Non-Communicable Diseases: NPCDCS ... - SIHFW Rajasthan

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Not modifiable: •Genetic family history •Age •Age at menarche Breast Cancer Risk Modifiable: •Diet •BMI •Exercise •Exogenous estrogen use •Alcohol h l consumption •Reproductive history <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution Potentially modifiable •Age at first birth •Age at menopause •Breast feeding 238
Sign and Symptoms A lump or thickening in or near the breast or in the underarm area Change in the size or shape of the breast Nipple turned inward Discharge (fluid) from the nipple, especially if it's bloody Dimpling or puckering in the skin of the breast Scaly, red, or swollen skin on the breast, nipple, or areola <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 239
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Non-Communicable Diseases: NPCDCS &
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Risk factors and NCDs largely preve
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Drivers of NCDs SIHFW: an ISO 9001:
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SIHFW: an ISO 9001:2008 certified I
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Epidemiological Transition Communi
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Challenges Many communicable disea
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SIHFW: an ISO 9001:2008 certified I
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Magnitude SEAR-2008: 14.5million t
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50 45 40 35 30 25 Estimated %of pre
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Trends in estimated %of deaths 80%
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Estimated and Projected Deaths due
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Pop.(2010): 1 224 614 327 Age stand
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Metabolic Risk factor Trends 126 Me
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26 Mean BMI 24 22 Male 20 Female 18
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Reported Cases & Deaths due to NCD-
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Total Number of Diabetic Cases - Ra
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Reported Deaths :Type 1 DM- Distric
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District Reported Deaths of Type 2
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Reported Cases of Deaths Due to Can
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District -wise reported Cancer Deat
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SIHFW: An ISO:9001:2008 certified I
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Implications of ↑ burden of NCDs
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MDG-6 NCD burden threatenst the (Co
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2% annual reduction in Chronic Dise
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Answer to the problem: ACT NOW Prev
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Risk factor/disease Tobacco use: Us
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Action at National Level: Two comp
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Strategies Prevention through beha
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Services Preventive, promotive , c
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Facility DH Services Early diagnosi
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Institutional Framework Integratio
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Screening MO to do: To conduct com
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Work closely with other sectors/ de
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Surveillance Surveillance is the on
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Risk Factor Surveillance: Focus …
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Risk factors common to major non-co
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Levels of Risk Factor Surveillance
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Actions at Hospitals Proper depict
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Structure re of presentation Risk
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Risk factor in NCD Any attribute,
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Risk factors May be truly causativ
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NHD of NCD Changes in life style st
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The WHO STEP approach to Surveillan
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STEPS emphasizes that small amounts
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SIHFW: an ISO 9001: 2008 certified
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Step1:Questionnaire Based Assessmen
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Step 3: Biochemical Measurements D
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Core Items Expanded Items Optional
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Behavioral Risk Factors “Actions/
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Modifiable Risk Factor: 2008 estima
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B. Diabetes ‣ Obesity ‣ Sedenta
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D. Cancer ‣ Environment ‣ Life
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Risk factors and level of NCD preve
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Goals of implementing these guideli
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Follow up Once the condition of th
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High risk With established cardiov
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If cholestrol can not be measured S
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Prevention of CVD (according to ind
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NPCDCS Components Prevention throu
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Thank you SIHFW: An ISO:9001:2008 c
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Problem on the rise : NCDs MI HT CO
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Major diet related NCDs Diabetes Ca
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Type of cancers Risk factors Diet R
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Prominent risk factor Disease Heart
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Life Style Modification Primary Pr
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Burden of the Bulge In India 1 in
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Android : Upper-body obesity--apple
