Dementia awareness presentation intended for general public/ patients/ potential and existing caregivers/ volunteers interested in spreading dementia awareness.
Visit my site for more information: http://dementiacarenotes.in
Dementia is a broad term which describes symptoms affecting memory, thinking ability that creates hindrance in performing daily activities. Two important brain functions are badly hit namely- memory and judgement.
Dementia is a broad term which describes symptoms affecting memory, thinking ability that creates hindrance in performing daily activities. Two important brain functions are badly hit namely- memory and judgement.
topic on dementia covering all aspects regarding classification,pathophysiology and treatment .Difference between MCI and DEMENTIA .best for post graduates ,house officers and medical students
Dementia is a type of Organic brain disorder . Mainly Alzheimer's type is described in the given ppt . Warning signs and nursing management and also treatment modalities have discussed in the ppt .
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
Schizophrenia is a mental disorder that usually appears in late adolescence or early adulthood. Characterized by delusions, hallucinations, and other cognitive difficulties, schizophrenia can often be a lifelong struggle. In this article, we will cover the causes, symptoms, and treatment of schizophrenia
topic on dementia covering all aspects regarding classification,pathophysiology and treatment .Difference between MCI and DEMENTIA .best for post graduates ,house officers and medical students
Dementia is a type of Organic brain disorder . Mainly Alzheimer's type is described in the given ppt . Warning signs and nursing management and also treatment modalities have discussed in the ppt .
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
Schizophrenia is a mental disorder that usually appears in late adolescence or early adulthood. Characterized by delusions, hallucinations, and other cognitive difficulties, schizophrenia can often be a lifelong struggle. In this article, we will cover the causes, symptoms, and treatment of schizophrenia
Teepa Snow, dementia and Alzheimer's expert, gave this presentation as one of several at an all-day caregiving workshop sponsored by Home Instead Senior Care of Sonoma County, located in Rohnert Park, CA.
The event was held on March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. About 100 people were in attendance including RPNs and CNAs. CEU credits were available.
The event was sponsored by Home Instead Senior Care of Sonoma County and Brighton Gardens Assisted Living in Santa Rosa.
Home Instead Senior Care of Sonoma County provides home care, personal care and companionship services to the seniors and the elderly in Petaluma, Santa Rosa, Rohnert Park, Sonoma, Windsor and throughout the County.
Dementia caregivers: introducing the caregivers (Presentation at ARDSICON 201...Swapna Kishore
Dementia caregivers handle a lot of work and responsibility for many years, but often do not realize how critical their role is. This presentation discusses caregiving in the context of dementia. It covers commonalities and differences amongst various types of caregivers. It looks at a range of caregivers who may vary in terms of their age, gender, relationship with the care-recipient, whether paid or unpaid, and whether living with the person or coordinating care from a distance.
For discussions on how to plan and cope with dementia home care, see: http://dementiacarenotes.in/caregivers/
Dementia is an acquired global impairment of intellect, memory and personality but without impairment of consciousness“
Or
According to WHO
Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing.
There are thousands of people in the UK caring for someone with Dementia in their own homes. This Dementia home care guide has been put together by Helping Hands to help family carers understand Dementia, and help their love ones live fulfilled lives.
Dementia is a condition where you experience a decline in your mental abilities, impacting your daily life. It can lead to difficulties with memory, thinking, and planning. The progression of dementia varies from person to person, with some individuals remaining stable for years, while others may experience a rapid decline. The important point is prevention for dementia and what one can do to manage it. Prevention for dementia can be easily acquired if we do some activities that will be mentioned in this article.
Dementia care during COVID: Suggestions using infographicsSwapna Kishore
Four infographics presenting tips for caring for someone with dementia during COVID times. Includes protecting the person from COVID infection, adjusting dementia care for COVID, getting medical support, and ways caregivers can get more help, do self- care and reduce stress.
Detailed discussions on these topics are available at the site https://dementiacarenotes.in
Dementia home care during COVID 19 (presented at AP HRDI, May 2020)Swapna Kishore
This presentation was made online on May 27, 2020, at Andhra Pradesh Human Resource Development Institute as part of their Knowledge Sharing Sessions. It starts with an overview of dementia home care and the status in India, to help appreciate challenges posed by COVID 19 in such care. It discusses aspects like how to protect someone with dementia from COVID, how to modify care due to COVID risk and also restrictions due to lockdown and such measures, , and how to manage medical support in these challenging times. As dementia care can be very stressful, it also discusses self-care and suggest some practical ways to manage such care in these times. Finally, it looks at ways caregivers can be supported by systems around us, including how these need to be integrated with other health care and support systems.
