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Ramakrishna Hospital

Psychiatrist Clinic

#806, 15th Cross, 3rd Block, 11th Main Road, Jayanagar. Landmark: Near Madhavan Park Bangalore
1 Doctor · ₹700
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Ramakrishna Hospital Psychiatrist Clinic #806, 15th Cross, 3rd Block, 11th Main Road, Jayanagar. Landmark: Near Madhavan Park Bangalore
1 Doctor · ₹700
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Our entire team is dedicated to providing you with the personalized, gentle care that you deserve. All our staff is dedicated to your comfort and prompt attention as well....more
Our entire team is dedicated to providing you with the personalized, gentle care that you deserve. All our staff is dedicated to your comfort and prompt attention as well.
More about Ramakrishna Hospital
Ramakrishna Hospital is known for housing experienced Psychiatrists. Dr. Vikram Prabhu, a well-reputed Psychiatrist, practices in Bangalore. Visit this medical health centre for Psychiatrists recommended by 53 patients.

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07:00 PM - 08:30 PM

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#806, 15th Cross, 3rd Block, 11th Main Road, Jayanagar. Landmark: Near Madhavan Park
Jayanagar Bangalore, Karnataka
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700 at clinic
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07:00 PM - 08:30 PM
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Parkinson's Disease: Dos and Don'ts

MBBS, MD - Physical Medicine & Rehabilitation
PMR (Physical Medicine & Rehabilitation) Specialist, Indore
Parkinson's Disease: Dos and Don'ts

Parkinson’s disease affects the part of the brain that controls muscle movement. The exact cause of this disease is not known, but there is a decrease in a chemical called dopamine in the brains of people with parkinson’s. There is no cure for parkinson’s, but it often progresses slowly and the signs can be managed.

Signs

The 4 most common signs of parkinson’s are:

• tremors or shaking when at rest

• muscle stiffness

• slowed movement or problems starting movement

• problems with balance and movement

As these signs worsen, you may also have trouble walking, talking, swallowing or doing simple tasks such as bathing or dressing. As the disease progresses, other signs such as pain, bowel or bladder problems and sleep problems may occur.

Your care

When you start to show signs of this disease, your doctor may order anti parkinsonian medicines or may also suggest some physical therapy to help manage your signs. The physical therapist can help you learn exercises, prescribed by a physiatrist, that can help you with movements.

You may need to work with your doctor to make adjustments in your medicines to keep your signs controlled. Over time, many people have side effects from the medicines used to treat parkinson’s disease, but they can be managed well.

You may also need occupational therapy or speech therapy to deal with signs as the disease progresses. As your signs get worse, surgery may be an option to reduce tremors.

Things you can do to manage your signs

When walking

• walk slowly with a straight posture and with your legs further apart. Think about taking big steps to help keep your steps more normal.

• use a 4-prong cane or a walker if needed.

• if you become stuck or freeze in one place, rock gently from side to
Side or pretend to step over an object on the floor.

• place tape strips on the floor to guide you through your house.
Remove area rugs and furniture from your walking path.

• stand up from a chair or bed slowly to avoid feeling dizzy or
Lightheaded.

When using the bathroom

• install grab bars on the walls, beside toilets and inside showers and bathtubs to help you stand up.

• use a shower chair inside the shower.

• install an elevated toilet seat to make standing up easier after using the toilet.

• shave with an electric razor.

When dressing

• wear loafers or shoes with velcro.

• wear simple dresses or pants with elastic waistbands such as sweatpants.


When eating or drinking

• use a cup with a large handle to make it easier to hold.

• use a bowl instead of a plate to limit spills and make it easier to scoop up food.


Work closely with your health care team to manage your signs of parkinson’s disease.

I have chest burning and severe heart rate many are saying its case of anxiety Please suggest how to cure it?

MSc Applied Biology, Diploma in Naturopathy
Ayurveda, Delhi
I have chest burning and severe heart rate many are saying its case of anxiety
Please suggest how to cure it?
not anxiety but may be one of the reasons ....acid reflex ......when the acid instead of going down it comes back up ......need lot of advice and result be v good
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I forget small details, and I feel I have some memory issues. I am 25, need some help and suggestions. Thanks a lot in advance.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear Lybrate user, At your age, Memory problems like amnesia are not common. Many young people are having problems with memory. These problems are either they are too busy or due to anxiety and stress. Busy people use organizers or employ a personal assistant because they can't remember every task. You need to understand this. If you still say, you are having memory problems, we need to check your memory using memory test. If you want more of my help in this regard, please contact me. Take care.
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DUE TO ALCOHOL WITHDRAWAL I SUFFERED DELIRIUM TREMENS WITH RUMFITS i am TAKING 2 MG lorazepam FOR MY ANXIETY DISORDER. initially i am ON CLONAZEPAM DUE TO BEING DRINKING I SUFFERED FROM DT AND RUMFITS. Now I left alcohol since from six months. Now I would like to have moderate drinking once in months. Pls explain me what I can do briefly.

