Medical Tourism 2016

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Quaal it Q i Shree y heaKrishna l hcare Hospital lt iis a priivilege.

Ever since its incept ion two years aggo, The R amanbhai Gokal Privilege Centre has been off ffering personal ised luxur y healt hcare to itts pat ients in Anand , Gujarat , Ind ia and t he world .

The Centre has 57 state- of-t he- art Gold rooms as wel l as Plat inum and Diamond suites and access to a range of indoor services. The level o of treatment for comprehensive and special it y care t hat we offer is not hing short of world- class. Especcial ly in t he areas of Adult and Card iac care, joint replacement , Wee are proud to have treated t housands wit h our comprehensive Cancer care, Neurolog y and Neurosurger y. W out-pat ient and indoor services. And it is our privilege to see t hem wal k out our doors heaalt hy and happy again.

S hr e e K r i s hn a H os p i t a l , G o ka l N a ga r, K a ra m s ad 388 325 G u j a ra t | r gp c@c h a r u t a r h e a l t h.o r g F o l lo w u s o n:

Gujarat Samachar & Asian Voice

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For Prompt, Proper and Economic Medical Care – India is the Destination There’s nothing more important than good health – that’s our principal capital asset.

Today more and more people in developed countries as well as developing ones are living longer. There's an unprecedented lengthening of our lives. But mere length is not enough. We all want better health too.

In Britain and other developed countries – heart, kidney, knee, cancer and other serious health problems seemed almost incurable a few decades ago. However, today things have changed for the better, thanks to better personal care and facilities available in hospitals and private medical centres. Almost all such health problems can be tackled well if proper treatment is taken on time.

In the UK the National Health Service (NHS) is, in spite of the various challenges and limitations, rendering a spectacular service. In the US and some other countries, health insurance is paramount. In the NHS, however, the supply side has failed to keep up with rapid growth in demand for better and quick service. The lack of resources, trained personnel, enough number of beds, etc. compels the NHS to delay or defer the treatment, which is not only harmful to patients physically but also affects their overall wellness. Such patients need immediate care. Private treatment is possible, but it comes at a price. For the uninsured it is an expensive affair here compared to other alternatives abroad.

There are many countries which are becoming a popular destination for medical tourism – the practice of travelling abroad to receive medical treatment. China, India and some countries in the Middle East and Asia have their own attractions. But India is comparatively better placed among such nations. The quality of healthcare, affordability and access to care in reputable hospitals in India are comparable to the standards available in developed societies.

Another aspect where India has an edge over others is English language. The availability of English speaking personnel in India makes the country a preferred choice for health tourism.

CB Comment

The added attraction for the approximately 25 million Indian diaspora to avail of medical care in India is the advantage of being treated in a familiar or well-acquainted environment – that of culture, tradition, language, diet, or for that matter social connectivity too has its own value.The present medical tourism market in India valued over $3 billion is likely to reach $7 to $8 billion by 2020.

The Indian Journal of Medical Ethics is aware that if India wishes to develop this type of “exports” which can also earn the country enormous goodwill, the standards must be continuously developed and maintained. Most states in India, especially Tamil Nadu, Maharashtra, Delhi, Punjab, Gujarat and Karnataka, are focusing to develop what is commonly called health tourism. Both national and regional authorities must ensure that there is no shortchange in services. Sometimes, thankfully very seldom, we hear about cavalier or cowboyish attempt to make illegal money out of it. This is not acceptable. Professionally-run hospitals should acknowledge and understand their responsibility and they must take care that commercial considerations do not outweigh the core responsibilities.

I am delighted to present our special Medical Tourism magazine, which is full of useful information. I also appreciate the support of the sponsors and advertisers, and acknowledge the hard work put in by the ABPL team

Yours Sincerly, CB Patel Publisher/Editor www.abplgroup.com

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Minister Health and Family Welfare, Medical Education, Environment (All Independent Charge) and Urban Development.

Gujarat Government

Shankar Chaudhary

Government of Gujarat

1st Floor, Swarnim Sankul-2 New Sachivalaya, Gandhinagar-382010.

Office Ph. No: (079) - 232 50195 Fax No: (079) 232 50189 Date: 28 September 2016

Message I am happy to know that Gujarat Samachar and Asian

Voice, keeping Gujarat's medical sector in mind, are releasing a magazine- 'Medical Tourism 2016', this

month. In the special edition, NRIs and NRGs will get an

overview of the health services provided in the state.

Gujarat Samachar publishes special editions on different

sectors and topics, every year, not only giving varied

reading material to its readers, but also acquainting them with different facts and stories. I appreciate the

Shankar Chaudhary

publication for this endeavor, and extend my well wishes to the team.

(Shankar Chaudhary)

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Medical Tourism Superior Services for Better Rates

Mitul Paniker

T

he concept of Medical Tourism has been catching speed in the past few years. Although it has caught the public eye recently, the concept is far from new.

Travelling for medical treatment dates thousands of years back, and sources suggest it were the Greeks, who began the tradition by going all the way to the Mediterranean to seek medical aid.

While the concept remains old, research shows the flow of the travel has flipped over. In the past, people from under-developed countries went to the richer ones for advanced therapy and cures. In the present, however, it is the opposite. The rising healthcare costs has pushed modern day patients to look for different, better, and cheaper means for health services. This is where, regions called the 'third world' countries, cash in.

Seeking out another country for such facilities are balanced on three things; quality of healthcare, affordability and access of care. Any patient can get quality treatment here for a small percentage of the cost they would pay in the US, Canada, Japan or Europe.

An article by a leading analyst read, "A patient from the United States is likely to be a middle class adult requiring surgical care who has no health insurance or who has inadequate coverage. Other groups pursuing medical tourism are people seeking cosmetic surgery, dental reconstruction, fertility treatment, gender reassignment procedures, and other treatments not covered by health insurance. The common feature in both groups is that their resources are adequate to purchase healthcare in low-cost medical tourism destinations but insufficient for them to comfortably have the same services in their local market." National health programmes usually do not own up for cosmetic surgery and similar other procedures; potentially widening the candidate spectrum for medical tourism.

There are patients from countries where the 6

Gujarat Samachar & Asian Voice

government healthcare system keeps a strong hold on access to services. Not to forget, services that are not widely available in these developed countries for different reasons. Patients go abroad for stem cell therapy, due to restrictions in theirs. Other such treatment procedures include sex change procedures and drug rehabilitation. Going to a foreign land not only satisfies them financially, the assurance of confidentiality and privacy is also a factor to consider.

Putting into perspective, the developing countries' choice of providing healthcare services at a comparatively inexpensive charge, it is known to be directly related to their economic status. Charged for healthcare services are appropriate for the level of economic development in which the services are provided. Low administrative and medico legal expenses for overseas practitioners also contribute to the affordability of offshore medical care. An article has cited, "The professional liability insurance premium for a surgeon in India is 4 per cent of that of a surgeon in New York." Slowly involving into an entire industry, Medical Tourism finds itself driven by patients who mostly feel betrayed by the system in their country. An article in a leading magazine cited a university professor as saying, "This is the potential of doing to the US healthcare system what the Japanese auto industry did to American car makers." It has become a fact that the changing scenario of the industry is affecting the healthcare landscape in industrialised countries.

