Microsoft word - health updates v for ios website 04-06-13
Details of Health Updates - V Health Updates – News/New Researches News / New Research Internet Address http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH Dementia 01-10-12 0001748/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH Alzheimer's disease 01-10-12 0001767/ http://zeenews.india.com/news/health/diseases/no A Simple Blood Test to detect w-a-simple-blood-test-to-detect-lung-and-breast- 01-10-12 Lung and Breast Cancer cancer_18993.html http://zeenews.india.com/news/health/diseases/gut Gut Bacteria can indicate Risk -bacteria-can-indicate-risk-of-developing- 01-10-12 of Developing Diabetes diabetes_18992.html http://zeenews.india.com/news/health/diseases/sm Smoking Linked with Early oking-linked-with-early-pancreatic- 01-10-12 Pancreatic Cancer cancer_19027.html Only Two in 100 aware of http://zeenews.india.com/news/health/diseases/onl 01-10-12 y-two-in-100-aware-of-aphasia_19028.html http://timesofindia.indiatimes.com/india/Chronic- Chronic Diseases haunt Indians diseases-haunt-Indians-over- 01-10-12 50/articleshow/16619568.cms http://www.financialexpress.com/news/screenaddi Screen-addicted Children may cted-children-may-suffer-newest-mental- 03-10-12 suffer Newest Mental Disorder disorder/1010013/ Acid attacks: Now, 100% http://www.financialexpress.com/news/acid- Medical cover, Rs 5 Lakh to attacks-now-100-medical-cover-rs-5-lakh-to-kin- 03-10-12 Kin in Case of Death in-case-of-death/1009124/2 Orthopaedic Study Conducted http://www.financialexpress.com/news/orthopaedi 03-10-12 c-study-conducted/1011195/1 http://zeenews.india.com/news/health/diseases/diff Difficulty in Chewing Food iculty-in-chewing-food-linked-to-dementia- 06-10-12 Linked to Dementia Risk risk_19087.html http://www.thehindu.com/news/cities/Delhi/brain- Brain Dead Girl gives New dead-girl-gives-new-lease-of- 06-10-12 Lease of Life life/article3967746.ece http://zeenews.india.com/news/health/diseases/un Unhygienic Britons are World`s hygienic-britons-are-world-s-worst-flu- 06-10-12 Worst Flu-spreaders spreaders_19086.html http://zeenews.india.com/news/health/diseases/con Contrary to Govt Claims, trary-to-govt-claims-leprosy-on-rise-in- 06-10-12 Leprosy on rise in Maharashtra maharashtra_19096.html http://zeenews.india.com/news/health/diseases/14- 14 Novel Biomarkers for Type 2 novel-biomarkers-for-type-2-diabetes- 06-10-12 Diabetes Identified identified_19085.html Botox offers Effective http://zeenews.india.com/news/health/diseases/bot Treatment for Urinary Urgency ox-offers-effective-treatment-for-urinary- 06-10-12 Incontinence urgency-incontinence_19083.html 65. Dementia
Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment;MCI
Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking,language, judgment, and behavior. Causes, incidence, and risk factors
Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in thebrain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the mostcommon type of dementia.
Lewy body disease is a leading cause of dementia in elderly adults. People with this condition haveabnormal protein structures in certain areas of the brain.
Dementia also can be due to many small strokes. This is called vascular dementia.
The following medical conditions also can lead to dementia:
Infections that can affect the brain, such as and
Some causes of dementia may be stopped or reversed if they are found soon enough, including:
Changes in blood sugar, sodium, and calcium levels (see:
Use of certain medications, including cimetadine and some cholesterol-lowering medications
Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increasesas a person gets older. Symptoms
Dementia symptoms include difficulty with many areas of mental function, including:
Cognitive skills (such as calculation, abstract thinking, or judgment)
Dementia usually first appears as forgetfulness.
Mild cognitive impairment is the stage between normal forgetfulness due to aging and thedevelopment of dementia. People with MCI have mild problems with thinking and memory that do notinterfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCIdevelops dementia.
Difficulty performing more than one task at a time
Difficulty solving problems or making decisions
Forgetting recent events or conversations
Taking longer to perform more difficult mental activities
The early symptoms of dementia can include:
Difficulty performing tasks that take some thought, but that used to come easily, such asbalancing a checkbook, playing games (such as bridge), and learning new information orroutines
Language problems, such as trouble finding the name of familiar objects
Losing interest in things you previously enjoyed, flat mood
Personality changes and loss of social skills, which can lead to inappropriate behaviors
As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take careof yourself. The symptoms may include:
Change in sleep patterns, often waking up at night
Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving
Forgetting events in your own life history, losing awareness of who you are
Having , arguments, striking out, and violent behavior
Poor judgment and loss of ability to recognize danger
Using the wrong word, not pronouncing words correctly, speaking in confusing sentences
People with severe dementia can no longer:
Perform basic activities of daily living, such as eating, dressing, and bathing
Other symptoms that may occur with dementia:
Signs and tests
A skilled health care provider can often diagnose dementia by performing a physical exam and askingquestions about the person's medical history.
The physical exam will include a neurological exam. Tests to check mental function will be done. Thisis called a mental status examination.
Other tests may be ordered to determine whether other problems could be causing dementia or makingit worse. These conditions include:
The following tests and procedures may be done:
Treatment
Treatment depends on the condition causing the dementia. Some people may need to stay in thehospital for a short time.
Stopping or changing medications that make confusion worse may improve brain function.
There is growing evidence that some kinds of mental exercises can help dementia.
Treating conditions that can lead to confusion often greatly improve mental functioning. Suchconditions include:
Medications may be needed to control behavior problems caused by a loss of judgment, increasedimpulsivity, and confusion. Possible medications include:
Certain drugs may be used to slow the rate at which symptoms worsen. The benefit from these drugs isoften small, and patients and their families may not always notice much of a change.
(Aricept), (Exelon), (Razadyne, formerly called Reminyl)
A person's eyes and ears should be checked regularly. Hearing aids, glasses, or maybe needed.
Psychotherapy or group therapy usually does not help because it may cause more confusion.
