NIMS- Developmental Medicine
Comprehensive Rehabilitation Services for the differently-abled children
NIMS Medicity, Aralumoodu, Neyyattinkara, Thiruvananthapuram, Kerala, India, popularly known as NIMS Medicity, is a 350 bedded Super speciality Hospital, which is one of the largest health care centres in South Kerala and South Tamilnadu. Its 40 departments include 20 specialities and 20 Super Specialties. NIMS Medicity offers free heart surgery project, free dialysis project, rehabilitation for HIV patients, free medical camps etc to the needy people.
The Managing Director of NIMS Medicity is also the patron of PADS (Parents Association of Disabled Students), which takes care of the education and healthcare needs of the mentally challenged students. Realizing the fact that rehabilitation and lifestyle training is the most important part of the care to be given to the mentally challenges students, we initiated free out patient service for the inmates of PADS.
NIMS Medicity has established its own audiology and speech rehabilitation centre named as “NIMS-Anne Sullivan Centre for specially-abled children” at Neyyattinkara. NIMS also established Kerala’s first speech and audiology rehabilitation centre “without a bill counter” at Centre for Rehabilitation of the differently-abled (CAD), LMS Polio Home, Thiruvananthapuram which has more than 500 inmates.
Besides, NIMS is also providing free rehabilitation services to the needy students of “SAKSHAMA, Nemom, Trivandrum, KARUNYA MEDICAL MISSION, Neyyattinkara etc. we have also signed MOU with rehabilitation centres such as Gerdi Gutperle Agasthiyar Muni Child CARE centre, Vellamadam, K.K. District, Shanthi Nilayam, Paruthivila, K.K. District, Jyothi Nilayam, Palapallam, Karungal, K.K. District.
It is estimated that India has around 80 million people with disability, which may be age-related, accident-related or due to some medical conditions. According to the World Bank, one in every 12 households in India has a person living with a disability.
It was our Endeavour to transform NIMS Medicity into a disabiled friendly zone offering unparalleled facilities with the objective of also caring for our special brothers and sisters, which would be first hospital of its kind in Kerala. Now we are all set to be declared as “Disabled Friendly Hospital”, which enables people with disabilities to freely and safely move and access facilities within the hospital, which provides an environment of independence to individuals with a disability, which is their right granted under Persons with disability act, 2016. We realize the importance to have a barrier free hospital environment, so that people with disabilities can carry out their basic activities independently.
Realizing the fact that rehabilitating the suffering ones to help them restore the health or normal life through training and therapy is the most prime human service to the society, we aim at providing the following comprehensive rehabilitation services for the differently abled persons, all in one campus.
1. Child development therapy
2. Behavioural therapy and special education
3. Audiology and speech therapy
4. Occupational therapy
5. Autistic physiotherapy
6. Physiatric medical management
7. Clinical psychology
8. Paediatric orthopaedics
11. Naturopathy and yoga
12. Ayurveda and holistic treatment
13. NIMS Centre for Advanced Biotechnology (NCAB)
14. Nutrition and dietetics
- 1. CHILD DEVELOPMENT THERAPY
Developmental therapists assess a child’s global development and identify specific areas of need and areas of strength. They will then develop play activities designed to help a child overcome their challenges and improve the quality of their interactions in order to help them gain confidence in their own ability to learn and to acquire typical skills. The children are provided with their own tools to navigate their way through their new world with a sense of wonder and enjoyment.
The developmental follow- up clinic in NIMS medicity was started in the year July 2010 with Mrs. Poornima Vinay as our Developmental Therapist under the guidance of Neonatology department headed by Consultant Neonatologist, Dr.Hazeena.
Since the year of its inception we have been handling babies who are at risk for development delay. Our aim has been to initiate early intervention, so as to provide overall developmental assessment and therapy to babies. Its a well known fact that the brain has significant neuroplasticity and can be manipulated and stimulated to reach a good developmental potential during the early years of life especially 0—3 years. Our babies, especially 600gms, extreme preterm and those with severe sepsis/meningitis and term intracranial haemorrhage are witnesses to the efficient early intervention therapy.
- 2. BEHAVIORAL THERAPY AND SPECIAL EDUCATION
Behavioral therapy and special education attempt to affect behavior change by teaching relevant tasks that are based around strategies to correct cognitive distortions through the application of logic and the search for evidence. Goals are clearly specified; decisions are made on how to best meet specified goals and how to measure progress toward goals to provide feedback. The intervention is task-oriented and focused on problem-solving.
