Dr S.S.Praharaj

 1.Previous appointments held with date & duration:
1. Asst. Professor of Neurosurgery, St Johns Medical College, Bangalore from Jan 93 to April 1994.
2. Registrar in Neurosurgery, Newcastle General Hospital, Newcastle upon Tyne, U.K. from April  1994 to June 1995
3. Asst. Professor of Neurosurgery, A.I.I.M.S., New Delhi from June 95 to Dec. 1995
4. Asst. Professor of Neurosurgery, NIMHANS, Bangalore from Dec. 95 to June 2000
4. Associate Professor of Neurosurgery, NIMHANS, Bangalore, July 2002 to June 2004
5. Additional Professor of Neurosurgery, NIMHANS, Bangalore, July 2004 to Aug 2006



2. Academic qualifications (degree onwards)


1. M.B.B.S                                  G.R.Medical College, 1984                 Passed 1st attempt
                                                     Gwalior, India

2. M.S.(Gen.                              G.R.Medical College,   1988              Passed 1st attempt
    Surgery)                                 Gwalior India

3. Diplomate National             National Board Exam    1992               Passed 1st attempt
    Board (neurosurgery)          New Delhi.

4. M.Ch (Neurosurgery)            Sree Chitra Tirunal      1992              Passed 1st attempt
    Inst. for Medical Sci.              (An Institute of National Importance)
    & Tech, Trivandrum,
               India
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3. Field of Specialization:
Microneurosurgery, Spinal surgery & Instrumentation, Epilepsy surgery, Skull base surgery, Craniofacial Reconstruction surgery, Critical Care management of Head Injury

4. Service experience:

1.  G.R.Medical College,       Resident in General              Sept. 1985 – Aug. 1988
    Gwalior, India                      Surgery

2.  Sri Chitra Tirunal Inst.      Senior Resident in                 Feb. 1989 – Jan. 1992
    for Medical Sci. &               Neurosurgery
    Tech.Trivandrum, India

3.  Sehgal Neurological       Consultant Neurosurgeon      Feb 1992 – Dec. 1992       
    Research Inst.          
    New Delhi 

4.  St.John’s Medical           Asst. Professor of                      Jan. 1993 – April 1994
    College, Bangalore,       of Neurosurgery
    India                                   Clinical & Research duties

5.  Univ. of Newcastle          Registrar                                    Apr 1994 – June 1995     
    Newcastle upon Tyne     in Neurosurgery
    U.K.                                    Clinical & Research duties

6. AIIMS, New Delhi            Asst. Professor                           June 1995 – Dec. 1995    
   India.                                  Of Neurosurgery
                                               Clinical & Research duties

7. NIMHANS, Bangalore      Asst. Professor                         Dec. 1995 – June 2000
   India                                      of Neurosurgery
                                                 Clinical & Research duties

8. NIMHANS, Bangalore       Assoc. Professor                     June 2000 – June 2004                                                                           of Neurosurgery
                                                   Clinical & Research duties

9. NIMHANS, Bangalore       Additional Professor             June 2004 – Aug 2006                                                                      of Neurosurgery
                                                   Clinical & Research duties



5. Report of significant contribution in the field of NEUROSURGERY

           In the field of patient care, I have helped to start and develop Spine surgery and Spinal instrumentation of all kinds at NIMHANS. Some of the surgeries I have pioneered are: cervical laminoplasty, anterior cervical plate and screw fixation, cervical lateral mass fixation, transthoracic approaches and fixations, thoracolumbar transpedicular fixations, posterior lumbar interbody fixations, etc. Epilepsy surgery is another area I have helped to develop in NIMHANS, along with a neurologist, neuroradiologist and neuropsychologist. The panel meets and discusses the case and the feasibility of surgery. I have started patient audit in NIMHANS and meetings are held every 1st and 3rd Saturday of the month. Along with another faculty member and neuropsychologists I am running Special Clinic (Post Trauma Clinic) on every Tuesday, apart from the routine OPDs on Fridays. I am also presently a PhD guide for a Psychiatry Social Work student. Over the period of last 10 years as consultant neurosurgeon in NIMHANS, have performed over 3000 neurosurgical operations including complex cranial and spinal operations.