Top medical tourism destinations are China, India, Israel, Jordan, Malaysia, Singapore, South Korea, Philippines, Taiwan, Turkey and the United Arab Emirates. Patients seek these places for cosmetic surgeries, Dentistry-related procedures, Cardiology and Cardiac surgery, Orthopaedic and spine surgeries, Bariatric surgeries, procedures related to the Reproductive System and Organ and Tissue Transplantation. www.abplgroup.com

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MEDICAL TOURISM IN INDIA

health tourists. Chennai fairs better than other cities in the country as it offers low costs, little to no waiting period and better facilities. Chennai is said to have an estimated 12,500 hospital beds, of which only half is used by the local population.

Medical Tourism Market Report: 2015 states that India is "one of the lowest cost and highest quality of all medical tourism destinations, it offers wide variety of procedures at about one-tenth the cost of similar procedures in the United States." The services provided in India are not limited to just healthcare. Tourists usually get a package deal that includes flights, hotels, treatment and a post-operative vacation. The cost differential is huge between India and other countries.

An Open-heart surgery costs up to $70,000 in Britain and $150,000 in the US. Meanwhile, in India, it could cost anywhere between $3000 to $10,000, in the best hospitals. A knee surgery costs $7,700 in India.

The Indian government has contributed accordingly in boosting the sector. The Indian Journal of Medical Ethics states that the administration made it clear in 2002, that the National Health Policy supports medical tourism. The report quoted, "To capitalise on the comparative cost advantage enjoyed by domestic health facilities in the secondary and tertiary sector, the policy will encourage the supply of services to patients of foreign origin on payment. The rendering of such services on payment in foreign exchange will be treated as 'deemed exports' and will be made eligible for all fiscal incentives extended to export earnings."

Modern day India has emerged as a global destination for a lot of sectors. The South Asian country's healthcare industry is a prime example of technology and a perfect balance of demand and supply. A research report on Indian Healthcare sector showed the medical tourism market in the country is valued over $3 billion, and promises to grow to $7-8 billion by 2020. The reason medical tourists prefer India for healthcare are the key opportunities in the Indian healthcare sector in the form of efficient infrastructure and technology. The insurance market is better and the medical systems are well developed.

A market research report found out that over 120,000 overseas patients came to India for medical treatment in 2005; the number substantially grew over the years. Another overview shows the medical infrastructure and technology in the country matches those in USA, UK and Europe. India can vie with some of its best hospitals and treatment centres in the world, making it the perfect destination.

India has 28 JCI hospitals. Overseas patients, once treated, are given choices of either recuperating in the hospital or at a paid accommodation nearby. There are several other hospitals which also give the option of continuing the treatment through telemedicine. India's "Health Capital" Chennai sees an estimated 150 international patients every day in its multi- and superspeciality centres. The city alone accounts for 45 per cent of overseas and 30 to 40 per cent of domestic

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An article published in Forbes India, summarises Medical Tourism in India in four points.

INFRASTRUCTURE AND BETTER HEALTH-RELATED INVESTMENTS WILL DECIDE THE FUTURE.

MEDICAL TOURISM MARKET IS ESTIMATED TO BE VALUED AT $ 4 BILLION.

While all trends point towards an increasing demand for medical services in India, some key factors will determine whether the Medical Tourism industry becomes as strong as its Information Technology industry. Here’s a list of some factors: • Infrastructure investment by the government: The health industry as a whole has seen meagre growth as far as infrastructure is concerned. This has been primarily due to investments coming from the private players in the market. The government needs to step in and provide basic infrastructure services which will improve basic access to high quality centres.

• Reducing barriers for visiting India for medical purposes: Currently, foreigners need the “M-Visa” to come to India for medical purposes. Obtaining the visa is a huge barrier for medical tourists wanting to come here. India should consider offering visa-on-arrival type of services and partner with medical and tourism providers to streamline administrative processes.

• Market health tourism in Western countries: With the ever-growing need for cheaper health care and complex health insurance offerings in the US and UK, Indian hospitals could target the neglected populations of those countries and draw them here to provide a cheaper alternative.

Health care tourism has been a key growth sector for more than a decade. Growing insurance market, strong pharmaceutical industry, cheap international travel, and quality health care are increasingly making India a preferred tourist destination. India hosts about 1.27 million tourists from countries such as the US, UK, and Canada in addition to visitors from neighbouring countries like Bangladesh, Sri Lanka and China.

This market includes secondary players from the tourism industry who greatly benefit from visitors to India. The government estimates that the growth of health-related services will be more than 5 per cent for the next 10 years and that should further attract more such visitors.

TOURISTS COME TO INDIA FOR ECONOMIC REASONS AND MARKET ATTRACTIVENESS. Procedures such as hip and knee replacement, face lift, and gastric bypass are far more affordable in India, including the cost of travel and accommodation, compared to the US. Moreover, these cosmetic procedures are not covered by most insurance providers in Western countries.

India has many top-notch centres for open-heart surgery and paediatric heart surgeries which are equipped with the latest equipment that are on par with these Western countries. India is also home to a number of alternative medicine techniques such as Ayurveda, Sidha, Unani, Yoga, Acupuncture and Homeopathy which are very popular among foreigners.

Such treatment opportunities give India the edge over its competitors like Thailand, Singapore, Malaysia, South Korea, and UAE. MAHARASHTRA, TAMIL NADU AND DELHI ARE TOP DESTINATIONS FOR FOREIGN VISITORS. Based on the government’s statistics of foreign tourists for 2010, more than 55 per cent of visitors went to medical centres in Maharashtra, Tamil Nadu and Delhi alone. Quality hotels, added tourism opportunities, and high-quality hospital care are the biggest reasons for this trend.

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GUJARAT JOINS THE RACE TO EMERGE AS THE NEXT IT PLACE FOR THE INDUSTRY The Gujarat State Government announced its first Medical Tourism Policy in the year 2006, where it said that the Gujarat Medical Tourism Council would be formed to put the planned policy to practice., the government promised to issue help to insurance companies to develop different packages of international standard, in the policy. The idea is to bring together modern allopathy and ancient Indian techniques like Yoga, Ayurveda, Homeopathy, Naturopathy, Aromatherapy, and Reiki. Gujarat's biggest business hub, Ahmedabad has taken the medical industry under consideration where its development is concerned. The 'Vibrant Gujarat' project has helped the city bring a radical change in the facilities and medical aids provided at the hospitals. Ahmedabad boasts of the largest civil hospital in Asia, and is home to some of the best Ayurvedic hospitals in the country that specialise in Panchakarna and natural cures. One of the most sought after treatments in Dentistry. Dental insurance coverage is usually expensive than other treatments. This helps tourists flock to India to get themselves treated. www.abplgroup.com

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Health Sexuality Teenage is a tumultuous period of life. It is the age when girls and boys go through the major physical, psychological, sexual and social changes. Most of the problems faced during teenage are associated with these changes. If managed well, these problems can be prevented. If overlooked or mismanaged, it can have adverse consequences affecting quality of life. Hence, I felt it prudent that we discuss the topic of health and sexuality in the context of teenage girls so that with proper information and guidance, these problems can be alleviated.

Dr. Sonal Desai

MENSES Irregular Menses This is a very common complaint. Up to two years after menarche (initiation of menses), menses can be irregular in frequency as well as in flow due to insufficient level of hormones. This is normal. It doesn’t require any treatment. If this irregularity continues beyond two years of menarche, one should see a doctor.

Painful Periods This is the most common complaint. In 90% of girls, pain occurs without any underlying pathological cause.

Simple analgesics like Ibuprofen and Mefenamic acid relieves the pain. Only 10% girls suffer due to an underlying pathological cause. So when simple analgesics don’t work, one should consult a doctor.

