scholarly journals A clinico-epidemiological study of cerebral palsy in western Rajasthan

2017 ◽  
Vol 4 (4) ◽  
pp. 1146
Author(s):  
Mohan Makwana ◽  
Harish Kumar Mourya ◽  
Saroj Mourya ◽  
B. D. Gupta ◽  
Ratan Lal Bhati ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Financial Burden ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Cortical Atrophy ◽  
Anthropometric Measurement ◽  
Class Iii ◽  
Social Trauma ◽  
Male Patients ◽  
The Mean

Background: Cerebral palsy (CP) is one of the leading causes of disability in children. Incidence of cerebral palsy varies from one to six per thousand live births. Besides handicapping a child, it causes considerable psychological and social trauma to the parents and financial burden to family and community. A cure for cerebral palsy (CP) has not yet been discovered, hence, a need for primary prevention of disease. But unfortunately, the etiology of cerebral palsy is poorly understood thereby eluding a definitive prevention strategy.Methods: All cases of non-progressive neurological disorder in the age group of 0-9 years were enrolled in the present study. Thorough and complete Obstetric history including antenatal, natal and post-natal were recorded. Woodside scale is used for assessment of neurodevelopment and a complete anthropometric measurement, physical examination including detailed Central Nervous System and all neuroimaging and EEG were recorded. Severity of cerebral palsy was assessed according to Minear's classification. Statistical analysis was done by standard statistical methods.Results: Majority of patients were males (78.26%) as compared to females. The mean age of male patients was 2.04±1.53 years and females was 3.67±3.14 years. Spastic type of CP was most common (93.47%), followed by mixed (4.34%) and atonic (2.17%) type. Quadriplegic CP was the most common (76.75%), followed by diplegia (11.62%) amongst the spastic variety. Risk factors found are maternal pyrexia (17.39%), home vaginal delivery (58.70%), birth asphyxia (67.39%), Neonatal seizures (39.13%) other factors being icterus neonatorum (13.04%) and meconium aspiration syndrome (13.04%), ICH (10.86%), septicemia (8.69%) and renal failure (4.34%). Majority of the patients (78.26%) had class III and IV functional impairment. Cortical atrophy was the most commonly (71.73%) seen abnormality on neuroimaging with CT-scan. Epilepsy was present in 47.82% patients.Conclusions: Cerebral palsy along with its associated dysfunctions definitely disturbs the routine of children's life as well as family life. We have to go a long way before something definitive can be done for these children and their families. 

scholarly journals Aetiology and comorbidities of cerebral palsy in a developing country

2018 ◽  
Vol 6 (10) ◽  
pp. 3246 ◽  
Author(s):  
Komomo I. Eyong ◽  
Asindi A. Asindi ◽  
Chimaeze Torty
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Social Class ◽  
Perinatal Care ◽  
Birth Asphyxia ◽  
Cortical Atrophy ◽  
Dominant Type ◽  
Care Givers ◽  
Neurology Clinic ◽  
Pregnancy And Delivery

Background: Cerebral palsy (CP) is a common disabling condition of movement and posture causing activity limitation arising from a static injury to the developing brain. Common risk factors for cerebral palsy in Africa include severe birth asphyxia, kernicterus and neonatal infections. This study is aimed at determining the aetiology and comorbidities associated with cerebral palsy in our environment.Methods: All children with CP presenting to the Paediatric Neurology clinic of the University of Calabar Teaching Hospital whose parent gave consent were recruited into the study. The biodata of the children and that of the parent’s/ care givers were obtained. A detailed pregnancy and delivery history, neonatal history, seizures during first three years of life and developmental mile stones was documented.Results: Seventy children with CP were recruited into the study of which 46 (65.7%) were males and 24 (34.3%) females. Majority of the children were from low social class and products of home, church or TBA’S delivery where supervision is poor. Severe birth asphyxia and CNS infections are the commonest identified risk factors. Spastic quadriplegic CP is the dominant type of CP followed by spastic hemiplegia. There is a significant statistical relationship between the aetiology and the type of CP. Epilepsy (60%) speech defect (42.9%) and microcephaly (40%) are the predominant comorbidities seen in the study. Cortical atrophy and ventricular dilatation are predominant CT findings in contrast to periventricular leukomalecia seen in developed countries.Conclusions: Majority of the patients with CP in this study are from low social class and were delivered in places with poor obstetrics care. Improved perinatal care through an adequate social support system may reduce the burden of the disease.