For information on how to take care of a loved one with dementia, see:
Expectations (prognosis)
People with mild cognitive impairment do not always develop dementia. However, when dementiadoes occur, it usually gets worse and often decreases quality of life and lifespan. Complications Complications depend on the cause of the dementia, but may include the following:
Increased infections anywhere in the body
Loss of ability to function or care for self
Side effects of medications used to treat the disorder
Calling your health care provider
The condition of a person with dementia gets worse
You are unable to care for a person with dementia at home
Prevention
Most causes of dementia are not preventable.
Quitting smoking and controlling high blood pressure and diabetes can help you reduce your risk ofvascular dementia. This is dementia caused by a series of small strokes. Eating a low-fat diet andexercising regularly may also reduce the risk of vascular dementia. References
1. Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338. 2. DeKosky ST, Kaufer DI, Hamilton RL, Wolk DA, Lopez OL. The dementias. In: Bradley WG,
Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 70.
3. Knopman DS. Alzheimer’s disease and other dementias. In: Goldman L, Schafer AI, eds. CecilMedicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 409.
4. Peterson RC. Clinical practice. Mild cognitive impairment. N Engl J Med 2011 Jun
5. Qaseem A, et al., American College of Physicians/American Academy of Family Physicians
Panel on Dementia. Current pharmacologic treatment of dementia: a clinical practice guidelinefrom the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2008 Mar 4;148(5):370-8.
Reviewed by: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai MedicalCenter, Los Angeles, and Department of Anatomy at UCSF, San Francisco, and CA. Reviewprovided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA,Medical Director, A.D.A.M., Inc. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001748/ 66. Alzheimer's disease Senile dementia - Alzheimer's type (SDAT); SDAT
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD) is oneform of dementia that gradually gets worse over time. It affects memory, thinking, and behavior. Causes, incidence, and risk factors You are more likely to get Alzheimer's disease (AD) if you:
Are older. However, developing AD is not a part of normal aging.
Have a close blood relative, such as a brother, sister, or parent with AD.
Have certain genes linked to AD, such as APOE epsilon4 allele
The following may also increase your risk, although this is not well proven:
Having high blood pressure for a long time
Early onset AD: Symptoms appear before age 60. This type is much less common than lateonset. However, it tends to get worse quickly. Early onset disease can run in families. Severalgenes have been identified.
Late onset AD: This is the most common type. It occurs in people age 60 and older. It may runin some families, but the role of genes is less clear.
The cause of AD is not clear. Your genes and environmental factors seem to play a role. Aluminum,lead, and mercury in the brain is no longer believed to be a cause of AD. Symptoms
Dementia symptoms include difficulty with many areas of mental function, including:
Dementia usually first appears as forgetfulness.
Mild cognitive impairment is the stage between normal forgetfulness due to aging, and thedevelopment of AD. People with MCI have mild problems with thinking and memory that do notinterfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCIdevelops AD.
Difficulty performing more than one task at a time
Forgetting recent events or conversations
Taking longer to perform more difficult activities
Difficulty performing tasks that take some thought, but used to come easily, such as balancinga checkbook, playing complex games (such as bridge), and learning new information orroutines
Language problems, such as trouble finding the name of familiar objects
Losing interest in things previously enjoyed, flat mood
Personality changes and loss of social skills
As the AD becomes worse, symptoms are more obvious and interfere with your ability to take care ofyourself. Symptoms can include:
Change in sleep patterns, often waking up at night
Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving
Forgetting events in your own life history, losing awareness of who you are
arguments, striking out, and violent behavior
Poor judgment and loss of ability to recognize danger
Using the wrong word, mispronouncing words, speaking in confusing sentences
Perform basic activities of daily living, such as eating, dressing, and bathing
Signs and tests
A skilled health care provider can often diagnose AD disease with the following steps:
Complete physical exam, including neurological exam
Asking questions about your medical history and symptoms
A diagnosis of AD is made when certain symptoms are present, and by making sure other causes ofdementia are not present.
Tests may be done to rule out other possible causes of dementia, including:
(CT) or (MRI) of the brain may be done to lookfor other causes of dementia, such as a brain tumor or stroke.
In the early stages of dementia, brain image scans may be normal. In later stages, an MRI mayshow a decrease in the size of different areas of the brain.
While the scans do not confirm the diagnosis of AD, they do exclude other causes of dementia(such as stroke and tumor).
However, the only way to know for certain that someone has AD is to examine a sample of their braintissue after death. The following changes are more common in the brain tissue of people with AD:
"Neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell)
"Neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, andprotein)
"Senile plaques" (areas where products of dying nerve cells have accumulated around protein). Treatment
There is no cure for AD. The goals of treatment are:
Slow the progression of the disease (although this is difficult to do)
Manage symptoms, such as behavior problems, confusion, and sleep problems
Change your home environment so you can better perform daily activities
Support family members and other caregivers
Medicines are used to help slow down the rate at which symptoms become worse. The benefit fromthese drugs is usually small. You and your family may not notice much of a change.
Before using these medicines, ask the doctor or nurse:
What are the potential side effects? Is the medicine worth the risk?
When is the best time, if any, to use these medicines?
(Aricept), (Exelon), and (Razadyne, formerly calledReminyl). Side effects include stomach upset, diarrhea, vomiting, muscle cramps, and fatigue.
(Namenda). Possible side effects include agitation or anxiety.
Other medicines may be needed to control aggressive, agitated, or dangerous behaviors. Examplesinclude and . These are usually given in very low doses due to therisk of side effects including an increased risk of death.
It may be necessary to stop any medications that make confusion worse. Such medicines may includepainkillers, central nervous system depressants, antihistamines, sleeping pills, and others. Never change or stop taking any medicines without first talking to your doctor.
Some people believe certain vitamins and herbs may help prevent or slowdown AD.
There is no strong evidence that Folate (vitamin B6), vitamin B12, and vitamin E prevent ADor slows the disease once it occurs.
High-quality studies have not shown that ginkgo biloba lowers the chance of developingdementia. DO NOT use ginkgo if you take blood-thinning medications like (Coumadin) or a class of antidepressants called monoamine oxidase inhibitors (MAOIs).
