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Transcript
Our Grateful Thanks
to:
C-14, Qutab Institutional Area, New Delhi - 110016Phone : 011 4203 0400
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It is said that one of the worst events that can happen in anyone of our lifetime is an inability to recollect. Recollect those very precious moments, celebrations of life, friends, relatives; this happens so slowly and subtly that by the time we realize it is often too late. Not uncommon is the presentation behavioral as only when behaviors is impaired do caregivers bring the person to the doctor. The memory issues have to be dug out by the doctor. As a neurologist the first reaction I often see is a denial, many have delayed and denied treatment because of this denial. Alzheimer's is something that happens to other not my parent/ spouse. This is sad as in doing so treatment and cognitive therapies are delayed and pushed to the periphery. Life goes on. They worsen and when they become incontinent to urine and stool is the second time around when the caregivers bring the person again. By then it is to late just so late.
Today, on this World Alzheimer's Day, my message is to all of us who are aging that any memory complaint, personality change, change in subtle things that the elderly have been doing for their entire life must be bought to the notice of the neurologist. Just as blood pressure is measured so the memory and psychological assessment needs to be done, Treatable entities need to be managed.
There are several friends and support groups like the ARDSI – Delhi chapter. Our team stands by in offering counseling and home visits for those who need help. We also have a day care facility and a chronic care facility where we are able to offer some change and quality time to persons with dementia.
It is imperative that many more such facilities are established.
For all of us that are aging it is necessary to add and choose the correct lifestyle changes as will be discussed from a good diet, stress free environment, healthy life choices, learn new things and be flexible in life.
Dr. ManjariTripathiPresidentARDSI – Delhi Chapter
Remember we can remember now and that this is the window period to fly free. Wish you all a health happy life .
Message
Dr. Manjari TripathiPresident
The Alzheimer’s & RelatedDisorder Society of IndiaARDSI-Delhi Chapter
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I am happy to learn that the Delhi Chapter is continuing its tradition of bringing out a souvenir on the occasion of World Alzheimer's Day this year too.
ARDSI has grown in stature and delivery of services over the past 20 years. And the credit for this should go to the chapters who are providing guidance, training and care services in different parts of India. This has enabled the society to raise the profile of dementia in the country. Our next major target is to impress upon the central government to come up with a country plan for addressing the needs and requirements of persons with dementia and their families. The Kerala State Initiative on dementia is a pioneering model of state private partnership to provide comprehensive support to persons with dementia in the state of Kerala. It is also an ideal concept to be replicated in other states.
I would like to congratulate the Delhi chapter for the fine work they are doing in the capital city and the day care centre run by them is one of the models for other chapters to emulate. They are blessed to have a wonderful group of volunteers and the dynamism of their President has contributed to the success of their activities.
Alzheimer's Disease International has decided to have the same theme 'Remember me' that we had last year. I am confident that the Delhi chapter will observe this theme by holding several events so the message is disseminated far and wide and reaches the common man.
All the best and keep up the good work!
MeeraPattabiramanChairpersonARDSI
Message
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Friends,
I send you greetings from my new home in "Samarkand" located in Santa Barbara, Ca.
As a message, I would like to share contents of a letter from the Alzheimer's Association International Conference, 2016 with prominent persons of the dementia research community, contributing their latest findings.
Novel research from Canadian scientists on the shared and separate causes of, markers for, and progression of Parkinson's and Alzheimer's could help identify new ways to treat the diseases.
An innovative program in Australia has reduced the use of antipsychotic drugs in dementia treatment in long-term care settings; in the United States, one-quarter of dementia patients are inappropriately treated with drugs that cause sedation.
A new American study suggests that treating people with Alzheimer's disease may increase survival and incur less overall cost of care than non-treatment.
'Samarkand' has a special residential unit for persons with dementia and Alzheimers. I will be happy to send ARDSI, details on the activities here for general information.
As you know, my thoughts and prayers are always with the programs in India.
With best wishes and blessings!
Nirmala M NarulaPresident Em ARDSI,Formerly President ARDSI-DC
Message
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Programme
September 21, 2016Gulmohar Hall, India Habitat Center
6:15 pm Refreshments
6:45 pm Welcome by Mrs. Renu VohraSecretary - ARDSI - Delhi Chapter
6:50 pm Release of Souvenir by Dr. Manjari TripathiPresident, ARDSI – Delhi ChapterProfessor Neurology, AIIMS
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Release of Book “VISMRIT – A Journey through Alzheimer's” Authored by Bina Berry
7:00 pm Talk by Dr.Vinod Kumar, MDEmeritus Professor and Senior Consultant in Medicine, St. Stephens Hospital“Healthy Ageing Beyond Health”
7:30 pm Talk by Shri Santosh Yoga“Yoga & Meditation for Mental Health"
7:40 pm Interactive Session Panellists :- Dr.Vinod Kumar, Dr. Manjari Tripathi& Dr. K. S. Anand, Professor of NeurologyHead of Department, RML Hospital
8:00 pm Vote of Thanks, Mr. S.N. KuckrejaVice President, ARDSI – Delhi Chapter
ARDSI
World Alzheimer's Day
The Alzheimer's & Related Disorders Society of India
September, 2016
President : Dr. Manjari TripathiProf. Department of Neurology
Vice President : Mr. S. N. Kuckreja
Member Secretary : Mrs. Renu Vohra
Treasurer : Wg Cdr Y. P. Singh
Members : Smt. Nirmala M. NarulaPresident (Emeritus) ARDSI
Dr. K. S. Anand
Dr. Mala Kapur Shankardass
Ms. Bina Berry
Mrs.Veena Sachdeva
Mrs. Reva Puri
Permanent Invitee : Dr. Vinod Kumar(Being Founder President) President (Emeritus) ARDSI
Special Invitee : Mr. M. M. SabharwalPresident (Emeritus) HelpAge India
Executive Director : Col. (Retd.) V.K. Khanna
ARDSI National Office
Chairman : Mrs. Meera Pattabiraman
President (Emeritus) ARDSI : Smt. Nirmala M. Narula
President (Emeritus) ARDSI : Dr. Vinod Kumar
Executive Director : Mr R. Narendhar
Hon Vice President, ADI : Dr. K. Jacob Roy
For more information contact:
(ARDSI), Delhi ChapterRZ – 62/9 Tughlakabad Extension, New Delhi – 110019
Helpline : 011 – 2999 4940, 6453 3663E-mail : [email protected] Website : www.alzheimersdelhi.org
Governing Body Members, ARDSI – Delhi Chapter
ARDSI – National Office
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Alzheimer's & Related Disorders Society of India (ARDSI), Delhi Chapter
Members rendering voluntary services to the organization:
1. Mr. S. N. Kuckreja 2. Wg. Cdr. Y.P. Singh
3. Mrs.Renu Vohra 4. Mrs. Veena Sachdeva
5. Mr. Bharat Mahey 6. Dr. Amita Rani Gupta
7. Mrs. Gita Das 8. Mrs. Poonam Verma
9. Mr. Vijay Seth 10. Mrs. Om Dhawan
11. Mr. Ashok Wadhwa 12. Mrs. Maya Misra
13. Mrs. Sheena Jaiswal 14. Mrs. Ranita Ray
15. Mr. Sanjeev Nath 16. Mrs. Reva Puri
17. Ms. Bina Berry 18. Mrs. Saran Maini
19. Mrs. Nutan Bhargava 20. Dr. Nita Kumar
21. Mr. Avinash C. Jain 22. Mrs. Shirin Sen
23. Mr. R. N. Grover 24 Mrs. Renu Malhotra
25. Mrs. Usha Dave 26. Mrs. Sushma Khanna
27. Mr. Deep Bajaj 28. Mrs. Anju Lowe
29. Mrs. Rita Bhalla 30. Ms. Kavita Mehra
31. Ms. Jyotika Dhawan 32. Mrs. Shalini Sinha
33. Dr. Nirmala Thakkar
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HE
ENILPL
FORGETFUL? CONFUSED?
For Information on
What to do
Who to see
Alzheimer’s HelplineTel : 29994940, 64533663
Email: [email protected]
elping individuals, families and caregivers
ducating callers on different aspects of dementia
istening to concerns of callers
roviding information on treatment and caregiving
inking families with community resources
nforming callers of our chapters and other support services
etworking with families and professionals
asing their anxieties by comforting them on line
The Alzheimer’s & Related Disorders Society of India (ARDSI)- Delhi Chapter
RZ- 62/9, Tughlakabad Extention, (Panchvati), New Delhi - 110019
Someone to stand by you
ARDSI
Annual Report for the Year 2015-2016
A Dementia Day Care Centre was commissioned at Panchvati Complex, RZ 62/9, Tughlakabad th
Extension w.e.f 17 December, 2011 as a joint project of HelpAge India and ARDSI- Delhi Chapter thas per MOU signed on 5 December, 2011 and being run for another financial year i.e, January
th2016 – December 2016 as per MOU signed on 18 January, 2016.
The MOU was to run a Dementia Day Care Centre & services in Delhi & NCR for 315 elderly and Family – A joint project of HI and ARDSI Delhi Chapter also to provide clinical and professional services viz. medical advice, Helpline, home visit, family counseling and training to caregivers.
To operationalise the Day Care Centre as per TOR, the process of hiring the staff was undertaken and over a period of time the following staff was engaged:-
(a) Technical Team - Mr.Ramendra Kumar - (Nursing Asst.)- Mrs.Shabnam - Caregiver- Mr. Sameer Teeprani - -do-- Mr.HiraLal - -do-- Mrs.SabrunNisha - Kitchen Staff- Mr. Raj Kumar - Safaiwala
Simultaneously action was taken to hire a vehicle for transportation of patients from their homes to the centre at 9:00 a.m. and back to their homes at 4:30 p.m.
Our Day Care Centre is working in full swing and has become very popular with the society and people have started relating our organization to the Day Care Centre. Thirty patients are now registered with us for the Day Care Center. Out of these thirty patients, ten are regular while others twenty come off and on. Not only this, we are receiving inquiries about the Centre almost on daily basis. This shows that people are getting to know about us, credit of which largely goes to concerted effort made by one and all and also to the electronic and print media's coverage that we received recently. We wish to increase our outreach to more and more patients.
