The outcomes of clinical investigations have informed physicians the “how, why, where, what and when”, so that best and context-specific treatments can be developed to treat and control of diseases. The results of these clinical research studies provide body of data from the local context; so that disease prevention, treatment and control protocols are designed with local information that is derived from experiences and studies to better inform physicians, researcher, and policy makers.
Clinical Sciences: Treatment Using Local Knowledge
Overview
Global Kashmiri Connect proudly presents Drs. Mohd. Sultan Khuroo, Abdul Hamid Zargar, Parvaiz Koul, Upendra Koul, Javeed Iqbal, and Nargis Bail Kaur. They represent the best Kashmiri clinical researchers in the field of gastroenterology, endocrinology, pulmonology, cardiology, pediatric, and microbiology. They committed their professional life in pursuit of knowledge at an early stage in their career, which has helped treat patients in Kashmir and rest of the world. Taken together, they have published about 2000 scientific papers, which is remarkable. These clinician researchers have also mentored a large number of physicians and researchers, so that the new leaders in clinical research emerge.
Drs. Altaf Lal will talk to these experts in a free-flowing conversation about their academic and professional journey in becoming leaders in clinical sciences with medical students and young professionals. As they share their experiences, these experts aim to inspire and guide medical students and young professionals on the path to becoming clinical researchers. By fostering a culture of inquiry and collaboration, they envision a future where the physician community in Kashmir continues to lead the way in generating innovative treatment strategies and improving patient outcomes for locally relevant problems. Besides providing solutions to local issues, they also stand out as leaders in a number of concepts subsequently adopted by the world.
Dr Khuroo is credited with identifying Hepatitis E for the first time. He also worked on biliary Ascariasis, GI bleed, etc. Dr. Zargar is a global expert on diabetes and various endocrine disorders like the iodine deficiency, Sheehan’s syndrome. Dr. Parvaiz Koul’s work focused on Influenza, COPD, RTA and High-altitude pulmonary adaptations and Dr. Upendra Koul is a world-renowned clinical and interventional cardiology. Dr. Javeed Iqbal has focused on Pediatric pulmonology and has worked on Thiamine deficiency, Cystic fibrosis, and Primary ciliary dyskinesia in Kashmir. Dr. Nargis Bali Kaur initial work as a PG student revolved around influenza viruses. She has subsequently worked on antimicrobial resistance and infection control and disease outbreak investigations.
Amidst the challenges and complexities of healthcare delivery in Low to Middle Income Countries (LMIC), these distinguished clinical researchers have also championed initiatives aimed at addressing local health disparities and enhancing access to care. Their commitment to community engagement and advocacy underscores a holistic approach to medical research, where scientific inquiry is seamlessly integrated with efforts to promote public health and social justice. By bridging the gap between research and practice, they exemplify the transformative potential of collaborative research and community-driven healthcare solutions.
Speakers:
Dr. Mohammad Sultan Khuroo
Dr. Mohammad Sultan Khuroo received his primary and secondary education in Sopore. He graduated from Medical College Srinagar Kashmir, India in 1967. He completed his postgraduate degree in General Medicine (MD) from Medical College Srinagar in 1972 and DM in Gastroenterology from the post-graduate Institute of Medical Education & Research, (PGIMER) Chandigarh, Punjab. He is known as the discovered of “Hepatitis E” as a new disease entity. He served as the Chair of the Department of Medicine and Gastroenterology at the “Sher-I-Kashmir Institute of Medical Sciences Srinagar, Kashmir, India (SKIMS)” and held the position of Dean Medical Faculty (1985-1986) and Director of SKIMS (1993-1996). During his 14 years tenure at SKIMS, he discovered the disease entity of “Hepato-Biliary Pancreatic Ascariasis”, established the role of proton pump inhibitors in peptic ulcer bleeding, described percutaneous drainage of hepatic Hydatidosis (commonly known as PAIR technique) and recognized the syndrome of portal biliopathy. In 1996, Prof. Khuroo became Head & Consultant of Gastroenterology and Liver Transplantation at the prestigious King Faisal Hospital and Research Centre (KFSH) in Riyadh, Saudi Arabia. During the 10 years he spent as a consultant gastroenterologist and hepatologist at KFSH, he helped to set up a program for Liver Transplantation in the Kingdom of Saudi Arabia. He returned to Kashmir in January 2005, where he established a tertiary Care Digestive Diseases Center in Srinagar and Dr. Khuroo’s Medical Trust. During his over three decade of teaching career, Prof. Khuroo guided 21 MD/Ph.D. projects and trained a large group of clinicians in the field of Medicine and Gastroenterology.
