Neurologist, Apollo Hospitals Hyderabad
#Fitness
#Equity
#Travel
/
On a mission to prevent people from becoming patients/
Online consultation: Apollo 24/7 app
6-yr old to me: "Doctor, I have grade 4 cancer and will live only for 6 more months, don't tell my parents about this"
1. It was another busy OPD, when a young couple walked in. They had a request "Manu is waiting outside. He has cancer, but we haven't disclosed that to him+
Sharing experiences of my
#fitness
journey
Could be of help to those who have planned to start theirs in 2023
1. My earlier self:Weighed 100 kg, could walk 5 km with great difficulty
Negatives: Worked 16-17 hours/day; slept 4-5 hours; overeating, indulged in junk food and sweets
9. "Doctor, we had a great time with Manu after we met you. He wanted to visit Disneyland and we went with him. We took temporary leave from job and spent quality time with Manu."
"We lost him a month back. Today's visit is to just thank you for giving us those best 8 months."
35-yr old consulted me today, as he wanted me to prescribe aspirin pill to prevent stroke.
His father aged 60 had recently suffered from stroke (paralysis), and he was concerned about his higher risk of getting stroke in future.
Instead of one pill (aspirin), I prescribed "6
Younger generation is slowly turning unhealthy
Young people in the age group of 20-50 years form a sizeable proportion of patients in my OPD now.
Most of them have one or more of the following abnormalities:
1. Overweight or obese
2. High HbA1C
3. Abnormal lipid profle
4. Low
A young woman who would repeatedly experience the smell of burning incense (when in reality none burnt)
1. It was nearing the end of a busy OPD, when 27-year-old Radha was brought for consultation, accompanied by her husband and mother-in-law. They all looked anxious.
#MedTwitter
10 qualities that make a
#doctor
popular (among
#patients
)
Surprisingly, it is not the
#NEETPG
score, reputation of medical college, gold medals received in medical college or number of research papers published. After 30 yrs as a practicing doctor, I present my observations here
Brain shrinkage starts at 40.
Brain volume reduces by 5% every decade after the age of 40, and at a much faster rate after 70.
Various strategies such as ensuring adequate sleep, minimizing stress, meditation, regular physical activity, engaging in cognitively-stimulating
A 45-year old gentleman consulted me yesterday. During his routine health check up, his BP was found to be on a higher side (140/90 mmHg). He was worried about an increased risk of stroke, as his father too was a hypertensive, and had suffered a stroke at age 60.
He wanted me to
Case of a woman whose shoe size increased from 5 to 7 over two years
1. It was an usual OPD, when I was counselling one of my patients with back pain about exercise, diet and correct posture. Incidentally, I noticed his wife's face who was sitting beside the patient.
#MedTwitter
How I (a
#neurologist
) helped a student pass in
#Mathematics
, which his Mathematics teacher couldn't manage
1. A 15-year old boy was brought to my clinic by his parents asking for some "pill" that would improve his interest and skill in mathematics, enabling him to pass exams
βDoc, please do an operation to remove the right side of my head so that I wonβt have to suffer from horrible headaches.β
32-year-old Ms. Neha (name changed) had been suffering from migraine for the past three years. During the first two years, she suffered from headaches about
1. Arti to me "Dr, when will my husband Anuj start talking & walking?" Her two kids aged 3 & 5 were holding her hands, as Anuj was brought into my OPD for review one month after suffering brain hemorrhage. Anuj had become paralysed on right side and lost his speech due to stroke
@hyderabaddoctor
With due regards , surely it can be one of the reasons but whatβs solution ? Discussing just causes would not prevent the sudden deaths. Medical fraternity must come up with standard protocol (of tests/prevention ) to eliminate these scary sudden deaths.
TamilNadu can't add more medical colleges: National Medical Commission (NMC)
Reasons given by NMC
1. There should be uniform distribution of doctors across the country. The recommended ratio of doctors is 1:1000 and TN already has 1 per 600 population,
2. Medical colleges shall
Happy to share that our son got selected for computer science major at Cornell University, Ithaca (NY) (top ranked Ivy league college for computer science).
