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1.
Telehealth and Medicine Today ; 6(2), 2021.
Article in English | ProQuest Central | ID: covidwho-2026471

ABSTRACT

Objective: During the coronavirus-2019 (COVID-19) times, we have all learned to appreciate the advantages of communicating with each other on the digital or virtual format. This included both social, commercial and professional settings. This was necessitated through the restrictions on direct physical contact mandated by the pandemic. Through innovations and adaptations, the practice of medicine has also changed with telemedicine, triggered by ‘necessity is the mother of invention’ concept being embraced by both patients and physicians. Neurology, traditionally seen as a complex speciality and the preserve of a couple of thousand practising neurologists in the country, has opened itself up to the telemedicine or tele-neurology format very easily in the anecdotal and a few pilot studies conducted globally and in India. Design: Despite the initial misgivings and anticipation of patient reluctance to adopt this technology, the real-world experience has been, to the contrary, where both young and old patients have readily embraced the new medium and cooperated with the neurologists to improve their care, which would otherwise have been severely restricted in the COVID-19 times. The neurologists have also adapted to the new way of working to deliver optimum diagnosis and care plans. Outcome measures: There have been technical glitches (in form of internet connectivity, smartphone hardware and software problems and lighting and camera angle and image stabilization issues to name a few), which have been reduced with practice and innovation. Feedback from neurologists, patients, and their carers via regular audits and questionnaires are being circulated, and practice parameters are being improved (IFNR survey- Ref 5). The contribution of national regulatory agencies, such as the Ministry of Health and Family Welfare (MoHFW), and stakeholders, such as the Telemedicine Society of India (TSI), has been phenomenal to facilitate the tele-neurology practice and make it safe for all stakeholders. Results: In a country of 1.37 billion population and only 2,500 accredited neurologists, there is a need for tele-neurology to be able to serve patients living in remote areas in mountains and coastal areas, and also in poorly connected areas on the plains. This becomes paramount for patients requiring specialised acute neurological care and to improve access, which now becomes a practical feasibility on the digital format to bring neurology to the doorsteps of the people. Follow-up care of patients, epidemiological studies of various neurological chronic illnesses and their audit will become realities cutting down on costs and time to access quality neurological care using the digital format for 21st-century India. Conclusions: Tele-neurology is no longer a vision, but a reality precipitated by the pandemic, the needs and aspirations of the Indian population, and the technological infrastructure India has achieved in the last 20 years.

2.
Ann Indian Acad Neurol ; 25(1): 7-10, 2022.
Article in English | MEDLINE | ID: covidwho-1726287

ABSTRACT

During the second wave of COVID-19 pandemic, there is a sudden increase in number of cases mucormycosis infection in India. This communication by the Tropical Neurology subsection expert group of the Indian Academy of Neurology (IAN) describes the clinical and diagnostic features, treatment of the disease and gives recommendations about the ways forward.

3.
Front Neurol ; 12: 667925, 2021.
Article in English | MEDLINE | ID: covidwho-1485081

ABSTRACT

The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.

4.
Ann Indian Acad Neurol ; 24(2): 138-141, 2021.
Article in English | MEDLINE | ID: covidwho-1227109

ABSTRACT

The COVID19 pandemic in India is causing significant morbidity and disruptions of healthcare delivery. The rapidly escalating contagion is straining our public health system, which is already under pressure due to a shortage of infrastructure and inadequate workforce. Neuro rehabilitation services that are still in its infancy in our country have been significantly interrupted in the last six months. An expert group from Indian Federation of Neurorehabilitation (IFNR) have formulated the guidelines and consensus recommendations for Neurologists, Physiatrists, and Therapists managing neurological disabilities during COVID 19. The aim of this consensus paper is to sensitize the clinicians and therapists about maintaining the continuum of care and rehabilitation needs of Covid patients as well as non Covid patients with neurological disorders during the ongoing COVID 19 pandemic.

