International Day of the Elderly -01.10.2014-Leaving No One Behind: Promoting a Society for All

International Day
of Older Persons
1 October 2014

2014 Theme:
Leaving No One Behind: Promoting a Society for All




Why do we need an International Day of Older Persons?   By 2020, half of our Indian population will be aged 50 or over.  People have a better quality of living, which means longer lives!

Well, as the population changes, the country will too.  We need to improve attitudes towards older people and appreciate the roles they play in society more.  They can be forgotten about and sometimes treated like lesser members of society.  That's definitely not how I want to be treated when I'm older, so let's take care of the elderly in the present and carry it on to the future!

"Leaving No-One Behind" necessitates the understanding that demography matters for sustainable development and that population dynamics will shape the key developmental challenges that the world in confronting in the 21st century. If our ambition is to "Build the Future We Want", we must address the population over 60 which is expected to reach 1.4 billion by 2030.

EHMTIC 2014 Copenhagen

Attended 4th European. Headache and Migraine Trust International Conference- EHMTIC from 1 8-21 September 2014 at Copenhagen Denmark

World Rabies Day 28.09.2014- Rabies Is Preventable

At least one person dies every ten minutes from rabies a disease that leaves him or her begging for the end.

Up to 60% of estimated 55,000 people are children under 15 years old. 95% of victims are from Africa or Asia, few have access to palliative care that would alleviate the suffering of their final hours.


It’s estimated that 20,000,000 dogs are indiscriminately culled every year, in misguided attempts to control the disease (tragically, culls cause disruptions in the population can actually accelerate outbreaks). 


84% of the people who die of rabies are from impoverished communities in rural areas of Africa and Asia.

Where rabies is endemic, every dog bite is a potential exposure so millions of people every year go in search of post-exposure prophylaxis to prevent the onset of the disease. This treatment is expensive and overwhelmingly, the price is paid by people who can least afford it.

The knock-on effects for families struggling to extract themselves from poverty are devastating.

A study published last year found that rabies currently costs the world’s poor $124 billion but could be prevented for just $6 billion.


World Rabies Day is here to spread the word that Rabies Is Preventable.



World Rabies Day is September 28

Rabies remains a major concern worldwide, killing more than 55,000 people every year. In the United States, one to two people die annually, and there were more than 6,000 reported cases of animal rabies in the U.S. in 2012.

In India every year 20000 people died of rabies.

World Rabies Day was officially launched in 2007, and aims to raise awareness about the public health impact of human
and animal rabies.



Key facts

Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.

Infection causes tens of thousands of deaths every year, mostly in Asia and Africa.

40% of people who are bitten by suspect rabid animals are children under 15 years of age.

Dogs are the source of the vast majority of human rabies deaths.

Immediate wound cleansing and immunization within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death.

Every year, more than 15 million people worldwide receive a post-exposure vaccination to prevent the disease – this is estimated to prevent hundreds of thousands of rabies deaths annually.

Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus. The disease affects domestic and wild animals, and is spread to people through close contact with infectious material, usually saliva, via bites or scratches.

Rabies is present on all continents with the exception of Antarctica, but more than 95% of human deaths occur in Asia and Africa. Once symptoms of the disease develop, rabies is nearly always fatal.

Rabies is a neglected disease of poor and vulnerable populations whose deaths are rarely reported. It occurs mainly in remote rural communities where measures to prevent dog to human transmission have not been implemented. Under-reporting of rabies also prevents mobilization of resources from the international community for the elimination of human dog-mediated rabies.

Symptoms

The incubation period for rabies is typically 1–3 months, but may vary from <1 week to >1 year. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) at the wound site.

As the virus spreads through the central nervous system, progressive, fatal inflammation of the brain and spinal cord develops.

Two forms of the disease can follow. People with furious rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia and sometimes aerophobia. After a few days, death occurs by cardio-respiratory arrest.

Paralytic rabies accounts for about 30% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. The muscles gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Diagnosis

No tests are available to diagnose rabies infection in humans before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present, the clinical diagnosis may be difficult. Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques aimed at detecting whole virus, viral antigens or nucleic acids in infected tissues (brain, skin, urine or saliva).