Seeking your continued blessingsππ
@Cornell
How a common nutritional deficiency turned an air hostess into a beggar
1. A few years ago, a smartly-dressed man entered my OPD with a shabbily-dressed woman, introducing her as his wife. Her hair was unkempt, clothes untidy and she wore a pair of torn sandals.
#MedTwitter
Making sense of Lipid Profile Test
Abnormal lipid levels are associated with a higher risk of coronary artery disease and stroke.
Generally lipid profile comprises of the following 4 important tests:
1. Total Cholesterol (less than 200 is considered normal),
2. LDL cholesterol
Why do a few young, physically active, seemingly healthy people suffer from heart attack?
1. A person with normal body weight, doing regular running, cycling, or working out in gym, is not immune to heart attack, as a few recent reports suggest. Here are some of the reasons why:
If you are offered hot samosa along with tea (not shown in the pic), and you proceed for the tea, totally ignoring the samosa, you have achieved a state of perfect "nirvana"! π
20 Simple Food-related and Lifestyle Changes that can help in Losing Weight or preventing Weight gain
Diet related tips
1. Avoid adding sugar in tea or coffee,
2. Avoid having rusk, cookies, or biscuits with tea/coffee,
3. Have an early dinner (about three hours before bedtime),
Intermittent
#fasting
and its impact on
#health
1/n
What is intermittent fasting (IF)?
A variety of eating patterns in which no or few calories are consumed for prolonged time periodsΒ
that can range from 12 hours to several days,Β
on a recurring basis.
#diet
#nutrition
Beauty Parlor
#Stroke
Syndrome
1. I recently saw a 50-year old woman with symptoms of dizziness, nausea & vomiting, which started during her hair wash with shampoo in a beauty parlor. Initially, she was taken to a gastroenterologist, who treated her symptomatically.
#Medtwitter
At CMC Vellore (1989), out of 60 seats, 56 seats were reserved: For Christians (45), SC/ST (4), underprivileged (2), Govt of India nominee (1) & open merit girls (4). I was one of the 4 boys selected in open merit. For MD Medicine, 4 out of 6 seats were reserved for Christians+
Actionable items that can ensure a healthy life; reduce the risk of serious diseases and increase lifespan
1. Sleep for 7-8 hours every night
2. Go to bed at the same time every time (+/- 30 minutes)
3. Avoid oversleeping (defined as sleeping for >9 hours)
4. Have dinner 3-4
A grand party with friends ended devastatingly for Aruj
1. 33-year old Aruj was visiting home after a gap of 5 years (after landing a job with handsome paycheck overseas). It called for a grand celebration and Aruj was in no mood to disappoint his friends.
#MedTwitter
A man who would become unconscious after singing romantic Kishore Kumar's Songs
1. 6 months ago, a 45-year-old man visited me for evaluation of a fainting episode that occurred while he was singing for a private gathering. He was a schoolteacher and singing was his passion.
Losing just one hour of sleep could take you four days to recover
β‘οΈThe optimum sleep duration is 7-8 hours per night. β‘οΈLack of sleep (sleep deprivation) results in various problems, such as poor attention, focus, concentration and memory.
β‘οΈPoor sleep also increases the risk
How to increase HDL cholesterol levels?
HDL cholesterol (HDL-C) is considered the βgoodβ cholesterol. Lower levels of HDL cholesterol are associated with higher risk of heart attack and stroke. On the other hand, higher HDL cholesterol level is associated with lower risk of
Intermittent fasting and running
1. Time-restricted feeding (8-hour eating window), as compared to normal feeding (12-hour eating window) decreases fat mass and maintains fat-free mass, while not affecting running performance, in trained male endurance runners.
2. Time
May 1999 was the first time I met her.
We liked each other as a friend and the friendship grew over time. However, we didn't give a marriage a serious thought at that time, as we were busy with studies then.
It was a pleasant surprise when our parents fixed our marriage. Both
11. Take home messages
*Work-life balance is essential.