Digital interventions to support families living with dementia in IndiaSwapna Kishore
Explores how digital interventions can be used to support dementia in India, especially given the huge gap in support in the coverage of conventional interventions available to the over four million families coping with dementia. Given the rapid growth in ICT across India, digital interventions can reach currently unsupported families from multiple demographics. Identifies digital areas to focus on given the digital usage patterns and trends and existing dementia support gaps, Suggests possible approach and priorities, and discusses integration of digital interventions should integrate with other interventions.
Also includes suggestions for how families living with dementia currently can make use of existing interventions.
This appeared as a chapter in "Dementia in India 2020" (Citation of report: Kumar CTS, Shaji KS, Varghese M, Nair MKC (Eds) Dementia in India 2020. Cochin: Alzheimer’s and Related Disorders Society of India (ARDSI), Cochin Chapter, 2019)
Navigating Support Systems for Dementia Home Care in India (ARDSICON2019)Swapna Kishore
In India bulk of dementia care happens at home and is the responsibility of family members. Additionally, dementia and care related awareness and support is very poor. Families don’t know what may be needed and where to start. They face challenges in care and also in navigating systems around them. They may not reach suitable education or guidance, or reliable services that can help. Most training and advice focus on actual dementia related care tasks, but offer very little in terms of how to achieve acceptable levels of these in the current environment.
This presentation looks at how family caregivers in India look for information and support and their experiences related to support. It looks at challenges families face given inadequate support systems. Personal stories provide insight into real life experiences of families. The presentation may help caregivers appreciate support realities and provide them ideas on what they can consider. Persons supporting caregivers (professionals, volunteers, social entrepreneurs) may get input that helps them decide where to focus their effort; this includes ways to help caregivers navigate existing systems better as well as how to prioritise creation of new interventions.
Understanding dementia diagnosis from a caregiver perspective (Ardsicon2018, ...Swapna Kishore
A dementia diagnosis can be a gateway for treatment and better care and support, but this does not always happen. In India, where only 10% of the families receive a diagnosis and this, too, happens usually later in the dementia, we need to understand diagnosis experiences better if we want to improve diagnosis-related experiences.
This presentation looks at how caregivers in India perceive dementia symptoms, obtain diagnosis, and understand and respond to the diagnosis. Experiences of several caregivers are used to understand what makes families seek medical help and look at barriers and hesitations that delay diagnosis, or delay the families from benefiting from the diagnosis. Areas where we can reconsider our dementia awareness and diagnosis approach to improve diagnosis experiences are discussed.
This presentation was made at the International Symposium on Dementia and 22nd Annual Conference of ARDSI (Alzheimer’s and Related Disorders Society of India), held at the Indian Institute of Science, Bangalore (India) on September 14 to 16, 2018.
Under-discussed challenges of dementia home care in India (Ardsicon2017)Swapna Kishore
There are many serious challenges faced by home caregivers that are not acknowledged and discussed openly. Lack of such discussion makes many caregivers feel isolated and unsupported. General advice given may be inappropriate and insensitive, It results in unintended silences because everyone assumes these issues are rare.
This presentation was made at the International Conference on “Advances in Dementia” & “XXI National Conference of ARDSI” held on 22nd, 23rd & 24th September, 2017 at Kolkata (India). It discusses four serious areas that pose extreme challenge using dementia home care in India as the context. Data is shared to show how serious and prevalent these are, and why we should not ignore these. The purpose of the presentation is to create some recognition around these under-discussed issues in the hope that this will enable creative approaches and better support. The four areas discussed are: Financial problems; Situations where caregivers have a past history of being abused; Lack of support to understand, believe, and begin acting on a diagnosis; and Lack of explanations and support for late-stage dementia care.
Using the Internet for improving dementia awareness and support: Practical su...Swapna Kishore
Concerned organizations and volunteers often want to tap the potential of the Internet and create a "good" website that can help dementia awareness and support. However, in practice, they face problems and may not be able to reach their target audience and meet their intended purpose.