Excessive Menses: Some girls suffer excessive blood flow during periods.

In this case, one should consult a doctor because if that continues for a longer time then it can lead to anaemia.

Height Total gain in height during adolescence in girls is 24 26 cm. Once menarche is attained the rate of growth decreases. There will be increase in height of 5 - 6 cm in total after initiation of periods.

The projected final height that is called Target height can be calculated by: TARGET HEIGHT = (MOTHER’S HEIGHT + FATHER’S HEIGHT) 6.5 ( in cm) 2 Good nutritious food and regular exercise in any form, including outdoor games, may help in increasing growth. However, genetics remains the key determinant.

If a girl fails to reach her desired height, elders need to increase her confidence by talking to her, clearly explaining that it is not her height that will determine her success. She should express herself completely in life, without the trauma of her height lingering over her head.

Breast size and related issues It is common to have small sized breast among young girls. Anatomically any size breast is normal. Variation in size of both the breast is also normal as long as it is capable of doing its function; that is producing milk and feeding a new born.

Vaginal Discharge Many girls complaint of watery thin discharge. This is a

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completely normal physiological discharge. There is no need for treatment. If it turns to white or yellowish thick in consistency, smells bad or is associated with itching, one should see a doctor and get examined.

Acne Lesions Teenage is an acne prone period for everyone. Acne lesions start appearing during mid teens and will disappear in late teens. They appear as a result of hormonal changes that happen in the body. Frequent face wash is helpful in containing the problem. A dermatologist can be consulted to treat the lesions.

Diet and Nutrition Girls should be made aware that they being healthy and fit is more important than being slim.

This is the right age to establish healthy food habits. As this is the growing age, their diet should have good amount of iron, calcium, vitamins and protein.

DAILY REQUIREMENTS: Iron :15 microgram Sources: Cereals, pulses particularly chickpeas and soya beans, green leafy vegetables, jaggery, dry fruits.

Calcium:1200 mg Sources: milk, curd, butter milk, cheese, cottage cheese. One glass of milk provides 400 mg of calcium.

Vitamin C: 65 microgram Sources: Citrous fruits, tomatoes, broccoli spinach etc.

Vaccines Apart from routine vaccines, girls 14

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should take vaccine to prevent Rubella infection (1 dose) and vaccine to prevent cervical cancer (3 doses).

Sexuality related issues There are mainly two kinds of issues related to sexuality.

Issues related to Expression of Sexuality: Expression of one’s sexuality should not harm others or one’s self. Sexual intercourse is not an impulsive act rather it should always be a thoughtful action because thoughtless sexual intercourse can lead to unintended pregnancy.

We all know teenage pregnancy is associated with many physical, psychological and social problems. It affects girl’s quality of life to a large extent.

Sexually Transmitted Diseases: Unprotected sex can lead to sexually transmitted diseases. As I said teenage is a tumultuous period of life. If dealt with responsibly, teenage can be the most wonderful period of a person’s life. www.abplgroup.com

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They say, “A smile is a curve that sets everything straight”. Not everyone is privileged to have the perfect curve to pierce hearts and set things straight in life. If you are not happy with gods way of designing of your special curve, you have specialist doctor’s help ready at “Care 32-Dental Centre” in Anand to improve upon nature’s design and give your smile a makeover.

Smile makeover or Smile designing is few from the list of the Dental Healthcare Services provided by one of the leading Dental Care clinics in Anand- “Care 32-Dental Centre”. The clinic which is run by two young but efficient Dental Surgeons- Dr Archana Dholakia and Dr Soham Dholakia have variety of Dental Healthcare Services to provide- from basic Dental treatments to Cosmetic Dentistry and Specialized Dental Services like Implant Prosthesis under one roof.

Care 32-Dental Centre is a state of the art Dental Centre in a very friendly and soothing environment as it strives to create an environment towards Total Dental Healthcare and reiterates its social commitment to serve the members of society by diffusing the knowledge of complete Oral Healthcare to the masses. With its highly skilled and reputed panel of specialist Dental Surgeons –spanning across all the fields of Dentistry, an array of Dental procedures right from Root Canal Treatment to advanced Smile makeovers, Dental Implants to Full Mouth Rehabilitation are all performed under one roof.

Care -32 Dental Centre also ensures Ultra Hygienic Care and strict standards of Sterilization.

Disposable materials and instruments are used wherever needed. Also, the most advanced techniques are performed using the latest equipments and materials.

Dr Dholakia has not only won trust and repute within

To list a few Dental Healthcare Services provided by the clinic

Implants and Implant Suported fix teeth & Dentures Fixed Bridges And Full Cast crowns (All Ceramic) Full and Partial Dentures Orthodontic Treatment (For Irregular and Malaligned Teeth) Clear braces to correct irregular teeth (invisible braces) Gum Surgeries with Laser (Painless and Bloodless) Dental Treatment for Children Root Canal Treatment Tooth Whitening (Bleaching) Third Molar (Wisdom Tooth) Surgery & Scaling etc.

Facial aesthetics, Dermal Fillers, Smile Design Pain relief and treatment clinic for Tempero Mandibular Joint and associated Headaches

Dr. Archana Dholakia Cosmetic Dental Surgeon

Charotar region specifically but also helped patients from other parts of Gujarat. Being a NRI hub, the Care 32- Dental Centre has also helped NRI and NRG patients overcome pain from varied Dental problems and set new teeth with Dental Implants.

There are many people who have TMJ (Tempero Mandubular Joint) problems causing un diagnosed headaches , which are due to TMJ joint problem or unbalanced occlusion. The clinic also treats such patients providing them relief from long standing pain caused due to these conditions.

Also they are coming up with state of the art one of the biggest dental and facial aesthetic centre in Gujarat when they shift to their new premises of around 5000 sq feet early next year.

Ghanshyam N. Patel who is settled from USA is one such patient who found relief from pain at Care32 Dental Centre. Says Mr Patel, “I feel very good and my teeth on Implants look very good plus I can chew perfectly. The clinic provides very decent, perfect and very good service at reasonable price,”

“A wonderful, caring, professional and smiling place to visit, for treatment of any dental problems, pains or discomfort. All work carried out to the highest standard, such that even an NRI does not need to fly back for any further work. Right first time every time,” said Hiten Patel from UK. “I, Dr Pravin Patel (UK) had undertaken Dental treatment from Dr Soham & Dr Archana at Care-32 Dental Clinic in Vidya nagar five years ago.

Dr Soham has replaced my eight Teeth by dental implants up to now and I haven’t faced any issues till now after the treatment. I had also gone through root canal with Dr Archana. The price was very reasonable and it was very damn cheaper than the UK price. I had the best treatment experience with Care 32 Dental Centre and will recommend all my friends & relatives to Dr. Soham & Dr. Archana.”

“I am Natubhai I. Patel of Montreal, Canada. I have done my Dental Implant from Dr Soham. I am quite satisfied with his services without any problem. Dr Soham is an excellent Implant Surgeon.”

Dr. Soham Dholakia Consulting Implantologist

10/11, 1st Floor, Chitrangana Complex, Anand-Vidyanagar Road, Anand-388001, Gujarat, INDIA Mobile: + 91-98982 32388, +91-98982 58040 Email: drarchana.dholakia@gmail.com / drsoham.dholakia@gmail.com

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Stay Fit T

he term 'Fitness' is not limited to merely a person's body. It also refers to their state of mind. Mental fitness is one of the priorities of the industry currently, and can only be achieved if the body is functioning well. The way to attain fitness, is to relax your own mind, and eliminate stress by exercising regularly, and eating right. Given the astonishing speed at which obesity rates, and diseases and conditions related to being overweight, are rising, it is advised to not ignore the importance of staying fit.

