During the Young Stroke Physicians and Researchers (YSPR) session at ESOC 2018, four early career stroke physicians and researchers will present their planned or ongoing projects and receive feedback from two renowned stroke experts. The session will be held on Wednesday May 16 at 8.30 in Hall J2.
The first speaker is Dr Jatinder Minhas (https://twitter.com/DrJMinhas), a Specialist Registrar in Geriatrics (Stroke) and General Internal Medicine and Doctoral Research Fellow based in Leicester, United Kingdom. He will be presenting The Feasibility of Improving Cerebral Autoregulation (CA) in Acute Intracerebral Haemorrhage (BREATHE-ICH) study, which is a CA-targeted interventional study utilising a simple bedside hyperventilatory manoeuvre. In acute ICH, impairment of CA has been associated with worsening clinical outcomes. Hypocapnia expands the plateau region of the CA curve subsequently improving CA and the ability to keep cerebral blood flow constant. This study aims to assess the feasibility of utilising hypocapnia (via hyperventilation) to improve CA in acute ICH.
How did you get involved in stroke research?
During my early clinical training I worked on the hyper acute stroke unit in Leicester. I thoroughly enjoyed the challenge of managing acute stroke and associated complications using a multi-disciplinary team approach. The department is research active and I soon learnt about the breadth of studies ranging from small observational studies to large multi-centre trials. I had always had an interest in physiology and the physiological perturbations during acute stroke provided an avenue to explore during a small initial project under the supervision of Professor Tom Robinson. This has since led to me developing a highly varied skill set including transcranial Doppler (TCD) measurements of cerebral blood flow, carbon dioxide manipulation of cerebral blood flow, logistic modelling and more recently an understanding of handling larger clinical trial data.
Why did you choose this topic?
Mechanistic studies assessing physiological changes in acute stroke provide a ‘beat-to-beat’ perspective on blood pressure and cerebral blood flow. TCD is a non-invasive, bedside tool that in my experience is highly acceptable to patients. I have enjoyed the challenge of developing TCD skills and using this knowledge to develop a study to further understand the physiological changes associated with acute intracerebral haemorrhage (ICH). The paucity of ICH studies is apparent and I believe there is a significant amount more to learn about blood pressure and blood flow control in this particularly vulnerable patient population.
What have been the most difficult challenges regarding your research career so far?
As a clinical academic, it can be incredibly difficult to ensure you maintain progress and competency in both clinical and academic practice. This is particularly tricky when applying for external Fellowship funding for doctoral studies. This is a highly competitive process requiring one to demonstrate the ability to deliver a novel project with potential impact in the area of research. The challenge was completing clinical exams, deriving robust pilot data and disseminating findings to support a strong application in a short period of time. I have been immensely grateful for the support provided by my Fellowship funder (Dunhill Medical Trust) who support research into a variety of ageing related diseases.
How do you balance work life and free time/home life?
I have found ensuring a balance at times a challenge. However, my wife (Paediatric doctor) and I forward plan and ensure we always make our respective regular activities (swimming and football training) with our 3-year-old son. Although sometimes scarce, we enjoy maximising free weekends by visiting family and enjoying day trips. I think prioritising well and working as a team has certainly helped us manage to date.