MBBS, MD - Psychiatry
Psychiatrist, Mumbai
DUE TO ALCOHOL WITHDRAWAL I SUFFERED DELIRIUM TREMENS WITH RUMFITS i am TAKING 2 MG lorazepam FOR MY ANXIETY DISORDER...
Alcohol dependence is associated with significant physical, mental and social problems. Physically, there can be liver failure, jaundice, vomiting of blood, passing blood in stools, stomach ulcers, damage to nerves of the body, swelling of legs, fluid collection in abdomen, and many more. Mentally, there is irreversible brain damage, worsening of anxiety or depression, triggering of psychosis and mood disorders, dementia, etc. From a social point of view, there may be isolation from neighbors or family, increased abusive behavior to children or spouses, legal problems, accidents, etc. Anti craving medications are available which will help to reduce the craving. Consult a psychiatrist with experience in deaddiction.
1 person found this helpful
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Mental Health

MBBS, MD - Psychiatry
Psychiatrist, Chennai
Mental Health

When your body is broken, you have no problem in seeking doctors help but when your mind is broken, why are you hesitant? Your mind is no holier than your body. 
Always seek doctor's help but never destroy your precious life.

5 people found this helpful

What is the supplementary medicine, which can stop the urge for Alcohol. I get the urge for alcohol in the evening and when take one peg then it goes ON.

C.S.C, D.C.H, M.B.B.S
General Physician,
There is no supplementary medicine, which can stop the urge for Alcohol. Only strong will power, determination, attending AA meetings and diverting mind when tempted will help you stop alcohol or may need professional help from a psychiatrist or de addiction centre. Try to do meditation and yoga. Read good books and listen to music and if you are believer attend Bhajans Alcohol causes 7 types of cancer, including breast, mouth and bowel cancers. When you drink alcohol, cancer-causing chemicals are formed. Alcohol also affects hormone levels and makes cells even more likely to be damaged by smoking. The less alcohol you drink, the lower the risk of cancer. No type of alcohol is better or worse than another, it is the alcohol itself that leads to the damage, regardless of whether it is in wine, beer or spirits. And drinking and smoking together are even worse for you. Not everyone who drinks alcohol will develop cancer. But on the whole, scientists have found that some cancers are more common in people who drink more alcohol than others. Every year, alcohol causes 4% of cancers .Tips to cut down on alcohol. There are lots of simple ways to cut down on the amount of alcohol you drink. It can help to work out if there are particular times or situations when you tend to have a drink, whether that’s a bad day at work or a weekly pub quiz tradition, and plan what you’ll say and do differently next time. Have more alcohol-free days a week. For liver health it’s best to have at least 2 days off alcohol in a row each week. Try agreeing on certain days with your partner or a friend and help each some wi other and stick to it. If you are planning to drink alcohol, decide on a limit in advance and make sure you don’t go over it. Swap every other alcoholic drink for a soft one – starting with your first drink. Try shandy instead of a pint of beer, or swap ne for soda and have a spritzer. Don’t stock up on beer, wine or spirits at home. Finish one drink before pouring another, because topping up drinks makes it harder to keep track of how much you’ve had and when you planned to stop. Avoid buying drinks in rounds, that way you don’t have to keep pace with anyone. Tell a friend or partner that you’re cutting down on alcohol, they can support you – or even join you.
1 person found this helpful
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Parkinson s Disease

MBBS, DNB, Fellowship in Neurosurgery
Neurosurgeon, Kolkata
Parkinson s Disease

Deep brain stimulation in Parkinson’s disease

Abstract: Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson’s disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients.

Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long-term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula-derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be discussed.

