Effectiveness of Recovery-Focused Mental Health Care of Older People With Memory Problems

Introduction Dementia is a syndrome due to disease of the brain, usually of a chronic nature, in which there is disturbance of multiple higher cortical functions including Memory, Comprehension, Thinking, Judgment, Orientation, language and communication skills and abstract thinking. It is one of the most challenging disorders both in terms of prevalence and economic burden. There are currently approximately 800,000 people with dementia in UK and national cost is 17 billion per year. It is estimated that in next thirty years, number of people with dementia will increase to 1.4 million and the national cost will be over 50 billion. The exceptional advances in modern medicine in terms of prolonging life expectancy do not necessarily improve the care delivered to people with dementia. Dementia is a progressive condition where clinical recovery is not possible despite the discovery of cognition enhancing drugs. This belief leads to low expectations that tend to erode hope and foster indignity. Advances in treatment of Alzheimer’s disease have, however, stimulated new thinking and methods of service delivery. At certain stage of their illness, if not from the very beginning, personal, and social recovery becomes more meaningful for service users than their clinical recovery. Objective To investigate whether recovery-orientated psychiatric assessment and therapeutic intervention enhances the wellbeing of people with memory problems and their family carers. Method This study was a preliminary randomised control study. Patients were randomly allocated to recovery focus group or treatment as usual group acting as the control. Participants in the recovery focus group received a recovery-focused pre-diagnostic wellbeing assessment and counselling, diagnostic consultation with written feedback and post-diagnostic support over a period of six months. Participants in both groups were assessed using the WHO Wellbeing Index (WHO-5) as the primary outcome measure. The Mini Mental State Examination, Cornell Scale for Depression in Dementia, EuroQol-5D and Zarit Burden Interview were used as secondary outcome measures. Written records of the narrative accounts of participants in the recovery focus group were also obtained. Results 48 patients with early dementia were recruited and agreed to take part in the study. Out of these, 34 patients completed the study, of which 17 patients were in the recovery focus group and 17 patients were in the treatment as usual group (control).There was a significant difference between the groups in terms of greater improvement in wellbeing as rated by the WHO – 5 Wellbeing Index in the recovery focus group compared to the control group. The secondary outcome measures in the areas of cognition, quality of life and caregiver burden showed no differences between the groups. However, case histories from the recovery focus group identified the main areas of improvement in improved mood, increased social interaction, reduction in carer strain and / or burden and improved self-worth and / or confidence. Conclusions This study shows that recovery focused care can enhance the wellbeing of people with mild to moderate dementia. The additional benefits perceived by the patients and their relatives /carers include improvement in mood symptoms, social interaction and confidence as well as reduction in carer burden and strain

Non availability of antiepileptic medications

It was the best of times, it was the worst of times” quoting Charles Dickens, I feel living in an era very similar to those times, with an ever widening gap between the different economical classes in our society. With the relative improvement in Health services across Pakistan may over the last 70 years and the absolute disastrous growth of 2.4% in population within the last decade, there is still a lot of disparity between the health care demand and supply for common man.

Post Herpes NMDAR Encephalitis in A 8 Month Old Girl

Patients with Herpes Simplex virus Encephalitis are seen to have a relapse of symptoms namely seizures and choreoathetoid movements along with impairment of consciousness1. Though infective relapse is a possibility requiring extended antiviral therapy2, immune mediated mechanism is most probable.3 Although there is a similarity of symptoms between relapsing HSVE and N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis, the most likely culprit is the latter

An unusual presentation of neurononopathic gauchers disease.

A six years old male child presented with tremor, ataxia, speech apraxia, supranuclear gaze palsy and hepatosplenomegaly. There was no history of seizures and psycho-cognitive abnormalities. The clinical and bone marrow findings were consistent with Gaucher\u27s disease type 3. KEY WORDS: Gauchers disease, Enzyme replacement therapy, Gene therapy, Bone marrow transplant

Experimental study of electrical heating to enhance oil production from oil-wet carbonate reservoirs

New approaches for enhanced oil recovery (EOR) with a reduced environmental footprint are required to improve recovery from mature oil fields, and when combined with carbon capture and storage (CCS) can provide useful options for resource maximisation during the net zero transition. Electrical heating is investigated as a potential EOR method in carbonate reservoirs. Samples were placed in an apparatus surrounded by a wire coil across which different DC (direct current) voltages were applied. Monitoring the imbibition of both deionized water (DW) and seawater (SW) into initially oil-wet Austin chalk showed that water imbibed into the rock faster when heated in the presence of a magnetic field. This was associated with a reduction in the water–air contact angle over time measured on the external surface of the sample. Without heating, the contact angle reduced from 127° approaching water-wet conditions, 90°, in 52 min, while in the presence of heating with 3 V, 6 V, and 9 V applied across a sample 17 mm in length, the time required to reach the same contact angle was only 47, 38 and 26 min, respectively, while a further reduction in contact angle was witnessed with SW. The ultimate recovery factor (RF) for an initially oil-wet sample imbibed by DW was 13% while by seawater (SW) the recorded RF was 26% in the presence of an electrical heating compared with 2.8% for DW and 11% for SW without heating. We propose heating as an effective way to improve oil recovery, enhancing capillary-driven natural water influx, and observe that renewable-powered heating for EOR with CCS may be one option to improve recovery from mature oil fields with low environmental footprint

