Browsing by Author "Alexander, A"

Now showing 1 - 13 of 13
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    A questionnaire survey about doctor-patient communication, compliance and locus of control among South Indian people with epilepsy
    (EPILEPSY RESEARCH, 2000)
    To date, very few studies have investigated patients' views on the information they receive from the doctor concerning epilepsy and its management. Little information is available about the influence of doctor-patient communication and locus of control on the compliance of persons with epilepsy. We investigated, through a questionnaire-interview design, among patients attending the epilepsy clinic of a tertiary referral center in South India, their views about the provision of information by the doctor, and their compliance and locus of control. We also determined the interrelation between doctor-patient communication, compliance and locus of control. Our subjects comprised 200 adult persons with epilepsy, 113 males and 87 females, mean age 30.5 (range 18-67) years. Over one-third of the subjects received from the doctor insufficient information about epilepsy and its treatment. There was a significant positive correlation between effective doctor-patient communication and compliance. A majority of our patients had an external locus of control, which negatively influenced the compliance. Even in a comprehensive epilepsy clinic of a model tertiary referral center in a developing country, a significant proportion of patients do not receive optimal information about epilepsy from the doctor. Knowledge about their disease will encourage people with epilepsy to make informed choices, and achieve better compliance and personal control of their problems. Educating primary and secondary care physicians about the importance of doctor-patient communication in the management of epilepsy and educating the public about the positive aspects of life in epilepsy cannot be overemphasized. (C) 2000 Published by Elsevier Science B.V. All rights reserved.
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    An instrumental activities of daily living scale for dementia screening in the elderly in developing countries
    (NEUROBIOLOGY OF AGING, 2002) Mathuranath, PS; George, A; Cherian, JP; Alexander, A; Verma, N; Gopinath, N
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    A critical evaluation of the lateralizing significance of material-specific memory deficits in patients with mesial temporal lobe epilepsy with hippocampal sclerosis
    (Epilepsy Behav, 2013-08) Jeyaraj, MK; Menon, RN; Justus, S; Alexander, A; Sarma, PS; Radhakrishnan, K
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    Effects of age, education and gender on verbal fluency
    (JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 2003)
    The objective was to study the effects of age, education and gender on verbal fluency in cognitively unimpaired, older individuals. The methods used were as follows: cognitively unimpaired elderly (55-84 years) subjects (n = 153), were administered category (animal) (CF) and letter (/pa/) (LF) fluency tasks, in their native language of Malayalam. Results and conclusions were (1) Level of education, but not age or gender, significantly influence LF. (2) Level of education (directly) and in the elderly subjects, age (inversely) affect CF. (3) Age, but not education, has a differential effect on the tasks of verbal fluency, influencing CF more than LF.
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    Management and referral patterns of epilepsy in India
    (SEIZURE, 1996)
    Evaluation of management and referral pattern is very important in the organization of medical services for epilepsy. In order to study the management and referral pattern of epilepsy, a structured questionnaire was administered to 100 epilepsy patients attending a referral hospital in Kerala State, India. Of these, 61.4% of them were living in villages; 65% had a monthly income less than Rs, 1000. Seventy-five percent of the patients had generalized seizures. The mean delay in diagnosis was more for those from villages (13.5 months) as compared to those from urban areas (6.4 months) and for women (11.7 months) as compared to men (7.8 months). Previous consultation before referral to this Institute included general practitioners (61%), specialists (50%) and neurologist or neurosurgeon (27%), Eighty-eight patients have had EEG and 51 patients have had CT Scans, Thirty-nine per cent of patients required hospitalization for control of seizures that was significantly (P = 0.036) higher among those living in an urban area. Seventy-five per cent of patients were collecting drugs from private pharmacies, No patient was collecting antiepileptic drugs from government institutions even though such a facility was available within 5 km of their residence. This study has revealed that the organization and delivery of neurological services for epilepsy leaves much to be desired.
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    Memory outcome following left anterior temporal lobectomy in patients with a failed Wada test
    (EPILEPSY & BEHAVIOR, 2015) Rathore, C; Alexander, A; Sarma, PS; Radhakrishnan, K
    Purpose: This study aimed to compare the memory outcome following left anterior temporal lobectomy (ATL) between patients with a failed Wada test and patients who passed the Wada test. Methods: From 1996 to 2002, we performed the Wada test on all patients with unilateral left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and concordant electroclinical data before ATL. We used a 12-item recognition paradigm for memory testing and awarded a score of + 1 for each correct response and -0.5 for each incorrect response. No patient was denied surgery on the basis ofWada scores. We assessed cognitive and memory functions using the Wechsler Adult Intelligence Scale and the Wechsler Memory Scale preoperatively and at one year after ATL. We compared the number of patients who showed decline in memory scores, as per the published reliable change indices, between the patients with a failed Wada test and the patients who passed the Wada test. Results: Out of the 116 eligible patients with left MTLE-HS, 88 underwent bilateral Wada test, while 28 underwent ipsilateral Wada test. None of them developed postoperative amnesia. Approximately, one-third of patients with a failed Wada memory test when the failure was defined as a contralateral score of <4, as an ipsilateral score of >8, and as an asymmetry score of <0. The patients with Wada memory failure had a longer pre-ATL duration of epilepsy (p < 0.003). The memory and quality-of-life outcomes did not differ between the group with a failed Wada memory test and the group who passed the Wada memory test. The results remained the same when analyses were repeated at various other cutoff points. Conclusion: The patients with left MTLE-HS with concordant electroclinical, MRI, and neuropsychological data should not be denied ATL solely on the basis of Wada memory test results. (C) 2015 Elsevier Inc. All rights reserved.