Transmission

People are usually infected following a deep bite or scratch by an infected animal. Dogs are the main host and transmitter of rabies. They are the source of infection in all human rabies deaths annually in Asia and Africa.

Bats are the source of most human rabies deaths in the Americas. Bat rabies has also recently emerged as a public health threat in Australia and western Europe. Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses and other wild carnivore host species are very rare.

Transmission can also occur when infectious material – usually saliva – comes into direct contact with human mucosa or fresh skin wounds. Human-to-human transmission by bite is theoretically possible but has never been confirmed.

Rarely, rabies may be contracted by inhalation of virus-containing aerosol or via transplantation of an infected organ. Ingestion of raw meat or other tissues from animals infected with rabies is not a source of human infection.

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis (PEP) consists of:

local treatment of the wound, initiated as soon as possible after exposure;

a course of potent and effective rabies vaccine that meets WHO recommendations; and

the administration of rabies immunoglobulin, if indicated.

Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death.

Local treatment of the wound

Removing the rabies virus at the site of the infection by chemical or physical means is an effective means of protection. Therefore, prompt local treatment of all bite wounds and scratches that may be contaminated with rabies virus is important. Recommended first-aid procedures include immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances that kill the rabies virus.

Recommended PEP

PEP depends on the type of contact with the suspected rabid animal (see table).




Table: Categories of contact and recommended post-exposure prophylaxis (PEP)

Categories of contact with suspect rabid animal

Post-exposure prophylaxis measures

Category I – touching or feeding animals, licks on intact skin

None

Category II – nibbling of uncovered skin, minor scratches or abrasions without bleeding

Immediate vaccination and local treatment of the wound

Category III – single or multiple transdermal bites or scratches, licks on broken skin; contamination of mucous membrane with saliva from licks, contacts with bats.

Immediate vaccination and administration of rabies immunoglobulin; local treatment of the wound

All category II and III exposures assessed as carrying a risk of developing rabies require PEP. This risk is increased if:

the biting mammal is a known rabies reservoir or vector species;

the animal looks sick or has an abnormal behaviour;

a wound or mucous membrane was contaminated by the animal’s saliva;

the bite was unprovoked; and

the animal has not been vaccinated.

In developing countries, the vaccination status of the suspected animal alone should not be considered when deciding whether to initiate prophylaxis or not.

Who is most at risk?

Dog rabies potentially threatens over 3 billion people in Asia and Africa. People most at risk live in rural areas where human vaccines and immunoglobulin are not readily available or accessible.

Poor people are at a higher risk, as the average cost of rabies post-exposure prophylaxis after contact with a suspected rabid animal is US$ 40 in Africa and US$ 49 in Asia, where the average daily income is about US$ 1–2 per person.

Although all age groups are susceptible, rabies is most common in children aged under 15. On average 40 % of post-exposure prophylaxis regimens are given to children aged 5–14 years, and the majority are male.

Anyone in continual, frequent or increased danger of exposure to rabies virus – either by nature of their residence or occupation – is also at risk. Travellers with extensive outdoor exposure in rural, high-risk areas where immediate access to appropriate medical care may be limited should be considered at risk regardless of the duration of their stay. Children living in or visiting rabies-affected areas are at particular risk.

Prevention

Eliminating rabies in dogs

Rabies is a vaccine-preventable disease. The most cost-effective strategy for preventing rabies in people is by eliminating rabies in dogs through vaccination. Vaccination of animals (mostly dogs) has reduced the number of human (and animal) rabies cases in several countries, particularly in Latin America. However, recent increases in human rabies deaths in parts of Africa, Asia and Latin America suggest that rabies is re-emerging as a serious public health issue.

Preventing human rabies through control of domestic dog rabies is a realistic goal for large parts of Africa and Asia, and is justified financially by the future savings of discontinuing post-exposure prophylaxis for people.

Preventive immunization in people
Safe, effective vaccines can be used for pre-exposure immunization. This is recommended for travellers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking as well as for long-term travellers and expatriates living in areas with a significant risk of exposure.