Key words: deep brain stimulation (DBS); Parkinson’s disease(PD),  stereotaxis

Introduction

Parkinson's disease is a slowly progressive, neurodegenerative disease characterized by tremor, rigidity, bradykinesia and postural instability. It is the most common movement disorder in middle or late life with a prevalence of about 0.3% of the general population, rising to 1% in people over 60 years of age. Approximately 130 000 people suffer from it in the UK and it presents an increasing burden in our ageing population. Pathological findings in Parkinson's disease demonstrate greatly diminished neuromelanin pigmented neurons in the substantia nigra of the basal ganglia with associated gliosis, and Lewy bodies present in many remaining neurons.

James Parkinson, in his original 1817 Essay on The Shaking Palsy, gave an account of six patients in which he noted signs of tremor, festinating gait and flexed posture.  Nearly two centuries from Parkinson's observations, and almost four decades after Cotzias' dramatic demonstration of levodopa's efficacy, the limitations and complications of levodopa treatment for Parkinson's disease have become well documented Five years after initiation of therapy, a majority of patients develop medication related motor complications, namely levodopa induced dyskinesias (LID) and motor fluctuations. Deep brain stimulation (DBS) has been developed primarily to address these treatment related motor complications and therapeutic failures.

Pathophysiology of PD

The loss of dopaminergic neurons in the substantia nigra, the main functional characteristic of PD, affects the circuit described above and leads to the cardinal motor symptoms of PD. While the exact mechanism of this process is unknown, animal research as well as human recordings have provided functional and biochemical evidence that bradykinesia in PD results from excessive activity in the STN and the GPi. This leads to an exaggerated beta (10-30 Hz) synchronization within and between structures in the basal ganglia circuitry  that could also contribute to rigidity and akinesia.

The pathophysiology of rest tremor in PD is less clear and probably more complicated. This symptom most likely results from a dysfunction of both the striato-pallidal-thalamocortical and the cerebellodentato-thalamocortical circuits, with hyperactivity and hypersynchronization between central oscillators.

Possible mechanism of action of DBS

DBS acts through delivering an electrical current in a specific target area of the brain. This current can be modulated through modification of voltage, frequency and duration of each electrical pulse delivered. The delivered energy creates an electrical field of variable size and shape according to the parameters used for stimulation. Although initially believed to stimulate the target, thus the name of the whole process, it seems that

DBS actually excites the neuronal fibers, but inhibits the neural cells. In fact, GPi DBS decreases the GPi mean firing rate back to a normal range in animal models as well as PD patients, and high frequency DBS has a similar effect as dopamine replacement therapies, and promotes faster (about 70 Hz) nonhypersynchronous activity in the basal ganglia, correlated with clinical improvement. This might be achieved through stimulation of bypassing inhibitory pathways, synaptic inhibition, depolarizing blockade, synaptic depression, and simulation-induced disruption of pathological network activity. Overall, this leads to modifications of the firing rate and pattern of neurons in the basal ganglia, as well as local release of neurotransmitters such as glutamate and adenosine. In addition, it seems that DBS also increases blood flow and stimulates neurogenesis. Over the last few years, functional imaging, specifically functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and single-photon emission computed tomography (SPECT), has been used in an attempt to clarify the mechanism of action of DBS. In fMRI, blood-oxygen-level-dependent (BOLD) signals are acquired, and oxygenated blood marks areas of neural stimulation or inhibition. On the other hand, PET and SPECT allow for imaging of multiple activity markers, such as blood flow, glucose and oxygen metabolism. While fMRI is less powerful than nuclear medicine techniques, it provides a much better spatial and temporal resolution. Because of the suspected inhibitory DBS effects in electrophysiological studies, reduced STN blood flow or glucose metabolism would have been expected on functional imaging. However, the opposite has been found to be true in an overwhelming majority of imaging studies to date. In addition, BOLD activation in the area surrounding the electrode has been reported, despite the electrode imaging artifact preventing direct observation of the STN around the electrode. This discrepancy between apparent STN inhibition in single-cell studies and activation in imaging studies might be explained by a few hypotheses. First, electrophysiological recordings identify short neuronal modulation (in the order of milliseconds) while neuroimaging methods may reflect the summed activity changes over seconds to minutes. Second, non-neuronal contributions to the change in blood flow and/or glucose metabolism cannot be excluded, and could confound the results of neuroimaging.

Finally, it is possible that PET and fMRI actually detect the increased activity in the axons, rather than in the cell bodies. Complicating matters further, some imaging studies after STN DBS have showed increased

activity in the GPi while others reported decreased activity in that nucleus. In summary, it is still unclear how exactly DBS affects the firing rate and pattern of neurons and how these changes actually modify the symptoms of Parkinson’s disease. DBS is presently more of an empirically proven treatment in search of physiological explanation.