*Hectic working hours, less sleep and stress are detrimental to health.
*High BP needs drugs, if non-drug measures fail.
*Periodic check ups for BP, sugar & cholesterol are needed, even if one goes to gym/does exercises.
Patient wanted three pills; instead, I prescribed him 10 pills (to optimize lipid levels and reduce stroke risk)
A 32-year old Mr Ashok (name changed) consulted yesterday for abnormal lipid levels. He was concerned about a higher risk of stroke, as his father had suffered a
3rd year runniversary
A brief about my three years of running journey
When I decided to start running in November 2020, I was the most unlikely to be a runner:
π΄Was nearing 50 (aged 49),
π΄Weighed about 100 Kg
π΄Suffered from pain due to ankylosing spondylitis,
π΄Hard pressed
Giving
#Paracetamol
in cases of mild
#Viral
#fever
may be harmful
1. It is a common practice to give paracetamol (acetaminophen) to children or adults suffering from viral fever. Research evidence shows that we may be causing more harm than good by this practice.
#MedTwitter
Sleeping for 2 or more hours extra during weekends could reduce the risk of stroke and heart attack in people who habitually sleep less than 6 hours during week days.
#sleep
#heartattack
#stroke
#Weekend
Case of a man who shaved only on right side of face
1. 70-year-old man was brought to OPD three months ago by his son, with a complaint that he had stopped shaving on left side of face for one week. He was also not using his left hand even though he had no weakness in that hand.
A 60 plus couple decided to enact the song of Rimjhim gire saawan. Look at them do it in
#Mumbai
. And their still existing chemistry. Excellent !!! (From SM)
Eating walnuts for 6 months was associated with better sustained attention and intelligence scores in teenagers
1. A total of 771 healthy teenagers aged 11β16 years were randomized into two equal groups (intervention or control).
#MedTwitter
#healthyfood
My grandparents were small time farmers in Bihar; my mother is a class 5 dropout from a village school in Bihar. Did my schooling (1st to 12th) from KV (with total fees of 1 k INR) and my MBBS from CMC Vellore (total fees of 10k INR), so, I am as ordinary as one can be!π
@hyderabaddoctor
@FitIndiaOff
Hesitated because you are like a famous doctor π but yes, next time I see you.. will surely talk. You are an inspiration!
9.Take home message
*Abnormal smell sensations lasting for brief periods could be olfactory seizures arising from temporal lobe of brain.
*Brain scan and EEG would help in confirming the diagnosis.
*Treatment (medical or surgical, depending on cause) results in excellent outcome.
10 tests one should do prior to starting running or doing any other exercises
Videos of young, apparently healthy people collapsing (while running marathons, working out in a gym or while playing a sport) often go viral. This creates anxiety among people who are already doing
Parents happy with their new car delivered on the auspicious day.
This is only their second car. Their first car was Maruti 800 bought in 1996 (which served them well for 27 years).
There are a lot of things to learn from our parents- simple living, ability to enjoy small
Investment lessons learnt over the past 10 years
I have been an investor for 10 years now. Started late (at 42) but learned fast and have enjoyed a fair bit of success. Sharing a few lessons from my investment journey that could be of help to the beginners.
1. Start early-
Mr Narayan Murthy's advice of reaching office by 6:20 AM, and to work until 8:30 PM is a recipe for becoming unhealthy and be at a higher risk of getting affected with serious lifestyle diseases.
π΄14-hour work/day + 1-2 hour/day commute time, would ensure that you devote 15-16
Heart rate during work out: What is desirable and what is unsafe?
1. For an aerobic activity to be effective, the intensity should be at least moderate. The best way to measure the intensity of workout such as running is to check the
#Heart
rate. This thread is about heart rate.
