Neurology

We envision Neurology department at NIMS as a vibrant, state of art and highly reputed neurological facility nationally and internationally. Although it will primarily provide world class diagnostic and treatment facilities to patients from all strata of society of Andhra Pradesh, patients from all over the Asia and Middle East and particularly SAARAC countries will also consult us for cost-effective advice and treatment. It will be a renowned university and besides offering post doctoral neurology courses to candidates from Andhra Pradesh to build neurological manpower in the state, it will also attract students from all over the world including western countries for fellowship courses in general neurology, stroke, epilepsy, movement disorders, neuromuscular diseases, critical care neurology and dementia. It will be a center par excellence for clinical research and will undertake long term hospital and community based studies to understand the risk factors and natural history of diseases. It will also be a major center in the development of new drugs by designing and participating in clinical drug trials. All the work done in the institute will find its expression in the prestigious international journals. It will organize international seminars and symposia, where there will be academic interaction and exchange between experts from all over the country and world and thousands of doctors will benefit. In short, it will be a leader in Neurology in the subcontinent.

A multicenter, double-blind, randomized, placebo-controlled, 4 parallel groups, dose-ranging trial evaluating the efficacy and safety of brivaracetam used as adjunctive treatment at doses of 5, 20 and 50 mg/day in b.i.d. administration (oral tablets of 2.5 or 10 mg) for a maximum of 7 weeks in subjects from 16 to 65 years with refractory epilepsy suffering from partial onset seizures whether or not secondarily generalized.

1. Prevalence of Carotid artery atherosclerosis in asymptomatic population”, funded by Indian Council of Medical Research (ICMR)

3. Cortical sinus thrombosis: Risk factors, clinical features, imaging and outcome of fully investigated cases in NIMS CVT Registry

4. Risk factors, mechanisms and outcome of consecutive cases of stroke in Hyderabad Stroke Registry

5. LY333531 Treatment for Symptomatic Peripheral Neuropathy in Patients with Diabetes. Recruited 14 patients. Study started Nov 2003 and ongoing.

6. LY333531 Treatment of Peripheral Neuropathy in Patients with Diabetes. Recruited 31 patients. Study started November 2003 and ongoing

7. Protocol 6002-EU-007: “A 16-week, Double blind, Placebo-Controlled, Randomized, Parallel Group, Multicentre, International Study to Evaluate the Efficacy and Safety of 40 mg/day KW-6002 (istradefylline) and that of Entacapone versus Placebo as treatment for Parkinson’s Disease in patiens with Motor Response Complications on Levodopa Therapy”. Study started January 2005 and ongoing

8. Protocol Number NW-1015/015/III/2003: A Phase III, Double-Blind, Placebo-controlled Study to determine the efficacy and safety of a low (50-100mg/day) and high (150-200mg/day) dose range of Safinamide, as add-on therapy, in patients with Early Idiopathic Parkinson’s disease treated with a stable dose of a single Dopamine agonist. Study started March 2005 and ongoing.

9. Protocol 6002-INT-001: “A long-Term, Multicenter, Open-Label Safety Study with Oral 20 or 40 mg/day Doses of KW-6002 (istradefylline) as treatment for Parkinson’s Disease in patients with Motor Response Complications on Levodopa Therapy”.

10. Protocol Number NW-1015/017/III/2003: A Phase III, Double-Blind, Placebo-controlled, 12-month Extension Study to investigate the efficacy and safety of a dose range of Safinamide of 50-200 mg/day as add-on therapy in patieants with Early Idiopathic Parkinson’s disease treated with a stable dose of a single Dopamine agonist.

11. LAM100034 : A multicenter, double blind, randomized, parallel group evaluation of LAMICTAL extended –release adjunctive therapy in subjects with partial seizures

12. LAM100036 : A multicenter, double blind, randomized, parallel group evaluation of LAMICTAL extended –release adjunctive therapy in subjects with generalized tonic-clonic seizures

13. Protocol No.: WX17798 A prospective, randomised, double-blind, placebo controlled, parallel group, multi-centre, 36 week trial to assess the efficacy and safety of adjunct mycophenolate mofetil (MMF) to maintain or improve symptom control with reduced corticosteroids in subjects with active Myasthenia Gravis.