Role of Rehabilitation consultant
- Comprehensive learning Assessments for Children with Autism, Attention Deficit Hyperactive Disorder, Mental retardation , Cerebral Palsy.
- Behavioural interventions.
- Handling Sensory Process Disorder.
- Improving eye contact and attention.
- Developing cognitive skills.
- Enhancing Interpersonal communication.
- Developing Socialization.
- Improving self care skills .
- Dealing with fine and gross motor disabilities.
- Teaching academic basic concepts by picture exchange communication system.
Facilities available at NIMS Medicity
- Facilities to deal with special kids from age of 6 month to 15 years.
- Special standing and sitting devices for children with cerebral palsy.
- Sensory input corner stair.
- Multi activity fine motor table.
- Sensory integration therapy room.
- Auditory integration therapy.
- Art therapy.
- Picture Exchange communication cards.
- Gross motor developing activities instruments.
- Indoor special play equipments(toddler slider, balance board, ball pool , skating board,tunnel ).
- Creative and innovative thinking activities.
- Materials for teaching basic academic concepts(animals,birds, colours, money , time ,alphabets and number ).
- Soft and moving toys.
- Sound making equipments from mild to strong .
- Fine motor activities.
- Different size therapy balls for toddlers and adult children.
- Parachute game for group therapy.
- All concepts wooden puzzles and flash cards.
- Materials to teach all types shapes and size.
- Pencil holding training tools.
- Pre vocational training instruments.
- Fun making toys for developing attention and focus
- Materials to develop adaptive skills.
- 3. AUDIOLOGY AND SPEECH THERAPY
Audiologists and speech-language pathologists evaluate and treat people who have communication disorders. Audiologists are concerned with the identification, measurement, and study of hearing and hearing impairments and with the treatment of persons with hearing disorders. Speech-language pathologists are specialists who diagnose and treat individuals with speech, language, voice, literacy and fluency disorders. Because speech and/or hearing problems are both communication disorders, audiologists and speech-language pathologists work together to determine sources of communication problems and to coordinate programs of rehabilitation.
Importance of Proper screening and assessment
- Helps the children with disabilities to regain the confidence and independence in-order to became self-reliant.
- Helps in raising efficiency of the disabled child and managing the after effect of disabilities .
- Prepares the family and the parents for a better and efficient handling and care taking of tIhe children with disabilities.
- Increase awareness regarding disabilities in parents and family members.
- Rehabilitation process is a needful process that provides assistance and guidance to the parents and to all other family members.
Facilities at NIMS Medicity
- Clinical screening ,assessment, identification, diagnosis, treatment and management of
A. hearing disorders in infants, children, adults and geriatrics, involving both peripheral and central pathways of hearing.
B. Tinnitus, hyperacusis and balance disorders.
C. Behavioural, psychoacoustic and electrophysiological measures of peripheral and central auditory system.
D. Vestibular system includes administration and interpretation of behavioural and electro physiological tests of balance.
- Assessment, selection, dispensing, validation, verification and servicing of individual amplification devices and ear moulds.
- Diagnostic assessment include Pure Tone Audiometry, Immitance audiometry, OAEand BERA
Pure Tone Audiometry: Basic test to identify hearing threshold levels of the individual for the determination of degree, type and configuration of hearingloss.
Immitance audiometry: Comprises of tests such as tympanometry and reflexometry.Tympanometry helps to identify pathologies related to external ear and middle ear.Acoustic reflexometry provides objective means of differentially diagnosing cochlear versus retrocochlear pathologies.
Oto-Acoustic Emissions (OAEs): Useful tool to assess cochlear outer hair cell function. Infant hearing screening program have been initiated by performing OAE screening.
Brainstem Evoked Response Audiometry (BERA) : Tests to identify hearing threshold levels in adults and children.
- Clinical screening , assessment, identification, diagnosis, treatment and management of speech language disorders in adult and children including speech sound disorders, language disorders, fluency disorders, voice disorders, resonance disorders, swallowing and feeding disorders and cognitive communicative disorders.