THE ROLE OF ACALYPHA INDICA LINN. EXTRACT ON HEART RATES WITH MYASTHENIA GRAVIS RAT MODEL

  Objective: Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction (NMJ) caused by antibodies that attack components of the postsynaptic membrane, impair neuromuscular transmission, and lead to weakness and fatigue of skeletal muscle. Acetylcholine is also used as a neurotransmitter in the autonomic nervous system. Striated cardiac muscle can be a target for immune attack manifesting as heart failure, arrhythmia, and sudden death. Involvement of the heart rate (HR) has been claimed and reported, but a causal connection between MG and altered cardiac function has not been found.Methods: For this study of experimental autoimmune MG (EAMG) is used rocuronium, prostigmine, and Acalypha indica (AI) Linn. compared with HR.Results: From the results, the study found that sympathetic activity of HR variability in EAMG injected with rocuronium 10 mg/kg body weight (BW) in 10 min significantly found increasing in measures of short-term variations in HR variability, indicating parasympathetic impairment.Conclusion: We conclude that in MG, cholinergic transmission is affected more diffusely than previously thought. Furthermore, AI was given orally 30 mg/kg BW has an effect similar to the injecting of prostigmine 10 mg/kg BW that can reduce HR. Driven by the fact that the pharmacological treatment of MG is unsatisfied, it needs the therapeutic development for MG using herbal ingredients of AI. This means that the AI compositions containing anti-MG whose composition should be investigated for the next research

The validity and precision of the leicester cough questionnaire in COPD patients with chronic cough

Background: A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated for a population of general patients presenting with chronic cough. We examined the psychometric performance of the LCQ in patients with COPD and chronic productive cough. Methods: Concurrent validity, internal consistency, reproducibility and responsiveness were determined. The St. George's Respiratory Questionnaire (SGRQ) and the Short Form-36 (SF-36) were used as external criteria. Questionnaires were completed at the start of the study. After 2 and 12 weeks the LCQ was repeated, together with a global rating of change. Results: In total 54 patients were included. Concurrent validity analysis showed significant correlations between corresponding domains of the LCQ and the SGRQ (r(s) - 0.31 to - 0.60). Corresponding domains of the LCQ and the SF-36 showed weaker correlations (r(s) 0.04 to 0.41). Internal consistency was adequate for two of the three domains (Cronbach's alpha 0.74 - 0.86). Test-retest reliability in stable patients was high (intraclass correlation coefficients 0.79 - 0.93). The mean difference after two weeks was 0.73 (+/- 1.75). Responsiveness analysis indicated that the LCQ was able to detect changes after 12 weeks. Conclusion: The LCQ is a valid, reliable, responsive instrument to measure health status in COPD patients with chronic productive cough

Non-Target Screening Method for the Identification of Persistent and Emerging Organic Contaminants in Seafood and Sediment from Jakarta Bay

Identification of persistent and emerging organic contaminants in green mussels (Perna viridis), various fishes, banana shrimp (Penaeus merguiensis) and sediment samples from Jakarta Bay has been employed. A non-target GC-MS screening approach has identified more than 60 individual organic compounds from the whole fractions either non-polar, semi-polar or acidic-polar compounds. The substances comprised as persistent organic pollutants (POPs) including DDT (dichlorodiphenyl trichloroethane) and its metabolites as well as high molecular weight polycyclic aromatic hydrocarbons (HMW-PAHs). Noteworthy, a number of emerging contaminants detected in the present study have never been reported previously either from the same location or from Asian waters. They include some priority contaminants of non-persistence halogens and emission of technical products, such as di-iso-propylnaphthalenes (DIPNs) dichlorobenzene (DCB), dichlorodiphenyl chloroethene (DDMU) and phenylmethoxynaphthalene (PMN). In general, the concentration order of the priority organic contaminants was sediment > green mussel > fishes > shrimp. Further analysis based on the spatial distribution, individual concentrations and bioavailability suggested that some contaminants are applicable as molecular marker for the assessment of anthropogenic emission in Jakarta Bay, i.e. DIPNs, linear alkylbenzenes (LABs), phenylmethoxynaphthalene (PMN), PAHs, dichlorobenzene, DDT and its metabolites

Potential Risk of Organic Contaminants to The Coastal Population Through Seafood Consumption from Jakarta Bay

A comprehensive study on exposure assessment of the priority organic contaminants via seafood consumption has been conducted to the coastal population of Jakarta Bay. Seafood is essential food source in Indonesia and also important income for the majority of coastal populations. A number of 152 respondents from 4 districts surounding the bay were interviewed to record their frequency and pattern on seafood consumption. In the same time, 13 seafood species were collected directly from Jakarta Bay during the dry and wet seasons for the assessment of organic contaminants. A non-target GC/MS screening identified more than 40 organic contaminants in which 6 of them are potentially considered as priority contaminants including 3 groups of carcinogenic contaminants i.e. dichlorodiphenyl-trichlorethane (DDT) and its metabolites (DDXs), dichlorobenzenes (DCB) and carcinogenic PAHs (PAH4). Further exposure analysis suggested cumulative health risk of these contaminants was less than official minimal risk level (MRL) and therefore categorized safe for the corresponding population. However, attention must be paid since additional exposure of either from the different food category or other exposure route may contribute to significantly elevate the health risk on the population as well as potential exposure of emerging contaminants