The effect of DBS on the cardinal symptoms of PD have been established in three randomized controlled clinical trials --- 

TABLE 1

Author, year

 

No of patients

Follow up

Target

Results

Deuschl et al., 2006

156

6 months

BL STN

QOL better with DBS, motor symptom better with DBS

 

Weaver et al., 2009

255

6 months

BL STN or GPi

Dyskinesia free ON time better with DBS

 

Williams et al., 2010

366

12 months

BL STN  or GPi

QOL better with DBS

 

 

PATIENT SELECTION for DBS in PD

Patient selection is a critical first step as poorly chosen candidates may not have optimal benefits and have increased morbidity. Several factors must be considered before determining if a patient is an appropriate candidate for DBS surgery. A multidisciplinary approach involving the neurosurgeon, neurologist, and neuropsychologist is important to determine the appropriate surgical candidate. It is also important that the diagnosis of idiopathic PD be confirmed prior to proceeding with DBS surgery. Key to this assessment is evaluating the surgical candidate in both the on and off medication states with a corroborating levodopa challenge. Perhaps the best prognostic indicator of a patient’s suitability for DBS surgery is their response to levodopa.In general, a levodopa challenge following a 12-hour medication withdrawal should provide at least a 33% improvement in the motor section of the Unified Parkinson’s Disease Rating Scale (UPDRS).

                     In our institute, we follow a simple chart(below) for screening of patients for DBS in PD.

 

 

  1.  

Age<75 years

 

  •  

No

  1.  

Idiopathic PD ( No PSP/MSA/NSD etc)

 

  •  

No

  1.  

Levodopa responsive  

                      

  •  

No

  1.  

Poor/adverse response to drug          

 

  1.  Increased off period                                                              

 

  1. Disabling dyskinesia                                                              

 

 

  1. Disabling motor fluctuations                 

 

 

Yes

 

Yes

 

 

Yes

 

 

No

 

No

 

 

No

  1.  

Degree of disability(UPDRS part III score)>25

 

  •  

No

  1.  

Neuropsychology, MMSE>24

 

  •  

No

  1.  

LEVODOPA CHALLENGE RESPONSE POSITIVE                                                   

 

(30% improvement in UPDRS after 12-hours off medication)

 

  •  

No

  1.  

Advanced  co-morbidity

 

Yes

  •  
  1.  

long term anticoagulation

 

Yes

  •  
  1.  

Willing for surgery and programming

 

  •  

No

 

 

PREOPERATIVE MANAGEMENT

A full medical assessment is a necessary part of the preoperative evaluation, as advanced PD patients tend to be elderly with significant comorbidities. Major issues are---

 

Anticoagulation/antiplatelets--- The risk of discontinuing medications that affect anticoagulation and

platelet aggregation should be weighed against the potential benefits in the quality of life offered by DBS surgery. However, timely discontinuation of these latter medications is mandatory for stereotactic surgery since intracerebral hematomas are the most serious of all potential complications from DBS. Any anticlotting medications, including aspirin, ticlopidine, clopidogrel, and all nonsteroidal anti-inflammatory drugs should be discontinued at least 7 to 10 days preoperatively to ensure the return of normal blood clotting function.

Arterial hypertension can also increase the risk of intracranial bleeding during stereotactic procedures and must be controlled in the weeks prior to surgery.

A prolonged discussion on the short- and long-term effects of DBS on Parkinson’s disease should be carried out with the patient, family, and caregivers.

The night prior to DBS surgery, the antiparkinsonian medications are typically held to pronounce the Parkinson’s symptoms at the time of surgery to see the clinical effects on symptoms during surgery and the families must be counselled regarding their role in facilitating the patient.

Target selection

The two main targets considered for DBS in PD are the STN and the GPi. current tendency is to prefer targeting the STN because of a greater improvement in the OFF phase motor symptoms as well as a higher chance to decrease the medication dosage and a lower battery consumption linked to the use of lower voltage in the STN compared to the GPi DBS. GPi can be the preferred target if LID is the main complaint. GPi DBS might be preferred for patients with mild cognitive impairment and psychiatric symptoms. Because STN DBS might have a higher rate of cognitive decline and/or depression and worsening of verbal fluency in some studies.