If you are considering any drugs or supplements, you should talk to your doctor first. Remember thatherbs and supplements available over the counter are NOT regulated by the FDA. Support Groups
For additional information and resources for people with Alzheimer's disease and their caregivers, see. Expectations (prognosis)
How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely toworsen quickly.
Patients with AD often die earlier than normal, although a patient may live anywhere from 3 - 20 yearsafter diagnosis.
The final phase of the disease may last from a few months to several years. During that time, thepatient becomes totally disabled. Death usually occurs from an infection or organ failure. Complications
Loss of muscle function that makes you unable to move your joints
Infection, such as urinary tract infection and pneumonia
Other complications related to immobility
Harmful or violent behavior toward self or others
Loss of ability to function or care for self
Calling your health care provider
Call your health care provider if someone close to you has symptoms of dementia.
Call your health care provider if a person with AD has sudden change in mental status. A rapid changemay be a sign of another illness.
Talk to your health care provider if you are caring for a person with AD and you can no longer carefor the person in your home. Prevention
Although there is no proven way to prevent AD, there are some practices that may be worthincorporating into your daily routine, particularly if you have a family history of dementia. Talk toyour doctor about any of these approaches, especially those that involve taking a medication orsupplement.
Eat cold-water fish (like tuna, salmon, and mackerel) rich in omega-3 fatty acids, at least 2 to 3times per week.
Reduce your intake of linoleic acid found in margarine, butter, and dairy products.
Increase antioxidants like carotenoids, vitamin E, and vitamin C by eating plenty of darklycolored fruits and vegetables.
Stay mentally and socially active throughout your life.
Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) like (Advil,Motrin), (Clinoril), or (Indocin). Statin drugs, a class of medicationsnormally used for high cholesterol, may help lower your risk of AD. Talk to your doctor aboutthe pros and cons of using these medications for prevention.
In addition, early testing of a vaccine against AD is underway. References
1. Aisen PS, Schneider LS, Sano M, Diaz-Arrastia R, van Dyck CH, et al. High-dose B vitamin
supplementation and cognitive decline in Alzheimer's disease: a randomized controlled trial. JAMA. 2008;300:1774-1783.
2. DeKosky ST, Kaufer DI, Hamilton RL, Wolk DA, Lopez OL. The dementias. In: Bradley WG,
Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 70.
3. DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, Saxton JA, et al. Ginkgo
biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008;300:2253-2262.
4. Knopman DS. Alzheimer’s disease and other dementias. In: Goldman L, Schafer AI, eds. CecilMedicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 409.
5. Mayeux R. Early Alzheimer's disease. N Engl J Med. 2010 Jun 10;362(4):2194-2201. 6. Peterson RC. Clinical practice. Mild cognitive impairment. N Engl J Med 2011 Jun
7. Qaseem A, et al., American College of Physicians/American Academy of Family Physicians
Panel on Dementia. Current pharmacologic treatment of dementia: a clinical practice guidelinefrom the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2008 Mar 4;148(5):370-8.
8. Querfurth HW, LaFerla FM. Alzheimer's disease. N Engl J Med. 2010 Jan 28;362(4):329-44.
Reviewed by: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai MedicalCenter, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Reviewprovided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA,Medical Director, A.D.A.M., Inc. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001767/ 67. Now, a Simple Blood Test to detect Lung and Breast Cancer
Last Updated: Thursday, September 27, 2012
Washington: Scientists claimed to have developed a simple blood test that can accurately detect thebeginning stages of breast and lung cancer in just an hour.
Researchers from the Kansas State University developed the test that can detect cancer even beforesymptoms like coughing and weight loss start.
The test works by detecting increased enzyme activity in the body. Iron nanoparticles coated with
amino acids and a dye are introduced to small amounts of blood or urine from a patient.
The amino acids and dye interact with enzymes in the patient`s urine or blood sample. Each type ofcancer produces a specific enzyme pattern, or signature, that can be identified by doctors.
"These enzyme patterns can also help distinguish between cancer and an infection or other diseasesthat commonly occur in the human body," researcher Stefan Bossmann said.
"For example, a person who smokes a lot of cigars may develop an inflammation in their lungs. Thatwill drive up some of the markers in the test but not all of them. Doctors will be able to see whetherthere was too much smoke inhalation or if there is something more serious going on," he said in astatement.
Once the test is administered, comprehensive results - which include enzyme patterns - are producedin roughly 60 minutes.
The researchers have designed a second testing method that is anticipated to produce the same resultsin about five minutes.
In addition to early detection, the team said the test can be tweaked to monitor cancer. For example,patients being treated with drugs can be observed for drug effectiveness.
Similarly, doctors can use the dye in the test to determine if the entirety of a tumour has beensuccessfully removed from a patient after surgery.
Researchers evaluated the test`s accuracy on 32 separate participants in various stages of breast orlung cancer. Data was collected from 20 people with breast cancer - ranging in age from 36 to 81 yearsold - and 12 people with lung cancer - ranging in age from 27 to 63 years old.
Twelve people without cancer were also tested as a control group. This group ranged in age from 26 to62 years old.
A blood sample from each participant was tested three times. Analysis of the data showed a 95 percent success rate in detecting cancer in participants, including those with breast cancer in stages 0 and1 and those with lung cancer in stages 1 and 2. http://zeenews.india.com/news/health/diseases/now-a-simple-blood-test-to-detect- lung-and-breast-cancer_18993.html 68. Gut Bacteria can indicate Risk of Developing Diabetes
Last Updated: Thursday, September 27, 2012
London: A new research has shown that the composition of a person’s intestinal bacteria could play animportant role in the development of type 2 diabetes.
The 1.5 kilograms of bacteria that we each carry in our intestines have an enormous impact on ourhealth and well being. The bacteria normally live in a sensitive equilibrium but if this equilibrium isdisrupted our health could suffer, researchers said.
“We have demonstrated that people with type 2 diabetes have a high level of pathogens in theirintestines,” said professor Jun Wang from the University of Copenhagen’s Department of Biology andNovo Nordisk Foundation Center for Basic Metabolic Research.
