World Stroke Day 2019 October 29th : "Cut Stroke In Half" focus on stroke risk and prevention PROF DR.M.A.ALEEM M.D., D.M.,(NEURO) NEUROLOGIST TRICHY TAMILNADU INDIA


World Stroke Day 2019 October 29th : "Cut Stroke In Half " focus on stroke risk and prevention

PROF DR.M.A.ALEEM M.D., D.M.,(NEURO)

EMERITUS PROFESSOR OF NEUROLOGY


THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY

PAST PRESIDENT TAMILNADU PONDICHERY ASSOCIATION OF NEUROLOGISTS

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL

CONSULTANT NEUROLOGIST AND EPILEPTOLOGIST (TRAINED AT INSTITUTION OF NEUROLOGY QUEEN`S SQUARE . LONDON.UK.) ABC HOSPITAL, ANNAMALAI NAGAR , TRICHY -620018

SECRETARY NEUROLOGIST ASSOCIATION TIRUCHIRAPPALLI

DIRECTOR ABC HOSPITAL TRICHY


The analysis of the Global Burden of Disease, which shows that globally the lifetime risk of stroke has risen and now stands at 1 in 4. Combined with the Interstroke findings that showed around 90% of strokes are linked to a small number of easily addressed risk factors, the potential impact of public understanding of stroke risk and prevention awareness is clear.

This year my message When it comes to stroke, think prevention – Don’t be the one.’is relevant and essential to everyone about stroke

Stroke is not prevented by hoping it will never happen to you. This campaign encourages everyone to be proactive by understanding their stroke risk and taking the steps to prevent stroke and its devastating consequences.

While our efforts on World Stroke Day are largely directed towards raising public awareness of the steps we can all take to reduce our risk, the 2019 campaign is a key component of our strategic commitment to 'Cut Stroke in Half'.

Stroke in India

Developing countries like India are facing a double burden of communicable and non-communicable diseases. Stroke is one of the leading causes of death and disability in our country. The estimated adjusted prevalence rate of stroke range, 84-262/100,000 in rural and 334-424/100,000 in urban areas. The incidence rate is 119-145/100,000 based on the recent population based studies. There is also a wide variation in case fatality rates with the highest being 42% .





Why stroke matters

A stroke can happen to anyone, at anytime and anywhere. Today stroke is the leading cause of disability worldwide and the second leading cause of death, but almost all strokes could be prevented.

This year 14.5 million people will have a stroke, 5.5 million people will die as a result.

80 million people have survived stroke worldwide.

Many stroke survivors face significant challenges that include physical disability, communication difficulties, changes in how they think and feel, loss of work, income


and social networks.

Learn about stroke


Stroke happens when the blood supply to part of the brain is cut off. Without blood, brain cells can be damaged or die.


Nearly 14 million people will have a stroke this year and around 5.5 million people will die as a result. Stroke can have different short- and long-term effects depending on which part of the brain is affected and how quickly it is treated.

Survivors can experience wide ranging disabilities including difficulties with mobility and speech, as well as how they think and feel. Fast access to treatment saves lives and improves stroke recovery.

Types of stroke

There are two main types of stroke, ischemic and haemorrhagic.

Ischemic strokes

These strokes occur as a result of an obstruction in a blood vessel supplying blood to the brain. An obstruction of blood flow in the blood vessel can cause a blood clot to form, this is called a cerebral thrombosis. The main cause of cerebral thromboses are fatty deposits in blood vessels and arteries (atherosclerosis).

Blood vessels can also be blocked by a blood clot that has formed in another part of the body, usually the heart or large arteries of the upper chest and neck. Sometimes a portion of a blood clot breaks loose, enters the bloodstream and travels through the brain's blood vessels until it reaches vessels too small to let it pass. This is called a cerebral embolism. The main cause of this kind of clot is an irregular heartbeat, known as atrial fibrillation (AF).

Haemorrhagic strokes

Haemorrhagic strokes happen when a weakened blood vessel ruptures and bleeds into the brain. The blood builds up and creates pressure on the surrounding brain tissue. These bleeds can be caused by an aneurysm or an arteriovenous malformation (AVM).

Aneurysm

An aneurysm is a ballooning of a weakened region of a blood vessel. If left untreated, the aneurysm continues to weaken until it ruptures and bleeds into the brain.

Arteriovenous Malformation (AVM)

An AVM is a cluster of abnormally formed blood vessels. Any one of these vessels can rupture, also causing bleeding into the brain.

Transient Ischemic Attack (TIA or mini-stroke)

A TIA is caused by a temporary disruption in the blood supply to an area of the brain. It can cause symptoms similar to a stroke, but unlike a stroke these symptoms pass quickly and usually fully resolve within 24 hours.

In the early stages of a TIA it is impossible to tell whether or not it is a stroke, so it is important to call emergency services. People who have TIA are also at risk of further TIAs or a full stroke, so it is important that they see a doctor who can look at the causes of the TIA and provide treatment for the underlying cause.

The risk factors for TIA are similar to those for stroke and similar to stroke, TIAs also contribute to an increased longer-term risk of dementia.

Recognising when someone is having a stroke and getting immediate emergency medical care makes a big difference to survival and recovery. Act FAST!

Signs of stroke FAST


Stroke happens when the blood supply to part of the brain is cut off. Without blood, brain cells can be damaged or die.

