The MBI-C has been administered in the Cognitive Neuroscience Clinic at the University of Calgary, Canada (n=227). We analyzed baseline MBI-C and gold standard neuropsychiatric inventory questionnaire (NPI-Q) scores in relation to MoCA scores in normal cognition (n=38), mild cognitive impairment (n=93) and dementia (n=74) patients using linear regression. An iterative procedure guaranteed things mirrored the five MBI spaces of 1) diminished inspiration 2) enthusiastic dysregulation 3) motivation dyscontrol 4) social impropriety and 5) irregular observation or thought content. Instrument language was built up from the earlier to relate to non-maniacal practically free more seasoned grown-ups.

Results:

With increasing severity of cognitive diagnosis, neuropsychiatric symptoms worsen (MBI-C and NPI-Q scores increase) and cognition declines (MoCA score decreases). Those with worsened cognition tend to be older, female and have less education. We found for every one point increase in MBI-C score, there is a 0.082 point decrease in MoCA score (p=0.007). For every one point increase in NPI-Q score, there is a 0.192 point decrease in MoCA score (p=0.006). There is no alteration yet age and training are confounders.

Discussion:

In the psychiatric outpatient clinic, the popularity of MBI was 3.5% and the frequency rate of dementia was 30.7 cases per 1000 person-years. MBI, MCI without MBI, and SCD without MBI increased the risk of dementia, while sleep disorder and depressive episode did not. In the MCI patients, those with affective dysregulation tended to develop dementia with a hazard ratio of 1.646 compared to those without. Therefore, MBI, especially affective dysregulation domain, might be associated with dementia.

Conclusion:

Given that the MBI-C is more sensitive in detecting neuropsychiatric symptoms in pre-dementia populations, there is a shallower point change in MoCA score. The MBI-C may be used to detect neuropsychiatric symptoms in normal cognition and MCI patients. Both cognitive and behavioral scales should be used to assess neuropsychiatric symptoms and cognitive decline in patients. Studies are required to determine the prognostic value of MBI for dementia development and for predicting different dementia subtypes.

In the Netherlands, about 43,000 people suffer a stroke each year, and more than 320,000 people have to cope with its consequences. Following a stroke, brain cells in the tissue surrounding the injury die, resulting in motor impairment and cognitive disabilities. Since current forms of rehabilitation are very tiring and repetitive for patients, novel effective rehabilitation approaches using serious gaming and virtual reality (VR) are being developed. With serious gaming, it is possible to study how people with cognitive disabilities, sometimes combined with ocular and/or motor deficits, observe their environment and process visual information. For instance, the standard tests for the assessment of post-stroke visual neglect are only useful when identifying peri-personal neglect (near space), and not personal (body) or extra-personal (far space) neglect. The shortcoming of screening for neglect in the extra-personal space can be overcome by using stereoscopic imaging in VR, which enables a three-dimensional environment. Furthermore, the field of view could be adapted during execution of different cognitive tasks to what the individual is able to see following post-stroke neglect or visual field loss. Consequently, assistive eye- and head-tracking technologies should be integrated with a VR environment to observe the gaze patterns and head movements of stroke patients. This assessment would allow more personalized rehabilitation and could possibly detect whether additional visual treatment is necessary. In this way, cognitive recovery will be accelerated by taking into account the possibilities of eye- and head-tracking in virtual environments for optimal cognitive assessment and rehabilitation following different types of stroke.

Background:

Virtual reality (VR) encounters (through games and virtual conditions) are progressively being utilized in physical, intellectual, and mental intercessions. Be that as it may, the effect of VR as a way to deal with recovery isn't completely comprehended, and its favorable circumstances over customary restoration procedures are yet to be built up.

Virtual reality is basically a route for people to outwardly interface with, control, and connect with PCs. Augmented reality can be viewed as a propelled type of human-PC collaboration that permits clients to become inundated inside engineered PC created virtual situations. The making of a connected with VR client experience can be cultivated utilizing blends of a wide assortment of collaboration gadgets, tangible presentation frameworks, and substance introduced in the virtual condition.

Virtual reality can be an absolutely vivid involvement with PC produced situations with 3-dimensional (3D) pictures or articles. In VR standards, members can investigate with a view of the real world. We along these lines note that the interest attributes of such VR settings can encourage the exercises required by recovery programs, however as a major aspect of an additionally captivating encounter. The VR-based exploratory methodologies have been found to offer focal points for people with extreme engine impairment, 16 and considers have exhibited improved inspiration.