            In the field of research, I have been involved with study of critical care management of head injury. We have evolved a protocol-based management of severe head injury so as to maintain an optimum CPP and measure the cerebral compliance. I was also the main investigator for conducting the multicentric International CRASH trial (Corticosteroid Randomisation after Severe Head Injury) at NIMHANS, after getting ethical approval. I was a Guest Faculty for conducting a workshop on “ICP monitoring” at the 5th Annual Conf. Of Indian Soc. of Neuroanesthesiology and Critical Care in Feb 2004.  I have been a guide for several theses for MCh as well as PhD degrees. 

            In the field of manpower development, I have been actively involved in the teaching and training of MCh students both of NIMHANS as well as of other institutions such as Sree Chitra Tirunal Inst. for Medical Sc and Tech, SGPGI, AIIMS, CMC Vellore, etc. A no. of post graduate students from all over Karnataka also come each year and I have conducted classes for them. We have an excellent training programme consisting of every morning pre-operative case discussions, interdepartmental and departmental seminars, journal clubs; and on every Saturday we have mortality meetings, clinical audit, grand rounds, thesis presentation, and case presentations. Apart from this I have conducted WHO lectures for general practitioners on SAH and AVM, and we train WHO fellows and assistant surgeons from time to time.



6. List of research projects:

1. CRASH TRIAL (Annexure –2)
a)Title of project:  “CORTICO STEROID RANDOMISATION AFTER SIGNIFICANT HEAD INJURY “.
b)Funding agency:  Medical Research Council of UK.
c) I was the main investigator-recruiting patients ensuring the drug is given and keeping all records.
d)Duration of Project:  Recruitment is over. 
e) Outcome of the project: It is still ongoing.  Results not analysed yet.
  2. NIH – funded Head Injury research at Baylor College of Medicine, Houston, Texas.
a)Head injury research programme project
b)NIH funded
c)I was a research associate in the programme from 1.10.01 to 20.06.02
d)Ongoing project.  Data Collection is going on.

3. “Psychosocial Impact on the Survivors of Road Traffic Accidents with Head Injury” – I was the Guide for this PhD Thesis, completed in Dec. 2005
4. “Outcome of Epilepsy Surgery for mesial temporal sclerosis” – I was the Guide for this MCh thesis, completed in 2004
5.  “Short Segment Instrumentation for Thoracolumbar fractures – A study of Clinical, Radiological and Operative factors influencing outcome” – Was Guide for this MCh thesis, completed in 2005
6.  “Analysis of Prognostic Factors in Acute Subdural Hematoma” – Was Guide for this MCh thesis completed in 2004
7. “ Cerebral Perfusion Pressure Management of Severe Head Injury” – Was Guide for this MCh Thesis completed in 2000.
8. “Effect of Angiography on Intracranial Pressure in Patients with Subarachnoid Hemorrhage” Research done in Newcastle Upon Tyne, U.K., as principal Investigator, 1994-1995.
8. “Immunohistochemical demonstration of Mycobacterial antigens in intracranial tuberculomas.” Project work during MCh, as Principal Investigator, 1991.



7.Papers / Chapters published


(a)Publications in Journals:

1.Praharaj S.S., Sengupta R.P., Chambers I.R., Mendelow A.D., et al. “Effect of angiography, anesthesia and operation on Intracranial pressure in patients of aneurismal Subarachnoid hemorrhage. J.Neurol Neurosurg and Psychiatry 1995. 59: 211.
2.Praharaj S.S., Coulthard A., Gholkar A., Mendelow A.D.. “Magnetic resonance angiographic assessment after EC – IC bypasses surgery “. J. Neurol Neurosurg and Psychiatr. 1996. 60(4): 439-411.
3.Praharaj, S.S. Sharma M.C., Prasad K., Misra N.K., Mahapatra A.K., “Unilateral meningeal thickening: A rare presentation of tubercular meningitis “. Clin. Neurol and Neurosurg, 1997, 99: 60-62.
4.Praharaj S.S., Kishore K.  Role of anticonvulsants in head injury.  Neurosciences Today, 1998, 2: 29-31.
5.Mohanty A., Anandh B., Sastry Kolluri V.R., Praharaj S.S.  Neuroendoscopic third ventriculostomy in the management of fourth ventricular outlet obstruction.  Minim Invas Neurosurg, 1999 Mar, 42(1): 18-21.
6.Praharaj S.S., Anand B., Sarath P., Kolluri V.R.S.  Laminoplasty – an evaluation of 24 cases. Neurology India 2000 Sept., 48(3) : 249-254.
7.Pillai S, Praharaj S.S., Mohanty A, Kolluri V.R.S, Prognostic factors in children with severe diffuse brain injuries: A study of 74 patients. Paediatr. Neurosurg 2001, 34(2) : 98-103.



