Dementia

Dementia is not a specific disease. Instead, dementia describes a group of symptoms effecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer’s disease is the most common cause of a progressive dementia. Dementia is progressive, which means the symptoms gradually get worse over time. The pace of worsening of symptoms may differ from one individual to another.

Memory loss generally occurs in dementia. However, memory loss alone doesn’t mean you have dementia. Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language, and the inability to perform some daily activities such as paying bills or becoming lost driving. Dementia can make the sufferer confused and unable to remember people and names. Changes in personality and social behavior are also common. 

 

Dementia symptoms vary depending on the cause, but common signs and symptoms include:

  • Orientation: losing track of time, day or date, or confusion about where the person is.  
  • Memory loss: difficulty in recalling everyday events, or recent activities.
  • Complex activities:  problems in concentrating, planning or organizing make it difficult to take decisions, solve everyday problems or remember a sequence of tasks.
  • Communication: difficulties in language occur with inability to name objects or finding the right word, at times irrelevant talking might also be present.
  • Visuo-spatial skills – problems judging distances (example on stairs) and seeing objects in three dimensions

 

Early signs of Dementia

Changes in mood, short-term memory loss, difficulty in finding the right words, loss of interest in hobbies or interests, spending time alone, difficulty doing normal, everyday tasks, confusion, and repetition of same questions are potential warning signs of dementia.

 

If you notice any of the above signs of dementia in someone elderly you know; get consultation from a Neuropsychiatrist as soon as you can. Timely intervention can slow down the degenerative process and avoid many further complications. 

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Schizophrenia

Schizophrenia is a severe and disabling psychiatric disorder. People with this disorder might behave in unusual manner. They may hear voices other people don’t hear. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can terrify people with the illness and make them withdrawn or aggressive. They might be seen talking to themselves and may not be able to carry out their normal, routine activities. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking. Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help.

Signs & Symptoms

 

 

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The fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms.

Positive symptoms

Positive symptoms are psychotic behaviors not seen in healthy people. People with positive symptoms often “lose touch” with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following:

§  Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. “Voices” are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.

§  Delusions are false beliefs that are not part of the person’s culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that someone can control their behavior with magnetic waves. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called “delusions of persecution.”

§  Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called “disorganized thinking.” This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called “thought blocking.” This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or “neologisms.”

§  Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available.

Negative symptoms

Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:

§  a person’s face does not move or he or she talks in a dull or monotonous voice

§  person may feel lack of lack of pleasure in everyday life

§  lack of ability to begin and sustain planned activities

§  speaking little, even when forced to interact.

The prevalence of schizophrenia in India is about three per 1,000 individuals. It is most often diagnosed between the ages of 15-35 and men and women are equally affected. Treatment helps relieve many symptoms of schizophrenia, but most people who have the disorder cope with symptoms throughout their lives. However, many people with schizophrenia can lead rewarding and meaningful lives in their communities. Treatment of this disorder includes medication as well as other psycho-social treatments. Family counselling is also an important part of treatment. 

 

Helping children with learning disabilities

Dyslexics’ performance varies from day to day. On some days, reading may come fairly easily. However, another day, they may be barely able to write their own name. This inconsistency is extremely confusing not only to the dyslexic, but also to others in his environment.as a result, knowingly or unknowingly, parents, teachers and peers often end up making comments or behaving in a manner which can only exacerbate emotional problems in these children. However awareness about certain steps and behaviors can ensure that such behavior is kept to the minimum, so as to foster positive well-being and feelings of acceptance among the children.

 

