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G. N. Narayana Reddy

Abstract

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Keywords

Community Mental Health, Family Therapy, Rehabilitation, Satellite Clinics, Self-help Groups, Mental Health Education

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G. N. Narayana Reddy

Abstract

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G. N. Narayana Reddy , G. K. Prusty , V. K. Srivastava , S. K. Shankar

Abstract

One hundred histologically confirmed intracranial neoplastic lesions in children under twelve has been analysed retrospectively. They constitute 13.4 % of all intracranial neoplastic lesions operated in this Institute from 1975 to 1980. The data is generally consistent with other reported large series. The maximum age incidence is between 5 and 12 years. Gliomas are the commonest tumour. The high grade gliomas tend to occur more frequently during the first quinquennium of life. Certain unusual presentations like fever, focal seizures in posterior fossa lesions and limb ataxia in supratentorial tumours have been emphasized. The mortality in relation to clinical presentation is discussed.

Keywords

Paediatric Neoplasia, Tumours of Brain

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V. K. Jain , E. Ramakrishna , Thimmappa Hegde , A. K. Reddy , B. S. Das , G. N. Narayana Reddy

Abstract

Three hundred and fifty five cases of primary Subarachnoid Haemorrhage (SAH) have been analysed from the point of view of their incidence, clinical presentation and management. These have been divided into three etiological groups - aneurysms, Arteriovenous Malformations (AVM) and 'other SAH', (where a case for SAH was not found). Majority of the patients treated conservatively, were in poor clinical condition. The mortality for operated cases was 22.8 % for aneurysms and 28.6% for AVMs.

Keywords

Subarachnoid Haemorrhage

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A. S. Hegde , A. Kishan , B. S. Das , G. N. Narayana Reddy

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This report reviews the clinical features, operative data and outcome of 32 cases of benign extramedullary foramen magnum tumours. There were 17 meningiomas, 10 schwanomas and 5 neurofibromas. The most frequent initial complaints were neck and occipital pain (46.9%), dysesthesia of one upper limb (21.9%) and one upper limb weakness (12.5%). The average time from initial symptom to diagnosis was 14 months. All the patients had motor weakness at admission and 18 (56.2%) cases were bedridden because of gross motor weakness. Contrast myelography was positive in all cases except one. Twenty five cases (78.1%) had good recovery and returned to normal work without significant disability. On follow-up tumour recurrence occurred in 4 cases (12.5%). The over-all mortality was 15.6%. The mortality rate appears to be higher in patients with pre-operative respiratory dysfunction and in those with tumour recurrence. The importance of early diagnosis and elective post-operative ventilation especially in patients with pre-operative respiratory dysfunction is emphasised.

Keywords

Foramen Magnum Tumour, Meningioma, Schwannoma, Respiratory Dysfunction, Extramedullary Tumour, Benign

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G. N. Narayana Reddy , S. M. Channabasavanna , M. Gourie-devi , B. S. Das , G. G. Prabhu , I. A. Shariff , V. G. Kaliaperumal , K. Reddamma

Abstract

With the object of providing mental health services in rural areas by involving the community in organising the services, four taluk headquarters were selected at a distance ranging from 50 to 115 km from NIMHANS. Satellite clinics, at Kanakapura (50 km), Maddur (85 km), Madhugiri (115 km) and Gauribidanur (85 km) were started in 1981. The community involvement helped in creating better awareness about mental illness. Epileptic patients predominated in all the four places. Under the existing circumstances and poor resources available, the professionals can effectively provide services to the neglected population of the rural areas by starting extension services as one of the innovative approaches.

Keywords

Satellite Clinics, Community Involvement

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G. N. Narayana Reddy , S. M. Channabasavanna , R. Srinivasa Murthy

Abstract

The National Mental Health Programme (NMHP) for India was the result of efforts to develop non-institutional models of mental health care. The NMHP envisages integration of mental health care with general health care and welfare activities. Since 1982, a number of steps to involve the professionals, health planners and strengthen the manpower needed have been undertaken. A result of all these efforts is its implementation in about 10 States / Union territories and financial support for the programme in the Seventh Five Year Plan.

