From the Director's Desk

From the Director's Desk

NIMHANS has completed five years as an ‘Institute of National Importance’.  The milestone is small, but is emotionally important. The milestone has been achieved through the efforts of many persons who have worked hard, both in leadership roles and behind the scenes. It is my pleasant task to lead the Institute forward in the coming years.

Trauma is ubiquitous. Trauma spans all age groups. Road traffic accidents comprise the single largest source of physical trauma. The number of cases of trauma at NIMHANS has been increasing sharply, across the years, and this number will continue to increase as the population and the road traffic density in the city increases. Trauma management is therefore an important concern at NIMHANS, with special attention to traumatic brain injury. NIMHANS has played an important role in trauma care, down the years, starting with promoting the use of helmets to prevent traumatic brain injury in two-wheeler riders. The emergency and neurosurgical services at NIMHANS are well equipped to manage patients with traumatic brain injury. However, many if not most patients with head injury also have multiple organ damage. The comprehensive care of trauma is consequently an important need. The development of a NIMHANS trauma care centre in the proposed Northern Campus will therefore be another landmark in the history of the institution.

The recently published National Mental Health Survey (October, 2016) draws attention to the pervasive problem of psychological and psychiatric dysfunction in the community. Given the scarcity of mental health manpower resources, it becomes important to consider newer and more efficient ways of reaching the unreached. In this context, in the field of Telemedicine, NIMHANS has harnessed digital technology to successfully reach the unreached parts of the country. Through telemedicine, psychiatric services have been made available to patients in many remote districts. There could be scope for the extension of such services in other parts of the country, and to patients with neurological and related disorders, as well. The possibilities are many.

The number and percentage of elderly persons in the population is expected to increase in the coming years; this is an inevitable demographic change that has already characterized developed countries. Elderly persons suffer from unique mental health challenges. One such challenge is cognitive decline. Decreasing the risk of cognitive decline and promotion of healthy aging is possible through the adoption of healthy lifestyle behaviours. The application of preventive medicine principles in geriatric psychiatric is an important need. NIMHANS is conducting significant research in the field. One such study is a longitudinal follow up of a cohort of elderly adults in neighbouring taluks.

On the practical front, we must acknowledge that our resources, though impressive, are not limitless. In this context, the hospital handles large caseloads in emergency, outpatient, and inpatient care. The caseloads are increasing sharply and, with the manpower and facilities available, it is often not humanly possible to do full justice to all patients. We are increasingly facing the necessity to preferentially address the more difficult and more serious cases, and to refer or transfer the less difficult, less serious, and recovering cases to neighbouring hospitals. There is a need to form a treatment network with neighbouring hospitals for the efficient and humane management of patients with neurological, neuropsychiatric, and neurosurgical disorders. NIMHANS is otherwise modernizing the outpatient department services to improve the efficiency and delivery of outpatient care to the large numbers of patients who attend outpatient services each day.

With the setting up of medical cyclotron at the Institute, a new era of modern technology for research has dawned for the study of the basic neurobiology of neuropsychiatric disorders, and for the development of newer treatments in the field.  Existing technical infrastructure for disciplines ranging from molecular biology to neuroradiology include facilities for proteomics, magnetoencephalography, and others.

With this background, we dedicate ourselves to patients and to the nation, at the completion of half a decade of bringing NIMHANS to the forefront of research, training, and treatment in the fields of neurology, neurosurgery, mental health, and related disciplines.

Dr. B. N. Gangadhar