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1.
Consultation, comprehensive assessment and workflow:
All clients consulting us have a comprehensive
world-class neurological, psychological and psychiatric
assessment, performed by our well-honed team of
multidisciplinary professionals. A copy of this
record is given to the client as a confidential
record for future use. The Director and Senior
Consultant Dr. E. S. Krishnamoorthy examines all
clients personally and arrives at a working diagnosis.
Investigations are discussed and arranged in a
systematic manner, and when external services
are required (for example brain scans), we liaise
with the best service providers in doing so. The
range of assessments and investigations are integrated
and discussed by the chief consultant with the
client and family (when appropriate) and a treatment
program is arrived at with due diligence and care.
The treatment program includes the judicious use
of medication to relieve problem symptoms. The
combinations of neurological and psychotropic
drugs we use have the advantage of fewer side
effects while providing excellent symptom relief.
The chief consultant through a process of periodic
case conferences and reviews closely supervises
the treatment by the therapy team, and progress
is carefully monitored.
2. Physical Assessment
and Therapy:
We offer a range of physical assessments and therapies.
A comprehensive assessment of muscle strength
and function is performed in all individuals with
focal neurological disorders, occupational use
of the affected limbs/ other body parts studied
in detail, gait assessments performed in clients
with difficulties in walking, and neuromuscular
assessments carried out in clients with weakness
or pain related disorders. Children consulting
us have a detailed neuro-developmental assessment
of motor function. Children, adolescents and young
adults are assessed for subtle developmental disability
which is often a predictor of academic or sports
performance.
A range of therapies are provided using physical
and occupational interventions to improve mobility
and limb function. The therapy program is customized
for each individual depending on their needs.
We use a range of equipment either solely or in
combination: transcutaneous nerve stimulation,
interferential therapy, short wave diathermy,
ultrasound therapy, massage and other interventions
for pain, abnormal sensations and weakness; gait
training for individuals with difficulty in walking;
exercises to build muscle strength in affected
individuals and so on. The desired endpoint of
all therapy is to relieve troublesome symptoms,
reduce disability and improve quality of life.
3. Psychological Assessment and Therapy:
A healthy mind is often the best predictor of
a healthy body. We do therefore routinely evaluate
the psychological status including the social
support and family support systems of each client.
The evaluation is for anxiety, depression and
a range of common emotional disorders. It also
includes standard personality profiling enabling
us to understand the client's expectations and
patterns of reaction to stress. The interventions
we plan are based on the results of the assessment
thus carried out.
Our range of psychological therapies is wide and
includes counseling for emotional and stress related
disorders; brief forms of psychodynamic therapy
for individuals with psychological stress; cognitive
behavior therapy for individuals with anxiety,
depression, obsessive compulsive disorder; cognitive
analytical therapy models for impulsivity, anger,
aggression and personality disorders; cognitive
retraining for disorders co-morbid to stroke,
parkinsonism, epilepsy and other Neuropsychiatric
illness; behavior therapy models for children
and young adults with intellect, memory and behavior
dysfunction; progressive muscular relaxation exercises
for emotional stress; marital and family therapy
for interactional, communication and sexual issues;
and social skills training for those with low
self confidence and poor communication and presentation
skills.
4. Child Neurodevelopment Clinic :
Disorders of brain and nervous system development
are among the most disabling disorders that affect
young children and their families. These include
several forms of mental retardation and learning
disability, cerebral palsy, dyslexia, autism,
attention deficit and hyperactivity disorder and
a spectrum of emotional and behavioral disorders
including those due to family and school stress.
Children with these disorders need the care and
attention of a multi-disciplinary team such as
ours, including neurologists, neuropsychiatrists,
physical, occupational and speech therapists,
psychologists with special training and interest
in education and development, social workers and
nurses. We offer comprehensive care and therapy
to children with these disorders and their families.
We liaise with schools (both mainstream and special
schools), engage in advocacy for these children
and consistently work towards encouraging and
enhancing their development. We also liaise with
the family and work towards building a cohesive
family environment in order to ensure for these
children the best possible outcome.
5. Elderly Neurological and Neuropsychiatric Services
:
Neurodegenerative disorders such as stroke, dementia,
Parkinson's disease, confusional states, peripheral
neuropathy and depression head the list of disabling
conditions that increasingly affect people as
they age. We offer a comprehensive and multidisciplinary
service for the elderly. We begin with a comprehensive
assessment by members of our team during which
we assess the illness, quantify the level and
range of disability and support available, is
carried out. Based on these results we build for
each individual a treatment package that decreases
symptoms, improves physical and psychological
functioning, and provides a better quality of
life. Very often, neuropsychiatric illness in
the elderly impacts on the entire family environment,
as a range of memory, behavior, dependence and
interactional issues are involved. Our team cares
for the family and aims to restore normal family
functioning. A home care service for the elderly
is available (see below).