  • Foster a good relationship with the child. (This will make the child try harder.)
  • Refrain from embarrassing the child or disciplining the child in front of his or her peers. (Since the child struggles with peer relationships this is crucial. This will distance the child from you, and increase the teasing that the child must endure)
  • Never discipline impulsive behavior, but offer those students ways of coping with their impulsive urges.
  • Always discipline non-compliant behavior! This is when the child willfully disobeys rules and limits. (Using positive reinforcement helps, but punishment on the basis of consequences is also effective.)
  • Never punish by withholding sports or other school-related activities. The child needs to stay active. A better punishment option is the restriction of TV viewing or computer time. Extra chores are another good discipline tool.
  • Attempt to restore the pupil’s confidence in himself.  Usually the child is referred to as a failure.  Now is an opportunity for him to succeed.  Let him know this.
  • Beware of the possibility of the pupil using avoidance techniques.  Frequently pupils find ways of “ by passing” certain areas in order to achieve the aim.  E.g., illegible handwriting so that their errors are not detected.
  • Be constructively critical.  It is preferable to give reasons and ways of overcoming them rather than negative reinforcement.
  • When marking work, be realistic but not demoralizing.  If the teacher marks every error it could be very depressing for the pupil.  Content is important and a comment regarding its standard is psychologically preferable to numerous crosses.
  • Red pens marking are discouraging.  All too frequently red marks means errors and are demoralizing.  Florescent markers are more suitable and they highlight the errors unobtrusively, in case it is possible to use them.
  • Encourage his talents by highlighting his strengths in classroom situations.  It helps to develop self-esteem.
  • Due to lack of self-confidence some children do not opt out for non-academic assignments. Asking them to carry out small tasks such as cleaning blackboard, collecting or distributing notebooks can help enhance their self-worth.
  • Since the child is not performing to the expected level in academics, it becomes a tendency to put in more and more time in academics. Participation in extra-curricular activities, or learning new sports, arts and crafts, is usually discouraged. On the contrary, this precisely should be encouraged. This leads to not only enhancing the child’s self-esteem, feelings of being successful in one area can lead to better performance in academics too.
  • Both teachers and parents need to offer consistent, ongoing encouragement and support. However, one rarely hears about this very important way to help youngsters. Encouragement involves at least four elements. First, listening to children’s feelings. Anxiety, anger and depression are daily companions for dyslexics. However, their language problems often make it difficult for them to express their feelings. Therefore, adults must help them learn to talk about their feelings. The effort, not just “the product”. For the child, grades should be less important than progress.
  • When confronting unacceptable behavior, adults must not inadvertently discourage the dyslexic child. Words such as “lazy” or “incorrigible” can seriously damage the child’s self–image.
  • Finally, it is important to help students set realistic goals for themselves. Most dyslexic students set perfectionistic and unattainable goals. By helping the child set an attainable goal, teachers can change the cycle of failure.
  • Even more important, the child needs to recognize and rejoice in his or her successes. To do so, he or she needs to achieve success in some area of life. In some cases, the dyslexic’s strengths are obvious, and many dyslexics’ self–esteem has been salvaged by prowess in athletics, art, or mechanics. However, the dyslexic’s strengths are often more subtle and less obvious. Parents and teachers need to find ways to relate the child’s interests to the demands of real life.
  • Providing opportunities to the child to deal witht heir own pain by reaching out to others can also be useful. These experiences help dyslexics feel more positive about themselves and deal more effectively with their pain and frustration. Many opportunities exist in our schools. One important area is peer tutoring. If dyslexic students do well in math or science, they can be asked to tutor a classmate who is struggling. Perhaps that student can reciprocate as a reader for the dyslexic student. Tutoring younger children, especially other dyslexics, can be a positive experience for everyone involved.
  • Caring adults must understand the cognitive and affective problems caused by dyslexia. Then they must design strategies that will help the dyslexic, like every other child, to find joy and success in academics and personal relationships.

Happy New Year

Happy New Year

May this year comes along with a lot of happiness, joy, peace, success, prosperity for everyone.
HAPPY NEW YEAR

Understanding Depression

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A common question most mental health professionals encounter is “How do we differentiate between Depression as a disease and Depression as a feeling?” Probably a reasonable explanation can be to say that feeling depressed is a healthy reaction to an external life event or situation, whereas ‘depression’ is when these feelings are out of proportion to external life events and/or continue longer than a healthy recovery period. Usually the ‘depressed’ feelings are far stronger with depression than we experience when ‘depression’ is not present.

Depression is a relentless, pervasive sense of despair; a paralysing condition characterised by a lack of interest in life and feelings of utter uselessness. If depression just meant “the blues” it wouldn’t have an official definition listed by the World Health Organisation. It is not something “you can come out of on your own if you have a strong will power”, or “think positive and you will come out of it”, “it is nothing, but weakness of spirit”. If it was just a case of depressed people “pulling themselves together” and getting on with life, doctors would not be required to help hordes of people who are unable to cope with life.

People suffering depression are battling an illness. It is not their fault that they have an illness. They have not failed. They are not lesser people and should not be seen as such.

However, due to the very nature of depressive conditions, that is precisely the way they will see themselves.

The danger signs of depression:

§  Two weeks of abnormal depressed mood.

§  Loss of interest and decreased energy.

§  Loss of confidence.

§  Excessive guilt.

§  Recurrent thoughts of death.

§  Poor concentration.

§  Agitation or retardation.