14. Protocol 1193 – An open label, multicentre follow up trial to evaluate the long term safety and efficacy of breviracetam used as adjunctive treatment at a flexible dose upto a maximum of 100mg/day in subjects aged 16 years or older suffering from partial onset seizures

16. Role of calcium and calpain in Duchenne muscular dystrophic cell death: an insight into apoptosis. Co-investigator, in collaboration with Institute of genetics and hospital for genetic disorders

17. Treatment of peripheral neuropathy in patients with diabetes mellitus. B7A-MC-MBBR

18. Treatment of symptomatic peripheral neuropathy in patients with diabetes mellitus. B7A-MC-MBCW

19. A cross sectional study to assess the correlation between the quantitative testing of vibration sensation and nerve conduction studies of peroneal and tibial nerves in patients with Diabetes mellitus

20. Correlation between F tacheo dispersion and double stimulation in early diabetic neuropathy

21. Phenotypic and genetic studies in Limb Girdle Muscular Dystrophy. In collaboration with CCMB Tarnaka

TOPMAT-PEP-3001- A randomized, double blind, placebo controlled, fixed dose ranging study to assess the safety, tolerability and efficacy of Topiramate oral liquid and sprinkle formulations as an adjunct to concurrent anticonvulsant therapy for infants (1-23months of age, inclusive) with refractory partial-onset seizures, with open label extension.

extension of pharmacokinetics and safety of topiramate administered as the oral liquid and sprinkle formulations as an adjunct to concurrent anticonvulsant therapy in infants (aged 1-23 months, inclusive) with refractory partial onset seizures.

24. Identification of major susceptibility genes for juvenile myoclonic epilepsy

STATISTICS RELATING TO INPATIENTS/OUTPATIENTS DURING THE YEAR

2002 1479 20045

2003 1732 32360

2004 1876 37448

1-4-05 to 31-3-06 2298

2002 1442 2196

2003 1706 2525

2004 2022 2541

1-4-05 to 31-3-06 2527 2026

Dr.Ramana Reddy received Best paper Award for “Predictors of poor quality of life in epilepsy” for his presentation in APNSA conference in July 2005 held at Rajahmundry

Ms.S.Sailaja, Neuro-Technologist was awarded best poster presentation in International Neuro-Electrophysiology Workshop (CUTE) held at New Delhi

Delivered a guest lecture on “Common CNS disorder” at National meeting organized for Medical Officers working in research laboratories in India in IICT, Hyderabad on 25-10-2005.

Delivered a guest lecture on “Cost Effective Evaluation of Transient Ischemic Attack “ at 12^th Annual Conference of Indian Academy of Neurology held on 23-25 September, at Jaipur

Delivered a guest lecture on “Stroke in Diabetes” in Annual Andhra Pradesh Diabetic Meeting at Vijayawada in Oct 2005

Delivered a guest lecture on “Modern Methods of Stroke Prevention” - Indo-US Stroke Symposium held in AIIMS, New Delhi 0n 15-12-2005.

Delivered a guest lecture on “Cerebral Venous Thrombosis” and “Cost effective evaluation of stroke” –in the Regional Asian Stroke Congress and 1^st Indian Stroke Association Congress held at Chennai.

Was invited for a guest lecture on “Deep brain stimulation program” at National Hospital, Colombo, Srilanka in August 2005

Delivered a guest lecture on “Spasticity” in Indo American Cancer Hospital, Hyderabad on 27^th August 2005.

Was invited as a consultant for starting “Deep brain stimulation in Parkinson’s disease” program in National Hospital, Colombo, Srilanka. Two patients were operated there.

13^th Annual Conference of Indian Academy of Neurology, September 23-25, 2005 at Jaipur – Presented a paper on “Deep brain stimulation in advanced Parkinson’s disease” and

Delivered a guest lecture on “Deep brain stimulation in neurological disorders” - ANEICON 2005 at Guwahati on 21^st October 2005.

61^st Annual Conference of Association of Physicians of India held at Patna from 30^th January to 2^nd February 2006, delivered a talk on “Newer concepts in management of Parkinsonism”.

Delivered a talk on “Role of Botulinum Toxin in the Management of Cerebral Palsy” at

National Institute for the Mentally Handicapped (NIMH) held on 2^nd September 2005,

Delivered a guest lecture on “Management of intracerebral hemorrhage” in a CME held at CGHS Hospital, Begumpet, Hyderabad

Delivered a guest lecture on Spontaneous Intracerebral Hemorrhage. Neurology CME Neurovision 2005 V Delivered a guest lecture on isakhapatnam.