5.
Front Neurol ; 12: 626399, 2021.
Article in English | MEDLINE | ID: covidwho-1110312

ABSTRACT

Background: Corona virus disease (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This has affected service delivery among all medical disciplines in India including neurorehabilitation services. Aims and Objectives: The aims and objectives of the study were to assess the effect of COVID-19 pandemic on neurorehabilitation services across India. Methodology: A prospective nationwide survey study was undertaken by the Indian Federation of Neurorehabilitation during the pandemic. A questionnaire was prepared using Google forms software consisting of four sections: demography, neurorehabilitation practice before COVID-19 pandemic, neurorehabilitation practice during COVID-19 pandemic, and continuing medical education during COVID-19 pandemic. Results: Responses (872) were received from neurorehabilitation professionals across the country out of which 2.2% professionals did not give consent for participating in the survey. Participants (36.6%) were practicing traditional or independent referral basis rehabilitation, while 63.4% participants were practicing multidisciplinary rehabilitation. On an average, respective units were conducting 500-750 therapy sessions per month. Majority of the rehabilitation units in India lacked a physiatrist, rehabilitation nurse, music therapist, cognitive therapist, and urologist. Approximately 80% of the rehabilitation units have the basic rehabilitation modalities and advance technology was present in only 20% of the rehabilitation units. During COVID-19 pandemic, 19.5% centers were providing elective services, 50.3% emergency services, 15.6% new outpatient services, and 22.7% were providing follow-up outpatient services. Centers (51.5%) were providing telerehabilitation services for neurological conditions during the times of COVID-19 pandemic. Professionals (61.1%) providing telerehabilitation were working from home. Among the patients who needed neurorehabilitation, 28% were doing their exercises independently, 31% were supervised by caregivers, 17% were supervised by therapists, and 24% were not receiving any therapy. Participants (95.5%) wanted to receive more training in the field of neurorehabilitation. The participants utilized webinars (71%), online courses (22%), case discussion forums (19%), panel discussions (13%), and literature search (8%) during COVID-19 pandemic to continue education. Conclusion: The study reflects the situation of neurorehabilitation service delivery in India during the pandemic as the respondents were from all parts of the country and included most components of the neurorehabilitation team. Neurorehabilitation services were severely affected across India during the COVID-19 pandemic. Tele-neurorehabilitation has emerged as a new service delivery model during the pandemic. Online means of education has emerged as the primary source of continuing medical education during the pandemic.

6.
Front Neurol ; 11: 664, 2020.
Article in English | MEDLINE | ID: covidwho-658453

ABSTRACT

With the rapid pace and scale of the emerging coronavirus 2019 (COVID-19) pandemic, a growing body of evidence has shown a strong association of COVID-19 with pre- and post- neurological complications. This has necessitated the need to incorporate targeted neurological care for this subgroup of patients which warrants further reorganization of services, healthcare workforce, and ongoing management of chronic neurological cases. The social distancing and the shutdown imposed by several nations in the midst of COVID-19 have severely impacted the ongoing care, access and support of patients with chronic neurological conditions such as Multiple Sclerosis, Epilepsy, Neuromuscular Disorders, Migraine, Dementia, and Parkinson disease. There is a pressing need for governing bodies including national and international professional associations, health ministries and health institutions to harmonize policies, guidelines, and recommendations relating to the management of chronic neurological conditions. These harmonized guidelines should ensure patient continuity across the spectrum of hospital and community care including the well-being, safety, and mental health of the patients, their care partners and the health professionals involved. This article provides an in-depth analysis of the impact of COVID-19 on chronic neurological conditions and specific recommendations to minimize the potential harm to those at high risk.

7.
Ann Indian Acad Neurol ; 23(Suppl 1): S15-S23, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-316384

ABSTRACT

The ongoing pandemic of COVID-19 is a global public health emergency. This has led to challenges for healthcare facilities to optimally manage other important medical emergencies. Stroke is an important public health emergency with significant mortality and morbidity. Timely treatment of acute stroke is critical to prevent disability. The current expert consensus statement on behalf of the Indian Stroke Association outlines the issues and suggestions related to the management of stroke during this ongoing COVID-19 pandemic.

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