Daily Routine of Patients
Our vehicle, accompanied by a care giver leaves our premises at about 8:30 a.m. to pick up patients from their homes and to bring them to the centre. They arrive at about 10:00 a.m. (depending upon the traffic). They are received by our care giving staff and after little rest and freshening up, the following routine is followed.
Program/Activities in Day Care Centre
l Prayer l Light exercisesl Music & gamesl Tea & refreshments l Recreational/ educational activitiesl Art & Craft Activitiesl Lunch
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l Evening tea & refreshmentsl Depart to their home
Patients vitals are checked and recorded by the Nursing Assistant everyday. Our staff is skilled to take care of the patients for their minor problems i.e. head ache, stomach problems etc.
Nutritious Diet
Patients have been advised to bring their lunch from home due to different dietary habits. However they are provided nutrients by way of fresh and dry fruits everyday along with snacks and tea by the centre.
Free Medicines
ARDSI - Delhi Chapter has over 1045 registered patients. Needy patients requiring medication are provided free medicines as per recommendations of Dr.ManjariTripathi, Neurologist, AIIMS and Dr. K. S. Anand, Head & Senior Neurologist of Dr. Ram ManoharLohia Hospital. On an average 10 patients are provided free medicines on a sustained basis, however, the maximum number of patients catered has been twelve. This helps the patients to lead a quality life despite having some form of dementia.
Home Visits of Volunteers
Home visits are made as a follow up of Helpline calls at the request of family members of patients where families are able to discuss the behavioral, medical and other related problems of patients with the volunteers and get appropriate tips to manage patients efficiently. This financial year our volunteers carried out ten home visits.
HelpLine
Service requirement of the patient is made known to us through Helpline. An exchange of 200 phone calls per month was made. Around 1000 patient's families got the appropriate information about services being offered by us and also received counseling for managing various conditions of dementia.
Research Work
Students from various universities of India and abroad, visited our chapter for their research work on Dementia. We supported them by providing adequate information and literature. We also referred number of individuals to NBRC for their research work.
World Alzheimer's Month
Interactive Session by Delhi Chapter at Community Center, Sector Alfa-1, Greater Noida
An interactive Session by Delhi Chapter was held at the Community Center attended by Senior th
Citizens of Sector Alfa-1, Greater Noida on 18 Sep, 2015. The session was conducted by Wg. Cdr. Y.P. Singh and Col. V.K. Khanna. After delivering their respective talks, they conducted Q & A Session,Mrs.GeetikaSengupta from HelpAge India was also in attendance.
Day rest
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Rahagiri (20 Sep, 2015)
An exercise for generating Public Awareness was undertaken at Connaught Place during the Rahagiri. General Public was given pamphlets on Alzheimer's and their queries on the subject were answered.
Radio Programme (21-22 Sep, 2015)
There were radio talks on FM Channels with in NCR and radio talks for national listener's by AIR. The talks were aired as follows:-
st(a) F.M. Rainbow – Good Morning India – 21 Sep 7 am to 9 am.st(b) F.M. Rainbow – Ashiana – 21 Sep 1 pm to 2 pm
nd(c) All India Radio – Health Talk – 22 Sep 21:30 hrs
stWorld Alzheimer's Day (21 Sep, 2015)
Like every year World Alzheimer's Day main event was organized at India Habitat Center. There was a gathering of more than 120 People comprising of representatives of NGO's for the elderly, doctors, staff from St. Stephens Hospital our special invitees and general public.
Current year theme “Remember Me” was depicted very appropriately by Dr.ManjariTripathi, President ARDSI – Delhi Chapter, during her lucid talk on modern thinking and latest findings about Alzheimer's Disease. She released the Souvenir of Delhi Chapter along with Mr. S.N. Kuckreja, Vice President, Mrs.RenuVohra Member Secretary and Executive Director Col. V.K.
Dr. Mala Manralgiving herpresentation on Nutrition Therapy
Our guests signing the register at reception table.
Pamphlets being distributed at Rahagiri A scene from Rahagiri
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Khanna. Ms. Mala Manral, Dietician, Neuroscience Center, AIIMS made a very exhaustive and informative presentation on “Medical Nutrition Therapy for the Prevention of Alzheimer's Disease”.
Her presentation was very well received by the audience as was evident from the Interactive Session held immediately after she concluded.
Vote of thanks was given by Vice President, ARDSI – Delhi Chapter Mr. S.N. Kuckreja.
WAD with Day Care Centre clients of Delhi Chapter
Families of our clients at Day Care Centre also celebrated World Alzheimer's Day. The family members shared their experiences about the improvements of patients and their behaviors and praised the services of ARDSI Delhi Chapter.
Founder's Day
Delhi Chapter celebrated their Founder's Day on 8 Feb, 2016. This year by organizing a picnic at Lodhi Garden. All members of the chapter, patients and their families, staff members and some guests joined the picnic. Every one thoroughly enjoyed the day.
Holi Celebration
Staff of Delhi Chapter celebrated Holi with the patients. The patients were treated to Holi Colours, Flowers and sweets one day before Holi.
Conclusion
Dementia Day Care Centre as joint project of Help Age India and ARDSI – Delhi Chapter has thbeen operational since 17 December, 2011. During the reporting year, we have 30 patients
registered out of which on an average ten persons are regularly attending the Day Care Center. Other activities like distribution of free medicines, home visits, training, interactive sessions etc., benefitted around 2000 people directly and the radio, WAD/WAM activities and TV programmes reached out to a wider audience. Though the target was of 315 beneficiaries, through this project approx 1500 people were benefitted directly and more than 10000 indirectly.
Dr.ManjariTriapthi releasing the Souvenir with Mrs. Renu Vohra and Mr. S.N. Kuckreja
Dr. Manjari Tripathi delivering her talk
Our clients celebrating World Alzheimer's Day at Day Care Center
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Is Modern Pace of Life Changing Our Brain - For the Better or Worse?
Dr. Vinod KumarEmeritus Professor, St. Stephens Hospital, Delhi
IntroductionAll of us remember our school days when we were told about many accidental or chance discoveries like Newton watching apple falling from the tree forming the basis of his theory of gravity, Archimedes' Eureka about finding new concepts of fluid dynamics or a young boy noticing a vibrating lid on a boiling pot upon which he went on to design a steam locomotive engine. Accidental as they were, their resulting final innovations were reflective of highly ingenious and thinking minds of scientists who achieved their accomplishment after years of planning and hard work. If we are to move closer to within last 30 to 40 years, many of us can recollect our parents and grandparents using finger tips for simple arithmetic calculations at home or shop without calculators or remembering telephone numbers without looking at their hard diaries. Those were the days when life was at an easy pace; there was no hurry or tension in day to day working; there were no electronic devices to click and people knew when to work and when to rest, exercise and sleep. For a moment, leave aside the thinkers and intellectuals of the past and present but consider common people of the past versus the present. How many of us can dial numbers without looking at phone directories or execute oral calculations? People born 50 years before or earlier seemed in no hurry while people of the present modern age always appear to be in a hurry. Does it mean there was more time available to older generation in their life to think and give adequate attention to a given task while the present genre of people enslaved by quick pace of modern technology have no such luxury? No doubt that progress in science and technology in the modern world is unmatched but are we raising people without innate quality of being duly attentive to ordinary daily tasks and the ones who are incapable of deep pondering and thinking that is often required over many simple matters in life.
Human MemoryMemory and power of cognition are few of the many precious gifts from Nature to man. Together with memory, understanding, comprehension, reasoningor making a decision are important cognitive requisites of human brain. If you do not give proper attention to a task and try to finish it off in great haste, you are less likely to remember the task if you were to be called upon to carry out that task again. Human brain is capable of storing and retrieving enormous amount of information and in order to keep our memory power well preserved, we have to be attentive too. Short-term memory is the information that a person is currently thinking about or is aware of. It is also called primary or active memory. Recent events and sensory data such as sounds are stored in short-term memory. Short-term memory often encompasses events over a period anywhere from 30 seconds to several days. Because short-term memories need to be recalled for a lesser amount of time than long-term memories, the ability of the brain to store short-term items is more limited. Long-term memory has much greater capacity and contains things such as fact, personal memories and the name of your third-grade teacher. The different stages of memory are handled by different parts of the brain. Short-term memory primarily takes place in the frontal lobe of the cerebral context. Then the information makes a stopover in the hippocampus and is then transferred to the areas of the cerebral cortex involved in language and perception for permanent storage.
