Christian Medical College, Ludhiana
DM Neurology Institution: Sri Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum
Post DM Neurology Institution: University of Alberta, Edmonton, Canada.
During my MD Internal Medicine training at Institute of Medical Sciences, Banaras Hindu University, Varanasi, I was often perplexed and pained by lack of treatment and eventual deaths of many of my stroke patients. This bolstered my resolve to conduct intervention studies in stroke patients to improve outcomes. At Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, while pursuing my DM Neurology training, I was involved in a project to improve motor recovery in stroke patients under the guidance of Dr K. Radhakrishnan. We used transcranial magnetic stimulation and/or functional electrical stimulation as an adjunct to conventional physiotherapy. We were able to improve motor recovery in stroke patients. The results of this study geared me to think regarding non-pharmacological therapies for stroke acute treatment and rehabilitation.
I met Dr Ashfaq Shuaib and Dr Kenneth Butcher in 2010 World Stroke Congress at Seoul and decided to do join University of Alberta, Canada for my stroke fellowship. Dr Shuaib had 30 years experience in conducting multicenter clinical stroke intervention trials. With him I was involved in many non-pharmacological (laser therapy for stroke rehabilitation, NEST 3; Sphenopalatine ganglion stimulation to improve blood flow to brain, IMPACT2b and transcranial ultrasound therapy, CLOTBUST-ER) and pharmacological studies. After first year I joined the group of Dr Kenneth Butcher to learn about the most important biomarker in stroke imaging. Dr Butcher has been a great mentor to me, he taught me manuscript writing, grant writing and how to develop clinical trials with rigorous methodology. Under his supervision I also joined Masters in Translational Medicine program. The translational medicine program has changed my outlook drastically, our class included people from bench, bedside and community. The course taught me the process of translation from animals to human and then to community at large. With this experience I wanted to design stroke intervention studies specific to India. They had to be low-cost or no cost, preferably non-pharmacological; however had go through the same rigorous assessment, needed for any expensive therapy. Remote ischaemic conditioning was fitting that bill perfectly.
I had worked with Dr Jeyaraj Pandian (Professor and Head, department of Neurology, Christian Medical College, Ludhiana) remotely, on a multicenter project to understand the predictors of outcome in minor ischaemic stroke. He has also conducted two pivotal intervention studies for stroke rehabilitation in India. These two factors helped me decide the place where I wanted to conduct my study. For last one year I have joined department of Neurology, Christian Medical College, Ludhiana as an assistant professor. The Wellcome/DBT India Alliance Intermediate Fellowship I will test whether remote ischaemic conditioning a low-cost intervention can effectively improve outcomes in stroke patients.