scholarly journals Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Maternal Risk Factors ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
The Mean

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.

scholarly journals Spinal Injuries in a Tertiary Care Referral Center of Western Nepal

2013 ◽  
Vol 2 (2) ◽  
pp. 156-159
Author(s):  
P Devkota ◽  
HK Manandhar ◽  
PB Khadka
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Spinal Injury ◽  
Financial Burden ◽  
Tertiary Care ◽  
Spinal Injuries ◽  
Neurological Deficits ◽  
Medical Sciences ◽  
Male Patients ◽  
The Mean

Background: Spinal injury is a devastating condition often affecting young and healthy individuals around the world. This devastating injury not only creates enormous physical and emotional cost to individuals but also gives tremendous financial burden to the society. We evaluate the demography, types and causes of the spinal injuries and their management in patients admitted in a hospital. Methods: Medical records of 45 patients who were presented with spinal injuries in a year were analyzed. The age, sex, mode of injury, sites, types and level of injury, hospital stay, and treatment given were analyzed. Frankel grading was used for the evaluation of the neurological deficits. Results: The mean age of the patient was 47.5 years (range 19 - 78). Male patients were 60% (n=27) and female 40% (n=18). There were 42.2% (n=19) patients with E grade, 24.4% (n=11) patients with C grade, 20% (n=9) patients with D, three 6.6% (n=3) patients with A and B grades each of patients according to Frankel grade. Lumbar spine was the commonest site of injury. The most common cause of injury was fall, followed by road traffic accidents (RTA) and others. Nineteen patients were treated conservatively, 16 were operated, five patients were referred to other centers due to various reasons and the other five patients were discharged on their request. Conclusions: Spinal injuries are one of the rapidly growing injuries in our society and the commonest mode of injury was fall. The majority of patients were from the hilly areas. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 156-159 DOI: http://dx.doi.org/10.3126/njms.v2i2.8967  

scholarly journals An observational study of meconium aspiration syndrome and its immediate outcome with relation to thick and thin meconium stained amniotic fluid

2018 ◽  
Vol 5 (2) ◽  
pp. 552
Author(s):  
Sushant Kumar ◽  
Minni Rani Akhouri
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Meconium Aspiration ◽  
Clinical Criteria ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: Meconium-stained amniotic fluid (MSAF) accounts for approximately 10-15% of live births and Meconium aspiration syndrome occurs in 5% among infants born through MSAF. The purpose of this study was to evaluate the outcome in neonates with meconium aspiration syndrome with regard to thin and thick meconium. Methods: A prospective cohort study of inborn neonates was done from April 2016 to August 2017 admitted in neonatal intensive care unit, Department of Paediatrics and Neonatology, RIMS, Ranchi after obtaining written informed consent from the parents or guardian and diagnosis of MAS was made depending on the clinical criteria and its clinical outcome was observed. MAS babies were studied on the basis of thin and thick meconium stained amniotic fluid.Results: The mean birth weight in thin meconium was 2760±394. The mean APGAR score in thin meconium at 1 minute (3.57±1.01) and 5 minutes (5.57±1.62) was significantly more than thick meconium. The mode of delivery in thin meconium was commonly by cesarean section (76.9%). There was need for resuscitation in 46.1% in thin meconium neonates which was significantly higher than neonates born with thick meconium 6.6% (P value 0.000). The most common complication in thin meconium was birth asphyxia (69.2%), followed by ARF and septicemia. Death was significantly higher in neonates born with thin meconium (69.2%)as compared to thick (20%) with P value of 0.000Conclusions: Amniotic fluid with thin meconium may cause more respiratory and other complications in neonates than amniotic fluid with thick meconium. Hence proper diagnosis and timely intervention can reduce the morbidity and mortality in neonates with meconium aspiration syndrome.