Keywords

Primary Health Care, Community Mental Health, NMHP

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C. R. Mukundan , G. N. Narayana Reddy , A. S. Hegde , Jayanthi Shankar , V. G. Kaliaperumal

Abstract

A prospective study of 42 patients with head trauma was conducted with the aim of determining the clinical recovery pattern and its relationship with the recovery of neuropsychological functions. Clinical evaluation was carried out at admission, fifteen days, one month, three months, and one year after the trauma. Neuropsychological assessment was made during the first month, third month, and at the one year follow up. Functions assessed were attentional processes, mental arithmetics, psychomotor functions, ideational fluency, visuospatial perception, and verbal and visual learning and memory functions. Results showed that maximum rate of clinical recovery was evident in the first month after the trauma, whereas neuropsychological deficits persisted. Significant recovery of ideational fluency, psychomotor functions, and verbal learning and memory functions occurred by the third month. Modality specific attentional deficits, impairment of visual learning and mental arithmetics were present in the third month assessment, and these deficits continued to persist even in the one year assessment. The findings are indicative of a discrepancy in the recovery rate of right and left hemisphere functions, with the right hemisphere functions showing slow or poor recovery.

Keywords

Head Trauma, Neuropsychological Deficits, Recovery, Right Hemisphere Functions

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G. N. Narayana Reddy , R. Srinivasa Murthy , M. K. Issac , C. R. Chandrasekhar , S. Moily

Abstract

National Mental Health Programme aims to provide mental health care through primary health care personnel. This type of care becomes accessible and acceptable to people. NIMHANS has been organising short term training programmes for PHC personnel since 1982. Follow up field visits were carried our in 1983 and in 1985 to review the mental health care activities of the trained personnel. At follow up health care work was not considered to be an additional burden and trained personnel were providing care to the mentally ill. A few constraints and difficulties regarding regular drug supply, records, monitoring and administrative support were identified.

Keywords

National Mental Health Programme, Community Mental Health, Primary Health Centers

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G. N. Narayana Reddy , M. G. Ramu , B. S. Ventkataram

Abstract

According to Indian thoughts, manas (mind) is one of the major operational concepts in the process of learning and the cause of bandha (entanglement/attachement). Manas has dimension which is anu (beyond atom in its minutest aspect), and is capable of remaining atindriya (beyond sensory perception). An attempt has been made to focus on various aspects like concept of atma, evolution and constituents of man, location of manas, dimension and qualities of manas and process of Jnanotpatti etc.

Keywords

Manas, Atma, Evolution, Constituents of Man, Jnanotpatti, Psyche

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G. N. Narayana Reddy , K. S. Narayana Swamy , D. K. Subbakrishna

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An attempt to assess the current status of manpower availability in the field of clinical neurosciences has been done with the help of a proforma. Information obtained regarding neurosciences manpower, clinical facilities and teaching programmes are compiled. This data is hoped to assist in future planning to develop these specialities.

Keywords

Neurosciences Facilities, Neurosciences Manpower

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G. Gururaj , G. N. Narayana Reddy , D. K. Subbakrishna

Abstract

With a view to develop a model for providing services to mental and neurologically ill patients in rural areas, neuro psychiatric extension services were started in 5 centres in Karnataka. An analysis of 667 patients profiles from these centres for the year 1986 revealed that children and adolescents were the major beneficiaries. Patients were attending these centres from within a radius of 20 km in high numbers. Duration of illness was varying, highest being less than 12 months. Epilepsy, neurotic disorders, mental retardation and psychosis were the major diagnostic categories. About 8.9% of cases were referred by local general practitioners to the centre and about 18% of cases were referred to NIMHANS for detailed procedures. Continuity of care and long term follow-up are highly essential for improving health status of patients attending these centres.