Modern Age and MemoryToday is the age of an entirely different modern world. Stress, anxiety, depression and use of drugs for their treatment are highly prevalent. Sedentary life is rampant and sleep is scare. Calculators, computers, smartphones and other personal digital assistants rule the roost. Gone are the days when you used your
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own brain as the calculator or dialed your best friend or your own driver from your memory; rather you are now habitual of calling them daily from your phone book. Their telephone numbers have already chiseled out of your memory. Ask your friend a question or an event, chances are he will google search for you in a minute and with pride rather than stress out his brain for the answer. Don't know the way to their house? Use a GPS. All this leads to under use of brain. Modern technology has taken the strain off our brains with the answers to so many problems available at the click of a button.Albert Einstein is often given credit for the quote, “I fear the day that technology will surpass human interaction. The world will have a generation of idiots.” While there is some doubt as to whether he ever uttered these exact words, there is no doubt that technology is changing our brains — and, it's generally agreed, not for the better. There is little doubt that our habitual use of technology is causing unexpected changes. A study found that smartphones seem to have altered the shape and function of the human brain. A neuroscientist at Zurich University, has discovered that people who use touchscreen phones on a daily basis have a larger somatosensory cortex - the area of the brain which controls the thumbs. London taxi drivers show an increase in the size of their hippocampus as a consequence of rote-learning the city's streetscape. But this part of the brain, so vital to memory, may also shrink with disuse - such as relying on satnavs. There are also indications there is some shrinkage of taxi drivers' hippocampus after they retire. Many scientists warn that over-use of modern technology may be linked to memory loss and depression in later life. Growing scientific evidence suggests a future where our brains may prematurely fail in later life through under-use, thanks to Mother Nature's rule that we 'use it or lose it'. You might describe this new threat to our mental health as 'e-mentia' - memory-related problems, and even depression, linked to our overuse of new technology. Following are some of the important factors influencing brain in today's world:
MultitaskingMultitasking is the new buzzword of civilization. If multitasking was an important innate skill, there should have always been a word for it. But the term multitasking did not exist before 1965. Today, multitasking has become a national pastime. No matter where and what we are doing at a given time, we can always add one more ball to the juggling act. People driving motor cars may be regularly checking emails on their mobiles and at the same time talking on their other cell phone, pausing only to yell at other drivers. Over time, multitasking has become a seemingly necessary skill for staying competitive at work and in contact with friends and family. It's essential for preventing a new form of anxiety — FOMO, the “fear of missing out.”People now pride themselves on their ability to multitask. It's not unusual for prospective employees to list “ability to multitask” as one of their best attributes on job applications. But is it really something to brag about? Conversely, multitasking is not essential for productivity and it takes a toll on brain health and performance. Doing several tasks simultaneously may seem like the height of efficiency. In the real world, multitasking actually wastes time and reduces work quality. Missed deadlines and shoddy work may get a person fired, but they're not the most worrisome consequence of multitasking. Juggling tasks can be very stressful. In the short term, stress makes you feel lousy. In the long term, it can become a serious threat to health -- and that's not even counting the dangers of listening to an ear phone while crossing the road. A social side effect of modern technology like face book is exchange of substance that may be excessive in social content but inadequate in depth of personal relationships. Constant barrage of social messaging cannot replace the joy of meeting your loved ones in person. Face book proponents however claim unending vistas of interaction with remotest of friends.
Cognitive Costs of Multitasking
Humans are in reality serial taskers, not multitaskers. Multitasking should be regarded and handled as an addiction. Here are some of the many ways trying to multitask is counterproductive.
1. Multitasking makes you less productive. Ask anyone why they multitask and they will almost certainly respond “to be more productive.”Ironically, it's been proven over and over again that multitasking has the exact opposite effect. It is estimated that multitasking costs the United States' economy $650 billion annually in wasted productivity.
2. Multitasking diminishes your mental performance. Juggling between tasks takes a toll on cognitive
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performance. It results in reduced attention span, learning, and performance. Interrupting one task to suddenly focus on another disrupts short-term memory.
3. Multitasking makes you a poor judge of your own abilities. Just as drinking too much alcohol erroneously makes you feel funnier and more attractive, heavy multitaskers also have unrealistic opinions of their skills. Research shows that those who believe they are excellent multitaskers, in fact, are some of the worst!
4. Multitasking can turn you into a zombie i.e. a person who acts without thinking and the one who does not notice what is happening. How can you brand a multitasker zombie an intelligent guy? You have probably seen real-life multitasking zombies trying to cross the street or navigate the aisles at the grocery store. These people who talk or text while walking or driving are a hazard to themselves and others.
5. Multitasking increases stress, anxiety, and depression and contributes to premature aging. Stress of all kinds decreases the length of telomeres — endcaps on your chromosomes similar to plastic tips on the ends of shoelaces. Every time a cell divides, the telomeres get a little shorter. When they reach a critically shortened length, the cell stops dividing and dies.
Stress, Anxiety, Depression, Alcohol and Substance AbuseSignificant stress or anxiety in the modern world can lead to problems with attention and memory. This is particularly common among people who may be juggling home and work responsibilities and are not sleeping well. When people feel stressed, stress hormones like steroids get over-secreted, which affect the brain because high cortisol levels are tied to the deterioration of the hippocampus, which is the site of memory in brain. Usually, easing stress can improve memory. Untreated chronic stress can also lead to depression, which in turn could also affect brain function including short term memory. Problems of drug and alcohol addiction is likely to be more with modern day stress and both alcoholism and drug abuse can also specially affect short term memory.
Sleep ApneaThis common but treatable sleep disorder is on the rise, thanks to physical inactivity, obesity and life style disorders. It causes breathing to stop briefly and frequently throughout the night. It is linked to memory loss and dementia. You might have sleep apnea if you wake up with a headache and have daytime fatigue or if your partner complains of loud snoring. When not treated, sleep apnea affects spatial navigational memory. This type of memory includes being able to remember directions or where you put things like your keys. The research suggests that deep sleep, also known as rapid eye movement (REM) sleep, plays an important role in memory. One explanation is that for people with sleep apnea, oxygen delivery to the brain is interrupted several hundred times during the night, The brain is stressed, so people wake up, The injury sleep apnea causes can show up as a variety of memory loss symptoms.
Diseases of CivilizationThese are mostly lifestyle disorders which are rampaging in the face of sedentary life styles, faulty diets, mental stress and excessive body weight consequent upon new age civilization. These include hypertension, diabetes mellitus, high lipids, obesity, heart diseases and all contribute to impaired memory and cognition. Above all, with ongoing rapid rise in the global population of older persons it is easy to imagine a virtual explosion of dementia epidemic in the very near future.
MedicationsSleeping pills, antihistamines, anti-anxiety medications, certain painkillers, cholesterol-lowering medication like statins, diabetes medication like metformin and antidepressants which are being increasingly utilized in the clinical practice are also known to affect memory and other functions of brain.
In conclusion, it is suggested that all above factors potentially responsible for negative effects on brain need serious and timely intervention.
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How the Rent Control Act Protects Tenant Rights
Gist of this Article
If a property owner defaults on repayment of a loan, the lending bank cannot have the tenant living there evicted if the rent lease has not expired.
A lease enables the owner of a property (lessor/landlord) to grant the right of possession of the property to his tenant (lessee). The tenant gets the right to enjoy the property for a specified period of time on payment of rent to the landlord. Rent Control Acts have been enacted by different state legislatures to secure t he rights of a specific class of tenants, namely the protected tenants. The Rent Control Act governs the relationship between a tenant and the landlord and specifies the rights and liabilities of each as well as the rules of ejectment with respect to such tenants.
The provisions of the Act restrict the right of a landlord to recover possession of his leased premises from a tenant whois also protected against arbitrary and unreasonable eviction from the property.
However, there have been instances of lessees being issued notices by banks to vacate the leased premises even before the expiry of the term of their lease. This happens because the leased premises were mortgaged to the banks as collateral security for monies borrowed by the landlord. The banks issue notices after the landlords defaulted on payments. The banks then ask for the handover of the property under the relevant provisions of The Securitization and Reconstruction of Financial Assets and Enforcement of Security Interest Act, 2002 (SARFAESI Act). In such cases, it is the unsuspecting tenant who suffers because of the landlord's default by being evicted from the property because of acts to take possession of the property by the bank even though the lease for the property had not expired.
In a recent case in the Supreme Court of India, an important question was raised whether the provisions of the SARFAESI Act could override the provisions of the Rent Control Act and how the right of “protected tenant's” could be protected if the landlord takes a loan by offering the very same property as security to a bank.
In the case in issue a loan was taken by some property owners from a particular bank. A property which was leased to a tenant was also a part of the properties which were mortgaged to the bank as security against the loan. The landlords failed to pay the dues within the stipulated time and thus the bank initiated proceedings under the SARFAESI Act and got an order to take possession of the secured asset. The tenant was issued a notice by the Bank to evict the premises within 12 days of the receipt of notice. The tenant fearing eviction filed a rent suit in the court of small causes. An interim order was passed in favour of the tenant and the landlord was restrained from obstructing the possession of the tenant over the premises during the pendency of the suit. The tenant then filed an application to stay the execution of the order passed in favour of the bank to take possession of the leased premises. This plea was, however, dismissed by the court which held that the order passed by the court of small causes in favour of the tenant was not binding on the bank. An appeal against this order was then filed by the tenant in the Supreme Court to retain his possession of the leased property. The Supreme Court held that once a tenancy is created, a tenant can be evicted only after following the due process of law, as prescribed under the provisions of the Rent
Control Act. A tenant cannot be arbitrarily evicted by using the provisions of the SARFAESI Act as that would amount to the diminishing the statutory rights of protection given to the tenant. The Court further
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held that the SARFAESI Act cannot be used to bulldoze the statutory rights vested in tenants under the Rent Control Act.
The Supreme Court also refused to accept the contention that the provisions of SARFAESI Act override the provisions of the various Rent Control Acts to allow a bank to evict a tenant from the tenanted premise, which has become a secured asset of the bank after the default on loan by the landlord. The Court held that if the contention to dispense with the procedure laid down under the provisions of the various Rent Control Acts is accepted, then the legislative powers of the state legislatures will be diluted which would amount to undermining the law enacted by the state legislature. Therefore, the Supreme Court set aside the judgments passed against the tenant and allowed the appeal made by the tenant there by allowing the tenant to remain undisturbed in the hypothecated property during the pendency of the lease in their favour. Sometimes, landlords adopt this method to both secure a loan and simultaneously get rid of an unwanted tenant who they otherwise can only evict under the provisions of the Rent Control law applicable which can take considerable time and effort. A low paying tenant in possession can diminish the value of a property and this no landlord would want.
This Judgment will help all especially Senior Citizens in rented premises who may find it convenient especially from a financial point of view to remain in the rented premises in their occupation.
MS. SEITA VAIDIALINGAMAdvocate, Supreme Court of India,15, Lawyers Chambers, Supreme Court, R. K. Garg Block, TilakMarg, New Delhi-110 001Phone No. 2338-8716 and 2338-5936 Cell No.0-98101-37479
Residence AddressndB-330, New Friends Colony, 2 Floor, New Delhi-110 025
Phone No.2684-6742 E-mail ID:[email protected]
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Neurologic Music Therapy in Alzheimer's Disease
Harshdeep Singh, Dept. of Cognitive Neuroscience, Faculty of Life Science, JSS Medical College, Mysore.
Dr. (Prof.) K. S. Anand, Dept. of Neurology, PGIMER &Dr. RML Hospital, New Delhi.
Keywords: Neurologic music therapy, brain plasticity, neuro-feedback and feed forward.