§  Sleep Disturbance

§  Change in appetite.

 

Research suggests that ongoing stressors, such as financial worries, a stressful job, redundancy or fear of unemployment are more likely to trigger a depressive episode in vulnerable people than one-off events in life. Long-term or serious illnesses such as diabetes or cancer can also lead to a bout of depression.

A personal risk factor that can be an important influence in whether or not you develop depression is your personality. Some people tend to always look on the darker side of things. According to beyondblue, personality traits that may put you at higher risk of developing depression include:

  • perfectionism
  • sensitive to personal criticism
  • unassertive
  • self-critical
  • shy, socially anxious
  • low self-esteem.

 

Depression can also run in families and some people may be at increased genetic risk of the condition. However, researchers have yet to find a simple genetic explanation, and this doesn’t mean that you will automatically develop depression if a parent or a close relative has it. Life events and your personal risk factors are as likely to determine your chance of developing depression. Other biological factors for depression include illnesses, ageing and gender.

 

You would not think twice about seeking expert help for any physical medical condition. The same rules must apply for depression or any other mental health problem. So if you can recognize the signs of depression in someone you know or yourself, get help today!

 
 
 
 
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Managing Learning Disabilities

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Dyslexia is caused by biological factors not emotional or family problems. The majority of dyslexic preschoolers are happy and well adjusted. Their emotional problems begin to develop when academic inputs do not match their learning style. Over the years, the frustration increases as classmates surpass the dyslexic student in reading skills. The frustration of children with dyslexia often centers on their inability to meet expectations. Their parents and teachers see a bright, enthusiastic child who is not learning to read and write. Time and again, dyslexics and their parents hear, “He’s such a bright child; if only he would try harder.” Ironically, no one knows exactly how hard the dyslexic is trying.

 

The pain of failing to meet other people’s expectations is surpassed only by dyslexics’ inability to achieve their goals. This is particularly true of those who develop expectations in order to deal with their anxiety. They grow up believing that it is “terrible” to make a mistake. However, their learning disability, almost by definition means that these children will make many “careless” or “stupid” mistakes. This is extremely frustrating to them, as it makes them feel chronically inadequate.

 

The dyslexic frequently has problems with social relationships. These can be traced to causes:

  • Dyslexic children may be physically and socially immature in comparison to their peers. This can lead to a poor self-image and less peer acceptance.
  • Dyslexics’ social immaturity may make them awkward in social situations.
  • Many dyslexics have difficulty reading social cues. They may be oblivious to the amount of personal distance necessary in social interactions or insensitive to other people’s body language.
  • Dyslexia often affects oral language functioning. Affected persons may have trouble finding the right words, may stammer, or may pause before answering direct questions. This puts them at a disadvantage as they enter adolescence, when language becomes more central to their relationships with peers.

 

Dyslexics’ performance varies from day to day. On some days, reading may come fairly easily. However, another day, they may be barely able to write their own name. This inconsistency is extremely confusing not only to the dyslexic, but also to others in his environment as a result, knowingly or unknowingly, parents, teachers and peers often end up making comments or behaving in a manner which can only exacerbate emotional problems in these children. However awareness about certain steps and behaviors can ensure that such behavior is kept to the minimum, so as to foster positive well-being and feelings of acceptance among the children.

The most common management method of learning disabilities is a combination of special education and occupational therapy inputs. The child is taught learning skills by building on the child’s abilities and strengths while correcting and compensating for disabilities and weaknesses. Occupational therapy inputs target motor functions and help children with their writing skills. Psychological therapies such as family counseling and individual therapies with children are helpful in order to enhance their self-esteem and overall emotional and social functioning.

 

Contact World Brain Center for Multimodal management of Learning Disability and get management tips in the areas of Child Psychology, Special Education, and Occupational Therapy.

What is ADHD?

Some children can never sit still, or do not seem to listen when called. They seem to be “on the go” or “run by a motor”. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined. However, they may have ADD/ADHD. Attention deficit hyperactivity disorder (ADHD) is a disorder that appears in early childhood. You may know it by the name attention deficit disorder, or ADD. ADD/ADHD makes it difficult for people to inhibit their spontaneous responses—responses that can involve everything from movement to speech to attentiveness.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most misunderstood, misdiagnosed and incorrectly managed disorders. It is also one of the most commonly diagnosed child psychiatric disorders. It affects about 5-12% of the children and is more prevalent among boys than girls. ADHD can affect relationships and school performance, thereby leading to self esteem problems. It may contribute to learning, social and emotional difficulties as well as career problems.