Dr. Abdul Hamid Zargar
Dr. Abdul Hamid Zargar studied at the Ganai Haman School (one room school) in Baramulla from 1st to 5rh grade. From 5th to 8th grade is studies in Jabri School, which means kids were taken to study by force. He completed his Higher Secondary School in Baramulla. He did his MBBS and MD (Medicine) from the Govt. Medical College Srinagar and DM (Endocrinology) from Postgraduate Institute of Medical Education and Research, Chandigarh. He is the former Director and Professor and Head Department of Endocrinology, Sheri-Kashmir Institute of Medical sciences, Srinagar, Kashmir. His studied iodine deficiency disorder in 202 villages in six districts of Kashmir from 1993-1995, which confirmed the presence of significant iodine- deficiency in Kashmir Valley. His studies also suggested the possibility of higher prevalence of follicular carcinoma in Kashmir Valley being a consequence of environmental iodine- deficiency. He also carried an extensive study to find out the influence of iodine-deficiency on euthyroid sick syndrome. He also studied the epidemiological and etiological aspects of primary infertility – one of the largest series on primary infertility. He also documented the presence of postpartum pituitary insufficiency (Sheehan’s syndrome), which has become almost extinct from the developed world.
Dr. Upendra Kaul
Dr. Upendra Kaul was born in village Hawal, District Pulwama. He recalls not speaking for the first 4 years, and also remembers that on the advice of the family priest, a replica of my tongue made in silver was offered at Kheer Bhawani which brought me speech. When he was six, his family moved to Delhi in 1948. His schooling was in Delhi, but the mind was always in the valley, thinking about the big family living lavishly in Hawal village and Srinagar, which he visited every summer. He studied medicine at the Maulana Azad Medical College, Delhi and did his graduation and post-graduation in Cardiology. He Joined the AIIMS as a faculty and worked hard to become an international figure. He is passionately called U Koul by Kashmiris, who seek treatment from him for cardiac ailments. He visits Kashmir very frequently, and has started two clinics there, one in Srinagar, Gauri Heart Centre and one in Hawal, Prasad Joo Khan Heart Centre. The village center draws patients from valley Pulwama, Shopian, Kulgam and Jammu areas Rajouri and Poonch (through Mughal Road). An NGO “Gauri Kaul Foundation” for improving the health care of South Kashmir was founded in 2021. All this makes him a contented and a proud Kashmiri.
Dr. Parvaiz Koul
Dr. Parvaiz Koul retired as the Director of SKIMS, Soura in 2024, having remained the chief of Pulmonary and Internal Medicine for over 16 years. He did his primary schooling from SS Mission School in Malaratta, Srinagar and then shifted to Islamia School, Rajori Kadal for 9th and 10th as the earlier school did not have 10th class. He did pre-medical education from Islamia College in Hawal and then joined GMC, Srinagar. He thanks SKIMS for the platform provided to him for all what he could achieve. Dr Koul expresses gratitude to his seniors as well as junior colleagues for their support, especially Drs. Khuroo and Zargar. He emphasizes on the value of inter-institutional collaborations that help magnify the output and facilitate design and execution of research practically impossible in stand-alone and detached circumstances. Institutions like ICMR, DST, DBT, CDC, WHO, NIH, etc not only have the talent pool to support research but also possess the facilities and funds that help not only help answer locally relevant questions but also support global studies with local data.
Dr. Javeed Iqbal
Dr. Javeed Iqbal completed his schooling from the Shaheen Public School, Srinagar, and his 10+2 education from the S.P Higher Secondary School, Srinagar. He joined the MBBS program at ASOMS Jammu in 1997 and graduated in 2002. In 2007, he did his postgraduate degree in Pediatrics from SKIMS Srinagar. Since 2013, he has been a full-time faculty member in the Department of Pediatrics and Neonatology. His primary focus is on the care of pediatric respiratory diseases, including pediatric flexible bronchoscopy, cystic fibrosis diagnostic and treatment services, asthma treatment services, and the diagnosis of primary ciliary dyskinesia by HSVMA. Over the past decade, he has published high-quality research on various pediatric respiratory disorders in leading national and international journals. He also has a keen interest in infantile thiamine deficiency and has published numerous papers on different forms of infantile beriberi. Currently, he is responsible for undertaking ICMR-sponsored extramural research project on infantile thiamine deficiency in the Kashmir Valley and epidemiology and mutational profile of cystic fibrosis in our region. Additionally, he has established a dedicated thiamine estimation and sweat chloride laboratories at SKIMS, which is funded by ICMR.
