#DrKKAnswers: Yes. But costly. In short run simple chloroquine is cheaper and as safe.
Showing posts with label Dr KK Answers. Show all posts
Showing posts with label Dr KK Answers. Show all posts
Thursday, August 4, 2011
Monday, July 25, 2011
Dr KK Answers: What is Mini-Mental State Examination?
Is the most widely used cognitive test for dementia. The examination takes approximately seven minutes to complete. It tests a broad range of cognitive functions including orientation, recall, attention, calculation, language manipulation, and constructional praxis.
The MMSE includes the following tasks:
- What is the date: (year)(season)(date)(day)(month) - 5 points
- Where are we: (state)(county)(town)(hospital)(floor) - 5 points
- Name three objects: Ask the patient all three after you have said them. Give one point for each correct answer. Then repeat them until he/she learns all three. Count trials and record. The first repetition determines the score, but if the patient cannot learn the words after six trials then recall cannot be meaningfully tested. Maximum score - 3 points.
- Serial 7s, beginning with 100 and counting backward: one point for each correct; stop after five answers. Alternatively, spell WORLD backwards: one point for each letter in correct order. Maximum score - 5 points.
- Ask for the three objects repeated above: one point for each correct. Maximum score - 3 points.
- Show and ask patient to name a pencil and wrist watch - 2 points.
- Repeat the following, "No ifs, ands, or buts." Allow only one trial - 1 point.
- Follow a three stage command, "Take a paper in your right hand, fold it in half, and put it on the floor." Score one point for each task executed. Maximum score - 3 points.
- On a blank piece of paper write "close your eyes;" ask the patient to read and do what it says - 1 point.
- Give the patient a blank piece of paper and ask him/her to write a sentence. The sentence must contain a noun and verb and be sensible - 1 point.
- Ask the patient to copy a design (eg, intersecting pentagons). All 10 angles must be present and two must intersect - 1 point.
The test is not sensitive for mild dementia, and scores may be influenced by age and education, as well as language, motor, and visual impairments.
For research purposes, some investigators use a cutoff score of 26 or 27 in symptomatic populations in order to not miss few true cases.
Dr KK Answers: What is the link with depression?
Screening for depression in patients with dementia is recommended because depression is a common treatable co-morbidity that may also masquerade as dementia.
Dr KK Answers: Should we do MRI in all cases?
Neuroimaging rules out patients who might have reversible causes of dementia that can be diagnosed with imaging studies (subdural hematoma, normal pressure hydrocephalus, treatable cancer). Structural neuroimaging with either a non-contrast head CT or MRI should be considered in the initial evaluation of all patients with dementia.
Dr KK Answers: Should we screen for B12 levels?
The American Academy
Dr KK Answers: What are Dementia syndromes?
The major dementia syndromes include
- Alzheimer disease
- Dementia with Lewy bodies
- Frontotemporal dementia
- Vascular (multi-infarct) dementia
- Parkinson disease with dementia
Dr KK Answers: What is Mild cognitive impairment?
MCI is presence of memory difficulty and objective memory impairment but preserved ability to function in daily life. Patients with MCI appear to be at increased risk of dementia.
Dr KK Answers: How common is dementia?
5 percent of individuals over age 65 years and 35 to 50 percent of persons over age 85 years have dementia, the pretest probability of dementia in an older person with reported memory loss is estimated to be at least 60 percent.
Dr KK Answers: What is age related cognitive decline?
The normal cognitive decline associated with aging consists primarily of mild changes in memory and the rate of information processing, which is not progressive and does not affect daily function.
Learning or acquisition performance decline uniformly with age. Delayed recall or forgetting remains relatively stable. Aging is associated with a decline in the acquisition and early retrieval of new information but not in memory retention.
Dr KK Answers: Who reports dementia?
Most patients with dementia do not present with a complaint of memory loss; it is often a spouse or other informant who brings the problem to the physician's attention.
Dr KK Answers: What is DSM-IV definition of dementia?
Evidence from the history and mental status examination that indicates major impairment in learning and memory as well as at least one of the following:
a. Impairment in handling complex tasks (eg, balancing a checkbook)
b. Impairment in reasoning ability (eg, unable to cope with unexpected events)
c. Impaired spatial ability and orientation (getting lost in familiar places)
d. Impaired language (word finding)
The cognitive symptoms must significantly interfere with the individual's work performance, usual social activities, or relationships with other people. There must be a significant decline from a previous level of functioning. The disturbances are of insidious onset and are progressive. The disturbances are not due to delirium; a major psychiatric diagnosis; systemic disease or another brain disease.
Patients with dementia may also have difficulty with
a. Learning and retaining new information (eg, trouble remembering events)
b. Behavior
Dr KK Answers: What is Alzheimer disease?
Ad is the most common form of dementia in the elderly, accounting for 60 to 80 percent of cases.
Dr KK Answers: What are cognitive functions?
They are memory, reasoning, language, calculations and spatial orientation.
Dr KK Answers: What is dementia?
It’s a disorder characterized by impairment of memory and at least one other cognitive domain (aphasia, apraxia, agnosia, executive function). These must represent a decline from previous level of function and be severe enough to interfere with daily function and independence.
Emedinews : Laughter the best medicine
A young boy enters a barber shop and the barber whispers to his customer, “This is the dumbest kid in the world. Watch while I prove it to you.” The barber puts a dollar bill in one hand and two quarters in the other, then calls the boy over and asks, “Which do you want, son?” The boy takes the quarters and leaves. “What did I tell you?” said the barber. “That kid never learns!”
Later, when the customer leaves, he sees the same young boy coming out of the ice cream store. “Hey, son! May I ask you a question? Why did you take the quarters instead of the dollar bill?” The boy licked his cone and replied, “Because the day I take the dollar, the game is over!”
(Contributed by Dr G M Singh)
Dr. KK’s tip on sore throat which can bite the heart
Sore throat caused by streptococcal bacteria can cause rheumatic fever which bites the heart and licks the joints. Typically, the sore throat is without cough, angry looking tonsils, red congested inside of the throat, pain in throat while swallowing of food and painful enlarged lymph nodes at the angle of mouth.
Dr. KK’s tip on sore throat
Presence of cough, nasal discharge, sneezing or redness of eyes means the sore throat is viral in nature and requires no antibiotic. A bacterial sore throat will be without above symptoms.
Dr.KK’s tip on Desi Ghee Vs Vanaspati Ghee
While Desi Ghee (butter oil) increases bad LDL cholesterol it does not affect the levels of good HDL cholesterol.
Vanaspati Ghee increases bad LDL cholesterol and reduces good HDL cholesterol. Vanaspati, therefore, is more harmful than Desi Ghee.
Emedinews: Dr KK's Formula of Eight (Holashtak)
Before Holi festival Holashtak of 8 days is observed. During these 8 days any auspicious work is not done. Holi is the festival for removing negativity from the mind and making friends with enemies. It takes minimum eight sittings for this to happen. ,
Emedinews Dr. KK’s tip on the cholesterol levels
1% rise in cholesterol levels will increase the chances of heart attack by 2%.
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