Delivered a guest lecture on Medical management of Cervical Spondylosis. XII APNS Conference-2005, Vijayawada

Delivered a guest lecture on Management of Intracerebral hemorrhage. International neurosurgery update- Delhi 2005

Delivered a guest lecture on Clinical evaluation of a patient with CNS infection. CME on Infections of CNS. NIMS, Hyderabad 21^st Jan 2006

Delivered a guest lecture on Approach to Acute Quadriparesis. CME .API- Regional Chapter Kakinada. March 5 2006

Biological and Mechanical Artifacts in EEG. Clinical EEG workshop- Recording, Reading, Reporting. From basics to bench March 24-26, 2006, Hyderabad

Artifacts- EEG reading session - Clinical EEG workshop- Recording, Reading, Reporting. From basics to bench March 24-26, 2006, Hyderabad.

EEG in Idiopathic generalized epilepsies. Clinical EEG workshop- Recording, Reading, Reporting. From basics to bench March 24-26, 2006, Hyderabad.

Cinical approach and management of epilepsy – Neurology update for physicians, 2005, Hyderabad.

How do we do it session – Refractory Medial Temporal Lobe Epilepsy: 12^th APNS conference 2005, Vijayawada.

Delivered a guest lecture on Memory disorders” –in IMA, Guntur on 05-09-2005.

Delivered a guest lecture on “ Understanding MCI” and “Linking Neuropsychology to clinical practice” - DEMCON 2005, Annual Conference of ADRDSI held at SCTIMST, Trivandrum

Delivered a guest lecture on “Neuro Imaging Techniques” at SWEEKAARA P.G. College for Hearing, Language and Speech, Seminar on Neuro Imaging Techniques and Aphasia held on 17-2-2006 at Secunderabad

Delivered series of following guest lectures in Neurology at the Ali Yavar Jung National Institute for the Hearing Handicapped, Secunderabad

Ms.S.Shanmukhi, Clinical Psychologist delivered a talk on “Enhancing the well being of individuals with anxiety” at National Seminar on promoting psychological well-being across the lifespan, being organized by the department of Psychology, Osmania university, Hyderabad

Kaul S, Meena AK, Suvarna, Prasad VVSRK, Shekar C. Subtypes of ischemic stroke in a metropolitan city of South India: 3 year data from a hospital based registry. Stroke 2004;35:243.

Subhash Kaul . Cost effective evaluation of Transient Ischemic attack. Annual Reviws of Indian Academy of Neurology. 2005

Rupam Borgohain. Manas Panagrahi,S.Afshan Jabeen, Shanmukhiukhi,S.Sitajayalakshmi.A.K.Meena published a review article on “Deep Brain Stimulation in Advanced Parkinsons disease” in Medicine update vol 16,2006

Meena AK, Kaul S, Suvarna A. Ischemic stroke mechanism in a metropolitan city of south IndiaL Hyderabad stroke registry )(Abs) . J Neurol Sciences Suppl. 1 2006, 238: S405, P-1194

Kannan MAK, Dasari S, Sundaram C, Rajshekar R. Limb girdle muscular dystrophy: a clinicopathological study J Neurol Sciences Suppl. 1 2006, 238: S163, P-0249.

Murthy JM, Meena AK, Chowdary GV, Narayanan JT. Myasthenic crisis: clinical features, complications and mortality. Neurol India 2005; 53(1):37-40.

Dr.S.Sitajayalakshmi’s paper on “Clinical and EEG study on probands with juvenile myoclonic epilepsy and their 1^st degree relatives” was accepted for publication in the journal “Seizure”.

Protective and susceptibility effects of hSKCa3 allelic variants on juvenile myoclonic epilepsy. Vijai J, Kapoor A, Ravishankar HM, Cherian PJ, Kuruttukulam G, Rajendran B, Sridharan R, Rangan G, Girija AS, Jayalakshmi S, Mohandas S, Mani KS, Radhakrishnan K, Anand A. J Med Genet. 2005 May; 42(5): 439-42.

