Sunday, June 17, 2018


Anuja’s suicide
When I was 10 year old, I remember once, there was a crowd gathered around Anuja’s (name changed) house, who lived about 100 meters away from our house. I too wanted to go there to find out what was happening, but was not allowed by my parents. Later on in the evening, I came to know that she committed suicide by hanging, as she scored only 81% marks in her tenth board examinations, which was well below her parents’ and her expectations. We hear several similar stories from different parts of our country. Depression, stress and anxiety are common before & during examinations. If one does not score high marks, they feel worthless, unfortunately leading to suicide in some cases.
Mental problems among students
I have been increasingly seeing young students with various psychological problems, such as sleep disturbance, anxiety, headaches, poor memory, body pains, decreased energy and depression. Fear of exam or fear of scoring low marks in an exam are the main reasons for these symptoms.
But is scoring high marks so important?
Marks have limited importance:
1. One needs to score “pass” marks in order to get promoted to the next class, which ranges from 35-50% in various classes/schools/colleges. 
2. One needs to score “qualifying” marks in order to become eligible to write competitive exams for UPSC, engineering, medical, etc (which ranges from 50-75% in various exams).
3. Class XII marks are taken into account for admissions into graduate courses of a few good colleges (which can be as high as 99% in some cases).
Drawbacks and demerits of marks:
1. There is no perfect correlation between marks and knowledge. A student with good knowledge may score lesser marks and someone with lesser knowledge may get very high marks. 
2. Examinations, unfortunately, do not assess the practical knowledge, intelligence, judgment and application of a student; they mainly assess the retention, recall and memory abilities. Communication skills, ability to deal with difficult situations, and interpersonal skills, which are so important in real life, are also not assessed by the “marks” system.
3. Marks obtained in 10th and 12th board exams do not have any meaning in the job/occupation one chooses later. For example, no patient of mine has ever asked me my marks from school or college days (however, I would be proud to tell those figures, as I scored high in most of the exams).
So, what should students do?
1. One should study to gain and acquire knowledge. Understanding the concepts is more important than just memorizing them. 
2. Marks do not matter much and obtaining high marks in an exam should not be the sole goal. 
3. Studies would be a pleasure, if it is taken as a means of gaining knowledge, rather than a means to score high marks in an exam. 
4. One should study “round-the-year” and not just before the exams. This would reduce the pressure prior to the exams. 
5. There is no need to feel bad, if one gets” low” marks in an examination. Most of the great men & women in the world were not class toppers in their school or college days.
I would be pleased to have your comments on this article.

Consultant Neurologist
Apollo Hospitals, Hyderabad

Thursday, June 14, 2018


Mr Parvesh (name changed), a 33-year old, was rushed into emergency department last night with sudden onset of chest pain and breathlessness. He was at his office at 11 PM, when he felt uneasy. He lied down on the sofa outside his office to take some rest. His friends found him unconscious and rushed him to the hospital. On arrival in ER, his pulse and BP were un-recordable. ECG showed features of massive heart attack. He was given the best cardio-pulmonary resuscitation, followed by the best medical care. All in vain, he passed away within four hours. 

Mr Parvesh is not alone. In my practice over the past 25 years, I have seen many young people (mostly men) in their 30s and 40s coming to the hospital with features of heart attack and brain stroke. This is unusual, as during my medical school training in early 90s, we were taught that heart attacks and brain strokes affect only older people in their 60s and 70s or even later. Now, about 40% of people suffering from heart attacks and brain strokes are young people (<50 years of age). 