Obese people have a 10 to 50 per cent increase in premature deaths, with majority of them cited to cardiovascular causes. Studies show as many as 74 per cent of adults identify as overweight or obese, and only 26 per cent of American adults participate in physical activities three or more times a week. Given the constant threat of issues caused by gaining a large amount of weight, the wise thing to do, is achieve a healthy and fit lifestyle. Making changes in your life, is a good start. They need not be major changes, just things you would enjoy and look forward to. The key is to focus at improving all areas of personal fitness; both mind and body.

Standard fitness guide suggests some key components associated with both, the 16

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physical and mental aspects of fitness:

Cardiovascular and Aerobic Conditioning

Aerobic activities are exercises that raise your heart rate to your target heart rate and maintain that level for at least 20 minutes. For a cardiovascular workout, 70 to 85 per cent of your maximum heart rate is the ideal range.

Your maximum heart rate will depend on your age. You can easily find this number and pick your target heart rate based on your fitness level. Aerobics is known to have its own benefits. Combine it with a healthy diet and you can losw weight and keep it at bay.

It will strengthen your heart, lower your blood pressure, reduce bad cholesterol, and lessen the risk of a heart attack.

Aerobic conditioning also controls blood sugar, and help manage diabetes.

Strength Training and Muscular Development

A musculoskeletal exercise type that helps increase resistance muscles can overcome. It improves your health in more ways than one.

This type of training strengthens, and helps the muscle grow themselves.

Stronger muscles reduce the risk of injury during daily activities or other exercise. www.abplgroup.com

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Weight training also helps bone health.

Strength training increases bone density, which reduces the risk of developing osteoporosis and fractures.

Stretching - Muscles, Ligaments and Tendons

One of the priorities of your fitness and wellbeing should be stretching. It should be done regularly, along with weight training or aerobic exercise at least three times a week. Stretching is best done after a brief physical warm-up routine. It works by increasing the muscles, ligaments, and tendons' ability to elongate.

While most exercises tighten them, stretching helps keep them flexible, and improves your range of motion.

The consequences of stretching are flexibility, and elongation of your body's soft tissue, improved blood circulation, oxygen supply to your muscles, ligaments, and tendons, and relaxation of tense muscles and from mental tension.

Mental Rest and Relaxation

Similar to our body, even our brain needs time to cool down. A tired brain can be stressful.

Mental relaxation is one of the key components to good health. Yoga is one of the most sought after ways to de-stress.

Seven Truths about Fitness 1) Muscles don't turn to fat when you stop exercising Muscle and fat are different types of tissue and one cannot turn into the other. But muscle consumes more calories even when you're not exercising; so if you allowed your muscle mass to drop but ate the same amount, you'd store the excess calories as fat.

2)Weight training won't build unsightly bulk on women Women don't have enough testosterone to develop massive bulges. Only serious body builders can achieve bulk.

Core Stability

This kind of training involves strengthening the muscles lining up your spine, and also make up your abdomen and pelvic floor.

They help control your posture, balance, and the power and efficiency with which you move.

C o r e Strengthening usually involves placing the body in a position where the core muscles are required for the body to maintain that position for a specific amount of time. It can minimalise, even prevent injuries associated with general physical activity, and creates smoother, more coordinated movement.

actually a better way to balance the equation than eating less. Ona very low-calorie diet, your body goes into survival mode, slowing your metabolism and burning lean muscle.

4) You can't sweat weight off in the sauna Any weight you lose is just water through sweating and this must be replaced quickly.

5) No one's too busy to hit the gym If you can't make time for the gym, try using the stairs instead of the lift. At home, gardening or playing football with the children will burn more calories than a brisk walk for the same duration. If it's leaving you warmer and breathing more heavily, it's working.

6) Lots of sit-ups won't give you strong abdominal muscles Experts sat you won't get muscle unless you reduce overall body fat.

7) Men can't get cellulite True, but neither can women, as there's no such thing. An expert said cellulite is just ordinary body fat plus gravity.

The Impact of Physical Activity on Your Health

• Prevent chronic diseases such as heart disease, cancer, and stroke • Control weight • Make your muscles stronger • Reduce fat • Promote strong bone, muscle, and joint development • Condition heart and lungs • Build overall strength and endurance • Improve sleep • Decrease potential of becoming depressed • Increase your energy and self-esteem • Relieve stress • Increase your chances of living longer

3)Eating less won't help lose weight If you eat more than you burn off, you'll get fat, but increasing your activity level is

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Yoga to Heal

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5000 year old exercise that combines the body, mind and the spirit, Yoga is one of the top go-to practices in the modern world. It is derived from the Sanskrit word 'Yuj' which means "to add" or "to join".

The term applies to a set of practices and methods, including those of Jainism and Buddhist. Yoga involves a lot of Asanas; poses that relieve stress and take the person into a state of relaxation. It is known to stimulate and soothe organs, improve concentration, and calm the participant.

MEDITATIVE POSTURE Begin by finding a comfortable seat and cross your legs, with your ankles crossed in front of you and knees resting slightly below the hips. You can place a pillow underneath to help elevate the hips and ease any discomfort. Taking a deep breath, with a long spine, open chest and relaxed shoulders, place both hands at your chest. Begin to think positive thoughts, and allow yourself to notice and revel in self-love and peace.

Observe the effect that the feeling has on your heart and body. Allow yourself to rest in this feeling of love, and notice how it feels to treat yourself the same way.

Continue breathing deeply into your heart, and for about two-five minutes, begin pairing the breath with a positive affirmation — 'My life is beautiful and I am grateful for all that I have' — you have in mind. Allow your body to relax with every exhalation as you begin to absorb its meaning. Even if this affirmation feels mechanical at first, by repeatedly focusing the mind on 22

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it, you are retraining your subconscious while subtly alleviating the negative self-talk.

CHILD'S POSE A few minutes later, flow into a supported child's pose (balasana), by using a thickly rolled blanket, between the thighs, so that the torso, chest, shoulders, head and neck are fully supported. As you sit back towards your heels and rest your arms by your sides, allow your body to fully release from the hips, tailbone, and pelvis, to the belly, shoulders, neck and face. Massage the forehead by gently rolling it from side to side on the blanket. Once there, continue to rest as you breathe deeply — with every exhalation let your muscles, spine and pelvis release deeper toward the ground. Breathe slowly and stay here for at least five minutes.

SPINAL MASSAGE Roll onto your back and hug the knees to your chest.

Try rocking forward and back to massage the spine a few times, and then side to side to massage the whole back. Roll knees around in slow circles to massage the lower back and invite any movement that feels nourishing to the spine, hips, lower back and shoulders. Stay here for a few minutes, hugging the knees toward your heart with care. You can pair each inhale and exhale with: 'I love and accept myself the way www.abplgroup.com

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I am,' while breathing into your heart space. When we treat ourselves in a loving, tender way — both in our physical postures and in the things that we say to ourselves — we begin to believe that we are worthy of unconditional love, acceptance and support.

THE WALL POSE Lie down on the ground (for support, you'll need one or two thick folded blankets/mats) and raise your legs high, touching the wall. Start by placing your support about six inches away from the wall.

Sit sideways on right end of the support, with your right side against the wall.