scholarly journals Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 413
Author(s):  
Hui-Ling Chen ◽  
Jason Chen-Chieh Fang ◽  
Chia-Jung Chang ◽  
Ti-Feng Wu ◽  
I-Kuan Wang ◽  
...  
Keyword(s):  
Cadmium Concentration ◽  
Class Ii ◽  
Cadmium Exposure ◽  
Class I ◽  
P Value ◽  
Tooth Decay ◽  
Class Iii ◽  
Orthodontic Patients ◽  
Urine Cadmium ◽  
The Mean

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

Baseline characteristics and clinical features of patients with heart failure with reduced ejection fraction: a European real-world, non-interventional registry study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
U Zeymer ◽  
L.H Lund ◽  
V Barrios ◽  
C Fonseca ◽  
A.L Clark ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Real World ◽  
Nyha Class ◽  
Funding Source ◽  
Class Iii ◽  
Reduced Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
Real World Setting ◽  
The Mean

Abstract Background Heart failure (HF) is a major medical and economic burden that is often managed in office based practices. Recently, the angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan (S/V) was introduced as novel therapeutic option into European guidelines for the management of HF. The ARIADNE registry aims to provide information on how outpatients with HF with reduced ejection fraction (HFrEF) are managed in Europe, in light of this novel treatment option. Methods ARIADNE was a prospective registry of patients with HFrEF treated by office-based cardiologists (OBC) or selected primary care physicians (recognized as HF specialists; PCP) in a real world setting. HFrEF patients were included prospectively, independently of whether treatment had been changed recently or not. 9069 patients were recruited from 687 centres in 17 European countries. Results The mean age of all patients was 68.1 years (S/V: 67.3 years, Non-S/V: 68.9 years). The majority of patients were in NYHA class II (61.3%), or NYHA class III (37.1%) overall, while more patients in the S/V group showed NYHA class III (S/V: 42.8%, Non-S/V: 30.9%). Mean LVEF was slightly lower in the S/V group than in the Non-S/V group (S/V: 32.7%, Non-S/V: 35.4%, overall 34.0%). The most frequently observed signs of HF were dyspnoea upon effort, followed by fatigue, palpitations on exertion at baseline. More patients tend to have more severe symptoms in the S/V groups (e.g. for dyspnoea on effort, Non-S/V: moderate 40.8%, severe 8.6%; S/V: moderate 46.4%, severe 14.1%). 44.0% of patients from the S/V group and 39.3% of non-S/V patients reported at least one hospitalization within 12 months prior to baseline, of which 73.3% in S/V and 69.9% in non-S/V patients were due to HF., At baseline, 44.7% of the patients used a CV device, of which most were implantable cardioverter defibrillator (ICD: Non-S/V 54.2%, S/V: 52.8%), implantable cardioverter defibrillator (CRT-ICD:Non-S/V 21.9%, S/V: 27.0%), and pacemaker (Non-S/V: 13.4%, S/V: 10.5%). The mean KCCQ overall summary score was 62.6 in the S/V group and 69.5 in the Non-S/V group at baseline. 83.9% of patients were treated with ARB or ACEi in Non-S/V group, (ACEi 57.3%, ARB 26.9%). The most frequently taken drug combinations in either group were ACEi/ ARB or S/V with β -blockers (Non-S/V 69.3%, S/V 67.3%). 40.2% in the Non-S/V group and 42.9% in S/V groups used a combination of ACEi/ARB or S/V, β-blocker and MRA. Conclusions The ARIADNE prospective registry provides insights and reflects variations in HF treatment practices in outpatients in Europe and the way S/V was introduced by OBCs and specialized PCPs in a real-world setting. In the observed population, S/V is more often prescribed to slightly younger patients with slightly lower LVEF, there was a greater observed percentage of S/V patients NYHA class III, with lower quality of life measurements and with more severe symptoms and recent hospitalizations for heart failure. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis Pharma AG

scholarly journals Birth asphyxia and cerebral palsy.