This presentation was made in the International Conference on “Advances in Dementia” & “XXI National Conference of ARDSI”, held on 22nd, 23rd & 24th September, 2017 at Kolkata (India). This presentation shares key issues related to creating and maintaining websites. It focuses on practical ways to approach website creation including factors to consider, decisions to take, components to plan for, how to proceed, and so on. The aspects to consider while setting priorities for website content are discussed. Common problems faced are discussed, and practical suggestions offered. Topics include Audience and Purpose, Content Creation and Presentation, Maintenance and Enhancements, Other Issues, and Moving Ahead.
Reduce Your Risk Of Dementia: A presentation in Hindi Swapna Kishore
This presentation explains what the risk factors for dementia are and what you can do to reduce your chance of getting dementia.
इस प्रस्तुति में देखें: डिमेंशिया/ अल्ज़ाइमर से कैसे बचें
डिमेंशिया (मनोभ्रंश) और सम्बंधित देखभाल के अनेक पहलू हैं. इनपर विस्तृत चर्चा के लिए हमारे वेबसाइट पर अनेक पृष्ठ हैं; देखें: http://dementiahindi.com/
What is Dementia: An introduction in Hindi Swapna Kishore
This presentation provides a basic introduction to what dementia is, the symptoms, types, progression, types, what care may involve, etc.
डिमेंशिया (मनोभ्रंश) और सम्बंधित देखभाल के अनेक पहलू हैं. इनपर विस्तृत चर्चा के लिए हमारे वेबसाइट पर अनेक पृष्ठ हैं; देखें: http://dementiahindi.com/
Dementia Home Care in India: Overview and Challenges ARDSICON 2015Swapna Kishore
Dementia Home Care in India: Overview and Challenges--- A presentation made at ARDSICON 2015, the 19th National Conference of ARDSI (Alzheimer's and Related Disorders Society of India), held at Mumbai, India.
If you are concerned about dementia home care, also see the pages at: http://dementiacarenotes.in/caregivers
Use of the Internet to spread dementia awareness and to support dementia care...Swapna Kishore
The Internet is a powerful tool to reach people. Internet usage is growing in every country, especially because of Internet on the smartphone. Unfortunately, this tool is often neglected or underutilized by volunteers and professionals working in the dementia awareness and caregiving domain. Our current methods of reaching out families affected by dementia are unable to cover many segments of society, and the Internet is a tool we cannot afford to neglect any more.
This presentation was made in the Asia Pacific Regional Conference of Alzheimer’s Disease International, held on 7-9 November, 2014, India Habitat Centre, New Delhi, India. It discusses the possibilities and limitations of using the Internet to make information available and also to support families coping with dementia. It covers topics relevant to persons considering whether and how to use the Internet. These include content creation approaches and criteria, and how to increase the reach of online resources and services. The talk also covers aspects like community building, maintenance of online material, and how online resources can complement other modalities used for awareness and support. The presentation briefly discusses how organizations can approach the project of developing online resources.
Geron 2014: Caregiver Issues and Challenges by Swapna Kishore (Kolkata, India)Swapna Kishore
Caregivers: Issues and Challenges Faced--- A caregiver perspective presented on Sept 6, 2014, as part of the theme symposium at GERON 2014, the 10th Annual National Conference of the Indian Association for Geriatric Mental Health, held at Kolkata, India.
If you are concerned about dementia home care, also see the pages at: http://dementiacarenotes.in/caregivers/
Dementia Support Group (In-person): Draft Approach/ Guidance Document Swapna Kishore
This detailed draft document for persons who may want to set up an in-person support group.Caregivers need support, and one very important mechanism is a support group where caregivers can meet and talk face-to-face (an in-person support group), or they can discuss a topic with an invited expert, or learn some important skill. This detailed draft document is intended for persons who may want to set up an in-person support group. Feedback/ comments may be sent to cyber.swapnakishore@gmail.com
Dementia Home Care: Context and Challenges in IndiaSwapna Kishore
Most dementia care in India happens at homes and is provided by family caregivers. Volunteers and other concerned persons need to understand the realities of dementia home care in India to be able to provide suitable help and suggestions, while remaining sensitive and respectful of what families achieve in face of so many challenges.
Read discusssions on handling dementia home care in India at: http://dementiacarenotes.in/caregivers/
Trained attendant orientation note for dementia careSwapna Kishore
Families looking after dementia patients at home usually need to employ an attendant who will help them look after the patient. However, in India, it is very difficult to get a trained attendant who understands dementia and what its care involves. This note is a orientation note for dementia care that can be used by family caregivers who want to make sure the attendant they employ understands what to expect and how to help the patient.
