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

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‣ diuretics (hydrochchlorthiozide), calcium channel blockers (amlodipine) and ACE inhibitors (Enalapril) are relatively cheap. ‣ Drug therapy should be started in individuals at the time of diagnosis if they have blood pressure more than 160/100mmHg (despite non-pharmacological interventions) ‣ or if BP>140/90 in diabetic subjects or end organ damage such as proteinurea, high blood urea, ECG evidence of left ventricular hypertrophy, presence of heart diseases and evidence of retinopathy. In all other individuals life style modification should be tried for at least six months before initiating drug therapy. <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 368
‣ Start with calcium channel blockers (specifically if the person is older than 55 years) and ‣ ACE inhibitors if less than 55 years. Recheck the BP in 2 weeks. If BP is not under control adding diuretics (Hydrochlorothiazide 12.5 mg a day) may be helpful. Normally this should bring the BP under control. ‣ If the BP is not controlled by the combination of Amlodipine 10mg +Hydrochlorothiazide 25mg aday or Enalapril 10mg and Hydrochlorothiazide 25mg a day, a referral to a higher center may be necessary. <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 369
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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
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Thank you SIHFW: an ISO 9001: 2008
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Structure re of presentation Basic
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What is Cancer SIHFW: an ISO 9001:
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Growth of Cells • Undesirable •
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Common Cancer sites Male- • Mout
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Prefix adeno- chondro- Meaning Nami
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India 0.8 million new cases/year
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Five Common Cancers Rank World Indi
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Issues in Cancer control Burden of
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Cancer patterns Predominance of To
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Prevention ention and screening Se
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Early diagnosis ‣ Individual’s
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Diagnosis Radiological Biochemica
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Cancer Interventions in different E
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350 Age wise distribution of deaths
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Common Cancer in Male 50000 45000 4
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No of Cancer Deaths -India 350 300
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Cancer Deaths -Rajasthan 60 50 40 5
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District wise Reported Cancer Death
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Projected Cases of Oral Cancer in I
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Age - wise distribution of Deaths d
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Symptoms of Cervical Cancer Post-m
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Evaluation and Management after Pap
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VIA Category Negative Positive Crit
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Cryotherapy (ablation) Management
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Age - wise distribution of Deaths d
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Sign and Symptoms A lump or thicke
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Diagnosis Breast awareness & breas
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Health professionals can - Key Mess
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Projected Cases of Lung Cancer in I
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Symptoms Persistent cough or worse
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National Programme SIHFW: An ISO:90
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National Cancer Registry Programme
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Schemes under NCCP Recognition of
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District Services under NCCP Healt
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Medical college Health Promotion &
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Why include Cancer In NPCDCS No u
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Objective e of TCC Scheme Develop
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Thank You For more details log on t
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Definition ‣ Group of brain dysfu
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Burden of Disease 7000000 6000000 5
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Risk Factors ‣ Age and Sex ‣ Hy
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Cerebrovascular Accident Risk Facto
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Cerebrovascular Accident Anatomy of
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Ischemic Cascade Cerebrovascular Ac
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‣ Trouble in walking Symptoms ‣
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Identification of an acute event S
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Diagnosis: CT without contrast Cer
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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
Page 317 and 318: SIHFW: An ISO:9001:2008 certified I
Page 319 and 320: Cerebrovascular Accident Treatment
Page 321 and 322: Cerebrovascular Accident Diagnostic
Page 323 and 324: CVA - Treatment Goals Surgical Tre
Page 325 and 326: Drug Therapy Cerebrovascular Accide
Page 327 and 328: Cerebrovascular Accident Rehabilita
Page 329 and 330: Cardio-Vascular Diseases SIHFW: An
Page 331 and 332: Source: WHO Burden of Disease Numb
Page 333 and 334: Cardiovascular Diseases group of di
Page 335 and 336: Newly emerging CVD risk factors ‣
Page 337 and 338: Resource Scenario-1 Scenario-2 Scen
Page 339 and 340: Prevention of CVD Heart disease and
Page 341 and 342: Hypertension “ high blood pressur
Page 343 and 344: Classification Primary / Essential
Page 345 and 346: Epidemiological Determinants Risk/
Page 347 and 348: Symptoms ‣ Headache ‣ Drowsines
Page 349 and 350: Criteria for diagnosing high blood
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Page 353 and 354: Physical examination should include
Page 355 and 356: Desirable: (at CHC/sub-district/dis
Page 357 and 358: Life style advice is advocated for
Page 359 and 360: Treatment Goals The aim should be
Page 361 and 362: Diuretics Thiazide Inhibit Na + /C
Page 363 and 364: Beta blockers Act by decreasing ca
Page 365 and 366: α adrenergic blockers Lower BP by
Page 367: Medicines are tailored depending on
Page 371 and 372: Compelling Indications for Compelli
Page 373 and 374: Management of Hypertension at diffe
Page 375 and 376: Follow-up and Monitoring Patients
Page 377 and 378: Ischemic Heart Disease Myocardial i
Page 379 and 380: Burden of IH Disease 10000000 22367
Page 381 and 382: Symptoms ‣ Abrupt, unexpected car
Page 383 and 384: Treatment of IHD ‣ Medical treatm
Page 385 and 386: Management & Prevention: Modifying
Page 387 and 388: ‣ Weakness in sternocleidomastoid
Page 389 and 390: Prevention ention ‣ Strokes are p
Page 391 and 392: ‣ Physical therapy to improve str
Page 393 and 394: Rheumatic heart diseases ‣ Compli
Page 395 and 396: ‣ Breathlessness ‣ Fatigue ‣
Page 397 and 398: Prevention ‣ Seek immediate medic
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Page 401 and 402: Conceptualization ation of NPHCE U
Page 403 and 404: Objectives es Provide Preventive,
Page 405 and 406: Ageing Ageing is a progressive biol
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Page 409 and 410: Ageing Progressive and generalized
Page 411 and 412: Some Facts! World population of 6.
Page 413 and 414: Projections 60+ 24 million in 1961
Page 415 and 416: India: Some Facts! Life expectancy
Page 417 and 418: 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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Non-Communicable Diseases: NPCDCS ... - SIHFW Rajasthan

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