In the new study, scientists examined the intestinal bacteria of 345 people from China, of which 171had type 2 diabetes.
The team managed to identify clear biological indicators that someday could be used in methods thatprovide faster and earlier diagnosis of type 2 diabetes.
The research also demonstrated that people with type 2 diabetes have a more hostile bacterialenvironment in their intestines, which can increase resistance to different medicines.
Similar studies carried out on sufferers of type 2 diabetes in Denmark also discovered a significantimbalance in the function of their intestinal bacteria and composition. Future Danish studies willexamine whether intestinal bacteria is already abnormal in people that are deemed to be at risk ofdeveloping diabetes.
“We are going to transplant gut bacteria from people that suffer from type 2 diabetes into mice andexamine whether the mice then develop diabetes,” said another of the lead scientists behind theproject, Professor Oluf Borbye Pedersen from the University of Copenhagen and centre director atLuCamp, the Lundbeck Foundation Centre for Applied Medical Genomics in Personalised DiseasePrediction, Prevention and Care.
By working together, a team of scientists from the University of Copenhagen and the BeijingGenomics Institute (BGI) was able to make to several breakthroughs in the field of ‘metagenomics’.
Scientists working on the EU research project MetaHIT have uncovered more than 3.3 million genesfrom gut bacteria found in people from Spain and Denmark. These genes could play a key role inunderstanding and treating a range of serious illnesses.
According to Professor Karsten Kristiansen from the University of Copenhagen’s Department ofBiology, the recent discovery is an important step in the comprehensive international research that iscurrently underway to investigate the interplay between intestinal bacteria and health.
“The European and Chinese working on the MetaHIT project were able to make important newdiscoveries about the relationship between intestinal bacteria and health. The new discovery indicatesa possible connection between type 2 diabetes and the intestinal bacteria in Chinese people,”Kristiansen said.
“It is important to point out that our discovery demonstrates a correlation. The big question now iswhether the changes in gut bacteria can affect the development of type 2 diabetes or whether thechanges simply reflect that the person is suffering from type 2 diabetes,” the researcher added.
Wang’s research was recently published in the scientific journal Nature.
ANI http://zeenews.india.com/news/health/diseases/gut-bacteria-can-indicate-risk-of- developing-diabetes_18992.html 69. Smoking Linked with Early Pancreatic Cancer
Washington: Those who smoke and drink heavily may develop pancreatic cancer at an earlier age thanthose who don`t, according to a new US study.
Researchers from the University of Michigan Health System found that heavy smokers with pancreaticcancer were diagnosed around 62 years and heavy drinkers at age 61 - almost a decade earlier than theaverage age of 72.
Smoking is a strong risk factor for pancreatic cancer and alcohol has been shown to cause oxidativedamage to the pancreas, which sets the stage for the inflammatory pathways that can lead to cancer,the American Journal of Gastroenterology reports.
The finding is based on study of 811 pancreatic cancer patients only indicate these habits can lead todeveloping pancreatic cancer earlier in life. The study does make a step toward understanding at whatage screening for pancreatic cancer should begin - once widespread screening is available, accordingto a Michigan statement.
"As screening programmes are developed, an understanding of how personal features influence theage of presentation will be important to optimize the timing of those screenings," saysgastroenterologist Michelle Anderson, assistant professor of internal medicine at Michigan who ledthe study.
Detecting pancreatic cancer early is difficult and contributes to the poor survival rates. By the timepancreatic cancer is diagnosed, it is frequently at an advanced stage and has spread to other organs.
Currently there are no tests available to easily find it in people who do not have symptoms. In thestudy, heavy smokers were defined as those who had more than a pack per day, and heavy drinkingwas measured at more than 39 grams a day, or about three average drinks per day. http://zeenews.india.com/news/health/diseases/smoking-linked-with-early- pancreatic-cancer_19027.html 70. Only two in 100 aware of Aphasia
Toronto: Only two of 100 people are aware of aphasia - a condition characterised either by partial or
total loss of speech or the capacity to write. It affects a third of stroke victims, a Canadian study says.
Aphasia occurs when there is stroke damage to language and communication centres in the brain. It
does not affect intelligence but can leave people unable to express themselves, find their words and
Thirty community volunteers trained by the York-Durham Aphasia Centre, a March of Dimes Canada
programme, collaborated with researchers from two Ontario universities in a survey of 832 adults in
They found that only two percent of respondents could correctly identify aphasia as a communication
disorder affecting the ability to speak, understand, read or write, according to a statement of York-
"Aphasia is poorly understood," says neurologist Michael Hill, co-chairman of the Canadian Stroke
Congress. "The sudden loss of language after a stroke creates huge challenges for individuals and their
families." As many as 100,000 Canadians are living with chronic aphasia.
"About one third of all people who have strokes experience some degree of aphasia but despite this
high prevalence, it just doesn`t get much attention," says Rick Berry, project coordinator, who worked
with clinical coordinator and speech-language pathologist Ruth Patterson on the survey.
"We wanted to gather some Canadian data to compare with surveys that have been done in other
These findings were presented at the Canadian Stroke Congress. http://zeenews.india.com/news/health/diseases/only-two-in-100-aware-of- aphasia_19028.html 71. Chronic Diseases haunt Indians over 50
NEW DELHI: This should serve as a wake-up call for India's 50 plus club, face a serious risk forchronic diseases. A prevalence of risk factors study by the (WHO)conducted this year among males and females aged 50 or older across six countries, including India,has some worrying findings for Indians.
According to the (SAGE), 87.9% men and 93.5% women inthis age group have insufficient nutrition intake, while 24% men and 26% women have low physicalactivity.
Around one in four men and equal number of women suffer from high blood pressure. Nearly 63%men and 30% women are daily smokers.
Almost three in four men aged 50 and above and over four in five women have high risk waist hipratio or abdominal obesity that greatly increases cardiovascular disease risk.
Nearly 1.3% males in the age group above 50 are obese. The case is worse for Indian women since 3%of them obese, according to United Nations Population Fund's (UNFPA) report on "Ageing in the 21stcentury" to be released on Monday.