Pre-exposure immunization is also recommended for people in certain high-risk occupations such as laboratory workers dealing with live rabies virus and other rabies-related viruses (lyssaviruses), and people involved in any activities that might bring them professionally or otherwise into direct contact with bats, carnivores, and other mammals in rabies-affected areas. As children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites, their immunization could be considered if living in or visiting high risk areas.

Our CM Jayalalithaa believe PEOPLE JUDGEMENT RATHER THAN PAPER WRITTEN JUDGMENT

Our CM Jayalalitha has been elected with full majority even wealth case was in progress. Our CM Jayalalithaa believe always PEOPLE JUDGEMENT RATHER THAN PAPER WRITTEN JUDGEMENT.

TN people always support Amma Definitely she will come out from ashes like the Pegasus bird

World Alzheimer’s Day, 21.09.2014-Dementia: can we reduce the risk?

World Alzheimer’s Day, September 21st


Dementia can we reduce the risk? Pro. Dr.M.A.Aleem M.D.D.M(Neuro) , Professor of Neurology, KAPV Government Medical College & MGM Government Hospital Trichy – 620017.Tamilnadu India. Cell: 94431-59940

Dementia is a syndrome – usually of chronic or progressive nature – in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment. Consciousness is not affected. By deterioration in emotional control, social behavior, or motivation.

Although dementia mainly affects older people, it is not a normal part of ageing.

World wide, 35.6 million people have dementia and there are 7.7 million new cases every year

Alzheimer’s disease is the most common cause of dementia and may contribute to 60 – 70% of cases.

World Alzheimer’s Day, September 21st of each year, is a day on which Alzheimer‘s organizations around the world concentrate their efforts on raising awareness about Alzheimer‘s and dementia. Alzheimer’s disease is the most common form of dementia, a group of disorders that impairs mental functioning.

Alzheimer’s disease is often called a family disease, because the chronic stress of watching a loved one slowly decline affects everyone.

Alzheimer’s is not a normal part of aging.

Alzheimer’s disease is an irreversible degeneration of the brain that causes disruptions in memory, cognition, personality, and other functions that eventually lead to death from complete brain failure.

Alzheimer’s is growing epidemic.

Alzheimer’s is on the rise throughout the world.

Worldwide, nearly 44 million people are believed to be living with Alzheimer’s disease or other dementias. By 2050, rates could exceed 135 million.

Every four seconds, a new case of dementia occurs somewhere in the world.


The overall economic impact is staggering.

If dementia care were a country’s economy, it would be the world’s 18th largest, ranking between Turkey and Indonesia. If it were a company, it would be the world’s largest by annual revenue, exceeding Walmart (US$414 billion) and Exxon Mobil (US$311 billion).

People who have Alzheimer’s disease need others to care for them, and many of those providing care are not paid for their time and services.

Caring for a person with Alzheimer’s or another dementia is often extremely difficult, and many family and other unpaid caregivers experience high levels of emotional stress and depression as a result.

Caring for someone with Alzheimer’s disease has been found to have a negative impact on the health, employment, income and financial security of many caregivers.

Alzheimer’s is the only leading cause of death that is still on the rise.

Alzheimer’s disease is the sixth – leading cause of death across all ages .For those 65 and older, it is the fifth – leading cause of death.

Between 2000 and 2008, deaths attributed to Alzheimer’s disease increased 66%, while those attributed to the number one cause of death – heart disease – decreased 13%. This increase reflects changes in patterns of reporting deaths on death certificates over time as well as an increase in the actual number of deaths attributable to Alzheimer’s. Alzheimer’s disease is the only major cause of death that significantly increased from 2009 to 2010, while other major causes of death declined.

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive disease in which healthy brain tissue degenerates, resulting in problems with memory, behavior, and other mental abilities. It is the most common cause of dementia (the loss of memory and other intellectual abilities serious enough to interfere with daily life)

What are the symptoms?

The symptoms of Alzheimer’s disease are more serious than the mild memory changes that typically accompany aging. Symptoms may start gradually but eventually become severe enough to interfere with activities of daily living. They include:
Increasingly worse memory loss, especially forgetting recently learned information

Difficulty performing familiar tasks, such as cooking or making a phone call

Difficulty in finding the right words.