- 4. OCCUPATIONAL THERAPY
Occupational therapy helps children gain independence while also strengthening the development of selfcare skills, fine motor skills like dexterity, hand movements, neuromotor development, carrying out practical activities at school and sensory integration. Occupational therapist aims to increase child’s self dependence and confidence and provide them with just right challenge to achieve their true potent occupational therapy does not focus on the problem but on how it affects the child’s ability to do normal every day activities.
Facilities available at NIMS
- Well structured and adapted toilet for toilet training.
- Dressing room for dressing and grooming training.
- Adapted kitchen for hands on training.
- Treatment area that can accommodate for activities and training.
Wedge, Foam, Beads, Clay, Theraputty, Cards, Scissors, Comb, Long handle 4D- brush, Puzzles,Rattles, Toys with light and sound, Crayons big.
- 5. AUTISTIC PHYSIOTHERAPY
In addition to the behavioral, sensory and social-emotional difficulties, many children with an Autism Spectrum Disorder (ASD) will also experience difficulties with their motor skills and capabilities.
Children with ASD may achieve early gross motor milestones such as sitting, crawling and independent walking within the expected timeframes, but the quality of their movements may be immature or stereotypical when compared with their peers. These early motor skills provide the foundations for the development of later motor skills which require more refined and sophisticated movement control. As a result, children with ASD may struggle to master higher level motor skills such as ball skills, skipping, riding a bike, balancing and hopping. These skills impact the child’s overall participation in peer and community activities, which subsequently will affect their overall development.
Some signs a child with ASD might benefit from the help of a paediatric-physiotherapist:
- Delayed achievement of gross motor milestones
- Difficulty with:
- Throwing, catching, kicking or dribbling a ball
- Jumping, hopping or skipping
- Playing on a playground
- Playing games or sports and keeping up with their peers
- Participating in community recreational or sporting programs
- Learning new physical skills
- Sitting in a chair properly, or for very long without fidgeting
- Poor posture
- Clumsiness or frequent falls
- Toe walking
A number of motor, sensory and musculoskeletal issues may be underlying the motor difficulties experienced by a child with ASD:
- Low muscle tone – muscle tone is the level of activity present in our muscles at rest.Children with ASD often have low muscle tone, which means that they require to use more strength and energy to move, and also alters the sensory feedback a child receives through their muscles when they move.
- Motor planning difficulties – this affects the child’s ability to optimally time, sequence and execute a movement. This is often seen as clumsiness, frequent falls, poor balance, or poor coordination.
- Poor core strength – as a result of their low muscle tone and motor planning difficulties,children with ASD often also have poor core strength. Children with ASD have difficulty recruiting the correct muscles in their core, and lack the strength and endurance to enable them to engage these muscles for functional activities.
- Poor posture – often develops as a result of the low muscle tone and poor core strength, and impacts on a child’s ability to master more sophisticated motor skills, fine motor skills, and can also impact their attention and participation in the classroom or at school.
- Tight muscles and joints – these develop as a result of the poor motor strategies and posture.
- Delayed achievement of, poor or inefficient balance reactions – these include the child’s automatic reactions to keep themselves upright when they start to lose their balance, and the automatic protective reactions to protect themselves from injuries when they fall.
A physiotherapist experienced in paediatrics will assess the child’s overall motor functioning,identify the underlying difficulties, and provide an intervention program to help, address orimprove these difficulties and subsequently the child’s overall functioning. Strategies that maybe used as part of a physiotherapy intervention plan include:
- Specific exercises or activities for muscle strength, posture, endurance, motor planning and balance reactions.
- Sensory feedback strategies to improve a child’s awareness of their body posture and movements.
- Recommendations for taping, orthotics, and/or other bracing or positioning strategies and equipment to enhance the child’s body alignment, posture and body awareness during functional or physical activities.
- Recommendations and support to participate in community based physical activity programs that will support their physical skills and endurance.
Physiotherapy can be a key ingredient in the treatment of motor difficulties for children with ASD. If you are concerned about your child’s development or their motor skills, or have a child you are working with who you think might benefit from physiotherapy intervention, please contact us at NIMS PHYSIOTHERAPY DEPARTMENT so we can assist them to achieve the best possible outcomes.
Physiotherapy for autism will, in general, focus on developing the gross motor skills, such as rolling, sitting, crawling, walking, jumping etc. these skills may be impaired in some autistic children as a result of low muscle tone. Problems with gross motor skills and coordination can interfere with the child’s day to day functioning as well as affecting social and physical development.