Stroke is a complex medical issue. But there are ways to significantly reduce its impact. Recognizing the signs of stroke early, treating it as a medical emergency, with admission to a specialized stroke unit, and access to the best professional care can substantially improve outcomes.

The main symptoms of stroke can be remembered and checked with the word FAST.

Face – is the face drooping to one one side


Arms – is there a weakness in one arm

Speech – is speech slurred or garbled

Time – if these symptoms are present it is time to call emergency services

Stroke treatment


Stroke is a complex medical issue. But there are ways to significantly reduce its impact. Recognizing the signs of stroke early, treating it as a medical emergency with admission to a specialized stroke unit, and access to the best professional care can substantially improve outcomes.


Stroke prevention


1 in 4 of us will have a stroke in our lifetime, but almost all strokes can be prevented. If you want to avoid a stroke the first step is to understand your individual risk factors.

Up to 90% of strokes could be prevented by addressing a small number of risk factors, including hypertension, diet, smoking and exercise. Preventive action on stroke would also contribute to a massive scale reduction in stroke and would conribute to global goals to reduce cardiovascular disease, cancer, diabetes and other significant causes of death and suffering worldwide.

Cut Stroke in Half


The World Stroke Organization is leading the development and implementation of an integrated prevention strategy that has potential to cut stroke in half by 2030. With a focus on low and middle income countries where stroke is not only more prevalent but has the most devastating impact the strategy includes:

Access to low-dose combination therapy for patients at medium risk of stroke


Development of stroke specialist Community Healthworkers


Access to innovative mobile technologies that support access to prevention infomormation

Key treatment issues

Low public awareness of symptoms, inadequate and uneven access to specialist stroke treatment and lack of coordinated action around the world are key issues in stroke.

Awareness

Saving lives and improving outcomes from stroke starts long before a patient has contact with a health professional. It starts with public awareness of stroke symptoms. Awareness of FAST improves timely access to specilaist medical treatment which minimises damage to the brain, increases the treatment options available, reducing the risk of death and disability. Sustained public awareness campaigns supported by governments and delivered in partnership with local stroke organizations go hand in hand with efforts to access to acute treatment.

Access to healthcare

Financial barriers to prevention and detection of stroke risk factors through universal health coverage and access to essential medicines is critical to stroke prevention and will reduce the individual and community costs of stroke. Acess to specialist acute stroke care through the development of stroke units and professional education is needed to broaden access to quality stroke care.

Rehabilitation and life after stroke

Rehabilitation starts in the hospital as soon as possible following a stroke. It can improve function and help the survivor regain as much independence as possible over time. Many stroke survivors will need on-going treatment to address the physical impact of stroke and to maintain their mental health and well-being. Universal health coverage should include access to rehabilitation and long-term care needs of stroke suruvivors.

SC consent for passive euthanasia hailed -The Hindu Tiruchi 10.3.2018

http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/medical-fraternity-hails-sc-consent-for-passive-euthanasia/article23018457.ece

Ramadan 2019 The Wisdom behind Fasting

The Wisdom behind Fasting

-PROF DR.M.A.ALEEM M.D., D.M.,(NEURO) 

EMERITUS PROFESSOR OF NEUROLOGY
THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY 

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT  MEDICAL COLLEGE AND MGM GOVERNMENT HOSPITAL
TRICHY- 620001

drmaaleem@hotmail.com

When Imam Sadiq was asked about the wisdom behind Ramalan fasting, he replied: “Allah (God) made fasting compulsory so that the poor and the rich would be the same. This is because the rich does not feel the pain of hunger to be able to understand and show mercy to the poor. Whenever he wants something, it is available to him. Therefore, God wanted His creation to be equal; for the rich to feel the pain of hunger so that He is kind to the weak and shows mercy to the poor”.

There is a difference between knowing something and feeling something. The rich know that there are hungry people, but now must fast to experience real hunger. Furthermore, this hunger reminds both the rich and poor of their hunger and thirst on the Day of Resurrection, a reminder which can have powerful effect on a person’s soul. Furthermore, one feels his weakness before God and will become humble towards Him.

The Benefits of Fasting

1. Accessing the mysteries

Imam Ali said, “God has placed five effects in five things: Respect in obedience, abjection in disobedience, wisdom and knowledge in hunger, solemnity in the night prayer, and richness in contentment.”

Hunger (or fasting) is said to be the place where wisdom is placed by the means of which a person can reach knowledge. In another hadith, Imam Ali says he is shocked by a person who tries to seek knowledge with a full stomach.

2. Banishing Satan

Once the Prophet asked his companions, “Do you want me to tell you of an act that if you act upon it will distance Satan from you, the way the east is distant from the west?” When they all showed interest, he mentioned three acts: Loving for the sake of God, giving charity, and fasting were tools to defeat Satan. As the Prophet said, “Fasting is a shield against the hellfire.”

3. Attracting God’s mercy and love

According the Prophet, God likes it when people lessen their speech, food intake, and sleep and dislikes over-eating, over-sleeping, and excessive talking. The Prophet also said there is nothing more detested by God than a full stomach.

Normally, during the Month of Ramalan, we are more likely to succeed in repenting, purifying ourselves, helping others, and being patient, as these are acts that earns us God’s love. It does not come as a surprise then that God appoints a group of angels to take care of those who fast.