Surgical technique

The basic components of DBS implantation surgery involve frame placement, anatomical targeting, physiological mapping, evaluation of macrostimulation thresholds for improvement in motor symptoms or induction of side effects, implantation of the DBS electrode and implantable pulse generator (IPG).

Head-frame placement

The CRW frame is the most commonly used followed by the Leksell frame. Placement of the frame is done under local anesthesia unless anxiety or uncontrollable movements necessitate the use of sedation or general anesthesia.

Leksell stereotactic frame  placed over the head of a patient showing the correct method for placement of the Leksell head-frame. The frame should be placed parallel to orbito-meatal line in order to approximate the AC-PC plane. It is attached to the patient’s head using four pins under local anesthesia.

Imaging and anatomic targeting

Computerized Tomography (CT) scans and MRI are the two main imaging modalities used for targeting when performing DBS implantations. A thin cut stereotactic CT (_2 mm slices with no gap and no gantry tilt) is obtained after frame placement and is then fused with the stereotactic MRI on a planning station (Stealth station). The advantage of fusing the CT with MRI is the ability to avoid image-distortions inherent to MR imaging adding to the stereotactic accuracy. To better define the STN, T2-weighted images (TR 2800, TE 90, flip angle 90˚, slice thickness 2.0 mm) were obtained.

The AC and the PC were marked and the centre of the AC–PC line determined. The next step is planning the entry point and trajectory. The strategy here is to avoid surface and sub-cortical vessels. After trajectory planning, the patient is placed supine on the operating table and the frame attached to the table using an adaptor. Prophylactic antibiotics are given at least 30 min prior to incision. The head is prepped and draped in a sterile fashion. Under local anesthesia, a burr-hole is placed on the calculated entry point marked on the skull. The entry point is determined by the calculated arc and ring angles. Hemostasis is achieved with bone wax and bipolar cautery.

A Medronic Stim-Loc anchoring device (Medtronic, Minneapolis, MN) burr-hole base ring is then placed on the burr-hole and secured with two screws which are used at the end of the procedure to anchor the DBS electrode.

The dura is then cauterized and opened exposing the underlying surface of the brain. The microdrive is then assembled and cannulae inserted 10 mm above the target to avoid lenticulostriate vessels found deeper. Gel- foam and fibrin glue is applied on dural hole to minimize cerebrospinal fluid (CSF) loss and air entry into the skull. Subsequently, microelectrode recording and stimulation is undertaken.

Microelectrode recording/ Mapping

Microelectrode mapping is used to precisely define the target STN and its boundaries as well as nearby critical structures. We believe microelectrode mapping is crucial in order to give one the best chance for optimal placement of the DBS lead given anatomical inaccuracies due to image distortion and intraoperative brain shifts secondary to CSF loss, and pneumocephalus that can lead to inaccuracies in defining the initial target coordinates and shifts in the target itself once the skull is opened. Microelectrode mapping is performed using platinum-iridium glass coated microelectrodes dipped in platinum black with an impedance of around 0.3–0.5 Mo. These platinum-iridium microelectrodes are capable of recording single unit activity and can also be used for micro-stimulation up to 100 mAwithout significant breakdown in their recording qualities.

As the recording electrode was advanced, entry into the STN was identified by a sudden increase in the density of cellular discharge, with the characteristic irregular pattern of discharge—spikes of different sizes, occurring at random intervals. On coming out of the STN a quiet period (background noise) was seen followed by recording from the substantia nigra if the recording was continued far enough, described as high frequency (50–60 spikes/s) discharge pattern.11 Characteristic STN recordings (visual and audio) were identified and the depth of the STN activity was noted. Identification of STN activity was only based on the visual identification. The centre of the point of best electrical activity was selected as the final target. The microelectrode was replaced with a permanent quadripolar macroelectrode (Medtronic electrode no. 3389) to target the centre of the STN electrical activity. The proximal part of this electrode consists of four nickel conductor wires insulated with a polytetrafluoroethylene jacket tubing. The distal part has four metallic noninsulated contacts of 1.5 mm spaced at 0.5 mm intervals. The diameter of the distal electrode is 1.27 mm. Based on the clinical response any of the four contacts can be used for stimulation. Macrostimulation using the DBS electrode itself is then used to determine benefits and side effects. In most cases lateral skull x rays were obtained at this point with image intensifier carefully positioned to locate the target point in the centre of the Leksell-G frame rings.