BMJ ◽  
1989 ◽  
Vol 299 (6694) ◽  
pp. 279-282 ◽  
Author(s):  
D. M. Hall
Keyword(s):  
Cerebral Palsy ◽  
Birth Asphyxia

Primary or Redo Posterior Sagittal Anorectoplasty without a Stoma: To Feed or Not to Feed?

2017 ◽  
Vol 29 (02) ◽  
pp. 150-152 ◽  
Author(s):  
Clare Skerrit ◽  
Alexander Dingemans ◽  
Victoria Lane ◽  
Alejandra Sanchez ◽  
Laura Weaver ◽  
...  
Keyword(s):  
Breast Milk ◽  
Wound Dehiscence ◽  
Anorectal Malformations ◽  
Wound Complication ◽  
Wound Complications ◽  
Age At Surgery ◽  
Significant Difference ◽  
Male Patients ◽  
The Mean ◽  
Picc Line

Introduction Repair of anorectal malformations (ARMs), primarily or with a reoperation, may be performed in certain circumstances without a diverting stoma. Postoperatively, the passage of bulky stool can cause wound dehiscence and anastomotic disruption. To avoid this, some surgeons keep patients NPO (nothing by mouth) for a prolonged period. Here, we report the results of a change to our routine from NPO for 7 days to clear fluids or breast milk. Materials and Methods After primary or redo ARM surgery, patients given clear liquids were compared to those who were kept strictly NPO. Age, indication for surgery, incision type, use of a peripherally inserted central catheter (PICC) line, and wound complications were recorded. Results There were 52 patients, including 15 primary and 37 redo cases. Group 1 comprised 11 female and 15 male patients. The mean age at surgery was 4.9 years (standard deviation [SD]: 2.3). There were 8 primary cases and 18 redo cases. Twelve (46.6%) received a PICC line. The average start of clear liquids was on day 5.3 (SD: 2.2) after examination of the wound, and the diet advanced as tolerated. The first stool passage was recorded on average on day 2.3 (SD: 1.3). Four minor wound complications and no major wound complications occurred.Group 2 comprised 14 females and 12 male patients. The mean age at surgery was 3.5 (SD: 2.4) years. There were 7 primary and 19 redo cases. One (3.8%) patient required a PICC line. A clear liquid diet was started within 24 hours after surgery. A regular diet was started on average on day 5.8 (SD: 1.3). The first stool passage was recorded on an average of day 1.6 (SD: 0.9). Three minor wound complications occurred; however, there was no significant difference between the two groups (SD: 0.71). One major wound complication occurred. However, there was no significant difference in major wound complications between the groups (SD: 0.33). Conclusion No increase in wound problems was noted in children receiving clear liquids or breast milk compared with the strict NPO group, and PICC line use was reduced. We believe this change in practice simplifies postoperative care without increasing the risk of wound complications.

scholarly journals Clinical and imaging outcomes after intrathecal injection of umbilical cord tissue mesenchymal stem cells in cerebral palsy: a randomized double-blind sham-controlled clinical trial

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Man Amanat ◽  
Anahita Majmaa ◽  
Morteza Zarrabi ◽  
Masoumeh Nouri ◽  
Masood Ghahvechi Akbari ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Cerebral Palsy ◽  
Umbilical Cord ◽  
Intrathecal Injection ◽  
Control Group ◽  
Umbilical Cord Tissue ◽  
The Mean ◽  
And Control ◽  
Experimental Group