Imam Sadiq said: “He who fasts in the warmth of the day for the sake of God and bears thirst and hunger, God appoints a thousand angels to touch him with love and give him glad tidings that when he breaks his fast God will tell him how he looks and smells. My angels! Be witnesses that I have forgiven him.”

On another occasion, Imam Sadiq said, “There are two moments of joy for a fasting person: one is when [the day finishes and] he breaks his fast and the other when he meets his Lord.”

4. Abundant reward

The reward one achieves because of fasting is so big that it cannot be compared to the difficulty he experiences when avoiding his desires for short moment. The reward given for fasting is more than that of other acts of worship. According to a Hadith Qudsi (divine saying):

“Every righteous act is rewarded ten times or a hundred times more except for fasting which is Mine and I will be its reward.”

Fasting is also the best example of patience. Imam Sadiq interpreted the term patience in the verse 2:45 as fasting. When patience is interpreted as fasting, the reward appointed for it is given for fasting as well:

“Indeed the patient will be paid in full their reward without any reckoning.” (39:10)

Although our entire existence is from God and it is only with his help that we can fast, still God is extremely loving and fasting is so special that for every breath a person takes in the month of fasting and for every moment of his sleep he will be rewarded. The Prophet said:

“He who fasts a day voluntarily, even if he is given gold as much as this world, still he has not received his reward completely, and it will only be completed on the Day of Judgement.”

The High Position of Those Who Fast

The biggest source of happiness for believers is when God accepts and loves them. Fasting opens a door to the love of God and puts people under His attention. The Prophet said, “Indeed, God has appointed angels to pray for those who fast.”

In another narration, the Prophet said that if angels are appointed to pray for a group of people, their prayer will be definitely accepted by God. The Prophet also said, “I swear by He in whose hands lies my life, the change in the smell of a fasting person’s mouth is more likable to God than the smell of musk.”

Of course, God will show more mercy to a person gives up on his desires for a while for His sake and submits his will to the will of God. Imam Ali said: “When a person fasts, his sleep will be counted as worship, his silence as tasbih (glorification of God), his prayers will be answered and his acts will be rewarded twice. Without a doubt, his prayers when he breaks his fast will be granted.”

The Prophet said: “Indeed, there is a special entrance to heaven called Rayyan from which no one will enter except for the people who fast.”

Therefore, fasting has many benefits, such as helping us tolerate our difficulties easier and making us better people who are worthy of God’s love and mercy and this is why fasting has been considered as one of the best acts of worship that existed in all divine religions.

Trichy smart city projerc

திருச்சி மாநகராட்சியின் சீர்மிகு நகர திட்டப்பணிகள் - ஆணையர் வெளியீடு


Thursday 27, June 2019, 23:59:29

  

திருச்சி மாநகராட்சியின் சீர்மிகு நகர திட்டத்தின் கீழ் மேற்கொள்ளப்பட்டு வரும் பணிகள் குறித்து மாநகராட்சி ஆணையர் ந.இரவிச்சந்திரன் விடுத்துள்ள செய்திக்குறிப்பில் தெரிவித்திருப்பதாவது:
கடந்த 2015-ம் ஆண்டு ஜூன் மாதம் 25-ந் தேதி மத்திய அரசால் சீர்மிகு நகர (ஸ்மார்ட் சிட்டி) திட்டம் தொடங்கப்பட்டது. 5 வருட காலத்தில் இந்தியா முழுவதிலும் இருந்து 100 நகரங்களை சீர்மிகு நகரங்களாக்க மத்திய அரசு தேர்வு செய்தது. அதில் தமிழகத்தில் 11 நகரங்கள் சீர்மிகு நகர திட்டத்துக்கு தேர்வு செய்யப்பட்டன.

உலகத்தரம் வாய்ந்த நகரங்களை மக்களின் எதிர்பார்ப்பு மற்றும் தேவைகளுக்கேற்ப உருவாக்குவதே சீர்மிகு நகரத்திட்டத்தின் நோக்கமாகும்.2017- 2018-ம் ஆண்டில், மத்திய அரசு இந்திய அளவில் 30 நகரங்களை தேர்வு செய்தது. அதில் தமிழ்நாட்டிலிருந்து 4 நகரங்கள் தேர்வு செய்யப்பட்டதில், திருச்சி மாநகராட்சியும் ஒன்றாகும். திருச்சி மாநகராட்சியில் முக்கிய திட்டங்கள் பட்டியலிடப்பட்டுள்ளன.
அவை வருமாறு:
புதை வடிகால் திட்டம்
*பூங்காக்கள் அபிவிருத்திப் பணி (16 பூங்காக்கள் மற்றும் 5 போக்குவரத்து திட்டு அழகு படுத்தும் பணி) ரூ.15 கோடியே 68 லட்சம் மதிப்பீட்டிலும், தில்லைநகர் 7-வது குறுக்குத்தெரு பகுதியில் புதிய வணிக வளாகம் கட்டும் பணி ரூ.15 கோடி மதிப்பீட்டிலும், புதை வடிகால் திட்டம்- பங்களிப்பு (திட்டம்-2, திட்டம்-3) ரூ.65 கோடியே 61 லட்சம் மதிப்பீட்டிலும் நடந்து வருகிறது.