"Risk factors for chronic diseases (such as smoking) vary by country. For example, 63% of men over50 in India smoke, compared with only 11% in Ghana. In China, 51% of women over 50 have highblood pressure, compared with 27% in India. The biggest underlying risk factor for chronic disease inolder people is high blood pressure, which can explain 12 to 19% of the total burden of disease indeveloping countries," says the UN report. India has around 90 million elderly and the figure isexpected to increase to 315 million constituting 20% of the total population by 2050.
What should further wake up the Indian 50 plus age group club is a separate Indian study thatconfirms a steep out-of- pocket expenditure to pay health bills.
The study has been conducted jointly by , Institute for Social and Economic Change(Bangalore), the Institute for Economic Growth (New Delhi) and the Tata Institute of Social Sciences(Mumbai) in seven states having a higher proportion of elderly population — Kerala, Tamil Nadu,Maharashtra, Orissa, West Bengal, Punjab and Himachal Pradesh.
Among those who were hospitalized (9%) in India, they spent 10 days of hospital admission on anaverage per episode and spent over Rs 8,800 on consultation, medicines and diagnostics.
In the case of out-patient treatment, the average expenditure was about Rs 1,230.
An elderly also spends Rs 500 every month towards medicines. Only 24% of the elderly go for generalhealth check-ups spending about Rs 600 for each check-up.
Around 75% of the elderly live in rural areas of which over 48% are women and of this, 55% arewidows. Nearly three out of five single older women are very poor and two out of three rural elderlyare fully dependent. Additionally, there is an increasing proportion of elderly at 80+ ages and is morepronounced among women.
The report says, "The overwhelming burden of disease in older persons is from non-communicablediseases (NCDs). Ischaemic heart disease, stroke and chronic lung disease are the biggest killers. Visual and hearing impairment, dementia and osteoarthritis are the main causes of disability. Thesediseases affect older persons in developing countries far more than in the developed world."
It adds, "Older people in developing countries lose five times as many years from chronic lung diseaseand twice as many from stroke as in developed countries. This disparity is even greater for the poorestcountries compared with the richest. Older people in developing countries also carry almost threetimes the burden of visual impairment as those in the developed world."The study also found thatabout 65% of elderly suffer from a chronic ailment of which arthritis/rheumatism, hypertension,cataract and diabetes are most prevalent, in that order. About one-third of the elderly suffer from twoor more chronic ailments simultaneously.
Morbidity levels tend to be higher among females across all age groups of elderly.
Babatunde Osotimehin, executive director of UNFPA, says, "With one in nine persons in the worldaged 60 years or over, projected to increase to one in five by 2050, population ageing is a phenomenonthat we can no longer ignore. Increasing longevity is one of humanity's greatest achievements. Indeed,population ageing is cause for celebration."
According to the Study on Global Ageing an Adult Health (SAGE), 87.9% men and 93.5% women inthis age group have insufficient nutrition intake, while 24% men and 26% women have low physicalactivity.
Around one in four men and equal number of women suffer from high blood pressure. Nearly 63%men and 30% women are daily smokers.
Almost three in four men aged 50 and above and over four in five women have high risk waist hipratio or abdominal obesity that greatly increases cardiovascular disease risk.
Nearly 1.3% males in the age group above 50 are obese. The case is worse for Indian women since 3%of them obese, according to United Nations Population Fund's (UNFPA) report on "Ageing in the 21st
century" to be released on Monday.
"Risk factors for chronic diseases (such as smoking) vary by country. For example, 63% of men over50 in India smoke, compared with only 11% in Ghana. In China, 51% of women over 50 have highblood pressure, compared with 27% in India. The biggest underlying risk factor for chronic disease inolder people is high blood pressure, which can explain 12 to 19% of the total burden of disease indeveloping countries," says the UN report. India has around 90 million elderly and the figure isexpected to increase to 315 million constituting 20% of the total population by 2050.
What should further wake up the Indian 50 plus age group club is a separate Indian study thatconfirms a steep out-of- pocket expenditure to pay health bills.
The study has been conducted jointly by UNFPA, Institute for Social and Economic Change(Bangalore), the Institute for Economic Growth (New Delhi) and the Tata Institute of Social Sciences(Mumbai) in seven states having a higher proportion of elderly population — Kerala, Tamil Nadu,Maharashtra, Orissa, West Bengal, Punjab and Himachal Pradesh.
Among those who were hospitalized (9%) in India, they spent 10 days of hospital admission on anaverage per episode and spent over Rs 8,800 on consultation, medicines and diagnostics.
In the case of out-patient treatment, the average expenditure was about Rs 1,230.
An elderly also spends Rs 500 every month towards medicines. Only 24% of the elderly go for generalhealth check-ups spending about Rs 600 for each check-up.
Around 75% of the elderly live in rural areas of which over 48% are women and of this, 55% arewidows. Nearly three out of five single older women are very poor and two out of three rural elderlyare fully dependent. Additionally, there is an increasing proportion of elderly at 80+ ages and is morepronounced among women.
The report says, "The overwhelming burden of disease in older persons is from non-communicablediseases (NCDs). Ischaemic heart disease, stroke and chronic lung disease are the biggest killers. Visual and hearing impairment, dementia and osteoarthritis are the main causes of disability. Thesediseases affect older persons in developing countries far more than in the developed world."
It adds, "Older people in developing countries lose five times as many years from chronic lung diseaseand twice as many from stroke as in developed countries. This disparity is even greater for the poorestcountries compared with the richest. Older people in developing countries also carry almost threetimes the burden of visual impairment as those in the developed world."The study also found thatabout 65% of elderly suffer from a chronic ailment of which arthritis/rheumatism, hypertension,cataract and diabetes are most prevalent, in that order. About one-third of the elderly suffer from twoor more chronic ailments simultaneously.
Morbidity levels tend to be higher among females across all age groups of elderly.
