Music therapy as a non-pharmacological intervention for persons living with dementia: client assessment and types of music therapy interventions

Geriatric giants account for the five most prevalent morbidities that cause immense decline in functional capacity and decreased quality of life. Immobility, instability leading to falls and fractures, incontinence, impaired cognition (dementia) and iatrogenesis affect majority of the ageing elderly leading to dependency, caregiving and associated burden among caregivers. Concept of non-pharmacological interventions in dementia care: interventions that involve non-pharmacological (non-medicinal) measures, have proven benefits to the people living with dementia (PLWD). music therapy, nature therapy that involves nature walks and living amidst natural spaces, have shown to have immense biophilia effects on the various organ systems in the human body. Immense health benefits have been documented among PLWD: dawn phenomenon is a clinical phenomenon where the PLWD experiences agitation, aggression and loud speech in the evenings associated with dementia. Out of all the seven studies published, there were significant improvements in mood, reduction in aggressive behavior, improving anxiety symptoms, reducing caregiver burnout and improving overall quality of life of the people living with dementia and their caregivers. With promising results among various interventional studies across the world, NPI is an important intervention with minimal to nil side effects with long term benefits on frequent administration.

Growth Kinetics of a Native Toxigenic Isolate of Bacillus Cereus under the Influence of Incubation Temperature, pH and Sodium Chloride in Broth System.

Aims: The growth behavior of vegetative cells and spores of a native toxigenic food isolate of Bacillus cereus CFR 1534 was studied under the influence of incubation temperature, pH and sodium chloride. Place and Duration of Study: The study was undertaken in the Department of Human Resource Development, CSIR-Central Food Technological Research Institute, Mysore 570020, India. The duration of study was during the period October 2009 to February 2010. Methodology: The experimental design was a central composite design (CCD) based on 3 factors and 5 levels. The factors for vegetative cells were incubation temperature (12- 48ºC), pH level (5.5-7.5) and sodium chloride (2-6%). With spores, the ranges of pH and NaCl levels were the same, while incubation temperature range was 22 to 42ºC. Results: Multiple regression analysis of experimental data relating to lag phase duration (LPD) and growth rate (GR) of B. cereus across the influencing factors in broth system revealed that LPD of vegetative cells and spores was primarily influenced by incubation temperature. In vegetative cells of B. cereus, the LPD was in the range of 3.1 to 31.5 h with the highest being observed at 48ºC and pH 6.5. The GR had the lowest of 0.2/h to highest of 2.2/h at 30ºC and pH 7.5. With spores, the lowest LPD of 5.8 h was at 42ºC and highest of 20.5 h at 22ºC and that of GR was in the range of 0.2/h at 22ºC to 0.7/h at 32ºC. Experimental tubes of vegetative cells with GR estimates of 1.3/h and above revealed positive reactions for toxigenic traits of haemolytic and lecithinase activities associated with B. cereus. Conclusion: In the case of vegetative cells, incubation temperature in the range of 12- 20ºC resulted in higher LPD, while in spores, higher LPD was observed with incubation temperatures of 22-26ºC. This could provide a basis to design protocols for a safe food in the food chain.

Outcome of teenage pregnancy.

Two hundred consecutive cases up to 19 years of age admitted for confinement at The Nowrosjee Wadia Maternity Hospital, Bombay, were studied. Out of these 200 girls, 6 were unmarried, 51 were anaemic, 20 had toxaemia of pregnancy. Six girls (43%) in the age group 15-17 years delivered prematurely as compared to only 26 girls (14%) in the age group of 17-19 years. This difference is statistically significant. Also, only, 4 girls (29%) in the age group of 15-17 years had full term normal delivery as compared to 113 girls (61%) in the age group of 17-19 years signifying that the outcome of pregnancy becomes worst in girls below the age of 17 years. Ten babies (71%) of mothers in the age group of 15-17 years were LBW as compared to 75 babies (44%) of mothers in the age group of 17-19 years signifying that the incidence of LBW babies is inversely proportional to maternal age. Teenage pregnant girls needed more attention for prevention and treatment of preeclampsia eclampsia, anaemia, prematurity and LBW.

Anti-convulsant therapy in eclampsia.

Seventy four patients presented with eclampsia at N.W.M. Hospital. Bombay. Among the patients with eclampsia, 64.9% were primis, 29.7% were gravida II-IV and 5.4% were grand multis. As many as 40.5% patients were less than 20 years of age, while 2.7% were over 30 years of age. 48.7% had antepartum convulsions, 40.5% had intrapartum convulsions, while 8 patients convulsed in the postpartum period. Besides standard management of eclamptic patients, 3 protocols of anticonvulsant therapy were utilised. 27% were managed with diphenyl hydantoin sodium, 43% with magnesium sulphate, and 30% by combination of diazepam and pentazocine. The maternal and perinatal outcome was evaluated. Control of convulsions was superior with magnesium sulphate while perinatal outcome was best with diphenyl hydantoin.