Exhale and, with one smooth movement, swing your legs up onto the wall and your shoulders and head down onto the floor. Bend your knees, press your feet into the wall and lift your pelvis off the support, tuck the support a little higher up under your pelvis, then lower your pelvis onto the support again. Lift and release the base of your skull away from the back of your neck and soften your throat. Release the heads of the thigh bones and the weight of your belly deeply into your torso, toward the back of the pelvis. Stay in this pose anywhere from five to 15 minutes. Instead, slide off the support onto the floor before turning to the side. This pose relieves tired or cramped legs and feet. Gently stretch the back

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legs, front torso, and the back of the neck. This pose is actually a supported variation of the shoulder stand (sarvangasana). This pose helps you calm the mind.

SHRAVASANA

The corpse pose or shravasana is not only the easiest, but it is also the most important asana in the yoga sequence. When you are in a state of shravasana (body flat facing the sky, with palms facing upwards), you are in a zero state. Allow yourself to feel nothing and let thoughts pass. It's also essential to pacify the from sensory organs. Soften the root of the tongue, the wings of the nose, the channels of the inner ears, and the skin of the forehead. Let the eyes sink to the back of the head, then turn them downward to gaze at the heart.

Remember, it is the total relaxation pose and doesn't require the body to put any additional physical effort.

Breathe in and say to yourself (in your mind), "I fill myself with an abundance of self-love, acceptance and divine energy". After a few moments of peace, gently roll to the right and place your arms at the centre to form a namaste pose and thank the Universe for this day.

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Veganism: A Trend Catching Traction

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he year 2016 is the year new and fashionable food trends took birth. "Officially" declared the Year of the Vegans, the world saw quirky dishes take over the food industry and the internet. We all are guilty of Instagramming our smoothie bowls and our Zucchini noodles (or as they are rightfully called, Zoodles), trying out the new vegan flavoured ice cream, and try a vain attempt at loving Kale.

The term Veganism lately caught speed, as celebrities chose to "convert"; most of them promoting a move against animal abuse. A survey taken earlier this year reported that the number of vegans in Britain alone rose by over 360 per cent in the past decade. To turn vegan means to adopt a plant-based diet, and a "clean eating" regime. Such diets are higher in dietary fibre, magnesium, folic acid, vitamin C, vitamin E, iron, and phytochemicals; lower in dietary energy, saturated fat, cholesterol, long-chain omega-3 fatty acids, vitamin D, calcium, zinc, and vitamin B12.

Vegans frown upon beef, pork, poultry, fowl, game, seafood, eggs, dairy, and other animal products like gelatin. Their lifestyle choice extends to other animal products including toiletries, leather, wool, and silk. The basic idea is the rejection of the commodification of animals. So what precisely does their diet constitute of?

They are based on grains and seeds, legumes, fruits, vegetables, edible mushrooms, and nuts. Also in style are mock meats made from soybeans or wheat-based gluten. Soybeans can be considered a staple as they are a complete protein, and can be consumed in different forms.

Adapting itself to the changing consumer demands, 24

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the food sector has begun selling high on veganism. It is detected that even though 98 per cent of Americans do not identify as vegans, they are attracted to its health benefits. A survey conducted last year found that 61 per cent of consumers enjoy menu items heavy with vegetables. There has also been a visible raise in the use of vegetables as an ingredient, between the year 2012 and 2015. An expert said, "A lot has to do with this being trendy, but also with the fact that the people are becoming more aware of what they're putting in their bodies these days. People are realising that there are negative health effects with excessive meat consumption, and more are trying to take action on health."

Research suggests these people have healthier weights with lower cholesterol levels and lower blood pressure compared to meat eaters. Such diets reduce the risk of diabetes and heart problems provide benefits that make far more sense. Now, the reason the trend is catching fire is because it is driven by the young. Over half the number of the total vegans, are aged somewhere between 15 to 34. Organisation Teen Vgn constantly speaks about the prominence of vegan role models. A volunteer said one of the reasons more people are inclined towards the trend is the growing number of celebrities and role models. Turning vegan has become fashionable now. Groups like this one run camps where teenagers are invited to participate in workshops on cooking courses, and talks on animal rights. Add to this the compelling benefits of social media and what we have on our hands is a revolution that refuses to die down. www.abplgroup.com

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One of the most frequently asked questions about veganism, is how different is it from vegetarianism? A vegetarian is a person who chooses to not eat meat for his/her own reasons. There are different variants, like the person who does not eat meat but eats fish (Pesco-vegetarian), and the person who does not eat meat, but does eat eggs (Lacto-ovo vegetarian).

Generally people who turn vegetarian, begin the diet because of health issues, or a looming sense of guilt over killing animals. Many are bothered with the issues connected to the meats and poultry bought from stores.

Religion is also a major factor; Hinduism and Jainism are promoters of a vegetarian diet. Christianity calls for a meatless diet during Lent.

The one prominent difference between being a vegan and, a vegetarian is that the former is a lifestyle.

As mentioned earlier in this article, vegans not only quit meat, they also neither wear clothing or cosmetics, do not own household items; basically anything that has to do with animals. People turn towards it because of their health, or their political or moral issues. A typical vegan hosts strong feelings for animals and believe they are not to be taken advantage of.

World's largest animal rights advocate group PETA launched a series of passionate social media campaigns in the first half of 2016, asking the masses to go vegan.

Given the high number of people following the group on the internet, sharing and commenting on their Facebook, Instagram, and Twitter, it is acceptable to say they played a major role in inspiring the vegan way. As per their website, they published a total of almost 500 posts on Facebook, just on vegan eating and the treatment of animals raised and killed for food. One of their most viral videos is the 'Chicken Dinner in Reverse' video, which received 15 million views, and was shared 151,500 times. They also published over 3000 tweets related to vegan eating this year alone. As per their sources, their biggest hit was a PETA Living recipe video for vegan chocolate crème eggs around Easter, which received over 108,000 views.

If this article has inspired you to try out the new and trendy lifestyle, PETA shows you three easy steps to turn over a green leaf.

What to Buy: Overhaul your shopping list by adding a few mock meats and nondairy delights. Best of all, many of these can be found at grocery stores in your neighborhood.

What to Make Where to Eat: There are usually vegan options no matter where you are; a restaurant, a friend's house, or www.abplgroup.com

on the road. You just have to know what to look (and ask) for. There are vegan and vegetarian restaurants around the country, but you can also find plenty of vegan options at restaurants that serve meat. When going to a friend's house to eat, call ahead of time and ask them what is on the menu. Offer to help make it vegan or bring a vegan dish to share. When travelling, keep an app on yourself that will help you find the closest vegan or vegetarian restaurant.

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Don't Eat "Healthy", Eat Smart

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iven the pace of the current world, it has nearly become a necessity to keep a tab on your health and diet. Healthy eating is often compared to a restrictive diet and, depriving one from the food they love. However, experts say eating “right” is mostly about planning your nutrition chart and giving your body what it needs, instead of what you think it wants.

The key, is moderation. It means to eat just as much as your body can take and not stuff yourself. The trick lies in eating small portions and not make any food offlimit. After all, the forbidden fruit is the sweetest. Seek foods low in saturated fats and trans fats to help reduce your risk of heart disease. Most of the fats you eat should be mono-unsaturated and poly-unsaturated oils.

Add a lot of fruits and vegetables in your diet; they are packed with vitamins, minerals, anti-oxidants and fiber.

Make your daily food colourful and be sure to get the recommended daily minimum of five servings of vegetables.