Babatunde Osotimehin, executive director of UNFPA, says, "With one in nine persons in the worldaged 60 years or over, projected to increase to one in five by 2050, population ageing is a phenomenonthat we can no longer ignore. Increasing longevity is one of humanity's greatest achievements. Indeed,population ageing is cause for celebration."
http://timesofindia.indiatimes.com/india/Chronic-diseases-haunt-Indians-over- 50/articleshow/16619568.cms 72. Screen-addicted Children may suffer Newest Mental Disorder Melbourne: Children addicted to using electronic devices may suffer from "internet-use disorder", a newly discovered and serious mental illness, according to a new study.
Psychologists argue video game and internet addictions share the characteristics of other addicts,including emotional shutdown, lack of concentration and withdrawal symptoms if the gadgets areremoved.
The formal inclusion of this new addiction in a worldwide psychiatric manual has been welcomed byAustralian psychology professionals in response to a wave of "always-on" technology engulfing kids,the 'Sydney Morning Herald' reported.
"With kids, gaming is an obvious issue. But overall, technology use could be a potential problem",said Mike Kyrios, Professor of Psychology. Other fallout can include devastating impacts for children and families as social interaction and even food are neglected in favour of the virtual worlds the children inhabit.
Australian experts contributed to the Australian Psychological Society's submission to theinternational manual, supporting the inclusion of an addiction focused on internet gaming.
The inclusion acknowledges risks posed by over-use of seemingly benign technologies, classifyinginternet-use disorder alongside other mental disorders that need further research before becoming arecognised mental illness that can be formally diagnosed.
Kyrios said once more research is invested in the disorder, it would allow health professionals todiagnose children with addictive behaviours from technology overuse and treat them appropriately,including strategies to change their obsessive over-reliance on being connected.
He said children with underlying obsessive compulsive disorders could be at risk from technologyoveruse. http://www.financialexpress.com/news/screenaddicted-children-may-suffer- newest-mental-disorder/1010013/ 73. Acid attacks: Now, 100% Medical cover, Rs 5 Lakh to Kin in Case of Death Chandigarh: The Haryana government recently amended the Relief and Rehabilitation of Women Acid Victims Scheme. Under the new amendment acid attack victims will now be fully re-imbursed for their medical treatment including plastic surgery at high-end specialised hospitals. Various private hospitals have been included in a list of approved hospitals where acid attack victims can now get their treatment. A sum of Rs 5 lakh will also be given to the legal heirs of the victims who succumb to their injuries.
The list of approved hospitals, which originally contained just PGIMS in Rohtak, PGIMER inChandigarh and AIIMS in New Delhi, has now been extended to include a number of privatehospitals.
“Escorts Hospital, Batra Hospital, Sir Ganga Ram Hospital, Indraprastha Apollo Hospital, RajivGandhi Cancer Institute, Maharaja Aggarsen Hospital and Charitable Trust in New Delhi, FortisHospital in Mohali, Drishti Eye Hospital and Sake Hospital in Panchkula have been added to the list,”said the director general of Haryan’s Women and Child Development Department.
The Relief and Rehabilitation of Women Acid Victims Scheme was originally launched in May, 2011to provide relief to girls and women residents of Haryana who had become victims of acid attack. http://www.financialexpress.com/news/acid-attacks-now-100-medical-cover-rs-5- lakh-to-kin-in-case-of-death/1009124/2 74. Orthopaedic Study Conducted
With the increasing number of accidents in Pune, the Sancheti Institute in collaboration with McMaster University, Canada, recently concluded a study to evaluate the characteristics and treatment of patients with fractures presenting to the emergency department across hospitals in India. Dr. Chetan Pradhan, Assistant medical director and head of the trauma department of the Sancheti institute has now been invited to the Orthopaedic Trauma Association Conference, to be held in Minneapolis, USA to deliver a lecture on the study. “With over 1300 patients recruited, our research centre aimed at understanding the standard of medical care prevalent in our country with an emphasis in difference of outcomes between private and public sectors,” he said. World Elders Day Observed
World Elders Day was observed recently and according to the report released on October 1 by UNFPA and HelpAge International on Ageing in the 21st Century, by 2050 in India women over 60 years would exceed the number of elderly men by 18.4 million. “The population of the elderly is increasing at 3.9 per cent as compared to 1.9 per cent of the total population. As per HelpAge's India study on Elder abuse, 31 per cent of the elderly interviewed reported facing abuse. The report has recommended the inclusion of the ageing and needs of the elderly in all national development policies,” a statement issued by HelpAge stated. Skin and Hair Diagnosis
Dr Niteen Dhepe, of Skin City PG Institute spoke to media persons recently on the latest trends in hairtransplantation and how diagnosis and treatment of all dermatological and trichology related problemsis possible. Dhepe explained various methods such as Follicular Unit Hair Transplant (FUT)technology, Follicular Unit Extraction FUE and the Low laser therapy for hair transplant, how it isdifferent, much easier and better and more economical on the pocket. Skin City Clinic was invited tothe Mexico World Congress of Cosmetic Dermatology to speak on the long term results of laser hairremoval in Indian skin. Nirmal Bharat Yatra Announced
WASH United and Quicksand Design Studio announced the impending kickoff of the Nirmal Bharat Yatra (NBY). NBY is a toilet and hygiene mela that harnesses the passion for cricket, the glamour of Bollywood, the fun of interactive games towards creating a “masala” of positive excitement around the long-neglected issues of sanitation and hygiene across India. More specifically, the NBY raises awareness of and facilitates behaviour change around sanitation and handwashing with soap. In addition, it also tackles the persisting taboos around menstrual hygiene management (MHM) in India. Thorsten Kiefer, Executive Director of WASH United, says: “We have looked at the things Indians really are passionate and excited about and transposed them into a sanitation and hygiene context. What we are trying to do with the Yatra is to make toilets and hygiene cool and sexy.” http://www.financialexpress.com/news/orthopaedic-study-conducted/1011195/1 75. Difficulty in Chewing Food Linked to Dementia Risk
Washington: Your chewing ability can determine your mental abilities, according to new researchfrom Karolinska Institute.
The older people become the more likely it is that they risk deterioration of cognitive functions, suchas memory, decision-making and problem solving.
Research indicates several possible contributors to these changes, with several studies demonstratingan association between not having teeth and loss of cognitive function and a higher risk of dementia.