The most valuable lifestyle habits that can keep you healthy (mentally and physically)
1. Sleep well (7-8 hours per night)
2. Follow a fixed sleep schedule (vary your sleep onset and waking up time by <30 minutes),
3. Have breakfast before 8 AM, and dinner before 8 PM (if you
The Consultation Fees offered was unimaginable
βDr, thank you for taking care of my mom. Unfortunately, she recently passed away. She has left something for you. Can I meet you sometime?β It was Mr Arun (name changed), son of Mrs Savitri (name changed), whom I had been treating
Clinical Case for junior
#doctors
and residents
17-year old girl, 1 year history of imbalance while walking, sways to either side. Tendency to fall while washing her face. Hearing impairment for 6 months. No positive family history
Diet: Pure
#vegetarian
#MedTwitter
#neurotwitter
5. After parents left the room to wait outside, Manu said- "Dr, I have read all about the disease on iPad and I am aware that I will live only for 6 more months but I haven't shared this with my parents, as they would get upset. They love me a lot. Please don't share with them"
Ashuβs parents wanted a memory pill so that he could do well in examinations
12-year-old Ashu (name changed) was a bright child, and he was doing well in studies until 5th grade. However, he changed for the worse during grade 6th. He failed and needed to repeat the 6th grade.
Yes, I hail from Bihar. Is Tamil out of bounds for a Bihariπ?
I can converse well in Telugu and Bangla too. I can understand Malayalam, Marathi, Kannada, Somali and Arabic too (enough to manage a patient with neuro issues).
8. Take home message
*Increase in shoe size (due to feet becoming larger) and changes in facial appearance in adults could be features of acromegaly (GH excess).
*Initial diagnosis can be made by a simple blood test- IGF 1
*Early treatment can prevent serious complications.
At 17 yrs age, travelled by train to Vellore (Tamil Nadu) from Bihar in 2nd class alone for interviews (as parents couldn't financially afford to accompany their minor son). No one from home could come to see me for 5 yrs. Took admission & managed everything on my own for 5 yrs+
A. Today, one person who recently turned 50 consulted me in OPD. He has no symptoms & is healthy. He has no known diseases. He wanted a check up & advice to ensure he does not convert into a patient for as long as possible. I love this concept of disease prevention.
#MedTwitter
7. I couldn't keep the promise to Manu, as it was important to bring family on the same page on this sensitive issue. It was vital that the family enjoyed together, whatever time was left. More so, as Manu knew about his illness. Whether he understood the gravity, I am unsure.
Which is the best exercise modality for reducing resting Blood Pressure (BP)?
Isometric exercise training is the most effective mode to reduce resting BP.
A recent network meta-analysis of randomised controlled trials (RCTs) by Edwards and colleagues concluded that:
Isometric
10 tips to make
#running
a consistent
#habit
I started running late at age 49 (on Nov 6 2021). Since then, I have done 600 runs (out of 657 days) of 10 km or more (includes 107 half
#marathon
& 1 full marathon).Lost 27 kgs (100 to 73 kg), resting HR 41, BP: 110/70; HbA1C 4.7%
What patients like in their doctors?
1. Smile: Many patients tell me that they feel at ease when they see a smile on the doctorβs face,
2. A doctor who listens: It is surprising to note that most patients tell me that the doctor who they earlier consulted did not properly listen
Prescription for being healthy & fit in 2024: Focus on the βbeginnersβ: Dr Sudhir Kumar MD DM
Health is our greatest wealth. There is no better time than the start of a new year to embark on this amazing journey towards better health & fitness. Many people donβt know where to
Case of a woman in whom βRunny Noseβ was caused by a Brain Disease
1. 35-year-old woman presented with intermittent
#runny
#nose
and
#headache
of one month duration.
Local physician suspected
#sinus
infection, treated her with a course of antibiotics, with which she improved.
Benefits of Drinking Coffee
1. Lower risk of type2 diabetes: Long-term preservation of proper liver and beta cell function of pancreas may account for the association of habitual coffee drinking with a lower risk of type2 diabetes, rather than acute improvement of metabolic
Taking 6000-9000 steps/day reduces the risk of cardiovascular disease (CVD) in older adults aged 60 or more
1. In a recent study, taking 6000 to 9000 steps per day was associated with a 40% to 50% lower risk of CVD, compared with taking 2000 steps per day.