*அரியமங்கலம் குப்பை கிடங்கு பிரச்சினைக்கு விஞ்ஞான முறையில் தீர்வு காணும் பணி ரூ.49 கோடியிலும், உய்யகொண்டான் கால்வாய் கரையை மேம்படுத்தும் பணி ரூ.17 கோடியே 56 லட்சத்திலும், தெருவிளக்குகளை எல்.இ.டி. விளக்குகளாக மாற்றம் செய்யும் பணி ரூ.23 கோடியே 40 லட்சத்திலும், சத்திரம் பஸ் நிலையத்தை மேம்படுத்தும் பணி ரூ.17 கோடியே 34 லட்சம் மதிப்பீட்டிலும் நடந்து வருகிறது.

* சூரிய ஒளி மின் நிலையம்
மேலும், ஒருங்கிணைந்த கட்டுப்பாட்டு மையம் அமைக்க ரூ.30 கோடி, பன்னடுக்கு வாகன நிறுத்துமிடம் அமைக்கும் பணிக்கு ரூ.19 கோடியே 70 லட்சம், பஞ்சப்பூர் பகுதியில் தரைமட்ட சூரிய ஒளி மின் நிலையம் அமைக்க ரூ.13 கோடியே 50 லட்சம், அரசு அலுவலக கட்டிடங்களில் சூரிய ஒளி மேற்கூரை அமைக்கும் பணிக்கு ரூ.6 கோடியே 44 லட்சம் என ஒதுக்கீடு செய்து பணிகள் தொடங்கி உள்ளன. காந்திமார்க்கெட் பகுதியில் போர் நினைவுச்சின்னத்தினை மின் விளக்குகளால் ஒளிரச்செய்யும் பணி ரூ.99 லட்சத்து 99 ஆயிரம் மதிப்பீட்டில் மேற்கொள்ளப்பட உள்ளது.

*சுற்றுலா வளர்ச்சி பணி களான மலைக்கோட்டை தெப்பக்குளத்தில் ஒலி-ஒளி காட்சி அமைக்கும் பணி, மெயின்கார்டுகேட் நுழைவு வாயிலினை வண்ண மின்விளக்குகளால் ஒளிரச்செய்யும் பணி, மலைக்கோட்டையை மின்விளக்குகளால் ஒளிரச்செய்யும் பணி மற்றும் புராதன பூங்கா அமைக்கும் பணிக்காக ரூ.38 கோடியே 19 லட்சம் ஒதுக்கப்பட்டுள்ளது. மேலும் புத்தூர் தினசரி சந்தையில் புதிய வணிக வளாகம் கட்டும் பணி ரூ.20 கோடியே 20 லட்சம் மதிப்பீட்டில் மேற்கொள்ளப்பட உள்ளது.
மேற்கண்டவாறு மாநகராட்சி ஆணையர் வெளியிட்டுள்ள செய்திக்குறிப்பில் கூறப்பட்டுள்ளது.


சேலத்துக்கு மீண்டும் கிடைக்குமா தமிழ்நாடு புதுச்சேரி பார் கவுன்சில் தலைவர் பதவி ?

Wednesday 19, September 2018, 13:20:35

பெரம்பலூர் பியூட்டி பார்லர் தாக்குதல் சம்பவ நிஜப் பின்னணி

Saturday 15, September 2018, 14:30:04

ஏரி நீர்வழித்தடம் ஆக்கிரமிப்பு: சேலம் குறிஞ்சி மருத்துவமனையை அகற்ற சென்னை உயர்நீதிமன்றம் உத்தரவு

Thursday 06, December 2018, 19:32:32

சேலத்தில் பிடிபட்ட சென்னை போலி வழக்குரைஞர்!

Wednesday 10, October 2018, 01:33:47

இறந்த ஆய்வாளரின் இறுதி ஊர்வலத்தேரைத் தோளில் சுமந்து சென்ற தர்மபுரி எஸ்.பி.

Sunday 30, September 2018, 12:25:12

Trichy Airport New Terminal - M.A.Aleem Advisory Committee Member Tiruchirappalli International Airport

https://www.dailythanthi.com/amp/Districts/Chennai/2019/02/11010817/Prime-Minister-Modi-laid-the-foundation-stone-of-a.vpf

M.A.Aleem

http://drmaaleem.blogspot.com/2014/02/blog-post_2072.html?m=1

M.A.Aleem Advisory Committee Member Tiruchirappalli International Airport

http://www.namadhutamilankural.com/%E0%AE%A4%E0%AE%BF%E0%AE%B0%E0%AF%81%E0%AE%9A%E0%AF%8D%E0%AE%9A%E0%AE%BF-%E0%AE%9A%E0%AE%B0%E0%AF%8D%E0%AE%B5%E0%AE%A4%E0%AF%87%E0%AE%9A-%E0%AE%B5%E0%AE%BF%E0%AE%AE%E0%AE%BE%E0%AE%A9-%E0%AE%A8/

Founders Day Jamal Mohamed college Trichy

https://tamil.oneindia.com/news/trichirappalli/jamal-mohamed-college-celebrates-its-founder-s-day-356814.html