Read a detailed discussion on using trained attendants for dementia home care at: http://dementiacarenotes.in/caregivers/toolkit/using-trained-attendants-for-dementia-home-care/
Introducing the caregiver role to persons new to it. Explains what caregivers need to understand about the disease, the impact caregiving may have, and how to plan for caregiving, coordinate it, set up systems for it, manage it, and also nurture oneself.
Read about caregiving at: http://dementiacarenotes.in/caregivers/
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Scope of this presentation
2
In this presentation, we provide an overview of
dementia:
• basic facts about dementia and its prevalence
• how dementia affects patients and people around them
• how we can help reduce the patient distress and
caregiver burden
Note: This presentation was prepared for use by persons conducting dementia awareness programs in
India. It can also be used by laypersons to get an initial understanding of dementia. While it contains
information useful for anyone interested, it includes data and examples from India. This material is not
a substitute for medical advice.
3. How familiar are you with...
(symptoms, causes, treatment)
3
Diabetes
Heart attack
Asthma
Kidney failure
Arthritis
Cancer
Stroke
It is likely that you have heard of most of these diseases, and are
familiar with the symptoms or impact of the diseases
4. How familiar are you with...
(symptoms, causes, treatment)
4
Dementia
Alzheimer’s
Fewer people are familiar with “dementia” or “Alzheimer’s Disease”,
their symptoms and treatment. However, dementia is prevalent, and
on the rise in all countries, and impacts both patient and family
adversely for many years.
5. When we see strange behaviour
(especially in the elderly)
• Repeats himself/ herself?
• Seems paranoid, suspicious, agitated for no reason?
• Keeps forgetting?
• Withdraws from people? Seems depressed?
• Seems confused?
5
Do you think they are all normal
ageing related difficulties?
6. What is Dementia
• Dementia is a general term used for progressive loss of brain
functions that affect the ability to live and increase
dependence
• Dementia is NOT part of normal ageing
• Dementia causes memory loss
• It affects thinking, speaking, and making decisions
• It interferes with the ability to perform normal activities of daily
living (shopping, handling finances, driving, personal hygiene)
• Persons start behaving differently (includes insomnia,
wandering, apathy, and aggression)
• In its final stages, dementia makes the patient fully dependent
6
7. Types of dementia
There are many diseases that cause the group
of symptoms called “dementia”
• Alzheimer’s, Vascular, Frontal lobe, Lewy Body,
and other such irreversible dementias are due
to physical changes in the brain.
• Alzheimer’s Disease is the most common
cause of dementia (50-75%)
• Dementia can also occur after strokes, or
because of other abnormalities in the brain
• A person can have more than one type of
dementia
• Some causes of dementia respond to treatment
(Vitamin B12 deficiency, hypothyroidism,
depression)-these are called reversible
dementias
7
Vascular
Alzheimer’s
Others
(Illustrative figure only; proportions do not
represent % of various types of dementia)
Persons
with
dementia
Persons
whose
dementia is
caused by
Alzheimer’s
Disease
8. Who gets dementia
• Dementia knows no social, economic, ethnic or
geographic boundaries. Dementia has struck some
of the most intellectual and active persons:
– Physics Nobel Prize winner 2009, Charles Kuen Kao
– US ex-president Ronald Reagan, UK ex-Prime Minister,
Margaret Thatcher
– Authors Iris Murdoch, Terry Pratchett
• Typical onset is after the age of sixty-five, but in
some cases dementia is seen in people in their 30s,
40s and 50s
8
9. Dementia: prevalence
• Worldwide, one new case of dementia every seven seconds.
• U S A statistics: Alzheimer’s Association Report, 2010:
• Alzheimer’s disease was the seventh-leading cause of death across all
ages in the United States in 2006.
• It was the fifth-leading cause of death for those aged 65 and older.
• More than 20 percent of women reaching age 65 ultimately developed
dementia (estimated lifetime risk ) (17% of men).
