Dr. Vivek Nambiar

Training & Work Experience

• Assistant Professor of Neurology and Head of Division of Stroke, Amrita Institute of Medical Sciences, Kochi from August 2013 onwards
• Stroke Fellowship, Calgary, Canada - 2011- 2013
• Consultant Neurologist, Caritas Hospital, Kottayam – 2009 – 2011
• Research Officer, Neuro epidemiology, Bombay Hospital - 01/06/2009 - 30/06/2009
• Senior Registrar in Neurology - 2006–2009
• DM Neurology under Professor Nadir E. Bharucha, Bombay Hospital Institute of Medical Sciences, Mumbai, India - Clinical decision making, regular-in patient management, teaching internal medicine and pediatrics post graduate residents, Electrophysiology, acute stroke therapeutics involving thrombolytic treatment.
• Worked with Dr. Anil Karapurkar, neuro-inteventionalist 2007, Bombay Hospital attended carotid stenting, AVM, aneurysm management
• Prof. K.Radhakrishnan, Sri Chitra Tirunal Institute, 2008 Kerala, India. - Electrophysiology training

Post M.D. Experience

• Assistant Professor (Medicine) Jan – Jun 2006 Karuna Medical College, Palghat, Kerala, India - Teaching UG students & managing medical wards
• In charge, Dept. of Cardiology 2004 – 2005 MOSSC Mission Hospital Trichur, Kerala - Management of cardiac emergencies, thrombolysis,ventilatory care

Research Experience

Ongoing projects:

• Director, province-wide Telestroke program, by Govt of Kerala state
• Principal Research Co-ordinator, Kerala State Prospective Stroke Registry, by Kerala Association of Neurologists
• Local PI, ATTEND trial ( a prospective randomzed trial on home-based physiotherapy in India)
• Local PI, Maternal and neonatal stroke registry by University of North Carolina
• Ongoing prospective studies on
  • Isoprostenoids and Aspirin resistance in acute stroke
  • TORBSST evaluation in acute stroke patients
  • Anticoagulation in Episodic atrial tachycardia
  • A two year experience of carotid stenting
  • Amyloid angiopathy in TIA and stroke

Stroke Research – At University of Calgary

Certifications of GCP, various stroke scales -NIHSS, ASPECTS, Stata12.2 course( statistical software training)
Actively involved as sub investigator in the following trials

• INTERSeCT study - Imaging study on clot features in acute stroke ( Multi centric observational study)
• ALIAS study - Randomized Trial on Albumin and placebo in acute moderate to severe ischemic stroke)
• DOUBT study- TIA like episodes prospective study
• IMS-3 study-Interventional management of stroke –RCT on endovascular or intravenous tPA trial
• CATCH study- Prospective observational study on effect of sleep apnea in minor stroke and TIA
• ASPIRE study- TIA related community study
• RESPECT study- Patent foramen ovale closure in embolic stroke – Multi centric RCT
• PROVE-IT study- Perfusion CT or CT angiography in acute stroke
• AQUT study-Acute qualitative T2 image study of reperfusion injury in acute stroke
• STOP-IT – study of Factor 7 on ICH
• SPOTLIGHT- of factor seven or placebo RCT in ICH
• GLORIA Registry-Safety registry for Dabigatran
• STAR registry- Solitaire stent retrieval in acute stroke
• ESCAPE- Randomised trial of endovascular stent retrieval and iv tPA in acute strokes within 12 hours.

Co investigator in

• Near infra red spectroscopy in Acute ischemic stroke study.
• Research Officer August 2009 - Department of Neuroepidemiology and Neurology, Bombay Hospital, Mumbai, India
• Co-investigator 2003-2004 - Leptospirosis Project, State Medical Research Council, Kerala, India

Affiliations to Organizations

• Association of Physicians, India
• Bombay Academy of Neurosciences
• Maharashtra Association of Neurology
• Indian Academy of Neurology
• Neurological Society of India
• World Stroke Organization
• Indian Stroke Association

