's the level of exercise that reduces your cardiovascular
00:22:23risk, so if you can get a smart watch or smart phone or
00:22:27some fit bit, some way to count the number of steps you're doing a day
00:22:31and get really aim for that 7 or 8,00 steps a day,
00:22:34that can control your weight, control your blood pressure, improve your
00:22:38overall cardiovascular risk profile. it's shown to reduce
00:22:42cancer rates as well, so exercise is really the
00:22:45best medicine we have. one other aspect that's
00:22:48rising is need to get good
00:22:51sleep, the condition of obstructive sleep apnea
00:22:54is there on the horizon and rising and we realize a great
00:22:58contributor, so that's the other
00:23:01aspect that I think we need to clearly understand, that's creeping in
00:23:05as one of the things we need to pay attention to, not only diet and
00:23:08exercise, but good restorative
00:23:11sleep,
00:23:18we are two systems in the body,
00:23:20the sympathetic nervous system that is related to stress
00:23:23and the parasympathetic nervous
00:23:26system that is related to relaxation, and
00:23:29every time we take a deep breath in and out, we're
00:23:33actually activating the vagus nerve
00:23:37which in turn would cause
00:23:40relaxation after a small number of
00:23:44breaths,
00:23:46so that this is why things like meditation and yoga help.
00:23:50full because they actually help the physiology of the
00:23:54body. We are now realizing
00:23:57that what is really good are the good
00:23:59fats? Not all fats are good, the saturated
00:24:03fats for instance, but if you want eat diets
00:24:07that are high in like avocado, which was one
00:24:11time thought to be something bad, olive oil,
00:24:14which is one of the the best oils and the good fats
00:24:18that come from nuts. in places like
00:24:21Cuba and lot of the other places, Puerto Rico,
00:24:25because they eat so much rice and peas, they have found
00:24:28that there is less in the way of arterosclerosis,
00:24:32that too, with some meat and fish will be a
00:24:36good diet. Of course,
00:24:39green, leafy vegetables and foods, you know,
00:24:43which are around and in abundance just so they take a
00:24:46little bit more effort to get them on the table. but if
00:24:50you use this, this will be one of the the most
00:24:54helpful things in achieving a long life.
00:26:53Caribbean Medical TV. Every year
00:26:56in March, we observe World Down Syndrome
00:26:59Day. Many in Trinidad and Tobago, like the rest of...
00:27:02world don multicolored socks to help raise awareness, but
00:27:06yet many people in classrooms, in the workplace, in
00:27:09public spaces, even in our own homes, do not
00:27:12understand people with down syndrome and how to support
00:27:16them. Over the years, Trinidad and Tibegos Down Syndrome
00:27:19family network has made strides to raise awareness and
00:27:22offer encouragement and community to families across the
00:27:26country. For members of the Down Syndrome Family
00:27:29Network, their mission to advocate for families of people with
00:27:32down syndrome is a highly personal one. It was difficult
00:27:36in the beginning. I didn't know anything about Down Syndrome, so I thought I
00:27:40was cursed you know for my son to be born with down syndrome. And
00:27:43then even realizing after three days that he also
00:27:47had congenital heart disease, he had three holes in his heart
00:27:50and needed the emergency surgery. So is almost
00:27:54like if okay, what next, what next? I mean he already has down
00:27:57syndrome, now you get three holes in his heart. Why, what did he do? What did
00:28:01I do, you to cause? this and not knowing that
00:28:04he didn't do anything, didn't do anything, it just happens and
00:28:08then a friend of mine, you know we actually sitting on having some
00:28:12drinks and i was ranting and he's just looking at
00:28:15me and over his drink he was sipping it and he looked at
00:28:19me straight in my eyes and he said what are you
00:28:23doing and he took a sip of his drink i wanted to slap that drink out
00:28:26of his hand you know and opened my
00:28:30mouth three times and i could not answer him
00:28:33because I realized then I wasn't doing
00:28:37anything, so I was a part of the problem, in fact I was the
00:28:40problem in my son's case, buse I wasn't doing anything
00:28:44to help him, and so that changed everything. The result was a
00:28:48collaboration among parents of children with down syndrome to
00:28:51establish a support network, means to reach out to those
00:28:55struggling and help them see that their children could have lives full
00:28:59of potential. I started educating myself, I started
00:29:02attending conferences abroad and that is
00:29:05where I got the concept of the network cuz I'm seeing how those
00:29:09other organizations grew from family support
00:29:12groups to huge international
00:29:15organizations, some of them are the largest advocacy
00:29:19organization for Down Syndrome in the world and it
00:29:23started off as family support group, so
00:29:26I came back and with some other parents we formed the Down
00:29:30Syndrome Family Network and in 15 years, you know, I
00:29:34always used to think that we haven't done anything, but people have to keep
00:29:37reminding me, look what you have done,
00:29:41the we the government has ratified the UN convention on the rights of persons
00:29:45with disabilities, they updated the national policy
00:29:48on persons with disabilities, and they have begun drafting
00:29:52national legislation for persons with disabilities, you know, so we
00:29:56anxiously away that, because that is the game changer right
00:29:59there for all persons with disabilities. "the support of
00:30:03organizations have helped to raise awareness of the best means to
00:30:06support families and people with down syndrome. truly power
00:30:10to make a difference program. they support us
00:30:13with our workshops and we have these workshops quarterly along with
00:30:17our conference annually in march where we bring
00:30:21parents together with professionals, you
00:30:24occupational therapists, speech therapists, physiotherapists
00:30:28and even as we had today in our
00:30:31workshop, find..." financial specialist from
00:30:34republic bank to tell us all about planning for the
00:30:37future investments and even starting from
00:30:40basic from a bank account and how that
00:30:44could help us plan for our children's future so
00:30:48power to make a difference is really making
00:30:51a difference partnership with the down syndrome family network
00:30:55and we hope that as we continue they will help
00:30:58add our cry.