So, what factors are responsible for this “undesirable” change?
1. Expectations to achieve everything as early as possible: Achievement and success are good things, but not at the cost of health. Young people work long hours. In my interaction with people, I have observed that 13-15 hours work schedules are not uncommon. Add to this, 1-2 hours of commute time, where is the time to unwind? Where is the time to relax with family and friends? Our bodies are not machines (even machines break down, when overused). Heart and brain work best, when working hours are 8-9 hours, with good breaks in weekends.
2. Working from home, working on weekends and even during holidays: Breakthroughs in communication (internet, mobile phones, etc) have their advantages; however, there are drawbacks too. People are in “work-mode” 24X7, 7 days a week, and perpetually. There is no time, when a person totally disconnects from work. Constant work or thought of work takes a heavy toll on the body, especially the heart and brain.
3. Lack of sleep: We need at least 7-8 hours of sleep in order to refresh and recharge. However, younger people are not getting more than 4-5 hours of sleep per night. Demanding work schedules, use of gadgets and late night socializing are some of the reasons for lesser sleep duration. Lack of sleep is strongly associated with higher risk of diabetes, high BP and cholesterol; all of whom are risk factors for stroke and heart attacks.
4. High stress levels: I see many young people in my clinic, belonging to various industries such as IT & software, banking & finance, education, etc. More than 90% of them say they are under stress. Stress is related to jobs as well as personal lives. So, if one felt that not getting a job or not getting married are reasons to be under stress, think twice; those with good jobs and good spouses are also equally stressed, if not more. This cannot be real. Jobs and families need to be cared for and modeled to give joy & happiness.
5. Greed for material things beyond one’s means: Peer pressure is very high. One wants to own a good car and a good house in 30s and even in 20s. As the incomes are low, many end up taking huge loans to fund these dreams. People are also spending more than their means on education of children and vacations. Paying EMIs are no fun! Any unexpected expenditure and reduction in income takes a toll on health and stress levels rise. One must live within their means and avoid taking loans to fulfill the “desires”. We need to be satisfied with what we have and avoid competing with “neighbours or friends” in acquiring materialistic things.
6. Unhealthy diet and habits: Fast foods, irregular food habits and "eating out" have become common. We need to remember, home food is the best and healthiest. “Outside” food is high on taste (due to high amount of salt, sugar and oil) but low on nutrition. 
Most people are not exercising. Moreover, they use vehicles for travelling short distances. Walking as a habit is dying. Most people use lifts and staircases are “hidden” (only to be used in case of emergency or fire)! People sit for long duration (at work, while watching TV, etc). Sitting is as dangerous as smoking, if not more. 
Pollution is increasing- both air and water. Their negative impact on health is well known.
7. Poor financial planning: Younger people do not invest wisely. Either the savings are kept idle in the banks (for a meager interest of 3-4%, which is taxable at the highest slab) or they invest most of their savings in real estate (bought at high prices, with no scope of growth in the near future). The best investment asset class is equity. For someone with less time, investing in equity mutual funds via SIP (systematic investment plans) are the best. You can expect a return of 10-12 % per year (with current tax rate of 10% on the profits, if redeemed after one year).
8. Ignoring health checkups: Our body does give warnings. Any abnormal symptom such as headache, dizziness, tiredness, breathing difficulty, chest pain, etc should be seriously taken and a doctor should be consulted. Even if there are no symptoms, preventive health checkups can help in detecting diseases in early stage, which can be treated well.
So, what can younger people do to live longer and healthier?
1. Find a job that you like (which may not be with the biggest pay cheque).
2. Work for reasonable hours (8-9 hours on average).
3. Cut-off from work when out of office, on weekends and while on vacation (except for occasional emergencies.
4. Take regular vacations with family and friends.
5. Sleep well (on an average 7-8 hours per night). Avoid doing regular night shift duties.
6. Exercise- it can be anything you like, such as walking, jogging, cycling, etc. At least 30 minutes per day and 5 days per week.
7. Prefer home food as much as possible.
8. Keep expenses as per your income. Avoid taking loans as much as possible.
9. Start investing early after analyzing your financial needs and goals.
10. Don’t ignore small warnings about health. Consult a doctor and have preventive health checkups.

Dr Sudhir Kumar MD DM
Consultant Neurologist

Tuesday, March 27, 2018



Headache is a common disorder. A large number of people suffer from headaches. Migraine and tension headaches are the commonest causes of headaches. They are not life-threatening, however, they cause significant disability, as pain impairs the quality of life. In some cases, headaches can be caused by serious causes, such as brain tumor, brain hemorrhage, brain fever, etc. 