Publications

• Differential effect of baseline CTA Collaterals on Clinical Outcome in patients enrolled in the IMS-III trial Bijoy K. Menon, MD;1,2,9 Emmad Qazi, BSc;1 Vivek Nambiar, MD;1Lydia D. Foster, MS;3 Sharon D. Yeatts, PhD;3 David Liebeskind, MD;4 Tudor G. Jovin,MD;5 Mayank Goyal, MD;1,2,9 Michael D. Hill, MD;1,2,6,9 Thomas A. Tomsick, MD;7 Joseph P. Broderick, MD;8 & Andrew M. Demchuk, MD1,2,9 for the IMS III Investigators: Stroke 2015 Accepeted
• Almekhlafi MA, Hockley A, Desai JA, Nambiar V, Mishra S, Volny O, Eesa M, Demchuk AM, Menon BK, Goyal M Overcoming the evening/weekend effects on time delays and outcomes of endovascular stroke therapy: the Calgary Stroke Program experience. J Neurointerv Surg. 2014 Dec;6(10):729-32.
• Nambiar V, Sohn SI, Almekhlafi MA, Chang HW, Mishra S, Qazi E, Eesa M, Demchuk AM, Goyal M, Hill MD, Menon BK. CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke. Am J Neuroradiol. 2013 Dec 26.
• Adatia S, Nambiar V, Kapadia R, Abuzinath A, Apel S, Alqarni M, Subramaniam S, Menon B. Acute ischemic stroke caused by paradoxical air embolism following injection sclerotherapy for varicose veins. Neurol India. 2013 Jul-Aug;61(4):431-3.
• Almekhlafi MA, Mishra S, Desai JA, Nambiar V, Volny O, Goel A, Eesa M, Demchuk AM, Menon BK, Goyal M .Not All "Successful" Angiographic Reperfusion Patients Are an Equal Validation of a Modified TICI Scoring System. Interv Neuroradiol. 2014 Feb;20(1):21-7.
• Adatia SP, Nambiar VK. Isolated cortical vein thrombosis from lumbar puncture: high suspicion yields high diagnostic yield. Neurol India. 2013 Mar-Apr;61(2):181-3.
• Almekhlafi MA, Hockley A, Desai JA, Nambiar V, Mishra S, Volny O, Eesa M, Demchuk AM, Menon BK, Goyal M. Overcoming the evening/weekend effects on time delays and outcomes of endovascular stroke therapy: the Calgary Stroke Program experience. J Neurointerv Surg. 2013 Dec 5.
• Bharucha NE, Raven RH, Nambiar VK. Review of seizures and status epilepticus in HIV and tuberculosis with preliminary view of Bombay Hospital Experience. Epilepsia. 2009 Dec;50 Suppl 12:64-6.
• Bharucha NE, Raven RH, Nambiar VK. Tuberculosis. In: Simon D. Shorvon, Frederick Andermann, Renzo Guerrini eds., “Causes of epilepsy”, Cambridge University Press 2011.
• Padmakumar B, Vivek KN. A study of rheumatological manifestations of leptospirosis; a prospective study of 320 cases. J.Indian Rheumatol. Assoc; vol.12 (supp. 1) Nov.2004: PI.10
• Leptospiral Myocarditis ; Dissertation, Kerala University, 2004.