Abstract Background This study assessed the safety and efficacy of intrathecal injection of umbilical cord tissue mesenchymal stem cells (UCT-MSC) in individuals with cerebral palsy (CP). The diffusion tensor imaging (DTI) was performed to evaluate the alterations in white-matter integrity. Methods Participants (4–14 years old) with spastic CP were assigned in 1:1 ratio to receive either UCT-MSC or sham procedure. Single-dose (2 × 107) cells were administered in the experimental group. Small needle pricks to the lower back were performed in the sham-control arm. All individuals were sedated to prevent awareness. The primary endpoints were the mean changes in gross motor function measure (GMFM)-66 from baseline to 12 months after procedures. The mean changes in the modified Ashworth scale (MAS), pediatric evaluation of disability inventory (PEDI), and CP quality of life (CP-QoL) were also assessed. Secondary endpoints were the mean changes in fractional anisotropy (FA) and mean diffusivity (MD) of corticospinal tract (CST) and posterior thalamic radiation (PTR). Results There were 36 participants in each group. The mean GMFM-66 scores after 12 months of intervention were significantly higher in the UCT-MSC group compared to baseline (10.65; 95%CI 5.39, 15.91) and control (β 8.07; 95%CI 1.62, 14.52; Cohen’s d 0.92). The increase was also seen in total PEDI scores (vs baseline 8.53; 95%CI 4.98, 12.08; vs control: β 6.87; 95%CI 1.52, 12.21; Cohen’s d 0.70). The mean change in MAS scores after 12 months of cell injection reduced compared to baseline (−1.0; 95%CI −1.31, −0.69) and control (β −0.72; 95%CI −1.18, −0.26; Cohen’s d 0.76). Regarding CP-QoL, mean changes in domains including friends and family, participation in activities, and communication were higher than the control group with a large effect size. The DTI analysis in the experimental group showed that mean FA increased (CST 0.032; 95%CI 0.02, 0.03. PTR 0.024; 95%CI 0.020, 0.028) and MD decreased (CST −0.035 × 10-3; 95%CI −0.04 × 10-3, −0.02 × 10-3. PTR −0.045 × 10-3; 95%CI −0.05 × 10-3, −0.03 × 10-3); compared to baseline. The mean changes were significantly higher than the control group. Conclusions The UCT-MSC transplantation was safe and may improve the clinical and imaging outcomes. Trial registration The study was registered with ClinicalTrials.gov (NCT03795974).

scholarly journals Etiology of Dementia in Thai Patients

2021 ◽  
pp. 64-70
Author(s):  
Pornpatr A. Dharmasaroja ◽  
Jintana Assanasen ◽  
Sunsanee Pongpakdee ◽  
Kankamol Jaisin ◽  
Praween Lolekha ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Functional Imaging ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Cortical Atrophy ◽  
Common Cause ◽  
Presenting Symptoms ◽  
Dementia Registry ◽  
The Mean ◽  
Baseline Characteristics

<b><i>Introduction:</i></b> Molecular imaging has been developed and validated in Thai patients, comprising a portion of patients in the dementia registry. This should provide a more accurate diagnosis of the etiology of dementia, which was the focus of this study. <b><i>Methods:</i></b> This was a multicenter dementia study. The baseline characteristics, main presenting symptoms, and results of investigations and cognitive tests of the patients were electronically collected in the registry. Functional imaging and/or molecular imaging were performed in patients with an equivocal diagnosis of the causes of dementia, especially in atypical dementia or young onset dementia (YOD). <b><i>Results:</i></b> There were 454 patients in the study. The mean age of the patients was 78 years, with 60% female. Functional imaging and/or molecular imaging were performed in 57 patients (57/454 patients, 13%). The most common cause of dementia was Alzheimer’s disease (AD; 50%), followed by vascular dementia (VAD; 24%), dementia with Lewy bodies (6%), Parkinson’s disease dementia (6%), frontotemporal dementia (FTD; 2.6%), progressive supranuclear palsy (2%), multiple system atrophy (0.8%), and corticobasal syndrome (0.4%). YOD accounted for 17% (77/454 patients), with a mean age of 58 years. The causes of YOD were early onset amnestic AD (44%), VAD (16%), behavioral variant FTD (8%), posterior cortical atrophy (6.5%), and logopenic variant primary progressive aphasia (5.2%). <b><i>Conclusion:</i></b> AD was the most common cause of dementia in Thai patients and the distribution of other types of dementia and main presenting symptoms were similar to previous reports in Western patients; however, the proportion of YOD was higher.

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