Cooking healthy food does not mean you compromise on your palate. Healthy food can be tasty if done right. Here are a few recipes that are wholesome and delectable.

Vegetarian Tikka Masala 3

tablespoons garam masala 1 teaspoon ground turmeric 3/4 teaspoon salt 1/4 teaspoon crushed red pepper (optional) 2 14-ounce packages extra-firm or firm tofu 1 tablespoon canola oil plus 2 teaspoons, divided 1 large onion, halved and sliced 1 large red bell pepper, quartered and sliced 1 tablespoon minced fresh ginger 2 cloves garlic, minced 1 tablespoon flour 1 28-ounce can diced tomatoes 1/3 cup half-and-half Method: Combine garam masala, turmeric, salt and crushed red pepper (if using) in a small bowl. Cut tofu into 1-inch cubes and blot dry with paper towels. Toss the tofu in a medium bowl with 1 tablespoon of the spice mixture.

Heat 1 tablespoon oil in a large nonstick skillet over medium-high heat. Add the tofu and cook, stirring every 2 minutes, until browned, 8 to 10 minutes. Transfer to a plate.

Add the remaining 2 teaspoons oil, onion, bell pepper, ginger and garlic and cook, stirring often, until starting to brown, 5 to 7 minutes. Add flour and the remaining spice mix; stir until fragrant and coated, about 1 minute. Add tomatoes, bring to a simmer and cook, stirring often, 26

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until the vegetables are tender, 3 to 5 minutes more.

Return the tofu to the pan; cook, stirring, until heated through, about 2 minutes. Remove from heat and stir in half-and-half.

Avial 45 g dry unsweetened coconut 1 tsp coriander seeds 3 garlic cloves 1 red onion 2 dried red chillies ¼ tsp turmeric 1 tsp tamarind 1 tsp vegetable oil 150g zucchini 100g green beans 125g cauliflower 80g green peas 200g potatoes, new 1 carrot (Use any seasonal vegetables) Method: Process coconut, garlic, coriander, chilli, onion, turmeric and tamarind to a paste (add water if necessary).

Heat oil and fry potato for 5 mins then add rest of veg and 1 cup water, cover and cook for 10 minutes.

Add spice paste, cover and cook for 10 mins until vegetables are soft.

Red Lentil & Carrot Soup

Parsley, chopped

1 white Onion, finely sliced 2 tsp Olive oil 3 garlic cloves, sliced 2 Carrot, scrubbed and diced 85g Red Lentils 1 Vegetable Stock cube, crumbled

Method: Put the kettle on to boil while you finely slice the onion. Heat the oil in a medium pan, add the onion and fry for 2 mins while you slice the garlic and dice the carrots. Add them to the pan, and cook briefly over the heat.

Pour in 1 litre of the boiling water from the kettle, stir in the lentils and stock cube, then cover the pan and cook over a medium heat for 15 mins until the lentils are tender. Take off the heat and stir in the parsley. Ladle into bowls, and scatter with finish off with some parsley leaves for garnish.

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Tao Gugji

2 Green chillies, chopped 1 Tablespoon Ginger, grated 2 Clove 1 Teaspoon ginger powder Salt as per taste 1 Teaspoon Red Chilli Powder 1 Teaspoon Turmeric Powder 1 Teaspoon Sugar 2 Teaspoon Coriander Powder 1 Teaspoon Garam Masala

1 Kg Turnip 4 Tablespoon Clarified butter 1 Teaspoon Cumin seeds A pinch of Asafoetida

leaves.

Serve warm with roti.

Blackberry Cobbler

2 cups fresh blackberries 1 cup white sugar 2 cups boiling water

Method: Peel, wash and cut the turnips into quarters.

Heat ghee in a frying pan and lightly sauté them in ghee, set aside. To the same ghee, add cumin, hing, cloves, green chillies, grated ginger and dry ginger powder, fry for 1–2 mins.

Now add turnips, salt, Red Chilli Powder, Turmeric Powder and sugar along with 1 1/2 cups of water.

Simmer on low heat for about 10 mins, then add Coriander Powder and Garam Masala. Stir to combine.

Let the turnips simmer over medium heat till the water evaporates. Garnish with chopped coriander

2 cups all-purpose flour 2 teaspoons baking powder 1 teaspoon salt 1 cup white sugar 1/3 cup softened butter 1 cup milk

Method : Preheat an oven to 350 degrees F (175 degrees C). Whisk the flour, baking powder, and salt together in a mixing bowl.

Cream 1 cup of sugar with the softened butter until light and fluffy.

Mix in the flour mixture alternately with the milk until no large lumps remain. Pour into a 9x13-inch baking dish. Arrange the berries over the batter, and sprinkle with the remaining 1 cup of sugar. Pour the boiling water over top.

Bake in the preheated oven until the batter has firmed and the berries are soft, about 50 minutes.

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1. Eat Breakfast Every Day: Skipping breakfast is a lot like skipping rope: neither gets you anywhere. Although lots of people think they’ll cut calories by cutting breakfast, the opposite is true. Studies show that eating breakfast helps you consume fewer total calories for the day. One national U.S. health and nutrition survey found that men who eat breakfast weigh about 2.7 kilograms (6 pounds) less than men who skip it; women weigh 4 kilograms (9 pounds) less. And a 10year study of almost 2,400 adolescent girls showed that those who ate any kind of breakfast had lower BMIs than girls who did not. People who eat cereal for breakfast have lower BMIs than people who skip breakfast or dine on meat and eggs.

not advising a high-protein, low-carb diet (shortterm studies of these diets do show improved weight loss, but the diets don’t seem to have any advantage over other diets in the long term), just that you make it a point to eat some protein with every meal (and every snack, too).

Other studies have shown that people on high-protein diets that are also rich in “slow-burning” carbohydrates low on the glycemic index (such as fruits and vegetables, beans, and wholewheat pasta) are less hungry and lose more weight than people on low-protein, highcarbohydrate diets.

Getting enough protein when you’re dieting also helps you lose fat, not muscle. Don’t overdo protein, though.

People with type 2 diabetes, which often affects the obese, are at greater risk for kidney disease, and overeating protein may increase the problem.

6 Ways to Prevent

OBESITY

2. Eat High Fibre Foods: Eat a bowl of brown rice topped with chickpeas and sautéed vegetables for lunch, and it’s likely you won’t want another bite until supper. High-fiber foods like these have few calories, little fat, and lots of bulk, which keeps you full. They’re also digested slowly, which means your blood sugar stays at an even keel instead of rapidly spiking and falling, which leaves you hungry again in no time. Whole grains also provide nutrients, such as magnesium and vitamin B6, that many weight-loss diets are deficient in. A great way to get a good dose of fibre is to start your day with high-fibre cereal.

3. Eat Raw, Leafy Green Vegetables: Head for the salad bar. Greens and raw vegetables like carrots, zucchini, and broccoli are remarkably low in calories but high in water and slow-digesting fiber, so they tend to fill you up.

Squelching your appetite isn’t the only reason to frequent the produce section. In a study of almost 18,000 people, researchers found that those who ate salads often had higher levels of vitamins C and E, folate, and carotenoids, important for overall health, than people who had fewer salads. Researchers have also found that people who eat a vegetarian diet weigh an average of 3 to 20 percent less than meat eaters.

And a study at George Washington University School of Medicine found that overweight women on a low-fat plant-based diet who were allowed to eat as much as they wanted lost an average of 5.4 kilograms (12 pounds) in 14 weeks compared with 3.6 kilograms (8 pounds) in the control group.