Introduction:
Music is a practical application of theories that uses feedback and feed forward mechanism of sensory, motor and cognitive loops to reproduce itself. It is such a complex process that opens up those neural pathways, which are otherwise not opened up. Therapeutic approach of music has not been considered in medicine. Cognitive neuroscience has brought a paradigm shift to that lateral view. Decades of research on music in cognitive neuroscience have resulted in a new therapeutic approach known as neurologic music therapy (NMT), which applies music listening and training to sensory, motor and cognitive dysfunctions occurring from various neurological conditions. NMT is the evidence-based use of stimulating neural pathways in the human brain. NMT has shown remarkable effects on patients of Alzheimer's disease.
Neurologic Music Therapy in Alzheimer's Disease:
Alzheimer's disease(AD) is a progressive neurodegenerative disease. In India more then ten millions cases are seen per year. It is one of the major causes of dementia. It starts really slowly and progress aggressively over time. The neurons in temporal lobe, parietal lobe, and frontal lobe start to die. Cingulate gyrus and locus coerlueus in brainstem nuclei is also found to be involved [1, 2].Neuroimaging studies show that the densities of specific brain areas reduce as the disease progress. [3]
Music works as a stimulus for the brain.[4] Dementia in AD as it progress impairs cognitive functioning which leads patients to be unable to perform activity of daily living. Even when the dementia has progressed enough the patients still respond to music. Different parameters of the sound affect different neurotransmitters like dopamine, epinephrine, norepinephrine, serotonin and melatonin, by manipulating overall synaptic weightage of the networks. Synaptic weightage carried for attention in frontal lobe is affected by music too. Music also affects sensory-motor integration pathways. Cerebellum isanother part that plays a most crucial role in musical experience and music training. It plays important roles in various cognitive tasks like motor timing [5], motor sequencing [6] and special organization of movements [7]. It plays a role also in motor coordination. Cerebellum is activated in sensorimotor networks influencing neuro-endocrinological status in patients with various neurological conditions. Brain plasticity requires complex cognitive tasks like precise spatial organization of relevant motor response. The empirical data acquired through music therapy research shows remarkable effects on brain plasticity [8]. A lot of factor affects brain plasticity. Increased density of gray matter results in enlargement of neurons whereas changes in synaptic weightage affect capillaries and glial cells, which helps reducing the rate of apoptosis. These effects ultimately result in enlargement of myelin cells [9], which further results in the changes in the velocity of the electrical impulses travelling through the axons and along the nerve fiber tracts. Increased rate of myelin cells finally results in increased nerve velocity [10].Long-term use of neurons results in the growth of neural pathway structures.
Alzheimer's disease has no cure. The existing treatments can justcontrol the symptoms for the time being. It is well observed that when the dementia in Alzheimer's disease is progressed the patients response to music while unable to response to other activities. [11] Patients are often seen to response to familiar
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melodies and sing along even when the melody is taken off. They also recognize the changes in the melodies. Emotions are highly involved in memory encoding. Memory encoding is highly associated majorly with limbic system. Limbic system is well known to be involved in the processing of emotions. Music works as stimulant for the brain and is shown to have evoked emotions and improve emotional dysfunctioning. The limbic system contains hippocampus and the network associated with hippocampus encodes and store and retrieve memory. And when the short-term memory is used in AD patients the amygdala networks are activated whereas the hippocampus is associated with long-term memory [12]. Amygdala processes emotional memory, which leads to emotions being a major factor for short-term memory of AD patients [13].
Recent study conducted on memory performance tasks being correlatedwith electrophysiological recordings (EEG) suggests that song rehearsal has strong therapeutic effects on improving memory by activating frontal lobes, bilaterally and opening up the pathways [11]. Music organizes neuronal activities in temporal order, which helps in organizing information. The organized information becomes much easier to process in AD patients. Using melodic intonation therapy modulated to rehearse the list of words existing in the song, study reveals enhanced memory performance compared to spoken rehearsal patients [14].
NMT is seen to improve linguistics deficits in dementia [15]. NMT has shown to improve speech trembling in last stage of dementia in AD. Patients also improve their syntax and semantics while speaking, due to NMT, beside their memory dysfunctionings. Music is very well known to release dopamine. Recent studies have shown that NMTimproves alertness [16] and attention [17] in persons with late stage dementia in AD. This could be due dopamine release from musical experience. Music has also been found to release anxiety [18] and agitation19] triggered by AD. Aggression also has been found to be controlled by NMT in patients with AD [20]. Music also helps countering depression in patients with AD [21]. Studies have also shown increased level of melatonin after music therapy, which may contribute to patient's calm mood [22].
Conclusion:
Research done is last couple of decades has shown that long term music training have tremendous effects on brain. It has been observed that music affects the brain at a molecular level. NMT seems to be promising for its therapeutic application. NMT opens new ways for future research. Effects of music on acetylcholine in both central nervous system and peripheral nervous system can be considered for future research. Though the computations are being carried out, still the effects of music on cyclic AMP and ATP can be considered for variances in synaptic weightage that ultimately contribute to the long term potentiation, for the future work
Reference:1.
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6.
Wenk, Gary L. "Neuropathologic changes in Alzheimer's disease." Journal of Clinical Psychiatry 64 (2003): 7-10.
Braak, Heiko, and Kelly Del Tredici. "Where, when, and in what form does sporadic Alzheimer's disease begin?." Current opinion in neurology 25.6 (2012): 708-714.
Braak, Heiko, and Kelly Del Tredici. "Where, when, and in what form does sporadic Alzheimer's disease begin?." Current opinion in neurology 25.6 (2012): 708-714.
Baird, Amee, and Séverine Samson. "Memory for music in Alzheimer's disease: unforgettable?." Neuropsychology review 19.1 (2009): 85-101.
5. Penhune, Virginia B., Robert J. Zatorre, and Alan C. Evans. "Cerebellar contributions to motor timing: a PET study of auditory and visual rhythm reproduction." Journal of cognitive neuroscience 10.6 (1998): 752-765.
Garraux, Gaëtan, et al. "Shared brain areas but not functional connections controlling movement timing and order." The Journal of Neuroscience 25.22 (2005): 5290-5297.
7. Rizzolatti, Giacomo, G. Luppino, and M. Matelli. "The organization of the cortical motor system: new
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concepts." Electroencephalography and clinical neurophysiology 106.4 (1998): 283-296.
8.
Fields, R. Douglas. "Myelination: an overlooked mechanism of synaptic plasticity?." The Neuroscientist 11.6 (2005): 528-531.
Doyon, J. U. L. I. E. N., et al. "Functional anatomy of motor skill learning."Neuropsychology of memory 3 (2002): 225-238.
Guetin, Stephane, et al. "Effect of music therapy on anxiety and depression in patients with Alzheimer's type dementia: randomised, controlled study."Dementia and geriatric cognitive disorders 28.1 (2009): 36-46.
Brotons, Melissa, and Patricia K. Pickett-Cooper. "The effects of music therapy intervention on agitation behaviors of Alzheimer's disease patients."Journal of Music Therapy 33.1 (1996): 2-18.
Mu¨nte TF, Altenmu¨ ller E, Ja¨ncke L. The musician's brain as a model of neuroplasticity.Nat Rev Neurosci. 2002; 3(6):473-478.
9. Altenmu¨ ller E, Schlaug G. Music, brain, and health: exploring biological foundations of music's health effects. In: MacDonald R, Kreutz G, Mitchell L, eds. Music, Health, and Wellbeing. Oxford, England: Oxford University Press; 2012:12-24.
10.
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15. Brotons, M. & Kroger, S.M. (2000). The impact of music therapy on language functioning in dementia.Journal of Music Therapy, 37(3), 183-95.
16. Clair, A.A. (1996). The effect of singing on alert responses in persons with late stage dementia.Journal of Music Therapy, 33(4), 234-247.
17. Gregory, D. (2002). Music listening for maintaining attention of older adults with cognitive impairments.Journal of Music Therapy, 39(4), 244-264.
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20. Clark, M.E., Lipe, A.W., &Bilbrey, M. (1998). Use of music to decrease aggressive behaviors in people with dementia.Journal of Gerontological Nursing, 24(7), 10-17.
21. Hanser, S.B., & Thompson, L.W. (1994). Effects of a music therapy strategy on depressed older adults.Journal of Gerontology, 49(6), P265-9
Cuddy LL, Duffin J (2005). "Music, memory, and Alzheimer's disease: is music recognition spared in dementia, and how can it be assessed?".primary. Medical Hypotheses. 64 (2): 229–35.
Thaut MH (2010). "Neurologic Music Therapy in Cognitive Rehabilitation =". Music Perception. 27 (4): 281–285.
14. Thaut MH, Peterson DA, McIntosh GC (2005). "Temporal entrainment of cognitive functions: musical mnemonics induce brain plasticity and oscillatory synchrony in neural networks underlying memory". secondary. Annals of the New York Academy of Sciences. 1060: 243–54.
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Genetics of Alzheimer's DiseaseKuljeet Singh Anand; DM,FIAN,FRCP
Ankur Wadhwa; MD, DM, Department of Neurology, PGIMER & Dr Ram ManoharLohia Hospital, Guru Gobind Singh Indraprashta University, New Delhi-110001
Alzheimer' disease (AD) is caused by deposition of abnormal amyloid protein in brain. It presents with problems in memory, difficulty in naming, difficulties in performing activities of daily living , problems in judgement ,reasoning and behaviour. At present treatment options for AD are limited. Various researchers have tried to find out risk factors for AD and have focussed on genetics of disease but the field is still evolving.
AD is most common form of dementia world wide .However it is important to rule out other reversible causes of dementia before making a diagnosis. These causes include vitamin deficiencies, thyroid abnormalities, infections and exposure to toxins. Apart from this various neurodegenerative conditions like Dementia with Lewy body (DLB), Huntington's disease and Parkinson 's disease may have overlapping features with AD and these should also be excluded before one is certain about AD diagnosis.
Most of the cases of AD are not seen in families and are sporadic. Sporadic AD is due to complex interactions between age, genetics, and environment. The most important risk factor for AD is age however researchers worldwide have implicated a number of genes for AD.