Problems with abstract thinking, such as trouble balancing a checkbook

Poor judgment, such as dressing inappropriately for the weather or overspending money

Misplacing things or putting them in unusual places, like putting car keys in the freezer

Disorientation, such as getting lost in familiar surroundings

Loss of initiative

Changes in mood, behavior, and personality.

Although the course of Alzheimer’s disease is individual and highly variable, most people with the condition will survive about eight to ten years after being diagnosed.

Stages of dementia

Dementia affects each person in a different way, depending upon the impact of the disease and the person’s personality before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.

Early stage: the early stage of dementia is often overlooked, because the onset is gradual. Common symptoms include:

Forgetfulness

Losing track of the time

Becoming lost in familiar places.

Middle stage: as dementia progresses to the middle stage, the signs and symptoms become clearer and more restricting. These include.

Becoming forgetful of recent events and people’s names

Becoming lost at home

Having increasing difficulty with communication

Needing help with personal care

Experiencing behavior changes, including wandering and repeated questioning.

Late stage: the late stage of dementia is one of near total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include:

Becoming unaware of the time and place.

Having difficulty recognizing relatives and friends

Having an increasing need for assisted self – care

Having difficulty walking

Experiencing behavior changes that may escalate and include aggression.

Common forms of Dementia

There are many different forms, or causes, of dementia. Alzheimer’s disease is the most common form of dementia and may contribute to 60 – 70% of cases. Other major forms include vascular dementia, dementia with Lowy bodies (abnormal aggregates of protein that develop inside nerve cells), and a group of diseases that contribute to front temporal dementia (degeneration of the frontal lobe of the brain). The boundaries between different forms of dementia are indistinct and mixed forms often co – exist.

Rates of dementia

World wide, 35.6 million people have dementia, with just over half (58%) living in low – and middle – income countries. Every year, there are 7.7 million new cases.

The estimated proportion of the general population aged 60 and over with dementia at a given time is between 2 to per 100 people.

The total number of people with dementia is projected to almost double 20 years, to 65.7 million in 2030 and 115.4 million in 2050. Much of this increase is attributable to the rising numbers of people with dementia living in low – and middle – income countries

What are the causes?

The exact cause of Alzheimer’s disease isn’t yet clear. However, scientists know that the brains of people with the condition contain abnormal clumps and knots of brain cells, called plaques and tangles. These plaques and tangles are made up of proteins that may be involved in the neurone (nerve cell) death that occurs in Alzheimer’s disease. Researchers also believe that the inflammation observed in the brains of some people with disease may play a central role.

Who is likely to develop Alzheimer’s disease?
Alzheimer’s appears be influenced by a combination of genetic, environmental, and other factors. Some major factors that appear to increase the risk of Alzheimer’s disease include:

Age: Alzheimer’s disease is most common in people older than age 65.

Family history: Having a parent or sibling with the disease slightly increases risk.
Genetic mutations: Three genetic mutations are known to cause early – onset Alzheimer’s, while a form of the APOE gene increases risk of late – onset disease.

Gender: Women are more likely than men to develop Alzheimer’s disease.

Other conditions: The same factors that raise the risk of heart disease, such as high blood pressure, high cholesterol, and diabetes, also increase Alzheimer’s risk.

Education: Research shows a link between lower education levels and higher risk of Alzheimer’s disease.

Head injure: Some studies show a link between traumatic head injuries and Alzheimer’s risk.

How is Alzheimer’s disease diagnosed?

Alzheimer’s disease is typically diagnosed after doctor’s rule out other conditions. There is no specific test used to diagnose or confirm the diagnosis of Alzheimer’s disease. General test than can help doctors determine whether a patient has Alzheimer’s disease include:

Physical exam

Blood tests

Mental and memory tests

Brain scans

What is the conventional treatment?