4. Turn to Fish, Chicken and Beans for Protein: We’re 28

Gujarat Samachar & Asian Voice

5. Eat Healthy Nuts: Nuts are crunchy, salty — and no longer forbidden. Even though nuts are fatty, they may help you shed weight, according to a number of studies.

Researchers believe that the healthy fat in nuts helps people feel full, and the protein may use up calories as it digests. Large studies have found that people who eat nuts regularly have lower BMIs than those who don’t.

6. Get Plenty of Calcium: Calcium, it turns out, may play a part in how fat is broken down and stored. The more calcium in a fat cell, the more fat it burns. In a study of obese adults, one group ate three 175-gram (6-ounce) servings of fat-free yogurt containing 1,100 milligrams of calcium per day. The other group ate one serving of dairy food containing 400 to 500 milligrams of calcium per day. Both groups also reduced their daily calories by 500. The yogurt group lost an average of more than 6.3 kilograms (14 pounds) compared to an average loss of 5 kilograms (11 pounds) in the lowcalcium group. The yogurt group also lost 81 percent more fat from their stomachs. Although studies have found low-fat dairy foods most effective, calcium from other sources, like broccoli or fortified orange juice, works, too.

Despite the positive studies, the jury is still out on this issue. While we wait for final answers, though, eating three servings of low-fat dairy products a day remains a healthy choice. www.abplgroup.com

Nishtha_Article.qxp_Layout 1 14/10/2016 15:29 Page 29

Dawn of a New Era in Central Gujarat

New LASER 4 SIGHT center at Nishant Eye Hospital, Anand

n Kokila Patel

Care & Laser Center.

On 25th September, 2016, I had the opportunity This machine is special as it performs most of the to grace the occasion for the inauguration of Nishant crucial steps of cataract surgery with laser which were Eye Hospital, Retina Care and Laser Center located at till now in conventional phaco method performed one of Anand's fastest developing area along the state manually and the whole process has now much more highway of Anand Lambhvel Road. precision, is safe and yields optimal visual results.

The simple and impressive look of the building Moreover the whole process is FDA approved. just floored me. I became curious to know more about In addition to this, they also have the Refractive Suite now which includes the combination of the it. I entered the building. The spacious reception area above mentioned machine and the state-of-the-art had the motto of the hospital which read‌'TRADITION along Wavelight EX500 Excimer machine from Germany. The with INNOVATION, INSPIRATION for PERFECTION & PASSION with RESPONISIBILITY'. The courteous staff led me around the EX500 is the world's fastest machine to perform LASIK hospital, which had a healing environment, ideal for a patient surgery so much so that it takes just 1.4 seconds to get rid of who requires not only quality medical service but also the one diopter of refractive error (glass power). It can correct all soothing presence of doctors. kinds of refractive errors, while all the treatment modalities I was informed that the hospital has been a pioneer in are FDA approved. bringing the best and most advanced eye care technology to The above two machines are capable of performing central Gujarat nearly four decades ago and the generation cataract and refractive surgery (LASIK) with the newer bladenext has now taken a giant leap forward with free femtosecond laser method. I was Unfolding a FUTURISTIC TECHNOLOGY the new hospital. I was told that the hospital is informed that now with the new statein the present times... equipped with the stateof-the-art technology, any adult patient of-the-art femtosecond above the age of 18 can get laser machine (LenSx, rid of his glasses provided from ALCON, USA ), first of the eye is suitable for its kind in the whole of surgery. The hospital also Central Gujarat (Anand , provides top of the line eye Kheda, Mahisagar & care for other eye diseases Panchmahals district) and like vitreoretinal disorders (diabetic retinopathy, ageamong the very few in India. related macular degeneration , So now like a select few glaucoma, etc.). The hospital leading centres the world over, the has three modular operation theatre with laminar flow next generation method of technology so that the chances of post operative infection performing cataract surgery i.e FEMTOSECOND ASSISTED are minimised; again a first for any eye hospital in central CATARACT SURGERY (FLACS ) is available in ANAND itself at gujarat. the new LASER 4 SIGHT center at Nishant Eye Hospital, Retina

Dr Bipin Patel

M.S. (Opth.) Eye Surgeon

For more Information Please contact: Dr. Purvi Soni Dr Nishant Patel

M.B.B.S., D.O. Contact Lens Specilaist

M.B.B.S., D.O.M.S., D.N.B. F.R.C.S. (Glasg. UK) F.V.R. (Mumbai) F.E.R.C. (Chennai) Eye Surgeon Retian Specialist Contact Lens Specialist

Dr. Anal Vyas

M.B.B.S., D.O. SICS & Phaco Surgeon

NISHANT EYE HOSPITAL & LASER CENTRE

OPP EYERISH HOSPITAL, NEAR ZYDUS HOSPITAL, LAMBHVEL ROAD, ANAND, GUJARAT TEL: 0091-2692 259887; 266713; MOB: 0091-9879158674 Email: eyecare.drnishant@gmail.com www.abplgroup.com

Gujarat Samachar & Asian Voice 29

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Medical Tourism 2012_Page23-32_Layout 1 14-10-2016 18:33 Page 31

Dementia and Its Types D

ementia is more common with advanced age and over half of all people age 85 or older may have some form of dementia. It however, is NOT a normal part of aging. Memory loss isn't the only sign of the disease. For a person to be diagnosed with it, he/she has to meet a certain criteria. For e.g; two or more core mental functions must be impaired, which include memory, language, skills, visual perception, and the ability to focus and pay attention. They also include cognitive skills such as the ability to reason and solve problems.

The disease refers to a loss of cognitive functioning; loss of the ability to think, remember, or reason, along with behavioural abilities. The severity of Dementia affects a person's daily life. The symptoms appear when nerve cells in the brain, which were once healthy, stop functioning, lose connections with other brain cells, and die.

FIVE STAGES OF DEMENTIA

The five different stages of the mental disease are cited as follows: Stage 1: CDR-0 or no Impairment Stage 2: CDR-0.5 or questionable Impairment Stage 3: CDR-1 or mild Impairment Stage 4: CDR-2 or moderate Impairment Stage 5: CDR-3 or severe Impairment To define the stages, six areas of functioning are taken into account; Judgment, Memory, Orientation, www.abplgroup.com

Community, Home and Hobbies, and Personal Care. As the patient moves along the stages, their symptoms keep getting worse. At Stage 1, there is no damage to the patient's ability to function. He/she is well-adjusted at home, has no memory issues, and is fully aware of time and place. The patient at Stage 2, might show slight difficulties like failing to handle timing well or failing to perform at full capacity, and yet remains fully independent. At Stage 3, the person may not be able to function independently in some areas of life; following directions and maintaining knowledge of time and place becomes problematic. Stage 4 is when the patient needs help but can function on their own in selected settings.

The patient is completely dependent in Stage 5, suffers from obvious damage to memory and shows very little understanding of the world around them.

Several people can't keep a grip on their emotions.

Their personalities may change, they may have delusions, may hallucinate, see or experience things which are otherwise, not real.

TYPES OF DEMENTIA

There are several factors and disorders that help advance the development of dementia. A report classifies them as Neurogenerative disorders such as AD, frontotemporal disorders, and Lewy body dementia.

They result in a progressive and irreversible loss of neurons and brain functions.