The current interview focuses on the common causes of headache. How should we diagnose migraine? It can be diagnosed based on symptoms in most cases. When should one consult a doctor for headache? When should one do a brain scan? How do we treat headaches? To get answers to these and other questions, please watch this interview. The link of the youtube video with the interview is:

Feel free to post your comments or ask any queries.

Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist,
Apollo Hospitals, Hyderabad

Monday, March 26, 2018



Epilepsy is a common neurological illness. It can be easily diagnosed and treated. People suffering from epilepsy can lead normal lives after treatment. Despite this, there are lot of misconceptions about this disease. There is a social stigma attached to epilepsy and epileptic patients. 

In this interview (in Hindi language), I have discussed the symptoms, diagnostic techniques and treatment options for people suffering from epilepsy. The link to youtube video is given below:

Please go through this video interview to learn more about epilepsy. Feel free to post your comments and queries.

Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad

Thursday, January 4, 2018

DRINKING WATER FOR A HEALTHY LIVING- All you ever wanted to know


Water forms 60% of our body weight and is essential for life. It should be consumed in adequate amounts for proper functioning of various organs.
Normal water intake
1.     Men: 3.7 liters per day
2.     Women: 2.7 liters per day (Pregnant and breast-feeding women need more water).
20% of this comes from food (fruits, vegetables, beverages, etc) and the remaining should be consumed in the form of plain water.
When do we need more water?
1.     Exercise- Exercise leads to water loss in the form of sweating. So, we should consume water before, during and after exercise. Avoid drinking too much water as it can be harmful; it could dilute the body fluids leading to hyponatremia (low sodium).
2.     In hot climates- Water loss is more via perspiration and sweating, and hence, more water is needed.
3.     During illnesses such as fever, vomiting and diarrhea. All these conditions lead to water loss and this loss needs to be replenished.
When should the water intake be reduced (less than normal intake)?
In some diseases, water intake needs to be reduced (under the supervision of a doctor). These are:
1.     Chronic kidney disease,
2.     Heart failure,
3.     Chronic liver disease,
4.     Hyponatremia (low sodium)- some cases are treated by restricting fluid intake. 
How do we know whether our water intake is normal or not?
If you rarely feel thirsty and if the colour of your urine is light yellow (or colorless), your water intake is probably adequate.
What is the best way of getting our daily water requirement?
·      Plain water is the best (safe, inexpensive, easily available and has zero calories).
·      20% of water can also come from fruits, vegetables, juice, milk, tea/coffee, etc
·      Soft (carbonated drinks), sports drinks, energy drinks and alcohol should not be routinely relied upon to complete the daily quota of water. Sports drinks may be taken if one does rigorous exercise for one hour or more.
Can more water intake help in weight loss?
The answer is yes. This is because many times, thirst is confused with hunger. So, whenever you feel hungry, drink water first. People, who consume more water, end up consuming less salt, less sugar and less saturated fats (this leads to weight loss).
A bottle of water before main meals could aid in weight loss.
Replace soda with water, tea of coffee to fight diabetes
Yes, you heard it right. The habit of having a “soft drink” (carbonated beverage) to quench your thirst can increase your chances of getting diabetes, as it contains high amount of sugar. Replacing soda/soft drinks with water, tea or coffee (without sugar) leads to lesser chance of getting diabetes.
Is drinking water on empty stomach in mornings useful?
Yes, drinking water in morning on empty stomach is helpful. Most of us have not had water for about eight hours prior to getting up, leading to mild dehydration. So, one should consume 2-3 glasses (600-800 ml) of water in mornings. This helps in improving bowel movements & urination (leading to release of toxins). This would also reduce hunger, leading to lesser consumption of carbohydrates and fats (thus promoting weight loss).
Providing water dispensers in schools could also be a cheap method of reducing obesity in children.