Dr. Nargis Bali Kaur
Dr. Nargis Bali Kaur was born and brought up in Srinagar. She did her schooling from Presentation Convent Higher Secondary School and her MBBS from SKIMS Medical College Bemina. Having done her Junior Residency in Surgery, she was aspiring to become a surgeon, but fate had other plans for her. She ended up doing her MD in Microbiology from the prestigious SKIMS, Soura. The world of Microbiology opened avenues for her especially in research and teaching. As she often says, “Microbiologists are unsung heroes that work behind the scenes and are the eyes and ears of the physician in this era of evidence-based medicine.” Her initial work as a PG student revolved around influenza viruses. She was inducted as a faculty member at SKIMS in 2018 and has since then worked on a number of projects linked to antimicrobial resistance and infection control. Microbiology is still in her infancy; she believes and the true potential of this discipline of medicine is yet to be achieved. The COVID-19 pandemic brought Microbiology and the Microbiologists along with ID physicians to the center stage. Apart from research she has keen interest in teaching as she believes that knowledge imparted to aspiring young students will help shape the future of medicine. That’s the legacy she intends to leave behind.
Knowledge Lounge
Notable Publications
Revolutionary Discoveries and Clinical Breakthroughs by Dr. M. S. Khuroo
Dr. M. S. Khuroo’s original research work in India has led to numerous discoveries, therapeutic advances, and the recognition of many new clinical syndromes. His research, published in high-impact journals such as the New England Journal of Medicine, the Lancet, the Annals of Internal Medicine, Hepatology, Gastroenterology, and the Green Journal, has not only showcased his expertise but also made a significant impact on the practice of clinical medicine globally. Here are 5 selected top publications that have made a significant impact on the practice of clinical medicine in India and abroad.
Citation score: 937
This study pointed to the existence of another human hepatitis virus. The article in The American Journal of Medicine in 1980 and the connoted term “Epidemic Non-A, Non-B Hepatitis” became an epoch-making event and was reproduced in the book “Classic Papers In Viral Hepatitis”, edited by Christine A. Lee and Howard C. Thomas with a forward from the late Dame Sheila Sherlock who called these papers a “Foundation laid by our predecessors.”
Citation score: 479
Hepatitis E was recognized to be transmitted through contaminated water. Here, we showed that hepatitis E is commonly transmitted from infected mothers to their babies, with significant perinatal morbidity and mortality.
Citation score: 509
The role of medical treatment for patients with bleeding peptic ulcers was uncertain. We showed that large doses of Omeprazole cause gastric anacidity (pH 6). This could stabilize the adherent clot placed on the artery in patients with bleeding peptic ulcer and prevent rebleeding. In this double-blind, placebo-controlled trial, we showed that large doses of Omeprazole decreased the rate of further bleeding and the need for surgery. Omeprazole, along with endotherapy, is now an established treatment protocol for bleeding peptic ulcers.
Citation score: 469
Hydatid disease is traditionally thought to be an absolute contraindication for needle aspiration. For the first time, we described an innovative technique of percutaneous drainage on a large cohort of patients with uncomplicated hydatid cysts liver. We undertook to drain hepatic hydatid cysts under ultrasound guidance and use hypertonic (20%) saline as a scolicidal agent, with the eventual disappearance of hydatid cysts in the follow-up (Radiology 1991; 180:141-5). Next, we showed that adjuvant albendazole therapy for percutaneous drainage is more effective than drainage alone (Gastroenterology 1993; 104:1452-9). Here, we showed that percutaneous drainage, combined with Albendazole therapy, is an effective and safe alternative to surgery for the treatment of uncomplicated hydatid cysts of the liver and requires a shorter hospital stay. Lastly, the long-term safety of percutaneous drainage of a large cohort of patients was confirmed (New Engl J Med 1998; 338:391- 3). Based on these reports from our laboratory, percutaneous drainage has since been accepted as a first-line therapy in a large subset of patients with hepatic hydatidosis.
Citation score: 405
We showed that in an endemic area, namely Kashmir, India, Ascaris lumbricoides advance into duodenum and invade bile and pancreatic ducts. We named this disease Hepato-Biliary and pancreatic Ascariasis (HBPA). HBPA was as common as gallstones in the causation of biliary and pancreatic diseases (Gastroenterology 1985; 88:418-23). Over the years, we established this disease’s natural history, diagnosis, and treatment algorithm. Here, 500 Patients with hepatobiliary and pancreatic disease due to ascariasis lumbricoides infection were studied. Five clinical presentations were recognized: acute cholecystitis, acute cholangitis, biliary colic, acute pancreatitis, and hepatic abscess. Intrahepatic duct and bile duct calculi (hepatolithiasis) developed in patients in whom dead worms formed the nidus of stones. Hepatolithiasis, as an aftermath of HBPA, was recognized to be endemic in Kashmir and constituted 12.5% of gallstone disease.
