Search PubMed⌕ Search

Biomedical subjects

N Gandhi

Publications and source records attributed to N Gandhi.

At least 19 recordsLinked to original sources
PubMed2001

A randomized controlled trial of community-oriented and hospital-oriented care for discharged psychiatric patients: influence of personality disorder on police contacts.

An important forensic psychiatric measure, contacts with police, was compared in a randomized, controlled trial of 155 patients with severe mental illness with a previous admission within the past two years. The patients, who also had their personality status addressed formally before randomization, were allocated to community multidisciplinary teams or to hospital-based care programs after discharge from in-patient care and were followed up for one year. A total of 138 patients (89%) had at least one post-baseline assessment and of these patients, 16 (12%) had at least one police contact in the year of the study, most of which were emergency assessments. The data showed significantly greater numbers of police contacts in patients with increasing severity of personality disturbance. Patients with such disturbance were six times more likely to have police contacts than those with no personality disorder. There were significantly more contacts in patients with borderline and antisocial (dissocial) personality disorder allocated to community-oriented care compared with hospital-oriented care. These findings have important implications for risk assessment in severe mental illness.

Adolescent↗
PubMed1998

Randomised controlled trial of two models of care for discharged psychiatric patients.

OBJECTIVE: To compare the clinical outcome and costs of care of psychiatric patients allocated to community multidisciplinary teams or to hospital based care programmes after discharge from inpatient care. DESIGN: Randomised controlled trial. SETTING: Inner London (Paddington and North Kensington) and outer London (Brent) psychiatric services. SUBJECTS: 155 patients with severe mental illness with a previous admission within the past 2 years. MAIN OUTCOME MEASURES: Ratings of clinical psychopathology, depression, anxiety, and social functioning; comprehensive costs of health care. RESULTS: Clinical outcomes were available for 133 patients and cost data for 144 patients after 1 year. The clinical outcomes of the two models of care were essentially similar, but admission to hospital was more likely in the hospital based care group and the costs of health care were 14% greater per patient than in the community group. This difference, however, was dwarfed by a twofold difference in the costs of care in the outer London services compared with those in inner London. This was explained largely by greater inpatient care for outer London patients (58 median bed days v 18 for inner London patients), more of which was provided by extracontractual referrals to other psychiatric hospitals as Brent had only 0.28/1000 beds available for acute adult patients compared with 0.82/1000 in Paddington and North Kensington over the period of the study. CONCLUSION: Aftercare by community teams for psychiatric patients with severe mental illness has a similar outcome to hospital based aftercare but with fewer admissions to hospital. When psychiatric bed requirements are insufficient for a population, however, neither form of aftercare is effective as greater use of hospital beds elsewhere swamps any advantage of community care programmes, with disintegration and discontinuity of psychiatric services leading to escalating costs.

Adolescent↗
PubMed1995

Integrated Child Development Services Scheme and nutritional status of Indian children.

The Integrated Child Development Services (ICDS) Scheme is one of the major National Human Resource Development Programmes of the Government of India. The programme completed 18 years of its effective operational duration on 2 October 1993. During this period we have conducted various baseline surveys, multicentre longitudinal and periodic studies, and unicentre special study projects to determine the impact of the programme on the nutritional status of children aged 0 to < 6 years and evaluate the coverage of the scheme. The children with normal nutrition in ICDS blocks constituted 50 per cent of the surveyed population in 1976 in comparison to 75 per cent observed in baseline data of 1990 survey. There was a highly significant decrease in severely malnourished children from 21 per cent in 1976 to 7 per cent in 1990. The benefit of the programme was evident in all sections of the society including Scheduled Castes, Scheduled Tribes, Backward and Minority communities. The nutritional services (supplementary nutrition, Vit. A, Iron, and Folic Acid) coverage of the children increased from 25 per cent in 1976 to 53 per cent in 1985 in ICDS blocks in comparison to 42 per cent in non-ICDS blocks, while that for pregnant and lactating women increased from 17 per cent and 14 per cent in 1976 to 25 per cent and 26 per cent 1985, respectively.

Adolescent↗
PubMed1992

Immunization coverage in India for areas served by the Integrated Child Development Services programme. The Integrated Child Development Services Consultants.

The Integrated Child Development Services (ICDS) programme was launched by the Indian government in October 1975 to provide a package of health, nutrition and informal educational services to mothers and children. In 1988 we studied the impact of ICDS on the immunization coverage of children aged 12-24 months and of mothers of infants in 19 rural, 8 tribal, and 9 urban ICDS projects that had been operational for more than 5 years. Complete coverage with BCG, diphtheria-pertussis-tetanus (DPT) and poliomyelitis vaccines was recorded for 65%, 63%, and 64% of children, respectively, in the ICDS population. By comparison, the coverage in the non-ICDS group was only 22% for BCG, 28% for DPT, and 27% for poliomyelitis. Complete immunization with tetanus toxoid was recorded for 68% of the mothers in the ICDS group and for 40% in the non-ICDS group. Coverage was greater in the urban and lower in the tribal projects. Scheduled castes, scheduled tribes, backward communities, and minorities (groups that have a high priority for social services) had immunization coverages in ICDS projects that were similar to those of higher castes.

Child, Preschool↗
PubMed1991

Postexposure rabies prophylaxis: when the guidelines are not respected.

Fifteen spontaneously reported cases of alleged lack of drug effect of postexposure antirabies prophylaxis using PCEC vaccine were analysed. The most striking finding was that in no case were the WHO guidelines for postexposure treatment of injuries caused by rabid animals respected. Therefore nothing points to insufficient vaccine efficacy. Better information for both the medical profession and the public about the treatment of exposed patients is needed.

Adult↗
PubMed1984

Sleep-awake responses elicited from medial preoptic area on application of norepinephrine and phenoxybenzamine in free moving rats.

The study makes an attempt to find out the action of norepinephrine (NE) and phenoxybenzamine (PB), applied at medial preoptic area (mPOA), in altering the sleep-awake responses, in free moving rats, which has not yet been reported. Effects of application of NE during day and PB during night, at mPOA, on sleep-awake responses, were compared with application of saline during identical periods. Application of NE produced arousal, whereas, PB produced the opposite effect. The findings are suggestive of the involvement of NE terminals at mPOA in normal arousal.

Animals↗
PubMed1978

Racial influences in open-angle glaucoma.

Blindness due to glaucoma is much greater in blacks than in whites. Using a computerized diagnostic index we identified more than 1,300 patients being treated for glaucoma in our outpatient clinics. Analysis of this clinic population indicated that open-angle glaucoma is more prevalent among blacks than in whites. They also indicate that open-angle glaucoma occurs at a younger age in the black population. We have very limited data that tend to indicate that open-angle glaucoma is a more severe disease in blacks than in whites; however, this evidence is far from conclusive. Finally, our findings indicate that in our institution we are seeing the full range of the glaucomatous process in the black population and not merely the end-stage disease.

Adult↗