Dr Sudhir Kumar MD DM (Neurology)
Consultant Neurologist
Apollo Hospitals, Jubilee Hills, Hyderabad

Monday, November 6, 2017



1. STROKE is a disease that affects:
A. Heart
B. Brain
C. Kidney
D. Lungs
2. Common symptoms of stroke include:
A. severe chest pain
B. Fits or convulsions
C. Paralysis of face, arms, legs, slurred speech
D. Breathing difficulty
3. If someone suffers from stroke at 9 PM,
A. He can go to OPD the next day
B. He should rush to the nearest general physician
C. He should rush to a hospital with 24X7 CT scan and neurologist on call
D. He can try home remedies for the night.
4. Is there a treatment available for patients with stroke, which would minimise disability
A. Yes
B. No
5. Common risk factors for stroke include all the following EXCEPT
A. Diabetes mellitus
B. Hypertension
C. Running on treadmill
D. Smoking
6. Which of the following measures is NOT helpful in preventing a recurrence of stroke in a person who has suffered stroke?
A. Taking Aspirin
B. Controlling BP and sugars,
C. Quitting smoking,
D. Skipping breakfast, if overweight
7. Physiotherapy helps in better and faster recovery of stroke survivors.
A. True
B. False
8. Stroke affects only older people
A. True
B. False
9. Proportion of population that may suffer a stroke in their lifetime
A. 1 in 10
B. 1 in 8
C. 1 in 6
D. 1 in 4
10. Stroke is treated by
A. Neurologist
B. Cardiologist
C. Nephrologist
D. Chest physician
Please go through these questions and answer them. Answers are posted below
Thank you for going through the questions. Here are the answers:
1. B
Stroke affects brain. It most commonly occurs due to blockage of blood supply to a part of the brain. In some cases, it can also occur due to rupture of a blood vessel.
2. C 
Common symptoms of stroke include sudden onset facial weakness, weakness of arm or leg, slurred speech, loss of vision on one side, imbalance while walking or severe headache.
3. C
Stroke is a medical emergency. The brain tissue can suffer irreversible damage, if not treated within the first four hours. Therefore, the patient should be rushed to a hospital with 24X7 CT scan facility. The treatment is administration of clot-buster therapy under the guidance of a neurologist.
4. A
Clot-buster therapy with tissue plasminogen activator or tenecteplase within the first four and a half hours after stroke onset can minimise disability.
5. C
Running on treadmill is a healthy exercise and protects from stroke.
6. C
Skipping breakfast is an unhealthy habit. Moreover, it does not help in reducing weight.
7. A
Physiotherapy is very helpful in faster recovery of stroke survivors. It should be started as early as possible.
8. B
Stroke predominantly affects older people, however, it can affect all ages, including children.
9. C
Stroke is a common cause of death and disability (along with heart attacks and cancer) in the world, and affects i in 6 people in their lifetime.
10. A
Stroke is a disease of brain and is treated by neurologist.
I hope you enjoyed this mini-quiz. I would love to hear your comments or any further queries.

Dr Sudhir Kumar MD DM
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad



Choice of foods is important, when it comes to prevention and treatment of certain neurological disorders. The article on this topic was published in November 2017 issue of B Positive magazine, a health and wellness magazine.

Dr Sudhir Kumar MD DM (Neurology)
Consultant Neurologist
Apollo Hospitals, Hyderabad

Sunday, October 29, 2017


On the occasion of World Stroke Day (29th October), an article published in Times of India newspaper, to raise awareness about the diagnosis, treatment options and prevention of stroke. 

The article can be accessed in Times of India (Hyderabad edition), dated 29th October 2017 (Page 31), at the following link:

Dr Sudhir Kumar MD DM
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad

Tuesday, September 12, 2017



The mind is probably the strongest organ of the body. When the mind believes, anything is achievable, nothing is impossible! It is said, success or failure is more often decided in the mind, than the actual event itself. Thus, in the toughest sports tournaments, the players with stronger mind usually prevail.