Although there is no cure for Alzheimer’s disease at this time, medications can help treat symptoms of the condition. Conventional doctors may recommend one of five prescription drugs currently approved to treat Alzheimer’s, depending on the severity of the illness. These medications are:

(galantamine)

(rivastigmine)

(donepezil)

(tacrine)

(memantine)

These drugs affect brain chemicals and may help improve symptoms of Alzheimer’s and allow patients to perform daily activities longer than they otherwise would be able to numerous new treatment s are being investigated in various stages of clinical trials.

Much can be, however, offered to support and improve the lives of people with dementia and their caregivers and families. The principal goals for dementia care are:

Early diagnosis

Optimizing physical health, cognition, activity and well – being

Identifying and treating accompanying physical illness

Detecting and treating behavioral and psychological symptoms
Providing information and long – term support to caregivers.

Risk factors and prevention

Research identifying modifiable risk factors of dementia is scarce. Prevention focuses on targets suggested by available evidence, which include countering risk factors for vascular disease, such as diabetes, midlife hypertension, midlife obesity, smoking and physical inactivity.

What therapies dose Doctor Will recommend for preventing and slowing the progression of Alzheimer’s disease?

Dietary changes: A2002 study published in the New England Journal of Medicine indicated that people who have high blood levels of toxic amino acid known as homocysteine have twice the usual risk of developing Alzheimer’s disease. Homocysteine levels tend to be higher in people whose diets are high in animal protein; conversely, fruits and leafy green vegetables provide folic acid and other B vitamins to help the body reduce homocysteine levels. It’s difficult to establish cause and effect but reducing animal protein and eating more plant foods is a good idea for general health, and may help to prevent or alleviate symptoms of Alzheimer’s.

An anti – inflammatory diet is generally protective against a wide range of diseases, and Alzheimer’s disease is believed to have an inflammatory component.

One particularly promising spice is turmeric; one of its components, curcumin is strongly anti – inflammatory. Elderly villagers in India have one of the world’s lowest rates of Alzheimer’s; the reason may be the turmeric that they consume in their daily curries.

Exericise: Research indicates that regular physical exercise can lower the risk of developing Alzheimer’s by up to 50 percent. A Japanese study found that among 265 people with both normal mental function and mild cognitive impairment due to Alzheimer’s after one year of moderate exercise intervention, 70 percent of participants showed significant improvement in memory function. And the more the participants exercised, the greater the improvement. Aim for at least 30 minutes of aerobic activity such as walking, cycling or swimming on most days of the week.
Mind/Body: People who participate in mentally stimulating activities such as reading and playing cards are at lower risk for developing Alzheimer’s disease. Other research shows that the more years of formal education you have the less likely you are to develop the condition. The theory is that challenging intellectual activity builds up rich neural connections that function as insurance against later brain – tissue losses, just as well – developed muscles maintain their integrity longer during periods of inactivity than atrophied muscles.

Traditional Chinese Medicine (TCM): In Chinese medicine, Alzheimer’s disease is not yet recognized as a separate disease entity. Instead, it falls under the broader category of senile dementia. Practitioners of TCM often recommend herbal preparations for senile dementia; more research is needed to determine effectiveness.

Supplements: Some studies suggest that vitamins C and E, either in foods or supplements are protective against Alzheimer’s. In a January, 2004 study published in the Archives of Neurology researchers reported that older people who took daily supplements containing at least 400 IU of vitamin E and 500 mg of vitamin C were 64 percent less likely to develop the condition.

In May of 2008, the journal Neurology published a study from Boston University School of Medicine showing that people who took ibuprofen for more than five years had a 44 percent lower than normal risk of developing Alzheimer’s and that other NSAIDs reduced the risk by 25 percent. This study included more than 49,000 U.S. veterans aged 55 and older who developed Alzheimer’s and nearly 200,000. Who didn’t. Ibuprofen is the active ingredient in Advil, Motrin and other pain medications. While this suggests that NSAIDs have a protective effect, it is not clear which ones work best or that people should start taking any of them to ward of Alzheimer’s . First of all, taking NSAIDs long – term isn’t risk – free. These drugs can cause serious gastrointestinal problems including stomach ulcers and bleeding, and even fatal GI bleeds, and it is not known yet know if the benefits out weight these risks. More research is needed to look at that and to determine which NSAIDs are most effective. If one (or all) of the drugs prove to work as well as studies so far indicate, the next step will be to determine when to take them – and for how long – for maximum protection.
Ginkgo (Ginkgo biloba), a traditional herbal preparation made from the leaves of the ginkgo tree can increases blood flow to the brain. Some clinical evidence suggests that ginkgo can be useful in slowing the progression of early Alzheimer’s disease and age – related dementia. If you want to try ginkgo for memory enhancement, take 40mg of a standardized extract with a ratio of 24% ginkgo flavones glycosides and 6% terpene lactones three times a day with meals. Give it a two – month trial.