Physiotherapists will use a wide variety of techniques and interventions to help an individual with autism to gain the most out of their movement, some of these techniques include
- Manual therapy
- Therapeutic exercise
- Hippotherapy – therapeutic horseback riding
- Vestibular rehab
- Sensory rehab
- Aquatic therapy
- Recreational therapy
- General play and so on..
All treatments will be age appropriate and related to developmental levels. At a young age, the main focus of physiotherapy will be on basic movement skills including sitting, standing and walking. As the child ages, treatment will focus on more complex movement skills including jumping, climbing stairs, throwing and catching. These skills are vital for social engagement in sports and general play, as well as physical development.
The physiotherapist will also work closely with the child’s parents/carers and teachers to educate them on technique that can help the child build muscle strength, gross motor and coordination skills whilst at home and within a school environment.
We are equipped with
- CX4 four channel electro therapy combo machine (Roscoe, USA)
- High power laser (A star, Poland)
- GK3 Virtual rehab
- Short wave diathermy
- Moist heat
- Electric Muscle stimulator
- Interferential therapy
- Traction unit
- Trans cutaneous electric nerve stimulator
- Ultra sound
- Pulsed electromagnetic field therapy
- Suspension equipment
- Multi activity work station for differently abled
- Climbing board and bar
- Cycle ergo meter
- Multi gym
- Shoulder wheel
- Continuous passive movement machine
- physio ball 45,65,95cm
- Hand exerciser
- Peg board regular
- Weight cuff
- Wobble board
- Ankle exerciser
- Parallel bar
- Gel ball set
- Clay, rep putty
- Weight cuff
- Counting and colouring, sorting beads
- Supination pronation – rainbow and zigzag type
- Vestibular board
- Balance pad
- Foam roller
- Hand held vibrator
- Quadriceps table
- Balance beam
- Jelly type morph ball
- Finger fine motor trainer
- Activity ball Corn brush
- Sensory sac
- Wooden intellectual geometry
- Balancing and eye-hand coordinator
- Magnetic multi colour box
- Disc swing
- Stair with slop
- Rope ladder four bars
- 6. PHYSIATRIC MEDICAL MANAGEMENT
Physical Medicine and Rehabilitation otherwise called Physiatry department takes over the medical and physiological needs and rehab care of disabled patients who had sustained a severe neurologic or devastating orthopaedic conditions.
NIMS Medicity has an interdisciplinary team of doctors, physiotherapists, occupational therapists, speech therapists, nurses, social workers, psychologist, prosthetists and orthotists works under the department of Physical Medicine and Rehabilitation or Physiatry. The coordinated work aims at maximizing the functional abilities of people with disabilities. The following are the list of clinic pathological conditions treated:
- Spinal Cord Injury
- Brain Injury due to trauma and other causes
- Developmental disorders such as cerebral palsy, spinal dysraphism
- Amputations of the extremities
- Rheumatological conditions
- Neuromuscular disorders
- Chronic pain
Physiatric Medicine and rehabilitation doctors conduct in-patient Stroke rehab, Brain injury rehab, Spinal cord injury rehab and other orthopaedic / neuromuscular disease rehabilitation.We arrange sequential counseling sessions with the patients family, set goals and make an integrated short term in patient rehab care plan or home care program for the patient.
- 7. CLINICAL PSYCHOLOGY
Clinical psychology plays a pivotal role in enhancing well being and quality of life of children with different abilities:
Assessment and diagnosis- To plan out comprehensive management, assessment must be done at the earliest. Clinical psychology offers standardized instruments to assess various cognitive variables such as intelligence, memory , learning capabilities etc. Today we have various scientific and objective clinical tests such as malin’s intelligence scale for children, vine land social maturity scale, squin form board etc to guage the cognitive aspects. Besides this, to diagnose different clinical conditions, test batteries have been developed. Learning disability is a neuropsy cological disability commonly seen among school children. NIMHANS Battery of learning disability is one such test with reliability and validity to pick up scientific learning disabilities. Autism screening test and test for attention deficit hyper activity disorder are commonly used to reach at diagnosis.
Management: The key management approach for differently abled is behavior modifiacation techniques. Successive approximation, reinforcement programmes, token economy, Premark principle are examples. These methods are used to maximize desirable behavior and minimize undesirable behavior. The primary educational plan is individualized approach, with remedial training. This is based on theories of Pavilovian, Skinnerian learning and motivational principles. Parenting counseling is very important element of the management. Cognitive retraining, supported employement, psychotherapy for co-morbid conditions are part and parcel of long term care.