One reason for this could be that few or no teeth makes chewing difficult, which leads to a reductionin the blood flow to the brain. However, to date there has been no direct investigation into thesignificance of chewing ability in a national representative sample of elderly people.
Now a team comprised of researchers from the Department of Odontology and the Aging ResearchCenter (ARC) at Karolinska Institute and from Karlstad University have looked at tooth loss, chewingability and cognitive function in a random nationwide sample of 557 people aged 77 or older.
They found that those who had difficulty chewing hard food such as apples had a significantly higherrisk of developing cognitive impairments.
This correlation remained even when controlling for sex, age, education and mental health problems,variables that are often reported to impact on cognition. Whether chewing ability was sustained withnatural teeth or dentures also had no bearing on the effect.
The results are published in the Journal of the American Geriatrics Society (JAGS). http://zeenews.india.com/news/health/diseases/difficulty-in-chewing-food-linked- to-dementia-risk_19087.html 76. Brain Dead Girl gives New Lease of Life
“We realised our daughter would never return, so we decided to help others”
When 17-year-old Payal (name changed because her parents preferred not to reveal it) was declaredbrain dead on September 2, a day short of her 18th birthday, at a private hospital in the Capital, herparents made what they claim was the most difficult decision of their lives. “We decided to donate ourchild’s organs, and today we are proud to say that she has helped save the lives of three persons andhelped restore sight to two others,” says Ajay Mathur, father of the deceased child.
The child had met with an accident on the outskirts of the Capital on August 23 and was admitted toBLK Super Specialty Hospital on August 25.
BLK Super Specialty Hospital Nephrology/Renal Transplant Services senior consultant and directorDr. Sunil Prakash says: “The patient was declared brain dead on September 2 and we harvested herorgans including kidneys, liver and cornea. While one kidney was used for a patient in our hospital, aliver and kidney was used by Army Research & Referral Hospital, New Delhi, and her corneas weredonated to the Centre for Sight.”
Speaking at a function organised by the hospital here on Thursday to felicitate the girl’s parents, Mr. Mathur said: “Donating her organs was an emotional decision for all of us. But we realised that ourdaughter was never going to return, so we decided to help others.”
Dr. Prakash said: “In India, thousands of patients die either for want of donors or because they had to wait for too long. Recent data shows that as many as 1.25 lakh Indians died in road accidents last year but only less than 20,000 of them had donated their kidneys, liver, pancreas or heart for potential recipients. In India, nearly 14 people are involved in fatal accidents every hour. Of these, one brain dead person could save 7-8 lives, which can overcome the shortage and prevent illegal activities of organ use.” http://www.thehindu.com/news/cities/Delhi/brain-dead-girl-gives-new-lease-of- life/article3967746.ece 77. Unhygienic Britons are World`s Worst Flu-spreaders Last Updated: Friday, October 05, 2012
London: Britons take fewer basic hygiene precautions like washing hands and sneezing into a tissueagainst catching flu than people in other countries, a new international study has found.
The survey by Harvard School of Public Health showed that just one in five cavalier Brits tried tokeep away from people with flu-like symptoms and fewer avoided shopping centres or sporting eventsduring the flu season.
Researchers carried out surveys in the UK, the US, Argentina, Japan and Mexico soon after the 2009H1N1 swine flu pandemic, the `Daily Mail` reported.
Around 900 people were asked how they had modified their behaviour when there was a risk of
catching the virus. Britons consistently had the most careless attitude.
Flu expert Professor John Oxford, a virologist at the University of London, said the results were"terribly disappointing".
"We have a lot to learn about avoiding infection. One explanation is that we have become complacentbecause we think drugs will always be available but it`s very likely we will get a novel infection atsome stage when it will be critical to do these basic things to stop us getting it," he said.
One in four Britons questioned said that when swine flu was sweeping the UK they covered theirmouth or nose with a tissue more frequently when sneezing or coughing, or used their elbow orshoulder to catch a sneeze or cough.
This compared with 61 per cent of Americans, 77 per cent of Mexicans, 64 per cent of Argentineansand 48 per cent of Japanese.
Fifty-three per cent of Britons said they washed their hands more often, compared with 72 per cent ofUS citizens, 86 per cent of Mexicans, 72 per cent of Japanese and 89 per cent of Argentineans.
People from the UK were also the least willing to avoid hugging or kissing members of their family orfriends during the pandemic.
Only 2 per cent of Britons said they followed this strategy, which was adopted by 46 per cent ofMexicans, 21 per cent of Americans and 19 per cent of Argentineans.
The question was not asked in Japan, where kissing is not the cultural norm.
Only one in five people in the UK tried to avoid being near someone with flu symptoms.
The study was published in The `Lancet` medical journal. http://zeenews.india.com/news/health/diseases/unhygienic-britons-are-world-s- worst-flu-spreaders_19086.html 78. Contrary to Govt Claims, Leprosy on rise in Maharashtra
Pune: Contrary to the official claims of elimination of leprosy in Maharashtra, the state is witnessing aconstant increase in the number of fresh cases detected 2007 onwards.
"It was officially declared in 2005 that leprosy has been eradicated in Maharashtra. However, freshcases are still being detected in the state," Sharadchandra Gokhale, founder president of theInternational Leprosy Union (ILU) claimed.
There is a further increase in the number of Multi-Bacilliary cases with child population accountingfor 12 per cent of total detected cases, he said.
The ILU, which is headquartered in the city, had in its search campaign conducted in 173 blocks in thestate last year had detected as many as 2,515 fresh cases, Gokhale said, emphasizing the need for a
door-to-door campaign to unearth fresh cases and timely treatment.
At present, the Annual New Case Detection Rate (ANCD) is 15.96 per cent per lakh population inMaharashtra, he said adding that the ILU had set up a human rights grievance cell in order to seekjustice for the affected as the disease continued to be socially stigmatised.
"There is still no let-up in the stigma attached to the disease and discrimination against the leprosy-affected continues unabated," said Indranath Banerjee, an associate researcher attached to the ILU.
Of the 2,28,474 new leprosy cases detected in the world in 2010, the figure for India stood at 1,26,800,which accounts for 55.5 per cent, the data available with ILU shows.
