BackgroundThe International Consortium (FTDC) that revised the diagnostic criteria for behavioural variant frontotemporal dementia (bvFTD) did not have an Asian representation. Whether the revised criteria are equally useful in the early detection of Asian bvFTD patients therefore remains largely unexplored. Earlier studies have indicated differences in clinical manifestations in Indian and other Asian bvFTD patients when compared to western groups. There is an urgent need for clarification, given the projected exponential rise in dementia in these countries and the imminent clinical trials on bvFTD.ObjectiveTo assess how Indian bvFTD patients fulfil the FTDC criteria, hypothesizing that our patients might present differently early in the illness.MethodIn a hospital-based retrospective observational study, we assessed 48 probable bvFTD patients, diagnosed according to the FTDC criteria, for the speed with which these criteria were fulfilled, the frequency of individual symptoms and their order of appearance during the illness.ResultsMost of our patients presented with moderate to severe dementia, in spite of having relatively short onset to diagnosis times. Patients on average took 1.4 years from onset to meet the FTDC criteria, with 90% of them presenting with four or more symptoms at diagnosis. Disinhibition was the commonest symptom and the first symptom in most patients.ConclusionWith most patients presenting with advanced and florid disease, the FTDC criteria have little additional impact in early identification of bvFTD in India. Modifying the criteria further could allow detection of Indian patients early enough for their inclusion in future clinical trials.
Introduction:The COVID-19 pandemic has had an unprecedented impact on students currently preparing to apply for medical school, including lost work experience opportunities and reduced support from schools. This study evaluated an annual widening participation course aimed at supporting Year 12 students local to Chelsea and Westminster Hospital NHS Foundation Trust, which was adapted into an online format in response to these challenges.Methods: Participants completed application forms, pre-course, post-course and daily evaluation questionnaires. Participants' pre-and post-course self-reported preparedness scores were analysed using a two-tailed paired t-test. Thematic analysis was performed on all free-text responses.Results: In the pre-course questionnaire (n=48), participants reported difficulties with applications due to the COVID-19 pandemic, predominantly through lost work experience and a lack of support from schools. In the postcourse questionnaire (n=42), participants gained an understanding of medical school interviews, the application process and insights from doctors. Interactive Q&A sessions and practice interviews were found to be particularly valuable, however some participants were unable to partake due to factors such as poor internet connection.Paired responses from participants completing both pre-and post-course questionnaires (n=40) demonstrated a statistically significant increase in preparedness in all areas assessed. Discussion: With a need for alternatives to clinical work experience and school support with applications, this virtual programme is an effective example of how widening participation activities can be sustained in the current climate and continued in the future. However, inadequate internet access can pose a barrier to participation and ways
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