Mosque function Inamkulatoor M.A.Aleem

http://thuruvamonline.blogspot.com/2015/06/blog-post_94.html?m=1

Mahatma Gandhi name for Everest Request by M.A.Aleem Neurologist Trichy

http://www.cockroachcreations.com/%E0%AE%AE%E0%AE%95%E0%AE%BE%E0%AE%A4%E0%AF%8D%E0%AE%AE%E0%AE%BE%E0%AE%B5%E0%AE%BF%E0%AE%A9%E0%AF%8D-%E0%AE%8E%E0%AE%B5%E0%AE%B0%E0%AF%86%E0%AE%B8%E0%AF%8D%E0%AE%9F%E0%AF%8D-%E0%AE%9A%E0%AE%BF%E0%AE%95/

Beat Neurologist Dr. M.A.ALEEM

https://www.dinamalar.com/news_detail.asp?id=595456

#Natharvali Urs 2019 - M.A.Aleem Trustee

https://www.dailythanthi.com/amp/News/Districts/2019/05/21024243/Chandana-Kodu-ceremony-at-Trichy-Nathursha-Mosque.vpf

#Natharvali Urs 2019 - M.A.Aleem Trustee

https://www.dailythanthi.com/amp/News/Districts/2019/05/21024243/Chandana-Kodu-ceremony-at-Trichy-Nathursha-Mosque.vpf

Trichy Airport New Terminal - M.A.Aleem Advisory Committee Member Tiruchirappalli International Airport

https://www.dailythanthi.com/amp/Districts/Chennai/2019/02/11010817/Prime-Minister-Modi-laid-the-foundation-stone-of-a.vpf

Napkin

https://patrikai.com/tamilnadu-pondycherry-association-of-neurologist-president-dr-aleem-welcomed-gst-exemption-for-sanitary-napkins/

M.A.Aleem

http://drmaaleem.blogspot.com/2014/02/blog-post_2072.html?m=1

M.A.Aleem Advisory Committee Member Tiruchirappalli International Airport

http://www.namadhutamilankural.com/%E0%AE%A4%E0%AE%BF%E0%AE%B0%E0%AF%81%E0%AE%9A%E0%AF%8D%E0%AE%9A%E0%AE%BF-%E0%AE%9A%E0%AE%B0%E0%AF%8D%E0%AE%B5%E0%AE%A4%E0%AF%87%E0%AE%9A-%E0%AE%B5%E0%AE%BF%E0%AE%AE%E0%AE%BE%E0%AE%A9-%E0%AE%A8/

M.A.Aleem Advisory Committee Member Tiruchirappalli International Airport

https://www.inneram.com/tamilnadu/19851-trichy-new-air-port-build-inauguration.html

Founders Day Jamal Mohamed college Trichy

https://tamil.oneindia.com/news/trichirappalli/jamal-mohamed-college-celebrates-its-founder-s-day-356814.html

M.A.Aleem gives lost respect

https://web.dailyhunt.in/news/india/tamil/tamil+nadu-epaper-tnadu/teeviravathikal+takkuthalil+uyirizhantha+ranuva+veerarkalukku+veera+vanakkam+sivachanthiran+udalukku+mathiya+amaicharkal+anjchali-newsid-108985812

Mosque function Inamkulatoor M.A.Aleem

http://thuruvamonline.blogspot.com/2015/06/blog-post_94.html?m=1

Mahatma Gandhi name for Everest Request by M.A.Aleem Neurologist Trichy

http://www.cockroachcreations.com/%E0%AE%AE%E0%AE%95%E0%AE%BE%E0%AE%A4%E0%AF%8D%E0%AE%AE%E0%AE%BE%E0%AE%B5%E0%AE%BF%E0%AE%A9%E0%AF%8D-%E0%AE%8E%E0%AE%B5%E0%AE%B0%E0%AF%86%E0%AE%B8%E0%AF%8D%E0%AE%9F%E0%AF%8D-%E0%AE%9A%E0%AE%BF%E0%AE%95/

Firecrackers safety M.A.Aleem Neurologist Trichy

http://mudukulathur.com/%E0%AE%AA%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AE%BF%E0%AE%B0%E0%AE%AE%E0%AE%BE%E0%AE%95-%E0%AE%B5%E0%AF%86%E0%AE%9F%E0%AE%BF%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AF%8B%E0%AE%AE%E0%AF%8D-%E0%AE%AA%E0%AE%9F%E0%AF%8D/

Autism

 Autism Spectrum Disorder 

- PROF DR.M.A.ALEEM M.D., D.M.,(NEURO) 

EMERITUS PROFESSOR OF NEUROLOGY
THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY

PAST PRESIDENT TAMILNADU PONDICHERY ASSOCIATION OF NEUROLOGISTS

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL

CONSULTANT NEUROLOGIST AND EPILEPTOLOGIST (TRAINED AT INSTITUTION OF NEUROLOGY QUEEN`S SQUARE . LONDON.UK.) ABC HOSPITAL, ANNAMALAI NAGAR , TRICHY -620018

SECRETARY NEUROLOGIST ASSOCIATION TIRUCHIRAPPALLI

DIRECTOR ABC HOSPITAL TRICHY


drmaaleem@hotmail.com

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL

What is autism spectrum disorder? 

What are some common signs of ASD? What disorders are related to ASD? How is ASD diagnosed? What causes ASD? What role do genes play? Do symptoms of autism change over time? How is autism treated? What research is being done? Where can I get more information? 

 What is autism spectrum disorder? 


Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. 

The symptoms are present from early childhood and affect daily functioning. The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013) includes Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. 