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    Neuropsychological and quality of life outcome after anterior temporal lobectomy for medically refractory temporal lobe epilepsy
    (EPILEPSIA, 2005) Alexander, A; Sylaja, PN; Cherian, PJ; Radhakrishnan, K; Sarma, PS
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    Neuropsychological impairment and altered thyroid hormone levels in epilepsy
    (NATIONAL MEDICAL JOURNAL OF INDIA, 1998)
    Background. Neuropsychological impairment is a common problem in epilepsy which interferes with the quality of life of patients. Similarly, thyroid hormone levels have been observed to be abnormal in patients with epilepsy on various treatments. This study aimed to ascertain any possible correlation between neuropsychological performance and thyroid hormone levels among epilepsy patients.Methods. Thyroid hormone levels, indices of neuropsychological performance and social adaptation of 43 epilepsy patients were compared with those of age- and sex-matched healthy control subjects.Results. Epilepsy patients exhibited significantly (p<0.001) lower scores on attention, memory, constructional praxis, finger tapping time, and verbal intelligence quotient (IQ) when compared with controls. Their T3, T4 and Free T3 levels were significantly lower; and TSH and Free T4 levels were significantly higher than that of controls. There was no statistically significant correlation between the indices of neuropsychological performance and thyroid hormone levels.Conclusion. We did not observe any correlation between neuropsychological impairment and thyroid hormone levels among patients with epilepsy.
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    QUALITY OF LIFE OUTCOME ACROSS YEARS AFTER ANTERIOR TEMPORAL LOBECTOMY FOR DRUG RESISTANT TEMPORAL LOBE EPILEPSY
    (EPILEPSIA, 2013) Alexander, A; Radhakrishnan, A; Varma, R; Radhakrishnan, K
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    QUALITY OF LIFE OUTCOME ACROSS YEARS AFTER ANTERIOR TEMPORAL LOBECTOMY FOR DRUG-RESISTANT TEMPORAL LOBE EPILEPSY
    (EPILEPSIA, 2011) Alexander, A; Radhakrishnan, A; Varma, R; Radhakrishnan, K
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    Sexual desire and satisfaction after resective surgery in patients with mesial temporal lobe epilepsy with hippocampal sclerosis
    (Epilepsy & Behavior, 2012-11) Ramesha, KN; Radhakrishnan, A; Jiayaspathi, A; Padickaparambal, S; Alexander, A; Unnikrishnan, JP; Sarma, PS; Radhakrishnan, K
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    Sexual desire and satisfaction after resective surgery in patients with mesial temporal lobe epilepsy with hippocampal sclerosis
    (EPILEPSY & BEHAVIOR, 2012) Ramesha, KN; Radhakrishnan, A; Jiayaspathi, A; Padickaparambal, S; Alexander, A; Unnikrishnan, JP; Sarma, PS; Radhakrishnan, K
    Utilizing a questionnaire, we inquired about the self-perceived sexual behavior of 50 married males with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) before and after anterior temporal lobectomy (ATL) and compared the results with those of 50 age-matched healthy married males. The sexual desire and satisfaction of the patients were poor when compared to the controls. Although a majority of the sexual domains improved following ATL, even after a median duration of five years, the sexual status of the patients did not match with that of the controls. Those who, after ATL, were seizure free, had one or no antiepileptic drug (AED) and had an EEG without epileptiform abnormalities achieved a better sexual outcome. We conclude that sexual dysfunction is frequent in male patients with MTLE-HS. They require preoperative assessment to identify their sexual inadequacies as well as counseling about the expected post-ATL sexual outcome. Discontinuation of enzyme-inducing AEDs facilitates post-ATL improvement in sexual function. (C) 2012 Elsevier Inc. All rights reserved.
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    Wada test does not predict memory outcome following anterior temporal lobectomy
    (EPILEPSIA, 2007) Rathore, C; Alexander, A; Nayak, D; Sarma, S; Radhakrishnan, K