Initial programming is always refined by using intra-operative macrostimulation data and a mono-polar review to identify the thresholds of stimulation for improvement in parkinsonian motor signs as well as the thresholds for inducing side effects at the level of each contact. The four variables that are used in programming are choice of contacts (0, 1, 2 or 3 used either as the cathode or anode), frequency of stimulation (hertz), pulse-width (ms) and amplitude (voltage).

POSTOPERATIVE MANAGEMENT

In the immediate hours after surgery, it is important to keep arterial blood pressure in the normal range. In addition, the patient’s preoperative drug regimen should be restarted immediately after surgery to avoid problems with dopaminergic withdrawal. Patients should undergo postoperative CT scans and/or MRI scans to assess the electrode location and intracranial status. In addition, plain X-rays are obtained to assess the location and geometry of the leads and hardware. Parkinson’s medications may need to be adjusted depending on the patient’s status. Cognitive and behavioral changes may occur in the postoperative period, particularly in older patients. Patients can be discharged as early as 24 hours after surgery, depending on their neurological and cognitive status.

Conclusion

For the last 50 years, levodopa has been the cornerstone of PD management. However, a majority of patients develop motor fluctuations and/or LID about 5 years after the initiation of therapy. DBS of the STN or the GPI grant to patients with PD improved quality of life and decreased motor complications, and has been approved as such by the Food and Drug Administration in the US in 2002. We reviewed the experience and available literature on DBS for Parkinson’s disease over the last decade and arrive at the following understandings.

The success of DBS surgery depends on the accurate placement of the leads and meticulous programming of the stimulation. Therefore, it is best accomplished by an experienced team of neurosurgeon, neurologist, and support staff dedicated to the treatment.

Reports of surgical complication rates and long-term side-effects of DBS are very variable, so benefits and potential adverse results should not be under- or over-emphasized.

While essentially equal in improving the motor symptoms of PD, STN and GPi might have their own benefits and risks, and the choice of the target should be individualized and adapted to the patient’s situation.

Knowledge to further improve DBS treatment for Parkinson’s disease, such as a more scientific and reliable protocol on programming, strategies to minimize cognitive and psychiatric complications, and the better

long-term maintenance of the implanted device, are still lacking.

Data on the impact of DBS on non-motor symptoms affecting the quality of life of PD patients, such as pain, speech or gastro-intestinal complaints, are still scarce. Further research in these areas will help make this useful treatment even more beneficial.

3 people found this helpful

Does A Healthy Diet Reduce The Risk Of Depression?

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
Does A Healthy Diet Reduce The Risk Of Depression?

Depression is a mental illness marked by feelings of profound sadness and low interest in positive activities. It is a persistent low mood that interferes with the ability to function and appreciate things in life. It may cause a wide range of symptoms, both physical and emotional. It can last for weeks, months, or years. There could be various causes of depression, but poor diet is one of the reasons revealed by researchers.

A certain study reinforces the hypothesis that a “healthy diet has the potential to not only ward off depression, but also prevent it."

Depressed individuals often have a poor diet quality and a decreased intake of nutrient rich food. But this is not yet clear in the case of healthy individuals suffering from depression.

A healthy diet characterized by vegetables, fruits, cereals, milk and low fat dairy products, pulses, fish, meat and poultry is associated with a lower risk of depression.

Increased intake of folate was also associated with a decreased risk of depression because low folic acid levels leads to low same (s-adenosylmethionine), which increases symptoms of depression. By improving folic acid status, same increases, and depressive symptoms drop. Vegetables, fruits, berries, whole-grains, meat and liver are the most important dietary sources of folate.

In addition, coffee and tea also act as anti-depressants to an extent because caffeine promotes the production of dopamine (a neurotransmitter released by the brain) which is responsible for the feeling of well being and happiness. But the amount of caffeine consumed should not be more than 300mg per day as caffeine is an addictive substance.

Omega 3-fatty acids, which are found in vegetable oil, nuts and fish oil, increase the level of serotonin (known as the happy hormone), which reduces the level of depression. Not only this, essential amino acids like tryptophan play a role in the formation of serotonin. Meat, fish, beans and eggs are good sources of essential amino acids.

Having refined carbohydrate and processed foods increases your blood sugar levels and does not provide any kind of nutrient to the body and brain. It even utilizes the mood enhancing vitamin b. Sugar also diverts the supply of another nutrient involved in mood enhancing, chromium. The best way to lower your sugar level is to have food low on the glycemic index.

Lastly, vitamin d deficiency may cause depression because vitamin d is responsible for brain development. So consume vitamin d rich foods such as egg, mushrooms, fish etc.