- 8. PAEDIATRIC ORTHOPAEDICS
Department of orthopaedics at NIMS Medicity provided treatment for simple fractures as well as conditions such as intricate hip and spine deformities in our children. Our paediatric orthopedic experts are highly qualified and skillful and specialized in diagnosis and treatment of bone & joint problems in growing children.
Aims of corrective surgery: To improve the function of the affected limb by:
- Overcoming the effects of muscle paralysis, e.g., tendon transfers
- Correcting deformities
- Restoring joint mobility
- Stabilizing flail and unstable joints
- Relieving pain
- Restoring limb length discrepancy
- Treat Abnormalities in children walk
- Treat differences in leg lengths
- Deformities are present at birth such as clubfeet and dislocated hips, deformities of hand, neck and back and feet
- Deformities that develop later in childhood such as crooked legs and curved
- Takes care of broken and tumor bones
- Infections in bones or joints
- Treatment of cerebral palsy, cervical spine problems in down syndrome
- 9. ENT
The ENT Rehabilitation is attention on speech and language therapy to help in speaking andlanguage thereby to help in vestibular rehabilitation. Therapy focus to recover balance and tominimize the practice of dizziness, recover patient’s stability while in motion, crease
coordination, reduce falls and anxiety.
IMPORTANCE IN REHABILITATION
- Early intervention
- Develop Phonological lexical and syntaxic ability
- To prevent hearing loss
- Substitution of sound via external and implanted hearing devices and functional substitution carried out by speech and language therapy.
CONDITIONS THAT NIMS ENT DEPARTMENT DIAGNOSES AND TREAT
- Ear condition and infections
- Nasal congestion (difficulty breathing, runny nose post nasal drip.
- Sinus problems.
- Hearing loss
- Balance disorder, including dizziness, vertigo, meniere’s disease
- Voice problems (hoarsenes laryngitis)
- Swallowing disorder
- Tonsil and infection problems
- Snoring and surgical treatment
- Sinus Surgery
- Thyroid Surgery
- Cancer of head and Neck
- Endotracheal intubation/ tracheotomy
- 10. OPHTHALMOLOGY
The Department of ophthalmology at NIMS Medicity, provide Rehabilitation services, needed to gain back the independence and freedom that once seemed lost.
- People with low vision can be taught a variety of techniques to perform daily activities with what vision remain. The Ophthalmology department specializes in following procedures and treatment.
- Eye Lasik Refractive Packages
- Lasik Eye Surgery
- Eye Care Treatment
- Lasik Treatment
- Refractive Surgery
- Laser Refractive Surgery
- Refractive Eye Correction Package
- Vision and Eye Care
- Eye Refractive Care Packages
- Cataract Surgery
- 11. NATUROPATHY AND YOGA
Naturopathy is a natural healing science using the healing powers of nature. The principle of Naturopathy is that the accumulation of toxins is the root cause of all diseases. Naturopathy and yoga are the age old sciences of healthy living. The Department of Naturopathy at NIMS MEDICITY provides all rehabilitatative services with reference to specially abled children and adults.
Naturopathy Services at NIMS MEDICITY have the potential to support the health,growth development and learning outcomes of physically disabled children. This may be through dietary intervention, nutritional supplements and natural therapies such as yoga therapy, hydrotherapy, acupuncture, massage therapy, music therapy, chromotherapy etc.
Gluten free casein free (GFCF) diet, vitamin C, multivitamin and mineral supplement,vitamin B6, magnesium and vitamin B6, folates, vitamin B 12, omega 3 fatty acids etc can improve disorders such as ASD (Autism spectrum disorder).
Yoga have demonstrated improvements in motor skills, social skills, communication skills, self efficacy, self confidence, sensory receptivity and attentiveness.
Under water massage, immersion bath, different hydrotherapy pack, hydrotherapy douches etc improve muscle tone, control hypersensitivity, stimulate the nerves etc.
Acupunctures has demonstrated improvements in improved communication,linguisticability, cognitive function etc.
It help to overcome hypersensitivity, increase muscle tone, and also to overcome dystrophy.
The Five Great Elements of Nature
The principle of Naturopathy is that the accumulation of toxins is the root cause of all diseases.Elimination of the toxins in our body is the route to health. The department of naturopathy provides treatments which are based on the 5 great elements of nature that have immense healing properties.