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Assessment of central obesity Wais
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Why is this happening Drivers of th
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Nutrition transitions: Absolute cau
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Body Mass Index (BMI ) Quetlet’s
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Classification BMI Classification W
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Sleep apnea and respiratory problem
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Weight management Weight gain Calor
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Weight loss goals Realistic Achie
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Lifestyle medicine: Need for change
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Dietary interventions Managing g /
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Life style modification & Diet Bala
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SIHFW: an ISO 9001: 2008 certified
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Total energy requirement Total ener
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Diet for NCD: Main focus ‣ Gradua
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Promoting Healthy lifestyle le Tra
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Strategies for Obesity Prevention e
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Tips for weight reduction Slow and
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‣ Avoid fried foods and bakery pr
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When to eat Set aside a time for
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Way to eat Eat slowly. Chew prop
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Recommendations in preventing diabe
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Calculating balanced diet Know Rec
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How to calculate balance diet Step
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Key recommendations -Diet • Frui
Page 187 and 188: Thank you SIHFW: an ISO 9001: 2008
Page 189 and 190: Structure re of presentation Basic
Page 191 and 192: What is Cancer SIHFW: an ISO 9001:
Page 193 and 194: Growth of Cells • Undesirable •
Page 195 and 196: Common Cancer sites Male- • Mout
Page 197 and 198: Prefix adeno- chondro- Meaning Nami
Page 199 and 200: India 0.8 million new cases/year
Page 201 and 202: Five Common Cancers Rank World Indi
Page 203 and 204: Issues in Cancer control Burden of
Page 205 and 206: Cancer patterns Predominance of To
Page 207 and 208: Prevention ention and screening Se
Page 209 and 210: Early diagnosis ‣ Individual’s
Page 211 and 212: Diagnosis Radiological Biochemica
Page 213 and 214: Cancer Interventions in different E
Page 215 and 216: 350 Age wise distribution of deaths
Page 217 and 218: Common Cancer in Male 50000 45000 4
Page 219 and 220: No of Cancer Deaths -India 350 300
Page 221 and 222: Cancer Deaths -Rajasthan 60 50 40 5
Page 223 and 224: District wise Reported Cancer Death
Page 225 and 226: Projected Cases of Oral Cancer in I
Page 227 and 228: Age - wise distribution of Deaths d
Page 229 and 230: Symptoms of Cervical Cancer Post-m
Page 231 and 232: Evaluation and Management after Pap
Page 233 and 234: VIA Category Negative Positive Crit
Page 235 and 236: Cryotherapy (ablation) Management
Page 237: Age - wise distribution of Deaths d
Page 241 and 242: SIHFW: An ISO:9001:2008 certified I
Page 243 and 244: Diagnosis Breast awareness & breas
Page 245 and 246: Health professionals can - Key Mess
Page 247 and 248: Projected Cases of Lung Cancer in I
Page 249 and 250: Symptoms Persistent cough or worse
Page 251 and 252: National Programme SIHFW: An ISO:90
Page 253 and 254: National Cancer Registry Programme
Page 255 and 256: Schemes under NCCP Recognition of
Page 257 and 258: SIHFW: An ISO:9001:2008 certified I
Page 259 and 260: District Services under NCCP Healt
Page 261 and 262: Medical college Health Promotion &
Page 263 and 264: Why include Cancer In NPCDCS No u
Page 265 and 266: Objective e of TCC Scheme Develop
Page 267 and 268: Thank You For more details log on t
Page 269 and 270: Definition ‣ Group of brain dysfu
Page 271 and 272: Burden of Disease 7000000 6000000 5
Page 273 and 274: Risk Factors ‣ Age and Sex ‣ Hy
Page 275 and 276: Cerebrovascular Accident Risk Facto
Page 277 and 278: Cerebrovascular Accident Anatomy of
Page 279 and 280: Ischemic Cascade Cerebrovascular Ac
Page 281 and 282: ‣ Trouble in walking Symptoms ‣
Page 283 and 284: Identification of an acute event S
Page 285 and 286: Diagnosis: CT without contrast Cer
Page 287 and 288: Cerebrovascular Accident Classifica
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CVA Recognition SIHFW: An ISO:9001:
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Cerebrovascular Accident Thrombotic
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Cerebrovascular Accident Common Sit
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Cerebrovascular Accident Embolic St
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Cerebrovascular Accident Goals for
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Cerebrovascular Accident Hemorrhage
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Cerebrovascular Accident Hemorrhagi
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Delayed Neurological deficit in Re
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Hemorrhagic-Subarachnoid Cerebral A
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Cerebrovascular Accident Clinical i
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Cerebrovascular Accident Clinical M
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Cerebrovascular Accident Treatment
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Cerebrovascular Accident Diagnostic
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CVA - Treatment Goals Surgical Tre
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Drug Therapy Cerebrovascular Accide
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Cerebrovascular Accident Rehabilita
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Cardio-Vascular Diseases SIHFW: An
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Source: WHO Burden of Disease Numb
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Cardiovascular Diseases group of di
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Newly emerging CVD risk factors ‣
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Resource Scenario-1 Scenario-2 Scen