• In India, the dementia population in 2010 was estimated as 37
lakhs (3.7 million) (as per the Dementia India Report 2010)
• As life expectancy goes up, so does the impact of dementia on
the population
9
10. 10 Warning Signs
• Memory changes that disrupt daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, work and leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality
(From Alzheimer’s Association, http://alz.org)
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11. The Diagnosis of Dementia
• If you suspect dementia in yourself/ someone else,
consult your GP, or a neurologist in any major
hospital. Memory clinics are also available
• What the neurologist may do:
– Understand your problems, current health, medical history
– Do a neurological evaluation, check your memory,
orientation, mental abilities by using tests (asking
questions, making you draw/ write something)
– Do blood tests to detect and treat reversible problems like
hypothyroidism, vitamin B12 deficiency
– Do brain scans (MRI, CT Scan, PET Scan)
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12. Understanding the role of neuron connections
Game: Pass the packet
• Pass a packet (in the audience) from one end of the room to
another, without anyone getting up. Note the time it takes for
the packet to reach the end of the room.
• Now identify some characteristic that only half of the audience
share (for example, people wearing spectacles). Repeat the
“pass the packet”, but this time, only people meeting that
characteristic may participate in passing the packet. Note the
time it takes for the packet to reach the end of the room.
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13. Understanding the role of neuron connections
• When you compare the time taken by the two “pass the
packet” games, as per the last slide, you will note that the
second game took longer. This seems obvious, because the
second time, fewer people were able to pass the packet, and
the person passing the packet had to spent time figuring out
whom to next pass the packet to.
• Our brain is a network of neurons. When we lose neurons
because they die/ get damaged, it is more difficult and slower
for our brain to process messages.
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14. The Brain
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What does the
brain do?
Image courtesy: ADEAR (Alzheimer’s Disease Education and Referral Center, http://www.nia.nih.gov/Alzheimers/Resources)
15. If your brain doesn’t work…
• What activities are possible without the brain?
15
16. Activity: Role Play
• Think of an activity you do every day.
• What are the steps involved?
• What happens if you forget one step?
• Examples of activities you can think about:
– Making tea
– Brushing your teeth
– Driving
– Talking on the phone
– Reading the newspaper
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17. The Brain
• Without the brain, you cannot:
– Remember anything
– Think, talk, listen, see
– Use any part of the body
• Examples of problems faced if the brain is not functioning properly
– Forgetting names of people
– Forgetting where you are or what you want to do
– Not noticing when it is hot or cold
– Not being able to balance/ walk properly
– Forgetting steps in daily activities
• You may brush your teeth but forget to rinse your mouth
• While making tea, you may forget to light the stove to boil the water
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18. Physical damage in Alzheimer’s Disease
(AD)
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Pre-clinical
Mild
to
moderate
Severe
Note how the brain shrinks
as the disease progresses
Image courtesy: ADEAR (Alzheimer’s Disease Education and Referral Center, http://www.nia.nih.gov/Alzheimers/Resources)
Dementia is the name given
to a set of symptoms related
to progressive loss of brain
function. Alzheimer’s
Disease is the most common
cause of dementia.
19. Healthy brain versus Alzheimer’s brain
19
Image courtesy: ADEAR (Alzheimer’s Disease Education and Referral Center, http://www.nia.nih.gov/Alzheimers/Resources)
Pet Scan of
Normal Brain
Pet Scan of Alzheimer’s
Disease (AD) Brain
20. The neurons are damaged
20
Image courtesy: ADEAR (Alzheimer’s Disease Education and Referral Center, http://www.nia.nih.gov/Alzheimers/Resources)
21. Dementia is NOT the same as normal
ageing
21
Normal Elder Dementia Patient
may forget part of an experience forgets entire experiences
remembers the experience later usually does not remember even later
understands written/ spoken directions slowly loses ability to understand any
directions
can use reminder notes loses ability to use reminder notes
can take care of himself loses the ability to take care of himself
22. Dementia affects…
• Memory
• Insight
• Ability to Plan
• Information Processing
• Ability to Reason or Learn New Ideas
• Language Skills
• Filtering Systems
• Orientation & Spatial awareness
• Pain Perception
• Tolerance to Stress
• Control Mechanisms
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23. Dementia Behaviour
• Patient behaviour changes because of dementia problems
– Patients cannot understand what is being said
– They respond differently to situations
– Often, they show strong emotions like frustration, rage, and withdrawal
• Sometimes, the patient’s behaviour can harm the patient
and/ or the people around the patient. This may happen
because some need (physical, emotional) is not met.