Also: Avoid smoking; smokers have twice the risk of developing Alzheimer’s as nonsmokers.

Protect yourself from head trauma, which has also been linked to increased Alzheimer’s risk, perhaps due to low – grade inflammation as the brain attempts to heal itself. Wear a helmet when on a motorcycle, bicycle, skates or skis, and high – traction footwear when surfaces are icy.

Maintain a normal weight; a study in Neurology online in March, 2008, revealed a potential link between excessive belly fat among people in their 40s and the onset of Alzheimer’s about 35 years later. Of the 6,583 people studied, those in the highest20 percent in terms of belly size were three times more likely to develop dementia than were those in lowest 20 percent.

Social and economic impacts
Dementia has significant social and economic implications in terms of direct medical costs, direct social costs and the costs of informal care. In 2010, the total global societal costs of dementia was estimated to be US$ 604 billion. This corresponds to 1.0% of the worldwide gross domestic product (GDP), or 0.6% if only direct costs are considered. The total cost as a proportion of GDP varied from 0.24% in low – income countries to 1.24% in high – income countries.

Impact on families and caregivers

Dementia is over whelming for the families of affected people and for their caregivers. Physical, emotional and economic pressures can cause great stress to families and caregivers, and support is required from the health, social, financial and legal systems.
Human rights

People with dementia are frequently denied the basic rights and freedoms available to other. In many countries, physical and chemical restraints are used extensively in care facilities for elderly people and in acute – care settings, even when regulations are in place to uphold the rights of people to freedom and choice.

An appropriated and supportive legislative environment based on internationally accepted human rights standards is required to ensure the highest quality of service provision to people with dementia and their caregivers.

E - Cigarette Health Issues-M A Aleem BMJ⁠ 2014;349:g5512

Analysis

Essay

E-cigarettes: the best and the worst case scenarios for public health—an essay by Simon Chapman

BMJ⁠ 2014⁠; 349⁠ doi: http://dx.doi.org/10.1136/bmj.g5512 (Published 09 September 2014)⁠

Cite this as: BMJ⁠ 2014;349:g5512

Responses

E - Cigarette Health Issues

The World Health Organization, United Kingdom and United States seem to favour regulating e-cigarettes in exactly the same way as tobacco, with strict advertising rules and heavy taxation. The European Union looks to be somewhere in the middle, proposing both controls on ingredients and nicotine strength and marketing restrictions. Some countries, such as Brazil, have simply banned them outright, while many local authorities – including New York City, Chicago and Los Angeles – have outlawed their use in public places, just like tobacco. With passions running high on both sides, the debate around e-cigarettes seems unlikely to be settled any time soon.

Competing interests: No competing interests

12 September 2014

M A Aleem

Neurologist

Kapv Govt Medical College MGM Govt Hospital ABC Hospital

Trichy 620018 Tamilnadu India

10th Asian & oceanian epilepsy congress

Attended the 10th Asian &Oceanian epilepsy congress at Singapore from 7th to10th August 2014

Neurologica 9.0 in 2014

As a key advisory board member attended the educational symposium on epilepsy update no women and child held at Beijing China from 23rd to 26th June 2014

World Suicide Prevention Day 10.09.2014- ‘suicide prevention: one world connected.’