Amyloid precursor protein (APP) gene, Presenilin 1(PSEN1) &Presenilin 2 (PSEN 2) have been most 1, 2, 3frequently studied and linked with early onset AD .The amyloid precursor protein forms into A-beta
amyloid, which gets deposited in brain and is neurotoxic. APP gene is located on chromosome 21q.This mutation accounts for 10-15% of early onset AD. The exact function of APP is still in research and the gene is believed to be important in synaptic transmission.
4Most common genetic mutation for early onset AD is in PSEN 1 gene, located on chromosome 14q .The PSEN 1 gene is implicated in different functions including calcium signalling and membrane stability. PSEN 2 gene is located on chromosome 1q and is considered least common gene responsible for causing early onset AD. The penetrance for PSEN 2 is considered to be less as compared to PSEN 1 and APP
5gene. PSEN 2 is considered to be pro apoptotic and increases cell death .
Another frequently studied and important gene for AD is apoE4 .It has three common alleles -2, 3, 4; apoE 4 is present in 45-60% of patients of AD. It acts as a modifier of age at onset in AD and remains the greatest risk factor for the same.
There are several other newer candidate genes which studies have linked with late onset AD including SORL1, CLU, CR1, Phosphatidylinositol Binding Clathrin Assembly Protein (PICALM), and Triggering receptor expressed on myeloid cells 2 (TREM2) . SORL1 is located on chromosome 11. The association of CLU gene with AD is based on its function to regulate the removal of amyloid-beta from the brain. Researchers hypothesize the imbalance in production and clearance of amyloid-beta is the most important mechanism for the development of Alzheimer's disease. Also chronic inflammation in the brain has been thought to be associated with the development of Alzheimer's disease. CR 1 protein gene is necessary for proper neuron function in memory formation for smooth communication between neurons and the PICALM gene has been linked to the process of communication among nerve cells. TREM 2, a more recently identified gene is involved in the regulation of the brain's response to inflammation as well, and many variants within this gene have been linked with increased risks of developing Alzheimer's disease.
Family members of patients with AD often enquire about genetic testing. The testing varies for early versus late onset AD since there has been different genes studied for each. Multiple mutations in PSEN1, PSEN2,
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APP, and APOE can cause AD; hence sequencing of entire coding region may be needed to assess the genetic risk. Genetic counselling forms an important part prior to ordering tests and counsellors have the responsibility to inform the family members of the implications of an inherited mutation. At times it is important that complete results might not be disclosed to all members of family as they may not cope up well with it.
Hence genetic testing in Alzheimer's disease is an important area of research and continues to expand. The coming years might witness new set of candidate genes and genetic markers for the disease. The implications of positive test result have to be understood and family members counselled beforehand for the same. Presently most clinicians rely on a good history from the care giver and neuropsychological testing for making a probable diagnosis. This can be supplemented by non contrast MRI and functional imaging if need permits.
References:1. Goate A, Chartier-Harlin MC, Mullan M, Brown J, Crawford F, et al. Segregation of a missense mutation in
the amyloid precursor protein gene with familial Alzheimer's disease. Nature 349(6311): 704-706.
2. Renbaum P, Levy-Lahad E. Monogenic determinants of familial Alzheimer's disease: presenilin-2 mutations. Cell Mol Life Sci 54(9): 910-919.
3. Rogaev EI, Sherrington R, Rogaeva EA, Levesque G, Ikeda M, et al. Familial Alzheimer's disease in kindreds with missense mutations in a gene on chromosome 1 related to the Alzheimer's disease type 3 gene. Nature 376: 775-778.
4. Brunkan AL, GoateAM (2005) Presenilin function and gammasecretase activity. J Neurochem 93(4): 769-792.
5. Wolozin B, Iwasaki K, Vito P, Ganjei JK, Lacanà E, et al. Participation of presenilin 2 in apoptosis: enhanced basal activity conferred by an Alzheimer's mutation. Science 274(5293): 1710- 1713
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Speed Breakers in our LifeSamuel H Paul
Introduction: A Speed Breaker!!
It is a name with which we are quite familiar with. The name of the device creates varied reactions to the people who use their vehicles regularly to commute.
It is a device to check and to regulate the flow of traffic at a safer and desirable speed. It is located in areas where caution in traffic movement is required, such as schools, hospitals, Institutional areas and near residential areas and where the speed limit is indicated on the roads.
One has to pay attention to these speed breakers for the safety of self and others and even the safety of the vehicles; otherwise, it can become an “Axle Breaker”!!
In our daily life, we experience the presence of this device in various forms and mode, and presence of this, affects our behaviour pattern and our beliefs and compels one to act accordingly to their trust in certain myths, psychological reasoning, trusts in rumours, and events, spread by word of mouth in family circles, community and colonies and society.
How it works: suppose we are going out for a party or some important work – suddenly a cat, that too a black one, crosses our paths – Oh stop-stop-not good luck, a bad omen-stop for a couple of minutes let the effect of omen pass, then proceed. Similarly, while proceeding, someone sneezes-again bad omen-you sneezed!!-again wait then start.
Seeing some animals, birds or reptiles is considered bad. Owl is considered bad-because its sight will bring injuries, seeing a bat (chamgader) in night is not considered auspicious at all, as it is considered a messenger of evil spirits.
Similarly, if in the night if a dog is crying, it is considered a signal that some near and dear one may pass away. The fear of death is anticipated. Taking name of some animals is considered in-auspicious (ashubh), any snake is hated and feared; and has to be destroyed because it is associated with the devil. There are so many things we fear about something un-eventful which is going to take place, by very common and innocent of living things, such as cats, dogs, bat, snake, owls, crow, wolf, fox etc. Are these animals/birds aware of their power to cast a shadow of sadness? Or cast an evil spell?
Such are the examples offering a ''speed Breaker'' in routine life, creating un-necessary phobia of a kind, bringing an uncalled for disruption in smooth flow of life.
There are some prevailing custom, traditions in our rituals which take place during births, deaths, marriages-and many more events during one's lifetime.
At child birth-'KalaTeeka' is applied on infant's face to ward off 'BuriNazar', don't know how a black-spot prevents from an evil eye. Some people like a black spot as a beauty spot. Colour plays specific role at specific occasion, white is indicative of purity but also a sign of widowhood; similarly black is a sign of mourning, as well as it is also a symbol of status, it indicates status in high society, a long black shiny car!!, a black well cut suit.
Personal Example – A personal experience which disturbed me very much – a close and dear friend was getting married. My friends and I were anticipating a good time of fun. But our enthusiasm was badly jolted when friend's mother who has been our dear aunty, suddenly declared she cannot attend the marriage – it
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jolted us – why not aunty? He is your son? So why not? She replied – because I am a Widow – and presence of a widow in a marriage ceremony or at any such ceremonies is considered very un-auspicious and would bring bad luck and miseries to the couple. How can the presence of the mother - at a time like this bring ill-luck? A Mother is a Mother first – We persuaded her to change her mind – but she said No! So, we told her if you don't attend, then we will also not attend and stay with you.
It was time for her to get concerned and she started pleading that you all must attend, what will he feel if you people are not there? We told her what will he feel if you, his mother is not there to bless him? Will he be happy? – Please come, if not then we will stay here with you. Our firm stand worked, she finally and reluctantly decided to attend in a plain and simple saree, with her face gleaming, and with tears in her eyes she blessed the couple. She must be feeling apprehensive, must be feeling motherly affection also, yet social binding were putting a barricade in what is so natural for a mother to do at this occasion. It would be equivalent to a crime to prevent a mother from participating at an family event like this.- A social evil.
It is a ''speed Breaker'' created by human beings, our thinking our rituals and un-sound mind sets. Such 'Speed Breakers' need to be broken down and destroyed. It is indicative of very negative behaviour. The friend and his family enjoy a very happy married life, leading a blessed family life. Why? Because they were blessed by his mother during their wedding.
The same friend's elder sister got married earlier, but she did not have a happy married life, there was misunderstanding, quarrels, dis-harmony in their life and family life become miserable. I came to know later that during her marriage - this very mother was not allowed to attend the wedding even though she wanted to. The elders and relatives did not even allow her to be near her daughter at all. Therefore is this the price she paid for not receiving the blessings of a mother who became a widow? It is felt that such prevailing rituals would altogether bring life to a dead end – not slow down but bring it to dead end. There are many such traditions in our life, which exist as very 'Negative Speed Breakers'.
Some Natural Phenomena are considered bad omen, and when this happens, it is believed some Celestial deity is expressing their anger – thus something harmful is going to take place. Certain rituals must be followed to calm-down the anger of deity.
These events are Solar Eclipse and Lunar eclipse. Out of these, Solar Eclipse is more of a concern. Fact is, it is as natural as weather changes, day & night, sunrise, sunset, - Earth orbits the sun, moon orbits the earth at one particular time, Moon comes between Earth and Sun, and moon's shadow falls on the Earth. Where it falls, it blocks the view, we can't see the sun. This is called Solar Eclipse; the moon has eclipsed the view of sun – which is believed to be an unauspicious event – “Speed Breaker”. Many beliefs and myths are related to it. Generally it is believed that it could be harmful if precautions are not taken- such beliefs – that child would be deformed if pregnant woman observes the solar eclipse in the open. Cooking food is taboo, fire is not lit.
My close association with this event, being a producer in Doordarshan I did the coverage of 1980 total Eclipse – as well in October, 1995; total solar eclipse which had a longer duration over India and traversed longer path over North India.
An educated lady, who was pregnant defied her-in-laws and elders, and went out in open to observe the 1980 solar eclipse; it took place about 2:00 pm in afternoon. It was a rare sight for many, but people feared that she will give birth to a deformed child due to effects of Solar Eclipse – Well after 15 years; another total
th thsolar Eclipse took place on 24 October, 1995. 24 was Diwali but it was shifted to 25 because of the prevailing myths that eclipse day is not auspicious at all.
We also did the TV coverage of this event at Alwar – because it occurred in early morning and we decided to do coverage away from the pollution of urban sky – Alwar offered an ideal clear sky. Also, we planned an interview to make public aware of what an eclipse is. It's a play of shadow – moon casts on earth, we don't see the sun at that spot and it is known as solar eclipse.
