Professor Aniruddh Kumar Purohit: A Neurosurgeon with a Difference

Le résumé fourni par la source

Prof. Aniruddh Kumar Purohit When Prof. Aniruddh Kumar Purohit comes to my mind, the instant thing which flashes across is cerebral palsy. Prof. A. K. Purohit, fondly called AKP, has immensely contributed to the neurosurgical treatment modalities of cerebral palsy. Prof. Purohit was born in 1957 at Kankaroli, near Udaipur, in the state of Rajasthan, to Dr. Chandra Shekhar and Kesar Devi Purohit in a humble lower middle-class family. His father (a renowned Sanskrit scholar) and mother, who lived for 93 years and 84 years, respectively, were both teachers. Prof. Purohit married Dr. Arun Prabha, who did her radiology training. She devoted herself more to raising two beautiful children, Abhishek, who is an Investment Banker Working in California and Dr. Abhilekha, who is a medical doctor. After finishing his schooling, he joined MBBS in 1974 at Ravindranath Tagore Medical College, Udaipur, and then did his general surgery masters (1981–1983) from the same college. After working for a few months in Ram Manohar Lohiya Hospital, New Delhi, he joined M. Ch. Neurosurgery at Sree Chitra Tirunal Institute of Medical Sciences, Thiruvananthapuram, in 1985. He was trained under Prof. Damodar Rout and other contemporary teachers for 3 years. I am told Prof. Purohit was a very self-disciplined and diligent student. Prof. Purohit devoted most of his neurosurgical practice (1988–2017) in a semi-government organization, the Nizam’s Institute of Medical Sciences (NIMS), an autonomous state government-aided institution in Hyderabad. Currently, he works with the Prime Aster Hospitals group in Hyderabad. Prof. Purohit is known for his discipline. I was fortunate to get trained under him and subsequently worked in his unit. For the 13 years of the professional association in the institute I had, while getting trained and serving, there were very few occasions where Prof. Purohit would not qualify to be the first one to come to class at 7 am, the preoperative sessions and emergency case discussions we had. There would be scrutiny and dichotomizations (tearing apart) of each case and in this process, the learning happened. This session would accompany a huge thermos of homemade tea he brought to the class. Such was his dedication and affection. Prof. Purohit will always be remembered for his contribution to the management of cerebral palsy. He started his work inspired by Dr. W. J. Peacock, who did a workshop here at NIMS in 1988 and later revisited it in 1989. He taught selection criteria and demonstrated rhizotomy on children with cerebral palsy having harmful-resistant spasticity. That set the ball rolling for the spasticity surgery work at NIMS. Interest in cerebral palsy is not the usual trend in neurosurgery practice, but Prof. Purohit made this difficult choice of working with cerebral palsy kids. Surgery was just one facet of management for Prof. Purohit. He involved himself right from the 1st day of consult till they grew up and got their respective placement in society as adults. The other day when I was reaching out to him, I got to know that he was attending the marriage of one of his cases whom he operated on when the boy was 6 years. Many such instances are there in my memory. Indeed he created a group of “Vacation, Vocation, and Relation” for the families of children with cerebral palsy. These families consider him God on land, and why not when he involves himself so much with every child holistically. Looking to the immense contribution, there were frequent neurosurgeon visitors from the country and overseas to the institute to learn spasticity surgery from Prof. Purohit. Although Prof. Purohit was very much involved with cerebral palsy management, he also loved and did vascular neurosurgery with passion. He would be meticulous in clipping an aneurysm or dissecting an AVM. I have beautiful memories of assisting such complex cases, and now, when I do these myself remember his tips and tricks. Those were the days when a neurosurgeon was doing everything, and Prof. Purohit was no different. If a day’s list was vascular, the next day would be meningioma or a schwannoma or a pituitary tumor, and the next day would be a spine fixation. The pattern of surgeries is not changed very much in the government set up in India largely to date, but yes, subspecialty has found its entry. The versatility of neurosurgeons has come down these days with the more number of neurosurgeons who wish to focus more on subspecialty. Prof. Purohit was a versatile neurosurgeon such as most of his generation, and at the same time, surprisingly, he did focus on a particular neurodisorder too. Prof. Purohit’s contribution to the literature in the field of cerebral palsy is noteworthy. He always popularized selective posterior rhizotomy (SPR) against the much expensive baclofen pump keeping in mind the financial constraints in a lower middle-income country like India. SPR is popularly called as selective dorsal rhizotomy in the West. Instead of doing a classical SPR as described in textbooks, he would do a limited vertical SPR and supplement it with peripheral selective motor fasciculotomy (SMF), as and when required.[1] He coined the term SMF, to be more precise about the ablation, which was akin to selective peripheral neurotomy, which was popularized by Sindou.[2] Technically, in SMF, one needs to know the areas where one exposes the nerves and then ablates the fascicles. The experience by which Prof. Purohit takes off the fascicles was something beyond my understanding. Sometimes, it would be 50%, sometimes 33%. The decision was precise as I would not see later any cases where a neurological deficit developed postsectioning. Those were the days when neuromonitoring was not floridly available in the institute, but then Prof. Purohit had the experience. A whole range of treatment modalities was available for cerebral palsy kids during the tenure of Prof. AKP, such as injecting botulinum toxin in the muscle belly, peripheral nerve surgery such as the SMF or the limited vertical SPR, intrathecal baclofen pump, and the soft-tissue release surgeries too. Prof. Purohit subsequently expanded the indications of such surgeries to other causes of spasticity, such as post-traumatic spinal and head injuries and dystonia (focal to general). The academic contributions of Prof. Purohit also need to be mentioned. He frequently attends national and international conferences where he is invited to speak on spasticity and dystonia, which he has mastered over the years. There are many chapters, articles, and theses written by him or under his guidance.[1,3–11] The first Indian Academy of Cerebral Palsy annual conference was organized by Prof. Purohit at Hyderabad in 2006; subsequently, in 2014, where his excellency, the President of India, late Dr. A. P. J. Abdul Kalam was the chief guest [Figures 1 and 2].Figure 1: IACPCON 2014Figure 2: Prof. A.K. Purohit with Late Dr. APJ Abdul Kalam AzadIn fact, he founded the academy in the year 2004 with five other members to bring and more scientific and holistic approach toward cerebral palsy and the associated disorders. He also established the Indian Journal of Cerebral Palsy, which was available a few years back. Looking into the miserable condition of the caregivers of cerebral palsy children, he founded the organization called Indian Family of Cerebral Palsy way back in the year 1993. This organization was the platform for families to share their stories and also bring awareness about the management, and have a holistic approach toward each member of the family too. He regularly conducts camps in various Indian cities and sometimes in SAARC countries too. He has conducted 70 camps to date where there is not only screening of cerebral palsy individuals but also surgeries. He did publish a book on cerebral palsy for Hindi-speaking people (Cerebral Palsy Gyaan Kosh, Pahalaa Vijay Kadam). I need to mention that Prof. Purohit has a flare for literature. He wrote many H

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.