Extra hepatic portal vein obstruction with parkinsonism and symmetric hyper intense basal ganglia On T1 weighted MRI - S.Sita Jayalakshhmi, Rupam Borgohain, S.Mohandas. Annals of Indian academy of Neurology; 2006, Jan- Mar, Vol9- 46

Dr.A.Suvarna’s paper on “Mild cognitive impairment’ published in January 2006 in the journal “Psychological Medicine”.

Alladi Suvarna, Kaul S, Meena AK: Pattern of Vascular Dementia in India: Study of Clinical Features, Imaging and Vascular Mechanisms from a Hospital Dementia Registry, Journal of Stroke and Cerebrovascular disease 2006;15:48-57

Alladi S, Meena AK, Kaul S, et al. Pattern of vascular cognitive impairment in South India. A clinical and imaging study from a hospital Dementia Registry. Stroke 2004;35:322(ab).

Prasad V, Kaul S, Meena A, Suvarna S, Jayalakshmi S, Jayanthi M, Borgohain R: Intravenous Thrombolytic Therapy in Acute Ischemic Stroke in a University Hospital of South India(Abs). J Neurol Sciences Suppl. 1 2006, 238: S449, P-1372

Prasad V, Srinivas B, Keerthi AS, Sita Jayalakshmi S, Meena AK, Borgohain R, Kaul S: Risk factors and determinants of mortality in patients of Intracerebral Hemorrhage in a Tertiary Hospital in South India(Abs) J Neurol Sciences Suppl. 1 2006, 238: S449, P-1373

Prasad V, Srinivas B, Keerthi AS, Sita Jayalakshmi S, Meena AK, Borgohain R, Kaul S: rtPA Treatment in Acute Ischemic Stroke and outcome in a University Hospital in India(ABS). J Neurol Sciences Suppl. 1 2006, 238: S449, P-1374

Dr. Subhash Kaul: presented paper titled “Prevalence of Asymptomatic Carotid Artery Stenosis in Random Sample from Andhra Pradesh” in 12^th Annual Conference of Indian Academy of Neurology, held on 23-25 September, 2005 at Jaipur.

Dr.Rupam Borgohain presented paper titled “ DBS in Parkinson’s disease” in APNSA conference held in july 2005 at vijaywada

Dr.Rupam Borgohain: presented paper titled “Experience of Deep Brain Stimulation from Nizam’s Institute of Medical Sciences, Hyderabad” in 12^th Annual Conference of Indian Academy of Neurology, held on 23-25 September, 2005 at Jaipur.

Dr.AK Meena: presented paper titled “Medical management of cervical spondylosis ” in APNSA conference held in july 2005 at vijaywada

Dr.AK Meena: presented paper titled “Clinical and pathological study in limb girdle muscular dystrophy” at the World Federation of Neurology Congress held at Sydney, Australia.

Meena AK, presented paper titled Thrombolytic therapy in acute ischemic stroke- NIMS experience. Neurocon Indore 2004.

Meena AK. presented paper titled Ischemic stroke mechanism in a metropolitan city of south IndiaL Hyderabad stroke registry )XVIII World Congress of Neurology. Sydney Nov 5-11 2005

Dr. S.Sitajayalakshmi: : presented paper titled “Predictors of mortality in status epilepticus” at the World Federation of Neurology Congress held at Sydney,Nov 2005 Australia.

Dr S.Sitajayalakshmi presented paper titled Epilepsy in sleep: A clinical, Electrophysiological and radiological study:, 16^th International Bethel - Cleveland Clinic Epilepsy Symposium Bielefeld/Germany, June 20 - June 22, 20

Dr.A.Suvarna: : presented paper titled “Widening the spectrum of Alzheimer’s disease” in APNSA conference held in july 2005 at vijaywada

Dr.A.Suvarna: presented paper titled “Mild cognitive impairment: Applicability of research criteria and neuropsychological features” and “Typical and atypical presentation of Alzheimer’s disease – A large clinicopathological study” at the World Federation of Neurology Congress held at Sydney, Australia.

Dr.VVSRK Prasad: presented paper titled “ Risk factors and determinants of mortality in patients of intracerebral hemorrhage in a tertiary hospital in South India” and “Intravenous thrombolytic therapy in acute ischemic stroke in a university hospital of South India” at the World Federation of Neurology Congress held at Sydney, Australia.

To commemorate World Brain Awareness Week, public awareness interactive session was held by the faculty of the department on 18/3/2006 at Learning Centre in NIMS.