In the interview some experts and a young good looking boy of 15 years was included. This boy was the
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son of the same educated lady who defied her elders and in-laws in 1980 and went out to enjoy the solar eclipse while pregnant. The boy in studio was her son – born hale & hearty and a perfect human being. I also invited his mother for interview but she was unable to come. By this experience I want to prove that our fear, related to natural phenomena is without any basis and our thinking make these as a “Speed Breaker” in our behaviour and thinking, which is absolutely redundant! Yes - one caution – Solar Eclipse does cause harm to eyes if we see it without any protection. Ultraviolet rays are very strong at the time of an eclipse and are capable of burning retina of eye – so please take precaution when eclipse takes place.
Naturally, you wish to observe this natural great event – but take great precaution to see through safety glasses – recommended and publicised by Department of Science & Technology. In 1995, many Diwali cards had a safety glass included.
Natural Breakers:- Nature presents its own 'Breakers' and they are the True and Real breakers in smooth flow of human life.
These are:- Earthquakes, Floods, Tsunami, volcanic eruptions, Tornadoes, Hurricane, Cloud burst, Forest fire, Land slide, Snow, avalanche – so on and so forth.
These natural occurrences are extremely devastating due to their strength and power, destructive beyond imagination. There is great loss of property, life and loss of livestock, the after effects is spread of disease and contamination, famine and many evils. Human being is helpless in preventing these occurrences.
Yet Survived – Human spirit is very resilient, it has tremendous will power to overcome the situation, Mind will provide human body power to stand-up and take charge, cross the barrier, start afresh. In a way ''Speed Breakers'' may be Blessings in Disguise. It makes us to pause and notice our follies – Where did we go wrong, what can be done to avoid wrong doings. Failures make us learn and become more wise.
Even after the strike of natural disaster – life is not totally destroyed, not dead. Human mind compels us to cross the 'Breakers'. Move ahead, be perseverant. Not to lose faith in our own strength and capabilities and utilise them effectively.
MOVE AHEAD, LEAVING THE “SPEED BREAKERS” BEHIND YOU, AND TOWARDS A PROGRESSIVE FUTURE, WHICH HAS BEEN WITNESSED EARLIER BY HUMAN ENDEAVER.
Samuel H PaulFormer Director- DoordarshanWinner of First International Educational TV Award in India.M. A - PsychologyM.S. - Communication-TV & AVA, Syracuse University-New York, USA.Course in Counselling & Guidance - EmoryUniversity Atlanta Georgia-USA
Contact: +919891645597
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Importance of Identification, Prevention and Treatment of Caregiver Syndrome
Dr. Ashima Nehra, Additional Professor, Clinical Neuropsychology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Ms. Shivani Sharma, Postgraduate, Department of Psychology, Arts Faculty Extension Building, University of Delhi, India.
Dementia is a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses that affect memory, thinking, behaviour and ability to perform everyday activities. [1] It is distinguished from other forms of cognitive impairment by its persistent, progressive and irreversible deterioration. [2] Dementia has been identified as an “International Health Priority” both for patients as well as their caregivers. [3]
Copious literature describes the potential consequences of providing care for such patients, thus, their caregivers have been referred to as the “hidden patient” or the “forgotten client”. [4] This complex and multidimensional construct with psychological, emotional, physical, social and financial consequences experienced by these caregivers is called caregiver burden or caregiver syndrome. [5] Numerous studies report that caregiving for Dementia patients is more stressful than other caregiving roles. [6]
Caregiver burden can be objective or subjective. The former refers to apparent behavioural phenomena (E.g.: disruption of daily routine) while the latter refers to the appraisal of burden by the caregiver (E.g.: sadness, anger). Overall the care giving process causes significant
Thus, identification of these characteristics is important in planning individually tailored interventions for caregivers. Apart from the aspects given in Figure 1, the life story, culture and historical setting of families should also be taken into consideration. [8] A variety of interventions can be planned with elements of:
l Psycho-Education: This is a process of knowledge sharing with the primary focus of helping carers develop coping skills and strategies. Greater knowledge about the disease and its implications helps gain control of the situation and deal it with effectively. This is usually used adjunct to other therapies. [8]
l The teaching of Coping Strategies: Problem focussed strategy focuses on alleviation of the source or stressor in an active and constructive way. Studies have proven its effectiveness in the initial stage of disease diagnosis. [9] Other studies have also validated the use of emotion focussed strategies which predominantly address the feelings associated with the stressor. [10] It has been noted that tendency towards problem-solving and a coping style of acceptance helps increase the Quality of Life (QOL) of caregivers. [11]
l Support Groups: These consist of small groups led by professionals that focus on education and providing support. [12] These groups provide an environment of comfort and ease thus encouraging caregivers to share their woes and insights into successful coping strategies. This platform thus helps
distress to the caretaker as it requires their involvement from diagnosis till treatment. [7] Both patient and caregiver attributes contribute to this negative effect and decreased Quality of Life (QOL) as a result of caregiving (Figure 1).
Figure 1: Conceptual framework showing that interplay between patient and caregiver attributes leads to caregiver burden which has four main aspects (psychological, social, physical and financial).
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them find solutions to similar problems or help others deal with similar problems they have faced in the past.
l Telephone and Computer-based support programmes: These mediums are examples of low-cost interventions to help deal with the psychological and emotional strain of the caregivers as they provide any desired information and link caregivers through tele-supported sessions facilitated by a social worker or psychologist. [13] Such programmes have been found to be efficacious in reducing symptoms of depression over a 6 month period. [14]
l Counselling: Numerous studies have revealed a high prevalence of depression and anxiety among Dementia caregivers. [15] Frequent counselling and cognitive behaviour therapy (CBT) sessions with a clinical psychologist have shown positive effects on the QOL of caregivers. [16]
l Other: Apart from these, spirituality, family counselling sessions, self-care and skills training facilitated by a psychologist can be beneficial in the caregiving process. [17]
Therefore, there is an increased need to identify these symptoms and concerns on time and seek help as coping style, acceptance and motivation explain the difference in perception of burden. [18] Most caregivers may not address their symptoms as they may think that this shifts focus from caring for their Dementia patient. However, it is important for the caregiver to maintain a high quality of life as a failure in their health may mean the fall of a support system which is imperative in improving the condition of Dementia patients. [19] Thus, apart from mental health professionals, it is vital that caregivers themselves become cognizant of these symptoms and deal with them on time in order to lead healthy and stress free lives.
We, at Clinical Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India; provide psycho-education, support counselling and recommendations to caregivers of Dementia patients to equip them to deal more efficiently with the challenges of care giving.
References:1. Nehra A., Bajpai, S. The Importance of Diagnosis & Assessment of Dementia: From a Neuropsychological Perspective.
Proceedings of World Alzheimer’s Day on Alzheimer’s & Related Disorders Society of India (ARSDI) Delhi Chapter. 2013 Sept 21:43-46.
2. Smale B, Dupuis SL. Caregivers of persons with dementia: roles, experiences, supports and coping. A literature review. 2004.
3. Gillick MR. Tangled minds: Understanding Alzheimer's disease and other dementias. Plume Books; 1999.
4. Pratt C, Wright SD, Schmall V. Burden, coping and health status: A comparison of family caregivers to community dwelling and institutionalized Alzheimer's patients. Journal of Gerontological Social Work. 1987 Apr 15;10(1-2):99-112.
5. George LK, Gwyther LP. Caregiver weil-being: A multidimensional examination of family caregivers of demented adults. The rontologist. 1986 Jun 1;26(3):253-9.
6. Ory MG, Hoffman RR, Yee JL, Tennstedt S, Schulz R. Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist. 1999 Apr 1;39(2):177-86.
7. Rabins PV. The caregiver’s role in Alzheimer’s disease. Dementia and geriatric cognitive disorders. 1998 Oct 23;9(Suppl. 3):25-8.
8. Ponce C, Ordonez T, Lima-Silva T, Santos G, Viola L, Nunes PV, Cachioni M. Effects of a psychoeducational intervention in family caregivers of people with Alzheimer’s disease. Dement Neuropsychol. 2011;5(3):226-37.
9. Zucchella C, Bartolo M, Pasotti C, Chiapella L, Sinforiani E. Caregiver burden and coping in early-stage Alzheimer disease. Alzheimer Disease & Associated Disorders. 2012 Jan 1;26(1):55-60.
10. Cooper C, Katona C, Orrell M, Livingston G. Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease. International journal of geriatric psychiatry. 2008 Sep 1;23(9):929-36.
11. Kneebone II, Martin PR. Coping and caregivers of people with dementia. British journal of health psychology. 2003 Feb 1;8(1):1-7.
12. Perkinson MA. Socialization to the family caregiving role within a continuing care retirement community. Medical anthropology. 1994 Nov 1; 16(1-4):249-67.
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13. Mahoney DF, Tarlow BJ, Jones RN. Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study. The Gerontologist. 2003 Aug 1;43(4):556-67.
14. Winter L, Gitlin LN. Evaluation of a telephone-based support group intervention for female caregivers of community-dwelling individuals with dementia. American journal of Alzheimer's disease and other dementias. 2007 Dec 1;21(6):391-7.
15. Prince M. Care arrangements for people with dementia in developing countries. International journal of geriatric psychiatry. 2004 Feb;19(2):170-7.
16. Pinquart M, Sörensen S. Helping caregivers of persons with dementia: which interventions work and how large are their effects?. International Psychogeriatrics. 2006 Dec 1;18(04):577-95.
17. Schulz R, Martire LM. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry. 2004 Jun 30;12(3):240-9.
18. Shaji KS. Dementia care in developing countries: The road ahead. Indian Journal of Psychiatry. 2009 Jan 1;51(5):5. distress to the caretaker as it requires their involvement from diagnosis till treatment. [7] Both patient and caregiver attributes contribute to this negative effect and decreased Quality of Life (QOL) as a result of caregiving (Figure 1).