Symptoms begin before age 7 years and can cause serious difficulties in home, school or work life. ADHD can be managed through behavioral or medical interventions or a combination of the two. It is most commonly diagnosed when children reach school age.

 

Causes of ADHD

The cause of ADHD is not known. Many working theories assume that brain chemistry is out of balance. There seems to be a genetic component to ADHD. Children who have ADHD often have at least one relative who also has it. Similarly, little is known about whether ADHD is related to diet. Foods sometimes linked to ADHD, such as chocolate, sugar and food additives do not cause ADHD; though they might make symptoms worse in people who have the disorder.

Factors that are not causes of ADHD include:

•Poor parenting

•Family problems

•Bad teachers / ineffective schools

•Too much television

•Refined sugar

•Food allergies

•Diet

If required ADHD symptoms can be treated through medicines, which are called stimulants. Behavioral Therapy is designed to help a child curb problematic behaviors. This may involve helping the child learn to organize time and activities. Or it could help a child complete homework. It may also involve helping the child control his or her impulses and responses to emotional stimuli. Educating parents about the disorder and its management is another important part of ADHD treatment. For parents, this may include learning parenting skills to help the child manage his or her behavior. That would involve skills such as giving positive feedback for desirable behaviors, ignoring undesirable behaviors, and giving time-outs when the child’s behavior is out of control. In some cases, the child’s entire family may be involved in this part of the treatment.

Studies show that medication alone and the combination of medicine and behavior therapy worked better than behavioral therapy alone for improving ADHD symptoms. 

 

Look out this space for management tips on ADHD, or contact our team for expert advice to help you with identifying ADHD and its management. 

Adjustment Disorder

 

Adjustment disorder is a short-term condition that occurs when a person is unable to cope with, or adjust to, a particular source of stress, such as a major life change, loss, or event. Because people with adjustment disorders often have symptoms of depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes called “situational depression.” Unlike major depression, however, an adjustment disorder is triggered by an outside stress and generally goes away once the person has adapted to the situation.

The type of stress that can trigger adjustment disorder varies depending on the person, but can include:

  • Ending of a relationship or marriage
  • Losing or changing job
  • Death of a loved one
  • Developing a serious illness (yourself or a loved one)
  • Being a victim of a crime
  • Having an accident
  • Undergoing a major life change (such as getting married, having a baby, or retiring from a job)
  • Living through a disaster, such as a fire, flood, or hurricane

 

A person with adjustment disorder develops emotional and/or behavioural symptoms as a reaction to a stressful event. These symptoms generally begin within three months of the event and rarely last for longer than six months after the event or situation. In an adjustment disorder, the reaction to the stressor is greater than what is typical or expected for the situation or event. In addition, the symptoms may cause problems with a person’s ability to function; for example, the person may be unable to sleep, work, or study.

Adjustment disorder is not the same as post-traumatic stress disorder (PTSD). PTSD generally occurs as a reaction to a life-threatening event and tends to last longer. Adjustment disorder, on the other hand, is short-term, rarely lasting longer than six months.

An adjustment disorder can have a wide variety of symptoms, which may include:

  • Feeling of hopelessness
  • Sadness
  • Frequent crying
  • Anxiety (nervousness)
  • Worry
  • Headaches or stomach aches
  • Palpitations (an unpleasant sensation of irregular or forceful beating of the heart)
  • Withdrawal or isolation from people and social activities
  • Absence from work or school
  • Dangerous or destructive behaviour, such as fighting, reckless driving, and vandalism
  • Changes in appetite, either loss of appetite, or overeating
  • Problems sleeping
  • Feeling tired or without energy
  • Increase in the use of alcohol or other drugs

Symptoms in children and teens tend to be more behavioural in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to experience more emotional symptoms, such as sadness and anxiety.

Adjustment disorder is very common and can affect anyone, regardless of gender, age, race, or lifestyle. Although an adjustment disorder can occur at any age, it is more common at times in life when major transitions occur, such as adolescence, mid-life, and late-life.

Treatment

Medication may be used to help control anxiety symptoms or sleeping problems. Psychotherapy (a type of counselling) is also a common treatment for adjustment disorder. Therapy helps the person understand how the stressor has affected his or her life. It also helps the person develop better coping skills. Support groups can also be helpful by allowing the person to discuss his or her concerns and feelings with people who are coping with the same stress. 