While such disorders have no cure, there are other Gujarat Samachar & Asian Voice 31

Medical Tourism 2012_Page23-32_Layout 1 14-10-2016 18:34 Page 32

types of dementia that can either be halted or even reversed with treatment. Some types of dementia are:

TAUOPATHIES

In some dementias, a protein called 'tau' clumps together inside nerve cells in the brain, causing the cells to stop functioning properly and die. Such disorders are called tauopathies.

In AD, the tau protein becomes twisted and aggregates to form bundles, called neurofibrillary tangles, inside the neurons. Abnormal clumps (plaques) of another protein, called amyloid, are prominent in spaces between brain cells and are a hallmark of the disease. Both plaques and tangles are thought to contribute to reduced function and nerve-cell death in AD, however, researchers do not fully understand this relationship.

Other types of tauopathies include the following disorders: Corticobasal degeneration (CBD) is a progressive neurological disorder characterised by nerve-cell loss and atrophy (shrinkage) of specific areas of the brain, including the cerebral cortex and the basal ganglia. It progresses gradually, with the onset of early symptoms around age 60. Other signs and symptoms may include memory loss; trouble making familiar, focused movements (apraxia) such as brushing one’s teeth; involuntary muscular jerks (myoclonus) and involuntary muscle contractions (dystonia); alien limb, in which the person feels as though a limb is being controlled by a force other than oneself; muscle rigidity (resistance to imposed movement); postural instability; and difficulty swallowing (dysphagia).

Frontotemporal disorders (FTD) are caused by a family of brain diseases that primarily affect the frontal and temporal lobes of the brain; they account for up to 10 percent of all dementia cases. Some, but not all, forms of FTD are considered tauopathies. In some cases, FTD is associated with mutations in the gene for tau (MAPT), and tau aggregates are present. However, other forms of FTD are associated with aggregates of the protein TDP-43, a mutated protein found among people with a type of ALS that is inherited.

Progressive supranuclear palsy (PSP) is a rare brain disorder that damages the upper brain stem, including the substantia nigra (a movement control center in the midbrain). This region is also affected in Parkinson’s disease, which may explain an overlap in motor symptoms shared by these disorders. Eye movements are especially affected, causing slow and then limited mobility of the eye. The most common early signs and symptoms include loss of balance, unexplained falls, general body stiffness, apathy, and depression. A person with this type of dementia may suddenly laugh or cry very easily (known as pseudobulbar affect). As the disorder progresses, people develop blurred vision and a characteristic vacant stare that involves loss of facial expression. Speech usually becomes slurred, and swallowing solid foods or liquids becomes difficult. PSP gets progressively worse, but people can live a decade or more after the onset of symptoms.

32

Gujarat Samachar & Asian Voice

SYNUCLEINOPATHIES

In such brain disorders, a protein called alpha-synuclein accumulates inside neurons. While it is not entirely known what role this protein plays, changes in the protein and/or its function have been linked to Parkinson’s disease and other disorders.

One type of synucleinopathy, Lewy body dementia, involves protein aggregates called Lewy bodies, balloon-like structures that form inside of nerve cells.

The initial symptoms may vary, but over time, people with these disorders develop very similar cognitive, behavioral, physical, and sleep- related symptoms. Lewy body dementia is one of the most common causes of dementia, after Alzheimer’s disease and vascular disease.

Types of Lewy body dementia include: Dementia with Lewy bodies (DLB), is one of the more common forms of progressive dementia.

Symptoms such as difficulty sleeping, loss of smell, and visual hallucinations often precede movement and other problems by as long as 10 years, which consequently results in DLB going unrecognised or misdiagnosed as a psychiatric disorder until its later stages. Neurons in the substantia nigra that produce dopamine die or become impaired, and the brain’s outer layer (cortex) degenerates. Later in the course of DLB, some signs and symptoms are similar to AD and may include memory loss, poor judgment, and confusion. Other signs and symptoms of DLB are similar to those of Parkinson’s disease, including difficulty with movement and posture, a shuffling walk, and changes in alertness and attention. Given these similarities, DLB can be very difficult to diagnose. There is no cure for DLB, but there are drugs that control some symptoms.

Parkinson’s disease dementia (PDD), is a clinical diagnosis related to DLB that can occur in people with Parkinson’s disease. It may affect memory, social judgment, language, or reasoning. Autopsy studies show that people with PDD often have amyloid plaques and tau tangles similar to those found in people with AD, though it is not understood what these similarities mean. A majority of people with Parkinson’s disease develop dementia, but the time from the onset of movement symptoms to the onset of dementia symptoms varies greatly from person to person. Risk factors for developing PDD include the onset of Parkinson’s-related movement symptoms followed by mild cognitive impairment and REM sleep behavior disorder, which involves having frequent nightmares and visual hallucinations.

VASCULAR DEMENTIA COGNITIVE IMPAIRMENT

AND

VASCULAR

Vascular dementia and vascular cognitive impairment (VCI) are caused by injuries to the vessels supplying blood to the brain. These disorders can be caused by brain damage from multiple strokes or any injury to the small vessels carrying blood to the brain. Dementia risk www.abplgroup.com

Medical Tourism 2012_Page23-32_Layout 1 14-10-2016 18:34 Page 33

can be significant even when individuals have suffered only small strokes. Vascular dementia and VCI arise as a result of risk factors that similarly increase the risk for cerebrovascular disease (stroke), including atrial fibrillation, hypertension, diabetes, and high cholesterol.

symptoms seen in AD that tend to affect several functions and both sides of the body. When the strokes occur on both sides of the brain, however, dementia is more likely than when stroke occurs on one side of the brain. In some cases, a single stroke can damage the brain enough to cause dementia.

Some types of vascular dementia include: Subcortical vascular dementia, also known as Binswanger’s disease. This is a rare form of Cerebral autosomal dominant dementia that involves extensive Personalities arteriopathy with subcortical infarcts and microscopic damage to the small blood may change, leukoencephalopathy (CADASIL).

This vessels and nerve fibers that make up white they may have matter. Its symptoms are related to the inherited form of cardiovascular disease results in a thickening of the walls of smalldelusions, may disruption of subcortical neural circuits and medium-sized blood vessels, eventually hallucinate, see involving short-term memory, organisation, stemming the flow of blood to the brain. It is attention, decisionmaking, and or experience mood, associated with mutations of a specific gene appropriate behavior. A characteristic feature things which called Notch3, which gives instructions to a of this disease is psychomotor slowness, are otherwise, such as an increase in the time it takes for a protein on the surface of the smooth muscle not real. cells that surround blood vessels. CADASIL is person to think of a letter and then write it on associated with multi-infarct dementia, stroke, a piece of paper. migraine with aura (migraine preceded by visual Other symptoms include urinary incontinence that is symptoms), and mood disorders. The first symptoms can unrelated to a urinary tract condition, trouble walking, appear in people between ages 20 and 40. clumsiness, slowness, lack of facial expression, and Multi-infarct dementia, is a type of dementia occurs speech difficulties. Symptoms tend to begin after age 60, and they progress in a stepwise manner. People with when a person has had several small strokes that subcortical vascular disease often have high blood damage brain cells. One side of the body may be pressure, a history of stroke, or evidence of disease of disproportionally affected, and multi-infarct dementia the large blood vessels in the neck or heart valves. may impair language or other functions, depending on the region of the brain that is affected. Doctors call these (Medical information on the subject has been taken “local” or “focal” symptoms, as opposed to the “global” from various sources.)

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Medical Tourism 2012_Page23-32_Layout 1 14-10-2016 18:35 Page 35

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