A diagnosis of ASD includes an assessment of intellectual disability and language impairment. ASD occurs in every racial and ethnic group, and across all socioeconomic levels. However, boys are significantly more likely to develop ASD than girls. The latest analysis from the Centers for Disease Control and Prevention estimates that 1 in 68 children has ASD. 

What are some common signs of ASD? 

Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.

 The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual. 

 Social impairment and communication difficulties 

Many people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other people’s feelings or talk about their own feelings. People with ASD may have very different verbal abilities ranging from no speech at all to speech that is fluent, but awkward and inappropriate. 

Some children with ASD may have delayed speech and language skills, may repeat phrases, and give unrelated answers to questions. In addition, people with ASD can have a hard time using and understanding non-verbal cues such as gestures, body language, or tone of voice. For example, young children with ASD might not understand what it means to wave goodbye. People with ASD may also speak in flat, robot-like or a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking. Repetitive and characteristic behaviors Many children with ASD engage in repetitive movements or unusual behaviors such as flapping their arms, rocking from side to side, or twirling. They may become preoccupied with parts of objects like the wheels on a toy truck. Children may also become obsessively interested in a particular topic such as airplanes or memorizing train schedules. 

Many people with ASD seem to thrive so much on routine that changes to the daily patterns of life — like an unexpected stop on the way home from school — can be very challenging. Some children may even get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.

 What disorders are related to ASD?

 Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome (which causes intellectual disability) and tuberous sclerosis (which causes benign tumors to grow in the brain and other vital organs) — each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases. 

 People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life — before age 3 — appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder. 

How is ASD diagnosed? 

ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps. 


 Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits. Very early indicators that require evaluation by an expert include: no babbling or pointing by age 1 no single words by age 16 months or two-word phrases by age 2 no response to name loss of language or social skills previously acquired poor eye contact excessive lining up of toys or objects no smiling or social responsiveness Later indicators include: impaired ability to make friends with peers impaired ability to initiate or sustain a conversation with others absence or impairment of imaginative and social play repetitive or unusual use of language abnormally intense or focused interest preoccupation with certain objects or subjects inflexible adherence to specific routines or rituals If screening instruments indicate the possibility of ASD, a more comprehensive evaluation is usually indicated. 

A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose and treat children with ASD. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for ASD, children with delayed speech development should also have their hearing tested. 

 What causes ASD? 

Scientists believe that both genetics and environment likely play a role in ASD. There is great concern that rates of autism have been increasing in recent decades without full explanation as to why. Researchers have identified a number of genes associated with the disorder. Imaging studies of people with ASD have found differences in the development of several regions of the brain. Studies suggest that ASD could be a result of disruptions in normal brain growth very early in development. These disruptions may be the result of defects in genes that control brain development and regulate how brain cells communicate with each other. 

Autism is more common in children born prematurely. Environmental factors may also play a role in gene function and development, but no specific environmental causes have yet been identified. The theory that parental practices are responsible for ASD has long been disproved. Multiple studies have shown that vaccination to prevent childhood infectious diseases does not increase the risk of autism in the population. 

 What role do genes play? 

Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, then the other will be affected between 36 to 95 percent of the time. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder also increases. 

Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons (synapses). Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social communication skills or engage in repetitive behaviors.

 Evidence also suggests that emotional disorders such as bipolar disorder and schizophrenia occur more frequently than average in the families of people with ASD. In addition to genetic variations that are inherited and are present in nearly all of a person’s cells, recent research has also shown that de novo, or spontaneous, gene mutations can influence the risk of developing autism spectrum disorder. De novo mutations are changes in sequences of deoxyribonucleic acid or DNA, the hereditary material in humans, which can occur spontaneously in a parent’s sperm or egg cell or during fertilization. The mutation then occurs in each cell as the fertilized egg divides. These mutations may affect single genes or they may be changes called copy number variations, in which stretches of DNA containing multiple genes are deleted or duplicated.  

Recent studies have shown that people with ASD tend to have more copy number de novo gene mutations than those without the disorder, suggesting that for some the risk of developing ASD is not the result of mutations in individual genes but rather spontaneous coding mutations across many genes.  De novo mutations may explain genetic disorders in which an affected child has the mutation in each cell but the parents do not and there is no family pattern to the disorder. 

Autism risk also increases in children born to older parents. There is still much research to be done to determine the potential role of environmental factors on spontaneous mutations and how that influences ASD risk. top Do symptoms of autism change over time? For many children, symptoms improve with age and behavioral treatment. During adolescence, some children with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. 

People with ASD usually continue to need services and supports as they get older, but depending on severity of the disorder, people with ASD may be able to work successfully and live independently or within a supportive environment. 


How is autism treated?

 There is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.

 Educational/behavioral interventions: 

Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

 Medications: 

While medication can’t cure ASD or even treat its main symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments. 

What research is being done? 