Depression is one of the leading health challenges in the world and its effect on public health, economics and quality of life are enormous. Not only the treatment of depression, but even the prevention of depression needs new approaches. Change in dietary and lifestyle factors are one of the possible approaches.

3 people found this helpful

How to get rid of fear and anxiety without medication. I'm doing yoga and breathing exercises but still not use. I'm getting head pain from overthinkig not able to do any work. From 4 months I'm suffering from this please help me to out of this.

MBBS
General Physician, Jalgaon
How to get rid of fear and anxiety without medication. I'm doing yoga and breathing exercises but still not use. I'm ...
Please Continue your current exercises Do meditation three times a day Take Saraswatarishta 20 ml twice a day for 6 mths.
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For e.g.l lost somebody close last year and since then feel very depressed and prefer keeping to myself all the time. Please help me.

BHMS
Homeopath, Secunderabad
For e.g.l lost somebody close last year and since then feel very depressed and prefer keeping to myself all the time....
May be you need to take a sincere reality check and correct yourself so that you can move on in life and achieve your goals. Talk to your friends and family members about your feelings and exchange the thoughts. Initially give yourself some time to start mingling with people who are close to you and then you can become more social. If you are not able to handle it then you can take the help of a psychiatrist or a counselor. You can also add Homeopathy as it is safe and gentle and can help you overcome the agony of separation naturally. A detailed case history is necessary to begin Homeopathy. You can contact me later if required. Do revert back to seek further guidance.
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I am 22 years old male. I have smoking habit since 1.5 years please help me to quit smoking I have tried many times but I couldn't is there any medicine or therapy.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear user. I can understand. Tobacco is addictive. Cigarette also contains 4000+ carcinogenic chemicals other than nicotine. Smoking can affect your mouth, throat, lungs, heart, stomach and brain in many ways. Cancer is one among the potential diseases smoking can cause. The best method is to leave it and continue with your will power. There are other methods like Nicotine Replacement therapy and pharmacotherapy combined. Nicotine chewing gums too help as an alternative for cigarettes. But still you will need will power. You may consult a physician or deaddiction therapist or a rehabilitation facility for further advice. You can also opt for online deaddiction therapy. Take care.
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Hello actually I am feel anxiety all the time also I don't have friends actually I expect the way I treat them they should treat me but that doesn't happens and whoever comes do not stay much my first weakness is that I get attached to anybody very easily it is very घबराहट type in my body.

Reparenting Technique, BA, BEd
Psychologist, Bangalore
Hello actually I am feel anxiety all the time also I don't have friends actually I expect the way I treat them they s...
I am afraid that you may be suffering from the rejection issue wherein you feel unwanted and also abandoned, and suffer separation anxiety. This can complicate your whole life. There must have been some incident in your early childhood that may have provoked this feeling: be it true or not. It is however possible to resolve this by learning to accept yourself and love yourself. The rejection issue will make you feel like you do not belong, although externally there may be all the signs that they do love you. It is your perception based on some incident in childhood that is influencing this feeling. The perception is more important than the actual event. You must do all kinds of loving things for yourself. That includes respecting your life, health and well being. Do not frequent people or places or situations where you are not wanted. You must exercise daily, eat a good diet and sleep well. Your identity is also something to work on. In the meantime, do a personality development course; attend workshops and conferences and talks to further your growth. The more educated you become, the more confidence you will develop. Generally meet more people and gradually learn to dispel all fear around them: they are also sometimes equally afraid of others!
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I am taking 1 nexito plus tab every night from last six month for my anxiety related problem, now how can I withdraw this medicine, please give advice, I tried to leave it but anxiety increased after leaving this tablets.

C.S.C, D.C.H, M.B.B.S
General Physician,
I am taking 1 nexito plus tab every night from last six month for my anxiety related problem, now how can I withdraw ...
Yu can gradually taper off and divert ind to reduce anxiety and find interesting things to so to occupy mind
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Hi sir/madam. When I am doing any work I am getting stressed faster comparing with other? I am planning to join gym. Is joining gym is a gud idea to over my problem?