• To prevent/ handle such behaviour, caregivers have to
– Learn how to talk to patients and how to help them
– Notice triggers than agitate/ upset patients and remove them
– Adapt the homes so that they are suitable for patients
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24. Caregiver skills: Communicating
• Communicating strategies should take into account the
reduced mental abilities
– Use simple sentences, simple words.
– Give only one instruction at a time
– Use gestures, if necessary (point out, wave hands).
– Do things that remind patient where she is and what she is doing or
should do. Let patient imitate if possible
– Give patient time to understand, and if necessary repeat. Do not get
irritated
– Do not question or contradict the patient, or get agitated
• Remember, patients may not understand the words, but they
sense the expressions and mood, and know if you are
irritated and angry.
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25. Caregiver skills: Useful tools
• Use routines- they give patients a sense of comfort
• Stimulate them to the extent that they find enriching
• Validation: When patients get agitated, say wrong things,
complain--understand the underlying reason and address that
• Distraction often works
• Help patients stay oriented with their surroundings by cueing
them about place, time, names, etc.
• Adjust environment to make it less threatening (add signs,
reduce visual clutter, remove TV, mirrors)
• Use games, labelled albums, music, aromatherapy
• Many tools and tips are available in caregiver forums, where
caregivers share situations and creative solutions
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26. Caregiver skills: Handling challenging
behaviour
• Identify behaviours of concern
– Focus on things that can harm patient, caregiver, society
• Find triggers
– Use knowledge of patient, the activity that triggered
behaviour, the environment, the type of communication,
and the state of the patient health to do this
• Use creativity to define and implement a strategy
• Check effectiveness of strategy, and fine-tune it
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27. Stages of Dementia
• There are three stages in Dementia.
– Early or Mild
– Middle or Moderate
– Late or Terminal stage
• Dementia may last anywhere from a couple of years to as
long as over a decade. It cannot be cured, and keeps getting
worse.
• Death is usually due to co-morbidities
• Understanding the stages of dementia helps us plan for them
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28. Early stage of dementia
• The patient
– Faces short-term memory problems
– Is unable to do complex things (like planning a party)
– Is unable to learn new things
– Often gets disoriented about date, place
– May wander
– Often gets frustrated, repeats things, gets angry, violent
– Acts suspicious, angry, restless
– May withdraw from activities (as lacks confidence)
• A lot of small things keep going wrong
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29. As dementia progresses...
• The patient
– Often forgets recent events, remembers distant past better.
– Is confused about time and place
– Wanders out, gets lost
– Sees or hears things that are not there
– Become very repetitive
– Often neglects personal hygiene and appetite
– May act irritable, anxious, self-centered, inflexible
– May become passive and withdraw
– Needs help in various activities, like:
• Bathing and hygiene, toilet, wearing clothes, combing hair,
walking, getting up
– May sometimes lose control over urine/ bowels
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30. Final stage of dementia
• The patient
– Is unable to recognize family members
– Is unable to talk, does not understand anything
– Sleeps most of the day, seems unaware of surroundings
– Becomes bed-ridden, totally dependent
– Has difficulty in swallowing—food goes into lungs, or patient chokes
– Gets infections easily
– Becomes incontinent (loss of control on bladder, bowels)
– Is withdrawn, insecure, may feel threatened most of the time.
• The goal of caregiving is comfort
Unlike many other conditions, dementia often involves a
long goodbye
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31. Some Medical Facts about Dementia
• Dementia is NOT infectious
– (you cannot “catch” it like you catch a cold)
• It usually affects older people (> 65 years)
– “early onset” happens if it affects people < 65 years, such
as 30, 40, 50. This is still rare
– As many diseases can cause dementia symptoms, the risk
factors vary.
– For Alzheimer’s Disease, family history increases risk/
probability, and so do some genes (like ApoE4 ). Very few
cases are caused by “deterministic” genes running in a
family; For details, see:
http://alz.org/alzheimers_disease_causes_risk_factors.asp
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32. Some Medical Facts about Dementia
• Only a few causes of dementia are reversible
• Most dementias are irreversible. As per current
medical knowledge:
– There is NO known prevention
• though good diet, exercise, and keeping the brain active might
delay symptoms
– There is NO cure
• Some medicines can partly delay some symptoms (not stop
progression), especially if given in early stages of the dementia
– The progression of such dementias CANNOT be stopped
• The patient will keep getting worse, till he/ she stops understanding
everything and is bed-ridden
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33. What may help delay…
Doctors suggest normal good health practices, such as
• Eat healthy diet (include fruits, vegetables)
• Exercise
• Keep brain active (no TV)
• Stay free of lifestyle diseases (High BP, diabetes, etc)
• Maintain an active social life
• Stay stress free
AND
• protect the head from injury
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34. Dementia Awareness in India
Dementia awareness is very poor in India. Some comments
from studies done in India:
• Family members speak of weak brain, when they speak of it at all. They
say it is natural phenomenon, as old age.