8.Anandh B, Mohanty A, Sampath S, Praharaj S.S., Sastry Kolluri V.R., Endoscopic approach to intraventricular cysticercal lesions.  Min. Invasive Neurosurg. 2001. Dec ; 44(4) : 194-6.
9.Jaykumar P.N, Kovoor J.M., Srikanth S.G., Praharaj S.S. 3D steady – state MR
10.cisternography in CSF rhinorrhoea.  Acta Radiologica 2001 Nov, 42(6) : 582-4.
11.Suresh H.S., Praharaj S.S., B.Indira Devi, Shukla.D, Sastry Kolluri V.R.  Prognosis in children with head injury – an analysis of 340 patients. Neurology India, 2003, 51(1) : 16-18.
12.Pillai S.V, Kolluri Sastry V.R., S.S.Praharaj, Outcome prediction model for severe diffuse brain injuries : Development and evaluation.  Neurology India Sept 2003, 51(3) : 345-349.
13.Praharaj S.S., Mohanty A, Kolluri Sastry V.R. Low Back pain – management perspective of a commonly encountered problem.  Annals of Indian Acad of Neurol 2004, 7 : 313-318
14.Pillai S., Praharaj S.S., GSU Rao, Kolluri Sastry V.R., Cerebral perfusion pressure management of severe diffuse head injury : Effect on brain compleance and Intracranial pressure.  Neurology India 2004 (Mar), 52 (1) : 67-71.
15.Praharaj S.S., Kolluri Sastry V.R. Head injury in children.  Review article Physician’s Digest 2004, 13 (4) :81-87.
16.Mohanty A, Suman R, Shankar SR, Satish S, Praharaj SS. Endoscopic third ventriculostomy in the management of Chiari I malformation with Syringomyelia associated with hydrocephalus. Clin Neurol Neurosurg 2005, Dec 108 (1) :87-92
17.Dayalan AH, Jyothi M, Keshava R, Thomas R, Gope ML, Praharaj SS, et al. Age dependant phopsphorylation and deregulation of p53 in human vestibular schwannomas. Molecular Carcinog 2006 Jan, 45 (1) : 38-46.


(b) Chapters in Books

        1.Praharaj SS, Dubey S, Kolluri VRS. What is adequate surgery for Glioma? The rationale for       cytoreduction. In :  A.K.Singh, S.Sinha (Eds) : Indian Clinical Neurosurgery, Vol II. Malignant Brain Tumors. CBS Publishers and Distributors, New Delhi. 2002 pp108-116.
        2. Praharaj SS, Das BS. Surgery for intra fourth ventricular tumors. In : Ramamurthy B, Tandon PN (Ed) : Indian textbook of operative Neurosurgery. B.I.Pub, New Delhi, 2005, pp527-534
        3.Praharaj SS, Kolluri VRS. Surgery for lumbar disc and lumbar canal stenosis. In : Ramamurthy B, Tandon PN (Ed): Indian Textbook of Operative Neurosurgery. B.I.Pub, New Delhi, 2005, pp 1037-1046.