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Prevention of CVD Heart disease and
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Hypertension “ high blood pressur
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Classification Primary / Essential
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Epidemiological Determinants Risk/
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Symptoms ‣ Headache ‣ Drowsines
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Criteria for diagnosing high blood
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Headache (severe hypertension) < mo
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Physical examination should include
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Desirable: (at CHC/sub-district/dis
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Life style advice is advocated for
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Treatment Goals The aim should be
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Diuretics Thiazide Inhibit Na + /C
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Beta blockers Act by decreasing ca
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α adrenergic blockers Lower BP by
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Medicines are tailored depending on
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‣ Start with calcium channel bloc
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Compelling Indications for Compelli
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Management of Hypertension at diffe
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Follow-up and Monitoring Patients
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Ischemic Heart Disease Myocardial i
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Burden of IH Disease 10000000 22367
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Symptoms ‣ Abrupt, unexpected car
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Treatment of IHD ‣ Medical treatm
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Management & Prevention: Modifying
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‣ Weakness in sternocleidomastoid
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Prevention ention ‣ Strokes are p
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‣ Physical therapy to improve str
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Rheumatic heart diseases ‣ Compli
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‣ Breathlessness ‣ Fatigue ‣
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Prevention ‣ Seek immediate medic
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Conceptualization ation of NPHCE U
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Objectives es Provide Preventive,
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Ageing Ageing is a progressive biol
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Ageing means….. Demographers: A
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Ageing Progressive and generalized
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Some Facts! World population of 6.
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Projections 60+ 24 million in 1961
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India: Some Facts! Life expectancy
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Household population p + 60 Age By
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Ageing: Common Myths Most elderly
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Integumentary System Production of
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Circulatory System Heart muscle be
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Nervous System Progressive loss of
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Urinary System Decreased circulati
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Reproductive e System Female: vagi
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Psychosocial Changes of Aging Lone
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Psychosocial changes can be a major
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Dementia Term used to describe a l
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Alzheimer’s Disease (continued)
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Meeting the Needs of the Elderly G
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Gender and Ageing g in India Discr
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Care - Services for Elderly l in In
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Primary Health Center Training of
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How to achieve it Ati Active advoc
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Mental Health : Problem, Strategies
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Health "Health is a state of compl
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Mental Health Problems in India 1%
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Extent of the problem… Mental He
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Mental Health Resources In India Ma
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Mental Health Resources In India…
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Mental Health Resources in India 2
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Objectives National Mental Health P
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Essentials of DMHP 1. A decentraliz
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Restrategised NMHP 2003 Components
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Integration of NMHP in NRHM Nation
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DMHP Evaluation Independent evalua
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NMHP Achievement Scheme Financial S
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Failures It is top down approach
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Urban Mental Health Meta analysis b
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NGO Work In INDIA SCARF (Schizophr
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Mental Health NGO Activities Treat
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Community Awareness Role of media
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Tobacco As per Global Adult tobacc
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Stepped Care Approach in Substance
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Future Direction Vision i 2020: Roa
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For more details log on to www. sih
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