6. Home Care Services:
This service accepts referrals from multiple sources;
doctors, community leaders, relatives of clients,
and the disabled elderly themselves. The first
step is a home visit and assessment by our multidisciplinary
team, arranged by appointment. During this visit
the illness is assessed in detail, the level of
disability quantified, and the range of assessments
and services that will be required are identified.
We offer a customized home based treatment program
for people with multiple disabilities and elderly
with mobility issues. The program includes a combination
of physical and occupational therapies as well
as cognitive, behavioral and motivational therapies.
We also work with the family to decrease caregiver
burden and stress and enhance services and quality
of care for the client.
7. Crisis Management Services for people with
emotional disorders
From time to time people with emotional disorders
enter a crisis situation that makes it difficult
for friends and families to help. We offer practical
advice and support including emergency home visits
by a member of our team to help defuse the crisis
situation. Requests for crisis intervention (in
those patients who have not previously consulted
us) should however be done in person, by a relative
or friend, who comes personally to the clinic
for a discussion. This is important as we need
to assess and take stock of the crisis and the
supports available before embarking on an intervention.
Clients may however attend the emergency rooms
of St. Isabel Hospital at anytime and make a request
to see Dr. ES Krishnamoorthy.
8. A comprehensive
mobile neuro-diagnostic laboratory including
EEG, EMG and Nerve Conduction studies, performed
in our clinic, in hospitals when patient is admitted
and at home when required using modern portable
digital equipment.
Innovative
Programs (Beyond conventional Neuropsychiatry)
9. Learning
and Aptitude Assessment and Career Counseling
Adolescents and young adults often find themselves
at the crossroads of academic and career development.
Not being sure about one's future direction
is the greatest source of stress for most young
people and results in neurological, psychological
and sometimes psychiatric symptoms. We use a
scientific approach to assess in each individual's
brain dominance, lobar functions, intellectual
ability, inherent strengths and weaknesses,
personality profiles, aptitudes, aspirations
and expectations and use this information to
provide a comprehensive and customized template,
helping the person arrive at a rational and
informed choice.
10.
Stress Management Training for the busy professional
The busy professional today is inundated with
multiple tasks that leave little time or opportunity
for relaxation. The demands of the workplace
combined with those of the family, often cause
considerable physical and emotional stress which
can manifest with neurological and psychological
symptoms. We offer a comprehensive stress management
training program that tackles effectively both
the physical and emotional aspects of stress.
The program includes progressive muscle relaxation
exercises, cognitive reorientation and muscle
and nerve stimulation techniques that distress
the individual and help achieve symptom amelioration.
One unique stress
related disorder is observed by us as a new
phenomenon that has developed over the last
decade in the computer professional. This is
a unique pain syndrome that affects the muscles
of the neck, shoulder, arm, forearm and wrist.
Severe muscle pain and spasm are the hallmarks
of this syndrome, so much so that a slipped
disc is often suspected. However, neither does
that clinical examination show a focal neurological
deficit, nor do scans reveal a slipped disc.
This "computer syndrome" is due to
repetitive stress injury to the soft tissues
(muscles, ligaments and nerves) from long hours
spent on the computer in less than ideal postures
and environments (poor seating, lighting, absence
of protective screens, poor upper limb support
while working, crowded workspaces etc.). Additional
symptoms that affect individuals with this syndrome
are restlessness, inability to concentrate,
worry, memory problems, mood swings, breathlessness,
palpitation, chest pain, nausea, stomach churning
etc. all of which are indicators of emotional
stress.
We have a comprehensive
program of management for this "computer
syndrome" that addresses both physical
and emotional stress and relieves muscle pain
and spasm.
11. Stress
Management Course for Professionals, Organizations
and Industry Leaders
Our Director and Senior Consultant Prof. ES
Krishnamoorthy is widely acknowledged as a leader
in this field and well known for his communication
and motivational skills. The team he leads has
worked with several large and reputed organizations
including academic institutions and the industry.
Our group customizes stress management workshops
for each organization we work with. In general
workshops include lectures, interactive discussions
and role play as effective means of communicating
information about making an environment stress
free. We develop through these workshops a knowledge
base on
- Physical, cognitive and emotional symptoms
of stress
- Prevention of stress
- Cognitive and behavioral management skills
- Organizational philosophy that ensures a stress
free environment
- Time management skills
- Multi-tasking skills
- Leadership skills
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