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.  NINDS and several other NIH Institutes and Centers support research on autism spectrum disorder.  Nearly 20 years ago the NIH formed the Autism Coordinating Committee (NIH/ACC) to enhance the quality, pace, and coordination of efforts at the NIH to find a cure for autism. The NIH/ACC has been instrumental in promoting research to understand and advance ASD. The NIH/ACC also participates in the broader Federal Interagency Autism Coordinating Committee (IACC), composed of representatives from various U.S. Department of Health and Human Services agencies, the Department of Education, and other governmental organizations, as well as public members, including individuals with ASD and representatives of patient advocacy organizations. One responsibility of the IACC is to develop a strategic plan for ASD research, which guides research programs supported by NIH and other participating organizations. NINDS and several other NIH institutes support autism research through the Autism Centers of Excellence (ACE), a trans-NIH initiative that supports large-scale multidisciplinary studies on ASD, with the goal of determining the causes of autism and finding new treatments. NINDS currently supports an ACE network focused on ASD and tuberous sclerosis complex (TSC). ASD occurs in approximately half of TSC patients. In particular, the ACE investigators are studying whether certain brain imaging and activity measures in infants diagnosed with TSC can predict the development of ASD. Such biomarkers could aid in understanding how and why ASD occurs in some children but not others, and help to identify patients who might benefit from early intervention. Other ACE centers and networks are investigating early brain development and functioning; genetic and non-genetic risk factors, including neurological, physical, behavioral, and environmental factors present in the prenatal period and early infancy; and potential therapies. NINDS funds additional research aimed at better understanding the factors that lead to ASD, including other studies on genetic disorders associated with ASD, such as TSC, Fragile X Syndrome, Phelan-McDermid syndrome (which features such autism-like symptoms as intellectual disability, developmental delays, and problems with developing functional language), and Rett syndrome (a disorder that almost exclusively affects girls and is characterized by slowing development, intellectual disability, and loss of functional use of the hands). Many of these studies use animal models to determine how specific known mutations affect cellular and developmental processes in the brain, yielding insights relevant to understanding ASD due to other causes and discovering new targets for treatments. NINDS researchers are studying aspects of brain function and development that are altered in people with ASD. For example, NINDS-funded researchers are investigating the formation and function of neuronal synapses, the sites of communication between neurons, which may not properly operate in ASD and neurodevelopmental disorders. Other studies use brain imaging in people with and without ASD to identify differences in brain connectivity and activity patterns associated with features of ASD. Researchers hope that understanding these alterations can help identify new opportunities for therapeutic interventions. Additional NINDS researchers are studying the relationship between epilepsy and autism. Through the National Center for Advancing Translational Sciences (NCATS) Rare Disease Clinical Research Network (RDCRN), NINDS and other NIH Institutes and Centers support a research consortium focused on three rare genetic syndromes associated with ASD and intellectual disability, including TSC and syndromes involving mutations in the genesSHANK3 (Phelan-McDermid syndrome) and PTEN. The goals of the consortium are to understand shared mechanisms across these syndromes, which may suggest common approaches to their treatment. NINDS supports autism spectrum disorder research through clinical trials at medical centers across the United States to better our knowledge about ASD treatment and care. Information about participating in clinical studies can be found at the “NIH Clinical Trials and You” website at www.nih.gov/health/clinicaltrials. Additional studies can be found at www.clinicaltrials.gov. People should talk to their doctor before enrolling in a clinical trial. More information about research on ASD supported by NINDS and other NIH Institutes and Centers can be found using NIH RePORTER (projectreporter.nih.gov), a searchable database of current and past research projects supported by NIH and other federal agencies. RePORTER also includes links to publications and resources from these projects. 






#Budget2019 News in Trichy @the_hindu

https://www.thehindu.com/news/cities/Tiruchirapalli/hike-in-petrol-levy-draws-consumers-ire/article28296717.ece

IndiGo to restore morning service in Bengaluru-Trichy sector Photo for representation. by S.Ganesan in TIRUCHI The Hindu on 17 OCTOBER 2019

https://www.thehindu.com/news/cities/Tiruchirapalli/indigo-to-restore-morning-service-to-bengaluru/article29720694.ece

Autism - M.A.Aleem

 Autism- Causes, Signs, Symptoms & Prevention 


 PROF DR.M.A.ALEEM M.D., D.M.,(NEURO) 

EMERITUS PROFESSOR OF NEUROLOGY
THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY

PAST PRESIDENT TAMILNADU PONDICHERY ASSOCIATION OF NEUROLOGISTS

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL

CONSULTANT NEUROLOGIST AND EPILEPTOLOGIST (TRAINED AT INSTITUTION OF NEUROLOGY QUEEN`S SQUARE . LONDON.UK.) ABC HOSPITAL, ANNAMALAI NAGAR , TRICHY -620018

SECRETARY NEUROLOGIST ASSOCIATION TIRUCHIRAPPALLI

DIRECTOR ABC HOSPITAL TRICHY


drmaaleem@hotmail.com

FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL


Among the several developmental disorders in children, autism is the most common brain disorder. According to the Indian Scale Assessment of Autism, there are approximately 2 million children with autism in India. 

Autism  defines  as a complex development disability that starts showing signs in the first three years of life. 

Autism is the result of a neurological disorder that hampers normal brain function. It adversely impacts the communication skills of a child as well as his ability to interact with people. 

Autism cannot be diagnosed up to 18 months and the ideal time to start its treatment is by one to two years. This is the best time because almost 80 per cent of the brain is developed in the first 36 months (three years). Unfortunately, due to sparse knowledge, parents start treatment late and it gets tough for the child to overcome the complexities. 

Early intervention can prevent disabilities in infants as well as toddlers. It is also important to note that autism has several spectrums. No two children suffering from autism will be the same. Every child with autism is on a different spectrum.