Method:

We present a systematic review which was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). During February and March of 2018, we conducted searches on PubMed (Medline), Virtual Health Library Search Portal databases (BVS), Web of Science (WOS), and Embase for all VR-related publications in the past 4 years (2015, 2016, 2017, and 2018). The keywords used in the search were “neurorehabilitation” AND “Virtual Reality” AND “devices.”

Results:

We sum up the writing which features that a scope of viable VR approaches are accessible. Studies distinguished were directed with post stroke patients, patients with cerebral paralysis, spinal string wounds, and different pathologies. Sound populaces have been utilized in the turn of events and testing of VR approaches intended to be utilized later on by individuals with neurological issues. A scope of advantages were related with VR mediations, remembering improvement for engine capacities, more prominent network support, and improved mental and intellectual capacity.

Conclusions:

The results from this review provide support for the use of VR as part of a neurorehabilitation program in maximizing recovery.

Abstract

New evidence on the efficacy and safety of dual antiplatelet therapy for secondary stroke prevention has been realized in the recent years. An updated meta-analysis was done to determine the effect of the various dual antiplatelets (including ticagrelor and cilostazol) vs aspirin alone on recurrence rate of ischemic stroke, cardiovascular morbidity and mortality, and its safety profile as reported through major bleeding.

Introduction:

Ischemic stroke is a far the most common type of stroke accounting for an approximately 80–90% of all strokes. According to World Health Organization (WHO) the cerebrovascular accidents or stroke are the second leading cause of mortality and the third leading cause of morbidity. It is a condition in which a region of the brain is deprived of blood flow which results to hypoxia of brain cells leads to the cell death and thereby resulting to the focal neurologic deficits depending on the area of damage. Transient ischemic attack on the other hand presents a similarly with an ischemic strokes but do not leave the evidence of damaged tissue. Transient impairment of blood flow occurs which reverses spontaneously without intervention.

Stroke is the only leading cause of long disability. In addition to the initial damage progression of focal deficits result to unfavorable outcomes. In past decades the intensive therapeutic and interventional strategies have been investigated to reduce the disability and recurrence of the stroke. According to Aoki, et al. the intravenous thrombolysis, endovascular therapy and aspirin have played key roles in reducing the stroke recurrence. Lifted from several prospective randomized controlled trials such as the ‘chance’ and point trials. The addition of clopidogrel to aspirin significantly decreased the neurologic deterioration in patients with acute non cardioembolic ischemic strokes. Other dual anti-platelet therapies have also been showed the positive impact. The management of ischemic strokes which have given rise to the several systematic reviews and also meta-analysis of these drugs. However, the subsequent pilot studies with a small population size involving antiplatelet drugs such as ticagrelor and cilostazol. When combined with aspirin did not confirm whether the clinical outcomes of patients with acute stroke would improve.

Two recent randomized control trials were published on the use of Cilostazol with Aspirin and Ticagrelor with Aspirin vs. Aspirin alone which were not included in the meta-analysis by Yang Y, et al., on Dual vs. Mono Antiplatelet Therapy for Acute Non-Cardioembolic Ischemic Stroke. These two additional randomized controlled trials provided the data that was used to update the current management of secondary prevention of acute ischemic stroke. Hence, the aim of this study was to present an updated systematic review involving several antiplatelets that are combined with aspirin as a dual therapy vs. aspirin alone in its effect to a recurrence of stroke in patients who have suffered from acute stroke composite events such cardiovascular morbidity and mortality. Safety as measured through major bleeding, among patients who have suffered from an acute non cardioembolic stroke.

Objectives:

The general objective of this study was to determine the effect of the various dual antiplatelets that including ticagrelor and cilostazol vs. aspirin alone on recurrence rate of ischemic stroke. Composite events like cardiovascular morbidity – acute coronary syndrome, and mortality, and its safety profile as reported through the major bleeding. In this study all randomized trials used had an acute stroke or transient ischemic attack time frame of less than 72 hours.

Methods:

PubMed, Cochrane and Science Direct data bases were utilized, RCTs evaluating dual antiplatelet vs mono antiplatelet therapy for acute ischemic stroke or transient ischemic attack within < 72 hours from ictus were searched up to July 2019. Risk ratio at 95% confidence intervals was calculated to evaluate stroke recurrence, cardiac events and mortality, and major bleeding.