Traits of a Strong Mind
A strong mind always looks at the positive aspect of things, because with regard to everything in life, there are both, positive and negative aspects.
·      Winners always focus on the positive aspect. Halfway in a marathon race, a person with a weak mind thinks, “half the distance is still yet to go and I may not be able to complete it well”. On the other hand, a person with a strong mind thinks, “I have finished half the race well, I can easily finish the second half equally well”. Needless to say, the runner with the stronger mind succeeds.
·      A person with a strong mind has a lot of self-belief. “When you do not believe in yourself, how can others believe in you?” So, you need to strongly inculcate the sense of self-belief in yourself at all times. This is considered as s stepping stone towards success.
·      Another feature of a person with strong mind is that he/she is always hopeful. They always hope for and expect a good outcome. Even when the whole world thinks otherwise, a person with strong mind always hopes for success. You would certainly agree to this one- how many times you have seen players winning a match from almost a losing position?! So, it is obvious that unwavering hope and self-belief are important for winning, even from “losing situations”.
·      A person with a strong mind looks at only the good qualities in another person and oversees the bad traits. Every individual has both good and bad qualities. It is always easy to focus on negative qualities of a person and criticize him. It takes a person with strong mind to focus on good qualities of others and appreciate them. This virtue makes them appear more congenial among masses. After all, no one likes a person who is always critical about him or her.
·      The most important quality in a person with strong mind is their ability to control emotions. Emotions and sensitivity are important for good social interactions; however, exaggerated emotional responses may interfere with daily life. A person with a weak mind may suffer from sadness and depression after a failure. On the other hand, a person with strong mind treats failure as a medium to work on flaws and successfully outgrows them. If one remains pre-occupied with negative emotions after a failure, there is no time and energy left to sharpen the skills to excel later. However, the person with a strong mind puts the failure behind and works harder in order to succeed at the next available opportunity.
·      Anger is a negative emotion, which a person with strong mind lacks. Strong-minded people are able to smile at all instances and events and strongly believe in letting bygones be bygones, because they know that anger does not solve a problem; on the contrary, it may aggravate it. Everyone likes a smile and appreciation- who likes getting reprimanded?! There is no wonder, then that people who often smile have a large number of admirers as compared to those who get angry with small issues.

The Making of a Strong Mind
From the above discussion, it is quite evident that a strong mind is vital for a fulfilling and successful life. So, is the “strong mind” inherited from one’s ancestors or can one do something to make the minds stronger? Well, here’s how you can build a strong mind. Just follow these methods:
1.     Regular exercises not only help you making physically fit, but also impacts your memory and thinking skills. There is a release of good chemicals such as endorphins and dopamine post-exercise, which elevate our mood and keeps depression away. So, stay active!
2.     Good nutrition is important to keep the brain strong. Timely balanced meals are the key. So, dig into foods that are good for the brain. These foods include fish, eggs, broccoli, asparagus, spinach, blueberries, dry fruits like almonds and walnuts, etc.
3.     Ensure adequate sleep of seven to eight hours at night, as it relaxes the body and mind. The mind gets re-energized after a restful sleep and is ready to take on the everyday challenges of life.
4.     The brain gets bored and inactive with a monotonous schedule and activities, and the risk of cognitive impairment increases with this schedule. On the other hand, challenging the brain with newer activities, such as learning a new language or playing a musical instrument, would make the brain sharper and stronger. This also boosts the self-confidence in a person.
5.     Avoiding smoking and alcohol as both these vices  have a negative influence on brain and mind functions, making them weaker and prone to mental illnesses.
6.     Socialize whenever you can! Isolation and loneliness are detrimental to brain and mind and make them weaker. On the other hand, greater social interactions, especially spending quality time with family and friends are healthy for brain and makes it stronger.

(This article was first published in the September 2017 issue of B POSITIVE, a health and wellness magazine)

Dr Sudhir Kumar MD DM (Neurology)
Apollo Hospitals, Hyderabad