World Suicide Prevention Day 10.09.2014

Dr.M.A.Aleem.M.D.D.M., (Neuro) professor of Neurology KAPV Government Medical college.& MGM Government Hospital Trichy -620017.Tamilnadu Cell: 94431-59940 E-mail: drmaaleem@hotmail.com

Introduction

Nearly 3000 People on average commit suicide daily according to WHO. For every person who completes a suicide, 20 or more may attempt to end their lives. About one million people die by suicide each year this roughly corresponds to one death every 40 seconds. Suicide is a major preventable cause of premature death which is influenced by psycho-social cultural and environmental risk factors that can be prevented through worldwide reduce suicides

World suicide prevention day, which first started in 2003, is annually held on September 10 each year. World suicide prevention Day aims to:

 Raise awareness that suicide is preventable.

 Improve education about suicide.

 spread information about suicide awareness

 Decrease stigmatization regarding suicide.

Suicide prevention: one world connected

Suicide is a major public health problem. The psychological pain that leads each of these individuals to take their lives is unimaginable. Their deaths leave families and friends bereft, and often have a major ripple effect on communities.The number of live lost each year through suicide exceeds the number of deaths due to homicide and war combined.

Suicide is the fifth leading causes of death among those aged 30-49 years in 2012 globally, and is the second leading cause of death in the 15-29 years age group in 2012 globally.

In 2012, suicide accounted for 1.4% of all deaths worldwide, making it the 15th leading cause of death. Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved.


Efforts to prevent suicide have been celebrated on world suicide prevention Day-September 10th –each year since 2003. In 2014, the theme of world suicide prevention Day is ‘suicide prevention: one world connected.’ the theme reflects the bract that connections are important at several levels if we are to combat suicide.

Connectedness is crucial to individuals who may be vulnerable to suicide. Studies have shown that social isolation can increase the risk of suicide and conversely, that having strong human bonds can be protective against it. Reaching out to those who have become disconnected from others and offering them support and friendship may be a life-saving act.

Connectedness can also be understood in terms of clinical care. Mental illness, particularly depression, is an important risk factor for suicide. Internationally, treatments for mental illness have improved, but access to these treatments remains unequal. Primary care providers, often the first port of call for people with mental illness, are not always able to diagnose and treat mental illness. Specialist mental health care providers are not always available, so referral options may be limited. Even when services are available, they are not always sufficiently well coordinated to provide optimal care. People with mental illness often’ fall through the cracks, particularly-but not exclusively-in developing countries. Connectedness and collaboration between services is also important at this level in prevention suicide. The right service or individual clinician must be available at the right time for someone with mental health problems, and must be able to offer and deliver effectively the full range of treatment options.

Finally, connectedness is necessary at a national and international level. Many clinical and non-clinical organizations are working towards the goal of preventing suicide, but their efforts are not always synchronized. World suicide prevention Day has proved to be very successful in encouraging organizations to coordinate their efforts and learn from each other. It has also assisted those who have been bereaved by suicide in making themselves heard in discussions about suicide prevention. This has sharpened the focus on activities that are effective in preventing suicide.

World Suicide Prevention Day in 2014 is significant because it makes the release by the WHO of the World Suicide Report (WSR). The report follows the adoption of the Comprehensive Mental Health Action plan 2013 – 2020 by the World Health Assembly, which commits all 194 member states to reducing their suicide rates by 10% by 2020.

Young Indians are more likely to commit suicide than previously thought, especially those living in wealthier and more educated regions, according to a study on Friday that experts say suggests India’s rapid development is driving many youths to despair.

Opportunities that have come with two decades of economic boom and open markets have also brought more job anxiety, higher expectations and more pressure to achieve, mental health experts said.In India suicide rates are highest in the 15-29 age groups, peaking in southern regions that are considered richer and more developed with better education, social welfare and health care.

That puts the young at high risk – new phenomenon experts said has happened recently as more middle-class youths strive to meet achievement expectations, and new technologies like cell phones and social networking sites help break down traditional family units once relied on for support.

The WHO reports about 1 million suicides a year, which would be a rate of about 14 per 100,000 in a global population of 7 billion. By comparison, the U.S. had 37,790 suicides in 2010, or a rate of 12.2 per 100,000 , while India’s rate of suicide tally at 187,000 would be near 16 per 10,0000 which is far higher than earlier reports and estimates of around 10/100,000.

There has been little scientific examination of suicide motives in India.