According to Indian mythology there are five main elements nature comprises of which are Jal(Water), Vayu (Air), Akash (Sky), Agni (Fire) and Prithvi (Earth). These together are also knownas Panchamahabhuta, which are also one of the chief attributes that form our body. In India,we use these elements in nature for the treatments.
- Earth (Mud baths, Mud packs)
- Water (Hydrotherapeutic methods in the form of Baths,Jets,Douches,Packs,Compresses)
- Air ( Breathing exercises, Outdoor walking, Open air baths)
- Fire – Sun baths( Thermoleum baths, Magnetised water, Colour charged oils / water)
Ether (Fasting therapy, Meditation)
Nutritional supplements provided at NIMS Naturopathy Department
These are the active ingredients taken from turmeric. From 100 gm of raw turmeric we will get only 1 to 1.5gm of curcumin. This is a high antioxidant which detoxify all free radicals which is being formed due to the toxin accumulation and as a by-product of body metabolism, which is being multiplying in millions every fraction of seconds. Free radical is an unstable atom, if it gets attached the cell, the cellular integrity is lost and become oxidized resulting in loss of function of that cell. If we supplement curcumin daily, the free radical will not get oxidized and become harmless, thereby the smooth functioning of cell will take place. More over it is absolutely liver protective and will correct all the functioning deformities of liver. It is also usefull in enhancing brain capabilities and co-ordination.
Diet naturals or diet substitutes
Diet naturals are the active ingredients taken from each food items which can act as medicine for the body, since food is the medicine for the body. But due to the modern food habits, we are not getting proper nutrients instead we are ingesting all sorts of unwanted chemicals or poison, which triggers the onset of different lifestyle disorders. Such diet naturals plays a very important role in the development and healing of cell injuries which will contribute a lot in the developmental process of the differently abled children.
It is the dried powder of separated leaves of the common wheat plant used as a drink ordietary supplement. It can be used for blood production to enhance the functioning ability of each cell by providing alkaline medium of blood PH value which is essential for the prevention of all life style disorders. it is absolutely detoxifying nourishing as capable of enhancing up to 300 enzymatic reactions in the body one teaspoon with a glass of water empty stomach is the dose.
Grape Seed Extract
It is the extract powder of grape seed .It is absolutely helpful for attention deficit syndrome enhance blood circulation, cellular rejuvenation, and nerve function.
Black Cumin Capsule and Tea
It is taken from black cumin THYMOQUINONE is the active ingredient absolutely helpful for blood thinning, skin, hair, and cellular regeneration etc. They are also useful in combating arthritic problem and autoimmune disorders. This also have antidiabetic and antihypertensive properties.
Flax Veg Oil
It is taken from the extract of flax seeds, which improves heart and skin health. It reduce constipation and prevents colon and rectal cancer. It reduces joint pain, maintains right BP and blood sugar levels.
Curcuma longa is potent antioxidant and anti inflammatory and immune modulating effects. Grape seed extract, Tulsi extract, Rosemary extract, Ashwagandha extract, and Passion flower extract give antioxidant, anxiolytic, carminalive, sedative and adaplugen effects respectively.
- 12. AYURVEDA AND HOLISTIC TREATMENT
Ayurveda is one of the world’s oldest medical systems with historical roots of the Indian subcontinent.
Ayurveda department at NIMS Medicity utilizes indigenous techniques in intervene in various neurological, muscular, locomotor, behavioral deficits, which are very vital as far as the differently abled children are concerned.
The treatment vary for each individual depending on the bodily constitution aiming to flush out cellular metabolic debris, restore internal tissues and maintaining vitality.
Facilities at NIMS Medicity
- The composite treatment plan involving ayurvedic oral medications as well as selected external and internal panchakarma procedures had proved to give a substantial clinical and patient centered outcome improvement in existing quality of life and neurological deficits.
- Ayurveda by its age old remedial treatment and medicines adopts various classical massage therapies, dhara, shirothalam, shirolepam, navarakizhi, herbal steam bath , etc in addition to oral treatments which would detoxify body holistically homeostasis of health system.
- Ayurvedic management aims to revive the functions and enhance recovery through treatments, yoga, diet and routine that stimulates and Rejunuvate brain cells, strengthen and tone the muscles, and improve overall health and well-being.