#walking
#Medtwitter
Litchi encephalitis (chamki bukhar): Facts and Myths
1. Lychee (or litchi) is a fruit, mostly grown in China, India and rest of Southeast Asia. Fruit ripening coincides with Indian summer (May-June).
There is a concern that eating litchi can cause brain fever and death.
25 Diet-related Tips that can be easily incorporated into daily lives for a Healthier Living
Dr Sudhir Kumar MD DM (X:
@hyderabaddoctor
)
1. When you are thirsty, choose water over fruit juice or soft drinks,
2. Diet soft drinks are not healthy,
3. While having tea or coffee,
8. Parents were in tears but they were still thankful and left OPD with a heavy heart.
I had almost forgotten this incident, when about 9 months later, the couple returned to see me. I recognized them at once and enquired about Manu's health.
2. Please see him and advise your treatment, and don't share the diagnosis to him". I nodded my head, accepting their request.
Manu, on a wheelchair, was brought in. He was referred by his
#oncologist
for management of seizures.
He had a smile, appeared confident & smart.
A teenager who continued enjoying the pleasurable
#emotions
induced by hot water bath until he became unconscious during one such bath
1. Here I am sharing the case of a 18-year old boy who used to experience extremely pleasurable emotions every time he poured water on his head
Take home message
1.
#vitamin
#B12
deficiency can cause rapidly progressive, severe dementia in young people.
2. Vitamin B12 deficiency can occur in non-vegetarians too (due to antibodies in gut preventing absorption of B12)
3. Vitamin B12 injections leads to rapid improvement.
6. I was shocked and couldn't speak for a few moments. I gathered myself- "sure, I will take care of what you said".
I called his parents and requested them to speak to me after making Manu wait outside.
I shared the entire conversation that transpired between Manu and me.
5-10 minute walk after every meal can help in better blood glucose and body weight management.
Ideal time to start walking is about 15-30 minutes after the meal.
One can walk at a leisurely pace to derive the health-related benefits.
Many of you feel upset about hospitals, pharma companies and doctors making money at the cost of treating patients.
It is in your hands if you want to hurt their business.
The top 10 diseases/conditions contributing to hospitals' patient load (not in any order) are:
1. Heart
Happy Woman's Day
β‘οΈShe was born in a village in Nalanda (Bihar) in 1955.
β‘οΈShe discontinued her studies in class 5th. The reason cited by her was she did not want to attend school in a saree, which was the norm in her village once girls attained puberty.
β‘οΈShe assisted her
Those of you who are planning to take up running on a regular basis in 2024, please read on:
I started running in November 2020 (completed >3 years of consistent running). During this period, I have run >14,000 km (including 822 10km runs and 133 half marathons). I run outdoors
Ten lifestyle tips to keep your heart healthy
1. Walk briskly (5 km/hour pace) or run (8 km/hour pace) on 4-5 days a week
2. Do strength training/resistance training/weight lifting on 2-3 days a week
3. Reduce total sitting duration
4. Break sitting every 30 minutes (by 1-2
Many things changed from 2014 to 2024
β Weight reduced from about 100 to 71
β Resting HR reduced from 70-75 to 40-45 bpm
β HbA1C dropped from 6 to 4.9%
β HDL cholesterol increased from 32 to 52
β Triglyceride reduced from 300 to 43
β Wardrobe completely changed
Lifestyle
Young Man in whom a Healthy Habit caused erectile dysfunction
1. 30-year-old Rijo consulted me for 3-month history of problem with erection. He was evaluated by Urologist/Andrologist & no cause for the same was found. Therefore, he was referred to rule out neurological disease.
3. On reviewing history and medical records- Manu had been diagnosed with glioblastoma multiforme grade 4 in left side of brain, due to which he had paralysis of right hand and leg. He had been operated, and was on chemotherapy. Seizures were due to brain cancer.
#MedTwitter
Today's long run was special!