MBBS
General Physician, Cuttack
Hi sir/madam. When I am doing any work I am getting stressed faster comparing with other? I am planning to join gym. ...
1.Go for regular exercise and play some games 2.Find time for relaxation like watching TV/listening music etc. 3.Develop some new hobby like painting/reading/writing 4. Do yoga, meditation, and deep breathing exercise like pranayama to calm your mind, control your emotions and relieve stress 5. Avoid smoking/alcohol if you take 6.Sleep for 7-8 hours daily to remain healthy 7.socialise with friends/relatives/family members 8.. Take good nourishing diet, plenty of green leafy veg tables, fruits and drnk plenty of water 8. Avoid severe physical and mental exertion
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Hi Doc! Recently I broke up with my girlfriend. I am trying my 100% to forget her but I facing hardship in that. I found that I am missing her n get down every time. Need your Help. Give your suggestion to come up with this bullshit thing. Thanks.

MBBS, MD - Psychiatry
Psychiatrist, Chennai
Hi Doc!
Recently I broke up with my girlfriend. I am trying my 100% to forget her but I facing hardship in that. I fo...
When you try to forget anything it means that you keeps on remembering particular thing. Don't make any effort to forget her else you ignore her. Try to engage in something and work hard in this then gradually she will be out of your memory. But when you trying to forget she won't leave she will be always in your memories. IGNORE.
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Hello doctor. I don't know whether I'm right or wrong. 7 years competed to my married life in this April. But in that 7 years. Starting 5 years had lots of problems in relation due to family, due to financial and lot of responsibilities in his shoulders. So we live separately I'm in my home for my studies and he in his job place. He comes once a week or month to see me. Afterwards I complete my diploma. I got job. So he take me with him to his job place. But we live for 1 week then again separate then after 1 year he come back and try to contact me. So I thought may be it's new beginning. He changes a lot, so we decided to go somewhere for 3 4 days. So on that days when I go bath he check my mobiles and social chats. So I too ask him his mobile. So when I check it he throughly chatting with his office girls and in his other history and all when check it all porn sites. I totally get upset. I scold him his colleagues. He say sorry he promised again not do all that. From that situations and now we have 14 months baby. He is good now. But the problems is that I never forget that incident of girls and his watching that kind of videos. I always doubting him that he again like that and I also fight regarding past. He change a lot for me but I cannot able till now. Always have doubt in him.

MBBS, MD - Psychiatry
Psychiatrist, Chennai
Hello doctor. I don't know whether I'm right or wrong. 7 years competed to my married life in this April. But in that...
Hi lybrate-user Don't worry. It happens in most of the marriages. Success of marriage is not depends on what you sacrifice for him and what he sacrificed for you. It always lies on UNDERSTANDING AND ACCEPTING. Try to understand him holistically both his positives and negatives. Try to accommodate his negatives. Having negatives is not a weakness but failure to aware one negatives is a weakness. Make him to accept his negatives. Then there won't be any problem. If there would be no problem between you peoples then nobody can enter between you. All the best.
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I feel really lonely. I lost my concentration and l always thinking negatively. I can't change my thoughts. Daily I lost my sleep .My mind thinking continuously about some other thoughts and I can't sleep. Please help me to sleep.

MBBS
General Physician, Madhubani
I feel really lonely. I lost my concentration and l always thinking negatively. I can't change my thoughts. Daily I l...
Just you have to change your routine. Do morning brisk walking. Evening you can join gym. Keep urself busy with people. For further management you can contact me.
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Mujhe 10 saal ho Gaye hai OCD problem mein mujhe yeh 4 saal pehle hi pata laga hai kyunki 4 saal pehle hi Maine psychiatrist se consult kiya unhone btaya OCD hai. Mera hmesha dimaag khayaalon se bhara rehta hai jaise agar kahin jaa rha hoon Kisi me mujhe dekh liya toh lagega kyun dekha isne dushman toh nai yeh Mera aur main baar baar check krunga jaa ke wahan ussi jgh. Main din mein 2 ya 3 baar masturbate bhi kr leta huun jisse Meri health bhut kharab ho jaati hai main allopathy medicines ke side effects se bhut darta huun aur depend nai hona chahta kya Ayurvedic mein iska treatment hai ya allopathy hi Leni padegi baaki Mera B12 aur vitamin d3 bhi kaafi kam aaya tha jisske karan mujhe ghabraat bhi bhut hoti thi main injections lagwa rha huun jisse gabrahat toh khatm hai par thoughts nai jaa rhe please help allopathy or ayurvedic.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear user. I can understand. Obsessive compulsive disorder is Excessive thoughts (obsessions) that lead to repetitive behaviours (compulsions). Obsessive-compulsive disorder is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours. OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life. Treatment includes talk therapy, medication or both. Take care.
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