Results:

Sixteen studies in the previous meta-analysis were included. Those excluded were trials where in the monotherapy treatment was not aspirin for uniformity of the control drug. Based on the relevant studies from January 2016 to June 2019. The data base searching and citation tracking of references identified 53,082, by using Boolean function. 44 trials were excluded and 6 randomized control trials were reviewed by full text for details and 4 of which were excluded due to the missing data wherein all channels to retrieve it were exhausted. Therefore 2 eligible randomized controlled trial were identified. Both of which compared its efficacy and safety versus aspirin in patients with acute non-cardioembolic ischemic stroke or transient ischemic attack.

Conclusion:

In acute non-cardioembolic ischemic strokes or those who have suffered a transient ischemic attack the dual antiplatelet therapy was associated with efficacy in stroke recurrence and composite cardiac events with a non-significant risk of major bleeding. Among patients with an acute non-cardioembolic ischemic stroke or transient ischemic attack within 72 h of ictus. Dual antiplatelet therapy was associated with an reduction in stroke recurrence and composite events such as Acute Coronary Syndrome and Cardiac related deaths when compared to the monotherapy. However, the dual antiplatelet therapy shows the decreased safety profile due to the possible. Although not statistically significant events of major bleeding as observed in this study. Factors that may have contributed to increased risk of major bleeding were the dosing and duration of treatment given. In conclusion the current data suggests that administration of short term dual antiplatelet therapy in the acute phase of ischemic stroke or transient ischemic attack was efficacious and relatively safe of which Cilostazol with Aspirin can be potential for standard treatment due to its evidence in reduction of stroke recurrence and being the most cost efficient combination although with not statistically significant bleeding risk.

Background:

Oral health is an essential part of general health. There is proving that patients suffering from mental illness are more vulnerable to dental neglect and poor oral health. Orodental diseases seem to be poorly recognized by psychiatrists, and oral health is no exception. Psychiatric disorders affect the general behavior of a person, impair the level of functioning, and alter perception toward oral health. Eating and sleeping patterns take precedence over personal hygiene, making them susceptible to many oral diseases. The two diseases that have a major impact on the oral cavity are dental caries (tooth decay) and periodontal disease (gum disease).

Patients & Methods:

This is a study of dental diseases in psychiatric patient’s comorbidity in Abha Psychiatric Hospital in Aseer region that is located at the southern area of Saudi Arabia, which is a high-altitude area of about 2500–3000 m above sea level. A written concent is obtained from every patients or first degree relatives in case of children. This study included all patients attending the Abha Psychiatric Hospital, which served a population of about 2 million persons during the period of 1 Hijri year of 1437. Data of all patients in the hospital during this year were reviewed, including age, sex, nationality, inpatient, or OPD patient. This hospital is the only governmental hospital with OPD and inpatient departments serving the area together, with some private hospitals and polyclinics giving outpatient service only.

The hospital consists of seven OPD clinics for adult psychiatric services working 4 days per week, and another OPD clinic for child and adolescent psychiatry and nine inpatient wards with 117 beds, including acute male psychiatric ward with 13 beds, acute male addiction ward with 15 beds, sub-acute psychiatric ward with 15 beds, sub-acute addiction ward with 15 beds, rehabilitation male ward with 15 beds, male chronic patients ward with 15 beds, jail ward with four beds, acute female ward with 10 beds, and sub-acute female ward with 10 beds. There are two more emergency room clinics working daily for 24 h with five beds for patient observation and for those patients waiting for admission, and there is a dental clinic operated by two dental specialist physicians working on a daily basis and serving all patients including OPD patients by direct referral from psychiatrists and inpatients by direct referral from their treating psychiatric doctors.

The data of all patients attending the dental clinic are registered through computer system in every OPD or admission office and then collected by the medical counting department.

Results:

Male patients were more in number compared with female patients (444 vs. 110). In addition, the age group between 25 and 45 years was more affected by dental problems than other groups. Also, the chronic psychiatric patients with a long stay at the psychiatric hospital were more affected than the newly admitted ones.

Discussion:

Mouth health is an integral part of general health, and it affects all aspects of life: personal, social and psychological. This is particularly important in patients with special needs, such as psychiatric patients. These patients have a tendency to be more prone to develop bucco-dental diseases, because of their lack of motivation, the difficulty to perform a proper mouth health technique, the hurdles that have to be overcome to treat them dentally, and the negative effects caused by psychotropic medications, affecting the normal physiology of salivary glands and epithelia of the oral mucous, causing xerostomy or sialorrhea. Different authors have reported that patients with mental illnesses get inadequate dental care because of ignorance, fear, stigmas, or negative attitudes by the professionals.

