Research and collaboration at VHS

(Continued from last fortnight)

Our Series on Prof. Krishnamoorthy Srinivas, his Life and his Work – V.

Early Research

A PL480 grant toward Rehabilitation Measures for Developmental Disabilities in Children was awarded to Dr. Srinivas at Durgabai Deshmukh Hospital and Andhra Mahila Sabha, a charitable registered NGO organisation. This institution had started with an initial focus on women’s health and empowerment and child health. Dr. Srinivas was already associated with the centre to offer his team’s expertise in the area of developmental disabilities.

The PL480 funding was a welcome incentive to streamline the programme of developmental disability rehabilitation. The assessment and progress on follow up were recorded with meticulous care and provided invaluable qualitative and quantitative data for clinical research and on weighing the possibilities of graded progress these children could achieve with rehabilitation as against no intervention. Dr. Mani, was the orthopaedician of the team. Antenatal care and early detection of developmental disabilities was encouraged. Twice a week our Neurology team, headed by Srinivas would go for two hours in the afternoon, to Durgabai Deshmukh hospital (Andhra Mahila Sabha), close to VHS, to assess the lined up cases. Srinivas himself or one of us would do the medical/neurological assessment. Palekar, our occupational therapist became an expert at neurodevelopmental assessment, and could pick up the subtlest deformity and analyse it, so that therapy followed the correct scientific methods. Mohan was our physiotherapist with priceless skill in his field. Jalaludeen was the special educator of our group. He had built a reputation of effecting significant improvement in the behaviour and mental performance of a large number of mentally challenged, ADHD and ASD children of our departments. Children who needed continued therapy were advised to follow up in our department at VHS. Creating awareness, counseling the parents and siblings, including genetic counseling, were part of the management routine.

Scaling Up

Over a period of four decades, the department of Neurology at VHS, grew in strength slowly but steadily. Eventually housed in over 5000 square feet of comprehensive space, assiduously refurbished, following World Health Organisation recommendations, and adopting a multidisciplinary approach.

The staff include consultants in Neurology, General Medicine and Neuro­behaviour, junior doctors trainees who spend a period of internship in the department, clinical psychologist, medical and psychiatric social workers, physiotherapists, special educators, dietician and speech therapist (the last on call.)

Prof. Srinivas receives the Meritorious Certificate Award for Distinguished Service in Community Neurology from VHS President Prof. M.S. Swaminathan and Mr. V.K. Subba Raj, Health Secretary, Govt. of Tamil Nadu.

A formal Corporate Social Responsibility (CSR) initiative launched by the projects team brought in greater awareness among industrialists to contribute towards healthcare for the have-nots. Many donors were enthused into supporting newer avenues of development, with a keen sense of participation. The new entrants in this CSR scheme added to the department coffers, allowing scope for further expansion. TINS-VHS became a formal amalgamation of several efforts.

The K. Gopalakrishna department of Neurology, supported by the UCAL group is the flagship clinical department that is focused towards providing comprehensive clinical care for the neurological patient at subsidised rates, covering over 4,000 patients a year.

The T.S. Srinivasan Centre for Clinical Neurosciences, supported by the TVS Motor Co. Ltd. and Sundaram Clayton is the flagship academic department with international links and projects focused on providing world class education. The centre has more recently adopted a health policy agenda with national and international links:

The M.V. Arunachalam Centre for Information and Education in Neuroscience – for education, counselling and support system for patients with neurological diseases and their families.

The Deepa Krishnan Comprehensive Child Neuro­development Unit.

The Hindu Neurological Database Centre and the G. Narasimhan Library.

The Vinothan Comprehensive Epilepsy Care Unit.

Sundaram Finance Neuro­rehabilitation Suite.

Madhuram Narayanan Vascular and Autonomic Function Unit and,

Lasersoft Ltd supported Technology Partnerships.

Clinical Research

As an academically oriented department, our clinical work with detailed case records spilt over spontaneously to clinical research questions.

The Stroke project, an ongoing project of the department over several years, had an early impact in the community health aspects with improved awareness of the risk factors. The department has published some significant hospital-based qualitative and quantitative data on stroke.

Alcoholism, binge drinking and young stroke were other areas of research focus for Srinivas and his team, which sparked off several hospital-based and community based studies.

Epilepsy was another large area of clinical and research interest. Drug compliance and regular follow up improved gradually with epilepsy counseling of patient and family. With the establishment of the dedicated epilepsy cell of TINS, individual psychosocial comorbidities of epilepsy received more attention. At community level, TINS battled against the stigma attached to the disorder.

Dr. N.D. Ramanujam is the clinical consultant from TINS to the Gaitonde AIDS centre of VHS and has generated interesting data towards publication, regarding the neurological complications of AIDS.
Collaboration with University College, London.

(To be concluded next fortnight)

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