"If the Union and state governments do not take serious note of this fact and initiate effective steps toeradicate leprosy, the problem would become more acute," Gokhale said.
To address the problems being faced by the Leprosy Affected Patients (LAP), the ILU has decided toconstitute `LAP`s Human Rights Cell` to take their collective and individual grievances to the HumanRights Commission, he added.
Gokhale said the WHO has already alerted the Indian government on the situation concerning LAPs inthe country, underlining a pressing need for conducting a fresh all-India survey to assess increase offresh cases and its eradication.
PTI http://zeenews.india.com/news/health/diseases/contrary-to-govt-claims-leprosy-on- rise-in-maharashtra_19096.html 79. 14 Novel Biomarkers for Type 2 Diabetes Identified Last Updated: Friday, October 05, 2012
Washington: Researchers have identified 14 new biomarkers for type 2 diabetes, which can serve asbasis for developing new methods of treatment and prevention of this metabolic disease.
The biomarkers can also be used to determine diabetes risk at a very early point in time. At the sametime the markers enable insight into the complex mechanisms of this disease, which still have not beencompletely elucidated.
The researchers led by Anna Floegel of the German Institute of Human Nutrition (DIfE) and TobiasPischon of the Max Delbrueck Center studied the blood of study participants from three differentstudies with respect to their metabolites (metabolomics).
The study was based on data and blood samples of the prospective EPIC-Potsdam study with morethan 27,500 study participants, the Tuebingen family study and the KORA study. The study wasconducted in collaboration with the German Center for Diabetes Research (DZD) and funded by theFederal Ministry of Education and Research (BMBF).
The aim of the current study was to identify metabolites in blood, which provide insight into thepathomechanisms of type 2 diabetes and in addition can be used as biomarkers to determine thedisease risk.
To this end, the researchers studied a total of 4,000 blood samples. About 3,000 of these samples camefrom the EPIC-Potsdam study, nearly 900 samples from the KORA study in Augsburg and 76 from
At the time the blood sample was taken, none of the study participants suffered from type 2 diabetes. However, during the average follow-up time of seven years, 800 Potsdam study participants and 91Augsburg participants were diagnosed with type 2 diabetes.
The 76 participants in the Tuebingen study were already classified at the beginning of the study asindividuals at high risk for type 2 diabetes. At the time the blood sample was taken, however, theywere still healthy.
Jerzy Adam ski and his team at the Institute of Experimental Genetics of Helmholtz ZentrumMuenchen analyzed the concentrations of 163 metabolites per blood sample. Fourteen of thesemetabolites exhibited a strong association with the development of type 2 diabetes.
“In addition to simple sugars, the 14 identified metabolites include various protein components andcholine-containing phospholipids which play a role in the structure of cell membranes and in thetransport of blood lipids,” said Anna Floegel, lead author of the study.
“Our findings particularly indicate a previously unknown role of phospholipids in type 2 diabetesdevelopment. This is a first clue which should definitely be pursued,” she added. http://zeenews.india.com/news/health/diseases/14-novel-biomarkers-for-type-2- diabetes-identified_19085.html 80. Botox offers Effective Treatment for Urinary Urgency Incontinence
Last Updated: Friday, October 05, 2012Washington: A new study has found that Botox (onabotulinum toxin-A) injections to the bladder areas effective as medication for treating urinary urgency incontinence in women, but the injection istwice as likely to completely resolve symptoms.
These findings were reported by a National Institutes of Health clinical trials network includingLoyola University Chicago Stritch School of Medicine (SSOM).
Urgency incontinence is urinary incontinence with a strong or sudden need to urinate. Traditionally,this condition has been treated with drugs known as anticholinergics, which reduce bladdercontractions by targeting the bladder muscle through the nervous system. However, many women whotake anticholinergic medications experience side effects, including constipation, dry mouth and dryeyes.
“Prior to this study, we reserved onabotulinum toxin-A for women who did not respond to traditionaloral medication. However, this research supports the use of either of these approaches as appropriatefirst-line treatment in women,” said Linda Brubaker, MD, MS, co-author and dean, SSOM.
Women are twice as likely to experience urinary incontinence as men.
This study evaluated 241 women with urinary urgency incontinence. One group of participantsreceived six-months of daily oral medication plus a saline injection. The other group received oneinjection of onabotulinum toxin-A (Botox) plus a daily oral placebo capsule. At the beginning of thestudy, patients had an average of five urgency incontinence episodes a day.
The average reduction in episodes over six months was 3.4 with oral medication and 3.3 withonabotulinum toxin-A. The proportion of women with complete resolution of urgency incontinencewas 13 percent with anticholinergics and 27 percent with onabotulinum toxin-A. Quality of lifeimproved in both groups without significant differences.
More participants in the anticholinergic group reported dry mouth (46 percent versus 31 percent)while the onabotulinum toxin-A group had more urinary tract infections (28 percent versus 15 percent)and more incomplete bladder emptying, requiring temporary bladder catheterization (5 percent versus0 percent).
“These results will help doctors weigh treatment options for women and make recommendations basedon individual patient needs,” said Dr. Brubaker, who is in the Division of Female Pelvic andReconstructive Surgery, Loyola University Health System.
These findings were published in the latest issue of The New England Journal of Medicine. http://zeenews.india.com/news/health/diseases/botox-offers-effective-treatment-for-urinary- urgency-incontinence_19083.html
Indian Judiciary JURISDICTION OF THE SUPREME COURT The Supreme Court has original, appellate and advisory jurisdiction. Its exclusive original jurisdiction extends to any dispute between the Government of India and one or more States or between the Government of India and any State or States on one side and one or more States on the other or between two or more States, if and insofar as t
Noninvasive home ventilation for chronic obstructive pulmonarydisease: indications, utility and outcomeStephan Budweiser, Rudolf A. Jo¨rresand Michael aCenter for Pneumology, Hospital Donaustauf,Donaustauf, bInstitute and Outpatient Clinic forDespite its widespread use, the role of noninvasive home mechanical ventilation for theOccupational, Social and Environmental Medicine,Ludwig-Maximilian