The social stigma attached with autism makes it difficult for kids and adults. There is a mindset towards people suffering from disabilities. People often stare and are insensitive towards children with autism. And for the same reason, parents do not allow their kids to mingle with other children. They eventually become outcasts and make it more challenging for both the kid and parents.Also, the mismatch between expectations of the parents and therapists is a prominent challenge. Parents have to understand that since no two kids with autism is alike, their improvement and progress will also vary. There is no quick cure for autism, thereby it is important for parents to set correct expectations. Consistent therapy is the best way to help the child. 

Autism Causes 

Until recently, the causes of Autism Spectrum Disorder were not known but now, more and more researches are trying to identify the trigger factors for the disease. 

1. Certain rare gene mutations, environmental stresses, parental age at the time of conception, maternal illnesses during pregnancy, difficulties during birth, oxygen deprivation to the child’s brain, among many other factors, can contribute to the disease’s development. 

2. Autism does not have any single reason which may be responsible for its onset. Research proves that abnormalities in the brain structure and function can often be the cause of Autism. However, hereditary, genetical, medical issues are yet to be confirmed causes for the condition. 

3. Many studies have shown that genes play a prime role in the development of Autism. But blaming genes alone is wrong. This is because families of children with Autism may have other kinds of disorders they may be suffering from. These can range from emotional disorders to social impairments. However, majority amount of studies indicate towards genes when it comes to causes of Autism. No one gene is responsible for Autism. 

4. Since no two people suffering from Autism are exactly alike, it is tough to boil down to one conclusion which maybe the cause of Autism. Researchers are still looking for biological factors like problems with metabolism, immunity system, brain connections, brain growth as some of the possible issues responsible for Autism. 

Autism Symptoms 

The characteristic symptoms of ASD can be observed in three major areas of development: 

1. Social interaction 
2. Communication (verbal and non-verbal) 
3. Thinking and behavioral skills 

People suffering from ASD experience a range of symptoms. Some common symptoms include the following: 

1. Not maintaining an eye contact or lacking smile when doing so 

 2. Not reacting or inconsistently reacting when their name is called out 

3. Hypersensitivity to noise 

4. Lost in own thoughts 

5. Hitting or biting themselves 

6. Not using gestures while communicating 

7. Inability to follow objects visually 

8. Inability to make friends 

9. Repetitive body movements or repeating their own sentences

 Autism- Causes, Signs, Symptoms & Prevention 

There are three main types of ASD 1. Asperger’s syndrome (AS) This is the mildest form of Autism. People suffering from Asperger’s syndrome will become obsessively interested in a particular object or subject. They would endlessly learn, read and discuss about it. Children with AS usually have an average or above average intelligence and this is why, it is often called as ‘High-Functioning Autism’. 

2. Pervasive developmental disorder, not otherwise specified (PDD-NOS) This is more severe than AS but less severe than autistic disorder. The symptoms of people suffering from PDD-NOS vary widely and no two people suffering from the disease will exhibit the same symptoms but some common symptoms may include the following: - Poor social interaction - Worse language skills than Asperger’s syndrome but better than Autistic disorder - Less repetitive behaviour than Asperger’s syndrome and Autistic disorder 

 3. Autistic disorder This is the most severe form of ASD and people suffering from the disorder will have severe impairments. They will have problems with social interaction, communication and will have the most repetitive behaviors. They may as well have mental retardation and seizures. 

There are two more types of ASD that are very rare 

1. Rett syndrome 

2. Childhood disintegrative disorder (CDD) 

People suffering from these disorders will exhibit symptoms such as losing language skills, losing intellectual skills, seizures, and they most likely do not recover their lost abilities. 

Autism Prevention 

Pregnant women should take extra care to prevent Autism in children. These precautions include: 

1. Regular visits to doctor and checking on your medication In order to prevent Autism, it is important to take your medical check ups and medications seriously during the course of your pregnancy. This will help you keep track of all the changes in your body and the baby’s body. This is also a key time, as the habits you will form during your pregnancy, will eventually be responsible for the brain development of your child. 

2. Less exposure to air-pollutionA study by Haravard School of Public Health concluded that the risk of developing Autism doubles in an infant in the third trimester of the mother, if she is exposed to too much of pollution. The particular pollutants responsible for the same are yet to be mentioned, but staying indoors when pollution levels are high, or sticking to indoor exercises and activities will surely help. 

3. Intake of folic acid, as per the doctor’s prescription The U.S department of Health and Human Services recommends pregnant woman to consume 400 to 800 mcg of folic acid daily. Research shows that women who take less folic acid during pregnancy may lead to their child developing Autism. 

4. Space out pregnancies Studies have found that pregnancies when spaced between the time period of two and five years have the lowest chance of developing Autism. Research has shown that children that were conceived within 12 months of the first pregnancy were 50 per cent more likely to develop Autism. Autism risk also increases if the parents are older in age, therefore consulting your doctor before starting a family is necessary. 

5. Avoid drinking alcohol and taking drugs Consumption of drugs and alcohol during pregnancy increases the chances of your child developing Autism. This is because the chemical property present in these two can severely affect the development of a child’s brain and hence should not be consumed at any cost. 


 

Stress and Neurological Disorders - M.A.Aleem in BMJ 2019;367:l6036

BMJ British Medical Journal 

Editorials

Stress related disorders and physical health

BMJ 2019367 doi: https://doi.org/10.1136/bmj.l6036 (Published 23 October 2019)

Cite this as: BMJ 2019;

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