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Cracking the Alzheimer's CodeSarah A. Khan, Manjari Tripathi and Pravat K Mandal
Neuroimaging and Neurospectroscopy Laboratory, National Brain Research Centre, Gurgaon, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi
A withered person with a scrambled mind and memories sealed away: that is the familiar face of someone suffering from Alzheimer's.The progress tends to be insidious and messy and the implications thundering. The disease disrupts a distinctly peaceful life with ferocious intensity thereby affecting millions worldwide. Ageing, one of its greatest causes, occurs more rapidly in developing than developed countries. Though imperative, the diagnosis and treatment of the disease is not a priority for these Less Developed Countries' healthcare systems as they face a dearth of economic and human resources for achieving widespread health care. This leaves many patients undiagnosed and even untreated. Presently, clinicians might not identify more than 95 % of patients in early stages of dementia and nearly 75% of moderate to severe dementia patients. As such, the first step in overcoming this problem should be formulating a precise diagnostic solution for dementia sufferers. Fortunately for the advances in understanding disease pathology, unique combinations of diagnostic methods have been identified that can sink much deeper into the disease's darkening world. One of these is a combination of Neuroimaging and Neuropsychology. Non–invasive (no blood test, no-x-ray) Neuroimaging techniques like Magnetic Resonance Spectroscopy (MRS) are marvelous whistlers of an impending attack on the brain. More than finding affirmation of the presence of a disorder, MRS techniques have been known to predict its onset. The last decade, in particular, has witnessed the emerging role of glutathione (GSH), an endogenous antioxidant, using MRS techniques, in the detection of neurodegenerative disorders like Alzheimer's disease. Furthermore, a linear correlation exists between these and Neuropsychological tests. An obvious reflection of which is the detailed analysis and inquiry that goes into appreciating the signs and symptoms of the disease. Together, they may provide significant information about the oxidative status of the brain, progress of the illness and prognosis What feels like hope for those many sufferers, their caregivers, mental health professionals and others at risk has also the possibility, the long shot, that it might aid the invention of a new drug that might negotiate some sort of a truce with the disease. In search of this purpose and optimism, the Neuroimaging and Neurospectroscopy lab at the National Brain Research Centre endeavours this potential possibility of a better tomorrow for all.
Contact:
Dr. Pravat Kumar MandalEmail: [email protected]: +91- 9910318922
References:1. Mandal PK, Saharan S, Khan SA, James M. Apps for Dementia Screening: A Cost-effective and Portable Solution. Journal
of Alzheimer's Disease. 2015 Aug 11;47:869-72.
2 Mandal PK, Saharan S, Tripathi M, Murari G. Brain Glutathione Levels–A Novel Biomarker for Mild Cognitive Impairment and Alzheimer's Disease. Biological psychiatry. 2015 Nov 15;78(10):702-10.
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Review of the Book
“Being My Mom's Mom– An Account of Personal Journey Before and After the Onset of Mom's Dementia”
by Loretta Anne Woodward Veney, 2013, Infinity Publishing, 173 pages.
Reviewer :
Dr. Mala Kapur Shankardass, a sociologist and gerontologist, Governing Body Member of ARDSI Delhi Chapter and
Associate Professor, Department of Sociology, Maitreyi College, University of Delhi, India. Email:[email protected]
Recently I had the opportunity to come across a heart warming book 'Being my mom's mom: a journey through dementia from a daughter's perspective', by Loretta Anne Woodward Veney, a paperback publication which is about the author's experience in coping with a parent's dementia, when she first heard in 2006 about the word from the doctor. Loretta a motivational teacher and trainer based in America narrates that her heart sank, but she tried to put a brave face for her mom. The book is a reminder of journeys which increasingly many daughters and sons are going through every year as we acknowledge the occurrence of this disease affecting generally the older populations. As Veney recollects her mother's response on hearing the diagnosis was “Besides dying, what's worse than not being able to remember anything?” Putting a brave front always Loretta for last ten years has been coping with her mom's gradual progressive decline in memory, reaching to a stage when her mom now does not recognise her as the daughter.
This book is good sharing of personal experience of caring for a closely related dementia patient, outlining things which go right and which do go wrong in care giving. There is narration of many touching heart breaking moments when the author realized that her mom did not understand even commonplace occurrences of daily living, that there was no point in reprimanding her about anything, complicating her life with a daughter's anger, treating her badly, or withholding love. Truly as Loretta expresses there comes a stage when a family care giver has to turn the role and become a mother, bring in those instincts and caring attitude with total forgiveness and much love. Showering love and care are the only solutions to deal with the problem as the grief of seeing a near ones memory fade away takes over. For the dementia patient there is no past and no future. As a care giver one has to live in the present and make the dementia affected patient as comfortable and loved as one can. The family care giver must let go of the pain and live in the moment shared with the near and dear dementia affected patient. Loretta suggests being practical about the situation of care giving and forgetting about grievances and sorrows. At no moment can you neglect the dementia affected person and always the patient's interests must be kept in the forefront. Emotional decisions should not influence action of caring but rather the well being of the patient given their state of health condition should shape the responses.
As the author points the family care givers must create positive experiences for the dementia patient and forget about the fact that the patient may not even recognise their relationship. Loretta recounts that her mother only thinks of her as a nice person doing her duty of care giving as she has forgotten that she has a daughter. Many experiences in caring for a dementia affected family member are frustrating as one needs lot of patience and tolerance in especially the later stages of this progressive disease, when the patient starts forgetting how to do simple activities of daily living.
The author narrates various incidences of activities which her mother started forgetting and how tough it became for her to start training her to do those. She recollects that often she thought of her mother as an adult whereas actually she had to be treated as a child learning the first steps of doing activities, such as how to sit, how to eat, how to use the toilet, how to perform daily activities of managing life. At the same time
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there are occasions when the dementia affected person has to be treated as a person with a mind of own, therefore they need to be given choices and options in deciding what to eat, what clothes to wear, when to sleep, when to get involved with various activities, etc. Like children, adults with dementia thrive on routines, regularity has to be set in, but there are various limitations too in following a pattern which care givers have to be aware of.
The book, very encouraging for those caring for dementia patients on a daily basis highlights the heartache and humour in dealing with this life-changing disease.Written in a straightforward, easy to read style, the book does an admirable job of stressing how every single day with a person suffering from dementia can be different and how it requires you “to love each of the different people your loved one may become.” The complexity of caring is brought out with tips on how to manage and cope by recognizing the mistakes one can make and overcoming them with patience and learning. It provides very informative reading and makes the reader feel that he or she is not alone in their journey of dealing with this devastatingand debilitating illness. The book provides so much of practical information, ideas, thoughts and help that can be used for helping with the care of a loved one, whether they have dementia or other health issues.
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F-18 THK 5117: A novel Tau Imaging ligand for Alzheimers Disease
Dr Madhavi Tripathi, Dr Saroj Yadav, Dr Vivek, Prof CS BalDepartment of Nuclear Medicine, AIIMS, New Delhi
Selective Tau imaging will enable improved understanding of Tau aggregation in the brain, thus facilitating research into the causes, diagnosis and treatment of major Tauopathies such as Alzheimers disease (AD), progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), chronic traumatic encephalopathy (CTE) and some variants of frontotemporal lobar degeneration (FTD). Such imaging studies will enable non-invasive assessment of the spatial and temporal pattern of Tau deposition over time, providing insight into the role of Tau in aging and helping to establish the relation between cognition, genotype, neurodegeneration and other biomarkers.
Tau Imaging in AD:
AD is the most common tauopathy and the leading cause of dementia worldwide. In AD tau deposits can be recognized histologically as neurofibrillary tangles (NFTs) and neuropil threads as well as dystrophic neurites in senile plaques, whilst ultrastructurally they aggregate in paired helical filaments (PHF). Tau is a phosphoprotein with a major role in stabilization of microtubules , which are critical for cytoskeletal support and intracellular transport. Six isoforms of Tau are categorized into two functionally different groups, which have either three repeats or four repeats of the microtubule-binding domain (1). Selective Tau PET tracers will enable in-vivo assessment of regional Tau burden and its relation to Aβ deposition in patients with AD (2-4). Post-mortem studies show that Tau deposition is highly associated with cognitive impairment (5-8) and Tau dysregulation is a major mediator of neurodegeneration (9). This has stimulated the development of therapeutics for the treatment of Alzheimer's Disease and non-Alzheimer's Disease tauopathies. Given these treatments are currently being developed, a non-invasive method of determining the tau burden in the brain would allow a better understanding of the pathophysiology of AD. It will also lead to improvements in differential diagnostic accuracy and accelerate drug discovery by facilitating patient selection and monitoring efficacy in novel anti-tau therapeutic trials. It would assist in the early and differential diagnosis of AD and non-AD tauopathies, while helping ascertain the relationship between the spatiotemporal distribution of tau aggregates in the brain to cognition and brain volumetrics. Development of tau imaging probes poses several more challenges than those associated with Aβ imaging, and these are mainly related to the idiosyncrasies of tau aggregation and deposition.
In contrast to Aβ, most tau aggregates are intracellular, which means the tau tracer has to cross the blood brain barrier and the cell membrane before reaching its targets. Further the different combinations of Tau isoforms manifest as different clinical phenotypes. Tau aggregates undergo a wide spectrum of post-translation modifications that, in addition to the combination of different isoforms, lead to diverse ultrastructural conformations and typical pathological lesions. Furthermore, tau aggregates coexist with other misfolded proteins sharing the same β-sheet secondary structure, as is in the case of Alzheimer's Disease where tau and Aβ are both co-localized in grey matter areas, where the concentrations of Aβ are, depending on the brain region, 5–20 times higher than those of tau.