Presentations

• Asymptomatic carotid stenosis- Is medical management sufficient’ as invited speaker at Indian Stroke Association Annual conference 2014, Trivandrum.
• Do reduced leptomeningeal collaterals in humans result in leukoaraiosis, lacunes and brain atrophy? Vivek Nambiar, Ondrej Volny, Sung Il Sohn, Emmad Qazi, Jayme Kosior, Mayank Goyal, Andrew M Demchuk, Bijoy K Menon. Europian stroke conference London 2013.
• Do baseline infarct volume thresholds predict outcome in acute ischemic stroke depending on how fast recanalization achieved? Vivek Nambiar, Sung Il Sohn, Emmad Qazi, Jayme Kosior, Mayank Goyal, Andrew M Demchuk, Bijoy K Menon-Platform presentation,European Stroke Conference , Lisbon May 2012.
• Lepto meningeal collaterals; Role in infarct growth reduction in patients with acute ischemic stroke Vivek Nambiar, Sung Il Sohn, Emmad Qazi, Abdul Qazi, Jayme Kosior, Mayank Goyal, Michael D Hill,Andrew M Demchuk, Bijoy K Menon CSC,2012
• Can attenuation characteristics on NCCT can be used instead the diffusion FLAIR mismatch in imaging triage of acute ischemic stroke patients? Vivek Nambiar, SI Sohn, E Qazi, A Qazi,J Kosior, M Goyal, MD Hill,AM Demchuk, BK Menon .Canadian Stroke Congress, Calgary, Canada 2012.
• Malignant emboli detected by TCD monitoring may predict post procedural DWI lesions and is most common during stent and distal protection device deployment during CAS. Mohammed A Almekhlafi, MD, MSc, FRCPC; Sachin Mishra, MD; Vivek Nambiar, DM, MD,Mayank Goyal, MD, FRCPC; Andrew M Demchuk,MD,FRCPC American Heart Association, Honolulu 2013.
• Qualitative or quantitative flair changes on MRI brain in acute ischemic strokes with major proximal occlusions does not predict intracranial hemorrhages S Adatia, V Nambiar, M Almekhlafi, SI Sohn, BK Menon, A Demchuk. Europian Neurological Soceity, Barcelona 2013.
• Not All Successful Reperfusion Patients Are Equal: The Need for a TICI2c Score. Mohammed A Almekhlafi, MD, MSc, FRCPC; Jamsheed Desai MD FRCPC; Sachin Mishra, MD; Vivek Nambiar, DM, MD; Muneer Eesa, MD; Bijoy K Menon, MD ; Ondrej Volny; Mayank Goyal, MD, FRCPC; Andrew M Demchuk, MD, FRCPC. ESC London 2013.
• Octogenarians should not be excluded from acute stroke intervention trials as major clinical responses arecommon with reperfusion. Mohammed A Almekhlafi, MD, MSc, FRCPC; Sachin Mishra, MD; Vivek Nambiar, DM, MD; Jamsheed Desai MD,FRCPC; Muneer Eesa, MD; Bijoy K Menon, MD; Ondrej Volny; Mayank Goyal, MD, FRCPC; Andrew M Demchuk, MD, FRCPC. ESC London 2013.
• Imaging-to- Stent deployment Time Interval Is Shorter during Daytime hours Vs. Evening Times in Endovascular Therapy for Acute Ischemic Stroke. Mohammed A Almekhlafi, MD, MSc, FRCPC, Jamsheed Desai MD FRCPC,Sachin Mishra, MD; Vivek Nambiar, DM, MD; Muneer Eesa, MD ; Bijoy K Menon, MD ; Ondrej Volny; Mayank Goyal, MD, FRCPC; Andrew M Demchuk, MD, FRCPC ESC London,2013 Accepted
• Radiographic predictors of Major neurologic improvement after Mechanical thrombectomy assisted recanalization in acute stroke. Jamsheed Desai MD FRCPC, Mohammed A Almekhlafi, MD, MSc, FRCPC, Sachin Mishra, MD; Vivek Nambiar, DM, MD; Muneer Eesa, MD ; Bijoy K Menon, MD ; Ondrej Volny; Mayank Goyal, MD, FRCPC; Andrew M Demchuk, MD, FRCPC ESC London 2013 Accepted
• Baseline clinical predictors of rapid neurological improvements in acute ishemic stroke patients treated with stentrievers. Jamsheed Desai MD FRCPC, Mohammed A Almekhlafi, MD, MSc, FRCPC; Vivek Nambiar, DM, MD; , Sachin Mishra, MD,Muneer Eesa, MD ; Bijoy K Menon, MD ; Ondrej Volny; Mayank Goyal, MD, FRCPC1; Andrew M Demchuk, MD, FRCPC ESC London 2013 Accepted
• Achieving an IV Needle to Arterial Puncture Time under 60 Minutes in Acute Endovascular Stroke Therapy is Feasible. Jamsheed Desai MD FRCPC; Mohammed A Almekhlafi, MD, MSc, FRCPC; Vivek Nambiar, DM, MD; , Sachin Mishra, MD Muneer Eesa, MD ; Bijoy K Menon, MD ; Ondrej Volny; Mayank Goyal, MD, FRCPC; Andrew M Demchuk, MD, FRCPC ESC 2013,London, Accepted
• Moya moya disease a rare cause of stroke- a case series, Vivek Nambiar,Yogesh Sharma, Nadir Bharucha. World Congress of Neurology, Bangkok. 2009
• Hansen’s disease: Uncommon presentation of a common disease,Vivek Nambiar,Yogesh Sharma, Nadir Bharucha. World Congress of Neurology, Bangkok 2009
• Bharucha NE, Raven RH, Nambiar VK. Status Epilepticus in HIV & TB. Innsbruck’s colloquium, Vienna, Austria 2009
• Primary progressive aphasia, Bombay Neurosciences Academy, 2008
• Multiple organ dysfunction in leptospirosis, API, Kerala Chapter, 2004
• Arrhythmia in leptospiral mycocarditis, API, Kerala Chapter, 2004