The likely reasons for the rise in suicide among young India people beyond the increased pressure that has come with new economic opportunity and social fragmentation.

The higher rates may come from “the greater likelihood of disappointments when aspirations that define success and happiness are distorted or unmet by the reality faced by young people in a rapidly changing society.The social networking was also making “loneliness more common” which may also predispose suicidal ideas Among men, 40 per cent of suicides were among people age 15-29. For women, in was nearly 60 per cent.


The numbers mean young men are nearly as likely to die from suicide and in traffic accidents, while rates of suicide among young women are nearly as high as the rate of death by complications from pregnancy of childbirth.

There are few facilities in India for mental health problems, and stigmas prevent many people from seeking support. Telephone help lines are often not adequately staffed, and many schools do not have counselors. But in Tamilnadu our chief minister has recently open the 104 help line which very much useful to prevent suicide in Tamilnadu.

Teleconsultation is better than Email . M A Aleem BMJ⁠ 2014;349:g5338

Head To Head

Should patients be able to email their general practitioner?

BMJ⁠ 2014⁠; 349⁠ doi: http://dx.doi.org/10.1136/bmj.g5338 (Published 02 September 2014)⁠

Cite this as: BMJ⁠ 2014;349:g5338

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Teleconsultation is better than Email

Through email only a little information about the health of a patient can be shared with a general practitioner. But through telephone and through web cameras much more information about the health status of a patient can be shared in a consultation with a general practitioner, who can guide the patient accordingly. This may also be useful to all at primary secondary and referral health care services in both developing and in developed countries.

Competing interests: No competing interests

05 September 2014

M A Aleem

Neurologist

Kapv Govt Medical College MGM Govt Hospital ABC Hospital

Trichy 620018 Tamilnadu India

Students hold fort at medical college

Students hold fort at medical college

Sep 2, 2014, 05.40AM IST TNN R. Gokul
Times of India Trichy



TRICHY: There was an air of excitement at the K A P Viswanatham Government Medical College (KAPVGMC) as classes for the first-year MBBS course commenced with renewed vigour on Monday. What is significant about the excitement, especially on the part of the institution was the fact that from this year, the college has been allowed to admit 150 students from the previous years' norm of 100 seats.

On Monday, students from all walks of life with many hailing from rural areas stepped into their new campus. The officials on the other hand are leaving no stone unturned and have formed an anti-ragging committee and a ragging squad to prevent the menace. The first day of the classes was marked with a function in which parents of all the 150 students from many parts of the state and some other states like Kerala, Andhra Pradesh, Telangana and Uttar Pradesh participated.

Recently, the Medical Council of India (MCI) had given the nod for the additional 50 seats from this year after a long struggle by the college. Though the MCI had given the approval to increase the seats to 150 from 100 seats in the last academic year itself, the recognition was delayed till few months back.

"We are happy with the recognition by MCI. The college last year itself was given the approval for 150 seats and it was recognised this year. Students from rural areas will be benefitted because of the increase in the number of seats," dean Dr P Karkuzhali told TOI on the sidelines of the fresher's day programme. She also said that the college was equipped with necessary academic facilities as well as accommodation for the students.

Of the total 150 seats, 89 seats were taken by female students while 61 seats went to male students. As many as 22 seats were allotted for all-India quota students.

Likewise, students from rural areas accounted for more than 60% of the total students in KAPVGMC. Karkuzhali said that many students preferred KAPVGMC after Madras Medical College in Chennai. An anti-ragging committee consisting of 15 doctors and a ragging squad with five doctors have been put in place to ensure there will be incidences of ragging in the college.

She also advised the parents to keep vigil on their children even after admitting them in colleges. "Many parents think that their duty is over after enrolling their children in colleges but it is not so. They should keep a watch on their children's attitude and their progress in their studies. The parents should send their feedback in the progress report sent to them," said Karkuzhali.

Dr M A Aleem, vice-principal of KAPVGMC told the students to keep up with the dress code laid down by directorate of medical education (DME). "The students should adopt the dress code prescribed for them. They should also avoid using cell phones during the classes," said Dr Aleem.