A drug delivery system of quercetin (QU)- exemplified liposomes (LS) united with RMP-7, a bradykinin simple, and lactoferrin (Lf) was produced for saturating the blood–mind hindrance (BBB) and saving declined neurons as an Alzheimer's malady (AD) pharmacotherapy. This colloquial plan of RMP-7-Lf-QU-LS was utilized to navigate human mind microvascular endothelial cells (HBMECs) controlled by human astrocytes (HAs) and to treat SK-N-MC cells after an affront with cytotoxic β-amyloid (Aβ) fibrils. We found that surface RMP-7 and Lf upgraded the penetrability for QU over the BBB without actuating solid poisonousness and harming the tight intersection. Furthermore, RMP-7-Lf-QU-LS altogether decreased Aβ-initiated neurotoxicity and improved the feasibility of SK-N-MC cells. Contrasted and free QU, RMP-7-Lf-QU-LS could likewise fundamentally hinder the statement of phosphorylated p38 and phosphorylated tau protein at serine 202 by SK-N-MC cells, demonstrating a significant job of RMP-7, Lf and LS in ensuring neurons against apoptosis. RMP-7-Lf-QU-LS are promising transporters in focusing on the BBB to forestall Aβ-offended neurodegeneration and can be potential for overseeing AD in future clinical application.

Keywords: Blood–brain barrier, Drug targeting, Alzheimer’s disease, neurodegeneration, β-amyloid, pharmacotherapy

Introduction:

Alzheimer’s disease (AD) is one of the most genuine neurodegenerative issue on the planet today. The most widely recognized side effect of AD is irreversible dementia, including ceaseless memory misfortune, wordy disarray about time as well as spot, subjective hindrance, and character change. Advertisement patients likewise showed an atrophic change in cerebrum parenchyma, arteriosclerotic tissue, and ensnarement of neurofibrils in cerebral neurons. Atomic science has demonstrated that two significant anatomical segments liable for AD pathology are stored β-amyloid (Aβ) of anomalous decrepit plaques and hyperphosphorylated tau protein of cholinergic neurons in the hippocampus. Considering the obsessive highlights, an apoptotic cell model to help with understanding neurodegeneration would be of viable use for AD treatment.

Materials and Methods:

Human astrocytes (HAs), endothelial cell medium (ECM) and astrocyte medium were gotten from Sciencell. SK-N-MC cells from human neuroblastoma were purchased from American Type Tissue Collection. Unfriendly to LfR monoclonal checking specialist, goat against mouse polyclonal discretionary immunizer immunoglobulin G (generous and light) (IgG (H + L)) conjugated with rhodamine, lysis pad, antagonistic to JNK (phospho T183 and Y185) (threatening to p-JNK), goat unfriendly to rabbit IgG (H + L) and against Aβ monoclonal neutralizer were gotten from Abcam.

Discussion:

RMP-7-Lf-QU-LS was created for focusing of the BBB and for conveying QU to SK-N-MC cells. Trial proof uncovered that an expansion in the mole level of SA expanded the molecule size and zeta potential however diminished the joining effectiveness of RMP-7 and Lf, when all is said in done. Also, fused RMP-7 and Lf on the particles expanded the degree of surface nitrogen. RMP-7 and Lf additionally somewhat upgraded the capacity of PI to cross the BBB and diminished the TEER, showing a minor tight intersection opening after treatment with RMP-7-Lf-QU-LS. Concerning continued discharge, disintegration of QU was in the request for QU-LS > Lf-QU-LS > RMP-7-Lf-QU-LS. Also, RMP-7-Lf-QU-LS had low cytotoxicity to HBMECs and HAs and could be perceived by HBMECs for upgrading the vehicle of QU over the BBB. As far as protein articulation, p-JNK, p-p38, and p-S202 in SK-N-MC cells were in the request for nothing QU > QU-LS > RMP-7-Lf-QU-LS, recommending that RMP-7-Lf-QU-LS could decrease neurotoxicity and improve neuronal endurance. Henceforth, RMP-7-Lf-QU-LS can go about as a potential neuroprotective framework for hindering Aβ-prompted apoptosis in AD the executives