Young Scientists at #LINO23: Ashwin Parchani – Connecting Clinical Medicine and Research

Ashwin Parchani, senior resident doctor at the All India Institute of Medical Sciences in Rishikesh, will participate in the 72^nd Lindau Nobel Laureate Meeting. He is looking forward to the opportunity to connect with professionals from all over the world, including fellow Young Scientists and Nobel Laureates. Learn more about his career and the turning points of his professional life.

The exact point of when I decided to become a scientist is not easily pinpointed, as it was less of a single moment and more of a gradual realisation. It was a process that involved a series of experiences, observations, and reflections throughout my medical career. These experiences were the early seeds of my interest in research.

For as long as I can remember, I have been fascinated by the remarkable intricacies of the human body. This deep-seated curiosity led me to pursue a career in medicine. As a resident doctor, I was intrigued by the pathophysiology of diseases, their varied clinical manifestations and therapeutics to cure it. However, throughout my journey as a physician, I found myself continually drawn to the uncharted territories of medicine, the questions that had yet to be answered. These experiences inspired me to make a transformative decision: to transition from a clinician to a clinician scientist.

From Clinical Practice to Research: Unveiling Unanswered Questions

As a clinician, I was trained to apply existing knowledge to diagnose and treat patients. But as a clinician scientist, I have the opportunity to generate knowledge, to answer the unanswered questions and to transform patient care. All my research ideas stemmed from an unanswered question during my time interacting with patients in the hospital. I have always been excited by the idea of bridging the gap between clinical medicine and research. Too often, these fields function in silos, when they are, in fact, two sides of the same coin. As a clinician scientist, I saw the potential to bring these two domains together, translating scientific discoveries into clinical applications that could directly benefit patients.

One of my guiding philosophies is that my patients are my teachers. The insights I gain from my day-to-day interactions with them provide a wealth of knowledge that not only enhances my clinical acumen but also forms the basis of my research. My direct work with patients keeps me grounded and constantly reminds me of the ultimate goal of my research: to improve patient care and quality of life.

Working as a Doctor During the COVID-19 Pandemic

A turning point came at the start of the COVID-19 pandemic, when humanity was grasped by uncertainty around the virus. While working as a doctor in the pandemic, I could palpate the fear and anxiety about the disease in my patients. Even amongst healthcare workers, I could perceive a significant level of stress and nervousness during healthcare delivery. This experience acted as a catalyst for my first research project – studying the psychological impact of COVID-19 pandemic amongst patients and their healthcare workers. As I concluded this study, it gave me immense satisfaction to decipher that the psychological impact of the pandemic was as significant as the physical health effect.

Responsibility for Current and Future Patients

Medicine is an ever-evolving field, and progress is reliant on continuous research and discovery. As a physician, I felt a responsibility not only to my current patients but also to future ones. By contributing to scientific literature, I could play a part in shaping the future of medicine, extending my impact beyond the individuals I directly treated. The transition from physician to scientist has broadened my perspective, allowing me to appreciate the intricate interplay between clinical practice and scientific research. It is a path that continually challenges me, fuels my curiosity, and reinforces my commitment to improving human health.

Currently, I am involved in two main projects: My first project is a quality improvement study focusing on assessing the appropriateness of Outpatient Department (OPD) prescriptions as per national and WHO guidelines on rational prescribing. The aim of this project is to ensure that our prescribing practices align with these guidelines, thereby optimising patient care, reducing adverse drug events, and preventing antimicrobial resistance. A key aspect of this study also involves assessing these prescriptions for potential drug-drug interactions and polypharmacy. By doing so, we aim to minimise the risk of harmful drug combinations and the overuse of medication, particularly in elderly patients. I believe this project is critical in maintaining the high standards of patient safety in healthcare.

Yoga to Control Blood Pressure

Simultaneously, I am working on a systematic review and meta-analysis titled “Role of Yoga in Managing Hypertension”. This project is derived from the astounding results we observed when employing yogic techniques in our integrative medicine clinic for managing hypertension. Our preliminary findings indicate that yoga can be a potent non-pharmacological strategy to control blood pressure. Through this comprehensive review and meta-analysis, we aim to collate worldwide evidence and substantiate these initial observations. The goal is to explore the potential of yoga as a standardised, complementary approach in hypertension management, which could be a game-changer, particularly in settings where access to healthcare facilities may be limited.

Alongside these research projects, I am also engaged in documenting case reports that highlight some of the challenging patient scenarios that we encounter in our department. These case reports focus not only on the complexity of the conditions but also on the innovative approaches we take in managing these cases. Some of these cases are quite challenging, involving rare diseases, complex presentations and unique therapeutic challenges. Case reports, though often overlooked in the hierarchy of clinical evidence, serve as a catalyst for hypothesis generation and can often be the first line of evidence of a new discovery.

Healthcare Supported by AI

I am privileged to be at the forefront of integrating innovative approaches of technology into healthcare – for example AI. India is making rapid strides in this field, and it’s exciting to be part of this evolution. AI applications have become part of our daily operations and patient care, such as electronic health records, AI-based stethoscopes, clinical decision support tools, telemedicine, mobile symptom tracking and remote monitoring. These AI applications have not only enhanced the efficiency of our operations but also improved the quality of patient care, offering a personalised and precise approach. It’s an exciting time to be part of this AI revolution in healthcare, and I look forward to the continued innovations that lie ahead.

The #LINO23 Opportunity

The participation in #LINO23 will be an invaluable opportunity that will fuel my passion for scientific research, offer significant learning experiences, and contribute to my growth as a clinician scientist. I would love to gain fresh perspectives and collaborate with fellow researchers in future projects. Finally, I expect this meeting to be a transformative experience for me, one that will provide me with unique insights, broaden my horizons, and enhance my scientific journey.

In the long term, I hope to not only contribute to the existing body of medical knowledge but also foster the next generation of clinician scientists. By imparting my clinical and research experiences, I aim to inspire young medical practitioners and researchers to merge the worlds of patient care and research, just as I strive to do every day.