Metformin in Acute Ischemic Stroke

Inclusion Criteria: * Patients with acute ischemic stroke(AIS) within 72 hours of symptom onset, ≥18 years of age, without large vessel occlusion (LVO) will be included in the study. All the following: 1. Adults aged ≥18 years. 2. Patient or Legally Acceptable Representative (LAR) willing to give informed consent before study procedure. 3. Acute stroke is ischemic in origin and radiologically confirmed by Computed Tomography (CT) scan prior to enrolment. 4. Pre-stroke mRS score of 0 or 1 and first ever episode of stroke 5. National Institute Health Stroke Scale (NIHSS) of \>5 (NIHSS Level of Consciousness (1A) score must be \<2). 6. Patients undergoing intravenous thrombolysis will be included. Exclusion Criteria: * Any of the following: 1. Patients receiving endovascular therapy or are candidates for any surgical intervention for treatment of stroke. 2. Prior history of stroke of any type (ischemic/hemorrhagic/ subarachnoid hemmorhage) 3. Patients classified as comatose (NIHSS Level of Consciousness (1A) score ≥ 2). 4. Evidence of intracranial hemorrhage in the baseline CT. 5. Pregnancy and lactation. 6. Patients with co-morbid illnesses like chronic liver disease/chronic kidney disease/malignancy limiting their life expectancy. 7. Concurrent participation in any other therapeutic clinical trial/ rehabilitation trial. 8. Patients are already on metformin treatment. • A non-interventional arm of patients who fulfill the eligibility criteria and are already on metformin before the stroke will also be recruited for the purpose of prospective follow-up to assess the outcome at 90 days. Patients without diabetes will not be excluded from the study, as the doses of metformin to be used in our study have been amply used in other studies in non-diabetes conditions for indications like cancer, dementia, polycystic ovarian disease, obesity.