Keywords

Extension Services, Satellite Clinics, Utilisation Pattern

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G. K. Prusty , G. N. Narayana Reddy

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In a study of 15 patients with closed severe head injury to correlate the changes in serum osmolality in relation to reduction of ICP and mannitol dosage, it was found that mannitol given at a dose of 0.4g/kg body weight was as effective as 0.8g/kg body weight in maintaining the desired ICP and serum osmolality upto 5h.

Keywords

Mannitol, Head Injury, Intracranial Pressure

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N. K. Venkataramana , P. Satishchandra , A. S. Hegde , G. N. Narayana Reddy

Abstract

Brainstem auditory evoked responses (BAER) are excellent non-invasive, sensitive diagnostic tools in identifying brainstem abnormalities in infants where clinical examination is difficult and/or may not be rewarding. The technique is simple, does not require the co-operation of the child and can be repeated without difficulty. The normative data of individual waves and interwave latencies of BAER in Indian infants are presented.

Keywords

Brainstem Auditory Responses, Infancy, Normative Data

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E. Ramakrishna , S. K. Shankar , V. K. Jain , T. Hegde , B. S. Das , G. N. Narayana Reddy , Sarala Das

Abstract

Subarachnoid haemorrhage and aneurysms are believed to be rare in India. A review of the Indian literature reveals no large-scale autopsy studies of subarachnoid haemorrhage. The authors have made a retrospective analysis of 1538 consentive cranial autopsies done over a period of 7 years. Macroscopic subarachnoid haemorrhage was identified in 158 (10%) cases. Among these ruptured aneurysms were seen in 33 (21%), arteriovenous malformations in 10 (6%), intracerebral haemotoma in 73 (46%) and cortical venous thrombosis in 8.2%. No cause was found for the subarachnoid haemorrhage in 9(5.5%) despite a detailed pathological study.

Keywords

Subarachnoid Haemorrhage, Aneurysm, Intracerebral Haematoma, Cortical Venous Thrombosis, Autopsy

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G. Gururaj , G. N. Narayana Reddy , I. A. Shariff , D. K. Subbakrishna

Abstract

Epilepsy has been recognised as a major neurological public health problem through several epidemiological studies. The present report aims at understanding the profile and characteristics of persons with epilepsy in rural areas. Information from 1292 first contact epilepsy patient was collected from five extension service centres of NIMHANS in a prospective manner. The age and sex distribution revealed that epilepsy was predominant in the age group of <20 years and among males. The catchment area distribution indicated that people within a radius of <10 kms formed 52% of the total subjects. The duration of illness was >12 months in 45.7% of cases. Generalised convulsive epilepsy constituted 50% of diagnostic categories. The first contact drop out rate was 22.1% within this group. The present study discusses the importance of various socio-demographic and service utilisation factors in the care for epilepsy patients in rural areas.

Keywords

Epilepsy, Epidemiology, Service Utilisation, Socio Demographic Factors, Descriptive Study

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V. G. Kaliaperumal , A. R. Khalilian , G. N. Narayana Reddy , B. S. Das

Abstract

This study reports classification of prognostic factors related to out-come after head injury as classified by the structural equation model. One hundred and eighty five patients constituted the study, out of which 51 patients died in the hospital, 11 were vegetative at discharge, 91 were discharged with deficit and 32 made good recovery. The outcome was assessed clinically and socially. Twenty predictors were employed. The structural equation model with two outcome variables and 19 predictors identified four latent variables. Pre-traumatic factor, traumatic factor, post-traumatic factor, and complications during hospitalization influenced the outcome from head injury. To obtain good recovery, all these factors have be taken into account to adopt a suitable strategy to manage patients with head injury.

Keywords

Head Injury, Outcome, Structural Equations Models

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