It was the 125th time I ran a distance of 21.1 Km (half marathon) or more (since Jan 2021).
For someone who started running at age 49, last three years have been a "dream run".
Weight reduced from 100 to 71 Kg,
HbA1C dropped from 5.6 to 4.6,
Lipid
Young woman who would lose eyesight in left eye each time she took hot water bath
1. 25-yr old woman consulted me with complaints of losing
#vision
in left eye after hot water bath. This had occurred 8 times in the past one month. Vision would get restored in a few hours on own.
2014-2024: The Decade of Transformation from obese to normal weight (from fat to fit)
2014 (Age 43)
π΄Weighed about 100 Kg
π΄Worked 13-14 hours/day
π΄Slept 4-5 hours/night
π΄Unhealthy eating pattern, including sweets; eating out often, and late dinners
π΄Hardly any exercise;
Intermittent
#fasting
may reduce symptoms of gastro esophageal reflux disease (
#GERD
)
1. GERD causes troublesome symptoms such as
#heartburn
and
#regurgitation
.
In a recent small short-duration study, eating in an 8-hour window, followed by 16-hr fasting improved these symptoms
How to achieve a lower heart rate (HR) while running?
HR increases while running as with any aerobic activity. Workout is more effective when HR increases. How much increase in HR is ideal? How to achieve a lower HR if it exceeds the recommended maximum HR? Sharing my experience
A common habit resulted in severe
#vision
impairment in a young woman
1. 30-year old Manju had severe disabling vision symptoms for one and half years. This included seeing floaters, bright flashes of light, dark zig zag lines and at times inability to see or focus on objects.
Is Walking after Meals Healthy?
Walking is a healthy habit and people prefer to walk in the mornings or evenings, before breakfast or dinner, respectively. There are contradictory opinions regarding potential health-related benefits of walking after meals.
Here, I present some
Cause of coma in a
#woman
surprised us!
1. 65-year old woman was brought in an
#unconscious
state to
#emergency
dept. She sounded normal over phone to her son about 24 hours earlier. She stayed alone, so, further details were not available.
#MedTwitter
#internalmedicine
An elderly man who repeatedly kicked the woman ahead of him while waiting in queue to board a flight
1. 69-year old Balu, while waiting to board a flight, started to repeatedly fling his right leg that hit the woman standing in front. The woman was shocked with this incident.
Why did I choose long-distance running as my regular exercise?
I was obese (wt 100 kg) at age 30, and remained between 95-100 until 43. It was due to overeating, eating junk foods, sweets & soft drinks, coupled with sedentary lifestyle (long OP hours, research work, less sleep).
How to evaluate the status of your health at home?
Dr Sudhir Kumar MD DM
We usually depend on doctorβs assessment and multiple investigations to evaluate the status of our health. This requires a visit to hospital, is time-consuming and incurs costs too. In this post, I will
4. I discussed the medical treatment with parents and answered a few queries. They were about to leave, when Manu requested his parents to allow him to talk to me in private. Parents accepted his request.
#Cancer
#seizure
#Children
How did our ancestors survive by eating so much rice but we can not?
β‘οΈOur ancestors had no access to icecreams, cakes, pastries, pizzas, burgers, noodles, soft drinks, ultraprocessed packaged foods, restaurant foods, street foods and so on.
β‘οΈOur ancestors had no access to
45 min Strength Training + 3km Walk
Wall sit exercise is great for glutes, thigh, calves and lower abdominal muscles. Target for 3 sets of 1-2 minutes
#fitness
#running
#walking
Simple Lifestyle Tips that could potentially change your Life (if you are just starting)
1. Start sleeping for 7 hours,
2. Limit working hours to 8-10 hours per day,
3. Have early dinner- restrict time window for eating (for example, eat between 9 AM to 7 PM),
4. Avoid eating
Doctors in India live 10 years lesser than average population- What can doctors do to save their lives?
1/n
Yes, you heard it right. Studies from Kerala and Pune by Indian Medical Association revealed these shocking statistics- doctors die about a decade earlier that the rest.