If you have symptoms of adjustment disorder, it is very important that you seek medical care. Major depression may develop if you don’t get treatment. Plus, you may develop a substance abuse problem if you turn to alcohol or drugs to help you cope with stress and anxiety.

Most people with adjustment disorder recover completely. In fact, a person who is treated for adjustment disorder may learn new skills that actually allow him or her to function better than before the symptoms began.

 

There is no known way to prevent adjustment disorder. However, strong family and social support can help a person work through a particularly stressful situation or event. The best prevention is early treatment, which can reduce the severity and duration of symptoms, and teach new coping skills.

 

Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is an anxiety disorder in which the person suffers from repeated thoughts and feels compelled to perform ritualized behavior. These thoughts and behaviors are uncontrollable, thought the person may try to resist or stop them. most people suffering from OCD do realize that their obsessive thoughts and compulsive behaviors are irrational, still they are unable to resist them and break free. Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, the person might check the door twenty times to make sure it is really locked, or repeat some religious phrase in his mind in “the right manner” to make himself/herself satisfied. Some people might have recurrent images which they find disturbing. 
 
The person might try to resist the urge to perform the compulsive behavior. Compulsive or neutralizing behaviors are usually carried out in a stereotypical way or according to the idiosyncratically defined “rules”. Carrying out compulsive or neutralizing behavior leads to temporary anxiety relief or the expectation that had ritualizing not been carried out, anxiety would have increased.  
 
Signs- Obsessive Behavior
¨Fear of being contaminated by germs or dirt or contaminating others.
¨Fear of causing harm to yourself or others.
¨Intrusive sexually explicit or violent thoughts and images.
¨Excessive focus on religious or moral ideas.
¨Fear of losing or not having things you might need.
¨Order and symmetry: the idea that everything must line up “just right.”
¨Superstitions; excessive attention to something considered lucky or unlucky.
 
Signs-Compulsive Behavior
¨Excessive double-checking of things, such as locks, appliances, and switches.
¨Repeatedly checking in on loved ones to make sure they’re safe.
¨Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
¨Spending a lot of time washing or cleaning.
¨Ordering or arranging things “just so.”
¨Praying excessively or engaging in rituals triggered by religious fear.
¨Accumulating “junk” such as old newspapers or empty food containers.
 
Other Symptoms
  • Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
  • Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
  • Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished.
  • Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
  • Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
Treatment for O.C.D.
Most psychiatrists and OCD therapists believe that combining behavior therapy, consisting of exposure and response prevention, and medicines is the most effective approach.
 
 
We at World Brain Center provide treatments involving medicines, behavior therapy (ERP) and family counselling. Watch out this space for more on OCD and it’s treatment, and real-life success stories of people who have managed their OCD with the help of WBC team. 
 

Dr. Neelesh Tiwari – The Founder Of WBC Hospital

World Brain Center

Dr. Neelesh Tiwari

Dr. Neelesh Tiwari the founder of the Hospital to create an institution that provided quality health care and clinical excellence in the field of Psychiatry, Psychology, Neurology, Neurosurgery and Rehabilitation. As the name depicts WBC and RI is one of the rare institute dedicated to all the disorders of the brain.

After doing his post graduation in psychiatry and six months training in neurology from the prestigious King George’s Medical College Lucknow, he has worked as chief after completion of his M.D. in K.G.M.C. Department of Psychiatry. After a successful career he moved to Institute of Human Behavior & Allied Sciences Shahadara, Delhi and Dr.Ram Manohar Lohia Hospital, New Delhi.

During his early career he got an inspiration to start a brain centre stemmed from the untimely and sad death of a patient Mahesh who could not be saved due to his unawareness of whether to see a neurologist / neurosurgeon / psychiatrist which led to marked delay in treatment and ultimately death. He has Published and presented dozens of papers / posters on different Neuro psychiatric problems in many International and National conferences. One of his new modern treatment techniques for a disorder also got published in Australian and New Zealand journal of psychiatry.

At present, he is serving as the Managing Director of World Brain Centre & Research Institute. His has served as personal surgeon to the family of Ex. President of India, to various ministers, member of Parliaments, senior bureaucrats and big business houses to people living below poverty line.

Dr Neelesh Tiwari has also awarded with prestigious Jansanskriti Award from Dr. G.B.G Krishnamurthy, Ex- Chief Election commissioner of India. Dr Neelesh Tiwari is a common face on television talk shows where his opinion regarding various psychiatric problems is held in high esteem. A man of multifaceted talents, he is also involved with various N.G.O’s as helping the poor and needy is a second nature to him.

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