In recent years, the main focus has been the development of selective ligands that allow early detection of Aβ deposition. Among these tracers, 18F-FDDNP was reported to nonselectively bind to both Aβ deposits and NFTs. Phenylquinoline derivatives binding with high affinity and selectivity for tau aggregates have been developed as candidates for tau imaging agents at Tohoku University in Sendai, Japan (10). Among them, 18F-THK523 (THK523) was the first reported selective tau imaging tracer that can non invasively detect tau deposits in a transgenic mouse brain. The very high tracer retention in white matter however precluded the visual assessment of distribution of tau pathology. Two improved arylquinoline derivatives were then developed F-18 THK 5105 and F-18 THK 5117 which showed high affinity to tau rich brain
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homogenates (11). First-in-human studies showed robust visual and quantitative separation of patients with AD from healthy controls based on PET scans of brain areas known to have high tau deposition with a regional profile distinct from Aβ imaging with Pittsburg Compound b (PiB) (12). Ishika et al (3) have shown that compared to patients with mild AD, patients with moderate AD showed greater changes in the tau load that were more widely distributed across the cortical regions. Furthermore, a significant correlation was observed between the annual changes in cognitive decline and regional [18F] THK-5117 binding. These results suggest that the cognitive decline observed in patients with AD is attributable to the progression of neurofibrillary pathology. Longitudinal assessmentof tau pathology will contribute to the assessment of disease progression and treatment efficacy. Okamura et al (11), showed that in patients with Alzheimer's disease, the inferior temporal cortex, which is an area known to contain high densities of neurofibrillary tangles in the Alzheimer's disease brain, showed prominent 18F-THK5105 retention. Compared with high frequency (100%) of 18F-THK5105 retention in the temporal cortex of patients with Alzheimer's disease, frontal 18F-THK5105 retention was less frequent (37.5%) and was only observed in cases with moderate-to-severe Alzheimer's disease. In contrast, 11C-Pittsburgh compound B retention was highest in the posterior cingulate cortex, followed by the ventrolateral prefrontal, anterior cingulate, and superior temporal cortices, and did not correlate with 18F-THK5105 retention in the neocortex. In healthy control subjects, 18F-THK5105 retention was 10% higher in the mesial temporal cortex than in the neocortex. Notably, unlike 11C-Pittsburgh compound B, 18F-THK5105 retention was significantly correlated with cognitive parameters, hippocampal and whole brain grey matter volumes, which was consistent with findings from previous post-mortem studies showing significant correlations of neurofibrillary tangle density with dementia severity or neuronal loss.
Tau imaging thus holds promise to disentangle the relation between Alzheimers, cognitive decline and the two pathological hallmarks Amyloid and Tau. We have started F-18 THK 5117 imaging in AIIMS and expect the results to be useful to the neurology specialists for management of their patients with dementia and mild cognitive impairment.
References : 1. Roberson ED, Scearce-Levie K, Palop JJ, Yan F, Cheng IH, Wu T, et al. Reducing endogenous tau ameliorates amyloid
beta-induced deficits in an Alzheimer's disease mouse model. Science 2007;316(5825):750–4.
2. David T. Chein, A. Katrin Sardenings, Shadfar Bahri, Joseph C. Waish, Fanrong Mu et al. Early Clinicla PET imaging results with the novel PHF-Tau radioligand F18-T808.Journal of Alzheimer's disease 38 (2005)171-184.
3. Aiko Ishiki,Nobuyunki Okamura, Ryuichi harda, Naoki Tomita,Kotaro Hiraoka, Ren Iwata et al. Longitudinal assessment of tau pathology in patients with Alzheimer's disease using 18F THK-5117(2015)PET.PLOS ONE 10(10).
4. Ryuichi Harda,Nobuyunki Okamura,Tetsuro Tago,Masahiro Maruyama,Makoto Higuchi, Hiroyuki Arai et al. Comparison of binding characteristics of 18F THK-523 and other amyloid imaging tracers of Alzheimer's disease pathology.Eur J Ned Med Mod Imaging(2013)40:125-132.
5. Masters CL, Cappai R, Barnham KJ, Villemagne VL. Molecular mechanisms for Alzheimer's disease: implications for neuroimagingand therapeutics. J Neurochem 2006;97(6):1700–25. doi:10.1111/j.1471-76.
6. Mohorko N, Bresjanac M. Tau protein and human tauopathies: an overview. Zdrav Vestn 2008;77(Suppl II):35–41.
7. McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, et al. Chronic traumatic encephalopathy in athletes:progressive tauopathy after repetitive head injury. J Neuropatho Exp Neurol 2009;68(7):709–35.
8. Delacourte A. Tauopathies: recent insights into old diseases. Folia Neuropathol 2005;43(4):244–57.
9. Wischik CM, Edwards PC, Lai RY, Roth M, Harrington CR.Selective inhibition of Alzheimer disease-like tau aggregation by phenothiazines. Proc Natl Acad Sci U S A 1996;93(20):11213–8.
10. Okamura N, Furumoto S, Harada R, Tago T, Yoshikawa T, Fodero-Tavoletti M, et al. Novel 18F-labeled arylquinoline derivatives for noninvasive imaging of tau pathology in Alzheimer disease. J Nucl Med 2013;54(8):1420–7. doi:10.2967/jnumed.112.117341.
11. Okamura N, Furumoto S, harada R, et al. In vivon selective imaging of tau pathology in Alzheimers disease with F-18 THK 5117. J Nucl med 2014; 55: 136. Okamura N, Furumoto S, Fodero-Tavloletti MT, et al. Non-invasive assessment of Alzheimers disease neurofibrillary pathology using F-18 THK 5105 PET. Brain 2014; 137: 1762-71.
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With Best Complements
From:
Mrs. Renu Vohra
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You Can Make a Difference Donations Received During 2015-2016
1. Mrs. Pushpa Chopra - 2,00,000
2. Wg. Cdr. R. N. Dawar - 1,00,000
3. World Bank - 84,434.98
4. Mr. Upal Roy - 82,500
5. Mrs. Vandini Khanna - 68,500
6. Mrs. Sonu Bhatnagar - 50,000
7. Ms. Jaya Subramaniam - 50,000
8. Lt Col. V. K. Aggarwal - 50,000
9. Mr. Kamal Naini Sharma - 50,000
10. Mrs. Nayana Agarwal - 35,000
11. Mrs. Sharda Subramaniam - 31,000
12. Dr. Santosh Chawla - 30,000
13. Mr. K. C. Rai - 30,000
14. Mr. V. K. Anand - 25,000
15. Krishna Somany Charitable Trust - 25,000
16. Shri Bharat International Private Limited - 25,000
17. Mr. S. P. Sharma - 22,000
18. Mr. Ram Arvind - 21,000
19. Mrs. Kamla Subramaniam - 20,500
20. Ms. Asha Pandit - 20,000
21. Ms. Meera Khanna - 20,000
22. Mr. S. N. Kuckreja - 15,000
23. Mr. Abhishek Saran - 10,135
24. Mrs. Usha Pratap Singh - 10,000
25. Mr. Lalit Nirula - 10,000
26. Ms. Meera Anand - 10,000
27. Mr. Bharat Mahay - 10,000
28. Mrs. Kamla Das - 10,000
29. Mr. Nitin Nath - 10,000
30. Mr. Kanwal Nath - 10,000
31. Mr. Ramesh Chandra Agarwal - 10,000
32. Focus Machines India Private Limited - 10,000
33. Mr. Arun Seth - 10,000
34. Mr. Raj Kumar Khanna - 10,000
35. Mr. Bipin C. Shah (FCRA) - 6,776.75
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36. Mrs. Tripta Sharma - 5,500
37. Mrs. Aradhna Sharma - 5,100
38. Mr. R. C. Gupta - 5,100
39. Ms. Anuradha Sharma - 5,000
40. Ms. Renu Sud Karnal - 5,000
41. Mr. Vinod C. Khanna - 5,000
42. Mrs. Gita Das - 5,000
43. Ms. Kamla Nath - 5,000
44. Tirupati Charitable Trust - 5,000
45. Mr. R.N. Grover - 5,000
46. Mr. G.C. Khanna - 5,000
47. Mr. Vijay Kumar Seth - 5,000
48. Mr. Gp. Capt Shailendra Mohan - 2,500
49. Mr. H. K. Kaul - 2,000
50. Ms. Konia Khanna - 2,000
51. Mr. R. R. Khullar - 2,000
52. Ms. Sneh Pasricha - 1,710
53. Mr. Avinash Chand Jain - 1,500
54. Mr. Inder Sharma - 1,100
55. Mr. Raj Khanna - 1,100
56. Academy of Fashion Studies - 1,000
57. Mr. K. L. Dalal - 1,000
58. Mr. K. N. Venugopal - 1,000
59. Mr. Shalabh Jain - 500
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Release of Souvenir on 21st Sept 2015 Audience of WAD 2015
Founders Day Picnic Founders Day Picnic
Talk Session Talk Session44
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Creative Activities by Clients at Day Care Centre Creative Activities by Clients at Day Care Centre
Celebrating Independence Day atDay Care Centre
Celebrating Independence Day atDay Care Centre
Chronic Care Facility at FaridabadPainting Activity at Day Care Centre45
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ALZHEIMER’S DISEASE LET’S MAKE A DIFFERENCE
WHAT SERVICES ARDSI-DELHI CHAPTER IS RENDERING
HOW YOU CAN HELP
l Awareness generation on Alzheimer’s Disease.l Training of volunteers and group of caregivers.l Identification of aged persons from different strata of the community within Delhi and NCR
to them support on Alzheimer’s and Related Disorders.l Online advice, counseling and dissipation of relevant information about Alzheimer’s
Disease through a dedicated Helpline service.l Maintain a pool of medical practitioner whose services can be used when required.l Carry out home visits to Alzheimer’s patients.l Memory testing and diagnosis at ARDSI-DC (Preliminary) and also at All India Institute of
Medical Science and Ram Manohar Lohia Hospital for detail investigation.l Provision and free distribution of essential medicines prescribed by qualified doctors to the
poor patients.
You can do a lot to help its victim and their families. Become a volunteer member of the ARDSI-Delhi Chapter to donate for a cause.
I wish to work as a volunteer member
I wish to Donate Rs..................................... Tick your choice
Monthly / Quarterly/ Yearly/ One Time
(Cheque should be made in favour of ARDSI-Delhi Chapter
Name. ....................................................................................... Age................................(In Capital Letters)
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Donation to ARDSI are eligible for Tax relief U/S 80 G of Income Tax Act 1961.
Alzheimer’s & Related Disorders Society of India (ARDSI)- Delhi ChapterRZ- 62/9, Tughlakabad Extention, (Panchvati), New Delhi - 110019
Tel. 011-29994940, 64533663
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