(c) Total number of publications : 20



8. Papers presented at National and international Conferences / Seminars / Symposia / Workshops etc.

1.Praharaj SS, Sengupta RP, Jenkins A, Mendelow AD. Effect of angiogram and anesthesia on ICP in aneurismal Subarachnoid hemorrhage. Ann. SBNS (Soc of British Neurosurgeons) meeting, Liverpool, Apr 1995.
2.Praharaj SS, Coulthard A, Gholkar A, Mendelow AD. MR Angiographic assessment of EC-IC bypass patency. Ann BNRG (British Neurol Res Group) meeting, Chollerford, UK, Apr 1995. Won the Best Paper Award.
3.Praharaj SS, Mahapatra AK, Mehta VS, Banerji AK. Pediatric head injury – an analysis od 220 cases. Ann Ind Soc of Paed Neurosurg conf, New Delhi, Sept 1995.
4.Praharaj SS, Mohanty A, Chandramouli BA, Kolluri VRS. Surgical management of Intraventricular Neurocysticercosis. Poster at 46th Ann NSI conf, Calcutta, Dec 1996. Won the Best Poster Award.
5.Praharaj SS, Anandh B, Sarath P Kolluri VRS. Laminoplasty – An evaluation. 47th Ann NSI conf, Trivandrum, Dec 1998.
6.Praharaj SS. Pathophysiological basis for the management of Head Injury. International Trauma and Crit Care Soc conf (ITACCS), Tirupathi Aug 1999. Invited Guest Lecture.
7.Praharaj SS. Recent advances in Management of Head Injury. CME on Critical Care, NIMHANS, Dec 1999. Invited Guest Lecture.
8.Praharaj SS, Sampath S, Mouli BAC. Cervical corpectomy and instrumentationfor spondylotic myelopathy and OPLL. 48th Ann NSI conf, Hyderabad, Dec 1999.
9.Praharaj SS, Anandh B. Open door laminoplasty – an evaluation of 30 cases. International conf on Spinal Surgery, Mumbai, Feb 2001. Invited Guest Lecture.
10.Praharaj SS. Instrumrntation for cervical spine – its usefulness and limitations. National conf on spine surgery July 2001. Invited Guest Lecture.
11.Praharaj SS. Controversies in the monitoring and management of head injury. Ann Neurotrauma Conf, Agra Aug 2002. Invited Guest Lecture.
12.Praharaj SS. Thoracolumbar fractures – rationale for management. Asnn Neurotrauma conf, Pune Aug 2003. Invited lecture. Invited Guest Lecture.
13.Conducted Workshop on ICP monitoring. At 5th Ann conf of Indian Soc of Neuroanesthesiology and Critical Care, Feb 2004. Invited Guest Lecture.
14.Praharaj S.S. Complications after transphenoidal surgery for pituitary tumours. At 6th Ann Conf of Skull Base Soc of India, Mumbai, Oct 5th – 7th, 2005. Invited Guest Lecture.
15.Praharaj S.S. : Scope of Surgery in Cervical Spinal Cord Injury. At the 15th Annual Conference of the Eastern Zonal Neurosurgical conference, Gwahati, Oct 20-22nd, 2005. Invited Guest Lecture.
16.Praharaj S.S. Laminoplasty – A viable alternative to Laminectomy? At the 54th Ann Conference of Neurological Soc. Of India, Vishakhapatnam, Dec 15 – 18, 2005.



9.Awards, distinctions and prizes etc.
       
1.Best Paper Award  and Upjohn Travelling Fellowship for : MR Angiographic assessment of EC-IC bypass patency. At British Neurological Research Group (BNRG) meeting, at Chollerford, UK. – April 1995
2.International College of Surgeons scholarship for undertaking research in U.K. on “Effect of Angiography on Intracranial pressure in patients with subarachnoid hemorrhage” during 1994-1995
3.NSI Best Poster Award for : Intraventricular neurocysticercosis – results. At Annual Conference of the Neurological Society of India, Calcutta, Dec 1996.
4.Chosen for :“Neurosurgical Update for Young Neurosurgeons of Asia” at Osaka, Japan, 1998


10. Fellowships / Memberships of National, International/Scientific societies, cademics, etc.
        1. Neurological Society of India    -   Life member
        2. Neuro-otological soc. of India   -   life member.
        3. Bangalore Neurological Soc.     -   life member
5.Asian Congress of Neurosurgeons – member
6.Visiting fellow for “Craniofacial reconstruction Surgery” at AIIMS, New Delhi, for 1 month in Sept 1997
7.Visiting fellow at Fujita health university, Nagoya, Japan, Sept-Oct 1998.
8.Research fellow in Head Injury at Baylor College of Medicine, Houston, Texas, for 1 yr from Sept 2001 to August 2002


15.Visits abroad during the past 5 years : (Annexure – 2)

Visited the Dept of Neurosurgery, Baylor College of Medicine, Houston Texas and worked as Research associate in head injury there  for 9 months under Professor Claudia Robertson, from 1st Oct 2001 to 30th June 2002.  The project was NIH funded head injury programme. The work included assessing patients for entry into the study, doing pressure autoregulation and CO2 reactivity studies, measuring  brain tissue pO2,  microdialysis, perfusion CT scan measurement of CBF, etc. This is an ongoing study.



11. Activities such as Medico Social Work, Popularisation of science and other  activities related to the field :

Have conducted workshops on SAH and AVMs under the aegis of WHO for general practitioner (GP).  This was to spread awareness of SAH among the GPs.  And also involved in training and teaching assistant surgeons who are deputed by the Karnataka Government from time to time for head trauma management training.