- 13. NIMS CENTRE FOR ADVANCED BIOTECHNOLOGY (NCAB)
Disability associated with mental disorder/illness is one of the major contributors to the global burden of disease. Mental illnesses towards disability are specific, serious brain disorders that directly influence our thinking, motivation, emotion, and social interactions. Thus, early diagnosis would certainly improve the clinical pathology where NIMS is committed to save lives of an individual suffering from mental disability and its related eg. Autism spectrum disorder, Alzheimer disease, Epilepsy, Insomnia and different degree of mental retardation, child with low cognitive functions and so on.
These studies make use of evermore sophisticated brain imaging technologies and cognitive neuroscience. Building on these accomplishments, the search for disease vulnerability genes is likely to yield the most important tools yet in our ongoing attempts to understand the brain in mental illness where NIMS Medicity is committed to play vital role using molecular diagnostic techniques for the early intervention of people suffering from mental disorders to improve their life quality.
Identifying genes that may play an important role in mental diseases is only a first step in understanding how a gene or genes affect an individual. Every human carries between ~ 18,000 coding genes; the products of these genes, acting together and in combination with the environment—enable every human characteristic.
NIMS is investing in these strategies to initiate the groundwork as a frontline leader for tomorrow’s discoveries, lead to the successful treatment.
Yet, NIMS is to succeed in its mission, the research we support must capitalize on the revolution that is occurring in genomic research and must take very seriously the complex genetics of mental disorders. Eventually, understanding the patho-physiology that underlies discrete forms of mental disorder will lead to novel, increasingly specific treatments and, followed by prevention.
GENETICS LABORATORY, NIMS MEDICITY
The genetics laboratory in NIMS is committed to address the following issue related to mental illness towards the disability, related to Autism spectrum disorder when an individual is reported to have the following clinical features.
Major clinical symptoms
- Impaired social interaction
- Impaired communication
- Repetitive and stereotypic behaviors
- Hyper- and hyposensitivity to sound and touch
- Stereotypic behavior around food and their presentation
- Abnormal sleep pattern Seizures Tantrums and/or self-injurious and aggressive behaviors
- Impaired motor development with toe walking, hypotonia, general clumsiness
X-linked, autosomal dominant, autosomal recessive.
This has been diagnosed by target gene panel analysis using Ion Torrent PGM sequencing
ADNP (OMIM: 611389)
ADSL (OMIM: 608222)
ALDH5a1 (OMIM: 610045)
AMT (OMIM: 238210)
ANKRD11 (OMIM: 611192)
ARID1B (OMIM: 614556)
CHD2 (OMIM: 602119)
FOXG1 (OMIM: 605515)
PCDH19 (OMIM: 300460)
SCN1A 9 (OMIM: 182389)
TSC1 (OMIM: 605284)
TSC2 (OMIM: 191092)
The genetics laboratory is equipped with the following major, minor and supporting instrument to perform whole genome sequencing (if necessary), targeted gene panel analysis and Realtime PCR based genotyping (eg. SNP detection, RFLP for diagnosis)
Instruments in NCAB
- 14. NUTRITION AND DIETETICS
Dietitians are responsible for the nutritional management of individuals who are referred to their care. It is well recognised that people with disabilities are at risk of nutritional problems and therefore it is very important that there is access to dietetic services for this group.
In children with Cerebral Palsy, feeding difficulties have been found to affect 60-90% of children. Many children with Autism Spectrum Disorder exhibit selective eating and therefore have selflimiting diets which are unbalanced and problematic. Equally, children with conditions such as Down’s Syndrome, Spina Bifida and Muscular Dystrophy experience a range of nutritional difficulties including undernutrition, eating, drinking and swallowing (EDS) disorders, constipation, vitamin & mineral deficiencies, bone problems, overweight/obesity, among others. A significant number of those presenting with EDS difficulties go on to require tube feeding.
The Dietetics department and nutrition at NIMS hospital formulates the most appropriate nutritional therapy for every patient. Individual requirements are considered through initial metabolic, biochemical and anthropometric data obtained by nutritional assessment of the patient.
Benefits of Nutritional Intervention
- Improved food and fluid consumption
- Improved nutritional status (e.g. increases in height & weight) Improved bowel pattern
- Increased immunity
- Lower rates of hospitalisation
- Improved health and well-being
- Better quality of life