Telemedicine A Boon For Acute Neurological Care

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BANDAR SERI BEGAWAN: The Head of the Neuroscience Stroke Rehabilitation Centre at the Jerudong Park Medical Centre (JPMC), Professor Datin Seri Laila Jasa Dr Uta Meyding-Lamade highlighted the profound impact of acute neurological care in Brunei, saying that developments made are only possible courtesy of telemedicine, tele-neuroradiology and tele-teaching, during her keynote address at the 2nd International Neurological Conference at the Chancellor Hall of Universiti Brunei Darussalarn yesterday, Borneo Bulletin reported.

The conference, which was jointly organised by Pengiran Anak Puteri Rashidah Sa’adatul Bolkiah (PAPRSB) Health Institute of Health Sciences and the Jerudong Park Medical Centre (JPMC), was entitled ‘New Advances in Neurology in Brunei Darussalam’ and was attended by the Minister of Energy at the Prime Minister’s Office, Pehin Datu Singamanteri Colonel (Rtd) Dato Seri Setia (Dr) Awang Haji Mohammad Yasmin bin Haji Umar, in his capacity as the Chairman of JPMC.

Also present were Chief Executive Director of JPMC, Dato Paduka Dr Haji Mohd Isham bin Haji Jaafar; Ambassador of the Republic of Germany to Brunei Darussalam, Mr Roland Grafe; Acting Vice Chancellor of UBD, Hajah Anis Faudzulani bind Hj Dzulkiflee; and Deputy Vice Chancellor of UBD, Associate Professor Dr Hajah Zohrah binti Haji Sulaiman.

The telemedicine system, a key feature at the NSRC enables videoconferences between doctors and nurses of Neuroscience Stroke Rehabilitation Centre (NRSC) and Krakenhaus Nordwest as well as assessment, interpretation, and reporting of MR-I and CT imaging to be conducted via a protected data line.

Data of neurophysiological examinations such as EEG and microscopic cell preparations can be discussed simultaneously with counterparts overseas.

During the last two years, over 1,500 people have been treated as in and out patients in NSRC.

Since its establishment, the centre has had the view that quality and comprehensive medical care should be made its primary focus and this has been proven through its modern and high-quality care of patients suffering from strokes and other neurological conditions, where emphasis is paid to multi-professional rehabilitation.

In combating the ill effects of stroke, a dedicated stroke unit treatment has proven to be highly effective for improving mortality and reducing disability, allowing for patients to get back to an independent lifestyle.

Touching on the developments of the NSRC and its commitment to excellent medical attention, modern methods of stroke treatments such as thromboly-sis – to resolve blood clots in the brain in order to avoid brain compression – have been performed in significant numbers in cooperation with neurosurgeons and specialists from other hospitals in Brunei.

Professor Datin Dr Uta Meyding-Lamade pointed out that everyone should be kept informed on strokes and its prevention and that holding public awareness campaigns repetitively are among the only measures that will change attitudes of those who are unfamiliar with the condition.

Since April 2012, three projects have been undertaken in cooperation with Krakenhaus Nordwest, University of Heidelberg and UBD.

Preliminary results have attracted attention in international conferences and have been published in scientific journals.

An epidemiological study has been proposed with a public survey on providing information about incidence and prevalence of strokes in addition to other neurological conditions among the Brunei populace; a study focusing on infections of the nervous system; the establishment of laboratory studies for the conduct of neuro-infection; and studies on the early diagnosis and treatment of dementia.

One of the highlights of the conference was poster presentations submitted by students – a culmination of their scientific projects performed during their attachments with Krakenhaus Nordwest Hospital in Frankfurt, Germany.

Some of the topics covered by students included Dk Hjh Nadirah binti Pg Hj Ahmad’s feasibility study on `Telemedicine and Electroencephalography; Hjh Zainab’s presentation entitled ‘What is the difference in stroke occurrence of ischemic and hemorrhage stroke and awareness of the risk factors among German and Brunei inhabitants’; and Daratul Ain bind Hj Durani’s feasibility study on ‘Cerebrospinal fluid- Is Telecytology possible?’

Local doctors from NSRC – Dr Chan Guan Choon and Dr Haji Mohammad Amri Haji Masri – also presented findings based on their case studies. Dr Chan Guan Choon displayed statistics of the 4.5-hour thrombolytic window, elderly patients, and overall patient demographics in the centre since its launch in 2010, while Dr Haji Muhammad Amri discussed Systemic Lupus of a 13-year-old girl.

Meanwhile, the Dean of PAPRSB Health Institute of Health Sciences, Dr Hajah Maslina Haji Mohsin said that various perspectives would be covered and explored, including an update on the state of neurological research and patients in Brunei.

The day-long conference also covered issues of cognition, infection and the application of new imaging techniques, in which Dr Hajah Maslina – played vital roles – urged their faculty members to stop viewing research as an additional commitment on top of teaching, but should be inculcated as a core business in the institute.

“There are still vast amounts of research to be done in this country and doors are open for collaboration with our partners in Brunei such as the Ministry of Health, Jerudong Park Medical Centre, and other international institutions”, she said.

Professor Datin Seri Laila Jasa Dr Uta Meyding-Lamade, as the co-chairperson of the organising committee said that patients who are admitted to a stroke unit as soon as symptoms are identified have an 80 per cent reduced risk compared to those who don’t act on the signs, which can lead to permanent disabilities.

“Stroke has tremendously changed with regard to treatment and His Majesty the Sultan and Yang DiPertuan of Brunei Darussalam has a powerful vision for the nation to deliver comprehensive medical services to every stroke patient in Brunei,” she said.

There were also presentations on topics such as ‘New Advances in Neuroimaging in Brunei’ by Professor Dr Bodo Kress; The role of hemicraniectomy in stroke’ by Dr Haroon Pillay; ‘New Advances in Neuroscience and Cognition’ by Associate Professor Dr Fatima Shad Kaneez; and ‘Epidemiology of stroke’ by Associate Professor Dr Mohd Ayub Sadiq.

Discussions were also held on ‘In vivo models for translation research in infectious diseases’ by Dr Francisco Javier Martinez Torres and ‘Studying Neuroinfections in Brunei Darussalam’ by Dr Siti Hanna Muharram.