• People believe Dementia is associated with, indeed, caused by family
neglect.
• When outsiders see patient yelling and wandering, and hear accusations
of mistreatment, they say this is a ‘Bad Family.'
• A caregiver quote: 'Family members think we are the cause for his illness -
they think we deserve all that is happening to us.’
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Caregivers must handle social stigma and blame in
addition to disturbed behaviour of the patient
(Source of some quotes: http://www.alz.co.uk/1066/qualitative_studies.php)
35. Multiple Facets of Dementia Care
• Research in dementia causes, treatments, risks, and in caregiver
intervention effectiveness
• Spreading dementia awareness to enable earlier diagnosis and
better support for patients and caregivers
• Ensuring availability of resources for diagnosis and treatment
• Providing financial aid: Dementia care often means loss of income
for patient and caregivers. Financial problems are often faced.
• Caregiving support: The patient’s wellbeing depends on the ability
of caregivers to look after them.
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Dementia is on the rise. More and more people are affected
as patients and caregivers. We need to support dementia
care through policies, facilities, and volunteer work.
36. Multiple Facets of Dementia Care
• Caregiver support: Caregivers can be supported
in multiple ways, such as
– Training in caregiving skills
– Support through support group meetings
– Facilities like respite care and day care
– Trained nurses and attendants to ease the work and stress of
home-based care for patients
– Home-based medical/ nursing services
– Counseling and support for tough decisions that end-of-life cases
involve, such as palliative care decisions
– Dementia-care homes for patients who cannot be cared for at
home
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37. The role of a caregiver
The caregiver role is critical for dementia care. We need to
understand how deeply a dementia patient affects the family
around him/ her.
– People caring for dementia patients may get sad or tired or upset
– People looking after their parents (who have dementia) may not spend
enough time with their own children
– The family may not be able to take holidays, talk, go for movies
– Because of poor awareness of dementia,
• the condition and its cause may not be diagnosed early
• outsiders may think the problems are because of neglect, and they
may blame and criticize
• there may be fights and blame-games within the family
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38. What caregivers can do
• As a caregiver
– Understand that the behaviour is because of dementia, and do not get
upset when the patient acts strangely
– Learn ways to talk to the patient, or handle problems like agitation
– Avail of community support to share tips and reduce overwhelm
– Do things with the patient that are fun (reading stories to the patient,
seeing albums together, going for walks). Think of ways to help the
patient remember things
• Remember, if the patient is less agitated/ helpless, caregiving
is easier and more pleasant
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Every patient is different in how fast dementia
progresses, and the order of what gets affected
39. What friends/ relatives/ neighbours can do
• As people around the caregiver
– Help the main caregivers take a break and
understand their moods
– Run errands for them
– Provide them emotional support
– Do not make too many demands on the main
caregiver
– Do not criticize
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40. If you are concerned about
dementia, you can...
• Join dementia awareness activities, such as walks
• Talk to others about dementia and caregivers, and help
spread the “voices” of patients and caregivers
• Raise funds for/ do volunteer work in facilities that help
patients and caregivers, such as day care, respite care.
Helplines
• Get trained as a counsellor to support patients and caregivers
• Participate in drug trials/ fund research
• Support and lobby for policies to help the cause of elder care
and dementia
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41. Summary
• Dementia is the progressive loss of brain functions that affects the
ability to live and increase dependence.
– It affects memory, the ability to understand and talk, and the ability to do things.
– Many diseases can result in the dementia symptoms (Alzheimer’s Disease is
the most common)
– Dementia usually (but not always) affects older people, but it is not a normal
part of ageing
• Medical science is not certain about its causes or prevention
– There is no cure for it
– Remaining active and living healthily are recommended to reduce risk
• Caring for a dementia patient is very challenging.
– Caregivers have to learn about dementia and caregiving skills
– They often make major adjustments in their lives, including giving up jobs
• We can help by supporting patients and caregivers and volunteering
for projects such as awareness campaigns and fund raising
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