ABSTRACT
Currently there is an emphasis on developing Integrated Care pathways for mental health problems. The concept of pathways draws heavily from principles of lean thinking and is therefore based on improving the efficiency of the system to provide quality services to persons with health problems. Development of pathways for schizophrenia, along with depression and dementia is high priority in Ontario, Canada. This is an exciting development, especially as this might trigger radical changes in the health system to improve the care of those with schizophrenia. As the pathways are fully developed in England, we have tried to highlight the issues that can facilitate or hinder the development and implementation of the pathways in Ontario, compared with England. Development of pathways offers unique opportunities, that might lead to substantial improvement in care of persons with psychosis.
ABSTRACT
Background: The recent engagement of Game base console is emerging in rehabilitation practice and its overall effectiveness has not been yetsubstantially manifested. Objective: To evaluate the effectiveness of Wii based balance interventions among Multiple Sclerosis people. Data Sources: A systemic search was conducted in the PubMed and Scopus data bases electronically up to February 2014. Study Selection: Randomized and non-randomized control trials with Wii intervention on balance as an outcome measure among people with Multiple Sclerosis were included in this review. Data Synthesis: After screening 57 studies, 7 were selected for full-text screening and 5 were included in this review. Three out of five were RCTs and rest were quasi experimental and 2-point crossover pilot studies. Total of 205 medically diagnosed mild to moderate MS people were in the selected studies with less than 6 expanded disability status scale (EDSS). Total of 13 different outcome measures were used on assessment of balance in Multiple sclerosis individuals and the most common outcomes were Berg balance scale (BBS), Center of Pressured (COP), Four Square step test (FSST), Time up and Go test (TUG). Three out of five studies report statistical significant improvement in the Four Square step test (FSST), Berg Balance Scale (BBS) and center of Pressure (COP) between intervention and control groups of MS. Conclusion: Review of the selected studies indicates that the inclusion of Wii game in balance exercise on Multiple sclerosis people improve static balance more effectivelyas compare to dynamic balance in mild to moderate level of disability. However evidence on the mode selection in Wii, treatment setting and frequency lacking. Further studies with large sample size and more homogenize outcome measure and control setting is recommended for future.
ABSTRACT
Skin diseases have high prevalence throughout the world which accounts for 10% of the workload of the family doctors. One of such disease is dermatophytosis [ringworm] which is caused by dermatophytes. They are more prevalent in economically under developed and developing countries where they contribute as a major health problem. The prevalence of superficial mycotic infections had risen to such a level that skin mycoses now affects more than 20-25% of the world population, making them one of the most frequent form of infections. In spite of the advances in antifungal and corticosteroid therapy which have completely altered the nature of skin clinics, there is no diminution in the number of patients with dermatophytosis attending for assistance. Subsequently the adverse effect of drugs has also worsened the condition. As per the literature of Unani System, two compound drugs viz. [Majoon Ushba] and [Marham Gulabi] which are supposed to be novel combination were chosen for this study as test group. The result was compared with Allopathic drugs viz. Griseofulvin and Sulphur Ointment as standard. Our study includes 30 .cases in each group. After completion of the study it was found that the test group was clinically as well as statistically significant at the same level as that of standard group